Tag: pubmed

Transl Psychiatry. 2021 Apr 19;11(1):226. doi: 10.1038/s41398-021-01265-2.

ABSTRACT

Psychotic experiences (PE) are associated with poorer functioning, higher distress and the onset of serious mental illness. Environmental exposures (e.g. childhood abuse) are associated with the development of PE. However, which specific exposures convey risk for each type or dimension of PE has rarely been explored. The Oxford Wellbeing Life and Sleep (OWLS) survey includes 22 environmental risk factors for psychosis and was designed to examine how environmental risks are associated with specific dimensions of PE. Multivariate logistic regression models were fit using these risk factors to predict six dimensions of PE (perceptual abnormalities, persecutory ideation, bizarre ideas, cognitive disorganisation, delusional mood and negative symptoms). Models were built using only 70% of the data, and then fit to the remaining data to assess their generalisability and quality. 1789 (27.2% men; mean age = 27.6; SD = 10.9) survey responses were analysed. The risk factors predictive of the most PE were anxiety, social withdrawal during childhood and trauma. Cannabis and depression predicted three dimensions with both predicting bizarre ideas and persecutory ideation. Psychological abuse and sleep quality each predicted two dimensions (persecutory ideation and delusional mood). Risk factors predicting one PE dimension were age (predicting cognitive disorganisation), physical abuse (bizarre ideas), bullying and gender (persecutory ideation); and circadian phase (delusional mood). These results lend support for a continuum of psychosis, suggesting environmental risks for psychotic disorders also increase the risk of assorted dimensions of PE. Furthermore, it advocates the use of dimensional approaches when examining environmental exposures for PE given that environmental risks distribute differently across dimensions.

PMID:33875641 | DOI:10.1038/s41398-021-01265-2

Sex Transm Infect. 2021 Apr 19:sextrans-2020-054875. doi: 10.1136/sextrans-2020-054875. Online ahead of print.

ABSTRACT

BACKGROUND: Global data show that transgender people (TGP) are disproportionally affected by HIV and sexually transmitted infections (STIs); however, data are scarce for Western European countries. We assessed gender identities, sexual behaviour, HIV prevalence and STI positivity rates, and compared these outcomes between TGP who reported sex work and those who did not.

METHODS: We retrospectively retrieved data from all TGP who were tested at the STI clinics of Amsterdam and The Hague, the Netherlands in 2017-2018. To identify one’s gender identity, a ‘two-step’ methodology was used assessing, first, the assigned gender at birth (assigned male at birth (AMAB)) or assigned female at birth), and second, clients were asked to select one gender identity that currently applies: (1) transgender man/transgender woman, (2) man and woman, (3) neither man nor woman, (4) other and (5) not known yet. HIV prevalence, bacterial STI (chlamydia, gonorrhoea and/or infectious syphilis) positivity rates and sexual behaviour were studied using descriptive statistics.

RESULTS: TGP reported all five categories of gender identities. In total 273 transgender people assigned male at birth (TGP-AMAB) (83.0%) and 56 transgender people assigned female at birth (TGP-AFAB) (17.0%) attended the STI clinics. Of TGP-AMAB, 14,6% (39/267, 95% CI 10.6% to 19.4%) were HIV-positive, including two new diagnoses and bacterial STI positivity was 15.0% (40/267, 95% CI 10.9% to 19.8%). Among TGP-AFAB, bacterial STI positivity was 5.6% (3/54, 95% CI 1.2% to 15.4%) and none were HIV-positive. Sex work in the past 6 months was reported by 53.3% (137/257, 95% CI 47.0% to 59.5%) of TGP-AMAB and 6.1% (3/49, 95% CI 1.3% to 16.9%) of TGP-AFAB. HIV prevalence did not differ between sex workers and non-sex workers.

CONCLUSION: Of all TGP, the majority were TGP-AMAB of whom more than half engaged in sex work. HIV prevalence and STI positivity rates were substantial among TGP-AMAB and much lower among TGP-AFAB. Studies should be performed to provide insight into whether the larger population of TGP-AMAB and TGP-AFAB are at risk of HIV and STI.

PMID:33875565 | DOI:10.1136/sextrans-2020-054875

Hosp Pediatr. 2021 Apr 19:hpeds.2020-002345. doi: 10.1542/hpeds.2020-002345. Online ahead of print.

