Category: Statistics

Int Tinnitus J. 2024 Mar 18;27(2):119-125. doi: 10.5935/0946-5448.20230019. Online ahead of print.

ABSTRACT

BACKGROUND: Noise-Induced Hearing Loss (NIHL) is a prevalent occupational hazard among healthcare professionals, including medical students. Despite its detrimental effects, the awareness and utilization of hearing protection measures among medical students in Saudi Arabia remain understudied.

OBJECTIVE: Is to determine the level of awareness and understanding of NIHL among medical students in Saudi Arabia, as well as their knowledge and usage of hearing protection measures and to identify potential barriers and facilitators for hearing protection utilization.

METHODS: A mixed-methods approach was employed, involving a questionnaire survey and semi-structured interviews. The survey collected data on demographics, knowledge of NIHL, and hearing protection practices among medical students. Subsequently, a semi-structured interview was conducted to obtain in-depth insights into the students’ experiences, attitudes, and beliefs regarding NIHL and the use of hearing protection.

RESULTS: The level about NIHL was 59.32%. Better access to information is associated with increased odds of awareness (odds ratio=3.07, p=0.012). Having relatives with hearing loss increases the odds of awareness (odds ratio =2.49, p=0.034). Individuals with hearing loss or impairment have higher odds of awareness (odds ratio =2.27, p=0.046). Ear Pain, temporary hearing loss, tinnitus, or ringing in the ear: These factors are not significantly associated with awareness of noise-induced hearing loss (p>0.05). Using hearing aids is strongly associated with increased odds of awareness (odds ratio =3.94, p=0.006).The quantitative analysis provided statistical information on the prevalence rates and factors influencing hearing protection usage, while the qualitative analysis uncover nuanced perspectives and experiences.

CONCLUSION: This research will contribute to the understanding of NIHL and hearing protection practices among medical students in Saudi Arabia. Improving hearing protection awareness and practices among medical students can ultimately reduce the incidence of NIHL and promote a healthier work environment within the healthcare sector.

PMID:38507624 | DOI:10.5935/0946-5448.20230019

Int Tinnitus J. 2024 Mar 18;27(2):104-112. doi: 10.5935/0946-5448.20230017. Online ahead of print.

ABSTRACT

BACKGROUND: Health care providers must be aware of the choices in aural rehabilitation methods and assessment procedures available presently to those with hearing impairment in order to facilitate early identification and intervention and ensure quality of care to those hearing impaired individuals. The referrals from the medical fraternities for the audiological services are not uniform across India. Part of reason may be that awareness about the roles of and responsibilities of audiologist’s is poor among medical practitioners. In some regions of India medical practitioners may be only grossly be aware of audiologists per se. They may not know enough to refer all individuals with hearing or balance disorders for the required audiological services.

AIM: To evaluate changes in pre survey and post survey after education intervention specifically planned for medical practitioners in the state of Sikkim, India. Education intervention included awareness about hearing impairment and its assessment and management by audiologists.

METHOD: A pre and post survey comparison research design with purposive convenient sampling technique was applied. Participants were medical practitioners working in geographical area of Sikkim at the time of the study. Inspection of demographic data of respondents showed that they were in their age range of 24 and 60 years and with work experience ranging 1-40 years. Participants were invited for an awareness talk which included, information about hearing loss, early identification and early intervention, tests and management of hearing loss in different age groups, need for hearing aids/cochlear implants, auditory training, and the role of an audiologist in the management of hearing loss and ways to prevent hearing loss. A pre and post awareness program responses were collected from all the participants using a customized questionnaire tool.

RESULTS: Respondents exhibited, in the pre-survey questionnaire, lack of awareness in many aspects of audiology, including assessing hearing impairment, diagnosing hearing loss, and the role of an audiologist. There was an overall, statistically significant difference in the level of performance on the pre-awareness and post-awareness responses.

CONCLUSION: Following an awareness campaign among the medical professionals in Sikkim, there was a considerable change in their level of awareness of hearing impairment, its assessment, and management by audiologists. The reach of the awareness campaign was significant as around 70% of subjects showed significant change in their knowledge and attitude towards hearing impairment, its management.

PMID:38507622 | DOI:10.5935/0946-5448.20230017

Int Tinnitus J. 2024 Mar 18;27(2):97-103. doi: 10.5935/0946-5448.20230016. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe an application’s development and validation process that aims to track hearing difficulties in adverse environments (a listening effort application).

DESIGN: 71 subjects were evaluated, divided into two groups: 30 subjects aged between 18 and 30, and 41 subjects aged between 40 and 65. All subjects had European Portuguese as their native language; the Montreal Cognitive Assessment (MOCA) scored above 24, and all could read and write. All subjects performed the intelligibility test in noise and the test of listening effort. The two tests were randomly applied in the free field in the audiometric cabin and the application.

