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Effect of Video Embedded with Hotspots with Dynamic Text on Single-Word Reading by Children with Multiple Disabilities

J Dev Phys Disabil. 2019;31(6):727-740. doi: 10.1007/s10882-019-09673-5.

ABSTRACT

BACKGROUND: The purpose of the study was to evaluate the effects of an intervention using an AAC app programmed with video visual scene displays (VSDs) embedded with hotspots with the Transition to Literacy (T2L) feature on single-word reading.

METHOD: Three school-aged children with multiple disabilities participated in a multiple baseline across participants design. Four names of characters in favorite movies and shows served as target words for each participant.

RESULTS: All three children demonstrated an increase in accurate identification of target words from baseline to intervention with Tau-U effect sizes for the participants of 0.69, 0.76, and 0.84, all of which were statistically significant (p<0.05).

CONCLUSIONS: Clinicians can consider including the intervention evaluated in the current study as one component of literacy intervention for school-aged children with multiple disabilities. Future research should further evaluate video VSDs and the T2L feature for use with individuals with multiple disabilities.

PMID:37220498 | PMC:PMC10202467 | DOI:10.1007/s10882-019-09673-5

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Knowledge and Awareness of Parents About the Difference Between Attention Deficit Hyperactivity Disorder and Childhood Absence Epilepsy in the Paediatric Population Makkah, Saudi Arabia: A Cross-Sectional Study

Cureus. 2023 Apr 21;15(4):e37945. doi: 10.7759/cureus.37945. eCollection 2023 Apr.

ABSTRACT

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder, mainly in children. The signs and symptoms of ADHD include inattention, impulsivity, and hyperactivity. Consequently, Childhood Absence Epilepsy (CAE) tends to present in children with sudden and recurrent episodes of loss of awareness alongside symptoms that occasionally include clonic, atonic, and simple automatisms. The present study evaluates parents’ knowledge in Makkah regarding the difference between ADHD and CAE.

METHODOLOGY: The study was conducted among Saudi Arabian parents living in Makkah. Data were collected in April 2022 through the use of an online survey that was distributed electronically via social media platforms. The inclusion criteria entailed parents from different socio-economic backgrounds. In contrast, the exclusion criteria entailed parents who had not been involved in raising their children and those with children with intellectual disabilities. A group of consultants was tasked with validating all data collected through an original questionnaire. To effectively calculate the study sample size, OpenEpi Version 3.01 was used. Lastly, all statistical analyses were conducted with Stata Social Sciences (SPSS®) software for Mac, version 26 (IBM Corp., Armonk, NY, USA).

RESULTS: A total of 633 participants completed the survey. Of the total respondents, approximately 1% indicated having a good knowledge level, 15.17% indicated having moderate knowledge, and the remaining 84% indicated poor knowledge of the subject under study. Approximately 46% of the participants reported that social media was the primary source of information. One significant issue regards the observation that the parent’s level of education was statistically associated with the level of knowledge.

CONCLUSION: There is limited awareness of the difference between (ADHD) and (CAE) among parents in the pediatric population. These findings highlight an opportunity to raise awareness using well-organized education programs in Makkah City.

PMID:37220468 | PMC:PMC10200272 | DOI:10.7759/cureus.37945

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Front-Line vs Second-Line Healthcare Workers: Susceptibility Prediction to COVID-19 Infection in a Tertiary Care Teaching Institute

Cureus. 2023 Apr 21;15(4):e37915. doi: 10.7759/cureus.37915. eCollection 2023 Apr.

