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Nevin Manimala Statistics

Therapeutic communication skills level among students undertaking the pediatric nursing course and the associated influencing factors

J Pediatr Nurs. 2023 Aug 19;73:34-43. doi: 10.1016/j.pedn.2023.08.015. Online ahead of print.

ABSTRACT

AIM: The present study to determine the level of therapeutic communication skills among the students undertaking the pediatric nursing course and explore the associated influencing factors.

METHODS: This descriptive cross-sectional study was conducted with 140 nursing students who took the pediatric nursing course. Data were collected using a Nursing Student Information Form and the Therapeutic Communication Skills Scale for Nursing Students. The mean and percentage calculations, t-test, ANOVA test, and regression analysis were conducted to analyze the correlations between the participants’ descriptive characteristics and their mean scores on the scales.

RESULTS: The participants’ mean scores obtained on the total Therapeutic Communication Skills Scale for Nursing Students and all of its subdimensions were observed to have a statistically significant correlation with variables such as gender, grade point average, willingness to select the nursing department, satisfaction with the nursing department, difficulty in establishing communication, perceived ability to establish social relations, difficulty in communicating with a child, perception of childhood life, experience with child care, fondness for children, interest in playing therapeutic games with children, and perceived ability to communicate with children. In Model 1, certain descriptive characteristics (satisfaction with the nursing department, difficulty in communicating with a child, experience with child care, interest in playing therapeutic games with children, and perceived ability to communicate with children) explained 52.4% of the therapeutic communication skills scores of the pediatric nursing students and were statistically significantly.

CONCLUSIONS: In this study, it was determined that some of the descriptive characteristics of the students who took the pediatric nursing course had a significant effect on their therapeutic communication skills.

IMPLICATIONS FOR PRACTICE: In order to develop the therapeutic communication skills of students undertaking a pediatric nursing course, it is necessary to support these students with a standard curriculum that includes student-centered, innovative, and interactive educational methods, such as role play, case analysis, and video-based learning. It is also recommended to conduct comparative studies on different educational approaches for nursing students undertaking pediatric nursing courses or meta-analyses to evaluate the effectiveness of such approaches.

PMID:37603925 | DOI:10.1016/j.pedn.2023.08.015

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Multimodality treatment of primary cardiac angiosarcoma: A systematic literature review

Cancer Treat Rev. 2023 Aug 16;120:102617. doi: 10.1016/j.ctrv.2023.102617. Online ahead of print.

ABSTRACT

BACKGROUND: Primary cardiac angiosarcoma (PCA) is the most prevalent histological type of cardiac sarcoma but its rarity poses a challenge for standardizing treatment protocols. Moreover, published studies are limited by small patient numbers and lack of randomization, making it challenging to establish evidence-based treatment strategies. This systematic review aims to consolidate the heterogeneous published data and identify factors related to the treatment outcome of PCA patients.

METHODS: The PubMed and Scopus bibliographic databases were systematically searched for original articles reporting clinical, treatment and outcome data for PCA patients. Kaplan-Meier analysis was used to calculate the time to progression and survival. The Log-Rank test was used to compare progression-free and overall survival data. The Cox proportional hazards regression model was used for univariate and multivariate analysis of survival data.

RESULTS: A total of 127 studies containing data for 162 patients were analyzed. The median age of the patient cohort was 45 years, with males being 1.5 times more frequently affected than females. Tumors were primarily located on the right side of the heart, with a median size of 6 cm. Median progression-free and overall survival of 5 months and 12 months, respectively, were calculated. Age, sex, and resection margins did not have a significant impact on PCA survival, as determined by both univariate and multivariate analyses. The presence of metastases at diagnosis was associated with lower overall survival in univariate analysis, although this effect was not significant in multivariate analysis. Multimodality treatment that incorporated surgery and adjuvant chemo-radiotherapy was associated with a statistically significant survival benefit. Median overall survival increased from 6 months with surgery alone to 13 months and 27 months with adjuvant chemotherapy and chemo-radiotherapy, respectively.

CONCLUSION: Multimodality treatment including surgery and chemo-radiotherapy was found to offer the greatest survival benefit for PCA patients.

