Tag: pubmed

Int J Drug Policy. 2021 Jun 5;95:103291. doi: 10.1016/j.drugpo.2021.103291. Online ahead of print.

ABSTRACT

BACKGROUND: Problem drinking and co-occurring depression symptoms affect men at high rates and are associated with increased risk of family violence. In low- and middle-income countries, there is a large treatment gap for services due to a lack of human resources. Moreover, masculine norms are a barrier to men seeking treatment for drinking and depression in healthcare settings. We examined an approach for engaging peer-fathers to deliver an intervention to reduce alcohol use, improve depressive symptoms, and increase family involvement among fathers in Kenya with problem drinking. The intervention-LEAD (Learn, Engage, Act, Dedicate)-combines motivational interviewing, behavioral activation, and masculinity discussion strategies.

METHODS: Community and religious leaders nominated fathers with no mental health training to serve as counselors (N=12); clients were recruited through community referrals. Nominated fathers completed a 10-day training beginning with treatment principles followed by manualized content. Three counselors were selected after training based on quantitative and qualitative assessments of communication skills, intervention knowledge, willingness to learn, ability to use feedback, and empathy. Supervision was tiered with local supervisors and clinical psychologist consultation. During LEAD delivery, counselor fidelity, delivery quality, and general and intervention-specific competencies were assessed. To evaluate acceptability, qualitative interviews were conducted with lay-counselors and clients (N=11). Descriptive statistics were calculated for quantitative outcomes; interviews were analyzed using thematic analysis.

RESULTS: Peer-father lay counselors treated nine clients, with eight completing treatment. Counselors reached high rates of fidelity (93.8%) and high to optimal ratings on quality of delivery, clinical competency, and intervention-specific competencies. Qualitative results suggested high acceptability, with counselors expressing satisfaction and empowerment in their roles. Clients likewise described positive experiences with counselors.

CONCLUSIONS: Findings provide initial support for the acceptability and feasibility of recruitment, selection, and training processes for peer-father lay counselors to deliver LEAD through a lens of masculinity that aligned with clients help-acceptance practices.

PMID:34107387 | DOI:10.1016/j.drugpo.2021.103291

Int J Nurs Knowl. 2021 Jun 9. doi: 10.1111/2047-3095.12338. Online ahead of print.

ABSTRACT

to analyze accuracy measures of the clinical indicators of Readiness for enhanced health management in patients with arterial hypertension and/or diabetes mellitus METHODS: prospective diagnostic accuracy study conducted with 359 patients with hypertension and/or diabetes mellitus, followed up in primary healthcare. Stratified random sampling was used to recruit participants. An assessment form was applied with sociodemographic data, health conditions, and information related to the clinical indicators under investigation. Sensitivity, specificity, predictive values, and likelihood ratios were analyzed FINDINGS: the sample was composed of 359 participants. The prevalence of Readiness for enhanced health management was 93.8%. There was a statistically significant association between the diagnosis and age under 60 years (p < 0.001), having only one chronic condition (p < 0.001), having normal blood pressure (p = 0.017) and blood glucose (p = 0.013) values, and having a nonsedentary (p = 0.026) and nonalcoholic (p = 0.044) lifestyle. All clinical indicators had high predictive values in predicting the nursing diagnosis under investigation. The indicator expresses desire to enhance management of symptoms was the most sensitive (99.7%) and specific (100%). The indicator expresses desire to enhance management of prescribed regimens was also highly specific (100%) CONCLUSION: all clinical indicators were accurate in predicting Readiness for enhanced health management IMPLICATIONS FOR NURSING PRACTICE: knowing which clinical indicators and sociodemographic/clinical characteristics best predict Readiness for enhanced health management, nurses in primary care can better plan nursing interventions and direct their goals.

PMID:34105897 | DOI:10.1111/2047-3095.12338

ACS Nano. 2021 Jun 9. doi: 10.1021/acsnano.0c10851. Online ahead of print.

