Think twice before you book? Modelling the choice of public vs private dentist in a choice experiment.

PubMed

Kiiskinen, Urpo; Suominen-Taipale, Anna Liisa; Cairns, John

2010-06-01

This study concerns the choice of primary dental service provider by consumers. If the health service delivery system allows individuals to choose between public-care providers or if complementary private services are available, it is typically assumed that utilisation is a three-stage decision process. The patient first makes a decision to seek care, and then chooses the service provider. The final stage, involving decisions over the amount and form of treatment, is not considered here. The paper reports a discrete choice experiment (DCE) designed to evaluate attributes affecting individuals' choice of dental-care provider. The feasibility of the DCE approach in modelling consumers' choice in the context of non-acute need for dental care is assessed. The aim is to test whether a separate two-stage logit, a multinomial logit, or a nested logit best fits the choice process of consumers. A nested logit model of indirect utility functions is estimated and inclusive value (IV) constraints are tested for modelling implications. The results show that non-trading behaviour has an impact on the choice of appropriate modelling technique, but is to some extent dependent on the choice of scenarios offered. It is concluded that for traders multinomial logit is appropriate, whereas for non-traders and on average the nested logit is the method supported by the analyses. The consistent finding in all subgroup analyses is that the traditional two-stage decision process is found to be implausible in the context of consumer's choice of dental-care provider.

Patient choice modelling: how do patients choose their hospitals?

PubMed

Smith, Honora; Currie, Christine; Chaiwuttisak, Pornpimol; Kyprianou, Andreas

2018-06-01

As an aid to predicting future hospital admissions, we compare use of the Multinomial Logit and the Utility Maximising Nested Logit models to describe how patients choose their hospitals. The models are fitted to real data from Derbyshire, United Kingdom, which lists the postcodes of more than 200,000 admissions to six different local hospitals. Both elective and emergency admissions are analysed for this mixed urban/rural area. For characteristics that may affect a patient's choice of hospital, we consider the distance of the patient from the hospital, the number of beds at the hospital and the number of car parking spaces available at the hospital, as well as several statistics publicly available on National Health Service (NHS) websites: an average waiting time, the patient survey score for ward cleanliness, the patient safety score and the inpatient survey score for overall care. The Multinomial Logit model is successfully fitted to the data. Results obtained with the Utility Maximising Nested Logit model show that nesting according to city or town may be invalid for these data; in other words, the choice of hospital does not appear to be preceded by choice of city. In all of the analysis carried out, distance appears to be one of the main influences on a patient's choice of hospital rather than statistics available on the Internet.

A practical method to test the validity of the standard Gumbel distribution in logit-based multinomial choice models of travel behavior

DOE PAGES

Ye, Xin; Garikapati, Venu M.; You, Daehyun; ...

2017-11-08

Most multinomial choice models (e.g., the multinomial logit model) adopted in practice assume an extreme-value Gumbel distribution for the random components (error terms) of utility functions. This distributional assumption offers a closed-form likelihood expression when the utility maximization principle is applied to model choice behaviors. As a result, model coefficients can be easily estimated using the standard maximum likelihood estimation method. However, maximum likelihood estimators are consistent and efficient only if distributional assumptions on the random error terms are valid. It is therefore critical to test the validity of underlying distributional assumptions on the error terms that form the basismore » of parameter estimation and policy evaluation. In this paper, a practical yet statistically rigorous method is proposed to test the validity of the distributional assumption on the random components of utility functions in both the multinomial logit (MNL) model and multiple discrete-continuous extreme value (MDCEV) model. Based on a semi-nonparametric approach, a closed-form likelihood function that nests the MNL or MDCEV model being tested is derived. The proposed method allows traditional likelihood ratio tests to be used to test violations of the standard Gumbel distribution assumption. Simulation experiments are conducted to demonstrate that the proposed test yields acceptable Type-I and Type-II error probabilities at commonly available sample sizes. The test is then applied to three real-world discrete and discrete-continuous choice models. For all three models, the proposed test rejects the validity of the standard Gumbel distribution in most utility functions, calling for the development of robust choice models that overcome adverse effects of violations of distributional assumptions on the error terms in random utility functions.« less

A practical method to test the validity of the standard Gumbel distribution in logit-based multinomial choice models of travel behavior

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ye, Xin; Garikapati, Venu M.; You, Daehyun

Most multinomial choice models (e.g., the multinomial logit model) adopted in practice assume an extreme-value Gumbel distribution for the random components (error terms) of utility functions. This distributional assumption offers a closed-form likelihood expression when the utility maximization principle is applied to model choice behaviors. As a result, model coefficients can be easily estimated using the standard maximum likelihood estimation method. However, maximum likelihood estimators are consistent and efficient only if distributional assumptions on the random error terms are valid. It is therefore critical to test the validity of underlying distributional assumptions on the error terms that form the basismore » of parameter estimation and policy evaluation. In this paper, a practical yet statistically rigorous method is proposed to test the validity of the distributional assumption on the random components of utility functions in both the multinomial logit (MNL) model and multiple discrete-continuous extreme value (MDCEV) model. Based on a semi-nonparametric approach, a closed-form likelihood function that nests the MNL or MDCEV model being tested is derived. The proposed method allows traditional likelihood ratio tests to be used to test violations of the standard Gumbel distribution assumption. Simulation experiments are conducted to demonstrate that the proposed test yields acceptable Type-I and Type-II error probabilities at commonly available sample sizes. The test is then applied to three real-world discrete and discrete-continuous choice models. For all three models, the proposed test rejects the validity of the standard Gumbel distribution in most utility functions, calling for the development of robust choice models that overcome adverse effects of violations of distributional assumptions on the error terms in random utility functions.« less

Modeling pedestrian shopping behavior using principles of bounded rationality: model comparison and validation

NASA Astrophysics Data System (ADS)

Zhu, Wei; Timmermans, Harry

2011-06-01

Models of geographical choice behavior have been dominantly based on rational choice models, which assume that decision makers are utility-maximizers. Rational choice models may be less appropriate as behavioral models when modeling decisions in complex environments in which decision makers may simplify the decision problem using heuristics. Pedestrian behavior in shopping streets is an example. We therefore propose a modeling framework for pedestrian shopping behavior incorporating principles of bounded rationality. We extend three classical heuristic rules (conjunctive, disjunctive and lexicographic rule) by introducing threshold heterogeneity. The proposed models are implemented using data on pedestrian behavior in Wang Fujing Street, the city center of Beijing, China. The models are estimated and compared with multinomial logit models and mixed logit models. Results show that the heuristic models are the best for all the decisions that are modeled. Validation tests are carried out through multi-agent simulation by comparing simulated spatio-temporal agent behavior with the observed pedestrian behavior. The predictions of heuristic models are slightly better than those of the multinomial logit models.

A multilevel model for comorbid outcomes: obesity and diabetes in the US.

PubMed

Congdon, Peter

2010-02-01

Multilevel models are overwhelmingly applied to single health outcomes, but when two or more health conditions are closely related, it is important that contextual variation in their joint prevalence (e.g., variations over different geographic settings) is considered. A multinomial multilevel logit regression approach for analysing joint prevalence is proposed here that includes subject level risk factors (e.g., age, race, education) while also taking account of geographic context. Data from a US population health survey (the 2007 Behavioral Risk Factor Surveillance System or BRFSS) are used to illustrate the method, with a six category multinomial outcome defined by diabetic status and weight category (obese, overweight, normal). The influence of geographic context is partly represented by known geographic variables (e.g., county poverty), and partly by a model for latent area influences. In particular, a shared latent variable (common factor) approach is proposed to measure the impact of unobserved area influences on joint weight and diabetes status, with the latent variable being spatially structured to reflect geographic clustering in risk.

Associations of financial stressors and physical intimate partner violence perpetration.

PubMed

Schwab-Reese, Laura M; Peek-Asa, Corinne; Parker, Edith

2016-12-01

Contextual factors, such as exposure to stressors, may be antecedents to IPV perpetration. These contextual factors may be amenable to modification through intervention and prevention. However, few studies have examined specific contextual factors. To begin to address this gap, we examined the associations between financial stressors and three types of physical IPV perpetration. This analysis used data from Wave IV of The National Longitudinal Study of Adolescent to Adult Health. We used logistic regression to examine the associations of financial stressors and each type of IPV (minor, severe, causing injury), and multinomial logit regression to examine the associations of financial stressors and patterns of co-occurring types of IPV perpetration (only minor; only severe; minor and severe; minor, severe, and causing injury; compared with no perpetration). Fewer men perpetrated threats/minor physical IPV (6.7 %) or severe physical IPV (3.4 %) compared with women (11.4 % and 8.8 %, respectively). However, among physical IPV perpetrators, a higher percentage of men (32.0 %) than women (21.0 %) reported their partner was injured as a result of the IPV. In logistic regression models of each type of IPV perpetration, both the number of stressors experienced and several types of financial stressors were associated with perpetrating each type of IPV. Utilities nonpayment, housing nonpayment, food insecurity, and no phone service were associated with increased odds of perpetrating each form of IPV in adjusted analysis. Eviction was associated with perpetrating severe physical IPV but not threats/minor IPV or IPV causing injury. In multinomial logit regression comparing patterns of IPV perpetration to perpetrating no physical IPV, the relationships of financial stressors were less consistent. Food insecurity was associated with perpetrating only minor physical IPV. Comparatively, overall number of financial stressors and four types of financial stressors (utilities nonpayment, housing nonpayment, food insecurity, and disconnected phone service) were associated with perpetrating all three forms of physical IPV. Combined with prior research, our results suggested interventions to improve financial well-being may be a novel way to reduce physical IPV perpetration.

Associations of financial stressors and physical intimate partner violence perpetration.

PubMed

Schwab-Reese, Laura M; Peek-Asa, Corinne; Parker, Edith

Contextual factors, such as exposure to stressors, may be antecedents to IPV perpetration. These contextual factors may be amenable to modification through intervention and prevention. However, few studies have examined specific contextual factors. To begin to address this gap, we examined the associations between financial stressors and three types of physical IPV perpetration. This analysis used data from Wave IV of The National Longitudinal Study of Adolescent to Adult Health. We used logistic regression to examine the associations of financial stressors and each type of IPV (minor, severe, causing injury), and multinomial logit regression to examine the associations of financial stressors and patterns of co-occurring types of IPV perpetration ( only minor; only severe; minor and severe; minor, severe, and causing injury; compared with no perpetration). Fewer men perpetrated threats/minor physical IPV (6.7 %) or severe physical IPV (3.4 %) compared with women (11.4 % and 8.8 %, respectively). However, among physical IPV perpetrators, a higher percentage of men (32.0 %) than women (21.0 %) reported their partner was injured as a result of the IPV. In logistic regression models of each type of IPV perpetration, both the number of stressors experienced and several types of financial stressors were associated with perpetrating each type of IPV. Utilities nonpayment, housing nonpayment, food insecurity, and no phone service were associated with increased odds of perpetrating each form of IPV in adjusted analysis. Eviction was associated with perpetrating severe physical IPV but not threats/minor IPV or IPV causing injury. In multinomial logit regression comparing patterns of IPV perpetration to perpetrating no physical IPV, the relationships of financial stressors were less consistent. Food insecurity was associated with perpetrating only minor physical IPV. Comparatively, overall number of financial stressors and four types of financial stressors (utilities nonpayment, housing nonpayment, food insecurity, and disconnected phone service) were associated with perpetrating all three forms of physical IPV. Combined with prior research, our results suggested interventions to improve financial well-being may be a novel way to reduce physical IPV perpetration.

Drivers of multidimensional eco-innovation: empirical evidence from the Brazilian industry.

PubMed

da Silva Rabêlo, Olivan; de Azevedo Melo, Andrea Sales Soares

2018-03-08

The study analyses the relationships between the main drivers of eco-innovation introduced by innovative industries, focused on cooperation strategy. Eco-innovation is analysed by means of a multidimensional identification strategy, showing the relationships between the independent variables and the variable of interest. The literature discussing environmental innovation is different from the one discussing other types of innovation inasmuch as it seeks to grasp its determinants and to mostly highlight the relevance of environmental regulation. The key feature of this paper is that it ascribes special relevance to cooperation strategy with external partners and to the propensity of innovative industry introducing eco-innovation. A sample of 35,060 Brazilian industries were analysed, between 2003 and 2011, by means of Binomial, Multinomial and Ordinal logistic regressions with microdata collected with the research and innovation department (PINTEC) from the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística). The econometric results estimated by the Logit Multinomial method suggest that the cooperation with external partners practiced by innovative industries facilitates the adoption of eco-innovation in dimension 01 with probability of 64.59%, 57.63% in dimension 02 and 81.02% in dimension 03. The data reveal that the higher the degree of eco-innovation complexity, the harder industries seek to obtain cooperation with external partners. When calculating with the Logit Ordinal and Binomial models, cooperation increases the probability that the industry is eco-innovative in 65.09% and 89.34%, respectively. Environmental regulation and innovation in product and information management were also positively correlated as drivers of eco-innovation.

Assessment of Malawian Mothers’ Malaria Knowledge, Healthcare Preferences and Timeliness of Seeking Fever Treatments for Children Under Five

PubMed Central

Oyekale, Abayomi Samuel

2015-01-01

Malaria is one of the major public health problems in Malawi, contributing to the majority of morbidity and mortality among children under five. Ignorance of malaria symptoms results in delayed treatment, which often degenerates into fatal emergencies. This study analyzed the impact of maternal malaria knowledge on healthcare preferences and timeliness of treating children with reported fever. The Malaria Indicator Survey data for 2012, which were adequately weighted, were analyzed using multinomial logit and Poisson regression models. The results showed low maternal average years of formal education (3.52) and average mothers’ age was 27.97 years. Majority of the women (84.98%) associated fever with malaria, while 44.17% associated it with chilling. Also, 54.42% and 32.43% of the children were treated for fever on the same day and the following day that fever started, respectively. About 9.70% paid for fever treatment from their regular incomes, while 51.38% sought treatment from either public or private health centers. Multinomial Logit regression results showed that relative to using of other treatments, probabilities of selecting private hospitals and public health centers increased with age of the household heads, resident in urban areas, mothers’ years of education, number of days taken off for treatment, paying medical bills from regular, occasional and borrowed incomes, and knowledge of diarrhea and shivering as symptoms of malaria. In the Poisson regression results, timeliness of seeking treatment was significantly enhanced by knowledge of fever as malaria symptom, residence in northern and central regions of Malawi and use of income from sale of assets to pay medical bills (p < 0.10).However, delays in treating children was motivated by age of the household heads, number of days taken off to care for sick child and usage of regular, borrowed and other incomes to pay medical bills. (p < 0.05). It was concluded that efficiency of public sector in treating malaria holds significant prospects for fighting malaria in Malawi. However, adequate efforts should be channeled in enhancing the knowledge of women on malaria symptoms, among others. PMID:25584420

Assessment of Malawian mothers' malaria knowledge, healthcare preferences and timeliness of seeking fever treatments for children under five.

PubMed

Oyekale, Abayomi Samuel

2015-01-09

Malaria is one of the major public health problems in Malawi, contributing to the majority of morbidity and mortality among children under five. Ignorance of malaria symptoms results in delayed treatment, which often degenerates into fatal emergencies. This study analyzed the impact of maternal malaria knowledge on healthcare preferences and timeliness of treating children with reported fever. The Malaria Indicator Survey data for 2012, which were adequately weighted, were analyzed using multinomial logit and Poisson regression models. The results showed low maternal average years of formal education (3.52) and average mothers' age was 27.97 years. Majority of the women (84.98%) associated fever with malaria, while 44.17% associated it with chilling. Also, 54.42% and 32.43% of the children were treated for fever on the same day and the following day that fever started, respectively. About 9.70% paid for fever treatment from their regular incomes, while 51.38% sought treatment from either public or private health centers. Multinomial Logit regression results showed that relative to using of other treatments, probabilities of selecting private hospitals and public health centers increased with age of the household heads, resident in urban areas, mothers' years of education, number of days taken off for treatment, paying medical bills from regular, occasional and borrowed incomes, and knowledge of diarrhea and shivering as symptoms of malaria. In the Poisson regression results, timeliness of seeking treatment was significantly enhanced by knowledge of fever as malaria symptom, residence in northern and central regions of Malawi and use of income from sale of assets to pay medical bills (p < 0.10).However, delays in treating children was motivated by age of the household heads, number of days taken off to care for sick child and usage of regular, borrowed and other incomes to pay medical bills. (p < 0.05). It was concluded that efficiency of public sector in treating malaria holds significant prospects for fighting malaria in Malawi. However, adequate efforts should be channeled in enhancing the knowledge of women on malaria symptoms, among others.

A Multilevel Model for Comorbid Outcomes: Obesity and Diabetes in the US

PubMed Central

Congdon, Peter

2010-01-01

Multilevel models are overwhelmingly applied to single health outcomes, but when two or more health conditions are closely related, it is important that contextual variation in their joint prevalence (e.g., variations over different geographic settings) is considered. A multinomial multilevel logit regression approach for analysing joint prevalence is proposed here that includes subject level risk factors (e.g., age, race, education) while also taking account of geographic context. Data from a US population health survey (the 2007 Behavioral Risk Factor Surveillance System or BRFSS) are used to illustrate the method, with a six category multinomial outcome defined by diabetic status and weight category (obese, overweight, normal). The influence of geographic context is partly represented by known geographic variables (e.g., county poverty), and partly by a model for latent area influences. In particular, a shared latent variable (common factor) approach is proposed to measure the impact of unobserved area influences on joint weight and diabetes status, with the latent variable being spatially structured to reflect geographic clustering in risk. PMID:20616977

Compensation of hospital-based physicians.

PubMed Central

Steinwald, B

1983-01-01

This study is concerned with methods of compensating hospital-based physicians (HBPs) in five medical specialties: anesthesiology, pathology, radiology, cardiology, and emergency medicine. Data on 2232 nonfederal, short-term general hospitals came from a mail questionnaire survey conducted in Fall 1979. The data indicate that numerous compensation methods exist but these methods, without much loss of precision, can be reduced to salary, percentage of department revenue, and fee-for-service. When HBPs are compensated by salary or percentage methods, most patient billing is conducted by the hospital. In contrast, most fee-for-service HBPs bill their patients directly. Determinants of HBP compensation methods are investigated via multinomial logit analysis. This analysis indicates that choice of HBP compensation methods are investigated via multinomial logit analysis. This analysis indicates that choice of HBP compensation methods is sensitive to a number of hospital characteristics and attributes of both the hospital and physicians' services markets. The empirical findings are discussed in light of past conceptual and empirical research on physician compensation, and current policy issues in the health services sector. PMID:6841112

Choice-Based Segmentation as an Enrollment Management Tool

ERIC Educational Resources Information Center

Young, Mark R.

2002-01-01

This article presents an approach to enrollment management based on target marketing strategies developed from a choice-based segmentation methodology. Students are classified into "switchable" or "non-switchable" segments based on their probability of selecting specific majors. A modified multinomial logit choice model is used to identify…

The Mixed Effects Trend Vector Model

ERIC Educational Resources Information Center

de Rooij, Mark; Schouteden, Martijn

2012-01-01

Maximum likelihood estimation of mixed effect baseline category logit models for multinomial longitudinal data can be prohibitive due to the integral dimension of the random effects distribution. We propose to use multidimensional unfolding methodology to reduce the dimensionality of the problem. As a by-product, readily interpretable graphical…

A new strategy to analyze possible association structures between dynamic nocturnal hormone activities and sleep alterations in humans.

PubMed

Kalus, Stefanie; Kneib, Thomas; Steiger, Axel; Holsboer, Florian; Yassouridis, Alexander

2009-04-01

The human sleep process shows dynamic alterations during the night. Methods are needed to examine whether and to what extent such alterations are affected by internal, possibly time-dependent, factors, such as endocrine activity. In an observational study, we examined simultaneously sleep EEG and nocturnal levels of renin, growth hormone (GH), and cortisol (between 2300 and 0700) in 47 healthy volunteers comprising 24 women (41.67 +/- 2.93 yr of age) and 23 men (37.26 +/- 2.85 yr of age). Hormone concentrations were measured every 20 min. Conventional sleep stage scoring at 30-s intervals was applied. Semiparametric multinomial logit models are used to study and quantify possible time-dependent hormone effects on sleep stage transition courses. Results show that increased cortisol levels decrease the probability of transition from rapid-eye-movement (REM) sleep to wakefulness (WAKE) and increase the probability of transition from REM to non-REM (NREM) sleep, irrespective of the time in the night. Via the model selection criterion Akaike's information criterion, it was found that all considered hormone effects on transition probabilities with the initial state WAKE change with time. Similarly, transition from slow-wave sleep (SWS) to light sleep (LS) is affected by a "hormone-time" interaction for cortisol and renin, but not GH. For example, there is a considerable increase in the probability of SWS-LS transition toward the end of the night, when cortisol concentrations are very high. In summary, alterations in human sleep possess dynamic forms and are partially influenced by the endocrine activity of certain hormones. Statistical methods, such as semiparametric multinomial and time-dependent logit regression, can offer ambitious ways to investigate and estimate the association intensities between the nonstationary sleep changes and the time-dependent endocrine activities.

Weather impacts on single-vehicle truck crash injury severity.

PubMed

Naik, Bhaven; Tung, Li-Wei; Zhao, Shanshan; Khattak, Aemal J

2016-09-01

The focus of this paper is on illustrating the feasibility of aggregating data from disparate sources to investigate the relationship between single-vehicle truck crash injury severity and detailed weather conditions. Specifically, this paper presents: (a) a methodology that combines detailed 15-min weather station data with crash and roadway data, and (b) an empirical investigation of the effects of weather on crash-related injury severities of single-vehicle truck crashes. Random parameters ordinal and multinomial regression models were used to investigate crash injury severity under different weather conditions, taking into account the individual unobserved heterogeneity. The adopted methodology allowed consideration of environmental, roadway, and climate-related variables in single-vehicle truck crash injury severity. Results showed that wind speed, rain, humidity, and air temperature were linked with single-vehicle truck crash injury severity. Greater recorded wind speed added to the severity of injuries in single-vehicle truck crashes in general. Rain and warmer air temperatures were linked to more severe crash injuries in single-vehicle truck crashes while higher levels of humidity were linked to less severe injuries. Random parameters ordered logit and multinomial logit, respectively, revealed some individual heterogeneity in the data and showed that integrating comprehensive weather data with crash data provided useful insights into factors associated with single-vehicle truck crash injury severity. The research provided a practical method that combined comprehensive 15-min weather station data with crash and roadway data, thereby providing useful insights into crash injury severity of single-vehicle trucks. Those insights are useful for future truck driver educational programs and for truck safety in different weather conditions. Copyright © 2016 Elsevier Ltd and National Safety Council. All rights reserved.

Saving for Success: Financial Education and Savings Goal Achievement in Individual Development Accounts

ERIC Educational Resources Information Center

Grinstead, Mary L.; Mauldin, Teresa; Sabia, Joseph J.; Koonce, Joan; Palmer, Lance

2011-01-01

Using microdata from the American Dream Demonstration, the current study examines factors associated with savings and savings goal achievement (indicated by a matched withdrawal) among participants of individual development account (IDA) programs. Multinomial logit results show that hours of participation in financial education programs, higher…

Multidimensional Computerized Adaptive Testing for Indonesia Junior High School Biology

ERIC Educational Resources Information Center

Kuo, Bor-Chen; Daud, Muslem; Yang, Chih-Wei

2015-01-01

This paper describes a curriculum-based multidimensional computerized adaptive test that was developed for Indonesia junior high school Biology. In adherence to the Indonesian curriculum of different Biology dimensions, 300 items was constructed, and then tested to 2238 students. A multidimensional random coefficients multinomial logit model was…

A panel multinomial logit analysis of elderly living arrangements: evidence from Aging In Manitoba longitudinal data, Canada.

PubMed

Sarma, Sisira; Simpson, Wayne

2007-12-01

Utilizing a unique longitudinal survey linked with home care use data, this paper analyzes the determinants of elderly living arrangements in Manitoba, Canada using a random effects multinomial logit model that accounts for unobserved individual heterogeneity. Because current home ownership is potentially endogenous in a living arrangements choice model, we use prior home ownership as an instrument. We also use prior home care use as an instrument for home care and use a random coefficient framework to account for unobserved health status. After controlling for relevant socio-demographic factors and accounting for unobserved individual heterogeneity, we find that home care and home ownership reduce the probability of living in a nursing home. Consistent with previous studies, we find that age is a strong predictor of nursing home entry. We also find that married people, those who have lived longer in the same community, and those who are healthy are more likely to live independently and less likely to be institutionalized or to cohabit with individuals other than their spouse.

Using Multidimensional Rasch Analysis to Validate the Chinese Version of the Motivated Strategies for Learning Questionnaire (MSLQ-CV)

ERIC Educational Resources Information Center

Lee, John Chi-Kin; Zhang, Zhonghua; Yin, Hongbiao

2010-01-01

This article used the multidimensional random coefficients multinomial logit model to examine the construct validity and detect the substantial differential item functioning (DIF) of the Chinese version of motivated strategies for learning questionnaire (MSLQ-CV). A total of 1,354 Hong Kong junior high school students were administered the…

A Multinomial Logit Model of Attrition that Distinguishes between Stopout and Dropout Behavior

ERIC Educational Resources Information Center

Stratton, Leslie S.; O'Toole, Dennis M.; Wetzel, James N.

2004-01-01

College attrition rates are of substantial concern to policy makers and economists interested in educational attainment and earnings opportunities. This is not surprising since nationwide, almost one-third of all first-time college students fail to return for their sophomore year. There exists a substantial body of literature seeking to model this…

A Multinomial Logit Approach to Estimating Regional Inventories by Product Class

Treesearch

Lawrence Teeter; Xiaoping Zhou

1998-01-01

Current timber inventory projections generally lack information on inventory by product classes. Most models available for inventory projection and linked to supply analyses are limited to projecting aggregate softwood and hardwood. The objective of this research is to develop a methodology to distribute the volume on each FIA survey plot to product classes and...

How School Choice Is Framed by Parental Preferences and Family Characteristics: A Study of Western Area, Sierra Leone

ERIC Educational Resources Information Center

Dixon, Pauline; Humble, Steve

2017-01-01

This research set out to investigate how, in a post-conflict area, parental preferences and household characteristics affect school choice for their children. A multinomial logit is used to model the relationship between education preferences and the selection of schools for 954 households in Freetown and neighboring districts, Western Area,…

An econometric analysis of changes in arable land utilization using multinomial logit model in Pinggu district, Beijing, China.

PubMed

Xu, Yueqing; McNamara, Paul; Wu, Yanfang; Dong, Yue

2013-10-15

Arable land in China has been decreasing as a result of rapid population growth and economic development as well as urban expansion, especially in developed regions around cities where quality farmland quickly disappears. This paper analyzed changes in arable land utilization during 1993-2008 in the Pinggu district, Beijing, China, developed a multinomial logit (MNL) model to determine spatial driving factors influencing arable land-use change, and simulated arable land transition probabilities. Land-use maps, as well as social-economic and geographical data were used in the study. The results indicated that arable land decreased significantly between 1993 and 2008. Lost arable land shifted into orchard, forestland, settlement, and transportation land. Significant differences existed for arable land transitions among different landform areas. Slope, elevation, population density, urbanization rate, distance to settlements, and distance to roadways were strong drivers influencing arable land transition to other uses. The MNL model was proved effective for predicting transition probabilities in land use from arable land to other land-use types, thus can be used for scenario analysis to develop land-use policies and land-management measures in this metropolitan area. Copyright © 2013 Elsevier Ltd. All rights reserved.

Model-based Clustering of Categorical Time Series with Multinomial Logit Classification

NASA Astrophysics Data System (ADS)

Frühwirth-Schnatter, Sylvia; Pamminger, Christoph; Winter-Ebmer, Rudolf; Weber, Andrea

2010-09-01

A common problem in many areas of applied statistics is to identify groups of similar time series in a panel of time series. However, distance-based clustering methods cannot easily be extended to time series data, where an appropriate distance-measure is rather difficult to define, particularly for discrete-valued time series. Markov chain clustering, proposed by Pamminger and Frühwirth-Schnatter [6], is an approach for clustering discrete-valued time series obtained by observing a categorical variable with several states. This model-based clustering method is based on finite mixtures of first-order time-homogeneous Markov chain models. In order to further explain group membership we present an extension to the approach of Pamminger and Frühwirth-Schnatter [6] by formulating a probabilistic model for the latent group indicators within the Bayesian classification rule by using a multinomial logit model. The parameters are estimated for a fixed number of clusters within a Bayesian framework using an Markov chain Monte Carlo (MCMC) sampling scheme representing a (full) Gibbs-type sampler which involves only draws from standard distributions. Finally, an application to a panel of Austrian wage mobility data is presented which leads to an interesting segmentation of the Austrian labour market.

Performance of the likelihood ratio difference (G2 Diff) test for detecting unidimensionality in applications of the multidimensional Rasch model.

PubMed

Harrell-Williams, Leigh; Wolfe, Edward W

2014-01-01

Previous research has investigated the influence of sample size, model misspecification, test length, ability distribution offset, and generating model on the likelihood ratio difference test in applications of item response models. This study extended that research to the evaluation of dimensionality using the multidimensional random coefficients multinomial logit model (MRCMLM). Logistic regression analysis of simulated data reveal that sample size and test length have a large effect on the capacity of the LR difference test to correctly identify unidimensionality, with shorter tests and smaller sample sizes leading to smaller Type I error rates. Higher levels of simulated misfit resulted in fewer incorrect decisions than data with no or little misfit. However, Type I error rates indicate that the likelihood ratio difference test is not suitable under any of the simulated conditions for evaluating dimensionality in applications of the MRCMLM.

A Study of Commuters’ Decision-Making When Delaying Departure for Work-Home Trips

NASA Astrophysics Data System (ADS)

Que, Fangjie; Wang, Wei

2017-12-01

Studies on the travel behaviors and patterns of residents are important to the arrangement of urban layouts and urban traffic planning. However, research on the characteristics of the decision-making behavior regarding departure time is not fully expanded yet. In this paper, the research focuses on commuters’ decision-making behavior regarding departure delay. According to the 2013 travel survey data of Suzhou City, a nested logit (NL) model was built to represent the probabilities of individual choices. Parameter calibration was conducted, so that the significant factors influencing the departure delay were obtained. Ultimately, the results of the NL model indicated that it performed better and with higher precision, compared to the traditional multinomial logit (MNL) model.

Disentangling WTP per QALY data: different analytical approaches, different answers.

PubMed

Gyrd-Hansen, Dorte; Kjaer, Trine

2012-03-01

A large random sample of the Danish general population was asked to value health improvements by way of both the time trade-off elicitation technique and willingness-to-pay (WTP) using contingent valuation methods. The data demonstrate a high degree of heterogeneity across respondents in their relative valuations on the two scales. This has implications for data analysis. We show that the estimates of WTP per QALY are highly sensitive to the analytical strategy. For both open-ended and dichotomous choice data we demonstrate that choice of aggregated approach (ratios of means) or disaggregated approach (means of ratios) affects estimates markedly as does the interpretation of the constant term (which allows for disproportionality across the two scales) in the regression analyses. We propose that future research should focus on why some respondents are unwilling to trade on the time trade-off scale, on how to interpret the constant value in the regression analyses, and on how best to capture the heterogeneity in preference structures when applying mixed multinomial logit. Copyright © 2011 John Wiley & Sons, Ltd.

Levels and patterns of physical activity and sedentary time among superdiverse adolescents in East London: a cross-sectional study.

PubMed

Curry, Whitney B; Dagkas, Symeon; Wilson, Marcia

2017-06-01

Little is known about the physical activity (PA) and sedentary time (ST) habits of adolescents from superdiverse communities in the UK. The objectives of this study are to examine and report the patterns of PA/ST among adolescents in East London living in superdiverse communities, to identify opportunities/barriers to PA and inform policy/practice. A total of 1260 young people (aged 11-13 years) from seven secondary schools in East London completed a questionnaire on PA/ST over the past seven days as part of the Newham's Every Child a Sports Person (NECaSP) intervention. Socio-demographic and anthropometric data were obtained. Significance tests were conducted to determine differences between socio-demographic and anthropometric predictors and PA/ST. Multinomial logit regression was used to explore the effects of ethnicity, sex, and body mass index (BMI) on PA levels. Males were significantly more likely to engage in PA at least five times during school in the past week (U = 5.07, z = -11.76, p < .05). Obese participants were less likely to report engaging in PA five times in the past week (U = 4.11, z =-1.17, p < .05). Black Caribbean girls (U = 5.08, z = -1.92, p < .05) were significantly more likely to report engaging in no activity. Multinomial logit regression analyses revealed that girls with higher BMI were less likely to engage in PA at least four times after school in the last week than boys (b = .11, Wald X 2 (1) = 9.81, p < .01). Walking (36.4%), jogging/running (29.9%), and football (28%) were the most frequently reported activities. Engaging girls in PA during and after school is important and making sports clubs and activities available and attractive to this target group may help increase engagement in PA and reduce ST. Findings support the need for more sex-specific and culturally responsive pedagogy in schools with curricula that respects diversity and individuality and has meaning and value amongst superdiverse young people. Finally, we need to extend current work presented and provide substantial evidence of the ways young people from minority ethnic groups process and act on the public health policy and the ways they understand and enact PA.

The Application of the Cumulative Logistic Regression Model to Automated Essay Scoring

ERIC Educational Resources Information Center

Haberman, Shelby J.; Sinharay, Sandip

2010-01-01

Most automated essay scoring programs use a linear regression model to predict an essay score from several essay features. This article applied a cumulative logit model instead of the linear regression model to automated essay scoring. Comparison of the performances of the linear regression model and the cumulative logit model was performed on a…

Predictors of Place of Death for Seniors in Ontario: A Population-Based Cohort Analysis

ERIC Educational Resources Information Center

Motiwala, Sanober S.; Croxford, Ruth; Guerriere, Denise N.; Coyte, Peter C.

2006-01-01

Place of death was determined for all 58,689 seniors (age greater than or equal to 66 years) in Ontario who died during fiscal year 2001/2002. The relationship of place of death to medical and socio-demographic characteristics was examined using a multinomial logit model. Half (49.2 %) of these individuals died in hospital, 30.5 per cent died in a…

Factors influencing spatial pattern in tropical forest clearance and stand age: Implications for carbon storage and species diversity.

Treesearch

E. H. Helmer; Thomas J. Brandeis; Ariel E. Lugo; Todd Kennaway

2008-01-01

Little is known about the tropical forests that undergo clearing as urban/built-up and other developed lands spread. This study uses remote sensing-based maps of Puerto Rico, multinomial logit models and forest inventory data to explain patterns of forest age and the age of forests cleared for land development and assess their implications for forest carbon storage and...

Design and analysis of simple choice surveys for natural resource management

USGS Publications Warehouse

Fieberg, John; Cornicelli, Louis; Fulton, David C.; Grund, Marrett D.

2010-01-01

We used a simple yet powerful method for judging public support for management actions from randomized surveys. We asked respondents to rank choices (representing management regulations under consideration) according to their preference, and we then used discrete choice models to estimate probability of choosing among options (conditional on the set of options presented to respondents). Because choices may share similar unmodeled characteristics, the multinomial logit model, commonly applied to discrete choice data, may not be appropriate. We introduced the nested logit model, which offers a simple approach for incorporating correlation among choices. This forced choice survey approach provides a useful method of gathering public input; it is relatively easy to apply in practice, and the data are likely to be more informative than asking constituents to rate attractiveness of each option separately.

Widen NomoGram for multinomial logistic regression: an application to staging liver fibrosis in chronic hepatitis C patients.

PubMed

Ardoino, Ilaria; Lanzoni, Monica; Marano, Giuseppe; Boracchi, Patrizia; Sagrini, Elisabetta; Gianstefani, Alice; Piscaglia, Fabio; Biganzoli, Elia M

2017-04-01

The interpretation of regression models results can often benefit from the generation of nomograms, 'user friendly' graphical devices especially useful for assisting the decision-making processes. However, in the case of multinomial regression models, whenever categorical responses with more than two classes are involved, nomograms cannot be drawn in the conventional way. Such a difficulty in managing and interpreting the outcome could often result in a limitation of the use of multinomial regression in decision-making support. In the present paper, we illustrate the derivation of a non-conventional nomogram for multinomial regression models, intended to overcome this issue. Although it may appear less straightforward at first sight, the proposed methodology allows an easy interpretation of the results of multinomial regression models and makes them more accessible for clinicians and general practitioners too. Development of prediction model based on multinomial logistic regression and of the pertinent graphical tool is illustrated by means of an example involving the prediction of the extent of liver fibrosis in hepatitis C patients by routinely available markers.

Bayesian Inference for the Stereotype Regression Model: Application to a Case-control Study of Prostate Cancer

PubMed Central

Ahn, Jaeil; Mukherjee, Bhramar; Banerjee, Mousumi; Cooney, Kathleen A.

2011-01-01

Summary The stereotype regression model for categorical outcomes, proposed by Anderson (1984) is nested between the baseline category logits and adjacent category logits model with proportional odds structure. The stereotype model is more parsimonious than the ordinary baseline-category (or multinomial logistic) model due to a product representation of the log odds-ratios in terms of a common parameter corresponding to each predictor and category specific scores. The model could be used for both ordered and unordered outcomes. For ordered outcomes, the stereotype model allows more flexibility than the popular proportional odds model in capturing highly subjective ordinal scaling which does not result from categorization of a single latent variable, but are inherently multidimensional in nature. As pointed out by Greenland (1994), an additional advantage of the stereotype model is that it provides unbiased and valid inference under outcome-stratified sampling as in case-control studies. In addition, for matched case-control studies, the stereotype model is amenable to classical conditional likelihood principle, whereas there is no reduction due to sufficiency under the proportional odds model. In spite of these attractive features, the model has been applied less, as there are issues with maximum likelihood estimation and likelihood based testing approaches due to non-linearity and lack of identifiability of the parameters. We present comprehensive Bayesian inference and model comparison procedure for this class of models as an alternative to the classical frequentist approach. We illustrate our methodology by analyzing data from The Flint Men’s Health Study, a case-control study of prostate cancer in African-American men aged 40 to 79 years. We use clinical staging of prostate cancer in terms of Tumors, Nodes and Metastatsis (TNM) as the categorical response of interest. PMID:19731262

Exploratory Analysis of Survey Data for Understanding Adoption of Novel Aerospace Systems

NASA Astrophysics Data System (ADS)

Reddy, Lauren M.

In order to meet the increasing demand for manned and unmanned flight, the air transportation system must constantly evolve. As new technologies or operational procedures are conceived, we must determine their effect on humans in the system. In this research, we introduce a strategy to assess how individuals or organizations would respond to a novel aerospace system. We employ the most appropriate and sophisticated exploratory analysis techniques on the survey data to generate insight and identify significant variables. We employ three different methods for eliciting views from individuals or organizations who are affected by a system: an opinion survey, a stated preference survey, and structured interviews. We conduct an opinion survey of both the general public and stakeholders in the unmanned aircraft industry to assess their knowledge, attitude, and practices regarding unmanned aircraft. We complete a statistical analysis of the multiple-choice questions using multinomial logit and multivariate probit models and conduct qualitative analysis on free-text questions. We next present a stated preference survey of the general public on the use of an unmanned aircraft package delivery service. We complete a statistical analysis of the questions using multinomial logit, ordered probit, linear regression, and negative binomial models. Finally, we discuss structured interviews conducted on stakeholders from ANSPs and airlines operating in the North Atlantic. We describe how these groups may choose to adopt a new technology (space-based ADS-B) or operational procedure (in-trail procedures). We discuss similarities and differences between the stakeholders groups, the benefits and costs of in-trail procedures and space-based ADS-B as reported by the stakeholders, and interdependencies between the groups interviewed. To demonstrate the value of the data we generated, we explore how the findings from the surveys can be used to better characterize uncertainty in the cost-benefit analysis of aerospace systems. We demonstrate how the findings from the opinion and stated preference surveys can be infused into the cost-benefit analysis of an unmanned aircraft delivery system. We also demonstrate how to apply the findings from the interviews to characterize uncertainty in the estimation of the benefits of space-based ADS-B.

The effects of mandatory health insurance on equity in access to outpatient care in Indonesia.

PubMed

Hidayat, Budi; Thabrany, Hasbullah; Dong, Hengjin; Sauerborn, Rainer

2004-09-01

This paper examines the effects of mandatory health insurance on access and equity in access to public and private outpatient care in Indonesia. Data from the second round of the 1997 Indonesian Family Life Survey were used. We adopted the concentration index as a measure of equity, and this was calculated from actual data and from predicted probability of outpatient-care use saved from a multinomial logit regression. The study found that a mandatory insurance scheme for civil servants (Askes) had a strongly positive impact on access to public outpatient care, while a mandatory insurance scheme for private employees (Jamsostek) had a positive impact on access to both public and private outpatient care. The greatest effects of Jamsostek were observed amongst poor beneficiaries. A substantial increase in access will be gained by expanding insurance to the whole population. However, neither Askes nor Jamsostek had a positive impact on equity. Policy implications are discussed.

Constrained and Unconstrained Partial Adjacent Category Logit Models for Ordinal Response Variables

ERIC Educational Resources Information Center

Fullerton, Andrew S.; Xu, Jun

2018-01-01

Adjacent category logit models are ordered regression models that focus on comparisons of adjacent categories. These models are particularly useful for ordinal response variables with categories that are of substantive interest. In this article, we consider unconstrained and constrained versions of the partial adjacent category logit model, which…

Impacts of geographical locations and sociocultural traits on the Vietnamese entrepreneurship.

PubMed

Vuong, Quan Hoang

2016-01-01

This paper presents new results obtained from investigating the data from a 2015 Vietnamese entrepreneurs' survey, containing 3071 observations. Evidence from the estimations using multinomial logits was found to support relationships between several sociocultural factors and entrepreneurship-related performance or traits. Specifically, those relationships include: (a) Active participation in entrepreneurs' social networks and reported value of creativity; (b) CSR-willingness and reported entrepreneurs' perseverance; (c) Transforming of sociocultural values and entrepreneurs' decisiveness; and, (d) Lessons learned from others' failures and perceived chance of success. Using geographical locations as the control variate, evaluations of the baseline-category logits models indicate their varying effects on the outcomes when combined with the sociocultural factors that are found to be statistically significant. Empirical probabilities that give further detail about behavioral patterns are provided; and toward the end, the paper offers some conclusions with some striking insights and useful explanations on the Vietnamese entrepreneurship processes.

Circulating Prolactin Associates With Diabetes and Impaired Glucose Regulation

PubMed Central

Wang, Tiange; Lu, Jieli; Xu, Yu; Li, Mian; Sun, Jichao; Zhang, Jie; Xu, Baihui; Xu, Min; Chen, Yuhong; Bi, Yufang; Wang, Weiqing; Ning, Guang

2013-01-01

OBJECTIVE Prolactin is a major stimulus for the β-cell adaptation during gestation and guards postpartum women against gestational diabetes. Most studies of the role of prolactin on glucose metabolism have been conducted in humans and animals during pregnancy. However, little is known concerning the association between circulating prolactin and glucose metabolism outside pregnancy in epidemiological studies. We aimed to determine whether the variation of circulating prolactin concentration associates with diabetes and impaired glucose regulation (IGR) in a cross-sectional study. RESEARCH DESIGN AND METHODS We recruited 2,377 participants (1,034 men and 1,343 postmenopausal women) without hyperprolactinemia, aged 40 years and older, in Shanghai, China. Diabetes and IGR were determined by an oral glucose tolerance test. Multinomial logit analyses were performed to evaluate the relationship of prolactin with diabetes and IGR. RESULTS Prolactin levels decreased from normal glucose regulation to IGR to diabetes. Multinomial logit analyses, adjusted for potential confounding factors, showed that high circulating prolactin was associated with lower prevalence of diabetes and IGR. The adjusted odds ratios (95% CI) for IGR and diabetes for the highest compared with the lowest quartile of prolactin were 0.54 (95% CI 0.33–0.89) and 0.38 (0.24–0.59) in men and 0.54 (0.36–0.81) and 0.47 (0.32–0.70) in women. CONCLUSIONS High circulating prolactin associates with lower prevalence of diabetes and IGR in the current study. Further studies are warranted to confirm this association. PMID:23340889

Analysis of crash proportion by vehicle type at traffic analysis zone level: A mixed fractional split multinomial logit modeling approach with spatial effects.

PubMed

Lee, Jaeyoung; Yasmin, Shamsunnahar; Eluru, Naveen; Abdel-Aty, Mohamed; Cai, Qing

2018-02-01

In traffic safety literature, crash frequency variables are analyzed using univariate count models or multivariate count models. In this study, we propose an alternative approach to modeling multiple crash frequency dependent variables. Instead of modeling the frequency of crashes we propose to analyze the proportion of crashes by vehicle type. A flexible mixed multinomial logit fractional split model is employed for analyzing the proportions of crashes by vehicle type at the macro-level. In this model, the proportion allocated to an alternative is probabilistically determined based on the alternative propensity as well as the propensity of all other alternatives. Thus, exogenous variables directly affect all alternatives. The approach is well suited to accommodate for large number of alternatives without a sizable increase in computational burden. The model was estimated using crash data at Traffic Analysis Zone (TAZ) level from Florida. The modeling results clearly illustrate the applicability of the proposed framework for crash proportion analysis. Further, the Excess Predicted Proportion (EPP)-a screening performance measure analogous to Highway Safety Manual (HSM), Excess Predicted Average Crash Frequency is proposed for hot zone identification. Using EPP, a statewide screening exercise by the various vehicle types considered in our analysis was undertaken. The screening results revealed that the spatial pattern of hot zones is substantially different across the various vehicle types considered. Copyright © 2017 Elsevier Ltd. All rights reserved.

Estimating wetland vegetation abundance from Landsat-8 operational land imager imagery: a comparison between linear spectral mixture analysis and multinomial logit modeling methods

NASA Astrophysics Data System (ADS)

Zhang, Min; Gong, Zhaoning; Zhao, Wenji; Pu, Ruiliang; Liu, Ke

2016-01-01

Mapping vegetation abundance by using remote sensing data is an efficient means for detecting changes of an eco-environment. With Landsat-8 operational land imager (OLI) imagery acquired on July 31, 2013, both linear spectral mixture analysis (LSMA) and multinomial logit model (MNLM) methods were applied to estimate and assess the vegetation abundance in the Wild Duck Lake Wetland in Beijing, China. To improve mapping vegetation abundance and increase the number of endmembers in spectral mixture analysis, normalized difference vegetation index was extracted from OLI imagery along with the seven reflective bands of OLI data for estimating the vegetation abundance. Five endmembers were selected, which include terrestrial plants, aquatic plants, bare soil, high albedo, and low albedo. The vegetation abundance mapping results from Landsat OLI data were finally evaluated by utilizing a WorldView-2 multispectral imagery. Similar spatial patterns of vegetation abundance produced by both fully constrained LSMA algorithm and MNLM methods were observed: higher vegetation abundance levels were distributed in agricultural and riparian areas while lower levels in urban/built-up areas. The experimental results also indicate that the MNLM model outperformed the LSMA algorithm with smaller root mean square error (0.0152 versus 0.0252) and higher coefficient of determination (0.7856 versus 0.7214) as the MNLM model could handle the nonlinear reflection phenomenon better than the LSMA with mixed pixels.

Contributing factors to vehicle to vehicle crash frequency and severity under rainfall.

PubMed

Jung, Soyoung; Jang, Kitae; Yoon, Yoonjin; Kang, Sanghyeok

2014-09-01

This study combined vehicle to vehicle crash frequency and severity estimations to examine factor impacts on Wisconsin highway safety in rainy weather. Because of data deficiency, the real-time water film depth, the car-following distance, and the vertical curve grade were estimated with available data sources and a GIS analysis to capture rainy weather conditions at the crash location and time. Using a negative binomial regression for crash frequency estimation, the average annual daily traffic per lane, the interaction between the posted speed limit change and the existence of an off-ramp, and the interaction between the travel lane number change and the pavement surface material change were found to increase the likelihood of vehicle to vehicle crashes under rainfall. However, more average daily rainfall per month and a wider left shoulder were identified as factors that decrease the likelihood of vehicle to vehicle crashes. In the crash severity estimation using the multinomial logit model that outperformed the ordered logit model, the travel lane number, the interaction between the travel lane number and the slow grade, the deep water film, and the rear-end collision type were more likely to increase the likelihood of injury crashes under rainfall compared with crashes involving only property damage. As an exploratory data analysis, this study provides insight into potential strategies for rainy weather highway safety improvement, specifically, the following weather-sensitive strategies: road design and ITS implementation for drivers' safety awareness under rainfall. Copyright © 2014 National Safety Council and Elsevier Ltd. All rights reserved.

Comparison of multinomial logistic regression and logistic regression: which is more efficient in allocating land use?

NASA Astrophysics Data System (ADS)

Lin, Yingzhi; Deng, Xiangzheng; Li, Xing; Ma, Enjun

2014-12-01

Spatially explicit simulation of land use change is the basis for estimating the effects of land use and cover change on energy fluxes, ecology and the environment. At the pixel level, logistic regression is one of the most common approaches used in spatially explicit land use allocation models to determine the relationship between land use and its causal factors in driving land use change, and thereby to evaluate land use suitability. However, these models have a drawback in that they do not determine/allocate land use based on the direct relationship between land use change and its driving factors. Consequently, a multinomial logistic regression method was introduced to address this flaw, and thereby, judge the suitability of a type of land use in any given pixel in a case study area of the Jiangxi Province, China. A comparison of the two regression methods indicated that the proportion of correctly allocated pixels using multinomial logistic regression was 92.98%, which was 8.47% higher than that obtained using logistic regression. Paired t-test results also showed that pixels were more clearly distinguished by multinomial logistic regression than by logistic regression. In conclusion, multinomial logistic regression is a more efficient and accurate method for the spatial allocation of land use changes. The application of this method in future land use change studies may improve the accuracy of predicting the effects of land use and cover change on energy fluxes, ecology, and environment.

Determinants of Health Insurance Coverage among People Aged 45 and over in China: Who Buys Public, Private and Multiple Insurance

PubMed Central

Jin, Yinzi; Hou, Zhiyuan; Zhang, Donglan

2016-01-01

Background China is reforming and restructuring its health insurance system to achieve the goal of universal coverage. This study aims to understand the determinants of public, private and multiple insurance coverage among people of retirement-age in China. Methods We used data from the China Health and Retirement Longitudinal Survey 2011 and 2013, a nationally representative survey of Chinese people aged 45 and over. Multinomial logit regression was performed to identify the determinants of public, private and multiple health insurance coverage. We also conducted logit regression to examine the association between public insurance coverage and demand for private insurance. Results In 2013, 94.5% of this population had at least one type of public insurance, and 12.2% purchased private insurance. In general, we found that rural residents were less likely to be uninsured (Relative Risk Ratio (RRR) = 0.40, 95% Confidence Interval (CI): 0.34–0.47) and were less likely to buy private insurance (RRR = 0.22, 95% CI: 0.16–0.31). But rural-to-urban migrants were more likely to be uninsured (RRR = 1.39, 95% CI: 1.24–1.57). Public health insurance coverage may crowd out private insurance market (Odds Ratio = 0.55, 95% CI: 0.48–0.63), particularly among enrollees of Urban Resident Basic Medical Insurance. There exists a huge socioeconomic disparity in both public and private insurance coverage. Conclusion The migrants, the poor and the vulnerable remained in the edge of the system. The growing private insurance market did not provide sufficient financial protection and did not cover the people with the greatest need. To achieve universal coverage and reduce socioeconomic disparity, China should integrate the urban and rural public insurance schemes across regions and remove the barriers for the middle-income and low-income to access private insurance. PMID:27564320

Occupant Perceptions and a Health Outcome in Retail Stores

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhao, Mingjie; Kim, Yang-Seon; Srebric, Jelena

Indoor Environmental Quality (IEQ) in commercial buildings, such as retail stores, can affect employee satisfaction, productivity, and health. This study administered an IEQ survey to retail employees and found correlations between measured IEQ parameters and the survey responses. The survey included 611 employees in 14 retail stores located in Pennsylvania (climate zone 5A) and Texas (climate zone 2A). The survey questionnaire featured ratings of different aspects of IEQ, including thermal comfort, lighting and noise level, indoor smells, overall cleanness, and environmental quality. Simultaneously with the survey, on-site physical measurements were taken to collect data of relative humidity levels, air exchangemore » rates, dry bulb temperatures, and contaminant concentrations. This data was analyzed using multinomial logit regression with independent variables being the measured IEQ parameters, employees’ gender, and age. This study found that employee perception of stuffy smells is related to formaldehyde and PM10 concentrations. Furthermore, the survey also asked the employees to report an annual frequency of common colds as a health indicator. The regression analysis showed that the cold frequency statistically correlates with the measured air exchange rates, outdoor temperatures, and indoor PM concentrations. Overall, the air exchange rate is the most influential parameter on the employee perception of the overall environmental quality and self-reported health outcome.« less

Trail impacts in Sagarmatha (Mt. Everest) National Park, Nepal: a logistic regression analysis.

PubMed

Nepal, S K

2003-09-01

A trail study was conducted in the Sagarmatha (Mt. Everest) National Park, Nepal, during 1997-1998. Based on that study, this paper examines the spatial variability of trail conditions and analyzes factors that influence trail conditions. Logistic regression (multinomial logit model) is applied to examine the influence of use and environmental factors on trail conditions. The assessment of trail conditions is based on a four-class rating system: (class I, very little damaged; class II, moderately damaged, class III, heavily damaged; and class IV, severely damaged). Wald statistics and a model classification table have been used for data interpretation. Results indicate that altitude, trail gradient, hazard potential, and vegetation type are positively associated with trail condition. Trails are more degraded at higher altitude, on steep gradients, in areas with natural hazard potential, and within shrub/grassland zones. Strong correlations between high levels of trail degradation and higher frequencies of visitors and lodges were found. A detailed analysis of environmental and use factors could provide valuable information to park managers in their decisions about trail design, layout and maintenance, and efficient and effective visitor management strategies. Comparable studies on high alpine environments are needed to predict precisely the effects of topographic and climatic extremes. More refined approaches and experimental methods are necessary to control the effects of environmental factors.

Fuzzy multinomial logistic regression analysis: A multi-objective programming approach

NASA Astrophysics Data System (ADS)

Abdalla, Hesham A.; El-Sayed, Amany A.; Hamed, Ramadan

2017-05-01

Parameter estimation for multinomial logistic regression is usually based on maximizing the likelihood function. For large well-balanced datasets, Maximum Likelihood (ML) estimation is a satisfactory approach. Unfortunately, ML can fail completely or at least produce poor results in terms of estimated probabilities and confidence intervals of parameters, specially for small datasets. In this study, a new approach based on fuzzy concepts is proposed to estimate parameters of the multinomial logistic regression. The study assumes that the parameters of multinomial logistic regression are fuzzy. Based on the extension principle stated by Zadeh and Bárdossy's proposition, a multi-objective programming approach is suggested to estimate these fuzzy parameters. A simulation study is used to evaluate the performance of the new approach versus Maximum likelihood (ML) approach. Results show that the new proposed model outperforms ML in cases of small datasets.

What influences participation in genetic carrier testing? Results from a discrete choice experiment.

PubMed

Hall, Jane; Fiebig, Denzil G; King, Madeleine T; Hossain, Ishrat; Louviere, Jordan J

2006-05-01

This study explores factors that influence participation in genetic testing programs and the acceptance of multiple tests. Tay Sachs and cystic fibrosis are both genetically determined recessive disorders with differing severity, treatment availability, and prevalence in different population groups. We used a discrete choice experiment with a general community and an Ashkenazi Jewish sample; data were analysed using multinomial logit with random coefficients. Although Jewish respondents were more likely to be tested, both groups seem to be making very similar tradeoffs across attributes when they make genetic testing choices.

Multiple-Shrinkage Multinomial Probit Models with Applications to Simulating Geographies in Public Use Data.

PubMed

Burgette, Lane F; Reiter, Jerome P

2013-06-01

Multinomial outcomes with many levels can be challenging to model. Information typically accrues slowly with increasing sample size, yet the parameter space expands rapidly with additional covariates. Shrinking all regression parameters towards zero, as often done in models of continuous or binary response variables, is unsatisfactory, since setting parameters equal to zero in multinomial models does not necessarily imply "no effect." We propose an approach to modeling multinomial outcomes with many levels based on a Bayesian multinomial probit (MNP) model and a multiple shrinkage prior distribution for the regression parameters. The prior distribution encourages the MNP regression parameters to shrink toward a number of learned locations, thereby substantially reducing the dimension of the parameter space. Using simulated data, we compare the predictive performance of this model against two other recently-proposed methods for big multinomial models. The results suggest that the fully Bayesian, multiple shrinkage approach can outperform these other methods. We apply the multiple shrinkage MNP to simulating replacement values for areal identifiers, e.g., census tract indicators, in order to protect data confidentiality in public use datasets.

Willingness to Pay for Improving the Residential Waste Disposal System in Korea: A Choice Experiment Study

NASA Astrophysics Data System (ADS)

Ku, Se-Ju; Yoo, Seung-Hoon; Kwak, Seung-Jun

2009-08-01

This study attempts to apply choice experiments with regard to the residential waste disposal system (RWDS) in Korea by considering various attributes that are related to RWDS. Using data from a survey conducted on 492 households, the empirical analysis yields estimates of the willingness to pay for a clean food-waste collection facility, the collection of small items (such as obsolete mobile phones and add-ons for personal computers), and a more convenient large waste disposal system. The estimation results of multinomial logit models are quite similar to those of nested logit models. The results reveal that residents have preferences for the cleanliness of facilities and the collection of small items. In Korea, residents are required to purchase and attach stickers for the disposal of large items; they want to be able to obtain stickers at not only village offices but also supermarkets. On the other hand, the frequency of waste collection is not a significant factor in the choice of the improved waste management program.

Willingness to pay for improving the residential waste disposal system in Korea: a choice experiment study.

PubMed

Ku, Se-Ju; Yoo, Seung-Hoon; Kwak, Seung-Jun

2009-08-01

This study attempts to apply choice experiments with regard to the residential waste disposal system (RWDS) in Korea by considering various attributes that are related to RWDS. Using data from a survey conducted on 492 households, the empirical analysis yields estimates of the willingness to pay for a clean food-waste collection facility, the collection of small items (such as obsolete mobile phones and add-ons for personal computers), and a more convenient large waste disposal system. The estimation results of multinomial logit models are quite similar to those of nested logit models. The results reveal that residents have preferences for the cleanliness of facilities and the collection of small items. In Korea, residents are required to purchase and attach stickers for the disposal of large items; they want to be able to obtain stickers at not only village offices but also supermarkets. On the other hand, the frequency of waste collection is not a significant factor in the choice of the improved waste management program.

A generalized nonlinear model-based mixed multinomial logit approach for crash data analysis.

PubMed

Zeng, Ziqiang; Zhu, Wenbo; Ke, Ruimin; Ash, John; Wang, Yinhai; Xu, Jiuping; Xu, Xinxin

2017-02-01

The mixed multinomial logit (MNL) approach, which can account for unobserved heterogeneity, is a promising unordered model that has been employed in analyzing the effect of factors contributing to crash severity. However, its basic assumption of using a linear function to explore the relationship between the probability of crash severity and its contributing factors can be violated in reality. This paper develops a generalized nonlinear model-based mixed MNL approach which is capable of capturing non-monotonic relationships by developing nonlinear predictors for the contributing factors in the context of unobserved heterogeneity. The crash data on seven Interstate freeways in Washington between January 2011 and December 2014 are collected to develop the nonlinear predictors in the model. Thirteen contributing factors in terms of traffic characteristics, roadway geometric characteristics, and weather conditions are identified to have significant mixed (fixed or random) effects on the crash density in three crash severity levels: fatal, injury, and property damage only. The proposed model is compared with the standard mixed MNL model. The comparison results suggest a slight superiority of the new approach in terms of model fit measured by the Akaike Information Criterion (12.06 percent decrease) and Bayesian Information Criterion (9.11 percent decrease). The predicted crash densities for all three levels of crash severities of the new approach are also closer (on average) to the observations than the ones predicted by the standard mixed MNL model. Finally, the significance and impacts of the contributing factors are analyzed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quality of life of patients from rural and urban areas in Poland with head and neck cancer treated with radiotherapy. A study of the influence of selected socio-demographic factors.

PubMed

Depta, Adam; Jewczak, Maciej; Skura-Madziała, Anna

2017-10-01

The quality of life (QoL) experienced by cancer patients depends both on their state of health and on sociodemographic factors. Tumours in the head and neck region have a particularly adverse effect on patients psychologically and on their social functioning. The study involved 121 patients receiving radiotherapy treatment for head and neck cancers. They included 72 urban and 49 rural residents. QoL was assessed using the questionnaires EORTC-QLQ-C30 and QLQ-H&N35. The data were analysed using statistical methods: a χ 2 test for independence and a multinomial logit model. The evaluation of QoL showed a strong, statistically significant, positive dependence on state of health, and a weak dependence on sociodemographic factors and place of residence. Evaluations of financial situation and living conditions were similar for rural and urban residents. Patients from urban areas had the greatest anxiety about deterioration of their state of health. Rural respondents were more often anxious about a worsening of their financial situation, and expressed a fear of loneliness. Studying the QoL of patients with head and neck cancer provides information concerning the areas in which the disease inhibits their lives, and the extent to which it does so. It indicates conditions for the adaptation of treatment and care methods in the healthcare system which might improve the QoL of such patients. A multinomial logit model identifies the factors determining the patients' health assessment and defines the probable values of such assessment.

Multinomial Logistic Regression Predicted Probability Map To Visualize The Influence Of Socio-Economic Factors On Breast Cancer Occurrence in Southern Karnataka

NASA Astrophysics Data System (ADS)

Madhu, B.; Ashok, N. C.; Balasubramanian, S.

2014-11-01

Multinomial logistic regression analysis was used to develop statistical model that can predict the probability of breast cancer in Southern Karnataka using the breast cancer occurrence data during 2007-2011. Independent socio-economic variables describing the breast cancer occurrence like age, education, occupation, parity, type of family, health insurance coverage, residential locality and socioeconomic status of each case was obtained. The models were developed as follows: i) Spatial visualization of the Urban- rural distribution of breast cancer cases that were obtained from the Bharat Hospital and Institute of Oncology. ii) Socio-economic risk factors describing the breast cancer occurrences were complied for each case. These data were then analysed using multinomial logistic regression analysis in a SPSS statistical software and relations between the occurrence of breast cancer across the socio-economic status and the influence of other socio-economic variables were evaluated and multinomial logistic regression models were constructed. iii) the model that best predicted the occurrence of breast cancer were identified. This multivariate logistic regression model has been entered into a geographic information system and maps showing the predicted probability of breast cancer occurrence in Southern Karnataka was created. This study demonstrates that Multinomial logistic regression is a valuable tool for developing models that predict the probability of breast cancer Occurrence in Southern Karnataka.

Willingness to pay for midwife-endorsed product: An Australian best-worst study.

PubMed

Lahtinen, Ville; Rundle-Thiele, Sharyn; Adamsen, Jannie Mia

2016-01-01

This article examined the impact of midwife endorsement on stated choice preferences in one of the highest volume baby care product categories, diapers. An online survey was conducted testing 12 alternatives of which six were midwife endorsed. A total of 215 responses were analyzed using best-worst and multinomial logit modeling. Results indicate that package size, price, and brand are more sensitive predictors of stated choice preferences than midwife endorsement. Respondents were willing to pay 2.3% more for a diaper that was endorsed by midwives. These findings suggest that midwife endorsement should be pursued by health marketers.

Simulating landscape change in the Olympic Peninsula using spatial ecological and socioeconomic data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Flamm, R.O.; Gottfried, R.; Lee, R.G.

1994-06-01

Ecological and socioeconomic data were integrated to study landscape change for the Dungeness River basin in the Olympic Peninsula, Washington State. A multinomial logit procedure was used to evaluate twenty-two maps representing various data themes to derive transition probabilities of land cover change. Probabilities of forest disturbance were greater on private land than public. Between 1975 and 1988, forest cover increased, grassy/brushy covers decreased, and the number of forest patches increased about 30%. Simulations were run to estimate future land cover. These results were represented as frequency distributions for proportion cover and patch characteristics.

Preferences for tap water attributes within couples: An exploration of alternative mixed logit parameterizations

NASA Astrophysics Data System (ADS)

Scarpa, Riccardo; Thiene, Mara; Hensher, David A.

2012-01-01

Preferences for attributes of complex goods may differ substantially among members of households. Some of these goods, such as tap water, are jointly supplied at the household level. This issue of jointness poses a series of theoretical and empirical challenges to economists engaged in empirical nonmarket valuation studies. While a series of results have already been obtained in the literature, the issue of how to empirically measure these differences, and how sensitive the results are to choice of model specification from the same data, is yet to be clearly understood. In this paper we use data from a widely employed form of stated preference survey for multiattribute goods, namely choice experiments. The salient feature of the data collection is that the same choice experiment was applied to both partners of established couples. The analysis focuses on models that simultaneously handle scale as well as preference heterogeneity in marginal rates of substitution (MRS), thereby isolating true differences between members of couples in their MRS, by removing interpersonal variation in scale. The models employed are different parameterizations of the mixed logit model, including the willingness to pay (WTP)-space model and the generalized multinomial logit model. We find that in this sample there is some evidence of significant statistical differences in values between women and men, but these are of small magnitude and only apply to a few attributes.

Quality of life of patients from rural and urban areas in Poland with head and neck cancer treated with radiotherapy. A study of the influence of selected socio-demographic factors

PubMed Central

Jewczak, Maciej; Skura-Madziała, Anna

2017-01-01

Introduction The quality of life (QoL) experienced by cancer patients depends both on their state of health and on sociodemographic factors. Tumours in the head and neck region have a particularly adverse effect on patients psychologically and on their social functioning. Material and methods The study involved 121 patients receiving radiotherapy treatment for head and neck cancers. They included 72 urban and 49 rural residents. QoL was assessed using the questionnaires EORTC-QLQ-C30 and QLQ-H&N35. The data were analysed using statistical methods: a χ2 test for independence and a multinomial logit model. Results The evaluation of QoL showed a strong, statistically significant, positive dependence on state of health, and a weak dependence on sociodemographic factors and place of residence. Evaluations of financial situation and living conditions were similar for rural and urban residents. Patients from urban areas had the greatest anxiety about deterioration of their state of health. Rural respondents were more often anxious about a worsening of their financial situation, and expressed a fear of loneliness. Conclusions Studying the QoL of patients with head and neck cancer provides information concerning the areas in which the disease inhibits their lives, and the extent to which it does so. It indicates conditions for the adaptation of treatment and care methods in the healthcare system which might improve the QoL of such patients. A multinomial logit model identifies the factors determining the patients’ health assessment and defines the probable values of such assessment. PMID:29181080

An INAR(1) Negative Multinomial Regression Model for Longitudinal Count Data.

ERIC Educational Resources Information Center

Bockenholt, Ulf

1999-01-01

Discusses a regression model for the analysis of longitudinal count data in a panel study by adapting an integer-valued first-order autoregressive (INAR(1)) Poisson process to represent time-dependent correlation between counts. Derives a new negative multinomial distribution by combining INAR(1) representation with a random effects approach.…

Modeling Polytomous Item Responses Using Simultaneously Estimated Multinomial Logistic Regression Models

ERIC Educational Resources Information Center

Anderson, Carolyn J.; Verkuilen, Jay; Peyton, Buddy L.

2010-01-01

Survey items with multiple response categories and multiple-choice test questions are ubiquitous in psychological and educational research. We illustrate the use of log-multiplicative association (LMA) models that are extensions of the well-known multinomial logistic regression model for multiple dependent outcome variables to reanalyze a set of…

How uncertain is the future of electric vehicle market: Results from Monte Carlo simulations using a nested logit model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Changzheng; Oak Ridge National Lab.; Lin, Zhenhong

Plug-in electric vehicles (PEVs) are widely regarded as an important component of the technology portfolio designed to accomplish policy goals in sustainability and energy security. However, the market acceptance of PEVs in the future remains largely uncertain from today's perspective. By integrating a consumer choice model based on nested multinomial logit and Monte Carlo simulation, this study analyzes the uncertainty of PEV market penetration using Monte Carlo simulation. Results suggest that the future market for PEVs is highly uncertain and there is a substantial risk of low penetration in the early and midterm market. Top factors contributing to market sharemore » variability are price sensitivities, energy cost, range limitation, and charging availability. The results also illustrate the potential effect of public policies in promoting PEVs through investment in battery technology and infrastructure deployment. Here, continued improvement of battery technologies and deployment of charging infrastructure alone do not necessarily reduce the spread of market share distributions, but may shift distributions toward right, i.e., increase the probability of having great market success.« less

How uncertain is the future of electric vehicle market: Results from Monte Carlo simulations using a nested logit model

DOE PAGES

Liu, Changzheng; Oak Ridge National Lab.; Lin, Zhenhong; ...

2016-12-08

Plug-in electric vehicles (PEVs) are widely regarded as an important component of the technology portfolio designed to accomplish policy goals in sustainability and energy security. However, the market acceptance of PEVs in the future remains largely uncertain from today's perspective. By integrating a consumer choice model based on nested multinomial logit and Monte Carlo simulation, this study analyzes the uncertainty of PEV market penetration using Monte Carlo simulation. Results suggest that the future market for PEVs is highly uncertain and there is a substantial risk of low penetration in the early and midterm market. Top factors contributing to market sharemore » variability are price sensitivities, energy cost, range limitation, and charging availability. The results also illustrate the potential effect of public policies in promoting PEVs through investment in battery technology and infrastructure deployment. Here, continued improvement of battery technologies and deployment of charging infrastructure alone do not necessarily reduce the spread of market share distributions, but may shift distributions toward right, i.e., increase the probability of having great market success.« less

Sample size determination for logistic regression on a logit-normal distribution.

PubMed

Kim, Seongho; Heath, Elisabeth; Heilbrun, Lance

2017-06-01

Although the sample size for simple logistic regression can be readily determined using currently available methods, the sample size calculation for multiple logistic regression requires some additional information, such as the coefficient of determination ([Formula: see text]) of a covariate of interest with other covariates, which is often unavailable in practice. The response variable of logistic regression follows a logit-normal distribution which can be generated from a logistic transformation of a normal distribution. Using this property of logistic regression, we propose new methods of determining the sample size for simple and multiple logistic regressions using a normal transformation of outcome measures. Simulation studies and a motivating example show several advantages of the proposed methods over the existing methods: (i) no need for [Formula: see text] for multiple logistic regression, (ii) available interim or group-sequential designs, and (iii) much smaller required sample size.

Food insufficiency and food insecurity as risk factors for physical disability among Palestinian refugees in Lebanon: Evidence from an observational study.

PubMed

Salti, Nisreen; Ghattas, Hala

2016-10-01

Potential interactions between malnutrition and disability are increasingly recognized, and both are important global health issues. Causal effects working from nutrition to disability and from disability back to nutrition present an empirical challenge to measuring either of these effects. However, disability affects nutrition whatever the cause of disability, whereas nutrition is likelier to affect disease-related disability than war- or work-related disability. This paper investigates the association of food insufficiency with the risk of physical disability. Data on disability by cause allow us to address the difficulty of reverse causality. Multinomial logit regressions of disability by cause on food insufficiency are run using survey data from 2010 on 2575 Palestinian refugee households in Lebanon. Controls include household sociodemographic, health and economic characteristics. Regressions of food insufficiency on disability by cause are also run. Disability has a significant coefficient in regressions of food insufficiency, whatever the cause of disability; but in regressions of disability on food insufficiency, food insufficiency is significant only for disease-related disability (log odds of disease-related disability .78 higher, p = .008). The difference in the results by cause of disability is evidence of a significant association between food insufficiency and disease-related disability, net of any reverse effect from disability to food access. The association between disease-related disability and food insufficiency is statistically significant suggesting that even taking into account feedback from disability to nutrition, nutrition is an effective level of intervention to avert the poverty-disability trap resulting from the impoverishing effect of disability. Copyright © 2016 Elsevier Inc. All rights reserved.