ABSTRACT

OBJECTIVES: Poor communication is a major contributor to sentinel events in hospitals. Suboptimal communication between physicians and nurses may be due to poor understanding of team members’ roles. We sought to evaluate the impact of a shadowing experience on nurse-resident interprofessional collaboration, bidirectional communication, and role perceptions.

METHODS: This mixed-methods study took place at 2 large academic children’s hospitals with pediatric residency programs during the 2018-2019 academic year. First-year residents and nurses participated in a reciprocal, structured 4-hour shadowing experience. Participants were surveyed before, immediately after, and 6 months after their shadowing experience by using an anonymous web-based platform containing the 20-item Interprofessional Collaborative Competency Attainment Survey, as well as open-ended qualitative questions. Quantitative data were analyzed via linear mixed models. Qualitative data were thematically analyzed.

RESULTS: Participants included 33 nurses and 53 residents from the 2 study sites. The immediate postshadowing survey results revealed statistically significant improvements in 12 Interprofessional Collaborative Competency Attainment Survey question responses for nurses and 19 for residents (P ≤ .01). Subsequently, 6 questions for nurses and 17 for residents revealed sustained improvements 6 months after the intervention. Qualitative analysis identified 5 major themes related to optimal nurse-resident engagement: effective communication, collaboration, role understanding, team process, and patient-centered.

CONCLUSIONS: The reciprocal shadowing experience was associated with an increase in participant understanding of contributions from all interprofessional team members. This improved awareness may improve patient care. Future work may be conducted to assess the impact of spread to different clinical areas and elucidate patient outcomes that may be associated with this intervention.

PMID:33875534 | DOI:10.1542/hpeds.2020-002345

RMD Open. 2021 Apr;7(2):e001510. doi: 10.1136/rmdopen-2020-001510.

ABSTRACT

OBJECTIVE: The role of alcohol in inflammatory disease remains debated. This study explores the relationship between alcohol and disease activity in patients with inflammatory arthritis.

METHODS: Patients attending a rheumatology clinic between 2010 and 2020 were prospectively followed. Information on demographics, alcohol use, smoking habits and disease outcome measures were collected from these patients. Statistical analysis included univariate and multivariate linear and binary logistic regressions, Mann-Whitney U tests and one-way analysis of variance with Tukey’s honest significant difference (HSD) test.

RESULTS: Of the 979 analysed patients, 62% had rheumatoid arthritis (RA), 26.7% had psoriatic arthritis (PsA) and 11.2% had ankylosing spondylitis. Mean DAS28-CRP (Disease Activity Score 28 – C-reactive protein) in RA and PsA at 1 year was 2.96±1.39, and 64.2% of patients were in remission (DAS28-CRP ≤2.6 or BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) ≤4). Both male gender and risky drinking (>15 units of weekly alcohol) were significantly associated with remission. Compared with women, men had an OR of 1.8 (1.1, 2.5) (p=0.034) for any alcohol consumption and 6.9 (4.7, 9.1) (p=0.001) for drinking at least 15 weekly drinks. When adjusted for gender, there was no association between alcohol and disease activity. Yet, when adjusted for alcohol consumption, gender still significantly influenced disease activity.

CONCLUSION: While it may appear that alcohol is linked to remission in inflammatory arthritis, when adjusted for gender, it is not. Men with inflammatory arthritis drink significantly more than women and have less severe disease activity.

PMID:33875561 | DOI:10.1136/rmdopen-2020-001510

J Dent Hyg. 2021 Apr;95(2):58-62.

ABSTRACT

Purpose: Poor ergonomics is one of the leading factors in developing musculoskeletal disorders. The purpose of this study was to evaluate the level of forward neck flexion of dental hygiene students during manual scaling procedures while wearing magnification loupes and investigate the prevalence of musculoskeletal neck pain.Methods: convenience sample of second year dental hygiene students was recruited for this observational study (n=24). A goniometer application was used to measure levels of neck flexion, while wearing dental loupes, 30 minutes into a manual scaling procedure. Participants completed a McGill Pain Questionnaire with a body diagram and an additional survey at the end of the session. Descriptive statistics were used to analyze the data.Results: All participants’ showed neck flexion exceeding 20° at the conclusion of a 30-minute manual scaling procedure. A majority (67%) were in a compromised range and 33% were in a harmful range. The top five pain descriptors identified in the pain questionnaire were aching, tiring-exhausted, throbbing, tender, and heavy. Pain was identified in the shoulder/trapezius (63%), cervical (50%), scapular (36%); and the participants’ reported pain ranging from 1 to 7.Conclusion: Fifty percent of the participants experienced cervical neck pain when exceeding a forward neck flexion of more than 20° during a manual scaling procedure. The shoulder/trapezius and cervical regions were most frequently identified as the location of pain or problems. An early prevalence of musculoskeletal pain in was observed in this sample population of dental hygiene students.

