Tag: nevin manimala

Prehosp Disaster Med. 2021 Jul 1:1-9. doi: 10.1017/S1049023X21000601. Online ahead of print.

ABSTRACT

OBJECTIVE: Performance feedback on clinical care and patient outcomes is a cornerstone of medical education, yet it remains lacking in the prehospital environment. Research seeking to establish the quantity of feedback provided to Emergency Medical Services (EMS) has been limited and studies focused on complimentary feedback or how feedback relates to EMS job satisfaction are lacking. The objectives of this study were to measure the frequency and nature of feedback received by EMS agencies and to identify the importance of receiving feedback as it relates to EMS job satisfaction.

METHODS: This was an anonymous, survey-based study of twenty-nine Basic Life Support (BLS) and fifteen Advanced Life Support (ALS) agencies located in Southeastern Minnesota (USA). Descriptive statistics and Fisher exact tests were used. The study was deemed exempt by the Mayo Clinic Institutional Review Board.

RESULTS: Ninety-four responses were included from nineteen different EMS agencies, including sixty-one (64.9%) paramedics and thirty-three (35.1%) emergency medical technicians (EMTs). One-half of all respondents reported that they had not received any type of feedback in the past 30 days, while another 43.6% of respondents indicated that they had only received feedback one to three times in the same time period. Twenty (60.6%) EMTs reported receiving no feedback in the past 30 days, compared with twenty-seven (44.3%) paramedics (P = .123). Of respondents receiving feedback, 65.9% reported never or rarely receiving positive reinforcing feedback and 60.6% reported never or rarely receiving constructive criticism or feedback regarding something that did not go well with patient care or transport. The majority of respondents were dissatisfied with the quantity (86.1%) and quality (73.4%) of feedback received. An overwhelming majority (93.6%) indicated that feedback on patient care or outcomes was important in influencing their overall job satisfaction. This high importance was maintained across all demographic groups.

CONCLUSION: Within the cohort of survey respondents, a paucity of feedback received by EMS personnel is a source of dissatisfaction for EMS providers. Feedback on patient care strongly relates to overall job satisfaction. These findings suggest system-wide opportunities for structured feedback processes, focusing upon both quality and quantity of delivered feedback, to improve both patient care and staff satisfaction.

PMID:34193330 | DOI:10.1017/S1049023X21000601

Antimicrob Resist Infect Control. 2021 Jun 30;10(1):101. doi: 10.1186/s13756-021-00967-y.

ABSTRACT

BACKGROUND: Vancomycin‑resistant Staphylococcus aureus (VRSA) is a serious public health challenging concern worldwide.

OBJECTIVES: Therefore, the objective of present study of 62 published studies was to evaluate the prevalence of VRSA based on different years, areas, isolate source, antimicrobial susceptibility testing, and the genetic determinants.

METHODS: We searched the relevant articles that focused on the prevalence rates of VRSA in PubMed, Scopus, Embase, and Web of Science from 2000 to 2019. Statistical analyses were conducted using STATA software (version 14.0).

RESULTS: The prevalence of VRSA was 2% before 2006, 5% in 2006-2014, and 7% in 2015-2020 that showed a 3.5-fold increase in the frequency of VRSA between before 2006 and 2020 years. The prevalence of VRSA was 5% in Asia, 1% in Europe, 4% in America, 3% in South America, and 16% in Africa. The frequencies of VRSA isolated from clinical, non-clinical, and mixed samples were 6%, 7%, and 14%, respectively. The prevalence of VRSA was 12% using disk diffusion agar method, 7% using MIC-base methods, and 4% using mixed-methods. The prevalence of vanA, vanB, and vanC1 positive were 71%, 26%, and 4% among VRSA strains. The most prevalent genotype was staphylococcal cassette chromosomemec (SCCmec) II, which accounted for 57% of VRSA. The most prevalent staphylococcal protein A (spa) types were t002, t030, and t037.

CONCLUSION: The prevalence of VRSA has been increasing in recent years particularly in Africa/Asia than Europe/America. The most prevalent of genetic determinants associated with VRSA were vanA and SCCmec II. This study clarifies that the rigorous monitoring of definite antibiotic policy, regular surveillance/control of nosocomial-associated infections and intensive surveillance of vancomycin-resistance are required for preventing emergence and further spreading of VRSA.

PMID:34193295 | DOI:10.1186/s13756-021-00967-y

Ir Vet J. 2021 Jun 30;74(1):19. doi: 10.1186/s13620-021-00199-x.

