Category: Statistics

Pain Manag Nurs. 2026 Aug 4:S1524-9042(26)00254-7. doi: 10.1016/j.pmn.2026.07.019. Online ahead of print.

ABSTRACT

PURPOSE: To explore the impact of health insurance on the rural-urban disparities in opioid misuse in the United States.

METHODS: A secondary analysis of the National Survey on Drug Use and Health (NSDUH) was conducted using datasets from 2021 to ​2023. Outcomes examined were past-month and past-year opioid misuse. Residence was categorized using the Core Based Statistical Area (CBSA) classifications: large CBSA (>1 million persons); small CBSA (<1 million persons); rural: residing in a non-CBSA. Statistical analysis included univariate analysis, multivariable logistic regression, and a model for each outcome that accounted for moderation between residence and insurance.

RESULTS: The weighted sample comprised 281,769,638 individuals, of whom 3.2% and 1.0% reported past-year and past-month opioid misuse, respectively. The multivariable analysis without moderation showed that, compared with non-Hispanic Whites, non-Hispanic Asians had lower odds of past-year opioid misuse (p < .001). Significant moderation was observed only for past-month opioid misuse. The main effect of residence showed that past-month misuse was lower among individuals living in non-CBSAs than among those in large CBSAs (aOR = 0.58; 95% CI, 0.39,0.85). After adjusting for moderation, individuals in non-CBSAs without health insurance had higher odds of past-month misuse than those in large CBSAs without insurance (aOR = 3.41, 95% CI, 1.37, 8.51). Higher income was protective against opioid misuse, but being male was associated with increased odds of misuse.

CONCLUSIONS: People from rural areas without health insurance had higher odds of past-month opioid misuse than those without health insurance in large CBSAs. These findings can guide focused interventions to address opioid misuse.

PMID:42552148 | DOI:10.1016/j.pmn.2026.07.019

Occup Environ Med. 2026 Aug 4:oemed-2025-110662. doi: 10.1136/oemed-2025-110662. Online ahead of print.

ABSTRACT

OBJECTIVE: To systematically review the evidence on the association between occupational exposure to pesticides and the risk of amyotrophic lateral sclerosis (ALS).

METHODS: A systematic search, conducted in eight bibliographic databases for publications between 1990 and 2025, identified observational studies estimating the risk of ALS after occupational pesticide exposure. Study quality was assessed using the WHO Risk of Bias (RoB) assessment instrument for systematic reviews, with the ROBINS-E (RoB in non-randomised studies of exposure) tool domains of bias. Pooled risk estimates were produced using random-effects models with restricted maximum likelihood, heterogeneity was assessed with I² statistics, and meta-regressions and publication bias explored with funnel plots and Egger’s test.

RESULTS: Eight case-control studies (1734 cases) were retained for meta-analysis from 767 initially screened articles. ‘Ever’ occupational exposure to pesticides was associated with an increased risk of ALS (n=6 studies, pooled OR (pOR)=1.6; 95% CI 1.1, 2.2; I²=57%), for combined sexes. The risk for exposure to herbicides was slightly greater (pOR=1.7, I²=0.0%) than for exposure to insecticides or fungicides (pORs=1.6, I²=0.0%). Based on three studies, ever exposure to high levels of pesticides was associated with a higher risk (pOR=2.7; 95% CI=1.4, 5.0) than exposure to low levels (pOR=1.9; 95% CI=1.0, 3.7). Self-reported exposure assessment methods and older publication dates (<2015) were statistically significant predictors of the effect size.

CONCLUSION: Despite the small number of studies and some heterogeneity, our results add to the evidence suggesting that occupational exposure to pesticides may increase the risk of ALS.

PMID:42552132 | DOI:10.1136/oemed-2025-110662

Mil Psychol. 2026 Aug 4:1-11. doi: 10.1080/08995605.2026.2713799. Online ahead of print.

