Tag: nevin manimala

Psychol Med. 2022 Nov 25:1-10. doi: 10.1017/S0033291722003531. Online ahead of print.

ABSTRACT

BACKGROUND: Access to evidence-based psychological treatment is a challenge worldwide. We assessed the effectiveness of a fully automated aviophobia smartphone app treatment delivered in combination with a $5 virtual reality (VR) viewer.

METHODS: In total, 153 participants from the Dutch general population with aviophobia symptoms and smartphone access were randomized in a single-blind randomized controlled trial to either an automated VR cognitive behavior therapy (VR-CBT) app treatment condition (n = 77) or a wait-list control condition (n = 76). The VR-CBT app was delivered over a 6-week period in the participants’ natural environment. Online self-report assessments were completed at baseline, post-treatment, at 3-month and at 12-month follow-up. The primary outcome measure was the Flight Anxiety Situations Questionnaire (FAS). Analyses were based on intent-to-treat.

RESULTS: A significant reduction of aviophobia symptoms at post-test for the VR-CBT app compared with the control condition [p < 0.001; d = 0. 98 (95% CI 0.65-1.32)] was demonstrated. The dropout rate was 21%. Results were maintained at 3-month follow-up [within-group d = 1.14 (95% CI 0.46-1.81)] and at 12-month follow-up [within-group d = 1.12 (95% CI 0.46-1.79)]. Six participants reported adverse effects of cyber sickness symptoms.

CONCLUSIONS: This study is the first to show that fully automated mobile VR-CBT therapy delivered in a natural setting can maintain long-term effectiveness in reducing aviophobia symptoms. In doing so, it offers an accessible and scalable evidence-based treatment solution that can be applied globally at a fraction of the cost of current treatment alternatives.

PMID:36426618 | DOI:10.1017/S0033291722003531

Int J Esthet Dent. 2022 Nov 25;17(4):448-467.

ABSTRACT

OBJECTIVE: The objective of the present study was to assess the progress and efficiency of at-home bleaching protocols with 10% carbamide peroxide using a new methodology based on dental photography.

MATERIALS AND METHODS: A 4-week overnight at-home bleaching protocol using whitening trays and 10% carbamide peroxide was performed on 52 patients. The tooth color was analyzed using standardized photographs taken every week for 4 weeks and at 4 months posttreatment. The values of the color evolution (ΔE00), L*, a*, and b* were also measured and used to assess the evolution of the chroma, luminosity, and hue using the CIEDE2000 formula. The statistical analyses were conducted at a significance level of P < 0.05 by means of a repeated measures analysis of variance (ANOVA).

RESULTS: The tooth color changed the most, and thus the highest ΔE00 was observed, after the first week of treatment. The color continued to change but to a lesser degree during the following weeks. After 4 weeks, the treatment proved to be very effective. Four months after the end of treatment, a color relapse was observed, though it was hardly perceptible to the human eye. The luminosity (L’) changed significantly between the beginning and the end of treatment, affecting the maxilla to a greater extent. The chroma evolution showed a high variance and a low relapse for both jaws. The hue was not affected significantly during the treatment and the stabilization.

CONCLUSIONS: Within the limitations of the present study, the authors were able to assess the progress and efficiency of at-home bleaching with 10% carbamide peroxide in terms of chroma, luminosity, and hue using a new methodology based on dental photography.

CLINICAL SIGNIFICANCE: This new method is effective and enables a reliable analysis of the evolution of a dental bleaching treatment, turning dental photo-graphy into an even more powerful tool for analysis and communication. It can also be used as a proof-of-concept, paving the way for further research on objective monitoring and evaluation of dental treatments using dental photography.

PMID:36426616

Int J Esthet Dent. 2022 Nov 25;17(4):436-447.

ABSTRACT

OBJECTIVE: The present study aimed to evaluate the gender-based association of gingival exhibit with lip dimensions, intercommissural width (ICW), interdental smile line (ISL), and gingival smile line (GSL) in periodontally healthy patients.

MATERIALS AND METHODS: 120 patients aged between 20 and 40 years were divided equally into two groups based on gender. The parameters of lip length (LL) at rest and on smiling, ICW, and the intraoral parameters of gingival exhibit in ISL and GSL were measured on digitized photographs in the maxillary anterior teeth.

RESULTS: The LL positions at rest and on smiling differed significantly: 23.50 ± 3.31 mm and 19.89 ± 1.91 mm, and 16.53 ± 2.94 mm and 13.91 ± 1.93 mm for males and females, respectively. The gingival exhibit of the interdental papillae in ISL was 3.01 ± 1.85 mm for males and 4.26 ± 1.85 mm for females, while the midfacial exhibit in GSL was 0.62 ± 1.01 mm for males and 1.24 ± 1.44 mm for females; both the differences were statistically significant.

