Tag: statistics

J Pediatr Nurs. 2022 Feb 18:S0882-5963(22)00036-7. doi: 10.1016/j.pedn.2022.02.004. Online ahead of print.

ABSTRACT

BACKGROUND: Perceptions and practices of parties in pediatric pain are critical in children’s access to adequate acute pain management. The personal factors of the child and parents have been shown to be central to pediatric pain management by the Symptom Management Theory.

AIM: To describe children and parents/guardians’ perceptions (knowledge, attitudes and beliefs) and practices regarding pediatric acute pain management and explain the influence of socio-cultural and environmental factors on those perceptions and practices.

METHODS: Descriptive cross-sectional survey using modified versions of the American Pain Society Patient Outcome Questionnaire-Revised among parents/guardians and children.

RESULTS: A convenience sample of 275 parents/guardians and 42 children aged 8 to 13 years admitted between date November 2018 and February 2019 to two Botswana tertiary hospitals completed the surveys. Forty-seven percent (n = 129) of parents/guardians reported the child to be in moderate-severe pain, while 38% (n = 16) of children reported pain as moderate-severe at the time of the survey. The children mean scores for cm-APS-POQ-R were 113(33) while parents/guardian’s guardians for m-APS-POQ-R were 123(26). The subscales except for the parents/’guardians’ pain interference (p = .96) were statistically significant (p = .000), showing adequate knowledge, positive attitudes and high pain intensity for both parents/guardians and children.

CONCLUSION: Parent/guardians and children reported a high incidence of acute pain, were content with pain management services, and showed adequate knowledge of pediatric pain and its management. The incongruence between the intensity of pain, satisfaction on the adequacy of pain management and knowledge and attitudes demonstrated in this study need further inquiry.

PMID:35190237 | DOI:10.1016/j.pedn.2022.02.004

J Arthroplasty. 2022 Feb 18:S0883-5403(21)00898-6. doi: 10.1016/j.arth.2021.11.033. Online ahead of print.

ABSTRACT

BACKGROUND: The ultrasound-guided adductor canal block (High-ACB) is an effective option for pain control in total knee arthroplasty (TKA), but its use can add substantial cost and preparatory time to a TKA procedure. An intraoperative adductor canal block (Low-ACB) performed by the operative surgeon has been described as an alternative. The hypothesis of this study is that the Low-ACB would achieve noninferior pain control and opioid utilization postoperatively when compared to the High-ACB.

METHODS: This is a retrospective study of a prospectively maintained database comparing the High-ACB vs the Low-ACB. The primary outcome measure was morphine milligram equivalents consumed. Secondary outcome measures included Visual Analog Scale pain scores, postoperative outcomes (Patient-Reported Outcome Measurement Information System, Knee Injury and Osteoarthritis Outcome Score, knee range of motion), length of stay, postoperative speed of mobilization, and complications related to the type of block.

RESULTS: There were 139 patients in the study. There was lower opioid use in the first 24 hours in the Low-ACB compared to the High-ACB group respectively (26.3 vs 30, P = .29) but this did not reach statistical significance. There was a statistically significant difference in Visual Analog Scale score on postoperative day 1 in the Low-ACB vs High-ACB groups respectively (4.6 vs 3.7, P = .02) but this did not reach the level of clinical significance. There was no statistical difference in the Patient-Reported Outcome Measurement Information System, Knee Injury and Osteoarthritis Outcome Score, or postoperative range of motion. There were no block-related complications in either group.

CONCLUSION: The Low-ACB is a safe, effective, and cost-saving alternative to the traditional High-ACB for pain control in TKA.

PMID:35190244 | DOI:10.1016/j.arth.2021.11.033

Dent Mater. 2022 Feb 18:S0109-5641(22)00026-4. doi: 10.1016/j.dental.2022.02.003. Online ahead of print.

ABSTRACT

OBJECTIVES: The fracture resistance of ultrathin computer-aided design and computer-aided manufacturing (CAD/CAM) occlusal veneers with different preparation designs was investigated under cycling mechanical loading and via finite element analysis (FEA).

