Chi-square Analysis Research Articles

Measuring the Swimming Skills of Adults Attending Swimming Lessons in Australia as a Drowning Prevention Measure.

Swimming and water safety skills are essential for reducing drowning. Swimming and water safety programs primarily focus on children, despite adults accounting for over 80% of fatal drowning in Australia. This study aims to identify types of adult swimming programs in Australia, who attends these programs, and measure their swimming skill achievement against national benchmarks. A retrospective cross-sectional study of adults attending swimming programs between 2018 and 2021 was conducted. Participant assessment records were analysed against the [Australian] National Swimming and Water Safety Framework and national benchmarks to be achieved by 6 and 12 years old. Descriptive statistics and Chi-square analysis were undertaken. Of 4914 adults attending swimming lessons, 44% were female, median age was 38 years, and 40% were from high socioeconomic areas. On average, adults attended nine lessons, averaging 4.5 h in the water. At their final assessment, 69% could swim at least 5 m (6-year-old benchmark), and 8% could swim 50 m continuously (12-year-old benchmark). Adults of all ages are learning to swim; however, only 8% are achieving the 12-year-old benchmark of swimming 50 m. An equity issue exists, with adults from lower socioeconomic areas and men less likely to be attending swimming programs. Developing and maintaining water safety skills throughout the lifespan is vital for reducing drowning risk among adults. SO WHAT?: Adults are spending time, money and effort learning to swim, however, more is needed to ensure that participants stay in lessons long enough to develop the necessary skills needed to be safe in the water.

Insecticide-treated bed nets (ITN) ownership and utilization patterns among caregivers with children under five years: A community-based cross-sectional study in Battor, North Tongu District, Ghana

Insecticide-treated nets (ITNs) are essential for malaria prevention, significantly reducing the incidence of malaria, particularly among children under five. However, the utilization of ITNs varies widely due to several factors. This study aimed to assess ITN ownership and utilization patterns among caregivers of children under five years old. A cross-sectional design was employed, utilizing a multi-stage sampling to collect quantitative data from 211 caregivers. Data analysis was performed using descriptive and inferential statistics via Stata 17. Of the total respondents (211), 77 (36.5%) own ITNs, while 134 (63.5%) do not own ITNs. Chi-square analysis revealed significant associations between ITN knowledge and factors such as sex (p = 0.025), educational level (p = 0.043), marital status (p < 0.001), religion (p = 0.020), challenges faced in using ITNs (p = 0.012), affordability (p = 0.001), and cultural beliefs (p = 0.003). Binary regression analysis indicated that caregivers facing challenges in using ITNs were 50% less likely to utilize them compared to those without such challenges (aOR = 0.50, 95% CI = 0.26–0.96, p = 0.040). Additionally, caregivers who found ITNs inconvenient or hot were 30% less likely to use them compared to those who viewed them as costly (aOR = 0.70, 95% CI = 0.43–1.33). To enhance ITN utilization, the Ghana Health Service should tailor interventions to address practical barriers and improve educational outreach, bridging the gap between knowledge and usage.

The promises and perils of a free rural inter-city transportation scheme: A mixed-methods study from Northern Saskatchewan

Abstract Objective Transportation is a critical health determinant, yet the last decade has witnessed rapid disinvestment across Canada (particularly in rural contexts) with negative health consequences. We sought to explore and describe the benefits and challenges faced in operating the first community-driven free-transportation scheme in Saskatchewan that emerged in response to widespread unavailability of public transportation due to budget cuts (austerity). Methods We conducted a mixed-methods community-based participatory research study involving 22 interviews with bus riders and service administrators. We also performed descriptive statistics and chi-squared analyses on bus rider data (data on 1185 trips routinely collected between July 2023 and December 2023) to explore sociodemographic characteristics and trip purposes of bus riders. Results All trips were completed by 616 community members using the free bus service between July 2023 and December 2023. Community members took an average of 5 trips (median = 2.0) with a maximum of 22 trips being taken by one community member (1.9% of all trips). Most trips were by women (53%), and older adults mostly used the free bus for medical purposes (22% of riders were older adults and 34% of these used the bus for medical reasons). Qualitatively, the bus service has increased access to care and promotes social participation and autonomy, especially for older adults. The service however faces some challenges, including funding disruptions and difficulty recruiting and retaining drivers. Conclusion Free inter-community transportation (i.e. transportation across cities and municipalities) promotes health equity and access. In contexts without access to public transportation, governments could support community-driven initiatives through increased funding.

