Mean Hours Research Articles

The Effect of Resuscitation Residents on the Duration of Pre-induction of Targeted Temperature Management in Out-of-Hospital Cardiac Arrest.

Background The Resuscitation Rotation is a novel second-year emergency medicine rotation focusing on the highest acuity patients, including out-of-hospital cardiac arrest (OHCA). The resuscitation resident (RR) functions as an extra physician during resuscitation and post return of spontaneous circulation (ROSC). The objective of this study is to examine if the presence of a RR decreases the pre-induction interval of targeted temperature management (TTM) for patients following OHCA. Methods A retrospective study was conducted at a tertiary care level 1 trauma center with an annual ED census of 127,323 visits in 2019. We retrospectively reviewed consecutive OHCA patients from September 1, 2014, to July 20, 2020, who underwent TTM. Patients were identified as cases with or without a RR. Clinical characteristics were summarized by the status of RR involvement and compared by using t-test and χ2 test for continuous and categorical variables, respectively. All tests with p < 0.05 were considered to indicate statistical significance. Results Our study population identified 198 adult OHCA patients that underwent TTM from 2014-2020. There were exclusions for missing TTM start time and for missing patient characteristics leaving 176 for final analysis, of which 55 (33.3%) had RR involvement. The mean time (hours) to TTM initiation (ie, the pre-induction phase) for patients involving the RR versus those without was not statistically significant (3.11 vs 3.34, p=0.39). Linear regression analysis indicates that the adjusted effect of RR involvement was not associated with the mean hours of pre-induction (p=0.47). Conclusion There is no statistically significant association of a RR on the duration of the pre-induction phase. Limitations include that both arms had prolonged pre-induction phases. This may represent a non-optimized TTM protocol. Future work will aim to use the RR to improve our pre-induction phase.

The Efficiency of Spinal Anesthesia among 4-10 Years Children

Objective: In this study our main goal is to evaluate the efficiency of spinal anesthesia among 4- 10 years children. Method: This prospective study was carried out at Cumilla Medical College hospital. A total of 50 pediatric patients 4 to 10 years of age group who were given spinal anesthesia for infraumbilical or lower extremity surgery during the 1-year period from January 2021 to December 2021 were included in the study. Results: During the study, majority patients were belong to 4-6 years age group 67%. During procedure, 80% patients’ position was sitting, followed by 50% cases number of punctures was single, where as 7% cases CSF reflux showed after 2nd puncture. Mean fasting hours were 5.82± 0.1 h. Injection atropine 0.01 mg/kg was given as premedication. Most of the patients were given ketamine either alone (59%) or with midazolam (41%). Other drugs used were diazepam (3%) and fentanyl (2%). there was no significant change in the mean value of systolic blood pressure, diastolic blood pressure, respiratory rate, and oxygen saturation after subarachnoid block at all time periods. After 10 min of SAB 95% patients achieved desired peak sensory level of T10 and Bromage score of 3. Conclusion: From our study we can recommend that spinal anesthesia is ideal, safe and cost- effective for day-case surgeries and there is no additional requirement of any special drugs or equipment’s for the procedure. Because of these benefits, spinal anesthesia preferred for children undergoing surgery in the lower part of the body.

Should Thyroid Lobectomy Be Performed as a Day-Case Procedure? A Single-Centre Retrospective Audit.