CONCLUSION: The gender variability in LL, the interdental papillae exhibit in ISL, and the midfacial exhibit in GSL can provide constructive guidelines that can be implemented in the esthetic zone.

PMID:36426615

J Sch Health. 2022 Nov 25. doi: 10.1111/josh.13288. Online ahead of print.

ABSTRACT

BACKGROUND: Our objective is to describe violence-related injuries to early adolescents that occurred at school, resulting in emergency department (ED) evaluation.

METHODS: This retrospective cohort study at an urban academic pediatric ED in Baltimore, MD, identified patients 10-15 years old who presented with an injury from intentional, interpersonal violence that occurred at school between January 2019-December 2020. Descriptive statistics were used to summarize patient and event characteristics.

RESULTS: Of 819 youth 10-15 years of age evaluated for a violence-related injury, school was the location in 115 cases (14.0%). All events occurred prior to the statewide stay at home order (March 30, 2020). School-injured youth had a mean age of 12.7 ± 1.7 years and were predominantly male (64.3%). Of the 115 cases, 75 (65.2%) involved an altercation with a peer, 26 (22.6%) involved a teacher or school staff, 6 (5.2%) involved a family member, 1 (0.9%) involved police, 6 (5.2%) involved an unknown party, and 1 (0.9%) involved an unrelated but known adult. All injured youth were discharged from the ED.

CONCLUSIONS: School-based violence is a well-recognized cause of traumatic injuries to adolescents and may involve peers, teachers, or school staff.

PMID:36426581 | DOI:10.1111/josh.13288

Technol Cancer Res Treat. 2022 Jan-Dec;21:15330338221141254. doi: 10.1177/15330338221141254.

ABSTRACT

Background: This retrospective cohort study was to assess the prognostic value of preoperative albumin-to-alkaline phosphatase ratio (AAPR) on survival outcome for patients with locally advanced oral squamous cell carcinoma (LAOSCC). Methods: A total of 250 patients with LAOSCC receiving upfront radical surgery at a single institute from January 2008 to December 2017 were enrolled. The primary endpoint was the survival predictability of preoperative AAPR on the 5-year overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Cox proportional hazards model was used for survival analysis. The X-tile software was used to estimate the optimal cut-off value of preoperative AAPR on survival prediction. A predictive nomogram incorporating the clinicopathological factors on OS was further generated. Results: The 5-year OS, CSS, and DFS rates were 68.6%, 79.7%, and 61.7%, respectively. The optimal cut-off of preoperative AAPR to predict the 5-year OS was observed to be 0.51. For those with preoperative AAPR≧0.51, the 5-year OS, CSS, and DFS were statistically significantly superior to those with preoperative AAPR<0.51 (OS: 76.1% vs 48.5%, P < .001; CSS: 84.3% vs 66.4%, P = .005; DFS: 68.9% vs 42.6%, P < .001). In Cox model, we observed that preoperative AAPR<0.51 was a significantly negative prognosticator of OS (HR: 2.22, 95% CI: 1.466-3.361, P < .001), CSS (HR: 2.037, 95% CI: 1.16-3.578, P = .013), and DFS (HR: 1.756, 95% CI: 1.075-2.868, P = .025). After adding the variable of preoperative AAPR, the c-index of the predictive nomogram incorporating assorted clinicopathological factors increases from 0.663 to 0.692 for OS. Conclusion: Our results suggest that preoperative AAPR serves as an independent survival predictor for patients with LAOSCC. The nomogram incorporating preoperative AAPR and various clinicopathological features may be a convenient tool to estimate the mortality risk for patients with LAOSCC.

PMID:36426570 | DOI:10.1177/15330338221141254

Andrology. 2022 Nov 25. doi: 10.1111/andr.13352. Online ahead of print.

ABSTRACT

BACKGROUND: Peyronie’s disease (PD) has a huge impact on patients’ physical and psychological wellbeing.

OBJECTIVES: To investigate whether patients’ age has an impact on PD symptomatic burden at first presentation.

MATERIALS & METHODS: Data from 129 consecutive heterosexual patients seeking first medical attention for PD at a single andrological tertiary-referral centre were collected. All patients completed the International Index for Erectile Function (IIEF) and the Peyronie’s Disease Questionnaire (PDQ). Descriptive statistics was used to compare clinical features between younger (≤40years) and older (>40 years) patients. Multivariable linear model assessed the impact of age, the degree of penile curvature, and their impact on PDQ (total scores and its domains), after adjusting for PD duration and IIEF-erectile function domain scores.

