Category: Statistics

Clin J Pain. 2026 Mar 9. doi: 10.1097/AJP.0000000000001369. Online ahead of print.

ABSTRACT

CONTEXT: Chronic pain affects 1 in 9 young adults worldwide. Intensive interdisciplinary pain treatment (IIPT) has shown favorable outcomes in pain intensity, mood, school attendance and social and physical functioning in pediatric studies. However, few IIPT programs are designed for young adults (YAs), a distinctly vulnerable developmental stage. Given this limitation, we sought to study the benefits of applying an IIPT model for YAs with chronic pain and functional impairment.

OBJECTIVES: This study aims to 1) describe the design and implementation of our pilot YA-IIPT program and 2) assess outcomes of YA-IIPT on pain experience, psychological and physical functioning, disability, and quality of life, in YAs with chronic pain and functional impairment.

METHODS: In this observational study, we adapted the pediatric IIPT model for YAs using a biopsychosocial approach to chronic pain treatment. Outcome measures included physical functioning, psychological functioning, disability and quality of life, and pain experience. Paired t-tests and repeated measure ANOVAs were used to compare admission, discharge, 6-week, and 6-month follow-up data.

RESULTS: Patients showed clinically and statistically significant improvements across the majority of physical and psychological functioning, disability, quality of life, and pain experience measures between admission and discharge (P values<0.01). Most improvements were maintained at 6-week and 6-month follow-up.

DISCUSSION: On average, participants in our YA-IIPT program demonstrated clinically and statistically significant improvements in most areas of functioning, quality of life, and pain experience that were maintained after discharge. Further research is needed on YA pain treatment and whether outcomes after YA-IIPT are sustained long term.

PMID:41797645 | DOI:10.1097/AJP.0000000000001369

Nurs Open. 2026 Mar;13(3):e70482. doi: 10.1002/nop2.70482.

ABSTRACT

AIM: To investigate the prevalence of patient-led covert recording in Western China, nurses’ attitudes towards covert recording and explore the factors.

DESIGN: A descriptive cross-sectional study.

METHODS: This study was conducted in 33 cities in 6 provinces of China from November to December 2021. A convenience sampling strategy was used to get access to 2323 participants, and a self-designed questionnaire was used for evaluation.

RESULTS: This study included 2124 nurses; of this, 442 (20.8%) had the experience of patient-led covert recording. After being covertly recorded, they felt stressful (76.9%), nervous (61.3%) and angry (58.6%). A total of 1287 (60.6%) nurses didn’t accept covert recording under any condition. There were differences in age, education, professional titles, years of working, departments, and management measures launched by hospitals between the groups with or without the experience of being covertly recorded. Furthermore, the binary logistic regression analysis showed that nurses running outpatient clinics (OR = 0.635, 95% CI: 0.425-0.950, p < 0.05) were accompanied by higher prevalence of patient-led covert recording while the opposite was true when hospitals launched related management measures (OR = 1.632, 95% CI: 1.126-2.366, p < 0.05).

CONCLUSIONS: Patient-led covert recording might be a form of workplace violence which could be stressful. Thus, it deserves attention and consideration. Management measures and training on patient-led covert recording are urgently required to meet the needs of nurses.

PATIENT OR PUBLIC CONTRIBUTION: The findings of this study emphasise the significant role of patient and public contributions in healthcare dynamics. By revealing nurses’ stress and anxiety associated with covert recordings, it highlights the need for open dialogue about privacy and consent. Engaging patients in discussions about the ethical implications of such recordings can foster collaboration and trust in clinical settings. The findings suggest that implementing better management measures in hospitals could alleviate negative impacts and enhance communication between patients and healthcare providers.

TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2100048557.

PMID:41797636 | DOI:10.1002/nop2.70482

Nurs Open. 2026 Mar;13(3):e70452. doi: 10.1002/nop2.70452.

ABSTRACT

AIM: This study aimed to examine the stress and burden experienced by parents of children with type 1 diabetes (T1D).

DESIGN: A quantitative cross-sectional approach was used, including the results from an online questionnaire about stress and burden in parents of children (10-17 years) with T1D.

METHODS: The data were collected using the Swedish-translated version of the Parental Stress Scale and the Zarit Scale of Caregiver Burden, analysed and presented through descriptive and inferential statistics.

