Tag: statistics

Front Public Health. 2025 Aug 18;13:1608109. doi: 10.3389/fpubh.2025.1608109. eCollection 2025.

ABSTRACT

BACKGROUND: Pneumoconiosis remains one of the most critical occupational health hazards globally. Utilizing data from the Global Burden of Disease (GBD) 2021, we have updated the epidemiological trends of pneumoconiosis.

METHODS: We conducted and analyzed pneumoconiosis-related data from the GBD 2021 study for individuals aged ≥20 years. Our analysis described the incident cases and age-standardized incidence rates (ASIRs) across various global regions and age groups. Temporal trends were evaluated using Estimated Annual Percentage Change (EAPC) for ASIRs between 1990 and 2021.

RESULTS: The ASIR of pneumoconiosis among individuals aged ≥20 years declined globally at an annual average of 0.48% between 1990 and 2021. Except for high socio-demographic index (SDI) regions, the ASIR of pneumoconiosis declined across all other SDI categories. Males had significantly higher incidence rates than females, especially in older adults. Silicosis emerged as the predominant type of pneumoconiosis, constituting ~56.7% of cases. While the ASIRs for silicosis, coal workers’ pneumoconiosis, and other pneumoconiosis decreased, the ASIRs for asbestosis exhibited a notable upward trend, with an EAPC of 1.21%. A strong negative correlation was observed between the EAPC of pneumoconiosis incidence and the 1990 ASIRs values. Notably, the EAPC showed a statistically significant but very weak positive correlation with the 2021 Human Development Index (HDI) values.

CONCLUSION: Despite a gradual global decline in the ASIR of pneumoconiosis, the disease burden remains substantial in certain regions. Our findings could inform governments and policymakers in developing targeted prevention strategies to mitigate this burden. Future strategies should integrate technological innovation with regulatory frameworks, prioritizing male-dominated high-risk sectors through strengthened global asbestos bans and lifetime health surveillance for workers in pneumoconiosis-prone occupations worldwide.

PMID:40900707 | PMC:PMC12400962 | DOI:10.3389/fpubh.2025.1608109

Front Public Health. 2025 Aug 18;13:1605296. doi: 10.3389/fpubh.2025.1605296. eCollection 2025.

ABSTRACT

OBJECTIVE: To assess the current status and identify factors influencing the medication literacy level of community residents, providing a scientific basis to enhance medication literacy and effectively promote the safe use of medications.

METHODS: A questionnaire survey was conducted among 2,008 community residents in Shenzhen, employing economic stratification and proportionate sampling methods. The analysis utilized various statistical methodologies, including T-tests, F-tests, multiple linear stepwise regression, and structural equation modeling to assess the current medication literacy status and the factors influencing it.

RESULTS: The levels of medication literacy among community residents typically exhibit a normal distribution. Specifically, 10.16% of residents achieved the excellent level, 40.49% reached the good level, 37.40% were classified as passing, and 11.95% were deemed to have failed. The analysis of factors influencing medication literacy revealed that demographic characteristics, such as age and educational level, as well as various elements of medication knowledge, attitude, behaviors, and skills, significantly impact medication literacy. Notably, medication knowledge emerged as the most critical factor. Structural equation modeling demonstrated that medication knowledge, attitude, behaviors, and skills mediate medication literacy, which can indirectly affect medication literacy and be utilized in multiple ways to improve it and ensure the safety of medication use effectively.

CONCLUSION: The level of medication literacy among community residents was commendable. However, the proportion of individuals with high medication literacy levels remained insufficient. Key influencing factors, such as medication knowledge, attitude, behaviors, and skills, are explored, offering insights for the government to implement initiatives that publicize medication knowledge, monitor and improve public medication behaviors, promote health education, and enhance community medication literacy and health development.

PMID:40900696 | PMC:PMC12399700 | DOI:10.3389/fpubh.2025.1605296

Front Public Health. 2025 Aug 18;13:1546867. doi: 10.3389/fpubh.2025.1546867. eCollection 2025.

ABSTRACT

OBJECTIVE: We aimed to assess the recent levels of knowledge and attitudes toward tobacco smoking among adolescents aged 12-16 years in 2010-2019, and to examine trends from 1999 to 2019.

