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The relationship between critical thinking and job performance among nurses: A descriptive survey study

Int J Nurs Pract. 2023 Jun 10:e13173. doi: 10.1111/ijn.13173. Online ahead of print.

ABSTRACT

AIM: This study investigated the relationship between nurses’ critical thinking skills and job performance and whether critical thinking and its subdomains predict job performance.

BACKGROUND: It is expected that nurses may use critical thinking skills to provide evidence-based quality patient care in health care settings. However, there is limited evidence about whether critical thinking is related to job performance among nurses.

DESIGN: This was a descriptive, cross-sectional survey study.

METHODS: The study included 368 nurses working in the inpatient wards of a university hospital in Turkey. The survey included a demographic information questionnaire, the Critical Thinking Scale in Clinical Practice for Nurses and the Nurses’ Job Performance Scale. The collected data were analysed using descriptive statistics, comparisons, reliability and normality tests, correlation and regression analysis.

RESULTS: Participating nurses got average scores from the critical thinking and job performance scale and sub-scales, and there was a positive, mid-level and statistically significant correlation between the scale scores. According to the multiple linear regression analysis results, personal critical thinking, interpersonal and self-management critical thinking and the total critical thinking scores positively affected the job performance scores of nurses.

CONCLUSION: As critical thinking predicts nurses’ job performance, managers of hospitals and nursing services should consider training programs or activities to increase nurses’ essential thinking competencies, thus improving clinical nurses’ performances.

PMID:37300343 | DOI:10.1111/ijn.13173

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Systematic Analysis of Tissue-Derived and Biofluid Extracellular Vesicle miRNAs Associated with Prostate Cancer

Adv Biol (Weinh). 2023 Jun 9:e2200327. doi: 10.1002/adbi.202200327. Online ahead of print.

ABSTRACT

Extracellular vesicles (EVs) are emerging as biomarker candidates for early detection of prostate cancer. Studies compare EV-microRNA (miRNA) expression in individuals with prostate cancer (PCa) with cancer-free samples for diagnostic purposes. The aim of this study is to review miRNA signatures to investigate the overlap between miRNAs enriched in PCa tissue and miRNAs enriched in EVs isolated from subjects with PCa biofluids (i.e., urine, serum, and plasma). Signatures dysregulated in EVs from PCa biofluids and tissue are potentially associated with the primary tumor site and might be more indicative of PCa at an early stage. A systematic review of EV-derived miRNAs and a reanalysis of PCa tissue miRNA sequencing data for comparison is presented. Articles in the literature are screened for validated miRNA dysregulation in PCa and compared with TCGA primary PCa tumor data using DESeq2. This resulted in 190 dysregulated miRNAs being identified. Thirty-one eligible studies are identified, indicating 39 dysregulated EV-derived miRNAs. The top ten markers identified as significantly dysregulated in the PCa tissue dataset TCGA (e.g., miR-30b-3p, miR-210-3p, miR-126-3p, and miR-196a-5p) have a significant expression change in EVs with the same directionality in one or several statistically significant results. This analysis highlights several less frequently studied miRNAs in PCa literature.

PMID:37300338 | DOI:10.1002/adbi.202200327

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A systematic review and meta-analysis of efficacy and safety of isavuconazole for the treatment and prophylaxis of invasive fungal infections

Mycoses. 2023 Jun 10. doi: 10.1111/myc.13622. Online ahead of print.

ABSTRACT

BACKGROUND: Isavuconazole is a novel triazole antifungal agent. However, the previous outcomes were highlighted by statistical heterogeneity. This meta-analysis aimed to validate the efficacy and safety of isavuconazole for the treatment and prophylaxis of invasive fungal infections (IFIs) compared with other antifungal agents (amphotericin B, voriconazole and posaconazole).

METHODS: Scopus, EMBASE, PubMed, CINAHL and Ichushi databases were searched for relevant articles that met the inclusion criteria through February 2023. Mortality, IFI rate, discontinuation rate of antifungal therapy and incidence of abnormal hepatic function were evaluated. The discontinuation rate was defined as the percentage of therapy discontinuations due to adverse events. The control group included patients who received other antifungal agents.

RESULTS: Of the 1784 citations identified for screening, 10 studies with an overall total of 3037 patients enrolled. Isavuconazole was comparable with the control group in mortality and IFI rate in the treatment and prophylaxis of IFIs, respectively (mortality, odds rate (OR) 1.11, 95% confidential interval (CI) 0.82-1.51; IFI rate, OR 1.02, 95% CI 0.49-2.12). Isavuconazole significantly reduced the discontinuation rate in the treatment (OR 1.96, 95% CI 1.26-3.07) and incidence of hepatic function abnormalities in the treatment and prophylaxis, compared with the control group (treatment, OR 2.31, 95% CI 1.41-3.78; prophylaxis, OR 3.63, 95% CI 1.31-10.05).

