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1.
Braz J Phys Ther ; 28(3): 101079, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38865832

RESUMO

BACKGROUND: The physical therapy profession has made efforts to increase the use of confidence intervals due to the valuable information they provide for clinical decision-making. Confidence intervals indicate the precision of the results and describe the strength and direction of a treatment effect measure. OBJECTIVES: To determine the prevalence of reporting of confidence intervals, achievement of intended sample size, and adjustment for multiple primary outcomes in randomised trials of physical therapy interventions. METHODS: We randomly selected 100 trials published in 2021 and indexed on the Physiotherapy Evidence Database. Two independent reviewers extracted the number of participants, any sample size calculation, and any adjustments for multiple primary outcomes. We extracted whether at least one between-group comparison was reported with a 95 % confidence interval and whether any confidence intervals were interpreted. RESULTS: The prevalence of use of confidence intervals was 47 % (95 % CI 38, 57). Only 6 % of trials (95 % CI: 3, 12) both reported and interpreted a confidence interval. Among the 100 trials, 59 (95 % CI: 49, 68) calculated and achieved the required sample size. Among the 100 trials, 19 % (95 % CI: 13, 28) had a problem with unadjusted multiplicity on the primary outcomes. CONCLUSIONS: Around half of trials of physical therapy interventions published in 2021 reported confidence intervals around between-group differences. This represents an increase of 5 % from five years earlier. Very few trials interpreted the confidence intervals. Most trials reported a sample size calculation, and among these most achieved that sample size. There is still a need to increase the use of adjustment for multiple comparisons.


Assuntos
Modalidades de Fisioterapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Tamanho da Amostra , Intervalos de Confiança
2.
Vaccine ; 2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38902185

RESUMO

In this article, we present and empirically illustrate two concepts about vaccines and the way they are perceived by the Argentinean population and the easiness in accessing vaccination in developing countries. First, we focus on the perceptions of people about vaccines in general and develop a confidence index, and second, we analyze barriers to vaccination, measuring the burden citizens have when they intend to receive immunization (or as caretakers, trying to comply with the vaccination calendar of children and adolescents): for this second concept, we develop an access index. The data comes from representative annual surveys from Argentina from 2019 until 2022 (each one with approximately 7000 responders), which allows us to describe trends and check for changes in the confidence in vaccines and barriers towards vaccination. We find high confidence in vaccines in Argentina, although there is a "structural break" in the confidence for all years after 2020. Because we changed the questionnaire and methodology regarding the access to vaccines index in 2022, the discussion focuses on the cross-section of 2022, observing that barriers to vaccination tend to affect less educated caretakers.

3.
Anal Chim Acta ; 1305: 342597, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38677839

RESUMO

BACKGROUND: Increasingly, measurement uncertainty has been used by pure and applied analytical chemistry to ensure decision-making in commercial transactions and technical-scientific applications. Until recently, it was considered that measurement uncertainty boiled down to analytical uncertainty; however, over the last two decades, uncertainty arising from sampling has also been considered. However, the second version of the EURACHEM guide, published in 2019, assumes that the frequency distribution is approximately normal or can be normalized through logarithmic transformations, without treating data that deviate from the normality. RESULTS: Here, six examples (four from Eurachem guide) were treated by classical ANOVA and submitted to an innovative nonparametric approach for estimating the uncertainty contribution arising from sampling. Based on bootstrapping method, confidence intervals were used to guarantee metrological compatibility between the uncertainty ratios arising from the results of the traditional parametric tests and the unprecedented proposed nonparametric methodology. SIGNIFICANCE AND NOVELTY: The present study proposed an innovative methodology for covering this gap in the literature based on nonparametric statistics (NONPANOVA) using the median absolute deviation concepts. Supplementary material based on Excel spreadsheets was developed, assisting users in the statistical treatment of their real examples.

