Tag: statistics

BMC Musculoskelet Disord. 2023 Apr 25;24(1):324. doi: 10.1186/s12891-023-06436-4.

ABSTRACT

BACKGROUND: The association of cognition with hand grip and pinch strength has been well-recognized in older adults. The authors sought to explore: (1) associations among forward head posture (FHP), cognition, and hand grip and pinch strength in older adults; and (2) the mediator role of FHP in these pathways using structural equation modeling (SEM).

METHODS: This cross-sectional study included 88 older adults (70.5% male; mean age = 68.75±3.87 years). Cognition was assessed by the Mini-Mental State Examination (MMSE), head posture by the Craniovertebral Angle (CVA) obtained from photographic analysis, hand grip strength by a handheld dynamometer, and pinch strength by a pinch meter. Using the two SEMs, a potential mediator role of the CVA was investigated. While the MMSE was addressed as an independent variable in both models, hand grip and pinch strength were addressed as dependent variables in model 1 and model 2, respectively.

RESULTS: The correlations between the CVA and MMSE (r = 0.310), hand grip strength (r = 0.370), and pinch strength (r = 0.274 to 0.292) were statistically significant (p < 0.001). In addition, significant associations were found between the MMSE and hand grip and pinch strength, ranging from 0.307 to 0.380 (p < 0.001). The mediation analysis showed that the standardized total (β = 0.41, p < 0.001) and indirect (mediated) effects (β = 0.12, p = 0.008) of the MMSE on hand grip strength were significant in model (1) The results were similar for model (2) The standardized total (β = 0.39, p = 0.001) and indirect effects (β = 0.10, p = 0.026) of the MMSE on pinch strength were significant. As a partial mediator in both models, the CVA explained 29% and 26% of the total effect in models 1 and 2, respectively.

CONCLUSIONS: The CVA was associated with the MMSE, hand grip strength, and pinch strength, and CVA partially mediates the association of the MMSE with grip and pinch strength in older adults, indicating that cognition had an effect on grip and pinch strength through an indirect path via head posture. This finding reveals that evaluating head posture and providing corrective therapeutic interventions as needed may be beneficial in reducing the negative impact of decreased cognition on motor functions in older adults.

PMID:37098544 | DOI:10.1186/s12891-023-06436-4

Malar J. 2023 Apr 25;22(1):136. doi: 10.1186/s12936-023-04570-x.

ABSTRACT

BACKGROUND: Measuring risk of malaria transmission is complex, especially in case of Plasmodium vivax. This may be overcome using membrane feeding assays in the field where P. vivax is endemic. However, mosquito-feeding assays are affected by a number of human, parasite and mosquito factors. Here, this study identified the contributions of Duffy blood group status of P. vivax-infected patients as a risk of parasite transmission to mosquitoes.

METHODS: A membrane feeding assay was conducted on a total of 44 conveniently recruited P. vivax infected patients in Adama city and its surroundings in East Shewa Zone, Oromia region, Ethiopia from October, 2019 to January, 2021. The assay was performed in Adama City administration. Mosquito infection rates were determined by midgut dissections at seven to 8 days post-infection. Duffy genotyping was defined for each of the 44 P. vivax infected patients.

RESULTS: The infection rate of Anopheles mosquitoes was 32.6% (296/907) with 77.3% proportion of infectious participants (34/44). Infectiousness of participants to Anopheles mosquitoes appeared to be higher among individuals with homozygous Duffy positive blood group (TCT/TCT) than heterozygous (TCT/CCT), but the difference was not statistically significant. The mean oocyst density was significantly higher among mosquitoes fed on blood of participants with FY*B/FY*B^ES than other genotypes (P = 0.001).

CONCLUSION: Duffy antigen polymorphisms appears to contribute to transmissibility difference of P. vivax gametocytes to Anopheles mosquitoes, but further studies are required.

PMID:37098534 | DOI:10.1186/s12936-023-04570-x

BMC Womens Health. 2023 Apr 25;23(1):194. doi: 10.1186/s12905-023-02364-6.