ABSTRACT

Atomic structures and adatom geometries of surfaces encode information about the thermodynamics and kinetics of the processes that lead to their formation, and which can be captured by a generative physical model. Here we develop a workflow based on a machine-learning-based analysis of scanning tunneling microscopy images to reconstruct the atomic and adatom positions, and a Bayesian optimization procedure to minimize statistical distance between the chosen physical models and experimental observations. We optimize the parameters of a 2- and 3-parameter Ising model describing surface ordering and use the derived generative model to make predictions across the parameter space. For concentration dependence, we compare the predicted morphologies at different adatom concentrations with the dissimilar regions on the sample surfaces that serendipitously had different adatom concentrations. The proposed workflow can be used to reconstruct the thermodynamic models and associated uncertainties from the experimental observations of materials microstructures. The code used in the manuscript is available at https://github.com/saimani5/Adatom_interactions.

PMID:34105943 | DOI:10.1021/acsnano.0c10851

Int J Clin Pract. 2021 Jun 9:e14444. doi: 10.1111/ijcp.14444. Online ahead of print.

ABSTRACT

INTRODUCTION: Adverse drug reactions are an important public health concern that affects doctor and dentist prescriptions and healthcare workers’ practice. We planned to evaluate the knowledge, attitudes, and practices of healthcare workers in our country about drug hypersensitivity reactions in pediatric patients and to determine the risk factors that may affect them.

METHOD: This study was carried out in a capital-located university hospital. Healthcare workers who are authorized to intervene in children (0-18 age group) including medical doctors, nurses and dentists were enrolled to study. The study questionnaire was developed by pediatric allergy and immunology specialists and pediatric nurses by considering the other studies on the same subject.

RESULTS: 354(88.5%) out of 400 healthcare workers, whose study survey was distributed, returned to us by filling the questionnaire. According to the groups of the profession, there was a statistically significant difference between the average of correct answers given to the questions evaluating knowledge levels(p <0.001). The doctors’ knowledge score(mean ± SD 18.6 ± 2.1) was the highest. The general attitudes of healthcare workers towards drug hypersensitivity reactions in children were similar and were positive(p <0.053). However, general practice patterns were significantly different(p <0.001). Nurses were observed to practice more positively than doctors and dentists. As the healthcare worker gets older, his practice score increased by 0.546; on the other hand, being a resident reduced the score from the practice score by 3,770.

CONCLUSION: Our results suggest that advanced training programs must be provided for healthcare workers in learning drug hypersensitivity reactions, particularly in pediatric patients.

PMID:34105870 | DOI:10.1111/ijcp.14444

Cancer Med. 2021 Jun 9. doi: 10.1002/cam4.4033. Online ahead of print.

ABSTRACT

BACKGROUND: Given the growing incidence and aggressive biological behavior of proximal gastric cancer (PGC) as reported, it is important to understand which regional or racial populations are at poor prognosis so that interventions can be treated appropriately. We sought to explore regional treatment differences as well as racial genes influence survival outcomes in China and the US patients with PGC.

METHODS: PGC patients defined as tumors with the epicenter located in cardia (C16.0) or fundus (C16.1) from 1996 to 2016 were identified from the Surveillance Epidemiology and End Results (SEER) in the United States as well as data from a high-volume National Cancer Center Database in China. Overall survival (OS) curves were plotted for different regional or racial groups, respectively, using the Kaplan-Meier method and compared statistically using the log-rank test. Differentially expressed genes (DEGs) analysis was performed using TCGA database.

RESULTS: Finally, the cohort consistent of 40973 PGC patients who enrolled in SEER database (n = 36305) or China National Cancer Center (n = 4668), and divided into 4 racial groups: Chinese (n = 5179), Black (n = 2429), White (n = 31185), and Others (n = 2096). After controlling for confounding variables, racial factors were independently associated with poor survival included Black ethnicity (HR = 1.376, 95% CI: 1.066-1.7760, p = 0.014) and White ethnicity (HR = 1.262, 95% CI: 1.005-1.583, p = 0.045) when compared to Chinese ethnicity in total PGC patients. Even in the same region for only US group, Chinese PGC patients also showed better prognosis.

