Tag: nevin manimala

Musculoskeletal Care. 2022 Mar 25. doi: 10.1002/msc.1635. Online ahead of print.

ABSTRACT

BACKGROUND: Pain, as a psychological experience, is caused by complex interactions among sensory-discriminative, motivational-affective, and cognitive-evaluative dimensions. The psychosocial approach is one of the important approaches in managing musculoskeletal pain in patients. Therefore, this study aimed to determine and compare the effects of psychosocial skills training on pain intensity in patients with acute and chronic musculoskeletal pain.

METHODS: In this quasi-experimental study, 64 patients with acute and chronic musculoskeletal pain were selected using convenience sampling and were divided into a control and an intervention group. Both groups received psychosocial training in pain management in groups of 8-10 people over six 1-h sessions. The data were collected at baseline, after the intervention, and 3 months later using a numerical rating scale (NRS). Then, the data were entered into the SPSS 22 software and were analysed using descriptive and inferential statistics.

RESULTS: In this study, the mean age of the participants was 50.10 ± 10.63 years and 60.9% of them were female. Based on the results, time had a significant effect on pain intensity (p < 0.001), but the effect of group on pain intensity was not statistically significant (p = 0.07). The group × time effect on pain intensity was also statistically significant (p < 0.001).

CONCLUSION: Psychosocial training had a positive impact on the reduction of pain among the patients with acute and chronic musculoskeletal pain. Additionally, the training was more effective in patients with acute pain due to early training. These findings can help healthcare providers in the field of musculoskeletal pain management, especially in patients with acute pain.

PMID:35332994 | DOI:10.1002/msc.1635

Health Info Libr J. 2022 Mar 25. doi: 10.1111/hir.12427. Online ahead of print.

ABSTRACT

BACKGROUND: A validated generic impact questionnaire can demonstrate how individual and groups of health libraries contribute to continuing education and patient care outcomes.

OBJECTIVES: To validate an existing generic questionnaire for Knowledge for Healthcare, England by examining: (1) internal reliability; (2) content validity; and (3) suggest revisions.

METHODS: Methods used included Cronbach’s alpha test, simple data mining of patterns among a data set of 187 questionnaire responses and checking respondents’ interpretation of questions.

RESULTS: Cronbach’s alpha was 0.776 (acceptable internal reliability). The patterns of responses indicated that respondents’ interpretations of the questions were highly plausible, and consistent. The meaning of ‘research’ varied among different occupational groups, but overall, respondents could identify relevant personal and service impacts. However, users were confused about the terms that libraries use to describe some services.

DISCUSSION: The analysis indicated that the questionnaire worked well for the two types of personal services (literature/evidence searches and training/e-learning) frequently cited on the responses. Further research may be required for library assessment of the impact of other services such as digital resource services.

CONCLUSIONS: The generic questionnaire is a reliable way of assessing the impact of health library and knowledge services, both individually and collectively.

PMID:35332978 | DOI:10.1111/hir.12427

J Esthet Restor Dent. 2022 Mar 25. doi: 10.1111/jerd.12908. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate, in vitro, the influence of at-home bleaching with 16% carbamide peroxide (CP) gels containing different thickeners on the color, gloss, roughness, and microhardness of a composite resin with bisphenol A (BPA) and without bisphenol A (BPA-free).

MATERIAL AND METHODS: Cylindrical samples (7 × 2 mm) of a composite resin with BPA (Filtek Z350 XT®; 3M/ESPE) and composite resin BPA-free (Vittra APS®; FGM) were subdivided into six subgroups (n = 12), according to the bleaching gel used: no bleaching (control), commercial gel with 16% CP and carbopol, experimental gel with 16% CP and carbopol, experimental gel with 16% CP and natrosol, experimental gel with carbopol and experimental gel with natrosol. At the end of the experimental phase, the specimens were analyzed for color (ΔE*_ab and ΔE₀₀ ), surface roughness (Ra), gloss (GU), and surface microhardness (SMH). The data for all analyzes were submitted to Levene’s test, Shapiro-Wilk’s test and ANOVA.

