Yoxas/statistical_literacy huggingface dataset:
Depressive disorder is one of the leading causes of disability worldwide; however its prevalence and association with inequality and crime is poorly characterised in Latin America. This study aimed to: i. systematically review population-based studies of prevalence of ICD/DSM depressive disorder in Latin America, ii. report pooled regional, country, and sex-specific prevalence estimates, and iii. test its association with four country-level development indicators: human development (HDI), income (Gini) and gender inequality (GII), and intentional homicide rate (IHR). We conducted a systematic review and meta-analysis of population-based studies reporting primary data on the prevalence of ICD/DSM depressive disorder in Latin America from 1990 to 2023, irrespective of language. We searched PubMed, PsycINFO, Cochrane Library, SciELO (regional database), LILAC (regional database), and available grey literature. Study quality was assessed using JBI's critical appraisal tools. We generated pooled estimates using random-effects meta-analysis; heterogeneity was assessed using the I2 statistic. Meta-regression analyses were used to test associations of depression prevalence with indicators of inequality and human development. The study was registered with PROSPERO (CRD42019143054). Using data from 40 studies in Latin America, lifetime, 12-month, and current prevalence of ICD/DSM depressive disorder were calculated at 12.58% (95% CI 11.00%-14.16%); 5.30% (4.55-6.06%), and 3.12% (2.22-4.03), respectively. Heterogeneity was high across lifetime, 12-month, and current prevalence, sex, and countries. 12-month and current prevalence was associated with higher Gini and GII, 12-month prevalence with lower HDI, and current prevalence with higher IHR. We found a high prevalence of ICD/DSM depressive disorders in Latin America, and a statistically significant association with inequality and development indicators. The high heterogeneity found across prevalence periods and the major gaps in country representation underscore the need to escalate efforts to improve mental health access and research capabilities in Latin America. Systematic, comparable prevalence estimates would inform more effective decision-making in the region. Pfizer Independent Medical Education Grant.
Depressive moods and behaviors are developmentally normative, yet potentially impairing, in preschool-aged children. In addition to frequency, duration of behavior is an important parameter to consider when characterizing risk for worsening mood dysregulation. The goal of this study was to identify the duration and severity of depressive moods and behaviors and associations with impairment in a large community sample of preschool-aged children using an online parent-report daily diary. Primary caregivers (N = 900) of 3-5-year-old children reported the daily duration of each instance of seven depressive moods and behaviors for 14 days. We used item response theory analyses to examine duration item characteristics. Moods and behaviors occurred at specific durations to be considered psychometrically severe/rare; for example, instances of sadness had to last an average total of 32 min per day or more, irritability at least 38 min, tantrums at least 30 min, and tearfulness/sensitivity at least 35 min. Longer durations of mood and behavior were associated with daily impairment, as well as older child age and less parental education. To our knowledge, this is the first study to delineate specific duration ranges for depressive moods and behaviors in preschool-aged children. These data, coupled with information about the frequency of mood-related behaviors, can assist child practitioners in differentiating normative patterns from less normative mood problems to evaluate which children may be at risk. Future work should identify the duration of depressive moods and behaviors in early childhood that predict clinically significant psychopathology over time.
