Category: Statistics

Womens Health (Lond). 2026 Jan-Dec;22:17455057261424102. doi: 10.1177/17455057261424102. Epub 2026 Apr 6.

ABSTRACT

BACKGROUND: Postnatal care (PNC) is recommended as a means of preventing maternal mortality during the postpartum period, but many women in low- and middle-income countries do not access care during this period.

OBJECTIVE: We set out to examine sociocultural preferences that have been portrayed as barriers to care.

DESIGN: We designed a qualitative study using the Health Equity Implementation Framework (HEIF).

METHODS: We performed an abductive analysis of 63 semi-structured interviews with women who had recently given birth in three regions of Ethiopia using the HEIF and an inductive-deductive codebook to understand why women in Ethiopia do not use recommended PNC.

RESULTS: We found that, in many cases, health providers do not consider women’s cultural safety a primary need, but rather as a barrier to care. However, women’s perceived refusal to participate in postnatal visits was, for many, an expression of agency and assertion of their needs for cultural safety.

CONCLUSION: We propose adding cultural safety to HEIF as a process outcome so that implementers consider cultural needs in a dynamic manner that does not ask patients to choose between meeting their cultural needs and receiving necessary health care during the postnatal period.

PMID:41937658 | DOI:10.1177/17455057261424102

Prog Community Health Partnersh. 2026;20(1):23-35. doi: 10.1353/cpr.2026.a987070.

ABSTRACT

BACKGROUND: In King County, Washington, the new HIV diagnosis rate is 10 times higher among African immigrants than the general population. Many African immigrants report never testing for HIV due to various reasons, including inaccessible testing, stigma around HIV and testing, and concerns over jeopardizing their immigration status.

OBJECTIVES: We partnered with the Ethiopian Community in Seattle, the Eritrean Health Board, and the Congolese United Foundation to deliver community-based HIV testing via health fairs at faith-based organizations in King County. We also worked to address community-level HIV-related stigma HIV through pilot implementation of an existing workshop intervention.

METHODS: We held four health fairs from September 2023 to April 2024 at three faith-based organizations, including free point-of-care HIV and other health screenings. Participants completed questionnaires related to sociodemographics and HIV testing history and stigma. Additionally, we adapted and piloted a faith-based HIV stigma reduction intervention called Project FAITHH.

RESULTS: There were 105 health fair attendees and 11 Project FAITHH workshop participants across the three communities. Sixty (52%) were women, 62 (54%) were from Ethiopia and Eritrea, and 85 (74%) had health insurance at the time. Seventy-two (69%) participants underwent HIV testing at the health fairs. Commonly perceived barriers to accessing HIV testing include fear of discovering their results, concerns about privacy and confidentiality, and anxiety about HIV-related stigma.

CONCLUSIONS: Building relationships between academic researchers, community organizations, and faith-based organizations can improve the acceptability of and access to HIV testing among African immigrant communities by addressing perceived barriers to HIV testing.

PMID:41937644 | DOI:10.1353/cpr.2026.a987070

Int J Dev Neurosci. 2026 Apr;86(2):e70121. doi: 10.1002/jdn.70121.

ABSTRACT

BACKGROUND: Pharmacotherapy plays an essential role in managing neurodevelopmental and psychiatric disorders in children, although most psychotropic medications are prescribed off-label. Caregivers’ hesitation toward medication remains an important issue in child psychiatry practice. This study aimed to investigate caregivers’ concerns and expectations regarding pharmacotherapy for their children and identify factors associated with their willingness to medicate.

METHODS: This cross-sectional study was conducted between August and December 2023 at the Center for Child Health, Behavior, and Department, University Hospital, Japan. Primary caregivers of children aged 2-15 years attending follow-up outpatient visits completed structured questionnaires assessing their concerns, expectations, and perceived treatment purposes. Descriptive statistics and multivariate logistic regression analyses were performed to identify predictors of caregivers’ willingness to medicate.

RESULTS: A total of 212 caregivers (92.5% mothers) participated. The most frequent diagnosis reported was autism spectrum disorder (47.6%), followed by attention deficit/hyperactivity disorder (25.5%). The leading concerns regarding pharmacotherapy were long-term medication use (56.1%), side effects (43.4%) and dependence (41.0%). Over 90% of caregivers expected child psychiatrists to provide supportive opportunities for both children and caregivers. Logistic regression analysis revealed that concern about long-term medication use was significantly associated with a positive attitude toward pharmacotherapy (p < 0.001). Caregivers’ perceived distress regarding their children’s problems, measured using a visual analogue scale, significantly decreased from 7.9 ± 2.0 at the initial visit to 5.3 ± 2.2 at present under medical care (paired t-test, p < 0.001).