Choice of contracts in the British National Health Service: an empirical study.

PubMed

Chalkley, Martin; McVicar, Duncan

2008-09-01

Following major reforms of the British National Health Service (NHS) in 1990, the roles of purchasing and providing health services were separated, with the relationship between purchasers and providers governed by contracts. Using a mixed multinomial logit analysis, we show how this policy shift led to a selection of contracts that is consistent with the predictions of a simple model, based on contract theory, in which the characteristics of the health services being purchased and of the contracting parties influence the choice of contract form. The paper thus provides evidence in support of the practical relevance of theory in understanding health care market reform.

Modelling of binary logistic regression for obesity among secondary students in a rural area of Kedah

NASA Astrophysics Data System (ADS)

Kamaruddin, Ainur Amira; Ali, Zalila; Noor, Norlida Mohd.; Baharum, Adam; Ahmad, Wan Muhamad Amir W.

2014-07-01

Logistic regression analysis examines the influence of various factors on a dichotomous outcome by estimating the probability of the event's occurrence. Logistic regression, also called a logit model, is a statistical procedure used to model dichotomous outcomes. In the logit model the log odds of the dichotomous outcome is modeled as a linear combination of the predictor variables. The log odds ratio in logistic regression provides a description of the probabilistic relationship of the variables and the outcome. In conducting logistic regression, selection procedures are used in selecting important predictor variables, diagnostics are used to check that assumptions are valid which include independence of errors, linearity in the logit for continuous variables, absence of multicollinearity, and lack of strongly influential outliers and a test statistic is calculated to determine the aptness of the model. This study used the binary logistic regression model to investigate overweight and obesity among rural secondary school students on the basis of their demographics profile, medical history, diet and lifestyle. The results indicate that overweight and obesity of students are influenced by obesity in family and the interaction between a student's ethnicity and routine meals intake. The odds of a student being overweight and obese are higher for a student having a family history of obesity and for a non-Malay student who frequently takes routine meals as compared to a Malay student.

Ordinal probability effect measures for group comparisons in multinomial cumulative link models.

PubMed

Agresti, Alan; Kateri, Maria

2017-03-01

We consider simple ordinal model-based probability effect measures for comparing distributions of two groups, adjusted for explanatory variables. An "ordinal superiority" measure summarizes the probability that an observation from one distribution falls above an independent observation from the other distribution, adjusted for explanatory variables in a model. The measure applies directly to normal linear models and to a normal latent variable model for ordinal response variables. It equals Φ(β/2) for the corresponding ordinal model that applies a probit link function to cumulative multinomial probabilities, for standard normal cdf Φ and effect β that is the coefficient of the group indicator variable. For the more general latent variable model for ordinal responses that corresponds to a linear model with other possible error distributions and corresponding link functions for cumulative multinomial probabilities, the ordinal superiority measure equals exp(β)/[1+exp(β)] with the log-log link and equals approximately exp(β/2)/[1+exp(β/2)] with the logit link, where β is the group effect. Another ordinal superiority measure generalizes the difference of proportions from binary to ordinal responses. We also present related measures directly for ordinal models for the observed response that need not assume corresponding latent response models. We present confidence intervals for the measures and illustrate with an example. © 2016, The International Biometric Society.

Body mass index and employment status: A new look.

PubMed

Kinge, Jonas Minet

2016-09-01

Earlier literature has usually modelled the impact of obesity on employment status as a binary choice (employed, yes/no). I provide new evidence on the impact of obesity on employment status by treating the dependent variable as a as a multinomial choice variable. Using data from a representative English survey, with measured height and weight on parents and children, I define employment status as one of four: working; looking for paid work; permanently not working due to disability; and, looking after home or family. I use a multinomial logit model controlling for a set of covariates. I also run instrumental variable models, instrumenting for Body Mass Index (BMI) based on genetic variation in weight. I find that BMI and obesity significantly increase the probability of "not working due to disability". The results for the other employment outcomes are less clear. My findings also indicate that BMI affects employment through its effect on health. Factors other than health may be less important in explaining the impact of BMI/obesity on employment. Copyright © 2016 Elsevier B.V. All rights reserved.

The Application of Censored Regression Models in Low Streamflow Analyses

NASA Astrophysics Data System (ADS)

Kroll, C.; Luz, J.

2003-12-01

Estimation of low streamflow statistics at gauged and ungauged river sites is often a daunting task. This process is further confounded by the presence of intermittent streamflows, where streamflow is sometimes reported as zero, within a region. Streamflows recorded as zero may be zero, or may be less than the measurement detection limit. Such data is often referred to as censored data. Numerous methods have been developed to characterize intermittent streamflow series. Logit regression has been proposed to develop regional models of the probability annual lowflows series (such as 7-day lowflows) are zero. In addition, Tobit regression, a method of regression that allows for censored dependent variables, has been proposed for lowflow regional regression models in regions where the lowflow statistic of interest estimated as zero at some sites in the region. While these methods have been proposed, their use in practice has been limited. Here a delete-one jackknife simulation is presented to examine the performance of Logit and Tobit models of 7-day annual minimum flows in 6 USGS water resource regions in the United States. For the Logit model, an assessment is made of whether sites are correctly classified as having at least 10% of 7-day annual lowflows equal to zero. In such a situation, the 7-day, 10-year lowflow (Q710), a commonly employed low streamflow statistic, would be reported as zero. For the Tobit model, a comparison is made between results from the Tobit model, and from performing either ordinary least squares (OLS) or principal component regression (PCR) after the zero sites are dropped from the analysis. Initial results for the Logit model indicate this method to have a high probability of correctly classifying sites into groups with Q710s as zero and non-zero. Initial results also indicate the Tobit model produces better results than PCR and OLS when more than 5% of the sites in the region have Q710 values calculated as zero.

Risk factors associated with the presence and severity of food insecurity in rural Honduras.

PubMed

Ben-Davies, Maureen E; Kinlaw, Alan; Estrada Del Campo, Yaniré; Bentley, Margaret E; Siega-Riz, Anna Maria

2014-01-01

To identify factors associated with the presence and severity of food insecurity among a sample of Honduran caregivers of young children. Cross-sectional study in which the dependent variable, household food insecurity, was measured using a fourteen-item questionnaire developed and validated in a population of similar cultural context. A predictive modelling strategy used backwards elimination in logistic regression and multinomial logit regression models to compute odds ratios and 95% confidence intervals for food insecurity. Rural Honduras in the department of Intibucá, between March and April 2009. Two-hundred and ninety-eight Honduran caregivers of children aged 6-18 months. Ninety-three per cent of households were classified as having some degree of food insecurity (mild, moderate or severe). After controlling for caregiver age and marital status, compared with caregivers with more than primary-school education, those with less than primary-school education had 3·47 (95% CI 1·34, 8·99) times the odds of severe food insecurity and 2·29 (95% CI 1·00, 5·25) times the odds of moderate food insecurity. Our results also found that child anthropometric status was not associated with the presence or severity of food insecurity. These results show that among the sociodemographic factors assessed, food insecurity in rural Honduras is associated with maternal education. Understanding key factors associated with food insecurity that are unique to Honduras can inform the design of interventions to effectively mitigate the negative impact of food insecurity on children.

Advances in nonmarket valuation econometrics: Spatial heterogeneity in hedonic pricing models and preference heterogeneity in stated preference models

NASA Astrophysics Data System (ADS)

Yoo, Jin Woo

In my 1st essay, the study explores Pennsylvania residents. willingness to pay for development of renewable energy technologies such as solar power, wind power, biomass electricity, and other renewable energy using a choice experiment method. Principle component analysis identified 3 independent attitude components that affect the variation of preference, a desire for renewable energy and environmental quality and concern over cost. The results show that urban residents have a higher desire for environmental quality and concern less about cost than rural residents and consequently have a higher willingness to pay to increase renewable energy production. The results of sub-sample analysis show that a representative respondent in rural (urban) Pennsylvania is willing to pay 3.8(5.9) and 4.1(5.7)/month for increasing the share of Pennsylvania electricity generated from wind power and other renewable energy by 1 percent point, respectively. Mean WTP for solar and biomass electricity was not significantly different from zero. In my second essay, heterogeneity of individual WTP for various renewable energy technologies is investigated using several different variants of the multinomial logit model: a simple MNL with interaction terms, a latent class choice model, a random parameter mixed logit choice model, and a random parameter-latent class choice model. The results of all models consistently show that respondents. preference for individual renewable technology is heterogeneous, but the degree of heterogeneity differs for different renewable technologies. In general, the random parameter logit model with interactions and a hybrid random parameter logit-latent class model fit better than other models and better capture respondents. heterogeneity of preference for renewable energy. The impact of the land under agricultural conservation easement (ACE) contract on the values of nearby residential properties is investigated using housing sales data in two Pennsylvania Counties. The spatial-lag (SLM), the spatial error (SEM) and the spatial error component (SEC) models were compared. A geographically weighted regression (GWR) model is estimated to study the spatial heterogeneity of the marginal implicit prices of ACE impact within each county. New hybrid spatial hedonic models, the GWR-SEC and a modified GWR-SEM, are estimated such that both spatial autocorrelation and heterogeneity are accounted. The results show that the coefficient of land under easement contract varies spatially within one county, but not within the other county studied. Also, ACE's are found to have both positive and negative impacts on the values of nearby residential properties. Among global spatial models, the SEM fit better than the SLM and the SEC. Statistical goodness of fit measures showed that the GWR-SEC model fit better than the GWR or the GWR-SEC model. Finally, the GWR-SEC showed spatial autocorrelation is stronger in one county than in the other county.

Value of arsenic-free drinking water to rural households in Bangladesh.

PubMed

Ahmad, Junaid; Goldar, Bishwanath; Misra, Smita

2005-01-01

Using contingent valuation survey data for about 2700 households in rural Bangladesh, and applying a multinomial logit model, the paper estimates the value of arsenic-free drinking water to the rural people. The estimates indicate that the rural people in arsenic-affected areas of Bangladesh place a low value on arsenic-free drinking water. It is about 10-14 percent of the amount they are willing to pay for piped water and only about 0.2-0.3 percent of the average household income. The implication of the result is that robust but costly arsenic reduction technologies such as activated alumina technology may find little social acceptance, unless heavily subsidized.

Adoption and Diffusion of Evidence-Based Addiction Medications in Substance Abuse Treatment

PubMed Central

Heinrich, Carolyn J; Cummings, Grant R

2014-01-01

ObjectiveTo examine the roles of facility-and state-level factors in treatment facilities’ adoption and diffusion of pharmaceutical agents used in addiction treatment. Data SourcesSecondary data from the National Survey of Substance Abuse Treatment Services (N-SSATS), Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Medicare and Medicaid Services, Alcohol Policy Information System, and Kaiser Family Foundation. Study DesignWe estimate ordered logit and multinomial logit models to examine the relationship of state and treatment facility characteristics to the adoption and diffusion of three pharmaceutical agents over 4 years when each was at a different stage of adoption or diffusion. Data CollectionN-SSATS data with facility codes, obtained directly from SAMHSA, were linked by state identifiers to the other publicly available, secondary data. Principal FindingsThe analysis confirms the importance of awareness and exposure to the adoption behavior of others, dissemination of information about the feasibility and effectiveness of innovations, geographical clustering, and licensing and accreditation in legitimizing facilities’ adoption and continued use of pharmacotherapies in addiction treatment. ConclusionsPolicy and administrative levers exist to increase the availability of pharmaceutical technologies and their continued use by substance abuse treatment facilities. PMID:23855719

Street choice logit model for visitors in shopping districts.

PubMed

Kawada, Ko; Yamada, Takashi; Kishimoto, Tatsuya

2014-09-01

In this study, we propose two models for predicting people's activity. The first model is the pedestrian distribution prediction (or postdiction) model by multiple regression analysis using space syntax indices of urban fabric and people distribution data obtained from a field survey. The second model is a street choice model for visitors using multinomial logit model. We performed a questionnaire survey on the field to investigate the strolling routes of 46 visitors and obtained a total of 1211 street choices in their routes. We proposed a utility function, sum of weighted space syntax indices, and other indices, and estimated the parameters for weights on the basis of maximum likelihood. These models consider both street networks, distance from destination, direction of the street choice and other spatial compositions (numbers of pedestrians, cars, shops, and elevation). The first model explains the characteristics of the street where many people tend to walk or stay. The second model explains the mechanism underlying the street choice of visitors and clarifies the differences in the weights of street choice parameters among the various attributes, such as gender, existence of destinations, number of people, etc. For all the attributes considered, the influences of DISTANCE and DIRECTION are strong. On the other hand, the influences of Int.V, SHOPS, CARS, ELEVATION, and WIDTH are different for each attribute. People with defined destinations tend to choose streets that "have more shops, and are wider and lower". In contrast, people with undefined destinations tend to choose streets of high Int.V. The choice of males is affected by Int.V, SHOPS, WIDTH (positive) and CARS (negative). Females prefer streets that have many shops, and couples tend to choose downhill streets. The behavior of individual persons is affected by all variables. The behavior of people visiting in groups is affected by SHOP and WIDTH (positive).

Street Choice Logit Model for Visitors in Shopping Districts

PubMed Central

Kawada, Ko; Yamada, Takashi; Kishimoto, Tatsuya

2014-01-01

In this study, we propose two models for predicting people’s activity. The first model is the pedestrian distribution prediction (or postdiction) model by multiple regression analysis using space syntax indices of urban fabric and people distribution data obtained from a field survey. The second model is a street choice model for visitors using multinomial logit model. We performed a questionnaire survey on the field to investigate the strolling routes of 46 visitors and obtained a total of 1211 street choices in their routes. We proposed a utility function, sum of weighted space syntax indices, and other indices, and estimated the parameters for weights on the basis of maximum likelihood. These models consider both street networks, distance from destination, direction of the street choice and other spatial compositions (numbers of pedestrians, cars, shops, and elevation). The first model explains the characteristics of the street where many people tend to walk or stay. The second model explains the mechanism underlying the street choice of visitors and clarifies the differences in the weights of street choice parameters among the various attributes, such as gender, existence of destinations, number of people, etc. For all the attributes considered, the influences of DISTANCE and DIRECTION are strong. On the other hand, the influences of Int.V, SHOPS, CARS, ELEVATION, and WIDTH are different for each attribute. People with defined destinations tend to choose streets that “have more shops, and are wider and lower”. In contrast, people with undefined destinations tend to choose streets of high Int.V. The choice of males is affected by Int.V, SHOPS, WIDTH (positive) and CARS (negative). Females prefer streets that have many shops, and couples tend to choose downhill streets. The behavior of individual persons is affected by all variables. The behavior of people visiting in groups is affected by SHOP and WIDTH (positive). PMID:25379274

Changes in the use of postacute care during the initial Medicare payment reforms.

PubMed

Lin, Wen-Chieh; Kane, Robert L; Mehr, David R; Madsen, Richard W; Petroski, Gregory F

2006-08-01

To examine changes in postacute care (PAC) use during the initial Medicare payment reforms enacted by the Balanced Budget Act of 1997. We used claims data from the 5 percent Medicare beneficiary sample in 1996, 1998, and 2000. Linked data from the Denominator file, Provider of Service file, and Area Resource File provided additional patient, hospital, and market-area characteristics. Six disease groups with high PAC use were selected for analysis. We used multinomial logit regression to examine how PAC use differed by year of service, controlling for patient, hospital, and market-area characteristics. There were major changes in PAC use, and a portion of services shifted to settings where reimbursement remained cost-based. During the first reform, the home health agency interim payment system, home health use decreased consistently across disease groups. This decrease was accompanied by increased use in skilled nursing facilities (SNFs). Following the implementation of the prospective payment system for SNFs, the use of inpatient rehabilitation facilities increased. The shift in usage among settings occurred in two stages that corresponded to the timing of payment reforms for home health agencies and SNFs. Evidence strongly suggests the substitutability between PAC settings. Financial incentives, in addition to clinical needs and individual preferences, play a major role in PAC use.

Stability and change in fertility preferences among young women in Malawi.

PubMed

Sennott, Christie; Yeatman, Sara

2012-03-01

Although studies have demonstrated change in fertility preferences over time, there is a lack of definitive knowledge about the level and direction of change among individuals, especially young and unmarried women. Furthermore, little is known about the factors associated with changes in fertility preferences over time. The analysis uses the first five waves of data from a longitudinal study of a random sample of women aged 15-25 in southern Malawi. The data were collected four months apart over an 18-month period, between June 2009 and December 2010. Multinomial logit regression models were used to calculate relative risk ratios and identify associations between four categories of life events-reproductive, relationship, health and economic-and shifts in fertility timing preferences. In each four-month period, more than half of the women reported changes in the desired timing of their next birth, and delays and accelerations in timing desires were common. Several life events, including having a child, entering a serious relationship and changes in household finances were associated with changes in the level and direction of fertility preference. Shifts in fertility timing preferences often occur in response to changes in life circumstances. Understanding the reasons for these shifts may aid family planning providers in meeting women's contraceptive needs.

Malaria care seeking behavior of individuals in Ghana under the NHIS: Are we back to the use of informal care?

PubMed

Fenny, Ama Pokuaa; Asante, Felix A; Enemark, Ulrika; Hansen, Kristian S

2015-04-12

Malaria is Ghana's most endemic disease; occurring across most parts of the country with a significant impact on individuals and the health system as whole. Treatment seeking for malaria care takes various forms. The National Health Insurance Scheme (NHIS) was introduced in 2004 to promote access to health services to mitigate the negative impact of the user fee regime. Ten years on, national coverage is less than 40% of the total population and patients continue to make direct payments for health services. This paper analyses the care-seeking behaviour of households for treatment of malaria in Ghana under the NHI policy. Using a cross-sectional survey of household data collected from three districts in Ghana covering the 3 ecological zones namely the coastal, forest and savannah, a multinomial logit model is estimated. The sample consists of 365 adults and children reporting being ill with malaria in the last four weeks prior to the study. Out of the total, 58% were insured and 71% of them sought care from a formal health facility. Among the insured, 15% chose informal care compared to 48% among the uninsured. The results from the multinomial logit estimations show that health insurance and travel time to health facility are significant determinants of health care demand. The results show that the insured are 6 times more likely to choose regional/district hospitals: 5 times more likely to choose health centres/clinics and 7 times more likely to choose private hospitals/clinics over informal care when compared with the uninsured. Individual characteristics such as age, education and wealth status were significant determinants of health care provider choice for specific categories of health facilities. Overall, for malaria care the uninsured are more likely to choose informal care compared to the insured for the treatment of malaria.

Modeling the dynamics of urban growth using multinomial logistic regression: a case study of Jiayu County, Hubei Province, China

NASA Astrophysics Data System (ADS)

Nong, Yu; Du, Qingyun; Wang, Kun; Miao, Lei; Zhang, Weiwei

2008-10-01

Urban growth modeling, one of the most important aspects of land use and land cover change study, has attracted substantial attention because it helps to comprehend the mechanisms of land use change thus helps relevant policies made. This study applied multinomial logistic regression to model urban growth in the Jiayu county of Hubei province, China to discover the relationship between urban growth and the driving forces of which biophysical and social-economic factors are selected as independent variables. This type of regression is similar to binary logistic regression, but it is more general because the dependent variable is not restricted to two categories, as those previous studies did. The multinomial one can simulate the process of multiple land use competition between urban land, bare land, cultivated land and orchard land. Taking the land use type of Urban as reference category, parameters could be estimated with odds ratio. A probability map is generated from the model to predict where urban growth will occur as a result of the computation.

An agent-based model for queue formation of powered two-wheelers in heterogeneous traffic

NASA Astrophysics Data System (ADS)

Lee, Tzu-Chang; Wong, K. I.

2016-11-01

This paper presents an agent-based model (ABM) for simulating the queue formation of powered two-wheelers (PTWs) in heterogeneous traffic at a signalized intersection. The main novelty is that the proposed interaction rule describing the position choice behavior of PTWs when queuing in heterogeneous traffic can capture the stochastic nature of the decision making process. The interaction rule is formulated as a multinomial logit model, which is calibrated by using a microscopic traffic trajectory dataset obtained from video footage. The ABM is validated against the survey data for the vehicular trajectory patterns, queuing patterns, queue lengths, and discharge rates. The results demonstrate that the proposed model is capable of replicating the observed queue formation process for heterogeneous traffic.

Religion, contraception, and method choice of married women in Ghana.

PubMed

Gyimah, Stephen Obeng; Adjei, Jones K; Takyi, Baffour K

2012-12-01

Using pooled data from the 1998 and 2003 Demographic and Health Surveys, this paper investigates the association between religion and contraceptive behavior of married women in Ghana. Guided by the particularized theology and characteristics hypotheses, multinomial logit and complementary log-log models are used to explore denominational differences in contraceptive adoption among currently married women and assess whether the differences could be explained through other characteristics. We found that while there were no differences between women of different Christian faiths, non-Christian women (Muslim and Traditional) were significantly more likely to have never used contraception compared with Christian women. Similar observations were made on current use of contraception, although the differences were greatly reduced in the multivariate models.

Demand for Health Insurance by Military Retirees

DTIC Science & Technology

2015-05-01

Plans,” The Journal of Health Economics 16, No. 2 (1997): 231–247 and Bruce A. Strombom, Thomas C. Buchmueller, and Paul J. Feldstein, “Switching Costs...Initiative: Volume 3. Health Care Utilization and Costs,” R -4244/3-HA (Santa Monica, CA: RAND Corporation, 1993). 10 probit regression model for TRICARE...Solomon (1998) Stanford University employees, panel data, 1994–95 HMO vs. PPO and FFS Logit -0.29 Fixed-Effects Logit -0.97 Barringer and Mitchell

Working hours and depressive symptoms over 7 years: evidence from a Korean panel study.

PubMed

Ahn, Seoyeon

2018-04-01

This study aims to examine how working hours influence depressive symptoms and the association between working hours and depressive symptoms differently across genders. The sample consists of salaried workers aged 25-64 years who participated in two consecutive waves of the seven-wave Korean Welfare Panel Study (2007-2013) (n = 6813 individuals, 27,986 observations) which is a survey of a nationally representative sample of the South Korean population. I apply logit regression and fixed-effects logit regression to examine the causal relation between (intra-)individual changes of working hours and depressive symptoms over a 7-year period. Results from logit model and fixed-effects logit model show that less than 30 h of work per week and more than 60 h of work per week are associated with significantly higher levels of depressive symptoms. Sex-stratified analyses reveal that women who worked over 60 h per week were at increased risk of showing depressive symptoms compared with women who worked 30-40 h per week. No significant increase in depressive symptoms was seen in men who worked more than 60 h per week. However, men working less than 30 h per week are more likely to report higher levels of depressive symptoms. These results suggest that work arrangement affects the mental health of men and women differently.

Age and pedestrian injury severity in motor-vehicle crashes: a heteroskedastic logit analysis.

PubMed

Kim, Joon-Ki; Ulfarsson, Gudmundur F; Shankar, Venkataraman N; Kim, Sungyop

2008-09-01

This research explores the injury severity of pedestrians in motor-vehicle crashes. It is hypothesized that the variance of unobserved pedestrian characteristics increases with age. In response, a heteroskedastic generalized extreme value model is used. The analysis links explanatory factors with four injury outcomes: fatal, incapacitating, non-incapacitating, and possible or no injury. Police-reported crash data between 1997 and 2000 from North Carolina, USA, are used. The results show that pedestrian age induces heteroskedasticity which affects the probability of fatal injury. The effect grows more pronounced with increasing age past 65. The heteroskedastic model provides a better fit than the multinomial logit model. Notable factors increasing the probability of fatal pedestrian injury: increasing pedestrian age, male driver, intoxicated driver (2.7 times greater probability of fatality), traffic sign, commercial area, darkness with or without streetlights (2-4 times greater probability of fatality), sport-utility vehicle, truck, freeway, two-way divided roadway, speeding-involved, off roadway, motorist turning or backing, both driver and pedestrian at fault, and pedestrian only at fault. Conversely, the probability of a fatal injury decreased: with increasing driver age, during the PM traffic peak, with traffic signal control, in inclement weather, on a curved roadway, at a crosswalk, and when walking along roadway.

Airline Choice for Domestic Flights in Sao Paulo Metropolitan Area: An Application of the Conditional Logit Model

NASA Technical Reports Server (NTRS)

Moreno, Marcelo Baena

2006-01-01

Using the conditional (multinomial) LOGIT model, this paper addresses airline choice in the S o Paulo Metropolitan Area. There are two airports in this region, where two, three or even four airlines compete for passengers flying to an array of domestic destinations. The airline choice is believed to be a result of the tradeoff passengers face among flight cost, flight frequency and airline performance. It was found that the lowest fare better explains airline choice than the highest fare, whereas direct flight frequencies give better explanation to airline choice than indirect (connections and stops) and total (direct plus indirect) ones. Out of 15 variables tested, the lowest fare was the variable that best explained airline choice. However, its signal was counterintuitive (positive) possibly because the cheapest airline was offering few flights, so passengers overwhelmingly failed to choose the cheapest airline. The model specification most adjusted to the data considered the lowest fare, direct flight frequency in the travel day and period (morning or afternoon peak) and airline age. Passengers departing from S o Paulo-Guarulhos International Airport (GRU) airport make their airline choice in terms of cost whereas those from Sao Paulo-Congonhas Airport (CGH) airport do not. Finally, senior passengers place more importance on airline age than junior passengers.

The relationship between venture capital investment and macro economic variables via statistical computation method

NASA Astrophysics Data System (ADS)

Aygunes, Gunes

2017-07-01

The objective of this paper is to survey and determine the macroeconomic factors affecting the level of venture capital (VC) investments in a country. The literary depends on venture capitalists' quality and countries' venture capital investments. The aim of this paper is to give relationship between venture capital investment and macro economic variables via statistical computation method. We investigate the countries and macro economic variables. By using statistical computation method, we derive correlation between venture capital investments and macro economic variables. According to method of logistic regression model (logit regression or logit model), macro economic variables are correlated with each other in three group. Venture capitalists regard correlations as a indicator. Finally, we give correlation matrix of our results.

Multinomial logistic regression in workers' health

NASA Astrophysics Data System (ADS)

Grilo, Luís M.; Grilo, Helena L.; Gonçalves, Sónia P.; Junça, Ana

2017-11-01

In European countries, namely in Portugal, it is common to hear some people mentioning that they are exposed to excessive and continuous psychosocial stressors at work. This is increasing in diverse activity sectors, such as, the Services sector. A representative sample was collected from a Portuguese Services' organization, by applying a survey (internationally validated), which variables were measured in five ordered categories in Likert-type scale. A multinomial logistic regression model is used to estimate the probability of each category of the dependent variable general health perception where, among other independent variables, burnout appear as statistically significant.

U.S. consumer demand for restaurant calorie information: targeting demographic and behavioral segments in labeling initiatives.

PubMed

Kolodinsky, Jane; Reynolds, Travis William; Cannella, Mark; Timmons, David; Bromberg, Daniel

2009-01-01

To identify different segments of U.S. consumers based on food choices, exercise patterns, and desire for restaurant calorie labeling. Using a stratified (by region) random sample of the U.S. population, trained interviewers collected data for this cross-sectional study through telephone surveys. Center for Rural Studies U.S. national health survey. The final sample included 580 responses (22% response rate); data were weighted to be representative of age and gender characteristics of the U.S. population. Self-reported behaviors related to food choices, exercise patterns, desire for calorie information in restaurants, and sample demographics. Clusters were identified using Schwartz Bayesian criteria. Impacts of demographic characteristics on cluster membership were analyzed using bivariate tests of association and multinomial logit regression. Cluster analysis revealed three clusters based on respondents' food choices, activity levels, and desire for restaurant labeling. Two clusters, comprising three quarters of the sample, desired calorie labeling in restaurants. The remaining cluster opposed restaurant labeling. Demographic variables significantly predicting cluster membership included region of residence (p < .10), income (p < .05), gender (p < .01), and age (p < .10). Though limited by a low response and potential self-reporting bias in the phone survey, this study suggests that several groups are likely to benefit from restaurant calorie labeling. Specific demographic clusters could be targeted through labeling initiatives.

Hard times and common mental health disorders in developing countries: insights from urban Ghana.

PubMed

Dzator, Janet

2013-01-01

Over the past century, the world has rapidly become urbanized, meaning more people now live in urban areas and cities than in rural areas. The mass movement of the rural poor to urban centers and cities has also changed the dynamics of poverty. Scarce employment opportunities, lack of assets, and sudden changes in economic conditions have been proposed as increasing the stress level for most urban residents, especially the poorer ones. Using a face-to-face household survey that included a six-item non-specific psychometric instrument, the data revealed how psychological distress may be patterned by socioeconomic status among urban residents in Ghana during difficult times characterized by food and fuel price hikes. The data collected in interviews of 1,158 adults (49% males and 51% females) who were 18 years and above were analyzed using multinomial logit regressions. The results confirmed previous findings and showed negative links between socioeconomic status, adverse life events, and psychological distress. Specifically, low income, low level of education, large household size, undesirable life events and being employed in agriculture was found to be associated with psychological disorders. The outcomes of this research project are consistent with previous findings-that people in lower socioeconomic strata and those who have suffered adverse events are more likely to suffer psychological distress. The implications of these results for behavioral health are discussed.

Spatial Distribution of Underweight, Overweight and Obesity among Women and Children: Results from the 2011 Uganda Demographic and Health Survey

PubMed Central

Turi, Kedir N.; Christoph, Mary J.; Grigsby-Toussaint, Diana S.

2013-01-01

While undernutrition and infectious diseases are still persistent in developing countries, overweight, obesity, and associated comorbidities have become more prevalent. Uganda, a developing sub-Saharan African country, is currently experiencing the public health paradox of undernutrition and overnutrition. We utilized the 2011 Uganda Demographic and Health Survey (DHS) to examine risk factors and hot spots for underweight, overweight, and obesity among adult females (N = 2,420) and their children (N = 1,099) using ordinary least squares and multinomial logit regression and the ArcGIS Getis-Ord Gi* statistic. Overweight and obese women were significantly more likely to have overweight children, and overweight was correlated with being in the highest wealth class (OR = 2.94, 95% CI = 1.99–4.35), and residing in an urban (OR = 1.76, 95% CI = 1.34–2.29) but not a conflict prone (OR = 0.48, 95% CI = 0.29–0.78) area. Underweight clustered significantly in the Northern and Northeastern regions, while overweight females and children clustered in the Southeast. We demonstrate that the DHS can be used to assess geographic clustering and burden of disease, thereby allowing for targeted programs and policies. Further, we pinpoint specific regions and population groups in Uganda for targeted preventive measures and treatment to reduce the burden of overweight and chronic diseases in Uganda. PMID:24157515

Elite formation under occupation: the internal stratification of palestinian elites in the West Bank and Gaza Strip.

PubMed

Mazawi, A E; Yogev, A

1999-09-01

This paper examines the internal stratification of Palestinian elites in the West Bank and Gaza Strip under Israeli occupation. Our general aim is to clarify the extent to which social and political subordination to outside rule influences the development of indigenous elites in stateless societies. In contrast to nation-state societies, such elites may be horizontally stratified into a wider range of institutional settings, and vertically stratified by anti-occupation activism alongside the attainment of occupational prestige. In addition, context-specific determinants of their stratification patterns, such as refugee status, regionality, and country in which educational credentials were acquired, should be considered. A secondary content analysis of interviews conducted by the Palestinian Panorama centre with 249 elite members reveals, that the vertical stratification of Palestinian elites along occupational attainment and anti-occupation activism constitutes two quite independent status dimensions. A multinomial logit regression shows that, horizontally, elite groups are embedded in four distinct types of institutional activity, further demonstrating the multi-faceted formation of Palestinian elites. Contextual resources, such as refugee versus non-refugee status, regionality, and the acquiring of Western credentials, have differential effects on the vertical and horizontal stratification of Palestinian elites. The implications of these findings for further research on elite formation in the post-Oslo Palestinian society and in other stateless societies are discussed in conclusion.

Decision-theoretic approach to data acquisition for transit operations planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ritchie, S.G.

The most costly element of transportation planning and modeling activities in the past has usually been that of data acquisition. This is even truer today when the unit costs of data collection are increasing rapidly and at the same time budgets are severely limited by continuing policies of fiscal austerity in the public sector. The overall objectives of this research were to improve the decisions and decision-making capabilities of transit operators or planners in short-range transit planning, and to improve the quality and cost-effectiveness of associated route or corridor-level data collection and service monitoring activities. A new approach was presentedmore » for sequentially updating the parameters of both simple and multiple linear regression models with stochastic regressors, and for determining the expected value of sample information and expected net gain of sampling for associated sample designs. A new approach was also presented for estimating and updating (both spatially and temporally) the parameters of multinomial logit discrete choice models, and for determining associated optimal sample designs for attribute-based and choice-based sampling methods. The approach provides an effective framework for addressing the issue of optimal sampling method and sample size, which to date have been largely unresolved. The application of these methodologies and the feasibility of the decision-theoretic approach was illustrated with a hypothetical case study example.« less

Meta-analysis data for 104 Energy-Economy Nexus papers.

PubMed

Hajko, Vladimír; Kociánová, Agáta; Buličková, Martina

2017-06-01

The data presented here are manually encoded characteristics of research papers in the area of Energy-Economy Nexus (empirical investigation of Granger causality between energy consumption and economic growth) that describe the methods, samples, and other details related to the individual estimations done in the examined empirical papers. Data cover papers indexed by Scopus, published in economic journals, written in English, after year 2000. In addition, papers were manually filtered to only those that deal with Energy-Economy Nexus investigation and have at least 10 citations at (at the time of query - November 2015). This data are to be used to conduct meta-analysis - associated dataset was used in Hajko [1]. Early version of the dataset was used for multinomial logit estimation in Master thesis by Kociánová [2].

Frequency and predictors of psychological distress after a diagnosis of epilepsy: A community-based study.

PubMed

Xu, Ying; Hackett, Maree L; Glozier, Nick; Nikpour, Armin; Bleasel, Andrew; Somerville, Ernest; Lawson, John; Jan, Stephen; Hyde, Lorne; Todd, Lisa; Martiniuk, Alexandra; Ireland, Carol; Anderson, Craig S

2017-10-01

The objective of the study was to determine the frequency and predictors of psychological distress after a diagnosis of epilepsy. The Sydney Epilepsy Incidence Study to Measure Illness Consequences (SEISMIC) was a prospective, multicenter, community-based study of people of all ages with newly diagnosed epilepsy in Sydney, Australia. Analyses involved multivariate logistic regression and multinomial logit regression to identify predictors of psychological distress, assessed using the Hospital Anxiety and Depression Scale (HADS) and the Strengths and Difficulties Questionnaire (SDQ), as part of structured interviews. Psychological distress occurred in 33% (95% confidence interval [CI] 26 to 40%) and 24% (95% CI 18 to 31%) of 180 adults at baseline and 12months, respectively, and 23% (95% CI 14 to 33%) of 77 children at both time points. Thirty adults and 7 children had distress at baseline who recovered at 12months, while 15 adults and 7 children had new onset of distress during this period. History of psychiatric or behavioral disorder (for adults, odds ratio [OR] 6.82, 95% CI 3.08 to 15.10; for children, OR 28.85, 95% CI 2.88 to 288.60) and higher psychosocial disability (adults, OR 1.17, 95% CI 1.07 to 1.27) or lower family functioning (children, OR 1.80, 95% CI 1.08 to 3.02) were associated with psychological distress (C statistics 0.80 and 0.78). Psychological distress is common and fluctuates in frequency after a diagnosis of epilepsy. Those with premorbid psychological, psychosocial, and family problems are at high risk of this adverse outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

Association of Rotating Night Shift Work with BMI and Abdominal Obesity among Nurses and Midwives.

PubMed

Peplonska, Beata; Bukowska, Agnieszka; Sobala, Wojciech

2015-01-01

Mounting epidemiological evidence suggests that night shift work may contribute to the etiology of increased body weight. The present study aimed to examine association between rotating night shift work and body mass index (BMI), and abdominal adiposity respectively among nurses and midwives. A cross-sectional study was conducted among 724 female nurses and midwives, aged 40-60 years (354 rotating night shift and 370 daytime workers) in Łódź, Poland, between 2008 and 2011. Information about occupational history and potential confounders was collected during personal interviews. Anthropometric measurements of body weight, height, waist (WC) and hip (HC) circumference were made, and body mass index (BMI), waist to hip ratio (WHR) and waist to height ratio (WHtR) were calculated. GLM regression models and multinomial logit regression models were fitted to explore the association between night shift work and anthropometric parameters, with adjustment for age, body silhouette at age 20, current smoking status, packyears, marital status, and menopausal hormone therapy use. Cumulative night shift work showed significant associations with BMI, WC, HC and WHtR, with BMI increasing by 0.477 kg/m2 per 1000 night duties and by 0.432 kg/m2 per 10000 night shift hours, WC increasing respectively by 1.089 cm and 0.99 cm, and HC by 0.72 cm and WHtR by 0.007 cm for both metrics. Both current and cumulative night work was associated with obesity (BMI≥30kg/m2), with OR=3.9 (95%CI:1.5-9.9), in women reporting eight or more night shifts per month. The results of the study support the previously reported relations between night shift work and development of obesity.

Association of Rotating Night Shift Work with BMI and Abdominal Obesity among Nurses and Midwives

PubMed Central

Peplonska, Beata; Bukowska, Agnieszka; Sobala, Wojciech

2015-01-01

Background Mounting epidemiological evidence suggests that night shift work may contribute to the etiology of increased body weight. The present study aimed to examine association between rotating night shift work and body mass index (BMI), and abdominal adiposity respectively among nurses and midwives. Methods A cross-sectional study was conducted among 724 female nurses and midwives, aged 40-60 years (354 rotating night shift and 370 daytime workers) in Łódź, Poland, between 2008 and 2011. Information about occupational history and potential confounders was collected during personal interviews. Anthropometric measurements of body weight, height, waist (WC) and hip (HC) circumference were made, and body mass index (BMI), waist to hip ratio (WHR) and waist to height ratio (WHtR) were calculated. GLM regression models and multinomial logit regression models were fitted to explore the association between night shift work and anthropometric parameters, with adjustment for age, body silhouette at age 20, current smoking status, packyears, marital status, and menopausal hormone therapy use. Results Cumulative night shift work showed significant associations with BMI, WC, HC and WHtR, with BMI increasing by 0.477 kg/m2 per 1000 night duties and by 0.432 kg/m2 per 10000 night shift hours, WC increasing respectively by 1.089 cm and 0.99 cm, and HC by 0.72 cm and WHtR by 0.007 cm for both metrics. Both current and cumulative night work was associated with obesity (BMI≥30kg/m2), with OR=3.9 (95%CI:1.5-9.9), in women reporting eight or more night shifts per month. Conclusion The results of the study support the previously reported relations between night shift work and development of obesity. PMID:26196859

The Impact of Income and Taxation in a Price-Tiered Cigarette Market - findings from the ITC Bangladesh Surveys.

PubMed

Huq, Iftekharul; Nargis, Nigar; Lkhagvasuren, Damba; Hussain, Akm Ghulam; Fong, Geoffrey T

2018-04-25

Taxing tobacco is among the most effective measures of tobacco control. However, in a tiered market structure where multiple tiers of taxes coexist, the anticipated impact of tobacco taxes on consumption is complex. This paper investigates changing smoking behaviour in lieu of changing prices and changing income. The objective of the paper is to evaluate the effectiveness of change in prices (through taxes) and change in income in a price-tiered cigarette market. A panel dataset from the International Tobacco Control Bangladesh surveys is used for analysis. For preliminary analysis transition matrices are developed. Next, probit and multinomial logit regression models are used to identify the effects of changes in prices and changes in income along with other control variables. Transition matrices show significant movement of smokers across price tiers from one wave to another. Regression results show that higher income raises the probability to up-trade and decreases the probability to down-trade. Results also show that higher prices raises the probability to up-trade and reduces the probability to down-trade. Although not significant, there exists a negative relationship between the probability to down-trade and the probability to intend to quit. It is evident from the results that a price-tiered market provides smokers more opportunities to accommodate their smoking behaviour when faced with price and income change. Therefore, tiered structure of the tax system should be replaced with uniform taxes. Moreover, overall cigarette taxes need to be raised to an extent so that it off-sets any positive effects of income growth. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

An ethnobiological study in Kala Chitta hills of Pothwar region, Pakistan: multinomial logit specification

PubMed Central

2014-01-01

Background This paper constitutes an important ethnobiological survey in the context of utilizing biological resources by residents of Kala Chitta hills of Pothwar region, Pakistan. The fundamental aim of this research endeavour was to catalogue and analyse the indigenous knowledge of native community about plants and animals. The study is distinctive in the sense to explore both ethnobotanical and ethnozoological aspects of indigenous culture, and exhibits novelty, being based on empirical approach of Multinomial Logit Specifications (MLS) for examining ethnobotanical and ethnozoological uses of specific plants and animals. Methods To document the ethnobiological knowledge, the survey was conducted during 2011–12 by employing a semi-structured questionnaire and thus 54 informants were interviewed. Plant and animal specimens were collected, photographed and properly identified. Distribution of plants and animals were explored by descriptive and graphical examination. MLS were further incorporated to identify the probability of occurrence of diversified utilization of plants and animals in multipurpose domains. Results Traditional uses of 91 plant and 65 animal species were reported. Data analysis revealed more medicinal use of plants and animals than all other use categories. MLS findings are also in line with these proportional configurations. They reveal that medicinal and food consumption of underground and perennial plants was more as compared to aerial and annual categories of plants. Likewise, medicinal utilization of wild animals and domestic animals were more commonly observed as food items. However, invertebrates are more in the domain of medicinal and food utilization. Also carnivores are fairly common in the use of medicine while herbivores are in the category of food consumption. Conclusion This study empirically scans a good chunk of ethnobiological knowledge and depicts its strong connection with indigenous traditions. It is important to make local residents beware of conservation status of species and authentication of this knowledge needs to be done in near future. Moreover, Statistically significant findings impart novelty in the existing literature in the field of ethnobiology. Future conservation, phytochemical and pharmacological studies are recommended on these identified plants and animals in order to use them in a more sustainable and effective way. PMID:24467739

Comparison of IRT Likelihood Ratio Test and Logistic Regression DIF Detection Procedures

ERIC Educational Resources Information Center

Atar, Burcu; Kamata, Akihito

2011-01-01

The Type I error rates and the power of IRT likelihood ratio test and cumulative logit ordinal logistic regression procedures in detecting differential item functioning (DIF) for polytomously scored items were investigated in this Monte Carlo simulation study. For this purpose, 54 simulation conditions (combinations of 3 sample sizes, 2 sample…

Discrete post-processing of total cloud cover ensemble forecasts

NASA Astrophysics Data System (ADS)

Hemri, Stephan; Haiden, Thomas; Pappenberger, Florian

2017-04-01

This contribution presents an approach to post-process ensemble forecasts for the discrete and bounded weather variable of total cloud cover. Two methods for discrete statistical post-processing of ensemble predictions are tested. The first approach is based on multinomial logistic regression, the second involves a proportional odds logistic regression model. Applying them to total cloud cover raw ensemble forecasts from the European Centre for Medium-Range Weather Forecasts improves forecast skill significantly. Based on station-wise post-processing of raw ensemble total cloud cover forecasts for a global set of 3330 stations over the period from 2007 to early 2014, the more parsimonious proportional odds logistic regression model proved to slightly outperform the multinomial logistic regression model. Reference Hemri, S., Haiden, T., & Pappenberger, F. (2016). Discrete post-processing of total cloud cover ensemble forecasts. Monthly Weather Review 144, 2565-2577.

Extreme Sparse Multinomial Logistic Regression: A Fast and Robust Framework for Hyperspectral Image Classification

NASA Astrophysics Data System (ADS)

Cao, Faxian; Yang, Zhijing; Ren, Jinchang; Ling, Wing-Kuen; Zhao, Huimin; Marshall, Stephen

2017-12-01

Although the sparse multinomial logistic regression (SMLR) has provided a useful tool for sparse classification, it suffers from inefficacy in dealing with high dimensional features and manually set initial regressor values. This has significantly constrained its applications for hyperspectral image (HSI) classification. In order to tackle these two drawbacks, an extreme sparse multinomial logistic regression (ESMLR) is proposed for effective classification of HSI. First, the HSI dataset is projected to a new feature space with randomly generated weight and bias. Second, an optimization model is established by the Lagrange multiplier method and the dual principle to automatically determine a good initial regressor for SMLR via minimizing the training error and the regressor value. Furthermore, the extended multi-attribute profiles (EMAPs) are utilized for extracting both the spectral and spatial features. A combinational linear multiple features learning (MFL) method is proposed to further enhance the features extracted by ESMLR and EMAPs. Finally, the logistic regression via the variable splitting and the augmented Lagrangian (LORSAL) is adopted in the proposed framework for reducing the computational time. Experiments are conducted on two well-known HSI datasets, namely the Indian Pines dataset and the Pavia University dataset, which have shown the fast and robust performance of the proposed ESMLR framework.

The arcsine is asinine: the analysis of proportions in ecology.

PubMed

Warton, David I; Hui, Francis K C

2011-01-01

The arcsine square root transformation has long been standard procedure when analyzing proportional data in ecology, with applications in data sets containing binomial and non-binomial response variables. Here, we argue that the arcsine transform should not be used in either circumstance. For binomial data, logistic regression has greater interpretability and higher power than analyses of transformed data. However, it is important to check the data for additional unexplained variation, i.e., overdispersion, and to account for it via the inclusion of random effects in the model if found. For non-binomial data, the arcsine transform is undesirable on the grounds of interpretability, and because it can produce nonsensical predictions. The logit transformation is proposed as an alternative approach to address these issues. Examples are presented in both cases to illustrate these advantages, comparing various methods of analyzing proportions including untransformed, arcsine- and logit-transformed linear models and logistic regression (with or without random effects). Simulations demonstrate that logistic regression usually provides a gain in power over other methods.

An Objective Screening Method for Major Depressive Disorder Using Logistic Regression Analysis of Heart Rate Variability Data Obtained in a Mental Task Paradigm.

PubMed

Sun, Guanghao; Shinba, Toshikazu; Kirimoto, Tetsuo; Matsui, Takemi

2016-01-01

Heart rate variability (HRV) has been intensively studied as a promising biological marker of major depressive disorder (MDD). Our previous study confirmed that autonomic activity and reactivity in depression revealed by HRV during rest and mental task (MT) conditions can be used as diagnostic measures and in clinical evaluation. In this study, logistic regression analysis (LRA) was utilized for the classification and prediction of MDD based on HRV data obtained in an MT paradigm. Power spectral analysis of HRV on R-R intervals before, during, and after an MT (random number generation) was performed in 44 drug-naïve patients with MDD and 47 healthy control subjects at Department of Psychiatry in Shizuoka Saiseikai General Hospital. Logit scores of LRA determined by HRV indices and heart rates discriminated patients with MDD from healthy subjects. The high frequency (HF) component of HRV and the ratio of the low frequency (LF) component to the HF component (LF/HF) correspond to parasympathetic and sympathovagal balance, respectively. The LRA achieved a sensitivity and specificity of 80.0 and 79.0%, respectively, at an optimum cutoff logit score (0.28). Misclassifications occurred only when the logit score was close to the cutoff score. Logit scores also correlated significantly with subjective self-rating depression scale scores ( p  < 0.05). HRV indices recorded during a MT may be an objective tool for screening patients with MDD in psychiatric practice. The proposed method appears promising for not only objective and rapid MDD screening but also evaluation of its severity.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brooker, A.; Gonder, J.; Lopp, S.

The Automotive Deployment Option Projection Tool (ADOPT) is a light-duty vehicle consumer choice and stock model supported by the U.S. Department of Energy’s Vehicle Technologies Office. It estimates technology improvement impacts on U.S. light-duty vehicles sales, petroleum use, and greenhouse gas emissions. ADOPT uses techniques from the multinomial logit method and the mixed logit method estimate sales. Specifically, it estimates sales based on the weighted value of key attributes including vehicle price, fuel cost, acceleration, range and usable volume. The average importance of several attributes changes nonlinearly across its range and changes with income. For several attributes, a distribution ofmore » importance around the average value is used to represent consumer heterogeneity. The majority of existing vehicle makes, models, and trims are included to fully represent the market. The Corporate Average Fuel Economy regulations are enforced. The sales feed into the ADOPT stock model. It captures key aspects for summing petroleum use and greenhouse gas emissions This includes capturing the change in vehicle miles traveled by vehicle age, the creation of new model options based on the success of existing vehicles, new vehicle option introduction rate limits, and survival rates by vehicle age. ADOPT has been extensively validated with historical sales data. It matches in key dimensions including sales by fuel economy, acceleration, price, vehicle size class, and powertrain across multiple years. A graphical user interface provides easy and efficient use. It manages the inputs, simulation, and results.« less

Logits and Tigers and Bears, Oh My! A Brief Look at the Simple Math of Logistic Regression and How It Can Improve Dissemination of Results

ERIC Educational Resources Information Center

Osborne, Jason W.

2012-01-01

Logistic regression is slowly gaining acceptance in the social sciences, and fills an important niche in the researcher's toolkit: being able to predict important outcomes that are not continuous in nature. While OLS regression is a valuable tool, it cannot routinely be used to predict outcomes that are binary or categorical in nature. These…

[Depression Symptoms of Mothers and Fathers of Persons with Schizophrenia].

PubMed

Alexandrowicz, Rainer W; König, Daniel; Unger, Annemarie; Klug, Günter; Soulier, Nathalie; Freidl, Marion; Friedrich, Fabian

2016-05-01

The purpose of the present study was to investigate if depression symptomatology of patients' parents is predicted by the symptoms of schizophrenia. 101 mothers and 101 fathers of the same patients suffering from schizophrenia were included into this study. Parents filled in the "Beck Depression Inventory". Patients were assessed by means of the "Positive and Negative Syndrome Scale". For statistical analyses a Multidimensional Random Coefficients Multinomial Logit Model was applied. We found a significant positive association between negative symptoms and depression severity of fathers and mothers. Further, a significant positive association between positive symptoms and depression severity of fathers, but not of mothers was found. Our results show that depression of mothers and of fathers is associated with symptoms of schizophrenia even when controlling for potential predictors. © Georg Thieme Verlag KG Stuttgart · New York.

Classification of Effective Soil Depth by Using Multinomial Logistic Regression Analysis

NASA Astrophysics Data System (ADS)

Chang, C. H.; Chan, H. C.; Chen, B. A.

2016-12-01

Classification of effective soil depth is a task of determining the slopeland utilizable limitation in Taiwan. The "Slopeland Conservation and Utilization Act" categorizes the slopeland into agriculture and husbandry land, land suitable for forestry and land for enhanced conservation according to the factors including average slope, effective soil depth, soil erosion and parental rock. However, sit investigation of the effective soil depth requires a cost-effective field work. This research aimed to classify the effective soil depth by using multinomial logistic regression with the environmental factors. The Wen-Shui Watershed located at the central Taiwan was selected as the study areas. The analysis of multinomial logistic regression is performed by the assistance of a Geographic Information Systems (GIS). The effective soil depth was categorized into four levels including deeper, deep, shallow and shallower. The environmental factors of slope, aspect, digital elevation model (DEM), curvature and normalized difference vegetation index (NDVI) were selected for classifying the soil depth. An Error Matrix was then used to assess the model accuracy. The results showed an overall accuracy of 75%. At the end, a map of effective soil depth was produced to help planners and decision makers in determining the slopeland utilizable limitation in the study areas.

Push or Pull: Changes in the Relative Risk and Growth of Entrepreneurship Among Older Households.

PubMed

Weller, Christian E; Wenger, Jeffrey B; Lichtenstein, Benyamin; Arcand, Carolyn

2018-03-19

Amid insufficient retirement savings and the growing need to work longer, it is important to understand why self-employment, especially entrepreneurship, has grown among older households. Older households may have been pushed into entrepreneurship by the growing risks of wage-and-salary employment as wages and jobs have become less stable. Alternatively, older households may have been pulled into entrepreneurship as the associated risks have declined, for instance, due to greater opportunities to diversify income away from risky business income. We examine the economic causes of the rise in entrepreneurship among older households. We use summary statistics and multinomial logit regressions to analyze the link between economic pressures in wage-and-salary employment, financial strength of entrepreneurship, and the presence and change of entrepreneurship among older households-aged 50 years or older. We use household data from the Federal Reserve's Survey of Consumer Finances from 1989 to 2013. We find little support for the claim that increased economic pressures are correlated with rising entrepreneurship. Instead, our results suggest that the growth of older entrepreneurship is coincident with increasing access to dividend and interest income. We also find some evidence that access to Social Security and other annuity benefits increases the likelihood of self-employment. Implications: Entrepreneurship among older households increasingly correlates with income diversification. Policymakers interested in encouraging more entrepreneurship among older households could consider increased access to income diversification through social insurance.

An application of the SF-6D to create heath values in Portuguese working age adults.

PubMed

Ferreira, Lara Noronha; Ferreira, Pedro Lopes; Pereira, Luís Nobre; Brazier, John

2008-01-01

This study describes the health-related quality of life (HRQOL) of the Portuguese working age population and investigates sociodemographic differences. Subjects randomly selected from the working age population (n=2,459) were assessed using the SF-36v2 and converted into the preference-based SF-6D. The mean SF-6D utility value was 0.70 (range 0.63-0.73). The mean utility value was lower for the lower educational level than for the highest. Women, people living in rural areas and older adults reported lower levels of utility values. Non-parametric tests showed that health utility values were significantly related to employment; unskilled manual workers reported utility values lower than non-manual workers. For different diseases, mean utility values ranged from 0.58 (sexual diseases) to 0.66 (hepatic conditions). Cluster analysis was adopted to classify individuals into three groups according to their answers to the SF-6D dimensions. Multinomial logit regression was used to detect sociodemographic characteristics affecting the probability of following each cluster pattern. This study yielded normative data by age and gender for the SF-6D. The authors conclude that SF-6D is an effective tool for measuring HRQOL in the community so that different population groups can be compared. The preference-based measure used seems to discriminate adequately across sociodemographic differences. These results allow a better understanding of the impact of sociodemographic variables on the burden of illness perception.

Comparison of standard maximum likelihood classification and polytomous logistic regression used in remote sensing

Treesearch

John Hogland; Nedret Billor; Nathaniel Anderson

2013-01-01

Discriminant analysis, referred to as maximum likelihood classification within popular remote sensing software packages, is a common supervised technique used by analysts. Polytomous logistic regression (PLR), also referred to as multinomial logistic regression, is an alternative classification approach that is less restrictive, more flexible, and easy to interpret. To...

Going Back Part-time: Family Leave Legislation and Women’s Return to Work

PubMed Central

2012-01-01

Using a multinomial logit model with data from the Survey of Income and Program Participation, this paper tests whether the implementation of the Family and Medical Leave Act (FMLA) is associated with an increase in return to work at part-time status among first-time mothers working full-time during their pregnancy. I find a statistically significant trend of increasingly higher odds of returning to work at part-time status relative to return at full-time status, beginning in 1993 (the year in which the FMLA is implemented). Furthermore, an additional week of either state or federal leave is significantly associated with a higher odds of return at part-time status. This article provides evidence that job protection and leave legislation may help facilitate higher levels of labor force participation among women with small children, through more flexible work arrangements. PMID:22685365

The demand for child curative care in two rural thanas of Bangladesh: effect of income and women's employment.

PubMed

Levin, A; Rahman, M A; Quayyum, Z; Routh, S; Barkat-e-Khuda

2001-01-01

This paper seeks to investigate the determinants of child health care seeking behaviours in rural Bangladesh. In particular, the effects of income, women's access to income, and the prices of obtaining child health care are examined. Data on the use of child curative care were collected in two rural areas of Bangladesh--Abhoynagar Thana of Jessore District and Mirsarai Thana of Chittagong District--in March 1997. In estimating the use of child curative care, the nested multinomial logit specification was used. The results of the analysis indicate that a woman's involvement in a credit union or income generation affected the likelihood that curative child care was used. Household wealth decreased the likelihood that the child had an illness episode and affected the likelihood that curative child care was sought. Among facility characteristics, travel time was statistically significant and was negatively associated with the use of a provider.

Determinants of edible oil choice by households in Tamil Nadu, India.

PubMed

Govindaraj, Gurrappa Naidu; Suryaprakash, Satrasala

2013-01-01

This study investigated the major determinants that influence the choice of edible oils by households across geographical zones in Tamil Nadu state, India. The primary data from 1,000 sample households were collected using a structured pre-tested questionnaire. Multinomial logit model was fitted for determining the factors. The results revealed that education, income, and households with a history of health problems were the important determinants that influenced the choice of low-saturated-fat oils, whereas the larger size households and weaker section households preferred low-priced palm oil. Income and education levels in Tamil Nadu state surged ahead in recent years. In consonance to these changes the nontraditional low-saturated fat containing sunflower oil demand will increase in many folds in coming years. Hence, besides traditional oils, sunflower oil production has to be stepped up on "mission mode" through appropriate production programs to meet the present and future edible oil demand domestically.

Social influence, agent heterogeneity and the emergence of the urban informal sector

NASA Astrophysics Data System (ADS)

García-Díaz, César; Moreno-Monroy, Ana I.

2012-02-01

We develop an agent-based computational model in which the urban informal sector acts as a buffer where rural migrants can earn some income while queuing for higher paying modern-sector jobs. In the model, the informal sector emerges as a result of rural-urban migration decisions of heterogeneous agents subject to social influence in the form of neighboring effects of varying strengths. Besides using a multinomial logit choice model that allows for agent idiosyncrasy, explicit agent heterogeneity is introduced in the form of socio-demographic characteristics preferred by modern-sector employers. We find that different combinations of the strength of social influence and the socio-economic composition of the workforce lead to very different urbanization and urban informal sector shares. In particular, moderate levels of social influence and a large proportion of rural inhabitants with preferred socio-demographic characteristics are conducive to a higher urbanization rate and a larger informal sector.

The relationship between organizational culture and performance in acute hospitals.

PubMed

Jacobs, Rowena; Mannion, Russell; Davies, Huw T O; Harrison, Stephen; Konteh, Fred; Walshe, Kieran

2013-01-01

This paper examines the relationship between senior management team culture and organizational performance in English acute hospitals (NHS Trusts) over three time periods between 2001/2002 and 2007/2008. We use a validated culture rating instrument, the Competing Values Framework, to measure senior management team culture. Organizational performance is assessed using a wide range of routinely collected indicators. We examine the associations between organizational culture and performance using ordered probit and multinomial logit models. We find that organizational culture varies across hospitals and over time, and this variation is at least in part associated in consistent and predictable ways with a variety of organizational characteristics and routine measures of performance. Moreover, hospitals are moving towards more competitive culture archetypes which mirror the current policy context, though with a stronger blend of cultures. The study provides evidence for a relationship between culture and performance in hospital settings. Copyright © 2012 Elsevier Ltd. All rights reserved.

Customization in Prescribing for Bipolar Disorder

PubMed Central

Hodgkin, Dominic; Volpe-Vartanian, Joanna; Merrick, Elizabeth L.; Horgan, Constance M.; Nierenberg, Andrew A.; Frank, Richard G.; Lee, Sue

2011-01-01

For many disorders, patient heterogeneity requires physicians to customize their treatment to each patient’s needs. We test for the existence of customization in physicians’ prescribing for bipolar disorder, using data from a naturalistic clinical effectiveness trial of bipolar disorder treatment (STEP-BD), which did not constrain physician prescribing. Multinomial logit is used to model the physician’s choice among five combinations of drug classes. We find that our observed measure of the patient’s clinical status played only a limited role in the choice among drug class combinations, even for conditions such as mania that are expected to affect class choice. However, treatment of a patient with given characteristics differed widely depending on which physician was seen. The explanatory power of the model was low. There was variation within each physician’s prescribing, but the results do not suggest a high degree of customization in physicians’ prescribing, based on our measure of clinical status. PMID:21506194

Customization in prescribing for bipolar disorder.

PubMed

Hodgkin, Dominic; Volpe-Vartanian, Joanna; Merrick, Elizabeth L; Horgan, Constance M; Nierenberg, Andrew A; Frank, Richard G; Lee, Sue

2012-06-01

For many disorders, patient heterogeneity requires physicians to customize their treatment to each patient's needs. We test for the existence of customization in physicians' prescribing for bipolar disorder, using data from a naturalistic clinical effectiveness trial of bipolar disorder treatment (STEP-BD), which did not constrain physician prescribing. Multinomial logit is used to model the physician's choice among five combinations of drug classes. We find that our observed measure of the patient's clinical status played only a limited role in the choice among drug class combinations, even for conditions such as mania that are expected to affect class choice. However, treatment of a patient with given characteristics differed widely depending on which physician was seen. The explanatory power of the model was low. There was variation within each physician's prescribing, but the results do not suggest a high degree of customization in physicians' prescribing, based on our measure of clinical status. Copyright © 2011 John Wiley & Sons, Ltd.

Going Back Part-time: Family Leave Legislation and Women's Return to Work.

PubMed

Schott, Whitney

2012-02-01

Using a multinomial logit model with data from the Survey of Income and Program Participation, this paper tests whether the implementation of the Family and Medical Leave Act (FMLA) is associated with an increase in return to work at part-time status among first-time mothers working full-time during their pregnancy. I find a statistically significant trend of increasingly higher odds of returning to work at part-time status relative to return at full-time status, beginning in 1993 (the year in which the FMLA is implemented). Furthermore, an additional week of either state or federal leave is significantly associated with a higher odds of return at part-time status. This article provides evidence that job protection and leave legislation may help facilitate higher levels of labor force participation among women with small children, through more flexible work arrangements.

Utilization of infertility services: how much does money matter?

PubMed

Farley Ordovensky Staniec, J; Webb, Natalie J

2007-06-01

To estimate the effects of financial access and other individual characteristics on the likelihood that a woman pursues infertility treatment and the choice of treatment type. The 1995 National Survey of Family Growth. We use a binomial logit model to estimate the effects of financial access and individual characteristics on the likelihood that a woman pursues infertility treatment. We then use a multinomial logit model to estimate the differential effects of these variables across treatment types. This study analyzes the subset of 1,210 women who meet the definition of infertile or subfecund from the 1995 National Survey of Family Growth. We find that income, insurance coverage, age, and parity (number of previous births) all significantly affect the probability of seeking infertility treatment; however, the effect of these variables on choice of treatment type varies significantly. Neither income nor insurance influences the probability of seeking advice, a relatively low cost, low yield treatment. At the other end of the spectrum, the choice to pursue assisted reproductive technologies (ARTs)-a much more expensive but potentially more productive option-is highly influenced by income, but merely having private insurance has no significant effect. In the middle of the spectrum are treatment options such as testing, surgery, and medications, for which "financial access" increases their probability of selection. Our results illustrate that for the sample of infertile of subfecund women of childbearing age studied, and considering their options, financial access to infertility treatment does matter.

Treatment preferences of originator versus biosimilar drugs in Crohn's disease; discrete choice experiment among gastroenterologists.

PubMed

Baji, Petra; Gulácsi, László; Lovász, Barbara D; Golovics, Petra A; Brodszky, Valentin; Péntek, Márta; Rencz, Fanni; Lakatos, Péter L

2016-01-01

To explore preferences of gastroenterologists for biosimilar drugs in Crohn's disease. Discrete choice experiment was carried out involving 51 Hungarian gastroenterologists in May 2014. The following attributes were used to describe hypothetical choice sets: 1) type of the treatment (biosimilar/originator), 2) severity of disease, 3) availability of continuous medicine supply, 4) frequency of the efficacy check-ups. Multinomial logit model was used to differentiate between three attitude types: 1) always opting for the originator, 2) willing to consider biosimilar for biological-naïve patients only, 3) willing to consider biosimilar treatment for both types of patients. Conditional logit model was used to estimate the probabilities of choosing a given profile. Men, senior consultants, working in inflammatory bowel disease center and treating more patients were more likely willing to consider biosimilar for biological-naïve patients only. Treatment type (originator/biosimilar) was the most important determinant of choice for patients already treated with biologicals, and the availability of continuous medicine supply in case of biological-naïve patients. The probabilities of choosing the biosimilar with all the benefits offered over the originator under current reimbursement conditions are 89% versus 11% for new patients, and 44% versus 56% for patients already treated with biological. For gastroenterologist, the continuous medical supply would be one of the major benefits of biosimilars. However, benefits offered in the scenarios do not compensate for the change from the originator to the biosimilar treatment of patients already treated with biologicals.

Evaluating risk factors for endemic human Salmonella Enteritidis infections with different phage types in Ontario, Canada using multinomial logistic regression and a case-case study approach

PubMed Central

2012-01-01

Background Identifying risk factors for Salmonella Enteritidis (SE) infections in Ontario will assist public health authorities to design effective control and prevention programs to reduce the burden of SE infections. Our research objective was to identify risk factors for acquiring SE infections with various phage types (PT) in Ontario, Canada. We hypothesized that certain PTs (e.g., PT8 and PT13a) have specific risk factors for infection. Methods Our study included endemic SE cases with various PTs whose isolates were submitted to the Public Health Laboratory-Toronto from January 20th to August 12th, 2011. Cases were interviewed using a standardized questionnaire that included questions pertaining to demographics, travel history, clinical symptoms, contact with animals, and food exposures. A multinomial logistic regression method using the Generalized Linear Latent and Mixed Model procedure and a case-case study design were used to identify risk factors for acquiring SE infections with various PTs in Ontario, Canada. In the multinomial logistic regression model, the outcome variable had three categories representing human infections caused by SE PT8, PT13a, and all other SE PTs (i.e., non-PT8/non-PT13a) as a referent category to which the other two categories were compared. Results In the multivariable model, SE PT8 was positively associated with contact with dogs (OR=2.17, 95% CI 1.01-4.68) and negatively associated with pepper consumption (OR=0.35, 95% CI 0.13-0.94), after adjusting for age categories and gender, and using exposure periods and health regions as random effects to account for clustering. Conclusions Our study findings offer interesting hypotheses about the role of phage type-specific risk factors. Multinomial logistic regression analysis and the case-case study approach are novel methodologies to evaluate associations among SE infections with different PTs and various risk factors. PMID:23057531

Comparing the efficiency of digital and conventional soil mapping to predict soil types in a semi-arid region in Iran

NASA Astrophysics Data System (ADS)

Zeraatpisheh, Mojtaba; Ayoubi, Shamsollah; Jafari, Azam; Finke, Peter

2017-05-01

The efficiency of different digital and conventional soil mapping approaches to produce categorical maps of soil types is determined by cost, sample size, accuracy and the selected taxonomic level. The efficiency of digital and conventional soil mapping approaches was examined in the semi-arid region of Borujen, central Iran. This research aimed to (i) compare two digital soil mapping approaches including Multinomial logistic regression and random forest, with the conventional soil mapping approach at four soil taxonomic levels (order, suborder, great group and subgroup levels), (ii) validate the predicted soil maps by the same validation data set to determine the best method for producing the soil maps, and (iii) select the best soil taxonomic level by different approaches at three sample sizes (100, 80, and 60 point observations), in two scenarios with and without a geomorphology map as a spatial covariate. In most predicted maps, using both digital soil mapping approaches, the best results were obtained using the combination of terrain attributes and the geomorphology map, although differences between the scenarios with and without the geomorphology map were not significant. Employing the geomorphology map increased map purity and the Kappa index, and led to a decrease in the 'noisiness' of soil maps. Multinomial logistic regression had better performance at higher taxonomic levels (order and suborder levels); however, random forest showed better performance at lower taxonomic levels (great group and subgroup levels). Multinomial logistic regression was less sensitive than random forest to a decrease in the number of training observations. The conventional soil mapping method produced a map with larger minimum polygon size because of traditional cartographic criteria used to make the geological map 1:100,000 (on which the conventional soil mapping map was largely based). Likewise, conventional soil mapping map had also a larger average polygon size that resulted in a lower level of detail. Multinomial logistic regression at the order level (map purity of 0.80), random forest at the suborder (map purity of 0.72) and great group level (map purity of 0.60), and conventional soil mapping at the subgroup level (map purity of 0.48) produced the most accurate maps in the study area. The multinomial logistic regression method was identified as the most effective approach based on a combined index of map purity, map information content, and map production cost. The combined index also showed that smaller sample size led to a preference for the order level, while a larger sample size led to a preference for the great group level.

Ordered LOGIT Model approach for the determination of financial distress.

PubMed

Kinay, B

2010-01-01

Nowadays, as a result of the global competition encountered, numerous companies come up against financial distresses. To predict and take proactive approaches for those problems is quite important. Thus, the prediction of crisis and financial distress is essential in terms of revealing the financial condition of companies. In this study, financial ratios relating to 156 industrial firms that are quoted in the Istanbul Stock Exchange are used and probabilities of financial distress are predicted by means of an ordered logit regression model. By means of Altman's Z Score, the dependent variable is composed by scaling the level of risk. Thus, a model that can compose an early warning system and predict financial distress is proposed.

Heat protection behaviour in the UK: results of an online survey after the 2013 heatwave.

PubMed

Khare, Swarna; Hajat, Shakoor; Kovats, Sari; Lefevre, Carmen E; de Bruin, Wändi Bruine; Dessai, Suraje; Bone, Angie

2015-09-10

The Heatwave Plan for England provides guidance for personal and home protection measures during heatwaves. Although studies in the USA, Australia and Europe have surveyed heat-related behaviours during heatwaves, few have been conducted in the UK. This study assesses personal and housing (at-home) behaviour and housing characteristics of the UK population during the 2013 heatwave. This paper analyses data from 1497 respondents of an online survey on heat protection measures and behaviour. Participants were asked questions about their behaviour during the 2013 heatwave, the characteristics of their current housing as well as about any negative health outcomes experienced due to the hot weather. We used multinomial logit regression to analyse personal and home heat protection behaviour and logistic regression to analyse characteristics of participants' current home (installed air conditioner, curtains etc.). We stratified the outcomes by age, sex, ethnicity, income, education and regional location. In 2013, for all heat-related illness (except tiredness), a higher proportion of those in the younger age groups reported symptoms compared with those in the older age groups. Women, higher income groups and those with higher education levels were found to be more likely to report always/often taking personal heat protective measures. The elderly were less likely to take some personal and home protective measures but were more likely to live in insulated homes and open windows at night to keep their home cool. Our study has found a high level of awareness of the actions to take during heatwaves in the UK, and has identified important demographic indicators of sections of the UK population that might benefit from additional or more targeted information. The health agencies should attempt to provide better information about heatwaves to those vulnerable (elderly, those at risk living in London, low income earners) or identify any barriers that might be preventing them from undertaking protective behaviour.

How do quality information and cost affect patient choice of provider in a tiered network setting? Results from a survey.

PubMed

Sinaiko, Anna D

2011-04-01

To assess how quality information from multiple sources and financial incentives affect consumer choice of physicians in tiered physician networks. Survey of a stratified random sample of Massachusetts state employees. Respondents were assigned a hypothetical structure with differential copayments for "Tier 1" (preferred) and "Tier 2" (nonpreferred) physicians. Half of respondents were told they needed to select a cardiologist, and half were told they needed to select a dermatologist. Patients were asked whether they would choose a Tier 1 doctor, a Tier 2 doctor, or had no preference in a case where they had no further quality information, a case where a family member or friend recommended a Tier 2 doctor, and a case where their personal physician recommended a Tier 2 doctor. The effects of copayments, recommendations, physician specialty, and patient characteristics on the reported probability of selecting a Tier 1 doctor are analyzed using multinomial logit and logistic regression. Relative to a case where there is no copayment differential between tiers, copayment differences of U.S.$10-U.S.$35 increase the number of respondents indicating they would select a Tier 1 physician by 3.5-11.7 percent. Simulations suggest copayments must exceed U.S.$300 to counteract the recommendation for a lower tiered physician from friends, family, or a referring physician. Sensitivity to the copayments varied with physician specialty. Tiered provider networks with these copayment levels appear to have limited influence on physician choice when contradicted by other trusted sources. Consumers' response likely varies with physician specialty. © Health Research and Educational Trust.

