Tag: nevin manimala

BMC Health Serv Res. 2023 Sep 7;23(1):962. doi: 10.1186/s12913-023-09986-4.

ABSTRACT

INTRODUCTION: Low adherence is a major challenge in healthcare worldwide, being particularly dangerous for patients with chronic diseases, such as cardiovascular diseases and heart failure, where strict adherence is essential. Non-adherence is observed in almost half of patients, and the consequences encompass a lack of therapeutic effects, health deterioration, decreased quality of life, and even death. For cardiovascular patients, the great importance of health education and pharmaceutical education can be provided within pharmaceutical care in community pharmacies. Therefore, our study aimed at evaluating the level of satisfaction with the “Healthy Heart” pharmaceutical service, in which patients received pictograms with dosage information affixed to their medication.

MATERIAL AND METHODS: The study was designed for patients who had been prescribed an antiplatelet medication for the first time. The patients were recruited by 577 pharmacies that took part in the study after completing a special course. Ultimately, 1590 patients were enrolled in the study. The project ran from November 2019 to January 2022.

RESULTS: Most of patients had a positive attitude to the “Healthy Heart” pharmaceutical service. More than 85% of the respondents were of the opinion that the pictograms facilitated the use of the medication, and 81.7% of the respondents stated that the system of labels helped in adherence. Over 66% of the respondents thought that such labels should be included in pharmacy services, and 77.92% of the participants reported that this system of labelling medications should be offered through all pharmacies.

CONCLUSIONS: Pharmaceutical labels in the pharmacists’ everyday practice can largely improve patient adherence. These efforts, provided as part of their pharmaceutical services, can have a huge influence on optimisation of patient health outcomes.

PMID:37679680 | DOI:10.1186/s12913-023-09986-4

BMC Ecol Evol. 2023 Sep 8;23(1):48. doi: 10.1186/s12862-023-02157-3.

ABSTRACT

BACKGROUND: Dipsadine snakes represent one of the most spectacular vertebrate radiations that have occurred in any continental setting, with over 800 species in South and Central America. Their species richness is paralleled by stunning ecological diversity, ranging from arboreal snail-eating and aquatic eel-eating specialists to terrestrial generalists. Despite the ecological importance of this clade, little is known about the extent to which ecological specialization shapes broader patterns of phenotypic diversity within the group. Here, we test how habitat use and diet have influenced morphological diversification in skull shape across 160 dipsadine species using micro-CT and 3-D geometric morphometrics, and we use a phylogenetic comparative approach to test the contributions of habitat use and diet composition to variation in skull shape among species.

RESULTS: We demonstrate that while both habitat use and diet are significant predictors of shape in many regions of the skull, habitat use significantly predicts shape in a greater number of skull regions when compared to diet. We also find that across ecological groupings, fossorial and aquatic behaviors result in the strongest deviations in morphospace for several skull regions. We use simulations to address the robustness of our results and describe statistical anomalies that can arise from the application of phylogenetic generalized least squares to complex shape data.

CONCLUSIONS: Both habitat and dietary ecology are significantly correlated with skull shape in dipsadines; the strongest relationships involved skull shape in snakes with aquatic and fossorial lifestyles. This association between skull morphology and multiple ecological axes is consistent with a classic model of adaptive radiation and suggests that ecological factors were an important component in driving morphological diversification in the dipsadine megaradiation.

PMID:37679675 | DOI:10.1186/s12862-023-02157-3

BMC Anesthesiol. 2023 Sep 7;23(1):302. doi: 10.1186/s12871-023-02262-2.

ABSTRACT

BACKGROUND: Emergence delirium (ED) is generally occurred after anesthesia associated with increased risks of long-term adverse outcomes. Therefore, this study aimed to evaluate the efficacy of preconditioning with nasal splint and mouth-breathing training on prevention of ED after general anesthesia.

METHODS: This randomized controlled trial enrolled 200 adult patients undergoing ESS. Patients were randomized to receive either nasal splinting and mouth breathing training (n = 100) or standard care (n = 100) before surgery. The primary outcome was the occurrence of ED within 30 min of extubation, assessed using the Riker Sedation-Agitation Scale. Logistic regression identified risk factors for ED.

RESULTS: Totally 200 patients were randomized and 182 aged from 18 to 82 years with 59.9% of males were included in the final analysis (90 in C-group and 92 in P-group). ED occurred in 16.3% of the intervention group vs. 35.6% of controls (P = 0.004). Male sex, smoking and function endoscopic sinus surgery (FESS) were independent risk factors for ED.

CONCLUSIONS: Preoperative nasal splinting and mouth breathing training significantly reduced the incidence of emergence delirium in patients undergoing endoscopic sinus surgery.

TRIAL REGISTRATION: ChiCTR1900024925 ( https://www.chictr.org.cn/index.aspx ) registered on 3/8/2019.

PMID:37679665 | DOI:10.1186/s12871-023-02262-2

Bone Marrow Transplant. 2023 Sep 7. doi: 10.1038/s41409-023-02094-1. Online ahead of print.

