Dietary fat and risk of breast cancer

BACKGROUND: Breast cancer is one of the major public health problems among women worldwide. A number of epidemiological studies have been carried out to find the role of dietary fat and the risk of breast cancer. The main objective of the present communication is to summarize the evidence from various case-control and cohort studies on the consumption of fat and its subtypes and their effect on the development of breast cancer. METHODS: A Pubmed search for literature on the consumption of dietary fat and risk of breast cancer published from January 1990 through December 2003 was carried out. RESULTS: Increased consumption of total fat and saturated fat were found to be positively associated with the development of breast cancer. Even though an equivocal association was observed for the consumption of total monounsaturated fatty acids (MUFA) and the risk of breast cancer, there exists an inverse association in the case of oleic acid, the most abundant MUFA. A moderate inverse association between consumption of n-3 fatty acids and breast cancer risk and a moderate positive association between n-6 fatty acids and breast cancer risk were observed. CONCLUSION: Even though all epidemiological studies do not provide a strong positive association between the consumption of certain types of dietary fat and breast cancer risk, at least a moderate association does seem to exist and this has a number of implications in view of the fact that breast cancer is an increasing public health concern

Child sexual abuse, psychopathology, trauma and attachment beliefs and interpersonal functioning among young adult survivors attending psychiatric services in India

Background: Child sexual abuse (CSA) is known to have short and long-term consequences which can have an impact even in adulthood. The objectives of the study were to explore the nature of CSA in individuals attending psychiatric services, the impact of CSA on psychopathology, trauma and attachment beliefs and interpersonal functioning in young adult survivors and factors associated with CSA and its impact. Methodology: The study adopted a cross-sectional exploratory design. The sample comprised of 246 young adult patients attending inpatient and outpatient psychiatric services of a tertiary care hospital in India. The tools used were: Mini International Neuropsychiatric Interview, Sexual and Physical Abuse History Questionnaire, abuse-related Beliefs Questionnaire, Sexual Abuse Severity Score, Trauma and Attachment Beliefs Scale, Brief Symptom Inventory and Social Adjustment-Self Report. Results: About 21% of the sample had a history of CSA; among them 70% were females. The age of CSA ranged between 8 and 12 years. About 34% of them had more than 5 such experiences and about half of them had more than 2 perpetrators with majority of the sample experiencing high coercion. The survivors of CSA had greater levels of psychopathology, trauma and attachment beliefs, difficulties in certain domains of interpersonal functioning in comparison with individuals without a history of CSA. Female gender, poor parental emotional support, and having more than one significant life event contributed to risk of CSA. Poor emotional support from parents and trauma related beliefs predicted psychopathology. Conclusion: The study has implications with respect to the assessment, research and conceptualization of therapy in individuals with a history of CSA

Effect of modeling a multilevel structure on the Indian population to identify the factors influencing HIV infection

Many studies have addressed the factors associated with HIV in the Indian population. Some of these studies have used sampling weights for the risk estimation of factors associated with HIV, but few studies have adjusted for the multilevel structure of survey data. The National Family Health Survey 3 collected data across India between 2005 and 2006. 38,715 females and 66,212 males with complete information were analyzed. To account for the correlations within clusters, a three-level model was employed. Bivariate and multivariable mixed effect logistic regression analysis were performed to identify factors associated with HIV. Intracluster correlation coefficients were used to assess the relatedness of each pair of variables within clusters. Variables pertaining to no knowledge of contraceptive methods, age at first marriage, wealth index and noncoverage of PSUs by Anganwadis were significant risk factors for HIV when the multileveled model was used for analysis. This study has identified the risk profile for HIV infection using an appropriate modeling strategy and has highlighted the consequences of ignoring the structure of the data. It offers a methodological guide towards an applied approach to the identification of future risk and the need to customize intervention to address HIV infection in the Indian population

Social support among persons with depressive disorders during COVID-19 pandemic

Context: The extent of depressive disorders is wide in the Indian population as reported by epidemiological studies, warranting a necessary area of intervention to cover the rampant treatment gap. Social support is known to vary as per the community-level changes, which may be attributed to events kickstarted by COVID-19. Objectives: This study aimed to assess the social support among persons with depressive disorders. Methods: This was a cross-sectional study conducted among 75 individuals of age ranging from 18 to 46 years from multi-ethnic communities across India. We used the Beck Depression Inventory-II and Multidimensional Scale of Perceived Social Support. Results: This sample had a mean age of 32 years (SD: 7.88 years), and recurrent depressive disorder was the larger prevalent psychopathology diagnosed during their routine clinical consultation in the hospital (69.3%). The majority of the respondents experienced moderate depression (n = 42), followed by mild depression (n = 14) and severe depression (n = 5). Social support and resilience were found to be mildly correlated with each other for persons with mild depression (r = 0.620; P = 0.018). Conclusion: Persons with mild depressive features may benefit from low-cost and community-based interventions directed to enhance social support and thus impact resilience. Psychosocial interventions must address the impact of moderate depression and recurrent depressive disorder and include social support at all spousal, family, and societal levels