ABSTRACT

Chlamydia spp. are prevalent zoonotic pathogens that infect a wide variety of host species. Chlamydia abortus (C. abortus) infection in yaks has been reported in Gansu and Qinghai province, China. However, no data about C. abortus infection are available in yaks in Tibet, China. A total of 938 serum samples was collected from yaks in Tibet, China and specific antibodies against C. abortus were detected by the enzyme-linked immunosorbent assay (ELISA). The results showed that the overall seroprevalence of C. abortus in yaks was 104/938 (11.1 %, 95 % confidence interval [CI] 9.1-13.1). The prevalence in female and male yaks was 59/556 (10.6 %, 95 % CI 8.0-13.2) and 45/382 (11.8 %, 95 % CI 8.5-15.0), respectively with no significant difference (p > 0.05). The seroprevalence of antibodies to C. abortus in yaks ranged from 8.0 to 18.2 % among the six different areas, and the difference was also without statistical significance (p > 0.05). The prevalence among different age groups ranged from 7.0 to 15.9 %, with a higher prevalence among 1 to 2 years age category. The results demonstrate the presence of C. abortus infection in yaks in Tibet and may pose a risk for the general yak populations in addition to its potential impact on public health and the local Tibetan economy. To our knowledge, this is the first seroprevalence survey of C. abortus in yaks in Tibet, China.

PMID:34193296 | DOI:10.1186/s13620-021-00199-x

Contracept Reprod Med. 2021 Jul 1;6(1):19. doi: 10.1186/s40834-021-00161-w.

ABSTRACT

BACKGROUND: Dual contraceptive is the use of a barrier like condom along with any modern contraceptive methods which has double significance for the prevention STI including HIV and unintended pregnancy. The prevalence and determinants of dual contraceptive utilization described by different studies were highly inconsistent in Ethiopia. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence and determinants of dual contraceptive utilization among HIV positive women in Ethiopia.

METHODS: International database mainly Pub Med, Google scholar, HINARI, EMBASE, Cochrane Library, AJOL was applied to identify original studies. STATA software version 14 was applied to analyze the pooled prevalence of dual contraceptive. I² test statistics was computed to check the presence of heterogeneity across the studies and eggers test was used to identify publication bias. The pooled prevalence of dual contraceptive utilization was estimated by using a random effects model. The associations between determinants and dual contraceptive utilization were evaluated by using both random and fixed effect models.

RESULT: A total 9 studies with 9168 HIV positive women were enrolled in this study. The pooled prevalence of dual contraceptive utilization among HIV positive women in Ethiopia was 26.14% (95% CI 21.20-31.08). Disclosure of HIV status (OR = 4.18,95%CI:2.26-7.72), partner involvement in post-test counselling (OR = 2.31,95%CI:1.63-3.25), open discussion about dual contraceptive with partner (OR = 4.27 95% CI:1.69-10.77), provision of counselling on dual contraceptives by health care provider (OR = 4.47,95% CI:3.81-5.24) and CD4 count > 350 cells/ mm³ (OR = 3.87,95%CI:3.53-4.23) were among the significant factors associated with dual contraceptive utilization.

CONCLUSION: The overall prevalence of dual contraceptive utilization among HIV positive women was significantly low. Disclosure of HIV status, partner involvement in post-test counselling, open discussion about dual contraceptive with partner, counselling on dual contraceptive by health care provider and CD4 count > 350 cells/ mm³ were positively affect dual contraceptive utilization. This study implies the need to develop plans and policies to improve partner involvement posttest counseling, integrate the counseling and provision of dual contraceptive at ART clinic at each level of health system.

PMID:34193304 | DOI:10.1186/s40834-021-00161-w

Contracept Reprod Med. 2021 Jul 1;6(1):21. doi: 10.1186/s40834-021-00163-8.

ABSTRACT

BACKGROUND: Malawi is one of the countries in SSA with the highest TFR. This study aimed to explore factors associated with modern contraceptive use and intention to use contraceptives among women of reproductive ages (15-49 years) in Malawi.

METHODS: The study used secondary data from 2015 to 16 Malawi Demographic and Health Survey (MDHS) dataset. Logistic regression models were used to derive adjusted odd ratios as the measures of association between need, predisposing and enabling factors, and contraceptive use and the intention to use contraceptives among women. The sample constituted 24,562 women who were successfully interviewed during the MDHS. All comparisons are considered statistically significant at 5% level.

