Tag: pubmed

Rev Bras Ter Intensiva. 2022 Nov 4;34(3):386-392. doi: 10.5935/0103-507X.20220446-pt. eCollection 2022.

ABSTRACT

OBJECTIVE: To analyze the association of patient safety culture perceived by nursing professionals with incidents recorded during nursing shifts in intensive care units.

METHODS: This was a cross-sectional study that investigated patient safety culture measured by the Hospital Survey on Patient Safety Culture instrument. Descriptive statistics, chi-square tests, Student’s t-test and multiple linear regression models were analyzed considering a significance level of 5%.

RESULTS: The study reported a mean of 3.1 (standard deviation of 0.4) for the culture of patient safety in the perception of nursing professionals and 480 incidents with and without damage recorded during the nursing shifts. The variables patient safety culture with a difference between means of 0.543 (95%CI 0.022 – 1.065; p < 0.05) and nursing assistants with a difference between means of -0.133 (95%CI -0.192 – -0.074; p < 0.05) were associated with the incidents recorded during the nursing shifts. Further, nursing assistants had a lower tendency to record incidents than did the nurses.

CONCLUSION: The strengthening of the patient safety culture and the aspects tangential to the nursing professionals represent a possible target for interventions to encourage the recording of incidents during the nursing shift shifts and improve patient safety.

PMID:36351070 | DOI:10.5935/0103-507X.20220446-pt

Rev Bras Ter Intensiva. 2022 Nov 4;34(3):367-373. doi: 10.5935/0103-507X.20220102-pt. eCollection 2022.

ABSTRACT

OBJECTIVE: To evaluate the mechanisms attributed to the prognostic value of peripheral ischemic microvascular reserve in patients with sepsis.

METHODS: This observational cohort study enrolled 46 consecutive septic patients in the intensive care unit between November 2020 and October 2021. After fluid resuscitation, the peripheral ischemic microvascular reserve was evaluated using the association of postocclusion reactive hyperemia with the peripheral perfusion index. Additionally, peripheral venous blood samples were used to evaluate the neuropeptide calcitonin gene-related peptide and substance P levels in the upper limb before and immediately after postocclusion reactive hyperemia.

RESULTS: There was no statistically significant correlation (p > 0.05) between basal values (pg/mL) or variations from neuropeptide levels (%) and the peripheral ischemic microvascular reserve (%).

CONCLUSION: Although calcitonin gene-related peptide and substance P may have a prognostic role in sepsis, these neuropeptides do not appear to contribute to peripheral ischemic microvascular reserve.

PMID:36351068 | DOI:10.5935/0103-507X.20220102-pt

Eur J Cardiovasc Nurs. 2022 Nov 9:zvac106. doi: 10.1093/eurjcn/zvac106. Online ahead of print.

ABSTRACT

AIMS: This integrative review aims to describe the current evidence concerning the relationship between a broad range of psychological factors (depression, depressive symptoms, anxiety, stress, and type-D personality) and self-care in patients with heart failure.

METHODS AND RESULTS: Six electronic databases were searched and keywords were used to identify potential eligible studies published within the last 10 years. To be eligible, individuals with heart failure aged 18 years or older and who were included in any type of observational study that examined the association between psychological factors and self-care were considered. Twenty articles were included, and 16 of them reported that depression/depressive symptoms were associated with poorer self-care, after controlling for age, sex, education level, cardiac history, or comorbidities. Five studies found that self-care confidence/self-efficacy mediates the relationship between depression/depressive symptoms and self-care. The association between depression/depressive symptoms and self-care varied in assessment methods and statistical approaches. Seven studies showed an inverse association between anxiety and self-care. Four studies found a stronger association between self-care and depression compared to the relationship between self-care and other psychological factors. Stress and type-D personality were both associated with self-care in four studies.

CONCLUSIONS: Depression/Depressive symptoms and anxiety were found to be inversely associated with self-care in patients with heart failure. Depression exhibited a stronger impact on self-care than other psychological factors. Limited studies assessed stress and type-D personality; the results should be considered with caution. Further studies are warranted on different psychological factors and their underlying mechanisms in individuals with heart failure.

PMID:36351041 | DOI:10.1093/eurjcn/zvac106

Sci Adv. 2022 Nov 11;8(45):eabm9982. doi: 10.1126/sciadv.abm9982. Epub 2022 Nov 9.

ABSTRACT

Effective policies to halt biodiversity loss require knowing which anthropogenic drivers are the most important direct causes. Whereas previous knowledge has been limited in scope and rigor, here we statistically synthesize empirical comparisons of recent driver impacts found through a wide-ranging review. We show that land/sea use change has been the dominant direct driver of recent biodiversity loss worldwide. Direct exploitation of natural resources ranks second and pollution third; climate change and invasive alien species have been significantly less important than the top two drivers. The oceans, where direct exploitation and climate change dominate, have a different driver hierarchy from land and fresh water. It also varies among types of biodiversity indicators. For example, climate change is a more important driver of community composition change than of changes in species populations. Stopping global biodiversity loss requires policies and actions to tackle all the major drivers and their interactions, not some of them in isolation.

