Category: Statistics

ANZ J Surg. 2021 Apr 23. doi: 10.1111/ans.16881. Online ahead of print.

ABSTRACT

BACKGROUND: The use of telehealth during the COVID-19 pandemic has emerged as both a necessary and significant tool in the provision of safe and timely healthcare in the field of otolaryngology. Increased access to specialist care in a regional setting is an additional benefit. Variation in diagnostic accuracy of telehealth consultations may affect diagnosis and management. Therefore, our aim is to determine the diagnostic concordance of telemedicine for otolaryngology in an Australian regional setting with physical consultations.

METHODS: Retrospective review was conducted for all patients who received an initial telemedicine appointment over a 7-month period during the COVID-19 pandemic in regional Victoria, Australia. Data were collected regarding initial diagnosis and management from telemedicine consultations, subsequent physical appointment findings and management and intraoperative findings. Statistical analysis was performed using Prism (version 8.0, GraphPad).

RESULTS: Two hundred and fifty-nine patients were included. The most common conditions referred were for consideration of tonsillectomy with or without adenoidectomy (44.0%). Overall diagnostic concordance of the initial referrer was 63.3% and for telephone appointments, it was 81.9%. Concordance of recommended treatment plans between telephone and physical appointments was 96.9%.

CONCLUSION: Although physical appointments are an essential aspect of practice in OHNS, there are significant benefits of phone only telemedicine within the context of a global pandemic which were compounded by a regional setting. Paediatric patients were found to have the highest concordance of diagnosis and treatment plans.

PMID:33890722 | DOI:10.1111/ans.16881

Anat Rec (Hoboken). 2021 Apr 23. doi: 10.1002/ar.24646. Online ahead of print.

ABSTRACT

Histomorphometric analysis of human cortical bone has documented the occurrence of secondary osteon variants. These include drifting osteons which form tails as they move erratically through the cortex and type II osteons which show partial resorption and redeposition within the cement line of the osteon. Little is known about the biological significance of these variants. Prior studies suggested correlations with age, biomechanics, diet, and mineral homeostasis. No study has yet tested for osteon variant associations with static measures of bone remodelling. In this study, thin sections (n=112) of the posterior femur representing a late English Medieval adult human osteological collection, subdivided by age, sex, and socio-economic status, were examined to determine whether remodelling indicators reconstructed from osteon parameters (area, diameter, area ratios) and densities differed between categories of presence or absence of type II and drifting osteon variants. Of the 112 sections, 33 presented with type II osteons, and 38 had drifting osteons. Sporadic statistically significant results were identified. Haversian canal:osteon area ratio differed (p = 0.017) with type II osteon presence, type II osteons were more prevalent in males than females (p = 0.048), and drifting osteons were associated with smaller osteon (p = 0.049) and Haversian canal area (p = 0.05). These results may be explained through some biological (sex) and social (status) processes such as a period of physiological recovery (e.g. following lactation, malnutrition). However, the general lack of consistent relationships between osteon variants and remodelling indicators suggests they occur as a result of natural variation.

PMID:33890727 | DOI:10.1002/ar.24646

Minerva Pediatr (Torino). 2021 Apr 23. doi: 10.23736/S2724-5276.21.06264-9. Online ahead of print.

ABSTRACT

BACKGROUND: Preterm infants born at less than 32 weeks of gestation are at higher risk of low total iron stores (iron deficiency). Serum ferritin is used as a valid total iron stores and iron deficiency biomarker, usually as a combination of ferritin and red blood cell counts.

METHODS: Serum hepcidin and ferritin values and red blood cell counts were obtained from 37 of 40 included premature infants born at less than 32 weeks of gestation at risk of iron deficiency. The first sample was obtained in the first week of life, and the second at transfer from the Neonatal intensive care unit to the maternity ward, when serum ferritin level below 25 μg/L has been defined as very low total iron stores (iron deficiency).

RESULTS: Ferritin median levels decreased from a median value of 152 μg/L at the first measurement to 54 μg/L at the second measurement. Hepcidin median levels also decreased from 30.1 μg/L to 2.1 μg/L. We found a positive and statistically significant correlation between levels of ferritin and hepcidin at both measurements (r = 0.57; p < 0.001 and r = 0.72; p < 0.001, respectively). Compared to serum hepcidin, ferritin at the first measurement has not statistically significant higher power in predicting children with iron deficiency before discharge from the hospital.

CONCLUSIONS: We found a correlation between ferritin and hepcidin levels. Nevertheless, hepcidin does not have a worse power in predicting children with iron deficiency compared to ferritin.

