scholarly journals Racial and Socioeconomic Differences in Social Work and Department of Child Services Reporting Patterns for THC Positive Pregnant Women

2020 ◽  
Vol 3 ◽  
Author(s):  
Sydney DiGregory ◽  
Anneli Cochrane ◽  
Brownsyne Tucker Edmonds
Keyword(s):  
Small Sample ◽  
Socioeconomic Differences ◽  
Urine Drug Screen ◽  
Exact Test ◽  
Child Services ◽  
Insurance Type ◽  
Chart Abstraction ◽  
Small Sample Sizes ◽  
Publicly Insured ◽  
Insured Patients

Background and Hypothesis: Tetrahydrocannabinol (THC) is the most commonly used illicit substance during pregnancy. Little research, most with conflicting data, exists on its impact on the developing fetus or birth outcomes. Reporting THC positive urine drug screen (UDS) to social worker (SW) has been left to provider discretion. Similarly, SW has discretion in reporting to Department of Child Services (DCS) if the newborn tests negative for drugs at birth. We hypothesize that there are racial and socioeconomic differences in reporting patterns that result in non-white and publicly insured patients being reported to SW or DCS at higher rates than white or privately insured patients.  Methods: Data were collected via Cerner and CareWeb chart abstraction of patients who delivered at IU Health hospitals between 1/1/16 to 12/31/17 and tested positive for THC, but no other drugs, during any stage of pregnancy. Data was entered into the secure and encrypted Redcap database. Demographic variables included mother’s age, race, ethnicity, insurance type, and number of previous pregnancies. Descriptive statistics were calculated for demographics by overall, SW, and DCS referral. p-values were calculated using Fisher’s Exact Test for small sample sizes and considered significant at the 0.05 level. The effects of age and number of previous pregnancies were analyzed using two-sample t-test for equal variances.  Results: 152 patients met inclusion criteria for the analysis. The study population was mostly white (68.4%) and black (30.3%). Their insurance type was 74.3% public, 17.8% private, and 7.9% uninsured. The vast majority of cases were referred to SW (90.8%) and DCS (87.7%). Neither patient race nor insurance were associated with referral to SW (p=.80, p=.79) or DCS (p=.30, p=.25).   Conclusion: There was no statistically significant association between demographic characteristics and referral patterns, though the study may be underpowered due to low non-referral rate. Addition of 2018-2019 data are planned.   

scholarly journals A correction to the exact test based on the Ewens sampling distribution

1996 ◽  
Vol 68 (3) ◽  
pp. 259-260 ◽  
Author(s):  
Montgomery Slatkin
Keyword(s):  
Small Sample ◽  
Sampling Distribution ◽  
Sample Sizes ◽  
Exact Test ◽  
Small Sample Sizes ◽  
Larger Sample

SummaryThe exact test for neutrality based on the Ewens sampling distribution described previously (Slatkin, 1994) is not correct. The problem is that the test as described is based on the probability of the ordered configuration of numbers of alleles, while it should be based on the probability of the unordered configuration. The correctly implemented exact test leads to results that are similar to those from the homozygosity test proposed by Watterson (1977) for relatively small sample sizes but can still differ substantially for larger sample sizes. Programs to perform the exact test are available from the author.

scholarly journals Medical Advisability of Youth Pitching Recommendations on the Internet

2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110366
Author(s):  
David F. Painter ◽  
James H. Dove ◽  
Kristina Monteiro ◽  
Peter K. Kriz ◽  
Brett D. Owens
Keyword(s):  
Cross Sectional Study ◽  
Small Sample ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Content Quality ◽  
Internet Information ◽  
Small Sample Sizes ◽  
Website Content ◽  
Google Search