METHODS: We used the most recent data from 145 countries/territories (hereafter “countries”) that conducted at least one Global Youth Tobacco Survey (GYTS) between 2010 and 2019 to assess the current levels of knowledge and attitudes toward tobacco smoking among adolescents aged 12-16 years. And 112 countries that conducted at least three GYTS surveys from 1999 to 2019 were used to assess the trends among adolescents aged 12-16 years over time.

RESULTS: Among 570,492 adolescents from 145 countries, 13.9% (95% CI, 11.9%-15.8%) incorrectly believed that tobacco smoking was not harmful, and 16.1% (95% CI, 15.2%-16.9%) believed that exposure to secondhand smoke was not harmful. A substantial proportion believed that quitting smoking was easy (42.5%; 95% CI, 36.9%-48.0%) or that short-term smoking was safe if followed by quitting (40.2%; 95% CI, 39.1%-41.3%). Additionally, 25.8% (95% CI, 24.8%-26.8%) believed that tobacco smoking helps young people feel more comfortable, 26.4% (95% CI, 24.8%-28.0%) believed that it helps them make more friends, and 15.8% (95% CI, 14.6%-17.0%) believed that it makes them appear more attractive. Among 1,734,258 adolescents from 112 countries, 67.9% of countries showed increasing or stable trends in the belief that smoking is not harmful, 75.9% for the belief that secondhand smoke exposure is not harmful, 38.4% for short-term smoking being safe, 32.1% for quitting being easy, and 69.6, 43.8, and 44.6% for the beliefs that smoking helps with comfort, making friends, and appearing attractive, respectively, from 1999 to 2019.

CONCLUSIONS: Incorrect beliefs and positive attitudes toward tobacco smoking were prevalent among adolescents worldwide. Moreover, these beliefs and attitudes toward tobacco smoking have either persisted or increased in most included countries over time. Targeted interventions and policies are needed to reduce these and promote accurate knowledge about tobacco use and its harmful effects.

PMID:40900693 | PMC:PMC12399639 | DOI:10.3389/fpubh.2025.1546867

Front Public Health. 2025 Aug 18;13:1627464. doi: 10.3389/fpubh.2025.1627464. eCollection 2025.

ABSTRACT

INTRODUCTION: Structured, well-being interventions are under-researched in non-Western workplaces. This study evaluates The Good Life training program-a participatory, multi-component training intervention-on employee well-being, engagement and stress in South Africa.

METHODS: Employing an exploratory, quasi-experimental, explanatory sequential mixed-methods design, we collected quantitative data from 50 South African respondents across three delivery formats (four half-days online, two full-days in classroom, and four half-days in classroom) at pre-training and 3 months post-training using five validated scales (PSS-4, UWES-3, SWLS, FS, WEMWBS-14). No concurrent control group was retained due to attrition and contamination; thus, causal inferences are cautious. Qualitative data were gathered via semi-structured interviews with a purposive subsample of 15 participants to elucidate mechanisms of change.

RESULTS: Two full-day workshops led to significant improvements in overall well-being and work engagement, whereas the online format produced a significant boost in well-being only. The half-day format showed no statistically significant changes. Qualitative findings highlighted immersive peer interaction, structured reflection and managerial support as core drivers of impact.

DISCUSSION: Immersive, HR-facilitated training shows promise for enhancing well-being and engagement in South African workplaces. Future research should employ randomized controlled designs, larger samples and objective measures (e.g., absenteeism, physiological indicators) to substantiate and extend these preliminary findings.

PMID:40900692 | PMC:PMC12399526 | DOI:10.3389/fpubh.2025.1627464

Health Sci Rep. 2025 Sep 1;8(9):e71202. doi: 10.1002/hsr2.71202. eCollection 2025 Sep.

ABSTRACT

BACKGROUND AND AIMS: Frailty is one of the most common syndromes in old age. This syndrome, associated with adverse health outcomes and increased economic costs, can affect the quality of life of elderly people. This study investigates the prevalence and determinants of frailty in community-dwelling Iranian older adults.

METHODS: This analytical cross-sectional study was conducted over 5 months among the retired elderly people (> 60 years) in Isfahan. The tools used in this study included a demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI), an assessment of polypharmacy, and the Edmonton Frail Scale. Data were analyzed using statistical tests in SPSS software.

