Yoxas/statistical_literacy huggingface dataset:
Despite doing well on antiretroviral therapy, many people living with HIV have expressed a willingness to accept substantial risks for an HIV cure. To date, few studies have assessed the specific quantitative maximal risk that future participants might take; probed whether, according to future participants, the risk can be offset by the benefits; and examined whether taking substantial risk is a reasonable decision. In this qualitative study, we interviewed 22 people living with HIV and used standard gamble methodology to assess the maximum chance of death a person would risk for an HIV cure. We probed participants' reasoning behind their risk-taking responses. Conventional inductive content analysis was used to categorize key themes regarding decision-making. We found that some people would be willing to risk even death for an HIV cure, and some of their reasons were plausible and went far beyond the health-related utility of an HIV cure. We contend that people's expressed willingness to take substantial risk for an HIV cure should not be dismissed out of hand.
Despite educational mandates to assess resident teaching competence, limited instruments with validity evidence exist for this purpose. Existing instruments do not allow faculty to assess resident-led teaching in a large group format or whether teaching was interactive. This study gathers validity evidence on the use of the Resident-led Large Group Teaching Assessment Instrument (Relate), an instrument used by faculty to assess resident teaching competency. Relate comprises 23 behaviors divided into six elements: learning environment, goals and objectives, content of talk, promotion of understanding and retention, session management, and closure. Messick's unified validity framework was used for this study. Investigators used video recordings of resident-led teaching from three pediatric residency programs to develop Relate and a rater guidebook. Faculty were trained on instrument use through frame-of-reference training. Resident teaching at all sites was video-recorded during 2018-2019. Two trained faculty raters assessed each video. Descriptive statistics on performance were obtained. Validity evidence sources include: rater training effect (response process), reliability and variability (internal structure), and impact on Milestones assessment (relations to other variables). Forty-eight videos, from 16 residents, were analyzed. Rater training improved inter-rater reliability from 0.04 to 0.64. The Φ-coefficient reliability was 0.50. There was a significant correlation between overall Relate performance and the pediatric teaching Milestone, r = 0.34, P = .019. Relate provides validity evidence with sufficient reliability to measure resident-led large-group teaching competence.
Despite effective treatments for fecal incontinence (FI), FI remains underdiagnosed and undertreated. This study sought to characterize and compare rates of, delays in, experiences with, and barriers to care seeking for FI among men and women. This study was a secondary analysis of electronic survey data collected from adults with FI. The survey included the use of a validated instrument to assess FI severity and questions that now comprise a validated instrument for assessing barriers to care seeking for FI in women. Descriptive analyses characterized differences between men and women. χ2 testing for categorical variables and t-testing for normally distributed continuous variables compared statistical differences. The sample (N = 548) was predominately female (84%), non-Hispanic White (90%), and insured (96%), with a mean Vaizey score (13.4 ± 5.3) consistent with moderate or severe FI. Care seeking rates (p = 0.81) and symptom duration before care seeking (p = 0.23) did not differ between women and men, but women were more likely than men to be told that effective treatments exist; most male and female respondents who sought care were offered treatment. Very few respondents had been asked about FI by a healthcare provider. Whereas normative thinking, limited life impact, and believing that a healthcare provider could not help were more common barriers to care seeking among men, avoidance, fear, and discouragement were more common in women. Men and women with FI seek care at similar rates and after experiencing symptoms for a similar duration of time. Very few patients with FI have been screened for it by a healthcare provider. Barriers to FI care seeking are different for women and men, and men are less likely than women to be informed about effective treatments by a healthcare provider.
Despite efforts to increase the participation of marginalized students in Science, Technology, Engineering, and Mathematics (STEM), neurodivergent students have remained underrepresented and underserved in STEM graduate programs. This qualitative study aims to increase understanding of the experiences of neurodivergent graduate students pursuing advanced degrees in STEM. In this analysis, we consider how common graduate school experiences interface with the invisibility of neurological diversity, thus contributing to a set of unique challenges experienced by neurodivergent students. In this qualitative study, 10 focus group sessions were conducted to examine the experiences of 18 students who identify as neurodivergent in graduate STEM programs at a large, research-intensive (R1) university. We used thematic analysis of the transcripts from these focus groups to identify three overarching themes within the data. The findings are presented through a novel model for understanding neurodivergent graduate STEM student experiences. The findings suggest that students who identify as neurodivergent feel pressure to conform to perceived neurotypical norms to avoid negative perceptions. They also may self-silence to maintain stability within the advisor-advisee relationship. The stigma associated with disability labels contributes a heavy cognitive and emotional load as students work to mask neurodiversity-related traits, navigate decisions about disclosure of their neurodivergence, and ultimately, experience significant mental health challenges and burnout. Despite these many challenges, the neurodivergent graduate students in this study perceived aspects of their neurodivergence as a strength. The findings may have implications for current and future graduate students, for graduate advisors who may or may not be aware of their students' neurodivergence, and for program administrators who influence policies that impact the wellbeing and productivity of neurodivergent students.
