Tag: pubmed

PLoS One. 2021 Jun 15;16(6):e0252750. doi: 10.1371/journal.pone.0252750. eCollection 2021.

ABSTRACT

INTRODUCTION: Religion and spirituality play important roles in the lives of many, including healthcare providers and their patients. The purpose of this study was to examine the relationships between religion, spirituality, and cultural competence of healthcare providers.

METHODS: Physicians, residents, and medical students were recruited through social platforms to complete an electronically delivered survey, gathering data regarding demographics, cultural competency, religiosity, and spirituality. Four composite variables were created to categorize cultural competency: Patient Care Knowledge, Patient Care Skills/Abilities, Professional Interactions, and Systems Level Interactions. Study participants (n = 144) were grouped as Christian (n = 95)/non-Christian (n = 49) and highly religious (n = 62)/not highly religious (n = 82); each group received a score in the four categories. Wilcoxon rank sum and Chi-square tests were used for analysis of continuous and discrete variables.

RESULTS: A total of 144 individuals completed the survey with the majority having completed medical school (n = 87), identifying as women (n = 108), white (n = 85), Christian (n = 95), and not highly religious (n = 82). There were no significant differences amongst Christian versus non-Christian groups or highly religious versus not highly religious groups when comparing their patient care knowledge (p = .563, p = .457), skills/abilities (p = .423, p = .51), professional interactions (p = .191, p = .439), or systems level interaction scores (p = .809, p = .078). Nevertheless, participants reported decreased knowledge of different healing traditions (90%) and decreased skills inquiring about religious/spiritual and cultural beliefs that may affect patient care (91% and 88%). Providers also reported rarely referring patients to religious services (86%).

CONCLUSIONS: Although this study demonstrated no significant impact of healthcare providers’ religious/spiritual beliefs on the ability to deliver culturally competent care, it did reveal gaps around how religion and spirituality interact with health and healthcare. This suggests a need for improved cultural competence education.

PMID:34129642 | DOI:10.1371/journal.pone.0252750

PLoS One. 2021 Jun 15;16(6):e0253316. doi: 10.1371/journal.pone.0253316. eCollection 2021.

ABSTRACT

OBJECTIVE: The discrepancy between admission and discharge diagnosis can lead to possible adverse patient outcomes. There are gaps in integrated studies, and less is understood about its characteristics and effects. Therefore, this study was conducted to determine the frequency, characteristics, and outcomes of diagnostic discrepancies at admission and discharge.

DESIGN AND DATA SOURCES: This retrospective study reviewed the admitting and discharge diagnoses of adult patients admitted at Aga Khan University Hospital (AKUH), Internal Medicine Department between October 2018 and February 2019. The frequency and outcomes of discrepancies in patient diagnoses were noted among Emergency Department (ED) physician versus admitting physician, admitting physician versus discharge physician, and ED physician versus discharge physician for the full match, partial match, and mismatch diagnoses. The studied outcomes included interdepartmental transfer, Intensive Care Unit (ICU) transfer, in-hospital mortality, readmission within 30 days, and the length of stay. For simplicity, we only analyzed the factors for the discrepancy among ED physicians and discharge physicians.

RESULTS: Out of 537 admissions, there were 25.3-27.2% admissions with full match diagnoses while 18.6-19.4% and 45.3-47.9% had mismatch and partial match diagnoses respectively. The discrepancy resulted in an increased number of interdepartmental transfers (5-5.8%), ICU transfers (5.6-8.7%), in-hospital mortality (8-11%), and readmissions within 30 days in ED (14.4%-16.7%). A statistically significant difference was observed for the ward’s length of stay with the most prolonged stay in partially matched diagnoses (6.3 ± 5.4 days). Among all the factors that were evaluated for the diagnostic discrepancy, older age, multi-morbidities, level of trainee clerking the patient, review by ED faculty, incomplete history, and delay in investigations at ED were associated with significant discrepant diagnoses.

CONCLUSIONS: Diagnostic discrepancies are a relevant and significant healthcare problem. Fixed patient or physician characteristics do not readily predict diagnostic discrepancies. To reduce the diagnostic discrepancy, emphasis should be given to good history taking and thorough physical examination. Patients with older age and multi-morbidity should receive significant consideration.