ABSTRACT

Background Since the beginning of the novel coronavirus disease in Wuhan city of China in 2019 and its spreading worldwide and taking the form of a pandemic, many healthcare workers (HCWs) were affected by coronavirus disease 2019 (COVID-19) infection. Though we have used many types of personal protective equipment (PPE) kits while taking care of COVID-19 patients, we have seen COVID-19 susceptibility in different working areas were different. The pattern of infection in different working areas depended on HCWs following COVID-19 appropriate behavior. Therefore, we planned to estimate the susceptibility of front-line HCWs and second-line HCWs to getting COVID-19 infection. Aim To determine the risk of COVID-19 in front-line healthcare workers as compared to second-line healthcare workers. Method and materials We planned a retrospective cross-sectional analysis of COVID-19-positive healthcare workers from our institute within six months. Their nature of duty was analyzed and they were divided into two groups: 1) Front-line HCWs were defined as those who were working or who have worked in screening areas of the outpatient department (OPD) or COVID-19 isolation wards within the prior 14 days and provided direct care to patients with confirmed or suspected COVID-19. 2) Second-line HCWs were those who were working in the general OPD or non-COVID-19 areas of our hospital and did not have contact with COVID-19-positive patients. Results A total of 59 HCWs became COVID-19 positive during the study period, 23 as front-line and 36 as second-line HCWs. The mean (SD) duration of work as a front-line worker was 51 and as a second-line worker was 84.4 hours. Fever, cough, body ache, loss of taste, loose stools, palpitation, throat pain, vertigo, vomiting, lung disease, generalized weakness, breathing difficulty, loss of smell, headache, and running nose were present in 21 (35.6%), 15 (25.4%), 9 (15.3%), 10 (16.9%), 3 (5.1%), 5 (8.5%), 5 (8.5%), 1 (1.7%), 4 (6.8%), 2 (3.4%), 11 (18.6%), 4 (6.8%), 9 (15.3%), 6 (10.2%) and 3 (5.1%), respectively. To predict the risk of getting COVID-19 infection in HCWs, binary logistic regression with COVID-19 diagnosis as the output variable was modeled with hours of working in COVID-19 wards as front-line and second-line workers as independent variables. The results showed that there was a 1.18 times increased risk of acquiring the disease for every one-hour excess of working as a front-line worker, whereas, for second-line workers, it was slightly lower, with a 1.11 times increased risk for developing COVID-19 disease with every one hour increase in duty hours. Both these associations were statistically significant (p=0.001 for front-line and 0.006 for second-line HCWs). Conclusion COVID-19 has taught us the importance of COVID-19 appropriate behavior in preventing the spread of respiratory organisms. Our study has shown that both the front-line and second-line HCWs are at increased risk of getting the infection and proper use of a PPE kit or mask can decrease the spread of such respiratory pathogens.

PMID:37220464 | PMC:PMC10200018 | DOI:10.7759/cureus.37915

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Distinguishing Infested Flour from Uninfested Flour through Chemometric Processing of DART-HRMS Data─Revealing the Presence of Tribolium castaneum, the Red Flour Beetle

J Agric Food Chem. 2023 May 23. doi: 10.1021/acs.jafc.3c00685. Online ahead of print.

ABSTRACT

Insect infestation of agricultural stored products is a significant challenge to food security across the globe. One common pest is Tribolium castaneum (red flour beetle). In a new approach to addressing the threat of these beetles, Direct Analysis in Real Time-High-Resolution Mass Spectrometry was used to examine infested and uninfested flour samples. These samples were then distinguished through statistical analysis techniques, including EDR-MCR, in order to highlight the important m/z values contributing to the differences in the flour profiles. A subset of these values responsible for the identification of infested flour (nominal m/z 135, 136, 137, 163, 211, 279, 280, 283, 295, 297, and 338) were further investigated, and compounds responsible for these masses included 2-(2-ethoxyethoxy)ethanol, 2-ethyl-1,4-benzoquinone, palmitic acid, linolenic acid and oleic acid. These results have the potential to lead to a rapid technique by which flour and other grains can be tested for insect infestation.

PMID:37219919 | DOI:10.1021/acs.jafc.3c00685

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Clinical Characteristics and Outcomes of Cancer Cases Among Syrian Refugees From Southern Turkey

JAMA Netw Open. 2023 May 1;6(5):e2312903. doi: 10.1001/jamanetworkopen.2023.12903.

ABSTRACT

IMPORTANCE: Cancer was a common noncommunicable disease in Syria before the present conflict and is now a major disease burden among 3.6 million Syrian refugees in Turkey. Data to inform health care practice are needed.

OBJECTIVE: To explore sociodemographic characteristics, clinical characteristics, and treatment outcomes of Syrian patients with cancer residing in the southern border provinces of Turkey hosting more than 50% of refugees.

DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective hospital-based cross-sectional study. The study sample consisted of all adult and children Syrian refugees diagnosed and/or treated for cancer between January 1, 2011, and December 31, 2020, in hematology-oncology departments of 8 university hospitals in the Southern province of Turkey. Data were analyzed from May 1, 2022, to September 30, 2022.

