Prior National Studies Research Articles

Syncing with Science: The Challenge of Knowledge-based Journalism to Report on Science in Pakistan

ABSTRACT The COVID-19 pandemic has triggered the public interest in science, and thus the need to report on scientific facts and information correctly has increased. While the pandemic has posed challenges to working journalists across the globe, problems for Pakistani journalists continue to grow. The country’s journalists struggle not only to report on the pandemic but also to report on other scientific matters ranging from environmental issues to technological developments. This indicates the timely need for journalists’ expert knowledge to report on science. Nevertheless, science journalism research is in its nascent stage in Pakistan, and there is no prior national study that analyzes science reporting in relation to knowledge-based journalism. Therefore, informed by the conceptual model of knowledge-based journalism, this study contributes a qualitative analysis of challenges that hinder the practice of knowledge-based journalism for science reporting within the context of Pakistan.

Geographic, Socio-Demographic and School Type Variation in Adolescent Wellbeing and Mental Health and Links with Academic Competence in the United Arab Emirates

Interest in adolescents’ wellbeing and mental health is growing worldwide, but little research in this area has been conducted in certain world regions and countries such as the United Arab Emirates (UAE). Geographic, socio-demographic and school type differences in adolescent wellbeing and mental health are commonly observed in the field, and the UAE is a diverse country where these types of differences have been found for other outcomes (notably, academic). Yet, no prior national study has explored these differences in terms of wellbeing and mental health in the nation. We address this gap by investigating differences across emirates, gender, socio-economic status, immigrant status, school sector and school curriculum for overall life satisfaction, positive affect, negative affect, meaning and purpose in life, and internalizing difficulties. We use linear regression to analyse cross-sectional data from the Programme for International Student Assessment (PISA) study from 2015 and 2018. We find substantial geographic, socio-demographic and school type differences in levels (2018) of wellbeing and mental health -which vary across distinct domains- and declines (2015–2018) of wellbeing. Better wellbeing and mental health are observed in the northern emirates and among boys. Better wellbeing and poorer mental health are observed among nationals (compared to expatriates) and in public schools (compared to private schools). Despite presenting the best academic outcomes, British schools present the worst wellbeing and mental health outcomes. However, results show the absence of a trade-off between academic competence and wellbeing and mental health, with evidence of a small positive association with wellbeing.

Higher Admittance to Specialized Palliative Care for Patients with High Education and Income: A Nationwide Register-Based Study.

Background: While associations between socioeconomic position, that is, income and education and admittance to specialized palliative care (SPC) have been investigated previously, no prior national studies have examined admittance to all types of SPC, that is, hospital-based palliative care team/units and hospice. Aim: To investigate whether cancer patients' education and income were associated with admittance to SPC (hospital-based palliative care team/unit, hospice). Design: Data sources were several nationwide registers. The association between SPC and education and income, respectively, was investigated using logistic regression analyses. Setting/Participants: Patients dying from cancer in Denmark 2010-12 (n = 41,741). Results: In the study population, 45% had lower secondary school, and 6% had an academic education. Patients with an academic education were more often admitted to SPC than those having lower secondary school (odds ratio [OR] = 1.69; 95% confidence interval [CI]: 1.51-1.89). Patients in the highest income quartile (Q4) were more often admitted than those in the lowest income quartile (Q1) (OR = 1.46; 95% CI: 1.37-1.56). This association was stronger for hospice (OR = 1.67 (95% CI: 1.54-1.81)) than for admittance to hospital-based palliative care team/unit (OR = 1.23 (95% CI: 1.14-1.31)). Compared with patients who had lower secondary school and the lowest income, the OR of admittance to SPC among the most affluent academics was 1.96 (95% CI: 1.71-2.25). Conclusion: This nationwide study indicates that admittance to SPC was clearly associated with education and income. We believe that the associations indicate inequity. Initiatives to improve access for patients with low education or income should be established.

Psychometric properties of the Organizational Culture and Readiness Scale for System-Wide Integration of Evidence-Based Practice.

