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Resettlement offers a "safe solution" for people who have experienced displacement. Nevertheless, refugees face additional challenges once resettled, including the erosion of their social fabric and the disruption of refugee communities. Therefore, social connections are crucial in resettlement. So far, the literature on social connections has focused on their functions (e.g., social support) and neglected this concept to the detriment of its meaning and related factors, so an in-depth exploration of social connections is necessary, especially in the problematic context of resettlement. To this end, 41 articles published between 2011 and 2022 and conducted with refugees and asylum seekers in resettlement contexts, were identified through searches in MEDLINE, Scopus, Google Scholar, and PsycINFO. The aim of this scoping review is to identify potentially broad literature on social connections in resettlement to provide an understanding of how refugees engage in social connections during this process. Four main social connections in the resettlement context emerged: (a) connections within the immediate community, (b) transnational connections, (c) connections with the mainstream community, and (d) connections with services. The results confirm the need to better explore how social connections impact refugees' experiences in resettlement and to grasp their political meaning in resettlement contexts. [ABSTRACT FROM AUTHOR]

Purpose: To reveal the prevalence of eating disorders (EDs) and related factors in pregnancy. Methods: The search was performed in PubMed, EBSCOhost, Web of Science, Scopus, Google Scholar, and Ovid databases search up to April 3, 2022, using the keywords combination of "(eating disorders OR anorexia nervosa OR bulimia nervosa OR binge eating disorder) AND (pregnancy OR pregnant)". Two researchers independently extracted data from the articles using a standard form. We evaluated the quality of the studies according to the Joanna Briggs Institute assessment tools. Results: The prevalence of EDs in pregnant women in the 11 studies involving 2,369,520 pregnant women was ranging between 0.5 and 10.6%. The prevalence of EDs in pregnant women was 4.3% (95% confidence interval 2%–9%; I2 = 99.5%). The prevalence of anorexia nervosa and binge eating disorder during pregnancy shows a statistically significant increase compared to pre-pregnancy, and the prevalence of bulimia nervosa during pregnancy decreases. The prevalence of EDs is higher in pregnant women under 30 years of age, secondary school graduates, married, and with normal BMI. Half of the pregnant women with EDs had anxiety and about one-third of pregnant women had depression. Excessive exercise is observed in 0.7% of pregnant women, fasting in 0.3%, laxative or diuretic use in 0.1%, and self-induced vomiting in 0.6%. Conclusions: This study is important as it is the first systematic review and meta-analysis to reveal the global prevalence of EDs in pregnant women and related factors. Continuing routine screening tests to detect EDs during pregnancy may contribute to taking special preventive measures for risk groups and protecting mother–child health. Trial registration: PROSPERO registration number (CRD42022324721), date of registration: 10/05/2022. [ABSTRACT FROM AUTHOR]

Background: Adherence to inhaled medications is key to chronic obstructive pulmonary disease (COPD) control and management. Objective: To assess errors and adherence to inhalation therapy in COPD patients, and identify potential factors associated with poor adherence. Methods: This cross-sectional study was conducted from October 1, 2022, to November 30, 2022, in 24 hospital outpatient departments in different cities of Hunan Province, China. Adherence to inhaled medications was measured using the 10-item Test of Adherence Inventory, and the results were expressed using both descriptive and inferential statistics. Results: A total of 2218 clinically confirmed adult COPD patients completed the questionnaires, and 1423 patients with more than a 3-month history of inhalation therapy were analyzed. This study found that 61.3% of patients made one or more use errors. Not holding the breath after inhalation or holding the breath for less than 3 s had the highest reporting rate (30.7%). A considerable proportion of patients (66.6%) demonstrated suboptimal adherence to inhaled medications. Patients who resided in rural areas (OR 1.45, 95% CI 1.12–1.88), used dual therapy (OR 1.47, 95% CI 1.05–2.05), and exhibited common use errors (OR 3.02, 95% CI 2.39–3.82) were more likely to present suboptimal adherence. Patients with CAT (Chronic Obstructive Pulmonary Disease Assessment Test) score < 10 (OR 0.73, 95% CI 0.56–0.94), a junior high school education and above (OR 0.73, 95% CI 0.57–0.94), and duration of inhaled medication use > 3 years (OR 0.63, 95% CI 0.47–0.83) were associated with better adherence. Conclusion: Suboptimal adherence to inhaled medications and many inhalation therapy errors were identified among COPD patients. Common use errors in inhaled medications, CAT score, and education background were predictive of and influenced adherence to inhaled medications. It is necessary to strengthen training in Chinese patients about inhaler use and follow-up intensively with patients throughout treatment, especially for patients with risk factors. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to analyze the correlation between the prognosis of osteochondral lesions of the talus and patient age, gender, duration of illness, and injury location, surface area, depth, and volume. Methods: A retrospective analysis of 44 patients who underwent talus osteochondral transplantation in the Department of Foot and Ankle Surgery of our hospital between January 2017 and December 2020 was performed. The clinical medical records of the patients were collected, and the location of the osteochondral lesion of the talus was determined according to the nine-division method. The surface area, depth, and volume of the osteochondral lesion of the talus were measured using mimics software in all patients. The visual analog scale (VAS), the American Orthopedic Foot and Ankle Society (AOFAS), and the SF-36 quality of life questionnaire scores were evaluated before surgery and at the last follow-up, and correlation analysis was performed. Results: Of 44 patients, 30 were followed up with a mean period of 24.33 ± 12.19 months. There were 18 men and 12 women, with an average age of 40.73 ± 10.57 years and an average disease duration of 28.30 ± 21.25 months. The VAS, AOFAS, and SF-36 scores of all patients at the last follow-up were significantly better than those before surgery. The degree of post-operative symptom improvement was not correlated with age, sex, duration of illness, and injury location, surface area, depth, and volume. Conclusion: The prognosis of osteochondral lesion of the talus is not related to patient age, gender, duration of disease, or injury location, surface area, depth, and volume. [ABSTRACT FROM AUTHOR]

