International Journal of Clinical Practice最新文献

Aims and Objectives. Admission in the intensive care unit is highly stressful, for both the child and family. This study aimed to identify the factors influencing the nurse-parent partnership in the pediatric intensive care units. Methods. The data were collected from 71 ICU nurses through a web-based survey by the Pediatric Nurse-Parent Partnership (NPP) Scale, Wong and Law Emotional Intelligence (EI) Scale, and patient-centered communication (PCC) proficiency by Park and Oh’s. Descriptive and inferential statistics were used to analyze the data. Results. The mean scores for NPP, EI, and PCC skills were 67.91 ± 9.62, 55.16 ± 5.77, and 33.38 ± 4.81, respectively. There was a positive correlation between NPP, EI (r = 0.71, p < 0.001), and PCC skills (r = 0.59, p < 0.001). In hierarchical multiple regression analysis, EI (p < 0.01) and PCC skills (p = 0.05) were the two stronger primary variables influencing NPP than the general variables such as gender, children, and an additional qualification in pediatric nursing with higher variance (59% vs 14%). Conclusion. The findings of the study supported that nurses’ EI and PCC skills as well as additional qualification or training in pediatric nursing were the primary factors influencing nurse-parent partnership in intensive care settings. Thus, effective intervention programs focusing on these factors should be initiated to strengthen NPP.

Background. There is still no consensus on the treatment of frozen shoulder (FS). Clinical studies on extracorporeal shockwave therapy (ESWT) combined with arthroscopic capsular release (ACR) for FS are still lacking. Objectives. To investigate the effect of ESWT on short-term functional recovery after arthroscopic capsular release (ACR). Methods. A randomized clinical trial including 49 patients who under ACR was included. The patients were assigned to the ESWT group (n = 24) or non-ESWT group (n = 25) 2 weeks after surgery. Routine advanced rehabilitation program are given to all participants, while the ESWT group additionally received 5 times shockwave therapy. Visual analog scale (VAS) pain score, Constant score, University of California Los Angeles score (UCLA), UCLA-satisfaction, and shoulder range of motion (ROM) in four directions of flexion, abduction, internal, and external rotation were analyzed at the baseline (2 weeks postsurgery), 2 weeks, 8 weeks, and 12 weeks of follow-up. Repeated measure ANOVA is used to analyze the above outcomes. Results. A total of 46 participants completed all assessments. Pain and function improved in both groups. Comparing between the groups, we found that lower VAS pain scores and higher internal rotation were found in the ESWT group at each follow-up stage (all P < 0.05, 12 weeks VAS-pain 95% CI: [ESWT: 1.55–2.19, non-ESWT: 2.11–2.76], and 12 weeks internal rotation 95% CI: [ESWT: 5.42–7.27, non-ESWT: 7.20–9.06]). Regarding functional scores, the UCLA and UCLA-satisfaction of the ESWT group was significantly higher than that of the control group at 8 weeks and 12 weeks of follow-up (all P < 0.05, 12 weeks UCLA 95% CI: [ESWT: 31.94-33.45, non-ESWT: 27.94-29.45], 12 weeks UCLA-satisfaction 95% CI: [ESWT: 4.32–5.00, non-ESWT: 2.50–4.32]), but there was no significant difference in Constant (P > 0.05, 12 weeks Constant 95% CI: [ESWT: 82.98-92.94, non-ESWT: 78.24–88.20]). Conclusion. Extracorporeal shockwave therapy has a good analgesic effect and improves internal rotation after arthroscopic capsular release through short-term follow-up.

Objective. The aim of the study was to assess some psychological factors that may be related to the attitude towards vaccination against COVID-19. Methods. The study involved 419 responders, including 317 people aged 36.10 ± 13.41 years who received vaccination against COVID-19 and 102 people aged 38.16 ± 12.33 years who decided not to be vaccinated. The study was conducted online in January-June 2022 in the Polish population. The following methods were used for the study: the generic conspiracist beliefs scale (GCBS), the perceived stress scale (PSS-10), and the state-trait anxiety inventory (STAI-X2). Results. In the conspiracy beliefs questionnaire, an average score of 34.41 ± 12.95 points was obtained in the vaccinated group and in the unvaccinated group 48.67 ± 13.62 points. The difference was statistically significant (P < 0.01). In the PSS-10 questionnaire, the vaccinated respondents obtained an average score of 19.55 ± 6.75 points, and in the unvaccinated group, the mean score was 18.44 ± 7 points. When comparing the two groups, no statistically significant differences were found. In the vaccinated group, the mean score was 46.96 ± 7.69 points in the state anxiety questionnaire (X2), and 45.85 ± 8.18 points in the unvaccinated group. There were no statistically significant differences between the study groups. Significant positive correlations were found in the results obtained in the conspiracy thinking scale (GCBS), the PSS-10 stress scale, and the anxiety scale as a personality trait (STAI-X2) in both study groups. Conclusions. People presenting conspiracy thinking may be more likely to show antivaccine attitudes compared to people not showing a tendency to this kind of thinking. Conspiracy thinking may not only be associated with a high level of anxiety as a personality trait but also with the level of experienced stress. In the group of unvaccinated people, stress was a significant predictor of conspiratorial thinking. In the group of vaccinated people, anxiety turned out to be a significant predictor of conspiracy thinking. Due to the presence of antivaccine groups, the task of the medical personnel is to educate the public. Moreover, extensive information campaigns are needed to promote vaccination safety in an accessible and understandable language.

