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Nevin Manimala Statistics

Informal caregivers of people with a diagnosis of schizophrenia: determinants and predictors of resilience

J Ment Health. 2021 Jul 20:1-8. doi: 10.1080/09638237.2021.1952945. Online ahead of print.

ABSTRACT

BACKGROUND: The extant literature portrays informal caregiving by family members who care for a person with a diagnosis of schizophrenia, as one that involves a tremendous amount of stress and burden.

AIM: This investigation sought to assess informal caregiving experience with regard to variables such as perceived positive aspects, preparedness, resilience, and life satisfaction.

METHOD: Data was collected from two groups of respondents accessing services at the Thanjavur Medical College Hospital, Tamil Nadu, India. The study group consisted of 75 family caregivers of persons with a diagnosis of schizophrenia and the reference group had an equal number of caregivers of people with minor physical ailments. The two groups were matched on important background factors, ensuring their comparability. Standardised instruments were administered to all respondents to collect data pertaining to the key variables and analysed using appropriate statistical procedures.

RESULTS: Results indicated that caregivers of people with a diagnosis of schizophrenia, while manifesting higher levels of resilience, perceived lesser positive aspects in their caring role. A significant statistical difference between both groups of respondents in terms of their life satisfaction and resilience. Regression analyses extracted preparedness and life satisfaction as significant contributors to the manifestation of resilience in the caregivers.

CONCLUSIONS: The study highlights the importance of caregiver preparedness and life satisfaction in enhancing their resilience.

PMID:34282713 | DOI:10.1080/09638237.2021.1952945

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A comparison of small-area deprivation indicators for public-health surveillance in Sweden

Scand J Public Health. 2021 Jul 20:14034948211030353. doi: 10.1177/14034948211030353. Online ahead of print.

ABSTRACT

AIMS: The aims of this study were to construct a small-area index of multiple deprivation (IMD) from single deprivation indicators (SDIs) and to compare the explanatory power of the IMD and SDIs with regard to mortality. We considered a small-area division of Sweden consisting of 5985 DeSO (Demografiska statistikområden), each with a population size between 653 and 4243 at the end of 2018.

METHODS: Four SDIs were provided by open-source data: (a) the proportion of inhabitants with a low economic standard; (b) the proportion of inhabitants aged 25-64 years with ⩽12 years of schooling; (c) the proportion of inhabitants aged 16-64 years who were not in paid employment; and (d) the proportion of inhabitants who lived in a rented apartment/house. A four-indicator IMD was constructed using factor analysis. As a validation, the IMD and SDIs were compared by exploring their DeSO-level associations with spatially smoothed death rates, with robustness checks of associations across different small-area contexts defined by degree of urbanisation and distribution of immigrants from non-Western countries.

RESULTS: The constructed IMD and SDI1 performed essentially equally and outperformed SDI2, SDI3 and SDI4. Associations between IMD/SDI1 and the spatially smoothed death rates were most pronounced within the age range 60-79 years, showing 5-8% lowered rates among those categorised in the least deprived quintiles of IMD and SDI1, respectively, and 7-9% elevated rates among those categorised in the most deprived quintiles. These associations were consistent within each small-area context.

CONCLUSIONS: We suggest prioritisation of SDI1, that is, a DeSO-level deprivation indicator based on open-access data on economic standard, for public-health surveillance in Sweden.

PMID:34282665 | DOI:10.1177/14034948211030353

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Periodontal Disease and Oral Health-Related Quality of Life in the Older Population in Indonesia

JDR Clin Trans Res. 2021 Jul 20:23800844211021391. doi: 10.1177/23800844211021391. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite being acknowledged as the second global burden of oral disease, periodontal disease has few epidemiologic studies in the literature, particularly for developing countries. Many previous studies have assessed the relationship between periodontal disease and oral health-related quality of life (OHRQoL), with patients attending dental clinic or hospitals rather than a general population. This study attempted to fill the knowledge gap in limited information about periodontal disease and OHRQoL, with reference to a general population in a developing country.

OBJECTIVES: To investigate the relationship between OHRQoL and periodontal diseases in an older population in Indonesia.

