Χ2 Test Of Independence Research Articles

Racial Disparities in Genetic Detection Rates for Inherited Retinal Diseases

The association of race and detection of pathogenic variants using wide-panel genetic testing for inherited retinal diseases (IRD), to our knowledge, has not been studied previously. To investigate the genetic detection rates of wide-panel testing in Black and non-Hispanic White patients with IRDs. This 2-group comparison used retrospective patient data that were collected at the University of Michigan (UM) and Blueprint Genetics (BG). At UM, inclusion criteria included having a clinical IRD diagnosis, wide-panel genetic testing, and both parents and the patient self-identifying as the same race (Black or non-Hispanic White). Logistic regression analysis was used; the dependent variable was genetic test result (positive or negative/inconclusive) and the independent variables were race, age, sex, phenotype, and number of genes tested. In the BG database, patients with wide-panel testing and self-reported race were included; detection rate comparison analysis based on race was performed using χ2 test of independence. These data were analyzed from October 30, 2013, through October 26, 2022. Genetic test result was considered positive if pathogenic/likely pathogenic variants were detected. A total of 572 patients were included in UM, 295 were males (51.6%). Mean age was 45 years. There were 54 Black patients (9.4%) and 518 White patients (90.6%). Black race (odds ratio [OR], 0.25; 95% CI, 0.14-0.46; P < .001) and age (OR per 10 years, 0.84; 95% CI, 0.76-0.92; P < .001) were independently associated with decreased odds of a positive test. In the BG database, 142 of 320 of Black patients (44.4%) had a positive/likely positive test result, a proportion lower than White patients (1691 of 2931 [57.7%]) (χ2 = 18.65; df = 1; P < .001). Results from this study highlight a lower genetic detection rate for Black patients than for White patients with IRDs. This supports a concern that the current development of IRD therapeutics is highly dependent on the ability to identify the genetic cause of disease. Patients with no known genetic diagnosis may be disadvantaged in terms of prognostication, inheritance counseling, reproductive decision-making, and eligibility for potential therapeutic options, including clinical trials. As future treatments become available, these findings suggest the need to examine the genetic detection rates across majority and minority subgroups alike.

Impact of an Adult Congenital Heart Disease Order Set in a Pediatric Cardiac Intensive Care Unit.

Background: Patients with congenital heart disease (CHD) are increasingly surviving to adulthood. Given their age- and condition-specific needs, the optimal postoperative setting for these patients is not yet determined. This study aims to evaluate the utility of an adult-specific order set in improving clinical outcomes for these patients in a pediatric cardiovascular intensive care unit (ICU). Methods: Adults with CHD (ACHD) admitted to the cardiovascular ICU following cardiac surgery at a pediatric tertiary care center were identified for a retrospective cohort study. Health care delivery metrics and clinical outcomes of participants who received the adult-specific order set were compared with control patients admitted prior to the intervention. Categorical outcomes were compared using the χ2 test of independence or Fisher exact test, and continuous outcomes were assessed using the t test. Results: A total of 130 ACHD patients received the intervention, with no significant differences observed in clinical outcomes when compared with 89 controls. While there was additionally no reduction in hospital-related mortality (2.3% vs 7.8%, RR 0.3; P = .1), clinician ordering behaviors were better aligned with best-practices following the intervention. Among patients with moderate or greater anatomic complexity, a post hoc analysis demonstrated reduced in-hospital mortality from those who received the adult order set. Conclusions: The implementation of an adult-specific order set in a pediatric care setting did not improve clinical outcomes for all ACHD patients. Patients with moderate and greater anatomic complexity did see a mortality benefit, suggestive that targeted electronic tools may most benefit those who have the highest risk.

