Tag: statistics

Ocul Immunol Inflamm. 2023 Feb 7:1-6. doi: 10.1080/09273948.2023.2169716. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the use of Carlevale IOL placement in patients with UGH, and to evaluate surgical outcomes.

DESIGN: In this retrospective study, 28 patients with UGH syndrome that were subjected to IOL explantation and concomitant Carlevale IOL implantation were included in the study.

METHODS: Information about VA, IOP, number of glaucoma medication, need for glaucoma surgery, presence of hemorrhage and inflammation were recorded up to 6 months after the procedure.

RESULTS: We found a statistically significant increase in mean visual acuity and complete resolution of uveitis in all patients. Mean IOP and the mean number of glaucoma medications were significantly decreased postoperatively, while 14% of patients required additional glaucoma surgery.

CONCLUSIONS: IOL explantation and concomitant Carlevale IOL implantation may provide a viable solution for UGH syndrome resolution, increases visual acuity, and decreases the need for glaucoma medication.

PMID:36749924 | DOI:10.1080/09273948.2023.2169716

J Agric Food Chem. 2023 Feb 7. doi: 10.1021/acs.jafc.2c07157. Online ahead of print.

ABSTRACT

This paper presents a multi-step methodology to identify relationships between integrative pesticide quantifications and land uses on a given watershed of the Adour-Garonne Basin (Southwestern France). In fact, a large amount of pesticide concentration data was collected from 51 sites located in the Adour-Garonne Basin for a 1 year monitoring period in 2016. The sampling devices used here were polar organic chemical integrative samplers (POCIS), which provided time-weighted average concentration estimates. For each study site, its associated watershed and land cover distribution were determined using Corine Land Cover 2012 (CLC 2012) and Geographic Information System (GIS). The large-scale data were analyzed using multivariate statistical analyses, such as hierarchical cluster analysis (HCA) and principal component analysis (PCA). HCA grouped the 51 sites into five clusters with similar primary land uses. Next, the integrated pesticide concentration and land use distribution data sets were analyzed in a PCA. The key variables responsible for discriminating the sample sites showed distribution patterns consistent with specific land uses. To confirm these observations, pesticide fingerprints from sites with contrasting land uses were compared using a waffle method. The overall multivariate approach allowed for the identification of contamination sources related to their likely initial use, at the watershed level, that could be useful for preventing or containing pesticide pollution beyond simply acting on areas at risk.

PMID:36749916 | DOI:10.1021/acs.jafc.2c07157

J Am Coll Health. 2023 Feb 7:1-10. doi: 10.1080/07448481.2023.2168547. Online ahead of print.

ABSTRACT

Objective: The study aims to capture the emotional challenges faced by international students due to the changes in U.S. visa regulations during the COVID-19 outbreak. Participants: 165 international students from University of Florida participated in the study. Methods: We conducted a cross-sectional online survey using previously validated questionnaire tools (PHQ-9 and GAD-7). The collected data was quantitatively analyzed through different statistical approaches, including ANOVA, Independent Sample t-Test, and Binary Logistic Regression. Results: 18.8% of our study sample had a moderately severe to severe depressive status, and 20.6% of the study sample had severe anxiety. Additionally, there was a statistically significant difference in the depression and anxiety scores based on gender. Conclusions: Our findings addressed the importance of taking serious measures when emotionally impactful political issues arise to prevent the development of mental illnesses among international students at U.S. institutions of higher education.

PMID:36749870 | DOI:10.1080/07448481.2023.2168547

Dimens Crit Care Nurs. 2022 May-Jun 01;41(3):151-156. doi: 10.1097/DCC.0000000000000520.

ABSTRACT

BACKGROUND: Although a variety of doses and duration of hydrocortisone have been reported as a treatment modality for congenital heart surgery patients with refractory hypotension, there remains a lack of understanding of the clinical use in pediatric cardiac programs.

OBJECTIVES: The aim of this study was to describe the current practice of steroid use for refractory hypotension in postoperative congenital heart surgery patients.

METHOD: Survey participants were recruited from the Consortium of Congenital Cardiac Care-Measurement of Nursing Practice. The survey focused on 4 areas: diagnosis, intervention, duration of therapy, and clinical decision making. Data were summarized using descriptive statistics.

RESULTS: Among the programs, 24 of 31 (77%) responded, with 21 (95%) using hydrocortisone as a treatment modality. Most, 20 (83%), reported no written clinical guideline for the use of hydrocortisone. Variation in dosing existed as 3 centers (14%) use 50 mg/m2/d, 6 (29%) use 100 mg/m2/d, and 8 (38%) indicated that dosing varies by provider.

DISCUSSION: Nearly all centers reported using hydrocortisone for the treatment of hypotension refractory to fluid resuscitation and vasoactive medications. Substantial variation in practice exists in areas of diagnosis, dosing, and duration of hydrocortisone. More research is needed to develop a clinical practice guideline to standardize practice.