Introduction The British Association of Endocrine and Thyroid Surgeons (BAETS) published guidance in 2012 advising against day-case thyroid lobectomy due to the unpredictable risk of post-operative haematoma. Due to the increasing pressures the National Health Service (NHS) faces, a position statement was released by BAETS in 2020 highlighting their support of day-case thyroid lobectomy in specific low-risk cases with the introduction of appropriate local protocols. Objective We aimed to assess post-operative complications of thyroid lobectomy at University Hospitals Bristol and Weston NHS Trust (UHBW), a tertiary centre for Otolaryngology, to consider the feasibility and safety of day-case surgery in our unit. Methods We conducted a retrospective audit of 140 elective thyroid lobectomy cases identified in the period of January 2017 to December 2018 at UHBW. Inclusion criteria included no previous thyroid surgery or major head and neck surgery, elective thyroid lobectomy procedure only, and surgery performed at UHBW by otolaryngology or maxillofacial teams. Exclusion criteria included emergency hemithyroidectomy; hemithyroidectomy as part of another procedure; and completion thyroidectomy. Results A total of 140 elective thyroid lobectomy procedures were performed between January 2017 and December 2018. Of them, 125 cases met inclusion criteria, and 15 cases were excluded: two emergency hemithyroidectomy, three incorrect coding, four hemithyroidectomy as part of another head and neck procedure, and six completion thyroidectomy. Mean age was 51.9 years (range: 20-88 years), with 30 (24.0%) male cases and 95 (76.0%) female cases. Mean in-patient stay was 1.4 days (range: 0-19 days), and mean hours in hospital were 34 hours. Two (1.6%) cases were discharged on the same day of their operation. Post-operative complications included five (4%) cases of post-operative haematoma, four (3.2%) cases of unilateral vocal cord palsy, one (0.8%) case of pneumonia, and three (2.4%) cases of wound infections. From those cases that developed post-operative haematoma, 80% (n=4/5) developed less than 24 hours after the procedure. One (20%) case of post-operative haematoma developed on day 6 after their procedure and required readmission for re-operation. Conclusion The unpredictable nature of post-operative haematoma poses a significant risk to patients and medicolegal implications. Our findings suggest that there were no predictable risk factors amongst our patient cohort and therefore day-case thyroid lobectomy should be avoided. Further research is required to identify low-risk patients who could benefit from day-case surgery.

Classroom language during COVID-19: Associations between mask-wearing and objectively measured teacher and preschooler vocalizations.

During the COVID-19 pandemic, mask-wearing in classrooms has become commonplace. However, there are little data on the effect of face-masks on children's language input and production in educational contexts, like preschool classrooms which over half of United States children attend. Leveraging repeated objective measurements, we longitudinally examined child and teacher speech-related vocalizations in two cohorts of 3.5-4.5-year-old children enrolled in the same oral language classroom that included children with and without hearing loss. Cohort 1 was observed before COVID-19 (no face-masks, N = 20) and Cohort 2 was observed during COVID-19 (with face-masks; N = 15). Vocalization data were collected using child-worn audio recorders over 12 observations spanning two successive school years, yielding 9.09 mean hours of audio recording per child. During COVID-19 teachers produced a higher number of words per minute than teachers observed prior to COVID-19. However, teacher vocalizations during COVID-19 contained fewer unique phonemes than teacher vocalizations prior to COVID-19. Children observed during COVID-19 did not exhibit deficits in the duration, rate, or phonemic diversity of their vocalizations compared to children observed prior to COVID-19. Children observed during COVID-19 produced vocalizations that were longer in duration than vocalizations of children observed prior to COVID-19. During COVID-19 (but not before), children who were exposed to a higher number of words per minute from teachers produced more speech-related vocalizations per minute themselves. Overall, children with hearing loss were exposed to teacher vocalizations that were longer in duration, more teacher words per minute, and more phonemically diverse teacher speech than children with typical hearing. In terms of production, children with hearing loss produced vocalizations that were longer in duration than the vocalizations of children with typical hearing. Among children observed during COVID-19, children with hearing loss exhibited a higher vocalization rate than children with typical hearing. These results suggest that children's language production is largely unaffected by mask use in the classroom and that children can benefit from the language they are exposed to despite teacher mask-wearing.

The Effectiveness of Multidisciplinary Team Huddles in Healthcare Hospital-Based Setting.

