Tag: nevin manimala

J Nurs Manag. 2021 Oct 26. doi: 10.1111/jonm.13499. Online ahead of print.

ABSTRACT

AIM: To explore the relationships among self-efficacy, information literacy, social support and career success of clinical nurses, and identify factors influencing clinical nurses’ career success in northwestern China.

BACKGROUND: Understanding the influencing factors of career success is important for the professional development of nurses and the improvement of clinical nursing quality. Many influencing factors of career success have been identified, but there is no large-scale research on the relationships among self-efficacy, information literacy, social support and career success of clinical nurses based on Kaleidoscope Career Model. Studies examining the association of the four factors remain limited.

METHODS: A total of 3,011 clinical nurses from 30 hospitals in northwestern China were selected in the cross sectional survey and the response rate was 94.71%. The clinical nurses completed the online self-report questionnaires including self-efficacy, information literacy, social support rating scale and career success scale. The data were analyzed by SPSS23.0 statistical software using t-test, analysis of variance, Pearson’s correlation and multiple linear regression. Structural Equation Model (SEM) was used to analyze the influencing factors of career success using Mplus 8.3.

RESULTS: The career success of clinical nurses in northwestern China was at a medium level. The linear multivariate regression analysis showed that self-efficacy (β=0.513), social support (β=0.230), information support (β=0.106), information consciousness (β=-0.097), information knowledge (β=0.067), information ethics (β=-0.053), hospital grade (β=0.118), marital status (β=-0.071) and age (β=-0.037) entered regression equation of clinical nurses’ career success (all P< 0.05). SEM results showed that the career success was negatively correlated with demographic characteristics, and positively correlated with social support and self-efficacy.

CONCLUSION: Demographic characteristics, self-efficacy, social support and information literacy are the influencing factors of nurses’ career success which should be considered in the process of promoting nurses’ career success.

IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers need to acknowledge the significance of nurses’ career success both for the realization of their own value and for the improvement of clinical nursing quality. They should encourage nurses to enhance self-efficacy and render more social support through incentive policies, and foster nurses’ information literacy through information technology training so as to improve their career success.

PMID:34704641 | DOI:10.1111/jonm.13499

Kardiol Pol. 2021 Oct 27. doi: 10.33963/KP.a2021.0142. Online ahead of print.

ABSTRACT

BACKGROUND: There is a need to develop patient classification methods to adjust post-discharge care, improving survival after ST-segment elevation myocardial infarction (STEMI).

AIMS: The study aimed to determine whether a neural network (NN) is better than logistic regression (LR) in mortality prediction in STEMI patients.

MATERIAL AND METHODS: The study included patients from the Polish Registry of Acute Coronary Syndromes (PL-ACS). Patients with the first anterior STEMI treated with the primary percutaneous coronary intervention (pPCI) of the left anterior descending (LAD) artery between 2009 and 2015 and discharged alive were included in the study. Patients were randomly divided into three groups: learning (60%), validation (20%), and test group (20%). Two models (LR and NN) were developed to predict 6-month all-cause mortality. The predictive values of LR and NN were evaluated with the Area Under the Receiver Operating Characteristics Curve (AUROC), and the comparison of AUROC for learning and test groups was performed. Validation of both methods was performed in the same group.

RESULTS: Out of 175,895 patients with acute coronary syndrome, 17 793 were included in the study. The all-cause 6-month mortality was 5.9%. Both NN and LR had good predictive values. Better results were obtained in the NN approach regarding the models’ statistical quality – AUROC 0.8422 vs 0.8137 for LR (P <0.0001). AUROC in the test groups were 0.8103 and 0.7939, respectively (P = 0.037).

CONCLUSIONS: The neural network may have a better predictive value than logistic regression in patients after the first STEMI.

PMID:34704605 | DOI:10.33963/KP.a2021.0142

Laryngoscope. 2021 Oct 27. doi: 10.1002/lary.29922. Online ahead of print.

ABSTRACT

OBJECTIVES/HYPOTHESIS: To determine the impact of vestibular schwannoma (VS) position relative to the internal auditory canal (IAC) on postoperative facial nerve function and extent of surgical resection.

STUDY DESIGN: Retrospective chart review.