CONCLUSIONS: Long-term pharmacotherapy remains a major concern among caregivers in child psychiatry, indicating the need for clinicians to address it earnestly.

PMID:41937632 | DOI:10.1002/jdn.70121

Alzheimers Dement. 2026 Apr;22(4):e71333. doi: 10.1002/alz.71333.

ABSTRACT

INTRODUCTION: The trajectories of cognitive decline before and after new-onset dual sensory impairment (DSI) remain largely unknown.

METHODS: Participants were included without DSI at baseline and with at least two recorded cognitive measures. A linear mixed-effects model was used to analyze the trend of cognitive function changes over time before and after DSI.

RESULTS: The annual rate of cognitive decline was similar at baseline between individuals who experienced DSI onset and individuals with non-DSI. After the DSI onset, the slope of global cognitive decline in the DSI group was statistically different from that in the non-DSI group (in the China Health and Retirement Longitudinal Study, β: -0.098 standard deviation [SD]/year; 95% confidence interval [CI]: -0.145 to -0.050. In the English Longitudinal Study of Ageing, β: -0.085 SD/year; 95% CI: -0.165 to -0.006).

DISCUSSION: Participants experienced accelerated cognitive decline upon developing new-onset DSI. Incident DSI is associated with accelerated cognitive decline after, but not before, the event.

PMID:41937619 | DOI:10.1002/alz.71333

Phytother Res. 2026 Apr 6. doi: 10.1002/ptr.70321. Online ahead of print.

ABSTRACT

Most Germans consider herbal medicinal products (HMPs) to be an important supplement to conventional medicine. Despite existing clinical evidence for safety and efficacy, they are still not sufficiently integrated into drug therapy of gynaecological complaints in everyday practice. By analysing patient-reported outcomes (PROs), this gap in medical care can be closed. Real-world data was extracted from the pharmaco-epidemiological database PhytoVIS. We analysed a sample (n = 1658) containing PROs from women who utilised HMPs to treat their gynaecological complaints applying descriptive and non-parametric bivariate statistical tests. Perceived effectiveness and tolerability of HMPs was rated as very good. For the treatment of menstrual complaints, Vitex agnus-castus L. was primarily used, and Actaea racemosa L. for menopausal complaints. Various herbal drugs were applied for uncomplicated urinary tract infections (uUTIs), but mainly Arctostaphylos uva-ursi (L.) Spreng. Regarding the pharmaceutical form, herbal teas were preferred for the treatment of uUTIs or by very young or elderly women. All other pharmaceutical forms were favoured for menstrual and menopausal complaints or middle-aged women. The pharmaceutical form did not impact the perceived therapeutic effectiveness. Our results provide valuable insights into patient preferences and show options for their integration into existing treatment strategies. By identifying the most popular and efficacious plants for certain gynaecological ailments, we support healthcare providers to better address the growing demand for complementary treatment options. This knowledge helps in tailoring healthcare to meet patient needs and to ensure the safety and efficacy of HMPs.

PMID:41937616 | DOI:10.1002/ptr.70321

Cardiovasc Ther. 2026;2026(1):e6940329. doi: 10.1155/cdr/6940329.

ABSTRACT

BACKGROUND: Sedentary behavior has become a major global public health challenge and is closely associated with cardiovascular disease (CVD). Sedentary behavior not only increases the risk of various chronic diseases but also poses significant threats to cardiovascular health. Existing studies suggest that sedentary behavior is an independent risk factor for CVD, but the underlying mechanisms across different populations remain inadequately explored.

METHODS: This study analyzed data from 31,034 participants in the National Health and Nutrition Examination Survey (NHANES) to investigate the relationship between sedentary behavior and CVD. Standardized questionnaires were used to collect sociodemographic and health information. Statistical analyses, including weighted t-tests, forest plots, logistic regression, and restricted cubic spline regression, were employed to examine the effects of sedentary time on CVD and related influencing factors.

RESULTS: The findings indicated that prolonged sedentary time was significantly associated with an increased risk of CVD, particularly among individuals aged 60 and older (OR = 17.297, p < 0.001) Factors such as age, gender, and hyperlipidemia played a critical role in the relationship between sedentary behavior and CVD. Restricted cubic spline regression analysis revealed that CVD risk increased markedly after 250 min of sedentary time, with a pronounced rise after 750 min. Multivariate regression analysis also confirmed the negative impact of sedentary behavior on cardiovascular health.

