59,183 results
Search Results
202. Do surveys with paper and electronic devices differ in quality and cost? Experience from the Rufiji Health and demographic surveillance system in Tanzania.
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Mukasa, Oscar, Mushi, Hildegalda P., Maire, Nicolas, Ross, Amanda, and de Savigny, Don
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ELECTRONIC health records , *CONFIDENCE intervals , *INTERVIEWING , *MEDICAL errors , *MEDICAL personnel , *SURVEYS , *ECONOMICS - Abstract
Background: Data entry at the point of collection using mobile electronic devices may make data-handling processes more efficient and cost-effective, but there is little literature to document and quantify gains, especially for longitudinal surveillance systems. Objective: To examine the potential of mobile electronic devices compared with paper-based tools in health data collection. Methods: Using data from 961 households from the Rufiji Household and Demographic Survey in Tanzania, the quality and costs of data collected on paper forms and electronic devices were compared. We also documented, using qualitative approaches, field workers, whom we called ‘enumerators’, and households’ members on the use of both methods. Existing administrative records were combined with logistics expenditure measured directly from comparison households to approximate annual costs per 1,000 households surveyed. Results: Errors were detected in 17% (166) of households for the paper records and 2% (15) for the electronic records (p < 0.001). There were differences in the types of errors (p = 0.03). Of the errors occurring, a higher proportion were due to accuracy in paper surveys (79%, 95% CI: 72%, 86%) compared with electronic surveys (58%, 95% CI: 29%, 87%). Errors in electronic surveys were more likely to be related to completeness (32%, 95% CI 12%, 56%) than in paper surveys (11%, 95% CI: 7%, 17%).The median duration of the interviews (‘enumeration’), per household was 9.4 minutes (90% central range 6.4, 12.2) for paper and 8.3 (6.1, 12.0) for electronic surveys (p = 0.001). Surveys using electronic tools, compared with paper-based tools, were less costly by 28% for recurrent and 19% for total costs. Although there were technical problems with electronic devices, there was good acceptance of both methods by enumerators and members of the community. Conclusions: Our findings support the use of mobile electronic devices for large-scale longitudinal surveys in resource-limited settings. [ABSTRACT FROM PUBLISHER]
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- 2017
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203. Urodynamic Parameters and Continence Outcomes in Asymptomatic Patients with Ileal Orthotopic Neobladder: A Systematic Review and Metanalysis.
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Asimakopoulos, Anastasios D., Finazzi Agrò, Enrico, Piechaud, Thierry, Gakis, Georgios, Gaston, Richard, and Rosato, Eleonora
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ILEUM surgery ,MEDICAL information storage & retrieval systems ,NEUROGENIC bladder ,URINARY incontinence ,URODYNAMICS ,TREATMENT effectiveness ,META-analysis ,DESCRIPTIVE statistics ,SYSTEMATIC reviews ,MEDLINE ,URINARY diversion ,MEDICAL databases ,ONLINE information services ,CONFIDENCE intervals - Abstract
Simple Summary: Among the various options for urinary diversion following radical cystectomy, the orthotopic neobladder most closely resembles the original bladder both in location and function. However, a significant number of patients with these reservoirs have dysfunctional voiding. Our objective here is to provide the first systematic review focusing on the urodynamic and continence outcomes of ileal orthotopic neobladders. By summarising these important outcomes, the current paper may represent the reference manuscript for outcome comparison in future papers. The manuscript also describes the methodology of the urodynamic evaluation of the neobladders, highlighting the frequent lack of precise indications, accurate guidelines (at the state of the art, the same parameters used for the native bladder are also used for the ileal neobladders), standardised definitions, and standard values for outcome comparison. By underlining these gaps, our systematic review may aid future studies in having more adequate designs and will allow for a more accurate functional evaluation of the patients harbouring an ileal neobladder. Introduction: The orthotopic neobladder is the type of urinary diversion (UD) that most closely resembles the original bladder. However, in the literature the urodynamic aspects are scarcely analysed. Objective: To provide the first systematic review (SR) on the urodynamic (UDS) outcomes of the ileal orthotopic neobladders (ONB). Continence outcomes are also presented. Methods: A PubMed, Embase and Cochrane CENTRAL search for peer-reviewed studies on ONB published between January 2001–December 2022 was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Results and Conclusion: Fifty-nine manuscripts were eligible for inclusion in this SR. A great heterogeneity of data was encountered. Concerning UDS parameters, the pooled mean was 406.2 mL (95% CI: 378.9–433.4 mL) for maximal (entero)cystometric capacity (MCC) and 21.4 cmH
2 O (95% CI: 17.5–25.4 cmH2 O) for Pressure ONB at MCC. Postvoid-residual ranged between 4.9 and 101.6 mL. The 12-mo rates of day and night-time continence were 84.2% (95% CI: 78.7–89.1%) and 61.7% (95% CI: 51.9–71.1%), respectively.Despite data heterogeneity, the ileal ONB seems to guarantee UDS parameters that resemble those of the native bladder. Although acceptable rates of daytime continence are reported the issue of high rates of night-time incontinence remains unsolved. Adequately designed prospective trials adopting standardised postoperative care, terminology and methods of outcome evaluation as well as of conduction of the UDS in the setting of ONB are necessary to obtain homogeneous follow-up data and to establish UDS guidelines for this setting. [ABSTRACT FROM AUTHOR]- Published
- 2024
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204. Impact of surgical site infection after open and laparoscopic surgery among paediatric appendicitis patients: A meta‐analysis.
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Liu, Jun and Wang, Qian
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APPENDECTOMY ,MEDICAL information storage & retrieval systems ,LAPAROSCOPIC surgery ,APPENDICITIS ,TREATMENT effectiveness ,META-analysis ,DESCRIPTIVE statistics ,SURGICAL complications ,OPERATIVE surgery ,SYSTEMATIC reviews ,ODDS ratio ,SURGICAL site infections ,CONFIDENCE intervals ,DISEASE risk factors ,CHILDREN - Abstract
Operative site wound infection is one of the most frequent infections in surgery. A variety of studies have shown that the results of laparoscopy might be superior to those of an open procedure. Nevertheless, there is still a lack of clarity as to whether there is a difference between open and laparoscopy with respect to the occurrence of wound infections in different paediatric operations. In this review, we looked at randomized, controlled studies that directly measured the rate of wound infection following an appendectomy with a laparoscope. We looked up four main databases for randomized, controlled studies that compare the treatment of paediatric appendicitis with laparoscopy. The surgeries included appendectomy. Through our search, we have determined 323 related papers and selected five qualified ones to be analysed according to the eligibility criteria. Five trials were also assessed for the quality of the documents. In the 5 trials, there were no statistically significant differences in the incidence of post‐operative wound infection among the paediatric appendectomy and the open‐access group (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.34–1.15, p = 0.13). The four trials did not show any statistically significant difference in abdominal abscesses among the laparoscopic and open‐access treatment groups (OR, 1.64; 95% CI, 0.90–3.01, p = 0.11). The four trials did not reveal any statistically significant difference in operating time (mean difference, −4.36; 95% CI, −17.31 to 8.59, p = 0.51). In light of these findings, the use of laparoscopy as compared with the open‐approach approach in paediatric appendectomies is not associated with a reduction in the risk of wound infection. [ABSTRACT FROM AUTHOR]
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- 2024
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205. Effect of comprehensive nursing care for the liver cancer patients undergoing interventional therapy in China: A systematic review and meta‐analysis.
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Zhang, Shimei, Li, Na, Mao, Xuying, and Yang, Dongxia
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LIVER tumors ,MEDICAL information storage & retrieval systems ,CINAHL database ,NURSING ,NURSING interventions ,TREATMENT effectiveness ,META-analysis ,ANXIETY ,SYSTEMATIC reviews ,MEDLINE ,SURGICAL complications ,ODDS ratio ,QUALITY of life ,ONLINE information services ,CONFIDENCE intervals ,HEPATOCELLULAR carcinoma ,MENTAL depression ,PHYSICAL activity - Abstract
Aims: This review aims to assess the effect of comprehensive nursing care on liver cancer patients undergoing interventional therapy in China. Methods: In accordance with PRISMA guidelines, we reviewed randomized controlled trials and observational studies assessing the effect of comprehensive nursing care against standard care on liver cancer patients undergoing specific interventional therapies in China, including PubMed, Embase, CENTRAL and CINAHL till June 2023. Data synthesis was conducted using a random‐effects model and reported as pooled odds ratio (OR) or mean difference (MD) or standardized mean differences (SMD). Results: Ten Chinese studies with 1682 participants were evaluated. Comprehensive nursing care significantly enhanced patient outcomes in liver cancer treatment. Quality of life improved markedly (OR: 0.16, 95% CI: 0.06–0.41). Notable reductions were observed in anxiety (MD: −8.96, 95% CI: −11.52 to −6.40) and depression (MD: −9.47, 95% CI: −11.79 to −7.14). Patients also experienced increased physical (SMD: 1.70, 95% CI: 1.15–2.25), social (SMD: 1.65, 95% CI: 1.14–2.16) and activity scores (SMD: 1.94, 95% CI: 1.49–2.39), alongside a decrease in post‐treatment complications (OR: 0.28, 95% CI: 0.21–0.37), demonstrating the multifaceted benefits of comprehensive care. Conclusion: Comprehensive nursing care may improve patient outcomes in liver cancer treatment, offering potential benefits in reducing the side effects of interventional therapy. Summary statement: What is already known about this topic? Liver cancer patients undergoing interventional therapy often experience significant physical and psychological challenges.Comprehensive nursing care has been hypothesized to offer potential benefits in addressing these challenges.There is limited evidence on the exact impacts of comprehensive nursing care on these patients, leading to knowledge gaps in its applicability and efficacy. What this paper adds? This review demonstrates that comprehensive nursing care can lead to significant improvements in the quality of life for liver cancer patients in China.This review provides evidence that comprehensive care reduces levels of anxiety and depression in these patients.This review shows that this approach boosts physical, social function and activity scores while also reducing post‐treatment complications. The implications of this paper: This paper suggests integrating comprehensive nursing care as a standard practice, given its potential to significantly improve patient outcomes and quality of life.This research emphasizes the importance of equipping oncology nurses with comprehensive care skills and expanding their roles to ensure optimal patient outcomes.Despite promising results, there is a need for further high‐quality, randomized controlled trials to confirm these findings and delve deeper into other potential benefits and best practices of comprehensive nursing care for liver cancer patients. [ABSTRACT FROM AUTHOR]
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- 2024
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206. The efficacy of Tai Chi for essential hypertension: A systematic review and meta‐analysis.
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Zhang, Pengchao, Zhang, Dan, and Lu, Deyi
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PSYCHOTHERAPY ,LIFESTYLES ,INTERPROFESSIONAL relations ,NITRIC oxide ,HYPERTENSION ,TAI chi ,TREATMENT effectiveness ,META-analysis ,EXERCISE intensity ,DESCRIPTIVE statistics ,SYSTEMATIC reviews ,MEDLINE ,MEDICAL databases ,DIASTOLIC blood pressure ,BLOOD pressure ,SYSTOLIC blood pressure ,HEALTH promotion ,CONFIDENCE intervals ,EVALUATION - Abstract
Aim: We aimed to assess the impact of Tai Chi interventions on individuals with essential hypertension and to compare the effects of Tai Chi versus control in this population. Background: Tai Chi has been extensively utilized in the prevention of essential hypertension. Nevertheless, there is a lack of consensus regarding its benefits for treating essential hypertension. Design: A systematic review and meta‐analysis was conducted. Data Sources We conducted a systematic literature search of the Medline, Scholar, Elsevier, Wiley Online Library, Chinese Academic Journal (CNKI) and Wanfang databases from January 2003 to August 2023. Review Methods: Using the methods of the Cochrane Collaboration Handbook, a meta‐analysis was conducted to assess the collective impact of Tai Chi exercise in controlling hypertension. The primary outcomes measured included blood pressure and nitric oxide levels. Results: The participants consisted of adults with an average age of 57.1 years who had hypertension (mean ± standard deviation systolic blood pressure at 148.2 ± 12.1 mmHg and diastolic blood pressure at 89.2 ± 8.3 mmHg). Individuals who practiced Tai Chi experienced reductions in systolic blood pressure of 10.6 mmHg, diastolic blood pressure of 4.7 mmHg and an increase in nitric oxide levels. Conclusions: Tai Chi can be a viable lifestyle intervention for managing hypertension. Greater promotion of Tai Chi by medical professionals could extend these benefits to a larger patient population. Summary statement: What is already known about this topic? Hypertension is the primary risk factor for cardiovascular disease.Essential hypertension accounts for 90% of the overall prevalence of hypertension.Tai Chi has been employed for the prevention and treatment of essential hypertension. What this paper adds: The study reveals that the efficacy of 24‐style Tai Chi intervention in combating hypertension surpasses that of traditional aerobic exercises and conventional drug therapy.The statistical significance of anti‐hypertensive effects is notably higher when practicing middle‐intensity 24‐style Tai Chi for 1 h. Implications of this paper: The findings suggest that 24‐style Tai Chi holds clinical significance for patients, nurses and healthcare decision‐makers involved in the prevention and treatment of hypertension. [ABSTRACT FROM AUTHOR]
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- 2024
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207. Factors influencing self‐care behaviour in patients with heart failure: Grit as a behavioural support factor.
