Category: Statistics

BMJ Open. 2022 Apr 5;12(4):e061908. doi: 10.1136/bmjopen-2022-061908.

ABSTRACT

INTRODUCTION: To successfully combat COVID-19 vaccine hesitancy and increase uptake, research has demonstrated that interventions are most effective when tailored to meet local needs through active engagement and co-development with communities. This mixed-methods project uses a human-centred design (HCD) approach to understand local perspectives of COVID-19 vaccine hesitancy and develop strategies to enhance vaccine confidence for children and adolescents.

METHODS AND ANALYSIS: Project ECHO (Étude Communautaire sur l’Hésitation vaccinale contre la COVID-19) combines population-based surveys of parents and adolescents with community-based participatory action research to design and pilot strategies to enhance COVID-19 vaccine confidence in two underserved and ethnoculturally diverse neighbourhoods of Montreal, Canada. Two surveys conducted 6 months apart through primary and secondary schools are used to monitor vaccine acceptance and its social determinants among children and youth. Analyses of survey data include descriptive and inferential statistical approaches. Community-led design teams of parents and youth from the two participating neighbourhoods, supported by academic researchers, design thinking experts and community partners, use an HCD approach to: (1) gather data to understand COVID-19 vaccine decision-making among parents and youth in their community and frame a design challenge (inspiration phase); (2) develop an intervention to address the design challenge (ideation phase) and (3) pilot the intervention (implementation phase). Strategies to evaluate the community-led interventions will be co-developed during the implementation phase.

ETHICS AND DISSEMINATION: This study has been approved by the research ethics boards of the Sainte-Justine University Hospital Centre and the University of Montreal. Community design teams will be involved in the dissemination of findings and the design of knowledge translation initiatives that foster dialogue related to COVID-19 vaccination for children and adolescents among community, school and public health stakeholders. Findings will be disseminated through peer-reviewed publications, conference presentations, community forums, policy briefs, and social media content.

PMID:35383090 | DOI:10.1136/bmjopen-2022-061908

BMJ Open. 2022 Apr 5;12(4):e057009. doi: 10.1136/bmjopen-2021-057009.

ABSTRACT

OBJECTIVE: The evidence base for social prescribing is inconclusive, and evaluations have been criticised for lacking rigour. This realist review sought to understand how and why social prescribing evaluations work or do not work. Findings from this review will contribute to the development of an evidence-based evaluation framework and reporting standards for social prescribing.

DESIGN: A realist review.

DATA SOURCES: ASSIA, CINAHL, Embase, Medline, PsycINFO, PubMed, Scopus Online, Social Care Online, Web of Science and grey literature.

ELIGIBILITY CRITERIA: Documents reporting on social prescribing evaluations using any methods, published between 1998 and 2020 were included. Documents not reporting findings or lacking detail on methods for data collection and outcomes were excluded.

ANALYSIS: Included documents were segregated into subcases based on methodology. Data relating to context, mechanisms and outcomes and the programme theory were extracted and context-mechanism-outcome configurations were developed. Meta-inferences were drawn from all subcases to refine the programme theory.

RESULTS: 83 documents contributed to analysis. Generally, studies lacked in-depth descriptions of the methods and evaluation processes employed. A cyclical process of social prescribing evaluation was identified, involving preparation, conducting the study and interpretation. The analysis found that coproduction, alignment, research agency, sequential mixed-methods design and integration of findings all contributed to the development of an acceptable, high-quality social prescribing evaluation design. Context-mechanism-outcome configurations relating to these themes are reported.

CONCLUSIONS: To develop the social prescribing evidence base and address gaps in our knowledge about the impact of social prescribing and how it works, evaluations must be high quality and acceptable to stakeholders. Development of an evaluation framework and reporting standards drawing on the findings of this realist review will support this aim.

PROSPERO REGISTRATION NUMBER: CRD42020183065.

PMID:35383075 | DOI:10.1136/bmjopen-2021-057009

BMJ Open. 2022 Apr 5;12(4):e055633. doi: 10.1136/bmjopen-2021-055633.

ABSTRACT

INTRODUCTION: Patients and families affected by paediatric cancer experience psychosocial burden not only during active treatment but also during follow-up care. Use of health services during follow-up treatment should be organised according to patients’ and family members’ needs with regard to their physical and mental situation. This study aims (1) at analysing healthcare use (medical and psychosocial) and associated factors in follow-up care of paediatric cancer patients and (2) at investigating the psychosocial situation and support needs of children and their families during follow-up care. Based on the results, recommendations for healthcare planning and for the development of new and the optimisation of existing support offers will be derived.