ABSTRACT

This study examines the psychological mechanisms through which belief in state war propaganda relates to combat motivation among Russian soldiers during the war in Ukraine. Using a cross-sectional survey of 1,060 Russian prisoners of war, we examined the relationship between belief in official propaganda narratives and two key outcomes: voluntary surrender and self-reported intentions to re-enlist. Results revealed that stronger belief in propaganda was associated with a lower likelihood of surrendering voluntarily and higher intentions to re-enlist upon release. Mediation analyses identified perceived legitimacy of the “Special Military Operation” (SMO) as the primary psychological pathway, such that only perceived legitimacy statistically accounted for the association between propaganda beliefs and both outcomes in our models. Contrary to expectations, identity fusion with the “Russian World” ideology and dehumanization of Ukrainians did not exhibit significant relationships in the mediation models once covariates were accounted for. These findings suggest that propaganda’s association with combat motivation may primarily be explained by soldiers’ perceptions of the war’s legitimacy rather than by identity-based or dehumanizing beliefs. The study offers empirical insights on propaganda’s link to combat motivation via legitimacy, informing narrative interventions in deradicalization and conflict psychology.

PMID:42552129 | DOI:10.1080/08995605.2026.2713799

Zhonghua Yan Ke Za Zhi. 2026 Aug 11;62(8):612-620. doi: 10.3760/cma.j.cn112142-20260427-00179.

ABSTRACT

Objective: To evaluate the changes of binocular visual function and patient satisfaction after small-incision lenticule extraction (SMILE) with micro-monovision in myopic patients with presbyopia. Methods: This was a single-arm clinical trial. Myopic patients with presbyopia who underwent micro-monovision SMILE at Beijing Tongren Hospital, Capital Medical University, from January 2019 to March 2021 were enrolled. The surgical design principle was full correction of the dominant eye for distance vision, with the non-dominant eye undercorrected by -1.50 D to -0.50 D for near vision. Best corrected distance visual acuity and best corrected near visual acuity (CNVA) for the dominant eye, non-dominant eye, and both eyes were measured before surgery. Uncorrected distance and near visual acuity (UDVA, UNVA), CDVA, and CNVA for the dominant eye, non-dominant eye, and both eyes were measured at 1, 3, 6 months, 3 years, and 5 years after surgery. Accommodative function parameters were measured preoperatively and at each postoperative follow-up visit, including binocular accommodative amplitude (AMP) measured by the push-up method, accommodative response (BCC) measured by the binocular cross-cylinder method, negative relative accommodation (NRA), and positive relative accommodation (PRA), as well as distance and near stereopsis and Worth 4-dot tests. A visual satisfaction questionnaire was administered after surgery. Results: A total of 51 patients (102 eyes) with myopia and presbyopia were included, comprising 19 males and 32 females, aged (41.68±2.47) years. Sixteen patients (32 eyes) completed the 5-year follow-up. The binocular UDVA and UNVA were (-0.02±0.06) logMAR and (0.01±0.09) logMAR at 5 years after surgery, respectively. The spherical equivalent of the dominant and non-dominant eyes was (-0.24±0.22) D and (-0.80±0.37) D, respectively. The binocular AMP decreased from (5.66±0.28) D before surgery to (4.36±0.19) D at 1 month after surgery, and returned to the preoperative level at 3 months after surgery; The PRA decreased from (-1.93±0.17) D before surgery to (-1.33±0.13) D at 1 month after surgery, and returned to the preoperative level at 6 months after surgery. The BCC increased at 1 month after surgery and returned to the preoperative level at 6 months after surgery (differences across time points were all statistically significant, P<0.05). These indicators slightly decreased at 3 and 5 years postoperatively compared with their respective recovered levels. There were no statistically significant differences in NRA and near stereopsis at any postoperative follow-up time point compared with preoperative values. All patients achieved 60″ distance and near stereopsis at each postoperative follow-up visit point, and the Worth 4-dot tests showed both central and peripheral fusion function in both eyes. The subjective satisfaction score was (9.06±1.18) (out of 10) at 5 years after surgery, with a satisfaction rate of 15/16. Conclusions: SMILE with micro-monovision had an impact on accommodative function in the early postoperative stage. The AMP, PRA, and BCC returned to preoperative levels at 3 and 6 months postoperatively, with a slight decrease at 3 to 5 years. The procedure did not affect binocular visual functions such as fusion and stereopsis. At 5 years after surgery, patients exhibited good distance and near vision, maintained binocular visual functions, and reported high subjective satisfaction.

