Publications by authors named "Klajdi Puka"

Article Synopsis
  • The study aimed to determine the minimum clinically important difference (MCID) for two versions of the Quality of Life in Childhood Epilepsy Questionnaire: the full 55-item version (QOLCE-55) and the shorter 16-item version (QOLCE-16).
  • Data were gathered from 74 children with epilepsy, using both anchor-based and distribution-based methods to estimate MCID values, with results indicating different scores for each version.
  • This research highlights the importance of understanding MCID values to assess whether changes in the quality of life for children with epilepsy are significant, informing better epilepsy care.
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Background And Aims: Increasing levels of alcohol use are associated with a risk of developing an alcohol use disorder (AUD), which, in turn, is associated with considerable burden. Our aim was to estimate the risk relationships between alcohol consumption and AUD incidence and mortality.

Method: A systematic literature search was conducted, using Medline, Embase, PsycINFO and Web of Science for case-control or cohort studies published between 1 January 2000 and 8 July 2022.

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Article Synopsis
  • The study aimed to assess the quality of life (HRQOL) of parents whose children underwent epilepsy surgery versus those treated with medical therapy over two years.
  • Researchers collected data from parents at multiple intervals and adjusted for various factors using a linear mixed model.
  • Results indicated similar HRQOL trajectories for both groups, but parents of surgical patients had slightly higher HRQOL, though overall improvement was limited, potentially due to persistent issues in the children.
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Importance: People with low socioeconomic status (SES) experience greater burden from alcohol-attributable health conditions and mortality at equal levels of alcohol consumption compared with those with high SES. A U-shaped association has been established between alcohol use and ischemic heart disease (IHD), but no study has explored how such an association differs by SES in the US.

Objective: To investigate how the association of alcohol use with ischemic heart disease mortality differs by SES in the general US population.

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Background: The Mindfulness Ambassador Program (MAP) is a group-based, facilitated mindfulness-based intervention (MBI). We sought to determine the effectiveness of MAP on reducing negative psychotic symptoms and enhancing mindfulness skills among persons experiencing early psychosis.

Methods: We conducted a pragmatic randomized controlled trial (RCT) at three early psychosis intervention (EPI) programs in Ontario, Canada.

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Article Synopsis
  • This study looked at how parents' happiness and stress levels changed over the first two years after their child was evaluated for epilepsy surgery.
  • It involved 259 parents and tracked their feelings about depression, anxiety, and family support at different times.
  • The research found three groups of parents: those who felt good all the time, those who felt a little better over time, and those who struggled but showed some slight improvement, with better outcomes linked to higher family income and children's health.
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Background: Alcohol consumption is the most important risk factor responsible for the disease burden of liver cirrhosis (LC). Estimates of risk relationships available usually neither distinguish between different causes such as alcohol-related LC or hepatitis-related LC, nor differentiate between morbidity and mortality as outcome. We aimed to address this research gap and identify dose-response relationships between alcohol consumption and LC, by cause and outcome.

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Article Synopsis
  • The study investigates how pre-operative factors impact health-related quality of life (HRQOL) for children two years after epilepsy surgery, focusing on those with drug-resistant epilepsy.
  • It found that a child’s older age at seizure onset and higher HRQOL before surgery significantly predicted better HRQOL outcomes post-surgery.
  • The results highlight the importance of assessing and improving a child’s pre-operative quality of life to enhance recovery and overall well-being after epilepsy surgery.
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Background: Racial and ethnic inequalities in all-cause mortality exist, and individual-level lifestyle factors have been proposed to contribute to these inequalities. In this study, we evaluate the extent to which the association between race and ethnicity and all-cause mortality can be explained by differences in the exposure and vulnerability to harmful effects of different lifestyle factors.

Methods: The 1997-2014 cross-sectional, annual US National Health Interview Survey (NHIS) linked to the 2015 National Death Index was used.

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Unlabelled: We estimate the effects of alcohol taxation, minimum unit pricing (MUP), and restricted temporal availability on overall alcohol consumption and review their differential impact across sociodemographic groups. Web of Science, Medline, PsycInfo, Embase, and EconLit were searched on 08/12/2022 and 09/26/2022 for studies on newly introduced or changed alcohol policies published between 2000 and 2022 (Prospero registration: CRD42022339791). We combined data using random-effects meta-analyses.

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Objectives: The purpose of this longitudinal cohort study was to examine the variables that influence health-related quality of life (HRQOL) after epilepsy surgery in children. We examined whether treatment type (surgical vs medical therapy) and seizure control are related to other variables that have been shown to influence HRQOL, namely depressive symptoms in children with epilepsy or their parents, and the availability of family resources.

Methods: In total, 265 children with drug-resistant epilepsy were recruited from eight epilepsy centers across Canada at the time of their evaluation for candidacy for epilepsy surgery and were assessed at baseline, 6-month, 1-year, and 2-year follow-up.

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Racial and ethnic inequalities in all-cause mortality exist, and individual-level lifestyle factors have been proposed to contribute to these inequalities. In this study, we evaluate the extent to which the association between race and ethnicity and all-cause mortality can be explained by differences in the exposure and vulnerability to harmful effects of different lifestyle factors. The 1997-2014 cross-sectional, annual US National Health Interview Survey (NHIS) linked to the 2015 National Death Index was used.

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Importance: Health-related quality of life (HRQOL) is regarded as a key outcome for evaluating treatment efficacy. However, it is uncertain how HRQOL evolves after epilepsy surgery compared with medical therapy, such as whether it continues to improve over time, improves and then remains stable, or deteriorates after a period of time.

