Category: Statistics

Adv Clin Exp Med. 2022 Aug 11. doi: 10.17219/acem/151640. Online ahead of print.

ABSTRACT

BACKGROUND: The assessment of the quality of life (QoL) in hematology-oncology patients is extremely important. The disease and anti-cancer therapy can cause adverse effects, directly impacting the physical and mental condition of the patient and indirectly influencing their social and professional situation. Therefore, a properly performed QoL assessment should take into account all of these aspects. Moreover, QoL assessment has a prognostic value in regard to treatment success and prognosis; therefore, the improvement in the QoL is often one of the goals of therapy.

OBJECTIVES: To identify the changes in QoL during therapy in patients with lymphoproliferative neoplasms.

MATERIAL AND METHODS: Forty-six hematology-oncology patients participated in this prospective single-center study. Their QoL was analyzed at 2 time points (before and after the first-line treatment). For this purpose, the EORTC QLQ-C30 questionnaire was used. All statistical analyses were performed using the STATISTICA v. 13 software. A value of p < 0.05 was considered statistically significant.

RESULTS: The study included patients with multiple myeloma (MM; 47.8%), non-Hodgkin lymphoma (NHL; 28.3%) and chronic lymphocytic leukemia (CLL; 23.9%). After the first line of treatment, patients perceived their overall QoL as slightly better than before starting the treatment, with an average increase of 1.94. Statistically significant differences were observed in physical and emotional functioning as well as fatigue, pain, dyspnea, appetite, and constipation.

CONCLUSIONS: In patients with lymphoproliferative neoplasms, after the first-line treatment, an improvement in an overall QoL and level of functioning, as well as a reduction in the severity of symptoms were observed.

PMID:35951626 | DOI:10.17219/acem/151640

PLoS One. 2022 Aug 11;17(8):e0272906. doi: 10.1371/journal.pone.0272906. eCollection 2022.

ABSTRACT

BACKGROUND: Human immunodeficiency virus (HIV) remains a global health threat, especially in developing countries. The successful scale-up of antiretroviral therapy (ART) programs to address this threat is hindered by a high proportion of patient loss to follow-up (LTFU). LTFU is associated with poor viral suppression and increased mortality. It is particularly acute among adolescents, who face unique adherence challenges. Although LTFU is a critical obstacle on the continuum of care for adolescents, few regional-level studies report the proportion of LTFU among adolescents receiving ART. Therefore, a systematic review and meta-analysis were conducted to estimate the pooled LTFU in ART programs among adolescents living with HIV in sub-Saharan Africa (SSA).

METHODS: We searched five databases (PubMed, Embase (Elsevier), PsycINFO, CINAHL, and Scopus) for articles published between 2005 and 2020 and reference lists of included articles. The PRISMA guidelines for systematic reviews were followed. A standardised checklist to extract data was used. Descriptive summaries were presented using narrative tables and figures. Heterogeneity within the included studies was examined using the Cochrane Q test statistics and I2 test. Random effect models were used to estimate the pooled prevalence of LTFU among ALHIV. We used Stata version 16 statistical software for our analysis.

RESULTS: Twenty-nine eligible studies (n = 285,564) were included. An estimated 15.07% (95% CI: 11.07, 19.07) of ALHIV were LTFU. Older adolescents (15-19 years old) were 43% (AOR = 0.57, 95% CI: 0.37, 0.87) more likely to be LTFU than younger (10-14 years old) adolescents. We find an insignificant relationship between gender and LTFU (AOR = 0.95, 95% CI: 0.87, 1.03). A subgroup analysis found that regional differences in the proportion of adolescent LTFU were not statistically significant. The trend analysis indicates an increasing proportion of adolescent LTFU over time.

CONCLUSIONS AND RECOMMENDATIONS: The proportion of LTFU among HIV-positive adolescents in SSA seems higher than those reported in other regions. Older adolescents in the region are at an increased risk for LTFU than younger adolescents. These findings may help policymakers develop appropriate strategies to retain ALHIV in ART services. Such strategies could include community ART distribution points, appointment spacing, adherence clubs, continuous free access to ART, and community-based adherence support.

PMID:35951621 | DOI:10.1371/journal.pone.0272906

Prev Chronic Dis. 2022 Aug 11;19:E49. doi: 10.5888/pcd19.210454.

ABSTRACT

INTRODUCTION: The density of tobacco retailers varies by community characteristics such as poverty levels or racial and ethnic composition. However, few studies have investigated how specific types of tobacco retailers vary by community characteristics. Our objective was to assess how the types of tobacco retailers in Ohio varied by the characteristics of the communities in which they were located.

