Publications by authors named "B N Johnson"

6,588 Publications

Impact of an Enhanced Recovery after Surgery Protocol on Unplanned Patient Encounters in the Early Post-Operative Period after Ureteroscopy.

J Endourol 2021 Sep 26. Epub 2021 Sep 26.

UT Southwestern Medical Center, Urology, 5323 Harry Hines Blvd, J8.106, Dallas, Texas, United States, 75390-9110;

Introduction: Ureteroscopy is associated with substantial patient-perceived morbidity. To improve the patient experience, we developed an Enhanced Recovery After Surgery (ERAS) protocol for URS. We sought to determine whether an ERAS protocol would reduce unplanned patient-initiated encounters.

Methods: The ERAS protocol involves the preoperative administration of four medications to patients undergoing URS. We reviewed data on 100 consecutive patients undergoing URS between April 2018 and August 2018. All unplanned post-operative encounters, including phone calls and online electronic medical record (EMR) messages, emergency department (ED) visits, and re-admissions within 30 days of surgery were recorded. A control group of patients undergoing URS between July 2013 and November 2014, served as a comparison group. Propensity score matching was performed. Statistical analysis included Mann-Whitney test, student's t-test and Fischer's exact. Univariable and multivariable analyses were performed.

Results: Using propensity score matching, 71 pre-ERAS (median age 57 years IQR 44-65) and 71 post-ERAS (median age 56 years IQR 47-68) patients were compared. ED visits and post-operative readmissions were comparable between the two groups. Among 98 calls from 39 patients, more unplanned phone calls/messages occurred in the pre-ERAS group than in the post-ERAS group (71 versus 27, respectively, p < 0.001). Multivariable regression analysis identified the ERAS protocol as a significant independent predictor of fewer patient calls (OR 0.24, 95% CI 0.12 - 0.50, p < 0.001).

Conclusions: Early analysis of an ERAS protocol for patients undergoing URS showed a reduction in patient-initiated communication, with implementation of the protocol.
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http://dx.doi.org/10.1089/end.2021.0435DOI Listing
September 2021

Study protocol for Healthy Conversations @ Playgroup: a multi-site cluster randomized controlled trial of an intervention to promote healthy lifestyle behaviours in young children attending community playgroups.

BMC Public Health 2021 Sep 26;21(1):1757. Epub 2021 Sep 26.

College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia.

Background: Early childhood is a critical window for preventing obesity and chronic disease. Yet, 1 in 4 Australian children aged 5 years and under are affected by overweight or obesity; and significant proportions of children under 5 years fail to meet guidelines for diet quality, physical activity (PA), screen time, and sleep. Consequently, effective interventions to promote healthy lifestyle behaviors and prevent obesity during early childhood are needed. Community playgroups provide an opportunity for parents, carers, and children to meet in a safe and relaxed environment to play and share information. The structure, low cost and reach of playgroups provide a unique platform to engage parents in a scalable program to promote healthful lifestyle behaviors and prevent childhood obesity. However, the evidence base for the effectiveness of health promotion programs delivered in community playgroup settings is limited and lacking credible evidence from rigorously conducted randomized controlled trials.

Methods: The Healthy Conversations @ Playgroup randomized controlled trial (RCT) aims to address the underlying behavioral risk factors for obesity by helping parents take effective steps to improve their child's dietary, PA, screen time, and sleep behaviors. The intervention program comprises 10 "healthy conversations" led by a trained peer facilitator, designed to increase parents' behavioral capability and self-efficacy to implement autonomy-supportive parenting practices. The program will be delivered biweekly during regularly scheduled playgroup sessions over 10-weeks. Effectiveness will be tested in a 2-arm cluster RCT involving 60 community playgroups in three states across Australia. After baseline assessments, participating playgroups will be randomly allocated to either intervention or wait-list control conditions. Primary outcomes (vegetable intake, discretionary foods, daily PA, screen time, sleep duration, and body mass index [BMI] z-score) will be assessed at baseline, immediately post-intervention (10-weeks; T2) and 6-months post-intervention (T3). Outcomes will be assessed for differential change at T2 and T3.

Discussion: The Healthy Conversations @ Playgroup trial will rigorously evaluate a novel peer-led intervention program to promote healthful lifestyle behaviors and prevent obesity in children and families attending community playgroups. If effective, the program could be immediately scaled-up and delivered in community playgroups across Australia.

Trial Registration: Trial registered 22nd January 2021 with the Australian and New Zealand Clinical Trials Registry ( ACTRN12621000055808 ).
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http://dx.doi.org/10.1186/s12889-021-11789-3DOI Listing
September 2021

Marijuana use and perinatal outcomes in obstetric patients at a safety net hospital.

Eur J Obstet Gynecol Reprod Biol 2021 Sep 16;266:36-41. Epub 2021 Sep 16.

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

Objective: To characterize the association between antepartum marijuana exposure and maternal and neonatal outcomes at our institution.

Study Design: Retrospective chart review identified an obstetric cohort of singleton gestations. Women with self-reported marijuana use were compared with non-users. Demographic characteristics, risk factors, and maternal-fetal outcomes were evaluated. Associations between outcomes and marijuana use were assessed with regression analysis.

