Core Support Research Articles

Temporal Analysis in Outcomes of Long-Term Mechanical Circulatory Support: Retrospective Study.

Mechanical assist device indications have changed in recent years. Reduced incidence of complications, better survival, and the third generation of mechanical support devices contributed to this change. In this single-center study, we focused on two time periods that are characterized by the use of different types of mechanical support devices, different patient characteristics, and change in the indications. The data were processed from the European Registry for Patients with Mechanical Circulatory Support (EUROMACS). We retrospectively defined two time intervals to reflect changes in ventricular assist device technology (period 1: 2007-2015; period 2: 2016-20222). A total of 181 patients underwent left ventricular assist device implantation. Device utilization was the following: HeartMate II = 52 (76.4%) and HeartWare = 16 (23.6%) in period 1 and HeartMate II = 2 (1.8%), HeartMate 3 = 70 (61:9%), HeartWare = 29 (25.7%), SynCardia TAH = 10 (8.8%), and BerlinHeart EXCOR = 2 (1.8%) in period 2. The outcomes of the time intervals were analyzed and evaluated. Survival was significantly higher during the second time period. Multivariate analysis revealed that age and bypass pump time are independent predictors of mortality. Idiopathic cardiomyopathy, bypass time, and the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) score are independent predictors of adverse events. Furthermore, the first period was noted to be at an increased risk of the following adverse events: pump thrombosis, gastrointestinal bleeding, and bleeding events. Despite the higher risk profile of the patients and persistent challenges, during the second period, there was a significant decrease in mortality and morbidity. The use of the HeartMate 3 device may have contributed to this result.

Nurse-mother communication and support: Perceptions of mothers in neonatal units

IntroductionHaving a hospitalized neonate is a stressful experience for parents, especially mothers. Thus, in recent years, a paradigm shift occurred in the neonatal units, focusing on the needs of parents and supporting them in addition to caring for neonates. The aim of this study was to evaluate the nurse-mother communication and support in neonatal units in Bushehr, Iran. MethodThis descriptive cross-sectional study was performed in neonatal units of 6 hospitals in Bushehr, Iran, in 2022. Using the census method, all eligible mothers who met the inclusion criteria were included in this study. Data collection tools included demographic information form, nurse-parent support tool and nurse-parent communication questionnaire. The collected data were analyzed by SPSS version 24 using descriptive statistics, independent t-test, one-way ANOVA and Pearson correlation test. ResultsThe total mean score of nurse-parent support tool was 3.72 ± 0.72 and the total mean score of nurse-parent communication questionnaire was 59/27 ± 12/82. Caregiving support had the highest mean score (4.07 ± 73 0.73) and emotional support had the lowest (3.42 ± 91 0.91). Also, a statistically significant difference was seen between the admitted unit variable and the mean score of nurse-mother communication and support. Additionally, there was a statistically significant difference between the mechanical ventilation status of the neonate and the mean score of nurse-mother support. A significant positive correlation was seen between the neonatal gestational age and the mean score of nurse-mother communication. ConclusionsThe total mean score of nurse-parent support and communication was moderate. Therefore, nursing support and communication need to be improved. Planning is needed to enhance the role of neonatal nurses and strengthen their support and communication skills in line with the family-centered care approach.

Social support in recently diagnosed diabetic patients: Risk factor for depression?

Background: social support is important for adaptation in chronic diseases, such as diabetes and depression, because it favors recovery and adherence to treatment. Introducing its evaluation in the follow-up of diabetic patients can reduce complications derived from secondary non-adherence. Aims: to establish social support in diabetic patients and its correlation with depressive symptoms. Methods: a cross-sectional analytical study nested in a cohort of 173 recently diagnosed diabetic patients (<6 months) in Colombia over 18 years of age, treated in a cardiovascular risk program in 2022. The Chronic Illness Social Support Inventory was used. Results: Most of the participants were women (77.5%); single(83.8%), age (mean = 62.6 years (SD 12.3)); glycemia (mean = 146.4 (SD 65.5)), glycosylated hemoglobin (mean = 7.6 (SD 1.7)). Cronbach's α coefficient for the general scale of the social support instrument was 0.9859. The mean social support was 168.5 (SD 37.4), range 38-228. The total social support score was normally distributed (Shapiro Wilk p > 0.05). The correlation between domains was statistically significant. The PHQ9 total score was significantly associated with the domains of Personal Interaction and Guide but did not significantly correlate with the overall social support score. The respondents who were at risk of developing depression were referred for treatment. Conclusions: findings suggest that perceived social support may play a significant role in the prevention and treatment of depression in diabetic patients. It is desirable that health professionals consider evaluating and enhancing social support to improve their mental health. More research is needed to gain a comprehensive understanding of this relationship.

