Category: Statistics

Leadersh Health Serv (Bradf Engl). 2021 Aug 5;ahead-of-print(ahead-of-print). doi: 10.1108/LHS-01-2021-0007.

ABSTRACT

PURPOSE: The Health Service Executive in Ireland seeks to further develop healthcare in the community. It has identified that this reform requires developing leadership amongst the staff. This study aims to identify what kind of leadership staff in community healthcare observe in practice and their leadership preferences. The core objective has been to identify the readiness of the organisation to implement the adopted national policy of integrated community care reform in terms of leadership development.

DESIGN/METHODOLOGY/APPROACH: An online cross-sectional survey was conducted using the Organisational Cultural Assessment Instrument, based on the Competing Values Framework. This tool identifies four overarching leadership types: Clan (Collaborative), Adhocracy (Creative), Market (Competitive) and Hierarchy (Controlling). Participants (n = 445) were a representative sample of regional community health care employees. They were asked to identify presently observed leadership and preferred leadership in practice. The statistical analysis emphasised a comparison of observed and preferred leadership types.

FINDINGS: Participants reported the current prevailing leadership type as Market (M = 34.38, SD = 6.22) and Hierarchical (M = 34.38, SD = 22.62), whilst the preferred or future style was overwhelmingly Clan (M = 40.38, SD = 18.08). Differences were significant (all p‘s < 0.001). The overall outcome indicates a predominance of controlling and competitive leadership and a lack of collaborative leadership to implement the planned reform.

ORIGINALITY/VALUE: During reform in healthcare, leadership in practice must be aligned to the reform strategy, demonstrating collaboration, flexibility and support for innovation. This unique study demonstrates the importance of examining leadership type and competencies to indicate readiness to deliver national community health care reform.

PMID:34346663 | DOI:10.1108/LHS-01-2021-0007

Nurs Open. 2021 Aug 4. doi: 10.1002/nop2.1021. Online ahead of print.

ABSTRACT

AIM: This study aimed to assess the effectiveness of a programme designed to promote global health competency among nursing students.

DESIGN: It used a randomized pre-post-test comparison group design to compare the effects of a global health competency programme among nursing students.

METHODS: Data collection for the pre-test was carried out for 2 days (25-26 October 2018) and that of post-test was conducted for 2 days (23-24 December 2018). A total of 38 fourth-year nursing students participated in this study (14 in the international nursing group, 11 in the transcultural nursing group and 13 in the complementary and alternative medicine group). The participants were from the nursing department of a university in Cheongju.

RESULTS: There were no statistically significant differences between the groups in the pre-test homogeneity test. The international nursing group showed statistically significant improvements between the pre- and post-tests in global health competency, cultural competency, global health confidence and cultural nursing confidence.

PMID:34346566 | DOI:10.1002/nop2.1021

Psychiatry Clin Neurosci. 2021 Aug 4. doi: 10.1111/pcn.13292. Online ahead of print.

ABSTRACT

AIM: To further investigate the neuroanatomical correlates of child sexual offending and disentangle them from the neural correlates of pedophilia, using a multivariate analytical approach in order to minimize loss of statistical power.

METHODS: This study presents structural MRI data on gray matter in an incarcerated, male population of 22 pedophilic and 21 non-pedophilic child sexual offenders, and 20 violent non-sexual offender controls, using a multivariate whole-brain approach using source-based morphometry.

RESULTS: We identify a network of several neuroanatomical regions exhibiting interrelated reduced gray matter in both child sexual offender groups relative to controls, comprising extensive clusters in the bilateral cerebellum and frontal lobe, as well as smaller clusters in the bilateral parietal, temporal, and occipital lobes, the bilateral basal ganglia, the medial cingulate and the hippocampus.

CONCLUSION: Our results speak to the interpretation that there are inter- and possibly connectivity-related brain structural abnormalities in child sexual offenders that are not (only) pertaining to pedophilia per se. Interpretations and limitations of the present data are discussed and recommendations for future works are given. This article is protected by copyright. All rights reserved.

PMID:34346537 | DOI:10.1111/pcn.13292

J Anat. 2021 Aug 3. doi: 10.1111/joa.13528. Online ahead of print.

