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Nevin Manimala Statistics

Engagement with young people as partners in health research: four case studies from Sub-Saharan Africa

Trop Med Int Health. 2021 Dec 3. doi: 10.1111/tmi.13702. Online ahead of print.

ABSTRACT

OBJECTIVES: Existing health services for young people (10-24 years), which are predominantly designed for but not with young people, often do not meet young people’s needs. The 2018 Global Consensus Statement on meaningful adolescent and youth engagement affirms that young people have a fundamental right to actively and meaningfully engage in all matters that affect their lives. We present four case studies from three countries in sub-Saharan Africa as practical examples of the engagement of young people as partners in health research. We critically reflect on best practices to inform and guide the increasing adoption of collaborative approaches.

METHODS: We developed a narrative summary of each case study through review of study documentation and discussions with research staff and young people. A youth engagement framework was used to describe partnership activities according to the following dimensions: purpose, process, positioning, perspective, power relations, place and protection. We reflected on innovative practices used, overall level of participation achieved, and strategies to address ethical, logistical and/or financial barriers.

RESULTS: In all case studies we found evidence of engagement activities that aligned with the Global Consensus Statement on Meaningful Youth Engagement. However, access to participation was often uneven and despite efforts, marginalised young people continue to have insufficient opportunities to engage. Furthermore, although young people had some opportunity to influence the research methods, many of the key design decisions had been determined prior to their involvement. In our case studies researchers had built in insufficient opportunities to evaluate the level and impact of youth engagement.

CONCLUSIONS: We therefore recommend early involvement of young people in the research process so that they can contribute to setting the research agenda, the design of planned studies and thus increase the scope of their engagement from the beginning. Youth engagement activities need to be evaluated from the perspective of all stakeholders including young people themselves with a focus on opportunities to engage, the level of engagement achieved, and impact of engagement. From the beginning, researchers should provide space for learning, and involve young people in encouraging critical reflection of what does not yet work, as well as what does, to enable improvements.

PMID:34861086 | DOI:10.1111/tmi.13702

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Holistic evaluation of long-term earthworm field studies with a fungicide

Integr Environ Assess Manag. 2021 Dec 2. doi: 10.1002/ieam.4562. Online ahead of print.

ABSTRACT

Plant protection products for placing on the market in the European Union need to meet rigorous safety criteria including the testing of lumbricid earthworms, the functionally most important soil organism group in Central European agricultural ecosystems. To address uncertainties and investigate the potential long-term in-crop effects of the fungicide Cantus® containing 50% boscalid as active substance, a series of standardized earthworm field studies with an overall duration of 5 years per study program was carried out in four German agricultural fields under realistic crop rotation conditions. A two-step approach was chosen to analyze the potential overall long-term effects on earthworms in agricultural fields: i) an assessment of the earthworm abundance development in the course of the four study programs in relation to the determined actual content of boscalid in soil and ii) an effect size meta-analysis of earthworm abundance one year after treatment for each consecutive year and study program. Measured boscalid concentrations in soil after multiple applications were well above the maximum boscalid residues observed in agricultural soils across Central Europe. There were isolated statistically significant reductions of earthworm abundance for some species and groups at some timepoints during the studies, but no consistent relationship to the Cantus® treatments was observed. These results were supported by the meta-analysis indicating no adverse effects on earthworm populations. Therefore, fluctuations of abundance are rather reflecting natural variation of the populations than a concentration-related response. Based on this comprehensive analysis we conclude that there is no application rate-related effect of the 5-year use of Cantus® on the earthworm communities’ development. The four study programs, paired with a comprehensive evaluation, directly address the concerns about potential long-term effects of boscalid on earthworms in the field and suggest that multi-year applications do not adversely affect earthworm populations. This article is protected by copyright. All rights reserved.

PMID:34861099 | DOI:10.1002/ieam.4562

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Clinical study of autoantibodies in type 1 diabetes mellitus children with ketoacidosis or microalbuminuria

J Clin Lab Anal. 2021 Dec 3:e24164. doi: 10.1002/jcla.24164. Online ahead of print.

ABSTRACT

AIMS: The study aimed to investigate the value of autoantibodies in predicting the risk of ketoacidosis or microalbuminuria in children with type 1 diabetes mellitus.

METHODS: Clinical data and laboratory indicators of 80 patients with type 1 diabetes admitted to the Department of Endocrinology in Tianjin Children’s Hospital, from June 2017 to March 2019, were retrospectively analyzed. The patients were divided into two groups: diabetes without ketoacidosis group (n = 20) and diabetes with ketoacidosis group (n = 60). The differences in general data, laboratory test indexes, and autoantibodies between the two groups were analyzed. Finally, ROC curves and multivariate logistic regression analysis were used to explore the value of autoantibodies in patients with ketoacidosis or microalbuminuria.

