Yoxas/statistical_literacy huggingface dataset:
Background: Breast milk is vital for the growth and development of preterm infants. However, in Neonatal Intensive Care Units (NICUs), mothers often encounter significant challenges in breastfeeding. Objective: This study aims to systematically evaluate the barriers to breastfeeding in NICUs, thereby providing evidence-based support for clinical practices. Methods: A comprehensive search was conducted in the Cochrane Library, PubMed, Web of Science, Embase, and Scopus databases, up to September 2023. Meta-analysis was performed using Stata 15.0, applying fixed or random effects models to calculate odds ratios (OR) and their 95% confidence intervals (CI). Study quality was assessed using the Newcastle-Ottawa Scale for cases and cohorts and the Agency for Healthcare Research and Quality standards for cross-sectional studies. Heterogeneity was evaluated using Cochran's chi-squared test (Cochran's Q) and I2 statistics, and publication bias was assessed through funnel plots and symmetry tests. Results: A total of 32 studies were included, encompassing 96,053 preterm infants. The main barriers to breastfeeding in preterm infants included: low gestational age (OR = 1.36, 95% CI: 1.06-1.75), lower maternal education (OR = 1.64, 95% CI: 1.39-1.93), insufficient breast milk (OR = 2.09, 95% CI: 1.39-1.93), multiple births (OR = 1.615, 95% CI: 1.18-2.210), smoking (OR = 2.906, 95% CI: 2.239-3.771), and single motherhood (OR = 1.439, 95% CI: 1.251-1.654). Conclusion: This study underscores the need for individualized breastfeeding support strategies in NICUs, taking into account the diverse backgrounds of mothers. Future research should focus on unraveling the underlying mechanisms affecting breastfeeding in preterm infants, with the goal of enhancing breastfeeding rates and improving developmental outcomes.
Background: Childhood sleep disordered breathing (SDB) has been linked to poorer academic performance; however, research has not investigated the extent improvement in SDB may alter outcomes across key academic skills. This study aimed to investigate if children's early SDB status could predict later academic outcomes, and if an improvement in SDB status across the early childhood years would coincide with better, later performance in key academic skills related to reading, numeracy, and listening comprehension. Methods: Eighty five case children with an SDB symptom score >25 (maximum 77) were matched to 85 control children (score <12) at recruitment (age 3). SDB severity (symptom history and clinical assessment) was evaluated at ages 3, 4, 6, and 8 years and performance on individually-administered academic skills assessed at age 8 (91% retention from age 3). Case children were categorized into "improved" or "not-improved" groups based on SDB trajectories over the 5 years. Contributions of SDB status and trajectory group to academic performance were determined using regression analysis adjusted for demographic variables. Results: History of SDB from age 3 predicted significantly poorer performance on some key academic skills (oral reading and listening skills) at age 8. Children whose SDB improved (45%) performed better in oral reading fluency than those whose SDB did not improve, but difficulties with specific tasks involving oral language (listening retell) remained when compared to controls. Conclusion: Findings support links between early SDB and worse academic outcomes and suggest key academic areas of concern around oral language. Findings highlight the need for child mental health professionals to be aware of children's sleep problems, particularly SDB (past and present), when assessing potential barriers to children's achievement, to assist with appropriate and timely referrals for evaluation of children's sleep difficulties and collaborative evaluation of response to intervention for sleep difficulties.
Background: Children with hearing loss have been found to have significantly more behavioral and emotional challenges than their typically hearing peers, though these outcomes are variable at the individual level. Working memory deficits have been found to relate to executive functioning and overall emotion regulation, leading to behavior challenges. Language development is essential for development of social relationships and communicating one's needs and this may lead to distress when children cannot communicate effectively. Based on prior findings in children with hearing loss and their typically hearing peers, working memory and language skills were hypothesized to be related to parent and teacher report of socio-emotional functioning. Methods: Participants were 35 children with hearing loss (66% female, M = 5.17 years old, SD = ±1.97) whose language, working memory, and socio-emotional functioning were evaluated during the course of treatment and educational planning. Results: Bivariate analyses indicated that working memory was related to a number of socio-emotional domains (e.g., functional communication, atypicality, withdrawal), as were language scores (e.g., social skills, inattention). The direction of these associations was such that stronger working memory and language skills were related to more regulated socio-emotional functioning. Conclusions: This study is limited in generalizability by size and the relative homogeneity of the sample. A call to action of the current study includes more education with regard to profiles and presentations of children with hearing loss, and an early focus on socio-emotional learning to foster the development of regulatory skills.