Assessment of Perceived Diversity and Inclusivity of Athletic Training Textbooks

Context Adopting diverse perspectives is increasingly important for athletic trainers (ATs) to provide care that fosters inclusion for all patients. Despite the NATA’s commitment to diversity, NATA membership remains approximately 80% White. Additionally, although ATs work with people from ethnically diverse backgrounds with unique body expression and body-size characteristics, it is unknown whether athletic training textbooks represent this diversity. Objective To investigate diversity characteristics of images including patients and clinicians within athletic training textbooks. Design Cross-sectional study. Patients or Other Participants Twenty percent (n = 15) of athletic training and health care textbooks included on the Board of Certification reference list were selected. Twenty percent of chapters from those textbooks were then randomly selected for inclusion. Main Outcome Measure(s) Descriptive statistics were calculated for person (athlete, nonathlete, clinician), setting (athletic venue, clinic, physician office, other), and demographic categories (perceived skin tone, race/ethnicity, age, gender, body size, body expression). Chi-square tests of goodness of fit were performed to determine significant differences between categories, and χ2 tests of independence were performed to determine differences across person type and category and across textbook domain and category. Results One thousand six hundred sixty-seven people were assessed from 1190 images. Images depicted statistically more persons with light skin tone (86%) assumed to be White (86%), young adults (75%) of average weight (95%), with no body expression diversity (95%). There were no major differences in subject characteristic majorities across person type or textbook domain. Conclusions Like other health care professions, a lack of image diversity was demonstrated within athletic training textbooks. To better recruit diverse students to the athletic training profession, and to prepare professional students to provide culturally competent and patient-centered care, these resources should better represent the diversity of ATs and their patients.

Gender Equity Perceptions Among Social and Administrative Sciences Pharmacy Faculty: An AACP-APhA Task Force Report

ObjectiveThe American Association of Colleges of Pharmacy’s Social and Administrative Sciences Section and the American Pharmacists Association-Academy of Pharmaceutical Research and Science’s Economic, Social and Administrative Sciences Section formed a Gender Equity Task Force to determine if there is evidence to suggest that there is gender disparity in pay; responsibilities; treatment by peers/colleagues, students, and administration; leadership opportunities; and rank, tenure status, and career advancement for Section members; and to develop recommendations to address existing disparities. MethodsA Qualtrics survey was emailed in December 2020 to all American Association of Colleges of Pharmacy’s Social and Administrative Sciences and American Pharmacists Association-Academy of Pharmaceutical Research and Science’s Economic, Social and Administrative Sciences Section members. The questionnaire included items regarding favorability toward men or women in various academic domains (research, teaching, service, recruitment, mentoring, and advancement). Participants were asked if they had experienced gender inequity, and if so, at what type of institution and academic rank. The χ2 tests of independence and post hoc comparisons were used to assess item responses according to gender. ResultsOf the respondents, 72% indicated that they had experienced gender inequity. Women and persons of color were more likely to do so. Women commonly reported that men received more favorable treatment in nearly all academic domains, whereas men reported that women and men were treated equally. ConclusionPharmacy faculty specializing in social and administrative sciences reported experiences of gender inequity and perceptions of gender inequity. Perception gaps existed between male and female faculty in numerous academic domains. Colleges and schools of pharmacy should increase awareness of, and strive to self-assess, gender inequity in their institutions.

Eating disorders and health literacy in Germany: results from two representative samples of adolescents and adults.

Eating disorders are associated with substantial burden for the affected individuals including negative health outcomes and increased mortality. So far, prevention programs for eating disorders have yielded mixed results concerning their efficacy. Therefore, more targeted prevention programs need to be developed. Health literacy has been identified as a potential influencing factor of eating disorders. This study aimed at exploring the relationship between likely cases of eating disorders and health literacy, alongside additional sociodemographic factors. Two large samples of adults (N = 3,011) and adolescents (N = 1,021) representative of the German-speaking population in Germany were recruited. Likely cases of eating disorders were identified using the SCOFF questionnaire. Health literacy was assessed with the HLS-EU-Q16 questionnaire. Sociodemographic information, including age, gender, social status and level of education, and subjective body image were obtained. χ2-tests of independence were calculated to determine the association between the investigated constructs. Suspected eating disorders were more likely in female than male adolescents but were not related to gender in adults. Rates of suspected eating disorders increased with increasing age in adolescents and decreased with increasing age in adults. While levels of education were unrelated to suspected eating disorders, low social status was associated with higher rates of suspected eating disorders in adults but not adolescents. Inadequate or problematic health literacy and negative body image were associated with higher rates of suspected eating disorders compared to adequate health literacy and more positive body image. Likely cases of eating disorders are related to health literacy and body image as well as sociodemographic factors. These constructs should therefore be addressed in future research to improve prevention programs.

