Category: Statistics

BMC Womens Health. 2024 Jul 15;24(1):401. doi: 10.1186/s12905-024-03248-z.

ABSTRACT

BACKGROUND: The relationship between the dietary insulin index (DII) and the disease’s risk is unknown, despite the fact that hyperinsulinemia is presumed to contribute to osteoporosis. The insulin response of various diets determines the DII. This study aimed to investigate the connection between postmenopausal Iranian women’s adherence to a diet with a higher insulinemic potential and osteoporosis.

METHODS: A total of 380 postmenopausal women were included in the current case-control study. A 168-item food frequency questionnaire (FFQ) with established validity and reliability was used to evaluate individuals’ daily calorie intake. The standard formula was employed to determine the dietary insulin load of each product. Subsequently, the calculation of DII was performed by dividing the dietary insulin load by the total energy consumed for each individual. In order to investigate the relationship between osteoporosis and DII, logistic regression was implemented.

RESULTS: The results of the current study demonstrated a substantial inverse relationship between osteoporosis and the DII, even after accounting for confounding variables (OR = 0.927; 95% CI = 0.888-0.967). The mean scores of DII (P < 0.001) was significantly higher in control group (36.82 ± 8.98) compared to the case group (33.53 ± 6.28).

CONCLUSIONS: Our findings suggest that keeping a diet high in insulin index and low in foods that are insulinogenic may improve bone mass density. Consequently, it may be essential for postmenopausal women to consume nutrients that stimulate insulin production in order to prevent osteoporosis.

PMID:39004741 | DOI:10.1186/s12905-024-03248-z

BMC Public Health. 2024 Jul 14;24(1):1871. doi: 10.1186/s12889-024-19420-x.

ABSTRACT

Post-traumatic stress disorder (PTSD) presents a significant challenge for firefighters. While research suggests that admiration may have a positive impact on individual psychological well-being, its specific influence on PTSD among firefighters remains unexplored. This study aims to investigate the association between admiration, motivation (both internal and external), and PTSD in a sample of 2156 firefighters in order to identify effective coping strategies for managing PTSD in this population. The findings indicate a statistically significant inverse relationship between admiration and PTSD, with motivation acting as a mediator. Furthermore, it is noteworthy that internal motivation is negatively correlated with PTSD in the model, while external motivation shows a positive correlation. The results suggest that feelings of admiration are associated with firefighter PTSD via motivation. Specifically, internal motivation stemming from admiration appears to have a mitigating effect on PTSD symptoms, while external motivation is linked to exacerbation of these symptoms. These results have implications for the development of theoretical frameworks and practical interventions aimed at preventing PTSD among firefighters.

PMID:39004732 | DOI:10.1186/s12889-024-19420-x

BMC Palliat Care. 2024 Jul 15;23(1):171. doi: 10.1186/s12904-024-01497-1.

ABSTRACT

BACKGROUND: Despite pain control being a top priority in end-of-life care, pain continues to be a troublesome symptom and comprehensive data on pain prevalence and pain relief in patients with different diagnoses are scarce.

METHODS: The Swedish Register of Palliative Care (SRPC) was used to retrieve data from 2011 to 2022 about pain during the last week of life. Data were collected regarding occurrence of pain, whether pain was relieved and occurrence of severe pain, to examine if pain differed between patients with cancer, heart failure, chronic obstructive pulmonary disease (COPD) and dementia. Binary logistic regression models adjusted for sex and age were used.

RESULTS: A total of 315 000 patients were included in the study. Pain during the last week of life was more commonly seen in cancer (81%) than in dementia (69%), heart failure (68%) or COPD (57%), also when controlled for age and sex, p < 0.001. Severe forms of pain were registered in 35% in patients with cancer, and in 17-21% in non-cancer patients. Complete pain relief (regardless of pain intensity) was achieved in 73-87% of those who experienced pain, depending on diagnosis. The proportion of patients with complete or partial pain relief was 99.8% for the whole group.

CONCLUSIONS: The occurrence of pain, including severe pain, was less common in patients with heart failure, COPD or dementia, compared to patients with cancer. Compared with cancer, pain was more often fully relieved for patients with dementia, but less often in heart failure and COPD. As severe pain was seen in about a third of the cancer patients, the study still underlines the need for better pain management in the imminently dying.

TRIAL REGISTRATION: No trial registration was made as all patients were deceased and all data were retrieved from The Swedish Register of Palliative Care database.

PMID:39004730 | DOI:10.1186/s12904-024-01497-1

Nutr J. 2024 Jul 15;23(1):74. doi: 10.1186/s12937-024-00963-z.