Patient safety metrics declined due to COVID-19-related strains placed on hospitals and hospital systems. Because evidence-based practice (EBP) can improve patient outcomes and quality of care and empower clinicians, a renewed focus on organizational EBP culture is needed. The Advancing Research and Clinical practice through close Collaboration (ARCC©) Model describes how to use a system-wide approach to advance and sustain EBP in hospital systems to improve outcomes. EBP culture is a key variable that directly impacts EBP knowledge, beliefs, competency, and implementation. The ARCC© Model uses the Organizational Culture and Readiness Scale for System-Wide Integration of Evidence-Based Practice (OCRSIEP) to identify organizational characteristics that influence clinician and patient outcomes. Although the scale has been reported to have excellent reliability, a comprehensive psychometric analysis has yet to be performed that confirms its construct validity. The aim of this study was to describe the OCRSIEP's construct validity and reliability via an in-depth psychometric analysis. OCRSIEP assessment data were obtained from a prior national study with 2344 nurses from 19 hospitals and healthcare systems. Descriptive statistics summarized the sample and distributions of the 25 scale items. Construct validity was assessed via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Cronbach's alpha assessed reliability. A one-factor model was supported by EFA with item Q17b excluded (i.e., to what extent are decisions generated from upper administration). Model fit indices for CFA indicated a good fit (CFI=0.978, TLI=0.973, RMSEA=0.077, SRMR=0.027). Cronbach's alpha was 0.96 for all items and 0.97 with item Q17b excluded, both indicating outstanding internal consistency. The OCRSIEP is valid and reliable and can be used to assess EBP culture and readiness in hospitals and healthcare systems at the organizational level.

Trends in Receipt of Buprenorphine and Naltrexone for Opioid Use Disorder Among Adolescents and Young Adults, 2001-2014

Opioid use disorder (OUD) frequently begins in adolescence and young adulthood. Intervening early with pharmacotherapy is recommended by major professional organizations. No prior national studies have examined the extent to which adolescents and young adults (collectively termed youth) with OUD receive pharmacotherapy. To identify time trends and disparities in receipt of buprenorphine and naltrexone among youth with OUD in the United States. A retrospective cohort study was conducted using deidentified data from a national commercial insurance database. Enrollment and complete health insurance claims of 9.7 million youth, aged 13 to 25 years were analyzed, identifying individuals who received a diagnosis of OUD between January 1, 2001, and June 30, 2014, with final follow-up date December 31, 2014. Analysis was conducted from April 25 to December 31, 2016. Time trends were identified and multivariable logistic regression was used to determine sociodemographic factors associated with medication receipt. Sex, age, race/ethnicity, neighborhood education and poverty levels, geographic region, census region, and year of diagnosis. Dispensing of a medication (buprenorphine or naltrexone) within 6 months of first receiving an OUD diagnosis. Among 20 822 youth diagnosed with OUD (0.2% of the 9.7 million sample), 13 698 (65.8%) were male and 17 119 (82.2%) were non-Hispanic white. Mean (SD) age was 21.0 (2.5) years at the first observed diagnosis. The diagnosis rate of OUD increased nearly 6-fold from 2001 to 2014 (from 0.26 per 100 000 person-years to 1.51 per 100 000 person-years). Overall, 5580 (26.8%) youth were dispensed a medication within 6 months of diagnosis, with 4976 (89.2%) of medication-treated youth receiving buprenorphine and 604 (10.8%) receiving naltrexone. Medication receipt increased more than 10-fold, from 3.0% in 2002 (when buprenorphine was introduced) to 31.8% in 2009, but declined in subsequent years (27.5% in 2014). In multivariable analyses, younger individuals were less likely to receive medications, with adjusted probability for age 13 to 15 years, 1.4% (95% CI, 0.4%-2.3%); 16 to 17 years, 9.7% (95% CI, 8.4%-11.1%); 18 to 20 years, 22.0% (95% CI, 21.0%-23.0%); and 21 to 25 years, 30.5% (95% CI, 30.0%-31.5%) (P < .001 for difference). Females (7124 [20.3%]) were less likely than males (13 698 [24.4%]) to receive medications (P < .001), as were non-Hispanic black (105 [14.8%]) and Hispanic (1165 [20.0%]) youth compared with non-Hispanic white (17 119 [23.1%]) youth (P < .001). In this first national study of buprenorphine and naltrexone receipt among youth, dispensing increased over time. Nonetheless, only 1 in 4 commercially insured youth with OUD received pharmacotherapy, and disparities based on sex, age, and race/ethnicity were observed.