PMID:34129648 | DOI:10.1371/journal.pone.0253316

J Oral Facial Pain Headache. 2021 Spring;35(2):93-104. doi: 10.11607/ofph.2719.

ABSTRACT

AIMS: To test the hypothesis that, in comparison with control, experimental noxious stimulation of the right masseter muscle would result in significant changes in the firing rates, thresholds, and recruitment orders of single-motor units (SMUs) of the nonpainful, synergistic right anterior temporalis muscle during goal-directed isometric biting task performance.

METHODS: Twenty healthy volunteers received an infusion of hypertonic saline (HS; 5% sodium chloride) into the right masseter to produce pain intensity of 40 to 60 on a 100-mm visual analog scale (VAS). Isotonic saline (IS) infusion was a control. Standardized biting tasks were performed with an intraoral force transducer, and intramuscular electromyographic activity was recorded from the right anterior temporalis muscle. Tasks (slow and fast ramp biting tasks, two-step biting task) were performed in 3 blocks: baseline, HS infusion, and IS infusion. Across blocks, SMU thresholds and firing rates were statistically compared, and SMU recruitment sequences were qualitatively compared. Statistical significance was set at P < .05.

RESULTS: No significant differences (P > .05) were noted between HS and IS infusion blocks in thresholds or firing rates of anterior temporalis SMUs. Individual SMUs showed increases or decreases in thresholds or firing rates or changes in recruitment sequences mostly during HS compared to IS infusion.

CONCLUSION: The reorganization of SMU activity that has been suggested to occur in both painful and nonpainful agonist jaw muscles may involve not only recruitments and de-recruitments of SMUs, but may also extend to more subtle increases and/or decreases in firing rates, thresholds, and recruitment sequences of individual SMUs in the nonpainful synergistic muscles.

PMID:34129654 | DOI:10.11607/ofph.2719

PLoS Negl Trop Dis. 2021 Jun 15;15(6):e0009411. doi: 10.1371/journal.pntd.0009411. Online ahead of print.

ABSTRACT

Visceral leishmaniasis (VL) is one of the most prevalent parasitic diseases worldwide. In 2019, 97% of the total numbers of cases in Latin America were reported in Brazil. In São Paulo state, currently 17.6% of infected individuals live in the western region. To study this neglected disease on a regional scale, we describe the spread of VL in 45 municipalities of the Regional Network for Health Assistance11(RNHA11). Environmental, human VL (HVL), and canine VL (CVL) cases, Human Development Index, and Lutzomyia longipalpis databases were obtained from public agencies. Global Moran’s I index and local indicators of spatial association (LISA) statistics were used to identify spatial autocorrelation and to generate maps for the identification of VL clusters. On a local scale, we determined the spread of VL in the city of Teodoro Sampaio, part of the Pontal of Paranapanema. In Teodoro Sampaio, monthly peri-domicile sand fly collection; ELISA, IFAT and Rapid Test serological CVL; and ELISA HVL serum surveys were carried out. In RNHA11 from 2000 to 2018, Lu. longipalpis was found in 77.8%, CVL in 69%, and HVL in 42.2% of the 45 municipalities, and 537 individuals were notified with HVL. Dispersion occurred from the epicenter in the north to Teodoro Sampaio, in the south, where Lu. longipalpis and CVL were found in 2010, HVL in 2018, and critical hotspots of CVL were found in the periphery. Moran’s Global Index showed a weak but statistically significant spatial autocorrelation related to cases of CVL (I = 0.2572), and 11 municipalities were identified as priority areas for implementing surveillance and control actions. In RNHA11, a complex array of socioeconomic and environmental factors may be fueling the epidemic and sustaining endemic transmission of VL, adding to the study of a neglected disease in a region of São Paulo, Brazil.

PMID:34129604 | DOI:10.1371/journal.pntd.0009411

PLoS One. 2021 Jun 15;16(6):e0252775. doi: 10.1371/journal.pone.0252775. eCollection 2021.

