Category: Statistics

Int J Equity Health. 2025 Apr 12;24(1):101. doi: 10.1186/s12939-025-02468-5.

ABSTRACT

BACKGROUND: Integrated care services have been initiated in China for several years, yet there remains a dearth of substantial evidence and research elucidating the service’s efficacy, particularly in underdeveloped areas. This study aims to address this gap by evaluating the effectiveness of integrated care from the patients’ perspective, thereby offering practical strategies to improve service effectiveness and promote health equity within county medical alliances.

METHODS: The Patient Perceptions of Integrated Care (PPIC) and European Quality of Life-5 Dimensions-5 Levels (EQ-5D-5 L) scales were employed to gather information on patients’ perceptions of integrated care and their self-rated health status. A total of 1093 respondents from two pilot areas were selected for data collection. T-tests and one-way analysis of variance (ANOVA) were recruited, additionally, the study utilized multiple linear regression models to examine the specific impact of various factors on the effectiveness of integrated care services.

RESULTS: The average score for the effectiveness of integrated healthcare services from the patients’ perspective was 67.72 (SD = 14.443, n = 1093). Statistical analysis revealed that as the respondents’ age increased and their self-rated health declined, the PPIC scores showed an upward trend. Regression analysis found that factors such as age, education level, income, health status, and level of healthcare intervention significantly influenced PPIC scores. Overall, there is a trend where respondents with higher health needs tend to have higher perceptions of the service, while those with relatively higher socioeconomic status are more likely to provide lower ratings. Additionally, increasing the frequency and duration of healthcare interventions can improve respondents’ evaluations of the services.

CONCLUSIONS: This study analyzes the effectiveness of integrated services in China’s county-level medical alliance from the patients’ perspective. It finds progress in resource integration and efficiency but identifies limitations in implementation, particularly in balancing equity. Socio-economic factors continue to affect the fairness of service utilization and patient satisfaction. Constraints in finance, human capital, and technology hinder the provision of more targeted services for vulnerable groups. To promote health equity, future services need to focus more on key populations and provide more targeted services, accelerate the integration of information technology, and expand service coverage to address the diverse needs of marginalized communities.

PMID:40221792 | DOI:10.1186/s12939-025-02468-5

J Cardiothorac Surg. 2025 Apr 12;20(1):192. doi: 10.1186/s13019-025-03427-5.

ABSTRACT

OBJECTIVE: Psychological factors are closely correlated with coronary heart disease, and gender discrepancies occurs in mental health after percutaneous coronary intervention (PCI) for acute coronary syndrome patients (ACS) are worth studying.

METHODS: This study collected data from patients aged ≥ 60 diagnosed with ACS who underwent PCI treatment within one week of admission to the Cardiovascular Department of Ji’an Central People’s Hospital between June 2021 and December 2022. The study group consisted of 113 female patients, whereas the control group consisted of 121 male patients. Baseline patient data, demography, and laboratory test results were collected. Anxiety and depression were assessed using the Self-rating anxiety scale (SAS) and Self-rating depression scale (SDS) before PCI and at 1, 4, and 12 weeks post-procedure. Descriptive data are presented as x̄±s. Group comparisons for continuous variables were conducted using t-tests, while categorical data were analyzed using chi-square tests. Multiple group comparisons were conducted using analysis of variance.

RESULTS: There were no statistically significant disparities observed in baseline characteristics between these two groups. The assessment of SAS and SDS scores exhibited no statistically significant difference between the two groups before PCI; however, after the procedure, elderly female ACS patients demonstrated notably elevated SAS and SDS scores when contrasted with their elderly male ACS counterparts. Both cohorts manifested their highest SAS and SDS scores before PCI, with a gradual reduction in these scores after the procedure. Elderly female ACS patients experienced a statistically significant reduction in SAS and SDS scores at both 4- and 12 weeks post-PCI compared to their pre-PCI scores.

CONCLUSIONS: Taken together, elderly female ACS patients undergoing PCI are more susceptible to the manifestation of anxiety and depression symptoms compared to their elderly male counterparts.

