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STI testing among young people attending music festivals in New South Wales, Australia: exploring the client segmentation concept in the ‘Down to Test’ program

Sex Health. 2021 Nov 16. doi: 10.1071/SH21101. Online ahead of print.

ABSTRACT

BACKGROUND: The ‘Down to Test (DTT)’ campaign is a sexually transmissible infection (STI) social marketing intervention delivered through outdoor music festival activations and supported by digital media communications in New South Wales, Australia. This paper investigates whether and how the tailored messages reached the intended audience.

METHODS: Data was collected through three annual rounds of online surveys post campaign exposure, targeting young people (aged 15-29years) attending 14 music festivals in NSW from October 2017 to March 2020. Descriptive statistics, principal component analysis and multivariable logic regression were applied to identify the key client segment and factors associated with a strong intention for future STI screening.

RESULTS: Of the 10044 participants with a valid urine specimen submitted, 261 (2.8%) tested positive for chlamydia. Altogether, 1776 participants (median age=22) self-completed the evaluation surveys online with more being female (73.4%) than male (26.2%). Participants were mostly Australian-born (89.5%), heterosexual (82.6%) and the majority being sexually active (96.7%). Rates of self-reported lifetime STI testing (70.4%) and intention for future STI screening (‘definitely yes’ in the next 12months, 39.0%) were also high. The most significant factor associated with future intention for STI testing is the Sexual Experience and Perception Factor (adjusted odds ratio [AOR]=2.02; 95%CI 1.76-2.32; P<0.001), followed by the Sexual Beliefs and Attitudes Factor (AOR=1.14; 95% CI 1.01-1.30; P<0.05).

CONCLUSIONS: The NSW state-wide DTT campaign has largely reached sexually active youth who are attentive to sexual health promotion messages and contributed to enhanced STI screening in a fun and peer-supportive environment.

PMID:34782058 | DOI:10.1071/SH21101

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Effect of Intramuscular Dexmedetomidine Administration Before Extubation on Post-Extubation Haemodynamics, Postoperative Sedation, and Analgesic Requirements: A Double Blind Placebo Controlled Study

Asian J Anesthesiol. 2021 Sep 1;59(3):102-110. doi: 10.6859/aja.202109_59(3).0004.

ABSTRACT

BACKGROUND: Dexmedetomidine, an α2-adrenoreceptor agonist has been successfully used for attenuating stress response to laryngoscopy. The present study was designed to evaluate the effects of intramuscular dexmedetomidine 30 minutes before extubation on hemodynamic response in patients undergoing laminectomy for prolapsed intervertebral disc (PIVD) under endotracheal intubation and general anesthesia.

METHODS: Present double-blinded randomized placebo-controlled study, included 100 patients from either sex with American Society of Anesthesiologists grades I and II and age from 18 to 60 years undergoing laminectomy for PIVD under general anesthesia. Patients were randomly divided into two groups of 50 each based on computer generated random numbers. The study group received dexmedetomidine (2.0 μg/ kg, i.m.) in 2.5 mL saline, and the control group received normal saline (placebo, i.m.) 2.5 mL. Drugs had been administered 30 minutes before anticipated time of extubation intramuscularly at the deltoid region. Comparison of continuous variables between two groups was done by using student’s unpaired t-test. Categorical data were analyzed by using chi-square test and Fischer Exact test as applicable.

RESULTS: Heart rate was found to be significantly lower in the study group, 15 minutes before extubation (P = 0.003), during and after extubation (P < 0.0001). The systolic and diastolic blood pressure was significantly lower in the study group during and after extubation (P < 0.05). Cough was significantly lower in the study group during extubation. No significant difference was observed in other complications (respiratory stridor, incidence of laryngospasm or bronchospasm and reintubation) between the two groups. Pain score at 5 minutes, 2 hours, and 4 hours post-extubation was significantly lower in the study group (P < 0.01). P-value < 0.05 was considered statistically significant.

CONCLUSIONS: Dexmedetomidine provides haemodynamic stability during extubation and post-extubation. It also provides post-operative calmness and reduces analgesic requirement and post-extubation complications.