Results: Of 2792 deliveries, 5.4% reported marijuana use. Compared to non-users, marijuana users entered prenatal care later, were younger, non-Hispanic, and used other illicit substances. Marijuana users had a higher rate of cesarean delivery (p = 0.01). After adjusting for confounders, marijuana use remained associated with 4.1-fold risk of delivering a small for gestational age (SGA) infant and 2.89-fold risk of neonatal oxygen use.

Conclusion: At a safety net hospital, antepartum marijuana use is significantly associated with cesarean delivery, SGA and supplemental oxygen use at birth. Healthcare disparities associated with marijuana use make this a population of critical interest.
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http://dx.doi.org/10.1016/j.ejogrb.2021.09.015DOI Listing
September 2021

Effects of Bismuth Subsalicylate and Encapsulated Calcium-Ammonium Nitrate on Feedlot Beef Cattle Production.

J Anim Sci 2021 Sep 22. Epub 2021 Sep 22.

Department of Animal and Dairy Science, University of Georgia - Tifton Campus, Tifton, GA, USA.

Two experiments were performed to evaluate the effects of bismuth subsalicylate (BSS) and calcium-ammonium nitrate (CAN) on in vitro ruminal fermentation, growth, apparent total tract digestibility of nutrients, liver mineral concentration, and carcass quality of beef cattle. In Exp. 1, 4 ruminally cannulated steers [520 ± 30 kg body weight (BW)] were used as donors to perform a batch culture and an in vitro organic matter digestibility (IVOMD) procedure. Treatments were arranged in a 2 × 2 factorial with factors being BSS [0 or 0.33% of substrate dry matter (DM)] and CAN (0 or 2.22% of substrate DM). In Exp. 2, 200 Angus-crossbred steers (385 ± 27 kg BW) were blocked by BW and allocated to 50 pens (4 steers/pen) in a randomized complete block design with a 2 × 2 + 1 factorial arrangement of treatments. Factors included BSS (0 or 0.33% of the diet DM) and non-protein nitrogen (NPN) source [urea or encapsulated CAN (eCAN) included at 0.68 or 2.0% of the diet, respectively] with 0.28% ruminally available S (RAS). A low S diet was included as a positive control containing urea (0.68% of DM) and 0.14% RAS. For Exp. 1, data were analyzed using the MIXED procedure of SAS with the fixed effects of BSS, CAN, BSS × CAN, and the random effect of donor. For Exp. 2, the MIXED procedure of SAS was used for continuous variables and the GLIMMIX procedure for categorical data. For Exp. 1, no differences (P > 0.230) were observed for IVOMD. There was a tendency (P = 0.055) for an interaction regarding H2S production. Acetate:propionate increased (P = 0.003) with the addition of CAN. In Exp. 2, there was a NPN source effect (P = 0.032) where steers consuming urea had greater carcass-adjusted final shrunk BW than those consuming eCAN. Intake of DM (P < 0.001) and carcass-adjusted average daily gain (P = 0.024) were reduced by eCAN; however, it did not affect (P = 0.650) carcass-adjusted feed efficiency. Steers consuming urea had greater (P = 0.032) hot carcass weight, and a BSS × NPN interaction (P = 0.019) was observed on calculated yield grade. Apparent absorption of S decreased (P < 0.001) with the addition of BSS. Final liver Cu concentration was reduced (P = 0.042) by 58% in cattle fed BSS, indicating that BSS may decrease Cu absorption and storage in the liver. The results observed in this experiment indicate that BSS does not have negative effects on feedlot steer performance whereas CAN may hinder performance of steers fed finishing diets.
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http://dx.doi.org/10.1093/jas/skab269DOI Listing
September 2021

Number of prior concussions predict poorer concussion care seeking in military cadets.

Brain Inj 2021 Sep 21:1-9. Epub 2021 Sep 21.

Department of Behavioral Sciences and Leadership, USAF Academy, Colorado, USA.

Primary Objective: To determine whether concussion history predicts concussion care seeking, self-management practices, or confidence to recognize/report.

Research Design: Cross-sectional.

Methods & Procedures: 706 United States Air Force Academy (USAFA) cadets completed survey items regarding concussion history (0,1,2,3+), likelihood of reporting a concussion, self-management, and confidence to recognize/report. We used multivariate ordinal and binary logistic regression models to predict responses using concussion history, sex, and race.Main outcomes & results: cadets with 1 (OR = 0.59, 95%CI:0.43-0.82), 2 (OR = 0.55, 95%CI:0.31-0.98), or 3+ (OR = 0.36, 95%CI:0.17-0.78) concussions while at USAFA had respective 41%, 45%, and 64% lower likelihood to report the concussion scenario (ref = no history, < .001). USAFA cadets with more extensive concussion histories had higher prevalence of not seeking care for a concussion ( < .001); more strongly endorsed self-management ( = .001-0.010); and had greater confidence in their ability to recognize a concussion ( = .005), ( = .198-0.413).

Conclusions: Prior concussion experiences may deter cadets from seeking medical care for future concussions. Interventions should address concussion history and clinicians should consider how the post-concussion management process might deter care seeking.
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http://dx.doi.org/10.1080/02699052.2021.1976418DOI Listing
September 2021
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