PMID:40221788 | DOI:10.1186/s13019-025-03427-5

BMC Vet Res. 2025 Apr 12;21(1):263. doi: 10.1186/s12917-025-04719-7.

ABSTRACT

Toxoplasma gondii stands as one of the most successful pathogens, capable of infecting nearly all warm-blooded species. It is estimated that up to 50% of human population might harbor Toxoplasmosis infections. One of the primary transmission routes is the consumption of tissue cysts from infected farm animals used for food production. Thus, controlling Toxoplasmosis in farm animals is of vital importance for human health and food safety. Selective breeding in farm animals, where available, could complement classical control measures like biosecurity measures, vaccination, and test-and-cull methods. This multidisciplinary approach will make the eradication of Toxoplasmosis more effective. For this purpose, we conducted four multi-locus genome-wide association (GWA) approaches to identify the polygenic factors underlying innate resistance to Toxoplasma gondii in naturally infected sheep. Our findings indicate that 16 single nucleotide polymorphisms (SNPs), exhibiting varying degrees of statistical power, play a significant role in host immunity against T. gondii infection. We propose the genes containing these SNPs or located within 100 ± Kb of them (PLSCR5, EPHA3, DGKB, IL12B, CGA, WDR64, TMEM158, CLMP, and SIAE) as potential candidate genes. This study represents the first exploration of host genetic factors against Toxoplasmosis in livestock, utilizing the ovine paradigm as its foundation.

PMID:40221787 | DOI:10.1186/s12917-025-04719-7

Nutr J. 2025 Apr 12;24(1):58. doi: 10.1186/s12937-025-01118-4.

ABSTRACT

BACKGROUND: Meal skipping is poorly understood among adolescents in Southeast Asia. The study aimed to investigate the type of and any meal skipping prevalence, its associated factors (sociodemographic and protective) and associations between meal skipping types and dietary, mental, and various health risk behaviour outcomes among school adolescents in the Philippines.

METHOD: The 2019 Philippines Global School-based Student Health Survey (GSHS), a nationally representative survey of teenagers aged 11 to 18 (mean age 13.8 years, Standard Deviation-SD = 1.5) that used a multistage sampling technique, provided the study’s data. In order to determine the variables associated with meal skipping (breakfast, lunch, dinner, any meal) and associations of meal skipping with six dietary indicators, four mental health indicators, and ten health risk behaviours, the study used bivariate and multivariable multinomial and binary logistic regression analysis.

RESULTS: The past-month prevalence of most skipping breakfast was 37.1%, most skipping lunch 20.1%, most skipping dinner 10.8%, and any meal skipping 68.1%. Most of the students (89.1%) reported having been exposed to healthy eating classes in school, and 51.7% said that they cannot buy soft drinks in school. Female sex, older adolescents, lower socioeconomic status, not being religious, no school truancy, low or no peer and/or parental support were associated with meal (breakfast, lunch, and/or dinner) skipping. Exposure to skipping breakfast, lunch, dinner, or any meal increased the odds of low vegetable, soft drink, and fast-food intake, overweight, obesity, suicidal ideation, plan, attempt, psychological distress, sedentary behaviour, alcohol use, drug use, physical injury, poor hand, and oral hygiene, and not always wearing a seatbelt.

CONCLUSION: Almost seven in 10 adolescents skipped any meal in the past month. Sociodemographic and protective factors were associated with meal skipping. Exposure to meal skipping was associated with 15 out of 17 dietary, mental health, and other health risk behaviour outcomes. In order to lower various adverse health outcomes in adolescents, the results thus showed how important it is to improve in a regular meal pattern, particularly meal frequency and meal skipping. Interventions incorporating parental and peer engagement could be strengthened alongside school health education to effectively address meal skipping behaviours.

PMID:40221786 | DOI:10.1186/s12937-025-01118-4

BMC Health Serv Res. 2025 Apr 12;25(1):537. doi: 10.1186/s12913-025-12710-z.