PMID:36351024 | DOI:10.1126/sciadv.abm9982

Eur Heart J. 2022 Nov 9:ehac670. doi: 10.1093/eurheartj/ehac670. Online ahead of print.

ABSTRACT

BACKGROUND: The choice of revascularization with coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) in people with ischaemic left ventricular dysfunction is not guided by high-quality evidence.

METHODS: A trial of CABG versus PCI in people with heart failure was modelled in-silico using routinely collected healthcare data. The in-silico trial cohort was selected by matching the target trial cohort, identified from Hospital Episode Statistics in England, with individual patient data from the STICH trial. Allocation to CABG versus complex PCI demonstrated random variation across administrative regions in England and was a valid statistical instrument. The primary outcome was 5-year all-cause mortality or cardiovascular hospitalization. Instrumental variable analysis (IVA) was used for the primary analysis. Results were expressed as average treatment effects (ATEs) with 95% confidence intervals (CI).

RESULTS: The target population included 13,519 heart failure patients undergoing CABG or complex PCI between April 2009 and March 2015. After matching, the emulated trial cohort included 2046 patients. The unadjusted primary outcome rate was 51.1% in the CABG group and 70.0% in the PCI group. IVA of the emulated cohort showed that CABG was associated with a lower risk of the primary outcome (ATE -16.2%, 95% CI -20.6% to -11.8%), with comparable estimates in the unmatched target population (ATE -15.5%, 95% CI -17.5% to -13.5%).

CONCLUSIONS: In people with heart failure, in-silico modelling suggests that CABG is associated with fewer deaths or cardiovascular hospitalizations at 5 years versus complex PCI. A pragmatic clinical trial is needed to test this hypothesis and this trial would be feasible.

PMID:36350978 | DOI:10.1093/eurheartj/ehac670

JBRA Assist Reprod. 2022 Nov 9. doi: 10.5935/1518-0557.20220043. Online ahead of print.

ABSTRACT

OBJECTIVE: Multiple genetic variants have been studied for years to try to find an association with polycystic ovary syndrome (PCOS). This meta-analysis will investigate if there are associations between increased risk of PCOS and rs6165 polymorphism in follicle stimulating hormone receptor (FSHR) gene and rs2479106 polymorphism in differentially expressed in Differentially Expressed in Normal and Neoplastic Development Isoform 1A (DENND1A) gene.

METHODS: Studies were identified from PubMed library, and case-control studies with correct polymorphisms and available genotype frequencies were included. The statistical analysis is done in Review Manager 5.3, and odds ratio (OR) with corresponding 95% confidence interval (CI) was calculated to see if any association with PCOS exists.

RESULTS: In the study of FSHR gene, eight articles with 1539 cases and 1877 controls were included. No relations were found between PCOS and rs6165 polymorphism in neither the allelic (OR=1.07, 95% CI=0.97-1.19, p=0.18), recessive (OR=1.21, 95% CI=0.98-1.50, p=0.07) nor the dominant (OR=1.05, 95% CI=0.91-1.20, p=0.53) model. The rs2479106 polymorphism in DENND1A gene included 10 studies with 3627 cases and 20325 controls. Only the Asian subgroup in the recessive model (OR=1.84, 95% CI=1.19-2.85, p=0.006) showed a positive relation with PCOS, while associations were not found within the overall results in the allelic (OR=1.09, 95% CI=0.98-1.21, p=0.10), recessive (OR=1.26, 95% CI=0.73-2.19, p=0.41) or the dominant (OR=1.31, 95% CI=1.00-1.71, p=0.05) model.

CONCLUSIONS: This meta-analysis suggests that rs2479106 polymorphism in DENND1A gene is associated with increased risk of PCOS in the Asian population. No relations were found with increased risk of PCOS and rs6165 polymorphism in FSHR gene.

PMID:36350975 | DOI:10.5935/1518-0557.20220043

Braz J Med Biol Res. 2022 Nov 4;55:e12141. doi: 10.1590/1414-431X2022e12141. eCollection 2022.

ABSTRACT

The aim of this study was to compare the frequency of dysplasia and human papillomavirus (HPV) infection in the anal canal of patients with Crohn’s disease (CD) with a control group and assess whether there is a correlation between use of immunosuppressants and anal manifestation of CD. Patients with CD and control individuals were submitted to anal cytology and material collection for polymerase chain reaction (PCR). The cytology was classified as normal, atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), or high-grade (HSIL). PCR was considered positive or negative according to virus presence or absence. A total of 117 patients were included (54 in the control group and 63 in the CD group, being 32 without and 31 with immunosuppressants). ASCUS and LSIL were found in 25.9 and 22.2% of control patients and 28.6 and 39.7% of CD patients. HPV was identified in 14.8% of the control group and 27% of the CD group. In CD patients, HPV was found in 37.5 and 16.1% of those without and with immunosuppressants, respectively. Patients with perianal involvement had 15.6% of PCR positivity. There was no statistical difference in dysplasia and infection by HPV between the groups. Use of immunosuppressants did not influence the result, but anal manifestation was inversely proportional to viral detection.

