Tag: statistics

PLoS Comput Biol. 2024 Mar 21;20(3):e1011933. doi: 10.1371/journal.pcbi.1011933. eCollection 2024 Mar.

ABSTRACT

This perspective is part of an international effort to improve epidemiological models with the goal of reducing the unintended consequences of infectious disease interventions. The scenarios in which models are applied often involve difficult trade-offs that are well recognised in public health ethics. Unless these trade-offs are explicitly accounted for, models risk overlooking contested ethical choices and values, leading to an increased risk of unintended consequences. We argue that such risks could be reduced if modellers were more aware of ethical frameworks and had the capacity to explicitly account for the relevant values in their models. We propose that public health ethics can provide a conceptual foundation for developing this capacity. After reviewing relevant concepts in public health and clinical ethics, we discuss examples from the COVID-19 pandemic to illustrate the current separation between public health ethics and infectious disease modelling. We conclude by describing practical steps to build the capacity for ethically aware modelling. Developing this capacity constitutes a critical step towards ethical practice in computational modelling of public health interventions, which will require collaboration with experts on public health ethics, decision support, behavioural interventions, and social determinants of health, as well as direct consultation with communities and policy makers.

PMID:38512898 | DOI:10.1371/journal.pcbi.1011933

PLoS One. 2024 Mar 21;19(3):e0300404. doi: 10.1371/journal.pone.0300404. eCollection 2024.

ABSTRACT

Vaccination is widely considered to be one of the most important prevention measures as a health strategy. This paper examines trends in basic childhood vaccination coverage and which country and time-dependent determinants may have influenced childhood immunization rates (1-dose BCG, 1- and 3-dose DTP (diphtheria, tetanus, pertussis), 1-dose measles, and 3-dose polio) between 1980 and 2020 across 94 countries. We identify economic, inequality, demographic, health, education, labor market, environmental, and political stability factors of immunization. To do this, we use data from the annual WHO and United Nations International Children’s Emergency Fund (UNICEF) coverage estimates. The empirical analysis consists of generalized estimating equation models to assess relationships between immunization rates and socioeconomic factors. Additionally, we follow the Barro and Sala-i-Martín approach to identify conditional convergence. Our findings show the strongest positive statistically significant association between immunization rates and GDP per capita, as well as births attended by skilled health staff. Moreover, our research demonstrates conditional convergence, indicating that countries converge towards different steady states. The present study brings new insights to investigating the determinants of childhood vaccination coverage and provides significant implications for health policies.

PMID:38512892 | DOI:10.1371/journal.pone.0300404

Personal Disord. 2024 Mar 21. doi: 10.1037/per0000652. Online ahead of print.

ABSTRACT

Problematic interpersonal relationships may represent both, a risk factor for the development or trigger of personality disorder (PD) symptoms and its consequences. Since peer relationships become more and more important in adolescence, the current study explores the cross-sectional association between recent bullying experiences and levels of impairment in personality functioning according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) alternative model of personality disorders (AMPD; Criterion A) in help-seeking adolescents (N = 493). Logistic and multiple regression analyses revealed that patients who were frequently bullied in the past 3 months (i.e., at least once a week) were more likely to reach the diagnostic threshold for PD according to the AMPD (OR = 1.71, p = .025) and showed higher levels of impairment in identity (β = .41, p < .001), empathy (β = .26, p = .002), and intimacy (β = .30, p = .001), but not self-direction, compared to patients who did not report any bullying experiences. Occasional bullying in the past 3 months (i.e., every few weeks) was neither associated with a greater likelihood to reach the diagnostic threshold for PD nor with greater impairments in identity, self-direction, empathy, or intimacy compared to no bullying. While the current study provides support for a correlation between bullying experiences and personality dysfunction (particularly in the elements identity and intimacy), longitudinal research is needed to clarify whether experiences of bullying cause or trigger personality dysfunction or/and vice versa. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:38512174 | DOI:10.1037/per0000652

J Consult Clin Psychol. 2024 Mar 21. doi: 10.1037/ccp0000871. Online ahead of print.

ABSTRACT

OBJECTIVE: Recurrent depressive episodes are preceded by changing mean levels of repeatedly assessed emotions (e.g., feeling restless), which can be detected in real time using statistical process control (SPC). This study investigated whether monitoring changes in the standard deviation (SD) of emotions and negative thinking improves the early detection of recurrent depression.

METHOD: Formerly depressed adults (N = 41) monitored their emotions five times a day for 4 consecutive months. During the study, 22 individuals experienced recurrent depression. We used SPC to detect warning signs (i.e., changing means and SDs) of four emotions (positive and negative affect with high or low arousal) and negative thinking.

RESULTS: SD-based warning signs only preceded 23%-36% of recurrences, but almost never reflected a false alarm (0%-16%). Correspondingly, SD-based warnings had a high specificity (at the cost of sensitivity), while mean-based warnings had a higher sensitivity (but lower specificity). There was little overlap in mean- and SD-based warning signs. For the majority of emotions, monitoring for high SDs alongside monitoring changes in mean levels improved the detection of depression (p < .015) compared to when only monitoring for changing mean levels.

