Category: Nevin Manimala

PLoS One. 2021 Apr 8;16(4):e0248823. doi: 10.1371/journal.pone.0248823. eCollection 2021.

ABSTRACT

BACKGROUND: The Family Health Strategy (FHS) became consolidated as a primary care model and gatekeeper for the Unified Health System (Sistema Único de Saúde, SUS) in the Brazil and it is considered one of the largest primary health care programmes in the world. Its rapid expansion allowed the SUS to meet the changing health care needs of the population remote localities of Brazilian municipalities.

METHODS: In the present study, exploratory data analysis was performed using modelling to provide a general overview of the study and to delineate possible structural characteristics of the cross-sectional time-series data. Panel regression methods were used to assess the association between FHS coverage and ambulatory care-sensitive hospitalizations (ACSH rates) in the municipalities of Pará, in the Brazilian Amazon, from 2008 to 2017.

RESULTS: The results showed strong evidence for the association between FHS coverage and ACSH rates, including reductions of 22% in preventable hospitalizations and 15% in hospital expenses that were directly linked to the 40% increase in FHS population coverage during the evaluated period. This expansion of primary care has mainly benefitted areas that are difficult to access and populations that were previously deprived of health care in the vast Amazon territory.

CONCLUSIONS: The findings of this study show that the increase of the expansion of primary care reduces the preventable hospitalization and the hospital expenses. This reinforces the need for public protection of the health of populations at risk and the positive impacts of primary care in the Brazilian Amazon.

PMID:33831030 | DOI:10.1371/journal.pone.0248823

PLoS One. 2021 Apr 8;16(4):e0249405. doi: 10.1371/journal.pone.0249405. eCollection 2021.

ABSTRACT

Faecal sample collection is crucial for gut microbiome research and its clinical applications. However, while patients and healthy volunteers are routinely asked to provide stool samples, their attitudes towards sampling remain largely unknown. Here, we investigate the attitudes of 780 Dutch patients, including participants in a large Inflammatory Bowel Disease (IBD) gut microbiome cohort and population controls, in order to identify barriers to sample collection and provide recommendations for gut microbiome researchers and clinicians. We sent questionnaires to 660 IBD patients and 112 patients with other disorders who had previously been approached to participate in gut microbiome studies. We also conducted 478 brief interviews with participants in our general population cohort who had collected stool samples. Statistical analysis of the data was performed using R. 97.4% of respondents reported that they had willingly participated in stool sample collection for gut microbiome research, and most respondents (82.9%) and interviewees (95.6%) indicated willingness to participate again, with their motivations for participating being mainly altruistic (57.0%). Responses indicated that storing stool samples in the home freezer for a prolonged time was the main barrier to participation (52.6%), but clear explanations of the sampling procedures and their purpose increased participant willingness to collect and freeze samples (P = 0.046, P = 0.003). To account for participant concerns, gut microbiome researchers establishing cohorts and clinicians trying new faecal tests should provide clear instructions, explain the rationale behind their protocol, consider providing a small freezer and inform patients about study outcomes. By assessing the attitudes, motives and barriers surrounding participation in faecal sample collection, we provide important information that will contribute to the success of gut microbiome research and its near-future clinical applications.

PMID:33831035 | DOI:10.1371/journal.pone.0249405

Hip Int. 2021 Apr 8:11207000211004862. doi: 10.1177/11207000211004862. Online ahead of print.

ABSTRACT

BACKGROUND: The modified Dunn procedure (MDP) has risen enthusiasm in treating slipped capital femoral epiphyses (SCFE) due to the anatomic reduction and high patients’ satisfaction rates at long-term follow-up. Main aim of this study is to compare clinical and radiographic outcomes of 2 cohorts with moderate to severe stable SCFE treated by MDP and in situ fixation.