ObjectiveHuddles are short, regular debriefings that are designed to provide frontline staff and bedside caregivers environments to share problems and identify solutions. Daily huddle implementation could improve medical safety work, problem identification and improvement, situation awareness and teamwork enhancement, the collaboration and communication between professionals and departments, and patient safety. This study aimed evaluated the effectiveness of a hospital-based huddle at a general medical ward in Taiwan.MethodsA Continuous Integration team was conducted by combining multidisciplinary frontline staff to huddle at a 74-bed general medical ward. Team Huddles started twice a week. A physical huddle run board was created, which contained four parts, including idea submitted, idea approved, working on an idea and standardizing. Problems were submitted to the board to be identified, and the solutions were evaluated through huddle discussion. We divided the problems into two groups: quick hits (resolved within 24–48hrs) and complex issues (resolved >48hrs). An anonymous questionnaire was designed to evaluate the huddle response.ResultsA total of 44 huddles occurred from September 9th, 2020, to September 30th, 2021, and 81 issues were identified and resolved. The majority issues were policy documentation (n=23; 28.4%). Sixty-seven (82.7%) issues were defined as quick hits, and the other fourteen (17.3%) issues were complex. The mean hours to the resolution of quick hits was 5.17 hours, median 3.5 hours, and range from 0.01–15.4 hours. The mean days to resolve completion issues were 19.73 days, median 7.5 days, and range 3.57–26.14 days. An overwhelming 92.9% of staff responded that huddles help to expedite the process to reach treatment goals, reduce clinical mistakes, near misses, reduce patient incidences, and help teamwork enhancement, with rating of 4.52 (on a 5-point Likert scale).ConclusionImplementing of multidisciplinary team huddle improved the accountability of issue identification, problem-solving and teamwork enhancement.

The Effect Of Covid-19 On Sedentary Behavior And Physical Activity Levels In College Students.

Participating in regular physical activity (PA) has various health benefits including, but not limited to, improved muscular and cardiorespiratory fitness, bone health, and reduces the risk of hypertension, coronary heart disease, stroke, diabetes, various types of cancer, and depression. Sedentary behavior is associated with increased blood pressure, increased cholesterol levels, lower self-esteem, social behavior problems, and poor academic achievement. Since the emergence of COVID-19, individuals needed to make various modifications in their daily lives, such as adjusting their levels of physical activity and/or their sedentary behavior. PURPOSE: To understand the effect of COVID-19 Pandemic on physical activity levels and sedentary behavior in college students. METHODS: A questionnaire was developed from two publicly available questionnaires: The International Physical Activity Questionnaire and the International Sedentary Assessment Tool. The questionnaires were modified to relate to college-aged individuals. Exclusion criteria were participating in any of the university varsity teams, or individuals that suffer a debilitating injury in the past six months. The questionnaires were distributed to students. Nineteen students participated in the study. Paired t-tests were used to determine the effects of COVID-19 on physical activity levels and sedentary behavior in college students, alpha level was set to 0.05. RESULTS: Significant increase in mean hours per week (hr/wk) spent in sedentary behavior was identified (p = 0.04). Students spent less hr/wk in sedentary behavior before COVID 19 (114.2 (50.9)) then during (139.2 (54.6)). No significant differences were found between the other dependent variables before and during COVID 19 respectively: vigorous PA 12.9 (13.9) hr/wk vs. 12.5 (11.6) hr/wk, (p = 0.882); moderate PA 15.4 (15.4) hr/wk vs, 12.5 (10.6) hr/wk, (p = 0.460); walking 19.1 (23.1) hr/wk vs. 11.8 (12.9) hr/wk, (p = 0.085); total time for PA 47.5 (42.3) hr/wk vs. 36.8 (25.8) hr/wk, (p = 0.288). CONCLUSION: The study identified a trend of decrease in physical activity levels and a significant increase in sedentary behavior during COVID-19 for these college students.