Food choice motivations and perceptions of healthy eating: a cross-sectional study among consumers in the UAE.

Investigating consumer food choice motivations is crucial for planning effective policies and targeted interventions. This study aimed to examine the food choice motivations and perceptions of healthy eating among adults in the United Arab Emirates (UAE) and to segment consumers based on their motivations. A web-based, cross-sectional study was conducted among adults in the UAE (n = 1209). An overall perception of healthy eating score was calculated based on the sum of the responses to the perception statements. Food motivation scores were calculated with a higher score indicating more influence of the food motivation group. Hierarchical Cluster Analysis (HCA) and K-means cluster analysis were used to identify and determine the optimal number of clusters. Differences between clusters were evaluated using an Independent sample t-test, One-Way ANOVA test, and Chi-square analysis. Participants mostly agreed that a healthy diet should be balanced, varied, and complete (84.4%), that fruit and vegetables are essential to a practice of healthy eating (82.8%), and that they can eat everything as long as it is in small quantities (60.1%). Females, younger adults, those with higher education levels, and those with normal BMI tended to have a slightly more positive perception of a healthy diet than their counterparts (p < 0.05). Health motivation (mean = 3.43, SD ± 0.78) exhibited the highest influence on the participants' food choices, followed by emotional motivations (mean = 3.26, SD ± 0.68). Health-related motivations mainly influenced food choices among participants in both identified clusters but were notably more emphasised in Cluster 1. Cluster 1 demonstrated significantly higher mean scores in all other categories than Cluster 2 (p < 0.001). Cluster 1 encompasses more female participants than males, while Cluster 2 comprises a more significant proportion of males and individuals falling within higher income brackets (p < 0.001). The results of the current study offer valuable insights into various crucial aspects that impact the decisions of individuals' food choices. Based on distinct motivational structures identified through cluster analysis, personalised approaches can encourage healthier dietary practices. A holistic approach acknowledging emotional, economic, environmental, alongside health-related factors is vital.

Gender and ethnoracial disparities in Veterans’ trauma exposure prevalence across differing life phases

BackgroundVeterans show increased vulnerability to trauma exposure. Yet, there is limited research examining Veterans’ prevalence of experiencing different trauma exposure types by race, gender, and ethnicity and across unique phases of life (i.e., pre-military service, during service, and post-service). This study compares trauma exposure prevalence across women and men Veterans of differing ethnoracial identities (i.e., white, Black, Hispanic) within three life phases (i.e., pre-military service, during military service, post-military service).MethodsThis study examined survey data from 3,544 Veterans (1,781 women; 1,686 men) across six discrete data collection points (between August 2018 to March 2022). Surveys were mailed nationally and oversampled for women (51.6%) and Veterans living in high crime areas (67.6%). Veterans reported on their exposure to various trauma types (e.g., sexual assault, physical assault, community violence, captivity, serious accident, witnessing violent death) at each wave of data collection using items from a modified Life Events Checklist. Veterans also reported on demographic information (e.g., gender, race, ethnicity). Chi-square analyses were conducted to compare prevalence of reported exposure to each trauma type within each life phase across gender and ethnoracial groups.ResultsThere were significant differences in trauma exposure prevalence across: (1) men vs. women Veterans; (2) white vs. Black vs. Hispanic Veterans; (3) Black vs. Hispanic vs. white women Veterans; and (4) Black vs. Hispanic, vs. white men Veterans. For example, in this study, Black men Veterans reported higher prevalence of intimate partner physical assault exposure pre-service (14.8%) and post-service (27.1%) than White men Veterans (9.0% and 13.8%; prevalence ratios = 1.64, 95% CI = 1.17, 2.32 and 1.96, 95% CI = 1.53, 2.51). White women Veterans were less likely to witness a violent death pre-service (11.5%) than Black (21.1%; prevalence ratio = 1.83, 95% CI = 1.42, 2.37) or Hispanic (18.1%) women Veterans.ConclusionsFindings help uncover disparities within Veteran subgroups. They inform mental health treatment and prevention services to better meet the needs of all Veterans across differing life phases.