METHODS: Medical records were analysed to collect demographic data, comorbidities and time from slip to surgery. The collected postoperative data were: avascular necrosis (AVN); complications; progression of osteoarthritis and subsequent procedures. Southwick angles (SA), alpha angles and Klein line were measured on the preoperative x-rays, on the immediate postoperative period and at the latest follow-up. Outcomes scores were recorded by the following questionnaires: the Harris Hip Score, the Hip disability and Osteoarthritis Outcome Score, the Merle d’Aubigné and Postel score and the Western Ontario and McMaster Universities Arthritis Index. Kaplan-Meier survivorship curve was calculated.

RESULTS: We compared 81 hips treated by MDP with 22 hips treated by in situ pinning (PS) for moderate/severe stable SCFE. No significant differences were found between the 2 groups in terms of age, BMI, comorbidities and preoperative slip angles. At the latest follow-up, postoperative anteroposterior mean slip angles were respectively 6.2 and 19.9° in MDP and PS group (p = 0.3). Slip angles in frog lateral view were 11° in the MDP group and 39.7° in the PS group (p = 0.2). MDP group achieved better correction angles on frog leg view (11° vs. 39.7°; p < 0.001). There was no statistically significant difference in the occurrence of AVN among both groups (19.7% MDP group vs. 31.8% PS group) (p = 0.2).

CONCLUSIONS: The MDP in treating severe stable SCFE showed the best deformities corrections in conjunction with the highest functional scores at long-term follow-up and similar rates of osteonecrosis compared to in situ fixation.

PMID:33829904 | DOI:10.1177/11207000211004862

Health Educ Behav. 2021 Apr 8:10901981211001851. doi: 10.1177/10901981211001851. Online ahead of print.

ABSTRACT

Health literacy is an amenable factor that can improve screening uptake. However, associations between the multidimensional health literacy domains and cervical cancer screening nonadherence are not known and should be considered to improve screening rates. The current quantitative study assessed the associations of multiple health literacy domains with cervical cancer screening nonadherence. Women aged 30 to 65 years without a hysterectomy were surveyed online (N = 812). Assessing, understanding, and appraising measures from the European Health Literacy Survey Questionnaire were adapted for cervical cancer screening. The outcome variable measured the application of cervical cancer information regarding adherence to the 2012 cervical cancer screening guidelines (yes/no). Adjusted logistic regression odds ratios (aORs) estimated nonadherence. Most of the women were non-Hispanic (81.4%) or White (68.1%), and aged 30 to 39 years (40%). The majority of the women (71%) were adherent to screening recommendations. The model with all domains of health literacy had the best model fit statistics compared with other models with different health literacy components. Older age and lack of insurance were statistically significant for screening nonadherence. Difficulty understanding health information (aOR = 3.15; 95% confidence interval [CI; 1.80, 5.51]) and less worry about cervical cancer (aOR = 1.74; 95% CI [1.03, 2.94]) were associated with higher odds of nonadherence. Higher cervical cancer knowledge (aOR = 0.93; 95% CI [0.87, 0.98]) and Hispanic ethnicity (aOR = 0.36; 95% CI [0.21, 0.61)] were associated with lower odds of nonadherence. Incorporating a multidimensional health literacy framework may better inform the need to develop easily understood interventions that address cervical cancer perceived vulnerability and acknowledge systemic sociodemographic influences on screening perceptions.

PMID:33829878 | DOI:10.1177/10901981211001851

Hip Int. 2021 Apr 8:11207000211006778. doi: 10.1177/11207000211006778. Online ahead of print.

ABSTRACT

PURPOSE: (1) To compare the pre- and postoperative driving performance in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS); (2) to examine the differences in driving performance between patients with versus without capsular repair.

METHODS: Patients who underwent arthroscopic hip surgery for FAIS were included. Driving performance of participating patients was collected using a driving simulator preoperatively and at 2 weeks, 4-6 weeks and 8-12 weeks postoperatively. Data collected included demographics, surgery laterality, intraoperative procedures, left and right turn reaction time, total turn reaction time, gas off time (GOF), and break reaction time (BRT). Repeated measures analysis of variance (ANOVA) was used for statistical analysis.