RESULTS: For all US Census tracts, convenience stores were the most common type of retailer selling tobacco. Yet, the prevalence of convenience stores was higher in high-poverty urban tracts than in low-poverty urban tracts. Discount stores were the second-most common type of tobacco retailer and were most prevalent in rural tracts and high-racial and ethnic minority urban tracts. Grocery stores, pharmacies, and vape or hookah shops typically had the highest prevalence in more advantaged tracts.

CONCLUSION: Our findings demonstrate that the distribution of specific retailer types varies by community characteristics. The distribution of these retailer types has implications for product availability and price, which may subsequently affect tobacco use and cessation. To create equitable outcomes, policies should focus on retailers such as convenience and discount stores, which are heavily located in communities experiencing tobacco-related health disparities.

PMID:35951439 | DOI:10.5888/pcd19.210454

Health Psychol. 2022 Aug 11. doi: 10.1037/hea0001211. Online ahead of print.

ABSTRACT

OBJECTIVE: During the COVID-19 pandemic, the U.S. public was encouraged to practice good hand hygiene, such as hand washing or the use of hand sanitizer. Young adults reported lower levels of hand hygiene compared to adults of other ages. The aim of the current study was to test the effectiveness of different messages to promote hand sanitizer use among young adults.

METHOD: Over a 6-week period, we examined whether 3 brief messages (gain-frame, static descriptive norms, dynamic descriptive norms), placed next to sanitizer dispensers in university residence halls, predicted dispenser use in comparison to dispensers with no sign. Amount of sanitizer usage was measured 3 times per week via the weight of dispenser units. We tracked and controlled for the number of positive COVID-19 cases in residence halls because we expected it might influence sanitizer usage.

RESULTS: Compared to no signage, dispensers with signs had 35% greater usage, with the static descriptive norms sign associated with greatest usage (46% compared to no sign), although differences did not reach conventional levels of significance. The strongest predictor of sanitizer use was a residence hall’s degree of COVID-19 risk based on the hall’s case positivity.

CONCLUSIONS: Dispensers with signs had higher use than those without signs, but this difference was not statistically significant. We conclude that compared to prior research, “nudges” such as evidence-based messaging may have had less of an effect on health behavior engagement due to methodological differences across studies or characteristics of the COVID-19 context. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

PMID:35951403 | DOI:10.1037/hea0001211

J Pers Soc Psychol. 2022 Aug 11. doi: 10.1037/pspp0000431. Online ahead of print.

ABSTRACT

Self-determination theory holds that the intrinsic and extrinsic content of people’s aspirations differentially affect their wellness. An evidence base spanning nearly 30 years indicates that focusing on intrinsic goals (such as for growth, relationships, community giving, and health) promotes well-being, whereas a focus on extrinsic goals (such as for wealth, fame, and beauty) deters well-being. Yet, the evidence base contains exceptions, and some authors have argued that focusing on extrinsic goals may not be universally detrimental. We conducted a systematic review and used multilevel meta-analytic structural equation modeling to evaluate the links between intrinsic and extrinsic aspirations with indices of well-being and ill-being. Across 92 reports (105 studies), 1,808 effects, and a total sample of N = 70,110, we found that intrinsic aspirations were linked positively with well-being, r = 0.24 [95% CI 0.22, 0.27], and negatively with ill-being, r = -0.11 [-0.14, -0.08]. When the variety of extrinsic aspiration scoring methods were combined, the link with well-being was not statistically significant, r = 0.02 [-0.02, 0.06]. However, when extrinsic aspirations were evaluated in terms of their predominance in the overall pattern of aspiring the effect was universally detrimental, linking negatively to well-being, r = -0.22 [-0.32, -0.11], and positively to ill-being, r = 0.23 [0.17, 0.30]. Meta-analytic conclusions about the associations between goal types and wellness are important because they inform how individuals could shape aspirations to support their own happiness and how groups and institutions can frame goals such that their pursuit is for the common good. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

PMID:35951379 | DOI:10.1037/pspp0000431

Aging (Albany NY). 2022 Aug 9;14(undefined). doi: 10.18632/aging.204212. Online ahead of print.

ABSTRACT

BACKGROUND: While iron is essential for normal brain functioning, elevated concentrations are commonly found in neurodegenerative diseases and are associated with impaired cognition and neurological deficits. Currently, only little is known about genetic and environmental factors that influence brain iron concentrations.