METHODS: Retrospective review of patients undergoing resection of large (≥25 mm) VSs. Outcome measures included early (≤1 month) facial function, long-term (≥1 year) facial function and extent of resection. Tumor measurements included the greatest dimension, dimension anterior to the IAC axis, dimension posterior to the IAC axis, and a ratio of posterior-to-anterior dimension (PA ratio).

RESULTS: A total of 127 patients met inclusion criteria. In early follow-up, 60% patients had good (House-Brackmann I-II), and 40% patients had poor (House-Brackmann III-VI) facial function. In long-term follow-up, 71% patients had good, and 29% patients had poor facial function. A total of 72% of patients underwent gross total resection (GTR) of their tumors. Patients with good facial function had significantly larger PA ratios than patients with poor function both early and long term; however, greatest dimension was the more clearly significant independent predictor of facial outcomes. A larger PA ratio was observed in patients in whom GTR was achieved, but this association was potentially confounded by surgeon preferences and was not statistically significant after controlling for surgical site.

CONCLUSIONS: This study demonstrates that VS position relative to the IAC axis can be used along with tumor size to predict postoperative facial outcomes. A greater proportion of tumor posterior to the IAC axis was associated with significantly better facial outcomes.

LEVEL OF EVIDENCE: 4 Laryngoscope, 2021.

PMID:34704617 | DOI:10.1002/lary.29922

Cardiovasc J Afr. 2021 Oct 11;32:1-5. doi: 10.5830/CVJA-2021-047. Online ahead of print.

ABSTRACT

AIM: In this study, we aimed to investigate the effect of the single aortic cross-clamp technique (SCT) (aortic cross-clamp only) versus the multiple-clamp technique (MCT) (aortic cross-clamp + side-biting clamp) on postoperative stroke in octogenarians undergoing coronary artery bypass grafting (CABG).

METHODS: A total of 171 patients aged 80 years and older who underwent isolated CABG were retrospectively analysed. The patients were divided into two groups according to the technique used during surgery: group 1 (n = 88) received the SCT, and group 2 (n = 83) received the MCT. Postoperative stroke was evaluated.

RESULTS: Of the patients, 127 were men and 44 were women. The mean age was 83.05 ± 8.81 years in group 1 and 82.14 ± 8.92 years in group 2. There was no statistically significant difference in the rate of postoperative stroke between the two techniques (p > 0.05).

CONCLUSIONS: Postoperative stroke in octogenarians may result from not only the cross-clamp technique used but also several other factors. We found that both techniques yielded similar outcomes.

PMID:34704588 | DOI:10.5830/CVJA-2021-047

J Pers Assess. 2021 Oct 27:1-13. doi: 10.1080/00223891.2021.1991359. Online ahead of print.

ABSTRACT

The extent to which morality and being a moral person are important to one’s identity is most commonly assessed using Aquino and Reed’s (2002) Self-Importance of Moral Identity Scale (SIMIS). This study provided detailed psychometric examinations of the structure and discrimination levels of the SIMIS in a large (N = 2108) and heterogeneous sample. Results indicated that the SIMIS is clearly 2-dimensional, as expected. The Internalization and Symbolization subscales provided sufficient, and sometimes high levels of test information across the latent trait continuums. There were no redundant items and no bias based on gender. The most notable, albeit minor, shortcomings were that there are too many response options and that test information (discrimination power) was diminished at high levels of the Internalization latent trait continuum, apparently due to skewness. The fluctuating levels of measurement precision resulted in slightly greater attenuations in effect sizes for Internalization than for Symbolization across data for 31 other measures. The present findings from a large dataset and a variety of modern, revealing statistical methods provided relatively consistent, favorable findings for the measure.

PMID:34704515 | DOI:10.1080/00223891.2021.1991359

J Obstet Gynaecol. 2021 Oct 27:1-5. doi: 10.1080/01443615.2021.1962820. Online ahead of print.