RESULTS: 21 subjects (9 males, 12 females) with a mean age of 30 ± 9 years were included and 57.1% of the subjects had right-sided surgery. There was no difference between the mean preoperative and the 2-week postoperative left (0.72 seconds and 0.75 seconds, respectively) right (0.77 seconds and 0.75 seconds, respectively), and total (0.74 seconds and 0.75 seconds, respectively) turn reaction times as well as GOF (0.62 seconds and 0.60 seconds, respectively) and BRT (0.92 seconds and 0.93 seconds, respectively), indicating that the patients’ driving performance returned to the preoperative level as early as 2 weeks following hip arthroscopy for FAIS. There was no significant difference amongst any of the driving variables between patients who underwent capsular repair (50%) and those who did not. There was no significant difference amongst any of the driving variable s between patients who underwent left versus right hip arthroscopy.

CONCLUSIONS: Patients’ driving performance returns to the preoperative level as early as 2 weeks after hip arthroscopy for FAIS. Surgery laterality nor capsular repair make any significant difference in the time for driving abilities to return to baseline. The impact of intraoperative procedures performed, and the analgesic medications used postoperatively on the driving ability of patients undergoing hip arthroscopy warrants further investigation in larger patient populations.

PMID:33829903 | DOI:10.1177/11207000211006778

Psychol Assess. 2021 Apr 8. doi: 10.1037/pas0001012. Online ahead of print.

ABSTRACT

Interoception is essential for the maintenance of physical and mental health. Paradigms assessing cardioceptive accuracy do not separate sensitivity from bias or are very demanding. We present the piloting (study 1; N = 60) and psychometric evaluation and validation (study 2; N = 84) of a novel task for the assessment of cardiac interoceptive perception following the principles of signal detection theory. By disentangling sensitivity and response bias, we demonstrate that the previously used interoceptive accuracy score of the heartbeat mental tracking task represents an amalgam of sensitivity and response bias. The new task demonstrated adequate test-retest reliabilities for sensitivity (d‘) and response bias (c). Sensitivity was inversely related (β = -.36) to somatic symptom distress after statistically controlling for response bias. The novel cardiovascular signal detection task is easy to implement, feasible, and promising in terms of unraveling the role of (cardiac) interoceptive perception in psychopathology. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:33829843 | DOI:10.1037/pas0001012

Psychol Aging. 2021 Apr 8. doi: 10.1037/pag0000600. Online ahead of print.

ABSTRACT

The present meta-analysis analyzed how the gap between subjective age and chronological age changes across the life-span and whether the size of this gap varies across regions of the globe. In addition, we tested for sources of the national differences. A systematic search in electronic databases (PsycInfo, Medline, Google Scholar, PSYNDEX) and cross-referencing identified 294 studies (with mean age ranging from 8 to 105 years) that were included in random-effects meta-analyses. While children felt about 3 years or 34% older than their chronological age, older adults (60+ years) felt, on average, between 10.74 and 21.07 years or 13%-18% younger. Associations between chronological age and the size of proportional differences between subjective and chronological were best described as a quadratic relationship, while associations with the size of absolute differences could also be described as a linear relationship. The widening of the gap between subjective age and chronological age across adulthood was found in all continents. Although adults reported a relatively younger subjective age across the globe, these differences were strongest in North America, Western Europe, and Australia/Oceania, and weakest in Africa. The regional differences disappeared after statistically controlling for national levels of individualism-collectivism, power distance, preference for young people rather than older adults, and quality of life of older people. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:33829847 | DOI:10.1037/pag0000600

Phytopathology. 2021 Apr 8. doi: 10.1094/PHYTO-11-20-0492-R. Online ahead of print.