MAIN OUTCOMES AND MEASURES: Demographic characteristics (date of birth, sex, and residence), date of first cancer-related symptom, date and place of diagnosis, disease status at first presentation, treatment modalities, date and status at last hospital visit, and date of death. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision and International Classification of Childhood Cancers, Third Edition, were used for the classification of cancer. The Surveillance, Epidemiology, and End Results system was applied for staging. The diagnostic interval was defined as the number of days from first symptoms until the diagnosis. Treatment abandonment was documented if the patient did not attend the clinic within 4 weeks of a prescribed appointment throughout the treatment.

RESULTS: A total of 1114 Syrian adult and 421 Syrian children with cancer were included. The median age at diagnosis was 48.2 (IQR, 34.2-59.4) years for adults and 5.7 (IQR, 3.1-10.7) years for children. The median diagnostic interval was 66 (IQR, 26.5-114.3) days for adults and 28 (IQR, 14.0-69.0) days for children. Breast cancer (154 [13.8%]), leukemia and multiple myeloma (147 [13.2%]), and lymphoma (141 [12.7%]) were common among adults, and leukemias (180 [42.8%]), lymphomas (66 [15.7%]), and central nervous system neoplasms (40 [9.5%]) were common among children. The median follow-up time was 37.5 (IQR, 32.6-42.3) months for adults and 25.4 (IQR, 20.9-29.9) months for children. The 5-year survival rate was 17.5% in adults and 29.7% in children.

CONCLUSIONS AND RELEVANCE: Despite universal health coverage and investment in the health care system, low survival rates were reported in this study for both adults and children with cancer. These findings suggest that cancer care in refugees requires novel planning within national cancer control programs with global cooperation.

PMID:37219908 | DOI:10.1001/jamanetworkopen.2023.12903

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Prediabetes and Fracture Risk Among Midlife Women in the Study of Women’s Health Across the Nation

JAMA Netw Open. 2023 May 1;6(5):e2314835. doi: 10.1001/jamanetworkopen.2023.14835.

ABSTRACT

IMPORTANCE: Whether prediabetes is associated with fracture is uncertain.

OBJECTIVE: To evaluate whether prediabetes before the menopause transition (MT) is associated with incident fracture during and after the MT.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data collected between January 6, 1996, and February 28, 2018, in the Study of Women’s Health Across the Nation cohort study, an ongoing, US-based, multicenter, longitudinal study of the MT in diverse ambulatory women. The study included 1690 midlife women in premenopause or early perimenopause at study inception (who have since transitioned to postmenopause) who did not have type 2 diabetes before the MT and who did not take bone-beneficial medications before the MT. Start of the MT was defined as the first visit in late perimenopause (or first postmenopausal visit if participants transitioned directly from premenopause or early perimenopause to postmenopause). Mean (SD) follow-up was 12 (6) years. Statistical analysis was conducted from January to May 2022.

EXPOSURE: Proportion of visits before the MT that women had prediabetes (fasting glucose, 100-125 mg/dL [to convert to millimoles per liter, multiply by 0.0555]), with values ranging from 0 (prediabetes at no visits) to 1 (prediabetes at all visits).

MAIN OUTCOMES AND MEASURES: Time to first fracture after the start of the MT, with censoring at first diagnosis of type 2 diabetes, initiation of bone-beneficial medication, or last follow-up. Cox proportional hazards regression was used to examine the association (before and after adjustment for bone mineral density) of prediabetes before the MT with fracture during the MT and after menopause.

RESULTS: This analysis included 1690 women (mean [SD] age, 49.7 [3.1] years; 437 Black women [25.9%], 197 Chinese women [11.7%], 215 Japanese women [12.7%], and 841 White women [49.8%]; mean [SD] body mass index [BMI] at the start of the MT, 27.6 [6.6]). A total of 225 women (13.3%) had prediabetes at 1 or more study visits before the MT, and 1465 women (86.7%) did not have prediabetes before the MT. Of the 225 women with prediabetes, 25 (11.1%) sustained a fracture, while 111 of the 1465 women without prediabetes (7.6%) sustained a fracture. After adjustment for age, BMI, and cigarette use at the start of the MT; fracture before the MT; use of bone-detrimental medications; race and ethnicity; and study site, prediabetes before the MT was associated with more subsequent fractures (hazard ratio for fracture with prediabetes at all vs no pre-MT visits, 2.20 [95% CI, 1.11-4.37]; P = .02). This association was essentially unchanged after controlling for BMD at the start of the MT.