Objective: This study is aimed to investigate the mental health status of COVID-19 survivors 1 year after discharge from hospital and reveal the related risk factors. Methods: From April 11 to May 11, 2021, 566 COVID-19 survivors in Huanggang city were recruited through their primary doctors. A total of 535 participants (94.5%) admitted to participate in the survey and completed the questionnaires. Five scales were applied including 7-Items Generalized Anxiety Disorder Scale, Patient Health Questionnaire-9, Impact of Event Scale-Revised, Pittsburgh Sleep Quality Index, and Fatigue Scale-14. The chi-square and the Fisher's exact test were used to evaluate the classification data, multivariate logistic regression was used to explore the related factors of sleep quality, fatigue, anxiety, depression, and post-traumatic stress disorder (PTSD). Results: One year after being discharged, of the 535 COVID-19 survivors, 252 (47.1%) had poor sleep quality; 157 (29.3%) had the symptoms of fatigue; 84 (15.7%),112 (20.9%), and 130 (24.3%) suffered from symptoms of anxiety, depression, and PTSD, respectively. The logistic regression analysis showed that history of chronic disease was risk factor for poor sleep quality (OR 2.501; 95% CI, 1.618–3.866), fatigue (OR 3.284; 95% CI 2.143–5.033), PTSD (OR 2.323; 95% CI 1.431–3.773) and depression (OR 1.950; 95% CI 1.106–3.436) in COVID-19 survivors. Smoking contributed to the poor sleep quality (OR 2.005; 95% CI 1.044–3.850), anxiety (OR 4.491; 95% CI 2.276–8.861) and depression (OR 5.459; 95% CI 2.651–11.239) in survivors. Drinking influenced fatigue (OR 2.783; 95% CI 1.331–5.819) and PTSD (OR 4.419; 95% CI 1.990–9.814) in survivors. Compared with college-educated survivors, survivors with high school education were at higher risk for poor sleep quality (OR 1.828; 95% CI 1.050–3.181) and PTSD (OR 2.521; 95% CI 1.316–4.830), and survivors with junior high school education were at higher risk for PTSD (OR 2.078; 95% CI 1.039–4.155). Compared with overweight survivors (BMI ≥ 23.0), survivors with normal BMI (18.5–22.9) (OR 0.600; 95% CI 0.405–0.889) were at lower risk for fatigue. While being housewife (OR 0.390; 95% CI 0.189–0.803) was protective factor for fatigue and having more family members was protective factor for PTSD (OR 0.404 95% CI 0.250–0.653) in survivors. Conclusions: One year after infection, poor sleep quality, fatigue, anxiety, depression, and PTSD, still existed in a relatively high proportion of COVID-19 survivors. Chronic disease history was an independent risk factor for poor sleep quality, fatigue, depression, and PTSD. Participants with low education levels were more likely to have mental problems than the others. We should focus on the long-term psychological impact of COVID-19 on survivors, and the government should apply appropriate mental health services to offer psychiatric support. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the impact of social and clinical factors on the diagnostic delay of chronic kidney disease (CKD) among Iranian patients. Materials and methods: Our study was conducted on 350 CKD patients who were referred to Faghihi and Motahari clinics (the two largest kidney diseases referral centers in Shiraz the capital of Fars province). Data were collected via an interviewer-administered questionnaire. A multiple linear regression model was used to measure the effect of factors affecting the delay of CKD diagnosis. Results: The medians and Interquartile ranges (IQR) of all delays, patient delay, and doctor delay were 6.5 (0–12.2), 5.1 (0–11.2), and 0.9 (0–3.1) months, respectively. The results showed that women were diagnosed 1.61 months earlier than men (p < 0.05). The duration of all delays in patients residing in the rural areas was 1.28 months longer than patients residing in the urban areas (p < 0.05). Also, patients with perceived good economic status were diagnosed 1.30 months earlier than patients who reported having very poor economic status (p < 0.05). Conclusions: The delay is in part due to the neglect and misinterpretation of symptoms by both patients and physicians. It is necessary to improve the awareness of CKD among general public and medical professionals. [ABSTRACT FROM AUTHOR]

