Tag: nevin manimala

Eur J Contracept Reprod Health Care. 2021 Mar 15:1-7. doi: 10.1080/13625187.2021.1891409. Online ahead of print.

ABSTRACT

INTRODUCTION: Contraceptive counselling is essential in women with chronic disease, though it is frequently overlooked. We aimed to assess practices and awareness in contraceptive counselling in hospital physicians caring for reproductive age women with chronic disease.

METHODS: A questionnaire was distributed in April 2017 to physicians from 16 medical specialties in a tertiary care hospital in Portugal. Statistical analysis performed using Microsoft Office Excel^® and IBM SPSS-Statistics^®.

RESULTS: Two-hundred physicians participated in the survey: 59.5% were female, 55% under 35 years-old and 48.5% were residents. Only 26.5% practiced in surgical specialties. Two-thirds consistently inquired about the use of contraception. Most referred patients to Family Planning services or performed contraceptive counselling when pregnancy posed significant health risks (89.0%), when prescribing teratogenic medication (79.5%) or drugs with potential interaction with contraceptives (75.0%). Lack of training in contraception was the main reason for not referring patients to Family Planning services. While 83% considered counselling very important, only 5% had recently undergone training and 12.5% felt knowledgeable enough to perform it. Only 12.5% were aware of the institution’s Family Planning resources. Female gender, non-surgical specialty, age over 35 years-old and over 10 years since specialisation were positively associated with awareness.

CONCLUSION: Most physicians addressed contraceptive management in women with comorbidities, but adequate training is lacking. Our results highlight the importance of communication between health care providers to achieve an adequate and multidisciplinary approach to reproductive and general health goals.

PMID:33719811 | DOI:10.1080/13625187.2021.1891409

Psychol Health Med. 2021 Mar 9:1-9. doi: 10.1080/13548506.2021.1898650. Online ahead of print.

ABSTRACT

This study evaluates Brazilians medical students’ Quality of Life and verified associated factors, according to graduation medical cycles: basic (two first years), theoretical-practical (third and fourth years) and clinical (fifth and sixth years). Data were obtained from QualiMed study, conducted at Medical School of Federal University of Minas Gerais, Brazil, using WHOQOL-Bref. Analyses were performed using ANOVA and multiple logistic regressions. A total of 1470 medical students participated and were more satisfied than dissatisfied with their quality of life. Psychological Domain obtained the worst assessment (60.64) and Environment Domain the best one (68.14). The perception of quality of life improved over the course, being worse in the basic cycle and better in the clinical cycle, statistically different for all domains (p-value<0.05). Most variables were negatively associated with quality of life, indicating that their absence reduces the chances of a better perception. Absence of regular physical activity and having depression symptoms were negatively associated with all WHOQOL-Bref Domains. Individual, behavioral and psychological aspects negatively impact the quality of life of evaluated students. Psychological support strategies, encouraging resilience and carrying out physical activities are recommended to improve quality of life, mainly in first years of medical school.

PMID:33719749 | DOI:10.1080/13548506.2021.1898650

Curr Med Res Opin. 2021 Mar 15:1. doi: 10.1080/03007995.2021.1902295. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the health-related quality of life (HRQoL) burden associated with postpartum depression (PPD), determine the extent to which clinical response impacts HRQoL, and estimate the impact of PPD and clinical response on healthcare resource utilization (HRU) and productivity.

METHODS: Patient data (n = 127) from two multicenter, randomized, double-blind, placebo-controlled phase 3 clinical trials evaluating the safety and efficacy of brexanolone injection in adults with PPD were employed for these post-hoc analyses. HRQoL and health utility were assessed with the SF-36-v2 Health Survey (SF-36v2) acute version. The 17-item Hamilton Rating Scale for Depression (HAMD-17) total score was used to identify clinical response (≥50% reduction in HAMD-17 total score). Baseline HRQoL burden was assessed by comparison to age- and gender-adjusted population normative data from the 2009 QualityMetric PRO Norming study. The impact of clinical response was evaluated by comparing day 7 and day 30 SF-36v2 scores between clinical responders and non-responders. Interpretations of the meaningfulness of clinical response was indirectly estimated via 2017 National Health and Wellness Survey data linking SF-36v2 mental component summary (MCS) scores to (HRU) and productivity.

RESULTS: Baseline HRQoL of patients with PPD was significantly below normative values. Day 7 and day 30 clinical response were associated with large and statistically significant improvements in HRQoL, greater likelihood of meeting SF-36v2 responder definitions, and reduced impairment. MCS levels corresponding to those observed in clinical responders were linked to lower HRU and productivity loss relative to non-responders.