RESULTS: Of 129, 24 (18.6%) patients were ≤40 years old. Young patients presented with a less severe curvature than older patients (median (IQR) 20° (15-36) vs. 50° (40-80); p = 0.04). However, younger age was associated with higher Psychological and Physical Symptoms, PDQ-Penile Pain, and PDQ- Symptom bother scores (Coeff -0.11, -0.21, and -0.17, respectively) (all p<0.05). Moreover, the greater the degree of curvature, the higher the PDQ-Psychological and Physical Symptoms and the PDQ-Symptom Bother scores (Coeff. 0.21 and 0.22, respectively; all p<0.05).

CONCLUSION: Around one in five men seeking first medical help for PD is younger than 40 years at presentation in the real-life setting. PD-related distress varies according to patients’ age, with younger men presenting with a greater risk of penile pain and symptom bother despite lower curvature. This article is protected by copyright. All rights reserved.

PMID:36426559 | DOI:10.1111/andr.13352

Arch Suicide Res. 2022 Nov 25:1-11. doi: 10.1080/13811118.2022.2150104. Online ahead of print.

ABSTRACT

OBJECTIVES: To estimate effects of potentially modifiable risk factors for self-harm among adolescents in the Child Protective Services (CPS) system.

METHODS: Data came from the National Survey of Child and Adolescent Well-being, a nationally representative longitudinal survey. Candidate risk factors included child’s feelings of worthlessness, the presence of supportive adults in the child’s life, and parental psychological aggression. Propensity score weighting (PSW) was used to control for observed confounders, and the average effect of experiencing the risk factor among those who did was estimated using weighted logistic regression.

RESULTS: Odds ratios for self-harm comparing youth with low and high parental psychological aggression to none were 0.93 (0.35-2.45) and 1.25 (0.55-2.82), respectively. The OR for feelings of worthlessness was 1.73 (0.70-4.27), and for supportive adults 0.58 (0.28-1.19). The combination of survey and propensity score weights may have affected statistical power.

CONCLUSIONS: Preventing self-harm in adolescents requires a multifaceted approach given the existing evidence base and lack of strong associations with individual risk factors. Fostering supportive relationships with adults merits future research given the observed, non-significant 42% reduction in odds of self-harm among CPS involved youth who had a supportive relationship with an adult, compared to those who did not.

PMID:36426537 | DOI:10.1080/13811118.2022.2150104

Lancet. 2022 Nov;400 Suppl 1:S79. doi: 10.1016/S0140-6736(22)02289-9.

ABSTRACT

BACKGROUND: A social prescribing link worker is responsible for enabling and supporting individuals, by assessing their needs and co-producing solutions to make use of appropriate, local, non-clinical resources or interventions. Because the role is new, link workers might not have professional backgrounds in dealing with individuals with complex needs, which can affect their decision making for the referral of individuals to appropriate community assets to support their needs. The aim of this work was to explore link workers’ level of education, and past and current training needs, and to ascertain how much link workers were willing to pay to access and complete training to improve their skill set.

METHODS: A mixed-methods approach was used, including semi-structured interviews with key stakeholders who commission and deliver social prescribing interventions employing link workers, and a stated preference techniques questionnaire containing contingent valuation questions. A thematic analysis approach was used to identify concepts of interest to develop the survey, which contained stated preference techniques to estimate the value of access to training by link workers. Descriptive statistics were used to describe and summarise the data.

FINDINGS: 54 respondents took the survey. 23 (43%) held an undergraduate degree and 13 (24%) held a Masters’ degree as their highest level of education; the remainder 18 (33%) did not have a graduate qualification. Social prescribing coordinators (n=6) interviews and link worker surveys (n=54) reported personal skills as the most essential skills required by link workers in developing relationships for effective social prescribing interventions. Training is available for link workers; however, training varies depending on the type of intervention delivered, with 38 (70%) of 54 link workers previously completing training to facilitate their development as a link worker. Results from the stated preference techniques questionnaire (n=54) indicated that 100% of the respondents would consider benefitting from training. Link workers are willing to pay an average of £58 from their personal funds to access training and the associated benefits to enhance their skills and knowledge.

INTERPRETATION: Our findings suggest that training needs to be included in social innovation funding applications to ensure that link workers receive adequate training to carry out their role of effective future social prescribing interventions. For the community of practice in social prescribing, training for link workers should be made available in their own local areas. External funding for the salary of the link worker is an obstacle for link worker development through training. Willingness-to-pay findings suggest that link workers place value on their professional development and would be willing to spend their own money on training to improve their knowledge and skills.

FUNDING: AM is supported by a KESS 2 studentship.

PMID:36426499 | DOI:10.1016/S0140-6736(22)02289-9

Lancet. 2022 Nov;400 Suppl 1:S68. doi: 10.1016/S0140-6736(22)02278-4.