Comparing facility-level methane emission rate estimates at natural gas gathering and boosting stations

Coordinated dual-tracer, aircraft-based, and direct component-level measurements were made at midstream natural gas gathering and boosting stations in the Fayetteville shale (Arkansas, USA). On-site component-level measurements were combined with engineering estimates to generate comprehensive facility-level methane emission rate estimates (“study on-site estimates (SOE)”) comparable to tracer and aircraft measurements. Combustion slip (unburned fuel entrained in compressor engine exhaust), which was calculated based on 111 recent measurements of representative compressor engines, accounts for an estimated 75% of cumulative SOEs at gathering stations included in comparisons. Measured methane emissions from regenerator vents on glycol dehydrator units were substantially larger than predicted by modelling software; the contribution of dehydrator regenerator vents to the cumulative SOE would increase from 1% to 10% if based on direct measurements. Concurrent measurements at 14 normally-operating facilities show relative agreement between tracer and SOE, but indicate that tracer measurements estimate lower emissions (regression of tracer to SOE = 0.91 (95% CI = 0.83–0.99), R2 = 0.89). Tracer and SOE 95% confidence intervals overlap at 11/14 facilities. Contemporaneous measurements at six facilities suggest that aircraft measurements estimate higher emissions than SOE. Aircraft and study on-site estimate 95% confidence intervals overlap at 3/6 facilities. The average facility level emission rate (FLER) estimated by tracer measurements in this study is 17–73% higher than a prior national study by Marchese et al.

Using Locally Derived Seroprevalence Data on Measles, Mumps, Rubella, and Varicella by Birth Cohort to Determine Risks for Vaccine-Preventable Diseases During International Travel.

Measles, mumps, rubella, and varicella (MMRV) were common childhood diseases in the United States prior to the introduction of their respective vaccines. Measles was declared eliminated in the United States in 2000. However, 628 cases were reported in 2014, the majority of which have been linked to international travel. The study team set out to investigate the seroprevalence of MMRV in our local population to determine whether such a process can lead to meaningful recommendations for assessing travelers at risk. We conducted a cross-sectional seroprevalence study using a quota sampling method. A total of 460 leftover serum samples were collected from individuals born prior to 1996, who live in the Lehigh Valley region of southeast Pennsylvania. The samples were allocated to five birth-year cohorts, and the seroprevalence of each cohort to MMRV was compared. Additionally, overall seroprevalence of each disease was compared with data from prior national studies. Gender differences within each birth cohort were also assessed. The overall seroprevalence values of measles, mumps, rubella, and varicella were 85.8, 82.8, 96.6, and 97.4%, respectively. There were significant associations between seroprevalence and birth cohort for measles (p = 0.01) as well as mumps (p = 0.037). The overall seroprevalence for our study sample was significantly different from the national seroprevalence results of measles, mumps, and rubella. Our study showed dramatically lower immunity rates for measles and mumps than those shown by prior national seroprevalence studies. The rates in many of the later birth cohorts born after 1966 were significantly lower than the rates reported as necessary to sustain herd immunity. Given that patients' immunization records are not always available or complete, collecting local seroprevalence data may be necessary to more accurately recommend antibody testing and vaccination during pre-travel assessments.

Riesgos laborales en trabajadores del sector informal del Cauca, Colombia

Background. A national study already led to establishing informal workers' exposure to risks in Colombia; however, the Cauca department was not included in this. Objective. Describing the occupational hazards of people working in the informal sector in five municipalities in the Cauca department during 2011. Materials and methods. This was a descriptive, cross-sectional study which involved 223 people; they answered questions from a standardised national survey. Results. The survey revealed that more than 20% of the people driving taxis and/or working in the dairy sector were exposed to risks regarding safety and about 1 in 4 of the hawkers, porters and vendors selling food in the street were exposed to environmental hazards. Porters had the highest exposure to health-related and physical load-related risks. Over 50% of porters, street-sellers and people selling minutes for cell phones were at location-specific individual risk (LSIR) and about 1 in 4 of the hawkers and street food-sellers were exposed to risk regarding public order. Conclusions. The risks to which workers were exposed in the informal sector in the municipalities studied in the Cauca department coincided with those found by a prior national study; however, a lack of organisation within groups of workers and a lack of public policy could trigger increased morbidity and mortality rates in this population.