Depressive symptoms are highly prevalent among adolescents in Western countries. However, although treatment for depressive symptoms is available, many adolescents do not seek help when they need it. Important barriers to help-seeking among adolescents include low mental health literacy and high stigma. Therefore, we have developed a game-based school program, Moving Stories, which combines mental health literacy training for depression with contact with someone with lived experience both in the digital and nondigital world. The aim of this study is to conduct a first test of the effectiveness of the newly developed game-based program, Moving Stories, using a cluster randomized controlled trial. A total of 185 adolescents participated, divided over 10 classes from 4 schools. Half of the classes were randomly selected to follow the Moving Stories program, whereas the other half were in the control group, where no intervention was provided. The adolescents filled out digital questionnaires at 4 time points, with questions on mental health literacy, stigma, depressive symptoms, and the program itself (before the program, after the program, 3-month follow-up, and 6-month follow-up). Using R (R Foundation for Statistical Computing), we ran linear mixed-effects models for all continuous outcome variables and generalized linear mixed-effects models for all binary outcome variables. Compared with the control group, participants in the Moving Stories group improved after the program in personal stigma (b=-0.53, 95% CI -1.02 to -0.03; t179.16=-2.08; P=.04). Effects on personal stigma lasted over time (3-month follow-up: b=-0.57, 95% CI -1.11 to -0.03; t174.39=-2.07; P=.04). Most adolescents in the Moving Stories group participated in the introduction (97/99, 98%) and contact session (93/99, 94%), played the game for 4 or 5 days (83/99, 83%), and indicated that they would recommend the game to their peers (90/98, 92%). The results of this study show the potential of Moving Stories as a stigma reduction program. With changes in the program to improve its effects on mental health literacy, Moving Stories could be implemented in schools to improve help-seeking in adolescents and reduce the negative consequences and burden of depressive symptoms. Dutch Trial Register NTR7033; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR7033. RR2-10.2196/11255.
Depressive symptoms are recognized as risk factors for cognitive impairment with intricate underlying biological mechanisms. We explored the link between depressive symptoms and cognitive impairment onset; we also assessed how this association is influenced by educational levels. This study included 5843 individuals aged ≥45 years, comprising 27,908 observations from 2006 to 2020. Based on repeated measurements of each participant, we estimated the association between depressive symptoms and cognitive impairment onset after a 2-year follow-up by using generalized estimating equations. The incidence rate was 9.4% among those individuals without depressive symptoms, which was in contrast with a rate of 21.0% among those individuals experiencing depressive symptoms. The odds ratio (OR) (95% confidence interval [CI]) for the association between depressive symptoms and cognitive impairment onset in the overall sample was 1.61 (1.47-1.76). This association was more pronounced among individuals with higher educational levels. Specifically, the OR (95% CI) of the association between depressive symptoms and cognitive impairment was highest among individuals with a college education (2.60 [1.78-3.81]), and the association was lowest among individuals with elementary or no education levels (1.45 [1.28-1.63]). Our findings highlight the idea that although individuals with higher educational backgrounds exhibit a diminished risk of cognitive impairment, the detrimental impacts of depressive symptoms on cognitive performance are particularly more pronounced within this group.
Dermatologic patient education materials (PEMs) are often written above the national average seventh- to eighth-grade reading level. ChatGPT-3.5, GPT-4, DermGPT, and DocsGPT are large language models (LLMs) that are responsive to user prompts. Our project assesses their use in generating dermatologic PEMs at specified reading levels. This study aims to assess the ability of select LLMs to generate PEMs for common and rare dermatologic conditions at unspecified and specified reading levels. Further, the study aims to assess the preservation of meaning across such LLM-generated PEMs, as assessed by dermatology resident trainees. The Flesch-Kincaid reading level (FKRL) of current American Academy of Dermatology PEMs was evaluated for 