Tag: statistics

Respir Care. 2025 Jan 28. doi: 10.1089/respcare.12478. Online ahead of print.

ABSTRACT

Background: The literature suggests there is variability in the clinical practice of spontaneous breathing trials (SBTs). Evidence-based literature and clinical practice guidelines (CPGs) have been published over time to address various aspects of SBT implementation. It can take many years for evidence-based recommendations to be adopted into clinical practice. The American Association for Respiratory Care recently published a CPG addressing 4 aspects of SBT implementation. Methods: This study evaluated how the clinical practice of SBTs compares to the recommendations of the CPG. An online survey was developed to assess how hospitals with SBT protocols perform different components of SBTs. Descriptive statistics were used in the data analysis. Results: A total of 26 representatives from different health care institutions in the United States met the criteria for data analysis; 61.5% of reported protocols use rapid shallow breathing index, which is not in alignment with the current recommendation; 77% reported the use of pressure support (PS); 11.5% specified the use of a T-piece, and 11% specified the option of either PS or T-piece during the SBT. The responses were 100% in alignment with the current recommendation of performing a SBT with or without support; 73.1% aligned with having a standardized approach to performing SBTs by specifying when the SBT will be initiated; 65.4% perform an SBT during the day, though it was not specified if it occurs before noon each day; 53.8% allow for an increase in F_IO2 during an SBT, which is not in alignment with the current recommendations. Conclusions: The reported hospitals’ protocols demonstrated moderate alignment with the 4 CPG recommendations. Identifying current discrepancies between clinical practice and CPGs will allow for the assessment of the adoption of recommendations into clinical practice over time. Further assessment could be performed to determine if there is an impact on patient outcomes.

PMID:39969913 | DOI:10.1089/respcare.12478

Bioinformatics. 2025 Feb 19:btaf076. doi: 10.1093/bioinformatics/btaf076. Online ahead of print.

ABSTRACT

SUMMARY: The Sequencing Read Archive is one of the largest and fastest-growing repositories of sequencing data, containing tens of petabytes of sequenced reads. Its data is used by a wide scientific community, often beyond the primary study that generated them. Such analyses rely on accurate metadata concerning the type of experiment and library, as well as the organism from which the sequenced reads were derived. These metadata are typically entered manually by contributors in an error-prone process, and are frequently incomplete. In addition, easy-to-use computational tools that verify the consistency and completeness of metadata describing the libraries to facilitate data reuse, are largely unavailable. Here we introduce HTSinfer, a Python-based tool to infer metadata directly and solely from bulk RNA-sequencing data generated on Illumina platforms. HTSinfer leverages genome sequence information and diagnostic genes to rapidly and accurately infer the library source and library type, as well as the relative read orientation, 3′ adapter sequence and read length statistics. HTSinfer is written in a modular manner, published under a permissible free and open-source license and encourages contributions by the community, enabling easy addition of new functionalities, for example for the inference of additional metrics, or the support of different experiment types or sequencing platforms.

AVAILABILITY AND IMPLEMENTATION: HTSinfer is released under the Apache License 2.0. Latest code is available via GitHub at https://github.com/zavolanlab/htsinfer, while releases are published on Bioconda. A snapshot of the HTSinfer version described in this article was deposited at Zenodo at 10.5281/zenodo.13985958.

PMID:39969909 | DOI:10.1093/bioinformatics/btaf076

Int J Palliat Nurs. 2025 Feb 2;31(2):58-67. doi: 10.12968/ijpn.2025.31.2.58.

ABSTRACT

BACKGROUND: Specialised outpatient paediatric palliative care (SOPPC) is vital for young people with life-limiting conditions and telehealth integration might improve this care.

AIM: Evaluate the acceptance and challenges of implementing teleconsultations among SOPPC healthcare professionals.

METHODS: A questionnaire, tailored to various professions in SOPPC, was developed. After pilot testing, it was distributed to all healthcare professionals in SOPPC in the county of Lower Saxony, Northern Germany. Statistical analyses, using descriptive methods, ensured the reliability of the findings.