A Longitudinal Study of Clinical Peer Reviewʼs Impact on Quality and Safety in U.S. Hospitals

Clinical peer review is the dominant method of event analysis in U.S. hospitals. It is pivotal to medical staff efforts to improve quality and safety, yet the quality assurance process model that has prevailed for the past 30 years evokes fear and is fundamentally antithetical to a culture of safety. Two prior national studies characterized a quality improvement model that corrects this dysfunction but failed to demonstrate progress toward its adoption despite a high rate of program change between 2007 and 2009. This study's online survey of 470 organizations participating in either of the prior studies further assessed relationships between clinical peer review program factors, including the degree of conformance to the quality improvement model (the QI model score), and subjectively measured program impact variables. Among the 300 hospitals (64%) that responded, the median QI model score was only 60 on a 100-point scale. Scores increased somewhat for the 2007 cohort (mean pair-wise difference of 5.9 [2-10]), but not for the 2009 cohort. The QI model is expanded as the result of the finding that self-reporting of adverse events, near misses, and hazardous conditions--an essential practice in high-reliability organizations--is no longer rare in hospitals. Self-reporting and the quality of case review are additional multivariate predictors of the perceived ongoing impact of clinical peer review on quality and safety, medical staff perceptions of the program, and medical staff engagement in quality and safety initiatives. Hospital leaders and trustees who seek to improve patient outcomes should facilitate the adoption of this best practice model for clinical peer review.

The association of diabetes complications with physical activity in a representative sample of older adults in the United States

OBJECTIVE Most adults with diabetes do not engage in the level of physical activity recommended for optimal disease management. Diabetes complications are not generally considered a clinical contraindication to exercise. No prior national studies have examined the associations of these complications with physical activity. METHODS Data are from the 2003 Diabetes Supplement to the nationally representative US Health and Retirement Study (n = 1811; age >50 years). Multiple logistic regression was used to examine the association between diabetes complications and the odds of meeting physical activity guidelines. RESULTS Forty-three percent of the sample met physical activity guidelines. Adjusting for sociodemographic variables, retinopathy (odds ratios (OR) OR = 0.54, 95% confidence intervals (CI) = 0.36-0.81), nephropathy (OR = 0.70, 95% CI = 0.50-0.99), neuropathy (OR = 0.75, 95% CI = 0.59-0.95), and heart disease (OR = 0.69, 95% CI = 0.51-0.94) were all independently associated with reduced odds of meeting guidelines. A borderline significant association was observed for stroke. DISCUSSION Adults with diabetes with complications of the eyes, kidneys, or nerves and those with heart disease are less likely to meet physical activity guidelines compared to those without these complications. These individuals may require additional support from health professionals to achieve recommended amounts of physical activity. More studies are needed to clarify the barriers and benefits to engaging in physical activity in the presence of diabetes complications.

Mental Health of Victims of Intimate Partner Violence: Results From a National Epidemiologic Survey

An increase in dating violence has heightened public concern over intimate partner violence. Intimate partner violence is defined as any threatened, attempted, or completed physical or sexual violence, and emotional abuse inflicted by a spouse, ex-spouse, current or former boyfriend or girlfriend, dating partner, or date (1). Approximately 30% of all female homicides are committed by a male intimate (2). The World Health Organization estimates that intimate partner violence costs the United States $12.6 billion or 0.1% of the gross domestic product (GDP) annually (3). Intimate partner violence accounts for 20% of nonfatal violent crimes against women and 3% of those against men (4). Accumulating evidence relates intimate partner violence to life threatening and significant adverse physical health consequences. Furthermore, intimate partner violence is associated with depression, posttraumatic stress disorder, and substance abuse (5, 6). The National Comorbidity Survey (NCS) reported that 17.4% and 18.4% of women and men respectively were victims of intimate partner violence during the course of their current marriage or cohabitation (7). Similarly, rates in the National Comorbidity Survey Replication (NCS-R) were 15.2% for females and 20.3% for males (8). Although prior national studies have examined the prevalence and predictive value of psychiatric disorders for intimate partner violence victimization, their cross-sectional design does not permit estimation of the effects of intimate partner violence on risk of incident or new onset psychiatric disorders. By drawing on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) a large, nationally representative sample of US adults, we sought to compare the 12-month incidence of psychiatric disorders in individuals who were victims of intimate partner violence during the past 12 months with those who were not victims, and examine whether increased frequency of exposure to violent acts is associated with an elevated incidence of psychiatric disorders.

