Category: Nevin Manimala

Am J Hum Biol. 2023 Jan 16:e23865. doi: 10.1002/ajhb.23865. Online ahead of print.

ABSTRACT

OBJECTIVE: This study evaluates whether vitamin D receptor (VDR) gene variations are associated with premenopausal breast cancer in Pakistani cohorts.

METHODS: Genomic DNA was isolated from 228 breast cancer patients and 500 non-cancer controls. Six polymorphic variants (rs11568820, rs4516035, rs2228570, rs1544410, rs7975232, rs731236) of the VDR gene were genotyped using PCR-RFLP analysis. All statistical analysis was carried out on IBM-SPSS 23 at p-value <.05. Chi-square test and odds ratios (ORs) along with 95% confidence interval (CIs) were applied to evaluate the relationship between VDR gene polymorphisms and breast cancer.

RESULTS: Results showed that the A/A genotype of EcoRV (OR = 2.125, 95% CI = 1.024 to 4.412) and the A/a genotype of Apa1 (OR = 6.094, 95%CI = 4.111 to 9.033) gene polymorphism had an increased risk of premenopausal breast cancer. No associations of the Bsm1 and Taq1 polymorphisms were observed in premenopausal women. Moreover, the Cdx2 GG (OR = 0.34, 95%CI = 0.192-0.602) genotype had a significant protective effect on breast cancer. However, strong LD was existed between Bsm1/Taq1 (D’ = 0.757, CI = 0.67-0.82) and Apa1/Taq1 (D’ = 0.695, CI = 0.6-0.77). Haplotype analysis showed no association between premenopausal breast cancer and VDR haplotypes.

CONCLUSION: These analyses indicates that the VDR EcoRV A/A and Apa1 A/a genotypes may be risk factors for breast cancer development among premenopausal women.

PMID:36645723 | DOI:10.1002/ajhb.23865

J Med Internet Res. 2023 Jan 16;25:e41939. doi: 10.2196/41939.

ABSTRACT

BACKGROUND: There is growing interest in using information and communication technologies (ICTs) to improve access to mental health services for youth experiencing homelessness (YEH); however, limited efforts have been made to synthesize this literature.

OBJECTIVE: This study aimed to review the research on the use of ICTs to provide mental health services and interventions for YEH.

METHODS: We used a scoping review methodology following the Arksey and O’Malley framework and guidelines from the Joanna Briggs Institute Manual for Evidence Synthesis. The results are reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). A systematic search was conducted from 2005 to 2021 in MEDLINE, Embase, CINAHL, PsycInfo, Cochrane, Web of Science, and Maestro and in ProQuest Thesis and Dissertations, Papyrus, Homeless Hub, and Google Scholar for gray literature. Studies were included if participants’ mean age was between 13 and 29 years, youth with mental health issues were experiencing homelessness or living in a shelter, ICTs were used as a means of intervention, and the study provided a description of the technology. The exclusion criteria were technology that did not allow for interaction (eg, television) and languages other than French or English. The data were analyzed using descriptive statistics and qualitative approaches. Two reviewers were involved in the screening and data extraction process in consultation with a third reviewer. The data were summarized in tables and by narrative synthesis.

RESULTS: From the 2153 abstracts and titles screened, 12 were included in the analysis. The most common types of ICTs used were communication technologies (eg, phone, video, and SMS text messages) and mobile apps. The intervention goals varied widely across studies; the most common goal was reducing risky behaviors, followed by addressing cognitive functioning, providing emotional support, providing vital resources, and reducing anxiety. Most studies (9/11, 82%) focused on the feasibility of interventions. Almost all studies reported high levels of acceptability (8/9, 89%) and moderate to high frequency of use (5/6, 83%). The principal challenges were related to technical problems such as the need to replace phones, issues with data services, and phone charging.

CONCLUSIONS: Our results indicate the emerging role of ICTs in the delivery of mental health services to YEH and that there is a high level of acceptability based on early feasibility studies. However, our results should be interpreted cautiously, considering the limited number of studies included in the analysis and the elevated levels of dropout. There is a need to advance efficacy and effectiveness research in this area with larger and longer studies.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2022-061313.

PMID:36645703 | DOI:10.2196/41939

J Med Internet Res. 2023 Jan 16;25:e41859. doi: 10.2196/41859.

ABSTRACT

BACKGROUND: Adjusting to new or additional parenting responsibilities increases stress and affects parental well-being. Existing research has highlighted both parents’ desire to receive more support. It has also been found that receiving sufficient social support enhances parenting outcomes. With the increasing popularity of mobile health apps, a Supportive Parenting App (SPA) intervention was developed to fulfill the support needs of parents during the perinatal period.