Background: Clinical faculty development plays a significant role in the professional empowerment of future physicians. Identification of educational needs is an important step in planning faculty development. This study identified the educational needs of medical faculties in the clinical setting. Methods: This cross-sectional needs assessment study was conducted in Iranian medical universities during 2016-2018 using a triangulation paradigm. A total of 384 medical clinical faculties, 54 medical education specialists, and 194 faculty evaluation forms completed by medical residents participated in the study using a convenient randomized sampling method. The data were gleaned with a researcher-made questionnaire with 14 areas developed on the basis of clinical education goals and contexts and were analyzed with SPSS16 using descriptive statistic indices such as mean, standard deviation, and frequency percentile. Analytical tests including independent t-test, chi-square and Cramer's V were also applied (p<0.05). The content validity, face validity, and reliability were approved. Results: The response rate was %59 (227) for clinical faculties, %77 (42) for medical education specialists, and %58 (110) for residents. Professionalism was the first priority of needs from the viewpoint of clinical faculties and faculty development planners. The clinical teachers' highest level skills, in their own perspective and also students' perspective, were procedure training and grand round, whereas their lowest level skills were emotional intelligence and morning report. The greatest gap existed between the current skill and the need is management and leadership in the clinical setting. Cramer's index ranged between 0.18 and 0.34 (p<0.05); hence, there was a correlation between the current status and the announced needs in all subjects. Conclusion: Designers of faculty development programs ought to pay due attention to areas of professionalism, management, and leadership and carry out accurate and comprehensive planning to enable students to become competent future physicians in the roles of therapist, manager, teacher, supporter, and researcher.
Background: Clinical reasoning is the basis of all clinical activities in the health team, and diagnostic reasoning is perhaps the most critical of a physician's skills. Despite many advances, medical errors have not been reduced. Studies have shown that most diagnostic errors made in emergency rooms are cognitive errors, and anchoring error was identified as the most common cognitive error in clinical settings. This research intends to determine the frequency and compare the percentage of anchoring bias perceived among faculty members versus residents in the emergency medicine department. Methods: In this quasi-experimental study, Emergency Medicine's Faculties and Residents are evaluated in clinical reasoning by nine written clinical cases. The clinical data for each clinical case was presented to the participants over three pages, based on receiving clinical and para-clinical information in real situations. At the end of each page, participants were asked to write up diagnoses. Data were analyzed using one-way ANOVA test. The SPSS software (Version 16.0) was employed to conduct statistical tests, and a P value < 0.05 was considered to be statistically significant. Results: Seventy-seven participants of the residency program in the Emergency Medical group volunteered to participate in this study. Data showed Faculties were significantly higher in writing correct diagnoses than residents (66% vs. 41%), but the anchoring error ratio was significantly lower in residents (33% vs. 75%). In addition, the number of written diagnoses, time for writing diagnoses, and Clinical experience in faculties and residents were compared. Conclusion: Findings showed that increasing clinical experience increased diagnostic accuracy and changed cognitive medical errors. Faculties were higher than residents in anchoring error ratio. This error could be the result of more exposure and more decision-making in the mode of heuristic or intuitive thinking in faculties.
Background: Cognitive assessments for patients with neurocognitive disorders are mostly measured by the Montreal Cognitive Assessment (MoCA) and Visual Cognitive Assessment Test (VCAT) as screening tools. These cognitive scores are usually left-skewed and the results of the association analysis might not be robust. This study aims to study the distribution of the cognitive outcomes and to discuss potential solutions. Materials and Methods: In this retrospective cohort study of individuals with subjective cognitive decline or mild cognitive impairment, the inverse-transformed cognitive outcomes are modelled using different statistical distributions. The robustness of the proposed models are checked under different scenarios: with intercept-only, models with covariates, and with and without bootstrapping. Results: The main results were based on the VCAT score and validated via the MoCA score. The findings suggested that the inverse transformation method improved the modelling the cognitive scores compared to the conventional methods using the original cognitive scores. The association of the baseline characteristics (age, gender, and years of education) and the cognitive outcomes were reported as estimates and 95% confidence intervals. Bootstrap methods improved the estimate precision and the bootstrapped standard errors of the estimates were more robust. Cognitive outcomes were widely analysed using linear regression models with the default normal distribution as a conventional method. We compared the results of our suggested models with the normal distribution under various scenarios. Goodness-of-fit measurements were compared between the proposed models and conventional methods. Conclusions: The findings support the use of the inverse transformation method to model the cognitive outcomes instead of the original cognitive scores for early-stage neurocognitive disorders where the cognitive outcomes are left-skewed.