ABSTRACT

BACKGROUND: Despite uptake of antenatal care (ANC), 70% of global burden of maternal and child mortality is prevalent in sub-Saharan Africa, particularly Nigeria, due to persistent home delivery. Thus, this study investigated the disparity and barriers to health facility delivery and the predictors of home delivery following optimal and suboptimal uptake of ANC in Nigeria.

METHODOLOGY: A secondary analysis of 34882 data from 3 waves of cross-sectional surveys (2008-2018 NDHS). Home delivery is the outcome while explanatory variables were classified as socio-demographics, obstetrics, and autonomous factors. Descriptive statistics (bar chart) reported frequencies and percentages of categorical data, median (interquartile range) summarized the non-normal count data. Bivariate chi-square test assessed relationship at 10% cutoff point (p < 0.10) and median test examined differences in medians of the non-normal data in two groups. Multivariable logistic regression (Coeff plot) evaluated the likelihood and significance of the predictors at p < 0.05.

RESULTS: 46.2% of women had home delivery after ANC. Only 5.8% of women with suboptimal ANC compared to the 48.0% with optimal ANC had facility delivery and the disparity was significant (p < 0.001). Older maternal age, SBA use, joint health decision making and ANC in a health facility are associated with facility delivery. About 75% of health facility barriers are due to high cost, long distance, poor service, and misconceptions. Women with any form of obstacle utilizing health facility are less likely to receive ANC in a health facility. Problem getting permission to seek for medical help (aOR = 1.84, 95%CI = 1.20-2.59) and religion (aOR = 1.43, 95%CI = 1.05-1.93) positively influence home delivery after suboptimal ANC while undesired pregnancy (aOR = 1.27, 95%CI = 1.01-1.60) positively influence home delivery after optimal ANC. Delayed initiation of ANC (aOR = 1.19, 95%CI = 1.02-1.39) is associated with home delivery after any ANC.

CONCLUSIONS: About half of women had home delivery after ANC. Hence disparity exist between suboptimal and optimal ANC attendees in institutional delivery. Religion, unwanted pregnancy, and women autonomy problem raise the likelihood of home delivery. Four-fifth of health facility barriers can be eradicated by optimizing maternity package with health education and improved quality service that expand focus ANC to capture women with limited access to health facility.

PMID:37098533 | DOI:10.1186/s12905-023-02364-6

BMC Oral Health. 2023 Apr 25;23(1):241. doi: 10.1186/s12903-023-02982-4.

ABSTRACT

INTRODUCTION: The purpose of this systematic review was to research the difference between root-filled teeth (RFT) and vital pulp teeth (VPT) in orthodontically induced external apical root resorption (EARR) and to offer suggestions for clinicians on therapeutic sequence and timing when considering combined treatment of endodontic and orthodontic.

MATERIALS AND METHODS: An electronic search of published studies was conducted before November 2022 in PubMed, Web of Science and other databases. Eligibility criteria were based on the Population, Intervention, Comparison, Outcome, and Study design (PICOS) framework. RevMan 5.3 software was used for statistical analysis. Single-factor meta-regression analysis was used to explore the sources of literature heterogeneity, and a random effects model was used for analysis.

RESULTS: This meta-analysis comprised 8 studies with 10 sets of data. As there was significant heterogeneity among the studies, we employed a random effects model. The funnel plot of the random effects model exhibited a symmetrical distribution, indicating no publication bias among the included studies. The EARR rate of RFT was significantly lower than that of VPT.

CONCLUSIONS: In the context of concurrent endodontic and orthodontic treatment, priority should be given to endodontic therapy, as it serves as the foundation for subsequent orthodontic procedures. The optimal timing for orthodontic tooth movement post-root canal therapy is contingent upon factors such as the extent of periapical lesion resolution and the degree of dental trauma sustained. A comprehensive clinical assessment is essential in guiding the selection of the most suitable approach for achieving optimal treatment outcomes.

PMID:37098519 | DOI:10.1186/s12903-023-02982-4

BMC Pulm Med. 2023 Apr 25;23(1):139. doi: 10.1186/s12890-023-02440-5.

