Tag: statistics

J Cardiovasc Nurs. 2021 Feb 28. doi: 10.1097/JCN.0000000000000798. Online ahead of print.

ABSTRACT

BACKGROUND: Although several authors have analyzed the effects of spirituality on stroke survivors’ physical functioning and on their own caregiver’s outcomes, such as quality of life, only few authors have explored the interaction between spirituality and anxiety and depression using a dyadic approach.

OBJECTIVES: The aim of this study was to analyze the influence of spirituality in the stroke survivor-caregiver dyad and specifically on anxiety and depression in both parties.

METHODS: A total of 217 stroke survivor-caregiver dyads were enrolled at discharge from several rehabilitation hospitals in central and southern Italy. The actor-partner interdependence model was used to analyze the dyadic data. To verify the differences in the effects between survivors and caregivers, comparisons were made between the χ2 values of the model in which actor and partner effects were constrained to be equal.

RESULTS: The average age of stroke survivors and their caregivers at baseline was 71.2 and 52.7 years, respectively. Among the stroke survivors, there were slightly more men than women, whereas 65% of the caregivers were women. Most stroke survivors had had an ischemic stroke. Four statistically significant actor effects were identified. Higher survivors’ and caregivers’ spirituality was associated with higher survivor and caregiver anxiety. The only significant partner effect that was identified was the association between stroke survivor spirituality and caregiver depression.

CONCLUSIONS: This study highlights the importance of studying spirituality in the population with stroke. Spirituality seems to play an important protective role in both stroke survivors’ and caregivers’ depression but not in anxiety.

PMID:33657064 | DOI:10.1097/JCN.0000000000000798

J Clin Psychopharmacol. 2021 Feb 27. doi: 10.1097/JCP.0000000000001374. Online ahead of print.

ABSTRACT

PURPOSE/BACKGROUND: This study aimed to evaluate the frequency of needing to switch the initial treatment of a stimulant to the alternative family in newly referred, medication-naive adults with attention-deficit/hyperactivity disorder (ADHD) initiating treatment with stimulants.

METHODS/PROCEDURES: Subjects were 49 unmedicated adults (18-45 years old) with Diagnostic and Statistical Manual of Disorders (Fifth Edition) ADHD who initiated treatment with a stimulant. Before the clinical assessment with an expert clinician, participants completed the Adult Self-Report, Behavior Rating Inventory of Executive Function-Adult Version, Emotional Dysregulation Subscale of the Barkley Current Behavior Scale-Self-report, and Mind Wandering Questionnaire. The rate of switching was examined using information from the electronic medical record for up to three clinical follow-up visits. Comparisons were made between those who did and did not need to switch on baseline demographic and clinical characteristics.

FINDINGS/RESULTS: Sixty-seven percent of ADHD patients were initially prescribed a methylphenidate product, and 33%, an amphetamine product. Forty-one percent of ADHD patients needed to switch from their initially prescribed stimulant family within 90 days of initiating treatment because of poor tolerability. Whereas the rate of switching was significantly higher in those initially prescribed methylphenidate, the rate of patients who required changes in formulation (long- to short-acting and vice versa) or additional antianxiety or antidepressant treatment (“strugglers”) was higher in those taking amphetamine. Switchers were more impaired on the Adult Self-Report Intrusive scale, whereas nonswitchers were more impaired on the Behavior Rating Inventory of Executive Function Inhibit and Task Monitor scales. However, these findings were small and of unclear clinical significance.

IMPLICATIONS/CONCLUSIONS: Forty-one percent of medication-naive adults with ADHD initiating stimulant treatment required a switch from the initially prescribed stimulant family to the alternative one because of poor tolerability. Switching could not be adequately predicted by baseline demographic or clinical characteristics. These findings call for improved efforts to help identify predictors of response to stimulant treatment in adults with ADHD to avoid unnecessary delays in identifying a safe and effective treatment for these patients.

PMID:33657069 | DOI:10.1097/JCP.0000000000001374

PLoS One. 2021 Mar 3;16(3):e0246785. doi: 10.1371/journal.pone.0246785. eCollection 2021.