RESULTS: Parents with a university education reported lower stress, burden, role strain, and personal strain but higher satisfaction compared to those with a high school education. Cohabiting participants reported lower stress than singles (d = 0.301), though these differences were not statistically significant. No significant differences were found regarding age, number of children, or place of living. Satisfaction was negatively correlated with stress, personal strain, and role strain, while stress was positively correlated with personal and role strain.

CONCLUSION: Parents with higher education and greater caregiving satisfaction reported lower stress, while single parents and those experiencing high role strain were most vulnerable. These findings highlight the importance of family-centered interventions and accessible psychosocial support to reduce stress and enhance outcomes for children with T1D.

PATIENT OR PUBLIC CONTRIBUTION: The findings highlight the importance of identifying parents who need support in medical, educational, emotional, and psychological areas. Healthcare professionals must implement family-centered interventions to create a supportive environment and enhance health outcomes for the entire family.

PMID:41797635 | DOI:10.1002/nop2.70452

Psychogeriatrics. 2026 Mar;26(2):e70156. doi: 10.1111/psyg.70156.

ABSTRACT

OBJECTIVES: To estimate the prevalence of extreme behavioural and psychological symptoms of dementia (BPSD) in hospitalised patients in comparison with people with dementia with a long hospital stay but no mental health and behavioural problems related to dementia.

DESIGN: Retrospective analysis using the Admitted Patient Data Collection for people aged ≥ 50 with a diagnosis of dementia who had a long stay (defined as ≥ 42 days) in a public hospital between January 2015 and December 2019.

SETTING: New South Wales (NSW), Australia.

PARTICIPANTS: People with dementia aged ≥ 50 years with long stays in NSW hospitals.

MEASUREMENTS: Characteristics of behaviour-related long stays (BRLS) and non-behaviour-related long stays (NBRLS) cohorts were compared using Welch’s t-test and Fisher’s exact test.

RESULTS: There were 115 people with dementia who had 120 BRLS (range 42-2043 days, median 86 days, IQR 53-151 days) and 6186 people with dementia who had 7523 NBRLS (range 42-5750 days, median 61 days, IQR 49-84 days). Those in the BRLS cohort were younger by a mean of 5.96 years (p < 0.001; Welch’s t-test, 95% CI 4.18-7.74) and more likely to be men (0.0062, p < 0.001, Fisher’s exact test). BRLS occurred predominantly in non-psychiatric public hospitals (92.4%). People with BRLS were more likely to have mental health comorbidities (n = 65, 56.5%) than people with NBRLS (2011, 32.7%).

CONCLUSIONS: BRLS in people with dementia are less common than NBRLS and are more likely to occur in the context of mental health comorbidities and in younger males.

PMID:41797625 | DOI:10.1111/psyg.70156

Stat Med. 2026 Mar;45(6-7):e70469. doi: 10.1002/sim.70469.

ABSTRACT

In multi-site clinical research, diagnostic assessments can vary across sites even when standardized criteria and instruments are used, leading to inconsistent disease classification. This issue is examined in settings with an anchor variable that confidently identifies disease when positive but provides no information when negative. A random effects model is introduced for site-specific sensitivity, along with likelihood-based methods for estimation and hypothesis testing. The approach addresses two objectives: testing whether diagnostic sensitivity varies across sites, and quantifying the magnitude of such variability. Validation data is incorporated to establish parameter identifiability. Laplace approximation and the Expectation-Maximization (EM) algorithm are further engaged to address the computational challenge caused by an intractable integral in the likelihood function. Likelihood ratio and score tests are constructed to account for the boundary constraint that arises when the null hypothesis places the variance component at zero. Simulation studies demonstrate the good performance in finite samples, with accurate parameter estimates and appropriate test size and power. Application to a multi-site Huntington disease cohort for diagnosing mild cognitive impairment reveals differences in diagnostic sensitivity across sites, with tests providing strong evidence of heterogeneity. This framework offers a principled approach for testing and quantifying site-level variability in diagnostic sensitivity, supporting more consistent inference in multi-site studies.

PMID:41797613 | DOI:10.1002/sim.70469

Br J Nutr. 2026 Mar 9:1-26. doi: 10.1017/S0007114526106618. Online ahead of print.

