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.

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.

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.

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.

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,…

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…

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.

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.

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…

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...

Generalized Partial Least Squares Approach for Nominal Multinomial Logit Regression Models with a Functional Covariate

ERIC Educational Resources Information Center

Albaqshi, Amani Mohammed H.

2017-01-01

Functional Data Analysis (FDA) has attracted substantial attention for the last two decades. Within FDA, classifying curves into two or more categories is consistently of interest to scientists, but multi-class prediction within FDA is challenged in that most classification tools have been limited to binary response applications. The functional…

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.

Multinomial logistic regression modelling of obesity and overweight among primary school students in a rural area of Negeri Sembilan

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

Ghazali, Amirul Syafiq Mohd; Ali, Zalila; Noor, Norlida Mohd

Multinomial logistic regression is widely used to model the outcomes of a polytomous response variable, a categorical dependent variable with more than two categories. The model assumes that the conditional mean of the dependent categorical variables is the logistic function of an affine combination of predictor variables. Its procedure gives a number of logistic regression models that make specific comparisons of the response categories. When there are q categories of the response variable, the model consists of q-1 logit equations which are fitted simultaneously. The model is validated by variable selection procedures, tests of regression coefficients, a significant test ofmore » the overall model, goodness-of-fit measures, and validation of predicted probabilities using odds ratio. This study used the multinomial logistic regression model to investigate obesity and overweight among primary school students in a rural area on the basis of their demographic profiles, lifestyles and on the diet and food intake. The results indicated that obesity and overweight of students are related to gender, religion, sleep duration, time spent on electronic games, breakfast intake in a week, with whom meals are taken, protein intake, and also, the interaction between breakfast intake in a week with sleep duration, and the interaction between gender and protein intake.« less

Multinomial logistic regression modelling of obesity and overweight among primary school students in a rural area of Negeri Sembilan

NASA Astrophysics Data System (ADS)

Ghazali, Amirul Syafiq Mohd; Ali, Zalila; Noor, Norlida Mohd; Baharum, Adam

2015-10-01

Multinomial logistic regression is widely used to model the outcomes of a polytomous response variable, a categorical dependent variable with more than two categories. The model assumes that the conditional mean of the dependent categorical variables is the logistic function of an affine combination of predictor variables. Its procedure gives a number of logistic regression models that make specific comparisons of the response categories. When there are q categories of the response variable, the model consists of q-1 logit equations which are fitted simultaneously. The model is validated by variable selection procedures, tests of regression coefficients, a significant test of the overall model, goodness-of-fit measures, and validation of predicted probabilities using odds ratio. This study used the multinomial logistic regression model to investigate obesity and overweight among primary school students in a rural area on the basis of their demographic profiles, lifestyles and on the diet and food intake. The results indicated that obesity and overweight of students are related to gender, religion, sleep duration, time spent on electronic games, breakfast intake in a week, with whom meals are taken, protein intake, and also, the interaction between breakfast intake in a week with sleep duration, and the interaction between gender and protein intake.

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.

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.

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.

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.

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.

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.

Regression Models For Multivariate Count Data

PubMed Central

Zhang, Yiwen; Zhou, Hua; Zhou, Jin; Sun, Wei

2016-01-01

Data with multivariate count responses frequently occur in modern applications. The commonly used multinomial-logit model is limiting due to its restrictive mean-variance structure. For instance, analyzing count data from the recent RNA-seq technology by the multinomial-logit model leads to serious errors in hypothesis testing. The ubiquity of over-dispersion and complicated correlation structures among multivariate counts calls for more flexible regression models. In this article, we study some generalized linear models that incorporate various correlation structures among the counts. Current literature lacks a treatment of these models, partly due to the fact that they do not belong to the natural exponential family. We study the estimation, testing, and variable selection for these models in a unifying framework. The regression models are compared on both synthetic and real RNA-seq data. PMID:28348500

Regression Models For Multivariate Count Data.

PubMed

Zhang, Yiwen; Zhou, Hua; Zhou, Jin; Sun, Wei

2017-01-01

Data with multivariate count responses frequently occur in modern applications. The commonly used multinomial-logit model is limiting due to its restrictive mean-variance structure. For instance, analyzing count data from the recent RNA-seq technology by the multinomial-logit model leads to serious errors in hypothesis testing. The ubiquity of over-dispersion and complicated correlation structures among multivariate counts calls for more flexible regression models. In this article, we study some generalized linear models that incorporate various correlation structures among the counts. Current literature lacks a treatment of these models, partly due to the fact that they do not belong to the natural exponential family. We study the estimation, testing, and variable selection for these models in a unifying framework. The regression models are compared on both synthetic and real RNA-seq data.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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

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.

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…

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.

Emotional Reactions to Stress among Adolescent Boys and Girls: An Examination of the Mediating Mechanisms Proposed by General Strain Theory

ERIC Educational Resources Information Center

Sigfusdottir, Inga-Dora; Silver, Eric

2009-01-01

This study examines the effects of negative life events on anger and depressed mood among a sample of 7,758 Icelandic adolescents, measured as part of the National Survey of Icelandic Adolescents (Thorlindsson, Sigfusdottir, Bernburg, & Halldorsson, 1998). Using multiple linear regression and multinomial logit regression, we find that (a)…

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.

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.

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.

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.

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.

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

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.

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.

Analysis of multinomial models with unknown index using data augmentation

USGS Publications Warehouse

Royle, J. Andrew; Dorazio, R.M.; Link, W.A.

2007-01-01

Multinomial models with unknown index ('sample size') arise in many practical settings. In practice, Bayesian analysis of such models has proved difficult because the dimension of the parameter space is not fixed, being in some cases a function of the unknown index. We describe a data augmentation approach to the analysis of this class of models that provides for a generic and efficient Bayesian implementation. Under this approach, the data are augmented with all-zero detection histories. The resulting augmented dataset is modeled as a zero-inflated version of the complete-data model where an estimable zero-inflation parameter takes the place of the unknown multinomial index. Interestingly, data augmentation can be justified as being equivalent to imposing a discrete uniform prior on the multinomial index. We provide three examples involving estimating the size of an animal population, estimating the number of diabetes cases in a population using the Rasch model, and the motivating example of estimating the number of species in an animal community with latent probabilities of species occurrence and detection.

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

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

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

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

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.

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.

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.

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

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.

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…

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.

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.

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…

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.

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.

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.

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…

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…

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…

A Bayesian Multinomial Probit MODEL FOR THE ANALYSIS OF PANEL CHOICE DATA.

PubMed

Fong, Duncan K H; Kim, Sunghoon; Chen, Zhe; DeSarbo, Wayne S

2016-03-01

A new Bayesian multinomial probit model is proposed for the analysis of panel choice data. Using a parameter expansion technique, we are able to devise a Markov Chain Monte Carlo algorithm to compute our Bayesian estimates efficiently. We also show that the proposed procedure enables the estimation of individual level coefficients for the single-period multinomial probit model even when the available prior information is vague. We apply our new procedure to consumer purchase data and reanalyze a well-known scanner panel dataset that reveals new substantive insights. In addition, we delineate a number of advantageous features of our proposed procedure over several benchmark models. Finally, through a simulation analysis employing a fractional factorial design, we demonstrate that the results from our proposed model are quite robust with respect to differing factors across various conditions.

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.

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.

Pig Data and Bayesian Inference on Multinomial Probabilities

ERIC Educational Resources Information Center

Kern, John C.

2006-01-01

Bayesian inference on multinomial probabilities is conducted based on data collected from the game Pass the Pigs[R]. Prior information on these probabilities is readily available from the instruction manual, and is easily incorporated in a Dirichlet prior. Posterior analysis of the scoring probabilities quantifies the discrepancy between empirical…

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.

Assessing coastal plain wetland composition using advanced spaceborne thermal emission and reflection radiometer imagery

NASA Astrophysics Data System (ADS)

Pantaleoni, Eva

Establishing wetland gains and losses, delineating wetland boundaries, and determining their vegetative composition are major challenges that can be improved through remote sensing studies. We used the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) to separate wetlands from uplands in a study of 870 locations on the Virginia Coastal Plain. We used the first five bands from each of two ASTER scenes (6 March 2005 and 16 October 2005), covering the visible to the short-wave infrared region (0.52-2.185mum). We included GIS data layers for soil survey, topography, and presence or absence of water in a logistic regression model that predicted the location of over 78% of the wetlands. While this was slightly less accurate (78% vs. 86%) than current National Wetland Inventory (NWI) aerial photo interpretation procedures of locating wetlands, satellite imagery analysis holds great promise for speeding wetland mapping, lowering costs, and improving update frequency. To estimate wetland vegetation composition classes, we generated a classification and regression tree (CART) model and a multinomial logistic regression (logit) model, and compared their accuracy in separating woody wetlands, emergent wetlands and open water. The overall accuracy of the CART model was 73.3%, while for the logit model was 76.7%. The CART producer's accuracy of the emergent wetlands was higher than the accuracy from the multinomial logit (57.1% vs. 40.7%). However, we obtained the opposite result for the woody wetland category (68.7% vs. 52.6%). A McNemar test between the two models and NWI maps showed that their accuracies were not statistically different. We conducted a subpixel analysis of the ASTER images to estimate canopy cover of forested wetlands. We used top-of-atmosphere reflectance from the visible and near infrared bands, Delta Normalized Difference Vegetation Index, and a tasseled cap brightness, greenness, and wetness in linear regression model with canopy cover as the dependent variable. The model achieved an adjusted-R 2 of 0.69 (RMSE = 2.7%) for canopy cover less than 16%, and an adjusted-R 2 of 0.04 (RMSE = 19.8%) for higher canopy cover values. Taken together, these findings suggest that satellite remote sensing, in concert with other spatial data, has strong potential for mapping both wetland presence and type.

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…

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…

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.

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.

Network-constrained group lasso for high-dimensional multinomial classification with application to cancer subtype prediction.

PubMed

Tian, Xinyu; Wang, Xuefeng; Chen, Jun

2014-01-01

Classic multinomial logit model, commonly used in multiclass regression problem, is restricted to few predictors and does not take into account the relationship among variables. It has limited use for genomic data, where the number of genomic features far exceeds the sample size. Genomic features such as gene expressions are usually related by an underlying biological network. Efficient use of the network information is important to improve classification performance as well as the biological interpretability. We proposed a multinomial logit model that is capable of addressing both the high dimensionality of predictors and the underlying network information. Group lasso was used to induce model sparsity, and a network-constraint was imposed to induce the smoothness of the coefficients with respect to the underlying network structure. To deal with the non-smoothness of the objective function in optimization, we developed a proximal gradient algorithm for efficient computation. The proposed model was compared to models with no prior structure information in both simulations and a problem of cancer subtype prediction with real TCGA (the cancer genome atlas) gene expression data. The network-constrained mode outperformed the traditional ones in both cases.

Web usage mining at an academic health sciences library: an exploratory study.

PubMed

Bracke, Paul J

2004-10-01

This paper explores the potential of multinomial logistic regression analysis to perform Web usage mining for an academic health sciences library Website. Usage of database-driven resource gateway pages was logged for a six-month period, including information about users' network addresses, referring uniform resource locators (URLs), and types of resource accessed. It was found that referring URL did vary significantly by two factors: whether a user was on-campus and what type of resource was accessed. Although the data available for analysis are limited by the nature of the Web and concerns for privacy, this method demonstrates the potential for gaining insight into Web usage that supplements Web log analysis. It can be used to improve the design of static and dynamic Websites today and could be used in the design of more advanced Web systems in the future.

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.

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

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…

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.

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.

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

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.

Factors Associated with Alcohol Use Before or During Sex Among Men Who Have Sex with Men in a Large Internet Sample from Asia.

PubMed

Yang, Cui; Guadamuz, Thomas E; Lim, Sin How; Koe, Stuart; Wei, Chongyi

2016-04-01

We explored factors associated with alcohol use before or during sex among a sample of 10,861 men who have sex with men (MSM) in Asia who were recruited online for the study. Multinomial logistic regression analysis indicated that having sex under the influence of alcohol was associated with having multiple male partners, seeking partners primarily through gay bar/gym/dance party/friends, selling sex and using multiple drugs during the past 6 months, and unprotected anal sex. More efforts are needed to better assess alcohol use and misuse among MSM in Asia and understand contextual influences on alcohol use and HIV-related behaviors in order to implement culturally-specific interventions.

The View From the Bottom: Relative Deprivation and Bullying Victimization in Canadian Adolescents.

PubMed

Napoletano, Anthony; Elgar, Frank J; Saul, Grace; Dirks, Melanie; Craig, Wendy

2016-12-01

We investigated the relation between relative deprivation (RD)-disparity in affluence between adolescents and their more affluent schoolmates-and involvement in bullying among 23,383 students (aged 9-19) in 413 schools that participated in the 2010 Canadian Health Behavior in School-Aged Children survey. Students reported family affluence and frequency of bullying victimization and perpetration during the previous 2 months. Using the Yitzhaki index of RD and multinomial logistic regression analysis, we found that RD positively related to three types of bullying victimization (physical, relational, and cyberbullying) and to two types of perpetration (relational and cyberbullying) after differences in absolute affluence were held constant. These findings suggest that RD uniquely contributes to risk of bullying involvement. © The Author(s) 2015.

Exploring consumers’ attitudes towards informal patient payments using the combined method of cluster and multinomial regression analysis - the case of Hungary

PubMed Central

2013-01-01

Background Previous studies on informal patient payments have mostly focused on the magnitude and determinants of these payments while the attitudes of health care actors towards these payments are less well known. This study aims to reveal the attitudes of Hungarian health care consumers towards informal payments to provide a better understanding of this phenomenon. Methods For the analysis, we use data from a survey carried out in 2010 in Hungary involving a representative sample of 1037 respondents. We use cluster analysis to identify the main attitude groups related to informal payments based on the respondents’ perception of and behavior related to informal payments. Multinomial logistic regression is applied to examine the differences between these groups in terms of socio-demographic characteristics, as well as past utilization and informal payments paid for health care services. Results We identified three main different attitudes towards informal payments: accepting informal payments, doubting about informal payments and opposing informal payments. Those who accept informal payments (mostly young or elderly people, living in the capital) consider these payments as an expression of gratitude and perceive them as inevitable due to the low funding of the health care system. Those who doubt about informal payments (mostly respondents outside the capital, with higher education and higher household income) are not certain whether these payments are inevitable, perceive them as similar to corruption rather than gratitude, and would rather use private services to avoid these payments. We find that the opposition to informal payments (mostly among men from small households and low income households) can be explained by their lower ability and willingness to pay. Conclusions A large share of Hungarian health care consumers has a rather positive attitude towards informal payments, perceiving them as “inevitable due to the low funding of the health care system”. From a policy point-of-view, the change of this consumer attitude will be essential to deal with these payments in addition to other policy strategies. PMID:23414488

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…

Modeling Unconscious Gender Bias in Fame Judgments: Finding the Proper Branch of the Correct (Multinomial) Tree

PubMed

Draine; Greenwald; Banaji

1996-03-01

In the preceding article, Buchner and Wippich used a guessing-corrected, multinomial process-dissociation analysis to test whether a gender bias in fame judgments reported by Banaji and Greenwald (Journal of Personality and Social Psychology, 1995, 68, 181-198) was unconscious. In their two experiments, Buchner and Wippich found no evidence for unconscious mediation of this gender bias. Their conclusion can be questioned by noting that (a) the gender difference in familiarity of previously seen names that Buchner and Wippich modeled was different from the gender difference in criterion for fame judgments reported by Banaji and Greenwald, (b) the assumptions of Buchner and Wippich's multinomial model excluded processes that are plausibly involved in the fame judgment task, and (c) the constructs of Buchner and Wippich's model that corresponded most closely to Banaji and Greenwald's gender-bias interpretation were formulated so as to preclude the possibility of modeling that interpretation. Perhaps a more complex multinomial model can model the Banaji and Greenwald interpretation.

Modeling unconscious gender bias in fame judgments: finding the proper branch of the correct (multinomial) tree.

PubMed

Draine, S C; Greenwald, A G; Banaji, M R

1996-01-01

In the preceding article, Buchner and Wippich used a guessing-corrected, multinomial process-dissociation analysis to test whether a gender bias in fame judgements reported by Banaji and Greenwald (Journal of Personality and Social Psychology, 1995, 68, 181-198) was unconscious. In their two experiments, Buchner and Wippich found no evidence for unconscious mediation of this gender bias. Their conclusion can be questioned by noting that (a) the gender difference in familiarity of previously seen names that Buchner and Wippich modeled was different from the gender difference in criterion for fame judgements reported by Banaji and Greenwald, (b) the assumptions of Buchner and Wippich's multinomial model excluded processes that are plausibly involved in the fame judgement task, and (c) the constructs of Buchner and Wippich's model that corresponded most closely to Banaji and Greenwald's gender-bias interpretation were formulated so as to preclude the possibility of modeling that interpretation. Perhaps a more complex multinomial model can model the Banaji and Greenwald interpretation.

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.

Depressive vulnerabilities predict depression status and trajectories of depression over 1 year in persons with acute coronary syndrome.

PubMed

Doyle, Frank; McGee, Hannah; Delaney, Mary; Motterlini, Nicola; Conroy, Ronán

2011-01-01

Depression is prevalent in patients hospitalized with acute coronary syndrome (ACS). We determined whether theoretical vulnerabilities for depression (interpersonal life events, reinforcing events, cognitive distortions, Type D personality) predicted depression, or depression trajectories, post-hospitalization. We followed 375 ACS patients who completed depression scales during hospital admission and at least once during three follow-up intervals over 1 year (949 observations). Questionnaires assessing vulnerabilities were completed at baseline. Logistic regression for panel/longitudinal data predicted depression status during follow-up. Latent class analysis determined depression trajectories. Multinomial logistic regression modeled the relationship between vulnerabilities and trajectories. Vulnerabilities predicted depression status over time in univariate and multivariate analysis, even when controlling for baseline depression. Proportions in each depression trajectory category were as follows: persistent (15%), subthreshold (37%), never depressed (48%). Vulnerabilities independently predicted each of these trajectories, with effect sizes significantly highest for the persistent depression group. Self-reported vulnerabilities - stressful life events, reduced reinforcing events, cognitive distortions, personality - measured during hospitalization can identify those at risk for depression post-ACS and especially those with persistent depressive episodes. Interventions should focus on these vulnerabilities. Copyright © 2011 Elsevier Inc. All rights reserved.

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.

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

Meta-analysis of haplotype-association studies: comparison of methods and empirical evaluation of the literature

PubMed Central

2011-01-01

Background Meta-analysis is a popular methodology in several fields of medical research, including genetic association studies. However, the methods used for meta-analysis of association studies that report haplotypes have not been studied in detail. In this work, methods for performing meta-analysis of haplotype association studies are summarized, compared and presented in a unified framework along with an empirical evaluation of the literature. Results We present multivariate methods that use summary-based data as well as methods that use binary and count data in a generalized linear mixed model framework (logistic regression, multinomial regression and Poisson regression). The methods presented here avoid the inflation of the type I error rate that could be the result of the traditional approach of comparing a haplotype against the remaining ones, whereas, they can be fitted using standard software. Moreover, formal global tests are presented for assessing the statistical significance of the overall association. Although the methods presented here assume that the haplotypes are directly observed, they can be easily extended to allow for such an uncertainty by weighting the haplotypes by their probability. Conclusions An empirical evaluation of the published literature and a comparison against the meta-analyses that use single nucleotide polymorphisms, suggests that the studies reporting meta-analysis of haplotypes contain approximately half of the included studies and produce significant results twice more often. We show that this excess of statistically significant results, stems from the sub-optimal method of analysis used and, in approximately half of the cases, the statistical significance is refuted if the data are properly re-analyzed. Illustrative examples of code are given in Stata and it is anticipated that the methods developed in this work will be widely applied in the meta-analysis of haplotype association studies. PMID:21247440

Planning for health: a community-based spatial analysis of park availability and chronic disease across the lifespan.

PubMed

Besenyi, Gina M; Kaczynski, Andrew T; Stanis, Sonja A Wilhelm; Bergstrom, Ryan D; Lightner, Joseph S; Hipp, J Aaron

2014-05-01

The purpose of this study was to explore the spatial relationship between park availability and chronic health conditions (CHCs) across age groups in Kansas City, MO. Multinomial logistic regression examined the association between having a park within one-half mile from home and the likelihood of having 0, 1, or 2 or more CHCs. Among respondents aged 40-59, those without a park within one-half mile from home were more than twice as likely to have 2 or more CHCs compared to respondents that had a park nearby. Parks may be an important protective factor for chronic diseases, especially among middle-aged adults among whom access to neighborhood recreational environments may be particularly important. Copyright © 2014 Elsevier Ltd. All rights reserved.

Factors Associated with Alcohol Use Before or During Sex Among Men Who Have Sex with Men in a Large Internet Sample from Asia

PubMed Central

Guadamuz, Thomas E.; Lim, Sin How; Koe, Stuart; Wei, Chongyi

2016-01-01

Abstract We explored factors associated with alcohol use before or during sex among a sample of 10,861 men who have sex with men (MSM) in Asia who were recruited online for the study. Multinomial logistic regression analysis indicated that having sex under the influence of alcohol was associated with having multiple male partners, seeking partners primarily through gay bar/gym/dance party/friends, selling sex and using multiple drugs during the past 6 months, and unprotected anal sex. More efforts are needed to better assess alcohol use and misuse among MSM in Asia and understand contextual influences on alcohol use and HIV-related behaviors in order to implement culturally-specific interventions. PMID:26789393

Smoking, alcohol consumption and betal-quid chewing among young adult Myanmar laborers in Thailand.

PubMed

Htin, Kyaw; Howteerakull, Nopporn; Suwannapong, Nawarat; TipayamongkholgulI, Mathuros

2014-07-01

Health-risk behaviors among young adults are a serious public health problem. This cross sectional study aimed to estimate the prevalence of single and concurrent multiple health-risk behaviors: smoking tobacco, consuming alcohol, and chewing betel quid among young adult Myanmar laborers in Mae Sot District, Tak Province, Thailand. Three hundred Myanmar laborers, aged 18-24 years, were interviewed using a structured questionnaire. About 33.6% reported no risk behaviors, 24.7% had one, and 41.7% had two or three risk behaviors. Multinomial logistic regression analysis showed six variables were significantly associated with health-risk behaviors: male gender, high/moderate custom/traditional influences, friends who smoked/consumed alcohol/chewed betel quid, and exposure to betel-quid chewing by other family members.

Determinants of financial performance of home-visit nursing agencies in Japan.

PubMed

Fukui, Sakiko; Yoshiuchi, Kazuhiro; Fujita, Junko; Ikezaki, Sumie

2014-01-09

Japan has the highest aging population in the world and promotion of home health services is an urgent policy issue. As home-visit nursing plays a major role in home health services, the Japanese government began promotion of this activity in 1994. However, the scale of home-visit nursing agencies has remained small (the average numbers of nursing staff and other staff were 4.2 and 1.7, respectively, in 2011) and financial performance (profitability) is a concern in such small agencies. Additionally, the factors related to profitability in home-visit nursing agencies in Japan have not been examined multilaterally and in detail. Therefore, the purpose of the study was to examine the determinants of financial performance of home-visit nursing agencies. We performed a nationwide survey of 2,912 randomly selected home-visit nursing agencies in Japan. Multinomial logistic regression was used to clarify the determinants of profitability of the agency (profitable, stable or unprofitable) based on variables related to management of the agency (operating structure, management by a nurse manager, employment, patient utilization, quality control, regional cooperation, and financial condition). Among the selected home-visit nursing agencies, responses suitable for analysis were obtained from 1,340 (effective response rate, 46.0%). Multinomial logistic regression analysis showed that both profitability and unprofitability were related to multiple variables in management of the agency when compared to agencies with stable financial performance. These variables included the number of nursing staff/rehabilitation staff/patients, being owned by a hospital, the number of cooperative hospitals, home-death rate among terminal patients, controlling staff objectives by nurse managers, and income going to compensation. The results suggest that many variables in management of a home-visit nursing agency, including the operating structure of the agency, regional cooperation, staff employment, patient utilization, and quality control of care, have an influence in both profitable and unprofitable agencies. These findings indicate the importance of consideration of management issues in achieving stable financial performance in home-visit nursing agencies in Japan. The findings may also be useful in other countries with growing aging populations.

The relationship between red blood cell distribution width and blood pressure abnormal dipping in patients with essential hypertension: a cross-sectional study.

