Category: Statistics

Nurse Educ Pract. 2021 Jun 3;54:103111. doi: 10.1016/j.nepr.2021.103111. Online ahead of print.

ABSTRACT

AIM: This study aims to determine the relationship between smartphone use among intern nursing students, fear of missing out and their care-related behaviour.

BACKGROUND: Today, smartphone use is common and fear of missing out is a prominent issue in our society; this behaviour and issue are linked and may lead to adverse consequences.

DESIGN: The study is conducted as a cross-sectional design.

METHODS: The target population in this research consists of senior nursing students (n = 101). There was no sampling selection and the study was completed with 97 students who agreed to participate in the research. Data were collected with introductory questionnaire forms, the Smartphone Addiction Scale (SAS), the Fear of Missing Out Scale (FoMOs) and the Caring Assessment Questionnaire (Care-Q). The valid and reliable SAS, FoMOs and Care-Q were transformed into online forms and the link was distributed to the participants via online Google forms.

RESULTS: Based on the results of the study, the mean scores were 83.30 ± 2.21 of SAS, 21.56 ± 6.42 for FOMOs and 5.54 ± 0.87 for Care-Q scale. There were statistically significant differences between gender and Care-Q score and between the duration of smartphone use, daily smartphone usage time and SAS score (p < 0.05). There was a weak positive relationship between SAS and FoMOs scale scores, along with a weak negative relationship between the accessibility and comfort sub-dimensions of the SAS and Care-Q scale. Also, the SAS score explains 0.4% of the comfort subscale of the Care-Q scale (p < 0.05).

CONCLUSIONS: Further research focusing on nursing students is recommended to identify potential adverse effects created by the use of smartphones and the fear of missing out. In addition, educators are recommended to develop guidelines and prepare new policies for smartphone use to minimise the potential negative effects of smartphone use and fear of missing out on student care behaviour.

PMID:34118778 | DOI:10.1016/j.nepr.2021.103111

Breast. 2021 Jun 2;59:16-26. doi: 10.1016/j.breast.2021.05.011. Online ahead of print.

ABSTRACT

Sweden has a population-based mammography screening programme for women aged 40-74. The objective of this study was to examine the association between mammography screening attendance and sociodemographic factors in 15 of Sweden’s 21 health care regions. Register-based information was collected on all mammography screening invitations and attendance during 2017 and 2018, and linked to individual-level sociodemographic data from Statistics Sweden. Odds ratios (ORs) and 95% confidence intervals (CIs) for attendance were computed by sociodemographic factor. The study sample included 1.5 million women, aged 40-75, with an overall screening attendance of 81.3%. The lowest odds of attending were found for women living without a partner (OR = 0.52, 95% CI: 0.52-0.53), low-income women (OR = 0.57, 95% CI: 0.56-0.57), and non-Nordic women born in Europe (OR = 0.60, 95% CI: 0.59-0.61). Other groups with lower odds of attending were women whose main source of income was social assistance or benefits (OR = 0.62, 95% CI: 0.62-0.63), those not owning their home (OR = 0.66, 95% CI: 0.66-0.67), and those with low level of education (OR = 0.72, 95% CI: 0.71-0.73). Having multiple of these sociodemographic characteristics further lowered the odds of attending. Although overall mammography screening attendance in Sweden is high, sociodemographic inequalities exist, and efforts should be made to address these. Particular attention should be given to low-income women who live without a partner.

PMID:34118780 | DOI:10.1016/j.breast.2021.05.011

Arch Oral Biol. 2021 Jun 6;129:105184. doi: 10.1016/j.archoralbio.2021.105184. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to systematically review the associations between periodontal diseases/tooth loss and sleep duration/quality.

MATERIAL AND METHODS: PubMed, Scopus, and Embase databases were searched (up to May 2021) to identify studies that assessed the association between periodontal diseases or number of teeth with sleep quality and sleep duration. Two researchers independently selected the studies and extracted the data. Considering the high heterogeneity among the included studies, meta-analysis was deemed unviable. Results are presented descriptively for sleep quality (studies that have used PSQI), self-reported sleep hours, and other tools that assessed sleep patterns.

