Category: Statistics

Syst Rev. 2023 Aug 2;12(1):134. doi: 10.1186/s13643-023-02279-1.

ABSTRACT

BACKGROUND: Involving collaborators and partners in research may increase relevance and uptake, while reducing health and social inequities. Collaborators and partners include people and groups interested in health research: health care providers, patients and caregivers, payers of health research, payers of health services, publishers, policymakers, researchers, product makers, program managers, and the public. Evidence syntheses inform decisions about health care services, treatments, and practice, which ultimately affect health outcomes. Our objectives are to: A. Identify, map, and synthesize qualitative and quantitative findings related to engagement in evidence syntheses B. Explore how engagement in evidence synthesis promotes health equity C. Develop equity-oriented guidance on methods for conducting, evaluating, and reporting engagement in evidence syntheses METHODS: Our diverse, international team will develop guidance for engagement with collaborators and partners throughout multiple sequential steps using an integrated knowledge translation approach: 1. Reviews. We will co-produce 1 scoping review, 3 systematic reviews and 1 evidence map focusing on (a) methods, (b) barriers and facilitators, (c) conflict of interest considerations, (d) impacts, and (e) equity considerations of engagement in evidence synthesis. 2. Methods study, interviews, and survey. We will contextualise the findings of step 1 by assessing a sample of evidence syntheses reporting on engagement with collaborators and partners and through conducting interviews with collaborators and partners who have been involved in producing evidence syntheses. We will use these findings to develop draft guidance checklists and will assess agreement with each item through an international survey. 3.

CONSENSUS: The guidance checklists will be co-produced and finalised at a consensus meeting with collaborators and partners. 4.

DISSEMINATION: We will develop a dissemination plan with our collaborators and partners and work collaboratively to improve adoption of our guidance by key organizations.

CONCLUSION: Our international team will develop guidance for collaborator and partner engagement in health care evidence syntheses. Incorporating partnership values and expectations may result in better uptake, potentially reducing health inequities.

PMID:37533051 | DOI:10.1186/s13643-023-02279-1

BMC Pulm Med. 2023 Aug 2;23(1):280. doi: 10.1186/s12890-023-02576-4.

ABSTRACT

BACKGROUND: In Tanzania little is known about how the respiratory system of small-holder fish vendors is affected by occupational exposure to biomass smoke and other associated factors. This study assessed the prevalence of lung obstruction and associated factors among small-holder fish vendors along coastal areas in Tanzania.

METHODS: A cross-sectional descriptive study was conducted in Bagamoyo and Kunduchi fish markets along coastal areas of Tanzania. Environmental air pollutant levels and composition were measured using a hand-held device. A standardized questionnaire was used to assess respiratory symptoms while EasyOne spirometer was used to test for lung function among small-holder fish vendors. Chronic Obstructive Pulmonary Disease (COPD) was defined as FEV1/FVC below the lower limit of normal. Data were analyzed using STATA Version 17. Descriptive statistics was performed and logistic regression analysis was used to determine factors that are associated with poor lung function presented as crude and adjusted odds ratio and their 95% confidence intervals.

RESULTS: A total of 103 participants were included in the study who were predominantly males 82 (79.6%). The participants’ mean age was 35.47 (± 8.77 SD) years. The hourly average concentration levels of PM₁, PM_2.5, PM_10, and CO exposure during fish frying were 653.6 (± 206.3 SD) μg/m³, 748.48 (± 200.6 SD) μg/m³, 798.66 (± 181.71 SD) μg/m³ and 62.6 (± 12.3 SD) ppm respectively which are higher than the WHO recommended limits. The prevalence of COPD was found to be 32.04% (95% CI 0.23-0.42). Most of the participants reported respiratory symptoms like coughing, wheezing, sputum production and breathlessness during performing their daily activities.