Objectives. This study aimed to use laboratory and clinical data of systemic lupus erythematosus (SLE) patients to construct prediction models for fundus complications in SLE. Methods. Routine blood test data and clinical information of 277 SLE patients were collected retrospectively. Based on their fundus examination, they were divided into two groups, with or without fundus lesions, defined as retinopathy and choroidopathy in this study. The data of the two groups were compared, and the prediction model was established using binary logistic regression analysis. Results. There were 85 patients in the fundus lesions’ group and 192 patients in the control group. Between the two groups, age, SLEDAI, serositis, hypertension, diabetes, anticardiolipin antibody (ACA), anti-Sm antibody, C-reactive protein (CRP), hemoglobin (Hb), platelet count (PLT), albumin (Alb), serum creatinine(Scr), urea, uric acid(UA), and immunoglobulin G(IgG) were significantly different (p < 0.05). Besides, age, SLEDAI, serositis, hypertension, diabetes, anti-SSB, CRP, Hb, PLT, FIB, Alb, Scr, urea, UA, GLU, and IgG were significantly correlated with SLE-related fundus lesions. PLT, fibrinogen (FIB), IgG, and urea were independent risk factors of SLE-related fundus lesions. The area under the curve (AUC) was 0.830 (p < 0.001; 95% CI = 0.762–0.898), and the nomogram was established with great evaluation efficiency demonstrated by the calibration curve and the Hosmer–Lemeshow test. The result of k-fold cross-validation also showed high prediction accuracy. Conclusions. We have found the independent risk factors of SLE-related fundus lesions and developed a model to improve the prediction of fundus lesions in SLE.

Introduction. Globally, hospitals are an important place in end-of-life care and most frequent place of death in Germany (47%), but at the same time, the least preferred one—both for patients and their informal caregivers. As hospital care in the dying phase on non-palliative care wards has rarely been studied systematically, we assessed the current state of care in the dying phase in hospitals as a first step. Methods. In an online survey, N = 165 national health experts were invited to answer eight open questions on care aspects, facilitators, barriers, and needs for improvement as well as COVID-19 pandemic specifics regarding hospital care in the dying phase. Sociodemographic data were analysed descriptively, and responses were analysed using qualitative thematic analysis. Results. Of n = 65 experts, 52% work as nursing staff and 30% as physicians. We identified facilitators, barriers, and needs for improvement regarding 11 topics on the following three levels: institutional level (general institutional conditions, hospital culture, and integration of specialist palliative care), team level (attitude towards and dealing with death and dying, competencies, communication, and teamwork) and care level (dying phase, symptom control, patient centredness, and involvement of informal caregivers). Conclusion. Improving care in the dying phase has to overcome barriers on various levels. We assume that rather “small” measures will find their way into clinical routine and contribute to the improvement of hospital care in the dying phase.

Most elderly persons suffer from chronic diseases. To treat chronic diseases, good medication adherence and refilling medication as physicians’ advice are key points of pharmaceutical therapy. However, the literature revealed that only limited studies have focused on the medication adherence of the elderly in rural communities. This study evaluated the adherence to medication and the degree of refilling prescriptions as physician’s advice by the Adherence to Refills and Medications Scale (ARMS) and evaluated the factors associated with poor adherence to medication. This cross-sectional study focused on the medication use of the elderly population in rural areas in western Taiwan and analyzed related personal and social factors which influence the behaviors of pharmaceutical therapy. In conclusion, most of the elderly who lived in rural areas in western Taiwan have poor adherence (ARMS score over 12) to medication and a poor degree of refilling prescriptions as per physicians’ advice. Moreover, age ≥75 years and low urbanization were significantly associated with poor adherence. Future research is warranted to assess the effect of the interventions to improve medication adherence on chronic disease control, disability, and mortality.

