Category: Statistics

Health Place. 2021 Jun 6;70:102599. doi: 10.1016/j.healthplace.2021.102599. Online ahead of print.

ABSTRACT

The role of intergenerational geographic proximity in individuals’ migration decisions has been well-established. The circumstances under which parents and their adult children move away from or remain close to each other are, however, less clear. Drawing on Norwegian register data for 2014-2016 and three-level logistic regression models, we examine whether formal care needs of older parents (aged ≥65) deter parent-child geographic divergence and whether variation in the likelihood of divergence is associated with municipal-level characteristics. After accounting for location-specific capital and parents’ and children’s sociodemographic characteristics, parents and children were less likely to diverge after the onset of parental care needs. Utilising in-home nursing decreased the likelihood of divergence for mothers while utilising institutionalised care decreased the likelihood of divergence for fathers. The use of in-home nursing care among single mothers further reduced the likelihood of divergence. Parents and adult children living in central areas were the least likely to diverge geographically. The likelihood of intergenerational divergence was lower for fathers and children living in municipalities with high healthcare spending.

PMID:34107444 | DOI:10.1016/j.healthplace.2021.102599

Heart Lung. 2021 Jun 6;50(5):714-719. doi: 10.1016/j.hrtlng.2021.04.018. Online ahead of print.

ABSTRACT

BACKGROUND: Pulmonary hypertension is a progressive, and disabling disease, however, there is little knowledge about impaired sexual function in this population.

AIM: To identify the prevalence of sexual dysfunction and the association between sexual dysfunction level and sociodemographic and clinical characteristics.

METHODS: A cross-sectional study with 71 women diagnosed with pulmonary hypertension without signs of clinical decompensation was carried out. Sexual function was assessed using the Female Sexual Function Index (FSFI) and functional capacity was assessed by 6-minute walk test. The relationships between sociodemographic and clinical characteristics with sexual function was performed using statistical tests. A p-value <0.05 was considered as significant.

RESULTS: 71.8% of patients self-reported sexual dysfunction as indicated as a score of <26.55 points on FSFI. Women with sexual dysfunction were older, higher average age of their last menstruation, had worse functional class, shorter distance covered and worse Borg score at the end of the 6-minute walk test.

CONCLUSION: There is evident impairment of sexual function self-reported by women with pH and the association of this condition with a decline in functional capacity was identified.

PMID:34107396 | DOI:10.1016/j.hrtlng.2021.04.018

Sci Total Environ. 2021 May 30;790:148148. doi: 10.1016/j.scitotenv.2021.148148. Online ahead of print.

ABSTRACT

The increasing salinization in the soil profile by irrigation water and groundwater upheaval is a widespread issue and considered as a major threat to agricultural production in arid and semi-arid regions. The present study aimed to propose a systematic SAR simulation involving the imaginary part of dielectric constant measurements of two consecutive seasons (dry and wet) to quantify and discriminate the irrigation-induced and upheaval-associated salinity from total salinity levels and investigate its impact on crop growth. The Sentinel-1 data of C-band frequency (5.36 GHz) acquired for both the dry and wet spells from 2015 to 2019 was instrumental in the present study. The total soil EC (Electrical Conductivity) was quantified from the imaginary part of dielectric constant (ε″) using semi-empirical microwave simulation “DSDM-SS”. Irrigation-induced salinity (ε_Irrigation″) and upheaval-associated salinity (ε_Upheaval″) were extracted from ε″ by proposing a site-, and climatic-specific novel model. The ε_Upheaval″ and ε_Irrigation″ have shown promising statistical significance with the in-situ soil EC (R² = 0.89, p = <0.001, rMSE = 1.08, Bias = 0.584) and groundwater EC measurements (R² = 0.85, p = <0.001, rMSE = 1.28, Bias = 1.16). The study found that the rate of salinity increase over time due to irrigation (77%) was considerably higher than the upheaval (42%) process. This demonstrated that the intensive use of groundwater for irrigation has a higher impact on vegetation vigor (θ = -0.87) than the upheaval process. The study revealed that crop failure in the dry season was provoked by osmotic stress and waterlogging conditions.

