Tag: pubmed

J Patient Saf. 2024 Dec 23. doi: 10.1097/PTS.0000000000001305. Online ahead of print.

ABSTRACT

OBJECTIVES: To analyze the aspects of suicide risks and their relation to patient safety attitudes among the nursing staff of a large public university hospital in Brazil.

METHODS: A cross-sectional and descriptive study with 226 nursing workers from a large public university hospital in Brazil. Socioprofessional information, health conditions, and family history related to suicide risk were collected through the Mini International Neuropsychiatric Interview Plus and the Safety Attitudes Questionnaire. A 95% CI was considered, and statistical tests such as the Student t test, χ2, analysis of variance, and multiple linear regression were used.

RESULTS: Most of the safety attitudes were below the average score considered positive (mean Safety Attitudes Questionnaire value >0.75), and 41 (18.1%) workers were considered to have any degree of suicide risk. Participants with parents or siblings who had attempted suicide were 3.44 times more likely to have moderate or high suicide risk. Negative safety attitudes were associated with health conditions and family history, considered suicide risk factors. Participants with moderate or high suicide risk were 2.83 times more likely to have worse patient safety attitudes concerning job satisfaction.

CONCLUSIONS: This study reveals significant associations between patient safety attitudes and the mental health of nursing workers, expanding the view of worker health management actions and, consequently, patient safety culture.

PMID:39705531 | DOI:10.1097/PTS.0000000000001305

Int J Periodontics Restorative Dent. 2024 Dec 20;0(0):1-17. doi: 10.11607/prd.7384. Online ahead of print.

ABSTRACT

PURPOSE: This study is designed to explore the effect of Er,Cr:YSGG laser tooth etching versus that of conventional tooth surface treatment on the shear bond strength of ceramic laminate veneers.

METHODS: Seventy-six maxillary premolars were assigned to two groups (n = 38) according to the type of enamel surface treatment approach. Group 1: samples treated with the conventional acid-etch protocol. Group 2: samples subjected to Er,Cr:YSGG laser. Light-curing resin cement was used to bond the restoration to the tooth and specimens were thermocycled for 30,000 cycles. Shear bond strength testing was conducted on all the specimens. The samples were observed using a scanning electron microscope to record enamel topography and a stereomicroscope to monitor the mode of failure. P ≤ 0.05 was considered significant.

RESULTS: There were no statistically significant differences between the acidetch and laser enamel surface treatment groups for the shear bond strength values at maximum load (MPa) (p-value = .627). There was a significantly higher proportion of cohesive failure in the acid-etch group compared to the laser treatment group and a significantly lower proportion of mixed failure in group 1 compared to group 2 (p-value = .022).

CONCLUSIONS: Concerning the bond strength of the laminate veneer, the effects of laser and traditional acid etching on the enamel surface were the same. Enamel surfaces can be successfully etched using a laser as an alternative to the traditional acid-etch method.

PMID:39705512 | DOI:10.11607/prd.7384

Psychol Rep. 2024 Dec 20:332941241308776. doi: 10.1177/00332941241308776. Online ahead of print.

ABSTRACT

Intimate partner violence (IPV) might increase the risk of depression, traumatic stress and affect cognitive performance. We analyzed the cognitive performance, psychological factors, and personality traits of 136 Brazilian women (n = 70 exposed to IPV and n = 66 non-exposed) aged 18 years or older. We utilized clinical interviews, the NEO Personality Inventory, and a neuropsychological testing battery. The statistical analyses employed moderation within variables, resulting in determination coefficients (r²) of 0.15 and 0.35. The husband was the primary aggressor, physical violence was the most frequent (90.6%). Women exposed to IPV exhibited more symptoms of post-traumatic stress disorder (PTSD), depression, neuroticism, difficulties in visual memory, and visuospatial abilities. The analysis indicated the influence of IPV, neuroticism, PTSD, and depression on the cognitive performance of the exposed to IPV.