RESULTS: A total of 80 children with type 1 diabetes were assessed, including 35 boys and 45 girls, ranging in age from 10 months to 15 years. The concentration of GADA, IA2A, and ZnT8A was not statistically different between the two groups, but the positive rate of ZnT8A was statistically significant (p = 0.038) and had a diagnostic value for the occurrence of ketoacidosis (p = 0.025). ZnT8A-positive patients had a higher titer of IA2A and a more frequent prevalence of GADA and IA2A than ZnT8A-negative patients (p < 0.01). In multivariate logistic regression analyses, the presence of positive ZnT8A was associated with a higher risk of microalbuminuria independent of age, sex, and BMI (OR = 4.184 [95% CI 1.034~16.934], p = 0.045).

CONCLUSIONS: The positive ZnT8A had diagnostic value for ketoacidosis in children with type 1 diabetes and had the highest specificity among the three kinds of autoantibodies. Moreover, ZnT8A positivity was related to a higher titer of IA2A and more frequent occurrence of multiple diabetes-related autoantibodies. Besides, the presence of positive ZnT8A was an independent risk factor of microalbuminuria in children with type 1 diabetes. Therefore, we can infer that positive ZnT8A may be related to ketoacidosis and microalbuminuria, accelerating the progression of T1DM.

PMID:34861060 | DOI:10.1002/jcla.24164

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Translation, validity, and reliability of NUTRISCORE: the nutrition risk assessment screening test for Turkish cancer patients

Nutr Clin Pract. 2021 Dec 3. doi: 10.1002/ncp.10804. Online ahead of print.

ABSTRACT

PURPOSE: The aim was to determine the validity and the reliability of the Turkish version of the screening test named NUTRISCORE in cancer patients.

METHODS: The language validity of the Turkish form of the study scale was provided by the translationback-translation method. NUTRISCORE and nutritional risk screening (NRS)-2002, malnutrition screening tool (MST), and European Diagnostic Criteria (EDC) were administered to 240 volunteers in oncology clinics, and receiver operating characteristic curves (ROC) were calculated for the validity and reliability analysis. Cohen’s kappa coefficient was used to determine the fit between the screening tests.

RESULTS: Thirteen experts were consulted for scale content validity, and the content validity index was found to be 0.94. The scale was administered to 67 patients with 4-week intervals for test-retest reliability, and a positive, high-level and statistically significant relationship was found between the two measurements (r = 0.971, P < 0.01). Compared with the reference test NRS-2002, the specificity values of NUTRISCORE, MST, and EDC screening tests were found to be 100%, 83%, and 91%, whereas the sensitivity values of same screening tests were calculated as 85%, 91% and 81%, respectively. According to Cohen’s kappa statistics, the kappa agreement between NRS-2002 and NUTRISCORE was 0.88, the kappa agreement between NRS-2002 and MST was 0.34, and it was found to be 0.73 for NRS-2002 and EDC.

CONCLUSION: The nutrition screening test named NUTRISCORE showed adequate validity and reliability in Turkish and can detect malnutrition risk of cancer patients treated in oncology clinics as a screening tool.

PMID:34861067 | DOI:10.1002/ncp.10804

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Knowledge, Awareness, and Practices (KAP) towards COVID-19 among the marine fishers of Maharashtra State of India: An online cross-sectional Analysis

PLoS One. 2021 Dec 3;16(12):e0261055. doi: 10.1371/journal.pone.0261055. eCollection 2021.

ABSTRACT

The knowledge, awareness, and practices (KAP) about COVID-19 among the marine fishers who are engaged in the high-risk occupations and depend on the vulnerable sources of income in the Maharashtra state of India, were investigated to understand the behavioral changes and vulnerability among the respondents because of COVID-19. Data were collected through an online survey from 1st July to 30th July 2020 during the first peak of COVID-19 in the study area by using the questionnaire. Authors based on the latest recommendations by the World Health Organization (WHO) developed the questionnaire and covered the KAP aspects under study. The questionnaire was administered through Google form link and the link was disseminated through social media such as Facebook and What’s App. The completed responses (n = 533) received from the eligible sample, excluding those outsides of the fisher community and duplicate entries were considered for analysis. Appropriate statistical tools were used to analyze the data. Among the respondents, 447 men (83.86%) and 86 women (16.14%), with a mean age of 45.4 years (M = 45.4, SD = 1.18). The results revealed that 70.92% of respondents perceived a low risk of infection because of COVID-19 with M = 1.77 and SD = 0.583, but authors found the perceived severity score high (M = 3.95, SD = 1.21) among the 60.97% of respondents. Around 95% of respondents were aware of the COVID-19, while almost all respondents knew the medium of infection and symptoms of COVID-19. The behavior of respondents towards COVID-19 infection was positive and was following sufficient precautionary measures suggested by WHO to protect themselves from COVID-19 infection. The results of multiple regression analysis revealed that the demographic features of respondents like age, education were significantly contributing to the KAP of the fisher community. The results confirmed the importance of KAP which is reflected in the behavioral responses of the fishers while tackling the COVID-19 pandemic situation. The results regarding the risk perception, severity, KAP about COVID-19 provide a collective understanding of the emerging infectious disease among the marine fishers of Maharashtra state of India.