Despite elevated health risks during young adulthood, many adolescents and young adults with serious health care needs face barriers during the transfer to an adult specialty practitioner, and health disparities may occur during the transition. To validate the content of an updated Social-Ecological Model of Adolescent and Young Adult Readiness for Transition to Promote Health Equity (SMART-E) in a group of adolescents and young adults with sickle cell disease (SCD) and their supports. Health equity framework components were reviewed. Systems of power (eg, institutional and practitioner bias) and environments or networks (eg, peer or school support) were added as SMART-E preexisting factors, and health literacy was included within readiness factors. Adolescents and young adults aged 16 to 29 years with SCD, caregivers, and practitioners participated in this convergent, mixed-methods study within Children's Hospital of Philadelphia between January and August 2022. Content validity was assessed through nominations of top 3 most important transition barriers prior to interviews and focus groups, ratings on importance of SMART-E factors (0-4 scale; ratings >2 support validity) after interviews and focus groups, nominations of 3 most important factors for transition and for health equity, and qualitative content analysis of interview transcripts. The study enrolled 10 pediatric adolescents and young adults (mean [SD] age, 18.6 [2.9] years; 4 female and 6 male), 10 transferred adolescents and young adults (mean [SD] age, 22.9 [2.1] years; 8 female and 2 male), 9 caregivers (mean [SD] age, 49.8 [8.7] years; 5 female and 4 male), and 9 practitioners (mean [SD] age, 45.6 [10.5] years; 8 female and 1 male). Quantitative ratings supported the content validity of SMART-E and met established criteria for validity. Systems of power was the most endorsed transition barrier (14 of 38 participants) reported prior to interviews and focus groups. After the interview, participants endorsed all SMART-E factors as important for transition, with new factors systems of power and environments and networks rated at a mean (SD) 2.8 (1.23) and 3.1 (0.90), respectively, on a 0 to 4 scale of importance. The most important factors for transition and equity varied by participant group, with all factors being endorsed, supporting the comprehensiveness of SMART-E. Qualitative data corroborated quantitative findings, further supporting validity, and minor modifications were made to definitions. SMART-E obtained initial content validation with inclusion of health equity factors for adolescents and young adults with SCD, caregivers, and practitioners. The model should be evaluated in other populations of adolescents and young adults with chronic disease.
Despite emerging studies suggesting that occupational physical activity (OPA) might be harmful to health, the available evidence is not definitive. Most of these research studies were conducted in high-income Western countries or in urbanized setting. In China, where over one-third of the population resides in rural area, the impact of OPA on health is not well understood. The goal of this study is to investigate how the association between OPA and mortality vary by urban-rural settings. Baseline data on OPA was gathered using the Global Physical Activity Questionnaire from 30,650 urban and 49,674 rural working adults as part of the 2013-2014 China Chronic Disease and Risk Factor Surveillance. Participants were followed for a median of 6.2 years, and death records were retrieved from the National Mortality Surveillance System until December 31, 2019. The multivariable Cox proportional hazard model was used to examine urban-rural differences in the association between OPA and all-cause and cardiovascular disease (CVD) mortality. Subgroup analyses were performed by sex, socioeconomic status, leisure time, transportation, and non-occupational physical activity. During the study period, 1342 deaths were recorded, of which 426 were caused by CVD. In rural area, working adults engaging in occupational moderate-to-vigorous physical activity (MVPA) for ≥40 h per week, compared to those without any, had an adjusted hazard ratio of 0.60 (95% CI: 0.49-0.73) for all-cause mortality and 0.55 (95% CI: 0.37-0.83) for CVD mortality. However, no significant association was found in urban area (0.84 [0.61-1.15] for all-cause mortality, Pinteraction = 0.036; and 0.94 [0.53-1.66] for CVD mortality, Pinteraction = 0.098). The negative associations of occupational MVPA with mortality were more pronounced in women, non-smokers, and those with less non-occupational physical activities. Hypertension, heart rate, and diabetes were important contributors to the relationship between occupational MVPA and mortality. The findings from the current study did not support the notion that high levels of OPA would induce harm. On the contrary, in rural setting, higher levels of OPA were associated with lower mortality risks. Furthermore, the observed urban-rural differences in the association between OPA and mortality underscored the need for context-specific public health guidelines on physical activities. R&D Program of Beijing Municipal Education Commission (KM202210025026),National Key Research and Development Program of China (2021YFC2500201), and Young Elite Scientist Sponsorship Program by BAST (BYESS2023385).