Dog and owner demographics impact dietary choices in Dog Aging Project cohort.

To describe the demographic factors of owners and their dogs associated with owner feeding choices and the regularity with which those diets were fed to a US-based population of dogs. This cross-sectional analysis examined 40,367 initial survey responses from US dog owners participating in the Dog Aging Project. The surveys were collected from January 2, 2020, to December 31, 2022, and included primary and secondary diet component types and dog and owner demographic variables. Each demographic variable was compared across diet type choices with a χ2 test of independence. Most owners (82%) fed a commercially prepared extruded dry diet (kibble) as the primary diet component. Most owners (89%) reported that they fed their dogs a consistent diet over time. Owner demographic factors (income, education level) were less correlated with difference in diet choices than dog demographic factors (size, neuter status, purebred status, activity level), but owner age did correlate with choice: younger owners tended to feed kibble more compared to older owners. Home-cooked diets were most often consumed by small (< 30-lb) dogs, purebred dogs in poorer health status, and dogs with owners aged 45 years or older. Raw diets were more commonly fed to purebred, intact, and highly active dogs. Ten percent of service dogs were reportedly fed a raw diet of some sort. Demographic variables are associated with statistically significant differences in diet types selected. Nutrition studies examining health outcomes associated with the feeding of different diet types should account for these factors during design or analysis in order to avoid bias. An epidemiological tool, the directed acyclic graph, is presented. This information will help clinicians in their discussions with clients about pet nutrition.

Postvasectomy Semen Analysis Compliance With Utilization of a Mail-In Semen Analysis Kit.

The AUA recommends postvasectomy semen analysis (PVSA) to verify successful vasectomy. However there remains poor patient compliance. We sought to assess whether mail-in PVSA improves patient compliance across a wide range of practice types. Prospective data were collected on all men who received a Fellow PVSA kit between April 2021 and August 2023 in a nationwide cohort. Date of kit activation, practice type, clinic zip code, and date of kit accession/processing at the lab was collected. Compliance rates for each practice area were reported. χ2 tests of independence, logistic regression models, and multivariable logistic analysis were performed to assess the impact of relevant variables. Overall compliance across all practice areas was 69% following an 18-week period of observation (n = 16,105) and 82% (n = 6687) following a 40-week period. Compliance rates were highest and similar for small urology practices (<5 providers), including Veterans Affairs practices, ranging from 76% to 82% at 18 weeks to 85% to 87% at 40 weeks. Large urology practices had slightly lower compliance rates with 66% at 18 weeks to 80% at 40 weeks. The univariable logistic regression model demonstrated that patients in small urology practices have a 63% greater odds of 26-week compliance, on average, compared to those who receive care in large urology practices (odds ratio 1.63, 95% CI 1.48-1.79). Fellow's mail-in PVSA offers improved PVSA compliance over previously published data. Improved compliance is seen across all practice types. Despite these successes, there is significant room for improvement to achieve 100% compliance.

Prevalence of Histopathologic Types of Gingival Lesions in the Iranian Population: A 22-Year Retrospective Study.

Gingiva is one of the supporting tissues around the teeth that can be affected by various neoplastic or nonneoplastic lesions. Previous studies have examined several types of gingival lesions, but the lack of a standardized classification system has hindered meaningful comparisons. Additionally, many studies focused primarily on reactive lesions. Our study aims to contribute to the understanding of gingival lesions by investigating their prevalence across age groups, genders, sites, and by their clinical presentation. This research could lead to improved diagnostic accuracy and treatment strategies. This retrospective study explores the prevalence of gingival lesions based on biopsies during a 22-year span. The patient's demographic details, including age, gender, and lesion's clinical presentation were systematically collected. These lesions were categorized into six groups. Descriptive statistics, χ2 test of independence, and one-way ANOVA were used for data analysis. Among the 7668 biopsied lesions, 684 (8.9%) lesions were located in the gingiva, with a greater occurrence in women (63.5%). Soft tissue tumors represented the most prevalent group in the gingival lesions (72.1%), and peripheral giant cell granuloma (PGCG) was the most frequent lesion (21.2%), followed by, pyogenic granuloma (19.3%), peripheral ossifying fibroma (17.8%) and focal fibrous hyperplasia (7.6%); all of which predominantly affected women, with mean ages falling in the fourth decade of life. Squamous cell carcinoma was recognized as the most common malignancy. In this study, PGCG was found to be the most common lesion in the gingiva in Iranian population. Further analysis using a unanimous categorization is required to confirm these results.

