Tag: nevin manimala

J Antimicrob Chemother. 2021 Apr 5:dkab096. doi: 10.1093/jac/dkab096. Online ahead of print.

ABSTRACT

BACKGROUND: Bacteraemia data are often used as a general measure of resistance prevalence but may poorly represent other infection types. We compared resistance prevalence between bloodstream infection (BSI) and lower respiratory tract infection (LRTI) isolates collected by the BSAC Resistance Surveillance Programme.

METHODS: BSI isolates (n = 8912) were collected during 2014-18 inclusive and LRTI isolates (n = 6280) between October 2013 to September 2018 from participating laboratories in the UK and Ireland, to a fixed annual quota per species group. LRTI isolates, but not BSI, were selected by onset: community for Streptococcus pneumoniae; hospital for Staphylococcus aureus, Pseudomonas aeruginosa and Enterobacterales. MICs were determined centrally by agar dilution; statistical modelling adjusted for ICU location and possible clustering by collection centre.

RESULTS: Resistance was more prevalent among the LRTI isolates, even after adjusting for a larger proportion of ICU patients. LRTI P. aeruginosa and S. pneumoniae were more often resistant than BSI isolates for most antibiotics, and the proportion of MRSA was higher in LRTI. For S. pneumoniae, the observation reflected different serotype distributions in LRTI and BSI. Relationships between LRTI and resistance were less marked for Enterobacterales, but LRTI E. coli were more often resistant to β-lactams, particularly penicillin/β-lactamase inhibitor combinations, and LRTI K. pneumoniae to piperacillin/tazobactam. For E. cloacae there was a weak association between LRTI, production of AmpC enzymes and cephalosporin resistance.

CONCLUSIONS: Estimates of resistance prevalence based upon bloodstream isolates underestimate the extent of the problem in respiratory isolates, particularly for P. aeruginosa, S. pneumoniae, S. aureus and, less so, for Enterobacterales.

PMID:33822968 | DOI:10.1093/jac/dkab096

Zdr Varst. 2021 Mar 18;60(2):114-123. doi: 10.2478/sjph-2021-0017. eCollection 2021 Jun.

ABSTRACT

INTRODUCTION: Future nurses should possess the knowledge and competences necessary to ensure patient safety. However, little evidence is available on the way in which students learn patient safety-related principles over time. This study explored the progress of a cohort of Italian undergraduate nursing students as they acquired patient safety knowledge and competences from time of enrolment to graduation.

METHODS: A longitudinal study carried out between 2015 and 2018 enrolled a cohort of 90 nursing students from two Italian Bachelor of Nursing Science Degree Courses at the Udine University, Italy. The students were followed-up on an annual basis and data collection was performed three times: at the end of the 1st, 2nd and 3rd years. The validated Italian version of the Professional Education in Patient Safety Survey tool was used to collect data.

RESULTS: At the end of the 1st year, students reported an average 4.19 out of 5 patient safety knowledge acquired in classrooms (CI 95%, 4.11-4.28), which was stable at the end of the 2nd (4.16; CI 95%, 4.06-4.26) and 3rd years (4.26; CI 95%, 4.16-4.32) and no statistical differences emerged over the years. With regard to the competences acquired in clinical settings, at the end of the 1st year the students reported an average 4.28 out of 5 (CI 95%, 4.20-4.37), which decreased significantly at the end of the 2nd year (4.15; CI 95%, 4.07-4.23; p=0.02) and increased at the end of the 3rd year (4.37; CI 95%, 4.27-4.47; p<0.01).

CONCLUSIONS: Nursing students’ competences in patient safety issues increases over time, while their knowledge remains stable. Students are more vulnerable at the end of the 1st year, when they seem to be overconfident about patient-safety issues.

PMID:33822834 | PMC:PMC8015659 | DOI:10.2478/sjph-2021-0017

Zdr Varst. 2021 Mar 18;60(2):82-89. doi: 10.2478/sjph-2021-0013. eCollection 2021 Jun.