Objective: To assess trajectory of HRQOL over 2 years in children with drug-resistant epilepsy (DRE) treated with surgery compared with medical therapy.

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Background: Whether written comments in entrustable professional activities (EPAs) translate into high-quality feedback remains uncertain.

Objective: We aimed to evaluate the quality of EPA feedback completed by faculty and senior residents.

Methods: Using retrospective descriptive analysis, we assessed the quality of feedback from all EPAs for 34 first-year internal medicine residents from July 2019 to May 2020 at Western University in London, Ontario, Canada.

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Article Synopsis
  • Life expectancy in the U.S. has stagnated and even declined since around 2010, with increasing inequalities based on socioeconomic status and demographics.
  • The SIMAH Project uses advanced microsimulation techniques to explore how alcohol use, socioeconomic factors, and race/ethnicity affect life expectancy disparities and the potential impact of alcohol control policies on these inequalities.
  • Preliminary findings show that this microsimulation model effectively reflects real demographic changes, offering a strong foundation for future public health policy development aimed at promoting equity.
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Objective: Minimally invasive magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has been proposed as an alternative to open epilepsy surgery, to address concerns regarding the risk of open surgery. Our primary hypothesis was that seizure freedom at 1 year after MRgLITT is noninferior to open surgery in children with drug-resistant epilepsy (DRE). The secondary hypothesis was that MRgLITT has fewer complications and shorter hospitalization than surgery.

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Background: The ongoing opioid epidemic and increases in alcohol-related mortality are key public health concerns in the USA, with well-documented inequalities in the degree to which groups with low and high education are affected. This study aimed to quantify disparities over time between educational and racial and ethnic groups in sex-specific mortality rates for opioid, alcohol, and combined alcohol and opioid poisonings in the USA.

Methods: The 2000-2019 Multiple Cause of Death Files from the National Vital Statistics System (NVSS) were used alongside population counts from the Current Population Survey 2000-2019.

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Aims: To estimate the probability of transitioning between different categories of alcohol use (drinking states) among a nationally representative cohort of United States (US) adults and to identify the effects of socio-demographic characteristics on those transitions.

Design, Setting And Participants: Secondary analysis of data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a prospective cohort study conducted in 2001-02 and 2004-05; a US nation-wide, population-based study. Participants included 34 165 adults (mean age = 45.

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Objectives: Many studies suggest that infective endocarditis (IE) in people who inject drugs is predominantly right sided, while other studies suggest left sided disease; few have differentiated by class of drug used. We hypothesised that based on differing physiological mechanisms, opioids but not stimulants would be associated with right sided IE.

Methods: A retrospective case series of 290 adult (age ≥18) patients with self-reported recent injection drug use, admitted for a first episode of IE to one of three hospitals in London Ontario between April 2007 and March 2018, stratified patients by drug class used (opioid, stimulant or both), and by site of endocarditis.

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Purpose: Health-related quality of life (HRQL) is compromised in children with epilepsy. We aimed to determine whether children diagnosed with epilepsy between ages 4-12 years who are exposed to a higher number of anti-seizure medication (ASM) over the first 2 years, have poorer HRQL 10 years after diagnosis.

Methods: Data were obtained from 195 children enrolled in the Health-Related Quality of Life in Children with Epilepsy Study (HERQULES) in Canada.

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Importance: The US has experienced increasing socioeconomic inequalities and stagnating life expectancy. Past studies have not disentangled 2 mechanisms thought to underlie socioeconomic inequalities in health, differential exposure and differential vulnerability, that have different policy implications.

Objective: To evaluate the extent to which the association between socioeconomic status (SES) and all-cause mortality can be decomposed into a direct effect of SES, indirect effects through lifestyle factors (differential exposure), and joint effects of SES with lifestyle factors (differential vulnerability).

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Aims: While nationally representative alcohol surveys are a mainstay of public health monitoring, they underestimate consumption at the population level. This paper demonstrates how to adjust individual-level survey data using aggregated alcohol per capita (APC) data for improved individual- and population-level consumption estimates.

Design And Methods: For the period 1984-2020, data on self-reported alcohol consumption in the past 30 days were taken from the Behavioral Risk Factor Surveillance System (BRFSS) involving participants (18+ years) in the United States (US).

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Unlabelled: Different studies have shown that females develop liver diseases at lower levels of alcohol consumption than males. Our aim was to quantify the dose-response relationship between alcohol consumption and the risk of liver cirrhosis by sex and identify the differences between females and males. A systematic review was conducted using PubMed/Medline and Embase to identify longitudinal and case-control studies that analyzed the relationship between the level of alcohol use and liver cirrhosis (LC) incidence, and mortality (ICD-8 and ICD-9 codes 571 and ICD-10 codes K70, K73, K74).

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For children with medication-resistant epilepsy who undergo multilobar or hemispheric surgery, the goal of achieving seizure freedom is met with a variety of potential functional consequences, both favorable and unfavorable. However, there is a paucity of literature that comprehensively addresses the cognitive, medical, behavioral, orthopedic, and sensory outcomes across the lifespan following large epilepsy surgeries in childhood, leaving all stakeholders underinformed with regard to counseling and expectations. Through collaboration between clinicians, researchers, and patient/caregiver stakeholders, the "Functional Impacts of Large Resective or Disconnective Pediatric Epilepsy Surgery: Identifying Gaps and Setting PCOR Priorities" meeting was convened on July 18, 2019, to identify gaps in knowledge and inform various patient-centered research initiatives.

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