RESULTS: Twenty studies (16 cross-sectional, two case-control, and two cohort) were included. Eight studies used the Pittsburgh Sleep Quality Index (PSQI) to assess quality of sleep. Six of these studies demonstrated that individuals with worse periodontal conditions demonstrated poorer sleep quality. However, most of the included studies that performed adjusted analysis showed no statistically significant association between self-reported hours of sleep and periodontitis. The mean number of present teeth was assessed in four studies; three of them demonstrated lower numbers of present teeth in individuals with inadequate sleep.

CONCLUSION: The literature shows conflicting results for the association between sleep hours and periodontitis. However, inadequate sleep may be associated with lower number of present teeth and periodontal diseases. Further studies are necessary in order to confirm these results.

PMID:34118748 | DOI:10.1016/j.archoralbio.2021.105184

J Infect Public Health. 2021 Apr 24;14(7):832-838. doi: 10.1016/j.jiph.2021.04.006. Online ahead of print.

ABSTRACT

BACKGROUND: Estimated seroprevalence of Coronavirus Infectious Disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) is a critical evidence for a better evaluation of the virus spread and monitoring the progress of COVID-19 pandemic in a population. In the Kingdom of Saudi Arabia (KSA), SARS-CoV-2 seroprevalence has been reported in specific regions, but an extensive nationwide study has not been reported. Here, we report a nationwide study to determine the prevalence of SARS-CoV-2 in the population of KSA during the pandemic, using serum samples from healthy blood donors, non-COVID patients and healthcare workers (HCWs) in six different regions of the kingdom, with addition samples from COVID-19 patients.

METHODS: A total of 11,703 serum samples were collected from different regions of the KSA including; 5395 samples from residual healthy blood donors (D); 5877 samples from non-COVID patients collected through residual sera at clinical biochemistry labs from non-COVID patients (P); and 400 samples from consented HCWs. To determine the seroprevalence of SARS-CoV-2, all serum samples, in addition to positive control sera from RT-PCR confirmed COVID-19 patients, were subjected to in-house ELISA with a sample pooling strategy, which was further validated by testing individual samples that make up some of the pools, with a statistical estimation method to report seroprevalence estimates.

RESULTS: Overall (combining D and P groups) seroprevalence estimate was around 11% in Saudi Arabia; and was 5.1% (Riyadh), 1.5% (Jazan), 18.4% (Qassim), 20.8% (Hail), 14.7% (ER; Alahsa), and 18.8% in Makkah. Makkah samples were only D group and had a rate of 24.4% and 12.8% in the cities of Makkah and Jeddah, respectively. The seroprevalence in Saudi Arabia across the sampled areas would be 12 times the reported COVID-19 infection rate. Among HCWs, 7.5% (4.95-10.16 CI 95%) had reactive antibodies to SARS-CoV-2 without reporting any previously confirmed infection. This was higher in HCWs with hypertension. The study also presents the demographics and prevalence of co-morbidities in HCWs and subset of non-COVID-19 population.

INTERPRETATION: Our study estimates the overall national serological prevalence of COVID-19 in Saudi Arabia to be 11%, with an apparent disparity between regions. This indicates the prevalence of asymptomatic or mild unreported COVID-19 cases.

PMID:34118732 | DOI:10.1016/j.jiph.2021.04.006

J Infect Public Health. 2021 Apr 23;14(7):863-875. doi: 10.1016/j.jiph.2021.04.005. Online ahead of print.

ABSTRACT

The ongoing coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global public health problem. The SARS-CoV-2 triggers hyper-activation of inflammatory and immune responses resulting in cytokine storm and increased inflammatory responses on several organs like lungs, kidneys, intestine, and placenta. Although SARS-CoV-2 affects individuals of all age groups and physiological statuses, immune-compromised individuals such as pregnant women are considered as a highly vulnerable group. This review aims to raise the concerns of high risk of infection, morbidity and mortality of COVID-19 in pregnant women and provides critical reviews of pathophysiology and pathobiology of how SARS-CoV-2 infection potentially increases the severity and fatality during pregnancy. This article also provides a discussion of current evidence on vertical transmission of SARS-CoV-2 during pregnancy and breastfeeding. Lastly, guidelines on management, treatment, preventive, and mitigation strategies of SARS-CoV-2 infection during pregnancy and pregnancy-related conditions such as delivery and breastfeeding are discussed.