ABSTRACT

BACKGROUND: Pulmonary Tuberculosis (PTB) is an important public health problem in Malaysia. In this country, limited research has been carried out on the impact of the disease on the health-related quality of life (HRQoL). Family support interventions had been shown to be effective in improving the PTB treatment outcomes.

OBJECTIVES: This study aims to determine the effectiveness of a newly developed Family Support Health Education (FASTEN) intervention in improving the health-related quality of life (HRQoL) among PTB patients in Melaka, as compared to the current conventional disease management.

MATERIALS AND METHODS: A single-blinded, randomized controlled field trial study design was conducted in Melaka from September 2019 until August 2021, involving newly diagnosed PTB patients. The participants were randomized either into the intervention group (FASTEN intervention) or into the control group (conventional management). They were interviewed by using a validated questionnaire that includes the Short Form 36 Health Survey version 2 (SF-36v2), at three time points: at diagnosis, two months and six months after diagnosis. Data were analyzed using IBM SPSS Statistics for Windows version 24. The Generalized Estimating Equations (GEE) analysis was used to evaluate the effectiveness of the intervention, in terms of the HRQoL score difference between the groups, adjusted for baseline covariates.

RESULTS: The HRQoL among PTB patients was lower than the HRQoL of general Malaysian population. Among the total 88 respondents, the three lowest HRQoL domains scores at baseline were Social Functioning (SF), Role limitation due to Physical condition (RP) and Vitality (VT) with the median (IQR) scores of 27.26 (10.03), 30.21 (11.23) and 34.77 (8.92) respectively. The median (IQR) for Physical Component Score (PCS) was 43.58 (7.44) and for Mental Component Score (MCS) was 40.71 (8.77). There were significant difference in the HRQoL median scores between the intervention group compared to the control group, as the Physical Functioning (PF) (p = 0.018), RP (p < 0.001), General Health (GH) (p < 0.001), VT (p < 0.001), SF (p < 0.001), Role limitation due to Emotional condition (RE) (p < 0.001), General Mental Health (MH) (p < 0.001), and the MCS (p < 0.001).

CONCLUSION: The FASTEN intervention is effective to improve the overall HRQoL among PTB patients, as the HRQoL scores were significantly higher in the intervention group compared to the control group who received conventional management. Therefore, it is recommended that the TB program should incorporate the involvement of family members in the patient’s management.

DATE OF REGISTRATION AND NUMBER: The protocol was registered with RCT registered body on 05/12/2019 (Australian New Zealand Clinical Trial Registry – Registration Number: ACTRN12619001720101).

PMID:37098515 | DOI:10.1186/s12890-023-02440-5

BMC Public Health. 2023 Apr 25;23(1):763. doi: 10.1186/s12889-023-15361-z.

ABSTRACT

BACKGROUND: Approximately two million Ghanaians suffer from mental disorders including depression. The WHO defines it as an illness characterized by constant sadness and loss of interest in activities that a person usually enjoys doing and this condition is the leading cause of mental disorders; however, the burden of depression on the aged population is fairly unknown. A better appreciation of depression and its predictors is necessary to design appropriate policy interventions. Therefore, this study aims to assess the prevalence and correlates of depression among older people in the Greater Kumasi of the Ashanti region.

METHODS: A cross-sectional study design with a multi-stage sampling approach was employed to recruit and collect data from 418 older adults aged 60 years and above at the household level in four enumeration areas (EAs) within the Asokore Mampong Municipality. Households within each EAs were mapped and listed by trained resident enumerators to create a sampling frame. Data was collected electronically with Open Data Kit application over 30 days through face-to-face interaction using the Geriatric Depression Scale (GDS). The results were summarized using descriptive and inferential statistics. A multivariable logistics regression using a forward and backward stepwise approach was employed to identify the predictors of depression in the study sample. All analyses were performed using STATA software version 16, and the significance level was maintained at a p-value < 0.05 and presented at a 95% confidence interval.