CONCLUSIONS: Warning signs for depression manifest not only in changing mean levels of emotions and cognitions but also in increasing SDs. These warnings could eventually be used to detect not just who is at increased risk for depression but also when risk is rising. Further research is needed to evaluate the clinical utility of depression SPC. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:38512172 | DOI:10.1037/ccp0000871

Psychol Trauma. 2024 Mar 21. doi: 10.1037/tra0001678. Online ahead of print.

ABSTRACT

OBJECTIVE: Homework has been shown to improve outcomes in cognitive-behavioral therapy, though less is known about the importance of homework during trauma-focused psychotherapy. Similarly, prior research suggests family context plays a key role in posttraumatic stress disorder (PTSD)-related distress and treatment engagement. One potential way that families can facilitate better treatment outcomes is by promoting homework engagement. This study examined the impact of a brief family intervention (BFI) for PTSD toward this aim. We hypothesized that veterans with PTSD whose family members (FMs) received the BFI would have better homework completion and quality than those who did not receive the BFI.

METHOD: This mixed-methods analysis examined 24 veteran-family dyads enrolled in a randomized clinical trial examining the BFI. All veterans were currently engaged in trauma-focused psychotherapy. Each veteran’s clinician rated their homework quality and completion after each therapy session. A subset of dyads also completed semistructured interviews posttreatment. A rapid qualitative analysis approach was used to examine themes in shifting family behavior post-BFI.

RESULTS: Quantitative analyses yielded partial support for our hypotheses: those in the BFI condition had significantly higher clinician-rated homework quality. While participants in the BFI condition had a higher homework completion rate, this difference did not reach statistical significance. Qualitative analyses suggested that the BFI prompted meaningful discussions about PTSD and increased FMs’ use of supportive (rather than accommodative) behavior when responding to PTSD-related distress.

CONCLUSIONS: Involving FMs in PTSD treatment appears to shift the family context in a manner that improves homework quality in veterans. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:38512169 | DOI:10.1037/tra0001678

Psychol Assess. 2024 Mar 21. doi: 10.1037/pas0001307. Online ahead of print.

ABSTRACT

Racial disparities in criminal justice outcomes are widely observed. In Canada, such disparities are particularly evident between Indigenous and non-Indigenous persons. The role of formal risk assessment in contributing to such disparities remains a topic of interest to many, but critical analysis has almost exclusively focused on actuarial or statistical risk measures. Recent research suggests that ratings from other common tools, based on the structured professional judgment model, can also demonstrate racial disparities. This study examined risk assessments produced using a widely used structured professional judgment tool, the Spousal Assault Risk Assessment Guide-Version 3, among a sample of 190 individuals with histories of intimate partner violence. We examined the relationships among race, risk factors, summary risk ratings, and recidivism while also investigating whether participants’ racial identity influenced the likelihood of incurring formal sanctions for reported violence. Spousal Assault Risk Assessment Guide-Version 3 risk factor totals and summary risk ratings were associated with new violent charges. Indigenous individuals were assessed as demonstrating more risk factors and were more likely to be rated as high risk, even after controlling for summed risk factor totals and prior convictions. They were also more likely to recidivate and to have a history of at least one reported act of violence that did not result in formal sanctions. The results suggest that structured professional judgment guidelines can produce disparate results across racial groups. The disparities observed may reflect genuine differences in the likelihood of recidivism, driven by psychologically meaningful risk factors which have origins in deep-rooted systemic and contextual factors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:38512165 | DOI:10.1037/pas0001307

MCN Am J Matern Child Nurs. 2024 Mar 21. doi: 10.1097/NMC.0000000000001020. Online ahead of print.

ABSTRACT

PURPOSE: To explore how perinatal nurses perceive the effects of visitor restrictions on patient care within a hospital setting.

STUDY DESIGN AND METHODS: We distributed a cross-sectional survey online to perinatal nurses in May of 2022. Characteristics of respondents were analyzed using descriptive statistics. Responses to an open-ended question were analyzed via conventional content analysis.

RESULTS: Among our sample of 101 nurses, we identified seven codes representing positive effects and seven codes representing negative effects. The most frequently reported positive effects were ability to provide person-centered care (n = 36, 35.6%) and less patient stress and more rest (n = 29, 28.7%). The most frequently reported negative effects were limited patient support (n = 22, 21.8%) and emotional distress to the patient (n = 15, 14.9%). Fourteen percent (n = 14) of respondents cited both positive and negative effects.

CLINICAL IMPLICATIONS: Nurses perceived that visitor restrictions resulted in both positive and negative patient experiences. Balancing clinical needs and safety considerations with emotional needs of the childbearing individual requires careful consideration by maternity care clinicians and health care systems. Subsequent research is needed to determine optimal visitation policies during intrapartum and postpartum with consideration to hospital context and patient preferences for optimal care.