Patient and nurse preferences for implementation of bedside handover: Do they agree? Findings from a discrete choice experiment.

PubMed

Whitty, Jennifer A; Spinks, Jean; Bucknall, Tracey; Tobiano, Georgia; Chaboyer, Wendy

2017-08-01

To describe and compare patients' and nurses' preferences for the implementation of bedside handover. Discrete choice experiment describing handover choices using six characteristics: whether the patient is invited to participate; whether a family member/carer/friend is invited; the number of nurses present; the level of patient involvement; the information content; and privacy. Two Australian hospitals. Adult patients (n=401) and nurses (n=200) recruited from medical wards. Mean importance scores for handover characteristics estimated using mixed multinomial logit regression of the choice data. Both patient and nurse participants preferred handover at the bedside rather than elsewhere (P<.05). Being invited to participate, supporting strong two-way communication, having a family member/carer/friend present and having two nurses rather than the nursing team present were most important for patients. Patients being invited to participate and supporting strong two-way communication were most important for nurses. However, contrary to patient preferences, having a family member/carer/friend present was not considered important by nurses. Further, while patients expressed a weak preference to have sensitive information handed over quietly at the bedside, nurses expressed a relatively strong preference for handover of sensitive information verbally away from the bedside. All participants strongly support handover at the bedside and want patients to participate although patient and nurse preferences for various aspects of bedside handover differ. An understanding of these preferences is expected to support recommendations for improving the patient hospital experience and the consistent implementation of bedside handover as a safety initiative. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Can a publicly funded home care system successfully allocate service based on perceived need rather than socioeconomic status? A Canadian experience.

PubMed

Laporte, Audrey; Croxford, Ruth; Coyte, Peter C

2007-03-01

The present quantitative study evaluates the degree to which socioeconomic status (SES), as opposed to perceived need, determines utilisation of publicly funded home care in Ontario, Canada. The Registered Persons Data Base of the Ontario Health Insurance Plan was used to identify the age, sex and place of residence for all Ontarians who had coverage for the complete calendar year 1998. Utilisation was characterised in two dimensions: (1) propensity - the probability that an individual received service, which was estimated using a multinomial logit equation; and (2) intensity - the amount of service received, conditional on receipt. Short- and long-term service intensity were modelled separately using ordinary least squares regression. Age, sex and co-morbidity were the best predictors (P < 0.0001) of whether or not an individual received publicly funded home care as well as how much care was received, with sicker individuals having increased utilisation. The propensity and intensity of service receipt increased with lower SES (P < 0.0001), and decreased with the proportion of recent immigrants in the region (P < 0.0001), after controlling for age, sex and co-morbidity. Although the allocation of publicly funded home care service was primarily based on perceived need rather than ability to pay, barriers to utilisation for those from areas with a high proportion of recent immigrants were identified. Future research is needed to assess whether the current mix and level of publicly funded resources are indeed sufficient to offset the added costs associated with the provision of high-quality home care.

Using choice-based conjoint to determine the relative importance of dental benefit plan attributes.

PubMed

Cunningham, M A; Gaeth, G J; Juang, C; Chakraborty, G

1999-05-01

The purpose of this study was to use conjoint analysis to determine the importance of specific dental benefit plan features for University of Iowa (UI) staff and to build a model to predict enrollment. From a random sample of 2000 UI staff, 40 percent responded (N = 773). The survey instrument was developed using seven attributes (five dental benefit plan features and two facility characteristics) each offered at three levels (e.g., premium = $20, $15, $10/month). Pilot testing was used to find a realistic range of plan options. Twenty-seven hypothetical dental benefit plans were developed using fractional factorial combinations of the three levels for each of the seven attributes. For all of the hypothetical plans, dental care was to be provided in the UI predoctoral dental clinic. Plan profiles were arranged four per page by combining the existing plan with three hypothetical plans, for a total of nine pages. Respondents' task was to select one plan from each set of four. A regression-like statistical model (Multinomial Logit) was used to estimate importance of each attribute and each attribute level. Relative importance (and coefficients) for each of the seven attributes are as follows: maximum annual benefit (.98), orthodontic coverage (.72), routine restorative (.70), major restorative (.67), time to complete treatment (.61), clinic hours of operation (.47), premium (.18). For each attribute, relative importance of each of three levels will also be presented. These coefficients for each level are used to predict enrollment for plans with specific combinations of the dental benefit plan features.

Citizen Participation in Patient Prioritization Policy Decisions: An Empirical and Experimental Study on Patients' Characteristics

PubMed Central

Diederich, Adele; Swait, Joffre; Wirsik, Norman

2012-01-01

Health systems worldwide are grappling with the need to control costs to maintain system viability. With the combination of worsening economic conditions, an aging population and reductions in tax revenues, the pressures to make structural changes are expected to continue growing. Common cost control mechanisms, e.g. curtailment of patient access and treatment prioritization, are likely to be adversely viewed by citizens. It seems therefore wise to include them in the decision making processes that lead up to policy changes. In the context of a multilevel iterative mixed-method design a quantitative survey representative of the German population (N = 2031) was conducted to probe the acceptance of priority setting in medicine and to explore the practicability of direct public involvement. Here we focus on preferences for patients' characteristics (medical aspects, lifestyle and socio-economic status) as possible criteria for prioritizing medical services. A questionnaire with closed response options was fielded to gain insight into attitudes toward broad prioritization criteria of patient groups. Furthermore, a discrete choice experiment was used as a rigorous approach to investigate citizens' preferences toward specific criteria level in context of other criteria. Both the questionnaire and the discrete choice experiment were performed with the same sample. The citizens' own health and social situation are included as explanatory variables. Data were evaluated using corresponding analysis, contingency analysis, logistic regression and a multinomial exploded logit model. The results show that some medical criteria are highly accepted for prioritizing patients whereas socio-economic criteria are rejected. PMID:22590619

Modeling health survey data with excessive zero and K responses.

PubMed

Lin, Ting Hsiang; Tsai, Min-Hsiao

2013-04-30

Zero-inflated Poisson regression is a popular tool used to analyze data with excessive zeros. Although much work has already been performed to fit zero-inflated data, most models heavily depend on special features of the individual data. To be specific, this means that there is a sizable group of respondents who endorse the same answers making the data have peaks. In this paper, we propose a new model with the flexibility to model excessive counts other than zero, and the model is a mixture of multinomial logistic and Poisson regression, in which the multinomial logistic component models the occurrence of excessive counts, including zeros, K (where K is a positive integer) and all other values. The Poisson regression component models the counts that are assumed to follow a Poisson distribution. Two examples are provided to illustrate our models when the data have counts containing many ones and sixes. As a result, the zero-inflated and K-inflated models exhibit a better fit than the zero-inflated Poisson and standard Poisson regressions. Copyright © 2012 John Wiley & Sons, Ltd.

Latent profile analysis of regression-based norms demonstrates relationship of compounding MS symptom burden and negative work events.

PubMed

Frndak, Seth E; Smerbeck, Audrey M; Irwin, Lauren N; Drake, Allison S; Kordovski, Victoria M; Kunker, Katrina A; Khan, Anjum L; Benedict, Ralph H B

2016-10-01

We endeavored to clarify how distinct co-occurring symptoms relate to the presence of negative work events in employed multiple sclerosis (MS) patients. Latent profile analysis (LPA) was utilized to elucidate common disability patterns by isolating patient subpopulations. Samples of 272 employed MS patients and 209 healthy controls (HC) were administered neuroperformance tests of ambulation, hand dexterity, processing speed, and memory. Regression-based norms were created from the HC sample. LPA identified latent profiles using the regression-based z-scores. Finally, multinomial logistic regression tested for negative work event differences among the latent profiles. Four profiles were identified via LPA: a common profile (55%) characterized by slightly below average performance in all domains, a broadly low-performing profile (18%), a poor motor abilities profile with average cognition (17%), and a generally high-functioning profile (9%). Multinomial regression analysis revealed that the uniformly low-performing profile demonstrated a higher likelihood of reported negative work events. Employed MS patients with co-occurring motor, memory and processing speed impairments were most likely to report a negative work event, classifying them as uniquely at risk for job loss.

Discrete choice experiments in pharmacy: a review of the literature.

PubMed

Naik-Panvelkar, Pradnya; Armour, Carol; Saini, Bandana

2013-02-01

Discrete choice experiments (DCEs) have been widely used to elicit patient preferences for various healthcare services and interventions. The aim of our study was to conduct an in-depth scoping review of the literature and provide a current overview of the progressive application of DCEs within the field of pharmacy. Electronic databases (MEDLINE, EMBASE, SCOPUS, ECONLIT) were searched (January 1990-August 2011) to identify published English language studies using DCEs within the pharmacy context. Data were abstracted with respect to DCE methodology and application to pharmacy. Our search identified 12 studies. The DCE methodology was utilised to elicit preferences for different aspects of pharmacy products, therapy or services. Preferences were elicited from either patients or pharmacists, with just two studies incorporating the views of both. Most reviewed studies examined preferences for process-related or provider-related aspects with a lesser focus on health outcomes. Monetary attributes were considered to be important by most patients and pharmacists in the studies reviewed. Logit, probit or multinomial logit models were most commonly employed for estimation. Our study showed that the pharmacy profession has adopted the DCE methodology consistent with the general health DCEs although the number of studies is quite limited. Future studies need to examine preferences of both patients and providers for particular products or disease-state management services. Incorporation of health outcome attributes in the design, testing for external validity and the incorporation of DCE results in economic evaluation framework to inform pharmacy policy remain important areas for future research. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

The two faces of enhancing utilization of health-care services: determinants of patient initiation and retention in rural Burkina Faso.

PubMed Central

Mugisha, Frederick; Bocar, Kouyate; Dong, Hengjin; Chepng'eno, Gloria; Sauerborn, Rainer

2004-01-01

OBJECTIVE: To explore the factors that determine whether a patient will initiate treatment within a system of health-care services, and the factors that determine whether the patient will be retained in the chosen system, in Nouna, rural Burkina Faso. METHODS: The data used were pooled from four rounds of a household survey conducted in Nouna, rural Burkina Faso. The ongoing demographic surveillance system provided a sampling framework for this survey in which 800 households were sampled using a two-stage cluster sampling procedure. More than one treatment episode was observed for a single episode of illness per patient. The multinomial logit model was used to explore the determinants of patient initiation to systems of modern, traditional and home treatment, and a binary logit model was used to explore the determinants of patient retention within the chosen health-care provider system. FINDINGS: The results suggest that the determinants of patient initiation and their subsequent retention are different. Household income, education, urban residence and expected competency of the provider are positive predictors of initiation, but not of retention, for modern health-care services. Only perceived quality of care positively predicted retention in modern health-care services. CONCLUSION: Interventions focusing on patient initiation and patient retention are likely to be different. Policies directed at enhancing initiation for modern health-care services would primarily focus on reducing financial barriers, while those directed at increasing retention would primarily focus on attributes that improve the perceived quality of care. PMID:15375446

Academic Achievement of Girls in Rural Schools in Kenya

ERIC Educational Resources Information Center

Mungai, A. M.

2012-01-01

This study examined the effect of two family factors (financial, social capital) and school factors on students' achievement. One hundred eighty two, seventh-grade female students from nine schools in Muranga district, Kenya, were studied. The statistical procedures included logit regression, cross-tabulations, frequency counting and chi-square…

Association Between Schizophrenia-Related Polygenic Liability and the Occurrence and Level of Mood-Incongruent Psychotic Symptoms in Bipolar Disorder.

PubMed

Allardyce, Judith; Leonenko, Ganna; Hamshere, Marian; Pardiñas, Antonio F; Forty, Liz; Knott, Sarah; Gordon-Smith, Katherine; Porteous, David J; Haywood, Caroline; Di Florio, Arianna; Jones, Lisa; McIntosh, Andrew M; Owen, Michael J; Holmans, Peter; Walters, James T R; Craddock, Nicholas; Jones, Ian; O'Donovan, Michael C; Escott-Price, Valentina

2018-01-01

Bipolar disorder (BD) overlaps schizophrenia in its clinical presentation and genetic liability. Alternative approaches to patient stratification beyond current diagnostic categories are needed to understand the underlying disease processes and mechanisms. To investigate the association between common-variant liability for schizophrenia, indexed by polygenic risk scores (PRSs), and psychotic presentations of BD. This case-control study in the United Kingdom used multinomial logistic regression to estimate differential PRS associations across categories of cases and controls. Participants included in the final analyses were 4436 cases of BD from the Bipolar Disorder Research Network. These cases were compared with the genotypic data for 4976 cases of schizophrenia and 9012 controls from the Type 1 Diabetes Genetics Consortium study and the Generation Scotland study. Data were collected between January 1, 2000, and December 31, 2013. Data analysis was conducted from March 1, 2016, to February 28, 2017. Standardized PRSs, calculated using alleles with an association threshold of P < .05 in the second Psychiatric Genomics Consortium genome-wide association study of schizophrenia, were adjusted for the first 10 population principal components and genotyping platforms. Multinomial logit models estimated PRS associations with BD stratified by Research Diagnostic Criteria subtypes of BD, by lifetime occurrence of psychosis, and by lifetime mood-incongruent psychotic features. Ordinal logistic regression examined PRS associations across levels of mood incongruence. Ratings were derived from the Schedules for Clinical Assessment in Neuropsychiatry interview and the Bipolar Affective Disorder Dimension Scale. Of the 4436 cases of BD, 2966 (67%) were female patients, and the mean (SD) age at interview was 46 [12] years. Across clinical phenotypes, there was an exposure-response gradient, with the strongest PRS association for schizophrenia (risk ratio [RR] = 1.94; 95% CI, 1.86-2.01), followed by schizoaffective BD (RR = 1.37; 95% CI, 1.22-1.54), bipolar I disorder subtype (RR = 1.30; 95% CI, 1.24-1.36), and bipolar II disorder subtype (RR = 1.04; 95% CI, 0.97-1.11). Within BD cases, there was an effect gradient, indexed by the nature of psychosis. Prominent mood-incongruent psychotic features had the strongest association (RR = 1.46; 95% CI, 1.36-1.57), followed by mood-congruent psychosis (RR = 1.24; 95% CI, 1.17-1.33) and BD with no history of psychosis (RR = 1.09; 95% CI, 1.04-1.15). For the first time to date, a study shows a polygenic-risk gradient across schizophrenia and BD, indexed by the occurrence and level of mood-incongruent psychotic symptoms.

School Exits in the Milwaukee Parental Choice Program: Evidence of a Marketplace?

ERIC Educational Resources Information Center

Ford, Michael

2011-01-01

This article examines whether the large number of school exits from the Milwaukee school voucher program is evidence of a marketplace. Two logistic regression and multinomial logistic regression models tested the relation between the inability to draw large numbers of voucher students and the ability for a private school to remain viable. Data on…

An investigation on fatality of drivers in vehicle-fixed object accidents on expressways in China: Using multinomial logistic regression model.

PubMed

Peng, Yong; Peng, Shuangling; Wang, Xinghua; Tan, Shiyang

2018-06-01

This study aims to identify the effects of characteristics of vehicle, roadway, driver, and environment on fatality of drivers in vehicle-fixed object accidents on expressways in Changsha-Zhuzhou-Xiangtan district of Hunan province in China by developing multinomial logistic regression models. For this purpose, 121 vehicle-fixed object accidents from 2011-2017 are included in the modeling process. First, descriptive statistical analysis is made to understand the main characteristics of the vehicle-fixed object crashes. Then, 19 explanatory variables are selected, and correlation analysis of each two variables is conducted to choose the variables to be concluded. Finally, five multinomial logistic regression models including different independent variables are compared, and the model with best fitting and prediction capability is chosen as the final model. The results showed that the turning direction in avoiding fixed objects raised the possibility that drivers would die. About 64% of drivers died in the accident were found being ejected out of the car, of which 50% did not use a seatbelt before the fatal accidents. Drivers are likely to die when they encounter bad weather on the expressway. Drivers with less than 10 years of driving experience are more likely to die in these accidents. Fatigue or distracted driving is also a significant factor in fatality of drivers. Findings from this research provide an insight into reducing fatality of drivers in vehicle-fixed object accidents.

The prevalences of impaired fasting glucose and diabetes mellitus in working age men of North China: Anshan Worker Health Survey.

PubMed

Liu, Lei; Zhou, Chuang; Du, Hang; Zhang, Kai; Huang, Desheng; Wu, Jingyang

2014-04-29

To investigate the prevalence of impaired fasting glucose (IFG) and total diabetes mellitus (DM) including known diabetes and newly diagnosed diabetes in working age men of North China. A cross-section study was conducted at health medical center of Ansteel Group Hospital in Anshan city of China. 37,345 males between 20-60 years of age were recruited in this study. Age-standardized prevalence of IFG and total DM in these working age men were 25.3% and 8.4%, respectively. The prevalence of IFG and total DM increased, as the age progressed. After multinomial logit analysis, age, systolic blood pressure, drinking, smoking, overweight and obesity, total cholesterol, triglycerides, serum creatinine and blood urea nitrogen were independent risk factors for both IFG and DM. The prevalence rate of IFG in Anshan male workers was higher compared with mainland China overall. Diabetes-related education and popularization of DM prevention programs should be actively carried out with age increasing.

Foot placement during error and pedal applications in naturalistic driving.

PubMed

Wu, Yuqing; Boyle, Linda Ng; McGehee, Daniel; Roe, Cheryl A; Ebe, Kazutoshi; Foley, James

2017-02-01

Data from a naturalistic driving study was used to examine foot placement during routine foot pedal movements and possible pedal misapplications. The study included four weeks of observations from 30 drivers, where pedal responses were recorded and categorized. The foot movements associated with pedal misapplications and errors were the focus of the analyses. A random forest algorithm was used to predict the pedal application types based the video observations, foot placements, drivers' characteristics, drivers' cognitive function levels and anthropometric measurements. A repeated multinomial logit model was then used to estimate the likelihood of the foot placement given various driver characteristics and driving scenarios. The findings showed that prior foot location, the drivers' seat position, and the drive sequence were all associated with incorrect foot placement during an event. The study showed that there is a potential to develop a driver assistance system that can reduce the likelihood of a pedal error. Copyright © 2016 Elsevier Ltd. All rights reserved.

Contraceptive practice in China: 1970-2004.

PubMed

Wang, Cuntong

2015-03-01

Using large-scale data from the national conventional statistics and nationally representative sample surveys, the current study aims to assess the level, mode, and determinants of modern contraceptive use from 1970 to 2004 among married couples aged 20 to 49 years in China. A relatively stable Chinese mode of contraception has been established and maintained since the 1980s, characterized by prominent, long-acting contraceptive use and the highest overall prevalence in the world during the past 3 decades. In recent years, the composition of contraceptive use has changed, characterized by the increasing use of the intrauterine device and short-acting methods and a drastic decrease in male and female sterilization. However, the dominance of the long-acting methods has not undergone substantial change. The results from a multinomial logit model employed in this study indicate that family planning policy and socioeconomic and demographic factors jointly influence contraceptive choice. In particular, contraceptive choice is closely associated with the strength of family planning policy in China. © 2011 APJPH.

Transitions between states of labor-force participation among older Israelis.

PubMed

Achdut, Leah; Tur-Sinai, Aviad; Troitsky, Rita

2015-03-01

The study examines the labor-force behavior of Israelis at older ages, focusing on the determinants of the transitions between states of labor-force participation between 2005 and 2010. The study uses panel data from the first two waves of the SHARE-Israel longitudinal survey. A multinomial logit model is used to examine the impact of sociodemographic characteristics, health state, and economic resources on labor-force transitions of people aged 50-67. The results emphasize the role of age and poor health in "pushing" older people out of the labor force or "keeping" them there. Spouse's participation is found to encourage individuals to leave the labor force or to refrain from joining it. However, living with a participating spouse is negatively associated with staying out of the labor force, consistent with the dominance of the complementarity of leisure effect found in the literature. Wealth as an economic resource available to individuals for retirement is also found to encourage individuals to leave the labor force or to refrain from joining it.

Gender and changing generational relations: spouse choice in Indonesia.

PubMed

Malhotra, A

1991-11-01

Many Asian societies are undergoing a nuptiality transition that is not only tied integrally to other aspects of family organization, but is also often more complex than standard studies of female age at marriage can reveal. To comprehend some of this complexity, we focus on the patterns of spouse choice for both men and women in central Java. The extent of parental control over mate selection is examined for change over time, gender differences, and likely determinants, including family class, education, premarital work, and residence. It is argued that the current marriage transition in Indonesia reflects both gender and generational hierarchies in the Javanese family system. The analysis is conducted using a multinomial logit model; in general, it yields results strongly supportive of the argument that the determinants of spouse selection differ by gender. The results also show that although there is a dramatic shift towards self-choice marriages, it is occurring within the context of historical and institutional factors specific to Javanese society.

Making difficult decisions: the role of quality of care in choosing a nursing home.

PubMed

Pesis-Katz, Irena; Phelps, Charles E; Temkin-Greener, Helena; Spector, William D; Veazie, Peter; Mukamel, Dana B

2013-05-01

We investigated how quality of care affects choosing a nursing home. We examined nursing home choice in California, Ohio, New York, and Texas in 2001, a period before the federal Nursing Home Compare report card was published. Thus, consumers were less able to observe clinical quality or clinical quality was masked. We modeled nursing home choice by estimating a conditional multinomial logit model. In all states, consumers were more likely to choose nursing homes of high hotel services quality but not clinical care quality. Nursing home choice was also significantly associated with shorter distance from prior residence, not-for-profit status, and larger facility size. In the absence of quality report cards, consumers choose a nursing home on the basis of the quality dimensions that are easy for them to observe, evaluate, and apply to their situation. Future research should focus on identifying the quality information that offers the most value added to consumers.

Making Difficult Decisions: The Role of Quality of Care in Choosing a Nursing Home

PubMed Central

Phelps, Charles E.; Temkin-Greener, Helena; Spector, William D.; Veazie, Peter; Mukamel, Dana B.

2013-01-01

Objectives. We investigated how quality of care affects choosing a nursing home. Methods. We examined nursing home choice in California, Ohio, New York, and Texas in 2001, a period before the federal Nursing Home Compare report card was published. Thus, consumers were less able to observe clinical quality or clinical quality was masked. We modeled nursing home choice by estimating a conditional multinomial logit model. Results. In all states, consumers were more likely to choose nursing homes of high hotel services quality but not clinical care quality. Nursing home choice was also significantly associated with shorter distance from prior residence, not-for-profit status, and larger facility size. Conclusions. In the absence of quality report cards, consumers choose a nursing home on the basis of the quality dimensions that are easy for them to observe, evaluate, and apply to their situation. Future research should focus on identifying the quality information that offers the most value added to consumers. PMID:23488519

The morality of attitudes toward nanotechnology: about God, techno-scientific progress, and interfering with nature

NASA Astrophysics Data System (ADS)

Vandermoere, Frederic; Blanchemanche, Sandrine; Bieberstein, Andrea; Marette, Stephan; Roosen, Jutta

2010-02-01

Using survey data, we examine public attitudes toward and awareness of nanotechnology in Germany ( N = 750). First, it is shown that a majority of the people are still not familiar with nanotechnology. In addition, diffusion of information about nanotechnology thus far mostly seems to reach men and people with a relative higher educational background. Also, pro-science and technology views are positively related with nanotech familiarity. Results further show that a majority of the people have an indifferent, ambiguous, or non-attitude toward nanotechnology. Multinomial logit analyses further reveal that nanotech familiarity is positively related with people's attitudes. In addition, it is shown that traditional religiosity is unrelated to attitudes and that individual religiosity is weakly related to nanotechnology attitudes. However, moral covariates other than religiosity seem of major importance. In particular, our results show that more negative views on technological and scientific progress as well as more holistic views about the relation between people and the environment increase the likelihood of having a negative attitude toward nanotechnology.

[Logistic regression model of noninvasive prediction for portal hypertensive gastropathy in patients with hepatitis B associated cirrhosis].

PubMed

Wang, Qingliang; Li, Xiaojie; Hu, Kunpeng; Zhao, Kun; Yang, Peisheng; Liu, Bo

2015-05-12

To explore the risk factors of portal hypertensive gastropathy (PHG) in patients with hepatitis B associated cirrhosis and establish a Logistic regression model of noninvasive prediction. The clinical data of 234 hospitalized patients with hepatitis B associated cirrhosis from March 2012 to March 2014 were analyzed retrospectively. The dependent variable was the occurrence of PHG while the independent variables were screened by binary Logistic analysis. Multivariate Logistic regression was used for further analysis of significant noninvasive independent variables. Logistic regression model was established and odds ratio was calculated for each factor. The accuracy, sensitivity and specificity of model were evaluated by the curve of receiver operating characteristic (ROC). According to univariate Logistic regression, the risk factors included hepatic dysfunction, albumin (ALB), bilirubin (TB), prothrombin time (PT), platelet (PLT), white blood cell (WBC), portal vein diameter, spleen index, splenic vein diameter, diameter ratio, PLT to spleen volume ratio, esophageal varices (EV) and gastric varices (GV). Multivariate analysis showed that hepatic dysfunction (X1), TB (X2), PLT (X3) and splenic vein diameter (X4) were the major occurring factors for PHG. The established regression model was Logit P=-2.667+2.186X1-2.167X2+0.725X3+0.976X4. The accuracy of model for PHG was 79.1% with a sensitivity of 77.2% and a specificity of 80.8%. Hepatic dysfunction, TB, PLT and splenic vein diameter are risk factors for PHG and the noninvasive predicted Logistic regression model was Logit P=-2.667+2.186X1-2.167X2+0.725X3+0.976X4.

Determinants of Anabolic-Androgenic Steroid Risk Perceptions in Youth Populations: A Multivariate Analysis

ERIC Educational Resources Information Center

Denham, Bryan E.

2009-01-01

Grounded conceptually in social cognitive theory, this research examines how personal, behavioral, and environmental factors are associated with risk perceptions of anabolic-androgenic steroids. Ordinal logistic regression and logit log-linear models applied to data gathered from high-school seniors (N = 2,160) in the 2005 Monitoring the Future…

Gaussian Process Regression Model in Spatial Logistic Regression

NASA Astrophysics Data System (ADS)

Sofro, A.; Oktaviarina, A.

2018-01-01

Spatial analysis has developed very quickly in the last decade. One of the favorite approaches is based on the neighbourhood of the region. Unfortunately, there are some limitations such as difficulty in prediction. Therefore, we offer Gaussian process regression (GPR) to accommodate the issue. In this paper, we will focus on spatial modeling with GPR for binomial data with logit link function. The performance of the model will be investigated. We will discuss the inference of how to estimate the parameters and hyper-parameters and to predict as well. Furthermore, simulation studies will be explained in the last section.

Korean, Japanese, and Chinese populations featured similar genes encoding drug-metabolizing enzymes and transporters: a DMET Plus microarray assessment.

PubMed

Yi, SoJeong; An, Hyungmi; Lee, Howard; Lee, Sangin; Ieiri, Ichiro; Lee, Youngjo; Cho, Joo-Youn; Hirota, Takeshi; Fukae, Masato; Yoshida, Kenji; Nagatsuka, Shinichiro; Kimura, Miyuki; Irie, Shin; Sugiyama, Yuichi; Shin, Dong Wan; Lim, Kyoung Soo; Chung, Jae-Yong; Yu, Kyung-Sang; Jang, In-Jin

2014-10-01

Interethnic differences in genetic polymorphism in genes encoding drug-metabolizing enzymes and transporters are one of the major factors that cause ethnic differences in drug response. This study aimed to investigate genetic polymorphisms in genes involved in drug metabolism, transport, and excretion among Korean, Japanese, and Chinese populations, the three major East Asian ethnic groups. The frequencies of 1936 variants representing 225 genes encoding drug-metabolizing enzymes and transporters were determined from 786 healthy participants (448 Korean, 208 Japanese, and 130 Chinese) using the Affymetrix Drug-Metabolizing Enzymes and Transporters Plus microarray. To compare allele or genotype frequencies in the high-dimensional data among the three East Asian ethnic groups, multiple testing, principal component analysis (PCA), and regularized multinomial logit model through least absolute shrinkage and selection operator were used. On microarray analysis, 1071 of 1936 variants (>50% of markers) were found to be monomorphic. In a large number of genetic variants, the fixation index and Pearson's correlation coefficient of minor allele frequencies were less than 0.034 and greater than 0.95, respectively, among the three ethnic groups. PCA identified 47 genetic variants with multiple testing, but was unable to discriminate ethnic groups by the first three components. Multinomial least absolute shrinkage and selection operator analysis identified 269 genetic variants that showed different frequencies among the three ethnic groups. However, none of those variants distinguished between the three ethnic groups during subsequent PCA. Korean, Japanese, and Chinese populations are not pharmacogenetically distant from one another, at least with regard to drug disposition, metabolism, and elimination.

Arsenic exposure and oral cavity lesions in Bangladesh.

PubMed

Syed, Emdadul H; Melkonian, Stephanie; Poudel, Krishna C; Yasuoka, Junko; Otsuka, Keiko; Ahmed, Alauddin; Islam, Tariqul; Parvez, Faruque; Slavkovich, Vesna; Graziano, Joseph H; Ahsan, Habibul; Jimba, Masamine

2013-01-01

To evaluate the relationship between arsenic exposure and oral cavity lesions among an arsenic-exposed population in Bangladesh. We carried out an analysis utilizing the baseline data of the Health Effects of Arsenic Exposure Longitudinal Study, which is an ongoing population-based cohort study to investigate health outcomes associated with arsenic exposure via drinking water in Araihazar, Bangladesh. We used multinomial regression models to estimate the risk of oral cavity lesions. Participants with high urinary arsenic levels (286.1 to 5000.0 μg/g) were more likely to develop arsenical lesions of the gums (multinomial odds ratio = 2.90; 95% confidence interval, 1.11 to 7.54), and tongue (multinomial odds ratio = 2.79; 95% confidence interval, 1.51 to 5.15), compared with those with urinary arsenic levels of 7.0 to 134.0 μg/g. Higher level of arsenic exposure was positively associated with increased arsenical lesions of the gums and tongue.

How do patient characteristics influence informal payments for inpatient and outpatient health care in Albania: Results of logit and OLS models using Albanian LSMS 2005

PubMed Central

2011-01-01

Background Informal payments for health care are common in most former communist countries. This paper explores the demand side of these payments in Albania. By using data from the Living Standard Measurement Survey 2005 we control for individual determinants of informal payments in inpatient and outpatient health care. We use these results to explain the main factors contributing to the occurrence and extent of informal payments in Albania. Methods Using multivariate methods (logit and OLS) we test three models to explain informal payments: the cultural, economic and governance model. The results of logit models are presented here as odds ratios (OR) and results from OLS models as regression coefficients (RC). Results Our findings suggest differences in determinants of informal payments in inpatient and outpatient care. Generally our results show that informal payments are dependent on certain characteristics of patients, including age, area of residence, education, health status and health insurance. However, they are less dependent on income, suggesting homogeneity of payments across income categories. Conclusions We have found more evidence for the validity of governance and economic models than for the cultural model. PMID:21605459

Grouped gene selection and multi-classification of acute leukemia via new regularized multinomial regression.

PubMed

Li, Juntao; Wang, Yanyan; Jiang, Tao; Xiao, Huimin; Song, Xuekun

2018-05-09

Diagnosing acute leukemia is the necessary prerequisite to treating it. Multi-classification on the gene expression data of acute leukemia is help for diagnosing it which contains B-cell acute lymphoblastic leukemia (BALL), T-cell acute lymphoblastic leukemia (TALL) and acute myeloid leukemia (AML). However, selecting cancer-causing genes is a challenging problem in performing multi-classification. In this paper, weighted gene co-expression networks are employed to divide the genes into groups. Based on the dividing groups, a new regularized multinomial regression with overlapping group lasso penalty (MROGL) has been presented to simultaneously perform multi-classification and select gene groups. By implementing this method on three-class acute leukemia data, the grouped genes which work synergistically are identified, and the overlapped genes shared by different groups are also highlighted. Moreover, MROGL outperforms other five methods on multi-classification accuracy. Copyright © 2017. Published by Elsevier B.V.

Dominance of Sterilization and Alternative Choices of Contraception in India: An Appraisal of the Socioeconomic Impact

PubMed Central

de Oliveira, Isabel Tiago; Dias, José G.; Padmadas, Sabu S.

2014-01-01

Background The recent decline in fertility in India has been unprecedented especially in southern India, where fertility is almost exclusively controlled by means of permanent contraceptive methods, mainly female sterilization, which constitutes about two-thirds of overall contraceptive use. Many Indian women undergo sterilization at relatively young ages as a consequence of early marriage and childbearing in short birth intervals. This research aims to investigate the socioeconomic factors determining the choices for alternative contraceptive choices against the dominant preference for sterilization among married women in India. Methods Data for this study are drawn from the 2005–06 National Family Health Surveys focusing on a sample of married women who reported having used a method of contraception in the five years preceding the survey. A multilevel multinomial logit regression is used to estimate the impact of socioeconomic factors on contraceptive choices, differentiating temporary modern or traditional methods versus sterilization. Findings Religious affiliation, women's education and occupation had overarching influence on method choices amongst recent users. Muslim women were at higher odds of choosing a traditional or modern temporary method than sterilization. Higher level of women's education increased the odds of modern temporary method choices but the education effect on traditional method choices was only marginally significant. Recent users belonging to wealthier households had higher odds of choosing modern methods over sterilization. Exposure to family planning messages through radio had a positive effect on modern and traditional method choices. Community variations in method choices were highly significant. Conclusion The persistent dominance of sterilization in the Indian family planning programme is largely determined by socioeconomic conditions. Reproductive health programmes should address the socioeconomic barriers and consider multiple cost-effective strategies such as mass media to promote awareness of modern temporary methods. PMID:24489759

Consumer preferences for electronic cigarettes: results from a discrete choice experiment.

PubMed

Czoli, Christine D; Goniewicz, Maciej; Islam, Towhidul; Kotnowski, Kathy; Hammond, David

2016-04-01

E-cigarettes present a formidable challenge to regulators given their variety and the rapidly evolving nicotine market. The current study sought to examine the influence of e-cigarette product characteristics on consumer perceptions and trial intentions among Canadians. An online discrete choice experiment was conducted with 915 Canadians aged 16 years and older in November 2013. An online commercial panel was used to sample 3 distinct subpopulations: (1) non-smoking youth and young adults (n=279); (2) smoking youth and young adults (n=264) and (3) smoking adults (n=372). Participants completed a series of stated-preference tasks, in which they viewed choice sets with e-cigarette product images that featured different combinations of attributes: flavour, nicotine content, health warnings and price. For each choice set, participants were asked to select one of the products or indicate 'none of the above' with respect to the following outcomes: interest in trying, less harm and usefulness in quitting smoking. The attributes' impact on consumer choice for each outcome was analysed using multinomial logit regression. Health warning was the most important attribute influencing participants' intentions to try e-cigarettes (42%) and perceived efficacy as a quit aid (39%). Both flavour (36%) and health warnings (35%) significantly predicted perceptions of product harm. The findings indicate that consumers make trade-offs with respect to e-cigarette product characteristics, and that these trade-offs vary across different subpopulations. Given that health warnings and flavour were weighted most important by consumers in this study, these may represent good targets for e-cigarette regulatory frameworks. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Assessing Medicare Part D Claim Completeness Using Medication Self-reports: The Role of Veteran Status and Generic Drug Discount Programs

PubMed Central

Zhou, Lei; Stearns, Sally C.; Thudium, Emily M.; Alburikan, Khalid A.; Rodgers, Jo Ellen

2015-01-01

Objective Medicare Part D claims are commonly used for research, but missing claims could compromise their validity. This study assessed two possible causes of missing claims: veteran status and Generic Drug Discount Programs (GDDP). Methods We merged medication self-reports from telephone interviews in the Atherosclerosis Risk in Communities Study (ARIC) with Part D claims for six medications (three were commonly in GDDP in 2009). Merged records (4,468) were available for 2,905 ARIC participants enrolled in Part D. Multinomial logit regression provided estimates of the association of concordance (self-report & Part D, self-report only, or Part D only) with veteran and GDDP status, controlling for participant socio-demographics. Results Sample participants were 74±5 years of age, 68% white and 63% female; 19% were male veterans. Compared to females, male veterans were 11% (95% CI: 7%–16%) less likely to have matched medications in self-report & Part D and 11% (95% CI: 7%–16%) more likely to have self-report only. Records for GDDP versus non-GDDP medications were 4% (95% CI: 1%–7%) more likely to be in self-report & Part D and 3% (95% CI: 1%–5%) less likely to be in Part D only, with no difference in self-report only. Conclusions Part D claims were more likely to be missing for veterans, but claims for medications commonly available through GDDP were more likely to match with self-reports. While researchers should be aware of the possibility of missing claims, GDDP status was associated with a higher rather than lower likelihood of claims being complete in 2009. PMID:25793271

Educational debt and intended employment choice among dental school seniors.

PubMed

Wanchek, Tanya; Nicholson, Sean; Vujicic, Marko; Menezes, Adriana; Ziebert, Anthony

2014-05-01

The authors examined the association between educational debt and dental school seniors' intended activity after graduation. The authors used multinomial logit regression analysis to estimate the relationship between dental educational debt and intended activity after graduation, controlling for potentially confounding variables. They used data from the 2004 through 2011 ADEA (American Dental Education Association) Survey of Dental School Seniors. Fourth-year dental school students with high levels of educational debt were more likely to express an interest in choosing to go into private practice, although the magnitude of this effect was relatively small. For each $10,000 increase in debt, the likelihood of choosing advanced education relative to private practice was 1.5 percent lower (relative risk ratio [RRR], 0.985 [95 percent confidence interval {CI}, 0.978-0.991]). For the same $10,000 increase in debt, the probability of choosing teaching, research and administration was 3.1 percent lower than that for choosing private practice (RRR, 0.969 [95 percent CI, 0.954-0.986]) and was 8.4 percent lower than that for choosing a government service position (RRR, 0.916 [95 percent CI, 0.908-0.924]). Although educational debt was statistically significant for predicting intended activity after graduation, the magnitude of influence of other variables such as sex, race and whether a parent is a dentist was substantially larger. Practical Implications Concerns regarding rising educational debt and its effect on the dental labor market may be misplaced. The characteristics of the dental school student body may be a more accurate predictor of employment choices that dental school seniors are making than are total educational debt levels.

Patient and nurse preferences for nurse handover—using preferences to inform policy: a discrete choice experiment protocol

PubMed Central

Spinks, Jean; Chaboyer, Wendy; Bucknall, Tracey; Tobiano, Georgia; Whitty, Jennifer A

2015-01-01

Introduction Nursing bedside handover in hospital has been identified as an opportunity to involve patients and promote patient-centred care. It is important to consider the preferences of both patients and nurses when implementing bedside handover to maximise the successful uptake of this policy. We outline a study which aims to (1) identify, compare and contrast the preferences for various aspects of handover common to nurses and patients while accounting for other factors, such as the time constraints of nurses that may influence these preferences.; (2) identify opportunities for nurses to better involve patients in bedside handover and (3) identify patient and nurse preferences that may challenge the full implementation of bedside handover in the acute medical setting. Methods and analysis We outline the protocol for a discrete choice experiment (DCE) which uses a survey design common to both patients and nurses. We describe the qualitative and pilot work undertaken to design the DCE. We use a D-efficient design which is informed by prior coefficients collected during the pilot phase. We also discuss the face-to-face administration of this survey in a population of acutely unwell, hospitalised patients and describe how data collection challenges have been informed by our pilot phase. Mixed multinomial logit regression analysis will be used to estimate the final results. Ethics and dissemination This study has been approved by a university ethics committee as well as two participating hospital ethics committees. Results will be used within a knowledge translation framework to inform any strategies that can be used by nursing staff to improve the uptake of bedside handover. Results will also be disseminated via peer-reviewed journal articles and will be presented at national and international conferences. PMID:26560060

Dominance of sterilization and alternative choices of contraception in India: an appraisal of the socioeconomic impact.

PubMed

de Oliveira, Isabel Tiago; Dias, José G; Padmadas, Sabu S

2014-01-01

The recent decline in fertility in India has been unprecedented especially in southern India, where fertility is almost exclusively controlled by means of permanent contraceptive methods, mainly female sterilization, which constitutes about two-thirds of overall contraceptive use. Many Indian women undergo sterilization at relatively young ages as a consequence of early marriage and childbearing in short birth intervals. This research aims to investigate the socioeconomic factors determining the choices for alternative contraceptive choices against the dominant preference for sterilization among married women in India. Data for this study are drawn from the 2005-06 National Family Health Surveys focusing on a sample of married women who reported having used a method of contraception in the five years preceding the survey. A multilevel multinomial logit regression is used to estimate the impact of socioeconomic factors on contraceptive choices, differentiating temporary modern or traditional methods versus sterilization. Religious affiliation, women's education and occupation had overarching influence on method choices amongst recent users. Muslim women were at higher odds of choosing a traditional or modern temporary method than sterilization. Higher level of women's education increased the odds of modern temporary method choices but the education effect on traditional method choices was only marginally significant. Recent users belonging to wealthier households had higher odds of choosing modern methods over sterilization. Exposure to family planning messages through radio had a positive effect on modern and traditional method choices. Community variations in method choices were highly significant. The persistent dominance of sterilization in the Indian family planning programme is largely determined by socioeconomic conditions. Reproductive health programmes should address the socioeconomic barriers and consider multiple cost-effective strategies such as mass media to promote awareness of modern temporary methods.

Do You Know What You Owe? Students' Understanding of Their Student Loans

ERIC Educational Resources Information Center

Andruska, Emily A.; Hogarth, Jeanne M.; Fletcher, Cynthia Needles; Forbes, Gregory R.; Wohlgemuth, Darin R.

2014-01-01

Using a data set that augments a student survey with administrative data from the Iowa State University Office of Financial Aid, the authors posed two questions: Do students know whether they have student loans? Do students know how much they owe on outstanding student loans? We used logistic and ordered logit regressions to answer these…

The Impact of School Socioeconomic Status on Student-Generated Teacher Ratings

ERIC Educational Resources Information Center

Agnew, Steve

2011-01-01

This paper uses ordinary least squares, logit and probit regressions, along with chi-square analysis applied to nationwide data from the New Zealand ratemyteacher website to establish if there is any correlation between student ratings of their teachers and the socioeconomic status of the school the students attend. The results show that students…

Calculating Preference Weights for the Labor and Delivery Index: A Discrete Choice Experiment on Women's Birth Experiences.

PubMed

Gärtner, Fania R; de Bekker-Grob, Esther W; Stiggelbout, Anne M; Rijnders, Marlies E; Freeman, Liv M; Middeldorp, Johanna M; Bloemenkamp, Kitty W M; de Miranda, Esteriek; van den Akker-van Marle, M Elske

2015-09-01

The aim of this study was to calculate preference weights for the Labor and Delivery Index (LADY-X) to make it suitable as a utility measure for perinatal care studies. In an online discrete choice experiment, 18 pairs of hypothetical scenarios were presented to respondents, from which they had to choose a preferred option. The scenarios describe the birth experience in terms of the seven LADY-X attributes. A D-efficient discrete choice experiment design with priors based on a small sample (N = 110) was applied. Two samples were gathered, women who had recently given birth and subjects from the general population. Both samples were analyzed separately using a panel mixed logit (MMNL) model. Using the panel mixed multinomial logit (MMNL) model results and accounting for preference heterogeneity, we calculated the average preference weights for LADY-X attribute levels. These were transformed to represent a utility score between 0 and 1, with 0 representing the worst and 1 representing the best birth experience. In total, 1097 women who had recently given birth and 367 subjects from the general population participated. Greater value was placed on differences between bottom and middle attribute levels than on differences between middle and top levels. The attributes that resulted in larger utility increases than the other attributes were "feeling of safety" in the sample of women who had recently given birth and "feeling of safety" and "availability of professionals" in the general population sample. By using the derived preference weights, LADY-X has the potential to be used as a utility measure for perinatal (cost-) effectiveness studies. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

New machine-learning algorithms for prediction of Parkinson's disease

NASA Astrophysics Data System (ADS)

Mandal, Indrajit; Sairam, N.

2014-03-01

This article presents an enhanced prediction accuracy of diagnosis of Parkinson's disease (PD) to prevent the delay and misdiagnosis of patients using the proposed robust inference system. New machine-learning methods are proposed and performance comparisons are based on specificity, sensitivity, accuracy and other measurable parameters. The robust methods of treating Parkinson's disease (PD) includes sparse multinomial logistic regression, rotation forest ensemble with support vector machines and principal components analysis, artificial neural networks, boosting methods. A new ensemble method comprising of the Bayesian network optimised by Tabu search algorithm as classifier and Haar wavelets as projection filter is used for relevant feature selection and ranking. The highest accuracy obtained by linear logistic regression and sparse multinomial logistic regression is 100% and sensitivity, specificity of 0.983 and 0.996, respectively. All the experiments are conducted over 95% and 99% confidence levels and establish the results with corrected t-tests. This work shows a high degree of advancement in software reliability and quality of the computer-aided diagnosis system and experimentally shows best results with supportive statistical inference.

A general equation to obtain multiple cut-off scores on a test from multinomial logistic regression.

PubMed

Bersabé, Rosa; Rivas, Teresa

2010-05-01

The authors derive a general equation to compute multiple cut-offs on a total test score in order to classify individuals into more than two ordinal categories. The equation is derived from the multinomial logistic regression (MLR) model, which is an extension of the binary logistic regression (BLR) model to accommodate polytomous outcome variables. From this analytical procedure, cut-off scores are established at the test score (the predictor variable) at which an individual is as likely to be in category j as in category j+1 of an ordinal outcome variable. The application of the complete procedure is illustrated by an example with data from an actual study on eating disorders. In this example, two cut-off scores on the Eating Attitudes Test (EAT-26) scores are obtained in order to classify individuals into three ordinal categories: asymptomatic, symptomatic and eating disorder. Diagnoses were made from the responses to a self-report (Q-EDD) that operationalises DSM-IV criteria for eating disorders. Alternatives to the MLR model to set multiple cut-off scores are discussed.

Alcohol Use-Related Problems Among a Rural Indian Population of West Bengal: An Application of the Alcohol Use Disorders Identification Test (AUDIT).

PubMed

Barik, Anamitra; Rai, Rajesh Kumar; Chowdhury, Abhijit

2016-03-01

To examine alcohol use and related problems among a rural subset of the Indian population. The Alcohol Use Disorders Identification Test (AUDIT) was used as part of Health and Demographic Surveillance of 36,611 individuals aged ≥18 years. From this survey data on 3671 current alcohol users were analysed using bivariate and multivariate ordered logit regression. Over 19% of males and 2.4% of females were current alcohol users. Mean ethanol consumption on a typical drinking day among males was estimated to be higher (96.3 gm) than females (56.5 gm). Mean AUDIT score was 11 among current alcohol users. AUDIT showed in the ordered logit regression estimated alcohol use-related problems to be low among women, Scheduled Tribes and unmarried people, whereas alcohol use-related problems registered high among Muslims. This rural population appears to be in need of an effective intervention program, perhaps targeting men and the household, aimed at reducing the level of alcohol use and related problems. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Divergent Preferences for HIV Prevention: A Discrete Choice Experiment for Multipurpose HIV Prevention Products in South Africa.

PubMed

Quaife, Matthew; Eakle, Robyn; Cabrera Escobar, Maria A; Vickerman, Peter; Kilbourne-Brook, Maggie; Mvundura, Mercy; Delany-Moretlwe, Sinead; Terris-Prestholt, Fern

2018-01-01

The development of antiretroviral (ARV)-based prevention products has the potential to substantially change the HIV prevention landscape; yet, little is known about how appealing these products will be outside of clinical trials, as compared with the existing options. We conducted a discrete choice experiment (DCE) to measure preferences for 5 new products among 4 important populations in the HIV response: adult men and women in the general population (aged 18 to 49 y), adolescent girls (aged 16 to 17 y), and self-identifying female sex workers (aged 18 to 49 y). We interviewed 661 self-reported HIV-negative participants in peri-urban South Africa, who were asked to choose between 3 unique, hypothetical products over 10 choice sets. Data were analyzed using multinomial, latent class and mixed multinomial logit models. HIV protection was the most important attribute to respondents; however, results indicate significant demand among all groups for multipurpose prevention products that offer protection from HIV infection, other STIs, and unwanted pregnancy. All groups demonstrated a strong preference for long-lasting injectable products. There was substantial heterogeneity in preferences within and across population groups. Hypothetical DCE data may not mirror real-world choices, and products will have more attributes in reality than represented in choice tasks. Background data on participants, including sensitive areas of HIV status and condom use, was self-reported. These results suggest that stimulating demand for new HIV prevention products may require a more a nuanced approach than simply developing highly effective products. No single product is likely to be equally attractive or acceptable across different groups. This study strengthens the call for effective and attractive multipurpose prevention products to be deployed as part of a comprehensive combination prevention strategy.

CAP payments and agricultural GHG emissions in Italy. A farm-level assessment.

PubMed

Coderoni, Silvia; Esposti, Roberto

2018-06-15

The Common Agricultural Policy (CAP) is an important external driver of European agricultural production. Nowadays and in its envisioned future structure post-2020, the CAP has among its major objectives tackling climate change, for what concerns both adaptation and mitigation strategies. However, little is known about the link between past CAP reforms and agricultural greenhouse gases (GHG) emissions. This paper investigates the possible role played by the Fischler Reform (FR) on the agricultural GHG emissions at the farm level. The FR represents a major CAP reform for which data availability allows an ex-post analysis about its actual impacts. The empirical analysis concerns a balanced panel of 6542 Italian Farm Accountancy Data Network observed over years the 2003-2007. Multinomial Logit models are estimated in sequence to express how the farm-level production choices, and the respective emissions, vary over time also in response to CAP expenditure. Results suggest that CAP expenditure had a role in the evolution of the farm-level emissions, though the direction of this effect may differ across farms and deserves further investigation. Copyright © 2018 Elsevier B.V. All rights reserved.

Residents’ Preferences for Household Kitchen Waste Source Separation Services in Beijing: A Choice Experiment Approach

PubMed Central

Yuan, Yalin; Yabe, Mitsuyasu

2014-01-01

A source separation program for household kitchen waste has been in place in Beijing since 2010. However, the participation rate of residents is far from satisfactory. This study was carried out to identify residents’ preferences based on an improved management strategy for household kitchen waste source separation. We determine the preferences of residents in an ad hoc sample, according to their age level, for source separation services and their marginal willingness to accept compensation for the service attributes. We used a multinomial logit model to analyze the data, collected from 394 residents in Haidian and Dongcheng districts of Beijing City through a choice experiment. The results show there are differences of preferences on the services attributes between young, middle, and old age residents. Low compensation is not a major factor to promote young and middle age residents accept the proposed separation services. However, on average, most of them prefer services with frequent, evening, plastic bag attributes and without instructor. This study indicates that there is a potential for local government to improve the current separation services accordingly. PMID:25546279

Effects of payment changes on trends in post-acute care.

PubMed

Buntin, Melinda Beeuwkes; Colla, Carrie Hoverman; Escarce, José J

2009-08-01

To test how the implementation of new Medicare post-acute payment systems affected the use of inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and home health agencies. Medicare acute hospital, IRF, and SNF claims; provider of services file; enrollment file; and Area Resource File data. We used multinomial logit models to measure realized access to post-acute care and to predict how access to alternative sites of care changed in response to prospective payment systems. A file was constructed linking data for elderly Medicare patients discharged from acute care facilities between 1996 and 2003 with a diagnosis of hip fracture, stroke, or lower extremity joint replacement. Although the effects of the payment systems on the use of post-acute care varied, most reduced the use of the site of care they directly affected and boosted the use of alternative sites of care. Payment system changes do not appear to have differentially affected the severely ill. Payment system incentives play a significant role in determining where Medicare beneficiaries receive their post-acute care. Changing these incentives results in shifting of patients between post-acute sites.

An empirical analysis of farm vehicle crash injury severities on Iowa's public road system.

PubMed

Gkritza, Konstantina; Kinzenbaw, Caroline R; Hallmark, Shauna; Hawkins, Neal

2010-07-01

Farm vehicle crashes are a major safety concern for farmers as well as all other users of the public road system in agricultural states. Using data on farm vehicle crashes that occurred on Iowa's public roads between 2004 and 2006, we estimate a multinomial logit model to identify crash-, farm vehicle-, and driver-specific factors that determine farm vehicle crash injury severity outcomes. Estimation findings indicate that there are crash patterns (rear-end manner of collision; single-vehicle crash; farm vehicle crossed the centerline or median) and conditions (obstructed vision and crash in rural area; dry road, dark lighting, speed limit 55 mph or higher, and harvesting season), as well as farm vehicle and driver-contributing characteristics (old farm vehicle, young farm vehicle driver), where targeted intervention can help reduce the severity of crash outcomes. Determining these contributing factors and their effect is the first step to identifying countermeasures and safety strategies in a bid to improve transportation safety for all users on the public road system in Iowa as well as other agricultural states. Copyright 2010 Elsevier Ltd. All rights reserved.

Age of smoking initiation among adolescents in Africa.

PubMed

Veeranki, Sreenivas P; John, Rijo M; Ibrahim, Abdallah; Pillendla, Divya; Thrasher, James F; Owusu, Daniel; Ouma, Ahmed E O; Mamudu, Hadii M

2017-01-01

To estimate prevalence and identify correlates of age of smoking initiation among adolescents in Africa. Data (n = 16,519) were obtained from nationally representative Global Youth Tobacco Surveys in nine West African countries. Study outcome was adolescents' age of smoking initiation categorized into six groups: ≤7, 8 or 9, 10 or 11, 12 or 13, 14 or 15 and never-smoker. Explanatory variables included sex, parental or peer smoking behavior, exposure to tobacco industry promotions, and knowledge about smoking harm. Weighted multinomial logit models were conducted to determine correlates associated with adolescents' age of smoking initiation. Age of smoking initiation was as early as ≤7 years; prevalence estimates ranged from 0.7 % in Ghana at 10 or 11 years age to 9.6 % in Cote d'Ivoire at 12 or 13 years age. Males, exposures to parental or peer smoking, and industry promotions were identified as significant correlates. West African policymakers should adopt a preventive approach consistent with the World Health Organization Framework Convention on Tobacco Control to prevent an adolescent from initiating smoking and developing into future regular smokers.

Impact of hedonic evaluation on consumers' preferences for beef attributes including its enrichment with n-3 and CLA fatty acids.

PubMed

Baba, Yasmina; Kallas, Zein; Costa-Font, Montserrat; Gil, José María; Realini, Carolina E

2016-01-01

The impact of hedonic evaluation on consumers' preferences for beef attributes was evaluated (origin, animal diet, fat content, color, price) including its enrichment with omega-3 (n-3) and conjugated linoleic acid (CLA) fatty acids. One group of consumers (n=325) received information about n-3 and CLA, while the other group (n=322) received no information. Consumers conducted a Discrete Choice Experiment (DCE), using the recently developed Generalized Multinomial Logit model; followed by a blind hedonic evaluation of beef samples, which were identified after tasting, and finally repeated the DCE. Results showed that hedonic evaluation had a significant impact on consumers' preferences, which were similar after tasting for all consumers, with less emphasis on the fat content, color, and origin attributes and greater emphasis on animal diet. Preference for n-3 enriched beef increased, while preference for CLA enriched beef was still not significant after tasting. The information provided had a significant effect on consumers' beef preferences, but no significant impact on beef liking scores. Copyright © 2015 Elsevier Ltd. All rights reserved.

Blood donation as a public good: an empirical investigation of the free rider problem.

PubMed

Abásolo, Ignacio; Tsuchiya, Aki

2014-04-01

A voluntary blood donation system can be seen as a public good. People can take advantage without contributing and have a free ride. We empirically analyse the extent of free riding and its determinants. Interviews of the general public in Spain (n = 1,211) were used to ask whether respondents were (or have been) regular blood donors and, if not, the reason. Free riders are defined as those who are medically capable to donate blood but do not. In addition, we distinguish four different types of free riding depending on the reason given for not donating. Binomial and multinomial logit models estimate the effect of individual characteristics on the propensity to free ride and the likelihood of the free rider types. Amongst those who are able to donate, there is a 67 % probability of being a free rider. The most likely free rider is female, single, with low/no education and abstained from voting in a recent national election. Gender, age, religious practice, political participation and regional income explain the type of free rider.

Access to Bridge Employment: Who Finds and Who Does Not Find Work After Retirement?

PubMed

Dingemans, Ellen; Henkens, Kène; Solinge, Hanna van

2016-08-01

Empirical studies on the determinants of bridge employment have often neglected the fact that some retirees may be unsuccessful in finding a bridge job. We present an integrative framework that emphasizes socioeconomic factors, health status, social context, and psychological factors to explain why some people fully retired after career exit, some participated in bridge jobs, while others unsuccessfully searched for one. Using Dutch panel data for 1,221 retirees, we estimated a multinomial logit model to explain participation in, and unsuccessful searches for, bridge employment. About 1 in 4 retirees participated in bridge employment after retirement, while 7% searched unsuccessfully for such work. Particularly those who experienced involuntary career exit were found to have a higher probability of being unsuccessful at finding bridge employment. The current study provides evidence for the impact of the social context on postretirement work and suggests a cumulative disadvantage in the work domain in later life. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Analyzing the severity of accidents on the German Autobahn.

PubMed

Manner, Hans; Wünsch-Ziegler, Laura

2013-08-01

We study the severity of accidents on the German Autobahn in the state of North Rhine-Westphalia using data for the years 2009 until 2011. We use a multinomial logit model to identify statistically relevant factors explaining the severity of the most severe injury, which is classified into the four classes fatal, severe injury, light injury and property damage. Furthermore, to account for unobserved heterogeneity we use a random parameter model. We study the effect of a number of factors including traffic information, road conditions, type of accidents, speed limits, presence of intelligent traffic control systems, age and gender of the driver and location of the accident. Our findings are in line with studies in different settings and indicate that accidents during daylight and at interchanges or construction sites are less severe in general. Accidents caused by the collision with roadside objects, involving pedestrians and motorcycles, or caused by bad sight conditions tend to be more severe. We discuss the measures of the 2011 German traffic safety programm in the light of our results. Copyright © 2013 Elsevier Ltd. All rights reserved.

A Comparison of Methods for Detecting Differential Distractor Functioning

ERIC Educational Resources Information Center

Koon, Sharon

2010-01-01

This study examined the effectiveness of the odds-ratio method (Penfield, 2008) and the multinomial logistic regression method (Kato, Moen, & Thurlow, 2009) for measuring differential distractor functioning (DDF) effects in comparison to the standardized distractor analysis approach (Schmitt & Bleistein, 1987). Students classified as participating…

Predicting The Type Of Pregnancy Using Flexible Discriminate Analysis And Artificial Neural Networks: A Comparison Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hooman, A.; Mohammadzadeh, M

Some medical and epidemiological surveys have been designed to predict a nominal response variable with several levels. With regard to the type of pregnancy there are four possible states: wanted, unwanted by wife, unwanted by husband and unwanted by couple. In this paper, we have predicted the type of pregnancy, as well as the factors influencing it using three different models and comparing them. Regarding the type of pregnancy with several levels, we developed a multinomial logistic regression, a neural network and a flexible discrimination based on the data and compared their results using tow statistical indices: Surface under curvemore » (ROC) and kappa coefficient. Based on these tow indices, flexible discrimination proved to be a better fit for prediction on data in comparison to other methods. When the relations among variables are complex, one can use flexible discrimination instead of multinomial logistic regression and neural network to predict the nominal response variables with several levels in order to gain more accurate predictions.« less

Modeling Information Content Via Dirichlet-Multinomial Regression Analysis.

PubMed

Ferrari, Alberto

2017-01-01

Shannon entropy is being increasingly used in biomedical research as an index of complexity and information content in sequences of symbols, e.g. languages, amino acid sequences, DNA methylation patterns and animal vocalizations. Yet, distributional properties of information entropy as a random variable have seldom been the object of study, leading to researchers mainly using linear models or simulation-based analytical approach to assess differences in information content, when entropy is measured repeatedly in different experimental conditions. Here a method to perform inference on entropy in such conditions is proposed. Building on results coming from studies in the field of Bayesian entropy estimation, a symmetric Dirichlet-multinomial regression model, able to deal efficiently with the issue of mean entropy estimation, is formulated. Through a simulation study the model is shown to outperform linear modeling in a vast range of scenarios and to have promising statistical properties. As a practical example, the method is applied to a data set coming from a real experiment on animal communication.

Gender, Alcohol Consumption Patterns, and Engagement in Sexually Intimate Behaviors among Adolescents and Young Adults in Nha Trang, Viet Nam

ERIC Educational Resources Information Center

Kaljee, Linda M.; Green, Mackenzie S.; Zhan, Min; Riel, Rosemary; Lerdboon, Porntip; Lostutter, Ty W.; Tho, Le Huu; Luong, Vo Van; Minh, Truong Tan

2011-01-01

A randomly selected cross-sectional survey was conducted with 880 youth (16 to 24 years) in Nha Trang City to assess relationships between alcohol consumption and sexual behaviors. A timeline followback method was employed. Chi-square, generalized logit modeling and logistic regression analyses were performed. Of the sample, 78.2% male and 56.1%…

Predictors of Early Termination in a University Counseling Training Clinic

ERIC Educational Resources Information Center

Lampropoulos, Georgios K.; Schneider, Mercedes K.; Spengler, Paul M.

2009-01-01

Despite the existence of counseling dropout research, there are limited predictive data for counseling in training clinics. Potential predictor variables were investigated in this archival study of 380 client files in a university counseling training clinic. Multinomial logistic regression, predictive discriminant analysis, and classification and…

Understanding Civic Identity in College

ERIC Educational Resources Information Center

Weerts, David J.; Cabrera, Alberto F.

2015-01-01

Past literature has examined ways in which college students adopt civic identities. However, little is known about characteristics of students that vary in their expression of these identities. Drawing on data from American College Testing (ACT), this study employs multinomial logistic regression to understand attributes of students who vary in…

Evaluating the Locational Attributes of Education Management Organizations (EMOs)

ERIC Educational Resources Information Center

Gulosino, Charisse; Miron, Gary

2017-01-01

This study uses logistic and multinomial logistic regression models to analyze neighborhood factors affecting EMO (Education Management Organization)-operated schools' locational attributes (using census tracts) in 41 states for the 2014-2015 school year. Our research combines market-based school reform, institutional theory, and resource…

Intergroup Relations and Predictors of Immigrant Experience

ERIC Educational Resources Information Center

Danso, Kofi; Lum, Terry

2013-01-01

Using survey data from 1,036 participants, which included 4 immigrant groups, we examined the factors that influence immigrants' experiences as they interact with nonimmigrant Americans. Logistic and multinomial regression results indicate that non-European immigrants were more likely to report negative experiences with Americans. The odds of…

The Role of Predictor Courses and Teams on Individual Student Success

ERIC Educational Resources Information Center

Baker-Eveleth, Lori Jo; O'Neill, Michele; Sisodiya, Sanjay R.

2014-01-01

Research suggests that diverse environments enhance conscious modes of thought, resulting in greater intellectual engagement and active thinking. Ordinal and multinomial logistic regression results indicate that accounting courses and business law classes are useful predictors of subsequent performance. Odds ratio estimates indicate that students…

Caregivers' Retirement Congruency: A Case for Caregiver Support

ERIC Educational Resources Information Center

Humble, Aine M.; Keefe, Janice M.; Auton, Greg M.

2012-01-01

Using the concept of "retirement congruency" (RC), which takes into account greater variation in retirement decisions (low, moderate, or high RC) than a dichotomous conceptualization (forced versus chosen), multinomial logistic regression was conducted on a sample of caregivers from the 2002 Canadian General Social Survey who were…

A stratification approach using logit-based models for confounder adjustment in the study of continuous outcomes.

PubMed

Tan, Chuen Seng; Støer, Nathalie C; Chen, Ying; Andersson, Marielle; Ning, Yilin; Wee, Hwee-Lin; Khoo, Eric Yin Hao; Tai, E-Shyong; Kao, Shih Ling; Reilly, Marie

2017-01-01

The control of confounding is an area of extensive epidemiological research, especially in the field of causal inference for observational studies. Matched cohort and case-control study designs are commonly implemented to control for confounding effects without specifying the functional form of the relationship between the outcome and confounders. This paper extends the commonly used regression models in matched designs for binary and survival outcomes (i.e. conditional logistic and stratified Cox proportional hazards) to studies of continuous outcomes through a novel interpretation and application of logit-based regression models from the econometrics and marketing research literature. We compare the performance of the maximum likelihood estimators using simulated data and propose a heuristic argument for obtaining the residuals for model diagnostics. We illustrate our proposed approach with two real data applications. Our simulation studies demonstrate that our stratification approach is robust to model misspecification and that the distribution of the estimated residuals provides a useful diagnostic when the strata are of moderate size. In our applications to real data, we demonstrate that parity and menopausal status are associated with percent mammographic density, and that the mean level and variability of inpatient blood glucose readings vary between medical and surgical wards within a national tertiary hospital. Our work highlights how the same class of regression models, available in most statistical software, can be used to adjust for confounding in the study of binary, time-to-event and continuous outcomes.

Race and Unemployment: Labor Market Experiences of Black and White Men, 1968-1988.

ERIC Educational Resources Information Center

Wilson, Franklin D.; And Others

1995-01-01

Estimation of multinomial logistic regression models on a sample of unemployed workers suggested that persistently higher black unemployment is due to differential access to employment opportunities by region, occupational placement, labor market segmentation, and discrimination. The racial gap in unemployment is greatest for college-educated…

Predicting the Frequency of Senior Center Attendance.

ERIC Educational Resources Information Center

Miner, Sonia; And Others

1993-01-01

Used data from 1984 Supplement on Aging of the National Health Interview Survey to examine frequency of senior center attendance. Estimated multinomial logistic regression model to distinguish between persons who rarely, sometimes, and frequently attend. Found that more frequent users are older. Greater frequency was associated with lower income…

Support vector machines classifiers of physical activities in preschoolers

USDA-ARS?s Scientific Manuscript database

The goal of this study is to develop, test, and compare multinomial logistic regression (MLR) and support vector machines (SVM) in classifying preschool-aged children physical activity data acquired from an accelerometer. In this study, 69 children aged 3-5 years old were asked to participate in a s...

Bullying and PTSD Symptoms

ERIC Educational Resources Information Center

Idsoe, Thormod; Dyregrov, Atle; Idsoe, Ella Cosmovici

2012-01-01

PTSD symptoms related to school bullying have rarely been investigated, and never in national samples. We used data from a national survey to investigate this among students from grades 8 and 9 (n = 963). The prevalence estimates of exposure to bullying were within the range of earlier research findings. Multinomial logistic regression showed that…

Diversity and Educational Benefits: Moving Beyond Self-Reported Questionnaire Data

ERIC Educational Resources Information Center

Herzog, Serge

2007-01-01

Effects of ethnic/racial diversity among students and faculty on cognitive growth of undergraduate students are estimated via a series of hierarchical linear and multinomial logistic regression models. Using objective measures of compositional, curricular, and interactional diversity based on actuarial course enrollment records of over 6,000…

Poverty and Material Hardship in Grandparent-Headed Households

ERIC Educational Resources Information Center

Baker, Lindsey A.; Mutchler, Jan E.

2010-01-01

Using the 2001 Survey of Income and Program Participation, the current study examines poverty and material hardship among children living in 3-generation (n = 486), skipped-generation (n = 238), single-parent (n = 2,076), and 2-parent (n = 6,061) households. Multinomial and logistic regression models indicated that children living in…

Victimization and Health Risk Factors among Weapon-Carrying Youth

ERIC Educational Resources Information Center

Stayton, Catherine; McVeigh, Katharine H.; Olson, E. Carolyn; Perkins, Krystal; Kerker, Bonnie D.

2011-01-01

Objective: To compare health risks of 2 subgroups of weapon carriers: victimized and nonvictimized youth. Methods: 2003-2007 NYC Youth Risk Behavior Surveys were analyzed using bivariate analyses and multinomial logistic regression. Results: Among NYC teens, 7.5% reported weapon carrying without victimization; 6.9% reported it with victimization.…

In-State Tuition Policies for Undocumented Youth

ERIC Educational Resources Information Center

Vargas, Edward D.

2011-01-01

This article is an investigation into why U.S. states have enacted, banned, or continued with the status quo regarding in-state tuition policies for unauthorized youth. Using data from multiple government and nonprofit sources, a series of multinomial logistic regressions are estimated to explain the determinants of state behavior across the…

Part-Time Community-College Faculty and the Desire for Full-Time Tenure-Track Positions: Results of a Single Institution Case Study

ERIC Educational Resources Information Center

Jacoby, Dan

2005-01-01

According to data derived from a community-college survey in the state of Washington, the majority of part-time faculty prefer full-time work. Using a logit regression analysis, the study reported in this paper suggests that typical part-timers enter their part-time teaching situations with the intent of becoming full-time, but gradually become…

Brief Report: Association of Myositis Autoantibodies, Clinical Features, and Environmental Exposures at Illness Onset With Disease Course in Juvenile Myositis.

PubMed

Habers, G Esther A; Huber, Adam M; Mamyrova, Gulnara; Targoff, Ira N; O'Hanlon, Terrance P; Adams, Sharon; Pandey, Janardan P; Boonacker, Chantal; van Brussel, Marco; Miller, Frederick W; van Royen-Kerkhof, Annet; Rider, Lisa G

2016-03-01

To identify early factors associated with disease course in patients with juvenile idiopathic inflammatory myopathies (IIMs). Univariable and multivariable multinomial logistic regression analyses were performed in a large juvenile IIM registry (n = 365) and included demographic characteristics, early clinical features, serum muscle enzyme levels, myositis autoantibodies, environmental exposures, and immunogenetic polymorphisms. Multivariable associations with chronic or polycyclic courses compared to a monocyclic course included myositis-specific autoantibodies (multinomial odds ratio [OR] 4.2 and 2.8, respectively), myositis-associated autoantibodies (multinomial OR 4.8 and 3.5), and a documented infection within 6 months of illness onset (multinomial OR 2.5 and 4.7). A higher overall clinical symptom score at diagnosis was associated with chronic or monocyclic courses compared to a polycyclic course. Furthermore, severe illness onset was associated with a chronic course compared to monocyclic or polycyclic courses (multinomial OR 2.1 and 2.6, respectively), while anti-p155/140 autoantibodies were associated with chronic or polycyclic courses compared to a monocyclic course (multinomial OR 3.9 and 2.3, respectively). Additional univariable associations of a chronic course compared to a monocyclic course included photosensitivity, V-sign or shawl sign rashes, and cuticular overgrowth (OR 2.2-3.2). The mean ultraviolet index and highest ultraviolet index in the month before diagnosis were associated with a chronic course compared to a polycyclic course in boys (OR 1.5 and 1.3), while residing in the Northwest was less frequently associated with a chronic course (OR 0.2). Our findings indicate that myositis autoantibodies, in particular anti-p155/140, and a number of early clinical features and environmental exposures are associated with a chronic course in patients with juvenile IIM. These findings suggest that early factors, which are associated with poorer outcomes in juvenile IIM, can be identified. © 2016, American College of Rheumatology.

Bivariate categorical data analysis using normal linear conditional multinomial probability model.

PubMed

Sun, Bingrui; Sutradhar, Brajendra

2015-02-10

Bivariate multinomial data such as the left and right eyes retinopathy status data are analyzed either by using a joint bivariate probability model or by exploiting certain odds ratio-based association models. However, the joint bivariate probability model yields marginal probabilities, which are complicated functions of marginal and association parameters for both variables, and the odds ratio-based association model treats the odds ratios involved in the joint probabilities as 'working' parameters, which are consequently estimated through certain arbitrary 'working' regression models. Also, this later odds ratio-based model does not provide any easy interpretations of the correlations between two categorical variables. On the basis of pre-specified marginal probabilities, in this paper, we develop a bivariate normal type linear conditional multinomial probability model to understand the correlations between two categorical variables. The parameters involved in the model are consistently estimated using the optimal likelihood and generalized quasi-likelihood approaches. The proposed model and the inferences are illustrated through an intensive simulation study as well as an analysis of the well-known Wisconsin Diabetic Retinopathy status data. Copyright © 2014 John Wiley & Sons, Ltd.