Perceived Social Support and Glycemic Control among Type 2 Diabetes Patients in a Tertiary Care Center in Chennai, Tamil Nadu, India

Introduction: Support from the external environment for enabling behavioral change, is often instrumental in mediating glycemic control in patients coping with diabetes. While evidence is scant in the Indian setting, there is a lack of consistency in findings among studies done elsewhere. Objective: To assess the perceived availability of social support and its association with glycemic control among type 2 diabetics. Method: Between October and December 2019, Cross sectional study was conducted among 150 adult patients, selected using convenient sampling method at the Diabetology clinic in a tertiary care centre in Chennai. Outpatients with a confirmed diagnosis of type 2 diabetes for at least one year, were recruited by convenient sampling. Perceived social support was assessed using the RAND-MOS social support survey instrument, while average of last three fasting blood glucose (FBG) readings determined glycemic status. Non-parametric Kruskal Wallis and Mann-Whitney U tests were used to analyze association of social support with glycemic control and socio-demographic determinants. Spearman’s correlation coefficients with 95% CIs are reported for association of individual domain scores with average FBG. All analyses were performed with SPSS Version 23. Results: Study participants were aged 35 to 85 years, and living with type 2 diabetes for a mean duration of 10 ± 7.7 years. The average FBG in the past year ranged from 79 to 398 mg/dl in these patients, with 41 (27%) and 109 (73%) being classified as having good and poor glycemic control, respectively. The median (IQR) social support summary score was 62 (40-81) on a scale of 0 – 100; perceived social support was reportedly low, intermediate, and high in 36 (24%), 74 (49%) and 40 (27%) participants, respectively. The level of social support was not found to be significantly associated with glycemic control (P=0.628); average FBG and summary social support score showed no correlation [ρ=.081 (95% CI: -.097, .253), P =.322]. Conclusion: While a three- fourths majority reported availability of social support for coping with diabetes, this was not found to be significantly associated with glycemic status. The potential role of support networks, beyond the immediate family, in improving health outcomes needs to be examined.

Mexican Breast Cancer Women and Their Partners: Individual and Couple Analysis

Breast cancer impacts the patients and their partners; their characteristics affect outcomes for themselves and the other members of the dyad and their relationship. This study explored whether the age of both couple members differentiates dyadic adjustment, social support, and quality of life perception and evaluates the relationship between dyadic adjustment, social support, and quality of life perception in Mexican couples with breast cancer. Methods: The cross-sectional correlational study included 120 patients with breast cancer and their partners. Couples were divided into two groups based on patients’ age. The couples’ dyadic adjustment, social support, and quality of life were evaluated. Results: Older dyads obtained the highest dyadic adjustment and social support scores compared to young dyads. Dyadic adjustment was associated with social support in both young and old couples. A positive relationship was found between young partners’ social support and dyadic adjustment and young patients’ quality of life and older partners’ dyadic adjustment and older patients’ quality of life. Conclusion: The results from both partners confirm that age determines the perceptions of younger and older couples concerning to the process and outcome relationship and their quality of life. In this sample, we can observe the relationship between both members of the couple.

