Reducing substance use among individuals subject to community supervision is an important goal for many judges and community corrections officers. Some jurisdictions have had success by ordering justice-involved individuals to frequent substance use testing with swift, certain, and fair (SCF) sanctions for non-compliance. South Dakota’s 24/7 Sobriety program is one example of a SCF program that has also been adopted statewide in Montana, North Dakota, and other jurisdictions. As other entities outside the Great Plains attempt to adopt the 24/7 approach, there is a need to examine how the program is implemented. This paper examines a 24/7-inspired pilot program that was implemented in a southwestern county in the US in 2018. Data on participation rates and testing results for the 6-month pilot program were examined. Using a semi-structured interview protocol with questions that were adapted from the Consolidated Framework for Implementation Research (CFIR) interview guide, we interviewed nine individuals from six stakeholder groups: 1) Court, 2) District Attorney, 3) Public Defender, 4) Probation, 5) Sheriff, and 6) the non-profit organization that administered the testing. There were important differences in how the program was implemented in the county versus South Dakota’s 24/7 program—namely, there was a different target population, participation was voluntary, and testing was conducted in a different setting which increased costs. While county stakeholders decided to discontinue the program after the pilot period, it was able to implement a SCF program and overcome many of the challenges it confronted. There is some interest in exploring implementation of the SCF with those arrested for driving under the influence of alcohol in the county. For jurisdictions considering the implementation of an SCF program, it makes sense to start with a pilot program with pre-determined objectives and timeline for consistency. It is also crucial to hold regular meetings with all relevant stakeholders before and during the pilot to address context-specific challenges. Conducting an implementation analysis of this process based on the CFIR guide can be useful for understanding why the pilot was a success or failure, and how it may be improved.
The aim of this scoping review is to map the current landscape of published research and perspectives on physician suicide. Findings could serve as a roadmap for further investigations and potentially inform efforts to prevent physician suicide.
Ovid MEDLINE, PsycINFO, and Scopus were searched for English-language publications from August 21, 2017 through April 28, 2018. Inclusion criteria were a primary outcome or thesis focused on suicide (including suicide completion, attempts, and thoughts or ideation) among medical students, postgraduate trainees, or attending physicians. Opinion articles were included. Studies that were non-English or those that only mentioned physician burnout, mental health, or substance use disorders were excluded. Data extraction was performed by two authors.
The search yielded 1,596 articles, of which 347 articles passed to the full-text review round. The oldest article was an editorial from 1903; 210 (60.3%) articles have been published from 2000 to present. Authors originated from 37 countries, and 143 (41.2%) were opinion articles. The most discussed were suicide risk factors and culture of practice issues, while the least discussed themes included public health and postvention.
Consistency and reliability of data and information about physician suicides could be improved. Data limitations partly contribute to these issues. Also, various suicide risk factors for physicians have been explored, and several remain poorly understood. Based on this scoping review, a public health approach, including surveillance and early warning systems, investigations of sentinel cases, and postvention may be impactful next steps in preventing physician deaths by suicide.
To conduct a pilot study on the lived experiences of people affected by the COVID-19 pandemic, and the mental health impacts of the COVID-19 pandemic on affected people.
This mixed methods study used random and snowball techniques to recruit 91 respondents (age range 18–58 years) from 14 countries. Accessing patients with COVID-19 was restricted because of the nature of the disease and the treatment they were receiving which limited their access to being selected for our pilot study. Therefore, our respondents were members of the general population who were directly or indirectly affected by the pandemic. Respondents completed online surveys consisting of the Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire 9 (PHQ-9) and open-ended questions. Collected data were subjected to IBM SPSS statistics software (v. 22.0) and thematic analysis.
Both quantitative and qualitative instruments reported very high feasibility, which is suggestive of an excellent feasibility of our mixed methods design. Second, we identified financial and time resources as major barriers to the recruitment process, and how to avert these in the main study was discussed. Third, COVID-19 pandemic had more anxious than depressive impacts on our respondents. We also found that more than half (58, 63.7%) of the total respondents showed high knowledge level of COVID-19, and the major sources from which they gained knowledge were television, radio, and online academic papers. Our qualitative insight showed five themes from the lived experiences of respondents from the COVID-19 pandemic. These themes were; changes in lifestyles, disruption of schooling activities, impact on options for health services, disruption of works and economy, and anxious and worrisome impacts, in that order.