PMID:33890745 | DOI:10.23736/S2724-5276.21.06264-9

J Marital Fam Ther. 2021 Apr 23. doi: 10.1111/jmft.12522. Online ahead of print.

ABSTRACT

Research on childhood sexual abuse (CSA) has consistently demonstrated the damaging effects of these experiences, not only on survivors’ development, but also on the nature and quality of their adult relationships, particularly romantic ones. Yet, research to date has not demonstrated a strong direct effect of CSA on relationship satisfaction. This study examined the pathways from CSA to relationship satisfaction via sexual shame and romantic partner attachment. Data collected through surveys from 732 adults were analyzed using a serial mediation model. As expected, the direct association between CSA and relationship satisfaction was statistically significant but rather weak. Results demonstrated that sexual shame, combined with either romantic partner attachment avoidance or romantic partner attachment anxiety, reduces relationship satisfaction. Specifically, three possible pathways mediated by sexual shame were identified. Implications of the findings are discussed and recommendations for clinical interventions with CSA survivors that address sexual shame and romantic partner attachment are provided.

PMID:33890687 | DOI:10.1111/jmft.12522

J Ultrasound Med. 2021 Apr 23. doi: 10.1002/jum.15728. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the performance of a two-step strategy compared with the International Ovarian Tumor Analysis (IOTA) – Assessment of Different NEoplasias in the adneXa (ADNEX) model for preoperative classification of adnexal masses.

METHODS: An ambispective diagnostic accuracy study based on ultrasound data collected at one university hospital between 2012 and 2018. Two ultrasonographers classified the adnexal masses using IOTA Simple Rules (first step). Not classifiable masses were evaluated using the IOTA ADNEX model (second step). Also, all masses were classified using the IOTA ADNEX model. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), positive likelihood ratio (LR+) and negative likelihood ratio (LR-), and receiver operating characteristic (ROC) curve were estimated. A P value of <.05 was used to determine statistical significance.

RESULTS: The study included 548 patients and 606 masses. Patients’ median age was 41 years with an interquartile range between 32 and 51 years. In the first step, 89 (14%) masses were not classifiable. In the second step, 55 (61.8%) masses were classified as malignant. Furthermore, for the totality of 606 masses, the IOTA ADNEX model estimated the probability that 126 (20.8%) masses were malignant. The two-step strategy had a sensitivity, specificity, PPV, NPV, LR+, LR-, and ROC curve of 86.8%, 91.01%, 51.9%, 98.4%, 9.7, 0.1, and 0.889, respectively; compared to IOTA ADNEX model that had values of 91.8%, 87.16%, 44.4%, 99%, 7.1, 0.09, and 0.895, respectively.

CONCLUSION: The two-step strategy shows a similar diagnostic performance when compared to the IOTA ADNEX model. The IOTA ADNEX model involves only one step and can be more practical, and thus would be recommended to use.

PMID:33890698 | DOI:10.1002/jum.15728

Int J Pharm Pract. 2021 Apr 23:riab013. doi: 10.1093/ijpp/riab013. Online ahead of print.

ABSTRACT

OBJECTIVES: Pharmacy professionals are required to take all necessary steps to protect commonly misused drugs such as opioids at their pharmacies to minimize the risk of diversion. The aim of this study is to assess Canadian pharmacy professionals’ knowledge and compliance with federal and provincial regulations using the computer-based educational platform Pharmacy5in5.

METHODS: A Narcotic Inventory module was created and reviewed by experts representing provincial and federal regulators. Descriptive statistics were used to analyze users’ performance in quizzes. Binomial regression and logistic regression models were used to investigate the effect of demographic factors on users’ performance. P-values less than 0.05 were considered statistically significant.

KEY FINDINGS: The analysis included data collected over a period of three months. A total of 792 users accessed the Narcotic Inventory module on the Pharmacy5in5 website between July 2019 and November 2019. Most of the users were licenced pharmacists (64%), female (72%), received their training in Canada (68%), and were practising in Ontario (80%). Users performed best on the quiz addressing the steps for reconciliation of inventory (93%), and worst on the quiz reviewing how to prepare for a Health Canada visit (66%).

CONCLUSIONS: Overall, pharmacy professionals showed adequate knowledge of the CDSA and provincial/territorial regulations regarding opioids inventory management. Conversely, the study highlighted poor compliance with the reporting of losses and theft of controlled substances by pharmacy professionals. Innovative approaches are needed to influence pharmacy professionals’ behaviours to improve their compliance with best practices concerning inventory management to reduce drug diversion.