Efficacy of the QuitSure App for Smoking Cessation in Adult Smokers: Cross-Sectional Web Survey.

Cigarette smoking remains one of the leading causes of preventable death worldwide. A worldwide study by the World Health Organization concluded that more than 8 million people die every year from smoking, tobacco consumption, and secondhand smoke. The most effective tobacco cessation programs require personalized human intervention combined with costly pharmaceutical supplementation, making them unaffordable or inaccessible to most tobacco users. Thus, digital interventions offer a promising alternative to these traditional methods. However, the leading smartphone apps available in the market today have either not been studied in a clinical setting or are unable to match the smoking cessation success rates of their expensive offline counterparts. We would like to understand whether QuitSure, a novel smoking cessation app built by Rapidkart Online Private Limited, is able to bridge this efficacy gap and deliver affordable and effective smoking cessation at scale. Our objective was to do an initial exploration into the engagement, efficacy, and safety of QuitSure based on the self-reported experiences of its users. Outcomes measured were program completion, the effect of program completion on smoking behavior, including self-reported cessation outcomes, and negative health events from using the app. All QuitSure registered users who created their accounts on the QuitSure app between April 1, 2021, and February 28, 2022, were sent an anonymized web-based survey. The survey results were added to their engagement data on the app to evaluate the feasibility and efficacy of the app as a smoking cessation intervention. The data were analyzed using descriptive statistics (frequencies and percentages) and the χ2 test of independence. In total, 1299 users who had completed the QuitSure program submitted the survey and satisfied the inclusion criteria of the study. Of these, 1286 participants had completed the program more than 30 days before filling out the survey, and 1040 (80.1%, 95% CI 79.1%-82.6%) of them had maintained prolonged abstinence for at least 30 days after program completion. A majority of participants (770/891, 86.4%) who were still maintaining abstinence at the time of submitting the survey did not experience any severe nicotine withdrawal symptoms, while 41.9% (373/891) experienced no mild withdrawal symptoms either. Smoking quantity prior to completing the program significantly affected quit rates (P<.001), with heavy smokers (>20 cigarettes per day) having a lower 30-day prolonged abstinence rate (relative risk=0.91; 95% CI 90.0%-96.2%) compared to lighter smokers. No additional adverse events outside of known nicotine withdrawal symptoms were reported. The nature of web-based surveys and cohort selection allows for extensive unknown biases. However, the efficacy rates of survey respondents who completed the program were high and provide a case for further investigation in the form of randomized controlled trials on the QuitSure tobacco cessation program.

Towards Socially Responsible Consumption: Assessing the Role of Prayer in Consumption

The issue of socially responsible consumer behavior has been of great interest to researchers for years. It seems important to acquire knowledge about consumer behavior, especially among young people, who are a special group of consumers. In recent years, it is not only the purchasing power of young people that has been growing, but also the range of market choices they make. In this context, it is important to identify the determinants of consumer behavior to predict the directions of changes in the behavior of young people as consumers. One of the interesting research areas is determining the role of prayer, or more broadly, human spiritual development, in shaping consumer behavior. Some research suggests that there is a relationship between religion, or more precisely, religious practices and consumption. This work presents the most important definitions of a socially responsible consumer, presenting the most important aspects of this attitude. This work also presents previous research on the relationship between religiosity, prayer and consumer behavior. This research on the SRC attitude among young people was conducted using an online survey. The collected data were tested using the χ2 test of independence. Owing to the obtained results, it was possible to indicate the aspects of SRC in which the attitude to prayer is important.