ABSTRACT

BACKGROUND: Cervical cancer is the fourth most common cancer in women worldwide. We aimed to assess the burden of cervical cancer risk factors among women in eight west African countries.

METHODS: Cross-sectional data from nationally representative samples of eight west African countries (Benin, Cameroon, Gambia, Guinea, Liberia, Mali, Nigeria, and Sierra Leone) as part of the demographic and health survey 2017-2020 were used. The interviewer-assisted survey assessed eight cervical cancer risk factors (smoking, early coitus, body-mass index, parity, early pregnancy, length of hormonal contraceptive use, multiple sexual partners, and sexually-transmitted infections). Data were analysed using descriptive statistics and Poisson regression. The Demographic and Health Service programme has ethical review documentation on the privacy and confidentiality of the respondents. We received authorisation to use the data from the Demographic and Health Service repository.

FINDINGS: A total of 128 173 women aged 15-49 years participated. Liberia had the highest number of risk factors (mean 3·05; SD 1·19), and Benin had the lowest (mean 2·20; SD 1·14). The mean age of first sexual intercourse was highest in Gambia at 18·15 years (95% CI 17·98-18·32) and lowest in Liberia at 15·72 years (15·62-15·81). Similarly, the highest mean age of first birth was 19·83 years (19·66-20·00) in Gambia, and the lowest is in Liberia at 18·69 years (18·54-18·83). Aside from Mali (45·9%), more than 50·0% of the women had at least two children. Age of first sexual intercourse, age of first birth, and parity were the most frequent risk factors across all the countries. Different age groups were significantly associated with the number of risk factors. Liberian women aged 30-34 years had the highest IRR of 30% (1·18-1·42; p<0·001) among all the countries. Women with the highest education level in Gambia and Nigeria had reduced risk. Limitations of the study included data collection from countries on different years and no human papillomavirus status data collection.

INTERPRETATION: Identification of age of first sexual intercourse, age of first birth, and parity as the most frequent risk factors of cervical cancer will support more focused public health interventions (such as human papillomavirus vaccination and cervical screening) in the countries that the data was collected from, as well as globally.

FUNDING: Federal Government of Nigeria.

PMID:36426487 | DOI:10.1016/S0140-6736(22)02278-4

Lancet. 2022 Nov;400 Suppl 1:S65. doi: 10.1016/S0140-6736(22)02275-9.

ABSTRACT

BACKGROUND: Adolescent dating and relationship violence (DRV) is widespread and associated with increased risk of subsequent poor mental health outcomes and partner violence in adulthood. Shifting social norms could be important for reducing DRV. We aimed to map and evaluate measures of social norms concerning DRV and gender reported in DRV research.

METHODS: We did a systematic review of global peer-reviewed and grey DRV literature in English, reporting on content and validity of measures used with individuals aged 10-18 years in four domains: descriptive DRV norms, injunctive DRV norms, descriptive gender norms, and injunctive gender norms. Searches included nine databases and Google Scholar (original search up to June, 2019; updated March, 2022), organisation websites (June, 2020), reference checking and known studies (June, 2019-May, 2022), and expert requests (September, 2019-April, 2022). Search terms included three concepts linked by “AND”: “social norms concerning DRV and/or gender”, “DRV”, and “adolescents”. Results were screened by title and abstract and then full text. After data extraction we summarised measure characteristics within each domain and assessed measures against seven quality criteria: participatory development, defined reference group, reliability (internal consistency, test-retest reliability, or split-half reliability), content validity, construct validity (association with DRV behaviour), other evidence of construct validity (association with theoretically related constructs) or convergent validity (factor analysis), and statistically desirable properties (responsiveness, absence of floor or ceiling effects, or data available on measures of central tendency and distribution of total score).

FINDINGS: 24 reports were included (14 North America, four Africa, four Europe, one Middle East, one Latin America) containing 40 measures assessing DRV (n=33) and gender (n=7) norms. No measure was shared across studies. 36 (90%) measures were significantly associated with DRV outcomes, 24 (60%) showed good reliability, and 38 (95%) had a defined reference group. Other evidence of quality was mixed. Several DRV norm measures specified heterosexual relationships, but measures rarely separated norms governing DRV by girls and boys. No measures specified same-sex relationships. Gender norm measures focused on violence, but missed broader gendered expectations underpinning DRV.

INTERPRETATION: Valid, reliable measures of social norms associated with DRV exist, but measurement methods are inconsistent. Researchers should report on development and quality of such measures, which should be gender-specific when norms exert gendered influence, consider sexual minority relationships, and assess gender norms beyond gendered violence. Evaluators should draw on such measures to assess whether changes to norms mediate effect on DRV.

FUNDING: US Agency for International Development (agreement number AID-OAA-A-15-00042).

PMID:36426484 | DOI:10.1016/S0140-6736(22)02275-9