bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the Impacts of Benson Relaxation Technique and Foot Reflexology Massage on Sleep Quality of Patients with Systolic Heart Failure: A Randomized Clinical Trial
Authors: Bakavoly Masoumeh Emami , Sajjadi Moosa , Ghasemi Reza , Ajamzibad Hosein
Published: May 2024

Background:

Cardiovascular diseases can affect sleep quality. The use of non-pharmacological methods to improve the sleep quality of heart failure patients is essential. Therefore, this study compared the effects of the Benson relaxation technique and foot reflexology massage on sleep quality of those patients.

Materials and Methods:

In this clinical trial study, 93 patients with systolic heart failure referred to Javad Al-Aeme heart clinic in Torbat Heydarieh were selected with purposive sampling method and divided into the foot reflexology massage, Benson relaxation technique, and control groups using the balanced blocking randomization method. The Benson relaxation technique and the foot reflexology massage were performed for 20 and 30 minutes three days per week for four weeks, respectively. The control group only received routine care. Sleep quality was measured by the Pittsburgh sleep quality index and then compared among the groups before and after the intervention. The data were analyzed using ANOVA, Tukey’s post hoc tests, paired t test, and Chi-square at the significant level of p < 0.05.

Results:

After interventions, the mean (SD) quality of sleep significantly increased in both intervention groups (Reflexology: pre-intervention 10.80 (3.40), post-intervention 6.60 (3.10), Benson relaxation: pre-intervention 15.50 (2.40) post-intervention 12 (2.60), compared to the control group (pre-intervention 10.50 (1.90) post-intervention 9.40(1.70) (p < 0.001). There was no significant difference between the two intervention groups (p = 0.53).

Conclusions:

The interventions improved the quality of sleep in patients with systolic heart failure. Therefore, these methods can be used as a suitable complementary treatment to improve the quality of sleep by nurses and midwives.
A Thematic Analysis of Dimensions of Spiritual Care
Authors: Abbasi Mohammad , Eskandari Narges , Heidari Akram , Heidari Morteza , Yoosefee Sadegh , Adeli Seyed-Hasan , Kazemi Abdolhassan
Published: May 2024

Background:

An overview of spiritual care studies can help reveal the dimensions of spiritual care and summarize the findings of available studies. Thus, we designed the present study based on existing studies to explain the dimensions of spiritual care.

Materials and Methods:

In this thematic analysis, we gathered the related articles published in Persian and English in the last 8 years (2013–2021) with the help of the keywords of Care, Support, Spirituality, Religion, Treatment, Hospice, and Palliative, and searching in electronic databases, including PubMed, Scopus, Web Of Sciences, Magiran, Islamic Science Citation (ISC), and Scientific Information Database (SID). We accurately studied 79 articles that met the inclusion criteria, and then the spiritual care components were extracted and coded, and finally, the codes were categorized as themes and sub-theme.

Results:

Thematic analysis of available studies revealed that the dimensions (theme) of spiritual care include: spiritual and religious assessment, developing a structure for providing spiritual care, establishing effective and supportive communication with the patient, training the patient, answering his questions, encouraging, maintaining, and improving social communications, encouraging the patient to live happily, helping the patient to achieve peace and calmness, supporting for spiritual rituals and activities, supporting and training the patient's family, and supporting the dying patient.

Conclusions:

Spiritual care includes various and numerous dimensions. Considering the widespread dimensions of spiritual care, it seems necessary to design and plan appropriate studies to reveal other spiritual care dimensions from the perspective of patients and care providers in different cultures.
The Relationship Between Professional Autonomy and Job Stress Among Intensive Care Unit Nurses
Authors: Asl Rasool Gharaaghaji , Taghinejad Roghaie , Parizad Naser , Jasemi Madine
Published: May 2024

Background:

Autonomy is an essential factor in the nursing profession. Nurses' autonomy can improve care quality, decrease mortality in patients, and attenuate job stress. This study aimed to investigate professional autonomy and its relationship with job stress among nurses working in Intensive Care Units (ICUs).

Materials and Methods:

This descriptive correlational study was conducted at Urmia nursing school in Iran in 2020. Three hundred ninety-eight nurses working at the ICUs entered the study. Data was collected using the Dempster Practice Behavior Scale (DPBS) and the Health and Safety Executive (HSE) questionnaire. Independent t-test and analysis of variance (ANOVA) were used to examine the relationship between demographics and study variables. Pearson's correlation coefficient was used to investigate the relationship between professional autonomy and job stress of nurses.

Results:

The mean (SD) of total professional autonomy and job stress score of nurses was, respectively, 102. 11(91. 88), and 115. 53(12. 42), indicating moderate autonomy and job stress. Professional autonomy had a significant positive correlation with job stress (r = 0.51, p < 0.001). It also had a significant positive correlation with work experience in ICU (r = 0.12, p = 0.014).