Registered dietitian's personal beliefs and characteristics predict their teaching or intention to teach fresh vegetable food safety.

PubMed

Casagrande, Gina; LeJeune, Jeffery; Belury, Martha A; Medeiros, Lydia C

2011-04-01

The Theory of Planned Behavior was used to determine if dietitians personal characteristics and beliefs about fresh vegetable food safety predict whether they currently teach, intend to teach, or neither currently teach nor intend to teach food safety information to their clients. Dietitians who participated in direct client education responded to this web-based survey (n=327). The survey evaluated three independent belief variables: Subjective Norm, Attitudes, and Perceived Behavioral Control. Spearman rho correlations were completed to determine variables that correlated best with current teaching behavior. Multinomial logistical regression was conducted to determine if the belief variables significantly predicted dietitians teaching behavior. Binary logistic regression was used to determine which independent variable was the better predictor of whether dietitians currently taught. Controlling for age, income, education, and gender, the multinomial logistical regression was significant. Perceived behavioral control was the best predictor of whether a dietitian currently taught fresh vegetable food safety. Factors affecting whether dietitians currently taught were confidence in fresh vegetable food safety knowledge, being socially influenced, and a positive attitude toward the teaching behavior. These results validate the importance of teaching food safety effectively and may be used to create more informed food safety curriculum for dietitians. Copyright © 2011 Elsevier Ltd. All rights reserved.

Which Kindergarten Children Are at Greatest Risk for Attention-Deficit/Hyperactivity and Conduct Disorder Symptomatology as Adolescents?

ERIC Educational Resources Information Center

Morgan, Paul L.; Li, Hui; Cook, Michael; Farkas, George; Hillemeier, Marianne M.; Lin, Yu-chu

2016-01-01

We sought to identify which kindergarten children are simultaneously at risk of moderate or severe symptomatology in both attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) as adolescents. These risk factor estimates have not been previously available. We conducted multinomial logistic regression analyses of multiinformant…

Foreign Diploma versus Immigrant Background: Determinants of Labour Market Success or Failure?

ERIC Educational Resources Information Center

Storen, Liv Anne; Wiers-Jenssen, Jannecke

2010-01-01

This article compares the labour market situation of graduates with different types of international background. The authors look at four groups of graduates: immigrants and ethnic Norwegians graduated in Norway and immigrants and ethnic Norwegians graduated abroad. By employing multinomial logistic regression analyses the authors find that ethnic…

Motivations and Benefits for Attaining HR Certifications

ERIC Educational Resources Information Center

Lester, Scott W.; Dwyer, Dale J.

2012-01-01

Purpose: The aim of this paper is to examine the motivations and benefits for pursuing or not pursuing the PHR and SPHR. Design/methodology/approach: Using a sample of 1,862 participants, the study used multinomial logistic and hierarchical linear regression to test six hypotheses. Findings: Participants pursuing SPHR were more likely to report…

School Climate: The Controllable and the Uncontrollable

ERIC Educational Resources Information Center

Sulak, Tracey N.

2018-01-01

A positive school climate impacts students by promoting positive relations among students, staff and faculty of the school. The current study used latent class analysis and multinomial regression with R3STEP to analyse patterns of negative behaviours in schools and test the association of these patterns with structural variables like school size,…

Racial Threat and White Opposition to Bilingual Education in Texas

ERIC Educational Resources Information Center

Hempel, Lynn M.; Dowling, Julie A.; Boardman, Jason D.; Ellison, Christopher G.

2013-01-01

This study examines local contextual conditions that influence opposition to bilingual education among non-Hispanic Whites, net of individual-level characteristics. Data from the Texas Poll (N = 615) are used in conjunction with U.S. Census data to test five competing hypotheses using binomial and multinomial logistic regression models. Our…

Caste, Class, and Urbanization: The Shaping of Religious Community in Contemporary India

ERIC Educational Resources Information Center

Stroope, Samuel

2012-01-01

Building on the implications of qualitative work from India and urbanism theories, I aim to understand whether religious bonding social capital in contemporary India increases with greater urbanization and whether such increases are moderated by caste or social class position. Results from multinomial logistic regression on 1,417 Hindu respondents…

American Youths' Access to Substance Abuse Treatment: Does Type of Treatment Facility Matter?

ERIC Educational Resources Information Center

Lo, Celia C.; Cheng, Tyrone C.

2013-01-01

Using data from the 2007 National Survey on Drug Use and Health, this study examines whether several social exclusion and psychological factors affect adolescents' receipt of substance abuse treatment. Multinomial logistic regression techniques were used to analyze data. The study asked how the specified factors provide pathways to receipt of…

Primary Factors Related to Multiple Placements for Children in Out-of-Home Care

ERIC Educational Resources Information Center

Eggertsen, Lars

2008-01-01

Using an ecological framework, this study identified which factors related to out-of-home placements significantly influenced multiple placements for children in Utah during 2000, 2001, and 2002. Multinomial logistic regression statistical procedures and a geographical information system (GIS) were used to analyze the data. The final model…

Institutional Discharges and Subsequent Shelter Use among Unaccompanied Adults in New York City

ERIC Educational Resources Information Center

Metraux, Stephen; Byrne, Thomas; Culhane, Dennis P.

2010-01-01

This study empirically examines the link between homelessness and discharges from other institutions. An administrative record match was undertaken to determine rates of discharge from institutional care for 9,247 unaccompanied adult shelter users in New York City. Cluster analysis and multinomial logistic regression analysis was then used to…

Predicting Teacher Value-Added Results in Non-Tested Subjects Based on Confounding Variables: A Multinomial Logistic Regression

ERIC Educational Resources Information Center

Street, Nathan Lee

2017-01-01

Teacher value-added measures (VAM) are designed to provide information regarding teachers' causal impact on the academic growth of students while controlling for exogenous variables. While some researchers contend VAMs successfully and authentically measure teacher causality on learning, others suggest VAMs cannot adequately control for exogenous…

Profiles of Supportive Alumni: Donors, Volunteers, and Those Who "Do It All"

ERIC Educational Resources Information Center

Weerts, David J.; Ronca, Justin M.

2007-01-01

In the competitive marketplace of higher education, college and university alumni are increasingly called on to support their institutions in multiple ways: political advocacy, volunteerism, and charitable giving. Drawing on alumni survey data gathered from a large research extensive university, we employ a multinomial logistic regression model to…

Impact of Perceived Risk and Friend Influence on Alcohol and Marijuana Use among Students

ERIC Educational Resources Information Center

Merianos, Ashley L.; Rosen, Brittany L.; Montgomery, LaTrice; Barry, Adam E.; Smith, Matthew Lee

2017-01-01

We performed a secondary analysis of Adolescent Health Risk Behavior Survey data (N=937), examining associations between lifetime alcohol and marijuana use with intrapersonal (i.e., risk perceptions) and interpersonal (e.g., peer approval and behavior) factors. Multinomial and binary logistic regression analyses contend students reporting lifetime…

Predicting College Success: Achievement, Demographic, and Psychosocial Predictors of First-Semester College Grade Point Average

ERIC Educational Resources Information Center

Saltonstall, Margot

2013-01-01

This study seeks to advance and expand research on college student success. Using multinomial logistic regression analysis, the study investigates the contribution of psychosocial variables above and beyond traditional achievement and demographic measures to predicting first-semester college grade point average (GPA). It also investigates if…

Profiles of internalizing and externalizing symptoms associated with bullying victimization.

PubMed

Eastman, Meridith; Foshee, Vangie; Ennett, Susan; Sotres-Alvarez, Daniela; Reyes, H Luz McNaughton; Faris, Robert; North, Kari

2018-06-01

This study identified profiles of internalizing (anxiety and depression) and externalizing (delinquency and violence against peers) symptoms among bullying victims and examined associations between bullying victimization characteristics and profile membership. The sample consisted of 1196 bullying victims in grades 8-10 (M age  = 14.4, SD = 1.01) who participated in The Context Study in three North Carolina counties in Fall 2003. Five profiles were identified using latent profile analysis: an asymptomatic profile and four profiles capturing combinations of internalizing and externalizing symptoms. Associations between bullying characteristics and membership in symptom profiles were tested using multinomial logistic regression. More frequent victimization increased odds of membership in the two high internalizing profiles compared to the asymptomatic profile. Across all multinomial logistic regression models, when the high internalizing, high externalizing profile was the reference category, adolescents who received any type of bullying (direct, indirect, or dual) were more likely to be in this category than any others. Copyright © 2018 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Prevalence of and risk factors for depressive symptoms among people living with HIV/AIDS receiving antiretroviral treatment in Wuhan, China: a short report.

PubMed

Rong, Hu; Nianhua, Xie; Jun, Xu; Lianguo, Ruan; Si, Wu; Sheng, Wei; Heng, Guo; Xia, Wang

2017-12-01

We aimed to explore the prevalence of and risk factors for depressive symptoms (DS) among people living with HIV/AIDS (PLWHA) receiving antiretroviral treatment (ART) in Wuhan, Hubei, China. A cross-sectional study evaluating adult PLWHA receiving ART in nine designated clinical hospitals was conducted from October to December 2015. The validated Beck Depression Inventory (BDI) was used to assess DS in eligible participants. Socio-demographical, epidemiological and clinical data were directly extracted from the case reporting database of the China HIV/AIDS Information Network. Multinomial regression analysis was used to explore the risk factors for DS. 394 participants were finally included in all analyses. 40.3% were found to have DS with 13.7% having mild DS and 26.6% having moderate to severe DS. The results of multinomial regression analysis suggested that being married or living with a partner, recent experience of ART-related side effects, and/or history of HCV infection were positively associated with mild DS, while increasing age was positively associated with moderate to severe DS.

The perception of the relationship between environment and health according to data from Italian Behavioural Risk Factor Surveillance System (PASSI).

PubMed

Sampaolo, Letizia; Tommaso, Giulia; Gherardi, Bianca; Carrozzi, Giuliano; Freni Sterrantino, Anna; Ottone, Marta; Goldoni, Carlo Alberto; Bertozzi, Nicoletta; Scaringi, Meri; Bolognesi, Lara; Masocco, Maria; Salmaso, Stefania; Lauriola, Paolo

2017-01-01

"OBJECTIVES: to identify groups of people in relation to the perception of environmental risk and to assess the main characteristics using data collected in the environmental module of the surveillance network Italian Behavioral Risk Factor Surveillance System (PASSI). perceptive profiles were identified using a latent class analysis; later they were included as outcome in multinomial logistic regression models to assess the association between environmental risk perception and demographic, health, socio-economic and behavioural variables. the latent class analysis allowed to split the sample in "worried", "indifferent", and "positive" people. The multinomial logistic regression model showed that the "worried" profile typically includes people of Italian nationality, living in highly urbanized areas, with a high level of education, and with economic difficulties; they pay special attention to their own health and fitness, but they have a negative perception of their own psychophysical state. the application of advanced statistical analysis enable to appraise PASSI data in order to characterize the perception of environmental risk, making the planning of interventions related to risk communication possible. ".

Socio-economic determinants of severe and moderate stunting among under-five children of rural Bangladesh.

PubMed

Mostafa, Kamal S M

2011-04-01

Malnutrition among under-five children is a chronic problem in developing countries. This study explores the socio-economic determinants of severe and moderate stunting among under-five children of rural Bangladesh. The study used data from the 2007 Bangladesh Demographic and Health Survey. Cross-sectional and multinomial logistic regression analyses were used to assess the effect of the socio-demographic variables on moderate and severe stunting over normal among the children. Findings revealed that over two-fifths of the children were stunted, of which 26.3% were moderately stunted and 15.1% were severely stunted. The multivariate multinomial logistic regression analysis yielded significantly increased risk of severe stunting (OR=2.53, 95% CI=1.34-4.79) and moderate stunting (OR=2.37, 95% CI=1.47-3.83) over normal among children with a thinner mother. Region, father's education, toilet facilities, child's age, birth order of children and wealth index were also important determinants of children's nutritional status. Development and poverty alleviation programmes should focus on the disadvantaged rural segments of people to improve their nutritional status.

Dental health services utilization and associated factors in children 6 to 12 years old in a low-income country.

PubMed

Medina-Solis, Carlo Eduardo; Maupomé, Gerardo; del Socorro, Herrera Miriam; Pérez-Núñez, Ricardo; Avila-Burgos, Leticia; Lamadrid-Figueroa, Hector

2008-01-01

To determine the factors associated with the dental health services utilization among children ages 6 to 12 in León, Nicaragua. A cross-sectional study was carried out in 1,400 schoolchildren. Using a questionnaire, we determined information related to utilization and independent variables in the previous year. Oral health needs were established by means of a dental examination. To identify the independent variables associated with dental health services utilization, two types of multivariate regression models were used, according to the measurement scale of the outcome variable: a) frequency of utilization as (0) none, (1) one, and (2) two or more, analyzed with the ordered logistic regression and b) the type of service utilized as (0) none, (1) preventive services, (2) curative services, and (3) both services, analyzed with the multinomial logistic regression. The proportion of children who received at least one dental service in the 12 months prior to the study was 27.7 percent. The variables associated with utilization in the two models were older age, female sex, more frequent toothbrushing, positive attitude of the mother toward the child's oral health, higher socioeconomic level, and higher oral health needs. Various predisposing, enabling, and oral health needs variables were associated with higher dental health services utilization. As in prior reports elsewhere, these results from Nicaragua confirmed that utilization inequalities exist between socioeconomic groups. The multinomial logistic regression model evidenced the association of different variables depending on the type of service used.

Statistical inference for Hardy-Weinberg proportions in the presence of missing genotype information.

PubMed

Graffelman, Jan; Sánchez, Milagros; Cook, Samantha; Moreno, Victor

2013-01-01

In genetic association studies, tests for Hardy-Weinberg proportions are often employed as a quality control checking procedure. Missing genotypes are typically discarded prior to testing. In this paper we show that inference for Hardy-Weinberg proportions can be biased when missing values are discarded. We propose to use multiple imputation of missing values in order to improve inference for Hardy-Weinberg proportions. For imputation we employ a multinomial logit model that uses information from allele intensities and/or neighbouring markers. Analysis of an empirical data set of single nucleotide polymorphisms possibly related to colon cancer reveals that missing genotypes are not missing completely at random. Deviation from Hardy-Weinberg proportions is mostly due to a lack of heterozygotes. Inbreeding coefficients estimated by multiple imputation of the missings are typically lowered with respect to inbreeding coefficients estimated by discarding the missings. Accounting for missings by multiple imputation qualitatively changed the results of 10 to 17% of the statistical tests performed. Estimates of inbreeding coefficients obtained by multiple imputation showed high correlation with estimates obtained by single imputation using an external reference panel. Our conclusion is that imputation of missing data leads to improved statistical inference for Hardy-Weinberg proportions.

Effects of Payment Changes on Trends in Post-Acute Care

PubMed Central

Buntin, Melinda Beeuwkes; Colla, Carrie Hoverman; Escarce, José J

2009-01-01

Objective To test how the implementation of new Medicare post-acute payment systems affected the use of inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and home health agencies. Data Sources Medicare acute hospital, IRF, and SNF claims; provider of services file; enrollment file; and Area Resource File data. Study Design We used multinomial logit models to measure realized access to post-acute care and to predict how access to alternative sites of care changed in response to prospective payment systems. Data Extraction Methods A file was constructed linking data for elderly Medicare patients discharged from acute care facilities between 1996 and 2003 with a diagnosis of hip fracture, stroke, or lower extremity joint replacement. Principal Findings Although the effects of the payment systems on the use of post-acute care varied, most reduced the use of the site of care they directly affected and boosted the use of alternative sites of care. Payment system changes do not appear to have differentially affected the severely ill. Conclusions Payment system incentives play a significant role in determining where Medicare beneficiaries receive their post-acute care. Changing these incentives results in shifting of patients between post-acute sites. PMID:19490159

User fees across ecosystem boundaries: Are SCUBA divers willing to pay for terrestrial biodiversity conservation?

PubMed

Roberts, Michaela; Hanley, Nick; Cresswell, Will

2017-09-15

While ecological links between ecosystems have been long recognised, management rarely crosses ecosystem boundaries. Coral reefs are susceptible to damage through terrestrial run-off, and failing to account for this within management threatens reef protection. In order to quantify the extent to that coral reef users are willing to support management actions to improve ecosystem quality, we conducted a choice experiment with SCUBA divers on the island of Bonaire, Caribbean Netherlands. Specifically, we estimated their willingness to pay to reduce terrestrial overgrazing as a means to improve reef health. Willingness to pay was estimated using the multinomial, random parameter and latent class logit models. Willingness to pay for improvements to reef quality was positive for the majority of respondents. Estimates from the latent class model determined willingness to pay for reef improvements of between $31.17 - $413.18/year, dependent on class membership. This represents a significant source of funding for terrestrial conservation, and illustrates the potential for user fees to be applied across ecosystem boundaries. We argue that such across-ecosystem-boundary funding mechanisms are an important avenue for future investigation in many connected systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

An introduction to multidimensional measurement using Rasch models.

PubMed

Briggs, Derek C; Wilson, Mark

2003-01-01

The act of constructing a measure requires a number of important assumptions. Principle among these assumptions is that the construct is unidimensional. In practice there are many instances when the assumption of unidimensionality does not hold, and where the application of a multidimensional measurement model is both technically appropriate and substantively advantageous. In this paper we illustrate the usefulness of a multidimensional approach to measurement with the Multidimensional Random Coefficient Multinomial Logit (MRCML) model, an extension of the unidimensional Rasch model. An empirical example is taken from a collection of embedded assessments administered to 541 students enrolled in middle school science classes with a hands-on science curriculum. Student achievement on these assessments are multidimensional in nature, but can also be treated as consecutive unidimensional estimates, or as is most common, as a composite unidimensional estimate. Structural parameters are estimated for each model using ConQuest, and model fit is compared. Student achievement in science is also compared across models. The multidimensional approach has the best fit to the data, and provides more reliable estimates of student achievement than under the consecutive unidimensional approach. Finally, at an interpretational level, the multidimensional approach may well provide richer information to the classroom teacher about the nature of student achievement.

A Bayesian hierarchical model for discrete choice data in health care.

PubMed

Antonio, Anna Liza M; Weiss, Robert E; Saigal, Christopher S; Dahan, Ely; Crespi, Catherine M

2017-01-01

In discrete choice experiments, patients are presented with sets of health states described by various attributes and asked to make choices from among them. Discrete choice experiments allow health care researchers to study the preferences of individual patients by eliciting trade-offs between different aspects of health-related quality of life. However, many discrete choice experiments yield data with incomplete ranking information and sparsity due to the limited number of choice sets presented to each patient, making it challenging to estimate patient preferences. Moreover, methods to identify outliers in discrete choice data are lacking. We develop a Bayesian hierarchical random effects rank-ordered multinomial logit model for discrete choice data. Missing ranks are accounted for by marginalizing over all possible permutations of unranked alternatives to estimate individual patient preferences, which are modeled as a function of patient covariates. We provide a Bayesian version of relative attribute importance, and adapt the use of the conditional predictive ordinate to identify outlying choice sets and outlying individuals with unusual preferences compared to the population. The model is applied to data from a study using a discrete choice experiment to estimate individual patient preferences for health states related to prostate cancer treatment.

PEER REVIEW FOR THE CONSUMER VEHICLE CHOICE ...

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency’s (EPA) Office of Transportation and Air Quality (OTAQ) has recently sponsored the development of a Consumer Vehicle Choice Model (CVCM) by the Oak Ridge National Laboratory (ORNL). The specification by OTAQ to ORNL for consumer choice model development was to develop a Nested Multinomial Logit (NMNL) or other appropriate model capable of estimating the consumer surplus impacts and the sales mix effects of greenhouse gas (GHG) emission standards. The CVCM will use output from the EPA’s Optimization Model for reducing Emissions of Greenhouse gases from Automobiles (OMEGA), including changes in retail price equivalents, changes in fuel economy, and changes in emissions, to estimate these impacts. In addition, the CVCM will accept approximately 60 vehicle types, with the flexibility to function with fewer or more vehicle types, and will use a 15 year planning horizon, matching the OMEGA parameters. It will be calibrated to baseline sales projection data provided by the EPA and will include a buy/no-buy option to simulate the possibility that consumers will choose to keep their old vehicle or to buy a used vehicle. To support EPA's future assessment of potential light duty greenhouse gas standards

Rural livestock asset portfolio in northern Ethiopia: a microeconomic analysis of choice and accumulation.

PubMed

Tegebu, Fredu Nega; Mathijs, Erik; Deckers, Jozef; Haile, Mitiku; Nyssen, Jan; Tollens, Eric

2012-01-01

Livestock fulfill different functions. Depending on their livelihood strategies, households differ in their choice of what type of animal to keep and on accumulation of the chosen animal overtime. Using a panel data of 385 rural households in a mixed farming system in northern Ethiopia, this paper investigates the dynamic behavior of rural households' livestock holding to identify determinants of choice and accumulation of livestock overtime. Choice is analyzed for a principal animal, the animal that constituted the largest value of livestock assets a household possessed, using a multinomial logit model. Results indicate that rural households differ in their choice of what type of animal to keep. Agro-climatic conditions, sex and age of household head, presence of an adult male member in a household, and liquidity are the major factors that influence the type of principal animal households keep. Conditional on the principal animal selected, we analyzed the factors that determine the accumulation of the chosen animals by correcting for selection bias. Area of land cultivated is the most significant factor that explains the number of animals households keep. Other factors include sex of household head, diversification into nonfarm self-employment, and shocks.

An Optimal Hierarchical Decision Model for a Regional Logistics Network with Environmental Impact Consideration

PubMed Central

Zhang, Dezhi; Li, Shuangyan

2014-01-01

This paper proposes a new model of simultaneous optimization of three-level logistics decisions, for logistics authorities, logistics operators, and logistics users, for regional logistics network with environmental impact consideration. The proposed model addresses the interaction among the three logistics players in a complete competitive logistics service market with CO2 emission charges. We also explicitly incorporate the impacts of the scale economics of the logistics park and the logistics users' demand elasticity into the model. The logistics authorities aim to maximize the total social welfare of the system, considering the demand of green logistics development by two different methods: optimal location of logistics nodes and charging a CO2 emission tax. Logistics operators are assumed to compete with logistics service fare and frequency, while logistics users minimize their own perceived logistics disutility given logistics operators' service fare and frequency. A heuristic algorithm based on the multinomial logit model is presented for the three-level decision model, and a numerical example is given to illustrate the above optimal model and its algorithm. The proposed model provides a useful tool for modeling competitive logistics services and evaluating logistics policies at the strategic level. PMID:24977209

An optimal hierarchical decision model for a regional logistics network with environmental impact consideration.

PubMed

Zhang, Dezhi; Li, Shuangyan; Qin, Jin

2014-01-01

This paper proposes a new model of simultaneous optimization of three-level logistics decisions, for logistics authorities, logistics operators, and logistics users, for regional logistics network with environmental impact consideration. The proposed model addresses the interaction among the three logistics players in a complete competitive logistics service market with CO2 emission charges. We also explicitly incorporate the impacts of the scale economics of the logistics park and the logistics users' demand elasticity into the model. The logistics authorities aim to maximize the total social welfare of the system, considering the demand of green logistics development by two different methods: optimal location of logistics nodes and charging a CO2 emission tax. Logistics operators are assumed to compete with logistics service fare and frequency, while logistics users minimize their own perceived logistics disutility given logistics operators' service fare and frequency. A heuristic algorithm based on the multinomial logit model is presented for the three-level decision model, and a numerical example is given to illustrate the above optimal model and its algorithm. The proposed model provides a useful tool for modeling competitive logistics services and evaluating logistics policies at the strategic level.

Patient and nurse preferences for nurse handover-using preferences to inform policy: a discrete choice experiment protocol.

PubMed

Spinks, Jean; Chaboyer, Wendy; Bucknall, Tracey; Tobiano, Georgia; Whitty, Jennifer A

2015-11-11

Nursing bedside handover in hospital has been identified as an opportunity to involve patients and promote patient-centred care. It is important to consider the preferences of both patients and nurses when implementing bedside handover to maximise the successful uptake of this policy. We outline a study which aims to (1) identify, compare and contrast the preferences for various aspects of handover common to nurses and patients while accounting for other factors, such as the time constraints of nurses that may influence these preferences.; (2) identify opportunities for nurses to better involve patients in bedside handover and (3) identify patient and nurse preferences that may challenge the full implementation of bedside handover in the acute medical setting. We outline the protocol for a discrete choice experiment (DCE) which uses a survey design common to both patients and nurses. We describe the qualitative and pilot work undertaken to design the DCE. We use a D-efficient design which is informed by prior coefficients collected during the pilot phase. We also discuss the face-to-face administration of this survey in a population of acutely unwell, hospitalised patients and describe how data collection challenges have been informed by our pilot phase. Mixed multinomial logit regression analysis will be used to estimate the final results. This study has been approved by a university ethics committee as well as two participating hospital ethics committees. Results will be used within a knowledge translation framework to inform any strategies that can be used by nursing staff to improve the uptake of bedside handover. Results will also be disseminated via peer-reviewed journal articles and will be presented at national and international conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Dutch Tariff for the Five-Level Version of EQ-5D.

PubMed

M Versteegh, Matthijs; M Vermeulen, Karin; M A A Evers, Silvia; de Wit, G Ardine; Prenger, Rilana; A Stolk, Elly

2016-06-01

In 2009, a new version of the EuroQol five-dimensional questionnaire (EQ-5D) was introduced with five rather than three answer levels per dimension. This instrument is known as the EQ-5D-5L. To make the EQ-5D-5L suitable for use in economic evaluations, societal values need to be attached to all 3125 health states. To derive a Dutch tariff for the EQ-5D-5L. Health state values were elicited during face-to-face interviews in a general population sample stratified for age, sex, and education, using composite time trade-off (cTTO) and a discrete choice experiment (DCE). Data were modeled using ordinary least squares and tobit regression (for cTTO) and a multinomial conditional logit model (for DCE). Model performance was evaluated on the basis of internal consistency, parsimony, goodness of fit, handling of left-censored values, and theoretical considerations. A representative sample (N = 1003) of the Dutch population participated in the valuation study. Data of 979 and 992 respondents were included in the analysis of the cTTO and the DCE, respectively. The cTTO data were left-censored at -1. The tobit model was considered the preferred model for the tariff on the basis of its handling of the censored nature of the data, which was confirmed through comparison with the DCE data. The predicted values for the EQ-5D-5L ranged from -0.446 to 1. This study established a Dutch tariff for the EQ-5D-5L on the basis of cTTO. The values represent the preferences of the Dutch population. The tariff can be used to estimate the impact of health care interventions on quality of life, for example, in context of economic evaluations. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

An exploration of parents' preferences for foot care in juvenile idiopathic arthritis: a possible role for the discrete choice experiment.

PubMed

Hendry, Gordon J; Turner, Debbie E; Gardner-Medwin, Janet; Lorgelly, Paula K; Woodburn, James

2014-02-06

An increased awareness of patients' and parents' care preferences regarding foot care is desirable from a clinical perspective as such information may be utilised to optimise care delivery. The aim of this study was to examine parents' preferences for, and valuations of foot care and foot-related outcomes in juvenile idiopathic arthritis (JIA). A discrete choice experiment (DCE) incorporating willingness-to-pay (WTP) questions was conducted by surveying 42 parents of children with JIA who were enrolled in a randomised-controlled trial of multidisciplinary foot care at a single UK paediatric rheumatology outpatients department. Attributes explored were: levels of pain; mobility; ability to perform activities of daily living (ADL); waiting time; referral route; and footwear. The DCE was administered at trial baseline. DCE data were analysed using a multinomial-logit-regression model to estimate preferences and relative importance of attributes of foot care. A stated-preference WTP question was presented to estimate parents' monetary valuation of health and service improvements. Every attribute in the DCE was statistically significant (p < 0.01) except that of cost (p = 0.118), suggesting that all attributes, except cost, have an impact on parents' preferences for foot care for their child. The magnitudes of the coefficients indicate that the strength of preference for each attribute was (in descending order): improved ability to perform ADL, reductions in foot pain, improved mobility, improved ability to wear desired footwear, multidisciplinary foot care route, and reduced waiting time. Parents' estimated mean annual WTP for a multidisciplinary foot care service was £1,119.05. In terms of foot care service provision for children with JIA, parents appear to prefer improvements in health outcomes over non-health outcomes and service process attributes. Cost was relatively less important than other attributes suggesting that it does not appear to impact on parents' preferences.

Applying crash data to injury claims - an investigation of determinant factors in severe motor vehicle accidents.

PubMed

Shannon, Darren; Murphy, Finbarr; Mullins, Martin; Eggert, Julian

2018-04-01

An extensive number of research studies have attempted to capture the factors that influence the severity of vehicle impacts. The high number of risks facing all traffic participants has led to a gradual increase in sophisticated data collection schemes linking crash characteristics to subsequent severity measures. This study serves as a departure from previous research by relating injuries suffered in road traffic accidents to expected trauma compensation payouts and deriving a quantitative cost function. Data from the National Highway Traffic Safety Administration's (NHTSA) Crash Injury Research (CIREN) database for the years 2005-2014 is combined with the Book of Quantum, an Irish governmental document that offers guidelines on the appropriate compensation to be awarded for injuries sustained in accidents. A multiple linear regression is carried out to identify the crash factors that significantly influence expected compensation costs and compared to ordered and multinomial logit models. The model offers encouraging results given the inherent variation expected in vehicular incidents and the subjectivity influencing compensation payout judgments, attaining an adjusted-R 2 fit of 20.6% when uninfluential factors are removed. It is found that relative speed at time of impact and dark conditions increase the expected costs, while rear-end incidents, incident sustained in van-based trucks and incidents sustained while turning result in lower expected compensations. The number of airbags available in the vehicle is also a significant factor. The scalar-outcome approach used in this research offers an alternative methodology to the discrete-outcome models that dominate traffic safety analyses. The results also raise queries on the future development of claims reserving (capital allocations earmarked for future expected claims payments) as advanced driver assistant systems (ADASs) seek to eradicate the most frequent types of crash factors upon which insurance mathematics base their assumptions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Age affects severity of venous gas emboli on decompression from 14.7 to 4.3 psia

NASA Technical Reports Server (NTRS)

Conkin, Johnny; Powell, Michael R.; Gernhardt, Michael L.

2003-01-01

INTRODUCTION: Variables that define who we are, such as age, weight and fitness level influence the risk of decompression sickness (DCS) and venous gas emboli (VGE) from diving and aviation decompressions. We focus on age since astronauts that perform space walks are approximately 10 yr older than our test subjects. Our null hypothesis is that age is not statistically associated with the VGE outcomes from decompression to 4.3 psia. METHODS: Our data are from 7 different NASA tests where 188 men and 50 women performed light exercise at 4.3 psia for planned exposures no less than 4 h. Prebreathe (PB) time on 100% oxygen ranged from 150-270 min, including ascent time, with exercise of different intensity and length being performed during the PB in four of the seven tests with 150 min of PB. Subjects were monitored for VGE in the pulmonary artery using a Doppler ultrasound bubble detector for a 4-min period every 12 min. There were six design variables; the presence or absence of lower body adynamia and five PB variables; plus five concomitant variables on physical characteristics: age, weight height, body mass index, and gender that were available for logistic regression (LR). We used LR models for the probability of DCS and VGE, and multinomial logit (ML) models for the probability of Spencer VGE Grades 0-IV at exposure times of 61, 95, 131, 183 min, and for the entire exposure. RESULTS: Age was significantly associated with VGE in both the LR and ML models, so we reject the null hypothesis. Lower body adynamia was significant for all responses. CONCLUSIONS: Our selection of tests produced a wide range of the explanatory variables, but only age, lower body adynamia, height, and total PB time was helpful in various combinations to model the probability of DCS and VGE.

Assessing rear-end crash potential in urban locations based on vehicle-by-vehicle interactions, geometric characteristics and operational conditions.

PubMed

Dimitriou, Loukas; Stylianou, Katerina; Abdel-Aty, Mohamed A

2018-03-01

Rear-end crashes are one of the most frequently occurring crash types, especially in urban networks. An understanding of the contributing factors and their significant association with rear-end crashes is of practical importance and will help in the development of effective countermeasures. The objective of this study is to assess rear-end crash potential at a microscopic level in an urban environment, by investigating vehicle-by-vehicle interactions. To do so, several traffic parameters at the individual vehicle level have been taken into consideration, for capturing car-following characteristics and vehicle interactions, and to investigate their effect on potential rear-end crashes. In this study rear-end crash potential was estimated based on stopping distance between two consecutive vehicles, and four rear-end crash potential cases were developed. The results indicated that 66.4% of the observations were estimated as rear-end crash potentials. It was also shown that rear-end crash potential was presented when traffic flow and speed standard deviation were higher. Also, locational characteristics such as lane of travel and location in the network were found to affect drivers' car following decisions and additionally, it was shown that speeds were lower and headways higher when Heavy Goods Vehicles lead. Finally, a model-based behavioral analysis based on Multinomial Logit regression was conducted to systematically identify the statistically significant variables in explaining rear-end risk potential. The modeling results highlighted the significance of the explanatory variables associated with rear-end crash potential, however it was shown that their effect varied among different model configurations. The outcome of the results can be of significant value for several purposes, such as real-time monitoring of risk potential, allocating enforcement units in urban networks and designing targeted proactive safety policies. Copyright © 2018 Elsevier Ltd. All rights reserved.

Hot mill process parameters impacting on hot mill tertiary scale formation

NASA Astrophysics Data System (ADS)

Kennedy, Jonathan Ian

For high end steel applications surface quality is paramount to deliver a suitable product. A major cause of surface quality issues is from the formation of tertiary scale. The scale formation depends on numerous factors such as thermo-mechanical processing routes, chemical composition, thickness and rolls used. This thesis utilises a collection of data mining techniques to better understand the influence of Hot Mill process parameters on scale formation at Port Talbot Hot Strip Mill in South Wales. The dataset to which these data mining techniques were applied was carefully chosen to reduce process variation. There are several main factors that were considered to minimise this variability including time period, grade and gauge investigated. The following data mining techniques were chosen to investigate this dataset: Partial Least Squares (PLS); Logit Analysis; Principle Component Analysis (PCA); Multinomial Logistical Regression (MLR); Adaptive Neuro Inference Fuzzy Systems (ANFIS). The analysis indicated that the most significant variable for scale formation is the temperature entering the finishing mill. If the temperature is controlled on entering the finishing mill scale will not be formed. Values greater than 1070 °C for the average Roughing Mill and above 1050 °C for the average Crop Shear temperature are considered high, with values greater than this increasing the chance of scale formation. As the temperature increases more scale suppression measures are required to limit scale formation, with high temperatures more likely to generate a greater amount of scale even with fully functional scale suppression systems in place. Chemistry is also a significant factor in scale formation, with Phosphorus being the most significant of the chemistry variables. It is recommended that the chemistry specification for Phosphorus be limited to a maximum value of 0.015 % rather than 0.020 % to limit scale formation. Slabs with higher values should be treated with particular care when being processed through the Hot Mill to limit scale formation.

An exploration of parents’ preferences for foot care in juvenile idiopathic arthritis: a possible role for the discrete choice experiment

PubMed Central

2014-01-01

Background An increased awareness of patients’ and parents’ care preferences regarding foot care is desirable from a clinical perspective as such information may be utilised to optimise care delivery. The aim of this study was to examine parents’ preferences for, and valuations of foot care and foot-related outcomes in juvenile idiopathic arthritis (JIA). Methods A discrete choice experiment (DCE) incorporating willingness-to-pay (WTP) questions was conducted by surveying 42 parents of children with JIA who were enrolled in a randomised-controlled trial of multidisciplinary foot care at a single UK paediatric rheumatology outpatients department. Attributes explored were: levels of pain; mobility; ability to perform activities of daily living (ADL); waiting time; referral route; and footwear. The DCE was administered at trial baseline. DCE data were analysed using a multinomial-logit-regression model to estimate preferences and relative importance of attributes of foot care. A stated-preference WTP question was presented to estimate parents’ monetary valuation of health and service improvements. Results Every attribute in the DCE was statistically significant (p < 0.01) except that of cost (p = 0.118), suggesting that all attributes, except cost, have an impact on parents’ preferences for foot care for their child. The magnitudes of the coefficients indicate that the strength of preference for each attribute was (in descending order): improved ability to perform ADL, reductions in foot pain, improved mobility, improved ability to wear desired footwear, multidisciplinary foot care route, and reduced waiting time. Parents’ estimated mean annual WTP for a multidisciplinary foot care service was £1,119.05. Conclusions In terms of foot care service provision for children with JIA, parents appear to prefer improvements in health outcomes over non-health outcomes and service process attributes. Cost was relatively less important than other attributes suggesting that it does not appear to impact on parents’ preferences. PMID:24502508

An Analysis of Army Dentists Using Logistic Regression: A Discrete-Time Logit Model for Predicting Retention

DTIC Science & Technology

2009-06-10

Reports (0704 0188), 1215 Jefferson Devis Highway, Suite 1204, Arlington, VA 22202 4302 Respondents should be aware that notwithstanding any other...NAME(S) AND ADDRESS(ES) US Army Medical Department Center and School BLDG 2841 MCCS-HGE-HA (Army-Baylor Program in Health & Business Administration...been used to model negative occurrences in the medical field, such as time to death from a certain disease. However, questions of whether and when

Complementarity in dietary supplements and foods: are supplement users vegetable eaters?

PubMed

Kang, Hyoung-Goo; Joo, Hailey Hayeon; Choi, Kyong Duk; Lee, Dongmin; Moon, Junghoon

2017-01-01

Background : The consumption of fruits, vegetables, and dietary supplements correlate. Most previous studies have aimed to identify the determinants of supplement uses or the distinct features of supplement users; this literature lacks a discussion on dietary supplement consumption as a predictor of fruit and vegetable consumption. Objective : This study examines how dietary supplement consumption correlates with fruit and vegetable consumption by combining scanner data and surveys of Korean household grocery shopping. Methods : Propensity score matching (PSM) is used to identify the relationship between dietary supplement consumption and fruit and vegetable consumption in a household. A logit regression using supplement consumption as the dependent variable is used. Then, the supplement takers (the treatment group) are matched with non-takers (the control group) based on the propensity scores estimated in the logit regression. The fruit and vegetable consumption levels of the groups are then compared. Results : We found that dietary supplement use is associated with higher fruit and vegetable consumption. This supports the health consciousness hypothesis based on attention bias, availability heuristics, the focusing effect, and the consumption episode effect. It rejects the health substitute hypothesis based on economic substitutes and mental accounting. Conclusions : Future research on the health benefits of dietary supplements should address the complementary consumption of fruits/vegetables and their health benefits to avoid misstating the health effects of supplements.

Complementarity in dietary supplements and foods: are supplement users vegetable eaters?

PubMed Central

Kang, Hyoung-Goo; Joo, Hailey Hayeon; Choi, Kyong Duk; Lee, Dongmin; Moon, Junghoon

2017-01-01

ABSTRACT Background: The consumption of fruits, vegetables, and dietary supplements correlate. Most previous studies have aimed to identify the determinants of supplement uses or the distinct features of supplement users; this literature lacks a discussion on dietary supplement consumption as a predictor of fruit and vegetable consumption. Objective: This study examines how dietary supplement consumption correlates with fruit and vegetable consumption by combining scanner data and surveys of Korean household grocery shopping. Methods: Propensity score matching (PSM) is used to identify the relationship between dietary supplement consumption and fruit and vegetable consumption in a household. A logit regression using supplement consumption as the dependent variable is used. Then, the supplement takers (the treatment group) are matched with non-takers (the control group) based on the propensity scores estimated in the logit regression. The fruit and vegetable consumption levels of the groups are then compared. Results: We found that dietary supplement use is associated with higher fruit and vegetable consumption. This supports the health consciousness hypothesis based on attention bias, availability heuristics, the focusing effect, and the consumption episode effect. It rejects the health substitute hypothesis based on economic substitutes and mental accounting. Conclusions: Future research on the health benefits of dietary supplements should address the complementary consumption of fruits/vegetables and their health benefits to avoid misstating the health effects of supplements. PMID:28904529

Primary and Secondary Socialization Impacts on Support for Same-Sex Marriage after Legalization in the Netherlands

ERIC Educational Resources Information Center

Lubbers, Marcel; Jaspers, Eva; Ultee, Wout

2009-01-01

Two years after the legalization of same-sex marriages in the Netherlands, 65% of the Dutch population largely or completely disagrees with the statement "gay marriage should be abolished." This article shows, by way of multinomial logistic regression analysis of survey data, which socializing agents influence one's attitude toward…

The Association between Electronic Bullying and School Absenteeism among High School Students in the United States

ERIC Educational Resources Information Center

Grinshteyn, Erin; Yang, Y. T.

2017-01-01

Background: We examined the relationship between exposure to electronic bullying and absenteeism as a result of being afraid. Methods: This multivariate, multinomial regression analysis of the 2013 Youth Risk Behavior Survey data assessed the association between experiencing electronic bullying in the past year and how often students were absent…

Perpetration of Intimate Partner Aggression by Men and Women in the Philippines: Prevalence and Associated Factors

ERIC Educational Resources Information Center

Ansara, Donna L.; Hindin, Michelle J.

2009-01-01

This study uses data from the 2002 Cebu Longitudinal Health and Nutrition Survey to examine the prevalence of and factors associated with intimate partner violence perpetration by husbands and wives in Cebu, Philippines. Multinomial logistic regression was used to identify the factors associated with wife-only, husband-only, and reciprocal…

Persistent Nonmedical Use of Prescription Stimulants among College Students: Possible Association with ADHD Symptoms

ERIC Educational Resources Information Center

Arria, Amelia M.; Garnier-Dykstra, Laura M.; Caldeira, Kimberly M.; Vincent, Kathryn B.; O'Grady, Kevin E.; Wish, Eric D.

2011-01-01

Objective: To investigate the possible association between untreated ADHD symptoms (as measured by the Adult ADHD Self-Report Scale) and persistent nonmedical use of prescription stimulants. Method: Multinomial regression modeling was used to compare ADHD symptoms among three groups of college students enrolled in a longitudinal study over 4…

A Multilevel Study of Students' Motivations of Studying Accounting: Implications for Employers

ERIC Educational Resources Information Center

Law, Philip; Yuen, Desmond

2012-01-01

Purpose: The purpose of this study is to examine the influence of factors affecting students' choice of accounting as a study major in Hong Kong. Design/methodology/approach: Multinomial logistic regression and Hierarchical Generalized Linear Modeling (HGLM) are used to analyze the survey data for the level one and level two data, which is the…

Behavioral and Emotional Strengths among Youth in Systems of Care and the Effect of Race/Ethnicity

ERIC Educational Resources Information Center

Barksdale, Crystal L.; Azur, Melissa; Daniels, Amy M.

2010-01-01

Behavioral and emotional strengths are important to consider when understanding youth mental health and treatment. This study examined the association between youth strengths and functional impairment and whether this association is modified by race/ethnicity. Multinomial logistic regression models were used to estimate the effects of strengths on…

Religiosity Profiles of American Youth in Relation to Substance Use, Violence, and Delinquency

ERIC Educational Resources Information Center

Salas-Wright, Christopher P.; Vaughn, Michael G.; Hodge, David R.; Perron, Brian E.

2012-01-01

Relatively little is known in terms of the relationship between religiosity profiles and adolescents' involvement in substance use, violence, and delinquency. Using a diverse sample of 17,705 (49 % female) adolescents from the 2008 National Survey on Drug Use and Health, latent profile analysis and multinomial regression are employed to examine…

Testing an Online English Course: Lessons Learned from an Analysis of Postcourse Proficiency Change Scores

ERIC Educational Resources Information Center

Jee, Rebecca Y.

2015-01-01

Voxy, an English-language-learning company, has developed a custom, in-house proficiency exam, the Voxy Proficiency Assessment (VPA), which is given to all learners at the beginning and end of their courses. Using Multinomial Logistic Regression (MLR), the impact of covariates, such as total learning activities completed and total number of…

Using multinomial logistic regression analysis to understand anglers willingness to substitute other fishing locations

Treesearch

Woo-Yong Hyun; Robert B. Ditton

2007-01-01

The concept of recreation substitutability has been a continuing research topic for outdoor recreation researchers. This study explores the relationships among variables regarding the willingness to substitute one location for another location. The objectives of the study are 1) to ascertain and predict the extent to which saltwater anglers were willing to substitute...

So Close, yet So Far Away: Early vs. Late Dropouts

ERIC Educational Resources Information Center

Ma, Yanli; Cragg, Kristina M.

2013-01-01

While some students drop out early in their academic career, others drop out close to completion. What similarities and differences exist between these early and late dropouts? Using a sample 3,520 first-time, full-time (FTFT) students seeking a bachelor's degree at a state university, this study employs multinomial logistic regression to model…

The Relationship of Selected Supply- and Demand-Side Factors to Forms of Perceived Discrimination among Adults with Multiple Sclerosis

ERIC Educational Resources Information Center

Roessler, Richard T.; Neath, Jeanne; McMahon, Brian T.; Rumrill, Phillip D.

2007-01-01

Single-predictor and stepwise multinomial logistic regression analyses and an external validation were completed on 3,082 allegations of employment discrimination by adults with multiple sclerosis. Women filed two thirds of the allegations, and individuals between 31 and 50 made the vast majority of discrimination charges (73%). Allegations…

High School Predictors of College Persistence: The Significance of Engagement and Teacher Interaction

ERIC Educational Resources Information Center

Sciarra, Daniel T.; Seirup, Holly J.; Sposato, Elizabeth

2016-01-01

This study investigated factors from high school that might predict college persistence. The sample consisted of 7,271 participants in three waves of data collection (2002, 2004 and 2006) who participated in the Educational Longitudinal Study (ELS; U.S. Department of Education, 2008). A multinomial logistic regression mode was employed to…

Clinicians' adherence to clinical practice guidelines for cardiac function monitoring during antipsychotic treatment: a retrospective report on 434 patients with severe mental illness.

PubMed

Manchia, Mirko; Firinu, Giorgio; Carpiniello, Bernardo; Pinna, Federica

2017-03-31

Severe mental illness (SMI) has considerable excess morbidity and mortality, a proportion of which is explained by cardiovascular diseases, caused in part by antipsychotic (AP) induced QT-related arrhythmias and sudden death by Torsade de Point (TdP). The implementation of evidence-based recommendations for cardiac function monitoring might reduce the incidence of these AP-related adverse events. To investigate clinicians' adherence to cardiac function monitoring before and after starting AP, we performed a retrospective assessment of 434 AP-treated SMI patients longitudinally followed-up for 5 years at an academic community mental health center. We classified antipsychotics according to their risk of inducing QT-related arrhythmias and TdP (Center for Research on Therapeutics, University of Arizona). We used univariate tests and multinomial or binary logistic regression model for data analysis. Univariate and multinomial regression analysis showed that psychiatrists were more likely to perform pre-treatment electrocardiogram (ECG) and electrolyte testing with AP carrying higher cardiovascular risk, but not on the basis of AP pharmacological class. Univariate and binomial regression analysis showed that cardiac function parameters (ECG and electrolyte balance) were more frequently monitored during treatment with second generation AP than with first generation AP. Our data show the presence of weaknesses in the cardiac function monitoring of AP-treated SMI patients, and might guide future interventions to tackle them.

Utility of an Abbreviated Dizziness Questionnaire to Differentiate between Causes of Vertigo and Guide Appropriate Referral: A Multicenter Prospective Blinded Study

PubMed Central

Roland, Lauren T.; Kallogjeri, Dorina; Sinks, Belinda C.; Rauch, Steven D.; Shepard, Neil T.; White, Judith A.; Goebel, Joel A.

2015-01-01

Objective Test performance of a focused dizziness questionnaire’s ability to discriminate between peripheral and non-peripheral causes of vertigo. Study Design Prospective multi-center Setting Four academic centers with experienced balance specialists Patients New dizzy patients Interventions A 32-question survey was given to participants. Balance specialists were blinded and a diagnosis was established for all participating patients within 6 months. Main outcomes Multinomial logistic regression was used to evaluate questionnaire performance in predicting final diagnosis and differentiating between peripheral and non-peripheral vertigo. Univariate and multivariable stepwise logistic regression were used to identify questions as significant predictors of the ultimate diagnosis. C-index was used to evaluate performance and discriminative power of the multivariable models. Results 437 patients participated in the study. Eight participants without confirmed diagnoses were excluded and 429 were included in the analysis. Multinomial regression revealed that the model had good overall predictive accuracy of 78.5% for the final diagnosis and 75.5% for differentiating between peripheral and non-peripheral vertigo. Univariate logistic regression identified significant predictors of three main categories of vertigo: peripheral, central and other. Predictors were entered into forward stepwise multivariable logistic regression. The discriminative power of the final models for peripheral, central and other causes were considered good as measured by c-indices of 0.75, 0.7 and 0.78, respectively. Conclusions This multicenter study demonstrates a focused dizziness questionnaire can accurately predict diagnosis for patients with chronic/relapsing dizziness referred to outpatient clinics. Additionally, this survey has significant capability to differentiate peripheral from non-peripheral causes of vertigo and may, in the future, serve as a screening tool for specialty referral. Clinical utility of this questionnaire to guide specialty referral is discussed. PMID:26485598

Utility of an Abbreviated Dizziness Questionnaire to Differentiate Between Causes of Vertigo and Guide Appropriate Referral: A Multicenter Prospective Blinded Study.

PubMed

Roland, Lauren T; Kallogjeri, Dorina; Sinks, Belinda C; Rauch, Steven D; Shepard, Neil T; White, Judith A; Goebel, Joel A

2015-12-01

Test performance of a focused dizziness questionnaire's ability to discriminate between peripheral and nonperipheral causes of vertigo. Prospective multicenter. Four academic centers with experienced balance specialists. New dizzy patients. A 32-question survey was given to participants. Balance specialists were blinded and a diagnosis was established for all participating patients within 6 months. Multinomial logistic regression was used to evaluate questionnaire performance in predicting final diagnosis and differentiating between peripheral and nonperipheral vertigo. Univariate and multivariable stepwise logistic regression were used to identify questions as significant predictors of the ultimate diagnosis. C-index was used to evaluate performance and discriminative power of the multivariable models. In total, 437 patients participated in the study. Eight participants without confirmed diagnoses were excluded and 429 were included in the analysis. Multinomial regression revealed that the model had good overall predictive accuracy of 78.5% for the final diagnosis and 75.5% for differentiating between peripheral and nonperipheral vertigo. Univariate logistic regression identified significant predictors of three main categories of vertigo: peripheral, central, and other. Predictors were entered into forward stepwise multivariable logistic regression. The discriminative power of the final models for peripheral, central, and other causes was considered good as measured by c-indices of 0.75, 0.7, and 0.78, respectively. This multicenter study demonstrates a focused dizziness questionnaire can accurately predict diagnosis for patients with chronic/relapsing dizziness referred to outpatient clinics. Additionally, this survey has significant capability to differentiate peripheral from nonperipheral causes of vertigo and may, in the future, serve as a screening tool for specialty referral. Clinical utility of this questionnaire to guide specialty referral is discussed.

[Econometric and ethical validation of regression logistics. Reducing of the number of patients in the evaluation of mortality].

PubMed

Castiel, D; Herve, C

1992-01-01

In general, a large number of patients is needed to conclude whether the results of a therapeutic strategy are significant or not. One can lower this number with a logit. The method has been proposed in an article published recently (Cost-utility analysis of early thrombolytic therapy, Pharmaco Economics, 1992). The present article is an essay aimed at validating the method, both from the econometric and ethical points of view.

Emergency Department Use by Nursing Home Residents: Effect of Severity of Cognitive Impairment

ERIC Educational Resources Information Center

Stephens, Caroline E.; Newcomer, Robert; Blegen, Mary; Miller, Bruce; Harrington, Charlene

2012-01-01

Purpose: To examine the 1-year prevalence and risk of emergency department (ED) use and ambulatory care-sensitive (ACS) ED use by nursing home (NH) residents with different levels of severity of cognitive impairment (CI). Design and Methods: We used multinomial logistic regression to estimate the effect of CI severity on the odds of any ED visit…

An Exploration of Teacher Attrition and Mobility in High Poverty Racially Segregated Schools

ERIC Educational Resources Information Center

Djonko-Moore, Cara M.

2016-01-01

The purpose of this study was to examine the mobility (movement to a new school) and attrition (quitting teaching) patterns of teachers in high poverty, racially segregated (HPRS) schools in the US. Using 2007-9 survey data from the National Center for Education Statistics, a multi-level multinomial logistic regression was performed to examine the…

A Process View on Implementing an Antibullying Curriculum: How Teachers Differ and What Explains the Variation

ERIC Educational Resources Information Center

Haataja, Anne; Ahtola, Annarilla; Poskiparta, Elisa; Salmivalli, Christina

2015-01-01

The present study provides a person-centered view on teachers' adherence to the KiVa antibullying curriculum over a school year. Factor mixture modeling was used to examine how teachers (N = 282) differed in their implementation profiles and multinomial logistic regression was used to identify factors related to these profiles. On the basis of…

Multinomial-Regression Modeling of the Environmental Attitudes of Higher Education Students Based on the Revised New Ecological Paradigm Scale

ERIC Educational Resources Information Center

Jowett, Tim; Harraway, John; Lovelock, Brent; Skeaff, Sheila; Slooten, Liz; Strack, Mick; Shephard, Kerry

2014-01-01

Higher education is increasingly interested in its impact on the sustainability attributes of its students, so we wanted to explore how our students' environmental concern changed during their higher education experiences. We used the Revised New Ecological Paradigm Scale (NEP) with 505 students and developed and tested a multinomial…

The Effect of Participating in Indiana's Twenty-First Century Scholars Program on College Enrollments

ERIC Educational Resources Information Center

Toutkoushian, Robert K.; Hossler, Don; DesJardins, Stephen L.; McCall, Brian; Gonzalez Canche, Manuel S.

2015-01-01

Our study adds to prior work on Indiana's Twenty-first Century Scholars(TFCS) program by focusing on whether participating in--rather than completing--the program affects the likelihood of students going to college and where they initially enrolled. We first employ binary and multinomial logistic regression to obtain estimates of the impact of the…

The Design and Analysis of Salmonid Tagging Studies in the Columbia Basin; Volume XII; A Multinomial Model for Estimating Ocean Survival from Salmonid Coded Wire-Tag Data.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ryding, Kristen E.; Skalski, John R.

1999-06-01

The purpose of this report is to illustrate the development of a stochastic model using coded wire-tag (CWT) release and age-at-return data, in order to regress first year ocean survival probabilities against coastal ocean conditions and climate covariates.

Sex-related perceptions associated with sexual activity status among Japanese adolescents who heavily use text messaging.

PubMed

Kawamura, Yoko

2012-01-01

This study examines the relationship between sex-related perceptions and engagement in sexual intercourse among adolescents in Japan who were heavy users of text massaging. Using the data from the 6th National Survey on Youth Sexual Behavior of 548 high school students who heavily use text messaging, multinomial logistic regression analyses on variables constructing sexual norms and gender-role attitudes were conducted to assess the relationship with sexual activity status as the first step. A backward stepwise elimination method of multinomial logistic regression was used as the second step at which variables for each set of two factors were tested, and as the third step at which variables of two factors were simultaneously tested. The study results showed that perceptions were related to engagement in sexual intercourse among adolescents who heavily used text messaging. In particular, those who perceived that sex is an act to be engaged in at an earlier stage of a relationship and that men have a stronger sex drive tended to be sexually active or have experienced sexual intercourse. These findings could be utilized to design more effective sexual health education messages for Japanese adolescents who are at an elevated risk.

Factors associated with happiness in the elderly persons living in the community.

PubMed

Luchesi, Bruna Moretti; de Oliveira, Nathalia Alves; de Morais, Daiene; de Paula Pessoa, Rebeca Mendes; Pavarini, Sofia Cristina I; Chagas, Marcos Hortes N

2018-01-01

The aim of the present study was to evaluate factors associated with happiness in a sample of Brazilian older adults. A study was conducted with 263 elderly people in the area of coverage of a family health unit located in the state of São Paulo, Brazil. The Subjective Happiness Scale was used to measure happiness, the final score of which determined one of three outcomes: not happy, intermediate, and happy. Disability, sociodemographic characteristics, and psychological, cognitive, and physical factors were considered for the multinomial logistic regression analysis. Statistically significant differences were found among the three groups regarding satisfaction with life, disability, social phobia, anxiety, depression, and frailty (p≤0.05). In the multinomial regression analysis, being "not happy" was significantly associated with satisfaction with life (RRR: 0.53), depression (RRR: 1.46), social phobia (RRR: 1.24), and age (RRR: 1.06). The present findings indicate that psychological factors and age influence the levels of happiness in older adults living in the community. Furthermore, better screening, diagnosis, and treatment of mental health disorders could increase the feeling of happiness among older adults. Copyright © 2017 Elsevier B.V. All rights reserved.

Perception of tourists regarding the smoke-free policy at Suvarnabhumi International Airport, Bangkok, Thailand.

PubMed

Sirichotiratana, Nithat; Yogi, Subash; Prutipinyo, Chardsumon

2013-08-30

This study was conducted during February-March 2012 to determine the perception and support regarding smoke-free policy among tourists at Suvarnabhumi International Airport, Bangkok, Thailand. In this cross-sectional study, 200 tourists (n = 200) were enrolled by convenience sampling and interviewed by structured questionnaire. Descriptive statistics, chi-square, and multinomial logistic regression were adopted in the study. Results revealed that half (50%) of the tourists were current smokers and 55% had visited Thailand twice or more. Three quarter (76%) of tourists indicated that they would visit Thailand again even if it had a 100% smoke-free regulation. Almost all (99%) of the tourists had supported for the smoke-free policy (partial ban and total ban), and current smokers had higher percentage of support than non-smokers. Two factors, current smoking status and knowledge level, were significantly associated with perception level. After analysis with Multinomial Logistic Regression, it was found that perception, country group, and presence of designated smoking room (DSR) were associated with smoke-free policy. Recommendation is that, at institution level effective monitoring system is needed at the airport. At policy level, the recommendation is that effective comprehensive policy needed to be emphasized to ensure smoke-free airport environment.

Evaluating the Relationship between Productivity and Quality in Emergency Departments

PubMed Central

Bastian, Nathaniel D.; Riordan, John P.

2017-01-01

Background In the United States, emergency departments (EDs) are constantly pressured to improve operational efficiency and quality in order to gain financial benefits and maintain a positive reputation. Objectives The first objective is to evaluate how efficiently EDs transform their input resources into quality outputs. The second objective is to investigate the relationship between the efficiency and quality performance of EDs and the factors affecting this relationship. Methods Using two data sources, we develop a data envelopment analysis (DEA) model to evaluate the relative efficiency of EDs. Based on the DEA result, we performed multinomial logistic regression to investigate the relationship between ED efficiency and quality performance. Results The DEA results indicated that the main source of inefficiencies was working hours of technicians. The multinomial logistic regression result indicated that the number of electrocardiograms and X-ray procedures conducted in the ED and the length of stay were significantly associated with the trade-offs between relative efficiency and quality. Structural ED characteristics did not influence the relationship between efficiency and quality. Conclusions Depending on the structural and operational characteristics of EDs, different factors can affect the relationship between efficiency and quality. PMID:29065673

POLO: a user's guide to Probit Or LOgit analysis.

Treesearch

Jacqueline L. Robertson; Robert M. Russell; N.E. Savin

1980-01-01

This user's guide provides detailed instructions for the use of POLO (Probit Or LOgit), a computer program for the analysis of quantal response data such as that obtained from insecticide bioassays by the techniques of probit or logit analysis. Dosage-response lines may be compared for parallelism or...

Lateralization of temporal lobe epilepsy by multimodal multinomial hippocampal response-driven models.

PubMed

Nazem-Zadeh, Mohammad-Reza; Elisevich, Kost V; Schwalb, Jason M; Bagher-Ebadian, Hassan; Mahmoudi, Fariborz; Soltanian-Zadeh, Hamid

2014-12-15

Multiple modalities are used in determining laterality in mesial temporal lobe epilepsy (mTLE). It is unclear how much different imaging modalities should be weighted in decision-making. The purpose of this study is to develop response-driven multimodal multinomial models for lateralization of epileptogenicity in mTLE patients based upon imaging features in order to maximize the accuracy of noninvasive studies. The volumes, means and standard deviations of FLAIR intensity and means of normalized ictal-interictal SPECT intensity of the left and right hippocampi were extracted from preoperative images of a retrospective cohort of 45 mTLE patients with Engel class I surgical outcomes, as well as images of a cohort of 20 control, nonepileptic subjects. Using multinomial logistic function regression, the parameters of various univariate and multivariate models were estimated. Based on the Bayesian model averaging (BMA) theorem, response models were developed as compositions of independent univariate models. A BMA model composed of posterior probabilities of univariate response models of hippocampal volumes, means and standard deviations of FLAIR intensity, and means of SPECT intensity with the estimated weighting coefficients of 0.28, 0.32, 0.09, and 0.31, respectively, as well as a multivariate response model incorporating all mentioned attributes, demonstrated complete reliability by achieving a probability of detection of one with no false alarms to establish proper laterality in all mTLE patients. The proposed multinomial multivariate response-driven model provides a reliable lateralization of mesial temporal epileptogenicity including those patients who require phase II assessment. Copyright © 2014 Elsevier B.V. All rights reserved.

Three-dimensional prediction of soil physical, chemical, and hydrological properties in a forested catchment of the Santa Catalina CZO

NASA Astrophysics Data System (ADS)

Shepard, C.; Holleran, M.; Lybrand, R. A.; Rasmussen, C.

2014-12-01

Understanding critical zone evolution and function requires an accurate assessment of local soil properties. Two-dimensional (2D) digital soil mapping provides a general assessment of soil characteristics across a sampled landscape, but lacks the ability to predict soil properties with depth. The utilization of mass-preserving spline functions enable the extrapolation of soil properties with depth, extending predictive functions to three-dimensions (3D). The present study was completed in the Marshall Gulch (MG) catchment, located in the Santa Catalina Mountains, 30 km northwest of Tucson, Arizona, as part of the Santa Catalina-Jemez Mountains Critical Zone Observatory. Twenty-four soil pits were excavated and described following standard procedures. Mass-preserving splines were used to extrapolate mass carbon (kg C m-2); percent clay, silt, and sand (%); sodium mass flux (kg Na m-2); and pH for 24 sampled soil pits in 1-cm depth increments. Saturated volumetric water content (θs) and volumetric water content at 10 kPa (θ10) were predicted using ROSETTA and established empirical relationships. The described profiles were all sampled to differing depths; to compensate for the unevenness of the profile descriptions, the soil depths were standardized from 0.0 to 1.0 and then split into five equal standard depth sections. A logit-transformation was used to normalize the target variables. Step-wise regressions were calculated using available environmental covariates to predict the properties of each variable across the catchment in each depth section, and interpolated model residuals added back to the predicted layers to generate the final soil maps. Logit-transformed R2 for the predictive functions varied widely, ranging from 0.20 to 0.79, with logit-transformed RMSE ranging from 0.15 to 2.77. The MG catchment was further classified into clusters with similar properties based on the environmental covariates, and representative depth functions for each target variable in each cluster calculated. Mass-preserving splines combined with stepwise regressions are an effective tool for predicting soil physical, chemical, and hydrological properties with depth, enhancing our understanding of the critical zone.

Logit Models for the Analysis of Two-Way Categorical Data

ERIC Educational Resources Information Center

Draxler, Clemens

2011-01-01

This article discusses the application of logit models for the analyses of 2-way categorical observations. The models described are generalized linear models using the logit link function. One of the models is the Rasch model (Rasch, 1960). The objective is to test hypotheses of marginal and conditional independence between explanatory quantities…

A Pilot Test of Indicator Species to Assess Uniqueness of Oak-Dominated Ecoregions in Central Tennessee

Treesearch

W. Henry McNab; David L. Loftis; Callie J. Schweitzer; Raymond Sheffield

2004-01-01

We used tree indicator species occurring on 438 plots in the Plateau counties of Tennessee to test the uniqueness of four conterminous ecoregions. Multinomial logistic regression indicated that the presence of 14 tree species allowed classification of sample plots according to ecoregion with an average overall accuracy of 75 percent (range 45 to 94 percent). Additional...

Brief Report: Sexual Orientation in Individuals with Autistic Traits--Population Based Study of 47,000 Adults in Stockholm County

ERIC Educational Resources Information Center

Rudolph, Christiane E. S.; Lundin, Andreas; Åhs, Jill W.; Dalman, Christina; Kosidou, Kyriaki

2018-01-01

We examined the association between autistic traits and sexual orientation in a general adult population (N = 47,356). Autistic traits were measured with the ten items Autistic Quotient questionnaire using a cut-off score of = 6. Sexual orientation was assessed by self-report. Multinomial logistic regression was used to estimate odds ratios (ORs)…

Mind-Mindedness as a Multidimensional Construct: Appropriate and Nonattuned Mind-Related Comments Independently Predict Infant-Mother Attachment in a Socially Diverse Sample

ERIC Educational Resources Information Center

Meins, Elizabeth; Fernyhough, Charles; de Rosnay, Marc; Arnott, Bronia; Leekam, Susan R.; Turner, Michelle

2012-01-01

In a socially diverse sample of 206 infant-mother pairs, we investigated predictors of infants' attachment security at 15 months, with a particular emphasis on mothers' tendency to comment appropriately or in a non-attuned manner on their 8-month-olds' internal states (so-called mind-mindedness). Multinomial logistic regression analyses showed…

Food and Drug Administration tobacco regulation and product judgments.

PubMed

Kaufman, Annette R; Finney Rutten, Lila J; Parascandola, Mark; Blake, Kelly D; Augustson, Erik M

2015-04-01

The Family Smoking Prevention and Tobacco Control Act granted the Food and Drug Administration (FDA) the authority to regulate tobacco products in the U.S. However, little is known about how regulation may be related to judgments about tobacco product-related risks. To understand how FDA tobacco regulation beliefs are associated with judgments about tobacco product-related risks. The Health Information National Trends Survey is a national survey of the U.S. adult population. Data used in this analysis were collected from October 2012 through January 2013 (N=3,630) by mailed questionnaire and analyzed in 2013. Weighted bivariate chi-square analyses were used to assess associations among FDA regulation belief, tobacco harm judgments, sociodemographics, and smoking status. A weighted multinomial logistic regression was conducted where FDA regulation belief was regressed on tobacco product judgments, controlling for sociodemographic variables and smoking status. About 41% believed that the FDA regulates tobacco products in the U.S., 23.6% reported the FDA does not, and 35.3% did not know. Chi-square analyses showed that smoking status was significantly related to harm judgments about electronic cigarettes (p<0.0001). The multinomial logistic regression revealed that uncertainty about FDA regulation was associated with tobacco product harm judgment uncertainty. Tobacco product harm perceptions are associated with beliefs about tobacco product regulation by the FDA. These findings suggest the need for increased public awareness and understanding of the role of tobacco product regulation in protecting public health. Copyright © 2015. Published by Elsevier Inc.

School Progress Among Children of Same-Sex Couples.

PubMed

Watkins, Caleb S

2018-06-01

This study uses logit regressions on a pooled sample of children from the 2012, 2013, and 2014 American Community Survey to perform a nationally representative analysis of school progress for a large sample of 4,430 children who reside with same-sex couples. Odds ratios from regressions that compare children between different-sex married couples and same-sex couples fail to show significant differences in normal school progress between households across a variety of sample compositions. Likewise, marginal effects from regressions that compare children with similar family dynamics between different-sex married couples and same-sex couples fail to predict significantly higher probabilities of grade retention for children of same-sex couples. Significantly lower grade retention rates are sometimes predicted for children of same-sex couples than for different-sex married couples, but these differences are sensitive to sample exclusions and do not indicate causal benefits to same-sex parenting.

Using GA-Ridge regression to select hydro-geological parameters influencing groundwater pollution vulnerability.

PubMed

Ahn, Jae Joon; Kim, Young Min; Yoo, Keunje; Park, Joonhong; Oh, Kyong Joo

2012-11-01

For groundwater conservation and management, it is important to accurately assess groundwater pollution vulnerability. This study proposed an integrated model using ridge regression and a genetic algorithm (GA) to effectively select the major hydro-geological parameters influencing groundwater pollution vulnerability in an aquifer. The GA-Ridge regression method determined that depth to water, net recharge, topography, and the impact of vadose zone media were the hydro-geological parameters that influenced trichloroethene pollution vulnerability in a Korean aquifer. When using these selected hydro-geological parameters, the accuracy was improved for various statistical nonlinear and artificial intelligence (AI) techniques, such as multinomial logistic regression, decision trees, artificial neural networks, and case-based reasoning. These results provide a proof of concept that the GA-Ridge regression is effective at determining influential hydro-geological parameters for the pollution vulnerability of an aquifer, and in turn, improves the AI performance in assessing groundwater pollution vulnerability.

Gender gap in parents' financing strategy for hospitalization of their children: evidence from India.

PubMed

Asfaw, Abay; Lamanna, Francesca; Klasen, Stephan

2010-03-01

The 'missing women' dilemma in India has sparked great interest in investigating gender discrimination in the provision of health care in the country. No studies, however, have directly examined discrimination in health-care financing strategies in the case of severe illness of sons versus daughters. In this paper, we hypothesize that households who face tight budget constraints are more likely to spend their meager resources on hospitalization of boys rather than girls. We use the 60th round of the Indian National Sample Survey (2004) and a multinomial logit model to test this hypothesis and to throw some light on this important but overlooked issue. The results reveal that boys are much more likely to be hospitalized than girls. When it comes to financing, the gap in the usage of household income and savings is relatively small, while the gender gap in the probability of hospitalization and usage of more onerous financing strategies is very high. Ceteris paribus, the probability of boys to be hospitalized by financing from borrowing, sale of assets, help from friends, etc. is much higher than that of girls. Moreover, in line with our theoretical framework, the results indicate that the gender gap intensifies as we move from the richest to poorest households. (c) 2009 John Wiley & Sons, Ltd.

Treatment-seeking behaviour and social health insurance in Africa: the case of Ghana under the National Health Insurance Scheme.

PubMed

Fenny, Ama P; Asante, Felix A; Enemark, Ulrika; Hansen, Kristian S

2014-10-27

Health insurance is attracting more and more attention as a means for improving health care utilization and protecting households against impoverishment from out-of-pocket expenditures. Currently about 52 percent of the resources for financing health care services come from out of pocket sources or user fees in Africa. Therefore, Ghana serves as in interesting case study as it has successfully expanded coverage of the National Health Insurance Scheme (NHIS). The study aims to establish the treatment-seeking behaviour of households in Ghana under the NHI policy. The study relies on household data collected from three districts in Ghana covering the 3 ecological zones namely the coastal, forest and savannah.Out of the 1013 who sought care in the previous 4 weeks, 60% were insured and 71% of them sought care from a formal health facility. The results from the multinomial logit estimations show that health insurance and travel time to health facility are significant determinants of health care demand. Overall, compared to the uninsured, the insured are more likely to choose formal health facilities than informal care including self-medication when ill. We discuss the implications of these results as the concept of the NHIS grows widely in Ghana and serves as a good model for other African countries.

Treatment-Seeking Behaviour and Social Health Insurance in Africa: The Case of Ghana Under the National Health Insurance Scheme

PubMed Central

Fenny, Ama P.; Asante, Felix A.; Enemark, Ulrika; Hansen, Kristian S.

