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This paper estimates the acute effect of community-level homicides on early childhood language development and explores the moderating role of maternal efficacy and satisfaction in Chile. It uses data from the 2017 wave of the Early Childhood Longitudinal Survey of Chilean Children (N = 1194, M[subscript age]: 52.8 months, 52% girls). Children in municipalities with homicides 1 month before the Peabody Picture Vocabulary assessment scored between 0.18 and 0.41 SDs lower compared to children in the same municipality but for whom homicides happened after the assessment. On average, higher maternal satisfaction appears to have a protective effect, though it dissipates in the most violent municipalities. Evidence that higher maternal efficacy protects children from the negative effects of violence is inconclusive.

BackgroundThis systematic review examined the existing literature to determine the evidence supporting the efficacy of online group treatments for anxiety-, obsessive-compulsive- and trauma-related disorders (AOTDs).MethodsA systematic review using the PUBMED, PsycInfo, Web of Science, and ClinicalTrials databases with no language, date, or study design filters was performed. The inclusion criteria comprised studies that examined individuals who had received a formal diagnosis of AOTDs, were aged 18 years or older, and had baseline and endpoint assessments of symptom severity using formal tools.ResultsFive studies on social anxiety disorder (SAD), four on post-traumatic stress disorder (PTSD) and one on tic disorders (TDs) were found. The studies were open-label (n = 2) and randomized controlled trials (RCTs) (n = 8), with five of the RCTs being non-inferiority trials. Most studies were conducted in the US and investigated psychological CBT based interventions via internet-based therapies (IBT: n = 4), video teleconferencing (VTC: n = 5) or a combination of both (n = 1). In SAD, IBT studies associated with a clinician assisted web-based forum (here termed “forum-enhanced” studies) were superior to waiting lists and not inferior to similar versions that were also “forum enhanced” but self-guided, “telephone enhanced” by a contact with a non-specialist, and “email enhanced” by a contact with a clinician individually. Studies involving VTC have shown comparable effectiveness to in-person interventions across some online group CBT based treatments for PTSD. Two open trials also demonstrated symptoms reductions of social anxiety and tics through VTC.ConclusionThere is evidence supporting the effectiveness of online group treatments for SAD and PTSD. Further studies from different research groups may be needed to replicate the use of these and other forms of online treatments in individuals with SAD, PTSD, and other clinical populations, such as OCD, panic disorder, agoraphobia and specific phobias.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023408491.

Transjugular intrahepatic portosystemic shunt (TIPS) is an effective intervention for portal hypertensive complications, but its effect on renal function is not well characterized. Here we describe renal function and characteristics associated with renal dysfunction at 30 days post-TIPS. Adults with cirrhosis who underwent TIPS at 9 hospitals in the United States from 2010 to 2015 were included. We defined "post-TIPS renal dysfunction" as a change in estimated glomerular filtration rate (ΔeGFR) ≤-15 and eGFR ≤ 60 mL/min/1.73 m2 or new renal replacement therapy (RRT) at day 30. We identified the characteristics associated with post-TIPS renal dysfunction by logistic regression and evaluated survival using adjusted competing risk regressions. Of the 673 patients, the median age was 57 years, 38% of the patients were female, 26% had diabetes mellitus, and the median MELD-Na was 17. After 30 days post-TIPS, 66 (10%) had renal dysfunction, of which 23 (35%) required new RRT. Patients with post-TIPS renal dysfunction, compared with those with stable renal function, were more likely to have nonalcoholic fatty liver disease (NAFLD; 33% versus 17%; P = 0.01) and comorbid diabetes mellitus (42% versus 24%; P = 0.001). Multivariate logistic regressions showed NAFLD (odds ratio [OR], 2.04; 95% confidence interval [CI], 1.00-4.17; P = 0.05), serum sodium (Na; OR, 1.06 per mEq/L; 95% CI, 1.01-1.12; P = 0.03), and diabetes mellitus (OR, 2.04; 95% CI, 1.16-3.61; P = 0.01) were associated with post-TIPS renal dysfunction. Competing risk regressions showed that those with post-TIPS renal dysfunction were at a higher subhazard of death (subhazard ratio, 1.74; 95% CI, 1.18-2.56; P = 0.01). In this large, multicenter cohort, we found NAFLD, diabetes mellitus, and baseline Na associated with post-TIPS renal dysfunction. This study suggests that patients with NAFLD and diabetes mellitus undergoing TIPS evaluation may require additional attention to cardiac and renal comorbidities before proceeding with the procedure.