Conclusions:

ICU nurses have moderate autonomy and job stress, and their autonomy is a significant positive predictor of their job stress. University authorities are recommended to develop practical strategies to enhance nurses' autonomy and eliminate factors that cause job stress in ICU nurses in order to preserve nurses' health, improve the quality of nursing care, and increase patient safety.
Early Enteral Nutrition Met Calories Goals Led by Nurse on Improve Clinical Outcome
Authors: Koontalay Apinya , Suksatan Wanich , Teranuch Aumpornpun
Published: May 2024

Background:

Critically ill patients face challenges in hypercatabolism due to crisis states, as it may lead to malnutrition. An early Enteral Nutrition (EN) within 24–48 h is recommended to use in order to improve clinical outcomes. This systematic scoping review is examined recently with the evidence of the early EN protocol led by nurses to drive and achieve the daily calorie target and improve clinical outcomes.

Materials and Methods:

The database of CINAHL, MEDLINE via PubMed and Scopus, Web of Science, and Embase through Ovid from January 2019 to September 2020, comprised of 221 articles which four articles are chosen and entered into the final analysis.

Results:

The findings show the benefits of the early EN to guide nurses to start the EN as soon as possible after admitted to the Intensive Care Unit or when hemodynamic is stable in order to achieve a daily calorie target regarding the reduced hospitalization, duration of mechanical ventilation, morbidity, and mortality.

Conclusions:

The synthesized results show the early EN led by a nurse to address the specific needs and the vital role of nutritional support, and also drive the enteral feeding for critically ill patients to reach the calorie target goals in short times to enhance clinical outcomes.
Barriers to Providing Spiritual Care from a Nurses' Perspective
Authors: Momeni Ghodratollah , Hashemi Maryam Sadat , Hemati Zeinab
Published: May 2024

Background:

Spirituality is an important dimension of holistic nursing, and spiritual care is essential to ensure the achievement of optimal care in nursing profession. The aim of this study was to explain the obstacles to providing spiritual care from the perspective of nurses.

Materials and Methods:

The present qualitative study was conducted between November 2020 and June 2021 with a content analysis approach. Participants included 30 nurses, selected through purposive sampling, working in the general wards and intensive care units of Isfahan University hospitals. Data collection method was semi-structured personal interviews. After recording and transcription word by word, all data were analyzed through qualitative content analysis. MAXQDA 11 was used for data analysis.

Results:

Research findings included 323 primary codes and two main categories “individual barriers and organizational barriers” and eight subcategories “non-compliance with human resources standards, lack of attention of organizational managers to the importance of holistic care, motivational barriers, training barriers, barriers to interprofessional collaboration, environmental barriers, barriers related to the nurses, and communication barriers.”

Conclusions:

Using the results of the study, policymakers and nursing managers will be able to help facilitate spiritual care, and ultimately, improve the quality of nursing care by improving the infrastructure and removing existing barriers.
Comparing the Fertility Desire and Related Factors in Mothers with Intellectually Disabled Children and Mothers with Healthy Children
Authors: Sheidanik Sepideh , Savabi-Esfahani Mitra , Shahverdi-Asadabadi Zohreh
Published: May 2024

Background:

The birth of a child with an intellectual disability is a common event. The fertility desire plays an important role in healthy reproductive programs. This study was conducted to compare the fertility desire and related factors in mothers with intellectually disabled and healthy children.

Materials and Methods:

The present study was a descriptive, cross-sectional study. The sample size consisted of 348 mothers with healthy and intellectually disabled children (174 per group). Sampling was performed at normal (six schools) and special primary schools (twelve schools) in Isfahan, Iran using stratified random sampling method. Attitude, subjective norms, perceived behavior control, and gender preference were assessed using a researcher-made questionnaire and psychological well-being using Ryff questionnaire. Data were analyzed by descriptive statistics, Independent t-test, Mann–Whitney U test, Chi-square test, and Logistic regression using SPSS 24.

Results:

In this study, 21.84% of mothers with healthy children and 13.79% of mothers with intellectually disabled children were willing to have other children. The fertility desire in mothers with intellectually disabled and healthy children decreased as their numbers of children (CI 95% =0.14-0.42) and age increased (CI 95% =0.80-0.93) by 0.87 and 0.24, respectively. There was statistically significant difference in mean score of psychological well-being between the two groups of mothers with fertility desire (p = 0.017). There was no statistically significant difference in mean score of attitude, subjective norms, perceived behavior control, and gender preference (p > 0.05).

Conclusions:

Apparently the awareness of fertility desire and related factors in mothers with healthy and intellectually disabled children may be helpful in healthy fertility counseling.
Post-Traumatic Stress Disorder and Its Related Factors in Nurses Caring for COVID-19 Patients
Authors: Mirzaei Alireza , Molaei Behnam , Habibi-Soola Aghil
Published: May 2024

Background:

Post-Traumatic Stress Disorder (PTSD) is a mental disorder that can result from direct or indirect contact with traumatic events. The current study aimed to evaluate PTSD and its related factors in nurses caring for COVID-19 patients.

Materials and Methods:

This study was a descriptive correlational study. Using convenience sampling methods, 395 nurses were enrolled in the study. The study instruments included demographic information, Impact of Event Scale-Revised (IES-R), and General Health and Job Content Questionnaire (JCQ). Data were analyzed using the Pearson correlation test, t-test, ANOVA, and multiple regression analysis.