2015-01-01

Health insurance is attracting more and more attention as a means for improving health care utilization and protecting households against impoverishment from out-of-pocket expenditures. Currently about 52 percent of the resources for financing health care services come from out of pocket sources or user fees in Africa. Therefore, Ghana serves as in interesting case study as it has successfully expanded coverage of the National Health Insurance Scheme (NHIS). The study aims to establish the treatment-seeking behaviour of households in Ghana under the NHI policy. The study relies on household data collected from three districts in Ghana covering the 3 ecological zones namely the coastal, forest and savannah. Out of the 1013 who sought care in the previous 4 weeks, 60% were insured and 71% of them sought care from a formal health facility. The results from the multinomial logit estimations show that health insurance and travel time to health facility are significant determinants of health care demand. Overall, compared to the uninsured, the insured are more likely to choose formal health facilities than informal care including self-medication when ill. We discuss the implications of these results as the concept of the NHIS grows widely in Ghana and serves as a good model for other African countries. PMID:25560361

Queues with Choice via Delay Differential Equations

NASA Astrophysics Data System (ADS)

Pender, Jamol; Rand, Richard H.; Wesson, Elizabeth

Delay or queue length information has the potential to influence the decision of a customer to join a queue. Thus, it is imperative for managers of queueing systems to understand how the information that they provide will affect the performance of the system. To this end, we construct and analyze two two-dimensional deterministic fluid models that incorporate customer choice behavior based on delayed queue length information. In the first fluid model, customers join each queue according to a Multinomial Logit Model, however, the queue length information the customer receives is delayed by a constant Δ. We show that the delay can cause oscillations or asynchronous behavior in the model based on the value of Δ. In the second model, customers receive information about the queue length through a moving average of the queue length. Although it has been shown empirically that giving patients moving average information causes oscillations and asynchronous behavior to occur in U.S. hospitals, we analytically and mathematically show for the first time that the moving average fluid model can exhibit oscillations and determine their dependence on the moving average window. Thus, our analysis provides new insight on how operators of service systems should report queue length information to customers and how delayed information can produce unwanted system dynamics.

Exacerbations of COPD: quantifying the patient's perspective using discrete choice modelling.

PubMed

Haughney, J; Partridge, M R; Vogelmeier, C; Larsson, T; Kessler, R; Ståhl, E; Brice, R; Löfdahl, C-G

2005-10-01

Patient-centred care is the current vogue in chronic obstructive pulmonary disease (COPD), but it is only recently that robust techniques have become available to determine patients' values and preferences. In this international cross-sectional study, patients' concerns and expectations regarding COPD exacerbations were explored using discrete choice modelling. A fractional factorial design was used to develop scenarios comprising a combination of levels for nine different attributes. In face-to-face interviews, patients were presented with paired scenarios and asked to choose the least preferable. Multinomial logit (with hierarchical Bayes) methods were used to estimate utilities. A total of 125 patients (82 males; mean age 66 yrs; 4.6 mean exacerbations.yr-1) were recruited. The attributes of exacerbations considered most important were impact on everyday life (20%), need for medical care (16%), number of future attacks (12%) and breathlessness (11%). The next most important attributes were speed of recovery, productive cough and social impact (all 9%), followed by sleep disturbance and impact on mood (both 7%). Importantly, analysis of utility shifts showed that patients most feared being hospitalised, housebound or bedridden. These issues were more important than symptom improvement. Strategies for the clinical management of chronic obstructive pulmonary disease should clearly address patients' concerns and focus on preventing and treating exacerbations to avoid these feared outcomes.

The Trajectory and the Related Physical and Social Determinants of Body Mass Index in Elementary School Children: Results from the Child and Adolescent Behaviors in Long-Term Evolution Study

PubMed Central

Chang, Hsing-Yi; Luh, Dih-Ling; Hurng, Baai-Shyun; Yen, Lee-Lan

2014-01-01

This study explored developmental trajectory patterns of BMI and associated factors. Participants included 1,609 students who were followed from age 7 to 12 years. Data collection involved annual self-administered questionnaires and records of height and weight. An ecological model was used to identify the factors associated with BMI trajectories. Group-based trajectory models and multinomial logit models were used in the statistical analysis. There were gender differences in BMI trajectories. Among boys, four BMI trajectories were normal or slightly underweight, persistently normal weight, overweight becoming obese, and persistently obese. Among girls, four BMI trajectories were persistently slightly underweight, persistently normal weight, persistently overweight, and persistently obese. The mean BMI in each trajectory group demonstrated an upward trend over time. In boys, BMI trajectories were significantly associated with after-school exercise, academic performance, family interactions, overweight parents, and father's education level. In girls, BMI trajectories were significantly associated with television viewing or computer use, family interactions, peer interactions, and overweight parents. Children under age 7 years who are already overweight or obese are an important target for interventions. The different factors associated with BMI trajectories can be used for targeting high risk groups. PMID:25114800

Economic and organizational determinants of HMO mergers and failures.

PubMed

Feldman, R; Wholey, D; Christianson, J

1996-01-01

This study analyzed data from all operational health maintenance organizations (HMOs) in the United States from 1986 through 1993. Eighty HMOs disappeared through mergers and 149 failed over that period. We estimated a multinomial logit model to predict whether an HMO would merge and survive, merge and disappear, or fail, relative to the probability of no event. We found that enrollment and profitability play a critical role in explaining HMO mergers and failures: large and profitable HMOs were more likely to merge and survive, but less likely to merge and disappear or fail. These results explain why HMO merger and failure rates fell after 1988, as most surviving HMOs became larger and more profitable. Among several market-area variables in the model, state anti-takeover regulations had a negative impact on mergers. Mergers were more likely in markets with more competing HMOs, but the overall market penetration of HMOs had no effect on mergers. This result may have important implications for the current debate over the future of the competitive health care strategy. If public policy successfully stimulates the development of large numbers of new HMOs, another wave of mergers and failures is likely to occur. But it appears that growth in overall HMO penetration will not lead inevitably to increased market concentration.

Farm Level Adaptation to Climate Change: The Case of Farmer's in the Ethiopian Highlands

NASA Astrophysics Data System (ADS)

Gebrehiwot, Tagel; van der Veen, Anne

2013-07-01

In Ethiopia, climate change and associated risks are expected to have serious consequences for agriculture and food security. This in turn will seriously impact on the welfare of the people, particularly the rural farmers whose main livelihood depends on rain-fed agriculture. The level of impacts will mainly depend on the awareness and the level of adaptation in response to the changing climate. It is thus important to understand the role of the different factors that influence farmers' adaptation to ensure the development of appropriate policy measures and the design of successful development projects. This study examines farmers' perception of change in climatic attributes and the factors that influence farmers' choice of adaptation measures to climate change and variability. The estimated results from the climate change adaptation models indicate that level of education, age and wealth of the head of the household; access to credit and agricultural services; information on climate, and temperature all influence farmers' choices of adaptation. Moreover, lack of information on adaptation measures and lack of finance are seen as the main factors inhibiting adaptation to climate change. These conclusions were obtained with a Multinomial logit model, employing the results from a survey of 400 smallholder farmers in three districts in Tigray, northern Ethiopian.

What factors drive heterogeneity of preferences for micro-health insurance in rural Malawi?

PubMed

Abiiro, Gilbert Abotisem; Torbica, Aleksandra; Kwalamasa, Kassim; De Allegri, Manuela

2016-11-01

Investigating the factors that drive differences in preferences for health insurance products among rural populations is a relevant policy issue that has so far received little attention. This study used a discrete choice experiment to explore heterogeneity of preferences for a prospective micro-health insurance (MHI) product in Malawi. Through an extensive qualitative study, six attributes, each associated with three levels, were derived and used to construct a D-efficient design. The attributes included unit of enrollment, management structure, health service benefit package, copayment levels, transportation coverage and monthly premium. The experiment was interviewer administered to a stratified random sample of household heads and their spouse(s). Using mixed logit and generalized multinomial logit models, respondent characteristics were interacted with MHI attributes to explore heterogeneity of preferences. The results showed that those in the higher age group (≥55 years) and those from households with higher household expenditure had significantly higher preferences for comprehensive and medium benefit packages than for a basic package. Those from households that incurred any healthcare expenditure within the past 4 weeks had lower preferences for the core family as a unit of enrollment than the individual, and higher preferences for coverage of transport costs. Women and non-micro-finance members had higher preferences for 25% copayment than for 50% copayment. There was evidence of scale heterogeneity signifying that the observed preference variations could have resulted from scale and variance differences, rather than real variations in the taste of respondents. To attract the relatively older and wealthier, prospective MHI should offer comprehensive health services benefit packages. Premium exemptions or subsidies should also be offered to the poor. Lower copayments can provide an incentive for women and non-micro-finance members, whilst coverage of transport costs can also attract those with recent history of incurring out-of-pocket healthcare expenditure to accept MHI. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Accounting for Scale Heterogeneity in Healthcare-Related Discrete Choice Experiments when Comparing Stated Preferences: A Systematic Review.

PubMed

Wright, Stuart J; Vass, Caroline M; Sim, Gene; Burton, Michael; Fiebig, Denzil G; Payne, Katherine

2018-02-28

Scale heterogeneity, or differences in the error variance of choices, may account for a significant amount of the observed variation in the results of discrete choice experiments (DCEs) when comparing preferences between different groups of respondents. The aim of this study was to identify if, and how, scale heterogeneity has been addressed in healthcare DCEs that compare the preferences of different groups. A systematic review identified all healthcare DCEs published between 1990 and February 2016. The full-text of each DCE was then screened to identify studies that compared preferences using data generated from multiple groups. Data were extracted and tabulated on year of publication, samples compared, tests for scale heterogeneity, and analytical methods to account for scale heterogeneity. Narrative analysis was used to describe if, and how, scale heterogeneity was accounted for when preferences were compared. A total of 626 healthcare DCEs were identified. Of these 199 (32%) aimed to compare the preferences of different groups specified at the design stage, while 79 (13%) compared the preferences of groups identified at the analysis stage. Of the 278 included papers, 49 (18%) discussed potential scale issues, 18 (7%) used a formal method of analysis to account for scale between groups, and 2 (1%) accounted for scale differences between preference groups at the analysis stage. Scale heterogeneity was present in 65% (n = 13) of studies that tested for it. Analytical methods to test for scale heterogeneity included coefficient plots (n = 5, 2%), heteroscedastic conditional logit models (n = 6, 2%), Swait and Louviere tests (n = 4, 1%), generalised multinomial logit models (n = 5, 2%), and scale-adjusted latent class analysis (n = 2, 1%). Scale heterogeneity is a prevalent issue in healthcare DCEs. Despite this, few published DCEs have discussed such issues, and fewer still have used formal methods to identify and account for the impact of scale heterogeneity. The use of formal methods to test for scale heterogeneity should be used, otherwise the results of DCEs potentially risk producing biased and potentially misleading conclusions regarding preferences for aspects of healthcare.

Classification of vegetation types in military region

NASA Astrophysics Data System (ADS)

Gonçalves, Miguel; Silva, Jose Silvestre; Bioucas-Dias, Jose

2015-10-01

In decision-making process regarding planning and execution of military operations, the terrain is a determining factor. Aerial photographs are a source of vital information for the success of an operation in hostile region, namely when the cartographic information behind enemy lines is scarce or non-existent. The objective of present work is the development of a tool capable of processing aerial photos. The methodology implemented starts with feature extraction, followed by the application of an automatic selector of features. The next step, using the k-fold cross validation technique, estimates the input parameters for the following classifiers: Sparse Multinomial Logist Regression (SMLR), K Nearest Neighbor (KNN), Linear Classifier using Principal Component Expansion on the Joint Data (PCLDC) and Multi-Class Support Vector Machine (MSVM). These classifiers were used in two different studies with distinct objectives: discrimination of vegetation's density and identification of vegetation's main components. It was found that the best classifier on the first approach is the Sparse Logistic Multinomial Regression (SMLR). On the second approach, the implemented methodology applied to high resolution images showed that the better performance was achieved by KNN classifier and PCLDC. Comparing the two approaches there is a multiscale issue, in which for different resolutions, the best solution to the problem requires different classifiers and the extraction of different features.

Knowledge and perception on tuberculosis transmission in Tanzania: Multinomial logistic regression analysis of secondary data.

PubMed

Ismail, Abbas; Josephat, Peter

2014-01-01

Tuberculosis (TB) is one of the most important public health problems in Tanzania and was declared as a national public health emergency in 2006. Community and individual knowledge and perceptions are critical factors in the control of the disease. The objective of this study was to analyze the knowledge and perception on the transmission of TB in Tanzania. Multinomial Logistic Regression analysis was considered in order to quantify the impact of knowledge and perception on TB. The data used was adopted as secondary data from larger national survey 2007-08 Tanzania HIV/AIDS and Malaria Indicator Survey. The findings across groups revealed that knowledge on TB transmission increased with an increase in age and level of education. People in rural areas had less knowledge regarding tuberculosis transmission compared to urban areas [OR = 0.7]. People with the access to radio [OR = 1.7] were more knowledgeable on tuberculosis transmission compared to those who did not have access to radio. People who did not have telephone [OR = 0.6] were less knowledgeable on tuberculosis route of transmission compared to those who had telephone. The findings showed that socio-demographic factors such as age, education, place of residence and owning telephone or radio varied systematically with knowledge on tuberculosis transmission.

Measuring decision weights in recognition experiments with multiple response alternatives: comparing the correlation and multinomial-logistic-regression methods.

PubMed

Dai, Huanping; Micheyl, Christophe

2012-11-01

Psychophysical "reverse-correlation" methods allow researchers to gain insight into the perceptual representations and decision weighting strategies of individual subjects in perceptual tasks. Although these methods have gained momentum, until recently their development was limited to experiments involving only two response categories. Recently, two approaches for estimating decision weights in m-alternative experiments have been put forward. One approach extends the two-category correlation method to m > 2 alternatives; the second uses multinomial logistic regression (MLR). In this article, the relative merits of the two methods are discussed, and the issues of convergence and statistical efficiency of the methods are evaluated quantitatively using Monte Carlo simulations. The results indicate that, for a range of values of the number of trials, the estimated weighting patterns are closer to their asymptotic values for the correlation method than for the MLR method. Moreover, for the MLR method, weight estimates for different stimulus components can exhibit strong correlations, making the analysis and interpretation of measured weighting patterns less straightforward than for the correlation method. These and other advantages of the correlation method, which include computational simplicity and a close relationship to other well-established psychophysical reverse-correlation methods, make it an attractive tool to uncover decision strategies in m-alternative experiments.

Perception of Tourists Regarding the Smoke-Free Policy at Suvarnabhumi International Airport, Bangkok, Thailand

PubMed Central

Sirichotiratana, Nithat; Yogi, Subash; Prutipinyo, Chardsumon

2013-01-01

This study was conducted during February-March 2012 to determine the perception and support regarding smoke-free policy among tourists at Suvarnabhumi International Airport, Bangkok, Thailand. In this cross-sectional study, 200 tourists (n = 200) were enrolled by convenience sampling and interviewed by structured questionnaire. Descriptive statistics, chi-square, and multinomial logistic regression were adopted in the study. Results revealed that half (50%) of the tourists were current smokers and 55% had visited Thailand twice or more. Three quarter (76%) of tourists indicated that they would visit Thailand again even if it had a 100% smoke-free regulation. Almost all (99%) of the tourists had supported for the smoke-free policy (partial ban and total ban), and current smokers had higher percentage of support than non-smokers. Two factors, current smoking status and knowledge level, were significantly associated with perception level. After analysis with Multinomial Logistic Regression, it was found that perception, country group, and presence of designated smoking room (DSR) were associated with smoke-free policy. Recommendation is that, at institution level effective monitoring system is needed at the airport. At policy level, the recommendation is that effective comprehensive policy needed to be emphasized to ensure smoke-free airport environment. PMID:23999549

Who Works Among Older Black and White, Well-Functioning Adults in the Health, Aging, and Body Composition Study?

PubMed Central

Rooks, Ronica N.; Simonsick, Eleanor M.; Schulz, Richard; Rubin, Susan; Harris, Tamara

2017-01-01

Objective: The aim of this study is to examine social, economic, and health factors related to paid work in well-functioning older adults and if and how these factors vary by race. Method: We used sex-stratified logistic and multinomial logistic regression to examine cross-sectional data in the Health, Aging, and Body Composition cohort study. The sample included 3,075 community-dwelling Black (42%) and White adults aged 70 to 79 at baseline. Results: Multinomial logistic regression analyses show Black men were more likely to work full-time, and Black women were more likely to work part-time. Men with ≥US$50,000 family income were more likely to work full-time. Men with better physical functioning were more likely to work full- and part-time. Women with ≥US$50,000 family income and fewer chronic diseases were more likely to work full-time. Women who were overweight and had fewer chronic diseases were more likely to work part-time. Discussion: Results suggest that well-functioning, older Black adults were more likely to work than their White counterparts, and working relates to better health and higher income, providing support for a productive or successful aging perspective. PMID:28894767

[The importance of memory bias in obtaining age of menarche by recall method in Brazilian adolescents].

PubMed

Castilho, Silvia Diez; Nucci, Luciana Bertoldi; Assuino, Samanta Ramos; Hansen, Lucca Ortolan

2014-06-01

To compare the age at menarche obtained by recall method according to the time elapsed since the event, in order to verify the importance of the recall bias. Were evaluated 1,671 girls (7-18 years) at schools in Campinas-SP regarding the occurrence of menarche by the status quo method (menarche: yes or no) and the recall method (date of menarche, for those who mentioned it). The age at menarche obtained by the status quo method was calculated by logit, which considers the whole group, and the age obtained by the recall method was calculated as the average of the mentioned age at menarche. In this group, the age at menarche was obtained by the difference between the date of the event and the date of birth. Girls who reported menarche (883, 52.8%) were divided into four groups according to the time elapsed since the event. To analyze the results, we used ANOVA and logistic regression for the analysis, with a significance level of 0.05. The age at menarche calculated by logit was 12.14 y/o (95% CI 12.08 to 12.20). Mean ages obtained by recall were: for those who experienced menarche within the previous year 12.26 y/o (±1.14), between > 1-2 years before, 12.29 y (±1.22); between > 2-3 years before, 12.23 y/o (±1.27); and more than 3 years before, 11.55y/o (±1.24), p < 0.001. The age at menarche obtained by the recall method was similar for girls who menstruated within the previous 3 years (and approaches the age calculated by logit); when more than 3 years have passed, the recall bias was significant.

Oral Microbiota and Risk for Esophageal Squamous Cell Carcinoma in a High-Risk Area of China.

PubMed

Chen, Xingdong; Winckler, Björn; Lu, Ming; Cheng, Hongwei; Yuan, Ziyu; Yang, Yajun; Jin, Li; Ye, Weimin

2015-01-01

Poor oral health has been linked with an increased risk of esophageal squamous cell carcinoma (ESCC). We investigated whether alteration of oral microbiota is associated with ESCC risk. Fasting saliva samples were collected from 87 incident and histopathologicallly diagnosed ESCC cases, 63 subjects with dysplasia and 85 healthy controls. All subjects were also interviewed with a questionnaire. V3-V4 region of 16S rRNA was amplified and sequenced by 454-pyrosequencing platform. Carriage of each genus was compared by means of multivariate-adjusted odds ratios derived from logistic regression model. Relative abundance was compared using Metastats method. Beta diversity was estimated using Unifrac and weighted Unifrac distances. Principal coordinate analysis (PCoA) was applied to ordinate dissimilarity matrices. Multinomial logistic regression was used to compare the coordinates between different groups. ESCC subjects had an overall decreased microbial diversity compared to control and dysplasia subjects (P<0.001). Decreased carriage of genera Lautropia, Bulleidia, Catonella, Corynebacterium, Moryella, Peptococcus and Cardiobacterium were found in ESCC subjects compared to non-ESCC subjects. Multinomial logistic regression analyses on PCoA coordinates also revealed that ESCC subjects had significantly different levels for several coordinates compared to non-ESCC subjects. In conclusion, we observed a correlation between altered salivary bacterial microbiota and ESCC risk. The results of our study on the saliva microbiome are of particular interest as it reflects the shift in microbial communities. Further studies are warranted to verify this finding, and if being verified, to explore the underlying mechanisms.

The impact of pain on labor force participation, absenteeism and presenteeism in the European Union.

PubMed

Langley, Paul; Müller-Schwefe, Gerhard; Nicolaou, Andrew; Liedgens, Hiltrud; Pergolizzi, Joseph; Varrassi, Giustino

2010-01-01

The aims of this paper are to generate estimates of the association between the experience and burden of pain, by severity and frequency, with (1) labor force participation and workforce status in five EU countries (the UK, France, Spain, Germany and Italy) and (2) patterns of absenteeism and presenteeism for the employed workforce. Data are from the internet-based 2008 National Health and Wellness Survey (NHWS). This survey covers both those who report experiencing pain in the last month as well as the no pain population. A series of regression models are developed with the no pain group as the reference category. The impact of pain, categorized by severity and frequency reported, is assessed within a labor supply framework for (1) labor force participation and (2) absenteeism and presenteeism. In the former case both binomial and multinomial logistic models are estimated; in the latter case ordered logit models are estimated. The results demonstrate that, in the context of health status, the experience of frequent severe and moderate pain has a dominant, independent and negative association with labor force participation and employment status as well as absenteeism and presenteeism. The presence of severe daily pain is associated with a 20-point reduction in the probability of being employed full-time; with moderate daily pain associated with a 10-point reduction. The impact of pain is far greater than the potential impact of other health status measures (e.g., chronic comorbidities and BMI). The experience of pain, notably severe and frequent pain, also outstrips the impact of other health status factors in absenteeism and presenteeism. The experience of pain, in particular severe daily pain, has a substantial negative association with labor force participation in these five European countries as well as reported absenteeism and presenteeism. As a measure of health status, it clearly outweighs other health status measures. Whether or not pain is considered as a disease in its own right, the experience of chronic pain, as defined here, presents policy makers with a major challenge. Programs to relieve the burden of pain in the community clearly have the potential for substantial benefits from societal, individual and employer perspectives.

Genomic-Enabled Prediction of Ordinal Data with Bayesian Logistic Ordinal Regression.

PubMed

Montesinos-López, Osval A; Montesinos-López, Abelardo; Crossa, José; Burgueño, Juan; Eskridge, Kent

2015-08-18

Most genomic-enabled prediction models developed so far assume that the response variable is continuous and normally distributed. The exception is the probit model, developed for ordered categorical phenotypes. In statistical applications, because of the easy implementation of the Bayesian probit ordinal regression (BPOR) model, Bayesian logistic ordinal regression (BLOR) is implemented rarely in the context of genomic-enabled prediction [sample size (n) is much smaller than the number of parameters (p)]. For this reason, in this paper we propose a BLOR model using the Pólya-Gamma data augmentation approach that produces a Gibbs sampler with similar full conditional distributions of the BPOR model and with the advantage that the BPOR model is a particular case of the BLOR model. We evaluated the proposed model by using simulation and two real data sets. Results indicate that our BLOR model is a good alternative for analyzing ordinal data in the context of genomic-enabled prediction with the probit or logit link. Copyright © 2015 Montesinos-López et al.

Minimal intervention dentistry for early childhood caries and child dental anxiety: a randomized controlled trial.

PubMed

Arrow, P; Klobas, E

2017-06-01

To compare changes in child dental anxiety after treatment for early childhood caries (ECC) using two treatment approaches. Children with ECC were randomized to test (atraumatic restorative treatment (ART)-based approach) or control (standard care approach) groups. Children aged 3 years or older completed a dental anxiety scale at baseline and follow up. Changes in child dental anxiety from baseline to follow up were tested using the chi-squared statistic, Wilcoxon rank sum test, McNemar's test and multinomial logistic regression. Two hundred and fifty-four children were randomized (N = 127 test, N = 127 control). At baseline, 193 children completed the dental anxiety scale, 211 at follow up and 170 completed the scale on both occasions. Children who were anxious at baseline (11%) were no longer anxious at follow up, and 11% non-anxious children became anxious. Multinomial logistic regression found each increment in the number of visits increased the odds of worsening dental anxiety (odds ratio (OR), 2.2; P < 0.05), whereas each increment in the number of treatments lowered the odds of worsening anxiety (OR, 0.50; P = 0.05). The ART-based approach to managing ECC resulted in similar levels of dental anxiety to the standard treatment approach and provides a valuable alternative approach to the management of ECC in a primary dental care setting. © 2016 Australian Dental Association.

Predictive occurrence models for coastal wetland plant communities: Delineating hydrologic response surfaces with multinomial logistic regression

NASA Astrophysics Data System (ADS)

Snedden, Gregg A.; Steyer, Gregory D.

2013-02-01

Understanding plant community zonation along estuarine stress gradients is critical for effective conservation and restoration of coastal wetland ecosystems. We related the presence of plant community types to estuarine hydrology at 173 sites across coastal Louisiana. Percent relative cover by species was assessed at each site near the end of the growing season in 2008, and hourly water level and salinity were recorded at each site Oct 2007-Sep 2008. Nine plant community types were delineated with k-means clustering, and indicator species were identified for each of the community types with indicator species analysis. An inverse relation between salinity and species diversity was observed. Canonical correspondence analysis (CCA) effectively segregated the sites across ordination space by community type, and indicated that salinity and tidal amplitude were both important drivers of vegetation composition. Multinomial logistic regression (MLR) and Akaike's Information Criterion (AIC) were used to predict the probability of occurrence of the nine vegetation communities as a function of salinity and tidal amplitude, and probability surfaces obtained from the MLR model corroborated the CCA results. The weighted kappa statistic, calculated from the confusion matrix of predicted versus actual community types, was 0.7 and indicated good agreement between observed community types and model predictions. Our results suggest that models based on a few key hydrologic variables can be valuable tools for predicting vegetation community development when restoring and managing coastal wetlands.

Knowledge about tuberculosis transmission among ever-married women in Bangladesh.

PubMed

Khandoker, A; Khan, M M H; Krämer, A; Mori, M

2011-03-01

To identify the level of knowledge about TB transmission among ever-married women aged 15-49 years (n = 10 996) in Bangladesh, one of the highest tuberculosis (TB) burden countries. We analysed data from the Bangladesh Demographic and Health Survey conducted in 2007. Covariate factors included age, district, urban/rural residence, marital status, education, husband's education and access to the media (television, radio, newspaper/magazine). Bivariate and multinomial logistic regression analyses were performed to find the correlates of correct knowledge of TB transmission. Knowledge about TB transmission was correctly reported by approximately 7.0% of women, and was significantly associated with education, district and access to media using multinomial logistic regression. The likelihood of correct knowledge was 3.5 times (OR 3.5, 95%CI 2.5-4.9) higher among women with ≥11 years of education than among women with no/primary education. A significantly higher OR for correct knowledge of TB transmission (OR 1.5, 95%CI 1.2-1.9) was found among women who watched television almost every day compared to women who watched less than once a week. Correct knowledge about TB transmission was very low among married women in Bangladesh. Factors such as education and access to media, especially television, could play an important role in improving knowledge about TB transmission among women in Bangladesh.

Multinomial logistic regression analysis for differentiating 3 treatment outcome trajectory groups for headache-associated disability.

PubMed

Lewis, Kristin Nicole; Heckman, Bernadette Davantes; Himawan, Lina

2011-08-01

Growth mixture modeling (GMM) identified latent groups based on treatment outcome trajectories of headache disability measures in patients in headache subspecialty treatment clinics. Using a longitudinal design, 219 patients in headache subspecialty clinics in 4 large cities throughout Ohio provided data on their headache disability at pretreatment and 3 follow-up assessments. GMM identified 3 treatment outcome trajectory groups: (1) patients who initiated treatment with elevated disability levels and who reported statistically significant reductions in headache disability (high-disability improvers; 11%); (2) patients who initiated treatment with elevated disability but who reported no reductions in disability (high-disability nonimprovers; 34%); and (3) patients who initiated treatment with moderate disability and who reported statistically significant reductions in headache disability (moderate-disability improvers; 55%). Based on the final multinomial logistic regression model, a dichotomized treatment appointment attendance variable was a statistically significant predictor for differentiating high-disability improvers from high-disability nonimprovers. Three-fourths of patients who initiated treatment with elevated disability levels did not report reductions in disability after 5 months of treatment with new preventive pharmacotherapies. Preventive headache agents may be most efficacious for patients with moderate levels of disability and for patients with high disability levels who attend all treatment appointments. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Physical victimization, gender identity and suicide risk among transgender men and women.

PubMed

Barboza, Gia Elise; Dominguez, Silvia; Chance, Elena

2016-12-01

We investigated whether being attacked physically due to one's gender identity or expression was associated with suicide risk among trans men and women living in Virginia. The sample consisted of 350 transgender men and women who participated in the Virginia Transgender Health Initiative Survey (THIS). Multivariate multinomial logistic regression was used to explore the competing outcomes associated with suicidal risk. Thirty-seven percent of trans men and women experienced at least one physical attack since the age of 13. On average, individuals experienced 3.97 (SD = 2.86) physical attacks; among these about half were attributed to one's gender identity or expression (mean = 2.08, SD = 1.96). In the multivariate multinomial regression, compared to those with no risk, being physically attacked increased the odds of both attempting and contemplating suicide regardless of gender attribution. Nevertheless, the relative impact of physical victimization on suicidal behavior was higher among those who were targeted on the basis of their gender identity or expression. Finally, no significant association was found between multiple measures of institutional discrimination and suicide risk once discriminatory and non-discriminatory physical victimization was taken into account. Trans men and women experience high levels of physical abuse and face multiple forms of discrimination. They are also at an increased risk for suicidal tendencies. Interventions that help transindividuals cope with discrimination and physical victimization simultaneously may be more effective in saving lives.

The Association of Electronic Health Record Adoption with Staffing Mix in Community Health Centers.

PubMed

Frogner, Bianca K; Wu, Xiaoli; Park, Jeongyoung; Pittman, Patricia

2017-02-01

To assess how medical staffing mix changed over time in association with the adoption of electronic health records (EHRs) in community health centers (CHCs). Community health centers within the 50 states and Washington, DC. Estimated how the change in the share of total medical staff full-time equivalents (FTE) by provider category between 2007 and 2013 was associated with EHR adoption using fractional multinomial logit. 2007-2013 Uniform Data System, an administrative data set of Section 330 federal grant recipients; and Readiness for Meaningful Use and HIT and Patient Centered Medical Home Recognition Survey responses collected from Section 330 recipients between December 2010 and February 2011. Having an EHR system did significantly shift the share of workers over time between physicians and each of the other categories of health care workers. While an EHR system significantly shifted the share of physician and other medical staff, this effect did not significantly vary over time. CHCs with EHRs by the end of the study period had a relatively greater proportion of other medical staff compared to the proportion of physicians. Electronic health records appeared to influence staffing allocation in CHCs such that other medical staff may be used to support adoption of EHRs as well as be leveraged as an important care provider. © Health Research and Educational Trust.

The effect of alcohol consumption on household income in Ireland.

PubMed

Ormond, Gillian; Murphy, Rosemary

2016-11-01

This paper presents a study of the effects of alcohol consumption on household income in Ireland using the Slán National Health and Lifestyle Survey 2007 dataset, accounting for endogeneity and selection bias. Drinkers are categorised into one of four categories based on the recommended weekly drinking levels by the Irish Health Promotion Unit; those who never drank, non-drinkers, moderate and heavy drinkers. A multinomial logit OLS Two Step Estimate is used to explain individual's choice of drinking status and to correct for selection bias which would result in the selection into a particular category of drinking being endogenous. Endogeneity which may arise through the simultaneity of drinking status and income either due to the reverse causation between the two variables, income affecting alcohol consumption or alcohol consumption affecting income, or due to unobserved heterogeneity, is addressed. This paper finds that the household income of drinkers is higher than that of non-drinkers and of those who never drank. There is very little difference between the household income of moderate and heavy drinkers, with heavy drinkers earning slightly more. Weekly household income for those who never drank is €454.20, non-drinkers is €506.26, compared with €683.36 per week for moderate drinkers and €694.18 for heavy drinkers. Copyright © 2016 Elsevier Inc. All rights reserved.

[Food satisfaction in Mapuche persons in the Metropolitan Region of Santiago, Chile].

PubMed

Schnettler, Berta; Miranda, Horacio; Sepúlveda, José; Denegri, Marianela; Mora, Marcos; Lobos, Germán

2011-06-01

Although the study and measurement of satisfaction with life has generated great interest in the last 15 years, there are few works which address satisfaction with food-related life. In order to identify variables which have an influence on satisfaction with food-related life among Mapuche persons, a survey was applied to 400 Mapuche subjects in the Santiago Metropolitan Region, Chile. The scales evaluated in the questionnaire included: SWFL (Satisfaction with Food-related Life), lifestyles, food, and Mapuche acculturation. It was found that 41.0% were extremely satisfied, 40.5% satisfied, 17.2% somewhat satisfied and 1.2% dissatisfied with their food-related life. To identify variables which have an influence on satisfaction with food, an ordinal multinomial logit model was proposed, which was significant (p < 0.01) as a whole. The probability of high satisfaction with food-related life increases as there are fewer children in the household, the person's expenditure on food increases, the person consumes some Mapuche foods, is aged 55 or more, consumes red meat in moderation, consumes foods without additives, try to balance work and private life, does not read the labels of products, and if he/she had Mapuche friends at school. Thus satisfaction with food-related life in Mapuche persons in the Metropolitan Region is related to demographic variables, expenditure on food, consumption of Mapuche foods and life-style.

The Challenge of Conditional Reimbursement: Stopping Reimbursement Can Be More Difficult Than Not Starting in the First Place!

PubMed

van de Wetering, E J; van Exel, Job; Brouwer, Werner B F

2017-01-01

Conditional reimbursement of new health technologies is increasingly considered as a useful policy instrument. It allows gathering more robust evidence regarding effectiveness and cost-effectiveness of new technologies without delaying market access. Nevertheless, the literature suggests that ending reimbursement and provision of a technology when it proves not to be effective or cost-effective in practice may be difficult. To investigate how policymakers and the general public in the Netherlands value removing a previously reimbursed treatment from the basic benefits package relative to not including a new treatment. To investigate this issue, we used discrete-choice experiments. Mixed multinomial logit models were used to analyze the data. Compensating variation values and changes in probability of acceptance were calculated for withdrawal of reimbursement. The results show that, ceteris paribus, both the general public (n = 1169) and policymakers (n = 90) prefer a treatment that is presently reimbursed over one that is presently not yet reimbursed. Apparently, ending reimbursement is more difficult than not starting reimbursement in the first place, both for policymakers and for the public. Loss aversion is one of the possible explanations for this result. Policymakers in health care need to be aware of this effect before engaging in conditional reimbursement schemes. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Allocation of authority in European health policy.

PubMed

Adolph, Christopher; Greer, Scott L; Massard da Fonseca, Elize

2012-11-01

Although many study the effects of different allocations of health policy authority, few ask why countries assign responsibility over different policies as they do. We test two broad theories: fiscal federalism, which predicts rational governments will concentrate information-intensive operations at lower levels, and redistributive and regulatory functions at higher levels; and "politicized federalism", which suggests a combination of systematic and historically idiosyncratic political variables interfere with efficient allocation of authority. Drawing on the WHO Health in Transition country profiles, we present new data on the allocation of responsibility for key health care policy tasks (implementation, provision, finance, regulation, and framework legislation) and policy areas (primary, secondary and tertiary care, public health and pharmaceuticals) in the 27 EU member states and Switzerland. We use a Bayesian multinomial mixed logit model to analyze how different countries arrive at different allocations of authority over each task and area of health policy, and find the allocation of powers broadly follows fiscal federalism. Responsibility for pharmaceuticals, framework legislation, and most finance lodges at the highest levels of government, acute and primary care in the regions, and provision at the local and regional levels. Where allocation does not follow fiscal federalism, it appears to reflect ethnic divisions, the population of states and regions, the presence of mountainous terrain, and the timing of region creation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Constitution of traditional chinese medicine and related factors in women of childbearing age.

PubMed

Jiang, Qiao-Yu; Li, Jue; Zheng, Liang; Wang, Guang-Hua; Wang, Jing

2018-04-01

This study investigates the constitution of traditional Chinese medicine (TCM) among women who want to be pregnant in one year and explores factors related to TCM constitution. This study was conducted on women who participated in free preconception check-ups provided by the Zhabei District Maternity and Child Care Center in Shanghai, China. The information regarding the female demographic characteristics, physical condition, history of pregnancy and childbearing, diet and behavior, and social psychological factors was collected, and TCM constitution assessment was performed. The Chi-square test, t-test, logistic regression analysis, and multinomial logistic regression analysis were used to explore the related factors of TCM constitution. The participants in this study were aged 28.3 ± 3.0 years. Approximately fifty-five women in this study had Unbalanced Constitution. Logistic regression analysis showed that Shanghai residence, dysmenorrhea, gum bleeding, aversion to vegetables, preference for raw meat, job stress, and economic stress were significantly and negatively associated with Balanced Constitution. Multinomial logistic analysis showed that Shanghai residence was significantly associated with Yang-deficiency, Yin-deficiency, and Stagnant Qi Constitutions; gum bleeding was significantly associated with Yin-deficiency, Stagnant Blood, Stagnant Qi, and Inherited Special Constitutions; aversion to vegetables was significantly associated with Damp-heat Constitution; job stress was significantly associated with Yang-deficiency, Phlegm-dampness, Damp-heat, Stagnant Blood, and Stagnant Qi Constitutions; and economic stress was significantly associated with Yang-deficiency, and Stagnant Qi Constitutions. The application of TCM constitution to preconception care would be beneficial for early identification of potential TCM constitution risks and be beneficial for early intervention (e.g., health education, and dietary education), especially during the women who do not have a medical condition and those who have related factors found in this study. Copyright © 2018. Published by Elsevier Taiwan LLC.

Drinking Patterns and Victimization among Male and Female Students in Mexico

PubMed Central

Strunin, Lee; Díaz-Martínez, L. Rosa; Díaz-Martínez, Alejandro; Heeren, Timothy; Winter, Michael; Kuranz, Seth; Hernández–Ávila, Carlos A.; Fernández-Varela, Héctor; Solís-Torres, Cuauhtémoc

2015-01-01

Aims: The purpose of this study is to estimate the prevalence of alcohol use and alcohol-related consequences, identify drinking profiles using latent profile analysis (LPA), and investigate associations between profiles and violent victimization among young people in Mexico. Methods: LPA identified profiles of drinking behavior in a survey of entering first year university students. Multinomial and logistic regression examined associations between drinking patterns, socio-demographic variables and violent victimization. Results: The LPA identified five profiles of behaviors and consequences among the 22,224 current, former and never drinkers: Non/Infrequent-No Consequences, Occasional-Few Consequences, Regular-Some Consequences, Heavy-Many Consequences and Excessive-Many Consequences drinkers. The Occasional-Few Consequences profile comprised the largest, and the Excessive-Many Consequences profile the smallest, group of drinkers. Multinomial regression showed males and older students more likely to be Heavy or Excessive-Many Consequences drinkers. Living alone was associated with higher odds, and higher maternal education with lower odds, of being a Non/Infrequent-No Consequences drinker. Heavier drinking profiles were more likely to experience violent victimization adverse consequences. Logistic regression showed male and female Heavy and Excessive-Many Consequences drinkers had the highest odds, and Non/Infrequent drinkers the lowest odds, of experiencing any victimization. Conclusion: Findings suggest changes in male and female drinking behavior and a continuation of the established pattern of infrequent but high consumption among Mexican youths. Both male and female Heavy and Excessive-Many Consequences drinkers were at elevated risk for experiencing victimization. Identifying cultural gender norms about drinking including drinker expectations and drinking context that contribute to these patterns can inform prevention efforts. PMID:25534933

The Relationship Between Developmental Assets and Food Security In Adolescents From A Low-Income Community

PubMed Central

Shtasel-Gottlieb, Zoë; Palakshappa, Deepak; Yang, Fanyu; Goodman, Elizabeth

2014-01-01

Purpose To explore the association between developmental assets (characteristics, experiences, and relationships that shape healthy development) and food insecurity among adolescents from a low-income, urban community. Methods This mixed methods study occurred in two phases. In Phase 1, using a census approach, 2350 6-12th graders from the public school district completed an anonymous survey that included the Development Assets Profile (DAP), youth self-report form of the Core Food Security Module, and demographic questions. Logistic and multinomial regression analyses determined independent associations between developmental assets and food security adjusting for demographics. In Phase 2, 20 adult key informant interviews and four semi-structured student focus groups were performed to explain findings from Phase 1. Results On average, DAP scores were consistent with national norms. Food insecurity was prevalent; 14.9% reported low food security and 8.6% very low food security (VLFS). Logistic regression revealed that higher DAP was associated with lower odds of food insecurity (OR=.96, 95% CI=.95-.97); family assets drove this association(OR=.93, 95% CI=.91-.95). In multinomial regression modeling, these associations persisted and, paradoxically, higher community assets were also associated with VLFS (ORVLFS=1.08, 95% CI=1.04-1.13). Qualitative analyses suggested that greater need among VLFS youth led to increased connections to community resources despite barriers to access such as stigma, home instability, and cultural differences. Conclusion Food insecurity is a pervasive problem among adolescents from low-income communities and is associated with lower developmental assets, particularly family assets. That community assets were higher among VLFS youth underscores the importance of community-level resources in struggling areas. PMID:25620305

The relationship between developmental assets and food security in adolescents from a low-income community.

PubMed

Shtasel-Gottlieb, Zoë; Palakshappa, Deepak; Yang, Fanyu; Goodman, Elizabeth

2015-02-01

To explore the association between developmental assets (characteristics, experiences, and relationships that shape healthy development) and food insecurity among adolescents from a low-income urban community. This mixed-methods study occurred in two phases. In phase 1, using a census approach, 2,350 6th to 12th graders from the public school district completed an anonymous survey that included the developmental assets profile (DAP), the youth self-report form of the Core Food Security Module, and demographic questions. Logistic and multinomial regression analyses determined independent associations between developmental assets and food security adjusting for demographics. In phase 2, 20 adult key informant interviews and four semistructured student focus groups were performed to explain findings from phase 1. On average, DAP scores were consistent with national norms. Food insecurity was prevalent; 14.9% reported low food security and 8.6% very low food security (VLFS). Logistic regression revealed that higher DAP was associated with lower odds of food insecurity (odds ratio [OR], .96; 95% confidence interval [CI], .95-.97); family assets drove this association (OR, .93; 95% CI, .91-.95). In multinomial regression modeling, these associations persisted, and paradoxically, higher community assets were also associated with VLFS (ORVLFS, 1.08; 95% CI, 1.04-1.13). Qualitative analyses suggested that greater need among VLFS youth led to increased connections to community resources despite barriers to access such as stigma, home instability, and cultural differences. Food insecurity is a pervasive problem among adolescents from low-income communities and is associated with lower developmental assets, particularly family assets. The fact that community assets were higher among VLFS youth underscores the importance of community-level resources in struggling areas. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Factors Associated with Substance Use in Adolescents with Eating Disorders

PubMed Central

Mann, Andrea P; Accurso, Erin C.; Stiles-Shields, Colleen; Capra, Lauren; Labuschagne, Zandre; Karnik, Niranjan S.; Grange, Daniel Le

2014-01-01

Purpose To examine the prevalence and potential risk factors associated with substance use in adolescents with eating disorders (EDs). Methods This cross-sectional study included 290 adolescents, ages 12 –18 years, who presented for an initial ED evaluation at The Eating Disorders Program at The University of Chicago Medicine (UCM) between 2001 and 2012. Several factors, including DSM-5 diagnosis, diagnostic scores, and demographic characteristics were examined. Multinomial logistic regression was used to test associations between several factors and patterns of drug use for alcohol, cannabis, tobacco, and any substance. Results Lifetime prevalence of any substance use was found to be 24.6% in those with anorexia nervosa (AN), 48.7% in bulimia nervosa (BN), and 28.6% in eating disorder not otherwise specified (EDNOS). Regular substance use (monthly, daily, and bingeing behaviors) or a substance use disorder (SUD) was found in 27.9% of all patients. Older age was the only factor associated with regular use of any substance in the final multinomial model. Older age and non-White race was associated with greater alcohol and cannabis use. Although binge-purge frequency and BN diagnosis were associated with regular substance use in bivariate analyses, gender, race and age were more robustly associated with substance use in the final multinomial models. Conclusions Co-morbid substance use in adolescents with EDs is an important issue. Interventions targeting high-risk groups reporting regular substance use or SUDs are needed. PMID:24656448

Added sugars and periodontal disease in young adults: an analysis of NHANES III data.

PubMed

Lula, Estevam C O; Ribeiro, Cecilia C C; Hugo, Fernando N; Alves, Cláudia M C; Silva, Antônio A M

2014-10-01

Added sugar consumption seems to trigger a hyperinflammatory state and may result in visceral adiposity, dyslipidemia, and insulin resistance. These conditions are risk factors for periodontal disease. However, the role of sugar intake in the cause of periodontal disease has not been adequately studied. We evaluated the association between the frequency of added sugar consumption and periodontal disease in young adults by using NHANES III data. Data from 2437 young adults (aged 18-25 y) who participated in NHANES III (1988-1994) were analyzed. We estimated the frequency of added sugar consumption by using food-frequency questionnaire responses. We considered periodontal disease to be present in teeth with bleeding on probing and a probing depth ≥3 mm at one or more sites. We evaluated this outcome as a discrete variable in Poisson regression models and as a categorical variable in multinomial logistic regression models adjusted for sex, age, race-ethnicity, education, poverty-income ratio, tobacco exposure, previous diagnosis of diabetes, and body mass index. A high consumption of added sugars was associated with a greater prevalence of periodontal disease in middle [prevalence ratio (PR): 1.39; 95% CI: 1.02, 1.89] and upper (PR: 1.42; 95% CI: 1.08, 1.85) tertiles of consumption in the adjusted Poisson regression model. The upper tertile of added sugar intake was associated with periodontal disease in ≥2 teeth (PR: 1.73; 95% CI: 1.19, 2.52) but not with periodontal disease in only one tooth (PR: 0.85; 95% CI: 0.54, 1.34) in the adjusted multinomial logistic regression model. A high frequency of consumption of added sugars is associated with periodontal disease, independent of traditional risk factors, suggesting that this consumption pattern may contribute to the systemic inflammation observed in periodontal disease and associated noncommunicable diseases. © 2014 American Society for Nutrition.

Effects of road network on diversiform forest cover changes in the highest coverage region in China: An analysis of sampling strategies.

PubMed

Hu, Xisheng; Wu, Zhilong; Wu, Chengzhen; Ye, Limin; Lan, Chaofeng; Tang, Kun; Xu, Lu; Qiu, Rongzu

2016-09-15

Forest cover changes are of global concern due to their roles in global warming and biodiversity. However, many previous studies have ignored the fact that forest loss and forest gain are different processes that may respond to distinct factors by stressing forest loss more than gain or viewing forest cover change as a whole. It behooves us to carefully examine the patterns and drivers of the change by subdividing it into several categories. Our study includes areas of forest loss (4.8% of the study area), forest gain (1.3% of the study area) and forest loss and gain (2.0% of the study area) from 2000 to 2012 in Fujian Province, China. In the study area, approximately 65% and 90% of these changes occurred within 2000m of the nearest road and under road densities of 0.6km/km(2), respectively. We compared two sampling techniques (systematic sampling and random sampling) and four intensities for each technique to investigate the driving patterns underlying the changes using multinomial logistic regression. The results indicated the lack of pronounced differences in the regressions between the two sampling designs, although the sample size had a great impact on the regression outcome. The application of multi-model inference indicated that the low level road density had a negative significant association with forest loss and forest loss and gain, the expressway density had a positive significant impact on forest loss, and the road network was insignificantly related to forest gain. The model including socioeconomic and biophysical variables illuminated potentially different predictors of the different forest change categories. Moreover, the multiple comparisons tested by Fisher's least significant difference (LSD) were a good compensation for the multinomial logistic model to enrich the interpretation of the regression results. Copyright © 2016 Elsevier B.V. All rights reserved.

A nonparametric multiple imputation approach for missing categorical data.

PubMed

Zhou, Muhan; He, Yulei; Yu, Mandi; Hsu, Chiu-Hsieh

2017-06-06

Incomplete categorical variables with more than two categories are common in public health data. However, most of the existing missing-data methods do not use the information from nonresponse (missingness) probabilities. We propose a nearest-neighbour multiple imputation approach to impute a missing at random categorical outcome and to estimate the proportion of each category. The donor set for imputation is formed by measuring distances between each missing value with other non-missing values. The distance function is calculated based on a predictive score, which is derived from two working models: one fits a multinomial logistic regression for predicting the missing categorical outcome (the outcome model) and the other fits a logistic regression for predicting missingness probabilities (the missingness model). A weighting scheme is used to accommodate contributions from two working models when generating the predictive score. A missing value is imputed by randomly selecting one of the non-missing values with the smallest distances. We conduct a simulation to evaluate the performance of the proposed method and compare it with several alternative methods. A real-data application is also presented. The simulation study suggests that the proposed method performs well when missingness probabilities are not extreme under some misspecifications of the working models. However, the calibration estimator, which is also based on two working models, can be highly unstable when missingness probabilities for some observations are extremely high. In this scenario, the proposed method produces more stable and better estimates. In addition, proper weights need to be chosen to balance the contributions from the two working models and achieve optimal results for the proposed method. We conclude that the proposed multiple imputation method is a reasonable approach to dealing with missing categorical outcome data with more than two levels for assessing the distribution of the outcome. In terms of the choices for the working models, we suggest a multinomial logistic regression for predicting the missing outcome and a binary logistic regression for predicting the missingness probability.

Applications manual for logit modes of express bus-fringe parking choices.

DOT National Transportation Integrated Search

1976-01-01

Manual computations and computerized applications of logit models are described. The models demonstrated reflect travel behavior concerning express bus-fringe parking transit. The specific travel issues addressed include the basic automobile vs. expr...

Assessing Success on the Uniform CPA Exam: A Logit Approach.

ERIC Educational Resources Information Center

Brahmasrene, Tantatape; Whitten, Donna

2001-01-01

A logit model was used to test the likelihood of success of 231 candidates on the Uniform Certified Public Accountants Examination. Significant determinants of success included undergraduate grade point average, age, private accounting experience, and gender. (SK)

The importance of job training to job satisfaction of older workers.

PubMed

Leppel, Karen; Brucker, Eric; Cochran, Jeremy

2012-01-01

If job training has positive impacts on worker satisfaction, then job training can have desirable consequences for an organization that result both directly through its effects on productivity and indirectly through its effects on job satisfaction. Furthermore, the aging of the workforce implies that older workers will become increasingly important to firms and to the economy. This study, therefore, seeks to examine the relationship between job training and job satisfaction, focusing in particular on U.S. workers born in 1964 or earlier. The results of ordered logit regression analysis indicate that availability and quality of training received directly affect job satisfaction.

Low Vision Rehabilitation for Adult African Americans in Two Settings.

PubMed

Draper, Erin M; Feng, Rui; Appel, Sarah D; Graboyes, Marcy; Engle, Erin; Ciner, Elise B; Ellenberg, Jonas H; Stambolian, Dwight

2016-07-01

The Vision Rehabilitation for African Americans with Central Vision Impairment (VISRAC) study is a demonstration project evaluating how modifications in vision rehabilitation can improve the use of functional vision. Fifty-five African Americans 40 years of age and older with central vision impairment were randomly assigned to receive either clinic-based (CB) or home-based (HB) low vision rehabilitation services. Forty-eight subjects completed the study. The primary outcome was the change in functional vision in activities of daily living, as assessed with the Veteran's Administration Low-Vision Visual Function Questionnaire (VFQ-48). This included scores for overall visual ability and visual ability domains (reading, mobility, visual information processing, and visual motor skills). Each score was normalized into logit estimates by Rasch analysis. Linear regression models were used to compare the difference in the total score and each domain score between the two intervention groups. The significance level for each comparison was set at 0.05. Both CB and HB groups showed significant improvement in overall visual ability at the final visit compared with baseline. The CB group showed greater improvement than the HB group (mean of 1.28 vs. 0.87 logits change), though the group difference is not significant (p = 0.057). The CB group visual motor skills score showed significant improvement over the HB group score (mean of 3.30 vs. 1.34 logits change, p = 0.044). The differences in improvement of the reading and visual information processing scores were not significant (p = 0.054 and p = 0.509) between groups. Neither group had significant improvement in the mobility score, which was not part of the rehabilitation program. Vision rehabilitation is effective for this study population regardless of location. Possible reasons why the CB group performed better than the HB group include a number of psychosocial factors as well as the more standardized distraction-free work environment within the clinic setting.

Reading Ability and Reading Engagement in Older Adults With Glaucoma

PubMed Central

Nguyen, Angeline M.; van Landingham, Suzanne W.; Massof, Robert W.; Rubin, Gary S.; Ramulu, Pradeep Y.

2014-01-01

Purpose. We evaluated the impact of glaucoma-related vision loss on reading ability and reading engagement in 10 reading activities. Methods. A total of 63 glaucoma patients and 59 glaucoma suspect controls self-rated their level of reading difficulty for 10 reading items, and responses were analyzed using Rasch analysis to determine reading ability. Reading engagement was assessed by asking subjects to report the number of days per week they engaged in each reading activity. Reading restriction was determined as a decrement in engagement. Results. Glaucoma subjects more often described greater reading difficulty than controls for all tasks except puzzles (P < 0.05). The most difficult reading tasks involved puzzles, books, and finances, while the least difficult reading tasks involved notes, bills, and mail. In multivariable weighted least squares regression models of Rasch-estimated person measures of reading ability, less reading ability was found for glaucoma patients compared to controls (β = −1.60 logits, P < 0.001). Among glaucoma patients, less reading ability was associated with more severe visual field (VF) loss (β = −0.68 logits per 5-dB decrement in better-eye VF mean deviation [MD], P < 0.001) and contrast sensitivity (β = −0.76 logits per 0.1-unit lower log CS, P < 0.001). Each 5-dB decrement in the better-eye VF MD was associated with book reading on 18% fewer days (P = 0.003) and newspaper reading on 10% fewer days (P = 0.008). No statistically significant reading restriction was observed for other reading activities (P > 0.05). Conclusions. Glaucoma patients have less reading ability and engage less in a variety of different reading activities, particularly those requiring sustained reading. Future work should evaluate the mechanisms underlying reading disability in glaucoma to determine how patients can maintain reading ability and engagement. PMID:25052992

Enrollment Management in Medical School Admissions: A Novel Evidence-Based Approach at One Institution.

PubMed

Burkhardt, John C; DesJardins, Stephen L; Teener, Carol A; Gay, Steven E; Santen, Sally A

2016-11-01

In higher education, enrollment management has been developed to accurately predict the likelihood of enrollment of admitted students. This allows evidence to dictate numbers of interviews scheduled, offers of admission, and financial aid package distribution. The applicability of enrollment management techniques for use in medical education was tested through creation of a predictive enrollment model at the University of Michigan Medical School (U-M). U-M and American Medical College Application Service data (2006-2014) were combined to create a database including applicant demographics, academic application scores, institutional financial aid offer, and choice of school attended. Binomial logistic regression and multinomial logistic regression models were estimated in order to study factors related to enrollment at the local institution versus elsewhere and to groupings of competing peer institutions. A predictive analytic "dashboard" was created for practical use. Both models were significant at P < .001 and had similar predictive performance. In the binomial model female, underrepresented minority students, grade point average, Medical College Admission Test score, admissions committee desirability score, and most individual financial aid offers were significant (P < .05). The significant covariates were similar in the multinomial model (excluding female) and provided separate likelihoods of students enrolling at different institutional types. An enrollment-management-based approach would allow medical schools to better manage the number of students they admit and target recruitment efforts to improve their likelihood of success. It also performs a key institutional research function for understanding failed recruitment of highly desirable candidates.

Monitoring stress and recovery: new insights for the prevention of injuries and illnesses in elite youth soccer players.

PubMed

Brink, Michel S; Visscher, Chris; Arends, Suzanne; Zwerver, Johannes; Post, Wendy J; Lemmink, Koen Apm

2010-09-01

Elite youth soccer players have a relatively high risk for injuries and illnesses due to increased physical and psychosocial stress. The aim of this study is to investigate how measures to monitor stress and recovery, and its analysis, provide useful information for the prevention of injuries and illnesses in elite youth soccer players. 53 elite soccer players between 15 and 18 years of age participated in this study. To determine physical stress, soccer players registered training and match duration and session rating of perceived exertion for two competitive seasons by means of daily training logs. The Dutch version of the Recovery Stress Questionnaire for athletes (RESTQ-Sport) was administered monthly to assess the psychosocial stress-recovery state of players. The medical staff collected injury and illness data using the standardised Fédération Internationale de Football Association registration system. ORs and 95% CIs were calculated for injuries and illnesses using multinomial regression analyses. The independent measures were stress and recovery. During the study period, 320 injuries and 82 illnesses occurred. Multinomial regression demonstrated that physical stress was related to both injury and illness (range OR 1.01 to 2.59). Psychosocial stress and recovery were related the occurrence of illness (range OR 0.56 to 2.27). Injuries are related to physical stress. Physical stress and psychosocial stress and recovery are important in relation to illness. Individual monitoring of stress and recovery may provide useful information to prevent soccer players from injuries and illnesses.

The status of diabetes control in Kurdistan province, west of Iran.

PubMed

Esmailnasab, Nader; Afkhamzadeh, Abdorrahim; Roshani, Daem; Moradi, Ghobad

2013-09-17

Based on some estimation more than two million peoples in Iran are affected by Type 2 diabetes. The present study was designed to evaluate the status of diabetes control among Type 2 diabetes patients in Kurdistan, west of Iran and its associated factors. In our cross sectional study conducted in 2010, 411 Type 2 diabetes patients were randomly recruited from Sanandaj, Capital of Kurdistan. Chi square test was used in univariate analysis to address the association between HgAlc and FBS status and other variables. The significant results from Univariate analysis were entered in multivariate analysis and multinomial logistic regression model. In 38% of patients, FBS was in normal range (70-130) and in 47% HgA1c was <7% which is normal range for HgA1c. In univariate analysis, FBS level was associated with educational levels (P=0.001), referral style (P=0.001), referral time (P=0.009), and insulin injection (P=0.016). In addition, HgA1c had a relationship with sex (P=0.023), age (P=0.035), education (P=0.001), referral style (P=0.001), and insulin injection (P=0.008). After using multinomial logistic regression for significant results of univariate analysis, it was found that FBS was significantly associated with referral style. In addition HgA1c was significantly associated with referral style and Insulin injection. Although some of patients were under the coverage of specialized cares, but their diabetes were not properly controlled.

Predictive occurrence models for coastal wetland plant communities: delineating hydrologic response surfaces with multinomial logistic regression

USGS Publications Warehouse

Snedden, Gregg A.; Steyer, Gregory D.

2013-01-01

Understanding plant community zonation along estuarine stress gradients is critical for effective conservation and restoration of coastal wetland ecosystems. We related the presence of plant community types to estuarine hydrology at 173 sites across coastal Louisiana. Percent relative cover by species was assessed at each site near the end of the growing season in 2008, and hourly water level and salinity were recorded at each site Oct 2007–Sep 2008. Nine plant community types were delineated with k-means clustering, and indicator species were identified for each of the community types with indicator species analysis. An inverse relation between salinity and species diversity was observed. Canonical correspondence analysis (CCA) effectively segregated the sites across ordination space by community type, and indicated that salinity and tidal amplitude were both important drivers of vegetation composition. Multinomial logistic regression (MLR) and Akaike's Information Criterion (AIC) were used to predict the probability of occurrence of the nine vegetation communities as a function of salinity and tidal amplitude, and probability surfaces obtained from the MLR model corroborated the CCA results. The weighted kappa statistic, calculated from the confusion matrix of predicted versus actual community types, was 0.7 and indicated good agreement between observed community types and model predictions. Our results suggest that models based on a few key hydrologic variables can be valuable tools for predicting vegetation community development when restoring and managing coastal wetlands.

Shared clinical decision making

PubMed Central

AlHaqwi, Ali I.; AlDrees, Turki M.; AlRumayyan, Ahmad; AlFarhan, Ali I.; Alotaibi, Sultan S.; AlKhashan, Hesham I.; Badri, Motasim

2015-01-01

Objectives: To determine preferences of patients regarding their involvement in the clinical decision making process and the related factors in Saudi Arabia. Methods: This cross-sectional study was conducted in a major family practice center in King Abdulaziz Medical City, Riyadh, Saudi Arabia, between March and May 2012. Multivariate multinomial regression models were fitted to identify factors associated with patients preferences. Results: The study included 236 participants. The most preferred decision-making style was shared decision-making (57%), followed by paternalistic (28%), and informed consumerism (14%). The preference for shared clinical decision making was significantly higher among male patients and those with higher level of education, whereas paternalism was significantly higher among older patients and those with chronic health conditions, and consumerism was significantly higher in younger age groups. In multivariate multinomial regression analysis, compared with the shared group, the consumerism group were more likely to be female [adjusted odds ratio (AOR) =2.87, 95% confidence interval [CI] 1.31-6.27, p=0.008] and non-dyslipidemic (AOR=2.90, 95% CI: 1.03-8.09, p=0.04), and the paternalism group were more likely to be older (AOR=1.03, 95% CI: 1.01-1.05, p=0.04), and female (AOR=2.47, 95% CI: 1.32-4.06, p=0.008). Conclusion: Preferences of patients for involvement in the clinical decision-making varied considerably. In our setting, underlying factors that influence these preferences identified in this study should be considered and tailored individually to achieve optimal treatment outcomes. PMID:26620990

Association of personality, neighbourhood, and civic participation with the level of perceived social support: the HUNT study, a cross-sectional survey.

PubMed

Grav, Siv; Romild, Ulla; Hellzèn, Ove; Stordal, Eystein

2013-08-01

The aim of the current study was to examine the association of personality, neighbourhood, and civic participation with the level of perceived social support if needed. The sample consists of a total of 35,797 men (16,035) and women (19,762) drawn from the Nord-Trøndelag Health Study 3 (HUNT3), aged 20-89, with a fully completed short version of the Eysenck Personality Questionnaire (EPQ) including a complete response to questions regarding perceived social support. A multinomial logistic regression model was used to investigate the association between the three-category outcomes (high, medium, and low) of perceived social support. The Chi-square test detected a significant (p < 0.001) association between personality, sense of community, civic participation, self-rated health, living arrangement, age groups, gender, and perceived social support, except between perceived social support and loss of social network, in which no significance was found. The crude and adjusted multinomial logistic regression models show a relation between medium and low scores on perceived social support, personality, and sources of social support. Interactions were observed between gender and self-rated health. There is an association between the level of perceived social support and personality, sense of community in the neighbourhood, and civic participation. Even if the interaction between men and self-reported health decreases the odds for low and medium social support, health professionals should be aware of men with poor health and their lack of social support.

Determinants of modern contraceptive use among sexually active men in Kenya.

PubMed

Ochako, Rhoune; Temmerman, Marleen; Mbondo, Mwende; Askew, Ian

2017-04-27

Research in Kenya has focussed on family planning from women's perspectives, with the aim of helping reduce the burden of unintended pregnancies. As such, the determinants of modern contraceptive use among sexually active women are well documented. However, the perspectives of men should be considered not only as women's partners, but also as individuals with distinct reproductive histories and desires of their own. This study seeks to understand the determinants of modern contraceptive use among sexually active men, by exploring factors that are correlated with modern contraceptive use. The data source is the nationally representative 2014 Kenya Demographic and Health Survey (DHS) of men aged 15-54 years. The analysis is restricted to 9,514 men who reported being sexually active in the past 12 months prior to the survey, as they were likely to report either doing something or not to avoid or delay pregnancy. We use bivariate and multinomial logistic regression to assess factors that influence modern contraceptive use among sexually active men. Findings from the bivariate and multinomial logistic regression indicate that region of residence, marital status, religion, wealth, interaction with a health care provider, fertility preference, number of sexual partners and access to media were all significantly associated with modern contraceptive use among sexually active men. Provider-client interaction as well as dissemination of information through mass media has the potential to increase knowledge and uptake of modern contraceptives. Similar efforts targeting segments of the population where contraceptive uptake is low are recommended.

Association between employee benefits and frailty in community-dwelling older adults.

PubMed

Avila-Funes, José Alberto; Paniagua-Santos, Diana Leticia; Escobar-Rivera, Vicente; Navarrete-Reyes, Ana Patricia; Aguilar-Navarro, Sara; Amieva, Hélène

2016-05-01

The phenotype of frailty has been associated with an increased vulnerability for the development of adverse health-related outcomes. The origin of frailty is multifactorial and financial issues could be implicated, as they have been associated with health status, well-being and mortality. However, the association between economic benefits and frailty has been poorly explored. Therefore, the objective was to determine the association between employee benefits and frailty. A cross-sectional study of 927 community-dwelling older adults aged 70 years and older participating in the Mexican Study of Nutritional and Psychosocial Markers of Frailty was carried out. Employee benefits were established according to eight characteristics: bonus, profit sharing, pension, health insurance, food stamps, housing credit, life insurance, and Christmas bonus. Frailty was defined according to a slightly modified version of the phenotype proposed by Fried et al. Multinomial logistic regression models were run to determine the association between employee benefits and frailty adjusting by sociodemographic and health covariates. The prevalence of frailty was 14.1%, and 4.4% of participants rated their health status as "poor." Multinomial logistic regression analyses showed that employee benefits were statistically and independently associated with the frail subgroup (OR 0.85; 95% CI 0.74-0.98; P = 0.027) even after adjusting for potential confounders. Fewer employee benefits are associated with frailty. Supporting spreading employee benefits for older people could have a positive impact on the development of frailty and its consequences. Geriatr Gerontol Int 2016; 16: 606-611. © 2015 Japan Geriatrics Society.

Environmental, Spatial, and Sociodemographic Factors Associated with Nonfatal Injuries in Indonesia.

PubMed

Irianti, Sri; Prasetyoputra, Puguh

2017-01-01

Background . The determinants of injuries and their reoccurrence in Indonesia are not well understood, despite their importance in the prevention of injuries. Therefore, this study seeks to investigate the environmental, spatial, and sociodemographic factors associated with the reoccurrence of injuries among Indonesian people. Methods . Data from the 2013 round of the Indonesia Baseline Health Research (IBHR 2013) were analysed using a two-part hurdle regression model. A logit regression model was chosen for the zero-hurdle part , while a zero-truncated negative binomial regression model was selected for the counts part . Odds ratio (OR) and incidence rate ratio (IRR) were the measures of association, respectively. Results . The results suggest that living in a household with distant drinking water source, residing in slum areas, residing in Eastern Indonesia, having low educational attainment, being men, and being poorer are positively related to the likelihood of experiencing injury. Moreover, being a farmer or fishermen, having low educational attainment, and being men are positively associated with the frequency of injuries. Conclusion . This study would be useful to prioritise injury prevention programs in Indonesia based on the environmental, spatial, and sociodemographic characteristics.

Effect of driver's age and side of impact on crash severity along urban freeways: a mixed logit approach.

PubMed

Haleem, Kirolos; Gan, Albert

2013-09-01

This study identifies geometric, traffic, environmental, vehicle-related, and driver-related predictors of crash injury severity on urban freeways. The study takes advantage of the mixed logit model's ability to account for unobserved effects that are difficult to quantify and may affect the model estimation, such as the driver's reaction at the time of crash. Crashes of 5 years occurring on 89 urban freeway segments throughout the state of Florida in the United States were used. Examples of severity predictors explored include traffic volume, distance of the crash to the nearest ramp, and detailed driver's age, vehicle types, and sides of impact. To show how the parameter estimates could vary, a binary logit model was compared with the mixed logit model. It was found that the at-fault driver's age, traffic volume, distance of the crash to the nearest ramp, vehicle type, side of impact, and percentage of trucks significantly influence severity on urban freeways. Additionally, young at-fault drivers were associated with a significant severity risk increase relative to other age groups. It was also observed that some variables in the binary logit model yielded illogic estimates due to ignoring the random variation of the estimation. Since the at-fault driver's age and side of impact were significant random parameters in the mixed logit model, an in-depth investigation was performed. It was noticed that back, left, and right impacts had the highest risk among middle-aged drivers, followed by young drivers, very young drivers, and finally, old and very old drivers. To reduce side impacts due to lane changing, two primary strategies can be recommended. The first strategy is to conduct campaigns to convey the hazardous effect of changing lanes at higher speeds. The second is to devise in-vehicle side crash avoidance systems to alert drivers of a potential crash risk. The study provided a promising approach to screening the predictors before fitting the mixed logit model using the random forest technique. Furthermore, potential countermeasures were proposed to reduce the severity of impacts. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

On the potential of models for location and scale for genome-wide DNA methylation data

PubMed Central

2014-01-01

Background With the help of epigenome-wide association studies (EWAS), increasing knowledge on the role of epigenetic mechanisms such as DNA methylation in disease processes is obtained. In addition, EWAS aid the understanding of behavioral and environmental effects on DNA methylation. In terms of statistical analysis, specific challenges arise from the characteristics of methylation data. First, methylation β-values represent proportions with skewed and heteroscedastic distributions. Thus, traditional modeling strategies assuming a normally distributed response might not be appropriate. Second, recent evidence suggests that not only mean differences but also variability in site-specific DNA methylation associates with diseases, including cancer. The purpose of this study was to compare different modeling strategies for methylation data in terms of model performance and performance of downstream hypothesis tests. Specifically, we used the generalized additive models for location, scale and shape (GAMLSS) framework to compare beta regression with Gaussian regression on raw, binary logit and arcsine square root transformed methylation data, with and without modeling a covariate effect on the scale parameter. Results Using simulated and real data from a large population-based study and an independent sample of cancer patients and healthy controls, we show that beta regression does not outperform competing strategies in terms of model performance. In addition, Gaussian models for location and scale showed an improved performance as compared to models for location only. The best performance was observed for the Gaussian model on binary logit transformed β-values, referred to as M-values. Our results further suggest that models for location and scale are specifically sensitive towards violations of the distribution assumption and towards outliers in the methylation data. Therefore, a resampling procedure is proposed as a mode of inference and shown to diminish type I error rate in practically relevant settings. We apply the proposed method in an EWAS of BMI and age and reveal strong associations of age with methylation variability that are validated in an independent sample. Conclusions Models for location and scale are promising tools for EWAS that may help to understand the influence of environmental factors and disease-related phenotypes on methylation variability and its role during disease development. PMID:24994026

A general regression framework for a secondary outcome in case-control studies.

PubMed

Tchetgen Tchetgen, Eric J

2014-01-01

Modern case-control studies typically involve the collection of data on a large number of outcomes, often at considerable logistical and monetary expense. These data are of potentially great value to subsequent researchers, who, although not necessarily concerned with the disease that defined the case series in the original study, may want to use the available information for a regression analysis involving a secondary outcome. Because cases and controls are selected with unequal probability, regression analysis involving a secondary outcome generally must acknowledge the sampling design. In this paper, the author presents a new framework for the analysis of secondary outcomes in case-control studies. The approach is based on a careful re-parameterization of the conditional model for the secondary outcome given the case-control outcome and regression covariates, in terms of (a) the population regression of interest of the secondary outcome given covariates and (b) the population regression of the case-control outcome on covariates. The error distribution for the secondary outcome given covariates and case-control status is otherwise unrestricted. For a continuous outcome, the approach sometimes reduces to extending model (a) by including a residual of (b) as a covariate. However, the framework is general in the sense that models (a) and (b) can take any functional form, and the methodology allows for an identity, log or logit link function for model (a).

No rationale for 1 variable per 10 events criterion for binary logistic regression analysis.