ABSTRACT

The morphology of the rib cage affects both the biomechanics of the upper body’s musculoskeletal structure and the respiratory mechanics. This becomes particularly important when evaluating skeletal deformities, as in adolescent idiopathic scoliosis (AIS). The aim of this study was to identify morphological characteristics of the rib cage in relation to the lung in patients with non-deformed and scoliotic spines. Computed tomography data of 40 patients without any visible spinal abnormalities (healthy group) and 21 patients with AIS were obtained retrospectively. All bony structures as well as the right and left lung were reconstructed using image segmentation. Morphological parameters were calculated based on the distances between characteristic morphological landmarks. These parameters included the rib position, length, and area, the rib cage depth and width, and the rib inclination angle on either side, as well as the spinal height and length. Furthermore, we determined the left and right lung volumes, and the area of contact between the rib cage and lung. Differences between healthy and scoliotic spines were statistically analysed using the t-test for unpaired data. The rib cage of the AIS group was significantly deformed in the dorso-ventral and medio-lateral directions. The anatomical proximity of the lung to the ribs was nearly symmetrical in the healthy group. By contrast, within the AIS group, the lung covered a significantly greater area on the left side of the rib cage at large thoracic deformities. Within the levels T1-T6, no significant difference in the rib length, depth to width relationship, or area was observed between the healthy and AIS groups. Inferior to the lung (T7-T12), these parameters exhibited greater variability. The ratio between the width of the rib cage at T6 and the thoracic spinal height (T1-T12) was significantly increased within the thoracic AIS group (1.1 ± 0.08) compared with the healthy group (1.0 ± 0.05). No statistical differences were found between the lung volumes among all the groups. While the rib cage was frequently strongly deformed in the AIS group, the lung and its surrounding ribs appeared to be normally developed. The observed rib hump in AIS appeared to be formed particularly by a more ventral position of the ribs on the concave side. Furthermore, the rib cage width to spinal height ratio suggested that the spinal height of the thoracic AIS-spine is reduced. This indicates that the spine would gain its growth-related height after correcting the spinal deformity. These are the important aspects to consider in the aetiology research and orthopaedic treatment of AIS.

PMID:34346505 | DOI:10.1111/joa.13528

Dev Med Child Neurol. 2021 Aug 4. doi: 10.1111/dmcn.14996. Online ahead of print.

ABSTRACT

AIM: To follow the functional development of a population-based cohort of children with cerebral palsy (CP) in rural Uganda and compare their development with the developmental trajectories of children from high-income countries (HIC).

METHOD: Eighty-one children (33 females, 48 males) aged 2 to 17 years (mean 8y 6mo, SD 4y 6mo) with CP were initially assessed in 2015 and then 4 years later using the 66-item Gross Motor Function Measure (GMFM-66), Pediatric Evaluation of Disability Inventory, Ugandan version (PEDI-UG), and functional classification systems. We calculated actual and reference scores (level of deviation from the developmental trajectories in HIC). A Wilcoxon signed-rank test was used for statistical analyses.

RESULTS: Children and young people with CP in Uganda exhibited no differences in scores between the first and second assessments for the GMFM-66 and PEDI-UG mobility skills, whereas they exhibited increased PEDI-UG social function (p<0.001) and self-care skills scores (p<0.001). Reference scores were more negative at the second assessment than at the first for the GMFM-66 (p=0.002) and PEDI-UG mobility (p=0.036) but not for PEDI-UG self-care. The increased difference in reference scores over the 4 years was primarily driven by younger children (2-5y) and children with milder impairments.

INTERPRETATION: The increased difference in reference scores between assessments suggests that children with CP in Uganda develop motor skills at a slower rate than peers in HIC. Limited access to health care and rehabilitation likely contributed to the lower scores and slower rate of development.

PMID:34346507 | DOI:10.1111/dmcn.14996

J Clin Pharm Ther. 2021 Aug 4. doi: 10.1111/jcpt.13505. Online ahead of print.

ABSTRACT

WHAT IS KNOWN AND OBJECTIVE: MTX pharmacology and toxicity involve several metabolizing enzymes and transporters whose functions have been suggested to be altered by genetic polymorphisms. The current study is to investigate the relationship between the genetic variation and MTX-induced adverse drug effects.