Results:

The mean (SD) age and work experience of the participants were 33.79 (6.74) years and 9.47 (6.47) years, respectively. Most nurses (86.60%) experienced PTSD. Multiple linear regression results showed general health (R
2 = 0.51, p = 0.001), job insecurity (R
2 = 0.51, p = 0.042), decision latitude (R
2 = 0.51, p = 0.037), and high age (R
2 = 0.51, p = 0.049) to be associated with an increase in PTSD, and having high social support (R
2 = 0.51, p = 0.043) was associated with a decrease in PTSD in nurses.

Conclusions:

Nurses have experienced high levels of PTSD after the fatal outbreak of COVID-19 disease. Stressful conditions associated with an increased likelihood of this disorder should be identified, and coping skills such as decision latitude (control) and social support should be strengthened to prevent the symptoms of this disorder in nurses.
Interprofessional Collaboration Competencies in the Health System
Authors: Vaseghi Fatemeh , Yarmohammadian Mohammad Hossein , Raeisi Ahmadreza
Published: May 2024

Background:

Today's health systems require the collaboration of diverse staff such as physicians, nurses, social workers, and other healthcare professionals. In addition to professional competencies, they also need to acquire interprofessional competencies. Effective interprofessional collaboration among healthcare professionals is one of the solutions that can promote the effectiveness of the health system using existing resources.

Materials and methods:

A systematic review was conducted in 2021 according to the PRISMA and through searching Web of Science, Scopus, PubMed, ProQuest, Science Direct, Emerald, Springer Link, Google Scholar, SID, and Magiran databases. The official websites of WHO, United Nations, and World Bank were also searched. The time frame for the research was from 2010 to 2020, and included both the English and Persian languages. Out of 7267 initially retrieved articles, 17 articles finally met the quality evaluation criteria and were analyzed through qualitative content analysis. Then their full texts were retrieved and analyzed in MAXQDA software, and final results were categorized.

Results:

Competencies have been explored in various areas of health care, especially in the clinical field. The competencies introduced were extracted and categorized into six domains of “patient-centered care,” “interprofessional communication,” “participatory leadership,” “conflict resolution,” “transparency of duties and responsibilities,” and “teamwork.” The competence of “transparency of duties and responsibilities” was mentioned in all studies and is required for any collaboration.

Conclusions:

Interprofessional competencies provide quality, safety, and patient-centeredness through effective collaboration. Integrating interprofessional competencies into the educational curriculum, in-service training, and continue education is essential to form effective interprofessional collaboration.
Association between Socioeconomic Status and the Utilization of Maternal Health Services in Nigeria
Authors: Maitanmi Bukola T. , Adelaja Abiodun A. , Okunola Damilola R. , Maitanmi Julius O. , Tola Yetunde O. , Akingbade Oluwadamilare
Published: May 2024

Background:

Maternal health is the mother’s state of well-being before, during, and after conception. Studies have suggested that the increasing maternal mortality rate is preventable provided maternal health services are accessible during pregnancy. This study explored the association between socioeconomic status and the utilization of maternal health services in the Federal Medical Centre (FMC), Abeokuta, Ogun State.

Materials and Methods:

This study is a cross-sectional survey. One hundred and eighty-eight pregnant women from the antenatal unit of a tertiary hospital in Southwestern Nigeria were selected using a convenience sampling technique. Data were collected via a pretested, self-designed questionnaire. The descriptive statistics were used to analyze the resulting data, and the hypotheses were tested using the Pearson product-moment correlation at 0.05 level of significance.

Result:

From the study, 72 (38.30%) and 58 (30.90%) agreed that their income and occupation influence their maternal health services utilization. Significant relationship (p < 0.05) existed between maternal health service utilization and age and between socioeconomic factors (occupation and income level) and utilization of maternal health services of pregnant women.

Conclusions:

Overall, this study revealed that the level of utilization of maternal health services among expectant women attending FMC is moderate. As this study has shown that socioeconomic factors influence the utilization of maternal health services, we recommend that interventions by health workers targeted at improving the utilization of maternal health services should consider these factors when designing such interventions. It is hoped that this will contribute to reducing maternal mortality and morbidity in this state.
Participation of Primary Care Nurses in the Prevention of Chronic Non-Communicable Diseases in the Republic of Kazakhstan: A Cross-Sectional Study
Authors: Masharipova Alexandra , Nurgaliyeva Nasikhat , Derbissalina Gulmira
Published: May 2024

Background:

Chronic diseases are a huge threat to public health in Kazakhstan and around the world. Many deaths can be prevented by using evidence-based behavioral interventions. Nurses, as the most numerous health care workers, can perform behavioral therapy for the prevention of Non-Communicable Diseases (NCDs). This study was conducted in order to explore the behavioral interventions performed by nurses, to analyze current problems, barriers and the attitude of nurses to these activities.

