Category: Statistics

BMC Health Serv Res. 2024 Jul 10;24(1):795. doi: 10.1186/s12913-024-11265-9.

ABSTRACT

BACKGROUND: In Sweden, approximately 2000 children live with Juvenile Idiopathic Arthritis (JIA). About half of them continue to have an active disease and need to transfer to adult rheumatology care. This study aimed to investigate Swedish adolescents’ and parents´ perceptions of readiness for transition from pediatric to adult rheumatology care.

METHODS: The study was a cross-sectional quantitative study. Patients at the pediatric rheumatology clinic at a university hospital in Sweden and members of The Swedish National Organization for Young Rheumatics aged 14-18 and their parents were invited to participate in the study. Data was collected with the Readiness for Transition Questionnaire (RTQ) focusing on adolescents’ transition readiness, adolescents’ healthcare behaviors and responsibility, and parental involvement. Data were analyzed with descriptive statistics. Comparative analyses were made using non-parametric tests with significance levels of 0.05 as well as factor analyses and logistic regression.

RESULTS: There were 106 adolescents (85 girls, 20 boys) and 96 parents answering the RTQ. The analysis revealed that many adolescents and parents experienced that the adolescents were ill-prepared to take over responsibility for several healthcare behaviors, such as booking specialty care appointments, calling to renew prescriptions and communicating with medical staff on phone and to transfer to adult care. Parents and adolescents alike stated that it was especially difficult for the adolescents to take responsibility for healthcare behaviors meaning that the adolescents had to have direct interaction with the healthcare professionals (HCPs) at the paediatric rheumatology clinic, for example to renew prescriptions. It was evident that the adolescents who perceived they were ready to take responsibility for the aspects related to direct interaction with HCPs were more overall ready to be transferred to adult care.

CONCLUSION: Adolescents need more support to feel prepared to transfer to adult care. With the results from this study, we can develop, customize, and optimize transitional care programs in Sweden for adolescents.

PMID:38987769 | DOI:10.1186/s12913-024-11265-9

BMC Nurs. 2024 Jul 10;23(1):471. doi: 10.1186/s12912-024-02039-z.

ABSTRACT

AIM: Assess the levels of psychological flexibility, burnout, and turnover intention among critical care nurses and assess the impact of psychological flexibility on burnout, and turnover intention among critical care nurses.

BACKGROUND: Burnout and turnover intentions among critical care nurses are rapidly increasing because of the challenges of COVID-19. There is a need for evidence-based interventions like psychological flexibility to be addressed in research to overcome those challenges.

METHODS: A descriptive correlational research. A convenient sample of 200 critical care nurses working in COVID-19 hospitals from two governorates in Egypt. The sociodemographic and clinical data sheet, the work-related acceptance and action questionnaire, the Copenhagen burnout inventory, and the adopted version of the staff nurses’ intention to leave the nursing profession questionnaire were used.

RESULTS: The majority of critical care nurses reported a moderate level of psychological flexibility (75.5%, Mean = 31.23), a moderate level of burnout (65.5%, Mean = 59.61), and low to moderate levels of intention to leave (73%, Mean = 5.95). Psychological flexibility has a statistically significant negative correlation with burnout (PC = -0.304, Sig = 0.000) and the intention to leave (PC = -0.258, Sig = 0.000). In addition, psychological flexibility has a predictable effect on decreasing burnout (R² = 0.232) and intention to leave (R² = 0.127) among critical care nurses.

CONCLUSION: critical care nurses in COVID-19 hospitals reported varied levels of burnout and an intention to leave that must be considered. The effect of psychological flexibility on burnout and intention to turnover highlighted the importance of improving it among critical care nurses by applying acceptance and commitment therapy as a management intervention.

PMID:38987768 | DOI:10.1186/s12912-024-02039-z

BMC Public Health. 2024 Jul 10;24(1):1847. doi: 10.1186/s12889-024-19384-y.

ABSTRACT

BACKGROUND: College and university students were an important population group of blood donors, especially in the current situation of tight blood supply. This study aimed to investigate the current status and determinants of blood donation among this population group in Wuhan using a structural equation model.

METHODS: We conducted a cross-sectional study involving 12 colleges and universities in Wuhan, China, including 5168 students. Sociodemographic characteristics, health status, knowledge about blood donation, and attitude toward blood donation were treated as latent variables, with blood donation as the observed variable. Confirmatory factor analysis was conducted using the Mplus 8.0 statistical software application, followed by the establishment of a structural equation model to assess the relationships that exist between these variables.

