Category: Statistics

Nurse Educ. 2025 Apr 10. doi: 10.1097/NNE.0000000000001869. Online ahead of print.

ABSTRACT

BACKGROUND: Despite playing an important role in patient care and advocacy, nurses are consistently underrepresented and quoted in <4% of health care media coverage. Media training may address this gap.

PURPOSE: The aims of this study were to develop, implement, and evaluate a media training program to assess whether, after program completion, nurses experience improvements in belief, understanding, confidence, and commitment toward media engagement.

METHODS: A program was developed based on the 10 published media competencies for nurses and assessed using Kirkpatrick’s evaluation model. A prospective pre-post observational study design was used.

FINDINGS: Participants self-reported improvement in all measured categories. Paired t-tests showed statistical significance in understanding the media’s benefit in promoting population health (P = .026) and increased confidence in performing necessary media skills (P = .0005).

CONCLUSION: Developing a media training program for nurses is a critical first step. The findings underscore the importance of equipping nurses with the skills and confidence necessary for impactful media engagement.

PMID:40209267 | DOI:10.1097/NNE.0000000000001869

Gac Med Mex. 2024;160(6):613-618. doi: 10.24875/GMM.24000311.

ABSTRACT

BACKGROUND: Guillain-Barré syndrome (GBS) is associated with 20% rate of long-term disability. This study explores the pathophysiology of GBS and the mechanism of intravenous immunoglobulin (IVIg).

OBJECTIVE: To investigate whether elevated immunoglobulin G (IgG) levels following IVIg administration are linked to improved recovery of independent walking at 6 months.

MATERIAL AND METHODS: A retro-prospective observational study was conducted. IgG levels were measured before treatment, 7- and 30-days post-initiation. Binary regression analysis assessed the impact of individual factors on prognosis and sequelae. The Kaplan-Meier curve was used to evaluate the proportion of patients who couldn´t walk unaided.

RESULTS: Forty-two patients were included. The mean baseline IgG level was 832.25 mg/dl, increasing to 3053.48 mg/dl at 7 days and decreasing to 1091.72 mg/dl at 30 days. IgG increases at 7 days were categorized into quartiles. Patients with a low increase in IgG levels (< 1945.5 mg/dl) at 7 days exhibited more severe clinical manifestations, including greater needs for invasive mechanical ventilation and increased autonomic dysfunction. Also had poorer walking outcomes at 6 months.

CONCLUSIONS: Lower increase in IgG levels at 7 days post-treatment is associated with a worse prognosis at 6 months, including a reduced likelihood of walking unaided.

PMID:40209256 | DOI:10.24875/GMM.24000311

Gac Med Mex. 2024;160(6):578-584. doi: 10.24875/GMM.M24000907.

ABSTRACT

BACKGROUND: Diabetic retinopathy (DR) being a leading cause of blindness. Identifying the risk factors for patients with a higher risk of vision loss is crucial.

OBJECTIVE: To identify the risk factors for urgent referrals in diabetic patients through an ophthalmic examination program.

MATERIAL AND METHODS: Specific criteria for urgent referral were established to facilitate attendance. Risk factors related to urgent referral were evaluated in a multiple logistic regression model.

RESULTS: A total of 1,265 patients were screened. 678 (54%) had DR, 245 (19.4%) had diabetic macular edema, and 124 (10%) had visually significant cataracts. 399 (31.4%) patients needed urgent referral. Significant risk factors for urgent referral were 10 to 20 years from diabetes diagnosis (OR = 5.71, p < 0.001), more than 20 years from diabetes diagnosis (OR = 15.36, p < 0.001), high systolic blood pressure (OR = 1.66 per mmHg, p = 0.003), and high HbA1c (OR = 1.15, p = 0.002), after adjusting for sex and age.

CONCLUSIONS: A third of the patients require urgent referral. Main causes of urgent referral were DME, severe or worse DR, cataract and high intraocular pressure. Principal risk factors were diabetes duration, systolic blood pressure and HbA1c.

