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Nevin Manimala Statistics

Projections of future temperature-related cardiovascular mortality under climate change, urbanization and population aging in Beijing, China

Environ Int. 2022 Apr 9;163:107231. doi: 10.1016/j.envint.2022.107231. Online ahead of print.

ABSTRACT

Climate change is causing the surface temperature to rise and the extreme weather events to increase in frequency and intensity, which will pose potential threats to the survival and health of residents. Beijing is facing multiple challenges such as coping with climate change, urbanization, and population aging, which puts huge decision-making pressure on decision maker. However, few studies that systematically consider the health effects of climate change, urbanization, and population aging for China. Based on the distributed lag nonlinear model (DLNM) and 13 global climate models in the Coupled Model Intercomparison Project Phase 6 (CMIP6), this study obtained the temporal and spatial distribution of surface temperature through statistical downscaling methods, and comprehensively explored the independent and comprehensive effects of urbanization and population aging on the projection of future temperature-related cardiovascular disease (CVD) mortality in the context of climate and population change. The results showed that only improving urbanization can reduce future temperature-related CVD mortality by 1.7-18.3%, and only intensified aging can increase future temperature-related CVD mortality by 48.8-325.9%. Taking into account the improving urbanization and intensified aging, future temperature-related CVD mortality would increase by 44.1-256.6%, and the increase was slightly lower than that of only intensified aging. Therefore, the intensified aging was the biggest disadvantage in tackling climate change, which would obviously magnify the mortality risks of temperature-related CVD in the future. Although the advancement of urbanization would alleviate the adverse effects of the intensified aging population, the mitigation effects would be limited. Even so, Urbanization should be continued to reduce health risks for residents. These findings would contribute to formulate policies related to mitigate climate change and reduce baseline mortality rate (especially the elderly) in international mega-city – Beijing. In addition, relevant departments should improve the medical health care level and optimize the allocation of social resources to better cope with and adapt to climate change.

PMID:35436720 | DOI:10.1016/j.envint.2022.107231

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Self-efficacy beliefs among baccalaureate nursing students – A cross-sectional, comparative study

Int J Nurs Educ Scholarsh. 2022 Apr 18;19(1). doi: 10.1515/ijnes-2021-0157.

ABSTRACT

The aim of this study is to explore baccalaureate nursing students’ self-efficacy beliefs related to theoretical coursework. Self-efficacy, i.e., the perception of one’s ability to successfully complete a task, has been shown to correlate positively with academic performance and persistence. Nursing students from a large Norwegian university participated (n=132). Data were collected through a digital questionnaire and analyzed using SPSS statistics. Descriptive analysis was performed. Student groups were compared according to gender, age, and year of study using one-way analyses of variance and independent sample t-tests. The findings suggest that the students’ self-efficacy beliefs related to theoretical coursework are quite high, with few significant differences between the groups. While the students have confidence in their ability to reach academic goals, self-efficacy when facing stress and distraction is lower. The findings may be of interest to educators striving to optimize learning in baccalaureate nursing programs.

PMID:35436394 | DOI:10.1515/ijnes-2021-0157

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Directly observed therapy to promote medication adherence in adolescent heart transplant recipients

Pediatr Transplant. 2022 Apr 18:e14288. doi: 10.1111/petr.14288. Online ahead of print.

ABSTRACT

PURPOSE: HT recipients experience high levels of medication non-adherence during adolescence. This pilot study examined the acceptability and feasibility of an asynchronous DOT mHealth application among adolescent HT recipients. The app facilitates tracking of patients’ dose-by-dose adherence and enables transplant team members to engage patients. The DOT application allows patients to self-record videos while taking their medication and submit for review. Transplant staff review the videos and communicate with patients to engage and encourage medication adherence.

METHODS: Ten adolescent HT recipients with poor adherence were enrolled into a single-group, 12-week pilot study examining the impact of DOT on adherence. Secondary outcomes included self-report measures from patients and parents concerning HRQOL and adherence barriers. Long-term health outcomes assessed included AR and hospitalization 6 months following DOT.

