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96, 95% CI 0.92|1.00; and 0.95, 95% CI 0.91|0.99, respectively) and also of behavioural problems (exp (b) 0.96, 95% CI 0.92|1.00; and 0.94, 95% CI 0.90|0.97, respectively). We found a statistically significant interaction of communication with father on the association of ACE with EBP, showing that the joint effects were less than multiplicative.
Difficult communication with mother and father is related to EBP among adolescents, and adolescents' communication with father moderates the association of ACE with both emotional and behavioural problems among adolescents.
Difficult communication with mother and father is related to EBP among adolescents, and adolescents' communication with father moderates the association of ACE with both emotional and behavioural problems among adolescents.
Overactive bladder (OAB) symptoms affect daily life by decreasing health-related quality of life (HRQol). However, there remain no very effective treatment for OAB. Pharmacotherapy is one of the best treatments, but it is not always efficient and may incur adverse events. Although behavioral therapy is another effective treatment, there are very few structured treatment manuals on how to prescribe behavioral therapy to treat OAB for whom. Cognitive behavioral therapy (CBT) is a psychotherapy consisting of structured sessions to solve problems with the collaborative empiricism between therapists and patients. OAB symptoms are supposed to worsen with cognitive distortion, and CBT is expected to be effective in treating OAB by modifying such cognitive processes. In this trial, we will evaluate the efficacy of CBT for OAB.
A randomized, controlled, open-label, multicenter parallel-group superiority trial will be conducted. Participants with moderate to severe OAB symptoms with or without pharmacotherapy will 13 . Registered on November 7, 2019.
The design process of a removable partial denture (RPD) consists of rests, major connectors, minor connectors, denture base, and retainer. The abutment tooth contour determines the location of the retention portion of the clasp at the retention areas. The load capacity of the clasp depends on various factors such as type, the position of a clasp, tooth position, clasp length, and pullout location. As a general rule, the amount of retention required to dislodge the RPD from the supporting structure should always be the minimum necessary to resist reasonable dislodging forces. Excessive force from the clasps may cause many problems. Although there are many reports on the retentive force of cast clasps using large devices, it has not been possible to measure it using simple devices until now.
The purpose of the present study is to develop a small-sized retentive force measurement device that can easily measure the retentive force of a clasp used for an RPD. It is to examine inter-rater and intra-rater reliabhe evaluation standard of the intraclass correlation coefficients of reliability value by ICC, it was evaluated as almost perfect and high reproducibility was confirmed.
The developed small-sized retentive force measurement device has reproducibility within and between the assessors.
The developed small-sized retentive force measurement device has reproducibility within and between the assessors.
The influence of anastomotic leakage (AL) on local recurrence rates and survival in rectal cancer remains controversial. The aim of this study was to analyze the effect of asymptomatic anastomotic leakage (AAL) and symptomatic anastomotic leakage (SAL) on short- and long-term outcome after curative rectal cancer resection.
All patients who underwent surgical resection of non-metastatic rectal cancer with curative intent from January 2005 to December 2017 were retrospectively analyzed. Short-term morbidity, long-term functional and oncological outcomes were compared between patients with SAL, AAL and without AL (WAL).
Overall, 200 patients were included and AL was observed in 39 (19.5%) patients (10 AAL and 29 SAL) with a median follow-up of 38.5 months. Rectal cancer location and preoperative neoadjuvant treatment was similar between the three groups. Postoperative 30-day mortality rate was nil. The permanent stoma rate was higher in patients with SAL or AAL compared to WAL patients (44.8 and 30% vs 9.3%, p< 0.001). The mean wexner continence grading scale was significantly different between AAL (11,4 ± 3,8), SAL (10,3 ± 0,6) and WAL (6,4 ± 4,7) groups (p= 0.049). The 3 and 5-year overall and disease-free survival rates were similar between the 3 groups (86.6% /84% vs 100%/100% vs 76%/70 and 82.9%/77% vs 100%/100% vs 94.7%/88.3% for patients with SAL, AAL, and WAL, p= 0.480 and p= 0.527).
The permanent stoma rate was significant higher in patients with SAL or AAL compared to WAL patients. AL did not impair long-term oncological outcome.
The permanent stoma rate was significant higher in patients with SAL or AAL compared to WAL patients. AL did not impair long-term oncological outcome.
The Childbirth Experience Questionnaire (CEQ) is a tool designed to assess women's perceptions about labor and delivery. The aim of this study was to perform the cross-cultural adaptation and validation of the Brazilian Portuguese version of the CEQ (CEQ-Br).
The original version of the CEQ was translated into Portuguese, analyzed by a committee of experts, back translated, and finally submitted to pilot-test. Two applications of the CEQ-Br were performed along with the quality of life questionnaire Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36). The SPSS software was used for statistical analysis, the intraclass correlation coefficient was used to investigate test-retest reliability, the internal consistency was investigated with the Cronbach's Alpha, and the construct validity was investigated via the Spearman correlation test. The level of significance was set at 5%.