PubMed

Su, Dan; Guo, Qi; Gao, Ya; Han, Jin; Yan, Bin; Peng, Liyuan; Song, Anqi; Zhou, Fuling; Wang, Gang

2016-02-23

To investigate whether red blood cell distribution width (RDW) is associated with the blood pressure (BP) reverse-dipper pattern in patients with hypertension. Cross-sectional study. Single centre. Patients with essential hypertension were included in our study (n=708). The exclusion criteria included age <18 or >90 years, incomplete clinical data, night workers, diagnosis of secondary hypertension, under antihypertensive treatment, intolerance for the 24 h ambulatory BP monitoring (ABPM) and BP reading success rate <70%. Physical examination and ABPM were performed for all patients in our study. The value of RDW was measured using an automated haematology analyser. The distribution of RDW in patients with hypertension among different circadian BP pattern groups was analyzed using analysis of variance (ANOVA). Multinomial logistic regression was applied to explore the associations of RDW and other relevant variables with ABPM results. There was significantly increased RDW in reverse dippers (13.52 ± 1.05) than dippers (13.25 ± 0.85) of hypertension (p=0.012). Moreover, multinomial logistic regression analysis showed that RDW (OR 1.325, 95% CI 1.037 to 1.692, p=0.024) and diabetes mellitus (OR 2.286, 95% CI 1.380 to 3.788, p=0.001) were significantly different when comparing the reverse-dipper BP pattern with the dipper pattern. However, there was no difference of RDW between the non-dipper pattern and the reverse-dipper pattern (OR 1.036, 95% CI 0.867 to 1.238, p=0.693). In addition to this, RDW was negatively correlated with the decline rate of nocturnal systolic BP (r=-0.113; p=0.003) and diastolic BP (r=-0.101; p=0.007). Our results suggested that RDW might associate with the abnormal dipper BP patterns of either reverse dipping or non-dipping homogeneously examined with 24 h ABPM. 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/

Determinants of financial performance of home-visit nursing agencies in Japan

PubMed Central

2014-01-01

Background Japan has the highest aging population in the world and promotion of home health services is an urgent policy issue. As home-visit nursing plays a major role in home health services, the Japanese government began promotion of this activity in 1994. However, the scale of home-visit nursing agencies has remained small (the average numbers of nursing staff and other staff were 4.2 and 1.7, respectively, in 2011) and financial performance (profitability) is a concern in such small agencies. Additionally, the factors related to profitability in home-visit nursing agencies in Japan have not been examined multilaterally and in detail. Therefore, the purpose of the study was to examine the determinants of financial performance of home-visit nursing agencies. Methods We performed a nationwide survey of 2,912 randomly selected home-visit nursing agencies in Japan. Multinomial logistic regression was used to clarify the determinants of profitability of the agency (profitable, stable or unprofitable) based on variables related to management of the agency (operating structure, management by a nurse manager, employment, patient utilization, quality control, regional cooperation, and financial condition). Results Among the selected home-visit nursing agencies, responses suitable for analysis were obtained from 1,340 (effective response rate, 46.0%). Multinomial logistic regression analysis showed that both profitability and unprofitability were related to multiple variables in management of the agency when compared to agencies with stable financial performance. These variables included the number of nursing staff/rehabilitation staff/patients, being owned by a hospital, the number of cooperative hospitals, home-death rate among terminal patients, controlling staff objectives by nurse managers, and income going to compensation. Conclusions The results suggest that many variables in management of a home-visit nursing agency, including the operating structure of the agency, regional cooperation, staff employment, patient utilization, and quality control of care, have an influence in both profitable and unprofitable agencies. These findings indicate the importance of consideration of management issues in achieving stable financial performance in home-visit nursing agencies in Japan. The findings may also be useful in other countries with growing aging populations. PMID:24400964

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.

Gender differences in social support and leisure-time physical activity.

PubMed

Oliveira, Aldair J; Lopes, Claudia S; Rostila, Mikael; Werneck, Guilherme Loureiro; Griep, Rosane Härter; Leon, Antônio Carlos Monteiro Ponce de; Faerstein, Eduardo

2014-08-01

To identify gender differences in social support dimensions' effect on adults' leisure-time physical activity maintenance, type, and time. Longitudinal study of 1,278 non-faculty public employees at a university in Rio de Janeiro, RJ, Southeastern Brazil. Physical activity was evaluated using a dichotomous question with a two-week reference period, and further questions concerning leisure-time physical activity type (individual or group) and time spent on the activity. Social support was measured with the Medical Outcomes Study Social Support Scale. For the analysis, logistic regression models were adjusted separately by gender. A multinomial logistic regression showed an association between material support and individual activities among women (OR = 2.76; 95%CI 1.2;6.5). Affective support was associated with time spent on leisure-time physical activity only among men (OR = 1.80; 95%CI 1.1;3.2). All dimensions of social support that were examined influenced either the type of, or the time spent on, leisure-time physical activity. In some social support dimensions, the associations detected varied by gender. Future studies should attempt to elucidate the mechanisms involved in these gender differences.

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 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.

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.

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

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.

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.

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.

Physical and temporal characteristics of under 19, under 21 and senior male beach volleyball players.

PubMed

Medeiros, Alexandre; Marcelino, Rui; Mesquita, Isabel; Palao, José Manuel

2014-09-01

This study aimed to assess the effects of age groups and players' role (blocker vs. defender specialist) in beach volleyball in relation to physical and temporal variables, considering quality of opposition. 1101 rallies from Under 19 (U19), 933 rallies from Under 21 (U21), and 1480 rallies from senior (senior) (Men's Swatch World Championships, 2010-2011) were observed using video match analysis. Cluster analysis was used to set teams' competitive levels and establish quality of opposition as "balanced", "moderate balanced" and "unbalanced" games. The analyzed variables were: temporal (duration of set, total rest time, total work time, duration of rallies, rest time between rallies) and physical (number of jumps and number of hits done by defenders and blockers) characteristics. A one-way ANOVA, independent samples t-test and multinomial logistic regression were performed to analyze the variables studied. The analysis of temporal and physical characteristics showed differences considering age group, player's role and quality of opposition. The duration of set, total rest time, and number of jumps done by defenders significantly increased from the U19 to senior category. Multinomial logistic regression showed that in: a) balanced games, rest time between rallies was higher in seniors than in U19 or U21; number of jumps done by defenders was higher in seniors than in U19) and U21; b) moderate balanced games, number of jumps done by defenders was higher in seniors than in U21 and number of jumps done by blockers was smaller in U19 than U21 or seniors; c) unbalanced games, no significant findings were shown. This study suggests differences in players' performances according to age group and players' role in different qualities of opposition. The article provides reference values that can be useful to guide training and create scenarios that resemble a competition, taking into account physical and temporal characteristics. Key PointsPlayer roles, quality of opposition, and competitive level of the teams influence physical and temporal characteristics, and they may be taken into consideration during the training by strength and conditioning coaches and coaches.More experienced players adopt strategies to better manage their effort and rest time between rallies.The game strategy affects the physical actions done by players (e.g. tendency to serve more to one player of the team affects the number of jumps performed by this player).

Long working hours and emotional well-being in korean manufacturing industry employees.

PubMed

Lee, Kyoung-Hye; Kim, Jong-Eun; Kim, Young-Ki; Kang, Dong-Mug; Yun, Myeong-Ja; Park, Shin-Goo; Song, Jae-Seok; Lee, Sang-Gil

2013-12-05

Korea is well known for its long work hours amongst employees. Because workers of the manufacturing industry are constantly exposed to extended work hours, this study was based on how long work hours affect their emotional well-being. The analysis was done using the secondary Korean Working Condition Survey (KWCS). Long work hours were defined to be more than 48 hours, and they were subcategorized into units of 52 hours and 60 hours. Based on the WHO (five) well-being index, emotional state was subdivided into three groups - reference group, low-mood group, and possible depression group- where 28 points and 50 points were division points, and two groups were compared at a time. Association between long work hours and emotional state was analyzed using binary and multinomial logistic regression analysis. Working for extended working hours in the manufacturing industry showed a statistically significant increase (t test p < 0.001) in trend among the possible depression group when compared to the reference group and the low-mood group. When demographical characteristics, health behaviors, socioeconomic state, and work-related characteristics were fixed as controlled variables, as work hours increased the odds ratio of the possible depression group increased compared to the reference group, and especially the odds ratio was 2.73 times increased for work hours between 48-52 and 4.09 times increased for 60 hours or more and both were statistically significant. In comparing the low-mood group and possible depression group, as work hours increased the odds ratio increased to 1.73, 2.39, and 4.16 times, and all work hours from working 48-52 hours, 53-60 hours, and 60 hours or more were statistically significant. Multinomial logistic regression analysis also showed that among the reference group and possible group, the possible depression group was statistically significant as odds ratio increased to 2.94 times in working 53-60 hours, and 4.35 times in 60 hours or more. Long work hours have an adverse effect on emotional well-being. A more diversified research towards variables that affect long work hours and emotional well-being and how they interact with each other and their relationship to overall health is imperative.

Demographic and Motivation Differences Among Online Sex Offenders by Type of Offense: An Exploration of Routine Activities Theories.

PubMed

Navarro, Jordana N; Jasinski, Jana L

2015-01-01

This article presents an analysis of the relationship between online sexual offenders' demographic background and characteristics indicative of motivation and offense type. Specifically, we investigate whether these characteristics can distinguish different online sexual offender groups from one another as well as inform routine activity theorists on what potentially motivates perpetrators. Using multinomial logistic regression, this study found that online sexual offenders' demographic backgrounds and characteristics indicative of motivation do vary by offense types. Two important implications of this study are that the term "online sexual offender" encompasses different types of offenders, including some who do not align with mainstream media's characterization of "predators," and that the potential offender within routine activity theory can be the focus of empirical investigation rather than taken as a given in research.

Employee well-being, early-retirement intentions, and company performance.

PubMed

von Bonsdorff, Monika E; Vanhala, Sinikka; Seitsamo, Jorma; Janhonen, Minna; Husman, Päivi

2010-12-01

To explore the relationship between employee well-being and early-retirement intentions, and the extent to which early-retirement intentions are associated with company performance. This study is based on cross-sectional survey data on the ageing employees of the Finnish metal industry and retail trade, collected in 2007 (company-level n = 129, employee-level n = 1281). It was analyzed using multinomial logistic and multiple regression analysis. Poor work ability, frequent emotional exhaustion, low organizational commitment, and job control were associated with the prevalence of early-retirement intentions among aging employees in both industries. Metal industry employees' early-retirement intentions were associated with weaker company performance measured by the perceptions of the manager. By enhancing well-being, employees may stay at work for longer rather than retiring early. Early-retirement intentions can be counterproductive for companies.

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.

Inter-model comparison of the landscape determinants of vector-borne disease: implications for epidemiological and entomological risk modeling.

PubMed

Lorenz, Alyson; Dhingra, Radhika; Chang, Howard H; Bisanzio, Donal; Liu, Yang; Remais, Justin V

2014-01-01

Extrapolating landscape regression models for use in assessing vector-borne disease risk and other applications requires thoughtful evaluation of fundamental model choice issues. To examine implications of such choices, an analysis was conducted to explore the extent to which disparate landscape models agree in their epidemiological and entomological risk predictions when extrapolated to new regions. Agreement between six literature-drawn landscape models was examined by comparing predicted county-level distributions of either Lyme disease or Ixodes scapularis vector using Spearman ranked correlation. AUC analyses and multinomial logistic regression were used to assess the ability of these extrapolated landscape models to predict observed national data. Three models based on measures of vegetation, habitat patch characteristics, and herbaceous landcover emerged as effective predictors of observed disease and vector distribution. An ensemble model containing these three models improved precision and predictive ability over individual models. A priori assessment of qualitative model characteristics effectively identified models that subsequently emerged as better predictors in quantitative analysis. Both a methodology for quantitative model comparison and a checklist for qualitative assessment of candidate models for extrapolation are provided; both tools aim to improve collaboration between those producing models and those interested in applying them to new areas and research questions.

[Relationship between Working Schedule and Sleeping Hours with Overweight and Obesity in Spanish Adult Population According to Data from the National Health Survey 2012].

PubMed

Marqueta de Salas, María; Rodríguez Gómez, Lorena; Enjuto Martínez, Diego; Juárez Soto, José Juan; Martín-Ramiro, José Javier

2017-03-01

Obesity is a public health problem worldwide. The aim of the present study was to determine the association between the type of working schedule and the sleeping hours per day with obesity and overweight. Cross-sectional study of the National Health Survey in 2012. We conducted an analysis of multinomial logistic regression and estimated the rates of possible risk of obesity and overweight versus the normal weight in relation to the type of working schedule and sleeping hours. Obesity among those who worked at night was 17,50% and those who had irregular works was 17,92%. Overweight among those who performed part-time works was 40,81% and 39,17% in night works. The obesity and overweight among those who slept less than six hours a day were 24,42% and 40,99% respectively. Regression analysis logistic showed OR=1,83 (IC95% 1,15-1,75) in irregular works and OR= 1,83 (IC95% 1,59-2,11) in people who slept less than six hours. Whenever overweight and obesity are present, a positive association between irregular jobs and short patterns of rest has been found, but stadistical significance is lost when estimating the OR adjusting the confounding factors.

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.

A person-centered analysis of posttraumatic stress disorder symptoms following a natural disaster: predictors of latent class membership.

PubMed

Rosellini, Anthony J; Coffey, Scott F; Tracy, Melissa; Galea, Sandro

2014-01-01

The present study applied latent class analysis to a sample of 810 participants residing in southern Mississippi at the time of Hurricane Katrina to determine if people would report distinct, meaningful PTSD symptom classes following a natural disaster. We found a four-class solution that distinguished persons on the basis of PTSD symptom severity/pervasiveness (Severe, Moderate, Mild, and Negligible Classes). Multinomial logistic regression models demonstrated that membership in the Severe and Moderate Classes was associated with potentially traumatic hurricane-specific experiences (e.g., being physically injured, seeing dead bodies), pre-hurricane traumatic events, co-occurring depression symptom severity and suicidal ideation, certain religious beliefs, and post-hurricane stressors (e.g., social support). Collectively, the findings suggest that more severe/pervasive typologies of natural disaster PTSD may be predicted by the frequency and severity of exposure to stressful/traumatic experiences (before, during, and after the disaster), co-occurring psychopathology, and specific internal beliefs. Copyright © 2013 Elsevier Ltd. All rights reserved.

A Person-Centered Analysis of Posttraumatic Stress Disorder Symptoms Following a Natural Disaster: Predictors of Latent Class Membership

PubMed Central

Rosellini, Anthony J.; Coffey, Scott F.; Tracy, Melissa; Galea, Sandro

2014-01-01

The present study applied latent class analysis to a sample of 810 participants residing in southern Mississippi at the time of Hurricane Katrina to determine if people would report distinct, meaningful PTSD symptom classes following a natural disaster. We found a four-class solution that distinguished persons on the basis of PTSD symptom severity/pervasiveness (Severe, Moderate, Mild, and Negligible Classes). Multinomial logistic regression models demonstrated that membership in the Severe and Moderate Classes was associated with potentially traumatic hurricane-specific experiences (e.g., being physically injured, seeing dead bodies), pre-hurricane traumatic events, co-occurring depression symptom severity and suicidal ideation, certain religious beliefs, and post-hurricane stressors (e.g., social support). Collectively, the findings suggest that more severe/pervasive typologies of natural disaster PTSD may be predicted by the frequency and severity of exposure to stressful/traumatic experiences (before, during, and after the disaster), co-occurring psychopathology, and specific internal beliefs. PMID:24334161

Clinical characteristics indicating adenomyosis at the time of hysterectomy: a retrospective study in 291 patients.

PubMed

Taran, F Andrei; Wallwiener, Markus; Kabashi, Drita; Rothmund, Ralf; Rall, Katharina; Kraemer, Bernhard; Brucker, Sara Y

2012-06-01

To better characterize adenomyosis as a disease entity. We retrospectively reviewed the medical records of women undergoing hysterectomy with a histologic diagnosis of adenomyosis, adenomyosis and leiomyomas, and leiomyomas alone. The study included 291 women: 38 with adenomyosis alone, 56 with adenomyosis and leiomyomas, and 197 with leiomyomas alone. In univariate analysis, women with adenomyosis were younger (p = 0.018) and had lower uterine weights (p < 0.001) and more disease-specific symptoms (p = 0.008). In multinomial logistic regression analysis, a lower uterine weight (OR 0.99, CI 95% 0.99-1.0), pelvic pain (OR 4.8, CI 95% 1.5-15.2), a history of smoking (OR 2.6, CI 95% 1.1-6.5) and at least one delivery (OR 4.3, CI 95% 1.5-12.3) were associated with a greater likelihood of having adenomyosis but not leiomyomas alone. Women undergoing hysterectomy with adenomyosis alone have different clinical characteristics from women with adenomyosis and leiomyomas and from those with only leiomyomas.

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

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.

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.

Marital status and survival of patients with oral cavity squamous cell carcinoma: a population-based study.

PubMed

Shi, Xiao; Zhang, Ting-Ting; Hu, Wei-Ping; Ji, Qing-Hai

2017-04-25

The relationship between marital status and oral cavity squamous cell carcinoma (OCSCC) survival has not been explored. The objective of our study was to evaluate the impact of marital status on OCSCC survival and investigate the potential mechanisms. Married patients had better 5-year cancer-specific survival (CSS) (66.7% vs 54.9%) and 5-year overall survival (OS) (56.0% vs 41.1%). In multivariate Cox regression models, unmarried patients also showed higher mortality risk for both CSS (Hazard Ratio [HR]: 1.260, 95% confidence interval (CI): 1.187-1.339, P < 0.001) and OS (HR: 1.328, 95% CI: 1.266-1.392, P < 0.001). Multivariate logistic regression showed married patients were more likely to be diagnosed at earlier stage (P < 0.001) and receive surgery (P < 0.001). Married patients still demonstrated better prognosis in the 1:1 matched group analysis (CSS: 62.9% vs 60.8%, OS: 52.3% vs 46.5%). 11022 eligible OCSCC patients were identified from Surveillance, Epidemiology, and End Results (SEER) database, including 5902 married and 5120 unmarried individuals. Kaplan-Meier analysis, Log-rank test and Cox proportional hazards regression model were used to analyze survival and mortality risk. Influence of marital status on stage, age at diagnosis and selection of treatment was determined by binomial and multinomial logistic regression. Propensity score matching method was adopted to perform a 1:1 matched cohort. Marriage has an independently protective effect on OCSCC survival. Earlier diagnosis and more sufficient treatment are possible explanations. Besides, even after 1:1 matching, survival advantage of married group still exists, indicating that spousal support from other aspects may also play an important role.

Marital status and survival of patients with oral cavity squamous cell carcinoma: a population-based study

PubMed Central

Shi, Xiao; Zhang, Ting-ting; Hu, Wei-ping; Ji, Qing-hai

2017-01-01

Background The relationship between marital status and oral cavity squamous cell carcinoma (OCSCC) survival has not been explored. The objective of our study was to evaluate the impact of marital status on OCSCC survival and investigate the potential mechanisms. Results Married patients had better 5-year cancer-specific survival (CSS) (66.7% vs 54.9%) and 5-year overall survival (OS) (56.0% vs 41.1%). In multivariate Cox regression models, unmarried patients also showed higher mortality risk for both CSS (Hazard Ratio [HR]: 1.260, 95% confidence interval (CI): 1.187–1.339, P < 0.001) and OS (HR: 1.328, 95% CI: 1.266–1.392, P < 0.001). Multivariate logistic regression showed married patients were more likely to be diagnosed at earlier stage (P < 0.001) and receive surgery (P < 0.001). Married patients still demonstrated better prognosis in the 1:1 matched group analysis (CSS: 62.9% vs 60.8%, OS: 52.3% vs 46.5%). Materials and Methods 11022 eligible OCSCC patients were identified from Surveillance, Epidemiology, and End Results (SEER) database, including 5902 married and 5120 unmarried individuals. Kaplan-Meier analysis, Log-rank test and Cox proportional hazards regression model were used to analyze survival and mortality risk. Influence of marital status on stage, age at diagnosis and selection of treatment was determined by binomial and multinomial logistic regression. Propensity score matching method was adopted to perform a 1:1 matched cohort. Conclusions Marriage has an independently protective effect on OCSCC survival. Earlier diagnosis and more sufficient treatment are possible explanations. Besides, even after 1:1 matching, survival advantage of married group still exists, indicating that spousal support from other aspects may also play an important role. PMID:28415710

Uncovering a latent multinomial: Analysis of mark-recapture data with misidentification

USGS Publications Warehouse

Link, W.A.; Yoshizaki, J.; Bailey, L.L.; Pollock, K.H.

2010-01-01

Natural tags based on DNA fingerprints or natural features of animals are now becoming very widely used in wildlife population biology. However, classic capture-recapture models do not allow for misidentification of animals which is a potentially very serious problem with natural tags. Statistical analysis of misidentification processes is extremely difficult using traditional likelihood methods but is easily handled using Bayesian methods. We present a general framework for Bayesian analysis of categorical data arising from a latent multinomial distribution. Although our work is motivated by a specific model for misidentification in closed population capture-recapture analyses, with crucial assumptions which may not always be appropriate, the methods we develop extend naturally to a variety of other models with similar structure. Suppose that observed frequencies f are a known linear transformation f = A???x of a latent multinomial variable x with cell probability vector ?? = ??(??). Given that full conditional distributions [?? | x] can be sampled, implementation of Gibbs sampling requires only that we can sample from the full conditional distribution [x | f, ??], which is made possible by knowledge of the null space of A???. We illustrate the approach using two data sets with individual misidentification, one simulated, the other summarizing recapture data for salamanders based on natural marks. ?? 2009, The International Biometric Society.

Uncovering a Latent Multinomial: Analysis of Mark-Recapture Data with Misidentification

USGS Publications Warehouse

Link, W.A.; Yoshizaki, J.; Bailey, L.L.; Pollock, K.H.

2009-01-01

Natural tags based on DNA fingerprints or natural features of animals are now becoming very widely used in wildlife population biology. However, classic capture-recapture models do not allow for misidentification of animals which is a potentially very serious problem with natural tags. Statistical analysis of misidentification processes is extremely difficult using traditional likelihood methods but is easily handled using Bayesian methods. We present a general framework for Bayesian analysis of categorical data arising from a latent multinomial distribution. Although our work is motivated by a specific model for misidentification in closed population capture-recapture analyses, with crucial assumptions which may not always be appropriate, the methods we develop extend naturally to a variety of other models with similar structure. Suppose that observed frequencies f are a known linear transformation f=A'x of a latent multinomial variable x with cell probability vector pi= pi(theta). Given that full conditional distributions [theta | x] can be sampled, implementation of Gibbs sampling requires only that we can sample from the full conditional distribution [x | f, theta], which is made possible by knowledge of the null space of A'. We illustrate the approach using two data sets with individual misidentification, one simulated, the other summarizing recapture data for salamanders based on natural marks.

Severity of mental illness as a result of multiple childhood adversities: US National Epidemiologic Survey.

PubMed

Curran, Emma; Adamson, Gary; Stringer, Maurice; Rosato, Michael; Leavey, Gerard

2016-05-01

To examine patterns of childhood adversity, their long-term consequences and the combined effect of different childhood adversity patterns as predictors of subsequent psychopathology. Secondary analysis of data from the US National Epidemiologic Survey on alcohol and related conditions. Using latent class analysis to identify childhood adversity profiles; and using multinomial logistic regression to validate and further explore these profiles with a range of associated demographic and household characteristics. Finally, confirmatory factor analysis substantiated initial latent class analysis findings by investigating a range of mental health diagnoses. Latent class analysis generated a three-class model of childhood adversity in which 60 % of participants were allocated to a low adversity class; 14 % to a global adversities class (reporting exposures for all the derived latent classes); and 26 % to a domestic emotional and physical abuse class (exposed to a range of childhood adversities). Confirmatory Factor analysis defined an internalising-externalising spectrum to represent lifetime reporting patterns of mental health disorders. Using logistic regression, both adversity groups showed specific gender and race/ethnicity differences, related family discord and increased psychopathology. We identified underlying patterns in the exposure to childhood adversity and associated mental health. These findings are informative in their description of the configuration of adversities, rather than focusing solely on the cumulative aspect of experience. Amelioration of longer-term negative consequences requires early identification of psychopathology risk factors that can inform protective and preventive interventions. This study highlights the utility of screening for childhood adversities when individuals present with symptoms of psychiatric disorders.

Temporal patterns of variable relationships in person-oriented research: longitudinal models of configural frequency analysis.

