Effect of mode of administration on Edinburgh Postnatal Depression Scale in the South Indian population: A comparative study on self-administered and interviewer-administered scores (Preprint)

BACKGROUND Edinburgh Postnatal Depression Scale (EPDS) is a validated screening tool widely used to assess perinatal depression (PND). However, due to stigma associated with PND, respondents could answer sensitive questions differently depending on the mode of administration, especially in culturally and linguistically diverse country like India. The present study explored longitudinal differences in EPDS scores between self-administered and interviewer-administered modes OBJECTIVE The main objective of this study was to evaluate the differences in EPDS administration between the self-administered and interviewer-administered modes, a longitudinal observational study to understand and improve the test score interpretation. The present study explores differences in EPDS scores in assessing PND longitudinally, comparing self and interview-based modes of EPDS administration in perinatal women of rural South India METHODS 177 women from rural South India were administered EPDS, self-administration followed by interviewer-administered for four visits, twice each during prenatal and postnatal visits. EPDS scores were compared between the two modes descriptively, graphically and by repeated mixed measure models. Classification of antenatal depression (AD), postnatal depression (PD) and PND based on the two modes were compared by McNemar Chi-square test. Clinical and psychosocial characteristics were examined to identify factors associated with differences in the scoring modes. Concordance rates and Goodman Kruskal’s Gamma coefficients were measured for individual EPDS items. RESULTS Longitudinal EPDS scores and rates of AD, PD and PND were significantly higher in self-administered mode. Recent adverse life events were the only factor observed to be significantly associated with the differences between the two modes. Rank correlation and concordance rates suggested stronger association for EPDS items relating to anhedonia subscale and moderate/weaker association for EPDS items relating to anxiety/depression subscales. CONCLUSIONS Our study findings suggest that the effect of mode of administration should be taken into account while using PND screening tools such as EPDS, especially in countries such as India with higher levels of illiteracy. CLINICALTRIAL The study was registered with the Clinical Trials Registry of India, registration no. CTRI/2017/11/010497 and was conducted from October 2017 to May 2019.

Medicinal Plants Used to Heal Wound in Karandamalai of Dindigul District in Tamil Nadu, Southern India

Due to the presence of antibiotic or antiseptic nature’s chemicals, plants are remarkable for the treatment of wounds. Having this fact as research theme, the present study was carried out to document the therapeutic uses of medicinal plants used to heal wound in Karandamalai of Dindigul district in Tamil Nadu. The frequent fieldwork was conducted from October 2019 to January 2020 for this study. The scientific name, family name, local name (in Tamil), part(s) used, mode of preparation, and mode of administration of medicine were recorded. A total of 24 medicinal remedies prepared from 24 plants were recorded. Further research on the phytochemistry and pharmacology of these medicinal plants should be conducted. Keywords: Medicinal plants, Wound healing, Karandamalai, Dindigul district, Tamil Nadu.

WHAT IS DEMOCRACY AND HOW HAS IT CHANGED OVER TIME?

Democracy is one of the fundamental priorities of modern civil societies and the mainstay of nations and governments. Some people believe that democracy was born in United States. But democracy was born thousands years ago in Ancient Greek. Today democracy is only alternative choice against authoritarian and repressive regimes emerges as one of the most eligible mode of administration. In this article, we will look at the types of democracies and how democracy has changed from first version to present version. Also, why philosophers’ divided on democracy? Key words: history, democracy, magna carta, turks, vikings, middle ages, modern democracy

Substantial SF-36 score differences according to the mode of administration of the questionnaire: an ancillary study of the SENTIPAT multicenter randomized controlled trial comparing web-based questionnaire self-completion and telephone interview

