Nevin Manimala

Diabet Med. 2021 May 30:e14611. doi: 10.1111/dme.14611. Online ahead of print.

ABSTRACT

AIM: To examine psychosocial and behavioural impacts of the COVID-19 pandemic and lockdown restrictions among adults with type 2 diabetes.

METHODS: Participants enrolled in the Progression of Diabetic Complications (PREDICT) cohort study in Melbourne, Australia (n=489 with a baseline assessment pre-2020) were invited to complete a phone/online follow-up assessment in mid-2020 (i.e. amidst COVID-19 lockdown restrictions). Repeated assessments that were compared with pre-COVID-19 baseline levels included anxiety symptoms (GAD-7), depressive symptoms (PHQ-8), diabetes distress (PAID), physical activity/sedentary behaviour, alcohol consumption, and diabetes self-management behaviours. Additional once-off measures at follow-up included COVID-19-specific worry, quality of life (QoL), and healthcare appointment changes (telehealth engagement and appointment cancellations/avoidance).

RESULTS: Among 470 respondents (96%; aged 66±9 years, 69% men), at least ‘moderate’ worry about COVID-19 infection was reported by 31%, and 29-73% reported negative impacts on QoL dimensions (greatest for: leisure activities, feelings about the future, emotional wellbeing). Younger participants reported more negative impacts (P<0.05). Overall, anxiety/depressive symptoms were similar at follow-up compared with pre-COVID-19, but diabetes distress reduced (P<0.001). Worse trajectories of anxiety/depressive symptoms were observed among those who reported COVID-19-specific worry, or negative QoL impacts (P<0.05). Physical activity trended lower (~10%), but sitting time, alcohol consumption and glucose-monitoring frequency remained unchanged. 73% of participants used telehealth, but 43% cancelled a healthcare appointment and 39% avoided new appointments despite perceived need.

CONCLUSIONS: COVID-19 lockdown restrictions negatively impacted QoL, some behavioural risk factors, and healthcare utilisation in adults with type 2 diabetes. However, generalised anxiety and depressive symptoms remained relatively stable.

PMID:34053106 | DOI:10.1111/dme.14611

Nurs Forum. 2021 May 30. doi: 10.1111/nuf.12616. Online ahead of print.

ABSTRACT

AIMS: This study was performed to determine the effect of distraction technique that was applied to 4-6-year-old children during blood drawal for decreasing the pain of the child during the procedure.

MATERIAL AND METHODS: The study was carried out as randomized controlled trial. Data were collected by individual information form, Faces Pain Scale-Revised (FPS-R), and a timer. Virtual reality glasses were used for distraction in the study.

RESULTS: Pain intensity and duration of crying significantly differed between the control and experimental groups. During the procedure, mean score of the children in the experimental group from “faces pain scale” was found to be 3.82 ± 1.20; the control group from “faces pain scale” was found to be 6.96 ± 2.08; and statistically significant differences were detected between both groups (p = 0.0001 and p = 0.001, respectively). When their duration of crying was examined, it was determined that mean crying time among the children in the experimental group was 8.43 ± 12.42 s and it was 33.65 ± 24.02 s among the children in control group; and the difference between groups was found to be statistically significant.

CONCLUSION: It was detected that using virtual reality glasses was an effective method in decreasing pain of the children during blood drawal procedure.

PMID:34053097 | DOI:10.1111/nuf.12616

Environ Sci Pollut Res Int. 2021 May 29. doi: 10.1007/s11356-021-14484-3. Online ahead of print.

ABSTRACT

A thorough understanding of the processes and driving factors of ion migration, dilution, and enrichment in arid inland river basins is the basis for implementing water resources management. In this study, we analyzed the water chemistry of streamflow, groundwater, and precipitation and the behavior of main elements in the Shiyang River Basin by means of the hydrochemical diagram and multivariate statistical analysis. The spatial variation of water chemistry was obvious, and the conversion between different water bodies was frequent. The ions migrated from the mountain area to the oasis and desert and accumulated near the terminal lake finally. There were obvious differences in hydrochemistry between surface water and groundwater. From the mountain to the basin, the hydrochemical type of surfer water has varied, and the hydrochemical type of groundwater has changed from Ca-Cl type to Na-Cl type. The hydrochemistry of the basin was controlled by silicate weathering. However, the influence of water-rock interaction on surface water and groundwater was different, and the surface water was more complex. Significantly, agricultural activities and sewage discharge had a negative impact on the water environment. Interbasin water transfer (IBWT) was a form of external ions input from outside the basin, which affected the chemical characteristics of surface water in the lower reaches to a certain extent. In arid areas, human impact on water chemistry needs to be paid attention. These results are helpful to strengthen the understanding of the relationship between different regions and different water bodies in the arid basin.