Materials and Methods:

A cross-sectional study was conducted among 260 nurses in the city of Nur-Sultan from 2019 to 2020. The sample was calculated using a formula and simple random sampling. The study was conducted using a specially compiled questionnaire. Descriptive statistics were chosen as a statistical method. Pearson’s Chi-square criterion was used to identify a statistically significant relationship between variables.

Results:

Among 260 nurses, 208 participants (80%) had the desire to conduct behavioral interventions among patients. Most nurses do not have enough time to conduct behavioral interventions. A short work experience affects to a greater extent nurses use passive training methods. Almost half (47.30%) of nurses rate their level of knowledge about the real effects of drugs, tobacco, alcohol, and preventive measures on the body as “average”.

Conclusions:

The work of nurses on the prevention of NCDs is not performed enough due to lack of working time and available domestic literature, heavy workload. Behavioral therapy should be based on reliable scientific evidence, which can be achieved through the development of clinical guidelines and continuous training of nurses.
Need Asseesment on Maternal Mental Health Care for Perinatal Mothers during COVID-19: A Qualitative Study
Authors: Winarni Lastri Mei , Damayanti Rita , Afiyanti Yati
Published: May 2024

Background:

During COVID-19 pandemic, the isolation, socialization, and extreme changes in daily life have some potential mental health consequences which should be recognized as a critical public health concern, especially for perinatal mothers. Therefore, it is very important to assess the needs for maternal mental health care in perinatal mothers during COVID-19 pandemic. This study aimed to explore mothers’ needs for maternal mental health care in the perinatal period during COVID-19 pandemic.

Material and Methods:

Realistic phenomenological approach was carried out in this qualitative study. The study was conducted at five community health centers in the city of Tangerang, Indonesia. In-depth interviews were conducted to 11 mothers who were pregnant, in labor, during puerperium and two months after giving birth with purposive sampling. Data were collected from May to August 2021. Interviews were conducted face to face, audio recorded, and transcribed verbatim. Data were analyzed by using Van Manen’s phenomenological method.

Result:

Initial finding revealed 254 codes, which were then reduced to 122 codes, 98 sub-categories, 22 categories, and 5 themes. There were five themes related to mothers’ needs for mental health care during COVID-19, i.e., health protocol during pandemic, psychological support, health education, simple coping mechanism, and support system.

Conclusions:

The needs can be fulfilled by the closest people the mothers have and healthcare system for perinatal mental health. Vaccination, health protocol, and psychological resilience should be delivered to mothers during COVID-19.
Effect and Safety of Castor Oil on Labor Induction and Prevalence of Vaginal Delivery
Authors: Amerizadeh Atefeh , Farajzadegan Ziba , Asgary Sedigheh
Published: May 2024

Background:

Castor oil is used in some countries to induce labor, but results on its effectiveness and safety is controversial. This systematic review and meta-analysis aimed to evaluate the effect of castor oil on labor induction and prevalence of vaginal delivery along with investigating its safety.

Materials and Methods:

PubMed, Scopus, Web of Science, and Google Scholar were searched systematically up to September 2020. Observational studies and Randomized Clinical Trials (RCTs), which assessed the effect of castor oil on labor induction in English and Persian languages using different combinations of the related key terms and Medical Subject Headings (MeSH) terms were collected and analyzed independently by two authors. Random effect model was used for meta-analysis. The studies were included in which the Relative Risk (RR) had been reported with 95% Confidence Intervals (CIs).

Results:

A total of 12 studies consisting 1653 pregnant women were included. The mean age of women who used castor oil was 24.72 years and in control group was 24.67 years. Results showed that labor induction was significantly higher in castor oil group than control group (RR: 3.27; 95% CI (1.96, 5.46)). Prevalence of vaginal delivery was 81% in the castor oil group and 69% in the control group.

Conclusions:

It can be concluded that use of castor oil has positive effect on labor induction and increases the prevalence of vaginal delivery. None of the studies considered in this meta-analysis reported any serious harmful effects for the use of castor oil.
Communication between Parents and Preschool-Aged Children about Tuberculosis Preventive Treatment
Authors: Rakhmawati Windy , Fitri Siti Yuyun Rahayu , Sriati Aat , Hendrawati Sri
Published: May 2024

Background:

Communication with preschool-aged children about Tuberculosis Preventive Treatment (TPT) is a challenge for parents. Good communication can encourage children to be involved in their treatment and enhance their adherence to the treatment. This study aimed to explore the experience of parents in communicating with their preschool-aged children about TPT.

Materials and Methods:

This study used a qualitative approach. Participants were 10 parents who were selected using the purposive sampling technique from three community health centers in Bandung City, Indonesia. The inclusion criteria for the study were parents who have a child aged 3–5 years who received or was receiving TPT. Semi-structured interviews were conducted to obtain the data, and when saturation was reached, no further interviews were conducted. Subsequently, the interviews were transcribed and analyzed using thematic analysis.

Results:

The findings revealed three themes with eight categories. The themes were persuading children, lack of understanding, and supporting communication.