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Song, Hyun Jin, Kim, Hye Young, Park, Sookkyoung, and Lee, Sun Hwa
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HEALTH self-care ,HEALTH literacy ,PSYCHOLOGICAL resilience ,PSYCHOLOGY of cardiac patients ,CROSS-sectional method ,SELF-efficacy ,STATISTICAL sampling ,MULTIPLE regression analysis ,HEART failure ,TERTIARY care ,DESCRIPTIVE statistics ,SOCIAL learning theory ,HEALTH behavior ,RESEARCH methodology ,ELECTRONIC health records ,SOCIAL support ,DATA analysis software ,CONFIDENCE intervals - Abstract
Aims: This study aimed to examine the relationship between heart failure knowledge, self‐efficacy, social support, grit and self‐care behaviour in patients with heart failure and to identify factors associated with patients' self‐care behaviour. Background: Most patients with heart failure are not as active in implementing self‐care behavioural practices as recommended by the guidelines. Design: This descriptive cross‐sectional study was designed based on Bandura's Social Cognitive Theory. Methods: This study included 138 patients who were diagnosed with heart failure in an outpatient department of cardiology at a tertiary hospital in Korea. Data were collected between July and October 2020 using a structured questionnaire and electronic medical records. Data were analysed using the SPSS/WIN 27.0 program. Results: Grit had the strongest association with self‐care behaviour among patients with heart failure, followed by social support, self‐efficacy and heart failure knowledge. These variables accounted for approximately 52% of the variance in self‐care behaviour. Conclusions: Health‐care professionals should assess patients' grit and develop patient‐tailored grit enhancement programmes. Based on the social cognitive theory, nursing intervention programmes that can simultaneously manage cognitive (knowledge and self‐efficacy), social and environmental (social support) and behavioural support (grit) factors should be developed and applied to nursing practices to promote self‐care. Summary statement: What is already known about this topic? Most patients with heart failure are not as active in implementing self‐care behavioural practices as recommended by the guidelines.Social cognitive theory is conceptualized as cognitive, social, environmental and behavioural in nature.Self‐care behaviour can be influenced by multi‐dimensional factors, including cognitive factors, such as knowledge and self‐efficacy, and social and environmental factors, such as social support. What this paper adds? Grit—a behavioural supporting element—was confirmed as a factor influencing the self‐care behaviour of patients with heart failure. The implications of this paper: Interventions for enhancing patients' grit should be developed; self‐efficacy, social support and heart failure knowledge for patients with heart failure should be considered in clinical nursing settings.Health‐care professionals should assess patients' grit and develop patient‐tailored grit enhancement programmes. [ABSTRACT FROM AUTHOR]
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- 2024
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208. Accuracy of temporomandibular disorders diagnosis evaluated through the diagnostic criteria for temporomandibular disorder (DC/TDM) Axis II compared to the Axis I evaluations: a systematic review and meta-analysis.
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Minervini, Giuseppe, Marrapodi, Maria Maddalena, Siurkel, Yuliia, Cicciù, Marco, and Ronsivalle, Vincenzo
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ONLINE information services ,COMPUTER software ,RELATIVE medical risk ,RESEARCH evaluation ,META-analysis ,TEMPOROMANDIBULAR joint ,PAIN measurement ,CONFIDENCE intervals ,SYSTEMATIC reviews ,FUNCTIONAL assessment ,QUALITY of life ,DESCRIPTIVE statistics ,TEMPOROMANDIBULAR disorders ,MEDLINE ,ODDS ratio ,EVALUATION - Abstract
Background: The temporomandibular joint (TMJ) is a complex joint that facilitates mandibular movements during speech, chewing, and swallowing activities. The Axis I evaluation of the DC/TMD focuses on assessing physical diagnoses related to TMDs. It includes an assessment of pain and functional limitations, such as jaw opening range, joint sounds, and joint tenderness. The Axis II evaluation of the DC/TMD provides information on the patient's psychological status and quality of life. This Systematic Review with Meta-Analysis aimed to evaluate the accuracy of Temporomandibular Disorders diagnosis considered through the Diagnostic Criteria for Temporomandibular Disorder (DC/TDM) axis II compared to the Axis I evaluations. Methods: A search was made in PubMed, Web of Science and Lilacs for articles published from the inception until 20 January 2023. We applied the Population, Exposure, Comparator, and Outcomes (PECO) model [1] to assess document eligibility. Only studies that evaluated patients by DC/TMD Axis I and Axis II were considered. Review Manager version 5.2.8 (Cochrane Collaboration) was used for the pooled analysis. We measured the odds ratio (OR) between the two groups (Axis I and Axis II). Results: Fifty-one articles were selected because of the search. Four papers were excluded before the screening: 2 pieces were not in English, and two were reviewed. The remaining 47 articles were selected for the title and abstract screening to evaluate whether they met the PECO criteria. Among these, four papers were established; the overall effect showed that there was no difference in TMD diagnosis between Axis I and Axis II (RR 1.17; 95% CI: 0.80– 1.71; Z:0.82; P =.41), suggesting that there is no difference between Axis I and Axis II. Conclusion: In conclusion, DC/TMD is an effective tool for the diagnosis of TMD. It improves the accuracy of TMD diagnosis, allows for the classification of subtypes, and assesses psychosocial factors that may impact the development or maintenance of TMD symptoms. [ABSTRACT FROM AUTHOR]
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- 2024
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209. The Effects of Back Schools on Non-Specific Back Pain: A Systematic Review and Meta-Analysis.
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Hernandez-Lucas, Pablo, Leirós-Rodríguez, Raquel, Lopez-Barreiro, Juan, and García-Soidán, José L.
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BACKACHE ,HEALTH education ,CONFIDENCE intervals ,MUSCULOSKELETAL pain ,EXERCISE therapy ,BIBLIOGRAPHIC databases ,PEOPLE with disabilities - Abstract
Background: Non-specific back pain is a global concern. Exercise and health education are crucial components in its management. The Back School is a theoretical practical program that integrates both elements. The objective of this study is to determine if Back School-based programs are effective in reducing pain, disability, and kinesiophobia in patients with non-specific back pain. Methods: A systematic review of research involving participants with non-specific back pain was carried out on databases such as PubMed, Scopus, Web of Science, and Medline. Results: In total, 25 papers were chosen for review. All of these papers focused on the effects on the lumbar area, with the exception of one paper that specifically targeted the cervical region. The pain variable showed statistically significant results with standardized mean differences of −1.01 (950 confidence interval = −1.39 to −0.63; p < 0.001), and the disability variable had standardized mean differences of −0.98 (95% confidence interval = −1.38 to −0.58; p < 0.001), and only one study analysed the kinesiophobia variable and concluded that Back School programs have a positive effect on kinesiophobia between the baseline and post-intervention levels. Conclusions: Back School programs have shown effectiveness in reducing non-specific back pain and lowering disability rates. [ABSTRACT FROM AUTHOR]
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- 2024
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210. Trends in Concentration and Flux of Total Suspended Matter in the Irrawaddy River.
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Zheng, Zhuoqi, Wang, Difeng, Fu, Dongyang, Gong, Fang, Huang, Jingjing, He, Xianqiang, and Zhang, Qing
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HYDROLOGICAL stations ,NATURE reserves ,REMOTE sensing ,CONFIDENCE intervals ,LANDSAT satellites - Abstract
Large rivers without hydrological data from remote sensing observations have recently become a hot research topic. The Irrawaddy River is among the major tropical rivers worldwide; however, published hydrological data on this river have rarely been obtained in recent years. In this paper, based on the existing measured the total suspended matter flux (F
TSM ) and discharge data for the Irrawaddy River, an inversion model of the total suspended matter concentration (CTSM ) is constructed for the Irrawaddy River, and the CTSM and FTSM from 1990 to 2020 are estimated using the L1 products of Landsat-8 OLI/TIRS and Landsat-5 TM. The results show that over the last 30 years, the FTSM of the Irrawaddy River decreased at a rate of 3.9 Mt/yr, which is significant at the 99% confidence interval. An increase in the vegetation density of the Irrawaddy Delta has increased the land conservation capacity of the region and reduced the inflow of land-based total suspended matter (TSM). The FTSM of the Irrawaddy River was estimated by fusing satellite data and data measured at hydrological stations. The research method employed in this paper provides a new supplement to the existing hydrological data for large rivers. [ABSTRACT FROM AUTHOR]- Published
- 2024
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211. Evaluating COVID-19 in Portugal: Bootstrap confidence interval.
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Tedim, Sofia, Afreixo, Vera, Felgueiras, Miguel, Leitão, Rui Pedro, Pinheiro, Sofia J., and Silva, Cristiana J.
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CONFIDENCE intervals ,COMMUNICABLE diseases ,COVID-19 ,ORDINARY differential equations ,STOCHASTIC differential equations - Abstract
In this paper, we consider a compartmental model to fit the real data of confirmed active cases with COVID-19 in Portugal, from March 2, 2020 until September 10, 2021 in the Primary Care Cluster in Aveiro region, ACES BV, reported to the Public Health Unit. The model includes a deterministic component based on ordinary differential equations and a stochastic component based on bootstrap methods in regression. The main goal of this work is to take into account the variability underlying the data set and analyse the estimation accuracy of the model using a residual bootstrapped approach in order to compute confidence intervals for the prediction of COVID-19 confirmed active cases. All numerical simulations are performed in R environment (R version. 4.0.5). The proposed algorithm can be used, after a suitable adaptation, in other communicable diseases and outbreaks. [ABSTRACT FROM AUTHOR]
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- 2024
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212. Perceptions of forest product businesses employees in Turkey regarding occupational health and safety during the COVID-19 pandemic.
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Kırklıkçı, Ahmet Bora and Bayram, Serap
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EMPLOYEE attitudes ,INDUSTRIAL safety ,CONFIDENCE intervals ,MULTIVARIATE analysis ,REGRESSION analysis ,RISK assessment ,CRONBACH'S alpha ,BUSINESS ,QUESTIONNAIRES ,DESCRIPTIVE statistics ,NATURE ,INDUSTRIAL hygiene ,COVID-19 pandemic ,FORESTS & forestry - Abstract
BACKGROUND: The COVID-19 pandemic has undeniably brought up the issue of Occupational Health and Safety (OHS) for businesses in Turkey. In this global pandemic, strategies developed to effectively address OHS risks and eliminate them with reliable, high-quality data have gained importance. OBJECTIVE: This study aimed to determine the perceptions of employees in the forest products industry in Turkey regarding the OHS during the COVID-19 pandemic. METHOD: The sample of the descriptive and analytical study consisted of a total of 371 employees in forest product businesses located in Turkey. The sample of the study was determined by the purpose-based sampling method. Data were collected both online and face-to-face from June 2022 to October 2022. The data were obtained using the Questionnaire of Employee and Business Characteristics and the Scale of Employees' Perceptions on the OHS (S-POHS) adapted by Özden (2022). Statistical analysis was performed using SPSS and calculated by descriptive analyses, pairwise comparison tests and multivariate regression analyses. RESULTS: 39.1% of the employees with a mean age of 34.12±8.78 years are high school graduates and 61.5% are workers. Significant differences were found in the S-POHS average scores of the employees in the businesses that produce paper-cardboard, have operated for less than 20 years, have a partnership structure with foreign capital and have an OHS Management System Quality Certificate (p < 0.05). CONCLUSION: While a positive OHS perception level has already been achieved in the forest products industry in business administrations and by employees, it is clear that this should not be lost and it should be prepared for the next crises by adding new applications. [ABSTRACT FROM AUTHOR]
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- 2024
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213. Effect of two different laparoscopic techniques on post‐operative wound complications in patients with benign gynaecological diseases: A meta‐analysis.
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He, Haining, Li, Tinglan, Cui, Manman, Jiang, Qin, Jiang, Fuchuan, Li, Min, and Liu, Yi
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ONLINE information services ,MEDICAL databases ,FEMALE reproductive organ diseases ,META-analysis ,MEDICAL information storage & retrieval systems ,CONFIDENCE intervals ,SYSTEMATIC reviews ,TIME ,VISUAL analog scale ,SEVERITY of illness index ,LAPAROSCOPY ,SURGICAL site infections ,DESCRIPTIVE statistics ,ADNEXAL diseases ,MEDLINE ,POSTOPERATIVE pain ,WOUND care ,DISEASE risk factors - Abstract
Single‐port laparoscopy (SPL) has existed for several years. This meta‐analysis was conducted to evaluate the efficacy of SPL compared with conventional laparoscopy (CL) in the treatment of benign gynecologic adnexal lesions. The purpose of this meta‐analysis is to evaluate the superiority of SPL versus CL in the treatment of post‐operative wound pain. The study looked for English‐language publications from PubMed, Embase, Cochrane Library and the Web of Science until June 2023. The main result was the visual analogue scale (VAS) after 2, 4, 6, 8, 12, 24 and 48 h after operation. The paper contains 10 related papers by means of e‐search. Of these, 4 were randomized controlled trials (RCTs), while 6 were non‐RCTs. The results indicated that SPL and CL were significantly different after 2, 24 and 48 h after operation. SPL had lower post‐operative pain after 2 h compared with CL (MD, −0.6; 95% CI, −0.98, −0.21; p = 0.002). After the operation, SPL also had a lower incidence of post‐operative pain after 24 h compared with CL (MD, −0.59; 95% CI, −1.12, −0.06; p = 0.03). And the difference in pain was at 48 h after the most significant (MD, −0.49; 95% CI, −0.75, −0.23; p = 0.0002). But after 6, 8 and 12 h after operation, there was no significant difference in the degree of pain. Thus, SPL operations may result in a lower degree of pain than CL in both the post‐operative and far post‐operative phase. [ABSTRACT FROM AUTHOR]
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- 2024
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214. Predictors of anxiety among pregnant women with gestational diabetes mellitus and their partners: The mediating role of marital satisfaction.