PMID:42552120 | DOI:10.3760/cma.j.cn112142-20260427-00179

Zhonghua Yan Ke Za Zhi. 2026 Aug 11;62(8):602-611. doi: 10.3760/cma.j.cn112142-20260508-00188.

ABSTRACT

Objective: To explore the safety, efficacy, predictability, binocular visual balance, and postoperative visual quality of a monocular bi-aspheric ablation profile combined with laser corneal refractive surgery in patients with refractive errors associated with presbyopia, and to provide clinical evidence for individualized surgical correction of presbyopia. Methods: This retrospective case series study included 64 patients (128 eyes) with refractive errors and presbyopia treated at Gansu Aier Eye Hospital from April 2022 to April 2026, comprising 25 males and 39 females with a mean age of (46.66±4.87) years. The dominant eye was designated for distance vision and treated with small-incision lenticule extraction (SMILE) or femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) according to the corneal characteristics and refractive status; the non-dominant eye was designated for near vision and treated with a monocular bi-aspheric ablation profile combined with FS-LASIK, in which a certain degree of residual myopia and negative spherical aberration were intentionally induced to increase depth of focus and enhance near vision. Postoperative follow-ups were conducted at 1 day, 1 month, 3 months, and 6 months. Binocular uncorrected distance visual acuity(BUDVA), binocular uncorrected near visual acuity (BUNVA), refractive outcomes, higher-order aberrations, and subjective visual quality were evaluated. Results: Subgroup analysis based on dominant-eye surgical procedure showed no significant differences in postoperative binocular distance or near visual acuity between the SMILE and LASIK groups. Pooled analysis showed that BUDVA remained stable throughout follow-up and was comparable to the preoperative level, while BUNVA was significantly improved postoperatively. At 1 month postoperatively, 94.2%(49/52) of patients achieved binocular uncorrected distance visual acuity of 20/25 or better, and 80.7%(42/52) achieved 20/20 or better; meanwhile, 94.2%(49/52) achieved BUNVA of 0.8 or better, and 80.7% (42/52)achieved 1.0 or better. The median efficacy index was 1.11 (interquartile range, 1.0 to 1.2). Postoperatively, uncorrected distance visual acuity was significantly better in the dominant eye than in the non-dominant eye (P<0.001), whereas uncorrected near visual acuity was significantly better in the non-dominant eye than in the dominant eye (P=0.010), indicating successful establishment of the intended monocular bi-aspheric visual profile. At 6 months, actual spherical equivalent correlated strongly with the predicted values in both dominant and non-dominant eyes (R²=0.924 and 0.922, respectively; all P<0.001). Safety analysis showed that 90.7%(39/43) of patients had postoperative distance visual acuity that remained stable or improved, with only 9.3%(4/43) experiencing a decline; for near visual acuity, 51.2% improved by 2 or more lines and only 2.3% declined. At 6 months, the root mean square of higher-order aberrations in non-dominant eyes increased significantly compared with baseline (P=0.027), whereas spherical aberration showed a decreasing trend without statistical significance. On the subjective visual quality questionnaire, most patients reported no or only occasional visual disturbances. Conclusions: The monocular bi-aspheric ablation profile combined with laser corneal refractive surgery demonstrated favorable safety, efficacy, and predictability in patients with refractive errors and presbyopia. It effectively enhanced near visual acuity while maintaining distance vision, thereby achieving binocular visual balance with good postoperative visual quality, and supporting its role as an individualized surgical approach for presbyopia correction.

PMID:42552119 | DOI:10.3760/cma.j.cn112142-20260508-00188

Tob Control. 2026 Aug 4:tc-2026-060085. doi: 10.1136/tc-2026-060085. Online ahead of print.

ABSTRACT

BACKGROUND: Specialty tobacco retailers, including vape shops, smoke shops and cigar shops, are important sources of tobacco access, yet there is no reproducible national database documenting their locations and consumer engagement.

