Category: Statistics

Zhonghua Yi Xue Za Zhi. 2021 Apr 13;101(14):1009-1014. doi: 10.3760/cma.j.cn112137-20201102-02990.

ABSTRACT

Objective: To evaluate the effect of the pessary treatment on general anxiety disorder in patients with symptomatic pelvic organ prolapse (POP). Methods: Between December 2018 and January 2020, 213 patients who received the pessary treatment for symptomatic POP in the Peking Union Medical College Hospital (PUMCH) were enrolled in this prospective observational study. Accepting the pessary successfully means that the patient keeping the pessary for 2 weeks were satisfied with it and willing to use it afterwards, or means that the patient having changed a new pessary and keeping it for 2 weeks were satisfied with it and willing to use it afterwards. The questionnaire General Anxiety Disorder-7 (GAD-7) was used to assess the anxiety state of POP patients, including 163 patients who accepted the pessary treatment successfully and 50 patients who failed, before and after the pessary treatment. A score of 10 or more was considered as the moderate or severe anxiety and defined as the anxiety disorder. Patients who accepted the pessary treatment successfully were followed up for 3 months. Results: Before the treatment, the prevalence of anxiety disorders was 20.9% (34 out of 163) for those patients accepting the pessary and that was 20.0% (10 out of 50) for those patients who failed in keeping the pessary, the difference of which were not statistically significant (P=0.896). The difference of demographic data and clinical characteristics between the anxiety disorder group and the non-anxiety disorder group were not statistically significant (P>0.05). After 3 months of the pessary treatment for those patients using the pessary treatment, the prevalence of anxiety disorders dropped to 3.7% (6/163) from 20.9% (P<0.001). The GAD-7 score of patients with anxiety disorders decreased from a median of 16.0 (12.5, 21.0) before the treatment to 1.0 (0, 4.0) after the treatment, and the difference was statistically significant (P<0.001). Conclusion: Around 20% POP patients receiving pessary treatment had the moderate or severe general anxiety disorder. After 3 months of using the pessary treatment, the prevalence of anxiety disorders in POP patients had dropped significantly.

PMID:33845539 | DOI:10.3760/cma.j.cn112137-20201102-02990

J Prev Med Public Health. 2021 Mar;54(2):110-118. doi: 10.3961/jpmph.20.179. Epub 2021 Jan 11.

ABSTRACT

OBJECTIVES: A growing number of people depend on flexible employment, characterized by outsider employment status and perceived job insecurity. This study investigated whether there was a synergistic effect of employment status (full-time vs. part-time) and perceived job insecurity on major depressive disorder.

METHODS: Data were derived from the 2012 Canadian Community Health Survey-Mental Health of 12 640 of Canada’s labor force population, aged 20 to 74. By combining employment status with perceived job insecurity, we formed four employment categories: full-time secure, full-time insecure, part-time secure, and part-time insecure.

RESULTS: Results showed no synergistic health effect between employment status and perceived job insecurity. Regardless of employment status (full-time vs. part-time), insecure employment was significantly associated with a high risk of major depressive disorder. Analysis of the interaction between gender and four flexible employment status showed a gender-contingent effect on this link in only full-time insecure category. Men workers with full-time insecure jobs were more likely to experience major depressive disorders than their women counterparts.

CONCLUSIONS: This study’s findings imply that perceived job insecurity may be a critical factor for developing major depressive disorder, in both men and women workers.

PMID:33845531 | DOI:10.3961/jpmph.20.179

J Prev Med Public Health. 2021 Mar;54(2):129-136. doi: 10.3961/jpmph.20.318. Epub 2021 Mar 4.

ABSTRACT

OBJECTIVES: This study examined demographic factors hampering access to healthcare at hospitals and suggests policy approaches to improve healthcare management in Thailand.

METHODS: The data for the study were drawn from a health and welfare survey conducted by the National Statistical Office of Thailand in 2017. The population-based health and welfare survey was systematically carried out by skilled interviewers, who polled 21 519 384 individuals. The independent variables related to demographic data (age, sex, religion, marital status, education, occupation, and area of residence), chronic diseases, and health insurance coverage. The dependent variable was the degree of access to healthcare. Multiple logistic regression analysis was subsequently performed on the variables found to be significant in the univariate analysis.