Background: Lung cancer was often accompanied by depression and anxiety. Nowadays, most investigations for depression and anxiety were concentrated in western medical hospitals, while few related studies have been carried out in the tradition Chinese medicine (TCM) ward. It was necessary to understand the proportion and related factors of depression and anxiety in the inpatients with lung cancer in TCM hospital.Methods: This study adopted cross-sectional research method, which enrolled a total of 222 inpatients with lung cancer in TCM hospital. PHQ-9 and GAD-7 scales were used to assess depression and anxiety for the inpatients, respectively. Demographic and clinical data were also collected. Statistical methods of the univariate analysis and the multivariate logistic regression model were used.Results: The proportion of depression and anxiety in the inpatients with lung cancer were 58.1% and 34.2%, respectively. Multivariate logistic regression analysis prompted that the common related factor of depression and anxiety was the symptom of insomnia(odds ratio [OR] 3.274, 95%CI 1.723-6.219; OR 2.201, 95%CI 1.132-4.277). Constipation and gender were the two anther-related factors of depression(OR 1.458, 95%CI 0.372-1.606; OR 1.298, 95%CI 0.151-1.588).Conclusion: Depression and anxiety were common for the inpatients with lung cancer in TCM hospital. Gender, insomnia, and constipation were related factors for depression, and insomnia was related factor for anxiety. Therefore, medical workers should pay close attention to the emotional changes of these high-risk patients and intervene the symptoms as early as possible. [ABSTRACT FROM AUTHOR]

Introduction: Multimodal analgesia (MMA) is a critical component of enhanced recovery after surgery (ERAS). However, little research revealed its intraoperative implementation by anesthesiologists, who are on the front line defending against surgical pain. Therefore, the objective of our study is to assess the adherence of anesthesiologists to MMA comprehensively. Methods: A retrospective study was conducted involving patients undergoing lung resection, knee arthroplasty, and radical mastectomy from pre/post-implementation year of MMA (Jan 1, 2013, to Dec 31, 2013, vs. 2019). Intraoperative analgesia regimens (analgesic mode) and hourly rated morphine milligram equivalents (MME) were compared. In addition, patient characteristics associated with continued opioid use after surgery, surgical types, and position level of anesthesiologists (attending-junior; above attending-senior) were also analyzed. Results: After MMA initiation, the rate of multimodal analgesic regimen (mode ≥ 2) was significantly increased (post- vs. pre-implementation, 31.57 vs. 21.50%, p < 0.05). However, MME did not show significant difference (post- vs. pre-implementation, 0.402 vs. 0.456, p > 0.05). Patient-level predictors of persistent opioid use after surgery were not related to increased analgesic mode. Lung resection [coefficient, − 0.538; 95% confidence interval (CI), − 0.695 to − 0.383, p < 0.001] and knee arthroplasty (coefficient, − 1.143; 95% CI, − 1.366 to − 0.925, p < 0.001) discouraged multiple analgesic mode, while senior anesthesiologists (coefficient, 0.674; 95% CI 0.548–0.800, p < 0.001) promoted it. Conclusions: Although anesthesiologists used more analgesics after promoting MMA, the "opioid-sparing" principle was not followed properly. The analgesic mode was not instructed by patients' characteristics appropriately. In addition, surgeries with cumbersome preparation/process impeded the use of multiple analgesic modes, while senior anesthesiologists preferred multiple analgesic modes. [ABSTRACT FROM AUTHOR]

