Tag: statistics

J Med Imaging Radiat Sci. 2021 Sep 25:S1939-8654(21)00202-2. doi: 10.1016/j.jmir.2021.08.017. Online ahead of print.

ABSTRACT

INTRODUCTION: Two-stage collaborative group testing is an assessment format where students first complete a summative assessment independently, and then immediately convene in a small group to complete the same assessment again. Research on two-stage collaborative group testing has shown that it increases immediate learning, improves communication and teamwork, and can lead to enhanced retention of course material; the latter of which is especially important for basic anatomical concepts among health care professionals such as medical radiation technologists. However, such previous research has often employed quasi-experimental designs that may limit both internal and external validity.

METHODS: Using a randomized crossover design with both quantitative and qualitative data analyses including robust intra-individual statistical comparisons, this research compared the educational impact of the two-stage collaborative group testing format (the COL condition) to traditional independent testing (the IND condition). Students (n=196) from two successive renditions of an introductory anatomy course were randomly assigned into groups of 3-5 students. Groups worked together throughout the term on various course elements, including three in-class, non-cumulative term tests (TTs). After practicing the collaborative format during TT1, during TT2 half the groups were assigned to the COL condition while the other half were assigned to the IND condition. Groups crossed over for TT3. All students completed a cumulative final examination independently, with performance data from that examination coded and extracted according to previous TT condition. Educational impact was evaluated as both immediate learning (by comparing IND and COL performance on the associated TT) as well as retention (by comparing final examination performance for topics previously IND tested versus previously COL tested). Students’ qualitative reflections were coded into categories and juxtaposed against quantitative Likert-style feedback to comprehensively explore students’ perception of the testing format for evidence of enjoyment, acceptability, and influence on relevant CAMRT professional competencies.

RESULTS: 167 students (85%) consented to data inclusion, with a final course grade of 75.5 ± 10.0%. On average, TT performance was 13.6 ± 11.6% greater on the COL test (90.4 ± 7.6%) than the IND test (76.7 ± 14.3%) (p<0.01, r = 0.76), results that support immediate learning. Contrary to expectations, final examination performance specific to the two experimental conditions was similar, with students earning an average of 69.6 ± 18.3% on questions that pertained to material they were previously IND tested on, and 67.4 ± 19.1% on questions they were previously COL tested on (ns). Students’ overall perceptions of the two-stage collaborative group testing format were overwhelmingly positive, with 84% indicating a belief that the format was a constructive learning opportunity and 74% recommending continued use. Written reflections revealed that students believed that collaborative testing enhanced their learning by both clarifying previous mistakes and reinforcing correct knowledge. Relevant CAMRT professional competencies included oral communication and interprofessional skills, capacity for productive teamwork, and collaborative practice.

SIGNIFICANCE: Although the results of this study do not support the use of two-stage collaborative group testing for retention of course material, they simultaneously reveal how the testing structure may be uniquely beneficial to students studying within the field of medical radiation sciences while also presenting a pragmatic example of how to implement this unique testing format.

PMID:34583909 | DOI:10.1016/j.jmir.2021.08.017

J Am Pharm Assoc (2003). 2021 Sep 17:S1544-3191(21)00374-5. doi: 10.1016/j.japh.2021.09.004. Online ahead of print.

ABSTRACT

BACKGROUND: Emotional intelligence (EI) is known to improve teamwork, communication, and organizational commitment. The role of EI has also influenced pharmacists’ ability to empathize, control emotions, and actively listen. Although EI’s impact on work-related components, including occupational stress, job performance, and psychological affective well-being, has been studied, there are no data specific to the practice of pharmacy.

OBJECTIVE: The primary objective of this study was to determine whether a significant correlation exists between pharmacist EI and work-related components.

METHODS: A voluntary Qualtrics survey (Qualtrics, Provo, UT) was distributed electronically to all active pharmacists licensed by the Florida Board of Pharmacy, which included questions from valid and reliable assessment tools. Spearman correlations were used to examine the association between EI facets and dependent variables of occupational stress, job performance, and psychological affective well-being. A subanalysis was conducted to evaluate demographic data. Statistical significance was set at P < 0.05 for all tests. Incomplete survey responses were included in the analysis.