METHODS: Eighty molars were prepared with a circular enamel ring until complete exposure of the occlusal dentin occurred. Forty were prepared via additional circular chamfer preparation. The teeth were restored with 0.5 mm-thick occlusal veneers. Each group received a CAD/CAM fabricated occlusal veneer with a low modulus of elasticity (composite, CeraSmart) and a high modulus of elasticity material (ceramic, Celtra Duo). The restorations were adhesively luted and underwent 2000 thermocycling cycles. The samples were loaded at 50 N under 1,000,000 cycles in a chewing simulator and were checked for failure after various cycles. A visible crack was defined as failure, and the Kaplan-Meier survival rate was used for data analysis. One sample per group was digitized using microcomputed tomography, and FEA was performed using open-source software. The comparative stresses were analyzed for specimens with and without chamfer preparation.

RESULTS: The survival probabilities were 60% for occlusal ceramic veneers without preparation and 40% for veneers with chamfer preparation, with no statistically significant differences. Composite veneers achieved 95% survival probability regardless of the preparation method. The main principal stress in ceramic restoration was visualized via FEA. In composite veneers, stress was also visible in the luting composite and dentin.

SIGNIFICANCE: The preparation method had no influence on mechanical fatigue. Minimally invasive preparation can be recommended. The restoration material is crucial for survival.

PMID:35190213 | DOI:10.1016/j.dental.2022.02.003

Vaccine. 2022 Feb 16:S0264-410X(22)00124-4. doi: 10.1016/j.vaccine.2022.02.002. Online ahead of print.

ABSTRACT

INTRODUCTION: A mass vaccination campaign against SARS-CoV-2 was initiated in European countries on December 27, 2020. This study compared the antibody response in a sample of healthcare workers (HCWs) who, after the first dose of the BNT162b2 mRNA vaccine, were infected with SARS-CoV-2 (infection group) with the response in a control group of HCWs immunized with two doses (vaccine group).

METHODS: This two-arm observational cohort study was carried out using routine health surveillance data obtained from HCWs at Bari Policlinico General Hospital (Italy). The antibody response was determined infection group and vaccine group.

RESULTS: Among the 100 HCWs, 25 (25.0%) were in the infection group and 75 (75.0%) in the full-vaccine group. At the serological evaluation, all of the HCWs tested positive, with a geometric mean titer (GMT) of 7106.8 (95 %CI = 5628.5-8973.4) and a statistically significant difference (p < 0.0001) between the infection group (GMT = 2139.7; 95 %CI = 1310.4-3493.6) and the vaccine group (GMT = 10603.6; 95 %CI = 8698.0-12926.8).

DISCUSSION: Our results shed light on the vaccine response of individuals in different risk categories. It also emphasizes the need for the continued use by HCWs of PPE and good practices during the window between the first and second anti-SARS-CoV-2 vaccinations.

PMID:35190212 | DOI:10.1016/j.vaccine.2022.02.002

J Prosthet Dent. 2022 Feb 18:S0022-3913(22)00066-X. doi: 10.1016/j.prosdent.2022.01.017. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: The placement of narrow-diameter implants (NDIs) in the posterior region is still debated in view of the high biomechanical risks in these areas.

PURPOSE: The purpose of this retrospective observational study was to evaluate the success and survival rates of NDIs restored with fixed prostheses in the posterior region (primary outcome) and analyze whether splinting multiple units (prosthesis design) affects the biological and mechanical complications (secondary outcome).

MATERIAL AND METHODS: Dental records from 2 private clinics were reviewed for NDIs in the posterior region installed between 2009 and 2018. Ninety study participants (58 women and 32 men) aged between 21 and 84 years (mean age 49.9 years) were recalled for the assessment of implant survival and success of 160 NDIs previously provided for partial posterior edentulism associated with moderate horizontal bone loss or reduced interradicular space (105 premolars and 55 molars). The implants were restored with metal-ceramic single crowns or splinted multiple-unit prostheses, either screw-retained or cemented on customized (n=100) or stock titanium abutments (n=60). Peri-implant probing depth (PPD), bleeding on probing (BOP), bone quality, type of edentulism, and patient satisfaction were scored. The chi-square test for independence and 2-sample Welch t test were performed for statistical analysis (α=.05).