METHODS AND ANALYSIS: We will conduct a prospective observational study using a naturalistic explorative design with quantitative and qualitative methods. Paediatric cancer patients in follow-up care, their parents and siblings will be invited to fill out a questionnaire at three measurement points (baseline, 6 months follow-up, 12 months follow-up; target n=252 complete data sets over all measurement points). Additionally, parents will be interviewed using a semistructured interview guideline (target n=15-20) at baseline. Quantitative data will be analysed using descriptive statistics, linear mixed models and regression models. Moreover, explorative analyses will be conducted. Qualitative data will be analysed using qualitative content analyses.

ETHICS AND DISSEMINATION: The study was approved by the Local Psychological Ethics Committee (LPEK-0281). Our findings will be published in scientific, peer-reviewed journals and presented to clinicians and researchers on conferences. To assure that results will be available to affected patients and families, a lay summary will be written and disseminated using several ways (upload on the homepage of the research group, upload on the homepage of the psychosocial working group in the Society for Paediatric Oncology/Haematology in Germany, sending to relevant patient organisations).

TRIAL REGISTRATION NUMBER: DRKS00025289.

PMID:35383068 | DOI:10.1136/bmjopen-2021-055633

Am J Perinatol. 2022 Apr 5. doi: 10.1055/a-1817-5522. Online ahead of print.

ABSTRACT

OBJECTIVES: A statewide Maryland Perinatal Neonatal Quality Collaborative, facilitated by the Maryland Patient Safety Center (MPSC), identified the three specific, measurable, attainable, relevant, and time-limited (SMART) aims to improve outcomes of NAS care: (1) to reduce hospital length of stay (LOS), (2) to reduce interhospital transfers, and (3) to reduce 30-day readmission rates of infants with neonatal abstinence syndrome (NAS).

STUDY DESIGN: The Maryland collaborative developed a bundle of best practices for care of infants with NAS. MPSC partnered with Vermont Oxford Network (VON) to utilize the VON NAS toolkit and provide its standardized NAS educational curriculum to address the three objectives for participating birthing hospitals. Efforts began in quarter 4 (Q4) 2016 and continued for two years. Thirty-one of Maryland’s 32 delivery hospitals (97%) participated in the two-year collaborative. Additionally, one specialty pediatric hospital with a NAS unit participated in the group learnings. Participating facilities implemented components of the MPSC NAS bundle and provided their staff caring for infants with NAS and their mothers access to the VON standardized educational curriculum. MPSC partnered with VON to conduct two audits of implementation of policies and procedures in Q1 2016 and Q3 2018. The Maryland Department of Health supplied quarterly aggregate hospital information on LOS, interhospital transfers, and 30-day readmissions of infants with a discharge diagnosis of ICD-10 P96.1.

RESULTS: Among term infants with NAS with total hospital stay greater than 5 days, we observed a non-significant reduction in both mean and median LOS of 1.5 days. In this same group, the rate of interhospital transfers fell significantly from 20.1% in 2016 to 13.8% in 2017 and to 11.0% in 2018.

CONCLUSION: The best practice bundle created by the Maryland collaborative was associated with a reduction in the percentage of infants with NAS who required interhospital transfer, thereby reducing family disruption.

PMID:35381608 | DOI:10.1055/a-1817-5522

J Am Acad Audiol. 2022 Apr 5. doi: 10.1055/a-1817-6840. Online ahead of print.

ABSTRACT

BACKGROUND: Identifying and understanding speech is difficult for individuals with sensorineural hearing loss, especially in noisy environments. Possible causes include less audibility of the signal, impaired temporal resolution and low selectivity of frequency. The hearing aid is the most common option used to minimize the problems faced by individuals with sensorineural hearing loss.

PURPOSE: To investigate the effects of multichannel and channel-free hearing aid signal processing techniques on spectral-temporal resolution and speech understanding in noise.

RESEARCH DESIGN: A experimental study was used in which the determined tests were applied to the participants.

STUDY SAMPLE: Thirty-four individuals with bilateral symmetrical sensorineural hearing loss between the ages of 18-70 were included in our study.

DATA COLLECTION AND ANALYSIS: Spectral-temporally modulated ripple test, random gap detection test (RDGT) and Turkish matrix test were applied to the participants using multichannel and channel-free hearing aids. All the data obtained were compared statistically in terms of the performances of the hearing aids.