RESULTS: There were no statistically significant differences between the results of the two methods (p>0.05). For the group aged between 40 and 65 years old, the ROC curve showed that intelligibility inferior to 68.5% and the number of correct answers lower than 1,5 in the listening effort test are the optimal cut-off for referral to further management. Both tests showed low sensitivity and specificity regarding individuals between 18 and 30 years old, indicating that the application is inappropriate for this age group.

CONCLUSIONS: The application is valid and can contribute to the screening and self-awareness of listening difficulties in middle age, with a reduction in the prevalence of dementia soon.

PMID:38507621 | DOI:10.5935/0946-5448.20230016

Am J Respir Crit Care Med. 2024 Mar 20. doi: 10.1164/rccm.202310-1965OC. Online ahead of print.

ABSTRACT

RATIONALE: Individuals with COPD have airflow obstruction and maldistribution of ventilation. For those living at high altitude, any gas exchange abnormality is compounded by reduced partial pressures of inspired oxygen.

OBJECTIVES: Does residence at higher-altitude exposure affect COPD outcomes, including lung function, imaging characteristics, symptoms, health status, functional exercise capacity, exacerbations, or mortality?

METHODS: From the SPIROMICS cohort, we identified individuals with COPD living below 1,000 ft (305 m) elevation (n= 1,367) versus above 4,000 ft (1,219 m) elevation (n= 288). Multivariable regression models were used to evaluate associations of exposure to high altitude with COPD-related outcomes.

MEASUREMENTS AND MAIN RESULTS: Living at higher altitude was associated with reduced functional exercise capacity as defined by 6MWD (-32.3 m, (-55.7 to -28.6)). There were no differences in patient-reported outcomes as defined by symptoms (CAT, mMRC), or health status (SGRQ). Higher altitude was not associated with a different rate of FEV1 decline. Higher altitude was associated with lower odds of severe exacerbations (IRR 0.65, (0.46 to 0.90)). There were no differences in small airway disease, air trapping, or emphysema. In longitudinal analyses, higher altitude was associated with increased mortality (HR 1.25, (1.0 to 1.55)); however, this association was no longer significant when accounting for air pollution.

CONCLUSIONS: Chronic altitude exposure is associated with reduced functional exercise capacity in individuals with COPD, but this did not translate into differences in symptoms or health status. Additionally, chronic high-altitude exposure did not affect progression of disease as defined by longitudinal changes in spirometry.

PMID:38507607 | DOI:10.1164/rccm.202310-1965OC

Ophthalmic Epidemiol. 2024 Mar 20:1-9. doi: 10.1080/09286586.2024.2319243. Online ahead of print.

ABSTRACT

PURPOSE: The prevalence of visual impairment is increasing, and there is a need to understand the functional implications. Using the American Community Survey (ACS) data, this study examined the relationship between visual impairment and functional difficulties in California.

METHODS: Using the 2010-2014 and 2015-2019 ACS 5-year estimates from the U.S. Census, data were obtained for visual impairment and functional difficulties including hearing, cognitive, ambulatory, self-care, and independent living difficulties. The prevalence of vision impairment and each functional difficulty was calculated on the Medical Service Study Area (MSSA) level in California. Unadjusted and adjusted linear regression models were performed to estimate the association between visual impairment and each functional difficulty, adjusting for age, sex, race and ethnicity, education level, English-speaking ability, poverty status, health insurance status, and urbanity of residence location.

RESULTS: The prevalence of visual impairment in California was 2.3% (659,502 of 28,794,572) in 2010-2014 and 2.3% (709,353 of 30,231,767) in 2015-2019 among the population ≥ 18 years old. There were statistically significant associations between the prevalence of vision impairment and increased prevalence of all functional difficulties, with the most positive correlation observed with ambulatory difficulty (slope estimate 0.58 ± 0.072 for 2010-2014 and 0.78 ± 0.082 for 2015-2019 for ambulatory difficulty).

CONCLUSIONS: There may be population-level impacts of functional consequences from vision impairment, suggesting the need for neighborhood-level investigation and policy-based interventions to address the burden of vision impairment on the population level.

PMID:38507605 | DOI:10.1080/09286586.2024.2319243

J Midwifery Womens Health. 2024 Mar 20. doi: 10.1111/jmwh.13624. Online ahead of print.