ABSTRACT

This study investigated the relationships of total dietary grain fibre (TGF) and its two subtypes (whole grain fibre (WGF) and refined grain fibre (RGF)) with essential hypertension (EHP) in a large-scale prospective cohort study. The participants were recruited by UK Biobank. Dietary grain fibre was assessed using the baseline touchscreen food-frequency questionnaire. New-onset EHP was defined by International Classification of Disease version 10. Cox proportional hazards model and restricted cubic spline (RCS) analysis were utilized to examine the associations of TGF and its subtypes with EHP. Additionally, mediation analysis was applied to assess whether the triglyceride-glucose (TyG) index and inflammatory index score (INFLA-score) mediated these associations. Among 60,315 participants without prior hypertension, 3,651 (6.05%) developed EHP over a median follow-up of 10.3 years, with an incidence density of 6.08 per 1,000 person-years. The adjusted hazard ratios for Q4 compared with Q1 were 0.828 (95% CI: 0.750, 0.914) for TGF and 0.842 (95% CI: 0.767, 0.936) for WGF. RCS analysis confirmed inverse relationships for TGF and WGF with EHP risk. But RGF showed no significant association with EHP. The TyG index and INFLA-score partially mediated the associations of TGF and WGF with EHP, with mediation proportions of 4.2% and 3.3% for TGF, and 4.9% and 5.2% for WGF, respectively. Jointly, TyG index and INFLA-score together mediated 5.6% between TGF and EHP, and 7.4% between WGF and EHP. In conclusion, higher intake of TGF and WGF reduce EHP risk, and this effect is only partly mediated by TyG index and INFLA-score.

PMID:41797603 | DOI:10.1017/S0007114526106618

Glob Health Action. 2026 Dec;19(1):2640684. doi: 10.1080/16549716.2026.2640684. Epub 2026 Mar 9.

ABSTRACT

BACKGROUND: Women with disabilities face heightened vulnerability to domestic violence and often encounter multiple barriers to seeking help. However, empirical evidence on help-seeking behaviour among this group in low-resource settings remains limited.

OBJECTIVE: The study assessed factors associated with help-seeking among women with disabilities following exposure to domestic violence in Uganda using nationally representative data.

METHODS: We analysed data from 2006, 2011, and 2016 Uganda Demographic and Health Surveys. Disability status was determined using Washington Group Short Set of Questions on functional difficulties. The sample comprised women with disabilities aged 15-49 who reported experiencing domestic violence. Descriptive statistics and logistic regression models estimated associations between socio-demographic characteristics and help-seeking, accounting for sampling weights, clustering, and stratification.

RESULTS: Help-seeking among women with disabilities remained low over time. In 2016, only about two in five women (43%) who experienced domestic violence reported seeking help. Employment and age were strongly associated with help-seeking. Employed women with disabilities were six times more likely to seek help than their unemployed peers (AOR = 6.68; 95% CI: 1.53-29.23). Younger women were less likely to seek help than older women. No significant associations were observed for education, wealth, or place of residence.

CONCLUSIONS: Employment and older age emerged as important enablers of help-seeking among women with disabilities who are experiencing domestic violence. Strengthening and implementing age-appropriate and inclusive labour policies that promote economic participation and awareness of support services for women with disabilities may enhance their access to domestic violence services in Uganda and similar low-resource settings.

PMID:41797601 | DOI:10.1080/16549716.2026.2640684

J Invest Surg. 2026 Dec;39(1):2586017. doi: 10.1080/08941939.2025.2586017. Epub 2026 Mar 9.

ABSTRACT

BACKGROUND: Postoperative sore throat (POST) is an distressing complication following endotracheal intubation, particularly with double-lumen tube (DLT) intubation. Study evaluated the effects of two local anesthetic techniques on hemodynamic responses and POST in DLT-intubated patients.

METHODS: A randomized controlled study was conducted with 60 patients scheduled for elective thoracic surgery. Participants were randomized into three groups: TrachoSpray group (2 mL of 10% lidocaine), Manual spray group (10% lidocaine) and, Control group (0.9% saline). Hemodynamic parameters, including systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP), were monitored preoperatively, intraoperatively, and postoperatively. POST was assessed using a visual analog scale at 2, 6, 12, and 24 h post-extubation.

RESULTS: Both lidocaine groups demonstrated significant reductions in SBP, DBP, and MAP at key time points compared to control group. Post-extubation, MAP was significantly higher in TrachoSpray group than lidocaine group (p = 0.04). No statistically significant differences in POST scores were observed between groups.

CONCLUSIONS: TrachoSpray device and manual lidocaine spray improved hemodynamic stability in DLT-intubated patients; however, neither method resulted in a significant reduction in POST scores. Further research is needed to confirm these hemodynamic benefits and to explore potential effects on long-term outcomes.

