Tag: pubmed

Gen Psychiatr. 2020 Nov 5;33(6):e100294. doi: 10.1136/gpsych-2020-100294. eCollection 2020.

NO ABSTRACT

PMID:34192237 | PMC:PMC7646317 | DOI:10.1136/gpsych-2020-100294

Gen Psychiatr. 2021 Mar 19;34(2):e100368. doi: 10.1136/gpsych-2020-100368. eCollection 2021.

ABSTRACT

BACKGROUND: Experiencing a pandemic can be very unsettling and may have a negative impact on the mental health of frontline healthcare workers (HCWs). This may have serious consequences for the overall well-being of HCWs, which in turn may adversely affect patient safety and the productivity of the institution.

AIMS: We designed a study to assess the prevalence of generalised anxiety disorder (GAD), depression and work-related stress experienced by the National Health Service staff in a large tertiary London hospital treating patients with COVID-19 during the current active phase of the COVID-19 era.

METHODS: An anonymous survey was designed with demographic data and three questionnaires. The Generalised Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 were used to assess anxiety and depression, respectively. The Health and Safety Executive Management Standards Indicator Tool was used to assess work-related stress. Staff from multiple specialties embracing cardiothoracic surgery, cardiology, respiratory medicine, endocrinology, oncology, imaging, anaesthesia and intensive care at our hospital were asked to complete the questionnaire between 25 May and 15 June 2020.

RESULTS: A total of 302 staff members (106 males and 196 females) completed the survey. The overall prevalence of GAD and depression was 41.4% and 42.7%, respectively. The prevalence of GAD and depression was significantly higher in females than in males and was statistically significant. Nurses were four times more likely to report moderate to severe levels of anxiety and depression as compared with doctors. Work-related stress was also observed to be prevalent in our surveyed population with the following standards: relationships, role, control and change showing a need for improvement.

CONCLUSIONS: Our study presents early evidence suggestive of a high prevalence of GAD, depression and work-related stress in HCWs. It is imperative that coherent strategies are implemented to improve the healthcare work environment during this pandemic and mitigate further injury to the mental health status of the healthcare population.

PMID:34192241 | PMC:PMC7987534 | DOI:10.1136/gpsych-2020-100368

S Afr J Physiother. 2021 May 10;77(1):1542. doi: 10.4102/sajp.v77i1.1542. eCollection 2021.

ABSTRACT

BACKGROUND: The limited data regarding dysphagia in high-level spinal cord injuries (SCIs) stem from economically developed countries. Dysphagia is prevalent in patients with cervical SCI; however, in a South African context, speech-language pathologists (SLPs) are not seen as key when managing this population. This may result in patients not being screened or identified early, leading to possible complications. The literature could provide useful insight on how best to address this clinical gap.

OBJECTIVES: The aim of my study was to conduct a scoping review on the description of dysphagia, the risk factors for developing dysphagia post-SCI and the practice patterns of team members working with dysphagia in cervical SCIs.

METHODS: A five-step scoping review was undertaken. Data were analysed by using descriptive statistics as well as a thematic analysis by using a top-down approach.

RESULTS: Through the process of screening according to the inclusion and exclusion criteria, 25 articles were included. Primarily, the pharyngeal phase was affected, which can lead to an aspiration pneumonia. The key risk factors were the presence of a tracheostomy tube, the use of ventilation and anterior spinal cord surgery. There was little mention regarding specific practice patterns, but an interdisciplinary approach was suggested as the most efficient model.

CONCLUSIONS: Specific guidelines and management options need to be considered for a South African context, given the high incidence of trauma-related injuries. There needs to be locally produced research, providing suggestions on how different team members can screen and identify dysphagia within this population. Solutions need to be unique, and contextually responsive and appropriate.

CLINICAL IMPLICATIONS: The team members and the roles of these different team members need to be re-examined in order to ensure the early identification and management of cervical SCI patients who are at risk of developing a dysphagia.