PMID:40209252 | DOI:10.24875/GMM.M24000907

Gac Med Mex. 2024;160(6):627-638. doi: 10.24875/GMM.M24000956.

ABSTRACT

BACKGROUND: In higher education institutions, the analysis of academic trajectories is key to evaluating training, which can generate interventions to promote regularity and improve terminal efficiency.

OBJECTIVE: To analyze the differences in the academic trajectories of the student body of the 2001 to 2018 generations of the medical degree at the National Autonomous University of Mexico (UNAM).

MATERIAL AND METHODS: A longitudinal comparative study was conducted with 18,739 UNAM Faculty of Medicine students, integrated by real cohorts from 2001 to 2018. Survival functions were adjusted with the KaplanMeier method and a Cox proportional hazards model was adjusted to evaluate the effect of sex and high school of origin. Failure in first-year students was also analyzed.

RESULTS: The study demonstrated that sex and baccalaureate history are variables that impact failure and consequently regularity and terminal efficiency.

CONCLUSIONS: Due to a lower failure rate, there is a higher regularity and terminal efficiency in men compared to women, and in those that were admitted from external baccalaureates or the National Preparatory School, compared to those from the College of Sciences and Humanities.

PMID:40209250 | DOI:10.24875/GMM.M24000956

Gac Med Mex. 2024;160(6):619-626. doi: 10.24875/GMM.M24000960.

ABSTRACT

BACKGROUND: The standardized assessment of the hypoplastic nasal bone (NB) by ultrasonography between 11-14 weeks’ gestation has value in the detection of fetal aneuploidies. The frequency of hypoplastic NB varies between populations and is unknown in Mexico.

OBJECTIVE: To analyze the performance of hypoplastic NB for the early detection of fetal aneuploidies in a Mexican population.

MATERIAL AND METHODS: A nested case-control study in a cohort of Mexican pregnant women. The inclusion criteria were live fetus with crown-rump length (CRL) 45-84 mm and the result of perinatal karyotype or phenotype at birth. Ultrasonographic assessment of the NB was standardized. The statistical analyses were univariable, multiple logistic regression, Bayes’ theorem and performance.

RESULTS: A total of 65 cases and 1187 controls were studied, with maternal age of 1753 years. The frequency of hypoplastic NB was 1.6% (95% CI, 0.9-2.3) in euploid fetuses versus 44.6% (95% CI, 32.5-56.7) with aneuploidies (p < 0.001, X²). Sensitivity for trisomy 21 was 58.3% (PPV 52.5%, NPV 98.7%). The probability of the hypoplastic NB was conditioned by aneuploidy (type), CRL, and nuchal translucency. The C-statistic of the Bayesian model was 0.904 (95% CI, 0.842-0.965).

CONCLUSIONS: A Mexican model of the NB had added value in the early detection of fetal aneuploidies.

PMID:40209249 | DOI:10.24875/GMM.M24000960

Gac Med Mex. 2024;160(6):585-593. doi: 10.24875/GMM.M24000958.

ABSTRACT

BACKGROUND: The pandemic effects on the mental health of health care personnel is a public health problem.

OBJECTIVE: To determine factors associated with psychopathological symptomatology in undergraduate medical students.

MATERIAL AND METHODS: 2961 students from four generations answered the GHQ-28 online: n₁. Pre-pandemic (n = 758) n2. Initial phase (n = 581), n₃. Acute phase (n = 705), and n₄. Protected return phase (n = 917), between August 2019 and September 2022. Using multivariable logistic regression models, factors associated (sociodemographic and clinical) with psychopathological symptomatology were identified.

RESULTS: 51.9% of students presented symptomatology, with a higher prevalence of depressive symptoms (22.9%), and somatic and sleep disturbance (11.1%). The pandemic phase (n₂: OR, 12.69; n₃: OR, 8.45; n₄: OR, 5.62), having a personal history of major depression (OR, 4.35), family history of depression (OR, 1.96), limited (OR, 1.54) and insufficient economic resources (OR, 2.09) and being female (OR, 1.46) were significantly associated with symptomatology.