PMID:34118736 | DOI:10.1016/j.jiph.2021.04.005

J Subst Abuse Treat. 2021 Apr 28;130:108440. doi: 10.1016/j.jsat.2021.108440. Online ahead of print.

ABSTRACT

BACKGROUND: The Veterans Health Administration (VHA) has made significant improvements in increasing prescribing of medication treatment for opioid use disorder (MOUD) and medication treatment for alcohol use disorder (MAUD); however, several barriers to treatment retention remain. In an effort to improve MOUD/MAUD retention, a Veterans Affairs (VA) facility established a pharmacist-led substance use disorder (SUD) transitions of care telephone clinic for patients discharged from an inpatient hospitalization on MOUD/MAUD, including buprenorphine/naloxone (BUP/NAL) and extended-release (ER) naltrexone injections. Pharmacists within the clinic assess aspects of treatment retention such as medication tolerability, perceived barriers to continuing treatment, status of current prescriptions, and appointment coordination.

OBJECTIVES: The primary objective of this study was to evaluate the impact of a pharmacist-led SUD transitions of care telephone clinic on MOUD/MAUD retention following inpatient initiation in patients with opioid use disorder (OUD) and/or alcohol use disorder (AUD). Secondary objectives included subanalyses of clinic impact on MOUD/MAUD retention based on study medication or diagnoses, health care utilization, and characterization of pharmacist interventions.

METHODS: The study identified patients for inclusion from inpatient units at a VA hospital. The study included patients if they were >18 years of age, had a diagnosis of AUD and/or OUD, and were initiated on ER naltrexone or BUP/NAL during admission and continued at discharge from August 1, 2018, to December 31, 2019. The study excluded patients if they declined clinic involvement, transferred facilities, moved beyond the VA catchment area, or were unable to be reached for initial contact after 3 telephone attempts. The intervention group included patients enrolled in the pharmacist-led SUD transitions of care telephone clinic, while the control group included patients initiated on MOUD/MAUD during admission who were eligible but not referred for clinic enrollment.

RESULTS/CONCLUSIONS: The study identified a total of 150 patients for inclusion (n = 54 intervention group; n = 96 control group). The study observed a statistically significant difference for the primary endpoint of combined 1- and 3-month MOUD/MAUD retention rates as measured by a continuous, multiple-interval measure of medication acquisition (CMA) of ER naltrexone and BUP/NAL for the intervention group vs. control group (1-month: 77.3% vs. 56.8%, p = 0.004; 3-month: 71.4% vs. 48%, p = 0.0002). When analyzed by study medication, we also observed a statistically significant improvement in continuous use of ER naltrexone for those enrolled in the clinic (1-month: 71.4% vs. 45.9%, p = 0.01; 3-month: 66.7% vs. 34.4%, p = 0.0003). The study did not observe any statistically significant improvements for BUP/NAL (1-month: 87.1% vs. 75.8%, p = 0.13; 3-month: 79.4% vs. 68.5%, p = 0.24) or establishment with a BUP/NAL clinic (90.5% vs. 80% patients established, p = 0.46). Likewise, the study did not observe any statistically significant differences for combined emergency department (ED) visits (1-month: 24.1% vs.17.1% patients with ED visit, p = 0.40; 3-month: 31.5% vs. 29.2% patients with ED visit, p = 0.85) or hospitalizations (1-month: 9.3% vs. 14.6% re-hospitalization, p = 0.45; 3-month: 14.8% vs. 26% re-hospitalization, p = 0.15) for those in the intervention group vs. the control group. Overall, the study observed statistically and clinically significant improvements in MOUD/MAUD retention rates for patients enrolled in a pharmacist-led SUD transitions of care telephone clinic.