CONCLUSIONS: PPD places substantial burden on HRQoL. Achievement of rapid clinical response (at day 7) and clinical response sustained several weeks following end of treatment (day 30) led to significant improvement in HRQoL, suggesting the importance of identifying women with PPD and providing effective treatment options.

PMID:33719782 | DOI:10.1080/03007995.2021.1902295

J Prim Care Community Health. 2021 Jan-Dec;12:21501327211002099. doi: 10.1177/21501327211002099.

ABSTRACT

INTRODUCTION: Health care workers (HCWs) are at the forefront to fight against COVID-19 pandemic. They are at more risk of contracting the infection. This study was planned to assess potential risk factors of 2019-novel coronavirus infection among HCWs working in a health facility and to evaluate the effectiveness of infection prevention and control measures among them.

METHODS: A study was conducted in a tertiary care hospital among HCWs who were directly or indirectly involved in the management of a confirmed or suspected case of COVID-19. The socio-demographic characteristics, history of exposure, IPC measures followed and clinical symptoms were compared between health care workers in COVID and non-COVID areas.

RESULTS: Majority (45%) of HCWs were nurses, followed by hospital/sanitary/technical attendants (30%) and doctors (24%). Out of a total of 256 HCWs, 2% tested positive. Around 80% of HCWs had ever attended any IPC training. A statistically significant association was found between posting area of HCWs and their exposure to COVID patients (duration of exposure, PPE has worn by HCWs, direct contact of HCWs with the patient’s material) and COVID positivity (P value <.001).

CONCLUSION: If health care workers were trained and take adequate precautions then the risk of getting an infection is minimized.

PMID:33719717 | DOI:10.1177/21501327211002099

Pers Soc Psychol Bull. 2021 Mar 10:146167221997619. doi: 10.1177/0146167221997619. Online ahead of print.

ABSTRACT

In recent years, an upsurge of polarization has been a salient feature of political discourse in America. A small but growing body of research has examined the potential relevance of intellectual humility (IH) to political polarization. In the present investigation, we extend this work to political myside bias, testing the hypothesis that IH is associated with less bias in two community samples (N₁ = 498; N₂ = 477). In line with our expectations, measures of IH were negatively correlated with political myside bias across paradigms, political topics, and samples. These relations were robust to controlling for humility. We also examined ideological asymmetries in the relations between IH and political myside bias, finding that IH-bias relations were statistically equivalent in members of the political left and right. Notwithstanding important limitations and caveats, these data establish IH as one of a small handful psychological features known to predict less political myside bias.

PMID:33719720 | DOI:10.1177/0146167221997619

Public Health Rep. 2021 Mar 15:333549211000305. doi: 10.1177/00333549211000305. Online ahead of print.

ABSTRACT

During the Russian influenza pandemic, which reached the United States in late 1889, US public health officials attempted to document the number of deaths associated with this disease outbreak. A historical perspective illuminates the complex categories used to classify deaths from influenza-associated diseases; substantial changes in weekly, monthly, and yearly death totals; and thoughtful efforts by health officials to measure the epidemic as it happened. The 1114 influenza deaths reported by the Connecticut State Board of Health in the 3 years after the January 1890 outbreak must be supplemented by the notable increases in the number of deaths from respiratory diseases, which elevates the likely toll to more than 7000 deaths during the epidemic. Whereas historians of public health have primarily examined efforts to control communicable diseases, this case study of mortality statistics reported by town officials and analyzed by the Connecticut State Board of Health demonstrates how officers of the local boards of health also responded to unexpected outbreaks of a familiar disease such as influenza. Understanding how organizations measured influenza-associated mortality illustrates an important stage in the development of American public health and also makes an important contribution to studying pandemics in history.

PMID:33719735 | DOI:10.1177/00333549211000305

J Transcult Nurs. 2021 Mar 10:1043659621999829. doi: 10.1177/1043659621999829. Online ahead of print.

NO ABSTRACT

PMID:33719744 | DOI:10.1177/1043659621999829

J Orthod. 2021 Mar 15:14653125211001079. doi: 10.1177/14653125211001079. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the colour stability of polymeric resins that could be used to 3D-print orthodontic brackets.

DESIGN: In vitro, laboratory study.

MATERIALS AND METHODS: Disc-shaped specimens were fabricated via 3D printing using three resins: Dental LT; Dental SG; and Clear. Five conditions were evaluated for each resin (n = 10 per treatment per resin) to assess its corresponding effect on colour and translucency: immersion in (1) red wine, (2) coffee, (3) tea and (4) distilled water (control), and (5) exposure to accelerated aging. Colour and translucency measurements were made before and after exposure using a spectrophotometer. Mean colour differences (ΔE₀₀) and changes in translucency parameter (ΔTP₀₀) were calculated for each sample using the CIEDE2000 colour difference formula.

