SAGE Open Medicine最新文献

Introduction: Urinary tract infections are prevalent among pregnant women and can lead to serious maternal and neonatal complications. Hypertensive disorders of pregnancy, a leading cause of maternal morbidity, may be associated with urinary tract infections. This study investigates whether bacteriuria detected via routine urinalysis, a standard screening in Indonesia, contributes to hypertension risk during pregnancy, aiming to enhance clinical management and screening protocols.

Aim of study: To evaluate the association between bacteriuria detected through routine urinalysis and hypertension during pregnancy in women at Margono Hospital, Purwokerto.

Methods: This study was conducted at Margono Hospital, Indonesia; the study included all pregnant women who delivered in 2022-2023, applying specific exclusion criteria. Urine samples were analyzed for bacteriuria, and statistical analysis determined the prevalence ratio and odds ratio for the correlation of bacteriuria and risk of hypertension.

Results: Hypertension prevalence was 1.52 times higher in patients with bacteriuria. The odds ratio was 1.379 (confidence intervals: 0.751-2.532) with a statistically significant p-value of <0.003. These findings indicate a significant association (p < 0.05) between positive bacteriuria and increased risk of hypertension and preeclampsia.

Conclusion: This study highlights a significant association between bacteriuria and hypertension in pregnancy, including severe complications like impending eclampsia. Pregnant women with urinary tract infections should be closely monitored for preeclampsia. Further research is needed to explore the mechanisms linking urinary tract infections and hypertension during pregnancy.

Background: There is a limited data examining the practice of using the airway pressure release ventilation mode for patients with acute respiratory distress syndrome among respiratory therapists.

Objectives: To evaluate the current practice and barriers when using airway pressure release ventilation mode in the management of patients with acute respiratory distress syndrome.

Methods: A cross-sectional online survey was disseminated between November 2022 and April 2023 to respiratory therapists in Saudi Arabia. Descriptive statistics were used to analyze the respondents' characteristics.

Results: Overall, 802 respiratory therapists (male: 59.60%) completed the survey. Five hundred nineteen (64.71%) did not receive training on airway pressure release ventilation mode. Moreover, 325 (40.52%) and 391 (48.75%) did not know if airway pressure release ventilation was used at their hospitals and if the mode was managed via protocol with acute respiratory distress syndrome patients. Of the participants, 276 (34.41%) reported that plateau pressure should be used as a target when setting P-high initially, while 427 (53.24%) believed that the initial P-low should be equal to 0 cmH₂O. Moreover, 468 (58.36%) believed that the initial T-high should be between 4 and 6 s, while 548 (68.33%) believed the initial T-low should be a set time (between 0.4 and 0.8) seconds. The most appropriate intervention to improve ventilation and oxygenation was to increase the P-high, which was reported by 370 (46.14%) and 326 (40.65%) respiratory therapists, respectively. Inadequate training was the most common barrier (678, 84.54%) to airway pressure release ventilation implementation.

Conclusion: Airway pressure release ventilation management varies between respiratory therapists which may be due to inadequate training and the absence of protocols.

Objectives: This study investigated the implementation of the ABCDEF bundle and the factors associated with its implementation according to national income levels.

Methods: This study is cross-sectional research. We conducted a secondary analysis of an international 1-day point-prevalence study that investigated the implementation of the ABCDEF bundle in critically ill patients. All patients admitted to the ICU were eligible. This study was conducted across 135 ICUs in 54 countries, including data from 664 patients. Outcomes were categorized according to the income level of the country (high-income, middle-income, and low-income countries) in which each ICU was located. A multilevel generalized linear model was developed to identify the factors associated with ABCDEF bundle implementation for each income level.

Results: We identified 664 patients in 79 high-income countries, 278 in 26 middle-income countries, and 287 in 30 low-income countries ICUs. Implementation rates of the ABCDEF bundle were low for all income levels but varied. Few individuals completed the entire bundle on the survey date. Common factors associated with the implementation among all income levels were a multidisciplinary team approach for Element A (pain) and mechanical ventilation use for Element C (sedation), which were also associated with lower Element E (mobility). The existence of a protocol was frequently identified as a promoting factor associated with ABCDEF bundle implementation. The associated factors varied by income level; for example, dedicated intensivists were only identified in high-income countries, but not in middle-income countries or low-income countries.

Conclusions: The overall low ABCDEF bundle implementation rates necessitate action. As factors associated with its implementation vary according to national income level, tailored strategies are essential for improving ICU care quality.