FINDINGS: The survey involved 96 participants from SOPPC teams. Teleconsultations were perceived as time-saving (physicians (80%), nursing (68%), psychosocial varied), facilitating patient-centred discussions (physicians (87%), nursing staff (72%), psychosocial had varied responses) and maintaining intensive contact during restrictions (85% agreement). Improved team communication (91%) and patient-family communication (physicians (80%), nursing (68%), psychosocial (62%) were perceived benefits. Concerns included language barriers (84%) and technical readiness (80%). While physicians and nursing professionals saw telehealth enhancing patient safety (64-95%), psychosocial professionals were more skeptical (38-62%).

CONCLUSION: This study highlights telehealth’s potential in SOPPC, stressing the need for tailored strategies. While nursing staff and physicians generally accept telehealth, psychosocial professionals express reservations. Overcoming barriers like language and technical readiness is crucial for maximising telehealth benefits.

PMID:39969901 | DOI:10.12968/ijpn.2025.31.2.58

JAMA Netw Open. 2025 Feb 3;8(2):e2460551. doi: 10.1001/jamanetworkopen.2024.60551.

ABSTRACT

IMPORTANCE: Patients who live in minority language communities often receive health care services of lower quality and safety compared with patients who speak the majority language. Yet the outcomes associated with care provided by physicians who speak a patient’s primary language remain unknown.

OBJECTIVE: To examine patient-physician language concordance and the risk of major adverse cardiovascular events (MACEs) among patients with hypertension.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study identified adults with self-reported hypertension in the Canadian Community Health Survey, a national survey that collects data from a representative sample of Canadians, from January 1, 2003, to December 31, 2014. Respondents (excluding those living in Quebec) had their hospitalization and mortality records linked to their survey responses. Data were analyzed from October 2023 to May 2024.

EXPOSURES: Respondents’ primary home language was defined using language spoken most often at home. Language spoken with a regular physician was used to measure patient-physician language concordance. Respondents who spoke to their regular physician in their primary home language were classified as having received language-concordant care, while all other respondents were classified as having received language-discordant care.

MAIN OUTCOMES AND MEASURES: MACEs within 5 years of survey completion.

RESULTS: Among the 124 583 patients included in this study, 114 239 (91.7%) spoke English, 4790 (3.8%) spoke French, 325 (0.3%) spoke an Indigenous language, and 5229 (4.2%) spoke an allophone (ie, other) language. The mean (SD) age of the cohort was 63.7 (14.8) years; 57.1% of the patients reported their sex as female. Very few respondents who spoke an Indigenous language at home (<4.6%) received language-concordant care. For French-speaking patients, there was no statistically significant difference in the risk of MACE between those who received language-concordant care and those who received language-discordant care (hazard ratio [HR], 1.09; 95% CI, 0.86-1.36). Allophone-speaking patients who received language-concordant care were 36% less likely to experience MACE (HR, 0.64; 95% CI, 0.51-0.80) compared with allophone-speaking patients who received language-discordant care.

CONCLUSIONS AND RELEVANCE: This retrospective cohort study found large disparities in both access to language-concordant care and risk of MACEs. These findings suggest that language-concordant care could potentially improve the health of individuals in minority language communities.

PMID:39969882 | DOI:10.1001/jamanetworkopen.2024.60551

JAMA Netw Open. 2025 Feb 3;8(2):e2460558. doi: 10.1001/jamanetworkopen.2024.60558.

ABSTRACT

IMPORTANCE: Mandatory vaccination is a major tool to combat increasing vaccine hesitancy. In principle, a vaccination law, ie, a mandatory vaccination law without exemptions, applies equally to everyone, but its effects across different socioeconomic groups (SEGs) remain unknown.

OBJECTIVE: To examine the association of a vaccination law with vaccination coverage in different SEGs during 1855 to 1900.

DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study monitored 45 years (1855-1900) of Finland’s first vaccination campaign against smallpox to estimate the association of the 1883 vaccination law with vaccination coverage in infants (age <1 year) across different SEGs. Data were analyzed from October 2023 to January 2024.

EXPOSURE: A mandatory smallpox vaccination law for all children.