Conclusions:

The findings are relevant for nurses and other health professionals who need to provide adequate information related to TPT and to develop media for parents and children during their communication. Nurses can collaborate with other physicians and software engineers to develop interesting media such as game applications to educate children about Tuberculosis (TB) prevention.
Caspian Nursing Process
Authors: Alijanpour Shayan , Alimohamadi Nasrollah , Khafri Soraya , Rokni Mostafa Akbarian , Khorvash Fariborz
Published: May 2024

Background:

Structural planning is essential for the management of constipation in stroke patients. The current study aims to determine the impact of a care plan on the frequency of new-onset constipation following stroke. Materials and Methods

:

This clinical trial was conducted on 132 stroke patients (two groups of 66) in three phases (pre-intervention, during discharge, 1 month after discharge). Clients were randomly assigned to blocks based on gender, type of stroke, and age. The care plan according to the nursing process was conducted. Data collection tools included a demographic–clinical information questionnaire, Rome IV criteria (diagnosis of constipation), and Bristol scale (consistency of stool). Data were analyzed using the Chi-square, McNemar, Wilcoxon, Analysis of Variance (ANOVA), and a general estimated model.

Results:

The prevalence of new-onset constipation following stroke in the control group decreased from 66 (100%) at admission to 39 (67.20%) at discharge and in the intervention group from 66 cases (100%) to 18 cases (34%) (p = 0.001), but it was not significant at follow-up (p = 0.16). The trend of frequency of constipation from admission to follow-up was generally significant in the intervention group (p = 0.03) vs the control group (p = 0.21). The difference in the mean number of cases of constipation was statistically significant (2.89) 2.10) control group vs 1.58 (1.65) intervention group, p < 0.001).

Conclusions:

A significant impact of the care plan was observed from admission to discharge, but further follow-up was required with more client-side collaboration. Therefore, the present care plan is recommended in the hospital and home care.
Immunotherapy rechallenge for an elderly patient with driver gene-negative non-small cell lung cancer: A case report and literature review
Authors: Zhang Zhiguo , Han Lei , Zhang Ying , Xun Pei , Zhao Ying
Published: May 2024

Advanced non-small cell lung cancer (NSCLC) negative for driver genes is a medical oncology treatment challenge. The increasingly widespread application of immunotherapy, especially programmed death-1 (PD-1)/programmed death-ligand 1 inhibitors, has changed the treatment pattern of patients with advanced NSCLC. In clinical practice, many patients with immune checkpoint inhibitor (ICI) discontinue treatment for a variety of reasons, and it is known as “immunotherapy rechallenge” to try ICI treatment again following discontinuation. We report an 82-year-old patient with advanced lung adenocarcinoma who was cured after 16 cycles (7.5 months) of PD-1 monoclonal antibody (mab) followed by 4 cycles of bevacizumab and PD-1 mab. Relapse occurred 21 months after treatment had been discontinued. After 10 cycles of immunotherapy, a partial response was achieved, with a 54-month survival and ongoing treatment. This study examines the diagnosis and treatment process, as well as provides a literature review of immunotherapy rechallenge.
Upper respiratory tract magnetic resonance imaging in coronavirus disease 2019
Authors: Shi Chunzi , Tang Zuohua , Shen Jie , Zhang Zhiyong , Jiang Chao , Shi Nannan , Wu Lianming , Jiang Yebin , Shan Fei , Song Fengxiang , Shi Yuxin
Published: May 2024

OBJECTIVE:

The objective of the study was to investigate magnetic resonance imaging (MRI) findings of the upper respiratory tract (URT; a main harbor site for infection) in patients with coronavirus disease 2019 (COVID-19), and their association with pneumonia severity.

MATERIALS AND METHODS:

URT MRI of 128 patients with confirmed COVID-19 was evaluated. URT lymphoid tissue hyperplasia as an overall score of adenoid mass, tonsil enlargement, and cervical adenopathy was analyzed, along with quantitative pneumonia data on chest computed tomography (CT).

RESULTS:

Effusion of the posterior laryngopharyngeal wall (98%) was the most common, followed by the nasopharyngeal (80%) and the posterior oropharyngeal (70%) walls. There was also evidence of (I) swelling of the epiglottis (99%) and vocal cord (58%), (II) mild or no (15%), moderate (42%), and severe (37%) nasopharyngeal roof thickness, (III) mild (50%), moderate (21%), and severe (3%) tonsil enlargement, and (IV) mild (22%), moderate (54%), and severe (20%) cervical lymph node enlargement. Ethmoid sinusitis was the most common (98%), which was followed by maxillary sinusitis (81%). Mastoiditis was present in 32% of patients. At follow-up (n = 22), nasopharyngeal wall thickening was improved in four patients. Chest CT images showed pneumonia in 57% of patients. There were also more focal adenoid masses, and tonsil and cervical lymph node enlargement. Furthermore, the URT lymphoid tissue hyperplasia scores were higher in patients without pneumonia than in those with pneumonia, while the four indexes were negatively correlated with CT pneumonia quantification at the peak time ( r = −0.26 to −0.49, P < 0.001).