Experiences of Lesbian, Gay, Bisexual, Transgender, and Queer Cardiology Physicians and Fellows in Training.

The number of practicing lesbian, gay, bisexual, transgender, and queer (LGBTQ+) cardiologists is unknown despite diversity initiatives focused on understanding workforce demographics. The aim of this study was to evaluate the prevalence, sources of mistreatment, and measures of wellness among the LGBTQ+cardiology community. An online survey was sent to the American College of Cardiology Fellow in Training and Early Career Professional Listservs and shared on social media sites. The survey included the Short-Negative Acts Questionnaire and LGBTQ+-specific harassment questions. Chi-square analysis and Fisher exact tests were performed to compare responses between LGBTQ+ and non-LGBTQ+respondents. A total of 188 respondents completed the survey (56% Fellow in Training). One-third (33%) identified as LGBTQ+. Gender identity data included: transgender (3%), nonbinary (2%), gender queer (1%), and agender (1%). LGBTQ+physicians were less likely to agree with the statements 'LGBTQ+patients were treated fairly' (40% vs 66%, P<0.001), and 'leadership dealt with people demonstrating poor behavior fairly' (34% vs 51%, P=0.029) compared to heterosexual peers. LGBTQ+physicians were more likely to report gender policing and heterosexist harassment compared to heterosexual peers (P=0.002). The majority of physicians (91%) were satisfied with their decision to become a cardiologist. This current analysis of LGBTQ+cardiologists in the workplace identifies opportunities to address mistreatment impacting the LGBTQ+community. Despite experiencing mistreatment, LGBTQ+cardiologists report high job satisfaction. Further work is necessary to create a safe space and diverse cohort of physicians required to meet the needs of LGBTQ+patients at risk for cardiovascular disease.

Muscle Activation–Deformation Correlation in Dynamic Arm Movements

Understanding the relationship between muscle activation and deformation is essential for analyzing arm movement dynamics in both daily activities and clinical settings. Accurate characterization of this relationship impacts rehabilitation strategies, prosthetic development, and athletic training by providing deeper insights into muscle functions. However, direct analysis of raw neuromuscular and biomechanical signals remains limited due to their complex interplay. Traditional research implicitly applied this relationship without exploring the intricacies of the muscle behavior. In contrast, in this study, we explored the relationship between neuromuscular and biomechanical signals via a motion classification task based on a proposed deep learning approach, which was designed to classify arm motions separately using muscle activation patterns from surface electromyography (sEMG) and muscle thickness deformation measured by A-mode ultrasound. The classification results were directly compared through the chi-square analysis. In our experiment, six participants performed a specified arm lifting motion, creating a general motion dataset for the study. Our findings investigated the correlation between muscle activation and deformation patterns, offering special insights into muscle contraction dynamics, and potentially enhancing applications in rehabilitation and prosthetics in the future.

Provider perspectives on caring for patients with limited English proficiency-a national survey of the Society of Gynecologic Oncology.

In diversity, equity and inclusion research, overcoming barriers in language discordant patient care is one of the largest and most challenging gaps. It is well established that patients with limited English proficiency (LEP) have higher rates of misdiagnosis, medical errors, and serious adverse events, and recommended best practices for LEP patient care are often not followed. Our team sought to elicit provider perspectives regarding the barriers they face in caring for LEP patients-especially the unique challenges faced when caring for patients with complex and sensitive diagnoses such as gynecologic cancer. A national survey was conducted through the Society of Gynecologic Oncology survey database during November and December of 2023. The survey included questions regarding the landscape of LEP patient care in varied geographic settings and practice types. It queried providers regarding available support and resources, as well as tools practitioners would recommend to improve care for LEP patients with gynecologic cancer. The results were assessed using descriptive statistics and Likert Scales and analyzed using t-tests, Fisher's Exact test, Chi-square analysis and ANOVA. 188 respondents completed the survey. Spanish was the most spoken non-English language in providers' patient populations; however, 39 different languages were reported as commonly spoken. Providers reported increases in stress and a lack of time in caring for LEP patients. When asked what interventions providers would recommend to improve LEP patient care, providers asked for more in-person interpreters (40%), more written patient instructions in needed languages (32%), and more time (17%). Understanding barriers to best practices in LEP patient care is vital to planning future interventions. While this survey was limited by the small percentage of respondents, it provides foundational information for future interventions intended to relieve over-burdened practitioners and systems and achieve the ultimate goal of improved outcomes for LEP patients.