METHODS: Heritability and bivariate heritability of regional brain iron concentrations, assessed by R2* relaxometry at 3 Tesla MRI, were estimated with variance components models in 130 middle-aged to elderly participants of the Austrian Stroke Prevention Family Study.

RESULTS: Heritability of R2* iron ranged from 0.46 to 0.82 in basal ganglia and from 0.65 to 0.76 in cortical lobes. Age and BMI explained up to 12% and 9% of the variance of R2* iron, while APOE ε4 carrier status, hypertension, diabetes, hypercholesterolemia, sex and smoking explained 5% or less. The genetic correlation of R2* iron among basal ganglionic nuclei and among cortical lobes ranged from 0.78 to 0.87 and from 0.65 to 0.97, respectively. R2* rates in basal ganglia and cortex were not genetically correlated.

CONCLUSIONS: Regional brain iron concentrations are mainly driven by genetic factors while environmental factors contribute to a certain extent. Brain iron levels in the basal ganglia and cortex are controlled by distinct sets of genes.

PMID:35951362 | DOI:10.18632/aging.204212

Gerontologist. 2022 Aug 11:gnac121. doi: 10.1093/geront/gnac121. Online ahead of print.

ABSTRACT

While the continent of Africa currently has the lowest share of adults ages 60 and older in its population among all world regions, the total number of older Africans is projected to triple between 2020 and 2050. Nigeria-Africa’s leading economy and most populated country-has the highest number of older people in the continent and the 19th highest across the globe, with the population of Nigerians aged 65 and older projected to nearly triple by 2050. However, the increase in older Nigerians is occurring against the backdrop of extreme poverty, unsolved development problems, socioeconomic inequality, the HIV/AIDS epidemic, and a decline in the traditional care and support of older adults. Additionally, the absence of an operational national aging policy or safety net services and programs poses a unique challenge to older Nigerians and their families. In this paper, we examined social statistics and the current literature to describe aging in the Nigerian context. Our findings highlight the importance of establishing effective governmental policy interventions for the adequate care and support of older Nigerians and the training of gerontological professionals. This paper will describe the demography of aging in Nigeria, significant areas of research, key scholars and publicly available datasets, public policy issues, and emerging issues affecting the health and well-being of older Nigerians.

PMID:35951349 | DOI:10.1093/geront/gnac121

Health Phys. 2022 Aug 10. doi: 10.1097/HP.0000000000001603. Online ahead of print.

ABSTRACT

Anecdotal evidence indicates there may be unpublished physical and psychological events associated with the medical treatment of plutonium intakes. A thorough review was conducted of the medical and bioassay records of current and previous Los Alamos National Laboratory (LANL) employees who had experienced plutonium intakes via wound or inhalation. After finding relatively incomplete information in the medical records, the research team interviewed current LANL employees who had undergone chelation therapy and/or surgical excision. Although the dataset is not large enough to reach statistically significant conclusions, it was observed that adverse events associated with treatment appear to be more frequent and more severe than previously reported.

PMID:35951340 | DOI:10.1097/HP.0000000000001603

JAMA Netw Open. 2022 Aug 1;5(8):e2226244. doi: 10.1001/jamanetworkopen.2022.26244.

ABSTRACT

IMPORTANCE: Individuals with severe obesity presenting for obesity surgery (OS) frequently show nonnormative eating behaviors (NEBs) and eating disorders (EDs), but the long-term course and prospective associations with weight loss and health-related quality of life (HRQOL) remain unclear.

OBJECTIVE: To examine the prevalence and prospective relevance of presurgical and postsurgical NEBs and EDs according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnosed through clinical interview, for weight loss and HRQOL up to 6 years following OS.

DESIGN, SETTING, AND PARTICIPANTS: In the prospective, multicenter Psychosocial Registry for Obesity Surgery cohort study, patients seeking OS were recruited at 6 OS centers in Germany and assessed at baseline before surgery and at 6 months and 1 to 6 years after surgery. From a consecutive sample of 1040 volunteers with planned OS from March 1, 2012, to December 31, 2020, a total of 748 (71.92%) were included in this study. Across follow-up, 93 of the 748 patients (12.43%) dropped out. Data were analyzed from April to November 2021.

INTERVENTIONS: Laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy.

MAIN OUTCOMES AND MEASURES: Both NEBs and EDs were identified using the Eating Disorder Examination interview. Main outcomes were the percentage of total body weight loss (%TBWL) and HRQOL (Impact of Weight on Quality of Life-Lite; range, 0-100, with 0 indicating worst and 100 indicating best).