ABSTRACT

BACKGROUND: Persons with ID most often have incomplete, contradictory and imprecise knowledge of sexuality and sexual intercourse itself. They are not provided with sufficient information on their own body and sexuality, and are often discouraged from and sanctioned for trying to sexually express themselves. Sexual abuse due to low sexual assertiveness is also common.

AIM: The principal aim of this study was to establish the presence or absence of sexual activity in adults with ID residing in institutional housing, as well as the level and structure of their knowledge of sexuality, their sexual assertiveness and preparedness to react in a sexually dangerous situation.

METHODS: The sample consisted of 100 participants with ID residing in institutional housing. The instruments used included the General Sexual Knowledge Questionnaire, What-if test and Hulbert index of sexual assertiveness. Comparative statistics included coefficient of linear correlation and multiple regression analysis.

RESULTS: The results showed that 82% of the participants are sexually active. Most participants admitted to sometimes having sexual intercourse against their wishes as well as to having difficulty asserting themselves. Their knowledge of pregnancy, contraception and sexually transmitted diseases was very low. Female participants and those that reported having sexual intercourse had more sexual knowledge and were also more sexually assertive.

CONCLUSION: Knowledge of sexuality and sexual assertiveness of persons with ID residing in institutional housing is very low. Additional information on sexuality is necessary, as well as support in learning to express their own desires and to deal with unwanted sexual activity.

PMID:33822835 | PMC:PMC8015653 | DOI:10.2478/sjph-2021-0013

J Crohns Colitis. 2021 Apr 5:jjab063. doi: 10.1093/ecco-jcc/jjab063. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Histological healing might be the ultimate therapeutic goal in ulcerative colitis (UC). Our aim was to investigate the association between histological disease activity as measured by a validated index and long-term outcomes in patients with UC.

METHODS: An observational retrospective cohort study was conducted at the Nancy University Hospital between January 2014 and March 2020. All consecutive patients with confirmed UC undergoing colonoscopy with biopsies and available histological reports were eligible for inclusion.

RESULTS: A total of 156 patients were included (53% female with a mean age of 41.3 ± 15.4 years). About a quarter of patients were in histological remission (Nancy index=0) at baseline (n=42, 26.9%). Median follow-up was 30.5 months (range 0-75). Sixteen patients with histological disease activity at baseline (Nancy index ≥ 1) underwent surgery during follow-up compared with no subject in the histological remission group (14.0% vs 0.0%, respectively, p=0.01). Similarly, a higher rate of hospitalization was found in patients with histological disease activity at baseline than in the histological remission group (36.0% vs 7.1%, respectively, p=0,001). The Kaplan Meier analysis showed that patients with histological disease activity at baseline had a 5-year surgery rate of 16.7% (logrank p=0.01) and a 5-year hospitalization rate of 19.7% (logrank p=0.0002). In the multivariate regression model, Nancy index > 0 was independently associated with the risk of hospitalization (hazard ratio 8.88, CI 95% 2.5-31.1, p=0.0007).

CONCLUSION: UC patients with histological disease activity, as measured by the Nancy index, have a greater risk of surgery and hospitalization.

PMID:33822915 | DOI:10.1093/ecco-jcc/jjab063

PLoS One. 2021 Apr 6;16(4):e0249560. doi: 10.1371/journal.pone.0249560. eCollection 2021.