CONCLUSION: Sedentary behavior is a significant independent risk factor for CVD, and reducing sedentary time is associated with a lower CVD risk. Enhancing public awareness of the hazards of sedentary behavior and implementing effective interventions, especially for the elderly, may contribute to improved cardiovascular health.

PMID:41937611 | DOI:10.1155/cdr/6940329

J Psychiatr Ment Health Nurs. 2026 Apr 6. doi: 10.1111/jpm.70127. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of art therapy in improving depressive and anxiety symptoms among adults with depression.

DESIGN: A systematic review and meta-analysis.

METHODS: Seven databases were searched from inception to November 14, 2025. Randomized controlled trials (RCTs) and quasi-experimental studies evaluating art therapy for adults with clinically diagnosed or screened depression were included. Two reviewers independently performed study selection, data extraction and quality assessment using Cochrane Risk of Bias 2.0 (RoB 2.0) and the Joanna Briggs Institute (JBI) checklist. Standardized mean differences (SMDs) were pooled using random-effects models, with subgroup and sensitivity analyses conducted to explore heterogeneity.

RESULTS: Fourteen studies (861 participants) were included in the systematic review, and 13 contributed data to the meta-analysis. Art therapy produced a significant reduction in depressive symptoms compared with control conditions (SMD = -0.69, 95% CI: -1.04 to -0.35; z = 3.92, p < 0.001). Effects on anxiety symptoms were small and not statistically significant. Exploratory subgroup analyses suggested larger effects in older adults, interventions lasting > 6 weeks, story therapy, individual formats and community settings. However, substantial heterogeneity and the inclusion of trials at risk of bias warrant cautious interpretation. Sensitivity analyses indicated stable results across model specifications.

CONCLUSION: Art therapy appears to be a promising intervention for improving depressive symptoms among adults with depression. In contrast, the result regarding anxiety outcomes is limited, with only three studies contributing data. High-quality studies with large samples, multiple centres and long follow-up durations should be performed to further reliably assess the treatment effects.

TRIAL REGISTRATION: PROSPERO registration number: CRD420251229306.

PMID:41937601 | DOI:10.1111/jpm.70127

Chronobiol Int. 2026 Apr 6:1-14. doi: 10.1080/07420528.2026.2650828. Online ahead of print.

ABSTRACT

Delayed-onset muscle soreness can hinder athletic performance by impairing recovery processes. Adequate and restorative sleep plays a crucial role in regulating hormonal balance, cardiovascular adaptation, and muscle tissue repair. However, intense exercise often disturbs sleep quality, thereby prolonging recovery. This study aimed to investigate whether improving sleep quality through melatonin supplementation could indirectly influence recovery parameters, including flexibility, cardiovascular indices, and muscle damage biomarkers, in active athletes. Twenty-four male athletes (18-25 y) from multiple sports, including soccer, basketball, volleyball, and athletics, participated. Participants (N = 24) were randomly assigned to a Melatonin group (3 mg/d for 5 nights before sleep at 10.00 PM, n = 12) or a Placebo group (n = 12). All subjects performed 30 min of eccentric plyometric exercise. Sleep quality was monitored using Fitbit Charge 3 devices, which have been validated against polysomnography for field use. Blood samples were collected pre-exercise and at 24-, 48-, 72-, and 96-h post-exercise to determine CK, IL-6, TNF-α, LDH, MYO, and AST levels. Melatonin supplementation significantly improved total sleep duration, flexibility scores, and resting heart rate compared to placebo (p < 0.05). However, melatonin did not produce statistically significant effects on muscle damage biomarkers (CK, LDH, MYO, AST, IL-6, TNF-α). These findings indicate that melatonin primarily enhances sleep and may aid cardiovascular recovery, with limited direct influence on biochemical markers of muscle damage after acute eccentric overload exercise. Low-dose melatonin supplementation may serve as a supportive, non-pharmacological strategy to improve sleep quality in athletes. While it did not significantly reduce biochemical indicators of muscle damage and cardiovascular recovery, the improved sleep-related recovery suggests potential indirect benefits for overall post-exercise adaptation.

PMID:41937599 | DOI:10.1080/07420528.2026.2650828

Asian Spine J. 2026 Apr 6. doi: 10.31616/asj.2025.0356. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective, cross-sectional study.

PURPOSE: Injuries to the lumbar spine may alter the lumbar intervertebral space (LIVS). This study aimed to establish the LIVS Dictionary, a standardized anatomical reference system for LIVS, and to evaluate its ability to detect ligamentous injuries using sex-specific normative data.