RESULTS: The prevalence of frailty, based on the Edmonton Frail Scale, was 17.4%. No statistically significant difference in mean frailty scores was observed between men and women (p = 0.286). Logistic regression analysis showed that older age (B = 0.067, OR = 1.07, 95% CI: 1.01-1.15), lower education (B = -2.66, OR for MSc = 0.07, 95% CI: 0.00-0.74), polypharmacy (B = 1.82, OR = 6.16, 95% CI: 2.8-13.50), and poor sleep quality (B = 0.59, OR = 1.80, 95% CI: 0.88-3.78) were significantly associated with a higher likelihood of frailty (p < 0.05).

CONCLUSION: This study’s results indicated that age, education, polypharmacy, and poor sleep quality are associated with an increased risk of frailty in Iranian elderly people. Therefore, timely screening and intervention are recommended to identify these factors and prevent their irreversible physical, psychological, and financial consequences.

PMID:40900684 | PMC:PMC12399986 | DOI:10.1002/hsr2.71202

Adv Neonatal Care. 2025 Sep 2. doi: 10.1097/ANC.0000000000001289. Online ahead of print.

ABSTRACT

BACKGROUND: Feeding intolerance can hinder enteral nutrition in infants, often necessitating transpyloric tube feeding. However, the success of transpyloric tube placement varies.

PURPOSE: To compare the rate of correct transpyloric tube placement in infants with and without gastric air insufflation, and to assess complications associated with postpyloric feeding.

METHODS: A randomized controlled trial was conducted in a tertiary neonatal unit of a public teaching hospital. The estimated sample size included 11 participants in the intervention group (IG) and 11 in the control group (CG). In the IG, transpyloric tube insertion was aided by gastric air insufflation. Correct positioning was defined as the distal end of the tube reaching the third or fourth portion of the duodenum, as confirmed by radiography.

RESULTS: The success rate of correct tube placement was the same in both groups (45.4% vs 45.4%, P = 1.000). Two infants experienced complications (necrotizing enterocolitis and jejunal perforation), neither of which were related to the procedure.

IMPLICATIONS FOR PRACTICE AND RESEARCH: There were no significant differences between the IG and CG in terms of birth weight (1030 g vs 985 g, P = .895), gestational age (27 weeks vs 28 weeks, P = .973), or age at the time of the procedure (28 days vs 39 days, P = .224). The rate of jejunal tube placement was also statistically similar (27.7% vs 9.1%, P = .269). Gastric air insufflation did not increase the rate of successful transpyloric tube placement. Observed complications were not attributable to the procedure.

PMID:40900658 | DOI:10.1097/ANC.0000000000001289

JAMA Netw Open. 2025 Sep 2;8(9):e2530123. doi: 10.1001/jamanetworkopen.2025.30123.

ABSTRACT

IMPORTANCE: Children born very preterm have increased health care use. However, there is a lack of research using contemporary national data quantifying hospitalizations after neonatal discharge to inform counseling of families and health care provision.

OBJECTIVE: To examine hospital admissions after neonatal discharge and before 2 years of age among children born at less than 32 weeks’ gestation and assess associations between hospitalization and neonatal morbidities.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used data from all neonatal units and admitting hospitals in England and Wales supplied from the National Neonatal Research Database, linked with the Hospital Episode Statistics Admitted Patient Care database in England and the Patient Episode Database for Wales. Participants were children born at 22 through 31 weeks’ gestation from January 1, 2013, to December 31, 2018, who were admitted to neonatal units and discharged home. Analysis was performed from June 26, 2024, to June 3, 2025.

EXPOSURES: Gestational age; sex; small-for-gestational-age status; season at time of neonatal discharge; neonatal morbidities, including bronchopulmonary dysplasia (BPD), severe necrotizing enterocolitis (NEC), and neonatal brain injury; and number of morbidities.

MAIN OUTCOMES AND MEASURES: Prevalence of hospital admission and total calendar days hospitalized across all admissions. Negative binomial regression was used to calculate the adjusted incidence rate ratio (AIRR) for total calendar days hospitalized, adjusting for gestational age, sex, small for gestational age, and season of neonatal discharge.