MAIN OUTCOMES AND MEASURES: Vaccination status was determined from vaccination records and defined as receiving 1 dose of the smallpox vaccine. The primary outcome was the annual vaccination coverage in different SEGs and its change before vs after the vaccination law.

RESULTS: A total of 40 008 children aged less than 1 year were included. The high SEG had high vaccination coverage, at a mean (SD) of 90% (49 percentage points), and the law was associated with halting its declining trend. For the middle SEG, the law was associated with a 26-percentage point increase in coverage, to a mean (SD) of 83% (50 percentage points). For the low SEG, the law had no association with vaccination coverage, which always remained below 35% (mean [SD]: prelaw, 26% [22 percentage points]; postlaw, 32% [23 percentage points]).

CONCLUSIONS AND RELEVANCE: In this cohort study, a historic vaccination law was not associated with increased vaccination in the SEG with the lowest vaccination coverage, emphasizing the need for additional interventions to increase vaccine uptake in low-coverage communities.

PMID:39969881 | DOI:10.1001/jamanetworkopen.2024.60558

JAMA Netw Open. 2025 Feb 3;8(2):e2460735. doi: 10.1001/jamanetworkopen.2024.60735.

ABSTRACT

IMPORTANCE: Two interventions to prevent severe respiratory syncytial virus (RSV) in infants were approved in 2023-a bivalent prenatal RSV prefusion F protein-based (RSVpreF) vaccine and an infant monoclonal antibody (nirsevimab). Understanding their uptake and clinical outcomes is essential for public health planning.

OBJECTIVE: To describe uptake of the prenatal RSVpreF vaccine and infant nirsevimab.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study was conducted at a single academic center among 647 pregnant individuals eligible for RSVpreF vaccination (32-36 weeks’ gestation between October 15, 2023, and January 31, 2024) and infants eligible for nirsevimab (no prenatal RSVpreF vaccination >14 days before delivery).

EXPOSURE: Pregnancy or birth during the 2023-2024 RSV season.

MAIN OUTCOMES AND MEASURES: RSVpreF vaccination among eligible pregnant individuals and nirsevimab administration prior to hospital discharge among eligible infants.

RESULTS: Of 647 eligible pregnant individuals (mean [SD] age, 34.6 [6.2] years; 355 nulliparous [54.9%]; 558 privately insured [86.2%]), 414 (64.0%) received the RSVpreF vaccine. Factors associated with higher RSVpreF uptake included older birthing parent age (adjusted odds ratio [AOR], 1.09; 95% CI, 1.05-1.12), nulliparity (AOR, 1.84; 95% CI, 1.31-2.60), private insurance (AOR, 2.19; 95% CI, 1.27-3.80), non-Hispanic ethnicity (AOR, 2.36; 95% CI 1.57-3.55; reference: Hispanic), receipt of any COVID-19 vaccine (AOR, 7.12; 95% CI, 3.91-13.70), 2023-2024 formula COVID-19 booster vaccine (AOR, 5.62; 95% CI, 3.80-8.48), influenza vaccine (AOR, 8.14; 95% CI, 5.38-12.50), or tetanus-diphtheria-pertussis vaccine (AOR, 6.86; 95% CI, 3.79-13.10). Factors associated with lower RSVpreF uptake included non-English language preference (AOR, 0.24; 95% CI, 0.10-0.52), Black race (AOR, 0.30; 95% CI, 0.16-0.57; reference: Asian), other or unknown race (AOR, 0.48; 95% CI, 0.30-0.76), and multiple gestation (AOR, 0.27; 95% CI, 0.07-0.88). Nirsevimab was administered to 183 of 261 eligible infants (70.1%) prior to hospital discharge. Among those who did not receive RSVpreF or standard prenatal vaccines, 40.4% of their neonates (19 of 47) received nirsevimab; among those who declined infant hepatitis B vaccination, 34.0% of their neonates (17 of 50) received nirsevimab. Respiratory syncytial virus coverage exceeded 80% during all months of the study period except October 2023, the first month during which prenatal RSV vaccination and infant nirsevimab were available. Preterm delivery occurred in 35 of 414 RSVpreF-vaccinated individuals (8.5%) and 43 of 233 unvaccinated individuals (18.5%). In a nested case-control analysis with preterm birth as the outcome, there was no significant association between RSVpreF vaccination and preterm birth (AOR, 1.03; 95% CI, 0.55-1.93).

