The study sought to determine the impact of the Big Five personality characteristics on aggressiveness among school children aged 12 to 16 in the Jenin governorate. The study employing the Big five-factor scale of Macri and Costa and the scale of aggressive behaviour in three areas [aggressive behaviour against oneself, aggressive behaviour against others, and aggressive behaviour against property]. The sample size in this study was 314 students. The quantitative study tool [the questionnaire] revealed the following correlation between the five major personality factors and aggression: neuroticism [+], openness [-], conscientiousness [-], extraversion [-], agreeableness [-]. The most prevalent main personality variables were conscientiousness and neuroticism. The degree of aggressiveness in the Jenin governorate was relatively low on the overall scale.
Context: In the US, 40 million people suffer from migraines; 8% have debilitating chronic migraines (CM). Standard care such as topiramate, onabotulinumtoxin A, and calcitonin gene-related peptide monoclonal antibodies are not universally effective and cause adverse effects (AE). Non-pharmacologic treatments such as osteopathic manipulative treatment (OMT) are reported effective and may minimize AEs but current studies are limited by non-uniformity of treatment protocols. Objective: To evaluate the feasibility of a standardized OMT procedure for CM and gather preliminary data on its effectiveness in a primary care setting. Study Design & Analysis: Prospective, single-arm feasibility study. Changes were evaluated using MANOVA to 95% confidence with f distribution for effect size. Setting: Outpatient clinical research center. Population Studied: Adults aged 18 to 60 seen within the last three years for chronic migraine (ICD 10 code G43.709) with no recent or ongoing treatment with topiramate or onabotulinumtoxin A. Intervention/Instrument: Participants received up to 5 biweekly treatments (minimum 3) of five 1-minute standardized myofascial release movements and completed 1- and 3-month post-treatment assessments. Outcome Measures: Primary: study completion rate and treatment satisfaction. Secondary: changes between baseline and 1-month, and baseline and 3-month scores on: Headache Impact Test (HIT-6) and the Migraine Specific Quality of Life Questionnaire (MSQ); changes between baseline and 3-month score on the Migraine Disability Assessment Test (MIDAS). Results: All 11 participants (mean age 47 years; 10 female, 1 male) completed the baseline, 1-, and 3-month assessments and ≥3 treatments. Treatment satisfaction was high (4.7/5). Improvements between baseline and 1-month were: HIT-6: 3.4->3.1 (p<.05, ηp2=0.16 (large effect)); MSQ: 2.9->2.2 (p=.087, ηp2=0.12 (medium effect)). Improvements between baseline and 3-month were: HIT-6: 3.4->2.9 (p=.074, ηp2=0.13 (medium effect)); MSQ: 2.9->2.0 (p=0.39, ηp2=0.09 (medium effect)); MIDAS: 9.1->5.6 (p<.05, ηp2=0.19 (large effect)). Conclusions: A standardized OMT protocol is feasible for chronic migraine treatment, with significant large effect size improvements on HIT-6 and MIDAS scores, and non-significant but medium effect size improvement on the MSQ. Improvements on the HIT-6 and MSQ wane over time. Further studies are warranted to confirm generalizability and characterize the extinction coefficient of efficacy.
Context The university community encompasses diverse characteristics, including various age groups and cultures. Since 2010, the number of international students in Canada has doubled (Yamba et al., 2021). The university's reality requires expertise in primary care, which is provided by registered nurses (RNs) and nurse practitioners (NPs) specializing in primary health care (PHNs). They contribute to proximity of care by promoting access to health care and services for the university community, including the student community, which is among the clientele that underuse health care system resources (Romo et al., 2019). Furthermore, international students generally do not have access to a family doctor. Thus, it was necessary to make health care and services accessible to our university community through a clinic. Objective, population and setting The objective is to develop and implement the CUSI, a nurse-led clinic, to increase health care access for the entire university community of Chicoutimi, Quebec, Canada. The clinic's mission is threefold: clinical practice, teaching and research. Study The development of the clinic followed the ten steps to setting up a nurse-led clinic (Hatchett, 2008) and the AGILE approach to project development (Cobb, 2011; Project Management Institute, 2018). The AGILE approach facilitates the use of an iterative cycle process in collaboration with the community and partners. It was operated based on the organic nursing model proposed by Contandriopoulos et al. (2017), a hypothetical model which emphasizes intra-professional collaboration and nursing expertise. This model enables the full occupancy of the clinical nurse role through the support of PHNs. Analysis and outcomes measure We analyzed the consultations using quantitative descriptive statistics, including continuous variables (number of consultations and visits with RNs or PHNs, number of medical referrals, number of reserved activities) and categorical variables (number of persons by age group, access to a family doctor). Results The CUSI was opened in February 2023. Half of the university students who visited the CUSI do not have access to a family doctor and are international students. Only 10% of the visits could not be handled exclusively by RNs and PHNs. Conclusions The CUSI was implemented to provide care to university community employees and students.