ABSTRACT

BACKGROUND: Smart healthcare systems are expected to have a positive impact on addressing challenges in healthcare. However, the real-world adoption and widespread integration of Smart healthcare systems still face many barriers, and their clinical utility lacks empirical research with large sample sizes, particularly in rural areas. The aim of this study is to evaluate the impact of a new smart healthcare system, the Health All-in-One Machines (HAMs), on improving the health services in rural areas of China.

METHODS: The data included health services information from 1,866 village clinics in Hainan, China, covering the period November 30, 2020, to April 30, 2023. The impact of Health All-in-One Machines on access to healthcare was measured using four outcome indicators: the number of patient visits, medical revenue, pharmaceutical revenue, and medical expense per patient. We conducted a three-phase interrupted time series study to explore the effects of the Health All-in-One Machines intervention on these indicators across two distinct periods: the second phase (26 weeks, adaptation period) and the third phase (74 weeks, full-scale implementation period).

RESULTS: The interrupted time-series analysis revealed that the Health All-in-One Machines intervention had no significant impact on outcome indicators comparing the pre-intervention period to the adaptation period. However, from the adaptation period to full implementation, significant impacts were observed. Specifically, notable level changes were observed: the number of patient visits increased by 37.85% (p < 0.01), medical revenue increased by 54.03% (p < 0.001), pharmaceutical revenue increased by 32.84% (p < 0.05), and medical expense per patient increased by 2.368 CNY (p < 0.001). Additionally, a significant trend change was observed in medical expense per patient, with a decrease of 0.15 CNY per week (p < 0.05).

CONCLUSIONS: This study provides empirical evidence of some positive changes in the Health All-in-One Machines intervention on the outcome indicators regarding the access to healthcare. Moreover, our analysis indicates that the Health All-in-One Machines intervention would at least take longer to take effect when implemented in large-scale rural healthcare institutions. The findings from this study provide insights for future delivery and policy making of Smart healthcare systems in rural areas.

PMID:40221780 | DOI:10.1186/s12913-025-12710-z

Harm Reduct J. 2025 Apr 12;22(1):52. doi: 10.1186/s12954-025-01207-x.

ABSTRACT

BACKGROUND: In 2017, Clark County, NV, implemented Public Health Vending Machines (PHVMs), an innovative approach to the dispensation of harm reduction supplies to persons who inject drugs (PWID), including sterile equipment and naloxone. Administrative data associated with PHVM operations can be valuable for understanding drug use behaviors among PWID. The current study examines the demographics and drug use profiles of PHVM registrants who completed the harm reduction survey between January 2021 to June 2023 with comparison to nation-wide trends.

METHODS: All registration forms for PHVM services in Clark County, NV, between 1/1/2021-6/30/2022 with a completed harm reduction survey were included for analysis. Descriptive statistics were used to characterize differences in applicant demographics as well as self-reported injection and non-injection drug use, risk behaviors, and interest in harm reduction services. Logistic regression models tested the association between types of injection drug use and overdose and risk behaviors.

RESULTS: A total of 637 PHVM applications with completed survey data were included for analysis. Respondents were an average of 36.1 ± 10.2 years old, 56.3% male sex, and 63.6% non-Hispanic White with 85.1% reporting injection drug use (IDU). Notably, greater proportions of respondents with histories of IDU also indicated non-injection drug administration, such as smoking and snorting. In the 3 months prior to registration, the majority of IDU respondents reported high risk drug use behaviors, including daily use, multiple injections per day, and opioid and stimulant co-use. Fentanyl was suspected in 62.1% of overdoses in the last 3 months. Compared to PWID using stimulants only, respondents with opioid and stimulant co-use had a higher likelihood of overdose (aOR 4.51; 95% CI 2.05, 11.1; p < 0.001) and re-using injection supplies (aOR 2.14; 95% CI 1.33, 3.48; p = 0.002). More opioid and stimulant co-use respondents were interested in treatment/detox and obtaining naloxone than those without co-use.