CONCLUSIONS: Our meta-analysis revealed that isavuconazole was not inferior to other antifungal agents for the treatment and prophylaxis of IFIs, with substantially fewer drug-associated adverse events and discontinuations. Our findings support the use of isavuconazole as the primary treatment and prophylaxis for IFIs.

PMID:37300337 | DOI:10.1111/myc.13622

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Morphological variation of the Pan talus relative to that of Gorilla

Am J Biol Anthropol. 2023 Jun 10. doi: 10.1002/ajpa.24796. Online ahead of print.

ABSTRACT

OBJECTIVES: Differences in talar articular morphology relative to locomotion have recently been found within Pan and Gorilla. Whole-bone talar morphology within, and shared variation among, Pan and Gorilla (sub)species, however, has yet to be investigated. Here we separately analyze talar external shape within Pan (P. t. troglodytes, P. t. schweinfurthii, P. t. verus, P. paniscus) and Gorilla (G. g. gorilla, G. b. beringei, G. b. graueri) relative to degree of arboreality and body size. Pan and Gorilla are additionally analyzed together to determine if consistent shape differences exist within the genera.

MATERIALS AND METHODS: Talar external shape was quantified using a weighted spherical harmonic analysis. Shape variation both within and among Pan and Gorilla was described using principal component analyses. Root mean square distances were calculated between taxon averages, and resampling statistics conducted to test for pairwise differences.

RESULTS: P. t. verus (most arboreal Pan) talar shape significantly differs from other Pan taxa (p < 0.05 for pairwise comparisons) driven by more asymmetrical trochlear rims and a medially-set talar head. P. t. troglodytes, P. t. schweinfurthii, and P. paniscus do not significantly differ (p > 0.05 for pairwise comparisons). All gorilla taxa exhibit significantly different talar morphologies (p < 0.007 for pairwise comparisons). The more terrestrial subspecies of G. beringei and P. troglodytes exhibit a superoinferiorly taller talar head/neck complex.

DISCUSSION: P. t. verus exhibits talar morphologies that have been previously related to more frequent arboreality. The adaptations in the more terrestrial G. beringei and P. troglodytes subspecies may serve to facilitate load transmission.

PMID:37300336 | DOI:10.1002/ajpa.24796

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Long-term outcomes after paediatric sepsis (LOTUS)-A protocol for an Australian cohort study

Nurs Crit Care. 2023 Jun 9. doi: 10.1111/nicc.12938. Online ahead of print.

ABSTRACT

BACKGROUND: Globally, sepsis has been identified as one of the leading causes of preventable childhood mortality and morbidity. Previous studies on intensive care patients estimated that approximately 30% of children with sepsis experience some form of disability at discharge. Development of care has seen growing numbers of children treated for sepsis not requiring a PICU admission; however, outcomes in this population are yet to be understood. Further focus is required to understand sepsis survivorship across the wider population to address knowledge gaps and morbidity burden in the broader surviving population.

AIMS: To assess the cognitive, physical, emotional and social health of children surviving sepsis 2 years after hospital discharge.

STUDY DESIGN: A prospective, observational cohort study.

RESULTS: Two hundred and thirty-two children will be screened, 2 years after their hospital admission, and approached for participation in this study. Children who are <18 years of age at follow-up, treated for sepsis-related organ dysfunction or septic shock in Queensland between October 2018 and December 2019, will be included. Children who are deceased at follow-up, under care of the state, or require English interpreters will be excluded from participation. Data will be collected through an online follow-up survey comprising validated caregiver-reported questionnaires covering the four Post Intensive Care Syndrome-paediatrics (PICS-p) domains (cognitive, physical, emotional and social health; Manning et al. Pediatr Crit Care Med, 2018, 19, 298-300). The primary outcome is an adaptive behaviour of the participants assessed using the Vinelands-3 tool. Secondary outcomes will include neurodevelopment, quality of life, child distress, overall function, executive function, caregiver’s distress and caregiver’s stress. Analysis of variance (ANOVA), Kruskal-Wallis and Fisher’s exact test/chi-squared tests will be used for statistical analyses. No adjustments will be made for multiple comparisons but it is acknowledged that comparisons made in this study are exploratory.

RELEVANCE TO CLINICAL PRACTICE: With more children surviving sepsis, there is a need for a more comprehensive assessment of patient and family outcomes to allow support structures for families leaving the hospital after sepsis. This study is expected to inform clinicians and stakeholders of patient and family well-being after sepsis survivorship.

PMID:37300332 | DOI:10.1111/nicc.12938

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Awareness of diagnosis predicts changes in quality of life in individuals with mild cognitive impairment and mild stage dementia

Int J Geriatr Psychiatry. 2023 Jun;38(6):e5939. doi: 10.1002/gps.5939.