OBJECTIVE: This study aimed to examine the effectiveness of the SPA on parental outcomes during the perinatal period.

METHODS: A 2-group pretest and repeated posttest randomized controlled trial was conducted wherein 200 couples (N=400 mothers and fathers) were recruited from 2 public health care institutions in Singapore. Parents were randomly assigned to intervention (100/200, 50%) or control (100/200, 50%) groups. The SPA intervention consisted of a mobile app-based psychoeducation and peer support program to support parents from pregnancy to 6 months post partum. The outcome measures included postnatal depression, anxiety, parental bonding, parental self-efficacy, perceived social support, and parenting satisfaction. Data were collected at baseline (at >24 weeks of gestation-age of viability in Singapore) and at the first, second, fourth, sixth, ninth, and 12th month post partum. Linear mixed models were used to compare parental outcomes between the groups, and a linear mixed model for repeated measures was used to examine within-group changes.

RESULTS: Parents in the intervention group mostly showed better outcomes compared with those in the control group. Parents in the intervention group had higher perceived social support than those in the control group at the first (effect size=1.59, 95% CI 0.38-2.80; Cohen standardized effect size=1.31; P=.01), second (effect size=1.98, 95% CI 1.09-2.88; Cohen standardized effect size=2.21; P=.003), and fourth (effect size=2.57, 95% CI 1.62-3.51; Cohen standardized effect size=2.72; P=.048) months post partum. However, parents in the intervention group showed significantly poorer parental bonding (effect size=1.67, 95% CI 0.24-3.11; Cohen standardized effect size=1.16; P=.02). The other parental outcomes did not differ significantly between groups. The scores of mothers and fathers also differed significantly for all outcomes except parental self-efficacy.

CONCLUSIONS: Parents in the intervention group generally fared better, especially regarding perceived social support. However, the lack of statistical significance in most outcomes showed the limited effectiveness of the SPA intervention, which may be because of the COVID-19 pandemic. Parental differences in outcome scores suggest that mothers and fathers have different support needs; therefore, interventions should be tailored accordingly. Further improvements and evaluations are needed to examine the effectiveness of the SPA intervention in enhancing parental outcomes. Despite statistically insignificant results, limitations should be considered to further improve mobile health app-based interventions such as SPA, as they could serve as reliable and convenient sources of support for parents.

TRIAL REGISTRATION: Clinicaltrails.gov NCT4706442; https://clinicaltrials.gov/ct2/show/NCT04706442.

PMID:36645699 | DOI:10.2196/41859

JMIR Serious Games. 2023 Jan 16;11:e34586. doi: 10.2196/34586.

ABSTRACT

BACKGROUND: Virtual reality (VR) can be used to build many different scenes aimed at reducing study-related stress. However, only few academic experiments on university students for preference testing have been performed.

OBJECTIVE: This study aims to assess the preference of VR games for stress and depression treatment using a discrete choice experiment (DCE).

METHODS: A total of 5 different attributes were selected based on the depression therapy parameters and attributes related to VR: (1) treatment modality; (2) therapy duration; (3) perceived remission rate; (4) probability of adverse events; and the (5) monthly cost of adding treatment to a discrete choice experiment. By comparing different attributes and levels, we could draw some conclusions about the depression therapy testing preference for university students; 1 university student was responsible for VR scene development and 1 for participant recruitment.

RESULTS: The utility value of different attributes for “0% Probability of adverse events” was higher than others (99.22), and the utility value of VR treatment as the most popular treatment method compared with counseling and medicine treatment was 80.95. Three parameter aspects (different treatments for depression) were statistically significant (P<.001), including “0%” and “50%” of “Probability of adverse events” and “¥500” (a currency exchange rate of ¥1 [Chinese yuan]=US $0.15 is applicable) of “The monthly cost of treatment.” Most individuals preferred 12 months as the therapy duration, and the odds ratio of “12 months” was 1.095 (95% CI 0.945-1.270) when compared with the reference level (6 months). Meanwhile, the cheapest price (¥500) of depression therapy was the optimum choice for most students.

CONCLUSIONS: People placed great preference on VR technology psychological intervention methods, which indicates that VR may have a potential market in the treatment of psychological problems. However, adverse events and treatment costs need to be considered. This study can be used to guide policies that are relevant to the development of the application of VR technology in the field of psychological pressure and depression treatment.