BackgroundSF-36 is a popular questionnaire for measuring self-perception of quality of life in a given population of interest. Surprisingly, no study compared score values issued from a telephone interview versus an internet-based questionnaire self-completion.MethodsPatients having an Internet connection and returning home after hospital discharge were enrolled in the SENTIPAT multicenter randomized trial the day of discharge. They were randomized to either self-complete a set of questionnaires using a dedicated website (I group) or to provide answers to the same questionnaires administered during a telephone interview (T group). This ancillary study of the trial compared SF-36 data relating to the post-hospitalization period in these two groups. In order to anticipate potential unbalanced characteristics of the respondents in the two groups, the impact of the mode of administration of the questionnaire on score differences was investigated using a matched sample of individuals originating from I and T groups (ratio 1:1), the matching procedure being based on a propensity score approach. SF-36 scores observed in I and T groups were compared with a Wilcoxon-Mann-Whitney test, the score differences between the two groups were also examined according to Cohen’s effect size.ResultsThere were 245/840 (29%) and 630/840 (75%) SF-36 questionnaires completed in the I and T group, respectively (p < 0.001). Globally, score differences between groups before matching were similar to those observed in the matched sample. Mean scores observed in T group were all above the corresponding values observed in the I group. After matching, score differences in six out of the eight SF-36 scales were statistically significant, with a mean difference greater than 5 for four scales and an associated mild effect size ranging from 0.22 to 0.29, and with a mean difference near this threshold for two other scales (4.57 and 4.56) and a low corresponding effect size (0.18 and 0.16, respectively).ConclusionsTelephone mode of administration of SF-36 involved an interviewer effect increasing SF-36 scores. Questionnaire self-completion via the Internet should be preferred and surveys combining various administration methods should be avoided.Trial RegistrationClinicalTrials.govNCT01769261, registered January 16, 2013.

Parent and Pediatrician Preferences for Type 1 Diabetes Screening in the U.S.

<a><b>Objective:</b> The purpose of this study was to use a discrete-choice experiment methodology to understand the relative importance of the attributes of screening tests for type 1 diabetes among parents and pediatricians in the United States.</a> <p><b>Research Design and Methods:</b> Online surveys presented hypothetical Screening Test profiles from which respondents chose their preferred test profile. Survey attributes were based on likely screening test options and included the mode of administration, where and when the test was conducted, the type of education and monitoring available to lower the risk of diabetic ketoacidosis (DKA), and whether a treatment was available that would delay onset of insulin dependence. Data were analyzed using random-parameters logit models.</p> <p><b>Results:</b> Parents placed the highest relative importance on monitoring programs that could reduce the risk of DKA to 1%, followed by treatment to delay onset of insulin dependence by 1 or 2 years, and, finally, avoiding a $50 out-of-pocket cost. Pediatricians placed equal importance on monitoring programs that reduced a patient’s risk of DKA to 1% and on avoiding a $50 out-of-pocket cost for the screening test, followed by the option of a treatment to delay the onset of insulin dependence. The mode of administration and location and timing of the screening were much less important to both parents and pediatricians<i>.</i></p> <p><b>Conclusions:</b> Parents and pediatricians preferred screening tests that were accompanied by education and monitoring plans to reduce the risk of DKA, had available treatment to delay type 1 diabetes, and had lower out-of-pocket costs.</p>

Parent and Pediatrician Preferences for Type 1 Diabetes Screening in the U.S.

<a><b>Objective:</b> The purpose of this study was to use a discrete-choice experiment methodology to understand the relative importance of the attributes of screening tests for type 1 diabetes among parents and pediatricians in the United States.</a> <p><b>Research Design and Methods:</b> Online surveys presented hypothetical Screening Test profiles from which respondents chose their preferred test profile. Survey attributes were based on likely screening test options and included the mode of administration, where and when the test was conducted, the type of education and monitoring available to lower the risk of diabetic ketoacidosis (DKA), and whether a treatment was available that would delay onset of insulin dependence. Data were analyzed using random-parameters logit models.</p> <p><b>Results:</b> Parents placed the highest relative importance on monitoring programs that could reduce the risk of DKA to 1%, followed by treatment to delay onset of insulin dependence by 1 or 2 years, and, finally, avoiding a $50 out-of-pocket cost. Pediatricians placed equal importance on monitoring programs that reduced a patient’s risk of DKA to 1% and on avoiding a $50 out-of-pocket cost for the screening test, followed by the option of a treatment to delay the onset of insulin dependence. The mode of administration and location and timing of the screening were much less important to both parents and pediatricians<i>.</i></p> <p><b>Conclusions:</b> Parents and pediatricians preferred screening tests that were accompanied by education and monitoring plans to reduce the risk of DKA, had available treatment to delay type 1 diabetes, and had lower out-of-pocket costs.</p>