Category: Statistics

Occup Med (Lond). 2024 Oct 19:kqae095. doi: 10.1093/occmed/kqae095. Online ahead of print.

ABSTRACT

BACKGROUND: Working from home (WFH) is becoming more common, but little is known about how it specifically affects neuro-divergent workers’ psychological and occupational well-being.

AIMS: This review aimed to explore the experiences of neuro-divergent staff WFH, including the challenges they face; the potential benefits of homeworking for this specific population and the support systems they require.

METHODS: We searched six electronic databases, as well as reference lists of included papers, one preprint server and Google, for literature on neuro-divergent workers’ experiences of WFH. Results were synthesized using thematic analysis.

RESULTS: We reviewed 25 studies (mostly based on data collected during the coronavirus disease 2019 pandemic), finding very little research statistically analysing the impact of WFH on well-being or productivity, or comparing the impact of WFH across neuro-divergent and neuro-typical populations. The (mostly qualitative) findings showed that neuro-divergent participants described various benefits and challenges of the sensory environment at home; the reduction of commuting; increased flexibility and lack of routine when homeworking; the reduction of ‘masking’ behaviours; lack of in-person social contact and increased use of technology.

CONCLUSIONS: The findings emphasize the importance of not assuming a one-size-fits-all approach to homeworking and suggest managers should be mindful of workers’ individual preferences for working whilst ensuring that all employees are appropriately supported. The results can inform future research and provide insights for employers to help them create more inclusive work environments.

PMID:39425901 | DOI:10.1093/occmed/kqae095

Eur Eat Disord Rev. 2024 Oct 19. doi: 10.1002/erv.3143. Online ahead of print.

ABSTRACT

OBJECTIVE: This national study aimed to estimate the prevalence of the transgender and gender-diverse identity and to assess the level of gender congruence, body dissatisfaction and quality of life among patients with eating disorders in Denmark.

METHOD: Patients with eating disorders were compared to a matched non-clinical comparison group. The survey included the Eating Disorder Examination Questionnaire and assessment of body dissatisfaction, gender congruence and quality of life.

RESULTS: In total 568 patients with eating disorders and 538 individuals from the non-clinical comparison group were included. The prevalence of individuals identifying as transgender or gender-diverse was 4.50% (n = 20) among patients with eating disorders, and 6.23% (n = 23) in the non-clinical comparison group (p-value = 0.276). The transgender and gender-diverse individuals with eating disorders showed no statistically significant differences in eating disorder symptomatology compared to the cisgender individuals with eating disorders; however, they reported significantly more body dissatisfaction, less gender congruence and lower quality of life.

CONCLUSION: The prevalence of transgender and gender-diverse individuals did not differ between patients with eating disorders and the non-clinical comparison group; however, transgender and gender-diverse individuals with eating disorders may be characterised by pronounced body dissatisfaction and low quality of life.

PMID:39425898 | DOI:10.1002/erv.3143

J Autism Dev Disord. 2024 Oct 19. doi: 10.1007/s10803-024-06618-6. Online ahead of print.

ABSTRACT

To examine change in driving and community mobility outcomes for teens and young adults with autism as a result of participating in an occupational therapy intervention designed as a Bootcamp as perceived by the participants and their parents. Matched questionnaires were completed by novice drivers with autism as well as their parents prior to and immediately after the intervention. The intervention consisted of a 5-day (32 h) intervention using interactive driving simulators, role playing, and highly interactive learning experiences. Sixty-seven participants and their parents completed the pre and post surveys. Of these, 52 (80%) were male and 13 (20%) were female, with a mean age of 17.8 ± 3.03 years. Wilcoxon signed rank tests was used for the Likert scale questions and paired t test for ratio level data. Results demonstrated participants perceived significant improvement in knowledge, skills and abilities related to both driving and community mobility. There were also significant differences in perception from the parents’ perspective, but not as evident as the participants. Only a few significant changes were perceived in terms of executive functioning, which support accuracy of the results. Findings also showed significantly improvement in anxiety and confidence.As driving and community mobility is critical for young adults with autism to be successful in adult roles, intervention for improving knowledge, skills, and abilities in this complex daily task is essential. This study demonstrates statistically significant outcomes of a driving and community mobility occupational therapy intervention from the perspective of the participants and their parents.

PMID:39425846 | DOI:10.1007/s10803-024-06618-6

Breast Cancer. 2024 Oct 19. doi: 10.1007/s12282-024-01643-w. Online ahead of print.

ABSTRACT

BACKGROUND: Cryoablation is currently being investigated as a minimally invasive alternative to breast-conserving surgery. This meta-analysis investigates the local recurrence and residual tumor rates after cryoablation for small early-stage breast cancers.