CONCLUSIONS:

URT lymphoid tissue hyperplasia assessed by MRI may be a protective factor against COVID-19 pneumonia.
A comparative study of internalized stigma and quality of life among patients of schizophrenia and bipolar affective disorder under remission, visiting a tertiary care center
Authors: Sumedha Kota Raga , Rao Sireesha Srinivasa , Boorla Vivaswan , Meda Aparna
Published: May 2024

Background:

Patients with schizophrenia and bipolar affective disorder (BPAD) diagnosis often experience high levels of internalized stigma, where they internalize negative societal views about mental illness. This can profoundly impact their quality of life (QOL), help-seeking behavior, adherence to treatment, increased disability, and increase the economic burden. This study was taken up to determine and compare internalized stigma in remitted patients of schizophrenia and bipolar disorder and correlate the association between internalized stigma and QOL.

Methodology:

A cross-sectional comparative hospital-based study with a sample size of 100 (48 patients of schizophrenia and 52 patients of bipolar disorder in remission) was taken for the study as per the International Classification of Diseases-10 criteria. Basic demographic data were collected using a semi-structured questionnaire. Remission was assessed by the Clinical Global Impressions-Severity Scale. Stigma was assessed using the Internalized Stigma of Mental Illness Scale and quality of life (QOL) was assessed using the World Health Organization Quality of Life Brief version (WHOQOL BREF), insight grading as per Comprehensive Textbook of Psychiatry 10th Edition. The level of significance was set at 0.05 for all statistical analyses.

Results:

A total of 100 subjects participated in the study, of which 48 belong to the schizophrenia group and 52 belong to the BPAD group. Prevalence of internalized stigma among subjects with schizophrenia is 54% and BPAD is 50%. There was a statistically significant association between diagnosis and self-stigma. Self-stigma was found to be more among female gender (P = 0.001), single (0.014), and unemployed (P = 0.010). There was a statistically significant negative correlation between internalized stigma scores and QOL.

Conclusion:

The current study found a strong negative correlation between internal stigma and QOL, suggesting that internal stigma may have a negative impact on social relationships, community participation, and physical and psychological well-being of the individual. Considering this, psychiatrist should formulate strategies to address internal stigma along with clinical manifestations.
Coping strategy as a predictor of quality of life among people living with the human immunodeficiency virus: A cross-sectional study
Authors: Edet Bassey Eyo , Essien Emmanuel Aniekan , Okafor Chidi John , Olose Emmanuel Omamurhomu , Odo Michael Odey , Atu Ginini Edward Eko
Published: May 2024

Context:

Coping is a modifiable factor that promotes mental well-being. Among people living with human immunodeficiency virus (HIV), it might affect outcomes such as quality of life (QOL).

Objective:

This study aims to determine the role of coping strategies as a predictor of QOL among HIV outpatients in a general hospital.

Methods:

This cross-sectional study involved 200 HIV patients under treatment. Consecutive clinic attendees were surveyed using a sociodemographic questionnaire, the 32-item Coping Strategies Inventory, and the World Health Organization QOL in HIV–BREF scale. Statistical analysis was conducted with a significance level set at 0.05.

Results:

Respondents, with a mean age of 35.54 (standard deviation = 10.88), were predominantly female (67.5%). After accounting for age and gender, linear regression analysis revealed that engagement coping positively predicted all domains (physical, psychological, independence level, social relationships, environment, and spirituality) of QOL (P < 0.05). Disengagement coping, however, emerged as a predictor solely for the social relationship domain (P < 0.05).

Conclusion:

Coping is a significant determinant of life quality among HIV patients and should be considered in the holistic treatment of patients.
Profile of inpatients with psychotic disorders referred to the consultation–liaison psychiatry unit in a general hospital in South India
Authors: Mathew Kathleen Anne , Methala Sharon Paul , Jith Arya , Bansal Rahul
Published: May 2024

Context:

Psychotic symptoms in patients with medical illnesses have been overlooked and have been understudied. It is important to understand the profile of such patients to facilitate early identification by the treating clinicians and to initiate appropriate referrals to consultation–liaison psychiatry (CLP).

Aims:

The aim of the study was to investigate the sociodemographic and clinical profile of inpatients with psychotic disorders referred to CLP services in a general hospital.

Settings and Design:

This was a retrospective record-based study conducted at the Department of Psychiatry in a Tertiary Care Hospital, Kochi, South India.

Materials and Methods:

The records of inpatients referred to psychiatry from April 2018 to April 2021 were obtained. Patients with psychotic disorders (organic and substance-induced psychotic disorders, schizophrenia, schizotypal, and delusional disorders) were included.

Statistical Analysis:

Descriptive statistics and independent samples t-test were employed for data analysis.

Results:

We obtained the records of 50 patients with a diagnosis of psychotic disorders from April 2018 to April 2021. The mean age of our sample was 50.86 ± 18.94 years, and the majority were females (54%). The most common reasons for referral were medication adjustment (44%) and agitation (28%). Organic delusional disorder was the most common diagnosis (28%). Only 54% of the subjects followed up in psychiatry as compared to 78% of subjects who followed up in medical departments after discharge.