Background: As the incidence of youth pitching injuries and surgical procedures attributed to overuse has drastically increased, there are quality concerns about popular internet resources regarding arm care for youth pitchers. Purpose/Hypothesis: To assess the medical advisability of online arm care recommendations for youth pitchers. It was hypothesized that websites contain misleading arm-care information that is discordant with medical advice. Study Design: Cross-sectional study. Methods: We reviewed the first 100 websites populated after a Google search for youth pitching recommendations. Websites were categorized by type (athletic organization, commercial, or educational) and content quality (medically advisable, discordant, or neutral), the latter with respect to the Pitch Smart guidelines used by Major League Baseball. Chi-square tests of independence and z tests of independent proportions were used to compare column proportions among categories of website content quality for each type of website source. Given the small sample sizes in some instances, the Fisher-Freeman-Halton exact test was performed to assess the relationship between website source type and quality of information. Results Of the 99 qualifying websites, 76 were categorized as medically advisable, 16 as discordant, and 7 as neutral. In addition, 92% of educational websites and 94.7% of athletic organization websites featured exclusively advisable content, whereas only 54.8% of commercial websites were advisable. Of the 16 discordant websites, 15 were commercial sites. Educational websites were significantly more advisable and neutral in content when compared with discordant information, while commercial websites were significantly predictive of discordant content. Among the first 50 websites populated according to Google, 42 (84%) were advisable, 6 (12%) discordant, and 2 (4%) neutral. The remaining websites (n = 49) featured 34 (69.4%) that were advisable, 10 (20.4%) discordant, and 5 (10.2%) neutral. Conclusion: Study findings indicated that websites of an educational nature are predictive of medically advisable content, while commercial websites (eg, blogs) are associated with discordant information. The abundance and availability of inaccurate internet information should be appreciated by medical professionals and parents/coaches of youth baseball players.

Integrating Visual and Bayesian Statistical Analyses in Single Case Experimental Research to Evaluate the Effectiveness and Magnitude of a Comprehensive Behavioral Intervention

2018 ◽  
Author(s):  
Prathiba Natesan ◽  
Smita Mehta
Keyword(s):  
Behavioral Intervention ◽  
Effect Size ◽  
Rate Ratio ◽  
Visual Analysis ◽  
Single Case ◽  
Small Sample ◽  
Statistical Analyses ◽  
Data Types ◽  
Ratio Effect ◽  
Small Sample Sizes

Single case experimental designs (SCEDs) have become an indispensable methodology where randomized control trials may be impossible or even inappropriate. However, the nature of SCED data presents challenges for both visual and statistical analyses. Small sample sizes, autocorrelations, data types, and design types render many parametric statistical analyses and maximum likelihood approaches ineffective. The presence of autocorrelation decreases interrater reliability in visual analysis. The purpose of the present study is to demonstrate a newly developed model called the Bayesian unknown change-point (BUCP) model which overcomes all the above-mentioned data analytic challenges. This is the first study to formulate and demonstrate rate ratio effect size for autocorrelated data, which has remained an open question in SCED research until now. This expository study also compares and contrasts the results from BUCP model with visual analysis, and rate ratio effect size with nonoverlap of all pairs (NAP) effect size. Data from a comprehensive behavioral intervention are used for the demonstration.

No Evidence that Experiencing Physical Warmth Promotes Interpersonal Warmth: Two Failures to Replicate Williams and Bargh (2008)

2018 ◽  
Author(s):  
Christopher Chabris ◽  
Patrick Ryan Heck ◽  
Jaclyn Mandart ◽  
Daniel Jacob Benjamin ◽  
Daniel J. Simons
Keyword(s):  
Null Hypothesis ◽  
Small Sample ◽  
Sample Sizes ◽  
Double Blind ◽  
Bayesian Analyses ◽  
Physical Warmth ◽  
Small Sample Sizes ◽  
Interpersonal Warmth

Williams and Bargh (2008) reported that holding a hot cup of coffee caused participants to judge a person’s personality as warmer, and that holding a therapeutic heat pad caused participants to choose rewards for other people rather than for themselves. These experiments featured large effects (r = .28 and .31), small sample sizes (41 and 53 participants), and barely statistically significant results. We attempted to replicate both experiments in field settings with more than triple the sample sizes (128 and 177) and double-blind procedures, but found near-zero effects (r = –.03 and .02). In both cases, Bayesian analyses suggest there is substantially more evidence for the null hypothesis of no effect than for the original physical warmth priming hypothesis.

scholarly journals Non-Invasive Monitoring of Adrenocortical Activity in Three Sympatric Desert Gerbil Species