PubMed

van Smeden, Maarten; de Groot, Joris A H; Moons, Karel G M; Collins, Gary S; Altman, Douglas G; Eijkemans, Marinus J C; Reitsma, Johannes B

2016-11-24

Ten events per variable (EPV) is a widely advocated minimal criterion for sample size considerations in logistic regression analysis. Of three previous simulation studies that examined this minimal EPV criterion only one supports the use of a minimum of 10 EPV. In this paper, we examine the reasons for substantial differences between these extensive simulation studies. The current study uses Monte Carlo simulations to evaluate small sample bias, coverage of confidence intervals and mean square error of logit coefficients. Logistic regression models fitted by maximum likelihood and a modified estimation procedure, known as Firth's correction, are compared. The results show that besides EPV, the problems associated with low EPV depend on other factors such as the total sample size. It is also demonstrated that simulation results can be dominated by even a few simulated data sets for which the prediction of the outcome by the covariates is perfect ('separation'). We reveal that different approaches for identifying and handling separation leads to substantially different simulation results. We further show that Firth's correction can be used to improve the accuracy of regression coefficients and alleviate the problems associated with separation. The current evidence supporting EPV rules for binary logistic regression is weak. Given our findings, there is an urgent need for new research to provide guidance for supporting sample size considerations for binary logistic regression analysis.

Logit and probit model in toll sensitivity analysis of Solo-Ngawi, Kartasura-Palang Joglo segment based on Willingness to Pay (WTP)

NASA Astrophysics Data System (ADS)

Handayani, Dewi; Cahyaning Putri, Hera; Mahmudah, AMH

2017-12-01

Solo-Ngawi toll road project is part of the mega project of the Trans Java toll road development initiated by the government and is still under construction until now. PT Solo Ngawi Jaya (SNJ) as the Solo-Ngawi toll management company needs to determine the toll fare that is in accordance with the business plan. The determination of appropriate toll rates will affect progress in regional economic sustainability and decrease the traffic congestion. These policy instruments is crucial for achieving environmentally sustainable transport. Therefore, the objective of this research is to find out how the toll fare sensitivity of Solo-Ngawi toll road based on Willingness To Pay (WTP). Primary data was obtained by distributing stated preference questionnaires to four wheeled vehicle users in Kartasura-Palang Joglo artery road segment. Further data obtained will be analysed with logit and probit model. Based on the analysis, it is found that the effect of fare change on the amount of WTP on the binomial logit model is more sensitive than the probit model on the same travel conditions. The range of tariff change against values of WTP on the binomial logit model is 20% greater than the range of values in the probit model . On the other hand, the probability results of the binomial logit model and the binary probit have no significant difference (less than 1%).

Identifying the determinants of childhood immunization in the Philippines.

PubMed

Bondy, Jennifer N; Thind, Amardeep; Koval, John J; Speechley, Kathy N

2009-01-01

A key method of reducing morbidity and mortality is childhood immunization, yet in 2003 only 69% of Filipino children received all suggested vaccinations. Data from the 2003 Philippines Demographic Health Survey were used to identify risk factors for non- and partial-immunization. Results of the multinomial logistic regression analyses indicate that mothers who have less education, and who have not attended the minimally-recommended four antenatal visits are less likely to have fully immunized children. To increase immunization coverage in the Philippines, knowledge transfer to mothers must improve.

Nested Logit Models for Multiple-Choice Item Response Data

ERIC Educational Resources Information Center

Suh, Youngsuk; Bolt, Daniel M.

2010-01-01

Nested logit item response models for multiple-choice data are presented. Relative to previous models, the new models are suggested to provide a better approximation to multiple-choice items where the application of a solution strategy precedes consideration of response options. In practice, the models also accommodate collapsibility across all…

Logit Estimation of a Gravity Model of the College Enrollment Decision.

ERIC Educational Resources Information Center

Leppel, Karen

1993-01-01

A study investigated the factors influencing students' decisions about attending a college to which they had been admitted. Logit analysis confirmed gravity model predictions that geographic distance and student ability would most influence the enrollment decision and found other variables, although affecting earlier stages of decision making, did…

Species richness alone does not predict cultural ecosystem service value

PubMed Central

Graves, Rose A.; Pearson, Scott M.; Turner, Monica G.

2017-01-01

Many biodiversity-ecosystem services studies omit cultural ecosystem services (CES) or use species richness as a proxy and assume that more species confer greater CES value. We studied wildflower viewing, a key biodiversity-based CES in amenity-based landscapes, in Southern Appalachian Mountain forests and asked (i) How do aesthetic preferences for wildflower communities vary with components of biodiversity, including species richness?; (ii) How do aesthetic preferences for wildflower communities vary across psychographic groups?; and (iii) How well does species richness perform as an indicator of CES value compared with revealed social preferences for wildflower communities? Public forest visitors (n = 293) were surveyed during the summer of 2015 and asked to choose among images of wildflower communities in which flower species richness, flower abundance, species evenness, color diversity, and presence of charismatic species had been digitally manipulated. Aesthetic preferences among images were unrelated to species richness but increased with more abundant flowers, greater species evenness, and greater color diversity. Aesthetic preferences were consistent across psychographic groups and unaffected by knowledge of local flora or value placed on wildflower viewing. When actual wildflower communities (n = 54) were ranked based on empirically measured flower species richness or wildflower viewing utility based on multinomial logit models of revealed preferences, rankings were broadly similar. However, designation of hotspots (CES values above the median) based on species richness alone missed 27% of wildflower viewing utility hotspots. Thus, conservation priorities for sustaining CES should incorporate social preferences and consider multiple dimensions of biodiversity that underpin CES supply. PMID:28320953

A Bayesian network based framework for real-time crash prediction on the basic freeway segments of urban expressways.

PubMed

Hossain, Moinul; Muromachi, Yasunori

2012-03-01

The concept of measuring the crash risk for a very short time window in near future is gaining more practicality due to the recent advancements in the fields of information systems and traffic sensor technology. Although some real-time crash prediction models have already been proposed, they are still primitive in nature and require substantial improvements to be implemented in real-life. This manuscript investigates the major shortcomings of the existing models and offers solutions to overcome them with an improved framework and modeling method. It employs random multinomial logit model to identify the most important predictors as well as the most suitable detector locations to acquire data to build such a model. Afterwards, it applies Bayesian belief net (BBN) to build the real-time crash prediction model. The model has been constructed using high resolution detector data collected from Shibuya 3 and Shinjuku 4 expressways under the jurisdiction of Tokyo Metropolitan Expressway Company Limited, Japan. It has been specifically built for the basic freeway segments and it predicts the chance of formation of a hazardous traffic condition within the next 4-9 min for a particular 250 meter long road section. The performance evaluation results reflect that at an average threshold value the model is able to successful classify 66% of the future crashes with a false alarm rate less than 20%. Copyright © 2011 Elsevier Ltd. All rights reserved.

Factors driving deforestation in common-pool resources in northern Mexico.

PubMed

Perez-Verdin, Gustavo; Kim, Yeon-Su; Hospodarsky, Denver; Tecle, Aregai

2009-01-01

The theory of collective action has been extensively used to explain the relationship between common-based property regimes and the conservation of natural resources. However, there are two key components of the theory that literature reports as puzzles in which no consensus exists about their effect on the performance of common-pool resources. These are group size and heterogeneity. This study analyzes the effects of these two key components on the effectiveness of community-based forestry, called ejidos, to protect their forest resources in northern Mexico. We used a multinomial logit model to determine the contribution of 16 explanatory variables to the dependent variable, a measure of success of ejidos defined by the presence of deforested, degraded, or forested conditions. The results show that corn yield, marginality, percent of forest area, total population, a forest value index, distance to markets, roads and towns, were all statistically significant in driving deforested conditions. Deforestation becomes more attractive for poor communities and as corn yield and distance to towns, roads, and markets decrease. In general, group size and heterogeneity had no significant effects on the presence of deforested conditions. Deforestation is driven by resource-specific characteristics, such as location and soil productivity, not by ejidos' attributes, such as total area or number of members. We argue that current institutional policies focusing on the structure of property right arrangements should be shifted (1) to provide better technology for land cultivation; (2) to reduce the marginality problem in poor communities; and (3) to strengthen local institutions.

Species richness alone does not predict cultural ecosystem service value.

PubMed

Graves, Rose A; Pearson, Scott M; Turner, Monica G

2017-04-04

Many biodiversity-ecosystem services studies omit cultural ecosystem services (CES) or use species richness as a proxy and assume that more species confer greater CES value. We studied wildflower viewing, a key biodiversity-based CES in amenity-based landscapes, in Southern Appalachian Mountain forests and asked ( i ) How do aesthetic preferences for wildflower communities vary with components of biodiversity, including species richness?; ( ii ) How do aesthetic preferences for wildflower communities vary across psychographic groups?; and ( iii ) How well does species richness perform as an indicator of CES value compared with revealed social preferences for wildflower communities? Public forest visitors ( n = 293) were surveyed during the summer of 2015 and asked to choose among images of wildflower communities in which flower species richness, flower abundance, species evenness, color diversity, and presence of charismatic species had been digitally manipulated. Aesthetic preferences among images were unrelated to species richness but increased with more abundant flowers, greater species evenness, and greater color diversity. Aesthetic preferences were consistent across psychographic groups and unaffected by knowledge of local flora or value placed on wildflower viewing. When actual wildflower communities ( n = 54) were ranked based on empirically measured flower species richness or wildflower viewing utility based on multinomial logit models of revealed preferences, rankings were broadly similar. However, designation of hotspots (CES values above the median) based on species richness alone missed 27% of wildflower viewing utility hotspots. Thus, conservation priorities for sustaining CES should incorporate social preferences and consider multiple dimensions of biodiversity that underpin CES supply.

Valuing QALYs in Relation to Equity Considerations Using a Discrete Choice Experiment.

PubMed

van de Wetering, Liesbet; van Exel, Job; Bobinac, Ana; Brouwer, Werner B F

2015-12-01

To judge whether an intervention offers value for money, the incremental costs per gained quality-adjusted life-year (QALY) need to be compared with some relevant threshold, which ideally reflects the monetary value of health gains. Literature suggests that this value may depend on the equity context in which health gains are produced, but the value of a QALY in relation to equity considerations has remained largely unexplored. The objective of this study was to estimate the social marginal willingness to pay (MWTP) for QALY gains in different equity subgroups, using a discrete choice experiment (DCE). Both severity of illness (operationalized as proportional shortfall) and fair innings (operationalized as age) were considered as grounds for differentiating the value of health gains. We obtained a sample of 1205 respondents, representative of the adult population of the Netherlands. The data was analysed using panel mixed multinomial logit (MMNL) and latent class models. The panel MMNL models showed counterintuitive results, with more severe health states reducing the probability of receiving treatment. The latent class models revealed distinct preference patterns in the data. MWTP per QALY was sensitive to severity of disease among a substantial proportion of the public, but not to the age of care recipients. These findings emphasize the importance of accounting for preference heterogeneity among the public on value-laden issues such as prioritizing health care, both in research and decision making. This study emphasises the need to further explore the monetary value of a QALY in relation to equity considerations.

Quantifying the impact of adaptive traffic control systems on crash frequency and severity: Evidence from Oakland County, Michigan.

PubMed

Fink, Joshua; Kwigizile, Valerian; Oh, Jun-Seok

2016-06-01

Despite seeing widespread usage worldwide, adaptive traffic control systems have experienced relatively little use in the United States. Of the systems used, the Sydney Coordinated Adaptive Traffic System (SCATS) is the most popular in America. Safety benefits of these systems are not as well understood nor as commonly documented. This study investigates the safety benefits of adaptive traffic control systems by using the large SCATS-based system in Oakland County, MI known as FAST-TRAC. This study uses data from FAST-TRAC-controlled intersections in Oakland County and compares a wide variety of geometric, traffic, and crash characteristics to similar intersections in metropolitan areas elsewhere in Michigan. Data from 498 signalized intersections are used to conduct a cross-sectional analysis. Negative binomial models are used to estimate models for three dependent crash variables. Multinomial logit models are used to estimate an injury severity model. A variable tracking the presence of FAST-TRAC controllers at intersections is used in all models to determine if a SCATS-based system has an impact on crash occurrences or crash severity. Estimates show that the presence of SCATS-based controllers at intersections is likely to reduce angle crashes by up to 19.3%. Severity results show a statistically significant increase in non-serious injuries, but not a significant reduction in incapacitating injuries or fatal accidents. Copyright © 2016 Elsevier Ltd and National Safety Council. All rights reserved.

Providing animal health services to the poor in Northern Ghana: rethinking the role of community animal health workers?

PubMed

Mockshell, Jonathan; Ilukor, John; Birner, Regina

2014-02-01

The Community Animal Health Workers (CAHWs) system has been promoted as an alternative solution to providing animal health services in marginal areas. Yet, access to quality animal health services still remains a fundamental problem for livestock dependent communities. This paper uses the concepts of accessibility, affordability, and transaction costs to examine the perceptions of livestock keepers about the various animal health service providers. The empirical analysis is based on a survey of 120 livestock-keeping households in the Tolon-Kumbungu and Savelugu-Nanton districts in the Northern Region of Ghana. A multinomial logit model was used to determine the factors that influence households' choice of alternative animal health service providers. The results show that the government para-vets are the most preferred type of animal health service providers while CAHWs are the least preferred. Reasons for this observation include high transaction costs and low performance resulting from limited training. In areas with few or no government para-vets, farmers have resorted to self-treatment or to selling sick animals for consumption, which has undesirable health implications. These practices also result in significant financial losses for farmers. This paper finds that the CAHWs' system is insufficient for providing quality animal health services to the rural poor in marginal areas. Therefore, market-smart alternative solutions requiring strong public sector engagement to support livestock farmers in marginal areas and setting minimum training standards for animal health service providers merit policy consideration.

Modeling Types of Pedal Applications Using a Driving Simulator.

PubMed

Wu, Yuqing; Boyle, Linda Ng; McGehee, Daniel; Roe, Cheryl A; Ebe, Kazutoshi; Foley, James

2015-11-01

The aim of this study was to examine variations in drivers' foot behavior and identify factors associated with pedal misapplications. Few studies have focused on the foot behavior while in the vehicle and the mishaps that a driver can encounter during a potentially hazardous situation. A driving simulation study was used to understand how drivers move their right foot toward the pedals. The study included data from 43 drivers as they responded to a series of rapid traffic signal phase changes. Pedal application types were classified as (a) direct hit, (b) hesitated, (c) corrected trajectory, and (d) pedal errors (incorrect trajectories, misses, slips, or pressed both pedals). A mixed-effects multinomial logit model was used to predict the likelihood of one of these pedal applications, and linear mixed models with repeated measures were used to examine the response time and pedal duration given the various experimental conditions (stimuli color and location). Younger drivers had higher probabilities of direct hits when compared to other age groups. Participants tended to have more pedal errors when responding to a red signal or when the signal appeared to be closer. Traffic signal phases and locations were associated with pedal response time and duration. The response time and pedal duration affected the likelihood of being in one of the four pedal application types. Findings from this study suggest that age-related and situational factors may play a role in pedal errors, and the stimuli locations could affect the type of pedal application. © 2015, Human Factors and Ergonomics Society.

Lifetime income patterns and alcohol consumption: Investigating the association between long- and short-term income trajectories and drinking

PubMed Central

Cerdá, Magdalena; Johnson-Lawrence, Vicki; Galea, Sandro

2011-01-01

Lifetime patterns of income may be an important driver of alcohol use. In this study, we evaluated the relationship between long-term and short-term measures of income and the relative odds of abstaining, drinking lightly-moderately and drinking heavily. We used data from the US Panel Study on Income Dynamics (PSID), a national population-based cohort that has been followed annually or biannually since 1968. We examined 3111 adult respondents aged 30-44 in 1997. Latent class growth mixture models with a censored normal distribution were used to estimate income trajectories followed by the respondent families from 1968-1997, while repeated measures multinomial generalized logit models estimated the odds of abstinence (no drinks per day) or heavy drinking (at least 3 drinks a day), relative to light/moderate drinking (<1-2 drinks a day), in 1999-2003. Lower income was associated with higher odds of abstinence and of heavy drinking, relative to light/moderate drinking. For example, belonging to a household with stable low income ($11-20,000) over 30 years was associated with 1.57 odds of abstinence, and 2.14 odds of heavy drinking in adulthood. The association between lifetime income patterns and alcohol use decreased in magnitude and became non-significant once we controlled for past-year income, education and occupation. Lifetime income patterns may have an indirect association with alcohol use, mediated through current socioeconomic conditions. PMID:21890256

Smallholder dairy sheep production and market channel development: an institutional perspective of rural Former Yugoslav Republic of Macedonia.

PubMed

Voors, M J; D'Haese, M

2010-08-01

The rural economy of the Former Yugoslav Republic of Macedonia has been adapting to new economic and political realities. Especially important for rural areas has been the breakdown of the socialist market structure in agriculture, which meant the demise of cooperative structures and farmers gaining access to new market outlets. The aim of this paper is to investigate the potential of dairy sheep farmers to enter into new contracts with buyers and to analyze why some farmers continue selling to traditional market outlets. Using survey data of dairy sheep farmers we studied the choice they make between 3 market outlets: (1) selling milk to a recently established large dairy processor, (2) selling milk to traditional small local processors, or (3) transforming milk on-farm into cheese and selling it at the farm gate or at local markets. The significance of determinants of choice for these markets were tested in a multinomial logit model, which showed that distance to the collection point of the large dairy processor was the most important determinant of whether farmers sold milk or made cheese, with those at a greater distance selling cheese. Furthermore, we analyzed the main sources of transaction costs in developing new market channels. Overcoming transport and transaction costs may contribute to higher income for the farmers and hence to improving their livelihoods. Copyright (c) 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Development of scales relating to professional development of community college administrators.

PubMed

Wolfe, Edward W; Van Der Linden, Kim E

2010-01-01

This article reports the results of an application of the Multidimensional Random Coefficients Multinomial Logit Model (MRCMLM) to the measurement of professional development activities in which community college administrators participate. The analyses focus on confirmation of the factorial structure of the instrument, evaluation of the quality of the activities calibrations, examination of the internal structure of the instrument, and comparison of groups of administrators. The dimensionality analysis results suggest a five-dimensional model that is consistent with previous literature concerning career paths of community college administrators - education and specialized training, internal professional development and mentoring, external professional development, employer support, and seniority. The indicators of the quality of the activity calibrations suggest that measures of the five dimensions are adequately reliable, that the activities in each dimension are internally consistent, and that the observed responses to each activity are consistent with the expected values of the MRCMLM. The hierarchy of administrator measure means and of activity calibrations is consistent with substantive theory relating to professional development for community college administrators. For example, readily available activities that occur at the institution were most likely to be engaged in by administrators, while participation in selective specialized training institutes were the least likely activities. Finally, group differences with respect to age and title were consistent with substantive expectations - the greater the administrator's age and the higher the rank of the administrator's title, the greater the probability of having engaged in various types of professional development.

Serum Nutritional Biomarkers and Their Associations with Sleep among US Adults in Recent National Surveys

PubMed Central

Beydoun, May A.; Gamaldo, Alyssa A.; Canas, Jose A.; Beydoun, Hind A.; Shah, Mauli T.; McNeely, Jessica M.; Zonderman, Alan B.

2014-01-01

Background The associations between nutritional biomarkers and measures of sleep quantity and quality remain unclear. Methods Cross-sectional data from the National Health and Nutrition Examination Surveys (NHANES) 2005–2006 were used. We selected 2,459 adults aged 20–85, with complete data on key variables. Five sleep measures were constructed as primary outcomes: (A) Sleep duration; (B) Sleep disorder; (C) Three factors obtained from factor analysis of 15 items and labeled as “Poor sleep-related daytime dysfunction” (Factor 1), “Sleepiness” (Factor 2) and “Sleep disturbance” (Factor 3). Main exposures were serum concentrations of key nutrients, namely retinol, retinyl esters, carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lutein+zeaxanthin, lycopene), folate, vitamin B-12, total homocysteine (tHcy), vitamin C, 25-hydroxyvitamin D (25(OH)D) and vitamin E. Main analyses consisted of multiple linear, logistic and multinomial logit models. Results Among key findings, independent inverse associations were found between serum vitamin B-12 and sleep duration, 25(OH)D and sleepiness (as well as insomnia), and between folate and sleep disturbance. Serum total carotenoids concentration was linked to higher odds of short sleep duration (i.e. 5–6 h per night) compared to normal sleep duration (7–8 h per night). Conclusions A few of the selected serum nutritional biomarkers were associated with sleep quantity and quality. Longitudinal studies are needed to ascertain temporality and assess putative causal relationships. PMID:25137304

Agency and Market Area Factors Affecting Home Health Agency Supply Changes

PubMed Central

Porell, Frank W; Liu, Korbin; Brungo, David P

2006-01-01

Objective To use the natural experiment created by the Medicare interim payment system (IPS) to study supply change behavior of home health agencies (HHAs) in local market areas. Data Sources One hundred percent Medicare home health claims for 1996 and 1999, linked with Medicare Provider of Service and Denominator files, and the Area Resource File. Study Design Medicare home health care (HHC) claims data were used to distinguish HHAs that changed the local market supply of Medicare HHC by their market exit or by significant expansion or contraction of their geographic service area between 1996 and 1999 from other HHAs. Multinomial logit models were estimated to analyze how characteristics of agencies and the market areas in which they served were associated with these different agency-level supply changes. Principal Findings Changes in local HHA supply stemming from geographic service area expansions and contractions rivaled those owing to agency closures and market entries. Agencies at greater risk of closure and service area contraction tended to be smaller, newer, freestanding agencies, operating with more visit-intensive practice styles in markets with more competitor agencies. Except for having much less visit-intensive practice styles, similar attributes characterized agencies that increased local supply through service area expansion. Conclusions Supply changes by HHAs largely reflected rational market responses by agencies to significant changes in financial incentives associated with the Medicare IPS. Recently certified agencies were among the most dynamic providers. Supply changes were more likely among agencies operating in more competitive market environments. PMID:16987305

Agency and market area factors affecting home health agency supply changes.

PubMed

Porell, Frank W; Liu, Korbin; Brungo, David P

2006-10-01

To use the natural experiment created by the Medicare interim payment system (IPS) to study supply change behavior of home health agencies (HHAs) in local market areas. One hundred percent Medicare home health claims for 1996 and 1999, linked with Medicare Provider of Service and Denominator files, and the Area Resource File. Medicare home health care (HHC) claims data were used to distinguish HHAs that changed the local market supply of Medicare HHC by their market exit or by significant expansion or contraction of their geographic service area between 1996 and 1999 from other HHAs. Multinomial logit models were estimated to analyze how characteristics of agencies and the market areas in which they served were associated with these different agency-level supply changes. Changes in local HHA supply stemming from geographic service area expansions and contractions rivaled those owing to agency closures and market entries. Agencies at greater risk of closure and service area contraction tended to be smaller, newer, freestanding agencies, operating with more visit-intensive practice styles in markets with more competitor agencies. Except for having much less visit-intensive practice styles, similar attributes characterized agencies that increased local supply through service area expansion. Supply changes by HHAs largely reflected rational market responses by agencies to significant changes in financial incentives associated with the Medicare IPS. Recently certified agencies were among the most dynamic providers. Supply changes were more likely among agencies operating in more competitive market environments.

Maternal violence, victimization, and child physical punishment in Peru.

PubMed

Gage, Anastasia J; Silvestre, Eva A

2010-07-01

This study examined whether mothers' experience of violence was a risk factor for physical punishment. Data were derived from the nationally representative 2000 Peru Demographic and Family Health Survey. Participants were 12,601 currently married women who were living with biological children aged 0-17 years and were responsible for disciplining the children. A multinomial logit model was used to determine the probabilities of using no physical punishment, slapping/spanking only, beating only, and both slapping/spanking and beating to discipline children. The study found that childhood history of physical punishment, a greater variety of intimate partner emotional violence and experience of intimate partner physical violence increased significantly a mother's probability of using physical punishment with her children, even after controlling for confounding factors. A mother's history of physical violence victimization by someone other than the current partner was also a significant factor for beating children as opposed to using non-physical forms of punishment. Mothers were at substantially increased risk of using physical punishment if they were victims of parental physical violence in childhood, intimate partner violence in the current union, and physical violence by someone other than the current partner. Increased public education is needed of the negative consequences of intimate partner emotional and physical violence victimization for mothers' childrearing strategies. There is a need to integrate intimate partner violence into child welfare programs and develop effective screening mechanisms for maternal violence victimization and child maltreatment. Copyright © 2010 Elsevier Ltd. All rights reserved.

An Empirical Bayes Estimate of Multinomial Probabilities.

DTIC Science & Technology

1982-02-01

multinomial probabilities has been considered from a decision theoretic point of view by Steinhaus (1957), Trybula (1958) and Rutkowska (1977). In a recent...variate Rypergeometric and Multinomial Distributions," Zastosowania Matematyki, 16, 9-21. Steinhaus , H. (1957), "The Problem of Estimation." Annals of

Modeling abundance using multinomial N-mixture models

USGS Publications Warehouse

Royle, Andy

2016-01-01

Multinomial N-mixture models are a generalization of the binomial N-mixture models described in Chapter 6 to allow for more complex and informative sampling protocols beyond simple counts. Many commonly used protocols such as multiple observer sampling, removal sampling, and capture-recapture produce a multivariate count frequency that has a multinomial distribution and for which multinomial N-mixture models can be developed. Such protocols typically result in more precise estimates than binomial mixture models because they provide direct information about parameters of the observation process. We demonstrate the analysis of these models in BUGS using several distinct formulations that afford great flexibility in the types of models that can be developed, and we demonstrate likelihood analysis using the unmarked package. Spatially stratified capture-recapture models are one class of models that fall into the multinomial N-mixture framework, and we discuss analysis of stratified versions of classical models such as model Mb, Mh and other classes of models that are only possible to describe within the multinomial N-mixture framework.

Plasma myelin basic protein assay using Gilford enzyme immunoassay cuvettes.

PubMed

Groome, N P

1981-10-01

The assay of myelin basic protein in body fluids has potential clinical importance as a routine indicator of demyelination. Preliminary details of a competitive enzyme immunoassay for this protein have previously been published by the author (Groome, N. P. (1980) J. Neurochem. 35, 1409-1417). The present paper now describes the adaptation of this assay for use on human plasma and various aspects of routine data processing. A commercially available cuvette system was found to have advantages over microtitre plates but required a permuted arrangement of sample replicates for consistent results. For dose interpolation, the standard curve could be fitted to a three parameter non-linear equation by regression analysis or linearised by the logit/log transformation.

College binge drinking: deviant versus mainstream behavior.

PubMed

Leppel, Karen

2006-01-01

College binge drinking is examined from the perspectives of two cultures. The traditional culture views binging as deviant; the second culture promotes it. In this context, logit regression is used to explore the effects of various factors, including student employment and parental education. Employed students are less likely to binge than are students who are not employed. Also, students whose mother is a college graduate, but whose father is not, are more likely to binge than other students. The prescriptions for reducing binge drinking are different when the behavior is perceived as mainstream rather than deviant. The research calls for the development of a process for promoting cultural change in an environment of continually changing student leadership.

Investigating risk factors of traffic casualties at private highway-railroad grade crossings in the United States.

PubMed

Haleem, Kirolos

2016-10-01

Private highway-railroad grade crossings (HRGCs) are intersections of highways and railroads on roadways that are not maintained by a public authority. Since no public authority maintains private HRGCs, fatal and injury crashes at these locations are of concern. However, no study has been conducted at private HRGCs to identify the safety issues that might exist and how to alleviate them. This study identifies the significant predictors of traffic casualties (including both injuries and fatalities) at private HRGCs in the U.S. using six years of nationwide crashes from 2009 to 2014. Two levels of injury severity were considered, injury (including fatalities and injuries) and no injury. The study investigates multiple predictors, e.g., temporal crash characteristics, geometry, railroad, traffic, vehicle, and environment. The study applies both the mixed logit and binary logit models. The mixed logit model was found to outperform the binary logit model. The mixed logit model revealed that drivers who did not stop, railroad equipment that struck highway users, higher train speeds, non-presence of advance warning signs, concrete road surface type, and cloudy weather were associated with an increase in injuries and fatalities. For example, a one-mile-per-hour higher train speed increases the probability of fatality by 22%. On the contrary, male drivers, PM peak periods, and presence of warning devices at both approaches were associated with a fatality reduction. Potential strategies are recommended to alleviate injuries and fatalities at private HRGCs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Clusters of anthropometric indicators of body fat associated with maximum oxygen uptake in adolescents

PubMed Central

2018-01-01

Introduction The aim of this study was to evaluate different clusters of anthropometric indicators (body mass index | BMI |, waist circumference | WC |, waist-to-height ratio | WHtR |, triceps skinfold |TR SF|, subscapular skinfold |SE SF|, sum of the triceps and subscapular skinfolds | ΣTR + SE |, and sum of the triceps, subscapular and suprailiac folds | ΣTR + SE + SI|) associated with the VO2max levels in adolescents. Methods The study included 1,132 adolescents (aged 14–19 years) enrolled in public schools of São José, Santa Catarina, Brazil, in the 2014 academic year. The dependent variable was the cluster of anthropometric indicators (BMI, WC, WHtR, TR SF, SE SF, SI SF, ΣTR + SE and ΣTR + SE + SI) of excess body fat. The independent variable was maximum oxygen uptake (VO2max), estimated by the modified Canadian aerobic fitness test—mCAFT. Control variables were: age, skin color, economic level, maternal education, physical activity and sexual maturation. Multinomial logistic regression was used for associations between the dependent and independent variables. Binary logistic regression was performed to identify the association between adolescents with all anthropometric indicators in excess and independent variables. Results One in ten adolescents presented all anthropometric indicators of excess body fat. Multinomial regression showed that with each increase of one VO2max unit, the odds of adolescents having three, four, five or more anthropometric indicators of excess body fat decreased by 0.92, 0.85 and 0.73 times, respectively. In the binary regression, this fact was reconfirmed, demonstrating that with each increase of one VO2max unit, the odds of adolescents having simultaneously the eight anthropometric indicators of excess body fat decreased by 0.55. Conclusion It was concluded that with each increase of one VO2max unit, adolescents decreased the odds of simultaneously presenting three or more anthropometric indicators of excess body fat, regardless of biological, economic and lifestyle factors. In addition, the present study identified that one in ten adolescents had all anthropometric indicators of excess body fat. PMID:29534098

Clusters of anthropometric indicators of body fat associated with maximum oxygen uptake in adolescents.

PubMed

Gonçalves, Eliane Cristina de Andrade; Nunes, Heloyse Elaine Gimenes; Silva, Diego Augusto Santos

2018-01-01

The aim of this study was to evaluate different clusters of anthropometric indicators (body mass index | BMI |, waist circumference | WC |, waist-to-height ratio | WHtR |, triceps skinfold |TR SF|, subscapular skinfold |SE SF|, sum of the triceps and subscapular skinfolds | ΣTR + SE |, and sum of the triceps, subscapular and suprailiac folds | ΣTR + SE + SI|) associated with the VO2max levels in adolescents. The study included 1,132 adolescents (aged 14-19 years) enrolled in public schools of São José, Santa Catarina, Brazil, in the 2014 academic year. The dependent variable was the cluster of anthropometric indicators (BMI, WC, WHtR, TR SF, SE SF, SI SF, ΣTR + SE and ΣTR + SE + SI) of excess body fat. The independent variable was maximum oxygen uptake (VO2max), estimated by the modified Canadian aerobic fitness test-mCAFT. Control variables were: age, skin color, economic level, maternal education, physical activity and sexual maturation. Multinomial logistic regression was used for associations between the dependent and independent variables. Binary logistic regression was performed to identify the association between adolescents with all anthropometric indicators in excess and independent variables. One in ten adolescents presented all anthropometric indicators of excess body fat. Multinomial regression showed that with each increase of one VO2max unit, the odds of adolescents having three, four, five or more anthropometric indicators of excess body fat decreased by 0.92, 0.85 and 0.73 times, respectively. In the binary regression, this fact was reconfirmed, demonstrating that with each increase of one VO2max unit, the odds of adolescents having simultaneously the eight anthropometric indicators of excess body fat decreased by 0.55. It was concluded that with each increase of one VO2max unit, adolescents decreased the odds of simultaneously presenting three or more anthropometric indicators of excess body fat, regardless of biological, economic and lifestyle factors. In addition, the present study identified that one in ten adolescents had all anthropometric indicators of excess body fat.

The Potential for Elimination of Racial-Ethnic Disparities in HIV Treatment Initiation in the Medicaid Population among 14 Southern States

PubMed Central

Zhang, Shun; McGoy, Shanell L.; Dawes, Daniel; Fransua, Mesfin; Rust, George; Satcher, David

2014-01-01

Objectives The purpose of this study was to explore the racial and ethnic disparities in initiation of antiretroviral treatment (ARV treatment or ART) among HIV-infected Medicaid enrollees 18–64 years of age in 14 southern states which have high prevalence of HIV/AIDS and high racial disparities in HIV treatment access and mortality. Methods We used Medicaid claims data from 2005 to 2007 for a retrospective cohort study. We compared frequency variances of HIV treatment uptake among persons of different racial- ethnic groups using univariate and multivariate methods. The unadjusted odds ratio was estimated through multinomial logistic regression. The multinomial logistic regression model was repeated with adjustment for multiple covariates. Results Of the 23,801 Medicaid enrollees who met criteria for initiation of ARV treatment, only one third (34.6%) received ART consistent with national guideline treatment protocols, and 21.5% received some ARV medication, but with sub-optimal treatment profiles. There was no significant difference in the proportion of people who received ARV treatment between black (35.8%) and non-Hispanic whites (35.7%), but Hispanic/Latino persons (26%) were significantly less likely to receive ARV treatment. Conclusions Overall ARV treatment levels for all segments of the population are less than optimal. Among the Medicaid population there are no racial HIV treatment disparities between Black and White persons living with HIV, which suggests the potential relevance of Medicaid to currently uninsured populations, and the potential to achieve similar levels of equality within Medicaid for Hispanic/Latino enrollees and other segments of the Medicaid population. PMID:24769625

Low Sex Hormone-Binding Globulin Levels Associate with Prediabetes in Chinese Men Independent of Total Testosterone

PubMed Central

Han, Bing; Li, Qin; Chen, Yi; Zhu, Chunfang; Chen, Yingchao; Xia, Fangzhen; Cang, Zhen; Lu, Meng; Chen, Chi; Lin, Dongping; Lu, Yingli

2016-01-01

Objective The association ns between prediabetes and androgens have been rarely reported, especially in Chinese men. We aimed to investigate whether androgens were associated with the prevalence of prediabetes diagnosed with new American Diabetes Association criteria in Chinese men and then to assess which androgen value was the most relevant factor. Methods A total of 2654 men (52.6±13.4 years old) were selected. Serum total testosterone (TT), sex hormone-binding globulin (SHBG) and free testosterone (FT) were measured. Covariance analysis of different androgen values were performed in age subgroups. Multinomial logistic regression was used for the association of TT, SHBG and FT with prediabetes and diabetes, as well as prediabetes in age subgroups. Results According to ADA new criteria, normoglycemia, prediabetes, and diabetes were diagnosed in 1405, 907 and 342 men, respectively. In covariance analysis, SHBG of prediabetes were found lower than that of normoglycemia but higher than that of diabetes (P <0.05). In multinomial logistic regression, serum TT and SHBG were inversely associated with prediabetes and diabetes. While, after full adjustment for age, residence area, economic status, waist circumference, metabolic factors, other two androgen values and HOMA-IR, only the associations of SHBG with prevalence of prediabetes and diabetes persisted statistically significant, especially in the elderly with prediabetes (all P for trend <0.05). Conclusions Serum androgen was inversely associated with prediabetes and diabetes in Chinese men. Low serum SHBG was the most relevant factor for prediabetes and diabetes. Whether it is an independent predictor for incident prediabetes in Chinese men needs further explorations. PMID:27583401

Reproductive risk factors assessment for anaemia among pregnant women in India using a multinomial logistic regression model.

PubMed

Perumal, Vanamail

2014-07-01

To assess reproductive risk factors for anaemia among pregnant women in urban and rural areas of India. The International Institute of Population Sciences, India, carried out third National Family Health Survey in 2005-2006 to estimate a key indicator from a sample of ever-married women in the reproductive age group 15-49 years. Data on various dimensions were collected using a structured questionnaire, and anaemia was measured using a portable HemoCue instrument. Anaemia prevalence among pregnant women was compared between rural and urban areas using chi-square test and odds ratio. Multinomial logistic regression analysis was used to determine risk factors. Anaemia prevalence was assessed among 3355 pregnant women from rural areas and 1962 pregnant women from urban areas. Moderate-to-severe anaemia in rural areas (32.4%) is significantly more common than in urban areas (27.3%) with an excess risk of 30%. Gestational age specific prevalence of anaemia significantly increases in rural areas after 6 months. Pregnancy duration is a significant risk factor in both urban and rural areas. In rural areas, increasing age at marriage and mass media exposure are significant protective factors of anaemia. However, more births in the last five years, alcohol consumption and smoking habits are significant risk factors. In rural areas, various reproductive factors and lifestyle characteristics constitute significant risk factors for moderate-to-severe anaemia. Therefore, intensive health education on reproductive practices and the impact of lifestyle characteristics are warranted to reduce anaemia prevalence. © 2014 John Wiley & Sons Ltd.

Urinary 8-iso-prostaglandin F2α as a marker of metabolic risks in the general Japanese population: The ROAD study.

PubMed

Mure, Kanae; Yoshimura, Noriko; Hashimoto, Marowa; Muraki, Shigeyuki; Oka, Hiroyuki; Tanaka, Sakae; Kawaguchi, Hiroshi; Nakamura, Kozo; Akune, Toru; Takeshita, Tatsuya

2015-07-01

To determine whether 8-iso-prostaglandin F2α (8-iso-PGF2α) is a reliable biomarker of the accumulation of metabolic risks [e.g., overweight, hypertension, impaired glucose tolerance (IGT), and dyslipidemia]. This was a cross-sectional study of the baseline characteristics of a Japanese general population cohort study: Research on Osteoarthritis/Osteoporosis Against Disability (ROAD). Of 1,690 participants, 1,527 fulfilled all questionnaires and examinations. Free and conjugated urinary 8-iso-PGF2α levels and metabolic syndrome (MetS) components including blood pressure, HbA1c, total cholesterol, high-density lipoprotein cholesterol (HDL-C), and non-HDL-C were analyzed. The data were analyzed by ANCOVA, multiple regression analysis, and multinomial logistic analysis. 8-iso-PGF2α was significantly associated with HbA1c and significantly inversely associated with total cholesterol and non-HDL-C. Notably, IGT with an HbA1c cut-off of 5.5% was significantly associated with 8-iso-PGF2α level in participants aged ≤50 years. Multinomial logistic regression analysis revealed 8-iso-PGF2α level was significantly associated with a greater number of MetS risks present; this association was stronger in younger participants. In participants aged ≥71 years, 8-iso-PGF2α was significantly associated with a greater number of MetS risks with higher IGT cut-offs. Urinary 8-iso-PGF2α can be a reliable marker of IGT and the accumulation of MetS risks, especially in younger people. © 2015 The Obesity Society.

Vitamin D status by sociodemographic factors and body mass index in Mexican women at reproductive age.

PubMed

Contreras-Manzano, Alejandra; Villalpando, Salvador; Robledo-Pérez, Ricardo

2017-01-01

To describe the prevalence of Vitamin D deficiency (VDD) and insufficiency (VDI), and the main dietary sources of vitamin D (VD) in a probabilistic sample of Mexican women at reproductive age participating in Ensanut 2012, stratified by sociodemographic factors and body mass index (BMI) categories. Serum concentrations of 25-hydroxyvitamin-D(25-OH-D) were determined using an ELISA technique in 4162 women participants of Ensanut 2012 and classified as VDD, VDI or optimal VD status. Sociodemographic, anthropometric and dietary data were also collected. The association between VDD/VDI and sociodemographic and anthropometry factors was assessed adjusting for potential confounders through an estimation of a multinomial logistic regression model. The prevalence of VDD was 36.8%, and that of VDI was 49.8%. The mean dietary intake of VD was 2.56 μg/d. The relative risk ratio (RRR) of VDD or VDI was calculated by a multinomial logistic regression model in 4162 women. The RRR of VDD or VDI were significantly higher in women with overweight (RRR: 1.85 and 1.44, p<0.05), obesity (RRR: 2.94 and 1.93, p<0.001), urban dwelling (RRR:1.68 and 1.31, p<0.06), belonging to the 3rd tertile of income (RRR: 5.32 and 2.22, p<0.001), or of indigenous ethnicity (RRR: 2.86 and 1.70, p<0.05), respectively. The high prevalence of VDD/VDI in Mexican women calls for stronger actions from the health authorities, strengthtening the actual policy of food supplementation and recommending a reasonable amount of sun exposure.

Concern about falling in older women with a history of falls: associations with health, functional ability, physical activity and quality of life.

PubMed

Patil, Radhika; Uusi-Rasi, Kirsti; Kannus, Pekka; Karinkanta, Saija; Sievänen, Harri

2014-01-01

Fear of falling has been linked to activity restriction, functional decline, decreased quality of life and increased risk of falling. Factors that distinguish persons with a high concern about falling from those with low concern have not been systematically studied. This study aimed to expose potential health-related, functional and psychosocial factors that correlate with fear of falling among independently living older women who had fallen in the past year. Baseline data of 409 women aged 70-80 years recruited to a randomised falls prevention trial (DEX) (NCT00986466) were used. Participants were classified according to their level of concern about falling using the Falls Efficacy Scale International (FES-I). Multinomial logistic regression analyses were performed to explore associations between health-related variables, functional performance tests, amount of physical activity, quality of life and FES-I scores. 68% of the participants reported a moderate to high concern (FES-I ≥ 20) about falls. Multinomial logistic regression showed that highly concerned women were significantly more likely to have poorer health and quality of life and lower functional ability. Reported difficulties in instrumental activities of daily living, balance, outdoor mobility and poorer quality of life contributed independently to a greater concern about falling. Concern about falling was highly prevalent in our sample of community-living older women. In particular, poor perceived general health and mobility constraints contributed independently to the difference between high and low concern of falling. Knowledge of these associations may help in developing interventions to reduce fear of falling and activity avoidance in old age.

Prevalence and Determinants of Secondhand Smoke Exposure Among Women in Bangladesh, 2011

PubMed Central

Minnwegen, Martina; Kaneider, Ulrike; Kraemer, Alexander; Khan, Md. Mobarak Hossain

2015-01-01

Background and Objectives: The population of Bangladesh is highly susceptible to secondhand smoke (SHS) exposure due to high smoking rates and low awareness about the harmful effects of SHS. This study aims to determine the prevalence of SHS exposure and highlight the essential determinants in developing successful strategies to prevent adverse health effects in Bangladesh. Methods: The analysis is based on the Bangladesh Demographic Health Survey 2011, in which 17,749 women in the reproductive age group (12–49 years) were included. The information regarding SHS exposure at home was derived from the question: “How often does anyone smoke inside your house?” The variable was recoded into 3 groups: daily exposure, low exposure (exposed weekly, monthly, or less than monthly), and no SHS exposure. We performed descriptive and bivariable analyses and multinomial logistic regression. Results: A total of 46.7% of the women reported high exposure to SHS at home. According to the multinomial logistic regression model, relatively lower education and lower wealth index were significantly associated with daily SHS exposure at home. The exposure differed significantly between the divisions of Bangladesh. Having children at home (vs. not) and being Islamic (compared to other religious affiliations) were protective factors. Conclusions: The study indicates that women from socioeconomically disadvantaged households are more likely to experience daily exposure to SHS at home. Therefore, especially these groups have to be targeted to reduce tobacco consumption. In addition to aspects of legislation, future strategies need to focus educational aspects to improve the population’s health status in Bangladesh. PMID:25125322

The dynamics of injection drug users' personal networks and HIV risk behaviors.

PubMed

Costenbader, Elizabeth C; Astone, Nan M; Latkin, Carl A

2006-07-01

While studies of the social networks of injection drug users (IDUs) have provided insight into how the structures of interpersonal relationships among IDUs affect HIV risk behaviors, the majority of these studies have been cross-sectional. The present study examined the dynamics of IDUs' social networks and HIV risk behaviors over time. Using data from a longitudinal HIV-intervention study conducted in Baltimore, MD, this study assessed changes in the composition of the personal networks of 409 IDUs. We used a multi-nomial logistic regression analysis to assess the association between changes in network composition and simultaneous changes in levels of injection HIV risk behaviors. Using the regression parameters generated by the multi-nomial model, we estimated the predicted probability of being in each of four HIV risk behavior change groups. Compared to the base case, individuals who reported an entirely new set of drug-using network contacts at follow-up were more than three times as likely to be in the increasing risk group. In contrast, reporting all new non-drug-using contacts at follow-up increased the likelihood of being in the stable low-risk group by almost 50% and decreased the probability of being in the consistently high-risk group by more than 70%. The findings from this study show that, over and above IDUs' baseline characteristics, changes in their personal networks are associated with changes in individuals' risky injection behaviors. They also suggest that interventions aimed at reducing HIV risk among IDUs might benefit from increasing IDUs' social contacts with individuals who are not drug users.

Cross-Jurisdictional Resource Sharing in Changing Public Health Landscape: Contributory Factors and Theoretical Explanations.

PubMed

Shah, Gulzar H; Badana, Adrian N S; Robb, Claire; Livingood, William C

2016-01-01

Local health departments (LHDs) are striving to meet public health needs within their jurisdictions, amidst fiscal restraints and complex dynamic environment. Resource sharing across jurisdictions is a critical opportunity for LHDs to continue to enhance effectiveness and increase efficiency. This research examines the extent of cross-jurisdictional resource sharing among LHDs, the programmatic areas and organizational functions for which LHDs share resources, and LHD characteristics associated with resource sharing. Data from the National Association of County & City Health Officials' 2013 National Profile of LHDs were used. Descriptive statistics and multinomial logistic regression were performed for the 5 implementation-oriented outcome variables of interest, with 3 levels of implementation. More than 54% of LHDs shared resources such as funding, staff, or equipment with 1 or more other LHDs on a continuous, recurring basis. Results from the multinomial regression analysis indicate that economies of scale (population size and metropolitan status) had significant positive influences (at P ≤ .05) on resource sharing. Engagement in accreditation, community health assessment, community health improvement planning, quality improvement, and use of the Community Guide were associated with lower levels of engagement in resource sharing. Doctoral degree of the top executive and having 1 or more local boards of health carried a positive influence on resource sharing. Cross-jurisdictional resource sharing is a viable and commonly used process to overcome the challenges of new and emerging public health problems within the constraints of restricted budgets. LHDs, particularly smaller LHDs with limited resources, should consider increased resource sharing to address emerging challenges.

Contraceptive awareness among men in Bangladesh.

PubMed

Islam, Mohammad Amirul; Padmadas, Sabu S; Smith, Peter W F

2006-04-01

A considerable gap exists between contraceptive awareness and use. Traditional approaches to measuring awareness are inadequate to properly understand the linkages between awareness and use. The objective of this study was to examine the degree of men's modern contraceptive awareness in Bangladesh and the associated determinants and further testing of a hypothesis that current contraceptive use confers a high degree of method awareness. This study used the couple data set from the Bangladesh Demographic and Health Survey (1999-2000). A two-level, multinomial logistic regression was used with the degree of contraceptive awareness as the dependent variable. The degree of awareness was measured by the reported number of modern contraceptive methods known among men aged 15-59 years. Men's responses on method awareness were classified according to those reported spontaneously and probed. Nearly 100% of the study participants reported having heard of at least one method and about half reported awareness of at least eight different methods of contraception. Multinomial logistic regression analyses showed that older and educated men were more likely to have reported a high degree of awareness. The findings confirmed our hypothesis that current contraceptive use is likely to confer a high degree of modern method awareness among men (p<0.001), after controlling for other important characteristics. Men who had a low degree of contraceptive awareness seem not properly informed of the wide range of contraceptive options. It is imperative that family planning intervention strategies in Bangladesh should focus on the degree and functional knowledge of contraceptive methods to improve the uptake of especially male-based modern methods.

Inequality in the hepatitis B awareness level in rural residents from 7 provinces in China.

PubMed

Zheng, Juan; Li, Quan; Wang, Jian; Zhang, Guojie; Wangen, Knut R

2017-05-04

The hepatitis B (HB) awareness level is an important factor affecting the rates of HB virus vaccination. To better understand income-related inequalities in the HB awareness level, it is imperative to identify the sources of inequalities and assess the contribution rates of these influential factors. This study analyzed the unequal distribution of the HB awareness level and the contributions of various influential factors. We performed a cross-sectional household survey with questionnaire-based, face-to-face interviews in 7 Chinese provinces. Responses from 7271 respondents were used in this analysis. Multinomial logistic regression was used for the analysis of contributing factors, and the concentration index was used as a measure of HB awareness inequalities. The HB awareness level varied across participants with different characteristics. Multinomial logistic regression of the explanatory factors of the HB awareness level showed that several estimated coefficients and relative risk ratios were statistically significant for middle- and high-level awareness, except for sex, occupation, and household income. The concentration index of the HB knowledge score was 0.140, indicating inequality gradients disadvantageous to the poor. The contribution rate of socioeconomic factors was the largest (60.8%), followed by demographic characteristics (29.0%) and geographic factors (4.3%). Demographic, socioeconomic, and geographic factors are associated with the HB awareness inequality. Therefore, to reduce inequality, HB-related health education targeting individuals with low socioeconomic status should be performed. Less-developed provinces, especially with high proportions of poor residents, warrant particular attention. Our findings may be beneficial to improve the HB virus vaccination rate for individuals with low socioeconomic status.

The relationship of tobacco and alcohol use with ageing self-perceptions in older people in Ireland.

PubMed

Villiers-Tuthill, Amanda; Copley, Antoinette; McGee, Hannah; Morgan, Karen

2016-07-22

Health behaviour patterns in older groups, including tobacco and alcohol use, are key factors in chronic disease prevention. We explore ageing self-perceptions as motivating factors behind smoking and drinking alcohol in older adults, and the complex reasons why individuals engage harmfully in these behaviours. Cigarette and alcohol use was assessed in a large cross-sectional national sample aged 50 years and above from the Irish Longitudinal Study on Ageing (TILDA) (n = 6,576). The Brief Ageing Perceptions Questionnaire (BAPQ) assessed individual's views of their own ageing across five domains. Study hypothesis that stronger beliefs on each of the BAPQ domains would be related to drinking and smoking was examined using multinomial logit models (MNLM). Regression parameter estimates for all variables were estimated relative risk ratios (RRR). More women were non-drinkers (30 % vs. 20 %) and men displayed significantly higher alcohol use patterns. One in five older Irish adults was a current smoker (16.8 % of women, 17 % of men), and smoking and harmful drinking were strongly associated (P < .001). Some domains of ageing perceptions were significantly associated with harmful drinking and smoking. While the risk of being be harmful drinker decreased with stronger beliefs about the positive consequences of ageing (RRR 0.89), it increased with higher scores on both emotional representation and control positive domains. Greater awareness of ageing and stronger emotional reaction to ageing increased likelihood of smoking. A greater sense of control over the outcomes of ageing was associated with increased risk of both harmful drinking (RRR control positive 1.16) and smoking (RRR control and consequences negative 1.25). This suggests optimistic bias in relation to perceived health risk from smoking and harmful drinking as a potential adverse effect of perceptions of control. Risks of concurrent smoking and harmful drinking increased with chronic awareness of ageing (RRR 1.24), and negative emotional responses to it (RRR 1.21), and decreased with stronger perceptions of the positive consequences of ageing (RRR 0.85). The relationship between ageing perceptions, smoking and drinking is complex. Altering perceptions of ageing may be a useful intervention target aimed at facilitating engagement in preventative health behaviours in older people.

Are regional variations in activity of dispatcher-assisted cardiopulmonary resuscitation associated with out-of-hospital cardiac arrests outcomes? A nation-wide population-based cohort study.

PubMed

Nishi, Taiki; Kamikura, Takahisa; Funada, Akira; Myojo, Yasuhiro; Ishida, Tetsuya; Inaba, Hideo

2016-01-01

Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) impacts the rates of bystander CPR (BCPR) and survival after out-of-hospital cardiac arrests (OHCAs). This study aimed to elucidate whether regional variations in indexes for BCPR and emergency medical service (EMS) may be associated with OHCA outcomes. We conducted a population-based observational study involving 157,093 bystander-witnessed, resuscitation-attempted OHCAs without physician involvement between 2007 and 2011. For each index of BCPR and EMS, we classified the 47 prefectures into the following three groups: advanced, intermediate, and developing regions. Nominal logit analysis followed by multivariable logistic regression including OHCA backgrounds was employed to examine the association between neurologically favourable 1-month survival, and regional classifications based on BCPR- and EMS-related indexes. Logit analysis including all regional classifications revealed that the number of BLS training course participants per population or bystander's own performance of BCPR without DA-CPR was not associated with the survival. Multivariable logistic regression including the OHCA backgrounds known to be associated with survival (BCPR provision, arrest aetiology, initial rhythm, patient age, time intervals of witness-to-call and call-to-arrival at patient), the following regional classifications based on DA-CPR but not on EMS were associated with survival: sensitivity of DA-CPR [adjusted odds ratio (95% confidence intervals) for advanced region; those for intermediate region, with developing region as reference, 1.277 (1.131-1.441); 1.162 (1.058-1.277)]; the proportion of bystanders to follow DA-CPR [1.749 (1.554-1.967); 1.280 (1.188-1.380)]. Good outcomes of bystander-witnessed OHCAs correlate with regions having higher sensitivity of DA-CPR and larger proportion of bystanders to follow DA-CPR. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

An Odds Ratio Approach for Detecting DDF under the Nested Logit Modeling Framework

ERIC Educational Resources Information Center

Terzi, Ragip; Suh, Youngsuk

2015-01-01

An odds ratio approach (ORA) under the framework of a nested logit model was proposed for evaluating differential distractor functioning (DDF) in multiple-choice items and was compared with an existing ORA developed under the nominal response model. The performances of the two ORAs for detecting DDF were investigated through an extensive…

Caregiver Burdens and Preventive Dental Care for Children with Autism Spectrum Disorder, Developmental Disability and/or Mental Health Conditions: National Survey of CSHCN, 2009-2010.

PubMed

Wiener, R Constance; Vohra, Rini; Sambamoorthi, Usha; Madhavan, S Suresh

2016-12-01

Objective The purpose of this study is to examine the burdens of caregivers on perception of the need and receipt of preventive dental care for a subset of children with special health care needs-children with Autism Spectrum disorder, developmental disability and/or mental health conditions (CASD/DD/MHC). Methods The authors used the 2009-2010 National Survey of CSHCN. The survey included questions addressing preventive dental care and caregivers' financial, employment, and time-related burdens. The associations of these burdens on perceptions and receipt of preventive dental care use were analyzed with bivariate Chi square analyses and multinomial logistic regressions for CASD/DD/MHC (N = 16,323). Results Overall, 16.3 % of CASD/DD/MHC had an unmet preventive dental care need. There were 40.0 % of caregivers who reported financial burden, 20.3 % who reported employment burden, and 10.8 % who reported time burden. A higher percentage of caregivers with financial burden, employment burden, and time-related burden reported that their CASD/DD/MHC did not receive needed preventive dental care (14.1, 16.5, 17.7 % respectively) compared to caregivers without financial, employment, or time burdens (9.0, 9.6 %, 11.0 % respectively). Caregivers with financial burden (adjusted multinomial odds ratio, 1.38 [95 % CI 1.02, 1.86] and employment burden (adjusted multinomial odds ratio, 1.45 [95 % CI 1.02, 2.06] were more likely to report that their child did not receive preventive dental care despite perceived need compared to caregivers without financial or employment burdens. Conclusions for practice Unmet needs for preventive dental care were associated with employment and financial burdens of the caregivers of CASD/DD/MHC.

Caregiver Burdens and Preventive Dental Care for Children with Autism Spectrum disorder, developmental disability and/or mental health conditions: National Survey of CSHCN, 2009–10

PubMed Central

Vohra, Rini; Sambamoorthi, Usha; Madhavan, S. Suresh

2016-01-01

Objective The purpose of this study is to examine the burdens of caregivers on one perception of the need and receipt of preventive dental care for a subset of children with special health care needs—children with Autism Spectrum disorder, developmental disability and/or mental health conditions (CASD/DD/MHC). Methods The authors used the 2009–2010 National Survey of CSHCN. The survey included questions addressing preventive dental care and caregivers’ financial, employment, and time-related burdens. The associations of these burdens on perceptions and receipt of preventive dental care use were analyzed with bivariate Chi square analyses and multinomial logistic regressions for CASD/DD/MHC (N=16,323). Results Overall, 16.3% of CASD/DD/MHC had an unmet preventive dental care need. There were 40.0% of caregivers who reported financial burden, 20.3% who reported employment burden, and 10.8% who reported time burden. A higher percentage of caregivers with financial burden, employment burden, and time-related burden reported that their CASD/DD/MHC did not receive needed preventive dental care (14.1 %, 16.5%, 17.7% respectively) compared to caregivers without financial, employment, or time burdens (9.0%, 9.6%, 11.0% respectively). Caregivers with financial burden (adjusted multinomial odds ratio, 1.38 [95%CI: 1.02, 1.86]) and employment burden (adjusted multinomial odds ratio, 1.45 [95%CI: 1.02, 2.06]) were more likely to report that their child did not receive preventive dental care despite perceived need compared to caregivers without financial or employment burdens. Conclusions for practice Unmet needs for preventive dental care were associated with employment and financial burdens of the caregivers of CASD/DD/MHC. PMID:27465058

Identifying Measurement Disturbance Effects Using Rasch Item Fit Statistics and the Logit Residual Index.

ERIC Educational Resources Information Center

Mount, Robert E.; Schumacker, Randall E.

1998-01-01

A Monte Carlo study was conducted using simulated dichotomous data to determine the effects of guessing on Rasch item fit statistics and the Logit Residual Index. Results indicate that no significant differences were found between the mean Rasch item fit statistics for each distribution type as the probability of guessing the correct answer…

Association of comorbid mental health symptoms and physical health conditions with employee productivity.

PubMed

Parker, Kristin M; Wilson, Mark G; Vandenberg, Robert J; DeJoy, David M; Orpinas, Pamela

2009-10-01

This study tests the hypothesis that employees with comorbid physical health conditions and mental health symptoms are less productive than other employees. Self-reported health status and productivity measures were collected from 1723 employees of a national retail organization. chi2, analysis of variance, and linear contrast analyses were conducted to evaluate whether health status groups differed on productivity measures. Multivariate linear regression and multinomial logistic regression analyses were conducted to analyze how predictive health status was of productivity. Those with comorbidities were significantly less productive on all productivity measures compared with all other health status groups and those with only physical health conditions or mental health symptoms. Health status also significantly predicted levels of employee productivity. These findings provide evidence for the relationship between health statuses and productivity, which has potential programmatic implications.

Victimization and health risk factors among weapon-carrying youth.

PubMed

Stayton, Catherine; McVeigh, Katharine H; Olson, E Carolyn; Perkins, Krystal; Kerker, Bonnie D

2011-11-01

To compare health risks of 2 subgroups of weapon carriers: victimized and nonvictimized youth. 2003-2007 NYC Youth Risk Behavior Surveys were analyzed using bivariate analyses and multinomial logistic regression. Among NYC teens, 7.5% reported weapon carrying without victimization; 6.9% reported it with victimization. Both subgroups were more likely than non-weapon carriers to binge drink, use marijuana, smoke, fight, and have multiple sex partners; weapon carriers with victimization also experienced persistent sadness and attempted suicide. Subgroups of weapon carriers have distinct profiles. Optimal response should pair disciplinary action with screening for behavioral and mental health concerns and victimization.

The choice of facilitators in medical tourism.

PubMed

Gan, Lydia L; Frederick, James R

2018-01-01

The study identified which of the four facilitators (themselves, agents, insurers, or doctors) consumers are most likely to use when they travel for various medical procedures. A survey conducted between 2011 and 2014 yielded 964 responses. The multinomial logistic regression results showed that being 51-64 years old was positively related to going on their own or using agents to arrange for knee replacements. Having a high school education or less was positively linked to using both agents and insurers to facilitate knee replacements, whereas having a bachelor's degree was negatively associated with going on their own for stem cell therapy.

Analysis of stationary and dynamic factors affecting highway accident occurrence: A dynamic correlated grouped random parameters binary logit approach.

PubMed

Fountas, Grigorios; Sarwar, Md Tawfiq; Anastasopoulos, Panagiotis Ch; Blatt, Alan; Majka, Kevin

2018-04-01

Traditional accident analysis typically explores non-time-varying (stationary) factors that affect accident occurrence on roadway segments. However, the impact of time-varying (dynamic) factors is not thoroughly investigated. This paper seeks to simultaneously identify pre-crash stationary and dynamic factors of accident occurrence, while accounting for unobserved heterogeneity. Using highly disaggregate information for the potential dynamic factors, and aggregate data for the traditional stationary elements, a dynamic binary random parameters (mixed) logit framework is employed. With this approach, the dynamic nature of weather-related, and driving- and pavement-condition information is jointly investigated with traditional roadway geometric and traffic characteristics. To additionally account for the combined effect of the dynamic and stationary factors on the accident occurrence, the developed random parameters logit framework allows for possible correlations among the random parameters. The analysis is based on crash and non-crash observations between 2011 and 2013, drawn from urban and rural highway segments in the state of Washington. The findings show that the proposed methodological framework can account for both stationary and dynamic factors affecting accident occurrence probabilities, for panel effects, for unobserved heterogeneity through the use of random parameters, and for possible correlation among the latter. The comparative evaluation among the correlated grouped random parameters, the uncorrelated random parameters logit models, and their fixed parameters logit counterpart, demonstrate the potential of the random parameters modeling, in general, and the benefits of the correlated grouped random parameters approach, specifically, in terms of statistical fit and explanatory power. Published by Elsevier Ltd.

Wet-season spatial variability of N2O emissions from a tea field in subtropical central China

NASA Astrophysics Data System (ADS)

Fu, X.; Liu, X.; Li, Y.; Shen, J.; Wang, Y.; Zou, G.; Li, H.; Song, L.; Wu, J.

2015-01-01

Tea fields emit large amounts of nitrous oxide (N2O) to the atmosphere. Obtaining accurate estimations of N2O emissions from tea-planted soils is challenging due to strong spatial variability. We examined the spatial variability of N2O emissions from a red-soil tea field in Hunan province, China, on 22 April 2012 (in a wet season) using 147 static mini chambers approximately regular gridded in a 4.0 ha tea field. The N2O fluxes for a 30 min snapshot (10-10.30 a.m.) ranged from -1.73 to 1659.11 g N ha-1 d-1 and were positively skewed with an average flux of 102.24 g N ha-1 d-1. The N2O flux data were transformed to a normal distribution by using a logit function. The geostatistical analyses of our data indicated that the logit-transformed N2O fluxes (FLUX30t) exhibited strong spatial autocorrelation, which was characterized by an exponential semivariogram model with an effective range of 25.2 m. As observed in the wet season, the logit-transformed soil ammonium-N (NH4Nt), soil nitrate-N (NO3Nt), soil organic carbon (SOCt), total soil nitrogen (TSNt) were all found to be significantly correlated with FLUX30t (r=0.57-0.71, p<0.001). Three spatial interpolation methods (ordinary kriging, regression kriging and cokriging) were applied to estimate the spatial distribution of N2O emissions over the study area. Cokriging with NH4Nt and NO3Nt as covariables (r= 0.74 and RMSE =1.18) outperformed ordinary kriging (r= 0.18 and RMSE =1.74), regression kriging with the sample position as a predictor (r= 0.49 and RMSE =1.55) and cokriging with SOCt as a covariable (r= 0.58 and RMSE =1.44). The predictions of the three kriging interpolation methods for the total N2O emissions of the 4.0 ha tea field ranged from 148.2 to 208.1 g N d-1, based on the 30 min snapshots obtained during the wet season. Our findings suggested that to accurately estimate the total N2O emissions over a region, the environmental variables (e.g., soil properties) and the current land use pattern (e.g., tea row transects in the present study) must be included in spatial interpolation. Additionally, compared with other kriging approaches, the cokriging prediction approach showed great advantages in being easily deployed, and more importantly providing accurate regional estimation of N2O emissions from tea-planted soils.

Wet-season spatial variability in N2O emissions from a tea field in subtropical central China

NASA Astrophysics Data System (ADS)

Fu, X.; Liu, X.; Li, Y.; Shen, J.; Wang, Y.; Zou, G.; Li, H.; Song, L.; Wu, J.

2015-06-01

Tea fields emit large amounts of nitrous oxide (N2O) to the atmosphere. Obtaining accurate estimations of N2O emissions from tea-planted soils is challenging due to strong spatial variability. We examined the spatial variability in N2O emissions from a red-soil tea field in Hunan Province, China, on 22 April 2012 (in a wet season) using 147 static mini chambers approximately regular gridded in a 4.0 ha tea field. The N2O fluxes for a 30 min snapshot (10:00-10:30 a.m.) ranged from -1.73 to 1659.11 g N ha-1 d-1 and were positively skewed with an average flux of 102.24 g N ha-1 d-1. The N2O flux data were transformed to a normal distribution by using a logit function. The geostatistical analyses of our data indicated that the logit-transformed N2O fluxes (FLUX30t) exhibited strong spatial autocorrelation, which was characterized by an exponential semivariogram model with an effective range of 25.2 m. As observed in the wet season, the logit-transformed soil ammonium-N (NH4Nt), soil nitrate-N (NO3Nt), soil organic carbon (SOCt) and total soil nitrogen (TSNt) were all found to be significantly correlated with FLUX30t (r = 0.57-0.71, p < 0.001). Three spatial interpolation methods (ordinary kriging, regression kriging and cokriging) were applied to estimate the spatial distribution of N2O emissions over the study area. Cokriging with NH4Nt and NO3Nt as covariables (r = 0.74 and RMSE = 1.18) outperformed ordinary kriging (r = 0.18 and RMSE = 1.74), regression kriging with the sample position as a predictor (r = 0.49 and RMSE = 1.55) and cokriging with SOCt as a covariable (r = 0.58 and RMSE = 1.44). The predictions of the three kriging interpolation methods for the total N2O emissions of 4.0 ha tea field ranged from 148.2 to 208.1 g N d-1, based on the 30 min snapshots obtained during the wet season. Our findings suggested that to accurately estimate the total N2O emissions over a region, the environmental variables (e.g., soil properties) and the current land use pattern (e.g., tea row transects in the present study) must be included in spatial interpolation. Additionally, compared with other kriging approaches, the cokriging prediction approach showed great advantages in being easily deployed and, more importantly, providing accurate regional estimation of N2O emissions from tea-planted soils.

Occupational Choice: A Conditional Logit Model with Special Reference to Wage Subsidies and Occupational Choice. Final Report.

ERIC Educational Resources Information Center

Boskin, Michael J.

A model of occupational choice based on the theory of human capital is developed and estimated by conditional logit analysis. The empirical results estimated the probability of individuals with certain characteristics (such as race, sex, age, and education) entering each of 11 occupational groups. The results indicate that individuals tend to…

Stochastic modeling of consumer preferences for health care institutions.

PubMed

Malhotra, N K

1983-01-01

This paper proposes a stochastic procedure for modeling consumer preferences via LOGIT analysis. First, a simple, non-technical exposition of the use of a stochastic approach in health care marketing is presented. Second, a study illustrating the application of the LOGIT model in assessing consumer preferences for hospitals is given. The paper concludes with several implications of the proposed approach.

Random preferences towards bioenergy environmental externalities: a case study of woody biomass based electricity in the Southern United States

Treesearch

Andres Susaeta; Pankaj Lal; Janaki Alavalapati; Evan Mercer

2011-01-01

This paper contrasts alternate methodological approaches of investigating public preferences, the random parameter logit (RPL) where tastes and preferences of respondents are assumed to be heterogeneous and the conditional logit (CL) approach where tastes and preferences remain fixed for individuals. We conducted a choice experiment to assess preferences for woody...

Predictors of functional vision changes after cataract surgery: the PROVISION study.

PubMed

Chaudhary, Varun; Popovic, Marko; Holmes, Julie; Robinson, Tammy; Mak, Michael; Mohaghegh P, S Mohammad; Eino, Dalia; Mann, Keith; Kobetz, Lawrence; Gusenbauer, Kaela; Barbosa, Joshua

2016-08-01

To ascertain whether time-to-treatment, sex, age, preoperative functional vision scores, education, and ocular comorbidities predict change in functional vision pre- to postoperatively in patients receiving cataract surgery. Prospective cohort study. Three hundred and forty-three cataract patients at the Hamilton Regional Eye Institute. Participants 18 years or older scheduled to undergo cataract surgery completed the Catquest-9SF functional vision questionnaire on the day of their surgery and were mailed a survey 2-3 months postoperatively. Multivariate linear regression was used to determine the ability of predictors to explain variability in functional vision change between questionnaire administrations. One hundred and sixty-six patients completed both baseline and follow-up questionnaires. Mean age of the cohort was 73.8 ± 8.1 years. Most patients were female (59.6%), had cataract surgery performed for the first time (66.9%), and had spent a mean time of 20.3 ± 20.7 weeks waiting for surgery. Functional vision improved in 83.7% of patients. The mean baseline Catquest-9SF score was the only significant predictor of functional vision improvement (adjusted R(2) = 0.47; F1,159 = 144.6; p < 0.001). Controlling for other variables, functional vision improved by 0.74 logits when mean baseline survey score increased by 1 logit. In most patients, functional vision improved after cataract surgery. Mean baseline Catquest-9SF score was a moderate predictor of the observed improvement. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

ACUTE LOWER RESPIRATORY INFECTION IN GUARANI INDIGENOUS CHILDREN, BRAZIL.

PubMed

Souza, Patricia Gomes de; Cardoso, Andrey Moreira; Sant'Anna, Clemax Couto; March, Maria de Fátima Bazhuni Pombo

2018-03-29

To describe the clinical profile and treatment of Brazilian Guarani indigenous children aged less than five years hospitalized for acute lower respiratory infection (ALRI), living in villages in the states from Rio de Janeiro to Rio Grande do Sul. Of the 234 children, 23 were excluded (incomplete data). The analysis was conducted in 211 children. Data were extracted from charts by a form. Based on record of wheezing and x-ray findings, ALRI was classified as bacterial, viral and viral-bacterial. A bivariate analysis was conducted using multinomial regression. Median age was 11 months. From the total sample, the ALRI cases were classified as viral (40.8%), bacterial (35.1%) and viral-bacterial (24.1%). It was verified that 53.1% of hospitalizations did not have clinical-radiological-laboratorial evidence to justify them. In the multinomial regression analysis, the comparison of bacterial and viral-bacterial showed the likelihood of having a cough was 3.1 times higher in the former (95%CI 1.11-8.70), whereas having chest retractions was 61.0% lower (OR 0.39, 95%CI 0.16-0.92). Comparing viral with viral-bacterial, the likelihood of being male was 2.2 times higher in the viral (95%CI 1.05-4.69), and of having tachypnea 58.0% lower (OR 0.42, 95%CI 0.19-0.92). Higher proportion of viral processes was identified, as well as viral-bacterial co-infections. Coughing was a symptom indicative of bacterial infection, whereas chest retractions and tachypnea showed viral-bacterial ALRI. Part of the resolution of non-severe ALRI still occurs at hospital level; therefore, we concluded that health services need to implement their programs in order to improve indigenous primary care.

Childhood abuse and late-life depression: Mediating effects of psychosocial factors for early- and late-onset depression.

PubMed

Wielaard, Ilse; Hoyer, Mathijs; Rhebergen, Didi; Stek, Max L; Comijs, Hannie C

2018-03-01

Childhood abuse makes people vulnerable to developing depression, even in late life. Psychosocial factors that are common in late life, such as loneliness or lack of a partner, may explain this association. Our aim was to investigate whether the association between childhood abuse and depression in older adults can be explained by psychosocial factors. Cross-sectional data were derived from the Netherlands Study of Depression in Older Persons (aged 60-93), including 132 without lifetime depression, 242 persons with an early-onset depression (<60 years), and 125 with a late-onset (≥60 years) depression. Childhood abuse (yes/no) and a frequency-based childhood abuse index were included. Multinomial regression and multivariable mediation analyses were used to examine the association between childhood abuse and the onset of depression, and the influence of loneliness, social network, and partner status. Multinomial regression analyses showed a significant association between childhood abuse and the childhood abuse index with early- and late-onset depression. Multivariable mediation analyses showed that the association between childhood abuse and early-onset depression was partly mediated by social network size and loneliness. This was particularly present for emotional neglect and psychological abuse, but not for physical and sexual abuse. No psychosocial mediators were found for the association between childhood abuse and late-onset depression. A smaller social network and feelings of loneliness mediate the association between childhood abuse and early-onset depression in older adults. Our findings show the importance of detecting childhood abuse as well as the age at depression onset and mapping of relevant psychosocial factors in the treatment of late-life depression. Copyright © 2018 John Wiley & Sons, Ltd.