ABSTRACT

BACKGROUND: Federal nutrition assistance programs serve as safety nets for many American households, and participation has been linked to increased food security and, in some instances, improved diet quality and mental health outcomes. The COVID-19 pandemic brought new and increased economic, social, and psychological challenges, necessitating inquiry into how nutrition assistance programs are functioning and associated with public health outcomes.

METHODS: Using data from a representative statewide survey administered in Vermont (n = 600) between July and September 2020, we examined participant experiences with major federal nutrition assistance programs: the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and school meal programs. We explored quantitative and qualitative responses regarding perceptions of program utility, and used nearest neighbors matching analyses in combination with bivariate statistical tests to assess associations between program participation and food insecurity, perceived stress, and fruit and vegetable intake as indicators of dietary quality.

RESULTS: One in four respondents (27.3%) used at least one federal nutrition assistance program. As compared to non-participants, we found higher rates of food insecurity among program participants (57.5% vs. 18.1%; p < 0.001), an association that persisted even when we compared similar households using matching techniques (p ≤ 0.001). From matched analyses, we found that, compared to low-income non-participants, low-income program participants were less likely to meet fruit intake recommendations (p = 0.048) and that low-income SNAP and WIC participants were less likely to meet vegetable intake recommendations (p = 0.035). We also found lower rates of perceived stress among low-income school meal participant households compared to low-income non-participants (p = 0.039). Despite these mixed outcomes, participants broadly valued federal nutrition assistance programs, characterizing them as helpful or easy to use.

CONCLUSIONS: We found that federal nutrition assistance programs as a group were not sufficient to address food insecurity and stress or increase fruit and vegetable intake in the state of Vermont during the early months of the COVID-19 pandemic. Nonetheless, participants perceived benefits from participation in these programs. Optimizing the utility of nutrition assistance programs depends on critical examination of their functioning under conditions of great stress.

PMID:39004722 | DOI:10.1186/s12937-024-00963-z

BMC Microbiol. 2024 Jul 15;24(1):261. doi: 10.1186/s12866-024-03409-y.

ABSTRACT

BACKGROUND: The excessive application of chemical fertilizers in the cultivation of Astragalus mongholicus Bunge results in a reduction in the quality of the medicinal plant and compromises the sustainable productivity of the soil. PGPB inoculant is a hot topic in ecological agriculture research. In the cultivation of Astragalus mongholicus, the screened nitrogen-fixing bacteria can promote plant growth, however, whether it can promote the accumulation of main bioactive components remains unknown. In this study, mixed inoculants containing 5 strains of growth promoting bacteria (Rhizobium T16 , Sinorhizobium T21 , Bacillus J1 , Bacillus G4 and Arthrobacter J2) were used in the field experiment. The metabolic substances in the root tissues of Astragalus mongholicus were identified during the harvest period by non-targeted metabolomics method, and the differential metabolites between groups were identified by statistical analysis. Meanwhile, high-throughput sequencing was performed to analyze the changes of rhizosphere soil and endophytic microbial community structure after mixed microbial treatment.

RESULTS: The results of non-targeted metabolism indicated a significant increase in the levels of 26 metabolites after treatment including 13 flavonoids, 3 saponins and 10 other components. The contents of three plant hormones (abscisic acid, salicylic acid and spermidine) also increased after treatment, which presumed to play an important role in regulating plant growth and metabolism. Studies on endosphere and rhizosphere bacterial communities showed that Rhzobiaceae, Micromonosporaceae, and Hypomicrobiaceae in endophytic, and Oxalobactereae in rhizosphere were significantly increased after treatment. These findings suggest their potential importance in plant growth promotion and secondary metabolism regulation.

CONCLUSIONS: This finding provides a basis for developing nitrogen-fixing bacteria fertilizer and improving the ecological planting efficiency of Astragalus mongholicus.

PMID:39004720 | DOI:10.1186/s12866-024-03409-y

BMC Public Health. 2024 Jul 15;24(1):1877. doi: 10.1186/s12889-024-19380-2.

ABSTRACT

BACKGROUND: Angina is a crucial risk signal for cardiovascular disease. However, few studies have evaluated the effects of ambient air pollution exposure on angina.

OBJECTIVE: We aimed to explore the short-term effects of air pollution on hospitalization for angina and its lag effects.

METHODS: We collected data on air pollutant concentrations and angina hospitalizations from 2013 to 2020. Distributed lag nonlinear model (DLNM) was used to evaluate the short-term effects of air pollutants on angina hospitalization under different lag structures. Stratified analysis by sex, age and season was obtained.