0791 Perceived racial discrimination predicts poor PAP adherence: a pilot study

Abstract Introduction Although racial and ethnic differences in continuous positive airway pressure (CPAP) adherence for people with obstructive sleep apnea (OSA) are well known, no studies have examined the influence of racial discrimination on CPAP use. The aim of this study was to determine if racial discrimination influenced CPAP use trajectories. Methods Participants with OSA initiating CPAP were enrolled from two sleep centers in New York City. Participants completed questionnaires including sociodemographics, perceived discrimination, daytime sleepiness, and depressive symptoms. Racial discrimination was measured via the validated Everyday Discrimination scale (EDS) , Participants endorsed at least one discriminatory experience “at least once a year” and race was the main reason for this treatment. Sociodemographic and questionnaire comparison were performed between participants reporting the presence and absence of racial discrimination. To examine differences in the trajectory of CPAP use based on racial discrimination status (between-subjects factor), we performed a two-factor repeated measures ANOVA with mean hours of daily use at 7, 30 and 90 days serving as the time dependent variable (within-subjects factor). Analyses were adjusted for depressive symptoms. Results The sample consisted of 88 participants (40% female; 40% Non-Hispanic Black; mean age of 57 ± 14 yrs). Twenty-two individuals (25% of the cohort) reported racial discrimination. In unadjusted two-factor repeated measures ANOVA, the test statistic for equality of racial discrimination CPAP adherence means over time was highly significant [ F = 9.71 (1, 68); p = 0.003] while the test for interaction between racial discrimination and time was marginally significant [F = 3.19 (1.53, 103.8); p = 0.059). Main effects for time were significant for participants reporting discrimination (p=0.04) but not for those without racial discrimination experiences (p=0.25). Thus, people reporting racial discrimination experienced greater decrement in CPAP use over time while a more stable CPAP use pattern was observed in those not perceiving racial discrimination. Conclusion Racial discrimination status may determine future poor CPAP adherence. Larger studies examining mechanisms of how perceived racial discrimination mediates worse CPAP adherence may assist in mitigating CPAP adherence disparities. Support (If Any) Natasha Williams was supported by grant from the National Institutes of Health: K23125939

Associations between socioeconomic status and physical activity among older adults: cross-sectional results from the OUTDOOR ACTIVE study.

BackgroundRegular physical activity (PA) is an important strategy for healthy ageing. Socioeconomic status was found to be a key determinant of PA, however, evidence on associations between socioeconomic status and PA among older adults is limited. The aim of this study was to contribute to research on the associations of socioeconomic status and PA among older adults by including self-reported and objectively measured PA data. Furthermore, we examined the self-reported PA data more closely by looking at the activities separately.MethodsCross-sectional data of 1507 participants (52.5% female) of the OUTDOOR ACTIVE study between 65 and 75 years, residing in Bremen, Germany, were included in the analyses. Self-reported PA was assessed via questionnaire and comprised all organised and non-organised activities. For analyses, mean hours per week of total and moderate to vigorous PA, and mean metabolic equivalents per week were used. Objectively measured PA was assessed using accelerometers over seven consecutive days. Socioeconomic status was included as an additive social class index containing education, income, and occupation. To test for associations between PA and socioeconomic status, linear regressions were carried out.ResultsSelf-reported PA showed significant negative associations with socioeconomic status for both men and women. Objectively measured PA was positively associated with socioeconomic status, which was significant in men but not in women. When examining physical activities separately, time spent on housework, gardening, biking, and walking decreased with increasing socioeconomic status. Women in the second SES quintile and men in the third quintile reported the most, and women in the first quintile and men in the fifth quintile the least hours per week spent on exercise.ConclusionsThe results of this study contributed to the existing research gap on the associations of socioeconomic status and PA among older adults. Moreover, we provided information on both self-reported and objectively measured PA, and showed the discrepancies in the two methods’ results. These findings can help to develop PA promotion interventions targeting specific socioeconomic status groups and to develop accurate, valid, and reliable self-reported and objective measurements of PA for older adults.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12877-022-03075-7.

Nonveterinarian staff increase revenue and improve veterinarian productivity in mixed and companion animal veterinary practices in the United States.

To determine the contributions of veterinarians and support staff to revenue and veterinarian productivity (ie, number of patients seen/full-time-equivalent veterinarian/wk) in private mixed and companion animal practices in the US and identify staff-to-veterinarian labor ratios (SVLRs) that maximized these 2 practice outputs. 409 owners of mixed and companion animal practices who participated in the 2020 AVMA Practice Owner Survey. Data regarding owner demographics, practice characteristics, labor (defined as mean total hours worked/wk), and gross revenue in 2019 were obtained from participating practices. Multivariable ordinary least-squares regression was used to identify factors associated with revenue and productivity as well as the SVLRs at which revenue and productivity were maximized. For each 10% increase in total veterinarian hours worked per week, revenue increased by a mean of approximately 9%. A 1-unit increase in total number of technician hours used to support 1 hour of veterinarian work was associated with a 20.5% increase in revenue but with no change in productivity. The same increase in total number of nonmedical staff hours was associated with a 17.0% increase in revenue and 14.4% increase in productivity. In terms of revenue, the optimal SVLRs for veterinary technicians and nonmedical staff were 9:1 and 8:1, respectively. In terms of productivity, the optimal SVLR for nonmedical staff was 10:1. Findings confirmed the important role of nonveterinarian staff in revenue and veterinarian productivity in mixed animal and companion animal practices and may be useful for making evidence-based staffing decisions.