This paper estimates the impact of home country natural disasters on the academic performance of immigrant students in New York City public schools. It provides credible evidence of these effects by exploiting the exogenous timing of natural disasters relative to testing dates in models with student fixed effects. Natural disasters in the home country lower immigrant students' test scores in reading by 0.051 standard deviation, and by 0.028 standard deviation in mathematics. This paper provides strong evidence that the home country is an important out-of-school factor shaping immigrant students' academic success and shows that children are affected by distal contexts in which they do not directly participate.

O objetivo deste estudo foi identificar o impacto da pandemia da Covid-19 na saúde do trabalhador a partir do alicerce teórico da Psicodinâmica do Trabalho (Dejours, 1992, 1994, 1999). Para tanto, realizou-se a revisão de literatura de artigos acadêmicos, publicados de 2020 a 2022, que abordassem as alterações ocorridas na organização de trabalho decorrentes da pandemia. Para a seleção de trabalhos, utilizou-se o banco de dados Google Acadêmico e, partindo dos procedimentos de Análise de Conteúdo de Bardin (2011) 19 estudos foram eleitos e, posteriormente, submetidos ao software IRaMuTeQ, sendo a discussão pautada a partir da Classificação Hierárquica Descendente. Os resultados apontaram para dois fatos desencadeadores de mudanças nas dinâmicas de trabalho gerando sofrimento laboral. O primeiro foi a implementação do teletrabalho sem capacitação, suporte ou garantia de tempo de descanso para os trabalhadores, e o segundo foi a sobrecarga de trabalho decorrente tanto do eventual aumento de demanda quanto da redução de mão de obra. Conclui-se pela necessidade de novas pesquisas sobre o tema.

Introdução: os antiinflamatórios não-esteroidais (AINEs) e analgésicos são medicamentos utilizados para a melhora da dor e da inflamação, com uso prevalente por estudantes universitários. Objetivo: análise do uso indiscriminado e efeitos colaterais desenvolvidos pelo uso de medicamentos das classes dos fármacos AINEs. Metodologia: o presente artigo trata-se de um estudo quantitativo transversal, realizado por meio de um questionário autoaplicado entre os estudantes dos cursos de Publicidade e Propaganda e Jornalismo do Centro Universitário Estácio de Ribeirão Preto, com avaliação descritiva dos fatos. Resultados: a partir do levantamento dos dados, foi notado que todos os estudantes dos cursos supracitados já se automedicaram com AINEs. Também foi constatado que a principal influência para o uso do medicamento escolhido foi indicação de pessoas próximas. Foram ainda identificados a sonolência como principal efeito adverso, dor como maior motivo para o uso e a dipirona como o medicamento mais frequentemente usado. Conclusão: os resultados em sua maior parte condisseram com as expectativas dos autores com base em consultas bibliográficas.