PMID:33875531

J Dent Hyg. 2021 Apr;95(2):63-70.

ABSTRACT

Purpose: Health science students have an increased source of stress due to the rigorous curriculum, high clinical expectations, and academic demands. The purpose of this study was to determine the effectiveness of a 15-minute yoga intervention to reduce stress in entry-level dental hygiene students.Methods: First year dental hygiene students were invited to participate in the experimental study (n=32) and were randomly assigned to either the experimental or control group. The stress reduction intervention (gentle yoga movements, breathing, and meditation) was performed prior to each final exam for a total of six times. The control group proceeded with their usual pre-exam routines. Baseline and post-trial blood pressure, pulse and 10-item Perceived Stress Scale (PSS) data were recorded for both groups. Repeated measures of blood pressure and pulse were recorded before and after yoga for the experimental group and the control group prior to each exam. Data analyses included Paired-samples t-test, Independent-samples t-test and ANOVA, (p=0.05).Results: The main effect for yoga from pre- to post-session was statistically significant for blood pressure (p=0.02 systolic; p=0.02 diastolic) but not for pulse (p=0.23). Significant effects on blood pressure measures showed yoga movement sessions reduced stress however the effects sizes were small. The paired t-tests indicated the 10-item PSS values were significantly lower (p<0.00). Statistical significance of differential, beneficial effects of yoga versus control were not demonstrated.Conclusion: Fifteen-minutes of yoga movements had feasibility, compliance, and appeared to have positive effects related to stress reduction. No evidence of statistical significance was demonstrated compared to the control. Research on a larger sample of entry-level dental hygiene students using yoga movements over the course of a semester is recommended.

PMID:33875532

J Dent Hyg. 2021 Apr;95(2):28-35.

ABSTRACT

Purpose: There is limited research about the job satisfaction (JS), burnout (BO), and intention to leave (ITL) amongst dental hygienists in clinical practice providing patient care. The purpose of this study was to explore current trends and the factors influencing JS, BO, and ITL among dental hygienists in their current positions.Methods: A cross-sectional research study was conducted with a convenience sample of dental hygienists recruited via social media sites. The web-based survey consisted of three previously validated instruments (Job Satisfaction Survey, Oldenburg Burnout Inventory, and Turnover Intention Scale). Descriptive statistics were used to analyze the data.Results: The survey completion rate was 77% (n=554). Job satisfaction and burnout were associated with five factors related to ITL: frustration, achieving personal-work related goals, considering leaving, accepting another job, job satisfying personal needs, and looking forward to another day at work. Findings indicated that higher levels of JS (β=-0.95, p<0.001) predicted decreased ITL while disengagement (β=0.79, p<0.001) and exhaustion (β=0.29, p<0.001) predicted an increase in ITL (F(3, 554)=141.63, R²=0.44, p<0.001). Increased JS predicted a decrease in willingness to accept another job (β=-0.55, p<0.001). Disengagement predicted a higher willingness to accept another job (β=0.60, p<0.001) however exhaustion did not (β=0.09, p<0.001; F(3, 554)=46.89, R²=0.20, p<0.001 ).Conclusion: Findings suggest there is overall job satisfaction amongst dental hygienists in clinical practice with the exception of the lack of fringe benefits and opportunities for promotion. Employers may need to identify ways to address these concerns to retain qualified dental hygienists. In addition, employers need to be proactive in addressing factors impacting burnout and dental hygienists’ intent to leave their positions.

PMID:33875527

J Dent Hyg. 2021 Apr;95(2):42-49.