PMID:34118708 | DOI:10.1016/j.jsat.2021.108440

Soc Sci Med. 2021 May 31;281:114090. doi: 10.1016/j.socscimed.2021.114090. Online ahead of print.

ABSTRACT

BACKGROUND: Promoting good hand hygiene in older children is an important measure to reduce the burden of common diseases such as diarrhoea and acute respiratory infections. The evidence around what works to change this behaviour, however, is unclear.

OBJECTIVES: To aid future intervention design and effective use of resources, this review aims to identify the individual components used in hand hygiene interventions and assesses their contribution to intended behavioural change.

METHODS: We systematically searched seven databases for experimental studies evaluating hand hygiene interventions targeting children (age 5-12) and quantitively reporting hand hygiene behaviour. Interventions in each study were categorised as ‘promising’, or ‘non-promising’ according to whether they led to a positive change in the targeted behaviour. Behaviour change techniques (BCTs) were identified across interventions using a standard taxonomy and a novel promise ratio calculated for each (the ratio of promising to non-promising interventions featuring the BCT). ‘Promising’ BCTs were those with a promise ratio of ≥2. BCTs were ranked from most to least promising.

RESULTS: Our final analysis included 19 studies reporting 22 interventions across which 32 unique BCTs were identified. The most frequently used were ‘demonstration of the behaviour’, ‘instruction on how to perform the behaviour’ and ‘adding objects to the environment’. Eight BCTs had a promise ratio of ≥2 and the five most promising were ‘demonstration of the behaviour’, ‘information about social and environmental consequences’, ‘salience of consequences’, ‘adding objects to the environment’, and ‘instruction on how to perform the behaviour’.

CONCLUSIONS: Our findings suggest that hand hygiene interventions targeting older children should employ a combination of promising BCTs that ensure children understand the behaviour and the consequences of their hand hygiene habits, appropriate hardware is available, and social support is provided. Researchers are encouraged to consistently and transparently describe evaluated interventions to allow promising components to be identified and replicated.

PMID:34118686 | DOI:10.1016/j.socscimed.2021.114090

J Neurol Sci. 2021 Jun 1;427:117518. doi: 10.1016/j.jns.2021.117518. Online ahead of print.

ABSTRACT

BACKGROUND: Age-related white matter lesions (WML) are common, impact neuronal connectivity, and affect motor function and cognition. In addition to pathological nigrostriatal losses, WML are also common co-morbidities in Parkinson’s disease (PD) that affect postural stability and gait. Automated brain volume measures are increasingly incorporated into the clinical reporting workflow to facilitate precision in medicine. Recently, multi-modal segmentation algorithms have been developed to overcome challenges with WML quantification based on single-modality input.

OBJECTIVE: We evaluated WML volumes and their distribution in a case-control cohort of PD patients to predict the domain-specific clinical severity using a fully automated multi-modal segmentation algorithm.

METHODS: Fifty-five subjects comprising of twenty PD patients and thirty-five age- and gender-matched control subjects underwent standardized motor/gait and cognitive assessments and brain MRI. Spatially differentiated WML obtained using automated segmentation algorithms on multi-modal MPRAGE and FLAIR images were used to predict domain-specific clinical severity. Preliminary statistical analysis focused on describing the relationship between WML and clinical scores, and the distribution of WML by brain regions. Subsequent stepwise regressions were performed to predict each clinical score using WML volumes in different brain regions, while controlling for age.

RESULTS: WML volume strongly correlates with both motor and cognitive dysfunctions in PD patients (p < 0.05), with differential impact in the frontal lobe and periventricular regions on cognitive domains (p < 0.01) and severity of motor deficits (p < 0.01), respectively.

CONCLUSION: Automated multi-modal segmentation algorithms may facilitate precision medicine through regional WML load quantification, which show potential as imaging biomarkers for predicting domain-specific disease severity in PD.

PMID:34118693 | DOI:10.1016/j.jns.2021.117518

J Subst Abuse Treat. 2021 Jun 3;130:108521. doi: 10.1016/j.jsat.2021.108521. Online ahead of print.