RESULTS: A total of 39,110 cases of angina hospitalization were included in the study. The results showed a significant positive correlation between PM_2.5, SO₂, NO₂, and CO and angina hospitalization. Their maximum harmful effects were observed at lag0-7 (RR = 1.042; 95% CI: 1.017, 1.068), lag0-3 (RR = 1.067; 95% CI: 1.005, 1.133), lag0-6 (RR = 1.078; 95% CI: 1.041, 1.117), and lag0-6 (RR = 1.244; 95% CI: 1.109, 1.397), respectively. PM₁₀ did not have an overall risk effect on angina hospitalization, but it did have a risk effect on women and the elderly. O₃ was significantly negatively correlated with angina hospitalization, with the most pronounced effect observed at lag0-6 (RR = 0.960; 95% CI: 0.940, 0.982). Stratified analysis results showed that women and the elderly were more susceptible to pollutants, and the adverse effects of pollutants were stronger in the cold season.

CONCLUSION: Short-term exposure to PM_2.5, SO₂, NO₂, and CO increases the risk of hospitalization for angina.

PMID:39004712 | DOI:10.1186/s12889-024-19380-2

BMC Nurs. 2024 Jul 14;23(1):474. doi: 10.1186/s12912-024-02156-9.

ABSTRACT

BACKGROUND: Oncology nurses are considered the group with the highest risk for moral distress, compassion fatigue and burnout. Mindful self-care may help oncology nurses improve their well-being and solve psychological problems. However, the investigation and in-depth analysis of mindful self-care among oncology nurses in China is lacking.

OBJECTIVES: To identify heterogeneity groups of oncology nurses on mindful self-care ability and examine the sociodemographic correlation to these profiles.

DESIGN: Cross-sectional descriptive study.

PARTICIPANTS: The study was carried out among oncology nurses in two affiliated comprehensive hospitals and one affiliated oncology hospital. A total of 839 oncology nurses were enrolled in this survey.

METHODS: From January to May 2023, a cross-sectional study was carried out among oncology nurses using convenient sampling. The subjects were given the brief Mindful Self-Care Scale (B-MSCS) and the General Demographic Information Questionnaire. Latent profile analysis using the Mplus 7.4 program was used to separate oncology nurses’ mindful self-care into a variety of subgroups. The SPSS 25.0 statistical program was used to analyze the data. One-way ANOVA and the chi-square test were performed to compare the score of B-MSCS in each class and the difference in sociodemographic characteristics among the subgroups. Multinomial logistic regression was used to examine the influence of the sociodemographic variables on each class.

RESULTS: The total score of the B-MSCS was 76.40 ± 13.19. The support structure dimension had the highest score, with an average mean value of 3.60, and physical care had the lowest score at 2.57. The findings of the latent profile analysis showed that respondents were divided into three classes, moderate mindful self-care(51.2%), low-low mindful relaxation(14.8%), and high-high mindfulness self-awareness(34.0%). Across scale scores and dimensions, three groups demonstrated statistically significant differences (p < 0.05). Univariate analysis revealed significant differences between the three profiles in terms of professional title, position, concern about self-care, interest in mindfulness, and experience with meditation (p < 0.05). Profile membership was predicted by 3 factors, namely, self-care status, interest in mindfulness, and experience with meditation.

CONCLUSION: The mindful self-care among oncology nurses can be categorized into three latent profiles: moderate mindful self-care, low-low mindful relaxation, and high-high mindfulness self-awareness. Multinomial logistic regression results indicated that whether oncology nurses concern about self-care, interest in mindfulness and have experience with meditation influenced different latent profiles. Nursing manager should develop targeted intervention based on the typological characteristics of the oncology nurses to improve their mindful self-care ability and mental health.

PMID:39004705 | DOI:10.1186/s12912-024-02156-9

BMC Med Educ. 2024 Jul 14;24(1):758. doi: 10.1186/s12909-024-05748-w.

ABSTRACT

BACKGROUND: Frequent attendance is a common issue for primary care health centres. The phenomenon affects the quality of care, increases doctors’ workloads and can lead to burnout.This study presents the results of an educational intervention for primary care physicians, aimed at helping them to decrease the prevalence rate of excessive attendance by patients at their centres.

METHODS: A training programme was carried out for 11 primary care doctors in Barcelona who had patient lists totalling 20,064 patients. The goal of the training was to provide the participating physicians with techniques to curb frequent attendance. Additionally, the programme sought to offer them strategies to prevent professional burnout and tools to better organize their everyday medical practice. The study used a quasi-experimental design for an evaluation of an educational intervention, featuring a pre-test assessment (before the training programme) and a post-test assessment (after the training programme), as well as comparison with a control group that did not undergo the training. The study assessed the effects of the programme on the rates of frequent attendance of patients served by the participating physicians. These rates were compared with those registered by the patients seen by the control group physicians over the same period.