ABSTRACT

The contemporary concept of sexual counseling for women with sexual problems, distress, and female sexual dysfunction (FSD) includes tailored medical and/or psychological intervention. The dual control model and the Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) are helpful for identifying risk factors and tailoring therapy for FSD. The current study aimed to (1) validate the Polish translation of the SESII-W in a sample of Polish women, and (2) verify the usefulness of the SESII-W in clinical practice. Five hundred nine white women age 18 to 55 years old (M ± SD age = 39.7 ± 11.3 years) were included in this cross-sectional study. Linguistic validation of the Polish translation of the SESII-W was first performed. A battery of tests was then used to evaluate reliability, convergent and discriminant validity, measurement invariances, and correlations between the SESII-W and other measures. Given that the original version of the SESII-W had unsatisfactory model fit, exploratory and confirmatory factor analyses were subsequently performed. Results showed a new final model that included 26 items with seven lower- and two higher-order factors and explained 58.9% of the variance in the data, with CFI = 0.93, RMSEA = 0.05 and χ2 = 693.39, p < 0.001. Cronbach’s α was 0.77 for Sexual Excitation (SE) and 0.88 for Sexual Inhibition (SI) scales. A moderate negative association between SI and the presence of FSD according to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria was noted. SE was positively associated with engaging in risky sexual behaviors, Extraversion and Openness to Experiences traits, and was negatively correlated with relationship quality. Finally, age was negatively correlated with all domains of the SESII-W except Arousal Contingency. SE and SI were both lower in older women as compared to younger once. These results demonstrate that the Polish version of SESII-W shows good psychometric properties. A higher propensity for SI was associated with the presence of sexual problems, distress, and FSD, whereas a higher propensity for SE was associated with greater engagement in risky sexual behaviors and personality type. However, future studies on larger and more diverse populations are required to confirm the replicability of the factor structure of the scale.

PMID:33822822 | DOI:10.1371/journal.pone.0249560

PLoS One. 2021 Apr 6;16(4):e0249665. doi: 10.1371/journal.pone.0249665. eCollection 2021.

ABSTRACT

To obtain market average return, investment managers need to construct index tracking portfolio to replicate target index. Currently, most literatures use financial data that has homogenous frequency when constructing the index tracking portfolio. To make up for this limitation, we propose a methodology based on mixed-frequency financial data, called FACTOR-MIDAS-POET model. The proposed model can utilize the intraday return data, daily risk factors data and monthly or quarterly macro economy data, simultaneously. Meanwhile, the out-of-sample analysis demonstrates that our model can improve the tracking accuracy.

PMID:33822827 | DOI:10.1371/journal.pone.0249665

Zdr Varst. 2021 Mar 18;60(2):97-104. doi: 10.2478/sjph-2021-0015. eCollection 2021 Jun.

ABSTRACT

INTRODUCTION: A patient safety culture (PSC) is a complex phenomenon, representing an essential part of the organizational culture and refers to the shared values, conceptions and beliefs which contribute to the formation and encouragement of safe behavioural models in a health organization. With this study, the authors wanted to delineate the attitude of hospital staff in Bulgaria regarding PSC and to document to whether attitudes differ between physicians and other healthcare professionals (HCPs).

METHODS: A national cross-sectional survey among 384 HCPs was conducted using an online version of the Bulgarian version of Hospital Survey on Patient Safety Culture (B-HSOPSC). The data was analysed with descriptive statistics, non-parametric Mann-Whitney U and x 2 tests.

RESULTS: The physicians represented 37.50% (144) of the sample and other HCPs 62.50% (240). Respondents from governmental/municipal hospitals prevailed (53.6%). The dimensions “Staffing” and “Non-punitive response to error” were most problematic, as their percentage of positive response rates (PRRs) were lowest. However, “Handoffs and transitions” and “Supervisor/manager expectations and actions promoting safety” showed the highest mean values in both physicians and other HCPs. From all participants, 76.0% have never reported an adverse event or error.

CONCLUSION: The results of the study show that all respondents demonstrate a positive attitude regarding PSC. A comparison of the mean values and that of PRRs in the dimensions did not show any group differences, according to the type of staff position, i.e. physicians or other HCPs.

PMID:33822831 | PMC:PMC8015657 | DOI:10.2478/sjph-2021-0015

J Spec Pediatr Nurs. 2021 Apr 6:e12334. doi: 10.1111/jspn.12334. Online ahead of print.

ABSTRACT

PURPOSE: For many children, needle procedures are fearful events that are often painful. The first step in symptom management is to assess the child’s pain and fear, and the next step is to use coping strategies to provide symptom relief for children who experience or feel pain and fear during procedures. The Children’s Action-Reaction Assessment Tool (CARAT) is built on action-reaction strategies. This study aimed to determine the inter-rater reliability of the CARAT when used during needle procedures with 3- to 7-year-old children. DESIGN AND METHODS: We used a quantitative approach in which 21 children were observed by two independent observers during needle procedures to evaluate the inter-rater reliability of the CARAT. Data were analysed with descriptive statistics, and the observation scores were calculated with an intraclass correlation coefficient (ICC) test on SPSS for Windows, version 25.