RESULTS: The overall blood donation rate among college and university students was 24.71%. The established model indicated that sociodemographic characteristics, health status, knowledge about blood donation, and attitude toward blood donation showed significant positive effects (0.135, 0.056, 0.321, and 0.389, respectively) on blood donation, among them, the direct effects were 0.076, -0.110, 0.143, and 0.389, respectively (P < 0.01). Additionally, sociodemographic characteristics, health status, and knowledge about blood donation had indirectly affected blood donation through the mediating effect of attitude towards blood donation. Their effects on attitude towards blood donation were 0.099, 0.243, and 0.468, respectively. (P < 0.01). The model could explain explained 22.22% of the variance in blood donation behavior among college and university students in Wuhan.

CONCLUSION: Blood donation among college and university students in Wuhan was associated with sociodemographic characteristics, health status, knowledge about blood donation, and attitude towards blood donation, with attitude being the primary influencing factor. Tailored recruitment strategies for blood donation among students should prioritize initiatives aimed at enhancing knowledge about blood donation and fostering positive attitudes toward it.

PMID:38987767 | DOI:10.1186/s12889-024-19384-y

BMC Vet Res. 2024 Jul 10;20(1):308. doi: 10.1186/s12917-024-04176-8.

ABSTRACT

BACKGROUND: The aim of this double-blind, placebo-controlled study was to investigate the effect of vitamin E supplementation as an addition to a commercial renal diet on survival time of cats with different stages of chronic kidney disease (CKD). In addition, we were interested whether vitamin E supplementation affects selected oxidative stress and clinical parameters. Thirty-four cats with CKD and 38 healthy cats were included in the study. Cats with CKD were classified according to the IRIS Guidelines; seven in IRIS stage 1, 15 in IRIS stage 2, five in IRIS stage 3 and seven in IRIS stage 4. Cats with CKD were treated according to IRIS Guidelines. Cats with CKD were randomly assigned to receive vitamin E (100 IU/cat/day) or placebo (mineral oil) for 24 weeks in addition to standard therapy. Plasma malondialdehyde (MDA) and protein carbonyl (PC) concentrations, DNA damage of peripheral lymphocytes and plasma vitamin E concentrations were measured at baseline and four, eight, 16 and 24 weeks thereafter. Routine laboratory analyses and assessment of clinical signs were performed at each visit.

RESULTS: Vitamin E supplementation had no effect on the survival time and did not reduce the severity of clinical signs. Before vitamin E supplementation, no significant differences in vitamin E, MDA and PC concentrations were found between healthy and CKD cats. However, plasma MDA concentration was statistically significantly higher (p = 0.043) in cats with early CKD (IRIS stages 1 and 2) than in cats with advanced CKD (IRIS stages 3 and 4). Additionally, DNA damage was statistically significantly higher in healthy cats (p ≤ 0.001) than in CKD cats. Plasma vitamin E concentrations increased statistically significantly in the vitamin E group compared to the placebo group four (p = 0.013) and eight (p = 0.017) weeks after the start of vitamin E supplementation. During the study and after 24 weeks of vitamin E supplementation, plasma MDA and PC concentrations and DNA damage remained similar to pre-supplementation levels in both the placebo and vitamin E groups.

CONCLUSIONS: Vitamin E supplementation as an addition to standard therapy does not prolong survival in feline CKD.

PMID:38987749 | DOI:10.1186/s12917-024-04176-8

BMC Public Health. 2024 Jul 10;24(1):1845. doi: 10.1186/s12889-024-19408-7.

ABSTRACT

BACKGROUND: Infection is the most common complication of pediatric patients with nephrotic syndrome. The factors associated with infection in nephrotic syndrome are lacking. The objective of the study was to identify the prevalence and associated factors among children with nephrotic syndrome aged 2 to 18 years.

METHODS: We conducted a hospital-based retrospective cross-sectional study. The data collector installed an Epi5 collector electronic data-collecting tool from Google Play. Then, we exported the data to Stata version 15.1 for analysis. The mean, standard deviation, frequency, and percentage were used for descriptive statistics. The logistic regression model was used to identify the factors associated with infection.