PMID:34053041 | DOI:10.1007/s11356-021-14484-3

Environ Sci Pollut Res Int. 2021 May 29. doi: 10.1007/s11356-021-14614-x. Online ahead of print.

ABSTRACT

This study is the first proper attempt to examine the influence of energy poverty on productivity. Specifically, the study investigates the effects on the level and convergence of total factor productivity of no access to clean fuels and technologies for cooking; no access to electricity in the total population; no access to electricity in the rural population; no access to electricity in the urban population; non-renewable electricity production; and non-renewable electricity consumption. The study examines a global sample of 45 developing countries from 2002 to 2017 and offers three empirical analysis findings. First, the mutual causalities between the five dimensions of energy poverty and total factor productivity are shown by a non-Granger causality test for panel data, except one-direction causality from no access to clean fuels and technologies for cooking to total factor productivity convergence, which hints a ‘vicious cycle’ of two variables. Second, the two-step system generalised method of moments estimates show significant negative impacts of no access to clean fuels and technologies for cooking and the three variables of no access to electricity on total factor productivity. In contrast, the production and consumption of non-renewable electricity appear to have significant positive effects. Third, the three-stage least squares estimates provide statistical evidence that the effects of energy poverty on total factor productivity are transmitted through human capital accumulation, Internet usage, and the shadow economy.

PMID:34053040 | DOI:10.1007/s11356-021-14614-x

Environ Sci Pollut Res Int. 2021 May 29. doi: 10.1007/s11356-021-14174-0. Online ahead of print.

ABSTRACT

Human disturbance has become the primary driving factor behind declining urban wetland ecological health due to rapid urbanization. Sediment microbial communities are critical for wetland ecosystem functioning but experience a range of natural and anthropogenic stressors due to rapid urbanization and land use changes, especially in developing countries. Polycyclic aromatic hydrocarbons (PAHs) released into the environment primarily come from anthropogenic sources like industrial activities and traffic emissions. Environmental PAH contamination is accelerating due to rapid urbanization, which also increases potential PAH-related dangers to human health. However, PAHs are widely distributed and not easy to centrally control. Microorganisms are the primary mediators of wetland purification, with most PAH-degrading microorganisms being bacteria. To better understand the influence of PAH contamination on urban wetland microbial communities, bacterial community compositions within sediments of urban wetlands in three land use types were investigated using high-throughput DNA sequencing and bioinformatics analyses. Statistical analyses revealed significant differences in overall microbial compositions among the three land use types, although γ-proteobacteria was the dominant phyla across all samples. Among the potential PAH-degrading bacterial taxa in sediments, Sphingomonas was the most prevalent. The distributions of PAH-degrading taxa were primarily affected by variance in organic compound abundances in addition to various physico-chemical variables, among which high-ring PAH content was a key parameter associated with bacterial distributions, except in the riverine wetlands. Functional inference via phylogenetic investigation of communities by reconstruction of unobserved states (PICRUSt) indicated that 30 of the 43 genes related to PAH metabolism were predicted to be present within the genomes of bacteria among the three land use type. In particular, dioxygenase and dehydrogenase genes involved in PAH degradation were inferred to be prevalent, indicating that the host urban wetlands exhibited strong potential for organic pollutant degradation.

PMID:34053037 | DOI:10.1007/s11356-021-14174-0

J Robot Surg. 2021 May 29. doi: 10.1007/s11701-021-01258-9. Online ahead of print.