METHODS: A systematic search was conducted on Embase, PubMed, Google Scholar, and the International Clinical Trials Registry Platform from inception to 16 June 2024. Studies of patients with breast cancers ≤ 20 mm treated with cryoablation only or cryoablation followed by surgery were included. Pooled local recurrence rates (cryoablation only) and pooled residual tumors rates (cryoablation followed by surgery) were estimated with mixed-effects models. Between-study heterogeneity was assessed using I² statistics. Where I² exceeded 50%, outlier and influence analysis, followed by sensitivity analysis excluding outliers, were conducted.

RESULTS: Twelve studies met inclusion criteria, of which 7 studies (530 female patients, 531 breast tumors) reported on patients treated with cryoablation only and 5 studies (220 female patients, 222 breast tumors) reported on patients treated with cryoablation followed by surgery. For studies on cryoablation only, pooled local recurrence rate was 1.1% (95% CI 0.42-3.03%) with low between-study heterogeneity (I² value = 0%; 95% CI 0.0-70.8%; p = 0.95). For studies on cryoablation followed by surgery, pooled residual tumor rate was 12.0% (95% CI 3.85-31.64%); however, substantial between-study heterogeneity (I² value = 76.1%; 95% CI 41.7-90.2%; p < 0.01) was present. Influence analysis revealed 1 outlier study. When this study was excluded, pooled residual tumor rate was 8.2% (95% CI 3.84-16.68%) with improvement in heterogeneity (I² value = 0%; 95% CI 0.0-84.7%; p = 0.64).

CONCLUSION: Pooled local recurrence and residual tumor rates after cryoablation are comparable to local recurrence rates after breast-conserving therapy and re-excision rates following breast-conserving surgery, respectively. These results are encouraging but should be interpreted with caution due to lack of comparative studies.

PMID:39425821 | DOI:10.1007/s12282-024-01643-w

Eur Geriatr Med. 2024 Oct 19. doi: 10.1007/s41999-024-01063-1. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to describe the clinical presentation of COVID-19 in hospitalized patients aged 80 or above and to identify predictors for death and complications throughout the epidemic waves of the disease.

METHODS: This was an observational, multicenter, ambispective study conducted between March 2020 and August 2021 using data collected in five centers from southern metropolitan area of Barcelona (COVID-MetroSud cohort). Patients were grouped based on the pandemic waves of inclusion in the registry. We conducted a descriptive analysis, followed by bivariate and multivariate analyses (binary logistic regression) to identify predictors of risk for death or complications.

RESULTS: A total of 1192 patients (mean [SD] age 85.7 [4.22] years and 46.8% female) were included. The most frequently reported symptoms in all waves were fever (63.1%), cough (56.5%), dyspnea (48.2%), and asthenia (27.5%). Laboratory and radiological findings consistently showed abnormal bilateral chest X-ray results (72.5% of patients) and elevated inflammatory markers such as lactate dehydrogenase (mean [SD] 335 [188] U/L), C-reactive protein (CRP) (mean [SD] 110 [88.4] U/L), and ferritin (mean [SD] 842 [1561] U/L). Acute respiratory distress syndrome (43.7%), renal failure (19.2%), and delirium (17.5%) were the most frequent complications. The overall mortality rate was 41.4% and declined across the epidemic waves. Age, diabetes mellitus, heart failure, dyspnea, and higher baseline levels of creatinine were identified as risk factors for complications, while a higher Barthel index and presence of cough were found to be protective. Age, dyspnea, abnormal bilateral chest X-ray, CRP, and sodium were identified as risk factors for death.

CONCLUSIONS: This study demonstrates the clinical presentation of COVID-19 (fever, cough, dyspnea, and asthenia) and the different risk factors for mortality and complications in octogenarian hospitalized patients throughout the pandemic. These findings could be highly valuable for managing future virus pandemics.

PMID:39425809 | DOI:10.1007/s41999-024-01063-1

Graefes Arch Clin Exp Ophthalmol. 2024 Oct 19. doi: 10.1007/s00417-024-06666-9. Online ahead of print.

ABSTRACT

PURPOSE: To compare the visual and anatomical results of navigated subthreshold micropulse laser (nSML) and photodynamic therapy (PDT) in the treatment of chronic central serous chorioretinopathy (CSCR).

METHODS: Patients who underwent either half-dose PDT or nSML for the management of chronic CSCR were included in this study. Comprehensive ophthalmic examination, fundus autofluorescence, and spectral domain optical coherence tomography (SD-OCT) were performed at baseline and at 1-, 3-, and 6-month follow-up visits after nSML or PDT. Fluorescein angiography and indocyanine green angiography were performed only at baseline. Main outcome measures were best corrected visual acuity (BCVA), central macular thickness (CMT), subretinal fluid (SRF), subfoveal choroidal thickness (SFCT), and choroidal vascularization index (CVI) that were collected at baseline and at each follow-up visit for up to 6 months.