RESULTS: In this study, the prevalence of infection among nephrotic syndrome children is 39.8% (95%CI: 30.7, 49.7). The types of infection identified were pneumonia, urinary tract infection, diarrheal disease, cutaneous fungal infection, intestinal parasitic infection, and sepsis. The presence of hematuria increased the odds of infection by 5-times. On the other hand, low level of serum albumin increased the odds of infection by 7%. Being a rural resident increased the odds of infection by 3.3-times as compared to urban.

CONCLUSIONS: Serum albumin level, presence of hematuria, and rural residence were significantly associated with infection. We recommended a longitudinal incidence study on large sample size at multicenter to strengthen this finding.

PMID:38987746 | DOI:10.1186/s12889-024-19408-7

BMC Cancer. 2024 Jul 10;24(1):820. doi: 10.1186/s12885-024-12525-x.

ABSTRACT

BACKGROUND: Potentially modifiable risk factors for hepatocellular carcinoma (HCC) have been investigated in observational epidemiology studies in East Asian and European populations, whereas the causal associations of most of these risk factors remain unclear.

METHODS: We collected genome-wide association summary statistics of 22 modifiable risk factors in East Asians and 33 risk factors in Europeans. Genetic summary statistics of HCC were sourced from the Biobank Japan study (1,866 cases and 195,745 controls) for East Asians, and the deCODE genetics study (406 cases and 49,302 controls) and the UK Biobank (168 cases and 372 016 controls) for Europeans. Two-sample Mendelian randomization (MR) analyses were performed independently for East Asian and European populations.

RESULTS: In East Asians, genetically predicted alcohol frequency, ever drinkers, aspartate aminotransferase (AST), hypothyroidism, chronic hepatitis B, and chronic hepatitis C, metabolic dysfunction-associated steatotic liver disease (MASLD), and autoimmune hepatitis were significantly associated with an increased HCC risk (P < 0.05/22). Among European population, alanine transaminase, AST, MASLD, percent liver fat, and liver iron content were significantly associated with a higher risk of HCC (P < 0.05/33). The replication dataset and meta-analysis further confirmed these results.

CONCLUSIONS: Although East Asian and European populations have different factors for HCC, their common modifiable risk factors AST and MASLD for HCC, offer valuable insights for targeted intervention strategies to mitigate society burden of HCC.

PMID:38987736 | DOI:10.1186/s12885-024-12525-x

BMC Oral Health. 2024 Jul 10;24(1):774. doi: 10.1186/s12903-024-04555-5.

ABSTRACT

BACKGROUND: Dental caries (decay or cavities) is the breakdown of teeth as a result of bacteria. Dental caries is one of the most preventable oral health problems and the most common chronic disease in primary school children. Poor dental and oral health affects the quality of children’s lives.

OBJECTIVES: The study aimed to synthesize the existing literature on the prevalence and associated factors of dental caries among primary school children in Ethiopia in 2024.

METHODOLOGY: Studies were searched through the search engines of Google Scholar, PubMed, Scopus, MEDLINE, and the Cochrane Library. Searching was made using keywords and MeSH terms for dental caries, dental plaque, primary school children, and Ethiopia. Heterogeneity was assessed using the Cochran Q test and I2 statistics. A random-effects model with a 95% confidence interval was used for prevalence and odds ratio estimations.

RESULT: The result of seven studies disclosed that the overall prevalence of dental caries in primary school children in Ethiopia was 35% (26-45%). high intake of sweets (OR = 2.71,95%CI:1.968-3.451), a poor habit of tooth cleaning (OR = 2.46; 95% CI: 2.761-5.045), Grade level 1-4(OR = 2.46; 95% CI: 1.523-3.397), having a history of toothache(OR = 2.99; 95% CI: 2.679-3.314), absence of toothpaste use(OR = 1.42; 95% CI: -1.278-4.109), reduction of the previous year’s academic score(OR = 5.51; 95% CI: 1.952-9.066), had a significant microbial load(OR = 3.82, CI: 3.439-4.192) and have acid bacillary pH on their teeth(OR = 2.42, CI: 1.494-3.335) were independent variables associated with dental carries among primary school children.

CONCLUSION: The overall prevalence of dental caries among primary school children in Ethiopia is 35%, ranging from 26 to 45%. However, variations in prevalence rates are observed based on sampling techniques. Studies using simple random sampling report a higher prevalence rate of 42%, while those employing multi-stage random sampling and systematic random sampling show lower rates of 30% and 35%, respectively. This indicates that the choice of sampling technique can impact reported prevalence rates, with simple random sampling yielding higher estimates compared to other methods.