CONCLUSION: Findings suggest that three out of ten participants had COPD and the major environmental air pollutants (PMs and CO) concentration levels were too high, suggesting that occupational exposure to biomass smoke may be a risk factor. This calls for effective approaches to reduce exposure and prevent known acute and chronic respiratory diseases that are associated with such exposure to air pollutants. Also the study calls for follow up or cohort studies to be conducted in this area.

PMID:37533046 | DOI:10.1186/s12890-023-02576-4

J Orthop Surg Res. 2023 Aug 2;18(1):558. doi: 10.1186/s13018-023-04032-9.

ABSTRACT

PURPOSE: The objective of this study was to identify the risk factors for admission deep venous thrombosis (aDVT) and proximal aDVT in nonagenarians and centenarians with intertrochanteric fracture (IF).

METHODS: We collected statistics on nonagenarians and centenarians with IF admitting from January 2010 to October 2022. Patients with aDVT were considered as the aDVT group and those without aDVT as the non-aDVT group. Additionally, we also conducted a subgroup analysis based on the location of aDVT to investigate the predictors of proximal aDVT. The demographics, comorbidities and admission laboratory examinations of patients were computed by univariate analysis, logistic regression analysis, and receiver operating characteristic (ROC) curve analysis.

RESULTS: In our study, the rate of aDVT (109 of 318) was 34.3%, and 5.7% (18 of 318) of patients had proximal aDVT. Logistic regression analysis showed that female patients and a high level of D-dimer were risk factors for aDVT. Similarly, hypoproteinemia and a high level of D-dimer were found to be risk factors for proximal aDVT. ROC curve analysis indicated the cut-off values of D-dimer to predict the aDVT and proximal aDVT were 1.28 mg/L and 1.485 mg/L, respectively.

CONCLUSIONS: Our findings investigated the risk factors of aDVT and proximal aDVT in nonagenarians and centenarians with IF and identified the cut-off values of D-dimer, helping us assess the risk of aDVT and proximal aDVT to manage early targeted interventions.

PMID:37533045 | DOI:10.1186/s13018-023-04032-9

BMC Public Health. 2023 Aug 2;23(1):1473. doi: 10.1186/s12889-023-16325-z.

ABSTRACT

BACKGROUND: We aimed to examine the lymphohematopoietic cancer mortality in a cohort of workers at a semiconductor manufacturing company in South Korea according to their jobs.

METHODS: A retrospective cohort was constructed using the personnel records of semiconductor manufacturing workers who were employed in a semiconductor company in South Korea in 1998-2012. Data on their vital status and causes of death were obtained from the National Statistical Office of South Korea. The standardized mortality ratios (SMRs) of lymphohematopoietic cancer were calculated.

RESULTS: A total of 288 deaths were reported, of which 22 were caused by lymphohematopoietic cancer, among 65,782 workers in 878,325 person-years. The SMRs for lymphohematopoietic cancer were 0.78 (95% confidence interval [CI] = 0.39-1.40; the number of observed cases [Obs] = 11) among male workers and 1.71 (95% CI = 0.85-3.06; Obs = 11) among female workers. Among female operators, excess deaths due to lymphohematopoietic cancer (SMR = 2.59, 95% CI = 1.24-4.76) and leukemia (SMR = 2.92, 95% CI = 1.26-5.76) were observed. However, they were not observed among office workers, facility managers, utility managers, or process managers.

CONCLUSION: Female operators involved in the semiconductor wafer fabrication process had higher risk of mortality from lymphohematopoietic cancer.

PMID:37533044 | DOI:10.1186/s12889-023-16325-z

Int J Equity Health. 2023 Aug 2;22(1):145. doi: 10.1186/s12939-023-01970-y.

ABSTRACT

BACKGROUND: Lung cancer is the main cause of cancer mortality worldwide and in Spain. Several previous studies have documented socio-economic inequalities in lung cancer mortality but these have focused on specific provinces or cities. The goal of this study was to describe lung cancer mortality in Spain by sex as a function of socio-economic deprivation.

