Tag: nevin manimala

Child Psychiatry Hum Dev. 2022 May 4. doi: 10.1007/s10578-022-01351-6. Online ahead of print.

ABSTRACT

Cognitive behavioural therapy is the first line of treatment for social anxiety disorder; however, children with social anxiety disorder do not respond as well to generic cognitive behavioural therapy programs, compared to children with other anxiety disorders. The aim of the study was to provide a preliminary examination of the efficacy and applicability of a new disorder specific intervention for children with social anxiety disorder. Five children aged 7-13 years, with a primary or secondary DSM-5 diagnosis of social anxiety disorder were provided with an adapted version of the Cool Kids anxiety program. Three out of the five children were in remission from social anxiety disorder at the end of the intervention and at 3-month follow-up. Statistically significant improvements were also noted in overall anxiety symptoms and functioning. Preliminary evidence was found for the efficacy of a social anxiety version of the Cool Kids program.

PMID:35507090 | DOI:10.1007/s10578-022-01351-6

World J Surg. 2022 May 4. doi: 10.1007/s00268-022-06575-0. Online ahead of print.

ABSTRACT

BACKGROUND: Preoperative anxiety is associated with increased morbidity and/or mortality in surgical patients. This study investigated the incidence, predictors, and association of preoperative anxiety with postoperative complications in vascular surgery.

METHODS: Consecutive patients undergoing aortic, carotid, and peripheral artery surgery, under general and regional anesthesia, from February until October 2019 were included in a cross-sectional study. Anesthesiologists assessed preoperative anxiety using a validated Serbian version of the Amsterdam Preoperative Anxiety and Information Scale. Patients were divided into groups with low/high anxiety, both anesthesia- and surgery-related. Statistical analysis included multivariate linear logistic regression and point-biserial correlation.

RESULTS: Of 402 patients interviewed, 16 were excluded and one patient refused to participate (response rate 99.7%). Out of 385 patients included (age range 39-86 years), 62.3% had previous surgery. High-level anesthesia- and surgery-related anxieties were present in 31.2 and 43.4% of patients, respectively. Independent predictors of high-level anesthesia-related anxiety were having no children (OR = 0.443, 95% CI: 0.239-0.821, p = 0.01), personal bad experiences with anesthesia (OR = 2.294, 95% CI: 1.043-5.045, p = 0.039), and time since diagnosis for ≥ 4 months (OR = 1.634, 95% CI: 1.023-5.983, p = 0.04). The female sex independently predicted high-level surgery-related preoperative anxiety (OR = 2.387, 95% CI: 1.432-3.979, p = 0.001). High-level anesthesia-related anxiety correlated with postoperative mental disorders (r_pb = 0.193, p = 0.001) and pulmonary complications (r_pb = 0.104, p = 0.042). Postoperative nausea (r_pb = 0.111, p = 0.03) and postoperative mental disorders (r_pb = 0.160, p = 0.002) correlated with high-level surgery-related preoperative anxiety.

CONCLUSIONS: Since preoperative anxiety affects the postoperative course and almost every third patient experiences anxiety preoperatively, routine screening might be recommended in vascular surgery.

PMID:35507076 | DOI:10.1007/s00268-022-06575-0

Orthod Craniofac Res. 2022 May 4. doi: 10.1111/ocr.12585. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate whether flash-free adhesive ceramic brackets (FFA) have a better clinical performance than conventional adhesive ceramic brackets (CVA) in patients undergoing multi-bracket orthodontic treatment.

MATERIALS AND METHODS: PubMed, CENTRAL, Web of Science, Scopus, Embase, CNKI, and Gray-literature were searched without restrictions up to January 2022. Both randomized controlled trials (RCTs) and controlled clinical trials (CCTs) were included. Risk of bias assessment was performed using the RoB 2.0 and ROBINS-I cochrane risk of bias tools.