PubMed

von Eye, Alexander; Mun, Eun Young; Bogat, G Anne

2008-03-01

This article reviews the premises of configural frequency analysis (CFA), including methods of choosing significance tests and base models, as well as protecting alpha, and discusses why CFA is a useful approach when conducting longitudinal person-oriented research. CFA operates at the manifest variable level. Longitudinal CFA seeks to identify those temporal patterns that stand out as more frequent (CFA types) or less frequent (CFA antitypes) than expected with reference to a base model. A base model that has been used frequently in CFA applications, prediction CFA, and a new base model, auto-association CFA, are discussed for analysis of cross-classifications of longitudinal data. The former base model takes the associations among predictors and among criteria into account. The latter takes the auto-associations among repeatedly observed variables into account. Application examples of each are given using data from a longitudinal study of domestic violence. It is demonstrated that CFA results are not redundant with results from log-linear modeling or multinomial regression and that, of these approaches, CFA shows particular utility when conducting person-oriented research.

Predicting Time Spent in Treatment in a Sample of Danish Survivors of Child Sexual Abuse.

PubMed

Fletcher, Shelley; Elklit, Ask; Shevlin, Mark; Armour, Cherie

2017-07-01

The aim of this study was to identify significant predictors of length of time spent in treatment. In a convenience sample of 439 Danish survivors of child sexual abuse, predictors of time spent in treatment were examined. Assessments were conducted on a 6-month basis over a period of 18 months. A multinomial logistic regression analysis revealed that the experience of neglect in childhood and having experienced rape at any life stage were associated with less time in treatment. Higher educational attainment and being male were associated with staying in treatment for longer periods of time. These factors may be important for identifying those at risk of terminating treatment prematurely. It is hoped that a better understanding of the factors that predict time spent in treatment will help to improve treatment outcomes for individuals who are at risk of dropping out of treatment at an early stage.

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.

The Validity of Dependence as a Health Outcome Measure in Alzheimer’s Disease

PubMed Central

Spackman, D. Eldon; Kadiyala, Srikanth; Neumann, Peter J.; Veenstra, David L.; Sullivan, Sean D.

2013-01-01

Background Relating to Alzheimer’s disease (AD), dependence has been defined as the increased need for assistance due to deterioration in cognition, physical functioning, and behavior. Our objective was to evaluate the association between dependence and measures of functional impairment. Methods Data were compiled by the National Alzheimer’s Coordinating Center. We used multinomial logistic regression to estimate the association between dependence and cognition, physical functioning, and behavior. Results The independent association with dependence was positive. Dependence was most strongly associated with physical functioning. A secondary analysis suggested a strong association of dependence with multiple impairments, as measured by the interaction terms, in more severe patients. Conclusions We find that dependence is simultaneously associated with physical functioning, cognition, and behavior, which support the construct validity of dependence. Dependence might be a more simple measure to explain the multifaceted disease progression of AD and convey the increasing need for care. PMID:23512996

The validity of dependence as a health outcome measure in Alzheimer's disease.

PubMed

Spackman, D Eldon; Kadiyala, Srikanth; Neumann, Peter J; Veenstra, David L; Sullivan, Sean D

2013-05-01

Relating to Alzheimer's disease (AD), dependence has been defined as the increased need for assistance due to deterioration in cognition, physical functioning, and behavior. Our objective was to evaluate the association between dependence and measures of functional impairment. Data were compiled by the National Alzheimer's Coordinating Center. We used multinomial logistic regression to estimate the association between dependence and cognition, physical functioning, and behavior. The independent association with dependence was positive. Dependence was most strongly associated with physical functioning. A secondary analysis suggested a strong association of dependence with multiple impairments, as measured by the interaction terms, in more severe patients. We find that dependence is simultaneously associated with physical functioning, cognition, and behavior, which support the construct validity of dependence. Dependence might be a more simple measure to explain the multifaceted disease progression of AD and convey the increasing need for care.

Validation of patient and nurse short forms of the Readiness for Hospital Discharge Scale and their relationship to return to the hospital.

PubMed

Weiss, Marianne E; Costa, Linda L; Yakusheva, Olga; Bobay, Kathleen L

2014-02-01

To validate patient and nurse short forms for discharge readiness assessment and their associations with 30-day readmissions and emergency department (ED) visits. A total of 254 adult medical-surgical patients and their discharging nurses from an Eastern US tertiary hospital between May and November, 2011. Prospective longitudinal design, multinomial logistic regression analysis. Nurses and patients independently completed an eight-item Readiness for Hospital Discharge Scale on the day of discharge. Patient characteristics, readmissions, and ED visits were electronically abstracted. Nurse assessment of low discharge readiness was associated with a six- to nine-fold increase in readmission risk. Patient self-assessment was not associated with readmission; neither was associated with ED visits. Nurse discharge readiness assessment should be added to existing strategies for identifying readmission risk. © Health Research and Educational Trust.

Romantic attraction and adolescent smoking trajectories.

PubMed

Pollard, Michael S; Tucker, Joan S; Green, Harold D; Kennedy, David P; Go, Myong-Hyun

2011-12-01

Research on sexual orientation and substance use has established that lesbian, gay, and bisexual (LGB) individuals are more likely to smoke than heterosexuals. This analysis furthers the examination of smoking behaviors across sexual orientation groups by describing how same- and opposite-sex romantic attraction, and changes in romantic attraction, are associated with distinct six-year developmental trajectories of smoking. The National Longitudinal Study of Adolescent Health dataset is used to test our hypotheses. Multinomial logistic regressions predicting smoking trajectory membership as a function of romantic attraction were separately estimated for men and women. Romantic attraction effects were found only for women. The change from self-reported heterosexual attraction to lesbian or bisexual attraction was more predictive of higher smoking trajectories than was a consistent lesbian or bisexual attraction, with potentially important differences between the smoking patterns of these two groups. Copyright © 2011 Elsevier Ltd. All rights reserved.

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.

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.

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.

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

Dengue-specific serotype related to clinical severity during the 2012/2013 epidemic in centre of Brazil.

PubMed

Rocha, Benigno A M; Guilarde, Adriana O; Argolo, Angela F L T; Tassara, Marianna Peres; da Silveira, Lucimeire A; Junqueira, Isabela C; Turchi, Marília D; Féres, Valéria C R; Martelli, Celina M T

2017-08-02

Please see Additional file 1 for translations of the abstract into the five official working languages of the United Nations. Currently, in Brazil, there is a co-circulation of the four dengue (DENV-1 to DENV-4) serotypes. This study aimed to assess whether different serotypes and antibody response patterns were associated with the severity of the disease during a dengue outbreak, which occurred in 2012/2013 in centre of Brazil. We conducted a prospective study with 452 patients with laboratory confirmed dengue in central Brazil, from January 2012 to July 2013. The clinical outcome was the severity of cases: dengue, dengue with warning signs, and severe dengue. The patients were evaluated at three different moments. Blood sampling for laboratory testing and confirmatory tests for dengue infection were performed. We performed a multinomial analysis considering the three categories of the dependent variable, as outlined above. The odds ratios (ORs) were calculated. A multinomial logistic regression model was applied for variables with a P-value <0.20. Statistical analysis was performed with STATA 12.0 software. Four hundred fifty-two patients (452/632, 71.5%) were diagnosed with dengue. The dengue virus (DENV) serotypes were identified in 243 cases. DENV-4 was detected in 135 patients (55.6%), DENV-1 in 91 (37.4%), DENV-3 in 13 (5.3%), and DENV-2 in 4 (1.6%). Patients with the DENV-1 serotype were more prone to present with several clinical and laboratory features as compared with DENV-4 patients, including spontaneous bleeding (P = 0.03), intense abdominal pain (P = 0.004), neurological symptoms (P = 0.09), and thrombocytopenia (P = 0.01). Secondary infection was more predominant among DENV-4 cases (80.0%) compared with DENV-1 cases (62.3%) (P = 0.03). The univariate analysis showed that females (OR = 2.12; 95% CI: 1.44-3.13; P < 0.01) had a higher risk of having dengue with warning signs. The multinomial analysis showed that severe dengue cases with secondary infection had an adjusted OR of 2.80 (95% CI: 0.78-10.00; P = 0.113) as compared with dengue fever with primary infection when adjusted for age and sex. The current data show that 5.8% of patients recruited for treatment in healthcare centres and hospitals during the study period had severe dengue. DENV-4 was the predominant serotype, followed by DENV-1, in a large outbreak of dengue in central Brazil. Our findings contribute to the understanding of clinical differences and immune status related to the serotypes DENV-1 and DENV-4 in central of Brazil.

Examining the relationships between life satisfaction and alcohol, tobacco and marijuana use among school-aged children.

PubMed

Lew, D; Xian, H; Qian, Z; Vaughn, M G

2018-05-03

There are many known risk factors associated with youth substance use. Nonetheless, the impact of life satisfaction (LS) on the use of alcohol, tobacco and marijuana by adolescents still remains largely unknown. The present analysis utilized data from the Health Behavior in School-Aged Children 2009-10 US study. Multilevel logistic regression models were used to assess the relationship between LS and individual substance use. Multilevel multinomial regression models examined the relationship with total number of substances used. After controlling for numerous variables associated with substance use, individuals reporting low LS were significantly more likely to ever use tobacco (OR = 1.34, 95% CI = [1.01, 1.78]), alcohol (OR = 1.45, 95% CI = [1.10, 1.92]) and marijuana (OR = 1.98, 95% CI = [1.39, 2.82]). Additionally, students with low LS were significantly more likely to use two substances (OR = 1.90, 95% CI = [1.15, 3.14]) and three substances concurrently (OR = 2.00, 95% CI = [1.27, 3.16]). The present study identified strong associations between LS and individual, as well as concurrent, substance use among adolescents. Interventions aiming to reduce adolescent substance use may benefit from incorporating components to improve LS.

Gender differences in social support and leisure-time physical activity

PubMed Central

Oliveira, Aldair J; Lopes, Claudia S; Rostila, Mikael; Werneck, Guilherme Loureiro; Griep, Rosane Härter; de Leon, Antônio Carlos Monteiro Ponce; Faerstein, Eduardo

2014-01-01

OBJECTIVE To identify gender differences in social support dimensions’ effect on adults’ leisure-time physical activity maintenance, type, and time. METHODS Longitudinal study of 1,278 non-faculty public employees at a university in Rio de Janeiro, RJ, Southeastern Brazil. Physical activity was evaluated using a dichotomous question with a two-week reference period, and further questions concerning leisure-time physical activity type (individual or group) and time spent on the activity. Social support was measured with the Medical Outcomes Study Social Support Scale. For the analysis, logistic regression models were adjusted separately by gender. RESULTS A multinomial logistic regression showed an association between material support and individual activities among women (OR = 2.76; 95%CI 1.2;6.5). Affective support was associated with time spent on leisure-time physical activity only among men (OR = 1.80; 95%CI 1.1;3.2). CONCLUSIONS All dimensions of social support that were examined influenced either the type of, or the time spent on, leisure-time physical activity. In some social support dimensions, the associations detected varied by gender. Future studies should attempt to elucidate the mechanisms involved in these gender differences. PMID:25210819

Refining the notion of maturing out: results from the national epidemiologic survey on alcohol and related conditions.

PubMed

Vergés, Alvaro; Haeny, Angela M; Jackson, Kristina M; Bucholz, Kathleen K; Grant, Julia D; Trull, Timothy J; Wood, Phillip K; Sher, Kenneth J

2013-12-01

Our aim was to determine if the decrease in drug use disorders with age is attributable to changes in persistence, as implied by the notion of maturing out. Also, we examined the association between role transitions and persistence, recurrence, and new onset of drug use disorders. We performed secondary analysis of the 2 waves of the National Epidemiologic Survey on Alcohol and Related Conditions data (baseline assessment 2001-2002, follow-up conducted 2004-2005). We conducted logistic regressions and multinomial logistic regression to determine the effect of age on wave 2 diagnosis status, as well as the interaction between age and role transitions. Rates of persistence were stable over the life span, whereas rates of new onset and recurrence decreased with age. Changes in parenthood, marital, and employment status were associated with persistence, new onset, and recurrence. We found an interaction between marital status and age. Our findings challenge commonly held notions that the age-related decrease in drug use disorders is attributable to an increase in persistence, and that the effects of role transitions are stronger during young, compared with middle and older, adulthood.

The relationship between problem gambling and mental and physical health correlates among a nationally representative sample of Canadian women.

PubMed

Afifi, Tracie O; Cox, Brian J; Martens, Patricia J; Sareen, Jitender; Enns, Murray W

2010-01-01

Gambling has become an increasingly common activity among women since the widespread growth of the gambling industry. Currently, our knowledge of the relationship between problem gambling among women and mental and physical correlates is limited. Therefore, important relationships between problem gambling and health and functioning, mental disorders, physical health conditions, and help-seeking behaviours among women were examined using a nationally representative Canadian sample. Data were from the nationally representative Canadian Community Health Survey Cycle 1.2 (CCHS 1.2; n = 10,056 women aged 15 years and older; data collected in 2002). The statistical analysis included binary logistic regression, multinomial logistic regression, and linear regression models. Past 12-month problem gambling was associated with a significantly higher probability of current lower general health, suicidal ideation and attempts, decreased psychological well-being, increased distress, depression, mania, panic attacks, social phobia, agoraphobia, alcohol dependence, any mental disorder, comorbidity of mental disorders, chronic bronchitis, fibromyalgia, migraine headaches, help-seeking from a professional, attending a self-help group, and calling a telephone help line (odds ratios ranged from 1.5 to 8.2). Problem gambling was associated with a broad range of negative health correlates among women. Problem gambling is an important public health concern. These findings can be used to inform healthy public policies on gambling.

Women's health in a rural community in Kerala, India: do caste and socioeconomic position matter?

PubMed Central

Mohindra, K S; Haddad, Slim; Narayana, D

2006-01-01

Objectives To examine the social patterning of women's self‐reported health status in India and the validity of the two hypotheses: (1) low caste and lower socioeconomic position is associated with worse reported health status, and (2) associations between socioeconomic position and reported health status vary across castes. Design Cross‐sectional household survey, age‐adjusted percentages and odds ratios, and multilevel multinomial logistic regression models were used for analysis. Setting A panchayat (territorial decentralised unit) in Kerala, India, in 2003. Participants 4196 non‐elderly women. Outcome measures Self‐perceived health status and reported limitations in activities in daily living. Results Women from lower castes (scheduled castes/scheduled tribes (SC/ST) and other backward castes (OBC) reported a higher prevalence of poor health than women from forward castes. Socioeconomic inequalities were observed in health regardless of the indicators, education, women's employment status or household landholdings. The multilevel multinomial models indicate that the associations between socioeconomic indicators and health vary across caste. Among SC/ST and OBC women, the influence of socioeconomic variables led to a “magnifying” effect, whereas among forward caste women, a “buffering” effect was found. Among lower caste women, the associations between socioeconomic factors and self‐assessed health are graded; the associations are strongest when comparing the lowest and highest ratings of health. Conclusions Even in a relatively egalitarian state in India, there are caste and socioeconomic inequalities in women's health. Implementing interventions that concomitantly deal with caste and socioeconomic disparities will likely produce more equitable results than targeting either type of inequality in isolation. PMID:17108296

Hospital financial position and the adoption of electronic health records.

PubMed

Ginn, Gregory O; Shen, Jay J; Moseley, Charles B

2011-01-01

The objective of this study was to examine the relationship between financial position and adoption of electronic health records (EHRs) in 2442 acute care hospitals. The study was cross-sectional and utilized a general linear mixed model with the multinomial distribution specification for data analysis. We verified the results by also running a multinomial logistic regression model. To measure our variables, we used data from (1) the 2007 American Hospital Association (AHA) electronic health record implementation survey, (2) the 2006 Centers for Medicare and Medicaid Cost Reports, and (3) the 2006 AHA Annual Survey containing organizational and operational data. Our dependent variable was an ordinal variable with three levels used to indicate the extent of EHR adoption by hospitals. Our independent variables were five financial ratios: (1) net days revenue in accounts receivable, (2) total margin, (3) the equity multiplier, (4) total asset turnover, and (5) the ratio of total payroll to total expenses. For control variables, we used (1) bed size, (2) ownership type, (3) teaching affiliation, (4) system membership, (5) network participation, (6) fulltime equivalent nurses per adjusted average daily census, (7) average daily census per staffed bed, (8) Medicare patients percentage, (9) Medicaid patients percentage, (10) capitation-based reimbursement, and (11) nonconcentrated market. Only liquidity was significant and positively associated with EHR adoption. Asset turnover ratio was significant but, unexpectedly, was negatively associated with EHR adoption. However, many control variables, most notably bed size, showed significant positive associations with EHR adoption. Thus, it seems that hospitals adopt EHRs as a strategic move to better align themselves with their environment.

Association between serum alkaline phosphatase and primary resistance to erythropoiesis stimulating agents in chronic kidney disease: a secondary analysis of the HERO trial.

PubMed

Badve, Sunil V; Zhang, Lei; Coombes, Jeff S; Pascoe, Elaine M; Cass, Alan; Clarke, Philip; Ferrari, Paolo; McDonald, Stephen P; Morrish, Alicia T; Pedagogos, Eugenie; Perkovic, Vlado; Reidlinger, Donna; Scaria, Anish; Walker, Rowan; Vergara, Liza A; Hawley, Carmel M; Johnson, David W

2015-01-01

Erythropoiesis stimulating agent (ESA)-resistant anemia is common in chronic kidney disease (CKD). To evaluate the determinants of severity of ESA resistance in patients with CKD and primary ESA-resistance. Secondary analysis of a randomized controlled trial (the Handling Erythropoietin Resistance with Oxpentifylline, HERO). 53 adult patients with CKD stage 4 or 5 and primary ESA-resistant anemia (hemoglobin ≤120 g/L, ESA resistance index [ERI] ≥1.0 IU/kg/week/gHb for erythropoietin or ≥0.005 μg/kg/week/gHb for darbepoeitin, no cause for ESA-resistance identified). Iron studies, parathyroid hormone, albumin, liver enzymes, phosphate or markers of oxidative stress and inflammation. Participants were divided into tertiles of ERI. Multinomial logistic regression was used to analyse the determinants of ERI tertiles. All patients, except one, were receiving dialysis for end-stage kidney disease. The mean ± SD ERI values in the low (n = 18), medium (n = 18) and high (n = 17) ERI tertiles were 1.4 ± 0.3, 2.3 ± 0.2 and 3.5 ± 0.8 IU/kg/week/gHb, respectively (P < 0.001). There were no significant differences observed in age, gender, ethnicity, cause of kidney disease, diabetes, iron studies, parathyroid hormone, albumin, liver enzymes, phosphate or markers of oxidative stress and inflammation between the ERI tertiles. The median [inter-quartile range] serum alkaline phosphatase concentrations in the low, medium and high ERI tertiles were 89 [64,121], 99 [76,134 and 148 [87,175] U/L, respectively (P = 0.054). There was a weak but statistically significant association between ERI and serum alkaline phosphatase (R(2) = 0.06, P = 0.03). Using multinomial logistic regression, the risk of being in the high ERI tertile relative to the low ERI tertile increased with increasing serum alkaline phosphatase levels (P = 0.02). No other variables were significantly associated with ERI. Small sample size; bone-specific alkaline phosphatase, other markers of bone turnover and bone biopsies not evaluated. Serum alkaline phosphatase was associated with severity of ESA resistance in ESA-resistant patients with CKD. Large prospective studies are required to confirm this association. ( Australian New Zealand Clinical Trials Registry 12608000199314).

Patterns and determinants of care seeking for obstetric complications in rural northwest Bangladesh: analysis from a prospective cohort study.

PubMed

Sikder, Shegufta S; Labrique, Alain B; Craig, Ian M; Wakil, Mohammad Abdul; Shamim, Abu Ahmed; Ali, Hasmot; Mehra, Sucheta; Wu, Lee; Shaikh, Saijuddin; West, Keith P; Christian, Parul

2015-04-18

In communities with low rates of institutional delivery, little data exist on care-seeking behavior for potentially life-threatening obstetric complications. In this analysis, we sought to describe care-seeking patterns for self-reported complications and near misses in rural Bangladesh and to identify factors associated with care seeking for these conditions. Utilizing data from a community-randomized controlled trial enrolling 42,214 pregnant women between 2007 and 2011, we used multivariable multinomial logistic regression to explore the association of demographic and socioeconomic factors, perceived need, and service availability with care seeking for obstetric complications or near misses. We also used multivariable multinomial logistic regression to analyze the factors associated with care seeking by type of obstetric complication (eclampsia, sepsis, hemorrhage, and obstructed labor). Out of 9,576 women with data on care seeking for obstetric complications, 77% sought any care, with 29% (n = 2,150) visiting at least one formal provider and 70% (n = 5,149) visiting informal providers only. The proportion of women seeking at least one formal provider was highest among women reporting eclampsia (57%), followed by hemorrhage (28%), obstructed labor (22%), and sepsis (17%) (p < 0.001). In multivariable analyses, socioeconomic factors such as living in a household from the highest wealth quartile (Relative Risk Ratio of 1.49; 95% CI of [1.33-1.73]), women's literacy (RRR of 1.21; 95% CI of [1.05-1.42]), and women's employment (RRR of 1.10; 95% CI of [1.01-1.18]) were significantly associated with care seeking from formal providers. Service factors including living less than 10 kilometers from a health facility (RRR of 1.16; 95% CI of [1.05-1.28]) and facility availability of comprehensive obstetric services (RRR of 1.25; 95% CI of 1.04-1.36) were also significantly associated with seeking care from formal providers. While the majority of women reporting obstetric complications sought care, less than a third visited health facilities. Improvements in socioeconomic factors such as maternal literacy, coupled with improved geographic access and service availability, may increase care seeking from formal facilities. Enhancing community awareness on symptoms of hemorrhage, sepsis, and obstructed labor and their consequences may promote care seeking for obstetric complications in rural Bangladesh. NCT00860470 .

Effective role of lady health workers in immunization of children in Pakistan.

PubMed

Afzal, Saira; Naeem, Azka; Shahid, Unaiza; Noor Syed, Wajiha; Khan, Urva; Misal Zaidi, Nayyar

2016-01-01

To determine the association of Lady Health Worker's role with immunization of children in Pakistan. Secondary analysis was conducted on data obtained from Pakistan's Demographic and Health Survey. Children who did not receive all doses of vaccines were considered incompletely immunized or vice versa. The association between determinants was assessed by simple and multivariable binary logistic regression. The mothers and fathers had a mean age of 32.7 (SD+8.6) years and 37.9 (SD +10.1) years, respectively. Age of mother greater than 35 (OR=0.93; 95% CI:0.70-1.25); born in Baluchistan (OR=3.47,95% CI:2.21-5.49); rural area dwellers (OR=2.04; 95% CI:1.65-2.51); female gender (OR=1.06; 95% CI:0.87-1.29); birth order (of last born child) greater than 7 (OR=2.21, 95% CI:1.60-3.06); delivered at home (OR=2.20, 95% CI:1.76-2.74); long distance to health care facility (OR=2.66, 95% CI:2.16-3.28); and no LHW visit in last 12 months (OR=1.91, CI:1.48-2.47) were significantly associated with incomplete immunization in bivariate analysis. In final model of multinomial regression analysis the absence of visit by LHW in last 12 months was the most significant factor when all risk factors were analyzed in last model. This study has concluded that visit of LHW in last 12 months was significantly associated with immunization.

Is Emotional Congruence With Children Associated With Sexual Offending in Pedophiles and Hebephiles From the Community?

PubMed

Konrad, Anna; Kuhle, Laura F; Amelung, Till; Beier, Klaus M

2018-02-01

Although emotional congruence with children (ECWC) is a risk factor for sexual offending against children, its conceptual validity has hardly been researched. This study aims to explore the construct of ECWC by evaluating the factor structure of the Child Identification Scale (CIS-R) and its relation to facets of sexual preference and child sexual abuse behaviors. It was hypothesized that the measure comprises consistent subscales that are differently associated with aspects of sexual preference and sexual offending against children. CIS-R data of a sample of 217 adult male pedophiles from the community were used for an exploratory principal component analysis (PCA). Group comparisons and a multinomial logistic regression analysis were conducted after including a non-pedophilic control group of 22 adult men. PCA revealed a three-factor solution for the CIS-R accounting for 30% of variance. Group comparisons found differences in overall scores and the factor labeled "Attachment to Children" between subgroups of sexual age and gender preference, but not between contact, online, and non-offenders. The regression analysis showed a pedophile sexual preference and the interaction between a hebephile sexual age preference and the factor "Attachment to Children" being associated with past offending behavior. The results indicate a wish to attach to children as core feature of the CIS-R measure assessing ECWC. It is discussed whether this is an inherent feature of pedophilia or rather an independent aspect being differently distinct in pedophiles.

[Detection and evaluation of the role of sarcopenia in elderly patients with cancer treated with chemotherapy. ONCOSARCO project].