OVERVIEW OF LITERATURE: This study presents the first computed tomography (CT)-based LIVS Dictionary from 457 asymptomatic subjects. It identifies sex-specific differences, age-linked degeneration patterns, and demonstrates its utility in detecting anterior ligament injuries, particularly among females.

METHODS: Enhanced whole-abdominal CT scans from 457 asymptomatic adults were retrospectively analyzed to construct the LIVS Dictionary. Seven anatomical regions encompassing 28 LIVS parameters were quantified using 3D Slicer. A validation cohort of 87 patients with five distinct types of lumbar fractures was included. Statistical analyses involved t -tests, Cohen’s d, uniform manifold approximation and projection clustering, and Elastic Net receiver operating characteristic (ROC) curve analysis with 95% confidence intervals (CIs).

RESULTS: Most LIVS parameters were significantly larger in males (25 of 28 parameters, p<0.05), particularly in the anterior regions. Age analysis revealed sex-specific degeneration patterns: males showed progressive LIVS reduction with age, whereas females exhibited localized decline after 80 years. Incidental anatomical variants included lumbarization in 5.25% and sacralization in 1.09% of the healthy cohort. Among fracture types, transverse process fractures produced the greatest LIVS alterations. The Elastic Net model demonstrated excellent predictive performance (area under the ROC curve=0.90; 95% CI, 0.88-0.92; accuracy=0.94).

CONCLUSIONS: Lumbar spine injuries produce quantifiable alterations in LIVS morphology. The LIVS Dictionary provides a validated framework for identifying these changes and captures sex-, age-, and fracture-related morphological variations with high diagnostic robustness. This framework establishes a foundation for clinical evaluation, biomechanical modeling, and forensic applications related to spinal stability.

PMID:41937573 | DOI:10.31616/asj.2025.0356

Addiction. 2026 Apr 6. doi: 10.1111/add.70411. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Cannabis use disorder (CUD) is a pressing public health concern in the United States, and understanding trends in prevalence requires considerations of how changes in measurement influence identification of CUD. Starting in 2021, the National Survey on Drug Use and Health (NSDUH) assessed CUD using all 11 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria in their entire sample; before then, studies could use a nine-criteria DSM-5-proxy measure based on shared DSM-IV criteria. We aimed to identify sociodemographic characteristics associated with additionally identified CUD when using the full DSM-5 measure compared with the DSM-5-proxy measure.

DESIGN: Observational study using nationally representative data.

SETTING: United States.

PARTICIPANTS: 39 973 participants ages 12 + who reported past-year cannabis use in the 2021-2023 NSDUH (weighted N = 57 872 556).

MEASUREMENTS: Additionally identified mild, moderate, or severe CUD was defined as meeting 2-3, 4-5, or 6 + of the 11 DSM-5 criteria and not meeting the same thresholds with the nine DSM-5-proxy criteria. Multinomial logistic regression models compared characteristics of people with additionally identified mild (vs. none), moderate (vs. mild), and severe (vs. moderate) CUD. We also calculated the percentage of people meeting each of the 11 criteria who had additionally identified CUD.

FINDINGS: Among people who reported past-year cannabis use, 30.5% had DSM-5 CUD, including 7.9% with additionally identified mild CUD not previously identified using the DSM-5-proxy measure, 6.9% with additionally identified moderate CUD and 3.4% with additionally identified severe CUD. People who were younger (vs. 35-49); multiracial (vs. white); non-Hispanic American Indian or Alaska Native (vs. white); or publicly insured or uninsured (vs. privately insured only) were more likely to have additionally identified CUD and/or CUD severity. People who were older (vs. 35-49); Hispanic (vs. white); were non-Hispanic Asian, Native Hawaiian, or Pacific Islander (vs. white); reported female sex (vs. male); or had annual income greater than $75 000 (vs. <$20 000) were less likely to have additionally identified CUD and/or CUD severity. Additionally identified CUD was most common among those meeting “craving” (25.0%), “withdrawal” (20.3%), and “spending time” (14.8%) criteria.

CONCLUSIONS: The full Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) measure of cannabis use disorder (CUD) additionally identified CUD differentially across sociodemographic groups in the United States, compared with the DSM-5-proxy measure. Some groups (e.g., people younger than 35 years old, people with any public or no insurance, and people who are multi-racial or non-Hispanic American Indian or Alaska Native) may need more CUD-related services and support than previously expected.

PMID:41937566 | DOI:10.1111/add.70411