CONCLUSIONS AND RELEVANCE: In this cohort study, uptake of the RSVpreF vaccine and infant nirsevimab was high. Nirsevimab uptake was high even among individuals who did not receive routine prenatal or infant vaccines. There was no significant association between RSVpreF vaccination and preterm birth. This study suggests that an RSV prevention strategy that included both prenatal vaccination and infant monoclonal antibody administration had high uptake and reassuring perinatal outcomes.

PMID:39969879 | DOI:10.1001/jamanetworkopen.2024.60735

J Forensic Nurs. 2025 Feb 19. doi: 10.1097/JFN.0000000000000536. Online ahead of print.

ABSTRACT

BACKGROUND: Recruiting, preparing, and retaining sexual assault nurse examiners (SANEs), particularly in rural and isolated areas, is increasingly difficult because of widespread emotional exhaustion and burnout among nurses. We describe our academic-clinical partnered development and initial outcomes from the ReImagine Clinical Residency. The residency is part of the larger Re LAB workforce program to support competency development and confidence building among current and future SANEs with limited experience.

METHODS: SANEs were screened and enrolled in the residency for 1-2 weeks, participating in patient encounters at hospitals in the Minneapolis-St. Paul metropolitan area. Preresidency and postresidency surveys were completed, including our SANE Practice Innovation Configuration Evaluation tool. Descriptive statistical and thematic analyses were conducted.

RESULTS: Eleven SANEs completed the ReImagine Clinical Residency; most were early-career nurses working in healthcare provider shortage areas in the United States. Statistically significant pre-post improvements were observed in five of the six SANE Practice Innovation Configuration Evaluation components. Residents described valuing the hands-on experience, diverse clinical environments, and preceptor support.

CONCLUSION: Residency programs are essential for addressing the specific professional development needs of novice SANEs and those with limited patient encounters in their current practice settings. By providing structured, precepted experiences, these residencies can contribute to workforce retention and ultimately strengthen patient care for victim-survivors of sexual violence.

PMID:39969867 | DOI:10.1097/JFN.0000000000000536

JMIR Public Health Surveill. 2025 Feb 19;11:e66056. doi: 10.2196/66056.

ABSTRACT

BACKGROUND: Research has shown that perceptions of a mental health need are closely associated with service demands and are an important dimension in needs assessment. Perceived and unmet mental health needs are important factors in the decision-making process regarding mental health services planning and resources allocation. However, few prediction tools are available to be used by policy and decision makers to forecast perceived and unmet mental health needs at the population level.

OBJECTIVE: We aim to develop prediction models to forecast perceived and unmet mental health needs at the provincial and health regional levels in Canada.

METHODS: Data from 2018, 2019, and 2020 Canadian Community Health Survey and Canadian Urban Environment were used (n=65,000 each year). Perceived and unmet mental health needs were measured by the Perceived Needs for Care Questionnaire. Using the 2018 dataset, we developed the prediction models through the application of regression synthetic estimation for the Atlantic, Central, and Western regions. The models were validated in the 2019 and 2020 datasets at the provincial level and in 10 randomly selected health regions by comparing the observed and predicted proportions of the outcomes.

RESULTS: In 2018, a total of 17.82% of the participants reported perceived mental health need and 3.81% reported unmet mental health need. The proportions were similar in 2019 (18.04% and 3.91%) and in 2020 (18.1% and 3.92%). Sex, age, self-reported mental health, physician diagnosed mood and anxiety disorders, self-reported life stress and life satisfaction were the predictors in the 3 regional models. The individual based models had good discriminative power with C statistics over 0.83 and good calibration. Applying the synthetic models in 2019 and 2020 data, the models had the best performance in Ontario, Quebec, and British Columbia; the absolute differences between observed and predicted proportions were less than 1%. The absolute differences between the predicted and observed proportion of perceived mental health needs in Newfoundland and Labrador (-4.16% in 2020) and Prince Edward Island (4.58% in 2019) were larger than those in other provinces. When applying the models in the 10 selected health regions, the models calibrated well in the health regions in Ontario and in Quebec; the absolute differences in perceived mental health needs ranged from 0.23% to 2.34%.