CONCLUSIONS AND RELEVANCE: This cohort study of midlife women suggests that prediabetes was associated with risk of fracture. Future research should determine whether treating prediabetes reduces fracture risk.

PMID:37219902 | DOI:10.1001/jamanetworkopen.2023.14835

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Neighborhood Income Mobility and Risk of Neonatal and Maternal Morbidity

JAMA Netw Open. 2023 May 1;6(5):e2315301. doi: 10.1001/jamanetworkopen.2023.15301.

ABSTRACT

IMPORTANCE: Residing in a low-income neighborhood is generally associated with worse pregnancy outcomes. It is not known if moving from a low- to higher-income area between 2 pregnancies alters the risk of adverse birth outcomes in the subsequent birth compared with women who remain in low-income areas for both births.

OBJECTIVE: To compare the risk of adverse maternal and newborn outcomes among women who achieved upward area-level income mobility vs those who did not.

DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study was completed in Ontario, Canada, from 2002 to 2019, where there is universal health care. Included were all nulliparous women with a first-time singleton birth at 20 to 42 weeks’ gestation, each residing in a low-income urban neighborhood at the time of the first birth. All women were then assessed at their second birth. Statistical analysis was conducted from August 2022 to April 2023.

EXPOSURE: Movement from a lowest-income quintile (Q1) neighborhood to any higher-income quintile neighborhood (Q2-Q5) between the first and second birth.

MAIN OUTCOMES AND MEASURES: The maternal outcome was severe maternal morbidity or mortality (SMM-M) at the second birth hospitalization or up to 42 days post partum. The primary perinatal outcome was severe neonatal morbidity or mortality (SNM-M) within 27 days of the second birth. Relative risks (aRR) and absolute risk differences (aARD) were estimated by adjusting for maternal and infant characteristics.

RESULTS: A total of 42 208 (44.1%) women (mean [SD] age at second birth, 30.0 [5.2] years) experienced upward area-level income mobility, and 53 409 (55.9%) women (age at second birth, 29.0 [5.4] years) remained in income Q1 between births. Relative to women who remained in income Q1 between births, those with upward mobility had a lower associated risk of SMM-M (12.0 vs 13.3 per 1000 births), with an aRR of 0.86 (95% CI, 0.78 to 0.93) and aARD of -2.09 per 1000 (95% CI, -3.1 to -0.9 per 1000 ). Likewise, their newborns experienced lower respective rates of SNM-M (48.0 vs 50.9 per 1000 live births), with an aRR of 0.91 (95% CI, 0.87 to 0.95) and aARD of -4.7 per 1000 (95% CI, -6.8 to -2.6 per 1000).

CONCLUSIONS AND RELEVANCE: In this cohort study of nulliparous women living in low-income areas, those who moved to a higher-income area between births experienced less morbidity and death in their second pregnancy, as did their newborns, compared with those who remained in low-income areas between births. Research is needed to determine whether financial incentives or enhancement of neighborhood factors can reduce adverse maternal and perinatal outcomes.

PMID:37219900 | DOI:10.1001/jamanetworkopen.2023.15301

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How to reduce erroneous Emergency Department admissions for the frail elderly

Ann Ig. 2023 May 24. doi: 10.7416/ai.2023.2571. Online ahead of print.

ABSTRACT

BACKGROUND: Readmission after a first hospitalization is a common occurrence. It may be due to incomplete treatment, poor care for underlying problems or reflect bad coordination with health services at the time of discharge. The aim of this study was to identify the factors and classify the pathologies that expose elderly patients to erroneous access to the Emergency/Urgency Department (EUD).

STUDY DESIGN: Retrospective observational study.

MATERIALS AND METHODS: From January 2016 to December 2019 we studied patients who had at least one readmission to the EUD in the six months following discharge. All EUD accesses of the same patient that occurred for the problem treated during the previous hospitalization were identified. Data was provided by the University Hospital of Siena. Patients were stratified by age, gender, and municipality of residence. We used an ICD-9-CM coding system to describe health problems. Statistical analysis was carried out with Stata software.