PubMed

Molina Garrido, Maria José; Guillén Ponce, Carmen; Fernández Félix, Borja Manuel; Muñoz Sánchez, Maria Del Mar; Soriano Rodríguez, Maria Del Carmen; Olaverri Hernández, Amaya; Santiago Crespo, Jose Antonio

To develop a predictive model of toxicity to chemotherapy in elderly patients with cancer, using the variables associated with sarcopenia, and to identify which of these parameters, sarcopenia or frailty, is the best predictor of toxicity to chemotherapy in the elderly. A prospective observational study with patients ≥70 years treated with chemotherapy in the Cancer Unit for the Elderly, in the Medical Oncology Section of the Hospital Virgen de la Luz de Cuenca. The following tests will be performed by each patient before chemotherapy: muscle strength (handgrip, cylindrical handgrip, pinch gauge, hip flexion, knee extension), muscle mass (skeletal muscle mass index), and physical function (gait speed and 5STS test). The occurrence of severe toxicity will be recorded over a period of 4 months of chemotherapy treatment. It will be evaluated, using logistic regression analysis, whether sarcopenia (defined by the European Working Group on Sarcopenia in Older People) or frailty (defined by the phenotype of frailty) is the best predictor of chemotherapy toxicity. Using a multinomial logistic regression analysis, we will try to create the first model to predict toxicity to chemotherapy in elderly patients with diagnosis of cancer, based on the definition of sarcopenia. It is expected that the final analysis of this project will be useful to detect predictive factors of toxicity to chemotherapy in elderly patients with cancer. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

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.

Are social security policies for Chinese landless farmers really effective on health in the process of Chinese rapid urbanization? a study on the effect of social security policies for Chinese landless farmers on their health-related quality of life

PubMed Central

2014-01-01

Background The continuing urbanization in China has resulted in a loss of land and rights among farmers. The social security of landless farmers has attracted considerable research attention. However, only few studies measure the health-related quality of life (HRQOL) of landless farmers by employing scientific standardized scales. By using five-dimensional European quality of life (EQ-5D) scales, this study measures the HRQOL of landless farmers from a new perspective and examines how the social security policies affect their HRQOL. Methods This study is based on a 2013 household survey that has been conducted among 1,500 landless famers who are residing in six resettlement areas in three cities within the Yangtze River Delta region, namely, Nanjing, Hangzhou, and Yangzhou. This study adopts EQ-5D scales to measure the HRQOL of these farmers. More than 50% of the respondents are in poor or non-serious health conditions, and over 50% are not satisfied with their current social security policies. The health conditions and social security policies are analyzed by multinomial regression analysis and the relationship between these two factors are analyzed via structural equation modeling (SEM). Results First, the descriptive statistical analysis shows that more than 50% of the respondents are in poor or non-serious health conditions, and that the largest proportion of these farmers are suffering from anxiety or depression, which is the most serious of the five dimensions. Second, multinomial regression analysis shows that the satisfaction of landless farmers with their social security policies improves their living conditions, particularly in their capacity for self-care, in their ability to perform daily activities, and in the reduction of pain, anxiety, and depression. Third, SEM model analysis shows that the satisfaction of landless farmers with their social security policies positively influences their HRQOL. Among the five dimensions of EQ-5D, daily activities produce the greatest influence on the HRQOL of landless farmers. As regards social security policies, the land acquisition compensation policy and the employment security policy produce the greatest and weakest influences on the HRQOL of landless farmers, respectively. Conclusions The rapid urbanization in China has deprived many farmers of their lands and of the benefits of urbanization. These farmers are often in a disadvantaged position in the land acquisition process. Statistic analysis in this paper shows that the satisfaction of landless farmers with their social security policies positively influences their HRQOL. The implementation and improvement of social security policies is very important for the long-term and sustainable development of these landless farmers. PMID:24433258

Are social security policies for Chinese landless farmers really effective on health in the process of Chinese rapid urbanization? A study on the effect of social security policies for Chinese landless farmers on their health-related quality of life.

PubMed

Liang, Ying; Lu, Wanyi; Wu, Wei

2014-01-15

The continuing urbanization in China has resulted in a loss of land and rights among farmers. The social security of landless farmers has attracted considerable research attention. However, only few studies measure the health-related quality of life (HRQOL) of landless farmers by employing scientific standardized scales. By using five-dimensional European quality of life (EQ-5D) scales, this study measures the HRQOL of landless farmers from a new perspective and examines how the social security policies affect their HRQOL. This study is based on a 2013 household survey that has been conducted among 1,500 landless famers who are residing in six resettlement areas in three cities within the Yangtze River Delta region, namely, Nanjing, Hangzhou, and Yangzhou. This study adopts EQ-5D scales to measure the HRQOL of these farmers. More than 50% of the respondents are in poor or non-serious health conditions, and over 50% are not satisfied with their current social security policies. The health conditions and social security policies are analyzed by multinomial regression analysis and the relationship between these two factors are analyzed via structural equation modeling (SEM). First, the descriptive statistical analysis shows that more than 50% of the respondents are in poor or non-serious health conditions, and that the largest proportion of these farmers are suffering from anxiety or depression, which is the most serious of the five dimensions. Second, multinomial regression analysis shows that the satisfaction of landless farmers with their social security policies improves their living conditions, particularly in their capacity for self-care, in their ability to perform daily activities, and in the reduction of pain, anxiety, and depression. Third, SEM model analysis shows that the satisfaction of landless farmers with their social security policies positively influences their HRQOL. Among the five dimensions of EQ-5D, daily activities produce the greatest influence on the HRQOL of landless farmers. As regards social security policies, the land acquisition compensation policy and the employment security policy produce the greatest and weakest influences on the HRQOL of landless farmers, respectively. The rapid urbanization in China has deprived many farmers of their lands and of the benefits of urbanization. These farmers are often in a disadvantaged position in the land acquisition process. Statistic analysis in this paper shows that the satisfaction of landless farmers with their social security policies positively influences their HRQOL. The implementation and improvement of social security policies is very important for the long-term and sustainable development of these landless farmers.

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

MPTinR: analysis of multinomial processing tree models in R.

PubMed

Singmann, Henrik; Kellen, David

2013-06-01

We introduce MPTinR, a software package developed for the analysis of multinomial processing tree (MPT) models. MPT models represent a prominent class of cognitive measurement models for categorical data with applications in a wide variety of fields. MPTinR is the first software for the analysis of MPT models in the statistical programming language R, providing a modeling framework that is more flexible than standalone software packages. MPTinR also introduces important features such as (1) the ability to calculate the Fisher information approximation measure of model complexity for MPT models, (2) the ability to fit models for categorical data outside the MPT model class, such as signal detection models, (3) a function for model selection across a set of nested and nonnested candidate models (using several model selection indices), and (4) multicore fitting. MPTinR is available from the Comprehensive R Archive Network at http://cran.r-project.org/web/packages/MPTinR/ .

Relation of socio-economic status to impaired fasting glucose and Type 2 diabetes: findings based on a large population-based cross-sectional study in Tianjin, China.

PubMed

Zhang, H; Xu, W; Dahl, A K; Xu, Z; Wang, H-X; Qi, X

2013-05-01

Studies on the relationship between socio-economic status and Type 2 diabetes mellitus in the Chinese population are sparse. We aimed to examine the relation of socio-economic status as represented by income, education and occupation to impaired fasting glucose, Type 2 diabetes, and the control of Type 2 diabetes in a large Chinese population. This study included 7315 individuals who were aged 20-79 years and living in Tianjin, China. Impaired fasting glucose and Type 2 diabetes were ascertained according to the 1999 World Health Organization criteria. Data were analysed using multinomial and binary logistic regression, with adjustment for potential confounders. Among all participants, 532 (7.3%) persons had impaired fasting glucose, 688 (9.4%) persons had Type 2 diabetes, including 288 (3.9%) previously undiagnosed Type 2 diabetes. In fully adjusted multinomial logistic regression, compared with higher income (≥ 2000 yuan, $243.3/month), lower income (< 1000 yuan, $121.70/month) showed odds ratios (95% confidence intervals) of 3.31 (2.48-4.41) for impaired fasting glucose, 4.50 (3.07-6.61) for undiagnosed Type 2 diabetes and 4.56 (3.20-6.48) for diagnosed Type 2 diabetes. These results remained significant in the analysis stratified by education and occupation. Furthermore, persons who were retired were more likely to have impaired fasting glucose [odds ratio 1.91 (1.40-2.45)], undiagnosed Type 2 diabetes [odds ratio 2.01) 1.40-2.89] and diagnosed Type 2 diabetes [odds ratio 3.02 (2.12-4.22)]. Among the patients with Type 2 diabetes previously diagnosed, lower education (less than senior high school), non-manual work and unemployment were related to worse glycaemic control (fasting blood glucose level > 8.5 mmol/l). Lower income and retirement are associated with increased odds of impaired fasting glucose and Type 2 diabetes in Tianjin, China. Education and occupation may play a role in glycaemic control among patients with Type 2 diabetes. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

Infection and Co-infection with Helminths and Plasmodium among School Children in Côte d’Ivoire: Results from a National Cross-Sectional Survey

PubMed Central

Yapi, Richard B.; Hürlimann, Eveline; Houngbedji, Clarisse A.; Ndri, Prisca B.; Silué, Kigbafori D.; Soro, Gotianwa; Kouamé, Ferdinand N.; Vounatsou, Penelope; Fürst, Thomas; N’Goran, Eliézer K.; Utzinger, Jürg; Raso, Giovanna

2014-01-01

Background Helminth infection and malaria remain major causes of ill-health in the tropics and subtropics. There are several shared risk factors (e.g., poverty), and hence, helminth infection and malaria overlap geographically and temporally. However, the extent and consequences of helminth-Plasmodium co-infection at different spatial scales are poorly understood. Methodology This study was conducted in 92 schools across Côte d’Ivoire during the dry season, from November 2011 to February 2012. School children provided blood samples for detection of Plasmodium infection, stool samples for diagnosis of soil-transmitted helminth (STH) and Schistosoma mansoni infections, and urine samples for appraisal of Schistosoma haematobium infection. A questionnaire was administered to obtain demographic, socioeconomic, and behavioral data. Multinomial regression models were utilized to determine risk factors for STH-Plasmodium and Schistosoma-Plasmodium co-infection. Principal Findings Complete parasitological and questionnaire data were available for 5,104 children aged 5-16 years. 26.2% of the children were infected with any helminth species, whilst the prevalence of Plasmodium infection was 63.3%. STH-Plasmodium co-infection was detected in 13.5% and Schistosoma-Plasmodium in 5.6% of the children. Multinomial regression analysis revealed that boys, children aged 10 years and above, and activities involving close contact to water were significantly and positively associated with STH-Plasmodium co-infection. Boys, wells as source of drinking water, and water contact were significantly and positively associated with Schistosoma-Plasmodium co-infection. Access to latrines, deworming, higher socioeconomic status, and living in urban settings were negatively associated with STH-Plasmodium co-infection; whilst use of deworming drugs and access to modern latrines were negatively associated with Schistosoma-Plasmodium co-infection. Conclusions/Significance More than 60% of the school children surveyed were infected with Plasmodium across Côte d’Ivoire, and about one out of six had a helminth-Plasmodium co-infection. Our findings provide a rationale to combine control interventions that simultaneously aim at helminthiases and malaria. PMID:24901333

Identification of the risk factors for osteoporosis among postmenopausal women.

PubMed

Demir, B; Haberal, A; Geyik, P; Baskan, B; Ozturkoglu, E; Karacay, O; Deveci, S

2008-01-01

The aim of this study was to determine the effect of different durations of menopause at the time of bone mineral density (BMD) measurement and of different age at menopause intervals on the prevalence of osteopenia and osteoporosis among untreated postmenopausal women. We also assessed related factors leading to low BMD. A total of 2769 postmenopausal women who had not taken any anti-osteoporosis treatment and/or hormone replacement therapy were divided into three groups according to duration of menopause at the time of BMD measurement. The women were also evaluated in four different age groups according to their age at menopause onset. Multinomial logistic regression analysis was used to determine related factors leading to low BMD. Investigated parameters include demographic characteristics, plasma glucose, lipids, and lipoproteins. According to World Health Organization (WHO) criteria, among 2769 patients, 449 (16.2%) were identified as having osteoporosis, 1085 (39.2%) as having osteopenia, and 1235 (44.6%) as having normal BMD. Osteoporosis was determined in 10.6% and 16.2% of women with menopause duration of 0-3 years and 4-7 years, respectively, whereas this rate was 31.9% in women with menopause duration of over 7 years (p = 0.001). The percentages for osteopenia remained constant among the three different menopause durations (0-3 years: 37.2%, 4-7 years: 42.1%, and >7 years: 40.9%). Thirty percent of women with age at onset of <40 years were osteoporotic. However, the percentages of women with osteoporosis among the other age groups were similar (40-46 years: 18.3%, 47-52 years: 14.1%, and >52 years: 15.4%). The percentages for osteopenia remained relatively constant among the four age groups (36.7, 40, 39.1 and 39%). According to the multinomial logistic regression analysis, duration of menopause at the time of BMD test and parity were positively correlated with both osteoporosis and osteopenia, while glucose level was negatively correlated with both osteoporosis and osteopenia. Age at menopause was negatively correlated only for osteoporosis. Low-density lipoprotein cholesterol (LDL-c) level may be accepted as a clinically significant factor for osteopenia (OR: 1.01; CI(95%): 1.00-1.02). No differences were determined in the prevalence of osteopenia and osteoporosis in women with menopause duration of >7 years when evaluated according to the four menopause age groups as described before (p = 0.74). Contribution to the regression model was 0.8% by age at menopause, 5.6% by menopause duration at time of BMD measurement, 5.8% by both factors. According to our results, osteoporosis is related more to the duration of menopause at the time of BMD measurement rather than the age at menopause among untreated postmenopausal women. High parity was determined as another risk factor for low BMD.

Leisure-time physical inactivity among healthcare workers.

PubMed

Rocha, Saulo Vasconcelos; Barbosa, Aline Rodrigues; Araújo, Tania Maria

2018-01-15

To estimate the prevalence of leisure-time physical inactivity (LTPI) and associated factors among healthcare workers. The cross-sectional study carried out with 2684 healthcare workers from 4 municipalities from the northeast region, Brazil. The LTPI was assessed by dichotomous question. The association between LTPI and the various independent variables was examined through the multinomial logistic regression analysis (crude and adjusted). The prevalence of LTPI was 47.9% (95% confidence interval (CI): 46.01-48.80). The adjusted analysis (sociodemographic and occupational characteristics) showed that women and individuals with higher levels of education were more LTPI (p = 0.05). The prevalence of LTPI was high among the population investigated, especially among women and individuals with higher education. These results show the importance of developing actions to encourage adherence to physical activity during leisure time among workers, especially among the most vulnerable groups (people with higher education and women), given the benefits of this behavior to health. Int J Occup Med Environ Health 2018;31(3):251-260. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

A behavioral economic reward index predicts drinking resolutions: moderation revisited and compared with other outcomes.

PubMed

Tucker, Jalie A; Roth, David L; Vignolo, Mary J; Westfall, Andrew O

2009-04-01

Data were pooled from 3 studies of recently resolved community-dwelling problem drinkers to determine whether a behavioral economic index of the value of rewards available over different time horizons distinguished among moderation (n = 30), abstinent (n = 95), and unresolved (n = 77) outcomes. Moderation over 1- to 2-year prospective follow-up intervals was hypothesized to involve longer term behavior regulation processes than abstinence or relapse and to be predicted by more balanced preresolution monetary allocations between short-term and longer term objectives (i.e., drinking and saving for the future). Standardized odds ratios (ORs) based on changes in standard deviation units from a multinomial logistic regression indicated that increases on this "Alcohol-Savings Discretionary Expenditure" index predicted higher rates of abstinence (OR = 1.93, p = .004) and relapse (OR = 2.89, p < .0001) compared with moderation outcomes. The index had incremental utility in predicting moderation in complex models that included other established predictors. The study adds to evidence supporting a behavioral economic analysis of drinking resolutions and shows that a systematic analysis of preresolution spending patterns aids in predicting moderation.

Microaggressions, Discrimination, and Phenotype among African Americans: A Latent Class Analysis of the Impact of Skin Tone and BMI.

PubMed

Keith, Verna M; Nguyen, Ann W; Taylor, Robert Joseph; Mouzon, Dawne M; Chatters, Linda M

2017-05-01

Data from the 2001-2003National Survey of American Life are used to investigate the effects of phenotype on everyday experiences with discrimination among African Americans (N=3343). Latent class analysis is used to identify four classes of discriminatory treatment: 1) low levels of discrimination, 2) disrespect and condescension, 3) character-based discrimination, and 4) high levels of discrimination. We then employ latent class multinomial logistic regression to evaluate the association between skin tone and body weight and these four classes of discrimination. Designating the low level discrimination class as the reference group, findings revealed that respondents with darker skin were more likely to be classified into the disrespect/condescension and the high level microaggression types. BMI was unrelated to the discrimination type, although there was a significant interaction effect between gender and BMI. BMI was strongly and positively associated with membership in the disrespect and condescension type among men but not among women. These findings indicate that skin tone and body weight are two phenotypic characteristics that influence the type and frequency of discrimination experienced by African Americans.

Substance Use, Violence, and Antiretroviral Adherence: A Latent Class Analysis of Women Living with HIV in Canada.

PubMed

Carter, Allison; Roth, Eric Abella; Ding, Erin; Milloy, M-J; Kestler, Mary; Jabbari, Shahab; Webster, Kath; de Pokomandy, Alexandra; Loutfy, Mona; Kaida, Angela

2018-03-01

We used latent class analysis to identify substance use patterns for 1363 women living with HIV in Canada and assessed associations with socio-economic marginalization, violence, and sub-optimal adherence to combination antiretroviral therapy (cART). A six-class model was identified consisting of: abstainers (26.3%), Tobacco Users (8.81%), Alcohol Users (31.9%), 'Socially Acceptable' Poly-substance Users (13.9%), Illicit Poly-substance Users (9.81%) and Illicit Poly-substance Users of All Types (9.27%). Multinomial logistic regression showed that women experiencing recent violence had significantly higher odds of membership in all substance use latent classes, relative to Abstainers, while those reporting sub-optimal cART adherence had higher odds of being members of the poly-substance use classes only. Factors significantly associated with Illicit Poly-substance Users of All Types were sexual minority status, lower income, and lower resiliency. Findings underline a need for increased social and structural supports for women who use substances to support them in leading safe and healthy lives with HIV.

[Factors associated with precarious prenatal care in a sample of post-partum adolescent mothers in maternity hospitals in Rio de Janeiro, Brazil, 1999-2000].

PubMed

Gama, Silvana Granado Nogueira da; Szwarcwald, Célia Landmann; Sabroza, Adriane Reis; Castelo Branco, Viviane; Leal, Maria do Carmo

2004-01-01

This study characterizes the women receiving precarious prenatal care according to socio-demographic variables, mother's reproductive history, family support, satisfaction with pregnancy, and risk behavior during pregnancy. A total of 1,967 adolescents were interviewed in the immediate post-partum in public and outsourced maternity hospitals in the City of Rio de Janeiro. The dependent variable was the number of prenatal appointments (0-3; 4-6; 7 or more). The statistical analysis aimed to test the hypothesis of homogeneity of proportions, including bi- and multivariate analysis, using multinomial logistic regression, in which the reference category for the response variable was 7 or more prenatal visits. Higher (and statistically significant) proportions of insufficient number of prenatal visits (0-3) were associated with: precarious sanitation conditions; not living with the child's father; attempted abortion; and smoking, drinking, and/or drug use during pregnancy. The results strongly indicate that mothers with worse living conditions and risk behavior during pregnancy were the same who lacked access to prenatal care.

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

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.

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.

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

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

Protein Multiplexed Immunoassay Analysis with R.

PubMed

Breen, Edmond J

2017-01-01

Plasma samples from 177 control and type 2 diabetes patients collected at three Australian hospitals are screened for 14 analytes using six custom-made multiplex kits across 60 96-well plates. In total 354 samples were collected from the patients, representing one baseline and one end point sample from each patient. R methods and source code for analyzing the analyte fluorescence response obtained from these samples by Luminex Bio-Plex ® xMap multiplexed immunoassay technology are disclosed. Techniques and R procedures for reading Bio-Plex ® result files for statistical analysis and data visualization are also presented. The need for technical replicates and the number of technical replicates are addressed as well as plate layout design strategies. Multinomial regression is used to determine plate to sample covariate balance. Methods for matching clinical covariate information to Bio-Plex ® results and vice versa are given. As well as methods for measuring and inspecting the quality of the fluorescence responses are presented. Both fixed and mixed-effect approaches for immunoassay statistical differential analysis are presented and discussed. A random effect approach to outlier analysis and detection is also shown. The bioinformatics R methodology present here provides a foundation for rigorous and reproducible analysis of the fluorescence response obtained from multiplexed immunoassays.

Treatment of Ductal Carcinoma In Situ Among Patients Cared for in Large Integrated Health Plans

PubMed Central

Haque, Reina; Achacoso, Ninah S.; Fletcher, Suzanne W.; Nekhlyudov, Larissa; Collins, Laura C.; Schnitt, Stuart J.; Quesenberry, Charles P.; Habel, Laurel A.

2013-01-01

Objective To examine whether use of adjuvant therapy varies by race/ethnicity among patients with ductal carcinoma in situ (DCIS) at 3 integrated health plan delivery sites based in California and Massachusetts. Study Design Cross-sectional study nested within a cohort of women diagnosed as having DCIS between 1990 and 2001. Methods We reviewed medical records of 3000 non-Hispanic white (69%), black (10%), Hispanic (9%), and Asian or Pacific Islander (12%) women diagnosed as having DCIS between 1990 and 2001 and treated with breast-conserving therapy. χ2 Test and multinomial logistic regression analysis were used to examine the association between race/ethnicity and use of adjuvant treatments after controlling for patient and clinical variables, including certain pathologic factors. Results We found no significant differences in DCIS adjuvant treatment among racial/ethnic groups in bivariate or multinomial analyses after adjusting for demographic characteristics, comorbidity, and clinical factors. Minority women were as likely to undergo adjuvant radiation therapy as non-Hispanic white women. However, women 70 years or older (odds ratio, 0.40; 95% confidence interval, 0.31–0.51) and women who lived in areas with low geocoded median family income (odds ratio, 0.65; 95% confidence interval, 0.48–0.89) were less likely to receive adjuvant radiation therapy. Tumor size and comedo histologic growth pattern were associated with increased likelihood of receiving radiation therapy. Conclusion Use of adjuvant therapy by minority women in these managed care plans is similar to that by non-Hispanic white women, although use was less among older women and among women who lived in poorer neighborhoods. PMID:20469955

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.

Vegetarian Diet and Cardiometabolic Risk among Asian Indians in the United States.

PubMed

Misra, Ranjita; Balagopal, Padmini; Raj, Sudha; Patel, Thakor G

2018-01-01

Research studies have shown that plant-based diets confer cardiovascular and metabolic health benefits. Asian Indians (AIs) in the US (who have often followed plant-based diets) have elevated risk for chronic diseases such as diabetes, metabolic syndrome, and obesity suggesting ethnic vulnerability that imply genetic and/or lifestyle causative links. This study explored the association between this ethnic group and diabetes, obesity, and metabolic syndrome after controlling for demographics, acculturation, family history of diabetes, and lifestyle and clinical risk factors. The sample comprised of 1038 randomly selected adult AIs in seven US sites. Prevalence and metabolic syndrome was estimated, and obesity was calculated using the WHO Asian criteria. Multivariate analysis included multinomial logistic regression. The mean age and length of residency in the US were 47 and 18.5 years, respectively. The majority of respondents were vegetarians (62%) and educated. A vegetarian lifestyle was associated with females, food label users, respondents with poor/fair current health status, less acculturated, and those who reported their diet had not changed after coming to the US. Vegetarian status was a protective factor and lowered the risk for diabetes but not for metabolic syndrome and obesity in the regression model. Results provide a firm basis for educational programs.

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

Vegetarian Diet and Cardiometabolic Risk among Asian Indians in the United States

PubMed Central

Balagopal, Padmini; Patel, Thakor G.