RESULTS: There was no significant difference between multichannel and channel-free hearing aids for spectral resolution and speech understanding in noise tests (p>0.05). While there was no significant difference between the two hearing aids for 500 Hz and 4000 Hz RGDT in temporal resolution measurement (p>0.05); for 1000 Hz (p=.045), 2000 Hz (p=.046) and composite RGDT (p=.001), statistically significant better performances were obtained with the channel-free hearing aids.

CONCLUSIONS: It is thought that faster processing of the incoming signal in the channel-free hearing aids improves the temporal resolution performance. It is predicted that our study findings might help to determine the signal processing technique that will maximize the communication skills of the patients in various conditions.

PMID:35381603 | DOI:10.1055/a-1817-6840

Knee. 2022 Apr 2;35:213-219. doi: 10.1016/j.knee.2022.03.012. Online ahead of print.

ABSTRACT

INTRODUCTION: Studies investigating complications between octogenarians and non-octogenarians undergoing primary total knee arthroplasty (TKA) are limited. Therefore, we investigated whether octogenarians are at greater odds of: (1) in-hospital lengths of stay (LOS) (2) readmission rates, (3) medical complications, and (4) hardware complications compared to non-octogenarians following TKA.

METHODS: A retrospective query of the PearlDiver database isolated 1,775,460 patients who underwent primary TKA from 2005 to 2014. Patients aged 80 and above represented the study cohort (n = 295,908) and patients 65 to 79 represented the control cohort (n = 1,479,552). Study group patients were matched to controls in a 1:5 ratio according to gender and medical comorbidities. Pearson’s Chi Square and logistic regression were used to analyze the primary outcomes of the study which included 90-day medical complications, 90-day readmission rates, 2-year implant-related complications, and in-hospital LOS. A p-value less than 0.001 was statistically significant.

RESULTS: Octogenarians were found to have significantly higher incidence and odds of 90-day readmission rates (10.59 vs. 9.35%; OR: 1.15, p < 0.0001) and significantly longer in-hospital LOS (3.69 days ± 1.95 vs. 3.23 days ± 1.83, p < 0.0001) compared to controls. Octogenarians also had equal incidence and odds of developing any medical complication (1.26 vs. 1.26%; OR: 0.99, p = 0.99) and lower incidence and odds (1.67 vs. 1.93%; OR: 0.86, p < 0.001) of implant-related complications compared to controls.

CONCLUSION: Octogenarians undergoing primary TKA have similar odds of medical related complications and lower odds of implant-related complications compared to non-octogenarian patients, whereas readmission rates and in-hospital LOS are greater.

PMID:35381573 | DOI:10.1016/j.knee.2022.03.012

Child Abuse Negl. 2022 Apr 2;128:105624. doi: 10.1016/j.chiabu.2022.105624. Online ahead of print.

ABSTRACT

BACKGROUND: Violence disclosure and help-seeking can mitigate adverse health effects associated with childhood violence, but little is known about facilitators and barriers of disclosure and help-seeking behaviors in sub-Saharan Africa.

OBJECTIVE: To understand factors associated with disclosure and help-seeking to inform care.

PARTICIPANTS AND SETTING: Participants aged 13-24 years old in the 2019 Namibia Violence Against Children and Youth Survey (VACS).

METHODS: We assessed the prevalence of victimization, disclosure, and help-seeking and examined factors associated with violence disclosure and help-seeking, separately, by gender.

RESULTS: 4211 girls and 980 boys participated in the Namibia VACS. The prevalence of childhood sexual violence differed significantly by gender (15.7% among girls, 9.8% among boys), but physical violence prevalence did not differ by gender. Among victims of sexual violence, 57.3% of girls disclosed and 10.4% sought help, compared with only 30.7% and 3.2% of boys. Among victims of physical violence, 61.1% of girls and 53.4% of boys disclosed, and 16.9% of girls and 17.7% of boys sought help. Older age, social support, and experiencing more types of violence were associated with sexual violence disclosure among boys, but none of these factors were associated with sexual violence disclosure among girls. Lower education, perpetrator type, and witnessing violence were associated with physical violence disclosure among girls, while peer support and perpetrator type were associated with physical violence disclosure among boys.

CONCLUSIONS: Factors associated with childhood violence differed by gender and violence type in Namibia, highlighting a need for gender-specific violence services to facilitate violence disclosure and help-seeking.

PMID:35381545 | DOI:10.1016/j.chiabu.2022.105624

Transl Oncol. 2022 Apr 2;20:101407. doi: 10.1016/j.tranon.2022.101407. Online ahead of print.