4.
Front Genet ; 15: 1353553, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38505828

RESUMO

Post-genomic implementations have expanded the experimental strategies to identify elements involved in the regulation of transcription initiation. Here, we present for the first time a detailed analysis of the sources of knowledge supporting the collection of transcriptional regulatory interactions (RIs) of Escherichia coli K-12. An RI groups the transcription factor, its effect (positive or negative) and the regulated target, a promoter, a gene or transcription unit. We improved the evidence codes so that specific methods are incorporated and classified into independent groups. On this basis we updated the computation of confidence levels, weak, strong, or confirmed, for the collection of RIs. These updates enabled us to map the RI set to the current collection of HT TF-binding datasets from ChIP-seq, ChIP-exo, gSELEX and DAP-seq in RegulonDB, enriching in this way the evidence of close to one-quarter (1329) of RIs from the current total 5446 RIs. Based on the new computational capabilities of our improved annotation of evidence sources, we can now analyze the internal architecture of evidence, their categories (experimental, classical, HT, computational), and confidence levels. This is how we know that the joint contribution of HT and computational methods increase the overall fraction of reliable RIs (the sum of confirmed and strong evidence) from 49% to 71%. Thus, the current collection has 3912 reliable RIs, with 2718 or 70% of them with classical evidence which can be used to benchmark novel HT methods. Users can selectively exclude the method they want to benchmark, or keep for instance only the confirmed interactions. The recovery of regulatory sites in RegulonDB by the different HT methods ranges between 33% by ChIP-exo to 76% by ChIP-seq although as discussed, many potential confounding factors limit their interpretation. The collection of improvements reported here provides a solid foundation to incorporate new methods and data, and to further integrate the diverse sources of knowledge of the different components of the transcriptional regulatory network. There is no other genomic database that offers this comprehensive high-quality architecture of knowledge supporting a corpus of transcriptional regulatory interactions.

5.
Vaccine ; 42(7): 1698-1703, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38355320

RESUMO

INTRODUCTION: Despite a recommendation by PAHO for Tdap vaccination in pregnant women since 2019, uptake remains suboptimal across Latin America. This study evaluated the knowledge and attitudes of women towards maternal Tdap vaccination in Colombia, Peru, and Panama to identify the critical behavioral and social drivers of Tdap vaccine uptake during pregnancy. METHODS: A cross-sectional online survey was undertaken between December 8, 2022, and January 11, 2023, targeting women in Colombia, Peru, or Panama with a child 12 months or under. We collected data on respondents' demographics, social and behavioral determinants of vaccine acceptance, determinants of vaccine uptake (using the validated 5As taxonomy), and previous vaccination experience. RESULTS: In the 938 respondents who completed the survey (Panama, n = 325; Peru, n = 305; Colombia, n = 308), 73-80 % had received the influenza vaccine, whereas only 30-39 % had received a Tdap vaccine. Significant correlates of Tdap vaccine uptake common to all three countries included a health professional recommendation, knowledge of the vaccine and location of vaccination, perceived vulnerability to pertussis infection, perceived importance of immunization, and receipt of a reminder. In specific countries, nonvaccinated women were more likely to cite issues with ease of access (Panama, Colombia), affordability (opportunity costs; Peru, Colombia), and understanding the rationale for vaccination in pregnancy (Panama, Colombia). CONCLUSION: To increase maternal Tdap vaccine uptake, health professionals should be encouraged to recommend vaccination consistently, and pregnant women should receive reminders explaining why and where to be vaccinated.


Assuntos
Vacinas contra Difteria, Tétano e Coqueluche Acelular , Coqueluche , Feminino , Humanos , Gravidez , Vacinas Bacterianas , Colômbia , Estudos Transversais , Panamá , Peru , Vacinação , Coqueluche/prevenção & controle
6.
Environ Sci Pollut Res Int ; 31(41): 53729-53742, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38308775

RESUMO

The present work intends to discuss parameter estimation and statistical analysis in adsorption. The Langmuir and Tóth isotherm models are compared for a set of carbon dioxide adsorption data on 13X zeolite from literature at different temperatures: 303, 323, 373, and 423 K. Statistical analyses were performed under frequentist and Bayesian perspectives. Under the frequentist statistical view, parameters were estimated using Maximum Likelihood estimation (MLE). Statistical analyses of parameters were performed by confidence regions in terms of elliptical approximation and likelihood region, while the evaluation of models was performed by chi-square statistics. The results showed that, for these nonlinear models, the elliptical region offers a poor approximation of the parameter estimates' confidence region, especially for the most correlated parameter pairs. Additionally, the four-parameter Tóth's equation yields less correlated parameters than the three-parameter Langmuir model. From a Bayesian perspective, the Markov chain Monte Carlo (MCMC) technique facilitated the reconstruction of the probability density functions of parameters as well as enabled the propagation of parametric uncertainties in the model responses. Finally, the accurate assessment of experimental uncertainty significantly influences the evaluation of models and their respective parameters.