2018-01-01

Research studies have shown that plant-based diets confer cardiovascular and metabolic health benefits. Asian Indians (AIs) in the US (who have often followed plant-based diets) have elevated risk for chronic diseases such as diabetes, metabolic syndrome, and obesity suggesting ethnic vulnerability that imply genetic and/or lifestyle causative links. This study explored the association between this ethnic group and diabetes, obesity, and metabolic syndrome after controlling for demographics, acculturation, family history of diabetes, and lifestyle and clinical risk factors. The sample comprised of 1038 randomly selected adult AIs in seven US sites. Prevalence and metabolic syndrome was estimated, and obesity was calculated using the WHO Asian criteria. Multivariate analysis included multinomial logistic regression. The mean age and length of residency in the US were 47 and 18.5 years, respectively. The majority of respondents were vegetarians (62%) and educated. A vegetarian lifestyle was associated with females, food label users, respondents with poor/fair current health status, less acculturated, and those who reported their diet had not changed after coming to the US. Vegetarian status was a protective factor and lowered the risk for diabetes but not for metabolic syndrome and obesity in the regression model. Results provide a firm basis for educational programs. PMID:29670913

The five-year diagnostic utility of "diagnostic orphans" for alcohol use disorders in a national sample of young adults.

PubMed

Harford, Thomas C; Yi, Hsiao-Ye; Grant, Bridget F

2010-05-01

This study was conducted to assess the association of "diagnostic orphans" at baseline and subsequent development of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) alcohol use disorders (AUDs) 5 years later. A sample of 8,534 respondents was drawn from the National Longitudinal Survey of Youth for the years 1989 and 1994. Diagnostic orphans were defined as respondents who met one or two alcohol dependence symptom criteria but did not meet the criteria for a diagnosis of alcohol abuse or dependence. Using multinomial logistic regression analysis, 1994 assessments of DSM-IV AUD were regressed on 1989 baseline assessments of diagnostic orphan status and DSM-IV AUD. In addition to demographic characteristics, other background variables included heavy episodic drinking at baseline and early problem behaviors (antisocial behaviors, illicit substance use, and age at onset of alcohol use). Findings from this 5-year prospective study indicate that diagnostic orphan status at baseline was predictive of DSM-IV AUD at follow-up. These associations remained significant when other early behavioral problems were included in the models. The present findings have important diagnostic implications for the proposed DSM-V, particularly for a dimensional diagnosis incorporating less severe forms of alcohol dependence.

Household Food Insecurity May Predict Underweightand Wasting among Children Aged 24-59 Months.

PubMed

Abdurahman, Ahmed A; Mirzaei, Khadijeh; Dorosty, Ahmed Reza; Rahimiforoushani, A; Kedir, Haji

2016-01-01

The aim of this study was to examine the association between household food insecurity and nutritional status among children aged 24-59 months in Haromaya District. Children (N = 453) aged 24-59 months were recruited in a community-based cross-sectional survey with a representative sample of households selected by a multistage sampling procedure in Haromaya District. Household Food Insecurity Access Scale and anthropometry were administered. Multinomial logistic regression models were applied to select variables that are candidate for multivariable model. The prevalences of stunting, underweight, and wasting among children aged 24-59 months were 61.1%, 28.1%, and 11.8%, respectively. The mean household food insecurity access scale score was 3.34, and 39.7% of households experienced some degree of food insecurity. By logistic regression analysis and after adjusting for the confounding factors, household food insecurity was significantly predictive of underweight (AOR = 2.48, CI = 1.17-5.24, p = .05) and chronic energy deficiency (AOR = 0.47, CI = 0.23-0.97, p = .04) and marginally significant for wasting (AOR = 0.53, CI = 0.27-1.03, p = .06). It is concluded that household food security improves child growth and nutritional status.

Use of Home- and Community-Based Services in Taiwan's National 10-Year Long-Term Care Plan.

PubMed

Yu, Hsiao-Wei; Tu, Yu-Kang; Kuo, Po-Hsiu; Chen, Ya-Mei

2018-05-01

We aimed to understand the relationships between care recipients' profiles and home- and community-based services (HCBS use patterns. Data were from the 2010 to 2013 Long-Term Care Service Management System in Taiwan ( N = 78,205). We used latent class analysis and multinomial logistic regression analyses. Three HCBS use patterns were found. Care recipients who lived alone, lived in less urbanized areas, and had instrumental activities of daily living disabilities were more likely to be in the home-based personal care group. Those in the home-based personal and medical care group were more likely than others to have a primary caregiver. Care recipients who had poorer abilities at basic activities of daily living and cognitive function, better household income, and lived in a more urbanized area were more likely to be in the non-personal care multiple services group. The findings suggest that policymakers alleviate barriers to accessing various patterns of HCBS should be encouraged.

Allelic variation contributes to bacterial host specificity

DOE PAGES

Yue, Min; Han, Xiangan; Masi, Leon De; ...

2015-10-30

Understanding the molecular parameters that regulate cross-species transmission and host adaptation of potential pathogens is crucial to control emerging infectious disease. Although microbial pathotype diversity is conventionally associated with gene gain or loss, the role of pathoadaptive nonsynonymous single-nucleotide polymorphisms (nsSNPs) has not been systematically evaluated. Here, our genome-wide analysis of core genes within Salmonella enterica serovar Typhimurium genomes reveals a high degree of allelic variation in surface-exposed molecules, including adhesins that promote host colonization. Subsequent multinomial logistic regression, MultiPhen and Random Forest analyses of known/suspected adhesins from 580 independent Typhimurium isolates identifies distinct host-specific nsSNP signatures. Moreover, population andmore » functional analyses of host-associated nsSNPs for FimH, the type 1 fimbrial adhesin, highlights the role of key allelic residues in host-specific adherence in vitro. In conclusion, together, our data provide the first concrete evidence that functional differences between allelic variants of bacterial proteins likely contribute to pathoadaption to diverse hosts.« less

Frailty syndrome and socioeconomic and health characteristics among older adults

PubMed Central

de Freitas Corrêa, Thais Aline; Dias, Flavia Aparecida; dos Santos Ferreira, Pollyana Cristina; Sousa Pegorari, Maycon

2017-01-01

Abstract Objective: To investigate the association of frailty syndrome with socioeconomic and health variables among older adults. Methods: This is a cross-sectional, observational and analytical household research conducted with a sample of 1,609 urban elderly. We used: semi-structured questionnaire, scales (Katz, Lawton and shortened version of Geriatric Depression Scale) and Fragility Phenotype proposed by Fried. Descriptive analysis was performed along with a bivariate and multinomial logistic regression model (p <0.05). Results: The prevalence of pre-frailty condition was 52.0% and the fragility corresponded to 13.6%. Pre-frailty and frailty associated factors were, respectively: age range between 70-79 years and ≥80 years; one to four morbidities and five or more morbidities categories; functional disability for basic and instrumental activities of daily life and depression indicative; whilst lack of a companion or income and female gender were only associated to pre-frailty. Conclusion: The conditions of pre-frailty and frailty levels were elevated with negative effects on the health of the elderly. PMID:29213155

Public Perceptions of GPS Monitoring for Convicted Sex Offenders: Opinions on Effectiveness of Electronic Monitoring to Reduce Sexual Recidivism.

PubMed

Budd, Kristen M; Mancini, Christina

2017-09-01

In the United States, electronic monitoring (EM) and global positioning systems (GPS) are new applications that are used to extensively monitor and track convicted sex offenders. What is unclear though are public perceptions of this strategy. This research examines public perceptions of a national sample of Americans on the use of GPS/EM with convicted sex offenders as a method to reduce their sexual recidivism. Using a multinomial regression model, we analyze the effects of sex offender myths and parental status on public perceptions that sex offender GPS/EM is very effective in reducing sexual recidivism. Findings suggest that public perceptions of effectiveness are partially driven by myths and also that parents are unsure of this strategy. The analysis contributes to the growing body of knowledge on public perceptions of GPS/EM to manage sex offenders in communities. Implications of the study and areas for future research are discussed in light of the findings.

[Alcohol consumption by university students].

PubMed

Pedrosa, Adriano Antonio da Silva; Camacho, Luiz Antonio Bastos; Passos, Sônia Regina Lambert; Oliveira, Raquel de Vasconcellos Carvalhaes de

2011-08-01

Consumption of alcoholic beverages is widely encouraged by the mass media, despite the related health risks. Today's students in the health fields are the professionals of tomorrow who will be providing advice and serving as role models for patients. The aim of this study was to analyze alcohol consumption and related factors among these students. A total of 608 male and female university students from Maceió, the capital of Alagoas State, Brazil, completed a self-administered questionnaire. Data analysis included Poisson regression and multinomial logistic models. Prevalence of lifetime use of alcohol was 90.4%. Prevalence of alcohol abuse was 18.3% in men and 6.1% in women. Heavier alcohol consumption and alcohol abuse were observed in males, older students, non-natives of Maceió, smokers, and those exposed to alcohol advertising. The results emphasized the vulnerability of these young people to risky health behaviors. Their future social role highlights distinct needs in their university education to enable them to act professionally in this area.

Occupational gradients in smoking behavior and exposure to workplace environmental tobacco smoke: The Multi-Ethnic Study of Atherosclerosis (MESA)

PubMed Central

Fujishiro, Kaori; Stukovsky, Karen D Hinckley; Roux, Ana Diez; Landsbergis, Paul; Burchfiel, Cecil

2012-01-01

Objectives This study examines associations of occupation with smoking status, amount smoked among current- and former-smokers (number of cigarettes/day and lifetime cigarette consumption (pack-years)), and workplace exposure to environmental tobacco smoke (ETS) independent from income and education. Methods This is a cross-sectional analysis of data from a community sample (n=6355, age range: 45–84) using logistic and multinomial regression. All analyses were stratified by sex and adjusted for socio-demographic variables. Results Male blue-collar and sales/office workers had higher odds of having consumed >20 pack-years of cigarettes than managers/professionals. For both male and female current- or former-smokers, exposure to workplace ETS was consistently and strongly associated with heavy smoking and greater pack-years. Conclusions Blue-collar workplaces are associated with intense smoking and ETS exposure. Smoking must be addressed at both the individual- and workplace-levels especially in blue-collar workplaces. PMID:22261926

US Household Food Shopping Patterns: Dynamic Shifts since 2000 and Socioeconomic Predictors

PubMed Central

Stern, Dalia; Robinson, Whitney R; Ng, Shu Wen; Gordon-Larsen, Penny; Popkin, Barry M

2016-01-01

Under the assumption that differential food access might underlie nutritional disparities, programs and policies have focused on the need to build supermarkets in underserved areas, in an effort to improve dietary quality. However, there is limited evidence about which types of stores different income and race-ethnic households use. We used cross-sectional cluster analysis to derive shopping patterns from US households’ volume food purchases (Nielsen Homescan) by store from 2000–2012. Multinomial logistic regression identified household SES characteristics that were associated with shopping patterns in 2012. We found three shopping patterns: primary-grocery, primary-mass-merchandise, and combination cluster. In 2012, we found no income/race-ethnic differences for grocery cluster membership. However, low-income non-Hispanic blacks (vs. non-Hispanic whites) had a significantly lower probability of belonging to the mass-merchandise cluster. These varied shopping patterns must be considered in future policy initiatives. Further, it is important to continue studying the complex rationale for people’s food shopping patterns. PMID:26526241

The influence of gender, age, education and household size on meal preparation and food shopping responsibilities.

PubMed

Flagg, Lee A; Sen, Bisakha; Kilgore, Meredith; Locher, Julie L

2014-09-01

To examine the extent to which the gendered division of labour persists within households in the USA in regard to meal planning/preparation and food shopping activities. Secondary analysis of cross-sectional data. 2007-2008 US National Health and Nutrition Examination Survey. Sub-sample of 3195 adults at least 20 years old who had a spouse or partner. Analyses revealed that the majority of women and men reported they shared in both meal planning/preparing and food shopping activities (meal planning/preparation: women 54 % and men 56 %; food shopping: women 60 % and men 57 %). Results from multinomial logistic regression analyses indicated that, compared with men, women were more likely to take primary responsibility than to share this responsibility and less likely to report having no responsibility for these tasks. Gender differences were observed for age/cohort, education and household size. This study may have implications for public health nutritional initiatives and the well-being of families in the USA.

Association Between Parental HPV Knowledge and Intentions to Have Their Daughters Vaccinated.

PubMed

Mansfield, Lisa N; Onsomu, Elijah O; Merwin, Elizabeth; Hall, Naomi M; Harper-Harrison, Alfreda

2018-04-01

Human papillomavirus (HPV) 16 and 18 causes 66% of cervical cancers (Dunne et al., 2014). Vaccination during adolescence can prevent HPV-associated cervical cancers, yet less than half of adolescent girls are vaccinated. This study examined the association between HPV knowledge and parental intentions to vaccinate daughters against HPV. A retrospective, cross-sectional, national data set from the 2006-2007 Health Information National Trends Survey (HINTS) was used. A multivariate multinomial logistic regression analysis was used to estimate the association between intent to vaccinate and HPV knowledge. After controlling for other covariates, parents who were knowledgeable were more likely to intend to have their daughters vaccinated compared with those who were not knowledgeable (adjusted relative risk ratio [aRRR] = 3.96, p = .004). Having HPV knowledge would significantly increase parents' intent for vaccination against the disease for their daughters. Health care providers should integrate HPV-related education for parents within their services, and policymakers should consider requiring HPV vaccination for school attendance.

Professional service use for a serious personal problem: Comparing older African Americans, Black Caribbeans, and non-Hispanic Whites using the National Survey of American Life

PubMed Central

Woodward, Amanda Toler; Chatters, Linda M.; Taylor, Harry Owen; Taylor, Robert Joseph

2014-01-01

Objectives Examines combinations of professionals visited for a serious personal problem. Methods The sample includes those aged 55 and older (n=862) from the National Survey of American Life (NSAL). Latent class analysis was used to identify groups of respondents based on types of professionals visited. Multinomial logistic regression was used to identify factors associated with group membership. Results Classes included health provider plus clergy, physician plus mental health provider, and limited provider use. Whites were more likely than African Americans to fall into the health provider plus clergy and physician plus mental health provider classes. Those with physical and emotional problems were more likely to be in the health provider plus clergy and physician plus mental health provider classes, respectively. Discussion Most respondents were in the limited provider use class suggesting that for many of problems, minimal professional help is utilized. Physicians and clergy were important across all three classes. PMID:25552527

Occupational gradients in smoking behavior and exposure to workplace environmental tobacco smoke: the multi-ethnic study of atherosclerosis.

PubMed

Fujishiro, Kaori; Stukovsky, Karen D Hinckley; Roux, Ana Diez; Landsbergis, Paul; Burchfiel, Cecil

2012-02-01

This study examines associations of occupation with smoking status, amount smoked among current and former smokers (number of cigarettes per day and lifetime cigarette consumption (pack-years)), and workplace exposure to environmental tobacco smoke (ETS) independent from income and education. This is a cross-sectional analysis of data from a community sample (n = 6355, age range: 45-84) using logistic and multinomial regression. All analyses were stratified by sex and adjusted for socio-demographic variables. Male blue-collar and sales/office workers had higher odds of having consumed more than 20 pack-years of cigarettes than managers/professionals. For both male and female current or former smokers, exposure to workplace ETS was consistently and strongly associated with heavy smoking and greater pack-years. Blue-collar workplaces are associated with intense smoking and ETS exposure. Smoking must be addressed at both the individual and workplace levels especially in blue-collar workplaces.

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

PubMed

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

2017-12-01

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 alcohol use-compared to students who had never used alcohol or marijuana-perceived lower alcohol risk ( p < .001), higher friend drinking approval ( p < .001), and greater friend drinking ( p = .003). Using both alcohol and marijuana in one's life was associated with being in public schools ( p = .010), higher grade levels ( p = .001), lower perceived alcohol ( p = .011) and marijuana use risk ( p = .003), higher friend approval of alcohol ( p < .001) and marijuana use ( p < .001), and believed more friends used alcohol ( p < .001). Compared to lifetime alcohol only, perceived friend academic performance decreased the risk of lifetime alcohol and marijuana use ( p = .043). Findings are beneficial to school nurses with students experiencing effects associated with substance use.

Overweight and Obesity among Women by Economic Stratum in Urban India

PubMed Central

Prusty, Ranjan Kumar

2014-01-01

Using data of the third round of the National Family Health Survey (NFHS) 2005-2006, this study examined the prevalence of overweight and obesity among women from different economic strata in urban India. The study used a separate wealth index for urban India constructed using principal components analysis (PCA). The result shows that prevalence of overweight and obesity is very high in urban areas, more noticeably among the non-poor households. Furthermore, overweight and obesity increase with age, education, and parity of women. The results of multinomial logistic regression show that non-poor women are about 2 and 3 times more at risk of being overweight and obese respectively. Marital status and media exposure are the other covariates associated positively with overweight and obesity. Thus, the growing demand which now appears before the Government or urban health planners is to address this rising urban epidemic with equal importance as given to other issues in the past. PMID:24847596

Key team physical and technical performance indicators indicative of team quality in the soccer Chinese super league.

PubMed

Yang, Gai; Leicht, Anthony S; Lago, Carlos; Gómez, Miguel-Ángel

2018-01-01

The aim of this study was to identify the key physical and technical performance variables related to team quality in the Chinese Super League (CSL). Teams' performance variables were collected from 240 matches and analysed via analysis of variance between end-of-season-ranked groups and multinomial logistic regression. Significant physical performance differences between groups were identified for sprinting (top-ranked group vs. upper-middle-ranked group) and total distance covered without possession (upper and upper-middle-ranked groups and lower-ranked group). For technical performance, teams in the top-ranked group exhibited a significantly greater amount of possession in opponent's half, number of entry passes in the final 1/3 of the field and the Penalty Area, and 50-50 challenges than lower-ranked teams. Finally, time of possession increased the probability of a win compared with a draw. The current study identified key performance indicators that differentiated end-season team quality within the CSL.

Childhood growth and development associated with need for full-time special education at school age.

PubMed

Mannerkoski, Minna; Aberg, Laura; Hoikkala, Marianne; Sarna, Seppo; Kaski, Markus; Autti, Taina; Heiskala, Hannu

2009-01-01

To explore how growth measurements and attainment of developmental milestones in early childhood reflect the need for full-time special education (SE). After stratification in this population-based study, 900 pupils in full-time SE groups (age-range 7-16 years, mean 12 years 8 months) at three levels and 301 pupils in mainstream education (age-range 7-16, mean 12 years 9 months) provided data on height and weight from birth to age 7 years and head circumference to age 1 year. Developmental screening was evaluated from age 1 month to 48 months. Statistical methods included a general linear model (growth measurements), binary logistic regression analysis (odds ratios for growth), and multinomial logistic regression analysis (odds ratios for developmental milestones). At 1 year, a 1 standard deviation score (SDS) decrease in height raised the probability of SE placement by 40%, and a 1 SDS decrease in head size by 28%. In developmental screening, during the first months of life the gross motor milestones, especially head support, differentiated the children at levels 0-3. Thereafter, the fine motor milestones and those related to speech and social skills became more important. Children whose growth is mildly impaired, though in the normal range, and who fail to attain certain developmental milestones have an increased probability for SE and thus a need for special attention when toddlers age. Similar to the growth curves, these children seem to have consistent developmental curves (patterns).

Clinical characteristics of type 2 diabetes patients with discordance between HbA1c and fasting plasma glucose in the real world: An analysis of the ORBIT study.

PubMed

Shu, Hua; Lu, Juming; Zhang, Puhong; Zhu, Dongshan; Li, Xian; Ji, Jiachao; Zhao, Fang; Ji, Linong

2018-05-01

We aimed to determine the clinical characteristics of type 2 diabetes patients on basal insulin therapy with inadequate glucose control due to discordance between glycated haemoglobin (HbA 1c ) and fasting plasma glucose (FPG) in the real world. This was a retrospective analysis of data from the ORBIT study in China. Clinical characteristics of patients with discordance between HbA 1c and FPG at baseline and at the end of 6 months of follow-up were analysed using multinomial logistic regression in 4 study groups divided by HbA 1c and FPG. Overall, of 6721 patients initiated on basal insulin, 853 achieved HbA 1c  < 7% but FPG ≥ 7 mmol/L (group 2), while 997 had FPG < 7 mmol/L but HbA 1c  ≥ 7% (group 3) at the end of follow-up. Patients in group 3 had a longer duration of type 2 diabetes compared with those in group 2 (7.22 ± 5.30 vs 6.00 ± 4.80 y, P < .05). Patients on glargine (32.90%) or detemir (36.88%) treatment accounted for a higher proportion of patients with both HbA 1c and FPG controlled than those on neutral protamine Hagedorn therapy (23.45%; P < .05). Per the multinomial logistic analysis, higher frequency of self-monitoring of blood glucose (SMBG) and use of glargine or detemir therapy were significantly inversely associated with risk of discordance between HbA 1c and FPG, while dose of insulin was a risk factor for discordance at the end of follow-up (all P < .05). Patients treated with insulin analogues (glargine or detemir), instead of neutral protamine Hagedorn, and with more frequent SMBG are more likely to exhibit concordance between HbA 1c and FPG. Copyright © 2018 John Wiley & Sons, Ltd.

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.

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

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.

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.

Comparing performance of multinomial logistic regression and discriminant analysis for monitoring access to care for acute myocardial infarction.

PubMed

Hossain, Monir; Wright, Steven; Petersen, Laura A

2002-04-01

One way to monitor patient access to emergent health care services is to use patient characteristics to predict arrival time at the hospital after onset of symptoms. This predicted arrival time can then be compared with actual arrival time to allow monitoring of access to services. Predicted arrival time could also be used to estimate potential effects of changes in health care service availability, such as closure of an emergency department or an acute care hospital. Our goal was to determine the best statistical method for prediction of arrival intervals for patients with acute myocardial infarction (AMI) symptoms. We compared the performance of multinomial logistic regression (MLR) and discriminant analysis (DA) models. Models for MLR and DA were developed using a dataset of 3,566 male veterans hospitalized with AMI in 81 VA Medical Centers in 1994-1995 throughout the United States. The dataset was randomly divided into a training set (n = 1,846) and a test set (n = 1,720). Arrival times were grouped into three intervals on the basis of treatment considerations: <6 hours, 6-12 hours, and >12 hours. One model for MLR and two models for DA were developed using the training dataset. One DA model had equal prior probabilities, and one DA model had proportional prior probabilities. Predictive performance of the models was compared using the test (n = 1,720) dataset. Using the test dataset, the proportions of patients in the three arrival time groups were 60.9% for <6 hours, 10.3% for 6-12 hours, and 28.8% for >12 hours after symptom onset. Whereas the overall predictive performance by MLR and DA with proportional priors was higher, the DA models with equal priors performed much better in the smaller groups. Correct classifications were 62.6% by MLR, 62.4% by DA using proportional prior probabilities, and 48.1% using equal prior probabilities of the groups. The misclassifications by MLR for the three groups were 9.5%, 100.0%, 74.2% for each time interval, respectively. Misclassifications by DA models were 9.8%, 100.0%, and 74.4% for the model with proportional priors and 47.6%, 79.5%, and 51.0% for the model with equal priors. The choice of MLR or DA with proportional priors, or DA with equal priors for monitoring time intervals of predicted hospital arrival time for a population should depend on the consequences of misclassification errors.

Markov switching multinomial logit model: An application to accident-injury severities.

PubMed

Malyshkina, Nataliya V; Mannering, Fred L

2009-07-01

In this study, two-state Markov switching multinomial logit models are proposed for statistical modeling of accident-injury severities. These models assume Markov switching over time between two unobserved states of roadway safety as a means of accounting for potential unobserved heterogeneity. The states are distinct in the sense that in different states accident-severity outcomes are generated by separate multinomial logit processes. To demonstrate the applicability of the approach, two-state Markov switching multinomial logit models are estimated for severity outcomes of accidents occurring on Indiana roads over a four-year time period. Bayesian inference methods and Markov Chain Monte Carlo (MCMC) simulations are used for model estimation. The estimated Markov switching models result in a superior statistical fit relative to the standard (single-state) multinomial logit models for a number of roadway classes and accident types. It is found that the more frequent state of roadway safety is correlated with better weather conditions and that the less frequent state is correlated with adverse weather conditions.

Bayesian Network Meta-Analysis for Unordered Categorical Outcomes with Incomplete Data

ERIC Educational Resources Information Center

Schmid, Christopher H.; Trikalinos, Thomas A.; Olkin, Ingram

2014-01-01

We develop a Bayesian multinomial network meta-analysis model for unordered (nominal) categorical outcomes that allows for partially observed data in which exact event counts may not be known for each category. This model properly accounts for correlations of counts in mutually exclusive categories and enables proper comparison and ranking of…

Using Discrete Loss Functions and Weighted Kappa for Classification: An Illustration Based on Bayesian Network Analysis

ERIC Educational Resources Information Center

Zwick, Rebecca; Lenaburg, Lubella

2009-01-01

In certain data analyses (e.g., multiple discriminant analysis and multinomial log-linear modeling), classification decisions are made based on the estimated posterior probabilities that individuals belong to each of several distinct categories. In the Bayesian network literature, this type of classification is often accomplished by assigning…

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.