RESULTS: The overall success rate was 89.37%. One implant had been removed 4 years after loading, another after 9 years, yielding a cumulative survival rate of 98.75%. Fourteen implants exhibited PPD > 5 mm. One implant and 1 abutment screw fractured, and 16 restorations demonstrated porcelain chipping. The chi-square test showed no significant relationship between prosthetic design and complications whether biological (P=.087) or mechanical (P=.805). Eighty-two percent of patients were satisfied with esthetics, 76% with function, 85% with total duration of treatment, and 90% with overall treatment cost.

CONCLUSIONS: Within the limitations of this retrospective study, NDIs may be considered a reliable option to replace posterior teeth. The prosthetic design had no significant impact on biological or mechanical complications.

PMID:35190196 | DOI:10.1016/j.prosdent.2022.01.017

Rev Esp Geriatr Gerontol. 2022 Feb 18:S0211-139X(22)00007-5. doi: 10.1016/j.regg.2022.01.002. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Hopelessness is characterized by a set of negative cognitive schemas about the future, conceptualized on the basis of three dimensions: affective, motivational and cognitive. This construct is linked to loneliness, the incidence of which in older adults is increasingly high. The aim of this research is to test whether hopelessness factors predict levels of loneliness in older adults.

MATERIAL AND METHODS: 138 non-institutionalized persons from Valencia city between 65-90 years old participated, with a mean age of 73.67 (SD=4.8), and 59.4% were women. The Beck Hopelessness Scale (BHS) and University of California Los Angeles Loneliness Scale (UCLA) were administered to assess participants.

RESULTS: The motivational and cognitive factors acted as statistically significant predictors of loneliness, while the affective factor was not presented as a significant factor. The final model obtained an R²adj=.442, F(3, 87)=23.97, p<.001.

CONCLUSIONS: Loneliness is a phenomenon of great concern in the field of gerontology due to its high incidence and impact. The results indicate that hopelessness, specifically loss of motivation and negative expectations about the future, are critical issues for the development of feelings of loneliness in older adults. Thus, it is relevant to pay attention to these variables in order to apply loneliness prevention programs.

PMID:35190191 | DOI:10.1016/j.regg.2022.01.002

Curr Pharm Teach Learn. 2022 Feb;14(2):215-221. doi: 10.1016/j.cptl.2021.11.020. Epub 2021 Dec 28.

ABSTRACT

BACKGROUND AND PURPOSE: The objectives of this study were to implement and assess a telepharmacy simulation for third-year students at two universities.

EDUCATIONAL ACTIVITY AND SETTING: Using telepharmacy, students completed a prescription verification activity and a patient counseling activity. Students completed surveys at baseline and after both activities. Focus groups were conducted after the second activity. Descriptive statistics, Cronbach’s alpha, paired t-tests, and qualitative analysis were used to evaluate data.

FINDINGS: There was a statistically significant increase in students’ perceptions using telepharmacy to deliver patient education before (mean (M) = 2.68, SD = 0.36) to after the experience (M = 2.97, SD = 0.52). A comparison of attitudes toward and intent to provide telepharmacy services found no differences before and after the experience. Following each activity, students felt somewhat to very confident in their abilities to verify a prescription medication and to counsel a patient using telepharmacy. Students demonstrated slight gains in knowledge pre-/post- regarding the use of telepharmacy. Focus group comments referred to the activities as realistic and of value.

SUMMARY: A purposeful telepharmacy simulation impacted students’ perceptions and knowledge on the use of telepharmacy. Students were confident in their abilities to verify and counsel on medications and felt the simulation helped them better understand the pharmacist’s role in telepharmacy. However, students indicated little intent to explore telepharmacy-based opportunities in the future. The results support the development of a more robust simulation and incorporation of didactic content into pharmacy curricula to train students in the use of telepharmacy.

PMID:35190164 | DOI:10.1016/j.cptl.2021.11.020

Curr Pharm Teach Learn. 2022 Feb;14(2):245-249. doi: 10.1016/j.cptl.2021.11.011. Epub 2021 Dec 27.