ABSTRACT

Allogeneic hematopoietic cell transplantation (allo-HCT) is curative for myelofibrosis (MF) but assessing risk-benefit in individual patients is challenging. This complexity is amplified in CALR-mutated MF patients, as they live longer with conventional treatments compared to other molecular subtypes. We analyzed outcomes of 346 CALR-mutated MF patients who underwent allo-HCT in 123 EBMT centers between 2005 and 2019. After a median follow-up of 40 months, the estimated overall survival (OS) rates at 1, 3, and 5 years were 81%, 71%, and 63%, respectively. Patients receiving busulfan-containing regimens achieved a 5-year OS rate of 71%. Non-relapse mortality (NRM) at 1, 3, and 5 years was 16%, 22%, and 26%, respectively, while the incidence of relapse/progression was 11%, 15%, and 17%, respectively. Multivariate analysis showed that older age correlated with worse OS, while primary MF and HLA mismatched transplants had a near-to-significant trend to decreased OS. Comparative analysis between CALR- and JAK2-mutated MF patients adjusting for confounding factors revealed better OS, lower NRM, lower relapse, and improved graft-versus-host disease-free and relapse-free survival (GRFS) in CALR-mutated patients. These findings confirm the improved prognosis associated with CALR mutation in allo-HCT and support molecular profiling in prognostic scoring systems to predict OS after transplantation in MF.

PMID:37679647 | DOI:10.1038/s41409-023-02094-1

Surg Endosc. 2023 Sep 7. doi: 10.1007/s00464-023-10369-3. Online ahead of print.

ABSTRACT

BACKGROUND: This retrospective cohort study aims to investigate emergency department (ED) visits and readmission after bariatric surgery among patients with a history of anxiety and/or depression. We predict that patients with a reported history of anxiety and/or depression will have more ED visits in the year following surgery than patients without a history of mental illness.

METHODS: Data were collected from the charts of all consecutive patients who underwent sleeve gastrectomy or gastric bypass surgery between March 2012 and December 2019. Data on baseline body mass index, mental health diagnosis and treatment and emergency department visits and hospital readmissions were retrospectively reviewed over the first year following surgery.

RESULTS: One thousand two hundred ninety-seven patients were originally included in this study and 1113 patients were included in the final analysis. Patients with a history of depression (OR 1.23; 95% CI 0.87-1.73), anxiety (OR 1.14; 95% CI 0.81-1.60), or both (OR 1.17; 95% CI 0.83-1.65) did not have a statistically significant increase in ED visits compared to patients without these disorders. Patients with a history of depression (OR 1.49; 95% CI 0.86-2.61), anxiety (OR 1.45; 95% CI 0.80-2.65) or both (OR 1.47; 95% CI 0.94-2.29) did not have a statistically significant increase in hospital readmissions in the first year after surgery compared to patients without these disorders. Patients treated with a sleeve gastrectomy were readmitted due to postoperative complications less frequently than those treated with other surgeries (OR 0.20; 95% CI 0.05-0.83).

CONCLUSION: Patients with a history of anxiety, depression or both did not have an increased rate of emergency department visits and hospital readmissions within the first year following bariatric surgery. This contradicts current literature and may be due to the multidisciplinary program patients undergo at this study’s home institution.

PMID:37679583 | DOI:10.1007/s00464-023-10369-3

Bull Math Biol. 2023 Sep 7;85(10):97. doi: 10.1007/s11538-023-01202-y.

ABSTRACT

Several safe and effective vaccines are available to prevent individuals from experiencing severe illness or death as a result of COVID-19. Widespread vaccination is widely regarded as a critical tool in the fight against the disease. However, some individuals may choose not to vaccinate due to vaccine hesitancy or other medical conditions. In some sectors, regular compulsory testing is required for such unvaccinated individuals. Interestingly, different sectors require testing at various frequencies, such as weekly or biweekly. As a result, it is essential to determine the optimal testing frequency and identify underlying factors. This study proposes a population-based model that can accommodate different personal decision choices, such as getting vaccinated or undergoing regular tests, as well as vaccine efficacies and uncertainties in epidemic transmission. The model, formulated as impulsive differential equations, uses time instants to represent the reporting date for the test result of an unvaccinated individual. By employing well-accepted indices to measure transmission risk, including the basic reproduction number, the peak time, the final size, and the number of severe infections, the study shows that an optimal testing frequency is highly sensitive to parameters involved in the transmission process, such as vaccine efficacy, disease transmission rate, test accuracy, and existing vaccination coverage. The testing frequency should be appropriately designed with the consideration of all these factors, as well as the control objectives measured by epidemiological quantities of great concern.

PMID:37679577 | DOI:10.1007/s11538-023-01202-y

Arch Gerontol Geriatr. 2023 Aug 31;117:105174. doi: 10.1016/j.archger.2023.105174. Online ahead of print.