PMID:34860859 | DOI:10.1371/journal.pone.0261055

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Prevalence, types and severity of medication errors associated with the use of automated medication use systems in ambulatory and institutionalized care settings: A systematic review protocol

PLoS One. 2021 Dec 3;16(12):e0260992. doi: 10.1371/journal.pone.0260992. eCollection 2021.

ABSTRACT

The use of automated systems within the medication use process has significantly reduce the occurrence of medication errors and the associated clinical and financial burden. However, automated systems lull into a false sense of security and increase the risk of medication errors that are often associated with socio-technical interactions, automation bias, workarounds and overrides. The objective of the systematic review is to determine the prevalence, types and severity of medication errors that are associated the use of automated systems in ambulatory and institutionalized care settings. The search strategy will be guided by PRISMA framework. Selected databases and relevant gray literature were searched and screening was done independently by two researchers between 01 April and 29 June 2021. These covered all relevant articles published from the inception of the use of automation in the medication use process (2000) until 2020. De-duplication and screening of all studies were done independently by two researchers with a clear inclusion / exclusion criteria. Data extraction and synthesis are currently on going (started on 06 July 2021) and being conducted independently but the validity and completeness of the processes will be confirmed by the third researcher. The Cochrane Risk of Bias tool and the Hoy et al’s quality assessment checklist will be used for the assessment of methodological bias while the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system will be used for the quality of evidence assessment. Detailed qualitative synthesis of key findings will be done with thematic and descriptive analyses. If the number and types of included studies permit, fixed or random effect model meta-analysis will be conducted based on the degree of homogeneity in the sampling frame used in the included studies. Heterogeneity will be assessed with I2 statistics and I2 > 50% will be considered a high statistical heterogeneity. The systematic review may provide new perspective especially from developing settings about the prevalence, types and severity of medication errors associated with the use of automated systems at all the stages of medication use process, and in all categories of patients. This may add to global knowledge in the research area. Systematic review registration: The systematic review was registered and published by PROSPERO (CRD42020212900).

PMID:34860852 | DOI:10.1371/journal.pone.0260992

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A systematic bibliometric review of clean energy transition: Implications for low-carbon development

PLoS One. 2021 Dec 3;16(12):e0261091. doi: 10.1371/journal.pone.0261091. eCollection 2021.

ABSTRACT

More voices are calling for a quicker transition towards clean energy. The exploration and exploitation of clean energy such as wind energy and solar energy are effective means to optimise energy structure and improve energy efficiency. To provide in-depth understanding of clean energy transition, this paper utilises a combination of multiple bibliometric mapping techniques, including HistCite, CiteSpace and R Bibliometrix, to conduct a systematic review on 2,191 clean energy related articles obtained from Web of Science (WoS). We identify five current main research streams in the clean energy field, including Energy Transition, Clean Energy and Carbon Emission Policy, Impact of Oil Price on Alternative Energy Stocks, Clean Energy and Economics, and Venture Capital Investments in Clean Energy. Clearly, the effectiveness of policy-driven and market-driven energy transition is an important ongoing debate. Emerging research topics are also discussed and classified into six areas: Clean Energy Conversion Technology and Biomass Energy Utilisation, Optimisation of Energy Generation Technology, Policy-Making in Clean Energy Transition, Impact of Clean Energy Use and Economic Development on Carbon Emissions, Household Use of Clean Energy, and Clean Energy Stock Markets. Accordingly, more and more research attention has been paid to how to improve energy efficiency through advanced clean energy technology, and how to make targeted policies for clean energy transition and energy market development. This article moves beyond the traditional literature review methods and delineates a systematic research agenda for clean energy research, providing research directions for achieving low-carbon development through the clean energy transition.

PMID:34860855 | DOI:10.1371/journal.pone.0261091

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Investigation of ANN architecture for predicting the compressive strength of concrete containing GGBFS

PLoS One. 2021 Dec 3;16(12):e0260847. doi: 10.1371/journal.pone.0260847. eCollection 2021.