ABSTRACT

Purpose: Human papillomavirus (HPV)-related oropharyngeal cancers (OPC) have significantly increased over the past three decades despite vaccine availability to prevent carcinogenic HPV types. Dental hygienists are well-positioned to provide HPV counsel to patients; however, most do not feel prepared to do so. The purpose of this study was to examine HPV content inclusion in dental hygiene program curricula in the United States (US).Methods: Dental hygiene program directors in the US were invited to participate in an electronic survey (n=309). The 20-item survey assessed the curricular content related to HPV as well as the faculty training in this area. Descriptive statistics were used to analyze the data.Results: Ninety surveys were returned for a response rate of 29%. Most programs spent up to 2 hours on HPV content. Students across all institutional settings received education on OPC risk factors (66.3%); HPV screening, referral, and management (78.7%); HPV vaccine knowledge (79.8%); and communication skills about HPV (77.5%). The majority of HPV-related content was taught by dental hygiene faculty, although dentists, oral pathologists or medical specialists were involved across all institutional settings.Conclusion: Results indicate that dental hygiene programs, regardless of institutional setting, provide two hours or less of HPV didactic content and clinical application. More research is needed to confirm the adequate time and teaching strategies required to assure that dental hygienists are well-prepared to address HPV preventive strategies.

PMID:33875529

J Dent Hyg. 2021 Apr;95(2):50-57.

ABSTRACT

Purpose: Legislative advocacy provides an avenue through which oral health disparities and alternative methods of delivering oral health care to underserved populations can be addressed. The purpose of this study was to assess advocacy knowledge, values, actions and perceived barriers of undergraduate and graduate students enrolled in a leadership course with a Legislative Advocacy Project (LAP).Methods: A pre-test/post-test online questionnaire was administered to a convenience sample of undergraduate and graduate dental hygiene students to measure advocacy knowledge, values, and actions resulting from participation in a LAP (n=38). Descriptive statistics assessed the average responses of perceived barriers. Two open-ended questions asked about participation in advocacy and providing feedback regarding the LAP.Results: Both groups (undergraduate, n=25; graduate, n=13) demonstrated a statistically significant change from the pre-test/post-test assessment of knowledge, values, and actions (p<0.001). No statistically significant differences were identified when comparing undergraduate and graduate level responses, pre-test and post-test scores and undergraduate and graduate level responses, and perceived barriers. The three greatest barriers were lack of time to participate in legislative activities, lack of comfort speaking to legislators and testifying before legislators. Responses to the open-ended questions suggested learning in the three lower levels of the affective domain.Conclusions: Knowledge, values, and actions were increased following the LAP. Strategies to address ongoing barriers should be implemented in advocacy curricula. The LAP was influential in integrating cognitive knowledge and changing receiving, responding, and valuing levels of the affective domain. An Affective Advocacy Model was developed based on the analysis of responses to the open-ended questions and current literature.

PMID:33875530

Diabetes Care. 2021 Apr 19:dc201794. doi: 10.2337/dc20-1794. Online ahead of print.

ABSTRACT

OBJECTIVE: Emerging data from animal and human pilot studies suggest potential benefits of glucagon-like peptide 1 receptor agonists (GLP-1RA) on lung function. We aimed to assess the association of GLP-1RA and chronic lower respiratory disease (CLRD) exacerbation in a population with comorbid type 2 diabetes (T2D) and CLRD.

RESEARCH DESIGN AND METHODS: A new-user active-comparator analysis was conducted with use of a national claims database of beneficiaries with employer-sponsored health insurance spanning 2005-2017. We included adults with T2D and CLRD who initiated GLP-1RA or dipeptidyl peptidase 4 inhibitors (DPP-4I) as an add-on therapy to their antidiabetes regimen. The primary outcome was time to first hospital admission for CLRD. The secondary outcome was a count of any CLRD exacerbation associated with an inpatient or outpatient visit. We estimated incidence rates using inverse probability of treatment weighting for each study group and compared via risk ratios.

RESULTS: The study sample consisted of 4,150 GLP-1RA and 12,540 DPP-4I new users with comorbid T2D and CLRD. The adjusted incidence rate of first CLRD admission during follow-up was 10.7 and 20.3 per 1,000 person-years for GLP-1RA and DPP-4I users, respectively, resulting in an adjusted hazard ratio of 0.52 (95% CI 0.32-0.85). For the secondary outcome, the adjusted incidence rate ratio was 0.70 (95% CI 0.57-0.87).

CONCLUSIONS: GLP-1RA users had fewer CLRD exacerbations in comparison with DPP-4I users. Considering both plausible mechanistic pathways and this real-world evidence, potential beneficial effects of GLP-1RA may be considered in selection of an antidiabetes treatment regimen. Randomized clinical trials are warranted to confirm our findings.

PMID:33875487 | DOI:10.2337/dc20-1794