CONCLUSIONS: Predicting perceived and unmet mental health at the population level is feasible. There are common factors that contribute to perceived and unmet mental health needs across regions, at different magnitudes, due to different population characteristics. Therefore, predicting perceived and unmet mental health needs should be region specific. The performance of the models at the provincial and health regional levels may be affected by population size.

PMID:39969822 | DOI:10.2196/66056

Clin Nurse Spec. 2025 Mar-Apr 01;39(2):82-90. doi: 10.1097/NUR.0000000000000879.

ABSTRACT

PURPOSE: Central line-associated bloodstream infection (CLABSI) rates have been consistently high at an academic comprehensive cancer hospital. CLABSI prevention bundles can mitigate central line infections, and many components focus on nursing practice. Identification of barriers to maintaining adherence to these elements is not always assessed or addressed. The purpose of this project was to increase adherence to CLABSI prevention nursing practices and to implement a sustainable program to elevate nurses’ skills and documentation of CLABSI prevention bundle components.

DESCRIPTION: Pre-implementation/post-implementation chart reviews, post-implementation visual audits, and a survey for nurses post project were completed over a 9-week period. This project identified and addressed barriers to CLABSI prevention bundle compliance. Audits assessed nursing practice elements of the CLABSI prevention bundle. Evidence-based Kamishibai cards (K-cards) were used as a visual audit tool to display compliance of CLABSI bundle elements.

OUTCOMES: Compliant documentation of daily chlorhexidine gluconate (CHG) bathing increased to 75%. Inconsistent communication practices and knowledge gaps were frequent barriers to compliance. Seventy-five percent of nurses reported the K-card display changed their own CLABSI prevention practices.

CONCLUSION: This project increased knowledge, adherence to CLABSI prevention practices, and awareness of components most often missed.

PMID:39969809 | DOI:10.1097/NUR.0000000000000879

J Cosmet Dermatol. 2025 Feb;24(2):e70068. doi: 10.1111/jocd.70068.

ABSTRACT

OBJECTIVE: The current study aimed to assess the prevalence of cosmetics utilization and perceived adverse effects among female final-year undergraduate students at the University of Gondar, northwest Ethiopia.

METHODS: An institutional-based cross-sectional study was carried out from October 2023 to May 2024. We used stratified, simple random sampling techniques to select study participants. Data were collected by using a self-administered questionnaire administered to trained graduate pharmacist students. EPI Info 7.1 was used for data entry, and SPSS version 26 was used for the data analysis. Descriptive statistics have been done for percentages and frequencies. We used bivariate and multiple logistic regressions to identify factors. Those variables with p < 0.05 were declared to be associated factors for the prevalence of cosmetics utilization and perceived adverse effects.

RESULTS: A total of 403 study participants were included, with a response rate of (96%). In the current study, 81% of the students were using cosmetics, and 55.6% were exposed to cosmetics-related adverse reactions, primarily skin rash (41%) and itching (38.3%). The most frequently used cosmetic products were toothpaste, lipstick, deodorant, and perfume, which accounted for 83.7%, 56.8%, and 24.7%, respectively. Lower age (20-25 years) AOR = 5.62, urban residence AOR = 1.97, health-related department AOR = 2.46, economic income 501-1000 Ethiopian birr AOR = 4.05, not love engaged AOR = 3.65, and 3 and 4 years of study AOR = 2.96, with a 95% CI, were significantly associated with cosmetic usage for the students. Shampoos and conditioners AOR = 3.42; hair dye use AOR = 3.40; read information from the container AOR = 2.11; add water or other agents to cosmetics AOR = 2.26; and test Cosmetic adverse reactions AOR = 4.10, with a 95% CI, were significantly associated with cosmetics-related adverse effects.

CONCLUSION: A significant proportion of the users suffered from cosmetic-related adverse reactions. The health care system should be restructured to consider rational cosmetic utilization practices and prevent adverse health effects.

PMID:39968726 | DOI:10.1111/jocd.70068