RESULTS: Forty-two eyes of 42 patients (PDT group-20 eyes, nSML group-22 eyes) affected by chronic CSCR were enrolled. At 6-month follow-up, no significant differences were observed between the nSML group compared to the PDT group in BCVA (0.10 [0.00; 0.20]) and 0.10 [0.10; 0.10], respectively, p=0.69, and between some OCT parameters, namely CMT and CVI. SFCT was significantly reduced in the PDT group more than in the nSML group (p=0.01). Twelve eyes (60%) in the PDT group had complete resolution of the SRF at 6 months compared to 8 eyes (36.4%) in the nSML group, but the difference was not statistically significant (p=0.14).

CONCLUSION: Results from patients treated with PDT and nSML showed that, at 6 months, no significant differences except for choroidal thickness. nSML is less invasive than PDT and can be used as an effective alternative to PDT.

KEY MESSAGES: WHAT IS KNOWN : Treating chronic CSCR is a therapeutic conundrum for clinicians because of a lack of definitive consensus over remediation options, two of which are photodynamic therapy (PDT) and navigated subthreshold micropulse laser (nSML) therapy.

THIS STUDY SHOWS: Results from patients treated with PDT and nSML showed no significant differences except for choroidal thickness. Even though patients treated with PDT recovered more quickly, retreatment was necessary due to fluid recollection. Although patients treated with nSML also needed retreatment, nSML is less invasive than PDT and can be used as an effective alternative to PDT.

PMID:39425791 | DOI:10.1007/s00417-024-06666-9

Langenbecks Arch Surg. 2024 Oct 19;409(1):313. doi: 10.1007/s00423-024-03499-2.

ABSTRACT

PURPOSE: To evaluate the safety and efficacy of transurethral holmium laser enucleation of the prostate (HoLEP) compared to bipolar transurethral resection of the prostate (bTUR-P) in the treatment of benign prostatic hyperplasia (BPH).

METHODS: A total of 220 BPH patients hospitalized from January 2022 to September 2023 were included in this study. These patients were randomly assigned to HoLEP and bTUR-P groups, with 110 participants in each group. We collected preoperative general information, perioperative data, complications, and postoperative follow-up indicators from both groups of patients.

RESULTS: The baseline characteristics of patients in both groups were similar, with no statistical significance (P > 0.05). Compared to the bTUR-P group, the HoLEP group exhibited significantly less intraoperative bleeding (P < 0.001), shorter bladder irrigation time (P = 0.002), shorter catheter retention time (P < 0.001), and reduced postoperative hospitalization (P = 0.002). Additionally, the pain score during urination after catheter removal was significantly lower in the HoLEP group (P < 0.001). Postoperative complications occurred in both groups; however, they were less frequent in the HoLEP group (4 cases), primarily consisting of urinary retention and postoperative bleeding. The bTUR-P group experienced more complications (9 cases). Significant reductions in postoperative residual urine volume (RUV) were observed in both groups (P < 0.001). Both groups also showed significant improvements in Quality of Life (QoL) scores and International Prostate Symptom Scores (IPSS), with the HoLEP group demonstrating a more significant decrease in IPSS (P < 0.001).

CONCLUSION: After comprehensive evaluation, HoLEP was superior to bTUR-P in terms of safety and efficacy. Therefore, HoLEP may be a preferable choice for the treatment of BPH.

PMID:39425787 | DOI:10.1007/s00423-024-03499-2

Environ Monit Assess. 2024 Oct 19;196(11):1079. doi: 10.1007/s10661-024-13231-8.

ABSTRACT

In response to the COVID-19 pandemic, the Iranian government swiftly implemented immediate and decisive measures to control the spread of the infection. This study aims to demonstrate the impact of restriction measure on air pollution, also to highlight the potential variability in results that can arias from different methodological approach. A comprehensive dual-approach assessment was conducted to evaluate the effect of the lockdown measures on criteria air pollutants. Firstly, a traditional approach compared air quality during the pandemic period with baseline conditions from 2013 to 2019. Secondly, observed air pollution values during different periods with varying restrictions in 2020 were compared with expected values. This comprehensive analysis allows for a robust comparison and quantification of the impact of different lockdown measures in Ahvaz. The study revealed significant changes in air pollutant concentrations in Ahvaz during 2020, with variations observed across different pollutants. Notable reductions were observed in O3 levels, particularly in November (-54.44% compared to the baseline) and December (-63.58% compared to expected values). Decreases in CO levels were observed in multiple months, while substantial reductions in PM10 and PM2.5 were observed during various periods. Inconsistencies in the magnitudes and directions of changes were found when comparing baseline and forecasted values. The overall stringency index showed an inverse association with changes in O3, NO2, and CO, with international travel controls and restrictions on internal movement having significant impacts. This study provides valuable insights into the impact of COVID-19 lockdown measures on air pollution in Ahvaz, Iran, using a comprehensive dual-approach assessment. The findings highlight the effectiveness of these measures in reducing specific criteria air pollutants and emphasize the importance of implementing appropriate strategies for air quality management during similar public health emergencies.

