Tag: nevin manimala

Subst Use Addctn J. 2026 Aug 14:29767342261465527. doi: 10.1177/29767342261465527. Online ahead of print.

ABSTRACT

BACKGROUND: Harmful substance use affects millions of people, producing health and social consequences that require both professional support and effective self-management. This study piloted a self-management program targeting the consequences of substance addiction in adults enrolled in medication-based program.

METHODS: A parallel-group pilot trial compared the Self-Management Substance Addiction Consequences Program (ADS Program) with treatment as usual (TAU) to assess the program’s effectiveness and identify the need for adjustments to the intervention or the trial design. Seventy-two randomly selected adults enrolled for at least 5 weeks in medication-based program for alcohol or other drugs participated. Data were collected at baseline and after 8 to 21 weeks to assess effects on substance addiction consequences (SAC) and positive mental health (PMH).

RESULTS: Of the 236 patients screened, 72 were randomized: 38 to the ADS Program and 34 to TAU. Twenty-five participants completed the ADS Program (34.2% attrition), and 16 completed TAU (52% attrition). ADS participants attended more sessions (6 vs 2), although still fewer than planned. Participants in the ADS Program demonstrated significant reduction in SAC (paired t(24) = -5.718, P < .001, d = -1.169). Similar improvements were observed in the TAU group (paired t(15) = -6.357, P < .001, d = -1.580), with no significant differences between groups (P > .05). PMH also improved in both groups. The ADS group showed a statistically significant increase (paired t(20) = -3.945, P < .001, d = -0.861), whereas the TAU group demonstrated marginally non-significant improvement (paired t(11) = -2.170, P = .053, d = -0.626). No significant between-group differences were identified (P > .05).

CONCLUSIONS: This pilot trial indicates that the ADS Program is feasible, safe, and potentially effective in supporting self-management of SAC. Findings suggest an adjusted duration of 6 to 18 weeks may be beneficial. Given the substantial dropout rate, further research with larger samples is needed to confirm effectiveness and improve retention.

PMID:42596740 | DOI:10.1177/29767342261465527

Child Care Health Dev. 2026 Sep;52(5):e70330. doi: 10.1111/cch.70330.

ABSTRACT

BACKGROUND: Childcare centres for toddlers and preschool-aged children serve as a setting crucial to mental development, as stable relationships with caregivers and peers outside the family form. Children with early mental health disorders, especially externalising behaviours, are at increased risk of being excluded from access to these institutional services.

METHODS: The retrospective study investigates partial or full exclusion from childcare centre attendance among toddlers and preschoolers (N = 177) who received psychiatric day clinic treatment within two periods (2018/2019 and 2023/2024). We compared excluded and non-excluded children regarding clinical parameters in a binary logistic regression. Furthermore, treatment trajectories were examined to assess reintegration into childcare settings as a potential therapeutic outcome.

RESULTS: Among the patients in the psychiatric day clinic for toddlers and preschoolers, the rate of exclusion from childcare centre attendance was 25.5% (2023/2024) and 8.0% (2018/2019), respectively. Boys were predominantly excluded from childcare centre attendance with 66.7% (2018/2019) and 92.3% (2023/2024). Overall for both cohorts, while male sex (p = 0.028) and cohort membership in the 2023/24 cohort (p = 0.009) predicted exclusion, other investigated variables (i.e., socioeconomic status, migration status, parental psychiatric condition) did not show an effect. In 78.1% of the excluded patients in the combined samples, (partial) reintegration or improvement of social integration was recorded or initiated during treatment.

CONCLUSIONS: In our study, exclusion from childcare attendance differed between 2018/2019 and 2023/2024 in toddler and preschool children, especially affecting boys. In line with the UN Convention on the Rights of the Child, 1989, ensuring inclusive access to early education regardless of physical or mental impairments should be an important therapeutic goal. Mental health professionals should pay special attention to and actively support prevention and reintegration regarding early life exclusion experiences from childcare centres.

PMID:42596739 | DOI:10.1111/cch.70330

Subst Use Addctn J. 2026 Aug 14:29767342261467585. doi: 10.1177/29767342261467585. Online ahead of print.