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.

Classifying emotion in Twitter using Bayesian network

NASA Astrophysics Data System (ADS)

Surya Asriadie, Muhammad; Syahrul Mubarok, Mohamad; Adiwijaya

2018-03-01

Language is used to express not only facts, but also emotions. Emotions are noticeable from behavior up to the social media statuses written by a person. Analysis of emotions in a text is done in a variety of media such as Twitter. This paper studies classification of emotions on twitter using Bayesian network because of its ability to model uncertainty and relationships between features. The result is two models based on Bayesian network which are Full Bayesian Network (FBN) and Bayesian Network with Mood Indicator (BNM). FBN is a massive Bayesian network where each word is treated as a node. The study shows the method used to train FBN is not very effective to create the best model and performs worse compared to Naive Bayes. F1-score for FBN is 53.71%, while for Naive Bayes is 54.07%. BNM is proposed as an alternative method which is based on the improvement of Multinomial Naive Bayes and has much lower computational complexity compared to FBN. Even though it’s not better compared to FBN, the resulting model successfully improves the performance of Multinomial Naive Bayes. F1-Score for Multinomial Naive Bayes model is 51.49%, while for BNM is 52.14%.

Semiparametric Thurstonian Models for Recurrent Choices: A Bayesian Analysis

ERIC Educational Resources Information Center

Ansari, Asim; Iyengar, Raghuram

2006-01-01

We develop semiparametric Bayesian Thurstonian models for analyzing repeated choice decisions involving multinomial, multivariate binary or multivariate ordinal data. Our modeling framework has multiple components that together yield considerable flexibility in modeling preference utilities, cross-sectional heterogeneity and parameter-driven…

[Association between the use of blood components and the five-year mortality after liver transplant].

PubMed

de Morais, Bruno Salomé; Sanches, Marcelo Dias; Ribeiro, Daniel Dias; Lima, Agnaldo Soares; de Abreu Ferrari, Teresa Cristina; Duarte, Malvina Maria de Freitas; Cançado, Guilherme Henrique Gomes Moreira

2011-01-01

Liver transplant (LT) surgery is associated with significant bleeding in 20% of cases, and several authors have demonstrated the risks related to blood components. The objective of the present study was to evaluate the impact of using blood components during hospitalization in five-year survival of patients undergoing LT. One hundred and thirteen patients were evaluated retrospectively. Several variables, including the use of blood components intraoperatively and throughout hospitalization, were categorized and evaluated by univariate analysis using Fisher's test. A level of significance of 5% was adopted. Results with p < 0.2 underwent multivariate analysis using multinomial logistic regression. Parenchymal diseases, preoperative renal dysfunction, and longer stay in hospital and ICU are associated with greater five-year mortality after LT (p < 0.05). Unlike the intraoperative use of blood components, the accumulated transfusion of packed red blood cell, frozen fresh plasma, and platelets during the entire hospitalization was associated with greater five-year mortality after liver transplantation (p < 0.01). This study emphasizes the relationship between the use of blood components during hospitalization and increased mortality in five years after LT. 2011 Elsevier Editora Ltda. All rights reserved.

Using Latent Class Analysis to Identify Profiles of Elder Abuse Perpetrators.

PubMed

DeLiema, Marguerite; Yonashiro-Cho, Jeanine; Gassoumis, Zach D; Yon, Yongjie; Conrad, Ken J

2018-06-14

Research suggests that abuser risk factors differ across elder mistreatment types, but abuse interventions are not individualized. To move away from assumptions of perpetrator homogeneity and to inform intervention approaches, this study classifies abusers into subtypes according to their behavior profiles. Data are from the Older Adult Mistreatment Assessment administered to victims by Adult Protective Service (APS) in Illinois. Latent class analysis was used to categorize abusers (N = 336) using victim and caseworker reports on abusers' harmful and supportive behaviors and characteristics. Multinomial logistic regression was then used to determine which abuser profiles are associated with 4 types of mistreatment-neglect, physical, emotional, and financial-and other sociodemographic characteristics. Abusers fall into 4 profiles descriptively labeled "Caregiver," "Temperamental," "Dependent Caregiver," and "Dangerous." Dangerous abusers have the highest levels of aggression, financial dependency, substance abuse, and irresponsibility. Caregivers are lowest in harmful characteristics and highest in providing emotional and instrumental support to victims. The 4 profiles significantly differ in the average age and gender of the abuser, the relationship to victims, and types of mistreatment committed. This is the first quantitative study to identify and characterize abuser subtypes. Tailored interventions are needed to reduce problem behaviors and enhance strengths specific to each abuser profile.

A Behavioral Economic Reward Index Predicts Drinking Resolutions: Moderation Re-visited and Compared with Other Outcomes

PubMed Central

Tucker, Jalie A.; Roth, David L.; Vignolo, Mary J.; Westfall, Andrew O.

2014-01-01

Data were pooled from three studies of recently resolved community-dwelling problem drinkers to determine whether a behavioral economic index of the value of rewards available over different time horizons distinguished among moderation (n = 30), abstinent (n = 95), and unresolved (n = 77) outcomes. Moderation over 1-2 year prospective follow-up intervals was hypothesized to involve longer term behavior regulation processes compared to abstinence or relapse and to be predicted by more balanced pre-resolution monetary allocations between short- and longer-term objectives (i.e., drinking and saving for the future). Standardized odds ratios (OR) based on changes in standard deviation units from a multinomial logistic regression indicated that increases on this “Alcohol-Savings Discretionary Expenditure” index predicted higher rates of both abstinence (OR = 1.93, p = .004) and relapse (OR = 2.89, p < .0001) compared to moderation outcomes. The index had incremental utility in predicting moderation in complex models that included other established predictors. The study adds to evidence supporting a behavioral economic analysis of drinking resolutions and shows that a systematic analysis of pre-resolution spending patterns aids in predicting moderation. PMID:19309182

Factors related to the nursing student-patient relationship: the students' perspective.

PubMed

Suikkala, Arja; Leino-Kilpi, Helena; Katajisto, Jouko

2008-07-01

The aim of this study was to describe nursing students' perceptions of factors related to three types of student-patient relationship identified in an earlier study: mechanistic, authoritative and facilitative. Another aim was to identify which factors predict the type of relationship. A convenience sample of 310 Bachelor of Health Care students was recruited. The data were collected by using a questionnaire especially designed for this study. Data analysis used the chi-square test, Fisher's exact test, one-way analysis of variance and multinomial logistic regression. Older age was the only significant predictor of a facilitative relationship, whereas fourth-year studies and support received from a person other than supervisor predicted an authoritative relationship. Furthermore, students in authoritative and facilitative relationships had a more positive perception of the patient's attributes as a patient and of patient's improved health and commitment to self-care than students in a mechanistic relationship. A positive perception of the atmosphere during collaboration was more common among students in an authoritative relationship than in a mechanistic relationship. The findings of this study offer useful clues for developing nursing education and empowering patients with a view to improving the quality of nursing care.

Prevalence of enamel defects and association with dental caries in preschool children.

PubMed

Massignan, C; Ximenes, M; da Silva Pereira, C; Dias, L; Bolan, M; Cardoso, M

2016-12-01

This was to evaluate the prevalence of the developmental defects of enamel (DDE) in primary teeth and its association with dental caries. A cross-sectional study with a randomised representative sample was carried out with 1101 children aged 2-5 years enrolled in public preschools (50% prevalence of DDE in primary teeth, a standard error of 3%, and a confidence level of 95%). Three calibrated dentists (K > 0.62) performed clinical examination. Data collected were: sex, age, DDE (Modified DDE Index) and dental caries (WHO). Descriptive analysis, Chi-square test and multinomial logistic regression were applied for data analysis. Among children, 565 (51.3%) were boys; mean age was 3.7 (±0.9 years). The prevalence of enamel defect was 39.1%; the prevalence of diffuse opacities, demarcated opacities and enamel hypoplasia was 25.3, 19.1 and 6.1%, respectively. The prevalence of dental caries was 31.0%, with mean def-t 1.14 (±2.44). Primary teeth with enamel hypoplasia had three times the odds of having dental caries than those with absence of enamel defects (OR = 3.10; 95% CI: 1.91, 5.01). The presence of enamel defects was moderate and associated with dental caries.

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.

Depression in university students: associations with impulse control disorders.

PubMed

Leppink, Eric W; Lust, Katherine; Grant, Jon E

2016-09-01

The purpose of this study was to assess the implications of depression in a sample of university students, particularly relating to impulse control disorders. While previous studies have shown high rates of depression among university students, no study to date has assessed whether levels of depression show associations with the incidence of impulse control disorders in this population. In all, 6000 students participated in the College Student Computer Use Survey. A total of 1717 students completed the scales of interest for this analysis. Participants were assigned to groups based on depression scores: severe (N = 75), mild/moderate (N = 647) and none (N = 995). The three groups were assessed using analysis of variance (ANOVA) or chi-square test. A multinomial logistic regression analysis was used to elucidate associations between depression and impulse control disorder diagnoses. Groups differed across demographic, health and academic variables. The severe depression group reported higher rates of skin-picking disorder, compulsive sexual behaviour and compulsive buying. Results suggest a significant association between depression and impulse control disorders. One possibility is that a facet of impulsivity contributes to both problems, which could be important information for clinicians. Future studies will need to clarify the exact nature of the relationship between depression and impulse control disorders.

Prolonged grief and post-traumatic growth after loss: Latent class analysis.

PubMed

Zhou, Ningning; Yu, Wei; Tang, Suqin; Wang, Jianping; Killikelly, Clare

2018-06-06

Bereavement may trigger different psychological outcomes, such as prolonged grief disorder or post-traumatic growth. The relationship between these two outcomes and potential precipitators remain unknown. The current study aimed to identify classes of Chinese bereaved individuals based on prolonged grief symptoms and post-traumatic growth and to examine predictors for these classes. We used data from 273 Chinese individuals who lost a relative due to disease (92.3%), accident (4.4%) and other reasons (1.8%). Latent class analysis revealed three classes: a resilient class, a growth class, and a combined grief/growth class. A higher level of functional impairment was found for the combined grief/growth class than for the other two classes. Membership in the combined grief/growth class was significantly predicted by the younger age of the deceased and the death of a parent, child or spouse. Subjective closeness with the deceased and gender were marginally significant predictors. When the four variables were included in the multinomial regression analysis, death of a parent, child or spouse significantly predicted the membership to the combined grief/growth class. These findings provide valuable information for the development of tailored interventions that may build on the bereaved individuals' personal strengths. Copyright © 2018. Published by Elsevier B.V.

Sociodemographic factors related to handgrip strength in children and adolescents in a middle income country: The SALUS study.

PubMed

Otero, Johanna; Cohen, Daniel Dylan; Herrera, Victor Mauricio; Camacho, Paul Anthony; Bernal, Oscar; López-Jaramillo, Patricio

2017-01-01

To determine sociodemographic factors associated with handgrip (HG) strength in a representative sample of children and adolescents from a middle income country. We evaluated youth between the ages of 8 and 17 from a representative sample of individuals from the Department of Santander, Colombia. Anthropometric measures, HG strength, and self-reported physical activity were assessed, and parents/guardians completed sociodemographic questionnairres. Multinomial logistic regression models were used to estimate the association between sociodemographic and anthropometric characteristics and tertiles of relative HG strength. We also produced centile data for raw HG strength using quantile regression. 1,691 young people were evaluated. HG strength increased with age, and was higher in males than females in all age groups. Lower HG strength was associated with indicators of higher socioeconomic status, such as living in an urban area, residence in higher social strata neighborhoods, parent/guardian with secondary education or higher, higher household income, and membership in health insurance schemes. In addition, low HG strength was associated with lower physical activity levels and higher waist-to-hip ratio. In a fully adjusted regression model, all factors remained significant except for health insurance, household income, and physical activity level. While age and gender specific HG strength values were substantially lower than contemporary data from high income countries, we found that within this middle income population indicators of higher socioeconomic status were associated with lower HG strength. This analysis also suggests that in countries undergoing rapid nutrition transition, improvements in socioeconomic conditions may be accompanied by reduction in muscle strength. © 2016 Wiley Periodicals, Inc.

The association between alcohol use and depressive symptoms across socioeconomic status among 40- and 45-year-old Norwegian adults.

PubMed

Martinez, Priscilla; Neupane, Sudan Prasad; Perlestenbakken, Berit; Toutoungi, Christina; Bramness, Jørgen G

2015-11-19

Little population-based data among middle-aged adults exists examining the relationships between depressive symptoms, alcohol use, and socio-economic status (SES). This study aimed to describe the relationships between depressive symptoms and alcohol use at different levels of SES and to determine differences across SES levels among a population-based sample of 40 and 45 year old adults in Norway. This analysis was based on data from two Norwegian health studies conducted in 2000 and 2001, and included community-dwelling Norwegian men and women aged 40 and 45 years. Self-reported frequency and quantity of alcoholic drinks was used to calculate past-year typical quantity of drinks consumed and frequency of 5+ drinks per occasion, or heavy episodic drinking (HED). Depressive symptoms were assessed with the 10-item Hopkins Symptom Checklist, and SES was measured as education level and employment status. To observe the association between depressive symptoms and alcohol use at each level of SES we fitted multinomial logistic regression models using each alcohol outcome as a dependent variable stratified by level of education and employment. To observe differences across levels of SES, we examined the interaction between depressive symptoms and SES level in multinomial logistic regression models for each alcohol measures. Having depressive symptoms was significantly associated with an increased risk of 5+ typical drinks among people in the lowest (RRR = 1.60, p ≤ 0.05) education level, and not among people in the highest. Conversely, significant associations were observed among all levels of employment. For frequency of HED, depressive symptoms was not significantly associated with frequency of HED at any education level. Depressive symptoms was associated with 13+ past year HED episodes among people with no employment (RRR = 1.97, p ≤ 0.05), and part-time employment (RRR = 2.33, p ≤ 0.01), and no association was observed among people with full-time employment. A significant interaction was observed for depressive symptoms and employment for risk of 13+ past-year HED episodes. The results show a variety of associations between depressive symptoms and alcohol use among people with lower SES, and suggest type of alcohol use and SES measure may influence the observation of an association between depressive symptoms and alcohol use at different SES levels.

Factors associated with being underweight, overweight and obese among ever-married non-pregnant urban women in Bangladesh.

PubMed

Khan, M M H; Kraemer, A

2009-08-01

Extremes of body mass index (BMI), viz. underweight, overweight and obese categories, are associated with a variety of adverse health outcomes such as diabetes mellitus, cardiovascular diseases, low birth weight, poor quality of life and higher mortality. In Bangladesh, the prevalence of underweightness is very high with an increasing trend of overweightness and obesity. This is a serious public health concern as it indicates a dual burden of disease. The present study assessed the associations of being underweight, overweight and obese with socioeconomic, demographical and migration variables among ever-married non-pregnant urban Bangladeshi women aged 13-49 years. The data was extracted from the Bangladesh Demographic and Health Survey 2004. Bivariable, factor and multinomial logistic regression analyses were performed in this study. The prevalence of being underweight, overweight and obese among ever-married non-pregnant urban women in Bangladesh was 25.2 percent, 15.7 percent and 3.9 percent, respectively. Age, education, region of residence, marital status, current use of contraception and type of occupation were significantly associated with BMI categories. Adjusted multinomial logistic regression analysis indicated that women with a high socioeconomic status were significantly negatively associated with being underweight (odds ratio [OR] 0.55, 95 percent confidence interval [CI] 0.48-0.63) but positively associated with being overweight (OR 1.70, 95 percent CI 1.48-1.96) and obese (OR 2.48, 95 percent CI 1.89-3.26), as compared to the women with normal BMI. In contrast, women who migrated from rural to urban areas showed a significantly positive association with being underweight (OR 1.15, 95 percent CI 1.04-1.27) but negative associations with being overweight (OR 0.80, 95 percent CI 0.71-0.89) and obese (OR 0.75, 95 percent CI 0.62-0.92), when compared with women who did not migrate. Suitable interventions based on further studies are needed to reduce the prevalence of being underweight and overweight among ever-married non-pregnant urban women in Bangladesh. Factors, viz. socioeconomic status, rural-urban migration and education, should be considered while developing interventional strategies to reduce the prevalence of extreme BMIs among women living in urban areas of Bangladesh.

An empirical comparison of methods for analyzing correlated data from a discrete choice survey to elicit patient preference for colorectal cancer screening

PubMed Central

2012-01-01

Background A discrete choice experiment (DCE) is a preference survey which asks participants to make a choice among product portfolios comparing the key product characteristics by performing several choice tasks. Analyzing DCE data needs to account for within-participant correlation because choices from the same participant are likely to be similar. In this study, we empirically compared some commonly-used statistical methods for analyzing DCE data while accounting for within-participant correlation based on a survey of patient preference for colorectal cancer (CRC) screening tests conducted in Hamilton, Ontario, Canada in 2002. Methods A two-stage DCE design was used to investigate the impact of six attributes on participants' preferences for CRC screening test and willingness to undertake the test. We compared six models for clustered binary outcomes (logistic and probit regressions using cluster-robust standard error (SE), random-effects and generalized estimating equation approaches) and three models for clustered nominal outcomes (multinomial logistic and probit regressions with cluster-robust SE and random-effects multinomial logistic model). We also fitted a bivariate probit model with cluster-robust SE treating the choices from two stages as two correlated binary outcomes. The rank of relative importance between attributes and the estimates of β coefficient within attributes were used to assess the model robustness. Results In total 468 participants with each completing 10 choices were analyzed. Similar results were reported for the rank of relative importance and β coefficients across models for stage-one data on evaluating participants' preferences for the test. The six attributes ranked from high to low as follows: cost, specificity, process, sensitivity, preparation and pain. However, the results differed across models for stage-two data on evaluating participants' willingness to undertake the tests. Little within-patient correlation (ICC ≈ 0) was found in stage-one data, but substantial within-patient correlation existed (ICC = 0.659) in stage-two data. Conclusions When small clustering effect presented in DCE data, results remained robust across statistical models. However, results varied when larger clustering effect presented. Therefore, it is important to assess the robustness of the estimates via sensitivity analysis using different models for analyzing clustered data from DCE studies. PMID:22348526

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.

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

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.

Using financial incentives to improve the care of tuberculosis patients.

PubMed

Lee, Cheng-Yi; Chi, Mei-Ju; Yang, Shiang-Lin; Lo, Hsiu-Yun; Cheng, Shou-Hsia

2015-01-01

Tuberculosis (TB) is a serious public health concern, and Taiwan has implemented a pay-for-performance (P4P) program to incentivize healthcare professionals to provide comprehensive care to TB patients. This study aims to examine the effects of the TB P4P program on treatment outcomes and related expenses. A population-based natural experimental design with intervention and comparison groups. Propensity score matching was conducted to increase the comparability between the P4P and non-P4P group. A total of 12,018 subjects were included in the analysis, with 6009 cases in each group. Generalized linear models and multinomial logistic regression were employed to examine the effects of the P4P program. The regression models indicated that patients enrolled in the P4P program had 14% more ambulatory visits than non-P4P patients (P < .001), but there were no differences in hospitalization rates. On average, P4P enrollees spent $215 (4.6%) less on TB-related expenses than their counterparts. In addition, P4P enrollees had a higher likelihood of being successfully treated (odds ratio, 1.56; P < .001) and were less likely to die compared with nonenrollees. Patients in the P4P program were less likely to die, were more likely to be treated successfully, and incurred lower costs. Providing financial incentives to healthcare institutions could be a feasible model for better TB control.

Information integration in health care organizations: The case of a European health system.

PubMed

Calciolari, Stefano; Buccoliero, Luca

2010-01-01

Information system integration is an important dimension of a company's information system maturity and plays a relevant role in meeting information needs and accountability targets. However, no generalizable evidence exists about whether and how the main integrating technologies influence information system integration in health care organizations. This study examined how integrating technologies are adopted in public health care organizations and chief information officers' (CIOs) perceptions about their influence on information system integration. We used primary data on integrating technologies' adoption and CIOs' perception regarding information system integration in public health care organizations. Analysis of variance (ANOVA) and multinomial logistic regression were used to examine the relationship between CIOs' perception about information system integration and the adopted technologies. Data from 90 health care organizations were available for analyses. Integrating technologies are relatively diffused in public health care organizations, and CIOs seem to shape information system toward integrated architectures. There is a significant positive (although modest, .3) correlation between the number of integrating technologies adopted and the CIO's satisfaction with them. However, regression analysis suggests that organizations covering a broader spectrum of these technologies are less likely to have their CIO reporting main problems concerning integration in the administrative area of the information system compared with the clinical area and where the two areas overlap. Integrating technologies are associated with less perceived problems in the information system administrative area rather than in other areas. Because CIOs play the role of information resource allocators, by influencing information system toward integrated architecture, health care organization leaders should foster cooperation between CIOs and medical staff to enhance information system integration.

Anthropometric Indices in Children With Refractory Epilepsy.

PubMed

Aminzadeh, Vahid; Dalili, Setila; Ashoorian, Yalda; Kohmanaee, Shahin; Hassanzadeh Rad, Afagh

2016-01-01

We aimed to assess the effect of body mass index (BMI) on reducing the risk of refractory seizure due to lipoid tissue factors. This matched case-control study, consisted of cases (Patients with refractory epilepsy) and controls (Healthy children) referred to 17 Shahrivar Hospital, Guilan University of Medical Sciences, Guilan, Iran during 2013-2014. Data were gathered by a form including demographic characteristics, type of epilepsy, predominant time of epilepsy, therapeutic approach, frequency of epilepsy, time of disease onset and anthropometric indices. We measured anthropometric indices and transformed them into Z-scores. Data were reported by descriptive statistics (mean and standard deviation) and analyzed by Pearson correlation coefficient, paired t test and multinomial regression analysis test using SPSS 19. There was no significant difference between sex groups regarding anthropometric indices. Generalized and focal types of epilepsies were noted on 57.5% and 38.75% of patients, respectively. Daytime epilepsies happened in 46.25% of patients and 33.75% noted no predominant time for epilepsies. Clinicians indicated poly-therapy for the majority of patients (92.5%). The most common onset times for epilepsies were 36-72 months for 32.5% of patients. Lower onset time indicated lower frequency of refractory epilepsies. Although, there was significant difference between Zheight and predominant time of epilepsies but no significant relation was found between types of epilepsies and frequency of epilepsies with anthropometric indices. Using multivariate regression analysis by backward LR, Zweight and birth weight were noted as the predicting factors of refractory epilepsies. This effect may be because of leptin. Therefore, researchers recommend further investigations regarding this issue in children with epilepsy.

Latent classes of emotional and behavioural problems in epidemiological and referred samples and their relations to DSM-IV diagnoses.

PubMed

Bianchi, Valentina; Brambilla, Paolo; Garzitto, Marco; Colombo, Paola; Fornasari, Livia; Bellina, Monica; Bonivento, Carolina; Tesei, Alessandra; Piccin, Sara; Conte, Stefania; Perna, Giampaolo; Frigerio, Alessandra; Castiglioni, Isabella; Fabbro, Franco; Molteni, Massimo; Nobile, Maria

2017-05-01

Researchers' interest have recently moved toward the identification of recurrent psychopathological profiles characterized by concurrent elevations on different behavioural and emotional traits. This new strategy turned to be useful in terms of diagnosis and outcome prediction. We used a person-centred statistical approach to examine whether different groups could be identified in a referred sample and in a general-population sample of children and adolescents, and we investigated their relation to DSM-IV diagnoses. A latent class analysis (LCA) was performed on the Child Behaviour Checklist (CBCL) syndrome scales of the referred sample (N = 1225), of the general-population sample (N = 3418), and of the total sample. Models estimating 1-class through 5-class solutions were compared and agreement in the classification of subjects was evaluated. Chi square analyses, a logistic regression, and a multinomial logistic regression analysis were used to investigate the relations between classes and diagnoses. In the two samples and in the total sample, the best-fitting models were 4-class solutions. The identified classes were Internalizing Problems (15.68%), Severe Dysregulated (7.82%), Attention/Hyperactivity (10.19%), and Low Problems (66.32%). Subsequent analyses indicated a significant relationship between diagnoses and classes as well as a main association between the severe dysregulated class and comorbidity. Our data suggested the presence of four different psychopathological profiles related to different outcomes in terms of psychopathological diagnoses. In particular, our results underline the presence of a profile characterized by severe emotional and behavioural dysregulation that is mostly associated with the presence of multiple diagnosis.

A new look at patient satisfaction: learning from self-organizing maps.

