Tag: nevin manimala

Geriatr Nurs. 2024 Nov 16;61:140-148. doi: 10.1016/j.gerinurse.2024.10.066. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to determine the effect of life story work on psychological well-being among the elderly.

MATERIALS & METHODS: This is a parallel, randomized, single-blind clinical trial conducted using a pretest-posttest design. A total of 60 elderly individuals were randomly recruited and assigned to two groups of Care As Usual (CAU) or Life Story Work (LSW). The LSW group received the life review therapy program based on Erikson’s theory over six 60-minute sessions. Data were collected using a demographic questionnaire and Ryff’s Psychological Well-Being Scale (PWBS). Data were analyzed using SPSS Statistics for Windows, version 16.0.

RESULTS: Life story work was shown to be effective in improving the elderly’s psychological well-being immediately and two months after the intervention in the LSW group (p < .001).

CONCLUSION: Life story work can be applied as a supportive and effective treatment method to promote psychological well-being among the elderly.

PMID:39550787 | DOI:10.1016/j.gerinurse.2024.10.066

J Neurol Sci. 2024 Nov 13;467:123305. doi: 10.1016/j.jns.2024.123305. Online ahead of print.

ABSTRACT

BACKGROUND: Creutzfeldt-Jakob disease (CJD) is a rapidly progressive neurodegenerative disorder characterized by neuronal damage. Emerging biomarkers, such as serum neurofilament light chain (sNfL), glial fibrillary acidic protein (sGFAP), and growth differentiation factor-15 (sGDF-15), are currently being studied for their potential use in this disease.

OBJECTIVES: This study analyzes the levels of sNfL, sGFAP, and sGDF-15, as well as their relationships, in patients with CJD compared to healthy controls (HC).

METHODS: A total of 19 CJD patients and 81 age- and sex-matched HCs were enrolled. Serum levels of sNfL and sGFAP were measured using ultrasensitive immunoassays, while sGDF-15 levels were assessed via ELISA. Statistical analyses included correlation analysis and analysis of covariance (ANCOVA) models.

RESULTS: CJD patients showed significantly higher serum levels of sNfL and sGFAP compared to HCs (p <0,001). sNfL levels were positively correlated with both sGFAP (Rho = 0,70; p < 0,001) and sGDF-15 (Rho = 0,60; p = 0,004). Interestingly, sGFAP levels were higher in female CJD patients compared to males (p = 0,001), while no significant difference in sNfL levels was observed between sexes.

CONCLUSIONS: In conclusion, this study explores the potential of sNfL, sGDF-15, and sGFAP as biomarkers in CJD patients. The higher levels of sNfL and sGFAP in CJD patients compared to healthy controls, along with the observed sex differences in sGFAP, highlight the need for further research into the interaction between astroglia and neurons in CJD, with a focus on sex as a key variable.

PMID:39550786 | DOI:10.1016/j.jns.2024.123305

Semin Arthritis Rheum. 2024 Oct 26;70:152559. doi: 10.1016/j.semarthrit.2024.152559. Online ahead of print.

ABSTRACT

OBJECTIVES: Patients with rheumatoid arthritis (RA) are more likely to develop work disability than the general population. We investigated whether individuals younger than 65 years of age who had both RA and new-onset work disability were at higher risk of CVD compared to similarly aged individuals with RA who did not develop disability. We identified the factors that best explained the excess risk.

METHODS: This was a retrospective cohort study using data from the CorEvitas RA registry. Patients younger than 65 with RA were included. Exposure was new-onset work disability, and comparator was consistently working individuals. Cohorts were age- and sex-matched. Demographics, medications, and disease specific factors were collected for all patients. Incidence rates (IR) for cardiovascular events were calculated using Poisson regression and explanatory multivariable models were built using Cox proportional hazard ratios (HR) to determine the factors that explained the excess CVD risk.

RESULTS: Age and sex-adjusted IR was 5.40 per 1,000 person-years in the new-onset work disability group compared to 2.17 per 1,000 person-years in the working group. Work disability associated with CVD with HR = 2.32 (95 % CI 1.52, 3.53) in the age- and sex-adjusted model. Multivariate models accounting for functional status, education, medications, and traditional CVD risk factors could not fully explain the excess risk for CVD in newly work disabled patients with RA: HR = 1.78 (1.09, 2.91).

CONCLUSIONS: Patients younger than 65 with RA and new-onset work disability are at significantly increased risk for incident CVD compared to working peers. The excess CVD risk remained unexplained after accounting for multiple variables, possibly due to variables we cannot fully account for, such as social determinants of health and allostatic load.

PMID:39550775 | DOI:10.1016/j.semarthrit.2024.152559

Med J Aust. 2024 Nov 18;221(10):546-553. doi: 10.5694/mja2.52511.

ABSTRACT

OBJECTIVE: To evaluate the management in Victorian general practice of people who have been hospitalised with stroke or transient ischaemic attacks (TIA).