ABSTRACT

BACKGROUND: Treatment for alcohol and opioid withdrawal when managed independently is well-established; however, specific guidance on their concurrent management is lacking. This review evaluated the relationship between buprenorphine initiation and time to initiation on key substance use disorder outcomes for inpatients at risk for both alcohol and opioid withdrawal.

METHODS: This single-center retrospective cohort study included patients admitted to the acute psychiatry unit from January 1, 2019 through September 30, 2023 and at risk for concurrent opioid and alcohol withdrawal. Patients were divided into 4 cohorts depending on time to buprenorphine initiation from admission: 0 to 24 hours (n = 85), 24 to 72 hours (n = 44), >72 hours (n = 16), and those who did not receive buprenorphine (n = 187). The primary outcome compared the patient-directed discharge (PDD) rate among the 4 cohorts. Secondary outcomes compared the overall length of stay, inpatient readmission rates at 30 and 90 days, and buprenorphine medication retention at 90 days. Descriptive statistics were used for analysis.

RESULTS: Of all psychiatric admissions meeting inclusion criteria (N = 332), 43.7% (n = 145) received buprenorphine. PDD rates were higher in those who did not receive buprenorphine compared to those who did (15.5% [n = 29] vs 6.9% [n = 10]) and in those who initiated buprenorphine between 24 and 72 hours versus 0 to 24 hours of admission (11.4% [n = 5] vs 5.9% [n = 5]). Absence of buprenorphine initiation also resulted in higher inpatient readmission rates at both 30 (25.1% [n = 47] vs 11.0% [n = 16]) and 90 days (46% [n = 86] vs 24.1% [n = 35]).

CONCLUSIONS: Patients who did not receive buprenorphine had the highest rate of PDD and readmission. Buprenorphine initiation within 24 hours of admission was associated with a lower rate of PDD. Results highlight the importance of the timely initiation of evidence-based medications for opioid use disorder in patients with concurrent alcohol withdrawal, leading to more favorable outcomes for patients and the facility.

PMID:42596730 | DOI:10.1177/29767342261467585

J Neonatal Perinatal Med. 2026 Aug 14:19345798261475686. doi: 10.1177/19345798261475686. Online ahead of print.

ABSTRACT

ObjectiveNeonatal hyperbilirubinemia (NHB) is a common clinical condition that may lead to long-term neurodevelopmental impairment due to bilirubin-induced neurotoxicity. The development of reliable methods for neurological monitoring in affected newborns remains a major challenge in neonatal care. This study aimed to evaluate the association between treatment and EEG changes on cerebral activity in infants with hyperbilirubinemia using conventional EEG.Methods & MaterialsThis prospective before-and-after study was conducted on neonates aged over 35 weeks of gestation who were diagnosed with hyperbilirubinemia. Demographic and clinical data, including neonatal age, sex, birth weight, presence of ABO incompatibility, and treatment modalities, were collected. Maternal data, including parity, mode of delivery, and maternal and neonatal blood groups, were also recorded.Conventional EEG was performed for all neonates during the first eight hours of hospitalization and repeated after therapeutic interventions, including phototherapy and, when indicated, exchange transfusion.ResultsA total of 26 neonates with hyperbilirubinemia were included in this study. The mean total serum bilirubin level before treatment was 23.01 ± 2.99 mg/dL.A statistically significant change in the EEG spectral power was observed before and after treatment in the frontal regions Fp1, Fp2, and Fz, particularly within the delta and beta frequency bands.Furthermore, the findings demonstrated that delta activity was significantly dominant in the Fp1, Fp2, and Fz regions both before and after treatment. In contrast, no dominant frequency bands were observed in the C3, O1, T3, C4, T4, Cz, and O2 regions either before or after treatment.ConclusionHyperbilirubinemia in neonates may be associated with alterations in cortical electrical activity as assessed by conventional EEG. In our study, delta band activity was significantly predominant in the frontal regions (Fp1, Fp2, and Fz) both before and after treatment. Moreover, delta band activity remained the predominant frequency in the frontal regions (Fp1, Fp2, and Fz) before and after treatment, suggesting persistent frontal cortical involvement despite treatment.Further studies with larger samples are recommended to clarify whether these EEG changes reflect a transient bilirubin effect or age-related maturation patterns.