PMID:37603906 | DOI:10.1016/j.ctrv.2023.102617

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Effectiveness of Training: Airway Management of Tracheostomized Pediatric Patients by Pediatric Residents and Anesthesiology Residents

J Craniofac Surg. 2023 Aug 21. doi: 10.1097/SCS.0000000000009628. Online ahead of print.

ABSTRACT

To evaluate the effect of training on increasing baseline knowledge of pediatrics and anesthesia residents about airway management of pediatric patients with tracheostomy. It is a prospective, descriptive, before and after survey study. A questionnaire was conducted to measure the baseline knowledge of pediatrics and anesthesia residents about airway management in patients with pediatric tracheotomy. The same questionnaire was repeated after the education. Of the 63 participants, 42 were pediatric residents and 21 were anesthesiology residents. While the number of participants who answered the cuff part, inner cannula part, obturator part and balloon part of the tracheostomy tube correctly before the training was 27, 4, 10, and 12, respectively, these numbers increased to 53, 52, 57, and 55 after the training. There was a statistically significant improvement after the training in the correct response of the cuff, inner cannula, obturator, and balloon sections. A statistically significant improvement was observed in the answers received after the training for all 7 questions regarding the clinical scenario of accidental decannulation and tracheostomy bleeding compared to the pre-training. There was a statistical improvement in part where the participants rated themselves. In conclusion, training increases the ability of healthcare professionals to cope with life-threatening complications related to pediatric tracheotomy. A standardized education program on pediatric tracheostomy should be included in the routine programs of associated departments such as emergency medicine, anesthesia, and pediatrics residencies.

PMID:37603891 | DOI:10.1097/SCS.0000000000009628

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Radiomics analysis of pericoronary adipose tissue based on plain CT for preliminary screening of coronary artery disease in patients with type 2 diabetes mellitus

Acta Radiol. 2023 Aug 21:2841851231189998. doi: 10.1177/02841851231189998. Online ahead of print.

ABSTRACT

BACKGROUND: Type 2 diabetes mellitus (T2DM) is associated with a markedly increased prevalence of coronary artery disease (CAD). Radiomics features of pericoronary adipose tissue (PCAT) were correlated with inflammation, which may have potential value in the prediction of CAD.

PURPOSE: To determine whether radiomics analysis of PCAT captured by plain computed tomography (CT) could predict obstructive CAD in patients with T2DM.

MATERIAL AND METHODS: The study included 155 patients with T2DM with suspected CAD between January 2020 and December 2021. Volumes of right coronary artery of 10-50 mm were delineated in the plain CT to extract radiomics features and PCAT CT attenuation (PCATa). Least absolute shrinkage and selection operator was used to select the useful radiomics features to calculate the radiomics score (Rad-score). Univariate and multivariable logistic regression were applied to select independent predictors. The predictive performance was evaluated by the area under the receiver operating characteristics curve (AUC).

RESULTS: Rad-score (per 0.1 increments: odds ratio [OR] = 1.297; P < 0.001), coronary artery calcium score (CACS) (OR = 1.003; P = 0.037), and sex (OR = 3.245; P = 0.026) were identified as independent predictors for obstructive CAD. Rad-score (AUC = 0.835) outperformed CACS (AUC = 0.780), sex (AUC = 0.665), and PCATa (AUC = 0.550) in predicting obstructive CAD (P = 0.017 and 0.003 for Rad-score vs. sex and PCATa, respectively); however, the improvement between Rad-score and CACS had no statistical significance (P = 0.490).

CONCLUSION: Plain CT-derived Rad-score may be used as a preliminary screening tool for obstructive CAD in patients with T2DM.

PMID:37603886 | DOI:10.1177/02841851231189998

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Retrospective Study of Long-term Surgical Outcomes in Patients Who had a Vaginal Hysterectomy in Conjunction with Pelvic Organ Prolapse Surgery

S D Med. 2023 May;76(5):198-207.

ABSTRACT

INTRODUCTION: Data on long-term outcomes and subjective patient symptom improvement following primary native tissue pelvic organ prolapse repair is limited. Our primary aim was to evaluate the long-term prolapse recurrence and retreatment rates of women who have undergone native tissue prolapse repair. Our secondary aim was to evaluate subjective patient improvement in pelvic floor symptoms and quality of life 7 to 10 years after surgery.