PMID:36645698 | DOI:10.2196/34586

Dent Traumatol. 2023 Jan 16. doi: 10.1111/edt.12817. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Avulsion of a permanent tooth is one of the most severe traumatic dental injuries, comprising an estimated 0.5%-16% of all dental injuries. The aim of this study was to estimate the direct financial costs of tooth avulsion in children based on stage of root maturity and the occurrence of ankylosis and to report patients’ characteristics and outcomes of treatment.

MATERIALS AND METHODS: A retrospective review of the dental records of children ages 6-18 who sustained a permanent tooth avulsion from 2010 to 2020 was completed. Relative Value Units (RVUs) were used to calculate the estimated cost of dental trauma care over the 2-year post-injury period for five different scenarios of avulsed teeth based on the stage of root maturity, the occurrence of ankylosis and whether the tooth was replanted.

RESULTS: There were 452 avulsed permanent teeth in 348 patients. Of those, 157 teeth were included in the cost analysis. Overall, the average direct dental cost of avulsion was 46.4 RVUs equal to $1619 USD based on the 2021 conversion rate ($34.89 per RVU). Direct costs ranged between 40 RVUs ($1396) and 52.8 RVUs ($1842) depending on the root maturation and ankylosis status or whether the tooth was replanted; however, ANOVA test did not show any statistically significant differences between the mean RVUs of different groups (p = .85). Patients returned 9.5 times on average over the 2-year study period for dental trauma care after avulsion.

CONCLUSION: The average direct cost of tooth avulsion within the limits of this study was $1619 USD. On average, patients returned for 9.5 follow-up visits after the avulsion. The stage of root maturity, the occurrence of ankylosis and whether the tooth was replanted or not were not significantly associated with the direct cost of dental care.

PMID:36645696 | DOI:10.1111/edt.12817

Psychol Med. 2023 Jan 16:1-9. doi: 10.1017/S0033291722003749. Online ahead of print.

ABSTRACT

BACKGROUND: Extensive evidence indicates that rates of psychotic disorder are elevated in more urban compared with less urban areas, but this evidence largely originates from Northern Europe. It is unclear whether the same association holds globally. This study examined the association between urban residence and rates of psychotic disorder in catchment areas in India (Kancheepuram, Tamil Nadu), Nigeria (Ibadan, Oyo), and Northern Trinidad.

METHODS: Comprehensive case detection systems were developed based on extensive pilot work to identify individuals aged 18-64 with previously untreated psychotic disorders residing in each catchment area (May 2018-April/May/July 2020). Area of residence and basic demographic details were collected for eligible cases. We compared rates of psychotic disorder in the more v. less urban administrative areas within each catchment area, based on all cases detected, and repeated these analyses while restricting to recent onset cases (<2 years/<5 years).

RESULTS: We found evidence of higher overall rates of psychosis in more urban areas within the Trinidadian catchment area (IRR: 3.24, 95% CI 2.68-3.91), an inverse association in the Nigerian catchment area (IRR: 0.68, 95% CI 0.51-0.91) and no association in the Indian catchment area (IRR: 1.18, 95% CI 0.93-1.52). When restricting to recent onset cases, we found a modest positive association in the Indian catchment area.

CONCLUSIONS: This study suggests that urbanicity is associated with higher rates of psychotic disorder in some but not all contexts outside of Northern Europe. Future studies should test candidate mechanisms that may underlie the associations observed, such as exposure to violence.

PMID:36645027 | DOI:10.1017/S0033291722003749

Int J Soc Psychiatry. 2023 Jan 16:207640221148092. doi: 10.1177/00207640221148092. Online ahead of print.

ABSTRACT

BACKGROUND: Medical students tend to experience high levels of stress during their studies, that can result in mental health disorders and burnout, further affecting academic performance and later ability to practice.

AIMS: To investigate previous and current mental health issues, significant sources of stress, burnout, and substance use among medical students in the United Arab Emirates (UAE).

METHOD: We conducted an online survey to collect data on demographics, sources of stress, mental health problems, burnout, and substance use in 385 medical students from the UAE University. We used the Oldenburg Burnout Inventory (OLBI), the General Health Questionnaire 12 (GHQ-12), and the CAGE questionnaire.

RESULTS: Our results indicated that 5.7% of participants had been diagnosed with a mental health condition prior to joining medical school, and that 21.6% of participants were diagnosed with a mental illness while in medical school. On the OLBI, 77.4% screened positive for burnout (81.3% for disengagement and 95.1% for exhaustion), with 74.5% screening positive for mental health difficulties on the GHQ-12 and <1% screening positive on the CAGE for problem drinking. There was a statistically significant positive correlation between scores on the OLBI and the GHQ-12.

CONCLUSIONS: Our study indicated that high levels of stress, burnout and mental illness are experienced among medical students in the UAE.