FINDINGS: Among 14 adolescent HT patients approached, 10 initiated the DOT intervention. Of these, 8 completed the 12-week intervention. Patients and caregivers reported high perceptions of acceptability and accessibility. Patients submitted 90.1% of possible videos demonstrating medication doses taken. MLVI values for the 10 patients initiating DOT decreased from 6 months prior to the intervention (2.86 ± 1.83) to 6 months following their involvement (2.08 ± 0.87) representing a 21.7% decrease in non-adherence, though not statistically significant given the small sample size.

CONCLUSIONS: Result of this pilot study provides promising insights regarding the feasibility, acceptability, and potential impact of DOT for adolescent HT recipients. Further randomized studies are required to confirm these observations.

PMID:35436376 | DOI:10.1111/petr.14288

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Did COVID-19 Impact Contraceptive Uptake? Evidence from Senegal

Stud Fam Plann. 2022 Apr 18. doi: 10.1111/sifp.12195. Online ahead of print.

ABSTRACT

This study assessed the impact of the COVID-19 pandemic on the number of new contraceptive acceptors in Senegal overall and by method. Monthly service data from March 2019 to December 2020 were extracted for the number of new contraceptive users of IUDs, implants, injectables, and oral contraceptive pills (OCPs). Data were analyzed using descriptive statistics and interrupted time series analysis for trend analyses overall and by the contraceptive method. Following the announcement of the first COVID-19 case in Senegal in March 2020, there was an immediate significant decrease in the number of new acceptors overall, and for new users of implants and injectables. From March-December 2020, the trend in monthly new family planning acceptors increased overall, mainly driven by significant increases in new IUD and implant acceptors. Compared to the period before the onset of COVID-19, there was a statistically significant shift from shorter-acting methods (OCPs, injectables) to long-acting reversible methods (IUDs, implants). Despite the immediate adverse impact of COVID-19-related restrictions, the number of new acceptors rebounded, trends in the number of new monthly acceptors significantly increased, and there was a significant shift to longer-acting methods.

PMID:35436350 | DOI:10.1111/sifp.12195

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Topical immunotherapy treatment of alopecia areata with diphenylcyclopropenone: regulatory T cells as biomarkers for treatment response

Dermatol Ther. 2022 Apr 18:e15522. doi: 10.1111/dth.15522. Online ahead of print.

ABSTRACT

Treatment of alopecia areata is often challenging, especially for patients with extended disease. Contact immunotherapy with diphenylcyclopropenone (DPCP) has been reported as an effective topical treatment but the exact immunologic mechanism of diverting the immune response is still unknown. We investigated the efficacy of topical immunotherapy with DPCD in acute, intermediate, and chronic lesions of AA and the response rate was associated with perifollicular infiltrate of T regulatory cells. Approximately two-thirds of our patients (67.5%) had a response rate > 50% after 6 months of DPCP therapy. Patients with acute and intermediate onset of the disease were more likely to respond to the therapy. Although responders demonstrated FOXP3+ positive lymphocytes in immunohistochemistry, this association could not be confirmed by statistical significance (p = 0.052). In patients with multiple lesions, that had different chronological onset, the lesions with more recent onset responded faster than lesions of longer duration. This article is protected by copyright. All rights reserved.

PMID:35436374 | DOI:10.1111/dth.15522

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Comparison of risks of arterial thromboembolic events and glaucoma with ranibizumab and aflibercept intravitreous injection: A nationwide population-based cohort study

PLoS One. 2022 Apr 18;17(4):e0267088. doi: 10.1371/journal.pone.0267088. eCollection 2022.

ABSTRACT

BACKGROUND: To compare intravitreal aflibercept injection with intravitreal ranibizumab injection for the risk of major arterial thromboembolic events (ATEs) and glaucoma.

METHODS: This retrospective, nationwide cohort study investigated 15 611 and 3867 patients aged >50 years with at least one pharmacy claim for intravitreal ranibizumab injection and aflibercept injection between 2011 and 2016, respectively. The inverse probability of treatment weighting method was performed to adjust the baseline difference between the two groups and the hazard risk of adverse events was estimated using the Cox proportional regression model.