METHODS: We analysed all registered deaths from lung cancer during the period 2011-2017 in Spain. Mortality data was obtained from the National Institute of Statistics, and socio-economic level was measured with the small-area deprivation index developed by the Spanish Society of Epidemiology, with the census tract of residence at the time of death as the unit of analysis. We computed crude and age-standardized rates per 100,000 inhabitants by sex, deprivation quintile, and type of municipality (rural, semi-rural, urban) considering the 2013 European standard population (ASR-E). We further calculated ASR-E ratios between the most deprived (Q5) and the least deprived (Q1) areas and mapped census tract smoothed standardized lung cancer mortality ratios by sex.

RESULTS: We observed 148,425 lung cancer deaths (80.7% in men), with 73.5 deaths per 100,000 men and 17.1 deaths per 100,000 women. Deaths from lung cancer in men were five times more frequent than in women (ASR-E ratio = 5.3). Women residing in the least deprived areas had higher mortality from lung cancer (ASR-E = 22.2), compared to women residing in the most deprived areas (ASR-E = 13.2), with a clear gradient among the quintiles of deprivation. For men, this pattern was reversed, with the highest mortality occurring in areas of lower socio-economic level (ASR-E = 99.0 in Q5 vs. ASR-E = 86.6 in Q1). These socio-economic inequalities remained fairly stable over time and across urban and rural areas.

CONCLUSIONS: Socio-economic status is strongly related to lung cancer mortality, showing opposite patterns in men and women, such that mortality is highest in women residing in the least deprived areas and men residing in the most deprived areas. Systematic surveillance of lung cancer mortality by socio-economic status may facilitate the assessment of public health interventions aimed at mitigating cancer inequalities in Spain.

PMID:37533035 | DOI:10.1186/s12939-023-01970-y

BMC Pregnancy Childbirth. 2023 Aug 2;23(1):556. doi: 10.1186/s12884-023-05877-y.

ABSTRACT

BACKGROUND: Neonatal mortality contributes about 47% of child mortality globally and over 50% of under-5 deaths in Ghana. There is limited population level analysis done in Ghana on predictors of neonatal mortality.

OBJECTIVES: The objective of the study was to examine the predictors of neonatal mortality in Ghana.

METHOD: This study utilizes secondary data from the 2017 Ghana Maternal Health Survey (GMHS). The GMHS survey focuses on population and household characteristics, health, nutrition, and lifestyle with particular emphasis on topics that affect the lives of newborns and women, including mortality levels, fertility preferences and family planning methods. A total of 10,624 respondents were included in the study after data cleaning. Descriptive statistical techniques were used to describe important background characteristics of the women and Pearson’s Chi-squares (χ²) test used to assess association between the outcome (neonatal death) and independent variables. Multivariate logistic regression analysis was done to estimate odd ratios and potential confounders controlled. Confidence level was held at 95%, and a p < 0.05 was considered statistically significant. Data analysis was done using STATA 15.

RESULTS: The prevalence of neonatal mortality was 18 per 1000 live births. ANC attendance, sex of baby, and skin-to-skin contact immediately after birth were predictors of neonatal mortality. Women with at least one ANC visit were less likely to experience neonatal mortality as compared to women with no ANC visit prior to delivery (AOR = 0.11; CI = 0.02-0.56, p = 0.01). Girls were less likely (AOR = 0.68; CI = 0.47-0.98; p = 0.03) to die during the neonatal period as compared to boys. Neonates who were not put skin-to-skin contact immediately after birth were 2.6 times more likely to die within the neonatal period than those who were put skin-to-skin contact immediately after birth (AOR = 2.59; CI = 1.75-3.83, p = 0.00).

CONCLUSION: Neonatal mortality remains a public health concern in Ghana, with an estimated rate of 18 deaths per 1,000 live births. Maternal and neonatal factors such as the sex of the newborn, the number of antenatal care visits, and skin-to-skin contact between the newborn and mother immediately after birth are the predictors of neonatal mortality in Ghana.