Maxillofacial Microvascular Free-Flap Reconstructions in Pediatric and Young Adult Patients-Outcomes and Potential Factors Influencing Success Rate.

Background: Maxillofacial microvascular free-flap reconstructions are significant interventions in the management of congenital defects, traumatic injuries, malignancies, and iatrogenic complications in pediatric and young adult patients. Craniofacial disorders within this demographic can result in profound functional, cosmetic, and psychosocial impairments, highlighting the critical need for thorough investigation into factors that may influence procedural success and postoperative quality of life. This retrospective chart review aims to examine the outcomes and potential influencing factors, aiming to offer valuable insights into optimizing the effectiveness of these reconstructions and improving patient outcomes. Methods: A single head and neck surgical team performed all the included 136 procedures. Demographic and surgical patient data were recorded. Type of transfer performed in each recipient site and major complications were analyzed. Relevant influencing factors, such as age, gender, and etiology of defect were determined using the ANOVA test and χ2 test of independence. Results: The results indicate a 90% success rate. No significant relationship was found between the incidence of total flap loss and patient age, etiology, or graft source. The maxillary reconstructions showed a higher incidence of total flap loss compared to mandibular reconstructions (11 vs. 3 cases). Conclusions: Despite the high success rate, the findings underline the necessity for further research to validate these observations and enhance surgical methods for pediatric and young adult patients.

Sociodemographic and treatment-related determinants of recent substance use among adults with comorbid substance misuse and psychotic disorders discharged from substance use treatment

IntroductionRates of alcohol and illicit substance use are higher among persons with psychotic disorders relative to the general population. The adverse health and psychological effects of substance use behaviors disproportionately impact persons with psychotic disorders. Prior research has shown that persons with psychotic disorders experience increased difficulty in reducing substance use behaviors, and interventions targeting substance use behavior change among this population have demonstrated limited effectiveness. One reason for this is that little is known about the factors that influence substance use and behavior change among this population. To address these disparities, the present study investigated sociodemographic and treatment-related factors of substance use recurrence among persons with psychotic disorders who received substance use treatment services. MethodsData came from the 2015–2018 Treatment Episode Dataset-Discharges (TEDS-D). TEDS-D collects annual data on adolescent and adult discharges from state-certified substance use treatment centers in the United States. The study conducted all analyses with a subsample of 1956 adult discharges with a psychotic disorder who received services from an outpatient substance use treatment center for at least one month. χ2 tests of independence and multivariable logistic regression analyses were used to examine associations of sociodemographic and treatment-related characteristics with substance use recurrence while in treatment (α < 0.05 analyses). The study presents results from multivariable logistic regression models as adjusted odds ratios (AORs) with 95 % confidence intervals (CI). ResultsThose who were age 50 or older, were referred to treatment by the criminal justice system, and attended substance use self-help groups had lower odds of substance use recurrence while in treatment. Sex, educational attainment, employment status, living situation, type of substance use, and treatment history were not significantly associated with substance use recurrence. ConclusionsIn designing treatment services, providers should consider whether focusing on sociodemographic, including cultural, factors can affect more positive substance use behavior change and other desired treatment outcomes among those with psychotic disorders and comorbid substance misuse. Further study is needed to identify these factors among specific subpopulations of those with psychotic disorders and substance misuse.

Collegiate Athletes With Diabetes: Baseline Medical Comorbidities and Preseason Concussion Testing Performance.