RESULTS: The completed CARAT indicated the use of action-reaction strategies. Neither action nor reaction strategies were frequently used. The parents were seldom involved in the procedure. The inter-rater reliability showed a sufficient correlation between the observers. PRACTICE IMPLICATIONS: This study showed promising results for the inter-rater reliability of the CARAT, which can be used to facilitate care for children. The observational tool can be used to assess the use of action-reaction strategies in conjunction with needle procedures in children aged 3-7 years.

PMID:33821544 | DOI:10.1111/jspn.12334

Clin Otolaryngol. 2021 Apr 5. doi: 10.1111/coa.13763. Online ahead of print.

ABSTRACT

OBJECTIVES: The optimal treatment strategy of combining systemic chemotherapy and radiotherapy for nasopharyngeal carcinoma (NPC) is controversial. This study aimed to compare the efficacy and toxicities of induction chemotherapy followed by intensity-modulated radiotherapy (IC-RT) versus concurrent chemoradiotherapy (CCRT) in NPC.

METHODS: Of 448 stage II-IVb NPC patients treated with IC-RT or CCRT were retrospectively analysed. The primary outcome was overall survival, which was analysed by using Kaplan-Meier curves and log-rank (Mantel-Cox) test.

RESULTS: The median follow-up was 66 months (interquartile range, 46-84 months). There was no statistically significant difference in the estimated 5-year overall survival (OS), progression-free survival (PFS), distance metastasis-free survival (DMFS) and locoregional relapse-free survival (LRFS) between IC-RT group and CCRT group (OS: 89.5% vs 91.7%, P = .568; PFS: 85.2% vs 87.5%, P = .615; DMFS: 90.9% vs 91.7%, P = .847; LRFS: 92.0% vs 96.9%, P = .104). In the multivariate analysis, the treatment group (IC-RT vs CCRT) was not an independent prognostic factor for OS, PFS, DMFS and LRFS. Less advanced tumour stage and lymph node stage were predictive of higher OS. EBV-DNA level was an independent prognostic factor that was only significantly associated with LRFS.

CONCLUSIONS: IC-RT achieves similar survival outcomes and treatment-related toxicities as CCRT in OS, PFS, DMFS and LRFS for patients with NPC. We need multicentre randomised controlled trials to reconfirm our data.

PMID:33821552 | DOI:10.1111/coa.13763

J Obstet Gynaecol Res. 2021 Apr 5. doi: 10.1111/jog.14784. Online ahead of print.

ABSTRACT

AIM: On December 31, 2019, an unknown outbreak of pulmonary disease was reported in China. The novel coronavirus SARS-CoV-2 was the etiologic agent of this disease, and responsible of the current pandemic of COVID-19. Accumulated evidence on placental features is based most on case-reports and small case-series, with differing results.

METHODS: We gathered a cohort of 29 infected pregnant mothers who delivered 32 newborns, and had placentas available for pathologic examination. Placentas were compared with a control group.

RESULTS: Of the 29 mothers, clinical and radiological features were similar to what was already described in COVID-19. Pregnancy modified some analytical parameters. One of the mothers succumbed to the disease. Of the 32 newborns, 1 developed an early infection, with positive reverse-transcriptase polymerase chain reaction (RT-PCR) at 48 h of life, with an initial RT-PCR negative. SARS-CoV-2 presence was assessed on placental tissue with immunohistochemistry and RT-PCR, both were negative. All newborns had good clinical outcomes. No differences in morphological placental findings were found among both groups.

CONCLUSION: Lack of statistically significant differences among case and control groups suggest that placentas from SARS-CoV-2 infected mothers represent a cohort of normal placentas only submitted because of maternal SARS-CoV-2 status. To the best of our knowledge, no irrefutable cases of vertical transmission have been yet described. Other authors have failed to demonstrate presence of viral RNA in placental tissue. Accumulated knowledge suggests that if vertical transmission is possible, it is a rare event.

PMID:33821521 | DOI:10.1111/jog.14784