Tag: pubmed

West Afr J Med. 2021 May 29;38(5):472-477.

ABSTRACT

BACKGROUND: Musculoskeletal disorders often pose significant limitation to activities of daily living due to pain or disability. These disorders often arise as a result of the normal aging process, but most have some predisposing factors that are lifestyle-related, especially in younger people as a result of repeated mal- posturing/ misuse of parts of the body in the course of their jobs or recreations. These disorders cause more functional limitations in the older adult population than any other group of disorders. Thus, with increasing aging of most populations of the world, it is expected that the burden of these disorders will continue to rise. There is paucity of epidemiological data on this subject and no published study showing the ease of affordability of treatment for these conditions in Nigeria, hence this study.

PATIENTS AND METHODS: A cross -sectional study of patients with chronic musculoskeletal conditions attending the orthopaedic outpatient clinic of Ahmadu Bello university Teaching Hospital between 1st July 2019 and 31st December 2019, involving physical interview of new patients and review of case notes of old patients seen within the period. Statistical analysis was done with the Statistical Package for the Social Sciences (SPSS) version 20.0, and descriptive statistics were employed to summarize data. Pearson Chi- square test was used to examine for association between age, occupational ergonomic factors and chronic musculoskeletal conditions.

RESULTS: Forty-six percent of the outpatients suffered from chronic musculoskeletal disorders. Chronic low back pain accounted for the greatest burden (64.9%), followed by osteoarthritis of the weight bearing joints (27%), chronic neck pain (4.8%) and rheumatoid arthritis (2.8%). 51.8% of the patients with chronic low back pain, 64.5% of chronic neck pain and 68.5% of osteoarthritis were in the middle-age group. Occupational ergonomic factors as an entity was a significant risk factor identified in almost all the conditions except rheumatoid arthritis (P = 0.0001). Only 121(18.7%) of the patients enjoyed health insurance, while majority do not. Also, 56.0% of the patients had the means of footing the cost of their treatment (either by way of health insurance coverage or out-of-pocket payment).

CONCLUSION: The burden of chronic musculoskeletal disorders is high in our region. There is a need for the government to organize ergonomic educational programs through seminars and workshops as part of public health education, and a wider, well funded health insurance policy that covers both the formal and informal sectors and the full extent of the management of these chronic disorders to make such care accessible to all.

PMID:34051720

Ecotoxicol Environ Saf. 2021 May 26;220:112375. doi: 10.1016/j.ecoenv.2021.112375. Online ahead of print.

ABSTRACT

129 Shenzhen residents’ hair samples were collected and the metal/metalloid concentrations of Hg, As, Pb, Cd, Cr, Cu, Mn, Zn, Fe and Ni were detected. Meanwhile, the relationships between metal/metalloid contents in human hair and gender, age, seafood diet habit, smoking habit, as well as the housing type (dwelling environment) were analyzed. Results showed that the average content of Hg, As, Pb, Cd, Cr, Cu, Mn, Zn, Fe and Ni in human hair of Shenzhen residents was 0.76 ± 0.96, 0.10 ± 0.04, 5.25 ± 4.88, 0.25 ± 0.33, 0.60 ± 0.31, 13.84 ± 3.67, 2.82 ± 2.01, 196.90 ± 145.01, 12.20 ± 5.10 and 0.34 ± 0.32 μg/g, respectively. Compared with other regions at home and abroad, most metal/metalloids in Shenzhen residents were at a moderate level, and the highly toxic elements (i.e. Pb, Cd, As and Hg) didn’t exceed the upper limit of normal values in China. Statistical analysis showed that the young male people contained significantly higher (p < 0.05) level of Pb (in age group of 20-30 years old) and Fe (in age group of 20-40 years old) in hair than the female people. Smokers had significantly (p < 0.05) higher level of Cd (0.35 μg/g) but lower level of Zn (101.24 µg/g) than non-smokers (Cd: 0.17 μg/g; Zn: 252.63 µg/g). Hg and Pb contents in hair of Shenzhen people were positively related with the frequencies of seafood consumption and the age, respectively. Moreover, residents lived in private buildings (well decorated house) accumulated significantly higher (p < 0.05) levels of Pb, Cr, Fe and Ni as compared with those lived in public rental house and village house (no decoration or simple decoration), suggesting that decoration material was also an important way for human exposure to heavy metals.

PMID:34051662 | DOI:10.1016/j.ecoenv.2021.112375

Radiol Oncol. 2021 May 31. doi: 10.2478/raon-2021-0024. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of the study was to derive and compare metabolic parameters relating to benign and malignant pulmonary nodules using dynamic 2-deoxy-2-[fluorine-18]fluoro-D-glucose (¹⁸F-FDG) PET/CT, and nodule perfusion parameters derived through perfusion computed tomography (CT).