RESULTS: A total of 942 responses were received and analyzed. Most of the respondents were aged 44 years or younger (42.5%), female (46.9%), identified as Caucasian (52.8%), and worked 31-40 hours weekly (20.6%). Most of the respondents reported a primary employment setting within community (29.3%) or hospital (18.6%) pharmacy. Higher EI correlated with lower levels of occupational stress, higher job performance, and higher psychological affective well-being. Secondary outcomes reported increased stress for both females and those practicing in the community setting; hospital-based pharmacists reported higher job performance and psychological affective well-being. Stress decreased with both age and years of experience.

CONCLUSION: Higher EI may support overall wellness for pharmacists on the basis of the results of this study. Additional evaluation of demographic data, including practice settings, and a more robust cohort of participants would provide more insight in this area.

PMID:34583907 | DOI:10.1016/j.japh.2021.09.004

Surg Obes Relat Dis. 2021 Sep 3:S1550-7289(21)00410-X. doi: 10.1016/j.soard.2021.08.011. Online ahead of print.

ABSTRACT

BACKGROUND: Research shows that surgery patients who have undergone Roux-en-Y gastric bypass (RYGB) are at increased risk for an alcohol use disorder (AUD). However, the mechanisms through which this increased risk is incurred are poorly understood. A host of variables have been proposed as potentially causal in developing AUDs, but empirical examination of many of these variables in human samples is lacking.

OBJECTIVES: Our objective was to examine the extent to which alcohol pharmacokinetics (PK), the rewarding effects of alcohol, and the relationship between these variables change from before to after weight loss surgery.

SETTING: Large healthcare facility in the Midwest United States METHODS: Thirty-four participants completed assessments before and 1 year after RYGB. They completed laboratory sessions and provided data on the PK of alcohol and the extent to which alcohol was reinforcing to them at each timepoint.

RESULTS: Findings show that the PK effects of alcohol (P < .01) and how rewarding alcohol was reported to be (P < .01) changed from before to 1 year after weight loss surgery. Further, statistically significant increases in the association between these variables were witnessed from before to 1 year after surgery (P < .01).

CONCLUSION: These results implicate changes (from before surgery to one year after) in the reinforcing and PK effects of alcohol as possible mechanisms for increased risk of alcohol use disorder following Roux-en-Y gastric bypass surgery.

PMID:34583891 | DOI:10.1016/j.soard.2021.08.011

J Voice. 2021 Sep 25:S0892-1997(21)00251-4. doi: 10.1016/j.jvoice.2021.08.001. Online ahead of print.

ABSTRACT

OBJECTIVES: Professional singers’ careers are usually associated with health-relevant factors that they themselves may or may not be able to influence. We have therefore investigated the effect of modifiable health-related behaviors and non-modifiable factors on singers’ occupational health.

METHODS: In an explorative, questionnaire-based study, self-reported, occupationally relevant health complaints and behaviors, along with singer-specific characteristics, were surveyed from 349 professional singers and voice teachers (116 men, 233 women; age 18-73 years) and the influence of age, gender, duration of daily and lifelong singing, voice category, and health-related behaviors (smoking, alcohol consumption, physical activity) on occupationally relevant health complaints were analyzed using bi- and multivariate statistical methods.

RESULTS: Singers reported less risky alcohol consumption (5.4% versus ≈15%) and smoking (15.5% versus 29.7%) than the general population, and too little physical activity was described in two thirds of both populations. After controlling for multiple testing, no effect was found for these behaviors, the time spent singing daily, gender, or voice categories on singers’ complaints. Health complaints were significantly fewer for males (P < .001) and older women and were reported more frequently for higher-pitched male voices, a trend not found in females.

CONCLUSION: Singers seem to smoke and drink less than members of the general population. These factors did not affect their complaints. Female singers described more work-related health complaints than males, a finding that corresponds to women in the general population. Older singers reported fewer complaints than younger singers, possibly because of selection effects or older singers acquiring strategies to avoid health-damaging behavior.