PMID:34781421 | DOI:10.6859/aja.202109_59(3).0004

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Use of Homeopathic Arnica montana 30cH for Postoperative Analgesia in Female Dogs Undergoing Elective Ovariohysterectomy

Homeopathy. 2021 Nov 15. doi: 10.1055/s-0041-1732352. Online ahead of print.

ABSTRACT

BACKGROUND: Ovariohysterectomy (OH) is one of the most frequent elective surgical procedures in routine veterinary practice. Arnica montana is a well-known medicine in phytotherapy, with proven analgesic, anti-inflammatory, antiseptic, healing, antioxidant and immunomodulatory activity. However, there is still a shortage of studies on the action and effects of the homeopathic formulation of the medicine on animals. The aim of this study was to evaluate analgesia with Arnica montana 30cH during the postoperative period after elective OH.

METHODS: Thirty healthy female dogs, aged 1 to 3 years, weighing 7 to 14 kg, were selected at the Veterinary Hospital in Campo Mourão, Paraná, Brazil. The dogs underwent the surgical procedure with an anaesthetic protocol and analgesia that had the aim of maintaining the patient’s wellbeing. After the procedure, they were randomly divided into three groups of 10. One group received Arnica montana 30cH; another received 5% hydroalcoholic solution; and the third group, 0.9% NaCl saline solution. All animals received four drops of the respective solution sublingually and under blinded conditions, every 10 minutes for 1 hour, after the inhalational anaesthetic had been withdrawn. The Glasgow Composite Measure Pain Scale was used to analyse the effect of therapy. Analysis of variance (ANOVA) followed by the Tukey test was used to evaluate the test data. Statistical differences were deemed significant when p ≤0.05.

RESULTS: The Arnica montana 30cH group maintained analgesia on average for 17.8 ± 3.6 hours, whilst the hydroalcoholic solution group did so for 5.1 ± 1.2 hours and the saline solution group for 4.1 ± 0.9 hours (p ≤0.05).

CONCLUSION: These data demonstrate that Arnica montana 30cH presented a more significant analgesic effect than the control groups, thus indicating its potential for postoperative analgesia in dogs undergoing OH.

PMID:34781409 | DOI:10.1055/s-0041-1732352

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Tissue Engineered Skeletal Muscle Model of Rheumatoid Arthritis Using Human Primary Skeletal Muscle Cells

J Tissue Eng Regen Med. 2021 Nov 15. doi: 10.1002/term.3266. Online ahead of print.

ABSTRACT

Rheumatoid arthritis (RA) is a chronic inflammatory disease primarily targeting the joints. Autoreactive immune cells involved in RA affect other tissues, including skeletal muscle. Patients with RA experience diminished physical function, limited mobility, reduced muscle function, chronic pain, and increased mortality. To explore the impact of RA on skeletal muscle, we engineered electrically responsive, contractile human skeletal muscle constructs (myobundles) using primary skeletal muscle cells isolated from the vastus lateralis muscle of 11 RA patients (aged 57-74) and 10 aged healthy donors (aged 55-76), as well as from the hamstring muscle of 6 young healthy donors (less than 18 years of age) as a benchmark. Since all patients were receiving treatment for the disease, RA disease activity was mild. In 2D culture, RA myoblast purity, growth rate, and senescence were not statistically different than aged controls; however, RA myoblast purity showed greater variance compared to controls. Surprisingly, in 3D culture, contractile force production by RA myobundles was greater compared to aged controls. In support of this finding, assessment of RA myofiber maturation showed increased area of sarcomeric α-actinin expression over time compared to aged controls. Furthermore, a linear regression test indicated a positive correlation between sarcomeric α-actinin protein levels and tetanus force production in RA and controls. Our findings suggest that medications prescribed to RA patients may maintain-or even enhance-muscle function, and this effect is retained and observed in in vitro culture. Future studies regarding the effects of RA therapeutics on RA skeletal muscle, in vivo and in vitro, are warranted. This article is protected by copyright. All rights reserved.

PMID:34781416 | DOI:10.1002/term.3266

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Sexual Self-esteem in Trans*People: Development of a New Questionnaire and Clinical Evaluation

Psychother Psychosom Med Psychol. 2021 Nov 15. doi: 10.1055/a-1658-0977. Online ahead of print.