PMID:34192210 | PMC:PMC8182465 | DOI:10.4102/sajp.v77i1.1542

S Afr J Physiother. 2021 May 17;77(1):1544. doi: 10.4102/sajp.v77i1.1544. eCollection 2021.

ABSTRACT

BACKGROUND: Shifting from face-to-face teaching to incorporating technology may prepare students better for future work as health professionals. Evidence of blended teaching’s effect on the academic performance of undergraduate physiotherapy students’ performance is scarce.

OBJECTIVE: The purpose of our study was to determine students’ theoretical and clinical performance in a blended teaching module compared to their own performance in two knowledge areas taught face to face, and student perceptions of blended teaching in the third-year physiotherapy curriculum.

METHODS: The cross-sectional study design included 47 third-year physiotherapy students. The orthopaedic module was delivered using a blended teaching approach in two consecutive semesters, whilst two other physiotherapy knowledge areas, neuromusculoskeletal and cardiopulmonary, in the same semesters were delivered face to face. Theoretical and clinical performances of students were compared for significance and effect. Students were assessed on their theoretical and clinical knowledge in all areas using the same assessment methods. The students (n = 43) also completed a survey on their blended teaching experience.

RESULTS: Significantly higher theoretical marks for orthopaedics were calculated compared to neuromusculoskeletal and cardiopulmonary for both semesters with a large positive effect (average Cohen d = 4.44) for blended teaching on theoretical examination performance; no statistically significant difference for clinical performances. Students felt engaged in the blended teaching process, and 72% preferred blended teaching over face-to-face teaching or online delivery.

CONCLUSION: Blended teaching improved the theoretical marks, demonstrating that knowledge acquisition was improved, but not clinical performance.

CLINICAL IMPLICATIONS: The study contributes to the knowledge base of blended learning in Health Science Education in South Africa. The authors identified a gap where future studies should investigate the effect of blended learning on clinical performance outcomes as a continuation from this one.

PMID:34192211 | PMC:PMC8182468 | DOI:10.4102/sajp.v77i1.1544

BMJ Paediatr Open. 2021 Feb 4;5(1):e000971. doi: 10.1136/bmjpo-2020-000971. eCollection 2021.

ABSTRACT

BACKGROUND: In Belgium, schools closed during the first lockdown in March 2020, with a partial reopening in May. They fully reopened in September. During the summer, infections started to increase in the general population, speeding up in September. Some measures were taken to limit social contacts but those were insufficient to mitigate the exponential rise of infections in October. Children were still receiving all lessons at school at that time and it was questioned whether this position was tenable. We systematically compared the benefits and harms of closing primary and secondary schools and developed a recommendation.

METHODS: A multidisciplinary panel, including school pupils and teachers, educational experts, clinicians and researchers, produced this recommendation in compliance with the standards for trustworthy rapid guidelines. The recommendation is based on data collected through national surveillance or studies from Belgium, and supported by a rapid literature review.

RESULTS: Closing schools during the first lockdown probably resulted in a large learning delay and possibly led to more cases of child abuse. We are uncertain about the effect on the infection rate, hospitalisations, transmission rates, mental health of children, teachers and parents. The panel concluded that the balance of benefits and harms of closing schools clearly shifts against closing schools. Detrimental effects are even worse for vulnerable children. This recommendation is affected by the local virus circulation.

CONCLUSION: The guideline panel issues a strong recommendation against closing schools when the virus circulation is low to moderate, and a weak recommendation against closing schools when the virus circulation is high. It does not apply when the school system cannot function due to lack of teachers, too many children who are at home or a shortage of support services. As the results of international studies are consistent with Belgian study results, this recommendation may also be relevant internationally.

PMID:34192193 | PMC:PMC7868123 | DOI:10.1136/bmjpo-2020-000971

S Afr J Physiother. 2021 May 18;77(1):1524. doi: 10.4102/sajp.v77i1.1524. eCollection 2021.

ABSTRACT

BACKGROUND: A limited number of studies on the epidemiology of injuries and fitness profiles of netball players in South Africa have been conducted, but no research on the potential morphological and skill-related fitness predictors of injuries could be located.