PMID:37533034 | DOI:10.1186/s12884-023-05877-y

BMC Health Serv Res. 2023 Aug 2;23(1):825. doi: 10.1186/s12913-023-09842-5.

ABSTRACT

BACKGROUND: In Brazil, despite advances in public health policies aimed at eliminating and controlling infectious and parasitic diseases, the incidence of neglected diseases is still high. The epidemiological scenario in Brazil of diseases such as tuberculosis and leprosy evidences a public policy agenda that has not been resolute in terms of control, nor in terms of elimination.

OBJECTIVE: To analyze the actions of diagnosis and treatment of leprosy and tuberculosis in the context of primary health care.

METHODS: In this ecological study, data from the third cycle of the Program for the Improvement of Access and Quality of Primary Care were extracted from electronic address of the Primary Health Care Secretariat of Brazil in the area of Actions, Programs and Strategies. A total of 37,350 primary health care teams were that answered the questionnaire were eligible, with variables extracted from leprosy and tuberculosis control actions. The municipalities were grouped according to the characteristic of the Brazilian municipality. The partition chi-square and the Residuals Test were used to assess whether there was a difference in the proportion of tuberculosis and leprosy actions between types of municipalities. Statistics were carried out using Minitab 20 and Bioestat 5.3.

RESULTS: Regarding the leprosy treatment location, there is a higher proportion of people referred to be treated at the reference in adjacent rural (p = 0.0097) and urban (p < 0.0001) municipalities; monitoring of people with leprosy referred to the service network (p. = 0.0057) in remote rural areas. Lower proportion of teams requesting bacilloscopy in remote rural areas (p = 0.0019). Rural areas have a higher proportion of teams that diagnose new cases (p = 0.0004). Regarding the actions of diagnosis and treatment of tuberculosis. There is a higher proportion of teams that carry out consultations at the unit itself in rural areas when compared to adjacent intermediaries (p = 0.0099) and urban (p < 0.0001); who requested sputum smear microscopy in adjacent intermediaries (p = 0.0021); X-ray in adjacent intermediaries (p < 0.0001) and urban (p < 0.0001); collection of the first sputum sample in urban (p < 0.0001) and adjacent rural areas (p < 0.0001); directly observed treatment (p < 0.0001) in adjacent rural municipalities.

CONCLUSION: There are inequalities in the diagnosis and treatment of leprosy and tuberculosis among the types of municipalities.

PMID:37533030 | DOI:10.1186/s12913-023-09842-5

Malar J. 2023 Aug 2;22(1):223. doi: 10.1186/s12936-023-04655-7.

ABSTRACT

BACKGROUND: Malaria infection during pregnancy endangers the pregnant woman, fetus, and newborn child. Thus, the use of an insecticide-treated net (ITN) is one of the most frequently advised methods for preventing malaria during pregnancy. Contrary findings have been reported in various studies on ITN utilization among pregnant women in Ethiopia. Therefore, this study was aimed to estimate the pooled prevalence of ITN utilization and its associated factors among pregnant women in Ethiopia.

METHODS: Published articles from PubMed, Google Scholar, Science Direct, AJOL and Cochrane library were systematically searched. All cross-sectional studies on ITN utilization among pregnant women were included in this meta-analysis. To estimate the pooled prevalence and odds ratio, a random-effect model was used; and a subgroup analysis was performed to identify the possible source of heterogeneity. Begg’s and Egger’s tests were used to identify possible publication bias.

RESULTS: Ten cross-sectional studies with 7,161 participants were included. The pooled prevalence of ITN utilization among all pregnant women who had access to ITN in Ethiopia was 59.42% (95% CI 51.14, 67.69). Statistically significant heterogeneity was observed (I² = 97.7%; p < 0.0001). Higher educational status (OR = 3.47, 95% CI 2.32, 5.2), pregnant women who had antenatal care visits (OR = 2.37, 95% CI 1.97, 2.65) and having good knowledge of malaria prevention practices (OR = 10.63, 95% CI 5.31, 21.29) were associated with ITN utilization among pregnant women.