METHODS: We invited 582 older people from community health centers. The 369 (63.4%) older people who agreed to participate consented to an oral health examination and a questionnaire capturing demographic, socioeconomic, behavioral, and Oral Health Impact Profile-14 (OHIP-14) data.

RESULTS: Almost 75% of the older people had generalized periodontitis; 3% had healthy periodontal status; and around 22% had localized periodontitis. There was a lack of statistical evidence for an association between periodontal disease status and OHRQoL. This result was based on the appraisal of the prevalence of the impact (Odds ratio [OR], 0.95 [95% CI, 0.54 to 1.59]; P = 0.77), difference in mean severities (0.07 [95% CI, -1.66 to 1.80]; P = 0.94), and extent of the impact (P = 0.996). However, we found evidence for a relationship between tooth mobility and OHRQoL for all of the OHIP assessments, including prevalence of the impact (OR, 1.87 [95% CI, 1.16 to 3.01]; P = 0.009), difference in mean severities (-2.98 [95% CI, -4.50 to -1.45]; P < 0.001), and extent of the impact (P = 0.001).

CONCLUSION: There was a lack of statistical evidence for a relationship between periodontal disease status and OHRQoL in this society. However, we found evidence that tooth mobility, as a sign of periodontal disease progression, is related to OHRQoL.

KNOWLEDGE TRANSFER STATEMENT: The present study can be used by dentists, community health workers, and policy makers in Indonesia to understand the prevalence, severity, and extent of the negative impacts of periodontal disease on older people’s quality of life. In addition, this study provides information about factors that might considerably affect the oral health-related quality of life in this society, such as brushing habits, dental visit, family income, DMF-T status, and subjective appraisal toward dental health.

PMID:34282670 | DOI:10.1177/23800844211021391

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Positive Masculinities and Gender-Based Violence Educational Interventions Among Young People: A Systematic Review

Trauma Violence Abuse. 2021 Jul 20:15248380211030242. doi: 10.1177/15248380211030242. Online ahead of print.

ABSTRACT

BACKGROUND: Hegemonic masculinity has been recognized as contributing to the perpetration of different forms of gender-based violence (GBV). Abandoning hegemonic masculinities and promoting positive masculinities are both strategies used by interventions that foreground a “gender-transformative approach.” Preventing GBV among young people could be strengthened by engaging young men. In this article, we aim to systematically review the primary characteristics, methodological quality, and results of published evaluation studies of educational interventions that aim to prevent different forms of GBV through addressing hegemonic masculinities among young people.

MAIN BODY: We conducted a systematic review of available literature (2008-2019) using Medline (PubMed), Scopus, Web of Science, PsycInfo, the CINAHL Complete Database, and ERIC as well as Google scholar. The Template for Intervention Description and Replication was used for data extraction, and the quality of the selected studies was analyzed using the Mixed Method Appraisal Tool. More than half of the studies were conducted in Africa (n = 10/15) and many were randomized controlled trials (n = 8/15). Most of the studies with quantitative and qualitative methodologies (n = 12/15) reported a decrease in physical GBV and/or sexual violence perpetration/victimization (n = 6/15). Longitudinal studies reported consistent results over time.

CONCLUSIONS: Our results highlight the importance of using a gender-transformative approach in educational interventions to engage young people in critical thinking about hegemonic masculinity and to prevent GBV.

PMID:34282677 | DOI:10.1177/15248380211030242

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Changes in the Transverse Dimension of the Maxillary Arch of 5-Year-Olds Born With UCLP Since the Introduction of Nationwide Guidance

Cleft Palate Craniofac J. 2021 Jul 20:10556656211028511. doi: 10.1177/10556656211028511. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether the transverse dimensions of the maxillary arch of 5-year-old children with unilateral cleft lip and palate (UCLP) have changed following centralization of cleft services in the United Kingdom.

DESIGN: Retrospective cross-sectional study.

SETTING: Digital analysis of UCLP maxillary dental casts.

PARTICIPANTS: All available maxillary dental casts from 5-year-old participants of the Clinical Standards Advisory Group (CSAG, N = 114) and Cleft Care UK (CCUK, N = 175) studies.