ABSTRACT

Hop powdery mildew, caused by the ascomycete fungus Podosphaera macularis is a consistent threat to sustainable hop production. The pathogen utilizes two reproductive strategies for overwintering and perennation: (i) asexual vegetative hyphae on dormant buds that emerge the following season as infected shoots; and (ii) sexual ascocarps (chasmothecia), which are presumed to discharge ascospores during spring rain events. We demonstrate that P. macularis chasmothecia, in the absence of any asexual P. macularis growth forms, are a viable overwintering source capable of causing early season infection two to three orders of magnitude greater than that reported for perennation via asexual growth. Two epidemiological models were defined that describe (i) temperature-driven maturation of P. macularis chasmothecia; and (ii) ascosporic discharge in response to the duration of leaf wetness and prevailing temperatures. Podosphaera macularis ascospores were confirmed to be infectious at temperatures ranging from 5 to 20°C. The organism’s chasmothecia were also found to adhere tightly to the host tissue on which they formed, suggesting that these structures likely overwinter wherever hop tissue senesces within a hop yard. These observations suggest that existing early season disease management practices are especially crucial to controlling hop powdery mildew in the presence of P. macularis chasmothecia. Furthermore, these insights provide a baseline for the validation of weather driven models describing maturation and release of P. macularis ascospores that can eventually be incorporated into hop disease management programs.

PMID:33829855 | DOI:10.1094/PHYTO-11-20-0492-R

Am J Orthopsychiatry. 2021 Apr 8. doi: 10.1037/ort0000545. Online ahead of print.

ABSTRACT

In the United States, Muslims have increasingly been the targets of discrimination. While prior research suggests that increased perceived discrimination is associated with elevated depression and anxiety symptoms in this population, no existing studies have explored whether this relationship is mediated by acculturative stress, and few have examined potential moderating factors. This study aimed to investigate whether acculturative stress mediates the relationship between perceived discrimination and depression and anxiety symptoms, as well as examine the moderating roles of Muslim identity and religious support. Participants included 205 Muslim college students, who completed an online survey. Findings revealed that the indirect effect of perceived discrimination on depression and anxiety symptoms via acculturative stress was statistically significant. In addition, religious support emerged as a significant moderator, with higher levels of religious support increasing the strength of the indirect effect on depression and anxiety symptoms. The results suggest clinicians and higher education staff working with Muslim college students should assess for perceptions of discrimination and acculturative stress, as well as examine the role that religious support plays in that individual’s life. Future research should examine how discrimination, acculturative stress, and involvement in one’s religious congregation affect mental health outcomes, as well as investigate whether these findings are generalizable to other religions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:33829813 | DOI:10.1037/ort0000545

Psychol Addict Behav. 2021 Apr 8. doi: 10.1037/adb0000721. Online ahead of print.

ABSTRACT

OBJECTIVE: Research indicates that a substance user identity (i.e., drinking, smoking, and marijuana identity) is positively correlated with substance use-related outcomes (e.g., frequency, quantity, consequences, and disorder symptoms). The current study aimed to meta-analytically derive single, weighted effect size estimates of the identity-outcome association as well as to examine moderators (e.g., substance use type, explicit/implicit assessment, demographic characteristics, and research design) of this association.

METHOD: Random effects meta-analysis was conducted on 70 unique samples that assessed substance user identity and at least one substance use-related outcome (frequency, quantity, consequences, and/or disorder symptoms), and provided the necessary information for effect size calculations.

RESULTS: Substance user identity was found to be a statistically significant moderate-to-large correlate of all substance use-related outcomes examined in the current study (r _w = .365, p < .001, r_w² = .133). The strongest associations were observed between identity and disorder symptoms (alcohol) and frequency of substance use (tobacco or marijuana). In terms of moderators of the identity-outcome association, the link between explicit drinking identity and alcohol use-related outcomes appeared to be stronger in magnitude than the relationship between implicit drinking identity and alcohol use-related outcomes; however, this difference appears to be largely due to the finding that implicit measures have lower reliability. The strongest identity-outcome association was observed among younger individuals.

CONCLUSIONS: Substance user identity is clearly an important correlate of substance use-related outcomes and this association is stronger among younger individuals. Additional theoretical, empirical, and intervention research is needed to utilize knowledge gleaned from the current study on the identity-outcome association. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:33829814 | DOI:10.1037/adb0000721