CONCLUSION: The utilization of ITNs among pregnant women was much lower than the national target. Higher education status, attending ANC and a good level of knowledge were found to be independent predictors of ITN utilization. Improving women’s understanding of ITNs will enhance their use, and the government and health sectors should encourage pregnant mothers to enroll in antenatal care.

PMID:37533029 | DOI:10.1186/s12936-023-04655-7

BMC Health Serv Res. 2023 Aug 2;23(1):824. doi: 10.1186/s12913-023-09849-y.

ABSTRACT

BACKGROUND: Telementorship has emerged as an innovative strategy to decentralise medical knowledge and increase healthcare capacity across a wide range of disease processes. We report the global experience with telementorship to support healthcare workers delivering hepatitis B virus (HBV) and hepatitis C virus (HCV) care and treatment.

METHODS: In early 2020, we conducted a survey of HBV and HCV telementorship programmes, followed by an in-depth interview with programme leads. Programmes were eligible to participate if they were located outside of the United States (U.S.), focused on support to healthcare workers in management of HBV and/or HCV, and were affiliated with or maintained adherence to the Project ECHO model, a telementorship programme pioneered at the University of New Mexico. One programme in the U.S., focused on HCV treatment in the Native American community, was purposively sampled and invited to participate. Surveys were administered online, and all qualitative interviews were performed remotely. Descriptive statistics were calculated for survey responses, and qualitative interviews were assessed for major themes.

RESULTS: Eleven of 18 eligible programmes completed the survey and follow up interview. Sixty-four percent of programmes were located at regional academic medical centers. The majority of programmes (64%) were led by hepatologists. Most programmes (82%) addressed both HBV and HCV, and the remainder focused on HCV only. The median number of participating clinical spoke sites per programme was 22, and most spoke site participants were primary care providers. Most ECHO sessions were held monthly (36%) or bimonthly (27%), with sessions ranging from 45 min to 2 h in length. Programme leaders identified collective learning, empowerment and collaboration to be key strengths of their telementorship programme, while insufficient funding and a lack of protected time for telementorship leaders and participants were identified as major barriers to success.

CONCLUSION: The Project ECHO model for telementorship can be successfully implemented across high and low-and-middle-income countries to improve provider knowledge and experience in management of viral hepatitis. There is a tremendous opportunity to further expand upon the existing experience with telementorship to support non-specialist healthcare workers and promote elimination of viral hepatitis.

PMID:37533025 | DOI:10.1186/s12913-023-09849-y

BMC Genomics. 2023 Aug 2;24(1):431. doi: 10.1186/s12864-023-09512-0.

ABSTRACT

The H9c2 myoblast cell line, isolated from the left ventricular tissue of rat, is currently used in vitro as a mimetic for skeletal and cardiac muscle due to its biochemical, morphological, and electrical/hormonal signaling properties. During culture, H9c2 cells acquire a myotube phenotype, where a critical component is the inclusion of retinoic acid (RA). The results from some authors on H9c2 suggested that thousands of genes respond to RA stimuli, while others report hundreds of genes responding to RA over different cell types. In this article, using a more appropriate experimental design, we first confirm the H9c2 cardiac phenotype with and without RA and report transcriptomic and physiological changes regarding calcium handling, bioenergetics, and other biological concepts. Interestingly, of the 2360 genes showing a transcriptional change, 622 genes were statistically associated with the RA response. Of these genes, only 305 were RA-specific, and the rest also showed a culture-time component. Thus, the major expression changes (from 74 to 87%) were indeed due to culture conditions over time. Unexpectedly, only a few components of the retinol pathway in KEGG responded to RA. Our results show the role of RA in the H9c2 cultures impacting the interpretation using H9c2 as an in vitro model.

PMID:37533008 | DOI:10.1186/s12864-023-09512-0