Effectiveness of intervention package on knowledge and attitude regarding functional needs and quality of life of elderly patients with psychiatric illness, among nursing interns

OBJECTIVE: To develop and assess the effectiveness of the intervention package on knowledge and attitude regarding meeting the functional needs and improving the quality of life of elderly patients with psychiatric illness, among nursing interns. MATERIALS AND METHODS: The study was carried out among 60 nursing interns of a tertiary government mental health setting. After the pretest, the educational intervention package on functional needs and quality of life of elderly patients with psychiatric illness was administered to the study group in four sessions. Posttest data collection was performed using the same questionnaires after 2 weeks after the last session. RESULTS: There was a statistically significant improvement in the knowledge and attitude of nursing students following the sessions of the intervention package. Pretest data showed that there is a positive correlation between the knowledge and attitude of study subjects. Overall knowledge has significantly improved after attending the intervention program (Z = 6.701, P < 0.001). Moreover, the overall attitude level has significantly improved after attending the intervention program (Z = 6.741, P < 0.001). CONCLUSION: The educational intervention package on functional needs and quality of life of elderly patients with psychiatric illness was effective in improving the knowledge and attitude regarding functional needs and quality of life of elderly patients with psychiatric illness, among nursing interns. Similar packages may be incorporated into the nursing curriculum in training future nurses for their better practice in this area

Effectiveness of anger management program on anger level, problem solving skills, communication skills, and adjustment among school-going adolescents

BACKGROUND: Anger is a natural feeling which is essential for survival, however, which can impair functioning if it is excessive. Adolescents need to be equipped with skills to cope with their anger for the promotion of their health and safety. This study aims to examine the effectiveness of anger management program on anger level, problem solving skills, communication skills, and adjustment among school-going adolescents. MATERIALS AND METHODS: An experimental, pre-test–post-test control group design with a multistage random sampling was adopted to select 128 school-going adolescents aged between 13 and 16 years. Experimental group received six sessions of anger management program, while control group received one session on anger management skill after the completion of post-assessment for both the groups. Sessions included education on anger, ABC analysis of behavior and relaxation training, modifying anger inducing thoughts, problem solving, and communication skills training. Assessment done after the 2 months of anger management program. Data were analyzed through descriptive and inferential statistics. RESULTS: Study reveals the improvement in the problem solving skills (81.66 ± 4.81), communication skills (82.40 ± 3.82), adjustment (28.35 ± 3.76), and decreased anger level (56.48 ± 4.97). Within the experimental and between the experimental and control group, post-test mean scores differed significantly (P < 0.05). CONCLUSION: The results revealed that the anger management program was effective in decreasing anger level and increasing problem solving skills, communication skills, and adjustment among school-going adolescents

Self-reported tobacco use, knowledge on tobacco legislation and tobacco hazards among adolescents in rural Kerala State

Context: Tobacco consumption initiated during the adolescent period is a major contributor to the pathogenesis of fatal diseases in adulthood. Information on tobacco use and awareness regarding tobacco legislation and hazards among adolescents in rural Kerala is limited. Aims: To assess the prevalence of tobacco use among adolescent students in a rural district in Kerala state and to understand the extent of awareness about the prominent legislative measures against tobacco and tobacco hazards. Materials and Methods: Data on awareness regarding health hazards due to tobacco use and legislation against tobacco consumption were collected from students of 15 randomly selected high schools in an educational sub-district in Kerala, using a cross-sectional study design. Chi-square and Fisher′s exact test statistics were used for statistical analysis. Results: A total of 1473 students participated in the study, of which 79% were males (mean age 15.4 years, SD 1.5). The overall prevalence of ′current tobacco users′ was 8%. A significant association between age and tobacco use was noted among tobacco habitues (P<0.05). Awareness regarding legislation against smoking in public places was more in the higher age-groups (P<0.05). Females were more aware of the ′smoking ban′ than males (P<0.05). Our survey of the awareness regarding the hazards associated with tobacco use revealed that 41.5% of the students knew about the link between oral cancer and tobacco, with the awareness being greater among females than among males (64.3% vs 35.4%). Conclusion: The finding that tobacco consumption increases with age is a matter of concern. In addition to their clinical work, dental professionals should also educate the public on the hazards of tobacco and conduct tobacco cessation programmes for adolescent groups to control the tobacco epidemic