Stage IIIA Non-Small Cell Lung Cancer Treatment and Outcomes: A Single Institution Retrospective Analysis.

Stage III non-small cell lung cancer (NSCLC) treatment remains challenging, with a multitude of treatment options available. We assessed Stage IIIA NSCLC outcomes by treatment received. We performed a single-institution retrospective review of NSCLC patients with Stage IIIA disease treated January 01, 2010-March 01, 2022. Demographics, treatments, outcomes, and failure patterns were collected. Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan-Meier analysis. Failure patterns were assessed for differences using chi-square analysis. Of 270 Stage III NSCLC patients, 134 had Stage IIIA disease with a median follow-up of 29.9 months and a median age of 66 years (IQR 60-75). 66 (49.3%) patients were male, and 105 (78.4%) were current/former smokers (with 30 median pack-years). Patients were treated with definitive radiation with/without chemotherapy (CRT; n = 77, 57.5%), surgery with neoadjuvant chemotherapy and/or radiation (Neoadj; n = 42, 31.3%), and surgery without neoadjuvant therapy (Surg; n = 15, 11.2%). Median PFS was 25.4 months (95% CI 12.5-42.6) for CRT, 22.6 months (95% CI 12.2-44.4) for Neoadj, and 22.8 months (95% CI 5.2-NA) for Surg with no significant intergroup difference (p = 0.99). Median OS was 57.0 months (95% CI 37.4-77.5) for CRT, 51.5 months (95% CI 36.7-65.5) for Neoadj, and 35.3 months (95% CI 16.8-NR) for Surg with no significant intergroup difference (p = 0.99). In this single institution retrospective study, we find no significant differences in PFS, OS, and failure patterns between patients with Stage IIIA NSCLC treated with definitive (chemo)radiation and surgery with or without neoadjuvant therapy. Further work in the immunotherapy era is needed.

Examining the Prevalence and Associated Factors of Sexually Transmitted Infections in People Living With HIV/AIDS at a Community Health Center in Bandung City, Indonesia.

This study aims to investigate the prevalence of sexually transmitted infections (STIs) and associated factors among people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (PLWHA) registered in a community health center (CHC) with HIV/AIDS support and treatment services in Indonesia. A cross-sectional study that included all PLWHA data from medical records registered in a CHC with HIV/AIDS support and treatment services was conducted in Bandung City, Indonesia, between March 2019 and March 2024. This CHC provides comprehensive and continuous HIV/AIDS services, including HIV testing, antiretroviral therapy (ART), and opportunistic infection management. The factors associated with the prevalence of STIs in PLWHA, including sociodemographic factors such as gender, age, education level, marital status, occupation, population group, referral origin, and clinical factors such as length of illness, duration of ART, clinical stage, and comorbidities, were analyzed by using chi-square analysis. Total 156 PLWHA data with STIs from medical records were collected (male, n = 152, 97.4%; female, n = 4, 2.6%). The prevalence of STIs among PLWHA was 32.1%, consisting of syphilis (n = 36; 72%), gonorrhea (n = 11; 22%), genital herpes (n = 2; 4%), and condyloma (n = 1; 2%). The following significant factors associated with the prevalence of STIs were population group men who have sex with men (MSM) (p = 0.046), referral origin from non-government organizations (NGOs) (p = 0.030), duration of disease (p = 0.023) and duration of ART ranging from 12 to 36 months (p = 0.023), and early clinical stage (p = 0.010). STIs affected over one-third of CHC-registered PLWHA, with syphilis being the most common. MSMs and patients referred by NGOs, with illness and treatment durations ranging from 12 to 36 months, as well as the early clinical stage of HIV, are associated with STIs among PLWHA. Intervention strategies to improve STI prevention and control in these populations are urgently needed.

Twenty-four-hour pattern of children with febrile seizures presenting to a United States Pediatric Emergency Department.

