| 1. |
- Al Awaji, N, et al.
(författare)
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Moderating Effects of Self-Esteem on the Relationship between Communication Anxiety and Academic Performance among Female Health College Students during the COVID-19 Pandemic
- 2022
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Ingår i: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 19:21
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Tidskriftsartikel (refereegranskat)abstract
- Unprecedented quarantine due to COVID-19 exposes individuals to withdraw from face-to-face interactions, which may influence communication and self-esteem (SE). Therefore, the overarching aims of this study are to examine the communication apprehension levels among female college students, and thus to investigate the moderating role of self-esteem on the relationship between communication apprehension and academic achievement. In this cross-sectional study, 287 female college students completed the survey, which was circulated through email. The survey included the following questionnaires: General Health Characteristics, Rosenberg Self-esteem Scale, and Personal Report of Communication Apprehension Scale. The results showed that 28.2% of participants were categorized as having a high level of communication apprehension, and only 9.8% had a low level of communication apprehension. The SE reported an overall score of 24.3 ± 2.14, indicating a high self-esteem level among students. The students’ grade point average (GPA) was positively correlated with SE. However, self-esteem as a moderator variable had no significant effect on the relationships between all predictors and GPA. The finding of the study highlights the need to implement different strategies to enhance students’ group discussions, meetings, and interpersonal communication to ensure the best learning outcomes. Future studies are required to investigate gender-based disparities in the relationship between communication apprehension and SE.
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| 2. |
- Al Awaji, N, et al.
(författare)
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Quality of Life, Needs and Fears of Mothers of Children with Disabilities in Saudi Arabia during the COVID-19 Lockdown
- 2021
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Ingår i: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 18:21
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Tidskriftsartikel (refereegranskat)abstract
- Substantial changes in life dynamics resulting from the outbreak of the coronavirus disease 2019 (COVID-19) could have an impact on the quality of life (QoL) of mothers of children with and without disabilities. This study compared the quality of life (QoL) of mothers of children with disabilities (MCD) to the QoL of mothers of children without disabilities (CON) in Saudi Arabia during COVID-19 lockdown. It explored mothers’ concerns and the type of support they need during the quarantine. A comparative cross-sectional study was conducted during the lockdown. An online questionnaire was distributed to mothers raising children with and without disabilities in Saudi Arabia. A total of 340 mothers participated in the study by completing the survey: 93 MCD and 247 CON. The QoL of MCD and CON was assessed using the WHOQOL-BREF questionnaire. Furthermore, detailed information was provided by the mothers regarding their needs and concerns during the lockdown. The results of the study revealed that the overall QoL was significantly higher in the CON group, compared to the MCD group, during the COVID-19 lockdown. The social well-being and environmental well-being reported by MCD were significantly lower on the total scale of the WHOQOL-BREF than those reported by the CON group. The comparison between the two groups revealed significant differences in the support required by mothers during the COVID-19 pandemic: a higher percentage of MCD needed emotional and psychological support, especially from family members. The major concerns reported by MCD were the deterioration of their children’s medical conditions and the lack of medical supplies during the lockdown.
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| 3. |
- Aldhahi, MI, et al.
(författare)
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Effect of Resilience on Health-Related Quality of Life during the COVID-19 Pandemic: A Cross-Sectional Study
- 2021
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Ingår i: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 18:21
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Tidskriftsartikel (refereegranskat)abstract
- The unprecedented outbreak of coronavirus disease 2019 (COVID-19) has caused a huge global health and economic crisis. The aim of the study was to examine the extent to which the resilience of a person is associated with the quality of life (QoL) of adults amongst Saudi Arabia. A cross-sectional study was conducted among a sample of adults in Saudi Arabia. A total of 385 adults voluntarily participated in and completed the survey. The quality of life was measured using the “World Health Organization QoL”. The “Connor-Davidson Resilience Scale” instrument was also used to assess resilience during the COVID-19 pandemic. Amongst the 385 participants, 179 (46%) showed a good QoL, and 205 (54%) reported a relatively poor QoL. The resilience was found to be significantly associated with QoL. The study further revealed that gender-based differences were dominant in the QoL; the men respondents reported a significantly higher QoL in all the domains in comparison to the women respondents. The gender, income, and psychological health and interaction effect of resilience and age explained 40% of the variance in the total score of QoL. In reference to the predictors of the physical health domain of QoL, resilience, gender, and psychological health were significantly associated with the physical health domain of the QoL (R2 = 0.26, p = 0.001). It was also noted that gender was not associated with the social relationships and environmental domains of QoL (p > 0.05). Findings showed a statistically significant association between the score of QoL and resilience, age, gender, income, and psychological health. These findings highlight the significant contribution of gender-based differences, psychological health, and resilience on the domains of QoL.