Despite endoscopic sinus surgery (ESS) being the standard best treatment for chronic rhinosinusitis with nasal polyps (CRSwNP), there still remains a high recurrence rate of nasal polyps after ESS. The aim of this study was to analyze the impact of ESS in the treatment of CRSwNP and identify possible predictors for revision surgery. We conducted a cross-sectional retrospective study of patients with CRSwNP submitted to ESS between the years 2013 and 2021. We analyzed 517 cases, of which 15.1% were submitted to revision ESS. The presence of hyposmia/anosmia, asthma, intolerance/allergy to non-steroid inflammatory drugs, non-steroidal anti-inflammatory drug exacerbated respiratory disease, and bilateral polyposis were more frequent in patients who needed revision surgery. Initial values of peripheral eosinophilia and Lund-Mackay scores were significantly higher in this sub-group of patients. Lund-Mackay score was the only independent risk factor for revision surgery. Factors like peripheral eosinophilia and Lund-Mackay score were associated with a higher probability of revision ESS. Applying these concepts to the clinical practice could help predict the evolution of patient's pathology in the post-operative period and identify in advance those cases that may need a multidisciplinary approach.
Despite Ethiopia's policy intention to provide recommended vaccination services to underprivileged populations, inequity in polio immunisation persists. This study examined inequity and trends in polio immunisation and determinant factors among children aged 12-23 months in Ethiopia between 2000 and 2019. Cross-sectional data from 2000, 2005, 2011, 2016 and 2019 Ethiopian demographic and health surveys were analysed with the updated version of the WHO's Health Equity Assessment Toolkit software. Six standard equity measures: equity gaps, equity ratios, population attributable risk, population attributable fraction, slope index of inequality and relative index of inequality were used. Datasets were analysed and disaggregated by the five equality stratifiers: economic status, education, place of residence, sex of the child and regions. Multilevel logistic regression analysis was used to identify determinant factors. Polio immunisation coverage was increased from 34.5% (2000) to 60.0% (2019). The wealth index-related inequity, in coverage of polio immunisation between quintiles 5 and 1, was 20 percentage points for most surveys. The population attributable risk and population attributable fraction measure in 2011 indicate that the national polio immunisation coverage in that year could have been improved by nearly 36 and 81 percentage points, respectively, if absolute and relative wealth-driven inequity, respectively, had been avoided. The absolute difference between Addis Ababa and Afar Region was 74 percentage points in 2000 and 60 percentage points in 2019. In multilevel analysis result, individual-level factors like wealth index, maternal education antenatal care and place of delivery showed statistical significance. Although polio immunisation coverage gradually increased over time, in the 20-year survey periods, still 40% of children remained unvaccinated. Inequities in coverage by wealth, educational status, urban-rural residence and administrative regions persisted. Increasing service coverage and improving equitable access to immunisations services may narrow the existing inequity gaps.
Despite everyday argumentation being crucial to human communication and decision-making, the cognitive determinants of argument evaluation are poorly known. This study examined how attitudes and aspects of cognitive sophistication, i.e., thinking styles and scientific literacy, relate to people's acceptance of poorly justified arguments (e.g., unwarranted appeals to naturalness) on controversial topics (e.g., genetically modified organisms (GMOs)). The participants were more accepting of poorly justified arguments that aligned with their attitudes compared to those that opposed their attitudes, and this was true regardless of one's thinking styles or level of scientific literacy. Still, most of the examined aspects of cognitive sophistication were also positively related to fallacy detection. The strongest cognitive predictors of correctly recognizing the fallacies were one's scientific reasoning ability and active open-mindedness. The results thus imply that decreasing misleading attitude effects, and increasing certain aspects of analytic and scientific thinking, could improve argumentation.
Despite extensive research and prodigious advances in neuroscience, our comprehension of the nature of schizophrenia remains rudimentary. Our failure to make progress is attributed to the extreme heterogeneity of this condition, enormous complexity of the human brain, limitations of extant research paradigms, and inadequacy of traditional statistical methods to integrate or interpret increasingly large amounts of multidimensional information relevant to unravelling brain function. Fortunately, the rapidly developing science of machine learning appears to provide tools capable of addressing each of these impediments. Enthusiasm about the potential of machine learning methods to break the current impasse is reflected in the steep increase in the number of scientific publication about the application of machine learning to the study of schizophrenia. Machine learning approaches are, however, poorly understood by schizophrenia researchers and clinicians alike. In this paper, we provide a simple description of the nature and techniques of machine learning and their application to the study of schizophrenia. We then summarize its potential and constraints with illustrations from six studies of machine learning in schizophrenia and address some common misconceptions about machine learning. We suggest some guidelines for researchers, readers, science editors and reviewers of the burgeoning machine learning literature in schizophrenia. In order to realize its enormous promise, we suggest the need for the disciplined application of machine learning methods to the study of schizophrenia with a clear recognition of its capability and challenges accompanied by a concurrent effort to improve machine learning literacy among neuroscientists and mental health professionals.