Assuntos
Teorema de Bayes , Adsorção , Método de Monte Carlo , Zeolitas/química , Dióxido de Carbono/química , Cadeias de Markov , Modelos Estatísticos , Temperatura
7.
Rev. saúde pública (Online) ; 58: 01, 2024. graf
Artigo em Inglês | LILACS | ID: biblio-1536768

RESUMO

ABSTRACT OBJECTIVE This study aims to propose a comprehensive alternative to the Bland-Altman plot method, addressing its limitations and providing a statistical framework for evaluating the equivalences of measurement techniques. This involves introducing an innovative three-step approach for assessing accuracy, precision, and agreement between techniques, which enhances objectivity in equivalence assessment. Additionally, the development of an R package that is easy to use enables researchers to efficiently analyze and interpret technique equivalences. METHODS Inferential statistics support for equivalence between measurement techniques was proposed in three nested tests. These were based on structural regressions with the goal to assess the equivalence of structural means (accuracy), the equivalence of structural variances (precision), and concordance with the structural bisector line (agreement in measurements obtained from the same subject), using analytical methods and robust approach by bootstrapping. To promote better understanding, graphical outputs following Bland and Altman's principles were also implemented. RESULTS The performance of this method was shown and confronted by five data sets from previously published articles that used Bland and Altman's method. One case demonstrated strict equivalence, three cases showed partial equivalence, and one showed poor equivalence. The developed R package containing open codes and data are available for free and with installation instructions at Harvard Dataverse at https://doi.org/10.7910/DVN/AGJPZH. CONCLUSION Although easy to communicate, the widely cited and applied Bland and Altman plot method is often misinterpreted, since it lacks suitable inferential statistical support. Common alternatives, such as Pearson's correlation or ordinal least-square linear regression, also fail to locate the weakness of each measurement technique. It may be possible to test whether two techniques have full equivalence by preserving graphical communication, in accordance with Bland and Altman's principles, but also adding robust and suitable inferential statistics. Decomposing equivalence into three features (accuracy, precision, and agreement) helps to locate the sources of the problem when fixing a new technique.


Assuntos
Intervalos de Confiança , Análise de Regressão , Interpretação Estatística de Dados , Inferência Estatística , Confiabilidade dos Dados
8.
Spec Care Dentist ; 43(6): 893-899, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38062526

RESUMO

INTRODUCTION: Special care dentistry (SCD) is still developing in XX. This study aimed to clarify whether primary care dentists are treating patients with special health care needs (SHCN), to know if they have had previous education on SCD (on an undergraduate or postgraduate level), whether their training level impacts their confidence when treating patients with SHCN, and to assess their opinion on SCD as a relevant topic in undergraduate education. METHODS: A survey was answered by 149 primary care dentists working for the National Health Service of the XX region in XX, including information on their daily clinical practice, undergraduate, and postgraduate training in SCD, and their opinions on them. RESULTS: Most interviewees would like to complement their training and believed that SCD should be formally incorporated into undergraduate programs. There was a significant association between confidence in treating patients with SHCN and the rating of their undergraduate training, and between confidence and the number of hours of continuous development courses. CONCLUSION: Most primary care dentists treat patients with SHCN regularly. Therefore, including training in the undergraduate curriculum and afterward becomes necessary to increase their confidence when facing this challenging group of patients.


Assuntos
Educação em Odontologia , Medicina Estatal , Humanos , Padrões de Prática Odontológica , Inquéritos e Questionários , Odontólogos , Atenção Primária à Saúde , Atitude do Pessoal de Saúde
9.
Pediatr Diabetes ; 20232023.
Artigo em Inglês | MEDLINE | ID: mdl-37929232