Impact of overburden due COVID-19 pandemic on psychological health and work efficacy of doctors in Mangalore city, Dakshina Kannada district -A cross-sectional study

Introduction and Aim: One of the greatest pandemics faced by the world was COVID-19 which has added increased strain and psychological impacts on healthcare workers. This study was conducted to find out the impact of overburden due to COVID-19 on the psychological health of doctors and further to know whether it has affected the services provided by them. Materials and Methods: An information sheet which contained the details regarding purpose and nature of the study, questionnaire and consent form were given to each participant. Data was collected through email, WhatsApp, and physical forms. Depression, anxiety, stress, self-efficacy, and perceived social support were assessed using standard questionnaires. Results: Out of the 205 participants, 9 (4%) had a mild depression, 6(3%) had mild anxiety and 6(3%) had mild stress. Female doctors, those involved in fever clinics and inpatient care of COVID patients had significantly higher scores for depression, anxiety and stress when compared to others. Those involved in ICU care of COVID patients had higher General Self Efficacy (GSE) scores. General Self Efficacy (GSE) and Multidimensional Scale of Perceived Social Support (MSPSS) scores showed a positive correlation. Conclusion: Doctors involved in care of COVID-19 patients at fever clinic and inpatient care had several mental health problems. Hence, they along with female doctors need to be periodically screened for these conditions periodically.

Peer bullying in adolescents and related factors

Abstract:&#x0D; Objective: This study aims to determine the frequency of peer bullying and exposure in adolescents and the factors associated with these behaviors. Methods: This cross-sectional study was carried out in a high school between February 2016 and November 2017. The study population was 203students. The 2013-2014 version of the questionnaire form (HBSCQ) used in the Health Behavior in School-aged Children study of the World Health Organization was used as the measurement tool. Logistic regression analysis was used to show the effect of social support to bullying. Results: The frequency of being exposed to peer bullying was 19.8%, and performing bullying was 23.7%.Being exposed to peer bullying was observed with a higher rate in those who migrated from another city. The average peer support score, family support score, and family communication score were significantly lower in those who were exposed to bullying. The behavior of bullying was observed with a significantly higher rate in those with fewer siblings, had negative opinions about the school and involved in a physical fight. According to the logistic regression analysis results, family support score was found to be protective against exposure to bullying. The protective effect of family communication and peer support scores continued to be significant after the adjustment. Conclusions: The results of the present research have shown that social support is effective in dealing with bullying and reducing bullying.&#x0D; &#x0D; Keywords: Adolescent, peer bullying, school health, social support

Missed Opportunities for Addressing Maternal Mental Health: A Thematic Analysis of Mothers’ Experiences of Using the Well Child Tamariki Ora Service in Aotearoa NZ

Maternal mental health plays a vital role in the overall wellbeing of mothers, children, families, whānau (core support network) and communities. However, many mothers face mental health challenges during the transition to parenthood. In this study, we used an online story-sharing platform to collect the experiences of mothers who have faced unmet needs while using the Well Child Tamariki Ora (WCTO) service in Aotearoa New Zealand. From the 420 submitted stories, 125 stories related to mental health need while using the WCTO service. Using thematic analysis, we identified three main themes that highlighted the experiences of mothers with the service. This includes (1) making it seem that I’m coping: Mothers’ fear of being judged; (2) i wish I had connected with my WCTO nurse: Fostering meaningful relationships to facilitate personal information sharing; and (3) beyond the baby: Mothers desire for recognition and support during WCTO visits. These findings point to several missed opportunities for WCTO providers to inquire about mental health and offer support needed by mothers. To address this, a relational approach to care would prioritise families and whānau as the focus of care rather than just monitoring the development of babies.

The moderating role of social support in the relationship between death anxiety and resilience among dialysis patients

BackgroundChronic Kidney Disease (CKD) who receive social support can cope with the challenges. Therefore, this study determined the moderating role of social support in the relationship between death anxiety and resilience among dialysis patients in Qazvin City.MethodsThis cross-sectional study used a descriptive-analytical approach on 347 dialysis patients in Qazvin City. The data collection tools included several questionnaires. The convenience sampling method was employed. The data were analyzed using SPSS software version 22 and mplus software version 7.2, employing descriptive statistics, such as mean and standard deviation for continuous variables and using counts and percentages for categorical/nominal variables. Regression analysis and tests were used to examine the relationships between variables. Structural Equation Modeling (SEM) analysis was employed to determine direct and indirect relationships between independent and dependent variables.ResultsThe prevalence of death anxiety was high (48.3%) among the patients. The mean resilience score was 62.59 ± 15.69, and the mean social support score was 52.23 ± 10.21. There was a significant association between resilience and social support (P < 0.001), as well as between resilience and death anxiety (P < 0.001). Furthermore, a significant relationship was observed between social support and death anxiety (p = 0.015). In the analysis of SEM, both the direct and indirect relationships between resilience and death anxiety were significant through the mediating variable of social support.ConclusionThis study demonstrates that there is a relationship between death anxiety and resilience, and social support significantly moderates the relationship between death anxiety and resilience.