RESULTS: Among the group of physicians who received the training, the mean prevalence of patients who qualified as frequent attenders decreased from 22% prior to the training programme to 8% after completion of the programme. In other words, 14% of patients (2,809) limited the frequency of their visits to primary care physicians after their physicians had completed the training programme. Meanwhile, the study recorded an average decrease of 3.1 visits per year by the patients of the physicians who had undergone the training. Statistically significant differences between this group and the control group were observed.

CONCLUSIONS: The educational intervention proved effective at helping primary care physicians to decrease their patients’ rates of frequent attendance. It also contributes to the impact research of continuing education on doctors and their patients. We need to increase primary care spending from the current 14% to the 25%, to address this problem, among others.

PMID:39004704 | DOI:10.1186/s12909-024-05748-w

BMC Public Health. 2024 Jul 15;24(1):1875. doi: 10.1186/s12889-024-19147-9.

ABSTRACT

BACKGROUND: Underweight is a prevalent health issue in children. This study aimed to identify factors associated with underweight in children aged 1-2 years in Hamadan city. Unlike the studies conducted in this field, which are cross-sectional and do not provide information on the effect of age changes on underweight, our longitudinal approach provides insights into weight changes over time. On the other hand, this study focuses on the high-risk age group of 1 to 2 years, which has only been addressed in a few studies.

METHODS: In this longitudinal study, 414 mothers with 1 to 2 year-old children referred to the health centers of Hamadan city, whose information is in the SIB system, a comprehensive electronic system, were examined to identify factors related to underweight. The response variable was weight-for-age criteria classified into three categories: underweight, normal weight, and overweight. A two-level longitudinal ordinal model was used to determine the factors associated with underweight.

RESULTS: Of the children studied, 201 (48.6%) were girls and 213 (51.4%) were boys. Significant risk factors for underweight included low maternal education (AOR = 3.56, 95% CI: 1.10-11.47), maternal unemployment (AOR = 3.38, 95% CI: 1.05-10.91), maternal height (AOR = 0.85, 95% CI: 0.79-0.92), lack of health insurance (AOR = 2.85, 95% CI: 1.04-7.84), gestational age less than 24 years (AOR = 3.17, 95% CI: 16.28-0.97), child age 12-15 months (AOR = 2.27, 95% CI: 1.37-3.74), and child’s birth weight (AOR = 0.63, 95% CI: 0.70-0.58).

CONCLUSION: Based on the results of the present study, it seems that the possibility of being underweight among children is more related to the characteristics of mothers; therefore, taking care of mothers can control some of the weight loss of children.

PMID:39004703 | DOI:10.1186/s12889-024-19147-9

BMC Cancer. 2024 Jul 14;24(1):839. doi: 10.1186/s12885-024-12632-9.

ABSTRACT

BACKGROUND: A few studies regarding the epidemiology and risk factors of Non-muscle Invasive Bladder Cancer (NMIBC) are reported from Sub-Saharan African countries (SSA), including Somalia, and the African literature is scant on the management of NMIBC. The present study aims to evaluate the clinical-histopathological characteristics and factors associated with the survival rate of patients with NMIBC.

METHOD: This six-year cohort study included 196 patients with NMIBC. It reviewed the clinical and histopathological characteristics and factors predicting cancer-specific survival for these patients.

RESULTS: The mean patient age was 59.01 ± 11.50 years, with a male-to-female ratio of 2.8:1. Urothelial carcinoma (UC) constituted the most common pathological type, accounting for 90.8%; Ta LG and T1HG were the most common histopathological tumour stage and grade (n = 90, 45.9%, vs. n = 56, 28.6%), respectively. The mean tumour size was 4.72 ± 2.81 cm. The cancer-specific mortality(CSM) was 13.3%. Age [2.252(2.310-2.943], p < 0.001], Gender [1.031(0.981-1.1.242),p < 0.001], tumour stage and grade [4.902(3.607-5.614),p < 0.001], tumour location [1.135(0.806-1.172),p < 0.001], number [0.510(0.410-0.920),p = 0.03], tumour size [1.523(0.936-1.541),p < 0.001], use of intravesical chemotherapy or BCG [2.810(1.972-4.381),p < 0.001], preoperative hydronephrosis grade [1.517(1.172-2.154),p < 0.001], and follow-up compliance [3.376(2.633-5.018),p < 0.001] were all associated with CSM. The 5-year overall survival was 57.1%, and cardiovascular diseases were the leading cause of mortality (n = 34), followed by diabetes (n = 28).

CONCLUSION: Our study findings revealed that UC constituted the most common pathological subtype, though less than forty per cent of our patients receive intravesical adjuvant therapies, which are crucial to minimizing disease morbidity and mortality. Initiatives improving uro-oncological care, including subspecialty training in oncology and essential cancer therapies, better access to urology services, and cancer screening programs, are much needed for optimal management plans and care in the country.

PMID:39004700 | DOI:10.1186/s12885-024-12632-9