RESULTS: In 748 patients undergoing OS (mean [SD] age, 46.26 [11.44] years; mean [SD] body mass index [calculated as weight in kilograms divided by height in meters squared], 48.38 [8.09]; 513 [68.58%] female), the mean (SD) %TBWL was 26.70% (9.61%), and the mean (SD) HRQOL improvement was 35.41 (20.63) percentage points across follow-up. Both NEBs and EDs were common before surgery, with postsurgical improvements of varying degrees. Whereas NEBs and EDs did not reveal significant prospective associations with %TBWL, loss-of-control eating at follow-up was concurrently associated with lower %TBWL (estimate, -0.09; 95% CI, -0.14 to -0.04). Loss-of-control eating (estimate, -0.10; 95% CI, -0.17 to -0.03 percentage points) and binge-eating disorder of low frequency and/or limited duration (estimate, -6.51; 95% CI, -12.69 to -0.34 percentage points) at follow-up showed significant prospective associations with lower HRQOL.

CONCLUSIONS AND RELEVANCE: This cohort study found prospective relevance of loss-of-control eating and binge-eating disorder of low frequency and/or limited duration for reduced long-term HRQOL following OS. These findings underline the importance of monitoring both NEBs, especially loss-of-control eating, and EDs in the long term postsurgically to identify patients in need of targeted prevention or psychotherapy.

PMID:35951326 | DOI:10.1001/jamanetworkopen.2022.26244

JAMA Ophthalmol. 2022 Aug 11. doi: 10.1001/jamaophthalmol.2022.3026. Online ahead of print.

ABSTRACT

IMPORTANCE: Taxane-based chemotherapy agents, such as docetaxel and paclitaxel, are used for treating a wide range of cancers. Although much has been published on adverse events related to taxanes, data on ocular outcomes with these very important drugs are scant.

OBJECTIVE: To quantify the risk of 3 mutually exclusive ocular adverse events of epiphora, cystoid macular edema (CME), and optic neuropathy with taxane-based chemotherapy agents by undertaking a large pharmacoepidemiologic study.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study design used a private health-claims database from the US that captures health information of more than 150 million enrollees. The study team created a cohort of new users of women with cancer who were taking taxane-based chemotherapy (docetaxel or paclitaxel) and new users of tamoxifen as controls. Study members were observed to the first incidence of each of the 3 mutually exclusive outcomes. An analysis of taxane-only users was also undertaken.

EXPOSURE: Tamoxifen (unexposed) and taxanes (ie, paclitaxel and docetaxel) as the exposed.

MAIN OUTCOMES AND MEASURES: First diagnosis of (1) epiphora, (2) cystoid macular edema (CME), or (3) optic neuropathy ascertained using International Statistical Classification of Diseases and Related Health Problems, Ninth Revision or International Statistical Classification of Diseases and Related Health Problems, Tenth Revision.

RESULTS: Among the 18 219 users in the epiphora analysis and optic neuropathy analysis, there were 1824 taxane users (paclitaxel and docetaxel) (age, mean [SD], 62.1 [12.7] years) and 16 395 tamoxifen users (age, mean [SD], 54.6 [12.8] years), respectively. The crude hazard ratio (HR) for epiphora was 5.55 (95% CI, 2.99-10.29) and adjusted HR was 5.15 (95% CI, 2.79-9.54). For optic neuropathy, the crude HR was 4.43 (95% CI, 1.10-17.82) and the adjusted HR was 4.44 (95% CI, 1.04-18.87). Among the 18 433 users in the CME analysis, there were 1909 taxane users (paclitaxel and docetaxel) (age, mean [SD], 62.5 years) and 16 524 tamoxifen users (age, mean [SD], 54.6 years). The crude HR for CME comparing taxane users with tamoxifen users was 1.37 (95% CI, 0.72-2.60) and adjusted HR was 1.33 (95% CI, 0.70-2.53). The HRs for epiphora and CME in the taxane cohort during the time of exposure compared with the period prior to use of the drugs were 2.86 (95% CI, 1.11-7.39) and 2.27 (95% CI, 0.68-7.54), respectively.

CONCLUSIONS AND RELEVANCE: In a cohort of women who were using taxane chemotherapy agents, there was an association with elevated risk for epiphora, CME, and optic neuropathy. Ophthalmologists and oncologists should be aware of these adverse events in women with breast cancer who receive these drugs.

PMID:35951320 | DOI:10.1001/jamaophthalmol.2022.3026