PMID:42596718 | DOI:10.1177/19345798261475686

J Periodontal Implant Sci. 2026 Jul 30. doi: 10.5051/jpis.2500240012. Online ahead of print.

ABSTRACT

PURPOSE: This pilot study investigated the effects of different extraction-socket bone-resorption patterns on alveolar ridge preservation (ARP) performed with an open-wound healing technique.

METHODS: Sites were divided into two groups according to cone-beam computed tomography (CBCT) findings obtained immediately after ARP surgery (T1): group 1 included sockets with vertical bone resorption >1/3 of the buccal/labial or lingual/palatal bone wall, and group 2 included sockets with vertical bone resorption ≤1/3 of the buccal/labial and lingual/palatal bone walls. Follow-up CBCT was performed approximately 5 months after surgery (T3). Hard-tissue changes were measured by superimposing CBCT images obtained at T0 (before tooth extraction), T1, and T3. Soft-tissue healing was evaluated at suture removal (T2), and biopsy specimens were collected before implant placement.

RESULTS: Sixteen participants with 19 sites completed this pilot study. All included patients underwent ARP with an intentionally exposed xenogeneic collagen matrix seal; however, one patient did not undergo implant-placement surgery at our hospital. Overall, CBCT measurements of ridge alterations showed excellent intra-rater reliability and minimal systematic bias. Bone resorption occurred in both groups (P<0.05), reflecting the natural bone-remodeling process. However, no intergroup differences were observed in horizontal or vertical dimensional changes. In addition, locally estimated scatterplot smoothing analysis identified bootstrap median inflection points below the 1/3 threshold, suggesting a possible nonlinear relationship between the vertical resorption proportion and three-dimensional changes. No statistically significant differences were observed in soft-tissue healing or implant-related outcomes. Histomorphometric evaluation of biopsy specimens showed new bone formation without signs of inflammation or fibrous encapsulation.

CONCLUSIONS: Within the limitations of this study, intentionally exposing the xenogeneic collagen matrix seal yielded comparable outcomes in non-contained and contained sockets. This finding may reflect the material’s ability to reduce the adverse effects of socket-wall resorption; however, larger multicenter studies are warranted.

TRIAL REGISTRATION: Chinese Clinical Trial Registry Identifier: ChiCTR2300078331.

PMID:42596716 | DOI:10.5051/jpis.2500240012

J Periodontal Implant Sci. 2026 Jun 15. doi: 10.5051/jpis.2601920096. Online ahead of print.

ABSTRACT

PURPOSE: This study evaluated the regenerative potential of a novel polyethylene glycol (PEG)-chitosan hydrogel as an alternative to a conventional collagen membrane for guided tissue regeneration (GTR) of class II furcation defects in a canine model.

METHODS: Standardized class II furcation defects were created in the maxillary third and fourth premolars of 6 beagle dogs. Sites were randomly allocated to 4 groups: 1) sham control, 2) particulate biphasic calcium phosphate (BCP) with a cross-linked collagen membrane (O3CM), 3) collagenated BCP with a collagen membrane (O3ColCM), and 4) particulate BCP with PEG-chitosan hydrogel (O3TG). After 8 weeks, specimens were processed for histological and histomorphometric analyses. The primary outcome was hard tissue area (HTA) within a predefined 3-mm region of interest.

RESULTS: Histologically, O3TG showed consolidated graft particles in close contact with the surrounding tissues and new bone formation extending coronally from the defect base, with no notable inflammatory response. Histomorphometric analysis revealed no statistically significant differences among the groups. Median HTA values ranged from 1.55 mm² in O3TG to 1.92 mm² in the control group (P=0.997). The non-filled area tended to be smaller in O3CM (0.68 mm²) and O3TG (0.66 mm²) than in the control group (1.14 mm²) and O3ColCM (1.58 mm²), although the difference was not statistically significant (P=0.258).