ABSTRACT

AIM OF THE STUDY: Our purpose was to develop a new instrument for the assessment of sexual self-esteem in German and to examine its psychometric properties. Subsequently, we aimed to investigate sexual self-esteem in trans*people.

METHODS: The construction and validation of the sexual self-esteem scale was realized in a sample of the general population (N=426; Study 1, online) based on confirmatory factor analysis and statistical item analysis. We then investigated an outpatient sample of trans*people (N=85; study 2) to compare sexual self-esteem with the population sample and to examine the associations between sexual self-esteem, body experience, and psychological and psychosomatic distress.

RESULTS: An acceptable model fit and good internal consistency for the final unidimensional 8-item solution of the sexual self-esteem scale (SSES) were confirmed. Sexual self-esteem was moderately associated with global self-esteem in the population sample. Trans*people showed a significantly lower sexual self-esteem compared to the normal population. Results also revealed the expected associations with body experience, but no association with psychological and psychosomatic distress.

CONCLUSION: The SSES is the first German-language and gender-neutral instrument to assess sexual self-esteem and provides good psychometric properties. It appears promising for monitoring the course and success of the transition treatment of trans*people as well as for its application in couples and sexual therapy.

PMID:34781378 | DOI:10.1055/a-1658-0977

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Proposal of a Basic Documentation for Child, Adolescent and Family Psychosomatics Based on a Synopsis of Basic Documentations for Children, Adolescents and Adults

Psychother Psychosom Med Psychol. 2021 Nov 15. doi: 10.1055/a-1635-6630. Online ahead of print.

ABSTRACT

In psychiatry, psychosomatics and psychotherapy, basic documentation (BaDo) is used as a quality assurance tool. For the field of child, adolescent and family psychosomatics, there is no uniform BaDo that can be used across facilities and care areas. The aim of the study was to propose a catalog of characteristics for the context of psychosomatic treatment of children and adolescents on the basis of a synoptic comparison of established BaDos METHODS: In the context of a qualitative document analysis, BaDo items from the children/youth and adult sector were evaluated in content analysis along a category system. The resulting aspects were then classified according to age and multidisciplinary content and evaluated with regard to their child/youth specificity. Descriptive statistical analysis of the results was performed RESULTS: Aspects of the categories Family Anamnesis and Biographical Anamnesis specified a BaDo for children and adolescents. For BaDos from the psychosomatic field, a record of pre-treatments was accentuated across age groups. The recording of socio-demographic data had to be adapted conceptually to the age-related needs of children and adolescents. CONCLUSION: On the basis of an empirical approach, a modular BaDo for child, youth and family psychosomatics could be formulated that enables institutional, sectoral and interdisciplinary evaluations. In a next step, the instrument should be evaluated in an application study and be consented to on a broad level.

PMID:34781379 | DOI:10.1055/a-1635-6630

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Impact of Complex Wounds on Health-Related Quality of Life: A Descriptive Study

J Wound Ostomy Continence Nurs. 2021 Nov-Dec 01;48(6):504-509. doi: 10.1097/WON.0000000000000824.

ABSTRACT

PURPOSE: To describe health-related quality of life (HRQoL) using the Wound-Quality of Life (Wound-QoL) questionnaire for those individuals referred to an academic medical center wound clinic.

DESIGN: Prospective, descriptive study.

SUBJECTS AND SETTING: One hundred eleven participants receiving care in an academic medical center wound clinic in the Southeastern United States. The sample comprised 67 males (60.4%) and 44 females (39.6%) with wounds of 6 major etiologies.

METHODS: From June 2019 through May 2020, a convenience sample of 111 individuals completed the Wound-QoL questionnaire at the initial visit to the wound clinic. The Wound-QoL questionnaire is a valid and reliable tool consisting of 17 questions related to wound-QoL measured on a 5-point Likert scale, ranging from 0 (not at all affected) to 4 (very much affected). The questions are assigned to the 3 subscales: “body,” “psyche,” and “everyday life.” The Wound-QoL individual items, subscales, and the total wound score (TWS) were calculated as mean values of the item scores, ranging from 0 to 4, where higher values correspond to decreased HRQoL. The TWS is defined as the sum of the 17 item responses, with values ranging from 0 to 68. Descriptive and parametric statistics were used to analyze the data from the Wound-QoL questionnaire.