METHODS: We develop a national database of specialty tobacco retailers in the USA by combining Google Maps business listings as of June 2024 with Advan unique visitor count data, updated to May 2024. We match approximately 20 000 businesses across both databases and observe roughly 50 million monthly visits to these locations. We then perform two cross-sectional analyses examining specialty retailer density and visits at the census tract and county levels.

RESULTS: We find strong clustering of all types of specialty retailers in low-income areas and fewer shops per capita in rural areas. We find that smoke and vape shop density is negatively correlated with both educational attainment and population share of racial and ethnic minorities. Cigar and smoke shops were less common in areas with high shares of young people aged 15-24. Additional businesses are positively associated with total consumer visits, with evidence of spillover effects across shop types.

CONCLUSIONS: This study provides the first reproducible national assessment of specialty tobacco retailer locations linked to consumer visit data, offering a new foundation for monitoring retail access and informing tobacco control policy.

PMID:42552112 | DOI:10.1136/tc-2026-060085

J Dent Hyg. 2026 Aug 3;100(4):6-18.

ABSTRACT

Purpose There is limited research regarding how work-life balance (WLB) affects job satisfaction, and intention to leave among dental hygienists in clinical practice. The purpose of this study was to examine the relationships between WLB, job satisfaction, and turnover intention among dental hygienists.Methods This study used a cross-sectional research design with a convenience sample of dental hygienists (n=274) recruited via social media. The web-based survey consisted of demographics and work characteristics, followed by three previously validated survey instruments: WLB Measure, Job Satisfaction Questionnaire (JSQ), and Turnover Intention Scale (TIS). Descriptive, correlational, and inferential analyses were used.Results The survey completion rate was 76% (n = 209). Participants reported an average WLB of 3.20 (SD = 1.06) and an average JSQ of 3.54 (SD = 0.67) on a scale of 1 to 5. Additionally, participants reported an average TIS of 16.75 (SD = 6.22) on a scale of 6 to 30. A regression analysis with WLB, JSQ, and covariates was done to identify predictors of turnover intention. The model predicted 63% (adjusted R² = 0.63, F (7, 200) = 47.33, p < .001) of the variance in turnover intention. Lower job satisfaction (JSQ; β = -0.65, t = -13.86, p < .001) and WLB (β = -0.21, t = -3.97, p < .001) predicted higher turnover intention.Conclusion Findings suggested both job satisfaction and WLB were predictors of an employee’s turnover intention or intention to leave. These results suggest employers should consider their role in employees’ overall WLB, and job satisfaction, considering factors such as workload, communication, opportunities for advancement, and adequate recognition to retain dental hygienists.

PMID:42552086

J Dent Hyg. 2026 Aug 3;100(4):36-46.

ABSTRACT

Purpose Dietary practices play a key role in chronic disease, and dental hygienists are well-positioned to provide person-centered care to enhance oral health and wellness, including nutritional counseling. The purpose of this study was to utilize the 15-item Food Frequency Questionnaire (FFQ) and Diet Quality Score (DQS) to explore the correlation between diet, periodontal inflammation, and the risk of periodontal disease.Methods A total of 1,470 patients of record from the University of Minnesota School of Dentistry dental hygiene clinic were invited to participate in an electronic survey assessing food frequencies. Responses to the 15-item FFQ were assessed using the DQS and were combined with the participants’ bleeding on probing (BOP) and periodontal risk assessment (PRA) scores. Descriptive and inferential statistics were used to analyze the data.Results A response rate of 26% was observed (N = 379). There was a negative correlation between the percentage of BOP sites and DQS scores, indicating an inverse relationship between diet and periodontal inflammation (p = .001). A significant difference in average total DQS scores was found among PRA scores (p = 0.020). Specifically, the low PRA and moderate PRA groups demonstrated a significant difference (p = 0.017). Additionally, significant differences were observed in PRA scores (p < 0.001) and total DQS (p = 0.025), suggesting variations in the risk of periodontal disease and diet quality.Conclusion The use of a 15-item FFQ and a DQS can serve as an effective screening tool for dietary habits as they relate to periodontal inflammation, supporting dental hygienists in identifying dietary risk factors for periodontal disease.