PMID:34107405 | DOI:10.1016/j.scitotenv.2021.148148

Water Res. 2021 May 27;201:117304. doi: 10.1016/j.watres.2021.117304. Online ahead of print.

ABSTRACT

Rising incidence of waterborne diseases including Legionellosis linked to low chlorine residuals in buildings and the availability of inexpensive testing options, create an opportunity for citizen science chorine monitoring to complement sampling done by water utilities. University researchers and Flint residents coordinated a citizen science chlorine surveillance campaign in Flint, Michigan in 2015-19, that helped expose the nature of two deadly Legionnaires Disease outbreaks in 2014-2015 during the Flint Water Crisis and progress of system recovery during the Federal emergency. Results obtained with an inexpensive color wheel were in agreement with a digital colorimeter (R² =0.99; p = 2.81 × 10^-21) at 15 sites geographically distributed across Flint. Blinded tests revealed good agreement between official (n = 2051) and citizen (n = 654) data in terms of determining whether regulatory guidelines for chlorine were met, but a discovery that the citizen data were statistically lower than the city’s (p<0.00001) especially in warm summer months led to recommendations for increased flushing of service lines before measurements. This work suggests that expanded citizen surveillance of chlorine, site specific flushing advice, and guidance on decisions about water heater set point could help consumers reduce Legionella risks in their homes. Citizen science initiatives for chlorine monitoring offer a unique opportunity for mutually beneficial collaborations between consumers and utilities to reduce the main source of waterborne disease in developed countries.

PMID:34107367 | DOI:10.1016/j.watres.2021.117304

Int J Drug Policy. 2021 Jun 5;95:103291. doi: 10.1016/j.drugpo.2021.103291. Online ahead of print.

ABSTRACT

BACKGROUND: Problem drinking and co-occurring depression symptoms affect men at high rates and are associated with increased risk of family violence. In low- and middle-income countries, there is a large treatment gap for services due to a lack of human resources. Moreover, masculine norms are a barrier to men seeking treatment for drinking and depression in healthcare settings. We examined an approach for engaging peer-fathers to deliver an intervention to reduce alcohol use, improve depressive symptoms, and increase family involvement among fathers in Kenya with problem drinking. The intervention-LEAD (Learn, Engage, Act, Dedicate)-combines motivational interviewing, behavioral activation, and masculinity discussion strategies.

METHODS: Community and religious leaders nominated fathers with no mental health training to serve as counselors (N=12); clients were recruited through community referrals. Nominated fathers completed a 10-day training beginning with treatment principles followed by manualized content. Three counselors were selected after training based on quantitative and qualitative assessments of communication skills, intervention knowledge, willingness to learn, ability to use feedback, and empathy. Supervision was tiered with local supervisors and clinical psychologist consultation. During LEAD delivery, counselor fidelity, delivery quality, and general and intervention-specific competencies were assessed. To evaluate acceptability, qualitative interviews were conducted with lay-counselors and clients (N=11). Descriptive statistics were calculated for quantitative outcomes; interviews were analyzed using thematic analysis.

RESULTS: Peer-father lay counselors treated nine clients, with eight completing treatment. Counselors reached high rates of fidelity (93.8%) and high to optimal ratings on quality of delivery, clinical competency, and intervention-specific competencies. Qualitative results suggested high acceptability, with counselors expressing satisfaction and empowerment in their roles. Clients likewise described positive experiences with counselors.

CONCLUSIONS: Findings provide initial support for the acceptability and feasibility of recruitment, selection, and training processes for peer-father lay counselors to deliver LEAD through a lens of masculinity that aligned with clients help-acceptance practices.