RESULTS: Only 2.5% of the population did not visit a hospital when necessary for outpatient-department treatment, hospitalization, or the provision of oral care. The primary reasons people gave for not availing themselves of the services offered by government hospitals when they were ill were-in descending order of frequency-insufficient time to seek care, long hospital queues, travel inconvenience, a lack of hospital beds, unavailability of a dentist, not having someone to accompany them, and being unable to pay for the transportation costs. Multiple logistic regression analysis showed that failure to access the health services provided at hospitals was associated with demographic, educational, occupational, health welfare, and geographic factors.

CONCLUSIONS: Accessibility depends not only on health and welfare benefit coverage, but also on socioeconomic factors and the degree of convenience associated with visiting a hospital.

PMID:33845533 | DOI:10.3961/jpmph.20.318

J Prev Med Public Health. 2021 Mar;54(2):145-152. doi: 10.3961/jpmph.20.507. Epub 2021 Mar 16.

ABSTRACT

OBJECTIVES: This study aimed to identify regional differences in the high-risk drinking rate among yearly alcohol users in Korea and to identify relevant regional factors for each quintile using quantile regression.

METHODS: Data from 227 counties surveyed by the 2017 Korean Community Health Survey (KCHS) were analyzed. The analysis dataset included secondary data extracted from the Korean Statistical Information Service and data from the KCHS. To identify regional factors related to the high-risk drinking rate among yearly alcohol users, quantile regression was conducted by dividing the data into 10%, 30%, 50%, 70%, and 90% quantiles, and multiple linear regression was also performed.

RESULTS: The current smoking rate, perceived stress rate, crude divorce rate, and financial independence rate, as well as one’s social network, were related to the high-risk drinking rate among yearly alcohol users. The quantile regression revealed that the perceived stress rate was related to all quantiles except for the 90% quantile, and the financial independence rate was related to the 50% to 90% quantiles. The crude divorce rate was related to the high-risk drinking rate among yearly alcohol users in all quantiles.

CONCLUSIONS: The findings of this study suggest that local health programs for high-risk drinking are needed in areas with high local stress and high crude divorce rates.

PMID:33845535 | DOI:10.3961/jpmph.20.507

J Sleep Res. 2021 Apr 12:e13352. doi: 10.1111/jsr.13352. Online ahead of print.

ABSTRACT

Due to the high prevalence of obstructive sleep apnea (OSA), it is recommended to use in-laboratory polysomnography (PSG) or a home sleep apnea test (HSAT) in uncomplicated adult subjects at high risk of OSA. The aims of the present study were to compare a HSAT device, a wrist worn peripheral arterial tone signal device (WatchPAT™-200 [WP]) with PSG and respiratory polygraphy (RP) in a low-risk population of OSA. A total of 47 adult subjects at low risk of OSA were simultaneously examined with the three different approaches in a single night. The sleep studies were scored independently and in a blinded fashion, then the results and the parameters (Respiratory Disturbance Index, apnea-hypopnea index [AHI] and oxygen desaturation index of 3%) were compared with several statistical analyses. The agreement between the sleep tools and correlation for the assessed parameters were analysed and compared with Bland and Altman plots and Pearson’s coefficient (WP versus PSG, r = 0.86). For the severity of OSA ranked according to PSG, the Cohen’s k was 0.60 and 0.82 for WP and RP, respectively. Specificity was higher for RP compared to WP for identifying the presence of OSA (AHIPSG cut-off ≥5 events/hr: 0.85 versus 0.73), while was quite similar in identifying patients who were more likely to be treated (AHIPSG cut-off ≥15 events/hr: 0.94 versus 0.96). Assessing the costs and the simplicity of the examination, the results of our present study demonstrate the usefulness of WP compared to PSG, especially in screening and follow-up for the ability to exclude subjects from treatment with continuous positive airway pressure (AHI <15 events/hr) in a population with a low pre-test risk of moderate-to-severe OSA.

PMID:33845515 | DOI:10.1111/jsr.13352

Clin Exp Emerg Med. 2021 Mar;8(1):30-36. doi: 10.15441/ceem.20.070. Epub 2021 Mar 31.

ABSTRACT

OBJECTIVE: This study aimed to determine the factors that affect successful esophageal foreign body (FB) removal using a Foley catheter and to identify methods to increase the success rate.