ABSTRACT

Background Limited literature is available evaluating retrospective student perceptions of the utility of a postgraduate preparation elective at graduation and career onset and its impact on residency match rates. This project sought to explore the perceived usefulness of a third-year elective course from 2016 to 2019 on post-graduation preparation and to compare the match rate of students enrolled vs. not enrolled in the elective. Impact The majority of students pursuing residency programs (94%) perceived the elective course as helpful in navigating the postgraduate training process. Of the students pursuing other employment, 77.8% found the elective to be helpful in navigating the employment process. The top five activities identified as most useful included: cover letters, letters of intent, and thank you cards overview; curriculum vitae workshop; interviewing tips; mock interviews; and overview of postgraduate training opportunities. The match rate was not statistically different between those who completed the elective (60.7%) vs. all school graduates (64.7%) (P =.70). Recommendations Consideration should be given to the topics to be included in this type of elective course depending on the targeted audience. Additionally, it may be more beneficial to introduce these types of topics and activities to students earlier in their didactic career and integrate them into different parts of the curriculum. Discussion The post-graduation preparation elective course was perceived positively by students in terms of preparing for their postgraduate plans. Limitations and confounders make it difficult to determine the true impact of this type of elective on successful residency match rates.

PMID:35190169 | DOI:10.1016/j.cptl.2021.11.011

Curr Pharm Teach Learn. 2022 Feb;14(2):159-165. doi: 10.1016/j.cptl.2021.11.013. Epub 2021 Dec 24.

ABSTRACT

INTRODUCTION: Pharmacy students experience high levels of perceived stress. Data regarding the impact of curricular revision on students’ stress level are lacking. The primary objective of this study was to compare perceived stress, academic self-concept, and coping strategies between pharmacy students prior to and following a curricular revision. Secondary objectives included determining university resources used by students to deal with stress.

METHODS: Students in the first, second, and third years of the pharmacy curriculum were asked to complete a survey, including the 14-item Perceived Stress Scale (PSS-14), Brief COPE, and Academic Self-Concept Scale (ASCS), and questions regarding use of university resources. Responses to the PSS-14, Brief COPE, and ASCS were compared to a student cohort prior to the curricular revision.

RESULTS: Perceived stress was reduced to a small, statistically significant degree following a curricular revision. In both cohorts, increased stress was statistically significantly correlated with decreased academic self-concept. Students reported increased use of self-distraction, along with decreased use of active coping, substance abuse, and planning, as coping strategies when compared to the previous cohort. Approximately half of the student cohort reported no use of university resources. The most commonly used resources were financial aid and mental health services.

CONCLUSIONS: Perceived stress decreased following the revision of a Doctor of Pharmacy curriculum. The most common coping strategies were positive and comparable with strategies reported by students in the former curriculum. The impact of curricular changes on student stress and the use of university resources in health professions students warrant further study.

PMID:35190157 | DOI:10.1016/j.cptl.2021.11.013

Curr Pharm Teach Learn. 2022 Feb;14(2):153-158. doi: 10.1016/j.cptl.2021.11.024. Epub 2021 Dec 27.

ABSTRACT

INTRODUCTION: The primary objective was to describe the percentage of physician assistant (PA) programs who utilize pharmacists to lecture on pharmacology/pharmacotherapeutics content. Secondary objectives were to describe the percentage of pharmacology/pharmacotherapeutics lectures pharmacists deliver, the percentage of programs who employ a full-time pharmacist to coordinate the Pharmacology/Pharmacotherapeutics courses, and the inclusion of pharmacists in other courses in the curricula.

METHODS: This was a prospective, cross-sectional, cohort survey. All PA programs listed on the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) website with an available email address for the Director of Pre-Clinical Education/Didactic Education, Academic Coordinator, or Chair/Director were recruited for the study. A link to an online survey was distributed to each program. The survey collected data on program characteristics as well as utilization of pharmacists in the curriculum. Descriptive statistics were used for all analyses.

RESULTS: Of the 187 programs receiving the survey, 66 completed the survey (35%). Eighty-three percent of programs reported that pharmacists were utilized to deliver pharmacology/pharmacotherapeutics content. For those programs who utilize pharmacists, 80% reported pharmacists teach more than 75% of the lectures. Twenty-three (35%) programs reported having a full-time pharmacist on faculty to coordinate these courses. Almost half of respondents also commented that pharmacists were involved in other courses in the curriculum.

CONCLUSIONS: More than 80% of programs responding to the survey utilize pharmacists to deliver pharmacology/pharmacotherapeutics content. Studying the utilization of pharmacists and their impact in other health sciences curricula is warranted.

PMID:35190156 | DOI:10.1016/j.cptl.2021.11.024