PMID:34107387 | DOI:10.1016/j.drugpo.2021.103291

Int J Nurs Knowl. 2021 Jun 9. doi: 10.1111/2047-3095.12338. Online ahead of print.

ABSTRACT

to analyze accuracy measures of the clinical indicators of Readiness for enhanced health management in patients with arterial hypertension and/or diabetes mellitus METHODS: prospective diagnostic accuracy study conducted with 359 patients with hypertension and/or diabetes mellitus, followed up in primary healthcare. Stratified random sampling was used to recruit participants. An assessment form was applied with sociodemographic data, health conditions, and information related to the clinical indicators under investigation. Sensitivity, specificity, predictive values, and likelihood ratios were analyzed FINDINGS: the sample was composed of 359 participants. The prevalence of Readiness for enhanced health management was 93.8%. There was a statistically significant association between the diagnosis and age under 60 years (p < 0.001), having only one chronic condition (p < 0.001), having normal blood pressure (p = 0.017) and blood glucose (p = 0.013) values, and having a nonsedentary (p = 0.026) and nonalcoholic (p = 0.044) lifestyle. All clinical indicators had high predictive values in predicting the nursing diagnosis under investigation. The indicator expresses desire to enhance management of symptoms was the most sensitive (99.7%) and specific (100%). The indicator expresses desire to enhance management of prescribed regimens was also highly specific (100%) CONCLUSION: all clinical indicators were accurate in predicting Readiness for enhanced health management IMPLICATIONS FOR NURSING PRACTICE: knowing which clinical indicators and sociodemographic/clinical characteristics best predict Readiness for enhanced health management, nurses in primary care can better plan nursing interventions and direct their goals.

PMID:34105897 | DOI:10.1111/2047-3095.12338

ACS Nano. 2021 Jun 9. doi: 10.1021/acsnano.0c10851. Online ahead of print.

ABSTRACT

Atomic structures and adatom geometries of surfaces encode information about the thermodynamics and kinetics of the processes that lead to their formation, and which can be captured by a generative physical model. Here we develop a workflow based on a machine-learning-based analysis of scanning tunneling microscopy images to reconstruct the atomic and adatom positions, and a Bayesian optimization procedure to minimize statistical distance between the chosen physical models and experimental observations. We optimize the parameters of a 2- and 3-parameter Ising model describing surface ordering and use the derived generative model to make predictions across the parameter space. For concentration dependence, we compare the predicted morphologies at different adatom concentrations with the dissimilar regions on the sample surfaces that serendipitously had different adatom concentrations. The proposed workflow can be used to reconstruct the thermodynamic models and associated uncertainties from the experimental observations of materials microstructures. The code used in the manuscript is available at https://github.com/saimani5/Adatom_interactions.

PMID:34105943 | DOI:10.1021/acsnano.0c10851

Int J Clin Pract. 2021 Jun 9:e14444. doi: 10.1111/ijcp.14444. Online ahead of print.

ABSTRACT

INTRODUCTION: Adverse drug reactions are an important public health concern that affects doctor and dentist prescriptions and healthcare workers’ practice. We planned to evaluate the knowledge, attitudes, and practices of healthcare workers in our country about drug hypersensitivity reactions in pediatric patients and to determine the risk factors that may affect them.

METHOD: This study was carried out in a capital-located university hospital. Healthcare workers who are authorized to intervene in children (0-18 age group) including medical doctors, nurses and dentists were enrolled to study. The study questionnaire was developed by pediatric allergy and immunology specialists and pediatric nurses by considering the other studies on the same subject.

RESULTS: 354(88.5%) out of 400 healthcare workers, whose study survey was distributed, returned to us by filling the questionnaire. According to the groups of the profession, there was a statistically significant difference between the average of correct answers given to the questions evaluating knowledge levels(p <0.001). The doctors’ knowledge score(mean ± SD 18.6 ± 2.1) was the highest. The general attitudes of healthcare workers towards drug hypersensitivity reactions in children were similar and were positive(p <0.053). However, general practice patterns were significantly different(p <0.001). Nurses were observed to practice more positively than doctors and dentists. As the healthcare worker gets older, his practice score increased by 0.546; on the other hand, being a resident reduced the score from the practice score by 3,770.