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Han, Rong‐rong, Xiang, Zhi‐xuan, Zhang, Shu‐han, and Gao, Ling‐ling
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FASTING ,STATISTICS ,STRUCTURAL equation modeling ,CONFIDENCE intervals ,MARITAL satisfaction ,CROSS-sectional method ,ONE-way analysis of variance ,MULTIPLE regression analysis ,PREGNANT women ,BLOOD sugar ,SPOUSES ,INCOME ,T-test (Statistics) ,PEARSON correlation (Statistics) ,WAGES ,DESCRIPTIVE statistics ,GESTATIONAL diabetes ,ANXIETY ,DATA analysis ,DATA analysis software ,DISEASE complications ,PREGNANCY - Abstract
Aims: This study aims to examine the prevalence of anxiety symptoms and identify predictors of anxiety among pregnant women with gestational diabetes mellitus and their partners and explore the mediating role of marital satisfaction between maternal and paternal anxiety. Design: A cross‐sectional study was conducted in Guangzhou, China, from July 2021 to May 2022. Methods: A total of 306 dyads of pregnant women with gestational diabetes mellitus and their partners completed the State–Trait Anxiety Inventory, Locke–Wallace Marital Adjustment Test and the socio‐demographic and clinical data sheet. Results: The prevalence of anxiety symptoms was 32.4% and 36.6% in pregnant women with gestational diabetes mellitus and their partners, respectively. The predictors of maternal anxiety were paternal anxiety, maternal marital satisfaction, maternal monthly salary, fasting glucose value and 1‐h glucose value. By contrast, the predictors of paternal anxiety were maternal anxiety, paternal marital satisfaction and paternal monthly salary. Moreover, the relationship between maternal and paternal anxiety was mediated by marital satisfaction. Conclusions: The anxiety symptoms of pregnant women with gestational diabetes mellitus and their partners influence each other, and this relationship was mediated by marital satisfaction. Every couple should be screened for anxiety symptoms and treated as a team rather than focusing solely on the pregnant woman. Summary statement: What is already known about this topic? Gestational diabetes mellitus is strongly associated with various short‐ and long‐term adverse maternal and neonatal outcomes.The diagnosis of gestational diabetes mellitus is stressful for pregnant women and their partners.No studies have been conducted to examine and compare the anxiety symptoms among pregnant women with GDM and their partners in mainland China. What this paper adds? The anxiety symptoms of pregnant women with gestational diabetes mellitus and their partners influence each other.The prevalence of anxiety symptoms was high in both pregnant women with gestational diabetes mellitus and their partners.Marital satisfaction played a mediating role between maternal and paternal anxiety. The implications of this paper: Study findings provide important information to guide future practice for nurses and other health‐care professionals.For the future, routine screening for anxiety symptoms is necessary for both pregnant women with gestational diabetes mellitus and their partners; mental health support should be delivered in a timely fashion for couples.Pregnant women with gestational diabetes mellitus and their partners should be treated as a team rather than focusing solely on pregnant women, with couples given training on enhancing marital satisfaction skills to prevent and reduce their anxiety symptoms. [ABSTRACT FROM AUTHOR]
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- 2024
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215. The effect of home nurse visits on infant weight and breastfeeding: Systematic review and meta‐analysis.
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Kahraman, Selma and Havlioğlu, Suzan
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NURSING audit ,HOME nursing ,EVALUATION of medical care ,ONLINE information services ,CINAHL database ,META-analysis ,MEDICAL information storage & retrieval systems ,CONFIDENCE intervals ,ANALYSIS of variance ,SYSTEMATIC reviews ,TREATMENT duration ,WEIGHT gain ,BIRTH weight ,BREASTFEEDING ,DESCRIPTIVE statistics ,POSTNATAL care ,MEDLINE ,ODDS ratio - Abstract
Aims: The primary aim of this systematic review and meta‐analysis is to evaluate the effects of home nurse visiting on infant weight and breastfeeding; the secondary aim is to determine the duration, frequency and content of home visits. Methods: A systematic search of the PubMed, CINAHL, Embase (Ovid), Web of Science, Google Scholar and DergiPark databases for publications between September 2000 and January 2019 was conducted using established methods in compliance with the PRISMA‐P declaration guideline. Two authors independently evaluated the studies for inclusion and bias, extracted the data and checked their accuracy. Results: This meta‐analysis includes a total of 34 studies, 28 on breastfeeding and nine on infant weight. The average effect size of the 28 studies investigating the effect on breastfeeding was found to be OR: 2.24; 95% CI: 1.73–2.90; p < 0.001. The average effect size of the nine studies investigating the effect on infant weight was found to be ES: 0.197; 95% CI: 0.027–0.368; p < 0.05. Conclusion: There is an association between nurse home visits and breastfeeding and infant weight. Home visits by nurses should continue to remain within the nursing role and be analysed appropriately for mother and baby health. Summary statement: What is already known about this topic? Two of the most important factors affecting infant morbidity and mortality are infant weight and breastfeeding.Although breastfeeding has numerous benefits for the baby, breastfeeding rates are decreasing in the world and in Turkey. Breastfeeding improves infant health and supports development.One of the factors that negatively affects infant health is low or below expected body weight. Inadequate weight gain will in turn negatively affect the healthy growth of the baby.It has been found that care, education and support related to breastfeeding and infant weight improve outcomes for babies and their mothers but there is no evidence that home visitation is an effective way to deliver this care. What this paper adds? Review results indicate home visits have a significant effect on improving infant health. A positive effect was detected between nurse home visits and breastfeeding and infant weight. The implications of this paper: Home visits should be presented and analysed appropriately for the mother and baby's health.Education, care and support during home visits help mothers breastfeed. [ABSTRACT FROM AUTHOR]
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- 2024
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216. Life Prediction of Ship CXF Cable Using a Non-Equidistant Grey Model With Small Samples.
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Cai, Li, Lin, Jingdong, and Liao, Xiaoyong
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ELECTRIC power transmission ,TELECOMMUNICATION cables ,CONFIDENCE intervals ,INFORMATION resources management ,PREDICTION models - Abstract
As is known, cable plays a significant role in electric power transmission of the ship. From the safety perspective, this paper aims to predict the ship cable life more accurately and analyze its reliability under small sample conditions. To achieve this goal, based on the non-equidistant grey model (NEGM (1, 1)), an optimized equal-dimension dynamic NEGM (1, 1) is proposed in this paper. In the improved model, the raw data smoothness and the background value are optimized to apply to grey model parameters. Equal-dimension dynamic prediction algorithm (EDDPA) is adopted to predict the lifetime of ship CXF type cable. Compared with the aging model from literature and NEGM (1, 1), the prediction effectiveness and reliability of the proposed model are more considerable. Interestingly, with the increase of recurrence times, the numerical results show this model has higher prediction performance. Finally, the reliability and confidence interval of the life evaluation of ship CXF cable are given to provide more valuable information for the cable management. [ABSTRACT FROM AUTHOR]
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- 2022
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217. The impact of surgical simulation on patient outcomes: a systematic review and meta-analysis.
- Author
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Meling, Trym R. and Meling, Torstein R.
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RANDOMIZED controlled trials ,CONFIDENCE intervals - Abstract
The use of simulation in surgical training is ever growing. Evidence suggests such training may have beneficial clinically relevant effects. The objective of this research is to investigate the effects of surgical simulation training on clinically relevant patient outcomes by evaluating randomized controlled trials (RCT). PubMed was searched using PRISMA guidelines: "surgery" [All Fields] AND "simulation" [All Fields] AND "patient outcome" [All Fields]. Of 119 papers identified, 100 were excluded for various reasons. Meta-analyses were conducted using the inverse-variance random-effects method. Nineteen papers were reviewed using the CASP RCT Checklist. Sixteen studies looked at surgical training, two studies assessed patient-specific simulator practice, and one paper focused on warming-up on a simulator before performing surgery. Median study population size was 22 (range 3–73). Most articles reported outcome measures such as post-intervention Global Rating Scale (GRS) score and/or operative time. On average, the intervention group scored 0.42 (95% confidence interval 0.12 to 0.71, P = 0.005) points higher on a standardized GRS scale of 1–10. On average, the intervention group was 44% (1% to 87%, P = 0.04) faster than the control group. Four papers assessed the impact of simulation training on patient outcomes, with only one finding a significant effect. We found a significant effect of simulation training on operative performance as assessed by GRS, albeit a small one, as well as a significant reduction to operative time. However, there is to date scant evidence from RCTs to suggest a significant effect of surgical simulation training on patient outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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218. Estimation of median survival time and its 95% confidence interval using SAS PROC LIFETEST.
- Author
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Talsma PA
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- Humans, Survival Analysis, Probability, Sample Size, Confidence Intervals
- Abstract
Estimation of median survival and its 95% confidence interval depends on the choice of the survival function, standard error, and a method for constructing the confidence interval. This paper outlines several available possibilities in SAS® (version 9.4) PROC LIFETEST and compares them on theoretical grounds and using simulated data, with criteria: ability to estimate the 95% CI, coverage probability, interval width, and appropriateness for practical use. Data are generated with varying hazard patterns, N, % censoring, and censoring patterns (early, uniform, late, last visit). LIFETEST was run using the Kaplan-Meier and Nelson-Aalen estimators and the transformations available (linear, log, logit, complementary log-log, and arcsine square root). Using the Kaplan-Meier estimator with the logarithmic transformation as well as with the logit leads to a high frequency of LIFETEST not being able to estimate the 95% CI. The combination of Kaplan-Meier with the linear transformation is associated with poor coverage achieved. For small samples, late/last visit censoring has a negative effect on being able to estimate the 95% CI. Heavy early censoring can lead to low coverage of the 95% CI of median survival for sample sizes up to and including N = 40. The two combinations that are optimal for being able to estimate the 95% CI and having adequate coverage are the Kaplan-Meier estimator with complementary log-log transformation, and the Nelson-Aalen estimator with linear transformation. The former fares best on the third criterion (smaller width) and is also the SAS® default and validates the choice of default.
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- 2024
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219. Wrapping input–output multipliers in confidence intervals.
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Stehrer, Robert, Rueda-Cantuche, José Manuel, Amores, Antonio F., and Zenz, David
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TIME series analysis ,DEGREES of freedom ,PANEL analysis ,INTERVAL analysis ,CONFIDENCE intervals - Abstract
Input–output multipliers are typically calculated as point estimates of the Leontief quantity model. From the previous literature, they can also be estimated (and their confidence intervals) directly from establishments'/industries' inputs and outputs data by running an appropriate econometric regression. However, previous contributions relied on analyses carried out for 1 single year, one country/region and a reduced number of degrees of freedom. This paper tests the robustness of the previous literature by using instead a time series of large-scale inter-country supply, use and input–output database with more than one country and more than 1 year, as well as panel data econometrics. [ABSTRACT FROM AUTHOR]
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- 2024
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220. Navigating the social media overload via control abilities: coping strategies and practices.
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Tran, Sinh Thi Thu and Chen, Jengchung Victor
- Subjects
- *
SOCIAL media , *DEFENSE mechanisms (Psychology) , *PSYCHOLOGICAL burnout , *RESEARCH funding , *PSYCHOLOGICAL adaptation , *DESCRIPTIVE statistics , *SURVEYS , *MATHEMATICAL models , *SOCIAL networks , *COMMUNICATION , *PSYCHOLOGICAL stress , *THEORY , *CONFIDENCE intervals , *INFORMATION overload - Abstract
Based on the stress coping theory, the present paper aims to investigate the influence of users' networking ability and profile control ability in mitigating the negativity of social media overload. This paper argues that in the social media context, instead of discontinuance, users tend to develop comprehensive strategies and practices to manage their social media usage. Via an exploratory factor analysis (EFA) study, five practices were identified, including continuous usage, reduced usage, setting adjustment, support seeking, and information avoidance. The results show that social media overload leads to both the perception of emotional exhaustion and disturbance handling while networking and profile control ability make users focus on disturbance handling. Besides, networking ability is found to weaken the relationship between social media overload and emotional exhaustion while profile control ability exaggerates that relationship. Finally, emotional exhaustion and disturbance handling both predict users' different social media management practices. [ABSTRACT FROM AUTHOR]
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- 2024
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221. The prevalence of occupational-related low back pain among working populations in sub-saharan Africa: a systematic review and meta-analysis.
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Atalay, Yibeltal Assefa, Gebeyehu, Natnael Atnafu, and Gelaw, Kelemu Abebe
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RISK assessment ,OCCUPATIONAL diseases ,GLOBAL burden of disease ,META-analysis ,DESCRIPTIVE statistics ,DISEASE prevalence ,WORK-related injuries ,SYSTEMATIC reviews ,MEDLINE ,QUALITY of life ,PUBLIC health ,ONLINE information services ,CONFIDENCE intervals ,DATA analysis software ,LUMBAR pain ,DISEASE risk factors - Abstract
Introduction: Work-related musculoskeletal disorders represent a major public health problem, contributing significantly to the global burden of disability-adjusted life years and affecting the quality of life of all population groups. The main problem in most musculoskeletal disorders is low back pain. Therefore, our study aims to identify the overall prevalence of work-related low back pain among the working population in sub-Saharan Africa. Methods: Research published between 2010 and 2023 in English, conducted in Sub-Saharan Africa was included in this systematic review and meta-analysis. Using Boolean logic operators and targeted keywords, we searched for publications on a number of electronic databases (Web of Science, PubMed, Google Scholar, African Journals Online (AJOL), and Science Direct). The Joanna Briggs Institute Critical Appraisal techniques were utilized to conduct a quality assessment of the papers and ascertain their relevance to the study. The degree of heterogeneity among the included studies, the 95% confidence interval, and the pooled prevalence were estimated using a random effects model. Sensitivity studies were carried out to determine the causes of heterogeneity and the impact of outliers. Results: In this study, a total of 970 articles were retrieved, and 35 studies were included in the systematic review and meta-analysis. The overall estimated pooled prevalence of low back pain among the working population in sub-Saharan Africa was (55.05% [95% CI: 49.34, 60.76]). Based on a sub-group analysis by countries, the higher pooled prevalence of low back pain was found in Uganda at (61.48% [95% CI: 40.39, 82.57]), while the lower pooled prevalence of low back pain was in Ghana at (34.48% [95% CI: 17.96, 51.01]). Conclusions: This systematic review and meta-analysis found that 55.05% of the included study participants experienced low back pain in the previous years. Therefore, it is recommended that policymakers incorporate and enhance strategies for the prevention and management of low back pain within the health system management guidelines of each country. [ABSTRACT FROM AUTHOR]
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- 2024
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222. Multi-task learning for predicting quality-of-life and independence in activities of daily living after stroke: a proof-of-concept study.
- Author
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Thi Nguyet Que Nguyen, García-Rudolph, Alejandro, Saurí, Joan, and Kelleher, John D.