Multiple paths of green and low-carbon development in industrial parks: group analysis based on the TOE framework

The green and low-carbon development of industrial parks plays an important role in promoting industrial and technological agglomeration, How to optimise their green and low-carbon development pathways is an important management question to be answered, requiring the examination of multiple path based on a histological perspective. Based on the technology–organisation–environment framework, this study selected 29 state-level economic and technological development zones (ETDZs) in China as research objects, and explored multiple sets of paths using fuzzy set qualitative comparison and necessity-contribution analysis. The study found that: 1) four promotion paths can be adopted for green low-carbon development of the zones: endogenous drive, balanced promotion, core support drive and comprehensive drive; 2) single environmental factor does not constitute a bottleneck hindering the green low-carbon development of the zones, which should be combined with the actual situation of the zones, and the balanced enhancement of the effectiveness of green and low-carbon should be realised through measures such as industrial policy, environmental risk prevention, and performance assessment of green policies. Finally, the study proposes the following policy recommendations: industrial parks should focus on the key role of environmental risk prevention, apply a combination of measures in accordance with their own realities, and appropriate external pressure can help promote green and low-carbon development.

A robust deep learning model for the classification of dental implant brands

ObjectiveIn cases where the brands of implants are not known, treatment options can be significantly limited in potential complications arising from implant procedures. This research aims to explore the application of deep learning techniques for the classification of dental implant systems using panoramic radiographs. The primary objective is to assess the superiority of the proposed model in achieving accurate and efficient dental implant classification. Material and MethodsA comprehensive analysis was conducted using a diverse set of 25 convolutional neural network (CNN) models, including popular architectures such as VGG16, ResNet-50, EfficientNet, and ConvNeXt. The dataset of 1258 panoramic radiographs from patients who underwent implant treatment at faculty of dentistry was utilized for training and evaluation. Six different dental implant systems were employed as prototypes for the classification task. The precision, recall, F1 score, and support scores for each class have included in the classification accuracy report to ensure accurate and reliable results from the model. ResultsThe experimental results demonstrate that the proposed model consistently outperformed the other evaluated CNN architectures in terms of accuracy, precision, recall, and F1-score. With an impressive accuracy of 95.74 % and high precision and recall rates, the ConvNeXt model showcased its superiority in accurately classifying dental implant systems. Notably, the model's performance was achieved with a relatively smaller number of parameters, indicating its efficiency and speed during inference. ConclusionThe findings highlight the effectiveness of deep learning techniques, particularly the proposed model, in accurately classifying dental implant systems from panoramic radiographs.

Variations in anxiety and emotional support among first-year college students across different learning modes (distance and face-to-face) during COVID-19.

College students with more emotional support experience lower levels of anxiety and other psychosocial and behavioral problems. During the COVID-19 pandemic, the emotional well-being of college students was additionally challenged by an abrupt shift to distance learning followed by a return to face-to-face classes. In this exploratory study, we compared the levels of perceived emotional support and anxiety among incoming first-year undergraduate students, prior to starting classes, which included different learning modes in five semesters of instruction from 2021-2023 (three distance semesters and two face-to-face semesters). Data from 8659 undergraduate students were extracted from a Mexican state university database, corresponding to students' responses collected during new student orientation week. Participants were students in the arts and humanities (9.7%), social and legal sciences (38%), life and health sciences (28.9%), and engineering and architecture (23.4%). Anxiety levels were measured with the GAD-7 scale, and emotional support was measured using a subscale of the PERACT-R (To go through with resilience) inventory. Comparisons of emotional support and anxiety scores among semesters revealed highly significant differences with small effect sizes. Anxiety levels increased significantly with mean average of 6.65 SD(5.52) during the baseline measure to the highest in 2022-2 to 7.53 SD(5.3) and Emotional Support decreased systematically each semester from baseline mean = 8.03 SD(2.0) to the lowest 7.52 SD(1.8) in 2022-2. The results show that a return to face-to-face classes was associated with increased anxiety levels, whereas levels of emotional support systematically decreased across the five semesters. MANOVA analysis revealed significant differences in anxiety and emotional support scores between semesters, with peaks during the learning mode semester that students returned to face-to-face classes after distance learning even after adjusting for gender. Given that the effect of emotional support on anxiety may be related to success in future educational and professional activities, it is important to develop interventions to restore and increase college students' emotional support levels and develop anxiety management strategies.