Febrile seizure (FS) is the most common convulsive disorder in children. Understanding its time-of-day pattern can provide insight into mechanisms and prevention. We explored clock-time variation of FS presentations of children to a US pediatric emergency department (PED) in comparison to two control cohorts: one (n = 5719) like-aged children presenting solely with fever, i.e., temperature > 100.4 °F/38°C, and one of children (n = 103,806) presenting for any medical emergency. Electronic medical records covering a 58-month span were searched for clock time of arrivals to the PED, with data assessed either by chi-square or Cosinor analyses to test for temporal variation and derive descriptive parameters. Presentation of the 84 FS cases exhibited a time-of-day difference (p = .038), being 5-fold higher between 16:00-19:59 h than 08:00-11:59 h. Presentations of both control groups additionally exhibited such difference, with peak numbers between 16:00 and 19:59 h. Fever intensity of cases tended to be greater by 0.58 °F (p > .10) in those attending the PED between 16:00-23:59 h than 00:00-07:59 h. The control group of children solely with fever showed (p < .0001) time-of-day variation in body temperature, with the difference between presentations of highest and lowest temperature, respectively at ∼21:40 and ∼09:40 h, of 0.4 °F. This is the first study to report time-of-day variation in FS of American children, which is like that reported in children of other countries. The peak number of presentations for FS corresponds in time both with that for fever without seizure and that for any medical emergency, and, additionally, fever intensity of fever controls.

Knowledge of Ghana’s liberal abortion law and use of modern contraceptives among women of reproductive age

BackgroundModern contraceptives have been widely promoted as an effective tool for birth control. They are highly effective for preventing unintended pregnancies thereby reducing the risk of abortions, maternal morbidities, and mortalities. Abortion or planned abstinence from sexual intercourse may be perceived as alternatives to the use of modern contraceptives. The aim of this study was to assess whether knowledge of the legal status of abortion, and knowledge of the monthly fertile period, were associated with the use of modern contraceptives among women of reproductive age in Ghana.MethodsWe used nationally representative secondary data from the 2017 Ghana Maternal Health Survey. A weighted sample of 23,466 non-pregnant women aged 15–49 years were included in the study. Pearson chi-square and multivariable logistic regression analysis were conducted to assess the association between the independent and the outcomes variables. Sampling weight, cluster, and strata were applied at all levels of the analysis.ResultsMore than half (55.4%) lived in urban area, 80.1% were 20 years or older, 52.2% were multiparous women, 61.9% had secondary or higher education, and 34.5% were in the lower two wealth quintiles. We found no statistically significant association between knowledge of the legal status of abortion and use of modern contraceptives, or between knowledge of the monthly fertile period and use of modern contraceptives. Women with history of an induced abortion were 1.57 times as likely to use modern contraceptives compared to those with no history [adjusted odds ratio (aOR) 1.57, 95% CI 1.41–1.75]. Each additional increase in knowledge of a different modern contraceptive method was associated with 1.25 times increase in modern contraceptive use (aOR 1.25, 95% CI 1.22–1.29).ConclusionsIntensifying education on modern contraceptive methods and use, especially at abortion facilities, may help improve the uptake of modern contraceptives among women in Ghana.

Cut-Off Values Able to Identify Migraine Patients With Increased Pressure-Pain Sensitivity Independent of the Migraine Cycle Through a Single Assessment: A Secondary Analysis of a Multicentre, Cross-Sectional, Observational Study.

Identify values that could predict the presence of increased pressure-pain sensitivity independent of the migraine cycle through a single assessment. This was a secondary analysis of a previous study in which 198 episodic and chronic migraine patients were assessed during all phases of the migraine cycle. Pressure pain threshold (PPT) was assessed over the temporalis, cervical spine, hand, and leg. Migraine patients were divided into two sub-groups: patients with increased pressure-pain sensitivity (IPS) and with No IPS (No-IPS). A Chi-squared Automatic Interaction Detection decision tree analysis was used to identify predictors to be included in the IPS or NoIPS group. To assess the internal validity of the model, a tenfold cross-validation was applied. 161 (81%) patients were included in the IPS group, while 37 (19%) in the NoIPS group. Migraine patients with: (1) Temporalis PPT ≤ 130 kPa; (2) Temporalis PPT > 130 kPa and ≤ 197.5 kPa and hand PPT ≤ 347.33 kPa; (3) Temporalis PPT > 197.5 kPa and hand PPT ≤ 315 kPa; were correctly included in the IPS group with a sensitivity of 96%, a specificity of 81%, a positive predictive value of 96%, and a negative predictive value of 81%. The accuracy of the model and the cross-validation analysis were respectively 93% and 92%. The high internal validity suggests that our model could precisely predict the presence of IPS independently by the phase in which the assessment occurred. Trigeminal and hand PPT cut-off values could be used to identify patients with IPS.