4 common (atopic dermatitis, acne vulgaris, psoriasis, and herpes zoster) and 4 rare (epidermolysis bullosa, bullous pemphigoid, lamellar ichthyosis, and lichen planus) dermatologic conditions. We prompted ChatGPT-3.5, GPT-4, DermGPT, and DocsGPT to "Create a patient education handout about [condition] at a [FKRL]" to iteratively generate 10 PEMs per condition at unspecified fifth- and seventh-grade FKRLs, evaluated with Microsoft Word readability statistics. The preservation of meaning across LLMs was assessed by 2 dermatology resident trainees. The current American Academy of Dermatology PEMs had an average (SD) FKRL of 9.35 (1.26) and 9.50 (2.3) for common and rare diseases, respectively. For common diseases, the FKRLs of LLM-produced PEMs ranged between 9.8 and 11.21 (unspecified prompt), between 4.22 and 7.43 (fifth-grade prompt), and between 5.98 and 7.28 (seventh-grade prompt). For rare diseases, the FKRLs of LLM-produced PEMs ranged between 9.85 and 11.45 (unspecified prompt), between 4.22 and 7.43 (fifth-grade prompt), and between 5.98 and 7.28 (seventh-grade prompt). At the fifth-grade reading level, GPT-4 was better at producing PEMs for both common and rare conditions than ChatGPT-3.5 (P=.001 and P=.01, respectively), DermGPT (P<.001 and P=.03, respectively), and DocsGPT (P<.001 and P=.02, respectively). At the seventh-grade reading level, no significant difference was found between ChatGPT-3.5, GPT-4, DocsGPT, or DermGPT in producing PEMs for common conditions (all P>.05); however, for rare conditions, ChatGPT-3.5 and DocsGPT outperformed GPT-4 (P=.003 and P<.001, respectively). The preservation of meaning analysis revealed that for common conditions, DermGPT ranked the highest for overall ease of reading, patient understandability, and accuracy (14.75/15, 98%); for rare conditions, handouts generated by GPT-4 ranked the highest (14.5/15, 97%). GPT-4 appeared to outperform ChatGPT-3.5, DocsGPT, and DermGPT at the fifth-grade FKRL for both common and rare conditions, although both ChatGPT-3.5 and DocsGPT performed better than GPT-4 at the seventh-grade FKRL for rare conditions. LLM-produced PEMs may reliably meet seventh-grade FKRLs for select common and rare dermatologic conditions and are easy to read, understandable for patients, and mostly accurate. LLMs may play a role in enhancing health literacy and disseminating accessible, understandable PEMs in dermatology.
Dermatology has long been recognized as a highly competitive field within medicine, with extremely limited spots available for aspiring dermatologists to secure residencies across the United States. We sought to evaluate the trends and factors influencing the match process in dermatology residencies, particularly given the changes brought on by the COVID-19 pandemic. Using data from publicly available match lists and regional categorizations, we studied the rates of internal and regional matches for dermatology applicants in the postpandemic era (2022-2023) compared with prepandemic statistics. Overall, the research sheds light on the evolving dynamics of dermatology residency matching in response to pandemic-induced changes and applicant preferences.
Dermatopathology education accounts for 30% of U.S. dermatology residency training. The COVID-19 pandemic expedited the implementation of virtual dermatopathology in place of traditional microscopy for resident education. This study examined U.S. dermatology residents' perceptions of virtual dermatopathology, as research in this area is lacking. An anonymous, confidential, institutional review board-approved survey was electronically distributed to U.S. dermatology residents consisting of 16 questions comparing attitudes towards virtual and traditional dermatopathology education. Responses were n = 59. Statistical analysis was performed using SAS software. Participants believe virtual imaging is superior to conventional microscopy in schedule flexibility (96.6% vs. 1.7%, p < 0.0001), lecture convenience (94.8% vs. 0.0%, p < 0.0001), personal review (96.6% vs. 0.0%, p < 0.0001), cost-effectiveness (64.4% vs. 6.8%, p < 0.0001), and board exam preparation (52.5% vs. 16.9%, p = 0.0005). Conventional microscopy was favored for image quality (50.8% vs. 25.4%, p = 0.0127) and overall utility (50.8% vs. 27.1%, p = 0.0195). Our study supports virtual dermatopathology utilization as a valuable tool in dermatology residency training. Also it is shown that conventional microscopy training continues to play a key role. Further studies should examine whether, if ever, virtual dermatopathology could gradually replace conventional microscopy with the advent of newer and more powerful digital and scanning technology.