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BARTHEL Index ,ACTIVITIES of daily living ,STANDARD deviations ,CONFIDENCE intervals ,STROKE patients - Abstract
A health-related (HR) profile is a set of multiple health-related items recording the status of the patient at different follow-up times post-stroke. In order to support clinicians in designing rehabilitation treatment programs, we propose a novel multi-task learning (MTL) strategy for predicting post-stroke patient HR profiles. The HR profile in this study is measured by the Barthel index (BI) assessment or by the EQ-5D-3L questionnaire. Three datasets are used in this work and for each dataset six neural network architectures are developed and tested. Results indicate that an MTL architecture combining a pre-trained network for all tasks with a concatenation strategy conditioned by a task grouping method is a promising approach for predicting the HR profile of a patient with stroke at different phases of the patient journey. These models obtained a mean F1-score of 0.434 (standard deviation 0.022, confidence interval at 95% [0.428, 0.44]) calculated across all the items when predicting BI at 3 months after stroke (MaS), 0.388 (standard deviation 0.029, confidence interval at 95% [0.38, 0.397]) when predicting EQ-5D-3L at 6MaS, and 0.462 (standard deviation 0.029, confidence interval at 95% [0.454, 0.47]) when predicting the EQ-5D-3L at 18MaS. Furthermore, our MTL architecture outperforms the reference single-task learning models and the classic MTL of all tasks in 8 out of 10 tasks when predicting BI at 3MaS and has better prediction performance than the reference models on all tasks when predicting EQ-5D-3L at 6 and 18MaS. The models we present in this paper are the first models to predict the components of the BI or the EQ-5D-3L, and our results demonstrate the potential benefits of using MTL in a health context to predict patient profiles. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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223. Information sources and vaccination in the COVID-19 pandemic.
- Author
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Asiamah, Nana Osei, Miller, Paige B., Yang, Xiaoxu, and Shrum, Wesley
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SOCIAL media ,RESEARCH funding ,VACCINATION ,HEALTH ,COVID-19 vaccines ,INFORMATION resources ,DESCRIPTIVE statistics ,MISINFORMATION ,COMMUNITIES ,AGE distribution ,ATTITUDE (Psychology) ,SURVEYS ,RACE ,ODDS ratio ,MATHEMATICAL models ,RELIGION ,VACCINE hesitancy ,THEORY ,CONFIDENCE intervals ,SOCIODEMOGRAPHIC factors ,COVID-19 pandemic ,ANTI-vaccination movement ,REGRESSION analysis - Abstract
Among the issues that remained contentious throughout the pandemic was vaccination: its efficacy, side effects, and the general reluctance of a substantial segment of the population to get vaccinated. The aim of this paper is to understand the role of health information sources in anti-vaccination sentiment and the decision to vaccinate. Regression models were used to analyze data from an online survey of adults in the United States in late 2021 (n = 10,221). The results of the study showed that: (a) information from local and national health experts had a significant positive association with getting the COVID-19 vaccine and a negative relationship with holding anti-vaccination sentiments while (b) information from social media and community/religious leaders had the opposite effect. Overall, this study highlights the importance of public health systems in the dissemination of information on vaccinations during pandemics. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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224. Association between lower limb alignment and low back pain: A systematic review with meta-analysis.
- Author
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Abbasi, Saeedeh, Mousavi, Seyed Hamed, and Khorramroo, Fateme
- Subjects
LUMBAR pain ,CROSS-sectional method ,CONFIDENCE intervals ,DATABASE searching ,EXPERIMENTAL design - Abstract
Low back pain (LBP) is a prevalent and costly condition globally, prompting the need to identify risk factors for effective management. Lower extremity misalignment plays a crucial role in the incidence of LBP. Therefore, we aimed to investigate the current evidence on a link between lower limb alignment and LBP, enhancing the understanding of this relationship. We searched four databases, including PubMed, Embase, Web of Science, and Scopus, up to September 2024. Inclusion criteria encompassed studies related to LBP and lower limb alignment, with eligible study types including case-control, cohort, and cross-sectional studies, all written in English. Two authors independently screened and assessed the methodological quality of the retrieved papers using the Downs and Black quality assessment checklist. Data of interest including study design, age, sample size, cases, association, and P-value were extracted from the included studies. Mean differences and 95% confidence intervals (CI) were calculated with random effects model in RevMan version 5.4. Thirteen articles evaluating lower limb alignment in individuals with LBP were included (102,359 participants in total). The meta-analysis results demonstrated that increased pronation with strong evidence(p = 0.02), increased hip internal rotation with moderate evidence, and increased knee internal rotation with limited evidence are associated with an increased risk of LBP. Overall, while some studies supported a relationship between lower limb alignment and LBP, the heterogeneity of study designs and methodological limitations hindered drawing a definitive conclusion. Future research should emphasize prospective cohort studies, incorporating objective measures of lower extremity alignment and standardized outcome measures. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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225. Health care service utilization among elderly in rural setting of Gandaki province, Nepal: a mixed method study.
- Author
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Poudel, Kamal, Malla, Dinesh Kumar, and Thapa, Kanchan
- Subjects
MEDICAL care use ,HEALTH services accessibility ,PUBLIC hospitals ,HEALTH status indicators ,INTERVIEWING ,LOGISTIC regression analysis ,CONTENT analysis ,DESCRIPTIVE statistics ,CHI-squared test ,FAMILY relations ,THEMATIC analysis ,ODDS ratio ,RACE ,TRANSPORTATION ,RURAL population ,RESEARCH methodology ,CONFIDENCE intervals ,SOCIAL support ,DATA analysis software ,FACTOR analysis ,OLD age - Abstract
Introduction: Globally, one in every six people will be elderly by 2030. In Nepal, there has been a notable rise in the aging and elderly. Addressing the healthcare needs of them is crucial. Despite the different efforts to advocate for healthy aging, various factors continue to limit this process. This paper aims to explore the utilization of healthcare services among the elderly population and uncover influences on the ability to access these services. Method: A mixed-method community-based study was conducted in Bihadi Rural Municipality of Parbat, Nepal. The quantitative segment involved interviews with 355 individuals aged ≥60 years, while 18 respondents were enlisted for in-depth interviews. We used descriptive statistics, chi-square test, and logistic regression in quantitative analysis. Similarly, content and thematic analysis were performed in the qualitative component. Results: This study reported that health service utilization among the respondents was 65.4%. Among the factors ethnicity (OR 3.728, 95% CI 1.062–15.887), not good health status (OR 2.943, 95% CI 1.15–8.046), bus as means of transportation (OR 8.397, 95% CI 1.587–55.091) had higher odds whereas government hospital (OR 0.046, 95% CI 0.009–0.193), not always available health staffs (OR 0.375, 95% CI 0.147–0.931), not sufficient medicine (OR 0.372, 95% CI 0.143–0.924), not available medicine (OR 0.014, 95% CI 0.002–0.068) had lower odds for health service utilization. Other factors identified from qualitative components include long waiting times, insufficient medicine, lack of trained health personnel, financial capacity, low utilization of health insurance, distance, and support from family members. Conclusions: Nonetheless, a portion of the elderly remained excluded from mainstream of healthcare services. A combination of social, healthcare-related, and individual factors influences the utilization of healthcare services. To ensure elderly-friendly services, prioritize geriatric care training, secure medication availability, and establish a dedicated health insurance program for them. In the current federal context, localizing evidence-based, innovative strategies to address the healthcare needs of the elderly is crucial. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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226. A multi-nozzle nebuliser does not improve tissue drug delivery during PIPAC.
- Author
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Sautkin, Yaroslaw, Weinreich, Juergen, and Reymond, Marc André
- Subjects
- *
PHARMACOLOGY , *BIOLOGICAL models , *INTRAPERITONEAL injections , *PERITONEUM , *LASERS , *CISPLATIN , *DATA analysis , *AEROSOLS , *PRODUCT design , *ANTINEOPLASTIC agents , *DRUG delivery systems , *PARTICLES , *DESCRIPTIVE statistics , *CANCER chemotherapy , *METASTASIS , *NEBULIZERS & vaporizers , *ANIMAL experimentation , *SPECTRUM analysis , *BLADDER , *DOXORUBICIN , *ONE-way analysis of variance , *STATISTICS , *PERITONEUM tumors , *COMPARATIVE studies , *DATA analysis software , *CONFIDENCE intervals , *INDUSTRIAL hygiene , *INDUSTRIAL safety , *SALT , *NONPARAMETRIC statistics , *EQUIPMENT & supplies - Abstract
Background: Multi-nozzle nebulisers for pressurised intraperitoneal aerosol chemotherapy (PIPAC) are implemented in clinical practice to improve the homogeneity of tissue drug delivery. Nonetheless, the advantages of such devices over one-nozzle nebulisers have not been demonstrated thus far. In this study, we compared the performance of multi- and one-nozzle nebulisers by conducting physical and ex vivo pharmacological experiments. Methods: The one-nozzle nebuliser Capnopen® and the multi-nozzle nebuliser were the subjects of this study. In physical experiments, the aerosol droplet size was measured by laser diffraction spectroscopy. Spatial spray patterns were depicted on blotting paper. Pharmacological experiments were performed on the enhanced inverted bovine urinary bladder model, demonstrating real-time tissue drug delivery, aerosol sedimentation and homogeneity of doxorubicin and cisplatin tissue distribution. Results: The multi-nozzle nebuliser had a sixfold greater aerosolisation flow and a threefold greater angle of aerosolisation than Capnopen®. The aerosol particle size and distribution range were higher than that of Capnopen®. Spray patterns on blotting paper were more extensive with the multi-nozzle nebuliser. Real-time tissue drug delivery with the multi-nozzle nebuliser was over 100 ml within 1 min, and the aerosol sedimentation was 48.9% ± 21.2%, which was not significantly different from that of Capnopen®. The doxorubicin and cisplatin tissue concentrations were greater with Capnopen®. Although there was no significant difference in the homogeneity of doxorubicin distribution between the two devices, the homogeneity of cisplatin distribution was significantly higher with Capnopen®. Conclusion: The multi-nozzle PIPAC nebuliser did not fulfil expectations. Even though the surface spray patterns were broader with the multi-nozzle nebuliser, the tissue drug homogeneity and concentration were greater with Capnopen®. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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227. Quantifying the Uncertainty of Reservoir Computing: Confidence Intervals for Time-Series Forecasting.
- Author
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Domingo, Laia, Grande, Mar, Borondo, Florentino, and Borondo, Javier
- Subjects
TIME series analysis ,CONFIDENCE intervals ,GAUSSIAN distribution ,MARKET prices ,BUSINESS planning - Abstract
Recently, reservoir computing (RC) has emerged as one of the most effective algorithms to model and forecast volatile and chaotic time series. In this paper, we aim to contribute to the understanding of the uncertainty associated with the predictions made by RC models and to propose a methodology to generate RC prediction intervals. As an illustration, we analyze the error distribution for the RC model when predicting the price time series of several agri-commodities. Results show that the error distributions are best modeled using a Normal Inverse Gaussian (NIG). In fact, NIG outperforms the Gaussian distribution, as the latter tends to overestimate the width of the confidence intervals. Hence, we propose a methodology where, in the first step, the RC generates a forecast for the time series and, in the second step, the confidence intervals are generated by combining the prediction and the fitted NIG distribution of the RC forecasting errors. Thus, by providing confidence intervals rather than single-point estimates, our approach offers a more comprehensive understanding of forecast uncertainty, enabling better risk assessment and more informed decision-making in business planning based on forecasted prices. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
228. Understanding Ethical Concerns Involving Vulnerable Human Participant Populations in Medical Research: Mixed-Method Analysis of Liberian Ebola Survivors' Experiences in PREVAIL I–VII.
- Author
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Hanson-DeFusco, Jessi, Davis, Decontee, Bommareddy, Meghana, and Olaniyan, Zainab Olayemi
- Subjects
PATIENT selection ,SELF-efficacy ,DATA analysis ,ENDOWMENTS ,CLINICAL trials ,HUMAN research subjects ,CONSUMER attitudes ,EBOLA virus disease ,AT-risk people ,INTERVIEWING ,STATISTICAL sampling ,MEDICAL care ,SYMPTOMS ,PARTICIPANT-researcher relationships ,REFLECTION (Philosophy) ,DESCRIPTIVE statistics ,CHI-squared test ,THEMATIC analysis ,FINANCIAL stress ,QUALITY of life ,RESEARCH methodology ,CONCEPTUAL structures ,STATISTICS ,DATA analysis software ,MEDICAL screening ,CONFIDENCE intervals ,PATIENT participation ,MEDICAL care costs ,NONPARAMETRIC statistics - Abstract
Background: As the number of large-scale outbreaks continues to rise worldwide, clinical trials are increasingly engaging disease-affected peoples within the Minority World (nations with over 80% poverty rates). Yet global health research inadequately addresses potential ethical issues of including impoverished, disease-affected populations and their contextual vulnerabilities in medical research. Objective: This paper presents a mixed-method analysis from our 2022 semi-structured survey capturing the experiences of Liberian Ebola Virus Disease (EVD) survivors serving as study participants in the Partnership for Research on Ebola Virus in Liberia (PREVAIL) clinical trials. Methods: Firstly, we conducted an extensive literature review of the scholarship related to biomedical research and ethical standards protecting study participants to inform our survey method and design. Applying a theoretical framework on vulnerability, we then qualitatively explored the survey responses of 19 EVD survivors' perceptions and experiences taking part in PREVAIL, including their expectations, treatment, delivered benefits, and quality of care. We further quantitatively codified their statements for underlying themes of reported negative experiences against standard ethical regulations in biomedical research, conducting a statistical analysis to inform generalizability. Most of the 19 survivors reported facing extreme ongoing vulnerabilities related to their disease status, including physical impairments, psychosocial stress, and socio-economic inequity. Results: Initially, the survivors tended to experience a sense of hope and pride in volunteering for PREVAIL. One in five participants reported benefiting from PREVAIL's regular medical diagnoses. However, most of their survey responses indicated prevalent negative shared experiences, including continually being confused or misinformed of their study participant rights, roles, and benefits; being burdened by heavy participation transaction costs; and repeated incidents of poor treatment and discrimination by PREVAIL staff after initial recruitment. PREVAIL participant satisfaction ranking is negatively correlated with receiving insufficient financial compensation (r = −0.51), extensive time requirements for each medical visit (−0.40), and being poorly treated by clinical staff (−0.67). [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