STUDY DESIGN: Retrospective observational study; analysis of linked Australian Stroke Clinical Registry (AuSCR) and general practice data.

SETTING: 383 general practices in the Eastern Melbourne, South Eastern Melbourne, and Gippsland primary health networks (Victoria), 1 January 2014 – 31 December 2018.

PARTICIPANTS: Adults who had been hospitalised with acute stroke or TIA and had at least two encounters with the same general practice during the observation period (7-18 months after the acute event).

MAIN OUTCOME MEASURES: Assessment of cardiometabolic risk factors (blood pressure, serum lipids, blood glucose, urinary protein); prescribing of guideline-recommended prevention medications (blood pressure-, lipid-, or glucose-lowering, antithrombotic agents); attainment of guideline targets for cardiometabolic risk factors at final assessment during observation period.

RESULTS: During 2014-2018, 3376 eligible AuSCR registrants (1465 women, 43.4%) had at least two encounters with one of the 383 general practices during the observation period; median age at stroke onset was 73.9 (interquartile range, 64.4-81.9) years, 737 events were TIAs (21.8%). Blood pressure was assessed in 2718 patients (80.5%), serum lipids in 1830 (54.2%), blood glucose in 1708 (50.6%). Prevention medications were prescribed for 2949 patients (87.4%), including lipid-lowering (2427, 71.9%) and blood pressure-lowering agents (2363, 70.0%). Blood glucose targets had been achieved by 1346 of 1708 patients assessed for this risk factor (78.8%), blood pressure targets by 1935 of 2717 (71.2%), and serum lipid targets by 765 of 1830 (41.8%). The incidence of having risk factors assessed was lower among patients aged 60 years or younger (incidence rate ratio [IRR], 0.97; 95% confidence interval [CI], 0.92-1.03) and those over 80 years of age (IRR, 0.92; 95% CI 0.88-0.97) than for those aged 61-80 years, and for women (IRR, 0.91; 95% CI, 0.87-0.95) and people with dementia (IRR, 0.89; 95% CI, 0.81-0.98). The likelihood of having classes of prevention medication prescribed was lower for patients aged 60 years or younger (IRR, 0.92; 95% CI, 0.88-0.97) and those over 80 years of age (IRR, 0.96; 95% CI, 0.92-0.997) than for patients aged 61-80 years, and for women (IRR, 0.95; 95% CI, 0.91-0.98) and people with dementia (IRR, 0.88; 95% CI, 0.78-0.98).

CONCLUSIONS: The general practice management of people who have been hospitalised with stroke or TIA could be improved. Effective monitoring of cardiometabolic risk factors will enable general practitioners to optimise care for people who need careful attention to prevent adverse secondary events.

PMID:39550757 | DOI:10.5694/mja2.52511

Lifetime Data Anal. 2024 Nov 17. doi: 10.1007/s10985-024-09641-y. Online ahead of print.

ABSTRACT

Interval sampling is widely used for collection of disease registry data, which typically report incident cases during a certain time period. Such sampling scheme induces doubly truncated data if the failure time can be observed exactly and doubly truncated and interval censored (DTIC) data if the failure time is known only to lie within an interval. In this article, we consider nonparametric estimation of the cumulative incidence functions (CIF) using doubly-truncated and interval-censored competing risks (DTIC-C) data obtained from interval sampling scheme. Using the approach of Shen (Stat Methods Med Res 31:1157-1170, 2022b), we first obtain the nonparametric maximum likelihood estimator (NPMLE) of the distribution function of failure time ignoring failure types. Using the NPMLE, we proposed nonparametric estimators of the CIF with DTIC-C data and establish consistency of the proposed estimators. Simulation studies show that the proposed estimator performs well for finite sample size.

PMID:39550754 | DOI:10.1007/s10985-024-09641-y

J Clin Exp Neuropsychol. 2024 Nov 17:1-10. doi: 10.1080/13803395.2024.2426826. Online ahead of print.

ABSTRACT

OBJECTIVE: Social cognition is essential for individuals to perceive, process, and interpret social information that enables them to function effectively in society. Korsakoff’s syndrome (KS) and alcohol-related dementia (ARD) are alcohol-related cognitive disorders that are likely to impair social cognition. This study aimed to investigate the ability to judge social norms in KS and ARD in comparison to healthy subjects.

METHOD: The study included 30 patients with KS, 10 patients with ARD, and 74 age-, sex-, and education-matched control participants. The Social Norms Questionnaire – Dutch version (SNQ-NL) was used to measure social cognition, and standardized tests were used to examine the association between social cognition and executive functioning.

RESULTS: Both KS and ARD patients performed worse in judging social norms when compared to healthy controls, but there was no significant difference between KS and ARD. Both KS and ARD patients performed worse on the SNQ-NL, judging appropriate behavior as inappropriate (Overadhere errors), than controls. When compared to control participants, patients with KS demonstrated significantly more Break Errors, while the differences between the ARD group and the control group did not reach statistical significance. There were no significant correlations between the SNQ-NL variables and performances on standardized tests for executive functioning in both the KS and control group.