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| 4. |
- Awad, Akil
(författare)
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Aspects of intensive care after cardiac arrest
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Cardiovascular disease, and in particular cardiac arrest with the subsequent associated brain injury, is the most common cause of death in many countries. Annually, around 6000 people suffer from Out-of-Hospital Cardiac Arrest (OHCA) in Sweden and only around 10% survive to hospital discharge. Apart from early cardiopulmonary resuscitation (CPR) and defibrillation, it has been difficult to find interventions that can increase survival in OHCA, in particular in the post-resuscitation phase. Methods and results: Study I. A national observational retrospective study, evaluating the adherence to Targeted Temperature Management (TTM) guidelines in Sweden after the publication of the TTM trial, and if the change in targeted temperature level (from 33 oC to 36 oC) influences 6-month survival. In total, 2899 OHCA patients were included, and of those, 1038 were treated by means of TTM. The proportion of patients with initial shockable rhythm receiving any TTM, i.e., following international guidelines, decreased after publication of the TTM trial (from 70.5% to 54.5%). There was no difference in 6-month survival between the TTM33 (47.2%) and the TTM36 (47.3%) groups (adjusted odds OR 1.12, 95% CI 0.80–1.56). Study II. A sub-analysis of the PRINCESS trial, in which 677 OHCA patients were randomized to trans-nasal intra-arrest cooling initiated by the emergency medical services (EMS) or cooling started after hospital arrival. In this sub-analysis, the association between early initiation of intra-arrest cooling and neurological outcome was evaluated. Early cooling (intervention group, n=150) was defined as cooling initiated ≤ 20 minutes from collapse, and these patients were propensity score-matched with comparable controls (n=150). The primary outcome was survival with good neurological outcome (defined as Cerebral Performance Category [CPC] 1–2) at 90 days. The proportion of cases with CPC 1–2 at 90 days was 23.3% in the intervention group vs. 16% in the control group (OR 1.92, 95% CI 0.95–3.85). In patients with shockable rhythm the corresponding figures were 50.9% (intervention) vs. 29.8% (control) (OR 3.25, 95% CI 1.06–9.97). Study III. A nationwide observational retrospective study, evaluating the association between different levels of hyperoxemia at Intensive Care Unit (ICU) arrival after cardiac arrest, and 30-day survival. Partial oxygen pressure (PaO2) was recorded in a standardized way at ICU admission (± one hour). Hyperoxemia was defined as mild (13.4–20 kPa), moderate (20.1–30 kPa), severe (30.1–40 kPa) or extreme (>40 kPa). Normoxaemia was defined as PaO2 8–13.3 kPa and hypoxemia as PaO2 <8 kPa. In total, 9735 patients were included. Of these, 44.6% were hyperoxemic, 44.8% were normoxaemic and 10.5% were hypoxemic. Compared with the normoxemia group, the adjusted risk ratios (RRs) for 30-day survival in the hyperoxemia groups were: mild 0.91 (95% CI 0.85–0.91), moderate 0.88 (95% CI 0.82–0.95), severe 0.79 (95% CI 0.7– 0.89), and extreme 0.68 (95% CI 0.58–0.79). Study IV. A post-hoc analysis of the TTM2 trial, in which 1900 resuscitated OHCA patients were randomized to either hypothermia (TTM of 33 oC) or normothermia (<37.8 oC) groups for 28 hours. This sub-analysis was carried out to evaluate if there is any association between the cooling method used, i.e., intravascular (IC) vs. surface cooling (SFC), in the TTM 33oC group, and neurological outcome. The primary outcome was survival with good neurological outcome (defined as modified Rankin scale [mRS] result of 0–3) at six months. In total, 876 patients were included in this study, in which 30% were treated by means of IC and 70% by SFC. At six months, after propensity score matching, 53.0% of the patients in the IC group and 42.3% of the patients in the SFC group were alive, with mRS scores of 0–3 (OR 1.5, 95% CI 1.05–2.15). The IC group demonstrated better cooling speed and precision compared with the SFC group. Conclusions: After publication of the TTM trial, fewer OHCA patients in Sweden received any TTM and this change of practice did not affect six-month survival among patients who underwent TTM. In the PRINCESS trial, intra-arrest cooling started within 20 minutes of arrest, compared with cooling started after hospital admission, was not associated with a significantly better neurological outcome. In the subgroup with shockable rhythms, early cooling was associated with better neurological outcome. Among resuscitated OHCA patients, hyperoxaemia at ICU admission, compared with normoxemia, was associated with lower 30-day survival. The association was stronger in connection with higher PaO2 levels. In OHCA patients in the TTM2 trial treated by means of TTM 33 oC, intravascular cooling, compared with surface cooling, was associated with better cooling performance and better neurological outcomes after six months.
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| 5. |
- Awad, Akil, et al.