PATIENTS AND METHODS: Twenty patients with 21 pulmonary nodules incidentally detected on CT underwent a dynamic ¹⁸F-FDG PET/CT and a perfusion CT. The maximum standardized uptake value (SUV_max) was measured on conventional ¹⁸F-FDG PET/CT images. The influx constant (K_i ) was calculated from the dynamic ¹⁸F-FDG PET/CT data using Patlak model. Arterial flow (AF) using the maximum slope model and blood volume (BV) using the Patlak plot method for each nodule were calculated from the perfusion CT data. All nodules were characterized as malignant or benign based on histopathology or 2 year follow up CT. All parameters were statistically compared between the two groups using the nonparametric Mann-Whitney test.

RESULTS: Twelve malignant and 9 benign lung nodules were analysed (median size 20.1 mm, 9-29 mm) in 21 patients (male/female = 11/9; mean age ± SD: 65.3 ± 7.4; age range: 50-76 years). The average SUV_max values ± SD of the benign and malignant nodules were 2.2 ± 1.7 vs. 7.0 ± 4.5, respectively (p = 0.0148). Average K_i values in benign and malignant nodules were 0.0057 ± 0.0071 and 0.0230 ± 0.0155 min^-1, respectively (p = 0.0311). Average BV for the benign and malignant nodules were 11.6857 ± 6.7347 and 28.3400 ± 15.9672 ml/100 ml, respectively (p = 0.0250). Average AF for the benign and malignant nodules were 74.4571 ± 89.0321 and 89.200 ± 49.8883 ml/100g/min, respectively (p = 0.1613).

CONCLUSIONS: Dynamic ¹⁸F-FDG PET/CT and perfusion CT derived blood volume had similar capability to differentiate benign from malignant lung nodules.

PMID:34051709 | DOI:10.2478/raon-2021-0024

Physiotherapy. 2021 Mar 26;112:55-63. doi: 10.1016/j.physio.2021.03.016. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore entry-level physiotherapy students’ attitudes and beliefs relating to weight bias and stigmatisation in healthcare.

DESIGN: Cross sectional survey of physiotherapy students.

METHODS: All final year physiotherapy students (n = 215) enrolled in entry-level physiotherapy programmes in the Republic of Ireland were invited to participate. Each received a questionnaire, consisting of 72 questions, within four key sections. Descriptive statistics and frequencies were used to analyse the data.

RESULTS: A response rate of 83% (179/215) was achieved. Whilst physiotherapy students, overall, had a positive attitude towards people with obesity, 29% had a negative attitude towards people with obesity, 24% had a negative attitude towards managing this population and most (74%) believed obesity was caused by behavioural and individual factors. Over one third of students (35%) reported that they would not be confident in managing patients with obesity and more than half (54%) felt treating patients with obesity was not worthwhile.

CONCLUSION: This study provides preliminary findings to suggest that weight stigma-reduction efforts are warranted for physiotherapy students. Helping students to understand that obesity is a complex, chronic condition with multiple aspects requiring a multi-faceted approach to its management might be the first step towards dispelling these negative attitudes towards patients living with obesity. Inclusion of a formal obesity curriculum should perhaps now be part of the contemporary physiotherapy students’ education.

PMID:34051594 | DOI:10.1016/j.physio.2021.03.016

Tuberculosis (Edinb). 2021 May 25;129:102086. doi: 10.1016/j.tube.2021.102086. Online ahead of print.

ABSTRACT

BACKGROUND: Mycobacterium tuberculosis (MTB) sRNAs are abundant. However, the level of MTB sRNA in peripheral blood remains elusive.

METHODS: Twenty MTB sRNAs annotated in the reference genome of H37Rv were detected in the plasma of 170 active pulmonary tuberculosis patients and 124 healthy people by qRT-PCR detection system. The differential expression of sRNAs were analyzed in two groups. The value of sRNAs for diagnosis of active tuberculosis were evaluated by ROC curve analysis.

RESULTS: Eight of the 20 sRNAs (MTS2823, MTS0997, MTS1338, ASdes, G2, C8, mcr15 and MTS1082) were found in at least 50% of the samples detected. The relative expression levels of MTS2823, MTS0997, MTS1338 and ASdes in plasma of tuberculosis patients were statistically higher than those in healthy controls. ROC curve analysis showed that the AUC of MTS0997, MTS1338, MTS2823 and ASdes were 0.8935 (95% CI 0.8109-0.9760), 0.8722 (95% CI 0.7862-0.9581), 0.8208 (95% CI 0.7246-0.9170) and 0.5792 (95% CI 0.4240-0.7344), respectively. The AUC value of combination of MTS0997, MTS1338 and MTS2823 was 0.914 (95% CI 0.8281-0.9926).