Trial registration: NA.

Objective: This pilot study aims to assess how individuals with rhythm perception, particularly musicians, are able to maintain the predefined chest compression rate during cardiopulmonary resuscitation compared to people without rhythm perception.

Methods: The study was conducted at the Pilsen Emergency Medicine Conference (Czechia) using a simulation-based cohort design. Participants performed chest compressions on a manikin for 120 s, with the first 10 s guided by a metronome. Participants were grouped based on self-reported rhythmic perception, such as playing a musical instrument. The primary outcome was the average chest compression rate per minute.

Results: A total of 67 participants were included. Both groups provided chest compression rate within the recommended limits. Musicians maintained a better chest compression rate (mean 110.56 compressions per minute) compared to nonmusicians (mean 107.31; T-test, p = 0.00074). Those with any rhythmic perception experience also performed better (T-test, p = 0.036931). Secondary factors, including gender, clinical experience, and prior resuscitation training, did not significantly affect the results.

Conclusion: This study demonstrates that individuals with rhythm perception, especially musicians, follow the predefined frequency of chest compressions more effectively.

Background: Despite multiple studies, less recent literature and data regarding the mortality associated with hip fractures in the elderly population are available.

Objectives: To assess the mortality data and functional outcomes of patients who underwent cemented and uncemented hemiarthroplasty in femoral neck fractures. To evaluate if preoperative (minimum 2 months) calcium and vitamin D supplement intake in patients affects postoperative mobilization with or without walker support.

Methods: All patients aged 65 and above who underwent hemiarthroplasty for femoral neck fractures in our tertiary care center were included. Postoperative functional outcomes were determined using the Modified Harris Hip score and Oxford Hip score at 3, 6, and 12 months. The mortality of the procedures was assessed at 3, 6, and 12 months. Individuals who took both calcium and vitamin D supplements for at least 2 months before surgery were divided into two groups: those who did not take supplements and those who did.

Results: We studied 110 patients above the age of 65 years. The postoperative mortality rate at 3, 6 months and 1 year postoperatively was found to be 3.6%, 4.7%, and 15.5% respectively. Functional outcomes were assessed at 3, 6, and 12 months postoperatively using modified Harris Hip score and Oxford Hip score and were found to be identical in both cemented and uncemented hemiarthroplasty groups. Patients who took calcium and vitamin D supplements preoperatively (minimum 2 months) could walk without support at the end of 1-year post-surgery.

Conclusion: Early surgery and early mobilization should be the main aim of treatment for femoral neck fractures.

Background: Studies across the extant literature suggest that less-experienced healthcare workers are more likely to experience adverse outcomes such as burnout, sick leaves, or intend to leave the profession. Thus, one's readiness to practice is an important element that requires more attention. While extensive research exists on the readiness of certain professions like nurses, a notable gap remains concerning other healthcare workers.

Purpose: This study sought to explore studies examining readiness to practice among various underrepresented healthcare workers.

Methods: We conducted a scoping review to determine the available research related to clinical and nonclinical areas related to the readiness to practice of healthcare workers, excluding physicians and nurses. We examined three databases, MEDLINE, CINAHL, and PsycINFO, from 1 January 2000 to 31 December 2023. Our search focused on readiness to practice among various healthcare professions, whether clinically focused or broadly related to professionalism.

Results: Our search identified 41 articles meeting the inclusion criteria from several professions, including but not limited to physiotherapists and occupational therapists, pharmacists, osteopaths/chiropractors, and social workers. Overall, studies differed in assessing readiness to practice with a broad range of identified clinical competencies that varied between professions and regions. Nonclinical skills, such as communication, conflict management, and cultural competence, were common barriers across professions.

Conclusion: Despite the heterogeneity in job roles, work settings, and geographical reasons, there is evidence to suggest that new healthcare professionals may be clinically adept but may be lacking in other nonclinical skills that could affect their work and well-being. With early-career healthcare workers particularly vulnerable to adverse outcomes in the workplace, future research should standardize core competencies, including nonclinical skills and well-being-related activities, as a prevention method across various health groups.

Background: The mental burden faced by university students in their early years is not frequently reported in the literature.

Objectives: The aim of this study is to investigate the prevalence and predictors of depression among preparatory (first) year university students using a predictive test developed from general health and well-being questionnaires.