ABSTRACT

Simulation is increasingly being used to train surgeons and access technical competency in robotic skills. The construct validity of using simulation performance for high-stakes examinations such as credentialing has not been studied appropriately. There are data on how simulation exercises can differentiate between novice and expert surgeons, but there are limited data to support their use for distinguishing intermediate from competent surgeons. Senior cardiothoracic trainees with limited robotic but significant laparoscopic experience (“intermediate surgeons”, IS) and practicing robotic thoracic surgeons (“competent surgeons”, CS) participating in a thoracic cadaver robotic course were evaluated on three Da Vinci (Xi) simulations. Scores were separately recorded into components and analyzed by t-test for significant differences between groups. 21 competent and 17 intermediate surgeons participated. Overall scores did not have a statistically significant difference in any exercise between groups. Simulation exercises do not appear to distinguish intermediate from competent surgeon performance of robotic skills. Without better validity data, the use of simulation for credentialing should be thoughtfully considered.

PMID:34053018 | DOI:10.1007/s11701-021-01258-9

Eat Weight Disord. 2021 May 30. doi: 10.1007/s40519-021-01218-0. Online ahead of print.

ABSTRACT

PURPOSE: The construct of food addiction has been gaining increased attention as a research topic. Currently, the Yale Food Addiction Scale 2.0 is the only measure to operationalize the addictive-like eating behavior according to addiction criteria proposed by the Diagnostic and Statistical Manual of Mental Disorders. The present study aimed at examining the psychometric properties of the Portuguese version of the Yale Food Addiction Scale 2.0, as well as investigating the convergent and divergent validity between this scale and the following measures: Eating Disorders Examination Questionnaire, Body Investment Scale, and Difficulties in Emotion Regulation Scale. We also sought to explore the moderator role of difficulties in emotion regulation in the relationship between food addiction and binge eating METHODS: A sample of 302 female college students (M_age = 21.37, SD = 3.24) completed self-report measures.

RESULTS: Sixteen (5.3%) participants were diagnosed as having food addiction. The confirmatory factor analysis suggested that the original one-dimensional structure is adequate to represent the Portuguese Yale Food Addiction Scale 2.0. The symptom count scores of the scale were correlated with body mass index, eating disordered behavior, body investment, and difficulties in emotion regulation. The severity level of the scale also discriminated the severity of eating disordered behaviors, body investment, and difficulties in emotion regulation. Finally, the relationship between food addiction and binge eating was moderated by difficulties engaging in goal-directed behavior when experiencing negative emotions.

CONCLUSION: The Portuguese version of the Yale Food Addiction Questionnaire 2.0 may be a useful tool to investigate food addiction.

LEVEL: IV descriptive studies.

PMID:34053016 | DOI:10.1007/s40519-021-01218-0

Breast Cancer Res Treat. 2021 May 29. doi: 10.1007/s10549-021-06261-0. Online ahead of print.

ABSTRACT

PURPOSE: To explore the relationship between physical activity (PA) and quality of life (QOL) among Hispanic and non-Hispanic white breast cancer (BC) cases and population-based controls from the New Mexico ‘Long-Term Quality of Life Study’.

METHODS: Self-reported PA (low, moderate, vigorous MET hours/week) at baseline and follow-up interviews (12-15 years) were available for 391 cases and controls and modeled using multiple linear regressions with SF-36 mean composite scores for physical and mental health. The change in PA from baseline to follow-up and interactions with ethnicity were also examined. Models were adjusted for age at diagnosis/baseline interview, education, comorbidities, body mass index, and change in PA.

RESULTS: PA intensities at each timepoint did not differ by case/control status; however, the change in vigorous PA was lower among cases (p = 0.03). At follow-up, low intensity PA increased mental health QOL scores among cases; however, the interaction between low intensity PA and ethnicity was statistically significant among controls indicating decreased mental health among Hispanics (p = 0.02). Change in moderate PA was associated with increased physical and mental health among cases (physical: β = 0.186, p = 0.008; mental: β = 0.225, p = 0.001) and controls (physical: β = 0.220, p < 0.0001; mental: β = 0.193, p = 0.002), when controlling for confounders.

CONCLUSION: Our results demonstrate that all levels of PA are important for mental health among BC cases, while activities of higher intensity are important for physical health among women overall. The statistical interaction observed between ethnicity and low intensity PA among controls for mental health warrants further research to provide a meaningful interpretation.