ABSTRACT

INTRODUCTION: Efforts to reduce primary cesarean birth may include supporting longer second stages of labor. Although midwifery-led care is associated with lower cesarean use, little has been published on associated outcomes of prolonged second stage (≥3 hours of pushing) for nulliparous individuals in US hospital-based midwifery care. Epidural analgesia and the role of passive descent in midwifery-led care are also underexplored in relation to the second stage. In this study, we report the incidence of prolonged second stage stratified by epidural analgesia and/or passive descent. Secondary aims included calculating the odds of cesarean birth, obstetric anal sphincter injury (OASI), postpartum hemorrhage (PPH), and neonatal complications.

METHODS: Data were collected prospectively from a single academic center in the United States from 2012 through 2019. Our cohort analysis of labors attended by midwives for nulliparous, term, singleton, and vertex pregnancies included both descriptive and inferential statistics comparing outcomes between prolonged versus nonprolonged pushing groups. We stratified the sample and quantified second stage outcomes by epidural analgesia and by use of passive descent.

RESULTS: Of the 1465 births, 17% (n = 247) included prolonged pushing. Cesarean ranged from 2.2% without prolonged pushing to 26.7% with prolonged pushing. Fetal malposition, epidural analgesia, and longer passive descent were more common among those with prolonged active pushing. Despite these factors, neither odds for PPH nor poor neonatal outcomes were associated with prolonged pushing. Those with more than one hour of passive descent in the second stage who also had prolonged active pushing had lower odds for cesarean but higher odds for OASI relative to those who had little passive descent before pushing for more than 3 hours.

DISCUSSION: Prolonged pushing occurred in nearly 2 of 10 nulliparous labors. Fetal malposition, epidural analgesia, and prolonged pushing were commonly observed with longer passive descent, cesarean, and OASI. Passive descent in these data likely reflects individualized midwifery care strategies when pushing was complicated by fetal malposition or other complexities.

PMID:38507603 | DOI:10.1111/jmwh.13624

G3 (Bethesda). 2024 Mar 20:jkae058. doi: 10.1093/g3journal/jkae058. Online ahead of print.

ABSTRACT

Streptococcus pneumoniae (the pneumococcus) is a globally distributed, human obligate opportunistic bacterial pathogen which, although often carried commensally, is also a significant cause of invasive disease. Apart from multi-drug resistant and virulent clones, the rate and direction of pneumococcal dissemination between different countries remains largely unknown. The ability for the pneumococcus to take a foothold in a country depends on existing population configuration, the extent of vaccine implementation, as well as human mobility since it is a human obligate bacterium. To shed light on its international movement, we used extensive genome data from the Global Pneumococcal Sequencing (GPS) project and estimated migration parameters between multiple countries in Africa. Data on allele frequencies of polymorphisms at housekeeping-like loci for multiple different lineages circulating in the populations of South Africa, Malawi, Kenya, and The Gambia were used to calculate the fixation index (Fst) between countries. We then further used these summaries to fit migration coalescent models with the likelihood-free inference algorithms available in the ELFI software package. Synthetic data were additionally used to validate the inference approach. Our results demonstrate country-pair specific migration patterns and heterogeneity in the extent of migration between different lineages. Our approach demonstrates that coalescent models can be effectively used for inferring migration rates for bacterial species and lineages provided sufficiently granular population genomics surveillance data. Further it can demonstrate the connectivity of respiratory disease agents between countries to inform intervention policy in the longer term.

PMID:38507601 | DOI:10.1093/g3journal/jkae058

Ophthalmic Epidemiol. 2024 Mar 20:1-10. doi: 10.1080/09286586.2024.2321892. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the prevalence and risk factors of age-related macular degeneration (AMD) in the Korean population.

METHODS: In this cross-sectional study based on the Korea National Health and Nutrition Examination Survey (2017-2020) data 13,737 participants aged ≥ 40 years with assessable fundus images were included. The prevalence and risk factors of AMD were evaluated. The prevalence of early AMD, geographic atrophy (GA), and neovascular AMD were also assessed. Logistic regression analyses were used to identify risk factors.

RESULTS: The prevalence (95% confidence interval [CI]) of AMD was 13.94% (13.15-14.72). The prevalence (95% CI) of early AMD, GA, and neovascular AMD was 13.07% (12.29-13.85), 0.26% (0.17-0.35), and 0.61% (0.47-0.75), respectively. The prevalence increased with age; it was 3.61%, 11.33%, 20.31%, 31.37%, and 33.98% in participants in their 40s, 50s, 60s, 70s, and ≥ 80 years, respectively. In multivariate analysis, AMD was positively associated with older age (p < 0.001; odds ratio [OR], 1.08; 95% CI, 1.07-1.09), male sex (p = 0.014; OR, 1.27; 95% CI, 1.05-1.53), and lower degree of education (p < 0.001; OR, 1.36 (for junior high school graduates); 95% CI, 1.12-1.65).