RESULTS: Eight articles, for seven studies, were included in this systematic review, and four split-mouth trials (SMT) were included in the meta-analysis. A random-effects meta-analysis found a statistically significant faster bonding time with FFA (mean difference (MD) = -93.85 seconds/quadrant, P = 0.002, 2 SMT), and no statistically significant difference regarding bracket failure rate at 6 months (risk ratio (RR) = 1.05; P = 0.93, 3 SMT), adhesive removal time (MD = -18.26 seconds/quadrant, P = 0.50, 2 SMT), and amount of remnant adhesive (MD = -0.13/bracket, P = 0.72, 2 SMT) between FFA and CVA. No difference (P > 0.05, 3 SMT) was found in enamel demineralization and periodontal measurements. CVA showed a statistically significant higher debonding pain score (P = 0.004, 1 SMT).

CONCLUSIONS: Both flash-free and conventional adhesive ceramic brackets had a similar clinical performance, except for the faster bonding with FFA. Further well-designed clinical trials are still required.

PMID:35506474 | DOI:10.1111/ocr.12585

J Comp Eff Res. 2022 May 4. doi: 10.2217/cer-2021-0266. Online ahead of print.

ABSTRACT

Aim: To demonstrate the potential of fourth-order polynomials within a non-linear optimisation framework for matching-adjusted indirect comparison (MAIC). Materials & methods: Simulated individual patient data were reweighted via fourth-order polynomials (polyMAIC) to match aggregate-level data across multiple baseline characteristics. The polyMAIC approach employed pre-specified matching tolerances and maximum allowable weights. Matching performance against aggregate-level targets was assessed, and also compared against the current industry-standard MAIC approach (Signorovitch). Results: The polyMAIC method matched aggregate-level targets within pre-specified tolerances. Effective sample sizes were either similar to or somewhat higher than those obtained from the Signorovitch method. Performance gains from polyMAIC tended to increase as matching complexity increased. Conclusion: PolyMAIC incorporates greater flexibility than the industry-standard MAIC approach and demonstrates matching potential.

PMID:35506464 | DOI:10.2217/cer-2021-0266

Biometrics. 2022 May 4. doi: 10.1111/biom.13687. Online ahead of print.

ABSTRACT

Analyses of biomedical studies often necessitate modeling longitudinal causal effects. The current focus on personalized medicine and effect heterogeneity makes this task even more challenging. Towards this end, structural nested mean models (SNMMs) are fundamental tools for studying heterogeneous treatment effects in longitudinal studies. However, when outcomes are binary, current methods for estimating multiplicative and additive SNMM parameters suffer from variation dependence between the causal parameters and the non-causal nuisance parameters. This leads to a series of difficulties in interpretation, estimation and computation. These difficulties have hindered the uptake of SNMMs in biomedical practice, where binary outcomes are very common. We solve the variation dependence problem for the binary multiplicative SNMM via a reparametrization of the non-causal nuisance parameters. Our novel nuisance parameters are variation independent of the causal parameters, and hence allow for coherent modeling of heterogeneous effects from longitudinal studies with binary outcomes. Our parametrization also provides a key building block for flexible doubly robust estimation of the causal parameters. Along the way, we prove that an additive SNMM with binary outcomes does not admit a variation independent parametrization, thereby justifying the restriction to multiplicative SNMMs. This article is protected by copyright. All rights reserved.

PMID:35506445 | DOI:10.1111/biom.13687

J Nurs Manag. 2022 May 4. doi: 10.1111/jonm.13657. Online ahead of print.

ABSTRACT

AIMS: To examine the psychometric properties of the Chinese version of the Culture of Care Barometer in healthcare organisations.

BACKGROUND: There is a lack of tools to gauge the caring culture in Chinese hospitals. The Culture of Care Barometer is a psychometrically sound measure for caring culture developed in Western settings.

METHODS: This study was guided by Sousa and Rojjanasrira’s methodological approach. A total of 2365 staff were recruited from two tertiary hospitals. The Barometer was administered with the Hospital Culture Evaluation Index and Minnesota Satisfaction Questionnaire.