ABSTRACT

BACKGROUND AND OBJECTIVE: This observational study examined how awareness of diagnosis predicted changes in cognition and quality of life (QOL) 1 year later in older adults with normal cognition and dementia diagnoses.

RESEARCH DESIGN AND METHODS: Older adults (n = 259) with normal cognition, mild cognitive impairment (MCI), or mild stage Alzheimer’s disease (AD) completed measures of diagnostic awareness, cognition, and multiple domains of QOL. We compared 1-year change in cognition and QOL by diagnostic group and diagnostic awareness.

RESULTS: Patients who were unaware of their diagnosis at baseline showed average decreases in both satisfaction with daily life (QOL-AD; paired mean difference (PMD) = -0.9, p < 0.05) and physical functioning (SF-12 PCS; PMD = -2.5, p < 0.05). In contrast, patients aware of their diagnosis at baseline showed no statistically discernable changes in most QOL domains (all p > 0.05). Of patients aware of their diagnosis at baseline (n = 111), those who were still aware (n = 84) showed a decrease in mental functioning at follow up (n = 27; SF-12 MCS). Change in MoCA scores in patients unaware of their diagnosis was similar to that in patients aware of their diagnosis, -1.4 points (95% CI -2.6 to -0.6) and -1.7 points (95% CI -2.4 to -1.1) respectively.

DISCUSSION AND IMPLICATIONS: Awareness of one’s diagnosis of MCI or AD, not the severity of cognitive impairment, may predict changes in patients’ mental functioning, expectations of their memory, satisfaction with daily life, and physical functioning. The findings may help clinicians anticipate the types of threats to wellbeing that a patient might encounter and identify key domains for monitoring.

PMID:37300313 | DOI:10.1002/gps.5939

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Risk perception in pregnancy: Patient-physician discrepancies, information consumption, and mental health outcomes

Birth. 2023 Jun 9. doi: 10.1111/birt.12730. Online ahead of print.

ABSTRACT

BACKGROUND: Little is known about the scope, causes, or consequences of risk overestimation. Our aim was to assess whether risk perceptions in pregnancy are heightened for a range of behaviors, related to consumption of health information, and associated with mental health indices.

METHODS: One hundred and fifty members of the American College of Obstetricians and Gynecologists were invited to participate in a patient-physician study, and 37% returned surveys. Physicians (n = 73) and prenatal patients (n = 388) rated the perceived safety of exposure to 40 behaviors during pregnancy. A subset of prenatal patients completed a postpartum follow-up survey (n = 103).

RESULTS: Statistical comparison of means indicated that patients overestimated the risk of 30 behaviors. Anchoring patient ratings against average physician ratings, 87.8% of total discrepancy scores reflected net risk overestimation. Greater risk overestimation was associated with higher consumption of pregnancy-related health information, but was not associated with anxiety or depression symptoms.

CONCLUSIONS: Risk perceptions may be heightened across a range of behaviors during pregnancy, even when empirical evidence of risk is absent. Information consumption could be associated with risk estimation, but causality and directionality have not been established. Further research on risk perceptions could have implications for prenatal care.

PMID:37300301 | DOI:10.1111/birt.12730

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Neighbourhood deprivation in childhood and adulthood and risk of arterial stiffness: the Cardiovascular Risk in Young Finns study

Blood Press. 2023 Dec;32(1):2220037. doi: 10.1080/08037051.2023.2220037.

ABSTRACT

Purpose: Individual socioeconomic status is associated with increased arterial stiffness, but limited data are available on the relations of neighbourhood deprivation with this vascular measure. We prospectively examined whether neighbourhood deprivation in childhood and adulthood predicts arterial stiffness indicated by pulse wave velocity (PWV).Materials and methods: The study population comprised 1,761 participants aged 3-18 years at baseline (1980) from the longitudinal Cardiovascular Risk in Young Finns cohort study. PWV was measured in 2007 by whole-body impedance cardiography at ages 30-45 years. Cumulative lifetime neighbourhood deprivation was assessed using data from socioeconomic circumstances in participants’ lifetime residential neighbourhoods, categorised as low versus high deprivation.Results: High deprivation in childhood and adulthood was associated with higher PWV in adulthood after adjustment for age, sex, and place of birth (mean difference = 0.57 m/s, 95%CI = 0.26-0.88, P for trend = 0.0004). This association was attenuated but remained statistically significant after further adjustment for childhood parental socioeconomic status and adulthood individual socioeconomic status (mean difference = 0.37 m/s, 95%CI = 0.05-0.70, P for trend 0.048). Also, low individual socioeconomic status in adulthood was associated with higher PWV when adjusted for age, sex, place of birth, parental socioeconomic status in childhood, and lifetime neighbourhood deprivation (mean difference = 0.54 m/s, 95%CI = 0.23-0.84, P for trend 0.0001).Conclusion: These findings suggest that lifetime neighbourhood deprivation and low adulthood socioeconomic status are independent risk factors for increased arterial stiffness in adulthood.