CONCLUSIONS: Within the limitations of this study, PEG-chitosan hydrogel achieved regenerative outcomes comparable to those of collagen membrane-based GTR while stabilizing BCP particles without adverse inflammation. Given its ease of handling and biocompatibility, PEG-chitosan hydrogel may represent a clinician-friendly alternative to collagen membranes for periodontal regeneration in class II furcation defects.

PMID:42596715 | DOI:10.5051/jpis.2601920096

J Periodontal Implant Sci. 2026 May 26. doi: 10.5051/jpis.2600560028. Online ahead of print.

ABSTRACT

PURPOSE: To retrospectively evaluate the effects of vestibuloplasty using a xenogeneic collagen matrix (XCM) at implant sites with insufficient peri-implant keratinized tissue (PIKT) and a shallow peri-implant vestibule (PIV).

METHODS: Patients who underwent vestibuloplasty with an XCM between July 2021 and August 2023 at Kyung Hee University Dental Hospital were included. Inclusion criteria were PIKT <2 mm, PIV <4 mm at baseline, and a follow-up duration of >6 months. Clinical parameters, including PIKT and PIV, were measured at baseline and at 1 month, 6 months, and the final visit. Marginal bone level (MBL), probing depth (PD), bleeding on probing (BOP), and the modified plaque index (mPI) were recorded at the final visit. Descriptive statistical analyses were performed.

RESULTS: Thirteen patients with 22 implant sites were included, with a mean follow-up of 1.19±0.27 years. Baseline PIKT and PIV were 0.59±0.57 mm and 2.66±0.81 mm, respectively. At the final visit, the mean gains in PIKT and PIV were 1.52±1.16 mm and 2.73±1.99 mm, resulting in final values of 2.11±1.01 mm and 5.39±1.85 mm, respectively. Clinical and radiographic peri-implant parameters indicated favorable conditions (PD: 2.30±0.61 mm; BOP: 0.15±0.26; mPI: 0.27; MBL: 1.23±0.97 mm).

CONCLUSIONS: Vestibuloplasty using an XCM was associated with achieving clinically accepted threshold values for PIKT and PIV while maintaining favorable peri-implant conditions. Long-term follow-up is warranted.

PMID:42596711 | DOI:10.5051/jpis.2600560028

J Periodontal Implant Sci. 2026 May 6. doi: 10.5051/jpis.2504740237. Online ahead of print.

ABSTRACT

PURPOSE: This study evaluated phase-specific peri-implant marginal bone level (MBL) changes associated with abutment disconnection and reconnection during prosthetic procedures by comparing implant-level (IL) and abutment-level (AL) restorative protocols over a 1-year period.

METHODS: This two-arm randomized controlled clinical trial included patients receiving posterior mandibular fixed partial dentures following soft tissue augmentation. Implants were randomly assigned (1:1) to IL or AL protocols. In the IL group, repeated abutment disconnection and reconnection were performed during prosthetic procedures, whereas in the AL group, a definitive abutment was connected and maintained without disconnection. Standardized periapical radiographs were obtained at implant placement (T0), 2 weeks after second-stage surgery (T1), at definitive prosthesis delivery (T2), and 1 year after loading (T3). MBL changes were analyzed by phase: suprastructure connection (T1-T0), prosthetic (T2-T1), maintenance (T3-T2), and cumulative (T3-T0). Statistical significance was set at P<0.05.

RESULTS: Implant success was 100% at 1 year in both groups. In the IL group, MBL changes were Δ(T1-T0)=-0.41±0.43 mm, Δ(T2-T1)=-0.34±0.38 mm, and Δ(T3-T2)=-0.31±0.43 mm, with a cumulative change of Δ(T3-T0)=-1.06±0.49 mm. In the AL group, the corresponding values were -0.81±0.44 mm, -0.14±0.24 mm, -0.12±0.30 mm, and -1.08±0.39 mm, respectively. Phase-specific remodeling differed between protocols, whereas the cumulative 1-year change was comparable.