229. Treatment failure among Sub-Sahara African children living with HIV: a systematic review and meta-analysis.
- Author
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Walle, Belete Gelaw, Tiruneh, Chalie Marew, Wubneh, Moges, Chekole, Bogale, Kassaw, Amare, Assefa, Yibeltal, Abebe, Kelemu, and Yigzaw, Zeamanuel Anteneh
- Subjects
ANTIRETROVIRAL agents ,HIV-positive persons ,HIV infections ,META-analysis ,DISEASE prevalence ,DESCRIPTIVE statistics ,SYSTEMATIC reviews ,MEDLINE ,MEDICAL databases ,TREATMENT failure ,ONLINE information services ,DATA analysis software ,CONFIDENCE intervals ,CHILDREN - Abstract
Background: Antiretroviral treatment failure is a global issue, particularly in developing countries such as Sub-Saharan Africa. Prior research findings were highly variable and inconsistent across areas. As a result, the goal of this systematic review and meta-analysis was to determine the pooled prevalence of treatment failure among children receiving antiretroviral medication in Sub-Saharan Africa. Methods: To find qualifying papers, we searched databases (such as PubMed, Google Scholar, African Journals Online, Scopus, and the Cochrane Library). The data were retrieved using Microsoft Excel and exported to STATA Version 14 for analysis. To check for publication bias, we employed Egger and Begg's regression tests. A random-effects model was used to assess the pooled prevalence of treatment failure due to high levels of variability. Results: Following the removal of duplicated articles and quality screening, a total of 33 primary articles were determined to be appropriate for inclusion in the final analysis for this study. Overall, the pooled prevalence of treatment failure among HIV-infected children was 25.86% (95% CI: 21.46, 30.26). There is great variety across the included studies, with the majority of them being conducted in Ethiopia. Cameroon had the greatest pooled prevalence of treatment failure among HIV-infected children, at 39.41% (95% CI: 21.54, 57.28), while Ethiopia had the lowest, at 13.77% (95% CI: 10.08, 17.47). Conclusions: The pooled estimate prevalence of treatment failure among HIV-infected children in Sub-Saharan Africa was high. The implementation of national and international policies and strategies on ART clinic care services should be given special focus in order to reduce treatment failure in children living with HIV/AIDS. Trial registration: The protocol has been registered in the PROSPERO database under the registration number CRD-429011. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
230. Turnover factors and retention strategies for chief executive officers in Australian hospitals.
- Author
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Mathew, Nebu, Liu, Chaojie, and Khalil, Hanan
- Subjects
EMPLOYEE retention ,PUBLIC hospitals ,WORK ,CORPORATE culture ,HEALTH facility administration ,PROPRIETARY hospitals ,OCCUPATIONAL roles ,LABOR turnover ,SAMPLE size (Statistics) ,MULTIPLE regression analysis ,LEADERSHIP ,STRATEGIC planning ,DESCRIPTIVE statistics ,HEALTH services administrators ,ORGANIZATIONAL structure ,ODDS ratio ,JOB satisfaction ,JOB stress ,CONFIDENCE intervals ,COMPARATIVE studies ,SOCIODEMOGRAPHIC factors ,DATA analysis software ,EXPERIENTIAL learning - Abstract
Objective: Hospital chief executive officers (CEOs) in Australia encounter various challenges such as financial constraints, changing regulations, and the necessity to uphold patient care standards. These challenges can contribute to rates of CEO turnover, which can disrupt healthcare organisations and affect the quality of services provided. This research aims to pinpoint the factors influencing hospital CEO turnover and explore effective strategies for retaining these vital leaders Methods: A survey was carried out among hospital CEOs throughout Australia. The survey, distributed through email and online platforms, gathered information on reasons behind turnover and methods for retaining CEOs. Data from 51 CEOs were analysed using statistical regression techniques and thematic analysis. Results: The findings from the survey indicated that 82.35% of CEOs identified stress and work-related pressure as the causes of turnover. Other significant factors included managing under-resourced organisations (68.62%), lack of support from the board (66.66%), and facing internal/external criticisms (58.82%). On average, respondents reported 5.16 reasons for leaving their positions with no significant differences found based on sociodemographic characteristics. It was pointed out that key ways to retain CEOs include building respect and trust between CEOs and board chairs, meeting the training and development needs of CEOs, and defining roles within the organisation. The importance of succession planning was also emphasised, with 94.12% of respondents acknowledging its significance for maintaining stability. Conclusion: The study underscores the multifaceted nature of CEO turnover in Australian hospitals influenced by organisational dynamics, performance factors, and personal elements. Effective retention strategies necessitate a culture within the organisation, defined roles, sufficient resources, and robust succession planning. Addressing these aspects can bolster leadership continuity and enhance the performance of healthcare organisations. What is known about the topic? High turnover rates among hospital chief executive officers (CEOs) negatively impact organisational stability and healthcare quality, causing disruptions in strategic decision-making, decreased employee morale, and potential declines in patient care standards. What does this paper add? This study identifies stress, lack of board support, and resource constraints as key factors driving CEO turnover in Australian hospitals. It also offers effective retention strategies, including fostering mutual respect between CEOs and boards, fulfilling training needs, and ensuring clear role definitions. What are the implications for practitioners? Implementing supportive organisational cultures, clear role definitions, and robust succession planning can enhance CEO retention. These measures will improve stability, strategic planning, and healthcare management, ultimately benefiting staff and patient care. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
231. What is the impact of successive COVID-19 lockdowns on population mental health? Findings from an Australian natural experiment using health service data.
- Author
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Lakhani, Ali and Sundararajan, Vijaya
- Subjects
PREVENTION of communicable diseases ,SELF-evaluation ,PSYCHOLOGY of physicians ,MENTAL health services ,PSYCHOLOGISTS ,RESOURCE allocation ,POPULATION health ,MEDICAL care ,GENERAL practitioners ,HEALTH policy ,DESCRIPTIVE statistics ,ANXIETY ,STAY-at-home orders ,EXPERIMENTAL design ,PSYCHOLOGICAL stress ,PUBLIC health ,COMPARATIVE studies ,CONFIDENCE intervals ,ANXIETY disorders ,COVID-19 pandemic ,SOCIAL distancing ,MEDICAL care costs ,PSYCHOSOCIAL factors ,MENTAL depression ,MEDICAL referrals - Abstract
Objective: The causal effect of successive population-wide lockdowns in response to increased COVID-19 cases on mental health has yet to be examined using robust methods. A natural experiment design underpinned by objective data can improve our understanding surrounding the definitive impact of social distancing restrictions. Methods: The study employed a natural experiment design underpinned by objective data. Health service cost for visits to general practitioners and psychologists and medication dispensing costs served as objective measures of mental health. Difference-in-difference (DID) estimators, which in this study quantify differences in spending changes between groups over time, were produced based on three comparisons: Victoria 2020 lockdown comparison, Victoria 2021 lockdown comparison, and New South Wales (NSW) 2021 lockdown comparison. Specifically, differences in public health service spending during lockdown periods and the same timeframe in 2019 for Victoria and NSW, and control groups (remaining states and territories), were compared. Results: Positive estimator values indicate that public health service spending for Victoria and NSW increased more during lockdown periods compared to control states and territories. The Victorian lockdowns of 2020 and 2021, but not the NSW lockdown of 2021, resulted in increased public spending for general practitioner mental health consults (2020 DID estimator: $8498.96 [95% CI $4012.84, $12,373.57], 2021 DID estimator: $6630.06 [95% CI $41.27, $13,267.20], all monetary values in AUD$) and short visits to psychologists (2020 DID estimator: $628.82 [95% CI $466.25, $796.00], 2021 DID estimator: $230.11 [95% CI $47.52, $373.98]). The first Victorian lockdown in 2020 and the NSW lockdown in 2021 resulted in greater spending on short visits to clinical psychologists. Spending on long visits to psychologists and clinical psychologists and medication spending did not change. Conclusions: Strict lockdowns can have an adverse impact on population mental health. The impact is particularly evident in those who have a history of previous mental health concerns but does not necessitate extra use of medications, suggesting that psychological care can address the adverse impact of the lockdowns. What is known about the topic? Previous research varied in methodology, using self-reports and healthcare data to understand COVID-19 social distancing public health measures' effects on mental health. What does this paper add? This study introduces robust, objective data via a natural experiment design, examining the impact of successive lockdowns on mental health service usage and medication expenditures in specific Australian regions. What are the implications for practitioners? Findings highlight the need for flexible mental health services that can swiftly respond to increased demands during prolonged restrictions, without necessarily increasing medication use, guiding future policy and resource allocation. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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232. Variation in direct healthcare costs to the health system by residents living in long-term care facilities: a Registry of Senior Australians study.
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Khadka, Jyoti, Ratcliffe, Julie, Caughey, Gillian, Air, Tracy, Wesselingh, Steve, Corlis, Megan, Evans, Keith, and Inacio, Maria
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DIAGNOSIS of dementia ,STATISTICAL models ,PROPRIETARY health facilities ,ELDER care ,RESEARCH funding ,LONG-term health care ,HOSPITAL care ,RETROSPECTIVE studies ,HOSPITAL emergency services ,DESCRIPTIVE statistics ,GOVERNMENT aid ,LONGITUDINAL method ,CONFIDENCE intervals ,MEDICAL care costs ,DEMENTIA patients ,PATIENT aftercare ,HOSPITAL costs - Abstract
Objective: This study aimed to examine the national variation in government-subsidised healthcare costs of residents in long-term care facilities (LTCFs) and costs differences by resident and facility characteristics. Methods: A retrospective population-based cohort study was conducted using linked national aged and healthcare data of older people (≥65 years) living in 2112 LTCFs in Australia. Individuals' pharmaceutical, out-of-hospital, hospitalisation and emergency presentations direct costs were aggregated from the linked healthcare data. Average annual healthcare costs per resident were estimated using generalised linear models, adjusting for covariates. Cost estimates were compared by resident dementia status and facility characteristics (location, ownership type and size). Results: Of the 75,142 residents examined, 70% (N = 52,142) were women and 53.4% (N = 40,137) were living with dementia. The average annual healthcare cost (all costs in $A) was $9233 (95% CI $9150–$9295) per resident, with hospitalisation accounting for 47.2% of the healthcare costs. Residents without dementia had higher healthcare costs ($11,097, 95% CI $10,995–$11,200) compared to those with dementia ($7561, 95% CI $7502–$7620). Residents living in for-profit LTCFs had higher adjusted average overall annual healthcare costs ($11,324, 95% CI $11,185–$11,463) compared to those living in not-for-profit ($11,017, 95% CI $10,895–$11,139) and government ($9731, 95% CI $9365–$10,099) facilities. Conclusions: The healthcare costs incurred by residents of LTCFs varied by presence of dementia and facility ownership. The variation in costs may be associated with residents' care needs, care models and difference in quality of care across LTCFs. As hospitalisation is the biggest driver of the healthcare costs, strategies to reduce preventable hospitalisations may reduce downstream cost burden to the health system. What is known about the topic? Residents living in long-term care facilities have high health and care needs, but little research exists on how downstream healthcare costs vary based on facility and individual characteristics. What does this paper add? Using linked national aged care and healthcare data, this study determined that the average annual healthcare cost per resident was $9233 (95% CI $9150–$9295), with hospitalisation accounting for nearly half of these costs. Furthermore, healthcare costs varied based on facility ownership and size, as well as whether individuals had dementia. What are the implications for practitioners? Understanding sectoral variation and learning from long-term care facilities with lower hospitalisation rates could be a strategic approach to reducing healthcare costs for long-term care residents. [ABSTRACT FROM AUTHOR]
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- 2024
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233. Informing the management of the post-COVID condition: insights from the Western Australian experience comparing those who tested positive and negative to early COVID-19 strains.
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Grove, Kristen, Cavalheri, Vinicius, Chih, HuiJun, Natarajan, Varsha, Harrold, Meg, Mohd, Sheeraz, Hurn, Elizabeth, Van der Lee, Lisa, Maiorana, Andrew, Tearne, Jessica, Watson, Carol, Pearce, Jane, Jacques, Angela, White, Ann, Vicary, Caitlin, Roffman, Caroline, Synnott, Emma-Leigh, Suttie, Ian, Lin, Ivan, and Larsson, Jade
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T-test (Statistics) ,DATA analysis ,COVID-19 testing ,POST-acute COVID-19 syndrome ,POLYMERASE chain reaction ,SEX distribution ,FATIGUE (Physiology) ,FISHER exact test ,MULTIPLE regression analysis ,LOGISTIC regression analysis ,FUNCTIONAL status ,AGE distribution ,ANXIETY ,MANN Whitney U Test ,CHI-squared test ,LONGITUDINAL method ,ODDS ratio ,CONVALESCENCE ,OBSTRUCTIVE lung diseases ,STATISTICS ,HEALTH outcome assessment ,DYSPNEA ,CONFIDENCE intervals ,COMPARATIVE studies ,DATA analysis software ,COVID-19 ,ASTHMA ,GRIP strength ,MENTAL depression - Abstract
Objective: This study aimed to compare the relative physical recovery and symptoms after SARS-CoV-2 infection between groups confirmed positive or negative to early strains of COVID-19. Methods: A prospective, longitudinal cohort study compared outcomes of metropolitan adults polymerase chain reaction-tested for COVID-19 between March and November 2020 in Western Australia. Control matching was attempted: inpatients (gender, age) and ambulatory clinic (gender, age, asthma, chronic pulmonary disease). One-year follow-up involved three repeated measures: physical function (grip strength and 1-min sit-to-stand) and patient-reported outcomes (Fatigue Severity Scale, modified Medical Research Council dyspnoea scale and Euroqol-5D-5L). Results: Three hundred and forty-four participants were recruited (154 COVID+, age 54 ± 18 years, 75 females [49%]); 190 COVID−, age 52 ± 16 years, 67 females [35%]) prior to national vaccination roll-out. No between-group differences in physical function measures were evident at any time point. Fatigue (OR 6.62, 95% CI 2.74–15.97) and dyspnoea (OR 2.21, 95% CI 1.14–4.30) were higher in the COVID+ group at second assessment (T2). On Euroqol-5D-5L, no between-group differences were evident in the physical function domains of self-care, mobility or usual activities at any time point. However, COVID+ participants were less likely to report an absence of anxiety or depression symptoms at T2 (OR 0.41, 95% CI 0.19–0.89). Conclusions: Neither statistical nor clinically meaningful differences in physical function were evident between COVID+ and COVID− participants to 12-months after acute illness. Symptoms of fatigue, dyspnoea, anxiety or depression were more prevalent in the COVID+ group til ~8 months after illness with between-group differences no longer evident at 1 year. What is known about the topic? COVID-19 evokes multi-system sequelae including persistent physical and mental health symptoms, functional impairments and poorer quality of life. What does this paper add? A COVID+ group had equivalent physical recovery over 12 months; but higher prevalence of fatigue, dyspnoea and anxiety/depression symptoms at ~8 months compared to a COVID− group. What are the implications for practitioners? Health authorities and employers should know that while adequate physical function may return within months, post-acute sequelae of COVID-19 impair sufferers for over 6 months, likely necessitating healthcare support and workplace adjustments to optimise timely return to participation. [ABSTRACT FROM AUTHOR]
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- 2024
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234. The effect of interventions in vaginal birth on fear of childbirth: A multicentre study.