ABSTRACT

Previous empirical evidence suggests that the engagement in social interactions across different everyday contexts occurs in a manner highly responsive to a person’s social affiliation needs. As has been shown repeatedly, social engagement (as well as disengagement) can be predicted from earlier situational need states, implying that homeostatic principles underlie a person’s social affiliative behaviors. However, little is known about the role of emotion in these regulative processes. For this reason, the present exploratory study investigated the predictive role of state feelings of loneliness in subsequent engagement in social interaction. Since loneliness is conceptually associated with both the need to reaffiliate as well as self-protecting tendencies potentially hindering engagement in social contact, the study investigated the possibility of both increases and decreases in social contacts resulting from state feelings of loneliness. Adopting an experience sampling methodology (ESM), a sample of 65 participants was recruited from a local university and was followed for 14 days. Subjects were prompted several times a day to rate their feeling states and the quantity of social interactions, using a fixed interval assessment schedule. Statistical analyses using multilevel analysis indicated that state feelings of loneliness had complex quadratic effects upon subsequent social interaction, leading to both increases and decreases in subsequent social interaction. Moreover, these effects were contingent upon previous engagement in social interaction, implying spillover effects across social contexts that are conditionally mediated by feelings of loneliness. These findings clearly imply an important, albeit complex role of state feelings of loneliness in the regulation of social affiliation, both as a predictor and a consequence of social interaction. These exploratory findings are discussed against the background of methodological and conceptual limitations, and several recommendations for future studies are made.

PMID:34129636 | DOI:10.1371/journal.pone.0252775

PLoS One. 2021 Jun 15;16(6):e0253400. doi: 10.1371/journal.pone.0253400. eCollection 2021.

ABSTRACT

This study was intended to explore and confirm the factorial structure and to analyze the psychometric properties of an instrument for university guidance and tutoring, apply it, and detect differences between sociodemographic variables. A total of 1,048 students from five universities in the province of Manabi (Ecuador) participated. The study was divided into two phases with differentiated samples. An exploratory phase, made up of 200 subjects (19.1%), and another confirmatory phase, made up of 848 (80.9%), where the questionnaire was also applied. The results supported the three-factor structure of the instrument called “Questionnaire for the Assessment of Guidance and Tutoring in Higher Education” (Q-AGT), with of a total of 21 items. The indices of goodness of fit, reliability and internal consistency of the model were considered satisfactory. The application of the questionnaire did not show statistically significant differences in the assessment of university guidance and tutoring between men and women, with a high value given by both sexes to the importance of tutoring, the demands and the competences of the teaching staff in the university. The differences were mainly found between universities and branches of knowledge. Among the main conclusions, what stands out is the achievement of a valid and reliable instrument to measure the development of guidance and tutoring in Latin American universities. This contributes to the assessment of university guidance and tutoring as a strategy for the integral development of the student- personally, academically and professionally- and as a possible protective factor against academic dropout.

PMID:34129641 | DOI:10.1371/journal.pone.0253400

Opt Lett. 2021 Jun 15;46(12):2824-2827. doi: 10.1364/OL.413102.

ABSTRACT

The instability of optical phase chaos synchronization between semiconductor lasers under master-slave open-loop configuration is investigated. The phase difference between the master and slave lasers is obtained and analyzed in experiment by heterodyne detection and Hilbert transform, and in simulation by solving the rate equations. The results show that the phase difference only maintains in a short duration time and then jumps to another value. A statistical analysis shows that both duration time and jumping values are random, proving that the phase chaos synchronization is unstable. A theoretical analysis shows that the instability of phase synchronization is caused by the jumping of the external cavity mode in the master laser.

PMID:34129550 | DOI:10.1364/OL.413102

PLoS One. 2021 Jun 15;16(6):e0251479. doi: 10.1371/journal.pone.0251479. eCollection 2021.

ABSTRACT

BACKGROUND: Smart devices (SDs) are widely used among adolescents. Numerous studies have recommended further research on this topic to find out the prevalence of SD overuse among school students and to what extent this is associated with psychological distress. The present study aimed to investigate the pattern of SD use among secondary and high school students in the state of Kuwait, as well as the possible associations with psychological problems, weight, physical activity, and school performance.

MATERIALS AND METHODS: The correlational study design aimed to survey students from public schools by using a questionnaire and valid instruments, which included: Smartphone Addiction Scale-Short Version (SAS-SV) and Stress, Anxiety, and Depression Scale-(DASS-21). Pearson’s correlation coefficient, t-tests, one-way ANOVA were applied to find associations or significant differences between the categorical variables, in which p < 0.05 was considered statistically significant.

