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Nevin Manimala Statistics

Translation, cultural adaptation and validity assessment of the Dutch version of the eHealth Literacy Questionnaire: a mixed-method approach

BMC Public Health. 2023 May 30;23(1):1006. doi: 10.1186/s12889-023-15869-4.

ABSTRACT

BACKGROUND: The digitalization of healthcare requires users to have sufficient competence in using digital health technologies. In the Netherlands, as well as in other countries, there is a need for a comprehensive, person-centered assessment of eHealth literacy to understand and address eHealth literacy related needs, to improve equitable uptake and use of digital health technologies.

OBJECTIVE: We aimed to translate and culturally adapt the original eHealth Literacy Questionnaire (eHLQ) to Dutch and to collect initial validity evidence.

METHODS: The eHLQ was translated using a systematic approach with forward translation, an item intent matrix, back translation, and consensus meetings with the developer. A validity-driven and multi-study approach was used to collect validity evidence on 1) test content, 2) response processes and 3) internal structure. Cognitive interviews (n = 14) were held to assess test content and response processes (Study 1). A pre-final eHLQ version was completed by 1650 people participating in an eHealth study (Study 2). A seven-factor Confirmatory Factor Analysis (CFA) model was fitted to the data to assess the internal structure of the eHLQ. Invariance testing was performed across gender, age, education and current diagnosis.

RESULTS: Cognitive interviews showed some problems in wording, phrasing and resonance with individual’s world views. CFA demonstrated an equivalent internal structure to the hypothesized (original) eHLQ with acceptable fit indices. All items loaded substantially on their corresponding latent factors (range 0.51-0.81). The model was partially metric invariant across all subgroups. Comparison of scores between groups showed that people who were younger, higher educated and who had a current diagnosis generally scored higher across domains, however effect sizes were small. Data from both studies were triangulated, resulting in minor refinements to eight items and recommendations on use, score interpretation and reporting.

CONCLUSION: The Dutch version of the eHLQ showed strong properties for assessing eHealth literacy in the Dutch context. While ongoing collection of validity evidence is recommended, the evidence presented indicate that the eHLQ can be used by researchers, eHealth developers and policy makers to identify eHealth literacy needs and inform the development of eHealth interventions to ensure that people with limited digital access and skills are not left behind.

PMID:37254148 | DOI:10.1186/s12889-023-15869-4

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Nevin Manimala Statistics

Predictors of desire to limit childbearing among reproductive age women in high fertility regions in Ethiopia. A multilevel mixed effect analysis

BMC Public Health. 2023 May 30;23(1):1011. doi: 10.1186/s12889-023-15952-w.

ABSTRACT

BACKGROUND: A high fertility rate can have a number of expensive consequences for developing nations, such as limiting economic growth, adversely impacting women and their children’s health, and reducing access to quality education, nutrition, and employment. The problem is more obvious in Ethipia’s high fertility regions. Therefore, this study aimed to assess predictors of desire to limit childbearing among reproductive age women in high fertility regions in Ethiopia.

METHODS: The analysis was based on secondary data using the 2016 Ethiopian Demographic and Health Survey. Stata version 14 software was used for analysis. A multi-level mixed-effect logistic regression analysis was fitted. Adjusted Odds Ratio at 95% confidence interval was used to show the strength and direction of the association. Statistical significance was declared at a P- value less than 0.05.

RESULTS: The overall desire to limit childbearing in high fertility regions in Ethiopia was 37.7% (95% CI: 36.28, 39.17). Age; 25-34 (AOR = 3.74; 95% CI: 2.97, 4.73), 35-49 years (AOR = 14; 95% CI: 10.85, 18.06), women education; Primary education (AOR = 0.73; 95% CI: 0.61, 0.88), secondary and higher (AOR = 0.29; 95% CI: 0.19, 0.43), from the community level variables Oromia National Regional state (AOR = 5.86; 95% CI: 2.82, 12.23), high proportion of community level poverity (AOR = 0.67; 95% CI: 0.45, 0.98), and high proportion of community level media exposure (AOR = 1.53; 95% CI: 1.07, 2.19) were statistically significant factors for desire to limit childbearing in high fertility regions of Ethiopia.