Aims: To quantitatively identify Bifidobacterium, S. wiggsiae and S. mutans in plaque samples obtained from children with severe-ECC and caries-free groups and to analyze their association with caries-related factors retrieved from the questionnaire in each group. Study design: To establish the 2 study groups, clinical examination in 122 Thai children, aged 2–5 years, recorded decayed, missing and filled teeth scores (dmft), in addition to plaque and gingival indices. Sixty one children in the caries-free group and 61 in the S-ECC group were identified. A questionnaire was used to assess the parent's attitudes and behavior regarding the child's oral hygiene care and diet. Methods: Pooled overnight supra gingival plaque was collected from each child using a sterile toothpick, released in 1 ml of TE buffer, transported on ice to the Laboratory and stored at – 20 °C. DNA was extracted from the plaque based on enzymatic lysis and quantitative real-time PCR using fluorescent dye (SYBR green) in addition to Agarose gel electrophoresis were performed. All laboratory and retrieved from the questionnaire data per child were recorded and statistically analysed. Results: S. wiggsiae (p < 0.005) and S. mutans (p < 0.001) were higher in the S-ECC group. Bifidobacterium, S. mutans, and S. wiggsiae were associated with the dmft score and gingival index (p < 0.001). The dmft scores of children who detected only S. mutans were significantly lower than the dmft scores of children who detected two bacteria; S. mutans + S. wiggsiae (p = 0.028), S. mutans + Bifidobacterium (p = 0.026), and three bacteria; S. mutans + Bifidobacterium + S. wiggsiae (p = 0.007). Children who found all three bacteria (Bi + Sm + Sw) had the highest dmft scores, followed by children who had two bacteria (Bi + Sw, or Bi + Sm, or Sw + Sm). The guardians' education levels, occupations, household income, prolonged bottle feeding, taking of water after bottle or breast feeding, eating sugar-coated crackers or bread with sweetened cream, and premature birth were the factors that related to S-ECC. Conclusion: Levels of S. wiggsiae and S. mutans, guardian's education, family economics, prolonged bottle feeding, eating high sugar-containing snacks and premature birth were associated with S-ECC. [ABSTRACT FROM AUTHOR]

The effects of glutamine dipeptide (GDP) on the growth performance, intestinal digestive enzyme activity, immune metabolism index, and gene expression of related factors of Penaeus vannamei were investigated in present study. Results showed that GDP obviously increased the weight gain rate, specific growth rate, and survival rate of P. vannamei but decreased the feed conversion ratio (FCR). The activities of amylase, protease, catalase (CAT), glutathione peroxidase (GSH-Px), and Na+–K+–ATPase in the intestine of P. vannamei fed with 0.5% and 1% GDP were significantly higher than those of the control group (P < 0.05), and the intestinal lipase and superoxide dismutase (SOD) activities of P. vannamei fed with 1% GDP were significantly higher than that of the control group (P < 0.05). The GDP significantly enhanced expression levels of the CAT and glutamine synthetase (GS) genes in the intestine of P. vannamei (P < 0.05), and the expressions of GSH-Px, toll receptor (TLR), glutathione S-transferase (GST), and trypsin genes in the intestine of P. vannamei were also significantly increased compared with the control group after 0.5% and 1% GDP supplementation (P < 0.05). The appropriate GDP level in P. vannamei feed was 0.5%. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the characteristics and related factors of insomnia of patients after operation for gastric cancer. Methods: A cross-sectional survey was carried out and finally 115 patients with insomnia after operation for gastric cancer were included. The general information, gastric cancer-related information, sleep quality, and other symptoms were investigated. Results: ① The Pittsburgh sleep quality index score of most insomnia patients after gastric cancer surgery was 11-15 points, and the sleep quality rating was "poor". ② The sleep quality of patients with insomnia after surgery for gastric cancer is related to the number of chemotherapy cycles, fatigue, and depression. ③ The probability of reduced sleep quality with the number of chemotherapy cycles >6 is 3.640 times that of ≤6. The probability of reduced sleep quality during moderate to severe fatigue was 4.390 times that of patients with no or mild fatigue. Conclusion: Attention to related factors may be associated with improvement of sleep quality in patients with gastric cancer after surgery. [ABSTRACT FROM AUTHOR]