PMID:36350971 | DOI:10.1590/1414-431X2022e12141

Rev Gaucha Enferm. 2022 Nov 4;43:e20210230. doi: 10.1590/1983-1447.2022.20210230.en. eCollection 2022.

ABSTRACT

OBJECTIVE: To evaluate the effect of using a mobile application on knowledge about human immunodeficiency virus among university students.

METHOD: A before-and-after intervention study, with 196 university students, from August to December 2018. The intervention consisted of using the educ@aids mobile application for 15 days. Univariate analyzes were performed using simple descriptive statistics and the McNemar test was used to compare knowledge before and after the intervention.

RESULTS: There was an improvement in knowledge after using educ@aids in the variables related to knowledge about the transmission of the virus; knowledge about treatment, cure and prevention; knowledge of other information about human immunodeficiency virus.

CONCLUSION: The use of educ@aids increased knowledge about the human immunodeficiency virus among health university students.

PMID:36350963 | DOI:10.1590/1983-1447.2022.20210230.en

Dental Press J Orthod. 2022 Nov 7;27(5):e222067. doi: 10.1590/2177-6709.27.5.e222067.oar. eCollection 2022.

ABSTRACT

OBJECTIVE: The study aimed at determining the antibacterial properties of composites containing silver nanoparticles (Ag NPs) or titanium dioxide nanoparticles (TiO2 NPs), and a fluoride-releasing composite against Streptococcus mutans and Lactobacillus acidophilus, and to evaluate the effect on shear bond strength (SBS) of nanoparticles-modified composites.

MATERIALS AND METHODS: An orthodontic composite was modified by adding 1% w/w Ag NPs or 1% w/w TiO2 NPs. Composite discs were prepared to evaluate the antibacterial properties of these modified composites against Streptococcus mutans and Lactobacillus acidophilus, using three different antibacterial tests, namely: Disk agar diffusion test, Biofilm inhibition test and eluted component test. For evaluating the shear bond strength, 80 extracted premolars were collected and divided into four groups (n=20 each), which were bonded with stainless steel preadjusted Edgewise brackets, by using these modified composites. Their SBS was then compared with that of the control group, using a universal testing machine.

RESULTS: Composite discs containing nanoparticles and fluoride were capable of producing growth inhibition zones for all bacterial types. Results of the biofilm inhibition test showed that all the study groups inhibited the bacterial count, in comparison to the control group. A significant difference of SBS was observed between all groups.

CONCLUSION: The antibacterial activity of orthodontic composites modified with Ag and TiO2 nanoparticles was significant, compared with conventional and fluoride-containing composites. The control group showed the highest SBS, followed by fluoride, titanium, and silver groups, with statistically significant difference in mean SBS values among all groups.

PMID:36350944 | DOI:10.1590/2177-6709.27.5.e222067.oar

JMIR Res Protoc. 2022 Nov 9;11(11):e42681. doi: 10.2196/42681.

ABSTRACT

BACKGROUND: Web-based instruction plays an essential role in health professions education (HPE) by facilitating learners’ interactions with educational content, teachers, peers, and patients when they would not be feasible in person. Within the unsupervised settings where web-based instruction is often delivered, learners must effectively self-regulate their learning to be successful. Effective self-regulation places heavy demands on learners’ motivation, so effective web-based instruction must be designed to instigate and maintain learners’ motivation to learn. Models of motivational design integrate theories of motivation with design strategies intended to create the conditions for motivated engagement. Teachers can use such models to develop their procedural and conceptual knowledge in ways that help them design motivating instruction in messy real-world contexts. Studies such as randomized controlled trials (RCTs) and other quasi-experimental designs that compare different motivational design strategies play a critical role in advancing models of motivational design. Synthesizing the evidence from those studies can identify effective strategies and help teachers and researchers understand the mechanisms governing why strategies work, for whom, and under what circumstances.

OBJECTIVE: The planned review aims to analyze how studies comparing motivational design strategies for web-based instruction in HPE support and advance models of motivational design by (1) controlling for established risks to internal validity, (2) leveraging authentic educational contexts to afford ecological validity, (3) drawing on established theories of motivation, (4) investigating a wide breadth of motivational constructs, and (5) analyzing mediators and moderators of strategy effects.

METHODS: The planned review will use database searching, registry searching, and hand searching to identify studies comparing motivational design strategies for web-based instruction, delivered to learners in HPE. Studies will be considered from 1990 onward. Two team members will independently screen studies and extract data from the included studies. During extraction, we will record information on the design characteristics of the studies, the theories of motivation they are informed by, the motivational constructs they target, and the mediators and moderators they consider.

RESULTS: We have executed our database and registry searches and have begun screening titles and abstracts.

CONCLUSIONS: By appraising the characteristics of studies that have focused on the motivational design of web-based instruction in HPE, the planned review will produce recommendations that will ensure impactful programs of future research in this crucial educational space.

TRIAL REGISTRATION: PROSPERO CRD42022359521; https://tinyurl.com/57chuzf6.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42681.

PMID:36350706 | DOI:10.2196/42681