CONCLUSIONS: AMD was detected in approximately one-third of individuals aged ≥ 70 years, thus indicating that AMD is a common disease among older Koreans. Regular fundus examinations in populations with risk factors for AMD as well as education on methods to prevent or delay AMD progression, such as the Mediterranean diet, are necessary.

PMID:38507599 | DOI:10.1080/09286586.2024.2321892

Am J Speech Lang Pathol. 2024 Mar 20:1-30. doi: 10.1044/2024_AJSLP-23-00366. Online ahead of print.

ABSTRACT

PURPOSE: Selecting vocabulary for preliterate individuals who use augmentative and alternative communication presents multiple challenges, as the number of symbols provided must be balanced with cognitive, motoric, and other needs. Prioritizing certain types of vocabulary thus becomes a necessity. For example, prioritizing core vocabulary-that is, words that are commonly used across a group of people and contexts-is a common practice that attempts to address some of these issues. However, most core vocabulary research to date has narrowly focused on individual word counts, ignoring other critical aspects of language development such as how vocabulary aligns with typical development and how children use core and fringe vocabulary within their utterances.

METHOD: Descriptive and inferential statistics were used to analyze 112 transcripts to describe how typically developing toddlers (aged 2.5 years) use core and fringe vocabulary within their utterances, in reference to a range of commonly used core vocabulary lists.

RESULTS: Results indicated that the proportion of the toddlers’ utterances that consisted of only core, only fringe, or core + fringe vocabulary varied dramatically depending on the size of the core vocabulary list used, with smaller core lists yielding few “core-only” utterances. Furthermore, utterances containing both core and fringe vocabulary were both grammatically and semantically superior to utterances containing only core or only fringe vocabulary, as evidenced by measures such as mean length of utterance and total number of words.

CONCLUSION: Thus, relying on word frequency counts is an insufficient basis for selecting vocabulary for aided preliterate communicators.

PMID:38507571 | DOI:10.1044/2024_AJSLP-23-00366

JMIR Public Health Surveill. 2024 Mar 20;10:e46903. doi: 10.2196/46903.

ABSTRACT

BACKGROUND: The COVID-19 pandemic necessitated public health policies to limit human mobility and curb infection spread. Human mobility, which is often underestimated, plays a pivotal role in health outcomes, impacting both infectious and chronic diseases. Collecting precise mobility data is vital for understanding human behavior and informing public health strategies. Google’s GPS-based location tracking, which is compiled in Google Mobility Reports, became the gold standard for monitoring outdoor mobility during the pandemic. However, indoor mobility remains underexplored.

OBJECTIVE: This study investigates in-home mobility data from ecobee’s smart thermostats in Canada (February 2020 to February 2021) and compares it directly with Google’s residential mobility data. By assessing the suitability of smart thermostat data, we aim to shed light on indoor mobility patterns, contributing valuable insights to public health research and strategies.

METHODS: Motion sensor data were acquired from the ecobee “Donate Your Data” initiative via Google’s BigQuery cloud platform. Concurrently, residential mobility data were sourced from the Google Mobility Report. This study centered on 4 Canadian provinces-Ontario, Quebec, Alberta, and British Columbia-during the period from February 15, 2020, to February 14, 2021. Data processing, analysis, and visualization were conducted on the Microsoft Azure platform using Python (Python Software Foundation) and R programming languages (R Foundation for Statistical Computing). Our investigation involved assessing changes in mobility relative to the baseline in both data sets, with the strength of this relationship assessed using Pearson and Spearman correlation coefficients. We scrutinized daily, weekly, and monthly variations in mobility patterns across the data sets and performed anomaly detection for further insights.

RESULTS: The results revealed noteworthy week-to-week and month-to-month shifts in population mobility within the chosen provinces, aligning with pandemic-driven policy adjustments. Notably, the ecobee data exhibited a robust correlation with Google’s data set. Examination of Google’s daily patterns detected more pronounced mobility fluctuations during weekdays, a trend not mirrored in the ecobee data. Anomaly detection successfully identified substantial mobility deviations coinciding with policy modifications and cultural events.

CONCLUSIONS: This study’s findings illustrate the substantial influence of the Canadian stay-at-home and work-from-home policies on population mobility. This impact was discernible through both Google’s out-of-house residential mobility data and ecobee’s in-house smart thermostat data. As such, we deduce that smart thermostats represent a valid tool for facilitating intelligent monitoring of population mobility in response to policy-driven shifts.

PMID:38506901 | DOI:10.2196/46903