(författare)
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Transnasal Evaporative Cooling in Out-of-Hospital Cardiac Arrest Patients to Initiate Hypothermia—A Substudy of the Target Temperature Management 2 (TTM2) Randomized Trial
- 2023
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Ingår i: Journal of Clinical Medicine. - 2077-0383. ; 12:23
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Tidskriftsartikel (refereegranskat)abstract
- Background: In animal models, early initiation of therapeutic cooling, intra-arrest, or restored circulation has been shown to be neuroprotective shortly after cardiac arrest. We aimed to assess the feasibility and cooling efficacy of transnasal evaporative cooling, initiated as early as possible after hospital arrival in patients randomized to cooling in the TTM2 trial. Methods: This study took the form of a single-center (Södersjukhuset, Stockholm) substudy of the TTM2 trial (NCT02908308) comparing target temperature management (TTM) to 33 °C versus normothermia in OHCA. In patients randomized to TTM33 °C, transnasal evaporative cooling was applied as fast as possible. The primary objectives were the feasibility aspects of initiating cooling in different hospital locations (i.e., in the emergency department, coronary cathlab, intensive care unit (ICU), and during intrahospital transport) and its effectiveness (i.e., time to reach target temperature). Transnasal cooling was continued for two hours or until patients reached a core temperature of <34 °C. Cooling intervals were compared to participants at the same site who were randomized to hypothermia and treated at 33 °C but who for different reasons did not receive transnasal evaporative cooling. Results: From October 2018 to January 2020, 32 patients were recruited, of which 17 were randomized to the TTM33. Among them, 10 patients (8 men, median age 69 years) received transnasal evaporative cooling prior to surface systemic cooling in the ICU. In three patients, cooling was started in the emergency department; in two patients, it was started in the coronary cathlab, and in five patients, it was started in the ICU, of which three patients were subsequently transported to the coronary cathlab or to perform a CT scan. The median time to initiate transnasal cooling from randomization was 9 min (range: 5 to 39 min). The median time from randomization to a core body temperature of 34 °C was 120 min (range 60 to 334) compared to 178 min among those in the TTM33 group that did not receive TNEC and to 33 °C 230 min (range: 152 to 351) vs. 276 min (range: 150 to 546). No feasibility or technical issues were reported. No adverse events occurred besides minor nosebleeds. Conclusions: The early induction of transnasal cooling in out-of-hospital cardiac arrest patients was feasible to initiate in the emergency department, coronary cathlab, ICU, and during intrahospital transport. Time to target temperature was shortened compared to standard cooling.
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| 6. |
- Dillenbeck, Emelie, et al.
(författare)
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The design of the PRINCESS 2 trial: A randomized trial to study the impact of ultrafast hypothermia on complete neurologic recovery after out-of-hospital cardiac arrest with initial shockable
- 2024
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Ingår i: American Heart Journal. - : MOSBY-ELSEVIER. - 0002-8703 .- 1097-6744. ; 271, s. 97-108
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Tidskriftsartikel (refereegranskat)abstract
- Background Delayed hypothermia, initiated after hospital arrival, several hours after cardiac arrest with 8-10 hours to reach the target temperature, is likely to have limited impact on overall survival. However, the effect of ultrafast hypothermia, i.e., delivered intra-arrest or immediately after return of spontaneous circulation (ROSC), on functional neurologic outcome after out -of -hospital cardiac arrest (OHCA) is unclear. In two prior trials, prehospital trans -nasal evaporative intra-arrest cooling was safe, feasible and reduced time to target temperature compared to delayed cooling. Both studies showed trends towards improved neurologic recovery in patients with shockable rhythms. The aim of the PRINCESS2-study is to assess whether cooling, initiated either intra-arrest or immediately after ROSC, followed by in -hospital hypothermia, significantly increases survival with complete neurologic recovery as compared to standard normothermia care, in OHCA patients with shockable rhythms. Methods/design In this investigator -initiated, randomized, controlled trial, the emergency medical services (EMS) will randomize patients at the scene of cardiac arrest to either trans -nasal cooling within 20 minutes from EMS arrival with subsequent hypothermia at 33 degrees C for 24 hours after hospital admission (intervention), or to standard of care with no prehospital or in -hospital cooling (control). Fever ( > 37,7 degrees C) will be avoided for the first 72 hours in both groups. All patients will receive post resuscitation care and withdrawal of life support procedures according to current guidelines. Primary outcome is survival with complete neurologic recovery at 90 days, defined as modified Rankin scale (mRS) 0-1. Key secondary outcomes include survival to hospital discharge, survival at 90 days and mRS 0-3 at 90 days. In total, 1022 patients are required to detect an absolute difference of 9% (from 45 to 54%) in survival with neurologic recovery (80% power and one-sided alpha= 0,025, beta = 0,2) and assuming 2,5% lost to follow-up. Recruitment starts in Q1 2024 and we expect maximum enrolment to be achieved during Q4 2024 at 20-25 European and US sites. Discussion This trial will assess the impact of ultrafast hypothermia applied on the scene of cardiac arrest, as compared to normothermia, on 90 -day survival with complete neurologic recover y in OHCA patients with initial shockable rhythm. Trial registration NCT06025123. (Am Heart J 2024;271:97-108.)
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