Physicians' Reactions to COVID-19: The Results of a Preliminary International Internet Survey.

OBJECTIVES: Physicians across the world have been disproportionately affected by the COVID-19 pandemic. This study was designed and conducted to assess the emotional and behavioural reactions of physicians to the initial phase of the COVID-19 pandemic. SUBJECTS AND METHODS: An online survey questionnaire using the google forms platform was constructed by the authors. The items in the questionnaire were based on clinical experience, relevant literature review and discussion with peers. A list of issues that were deemed as essential components of the experience of the pandemic relevant to physicians was arrived at. Thereafter these issues were operationalized into question form and hosted on the google forms platform. The link to this questionnaire was circulated by the authors among their peer groups in the month of April 2020. RESULTS: We received 295 responses and 3 were unusable. Most of the responses were from India, the United States of America, Australia, Canada and the United Kingdom. About 60% of the respondents identified themselves as frontline and had a decade of clinical experience. Most respondents reported being anxious due to the pandemic and also observed the same in their peers and families. A majority also observed changes in behaviour in self and others and advanced a variety of reasons and concerns. A sense of duty was the most commonly employed coping mechanism. CONCLUSION: Physicians are not immune from information and misinformation, or cues in the environment. Behavioural choices are not always predicted by knowledge but by a combination of knowledge, emotional state, personality and environment. Healthcare settings need to be ready for emergencies and should focus on reducing uncertainty in physicians. These factors may also be gainfully used in the mental health promotion of physicians in COVID-19 care roles.

Evaluation of Mandibular Condylar Changes in Patients Following Orthognathic Surgery: A Retrospective Study.

BACKGROUND: Condylar resorption as a cause of relapse after orthognathic surgery is well known. Several authors have presented evidence of the relation between orthognathic surgery and condylar remodeling and resorption. This study was done to appraise the condylar changes along with the form and function following orthognathic surgery, as well as to assess what factors may have contributed to the problems. METHODOLOGY: A diagnosis of progressive condylar resorption (PCR) was made by comparison of preoperative and postoperative radiographs (cephalometric radiograms), as well as clinical evaluations. The radiographs were taken for each patient preoperatively and postoperatively, which include immediately after osteotomy, at 6 months and 24 months. Additional radiographs were taken when required. Then, preoperative and postoperative tracings were compared at 24 months postoperatively. RESULTS AND CONCLUSION: It can be concluded from this study that females of relative low age (<18 years) appeared to be a high-risk factor for the occurrence of condylar alteration including PCR. A steep mandibular plane angle, the low facial height ratio (post/ant), and magnitude of surgery were also significantly related to the occurrence of condylar alteration, but the multivariance regression showed that these parameters had only limited value.

Affect regulation, social context, and sexual intercourse in adolescents.

This study examined trajectories of positive and negative affect surrounding penile-vaginal sexual intercourse (sex) in adolescents and explored the influence of companionship on these trajectories. Using a handheld computer, sexually active adolescents (N = 67) reported momentary affect and sex events in response to several random signals each day for 1 week (1,777 reports, 266 sex events). Cubic spline regression analyses showed that positive affect began to increase before sex, peaked at the time sex was reported, and then returned to baseline. Negative affect did not differ from baseline before sex, but decreased following sex. Improvement in affect before and after sex varied according to companionship. Understanding the complex associations of affect, companionship, and sex has implications for interpreting and intervening on adolescent sexual behavior in social context.

Depressive symptoms and sexual risk behavior in young, chlamydia-infected, heterosexual dyads.

PURPOSE: To examine associations between depressive symptoms and dyad-level sexual risk behavior in young heterosexual dyads with sexually transmitted infection (STI). METHODS: Chlamydia-positive 14-24-year-old, heterosexually active outpatients and their opposite-sex partners completed an assessment that included demographics, past and recent STI risk behaviors, and the Beck Depression Inventory (BDI). Participants in the top 25% of BDI scores within gender were categorized as depressed. Variables were created to identify dyads in which the female or male partner was depressed, as well as a measure of concordance of depression between partners. Dyad-level STI risk variables were created from the STI risk characteristics reported by each dyad member, and associations between these and the depression variables were analyzed. RESULTS: The 130 dyads were comprised of young men and women at high STI risk. One-third of dyads had at least one depressed partner. Dyads in which the female partner was depressed had greater partner age difference, greater total number of lifetime partners, and one or more partners reporting substance use within 2 hours before sex, compared with dyads in which the female partner was not depressed. Dyads in which the male partner was depressed were more likely than the nondepressed-male dyads to report substance use before sex. All dyads in which both partners were depressed reported substance use before sex. CONCLUSIONS: In young, chlamydia-infected, heterosexual dyads, depressive symptoms, especially in women, is related to increased dyad-level STI risk, including greater partner age difference, more partners, and substance use before sex.