RESUMO

Objective: The Diabetes Device Confidence Scale (DDCS) is a new scale designed to evaluate school nurse confidence with diabetes devices. We hypothesized that DDCS score would be associated with related constructs of school nurse diabetes knowledge, experience, and training. Research Design and Methods: In a cross-sectional study, we co-administered the DDCS and Diabetes Knowledge Test 2 (DKT2) questionnaires to school nurses in Pennsylvania. We summarized DDCS scores (range 1-5) descriptively. We evaluated the relationship between DKT2 percent score and DDCS mean score with the Spearman correlation coefficient. Simple linear regression examined school nurse characteristics as predictors of DDCS score. Results: A total of 271 completed surveys were received. Mean DDCS score was 3.16±0.94, indicating moderate confidence with devices overall. School nurses frequently reported low confidence in items representing specific skills, including suspending insulin delivery (40%), giving a manual bolus (42%), knowing when to calibrate a continuous glucose monitor (48%), changing an insulin pump site (54%), and setting a temporary basal rate (58%). Mean DKT2 score was 89.5±0.1%, which was weakly but not significantly correlated with DDCS score (r=0.12, p=0.06). Formal device training (p<0.001), assisting ≥5 students with diabetes devices in the past 5 years (p<0.01), and a student caseload between 1000-1500 students (p<0.001) were associated with higher mean DDCS score. Conclusions: DDCS score is related to prior training and experience, providing evidence for the scale's convergent validity. The DDCS may be a useful tool for assessing school nurse readiness to use devices and identify areas to enhance knowledge and practical skills.


Assuntos
Diabetes Mellitus , Humanos , Estudos Transversais , Diabetes Mellitus/terapia , Insulina , Inquéritos e Questionários , Estudantes
10.
Psychol Sport Exerc ; 67: 102434, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37665887

RESUMO

Guided by the Sport-Confidence Model, this study examined the associations among a positive body image, sport-confidence, and sport performance evaluations. Using a cross-sectional design, a purposive sample of 314 Jamaican athletes (male = 70.7%; Mage = 22.85; SD = 4.89) completed measures of body and functionality appreciation, sport-confidence, and subjective sport performance. Results from path analysis provided evidence for good model-data fit. Body (B = 9.03, p < .001) and functionality (B = 4.93, p = .036) appreciation exerted direct effects on sport-confidence. Sport-confidence exerted a direct effect on sport performance evaluations (B = 0.09, p < .001). Body (B = 0.79, CI95% [0.44, 1.17]) and functionality (B = 0.43, CI95% [0.05, 0.92]) appreciation exerted indirect effects on sport performance evaluations through sport-confidence. Results indicate that supporting the development of a positive body image in athletes may contribute to feelings of sport-confidence and positive performance outcomes.


Assuntos
Imagem Corporal , Esportes , Masculino , Humanos , Adulto Jovem , Adulto , Estudos Transversais , Jamaica , Atletas
11.
Public Health Pract (Oxf) ; 6: 100419, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37608848

RESUMO

Objective: Assess the perceived protection afforded by a range of COVID-19 vaccines in immune-mediated inflammatory diseases patients previously vaccinated against SARS-CoV-2. Study design: Survey. Methods: On-line cross-sectional survey aimed at evaluating the perceived protection (and its determinants) afforded by a range of COVID-19 vaccines among immune-mediated inflammatory diseases previously vaccinated for COVID-19. Results: Out of 493 eligible respondents who lived in Brazil, 397 (80.5%) were confident that their primary vaccination series would protect them against severe COVID-19. In multivariate analysis, only overlapping immune-mediated inflammatory diseases remained (negatively) associated with the perception of protection. Conclusions: No influence was found between COVID-19 vaccine types and the perception of protection after initial vaccinations.

12.
Sex Reprod Health Matters ; 31(1): 2240570, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37565792

RESUMO

The objective of this research was to develop and assess the validity of a scale to measure perceived abortion self-efficacy (PASE). Perceived abortion self-efficacy is defined as an individual's perceived confidence in their ability to carry out the tasks necessary to end a pregnancy safely and successfully. During the first phase of this study between February and April 2018, we conducted qualitative research using in-depth interviews and focus group discussions with women in Bolivia, Nepal, and Nigeria to explore domains of PASE. Using the qualitative data, we prepared a draft set of measures with 31 items. In October and November 2018, the second phase of the study included field testing 31 draft items with a convenience sample of approximately 1200 women across the three study countries. Exploratory factor analysis was conducted to identify an appropriate scale structure, resulting in a 15-item, 3-factor model. The three factors represent the concepts of enlisting social resources, accessing information and care, and resilience. In the third and final phase in September and October 2019, the validity of the 15 scale items was assessed. The scale was administered to a new sample of approximately 400 women in each country. Confirmatory factor analyses were conducted to test model fit for the scale structure identified during the second phase. The results from this study suggest that the final PASE scale has considerable potential to be a valid measure of PASE. The new 15-item PASE scale presented in this paper can be used to evaluate programmes or interventions designed to improve women's PASE and to assess the state of PASE in populations.