PMID:36749864 | DOI:10.1097/DCC.0000000000000520

Dimens Crit Care Nurs. 2022 May-Jun 01;41(3):124-131. doi: 10.1097/DCC.0000000000000522.

ABSTRACT

BACKGROUND: A major academic medical center in the Midwest has expanded their extracorporeal membrane oxygenation (ECMO) program from 8 ECMO cases in 2014 to 97 ECMO cases in 2017. The Extracorporeal Life Support Organization states that standardized policies, procedures, and standards of care are necessary for an ECMO center to be successful.

LOCAL PROBLEM: With the rapid growth of the ECMO program, this medical center has chosen to transition nurses and respiratory therapists into the role of ECMO specialist to bridge the gap in care created by the influx in patients. Currently, no specific set of policies/procedures or standards of care exist for ECMO patients. The primary objective of this study is to improve the self-efficacy of ECMO specialists and bedside nurses through the development of a comprehensive ECMO program that includes standardized policies and procedures, order sets, and evidence-based patient management guidelines.

METHODS/IMPLEMENTATION: The General Self-Efficacy Survey was used to assess the self-efficacy of both the ECMO specialists and the bedside nurses before implementation of the program. An ECMO manual was created that contained education on veno-arterial and veno-venous ECMO, policies and procedures, and patient management guidelines. An EPIC order set was created to ensure the correct protocols and management guidelines were ordered for all ECMO patients. Postimplementation self-efficacy surveys, direct observations, and chart audits occurred to assess program fidelity.

RESULTS: The self-efficacy was assessed of the ECMO specialists and beside nurses 4 months after implementation of policies, procedures, patient management guidelines, and an ECMO order set. The ECMO specialists’ self-efficacy survey responses increased by 25% and the bedside nurses’ self-efficacy survey responses increased by 27% after 4 months. Direct observation of ECMO specialist handoff to ensure protocol fidelity also occurred. There was a 40% increase in ECMO specialist handoff taking place and a 72% increase in ECMO circuit examination.

CONCLUSIONS: With the significant growth of ECMO patients, policies, protocols, and management guidelines are essential to provide safe care to these patients. There was a statistically significant improvement in the self-efficacy of both the ECMO specialists and bedside nurses. This was shown to directly correlate to an improvement in professional practice behaviors and ultimately improve the quality of patient care provided to ECMO patients.

PMID:36749860 | DOI:10.1097/DCC.0000000000000522

Comput Inform Nurs. 2023 Feb 4. doi: 10.1097/CIN.0000000000000991. Online ahead of print.

ABSTRACT

This study evaluated the effectiveness of the Transitional Care Model Stroke Turkey for stroke patients and caregivers as regards the competence of caregivers and patient outcomes. It is a parallel-group, assessor-blinded monocenter conducted with 126 participants in total (66 intervention included 33 stroke patients and 33 caregivers; 60 control groups included 30 stroke patients and 30 caregivers), between March and August 2018. The Transitional Care Model Stroke Turkey program lasts for 13 to 20 weeks. It includes a 12-week follow-up after discharge, a minimum of three hospital visits, one home visit, minimum 18 phone calls, and Web-based training. The intervention group exhibited better caregiver competence (13.48 ± 2.31), preparation for care (28.48 ± 4.74), and e-health literacy (34.42 ± 4.74) than the control group (respectively, 11.37 ± 2.48, 20.93 ± 7.10, 26.93 ± 8.53) (P < .001). Emotional exhaustion and depersonalization increased in the control group, but remained the same in the intervention group. Personal accomplishment decreased in the intervention group, unlike in the control group. Within 12 weeks of discharge, five patients from the intervention group and seven patients from the control group were rehospitalized. There was no statistical difference between stroke patients in either group in terms of having previously used home healthcare services. The Transitional Care Model Stroke Turkey is a practical model for stroke patients transitioning from hospital to home.

PMID:36749850 | DOI:10.1097/CIN.0000000000000991

Comput Inform Nurs. 2023 Feb 4. doi: 10.1097/CIN.0000000000001009. Online ahead of print.

ABSTRACT

The purpose of this study was to determine the effectiveness of a culturally responsive interactive gaming mHealth educational application designed to improve diabetes health literacy among an underserved urban population in India when compared with a traditional approach of verbal education. In addition, relationships between participant sociodemographic variables and participant knowledge were assessed. A randomized controlled trial was conducted using a two-arm parallel, single-blinded intervention and control group design. The parallel groups were the mHealth Education group serving as the intervention group and the Verbal Education group serving as the control group. The mHealth application was as effective in improving diabetes health literacy as verbal education. Results for the difference in posttest and pretest score between the two groups indicated there was no statistically significant difference between groups (P = .9306). However, there was a significant improvement in the difference in posttest and pretest scores for each group (P < .0001), indicating that the culturally responsive type 2 diabetes educational content was effective in improving type 2 diabetes health literacy among both groups. This study answers a call by the World Health Organization that advocates for evidence-based mHealth interventions that offer unique opportunities for cost-effective informatics service delivery in low- and middle-income countries.