Background. Delayed cord clamping (DCC) for more than one minute is associated with nutritional and developmental benefits for newborns. However, there is limited evidence regarding the relationship between DCC and outcomes in resource-limited settings. This study aims to assess the effect of the time of cord clamping on serum bilirubin level 24 hours after birth in an Ethiopian Tertiary Care hospital. Methods. A three-arm, single-blind, exploratory randomized controlled trial was conducted between October 2019 and January 2020 targeting healthy, full-term neonates. Study participants were randomly assigned into one of the following intervention groups depending on the timing of cord clamping: immediate cord clamping (<30 seconds), intermediate cord clamping (60 seconds), and DCC (180 seconds). The primary outcome is serum bilirubin level in the newborns, which was assessed 24 hours after birth and before they were discharged home. Descriptive analysis was applied to assess differences between groups in terms of demographic, obstetric, and social characteristics of the participants, while a linear regression model was employed to examine the association between cord clamping time and serum bilirubin level. Result. A total of 141 term newborns were included and randomized into the three categories. The demographic, social, and obstetrics characteristics of included participants were not different across groups except for the labor duration (P value <0.05). While the time of cord clamping was not a significant predictor of total serum bilirubin levels at 24 hours postbirth, cord blood total serum bilirubin (coefficient: 0.24; p < 0.05) and bilirubin nomogram high-risk zone (coefficient: 6.25; p < 0.001) were found to be significant predictors. (4) Conclusion. Our findings indicate that the time of umbilical cord clamping does not affect the total serum bilirubin level of neonates at least within 24 hours of birth.

Background. Long noncoding RNAs (lncRNAs) often facilitate cellular communication via exosomes. However, their specific roles in head and neck squamous cell carcinoma (HNSCC) are not well understood. Methods. We extracted data on exosome-related lncRNAs from exoRBase and collected transcriptional profiles and clinical details for HNSCC from the TCGA database. Data preprocessing and analyses incorporated Tumor Mutation Burden and Microsatellite Instability from Researcher’s Home and drug sensitivity information from Genomics of Drug Sensitivity in Cancer database. We developed a prognostic model using Cox regression and LASSO regression analysis, with subsequent multivariate analysis to identify significant prognostic indicators. We also constructed a nomogram to evaluate the model’s clinical relevance, performed Gene Set Enrichment Analysis (GSEA), and analyzed the immune microenvironment and therapy sensitivity using CIBERSORT and TIDE algorithms. Supporting in vitro experiments and statistical analyses were conducted. Results. Our comprehensive investigation revealed 17 exosome-associated lncRNAs critical for patient survival in HNSCC. This enabled the development of a prognostic model that effectively stratifies patients into high-risk and low-risk categories. These lncRNAs correlate with patient demographics and clinical characteristics such as age, gender, and tumor stage. GSEA highlighted significant gene expression differences between the risk groups, particularly in pathways related to muscle formation, cellular transition, and immune response. The analysis of the immune microenvironment showed distinct immune cell infiltration patterns in high-risk patients, indicative of compromised immune defenses. In addition, we explored the expression of critical immune checkpoints and their impact on immunotherapy efficacy, demonstrating that risk scores may predict treatment responses. Notably, LINC01564 was overexpressed in HNSCC, associated with poorer prognosis, enhanced xenobiotic metabolism, and altered immune cell infiltration. Experimental validation confirmed LINC01564’s role in promoting tumor cell proliferation, invasion, and migration, highlighting its therapeutic potential. Conclusions. Our study highlights the importance of exosome-associated lncRNAs in HNSCC, identifying 17 critical lncRNAs as vital prognostic markers. The upregulation of LINC01564, associated with poor outcomes and increased tumor aggressiveness, underscores its potential as a therapeutic target.

Diabetes nephropathy (DN) is increasingly recognized as a critical complication in individuals with diabetes and a significant contributor to end-stage renal disease (ESRD). Bailing capsules, which contain fermented cordyceps mycelium, are commonly utilized in treating various kidney disorders, including DN in clinical practice. This review aims to comprehensively detail the pharmacologically active components of Bailing, its mechanisms of action, and its clinical usage. By employing network pharmacology, we delve into the possible pathways Bailing impacts DN treatment. Current studies suggest that Bailing’s efficacy in DN primarily involves mechanisms related to lipid and atherosclerosis, cancer pathways, and small-cell lung cancer. Key active ingredients in Bailing that contribute to its therapeutic effects include arachidonic acid, linalyl acetate, β-sitosterol, and CLR. Furthermore, for literature selection in this review, we integrated GPT-4 with bias analysis coprocessing. This evaluation provides a foundational understanding and direction for future research into the use of Bailing as a novel treatment for DN.