PMID:34583882 | DOI:10.1016/j.jvoice.2021.08.001

Neurologia (Engl Ed). 2021 Sep 25:S2173-5808(21)00143-7. doi: 10.1016/j.nrleng.2019.12.004. Online ahead of print.

ABSTRACT

INTRODUCTION: Manual therapy has been shown to reduce self-reported symptoms in patients with chronic tension-type headache (CTTH). However, simultaneous application of suboccipital muscle inhibition and interferential current has not previously been investigated. This study evaluates the effectiveness of combined treatment with suboccipital muscle inhibition and interferential current compared to standard treatment for pain, disability, and headache impact in patients with CTTH.

METHODS: Patients were randomly allocated to receive either standard treatment (n = 13) or the experimental treatment (n = 12), consisting of 20 minutes of suboccipital muscle inhibition plus interferential current twice weekly for 4 weeks. The primary outcome was improvement in pain, and secondary outcomes included improvement in headache-related disability and reduction in headache impact, which were assessed at baseline and at 4 weeks by a blinded rater.

RESULTS: Statistical analysis showed improvements in the experimental treatment group at 4 weeks for headache-related disability (Neck Disability Index: Hedges’ g = 1.01, P = .001; and Headache Disability Inventory: Hedges’ g = 0.48, P = .022) and headache impact (6-item Headache Impact Test: Hedges’ g = 0.15, P = .037) but not for self-reported pain (numerical rating scale: Hedges’ g = 1.13, P = .18).

CONCLUSIONS: Combined treatment with suboccipital muscle inhibition and interferential current in patients with CTTH did not significantly improve self-reported pain but did reduce disability and the impact of headache on daily life at 4 weeks. These improvements exceed the minimum clinically important difference, demonstrating the clinical relevance of our findings.

PMID:34583886 | DOI:10.1016/j.nrleng.2019.12.004

Am J Perinatol. 2021 Sep 28. doi: 10.1055/s-0041-1735214. Online ahead of print.

ABSTRACT

OBJECTIVE: An alternative therapy for preterm infants with a hemodynamically significant patent ductus arteriosus (hsPDA) is needed when cyclooxygenase inhibitors fail or where treatment is contraindicated due to coexisting renal failure, necrotizing enterocolitis, and/or intestinal perforation. No studies have evaluated the efficacy of per rectum (PR) acetaminophen. The study aimed to evaluate the efficacy of PR acetaminophen in modulating the risk of PDA ligation.

STUDY DESIGN: A retrospective matched case-control study was conducted to compare neonates born <29 weeks’ gestation with evidence of hsDA, in an era when rescue rectal acetaminophen was used (January 2014-March 2018) as a treatment strategy, versus historical controls (July 2006-August 2012). All patients underwent comprehensive echocardiography assessment of ductal shunt volume according to a standardized protocol. Acetaminophen treated neonates were matched according to demographics, gestation, preintervention echocardiography features, and comorbidities. Control patients were selected when an echocardiography was performed at an equivalent postnatal age. Infants with a genetic syndrome, severe congenital malformation, or major forms of congenital heart disease excluding small atrial septal defect or ventricular septal defect, PDA, or patent formale ovale were excluded. The primary outcome was surgical ligation of the PDA. Secondary outcomes included echocardiography indices of hemodynamic significance, the composite of death, or severe BPD (defined by ventilator dependence at 36 weeks postmenstrual age). Descriptive statistics and univariate (t-tests, Fisher’s exact test, and Mann-Whitney U test) analyses were used to evaluate clinical and echocardiography characteristics of the groups and compare outcomes.

RESULTS: Forty infants (20 cases and 20 controls), with similar demographic and echocardiography features, were compared. Cases received 6.8 ± 0.7 days (60 mg/kg/day) of PR acetaminophen. Responders (n = 12, 60%) had echocardiography evidence of reduced ductal diameter (2.2 mm [1.9-2.6] to 1.1 mm [0-1.7], p = 0.002), left ventricular output (363 ± 108-249 ± 61 mL/min/kg; p = 0.002) and left atrium to aortic root ratio (1.7 ± 0.3-1.3 ± 0.2; p = 0.002) following treatment. The rate of PDA ligation was 50% lower (p = 0.02) and composite outcome of death or severe bronchopulmonary dysplasia was reduced (p = 0.04) in the acetaminophen group.