A single institution retrospective study evaluating mitomycin dosing during chemoradiation in anal squamous cell carcinoma.

7 Background: Mitomycin (MMC) is used concurrently during chemoradiation (CRT) treatment for non-metastatic anal squamous cell carcinoma (SCCA). The most effective dosing of MMC is not established, and due to concerns for tolerability, many have adopted a dose-reduction strategy. This study evaluates differences in treatment response and recurrence between MMC dosing in this setting. Methods: Demographics, age, smoking history, staging, and treatment history were collected for patients with non-metastatic SCCA treated with CRT from January 2011-September 2024 at a tertiary cancer center. Chi-square analyses compared categorical variables, and ANOVA tests were used to compare treatment response and recurrence between 3 MMC doses (12mg/m 2 x 1 dose with cap of 20mg, 10mg/m 2 x 2 doses, 10mg/m 2 x 1 dose). Results: There were 124 patients, 6 of whom were excluded due to lack of follow up. Of the 118 included, 70% were female, 16% Black, 3% Hispanic/Latino, and 58% current/former smokers. Median age was 61 years (31-98). Thirty-three (28%) pts were treated with MMC 12mg/m 2 , 71 (60%) with 10mg/m 2 x2 doses, and 14 (12%) with 10mg/m 2 x1 dose. Stage I included 18% of 12mg/m2, 7% of 10mg/m 2 x2 doses, and 7% of 10mg/m 2 x1 dose; stage II included 18% of 12mg/m2, 37% of 10mg/m 2 x2 doses, and 50% of 10mg/m 2 x1 dose; stage III included 64% of 12mg/m2, 56% of 10mg/m 2 x2 doses, and 43% of 10mg/m 2 x1 dose. A total of 39.7% were treated with MMC/capecitabine and 60.3% with MMC/fluorouracil. Complete response was achieved in 91% receiving the 12mg/m 2 , 75% receiving 10mg/m 2 x2 dose, and 71% receiving 10mg/m 2 x1 dose (p=0.13, Table 1). Using logistic regression with MMC dose, stage, age, and smoking status as independent predictors, the odds of achieving complete response were lower in 10mg/m 2 x2 doses (p=0.03) and 10mg/m 2 x1 dose (p=0.03) compared to 12mg/m 2 . Local, regional, or metastatic recurrence occurred in 15% of pts receiving 12mg/m 2 , 17% of 10mg/m 2 x2 doses, and 7% of 10mg/m 2 x1 dose. No significant difference was seen in local (p=0.52), regional (p=0.93), metastatic (p=0.87), or overall recurrence (p=0.65) between the MMC doses. Conclusions: Odds of achieving complete response was greater with 12mg/m 2 dosing. Local, regional, and metastatic recurrence were similar among the different MMC dosing cohorts. Differences in tolerance and side effects should be delineated to guide individualized dosing of MMC.

RELATIONSHIP BETWEEN STRESS AND TEMPOROMANDIBULAR JOINT DISORDERS IN MEDICAL AND DENTISTRY STUDENT OF UNIVERSITAS JENDERAL ACHMAD YANI

Temporomandibular joint disorder is a condition that is often unrecognized by patients. One of the etiologies of temporomandibular joint disorder is stress. Medical and dental students may experience stress associated with symptoms of temporomandibular joint disorders. The aim of this study was to determine the relationship between stress and temporomandibular joint disorders in dental and medical faculty students. The research design is analytic with a cross-sectional method on 196 students of Medicine and Dentistry at The University Jenderal Achmad Yani, class of 2020. Chi-square analysis was utilized to investigate the relationship between temporomandibular joint disorders and stress. The results indicate a significant association between symptoms of temporomandibular joint disorders and stress (p = 0.002). Stress is one of the etiological factors in the occurrence of temporomandibularjoint disorders.

Laryngeal Squamous Cell Carcinoma Incidence and Survival Trends in the United States: A Population-Based Analysis of Two Decades.