PMID:39425759 | DOI:10.1007/s10661-024-13231-8

Ann Work Expo Health. 2024 Oct 19:wxae077. doi: 10.1093/annweh/wxae077. Online ahead of print.

ABSTRACT

INTRODUCTION: Eldercare organizations face high sickness absence rates and staff turnover and rely heavily on temporary workers to fill staffing gaps. Temporary workers may experience differences in job demands and resources compared with permanent workers, but this has been largely understudied.

OBJECTIVE: To compare perceived job demands and resources between permanent and temporary Swedish eldercare workers.

METHODS: Permanent and temporary eldercare workers in a Swedish municipality were invited to answer a digital survey on work environment conditions. Differences between permanent and temporary workers in job demands and resources were analyzed using multivariate analysis of variance adjusted for age, sex, place of birth, and percent of full-time work and univariate analyses were conducted to consider differences in specific factors.

RESULTS: A total of 1076 permanent and 675 temporary workers received the survey, and the final study sample included 451 permanent and 151 temporary workers. Multivariate analyses revealed that temporary workers reported statistically significant lower job demands compared to permanent workers, but no statistically significant differences in resources were found between the groups. Univariate analyses showed that temporary workers reported lower quantitative demands, perceived exertion, and time spent bending forward, than permanent workers. These data suggest comparable support across groups, but a higher workload among permanent workers.

CONCLUSION: Our findings indicate that temporary workers experienced lower job demands than permanent workers, but that no notable difference was found in resources. Interventions aimed at distributing job demands more evenly among eldercare workers with different employment forms may be necessary.

PMID:39425749 | DOI:10.1093/annweh/wxae077

Cancer Control. 2024 Jan-Dec;31:10732748241290769. doi: 10.1177/10732748241290769.

ABSTRACT

BACKGROUND: Prescription opioids are essential in managing pain among adults with chronic pain conditions. However, persistent use over time can lead to negative health consequences. Identifying individuals with persistent use over time and their characteristics can inform clinical decision-making and aid in reducing the risk of abuse and overdose deaths.

OBJECTIVE: This study aims to examine trajectories of prescription opioid use over time and factors associated with these trajectories among older cancer survivors with any non-cancer pain conditions (NCPC).

METHODS: We conducted a retrospective cohort study design with longitudinal data of older (age at cancer diagnosis ≥67 years) cancer (incident breast, colorectal, and prostate cancers, or non-Hodgkin lymphoma) survivors with any NCPC. Data were derived from the 2007-2015 linked Surveillance, Epidemiology, and End Results (SEER)-Medicare dataset (N = 35,071). Group-Based Trajectory Modeling (GBTM) was used to identify homogeneous subgroups (distinct trajectories) of individuals based on every 90-day prescription opioid use during pre-cancer diagnosis (t₁-t₄), acute cancer treatment (t₅-t₈), and post-cancer treatment (t₉-t₁₂) periods. Biological factors, social determinants of health (SDoH), physical and mental health, medication use, health care use, and external factors associated with a trajectory membership were analyzed with multivariable multinomial logistic regressions.

RESULTS: Four distinct trajectories of opioid use were identified: (1) increase-decrease use (6.1%); (2) short-term use after cancer diagnosis (40.6%); (3) low-use (41.0%); and (4) persistent use (12.3%). In the fully-adjusted multinomial logistic regression, the SDoH such as Non-Hispanic Black [adjusted odds ratios (AOR) = 1.69; 95%CI = 1.48, 1.93)] and rural residence (AOR = 1.49; 95%CI = 1.15, 1.94)], comorbid anxiety (AOR = 1.33; 95%CI = 1.18, 1.51), and medication use (NSAIDs – AOR = 1.20; 95%CI = 1.10, 1.30) were associated with membership in the persistent use group. Persistent use was less likely among those with higher fragmented care index (AOR = 0.95, 95%CI = 0.93, 0.97) and those living in counties with higher Medicare advantage penetration (AOR = 0.96; 95%CI = 0.95, 0.97).

CONCLUSIONS: One in eight older adults had persistent opioid use over time. The profile characteristics of this group were different from the other trajectory groups. Policies and programs to reduce chronic opioid use need to consider the intra- and inter-individual variability to reduce opioid-related morbidity and mortality.

PMID:39425746 | DOI:10.1177/10732748241290769