RESULTS: We studied 1,230 patients (46.6% females) the mean age was 78.2 ± 14.3. Most of them, 721 (58.6%) were ≥80 years old, 334 (27.1%) were 65-79, 138 (11.2%) were 41-64, and only 37 (3.0%) were ≤40. Patients who lived in Municipality of Siena had a lower probability to return than to those living in other municipalities (OR 0.76; 95%CI: 0.62-0.93; p<0,05). The main causes of readmission for ≥65 years old were “symptoms, signs and ill-defined conditions” (18.3%), “respiratory diseases” (15.0%), “injury and poisoning” (14.1%), “cardiovascular diseases” (11.8%), “classification of factors influencing health status and contact with health services” (9.8%), “genitourinary diseases” (6.6%) and “digestive diseases (5.7%).

CONCLUSIONS: We observed that patients residing a greater distance from the hospital facilitates the risk of readmission. The factors that were exposed could be used to identify frequent users and initiate measures to reduce their access.

PMID:37219889 | DOI:10.7416/ai.2023.2571

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Sleep duration, sleep quality and obesity in the Canadian Armed Forces

Health Rep. 2023 May 17;34(5):3-14. doi: 10.25318/82-003-x202300500001-eng.

ABSTRACT

BACKGROUND: Research has identified an association between sleep and obesity in the general population. It is also important to examine this association in a military population.

DATA AND METHODS: Data from the 2019 Canadian Armed Forces Health Survey (CAFHS) were used to estimate the prevalence of sleep duration, sleep quality characteristics, overweight and obesity for Regular Force members. The relationship of sleep duration and sleep quality with obesity was assessed with multivariable logistic regression that controlled for sociodemographic, work and health characteristics.

RESULTS: Females were significantly more likely than males to report meeting recommended sleep duration (7 hours to less than 10 hours; 48.7% vs. 40.4%), trouble falling or staying asleep (32.3% vs. 23.5%), or that sleep was not refreshing (64.0% vs. 57.7%). Difficulty staying awake did not differ significantly between males and females (6.3% vs. 5.4%). Obesity, but not being overweight, was significantly more prevalent among those who had short (less than 6 hours) or borderline (6 hours to less than 7 hours) sleep duration, or poor sleep quality. Compared with recommended sleep duration, short sleep duration (adjusted odds ratio [AOR] 1.3; 95% confidence interval [CI]: 1.2 to 1.6) and borderline sleep duration (AOR 1.2; 95% CI: 1.1 to 1.4) were associated with obesity for males, but not females, in fully controlled models. Sleep quality indicators were not independently associated with obesity.

INTERPRETATION: This study adds to the body of evidence that identifies an association between sleep duration and obesity. The results emphasize the importance of sleep as one of the components of the Canadian Armed Forces Physical Performance Strategy.

PMID:37219888 | DOI:10.25318/82-003-x202300500001-eng

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Assessing the Impact of a New Pediatric Healthcare Facility on Medication Administration: A Human Factors Approach

J Nurs Adm. 2023 Jun 1;53(6):331-336. doi: 10.1097/NNA.0000000000001295.

ABSTRACT

OBJECTIVE: This observational descriptive study was designed to measure the effect a new evidence-based design (EBD) hospital has on pediatric medication safety.

BACKGROUND: Medication safety is a priority for nurse leaders. Controlling system design by increasing the understanding of the impact human factors have could improve medication delivery.

METHODS: Medication administration data from 2 studies conducted at the same hospital, 1 at an older facility in 2015 and the other at a new EBD facility in 2019, were compared using a similar research design.

RESULTS: Results indicate that rates of distractions per 100 drug administrations were all statistically significant, favoring the 2015 data regardless of the EBD. No statistically significant differences were observed in error rates of any type when comparing the data collected in the older facility versus the newer EBD facility.

CONCLUSION: This study demonstrated that EBD alone does not ensure the absence of medication errors. By comparing 2 data sets, unanticipated associations were found that could impact safety. Despite the new facility’s contemporary design, distractions persisted that could inform nurse leaders in developing interventions to support a safer patient care environment using a human factors approach.

PMID:37219885 | DOI:10.1097/NNA.0000000000001295