PMID:37300298 | DOI:10.1080/08037051.2023.2220037

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Intravenous Transplantation of Adipose-Derived Mesenchymal Stem Cells Promoted The Production of Dopaminergic Neurons and Improved Spatial Memory in A Rat Model of Parkinson’s Disease

Cell J. 2023 May 28;25(5):317-326. doi: 10.22074/cellj.2023.1972266.1161.

ABSTRACT

OBJECTIVE: Parkinson’s disease (PD) is a neurodegenerative disorder described by the dynamic decline of dopaminergic neurons in the substantia nigra pars compacta (SNpc). Stem cell transplantation is a new therapeutic strategy in the treatment of PD. The objective of the study was to assess the impact of intravenous infusion of adipose-derived mesenchymal stem cells (AD-MSCs) on memory disorder in Parkinsonian rats.

MATERIALS AND METHODS: In this experimental study, male Wistar rats were randomly divided to four groups containing sham, cell treatment, control, and lesion. The cell treatment group received intravenous injection of AD-MSCs 12 days after PD induction by bilateral injection of 6-hydroxydopamine. Four weeks after lesion formation, spatial memory was examined using the Morris water maze (MWM) assessment. The rats’ brains were removed and assessed by bromodeoxyuridine (BrdU), tyrosine hydroxylase (TH), and glial fibrillary acidic protein (Gfap) immunostaining.

RESULTS: Statistical analyses revealed a significant addition and reduction in time spent and escape latency in the target quadrant, respectively, in the cell group as compared to the lesion group. Also, BrdU-labeled cells were present in the substantia nigra (SN). The density of TH-positive cells was significantly increased in the AD-MSCs transplantation group as compared to the lesion group, and the density of astrocytes significantly diminished in the AD-MSCs transplantation group as compared to the lesion group.

CONCLUSION: It appears that AD-MSCs treatment for Parkinson’s could decrease the density of astrocytes and promote the density of TH-positive neurons. It appears that AD-MSCs could improve spatial memory impairment in PD.

PMID:37300293 | DOI:10.22074/cellj.2023.1972266.1161

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Simultaneous integrated dose reduction intensity-modulated radiotherapy effectively reduces cardiac toxicity in limited-stage small cell lung cancer

Cancer Biol Med. 2023 Jun 9:j.issn.2095-3941.2022.0326. doi: 10.20892/j.issn.2095-3941.2022.0326. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the clinical outcomes and toxicities of once daily (QD) simultaneous dose reduction intensity-modulated radiotherapy (SDR-IMRT-QD; SDR-QD) versus conventional QD IMRT (C-QD) and twice daily (BID) IMRT in patients with limited-stage small cell lung cancer (LS-SCLC).

METHODS: After propensity score matching (PSM), a retrospective analysis involving 300 patients with LS-SCLC treated using SDR-QD, C-QD, or BID was performed from January 1, 2014 to December 31, 2019. The prescribed irradiation dose in the SDR-QD cohort was 60 Gy/PGTV and 54 Gy/PTV QD. The radiation dose was 60 Gy for both PGTV and PTV QD in the C-QD cohort. The radiation dose was 45 Gy for both PGTV and PTV in the BID cohort. Toxicities, short-term effects, and survival outcomes were recorded. A meta-analysis on the protective effects of pharmaceuticals for cardiac toxicities induced by anti-tumor therapy was performed.

RESULTS: The median overall survival time (MST) in the 3 cohorts were 32.7 months (SDR-QD), 26.3 months (C-QD), and 33.6 months (BID); the differences between groups were statistically significant. Lower toxicities and doses to organs-at-risk (OARs) occurred in the SDR-QD and BID cohorts. Further, the cardiac dose dosimetric parameter Vheart40 was negatively associated with survival (r = -0.35, P = 0.007). A Vheart40 value of 16.5% was recommended as a cut-off point, which yielded 54.7% sensitivity and 85.7% specificity for predicting negative survival outcomes. The meta-analysis indicated that pharmaceuticals significantly reduced the cardiac toxicities induced by chemotherapy, but not radiotherapy.

CONCLUSIONS: SDR-QD was shown to have similar toxicities and survival compared with BID, but fewer toxicities and better survival than C-QD. In addition, cardiac dose exposure was negatively associated with survival. Thus, 16.5% of the cardiac dosimetric parameter Vheart40 is recommended as the cut-off point, and a Vheart40 > 16.5% predicts poor survival.

PMID:37300284 | DOI:10.20892/j.issn.2095-3941.2022.0326