People with diabetes mellitus (DM) are at increased risk for adverse health events and complications throughout their lifetime. Whether DM significantly affects collegiate athletes' concussion baseline testing performance remains unclear. To (1) describe the prevalence of DM and associated comorbidities and (2) compare concussion baseline testing performance between student-athletes with DM and student-athletes without DM (NoDM). Retrospective, cross-sectional study. University. Using the Concussion, Assessment, Research and Education (CARE) Consortium research database, we matched athletes with self-reported DM (N = 229) by institution, sex, age, sport, position, testing year, and concussion history to athletes with NoDM (N = 229; total sample mean age = 19.6 ± 1.4 years, women = 42%). Descriptive statistics and χ2 tests of independence with subsequent odds ratios were calculated. Independent-samples t tests compared baseline symptoms, neurocognitive testing, and balance performance between athletes with DM and athletes with NoDM. Effect sizes were determined for significant group differences. At baseline, athletes with DM had higher rates of self-reported pre-existing balance disorders, sleep disorders, seizure disorders, motion sickness, learning disorders, vision and hearing problems, psychiatric disorders, depression, bipolar disorder, nonmigraine headaches, and meningitis than athletes with NoDM (P values < .05). We found balance differences between groups (P = .032, Cohen d = 0.17) such that, on average, athletes with DM had 1 additional error on the Balance Error Scoring System (DM = 13.4 ± 6.5; NoDM = 12.1 ± 5.9). No other comparisons yielded significant results. Although athletes with DM had high rates of self-reported balance disorders, sleep disorders, seizures, and meningitis, their baseline neurocognitive testing results were largely identical to those of athletes with NoDM. Our findings suggested that nonclinically meaningful differences were present in concussion baseline balance testing but no significant differences were noted in cognitive testing; however, the effect of DM on concussion recovery remains unknown.

Epidemiology of Craniomaxillofacial Fractures Over a 5-year Period at a Midwestern Level 1 Trauma Center Serving a Large Rural Population

Though the epidemiology of craniomaxillofacial (CMF) fractures has been well documented at urban hospitals, the characteristics of these fractures in rural hospitals have not been well studied. The purpose of this study is to report on the epidemiology of CMF fractures at a regional Level 1 trauma center serving a large rural population in central Illinois. This is a retrospective cohort study at a community-based regional tertiary referral center that serves a predominantly rural population. Inclusion criteria comprised patients with radiologically confirmed CMF fractures between 2015 and 2019. Patients with incomplete medical records were excluded. Predictor variables included demographics (age, admission source, race, and sex) and etiology of CMF fracture (assault/domestic violence, all-terrain vehicle/off-road, falls, farm-related, motor vehicle collisions, gunshot wound, and others). The primary outcome variable was the CMF anatomic location including nasal bone, orbit, mandible, malar/maxillary, and other CMF fractures. The covariates are not applicable. Descriptive statistics were used to summarize a sample of the population characteristics. Wilcoxon ranked sign tests and χ2 tests of independence were used to assess for statistically significant associations between select variables of interest. Statistical significance was defined as P<.05. Between 2015 and 2019, a total of 2,334 patients presented to the emergency department with a CMF fracture. After applying the inclusion/exclusion criteria, the final sample was composed of 1,844 patients for the management of 2,405 CMF fractures. The majority of patients were male(62.0%) and young adults (aged 18-39) had the highest number of CMF fractures (819) relative to all other age groups. The most common fracture etiology was fall(37.3%), and nasal bone fractures represented the most common fracture location(41.6%). χ2 analyses revealed statistically significant associations between the anatomic location of CMF fracture incurred, and differing categories of age, admission source, race, sex, and etiology. Our study shows that patients seen at our Midwestern Level 1 trauma center are more likely to present with nasal bone and malar/maxillary fractures due to falls. In studies based in urban centers, patients are likely to present with orbital and mandibular fractures due to falls and assault.

Assessment of post-thrombectomy brain hemorrhage in acute ischemic stroke with dual-energy CT: how reliable is it in clinical practice?

Acute ischemic stroke is currently among the main causes of mortality in Western countries. The current guidelines suggest different flowcharts of diagnostic work-up and treatment modalities, including endovascular thrombectomy. Immediately after intra-arterial recanalization, a brain CT scan is usually performed to assess for the presence of peri-procedural complications; in this setting, it is very hard, if possible, to differentiate blood from iodinated contrast material, which is normally present in ischemic tissue because of BBB disruption. Dual-energy CT may be used for this purpose, exploiting its ability to discriminate different materials. We retrospectively studied 44 patients with acute ischemic stroke who were treated with endovascular recanalization at San Giovanni Bosco Hospital in Turin and were then scanned with DECT technology. Subsequent scan was used as standard, since iodine from contrast staining is usually reabsorbed in 24h and blood persists longer. A χ2 test of independence was performed to examine the relationship between blood detected by DECT scan after the endovascular procedure and the presence of blood in the same areas on the following scans, with a significant result: χ2 (1, N = 37) = 10.7086, p = 0.0010. Patients with blood detected on DECT scans had a double chance of having hemorrhagic infarction in follow-up scans, (RR 2.02). The sensitivity and specificity of DECT were respectively 70% and 90%, with an overall diagnostic accuracy of 76% and a positive and negative predictive value, respectively, of 95% and 53%. Dual-energy CT scan after endovascular recanalization in ischemic stroke identifies early hemorrhagic infarction with excellent specificity and good overall diagnostic accuracy, representing a reliable diagnostic tool in everyday clinical practice.