PMID:42552085

J Dent Hyg. 2026 Aug 3;100(4):58-67.

ABSTRACT

Purpose Feedback literacy is a pivotal concept in education. Students with well-developed feedback literacy are able to understand, interpret, and implement feedback effectively to improve learning and performance. The purpose of the study was to evaluate the effectiveness of a feedback literacy course for dental hygiene students.Methods This study utilized a quantitative randomized control trial comprising a convenience sample of 42 dental hygiene students over two consecutive semesters. The control group received no formal feedback education, while the experimental group completed a feedback literacy module with an in-person feedback workshop, a follow-up in-person reflection activity, and online feedback literacy resources. Feedback Literacy was measured using the Feedback Literacy Scale, where participants self-rated their abilities on a Likert scale. A pre/posttest design was used, paired with supplemental open-ended questions for the experimental group to determine perceived program impact. Descriptive statistics were used to analyze the data.Results Overall Feedback Literacy posttest mean scores of the experimental group (n = 21) were significantly higher (p < 0.001) when compared to controls (n = 21). The experimental group demonstrated statistically significant improvements in Appreciation of Feedback (p < .001), Positive Attitude toward Feedback (p = .001), and Openness to Feedback (p < .001). Four key concepts emerged from open-ended questions posed to experimental group, namely: valuing feedback, seeking feedback, managing emotions, and enhancing self-assessment.Conclusion Students may benefit from feedback literacy training delivered early in their education. The feedback literacy module helped students value feedback, use self-assessment to identify learning gaps, actively seek feedback, and regulate emotions during feedback.

PMID:42552082

BMJ Paediatr Open. 2026 Aug 4;10(1):e004689. doi: 10.1136/bmjpo-2026-004689.

ABSTRACT

INTRODUCTION: Up to 30% of in-utero selective serotonin reuptake inhibitor (SSRI)-exposed newborns experience withdrawal and up to 60% experience behavioural impacts. Breastfeeding may offer benefits from skin-to-skin contact and transfer of SSRIs through breastmilk. Limited data are available on healthcare utilisation of these newborns beyond neonatal intensive care unit admission. We aimed to identify whether newborn feeding method affected healthcare utilisation in the first 30 days of postnatal life among Neonates With In-utero SSRI Exposure (NeoWISE).

METHODS: This retrospective cohort study included newborns born in Ontario hospitals between 1 April 2012 and 31 March 2020 to beneficiaries of the Ontario Drug Benefit Program who filled at least one SSRI prenatal prescription. Administrative health and birth registry data were used. Newborn feeding methods were available from birth to hospital discharge. Outcomes were postnatal length of stay (LOS), emergency department visit(s) and hospital readmission within the first 30 days of life. Adjusted linear regression models using inverse probability of treatment weights for feeding method were conducted.

RESULTS: The cohort included a total of 5079 NeoWISE participants, with 3321 (65.4%) exclusively breastfed. Formula-fed infants were more likely to have older mothers with an urban residence, lower income quintile, prior live birth, who smoked at delivery and to be born via caesarean delivery; these imbalances were balanced after propensity score weighting. Exclusively breastfed newborns were significantly less likely to have postnatal LOS ≥3 days (11.6% vs 16.3%) (adjusted relative risk (adjRR) 0.84, 95% CI 0.72 to 0.97), but more likely to have emergency department visit (adjRR 1.42, 95% CI 1.03 to 1.97) and hospital readmission (adjRR 1.78, 95% CI 1.21 to 2.62) compared with formula-fed newborns, primarily due to jaundice.

CONCLUSION: Women taking SSRI medication during pregnancy should receive anticipatory guidance about newborn feeding effectiveness, signs of jaundice and when to seek healthcare after birth. In-hospital feeding method was associated with emergency department visits and hospital readmission among NeoWISE. Breastfeeding cessation was not measured and could have affected estimated associations.

PMID:42552081 | DOI:10.1136/bmjpo-2026-004689