PMID:33890668 | DOI:10.1093/ijpp/riab013

Int J Pharm Pract. 2021 Apr 23:riab019. doi: 10.1093/ijpp/riab019. Online ahead of print.

ABSTRACT

BACKGROUND: Sub-Saharan Africa, a region faced with a double challenge of infectious and non-communicable diseases requires strengthening of hospital pharmacy practice to improve treatment outcomes and patient safety.

OBJECTIVES: The objectives of this study were to assess the current state of pharmacy practice in hospitals in Namibia and to identify opportunities for expanding pharmacists’ role in addressing public health challenges and improving medicines use outcomes.

METHODS: A survey utilized FIP’s self-assessment tool to evaluate current hospital pharmacy practice in Namibia against best practices articulated in the Basel Statements. The study was conducted among hospital pharmacists across Namibia. Quantitative and qualitative data were analysed using descriptive statistics and thematic analysis.

KEY FINDINGS: The study was conducted in 24 hospital pharmacies across Namibia, the majority of which were public facilities (67%). Overall, current hospital pharmacy practice activities are focused on medicine procurement, preparation and distribution. The main barriers to optimal hospital pharmacy services are associated with limited human resources and collaboration across healthcare providers, as well as policy gaps.

CONCLUSIONS: There is a strong desire among hospital pharmacists to expand their contributions to improving medicines outcomes and solving public health problems. Namibia’s pharmacy educational system is a strength and should be utilized to continue advancing hospital pharmacy practice and medicines use. Therapeutics committees are usually part of each hospital’s structure and can be very effective for hospital-based policy change. The opportunity exists to optimize pharmacists’ contributions by utilizing the local therapeutics committees in combination with the educational system to advance hospital pharmacy practice in Namibia.

PMID:33890674 | DOI:10.1093/ijpp/riab019

J Forensic Sci. 2021 Apr 23. doi: 10.1111/1556-4029.14710. Online ahead of print.

ABSTRACT

Fingermark ridge drift is a random modification of (aged) fingermark patterns at a ridge scale. This phenomenon was previously proven to alter key elements used for identifications, such as the appearance of minutiae. Little is currently reported on the underlying factors contributing to its occurrence. The present study was designed to investigate further the variables of a previous study by including a total of 768 fingermarks from a male and female, two substrates (glazed ceramic tile and plastic), two distinct color powder developers (carbon black and titanium dioxide), three indoor lighting conditions (direct natural light, shade, and darkness), and two secretion types (sebaceous- and eccrine-rich). Fingermarks were aged for 2-72 days, powdered, photographed, and drift detected by three independent observers. All aged fingermarks (672) were compared relative to fresh fingermarks (96), and ridge drift was observed in 42 of 672 (6%) fingermarks, while 168 (25%) were reported as indeterminate results. While ridge drift was detected in multiple fingermarks across all independent variables, statistical analysis using a multinomial logistics model showed that only powder type, secretion type, and the substrate indicated a significant correlation with increased incidences of this phenomenon. There was no significant correlation with the donor, time since deposition, or the environmental lighting conditions used. The highest incidence occurred when carbon black powder was used on a plastic substrate (>10%). The average observation of ridge drift is 6% of samples supporting that this phenomenon is not a rare event, particularly considering the conservative analysis approach implemented.

PMID:33890675 | DOI:10.1111/1556-4029.14710

Public Health Nurs. 2021 Apr 23. doi: 10.1111/phn.12913. Online ahead of print.

ABSTRACT

OBJECTIVE: This study examines the knowledge levels pertaining to early childhood caries (ECC) among grassroot workers of rural India.

DESIGN: A questionnaire study assessing the awareness levels of various ECC aspects was carried out among 88 auxiliary nurse midwives (ANMs), 140 Anganwadi workers (AWWs), and 210 Accredited Social Health Activist (ASHA) workers in a district of Southern India. A 24-item pretested, structured, and close-ended, self-administered questionnaire was used to collect information on the knowledge of early childhood oral health-related factors. Descriptive statistics and multivariate ANOVA were used to summarize the results.

RESULTS: Overall, only 59% of ANMs, 49% of AWWs, and 47% of ASHA workers were found to have adequate knowledge about ECC.

CONCLUSION: The current study clearly highlighted the discrepancy in the awareness levels among grassroot health care workers. A deficit was found to exist in the knowledge of the tested health care workers regarding infant oral care and ECC transmissibility.

PMID:33890686 | DOI:10.1111/phn.12913

Lancet Digit Health. 2021 May;3(5):e280-e282. doi: 10.1016/S2589-7500(21)00054-6.

NO ABSTRACT

PMID:33890577 | DOI:10.1016/S2589-7500(21)00054-6