RESULTS: The content validity index were calculated as 0.99. The goodness of fit indices, apart from the model chi-square, which was statistically significant, all exceeded established thresholds for adequate fit. The internal consistency was very satisfactory. Pearson’s correlation indicated that the tool has good concurrent and convergent validity.

CONCLUSIONS: The Barometer is a reliable and valid instrument to assess front-line staff perspectives on a caring culture in Chinese hospitals.

IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers can use the Barometer to gauge the caring culture in China. Tailored interventions can be designed to address specific domains, and additional support can be provided to more vulnerable departments or staff groups.

PMID:35506434 | DOI:10.1111/jonm.13657

Australas Psychiatry. 2022 May 4:10398562221080740. doi: 10.1177/10398562221080740. Online ahead of print.

ABSTRACT

OBJECTIVE: Test whether extra time with alcohol and drug nurses for inpatients at a Mental Health Unit (MHU) reduces post-discharge mental and co-occurring alcohol and drug problems and increases engagement in alcohol and drug treatment more than a Brief Information Pack (BIP).

METHOD: Single blind randomised control trial in block design compared two alcohol and drug nurse delivered interventions over 6 months post-discharge using the Alcohol Use Disorders Identification Test (AUDIT) and Brief Symptom Inventory index of overall psychological distress Global Severity Index (GSI).

RESULTS: Alcohol and drug nurse delivered BIP was associated with a statistically significant reduction in AUDIT measured alcohol use for the highest follow-up score across the 6-month post-discharge period, n = 20, t = 2.24, p = 0.037, d = 0.50 and for the extra time intervention, n = 11, t = 2.51, p = 0.031, d = 0.76.

CONCLUSIONS: MHUs may benefit from the integration of alcohol and drug nurses with community alcohol and drug treatment experience.

PMID:35506425 | DOI:10.1177/10398562221080740

Schweiz Arch Tierheilkd. 2022 May;164(5):401-412. doi: 10.17236/sat00356.

ABSTRACT

Equine pastern dermatitis has a high prevalence in the equine population, especially in draft breeds. This skin condition is difficult to treat, and it is suspected that owners often decide on a treatment without consulting a veterinarian. The objectives of this study were to describe owner-reported clinical signs, severity, and reasons to consult a veterinarian. Moreover, we inquired about preventive measures and treatments, both instituted by owners without previous consultation or prescribed by their veterinarians. A total of 123 horses (owners recruited over social media) were included in the study. All horses suffered from equine pastern dermatitis at least once in the two years preceding the study. Standardized questionnaires collecting information on management, housing conditions, clinical signs as well as preventive measures and treatments were filled out by participants. The data was recorded, and descriptive statistics were performed. Most horses (71 out of 115 available answers, 62 %) had shown clinical signs of equine pastern dermatitis at least four times in their lives. A total of 113 horses (92 % of all included horses) were affected by equine pastern dermatitis at the time of the interview. For 37 horses (32 %) out of 114 available answers the owners consulted their veterinarian only after the horse showed signs of pain or lameness. Usually, treatments that did not require a medical prescription were applied without consulting their veterinarian (e. g. only 9 % (14 out of 150 prescriptions) of topical creams promoting wound healing were prescribed by a veterinarian). A total of 31 treatment decisions (55 %) with creams containing anti-bacterial, anti-mycotic and/or anti-inflammatory agents and 100 % of systemic medications containing anti-bacterial, anti-parasitic or anti-inflammatory agents were prescribed by veterinarians. Overall, 69 % of treatment decisions were made without consulting a veterinarian, making it then more difficult to determine underlying causes for the pastern dermatitis and rendering the treatment often longer and more onerous. To raise owner awareness of possible consequences if a veterinarian is consulted too late in the disease process, specific information campaigns to improve animal welfare should be considered.

PMID:35506419 | DOI:10.17236/sat00356

Infect Control Hosp Epidemiol. 2022 May 4:1-6. doi: 10.1017/ice.2022.97. Online ahead of print.