Reintroducing rest: evaluation of a patient-guided sleep workbook in a community mental health team setting

Purpose Sleep disturbance is a common difficulty in the general population. It has become particularly prevalent in the context of disruption to routine brought about by the COVID-19 pandemic. The purpose of this study was to trial a patient-guided “sleep workbook” intervention, which was developed by multidisciplinary team members, combining principles of sleep hygiene education and cognitive behavioural therapy for insomnia behavioural strategies, and to evaluate its efficacy in a mixed-methods study. Design/methodology/approach Service users of the community mental health service were invited to participate. A total of 30 service users agreed to participate. A total of 15 participants completed both the intervention and the mixed-methods survey. Four participated in the focus group. Descriptive and inferential statistics were performed on the collected quantitative data. A thematic analysis was carried out of qualitative survey responses and focus group discourse. Findings There was a statistically and clinically significant improvement in quantity and quality of sleep following intervention. Mean hours of sleep prior to the intervention was 4.4 hours [standard deviation (SD) = 2.2], compared to 6.1 hours (SD = 2.2) afterwards (p = 0.003). Quality of sleep improved from a mean of 2.5 (SD = 2.1) to 6.1 (SD = 2.3) following the intervention (p = &lt;0.001). Four themes were developed using the qualitative data: “under-recognition of sleep difficulties”, “ruminations”, “practical utility” and “therapeutic autonomy”. Originality/value There is a growing need for occupational therapists and clinicians to provide interventions for patients with sleep difficulties and to develop sleep management practice. This patient-guided sleep workbook may be an effective intervention for these patients.

МЕТОД АНАЛІТИЧНОГО МОДЕЛЮВАННЯ БЕЗВІДМОВНОСТІ БОЙОВИХ ЗАСОБІВ ЗЕНІТНИХ РАКЕТНИХ ВІЙСЬК

The article sets out a method for analytical modeling of the recoverability of anti-aircraft missile forces using the example of a self-propelled fire launcher (SOU) of the Buk anti-aircraft missile system. The main attention is paid to one of the properties of technical reliability, namely the reliability of weapons and military equipment. This is especially true of the IWT anti-aircraft missile forces, the failure to fulfill the tasks of which due to failures in operation can lead to serious consequences in operation or battle. The improved method of mathematical modeling of reliability allows taking into account the possibility of developing elements of aging and wear of MCS components in the process of expending the released resource at the operation stage, as well as taking into account the conditions of hostilities by using and developing a mathematical model in the form of a Weibull distribution in order to obtain more guaranteed indicators of reliability. It is advisable to select the final value of the mean hour of MTBF failure taking into account reaching the value of the ratio between the number of MTBF disabled due to only limited technical reliability and the amount of equipment that failed due to enemy fire action. This will increase the efficiency of the system for updating damaged MDS during hostilities, and improve the planning of production activities of repair bodies. It will also be possible to increase the overall combat effectiveness of the anti-aircraft missile regiment in the process of repelling a raid of air attack vehicles. When setting the specified ratio value, the required MTBF value can be calculated (before failure). The improved method of mathematical modeling adequately reflects the failure-free operation of the combat vehicles of the Buk anti-aircraft missile system, taking into account the conditions of hostilities. Keywords: probability of failure-free operation, failure-free simulation, continuous operation time, distribution parameters, time between failures, limited technical reliability.