CONCLUSION: Nearly four in ten women had the desire to limit childbearing in high fertility regions in Ethiopia. Thus, to fulfill the women’s desire to limit childbearing, Ministry of Health and health facilities are needed to increase financial support strategies and Family planning programs that enable pregnant women from poor households to use health services. In addition, increasing community level media exposure are important interventions.

PMID:37254145 | DOI:10.1186/s12889-023-15952-w

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Nevin Manimala Statistics

Socioeconomic and geographical inequalities in health care coverage in Mozambique: a repeated cross-sectional study of the 2015 and 2018 national surveys

BMC Public Health. 2023 May 30;23(1):1007. doi: 10.1186/s12889-023-15988-y.

ABSTRACT

BACKGROUND: Over the past years, Mozambique has implemented several initiatives to ensure equitable coverage to health care services. While there have been some achievements in health care coverage at the population level, the effects of these initiatives on social inequalities have not been analysed.

OBJECTIVE: The present study aimed to assess changes in socioeconomic and geographical inequalities (education, wealth, region, place of residence) in health care coverage between 2015 and 2018 in Mozambique.

METHODS: The study was based on repeated cross-sectional surveys from nationally representative samples: the Survey of Indicators on Immunisation, Malaria and HIV/AIDS in Mozambique (IMASIDA) 2015 and the 2018 Malaria Indicator survey. Data from women of reproductive age (15 to 49 years) were analysed to evaluate health care coverage of three indicators: insecticide-treated net use, fever treatment of children, and use of Fansidar malaria prophylaxis for pregnant women. Absolute risk differences and the slope index of inequality (SII) were calculated for the 2015 survey period and the 2018 survey period, respectively. An interaction term between the socioeconomic and geographical variables and the period was included to assess inequality changes between 2015 and 2018.

RESULTS: The non-use of insecticide-treated nets dropped, whereas the proportion of women with children who were not treated for fever and the prevalence of women who did not take the full Fansidar dose during pregnancy decreased between 2015 and 2018. Significant reductions in the inequality related to insecticide-treated net use were observed for all socioeconomic variables. Concerning fever treatment, some reductions in socioeconomic inequalities were observed, though not statistically significant. For malaria prophylaxis, the SII was significant for education, wealth, and residence in both periods, but no significant inequality reductions were observed in any of these variables over time.

CONCLUSIONS: We observed significant reductions of socioeconomic inequalities in insecticide-treated net use, but not in fever treatment of children and Fansidar prophylaxis for pregnant women. Decision-makers should target underserved populations, specifically the non-educated, poor, and rural women, to address inequalities in health care coverage.

PMID:37254141 | DOI:10.1186/s12889-023-15988-y

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Nevin Manimala Statistics

Publication rates of congress abstracts is associated with abstract quality: Evaluation of Turkish National Medical Education Congresses and Symposia between 2010 and 2014 using MERSQI

BMC Med Educ. 2023 May 30;23(1):394. doi: 10.1186/s12909-023-04383-1.

ABSTRACT

There are many parameters that could be used to evaluate the quality of scientific meetings such as publication rates of meeting abstracts as full-text articles after the meeting or scoring with validated quality scales/tools that evaluate individual papers, project proposals, or submitted abstracts. This study aimed to determine the full-text publication rates for abstracts presented at Turkish National Medical Education Congresses and Symposia and to assess the quality of given abstracts. Abstracts presented at national medical education congresses and symposia between 2010 and 2014 in Türkiye were evaluated. Initially, the abstracts were evaluated if they were published as full-text articles in international and national peer-reviewed journals following the meeting. Secondly, the quality of presented abstracts was assessed with the Medical Education Research Study Quality Instrument (MERSQI) scale. Overall publication rate for the abstracts was 11.3%. The publication rate of oral and poster presentations were 26.6% and 8.1%, respectively. Oral presentations had a statistically higher publication rate than poster presentations (p = .000). The mean MERSQI score for abstracts was 7.73 ± 2.59. The oral presentations had higher MERSQI mean scores than poster presentations (8.28 ± 2.46 vs. 7.61 ± 2.6; p = .032). Similarly, published abstracts had a significantly higher score compared to unpublished abstracts (10.07 ± 2.74 vs. 7.43 ± 2.41; p = .000). Interestingly, there was no statistical difference between the mean MERSQI scores of the published oral and poster presentations (9.33 ± 2.45 vs. 10.61 ± 2.72; p = .101). This study showed that the main factor for a meeting abstract to be published as a full-text article is the scientific quality of the study. The quality of presentations at annual medical education meetings in Türkiye were low compared with international meetings which did not improve over five years. An institutional policy that would set quality standards for medical education research and increase the awareness of researchers on the topic might help improve the design, execution, and reporting of such studies in Türkiye. The MERSQI could be a valuable tool to monitor the quality of submitted abstracts and to increase the awareness of novice researchers on high quality research.