ABSTRACT

The rising caesarean section (CS) rate is a complex issue, particularly in an increasingly heterogenous nulliparous population. The study aim was to stratify the CS rate in nulliparous women by age and BMI to determine if any difference existed. This was a retrospective review of CS procedures of nulliparous women in two centres in Ireland (2014 through 2017). Data were obtained for 17,177 women from the hospital databases and CS procedures determined for each age and BMI category. Significant differences were observed when CS rates were stratified in this manner. The CS rates for women <20 years/BMI < 18.5 was 8.8 versus 57.6% for women 35 – 39 years/BMI 30 – 34 and 76 – 100% for all women >45 years (p<.005). The development of customised charts subdivided by age and BMI may be a useful counselling tool and assist in the comparison of rates between units.Impact statementWhat is already known on this subject? It is well known that along with rising CS rates globally, there have also been significant changes in maternal demographics-with increasing maternal age at first birth and increasing maternal BMI. It is well established that both of these factors affect the rate of CS in a population.What do the results of this study add? This study sought to stratify the CS rate in nulliparous women by age and BMI to determine if any difference existed. The results of the study showed an increasing CS rate for increasing age and BMI categories that was statistically significant.What are the implications of these findings for clinical practice and/or further research? Additional research using larger population data sets could allow the development of customised charts for nulliparous women subdivided by age and BMI which could act as a useful counselling tool in clinical practice, as well as assist in the comparison of CS rates between units.

PMID:34704524 | DOI:10.1080/01443615.2021.1962820

ESC Heart Fail. 2021 Oct 26. doi: 10.1002/ehf2.13673. Online ahead of print.

ABSTRACT

AIMS: Some risk assessment tools have been developed to categorize mortality risk in heart transplant recipients, but it is unclear whether these tools can be used interchangeable in different transplant regions.

METHODS AND RESULTS: We performed a retrospective single-centre study in 1049 adult German heart transplant recipients under jurisdiction of Eurotransplant. Univariable and multivariable Cox regression analysis was used to generate a risk scoring system. C-statistics were used to compare our score with a US score and a French score regarding their ability to discriminate between 1 year survivors and non-survivors within our study cohort. Of 38 parameters assessed, seven recipient-specific parameters [age, height, dilated cardiomyopathy (DCM), ischaemic cardiomyopathy (ICM), total bilirubin, extracorporeal membrane oxygenation (ECMO), and biventricular assist device/total artificial heart (BVAD/TAH) implant], one donor-specific parameter (cold ischaemic time), and one recipient-independent and donor-independent other parameter (late transplant era) were statistically significant in predicting 1 year mortality. The initial score was generated by using the regression coefficients from the multivariable analysis as follows: 1.70 * ln age – 4.0 * ln height – 0.9 * diagnosis (= 1 if diagnosis = DCM) – 0.67 * diagnosis (= 1 if diagnosis = ICM) + 0.33 * ln total bilirubin + 1.74 * ln cold ischaemic time + 0.98 * mechanical circulatory support (MCS) implant (= 1 if MCS implant = ECMO) + 0.47 * MCS implant (= 1 of MCS implant = BVAD/TAH) – 0.66 * transplant era (= 1 if transplant era = 2017-2018). The initial score was converted into the Bad Oeynhausen (BO) score as a positive integer variable by means of the following formula: BO score = (initial score + 8) * 3. In patients scoring 2 to <7 points (n = 112), 7 to <11 points (n = 580), 11 to <15 points (n = 339), and 15 to 20 points (n = 18), 1 year survival was 93.1%, 84.2%, 66.9%, and 27.8%, respectively. The c-index of our score was 0.73 [95% confidence interval (CI): 0.69-0.77]. Values were in our cohort for the US and French scores 0.66 (95% CI: 0.62-0.70) and 0.63 (95% CI: 0.59-0.67), respectively.

CONCLUSIONS: Data indicate that our score, but also risk assessment tools from other transplant regions, may be used as a reliable support for risk-adjusted organ allocation and potentially help to improve outcomes in heart transplantation. Further developments will have to include as yet unaccounted risk factors for even more reliable predictions.

PMID:34704397 | DOI:10.1002/ehf2.13673

Nurs Open. 2021 Oct 26. doi: 10.1002/nop2.1099. Online ahead of print.

ABSTRACT

AIMS AND OBJECTIVES: To trial three mobile translation apps in the healthcare setting to address language barriers in everyday care between healthcare staff and older people with limited English proficiency (LEP).