CONCLUSIONS: The pandemic influenced the mental health of undergraduate medical students. Actions aimed at promoting healthy educational environments, and strategies for prevention and care of psychopathological symptomatology are necessary.

PMID:40209244 | DOI:10.24875/GMM.M24000958

Gac Med Mex. 2024;160(6):602-612. doi: 10.24875/GMM.24000279.

ABSTRACT

BACKGROUND: Mexico is one of the countries with the highest case-fatality ratio due to COVID-19.

OBJECTIVE: Explore the reasons for not getting vaccinated against COVID-19.

MATERIAL AND METHODS: A nationwide telephone survey, comprising all 32 states of Mexico, was conducted to examine associations between inoculation against COVID-19 and other characteristics, the chi-square test and logistic regression analysis were applied.

RESULTS: Out of 3 126 adults, 68% reported complete vaccination, 21% the first dose, 11% remained unvaccinated. Using logistic regression models: place of residence -Other central state and State of Mexico-, being single, lower education level, younger age, lower BMI, not getting tested for COVID-19, and the perception of COVID-19 as unreal and not severe, were all significantly associated with non-vaccination, i.e. not receiving any dose of anti-COVID vaccine. The predominant reasons for not getting vaccinated were: 63% “external barriers” (e.g., not being able to attend an appointment), and 37% “internal motives” (e.g., considering that the vaccine does not work).

CONCLUSIONS: The causes of non-vaccination against COVID-19 are related to social and geographical determinants. Addressing external barriers is necessary to promote equity in vaccination. Reviewing the results in the context of earlier studies on the willingness to vaccinate, the gap between intention and vaccination is notable.

PMID:40209243 | DOI:10.24875/GMM.24000279

JMIR Aging. 2025 Apr 10;8:e64324. doi: 10.2196/64324.

ABSTRACT

BACKGROUND: Digital technology in dementia is an area of great development with varying experiences across countries. However, novel digital solutions often lack a patient-oriented perspective, and several relevant barriers prevent their use in clinics.

OBJECTIVE: In this study, we reviewed the existing literature on knowledge, familiarity, and competence in using digital technology and on attitude and experiences with digital tools in Alzheimer disease. The main research question is whether digital competence and attitudes of patients and caregivers may affect the adoption of digital technology.

METHODS: Following the PRISMA guidelines, a literature search was conducted by two researchers in the group. Inter-rater reliability was calculated with Cohen κ statistics. The risk of bias assessment was also recorded.

RESULTS: Of 597 initial records, only 18 papers were considered eligible. Analyses of inter-rater reliability showed good agreement levels. Significant heterogeneity in study design, sample features, and measurement tools emerged across studies. Quality assessment showed a middle-high overall quality of evidence. The main factors affecting the adoption of digital technology in patients and caregivers are severity of cognitive deficits, timing of adoption, and the availability of training and support. Additional factors are age, type of digital device, and ease of use of the digital solution.

CONCLUSIONS: Adoption of digital technology in dementia is hampered by many patient-related barriers. Improving digital competence in patient-caregiver dyads and implementing systematic, patient-oriented strategies for the development and use of digital tools are needed for a successful incorporation of digital technology in memory clinics.

PMID:40209218 | DOI:10.2196/64324

JMIR Infodemiology. 2025 Apr 10;5:e55065. doi: 10.2196/55065.

ABSTRACT

BACKGROUND: Social media holds an increasingly significant position in contemporary society, wherein evolving public perspectives are mirrored by changing information. However, there remains a lack of comprehensive analysis regarding the nature and evolution of dental health care information on Chinese social media platforms (SMPs) despite extensive user engagement and voluminous content.

OBJECTIVE: This study aimed to probe into the nature and evolution of dental health care information on Chinese SMPs from 2018 to 2022, providing valuable insights into the evolving digital public perception of dental health for dental practitioners, investigators, and educators.