Inefficiencies of electronic medical record use by surgical healthcare providers

ObjectivesElectronic medical records (EMRs) are intended to reduce healthcare costs and improve quality of care. Nevertheless, usability issues common to EMRs have been noted. Given the time demands of a clinic and surgery schedule, as well as the association between EMR usage and burnout, continued investigation into the utility of EMRs is important. We investigated the number of login encounters and time expended on EMRs by surgeons and advanced practice providers (APPs) across several surgical specialties. MethodsA one-year retrospective study was conducted at a tertiary pediatric hospital utilizing EMR data for surgeons and surgical APPs. Encounters and hours expended on EMR were calculated and stratified into three categories: within working hours, after-hours during the work week, and during the weekend. The mean hours expended per provider were calculated and compared between provider types and surgical specialty. ResultsMean time spent on EMR within working hours and after-hours during the work week was significantly less for surgeons than surgical APPs (1.76 hours/day vs. 2.10 hours/day, p<0.0001; 0.272 hours/day vs. 0.299 hours/day, p = 0.0173, respectively). Orthopedic surgery providers spent the most time logged into EMRs during working hours (2.33 hours/day), while neurosurgery expended the least time (1.42 hours/day). A high volume of encounters occurred within and outside working hours for all providers. ConclusionsRegardless of provider type or surgical specialty, substantial time was still universally expended navigating EMRs. This single institution study suggests that opportunities to optimize utility of EMR should be further explored to improve provider work-life balance.

Seroprevalence of COVID-19 IgG Antibody in Resident and Fellow Physicians in Milwaukee, Wisconsin: Analysis of a Cross-Sectional Survey.

Medical trainees are likely at differential risk of exposure to COVID-19 per respective clinical activity. We sought to determine the seroprevalence of COVID-19 antibody (Ab) among resident and fellow physicians with varying degrees of exposure to COVID-19. A cross-sectional study of Milwaukee-based resident and fellow physicians, encompassing December 2019-June 2020, was conducted. Relevant variables of interest were ascertained by survey and payroll data, and Abbott ARCHITECT Ab test (index cut-off of ≥1.4) was performed. Descriptive statistics were generated, with 95% CI calculated for the study's primary outcome of seroprevalence. Among survey respondents (92 of 148, 62%), 61% were male, 44% were non-White, mean age was 31 years, 94% had no underlying conditions, and 52% were either family or internal medicine residents. During the study period, ≥32% reported cough, headache, or sore throat and 62% traveled outside of Wisconsin. Overall, 83% thought they had a COVID-19 exposure at work and 33% outside of work; 100% expressed any exposure. Of those exposed at work, 56% received COVID-19 pay, variously receiving 69 mean hours (range: 0-452). Ultimately, 82% (75 of 92) had an Ab test completed; 1 individual (1.3%; 95% CI: 0.0-3.9) tested seropositive, was not previously diagnosed, and had received COVID-19 pay. The low Ab seroprevalence found in resident and fellow physicians was similar to the concurrently reported 3.7% Ab-positive rate among 2456 Milwaukee-based staff in the same integrated health system. Ultimately, COVID-19 seroconversion may be nominal in properly protected resident and fellow physicians despite known potential exposures.

Developing a Predictive Model for Depressive Disorders Using Stacking Ensemble and Naive Bayesian Nomogram: Using Samples Representing South Korea.

This study provided baseline data for preventing depression in female older adults living alone by understanding the degree of their depressive disorders and factors affecting these depressive disorders by analyzing epidemiological survey data representing South Koreans. To achieve the study objective, this study explored the main risk factors of depressive disorders using the stacking ensemble machine technique. Moreover, this study developed a nomogram that could help primary physicians easily interpret high-risk groups of depressive disorders in primary care settings based on the major predictors derived from machine learning. This study analyzed 582 female older adults (≥60 years old) living alone. The depressive disorder, a target variable, was measured using the Korean version of Patient Health Questionnaire-9. This study developed five single predictive models (GBM, Random Forest, Adaboost, SVM, XGBoost) and six stacking ensemble models (GBM + Bayesian regression, RandomForest + Bayesian regression, Adaboost + Bayesian regression, SVM + Bayesian regression, XGBoost + Bayesian regression, GBM + RandomForest + Adaboost + SVM + XGBoost + Bayesian regression) to predict depressive disorders. The naive Bayesian nomogram confirmed that stress perception, subjective health, n-6 fatty acid, n-3 fatty acid, mean hours of sitting per day, and mean daily sleep hours were six major variables related to the depressive disorders of female older adults living alone. Based on the results of this study, it is required to evaluate the multiple risk factors for depression including various measurable factors such as social support.