Dermoscopy is known to increase the diagnostic accuracy of pigmented skin lesions (PSLs) when used by trained professionals. The effect of dermoscopy training on the diagnostic ability of dermal therapists (DTs) has not been studied so far. This study aimed to investigate whether DTs, in comparison with general practitioners (GPs), benefited from a training programme including dermoscopy, in both their ability to differentiate between different forms of PSL and to assign the correct therapeutic strategy. In total, 24 DTs and 96 GPs attended a training programme on PSLs. Diagnostic skills as well as therapeutic strategy were assessed, prior to the training (pretest) and after the training (post-test) using clinical images alone, as well as after the addition of dermatoscopic images (integrated post-test). Bayesian hypothesis testing was used to determine statistical significance of differences between pretest, post-test and integrated post-test scores. Both the DTs and the GPs demonstrated benefit from the training: at the integrated post-test, the median proportion of correctly diagnosed PSLs was 73% (range 30-90) for GPs and 63% (range 27-80) for DTs. A statistically significant difference between pretest results and integrated test results was seen, with a Bayes factor > 100. At 12 percentage points higher, the GPs outperformed DTs in the accuracy of detecting PSLs. The study shows that a training programme focusing on PSLs while including dermoscopy positively impacts detection of PSLs by DTs and GPs. This training programme could form an integral part of the training of DTs in screening procedures, although additional research is needed.
Describe and compare the experiences and preferences of Deaf and hearing individuals with different levels of health literacy in accessing, interpreting, and acting upon online health information. We conducted semi-structured interviews with 17 Deaf and 10 hearing participants with high and low health literacy from three healthcare sites. We conducted thematic analysis of the transcripts to explore information navigation experiences, information sources and dissemination preferences. We found thematic differences between Deaf and hearing participants with high and low health literacy in terms of information needs, information search experiences, information search perceptions, and preferred information dissemination approaches. Relative to hearing counterparts, Deaf participants were more likely to encounter challenges in accessing and understanding online information. Deaf participants with low health literacy were more likely to rely on visual graphics to support their understanding of the information than those with high health literacy. Deaf participants advocated for tailored approaches to disseminate health information to Deaf communities. Our findings suggest that differences in online health information navigation experiences and accessibility may inform disparities in health literacy outcomes between Deaf and hearing individuals. Online health information should be presented in a manner accessible to Deaf community members.
Describe the effects of data literacy training and continuous performance reports on ICU staff compliance with the 6-element ICU quality bundle approach known as the ABCDEF (A-F) bundle and patient outcomes. Stepped-wedge cluster randomized trial conducted during an institutional A-F bundle implementation program. Single-center study conducted in eight adult ICUs. Adult patients admitted for at least 24 hours, not undergoing active withdrawal of life support or palliative care. Four ICUs in the intervention group received bundle-related staff education, data literacy training, and weekly bundle performance reports during the 12-month study period. The four ICUs in the nonintervention group received none of these interventions. Bundle compliance and patient outcomes were tracked, including ICU and hospital mortality, transfer and discharge, discharge disposition, mechanical ventilation, and ICU delirium. In the intervention group, staff education alone increased bundle compliance from 9% to 16% (p < 0.0001); data literacy training further increased compliance from 16% to 21% (p = 0.03). This improvement was sustained throughout the study period including the onset of the COVID-19 pandemic and was greater than improvement in the nonintervention group (p < 0.001). Full A-F bundle compliance was associated with a lower likelihood of next-day ICU and hospital mortality, discharge to a facility other than home, and was associated with a higher likelihood of next-day extubation in patients. Next-day ICU and hospital discharge likelihood decreased, and delirium frequency was not affected. This is the first study demonstrating that the combination of staff education, data literacy training, and access to performance data improves A-F bundle compliance, sustains performance, and improves ICU patient outcomes (ICU and hospital mortality, mechanical ventilation duration, and home discharge rates). In contrast to previous studies, increased bundle compliance did not hasten ICU or hospital discharges or reduce delirium frequency in patients.
Description Microaggressions are pervasive throughout society, including in healthcare and academic institutions. They are often unconscious but accumulate over time, and they negatively impact the recipients' productivity and achievement by creating a sense of inadequacy as well as a lack of belonging. We outline several evidence-based strategies and teaching frameworks that institutions and training programs can adopt to reduce the prevalence and impact of microaggressions against trainees from historically marginalized groups, and that can promote psychological safety for everyone.