PMID:37254136 | DOI:10.1186/s12909-023-04383-1

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Nevin Manimala Statistics

Co-infection patterns in the ectoparasitic community affecting the Iberian ibex Capra pyrenaica

Parasit Vectors. 2023 May 30;16(1):172. doi: 10.1186/s13071-023-05797-y.

ABSTRACT

BACKGROUND: Sarcoptic mange is one of the main parasitic diseases affecting the Iberian ibex Capra pyrenaica. Scabietic animals suffer a decline in body condition and reproductive fitness and in severe cases may die. Although several previous studies of the pathology of this disease and the physiological changes it produces in ibex have been carried out in recent years, our knowledge of the relationship between Sarcoptes scabiei and other ectoparasites of this host is still limited.

METHODS: We analysed 430 Iberian ibex skin samples. Ectoparasites were removed, counted and identified. Mite (S. scabiei) numbers were obtained after digesting the skin samples in a 5% KOH solution. We modelled mite numbers in terms of host sex and age, site, year, season and the presence of other ectoparasites such as ticks and lice using generalized linear mixed models (GLMMs) and ectoparasite co-occurrence patterns using two different models: the probabilistic model species co-occurrence and the generalized linear latent variable model (GLLVM).

RESULTS: The ectoparasite community was mainly composed of S. scabiei, six ticks (Haemaphysalis sulcata, Haemaphysalis punctata, Rhipicephalus bursa, Rhipicephalus turanicus, Dermacentor marginatus and Ixodes ricinus) and two lice (Bovicola crassipes and Linognathus stenopsis). Adult male ibex harboured more mites than females. Mite numbers varied greatly spatially and seasonally and increased with the presence of other parasites. Some positive co-occurrence relationships between pairs of different ectoparasites were observed, particularly between ticks. The presence of S. scabiei negatively affected lice and H. sulcata numbers.

CONCLUSIONS: Sarcoptic mange has spread above all in ibex populations in and around the Mediterranean Basin, where it is now found in almost a third of its host’s range. Mite numbers varied seasonally and spatially and were higher in male hosts. The presence of S. scabiei had a negative effect on lice numbers but favoured the presence of ticks.

PMID:37254132 | DOI:10.1186/s13071-023-05797-y

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Nevin Manimala Statistics

Are we equally at risk of changing smoking behavior during a public health crisis? Impact of educational level on smoking from the TEMPO cohort

BMC Public Health. 2023 May 30;23(1):1016. doi: 10.1186/s12889-023-15799-1.

ABSTRACT

BACKGROUND: The COVID-19 pandemic as a public health crisis has led to a significant increase in mental health difficulties. Smoking is strongly associated with mental health conditions, which is why the pandemic might have influenced the otherwise decline in smoking rates. Persons belonging to socioeconomically disadvantaged groups may be particularly affected, both because the pandemic has exacerbated existing social inequalities and because this group was more likely to smoke before the pandemic. We examined smoking prevalence in a French cohort study, focusing on differences between educational attainment. In addition, we examined the association between interpersonal changes in tobacco consumption and educational level from 2018 to 2021.

METHODS: Using four assessments of smoking status available from 2009 to 2021, we estimated smoking prevalence over time, stratified by highest educational level in the TEMPO cohort and the difference was tested using chi2 test. We studied the association between interpersonal change in smoking status between 2018 and 2021 and educational attainment among 148 smokers, using multinomial logistic regression.

RESULTS: Smoking prevalence was higher among those with low education. The difference between the two groups increased from 2020 to 2021 (4.8-9.4%, p < 0.001). Smokers with high educational level were more likely to decrease their tobacco consumption from 2018 to 2021 compared to low educated smokers (aOR = 2.72 [1.26;5.89]).