An examination of entrepreneurship education in the United States

Purpose – This paper seeks to provide an analytical overview of the current state of entrepreneurship education in the USA for the years 2004‐2005.Design/methodology/approach – The author performed an extensive review of the literature in entrepreneurship education and enhanced the review by conducting a national survey of two and four‐year colleges and universities. This survey was the sixth since 1979 conducted by the author to examine trends and the “current state of entrepreneurship education.”Findings – The 2004‐2005 survey indicates that the trends, especially in the use of technology initially examined in prior national studies of entrepreneurship, have continued in a similar direction and in some areas, for example, the use of technology has increased dramatically. Also, new findings confirm that the traditional teaching method of requiring students to create a business plan is still used and is popular. Finally, the data show that entrepreneurship educators are increasingly using guest speakers a...

Perceptions of People With Tetraplegia Regarding Surgery to Improve Upper-Extremity Function

In the United States, more than 100,000 Americans live with the disability of tetraplegia. These individuals must struggle through long and complicated rehabilitations. Upper-extremity reconstructive surgery can improve use of the upper limb for appropriate candidates; however, a prior national study showed that these procedures rarely are performed. This cross-sectional survey identified the attitudes and beliefs of people with tetraplegia that may dissuade potential candidates from receiving these procedures. An oral survey was designed to determine priorities of reconstruction in individuals with tetraplegia. This survey was administered to 50 people with tetraplegia. Among those surveyed, 13 (26%) had never heard of upper-extremity reconstructive surgery, but 22 (44%) were interested in upper-extremity reconstruction. People with tetraplegia who had a negative first impression of these procedures were far less likely to want reconstruction 0 (0%) vs. 11 (45%). Of patients who learned about these procedures from their physicians, 10 (67%) had a negative first impression after the physician consultation. Although many people with tetraplegia understand the benefits of upper-extremity reconstruction, a large number of them are unaware of or have unfavorable attitudes toward these procedures. These negative attitudes may account for the marked underuse of upper-extremity reconstructive procedures in the United States.

An Analysis of Women’s and Men’s Surgical Priorities and Willingness to Have Rheumatoid Hand Surgery

Our prior national study showed gender differences in the rates of rheumatoid arthritis hand surgery. This project evaluated whether men's versus women's preferences, as opposed to physician biases, contribute to these variations. A self-administered questionnaire was administered to 126 patients with rheumatoid arthritis at our institution; 117 (93%) of these patients completed the questionnaire. Chi-square tests, t tests, the Wilcoxon rank sum test, and multiple logistic regressions were used for the analyses. The results were compared with our national mailed survey of 500 rhematologists and 500 hand surgeons in the United States that evaluated physicians' attitudes toward the indications and outcomes of rheumatoid hand surgery. When we asked physicians who values hand aesthetics more, 378 (73%) chose women compared with less than 2 (1%) who chose men; when asked who values hand function more, 35 (7%) chose women, 83 (16%) chose men, and 396 (77%) thought there was no difference; and when asked who is more willing to have hand surgery, 219 (43%) chose women compared with 6% who chose men. In this patient survey, however, women and men were equally willing to have hand surgery, and they placed equal value in hand appearance, function, and pain. Women, however, appeared more risk adverse and concerned about the potential pain and inconvenience from surgery. Physicians' biases appear to conflict with patient preferences regarding rheumatoid hand surgery. Physicians should understand patients' preferences during the shared decision-making process for surgery.

Reperfusion Times: Are We Improving?

Time is myocardium. National authorities have established benchmarks of 30 minutes for door-to-needle time for fibrinolysis and 90 minutes for door-to-balloon time for angioplasty. A prior national study reported a mean door-to-needle time of 62 minutes in 1990 and 38 minutes in 1999; limited information is available about changes in …