Closed testing procedure for multiplicity control. An application on oxidative stress parameters in Hashimoto's Thyroiditis

Closed Testing procedures represent an effective solution to the need to make inferences on multiple aspects at the same time, controlling the Familywise Error Rate (FWER), that is the error rate of the hierarchical family. Closed Testing procedures have a high degree of adaptability to a wide range of experimental situations, both in parametric than in non-parametric ambit. The attention is focused on the  Bonferroni-Holm method, frequently used to counteract the problem of multiple comparisons. The present paper aims to show an original application of the Closed Testing procedures for multiplicity control in medical research, with reference to the oxidative stress; in particular the Min-P Bonferrroni-Holm method was applied to the p-value adjustment, related to three parameters (BAP, D-ROMS, AGEs) of oxidative stress in Hashimoto’s thyroidytis

Psychological stress in nurses assisting Amyotrophic Lateral Sclerosis patients: a statistical analysis based on Non-Parametric Combination test

We aimed to evaluate the psychological, emotional and relational burden of nurses who provide assistance to patients affected by Amyotrophic Lateral Sclerosis (ALS). A survey was conducted by administering a questionnaire, the “Health Professions Stress and Coping Scale”, which proposes some potentially stressful work situations. The questionnaire was administered to 105 nurses working in hospitals where there is a ward for patients suffering from ALS. We used the "Non-Parametric Combination Test", a multivariate methodology based on permutation solution, widely applicable in various research contexts. Firstly, we investigated the areas of stress; then, the attention was focused on the different coping strategies adopted by respondent nurses within each stress area. The analyses were stratified according to different confounding factors, in order to control their potential effect. The results show the presence of an average level of stress, regardless of gender and educational status. Furthermore, there are significant differences in stress levels in subjects classified according to the ward in which they operate and a positive correlation between higher stress levels and the number of service years was found. In the future this study could also be of interest to nurses working in wards with potentially stressful situations

Vulnerability and physical well-being of caregivers: what relationship?

Objectives. To assess relationships among burden, compassion, and well-being and health among an active group of caregivers. Methods. 301 caregivers with female prevalence (F = 61.1%, M = 38.9%) and ages between 18 and 84 years old (average = 38.72; SD 13.36) participated. Evaluation was carried using standardized instruments to assess: Burdens (CBI), dimensions related to Compassion and Burnout (ProQOL-5), State of Well-being (Who-5) and particular health-related domains (Emotional state, Physical health, Depressive Polarity, Dysphoric Polarity-SF-36). Correlational analyses and multivariate linear regressions were performed. Results. Positive correlations emerged between Burdens and Compassion Fatigue, Well-being and Satisfaction; inverse correlations emerged among Well-being and Burnout, Compassion Satisfaction and Emotional State, with the exception of Time Dependence. Multivariate linear regression indicated relations among Compassion Fatigue with Depression and Social Burden, Compassion Satisfaction with Depressive Polarity and Dysphoria and Burnout with Social Burden. Conclusions. Caregivers’ work presents various risks, with negative outcomes that need to be addressed for this group of professionals. These risks present a professional and human development opportunity

Personality and phobias in adolescence: age and gender in psychopathological expressions

Background: Although the understanding of adolescent phobias is important, this phenomenon has thus far not been adequately researched. This report, based on clinical experience, highlights prevalent phobic phenomena linked to personality characteristics. Methods: A sample of 241 adolescents from High School and the University of Messina, Italy was evaluated for phobic responses using the SAFA Scales. Personality types and aspects were assessed by the Myers-Briggs Type Indicator F Form. Results: The results were consistent with the reported literature and revealed that psychopathological phenomena such as anxiety, obsession, eating disorders and phobias decreased with aging; however, depression remained constant over time. Significant differences emerged regarding gender, with the presence of higher scores on all scales except obsession for the female group. Personality analysis revealed aspects linked to the relations between psychopathological variables, introversion/ extraversion (such as polar dimensions), and rational/ irrational functions. Conclusion: This research indicates that phobic phenomena may be underestimated in adolescents and links personality types and symptoms with phobic phenomena, indicating the potential need for interventions in adolescents

egg consumption among young people a study through the application of the logistic regression model

The purpose of the present survey is to study and to investigate the proper eating style, focusing the attention on the propensity to "egg" consumption, in the diet of young people, with reference to the students attending the University of Messina. The data collection technique that was used consisted of the administration of a distributed anonymous ad hoc questionnaire by directly interviewing a sample of university students. In order to individualize the possible variables which may influence the frequency of egg consumption, a logistic regression model was used. It is a particular case of generalized linear model whose link function is the log it function. It is frequently applied when the dependent variable y is, dichotomous. The research results indicate that the only two statistically significant variables are the eating style and the reading of the product label. Moreover, the Hosmer and Leme show test for model's adequacy guaranteed that the estimates provided by the model are not significantly different from the observations

Improving health performances: To what extent patient satisfaction may influence quality?