PMID:36749847 | DOI:10.1097/CIN.0000000000001009

Am J Speech Lang Pathol. 2023 Feb 7:1-11. doi: 10.1044/2022_AJSLP-22-00257. Online ahead of print.

ABSTRACT

PURPOSE: Spinal pathology is very common with advancing age and can cause dysphagia; however, it is unclear how frequently these pathologies affect swallowing function. This study evaluates how cervical spinal pathology may impact swallowing function in dysphagic individuals observed during videofluoroscopic swallowing studies (VFSSs).

METHOD: A retrospective case-control study was performed on 100 individuals with dysphagia as well as age-/gender-matched healthy controls (HCs) with available VFSS. Spinal anatomy of patients was classified into two predetermined categories, and a consensus decision of whether spinal pathology influenced swallowing physiology was made. Validated swallow metrics, including Modified Barium Swallow Impairment Profile (MBSImP) component scores, Penetration-Aspiration Scale (PAS) maximum scores, and 10-item Eating Assessment Tool (EAT-10) scores, were compared between the spine-associated dysphagia (SAD), non-SAD (NSAD), and HC groups using Kruskal-Wallis one-way analysis of variance.

RESULTS: Most patients with dysphagia had spinal pathology. Spinal pathology was judged to be the primary etiology of dysphagia in 16.9% of patients with abnormal spine pathology. Median EAT-10 scores were statistically different among the three groups, with the NSAD group scoring the highest and the HC group scoring the lowest. Similarly, median PAS scores were significantly different between dysphagic groups and HCs. Median MBSImP Oral Total scores were significantly different only between the NSAD group and HCs, whereas Pharyngeal Total score was not significantly different among the groups.

CONCLUSIONS: Spinal pathology is commonly observed during VFSS and can contribute to dysphagia, resulting in worse swallowing-related outcomes when compared with HCs. Patients judged to have SAD tended to have better outcomes than patients with dysphagia from other etiologies, perhaps due to the progressive nature of spinal disease that allows for compensatory swallowing physiology over time.

PMID:36749843 | DOI:10.1044/2022_AJSLP-22-00257

Comput Inform Nurs. 2023 Feb 6. doi: 10.1097/CIN.0000000000001010. Online ahead of print.

ABSTRACT

Virtual reality simulation offers students the opportunity to acquire clinical and psychomotor skills in a safe and interactive environment. This study describes the usability of virtual reality simulation among undergraduate nursing and midwifery students. Participants were recruited using convenience and snowball sampling and engaged in a 20-minute virtual reality simulation scenario of their choice. They then completed a 21-item survey comprising a sociodemographic questionnaire, the System Usability Scale, a satisfaction questionnaire, and open-ended questions. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using deductive content analysis. Forty-three students participated in this study. The mean (SD) System Usability Scale score was 75.87 (13.7), indicating that virtual reality simulation was acceptable. Almost all participants were either “extremely satisfied” or “somewhat satisfied” with virtual reality simulation, which was perceived as informative and enjoyable, fostering safe and self-directed learning without causing patient harm. Participants recommended using virtual reality simulation to practice clinical skills, prepare for clinical placements, and learn about rare clinical situations. Virtual reality simulation needs to be underpinned by a strong pedagogy and aligned with learning outcomes. Educators and students should be trained in virtual reality simulation prior to its integration into the curriculum.

PMID:36749836 | DOI:10.1097/CIN.0000000000001010

JBRA Assist Reprod. 2023 Feb 7. doi: 10.5935/1518-0557.20220049. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the response to weight loss guidance in the anthropometric parameters of obesity and overweight infertile patients assisted fertilization treatment (high and low complexity).

METHODS: Retrospective cohort study. This survey was conducted in a population of overweight and obese infertile patients. In the first consultation at the assisted reproduction clinic (Human Reproduction Laboratory HC / UFG), obese and overweight patients were weighed, measured and instructed to lose weight and informed that being overweight could reduce the chances of success in the treatment.

RESULTS: We analyzed 56 overweight and obese patients admitted for infertility treatment at the Human Reproduction Center HC/UFG. The mean age of overweight and obese patients was 35.78 years, SD 3.70. After the orientation, only 8.92% of patients would achieve the normality rating for BMI, overweight 39.28% (decreased 14.29%), obesity I 37.5%, obesity II 10.71% and obesity III 3.57% (all degrees of obesity increased 1.79%). The mean weight of patients before and after guidance was statistically significant (p<0.0046). The mean values of BMI before and after guidance were also statistically significant (p<0.0038).

CONCLUSIONS: Weight loss guidance in this population had no effect on weight loss. On the contrary, the mean weight of patients after guidance was statistically higher than the mean in the first consultation (both weight and BMI). It is suggested that for obese and overweight infertile patients, in addition to guidance for reduction, an appointment with a nutritionist and/or endocrinologist should be immediately scheduled.

PMID:36749806 | DOI:10.5935/1518-0557.20220049