RESULTS: Statistically significant effects of the resin material, the treatment condition and interactions effects of material and condition were observed for ΔE₀₀ and ΔTP₀₀ (P < 0.001). The most pronounced changes in colour (ΔE₀₀) were a result of the staining effects of wine on all three resins, ranging from 14.5 ± 0.6 to 20.8 ± 1.2. Dental LT, Dental SG and Clear resins all showed changes in colour when exposed to certain staining agents. Dental SG and Clear resins exhibited changes in colour with aging, while the colour of Dental LT resin remained stable with aging.

CONCLUSIONS: The colour changes of the resins investigated does not support their use in 3D-printed aesthetic bracket applications.

PMID:33719707 | DOI:10.1177/14653125211001079

Med Decis Making. 2021 Mar 10:272989X21994553. doi: 10.1177/0272989X21994553. Online ahead of print.

ABSTRACT

BACKGROUND: Surrogate endpoints (i.e., intermediate endpoints intended to predict for patient-centered outcomes) are increasingly common. However, little is known about how surrogate evidence is handled in the context of health technology assessment (HTA).

OBJECTIVES: 1) To map methodologies for the validation of surrogate endpoints and 2) to determine their impact on acceptability of surrogates and coverage decisions made by HTA agencies.

METHODS: We sought HTA reports where evaluation relied on a surrogate from 8 HTA agencies. We extracted data on the methods applied for surrogate validation. We assessed the level of agreement between agencies and fitted mixed-effects logistic regression models to test the impact of validation approaches on the agency’s acceptability of the surrogate endpoint and their coverage recommendation.

RESULTS: Of the 124 included reports, 61 (49%) discussed the level of evidence to support the relationship between the surrogate and the patient-centered endpoint, 27 (22%) reported a correlation coefficient/association measure, and 40 (32%) quantified the expected effect on the patient-centered outcome. Overall, the surrogate endpoint was deemed acceptable in 49 (40%) reports (k-coefficient 0.10, P = 0.004). Any consideration of the level of evidence was associated with accepting the surrogate endpoint as valid (odds ratio [OR], 4.60; 95% confidence interval [CI], 1.60-13.18, P = 0.005). However, we did not find strong evidence of an association between accepting the surrogate endpoint and agency coverage recommendation (OR, 0.71; 95% CI, 0.23-2.20; P = 0.55).

CONCLUSIONS: Handling of surrogate endpoint evidence in reports varied greatly across HTA agencies, with inconsistent consideration of the level of evidence and statistical validation. Our findings call for careful reconsideration of the issue of surrogacy and the need for harmonization of practices across international HTA agencies.

PMID:33719711 | DOI:10.1177/0272989X21994553

J Am Psychiatr Nurses Assoc. 2021 Mar 14:1078390321999725. doi: 10.1177/1078390321999725. Online ahead of print.

ABSTRACT

BACKGROUND: Although previous studies have separately revealed that parameters such as anxiety, depression, and secondary traumatic stress (STS) are associated with burnout, there is still a limited understanding of the relationship between anxiety, depression, and STS and burnout in intensive care unit (ICU) nurses.

AIMS: To investigate the relationship between levels of burnout, anxiety, depression, and STS in ICU nurses.

METHOD: A cross-sectional study was conducted with ICU nurses (N = 164) from a university hospital in eastern Turkey. The participants completed the anxiety, depression, STS, and burnout scales along with the descriptive characteristics form. The data were analyzed using descriptive statistics, correlation, and logistic regression analysis.

RESULTS: The mean scores for STS, anxiety, depression, and burnout were 40.60 ± 13.77, 17.14 ± 12.90, 13.28 ± 9.75 and 41.39 ± 14.87, respectively. The results showed that, in the ICU nurses, anxiety, depression, and STS components explained 61% of emotional exhaustion, 38% of depersonalization, and 13% of personal accomplishment.

CONCLUSIONS: While the present findings supported the paradigm that burnout in ICU nurses is associated with STS, anxiety, and depression, they also revealed some details about the psychopathological factors associated with burnout. These details were as follows: (1) individuals who resorted to avoidance as a component of STS on a high level were more likely to experience emotional exhaustion and depersonalization, (2) individuals with severe depressive symptoms were more likely to experience a decrease in their personal accomplishment, and (3) individuals with anxiety symptoms were more likely to experience both emotional exhaustion and personal accomplishment.

PMID:33719680 | DOI:10.1177/1078390321999725