PMID:36645023 | DOI:10.1177/00207640221148092

J Biosoc Sci. 2023 Jan 16:1-9. doi: 10.1017/S0021932022000542. Online ahead of print.

ABSTRACT

Acquired immune deficiency syndrome (UNAIDS) has risen as the serious public health problem across the world. Knowledge about HIV/AIDS is the cornerstone for prevention and treatment. Research is needed to explore the attitude and the effect of different demographic, geographic, and socioeconomic and media exposure factors on males knowledge about HIV in Pakistan. In this study, latest secondary data are used from Pakistan Demographic and Health Survey 2017-18. Sample results show that the majority of the respondents (70%) have knowledge about AIDS. Regression Modeling reveals that man’s knowledge about HIV/AIDS is associated with age, place of residence, educational level, wealth index, ethnicity and media exposure factors. Males of age group 35-39, with higher education, belonging to Pukthon ethnicity, having exposure to mass media on a daily basis and belonging to richest wealth quintile has high Knowledge of HIV/AIDS. For example, the regression model predicts that men between the ages of 35 and 39 from Islamabad who live in urban areas, have higher education, are of Pukhtoon ethnicity, are the head of the household, belong to the richest quintile, work in professional occupations, and use media exposure factors on a daily basis would have probability of 97% of having knowledge of HIV/AIDS. But there is still need to focus to increase the men’s knowledge of HIV/AIDS.

PMID:36645008 | DOI:10.1017/S0021932022000542

Trends Psychiatry Psychother. 2023 Jan 16. doi: 10.47626/2237-6089-2021-0456. Online ahead of print.

ABSTRACT

INTRODUCTION: Childhood maltreatment is extremely harmful to health, especially regarding the development of psychiatric disorders throughout life. The objective of this study was to describe the prevalence and types of maltreatment and investigate the association between maltreatment and anxiety and depressive symptoms, sociodemographic variables, and risk behaviors in a sample of school adolescents. The study also identified which variables were the greatest predictors of anxiety and depressive symptoms.

METHOD: We conducted a cross-sectional study with a sample of 654 students aged 11 to 17 years. We collected sociodemographic data and applied the Revised Child Anxiety and Depression Scale (RCADS-47) to measure anxiety and depressive symptoms, and the Childhood Trauma Questionnaire (CTQ) to evaluate maltreatment and adverse experiences in childhood and adolescence, like abuse and negligence. Statistical analyses were made to obtain correlations between sociodemographic data, anxiety, depression, and types of maltreatment. Also, a regression analysis was made to identify the maltreatment types that predict psychological symptoms.

RESULTS: Emotional abuse and emotional neglect are the most prevalent types of maltreatment. Statistically, emotional abuse was the maltreatment most correlated with depression and anxiety and tended to co-occur simultaneously with other types of maltreatment. Also, emotional and sexual abuse were the greatest predictors of anxiety and depression in adolescence.

CONCLUSION: The above results reinforce the findings of previous studies in terms of understanding the effects of maltreatment. They point to emotional abuse as the main predictor of depressive and anxiety symptoms.

PMID:36645004 | DOI:10.47626/2237-6089-2021-0456

Laryngoscope. 2023 Jan 16. doi: 10.1002/lary.30566. Online ahead of print.

ABSTRACT

BACKGROUND: Orbital defects have a profound impact on orbital function and symmetry of the face and are difficult to reconstruct given the complexity of this area. The paramedian forehead flap (PMFF) has not been well studied in reconstruction of orbital defects.

METHODS: Retrospective review of patients who underwent reconstruction of periorbital defects with PMFF between 2016 and 2021. Variables were ocular adnexal asymmetry, functional outcomes, and orbital complications.

RESULTS: Eighteen patients met inclusion criteria. Mean defect size was 11.1 ± 7.5 cm. The most common subsite involved was medial canthus in 88.9% of patients. There was no statistically significant difference between mean medial canthus to midline ratio and mean medial brow to midline ratio when compared to the assumed normal of 1. The medial canthus to pupil ratio and medial canthus to lateral canthus ratio had a statistically significant mean difference from 1.0 (p = 0.003 for both). In 22.2% of patients, the orbit was functional with impairment; the remaining had no impairment. Surgical sequelae occurred in 12/18 (66.7%) of patients, most commonly epiphora in 9/18 (50%) of patients, and ectropion in 5/18 (27.7%).

CONCLUSION: The PMFF is feasible for medial periorbital reconstruction with acceptable functional and symmetrical outcomes and low morbidity.

LEVEL OF EVIDENCE: 4 Laryngoscope, 2023.

PMID:36644993 | DOI:10.1002/lary.30566