CONCLUSION: Rectal acetaminophen was associated with improvement in echocardiography indices of PDA shunt volume, a 50% reduction in PDA ligation rates and a reduction in the composite outcome of death or severe BPD. Pharmacologic and further prospective clinical studies are needed.

KEY POINTS: · Many preterm infants encounter the clinical consequences of a hemodynamically significant PDA.. · The merits and optimal timing of PDA ligation remains an area of controversy amongst neonatologists.. · Cyclooxygenase inhibitors are associated with adverse events or are often contraindicated..

PMID:34583409 | DOI:10.1055/s-0041-1735214

Pediatr Pulmonol. 2021 Sep 28. doi: 10.1002/ppul.25692. Online ahead of print.

ABSTRACT

BACKGROUND: Spirometry values of First Nations Australian children are lower than White children. One explanation relates to differences in the sitting-height/standing-height ratio (Cormic Index), as this accounts for up to half the observed differences in spirometry values between White children and other ethnicities. We investigated whether the Cormic Index of First Nations children differs from White children and if this explains the lower spirometry values of First Nations children.

METHODS: First Nations children (n = 619) aged 8-16 years were recruited from nine Queensland communities. Their spirometry and Cormic Index data were compared to that of White children (n = 907) aged 8-16 years from the NHANES III dataset.

RESULTS: FEV₁ and FVC of First Nations children was 8% lower for children aged 8-11.9 years and 9%-10% lower for children aged 12-16 years. The Cormic Index was statistically lower in the First Nations 8-11.9 years group (median = 0.515, interquartile range [IQR]: 0.506-0.525) compared with White children (0.519, IQR: 0.511-0.527), and this difference was greater in the 12-16 years group (0.505, IQR: 0.492-0.516; 0.520, IQR: 0.510-0.529). Adjusting for age, sex, and standing height, lower Cormic Index of First Nations children accounts for 14% (95% confidence interval [CI]: 7%-21%) of FEV₁ and 15% (95% CI: 8%-21%) of FVC differences in the younger group, and 26% (95% CI: 16%-37%) of FEV₁ and 31% (95% CI: 19%-42%) of FVC differences in the older group.

CONCLUSION: Ethnic differences in Cormic Index partly account for why healthy First Nations Australian children have lower spirometry values than White children. As childhood spirometry values impact adult health, other contributing factors require attention.

PMID:34583422 | DOI:10.1002/ppul.25692

Handchir Mikrochir Plast Chir. 2021 Sep;53(5):467-474. doi: 10.1055/a-1559-2783. Epub 2021 Sep 28.

ABSTRACT

PURPOSE: This retrospective study compares the functional outcome after early active postoperative motion with the outcome after 6 weeks of immobilization by splinting in patients with proximal phalangeal fractures treated by percutaneous, antegrade pinning.

PATIENTS AND METHODS: 46 out of 90 patients treated by closed reduction and percutaneous antegrade pinning of isolated fractures of the proximal phalanges were re-evaluated on average after 18.5 months. There were 17 women and 29 men with a mean age of 42.8 years. 28 patients underwent early active postoperative motion and 18 patients were immobilized by splinting for 6 weeks postoperatively. The two groups were statistically comparable with respect to age, gender, fracture localisation and morphology, mechanism of injury and operative time. Follow-up examination included measurement of active and passive range of motion (TAM; TPM) of the injured finger and the uninjured finger of the opposite side as well as grip strength of both hands. In addition, postoperative complications, the DASH-score and time interval between surgery and return to work were registered.

RESULTS: There were no significant differences between the two groups regarding rate of complication, number or required revisions, finger motion and grip strenght. Patients with early active motion returned earlier back to work than patients treated by postoperative splinting (2.5 vs. 9.0 weeks; p = 0.035). With 1.7 the DASH-score in the group with early active motion was better than in the splinting group with 2.5 (p = .269).