ABSTRACT

BACKGROUND & PURPOSE: Pre-stroke impairment of activities of daily living (ADL) is considered a major determinant for functional outcome after stroke. However, findings are based on studies in stroke patients in which pre-stroke information is gathered retrospectively, with inherent risks of selection and recall bias. The objective of this study was to verify the predictive value of pre-stroke ADL with respect to ADL decline in a large prospective cohort of community dwelling older subjects with known vascular risk factors or vascular disease, thereby minimizing selection and recall bias.

METHODS: Within the four-year study follow-up of a cohort including 5,804 community dwelling older subjects from three countries at risk for vascular disease, incident stroke survivors were identified. Incident myocardial infarction (MI) survivors and the remaining study survivors without incident vascular events served as comparison groups. Multivariate logistic regression analyses for each of the aforementioned groups were performed to assess associations between pre-stroke ADL by the Barthel Index (BI) and Instrumental Activities of Daily Living (IADL) scale and risk for ADL decline.

RESULTS: In stroke survivors, neither pre-event BI (n = 230, OR 1.00 (95% CI 0.83-1.23)) nor IADL (OR 1.07 (95% CI 0.94 – 1.20)) predicted risk of post-stroke ADL decline in contrast to ADL decline after MI (n = 443, OR 0.83 (95% CI 0.70-0.98) and 0.87 (95% CI 0.78-0.97) respectively) and the group without vascular events (n = 4336, OR 0.85 (95% CI 0.78-0.92) and 0.87 (95% CI 0.83-0.92) respectively).

CONCLUSIONS: In the present prospective cohort of community dwelling older subjects with known vascular risk factors, pre-stroke ADL measured by BI and IADL scale did not predict post-stroke ADL decline.

PMID:37677863 | DOI:10.1016/j.archger.2023.105174

Clin J Oncol Nurs. 2023 Mar 16;27(2):147-153. doi: 10.1188/23.CJON.147-153.

ABSTRACT

BACKGROUND: Limited English proficiency (LEP) is a limited ability to read, write, speak, and understand English. About 145,000 individuals with LEP will be diagnosed with a new cancer annually, and English remains the dominant language spoken in the U.S. medical system.

OBJECTIVES: The goal of this article is to discuss the issues faced by patients with LEP and cancer who are unable to communicate effectively with oncology providers.

METHODS: This overview used published U.S. government statistics, information from consensus and policy organizations, and clinical studies published between 2017 and 2022.

FINDINGS: Federal laws prohibit discrimination based on immigration status. People with LEP experience delayed cancer diagnoses and often receive inadequate treatment. Patients with LEP often have limited understanding of the medical system and do not receive language-concordant information about their cancer and treatment options.

PMID:37677828 | DOI:10.1188/23.CJON.147-153

Oncol Nurs Forum. 2022 Dec 16;50(1):115-127. doi: 10.1188/23.ONF.115-127.

ABSTRACT

OBJECTIVES: To examine colorectal cancer survivors’ positive psychology and symptom characteristics, and to assess for potential impact of prior trauma on these relationships during acute cancer survivorship.

SAMPLE & SETTING: A cross-sectional study of 117 colorectal cancer survivors was conducted at a National Cancer Institute-designated cancer center.

METHODS & VARIABLES: Participants completed a demographic questionnaire, and the Carver Benefit Finding Scale and Posttraumatic Growth Inventory assessed positive psychology. Descriptive statistics and multiple linear regression analyses were performed.

RESULTS: 49 symptoms were reported and varied based on prior trauma. Significance was found between positive psychology and symptom frequency (p < 0.001); symptoms reported almost daily and daily were inversely related to positive psychology.

IMPLICATIONS FOR NURSING: Nurses should prioritize symptoms; less frequent symptoms improve positive psychology. Early identification of positive changes may promote survivors’ self-awareness and management skills to mitigate adverse symptoms.

PMID:37677795 | DOI:10.1188/23.ONF.115-127

Clin J Oncol Nurs. 2023 Jul 20;27(4):411-417. doi: 10.1188/23.CJON.411-417.

ABSTRACT

BACKGROUND: Older women diagnosed with breast cancer are at risk for malnutrition.

OBJECTIVES: This article aims to evaluate the relationships among cancer stage, pain, functional status, depression, and malnutrition, and to determine whether these symptoms predict nutritional status.

METHODS: This cross-sectional study included women (N = 72) aged 70 years or older diagnosed with breast cancer at an academic medical center in the midwestern United States. The Timed Up and Go Test, Activities of Daily Living Scale, Numeric Pain Rating Scale, Geriatric Depression Scale, and Mini Nutritional Assessment were used. Demographic characteristics were evaluated using descriptive statistics. Bivariate and point-biserial correlations and linear regressions were used.

FINDINGS: Participants’ Mini Nutritional Assessment scores were significantly related to cancer stage, pain, depression, and Activities of Daily Living Scale scores.

PMID:37677771 | DOI:10.1188/23.CJON.411-417