RESULTS: For ΔE*_ab and ΔE₀₀ no statistically significant differences were found between all groups evaluated. Bleaching with experimental 16% CP gel with carbopol resulted in the lowest GU values for both composite resins evaluated. 16% CP experimental gel with natrosol resulted in higher Ra for the BPA composite resin and the bleaching with natrosol resulted in higher Ra for BPA-free. About 16% CP experimental gel with carbopol and 16% CP experimental gel with natrosol resulted in the lowest final SMH for composite resin with BPA. For the BPA-free composite resin, no differences were found between the groups in SMH for the same resin, however they presented the lowest values compared with all others groups.

CONCLUSION: The effects on physical properties are dependent on the composition of the composite resin and the thickener/bleaching gel used. The BPA-free composite resin showed less changes after exposure to bleaching agent, although its initial physical properties were worse compared to a bleached BPA.

CLINICAL RELEVANCE: The hydrogen peroxide and thickener of the at-home bleaching gel does impact the properties of composites with BPA or BPA-free such as gloss, roughness and surface microhardness, extremely important factors for maintaining an aesthetically and physically satisfactory restoration. BPA-free composite resins have inferior properties after at-home bleaching with different thickeners.

PMID:35332985 | DOI:10.1111/jerd.12908

Health Soc Care Community. 2022 Mar 25. doi: 10.1111/hsc.13765. Online ahead of print.

ABSTRACT

To a great extent, older people in Sweden, often with extensive care needs, are cared for in their own home. Support is often needed from both family and professional caregivers. This study aimed to describe and analyse different aspects of health, functioning and social networks, and how they relate to formal and informal care in the home among older adults. Analyses were performed utilising data from the OCTO-2 study, with a sample of 317 people living in Jönköping County, aged 75, 80, 85 or 90 years, living in their own homes. Data were collected with in-person-testing. Based on receipt of care, the participants were divided into three groups: no care, informal care only, and formal care with or without informal care. Descriptive statistics and multinomial regression analysis were performed to explore the associations between received care and different aspects of health (such as multimorbidity, polypharmacy), social networks (such as loneliness, number of confidants) and functioning (such as managing daily life). The findings demonstrate that the majority of the participants received no care at home (61%). Multimorbidity and polypharmacy were more common among those receiving some kind of care in comparison to those who received no care; moreover, those receiving some kind of care also had difficulties managing daily life and less satisfaction with their social networks. The multinomial logistic regression analyses demonstrated that age, functioning in daily life, perceived general health and satisfaction with the number of confidants were related to receipt of care, but the associations among these factors differed depending on the type of care that was received. The results show the importance of a holistic perspective that includes the older person’s experiences when planning home care. The results also highlight the importance of considering social perspectives and relationships in home care rather than focusing only on health factors.

PMID:35332977 | DOI:10.1111/hsc.13765

J Magn Reson Imaging. 2022 Mar 25. doi: 10.1002/jmri.28158. Online ahead of print.

ABSTRACT

BACKGROUND: The feasibility and reproducibility of multifrequency MR elastography (MRE) for diagnosing pancreatic ductal adenocarcinoma (PDAC) have not been reported.

PURPOSE: To determine the feasibility and reproducibility of multifrequency MRE for assessing pancreatic stiffness in healthy and diseased pancreases.

STUDY TYPE: Prospective.

SUBJECTS: A total of 40 healthy volunteers and 10 patients with PDAC were prospectively recruited between March 2018 and October 2021.

FIELD STRENGTH/SEQUENCE: A 3.0-T pancreatic MRE at frequencies in the order of 30, 40, 60, 80, and 100 Hz.

ASSESSMENT: Body mass index (BMI) and wave distance of the healthy pancreas and PDAC were measured. Image quality was assessed using the image quality score (IQS: 1-4, ≥3 were considered diagnostic quality). Three readers independently performed the pancreatic stiffness and IQS assessments to evaluate reproducibility.

STATISTICAL TESTS: Logistic regression analyses were performed to determine variables that influenced IQS. Statistical significance was set at P <0.05. Levels of inter- and intrarater agreement were assessed using intraclass correlation coefficients (ICC) and Cohen’s kappa coefficient (κ). Good reproducibility was set at ICC and κ ≥ 0.8.