Background: Communication and interpersonal skills are essential medical components of oncology patient care. Patients and families rely on physicians for treatment, expertise, guidance, hope, meaning, and compassion throughout a life-threatening illness. A provider's inability to empathize with patients is linked to physician-related fatigue and burnout. Because oncology training programs focus on teaching evidence-based medicine and clinical acumen, little time may be dedicated to professional development and acquisition of interactive skills. Traditional communication courses typically include two components: formal, knowledge-based learning skills, which are gained from didactic lectures, and role-playing, which usually occurs in small groups. We report the implementation of a novel longitudinal communication curriculum for trainees in Oncology. Materials and Methods: At a single-center institution, an innovative communication curriculum titled "REFLECT" (Respect, Empathy, Facilitate Effective Communication, Listen, Elicit Information, Compassion, and Teach Others) was implemented for radiation oncology residents and medical oncology fellows to improve and refine physician/patient interactions. All oncology specialty residents and fellows were eligible to participate in this communication curriculum. The curriculum emphasized a reflective process to guide trainees through challenging scenarios. Results: Since October 2018, this comprehensive course consisted of quarterly (four hour) workshops comprising assigned reading, knowledge assessments, didactic lectures, expert guest lecturers, standardized patient simulations, role-playing, patient/expert panels, coaching, reflective writing, and debriefing/feedback sessions. The curriculum provided longitudinal communication training integrated with the learners' daily physician/patient encounters rather than occasional isolated experiences. Fifteen workshops have been completed. Each focused on navigating challenging situations with patients, loved ones, or colleagues. Conclusions: Future directions of the curriculum will entail improving the communication skills of oncology trainees and gathering communication improvement data to assess the program's success formally.
Background: Continuous glucose monitoring (CGM) is an evolving technology that provides a wealth of information to aid in managing diabetes. Professional CGM (ProCGM) is recommended when personal CGM is not desired or available. Patients in medically underserved areas may have limited access to personal CGM devices, thus ProCGM devices can be used for short-term monitoring and medication adjustment. Clinical pharmacists are well-positioned to help set up and establish personal and professional CGM management services. Objectives: To determine the effect of ProCGM in patients with persistently uncontrolled type 2 diabetes in a medically underserved population (MUP). Methods: Pre-post intervention analysis of a single cohort of patients in a public health center. Patients with persistently uncontrolled (A1c > 9%) and taking at least one daily dose of insulin were included. Included participants wore a ProCGM sensor and met with the clinical pharmacist at least once for ProCGM data interpretation and education. The primary analysis evaluated patients who achieved an A1c <9% 1-6 months after intervention. The change in A1c was also evaluated. Participants completed a pre- and post-survey about their experience. Results: Twenty-two patients were included in the final analysis. Ten patients achieved an A1c <9% (45%). The mean A1c pre- and post-ProCGM was 11.0% and 9.8% respectively, with a decrease of -1.2% (p=0.055) overall and a decrease of -1.7% for patients who wore the sensor for at least 10 days (p=0.012; n=15). Using the CGM data 91% of participants had a change to their medication regimen and 45% achieved an A1c <9%. Six participants experienced hypoglycemia per the CGM report, but only two were aware of it. After reviewing their glucose report with the pharmacist, 95% of the respondents agreed or strongly agreed to feeling more knowledgeable about blood sugar patterns after reviewing the report with a pharmacist. Conclusion: Almost half of the patients in the study achieved an A1c <9%. This study demonstrated glycemic benefit in patients in a MUP who wore a ProCGM for at least 10 days and met with a clinical pharmacist. Data from ProCGM enabled patients to better understand glucose patterns in those with persistently uncontrolled type 2 diabetes.
Background: Coronavirus disease 2019 (COVID-19) can lead to persistent and debilitating symptoms referred to as Post-Acute sequelae of SARS-CoV-2 infection (PASC) This broad symptomatology lasts for months after the acute infection and impacts physical and mental health and everyday functioning. In the present study, we aimed to evaluate the prevalence and predictors of long-term impairment of working ability in non-elderly people hospitalised for COVID-19. Methods: This cross-sectional study involved 322 subjects hospitalised for COVID-19 from 1 March 2020 to 31 December 2022 in the University Hospital of Bari, Apulia, Italy, enrolled at the time of their hospital discharge and followed-up at a median of 731 days since hospitalization (IQR 466-884). Subjects reporting comparable working ability and those reporting impaired working ability were compared using the Mann-Whitney test (continuous data) and Fisher's test or Chi-Square test (categorical data). Multivariable analysis of impaired working ability was performed using a logistic regression model. Results: Among the 322 subjects who were interviewed, 184 reported comparable working ability (57.1%) and 134 reported impaired working ability (41.6%) compared to the pre-COVID-19 period. Multivariable analysis identified age at hospital admission (OR 1.02, 95% CI 0.99 to 1.04), female sex (OR 1.90, 95% CI 1.18 to 3.08), diabetes (OR 3.73, 95% CI 1.57 to 9.65), receiving oxygen during hospital stay (OR 1.76, 95% CI 1.01 to 3.06), and severe disease (OR 0.51, 95% CI 0.26 to 1.01) as independent predictors of long-term impaired working ability after being hospitalised for COVID-19. Conclusions: Our findings suggest that PASC promotes conditions that could result in decreased working ability and unemployment. These results highlight the significant impact of this syndrome on public health and the global economy, and the need to develop clinical pathways and guidelines for long-term care with specific focus on working impairment.