Prevalence of Physical Activity Among Healthcare Students in King Saud University, Riyadh, Saudi Arabia. An Observational Study

Background and ObjectivePhysical inactivity is 1 of the most important cardiovascular risk factors causing higher morbidity and mortality rate worldwide. Thus, the promotion of physical activity (PA) is 1 of the fundamental pillars in the primary prevention of heart disease. Therefore, this study aimed to assess the prevalence of Physical Activity among healthcare Students in the Riyadh region, Saudi Arabia.MethodsAn observational, descriptive, cross-sectional study using paper-based printed questionnaires was conducted among Emergency medical students (EMS) from the Prince Sultan College for Emergency Medical Services King Saud University. To evaluate the physical activity, Global Physical Activity Questionnaire (16-items) developed by the World health organization was used. The questionnaires talk about activity at work (6 items), travel to and from places (3-items), recreational activities (6- items), and sedentary behavior (1-item). Both binary answers (Yes\\No) and continuous scales were used to collect the data. Data were descriptively analyzed using a statistical package for social science version 26 (SPSS).ResultsThe prevalence of PA among students was 69.9% (n = 123). The most common type of physical activity was walking, accounted for 51.7% (n = 91), followed by Gym/bodybuilding 25% (n = 44), running 24.4% (n = 43). A total of 7.16 mean hours (SD = 11.23) were spent by students doing vigorous-intensity activities on a typical day, while 4.93(SD = 8.84) of mean hours were spent on moderate-intensity activities. Additionally, more than half of the students 55.7% (n = 98) performed vigorous-intensity sports, fitness, or recreational activities that cause large increases in breathing or heart rate (for at least 10 minutes continuously). The mean time spent by the students in this study performing vigorous-intensity sports, and fitness activity were 4.60(SD = 10.22) mean hours per day. The sedentary behavior, like constant sitting, was reported to be 7.33 (SD = 4.24) mean hours per day.ConclusionIn conclusion, about 3 in ten EMS students are physically inactive, which could be due to study-related actions. Future research among undergraduates should focus on approaches to increase PA is needed.

Prevalence of musculoskeletal disorders in students aged 13–18 years with the use of smartphones for online classes

CONTEXT: Smartphones are a common gadget used by individuals in day-to-day life for various purposes. Especially in the lockdown period, the use of gadgets increased tremendously for the purpose of attending online classes. Inefficient use of smartphones by students for attending online classes may lead to several long-term musculoskeletal disorders.AIMS: The aim of this study was to find the prevalence of musculoskeletal disorders with the use of smartphones during online classes.SETTINGS AND DESIGN: Community setup, cross-sectional Study design.SUBJECTS AND METHODS: The approval of the Institutional Ethical Committee was obtained. Informed consent was obtained from the participants and a self-made validated questionnaire was circulated to 202 students through online mode.STATISTICAL ANALYSIS USED: This was a descriptive data analysis.RESULTS: Two hundred two students participated in the study with a mean age of 15.5 ± 2.58 years. The mean hours of use of smartphones for attending online classes were 4.81 h ± 2.18 h and the mean hours of use of smartphones for other purposes such as gaming and social media was 2.69 h ± 1.79 h. Neck pain showed the most prevalence among other joints which was supported by the finding that 34.74% of students complained of pain in the neck.CONCLUSIONS: The prevalence of musculoskeletal disorders is common after smartphone use for online classes and was found to be in the neck, shoulder, upper back, and lower back.

Serum 25-hydroxyvitamin D and risk of cancer in a large community population under investigation for cardiovascular disease: a retrospective cohort study

ObjectivesIt remains unclear whether vitamin D status is related to cancer risk. We examined this relationship using laboratory, administrative and survey data.DesignRetrospective cohort study.SettingAll care settings within Calgary, Alberta, Canada...