RESULTS: In logistic regression analysis, a diagnostic IQS in healthy volunteers was independently associated with a lower BMI (odds ratio [OR] = 0.89 kg/m^-2 ), shorter wave distance (OR = 0.70 cm^-1 ), and lower frequency (30 and 40 Hz: OR = 170.01 and 96.02). In PDAC, frequency was the only independent factor for diagnostic IQS (30-60 Hz: OR = 46.18, 46.18, and 17.20, respectively) with 100 Hz as a reference. In healthy volunteers, good reproducibility was observed at 30 and 40 Hz. In PDAC, good reproducibility was observed at 30-60 Hz.

DATA CONCLUSION: MRE at 30 and 40 Hz provides diagnostic wave images and reliable measurements of pancreatic stiffness in healthy volunteers. MRE at 30-60 Hz is acceptable for PDACs (IQS ≥ 3, ICC and κ ≥ 0.80).

EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 2.

PMID:35332973 | DOI:10.1002/jmri.28158

Int J Eat Disord. 2022 Mar 25. doi: 10.1002/eat.23698. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the impact of our new rapid refeeding protocol on patients with anorexia nervosa (AN) in our Eating Disorders Program. We hypothesize that the new protocol would lead to a more rapid weight gain and a shorter length of stay, with no effect on medical complications or program completion.

METHOD: This cohort design included consecutive inpatients and day hospital patients admitted to the program with a BMI <18 kg/m² and a diagnosis of AN between 2007 and 2020; N = 326 patients. Main outcomes measured were rate of weight gain and length of stay. Safety indicators included electrolyte disturbances and supplementation required, complications including refeeding syndrome and completion of the program. A p value <.05 was considered statistically significant.

RESULTS: Total length of stay was 21 days shorter for patients on the rapid refeeding protocol compared to the traditional refeeding protocol. Patients on the new protocol gained 0.21 more kg/week compared to patients on the old protocol. There was no difference in completion rates between programs. Electrolyte imbalances were mild to moderate and easily treated with oral electrolyte supplementation. There were no deaths or cases of refeeding syndrome with either protocol.

DISCUSSION: This is the first Canadian study to assess the effectiveness and safety of rapid refeeding in an adult population. Rapid refeeding protocols can be safely administered and are cost effective. Shorter hospital admissions are desirable to minimize possible regression and dependency on inpatient services and positively impacts patients’ quality of life.

PUBLIC SIGNIFICANCE: This study advances the idea that rapid refeeding in patients with anorexia nervosa can be administered safely and effectively with close medical monitoring. In addition, rapid refeeding leads to shorter hospital stays, with a cost-savings to the health system. Shorter admissions are desirable to minimize possible regression and dependency on inpatient services and also positively impacts patients’ quality of life.

PMID:35332954 | DOI:10.1002/eat.23698

Head Neck. 2022 Mar 25. doi: 10.1002/hed.27041. Online ahead of print.

ABSTRACT

This systematic review is the first to provide evidence regarding demographic, clinical, and imaging characteristics, as well as information related to survival, of patients with oral and maxillofacial metastases of occult primary tumors. Case reports, case series, and cross-sectional studies were included. Ten databases were searched. The risk of bias was assessed using the Joanna Briggs Institute appraisal tools. Overall, 353 articles (413 patients) were included. Statistically significant associations between survival and multiplicity of metastatic foci, and between each of the main primary sites and some features of the oral lesions were observed. Some clinical and imaging characteristics can help dentists in raising diagnostic suspicions and also in relating to plausible primary sites. Early diagnosis of oral and maxillofacial metastases can positively affect the survival rate when they are the only focus of dissemination, conferring an important role on the dentist.

PMID:35332969 | DOI:10.1002/hed.27041

J Am Geriatr Soc. 2022 Mar 25. doi: 10.1111/jgs.17751. Online ahead of print.

ABSTRACT

BACKGROUND: Transition-related patient safety errors are high among patients discharged from hospitals to skilled nursing facilities (SNFs), and interventions are needed to improve communication between hospitals and SNF providers. Our objective was to describe the implementation of a pilot telehealth videoconference program modeled after Extension for Community Health Outcomes-Care Transitions and examine patient safety errors and readmissions.