RESULTS: Among the 39 413 children included (21 360 [54.2%] male; median gestational age at birth, 29 weeks [IQR, 27-31 weeks]), 26 276 (66.7%) did not have major neonatal morbidities. A total of 26 498 children (67.2%) had at least 1 episode of hospitalization between neonatal discharge and the age of 2 years. This ranged from 6138 of 10 444 children born at 31 weeks’ gestation (58.8%) to 450 of 517 born at less than 24 weeks (87.0%). The median number of total calendar days hospitalized across admissions increased from 1 day (IQR, 0-5 days) for children born at 31 weeks’ gestation to 8 days (IQR, 3-21 days) for those born at less than 24 weeks. Neonatal morbidities were associated with increased total days hospitalized; the AIRR for total hospitalization days for children with vs without BPD was 1.80 (95% CI, 1.72-1.88), for those with vs without severe NEC was 1.88 (95% CI, 1.65-2.15), and for those with vs without neonatal brain injury was 1.46 (95% CI, 1.36-1.57). Combinations of morbidities were associated with total expected days hospitalized: the model estimated that a child born at less than 24 weeks’ gestation with 3 morbidities would have 40.6 days (95% CI, 34.8-44.3 days) of hospitalization before age 2 years.

CONCLUSIONS AND RELEVANCE: In this cohort study of children born very preterm discharged from neonatal care in England and Wales, most children experienced hospitalization before their second birthday, and hospitalizations were associated with lower gestational age and neonatal morbidities. These findings can aid counseling and suggest that further research should investigate interventions to prevent hospitalization in this population.

PMID:40900591 | DOI:10.1001/jamanetworkopen.2025.30123

Sao Paulo Med J. 2025 Sep 1;143(6):e20252853. doi: 10.1590/1516-3180.2025.2853.13062025. eCollection 2025.

ABSTRACT

BACKGROUND: Functional constipation is characterized by a set of symptoms including hardened stools, abdominal discomfort, a tendency to retain stools, and eventual fecal incontinence. This condition negatively affects the quality of life of the affected individuals and has potential psychosocial repercussions.

OBJECTIVES: To assess the epidemiological, clinical, and therapeutic aspects of functional constipation in patients treated at a pediatric gastroenterology outpatient clinic.

DESIGN AND SETTING: Descriptive observational study with a quantitative approach using secondary data collected from the medical records of a pediatric gastroenterology outpatient clinic in Criciúma between 2018 and 2023.

METHODS: This study was approved by the Human Research Ethics Committee of the Universidade do Extremo Sul Catarinense (Unesc) under number 6.788.465. Sociodemographic, clinical, and therapeutic variables were evaluated in 67 patients aged 0-18 years who were diagnosed with Functional Constipation (ICD K590) during the study period. Data were analyzed using descriptive statistics in the Statistical Package for the Social Sciences (SPSS), version 25.0.

RESULTS: There was a predominantly female profile (36; 53.7%), with an average age at diagnosis of 7.75 years (± 3.96). The main symptoms included abdominal pain (52, 77.6%) and hardened stools (42, 62.7%), with an average interval of 4 days between bowel movements. Treatment consisted of macrogol prescriptions (60, 89.6%), with most patients showing complete symptom improvement (49, 73.1%).

CONCLUSION: Analysis of medical records highlighted the need for continuous monitoring and targeted interventions, considering the variability of symptoms and individual characteristics of patients.

PMID:40900577 | DOI:10.1590/1516-3180.2025.2853.13062025

JAMA Psychiatry. 2025 Sep 3. doi: 10.1001/jamapsychiatry.2025.2039. Online ahead of print.

ABSTRACT

IMPORTANCE: Lithium augmentation is an effective treatment for patients with major depression after inadequate antidepressant response, but therapeutic outcomes vary considerably between individuals. Molecular studies may provide novel insights into treatment prediction and guide personalized therapy.

OBJECTIVE: To investigate the association of polygenic risk scores (PRS) for schizophrenia (SCZ), major depressive disorder (MDD), and bipolar disorder (BIP) with clinical outcomes after lithium augmentation.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study analyzed prospectively assessed treatment outcomes in patients who underwent lithium augmentation. Disorder-specific PRS were calculated using well-powered genome-wide association study summary statistics. Participants were recruited from 13 psychiatric hospitals, primarily in the greater Berlin area, between 2008 and 2020. They were patients with MDD who showed inadequate response to at least 1 antidepressant, a baseline score of 12 or more on the 17-item Hamilton Depression Rating Scale (HAMD-17), adequate treatment duration (≥4 weeks), and no diagnostic or co-medication changes. Data analysis was conducted between June 2022 and November 2023.

EXPOSURE: Polygenic risk scores for MDD, SCZ, or BIP.