Summary: This study reports hospitalization costs of fracture in Chinese patients aged over 45 years and evaluates their related factors in different fracture groups. Purpose: To report hospitalization costs of treating fractures in Chinese patients aged over 45 years and to investigate the sociodemographic and health system factors related to variation in the costs. Methods: Study participants were selected from the 2016 Health Accounts Database in Jiangsu in which patients' hospitalization costs were kept at various levels in hospitals. A multi-stage stratified sampling method was used to select study participants. Electronic medical records of patients aged 45 years and over with fractures were included. The International Classification of Diseases, Tenth Revision (ICD-10) was used to identify patients who were hospitalized due to fractures. A generalized linear model was used to estimate the extent to which a range of health system and sociodemographic factors were associated with the variation on hospitalization costs. Costs data were presented and analyzed using 2016 U.S. dollars. Results: A total of 39,300 patients were included in the study. Vertebra, tibia/fibula, and hip were the most frequent fracture sites. The mean (median) of hospitalization cost of included fractures ranged from USD 3142 (USD 2420) for hand and wrist fractures to USD 10,355 (USD 9673) for hip fractures. Longer length of hospital stay, higher hospital level, and being covered by a health insurance were associated with higher hospitalization costs for all fracture types. Conclusion: Our study reports hospital costs of the fracture using a large health accounts database in China and investigates the associated factors of hospital costs. Our results may inform cost-of-illness studies and economic evaluations of fracture preventions. [ABSTRACT FROM AUTHOR]

Purpose: Previous reports revealed a correlation between psychological problems and spinal surgery. There is a lack of knowledge on the effect of anxiety on the percutaneous transforaminal endoscopic discectomy (PTED) outcome at the two year follow-up. The purpose of this study is to investigate changes in anxiety after PTED among patients with lumbar disc herniation (LDH), to compare the effect of anxiety on the prognosis using propensity score matching analysis, and to identify the related parameters of anxiety. Methods: A total of 145 patients with LDH requiring PTED surgery were included. Twenty-six LDH patients with anxiety were matched with 26 control patients utilizing propensity score matching analysis. The demographic and peri-operative data were collected and analyzed. A correlation analysis was utilized. Results: Both groups achieved significant improvements in visual analogue scale (VAS) scores for pain, Japanese Orthopedic Association (JOA) scores for neurological deficit, and 36-item Short-Form Health Survey (SF-36) scores and Oswestry Disability Index (ODI) scores for quality of life. A statistical difference was detected between the pre-operative and the post-operative Zung Self-Rating Anxiety Scale scores in the anxiety cohort. However, the difference between the anxiety group and the control group was statistically significant in the aforementioned parameters. The VAS, JOA, ODI and the SF-36 scores, and the disease duration were associated with pre-operative anxiety. Conclusion: PTED may provide significant improvements in clinical outcomes and symptoms of anxiety. A negative impact on the patient's prognosis may be caused by the presence of anxiety. Pain severity, neurological deficit, disease duration, and quality of life were associated with anxiety. [ABSTRACT FROM AUTHOR]

The relationship between pathological changes in liver tissue and the level of hepatitis B surface antigen (HBsAg) remains unclear. This study aimed to analyze the pathological changes in liver tissue and its related factors in patients with low-level HBsAg in order to provide a basis for judging the condition of these patients. A retrospective study was performed on 96 chronic hepatitis B patients with HBsAg levels < 1400 IU/ml and > 0.05 IU/ml. The histopathological examination of these patients was conducted. Univariate and multivariate analyses were used to determine risk factors for pathological changes. Among the 96 patients, 57.3% (55) had inflammatory events ≥ G2 and 33.4% (33) had fibrosis ≥ S2. HBV infection duration (p = 0.001) and splenic vein diameter (p = 0.001) were independent risk factors of liver inflammation (≥ G2) in patients with low-level HBsAg, while AST (p = 0.006) and PLT (p = 0.005) were independent risk factors of liver fibrosis (≥ S2). Moreover, HBV infection duration (p < 0.001) and spleen vein (p = 0.001) were independent factors of potential antiviral treatment. Liver inflammation and fibrosis are still common in patients with low-level HBsAg; thus, the monitoring and appropriate antiviral treatment cannot be ignored. [ABSTRACT FROM AUTHOR]