RESULTS: Overall 54.8% of women were currently using contraceptives, while 69.1% had the intention to use contraceptives. The odds of contraceptive use were significantly low among, women aged 15-19 years, 20-24 years, 25-29 years, 30-34 years, 35-39 years and 40-44 years compared to women aged 45-49 years; women of Tonga ethnic group (OR = O.60, CI = 0.43 0.84) compared to women of Nyanga ethnic group; women from poor households (OR = 0.78, CI = 0.68-0.90) and middle income households (OR = 0.84, CI = 0.74-0.95) compared to women from rich household. Nonetheless, women with no past experience of terminated pregnancy (OR = 1.50, CI = 1.34-1.68) were more likely to use contraceptives compared to women with past experience of terminated pregnancy. Similarly, Women with primary education (OR = 1.56, CI = 1.16-2.09) and secondary education (OR = 1.39, CI = 1.04-1.85) were more likely to use contraceptives compared to women with higher education. While the odds of intending to use contraceptives were significantly high with age only thus among women aged 15-19 years, (OR = 15.18, CI = 5.94-38.77); 20-24 years (OR = 16.77, CI = 7.46-37.71); 25-29 years (OR = 6.75, CI = 3.16-14.45); 30-34 years (OR = 7.75, CI = 3.61-16.65) and 35-39 years (OR = 5.05, CI = 2.29-11.12) compared to women aged 45-49 years.

CONCLUSION: As direct policy measure; information, education and communication programmes on family planning among poor and middle income women, and all women in reproductive ages should be strengthened.

PMID:34193289 | DOI:10.1186/s40834-021-00163-8

Mov Ecol. 2021 Jun 30;9(1):34. doi: 10.1186/s40462-021-00270-w.

ABSTRACT

BACKGROUND: Reintroducing predators is a promising conservation tool to help remedy human-caused ecosystem changes. However, the growth and spread of a reintroduced population is a spatiotemporal process that is driven by a suite of factors, such as habitat change, human activity, and prey availability. Sea otters (Enhydra lutris) are apex predators of nearshore marine ecosystems that had declined nearly to extinction across much of their range by the early 20th century. In Southeast Alaska, which is comprised of a diverse matrix of nearshore habitat and managed areas, reintroduction of 413 individuals in the late 1960s initiated the growth and spread of a population that now exceeds 25,000.

METHODS: Periodic aerial surveys in the region provide a time series of spatially-explicit data to investigate factors influencing this successful and ongoing recovery. We integrated an ecological diffusion model that accounted for spatially-variable motility and density-dependent population growth, as well as multiple population epicenters, into a Bayesian hierarchical framework to help understand the factors influencing the success of this recovery.

RESULTS: Our results indicated that sea otters exhibited higher residence time as well as greater equilibrium abundance in Glacier Bay, a protected area, and in areas where there is limited or no commercial fishing. Asymptotic spread rates suggested sea otters colonized Southeast Alaska at rates of 1-8 km/yr with lower rates occurring in areas correlated with higher residence time, which primarily included areas near shore and closed to commercial fishing. Further, we found that the intrinsic growth rate of sea otters may be higher than previous estimates suggested.

CONCLUSIONS: This study shows how predator recolonization can occur from multiple population epicenters. Additionally, our results suggest spatial heterogeneity in the physical environment as well as human activity and management can influence recolonization processes, both in terms of movement (or motility) and density dependence.

PMID:34193294 | DOI:10.1186/s40462-021-00270-w

Microbiome. 2021 Jun 30;9(1):152. doi: 10.1186/s40168-021-01070-5.

ABSTRACT

BACKGROUND: The human microbiota plays several roles in health and disease but is often difficult to determine which part is in intimate relationships with the host vs. the occasional presence. During the Mars500 mission, six crewmembers lived completely isolated from the outer world for 520 days following standardized diet regimes. The mission constitutes the first spaceflight simulation to Mars and was a unique experiment to determine, in a longitudinal study design, the composition and importance of the resident vs. a more variable microbiota-the fraction of the human microbiota that changes in time and according to environmental conditions-in humans.

METHODS: Here, we report the characterization of the salivary microbiota from 88 samples taken during and after Mars500 mission for a total of 720 days. Amplicon sequencing of the V3-V4 regions of 16S rRNA gene was performed, and results were analyzed monitoring the diversity of the microbiota while evaluating the effect of the three main variables present in the experimental system: time, diet, and individuality of each subject.

RESULTS: Results showed statistically significant effects for either time, diet, and individuality of each subject. The main contribution came from the individuality of each subject, emphasizing salivary microbiota-personalized features, and an individual-based resilience of the microbiota.

CONCLUSIONS: The uniqueness of Mars500 mission, allowed to dampen the effect of environmental variables on salivary microbiota, highlighting its pronounced personalization even after sharing the same physical space for more than a year. Video abstract.

PMID:34193273 | DOI:10.1186/s40168-021-01070-5

BMC Res Notes. 2021 Jun 30;14(1):254. doi: 10.1186/s13104-021-05672-y.

ABSTRACT

OBJECTIVE: To evaluate in-vitro quality of paracetamol 500 mg tablet brands marketed in Saudi Arabia.