RESULTS: The study included 1,993 students from secondary schools (48.9%) and high schools (51.1%), of which 47.5% were male and 52.5% were female. There were significant statistical differences in the pattern of use of SDs, addiction to SD use, stress, anxiety, and depression according to gender, school type, school performance, and sport engagement. In addition, there were positive correlations between students’ addiction to SD use and stress, anxiety, and depression.

CONCLUSIONS: The findings suggest that excessive SD use is associated with addiction among secondary and high school students. In addition, levels of stress, anxiety, and depression differ according to the number of hours of SD use. Strategies should be developed at the community and school levels to avoid the overuse of SDs among school-aged students.

PMID:34129598 | DOI:10.1371/journal.pone.0251479

PLoS Negl Trop Dis. 2021 Jun 15;15(6):e0009521. doi: 10.1371/journal.pntd.0009521. Online ahead of print.

ABSTRACT

BACKGROUND: Cholera, an acute diarrheal disease is a major public health problem in many developing countries. Several rapid diagnostic tests (RDT) are available for the detection of cholera, but their efficacies are not compared in an endemic setting. In this study, we have compared the specificity and sensitivity of three RDT kits for the detection of Vibrio cholerae O1 and compared their efficiency with culture and polymerase chain reaction (PCR) methods.

METHODS: Five hundred six diarrheal stool samples collected from patients from two different hospitals in Kolkata, India were tested using SD Bioline Cholera, SMART-II Cholera O1 and Crystal-VC RDT kits. All the stool samples were screened for the presence of V. cholerae by direct and enrichment culture methods. Stool DNA-based PCR assay was made to target the cholera toxin (ctxAB) and O1 somatic antigen (rfb) encoding genes. Statistical evaluation of the RDTs has been made using STATA software with stool culture and PCR results as the gold standards. The Bayesian latent class model (LCM) was used to evaluate the diagnostic tests in the absence of the gold standard.

RESULTS: Involving culture technique as gold standard, the sensitivity and specificity of the cholera RDT kits in the direct testing of stools was highest with SAMRT-II (86.1%) and SD-Cholera (94.4%), respectively. The DNA based PCR assays gave very high sensitivity (98.4%) but the specificity was comparatively low (75.3%). After enrichment, the high sensitivity and specificity was detected with SAMRT-II (78.8%) and SD-Cholera (99.1%), respectively. Considering PCR as the gold standard, the sensitivity and specificity of the RDTs remained between 52.3-58.2% and 92.3-96.8%, respectively. In the LCM, the sensitivity of direct and enrichment testing was high in SAMRT-II (88% and 92%, respectively), but the specificity was high in SD cholera for both the methods (97% and 100%, respectively). The sensitivity/specificity of RDTs and direct culture have also been analyzed considering the age, gender and diarrheal disease severity of the patients.

CONCLUSION: Overall, the performance of the RDT kits remained almost similar in terms of specificity and sensitivity. Performance of PCR was superior to the antibody-based RDTs. The RTDs are very useful in identifying cholera cases during outbreak/epidemic situations and for making them as a point-of-care (POC) testing tool needs more improvement.

PMID:34129602 | DOI:10.1371/journal.pntd.0009521

IEEE Trans Image Process. 2021 Jun 15;PP. doi: 10.1109/TIP.2021.3087943. Online ahead of print.

ABSTRACT

In the low-photon imaging regime, noise in the image sensors is dominated by shot noise, best modeled statistically as Poisson distribution. In this work, we show that the Poisson likelihood function is very well matched with the Bayesian estimation of the “difference of log of contrast of pixel intensities.” More specifically, our work is rooted in statistical compositional data analysis, whereby we reinterpret the Aitchison geometry as a multi-resolution analysis in the log-pixel domain.We demonstrate that the difference-log-contrast has wavelet-like properties that correspond well with the human visual system, while being robust to illumination variations. We derive a denoising technique based on an approximate conjugate prior for the latent Aitchison variable that gives rise to an explicit minimum mean squared error estimation. The resulting denoising technique preserves image contrast details that are arguably more meaningful to human vision than the pixel intensity values themselves.

PMID:34129497 | DOI:10.1109/TIP.2021.3087943