METHODS: This retrospective cohort study included patients who had undergone primary prolapse repair surgery including a hysterectomy and native tissue repair by a single surgeon at a tertiary pelvic floor center from 2009 to 2013. The Pelvic Floor Distress Inventory was distributed to subjects before and 7 to 10 years after surgery and preand post-operative survey results were compared. Subjects were asked if they had symptom recurrence and if they required retreatment.

RESULTS: One hundred twelve of the 204 distributed surveys were returned, yielding a 54.9% response rate. 8.6% of subjects reported prolapse symptom recurrence. 1.9% of subjects were retreated with a pessary. No subjects required additional prolapse repair surgery. 77.1% of subjects had improved PFDI-20 scores following surgery with an average improvement of 46.21 points. Statistically significant score improvements were also observed on PFDI-20 subsections.

CONCLUSIONS: Primary pelvic organ prolapse repair utilizing native tissue results in low recurrence and retreatment rates. Patients can expect long-term clinical improvement in pelvic floor disorders and quality of life following prolapse surgery. Definitions of surgical success should be based on subjective patient symptoms and quality of life measures.

PMID:37603869

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Changes in attitudes toward alcohol control policies in Lithuania. Findings from two representative surveys in 2015 and 2020

Am J Drug Alcohol Abuse. 2023 Aug 21:1-11. doi: 10.1080/00952990.2023.2238322. Online ahead of print.

ABSTRACT

Background: A set of evidence-based alcohol control policy measures was adopted in the period 2016-2020 in Lithuania. The present study fills a knowledge gap on how changes in alcohol control policy are associated with attitudes toward different alcohol policy measures.Objective: This study aims to explore whether support for key alcohol control policy measures in Lithuania declined following implementation of alcohol control measures.Methods: Data came from the Standard European Alcohol Survey. Two representative surveys with the same questionnaire, were conducted in Lithuania in 2015 (N = 1513, 51.7% female, response rate was 38.9%) and 2020 (N = 1015, 50.6% female, response rate was 38.0%). Multi-stage stratified probability sampling was applied. Surveys were carried out using computer-assisted face-to-face interviews, descriptive statistics and multiple logistic regression analyses was applied. We used a binomial logistic regression analysis and the Pearson chi-square test.Results: There was a significant decline in a proportion of respondents who agreed that the number of alcohol selling places should be kept low (OR: 0.84, p = .032), alcohol prices should be kept high (OR: 0.83, p = .027), and the police should be allowed to randomly check whether the driver is sober (OR: 0.65, p < .001). The proportion of respondents who agree that individuals are responsible enough with their drinking significantly declined (OR: 0.76, p = .003).Conclusion: Support for restrictions on alcohol-selling points, increase in alcohol price, and random alcohol testing of drivers declined following the adoption of new alcohol control policy measures. Our findings might be beneficial for policy-makers planning alcohol control policies and information campaigns.

PMID:37603857 | DOI:10.1080/00952990.2023.2238322

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Reply to G. Wang et al

J Clin Oncol. 2023 Aug 21:JCO2301420. doi: 10.1200/JCO.23.01420. Online ahead of print.

NO ABSTRACT

PMID:37603826 | DOI:10.1200/JCO.23.01420

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Association of Prolactin, Oxytocin and Homocysteine with the clinical and cognitive features of a First Episode of Psychosis over a 1-year follow-up

Int J Neuropsychopharmacol. 2023 Aug 21:pyad051. doi: 10.1093/ijnp/pyad051. Online ahead of print.

ABSTRACT

BACKGROUND: The clinical debut of schizophrenia is frequently a first episode of psychosis (FEP). As such, there is considerable interest in identifying associations between biological markers and clinical or cognitive characteristics that help predict the progression and outcome of FEP patients. Previous studies showed that high prolactin, low oxytocin and high homocysteine are factors associated with FEP 6 months after diagnosis, at which point plasma levels were correlated with some clinical and cognitive characteristics.

METHODS: We re-examined 75 patients 12 months after diagnosis to measure the evolution of these molecules and to assess their association with clinical features.

RESULTS: At follow-up, FEP patients had lower prolactin levels than at baseline, and patients treated with risperidone or paliperidone had higher prolactin levels than patients who received other antipsychotic agents. By contrast, no changes in oxytocin and homocysteine plasma levels were observed between the baseline and follow-up. In terms of clinical features, we found that plasma prolactin and homocysteine levels were correlated with the severity of the psychotic symptoms in male FEP patients, suggesting that they might be factors associated with psychotic symptomatology but only in men. Together with oxytocin, these molecules may also be related to sustained attention, verbal ability and working memory cognitive domains in FEP patients.