PMID:34052975 | DOI:10.1007/s10549-021-06261-0

Cerebellum. 2021 May 30. doi: 10.1007/s12311-021-01276-1. Online ahead of print.

ABSTRACT

Evaluation of ataxia in children is challenging in clinical practice. This is particularly true for highly heterogeneous conditions such as primary mitochondrial disorders (PMD). This study aims to explore cerebellar and brain abnormalities identified on MRI as potential predictors of ataxia in patients with PMD and, likewise, to determine the effect of the patient’s genetic profile on these predictors as well as determination of the temporal relationship of clinical ataxia with MRI findings. We evaluated clinical, radiological, and genetic characteristics of 111 PMD patients younger than 21 years of age at The Children’s Hospital of Philadelphia. Data was extracted from charts. Blinded radiological evaluations were carried out by experienced neuroradiologists. Multivariate logistic regression and generalized equation estimates were used for analysis. Ataxia was identified in 41% of patients. Cerebellar atrophy or putaminal involvement with mitochondrial DNA (mtDNA) mutations (OR 1.18, 95% CI 1.1-1.3, p < 0.001) and nuclear DNA mutation with no atrophy of the cerebellum (OR 1.14, 95% CI 1.0-1.3, p = 0.007) predicted an increased likelihood of having ataxia per year of age. Central tegmental tract predicted the presence of ataxia independent of age and pathogenic variant origin (OR 9.8, 95% CI 2-74, p = 0.009). Ataxia tended to precede the imaging finding of cerebellar atrophy. Cerebellar atrophy and putaminal involvement on MRI of pediatric-onset PMD may predict the presence of ataxia with age in patients with mtDNA mutations. This study provides predicted probabilities of having ataxia per year of age that may help in family counseling and future research of the population.

PMID:34052969 | DOI:10.1007/s12311-021-01276-1

West Afr J Med. 2021 May 29;38(5):472-477.

ABSTRACT

BACKGROUND: Musculoskeletal disorders often pose significant limitation to activities of daily living due to pain or disability. These disorders often arise as a result of the normal aging process, but most have some predisposing factors that are lifestyle-related, especially in younger people as a result of repeated mal- posturing/ misuse of parts of the body in the course of their jobs or recreations. These disorders cause more functional limitations in the older adult population than any other group of disorders. Thus, with increasing aging of most populations of the world, it is expected that the burden of these disorders will continue to rise. There is paucity of epidemiological data on this subject and no published study showing the ease of affordability of treatment for these conditions in Nigeria, hence this study.

PATIENTS AND METHODS: A cross -sectional study of patients with chronic musculoskeletal conditions attending the orthopaedic outpatient clinic of Ahmadu Bello university Teaching Hospital between 1st July 2019 and 31st December 2019, involving physical interview of new patients and review of case notes of old patients seen within the period. Statistical analysis was done with the Statistical Package for the Social Sciences (SPSS) version 20.0, and descriptive statistics were employed to summarize data. Pearson Chi- square test was used to examine for association between age, occupational ergonomic factors and chronic musculoskeletal conditions.

RESULTS: Forty-six percent of the outpatients suffered from chronic musculoskeletal disorders. Chronic low back pain accounted for the greatest burden (64.9%), followed by osteoarthritis of the weight bearing joints (27%), chronic neck pain (4.8%) and rheumatoid arthritis (2.8%). 51.8% of the patients with chronic low back pain, 64.5% of chronic neck pain and 68.5% of osteoarthritis were in the middle-age group. Occupational ergonomic factors as an entity was a significant risk factor identified in almost all the conditions except rheumatoid arthritis (P = 0.0001). Only 121(18.7%) of the patients enjoyed health insurance, while majority do not. Also, 56.0% of the patients had the means of footing the cost of their treatment (either by way of health insurance coverage or out-of-pocket payment).

CONCLUSION: The burden of chronic musculoskeletal disorders is high in our region. There is a need for the government to organize ergonomic educational programs through seminars and workshops as part of public health education, and a wider, well funded health insurance policy that covers both the formal and informal sectors and the full extent of the management of these chronic disorders to make such care accessible to all.

PMID:34051720