CONCLUSIONS: MTB sRNAs MTS2823, MTS0997 and MTS1338 have the potential to be plasma biomarkers for active pulmonary tuberculosis.

PMID:34051642 | DOI:10.1016/j.tube.2021.102086

Comp Immunol Microbiol Infect Dis. 2021 May 15;77:101665. doi: 10.1016/j.cimid.2021.101665. Online ahead of print.

ABSTRACT

This study aimed to investigate the epidemiology of 10 suspicious pathogenic bacteria in 250 stomach contents of aborted calf, lamb, and goat foetuses in 2019. The 155 positive samples obtained from PCR consisted of 53 (58.88 %) bacteria from 90 lamb samples, 10 (43.47 %) bacteria from 23 goat samples, and 92 (67.15 %) bacteria from 137 calf samples. The five most common bacteria associated with abortions were Brucella melitensis, 52 (20.9 %); B. abortus, 13 (5.2 %); Leptospira spp., 34 (13.6 %); Campylobacter fetus, 52 (20.9 %); and Coxiella burnetii, 4 (1.6 %). The highest rate of B. melitensis (65.4 %), B. abortus (69.2 %), Leptospira spp. (67.6 %), and C. fetus (50 %) was detected in the aborted calf samples. The highest individual rate was that of C. fetus (5.2 %). The flock-herd rates of B. melitensis, B. abortus, Leptospira spp., C. fetus, and C. burnetii infections in the 29 farms studied were 34.48 %, 20.69 %, 62.06 %, 82.75 %, and 3.44 %, respectively, with a confidence level and interval of 95 %. The frequency of abortions caused by Leptospira spp. and Campylobacter fetus may be related to increasing in B. melitensis. The rates of aborted calf, lamb, and goat foetuses among the various sampling periods and regions were significantly (P < 0.01) different. In conclusion, precautions should be applied to reduce the spread of these bacterial agents in high-risk areas and to eliminate the risk of harbouring these zoonotic infections in humans. Therefore, these results must be taken into account in the development of control and protection strategies against abortions in animals.

PMID:34051649 | DOI:10.1016/j.cimid.2021.101665

Int J Nurs Stud. 2021 May 2;120:103955. doi: 10.1016/j.ijnurstu.2021.103955. Online ahead of print.

ABSTRACT

BACKGROUND: Caregivers of patients with chronic conditions or disability experience fatigue, burden and poor health-related quality of life. There is evidence of the effectiveness of support interventions for decreasing this impact. However, little is known about the benefits of home-based nursing intervention in primary health care.

OBJECTIVES: To evaluate the effectiveness of a home-based, nurse-led-intervention (CuidaCare) on the quality of life of caregivers of individuals with disabilities or chronic conditions living in the community, measured at 12-month follow-up.

METHODS: A pragmatic, two-arm, cluster-randomized controlled trial with a 1-year follow-up period was performed between June 2013 and December 2015. Consecutive caregivers aged 65 years or older, all of whom assumed the primary responsibility of caring for people with disabling conditions for at least 6 months a year, were recruited from 22 primary health care centers. Subsequently, 11 centers were randomly assigned to usual care group, and 11 were assigned to the intervention group. The caregivers in the intervention group received the usual care and additional support (cognitive restructuring, health education and emotional support). The primary outcome was quality of life, assessed with the EQ-5D instrument (visual analog scale and utility index score); the secondary outcome variables were perception of burden, anxiety, and depression. Data were collected at baseline, at the end of the intervention, and at the 6- and 12-month follow-up visits. We analyzed the primary outcome as intention-to-treat, and missing data were added using the conditional mean single imputation method.

RESULTS: A total of 224 caregivers were included in the study (102 in the intervention group and 122 in the usual care group). Generalized Estimating Equation models showed that the CuidaCare intervention was associated with a 5.46 point (95% CI: 2.57; 8.35) change in the quality of life, as measured with the visual analog scale adjusted for the rest of the variables at 12 months. It also produced an increase of 0.04 point (95% CI: 0.01; 0.07) in the utilities. No statistically significant differences were found between the two groups at 12 months with respect to the secondary outcomes.

CONCLUSIONS: The findings suggest that incorporating a home-based, nurse-led-intervention for caregivers into primary care can improve the health-related quality of life of caregivers of patients with chronic or disabling conditions.

PMID:34051585 | DOI:10.1016/j.ijnurstu.2021.103955

Early Hum Dev. 2021 May 17;158:105394. doi: 10.1016/j.earlhumdev.2021.105394. Online ahead of print.