ABSTRACT

The availability of reliable socioeconomic data is critical for the design of urban policies and the implementation of location-based services; however, often, their temporal and geographical coverage remain scarce. We explore the potential for insurance customers data to predict socioeconomic indicators of Swiss municipalities. First, we define a features space by aggregating at city-level individual customer data along several behavioral and user profile dimensions. Second, we collect official statistics shared by the Swiss authorities on a wide spectrum of categories: Population, Transportation, Work, Space and Territory, Housing, and Economy. Third, we adopt two spatial regression models exploring both global and local geographical dependencies to investigate their predictability. Results show consistently a correlation between insurance customer characteristics and official socioeconomic indexes. Performance fluctuates depending on the category, with values of R2 > 0.6 for several target variables using a 5-fold cross validation. As a case study, we focus on predicting the percentage of the population using public transportation and we discuss the implications on a regional scope. We believe that this methodology can support official statistical offices and it could open up new opportunities for the characterization of socioeconomic traits at highly-granular spatial and temporal scales.

PMID:33657089 | DOI:10.1371/journal.pone.0246785

PLoS Comput Biol. 2021 Mar 3;17(3):e1008811. doi: 10.1371/journal.pcbi.1008811. Online ahead of print.

ABSTRACT

Forecasting the risk of pathogen spillover from reservoir populations of wild or domestic animals is essential for the effective deployment of interventions such as wildlife vaccination or culling. Due to the sporadic nature of spillover events and limited availability of data, developing and validating robust, spatially explicit, predictions is challenging. Recent efforts have begun to make progress in this direction by capitalizing on machine learning methodologies. An important weakness of existing approaches, however, is that they generally rely on combining human and reservoir infection data during the training process and thus conflate risk attributable to the prevalence of the pathogen in the reservoir population with the risk attributed to the realized rate of spillover into the human population. Because effective planning of interventions requires that these components of risk be disentangled, we developed a multi-layer machine learning framework that separates these processes. Our approach begins by training models to predict the geographic range of the primary reservoir and the subset of this range in which the pathogen occurs. The spillover risk predicted by the product of these reservoir specific models is then fit to data on realized patterns of historical spillover into the human population. The result is a geographically specific spillover risk forecast that can be easily decomposed and used to guide effective intervention. Applying our method to Lassa virus, a zoonotic pathogen that regularly spills over into the human population across West Africa, results in a model that explains a modest but statistically significant portion of geographic variation in historical patterns of spillover. When combined with a mechanistic mathematical model of infection dynamics, our spillover risk model predicts that 897,700 humans are infected by Lassa virus each year across West Africa, with Nigeria accounting for more than half of these human infections.

PMID:33657095 | DOI:10.1371/journal.pcbi.1008811

Br J Gen Pract. 2021 Mar 2:BJGP.2020.0178. doi: 10.3399/BJGP.2020.0178. Online ahead of print.

ABSTRACT

BACKGROUND: In England, general practitioners (GPs) are independent contractors working to a national contract. Since 2017 the contract requires GPs to use electronic tools to proactively identify moderate and severe frailty in people aged 65 and over and offer interventions to help those identified to stay well and maintain independent living. Little is currently known about GPs’ views of this contractual requirement.

AIM: To explore GPs’ views of identifying frailty and offering interventions for those living with moderate or severe frailty.

DESIGN AND SETTING: Sequential mixed-methods study of GPs in the East Midlands region of England (Derbyshire, Leicestershire, Lincolnshire, Nottinghamshire, Northamptonshire) between January and May 2019.

METHODS: Survey of GPs by online questionnaire, followed by semi-structured interview. Based on survey responses GPs with a range of views on identifying frailty, GP and practice characteristics, were selected for interview. Questionnaires were analysed using descriptive statistics. Interview transcripts were analysed using framework analysis.

RESULTS: 188 (6.1%) GPs responded to the survey and 18 GPs were interviewed. GPs were broadly supportive of identifying frailty, but felt risk-stratification tools lacked sensitivity and specificity and wanted evidence showing clinical benefit. Frailty identification increased workload and was under-resourced, with limited time for, and access to necessary interventions. GPs felt they lacked knowledge about frailty and more education was required.

CONCLUSION: Proactively identifying and responding to frailty in primary care requires GP education, highly sensitive and specific risk-stratification tools, access to interventions to lessen the impact of frailty and adequate resourcing to achieve its potential clinical impact.