Background: Culinary medicine (CM), an emerging discipline, is a novel approach that focuses on the art of food and cooking to prevent or improve health outcomes among chronic patients suffering from lifestyle diseases. The concept originated in the USA, gaining interest from scholars in medicine, nutrition, nursing, and the gastronomic discipline. Notably, in the last five years, there has been exponential growth in CM literature. In this regard, this study sought to examine the growth, performance and distinct research themes of CM literature over time. Methods: To achieve the study's objectives, this study employs descriptive, performance and bibliometric analysis. The descriptive analysis was applied to examine the growth of the CM literature since its emergence. The performance analysis was used to identify the most influential journals, articles, and authors in the CM domain. The bibliographic coupling analysis was adopted to discover the various research themes of the CM knowledge base. Results: This study identifies three stages of literature development: Early stage, modest growth stage, and emerging stage. Further, the results indicate that most of the studies on CM had been conducted in developed countries. Our findings reveal a clear interest in integrating the CM curriculum into medical/nutrition education programs in recent years. Additionally, the study discovers four distinct main research themes: knowledge assessment, impact measurement, acceptance and efficacy, and implementation of CM. Conclusions: These findings are helpful for scholars in medicine, nutrition, nursing, and gastronomy as they provide an overview of CM's development and research focus. Future studies could focus on expanding the geographical distribution of research on CM and further exploring the identified research themes to gain a deeper understanding of the potential of this approach for improving health outcomes among chronic disease patients.
Background: Death can be difficult to address personally, to discuss and to plan for. Since 2016 The Omega Course (Omega) has educated local people in Kenilworth, UK, about death and dying; broaching these issues and teaching communication skills whilst enabling social interaction. It aspires to produce practical outcomes with positive implications for end of life (EoL) planning and future neighbourhood care within the town. Aim: To investigate the impact of Omega on the attitudes and actions of participants. Method: Anonymous questionnaires, distributed by Qualtrics, or by post if preferred, were sent to 62 participants of Omega aged 22-94 two and a half years post course institution. Thematic analysis and inferential statistics were used. Results: 23 replies (37%) scored changes across 4 areas; barriers to discussion, ease discussing death, fears about death and future planning capability. All showed a significant beneficial change using a Paired Sample t-test (P< .01). Respondents noted common fears of death and dying, barriers to discussing the topic and planning for it. The course helped to allay fear, enabled discussion and encouraged planning for death and EoL. Respondents rated the course as 9.1/10 for achieving its aims. They appreciated discussing death and dying in a supportive environment and found the approach effective in developing their skills and changing attitudes. Conclusion: Omega has the potential to change attitudes towards death; promoting discussion, planning, and tackling misconceptions.
Background: Despite a growth in interest in recent years in the benefits of working co-creatively with the Arts for people living with dementia, little attention has been given to understanding the role of the professional artists within this context. This paper has been informed by the insights gained from a series of conversations, observations and journals that were kept by four UK based artists (two musicians and two dancers) who reflexively interrogated what they were doing during the course of an 8-week co-creative arts project with people living with dementia. Methods: The research used an empirical case study methodology, with the authors adopting a thematic approach to the analysis of the data. Results: Thematic analysis resulted in three main themes: Authenticity, Enabling Risk and Togetherness. These themes characterise the skills, techniques and specialised knowledge used by the artists during the co-creative sessions. Conclusions: Following this analysis, the article argues that the beneficial effects for people living with dementia of co-creative art-based work come about through the conscious application by the artists of their shared skills and knowledge, acquired through training and ongoing artistic practice. Rather than an assumption that 'The Arts' are in themselves beneficial for people living with dementia, we must consider the active role played by the artists who are so integral to the process.