CONCLUSIONS: The demographics and drug use behaviors of the PHVM PWID are consistent with contemporaneous county and nation-wide. As the overdose crisis evolves, PHVM could be pivotal tools in the early detection of new risks to facilitate timely adaptation of harm reduction strategies to improve morbidity and mortality.

PMID:40221778 | DOI:10.1186/s12954-025-01207-x

Antimicrob Resist Infect Control. 2025 Apr 12;14(1):29. doi: 10.1186/s13756-025-01530-9.

ABSTRACT

BACKGROUND: Good quality data is essential in optimising containment strategies for antimicrobial resistance, a global public health threat estimated to cause around 10 million deaths yearly and up-to 5% loss in GDP by 2050 if left unaddressed. The laboratory system plays an important role in the collection of high-quality data as well as ensuring validity, reliability and timeliness of data. However, in many low-medium income countries including Nigeria, the technical capacity of the laboratory for fulfilling these responsibilities is unknown. This paucity of information limits piloting of strategies to complement existing surveillance and planning improvement of subsequent laboratory iterations into the surveillance system. The focus of this study was to assess the gaps, vulnerabilities and enablers of laboratory strengthening processes in the scope of technical capacity for clinical and public health functions and to provide a roadmap for improved surveillance of antimicrobial resistance in Nigeria.

METHODS: A cross-sectional study design utilising structured questionnaire administered online via Qualtrics and reported in accordance with strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Data analysis involved descriptive and inferential statistics as well as bivariate and multivariate logistics to test predictive analysis of relationship between variables.

RESULTS: A total of 302 laboratories completed the questionnaire, 107 (53.4%) government laboratories and 195 (64.6%) private sector laboratories. 18.2% reported excellent knowledge, 25.5% has excellent capacity, 7.3% are fully ready for surveillance, 12.3% are participating in some surveillance, and 1.0% record important microbiological data that correlates with epidemiological information.

CONCLUSION: Tertiary laboratories reported highest performance across all surveillance quality indicators (SQIs). AMR surveillance is skewed toward government and tertiary laboratories, leaving lower-level and rural facilities underutilized despite their potential. This results in missing community-level data and undermines the representativeness of surveillance. The study identifies gaps in recruitment, assessment, and oversight but also offers strategies to address these issues.

PMID:40221775 | DOI:10.1186/s13756-025-01530-9

Ital J Pediatr. 2025 Apr 12;51(1):114. doi: 10.1186/s13052-025-01954-4.

ABSTRACT

BACKGROUND: There is currently no established optimal anticoagulation protocol for plasma exchange (PE) in pediatric patients at a high risk of bleeding. Therefore, we aimed to evaluate the efficacy and safety of regional citrate anticoagulation (RCA) and nafamostat mesylate (NM) for PE anticoagulation in this patient group.

METHODS: This retrospective study analyzed data from 66 children with high bleeding risk who underwent PE in the Pediatric Intensive Care Unit of Hunan Children’s Hospital between June 2018 and January 2023. Patients were divided into two groups: RCA-PE (n = 45) and NM-PE (n = 21), and filter performance and adverse reaction rates were compared. Statistical analysis utilized SPSS 25.0, comprising two-sample t-tests, chi-square or Fisher’s exact tests, and Mann-Whitney U tests, as appropriate. Data visualization was performed using ggplot2 in R-studio. P < 0.05 was considered statistically significant.

RESULTS: No statistically significant differences were found between the two groups in initial transmembrane pressure (TMP) [17.0 (14.0, 21.5) mmHg vs. 16.0 (14.0, 19.5) mmHg, P = 0.614], maximum TMP [46.0 (42.0, 49.5) mmHg vs. 43.0 (41.5, 49.5) mmHg, P = 0.689], and final TMP [40.0 (35.5, 45.0) mmHg vs. 38.0 (35.0, 42.0) mmHg, P = 0.298]. Filter grade distribution and bleeding events also showed no statistically significant difference between the groups. However, the NM-PE group had significantly lower overall adverse reaction and metabolic alkalosis rates (both P < 0.05) compared to the RCA-PE group.

