Multimorbidities associated with bruxism: a population-based study. Campinas- Brazil

Background Bruxism is a relevant topic in public health, as it represents an increasingly frequent parafunctional activity and also for presenting musculoskeletal and dental effects affecting the health and well-being of the affected population. The reviewed literature shows that bruxism is associated with some health problems, but with multimorbidities has not yet been investigated. Objective To identify the association of bruxism with a multimorbidity pattern. Methods A population-based cross-sectional study was conducted with a sample composed of 1986 adults (≥20 years of age). This study used data from the Third Health Survey of the City of Campinas conducted in 2014 and 2015 (ISACamp 2014/15). A principal component analysis was performed to identify in which multimorbidity pattern, present in the population, bruxism is included. From this pattern, the variable number of diseases was created (0; 1; 2 to 4; 5 or more). The prevalence of bruxism was established according to this variable and associations were tested using the Rao-Scott chi-square test and Poisson regression. Results The factor analysis revealed three relevant patterns of multimorbidity in the population of Campinas. Bruxism was part of the pattern also composed of: asthma, rhinitis, sinusitis, allergy, migraine/headache, emotional/mental problem, dizziness/vertigo and back pain. The prevalence of bruxism increased more than fivefold in the concomitant presence of five or more of these conditions (PR = 5.35;95%CI:3.35 to 8.45). Conclusions Knowledge about the association of bruxism with a pattern of multimorbidities can show the direction of health actions in multidisciplinary teamwork, prioritizing the reduction in harm caused by the simultaneous presence of health problems associated with bruxism. We also emphasize the possible role of bruxism as an indicator of multimorbidities, especially those associated with the pattern found. Key messages Bruxism was more associated with multimorbidities of the pattern composed of asthma, rhinitis, sinusitis, dizziness/vertigo, migraine/headache, emotional/mental problem, back pain and allergy. The concomitant presence these conditions increased the prevalence of bruxism up to fivefold.

Health-related quality of life among patients with hypertension: population-based survey using EQ-5D-5L in Hong Kong SAR, China

ObjectivesTo evaluate the effect of hypertension and related comorbidities on the health-related quality of life (HRQoL) using EuroQol 5-dimensions instrument with five-level scale (EQ-5D-5L) Hong Kong (HK) version.DesignData were analysed by a secondary data analysis based on a cross-sectional study assessing experience on public specialist outpatient service.SettingA representative sample was recruited from 26 specialist outpatient clinics in HK.ParticipantsA total of 4528 patients with hypertension aged 18 or above who responded to the survey.InterventionEQ-5D-5L HK was applied to assess the HRQoL. The five-dimension descriptive system and the utility index of EQ-5D-5L were treated as the dependent variable in the current study. Regression modelling was applied to estimate the effect of hypertension and related comorbidities on health-related quality of life.ResultsMore respondents were women (53.9%), aged ≥65 years old (60.1%), and with primary educational attainment or below (52.3%). A total of 1466 respondents (32.4%) also reported suffering from diabetes, heart disease (20.8%), vision problem (1.7%) and cancer (1.5%). In the ordinal least squares model, utility decreased most when patients reported having physical disability associated with hypertension (beta=−0.395, SE=0.047), and 0.128, 0.064, 0.05 and 0.048 for mental problem, cancer, vision problem and heart problem. In the Tobit model, the utility reduced most for comorbidity of physical disability, and then mental problem, cancer, vision problem, heart problem and diabetes. For first part of two-part model, respondents coliving with mental problem were 10% less likely to report a full health. For the second part of two-part model, the respondents with physical disability had 0.294 lower in utility.ConclusionsRespondents with hypertension reported a low EQ-5D utility score. Respondents were women, with a high education, fully employed and living with families reported better HRQoL. There is a significant effect of comorbidity influence on the decreased HRQoL, particularly those with physical disability and mental problem.

Inability to Trust People in The Novel The Leavers by Lisa Ko

The purpose of this analysis is to expose the issue of inability to trust people which is done by an immigrant child who was separated multiple times from his family. The purpose of this study is to know the contribution of character, plot (conflict), and setting in revealing the inability to trust people. This analysis is related to the concept of neurosis by Sigmund Freud and Psychosocial Development by Erik Erikson that is supported by the text and context based interpretation. The result of this analysis shows the protagonist suffers from social relationship and mental problem that can be seen from his attitude and behavior.

PENURUNAN TINGKAT ANSIETAS MAHASISWA DALAM MENYUSUN SKRIPSI MELALUI TERAPI GENERALIS ANSIETAS

DECREASING ANSIETAS LEVELS OF STUDENTS IN PREPARING THE SKRIPSI THROUGH ANSIETAS GENERALIS THERAPY ABSTRACTWhen students make thesis, they get several problems which cause anxiety. The anxiety that not handled soon will become emotional mental problem. The way to overcome anxiety is anxiety generalist therapy. The purpose of this study was determine the affect of anxiety generalist therapy with the student anxiety levels during making thesis. The design of this study used quasi experiment one group design pretest-posttest. The sample were 68 students who divided into 2 groups, first group is the students who hadn’t proposal examination and the second group is the students who had proposal examination. The result of Mann Whitney statistic test showed p value of both group is 0,000 (p<0,05) with heavy anxiety decreasing in the group which had not proposal examination (61,7%) and the group which had proposal examination the moderate anxiety is decreased (17,6%). The result of this study showed there are affect of anxiety generalist therapy to the student anxiety levels who makes thesis in the group student who hadn’t proposal examination and already proposal examination. anxiety generalist therapy can applied as independent on the students who anxiety when makes thesis and it’s used nurses to help anxiety of patient.

Outcomes, Implications, and Concluding Thoughts

This concluding chapter reviews the alternative paths for how workers are dealing with conditions of the precarious new economy. They are entering common occupations in everyday workplaces that people do not normally think of as knowledge-based or culturally relevant, and transforming them into high-end, quality jobs that fuse mental and manual labor and that people with other work opportunities see as viable career options. These workers experience manual labor as meaningful and even fun through the enactment of a set of cultural repertoires that allow for physical, bodily labor, challenging mental problem-solving, cultural understanding, and interpersonal communication. The jobs also require the confident performance of each of these work practices in concert, not independently of the others.