CONCLUSIONS: This study aimed to investigate the ability to judge social norms in KS and ARD in comparison to healthy subjects. The results show that compared to a control group, both KS and ARD patients performed worse in judging social norms. KS and ARD patients scored equally low on social norms identification. Overall, these findings can further help us understand the difficulties in social behavior as experienced by patients and care staff, since problems in accurately judging social norms could possibly contribute to the severe behavioral issues as observed in alcohol-related disorders.

PMID:39550715 | DOI:10.1080/13803395.2024.2426826

Recenti Prog Med. 2024 Nov;115(11):566-567. doi: 10.1701/4365.43605.

ABSTRACT

OBJECTIVES: To assess the safety profile of dietary supplements with a focus on those purchased online or reported via the internet.

RESULTS: Among the 2,367 reports of Adverse Reactions (ARs) to dietary supplements collected within the Italian Phitovigilance System, 49.4% were from citizens and 33.7% from companies. From these we selected 129 reports (6%) in which an online purchase or an adverse reaction retrieved from the web was indicated (e.g. Amazon®). The most frequent ARs referred to the gastrointestinal tract (31.4%) and the central nervous system (17.6%). Nineteen percent were used for sleep disorders and 14% for disturbances of the prostate.

CONCLUSIONS: The Italian Phytovigilance System is the only tool that provides information on the possible risks associated with the use of food supplements purchased online but the quality of the information collected needs to be improved.

PMID:39550666 | DOI:10.1701/4365.43605

Recenti Prog Med. 2024 Nov;115(11):556-557. doi: 10.1701/4365.43600.

ABSTRACT

This study evaluated the use of ChatGPT among current and former medical students enrolled at Italian universities. The primary goal was to assess its usage and applications in education. Secondary objectives included gathering opinions and satisfaction levels with ChatGPT for educational purposes. The survey included 208 participants, mainly Italian (95%) and aged 18-23 (76%). Most students were from public universities (62%). Nearly all respondents (99%) knew ChatGPT, and 79% used it for study support. Additionally, 81% consider AI suitable for educational purposes, and 39% positively changed their opinion after using it. While 78% found ChatGPT helpful, limitations like confusion (25%) and accuracy concerns (18%) were noted. Still, 85% found responses accurate, and 89% planned to keep using it, with 81% recommending it to peers. Our findings show ChatGPT is widely used by Italian medical students, despite concerns about accuracy and over-reliance. As we witness the rapid advent and evolution of these tools, it is crucial to consider their attentive and deliberate integration into various aspects of our lives.

PMID:39550661 | DOI:10.1701/4365.43600

Recenti Prog Med. 2024 Nov;115(11):550-551. doi: 10.1701/4365.43597.

ABSTRACT

This analysis aims to describe the care pathways of patients with central nervous system (Cns) tumors during the last 30 days of life, using relevant indicators retrieved from regional healthcare information system data, compare these indicators with those of patients who died from other solid tumors, and assess the role of socioeconomic position (Sep) in accessing end-of-life care among Cns patients. The study included 2,795 patients who died from Cns tumors between 2015 and 2019. In the last 30 days of life, compared to the solid tumor cohort, Cns patients had less access to emergency services and hospitalizations. Regarding treatments, the percentage of opioid users was significantly lower than that of solid tumor patients. Concerning the role of Sep, Cns patients with a higher Sep were less likely to access the Emergency Room and more likely to receive antitumor. In conclusion, the analysis of administrative databases in epidemiology is essential in order to monitor care pathways targeted at highly vulnerable populations.

PMID:39550658 | DOI:10.1701/4365.43597

Recenti Prog Med. 2024 Nov;115(11):547-549. doi: 10.1701/4365.43596.

ABSTRACT

For many new oncological drugs, including target therapy and immunotherapy, the treatment should be continued as long as the patient is deriving clinical benefit from therapy or until unacceptable toxicity occurs. Drug survival or Time to treatment discontinuation (Ttd) or persistence have become important intermediate efficacy endpoints, especially in real-world settings due to their strong correlation with endpoints such as Time to treatment failure (Ttf) and Progression free survival (Pfs). Our methodology is based on validated indicators and information technology tools, to develop continuous and updated oncology drug utilization reports in hospital setting which include data about enrolment curves, Ttd, adherence, dose intensity, dose changes and budget impact. We present, as real-world example, the case of anti-EGFR in first line NSCLC. We analysed data of first and second generation drugs (afatinib, gefitinib, erlotinib) and the new third generation drug (osimertinib). Median Ttd and adherence as Proportion of days covered (Pdc) were respectively 11.6 versus 23.4 months and 0.92 versus 0.95.

PMID:39550657 | DOI:10.1701/4365.43596