CONCLUSIONS: In conclusion, we demonstrated the different survival outcomes of PGC patients in different regions or races from two high-volume database SEER and China National Cancer Center database. These survival differences are likely influenced by a number of factors (e.g., access to screening, quality of gastrectomy, neo/adjuvant therapy, and biological genes itself). More importantly, a better understanding of these disparities could lead to interventions that may help to abolish these disparities.

PMID:34105890 | DOI:10.1002/cam4.4033

Int Wound J. 2021 Jun 9. doi: 10.1111/iwj.13638. Online ahead of print.

ABSTRACT

Fat grafting is a well-established method in plastic surgery. Despite many technical advances, standardised recommendations for the use of prophylactic antibiotics in fat grafting are not available. This retrospective multicentre study aims to analyse the use of prophylactic antibiotics in fat grafting and to compare complication rates for different protocols. A retrospective medical chart review of 340 patients treated with fat grafting of the breast from January 2007 to March 2019 was performed in three plastic surgery centres. Complications, outcomes, and antibiotic regimes were analysed. The Clavien-Dindo classification was applied. All patients received perioperative antibiotic prophylaxis: 33.8% (n = 115) were treated with a single shot (group 1), 66.2% (n = 225) received a prolonged antibiotic scheme (group 2). There was no significant difference in the number of sessions (P = .475). The overall complication rate was 21.6% (n = 75), including graft resorption, fat necrosis, infection, and wound healing problems. Complication rates were not significantly different between groups. Risk factors for elevated complication rates in this specific patient group are smoking, chemotherapy, and irradiation therapy. The complication rate for lipografting of the breast is low, and it is not correlated to the antibiotic protocol. The use of prolonged prophylactic antibiotics does not lower the complication rate.

PMID:34105891 | DOI:10.1111/iwj.13638

J Esthet Restor Dent. 2021 Jun 9. doi: 10.1111/jerd.12793. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of surface treatments on optical, colorimetric, and surface characteristics of lithium disilicate glass-ceramic.

MATERIALS AND METHODS: Specimens (n = 5, IPS e.max CAD) were randomly allocated to the following treatments: mirror-polished: SiC papers; as-cut: mimicking CAD-CAM milling; ground: 90-120 μm-grit diamond bur; ground polished: ground, finished (46-30 μm-grit diamond bur), polished (diamond cups, brush and diamond paste); ground glazed: ground, glazed; ground polished glazed: association of methods. CIELAB color coordinates were obtained by a spectrophotometer. CIEDE2000 color differences (ΔE₀₀ ) and the translucency parameter (TP₀₀ ) were calculated. Light transmittance was assessed with a colorimeter. Surface characteristics (topography and roughness) were analyzed. Statistical differences for each condition and outcome were detected using one-way ANOVA with Tukey’s post-hoc test (α = 0.05).

RESULTS: TP₀₀ data show statistical reduction after grinding (p < 0.05), which was only restored with polishing (solely or with glazing). ΔE₀₀ shows that grinding results in perceptible variations in color (above 0.81), which were restored after all post-processing protocols (exception to only glaze application in contact with a black background). Light transmittance data corroborated such performance. Polishing and glazing reduced roughness and improved surface topography.

CONCLUSION: Grinding statistically increased roughness, reduced translucency, light transmittance through the ceramic, and resulted on color differences. On contrary, polishing (followed or not by glazing) reduced roughness and enhanced ceramic translucency and light transmittance. Glaze also reduced roughness, but it still presented reduced translucency. The positioning (facing up or down) of the ceramic treated surface influenced the considered outcomes.

CLINICAL SIGNIFICANCE: Grinding with diamond burs results in a deleterious impact to the optical, colorimetric and surface characteristics of lithium disilicate ceramic. Thus, polishing (followed or not by glazing) is recommended for optical and topographical enhancements when lithium disilicate monolithic restorations require occlusal adjustments.

PMID:34105868 | DOI:10.1111/jerd.12793

Int J Clin Pract. 2021 Jun 9:e14453. doi: 10.1111/ijcp.14453. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to examine the relationship between urolithiasis and gastric wall fat halo sign (FHS).