ABSTRACT

OBJECTIVE: Ventilator-associated pneumonia (VAP) is one of the most common healthcare-associated infections in pediatric intensive care units (PICUs), but its definite diagnosis remains controversial. The CDC Ventilator-Associated Event (VAE) module (validated in adults) constitutes a new approach for VAP surveillance.

DESIGN: We described epidemiological characteristics of PICU VAE cases, investigated possible risk factors, and evaluated 3 different sets of diagnostic VAE criteria.

SETTING: This study was conducted in a PICU in a tertiary-care general hospital in northern Greece during 2017-2019.

PATIENTS: The study included patients aged 35 days-16 years who received mechanical ventilation.

METHODS: From medical records, we retrieved epidemiological data, clinical data, and laboratory characteristics as well as ventilator settings for our analysis. We assessed “oxygen deterioration” for the tier 1 CDC VAE module using 3 sets of diagnostic criteria: (1) CDC adult VAE criteria [increase of daily minimum fraction of inspired oxygen (FiO2) ≥ 0.2 or positive end expiratory pressure (PEEP) ≥ 3 cmH2O for 2 days], (2) the US pediatric VAE criteria [increase of FiO2 ≥ 0.25 or mean airway pressure (MAP) ≥ 4 cmH2O for 2 days], and (3) the European pediatric VAE criteria (increase of FiO2 ≥ 0.2 or PEEP ≥ 2 cmH2O for 1 day or increase of FiO2 ≥ 0.15 and PEEP ≥ 1 cm H2O for 1 day).

RESULTS: Among 326 children admitted to the PICU, 301 received mechanical ventilation. The incidence rate according to the CDC adult VAE criteria was 4.7 per 1,000 ventilator days. For the US pediatric VAE criteria the incidence rate was 6 per 1,000 ventilator days. For the European pediatric VAE criteria the incidence rate was 9.7 per 1,000 ventilator days. These results revealed statistically significant correlation of all 3 algorithms with adverse outcomes, including mortality.

CONCLUSIONS: All VAE algorithms were associated with higher mortality rates. Our findings highlight the need for a unified pediatric VAE definition to improve preventive strategies.

PMID:35506391 | DOI:10.1017/ice.2022.97

Dent Med Probl. 2022 Apr 29. doi: 10.17219/dmp/143547. Online ahead of print.

ABSTRACT

BACKGROUND: Dental caries is an infectious microbial disease of the teeth, affecting mostly young children. It is caused by the interplay of numerous factors that are more common in susceptible and lower-income groups. Therefore, there is a dire need for a simple yet effective method of treating dental caries.

OBJECTIVES: The aim of the study was to compare the effectiveness of 38% silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) in the treatment of dental caries in a school setting.

MATERIAL AND METHODS: A randomized clinical trial (RCT) using a parallel-group design was conducted among schoolchildren aged 6-12 years. Oral hygiene practices and sugar exposure were recorded at baseline. In the schoolchildren, 190 dental caries lesions were restored using 38% SDF (group 1) or ART (group 2). The χ 2 test and the Kaplan-Meier survival analysis were done to assess the 2 treatment modalities. The RCT was carried out and reported in accordance with the CONSORT (Consolidated Standards of Reporting Trials) checklist.

RESULTS: A total of 190 children fulfilled the inclusion criteria and the mean age of the study population was 9.3 ±1.3 years. The majority of the participants brushed their teeth once daily, using a toothbrush, rinsed their mouth after meals and had optimal sugar exposure. In measuring the outcome of the interventions after 9 months, 58.9% of the participants from group 1 had their restorations intact as compared to 47.8% in group 2, and this was found to be statistically significant (p = 0.004). The survival analysis using the log rank test showed 38% SDF to be better in comparison with ART.

CONCLUSIONS: This study indicated that SDF was better at arresting caries, and hence it can be considered a viable treatment option in areas with limited access to oral healthcare.

PMID:35506381 | DOI:10.17219/dmp/143547