Family, peer, and media predictors of becoming eating disordered.

OBJECTIVE: To identify predictors of becoming eating disordered among adolescents. DESIGN: Prospective cohort study. SETTING: Self-report questionnaires. SUBJECTS: Girls (n = 6916) and boys (n = 5618), aged 9 to 15 years at baseline, in the ongoing Growing Up Today Study (GUTS). Main Exposures Parent, peer, and media influences. MAIN OUTCOME MEASURES: Onset of starting to binge eat or purge (ie, vomiting or using laxatives) at least weekly. RESULTS: During 7 years of follow-up, 4.3% of female subjects and 2.3% of male subjects (hereafter referred to as "females" and "males") started to binge eat and 5.3% of females and 0.8% of males started to purge to control their weight. Few participants started to both binge eat and purge. Rates and risk factors varied by sex and age group (<14 vs > or =14 years). Females younger than 14 years whose mothers had a history of an eating disorder were nearly 3 times more likely than their peers to start purging at least weekly (odds ratio, 2.8; 95% confidence interval, 1.3-5.9); however, maternal history of an eating disorder was unrelated to risk of starting to binge eat or purge in older adolescent females. Frequent dieting and trying to look like persons in the media were independent predictors of binge eating in females of all ages. In males, negative comments about weight by fathers was predictive of starting to binge at least weekly. CONCLUSIONS: Risk factors for the development of binge eating and purging differ by sex and by age group in females. Maternal history of an eating disorder is a risk factor only in younger adolescent females.

The validity of self-reported weight change among adolescents and young adults.

OBJECTIVE: To assess the association of weight change based on serial self-reported vs. measured weights. RESEARCH METHODS AND PROCEDURES: Two thousand two hundred eighty-four male and 2,476 female participants in the National Longitudinal Study of Adolescent Health who provided information on weight at Waves II and III and were at least 16 years of age were studied. Linear regression was used to assess predictors of the discrepancy between weight change based on self-reported vs. measured weights. Logistic regression was used to identify predictors of self-report correctly classifying participants in terms of weight change category. RESULTS: Self-reported weight was slightly lower than measured weight at Waves II and III, but weight change based on self-reported weights underestimated true weight change by only 2.1 (female participants) to 2.8 (male participants) pounds. Overweight and obese female participants were consistent in their under-reporting of their weight more than their leaner peers; thus, the discrepancy between weight change from Wave II to Wave III based on serial self-reports vs. measured weights was significantly smaller among the obese female vs. healthy-weight female participants (0.3- vs. 2.3-pound underestimation, p < 0.05). Among the male participants, the same pattern was evident. African-American ethnicity, Hispanic ethnicity, the level of physical activity, the hours per week watching television, and weight change efforts were not related to the discrepancy between weight change based on self-reported vs. measured weights. DISCUSSION: The discrepancy between weight change based on self-report vs. measured weights was minor and not related to race, weight change efforts, activity, or inactivity, thus suggesting that much of the error is random.

Race and gender differences in the association of dieting and gains in BMI among young adults.

OBJECTIVE: To assess the relationship between dieting and subsequent weight change and whether the association varies by gender or race/ethnicity. RESEARCH METHODS AND PROCEDURES: Male (n = 4100) and female (n = 4302) participants in the National Longitudinal Study of Adolescent Health who provided information on weight and height at baseline and two follow-up assessments and were not missing information on weight control strategies or race were studied. Generalized estimating equations were used to assess whether dieting to lose or maintain weight at Wave I or II predicted BMI (kg/m(2)) change between adolescence and young adulthood (Wave II to III). Analyses were stratified by gender and took sampling weights and clustering into account. RESULTS: At Wave I, the mean age of the participants was 14.9 years. Approximately 29.3% of female participants and 9.8% of male participants reported dieting in Wave I or II. Fewer African Americans than whites (6.2% vs. 10.0% and 25.5% vs. 31.2%, p = 0.007 and p = 0.02, among males and females, respectively) reported dieting. Between Waves II and III, participants gained on average 3.3 kg/m(2). Independent of BMI gain during adolescence (Waves I to II), female participants who dieted to lose or maintain weight during adolescence made larger gains in BMI during the 5 years between Waves II and III (mean additional gain, 0.39 kg/m(2); 95% confidence interval, 0.08 to 0.71) than their nondieting peers. The association was not significant among the male participants. The association was largest among African-American female participants. DISCUSSION: The results suggest that not only is dieting to lose weight ineffective, it is actually associated with greater weight gain, particularly among female adolescents. Female African-American dieters made the largest BMI gains.