METHODS: This study was conducted on 3 major Chinese SMPs: Weibo, WeChat, and Zhihu. Data from March 1 to 31 in 2018, 2020, and 2022 were sampled to construct a social media original database (ODB), from which the most popular long-text posts (N=180) were selected to create an analysis database (ADB). Natural language processing (NLP) tools were used to assist tracking topic trends, and word frequencies were analyzed. The DISCERN health information quality assessment questionnaire was used for information quality evaluation.

RESULTS: The number of Weibo posts in the ODB increased approximately fourfold during the observation period, with discussion of orthodontic topics showing the fastest growth, surpassing that of general dentistry after 2020. In the ADB, the engagement of content on Weibo and Zhihu also displayed an upward trend. The overall information quality of long-text posts on the 3 platforms was moderate or low. Of the long-text posts, 143 (79.4%) were written by nonprofessionals, and 105 (58.3%) shared personal medical experiences. On Weibo and WeChat, long-text posts authored by health care professionals had higher DISCERN scores (Weibo P=.04; WeChat P=.02), but there was a negative correlation between engagement and DISCERN scores (Weibo tau-b [τb]=-0.45, P=.01; WeChat τb=-0.30, P=.02).

CONCLUSIONS: There was a significant increase in the dissemination and evolution of public interest in dental health care information on Chinese social media during 2018-2022. However, the quality of the most popular long-text posts was rated as moderate or low, which may mislead patients and the public.

PMID:40209216 | DOI:10.2196/55065

J Med Internet Res. 2025 Apr 10;27:e68936. doi: 10.2196/68936.

ABSTRACT

BACKGROUND: Diabetes mellitus significantly increases the risk of severe complications from influenza, necessitating targeted vaccination efforts. Despite vaccination being the most effective preventive measure, coverage remains below the World Health Organization’s targets, partly due to limited awareness among patients. This study evaluated a digital health intervention aimed at improving influenza vaccination rates among adults with diabetes.

OBJECTIVE: This study aimed to demonstrate the effectiveness of digital health platforms in increasing vaccination rates among people with diabetes and to emphasize the impact of tailored messaging frequency on patient engagement and health behavior change. We hypothesized that digital tools providing empirical evidence of increased health risk awareness can effectively drive preventive actions.

METHODS: The study leveraged the Dario (Dario Health Corp) digital health platform to retrospectively analyze data from 64,904 users with diabetes assigned by the platform into three groups: (1) Group A received previously studied monthly flu nudge messages; (2) Group B received an adapted intervention with 2-3 monthly messages; (3) Group C served as the control with no intervention. Surveys were conducted at baseline, 3 months, and 6 months to assess vaccination status, awareness of influenza risks, and recollection of educational content. Statistical analyses, including logistic regression, chi-square tests, and t tests, were used to evaluate differences between groups.

RESULTS: Out of 64,904 users, 8431 completed the surveys. Vaccination rates were 71.0% in group A, 71.9% in group B, and 70.5% in group C. Group B showed significantly higher awareness of influenza risks compared with the control group odds ratio (OR; OR 1.35, 95% CI 1.12-1.63; P=.001), while group A did not (OR 1.10, 95% CI 0.92-1.32; P=.27). Recollection of educational content was also higher in groups A (OR 1.29, 95% CI 1.07-1.56; P=.008) and B (OR 1.92, 95% CI 1.59-2.33; P<.001) compared with the control. In addition, a significant correlation between awareness and vaccination rates was found only in group B (χ²(df=1)=6.12, P=.01).

CONCLUSIONS: The adapted digital intervention (group B) effectively increased awareness of influenza risks and recollection of educational content, which correlated with the higher trend in vaccination rates. This study demonstrates the potential of digital health tools to enhance influenza vaccination among people with diabetes by improving risk awareness and education. Further research should focus on optimizing these interventions to achieve significant improvements in vaccination uptake and overall public health outcomes.

TRIAL REGISTRATION: ClinicalTrials.gov NCT06840236; https://clinicaltrials.gov/study/NCT06840236.

PMID:40209214 | DOI:10.2196/68936