MAIN OUTCOMES AND MEASURES: Response was defined as a 50% or greater reduction in HAMD-17 score, remission as a HAMD-17 score of 7 or less. Cox proportional hazards models, adjusted for ancestry, demographic, and clinical covariates, were used to estimate hazard ratios (HRs) for favorable outcomes.

RESULTS: Among 193 patients (mean [SD] age, 49.5 [13.4] years; 118 [61.1%] female and 75 [38.9%] male), higher BIP-PRS were associated with both response (HR, 1.29; 95% CI, 1.02-1.63; P = .03) and remission (HR, 1.52; 95% CI, 1.14-2.04; P = .004), explaining 2.51% and 4.53% of the variability in treatment outcomes, respectively. Individuals in the highest tertile of the BIP-PRS distribution had a 2.02-fold (95% CI, 1.15-3.53) higher likelihood of response and a 2.26-fold (95% CI, 1.17-4.36) higher chance of remission compared with those in the lowest tertile. Additionally, lower MDD-PRS was associated with better response to lithium augmentation (HR, 0.81; 95% CI, 0.66-1.00; P = .048; Nagelkerke R2 = 1.99%). No significant associations were observed between SCZ-PRS and response (HR, 1.00; 95% CI, 0.80-1.24; P = .97) or remission (HR, 1.12; 95% CI, 0.85-1.48; P = .42).

CONCLUSIONS AND RELEVANCE: Individuals carrying a higher polygenic burden for BIP and lower polygenic risk for MDD are more likely to benefit from lithium augmentation. Our findings suggest that disease-related PRS may aid in developing treatment prediction models for lithium augmentation response in depression, potentially informing clinical decision-making.

PMID:40900576 | DOI:10.1001/jamapsychiatry.2025.2039

JAMA Surg. 2025 Sep 3. doi: 10.1001/jamasurg.2025.3221. Online ahead of print.

ABSTRACT

IMPORTANCE: Traumatic rib fractures are associated with significant morbidity, including pulmonary complications and prolonged opioid use. Identifying adjunctive treatments that can reduce opioid consumption without compromising safety remains a clinical priority, particularly in nonintubated trauma patients.

OBJECTIVE: To evaluate whether adding dexmedetomidine to standard multimodal analgesia reduces opioid consumption in nonintubated patients in the intensive care unit (ICU) with traumatic rib fractures. It was hypothesized that adjunctive dexmedetomidine would reduce opioid use and improve numerical pain scores.

DESIGN, SETTING, AND PARTICIPANTS: This prospective, randomized, double-blind, placebo-controlled clinical trial was conducted from July 2021 to October 2023. Data were analyzed during January 2024. The study took place at a single academic level I trauma center ICU. Participants included nonintubated adult trauma patients (18 years or older) with 3 or more rib fractures who were admitted to the ICU. Exclusion criteria included a Glasgow Coma Scale score less than 14, bradycardia, hypotension, pregnancy, cirrhosis, chronic opioid use, or inability to consent. Of 41 enrolled patients, 19 received dexmedetomidine (46.3%).

EXPOSURE: Continuous intravenous infusion of dexmedetomidine (0.4 to 0.6 µg/kg per hour) or placebo (normal saline) for up to 48 hours, in addition to standard multimodal pain management.

MAIN OUTCOMES AND MEASURES: The primary outcome was the numerical pain score (NPS) over 48 hours. Secondary outcomes included oral morphine equivalents (OME) at 24 and 48 hours and pulmonary complications.

RESULTS: Among 41 patients (median age, 62 years; median injury severity score, 20), no significant differences were found in baseline characteristics between groups. Mean OME at 24 hours was 59.2 mg (dexmedetomidine) vs 54.9 mg (placebo) and 125.5 mg vs 87.1 mg at 48 hours. Median NPS was 4 in both groups. Pulmonary complication rates and ICU length of stay were also similar. Dexmedetomidine was discontinued in 47.4% of patients due to adverse events or patient request.

CONCLUSIONS AND RELEVANCE: Adjunctive dexmedetomidine did not reduce opioid consumption, improve pain scores, or lower pulmonary complication rates in nonintubated patients in the ICU with traumatic rib fractures. These findings do not support routine use of dexmedetomidine for analgesia in this patient population.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05321121.

PMID:40900569 | DOI:10.1001/jamasurg.2025.3221