PMID:33657008 | DOI:10.3399/BJGP.2020.0178

Am J Phys Med Rehabil. 2021 Feb 27. doi: 10.1097/PHM.0000000000001740. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate and compare the efficacy of an online and a traditionally delivered undergraduate elective courses in improving medical students’ disability related knowledge and attitudes.

METHODS: A randomized controlled design was implemented. Participants were medical students randomly assigned into summer 8-week disability and the society (OT100) online course, OT100 traditional course, or Wellness and Life Styles (PT100) control. Demographics were collected in addition to participants’ level disability knowledge and Attitudes Toward People with Disability scale scores (ATDP) one week prior to the semester and one week after it. Multivariate analysis of covariance (MANCOVA) using general linear model (GLM) was conducted to evaluate groups’ differences in main outcome measures.

RESULTS: In total, 198 undergraduate medical students successfully completed the study conditions; OT100 online (n = 74), OT100 traditional (n = 59), and PT100 (n = 65). OT100 groups (traditional and online) change scores were statistical similar for disability knowledge (p = 0.966) and attitudes (p = 0.705) but significantly better (p < 0.001) than the control group.

CONCLUSIONS: OT100 course delivered traditionally or regular appeared effective in improving medical students’ disability knowledge and ATDP. More studies are needed to create effective methods improving healthcare professionals’ disability related knowledge and attitudes.

PMID:33657029 | DOI:10.1097/PHM.0000000000001740

Adv Exp Med Biol. 2021;1321:245-251. doi: 10.1007/978-3-030-59261-5_21.

ABSTRACT

Aim The COVID-19 was declared a pandemic in early 2020 and is associated with high public anxiety all over the world. The healthcare community is at the highest risk of infection and thereby prone to most distress. The aim of this study was to explore and evaluate the degree of depression, anxiety, and stress levels among medical college students during the COVID-19 epidemic in Iran. Methods A cross-sectional study was conducted in February and March 2020, 3 weeks after the first reported COVID-19 infection was identified in Iran. All medical college students who entered clinical courses were eligible for the study. Depression, stress, and anxiety were evaluated in these students using the DASS-21 questionnaire. Participants were selected by using availability sampling. All statistical analyses were performed using R version 3.5.1. Results The total number of participants was 207, with 143 males and 64 females. More than half of the participants (57.97%) were married. The mean duration of working experience among students with COVID-19 infection and experience in a medical ward was 3.00 ± 1.27 days and 17.40 ± 7.26 months, respectively. The majority of students had 2 or 3 days working experience with COVID-19 infection. The mean anxiety score of participants was 28.56 ± 4.68, the depression score was 29.36 ± 4.42, and the stress score was 28.99 ± 4.53. Our findings indicated that the mean scores of depression were at an “extremely severe” level, while stress and anxiety were at “severe” levels. The prevalence of “severe” symptoms of depression, stress, and anxiety was 69.57%, 60.87%, and 99.04%, respectively. Conclusions There is a high prevalence of anxiety and depression among medical students who were exposed to COVID-19-infected patients. Our results highlight the need to establish psychological support programs, training, and self-care for medical college students in relation to mental health. We recommend incorporation of molecular biomarker tests into an algorithm to aid in assessments and consideration of the appropriate therapeutic responses.

PMID:33656729 | DOI:10.1007/978-3-030-59261-5_21

Adv Exp Med Biol. 2021;1321:253-260. doi: 10.1007/978-3-030-59261-5_22.

ABSTRACT

Aim The ongoing COVID-19 outbreak has not only had an impact on physical health but also on psychological health. The aim of this study was to measure the prevalence and severity of psychological distress in the community due to the COVID-19 pandemic. Methods This cross-sectional survey was conducted in February and March 2020 in Tehran, Iran. We analyzed demographic characteristics and assessed depression, anxiety, and stress levels in 241 people using convenience sampling and the DASS-21 questionnaire. All statistical analyses were performed using R. Results The study population included 241 community-dwelling participants, of whom 145 were women and 96 were males. The mean age was 49.16 ± 8.01 years. Approximately two-thirds of participants (n = 158) reported no history of comorbid illness. The mean scores of depression and stress were at a “severe” level, while anxiety levels were at an “extremely severe” level. The prevalence of severe and extremely severe depression readings was 51.45 and 38.17%, respectively. In the anxiety subscale, the prevalence of severe and extremely severe depression was 95.90 and 4.1%, and in the stress subscale the prevalence was 48.97 and 4.98%, respectively. Conclusion In this study, people reported experiencing severe and extremely severe psychological distress. Therefore, there is an urgent need to implement mental health intervention policies to cope with this ongoing challenge. We suggest that the incorporation of molecular biomarker tests into the algorithm could aid in assessment of patients and guide the most appropriate therapeutic response.