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Atan, Senay Unsal, Daşıkan, Zeynep, Ibis, Berna Kaya, Köprülü, Cigdem, Donmez, Elmas Mutlugunes, Kırcan, Nurten Denizhan, Ocalan, Dilek, and Erdogan, Meryem
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CHILDBIRTH & psychology ,FEAR ,CROSS-sectional method ,PHYSICAL diagnosis ,PAIN measurement ,SCALE analysis (Psychology) ,STATISTICAL models ,DELIVERY (Obstetrics) ,VAGINA ,HEALTH attitudes ,SATISFACTION ,CRONBACH'S alpha ,DATA analysis ,QUESTIONNAIRES ,VISUAL analog scale ,KRUSKAL-Wallis Test ,MULTIPLE regression analysis ,DESCRIPTIVE statistics ,PREGNANT women ,LABOR pain (Obstetrics) ,MANN Whitney U Test ,AGE distribution ,ECONOMIC status ,INTRAPARTUM care ,PRENATAL care ,RESEARCH ,PARITY (Obstetrics) ,URBAN hospitals ,STATISTICS ,UNPLANNED pregnancy ,DATA analysis software ,CONFIDENCE intervals ,EDUCATIONAL attainment ,EMPLOYMENT - Abstract
Aim: This cross‐sectional multicentre study aimed to determine the effect of interventions during vaginal birth for fear of childbirth. Methods: In this cross‐sectional and analytical study, 852 women who had a vaginal birth between 2019 and 2020 were enrolled. Data were collected using the Descriptive Questionnaire and Wijma Birth Expectation/Experience Scale Version B. Results: The mean total Wijma Birth Expectation/Experience Scale Version B score of the women was 97.00 ± 24.24, indicating severe and clinical levels of fear of childbirth. Moreover, 69.4% of the women had clinical, 18.6% had severe and 12% had moderate levels of fear of childbirth. During birth, women who had close supporters, who were allowed to move and who did not undergo amniotomy, enema, perineal shaving and electronic foetal monitoring had a low level of fear of childbirth. As the number of pregnant women in the labour room, frequency of vaginal examinations, duration of delivery/hour, severity of labour pain and negative perception of the approach of health professionals increased, the women's fear of childbirth increased. Fear of childbirth decreased as the frequency of antenatal follow‐ups, number of births and satisfaction levels of the women increased (p < 0.05). Low income perception, irregular prenatal follow‐up, severe labour pain and a long duration of labour were strong predictors of increased fear of childbirth. Increasing number of births, high birth satisfaction level and positive perception of the approach of health professionals were strong predictors of reduced fear of childbirth. Conclusions: The reduction of interventions in vaginal delivery and support from health care providers during delivery can be effective in reducing fear of childbirth. Summary statement: What is already known about this topic? Fear of childbirth (FOC) is a problem experienced by most women.Sociodemographic characteristics and past experiences can increase FOC.Birth interventions are common as the majority of births in Turkey take place in health institutions. What does this paper add? Women who have vaginal births appear to have severe and clinical levels of fear of childbirth. Multiparity, mobilization, high birth satisfaction and positive approaches by health care providers are strong predictors of reduced FOC.Enema, amniotomy and fundal pressure application, high‐intensity labour pain and a long duration of labour are strong predictors of increased FOC. The implications of this study: Many current routine interventions during childbirth should be avoided.The reduction of interventions in vaginal birth and support from health professionals during labour can be effective in reducing fear of childbirth and negative consequences related to FOC, as well as helping to achieve non‐invasive vaginal deliveries.It is recommended that hospitals be organized in line with the criteria of mother‐friendly hospitals, health professionals be trained and the environments in which women give birth be improved. [ABSTRACT FROM AUTHOR]
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- 2024
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235. Reliability testing of the Health of the Nation Outcome Scales 2018.
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Painter, Jon and James, Mick
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CRONBACH'S alpha ,RESEARCH methodology evaluation ,STATISTICAL sampling ,RESEARCH evaluation ,DESCRIPTIVE statistics ,PSYCHOMETRICS ,RESEARCH methodology ,INTRACLASS correlation ,PSYCHIATRIC nursing ,CASE studies ,CONFIDENCE intervals ,INTER-observer reliability ,NURSING students ,RELIABILITY (Personality trait) ,EVALUATION - Abstract
Accessible Summary: What is known on the subject: The Health of the Nation Outcome Scales (HoNOS) is a widely used clinical measure designed to rate and monitor the outcomes of service users accessing specialist mental healthcare.Since its development (in 1996), numerous research studies have confirmed the HoNOS captures the aspects of care that it purports to (validity), and that clinicians' ratings are consistent both over time, and between different raters (reliability). What the paper adds to existing knowledge: In 2018, the HoNOS was reviewed with updates made to some terminology and other revisions intended to remove ambiguity in the guidance for raters. However, although the new version (HoNOS 2018) was accompanied by a recommendation that its validity and reliability be re‐tested this was not undertaken.To our knowledge, this is the first study to re‐assess the updated tool's reliability by measuring the level of agreement between different raters. Our findings confirm that there is an acceptable level of consistency between student mental health nurses that have been trained to use the (new) HoNOS 2018. What are the implications for practice: The HoNOS is nationally mandated for use by all specialist mental healthcare providers in the UK.Our findings provide some assurance that, with appropriate update training and monitoring of organisational‐level data sets, the original HoNOS glossary can safely be replaced with the HoNOS 2018 to ensure more contemporary routine outcome measurement can occur. Introduction: The Health of the Nation Outcome Scales (HoNOS) is a well‐established clinician rated outcome measure for use in mental health services. Following an international review, an updated version (HoNOS 2018) was published with a recommendation that its psychometric properties be re‐tested prior to widespread implementation. To date, only one such study has been published. Aims: To test the inter‐rater agreement levels for HoNOS 2018. Method: Third‐year student mental health nurses received training to complete the HoNOS 2018. Following this timetabled session, they were each invited to independently rate two, randomly selected, videos of (simulated) patient interviews. The resulting data were then analysed to calculate the tool's internal consistency and inter‐rater agreement levels. Results: The 55 participants provided 106 ratings from four vignettes. Cronbach's alphas and McDonalds omegas confirmed the revised tool's internal consistency was acceptable. Average measure intraclass correlation coefficients for the four patient vignettes indicated excellent reliability. Implications for practice: This study provides initial assurance that the HoNOS 2018 is a reliable clinician rated outcome measure suitable for use in routine clinical practice by relatively inexperienced mental health practitioners with limited training. [ABSTRACT FROM AUTHOR]
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- 2024
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236. Longitudinal association of social isolation and loneliness with physical function among in‐patients living with schizophrenia.
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Chen, Li‐Jung, Steptoe, Andrew, Chien, I‐Chia, and Ku, Po‐Wen
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SCHIZOPHRENIA ,RISK assessment ,PEARSON correlation (Statistics) ,RESEARCH funding ,FUNCTIONAL assessment ,QUESTIONNAIRES ,LONELINESS ,FUNCTIONAL status ,DESCRIPTIVE statistics ,LONGITUDINAL method ,STATISTICAL reliability ,COMPARATIVE studies ,INTERPERSONAL relations ,SOCIODEMOGRAPHIC factors ,CONFIDENCE intervals ,DATA analysis software ,SOCIAL isolation ,ACTIVITIES of daily living - Abstract
What is Known on the Subject?: People living with schizophrenia have reduced physical function and are more likely to experience loneliness than those without condition.Low physical function is associated with greater loneliness in people with psychosis. However, it is unclear whether social isolation and loneliness contribute to impaired physical function in this population.Loneliness is linked to an increased risk of physical function impairment among older individuals, but research on patients living with schizophrenia is limited. What This Paper Adds to Existing Knowledge?: This study is the first to evaluate the longitudinal association of social isolation and loneliness with physical function among inpatients living with schizophrenia.It showed that more than one third of the participants experienced a decline in physical function over a 2‐year period.Loneliness, rather than social isolation, was associated with an increase in physical function impairment over 2 years among inpatients living with schizophrenia. What are the Implications for Practice?: Healthcare professionals should recognize loneliness as a potential risk factor for impaired physical function among inpatients diagnosed with schizophrenia.It is recommended that people living with schizophrenia are assessed for loneliness and that interventions are offered to alleviate their feelings of loneliness.Implementing interventions to reduce loneliness may help improve physical function and overall quality of life for individuals living with schizophrenia. Introduction: Patients living with schizophrenia often experience low physical function, which is associated with negative health outcomes. Therefore, investigating the risk factors for physical function is crucial in this population. Aim: This study examined the longitudinal association of social isolation and loneliness with physical function among inpatients living with schizophrenia. Methods: Physical function was assessed using measures of activities daily living (ADL), instrumental activities daily living (IADL) and the combination scores of ADL/IADL. Social isolation was indexed with five types of social connection and loneliness was measured using UCLA Loneliness Scale. Results: Social isolation was not associated with the measures of physical function over 2 years. Loneliness exhibited an association with IADL and ADL/IADL at follow‐up, after adjustment for baseline levels of the outcomes. These associations remained when both social isolation and loneliness were simultaneously entered into the model. Discussion: Loneliness, rather than social isolation, was associated with increased physical function impairment over 2 years among inpatients living with schizophrenia. Implications for Practice: Healthcare professionals should consider loneliness as a potential risk factor for impaired physical function. It would be beneficial to assess patients for loneliness and implement interventions to reduce feelings of loneliness. [ABSTRACT FROM AUTHOR]
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- 2024
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237. A hybrid model to improve IC-related metrics of semantic similarity between words.
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Xiao, Jia
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WILCOXON signed-rank test ,STATISTICAL correlation ,RANK correlation (Statistics) ,CONFIDENCE intervals ,SAMPLE size (Statistics) - Abstract
This paper proposes a hybrid model to improve Information Content (IC) related metrics of semantic similarity between words, named IC+SP, based on the essential hypothesis that IC and the shortest path are two relatively independent semantic evidences and have approximately equal influences to the semantic similarity metric. The paradigm of IC+SP is to linearly combine the IC-related metric and the shortest path. Meanwhile, a transformation from the semantic similarity of the concepts to that of the words is presented by maximizing every component of IC+SP. 13 improved IC-related metrics based on IC+SP are formed and implemented on the experimental platform HESML Lastra-Díaz (Inf Syst 66:97–118, 2017). Pearson's and Spearman's correlation coefficients on well-accepted benchmarks for the improved metrics compare to those for the original ones to evaluate IC+SP. I introduce the Wilcoxon Signed-Rank Test needing no standard distribution hypothesis, while, this hypothesis is required by T-Test on the sample of small size. T-Test, as well as the Wilcoxon Signed-Rank Test, conduct on the differences of the correlative coefficients for improved and original metrics. It is expected that the improved IC-related metrics could significantly outperform their corresponding original ones, and the experimental results, including the comparisons of mean and maximum of correlation coefficients as well as the p-value and confidence interval of both tests, accomplish the anticipation in the vast majority of cases. [ABSTRACT FROM AUTHOR]
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- 2024
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238. Prognostic importance of NUP98-rearrangements in acute myeloid leukemia: A systematic review and meta-analysis.
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Sheikhi, Maryam, Siyadat, Payam, Rostami, Mehrdad, Sadeghian, Mohammad Hadi, Zahiri, Elnaz, Ghorbani, Mohammad, Ayatollahi, Hossein, Ayatollahi, Amirali, Attarbashi, Reza Hemmatan, and Khoshnegah, Zahra
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ACUTE myeloid leukemia ,GENE fusion ,PROGNOSIS ,OVERALL survival ,CONFIDENCE intervals - Abstract
Background: NUP98 gene fusions in acute myeloid leukemia (AML) have recently attracted much interest. Despite substantial research illuminating the roles of NUP98 fusions in the course of AML, their impacts on the outcome of patients with AML should be explored in more detail. As a result, this meta-analysis was designed to provide further light on the prognostic implications of NUP98 fusions in AML. Methods: We completed an extensive search in PubMed, Scopus, and Web of Science to identify papers evaluating the prognostic effects of NUP98 rearrangements in patients with AML until August 22, 2022. In total, 15 publications with 6142 participants fulfilled the requirements for the current meta-analysis. All the qualified studies were examined for information regarding HRs and 95% confidence interval (95%CI) for overall survival (OS) and event-free survival (EFS). In addition, we utilized Comprehensive Meta-analysis software version 2 (CMA2) for calculating pooled HRs and 95% CI. Results: Our analyses for NUP98-NSD1 indicated that this fusion could significantly impact the outcome of patients with AML (pooled HR: 2.84; 95% CI: 2.49-3.24, P=0.000). Additionally, we observed a strong correlation between NUP98-KDM5A rearrangement and poor prognosis in AML (pooled HR: 2.65; 95% CI: 2.5-2.81; P=0.000). A subgroup analysis also showed that the NUP98-NSD1 and FLT3-ITD together confer a poor prognostic effect (pooled HR: 2.60, 95% CI: 1.61-4.18; P=0.000). Conclusions: NUP98 fusions could significantly impact the outcome of patients with AML. The use of these fusions as prognostic indicators in AML seems rational. [ABSTRACT FROM AUTHOR]
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- 2024
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239. Population age structure dependency of the excess mortality P-score.