Animals ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 75
Author(s):  
Álvaro Navarro-Castilla ◽  
Mario Garrido ◽  
Hadas Hawlena ◽  
Isabel Barja
Keyword(s):  
Small Sample ◽  
Post Injection ◽  
Control Groups ◽  
Treatment Groups ◽  
Adrenocortical Activity ◽  
Non Invasive ◽  
Endocrine Status ◽  
Corticosterone Metabolites ◽  
Small Sample Sizes ◽  
Fecal Corticosterone Metabolites

The study of the endocrine status can be useful to understand wildlife responses to the changing environment. Here, we validated an enzyme immunoassay (EIA) to non-invasively monitor adrenocortical activity by measuring fecal corticosterone metabolites (FCM) in three sympatric gerbil species (Gerbillus andersoni, G. gerbillus and G. pyramidum) from the Northwestern Negev Desert’s sands (Israel). Animals included into treatment groups were injected with adrenocorticotropic hormone (ACTH) to stimulate adrenocortical activity, while control groups received a saline solution. Feces were collected at different intervals and FCM were quantified by an EIA. Basal FCM levels were similar in the three species. The ACTH effect was evidenced, but the time of FCM peak concentrations appearance differed between the species (6–24 h post-injection). Furthermore, FCM peak values were observed sooner in G. andersoni females than in males (6 h and 18 h post-injection, respectively). G. andersoni and G. gerbillus males in control groups also increased FCM levels (18 h and 48 h post-injection, respectively). Despite the small sample sizes, our results confirmed the EIA suitability for analyzing FCM in these species as a reliable indicator of the adrenocortical activity. This study also revealed that close species, and individuals within a species, can respond differently to the same stressor.

scholarly journals Use of Antiplatelet Agents Decreases the Positive Predictive Value of Fecal Immunochemical Tests for Colorectal Cancer but Does Not Affect Their Sensitivity

2021 ◽  
Vol 11 (6) ◽  
pp. 497
Author(s):  
Yoonsuk Jung ◽  
Eui Im ◽  
Jinhee Lee ◽  
Hyeah Lee ◽  
Changmo Moon
Keyword(s):  
Colorectal Cancer ◽  
Large Scale ◽  
Screening Program ◽  
Antiplatelet Agents ◽  
Population Based ◽  
Small Sample ◽  
Antithrombotic Agents ◽  
Predictive Values ◽  
Prescription Rates ◽  
Small Sample Sizes

Previous studies have evaluated the effects of antithrombotic agents on the performance of fecal immunochemical tests (FITs) for the detection of colorectal cancer (CRC), but the results were inconsistent and based on small sample sizes. We studied this topic using a large-scale population-based database. Using the Korean National Cancer Screening Program Database, we compared the performance of FITs for CRC detection between users and non-users of antiplatelet agents and warfarin. Non-users were matched according to age and sex. Among 5,426,469 eligible participants, 768,733 used antiplatelet agents (mono/dual/triple therapy, n = 701,683/63,211/3839), and 19,569 used warfarin, while 4,638,167 were non-users. Among antiplatelet agents, aspirin, clopidogrel, and cilostazol ranked first, second, and third, respectively, in terms of prescription rates. Users of antiplatelet agents (3.62% vs. 4.45%; relative risk (RR): 0.83; 95% confidence interval (CI): 0.78–0.88), aspirin (3.66% vs. 4.13%; RR: 0.90; 95% CI: 0.83–0.97), and clopidogrel (3.48% vs. 4.88%; RR: 0.72; 95% CI: 0.61–0.86) had lower positive predictive values (PPVs) for CRC detection than non-users. However, there were no significant differences in PPV between cilostazol vs. non-users and warfarin users vs. non-users. For PPV, the RR (users vs. non-users) for antiplatelet monotherapy was 0.86, while the RRs for dual and triple antiplatelet therapies (excluding cilostazol) were 0.67 and 0.22, respectively. For all antithrombotic agents, the sensitivity for CRC detection was not different between users and non-users. Use of antiplatelet agents, except cilostazol, may increase the false positives without improving the sensitivity of FITs for CRC detection.

scholarly journals Perioperative digital behaviour change interventions for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation: a scoping review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Katarina Åsberg ◽  
Marcus Bendtsen
Keyword(s):  
Physical Activity ◽  
Smoking Cessation ◽  
Behaviour Change ◽  
Scoping Review ◽  
Text Messaging ◽  
Text Message ◽  
Feasibility Studies ◽  
Small Sample ◽  
Small Sample Sizes ◽  
Randomised Controlled