Conclusions:

Psychotic disorders are frequently noted in patients admitted with medical illnesses in a general hospital setup. It is important for clinicians in nonpsychiatric divisions of a general hospital to be aware of the profile of such patients to ensure timely detection of symptoms and initiate appropriate referrals to the CLP team.
Minimal subfields of elliptic curves
Authors: Ghosh Samprit
Published: May 2024

For an elliptic curve E defined over a number field K and
$L/K$
a Galois extension, we study the possibilities of the Galois group Gal
$(L/K)$
, when the Mordell–Weil rank of
$E(L)$
increases from that of
$E(K)$
by a small amount (namely 1, 2, and 3). In relation with the vanishing of corresponding L-functions at
$s=1$
, we prove several elliptic analogues of classical theorems related to Artin’s holomorphy conjecture. We then apply these to study the analytic minimal subfield, first introduced by Akbary and Murty, for the case when order of vanishing is 2. We also investigate how the order of vanishing changes as rank increases by 1 and vice versa, generalizing a theorem of Kolyvagin.
Counting elements of the congruence subgroup
Authors: Bulinski Kamil , Shparlinski Igor E.
Published: May 2024

We obtain asymptotic formulas for the number of matrices in the congruence subgroup
$$\begin{align*}\Gamma_0(Q) = \left\{ A\in\operatorname{SL}_2({\mathbb Z}):~c \equiv 0 \quad\pmod Q\right\}, \end{align*}$$
which are of naive height at most X. Our result is uniform in a very broad range of values Q and X.
Разностные свойства случайных отображений и их композиций
Authors: Denisov Oleg Viktorovich
Published: May 2024

Изучаются свойства матриц переходных вероятностей разностей случайных отображений и подстановок, в том числе преобразований Фейстеля, а также их композиций. Показано, что модель Луби - Ракофф является марковским шифром.
Удаленность векторных булевых функций от аффинных аналогов (по следам Восьмой международной олимпиады по криптографии)
Authors: Ryabov Vladimir Gennadievich
Published: May 2024

Изучается расстояние Хэмминга от векторной булевой функции до множества аффинных отображений (нелинейность векторной функции). Получены новые верхняя граница нелинейности векторных функций и нижняя граница нелинейности для отображений с заданной дифференциальной равномерностью, которые уточняют ранее известные. Найдена зависимость расстояния Хэмминга между векторной функцией и аффинным отображением от коэффициентов Уолша - Адамара ненулевых линейных комбинаций координат векторной функции, позволяющая дать оценки нелинейности через указанные коэффициенты.
Outcomes of endoscopic submucosal dissection in cirrhotic patients: First American cohort
Authors: Pecha Robert Luke , Ayoub Fares , Patel Ankur , Muftah Abdullah , Wright Michael W , Khalaf Mai A , Othman Mohamed O
Published: May 2024

BACKGROUND

Among patients with cirrhosis and pre-malignant or early malignant mucosal lesions, surgical intervention carries a much higher bleeding risk. When such lesions are discovered, endoscopic submucosal dissection (ESD) may offer curative therapy with lower risks than surgery and improved outcomes compared to traditional endoscopic resection.

AIM

To evaluate the outcomes of ESD in patients with cirrhosis.

METHODS

Patients with cirrhosis undergoing ESD between July 2015 and August 2022 were retrospectively matched in 1:2 fashion to controls based on lesion location, size, and anticoagulation use. Procedural outcomes were compared between groups.

RESULTS

A total of 64 Lesions from 59 patients were included (16 cirrhosis, 43 control). There were no differences in patient or lesion characteristics between groups. En bloc and curative resection was achieved in 84.21%, 78.94% of the cirrhosis group and 88.89%, 68.89% of controls, respectively, with no significant differences. Cirrhotic patients had significantly higher rates of intra-procedural coagulation grasper use for control of bleeding (47.37% vs 20%; P = 0.02). There were otherwise no significant differences in adverse event rates. In the 29 patients with follow up, we found higher rates of recurrence in the cirrhosis group compared to controls (40% vs 5.26%; P = 0.019), however this effect did not persist on multivariable analysis controlling for known confounders.

CONCLUSION

ESD may be safe and effective in patients with cirrhosis. Most procedure related outcomes were not significantly different between groups. Intra-procedural bleeding requiring use of the coagulation grasper use was expectedly higher in the cirrhosis group given the known effects of liver disease on hemostasis.
Gestational diabetes mellitus may predispose to metabolic dysfunction-associated steatotic liver disease
Authors: Milionis Charalampos , Ilias Ioannis , Koukkou Eftychia
Published: May 2024