CONCLUSION: Current findings showed a widening of the social inequality gap in relation to smoking rates, underscoring the increased vulnerability of persons with low educational level to smoking and the likely inadequate focus on social inequalities in relation to tobacco control policies during the pandemic.

PMID:37254131 | DOI:10.1186/s12889-023-15799-1

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Nevin Manimala Statistics

Measuring the intensity of mental healthcare: development of the Mental Healthcare Intensity Scale (MHIS)

BMC Psychiatry. 2023 May 30;23(1):377. doi: 10.1186/s12888-023-04752-6.

ABSTRACT

BACKGROUND: There are considerable differences among mental healthcare services, and especially in developed countries there are a substantial number of different services available. The intensity of mental healthcare has been an important variable in research studies (e.g. cohort studies or randomized controlled trials), yet it is difficult to measure or quantify, in part due to the fact that the intensity of mental healthcare results from a combination of several factors of a mental health service. In this article we describe the development of an instrument to measure the intensity of mental healthcare that is easy and fast to use in repeated measurements.

METHODS: The Mental Healthcare Intensity Scale was developed in four stages. First, categories of care were formulated by using focus group interviews. Second, the fit among the categories was improved, and the results were discussed with a sample of the focus group participants. Third, the categories of care were ranked using the Segmented String Relative Rankings algorithm. Finally, the Mental Healthcare Intensity Scale was validated as a coherent classification instrument.

RESULTS: 15 categories of care were formulated and were ranked on each of 12 different intensities of care. The Mental Healthcare Intensity Scale is a versatile questionnaire that takes 2-to-3 min to complete and yields a single variable that can be used in statistical analysis.

CONCLUSIONS: The Mental Healthcare Intensity Scale is an instrument that can potentially be used in cohort studies and trials to measure the intensity of mental healthcare as a predictor of outcome. Further study into the psychometric characteristics of the Mental Healthcare Intensity Scale is needed.

PMID:37254123 | DOI:10.1186/s12888-023-04752-6

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Nevin Manimala Statistics

Prevalence and variability of HIV/AIDS-associated neurocognitive impairments in Africa: a systematic review and meta-analysis

BMC Public Health. 2023 May 30;23(1):997. doi: 10.1186/s12889-023-15935-x.

ABSTRACT

BACKGROUND: HIV/AIDS-associated neurocognitive impairments negatively affect treatment adherence, viral load suppression, CD4 count, functionality, and the overall quality of life of people with seropositive status. However, huge variability is observed across primary studies regarding the prevalence and determinants of neurocognitive impairment in people with HIV/AIDS. This systematic review and meta-analysis sought to determine the pooled prevalence of neurocognitive impairment and identify factors contributing to variations in its estimate among people living with HIV/AIDS in Africa.

METHODS: A comprehensive literature search of scientific databases (Medline/PubMed, SCOPUS, Web of Science, PsycINFO, and EMBASE) was performed from inception onward. Google and Google Scholar were also searched for grey literature. Research articles available until July 15, 2022 were included. We used STATA-version 14 statistical software for analysis. A random effect model was executed to pool the reported prevalence of neurocognitive impairments. Subgroup analysis was done to show variations in the prevalence of neurocognitive impairments and factors that might contribute to these variations.

RESULTS: A literature search resulted in 8,047 articles. After the removal of duplications and thorough evaluation, a total of 49 studies were included in the meta-analysis. The prevalence of HIV/AIDS-associated neurocognitive impairments was highly variable across studies, ranging from 14% to 88%, yielding the pooled prevalence of HIV/AIDS-associated neurocognitive impairment to be 46.34% [95% CI (40.32, 52.36)] and I2 = 98.5% with a P-value of 0.001.

CONCLUSIONS: A large proportion of people living with HIV/AIDS in Africa have HIV/AIDS-associated neurocognitive impairment. This illustrates the need to establish practical approaches to early identification and effective control of HIV/AIDS-associated neurocognitive impairments. However, there were variabilities in the reported prevalence of HIV/AIDS-associated neurocognitive impairments across studies. This further demonstrates the need to have consistent measurement approaches.

TRIAL REGISTRATION: PROSPERO 2022, “CRD42020166572”.