Background: SARS-CoV-2 (Covid-19) infection was declared a global pandemic by the World Health Organization on March 11, 2020. The guidelines and management of pregnant mothers and their neonates rapidly evolved and often varied. Objective In this study, we evaluated the epidemiological, clinical characteristics, and outcomes of neonates born to mothers with a history of Covid-19 infection at any time during their pregnancy during the pre-Delta, Delta, and Omicron waves in the West Texas communities of Lubbock and Odessa. We sought to evaluate the relevance of Covid-19 PCR testing in asymptomatic neonates, readmission rates, preterm birth risk, and NICU admission percentages. Design/Methods: This multi-center retrospective cohort study included maternal-neonate dyads who delivered between March 1, 2020, and February 28, 2022, at three hospitals in west Texas. Dyads were included if mothers had positive Covid-19 tests at any point during pregnancy up to 48 hours after delivery. We collected demographic and clinical characteristics for mothers and babies from direct chart review. We generated descriptive statistics using Sas 9.4. Results: We included 551 infants in our study population. The average gestational age at delivery was 38.1 weeks, SD(standard deviation) +/_ 2.4, and the average maternal age was 27.3 SD+/- 5.7, and 60% (n=282) of mothers with no co-morbidities. Most mothers had symptoms (n= 302, 58.2%), although most received no treatment for Covid (94.1% v%, n=386). For the cohort, 12.4% (n=64) of infants were premature (< 37 weeks), and 11.6% (n=60) were admitted to the NICU. For infants not requiring ICU care, most were not separated from their mothers (98.3%, n=425). For infants with data for post-natal testing available, most were not tested for Covid-19 (n=239, 57%), and only 1.2% tested positive (n=5). Very few infants, 0.9% (n=4), were readmitted to the hospital with conditions due to Covid-19. Conclusions: As in other cohorts, infant outcomes after exposure to maternal Covid-19 were generally consistent with those seen in the general neonatal population. Few infants experienced apparent postnatal complications of Covid-19 exposure. In this multi-center cohort, some aspects of care varied across centers and over time as each hospital developed policies and reacted to evolving evidence and recommendations. Despite the variances in care, there were no significant alterations in the outcome.
Context: Probiotics are defined as "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host." Bifidobacterium animalis subsp. lactis (BB-12) is the most studied Bifidobacterium in the world and widely used in foods and supplements. Objectives: Our aim was to evaluate adverse events (AEs) in clinical trials of BB-12. Study Design and Analysis: A systematic review following the Cochrane Handbook rules was initially conducted. Two independent reviewers separately searched for articles that qualified based on the following criteria: English language, double-blinded, randomized, and placebo-controlled trial of BB-12. Standard meta-analysis methods were used to examine the pooled data and individual general linear regression modeling was used for the IPDMA. Setting: NA. Population Studied: Individuals in published clinical trials. Interventions: Active treatment with BB-12 and matching placebo. Outcome Measures: Adverse Events. Results: One hundred and seventy-nine studies were identified of which 33 initially qualified for the study. Seventeen of the 33 studies were eligible for the meta analysis, as they had published AE data. All authors of the 33 studies were contacted for the IPDMA and only papers that included full individual and non-zero data were included. Results from nine studies in the MA demonstrated there was no difference in the rates of AE between the placebo and probiotic groups; difference in rates = .02, 95% CI (-0.01, .04). For the individual presence of AEs in the six studies included in the IPDMA the adjusted OR was 1.39 [.98, 1.97]. Conclusions: The MA and IPDMA found equal AE rates between BB-12 intervention and placebo groups. This is important due to the wide usage of BB12 in foods and supplements. We found that half of the RCTs analyzed for the MA did not report AE data, a major limitation in the probiotic literature.
Context: Despite their bottom dwelling in the hierarchy of evidence, case reports continue to be a popular form of contribution to the medical literature. PubMed indexed 639,761 publications in the case report category between 2010-2019. This overload challenges clinicians to assign value and meaning to reported cases and provides ambiguous direction to learners on how to select cases to report. Objective: To apply a typology of contribution to the literature to ten years of published case reports. Study design and analysis: Manifest content analysis with descriptive and inferential statistical analysis Population studied: Using PubMed, we sampled case reports published in 10 peer reviewed journals from 2010–2019. Journals included: Journal of the American Academy of Dermatology, American Journal of Emergency Medicine, Anesthesiology, Annals of Internal Medicine, Journal of the American Board of Family Medicine, Journal of Clinical Oncology, Neurology, Otolaryngology, Obstetrics and Gynecology, and Pediatrics. Results: We identified 942 published manuscripts using the search criteria. 647 met the definition of a case report. Across journals, the form and frequency of case reports varied widely. Within the typology, 122 (18.9%) reported detection cases, representing an actual first in the medical literature. 123 (19%) reported extension cases, extending the boundaries of what is known. 395 (61.1%) reported diffusion cases, which use a case to summarize a medical topic. 7 (1.1%) reported fascination cases, spotlighting the wonder-inducing quality of a case. Across journal types (primary care, medicine subspecialty, surgical), diffusion was the most frequent type of case report. For impact, detection cases were cited more frequently in PubMed (mean = 4.20) than extension (mean = 3.51), diffusion (mean = 3.19), or fascination (mean = 2.43) reports. Extension case reports were statistically more likely to explicitly identify authors as trainees (15.4%) than detection (4.9%), diffusion (7.1%), or fascination (0) reports. Conclusion: This description of case reports in peer-reviewed literature applies a novel typology for the role and impact of case reports. This typology allows trainees, and their faculty, who are considering writing a case report to critically analyze why it is worth publishing and how they frame the presentation to contribute to the evidence base.