ABSTRACT

BACKGROUND: Methadone use for the management of opioid dependency during pregnancy is commonplace. Methadone levels are altered during pregnancy due to changes in maternal physiology. Despite this, a paucity of data exist regarding the most appropriate optimal dosing regimens during pregnancy.

METHODS: This study applied a pharmacokinetic modeling approach to examine gestational changes in R- and S-methadone concentrations in maternal plasma and fetal (cord) blood. This study did so to derive a theoretical optimal dosing regimen during pregnancy, and to identify the impact of Cytochromes P450 (CYP) 2B6 and 2C19 polymorphisms on methadone maternal and fetal pharmacokinetics.

RESULTS: The study noted significant decreases in maternal R- and S-methadone plasma concentrations during gestation, with concomitant increases in fetal levels. At a dose of 90 mg once daily, 75% (R-) and 94% (S-) of maternal methadone trough levels were below the lower therapeutic window at term (week 40). The developed optimal dosing regimen escalated doses to 110 mg by week 5, followed by 10 mg increments every 5 weeks up to a maximum of 180 mg once daily near term. This increase resulted in 27% (R-) and 11% (S-) of subjects with trough levels below the lower therapeutic window at term. CYP2B6 poor metabolizers (PM) and either CYP2C19 extensive metabolizers (EM), PM, or ultra-rapid (UM) metabolizer phenotypes demonstrated statistically significant increases in concentrations when compared to their matched CYP2B6 EM counterparts.

CONCLUSIONS: Specific and gestation-dependent dose titrations are required during pregnancy to reduce the risks associated with illicit drug use and to maintain fetal safety.

PMID:34118695 | DOI:10.1016/j.jsat.2021.108521

Sci Total Environ. 2021 Jun 3;791:148127. doi: 10.1016/j.scitotenv.2021.148127. Online ahead of print.

ABSTRACT

In order to trace the sources of sediment materials and trace metals in the Weser River system (Germany), and the riverine input to the North Sea, Sr, Nd and Pb isotopes, together with multi-elemental compositions, were measured for sediments collected over the entire Weser River Basin, from headwaters to the estuary. Mass fractions of metals, including Ag, Cd, and Pb, and of one metalloid, Sb, higher than their crustal abundance, were observed within the entire Weser Basin. Isotope-amount ratio n(⁸⁷Sr)/n(⁸⁶Sr) and ε_Nd ranged from 0.71182 ± 0.00005 to 0.72880 ± 0.00009 and -11.3 ± 0.3 to -21.0 ± 0.3, respectively. n(²⁰⁶Pb)/n(²⁰⁴Pb), n(²⁰⁷Pb)/n(²⁰⁴Pb), and n(²⁰⁸Pb)/n(²⁰⁴Pb) ranged from 18.226 ± 0.008 to 18.703 ± 0.012, 15.613 ± 0.007 to 15.653 ± 0.012 and 38.14 ± 0.02 to 38.84 ± 0.02, respectively. Sr and Nd isotope compositions reflected primarily a mixture of natural materials derived from the Weser Basin. Pb isotope signatures indicated strong anthropogenic influences in the middle-lower Weser region. Pb isotopic compositions in the sediments from the Aller (tributary of the Weser) and its tributary suggested influence from historical Pb-Zn ore mining in the Harz Mountains that might contribute to the observed elevated mass fractions of Ag, Cd, Sb and Pb in that region. K-means cluster and principal component analysis of the Sr, Nd, and Pb isotope data yielded results consistent with their isotope systematics, supporting statistical analysis as an unsupervised tool in isotope fingerprinting studies. Sr, Nd, and Pb isotopic signatures in the sediments of the Weser were distinctively different from those of another major river discharging into the North Sea, the Elbe. This suggested that this Sr, Nd, and Pb isotope dataset can be used to distinguish riverine input of sediment materials and metals between the two rivers, thereby assessing their individual contribution to materials transported into the North Sea.

PMID:34118659 | DOI:10.1016/j.scitotenv.2021.148127