The Impact of Social Media on the Academic Life and Performance of High School Students in Eastern Province, Saudi Arabia

Social media has a vital part of an individual's life that allows people to communicate with one another. In recent days the prevalence of addiction to social media among students is a serious issue. The objective of this study was to assess the impact of social media on the academic life and performance of high school students in Saudi schools, in Eastern Province Saudi Arabia. This was a cross-sectional questionnaire-based study conducted in a Saudi school over 3 months (Nov 2020 Jan 2021), where 203 high school students were participated in the study. Data collected from the questionnaire included the academic performance in terms of school marks, the duration of social media use, time spend for studying, and social media addiction. Data analysis was performed using a statistical package for social science version 26 (SPSS) was used. Most of the participants were male students 131 (64%) and half of them 82 (40.4%) were in their academic second year. The mean time spent by students studying in a week was 18.50(M=18.50, SD = 8.33), while 3.79 mean hours per day were spent by students to use social media (M= 3.79, SD=2.65). A large majority of the participants using WhatsApp 191(94%) followed by snap chat 176 (86.7%). About 171 (84.2%) agreed that the time spend on social networks takes up their time for studying. Based on Internet distraction, 81.3% of the participants agreed that social network is the main reason for their distraction in studies. The time spend on studying per week were significantly associated with gender (P= 0.0001), age (P= 0.0001). Also there was significant difference between male and female in the final exam scoring (P= 0.0001). The results found that the use of social media among Saudi school students’ found high. Additionally, findings reported that the use of social media has distracted students from studying.

Foot school: Preoperative education before day case elective foot and ankle surgery reduces the length of stay after surgery

BackgroundThis study evaluates the impact of preoperative education on the length of hospital stay after foot and ankle surgery. There are several studies on the benefits of preoperative education prior to hip and knee arthroplasty, especially their role in facilitating early discharges. But studies on the benefits of foot school (Preoperative education) prior to Foot and Ankle surgeries are limited. The aim of this study was to determine if Foot school played a role in expediting early and safe discharges in patients of elective foot and ankle surgeries MethodsAll patients listed for an elective foot and ankle procedure were invited to attend foot school, which consisted of a multi-disciplinary team whose aim was to educate patients about their surgical procedures, rehabilitation and discharge goals. Not all patients attended foot school, as attendance to foot school was recommended but not mandatory for surgery. Data on all foot and ankle surgeries performed in 2019 were collected, and patients were divided into two groups based on their foot school attendance. Results92% of the patients who attended foot school were discharged on the same day. 65% of patients who did not attend foot school returned home the same day. There was a statistically significant difference in the observed mean hours after surgery between the two groups. Patients who attended foot school stayed at the hospital for a lesser duration than those who did not (mean difference = 8.55 h, p-value = 0.004). Early discharges can also increase the turnover of patients for day case procedures and improve cost savings. The cost analysis also showed that a portion of the savings from a reduced hospital stay could run foot school service. ConclusionOur study demonstrates that preoperative education allows a significantly shorter hospital stay, thereby facilitating early patient discharges. This can improve the patient turnover rate and also would save the hospital cost per procedure. Patients should, therefore, be encouraged to attend Foot school before their surgical procedure.

Physical Activity and Sleep in 11-Year Old Children With a Familial High Risk of Schizophrenia or Bipolar Disorder. The Danish High Risk and Resilience Study-VIA 11.

People with schizophrenia and bipolar disorder are at increased risk of having comorbid somatic illness. This is partly due to lack of physical activity, which may originate from childhood. Sleep disturbances are associated with schizophrenia and bipolar disorder. We aimed to assess physical activity and sleep in children at familial high risk of schizophrenia or bipolar disorder and population-based controls. This study is part of The Danish High Risk and Resilience Study-VIA 11. Children aged 11 born to parents with schizophrenia (FHR-SZ) (N = 133), bipolar disorder (FHR-BP) (N = 84), or controls (C) (N = 150) were assessed by accelerometry for an average of 6.9 days. High-intensity physical activity was significantly lower in children at FHR-SZ and FHR-BP compared to controls, (mean hours per day for FHR-SZ: 0.29, SD 0.19, for FHR-BP: 0.27, SD 0.24, and for controls 0.38, SD 0.22, P = <.001). Sleep did not differ between the groups. Children at FHR-SZ or FHR-BP had less physical activity compared to controls. Our study highlights a research area that reveals a hitherto unexplored disadvantage of being born to parents with schizophrenia or bipolar disorder. Further research is needed to enhance better understanding of causal pathways and consequences of reduced physical activity in children with FHR-SZ and FHR-BP.