METHODS: In this retrospective, cross-sectional study, we included pediatric patients who presented with esophageal FB impaction that was removed using a Foley catheter in the emergency departments of tertiary care and academic hospitals. We analyzed the effect of the patients’ age, sex, and symptoms; FB type, size, and location; Foley catheter size; complications during FB removal; duration between FB ingestion and removal; operator’s years of training; sedation; success rate of FB removal; endoscopy; and patient’s posture during FB removal on the success of Foley catheter-based FB removal.

RESULTS: Of the 43 patients we enrolled, Foley catheter-based FB removal was successful in 81.4% (35/43) but failed in 18.6% (8/43) of patients; no FB-removal-related complications were reported. There was no significant association between the success rate of Foley catheter-based FB removal and any study variable. A higher number of years in training tended to increase the success rate of Foley catheter-based FB removal, although statistical significance was not achieved.

CONCLUSION: Children’s esophageal FB removal is a practical challenge in the emergency rooms, and using a Foley catheter is associated with a high success rate of the removal and low occurrence of complications. In this study, no single variable was found correlated with the success rate of Foley catheter-based esophageal FB removal in pediatric patients, which may indicate multiple variables interacting with one another to affect the success rate.

PMID:33845520 | DOI:10.15441/ceem.20.070

J Prev Med Public Health. 2021 Mar;54(2):86-95. doi: 10.3961/jpmph.20.540. Epub 2021 Jan 19.

ABSTRACT

OBJECTIVES: This study investigated associations between perceptions of coronavirus disease 2019 (COVID-19) and the prevalence of posttraumatic stress disorder (PTSD) in workers at hospitals designated to treat COVID-19, as well as the difference in the magnitude of these associations by occupational type and previous Middle East respiratory syndrome coronavirus (MERS-CoV) experience.

METHODS: The participants were workers at hospitals designated to treat COVID-19 who completed a questionnaire about their perceptions related to COVID-19, work experience during the previous MERS-CoV outbreak, and symptoms of PTSD ascertained by the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders. Participants’ characteristics were compared using the chi-square test. Multivariable logistic regression was performed to evaluate the associations between perceptions and the prevalence of PTSD, stratified by occupational type and previous MERS-CoV experience.

RESULTS: Non-medical personnel showed stronger associations with PTSD than medical personnel according to general fear (odds ratio [OR], 6.67; 95% confidence interval [CI], 1.92 to 23.20), shortages of supplies (OR, 1.29; 95% CI, 1.07 to 1.56), and issue-specific fear (OR, 1.29; 95% CI, 1.05 to 1.59). Those with prior MERS-CoV quarantine experience were more prone to PTSD than those without such experience in terms of general fear (OR, 1.70; 95% CI, 1.22 to 2.37), shortages of supplies (OR, 1.24; 95% CI, 1.10 to 1.40), and issue-specific fear (OR, 1.21; 95% CI, 1.06 to 1.38).

CONCLUSIONS: During the COVID-19 pandemic, non-medical personnel tended to have higher odds of being categorized as having PTSD. Workers with prior MERS-CoV experience were more susceptible than those without such experience. These findings suggest the need for timely interventions to manage human resources for a sustainable quarantine system.

PMID:33845528 | DOI:10.3961/jpmph.20.540

Value Health Reg Issues. 2021 Apr 9;24:199-213. doi: 10.1016/j.vhri.2020.12.010. Online ahead of print.

ABSTRACT

OBJECTIVES: This article explores the consequences of hospitalization expenditure on noncommunicable diseases (NCD) and its impact on out-of-pocket expenditure (OOPE), catastrophic health expenditure, impoverishment, and hardship financing of households in India.

METHODS: Data on hospitalized cases of NCDs from the 3 rounds of National Sample Surveys (NSS) (2004, 2014, 2018) were used. Bivariate and multivariate analyses were conducted to investigate the socioeconomic differentials of the impact of OOPE on catastrophic health expenditure, impoverishment, and exposure to hardship financing.

RESULTS: Rural households had greater exposure to catastrophic health expenditure but urban households had higher risk of impoverishment due to OOPE. Older patients (aged ≥60 years) had the highest hospitalization rate per 100 000, including increase in average healthcare expenditure from 2004 to 2018. At 10% and 30% thresholds, 50% and 25% of the households, respectively, faced catastrophic health expenditure across all the 3 rounds. Due to OOPE on hospitaliation treatment for NCDs, about 3.8%, 7.4% and 4.8% of households fell below poverty line, and percentage shortfall in income for the population from the poverty line was 3%, 4.9% and 3%, in 2004, 2014 and 2018 respectively. Percentage of households facing hardship financing reduced from 49.2% in 2004 to 24.4% 2014 and 12.7% in 2018.