INTERVENTIONS: Quantitative measurements of the intercanine width (ICW), intermolar width (IMW), and the distance from the midline to the greater and lesser side canine (GC/LC) and greater side and lesser side second primary molar (GE/LE). Degree measurements of the greater and lesser arch form angles, arch length, anterior palatal depth (APD), and posterior palatal depth were also measured.

MAIN OUTCOME: Differences between the transverse dimensions of the maxillary arch for the CSAG and CCUK cohorts.

RESULTS: In 5 (ICW, IMW, LC, LE, and APD) of the 11 measurements, there was a statistically significant difference between the CSAG and CCUK cohorts. In all of these, the CCUK values were greater than CSAG.

CONCLUSIONS: There have been small but positive improvements for the transverse maxillary dimensions since centralization of the UK cleft service.

PMID:34282648 | DOI:10.1177/10556656211028511

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Orladeyo (Berotralstat): A Novel Oral Therapy for the Prevention of Hereditary Angioedema

Ann Pharmacother. 2021 Jul 20:10600280211032982. doi: 10.1177/10600280211032982. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this article is to review the available trials that led to the Food and Drug Administration (FDA) approval of berotralstat, an oral kallikrein inhibitor, for the prevention of hereditary angioedema (HAE) attacks.

DATA SOURCES: PubMed and ClincalTrials.gov were searched using key term berotralstat to identify phase III clinical trials related to the FDA approval of berotralstat from April 2018 to May 2021.

STUDY SELECTION AND DATA EXTRACTION: Trials selected were those that influenced the FDA approval of berotralstat or provided novel information regarding the safety and efficacy of this therapy in the treatment of HAE.

DATA SYNTHESIS: Both APeX-2 and ApeX-J found clinically significant benefit with berotralstat 150 mg daily for reduction in HAE attacks when compared with placebo (1.31 vs 2.35, P < 0.001, and 1.11 vs 2.18, P < 0.001, attacks in the APeX-2 and APeX-J trials, respectively). APeX-2 also showed a statistically significant benefit for berotralstat 110 mg daily (1.65 vs 2.35 attacks [1.65 attacks, P = 0.024]).

RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: An advantage berotralstat has over the other approved therapies is that it is administered orally, which may garner patient preference because of ease of administration. Berotralstat has also shown a potential benefit in reducing the need for standard-of-care treatment for HAE attacks, which has not been studied with alternative agents.

CONCLUSIONS: Berotralstat 150 mg daily has been proven safe and effective in clinical studies and appears to be a viable oral alternative to parenteral medications currently used in HAE prophylaxis.

PMID:34282650 | DOI:10.1177/10600280211032982

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Relative Validity and Reproducibility of a Food Frequency Questionnaire for Assessing Dietary Patterns and Food Group Intake in Older New Zealand Adults: The Researching Eating, Activity, and Cognitive Health Study

J Acad Nutr Diet. 2021 Jul 16:S2212-2672(21)00372-5. doi: 10.1016/j.jand.2021.05.022. Online ahead of print.

ABSTRACT

BACKGROUND: Dietary pattern analysis considers the overall dietary intake and combinations of foods eaten. Valid and reproducible tools for determining dietary patterns are necessary to assess diet-disease relationships.

OBJECTIVE: This study evaluated the relative validity and reproducibility of the Researching Eating, Activity, and Cognitive Health (REACH) Study food frequency questionnaire (FFQ) specifically designed to identify dietary patterns in older adults.

DESIGN: A subset of participants from the REACH study completed two identical 109-item FFQs 1 month apart (FFQ1 and FFQ2) to assess reproducibility and a 4-day food record between FFQ administrations to assess relative validity. Foods from each dietary assessment tool were assigned to 57 food groups. Principal component analysis was applied to the food group consumption reported in each dietary assessment tool to derive dietary patterns.

PARTICIPANTS AND SETTING: Dietary data were collected (2018 and 2019) from a subset of the REACH study (n = 294, 37% men) aged 65 to 74 years, living in Auckland, New Zealand.

MAIN OUTCOME MEASURES: Daily intakes of 57 food groups and dietary patterns of older adults participating in REACH living in New Zealand.