PMID:41797600 | DOI:10.1080/08941939.2025.2586017

Indian J Cancer. 2025 Oct 1;62(4):541-547. doi: 10.4103/ijc.ijc_643_23. Epub 2026 Mar 7.

ABSTRACT

BACKGROUND: CDK4/6 inhibitors have become the standard of care for the treatment of HR+ metastatic breast cancer (MBC) based on clinical trials. However, real-world experience and efficacy in various subgroups are still lacking. Therefore, we conducted a study to analyze the use of CDK4/6 inhibitors in the treatment of HR-positive MBC and assess the related outcomes.

METHODS: A total of 120 patients who received CDK4/6 inhibitors from 2015 to 2021 were analyzed. Detailed clinical, demographic information and tumor-related factors were obtained for each patient. Progression-free survival (PFS), toxicity profile, and tolerance to CDK4/6i were analyzed and correlated.

RESULTS: Among the 120 patients analyzed, 100 received palbociclib, while ribociclib, and abemaciclib were given to ten patients each. The median age of the population was 57 years. With a median follow-up of 28 months, the median PFS and overall survival (OS) were 25 and 54 months, respectively. The PFS did not significantly differ among different anti-hormonal agents used in combination with CDK4/6 inhibitors. Patients who were resistant to endocrine therapy had a shorter PFS compared to treatment-naive MBC patients (22 versus 40 months). Patients with strong hormonal receptor expression had a significantly better PFS compared to those with weak expression (25 versus 14 months). Her2Neu-negative patients responded better than those with low positive expression (P = 0.039). Visceral metastatic disease was associated with a significantly shorter PFS (17 months) compared to skeletal metastasis (32 months). There was no statistical significance when CDK4/6 inhibitors were used in different lines of treatment or with dose reduction.

CONCLUSION: CDK4/6 inhibitors demonstrate similar responses and better tolerance in real-world evidence. Further studies are necessary to identify other predictive and resistance factors for the use of CDK4/6 inhibitors.

PMID:41797591 | DOI:10.4103/ijc.ijc_643_23

Indian J Cancer. 2025 Oct 1;62(4):528-534. doi: 10.4103/ijc.ijc_96_25. Epub 2026 Mar 7.

ABSTRACT

BACKGROUND: Epithelial malignancies, which constitute the majority of adult cancers, are relatively rare in the pediatric population, accounting for only 2% of all childhood tumors. In contrast to common childhood cancers-which typically arise from embryonal or mesenchymal tissues-epithelial malignancies originate from the epithelial lining of glands and include carcinomas of the lung, breast, colon, and genitourinary tract. Understanding the occurrence, behavior, and treatment outcomes of adult-type epithelial malignancies in children is essential for developing age-appropriate management strategies and improving long-term survival. This emerging subset of pediatric cancers warrants further investigation and collaborative efforts to establish optimal diagnostic criteria, staging systems, and therapeutic approaches tailored to younger patients. We undertook a 5-year retrospective analysis of children diagnosed with adult-type epithelial malignancies at our center.

METHODS: Study Design: This is a retrospective data analysis conducted at MVR Cancer Centre and Research Institute (MVRCCRI), focusing on pediatric patients below 18 years of age who presented between the years January 2019 and December 2024. Inclusion criteria: All children under 18 years of age who presented to MVRCCRI provided they had an adult-type neoplasm of epithelial origin were included in this study. Statistical analysis was performed. The mean, intervals and percentages in each group were calculated. Institutional ethical committee approval was obtained for this retrospective review.

RESULTS: A total of 69 children who were younger than 18 years were included in the study. There were 18 males and 51 females in the study giving a male to female ratio of 1:2.8. Three children had a family history of malignancy: one had a history of consanguinity was diagnosed with CMMRD on genetic evaluation, and the other had a mother with breast cancer and a pathological variant in the ATM gene. The third child with adrenocortical carcinoma had a pathological variant in TP53 diagnosed in mother. The children were analyzed based on the primary diagnosis. The largest group of epithelial malignancies in our cohort was thyroid malignancy, and the second largest group was carcinoma of the salivary glands. Children who presented with early stages of disease fared well in all the groups.

CONCLUSION: Adult-type epithelial neoplasms in children and adolescents are distinct entities, characterized by unique biological behaviors and genetic signatures. Treatment approaches should integrate principles from adult oncology and collaborative studies are essential to define the epidemiology, for staging and prognostic markers, and also to develop pediatric-specific treatment protocols for these malignancies.

PMID:41797589 | DOI:10.4103/ijc.ijc_96_25