Background Patient reporting of adverse drug reactions (ADRs) could supplement the existing reporting system and contribute to early detection of ADRs. The confidence in ADR identification and their attribution of ADRs were limited to outpatients. Objective To determine the type and frequency of ADRs reported by outpatients, to evaluate confidence and accuracy in ADR identification as well as contributing factors. Setting University hospital in northeastern Thailand Method Cross-sectional study using questionnaires distributed to 500 outpatients who claimed to have experienced an ADR. Confidence in identifying ADRs was measured by visual analogue score (VAS), while accuracy of reported ADRs was determined using Naranjo algorithm and WHO criteria. Main outcome measure Number and type of ADRs, confidence rating and accuracy category. Results In total, 390 outpatients completed the questionnaire (response rate = 78.0%). Rash (19.0%), nausea/vomiting (7.4%), and dizziness (5.8%) were the top three reported ADRs. Sixty-one percent of respondents rated their level of confidence in identifying ADRs as high (VAS 9.2 ± 0.95), which was associated with having underlying diseases (OR 1.93), low number of reported symptoms (OR 0.38) and severe ADRs (OR 1.33). Causality assessment was classified as true ADRs in 90.0% and 88.9% of cases, using Naranjo algorithm and WHO criteria, respectively. Respondents with low number of reported symptoms (OR 0.27) and high level of confidence had greater accuracy in ADR identification (OR 1.11). Conclusion The outpatients reported a high proportion of potential ADRs with high confidence and accuracy. Patient reporting of ADRs has potential to support the pharmacovigilance system. [ABSTRACT FROM AUTHOR]

Few studies focus on the prevalence and related factors of successful aging (SA) among Chinese rural elders living in nursing homes. This study aims to make an operational definition of successful aging, estimate the prevalence of SA, and identify factors related to SA among Chinese rural elders living in nursing homes. Data for this cross-sectional study were collected by face-to-face interviews in five rural public nursing homes. A total of 205 elders aged 60 years and above were asked to answer a series of questions. Descriptive analysis, independent sample t tests, χ tests, and multivariate logistic regression were used to show the prevalence and related factors of SA. The prevalence of SA in this population is 17.6% based on a multidimensional construct composed of: few chronic diseases, good cognitive and physical functioning, good mental health, and active social engagement. The logistic regression results indicate that successful agers are more likely to be younger, married, resilient, and better off economically, whereas gender, education, and social support are not related to SA independently. This model accounts for 45.8% of the variance in SA. These results suggest some tentative recommendations for elders, relevant decision-makers or employees in nursing homes, and administrative bodies. More rigorous longitudinal design is necessary to investigate the causality of the related factors and SA. [ABSTRACT FROM AUTHOR]

Background: Among the chronic rheumatic diseases, hip and knee osteoarthritis (OA) is the most prevalent and is a leading cause of pain and disability in most countries worldwide. Its prevalence increases with age and generally affects women more frequently than men. OA is strongly associated with aging and heavy physical occupational activity, a required livelihood for many people living in rural communities in developing countries. Determining region-specific OA prevalence and risk factor profiles will provide important information for planning future cost effective preventive strategies and health care services. Materials and Methods: The study was a community based cross sectional study to find out the prevalence of primary knee OA in India which has a population of 1.252 billion. The study was done across five sites in India. Each site was further divided into big city, small city, town, and village. The total sample size was 5000 subjects. Tools consisted of a structured questionnaire and plain skiagrams for confirmation of OA. Diagnosis was done using Kellgren and Lawrence scale for osteoarthritis. Results: Overall prevalence of knee OA was found to be 28.7%. The associated factors were found to be female gender (prevalence of 31.6%) (P = 0.007), obesity (P = 0.04), age (P = 0.001) and sedentary work (P = 0.001). Conclusions: There is scarcity of studies done in India which has varied socio geographical background and communities. We conducted this study for analyzing the current prevalence of OA in different locations. This study has evidenced a large percentage of population as borderline OA; therefore, it depends mainly on the prevention of modifiable risk factors to preserve at ease movement in elderly population through awareness programs. [ABSTRACT FROM AUTHOR]