RESULTS: The study achieved a response rate of 97.7% from the estimated sample size of 428 respondents. The mean age was 69.9 (SD = 8.8), and the distribution was similar for both sexes (p = 0.25). The prevalence of depression in this study was 42.1% and dominated by females, older adults (> 80 years), and lower economic class respondents. The rate was 43.4% for both consumers of alcohol and smokers with a history of stroke (41.2%) and taking medication for chronic conditions (44.2%). The predictors of depression in our study were being single, low class [aOR = 1.97; 95% CI = 1.18-3.27] and having other chronic conditions [aOR = 1.86; 95% CI = 1.59-4.62], and the inability to manage ones’ own affairs [aOR = 0.56; 95% CI = 0.32-0.97].

CONCLUSION: The study provides data that can inform policy decisions on the care of the elderly with depression in Ghana and other similar countries, confirming the need to provide support efforts towards high-risk groups such as single people, people with chronic health conditions, and lower-income people. Additionally, the evidence provided in this study could serve as baseline data for larger and longitudinal studies.

PMID:37098513 | DOI:10.1186/s12889-023-15361-z

BMC Public Health. 2023 Apr 26;23(1):769. doi: 10.1186/s12889-023-15668-x.

ABSTRACT

BACKGROUND: The East North Central Census division (aka the Great Lakes region) experienced a decrease in life expectancy of 0.3 years from 2014 to 2016 – one of the largest declines across the nine Census divisions. Disadvantaged groups that typically have below-average life expectancy, including Black individuals and those without a college education, may have been disproportionately affected by this longevity shift. This investigation examines life expectancy changes among different sex, race, and education groups in the Great Lakes region, and how specific causes of death contributed to within-group longevity changes over time and across age.

METHODS: We used 2008 to 2017 death counts from the National Center for Health Statistics and American Community Survey population estimates to measure within-group change in life expectancy at age 25 among non-Hispanic Black and white males and females by educational attainment. We decomposed life expectancy change over time for each subgroup by 24 causes of death and measured their contribution to longevity change across 13 age groups.

RESULTS: Among persons with ≤ 12 years of education, white males and females experienced 1.3- and 1.7-year longevity declines respectively, compared to a 0.6-year decline among Black males and a 0.3-year decline among Black females. Life expectancy declined among all groups with 13-15 years of education, but especially Black females, who experienced a 2.2-year loss. With the exception of Black males, all groups with 16 + years of education experienced longevity gains. Homicide contributed 0.34 years to longevity decline among Black males with ≤ 12 years of education. Drug poisoning made large contributions to longevity losses among Black females with ≤ 12 years of education (0.31 years), white males and females with 13-15 years of education (0.35 and 0.21 years, respectively), and white males and females with ≤ 12 years of education (0.92 and 0.65 years, respectively).

CONCLUSIONS: Public health efforts to reduce the risks of homicide among Black males without a college education and drug poisoning among all groups could improve life expectancy and reduce racial and educational longevity disparities in the Great Lakes region.

PMID:37098511 | DOI:10.1186/s12889-023-15668-x

BMC Psychiatry. 2023 Apr 25;23(1):287. doi: 10.1186/s12888-023-04741-9.

ABSTRACT

BACKGROUND: The limited available data suggest that the prevalence of problem gambling is increased among young adults with first-episode psychosis, possibly due in part to several risk factors for problem gambling that are common in this population. Aripiprazole, a widely used antipsychotic drug, has also been linked to cases of problem gambling, but causality remains uncertain. Although the consequences of problem gambling further hinder the recovery of people with first-episode psychosis, there is a paucity of research about this comorbidity and its risk factors. Additionally, to our knowledge, no screening instrument for problem gambling tailored to these individuals exists, contributing to its under-recognition. Further, treatment approaches for problem gambling adapted to this population are at an embryonic stage, while existing treatments effectiveness remains to be documented. Using an innovative screening and assessment procedure for problem gambling, this study aims to identify risk factors for problem gambling among people with first-episode psychosis and to document the effectiveness of standard treatment approaches.