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Ullrich-Kniffka, Niklas and Schöley, Jonas
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DEATH ,PROBABILITY theory ,EMPIRICAL research ,AGE distribution ,DESCRIPTIVE statistics ,RESEARCH bias ,EPIDEMICS ,COMPARATIVE studies ,CONFIDENCE intervals ,COVID-19 pandemic ,COVID-19 - Abstract
Background: Since the outbreak of the COVID-19 pandemic, the excess mortality P-score has gained prominence as a measure of pandemic burden. The P-score indicates the percentage by which observed deaths deviate from expected deaths. As the P-score is regularly used to compare excess mortality between countries, questions arise regarding the age dependency of the measure. In this paper we present formal and empirical results on the population structure bias of the P-score with a special focus on cross-country comparisons during the COVID-19 pandemic in Europe. Methods: P-scores were calculated for European countries for 2021, 2022, and 2023 using data from the 2024 revision of the United Nations' World Population Prospects and the HMDs Short Term Mortality Fluctuations data series. The expected deaths for 2021, 2022, and 2023 were estimated using a Lee–Carter forecast model assuming pre-pandemic conditions. P-score differences between countries were decomposed using a Kitagawa-type decomposition into excess-mortality and structural components. To investigate the sensitivity of P-score cross-country rankings to differences in population structure we calculated the rank-correlation between age-standardized and classical P-scores. Results: The P-score is an average of age-specific percent excess deaths weighted by the age-distribution of expected deaths. It can be shown that the effect of differences in the distribution of deaths only plays a marginal role in a European comparison. In most cases, the excess mortality effect is the dominant effect. P-score rankings among European countries during the COVID-19 pandemic are similar under both age-standardized and classical P-scores. Conclusions: Although the P-score formally depends on the age-distribution of expected deaths, this structural component only plays a minor role in a European comparison, as the distribution of deaths across the continent is similar. Thus, the P-score is suitable as a measure of excess mortality in a European comparison, as it mainly reflects the differences in excess mortality. However, this finding should not be extrapolated to global comparisons, where countries could have very different death distributions. In situations were P-score comparisons are biased age-standardization can be applied as a solution. [ABSTRACT FROM AUTHOR]
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- 2024
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240. The Concerns Expressed by Spanish Wage‐Earners in Regard to Psychosocial Risk Factors during the 2008 Crisis.
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Bilbao-Ubillos, Javier, Leivar-Santiago, Dolores, Ramos-Carvajal, Carmen, and Ramos-Pichardo, Juan Diego
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WORK-related injuries risk factors ,RECESSIONS ,SOCIAL security ,PROFESSIONAL autonomy ,SECONDARY analysis ,WORK environment ,SOCIAL factors ,LOGISTIC regression analysis ,INVESTMENTS ,PEER relations ,SEX distribution ,BLUE collar workers ,SPANIARDS ,DISMISSAL of employees ,DESCRIPTIVE statistics ,MULTIVARIATE analysis ,DOWNSIZING of organizations ,WAGES ,SURVEYS ,EMPLOYEE promotions ,ATTRIBUTION (Social psychology) ,CONFIDENCE intervals ,PSYCHOSOCIAL factors ,EMPLOYEES' workload - Abstract
Background. Social and organisational changes in businesses have led to the appearance of "emergent risks" which affect workers but are less evident and hard to quantify such as psychosocial risks. Linked to psychosocial risks, issues such as work‐related stress and workplace violence are major challenges to occupational health and safety. This paper analyses the trends in the concerns expressed by wage‐earners in Spain regarding psychosocial factors that may affect them in the workplace. Methods. A causal analysis based on the application of binary logistic regression is presented, covering certain social and occupational characteristics of survey respondents and the psychosocial factors included in the Spanish National Surveys of Working Conditions for 2007 and for 2011‐2012. Binary logistic regression is a multivariate statistical tool that serves as a classification technique, identifying the variables that affect the probability of the event to be studied (dichotomous variable). This technique has the advantage that it does not require that the explanatory variables follow a normal distribution. The aim is to estimate the influence of the explanatory variables on the probability of the occurrence of the event under study, represented by the explained variable. Results. During the economic crisis of 2008, workers became more concerned about losing their jobs and about factors related to personnel cutbacks and decreases in investment in the prevention of occupational risks. Downsizing due to the crisis led to increased workloads for many of those still in work. Thus, in 2011, the likelihood of workers being concerned about working hours was greater, especially among respondents aged 25–34 and those working in commerce and transport. Workload was found to be a particular concern among respondents aged 25–34 and among workers in transport, communication, financial, professional, and administrative activities; health‐related activities; and industry. Conclusions. Policy should also be directed towards improving the structural aspects of psychosocial variations, in terms of work conditions, employment protection, and employment security to protect workers against income fluctuations as a result of job loss. [ABSTRACT FROM AUTHOR]
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- 2024
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241. A systematic review and meta analysis on digital mental health interventions in inpatient settings.
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Diel, Alexander, Schröter, Isabel Carolin, Frewer, Anna-Lena, Jansen, Christoph, Robitzsch, Anita, Gradl-Dietsch, Gertraud, Teufel, Martin, and Bäuerle, Alexander
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MENTAL illness treatment ,EFFECT sizes (Statistics) ,MENTAL health services ,DATA analysis ,MEDICAL care ,DIGITAL health ,INTERNET ,HOSPITAL patients ,META-analysis ,DESCRIPTIVE statistics ,SYSTEMATIC reviews ,MEDLINE ,STATISTICS ,ONLINE information services ,QUALITY assurance ,CONFIDENCE intervals ,PSYCHOLOGY information storage & retrieval systems ,PUBLICATION bias - Abstract
E-mental health (EMH) interventions gain increasing importance in the treatment of mental health disorders. Their outpatient efficacy is well-established. However, research on EMH in inpatient settings remains sparse and lacks a meta-analytic synthesis. This paper presents a meta-analysis on the efficacy of EMH in inpatient settings. Searching multiple databases (PubMed, ScienceGov, PsycInfo, CENTRAL, references), 26 randomized controlled trial (RCT) EMH inpatient studies (n = 6112) with low or medium assessed risk of bias were included. A small significant total effect of EMH treatment was found (g = 0.3). The effect was significant both for blended interventions (g = 0.42) and post-treatment EMH-based aftercare (g = 0.29). EMH treatment yielded significant effects across different patient groups and types of therapy, and the effects remained stable post-treatment. The results show the efficacy of EMH treatment in inpatient settings. The meta-analysis is limited by the small number of included studies. [ABSTRACT FROM AUTHOR]
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- 2024
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242. The Association of Dietary Micronutrient Intake and Systemic Inflammation among Patients with Type 2 Diabetes: A Cross-Sectional Study.
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Izuora, Kenneth, Alver, Amalie, Basu, Arpita, Batra, Kavita, Williams, Shelley J., and Ebersole, Jeffrey L.
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RISK assessment ,CROSS-sectional method ,PEARSON correlation (Statistics) ,IRON ,IRON in the body ,FOOD consumption ,BODY mass index ,DISEASE duration ,GLYCOSYLATED hemoglobin ,ACADEMIC medical centers ,LOGISTIC regression analysis ,SEX distribution ,NUTRITIONAL assessment ,MICRONUTRIENTS ,DESCRIPTIVE statistics ,AGE distribution ,NUTRITIONAL requirements ,ODDS ratio ,TYPE 2 diabetes ,AMYLOID ,FIBRINOGEN ,STATISTICS ,INFLAMMATION ,FOOD preferences ,FOOD diaries ,DATA analysis software ,CLINICS ,CONFIDENCE intervals ,BIOMARKERS ,C-reactive protein ,REGRESSION analysis ,DISEASE risk factors - Abstract
Inflammation contributes to the pathogenesis of type 2 diabetes (T2DM). This study sought to document how the systemic biomarkers of inflammation varied based on food choices among patients with T2DM. This cross-sectional study enrolled ambulatory patients with T2DM. Demographic and clinical information was collected. Five drops of fingerstick blood were collected using an absorbent paper device (HemaSpot HFR). C-reactive protein (CRP), serum amyloid A protein (SAA), and fibrinogen were measured using a Luminex assay. Patient-generated 7-day food diaries were analyzed using a validated food processor software. Data were analyzed by Pearson's correlation tests, linear regression and logistic regression with the significance level set at 0.05. Among the 71 participants, 43 (60.6%) were females. The average age and duration of T2DM were 64.1 ± 10.3 and 15.8 ± 9.1 years, respectively. In a simple linear regression run with selected micronutrients, iron [F (1, 53) = 5.319, p < 0.05, adj. R
2 = 0.074] significantly predicted plasma CRP. This significance was lost with multiple linear regressions including age, gender, BMI, T2DM duration, T2DM complications, glycohemoglobin A1c (HbA1c) and other micronutrients. The average intake of most micronutrients by the participants was below the recommended daily intake. A higher intake of iron-rich foods was associated with higher levels of systemic inflammation in a simple linear regression model, but the association was not present after adjusting for patient factors like age, gender, BMI and T2DM-related variables. This relationship needs to be explored further given the key role of inflammation in the pathogenesis of T2DM and its associated complications. [ABSTRACT FROM AUTHOR]- Published
- 2024
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243. A randomized trial testing digital medicine support models for mild-to-moderate alcohol use disorder.
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Quanbeck, Andrew, Chih, Ming-Yuan, Park, Linda, Li, Xiang, Xie, Qiang, Pulvermacher, Alice, Voelker, Samantha, Lundwall, Rachel, Eby, Katherine, Barrett, Bruce, and Brown, Randall
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ALCOHOLISM treatment ,SUPPORT groups ,SELF-evaluation ,RESEARCH funding ,MENTAL health ,MEDICAL care ,DIGITAL health ,STATISTICAL sampling ,INTERNET ,TREATMENT effectiveness ,RANDOMIZED controlled trials ,ODDS ratio ,QUALITY of life ,COMPARATIVE studies ,CONFIDENCE intervals - Abstract
This paper reports the results of a hybrid effectiveness-implementation randomized trial that systematically varied levels of human oversight required to support the implementation of a digital medicine intervention for persons with mild-to-moderate alcohol use disorder (AUD). Participants were randomly assigned to three groups representing possible digital health support models within a health system: self-monitored use (SM; n = 185), peer-supported use (PS; n = 186), or a clinically integrated model CI; (n = 187). Across all three groups, the percentage of self-reported heavy drinking days dropped from 38.4% at baseline (95% CI [35.8%, 41%]) to 22.5% (19.5%, 25.5%) at 12 months. The clinically integrated group showed significant improvements in mental health and quality of life compared to the self-monitoring group (p = 0.011). However, higher attrition rates in the clinically integrated group warrant consideration in interpreting this result. Results suggest that making a self-guided digital intervention available to patients may be a viable option for health systems looking to promote alcohol risk reduction. This study was prospectively registered at clinicaltrials.gov on 7/03/2019 (NCT04011644). [ABSTRACT FROM AUTHOR]
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- 2024
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244. The prevalence of disability in older adults with multimorbidity: a meta-analysis.
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Zhang, Jin, Sun, Yan, and Li, Aiying
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MEDICAL information storage & retrieval systems ,MEDICAL care use ,RESEARCH funding ,CINAHL database ,SEX distribution ,DISEASE prevalence ,META-analysis ,DESCRIPTIVE statistics ,AGE distribution ,POPULATION geography ,SYSTEMATIC reviews ,MEDLINE ,ODDS ratio ,MEDICAL databases ,MARITAL status ,ONLINE information services ,CONFIDENCE intervals ,COMORBIDITY ,PEOPLE with disabilities ,ACTIVITIES of daily living ,OLD age - Abstract
Background: Disability is typically correlated with lower quality of life and decreased capacity for self-care. It has been demonstrated that multimorbidity is closely linked to a variety of unfavorable events, such as disability. Researchers are still figuring out how and to what extent co-morbidities impact disability, though. In order to fill up this gap, this study examines the prevalence and contributing variables of disability in older patients who have multimorbidity. Methods: We conducted a systematic search of Pubmed, Cochrane Library, Web of Science, Embase, and CINAL databases for articles from their inception until September 2023. We selected co-morbid older adults aged > 60 years and used the ADL scale or any scale that assesses disability as an assessment tool. We excluded literature that did not meet the criteria, and literature that could not be included in the data we needed. We extracted data from the included literature and calculated synthetic prevalence rates, ORs, and 95% confidence intervals. Results: A total of 32 papers (71,135 older adults) were included in the study. The prevalence of disability among older patients with multimorbidity was around 34.9% (95% CI = 25.8-43.9%). Subgroup analysis showed higher rates of disability among comorbidities who were older, female, unmarried, and long-term users of health services. And the incidence of disability increased each year. Meanwhile, the regions of the United States, China, and Spain showed higher rates of disability. Conclusions: Disability rates in older patients with multimorbidity are higher, thus it's critical to focus on risk factors while fully accounting for regional variances. [ABSTRACT FROM AUTHOR]
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- 2024
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245. Effects of High-Intensity Interval Training on the Parameters Related to Physical Fitness and Health of Older Adults: A Systematic Review and Meta-Analysis.