CONCLUSION: OOPE by households are still very high and hence the higher effects of CHE, impoverishment and exposure to hardship financing due to health expenditure in India. This study proposes that along with increase in budgetary allocations for healthcare, the government should develop suitable policies to expand the effectiveness of government-sponsored health insurance, such as developing a specific NCD service package to be included in the health insurance program.

PMID:33845450 | DOI:10.1016/j.vhri.2020.12.010

J Neurol Surg A Cent Eur Neurosurg. 2021 Apr 12. doi: 10.1055/s-0041-1722968. Online ahead of print.

ABSTRACT

BACKGROUND AND STUDY AIMS: Spinal schwannomas are benign slow-growing tumors, and gross total resection is the gold standard of treatment. The conventional surgical approach is laminectomy, which provides a wide working area. Today minimally invasive surgery (MIS) is popular because it is associated with shorter hospital stay, less operative blood loss, minimized tissue traumas and relative postoperative pain, and, and spine surgery, avoidance of spinal instability.

MATERIAL AND METHODS: From January 2016 to December 2019, we operated on 40 patients with spinal intradural extramedullary tumor (schwannoma) with laminectomy or hemilaminectomy. Baseline medical data, including patients’ sex and age, tumor location, days of postoperative bed rest, operative time, length of hospitalization, and 1-month visual analog scale (VAS) value were collected and analyzed. Data analysis was performed using STATA/IC 13.1 statistical package (StataCorp LP, College Station, Texas, United States).

RESULTS: Hemilaminectomy was associated with faster operative time (p < 0.001), shorter postoperative time spent in bed (p < 0.001), and shorter hospitalization (p < 0.001). At 1-month follow-up, the mean VAS score was 4.6 (1.7) among the laminectomy patients and 2.5 (1.3) among the hemilaminectomy patients (p < 0.001). Postoperative complications occurred in 1 (7.7%) and 7 (25.9%) patients in the hemilaminectomy and laminectomy groups, respectively (p = 0.177).

CONCLUSIONS: Unilateral hemilaminectomy has significant advantages compared with laminectomy in spinal schwannoma surgery including shorter operative time, less time spent in bed, shorter hospitalization, and less postoperative pain.

PMID:33845505 | DOI:10.1055/s-0041-1722968

J Neurol Surg A Cent Eur Neurosurg. 2021 Apr 12. doi: 10.1055/s-0040-1721017. Online ahead of print.

ABSTRACT

BACKGROUND: The human brain can respond to and participate in music. Learning to play a musical instrument requires complex multimodal skills involving the simultaneous perception of several sensory modalities. In case of brain damage, the musician and nonmusician brains may have different capacities for reorganization and neural remapping. We aimed to investigate the effect of music on patients who had a brain tumor and/or underwent a neurosurgical procedure, comparing the recovery of those who had a musical background with those who did not.

METHODS: A literature review was performed to search for any evidence on this issue. We divided the cases into two groups: as group I consisted of the nonmusician patients, while group II consisted of musicians with a neurosurgical disease. Studies were rated from 0 (no effect) to 4 (high effect).

RESULTS: We found seven published studies as well as case reports. It was observed that the outcomes and quality of life of the musician group were better than those of the control groups or nonmusician patients in all of the investigated studies, but no statistical difference between musicians and nonmusicians was found.

CONCLUSION: Music-related structural changes in the brain may occur in musicians. However with limited number of cases, it cannot be assorted the improved recovery in musicians after neurosurgical disease or procedures by his or her enhanced plasticity. There are limited number of cases, for that reason, it cannot be assorted the improved recovery in musicians after neurosurgical disease or procedures by his or her enhanced plasticity. Professional musicians, who are making a living through their musical abilities, may also have a strong motivation to undergo stressful and enduring rehabilitation. An early restart of the musical activity in musicians with neurosurgical disease may lead to better outcomes, better quality of life, and better psychological parameters, in a shorter time than in nonmusicians.

PMID:33845506 | DOI:10.1055/s-0040-1721017