Frequencies of apolipoprotein E alleles in depressed patients undergoing hemodialysis--a case-control study.

PubMed

Su, Yan-yan; Zhang, Yun-fang; Yang, Shen; Wang, Jie-lin; Hua, Bao-jun; Luo, Jie; Wang, Qi; Zeng, De-wang; Lin, Yan-qun; Li, Hong-yan

2015-06-01

To explore the relation between the frequencies of apolipoprotein E (ApoE) alleles and the occurrence of depression in patients undergoing hemodialysis in a Chinese population. We examined the ApoE alleles in a sample of 288 subjects: 72 patients with depression under hemodialysis, 74 patients without depression under hemodialysis, 75 patients with depression under nondialytic treatment and 67 patients without depression under nondialytic treatment. The depression state was assessed using the Center for Epidemiological Studies Depression (CES-D) scale. Associations between the occurrence of depression and the frequencies of ApoE alleles were examined using multinomial logistic regression models with adjustment of relevant covariates. Information about sociodemographics, clinical data, vascular risk factors and cognitive function was also collected and evaluated. The frequencies of ApoE-ɛ2 were significantly different between depressed and non-depressed patients irrespective of dialysis (p < 0.05), but no significant difference was found in the frequencies of ApoE-ɛ4 (p > 0.05). Serum ApoE levels were significantly different between depressed and non-depressed patients in the whole sample (p < 0.05). Multinomial logistic regression models showed significant association between the frequency of ApoE-ɛ2 and the occurrence of depression in the Chinese population after control of relevant covariates, including age, sex, educational level, history of smoking and drinking, vascular risk factors and cognitive function. No association between the frequency of ApoE-ɛ4 and the occurrence of depression was found in patients undergoing hemodialysis. Further research is needed to find out if ApoE-ɛ2 acts as a protective factor in Chinese dialysis population since it might decrease the prevalence of depression and delay the onset age.

Inequality in the hepatitis B awareness level in rural residents from 7 provinces in China

PubMed Central

Zheng, Juan; Li, Quan; Wang, Jian; Zhang, Guojie; Wangen, Knut R.

2017-01-01

ABSTRACT The hepatitis B (HB) awareness level is an important factor affecting the rates of HB virus vaccination. To better understand income-related inequalities in the HB awareness level, it is imperative to identify the sources of inequalities and assess the contribution rates of these influential factors. This study analyzed the unequal distribution of the HB awareness level and the contributions of various influential factors. We performed a cross-sectional household survey with questionnaire-based, face-to-face interviews in 7 Chinese provinces. Responses from 7271 respondents were used in this analysis. Multinomial logistic regression was used for the analysis of contributing factors, and the concentration index was used as a measure of HB awareness inequalities. The HB awareness level varied across participants with different characteristics. Multinomial logistic regression of the explanatory factors of the HB awareness level showed that several estimated coefficients and relative risk ratios were statistically significant for middle- and high-level awareness, except for sex, occupation, and household income. The concentration index of the HB knowledge score was 0.140, indicating inequality gradients disadvantageous to the poor. The contribution rate of socioeconomic factors was the largest (60.8%), followed by demographic characteristics (29.0%) and geographic factors (4.3%). Demographic, socioeconomic, and geographic factors are associated with the HB awareness inequality. Therefore, to reduce inequality, HB-related health education targeting individuals with low socioeconomic status should be performed. Less-developed provinces, especially with high proportions of poor residents, warrant particular attention. Our findings may be beneficial to improve the HB virus vaccination rate for individuals with low socioeconomic status. PMID:28277091

Opinions About Electronic Cigarette Use in Smoke-Free Areas Among U.S. Adults, 2012

PubMed Central

Dube, Shanta R.; Sterling, Kymberle; Whitney, Carrie; Eriksen, Michael P.

2015-01-01

Introduction: In the United States, electronic cigarettes (e-cigarettes) are currently unregulated, extensively marketed, and experiencing a rapid increase in use. The purpose of this study was to examine the opinions of U.S. adults about e-cigarette use in smoke-free public areas. Methods: Data were obtained from the online HealthStyle survey administered to a probability sample of a nationally representative online panel. The study included 4,043U.S. adults, aged 18 years or older who responded to this question, “Do you think e-cigarette should be allowed to be used in public areas where tobacco smoking is prohibited?” Multinomial logistic regression analyses were used to examine opinions on e-cigarette use in smoke-free areas by sex, age, race/ethnicity, household income, education, census region, and cigarette smoking status and e-cigarette awareness and ever use. Results: Overall, about 40% of adults were uncertain whether e-cigarettes should be allowed in smoke-free areas, 37% opposed, while 23% favored their use in smoke-free public places. Multinomial logistic regression analyses showed that adults who were aware, ever used e-cigarettes, and current cigarette smokers were more likely to express an “in favor” opinion than adults who expressed an uncertain opinion (don’t know). Conclusion: Over 75% of U.S. adults reported uncertainty or disapproval of the use of e-cigarettes in smoke-free areas. Current cigarette smokers, adults aware or have ever used e-cigarettes were more supportive to exempting e-cigarettes from smoking restrictions. With impending regulation and the changing e-cigarette landscape, continued monitoring and research on public opinions about e-cigarette use in smoke-free places are needed. PMID:25358659

Trajectories of Childbearing among HIV Infected Indian Women: A Sequence Analysis Approach

PubMed Central

Darak, Shrinivas; Mills, Melinda; Kulkarni, Vinay; Kulkarni, Sanjeevani; Hutter, Inge; Janssen, Fanny

2015-01-01

Background HIV infection closely relates to and deeply affects the reproductive career of those infected. However, little is known about the reproductive career trajectories, specifically the interaction of the timing of HIV diagnosis with the timing and sequencing of reproductive events among HIV infected women. This is the first study to describe and typify this interaction. Methods Retrospective calendar data of ever married HIV infected women aged 15-45 attending a HIV clinic in Pune, Maharashtra, Western India (N=622) on reproductive events such as marriage, cohabitation with the partner, use of contraception, pregnancy, childbirth and HIV diagnosis were analyzed using sequence analysis and multinomial logistic regression. Results Optimal matching revealed three distinct trajectories: 1) HIV diagnosis concurrent with childbearing (40.7%), 2) HIV diagnosis after childbearing (32.1%), and 3) HIV diagnosis after husband’s death (27.2%). Multinomial logistic regression (trajectory 1 = baseline) showed that women who got married before the age of 21 years and who had no or primary level education had a significantly higher risk of knowing their HIV status either after childbearing or close to their husband’s death. The risk of HIV diagnosis after husband’s death was also higher among rural women and those who were diagnosed before 2005. Conclusions Three distinct patterns of interaction of timing of HIV diagnosis with timing and sequencing of events in the reproductive career were observed that have clear implications for (i) understanding of the individual life planning process in the context of HIV, (ii) formulation of assumptions for estimating HIV infected women in need of PMTCT services, and (iii) provision of care services. PMID:25906185

No compelling positive association between ovarian hormones and wearing red clothing when using multinomial analyses.

PubMed

Blake, Khandis R; Dixson, Barnaby J W; O'Dean, Siobhan M; Denson, Thomas F

2017-04-01

Several studies report that wearing red clothing enhances women's attractiveness and signals sexual proceptivity to men. The associated hypothesis that women will choose to wear red clothing when fertility is highest, however, has received mixed support from empirical studies. One possible cause of these mixed findings may be methodological. The current study aimed to replicate recent findings suggesting a positive association between hormonal profiles associated with high fertility (high estradiol to progesterone ratios) and the likelihood of wearing red. We compared the effect of the estradiol to progesterone ratio on the probability of wearing: red versus non-red (binary logistic regression); red versus neutral, black, blue, green, orange, multi-color, and gray (multinomial logistic regression); and each of these same colors in separate binary models (e.g., green versus non-green). Red versus non-red analyses showed a positive trend between a high estradiol to progesterone ratio and wearing red, but the effect only arose for younger women and was not robust across samples. We found no compelling evidence for ovarian hormones increasing the probability of wearing red in the other analyses. However, we did find that the probability of wearing neutral was positively associated with the estradiol to progesterone ratio, though the effect did not reach conventional levels of statistical significance. Findings suggest that although ovarian hormones may affect younger women's preference for red clothing under some conditions, the effect is not robust when differentiating amongst other colors of clothing. In addition, the effect of ovarian hormones on clothing color preference may not be specific to the color red. Copyright © 2017 Elsevier Inc. All rights reserved.

Risk factors associated with recurrent homelessness after a first homeless episode.

PubMed

McQuistion, Hunter L; Gorroochurn, Prakash; Hsu, Eustace; Caton, Carol L M

2014-07-01

Alcohol and drug use are commonly associated with the experience of homelessness. In order to better understand this, we explored the prevalence of drug and alcohol use as it related to successful re-housing within a sample of first-time single homeless adults at municipal shelters. From within this sample, we compared the features of recurrent homelessness with those of chronic homelessness and of being stably housed. We interviewed 344 subjects upon shelter entry and followed each one every six months for 18 months using standardized social and mental health measures. We analyzed baseline assessments relative to housing experiences during follow-up using Chi square and multinomial logistic regression. Eighty-one percent (N = 278) obtained housing over 18 months, of which 23.7 % (N = 66) experienced homelessness again. Recurrent homelessness was more common among those with a high school education and if initially re-housed with family. Bivariate analysis resulted in the observation of the highest rate of alcohol and other drug use among this recurrent group and multinomial logistic regression supported this only with the coupling of arrest history and diagnosed antisocial personality disorder. With relatively high rates of recurrent homelessness, there were differences between subjects who experienced recurrent homelessness compared to those who were stably housed and with chronic homelessness. That alcohol and other substance use disorders were associated with recurrent homelessness only if they were linked to other risk factors highlights the complexity of causes for homelessness and a resultant need to organize them into constellations of causal risk factors. Consistent with this, there should be initiatives that span bureaucratic boundaries so as to flexibly meet multiple complex service needs, thus improving outcomes concerning episodes of recurrent homelessness.

Associations Between Perceived Race-based Discrimination and Contraceptive Use Among Women Veterans in the ECUUN Study.

PubMed

MacDonald, Serena; Hausmann, Leslie R M; Sileanu, Florentina E; Zhao, Xinhua; Mor, Maria K; Borrero, Sonya

2017-09-01

To describe perceived race-based discrimination in Veterans Affairs (VA) health care settings and assess its associations with contraceptive use among a sample of women Veterans. This study used data from a national telephone survey of women Veterans aged 18-44 receiving health care in VA who were at risk of unintended pregnancy. Participants were asked about their perceptions of race-based discrimination while seeking VA health care and about their contraceptive use at last heterosexual intercourse. Logistic and multinomial regression analyses were used to examine associations between perceived race-based discrimination with use of prescription contraception. In our sample of 1341 women Veterans, 7.9% report perceived race-based discrimination when receiving VA care, with blacks and Hispanics reporting higher levels of perceived discrimination than white women (11.3% and 11.2% vs. 4.4%; P<0.001). In logistic and multinomial regression analyses adjusting for race/ethnicity, age, income, marital status, parity, and insurance, women who perceived race-based discrimination were less likely to use any prescription birth control than women who did not (odds ratio, 0.65; 95% confidence interval, 0.42-1.00), with the largest difference seen in rates of intrauterine device or implant use (odds ratio, 0.40; 95% confidence interval, 0.20-0.79). In this national sample of women Veterans, over 10% of racial/ethnic minority women perceived race-based discrimination when receiving care in VA settings, and perceived racial/ethnic discrimination was associated with lower likelihood of prescription contraception use, especially intrauterine devices and implants. VA efforts to enhance respectful interactions may not only improve patient health care experiences, but also represent an opportunity to improve reproductive health outcomes for women Veterans.

The heterogeneous health latent classes of elderly people and their socio-demographic characteristics in Taiwan.

PubMed

Liu, Li-Fan; Tian, Wei-Hua; Yao, Hui-Ping

2014-01-01

The health care needs of elderly people were influenced by their heterogeneity. This study aimed to identify the health latent classes of elderly people by using latent class analysis to deal with heterogeneity and examine their socio-demographic characteristics. Data came from the 2005 National Health Interview Survey (NHIS) in Taiwan. In total, 2449 elderly individuals with available health indicators were examined in latent class analysis (LCA), and 2217 elderly community-dwellings with complete socio-demographic data were analyzed by multinomial logistic regression. Four health latent classes were identified which included 1066 (43.5%) people in the High Comorbidity (HC), 152 (6.2%) in the Functional Impairment (FI), 252 (10.3%) in the Frail (FR), and 979 (40.0%) in the Relatively Healthy (RH) group. Multinomial logistic regressions revealed socio-demographic characteristics among health classes. The variables associated with an increased likelihood of being in the FR group were age, female, and living with families. They were also correlated to ethnicity and educations. Apart from age and gender, the Functional Impairment group was less likely to be ethnicity of Hakka, more likely to live with others than were the RH group. The HC group tended to be younger, with higher educations, and more likely to live in urban area than the Functional Impairment group. The correlations between health classes and socio-demographic factors were discussed. The health status of elderly people includes a variety of health indicators. A person-centered approach is critical to identify the health heterogeneity of elderly people and manage their care needs by targeting differential aging. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A cross-sectional study of the association of age, race and ethnicity, and body mass index with sex steroid hormone marker profiles among men in the National Health and Nutrition Examination Survey (NHANES III)

PubMed Central

Ritchey, Jamie; Karmaus, Wilfried; Sabo-Attwood, Tara; Steck, Susan E; Zhang, Hongmei

2012-01-01

Objectives Since sex hormone markers are metabolically linked, examining sex steroid hormones singly may account for inconsistent findings by age, race/ethnicity and body mass index (BMI) across studies. First, these markers were statistically combined into profiles to account for the metabolic relationship between markers. Then, the relationships between sex steroid hormone profiles and age, race/ethnicity and BMI were explored in multinomial logistic regression models. Design Cross-sectional survey. Setting The US Third National Health and Nutrition Examination Survey (NHANES III). Participants 1538 Men, >17 years. Primary outcome measure Sex hormone profiles. Results Cluster analysis was used to identify four statistically determined profiles with Blom-transformed T, E, sex hormone binding globulin (SHBG), and 3-α diol G. We used these four profiles with multinomial logistic regression models to examine differences by race/ethnicity, age and BMI. Mexican American men >50 years were associated with the profile that had lowest T, E and 3-α diol G levels compared to other profiles (p<0.05). Non-Hispanic Black, overweight (25–29.9 kg/m2) and obese (>30 kg/m2) men were most likely to be associated with the cluster with the lowest SHBG (p<0.05). Conclusion The associations of sex steroid hormone profiles by race/ethnicity are novel, while the findings by age and BMI groups are largely consistent with observations from single hormone studies. Future studies should validate these hormone profile groups and investigate these profiles in relation to chronic diseases and certain cancers. PMID:23043125

Estimation of social value of statistical life using willingness-to-pay method in Nanjing, China.

PubMed

Yang, Zhao; Liu, Pan; Xu, Xin

2016-10-01

Rational decision making regarding the safety related investment programs greatly depends on the economic valuation of traffic crashes. The primary objective of this study was to estimate the social value of statistical life in the city of Nanjing in China. A stated preference survey was conducted to investigate travelers' willingness to pay for traffic risk reduction. Face-to-face interviews were conducted at stations, shopping centers, schools, and parks in different districts in the urban area of Nanjing. The respondents were categorized into two groups, including motorists and non-motorists. Both the binary logit model and mixed logit model were developed for the two groups of people. The results revealed that the mixed logit model is superior to the fixed coefficient binary logit model. The factors that significantly affect people's willingness to pay for risk reduction include income, education, gender, age, drive age (for motorists), occupation, whether the charged fees were used to improve private vehicle equipment (for motorists), reduction in fatality rate, and change in travel cost. The Monte Carlo simulation method was used to generate the distribution of value of statistical life (VSL). Based on the mixed logit model, the VSL had a mean value of 3,729,493 RMB ($586,610) with a standard deviation of 2,181,592 RMB ($343,142) for motorists; and a mean of 3,281,283 RMB ($505,318) with a standard deviation of 2,376,975 RMB ($366,054) for non-motorists. Using the tax system to illustrate the contribution of different income groups to social funds, the social value of statistical life was estimated. The average social value of statistical life was found to be 7,184,406 RMB ($1,130,032). Copyright © 2016 Elsevier Ltd. All rights reserved.

Farmers' Options to Address Water Scarcity in a Changing Climate: Case Studies from two Basins in Mediterranean Chile.

PubMed

Roco, Lisandro; Poblete, David; Meza, Francisco; Kerrigan, George

2016-12-01

Irrigated agriculture in Mediterranean areas faces tremendous challenges because of its exposure to hydroclimatic variability, increasing competition for water from different sectors, and the possibility of a climatic change. In this context, efficient management of water resources emerges as a critical issue. This requires the adoption of technological innovations, investment in infrastructure, adequate institutional arrangements, and informed decision makers. To understand farmers' perceptions and their implementation of climate change adaptation strategies with regards to water management, primary information was captured in the Limarí and Maule river basins in Chile. Farmers identified stressors for agriculture; climate change, droughts, and lack of water appeared as the most relevant stressors compared to others productive, economic, and institutional factors; revealing a rising relevance of climate related factors. While most producers perceived climate changes in recent years (92.9 %), a significant proportion (61.1 %) claim to have experienced drought, whereas only a fraction (31.9 %) have implemented a strategy to deal with this situation. Identified actions were classified in four groups: investments for water accumulation, modernization of irrigation systems, rationalization of water use, and partnership activities. Using a multinomial logit model these strategies were related to socioeconomic and productive characteristics. Results show that gender and farm size are relevant for investments, implementation and improvement of irrigation systems. For all the strategies described, access to weather information was a relevant element. The study provides empirical evidence of a recent increase in the importance assigned to climate factors by producers and adaptation options that can be supported by agricultural policy.

Associations between birth health, maternal employment, and child care arrangement among a community sample of mothers with young children.

PubMed

Chiao, Chi; Chyu, Laura; Ksobiech, Kate

2014-01-01

Although a large body of literature exists on how different types of child care arrangements affect a child's subsequent health and sociocognitive development, little is known about the relationship between birth health and subsequent decisions regarding type of nonparental child care as well as how this relationship might be influenced by maternal employment. This study used data from the Los Angeles Families and Neighborhoods Survey (L.A.FANS). Mothers of 864 children (ages 0-5) provided information regarding birth weight, maternal evaluation of a child's birth health, child's current health, maternal employment, type of child care arrangement chosen, and a variety of socioeconomic variables. Child care options included parental care, relative care, nonrelative care, and daycare center. Multivariate analyses found that birth weight and subjective rating of birth health had similar effects on child care arrangement. After controlling for a child's age and current health condition, multinomial logit analyses found that mothers with children with poorer birth health are more likely to use nonrelative and daycare centers than parental care when compared to mothers with children with better birth health. The magnitude of these relationships diminished when adjusting for maternal employment. Working mothers were significantly more likely to use nonparental child care than nonemployed mothers. Results suggest that a child's health early in life is significantly but indirectly related to subsequent decisions regarding child care arrangements, and this association is influenced by maternal employment. Development of social policy aimed at improving child care service should take maternal and family backgrounds into consideration.

National newspaper portrayal of nursing homes: tone of coverage and its correlates.

PubMed

Miller, Edward A; Tyler, Denise A; Mor, Vincent

2013-01-01

The mass media can exert considerable influence over the relative saliency of different public policy concerns. Because emotional resonance can have a strong impact on how the general public and policy makers perceive specific issues, the purpose of this study is to characterize the tone of nursing home coverage in the national media. Keyword searches of LexisNexis were used to identify 1562 articles published in 4 national newspapers from 1999 to 2008. The content of each article was analyzed and tone, themes, prominence, focal entity, and geographic focus assessed. Multinomial logit was used to examine the correlates of tone. Most articles were negative (49.2%) or neutral (40.3%); few were positive (10.5%). Both positive and negative articles were considerably more likely than neutral articles (>10 times) to be an opinion piece. Negative articles were three quarters more likely to be on the front page and two thirds more likely to focus on industry actors. Positive articles were 10 times more likely to be about community actors and two and three quarters more likely to be about local issues. Positive articles were considerably more likely to be about quality; negative articles about negligence/fraud and natural disasters. Findings suggest that negative reporting predominates and its impact on public perceptions and government decision making may be reinforced by its prominence and focus on industry interests/behavior. The adverse impact of media coverage on the industry's reputation has likely influenced consumer care choices, particularly in light of growing competition from the home-based and community-based and assisted living sectors.

Physical Fitness, Physical Activity, Sedentary Behavior, or Diet-What Are the Correlates of Obesity in Polish School Children?

PubMed

Czyż, Stanisław H; Toriola, Abel L; Starościak, Wojciech; Lewandowski, Marek; Paul, Yvonne; Oyeyemi, Adewale L

2017-06-20

There is substantial evidence of rising prevalence of overweight and obesity and its co-morbidities among children in western-high income developed countries. In the European Union, the prevalence of overweight and obesity is increasing fastest among Polish children. Yet, there is paucity of evidence on the relationship of behavioral factors with body weight status of children in Poland. This study examined the association of obesity with physical fitness, physical activity, sedentary behavior and diet among Polish children. A total of 641 children (10-15 years) recruited from the Lower Silesia region of Poland participated in this cross-sectional study. Participants' anthropometrics, physical fitness, physical activity, sedentary behavior and dietary intake were assessed. Outcome variables were weight categories (according to body mass index [BMI], waist-to-hip ratio [WHR], and percentage body fat [% BF]). The strongest negative correlation was found between VO₂max and %BF ( r = -0.39, p <0.05). Significant negative correlation was also found between VO₂max and weight categories ( r = -0.15). Results of the multinomial logit analysis showed that VO₂max increased in groups of overweight, normal weight and underweight children by 13%, 26% and 19%, respectively as compared to the group of obese children. VO₂max and weight and obesity indices were strongly correlated in both gender and age groups. Education and intervention programs to increase physical fitness (VO₂max) through aerobic training are recommended for Physical Education teachers, parents and children in order to reduce the rate of overweight and obesity among children in the Lower Silesia region of Poland.

Intergenerational Transfers of Preferences for Science Careers in Comparative Perspective

NASA Astrophysics Data System (ADS)

Sikora, Joanna; Pokropek, Artur

2012-11-01

Using data from 24 countries, which participated in the 2006 Programme for International Student Assessment (PISA), we examine the relationship between parental science employment and students' career expectations. In contrast to prior PISA-based studies, we find that the link between parental employment and adolescent plans to work in science is non-trivial and merits attention. In this context, we consider three versions of the gender socialisation hypothesis. The strong variant posits that girls' plans are shaped solely by their mothers' career pathways while boys model their expectations exclusively on fathers' occupations. The weaker version of this hypothesis expects children to be influenced more by the same-sex than by the opposite-sex parent. Finally, the third possibility is that, as egalitarian ideologies prevail, parents inspire adolescent occupational plans regardless of gender. These hypotheses are assessed separately for student career plans related to biology, agriculture and health (BAH) in contrast to computing, engineering and mathematics (CEM), because the involvement in these fields of science is known to be segregated by gender. Using two-level multinomial logit modelling, we find some support for the weak version of the gender socialisation hypothesis. Although within-family transfers of preferences for science careers vary considerably across countries, we note certain regularities. In many nations, relevant paternal employment enhances sons' interest in science careers regardless of their field. In contrast, maternal employment inspires daughters in fewer countries and this influence tends to be limited to careers in BAH. We discuss the possible implications of these findings for science educators.

Ecological risk assessment of ecosystem services in the Taihu Lake Basin of China from 1985 to 2020.

PubMed

Xu, Xibao; Yang, Guishan; Tan, Yan; Zhuang, Qianlai; Li, Hengpeng; Wan, Rongrong; Su, Weizhong; Zhang, Jian

2016-06-01

There are tremendous theoretical, methodological and policy challenges in evaluating the impact of land-use change on the degradation of ecosystem services (ES) at the regional scale. This study addresses these challenges by developing an interdisciplinary methodology based on the Procedure for Ecological Tiered Assessment of Risk (PETAR). This novel methodology integrates ecological models with a land-use change model. This study quantifies the multi-dimensional degradation risks of ES in the Taihu Lake Basin (TLB) of China from 1985 to 2020. Four key ES related to water purification, water quantity adjustment, carbon sequestration and grain production are selected. The study employs models of Denitrification-Decomposition (DNDC), Soil-Water-Atmosphere-Plant (SWAP), Biome-BGC and Agro-ecological Zoning (AEZ) for assimilations. Land-use changes by 2020 were projected using a geographically weighted multinomial logit-cellular automata (GWML-CA) model. The results show that rapid land-use change has posed a great degradation risk of ES in the region in 1985-2020. Slightly less than two-thirds of the basin experienced degradation of ES over the 1985-2010 period, and about 12% of the basin will continue to experience degradation until 2020. Hot spots with severe deterioration in 2010-2020 are projected to be centered around some small and less developed cities in the region. Regulating accelerated urban sprawl and population growth, reinforcing current environmental programs, and establishing monitoring systems for observing dynamics of regional ES are suggested as practical counter-measures. Copyright © 2015 Elsevier B.V. All rights reserved.

Aspects of research and development contract terms in the bio/pharmaceutical sector.

PubMed

Banerjee, Tannista

2012-01-01

The cost of new drug development is increasing every year. Pharmaceutical companies use R&D joint ventures, mergers, and outsource different stages of pharmaceutical R&D activities for a faster and cost minimizing method of innovation. Pharmaceutical companies outsource R&D activities to independent small biotech or pharmaceutical companies that specialize in different stages of pharmaceutical R&D. This chapter examines the determinants of the payment structure of research contracts between large bio/pharmaceutical companies and specialized research firms. Determinants of R&D contracts are analyzed using detailed R&D contract data between bio/pharmaceutical companies and independent research firms for 10 years. A multinomial logit model is used in order to understand the determinants of three different types of contracts; royalty contracts, fixed payment contracts, and the mixed contracts. Under uncertainty, the likelihood of a royalty contract rises for the early stages of the research and with the patent stock of the research firm. It is more likely to observe both royalty and fixed payment if the pharmaceutical client has past contracts with the same research firm. The results also suggest that if Food and Drug Administration (FDA) is more stringent in any disease area in reviewing the new drug application, then the likelihood of signing pure royalty contract decreases. Understanding the nature of R&D contracts and the effects of FDA's behavior on the pharmaceutical R&D contract is important because these contracts not only affect the cost of new drug invention but also the quality and the rate of invention. VALUE: Results are useful for both the pharmaceutical companies and the economic/business researchers.

Vaccine preferences and acceptance of older adults.

PubMed

Eilers, R; de Melker, H E; Veldwijk, J; Krabbe, P F M

2017-05-15

Expanding vaccination programs for the older population might be important as older adults are becoming a larger proportion of the general population. The aim of this study is to determine the relative importance of vaccine and disease specific characteristics and acceptance for Dutch older adults, including pneumococcal disease, herpes zoster, pertussis vaccination, and influenza vaccination. A discrete choice experiment was conducted to generate choice data that was analyzed using a mixed multinomial logit statistical model. Important factors that were associated with vaccination acceptance in older adults are high mortality risk of the infectious disease, high susceptibility of getting the infectious disease, and high vaccine effectiveness. Age, influenza vaccination in 2013 and self-perceived health score were identified as personal factors that affect vaccine preference. Potential vaccination rates of older adults were estimated at 68.1% for pneumococcal vaccination, 58.1% for herpes zoster vaccination, 53.9% for pertussis vaccination and 54.3% for influenza vaccination. For persons aged 50-65, potential vaccination rates were estimated at 58.1% for pneumococcal vaccination, 49.5% for herpes zoster vaccination, 43.9% for pertussis vaccination and 42.2% for influenza vaccination. For persons aged 65 and older, these were respectively 76.2%, 67.5%, 57.5% and 65.5%. Our results suggest that older adults are most likely to accept pneumococcal vaccination of the four vaccines. Information provision accompanied with the implementation of a new vaccine has to be tailored for the individual and the vaccine it concerns. Special attention is needed to ensure high uptake among persons aged 50-65years. Copyright © 2017 Elsevier Ltd. All rights reserved.

Subsidies and the Demand for Individual Health Insurance in California

PubMed Central

Susan Marquis, M; Buntin, Melinda Beeuwkes; Escarce, José J; Kapur, Kanika; Yegian, Jill M

2004-01-01

Objective To estimate the effect of changes in premiums for individual insurance on decisions to purchase individual insurance and how this price response varies among subgroups of the population. Data Source Survey responses from the Current Population Survey (), the Survey of Income and Program Participation (), the National Health Interview Survey (), and data about premiums and plans offered in the individual insurance market in California, 1996–2001. Study Design A logit model was used to estimate the decisions to purchase individual insurance by families without access to group insurance. This was modeled as a function of premiums, controlling for family characteristics and other characteristics of the market. A multinomial model was used to estimate the choice between group coverage, individual coverage, and remaining uninsured for workers offered group coverage as a function of premiums for individual insurance and out-of-pocket costs of group coverage. Principal Findings The elasticity of demand for individual insurance by those without access to group insurance is about −.2 to −.4, as has been found in earlier studies. However, there are substantial differences in price responses among subgroups with low-income, young, and self-employed families showing the greatest response. Among workers offered group insurance, a decrease in individual premiums has very small effects on the choice to purchase individual coverage versus group coverage. Conclusions Subsidy programs may make insurance more affordable for some families, but even sizeable subsidies are unlikely to solve the problem of the uninsured. We do not find evidence that subsidies to individual insurance will produce an unraveling of the employer-based health insurance system. PMID:15333122

The emotional and practical experiences of formula-feeding mothers.

PubMed

Fallon, Victoria; Komninou, Sophia; Bennett, Kate M; Halford, Jason C G; Harrold, Joanne A

2017-10-01

The majority of infant-feeding research is focused on identifying mother's reasons for the cessation of breastfeeding. The experience of mothers who choose to use formula is largely overlooked in quantitative designs. This study aimed to describe the emotional and practical experiences of mothers who formula feed in any quantity, and examine whether these experiences would vary among different cohorts of formula-feeding mothers according to prenatal feeding intention and postnatal feeding method. A total of 890 mothers of infants up to 26 weeks of age, who were currently formula feeding in any quantity, were recruited through relevant international social media sites via advertisements providing a link to an online survey. Predictors of emotional experiences included guilt, stigma, satisfaction, and defense as a result of their infant feeding choices. Practical predictor variables included support received from health professionals, respect displayed by their everyday environment, and main sources of infant feeding information. Descriptive findings from the overall sample highlighted a worryingly high percentage of mother's experienced negative emotions as a result of their decision to use formula. Multinomial logit models revealed that negative emotions such as guilt, dissatisfaction, and stigma were directly associated with feeding intention and method. The evidence suggests that the current approach to infant-feeding promotion and support may be paradoxically related to significant issues with emotional well-being. These findings support criticisms of how infant-feeding recommendations are framed by health care professionals and policy makers, and highlight a need to address formula feeding in a more balanced, woman-centered manner. © 2016 John Wiley & Sons Ltd.

Farmers' Options to Address Water Scarcity in a Changing Climate: Case Studies from two Basins in Mediterranean Chile

NASA Astrophysics Data System (ADS)

Roco, Lisandro; Poblete, David; Meza, Francisco; Kerrigan, George

2016-12-01

Irrigated agriculture in Mediterranean areas faces tremendous challenges because of its exposure to hydroclimatic variability, increasing competition for water from different sectors, and the possibility of a climatic change. In this context, efficient management of water resources emerges as a critical issue. This requires the adoption of technological innovations, investment in infrastructure, adequate institutional arrangements, and informed decision makers. To understand farmers' perceptions and their implementation of climate change adaptation strategies with regards to water management, primary information was captured in the Limarí and Maule river basins in Chile. Farmers identified stressors for agriculture; climate change, droughts, and lack of water appeared as the most relevant stressors compared to others productive, economic, and institutional factors; revealing a rising relevance of climate related factors. While most producers perceived climate changes in recent years (92.9 %), a significant proportion (61.1 %) claim to have experienced drought, whereas only a fraction (31.9 %) have implemented a strategy to deal with this situation. Identified actions were classified in four groups: investments for water accumulation, modernization of irrigation systems, rationalization of water use, and partnership activities. Using a multinomial logit model these strategies were related to socioeconomic and productive characteristics. Results show that gender and farm size are relevant for investments, implementation and improvement of irrigation systems. For all the strategies described, access to weather information was a relevant element. The study provides empirical evidence of a recent increase in the importance assigned to climate factors by producers and adaptation options that can be supported by agricultural policy.

Counseling during Maternal and Infant Health Visits and Postpartum Contraceptive use in Uttar Pradesh, India

PubMed Central

Rajan, Sowmya; Speizer, Ilene S.; Calhoun, Lisa M.; Nanda, Priya

2017-01-01

Context Postpartum family planning is a compelling concern of global significance due to its salience to unplanned pregnancies, and to maternal and infant health in developing countries. Yet, women face the highest level of unmet need for contraception in the year following a birth. A cost-effective way to inform women about their risk of becoming pregnant after the birth of a child is to integrate family planning counseling and services with maternal and infant health services. Methods We use recently collected survey data from 2733 women from six cities in Uttar Pradesh, India who had a recent birth (since 2011) to examine the role of exposure to family planning information at maternal and infant health visits on (1) any contraceptive use in the postpartum period, and (2) choice of modern method in the postpartum period. We use discrete-time event history multinomial logit models to examine the duration to contraceptive use, and choice of modern method, in the 12 months following the last birth since 2011. Results We find that receiving counseling in an institution at the time of delivery has the strongest influence on women’s subsequent uptake of modern contraception (female sterilization and IUD). Being visited by a CHW in the extended postpartum period was also strongly associated with subsequent uptake of modern contraception (IUD, condom and hormonal contraception). Conclusion Providing postpartum family planning counseling at key junctures during maternal health visits has the potential to increase uptake of modern contraceptive method in urban Uttar Pradesh. PMID:28649295

Logit-normal mixed model for Indian monsoon precipitation

NASA Astrophysics Data System (ADS)

Dietz, L. R.; Chatterjee, S.

2014-09-01

Describing the nature and variability of Indian monsoon precipitation is a topic of much debate in the current literature. We suggest the use of a generalized linear mixed model (GLMM), specifically, the logit-normal mixed model, to describe the underlying structure of this complex climatic event. Four GLMM algorithms are described and simulations are performed to vet these algorithms before applying them to the Indian precipitation data. The logit-normal model was applied to light, moderate, and extreme rainfall. Findings indicated that physical constructs were preserved by the models, and random effects were significant in many cases. We also found GLMM estimation methods were sensitive to tuning parameters and assumptions and therefore, recommend use of multiple methods in applications. This work provides a novel use of GLMM and promotes its addition to the gamut of tools for analysis in studying climate phenomena.

Expenditures on family dental care by active duty soldiers.

PubMed

Chisick, M C

1996-01-01

Expenditures on family dental care by U.S. active duty soldiers were explored in this 1992 worldwide survey. Of 9,560 respondents (62% response rate), 7,187 claimed dependents and 5,569 provided reliable data. Mean annual expenditures and multinomial regression on a distribution of expenditures were calculated. Results show average family dental care expenditures were as follows: total sample, $135; childless couples, $59; couples with children, $154; and single parents, $120. Between 72 and 83% of families spent $0 on dental care. Excluding non-spenders, overall expenditures averaged as follows: total sample, $531; childless couples, $354; couples with children, $560; and single parents, $470. Regression results show that expenditures on family dental care by soldiers are influenced by different factors depending on family composition. Policy measures to encourage optimal dental care by families of active duty soldiers should focus on increasing insurance coverage and use.

Work performance decrements are associated with Australian working conditions, particularly the demand to work longer hours.

PubMed

Holden, Libby; Scuffham, Paul A; Hilton, Michael F; Vecchio, Nerina N; Whiteford, Harvey A

2010-03-01

To demonstrate the importance of including a range of working conditions in models exploring the association between health- and work-related performance. The Australian Work Outcomes Research Cost-benefit study cross-sectional screening data set was used to explore health-related absenteeism and work performance losses on a sample of approximately 78,000 working Australians, including available demographic and working condition factors. Data collected using the World Health Organization Health and Productivity Questionnaire were analyzed with negative binomial logistic regression and multinomial logistic regressions for absenteeism and work performance, respectively. Hours expected to work, annual wage, and job insecurity play a vital role in the association between health- and work-related performance for both work attendance and self-reported work performance. Australian working conditions are contributing to both absenteeism and low work performance, regardless of health status.

Husband/Partner Intoxication and Intimate Partner Violence Against Women in the Philippines.

PubMed

Kerridge, Bradley T; Tran, Phu

2016-09-01

This study examined husband/partner intoxication and experience with physical, sexual, and emotional intimate partner violence against women (IPVAW) using data derived from a nationally representative survey conducted in the Philippines in 2013. Multivariate logistic regression analyses were used to examine the association between intoxication and 3 different types of intimate partner violence against women. Multinomial logistic regression was used to examine intoxication and severity of violence. In this sample, 28.8% of women reported experiencing any form of intimate partner violence and 92.9% of women reported their partner being intoxicated at least sometimes. Intoxication was significantly associated with all 3 types of intimate partner violence, while the odds of experiencing one form of IPVAW versus no form of IPVAW and 2 forms of IPVAW versus 1 form of IPVAW was greater among women reporting frequency of husband/partner intoxication as often. © 2016 APJPH.

Consistency in reporting condom use between husbands and wives in Bangladesh.

PubMed

Islam, Mohammad Amirul; Padmadas, Sabu S; Smith, Peter W F

2010-07-01

Consistency in reporting contraceptive use between spouses is little understood, especially in developing settings. This research challenges the accuracy of measuring contraceptive prevalence rate, which is traditionally calculated based on women's responses. Multinomial logistic regression techniques are employed on a couple dataset from the 1999-2000 Bangladesh Demographic and Health Survey (DHS) to investigate the consistency in reporting condom use between husbands and wives. The level of inconsistency in reporting condom use was about 46%, of which about 32% was explained by husbands reporting condom use while wives did not, and 14% by wives reporting condom use while husbands did not. Regression analysis showed that couple education and age difference between the spouses are significant determinants of inconsistent reporting behaviour. The findings suggest the need for alternative approaches (questions) in the DHS to ensure consistency in the collection of data related to use of family planning methods.

Perceived health status and daily activity participation of older Malaysians.

PubMed

Ng, Sor Tho; Tengku-Aizan, Hamid; Tey, Nai Peng

2011-07-01

This article investigates the influence of perceived health status on the daily activity participation of older Malaysians. Data from the Survey on Perceptions of Needs and Problems of the Elderly, which was conducted in 1999, were used. The negative binomial regression results show that older persons with good perceived health status reported more varieties of daily activity participation, especially among the uneducated and those with below-average self-esteem. The multinomial logistic regression model suggests that older persons with good perceived health status tended to engage daily in paid work only or with leisure activities, whereas those perceived to have poor health were more likely to engage in leisure activities only or leisure and family role activities. Promotion of a healthy lifestyle at a younger age encourages every person to monitor and take responsibility for their own health, which is a necessary strategy to ensure active participation at an older age, and thus improve their well-being.

Using a metal detector to determine lead sinker abundance in waterbird habitat

USGS Publications Warehouse

Duerr, A.E.; DeStefano, S.

2000-01-01

Waterbirds have died of lead poisoning from ingesting lead fishing sinkers in the United States and Europe. Estimating abundance and distribution of sinkers in the environment will help researchers to understand the potential effects of lead poisoning from sinker ingestion. We used a metal detector to test how environmental conditions and sinker characteristics affected detection of sinkers. Odds of detecting a lead sinker depended on the interaction of sinker mass and depth where it was buried (P=0.002). The odds of detecting a sinker increased with mass and decreased with depth buried. Lead split-shot sinkers were less detectable than tin, brass, and stainless steel sinkers. Detecting lead sinkers was not influenced by sinker shape, substrate type, or whether we searched underwater or on land. We developed a model to determine the proportion of sinkers detected when this detector is used to search for sinkers, so sinker abundance can be estimated. The log odds (Logit) of detecting a lead sinker with mass M g buried D cm below the surface was Logit Y= -1.63 + 4.20 M - 0.45 D - 0.27 MD + 0.0002 D2. The probability of detecting a lead sinker was e(Logit Y)/(1 + e(Logit Y)). At the surface, 90% of sinkers with mass 0.9 g will be detected.

Radiomorphometric analysis of frontal sinus for sex determination.

PubMed

Verma, Saumya; Mahima, V G; Patil, Karthikeya

2014-09-01

Sex determination of unknown individuals carries crucial significance in forensic research, in cases where fragments of skull persist with no likelihood of identification based on dental arch. In these instances sex determination becomes important to rule out certain number of possibilities instantly and helps in establishing a biological profile of human remains. The aim of the study is to evaluate a mathematical method based on logistic regression analysis capable of ascertaining the sex of individuals in the South Indian population. The study was conducted in the department of Oral Medicine and Radiology. The right and left areas, maximum height, width of frontal sinus were determined in 100 Caldwell views of 50 women and 50 men aged 20 years and above, with the help of Vernier callipers and a square grid with 1 square measuring 1mm(2) in area. Student's t-test, logistic regression analysis. The mean values of variables were greater in men, based on Student's t-test at 5% level of significance. The mathematical model based on logistic regression analysis gave percentage agreement of total area to correctly predict the female gender as 55.2%, of right area as 60.9% and of left area as 55.2%. The areas of the frontal sinus and the logistic regression proved to be unreliable in sex determination. (Logit = 0.924 - 0.00217 × right area).

Flexible link functions in nonparametric binary regression with Gaussian process priors.

PubMed

Li, Dan; Wang, Xia; Lin, Lizhen; Dey, Dipak K

2016-09-01

In many scientific fields, it is a common practice to collect a sequence of 0-1 binary responses from a subject across time, space, or a collection of covariates. Researchers are interested in finding out how the expected binary outcome is related to covariates, and aim at better prediction in the future 0-1 outcomes. Gaussian processes have been widely used to model nonlinear systems; in particular to model the latent structure in a binary regression model allowing nonlinear functional relationship between covariates and the expectation of binary outcomes. A critical issue in modeling binary response data is the appropriate choice of link functions. Commonly adopted link functions such as probit or logit links have fixed skewness and lack the flexibility to allow the data to determine the degree of the skewness. To address this limitation, we propose a flexible binary regression model which combines a generalized extreme value link function with a Gaussian process prior on the latent structure. Bayesian computation is employed in model estimation. Posterior consistency of the resulting posterior distribution is demonstrated. The flexibility and gains of the proposed model are illustrated through detailed simulation studies and two real data examples. Empirical results show that the proposed model outperforms a set of alternative models, which only have either a Gaussian process prior on the latent regression function or a Dirichlet prior on the link function. © 2015, The International Biometric Society.

Flexible Link Functions in Nonparametric Binary Regression with Gaussian Process Priors

PubMed Central

Li, Dan; Lin, Lizhen; Dey, Dipak K.

2015-01-01

Summary In many scientific fields, it is a common practice to collect a sequence of 0-1 binary responses from a subject across time, space, or a collection of covariates. Researchers are interested in finding out how the expected binary outcome is related to covariates, and aim at better prediction in the future 0-1 outcomes. Gaussian processes have been widely used to model nonlinear systems; in particular to model the latent structure in a binary regression model allowing nonlinear functional relationship between covariates and the expectation of binary outcomes. A critical issue in modeling binary response data is the appropriate choice of link functions. Commonly adopted link functions such as probit or logit links have fixed skewness and lack the flexibility to allow the data to determine the degree of the skewness. To address this limitation, we propose a flexible binary regression model which combines a generalized extreme value link function with a Gaussian process prior on the latent structure. Bayesian computation is employed in model estimation. Posterior consistency of the resulting posterior distribution is demonstrated. The flexibility and gains of the proposed model are illustrated through detailed simulation studies and two real data examples. Empirical results show that the proposed model outperforms a set of alternative models, which only have either a Gaussian process prior on the latent regression function or a Dirichlet prior on the link function. PMID:26686333

Social factors, weight perception, and weight control practices among adolescents in Mexico.

PubMed

Bojorquez, Ietza; Villatoro, Jorge; Delgadillo, Marlene; Fleiz, Clara; Fregoso, Diana; Unikel, Claudia

2018-06-01

We evaluated the association of social factors and weight control practices in adolescents, and the mediation of this association by weight perception, in a national survey of students in Mexico ( n = 28,266). We employed multinomial and Poisson regression models and Sobel's test to assess mediation. Students whose mothers had a higher level of education were more likely to perceive themselves as overweight and also to engage in weight control practices. After adjusting for body weight perception, the effect of maternal education on weight control practices remained significant. Mediation tests were significant for boys and non-significant for girls.

The outcome of tuberculosis treatment in subjects with chronic kidney disease in Brazil: a multinomial analysis*

PubMed Central

Reis-Santos, Barbara; Gomes, Teresa; Horta, Bernardo Lessa; Maciel, Ethel Leonor Noia

2013-01-01

OBJECTIVE: To analyze the association between clinical/epidemiological characteristics and outcomes of tuberculosis treatment in patients with concomitant tuberculosis and chronic kidney disease (CKD) in Brazil. METHODS: We used the Brazilian Ministry of Health National Case Registry Database to identify patients with tuberculosis and CKD, treated between 2007 and 2011. The tuberculosis treatment outcomes were compared with epidemiological and clinical characteristics of the subjects using a hierarchical multinomial logistic regression model, in which cure was the reference outcome. RESULTS: The prevalence of CKD among patients with tuberculosis was 0.4% (95% CI: 0.37-0.42%). The sample comprised 1,077 subjects. The outcomes were cure, in 58%; treatment abandonment, in 7%; death from tuberculosis, in 13%; and death from other causes, in 22%. The characteristics that differentiated the ORs for treatment abandonment or death were age; alcoholism; AIDS; previous noncompliance with treatment; transfer to another facility; suspected tuberculosis on chest X-ray; positive results in the first smear microscopy; and indications for/use of directly observed treatment, short-course strategy. CONCLUSIONS: Our data indicate the importance of sociodemographic characteristics for the diagnosis of tuberculosis in patients with CKD and underscore the need for tuberculosis control strategies targeting patients with chronic noncommunicable diseases, such as CKD. PMID:24310632

Mathematical models application for mapping soils spatial distribution on the example of the farm from the North of Udmurt Republic of Russia

NASA Astrophysics Data System (ADS)

Dokuchaev, P. M.; Meshalkina, J. L.; Yaroslavtsev, A. M.

2018-01-01

Comparative analysis of soils geospatial modeling using multinomial logistic regression, decision trees, random forest, regression trees and support vector machines algorithms was conducted. The visual interpretation of the digital maps obtained and their comparison with the existing map, as well as the quantitative assessment of the individual soil groups detection overall accuracy and of the models kappa showed that multiple logistic regression, support vector method, and random forest models application with spatial prediction of the conditional soil groups distribution can be reliably used for mapping of the study area. It has shown the most accurate detection for sod-podzolics soils (Phaeozems Albic) lightly eroded and moderately eroded soils. In second place, according to the mean overall accuracy of the prediction, there are sod-podzolics soils - non-eroded and warp one, as well as sod-gley soils (Umbrisols Gleyic) and alluvial soils (Fluvisols Dystric, Umbric). Heavy eroded sod-podzolics and gray forest soils (Phaeozems Albic) were detected by methods of automatic classification worst of all.

Logit-normal mixed model for Indian Monsoon rainfall extremes

NASA Astrophysics Data System (ADS)

Dietz, L. R.; Chatterjee, S.

2014-03-01

Describing the nature and variability of Indian monsoon rainfall extremes is a topic of much debate in the current literature. We suggest the use of a generalized linear mixed model (GLMM), specifically, the logit-normal mixed model, to describe the underlying structure of this complex climatic event. Several GLMM algorithms are described and simulations are performed to vet these algorithms before applying them to the Indian precipitation data procured from the National Climatic Data Center. The logit-normal model was applied with fixed covariates of latitude, longitude, elevation, daily minimum and maximum temperatures with a random intercept by weather station. In general, the estimation methods concurred in their suggestion of a relationship between the El Niño Southern Oscillation (ENSO) and extreme rainfall variability estimates. This work provides a valuable starting point for extending GLMM to incorporate the intricate dependencies in extreme climate events.

Strategies for controlling item exposure in computerized adaptive testing with the partial credit model.

PubMed

Davis, Laurie Laughlin; Dodd, Barbara G

2008-01-01

Exposure control research with polytomous item pools has determined that randomization procedures can be very effective for controlling test security in computerized adaptive testing (CAT). The current study investigated the performance of four procedures for controlling item exposure in a CAT under the partial credit model. In addition to a no exposure control baseline condition, the Kingsbury-Zara, modified-within-.10-logits, Sympson-Hetter, and conditional Sympson-Hetter procedures were implemented to control exposure rates. The Kingsbury-Zara and the modified-within-.10-logits procedures were implemented with 3 and 6 item candidate conditions. The results show that the Kingsbury-Zara and modified-within-.10-logits procedures with 6 item candidates performed as well as the conditional Sympson-Hetter in terms of exposure rates, overlap rates, and pool utilization. These two procedures are strongly recommended for use with partial credit CATs due to their simplicity and strength of their results.

Intrafirm planning and mathematical modeling of owner's equity in industrial enterprises

NASA Astrophysics Data System (ADS)

Ponomareva, S. V.; Zheleznova, I. V.

2018-05-01

The article aims to review the different approaches to intrafirm planning of owner's equity in industrial enterprises. Since charter capital, additional capital and reserve capital do not change in the process of enterprise activity, the main interest lies on the field of share repurchases from shareholders and retained earnings within the owner's equity of the enterprise. In order to study the effect of share repurchases on the activities of the enterprise, let us use such mathematical methods as event study and econometric modeling. This article describes the step-by-step algorithm of carrying out event study and justifies the choice of Logit model in econometric analysis. The article represents basic results of conducted regression analysis on the effect of share repurchases on the key financial indicators in industrial enterprises.

The effect of consumers’ perception to the satisfaction of use of traditional medicines in Medan

NASA Astrophysics Data System (ADS)

Siregar, R. S.; Supriana, T.; Haryanti, S.

2018-02-01

Consumption of chemical medicines fluctuated in 2009-2014, whereas the consumption of solid traditional medicine increased in 2009-2014. The purpose of this study is to analyse the influence of consumers’s perception on the consumption of traditional medicinal plants. The data was analysed by using a binomial logit regression analysis. It is found that the consumers’s perceptions affect customer satisfaction simultaneously are the health benefits variable, quality of traditional medicine variable, price of traditional medicine and available product; the health benefits variable and quality of traditional medicine variable partially have significant effects to customers’s satisfaction simultaneously satisfaction partially; the health benefit variable and quality of traditional medicine is found to have a marginal effect of 7% and 4%, respectively.

Insights into the latent multinomial model through mark-resight data on female grizzly bears with cubs-of-the-year

USGS Publications Warehouse

Higgs, Megan D.; Link, William; White, Gary C.; Haroldson, Mark A.; Bjornlie, Daniel D.

2013-01-01

Mark-resight designs for estimation of population abundance are common and attractive to researchers. However, inference from such designs is very limited when faced with sparse data, either from a low number of marked animals, a low probability of detection, or both. In the Greater Yellowstone Ecosystem, yearly mark-resight data are collected for female grizzly bears with cubs-of-the-year (FCOY), and inference suffers from both limitations. To overcome difficulties due to sparseness, we assume homogeneity in sighting probabilities over 16 years of bi-annual aerial surveys. We model counts of marked and unmarked animals as multinomial random variables, using the capture frequencies of marked animals for inference about the latent multinomial frequencies for unmarked animals. We discuss undesirable behavior of the commonly used discrete uniform prior distribution on the population size parameter and provide OpenBUGS code for fitting such models. The application provides valuable insights into subtleties of implementing Bayesian inference for latent multinomial models. We tie the discussion to our application, though the insights are broadly useful for applications of the latent multinomial model.

Development and validation of a mortality risk model for pediatric sepsis.

PubMed

Chen, Mengshi; Lu, Xiulan; Hu, Li; Liu, Pingping; Zhao, Wenjiao; Yan, Haipeng; Tang, Liang; Zhu, Yimin; Xiao, Zhenghui; Chen, Lizhang; Tan, Hongzhuan

2017-05-01

Pediatric sepsis is a burdensome public health problem. Assessing the mortality risk of pediatric sepsis patients, offering effective treatment guidance, and improving prognosis to reduce mortality rates, are crucial.We extracted data derived from electronic medical records of pediatric sepsis patients that were collected during the first 24 hours after admission to the pediatric intensive care unit (PICU) of the Hunan Children's hospital from January 2012 to June 2014. A total of 788 children were randomly divided into a training (592, 75%) and validation group (196, 25%). The risk factors for mortality among these patients were identified by conducting multivariate logistic regression in the training group. Based on the established logistic regression equation, the logit probabilities for all patients (in both groups) were calculated to verify the model's internal and external validities.According to the training group, 6 variables (brain natriuretic peptide, albumin, total bilirubin, D-dimer, lactate levels, and mechanical ventilation in 24 hours) were included in the final logistic regression model. The areas under the curves of the model were 0.854 (0.826, 0.881) and 0.844 (0.816, 0.873) in the training and validation groups, respectively.The Mortality Risk Model for Pediatric Sepsis we established in this study showed acceptable accuracy to predict the mortality risk in pediatric sepsis patients.

Development and validation of a mortality risk model for pediatric sepsis

PubMed Central

Chen, Mengshi; Lu, Xiulan; Hu, Li; Liu, Pingping; Zhao, Wenjiao; Yan, Haipeng; Tang, Liang; Zhu, Yimin; Xiao, Zhenghui; Chen, Lizhang; Tan, Hongzhuan

2017-01-01

Abstract Pediatric sepsis is a burdensome public health problem. Assessing the mortality risk of pediatric sepsis patients, offering effective treatment guidance, and improving prognosis to reduce mortality rates, are crucial. We extracted data derived from electronic medical records of pediatric sepsis patients that were collected during the first 24 hours after admission to the pediatric intensive care unit (PICU) of the Hunan Children's hospital from January 2012 to June 2014. A total of 788 children were randomly divided into a training (592, 75%) and validation group (196, 25%). The risk factors for mortality among these patients were identified by conducting multivariate logistic regression in the training group. Based on the established logistic regression equation, the logit probabilities for all patients (in both groups) were calculated to verify the model's internal and external validities. According to the training group, 6 variables (brain natriuretic peptide, albumin, total bilirubin, D-dimer, lactate levels, and mechanical ventilation in 24 hours) were included in the final logistic regression model. The areas under the curves of the model were 0.854 (0.826, 0.881) and 0.844 (0.816, 0.873) in the training and validation groups, respectively. The Mortality Risk Model for Pediatric Sepsis we established in this study showed acceptable accuracy to predict the mortality risk in pediatric sepsis patients. PMID:28514310

Burden and predictors of Staphylococcus aureus and S. pseudintermedius infections among dogs presented at an academic veterinary hospital in South Africa (2007–2012)

PubMed Central

Oguttu, James Wabwire; Sithole, Fortune

2017-01-01

Background Staphylococci are commensals of the mucosal surface and skin of humans and animals, but have been implicated in infections such as otitis externa, pyoderma, urinary tract infections and post-surgical complications. Laboratory records provide useful information to help investigate these infections. Therefore, the objective of this study was to investigate the burdens of these infections and use multinomial regression to examine the associations between various Staphylococcus infections and demographic and temporal factors among dogs admitted to an academic veterinary hospital in South Africa. Methods Records of 1,497 clinical canine samples submitted to the bacteriology laboratory at a veterinary academic hospital between 2007 and 2012 were included in this study. Proportions of staphylococcal positive samples were calculated, and a multinomial logistic regression model was used to identify predictors of staphylococcal infections. Results Twenty-seven percent of the samples tested positive for Staphylococcus spp. The species of Staphylococcus identified were S. pseudintermedius (19.0%), S. aureus (3.8%), S. epidermidis (0.7%) and S. felis (0.1%). The remaining 2.87% consisted of unspeciated Staphylococcus. Distribution of the species by age of dog showed that S. pseudintermedius was the most common (25.6%) in dogs aged 2–4 years while S. aureus was most frequent (6.3%) in dogs aged 5–6 years. S. pseudintermedius (34.1%) and S. aureus (35.1%) were the most frequently isolated species from skin samples. The results of the multivariable multinomial logistic regression model identified specimen, year and age of the dog as significant predictors of the risk of infection with Staphylococcus. There was a significant temporal increase (RRR = 1.17; 95% CI [1.06–1.29]) in the likelihood of a dog testing positive for S. pseudintermedius compared to testing negative. Dogs ≤ 8 years of age were significantly more likely to test positive for S. aureus than those >8 years of age. Similarly, dogs between 2–8 years of age were significantly more likely to test positive for S. pseudintermedius than those >8 years of age. In addition, dogs 2–4 years of age (RRR = 1.83; 1.09–3.06) were significantly more likely to test positive for S. pseudintermedius compared to those <2 years of age. The risk of infection with S. pseudintermedius or S. aureus was significantly higher in ear canal and skin specimens compared to other specimens. Conclusions The findings suggest that S. pseudintermedius and S. aureus were the most commonly isolated species from dogs presented at the study hospital. Age of the dog and the location of infection were significant predictors of infection with both Staphylococcus species investigated. Significant increasing temporal trend was observed for S. pseudintermedius but not S. aureus. This information is useful for guiding clinical decisions as well as future research. PMID:28417060

Safety performance of traffic phases and phase transitions in three phase traffic theory.

PubMed

Xu, Chengcheng; Liu, Pan; Wang, Wei; Li, Zhibin

2015-12-01

Crash risk prediction models were developed to link safety to various phases and phase transitions defined by the three phase traffic theory. Results of the Bayesian conditional logit analysis showed that different traffic states differed distinctly with respect to safety performance. The random-parameter logit approach was utilized to account for the heterogeneity caused by unobserved factors. The Bayesian inference approach based on the Markov Chain Monte Carlo (MCMC) method was used for the estimation of the random-parameter logit model. The proposed approach increased the prediction performance of the crash risk models as compared with the conventional logit model. The three phase traffic theory can help us better understand the mechanism of crash occurrences in various traffic states. The contributing factors to crash likelihood can be well explained by the mechanism of phase transitions. We further discovered that the free flow state can be divided into two sub-phases on the basis of safety performance, including a true free flow state in which the interactions between vehicles are minor, and a platooned traffic state in which bunched vehicles travel in successions. The results of this study suggest that a safety perspective can be added to the three phase traffic theory. The results also suggest that the heterogeneity between different traffic states should be considered when estimating the risks of crash occurrences on freeways. Copyright © 2015 Elsevier Ltd. All rights reserved.

Changes in cigarette prices, affordability, and brand-tier consumption after a tobacco tax increase in Thailand: Evidence from the Global Adult Tobacco Surveys, 2009 and 2011

PubMed Central

Husain, Muhammad Jami; Kostova, Deliana; Mbulo, Lazarous; Benjakul, Sarunya; Kengganpanich, Mondha; Andes, Linda

2017-01-01

Despite the 2009 implementation of a tobacco tax increase in Thailand, smoking rates remained unchanged between 2009 and 2011. Prior evidence has linked cigarette tax increases to compensatory behaviours aimed at lowering the cost of smoking, such as switching to lower-priced cigarette brands. Using data from 2009 and 2011 Global Adult Tobacco Surveys in Thailand, we estimated unadjusted changes in cigarette prices paid, cigarette affordability, and consumption of cigarettes in three price categories classified as upper-, middle-, and lower-priced brand tiers (or price tertiles). We used ordered logit regression to analyse the correlates of price-tier choice and to estimate the change in price-tier consumption adjusted for demographic and region characteristics. Between 2009 and 2011, real cigarette prices increased, but the affordability of cigarettes remained unchanged overall. There was a significant reduction in the consumption of cigarette brands in the top price-tier overall, accompanied by increases in the consumption of brands in the bottom and middle price-tiers, depending on the region. Adjusted estimates from the logit models indicate that, on average, the proportion of smokers selecting brands from upper- and middle price-tiers decreased while consumption of lower price-tier brands increased during the study period. The estimated shifts in consumption from more expensive to less expensive cigarette brands and the overall lack of change in cigarette affordability in Thailand between 2009 and 2011 are both factors that may have contributed to the observed lack of change in smoking rates after the 2009 tax increase. PMID:28579499

Getting the right balance? A mixed logit analysis of the relationship between UK training doctors’ characteristics and their specialties using the 2013 National Training Survey

PubMed Central

Chalkley, Martin

2017-01-01

Objective To analyse how training doctors’ demographic and socioeconomic characteristics vary according to the specialty that they are training for. Design Descriptive statistics and mixed logistic regression analysis of cross-sectional survey data to quantify evidence of systematic relationships between doctors’ characteristics and their specialty. Setting Doctors in training in the United Kingdom in 2013. Participants 27 530 doctors in training but not in their foundation year who responded to the National Training Survey 2013. Main outcome measures Mixed logit regression estimates and the corresponding odds ratios (calculated separately for all doctors in training and a subsample comprising those educated in the UK), relating gender, age, ethnicity, place of studies, socioeconomic background and parental education to the probability of training for a particular specialty. Results Being female and being white British increase the chances of being in general practice with respect to any other specialty, while coming from a better-off socioeconomic background and having parents with tertiary education have the opposite effect. Mixed results are found for age and place of studies. For example, the difference between men and women is greatest for surgical specialties for which a man is 12.121 times more likely to be training to a surgical specialty (relative to general practice) than a woman (p-value<0.01). Doctors who attended an independent school which is proxy for doctor’s socioeconomic background are 1.789 and 1.413 times more likely to be training for surgical or medical specialties (relative to general practice) than those who attended a state school (p-value<0.01). Conclusions There are systematic and substantial differences between specialties in respect of training doctors’ gender, ethnicity, age and socioeconomic background. The persistent underrepresentation in some specialties of women, minority ethnic groups and of those coming from disadvantaged backgrounds will impact on the representativeness of the profession into the future. Further research is needed to understand how the processes of selection and the self-selection of applicants into specialties gives rise to these observed differences. PMID:28801397

Depressive symptoms are associated with salivary shedding of Epstein-Barr virus in female adolescents: The role of sex differences.

PubMed

Ford, Jodi L; Stowe, Raymond P

2017-12-01

Adolescent females have a higher prevalence of depression in comparison to their male peers - a disparity that has been increasing over the past decade. Depression is of concern as it is associated with chronic disease and to immune dysregulation, which may be one mechanism linking depression to future pathology. This study examined the extent to which sex moderated the association between depressive symptoms and immune dysregulation during adolescence using Epstein-Barr virus (EBV) reactivation, a biomarker of cellular immune response, as a model. A representative community sample of 259 female and 279 male adolescents aged 11-17 years who were EBV IgG positive were examined. Trained interviewers collected the data during two home visits, one week apart. Depressive symptoms were measured at the first visit using the 9 item short-form of the Center for Epidemiologic Studies-Depression scale. EBV biomarkers were collected via saliva at the second visit and included a qualitative measure of EBV viral capsid antigen immunoglobulin G to assess prior EBV infection and a quantitative measure of EBV DNA to assess the number of viral copies shed in the saliva. In multivariable logistic regression analyses, increasing depressive symptoms were significantly associated with salivary shedding of EBV DNA for adolescent females only (logit=0.66, se=0.30, p<0.05), and the interaction between sex and depressive symptoms on salivary shedding of EBV DNA was statistically significant (logit=-1.19, se=0.42, p<0.01). Sensitivity analyses were conducted in which sex was examined as a moderator in the relationship between depressive symptoms and salivary EBV DNA quantitative copies via Tobit regression; results were consistent with the presented findings. Depressive symptoms are associated with EBV reactivation among EBV positive female adolescents, but not males. Future research is needed to examine EBV reactivation in female adolescents as a mechanism linking depression to future chronic disease and the role of sex hormones in explaining sex differences in the relationship between depressive symptoms and EBV reactivation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Alcohol use among university students: Considering a positive deviance approach.

PubMed

Tucker, Maryanne; Harris, Gregory E

2016-09-01

Harmful alcohol consumption among university students continues to be a significant issue. This study examined whether variables identified in the positive deviance literature would predict responsible alcohol consumption among university students. Surveyed students were categorized into three groups: abstainers, responsible drinkers and binge drinkers. Multinomial logistic regression modelling was significant (χ(2) = 274.49, degrees of freedom = 24, p < .001), with several variables predicting group membership. While the model classification accuracy rate (i.e. 71.2%) exceeded the proportional by chance accuracy rate (i.e. 38.4%), providing further support for the model, the model itself best predicted binge drinker membership over the other two groups. © The Author(s) 2015.

A Typology of Violence against Self and Others and Its Associations with Drinking and Other Drug Use among High School Students in a U.S. General Population Survey

PubMed Central

Harford, Thomas C.; Yi, Hsiao-ye; Freeman, Robert C.

2015-01-01

This study examined associations between binge drinking and other substance use and perpetration of violence against self and others. Data were pooled from the 2003, 2005, and was constructed to reflect four categories of behaviors: other-directed violence only, self-directed violence only, combined other- and self-directed violence, and no violence. Results from multinomial logistic regressions show that the frequency of binge drinking and other substance use were significant risk factors for each of the violence categories relative to no-violence. However, the strengths of these associations varied across the violence categories. PMID:26478688

Dietary and exercise change following acute cardiac syndrome onset: A latent class growth modelling analysis.

PubMed

Bennett, Paul; Gruszczynska, Ewa; Marke, Victoria

2016-10-01

The present study aim determine sub-group trajectories of change on measures of diet and exercise following acute coronary syndrome. 150 participants were assessed in hospital, 1 month and 6 months subsequently on measures including physical activity, diet, illness beliefs, coping and mood. Change trajectories were measured using latent class growth modelling. Multinomial logistic regression was used to predict class membership. These analyses revealed changes in exercise were confined to a sub-group of participants already reporting relatively high exercise levels; those eating less healthily evidenced modest dietary improvements. Coping, gender, depression and perceived control predicted group membership to a modest degree. © The Author(s) 2015.

Poverty and Material Hardship in Grandparent-Headed Households.

PubMed

Baker, Lindsey A; Mutchler, Jan E

2010-08-01

Using the 2001 Survey of Income and Program Participation, the current study examines poverty and material hardship among children living in 3-generation (n = 486), skipped-generation (n = 238), single-parent (n = 2,076), and 2-parent (n = 6,061) households. Multinomial and logistic regression models indicated that children living in grandparent-headed households experience elevated risk of health insecurity (as measured by receipt of public insurance and uninsurance)-a disproportionate risk given rates of poverty within those households. Children living with single parents did not share this substantial risk. Risk of food and housing insecurity did not differ significantly from 2-parent households once characteristics of the household and caregivers were taken into account.

Welfare recipients’ involvement with child protective services after welfare reform

PubMed Central

Nam, Yunju; Meezan, William; Danziger, Sandra K.

2007-01-01

Objective This study identifies factors associated with child protective services (CPS) involvement among current and former welfare recipients after welfare reform legislation was passed in the US in 1996. Method Data come from the Women’s Employment Study, a longitudinal study of randomly selected welfare recipients living in a Michigan city in 1997 (N = 541). In order to identify risk factors for CPS involvement among current and former welfare recipients, multinomial logit analyses with 29 independent variables were employed on a trichotomous dependent variable: no CPS involvement, investigation only, and supervision by CPS after investigation. Results The relationship between work and involvement with CPS differs by work experience prior to welfare reform. As the percentage of months working after welfare reform increased, the risk of being investigated by CPS declined among those with prior work experience but the risk increased among those without prior work experience. However, work variables were not significant predictors of supervision by CPS after an initial investigation. Further, race, cohabitation, childhood welfare receipt, having a learning disability, having a large number of children, being newly divorced, living in a high problem neighborhood, and being convicted of a crime were associated with one’s probability of being either investigated or supervised by CPS. Conclusions These findings suggest that employment could have increased the stress levels of current or former welfare recipients without prior work experience to the point where they were prone to minor child rearing mistakes that resulted in a CPS investigation, but were not severe enough to warrant opening the case for supervision. Supports should be provided to welfare mothers who are prone to involvement with CPS; expansions in the childcare subsidy and a reduction or delay in work requirements might also help these families. PMID:17116329

Welfare recipients' involvement with child protective services after welfare reform.

PubMed

Nam, Yunju; Meezan, William; Danziger, Sandra K

2006-11-01

This study identifies factors associated with child protective services (CPS) involvement among current and former welfare recipients after welfare reform legislation was passed in the US in 1996. Data come from the Women's Employment Study, a longitudinal study of randomly selected welfare recipients living in a Michigan city in 1997 (N=541). In order to identify risk factors for CPS involvement among current and former welfare recipients, multinomial logit analyses with 29 independent variables were employed on a trichotomous dependent variable: no CPS involvement, investigation only, and supervision by CPS after investigation. The relationship between work and involvement with CPS differs by work experience prior to welfare reform. As the percentage of months working after welfare reform increased, the risk of being investigated by CPS declined among those with prior work experience but the risk increased among those without prior work experience. However, work variables were not significant predictors of supervision by CPS after an initial investigation. Further, race, cohabitation, childhood welfare receipt, having a learning disability, having a large number of children, being newly divorced, living in a high problem neighborhood, and being convicted of a crime were associated with one's probability of being either investigated or supervised by CPS. These findings suggest that employment could have increased the stress levels of current or former welfare recipients without prior work experience to the point where they were prone to minor child rearing mistakes that resulted in a CPS investigation, but were not severe enough to warrant opening the case for supervision. Supports should be provided to welfare mothers who are prone to involvement with CPS; expansions in the childcare subsidy and a reduction or delay in work requirements might also help these families.

Evaluation of motorcycle safety strategies using the severity of injuries.

PubMed

Jung, Soyoung; Xiao, Qin; Yoon, Yoonjin

2013-10-01

The growth of motorcycle fatalities in California has been especially prominent, specifically with regard to the 24 and under age group and those aged 45-54. This research quantitatively examined factors associated with motorcyclist fatalities and assessed strategies that could improve motorcyclist safety, specifically focusing on the two age groups mentioned above. Severity of injury was estimated separately for both age groups with multinomial logit models and pseudo-elasticity using motorcycle-related collision data that was collected between 2005 and 2009. The results were compared with motorcyclists aged 35-44, a group that shows a consistent trend of fatalities. This research found that lack or improper use of helmets, victim ejection, alcohol/drug effects, collisions (head-on, broadside, hit-object), and truck involvement were more likely to result in fatal injuries regardless of age group. Weekend and non-peak hour activity was found to have a strong effect in both the younger and older age groups. Two factors, movement of running off the road preceding a collision and multi-vehicle involvement, were found to be statistically significant factors in increasing older motorcyclist fatalities. Use of street lights in the dark was found to decrease the probability of severe injury for older motorcyclists. Driver type of victim, at-fault driver, local road, and speed violation were significant factors in increasing the fatalities of younger motorcyclists. Road conditions and collision location factors were not found to be statistically significant to motorcyclist fatalities. Based on the statistically significant factors identified in this research, the following safety strategies appear to be effective methods of reducing motorcyclist fatalities: public education of alcohol use, promoting helmet use, enforcing heavy vehicle and speed violations, improving roadway facilities, clearer roadway guidance and street lighting systems, and motorcyclist training. Copyright © 2013 Elsevier Ltd. All rights reserved.

Patient Preferences for Managing Insomnia: A Discrete Choice Experiment.