ABSTRACT

An extensive simulation program is used in this study to discover the best ANN model for predicting the compressive strength of concrete containing Ground Granulated Blast Furnace Slag (GGBFS). To accomplish this purpose, an experimental database of 595 samples is compiled from the literature and utilized to find the best ANN architecture. The cement content, water content, coarse aggregate content, fine aggregate content, GGBFS content, carboxylic type hyper plasticizing content, superplasticizer content, and testing age are the eight inputs in this database. As a result, the optimal selection of the ANN design is carried out and evaluated using conventional statistical metrics. The results demonstrate that utilizing the best architecture [8-14-4-1] among the 240 investigated architectures, and the best ANN model, is a very efficient predictor of the compressive strength of concrete using GGBFS, with a maximum R2 value of 0.968 on the training part and 0.965 on the testing part. Furthermore, a sensitivity analysis is performed over 500 Monte Carlo simulations using the best ANN model to determine the reliability of ANN model in predicting the compressive strength of concrete. The findings of this research may make it easier and more efficient to apply the ANN model to many civil engineering challenges.

PMID:34860842 | DOI:10.1371/journal.pone.0260847

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Analysis of case fatality rate of SARS-CoV-2 infection in the Spanish Autonomous Communities between March and May 2020

PLoS One. 2021 Dec 3;16(12):e0260769. doi: 10.1371/journal.pone.0260769. eCollection 2021.

ABSTRACT

OBJECTIVE: The Spanish health system is made up of seventeen regional health systems. Through the official reporting systems, some inconsistencies and differences in case fatality rates between Autonomous Communities (CC.AA.) have been observed. Therefore the objective of this paper is to compare COVID-19 case fatality rates across the Spanish CC.AA.

MATERIAL AND METHODS: Observational descriptive study. The COVID-19 case fatality rate (CFR) was estimated according to the official records (CFR-PCR+), the daily mortality monitory system (MoMo) record (CFR-Mo), and the seroprevalence study ENE-COVID-19 (Estudio Nacional de sero Epidemiologia Covid-19) according to sex, age group and CC.AA. between March and June 2020. The main objective is to detect whether there are any differences in CFR between Spanish Regions using two different register systems, i. e., the official register of the Ministry of Health and the MoMo.

RESULTS: Overall, the CFR-Mo was higher than the CFR-PCR+, 1.59% vs 0.98%. The differences in case fatality rate between both methods were significantly higher in Castilla La Mancha, Castilla y León, Cataluña, and Madrid. The difference between both methods was higher in persons over 74 years of age (CFR-PCR+ 7.5% vs 13.0% for the CFR-Mo) but without statistical significance. There was no correlation of the estimated prevalence of infection with CFR-PCR+, but there was with CFR-Mo (R2 = 0.33). Andalucía presented a SCFR below 1 with both methods, and Asturias had a SCFR higher than 1. Cataluña and Castilla La Mancha presented a SCFR greater than 1 in any scenario of SARS-CoV-2 infection calculated with SCFR-Mo.

CONCLUSIONS: The PCR+ case fatality rate underestimates the case fatality rate of the SARS-CoV- 2 virus pandemic. It is therefore preferable to consider the MoMo case fatality rate. Significant differences have been observed in the information and registration systems and in the severity of the pandemic between the Spanish CC.AA. Although the infection prevalence correlates with case fatality rate, other factors such as age, comorbidities, and the policies adopted to address the pandemic can explain the differences observed between CC.AA.

PMID:34860848 | DOI:10.1371/journal.pone.0260769

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Elevated Blood Pressure in Women of Childbearing Age in the United States

MCN Am J Matern Child Nurs. 2022 Jan-Feb 01;47(1):47-51. doi: 10.1097/NMC.0000000000000775.

ABSTRACT

PURPOSE: Elevated blood pressure is frequently associated with adverse health issues among women during and after childbirth in the United States. The purpose of this study was to describe incidence of and determine predictors of prehypertension and hypertension among women of childbearing age in the United States.

STUDY DESIGN AND METHODS: Using secondary data analysis, existing data from the National Health and Nutrition Examination Survey (NHANES; 2013-2018) were used to address study aims. Inclusion criteria were women in the age range commonly considered to be of childbearing age, 15 to 44 years of age. Simple random sampling was to select subjects from the 2,932 women in the NHANES dataset who met inclusion criteria. We calculated a sample size as adequate for the statistical group comparison to be significant with a power of 95% to detect a difference among groups. An ordinal logistic regression model was created to discriminate predictors of normotensive blood pressure, prehypertension, and hypertension.

RESULTS: The sample (n = 393) included 300 women with normal blood pressure, 46 women with prehypertension, and 47 with hypertension. Older women (within childbearing age range), women with high body mass index, and African American women are highly likely to have prehypertension and hypertension.

CLINICAL IMPLICATIONS: Contrary to previous research, poverty income ratio was not associated with prehypertension and hypertension. Future research should test interventions that include promoting heathy lifestyles and address elevated body mass index. Interventions should be tailored to be culturally appropriate for African American women and older women within this age range.

PMID:34860787 | DOI:10.1097/NMC.0000000000000775