An Exploration of Associations Between Self-Care Practices and Clinical Self-Efficacy in Speech-Language Pathology Graduate Students

Purpose: Previous studies have suggested that many speech-language pathology graduate students experience significant levels of stress throughout their programs. If not effectively mitigated, these stressors could negatively impact students' academic and clinical development. Self-care practices are one potential option that could help address the stressors students encounter throughout their graduate programs. The purpose of this research was to explore potential associations between self-care practices and clinical self-efficacy in speech-language pathology graduate students. Method: This topic was explored using a nonexperimental research design that included descriptive and correlational analyses. A survey that included demographic questions, the Mindful Self-Care Scale–Standard, and a modified version of the Clinical Self-Efficacy Appraisal Inventory was completed by 68 students who were enrolled in a speech-language pathology graduate program. Results: Small positive and significant correlational associations were observed between Mindful Awareness and total Mindful Self-Care Scale–Standard scores and all measured aspects of clinical self-efficacy. The associations between Supportive Relationships and Supportive Structure subscale scores and some aspects of clinical self-efficacy also reached significance. No significant associations were observed between Mindful Relaxation, Physical Care, or Self-Compassion and Purpose subscale scores and any measured domain of clinical self-efficacy. Conclusion: While limitations exist due to the exploratory nature of this study, the results provide an initial examination of associations between self-care practices and clinical self-efficacy.

Effect of pre-morbid frailty status on in hospital mortality in critically ill patients.

Objective: To determine the pre-morbid frailty and its association with in-hospital mortality among critically ill patients admitted in intensive care unit (ICU) of a tertiary care hospital. Study Design: Cross-sectional study. Setting: ICU of Sindh Institute of Urology and Transplantation, Karachi, Pakistan. Period: December 2022 to July 2023. Material &amp; Methods: Patients of age 18 years or older, admitted to the ICU were included. Frailty was defined as per Clinical Frailty Scale (CFS). Detailed history was taken to assess frailty status two weeks prior to hospital admission. Patients were classified as pre-morbid frail if their score was higher than 4. Results: Total 151 patients were analyzed with median age of 47 (IQR= 33-59) years. There were 106 (70.2%) male patients, whereas and 92 (60.9%) were having comorbidities. Median CFS score was 4 (IQR=3-5). Out of 151 patients admitted to ICU, 56 (37.1%) had frail. Odds of frailty were increasing with increasing age and among those who had comorbidity. Mechanical ventilation (MV) days (p=0.234), hemodynamic support days (p=0.216) and LOS (p=0.903) were not significantly different among frail and non-frail patients. Nearly half of the patients had died (49%). Mortality was noted in 74 (49.0%) patients. Need of MV, hemodynamic support, APACHEII and SOFA score were associated with mortality (p&lt;0.05). Conclusion: There was considerable burden of frailty among critically ill patients admitted in ICU. However, in-hospital outcomes including mechanical ventilation, hemodynamic support and mortality were not associated with frailty status.

The Influence of Social Support on Depression Among Elderly People in Serbia

Abstract Social factors such as social support, integration, and belonging to the community are positive resources against adverse events and living conditions. This study at examining the influence of social support on depression among elderly people in Serbia. The research was done according to the type of cross-sectional study, a mass survey of a random, representative stratified two-stage sample of the population of Serbia in 2013, which was conducted by the Ministry of Health of the Republic of Serbia. The target population consisted of 3540 respondents aged 65 and over. The Patient Health Questionnaire-8 (PHQ-8) was used to evaluate the presence of depressive symptoms and the social support score from the questionnaire Oslo-3 scale of social support. The relations between depression symptoms and social support were examined with univariate logistic regression analyses. In the univariate regression model, social support stood out as a strong predictor of depression. People with weak social support are three and a half times more likely (OR = 3.45) to have depression compared to those with strong social support. Men with small social support were more likely to have depression (OR = 5.08) than women (OR = 3.41). These results indicate the urgency of addressing depression as a public health priority to reduce the burden and disability and improve the overall health of the elderly population.