PubMed

Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Saini, Bandana; Laba, Tracey-Lea

2018-03-03

Despite the rapid development of effective treatments, both pharmacological and non-pharmacological, insomnia management remains suboptimal at the practice interface. Patient preferences play a critical role in influencing treatment outcomes. However, there is currently a mismatch between patient preferences and clinician recommendations, partly perpetuated by a limited understanding of the patients' decision-making process. The aim of our study was to empirically quantify patient preferences for treatment attributes common to both pharmacological and non-pharmacological insomnia treatments. An efficient dual-response discrete choice experiment was conducted to evaluate patient treatment preferences for managing insomnia. The sample included 205 patients with self-reported insomnia and an Insomnia Severity Index ≥ 14. Participants were presented with two unlabelled hypothetical scenarios with an opt-out option across 12 choice sets. Data were analyzed using a mixed multinomial logit model to investigate the influence of five attributes (i.e. time, onset of action, maintainability of improved sleep, length of treatment, and monthly cost) on treatment preferences. Treatments were preferentially viewed if they conferred long-term sleep benefits (p < 0.05); had an ongoing, as opposed to a predefined, duration of treatment course (p < 0.05); required some, as opposed to no, additional time commitment (p < 0.05); and had lower monthly out-of-pocket treatment costs (p < 0.001). However, treatment onset of action had no influence on preference. Age, help-seeking status, concession card status and fatigue severity significantly influenced treatment preference. Participants' prioritization of investing time in treatment and valuing the maintainability of therapeutic gains suggests a stronger inclination towards non-pharmacological treatment, defying current assumptions that patients prefer 'quick-fixes' for managing insomnia.

Patient preferences for outcomes of depression treatment in Germany: a choice-based conjoint analysis study.

PubMed

Zimmermann, Thomas M; Clouth, Johannes; Elosge, Michael; Heurich, Matthias; Schneider, Edith; Wilhelm, Stefan; Wolfrath, Anette

2013-06-01

In general, treatment efficacy in depressed patients is evaluated mainly based on the core symptoms of depression. However, patients might consider different outcomes. This study used choice-based conjoint analysis (CBC) to evaluate patient preferences for depression treatment outcomes. Adult subjects from Germany, currently or previously on antidepressant treatment, were presented with 18 pairs of hypothetical treatment outcome scenarios, differing in eight attributes (2-3 factor levels each): depressed mood, loss of interest and enjoyment, loss of energy/fatigue, sleep disturbance, feelings of guilt, depression-related pain, treatment duration, side effects after 2 weeks. Attributes and factor levels were defined by literature review, expert consultations, and in-depth subject interviews. Data were analyzed using multinomial logit modeling; individual part-worth utilities were estimated using hierarchical Bayes routines. Two hundred twenty-seven subjects (89.4% currently treated with antidepressants, 30.0% with depression-related pain) completed the survey. They valued the relative importance of outcomes as follows: loss of energy/fatigue 18.5%, side effects after 2 weeks 14.2%, loss of interest and enjoyment 13.5%, depression-related pain 12.0%, sleep disturbance 12.0%, feelings of guilt 11.5%, treatment duration 9.9%, depressed mood 8.5%. Participants were not required to meet ICD-10 or DSM-IV criteria for depression and had heterogeneous disease severity. CBC analysis was able to reveal patient preferences for outcomes of depression treatment. Subjects valued the ability to cope with activities of everyday living highest. They considered being free of depression-related pain and side effects more important than being free of depressed mood. These findings should be considered when making treatment decisions. Copyright © 2012 Elsevier B.V. All rights reserved.

Obesity and the burden of health risks among the elderly in Ghana: A population study.

PubMed

Boateng, Godfred O; Adams, Ellis A; Odei Boateng, Mavis; Luginaah, Isaac N; Taabazuing, Mary-Margaret

2017-01-01

The causes and health risks associated with obesity in young people have been extensively documented, but elderly obesity is less well understood, especially in sub-Saharan Africa. This study examines the relationship between obesity and the risk of chronic diseases, cognitive impairment, and functional disability among the elderly in Ghana. It highlights the social and cultural dimensions of elderly obesity and discusses the implications of related health risks using a socio-ecological model. We used data from wave 1 of the Ghana Study on Global Ageing and Adult Health (SAGE) survey-2007/8, with a restricted sample of 2,091 for those 65 years and older. Using random effects multinomial, ordered, and binary logit models, we examined the relationship between obesity and the risk of stage 1 and stage 2 hypertension, arthritis, difficulties with recall and learning new tasks, and deficiencies with activities of daily living and instrumental activities of daily living. Elderly Ghanaians who were overweight and obese had a higher risk of stage 1 and stage 2 hypertension, and were more likely to be diagnosed with arthritis and report severe deficiencies with instrumental activities of daily living. Those who were underweight were 1.71 times more likely to report severe difficulties with activities of daily living. A sub analysis using waist circumference as a measure of body fat showed elderly females with abdominal adiposity were relatively more likely to have stage 2 hypertension. These findings call for urgent policy initiatives geared towards reducing obesity among working adults given the potentially detrimental consequences in late adulthood. Future research should explore the gendered pathways leading to health disadvantages among Ghanaian women in late adulthood.

The use of choice experiments in the analysis of tourist preferences for ecotourism development in Costa Rica.

PubMed

Hearne, Robert R; Salinas, Zenia M

2002-06-01

Many nations promote nature-based tourism in order to promote the dual goals of nature conservation and income generation. To be most effective in providing services that facilitate achievement of these goals, decision makers will need to understand and incorporate tourist preferences for nature appreciation, infrastructure, use restrictions, and other attributes of national parks and protected areas. This paper presents the use of choice experiments as a mechanism to analyze preferences of national and international tourists in relation to the development of Barva Volcano Area in Costa Rica. In this section of the Braulio Carrillo National Park, managers are faced with an immediate need to plan for greatly increased visitation rates due to a new road, which will greatly improve access. Choice sets were developed in collaboration with park managers. A survey was conducted of 171 Costa Rican and 271 foreign tourists who visited Poás Volcano, a well-visited alternative site to Barva Volcano. Survey data was analyzed using conditional multinomial logit models. Results of the study demonstrate, that both sets of tourists preferred: (i) improved infrastructure; (ii) aerial trams with observation towers and picnic areas; (iii) more information; and (iv) low entrance fees. Foreign tourists demonstrated strong preferences for the inclusion of restrictions in the access to some trails, whereas Costa Ricans did not show any significant preference for restrictions. Marginal willingness-to-pay for greater information was estimated to be $1.54 for foreign tourists and $1.01 for Costa Rican visitors. The study concludes that choice experiments are a useful tool in the analyses of tourist preferences for the development of protected areas in developing countries.

Women's Benefits and Harms Trade-Offs in Breast Cancer Screening: Results from a Discrete-Choice Experiment.

PubMed

Sicsic, Jonathan; Pelletier-Fleury, Nathalie; Moumjid, Nora

2018-01-01

Over the past decade, the benefits and harms balance of breast cancer (BC) screening has been widely debated. To elicit women's trade-offs between the benefits and harms of BC screening and to analyze the main determinants of these trade-offs. A discrete-choice experiment with seven attributes depicting BC screening programs including varying levels of BC mortality, overdiagnosis, and false-positive result was used. Eight hundred twelve women aged 40 to 74 years with no personal history of BC recruited by a survey institute and representative of the French general population (age, socioeconomic level, and geographical location) completed the discrete-choice experiment. Preference heterogeneity was investigated using generalized multinomial logit models from which individual trade-offs were derived, and their main determinants were assessed using generalized linear models. Screening acceptance rates under various benefits and harms ratios were simulated on the basis of the distribution of individual preferences. The women would be willing to accept on average 14.1 overdiagnosis cases (median = 9.6) and 47.8 false-positive results (median = 27.2) to avoid one BC-related death. After accounting for preference heterogeneity, less than 50% of women would be willing to accept 10 overdiagnosis cases for one BC-related death avoided. Screening acceptance rates were higher among women with higher socioeconomic level and lower among women with poor health. Women are sensitive to both the benefits and the harms of BC screening and their preferences are highly heterogeneous. Our study provides useful results for public health authorities and clinicians willing to improve their recommendations of BC screening on the basis of women's preferences. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Measuring Care-Related Quality of Life of Caregivers for Use in Economic Evaluations: CarerQol Tariffs for Australia, Germany, Sweden, UK, and US.

PubMed

Hoefman, Renske J; van Exel, Job; Brouwer, Werner B F

2017-04-01

Informal care is often not included in economic evaluations in healthcare, while the impact of caregiving can be relevant for cost-effectiveness recommendations from a societal perspective. The impact of informal care can be measured and valued with the CarerQol instrument, which measures the impact of informal care on seven important burden dimensions (CarerQol-7D) and values this in terms of general quality of life (CarerQol-VAS). The CarerQol can be included at the effect side of multi-criteria analyses of patient interventions or in cost-effectiveness or utility analysis of interventions targeted at caregivers. At present, utility scores based on relative utility weights for the CarerQol-7D are only available for the Netherlands. This study calculates CarerQol-7D tariffs for Australia, Germany, Sweden, UK, and US. Data were collected among the general population in Australia, Germany, Sweden, UK, and US by an Internet survey. Utility weights were collected with a discrete choice experiment with two unlabeled alternatives described in terms of the seven CarerQol-7D dimensions. An efficient experimental design with priors obtained from the Netherlands was used to create the choice sets. Data was analyzed with a panel mixed multinomial logit model with random parameters. In all five countries, the CarerQol-7D dimensions were significantly associated with the utility of informal care situations. Physical health problems were most strongly associated with the utility for informal care situations. The tariff was constructed by adding up the relative utility weights per category of all CarerQol-7D dimensions for each country separately. The CarerQol tariffs for Australia, Germany, Sweden, UK, and US facilitate the inclusion of informal care in economic evaluations.

The impact of vaccination and patient characteristics on influenza vaccination uptake of elderly people: A discrete choice experiment.

PubMed

de Bekker-Grob, Esther W; Veldwijk, Jorien; Jonker, Marcel; Donkers, Bas; Huisman, Jan; Buis, Sylvia; Swait, Joffre; Lancsar, Emily; Witteman, Cilia L M; Bonsel, Gouke; Bindels, Patrick

2018-03-07

To improve information for patients and to facilitate a vaccination coverage that is in line with the EU and World Health Organization goals, we aimed to quantify how vaccination and patient characteristics impact on influenza vaccination uptake of elderly people. An online discrete choice experiment (DCE) was conducted among 1261 representatives of the Dutch general population aged 60 years or older. In the DCE, we used influenza vaccination scenarios based on five vaccination characteristics: effectiveness, risk of severe side effects, risk of mild side effects, protection duration, and absorption time. A heteroscedastic multinomial logit model was used, taking scale and preference heterogeneity (based on 19 patient characteristics) into account. Vaccination and patient characteristics both contributed to explain influenza vaccination uptake. Assuming a base case respondent and a realistic vaccination scenario, the predicted uptake was 58%. One-way changes in vaccination characteristics and patient characteristics changed this uptake from 46% up to 61% and from 37% up to 95%, respectively. The strongest impact on vaccination uptake was whether the patient had been vaccinated last year, whether s/he had experienced vaccination side effects, and the patient's general attitude towards vaccination. Although vaccination characteristics proved to influence influenza vaccination uptake, certain patient characteristics had an even higher impact on influenza vaccination uptake. Policy makers and general practitioners can use these insights to improve their communication plans and information regarding influenza vaccination for individuals aged 60 years or older. For instance, physicians should focus more on patients who had experienced side effects due to vaccination in the past, and policy makers should tailor the standard information folder to patients who had been vaccinated last year and to patient who had not. Copyright © 2018 Elsevier Ltd. All rights reserved.

Comparison of four statistical and machine learning methods for crash severity prediction.

PubMed

Iranitalab, Amirfarrokh; Khattak, Aemal

2017-11-01

Crash severity prediction models enable different agencies to predict the severity of a reported crash with unknown severity or the severity of crashes that may be expected to occur sometime in the future. This paper had three main objectives: comparison of the performance of four statistical and machine learning methods including Multinomial Logit (MNL), Nearest Neighbor Classification (NNC), Support Vector Machines (SVM) and Random Forests (RF), in predicting traffic crash severity; developing a crash costs-based approach for comparison of crash severity prediction methods; and investigating the effects of data clustering methods comprising K-means Clustering (KC) and Latent Class Clustering (LCC), on the performance of crash severity prediction models. The 2012-2015 reported crash data from Nebraska, United States was obtained and two-vehicle crashes were extracted as the analysis data. The dataset was split into training/estimation (2012-2014) and validation (2015) subsets. The four prediction methods were trained/estimated using the training/estimation dataset and the correct prediction rates for each crash severity level, overall correct prediction rate and a proposed crash costs-based accuracy measure were obtained for the validation dataset. The correct prediction rates and the proposed approach showed NNC had the best prediction performance in overall and in more severe crashes. RF and SVM had the next two sufficient performances and MNL was the weakest method. Data clustering did not affect the prediction results of SVM, but KC improved the prediction performance of MNL, NNC and RF, while LCC caused improvement in MNL and RF but weakened the performance of NNC. Overall correct prediction rate had almost the exact opposite results compared to the proposed approach, showing that neglecting the crash costs can lead to misjudgment in choosing the right prediction method. Copyright © 2017 Elsevier Ltd. All rights reserved.

Fresh meat packaging: consumer acceptance of modified atmosphere packaging including carbon monoxide.

PubMed

Grebitus, Carola; Jensen, Helen H; Roosen, Jutta; Sebranek, Joseph G

2013-01-01

Consumers' perceptions and evaluations of meat quality attributes such as color and shelf life influence purchasing decisions, and these product attributes can be affected by the type of fresh meat packaging system. Modified atmosphere packaging (MAP) extends the shelf life of fresh meat and, with the inclusion of carbon monoxide (CO-MAP), achieves significant color stabilization. The objective of this study was to assess whether consumers would accept specific packaging technologies and what value consumers place on ground beef packaged under various atmospheres when their choices involved the attributes of color and shelf life. The study used nonhypothetical consumer choice experiments to determine the premiums that consumers are willing to pay for extended shelf life resulting from MAP and for the "cherry red" color in meat resulting from CO-MAP. The experimental design allowed determination of whether consumers would discount foods with MAP or CO-MAP when (i) they are given more detailed information about the technologies and (ii) they have different levels of individual knowledge and media exposure. The empirical analysis was conducted using multinomial logit models. Results indicate that consumers prefer an extension of shelf life as long as the applied technology is known and understood. Consumers had clear preferences for brighter (aerobic and CO) red color and were willing to pay $0.16/lb ($0.35/kg) for each level of change to the preferred color. More information on MAP for extending the shelf life and on CO-MAP for stabilizing color decreased consumers' willingness to pay. An increase in personal knowledge and media exposure influenced acceptance of CO-MAP negatively. The results provide quantitative measures of how packaging affects consumers' acceptance and willingness to pay for products. Such information can benefit food producers and retailers who make decisions about investing in new packaging methods.

A predictive index of axillary nodal involvement in operable breast cancer.

PubMed Central

De Laurentiis, M.; Gallo, C.; De Placido, S.; Perrone, F.; Pettinato, G.; Petrella, G.; Carlomagno, C.; Panico, L.; Delrio, P.; Bianco, A. R.

1996-01-01

We investigated the association between pathological characteristics of primary breast cancer and degree of axillary nodal involvement and obtained a predictive index of the latter from the former. In 2076 cases, 17 histological features, including primary tumour and local invasion variables, were recorded. The whole sample was randomly split in a training (75% of cases) and a test sample. Simple and multiple correspondence analysis were used to select the variables to enter in a multinomial logit model to build an index predictive of the degree of nodal involvement. The response variable was axillary nodal status coded in four classes (N0, N1-3, N4-9, N > or = 10). The predictive index was then evaluated by testing goodness-of-fit and classification accuracy. Covariates significantly associated with nodal status were tumour size (P < 0.0001), tumour type (P < 0.0001), type of border (P = 0.048), multicentricity (P = 0.003), invasion of lymphatic and blood vessels (P < 0.0001) and nipple invasion (P = 0.006). Goodness-of-fit was validated by high concordance between observed and expected number of cases in each decile of predicted probability in both training and test samples. Classification accuracy analysis showed that true node-positive cases were well recognised (84.5%), but there was no clear distinction among the classes of node-positive cases. However, 10 year survival analysis showed a superimposible prognostic behaviour between predicted and observed nodal classes. Moreover, misclassified node-negative patients (i.e. those who are predicted positive) showed an outcome closer to patients with 1-3 metastatic nodes than to node-negative ones. In conclusion, the index cannot completely substitute for axillary node information, but it is a predictor of prognosis as accurate as nodal involvement and identifies a subgroup of node-negative patients with unfavourable prognosis. PMID:8630286

Australian Public Preferences for the Funding of New Health Technologies: A Comparison of Discrete Choice and Profile Case Best-Worst Scaling Methods.

PubMed

Whitty, Jennifer A; Ratcliffe, Julie; Chen, Gang; Scuffham, Paul A

2014-07-01

Ethical, economic, political, and legitimacy arguments support the consideration of public preferences in health technology decision making. The objective was to assess public preferences for funding new health technologies and to compare a profile case best-worst scaling (BWS) and traditional discrete choice experiment (DCE) method. An online survey consisting of a DCE and BWS task was completed by 930 adults recruited via an Internet panel. Respondents traded between 7 technology attributes. Participation quotas broadly reflected the population of Queensland, Australia, by gender and age. Choice data were analyzed using a generalized multinomial logit model. The findings from both the BWS and DCE were generally consistent in that respondents exhibited stronger preferences for technologies offering prevention or early diagnosis over other benefit types. Respondents also prioritized technologies that benefit younger people, larger numbers of people, those in rural areas, or indigenous Australians; that provide value for money; that have no available alternative; or that upgrade an existing technology. However, the relative preference weights and consequent preference orderings differed between the DCE and BWS models. Further, poor correlation between the DCE and BWS weights was observed. While only a minority of respondents reported difficulty completing either task (22.2% DCE, 31.9% BWS), the majority (72.6%) preferred the DCE over BWS task. This study provides reassurance that many criteria routinely used for technology decision making are considered to be relevant by the public. The findings clearly indicate the perceived importance of prevention and early diagnosis. The dissimilarity observed between DCE and profile case BWS weights is contrary to the findings of previous comparisons and raises uncertainty regarding the comparative merits of these stated preference methods in a priority-setting context. © The Author(s) 2014.

Validating the European Health Literacy Survey Questionnaire in people with type 2 diabetes: Latent trait analyses applying multidimensional Rasch modelling and confirmatory factor analysis.

PubMed

Finbråten, Hanne Søberg; Pettersen, Kjell Sverre; Wilde-Larsson, Bodil; Nordström, Gun; Trollvik, Anne; Guttersrud, Øystein

2017-11-01

To validate the European Health Literacy Survey Questionnaire (HLS-EU-Q47) in people with type 2 diabetes mellitus. The HLS-EU-Q47 latent variable is outlined in a framework with four cognitive domains integrated in three health domains, implying 12 theoretically defined subscales. Valid and reliable health literacy measurers are crucial to effectively adapt health communication and education to individuals and groups of patients. Cross-sectional study applying confirmatory latent trait analyses. Using a paper-and-pencil self-administered approach, 388 adults responded in March 2015. The data were analysed using the Rasch methodology and confirmatory factor analysis. Response violation (response dependency) and trait violation (multidimensionality) of local independence were identified. Fitting the "multidimensional random coefficients multinomial logit" model, 1-, 3- and 12-dimensional Rasch models were applied and compared. Poor model fit and differential item functioning were present in some items, and several subscales suffered from poor targeting and low reliability. Despite multidimensional data, we did not observe any unordered response categories. Interpreting the domains as distinct but related latent dimensions, the data fit a 12-dimensional Rasch model and a 12-factor confirmatory factor model best. Therefore, the analyses did not support the estimation of one overall "health literacy score." To support the plausibility of claims based on the HLS-EU score(s), we suggest: removing the health care aspect to reduce the magnitude of multidimensionality; rejecting redundant items to avoid response dependency; adding "harder" items and applying a six-point rating scale to improve subscale targeting and reliability; and revising items to improve model fit and avoid bias owing to person factors. © 2017 John Wiley & Sons Ltd.

Inflammatory bowel disease patients prioritize mucosal healing, symptom control, and pain when choosing therapies: results of a prospective cross-sectional willingness-to-pay study.

PubMed

Gregor, James C; Williamson, Martin; Dajnowiec, Dorota; Sattin, Bernie; Sabot, Erik; Salh, Baljinder

2018-01-01

Given the large armamentarium of therapies for inflammatory bowel disease (IBD), physicians cannot fully describe all treatments to patients and, therefore, make assumptions regarding treatment attributes communicated to patients. This study aimed to assess out-of-pocket willingness-to-pay that IBD patients allocate to treatment attributes. Adult patients receiving therapy for IBD were invited to access a cross-sectional web-based discrete-choice experiment (May 22-August 31, 2015) that presented paired medication scenarios with varying efficacy, safety, and administration parameters. Preference weights and willingness-to-pay for each attribute level were assessed by a hierarchical Bayes method including a multinomial logit model. A total of 586 IBD patients were included, 404 (68.9%) with Crohn's disease and 182 (31.1%) with ulcerative colitis. Genders were evenly distributed; the majority of patients (70.1%) were 50 years or younger and had postsecondary education (75.4%), while the median health status was 7 (Likert scale: 1 [poor] - 10 [perfect]). Regarding relative preference-weight estimates, for the average respondent, reducing pain during administration, mucosal healing, and symptom relief were the highest-ranking attributes. Conversely, infusion reactions and risk of hospitalization or surgery were the lowest-ranking attributes. In multivariate analysis, patient sociodemographics did not affect the rank order of attributes although small differences were observed between asymptomatic and symptomatic patients in the previous year. This study has important implications related to understanding patient preferences and designing patient-centered strategies. IBD patients prioritize treatments with low administration pain. Additionally, these results concur with treatment guidelines emphasizing patients' preference for mucosal healing and symptom control.

Physical Fitness, Physical Activity, Sedentary Behavior, or Diet—What Are the Correlates of Obesity in Polish School Children?

PubMed Central

Czyż, Stanisław H.; Toriola, Abel L.; Starościak, Wojciech; Lewandowski, Marek; Paul, Yvonne; Oyeyemi, Adewale L.

2017-01-01

There is substantial evidence of rising prevalence of overweight and obesity and its co-morbidities among children in western-high income developed countries. In the European Union, the prevalence of overweight and obesity is increasing fastest among Polish children. Yet, there is paucity of evidence on the relationship of behavioral factors with body weight status of children in Poland. This study examined the association of obesity with physical fitness, physical activity, sedentary behavior and diet among Polish children. A total of 641 children (10–15 years) recruited from the Lower Silesia region of Poland participated in this cross-sectional study. Participants’ anthropometrics, physical fitness, physical activity, sedentary behavior and dietary intake were assessed. Outcome variables were weight categories (according to body mass index [BMI], waist-to-hip ratio [WHR], and percentage body fat [% BF]). The strongest negative correlation was found between VO2max and %BF (r = −0.39, p <0.05). Significant negative correlation was also found between VO2max and weight categories (r = −0.15). Results of the multinomial logit analysis showed that VO2max increased in groups of overweight, normal weight and underweight children by 13%, 26% and 19%, respectively as compared to the group of obese children. VO2max and weight and obesity indices were strongly correlated in both gender and age groups. Education and intervention programs to increase physical fitness (VO2max) through aerobic training are recommended for Physical Education teachers, parents and children in order to reduce the rate of overweight and obesity among children in the Lower Silesia region of Poland. PMID:28632175

Overweight and obesity trends among active duty military personnel: a 13-year perspective.

PubMed

Reyes-Guzman, Carolyn M; Bray, Robert M; Forman-Hoffman, Valerie L; Williams, Jason

2015-02-01

The U.S. population has shown increasing rates of overweight and obesity in recent years, but similar analyses do not exist for U.S. military personnel. It is important to understand these patterns in the military because of their impact on fitness and readiness. To assess prevalence and trends in overweight/obesity among U.S. service members and to examine the associations of sociodemographic characteristics, exercise, depression, and substance use with these patterns. Analyses performed in 2013 used five large population-based health-related behavior surveys conducted from 1995 to 2008. Main outcome measures were overweight and obesity among active duty military personnel based on BMI. Combined overweight and obesity (BMI≥25) increased from 50.6% in 1995 to 60.8% in 2008, primarily driven by the rise in obesity (BMI≥30) from 5.0% to 12.7%. For overweight, military women showed the largest increase. For obesity, all sociodemographic groups showed significant increases, with the largest among warrant officers, senior enlisted personnel, and people aged 36-45 years. Adjusted multinomial logit analyses found that service members aged 26 years and older, men, non-Hispanic blacks and Hispanics, enlisted personnel, married personnel, and heavy drinkers had the highest risk both for overweight and obesity. Combined overweight and obesity in active duty personnel rose to more than 60% between 1995 and 2008, primarily because of increased obesity. The high prevalence of overweight and obesity needs attention and has implications for Department of Defense efforts to improve the health, fitness, readiness, and quality of life of the Active Forces. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Providing Informal Care in Terminal Illness: An Analysis of Preferences for Support Using a Discrete Choice Experiment.

PubMed

Hall, Jane; Kenny, Patricia; Hossain, Ishrat; Street, Deborah J; Knox, Stephanie A

2014-08-01

The trend for terminally ill patients to receive much of their end-of-life care at home necessitates the design of services to facilitate this. Care at home also requires that informal care be provided by family members and friends. This study investigated informal carers' preferences for support services to aid the development of end-of-life health care services. This cross-sectional study used 2 discrete choice experiments to ascertain the preferences of carers supporting patients with different levels of care need, determined by the assistance needed with personal care and labeled High Care (HC) and Low Care (LC). The sample included 168 informal carers of people receiving palliative care at home from 2 palliative care services in Sydney, Australia. Data were collected in face-to-face interviews; carers chose between 2 hypothetical plans of support services and their current services. Data were analyzed with generalized multinomial logit models that were used to calculate the impact of each attribute on the probability of a carer choosing a service plan. Preferred support included nursing services; the probability of choosing a plan increased significantly if it included nurse home visits and phone advice (P < 0.001). HC carers also wanted doctor home visits, home respite, and help with personal care (P < 0.05), and LC carers wanted help with household tasks, transport, and a case coordinator (P < 0.001). On average, both groups of carers preferred their current services, but this varied with characteristics of the carer and the caregiving situation. The most valued services are those that support carers in their caregiving role; however, supportive care preferences vary with the different circumstances of patients and carers. © The Author(s) 2013.

Subsidies and the demand for individual health insurance in California.

PubMed

Marquis, M Susan; Buntin, Melinda Beeuwkes; Escarce, José J; Kapur, Kanika; Yegian, Jill M

2004-10-01

To estimate the effect of changes in premiums for individual insurance on decisions to purchase individual insurance and how this price response varies among subgroups of the population. Survey responses from the Current Population Survey (http://www.bls.census.gov/cps/cpsmain.htm), the Survey of Income and Program Participation (http://www.sipp.census.gov/sipp), the National Health Interview Survey (http://www.cdc.gov/nchs/nhis.htm), and data about premiums and plans offered in the individual insurance market in California, 1996-2001. A logit model was used to estimate the decisions to purchase individual insurance by families without access to group insurance. This was modeled as a function of premiums, controlling for family characteristics and other characteristics of the market. A multinomial model was used to estimate the choice between group coverage, individual coverage, and remaining uninsured for workers offered group coverage as a function of premiums for individual insurance and out-of-pocket costs of group coverage. The elasticity of demand for individual insurance by those without access to group insurance is about -.2 to -.4, as has been found in earlier studies. However, there are substantial differences in price responses among subgroups with low-income, young, and self-employed families showing the greatest response. Among workers offered group insurance, a decrease in individual premiums has very small effects on the choice to purchase individual coverage versus group coverage. Subsidy programs may make insurance more affordable for some families, but even sizeable subsidies are unlikely to solve the problem of the uninsured. We do not find evidence that subsidies to individual insurance will produce an unraveling of the employer-based health insurance system.

Evoked Emotions Predict Food Choice

PubMed Central

Dalenberg, Jelle R.; Gutjar, Swetlana; ter Horst, Gert J.; de Graaf, Kees; Renken, Remco J.; Jager, Gerry

2014-01-01

In the current study we show that non-verbal food-evoked emotion scores significantly improve food choice prediction over merely liking scores. Previous research has shown that liking measures correlate with choice. However, liking is no strong predictor for food choice in real life environments. Therefore, the focus within recent studies shifted towards using emotion-profiling methods that successfully can discriminate between products that are equally liked. However, it is unclear how well scores from emotion-profiling methods predict actual food choice and/or consumption. To test this, we proposed to decompose emotion scores into valence and arousal scores using Principal Component Analysis (PCA) and apply Multinomial Logit Models (MLM) to estimate food choice using liking, valence, and arousal as possible predictors. For this analysis, we used an existing data set comprised of liking and food-evoked emotions scores from 123 participants, who rated 7 unlabeled breakfast drinks. Liking scores were measured using a 100-mm visual analogue scale, while food-evoked emotions were measured using 2 existing emotion-profiling methods: a verbal and a non-verbal method (EsSense Profile and PrEmo, respectively). After 7 days, participants were asked to choose 1 breakfast drink from the experiment to consume during breakfast in a simulated restaurant environment. Cross validation showed that we were able to correctly predict individualized food choice (1 out of 7 products) for over 50% of the participants. This number increased to nearly 80% when looking at the top 2 candidates. Model comparisons showed that evoked emotions better predict food choice than perceived liking alone. However, the strongest predictive strength was achieved by the combination of evoked emotions and liking. Furthermore we showed that non-verbal food-evoked emotion scores more accurately predict food choice than verbal food-evoked emotions scores. PMID:25521352

Plan Selection in the Non-Group Market in the First Year of the Health Insurance Marketplace.

PubMed

Gillen, Emily; Lich, Kristen Hassmiller; Trantham, Laurel; Silberman, Pam; Weinberger, Morris; Holmes, Mark

2017-01-01

BACKGROUND The Affordable Care Act (ACA)-created Marketplaces reduced barriers to entry in the non-group health insurance market. Although tax credits were available to individuals who enrolled in qualified health plans (QHPs) beginning in 2014, many individuals chose not to switch plans. We examined characteristics associated with switching from a non-ACA compliant plan to a QHP in 2014 and, conditional on switching, the characteristics associated with selection of a specific plan level. METHODS Using claims data from a large commercial insurer, we examined characteristics associated with switching to a QHP in 2014. For those who did switch, we used a multinomial logit model to estimate odds of selecting different metal levels-representing varying degrees of coverage-for a group of the highest and lowest risk individuals. RESULTS We found individuals most likely to benefit from the premium and benefit requirements on QHPs were more likely to switch to QHPs. Individuals at high-risk for high health care expenditures who had advance premium tax credits (APTCs) had lower odds of choosing a less generous plan compared to individuals without APTCs (odds of bronze plan over silver: 0.40, CI: 0.30 - 0.55), while individuals at low-risk of being high cost with APTCs were more likely to select a plan with a lower premium (odds bronze plan over silver: 1.35, CI: 1.09 - 1.66). LIMITATIONS This study was conducted with data from 1 health plan, limiting its national generalizability; however, this study is a good representation of activity within the state. CONCLUSIONS APTCs are important for ensuring that less healthy individuals are able to afford adequate levels of coverage. ©2017 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Eliciting preferences for waterpipe tobacco smoking using a discrete choice experiment: implications for product regulation

PubMed Central

Salloum, Ramzi G; Maziak, Wasim; Hammond, David; Nakkash, Rima; Islam, Farahnaz; Cheng, Xi; Thrasher, James F

2015-01-01

Objectives Waterpipe smoking is highly prevalent among university students, and has been increasing in popularity despite mounting evidence showing it is harmful to health. The aim of this study was to measure preferences for waterpipe smoking and determine which product characteristics are most important to smokers. Setting A large university in the Southeastern USA. Participants Adult waterpipe smokers attending the university (N=367). Design Participants completed an Internet-based discrete choice experiment to reveal their preferences for, and trade-offs between, the attributes of hypothetical waterpipe smoking sessions. Participants were presented with waterpipe lounge menus, each with three fruit-flavoured options and one tobacco flavoured option, in addition to an opt out option. Nicotine content and price were provided for each choice. Participants were randomised to either receive menus with a text-only health-warning message or no message. Outcome measures Multinomial and nested logit models were used to estimate the impact on consumer choice of attributes and between-subject assignment of health warnings respectively. Results On average, participants preferred fruit-flavoured varieties to tobacco flavour. They were averse to options labelled with higher nicotine content. Females and non-smokers of cigarettes were more likely than their counterparts to prefer flavoured and nicotine-free varieties. Participants exposed to a health warning were more likely to opt out. Conclusions Fruit-flavoured tobacco and lower nicotine content labels, two strategies widely used by the industry, increase the demand for waterpipe smoking among young adults. Waterpipe-specific regulation should limit the availability of flavoured waterpipe tobacco and require accurate labelling of constituents. Waterpipe-specific tobacco control regulation, along with research to inform policy, is required to curb this emerging public health threat. PMID:26353876

Evoked emotions predict food choice.

PubMed

Dalenberg, Jelle R; Gutjar, Swetlana; Ter Horst, Gert J; de Graaf, Kees; Renken, Remco J; Jager, Gerry

2014-01-01

In the current study we show that non-verbal food-evoked emotion scores significantly improve food choice prediction over merely liking scores. Previous research has shown that liking measures correlate with choice. However, liking is no strong predictor for food choice in real life environments. Therefore, the focus within recent studies shifted towards using emotion-profiling methods that successfully can discriminate between products that are equally liked. However, it is unclear how well scores from emotion-profiling methods predict actual food choice and/or consumption. To test this, we proposed to decompose emotion scores into valence and arousal scores using Principal Component Analysis (PCA) and apply Multinomial Logit Models (MLM) to estimate food choice using liking, valence, and arousal as possible predictors. For this analysis, we used an existing data set comprised of liking and food-evoked emotions scores from 123 participants, who rated 7 unlabeled breakfast drinks. Liking scores were measured using a 100-mm visual analogue scale, while food-evoked emotions were measured using 2 existing emotion-profiling methods: a verbal and a non-verbal method (EsSense Profile and PrEmo, respectively). After 7 days, participants were asked to choose 1 breakfast drink from the experiment to consume during breakfast in a simulated restaurant environment. Cross validation showed that we were able to correctly predict individualized food choice (1 out of 7 products) for over 50% of the participants. This number increased to nearly 80% when looking at the top 2 candidates. Model comparisons showed that evoked emotions better predict food choice than perceived liking alone. However, the strongest predictive strength was achieved by the combination of evoked emotions and liking. Furthermore we showed that non-verbal food-evoked emotion scores more accurately predict food choice than verbal food-evoked emotions scores.

Multi-disciplinary decision making in general practice.

PubMed

Kirby, Ann; Murphy, Aileen; Bradley, Colin

2018-04-09

Purpose Internationally, healthcare systems are moving towards delivering care in an integrated manner which advocates a multi-disciplinary approach to decision making. Such an approach is formally encouraged in the management of Atrial Fibrillation patients through the European Society of Cardiology guidelines. Since the emergence of new oral anticoagulants switching between oral anticoagulants (OACs) has become prevalent. This case study considers the role of multi-disciplinary decision making, given the complex nature of the agents. The purpose of this paper is to explore Irish General Practitioners' (GPs) experience of switching between all OACs for Arial Fibrillation (AF) patients; prevalence of multi-disciplinary decision making in OAC switching decisions and seeks to determine the GP characteristics that appear to influence the likelihood of multi-disciplinary decision making. Design/methodology/approach A probit model is used to determine the factors influencing multi-disciplinary decision making and a multinomial logit is used to examine the factors influencing who is involved in the multi-disciplinary decisions. Findings Results reveal that while some multi-disciplinary decision-making is occurring (64 per cent), it is not standard practice despite international guidelines on integrated care. Moreover, there is a lack of patient participation in the decision-making process. Female GPs and GPs who have initiated prescriptions for OACs are more likely to engage in multi-disciplinary decision-making surrounding switching OACs amongst AF patients. GPs with training practices were less likely to engage with cardiac consultants and those in urban areas were more likely to engage with other (non-cardiac) consultants. Originality/value For optimal decision making under uncertainty multi-disciplinary decision-making is needed to make a more informed judgement and to improve treatment decisions and reduce the opportunity cost of making the wrong decision.

Bicycle safety helmet legislation and bicycle-related non-fatal injuries in California.

PubMed

Lee, Brian Ho-Yin; Schofer, Joseph L; Koppelman, Frank S

2005-01-01

The objective of this study was to determine whether the bicycle safety helmet legislation in California, enacted in 1994, was associated with statistically significant reductions in head injuries among bicyclists aged 17 years and under who were subjected to the law. The study used 44,069 patient discharge cases from all public hospitals in California, from 1991 through 2000, and a case-control design to make direct comparisons between those subjected to the law (Youth) and those who were not (Adult) across the pre- and post-legislation periods. An aggregate data analysis approach and a pooled disaggregate data fitting technique using multinomial logit models were applied. The legislation was found to be associated with a reduction of 18.2% (99% confidence interval: 11.5-24.3%) in the proportion of traumatic brain injuries (Head-TBI) among Youth bicyclists. The proportions of other head, face, and neck injuries were not significantly changed across the pre- and post-legislation periods in this age group but there was a corresponding increase of 9% (5-13%) in the proportion of all other injuries. On the other hand, there was no statistically significant change in the proportions of injury outcomes for Adult bicyclists. The youngest riders, aged 0-9 years, had the greatest decrease in the proportion of Head-TBI. The reduction was the same for motor vehicle and non-motor-vehicle-related incidents. The bicycle safety helmet legislation was associated with a decrease in the likelihood of Head-TBI for non-urban residents but not for urbanites, for males but not for females, and for Whites, Asians, and Hispanics, but not Blacks and others.

Comparing Analytic Hierarchy Process and Discrete-Choice Experiment to Elicit Patient Preferences for Treatment Characteristics in Age-Related Macular Degeneration.

PubMed

Danner, Marion; Vennedey, Vera; Hiligsmann, Mickaël; Fauser, Sascha; Gross, Christian; Stock, Stephanie

2017-09-01

In this study, we conducted an analytic hierarchy process (AHP) and a discrete choice experiment (DCE) to elicit the preferences of patients with age-related macular degeneration using identical attributes and levels. To compare preference-based weights for age-related macular degeneration treatment attributes and levels generated by two elicitation methods. The properties of both methods were assessed, including ease of instrument use. A DCE and an AHP experiment were designed on the basis of five attributes. Preference-based weights were generated using the matrix multiplication method for attributes and levels in AHP and a mixed multinomial logit model for levels in the DCE. Attribute importance was further compared using coefficient (DCE) and weight (AHP) level ranges. The questionnaire difficulty was rated on a qualitative scale. Patients were asked to think aloud while providing their judgments. AHP and DCE generated similar results regarding levels, stressing a preference for visual improvement, frequent monitoring, on-demand and less frequent injection schemes, approved drugs, and mild side effects. Attribute weights derived on the basis of level ranges led to a ranking that was opposite to the AHP directly calculated attribute weights. For example, visual function ranked first in the AHP and last on the basis of level ranges. The results across the methods were similar, with one exception: the directly measured AHP attribute weights were different from the level-based interpretation of attribute importance in both DCE and AHP. The dependence/independence of attribute importance on level ranges in DCE and AHP, respectively, should be taken into account when choosing a method to support decision making. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Patients' sense of security during palliative care-what are the influencing factors?

PubMed

Milberg, Anna; Friedrichsen, Maria; Jakobsson, Maria; Nilsson, Eva-Carin; Niskala, Birgitta; Olsson, Maria; Wåhlberg, Rakel; Krevers, Barbro

2014-07-01

Having a sense of security is vitally important to patients who have a limited life expectancy. We sought to identify the factors associated with patients' sense of security during the palliative care period. We recruited 174 adult patients (65% of those eligible) from six palliative home care units. The relationship between the patients' sense of security during palliative care and individual factors was evaluated in a stepwise procedure using the generalized linear model (ordinal multinomial distribution and logit link). Respondents' ratings of their sense of security ranged from 1 (never) to 6 (always), with a mean value of 4.6 (SD 1.19). Patients with lower feelings of security experienced higher stress; more worry about personal finances; lower feelings of self-efficacy; a lower sense of security with the palliative care provided (lower ratings on subscales of care interaction); mastery; prevailed own identity; higher symptom intensity (especially depression, anxiety, and lack of well-being); lower health-related quality of life; lower attachment anxiety and avoidance; less support from family, relatives, and friends; lower comfort for those closest to them; and more often had gynecological cancer. Six variables (mastery, nervousness and stress, gynecological cancer, self-efficacy, worrying about personal finances, and avoidance) were selected in building the stepwise model. These findings stress the importance of palliative care services in supporting dying patients' sense of security through symptom management with a wide scope and through supporting the patients' sense of mastery, identity, and perception of a secure care interaction and also through attention to the family members' situation. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Modeling Preference and Willingness to Pay for Drought Tolerance (DT) in Maize in Rural Zimbabwe.

PubMed

Kassie, Girma T; Abdulai, Awudu; Greene, William H; Shiferaw, Bekele; Abate, Tsedeke; Tarekegne, Amsal; Sutcliffe, Chloe

2017-06-01

Maize plays a leading role in the food security of millions in southern Africa, yet it is highly vulnerable to the moisture stress brought about by the erratic rainfall patterns that characterize weather systems in the area. Developing and making drought-tolerant maize varieties available to farmers in the region has thus long been a key goal on the regional development agenda. Farm-level adoption of these varieties, however, depends on local perceptions of the value they add, along with willingness to pay (WTP) for it. Focusing on Zimbabwe, this research aimed at estimating the implicit prices farmers are willing to pay for drought tolerance in maize compared to other preferred traits. Using a choice experiment framework, we generated 12,600 observations from a random sample of 1,400 households in communal areas within 14 districts of Zimbabwe. Taste parameters and heterogeneities were estimated using the generalized multinomial logit model (G-MNL). The results reveal drought tolerance, grain yield, covered cob tip, cob size, and semi-flint texture to be the most preferred traits by farm households in Zimbabwe. The WTP estimates show that farmers are willing to pay a premium for drought tolerance equal to 2.56, 7, 3.2, and 5 times higher than for an additional ton of yield per acre, bigger cob size, larger grain size, and covered cob tip, respectively. We suggest designing and implementing innovative ways of promoting DT maize along with awareness-raising activities to enhance contextual understandings of drought and drought risk to speed adoption of new DT maize varieties by risk-prone farming communities. Given the high level of rural literacy and the high rate of adoption of improved maize, trait-based promotion and marketing of varieties constitutes the right strategy.

Perceived Race-Based Discrimination, Employment Status, and Job Stress in a National Sample of Black Women: Implications for Health Outcomes

PubMed Central

Mays, Vickie M.; Coleman, Lerita M.; Jackson, James S.

2013-01-01

Previous research has not systematically examined the relationship of perceived race-based discriminations to labor force participation or job related stresses–problems experienced by Black women. The present study investigated the relative contributions of perceived race-based discriminations and sociodemographic characteristics to employment status and job stress in a national probability sample (the National Survey of Black Americans; J. S. Jackson, 1991) of Black women in the United States. Logit and polychotomous logistic regression analyses revealed that Black women’s current employment status was best explained by sociodemographic measures. In contrast, the combination of perceived discrimination and sociodemographics differentially affects patterns of employment status and perceived job stress in the work environment of Black women. Implications of these findings for the health of African American women are discussed. PMID:9547054

Paying for Cures: How Can We Afford It? Managed Care Pharmacy Stakeholder Perceptions of Policy Options to Address Affordability of Prescription Drugs.

PubMed

Yeung, Kai; Suh, Kangho; Basu, Anirban; Garrison, Louis P; Bansal, Aasthaa; Carlson, Josh J

2017-10-01

High-priced medications with curative potential, such as the newer hepatitis C therapies, have contributed to the recent growth in pharmaceutical expenditure. Despite the obvious benefits, health care decision makers are just beginning to grapple with questions of how to value and pay for curative therapies that may feature large upfront cost, followed by health benefits that are reaped over a patient's lifespan. Alternative policy options have been proposed to promote high value and financially sustainable use of these therapies. It is unclear which policy options would be most acceptable to health care payer and biomedical manufacturer stakeholders. To (a) briefly review pharmaceutical policy options to address health system affordability and (b) assess the acceptability of alternative policy options to health care payers and biomedical manufacturers before and after an Academy of Managed Care Pharmacy (AMCP) continuing pharmacy education (CPE) session. We searched MEDLINE and Cochran databases for pharmaceutical policy options addressing affordability. With input from a focus group of managed care professionals, we developed CPE session content and an 8-question survey focusing on the most promising policy options. We fielded the survey before and after the CPE session, which occurred as part of the 2016 AMCP Annual Meeting. We first conducted a chi-squared goodness-of-fit test to assess response distributions. Next, we tested how responses differed before and after by using an ordered logit and a multinomial logit to model Likert scale and unordered responses, respectively. Although risk-sharing payments over time remained the most favorable choice before (37%) and after (35%) the CPE session, this choice was closely followed by HealthCoin after the session, which increased in favorability from 4% to 33% of responses (P = 0.001). About half of the respondents (54%) indicated that legislative change is the most significant barrier to the implementation of any policy. As high-cost curative drugs reach the market, managed care stakeholders need information from a balanced education source regarding alternative policies to address affordability. We found that after the AMCP CPE session, risk-sharing payments over time and HealthCoin were the most favorable options. No funding was provided for this research. Carlson reports consulting fees from Genentech, Pfizer, and Seattle Genetics. The other authors have nothing to disclose. Study concept and design were contributed by Yeung, Garrison, and Carlson. Yeung collected the data, which were interpreted by Yeung and Basu. The manuscript was written by Yeung, Suh, and Bansal and revised by Yeung. A portion of this research was presented at the Academy of Managed Care & Specialty Pharmacy Annual Meeting as a continuing education session entitled "Paying for Cures: How Can We Afford It?" on April 20, 2016, in San Francisco, California.

High depressive symptomatology among older community-dwelling Mexican Americans: the impact of immigration.

PubMed

Gerst, Kerstin; Al-Ghatrif, Majd; Beard, Holly A; Samper-Ternent, Rafael; Markides, Kyriakos S

2010-04-01

This analysis explores nativity differences in depressive symptoms among very old (75+) community-dwelling Mexican Americans. Cross-sectional analysis using the fifth wave (2004-2005) of the Hispanic Established Population for the Epidemiological Study of the Elderly (Hispanic EPESE). The sample consisted of 1699 non-institutionalized Mexican American men and women aged 75 years and above. Depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale (CES-D). Logistic regression was used to predict high depressive symptoms (CES-D score 16 or higher) and multinomial logistic regression was used to predict sub-threshold, moderate, and high depressive symptoms. Results showed that elders born in Mexico had higher odds of more depressive symptoms compared to otherwise similar Mexican Americans born in the US. Age of arrival, gender, and other covariates did not modify that risk. The findings suggest that older Mexican American immigrants are at higher risk of depressive symptomatology compared to persons born in the US, which has significant implications for research, policy, and clinical practice.

Characteristics in the first vaginal birth and their association with mode of delivery in the subsequent birth.

PubMed

Chen, Jian Sheng; Ford, Jane B; Ampt, Amanda; Simpson, Judy M; Roberts, Christine L

2013-03-01

The extent to which complications or adverse outcomes in a first vaginal birth may contribute to mode of delivery in the next birth remains unclear. This study examines the impact of the first birth on subsequent mode of delivery. The study population included women with a first vaginal birth and a consecutive second birth. Data were obtained from linked birth and hospital records for the state of New South Wales, Australia 2000-09. The primary outcome was the mode of delivery for the second birth. Planned caesarean was modelled using logistic regression; intrapartum caesarean and instrumental delivery were modelled using multinomial logistic regression. Of the 114 287 second births, 4.2% were planned caesarean, 3.0% were intrapartum caesarean and 4.8% were instrumental deliveries. Adjusted risk factors from the first birth for a planned second birth caesarean were third to fourth degree tear [odds ratio (OR) = 5.0 [95% confidence interval (CI) 4.6, 5.4

Valuing Non-market Benefits of Rehabilitation of Hydrologic Cycle Improvements in the Anyangcheon Watershed: Using Mixed Logit Models

NASA Astrophysics Data System (ADS)

Yoo, J.; Kong, K.

2010-12-01

This research the findings from a discrete-choice experiment designed to estimate the economic benefits associated with the Anyangcheon watershed improvements in Rep. of Korea. The Anyangcheon watershed has suffered from streamflow depletion and poor stream quality, which often negatively affect instream and near-stream ecologic integrity, as well as water supply. Such distortions in the hydrologic cycle mainly result from rapid increase of impermeable area due to urbanization, decreases of baseflow runoff due to groundwater pumping, and reduced precipitation inputs driven by climate forcing. As well, combined sewer overflows and increase of non-point source pollution from urban regions decrease water quality. The appeal of choice experiments (CE) in economic analysis is that it is based on random utility theory (McFadden, 1974; Ben-Akiva and Lerman, 1985). In contrast to contingent valuation method (CVM), which asks people to choose between a base case and a specific alternative, CE asks people to choice between cases that are described by attributes. The attributes of this study were selected from hydrologic vulnerability components that represent flood damage possibility, instreamflow depletion, water quality deterioration, form of the watershed and tax. Their levels were divided into three grades include status quo. Two grades represented the ideal conditions. These scenarios were constructed from a 35 orthogonal main effect design. This design resulted in twenty-seven choice sets. The design had nine different choice scenarios presented to each respondent. The most popular choice models in use are the conditional logit (CNL). This model provides closed-form choice probability calculation. The shortcoming of CNL comes from irrelevant alternatives (IIA). In this paper, the mixed logit (ML) is applied to allow the coefficient’s variation for random taste heterogeneity in the population. The mixed logit model(with normal distributions for the attributes) fit the data best, indication that allowing for both heterogeneous preferences across households and correlation between repeated choices may represent actual choice behaviors best of all the estimated models. The annual benefits to improve of the Anyancheon watershed for 1% improvement of each attribute was 406.7 billion Won(0.34 billion USD). This study is expected to contribute to the decision-making process for policy-makers by providing useful methodological framework and quantitative information related to watershed improvement projects.Table 1. Estimated Results of Conditional Logit and Mixed Logit Model 1) t-values are shown in brackets

Contributions of sociodemographic factors to criminal behavior

PubMed Central

Mundia, Lawrence; Matzin, Rohani; Mahalle, Salwa; Hamid, Malai Hayati; Osman, Ratna Suriani

2016-01-01

We explored the extent to which prisoner sociodemographic variables (age, education, marital status, employment, and whether their parents were married or not) influenced offending in 64 randomly selected Brunei inmates, comprising both sexes. A quantitative field survey design ideal for the type of participants used in a prison context was employed to investigate the problem. Hierarchical multiple regression analysis with backward elimination identified prisoner marital status and age groups as significantly related to offending. Furthermore, hierarchical multinomial logistic regression analysis with backward elimination indicated that prisoners’ age, primary level education, marital status, employment status, and parental marital status as significantly related to stealing offenses with high odds ratios. All 29 nonrecidivists were false negatives and predicted to reoffend upon release. Similarly, all 33 recidivists were projected to reoffend after release. Hierarchical binary logistic regression analysis revealed age groups (24–29 years and 30–35 years), employed prisoner, and primary level education as variables with high likelihood trends for reoffending. The results suggested that prisoner interventions (educational, counseling, and psychotherapy) in Brunei should treat not only antisocial personality, psychopathy, and mental health problems but also sociodemographic factors. The study generated offending patterns, trends, and norms that may inform subsequent investigations on Brunei prisoners. PMID:27382342

Clinical, biomarker, and genetic predictors of specific types of atrial fibrillation in a community-based cohort: data of the PREVEND study.

PubMed

Hobbelt, Anne H; Siland, Joylene E; Geelhoed, Bastiaan; Van Der Harst, Pim; Hillege, Hans L; Van Gelder, Isabelle C; Rienstra, Michiel

2017-02-01

Atrial fibrillation (AF) may present variously in time, and AF may progress from self-terminating to non-self-terminating AF, and is associated with impaired prognosis. However, predictors of AF types are largely unexplored. We investigate the clinical, biomarker, and genetic predictors of development of specific types of AF in a community-based cohort. We included 8042 individuals (319 with incident AF) of the PREVEND study. Types of AF were compared, and multivariate multinomial regression analysis determined associations with specific types of AF. Mean age was 48.5 ± 12.4 years and 50% were men. The types of incident AF were ascertained based on electrocardiograms; 103(32%) were classified as AF without 2-year recurrence, 158(50%) as self-terminating AF, and 58(18%) as non-self-terminating AF. With multivariate multinomial logistic regression analysis, advancing age (P< 0.001 for all three types) was associated with all AF types, male sex was associated with AF without 2-year recurrence and self-terminating AF (P= 0.031 and P= 0.008, respectively). Increasing body mass index and MR-proANP were associated with both self-terminating (P= 0.009 and P< 0.001) and non-self-terminating AF (P= 0.003 and P< 0.001). The only predictor associated with solely self-terminating AF is prescribed anti-hypertensive treatment (P= 0.019). The following predictors were associated with non-self-terminating AF; lower heart rate (P= 0.018), lipid-lowering treatment prescribed (P= 0.009), and eGFR <60 mL/min/1.73 m2 (P= 0.006). Three known AF-genetic variants (rs6666258, rs6817105, and rs10821415) were associated with self-terminating AF. We found clinical, biomarker and genetic predictors of specific types of incident AF in a community-based cohort. The genetic background seems to play a more important role than modifiable risk factors in self-terminating AF.

Associations between the home environment and children's sweet beverage consumption at 2-year follow-up: the 'Be active, eat right' study.

PubMed

van Grieken, A; Renders, C M; van de Gaar, V M; Hirasing, R A; Raat, H

2015-04-01

This study evaluates the association between home environmental characteristics and sweet beverage consumption (i.e. beverages that contain sugar) of 7-year-old children. The population for analysis consisted of n = 2047 parents and their children from the population-based 'Be active, eat right' study. Data on sociodemographic characteristics, parental beliefs, parenting practices and child's sweet beverage consumption were obtained by parental report with questionnaires. We performed linear and multinomial regression analyses evaluating associations between characteristics at age 5 years and (i) consumption at 7 years and (ii) consumption patterns between age 5 and 7 years with reference category 'low consumption'. Based on the report from their parents, 5-year-old children drank on average 3.0 (SD:1.4) sweet beverage per day. Children consumed less sweet beverages at age 7 years (beta -0.16, 95% confidence interval [CI] -0.24 to -0.09) when there were less sweet beverages available at home. The multinomial regression model showed that children with parents who discouraged sweet beverage consumption were more likely to decrease their sweet beverage consumption over the study period (odds ratio: 1.24, 95% CI 1.07 to 1.43). Moreover, when there were less sweet beverages available at home, children were less likely to increase their consumption or have a high consumption over the study period (odds ratio: 0.70, 95% CI 0.59 to 0.83 and 0.61, 95% CI 0.54 to 0.70, respectively). The results showed that characteristics of the home environment are associated with the consumption of sweet beverages among children. Specifically, the availability of sweet beverages at home is associated with the child's sweet beverage consumption. © 2014 The Authors. Pediatric Obesity © 2014 World Obesity.

Enzymatic Activity of Glutathione S-Transferase and Dental Fluorosis Among Children Receiving Two Different Levels of Naturally Fluoridated Water.

PubMed

Bonola-Gallardo, Irvin; Irigoyen-Camacho, María Esther; Vera-Robles, Liliana; Campero, Antonio; Gómez-Quiroz, Luis

2017-03-01

This study was conducted to measure the activity of the enzyme glutathione S-transferase (GST) in saliva and to compare the activity of this enzyme in children with and without dental fluorosis in communities with different concentrations of naturally fluoridated water. A total of 141 schoolchildren participated in this cross-sectional study. Children were selected from two communities: one with a low (0.4 ppm) and the other with a high (1.8 ppm) water fluoride concentration. Dental fluorosis was evaluated by applying the Thylstrup and Fejerskov Index (TFI) criteria. Stimulated saliva was obtained, and fluoride concentration and GST activity were measured. The GST activity was compared among children with different levels of dental fluorosis using multinomial logistic regression models and odds ratios (OR). The mean age of the children was 10.6 (±1.03) years. Approximately half of the children showed dental fluorosis (52.5 %). The average GST activity was 0.5678 (±0.1959) nmol/min/μg. A higher concentration of fluoride in the saliva was detected in children with a higher GST activity (p = 0.039). A multinomial logistic regression model used to evaluate the GST activity and the dental fluorosis score identified a strong association between TFI = 2-3 (OR = 15.44, p = 0.007) and TFI ≥ 4 (OR = 55.40, p = 0.026) and the GST activity level, compared with children showing TFI = 0-1, adjusted for age and sex. Schoolchildren with higher levels of dental fluorosis and a higher fluoride concentration in the saliva showed greater GST activity. The increased GST activity most likely was the result of the body's need to inactivate free radicals produced by exposure to fluoride.

Help-seeking in people with exceptional experiences: results from a general population sample.

PubMed

Landolt, Karin; Wittwer, Amrei; Wyss, Thomas; Unterassner, Lui; Fach, Wolfgang; Krummenacher, Peter; Brugger, Peter; Haker, Helene; Kawohl, Wolfram; Schubiger, Pius August; Folkers, Gerd; Rössler, Wulf

2014-01-01

Exceptional experiences (EE) are experiences that deviate from ordinary experiences, for example precognition, supernatural appearances, or déjà vues. In spite of the high frequency of EE in the general population, little is known about their effect on mental health and about the way people cope with EE. This study aimed to assess the quality and quantity of EE in persons from the Swiss general population, to identify the predictors of their help-seeking, and to determine how many of them approach the mental health system. An on-line survey was used to evaluate a quota sample of 1580 persons representing the Swiss general population with respect to gender, age, and level of education. Multinomial logistic regression was applied to integrate help-seeking, self-reported mental disorder, and other variables in a statistical model designed to identify predictors of help-seeking in persons with EE. Almost all participants (91%) experienced at least one EE. Generally, help-seeking was more frequent when the EE were of negative valence. Help-seeking because of EE was less frequent in persons without a self-reported mental disorder (8.6%) than in persons with a disorder (35.1%) (OR = 5.7). Even when frequency and attributes of EE were controlled for, people without a disorder sought four times less often help because of EE than expected. Persons with a self-reported diagnosis of mental disorder preferred seeing a mental health professional. Multinomial regression revealed a preference for healers in women with less education, who described themselves as believing and also having had more impressive EE. Persons with EE who do not indicate a mental disorder less often sought help because of EE than persons who indicated a mental disorder. We attribute this imbalance to a high inhibition threshold to seek professional help. Moreover, especially less educated women did not approach the mental health care system as often as other persons with EE, but preferred seeing a healer.

Can integrated health services delivery have an impact on hypertension management? A cross-sectional study in two cities of China.

PubMed

Li, Haitao; Sun, Ying; Qian, Dongfu

2016-11-30

Policy makers require information regarding performance of different primary care delivery models in managing hypertension, which can be helpful for better hypertension management. This study aims to compare continuity of care among hypertensive patients between Direct Management (DM) Model of community health centers (CHCs) in Wuhan and Loose Collaboration (LC) Model in Nanjing. A cross-sectional questionnaire survey was conducted. Four CHCs in each city were randomly selected as study settings. 386 patients in Nanjing and 396 in Wuhan completed face-to-face interview surveys and were included in the final analysis. The relational continuity and coordination continuity (including both information continuity and management continuity) were measured and analyzed. Binary or multinomial logistic regression models were used for comparison between the two cities. Participants from Nanjing had better relational continuity with primary care providers as compared with those from Wuhan, including more likely to be familiar with a CHC physician (OR = 2.762; 95%CI: 1.878 to 4.061), taken care of by the same CHC physician (OR = 1.846; 95%CI: 1.262 to 2.700), and known well by a CHC physician (OR = 1.762; 95%CI: 1.206 to 2.572). Multinomial logistic regression analyses showed there were significant differences between the two cities in reported frequency of communications between hospital and CHC physicians (P = 0.001), whether hospital and CHC physicians gave same treatment suggestions (P = 0.016), as well as how treatment strategy was formulated (P < 0.001). Participants in Wuhan were less likely than those in Nanjing to consider there was continuum regarding health services provided by hospital and CHC physicians (OR = 3.932; 95%CI: 2.394 to 6.459). Our study shows that continuity of care is better for LC Model in Nanjing than DM Model in Wuhan. Our study suggests there is room for improvement regarding relational and information continuity in both cities.

A site specific model and analysis of the neutral somatic mutation rate in whole-genome cancer data.

PubMed

Bertl, Johanna; Guo, Qianyun; Juul, Malene; Besenbacher, Søren; Nielsen, Morten Muhlig; Hornshøj, Henrik; Pedersen, Jakob Skou; Hobolth, Asger

2018-04-19

Detailed modelling of the neutral mutational process in cancer cells is crucial for identifying driver mutations and understanding the mutational mechanisms that act during cancer development. The neutral mutational process is very complex: whole-genome analyses have revealed that the mutation rate differs between cancer types, between patients and along the genome depending on the genetic and epigenetic context. Therefore, methods that predict the number of different types of mutations in regions or specific genomic elements must consider local genomic explanatory variables. A major drawback of most methods is the need to average the explanatory variables across the entire region or genomic element. This procedure is particularly problematic if the explanatory variable varies dramatically in the element under consideration. To take into account the fine scale of the explanatory variables, we model the probabilities of different types of mutations for each position in the genome by multinomial logistic regression. We analyse 505 cancer genomes from 14 different cancer types and compare the performance in predicting mutation rate for both regional based models and site-specific models. We show that for 1000 randomly selected genomic positions, the site-specific model predicts the mutation rate much better than regional based models. We use a forward selection procedure to identify the most important explanatory variables. The procedure identifies site-specific conservation (phyloP), replication timing, and expression level as the best predictors for the mutation rate. Finally, our model confirms and quantifies certain well-known mutational signatures. We find that our site-specific multinomial regression model outperforms the regional based models. The possibility of including genomic variables on different scales and patient specific variables makes it a versatile framework for studying different mutational mechanisms. Our model can serve as the neutral null model for the mutational process; regions that deviate from the null model are candidates for elements that drive cancer development.

An Assessment of Correlation between Dermatoglyphic Patterns and Sagittal Skeletal Discrepancies

PubMed Central

Philip, Biju; Madathody, Deepika; Mathew, Manu; Paul, Jose; Dlima, Johnson Prakash

2017-01-01

Introduction Investigators over years have been fascinated by dermatoglyphic patterns which has led to the development of dermatoglyphics as a science with numerous applications in various fields other than being the best and most widely used method for personal identification. Aim To assess the correlation between dermatoglyphic patterns and sagittal skeletal discrepancies. Materials and Methods A total of 180 patients, aged 18-40 years, were selected from those who attended the outpatient clinic of the Deparment of Orthodontics and Dentofacial Orthopedics, Mar Baselios Dental College, Kothamangalam, Kerala, India. The fingerprints of both hands were taken by ink and stamp method after proper hand washing. The patterns of arches, loops and whorls in fingerprints were assessed. The total ridge count was also evaluated. Data was also sent to the fingerprint experts for expert evaluation. The sagittal jaw relation was determined from the patient’s lateral cephalogram. The collected data was then statistically analyzed using Chi-square tests, ANOVA and Post-hoc tests and a Multinomial regression prediction was also done. Results A significant association was observed between the dermatoglyphic pattern exhibited by eight fingers and the sagittal skeletal discrepancies (p<0.05). An increased distribution of whorl pattern was observed in the skeletal Class II with maxillary excess group and skeletal Class II with mandibular deficiency group while an increased distribution of loop pattern was seen in the skeletal Class III with mandibular excess group and skeletal Class III with maxillary deficiency group. Higher mean of total ridge count was also seen in the groups of skeletal Class II with maxillary excess and skeletal Class II with mandibular deficiency. Multinomial regression predicting skeletal pattern with respect to the fingerprint pattern showed that the left thumb impression fits the best model for predicting the skeletal pattern. Conclusion There was a significant association between dermatoglyphic patterns and sagittal skeletal discrepancies. Dermatoglyphics could serve as a cost effective screening tool of these craniofacial problems. PMID:28511506

Determinants of postnatal care non-utilization among women in Nigeria.

PubMed

Somefun, Oluwaseyi Dolapo; Ibisomi, Latifat

2016-01-11

Although, there are several programs in place in Nigeria to ensure maternal and child health, maternal and neonatal mortality rates remain high with maternal mortality rates being 576/100,000 and neonatal mortality rates at 37/1000 live births (NDHS, 2013). While there are many studies on the utilization of maternal health services such as antenatal care and skilled delivery at birth, studies on postnatal care are limited. Therefore, the aim of this study is to examine the factors associated with the non-utilization of postnatal care among mothers in Nigeria using the Nigeria Demographic and Health Survey (NDHS) 2013. For analysis, the postnatal care uptake for 19,418 children born in the 5 years preceding the survey was considered. The dependent variable was a composite variable derived from a list of questions on postnatal care. A multinomial logistic regression model was applied to examine the adjusted and unadjusted determinants of non-utilization of postnatal care. Results from this study showed that 63% of the mothers of the 19,418 children did not utilize postnatal care services in the period examined. About 42% of the study population between 25 and 34 years did not utilize postnatal care and 61% of the women who did not utilize postnatal care had no education. Results from multinomial logistic regression show that antenatal care use, distance, education, place of delivery, region and wealth status are significantly associated with the non-utilization of postnatal care services. This study revealed the low uptake of postnatal care service in Nigeria. To increase mothers' utilization of postnatal care services and improve maternal and child health in Nigeria, interventions should be targeted at women in remote areas who don't have access to services and developing mobile clinics. In addition, it is crucial that steps should be taken on educating women. This would have a significant influence on their perceptions about the use of postnatal care services in Nigeria.

Does Smoke from Biomass Fuel Contribute to Anemia in Pregnant Women in Nagpur, India? A Cross-Sectional Study

PubMed Central

Page, Charlotte M.; Patel, Archana; Hibberd, Patricia L.

2015-01-01

Background Anemia affects upwards of 50% of pregnant women in developing countries and is associated with adverse outcomes for mother and child. We hypothesized that exposure to smoke from biomass fuel – which is widely used for household energy needs in resource-limited settings – could exacerbate anemia in pregnancy, possibly as a result of systemic inflammation. Objective To evaluate whether exposure to smoke from biomass fuel (wood, straw, crop residues, or dung) as opposed to clean fuel (electricity, liquefied petroleum gas, natural gas, or biogas) is an independent risk factor for anemia in pregnancy, classified by severity. Methods A secondary analysis was performed using data collected from a rural pregnancy cohort (N = 12,782) in Nagpur, India in 2011-2013 as part of the NIH-funded Maternal and Newborn Health Registry Study. Multinomial logistic regression was used to estimate the effect of biomass fuel vs. clean fuel use on anemia in pregnancy, controlling for maternal age, body mass index, education level, exposure to household tobacco smoke, parity, trimester when hemoglobin was measured, and receipt of prenatal iron and folate supplements. Results The prevalence of any anemia (hemoglobin < 11 g/dl) was 93% in biomass fuel users and 88% in clean fuel users. Moderate-to-severe anemia (hemoglobin < 10 g/dl) occurred in 53% and 40% of the women, respectively. Multinomial logistic regression showed higher relative risks of mild anemia in pregnancy (hemoglobin 10-11 g/dl; RRR = 1.38, 95% CI = 1.19-1.61) and of moderate-to-severe anemia in pregnancy (RRR = 1.79, 95% CI = 1.53-2.09) in biomass fuel vs. clean fuel users, after adjusting for covariates. Conclusion In our study population, exposure to biomass smoke was associated with higher risks of mild and moderate-to-severe anemia in pregnancy, independent of covariates. Trial Registration ClinicalTrials.gov NCT 01073475 PMID:26024473

Adrenal venous sampling in primary aldosteronism: multinomial regression modeling to detect aldosterone secretion lateralization when right adrenal sampling is missing.

PubMed

Durivage, Camille; Blanchette, Rémi; Soulez, Gilles; Chagnon, Miguel; Gilbert, Patrick; Giroux, Marie-France; Bourdeau, Isabelle; Oliva, Vincent L; Lacroix, André; Therasse, Eric

2017-02-01

Difficulty to recognize or canulate the right adrenal vein is the most frequent cause of adrenal venous sampling (AVS) failure. We aimed to assess multinomial regression modeling (MRM) of peripheral and left adrenal vein samplings to detect lateralization of aldosterone secretion when the right AVS is missing. Simultaneous bilateral AVS samplings were performed before (basal) and after intravenous cosyntropin injection in 188 consecutive patients between December 1989 and September 2015. Different reference standards for lateralization of aldosterone secretion were defined for basal and for postcosyntropin AVS and according to lateralization index cutoffs at least 2 and at least 4. MRMs were built to detect lateralization of aldosterone secretion according to these reference standards using only peripheral and left adrenal veins samplings (without the right AVS). Detection accuracy was assessed by the area under the receiver operating characteristic (AUROC) curves and detection sensitivities were reported for specificity at least 95%. For basal AVS with lateralization index at least 2, AUROC were respectively 0.931 [95% confidence interval (CI) 0.894-0.968] and 0.922 (95% CI 0.882-0.962) for right and left lateralization of aldosterone secretion detection and MRM could detect respectively 65.5 and 62.7% of the right and left lateralization of aldosterone secretion. For AVS after cosyntropin with lateralization index at least 4, AUROC were respectively 0.964 (95% CI: 0.940-0.987) and 0.955 (95% CI: 0.927-0.983) for right and left lateralization of aldosterone secretion, and MRM could detect respectively 77.2 and 72.9% of the right and left lateralization of aldosterone secretion. MRM can detect lateralization of aldosterone secretion without the right AVS in most patients and could eliminate the need for repeat AVS when right adrenal vein canulation is nonselective or impossible.

Adjunctive Self-hypnotic Relaxation for Outpatient Medical Procedures: A Prospective Randomized Trial with Women Undergoing Large Core Breast Biopsy

PubMed Central

Lang, Elvira V.; Berbaum, Kevin S.; Faintuch, Salomao; Hatsiopoulou, Olga; Halsey, Noami; Li, Xinyu; Berbaum, Michael L.; Laser, Eleanor; Baum, Janet

2008-01-01

Medical procedures in outpatient settings have limited options of managing pain and anxiety pharmacologically. We therefore assessed whether this can be achieved by adjunct self-hypnotic relaxation in a common and particularly anxiety provoking procedure. 236 women referred for large core needle breast biopsy to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n= 82), or self-hypnotic relaxation (n=78) during their procedures. Patients’ self-ratings at 10 minute-intervals of pain and anxiety on 0–10 verbal analog scales with 0=no pain/anxiety at all, 10=worst pain/anxiety possible, were compared in an ordinal logistic regression model. Women’s anxiety increased significantly in the standard group (logit slope = 0.18, p < 0.001), did not change in the empathy group (slope = −0.04, p = 0.45), and decreased significantly in the hypnosis group (slope = −0.27, p < 0.001). Pain increased significantly in all three groups (logit slopes: standard care = 0.53, empathy = 0.37, hypnosis = 0.34; all p < 0.001) though less steeply with hypnosis and empathy than standard care (p = 0.024 and p = 0.018 respectively). Room time and cost were not significantly different in an univariate ANOVA despite hypnosis and empathy requiring an additional professional: 46 minutes/$161 for standard care, 43 minutes/$163 for empathy, and 39 minutes/$152 for hypnosis. We conclude that, while both structured empathy and hypnosis decrease procedural pain and anxiety, hypnosis provides more powerful anxiety relief without undue cost and thus appears attractive for outpatient pain management. PMID:16959427