The development of type 2 diabetes mellitus is a major contributing factor to the worldwide health burden of metabolic dysfunction-associated steatotic liver disease (MASLD). Insulin resistance, subclinical inflammation, dyslipidemia, obesity, and hypertension are all factors in this reciprocal interaction that contribute to the development of MASLD, which includes hepatocellular carcinoma, advanced fibrosis/cirrhosis, and non-alcoholic steatohepatitis (NASH). A new risk factor for MASLD/NASH that affects the course of the disease independently throughout life is gestational diabetes mellitus (GDM). Women with a history of GDM had a higher chance of developing NASH, according to a recent study that used a large-scale database. Although the precise etiology is yet unknown, temporary disruption of pancreatic beta cell activity during pregnancy may set off systemic inflammation, affecting distant organs including the liver. Early screening and management strategies are crucial in mitigating MASLD progression and preventing adverse cardiovascular events in affected individuals.
Review on FPGA Implementation of CORDIC Algorithm
Authors: M. Darshan , D. Vikram Babu , M. V. Charan , C. Sachin , M. Suchitra
Published: May 2024

The Coordinate Rotation Digital Computer (CORDIC) algorithm has emerged as a pivotal method for executing trigonometric and various mathematical operations within digital systems. Field-Programmable Gate Arrays (FPGAs) have witnessed a remarkable surge in adoption for implementing the CORDIC algorithm owing to their inherent flexibility and exceptional performance capabilities. This paper endeavours to provide a comprehensive overview of FPGA implementations of the CORDIC algorithm, elucidating both the advantages and challenges associated with this methodology. It thoroughly examines various FPGA architectures customized for CORDIC implementation, meticulously analyzing their respective trade-offs regarding resource utilization, performance metrics, and accuracy levels. Moreover, the paper explores numerous applications where the FPGA-based CORDIC algorithm shines, illustrating its adaptability across diverse domains like digital signal processing and control systems. These applications underscore the algorithm's efficacy in addressing real-world challenges and its potential to significantly augment system performance and efficiency.By furnishing profound insights into FPGA-based CORDIC implementations, this paper serves as an invaluable resource for engineers and researchers keen on harnessing the capabilities of FPGAs for high-performance mathematical computations in digital systems.
Student Athletic Therapists' Knowledge of Pain-Relieving Medications: A Nationwide Study
Authors: Vandertuin Jacqueline , Abdulla Dalya , Lowther Stephanie , Collins Joshua
Published: May 2024

Purpose: Misuse of pain-relieving medications (PRMs), including opioids, is high among injured athletes. Athletes are increasingly relying on PRMs and as a result, it is likely that student athletic therapists (SATs) have managed athletes who have misused PRMs and may have potentially missed important symptoms placing athletes in harm. While dispensing PRMs is not within the scope of practice of the SAT, recognition and referral are. Previous research has found that SATs feel ill prepared to recognize PRM misuse and feel tremendous pressure to provide correct health information to the athlete. The purpose of this study was to expand on previous pilot work and uncover SATs knowledge on PRMs nationally. Method: A survey was sent to SATs currently studying in accredited Athletic Therapy programs and recent graduates (AATP). Results: A total of 57 surveys were completed. Results indicated that SATs believed they lacked sufficient knowledge related to PRMs and opioids however their personal knowledge of PRMs and opioids empowered them to provide athlete education on such medications. Over half of the SATs indicated that they have been approached by athletes and coaches to provide PRMs. SATs reported experiencing considerable pressure to provide athletes with correct information and showed stigma towards athletes misusing opioids. Conclusions: Although SATs reported the ability to recognize an athlete misusing opioids, they were unsure of how to make a quick decision when faced with potential opioid misuse situations. Recommendations: We recommend that curriculum, as well as clinical educators, address the pressure SATs experience and reinforce education to help identify and manage athletes who potentially misuse PRMs. Our study provides insight into the current level of knowledge of Canadian SATs regarding PRMs and opioids to help educators and others who work with SATs in a field setting.
Hearing Loss as a Risk Factor for Cognitive Decline in the Elderly: A Rapid Review
Authors: Large Natalie , Nicholson Nannette
Published: May 2024

Purpose: The aim of this rapid review was to identify and evaluate evidence exploring hearing loss as a risk factor for cognitive decline in the elderly population. Methods: A literature search was performed in three databases: CINAHL, Cochrane Central, and PubMed. The PRISMA template was used to record the search and selection process. Search criteria included older adults aged 65 and up with diagnosed or self-reported hearing loss and no previous diagnosis of dementia or Alzheimer’s disease. Participants were excluded if they had been diagnosed with dementia or tested for it before the study began. Hearing loss was categorized using the pure tone average (PTA): normal (/= 25-40 dB), and moderate to severe impairment (> 40 dB). Selected research studies were critically appraised using the JBI checklist. A custom data extraction form was used to record inclusion/exclusion criteria, PICO data elements, risk of bias, and level of evidence. Results: Three longitudinal cohort studies met the inclusion criteria. The Joanna Briggs Institute evidence hierarchy was used to rate the level and quality of the studies. Results of the rapid review indicate the quality of studies a high or moderately high. A summary of the results for each study is provided. Clinical Implications: This review contributes to the growing body of literature suggesting that untreated hearing loss is a risk for cognitive decline. While there are various hypotheses on whether there is a definitive relationship between the two, many of the studies reviewed found that a hearing loss in older adults will result in a poorer change of cognitive ability or cognitive decline. Any patient aged 65 years or more indicating concern about hearing loss should be referred to an audiologist for a comprehensive hearing evaluation.