OBJECTIVES: We investigated whether morphological or skill-related factors measured in the pre-season could predict injuries sustained in-season.

METHOD: In our cohort study, 77 under-18 (U18), U19, U21 and senior elite netball players underwent pre-season testing including anthropometry, balance, flexibility, explosive power, upper and lower body strength, core strength, speed and agility testing. A questionnaire was used to collect demographic data, elite-level experience and injury history. Injuries in pre-season, training and matches were recorded during the subsequent 2017-2018 season using an injury profile sheet.

RESULTS: Amongst the 77 players who underwent pre-season fitness tests, 33 players (42.9%) had at least one injury. Regarding player morphology, a significant association of body mass and body fat percentage with injury risk was found in a simple logistic regression. In a multiple logistic regression analysis, only fat percentage (p = 0.0508) remained a significant predictor of injury at the 10% significance level, with higher fat percentage being associated with lower injury risk.

CONCLUSION: Heavier players and players with a higher fat percentage had a decreased injury risk.

CLINICAL IMPLICATIONS: As a result of the apparent protective effect of heavier weight of players, referees should more strictly enforce the no-contact rule in netball. Further research on functional movement screening as a tool for potential prediction of injury in netball is recommended.

PMID:34192207 | PMC:PMC8182463 | DOI:10.4102/sajp.v77i1.1524

S Afr J Physiother. 2021 May 31;77(1):1536. doi: 10.4102/sajp.v77i1.1536. eCollection 2021.

ABSTRACT

BACKGROUND: Metacarpal fractures, one of the most prevalent upper limb fractures, account for 10% of all bony injuries.

OBJECTIVE: Our systematic review aimed to review, appraise and collate available evidence on hand rehabilitation programmes for the management of second to fifth metacarpal fractures in an adult human population after conservative and surgical management. Since 2008, no review on a similar topic has been performed, thus informing clinical practice for physiotherapists and occupational therapists.

METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) principles guided the reporting. Experimental, quasi-experimental, cohort and case-control studies between January 2008 and September 2018 were included. Searches were conducted on Medline, Academic Search Ultimate, CINAHL, CAB Abstracts, Health Source – Consumer Edition, Health Source: Nursing/Academic Edition, SPORTDiscus, Africa-Wide Information and MasterFILE Premier, Web-of-Science and Scopus. Screening, selection, appraisal and data extraction were independently performed by two reviewers. No meta-analysis was performed.

RESULTS: A total of 1015 sources were identified, 525 duplicates removed and 514 excluded. Three articles were included in the final data extraction: one randomised controlled trial (RCT) and two observational studies.

CONCLUSION: Limited evidence is available that a well-designed, well-implemented home-based exercise programme results in statistically significant improved hand function (p ˂ 0.0001) and digital total active motion (TAM) (p = 0.013) compared with traditional physiotherapy (PT) post-surgically.

CLINICAL IMPLICATIONS: Our study contributes to the knowledge base of hand rehabilitation after an individual sustained a second to fifth metacarpal fracture. The authors identified a gap where future studies should further investigate the effect of hand rehabilitation after conservative and surgical management.

PMID:34192208 | PMC:PMC8182452 | DOI:10.4102/sajp.v77i1.1536

BMJ Paediatr Open. 2021 Feb 2;5(1):e000942. doi: 10.1136/bmjpo-2020-000942. eCollection 2021.

ABSTRACT

COVID-19 has significantly impacted young people’s lives yet little is known about the COVID-19 related sources of information they access. We performed a cross-sectional survey of pupils (11-16 years) in North Staffordshire, UK. 408 (23%) pupils responded to an online survey emailed to them by their school. Descriptive statistics were used to summarise the data. Social media, accessed by 68%, played a significant role in the provision of information, despite it not being considered trustworthy. 89% felt that COVID-19 had negatively affected their education. Gaps in the provision of information on COVID-19 have been identified.