Laryngeal cancer has undergone a complex evolution in incidence, management, and standards of care over the past 20 years. Disease-wide demographic and survival risk factors have yet to be elucidated. Examine incidence, management, and survival trends in laryngeal cancer from 2000 to 2019. The Surveillance, Epidemiology, and End Results database was utilized to identify age-adjusted incidence rates (AAIRs) of laryngeal squamous cell carcinoma (LSCCa) from 2000 to 2019. Joinpoint regression was conducted to identify annual percentage changes (APCs). Chi-squared analysis was used to find changes in demographic, clinicopathologic, and treatment changes over the study period. Finally, univariate Kaplan-Meier and COX multivariate regressions were conducted to identify survival differences. There were 46 266 cases of LSCCa identified between 2000 and 2019 with AAIR of 2.7 per 100 000 person-years with APC of -2.6% [95% CI: -2.8% to 2.4%]. These rates have largely been down-trending among demographic substratifications. Age at initial diagnosis has been increasing (64.6 → 66.0, p < 0.001). Higher median household income was associated with lower AAIR (35 000 5.3; > $75 000 2.2) and increased annual percentage decrease (< $35 000, -1.1%*; > $75 000, -3.2%*). There were no other clinically significant differences in demographic and clinicopathologic trends although persistent demographic differences were noted. Late T-stage at diagnosis has increased over the study period (T3, 18% → 23%, p < 0.001). Treatment with primary chemoradiotherapy has increased significantly (20.0% → 27.0%, p < 0.001). On univariate analysis, there were no significant differences in survival; however, on multivariate analysis, there has been a progressive improvement in disease-specific and overall survival over 5-year bins. Late-stage disease had a progressive improvement in survival with each treatment period on both univariate and multivariate analysis. There has been a progressively significant decrease in age-adjusted incidence of LSCCa with increased utilization of primary chemoradiotherapy. When adjusted for associated characteristics, there has been a continuing improvement in survival over the study period, primarily in late-stage disease.

Exploring the Link Between Maternal Oral Health Literacy and Child Oral Health Behaviours.

Caregiver's oral health literacy (OHL) has a multidimensional impact on child oral health outcomes. In infants and toddlers, oral health behaviours (OHB) play a crucial role in the development of early childhood caries and could be related to the caregiver's OHL. A simple OHL assessment may help identify children at risk of caries. This study aimed to investigate the association between maternal OHL and the child OHBs during the first 2 years of life. A cross-sectional study was conducted with 398 mothers of children aged 6 to 24 months. Maternal OHL was assessed using the ThREALD-30. Maternal demographics, oral health knowledge, and child OHBs were collected through self-administered questionnaires. ThREALD-30 scores were compared using the Mann-Whitney U and Kruskal-Wallis tests. Spearman's rank correlation and gamma generalized linear models were used to identify factors associated with OHL. Binary logistic regression examined the association between maternal OHL and child OHBs. The Receiver Operating Characteristics curve determined a cut-off OHL score for severely deleterious child OHBs, and Chi-square analyses assessed the association with the cut-off. The mean maternal ThREALD-30 was 23.7 (SD = 5.0), showing a strong positive correlation with oral health knowledge (r = 0.81, P < .001) and associations with low education and family income (P < .001). Logistic regression showed that lower ThREALD-30 levels were associated with poor child OHBs, including nighttime feeding, sugary bottle feeding, and no oral cleaning (P < .05). ThREALD-30 score ≤21 related to severely deleterious child OHBs. Lower maternal OHL was strongly associated with poor child OHBs, with a ThREALD-30 score ≤21 indicating a high risk of caries. ThREALD-30 may be a useful screening tool for assessing mothers with young children at risk of early childhood caries.

The Influence of Relative Age and Biological Maturity on Youth Weightlifting Performance.

Relative age effects and biological maturation are common biases within youth talent identification and development programs; however, their respective influence on youth weightlifting is unknown. Skeletal age, determined from ultrasonography, and competitive total loads (kg) were collected in 49 national age group weightlifters (boys: n = 24, age = 13.8 [2.4]y; girls: n = 25, age = 13.2 [2.4]y). The discrepancy score between skeletal age and chronological age was used to determine maturity timing, and participants' birth dates were classified into birth quartiles to examine relative age effects. Chi-square analysis (χ2) showed that birth quartile distributions across the age groups were not significantly different from national norms; however, maturity biases were evident, with significantly more "early maturers" and significantly fewer "on time maturers" than expected (P < .05). Regression analyses indicated that a large amount of variance in weightlifting performance (ie,absolute combined total) could be explained by skeletal age in both boys (R2 = .73) and girls (R2 = .75). Biological maturation influences selection into weightlifting talent pathways to a greater extent than relative age. Maturation also has a strong influence on weightlifting performance and should be considered to facilitate both the identification and development of weightlifting talent.