Assuntos
Aborto Induzido , Autoeficácia , Gravidez , Humanos , Feminino , Nepal , Bolívia , Nigéria
13.
Braz J Cardiovasc Surg ; 38(5): e20220442, 2023 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-37540728

RESUMO

OBJECTIVE: In this study, we aimed to evaluate the factors affecting major adverse event (MAE) development after full-term neonatal cardiac surgery. METHODS: This study was conducted retrospectively on newborns who underwent congenital heart surgery between June 1, 2020, and June 1, 2022. MAE was defined as the presence of at least one of the following: cardiac arrest, unplanned reoperation, emergency chest opening, admission to the advanced life support system, and death. The role of blood lactate level, vasoactive inotropic score (VIS), and cerebral near-infrared spectroscopy (NIRS) changes in predicting MAE was investigated. RESULTS: A total of 240 patients (50% male) were operated during the study period. The median age of patients was seven days (interquartile range 3-10 days). MAE was detected in 19.5% of the cases. Peak blood lactate levels >7 mmol/liter (area under the curve [AUC] 0.72, 95% confidence interval [CI] [0.62-0.82], P<0.001, sensitivity 76%, specificity 82%, positive predictive value [PPV] 88%) was an independent risk factor for MAE (odds ratio [OR] 2.7 [95% CI 1.3-6]). More than 30% change in NIRS value during the operative period (AUC 0.84, 95% CI [0.80-0.88], P<0.001, sensitivity 65%, specificity 85%, PPV 90%) was a strong predictor of MAE. VIS > 10 was an independent risk factor (AUC 0.75, 95% CI [0.70-0.84], P<0.001, sensitivity 86%, specificity 80%, PPV 84%) and strongly predicted MAE (OR 1.4 [95% CI 0.9-5]). CONCLUSION: Cerebral NIRS changes > 30%, high blood lactate levels, and VIS score within the 48 hours may help to predict the development of MAE in the postoperative period.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Cardiopatias Congênitas , Recém-Nascido , Humanos , Masculino , Feminino , Estudos Retrospectivos , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Cardiopatias Congênitas/cirurgia , Unidades de Terapia Intensiva , Lactatos
14.
Vaccines (Basel) ; 11(7)2023 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-37514966

RESUMO

The embrace of coronavirus disease 2019 (COVID-19) vaccine conspiracies has been linked to vaccine hesitancy. This study aimed to investigate the relationship between COVID-19 vaccine conspiracy theories and perceived vaccine effectiveness. The study utilized a longitudinal follow-up study in which adults in Chile completed surveys in December 2020 (T1) and May 2021 (T2). The psychometric properties of the five-item instrument on conspiracy theories for the COVID-19 vaccine were evaluated using data from T1 (n = 578). A confirmatory one-factor structure with suitable indicators of reliability was found. The longitudinal analysis (n = 292) revealed that conspiracy theories about the COVID-19 vaccine in T1 were associated with lower beliefs in its effectiveness in T2. However, no significant association was found between beliefs in effectiveness in T1 and conspiracy theories in T2. The study suggests that beliefs in conspiracy theories may temporally precede beliefs in vaccine effectiveness for COVID-19. The results have implications for strategies to address vaccine conspiracy beliefs and their implementation at the public policy level.

15.
Psychol Rep ; : 332941231191067, 2023 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-37496382

RESUMO

Metacognition refers to the human capacity to access and monitor one's own mental states. Recent research suggests that this capacity expands to the social world, e.g., when individuals explicitly share their cognitive processes with others. Additionally, metacognition is also linked to cognitive flexibility, and the latter to ideologically radical behaviors. Indeed, the absence of control over one's own mental activity could be at the base of different phenomena linked to social cognition. We investigate the metacognitive capacity of individuals in relation to the radicality with which they make a moral choice (utilitarian vs. deontological). For this purpose, 76 participants were submitted to 24 hypothetical situations, with the aim of evaluating the consistency (i.e., the radicality) of their moral choices. Then, in an independent experimental session, we evaluated the participants' metacognitive efficiency. We managed to demonstrate that individual metacognition scores are correlated with the radicality of a moral choice. We discussed the impact and relevance of metacognition in ecological contexts, particularly where subjective evaluation of the environment involves individual choices with social consequences.