PMID:39705508 | DOI:10.1177/00332941241308776

Clin Infect Dis. 2024 Dec 20:ciae632. doi: 10.1093/cid/ciae632. Online ahead of print.

ABSTRACT

BACKGROUND: Little is known about how symptoms or symptom clusters of Post-COVID Conditions (PCC) impact an individual’s return to pre-COVID health.

METHODS: We used four state-level COVID-19 case reporting systems and patient-reported survey data to identify patients with PCC and associations with an individual’s return to pre-COVID health after laboratory-confirmed SARS-CoV-2 infection. Participants had a positive SARS-CoV-2 test between March-December 2020. Weighted regression models were used to 1) estimate prevalence of PCC; 2) identify risk factors associated with developing PCC; and 3) examine associations between PCC symptom clusters and return to pre-COVID health. Factor analysis was used to statistically identify post-COVID symptom clusters.

FINDINGS: Prevalence of PCC in this population-based sample was 29·9% for persons with SARS-CoV-2 infection, during the pre-delta variant period (March-December 2020); 77·2% of persons experiencing PCC had not returned to pre-COVID health within 8-60 weeks after infection. Female sex, acute COVID-19 illness severity, and number of pre-existing comorbidities were significant risk factors associated with PCC. Myalgic encephalomyelitis/chronic fatigue syndrome-like symptoms, upper-respiratory symptoms, and gastrointestinal symptoms were significantly associated with not returning to pre-COVID health.

INTERPRETATION: Understanding PCC symptom clustering may provide insight into pathophysiology, severity of PCC, and management for patients who have not returned to their usual state of health after SARS-CoV-2 infection. Tracking PCC can help measure the impact of COVID-19 vaccination and acute COVID-19-specific treatments on reducing PCC in the US.

PMID:39705503 | DOI:10.1093/cid/ciae632

Medicine (Baltimore). 2024 Dec 20;103(51):e40888. doi: 10.1097/MD.0000000000040888.

ABSTRACT

This study investigated the potential association between uranium exposure and mortality from cerebrovascular diseases, with a focus on the mediating effects of lipid indicators. Employing recommended sampling weights to account for National Health and Nutrition Examination Survey’ complex survey design, this analysis drew from data collected between 2005 and 2016. The study examined the impact of uranium on mortality from cerebrovascular diseases using various statistical approaches, including Cox regression to assess linear relationships within metal mixtures. It also evaluated the role of lipid-adjusted plutonium (LAP) as a mediator and verified the persistence of associations across different subgroups. The study encompassed 4312 participants and established a significant direct link between uranium levels and mortality from cerebrovascular diseases (hazard ratio (95%CI) = 20.4243 (20.1347-20.7181), P = .0266). It also identified LAP as a mediating factor in the relationship, accounting for a mediated proportion of 1.35%. The findings highlight a pivotal connection between uranium exposure and increased mortality due to cerebrovascular diseases, with LAP playing a significant intermediary role.

PMID:39705492 | DOI:10.1097/MD.0000000000040888

Medicine (Baltimore). 2024 Dec 20;103(51):e41004. doi: 10.1097/MD.0000000000041004.

ABSTRACT

Pharmacists, as an integral part of the healthcare team, can play a crucial role in preventing drug-related problems in patients with chronic kidney disease that arise due to inappropriate doses. This study aimed to develop and validate a new tool, the renal dosing questionnaire (RDQ-13), for pharmacists working across hospital, community, and retail pharmacy settings. A cross-sectional study was conducted from January to March 2023 among pharmacists working in different settings. The RDQ-13 scale consists of 3-sections, encompassing demographic details, a knowledge section with 6 domains, each having 4 questions with the choice of “yes/no,” an attitude section featuring a Likert scale for 4 items, and a perception section featuring a Likert scale for 3 items. The assessment of construct and discriminative validity was performed along with testing for reliability. The average variance extracted value and the composite reliability value were used for convergent validity. A total of 65 pharmacists completed the RDQ-13, but at retest n = 2 participants were dropped (response rate at retest was 96.9%). Exploratory factor analysis revealed 3-factor loadings with 59.1% of the variance, whereas the Kaiser-Mayer-Olkin value was 0.60. The Cronbach alpha value of 0.700 indicates good internal consistency, whereas the intraclass correlation coefficient (ICC) for the test and retest showed that most domains/scores were statistically significant (P < .001), showing an excellent agreement between the test and retest. The RDQ-13 underwent extensive validation through a cross-sectional survey, demonstrating high content and face validity. The scale showed consistent responses over time (test-retest stability) and good internal consistency.