RESULTS: No significant difference was noted between intravitreal ranibizumab and aflibercept injection for arterial thromboembolic risk, including ischemic stroke and acute myocardial infarction, during a 2-year follow-up (adjusted hazard ratio (HR): 0.87, 95% confidence interval (CI): 0.53-1.42; P = .583). Subgroup analyses revealed that patients age >65 years (adjusted HR: 0.64, 95% CI: 0.45-0.92) and those without coronary artery disease (adjusted HR: 0.59, 95% CI: 0.37-0.95) had significantly lower arterial thromboembolic risk in the aflibercept group than in the ranibizumab group. Additionally, the risk of glaucoma development after intravitreal injection did not significantly differ between the two groups (adjusted HR: 0.63, 95% CI: 0.37-1.06; P = .084).

CONCLUSIONS: No significant differences in the risk of major ATEs and glaucoma were found between ranibizumab and aflibercept, and aflibercept might be safe for use in elderly patients.

PMID:35436315 | DOI:10.1371/journal.pone.0267088

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Risk perceptions regarding inclusion of seasonal influenza vaccinations in the school immunization program in Israel: Arab vs. Jewish mothers

PLoS One. 2022 Apr 18;17(4):e0267279. doi: 10.1371/journal.pone.0267279. eCollection 2022.

ABSTRACT

BACKGROUND: The issue of whether to include seasonal influenza vaccinations in school-located vaccination programs (SLIV) has been examined in many countries, mainly in the context of economic effectiveness and morbidity prevention. Yet not enough studies have examined the impact of parental risk perceptions, health literacy and SLIV on parental vaccination uptake.

OBJECTIVES: The most recent statistics in Israel point to a higher rate of seasonal influenza vaccination among Arab children (aged 7-9 years) than among Jewish children in the same age group. The present study attempts to explain this high vaccination uptake among mothers from Arab society by comparing their risk perceptions regarding seasonal influenza vaccination and disease to those of Jewish mothers. The study further examines the impact of SLIV on parental risk perceptions and influenza vaccination uptake.

METHODS: This cross-sectional study included mothers of children in the second and third grades faced with the decision of whether their children should receive the seasonal influenza vaccination at school. The study population included a stratified sample of Jewish mothers (n = 159) and Arab mothers from all the Arab population sub-groups: Muslim, Christian, Druse and Bedouin (n = 534).

RESULTS: A comparison of the Arab and Jewish populations revealed a significant difference in vaccination rates; 61.7% among Arab mothers compared to 33.5% among Jewish mothers (χ2(1) = 39.15, P<0.0001). Moreover, significant differences emerged between the Arab and Jewish populations in health literacy and ability to seek information regarding the seasonal influenza vaccination (t (691) = -5.81, p < 0.0001). While no differences emerged in mothers’ perceptions regarding influenza as a disease (t (691) = 1.20, p = 0.2318), Arab mothers perceived the vaccination to be safer than Jewish mothers (t (691) = 2.74, p = 0.0063) and saw its inclusion in the school-located vaccination program as providing more legitimacy (Z = -6.6719, P < .0001).

CONCLUSION: This study showed that the factors influencing vaccination uptake among both the Arab and the Jewish populations include perceived influenza risk, perceived vaccination risk, inclusion in the school-located vaccination program and health literacy. Moreover, influenza vaccination uptake is higher among those who have positive attitudes toward vaccinations, low risk perceptions regarding the vaccine, and low health literacy that impedes their ability to seek information. The research also points to the need for education and tools to boost health literacy among minority groups so that mothers can make independent and informed decisions about whether or not to vaccinate their children.

PMID:35436312 | DOI:10.1371/journal.pone.0267279

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Association between paracetamol use during pregnancy and perinatal outcomes: Prospective NISAMI cohort

PLoS One. 2022 Apr 18;17(4):e0267270. doi: 10.1371/journal.pone.0267270. eCollection 2022.

ABSTRACT

BACKGROUND: Paracetamol is widely used to manage fever and pain during pregnancy worldwide. However, paracetamol may affect the pregnant woman and fetus, once this drug crosses the placental barrier after therapeutic doses and may impair fetal liver function, affecting fetus growth and development. Thus, this study aimed to investigate the association between paracetamol use during pregnancy and perinatal outcomes as preterm birth, low birth weight, and small for gestational age.