PubMed

Voutilainen, Ari; Kvist, Tarja; Sherwood, Paula R; Vehviläinen-Julkunen, Katri

2014-01-01

To some extent, results always depend on the methods used, and the complete picture of the phenomenon of interest can be drawn only by combining results of different data processing techniques. This emphasizes the use of a wide arsenal of methods for processing and analyzing patient satisfaction surveys. The purpose of this study was to introduce the self-organizing map (SOM) to nursing science and to illustrate the use of the SOM with patient satisfaction data. The SOM is a widely used artificial neural network suitable for clustering and exploring all kind of data sets. The study was partly a secondary analysis of data collected for the Attractive and Safe Hospital Study from four Finnish hospitals in 2008 and 2010 using the Revised Humane Caring Scale. The sample consisted of 5,283 adult patients. The SOM was used to cluster the data set according to (a) respondents and (b) questionnaire items. The SOM was also used as a preprocessor for multinomial logistic regression. An analysis of missing data was carried out to improve the data interpretation. Combining results of the two SOMs and the logistic regression revealed associations between the level of satisfaction, different components of satisfaction, and item nonresponse. The common conception that the relationship between patient satisfaction and age is positive may partly be due to positive association between the tendency of item nonresponse and age. The SOM proved to be a useful method for clustering a questionnaire data set even when the data set was low dimensional per se. Inclusion of empty responses in analyses may help to detect possible misleading noncausative relationships.

Polydrug Use and HIV Risk Among People Who Inject Heroin in Tijuana, Mexico: A Latent Class Analysis.

PubMed

Meacham, Meredith C; Rudolph, Abby E; Strathdee, Steffanie A; Rusch, Melanie L; Brouwer, Kimberly C; Patterson, Thomas L; Vera, Alicia; Rangel, Gudelia; Roesch, Scott C

2015-01-01

Although most people who inject drugs (PWID) in Tijuana, Mexico, primarily inject heroin, injection and non-injection use of methamphetamine and cocaine is common. We examined patterns of polydrug use among heroin injectors to inform prevention and treatment of drug use and its health and social consequences. Participants were PWID residing in Tijuana, aged ≥18 years who reported heroin injection in the past six months and were recruited through respondent-driven sampling (n = 1,025). Latent class analysis was conducted to assign individuals to classes on a probabilistic basis, using four indicators of past six-month polydrug and polyroute use: cocaine injecting, cocaine smoking or snorting, methamphetamine injecting, and methamphetamine smoking or snorting. Latent class membership was regressed onto covariates in a multinomial logistic regression. Latent class analyses testing 1, 2, 3, and 4 classes were fit, with the 3-class solution fitting best. Class 1 was defined by predominantly heroin use (50.2%, n = 515); class 2 by methamphetamine and heroin use (43.7%, n = 448), and class 3 by methamphetamine, cocaine, and heroin use (6.0%, n = 62). Bivariate and multivariate analyses indicated a group of methamphetamine and cocaine users that exhibited higher-risk sexual practices and lower heroin injecting frequency, and a group of methamphetamine users who were younger and more likely to be female. Discrete subtypes of heroin PWID were identified based on methamphetamine and cocaine use patterns. These findings have identified subtypes of heroin injectors who require more tailored interventions to reduce the health and social harms of injecting drug use.

Polydrug use and HIV risk among people who inject heroin in Tijuana, Mexico: A Latent class analysis

PubMed Central

Meacham, M.C.; Rudolph, A.E.; Strathdee, S.A.; Rusch, M.L.; Brouwer, K.C.; Patterson, T.L.; Vera, A.; Rangel, G.; Roesch, S.C.

2016-01-01

Background Although most people who inject drugs (PWID) in Tijuana, Mexico, primarily inject heroin, injection and non-injection use of methamphetamine and cocaine is common. We examined patterns of polydrug use among heroin injectors to inform prevention and treatment of drug use and its health and social consequences. Methods Participants were PWID residing in Tijuana aged ≥ 18 years who reported heroin injection in the past 6 months and were recruited through respondent driven sampling (n=1025). Latent class analysis was conducted to assign individuals to classes on a probabilistic basis, using four indicators of past 6 month polydrug and polyroute use: cocaine injecting, cocaine smoking or snorting, methamphetamine injecting, methamphetamine smoking or snorting. Latent class membership was regressed onto covariates in a multinomial logistic regression. Results Latent class analyses testing 1, 2, 3, and 4 classes were fit, with the 3-class solution fitting best. Class 1 was defined by predominantly heroin use (50.2%, n=515); class 2 by methamphetamine and heroin use (43.7%, n=448), and class 3 by methamphetamine, cocaine, and heroin use (6.0%, n=62). Bivariate and multivariate analyses indicated a group of methamphetamine and cocaine users that exhibited higher risk sexual practices and lower heroin injecting frequency, and a group of methamphetamine users who were younger and more likely to be female. Conclusions Discrete subtypes of heroin PWID were identified based on methamphetamine and cocaine use patterns. These findings have identified subtypes of heroin injectors who require more tailored interventions to reduce the health and social harms of injecting drug use. PMID:26444185

Factors associated with past research participation among low-income persons living with HIV.

PubMed

Slomka, Jacquelyn; Kypriotakis, Georgios; Atkinson, John; Diamond, Pamela M; Williams, Mark L; Vidrine, Damon J; Andrade, Roberto; Arduino, Roberto

2012-08-01

We described influences on past research participation among low-income persons living with HIV (PLWH) and examined whether such influences differed by study type. We analyzed a convenience sample of individuals from a large, urban clinic specializing in treating low-income PLWH. Using a computer-assisted survey, we elicited perceptions of research and participating in research, barriers, benefits, "trigger" influences, and self-efficacy in participating in research. Of 193 participants, we excluded 14 who did not identify any type of study participation, and 17 who identified "other" as study type, resulting in 162 cases for analysis. We compared results among four groups (i.e., 6 comparisons): past medical participants (n=36, 22%), past behavioral participants (n=49, 30%), individuals with no past research participation (n=52, 32%), and persons who had participated in both medical and behavioral studies (n=25, 15%). Data were analyzed using chi-square tests for categorical variables and ANOVA for continuous variables. We employed a multinomial probit (MNP) model to examine the association of multiple factors with the outcome. Confidence in ability to keep appointments, and worry about being a 'guinea pig' showed statistical differences in bivariate analyses. The MNP regression analysis showed differences between and across all 6 comparison groups. Fewer differences were seen across groupings of medical participants, behavioral participants, and those with no past research experience, than in comparisons with the medical-behavioral group. In the MNP regression model 'age' and level of certainty regarding 'keeping yourself from being a guinea pig' showed significant differences between past medical participants and past behavioral participants.

Link between perceived smoking behaviour at school and students smoking status: a large survey among Italian adolescents.

PubMed

Backhaus, I; D'Egidio, V; Grassucci, D; Gelardini, M; Ardizzone, C; La Torre, G

2017-10-01

To investigate a possible link between sociodemographic factors, the perception of smoking habits at school and smoking status of Italian adolescents attending secondary school. The study was a cross-sectional study. An anonymous online survey was employed to gather information on age, gender, smoking status and to examine the perception of smoking behaviour on the school premises. Chi-squared and Kruskal-Wallis tests were performed for the univariate analysis and logistic and multinomial regressions for the multivariate analysis. The statistical analyses included 1889 students. Univariate analysis showed significant differences concerning knowledge between smoker and non-smoker concerning the harmfulness of smoking (P < 0.001). According to the multivariate analysis smokers had a higher perception of teacher, principal or janitor smoking at school (odds ratio: 1.54 [95% confidence interval 1.26-1.89]). Students older than 19 years most often begin smoking because their friends smoke compared with younger students (adjusted odds ratio: 1.18 [95% confidence interval 0.48-2.89]). School environment and behaviour of role models play a crucial part in student smoking. To prevent and reduce youth tobacco smoking, not merely the presence of preventive measures is important but greater attention needs to be placed on the enforcement of smoking policies. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Slums and malnourishment: evidence from women in India.

PubMed

Swaminathan, Hema; Mukherji, Arnab

2012-07-01

We examined the association between slum residence and nutritional status in women in India by using competing classifications of slum type. We used nationally representative data from the 2005-2006 National Family Health Survey (NFHS-3) to create our citywide analysis sample. The data provided us with individual, household, and community information. We used the body mass index data to identify nutritional status, whereas the residential status variable provided slum details. We used a multinomial regression framework to model the 3 nutrition states-undernutrition, normal, and overnutrition. After we controlled for a range of attributes, we found that living in a census slum did not affect nutritional status. By contrast, living in NFHS slums decreased the odds of being overweight by 14% (95% confidence interval [CI] =0.79, 0.95) and increased the odds of being underweight by 10% (95% CI=1.00, 1.22). The association between slum residence and nutritional outcomes is nuanced and depends on how one defines a slum. This suggests that interventions targeted at slums should look beyond official definitions and include current living conditions to effectively reach the most vulnerable.

Excessive internet use in European adolescents: what determines differences in severity?

PubMed

Blinka, Lukas; Škařupová, Kateřina; Ševčíková, Anna; Wölfling, Klaus; Müller, Kai W; Dreier, Michael

2015-02-01

This study investigated the differences between non-excessive, moderately excessive, and highly excessive internet use among adolescents. These differences were explored in terms of personal characteristics, psychological difficulties, environmental factors, and manner of internet use. A representative sample was investigated, consisting of 18,709 adolescents aged 11-16 and their parents, from 25 European countries. Excessive internet use was measured using a five item scale covering following factors: salience, conflict, tolerance, withdrawal symptoms, and relapse and reinstatement. The main data analysis utilised multinomial and binary logistic regression models. The vast majority of respondents reported no signs of excessive internet use. Moderately excessive users (4.4%) reported higher emotional and behavioural difficulties, but also more sophisticated digital skills and a broader range of online activities. The highly excessive users (1.4%) differed from the non-excessive and moderately excessive users in their preference for online games and in having more difficulties with self-control. Adolescents who struggle with attention and self-control and who are inclined toward online gaming may be especially vulnerable to the otherwise uncommon phenomenon of excessive internet use.

Interpersonal polyvictimization and mental health in males.

PubMed

Burns, Carol Rhonda; Lagdon, Susan; Boyda, David; Armour, Cherie

2016-05-01

A consistent conclusion within the extant literature is that victimization and in particular polyvictimization leads to adverse mental health outcomes. A large body of literature exists as it pertains to the association between victimisation and mental health in studies utilising samples of childhood victims, female only victims, and samples of male and female victims; less research exists as it relates to males victims of interpersonal violence. The aim of the current study was therefore to identify profiles of interpersonal victimizations in an exclusively male sample and to assess their differential impact on a number of adverse mental health outcomes. Using data from 14,477 adult males from Wave 2 of the NESARC, we identified interpersonal victimization profiles via Latent Class Analysis. Multinomial Logistic Regression was subsequently utilized to establish risk across mental health disorders. A 4-class solution was optimal. Victimisation profiles showed elevated odds ratios for the presence of mental health disorders; suggesting that multiple life-course victimisation typologies exists, and that victimization is strongly associated with psychopathology. Several additional notable findings are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Do incest, depression, parental drinking, serious romantic relationships, and living with parents influence patterns of substance use during emerging adulthood?

PubMed

Snyder, Susan M; Rubenstein, Casey

2014-01-01

This study examined how incest, depression, parental drinking, relationship status, and living with parents affect patterns of substance use among emerging adults, 18 to 25 years old. The study sample included (n = 11,546) individuals who participated in Waves I, II, and III of the National Longitudinal Study of Adolescent Health (Add Health). The study used separate latent class analysis for males and females to determine how patterns of substance use clustered together. The study identified the following three classes of substance use: heavy, moderate, and normative substance use patterns. Multinomial logistic regression indicated that, for females only, incest histories also nearly doubled the risk of heavy-use class membership. In addition, experiencing depression, being single, and not living with parents serve as risk factors for males and females in the heavy-use group. Conversely, being Black, Hispanic, or living with parents lowered the likelihood of being in the group with the most substance use behaviors (i.e., heavy use). Findings highlight the need for interventions that target depression and female survivors of incest among emerging adults.

Do Incest, Depression, Parental Drinking, Serious Romantic Relationships, and Living with Parents Influence Patterns of Substance Use During Emerging Adulthood?

PubMed Central

Snyder, Susan M.; Rubenstein, Casey

2016-01-01

This study examined how incest, depression, parental drinking, relationship status, and living with parents affect patterns of substance use among emerging adults, 18 to 25 years old. The study sample included (n = 11,546) individuals who participated in Waves I, II, and III of the National Longitudinal Study of Adolescent Health (Add Health). The study used separate latent class analysis for males and females to determine how patterns of substance use clustered together. The study identified the following three classes of substance use: heavy, moderate, and normative substance use patterns. Multinomial logistic regression indicated that, for females only, incest histories also nearly doubled the risk of heavy-use class membership. In addition, experiencing depression, being single, and not living with parents serve as risk factors for males and females in the heavy-use group. Conversely, being Black, Hispanic, or living with parents lowered the likelihood of being in the group with the most substance use behaviors (i.e., heavy use). Findings highlight the need for interventions that target depression and female survivors of incest among emerging adults. PMID:25052877

Changes in Social Exclusion Indicators and Psychological Distress Among Homeless People Over a 2.5-Year Period.

PubMed

Van Straaten, Barbara; Rodenburg, Gerda; Van der Laan, Jorien; Boersma, Sandra N; Wolf, Judith R L M; Van de Mheen, Dike

2018-01-01

Although homelessness is inherently associated with social exclusion, homeless individuals are rarely included in conventional studies on social exclusion. Use of longitudinal survey data from a cohort study on homeless people in four major Dutch cities ( n  = 378) allowed to examine: changes in indicators of social exclusion among homeless people over a 2.5-year period after reporting to the social relief system, and associations between changes in indicators of social exclusion and changes in psychological distress. Multinomial logistic regression analysis was applied to investigate the associations between changes in indicators of social exclusion and changes in psychological distress. Improvements were found in various indicators of social exclusion, whereas financial debts showed no significant improvement. Changes in unmet care needs, health insurance, social support from family and relatedness to others were related to changes in psychological distress. This study demonstrated improvements in various indicators of social exclusion among homeless people over a period of 2.5 years, and sheds light on the concept of social exclusion in relation to homelessness.

The Influence of Gender, Age, Education, and Household Size on Meal Preparation and Food Shopping Responsibilities

PubMed Central

Lee Anne, Flagg; Bisakha, Sen; Kilgore, Meredith L.; Locher, Julie L.

2013-01-01

Objective To examine the extent to which the gendered division of labor persists within households in the US in regard to meal planning/preparation and food shopping activities. Design Secondary analysis of cross-sectional data. Setting 2007-2008 U.S. National Health and Nutrition Examination Survey. Subjects Subsample of 3,195 adults at least 20 years old who had a spouse or partner. Results Analyses revealed that the majority of women and men reported that they shared in both meal planning/preparing and food shopping activities (meal planning/preparation: women, 54 % and men, 56 % and food shopping: women, 60 % and men, 57 %). Results from multinomial logistic regression analyses indicated that, compared to men, women are more likely to take primary responsibility than to share this responsibility and are less likely to report having no responsibility for these tasks. Gender differences were observed for age/cohort, education, and household size. Conclusions This study may have implications for public health nutritional initiatives and the well-being of families in the US. PMID:23988018

Factors leading African Americans and black Caribbeans to use social work services for treating mental and substance use disorders.

PubMed

Cheng, Tyrone C; Robinson, Michael A

2013-05-01

This secondary analysis of 5,000 African Americans and black Caribbeans explored how their use of social work services to address mental and substance use disorders was associated with the disorder involved as well as their perceived need for services, belief system, family resources, proximity to services, social-structural factors, and demographic characteristics. The sample was extracted from a national data set. Results of multinomial logistic regression showed that use of social work services was increased by dual diagnosis, substance use disorder alone, and mental disorder alone; by deteriorating mental health; by perceived stigma in treatment use; by welfare receipt and insurance coverage for mental health services; and by college graduation. Results also showed that use of services outside social work was promoted by dual diagnosis, substance use disorder alone, and mental disorder alone; by deteriorating mental health; by experience of racial discrimination; by insurance coverage for mental health services; by college education or graduation; and by female gender and increasing age. The findings' implications for social work intervention and education are discussed.

The three latent classes of adolescent delinquency and the risk factors for membership in each class.

PubMed

Hasking, Penelope Anne; Scheier, Lawrence M; Abdallah, Arbi Ben

2011-01-01

This study used latent class analysis to examine subpopulation membership based on self-reports of delinquent behaviors obtained from Australian youth. Three discrete identifiable classes were derived based on 51 indicators of physical violence, property damage, minor infractions, drug use, and social delinquency. One class of youth engaged in primarily rule breaking and norm violations including underage alcohol use, typical of this age period. A second class was more actively delinquent emphasizing drug use, trespassing, and various forms of disobedience. A third class of highly delinquent youth differed from their counterparts by endorsing drug use, thievery that involved stealing money, goods, and cars, property damage, gambling, precocious sexual experiences, involvement with pornographic materials, and fighting. Multinomial logistic regression predicting class membership indicated highly delinquent youth were more likely to be older males, use venting coping strategies, and be fun or novelty seeking compared with rule breakers. Findings are discussed in terms of refining current taxonomic arguments regarding the structure of delinquency and implications for prevention of early-stage antisocial behavior. © 2010 Wiley-Liss, Inc.

Nutritional status of urban adolescents: individual, household and neighborhood factors based on data from The BH Health Study.

PubMed

Bispo, Stephanie; Correia, Maria Isabel Toulson Davisson; Proietti, Fernando Augusto; Xavier, César Coelho; Caiaffa, Waleska Teixeira

2015-11-01

The increasing prevalence of overweight in young people suggests that adolescent nutritional status is influenced by environmental factors. Using hierarchical modelling, this study aimed to analyse the association between individual, household and neighborhood factors and adolescent nutritional status and well-being. The study used data from a population-based household survey conducted in Belo Horizonte, the capital of the State of Minas Gerais, Brazil, between 2008 and 2009. Data was obtained from an adult and adolescent in each household using a confidential questionnaire and anthropometric measurements. Adolescent nutritional status was evaluated using multinomial regression analysis considering distal and proximal influences. The prevalence of overweight and thinness among the sample of 1,030 adolescents was 21.9% and 4.6%, respectively. Although variables from all blocks remained in the final model, head of household education level, family habits and family nutritional status were shown to strongly influence adolescent nutritional status. New approaches to public health are needed which focus on raising awareness and promoting health education targeting teenagers and their social context.

Effects of Sachet Water Consumption on Exposure to Microbe-Contaminated Drinking Water: Household Survey Evidence from Ghana

PubMed Central

Wright, Jim; Dzodzomenyo, Mawuli; Wardrop, Nicola A.; Johnston, Richard; Hill, Allan; Aryeetey, Genevieve; Adanu, Richard

2016-01-01

There remain few nationally representative studies of drinking water quality at the point of consumption in developing countries. This study aimed to examine factors associated with E. coli contamination in Ghana. It drew on a nationally representative household survey, the 2012−2013 Living Standards Survey 6, which incorporated a novel water quality module. E. coli contamination in 3096 point-of-consumption samples was examined using multinomial regression. Surface water use was the strongest risk factor for high E. coli contamination (relative risk ratio (RRR) = 32.3, p < 0.001), whilst packaged (sachet or bottled) water use had the greatest protective effect (RRR = 0.06, p < 0.001), compared to water piped to premises. E. coli contamination followed plausible patterns with digit preference (tendency to report values ending in zero) in bacteria counts. The analysis suggests packaged drinking water use provides some protection against point-of-consumption E. coli contamination and may therefore benefit public health. It also suggests viable water quality data can be collected alongside household surveys, but field protocols require further revision. PMID:27005650

The Association Between Low Grade Systemic Inflammation and Skin Diseases: A Cross-sectional Survey in the Northern Finland Birth Cohort 1966.

PubMed

Sinikumpu, Suvi-Päivikki; Huilaja, Laura; Auvinen, Juha; Jokelainen, Jari; Puukka, Katri; Ruokonen, Aimo; Timonen, Markku; Tasanen, Kaisa

2018-01-12

Low grade inflammation is associated with many noncommunicable diseases. The association between skin diseases in general and systemic inflammation has not previously been studied at the population level. A whole-body investigation on 1,930 adults belonging to Northern Finland Birth Cohort 1966 was performed and high sensitive C-reactive protein (CRP) level was measured as a marker of low grade inflammation in order to determine the association between low grade inflammation and skin diseases in an unselected adult population. After adjustment for confounding factors the following skin disorders were associated with low grade inflammation in multinomial logistic regression analysis: atopic eczema (OR 2.2, 95% CI 1.2-3.9), onychomycosis (OR 2.0, 1.2-3.2) and rosacea (OR 1.7, 1.1-2.5). After additionally adjusting for body mass index and systemic diseases, the risks for atopic eczema (OR 2.4, 1.3-4.6) and onychomycosis (OR 1.9, 1.1-3.1) remained statistically significant. In conclusion, low grade inflammation is present in several skin diseases.

Effects of Sachet Water Consumption on Exposure to Microbe-Contaminated Drinking Water: Household Survey Evidence from Ghana.

PubMed

Wright, Jim; Dzodzomenyo, Mawuli; Wardrop, Nicola A; Johnston, Richard; Hill, Allan; Aryeetey, Genevieve; Adanu, Richard

2016-03-09

There remain few nationally representative studies of drinking water quality at the point of consumption in developing countries. This study aimed to examine factors associated with E. coli contamination in Ghana. It drew on a nationally representative household survey, the 2012-2013 Living Standards Survey 6, which incorporated a novel water quality module. E. coli contamination in 3096 point-of-consumption samples was examined using multinomial regression. Surface water use was the strongest risk factor for high E. coli contamination (relative risk ratio (RRR) = 32.3, p < 0.001), whilst packaged (sachet or bottled) water use had the greatest protective effect (RRR = 0.06, p < 0.001), compared to water piped to premises. E. coli contamination followed plausible patterns with digit preference (tendency to report values ending in zero) in bacteria counts. The analysis suggests packaged drinking water use provides some protection against point-of-consumption E. coli contamination and may therefore benefit public health. It also suggests viable water quality data can be collected alongside household surveys, but field protocols require further revision.

Training and retaining staff to competently deliver an evidence-based practice: the role of staff attributes and perceptions of organizational functioning.

PubMed

Garner, Bryan R; Hunter, Brooke D; Godley, Susan H; Godley, Mark D

2012-03-01

Within the context of an initiative to implement evidence-based practices (EBPs) for adolescents with substance use disorders, this study examined the extent to which staff factors measured at an initial EBP training workshop were predictive of EBP competence and turnover status of staff (N = 121) measured 6, 9, and 12 months posttraining. By the final assessment point, 52.3% of staff transitioned to the employed/EBP-competent category, 26.6% transitioned to the not employed/not EBP-competent category, 4.6% transitioned to the not employed/EBP-competent category, and 16.5% had not transitioned out of the initial category. Multilevel multinomial regression analysis identified several measures that were significant predictors of staff transitions to the not employed/not EBP-competent category (e.g., program needs, job satisfaction, burnout) and transitions to the employed/EBP-competent category (e.g., months in position, pressures for change, influence). Findings have implications for the development and testing of strategies to train and retain staff to deliver EBPs in practice settings. Copyright © 2012 Elsevier Inc. All rights reserved.

A national survey of skin infections, care behaviors and MRSA knowledge in the United States.

PubMed

Wilder, Jocelyn R; Wegener, Duane T; David, Michael Z; Macal, Charles; Daum, Robert; Lauderdale, Diane S

2014-01-01

A nationally representative sample of approximately 2000 individuals was surveyed to assess SSTI infections over their lifetime and then prospectively over six-months. Knowledge of MRSA, future likelihood to self-treat a SSTI and self-care behaviors was also queried. Chi square tests, linear and multinomial regression were used for analysis. About 50% of those with a reported history of a SSTI typical of MRSA had sought medical treatment. MRSA knowledge was low: 28% of respondents could describe MRSA. Use of protective self-care behaviors that may reduce transmission, such as covering a lesion, differed with knowledge of MRSA and socio-demographics. Those reporting a history of a MRSA-like SSTI were more likely to respond that they would self-treat than those without such a history (OR 2.05 95% CI 1.40, 3.01; p<0.001). Since half of respondents reported not seeking care for past lesions, incidence determined from clinical encounters would greatly underestimate true incidence. MRSA knowledge was not associated with seeking medical care, but was associated with self-care practices that may decrease transmission.

Towards a post-traumatic subtype of obsessive-compulsive disorder.