PMID:38512154 | DOI:10.1097/NMC.0000000000001020

Int J Neurosci. 2024 Mar 21:1-12. doi: 10.1080/00207454.2024.2334375. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the variations in serum levels of microRNA-21 (miR-21) and S-100B protein in neonates with hypoxic-ischemic encephalopathy (HIE) after receiving hypothermia therapy and explore the correlation of these biomarkers with the neurodevelopmental prognosis of the infants.

METHODS: This retrospective analysis included 90 neonatal HIE patients diagnosed and treated between January 2019 and December 2022. Real-time quantitative PCR and enzyme-linked immunosorbent assay (ELISA) methods were used to measure miR-21 and S-100B protein levels. Neurodevelopmental assessments were conducted at one year, and follow-up was performed using the Bayley Scales of Infant and Toddler Development third edition. Statistical analysis was carried out using SPSS software, with t-tests for continuous variables, chi-square tests for categorical data, Pearson correlation coefficient for correlation analysis, and multivariate regression analysis to adjust for confounding factors.

RESULTS: After hypothermia therapy, the observation group showed a significant decrease in miR-21 and S-100B protein levels (P < 0.001), and neurodevelopmental scores were significantly higher than the control group (P < 0.05). Correlation analysis indicated a negative correlation between miR-21 and neurodevelopmental scores (r=-0.62, P < 0.001), as well as a negative correlation between S-100B protein levels (r=-0.76, P < 0.001). Multivariate regression analysis demonstrated that miR-21 levels and S-100B protein levels maintained independent negative correlations with neurodevelopmental scores (P < 0.001).

CONCLUSION: Hypothermia therapy significantly reduces serum levels of miR-21 and S-100B protein in neonatal HIE patients and may be associated with better prognosis. miR-21 and S-100B serve as prognostic biomarkers, aiding in predicting and improving the treatment outcomes and long-term prognosis of neonatal HIE.

PMID:38512134 | DOI:10.1080/00207454.2024.2334375

Int J Neurosci. 2024 Mar 21:1-18. doi: 10.1080/00207454.2024.2334368. Online ahead of print.

ABSTRACT

OBJECTIVE: This study focuses on exploring the efficacy observation, complications, and nursing aspects of using enteral nutrition suspension in patients with acute ischemic stroke.

METHODS: This study retrospectively analyzed clinical data from 188 patients with acute ischemic stroke treated in the Neurology Department of our hospital from October 2022 to September 2023. Patients who received routine treatment and nursing interventions were included in the control group (96 cases), while patients who received additional treatment with enteral nutrition suspension on top of the control group were included in the treatment group (92 cases). Relevant indicators data changes before and after treatment were recorded for each patient, along with the occurrence of complications in both groups, and statistical analysis was conducted.

RESULTS: The treatment group had fewer days in the ICU and total hospitalization days compared to the control group, with P < 0.05. Patients in the treatment group had higher levels of serum albumin (ALB) and serum prealbumin (PA) than those in the control group, with P < 0.05. The occurrence of abdominal pain, diarrhea, constipation, bloating, and acid reflux in the treatment group was lower than in the control group, with P < 0.05. There was no significant difference in the occurrence of adverse outcomes at discharge, death at discharge, cerebral hemorrhage, lung infection, and gastrointestinal bleeding between the two groups (P > 0.05).

CONCLUSION: The application of enteral nutrition suspension in patients with acute ischemic stroke effectively provides the necessary nutrients, maintains nutritional balance, promotes tissue repair and recovery, and reduces the length of hospital stay.

PMID:38512133 | DOI:10.1080/00207454.2024.2334368

Elife. 2024 Mar 21;12:RP93246. doi: 10.7554/eLife.93246.

ABSTRACT

The link between metabolic syndrome (MetS) and neurodegenerative as well as cerebrovascular conditions holds substantial implications for brain health in at-risk populations. This study elucidates the complex relationship between MetS and brain health by conducting a comprehensive examination of cardiometabolic risk factors, brain morphology, and cognitive function in 40,087 individuals. Multivariate, data-driven statistics identified a latent dimension linking more severe MetS to widespread brain morphological abnormalities, accounting for up to 71% of shared variance in the data. This dimension was replicable across sub-samples. In a mediation analysis, we could demonstrate that MetS-related brain morphological abnormalities mediated the link between MetS severity and cognitive performance in multiple domains. Employing imaging transcriptomics and connectomics, our results also suggest that MetS-related morphological abnormalities are linked to the regional cellular composition and macroscopic brain network organization. By leveraging extensive, multi-domain data combined with a dimensional stratification approach, our analysis provides profound insights into the association of MetS and brain health. These findings can inform effective therapeutic and risk mitigation strategies aimed at maintaining brain integrity.

PMID:38512127 | DOI:10.7554/eLife.93246