DESIGN: A mixed-methods exploratory study.

METHODS: A two-month trial of three translation apps was conducted across four aged-care hospital wards. Observed interactions during use of translation apps were recorded, and staff surveys regarding the use of translation apps were collected at the end of the trial. Data were analysed using descriptive statistics and thematic content analysis of open-ended responses in the surveys and observations. Findings from the thematic content analysis are reported using the Standards for Reporting of Qualitative Research (SRQR) checklist.

RESULTS: Translation apps were mostly used for identifying pain and assisting with activities of daily living. Qualitative findings revealed that translation apps aided staff in providing care and improved rapport; however, practical shortcomings were identified.

PMID:34704379 | DOI:10.1002/nop2.1099

Clin Exp Dent Res. 2021 Oct 26. doi: 10.1002/cre2.507. Online ahead of print.

ABSTRACT

OBJECTIVES: Decontamination of biofilm-colonized rough implant surfaces remains challenging. We investigated the effect of airflow with glycine powder (AFG) on decontamination of mature oral multispecies biofilm from a sandblasted and acid etched (SLA) titanium surface.

MATERIALS AND METHODS: Subgingival dental plaque was cultured on SLA disks anaerobically for 21 days. AFG with various settings and distances was applied directly on the disks with or without previous rinse of 0.9% NaCl. The specimens were then analyzed through scanning electron microscope and remaining bacteria on the implant surface were quantified and statistically compared.

RESULTS: Mature oral biofilm with cocci and rods as major morphotypes, as well as spiral- and filamentous-shaped organisms, was formed on the untreated disks. Saline rinsing removed the thick biofilm layer but left numerous of coccoid bacteria in rough surface pits. AFG effectively removed most of the bacteria from the pits. Both 25% and 50% power settings were equally effective at 3-mm distance. With 50% power, AFG successfully removed bacteria at both 3- and 6-mm distance. When AFG was applied on native biofilm without prior rinsing with saline, it effectively removed the biofilm including bacteria in the pits.

CONCLUSION: Application of AFG appears effective in removing bacteria from rough implant surfaces.

PMID:34704380 | DOI:10.1002/cre2.507

J Surg Educ. 2021 Oct 23:S1931-7204(21)00271-3. doi: 10.1016/j.jsurg.2021.10.002. Online ahead of print.

ABSTRACT

OBJECTIVE: Prior to 2015 residents in our Accreditation Council for Graduation Medical Education (ACGME) colon and rectal surgery training program were in charge of managing, with faculty oversight, the outpatient anorectal clinic at our institution. Starting in 2015 advanced practice providers (APPs) working in the division assumed management of the clinic. The effect of APPs on ACGME resident index diagnostic case volumes has not been explored. Herein we examine ACGME case log graduate statistics to determine if the inclusion of APPs into our anorectal clinic practice has negatively affected resident index diagnostic anorectal case volumes.

DESIGN: ACGME year-end program reports were obtained for the years 2011 to 2019. Program anorectal diagnostic index volumes were recorded and compared to division volumes. Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) tests were conducted to assess whether the number of cases per year (for each respective case type) prior to the introduction of APPs into the anorectal clinic (2011-2014) differed from the number of cases per year with the APP clinic in place (2015-2018). A p-value <0.05 was considered statistically significant.

SETTING: Mayo Clinic, Rochester, Minnesota (quaternary referral center).

PARTICIPANTS: Colon and rectal surgery resident year-end ACGME reports (2011-2019).

RESULTS: ANOVAs revealed a marginally significant (p = 0.007) downtrend for hemorrhoid diagnostic codes, and a significant uptrend (p = 0.000) for fistula cases. Controlling for overall division volume, ANCOVA only reveled significance for fistula cases (p = 0.004) with the involvement of APPs.

CONCLUSIONS: At our institution we found the inclusion of APPs into our anorectal clinic practice did not negatively affect colon and rectal surgery resident ACGME index diagnostic anorectal case volumes. Inclusion of APPs into a multidisciplinary practice can promote resident education by allowing trainees to pursue other educational opportunities without hindering ACGME index case volumes.

PMID:34702690 | DOI:10.1016/j.jsurg.2021.10.002