METHODS: This is a multicenter prospective cohort study conducted in two first-episode psychosis clinics, including all patients admitted between November 1st, 2019, and November 1st, 2023, followed for up to 3 years until May 1st, 2024. These 2 clinics admit approximately 200 patients annually, for an expected sample size of 800 individuals. The primary outcome is the occurrence of a DSM-5 diagnosis of gambling disorder. All patients are screened and evaluated for problem gambling using a systematic procedure at admission, and every 6 months thereafter. Socio-demographic and clinical variables are prospectively extracted from the patients’ medical records. The nature and effectiveness of treatments for problem gambling offered to affected individuals are also documented from medical records. Survival analyses with Cox regression models will be used to identify potential risk factors for problem gambling. Descriptive statistics will document the effectiveness of treatments for problem gambling in this population.

DISCUSSION: A better understanding of potential risk factors for problem gambling among people with first-episode psychosis will allow for better prevention and detection of this neglected comorbidity. Results of this study will also hopefully raise clinicians’ and researchers’ awareness and serve as the basis to adapted treatments that will better support recovery.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT05686772. Retrospectively registered, 9 January 2023.

PMID:37098506 | DOI:10.1186/s12888-023-04741-9

BMC Nurs. 2023 Apr 25;22(1):137. doi: 10.1186/s12912-023-01310-z.

ABSTRACT

BACKGROUND: Job satisfaction and factors affecting them are among the most important social issues. Resilience has a moderating role in the relationship between stress and diseases, so it can affect a person’s job satisfaction because it enables a person to deal with adverse conditions. This study aimed to investigate the relationship between nurses’ psychological resilience and job satisfaction during the COVID-19 outbreak.

METHODS: This descriptive-analytical cross-sectional study (2022) used convenience sampling to select 300 nurses. The Connor and Davidson Resilience Scale and Minnesota Satisfaction Questionnaire were used to collect data. The data were then analyzed with SPSS 22 and statistical methods (Independent t-test, Analysis of Variance, Pearson correlation coefficient, and Multiple linear regression).

RESULTS: The study results showed a positive and poor relationship between resilience, some of its dimensions (trust in individual instincts, tolerance of negative affect (p = 0.006), positive acceptance of change and secure relationships (p = 0.01), spiritual influences (p = 0.04)) and job satisfaction (p < 0.001). In other words, nurses’ high level of resilience increased their job satisfaction and vice versa.

CONCLUSIONS: Enhancing the resilience of frontline nurses during the COVID-19 pandemic improved their job satisfaction and affected care provided by them. Nurse managers can control nurses’ resilience and offer interventions that would strengthen it, especially at crises.

PMID:37098504 | DOI:10.1186/s12912-023-01310-z

BMC Cardiovasc Disord. 2023 Apr 25;23(1):208. doi: 10.1186/s12872-023-03234-7.

ABSTRACT

Brugada syndrome is an inherited cardiac arrhythmia disorder that is mainly associated with mutations of the cardiac voltage-gated sodium channel alpha subunit 5 (SCN5A) gene. The clinical symptoms include ventricular fibrillation and an increased risk of sudden cardiac death. Human-induced pluripotent stem cell (hiPSC) lines were derived from symptomatic and asymptomatic individuals carrying the R1913C mutation in the SCN5A gene. The present work aimed to observe the phenotype-specific differences in hiPSC-derived cardiomyocytes (CMs) obtained from symptomatic and asymptomatic mutation carriers. In this study, CM electrophysiological properties, beating abilities and calcium parameters were measured. Mutant CMs exhibited higher average sodium current densities than healthy CMs, but the differences were not statistically significant. Action potential durations were significantly shorter in CMs from the symptomatic individual, and a spike-and-dome morphology of action potential was exclusively observed in CMs from the symptomatic individual. More arrhythmias occurred in mutant CMs at single cell and cell aggregate levels compared with those observed in wild-type CMs. Moreover, there were no major differences in ionic currents or intracellular calcium dynamics between the CMs of asymptomatic and symptomatic individuals after the administration of adrenaline and flecainide.In conclusion, mutant CMs were more prone to arrhythmia than healthy CMs but did not explain why only one of the mutation carriers was symptomatic.

PMID:37098502 | DOI:10.1186/s12872-023-03234-7