Video-assisted thoracoscopic surgery (VATS) lobectomy has become a standard procedure for lung cancer treatment. Conversion-related factors and learning curve impacts, were poorly described. The aim of this study was to review the reasons and related factor for conversion in VATS lobectomy and the impact on this of the surgeon's learning curve. From June 2009 to May 2014, 154 patients who underwent a VATS lobectomy were included in our study. Patients' characteristics, pathology background, operative times, overall length of stay, overall morbidity and type of major complications were recorded for all patients and compared between non converted ( n = 133) and converted ( n = 21) patients. To evaluate surgeon's learning curve, we analyzed rates and causes of conversion in the first period (first 77 patients) and in the last period (78-154 patients). Patients characteristics were similar between converted and non-converted groups. Patients who were converted to open thoracotomy presented more frecuently tumors >3 cms ( P = 0.02). The average of operative times and the length of stay were not significantly different between groups. Overall morbidity and major complications were also similar in both groups. There were no impact of surgeon's learning curve in overall rate conversion in both groups. Emergency conversion was always secondary to vascular accidents, all in the first group ( p = 0.059). Surgeons should be expecting to perform a conversion to a thoracotomy in patients who present in preoperative studies, tumors greater than 3 cms. Learning curve only affected the emergency conversion, occurred all in the first half of our series. [ABSTRACT FROM AUTHOR]

Purpose: The metabolic syndrome (MetS) in adolescents is a growing problem. The objectives were to verify the association among early predictors such as birth weight, breastfeeding, maternal weight status, smoking during pregnancy, and the development of MetS. Methods: A cross-sectional study was performed of 976 children and adolescents, 10-15 years of age, at schools in the provinces of Granada and Almeria (Spain). For this purpose, we analyzed the physical characteristics as well as the biochemical markers of the participants with a view to ascertaining the prevalence of the MetS. Relevant data were also extracted from the clinical histories of their mothers. Results: It was found that 3.85 % of the female subjects and 5.38 % of the male subjects in the sample population suffered from MetS. In both sexes, there was an association between birth weight and positive MetS diagnosis (OR 1.27). For both males and females, there was an inverse association between the length of time that they had been breastfed and positive MetS diagnosis (OR 3.16; OR 1.70; OR 0.13). There was also a significant association between maternal weight (OR 30.79; OR 49.36) and cigarette consumption during pregnancy (OR 1.47) and the subsequent development of MetS in the children of these mothers. Conclusions: Those subjects born with a higher than average birth weight had a greater risk of developing MetS in childhood and adolescence. Breastfeeding children for longer than 6 months protected them from MetS in their early years as well as in their teens. Other risk factors for MetS were maternal smoking during pregnancy as well as maternal overweight and obesity. [ABSTRACT FROM AUTHOR]

Purpose: There is a growing population of older people living alone within the context of dramatic population ageing and changing living arrangements. However, little is known about the quality of life (QoL) of older people living alone in Mainland China. This study aimed to investigate QoL and its related factors among Chinese older people who live alone. Methods: A stratified random cluster sample of 521 community-dwelling older people living alone in Shanghai completed a structured questionnaire through face-to-face interviews. QoL was measured using the Older People's Quality of Life Questionnaire. Other data collected included self-rated health, physical health, cognitive function, depression, functional ability, loneliness, social support, physical activity, health services satisfaction, satisfaction with overall dwelling conditions and socio-demographic variables. Results: Older people living alone in Mainland China rated social relationships and financial circumstances as sources of low satisfaction within their QoL. Multiway analysis of variance showed that satisfaction with overall dwelling conditions, self-rated health, functional ability, depression, economic level, social support, loneliness, previous occupation and health services satisfaction were independently related to QoL, accounting for 68.8 % of the variance. Depression and previous occupation had an interaction effect upon QoL. Conclusions: This study identified nine factors influencing the QoL of older people living alone in Mainland China. Interventions to increase satisfaction with dwelling conditions, improve economic level, social support and functional ability, decrease loneliness and depression and improve health services satisfaction appear to be important for enhancing their QoL. [ABSTRACT FROM AUTHOR]