STATISTICAL ANALYSIS: Agreement of dietary pattern loadings were assessed using Tucker’s congruence coefficient. Agreement of dietary pattern scores and food group intakes were assessed using Spearman correlation coefficients (acceptable correlation rho = 0.20 to 0.49), weighted kappa statistic (acceptable statistic κw = 0.20 to 0.60), and Bland-Altman analysis, including mean difference, limits of agreement, plots, and slope of bias.

RESULTS: Three similar dietary patterns were identified from each dietary assessment tool: Mediterranean style, Western, and prudent. Congruence coefficients between factor loadings ranged from 0.54 to 0.80. Correlations of dietary pattern scores ranged from 0.47 to 0.59 (reproducibility) and 0.33 to 0.43 (validity) (all P values < 0.001); weighted kappa scores from 0.40 to 0.48 (reproducibility) and 0.27 to 0.37 (validity); limits of agreement from ± 1.79 to ± 2.09 (reproducibility) and ± 2.09 to ± 2.27 (validity); a negative slope of bias was seen in the prudent pattern for reproducibility and validity (P < 0.001).

CONCLUSIONS: The REACH FFQ generated dietary patterns with acceptable reproducibility and relative validity and therefore can be used to examine associations between dietary patterns and health outcomes in older New Zealand adults.

PMID:34281811 | DOI:10.1016/j.jand.2021.05.022

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Comparison of the efficacy of two-time versus one-time micro-osteoperforation on maxillary canine retraction in orthodontic patients: A split-mouth randomized controlled clinical trial

Int Orthod. 2021 Jul 16:S1761-7227(21)00082-6. doi: 10.1016/j.ortho.2021.06.003. Online ahead of print.

ABSTRACT

BACKGROUND: Micro-osteoperforation (MOP), a minimally invasive technique for accelerating the rate of orthodontic tooth movement has been research extensively, but with varied clinical results.

OBJECTIVE: To compare the efficacy of one-time versus two-time micro-osteoperforation on the rate of maxillary canine retraction, its influence on anchorage loss, canine angulation and the levels of interleukin (IL-1β) in gingival crevicular fluid (GCF).

MATERIALS AND METHODS: The split-mouth study included 16 patients in which the left and right sides were randomly allocated to the control side (one-time MOP) and experimental side (two-time MOP). MOP was performed on both sides distal to the maxillary canines and canine retraction was carried out using NiTi closed coil springs (150gm) and direct anchorage with miniscrew implants. The second MOP was performed on experimental side one month after the first MOP. The rate of canine movement was assessed using 3D model superimposition over a period of six months. The type of tooth movement, anchorage loss and levels of IL-1β were also evaluated.

RESULTS: Sixteen patients (mean age, 17.87±3.34 years) were analysed for a rate of canine retraction, anchorage loss, and type of tooth movement, while 15 patients were analysed for IL-1β. The rate was significantly higher on two-time MOP side after two months (P<0.001). No statistical difference was found in anchorage loss and controlled tipping of canines was observed. The IL-1β levels immediately after 2nd MOP were significantly higher than 1st MOP (P<0.001).

CONCLUSION: The two-time intervention of MOP is more efficacious than one-time MOP in accelerating tooth movement.

PMID:34281788 | DOI:10.1016/j.ortho.2021.06.003

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Oxaliplatin, an Anticancer Agent, Causes Erectile Dysfunction in Rats due to Endothelial Dysfunction

J Sex Med. 2021 Jul 16:S1743-6095(21)00529-4. doi: 10.1016/j.jsxm.2021.06.004. Online ahead of print.

ABSTRACT

BACKGROUND: Chemotherapeutics, one of the standard treatment options for cancer worldwide, have various adverse effects, including erectile dysfunction (ED).

AIM: To investigate erectile function in an animal model after administration of the anticancer agent oxaliplatin (L-OHP).