Main study is feasible with minor addition required on our protocol. Given other findings, we recommend the need for adaptive coping skill training, and appropriate information sharing during pandemics. There is also the need for psychosocial preparation due to the uncertainty of pandemics. In addition, averting the likely adverse economic impacts from pandemics should be of concern to governments and other stakeholders during pandemics. Finally, we recommend that governments and other stakeholders should be cautious about the likelihood of limited health service options for the general public during pandemics.
The primary objective of this paper is to present a short measure of perceptions on the impact of the COVID-19 pandemic on quality of life, along with analysis of its reliability and validity in non-clinical and clinical samples.
The scale was named The COV19 – Impact on Quality of Life (COV19-QoL) and it consists of six items presented in the form of a 5-point Likert scale. The items (i.e. statements) cover main areas of quality of life with regard to mental health. The scale was administered to 1346 participants from the general population in Croatia (the non-clinical sample) and 201 patients with severe mental illness recruited from four European countries (Bosnia and Herzegovina, Montenegro, North Macedonia and Serbia), constituting the clinical sample. The clinical sample was part of the randomised controlled trial IMPULSE funded by the European Commission. Data on age and gender were collected for both samples, along with psychiatric diagnoses collected for the clinical sample.
Main findings included a high internal consistency of the scale and a moderate to strong positive correlation among participants’ scores on different items. Principal component analysis yielded one latent component. The correlation between participants’ age and their results on COV19-QoL was negligible. Participants’ perceived quality of life was the most impacted domain, whereas mental health, personal safety and levels of depression were the least impacted domains by the pandemic.
The COV19-QoL is a reliable and valid scale which can be used to explore the impact of COVID-19 on quality of life. The scale can be successfully used by researchers and clinicians interested in the impact of the pandemic on people experiencing various pre-existing mental health issues (e.g. anxiety, mood and personality disorders) as well as those without such issues.
Aim: The aim of this study was to determine and analyse the relations between anthropometric parameters, red blood cells’ (RBC) variables and cardio-physiological parameters in healthy and physically active children and adolescents.
Material and Methods: In this study 625 subjects, (410 males and 215 females; age span 8 to 18 years) underwent body composition analysis (Matiegka method), blood analysis and ergometry testing (Bruce protocol).
Results: In both groups, body height and weight were positively correlated with RBC variables. In female group almost all correlations between RBC variables and body components were insignificant. In boys all absolute body mass components showed positive correlations with RBC variables with notice that body fat mass had lowest correlation coefficient. Body fat percent (BF %) did not show any correlation with RBC variables in both gender groups. In boys BF % had moderate negative correlation with aerobic performance: exercise time (ET) and VO2max (rs = -0.41 and rs = -0.39). Lean body components showed weak positive correlations with ET and VO2max. RBC count did not show significant correlation with any cardio-physiological parameter in both groups. Haematocrit and haemoglobin showed weak positive correlations with VO2 max and general endurance (exercise time). In girls all correlations between cardio-physiological and RBC variables were insignificant. The relationship between all body components and all cardio-physiological variables in girls were statistically insignificant.
Conclusions: Our findings revealed that there are some expected positive correlations between lean body mass components, aerobic performance and RBC variables in boys, while in girls such relations were not noticed.
Introduction: Prostate carcinoma is the most frequent malign neoplasm among men with an ever-growing incidence rate. TMPRSS2-ERG fusion transcript leads to the androgen induction of ERG proto-oncogenes expression, representing a high presence of oncogenes alteration among prostate tumour cells.
Aim: The aim of this research was to detect and evaluate theTMPRSS2-ERG fuse transcript in the tissues of patients with prostate cancer, and establish a base of material of these samples for further genetic examination.
Materials and methods: The research was a prospective clinical study that involved and focused on random sampling of 101 patients (62 with prostate cancer-study group and 39 with benign changes in the prostate-control group). Real time PCR analysis for detection of the TMPRSS2-ERG fusion transcript in prostate tissue was performed and also data from the histopathology results of tissues were used, as well as data for the level of PSA (prostate-specific antigen) in blood.
Results: TMPRSS2-ERG fusion transcript was detected in 20 out of 62 (32.2%) patients with prostate carcinoma and among no patients with benign changes whatsoever. There were no significant differences between patients with/without detected TMPRSS2-ERG fusion related to Gleason score. Among 50%, in the study group this score was greater than 7 per/for Median IQR=7 (6-8). Significant difference was recognized, related to the average value of PSA in favour of significantly higher value of PSA in the study group with prostate cancer, but there was also no significant difference between samples with prostate cancer who were with/without detected TMPRSS2-ERG fusion transcript related to PSA level.
Discussion: The results from this research are in accordance with the values and results from analyses done in several research centres and oncological institutes.