RESULTS: The mean TWS was approximately 3 points higher for Whites (n = 84) than for Blacks (n = 27) (32.42, SD = 17.96 vs 29.51, SD = 19.39), but this difference was not significant (P = .473). An independent-samples t test of TWS versus sex was not significant (P = .446). The TWS by age category was significant (P = .015), showing differences in mean scores based on age category. We found that the youngest (ages 17-39 years) and oldest (ages 70-98 years) participants were less bothered by their wounds in almost all respects than those in the middle age range (ages 40-69 years). The individual item means varied between 0.84 and 2.72, out of a possible range of 0 to 4. The highest means were for items on the emotional subscale with means from 1.93 to 2.72. Analysis of variance was used to examine the TWS and the 3 subscales over the 6 wound types; none were found to be significant (TWS: P = .454, body: P = .722, psyche: P = .452, everyday life: P = .087).

CONCLUSION: Wound-QoL questionnaire scores indicated that the greatest impact of a wound on HRQoL was on the emotional subscale. These 4 items are related to the individual expressing worry, fear, unhappiness, or frustration with wound healing. The Wound-QoL questionnaire may be used to evaluate the impact the wound has on the individual’s HRQoL.

PMID:34781305 | DOI:10.1097/WON.0000000000000824

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Occupational Goal Intervention Method for the Management of Executive Dysfunction in People With Treatment-Resistant Schizophrenia: A Randomized Controlled Trial

Am J Occup Ther. 2021 May 1;75(3):7503180050. doi: 10.5014/ajot.2021.043257.

ABSTRACT

IMPORTANCE: The occupational goal intervention (OGI) method has been proven effective in improving executive function (EF) in people with schizophrenia, but it has not yet been tested with those with treatment-resistant schizophrenia (TRS).

OBJECTIVE: To test the efficacy of the OGI in people with TRS.

DESIGN: Single-blind randomized controlled trial.

SETTING: The Schizophrenia Program, Institute of Psychiatry, University of São Paulo General Hospital, Brazil.

PARTICIPANTS: People with TRS according to Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria, ages 18 to 55. Outcomes and Measures: Primary outcome: improvement in EF as measured by the Behavioural Assessment of the Dysexecutive Syndrome (BADS).

SECONDARY OUTCOMES: improvement of functionality, as measured by the Direct Assessment of Functional Status-Revised (DAFS-BR), and improvement in autonomy in activities of daily living (ADLs), as measured by the Independent Living Skills Survey (ILSS-BR), administered to caregivers. The outcomes were measured at baseline, posttreatment, and follow-up.

INTERVENTION: Participants were divided into two groups: OGI and craft activities (control). Each group participated in 30 sessions during 15 wk, with follow-up at 6 mo postintervention.

RESULTS: The OGI group improved significantly compared with the control group, with medium to large effect sizes in posttreatment scores on the BADS and DAFS-BR. The ILSS-BR showed the highest effect sizes at posttreatment and follow-up.

CONCLUSIONS AND RELEVANCE: The OGI method is effective for improving EF, occupational performance and ADLs in people with TRS. What This Article Adds: The OGI method is an important therapeutic tool for use in the occupational therapy clinic.

PMID:34781358 | DOI:10.5014/ajot.2021.043257

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SD-OCT analysis in syndromic and non-syndromic forms of retinitis pigmentosa due to USH2A gene mutations

Ophthalmic Res. 2021 Nov 15. doi: 10.1159/000520329. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aims to analyze macular structure by using SD-OCT in a cohort of patients affected by autosomal recessive retinitis pigmentosa and Usher syndrome, due to genetic variants in USH2A gene, and to correlate OCT parameters with functional and genetic data.

METHODS: The subjects of this study were 92 patients, 46 syndromic (Ush2) and 46 non-syndromic (arRP), with clinical and genetic diagnosis of USH2A-related retinal dystrophy, who underwent a complete ophthalmic examination and spectral domain OCT analysis. The study focused on evaluating the differences between the two groups in the following parameters: best corrected visual acuity (BCVA), ellipsoid zone width (EZ), presence of epiretinal membrane (ERM) and cystic macular lesions (CML). Variants in USH2A gene were divided in 3 categories, according to the expected impact (low/high) at protein level of the different variants on each allele.