The protective effect of social support on all-cause and cardio-cerebrovascular mortality among middle-aged and older adults in the US

The relationship between social support and mortality, especially cardio-cerebrovascular mortality, still has some limitations in the assessment of social support, sample selection bias, and short follow-up time. We used the data from 2005 to 2008 National Health and Nutrition Examination Survey to examine this relationship. The study analyzed a total of 6776 participants, divided into Group 1, Group 2, and Group 3 according to the social support score (0–1; 2–3; 4–5). Multivariable adjusted COX regression analyses of our study showed that Group 3 and Group 2 had a reduced risk of all-cause and cardio-cerebrovascular mortality (Group 3 vs 1, HR: 0.55, P < 0.001; HR: 0.4, P < 0.001; Group 2 vs 1, HR: 0.77, P = 0.017; HR: 0.58, P = 0.014) compared with Group 1. The same results were observed after excluding those who died in a relatively short time. Additionally, having more close friends, being married or living as married, and enough attending religious services were significantly related to a lower risk of mortality after adjustment. In brief, adequate social support is beneficial in reducing the risk of all-cause mortality and cardio-cerebrovascular mortality in middle-aged and older adults, especially in terms of attending religious services frequency, the number of close friends, and marital status.

The role of social support in antiretroviral therapy uptake and retention among pregnant and postpartum women living with HIV in the Greater Accra region of Ghana.

The role of social support in antiretroviral therapy (ART) uptake and retention among pregnant and postpartum women in Ghana's capital, Accra, has received limited attention in the literature. This cross-sectional study extends existing knowledge by investigating the role of social support in ART adherence and retention among pregnant and postpartum women in Accra. We implemented a cross-sectional study in eleven (11) public health facilities. Convenience sampling approach was used to recruit 180 participants, out of which 176 with completed data were included in the study. ART adherence in the three months preceding the survey (termed consistent uptake), and ART retention were the outcomes of interest. Initial analysis included descriptive statistics characterized by frequencies and percentages to describe the study population. In model building, we included all variables that had p-values of 0.2 or lesser in the bivariate analysis to minimize negative confounding. Overall, a two-sided p-value of < 0.05 was considered statistically significant. Data were analyzed using Stata version 14.1 (College Station, TX). In the multivariate model, we realized a lower odds trend between social support score and consistent ART adherence, however, this was insignificant. Similarly, both the univariate and multivariate models showed that social support has no relationship with ART retention. Meanwhile, urban residents had a higher prevalence of ART adherence (adjusted Prevalence ratio (aPR) = 2.04, CI = 1.12-3.73) relative to rural/peri-urban residents. As compared to those below age 30, women aged 30-34 (aPR = 0.58, CI = 0.34-0.98) and above 35 (aPR = 0.48, CI = 0.31-0.72) had lower prevalence of ART adherence Women who knew their partner's HIV status had lower prevalence of ART adherence compared to those who did not know (aPR = 0.62, CI = 0.43-0.91). Also, having a rival or co-wife was significantly associated with ART retention such that higher prevalence of ART adherence among women with rivals relative to those without rivals (aOR = 1.98, CI = 1.16-3.36). Our study showed that social support does not play any essential role in ART adherence among the surveyed pregnant and postpartum women. Meanwhile, factors such as having a rival and being under the age of thirty play an instrumental role. The study has signaled the need for ART retention scale-up interventions to have a multi-pronged approach in order to identify the multitude of underlying factors, beyond social support, that enhance/impede efforts to achieve higher uptake and retention rates.