Conclusion: The positive findings in small scale studies encourage the implementation of larger scale studies that will be enriched with results of genetic transcript in blood and urine and will define the positive diagnostic meaning of the TMPRSS-ERG fusion transcript.
Introduction: One of the most important types of microorganisms in the oral cavity in both healthy and non-healthy individuals is Fusobacterium nucleatum. Although present as a normal resident in the oral cavity, this Gram-negative pathogen is dominant in periodontal disease and it is involved in many invasive infections in the population, acute and chronic inflammatory conditions, as well as many adverse events with a fatal outcome.
Aim: To determine the role of F. nucleatum in the development of polymicrobial biofilms thus pathogenic changes in and out of the oral media.
Material and method: A systematic review of the literature concerning the determination and role of F. nucleatum through available clinical trials, literature reviews, original research and articles published electronically at Pub Med and Google Scholar.
Conclusion: The presence of Fusobacterium nucleatum is commonly associated with the health status of individuals. These anaerobic bacteria plays a key role in oral pathological conditions and has been detected in many systemic disorders causing complex pathogenethic changes probably due to binding ability to various cells thus several virulence mechanisms.
Most common diseases and conditions in the oral cavity associated with F.nucleatum are gingivitis (G), chronic periodontitis (CH), aggressive periodontitis (AgP), endo-periodental infections (E-P), chronic apical periodontitis (PCHA). The bacterium has been identified and detected in many systemic disorders such as coronary heart disease (CVD) pathological pregnancy (P); polycystic ovary syndrome (PCOS), high-risk pregnancy (HRP), colorectal cancer (CRC); pre-eclampsia (PE); rheumatoid arthritis (RA); osteoarthritis (OA).
Aim: The present study aimed to investigate the effectiveness of PRF in the treatment of infrabony defects in patients with chronic periodontitis by evaluating the clinical outcome through periodontal depth, clinical attachment level at the baseline, 6 and 9 months post operatively.
Material and Methods: Sixty infrabony defects with probing depth ≥ 5 mm were treated. The inclusion criterion was the necessity for surgical bilateral maxillary treatment. By using split-mouth study design, each patient had one side treated with conventional flap surgery and the other side with conventional flap surgery and PRF. Clinical parameters, such as probing depth (PD) and clinical attachment lost (CAL), were recorded in both groups at baseline, 6 and 9 months post operatively.
Results: Positive effects for all clinical and radiographic parameters were evident in the group with PRF. Mean PD reduction demonstrated statistically significant greater results in the test group (4.00±1.07 mm) compared to the control one (4.83±0.99 mm), p = 0.003 after 9 months postoperatively. After 9 months, there were better results in the test group compared to the control group for CAL (5.60±1.61 mm, 6.20±1.58 mm), but statistically not significant.
Conclusion: Additional use of PRF in the conventional surgical treatment of infrabony defects demonstrated better parameters than the open flap debridement alone.
For achieving the good health and wellbeing for all children, the main role of pediatrician and other health care professionals is to follow their development.
We implemented developmental monitoring for 465 children at the age of 12 - 60 months, in the period of 4 years (2016 - 2019), using standard algorithm in which start is always with child history. It should be comprehensive, and must include a detailed prenatal, perinatal, and postnatal history.
Obtained results showed that 16.13% of participants have some serious illness in family history, and the same percentage (16.13%) manifested serious perinatal problems which imposed the support in intensive care unit. Breastfeed are 49,46 % of children. Only 7,53 % are not completely vaccinated.
About the parameters for the development, we obtained that 11,83 % were not walking at the time of the assessment, and 65,81 % were not speaking. Toilet control was negative, and in 75,27 % they still were wearing diapers.
Allergic manifestations at the time when the assessment was done is present in 8,60%. Finally, serious illness in child past history was positive in 19.35 % of evaluated sample.
We concluded that a good history is needed and indispensable in the assessment process, particularly when exogenous causes are identified as the risk for the developmental delay. Obtained positive answers are directory for further investigation as well to correlate risk-consequences relationship.
In their daily practice dentists frequently have patients showing signs of stress-related oral manifestations in different forms. Stress-related aetiology of oral changes are still not investigated enough, and present a subgroup of psychosomatic diseases which had been recognized in medicine a long time ago. Recognition of such psychological or emotional disturbance needs deep evaluation “per exclusionem”, and is beneficial for both the patient and clinician. Psychological management should be taken into consideration when treating patients with these psychosomatic disorders. Therapeutic approach comprises different forms of psychotherapy and medication as well.