RESULTS: Two reference (R1 and R2) and seven generic (G1-G7) brands were commercially available. Four brands were single-drug, containing paracetamol only (R1, G1-G3) and five contained additional active ingredients (R2, G4-G7). All brands were immediate-release. Weight variation (n = 20, range as percent difference from mean), active substance content (n = 20, mean (SD) as percent difference from label), breaking force (n = 10, mean (SD)), and friability (n = 20, as percent weight loss) ranged from 97 to 102%, 96.1% (2.9%) to 99.8% (1.1%), 9.9 (0.4) to 21.0 (0.9) kg, and 0.017% to 0.809%, respectively. Disintegration (water medium) time (n = 6, minute: second) ranged from 02:35-03:09 to 12:49-13:10. Dissolution (phosphate buffer, pH 5.8) profile showed a mean release at 30 min of 87% to 97% of label content, with seven brands passing stage-1 (≥ 85% for each of 6 test units) and two passing stage-2 (mean of 12 test units ≥ 85%) criteria. Despite statistically significant differences between R1 and R2 and some of their corresponding generic brands in active substance content, breaking force, and amount dissolved at 30 min, all nine brands met the pre-specified quality standards.

PMID:34193274 | DOI:10.1186/s13104-021-05672-y

Cancer Imaging. 2021 Jun 30;21(1):45. doi: 10.1186/s40644-021-00416-4.

ABSTRACT

OBJECTIVES: To evaluate gadoxetic acid-enhanced liver MRI (EOB-MRI) versus contrast-enhanced computed tomography (CECT) for preoperative detection of liver metastasis (LM) and reduction of open-close laparotomies for pancreatic ductal adenocarcinoma (PDAC).

METHODS: Sixty-six patients with PDAC had undergone preoperative EOB-MRI and CECT. LM detection by EOB-MRI and CECT and their impact on surgical planning, open-close laparotomies were compared by clinical and radiology reports and retrospective analysis of imaging by two blinded independent readers. Histopathology or imaging follow-up was the reference standard. Statistical analysis was performed at patient and lesion levels with two-sided McNemar tests.

RESULTS: EOB-MRI showed higher sensitivity versus CECT (71.7% [62.1-80.0] vs. 34% [25.0-43.8]; p = 0.009), comparable specificity (98.6%, [96.9-99.5] vs. 100%, [99.1-100], and higher AUROC (85.1%, [80.4-89.9] vs. 66.9%, [60.9-73.1]) for LM detection. An incremental 7.6% of patients were excluded from surgery with a potential reduction of up to 13.6% in futile open-close laparotomies due to LM detected on EOB-MRI only.

CONCLUSIONS: Preoperative EOB-MRI has superior diagnostic performance in detecting LM from PDAC. This better informs surgical eligibility with potential reduction of futile open-close laparotomies from attempted curative intent pancreatic cancer surgery.

PMID:34193282 | DOI:10.1186/s40644-021-00416-4

BMC Sports Sci Med Rehabil. 2021 Jun 30;13(1):71. doi: 10.1186/s13102-021-00300-5.

ABSTRACT

BACKGROUND: The “FIFA 11 + Shoulder” programme has been reported to reduce the incidence of upper extremity injuries among soccer goalkeepers. It has also been recommended for overhead sports. The purpose of this study was therefore to investigate the effect of an 8-week “FIFA 11 + shoulder” (11 + S) programme on shoulder joint position sense (JPS), threshold to detect passive motion (TTDPM) and upper quarter Y Balance Test in young male volleyball players.

METHODS: Thirty-two healthy young elite male volleyball players (17.49 ± 1.47 years) participated in this quasi-experimental study. Participants, recruited from two clubs participating in Iranian premier league, were randomly assigned into two groups; (1) the intervention group who performed the “FIFA 11 + shoulder” programme as their warm up protocol, three times per week, and (2) the control group who kept their routine warm up protocol meanwhile. Proprioception tests including JPS and TTDPM of internal and external rotator muscles of the dominant shoulder were recorded via the isokinetic system pro 4. The upper quarter Y Balance Test determined the shoulder dynamic stability.

RESULTS: No statistically significant differences were observed for JPS and TTDPM of shoulder internal and external rotator muscles; shoulder stability however significantly increased only in the intervention group (p = 0.03, ηp²=0.02).

CONCLUSION: Upper quarter dynamic stability improvement due to the 11+S programme leads to volleyball players’ performance and may therefore contribute to a reduction in risk of sustaining injury if applied long-term.

TRIAL REGISTRATION: The trial was retrospectively registered atIranian Registry of Clinical Trials with the number of IRCT20201030049193N1 at 04/12/2020.

PMID:34193267 | DOI:10.1186/s13102-021-00300-5