ABSTRACT

Brain tumors are the leading cause of cancer-related deaths in children. Tailored therapies need preclinical brain tumor models representing a wide range of molecular subtypes. Here, we adapted a previously established brain tissue-model to fresh patient tumor cells with the goal of establishing3D in vitro culture conditions for each tumor type.Wereported our findings from 11 pediatric tumor cases, consisting of three medulloblastoma (MB) patients, three ependymoma (EPN) patients, one glioblastoma (GBM) patient, and four juvenile pilocytic astrocytoma (Ast) patients. Chemically defined media consisting of a mixture of pro-neural and pro-endothelial cell culture medium was found to support better growth than serum-containing medium for all the tumor cases we tested. 3D scaffold alone was found to support cell heterogeneity and tumor type-dependent spheroid-forming ability; both properties were lost in 2D or gel-only control cultures. Limited in vitro models showed that the number of differentially expressed genes between in vitro vs. primary tissues, are 104 (0.6%) of medulloblastoma, 3,392 (20.2%) of ependymoma, and 576 (3.4%) of astrocytoma, out of total 16,795 protein-coding genes and lincRNAs. Two models derived from a same medulloblastoma patient clustered together with the patient-matched primary tumor tissue; both models were 3D scaffold-only in Neurobasal and EGM 1:1 (v/v) mixture and differed by a 1-mo gap in culture (i.e., 6wk versus 10wk). The genes underlying the in vitrovs. in vivo tissue differences may provide mechanistic insights into the tumor microenvironment. This study is the first step towards establishing a pipeline from patient cells to models to personalized drug testing for brain cancer.

PMID:35381525 | DOI:10.1016/j.tranon.2022.101407

J Biomech. 2022 Mar 29;136:111069. doi: 10.1016/j.jbiomech.2022.111069. Online ahead of print.

ABSTRACT

Advancements in technology and finite element software have made it possible to develop simulation-based exploration of subject-specific tibiofemoral joint kinematics. In this study, the goal was to develop baseline knee models that accurately predict anterior tibial displacement when undergoing a Lachman and pivot shift test. A total of 22 subject-specific adolescent tibiofemoral joint finite element representations were developed using FEBio. The models were subject to loading conditions established in the literature to simulate the two clinical tests. Anterior tibial translations that were measured through clinical, historical controls were used to validate the proposed models. A 95% confidence interval showed that the simulated Lachman and pivot shift tests of the juvenile knee models were not statistically different from the historical controls and were in accordance with the anterior tibial translations that were measured experimentally. Clinically, simulations are important in advancing the field of knee finite element modeling, particularly in pediatric applications where the surgeon must balance restoring full function in a patient who is skeletally immature and where the growth plate is vulnerable. The methodologies created in developing these foundational models can be utilized to build more anatomically complex finite element representations that can both predict ligament stresses in response to dynamic activities and analyze the effects of different insertion sites.

PMID:35381503 | DOI:10.1016/j.jbiomech.2022.111069

J Plant Physiol. 2022 Mar 26;272:153686. doi: 10.1016/j.jplph.2022.153686. Online ahead of print.

ABSTRACT

The color of plant leaves can be assessed qualitatively by color charts or after processing of digital images. This pilot study employed a novel pocket-sized sensor to obtain the color of plant leaves. In order to assess its performance, a color-dependent parameter (SPAD index) was used as the dependent variable, since there is a strong correlation between SPAD index and greenness of plant leaves. A total of 1,872 fresh and intact leaves from 13 crops were analyzed using a SPAD-502 meter and scanned using the Nix™ Pro color sensor. The color was assessed via RGB and CIELab systems. The full dataset was divided into calibration (70% of data) and validation (30% of data). For each crop and color pattern, multiple linear regression (MLR) analysis and multivariate modeling [least absolute shrinkage and selection operator (LASSO), and elastic net (ENET) regression] were employed and compared. The obtained MLR equations and multivariate models were then tested using the validation dataset based on r, R², root mean squared error (RMSE), and mean absolute error (MAE). In both RGB and CIELab color systems, the Nix™ Pro color sensor was able to differentiate crops, and the SPAD indices were successfully predicted, mainly for mango, quinoa, peach, pear, and rice crops. Validation results indicated that ENET performed best in most crops (e.g., coffee, corn, mango, pear, rice, and soy) and very close to MLR in bean, grape, peach, and quinoa. The correlation between SPAD and greenness is crop-dependent. Overall, the Nix™ Pro color sensor was a fast, sensible and an easy way to obtain leaf color directly in the field, constituting a reliable alternative to digital camera imagery and associated image processing.

PMID:35381493 | DOI:10.1016/j.jplph.2022.153686