METHODS: A total of 80 paediatric patients (aged 1-14 years) were enrolled in this study. Toxicity was assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 scoring system. Genotyping was performed by MassARRAY Assay method. Data were analysed using Spss statistical package version 17.0 and Plink v1.07 software. The HWE was tested by a chi-square test. The Fisher’s exact test (chi-squaretest) was used to compare the distributions of genotypes between cases and controls. OR and 95%CI were applied to evaluate the association of genetic variants with the presence of mucositis using unconditional logistic regression.

RESULTS AND DISCUSSION: Mucosal inflammatory injuries were found in 28 children. SNPs of rs1128503 (p = 0.0022, OR = 3.04, 95%CI = 1.39-6.64) and rs1045642 (p = 0.0052, OR = 2.38, 95%CI = 1.15-5.00) located in the gene of ABCB1 and SNPs of rs1801133 (p = 0.040, OR = 2.50, 95%CI = 1.06-5.88) located in the gene of MTHFR show marked impacts on the risk of developing mucositis.

WHAT IS NEW AND CONCLUSION: SNPs of ABCB1 rs1128503, rs1045642 and MTHFR rs1801133 can be risk predictor for MTX-induced mucositis in Chinese paediatric patients diagnosed with acute lymphoblastic leukaemia, lymphoma or osteosarcoma.

PMID:34346513 | DOI:10.1111/jcpt.13505

Phys Chem Chem Phys. 2021 Aug 4. doi: 10.1039/d1cp01993g. Online ahead of print.

ABSTRACT

Hyperthermal oxidation of silicon is envisaged to be an alternative to silicon-on-insulator (SOI) waveguide fabrication for photonic integrated circuit (PIC) devices, and thus the local oxidation of silicon (LOCOS) technique has attracted attention. In this article, starting with the thermodynamic insights into the Deal-Grove model for defining the thermal oxidation, we model the Henry’s law constant in the silicon oxidation process with the ensemble contributions of thermodynamic and chemical energies, and extract an empirical model with the published statistical data. Then, the simulations show the dramatic temperature/time dependences of Henry’s constant, and the different effects of the thermodynamic and chemical energies. Systematic simulations of the temperature/time dependences of both the growth rate and thickness of oxide are carried out where the temperature dependence of the oxidant diffusivity is also considered. Consequently, the simulation results from the two models astonishingly agree with each other. Typically, at 1100 °C, with a 3 h oxidation time, 2.10 and 1.34 μm SiO2 layers can be grown with the thermodynamic model under two diffusivity models, while with the empirical one, the two extreme cases can grow 2.10 and 1.28 μm SiO2 layers, respectively.

PMID:34346429 | DOI:10.1039/d1cp01993g

Int J Cancer. 2021 Aug 4. doi: 10.1002/ijc.33757. Online ahead of print.

ABSTRACT

Colorectal cancer is a leading cancer worldwide and in Vietnam. Adenomas (adenomatous polyps) is an important precursor of colorectal cancer. There is currently no study to determine the modifiable risk factors for colorectal adenomas, including body mass index (BMI) in Vietnam. We conducted an individually matched case-control study of 1,149 colorectal adenomas and 1,145 controls in a large-scale colorectal screening program involving 103,542 individuals aged 40-75 years old in Hanoi, Vietnam. Conditional logistic regression was used to evaluate the association between BMI and colorectal adenomas prevalence, after controlling for potential confounders. Overall, comparing to normal weight (i.e., 18.5-22.9 kg/m² ), underweight (i.e., BMI<18.5) was associated with a non-statistically significant increased prevalence of colorectal adenomas (odd ratio-OR=1.29 and 95% confident interval-CI: 0.88-1.87). This association became significant among male (OR=1.98, 95% CI: 1.20-3.27), male who were ever smokers (OR=2.59, 95% CI: 1.33-5.03), non-regular exercise (OR=2.44, 95% CI: 1.26-4.73) and individuals with cardiometabolic disorders (OR=3.46, 95% CI: 1.19-10.00). The association between underweight and colorectal adenomas did not vary by smoking status, drinking status, family history of cancer, adenomas types or cardiometabolic disorders. No association was observed among obese individuals (BMI≥25). In the population with low prevalence of obesity, we found that the association between BMI and colorectal adenomas followed a reversed J-shape that underweight was associated with increased prevalence. Further studies are, therefore, warranted to replicate our results and to investigate the biologic mechanism the effect of underweight on colorectal adenomas prevalence.