Design thinking pedagogy was commonly adopted in higher education across professional fields, but not in nursing education. To enhance design thinking competence of nursing students, integrating design thinking pedagogy has been suggested. To assess the effect of incorporating design thinking pedagogy into Leadership Development courses on design thinking competence in nursing students. Prospective non-randomized study. This study was conducted in a University of Science and Technology in northern Taiwan. Nursing students taking elective Leadership Development courses were included as the experimental group (n = 150). Age- and gender-matched nursing students without taking Leadership Development courses were included as the control group (n = 150). Two self-reported questionnaires, Taiwanese version of Creative Synthesis Inventory (CSI-TW) and Design Thinking Traits Questionnaire (DTTQ-TW), were used to assess design thinking competence of nursing students before and after test. Analysis of covariance (ANCOVA) after adjustment for pre-test mean scores was performed to assess differences in the adjusted post-test mean scores between the two groups. The ANCOVA analysis indicated nursing students in the experimental group had significantly improved total scores of and subscale scores of CSI-TW compared to those of the control group. Although total score of DTTQ-TW as well as subscale scores of feedback-seeking and experimentalism were significantly enhanced in the experimental group than their control counterparts, no significant differences in subscale scores of integrative thinking, optimism, and collaboration were observed between two groups. Design thinking pedagogy significantly improved overall design thinking competence of nursing students. This study provided quantitative evidence to support the implementation of design thinking pedagogy in nursing education to facilitate the design thinking competence of nursing students.
Designing an over-the-counter medication electronic health record (OTC-EHR) may help improve OTC usage. An online survey for the conceptual OTC-EHR design examined participant characteristics, attitudes towards obtaining user-shared OTC medication information, health-related application usage, and the inclination to share anonymized health information. Descriptive statistics, tests to assess statistical significance, and text mining were used to analyze the results. The findings revealed that Japanese consumers, particularly those with high eHealth literacy and women, possess relatively positive attitudes towards obtaining user-shared OTC medication information than those with low eHealth literacy (t (280.71) = -4.11, p < 0.001) and men (t (262.26) = -2.78, p = 0.006), respectively. Most consumers own smartphones but do not use health-related applications. A minority held positive attitudes about sharing anonymized health information. The perceived helpfulness of OTC-EHR was positively associated with the usage of health-related applications (χ2 (4) = 18.35, p = 0.001) and attitude towards sharing anonymized health information (χ2 (3) = 19.78, p < 0.001). The study findings contribute towards OTC-EHR's design to enhance consumers' self-medication and reduce risks, while the psychological barriers to sharing anonymized health information should be improved by increasing the OTC-EHR's penetration rate and engaging in appropriate information design.
Designing interventions to support the safe development of rapidly growing livestock value chains in sub-Saharan Africa requires a clear understanding of consumer demands. This study aimed to determine purchase patterns, consumers' preferences, and willingness to pay for safe pork attributes; specifically, the presence of a veterinary inspection stamp and the cleanliness of the butchery. A discrete choice experiment-based survey was used to investigate the purchasing behavior of 401 pork consumers: 253 buying raw pork for household consumption, and 148 buying cooked pork for out-of-home consumption. The study findings indicate that the average quantity of pork purchased by consumers was approximately 0.4 Kg per transaction, with the majority of consumers making several purchases per week. The average price per Kg of pork was KES 310 (Approx. 2.60 USD) at the time of the study. Data from the choice experiment showed that consumers were willing to pay a price premium of KES 245 (Approx. 2.1 USD) and KES 164 (Approx. 1.4 USD) per Kg for evidence of better veterinary meat inspection and higher butchery hygiene respectively; further, these were the two most important attributes they considered while making a pork purchase decision. These findings highlight the potential to leverage consumers' willingness to pay to improve the food safety within pork value chains in this context. Investing to increase consumer awareness on food safety issues should be considered to generate an effective market demand, especially in rural areas with relatively lower literacy levels.