METHODS: Male Wistar/ST rats were divided into 2 groups: L-OHP rats (n = 21), which were intravenously administered L-OHP (4 mg/kg; twice a week for 4 weeks), and Control rats (n = 21), which were injected with the same volume of 5% glucose solution, using the same dosing schedule. At the end of the study period, erectile function was evaluated by measuring intracavernous pressure (ICP) and mean arterial pressure (MAP) after cavernous nerve stimulation (n = 9-10). Endothelial function was evaluated with an isometric tension study using corpus cavernosum strips (n = 11). Western blot analysis was used to assess neuronal nitric oxide (nNOS) and endothelial NO synthase (eNOS) protein levels (n = 7). Real-time quantitative polymerase chain reaction (qRT-PCR) was used to assess the expression of inflammation- and oxidative stress-related markers (nicotinamide adenine dinucleotide phosphate oxidase-1, p22phox, interleukin [IL]-6, and nuclear factor-kappa B) (n = 6). Statistical significance was determined using the Student’s t-test.

OUTCOMES: The L-OHP group had a significantly lower ICP:MAP ratio than the control group (P < .05). Compared to the Control group, the L-OHP group exhibited significantly lower responses to ACh and eNOS protein levels and significantly higher inflammatory biomarker levels.

CLINICAL TRANSLATION: The results based on this animal model indicate that use of the anticancer agent L-OHP should be considered as a risk factor for ED occurring via reduction of NO bioavailability in humans; our results provide possible treatment strategies for maintaining the erectile function of cancer survivors.

STRENGTHS AND LIMITATIONS: Our study showed that the anticancer agent L-OHP has the propensity to cause ED in rats. A major limitation of this study is the lack of an established cure for ED associated with L-OHP and the lack of clinical evidence.

CONCLUSIONS: L-OHP causes ED in rats via reduction of NO bioavailability caused by endothelial dysfunction. Kataoka T, Mori T, Suzuki J, et al. Oxaliplatin, an Anticancer Agent, Causes Erectile Dysfunction in Rats due to Endothelial Dysfunction. J Sex Med 2021;XX:XXX-XXX.

PMID:34281797 | DOI:10.1016/j.jsxm.2021.06.004

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VATS Versus Open Lobectomy in Pathological T1 SCLC: A Multi-Center Retrospective Analysis

Clin Lung Cancer. 2021 Jun 24:S1525-7304(21)00158-3. doi: 10.1016/j.cllc.2021.06.007. Online ahead of print.

ABSTRACT

BACKGROUND: Video-assisted thoracic surgery (VATS) has been widely used in the surgical treatment of thoracic diseases, and it suggested surgical and oncological advantages compared with open surgery. However, reports on the application of VATS in surgery of small cell lung cancer (SCLC) are scarce. This study aimed to explore the advantages and disadvantages of different surgical approaches in the treatment of pathological stage T1(pT1) SCLC in terms of safety, clinical outcomes, and lymph node dissection.

PATIENTS AND METHODS: Patients who underwent lobectomy for pT1 SCLC between January 2014 and September 2017 were identified from the National Collaborative Lung Cancer Database (LinkDoc Database). The patients were stratified based on the surgery approach (VATS or open lobectomy). Perioperative outcomes and long-term survival were analyzed using SPSS software.

RESULTS: A total of 169 patients with pT1 SCLC met the criteria and were enrolled for this study, including 110 cases of VATS lobectomies and 59 cases of open lobectomies. VATS lobectomy was associated with less blood loss than open surgery (168.1 ± 237.4 vs. 340.0 ± 509.8 mL, P = .002). Open lobectomy harvested more N2 LNs (11.8 ± 8.2 vs. 8.4 ± 5.8, P = .048) and identified more metastasis positive LNs (3.1 ± 6.0 vs. 1.4 ± 3.0, P = .050). Open lobectomy associated with longer overall survival (OS) but has no statistical difference (23.4 ± 13.2 vs. 20.2 ± 10.9, P = .070).

CONCLUSION: Open lobectomy had better lymph node dissection results, and comparable postoperative complications, postoperative hospital stay, and OS to VATS lobectomy. Further studies may still be needed to confirm the recommendation of thoracoscopic approach as a routine surgical procedure for operable SCLC, and until then, open surgery should still be considered.

PMID:34281774 | DOI:10.1016/j.cllc.2021.06.007