MATERIAL-METHOD: The data of 382 patients who presented to our clinic with the complaint of flank pain were analyzed retrospectively. According to the results of non-contrast computed tomography, the patients were divided into two groups those with ureteral stones (Group 1) and those without urinary stones (Group 2). The patients’ age, gender, weight, height, body mass index (BMI), cholesterol, triglyceride, blood urea nitrogen, creatinine, and gastric wall FHS data were evaluated.

RESULTS: When Groups 1 and 2 were compared in terms of FHS positivity, FHS was detected in 140 (57.3%) of 244 patients in Group 1 and 24 (17%) of 138 patients in Group 2, indicating a statistically significant difference (p < 0.001).

CONCLUSION: A statistically significant relationship was found between urinary stone disease and gastric wall FHS.

PMID:34105869 | DOI:10.1111/ijcp.14453

Int J Clin Pract. 2021 Jun 9:e14451. doi: 10.1111/ijcp.14451. Online ahead of print.

ABSTRACT

AIM: The aim of the study is to determine the effects of constipation symptoms and nutritional status on disease-related parameters, such as disease duration, spirometry test and quality of life, of COPD patients.

METHODS: The research was performed with 48 COPD patients attending the center from January 2019 to August 2019. Assessment of constipation symptoms were done by Constipation Severity Instrument (CSI), while for quality of life assessment St George Respiratory Questionnaire (SGRQ) was used. Patient’s nutritional status was determined by food frequency questionnaire. Body mass index (BMI) and fat-free mass index (FFMI) of the patients were identified with the bioelectrical impedance analysis (BIA) method. Statistical assessment of data were done with SPSS 22 programme.

RESULTS: According to the relationship between CSI scores and COPD disease parameters there was a weak positive correlation between the CSI obstructive defecation subscale and SGRQ activity score and weak positive correlation between CSI colonic inertia subscale and COPD duration from the diagnosis. We found a weak negative correlation between protein intake percentage and SGRQ impact score. As the disease duration increased, the total fat, polyunsaturated fatty acids and vitamin E intake of individuals were determined to reduce.

CONCLUSION: According to our results, there were some changes in the nutrient intake depending on the duration of COPD and possible constipation in COPD patients may affect the quality of life.

PMID:34105860 | DOI:10.1111/ijcp.14451

J Int AIDS Soc. 2021 Jun;24(6):e25756. doi: 10.1002/jia2.25756.

ABSTRACT

INTRODUCTION: Achieving optimal adherence to antiretroviral therapy (ART) among adolescents living with HIV (ALWHIV) is challenging, especially in low-resource settings. To help accurately determine who is at risk of poor adherence, we developed and internally validated models comprising multi-level factors that can help to predict the individualized risk of poor adherence among ALWHIV in a resource-limited setting such as Uganda.

METHODS: We used data from a sample of 637 ALWHIV in Uganda who participated in a longitudinal study, “Suubi+Adherence” (2012 to 2018). The model was developed using the Least Absolute Shrinkage and Selection Operator (LASSO) penalized regression to select the best subset of multi-level predictors (individual, household, community or economic-related factors) of poor adherence in one year’s time using 10-fold cross-validation. Seventeen potential predictors included in the model were assessed at 36 months of follow-up, whereas adherence was assessed at 48 months of follow-up. Model performance was evaluated using discrimination and calibration measures.

RESULTS: For the model predicting poor adherence, five of the 17 predictors (adherence history, adherence self-efficacy, family cohesion, child poverty and group assignment) were retained. Its ability to discriminate between individuals with and without poor adherence was acceptable; area under the curve (AUC) = 69.9; 95% CI: 62.7, 72.8. There was no evidence of possible areas of miscalibration (test statistic = 1.20; p = 0.273). The overall performance of the model was good.

CONCLUSIONS: Our findings support prediction modelling as a useful tool that can be leveraged to improve outcomes across the HIV care continuum. Utilizing information from multiple sources, the risk prediction score tool applied here can be refined further with the ultimate goal of being used in a screening tool by practitioners working with ALWHIV. Specifically, the tool could help identify and provide early interventions to adolescents at the highest risk of poor adherence and/or viral non-suppression. However, further fine-tuning and external validation may be required before wide-scale implementation.

PMID:34105865 | DOI:10.1002/jia2.25756