CONCLUSIONS: Under conditions of vertical soft tissue augmentation, abutment disconnection and reconnection were associated with phase-specific MBL remodeling; however, cumulative 1-year MBL changes were similar between IL and AL protocols.

PMID:42596708 | DOI:10.5051/jpis.2504740237

Nucl Med Commun. 2026 Aug 14. doi: 10.1097/MNM.0000000000002230. Online ahead of print.

ABSTRACT

OBJECTIVE: Nuclear medicine is a well-established modality for assessing infection or loosening of prosthetic joint replacements. However, previous research suggests that loosening and low-grade periprosthetic infection can appear similar. Patients with vitamin D deficiency have been noted to have poorer outcomes postsurgery for both infection and loosening. Patients with low-grade uptake and low vitamin D levels may be mismanaged if imaging is inaccurate. This study evaluated the association between nuclear medicine imaging accuracy and vitamin D levels in patients with prosthetic joint replacements.

METHODS: A retrospective single-center cohort study was carried out. Data were collected anonymously with 298 cases including knee and hip prostheses. Clinical findings were split into two categories: matched, whereby scan reports agreed with clinical findings, and unmatched, whereby they did not match and therefore imaging was inaccurate. Chi-squared and Fisher’s exact tests were performed to assess statistical significance.

RESULTS: Analysis shows a statistically significant association between imaging accuracy of prosthetic joint replacements and vitamin D level (P < 0.001). There was no significant difference between prosthesis types. Patients with low vitamin D were 2.61 times more likely to have inaccurate results.

CONCLUSION: There was an association between vitamin D levels and nuclear medicine imaging accuracy, and imaging results in cases with low vitamin D levels were two times more likely to be inaccurate. Prospective research would be appropriate to further confirm this. Vitamin D levels could be used as an indicator for the accuracy of imaging results, or low vitamin D levels could be managed before imaging.

PMID:42596699 | DOI:10.1097/MNM.0000000000002230

J Nurs Manag. 2026;2026(1):e2066972. doi: 10.1155/jonm/2066972.

ABSTRACT

OBJECTIVES: To evaluate the impact of implementing an evidence-based intrapartum care quality improvement program on childbirth outcomes for laboring women.

METHODS: A quasiexperimental interrupted time series (ITS) study using routinely collected hospital data was conducted at the Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China. The study period spanned from November 1, 2021, to December 31, 2022, with a 4-month preparation phase (April 1, 2022, to July 31, 2022) excluded from analysis. A total of 422 women were included (211 preintervention and 211 postintervention), aggregated into 20 biweekly time points (10 preintervention and 10 postintervention). Key measures included intrapartum cesarean section (ICS) rates, oxytocin use, duration of labor, and childbirth experience scores. Sociodemographic and clinical data were extracted from routine records, and childbirth experience was assessed using the Childbirth Experience Questionnaire (CEQ 2.0).

RESULTS: Prior to the intervention, the ICS rate increased by 2.057% per biweekly time point (p = 0.015). After implementation, the ICS rate showed a decreasing trend, with a slope reduction of 2.782% compared with the preintervention trend (p = 0.018), resulting in an overall postintervention slope of -0.725% per biweekly time point. The estimated contribution of the intervention to ICS reduction was -22.69%. Compared with the preintervention group, women in the intervention phase had lower oxytocin use (71.09% vs. 80.09%, p < 0.05), shorter total labor duration (median 456.5 min [265.0-602.5] vs. 472.5 min [280.0, 670.0], p < 0.05), and higher childbirth experience scores (72.23 ± 9.76 vs. 69.27 ± 8.84, p < 0.05).

CONCLUSION AND IMPLICATIONS FOR NURSING MANAGEMENT: This quality improvement program effectively optimized intrapartum care through reduced medical interventions and enhanced childbirth experiences. Successful scaling up requires institutional commitment to midwifery continuity models, context-adaptive implementation strategies, and sustained investment in midwifery training and outcome monitoring systems to ensure equitable and woman-centered care delivery.

PMID:42596690 | DOI:10.1155/jonm/2066972