Since COVID-19 was recognized as a global pandemic, the incidence, prevalence and mortality resulting from the disease has been described by the media widely and often. In order to reduce the rapid transmission of the virus, social institutions such as health care and government have asked citizens to adhere to both avoidant and preventive behaviors. Risk of illness and death and avoidance behavior are common elements in media coverage. In this context we explore both Recreancy Theory and Media Agenda Setting Theory. Recreancy Theory states that citizens base their risk assessments upon their evaluation of the abilities of social institutions to adequately manage and regulate risk. Media Agenda setting Theory argues that the press and other media coverage of the news has an effect on which issues, institutions, or events people pay attention to think are important. The data we use are taken from a U.S. survey conducted in March 2020 (N=8685). We first investigate the role of recreancy theory on the public’s perception that the COVID-19 is a risk for the U.S. population; and second, we investigate the extent to which that risk affects avoidant behavior change. Our findings provide partial support for Recreancy Theory that is, differences in citizen’s evaluation of the performance of different levels of government (President, State and Local Government) affects their perception of the virus as a threat to the well-being of the population. It also affects their willingness to engage in avoidant behaviors. Consistent with the Media Agenda Setting Theory, we found that frequency of exposure to the news increased both the perception of risk and the adherence to avoidant behaviors. The theoretical implications are discussed.
The four highly conserved and non- imprinted genes (NIPA1, NIPA2, CYFIP1 and TUBGCP5) are located on the proximal 15q in the region between BP1 and BP2 which spans approximately 500 kb. Here, we report on a paternally inherited 15q11.2 breakpoint 1-2 microduplication carrier with epilepsy, near-normal neurodevelopment, mild intellectual disability and speech delay. The father had a normal phenotype, suggesting the variable expressivity. Proximal 15q breakpoint 1-2 region copy number variants may not warrant a clinical outcome since the phenotypic variability and low penetrance. We believe that greater understanding of the possible underlying molecular, genetic, and environmental modifying factors of the copy number variants in this susceptibility locus will aid in our clinical approach.
Background: The increasing use of digital devices involves a potential risk for public health. Screens are generally made with LED lights, with a peak of emission in the area of visible spectrum corresponding to blue light. Given the high amount of blue light energy, several studies suggest a subsequent phototoxic damage to the retina. Blue light radiation may have greater impact on children particularly given that retina is not entirely developed at this age, larger pupillary diameters and frequent shorter viewing distances when compared to adults. Methods: The amount of blue light potentially penetrating the eye of adults and children was assessed. Light amounts reaching the eye were theoretically calculated according to measured pupillary diameters and reading distances. Results: The amount of visible radiation reaching the pupil is theoretically 1.4 times higher when using a smartphone than when using a PC. Light amount reaching the eye depends on reading distance. The shorter reading distance, the higher light amount reaches the eye. Children are likely exposed to a 40% higher light dose than adults because of their body-anatomic features. Conclusions: Exposure to LED screen devices should be particularly considered among children. Long-term effects of blue light exposure should me more carefully investigated.
Background: Generic Medicines are low-cost alternatives to the branded medicines. The quality of generic medicines has always been the point of concern to all consumers, physicians and pharmacists. This study is conducted to understand the perception of doctors towards Quality of Generic Medicines particularly with respect to the Safety Index of Generic Drugs. This will help us to understand the therapeutic impact of quality of generic medicines. Objective: To study the perception of Doctors regarding the Safety Index of Generic Medicines and Branded Generic Medicines that prevails in the market of Nagpur Region. Materials and Methods: A well framed questionnaire with 5-point scale is used to collect the data. Ethical standards are being practised for the study. Statistical Analysis Used: The data collected is being analysed by Hypothesis Testing by Proportion Method. Results: Out of the total sample of 182 doctors, 70% of the population prefers to use generic medicines in their prescription. Out of the doctors who prescribe Generic Medicines in their prescription, more than 50% doctors i.e. majority of doctors perceive that Generic Medicines and Branded Generic Medicines have same Safety Index. Conclusion: Doctors consider to prescribe generic medicines only if the quality results are maintained. Doctors’ inclination towards the prescribing of generic medicines can be seen. It is therefore important to maintain the quality standards of the generic medicines. Out of the doctors who do not prescribe generic medicines, majority of them perceive them to be of sub-standard quality due to low Safety Index. Hence, the Safety Index is the dominating factor behind the decision to not to choose generic medicines for their prescriptions.