ABSTRACT

BACKGROUND: Increased survival of preterm neonates who require hospitalization at the Neonatal Intensive Care Unit has led to an increase in infections. This study aims to describe the temporal trend, risk factors, and outcome of healthcare-associated infections in a NICU of a high complexity hospital, with emphasis on the differences of incidence between bacterial and fungal infections.

METHODS: The study was carried out from January 2013 to December 2016, with daily follow-up of the newborns by the National Healthcare Safety Network.

RESULTS: The study included 881 newborns, of whom 214 had a bacterial infection, 19 had fungi infection, and 12 bacterial and fungal infections associated. The hospital infection rate was 12/1000 patient-days. SNAPPE>24, days of hospitalization and PICC days were independent risk factors for the development of fungal and bacterial infection, respectively, with statistical significance for bacterial and fungal infections. The mortality rate was 2.6 times higher in those who had fungal infection than in those who had a bacterial infection. The occurrence of invasive infections was higher in the years 2015 and 2016 and Gram-negative bacteria and yeasts were more frequent, impacting morbidity and mortality.

CONCLUSIONS: The use of invasive devices is a risk factor for the occurrence of HAI caused by bacteria and fungi. The frequency of deaths was higher in the group of neonates with fungal infection. These results point to the importance of constant epidemiological surveillance and measures of effective control of infections in NICU.

PMID:34051584 | DOI:10.1016/j.earlhumdev.2021.105394

Nurse Educ Today. 2021 May 19;103:104976. doi: 10.1016/j.nedt.2021.104976. Online ahead of print.

ABSTRACT

BACKGROUND: Workplace violence in healthcare remains a significant issue for healthcare professional, in terms of risk to patients and staff. One part of a workplace violence prevention and management programme is to educate staff in their response to critical events. Drawn from the disaster management literature, tabletop exercises were used in this study to simulate workplace violence and educate staff on the appropriate emergency response during a violent event. The use of tabletop exercise in this context is a novel approach to workplace violence prevention management.

AIM AND OBJECTIVE: This study describes the development and effectiveness of tabletop exercises in preparing health practitioners in violence prevention and management emergency response systems.

METHODS: Using a sequential explanatory mixed method design. The study comprised of two phases 1) quasi-experimental (quantitative) and 2) focus group (qualitative) to evaluate the effectiveness of the violence prevention management tabletop exercises. COREQ guidelines were followed the qualitative arm of the study and the TREND statement for the quantitative part of the study.

RESULTS: Statistically significant improvements in healthcare professional confidence levels were found two weeks post the tabletop exercises. A post focus group revealed three categories concerning the participant’s experiences of the tabletop exercises, (role clarity, adult learning and organisational support).

CONCLUSION: Tabletop exercise may provide a, low cost, context specific novel approach to educating staff in emergency violence response systems at a tertiary referral hospital. Educators and policy makers may consider the use of tabletop exercises in the ongoing work in preparing health care staff for workplace violence.

RELEVANCE TO CLINICAL PRACTICE: Successful tabletop exercises should consider a local ward level context, the use of adult learning principles, have high level organisational support and cover role clarity as a key learning area.

PMID:34051542 | DOI:10.1016/j.nedt.2021.104976

Nurse Educ Today. 2021 May 13;103:104955. doi: 10.1016/j.nedt.2021.104955. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of Mobile Augmented Reality (MAR) educational materials on the knowledge and skill levels of nursing students on injection practices.

METHOD: This controlled experimental study was carried out with 122 first-year nursing students, 64 of whom were included in the experimental group and 58 in the control group. Data were collected between March and April 2018 using an information form, a pre-test, a post-test, a persistence test, and injection evaluation checklists. In the study, the experimental group used MAR applications and the control group used traditional teaching methods in learning injection practices.

RESULTS: There was no statistically significant difference between the pre-test scores of the students in the experimental and control groups, which determined the knowledge level of subcutaneous, intramuscular, and intravenous injections before the lesson (p > 0.05). After the lesson, it was found statistically significant that the post-test and persistence test scores of students in the experimental group were higher than the control group (p < 0.05). In the first and second/persistence skill evaluations, the injection skill scores of the students in the experimental group were higher than the control group (p < 0.05), which was also statistically significant. In addition, the students in the experimental group stated that MAR applications increased their motivation and self-confidence and reduced their concerns.

CONCLUSION: It was determined that MAR applications had a positive effect on the knowledge and skill levels of nursing students regarding injection practices and provided persistence in the learned knowledge and skills.

PMID:34051543 | DOI:10.1016/j.nedt.2021.104955