PMID:33656730 | DOI:10.1007/978-3-030-59261-5_22

J Assist Reprod Genet. 2021 Mar 3. doi: 10.1007/s10815-021-02131-2. Online ahead of print.

ABSTRACT

OBJECTIVE: The primary objective of this study was to test the hypotheses that compared to IVF cycles undergoing preimplantation genetic testing for aneuploidy (PGT-A) with or without testing for monogenic disorders (PGT-M), IVF cycles undergoing PGT for structural rearrangements (PGT-SR) will have (1) a poorer blastocyst conversion rate and (2) fewer usable blastocysts available for transfer. Secondarily, the study aimed to compare pregnancy outcomes among PGT groups.

PATIENTS: Retrospective cohort study including cycles started from January 1, 2012, to March 30, 2020, with the intent of pursuing PGT-A, PGT-A with PGT-M, and PGT-SR, with trophectoderm biopsy on days 5 or 6.

RESULTS: A total of 658 women underwent 902 cycles, including 607 PGT-A, 216 PGT-A&M, and 79 PGT-SR cycles. When compared with the blastocyst conversion rate for the PGT-A group (59.4%), and after adjustment for patient age, total number of mature oocytes, BMI, and ICSI, there were no significant differences for either the PGT-A&M (69.7%, aRR 1.03, 95% CI 0.96-1.10) or PGT-SR (63.2%, aRR1.04, 95% CI 0.96-1.13) groups. Compared to the PGT-A group, the proportion of usable blastocysts was statistically significantly lower in the PGT-SR group: 35.1% versus 24.4% (aRR 0.57, 95% CI 0.46-0.71) and the PGT-A&M group: 35.1% versus 31.5% (aRR 0.68, 95% CI 0.58-0.81). Implantation, pregnancy, and miscarriage rates were equivalent for all groups.

CONCLUSION: Patients with structural rearrangements have similar blastocyst development but significantly fewer usable blastocysts available for transfer compared to PGT-A testers. Nevertheless, with the transfer of a usable embryo, PGT-SR testers perform as well as those testing for PGT-A.

PMID:33656620 | DOI:10.1007/s10815-021-02131-2

Adv Exp Med Biol. 2021;1321:229-236. doi: 10.1007/978-3-030-59261-5_19.

ABSTRACT

AIM: Patients with confirmed COVID-19 infection can develop several psychological consequences. Epidemiological data on mental health and psychological disorder inpatients infected with COVID-19 pneumonia are not available in Iranian patients. The purpose of this study was to evaluate the anxiety, stress, and depression of patients with COVID-19.

MATERIAL AND METHODS: This cross-sectional survey was conducted in 2020. All confirmed patients with COVID-19 were included in the study by census sampling. Assessment of depression, stress, and anxiety was performed using the DASS-21 questionnaire. All statistical analyses were performed using R version 3.5.1.

RESULTS: The questionnaires were completed by 221 patients with COVID-19 infection (204 males, 17 females). The mean age was 45.90 ± 7.73 years. Our results indicated that the mean scores of depression and anxiety were at “extremely severe” levels, while stress levels were “severe.” The prevalence of “extremely severe” symptoms of depression and anxiety was 54.29% and 97.29%, respectively. The prevalence of severe stress was 46.61%.

CONCLUSION: In this study, patients infected with COVID-19 reported severe and extremely severe experience psychological distress. Further studies should focus on the combined use of psychological and molecular biomarker testing to increase accuracy. Overall, the findings demonstrate the necessity of special intervention programs for the confirmed patients with emerging infectious disease COVID-19 to promote mental health needs.

PMID:33656727 | DOI:10.1007/978-3-030-59261-5_19