Methods: A cross-sectional study was conducted among university students in the eastern region of Saudi Arabia from March 2023 to June 2023. A self-administered electronic general health and well-being questionnaire was implemented. Written informed consent was obtained from the participants after explaining the study's purposes. The questionnaire consisted of three parts. Part I described the objective of the study and maintained the confidentiality of the data, part II contained questions about demographic data, and part III contained the scales of the items to assess the physical and psychological health.

Results: The findings demonstrated a significant positive correlation between depressive symptoms and both perceived stress (r = 0.444, p < 0.01) and perceived burdens (r = 0.735, p < 0.01). In addition, there were significant negative correlations between the depressive symptoms and gender (r = -0.144, p < 0.05), economic level (r = -0.178, p < 0.05), and social support (r = -0.312, p < 0.01). Furthermore, the results revealed that body mass index (b = 0.272, t(146) = 4.636, p < .001), perceived stress (b = 0.182, t(146) = 2.910, p < 0.01), and perceived burdens (b = 0.593, t(146) = 9.507, p < .001) were significant predictors of depressive symptoms among Saudi university junior students.

Conclusion: Our findings emphasize the need for tailored mental health support services to address depression and its predictors, especially during critical transition periods like the early stages of university life, as early detection and intervention can lead to improved management and better control of the depression.

Atherosclerosis is a chronic inflammatory disease affecting the vascular system, characterised by the accumulation of modified lipoproteins, immune cell aggregation and the development of fibrous tissue within blood vessel walls. As atherosclerosis impacts blood vessels, its adverse effects may manifest across various tissues and organs. In this review, we examine the association of atherosclerosis with Alzheimer's disease, stroke, pancreatic and thyroid dysfunction, kidney stones and chronic kidney diseases. In several cases, the reciprocal causative effect of these diseases on the progression of atherosclerosis is also discussed. Particular attention is given to common risk factors, biomarkers and identified molecular mechanisms linking the pathophysiology of atherosclerosis to the dysfunction of multiple tissues and organs. Understanding the role of atherosclerosis and its associated microenvironmental conditions in the pathology of multi-organ disorders may unveil novel therapeutic avenues for the prevention and treatment of cardiovascular and associated diseases.

Objectives: Our study aimed to identify the complex interplay between self-efficacy, self-care practice, and glycaemic control among people with type 2 diabetes mellitus (PWDs) to inform the design of more targeted and effective behavioural interventions in primary care.

Methods: A cross-sectional descriptive study was performed with 294 PWDs managed in primary care. The Diabetes Management Self-Efficacy Scale (DMSES) and Summary of Diabetes Self-Care Activities (SDSCA) questionnaire measured patients' self-efficacy and self-care practice. Multivariate logistic regression models were developed to explore how SDSCA, DMSES, and their combined effect relate to glycaemic control, adjusting for patient characteristics. Network analysis in R software examined relationships between self-efficacy and self-care dimensions across glycaemic control subgroups using a Gaussian graphical model with the extended Bayesian information criterion.

Results: Half the PWDs (50.7%) had suboptimal glycaemic control. Better glycaemic control was consistently associated with higher self-efficacy (odds ratio (OR) = 0.76, 95% confidence (CI) (0.60, 0.97), p = 0.03), shorter duration of diabetes (OR = 1.89, 95% CI (1.08, 3.31), p = 0.03), normal waist circumference (OR = 1.76, 95% CI (1.02, 3.05), p = 0.04), absence of diabetes complications (OR = 2.09, 95% CI (1.10, 3.98), p = 0.02), and treatment with oral hypoglycaemic agents (OR = 3.05, 95% CI (1.53, 6.09), p < 0.01). Network analysis among people with well-controlled HbA1c revealed that diet adherence and self-efficacy had the most robust connection, with diet self-efficacy strongly associated with most self-efficacy dimensions. Self-efficacy in exercise, blood glucose monitoring, and foot care are the most central factors in the network structures for PWDs with suboptimal glycaemic control.

Conclusions: Our study highlights the critical role of self-efficacy in diabetes primary care. For people with optimal glycaemic control, prioritising self-efficacy in diet adherence is crucial for sustaining glycaemic outcomes and supporting other self-care behaviours. Among those with suboptimal glycaemic control, enhancing self-efficacy in exercise, blood glucose monitoring, and foot care is essential. Targeted education programs, personalised counselling, and E-health tools can further empower patients to manage their diabetes more effectively.