Patient satisfaction constitutes an objective to achieve in the provision of qualitatively adequate health services; it relies on patient involvement, that is obtained through surveys aimed at letting patient to express their opinion on the health care received. Patients may provide the best source of accurate information, primarily on issues such as clarity of explanations given by physicians or barriers to care, accessibility and cleanliness of health structures. This analysis summarises the experience of a sample of patient interviewed at the University Polyclinic in Messina (Sicily, Italy) and provides a detailed assessment of the satisfaction of patients who experienced health services at different Departments. Information collected through a specific survey is used to build a dataset with more than 350 observations. Regressors are carefully selected and compared through a radar chart. A rigorous empirical methodology, based on the estimation of a logistic model, is then applied. Results outlines how factors relevant for patient satisfaction are related both to the ambulatory where the health care is provided and its characteristics, together with the judgement about the quality of care received by physicians and nurses. Other crucial factors in determining a higher satisfaction were the availability of parking lots, the cleaning of structures and the judgment on physicians, the latter endorsing the high probability of being highly satisfied when expectations on physicians’ competences and professionalism are confirmed. The “Contact details”, i.e. the indications of the people to contact in case of need, strengthen the overall positive experience of patients. This study enriches the existing literature on patient satisfaction and is aimed at rethinking the organization of the health assistance offered at University Polyclinics, with the primary objective to guarantee the highest patient satisfaction

analysis of the propensity to fruit consumption among young people through the cumulative proportional odds model

After in-depth studies, the World Health Organization (WHO), asserts and suggests that in order to improve human health and well-being it is necessary to eat 400 grams of fruit and vegetables on a daily basis, as well as to consume potatoes and other starchy tubers such as manioc. In Europe, recommendations vary from country to country. Generally, these suggestions are in line with those of the WHO. However, some countries recommend a greater amount: For example, Denmark suggests more than 600 grams each day. The main goal of the present work is to analyse the fruit-consumption behaviour among young people, particularly university students and to identify the target of young people who frequently consume fruit. The present survey, therefore, has the aim of establishing a scientific reference framework regarding the propensity to "fruit" consumption in the diet of the students attending the University of Messina. In order to identify the existence of possible variables that may influence the frequency of fruit consumption, it was deemed appropriate to estimate an adequate regression model. Since the response variable was one of ordinal type on 4 levels (0 = never; 1 = once or twice a week; 2 = 3-5 times a week; 3 = each day) the Cumulative Proportional Odds Model, an extension of the general linear model to ordinal categorical data, was used

Serology of Viral Infections and Tuberculosis Screening in an IBD Population Referred to a Tertiary Centre of Southern Italy

Background. With the introduction of more potent immunosuppressive agents in inflammatory bowel disease, prevention of opportunistic infections has become necessary by introducing screening programs. Prevalence of the most important infectious agents may vary in different geographical areas. The aim of our study was to assess the immune status for hepatitis B, varicella, mononucleosis, and cytomegalovirus infection together with the determination of the hepatitis C and tuberculosis status in Southern Italy. Methods. Prevalence of latent tuberculosis, together with serology of hepatitis B and C, Epstein-Barr virus, varicella zoster, and cytomegalovirus were collected by analysing retrospectively the clinical charts of IBD patients. Data were integrated with demographic and clinical features. Results. Data from 509 IBD patients divided in two age groups showed a prevalence of HBV infection in nonvaccinated patients of 9%. Seroprotection (HBsAb) in vaccinated IBD patients was lower (p 37 years of age. Conclusions. In younger patients, high susceptibility rates for primary herpesvirus infections should determine the choice of treatment. Loss of HBV seroprotection in already vaccinated patients should be considered for booster vaccination programs

Promjene intraokularnog tlaka i sistemskog krvnog tlaka u pasa za vrijeme vježbe umjerenog intenziteta na pokretnoj traci - kratki prikaz

Physical exercise in humans induces changes in intraocular pressure, relating to the type and intensity of the workload. The purpose of the present study was to evaluate the variations in intraocular pressure and arterial blood pressure in dogs that underwent physical exercise on a treadmill. Thirty dogs were submitted to physical exercise consisting of walking (15 minutes), trotting (20 minutes), and walking (10 minutes). The intraocular pressure, blood pressure and pulse rate were recorded for each dog before starting the treadmill exercise, immediately after it ended, and after 20 minutes of passive recovery. Two-way repeated analysis of variance measurement showed the significant effect of treadmill exercise (P≤0.01) on intraocular pressure, pulse rate and diastolic blood pressure. No significant changes were observed to systolic blood pressure. Intraocular pressure and diastolic blood pressure decreased significantly during the passive recovery, and were strongly related. The pulse rate was significantly lower during the passive recovery. Although the mechanism determining the reduction in intraocular pressure during exercise remains not fully understood, our results suggest that it is strongly related to variations in arterial blood pressure.physical exercise; eye; ocular variable; arterial blood pressure; dogTjelesna vježba u ljudi uzrokuje promjene u intraokularnom tlaku, ovisno o vrsti i intenzitetu opterećenja. cilj ovog istraživanja bio je procijeniti varijacije intraokularnog tlaka i arterijski krvni tlak u pasa podvrgnutih tjelesnoj aktivnosti na pokretnoj traci. Trideset pasa izloženo je tjelesnoj aktivnosti koja se sastojala od hodanja (15 minuta), trčanja u formi kasa (20 minuta) i hodanja (10 minuta). Za svakog su psa zabilježeni intraokularni tlak, krvni tlak i srčani puls prije početka aktivnosti, odmah nakon završetka aktivnosti i 20 minuta nakon oporavka. Dvosmjerna analiza varijance za ponovljena mjerenja pokazala je znakovit učinak vježbe na pokretnoj traci (P ≤ 0,01) na intraokularni tlak, srčani puls i dijastolički krvni tlak. Nije bilo znakovitih promjena u sistoličkom krvnom tlaku. Intraokularni tlak i dijastolički krvni tlak znakovito su se smanjili za vrijeme oporavka i bili u znatnoj korelaciji. Srčani puls bio je znakovito niži za vrijeme oporavka. Iako mehanizam koji utječe na smanjenje intraokularnog tlaka nije sasvim jasan, rezultati pokazuju da je on u čvrstoj vezi s promjenama arterijskog krvnog tlaka