CONCLUSION: Our results suggest that advanced training programs must be provided for healthcare workers in learning drug hypersensitivity reactions, particularly in pediatric patients.

PMID:34105870 | DOI:10.1111/ijcp.14444

Cancer Med. 2021 Jun 9. doi: 10.1002/cam4.4033. Online ahead of print.

ABSTRACT

BACKGROUND: Given the growing incidence and aggressive biological behavior of proximal gastric cancer (PGC) as reported, it is important to understand which regional or racial populations are at poor prognosis so that interventions can be treated appropriately. We sought to explore regional treatment differences as well as racial genes influence survival outcomes in China and the US patients with PGC.

METHODS: PGC patients defined as tumors with the epicenter located in cardia (C16.0) or fundus (C16.1) from 1996 to 2016 were identified from the Surveillance Epidemiology and End Results (SEER) in the United States as well as data from a high-volume National Cancer Center Database in China. Overall survival (OS) curves were plotted for different regional or racial groups, respectively, using the Kaplan-Meier method and compared statistically using the log-rank test. Differentially expressed genes (DEGs) analysis was performed using TCGA database.

RESULTS: Finally, the cohort consistent of 40973 PGC patients who enrolled in SEER database (n = 36305) or China National Cancer Center (n = 4668), and divided into 4 racial groups: Chinese (n = 5179), Black (n = 2429), White (n = 31185), and Others (n = 2096). After controlling for confounding variables, racial factors were independently associated with poor survival included Black ethnicity (HR = 1.376, 95% CI: 1.066-1.7760, p = 0.014) and White ethnicity (HR = 1.262, 95% CI: 1.005-1.583, p = 0.045) when compared to Chinese ethnicity in total PGC patients. Even in the same region for only US group, Chinese PGC patients also showed better prognosis.

CONCLUSIONS: In conclusion, we demonstrated the different survival outcomes of PGC patients in different regions or races from two high-volume database SEER and China National Cancer Center database. These survival differences are likely influenced by a number of factors (e.g., access to screening, quality of gastrectomy, neo/adjuvant therapy, and biological genes itself). More importantly, a better understanding of these disparities could lead to interventions that may help to abolish these disparities.

PMID:34105890 | DOI:10.1002/cam4.4033

Int Wound J. 2021 Jun 9. doi: 10.1111/iwj.13638. Online ahead of print.

ABSTRACT

Fat grafting is a well-established method in plastic surgery. Despite many technical advances, standardised recommendations for the use of prophylactic antibiotics in fat grafting are not available. This retrospective multicentre study aims to analyse the use of prophylactic antibiotics in fat grafting and to compare complication rates for different protocols. A retrospective medical chart review of 340 patients treated with fat grafting of the breast from January 2007 to March 2019 was performed in three plastic surgery centres. Complications, outcomes, and antibiotic regimes were analysed. The Clavien-Dindo classification was applied. All patients received perioperative antibiotic prophylaxis: 33.8% (n = 115) were treated with a single shot (group 1), 66.2% (n = 225) received a prolonged antibiotic scheme (group 2). There was no significant difference in the number of sessions (P = .475). The overall complication rate was 21.6% (n = 75), including graft resorption, fat necrosis, infection, and wound healing problems. Complication rates were not significantly different between groups. Risk factors for elevated complication rates in this specific patient group are smoking, chemotherapy, and irradiation therapy. The complication rate for lipografting of the breast is low, and it is not correlated to the antibiotic protocol. The use of prolonged prophylactic antibiotics does not lower the complication rate.

PMID:34105891 | DOI:10.1111/iwj.13638