The study included 308 women with a mean age of 31.1 ± 8.7 years. The internal consistency results for the total CEQ-Br score was considered adequate (0.89), the test-retest showed a substantial result with an ICC of 0.90, and the construct validity was analyzed via the Spearman correlation between all SF-36 dimensions and the total CEQ-B score, the analyses were considered adequate.
The results presented in this CEQ-Br validation study showed that the instrument was reliable in measuring the established psychometric properties and was considered valid. Therefore, the CEQ-Br can be applied to the Brazilian population.
The results presented in this CEQ-Br validation study showed that the instrument was reliable in measuring the established psychometric properties and was considered valid. Therefore, the CEQ-Br can be applied to the Brazilian population.
To systematically review the association between knee abduction kinematics and kinetics during weight-bearing activities at baseline and the risk of future anterior cruciate ligament (ACL) injury.
Systematic review and meta-analysis according to PRISMA guidelines. A search in the databases MEDLINE (PubMed), CINAHL, EMBASE and Scopus was performed. Inclusion criteria were prospective studies including people of any age, assessing baseline knee abduction kinematics and/or kinetics during any weight-bearing activity for the lower extremity in individuals sustaining a future ACL injury and in those who did not.
Nine articles were included in this review. Neither 3D knee abduction angle at initial contact (Mean diff -1.68, 95%CI - 4.49 to 1.14, ACL injury n = 66, controls n = 1369), peak 3D knee abduction angle (Mean diff -2.17, 95%CI - 7.22 to 2.89, ACL injury n = 25, controls n = 563), 2D peak knee abduction angle (Mean diff -3.25, 95%CI - 9.86 to 3.36, ACL injury n = 8, controls n = 302), 2D medial knee duated in future studies.
Seminoma accounts for 30-50% of testicular germ cell tumors (TGCT)-the most common solid malignancy in men aged 15-35 years. The American Joint Committee on Cancer (AJCC) 8th edition (2018) created the subclassifications pT1a (tumor size < 3 cm) and pT1b (≥ 3 cm), despite not being universally recognized. Rete testis invasion (RTI) and tumor size > 4 cm are considered features associated with a higher recurrence risk, but not formally used for staging. The authors propose further understanding the subclassification's potential impact in clinical practice, by summarizing current evidence and reviewing clinical cases in their institutions.
All consecutive cases of seminoma stage I, pT1 treated in two institutions between January 2005 and December 2016 were included. Clinical data were retrieved, and variables were analyzed using SPSS. Relevant literature on the topic was reviewed.
Seminoma pT1 was identified in 58 patients. By using newly AJCC criteria, 29 (50%) would have been staged as pT1a and 29t of the recently updated criteria. We would recommend using the latest AJCC staging system, although the individual risk of relapse, long-term toxicities and patient preferences should be taken into account when considering surveillance or active treatment adjuvant options.
In our population, the exploratory analysis of the newly created AJCC criteria showed no significant difference in recurrence or death, although pT1b was associated with adverse biomarkers, such as RTI and EN, but its clinical relevance remains incompletely understood. Our results confirm an excellent prognosis, regardless of subcategorization, thus a larger population and a longer follow-up time are needed to understand prospectively the impact of the recently updated criteria. We would recommend using the latest AJCC staging system, although the individual risk of relapse, long-term toxicities and patient preferences should be taken into account when considering surveillance or active treatment adjuvant options.
The Mind, Exercise, Nutrition … Do it! (MEND) childhood obesity intervention was implemented in British Columbia (B.C.), Canada from April 2013 to June 2017. The study objective was a) to describe and explore program reach, attendance, satisfaction, acceptability, fidelity, and facilitators and challenges during scale-up and implementation of MEND in B.C. while b) monitoring program effectiveness in improving children's body mass index (BMI) z-score, waist circumference, dietary and physical activity behaviours, and psychological well-being.
This prospective, pragmatic implementation evaluation (Hybrid Type 3 design) recruited families with children and adolescents aged 7-13 with a BMI ≥ 85th percentile for age and sex. The 10-week MEND B.C. program was delivered in 27 sites, throughout all five B.C. health regions (Northern, Interior, Island, Fraser, and Vancouver Coastal) over 4 years. Families attended two weekly in-person group sessions aimed to increase physical activity and promote healthy eating. Bmplementation, and the need to tailor the program locally to be more flexible and culturally relevant.
The program reached a broad demographic of children and adolescents in B.C. Families were highly satisfied with the program delivery. MEND. MK571 B.C. at scale was effective across all four evaluation years in improving BMI z-score, lifestyle behaviours and psychological well-being among children. Future interventions need to explore strategies to enhance program delivery flexibility.
The program reached a broad demographic of children and adolescents in B.C. Families were highly satisfied with the program delivery. MEND. B.C. at scale was effective across all four evaluation years in improving BMI z-score, lifestyle behaviours and psychological well-being among children. Future interventions need to explore strategies to enhance program delivery flexibility.