METHODS AND FINDINGS: Data from 760 pregnant women within the NISAMI Cohort between June 2012 and February 2014 were analyzed. Logistic regression was used to estimate the association among paracetamol use during pregnancy and preterm birth, low birth weight, and small for gestational age. Multivariate analyses were adjusted for socioeconomic, maternal, pregnancy, and newborn covariates. Around 14% of women were exposed to paracetamol during pregnancy. A decrease in paracetamol use throughout pregnancy was observed. Lower risk of low birth weight in infants born to women exposed to the drug (OR 0.21; IC 95% 0.01-0.99) was found. Paracetamol use during pregnancy was not statistically associated with preterm birth or small for gestational age.

CONCLUSIONS: The findings of this study do not suggest an increased risk of perinatal outcomes. However, it should not be assumed that paracetamol is a risk-free medication and its use must be rational.

PMID:35436308 | DOI:10.1371/journal.pone.0267270

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COVID-19 precautionary practices and associated factors among clients visiting a tertiary hospital, Addis Ababa, Ethiopia

PLoS One. 2022 Apr 18;17(4):e0267000. doi: 10.1371/journal.pone.0267000. eCollection 2022.

ABSTRACT

BACKGROUND: Despite efforts to contain the spread of COVID-19, Addis Ababa, the country’s COVID-19 epicenter, is experiencing a sharp increase in the number of cases and death rate. While poor public adherence to COVID-19 precautionary practices is evident, factors associated with it are not well studied. We aimed to assess the level of practice of COVID-19 precaution and associated factors.

METHODS: This was a hospital-based cross-sectional study conducted from February 1st to 15th, 2021 at Saint Paul’s Hospital Millennium Medical College, a tertiary teaching hospital in Addis Ababa, Ethiopia. We used a structured questionnaire to conduct a face-to-face exit interview with clients visiting the hospital. Systematic random sampling was employed to recruit study participants. Binary and multivariable logistic regressions were implemented to examine factors associated with precautionary practices. Statistical significance was declared at p-value <0.05. The Crude odds ratio (COR) and Adjusted odds ratio (AOR) were reported with a 95% confidence interval.

RESULTS: We analyzed data obtained from 262 participants. The mean age of participants was 36 (SD+12) years. The majority (207, 79%) of the study participants had a favorable attitude towards prevention and control measures of COVID-19. A little over half (116, 55.7%) of the respondents had a satisfactory level of practice of COVID-19 precautions. Living in an area with strict enforcement of COVID-19 precautionary measures [AOR: 2.25, 95% CI (1.22-4.15)], and having a favorable attitude of COVID-19 prevention [AOR: 4.88, 95% CI (2.08-11.68)] were significantly associated with satisfactory COVID-19 precautionary practices.

CONCLUSIONS: The level of practice of COVID-19 precaution was unsatisfactory. Favorable attitude and stricter enforcement of COVID-19 preventive measures might have contributed more to adherence to precautionary practices. The findings highlight the need for a public health education strategy targeted at improving attitudes of the community on COVID-19 focusing on the effectiveness of preventive measures.

PMID:35436310 | DOI:10.1371/journal.pone.0267000

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Impact of tourism on sustainable development in BRI countries: The moderating role of institutional quality

PLoS One. 2022 Apr 18;17(4):e0263745. doi: 10.1371/journal.pone.0263745. eCollection 2022.

ABSTRACT

This study investigated the influence of tourism on sustainable development while considering institutional quality as a moderating variable. Moreover, exchange rate, urbanization, household consumption, per capita income and renewable energy per capita were also essential factors in determining sustainable development. The sample consists of 64 Belt and Road Initiative (BRI) countries from 2003-2018. The outcomes of the two-step system GMM confirmed the statistically significant and positive dynamic nature of sustainable development and its relationship with tourism and other determinants at a significance level of 1% for BRI countries. Institutional quality enhanced the 4.693% sustainability path to achieve the sustainable development goals (SDGs) agenda with regionally interconnected countries at significance level of 1%. Renewable energy per-capita and income per-capita played a significant and positive role, while the exchange rate, household consumption, and urbanization negatively influenced by hurting thd path of sustainable development. The current research findings have valuable contributions to academics as it offers novel insights about the 0. 351% influence of tourism on sustainable development at significance level of 1%, and it proposes valued suggestions to policymakers concerning tourism development strategies.

PMID:35436304 | DOI:10.1371/journal.pone.0263745