PMID:34192190 | PMC:PMC7868121 | DOI:10.1136/bmjpo-2020-000942

BMJ Paediatr Open. 2021 Mar 15;5(1):e000967. doi: 10.1136/bmjpo-2020-000967. eCollection 2021.

ABSTRACT

BACKGROUND: The SARS-CoV-2 pandemic and initial public health response led to significant changes in health service delivery, access and utilisation. However, SARS-CoV-2 illness burden in children and young people (CYP) is low. To inform effective child public health interventions, we aimed to compare patterns of paediatric emergency department presentation during the initial pandemic response with a previous non-pandemic period.

METHODS: Retrospective review of attendances (0-18 years) over the initial pandemic (2 March 2020-3 May 2020) compared with 2019. Outcome measures included number of attendances, referral source, presenting complaint, discharge diagnosis and disposal. Descriptive statistics with subgroup analysis by age/sex/ethnicity and pandemic time periods (pre-lockdown, lockdown weeks 1-3 and lockdown weeks 4-6) was performed.

RESULTS: 4417 attendances (57% illness and 43% injuries) occurred, compared with 8813 (57% illness and 43% injuries), a reduction of 50%, maximal in lockdown week 2 (-73%). Ranking of top three illness presentations changed across the pandemic weeks. Breathing difficulty dropped from first (300, 25%) to second (117, 21%) to third (59, 11%) (p<0.001). Abdominal pain rose from the third pre-lockdown (87, 7%) and lockdown weeks 1-3 (37, 7%) to second in weeks 4-6 (62, 12%; p=0.004). Fever ranked second (235, 19%) in pre-lockdown and first in weeks 1-3 (134, 24%) and weeks 4-6 (94, 18%; p=0.035).

CONCLUSIONS: Despite a 50% reduction, there was no significant change in acuity of illness. Rank of illness presentations changed, with abdominal pain ranking second and fever first, an important change from previous, which should prompt further research into causes. CYP-specific public health messaging and guidance for primary care are required in this second wave to ensure access to appropriate emergency services.

PMID:34192192 | PMC:PMC7969761 | DOI:10.1136/bmjpo-2020-000967

BMJ Paediatr Open. 2020 Sep 22;4(1):e000801. doi: 10.1136/bmjpo-2020-000801. eCollection 2020.

ABSTRACT

OBJECTIVE: To describe and compare the effect of level 5 lockdown measures on the workload and case mix of paediatric patients presenting to a district-level emergency centre in Cape Town, South Africa.

METHODS: Paediatric patients (<13 years) presenting to Mitchells Plain Hospital were included. The level 5 lockdown period (27 March 2020-30 April 2020) was compared with similar 5-week periods immediately before (21 February 2020-26 March 2020) and after the lockdown (1 May 2020-4 June 2020), and to similar time periods during 2018 and 2019. Patient demographics, characteristics, International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) diagnosis, disposition and process times were collected from an electronic patient tracking and registration database. The χ² test and the independent samples median test were used for comparisons.

RESULTS: Emergency centre visits during the lockdown period (n=592) decreased by 58% compared with 2019 (n=1413) and by 56% compared with the 2020 prelockdown period (n=1342). The proportion of under 1 year olds increased by 10.4% (p<0.001), with a 7.4% increase in self-referrals (p<0.001) and a 6.9% reduction in referrals from clinics (p<0.001). Proportionally more children were referred to inpatient disciplines (5.6%, p=0.001) and to a higher level of care (3.9%, p=0.004). Significant reductions occurred in respiratory diseases (66.9%, p<0.001), injuries (36.1%, p<0.001) and infectious diseases (34.1%, p<0.001). All process times were significantly different between the various study periods.

CONCLUSION: Significantly less children presented to the emergency centre since the implementation of the COVID-19 lockdown, with marked reductions in respiratory and infectious-related diseases and in injuries.

PMID:34192174 | PMC:PMC7509946 | DOI:10.1136/bmjpo-2020-000801