PMID:39705490 | DOI:10.1097/MD.0000000000041004

Thyroid. 2024 Dec 20. doi: 10.1089/thy.2024.0270. Online ahead of print.

ABSTRACT

Background: Several meta-analyses have found no association between Graves’ disease (GD) and an increased risk of incident diabetes; however, the intricate relationship between thyroid dysfunction and diabetes remains underexplored. In this study, we aimed to evaluate the risk of incident type 2 diabetes (T2DM) in a population newly diagnosed with GD, focusing on different treatment methods and treatment duration. Methods: This was a retrospective population-based study utilizing data from the Korean National Health Insurance database. We included 36,243 patients with GD and 36,243 controls, matched with age and sex. We calculated the incidence of T2DM among patients and controls based on treatment methods, such as medical therapy, radioactive iodine therapy (RAIT), and surgery. We examined the cumulative dose and duration of antithyroid drug (ATD) use for each patient. Results: The majority of patients (34,867, 96.2%) were treated with ATDs, followed by RAIT (1093 patients, 3%), and surgery (283 patients, 0.8%). After adjusting for age; sex; income; comorbidities, including hypertension, dyslipidemia, and cancer; body mass index; smoking; drinking; and exercise, patients with GD exhibited a higher risk of developing diabetes (hazard ratio [HR] = 1.13 [95% confidence interval 1.06-1.21]) than controls (5.1% vs. 4.5%, respectively). While the risk was the highest within the first six months after GD diagnosis (HR = 3.21), it was significant between six months and two years (HR = 1.36) and was comparable with the controls two years after GD diagnosis (HR = 0.93). A longer duration of ATD treatment and a higher cumulative dose were associated with an increased risk of diabetes. However, the risks for T2DM did not differ according to treatment modality or clinical outcomes, which was probably related to the small number of patients in each subgroup. Conclusions: Our findings highlight the negative impact of GD on the development of T2DM. Patients newly diagnosed with GD can be considered for diabetes screening to facilitate early detection and intervention.

PMID:39705078 | DOI:10.1089/thy.2024.0270

Curr Med Res Opin. 2024 Dec 20:1-9. doi: 10.1080/03007995.2024.2438996. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to describe clinical characteristics-including blood counts and pharmacologic cytoreductive treatment patterns-and outcomes after 6 months of hydroxyurea (HU) treatment among patients with polycythemia vera (PV) in US community practices.

METHODS: This retrospective observational study included adult patients with a PV diagnosis (1JAN2008-31JAN2020) and ≥2 postdiagnosis visits in the iKnowMed electronic health record database (US Oncology Network and non-Network clinics). Suboptimal HU response required ≥1 criterion after ≥3 months of treatment: white blood cell count (WBC) >10 × 10⁹/L, platelet count >400 × 10⁹/L, and/or hematocrit >45%. Patient characteristics were summarized from structured data using descriptive statistics; overall survival was assessed by Kaplan-Meier method.

RESULTS: Among 5871 patients, mean age at diagnosis was 66.1 years (69.8% ≥60 years); 67.2, 59.4, 38.2, and 33.9% of patients had elevated hematocrit, hemoglobin, WBC, and platelets, respectively; 6.1% had a previous thrombotic event. Of 4185 (71.3%) high-risk and 1675 low-risk patients, 55.0 and 32.0% received pharmacologic cytoreductive treatment, most commonly HU (89.8 and 88.9%). After 6 months of pharmacologic cytoreductive treatment, 56.9% had a suboptimal response. Five-year survival probability was 81.5 and 84.3% among patients with suboptimal and optimal responses to HU, respectively, which was not statistically different but suggests potential for survival benefits with longer follow-up.