16.
J Dent Educ ; 87(9): 1242-1249, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37160672

RESUMO

OBJECTIVES: The aim of this study was to develop and evaluate the effect of a manual dexterity training program on manual dexterity, perception of self-confidence, quality of cavity preparations, and ergonomic work posture of dental students prior to preclinical training. METHODS: Students in the first year of the undergraduate dentistry program (N = 63) participated in this study. The program consisted of eight phases in which students performed different types of activities. The dependent variables were: manual dexterity assessed by the modified Dental Manual Dexterity Assessment; self-confidence to perform a preclinical procedure using the VAS scale; quality of Class I cavity preparation; angular deviation from the neutral position of the neck, trunk, wrist and distance between the student's eyes and the mannequin's tooth. These variables were evaluated at two different times: before and after the application of the program. The independent variable was the preclinical manual dexterity training program. After meeting the assumption of normality, the paired t-Student test was performed, the significance level was 5%. RESULTS: The results showed a statistically significant difference in relation to manual dexterity (p < 0.001), self-confidence (p < 0.001), quality of cavity preparations (p < 0.001), distance from the eyes of the student/mannequin (p < 0.001), deviation angle of the neutral position of the trunk (p = 0.007) and wrists (p < 0.001), with better results in posttraining. CONCLUSION: It was possible to conclude that, in general, the proposed training positively influenced the self-confidence, dexterity, quality of work, and ergonomics of the evaluated students.


Assuntos
Estudantes de Odontologia , Dente , Humanos , Preparo da Cavidade Dentária , Autoimagem
17.
Open Forum Infect Dis ; 10(5): ofad201, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37234512

RESUMO

Background: Despite high rates of coronavirus disease 2019 (COVID-19)-related maternal mortality, Jamaica currently has little data on COVID-19 vaccine uptake among pregnant women. Methods: We conducted a cross-sectional, web-based survey of 192 reproductive-aged women in Jamaica from February 1 to 8, 2022. Participants were recruited from a convenience sample of patients, providers, and staff at a teaching hospital. We assessed self-reported COVID-19 vaccination status and COVID-19-related medical mistrust (operationalized as vaccine confidence, government mistrust, and race-based mistrust). We used multivariable modified Poisson regression to test the association between vaccine uptake and pregnancy. Results: Of 192 respondents, 72 (38%) were pregnant. Most (93%) were Black. Vaccine uptake was 35% in pregnant women versus 75% in nonpregnant women. Pregnant women were more likely to cite healthcare providers versus the government as trustworthy sources of COVID-19 vaccine information (65% vs 28%). Pregnancy, low vaccine confidence, and government mistrust were associated with a lower likelihood of COVID-19 vaccination (adjusted prevalence ratio [aPR] = 0.68 [95% confidence interval {CI}, .49-.95], aPR = 0.61 [95% CI, .40-.95], and aPR = 0.68 [95% CI, .52-.89], respectively). Race-based mistrust was not associated with COVID-19 vaccination in the final model. Conclusions: Pregnancy, low vaccine confidence, and government mistrust were associated with a lower likelihood of COVID-19 vaccination among reproductive-aged women in Jamaica. Future studies should evaluate the efficacy of strategies proven to improve maternal vaccination coverage, including standing "opt-out" vaccination orders and collaborative provider and patient-led educational videos tailored for pregnant individuals. Strategies that decouple vaccine messaging from government agencies also warrant evaluation.