RESULTS: BCVA and EZ width were significantly lower in Ush2 than in arRP patients (p < 0.0001 and p = 0.001). ERM was detected in 34.8% (16/46) of arRP patients and in 65.2% (30/46) of Ush2 patients (p = 0.003). CML was detected in 17.4% (8/46) of arRP patients and 30.4% (14/46) of Ush2 patients (p = 0.14). The allelic distribution was statistically different (p = 0.0003) by dividing the two diseases: for Ush2 patients it was 45.7% (high/high), 39.1% (low/high) and 15.2% (low/low); for arRP patients it was 8.7% (high/high), 56.5% (low/high) and 34.8% (low/low). The severity class of the variants significantly affected VA and EZ width parameters (p = 0.004 and p = 0.002, respectively).

CONCLUSION: Retinal disease, as evaluated by means of SD-OCT, shows more advanced degeneration signs in the syndromic than the non-syndromic form of retinal dystrophy related to USH2A gene. Variant types and allelic profiles are determining factors for the onset of syndromic features. However, since the three allelic profiles can be found in both Usher and RP patients, other factors must necessarily play a determining role.

PMID:34781295 | DOI:10.1159/000520329

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Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features Is Not a Cytological Diagnosis, but It Influences Cytological Diagnosis Outcomes: A Systematic Review and Meta-Analysis

Acta Cytol. 2021 Nov 15:1-21. doi: 10.1159/000519757. Online ahead of print.

ABSTRACT

BACKGROUND: A low-risk thyroid tumour, non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was introduced in 2016. NIFTP criteria require a thorough histological examination to rule out capsular and lymphovascular invasion, which denies the possibility of preoperative cytological diagnosis. Nevertheless, since the adoption of the new entity, the cytology of NIFTP has been a subject of interest.

OBJECTIVES: The present systematic review and meta-analysis investigate the cytological diagnosis of NIFTP.

METHOD: An online PubMed literature search was conducted between March 1, 2020, and June 30, 2020, for all original articles considering the cytology of histologically proven NIFTP. The studies including data on fine needle aspiration specimens classified by The Bethesda System for Reporting Thyroid Cytology (TBSRTC) categories, risk of malignancy (ROMs) in the TBSRTC categories, and cytomorphological features of NIFTP were included in the meta-analysis. Non-English studies and case reports were excluded. The data were tabulated and statistical analysis was performed with Open Meta-Analyst program.

RESULTS: Fifty-eight studies with a total of 2,553 NIFTP cases were included in the study. The pooled prevalence of NIFTP cases was calculated among 25,892 surgically resected cases from 20 studies and the results show that NIFTP consisted 4.4% (95% confidence interval [CI]: 3.5-5.4%) of all cases. Most of the NIFTP cases (79.0%) belonged to the intermediate categories of TBSRTC. The pooled distribution of NIFTP cases in each TBSRTC category was 1.3% (95% CI: 0.8-1.7%) in non-diagnostic (ND), 8.9% (95% CI: 6.9-10.8%) in benign, 29.2% (95% CI: 25.0-33.4%) in atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS), 24.2% (95% CI: 19.6-28.9%) in follicular neoplasm (FN), 19.5% (95% CI: 16.1-22.9%) in suspicious for malignancy (SM), and 6.9% (95% CI: 5.2-8.7%) in malignant. Compared to pre-NIFTP era, the pooled risk differences of ROM were reduced by 2.4% in ND, 2.7% in benign, 8.2% in AUS/FLUS, 8.2% in FN, 7.3% in SM, and 1.1% in the malignant category. The cytomorphological features of NIFTP were similar to follicular variant of papillary thyroid carcinoma (FVPTC) but lesser to papillary thyroid carcinoma (PTC).

CONCLUSIONS: Based on our results, NIFTP remains a histological diagnosis. Although cytomorphological features cannot be used in differentiating NIFTP from FVPTC, they may guide in separating NIFTP from PTC. Features such as papillae, microfollicles, giant cells, psammoma bodies, and the amount of papillary-like nuclear features should be taken into account when suspicious of NIFTP. NIFTP should not have papillae or psammoma bodies, and giant cells were rarely observed.

PMID:34781293 | DOI:10.1159/000519757