CONCLUSION: Nearly half of high-risk patients with PV did not receive pharmacologic cytoreductive treatment. Of those who did, over half had suboptimal response, suggesting these patients may need dose adjustments, improved adverse effect management, or alternative treatments. Longer follow-up may be needed to assess an association between HU response and survival.

PMID:39705076 | DOI:10.1080/03007995.2024.2438996

J Strength Cond Res. 2024 Dec 19. doi: 10.1519/JSC.0000000000005023. Online ahead of print.

ABSTRACT

Molina, R, Lapresa, D, Arana, J, Álvarez, I, and Salazar, H. Wellness and session rating of perceived exertion in professional basketball players within different weekly contexts. J Strength Cond Res XX(X): 000-000, 2024-The objective of this article was to analyze the level of well-being-through the wellness questionnaire-and the training load-based on the session rating of perceived exertion (sRPE)-in professional basketball players within different weekly contexts during the season 2020/2021. The team analyzed played 2 competitions: Endesa League (Asociación de Clubes de Baloncesto)-the highest level of competition in Spain-and the Basketball Champions League at the European level. Non-parametric statistics have been used because of the size of the sample and the ordinal nature of the scores. The contrast of related groups has not been significant for the wellness variable, remaining stable scores throughout different weekly contexts (weeks without competition, regular weeks with 1 game, and congested weeks with 2 or more games). Regarding the training load results, a significant effect size has been found in the contrast of medians depending on the proximity to the game in regular weeks and congested weeks, while in weeks without competition, moments of load alternation have been detected. This work is an example of the practical application of the wellness-sRPE relationship as an effective indicator within the week periodization.

PMID:39705063 | DOI:10.1519/JSC.0000000000005023

JAMA Health Forum. 2024 Dec 6;5(12):e244544. doi: 10.1001/jamahealthforum.2024.4544.

ABSTRACT

IMPORTANCE: Concerns around excessive opioid prescribing have been used to argue against the expansion of the scope of practice of nurse practitioners (NPs), but the association of NP practice independence with high-risk opioid prescribing is not well understood.

OBJECTIVE: To assess whether the rates of high-risk opioid prescribing changed in association with NP independence legislation.

DESIGN, SETTING, AND PARTICIPANTS: This difference-in-differences analysis compared rates of high-risk opioid prescribing in 6 states over 2 years following the adoption of NP independence compared with 10 neighboring nonadopting states from January 2012 to December 2021. Prescription insurance claims for 2 874 213 continuously enrolled individuals (members) aged 18 to 64 years from Blue Cross Blue Shield Axis were analyzed. Data analysis was carried out from 2021 to 2024.

EXPOSURE: Timing of the legislative effective date of NP independence in a state.

MAIN OUTCOMES AND MEASURES: The primary outcome was the rate of opioid prescriptions that overlapped with a prescription for a central nervous system (CNS) depressant. Secondary outcomes included the number of days of opioid-CNS depressant overlap, as well as the dosage and days supplied of opioids among all members and among opioid-naive members.

RESULTS: Six states that adopted NP independence legislation and 10 nonadopting neighboring states were similar in terms of demographic characteristics and had comparable pretrends in prescribing. The estimated change in the rate of opioid prescriptions that overlapped with a CNS depressant was -0.03 per 100 members per month (95% CI, -0.11 to 0.05). Changes in the number of days of opioid-CNS depressant overlap and in the dosage and days supplied of opioids among all members and among opioid-naive members were also small and statistically insignificant.

CONCLUSIONS AND RELEVANCE: The results of this difference-in-differences analysis suggest that there was no relative increase in rates of high-risk opioid prescribing during the 2 years following the adoption of independence for NPs.

PMID:39705044 | DOI:10.1001/jamahealthforum.2024.4544