Purpose: In patients who underwent arthroscopic meniscectomy for medial meniscus tears, the authors wished to ascertain (1) whether varus alignment in the lower extremity would increase after an operation and (2) if so, what the related factors would be. Methods: Among 181 patients from 20 to 60 years of age who underwent arthroscopic medial meniscectomy for medial meniscus tears between 2002 and 2005, 56 patients followed for a minimum period of 5 years were enroled for this study. Alignment in the lower extremity was measured preoperatively and again at the last follow-up. Change in varus alignment (the difference between preoperative alignment and alignment at the last follow-up) was analyzed in relation to sex, age, body mass index (BMI), resection amount (partial vs. total), preoperative alignment, and follow-up duration, using multiple linear regression analysis. Results: Varus deformity increased by 1.7° ± 1.5° from a preoperative mean of 2.4° ± 2.4° to a mean of 4.1° ± 3.0° at the last follow-up, which was statistically significant ( p = 0.000). From multiple linear regression analysis, only the resection amount (partial meniscectomy or total meniscectomy) was found to be significantly related to the change in varus alignment ( p = 0.002). Other factors including sex, age, BMI, preoperative alignment, presence of cartilage injury and follow-up duration were not significantly related to the change in varus alignment after the operation. Conclusions: Arthroscopic meniscectomy performed in patients with medial meniscus tears aggravated varus alignment in the lower extremity at the last follow-up. In addition, the increase in varus deformity was significantly higher among patients with total meniscectomy than among those with partial meniscectomy. Level of evidence: Retrospective comparative study, Level III. [ABSTRACT FROM AUTHOR]

Purpose: The purposes of this study are to confirm factors that affect the diameter of hamstring tendon autograft and to compare failure rates between the factors after anterior cruciate ligament (ACL) reconstruction. Methods: A total of 296 patients that underwent reconstruction using hamstring tendon autograft at our clinics for ACL injury between September 2005 and June 2008 were enrolled for this study. The diameters of gracilis and semitendinosus tendons (harvested from the affected knee) and four-strand graft tendon made by folding the gracilis and semitendinosus tendons in two layers were measured. Before operating, we recorded the age, height, weight, Body Mass Index (BMI), gender and athlete versus non-athlete identity of the subjects and checked their correlations with graft diameters. Patients that recorded a grade C or D on the International Knee Documentation Committee Knee Examination Form, as well as patients that underwent revision, were defined as failures and analysed by related factors. Results: The mean diameter was 1.5 mm ± 0.2 for gracilis tendon, 2.2 mm ± 0.3 for semitendinosus tendon and 7.2 mm ± 0.7 for graft tendon. Except for age, factors including height, weight, BMI, gender and athlete versus non-athlete identity were found to be significantly related to graft diameter. Correlation was strongest with height ( p < 0.001). With respect to failure rates after ACL reconstruction, patients with a graft diameter of 8.0 mm or more demonstrated statistically better results than patients with a diameter of below 8.0 mm ( p = 0.043). However, failure rates did not differ significantly with respect to other factors. Conclusions: The diameter of hamstring tendon autograft may be different depending on height, weight, BMI and gender of the patient, as well as whether or not the patient is an athlete. Although we did not find statistically significant differences in failure rates after ACL reconstruction, this study demonstrated relatively better results in patients with a graft diameter of 8.0 mm or more. Level of evidence: Case series, Level IV. [ABSTRACT FROM AUTHOR]

Sufferers of breast cancer are often plagued by various psychological problems. Mastectomy, which has a serious influence on the female sex characteristics, can bring about especially serious psychological problems. These problems affect not only the patients’ quality of life but also the beginning, development, and end of the disease. This paper reviewed the relationships between the patients’ personal factors, the disease itself, treatment factors, and other socio-psychological factors and psychological conditions so as to provide new ideas for the psychological intervention on breast cancer patients, comprehensive clinical diagnosis and treatment, and prevention and cure. [ABSTRACT FROM AUTHOR]

This study was conducted to determine rate and related factors of dyspareunia. Three hundred and nineteen women aged 15–49 years were surveyed. A questionnaire was used to collect data. Pelvic examinations and connective tissue disorders were investigated. At whole 54.5% had dyspareunia. The means of gravidity, parity, delivery without episiotomy and vaginal length were more in women with dyspareunia. Heavy lifting, chronic pulmonary obstructive disease, arthritis, constipation, pelvic organ prolapse and pelvic muscle strength had significant relation to dyspareunia. The prevalence of urinary infection, stress incontinence, urgency, positional changes to start or complete voiding, fecal straining, low back pain, digital manipulation of vagina, perineum or anus to complete defecation, feeling genital pain or pressure and sensation of a mass in vagina was more in women with dyspareunia. These factors can be considered in the evaluation of women, to prevent those at risk and also have better management of this disorder.International Journal of Impotence Research (2007) 19, 88–94. doi:10.1038/sj.ijir.3901495; published online 22 June 2006 [ABSTRACT FROM AUTHOR]