CONCLUSION: Patients with early active postoperative motion returned earlier back to work. There was no significant difference between both groups respecting global finger function.Compliant patients with a fracture of the proximal phalanx treated by closed reduction and percutaneous pinning can be treated with early active motion postoperatively.

PMID:34583402 | DOI:10.1055/a-1559-2783

Orthop Nurs. 2021 Sep-Oct 01;40(5):281-289. doi: 10.1097/NOR.0000000000000787.

ABSTRACT

Beyond the spine-specific pathology, patient factors such as associated medical and psychosocial conditions, understanding of the treatment process, and the degree of patient activation-defined as the ability of the individual to utilize the available information and actively engage in making their healthcare decisions-can influence outcomes after posterolateral lumbar fusion (PLF) surgery. A retrospective observational cohort study of 177 patients undergoing PLF at a single institution was conducted. Patient demographics, medical and psychosocial risk factors, and outcomes were compared between patients who attended a nurse navigator-led group preoperative education course and those who did not. Patients attending the course were younger, more likely to undergo one-level fusion, less likely to undergo 5- or more-level fusion, and had less comorbidity burden as measured by the hierarchical condition categories score. No differences in psychosocial risk factors were observed between groups. Course attendees had a significantly shorter length of stay (2.12 vs. 2.60 days, p = .042) and decreased average hospital cost (U.S. $10,149 vs. U.S. $14,792, p < .001) than those who did not attend; no differences in other outcomes were observed. After controlling for differences in risk factors, patients enrolled in a preoperative education course demonstrated a statistically significant reduction in hospital cost (β=-4,143, p < .001). Preoperative education prior to PLF surgery may reduce hospital cost, possibly through increased patient activation. Given the relatively high prevalence of psychosocial risk factors in this and similar patient populations, optimizing patient activation and engagement is important to achieve high value care. Based on our findings, nurse navigator-led preoperative education appears to be valuable in this patient population and should be included in enhanced recovery protocols.

PMID:34583373 | DOI:10.1097/NOR.0000000000000787

J Knee Surg. 2021 Sep 28. doi: 10.1055/s-0041-1735159. Online ahead of print.

ABSTRACT

Patellofemoral arthroplasty (PFA) is acknowledged as the method for the treatment of isolated patellofemoral osteoarthritis (PFOA). Few previous studies have assessed the patient-reported outcomes (PROs) and risk factors of less improvement of PROs in patients undergoing PFA. A retrospective analysis was performed, including all patients who had undergone PFA. Pre- and postoperative PROs included the Oxford Knee Score (OKS) and Kujala score. Univariate and multivariate statistical analyses were performed to assess influencing factors of less improvement of PROs including the demographic factors (gender, age, body mass index, smoking, opioid usage, and duration of symptoms [DOSs]), surgical factors (concomitant surgery), and imaging factors (trochlear dysplasia [TD], patellar height, the degree of PFOA). A total of 46 PFAs were analyzed with a mean follow-up of 37 ± 7 months. The mean age at surgery was 61.1 ± 7.7 years. Patients showed significant improvement in all PROs (p < 0.001). Patients with TD preoperatively have greater improvement in OKS and Kujala score postoperatively (19.2 ± 5.0 vs. 23.1 ± 3.6, p = 0.038). Longer DOSs (≥1 year) had a greater mean improvement in OKS and Kujala score (p = 0.011 and p = 0.000). According to the measurement of patella height, patients with patella alta (Caton-Deschamps index [CDI] ≥1.3) showed less improvement in both OKS and Kujala score (p = 0.000 and p = 0.002). PFA is a safe and efficient surgery with good PROs. Patella alta with a CDI ≥1.3 and duration of preoperative symptoms ≤ 1 year were risk factors for decreased OKS and Kujala score improvement, while the preoperative presence of TD was significantly predictive factors for increased OKS improvement.

PMID:34583395 | DOI:10.1055/s-0041-1735159