Abstract Background Evidence suggests that unhealthy lifestyle behaviours are modifiable risk factors for postoperative complications. Digital behaviour change interventions (DBCIs), for instance text messaging programs and smartphone apps, have shown promise in achieving lifestyle behaviour change in a wide range of clinical populations, and it may therefore be possible to reduce postoperative complications by supporting behaviour change perioperatively using digital interventions. This scoping review was conducted in order to identify existing research done in the area of perioperative DBCIs for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation. Main text This scoping review included eleven studies covering a range of surgeries: bariatric, orthopaedic, cancer, transplantation and elective surgery. The studies were both randomised controlled trials and feasibility studies and investigated a diverse set of interventions: one game, three smartphone apps, one web-based program and five text message interventions. Feasibility studies reported user acceptability and satisfaction with the behaviour change support. Engagement data showed participation rates ranged from 40 to 90%, with more participants being actively engaged early in the intervention period. In conclusion, the only full-scale randomised controlled trial (RCT), text messaging ahead of bariatric surgery did not reveal any benefits with respect to adherence to preoperative exercise advice when compared to a control group. Two of the pilot studies, one text message intervention, one game, indicated change in a positive direction with respect to alcohol and tobacco outcomes, but between group comparisons were not done due to small sample sizes. The third pilot-study, a smartphone app, found between group changes for physical activity and alcohol, but not with respect to smoking cessation outcomes. Conclusion This review found high participant satisfaction, but shows recruitment and timing-delivery issues, as well as low retention to interventions post-surgery. Small sample sizes and the use of a variety of feasibility outcome measures prevent the synthesis of results and makes generalisation difficult. Future research should focus on defining standardised outcome measures, enhancing patient engagement and improving adherence to behaviour change prior to scheduled surgery.

scholarly journals Candida infective endocarditis: A retrospective study of patient characteristics and risk factors for death in 703 U.S. cases, 2015-2019

2020 ◽  
Author(s):  
Jonathan P Huggins ◽  
Samuel Hohmann ◽  
Michael Z David
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Liver Failure ◽  
Patient Characteristics ◽  
Medication Administration ◽  
Small Sample ◽  
Risk Of Death ◽  
Opiate Abuse ◽  
Small Sample Sizes ◽  
Valve Pathology

Abstract Background Candida endocarditis is a rare, sometimes fatal complication of candidemia. Past investigations of this condition are limited by small sample sizes. We used the Vizient clinical database to report on characteristics of patients with Candida endocarditis and to examine risk factors for in-hospital mortality. Methods This was a multicenter, retrospective cohort study of 703 inpatients admitted to 179 United States hospitals between October 2015 and April 2019. We reviewed demographic, diagnostic, medication administration, and procedural data from each patient’s initial encounter. Univariate and multivariate logistic regression analyses were used to identify predictors of in-hospital mortality. Results Of 703 patients, 114 (16.2%) died during the index encounter. One hundred and fifty-eight (22.5%) underwent an intervention on a cardiac valve. On multivariate analysis, acute and subacute liver failure was the strongest predictor of death (OR 9.2, 95% CI 4.8 –17.7). Female sex (OR 1.9, 95% CI 1.2 – 3.0), transfer from an outside medical facility (OR 1.8, 95% CI 1.1 – 2.8), aortic valve pathology (OR 2.7, 95% CI 1.5 – 4.9), hemodialysis (OR 2.1, 95% CI 1.1 – 4.0), cerebrovascular disease (OR 2.2, 95% CI 1.2 – 3.8), neutropenia (OR 2.5, 95% CI 1.3 – 4.8), and alcohol abuse (OR 2.9, 95% CI 1.3 – 6.7) were also associated with death on adjusted analysis, whereas opiate abuse was associated with a lower odds of death (OR 0.5, 95% CI 0.2 – 0.9). Conclusions We found that the inpatient mortality rate was 16.2% among patients with Candida endocarditis. Acute and subacute liver failure was associated with a high risk of death while opiate abuse was associated with a lower risk of death.

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