Despite high hepatitis B (HBV) prevalence among people of Vietnamese ethnicity in Australia and elsewhere, there is limited research on levels of HBV knowledge and factors associated with such knowledge. The aim of this study was to examine HBV knowledge and associated demographic and attitudinal factors among people of Vietnamese ethnicity in Australia. People of Vietnamese ethnicity (n = 966) were recruited through community events and social media groups to complete online surveys measuring HBV knowledge, attitudes towards HBV, levels of mistrust in Western medicine, and demographic characteristics. Findings of this study indicate that levels of knowledge are mixed, with gaps in knowledge related to transmission and treatment of the virus. Those with greater knowledge of HBV tended to be older, have higher levels of formal education, have been tested for HBV, and know someone living with HBV. Those with lower levels of knowledge tended to have more negative attitudes towards the virus and greater levels of mistrust in Western medicine. Given that health literacy is connected to effective communication from health providers, we suggest that there is a need for the development of health promotion and education resources targeted at people of Vietnamese ethnicity and translated into Vietnamese. We propose that such resources be developed in consultation with Vietnamese communities and health providers to ensure that they are culturally appropriate and sensitive to people of Vietnamese ethnicity living in Australia.
Despite high vulnerability to infection, hand disinfection compliance in emergencies is low. This is regularly justified as the disinfection procedure delays life support, and instead, wearing disposable gloves is preferred. Simulation studies showed higher achievable compliance than detected in real-life situations. This study aimed to explore healthcare providers' attitudes toward hand disinfection and using gloves in emergencies. We conducted an anonymous online survey in Germany on the attitude and subjective behavior in the five moments of hand hygiene in a closed environment and an open convenience sampling survey. Statistics included paired student's t-tests corrected for multiple testing. For qualitative analysis, we employed a single-coder approach. In 400 participants, we detected low priority of WHO-1 (before touching a patient) and WHO-2 (before clean/aseptic procedure) hand hygiene moments, despite knowing the risks of omission of hand disinfection. For all moments, self-assessment exceeded the assessment of colleagues (p < 0.001). For WHO-3, we detected a lower disinfection priority for wearing gloves compared to contaminated bare hands. Qualitative analyses revealed five themes: basic conditions, didactic implementations, cognitive load, and uncertainty about feasibility and efficacy. Considering bias, the study's subjective nature, the unknown role of emergency-related infections contributing to hospital-acquired infections, and different experiences of healthcare providers, we conclude that hand disinfection before emergencies is de-prioritized and justified by the emergency situation regardless of the objective feasibility. This study reveals subjective and objective barriers to implementation of WHO-1 and WHO-2 moments of hand disinfection to be further evaluated and addressed in educational programs.
Despite Hong Kong's world leading longevity, little is known about its associated disability burden and social patterning. Hence, this study assessed the gender-specific secular trends and area-level inequalities in life expectancy (LE) and disability-free life expectancy (DFLE) at age 65 in Hong Kong. Population structure, death records, and disability data in 2007, 2013, and 2020 were retrieved from the Census and Statistics Department to estimate LE and DFLE using the Sullivan Method. District-based sociodemographic indicators were used to compare LE and DFLE across 18 districts of Hong Kong in 2013. Between 2007 and 2020, LE at age 65 increased by 3.7 years (from 18.3 to 22.0) in men and by 2.1 years (from 22.7 to 24.8) in women. By contrast, DFLE increased more slowly, by 1.8 years (from 14.6 to 16.3) in men and by only 0.1 year (from 16.4 to 16.5) in women, leading to a substantial increase in proportion of life spent with disability. Results from multiple linear regression using district-based data in 2013 showed a similar extent of associations of education with LE and DFLE (mean year difference: 0.81 [95% CI: 0.14, 1.48] and 0.68 [0.10, 1.27], respectively, per 10% increase in average education level), while female gender was more strongly associated with LE (4.44 [3.56, 5.31]) than with DFLE (2.00 [1.18, 2.82]). Expansion of disability burden and male-female health-survival paradox hold true in Hong Kong. Unlike Western countries with a stronger socioeconomic patterning of DFLE, the extent of area-level socioeconomic inequalities in LE and DFLE appears to be more comparable in Hong Kong. Health and Medical Research Fund (Ref. no. : 19202031) by the Health Bureau of Hong Kong.