PMID:37254121 | DOI:10.1186/s12889-023-15935-x

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Nevin Manimala Statistics

Optimal sequencing of the first- and second-line target therapies in metastatic renal cell carcinoma: based on nationally representative data analysis from the Korean National Health Insurance System

BMC Cancer. 2023 May 30;23(1):483. doi: 10.1186/s12885-023-10991-3.

ABSTRACT

BACKGROUND: The authors intend to compare the effects of each targeted therapy (TT) in the treatment of patients with metastatic renal cell carcinoma (mRCC) using big data based on the Korean National Health Insurance System (NHIS) and determine the optimal treatment sequence.

METHODS: Data on the medical use of patients with kidney cancer were obtained from the NHIS database from January 1, 2002, to December 31, 2020. Patient variables included age, sex, income level, place of residence, prescribing department, and duration from diagnosis to the prescription date. The primary outcome was overall survival (OS) for each drug and sequencing. We performed propensity score matching (PSM) according to age, sex, and Charlson Comorbidity Index based on the primary TTs.

RESULTS: After 1:1 PSM, the sunitinib (SUN) (n = 1,214) and pazopanib (PAZ) (n = 1,214) groups showed a well-matched distribution across the entire cohort. In the primary treatment group, PAZ had lower OS than SUN (HR, 1.167; p = 0.0015). In the secondary treatment group, axitinib (AXI) had more favorable OS than cabozantinib (CAB) (HR, 0.735; p = 0.0118), and everolimus had more adverse outcomes than CAB (HR, 1.544; p < 0.0001). In the first to second TT sequencing, SUN-AXI had the highest OS; however, there was no statistically significant difference when compared with PAZ-AXI, which was the second highest (HR, 0.876; p = 0.3312). The 5-year survival rate was calculated in the following order: SUN-AXI (51.44%), PAZ-AXI (47.12%), SUN-CAB (43.59%), and PAZ-CAB (34.28%). When the four sequencing methods were compared, only SUN-AXI versus PAZ-CAB (p = 0.003) and PAZ-AXI versus PAZ-CAB (p = 0.017) were statistically significant.

CONCLUSIONS: In a population-based RWD analysis of Korean patients with mRCC, SUN-AXI sequencing was shown to be the most effective among the first to second TT sequencing methods in treatment, with a relative survival advantage over other sequencing combinations. To further support the results of this study, risk-stratified analysis is needed.

PMID:37254112 | DOI:10.1186/s12885-023-10991-3

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Nevin Manimala Statistics

Evaluation of surface electromyography of selected neck muscles during the whiplash mechanism in aware and unaware conditions due to safe punching in kickboxing

BMC Musculoskelet Disord. 2023 May 30;24(1):429. doi: 10.1186/s12891-023-06563-y.

ABSTRACT

BACKGROUND: Kickboxing is considered as a combat sport in progress, in which injuries are frequent and significant, and close injury monitoring is highly recommended. Sports injuries to the head and neck are estimated to cause 70% deaths and 20% permanent disabilities although they are much less common than those to the limbs. Whiplash mechanism involves the rapid extension (opening) and flexion (bending) of neck. The purpose of the current study was to investigate the electromyographic activity of selected muscles in the whiplash mechanism in aware and unaware conditions of the safe punching in kickboxing so that we can design special exercises.

METHOD: In the present study, 24 male kickboxing athletes aged 18-40 years were selected based on a purposive sampling method. The surface electromyography (EMG) signals of muscles were recorded with and without awareness of safe punching by using a nine-channel wireless EMG device. Additionally, a nine-channel 3D inertial measurement unit (IMU, wireless,) was utilized to determine the acceleration, kinematics, and angular velocity of the subjects’ head. The statistical dependent t-test was applied to compare the EMG activity of each muscle, as well as its participation ratio.

RESULTS: The results of statistical analysis represented a significant increase in the EMG activity of sternocleidomastoid (p = 0.001), upper trapezius (p = 0.001) and cervical erector spinae muscles (p = 0.001), as well as the neck extension and flexion angles between the athletes aware (open eyes) and unaware (closed eyes) of the safe punching.

CONCLUSION: In this study, the EMG activity of the sternocleidomastoid, upper trapezius, and cervical erector spine muscles in the aware condition was significantly different from the activity under unaware condition. In fact, the intended muscles exhibited significantly different behaviors in preventing extension and flexion in the two conditions.

PMID:37254094 | DOI:10.1186/s12891-023-06563-y