PMID:34346504 | DOI:10.1002/ijc.33757

Sci Total Environ. 2021 Jul 21;797:149199. doi: 10.1016/j.scitotenv.2021.149199. Online ahead of print.

ABSTRACT

BACKGROUND: There is little work in assessing the impact of storm events combined with power outage (PO). In this study, we evaluated the individual and synergistic impacts of wind events and PO on overall and subtypes of injuries in New York State (NYS) and by demographics.

METHODS: The emergency department (ED) visit data were obtained from the NYS Department of Health from November-April 2005-2013 to identify injury cases, length of stay and care costs. Wind event was defined according to high wind, strong wind or thunderstorm wind defined by NOAA. PO occurrence was defined when PO coverage exceeded the 50th percentile of its distribution. By comparing non-event days, we used distributed lag nonlinear models to evaluate the impacts of wind events, PO, and their combined effect on injuries during the cold season over a 0-3-day lag period, while controlling for time-varying confounders. The differences in critical care indicators between event and non-event days were also evaluated.

RESULTS: Overall injuries ED visits (16,628,812) significantly increased during the wind events (highest Risk Ratio (RR): 1.05; 95% CI: 1.02-1.08), and were highest when wind events cooccurred with PO (highest RR: 1.14; 95% CI: 1.10-1.18), but not during PO alone (RR: 1.00; 95%CI: 0.96-1.04). The increase was also observed with all subgroups through Day 2 after the event. Greater risks exist for older adults (≥65 years) and those on Medicaid. After the joint occurrences of wind events and PO, average visits are 0.2 days longer, and cost 13% more, compared to no wind/no PO days.

CONCLUSION: There is a significant increase in ED visits, length of stay and cost of injuries during wind events, especially when they coupled with PO and especially among older cases and Medicaid holders. Our findings may be used for planning disaster preparedness and recovery efforts.

PMID:34346383 | DOI:10.1016/j.scitotenv.2021.149199

JMIR Form Res. 2021 Aug 1. doi: 10.2196/30761. Online ahead of print.

ABSTRACT

BACKGROUND: HIV infection rates among sexual minority men and transgender individuals, particularly adolescents and young adults, remain elevated in the United States despite continued improvement in HIV public health response. However, there remains a knowledge gap in understanding what barriers this community faces in receiving HIV care and prevention resources. To address this, the Keeping it LITE study was conducted to assess HIV risk factors and barriers to preventive treatment in a large national cohort of young sexual minority men and transgender individuals at high risk of HIV infection.

OBJECTIVE: The objective of this formative research manuscript is to evaluate the feasibility of enrolling a large remote cohort, challenges encountered in recruitment, and adjustments made to address these challenges.

METHODS: A large national cohort (n=3444) of young sexual minority men and transgender individuals was recruited. Participants were recruited via advertisements on social media, LGBTQ+ apps, print advertising, and word of mouth. Before enrolling, participants verified HIV status with an at-home HIV test or by providing their own testing documentation. Descriptive statistics were generated and a series of logistic regressions were conducted to evaluate demographic differences between recruitment methods, HIV testing methods, and enrollment status.

RESULTS: The Keeping it LITE study was particularly successful in recruiting participants via social media, with over half of participants recruited from advertisements on social media platforms such as Facebook, Instagram, and Snapchat. Participants were also recruited via word-of-mouth, LGBTQ+ apps (i.e. Grindr, Scruff), and print advertisements, and participants recruited from these sources tended to be older and have a higher risk profile. The study was and was also successful in recruiting a large sample of transgender youth, particularly transgender men and nonbinary individuals. At-home HIV testing was acceptable and more heavily utilized by younger participantsand even preferred by some participants, though several barriers were encountered and overcome in the implementation of this testing. The study had more limited success in recruiting 13-17-year-old participants due to lower enrollment rates and barriers to advertising on some social media platforms. Implications of these findings for future development of HIV research and intervention protocols among sexual minority and trans youth are discussed.

CONCLUSIONS: The methods utilized in the Keeping it LITE study, particularly recruitment via social media, were found to be feasible and acceptable to participants.

PMID:34346403 | DOI:10.2196/30761