Comparative effectiveness of verbal instruction versus video-based education (VIVid) among family caregivers for improving the quality of life in advanced head and neck cancer patients receiving palliative care in Eastern India: a randomized controlled trial.

PURPOSE: To determine if video-based educational intervention compared to the standard verbal guidelines, provided to caregivers on home-based palliative care could enhance the quality of life (QoL) in advanced head and neck cancer (HNC) patients. METHODS: The study employed a prospective, two-arm parallel-group, randomized controlled trial design. Investigators prepared a real-world demonstrational video of ten minutes duration regarding home-based care for family caregivers, with voice-over in Odia language (Eastern India). The contents of the video addressed the management of common problems in palliative care among HNC patients. This study included 180 participants, 90 patient & caregiver dyads randomized to interventional (video-based education) or control (verbal instruction) groups. Patients' QoL was measured at baseline and 3 weeks follow-up using EORTC QLQ C30. Data were analyzed descriptively, and the Chi-square, Mann-Whitney U, T-test, spearman correlation, and multiple hierarchical regression analyses were employed for statistical analysis, with a significance level of p < 0.05. RESULTS: Seventy participant dyads completed the planned two assessments: baseline and at the end of 3rd week (Intervention = 37; Control = 33). The intervention group showed a significant improvement in the patient's health-related QoL, physical, emotional, and social functioning. Symptom burden reduction was observed for pain, nausea, and fatigue. A significant increase in the change in QoL with the video-based education group (VBE) compared to the verbal instruction (VI) group after adjusting for age, gender, physical functioning, and pain symptomology (adjusted R2 = 0.402) was noted. CONCLUSION: VBE intervention using smart-phone may offer caregivers a viable means of enhancing self-management while improving patients' QoL within the socio-cultural challenges for home-based palliative care in India. Further research on training caregivers using digital interventions and home-based visits is recommended. TRIAL REGISTRATION NUMBER: CTRI/2021/06/034473 [Registered on: 30/06/2021].

Preparedness toward participation in disaster management: An online survey among dental practitioners in a disaster-prone region of Eastern India.

BACKGROUND: Dentists are often overlooked resources in the workforce for disaster management (DM). To determine the knowledge, attitudes, willingness, and self-perceived effectiveness to participate in DM among general dental practitioners (GDPs) of Eastern India. MATERIALS AND METHODS: A web-based online survey was conducted among 256 Dental Council of India registered GDPs of Cuttack district, Odisha. The 45-item survey comprised closed-ended questions on the demographic data of the participants, years of practice, previous experience in DM, and willingness to participate. Other domains assessed were the participants' objective knowledge of DM, attitude, and self-perceived effectiveness toward participation during disasters. Data were analyzed descriptively, and the Chi-square and Mann-Whitney U tests were used for statistical analysis, with a significance threshold of P < 0.05. RESULT: A total of 154 responses were analyzed, giving a response rate of 60.16%. The average age was ≤35 years, 59.1% were BDS dentists and 78.6% had less than 10 years of practice. Only 18% of them had previous experience with DM, and merely 3.2% were formerly trained; however, 95.5% of the dentists were willing to participate in DM. The mean DM knowledge and attitude scores were 16.12 (CI = 15.4-16.8) and 5.79 (5.45-6.13), respectively. Knowledge and attitude showed a significant correlation. About 56% indicated that they would be able to respond effectively to a disastrous event. Significant associations were observed between age group (P = 0.008), years of clinical practice (P = 0.001), qualification (P = 0.012), previous participation (P = 0.029), and self-perceived effectiveness. CONCLUSION: The knowledge regarding DM among respondents was at an average level. However, the majority of them were found to have a positive attitude toward participation in DM. Thus, including DM in dental curricula and drills for dental professionals might prove beneficial as almost all GDPs were showing greater self-perceived effectiveness and willingness to participate in disasters.

Prevalence, Trends, and Associated Risk Factors of Traumatic Dental Injury among Children and Adolescents in India: A Systematic Review and Meta-analysis.

AIM AND OBJECTIVE: Traumatic dental injury (TDI) is a significant public health concern. This study aimed to perform a systematic review on the prevalence, trends, and possible risk factors of dental trauma in permanent teeth among children and adolescents in India. MATERIALS AND METHODS: Literature search was carried out, in PubMed, EMBASE, Web of Science, Cochrane, Google scholar, and Gray literature (MDS dissertation, manuscripts) database up to October 5, 2020, reporting on dental trauma prevalence in India. Meta-analyses were done using random effects model. Pooled estimates were calculated with a confidence interval of 95% (95% CI) both for prevalence and odds ratios (OR). Trend analysis was performed for the included studies. Quality assessment of the included studies was done using the Hoy checklist for prevalence studies. Qualitative synthesis was done for predictors in which meta-analysis could not be performed. RESULTS: This online searching strategy collected and listed 2,491 articles on this topic. After evaluating their titles and abstracts, only 59 were finally selected for complete review and data collection. All studies had been performed in children and adolescents. The pooled prevalence of dental trauma in permanent teeth was 11%. Positive summary association of dental trauma with male gender (pooled OR = 1.52; 95% CI: 1.37-1.70), inadequate lip coverage (pooled OR = 4.76; 95% CI: 3.18-7.11), and increased overjet of >3.5mm (pooled OR = 4.84; 95% CI: 2.86-8.19) and >5.5 mm (pooled OR = 4.93; 95% CI: 4.32-5.63) was observed. Prevalence of dental trauma showed an increasing trend with time. All of the studies were having moderate-high risk of bias. CONCLUSION: Approximately 9-13% of the children and adolescents in India presented some type of TDI in permanent teeth, with an increasing trend. Boys, children, and adolescents presenting inadequate lip coverage, or an increased overjet greater than 3.5 and 5.5 mm are more likely to have traumatic dental injuries. CLINICAL SIGNIFICANCE: Future population-based analytical studies on TDI in India are recommended.