18.
Vaccine ; 41(19): 3099-3105, 2023 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-37061374

RESUMO

OBJECTIVE: The objectives of this study were to evaluate parental confidence and attitudes towards immunization in urban Guatemala between private versus public health systems and their impact on vaccination timeliness in their children. METHODS: A cross-sectional survey was conducted in parents 6-18-month-old children who attended well-child outpatient clinics from two health systems (public employee-based insurance and private health care) in Guatemala City from November 2017 through August 2018. Parental demographics, household characteristics, food insecurity, vaccine hesitancy using the WHO SAGE Vaccine Hesitancy Scale, and information on parental use of social media platforms and vaccine information sources were collected. RESULTS: Five hundred-three parents were surveyed, most of them mothers. Only 9 parents reported they had previously refused a vaccine for their child: 8 (3.2 %) from private clinics and 1 (0.4 %) from the public clinic (p = 0.02). Significantly more children attending private clinics (226, 90.4 %) were shown to have a delay in any of their vaccines scheduled for the first 2 years of life compared to those in the public clinic (169, 66.8 %; p < 0.01). Children of parents having a college degree (84.5 vs 70.1 %; p < 0.001), earning more than US$ 1,000 per month (81.5 vs 70.7 %; p < 0.001), and having a computer at home (81.4 vs 70.2; p = 0.007) were more likely to have any delays in the scheduled vaccines. Parents seeking care at private clinics were 1.14 times more at risk of delaying a vaccine compared to those at the public clinic, adjusted for other covariates (p = 0.03, 95 % CI: 1.01, 1.28). CONCLUSIONS: In Guatemala, children receiving immunizations at private clinics were significantly more likely than those attending public clinics to be delayed in their immunization schedule and to remain more days without the recommended protection, especially for third doses of the primary vaccine series.


Assuntos
Vacinação , Vacinas , Feminino , Humanos , Lactente , Guatemala , Estudos Transversais , Imunização , Pais , Atitude , Conhecimentos, Atitudes e Prática em Saúde
19.
J Appl Stat ; 50(5): 1037-1059, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37065622

RESUMO

Proficiency testing (PT) determines the performance of individual laboratories for specific tests or measurements and it is used to monitor the reliability of laboratories measurements. PT plays a highly valuable role as it provides objective evidence of the competence of the participant laboratories. In this paper, we propose a multivariate calibration model to assess equivalence among laboratories measurements in PT. Our method allows to deal with multivariate data, where the item under test is measured at different levels. Although intuitive, the proposed model is nonergodic, which means that the asymptotic Fisher information matrix is random. As a consequence, a detailed asymptotic analysis was carried out to establish the strategy for comparing the results of the participating laboratories. To illustrate, we apply our method to analyze the data from the Brazilian engine test group, PT program, where the power of an engine was measured by eight laboratories at several levels of rotation.

20.
J Clin Nurs ; 32(17-18): 5668-5692, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36894868

RESUMO

AIM: To evaluate the simulation design characteristics that may influence the stress, anxiety and self-confidence of undergraduate nursing students during learning. DESIGN: Systematic review with meta-analysis. DATA SOURCES: Searchers were conducted in October 2020 and updated in August 2022 in the databases CENTRAL, CINAHL, Embase®, ERIC, LILACS, MEDLINE, PsycINFO®, Scopus and Web of Science, PQDT Open (ProQuest), BDTD, Google Scholar and specific journals on simulation. REVIEW METHODS: This review was conducted according to the recommendations of Cochrane Handbook for Systematic Reviews and reported according to the PRISMA Statement. Experimental and quasi-experimental studies that compared the effect of simulation on stress, anxiety and self-confidence of nursing students were included. The selection of studies and data extraction was performed independently by two reviewers. Simulation information was collected as prebriefing, scenario, debriefing, duration, modality, fidelity and simulator. Data summarization was performed by qualitative synthesis and meta-analytical methods. RESULTS: Eighty studies were included in the review, and most reported in detail the structure of the simulation, contemplating prebriefing, scenario, debriefing and the duration of each step. In subgroup meta-analysis, the presence of prebriefing, duration of more than 60 min and high-fidelity simulations helped reduce anxiety, while the presence of prebriefing and debriefing, duration, immersive clinical simulation modalities and procedure simulation, high-fidelity simulations and use of mannequins, standardised patients and virtual simulators, contributed to greater students' self-confidence. CONCLUSIONS: Different modulations of simulation design components imply reduction of anxiety and increased self-confidence in nursing students, especially highlighting the quality of the methodological report of simulation interventions. RELEVANCE TO CLINICAL PRACTICE: These findings help to support the need of more rigorous methodology in simulation designs and research methods. Consequently, impact on the education of qualified professionals prepared to work in clinical practice. No Patient or Public Contribution.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Humanos , Bacharelado em Enfermagem/métodos , Competência Clínica , Aprendizagem , Ansiedade
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