CONCLUSION: This study suggests that focusing on prolactin, oxytocin and homocysteine at a FEP may help select adequate pharmacological treatments and develop new tools to improve the outcome of these patients, where sex should also be borne in mind.

PMID:37603404 | DOI:10.1093/ijnp/pyad051

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Real-World Evidence of a Hospital-Linked Digital Health App for the Control of Hypertension and Diabetes Mellitus in South Korea: Nationwide Multicenter Study

JMIR Form Res. 2023 Aug 21;7:e48332. doi: 10.2196/48332.

ABSTRACT

BACKGROUND: Digital health care apps have been widely used for managing chronic conditions such as diabetes mellitus and hypertension, providing promising prospects for enhanced health care delivery, increased patient engagement, and improved self-management. However, the impact of integrating these apps within hospital systems for managing such conditions still lacks conclusive evidence.

OBJECTIVE: We aimed to investigate the real-world effectiveness of using hospital-linked digital health care apps in lowering blood pressure (BP) and blood glucose levels in patients with hypertension and diabetes mellitus.

METHODS: Nationwide multicenter data on demographic characteristics and the use of a digital health care app from 233 hospitals were collected for participants aged 20 to 80 years in South Korea between August 2021 and June 2022. We divided the participants into 2 groups: 1 group consisted of individuals who exclusively used the digital health app (control) and the other group used the hospital-linked digital health app. All the patients participated in a 12-week digital health care intervention. We conducted a comparative analysis to assess the real-world effectiveness of the hospital-linked digital health app. The primary outcome was the differences in the systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG) level, and postprandial glucose (PPG) level between baseline and 12 weeks.

RESULTS: A total of 1029 participants were analyzed for the FBG level, 527 participants were analyzed for the PPG level, and 2029 participants for the SBP and DBP were enrolled. After 12 weeks, a hospital-linked digital health app was found to reduce SBP (-5.4 mm Hg, 95% CI -7.0 to -3.9) and DBP (-2.4 mm Hg, 95% CI -3.4 to -1.4) in participants without hypertension and FBG level in all participants (those without diabetes, -4.4 mg/dL, 95% CI -7.9 to -1.0 and those with diabetes, -3.2 mg/dL, 95% CI -5.4 to -1.0); however, there was no statistically significant difference compared to the control group (using only digital health app). Specifically, participants with diabetes using a hospital-linked digital health app demonstrated a significant decrease in PPG after 12 weeks (-10.9 mg/dL, 95% CI -31.1 to -5.3) compared to those using only a digital health app (P=.006).

CONCLUSIONS: Hospital-linked digital interventions have greatly improved glucose control for diabetes compared with using digital health technology only. These hospital-linked digital health apps have the potential to offer consumers and health care professionals cost-effective support in decreasing glucose levels when used in conjunction with self-monitoring.

PMID:37603401 | DOI:10.2196/48332

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The impact of predators of mosquito larvae on Wolbachia spreading dynamics

J Biol Dyn. 2023 Dec;17(1):2249024. doi: 10.1080/17513758.2023.2249024.

ABSTRACT

Dengue fever creates more than 390 million cases worldwide yearly. The most effective way to deal with this mosquito-borne disease is to control the vectors. In this work we consider two weapons, the endosymbiotic bacteria Wolbachia and predators of mosquito larvae, for combating the disease. As Wolbachia-infected mosquitoes are less able to transmit dengue virus, releasing infected mosquitoes to invade wild mosquito populations helps to reduce dengue transmission. Besides this measure, the introduction of predators of mosquito larvae can control mosquito population. To evaluate the impact of the predators on Wolbachia spreading dynamics, we develop a stage-structured five-dimensional model, which links the predator-prey dynamics with the Wolbachia spreading. By comparatively analysing the dynamics of the models without and with predators, we observe that the introduction of the predators augments the number of coexistence equilibria and impedes Wolbachia spreading. Some numerical simulations are presented to support and expand our theoretical results.

PMID:37603352 | DOI:10.1080/17513758.2023.2249024