Awareness and Knowledge of Stuttering among Malaysian School-Aged Children: An Exploratory Study

Introduction: Knowledge and awareness of stuttering are closely associated with attitudes toward stuttering. Few studies have been conducted on the knowledge and awareness of school-aged children, and none have been conducted in Malaysia. This study aimed to: (a) determine knowledge and awareness of stuttering among Malaysian school-aged children, and (b) determine whether there are differences between age group, gender, and people who stutter (PWS) exposure groups. Methods: A cross-sectional study was conducted among 192 Malay school-aged children (mean age = 9.47, SD = 1.781) recruited via email and social media platforms. They completed a Malay version of the questionnaire devised by van Borsel et al. (1999) on various aspects of stuttering, including prevalence, onset, gender distribution, occurrence in different cultures, cause, treatment, intelligence, and heredity of stuttering. The χ2 test of independence was performed to compare the distributions of survey responses by age group, gender, and PWS exposure group. Results: Around half of the school-aged children had met a person who stutters, but certain aspects of their knowledge were limited. Knowledge also differed according to age and gender. Girls were more knowledgeable about stuttering than boys. Regarding stuttering treatment, younger children had more positive attitudes than older children. Participants who did not know a PWS were more likely to consult their family doctor rather than a speech-language pathologist in relation to stuttering. Conclusion: Knowledge and awareness of stuttering among Malaysian school-aged children were limited. Findings of this study could be used to develop a stuttering awareness program specific to children to increase their knowledge and awareness about stuttering.

ANALYSIS OF THE INTERACTION OF MICE TOURISM DEVELOPMENT FACTORS (THE CASE OF ASTANA CITY IN KAZAKHSTAN)

The purpose of this study is to research whether some factors of the development of MICE tourism influence each other in the capital of Kazakhstan.The author conducted a survey and analyzed the interaction of the effectiveness of interaction between the authorized government body and private organizations, the level destination marketing of development and number of experienced specialists. This study used the method of one-phase analysis of variance (ANOVA analysis), as well as the method of analyzing contingency tables (χ2 test of independence (Pearson's chi-squared test) using the SPSS program. The study sample includes 50 respondents directly related to the development of tourism in Astana city. The results of this analysis indicate that the number of experienced professionals in the field of MICE tourism development significantly influences the level of marketing development of a destination with a p-value of 0.010 &lt; 0.05. The second result of the analysis showed that the number of experienced specialists in the field of MICE tourism development does not affect the effectiveness of interaction between the authorized state body and private organizations in the field of tourism with the p-value of 0.347 &gt; 0.05. The following result of the analysis suggests that the effectiveness of interaction between the authorized government body and private organizations in the field of tourism does not affect the level of development of destination marketing, while the independence criterion χ2 with p-value 0.958 &gt; 0.05.

Exploring Sociodemographic and Chronic Disease Factors Associated With Chronic, Seasonal, Intramonthly, and Intermittent Presentations of Food Security Instability