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Liang, Wei, Wang, Xiang, Cheng, Shishi, Jiao, Jiao, Zhu, Xiangui, and Duan, Yanping
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EXERCISE physiology ,MEDICAL information storage & retrieval systems ,CARDIOPULMONARY fitness ,HEALTH status indicators ,RESEARCH funding ,SPORTS ,HEART rate monitoring ,BODY mass index ,ADIPOSE tissues ,STRETCH (Physiology) ,HIGH-intensity interval training ,BODY composition ,META-analysis ,INFORMATION storage & retrieval systems ,DESCRIPTIVE statistics ,RESISTANCE training ,SYSTEMATIC reviews ,MEDLINE ,WAIST circumference ,MUSCLE strength ,PHYSICAL fitness ,MEDICAL databases ,DIASTOLIC blood pressure ,ONLINE information services ,SYSTOLIC blood pressure ,CONFIDENCE intervals ,PSYCHOLOGY information storage & retrieval systems ,POSTURAL balance ,REGRESSION analysis ,PHYSICAL mobility ,OLD age - Abstract
Background: As a novel and time-efficient exercise form, high-intensity interval training (HIIT) has shown great potential in improving health-related physical fitness among diverse populations. However, empirical evidence on its efficacy among the elderly has not been well summarized. This systematic review and meta-analysis aimed to determine the effect of HIIT interventions on the parameters related to physical fitness and health of older adults, including resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), cardiorespiratory fitness (CRF), body mass index (BMI), body fat percent (BF%), waist circumference (WC), muscular endurance (ME), muscular strength (MS), muscular power (MP), balance and flexibility, compared to non-exercise and other-exercise (e.g., moderate-intensity continuous training, resistance training) conditions. Methods: Literature published from January 2000 to May 2023 was collected through extensive searches across eight databases and relevant review papers. Randomized controlled trials (RCTs) featuring a minimum 2-week exercise intervention for older adults (≥ 60 years) were included. The pooled effect size of Hedges'g was estimated using random-effects models in R. Meta-regression was performed for both categorical (health status, duration of training programme, and frequency) and continuous moderators (mean age, male rate, and attrition rate). Results: Forty-four eligible RCTs with 1863 participants (52.1% female; 60.5–81.2 years) were included in the quantitative analysis. Compared to non-exercise condition, HIIT significantly improved resting HR (g = -0.36, 95%CI = [-0.67, -0.05], P = 0.032), SBP (g = -0.29, 95%CI = [-0.54, -0.03], P = 0.008), CRF (g = 0.77, 95%CI = [0.51, 1.04], P < 0.001), BF% (g = -0.26, 95%CI = [-0.41, -0.11], P = 0.006), MS (g = 0.47, 95%CI = [0.23, 0.71], P = 0.004), ME (g = 0.65, 95%CI = [0.10, 1.19], P = 0.036), and balance (e.g., timed-up-and-go) (g = -0.79, 95%CI = [-1.19, -0.40], P = 0.035). Compared to other-exercise condition, HIIT significantly improved resting HR (g = -0.11, 95%CI = [-0.21, -0.01], P = 0.029), SBP (g = -0.14, 95%CI = [-0.28, -0.01], P = 0.038), and CRF (g = 0.23, 95%CI = [0.07, 0.38], P = 0.008). No significant difference was found between HIIT and non-exercise condition for DBP, BMI and WC, as well as between HIIT and other-exercise condition for DBP, BMI, BF%, WC, ME, and balance (all P > 0.05). Meta-regression indicated that mean age moderated the HIIT effect on resting HR (b = -0.02, P = 0.014; HIIT vs. other-exercise condition) and SBP (b = 0.03, P = 0.048; HIIT vs. non-exercise), and attrition rate moderated the effect on CRF (b = 0.03, P = 0.007; HIIT vs. non-exercise). Conclusion: This study supports the efficacy of HIIT in improving resting HR, SBP, CRF, BF%, MS, ME and balance among older adults. More empirical evidence is needed to determine the efficacy of HIIT for MP and flexibility in this population. Trial Registration: PROSPERO CRD42022316246. Key Points: • HIIT is an effective approach for improving older adults' resting heart rate (HR), systolic blood pressure (SBP), cardiorespiratory fitness (CRF), body fat percent (BF%), muscular strength (MS), and balance, compared with non-exercise condition. • HIIT outperformed the other exercise interventions in improving older adults' resting HR, SBP, CRF, and muscular endurance (ME). • Mean age and attrition rate were identified as potential moderators for the HIIT effects on resting HR, SBP and CRF. [ABSTRACT FROM AUTHOR]
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- 2024
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246. Psychological impact of the earthquake 2023 in Turkey.
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Kizilhan, Jan Ilhan, Neumann, Johanna, Aslan, Siyabend, Aladag, Erdal, Dogan, Abdulsamet, Mese, Abdullativ, Bekisoglu, Ahmet, and Wenzel, Thomas
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PSYCHIATRIC epidemiology ,MENTAL illness risk factors ,COMPETENCY assessment (Law) ,MENTAL illness prevention ,POST-traumatic stress disorder ,RISK assessment ,CROSS-sectional method ,FEAR ,SUBSTANCE abuse ,PSYCHOLOGICAL distress ,ACADEMIC medical centers ,SUICIDAL ideation ,CRONBACH'S alpha ,DATA analysis ,QUESTIONNAIRES ,LOGISTIC regression analysis ,INTERVIEWING ,DISEASE prevalence ,SELF medication ,DESCRIPTIVE statistics ,MANN Whitney U Test ,MULTIVARIATE analysis ,SUICIDAL behavior ,RESEARCH ,STATISTICS ,SOCIAL support ,GRIEF ,ALCOHOL drinking ,DATA analysis software ,CONFIDENCE intervals ,COMPARATIVE studies ,NATURAL disasters ,WELL-being ,MENTAL depression - Abstract
Background: The Turkish and Syrian earthquake on February 6th 2023, was one of the deadliest earthquakes in the last decade. It affected approximately 26 million people and left at least 50.000 dead. In this paper, we analyzed the psychological impact and the relationship between mental health factors, earthquake-related experiences and stressors, and resources related to the earthquake, 4 months after the event. Methods: We conducted an analytical cross-sectional study, applying a survey to 320 adults (18–93 years old) in Adiyaman, Turkey. Post-traumatic stress disorder (PTSD) symptoms were assessed using the PC-PTSD, general psychiatric morbidity using the GHQ-12, together with questions focusing on suicidality, drug abuse, as well as experiences, related stressors and received support related to the earthquake. Results: We found a high prevalence of general mental health symptoms, and of PTSD. Fear of aftershocks and the loss of close family members were found to be risk factors for such symptoms. We didn't find significant differences in the GHQ or the PC-PTSD scores when considering ethnicity, religion or financial income. Conclusions: High levels of general mental health symptoms and PTSD symptoms were found 4 months after the earthquake and need to be addressed in all groups, independently from potential religious, social or ethnic backgrounds. The results indicate a large psychiatric and material burden on the entire sample and some priority needs. [ABSTRACT FROM AUTHOR]
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- 2024
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247. Social Needs Screening Via Electronic Tablet in Pediatric Primary Care.
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Gorecki, Michelle C., Klein, Melissa D., Anyigbo, Chidiogo U., Beck, Andrew F., Henize, Adrienne W., Ehrlich, Shelley R., MacDougall, Melinda C., and Burkhardt, Mary Carol
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MEDICAL care laws , *MENTAL health , *SOCIAL determinants of health , *PRIMARY health care , *POCKET computers , *RETROSPECTIVE studies , *TIME series analysis , *DESCRIPTIVE statistics , *PEDIATRICS , *SOCIAL case work , *ODDS ratio , *NEEDS assessment , *MEDICAL screening , *MEDICAL needs assessment , *CONFIDENCE intervals , *MEDICAL referrals , *CAREGIVER attitudes , *CHILDREN - Abstract
OBJECTIVES: (1) Assess whether health-related social needs (HRSN)/caregiver mental health concerns (CMHC) disclosure rates differ when screening questions are administered on paper versus electronic tablet. (2) Evaluate whether changes in need identification alters referral rates to social work and our medical-legal partnership (MLP). METHODS: We conducted a retrospective review of HRSN/CMHC screening in publicly insured patients 0-18 years presenting for well-child visits in three primary care practices. Our primary outcome was HRSN/CMHC disclosure rate, comparing the proportion of positive HRSN/ CMHC screens during the 11 months before and after screening modality change. Generalized estimating equations and interrupted time series (ITS) were used to assess changes over time. Mediation analyses assessed the indirect effect of HRSN/CMHC disclosure during the electronic screening period on changes in referrals to social work/MLP. RESULTS: A total of 16,151 patients had paper-based HRSN/CMHC screens; 13,019 patients had electronic screens. Overall, 11% of paper-based screens identified ≥1 need, compared to 26% of electronic screens (p<0.001). All three practices saw an increase in disclosure rate after transition from paper to electronic screening (odds ratio [OR] range 1.54 to 4.24). Using ITS, two of three practices had significantly increased odds of need disclosure with electronic screens compared to paper (OR 3.0, 95% confidence interval [CI] 2.5, 3.6; and OR 1.7, 95%CI 1.2, 2.4). Increased HRSN/CMHC disclosure rates from transitioning to electronic screening mediated increased referrals to social work/MLP. CONCLUSIONS: Electronic screening was associated with an increased HRSN/CMHC disclosure rate compared to paper, which led to increased referrals to social work/MLP. [ABSTRACT FROM AUTHOR]
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- 2024
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248. The significant yet short‐term influence of research covidization on journal citation metrics.
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Zheng, Xiang and Ni, Chaoqun
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SERIAL publications , *MEDICAL care research , *MEDICAL personnel , *PERIODICAL articles , *CITATION analysis , *DESCRIPTIVE statistics , *ALLIED health personnel , *PSYCHOLOGY , *RESEARCH , *BIBLIOMETRICS , *IMPACT factor (Citation analysis) , *PUBLIC health , *CONFIDENCE intervals , *COVID-19 , *COVID-19 pandemic , *REGRESSION analysis - Abstract
COVID‐19 has emerged as a major research hotspot and trending topic in recent years, leading to increased publications and citations of related papers. While concerns exist about the potential citation boost in journals publishing these papers, the specifics are not fully understood. This study uses a generalized difference‐in‐differences approach to examine the impact of publishing COVID‐19 papers on journal citation metrics in the Health Sciences fields. Findings indicate that journals publishing COVID‐19 papers in 2020 received significantly higher citation premiums due to COVID‐19 in 2020 and continued to benefit from the premium in 2021 in certain fields. In contrast, journals that began publishing COVID‐19 papers in 2021 experienced weaker citation premiums. The citation premiums exhibit some negative spillover effect: Although the publication volume of non‐COVID‐19 papers also surged, these papers experienced insignificant or negative citation gains, even when published in the same journals as COVID‐19 papers. COVID‐19 papers published in high‐impact journals brought higher citation premiums than those in low‐impact journals in most fields, indicating a potential Matthew effect. These citation premiums can affect various citation‐based journal metrics, such as our simulated impact factor and SCImago Journal Rank, to different degrees. Compared to the simulated impact factor, other normalized journal metrics are less influenced by citation premiums. The results highlight a "gold rush" pattern in which early entrants establish their citation advantage in research hotspots and caution against using citation‐based metrics for research assessment. [ABSTRACT FROM AUTHOR]
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- 2024
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249. The Global Prevalence of Sexual Disorder in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.
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Salari, Nader, Hesampour, Arian, Abdolmaleki, Amir, Heidarian, Pegah, Shohaimi, Shamarina, and Mohammadi, Masoud
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FEMALE reproductive organ diseases , *MEDICAL information storage & retrieval systems , *RESEARCH funding , *RHEUMATOID arthritis , *META-analysis , *DISEASE prevalence , *DESCRIPTIVE statistics , *MALE reproductive organ diseases , *WORLD health , *SYSTEMATIC reviews , *MEDLINE , *SEXUAL dysfunction , *QUALITY of life , *ONLINE information services , *CONFIDENCE intervals , *DATA analysis software - Abstract
Rheumatoid arthritis (RA) is an autoimmune-associated pathology with an articular inflammatory basis. RA is diagnosed by severe pain, movement restriction, fatigue, anxiety, depression, and sexual disorder (SD). This pathology can potentially reduce the quality of life and cause many problems. The electronic databases of PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar search engine were systematically searched for the papers reporting the prevalence of SD in patients with RA (by August 2023). Following paper collection and data extraction, the Random Effects model was used to perform the data analysis (CMA, v.2). The heterogeneity of studies was assessed using I2 index. Following the assessment of 53 eligible studies with a sample size of 9,174 cases, the overall prevalence of SD in RA patients was 32.4% (95% CI:24.4–41.6). Also, the prevalence of SD in RA females and males was 36.5% (95% CI: 26.4–48) and 23.5% (95% CI:12.6–39.4), respectively. Based on the findings, the prevalence of SD among RA individuals was found relatively high; thus, the application of measures seems necessary to prevent sexual disorders in RA cases. These strategies are useful for health policymakers. [ABSTRACT FROM AUTHOR]
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- 2024
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250. Uncertainty quantification in high-dimensional linear models incorporating graphical structures with applications to gene set analysis.
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Tan, Xiangyong, Zhang, Xiao, Cui, Yuehua, and Liu, Xu
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ASYMPTOTIC normality ,GENE regulatory networks ,FUNCTIONAL connectivity ,INFORMATION networks ,CONFIDENCE intervals - Abstract
Motivation The functions of genes in networks are typically correlated due to their functional connectivity. Variable selection methods have been developed to select important genes associated with a trait while incorporating network graphical information. However, no method has been proposed to quantify the uncertainty of individual genes under such settings. Results In this paper, we construct confidence intervals (CIs) and provide P -values for parameters of a high-dimensional linear model incorporating graphical structures where the number of variables p diverges with the number of observations. For combining the graphical information, we propose a graph-constrained desparsified LASSO (least absolute shrinkage and selection operator) (GCDL) estimator, which reduces dramatically the influence of high correlation of predictors and enjoys the advantage of faster computation and higher accuracy compared with the desparsified LASSO. Theoretical results show that the GCDL estimator achieves asymptotic normality. The asymptotic property of the uniform convergence is established, with which an explicit expression of the uniform CI can be derived. Extensive numerical results indicate that the GCDL estimator and its (uniform) CI perform well even when predictors are highly correlated. Availability and implementation An R package implementing the proposed method is available at https://github.com/XiaoZhangryy/gcdl. [ABSTRACT FROM AUTHOR]
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- 2024
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