METHODS: A multidisciplinary telehealth videoconference program was implemented at two academic hospitals for patients discharged to participating SNFs. Process measures, patient safety errors, and hospital readmissions were evaluated retrospectively for patients discussed at weekly conferences between July 2019-January 2020. Results were mapped to the constructs of the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) model. Descriptive statistics were reported for the conference process measures, patient and index hospitalization characteristics, and patient safety errors. The primary clinical outcome was all-cause 30-day readmissions. An intention-to-treat (ITT) analysis was conducted using logistic regression models fit to compare the probability of 30-day hospital readmission in patients discharged to participating SNFs across 7 months prior to after telehealth project implementation.

RESULTS: There were 263 patients (67% of eligible patients) discussed during 26 telehealth videoconferences. Mean discussion time per patient was 7.7 min and median prep time per patient was 24.2 min for the hospital pharmacist and 10.3 min for the hospital clinician. A total of 327 patient safety errors were uncovered, mostly related to communication (54%) and medications (43%). Differences in slopes (program period vs. pre-implementation) of the probability of readmission across the two time periods were not statistically significant (OR 0.95, [95% CI 0.75, 1.19]).

CONCLUSIONS: A pilot care innovations telehealth videoconference between hospital-based and SNF provider teams was successfully implemented within a large health system and enhanced care transitions by optimizing error-prone transitions. Future work is needed to understand process flow within nursing homes and its impact on clinical outcomes.

PMID:35332931 | DOI:10.1111/jgs.17751

Rev Neurol. 2022 Apr 1;74(7):209-218. doi: 10.33588/rn.7407.2021411.

ABSTRACT

INTRODUCTION: There is evidence of predemential stages in Vascular Dementia (VD). Alzheimer Disease (AD) and VD share common risk factors and mechanisms. Vascular comorbility may present in 30-60% of patients with AD (mixed dementia). This work seeks to evaluate the impact of the severity of structural vascular damage according to the Fazekas classification (F) on functional cognitive performance in patients with Mild Cognitive Impairment (MCI).

PATIENTS AND METHODS: A cross-sectional study of patients with MCI aged 65 years or older who had brain MRI was carried out. A neurocognitive battery and the EFE (Extended Functional Study) scale were administered to assess complex functionality. The patients were divided according to Fazekas classification: 0-1, 2 and 3. Bivariate analysis and multivariate analysis were performed.

RESULTS: 346 patients were included, age: 77.9 (SD 6.1). 66.2% presented F01, 22.8% F2 and 11% F3. Age and MMSE value were statistically significant. Multivariate analysis showed an independent association between vascular damage and complex functional alteration measured by EFE.

CONCLUSIONS: In conclusion, the progression of structural damage to a predominance of white matter would affect global cognitive performance and tasks related to executive function. The most significant finding was the correlation of the degree of vascular damage with the deficit of complex functionality measured with clinical tools that include technological resources. The clinical value of identifying individuals with prodromal DV is highlighted as it could optimize prevention measures.

PMID:35332924 | DOI:10.33588/rn.7407.2021411

Cereb Cortex. 2022 Mar 24:bhac117. doi: 10.1093/cercor/bhac117. Online ahead of print.

ABSTRACT

A critical way for humans to acquire information is through language, yet whether and how language experience drives specific neural semantic representations is still poorly understood. We considered statistical properties captured by 3 different computational principles of language (simple co-occurrence, network-(graph)-topological relations, and neural-network-vector-embedding relations) and tested the extent to which they can explain the neural patterns of semantic representations, measured by 2 functional magnetic resonance imaging experiments that shared common semantic processes. Distinct graph-topological word relations, and not simple co-occurrence or neural-network-vector-embedding relations, had unique explanatory power for the neural patterns in the anterior temporal lobe (capturing graph-common-neighbors), inferior frontal gyrus, and posterior middle/inferior temporal gyrus (capturing graph-shortest-path). These results were relatively specific to language: they were not explained by sensory-motor similarities and the same computational relations of visual objects (based on visual image database) showed effects in the visual cortex in the picture naming experiment. That is, different topological properties within language and the same topological computations (common-neighbors) for language and visual inputs are captured by different brain regions. These findings reveal the specific neural semantic representations along graph-topological properties of language, highlighting the information type-specific and statistical property-specific manner of semantic representations in the human brain.

PMID:35332914 | DOI:10.1093/cercor/bhac117