CONCLUSIONS: NM demonstrates similar efficacy but superior safety compared with RCA, making it a more suitable anticoagulation strategy for children with high bleeding risk. Study limitations include single-center design, selection bias, and uncertain NM dosage.

PMID:40221768 | DOI:10.1186/s13052-025-01954-4

Harm Reduct J. 2025 Apr 12;22(1):51. doi: 10.1186/s12954-025-01201-3.

ABSTRACT

BACKGROUND: Over a million people have died from overdose since 1999, over 600,000. of which involved opioids. Treatment options that focus on overdose prevention are desperately needed and buprenorphine treatment is a form of opioid prevention if provided in a harm reduction setting. Co-morbid opioid and stimulant use disorders have increased at a higher rate than other co-morbid combinations between 2011 and 2019. The objective of this study was to identify the effects of psychostimulant use on buprenorphine treatment retention.

METHODS: We conducted an analysis of a cohort of 143 individuals with opioid use disorder that initiated treatment in a low-threshold, urban office based opioid treatment (OBOT) clinic located in Nashville Tennessee between 2018 and 2020. Retention was measured at 1, 3, and 6-months. Logistic regression was used to identify differences between people who tested positive for stimulants and people who did not.

RESULTS: The majority of the patients were white (83%), male (64%), unhoused (59%) and uninsured (70%). There was moderate psychostimulant use in the sample with 19% testing positive for cocaine and 13% testing positive for methamphetamine at baseline. Patients testing positive for cocaine prior to their six month retention point had 0.279 lower odds of being retained in treatment. Further, testing positive for either cocaine or methamphetamine resulted in 0.284 and 0.258 odds of retention at 3 and 6-months respectively.

CONCLUSION: This study examined the impact of stimulant use on retention in buprenorphine treatment within a low-threshold OBOT clinic. Our findings differ from previous research that reported significant decreases in retention among methamphetamine users. Instead, results suggest that patients using psychostimulants can be effectively retained in care within a low-resource, low-threshold setting, though increased clinical engagement may be beneficial for those testing positive for cocaine or methamphetamine. Given the limited access to buprenorphine treatment, these findings underscore the urgent need for expanded, accessible treatment models that can effectively serve individuals with co-occurring stimulant use.

PMID:40221764 | DOI:10.1186/s12954-025-01201-3

BMC Public Health. 2025 Apr 12;25(1):1376. doi: 10.1186/s12889-025-22648-w.

ABSTRACT

BACKGROUND: E-health literacy is closely linked to a wide range of health outcomes, encompassing the control of diseases, self-efficacy, and the quality of life concerning health, as well as the attitudes and behaviors exhibited by patients. Therefore, we conducted this study to investigate e-health literacy and examine the relationship between e-health literacy and self-care behaviors in Iranian middle-aged type 2 diabetes.

METHODS: This cross-sectional study was conducted among 313 middle-aged (30-60 years) type 2 diabetics covered by the health care centers of Neyshabur City, Iran, in 2023. They were selected through a stratified random sampling method. Data was gathered using a demographic characteristics questionnaire, a Summary of Diabetes Self-care Activities, and an Electronic Health Literacy scale. Collected data were analyzed using multiple linear regression, t-test, one-way analysis of variance, and chi-square tests by SPSS software version 22, and the significance level was considered 0.05.

RESULTS: The mean age of the respondents was 48.41 ± 7.1 years. The mean (± SD) of the diabetes Self-care activities was 49.28 (14.9), and the mean (± SD) of e-health literacy was 20.6 (7.78). Most diabetics had low e-health Literacy 192(61.5%). After adjusting for the variables of type of treatment, measuring blood sugar at home, marital status, occupation and economic status, e-health literacy (B = , 0.277, T = 4.5, P < .05) was the statistically significant independent factor associated with diabetes self-care activities.

CONCLUSION: Executing educational programs focusing on promoting e-health literacy can increase diabetes self-care activities, increasing overall diabetes’s quality of life.

PMID:40221762 | DOI:10.1186/s12889-025-22648-w