PMID:38987729 | DOI:10.1186/s12903-024-04555-5

BMC Oral Health. 2024 Jul 10;24(1):771. doi: 10.1186/s12903-024-04526-w.

ABSTRACT

BACKGROUND: Traumatic dental injury (TDI) is a growing public health concern worldwide, and children and adolescents are commonly affected. Because TDI often occurs at school, the response of teachers to these injuries is crucial. However, teachers in various countries have been shown to lack knowledge of effective TDI first-aid response and need an intervention to improve their knowledge. The aim of the study presented here was to ascertain and analyze teachers’ knowledge of and attitude about TDI in Mongolia.

MATERIALS AND METHODS: A cross-sectional study of full-time teachers in Mongolia was performed using an online questionnaire (compiled from relevant studies) from September 2022 to December 2022. The questionnaire consists of 47 items and among them 14 were used to assess the teacher’s knowledge, and 5 were for attitude towards TDI. The maximum possible score was 14 points and grouped as follows good, moderate, and poor. T-test, ANOVA test (post-hoc) and linear regression analysis were performed.

RESULTS: The online survey provided quantitative data from 2821 participants: 28% were elementary school teachers, 29% middle school teachers, and 42% high school teachers. Their mean age was 36.7 ± 9 years, and 2433 (86%) were female. The mean score of the TDI knowledge of the teachers was 5.3 ± 2.1 out of 14. The ANOVA test showed that older (p < 0.01) and more experienced teachers (p < 0.01) had higher scores. Teachers in the eastern (5.46 ± 2.2) and southern (5.49 ± 2.2) provinces had higher mean scores than in the other provinces (p < 0.02). Teachers majored in natural sciences (5.4 ± 2.2) had a higher score than those in the social sciences (5.2 ± 2.1) and difference were significant (p < 0.02). The multiple regression model statistically significantly predicted a one-year increase in experience, the TDI score increased 0.034 (95% CI 0.026, 0.043) unit.

CONCLUSIONS: The knowledge regarding TDI and effective first-aid response to such injury is low in teachers in Mongolia. However, the teachers’ attitude about TDI was positive and they wanted to learn and improve their knowledge. Therefore, further education and training programs are advised.

PMID:38987725 | DOI:10.1186/s12903-024-04526-w

BMC Med Res Methodol. 2024 Jul 10;24(1):146. doi: 10.1186/s12874-024-02268-5.

ABSTRACT

BACKGROUND: Risk prediction models are routinely used to assist in clinical decision making. A small sample size for model development can compromise model performance when the model is applied to new patients. For binary outcomes, the calibration slope (CS) and the mean absolute prediction error (MAPE) are two key measures on which sample size calculations for the development of risk models have been based. CS quantifies the degree of model overfitting while MAPE assesses the accuracy of individual predictions.

METHODS: Recently, two formulae were proposed to calculate the sample size required, given anticipated features of the development data such as the outcome prevalence and c-statistic, to ensure that the expectation of the CS and MAPE (over repeated samples) in models fitted using MLE will meet prespecified target values. In this article, we use a simulation study to evaluate the performance of these formulae.

RESULTS: We found that both formulae work reasonably well when the anticipated model strength is not too high (c-statistic < 0.8), regardless of the outcome prevalence. However, for higher model strengths the CS formula underestimates the sample size substantially. For example, for c-statistic = 0.85 and 0.9, the sample size needed to be increased by at least 50% and 100%, respectively, to meet the target expected CS. On the other hand, the MAPE formula tends to overestimate the sample size for high model strengths. These conclusions were more pronounced for higher prevalence than for lower prevalence. Similar results were drawn when the outcome was time to event with censoring. Given these findings, we propose a simulation-based approach, implemented in the new R package ‘samplesizedev’, to correctly estimate the sample size even for high model strengths. The software can also calculate the variability in CS and MAPE, thus allowing for assessment of model stability.

CONCLUSIONS: The calibration and MAPE formulae suggest sample sizes that are generally appropriate for use when the model strength is not too high. However, they tend to be biased for higher model strengths, which are not uncommon in clinical risk prediction studies. On those occasions, our proposed adjustments to the sample size calculations will be relevant.

PMID:38987715 | DOI:10.1186/s12874-024-02268-5