Self-Guided Smartphone App (Vimbo) for the Reduction of Symptoms of Depression and Anxiety in South African Adults: Pilot Quantitative Single-Arm Study.

Barriers to mental health assessment and intervention have been well documented within South Africa, in both urban and rural settings. Internationally, evidence has emerged for the effectiveness of technology and, specifically, app-based mental health tools and interventions to help overcome some of these barriers. However, research on digital interventions specific to the South African context and mental health is limited. This pilot study investigated the feasibility of using an app (Vimbo) to treat symptoms of anxiety and depression in South African adults recruited from a community sample. The Vimbo app is a self-guided, cognitive behavioral therapy-based digital intervention for common mental health difficulties developed for the South African context. This pilot study used a naturalistic, single-arm design testing the Vimbo app over 12 weeks, from October 2020 to February 2021. Participants were recruited through the South African Depression and Anxiety Group and social media advertisements online. A 2-week retention period was used to allow for a minimum of 2 datasets. App usage and engagement metrics were extracted directly from the back end of the app. Based on the model, researchers expected many users to discontinue usage when their symptom levels entered a healthy range. Pre-post review of symptom levels was used to reflect on clinical recovery status at discontinuation after the retention period. A total of 218 applicants met study eligibility criteria and were invited to download the Vimbo app. Of these, 52% (114/218) of the participants registered with the app, who indicated multiple variances of depression and anxiety symptoms ranging in severity from mild to severe. Two participants users withdrew from the study. Moreover, 69% (77/112) of users were retained, including 8 who had technical issues with their treatment. When comparing broad uptake across all interested participants, chi-square analysis indicated significantly reduced uptake in participants identifying as "unemployed but seeking employment" (χ24=10.47; N=251; P=.03). When considering app usage for the entire cohort (n=69, excluding participants with technical issues), there was a mean of 72.87 (SD 71.425) total module pages read, a mean of 30% (SD 29.473%) of prescribed content completed, and a mean of 19.93 (SD 27.517) times engaging with tools and skills. Our findings support the case for continued exploration of app-based interventions for treating depression and anxiety in South Africa. Developing strategies to increase access and improve intervention uptake may prove essential to helping mobile health interventions make as significant an impact as possible. Future research should include a randomized controlled trial with a larger sample to further assess the efficacy of app-based interventions in treating mental health difficulties in South Africa.

Analyzing the Impact of Alcohol on Driving Performance and Road Traffic Accidents: Evidence from Simulations and Limited-Time Data from Bangladesh

This study evaluated the effects of alcohol consumption on driving performance and its contribution to road traffic accidents using simulated experiments and real-world data from 2016 to 2018. The simulated experiments involved 25 drivers, revealing significant impairments in reaction time, vigilance, perception, and control at varying blood alcohol concentration (BAC) levels. Higher BAC levels were associated with increased accident rates, with statistical analysis demonstrating a linear trend between BAC and performance metrics such as average speed (p &lt; 0.05), speed variability (p &lt; 0.01), and lane position deviation (p &lt; 0.01). Real-world data indicated a total of 6,114 accidents in 2016, 5,345 in 2017, and 5,367 in 2018, with a notable decline in serious and fatal accidents by 2018 (fatal accidents decreased from 2,197 in 2016 to 219 in 2018). However, slight accidents rose sharply from 2,662 in 2017 to 4,673 in 2018. Alcohol-related cases peaked at 163 in 2017 before dropping to 125 in 2018. Chi-square analysis found no statistically significant relationship between fatalities and exceeding the legal BAC limit (p = 0.1013 for 2016, p = 0.0981 for 2017, p = 0.1923 for 2018). The study emphasizes the persistent role of alcohol in increasing road safety risks, particularly in accident severity. These findings highlight the importance of stricter enforcement of BAC regulations, public awareness campaigns, and targeted interventions to mitigate high-risk behaviors, such as speeding and poor vehicle control, to enhance road safety outcomes.