Abstract Background The capacity to deliver essential health services has been negatively impacted by the COVID-19 pandemic, particularly due to lockdown restrictions. Telemedicine provides a safe, efficient, and effective alternative that addresses the needs of patients and the health system. However, there remain implementation challenges and barriers to patient adoption in resource-limited settings as in the Philippines. This mixed methods study aimed to describe patient perspectives and experiences with telemedicine services, and explore the factors that influence telemedicine use and satisfaction. Methods An online survey consisting of items adapted from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & Group Adult Visit Survey 4.0 (beta) and the Telehealth Usability Questionnaire (TUQ) was completed by 200 participants aged 18 to 65 years residing in the Philippines. A subsample of 16 participants was interviewed to provide further insights on their experiences. We used descriptive statistics to analyze survey data and thematically analyzed data from interviews guided by the principles of grounded theory. Results Participants were generally satisfied with telemedicine, and found it to be an efficient and convenient means of receiving healthcare. About 3 in 5 perceived telemedicine as affordable, with some finding telemedicine costs to be high and comparable to in-person consultations. Our results suggest that participants preferred telemedicine services, especially in cases where they feel that their condition is not urgent and does not need extensive physical examination. Safety against COVID-19, privacy, accessibility, and availability of multiple communication platforms contributed to patient satisfaction with telemedicine. Negative perceptions of patients on quality of care and service related to their telemedicine provider, inherent limitations of telemedicine in the diagnosis and management of patients, perceived high costs especially for mental health conditions, and poor connectivity and other technological issues were barriers to telemedicine use and satisfaction. Conclusion Telemedicine is viewed as a safe, efficient, and affordable alternative to receiving care. Expectations of patients on costs and outcomes need to be managed by providers to increase satisfaction. Continued adoption of telemedicine will require improvements in technology infrastructure and technical support for patients, training and performance evaluation of providers to ensure quality of care and service, better patient communication to meet patient needs, and integration of telemedicine services in remote areas that have limited access to medical services. Telemedicine, to realize its full potential, should be centered in health equity – addressing patient barriers and needs, reducing health disparities across population groups and settings, and providing quality services to all.

Abstract Background Surgical reconstruction of the posterior cruciate ligament (PCL) can be technically challenging given the proximity of the popliteal artery to the PCL tibial insertion. This "no-safe zone" makes some knee surgeons less confident and willing to perform this surgical procedure. Surgical technique We present a PCL tibial inlay reconstruction technique using a set of instruments involving three tools (a slot cut, a bone plug positioner, and an impactor). Conclusion This set of instruments allows a more reproducible posteromedial approach and to produce a PCL tibial slot in a posterior cruciate ligament inlay reconstruction with the patient supine in bicruciate ligament injury reconstruction.

Abstract Background Individuals with obsessive–compulsive disorder (OCD) often feel compelled to perform (compulsive) behaviors, thus raising questions regarding their free will beliefs and experiences. In the present study, we investigated if free will related cognitions (free will beliefs or experiences) differed between OCD patients and healthy subjects and whether these cognitions predicted symptom changes after a one-year follow up. Methods Sixty OCD outpatients were assessed for their beliefs in and experiences of free will at baseline and after one year of treatment. A subsample of 18 OCD patients had their beliefs compared to 18 age and gender matched healthy controls. A regression analysis was performed to investigate whether free will cognitions at baseline were able to predict long-term OCD severity scores. Results Patients with OCD and healthy controls do not seem to differ in terms of their beliefs in free will (U = 156.0; p = 0.864). Nonetheless, we found significant negative correlation between (i) duration of illness and strength of belief in determinism (ρ = -0.317; p = 0.016), (ii) age and perception of having alternative possibilities (ρ = -0.275; p = 0.038), and (iii) symptoms’ severity and perception of having alternative possibilities (ρ = -0.415; p = 0.001). On the other hand, the experience of being an owner of ones’ actions was positive correlated with the severity of symptoms (ρ = 0.538; p

This paper estimates the effect of charter schools on the diversity of nearby traditional public schools (TPSs) and neighborhoods in New York City. We employ a difference-in-differences approach that exploits the variation in the expansion of the charter sector between grades in the same school. This approach allows us to isolate the effect of charter schools from other neighborhood demographic changes. Our results show small positive effects of charter school expansion on TPS diversity as measured by the entropy score. This change is explained by small increases in the number of White students attending nearby TPSs and larger reductions in the number of Black and Hispanic students in these schools. We also find descriptive evidence that while both neighborhoods and TPSs are slightly more diverse following charter school expansion, schools are changing faster than their surrounding neighborhoods. [ABSTRACT FROM AUTHOR]