Optimism among Medical Students at the Faculty of Medicine and Pharmacy in Casablanca

Background: Optimism plays a crucial role in the journey of medical students. A high degree of optimism can translate into commendable academic outcomes, while a diminished level may precipitate setbacks. multiple factors can exert influence on the optimism levels of students, thereby impacting their academic achievements. Objective: To describe the level of optimism and explore the factors that impact the optimism levels in medical students. Methodology: A cross-sectional study was conducted at the Faculty of Medicine and Pharmacy in Casablanca from June to July 2023. A random sampling method was used to enroll the study participants, and data were collected through self-administered questionnaires encompassing sociodemographic characteristics, academic performance, lifestyle practices, self-esteem, social support, and optimism score. Statistical analyses incorporated Chi-square test, Student's t-test, Mann-Whitney test, ANOVA, and correlations. Results: In total, 234 participants responded to the questionnaire, 64.5% of which were female. The average age was 20.4 years (±1.8). The majority of the students came from a medium socio-economic level (88.9%) and lived with their parents (76.9%). The primary sources of subsistence were predominantly familial, (59.8%). Academic challenges were evident, with 5.6% of the students experiencing repetition and 42.7% requiring catch-up exams. The median number of friends per student stood at 3 (IQR=3), and a considerable proportion engaged in leisure activities (55.1%) and physical activities (51.7%). Stress was prevalent among 64.5% of students, while 19.3% grappled with chronic illnesses. Instances of trauma, psychiatric consultations, contemplation of seeking help (48.2%), and psychiatric treatments (10.6%) were also reported. The mean optimism score was 13.5 (±3.8 SD), indicating a modest level of optimism. Notably, 51.5% exhibited a low level of optimism, 37.3% a moderate level, and 11.6% a high level. Optimism scores ....

Surgical Outcomes of Centrifugal Continuous-Flow Implantable Left Ventricular Assist Devices: Heartmate 3 versus Heartware Ventricular Assist Device.

Left ventricular assist devices (LVADs) are widely employed as a therapeutic option for end-stage heart failure. We evaluated the outcomes associated with centrifugal-flow LVAD implantation, comparing 2 device models: the Heartmate 3 (HM3) and the Heartware Ventricular Assist Device (HVAD). Data were collected from patients who underwent LVAD implantation between June 1, 2015 and December 31, 2022. We analyzed overall survival, first rehospitalization, and early, late, and LVAD-related complications. In total, 74 patients underwent LVAD implantation, with 42 receiving the HM3 and 32 the HVAD. A mild Interagency Registry for Mechanically Assisted Circulatory Support score was more common among HM3 than HVAD recipients (p=0.006), and patients receiving the HM3 exhibited lower rates of preoperative ventilator use (p=0.010) and extracorporeal membrane oxygenation (p=0.039). The overall early mortality rate was 5.4% (4 of 74 patients), with no significant difference between groups. Regarding early right ventricular (RV) failure, HM3 implantation was associated with a lower rate (13 of 42 [31.0%]) than HVAD implantation (18 of 32 [56.2%], p=0.051). The median rehospitalization-free period was longer for HM3 recipients (16.9 months) than HVAD recipients (5.3 months, p=0.013). Furthermore, HM3 recipients displayed a lower incidence of late hemorrhagic stroke (p=0.016). In the multivariable analysis, preoperative use of continuous renal replacement therapy (odds ratio, 22.31; p=0.002) was the only significant predictor of postoperative RV failure. The LVAD models (HM3 and HVAD) demonstrated comparable overall survival rates. However, the HM3 was associated with a lower risk of late hemorrhagic stroke.

Impact of perceived social support on psychological resilience: A comparison between medical and surgical postgraduate residents.

To identify the predictable relationship and differences between perceived social support and psychological resilience among medical and surgical postgraduate residents. The analytical cross-sectional study was conducted from July to September 2021 at Dr Ruth K.M. Pfau Civil Hospital, Karachi, and comprised postgraduate medical and surgical residents of either gender. Data was collected using validated self-administered questionnaires. Data was analysed using SPSS 22. Of the 200 residents, 100(50%) were medical residents and 100(50%) were surgery residents. Besides, 161 (80.5%) were females and 39(19.5%) were males. The overall mean age was 27.57±2.13 years. Mean perceived social support score was 62.53±15.41 and mean score for psychological resilience was 70.40±13.73. Perceived social support was a significant predictor of resilience (p=0.0001). Medical residents scored significantly higher (p=0.034) on perceived social support compared to residents from surgery departments. Marital status, residency year, and birth order in the family significantly differed with reference to perceived social support and resilience (p<0.05). There was a favourable role of perceived social support in building resilience among postgraduate residents.