BackgroundFood insecurity impacts 13.5 million US households yearly. Although food security instability (FS-I) can have many temporal presentations, these are not measured in the current US Household Food Security Survey Module. ObjectiveExplore sociodemographic and chronic disease correlates of 4 FS-I types (chronic, seasonal, intramonthly, and intermittent) using a 3-item US Household Food Security Survey Module instability supplement. DesignThis study was a secondary analysis of cross-sectional survey pilot data collected to validate the US Household Food Security Survey Module instability supplement. Participants and settingAdults at risk for food insecurity (n = 420) were recruited and answered the survey on their households’ behalf from April to June 2021. The participants were recruited from 7 community organizations from 5 states (California, Florida, Maryland, North Carolina, and Washington). Main outcome measuresThe main outcomes were the odds of having a chronic, seasonal, intramonthly, or intermittent FS-I score ≥1 based on several sociodemographic factors and having ≥1 chronic disease. Statistical analyses performedDifferences among the 4 FS-I types were analyzed using contingency tables and χ2 tests of independence. Then, mixed-effects logistic binary and conditional regressions were run for each FS-I type using clustering by state and odds ratios and 95% CI to interpret results. ResultsThe most common FS-I type experienced by the sample was intramonthly (n = 183 [43%]). Nonchronic food insecurity was most likely to happen during the winter, at the end of the month, or randomly with no certain time frame. FS-I in any form was associated with low income, chronic FS-I was associated with younger age and male sex, seasonal FS-I was associated with having no government-subsidized health insurance and females, intramonthly FS-I was associated with participation in nutrition assistance programs, and intermittent FS-I had lower odds among Hispanic/Latino households. ConclusionsFurther research is needed to explore other FS-I correlates and establish causative relationships; however, these results can be used with clinical judgment for targeted food insecurity screening and treatment.

Perception And Uptake Of Hepatitis B Virus Vaccine Among Healthcare Trainees In A Nigerian University

Background: With a worldwide prevalence and high endemicity in Nigeria, the burden of HBV infection is of public health concern. Primary prevention through vaccination is the mainstay of control. Healthcare workers and trainees are posed with a risk of exposure. This study was conducted to determine the level of awareness and vaccine uptake among healthcare students in Nnewi, Nigeria. Methodology: A cross-sectional study by convenience sampling method between February-March 2018. The data was obtained using self-administered questionnaires with 261 respondents. Analysis was done using SPSS version 20. χ2 test of independence was determined with p-value set at 5%. Result: 92.7% of respondents were aware of HBV, 47% knew it was common, and 80.8% believed it was vaccine-preventable. 23.4% had a prior vaccination and 4.6% had at least 3 doses. 34.4% of those unvaccinated did not know of vaccination, and 24.4% lacked interest, 20.6% was due to busy schedule, and 19.4% due to cost. Vaccine uptake was significantly associated with study year but not with the study department. Conclusion: There was a good level of awareness of HBV vaccination but without a corresponding level of vaccine uptake due to hindrances such as schedule, cost, and disinterest.Vaccination prevention strategies for HBV should include healthcare trainees by policy to improve vaccination coverage and increase control of infection as they are at potential risk of exposure hazards in the course of their training and subsequent healthcare careers.

Workers with Lived and Living Experience: Characteristics and Wellbeing in the Australian AOD Sector

Introduction: Little data exists examining workers with lived/living experience of alcohol and other drug (AOD) use who are not in designated peer roles. The prevalence of these workers within the national workforce, and their levels of wellbeing, are currently unknown. The current study therefore explored the prevalence, characteristics, and predictors of wellbeing among workers with different types of lived experience (personal vs family/other) compared to those without any reported lived experience. Methods: A cross-sectional survey was conducted of the Australian AOD workforce. Group differences were explored on variables of interest via frequency statistics, χ2 tests of independence, multivariate analysis of variance, and linear regression. Results: Of the 986 AOD workers in direct client service roles, 2.4% were in a designated peer role, but 67.2% reported lived experience (34.5% personal lived experience and 32.8% family/other lived experience). Substantial proportions had not disclosed their lived experience to their workplace (27.4% with personal lived experience and 43.3% with other lived experience). Wellbeing (i.e., levels of burnout and engagement) did not differ significantly between groups. Predictors of wellbeing across all three groups included age, work intensity (e.g., heavy workloads), and finding work to be personally meaningful; additional differences between groups were also identified. Discussion: More than two-thirds of AOD workers in Australia have some form of lived experience, however this is not reflected in the number of peer roles. Initiatives that reach all workers with lived experience are required to safeguard their wellbeing, enhance recruitment and retention, and support best practice.