PubMed

Fontenelle, Leonardo F; Cocchi, Luca; Harrison, Ben J; Shavitt, Roseli G; do Rosário, Maria Conceição; Ferrão, Ygor A; de Mathis, Maria Alice; Cordioli, Aristides V; Yücel, Murat; Pantelis, Christos; Mari, Jair de Jesus; Miguel, Euripedes C; Torres, Albina R

2012-03-01

We evaluated whether traumatic events are associated with a distinctive pattern of socio-demographic and clinical features of obsessive-compulsive disorder (OCD). We compared socio-demographic and clinical features of 106 patients developing OCD after post-traumatic stress disorder (PTSD; termed post-traumatic OCD), 41 patients developing OCD before PTSD (pre-traumatic OCD), and 810 OCD patients without any history of PTSD (non-traumatic OCD) using multinomial logistic regression analysis. A later age at onset of OCD, self-mutilation disorder, history of suicide plans, panic disorder with agoraphobia, and compulsive buying disorder were independently related to post-traumatic OCD. In contrast, earlier age at OCD onset, alcohol-related disorders, contamination-washing symptoms, and self-mutilation disorder were all independently associated with pre-traumatic OCD. In addition, patients with post-traumatic OCD without a previous history of obsessive-compulsive symptoms (OCS) showed lower educational levels, greater rates of contamination-washing symptoms, and more severe miscellaneous symptoms as compared to post-traumatic OCD patients with a history of OCS. Copyright © 2011 Elsevier Ltd. All rights reserved.

Differentiating positive and negative self-rated health: results from a cross-sectional study in Estonia.

PubMed

Reile, Rainer; Leinsalu, Mall

2013-08-01

To examine possible differences in the correlates of positive and negative self-rated health (SRH). Data for 2,127 men and 2,385 women in the 25-74 age group came from the Estonian Health Interview Survey 2006. Multinomial logistic regression analysis was used to study the association of socio-demographic, physical and psychological health and well-being characteristics with positive (good or very good) and negative (bad or very bad) SRH as compared to fair SRH. Negative SRH was related to male gender, the presence of chronic illnesses, limitations in daily activities and physical functioning, emotional distress, an external locus of control, and to low satisfaction with life and physical fitness. These indicators (except satisfaction with life) were also related to positive SRH, presenting a mirrored pattern of association. Additionally, positive SRH was related to younger age, an Estonian ethnic identity, and to higher education and income. Although SRH forms a ill/healthy continuum when physical and psychological health characteristics are considered, the broader spectrum of predictors indicates that positive SRH and negative SRH are two distinct and alternative concepts.

Does Feedback-Related Brain Response during Reinforcement Learning Predict Socio-motivational (In-)dependence in Adolescence?

PubMed Central

Raufelder, Diana; Boehme, Rebecca; Romund, Lydia; Golde, Sabrina; Lorenz, Robert C.; Gleich, Tobias; Beck, Anne

2016-01-01

This multi-methodological study applied functional magnetic resonance imaging to investigate neural activation in a group of adolescent students (N = 88) during a probabilistic reinforcement learning task. We related patterns of emerging brain activity and individual learning rates to socio-motivational (in-)dependence manifested in four different motivation types (MTs): (1) peer-dependent MT, (2) teacher-dependent MT, (3) peer-and-teacher-dependent MT, (4) peer-and-teacher-independent MT. A multinomial regression analysis revealed that the individual learning rate predicts students’ membership to the independent MT, or the peer-and-teacher-dependent MT. Additionally, the striatum, a brain region associated with behavioral adaptation and flexibility, showed increased learning-related activation in students with motivational independence. Moreover, the prefrontal cortex, which is involved in behavioral control, was more active in students of the peer-and-teacher-dependent MT. Overall, this study offers new insights into the interplay of motivation and learning with (1) a focus on inter-individual differences in the role of peers and teachers as source of students’ individual motivation and (2) its potential neurobiological basis. PMID:27199873

Women's Retirement Expectations: How Stable Are They?

PubMed Central

Hardy, Melissa A.

2009-01-01

Objective Using the National Longitudinal Survey of Mature Women, we examine between- and within-person differences in expected retirement age as a key element of the retirement planning process. The expectation typologies of 1,626 women born between 1923 and 1937 were classified jointly on the basis of specificity and consistency. Methods Latent class analysis was used to determine retirement expectation patterns over a 7-year span. Multinomial logistic regression analyses were employed to estimate the effects of demographic and status characteristics on the likelihood of reporting 4 distinct longitudinal patterns of retirement expectations. Results Substantial heterogeneity in reports of expected retirement age between and within individuals over the 7-year span was found. Demographic and status characteristics, specifically age, race, marital status, job tenure, and recent job change, sorted respondents into different retirement expectation patterns. Conclusions The frequent within-person fluctuations and substantial between-person heterogeneity in retirement expectations indicate uncertainty and variability in both expectations and process of expectation formation. Variability in respondents' reports suggests that studying retirement expectations at multiple time points better captures the dynamics of preretirement planning. PMID:19176483

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

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.

Identifying predictors of childhood anaemia in north-east India.

PubMed

Dey, Sanku; Goswami, Sankar; Dey, Tanujit

2013-12-01

The objective of this study is to examine the factors that influence the occurrence of childhood anaemia in North-East India by exploring dataset of the Reproductive and Child Health-II Survey (RCH-II). The study population consisted of 10,137 children in the age-group of 0-6 year(s) from North-East India to explore the predictors of childhood anaemia by means of different background characteristics, such as place of residence, religion, household standard of living, literacy of mother, total children ever born to a mother, age of mother at marriage. Prevalence of anaemia among children was taken as a polytomous variable. The predicted probabilities of anaemia were established via multinomial logistic regression model. These probabilities provided the degree of assessment of the contribution of predictors in the prevalence of childhood anaemia. The mean haemoglobin concentration in children aged 0-6 year(s) was found to be 11.85 g/dL, with a standard deviation of 5.61 g/dL. The multiple logistic regression analysis showed that rural children were at greater risk of severe (OR = 2.035; p = 0.003) and moderate (OR = 1.23; p = 0.003) anaemia. All types of anaemia (severe, moderate, and mild) were more prevalent among Hindu children (OR = 2.971; p = 0.000), (OR = 1.195; p = 0.010), and (OR = 1.201; p = 0.011) than among children of other religions whereas moderate (OR = 1.406; p = 0.001) and mild (OR = 1.857; p=0.000) anaemia were more prevalent among Muslim children. The fecundity of the mother was found to have significant effect on anaemia. Women with multiple children were prone to greater risk of anaemia. The multiple logistic regression analysis also confirmed that children of literate mothers were comparatively at lesser risk of severe anaemia. Mother's age at marriage had a significant effect on anaemia of their children as well.

Multinomial mixture model with heterogeneous classification probabilities

USGS Publications Warehouse

Holland, M.D.; Gray, B.R.

2011-01-01

Royle and Link (Ecology 86(9):2505-2512, 2005) proposed an analytical method that allowed estimation of multinomial distribution parameters and classification probabilities from categorical data measured with error. While useful, we demonstrate algebraically and by simulations that this method yields biased multinomial parameter estimates when the probabilities of correct category classifications vary among sampling units. We address this shortcoming by treating these probabilities as logit-normal random variables within a Bayesian framework. We use Markov chain Monte Carlo to compute Bayes estimates from a simulated sample from the posterior distribution. Based on simulations, this elaborated Royle-Link model yields nearly unbiased estimates of multinomial and correct classification probability estimates when classification probabilities are allowed to vary according to the normal distribution on the logit scale or according to the Beta distribution. The method is illustrated using categorical submersed aquatic vegetation data. ?? 2010 Springer Science+Business Media, LLC.

University-Industry Linkages in Developing Countries: Perceived Effect on Innovation

ERIC Educational Resources Information Center

Vaaland, Terje I.; Ishengoma, Esther

2016-01-01

Purpose: The purpose of this paper is to assess the perceptions of both universities and the resource-extractive companies on the influence of university-industry linkages (UILs) on innovation in a developing country. Design/Methodology/Approach: A total of 404 respondents were interviewed. Descriptive analysis and multinomial logistic regression…

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

Cognitive overload? An exploration of the potential impact of cognitive functioning in discrete choice experiments with older people in health care.

PubMed

Milte, Rachel; Ratcliffe, Julie; Chen, Gang; Lancsar, Emily; Miller, Michelle; Crotty, Maria

2014-07-01

This exploratory study sought to investigate the effect of cognitive functioning on the consistency of individual responses to a discrete choice experiment (DCE) study conducted exclusively with older people. A DCE to investigate preferences for multidisciplinary rehabilitation was administered to a consenting sample of older patients (aged 65 years and older) after surgery to repair a fractured hip (N = 84). Conditional logit, mixed logit, heteroscedastic conditional logit, and generalized multinomial logit regression models were used to analyze the DCE data and to explore the relationship between the level of cognitive functioning (specifically the absence or presence of mild cognitive impairment as assessed by the Mini-Mental State Examination) and preference and scale heterogeneity. Both the heteroscedastic conditional logit and generalized multinomial logit models indicated that the presence of mild cognitive impairment did not have a significant effect on the consistency of responses to the DCE. This study provides important preliminary evidence relating to the effect of mild cognitive impairment on DCE responses for older people. It is important that further research be conducted in larger samples and more diverse populations to further substantiate the findings from this exploratory study and to assess the practicality and validity of the DCE approach with populations of older people. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Exploratory multinomial logit model-based driver injury severity analyses for teenage and adult drivers in intersection-related crashes.

PubMed

Wu, Qiong; Zhang, Guohui; Ci, Yusheng; Wu, Lina; Tarefder, Rafiqul A; Alcántara, Adélamar Dely

2016-05-18

Teenage drivers are more likely to be involved in severely incapacitating and fatal crashes compared to adult drivers. Moreover, because two thirds of urban vehicle miles traveled are on signal-controlled roadways, significant research efforts are needed to investigate intersection-related teenage driver injury severities and their contributing factors in terms of driver behavior, vehicle-infrastructure interactions, environmental characteristics, roadway geometric features, and traffic compositions. Therefore, this study aims to explore the characteristic differences between teenage and adult drivers in intersection-related crashes, identify the significant contributing attributes, and analyze their impacts on driver injury severities. Using crash data collected in New Mexico from 2010 to 2011, 2 multinomial logit regression models were developed to analyze injury severities for teenage and adult drivers, respectively. Elasticity analyses and transferability tests were conducted to better understand the quantitative impacts of these factors and the teenage driver injury severity model's generality. The results showed that although many of the same contributing factors were found to be significant in the both teenage and adult driver models, certain different attributes must be distinguished to specifically develop effective safety solutions for the 2 driver groups. The research findings are helpful to better understand teenage crash uniqueness and develop cost-effective solutions to reduce intersection-related teenage injury severities and facilitate driver injury mitigation research.

Colorectal cancer outcomes and treatment patterns in patients too young for average-risk screening.

PubMed

Abdelsattar, Zaid M; Wong, Sandra L; Regenbogen, Scott E; Jomaa, Diana M; Hardiman, Karin M; Hendren, Samantha

2016-03-15

Although colorectal cancer (CRC) screening guidelines recommend initiating screening at age 50 years, the percentage of cancer cases in younger patients is increasing. To the authors' knowledge, the national treatment patterns and outcomes of these patients are largely unknown. The current study was a population-based, retrospective cohort study of the nationally representative Surveillance, Epidemiology, and End Results registry for patients diagnosed with CRC from 1998 through 2011. Patients were categorized as being younger or older than the recommended screening age. Differences with regard to stage of disease at diagnosis, patterns of therapy, and disease-specific survival were compared between age groups using multinomial regression, multiple regression, Cox proportional hazards regression, and Weibull survival analysis. Of 258,024 patients with CRC, 37,847 (15%) were aged <50 years. Young patients were more likely to present with regional (relative risk ratio, 1.3; P<.001) or distant (relative risk ratio, 1.5; P<.001) disease. Patients with CRC with distant metastasis in the younger age group were more likely to receive surgical therapy for their primary tumor (adjusted probability: 72% vs 63%; P<.001), and radiotherapy also was more likely in younger patients with CRC (adjusted probability: 53% vs 48%; P<.001). Patients younger than the recommended screening age had better overall disease-specific survival (hazards ratio, 0.77; P<.001), despite a larger percentage of these individuals presenting with advanced disease. Patients with CRC diagnosed at age <50 years are more likely to present with advanced-stage disease. However, they receive more aggressive therapy and achieve longer disease-specific survival, despite the greater percentage of patients with advanced-stage disease. These findings suggest the need for improved risk assessment and screening decisions for younger adults. © 2016 American Cancer Society.

Unacceptable treatment outcomes and associated factors among India's initial cohorts of multidrug-resistant tuberculosis (MDR-TB) patients under the revised national TB control programme (2007-2011): Evidence leading to policy enhancement.

PubMed

Parmar, Malik M; Sachdeva, Kuldeep Singh; Dewan, Puneet K; Rade, Kiran; Nair, Sreenivas A; Pant, Rashmi; Khaparde, Sunil D

2018-01-01

Globally, India has the world's highest burden of multidrug-resistant tuberculosis (MDR-TB). Programmatic Management of Drug Resistant TB (PMDT) in India began in 2007 and nationwide coverage was achieved in early 2013. Poor initial microbiological outcomes under the Revised National Tuberculosis Control Programme (RNTCP) prompted detailed analysis. This is the first study on factors significantly associated with poor outcomes in MDR-TB patients treated under the RNTCP. To evaluate initial sputum culture conversion, culture reversion and final treatment outcomes among MDR-TB patients registered in India from 2007 to early 2011 who were treated with a standard 24-month regimen under daily-observed treatment. This is a retrospective cohort study. Clinical and microbiological data were abstracted from PMDT records. Initial sputum culture conversion, culture reversion and treatment outcomes were defined by country adaptation of the standard WHO definitions (2008). Cox proportional hazards modeling with logistic regression, multinomial logistic regression and adjusted odds ratio was used to evaluate factors associated with interim and final outcomes respectively, controlling for demographic and clinical characteristics. In the cohort of 3712 MDR-TB patients, 2735 (73.6%) had initial sputum culture conversion at 100 median days (IQR 92-125), of which 506 (18.5%) had culture reversion at 279 median days (IQR 202-381). Treatment outcomes were available for 2264 (60.9%) patients while 1448 (39.0%) patients were still on treatment or yet to have a definite outcome at the time of analysis. Of 2264 patients, 781 (34.5%) had treatment success, 644 (28.4%) died, 670 (29.6%) were lost to follow up, 169 (7.5%) experienced treatment failure or were changed to XDR-TB treatment. Factors significantly associated with either culture non-conversion, culture reversion and/or unfavorable treatment outcomes were baseline BMI < 18; ≥ seven missed doses in intensive phase (IP) and continuation phase (CP); cavitary disease; prior treatment episodes characterized by re-treatment regimen taken twice, longer duration and more episodes of treatment; any weight loss during treatment; males and additional resistance to first line drugs (Ethambutol, Streptomycin). In a subgroup of 104 MDR-TB patients, 62 (59.6%) had Ofloxacin resistance among whom only 25.8% had treatment success, half of the success (54.8%) seen in Ofloxacin sensitive patients. Baseline susceptibility to Ofloxacin (HR 2.04) and Kanamycin (HR 4.55) significantly doubled and quadrupled the chances for culture conversion respectively while baseline susceptibility to Ofloxacin (AOR 0.37) also significantly reduced the odds of unfavorable treatment outcomes (p value ≤0.05) in multinomial logistic regression model. India's initial MDR-TB patients' cohort treated under the RNTCP experienced poor treatment outcomes. To address the factors associated with poor treatment outcomes revealed in our study, a systematic multi-pronged approach would be needed. A series of policies and interventions have been developed to address these factors to improve DR-TB treatment outcomes and are being scaled-up in India.

Unacceptable treatment outcomes and associated factors among India's initial cohorts of multidrug-resistant tuberculosis (MDR-TB) patients under the revised national TB control programme (2007–2011): Evidence leading to policy enhancement

PubMed Central

Sachdeva, Kuldeep Singh; Dewan, Puneet K.; Rade, Kiran; Nair, Sreenivas A.; Pant, Rashmi; Khaparde, Sunil D.

2018-01-01

Background Globally, India has the world’s highest burden of multidrug-resistant tuberculosis (MDR-TB). Programmatic Management of Drug Resistant TB (PMDT) in India began in 2007 and nationwide coverage was achieved in early 2013. Poor initial microbiological outcomes under the Revised National Tuberculosis Control Programme (RNTCP) prompted detailed analysis. This is the first study on factors significantly associated with poor outcomes in MDR-TB patients treated under the RNTCP. Objective To evaluate initial sputum culture conversion, culture reversion and final treatment outcomes among MDR-TB patients registered in India from 2007 to early 2011 who were treated with a standard 24-month regimen under daily-observed treatment. Methods This is a retrospective cohort study. Clinical and microbiological data were abstracted from PMDT records. Initial sputum culture conversion, culture reversion and treatment outcomes were defined by country adaptation of the standard WHO definitions (2008). Cox proportional hazards modeling with logistic regression, multinomial logistic regression and adjusted odds ratio was used to evaluate factors associated with interim and final outcomes respectively, controlling for demographic and clinical characteristics. Results In the cohort of 3712 MDR-TB patients, 2735 (73.6%) had initial sputum culture conversion at 100 median days (IQR 92–125), of which 506 (18.5%) had culture reversion at 279 median days (IQR 202–381). Treatment outcomes were available for 2264 (60.9%) patients while 1448 (39.0%) patients were still on treatment or yet to have a definite outcome at the time of analysis. Of 2264 patients, 781 (34.5%) had treatment success, 644 (28.4%) died, 670 (29.6%) were lost to follow up, 169 (7.5%) experienced treatment failure or were changed to XDR-TB treatment. Factors significantly associated with either culture non-conversion, culture reversion and/or unfavorable treatment outcomes were baseline BMI < 18; ≥ seven missed doses in intensive phase (IP) and continuation phase (CP); cavitary disease; prior treatment episodes characterized by re-treatment regimen taken twice, longer duration and more episodes of treatment; any weight loss during treatment; males and additional resistance to first line drugs (Ethambutol, Streptomycin). In a subgroup of 104 MDR-TB patients, 62 (59.6%) had Ofloxacin resistance among whom only 25.8% had treatment success, half of the success (54.8%) seen in Ofloxacin sensitive patients. Baseline susceptibility to Ofloxacin (HR 2.04) and Kanamycin (HR 4.55) significantly doubled and quadrupled the chances for culture conversion respectively while baseline susceptibility to Ofloxacin (AOR 0.37) also significantly reduced the odds of unfavorable treatment outcomes (p value ≤0.05) in multinomial logistic regression model. Conclusion India’s initial MDR-TB patients’ cohort treated under the RNTCP experienced poor treatment outcomes. To address the factors associated with poor treatment outcomes revealed in our study, a systematic multi-pronged approach would be needed. A series of policies and interventions have been developed to address these factors to improve DR-TB treatment outcomes and are being scaled-up in India. PMID:29641576

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.

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

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.

Analysis of Friendship Network and its Role in Explaining Obesity

PubMed Central

Marathe, Achla; Pan, Zhengzheng; Apolloni, Andrea

2013-01-01

We employ Add Health data to show that friendship networks, constructed from mutual friendship nominations, are important in building weight perception, setting weight goals and measuring social marginalization among adolescents and young adults. We study the relationship between individuals’ perceived weight status, actual weight status, weight status relative to friends’ weight status and weight goals. This analysis helps us understand how individual weight perceptions might be formed, what these perceptions do to the weight goals, and how does friends’ relative weight affect weight perception and weight goals. Combining this information with individuals’ friendship network helps determine the influence of social relationships on weight related variables. Multinomial logistic regression results indicate that relative status is indeed a significant predictor of perceived status, and perceived status is a significant predictor of weight goals. We also address the issue of causality between actual weight status and social marginalization (as measured by the number of friends) and show that obesity precedes social marginalization in time rather than the other way around. This lends credence to the hypothesis that obesity leads to social marginalization not vice versa. Attributes of friendship network can provide new insights into effective interventions for combating obesity since adolescent friendships provide an important social context for weight related behaviors. PMID:25328818

Workplace social capital and co-occurrence of lifestyle risk factors: the Finnish Public Sector Study.

PubMed

Väänänen, A; Kouvonen, A; Kivimäki, M; Oksanen, T; Elovainio, M; Virtanen, M; Pentti, J; Vahtera, J

2009-07-01

The aim of this prospective study was to examine the link between individual and ecological workplace social capital and the co-occurrence of adverse lifestyle risk factors such as smoking, heavy drinking, physical inactivity and overweight. Data on 25 897 female and 5476 male public sector employees were analysed. Questionnaire surveys conducted in 2000-2002 (baseline) and 2004-2005 (follow-up) were used to assess workplace social capital, lifestyle risk factors and other characteristics. Multilevel multinomial logistic regression analysis was used to examine associations between individual and ecological social capital and the co-occurrence of lifestyle risk factors. In the cross-sectional analysis adjusted for age, sex, marital status and employer, low social capital at work at both the individual and ecological level was associated with at least a 1.3 times higher odds of having more than two lifestyle risk factors versus having no risk factors. Similar associations were found in the prospective setting. However, additional adjustment for the co-occurrence of risk factors and socioeconomic status at baseline attenuated the result to non-significant. Social capital at work seems to be associated with a lowered risk of co-occurrence of multiple lifestyle risk factors but does not clearly predict the future risk of this co-occurrence.

Social disorganization and the profile of child welfare: Explaining child welfare activity by the community-level factors.

PubMed

Harrikari, Timo

2014-10-01

This article addresses the question of the structure of local child welfare activities in light of community-level factors. It poses the following research questions: how are different community-level factors related to child welfare client structures in communities and what is the extent to which these factors explain structural differences? The applied theoretical framework is based on social disorganization and strain theories as well as human developmental approach. The data has been collected from two Finnish national databases and it consists of variables containing 257 Finnish municipalities. The method of analysis is multinomial logistic regression. The results suggest that the local child welfare structures are tied to social disorganization, policing and culture as well as to the intensity of control in the communities. In general, the more fragile the communal structures, the more last-resort child welfare there is in the community. Combining fragile communal structures with weak dependency ratio and high proportion of social workers, the more intense the level of child welfare statistics indicated. The results indicate that the theoretical framework for the application of child welfare activity analysis is justified, but they also suggest that it requires further development through both context-bound reflection and application. Copyright © 2014 Elsevier Ltd. All rights reserved.

A latent class analysis of substance use and culture among gay, bisexual and other men who have sex with men.

PubMed

Card, Kiffer G; Armstrong, Heather L; Carter, Allison; Cui, Zishan; Wang, Lu; Zhu, Julia; Lachowsky, Nathan J; Moore, David M; Hogg, Robert S; Roth, Eric A

2018-03-28

Assessments of gay and bisexual men's substance use often obscures salient sociocultural and identity-related experiences related to how they use drugs. Latent class analysis was used to examine how patterns of substance use represent the social, economic and identity-related experiences of this population. Participants were sexually active gay and bisexual men (including other men who have sex with men), aged ≥ 16 years, living in Metro Vancouver (n = 774). LCA indicators included all substances used in the past six months self-reported by more than 30 men. Model selection was made with consideration to model parsimony, interpretability and optimisation of statistical criteria. Multinomial regression identified factors associated with class membership. A six-class solution was identified representing: 'assorted drug use' (4.5%); 'club drug use' (9.5%); 'street drug use' (12.1%); 'sex drug use' (11.4%); 'conventional drug use' (i.e. tobacco, alcohol, marijuana; 25.9%); and 'limited drug use' (36.7%). Factors associated with class membership included age, sexual orientation, annual income, occupation, income from drug sales, housing stability, group sex event participation, gay bars/clubs attendance, sensation seeking and escape motivation. These results highlight the need for programmes and policies that seek to lessen social disparities and account for social distinctions among this population.

Reporting of research quality characteristics of studies published in 6 major clinical dental specialty journals.

PubMed

Pandis, Nikolaos; Polychronopoulou, Argy; Madianos, Phoebus; Makou, Margarita; Eliades, Theodore

2011-06-01

The objective of this article was to record reporting characteristics related to study quality of research published in major specialty dental journals with the highest impact factor (Journal of Endodontics, Journal of Oral and Maxillofacial Surgery, American Journal of Orthodontics and Dentofacial Orthopedics; Pediatric Dentistry, Journal of Clinical Periodontology, and International Journal of Prosthetic Dentistry). The included articles were classified into the following 3 broad subject categories: (1) cross-sectional (snap-shot), (2) observational, and (3) interventional. Multinomial logistic regression was conducted for effect estimation using the journal as the response and randomization, sample calculation, confounding discussed, multivariate analysis, effect measurement, and confidence intervals as the explanatory variables. The results showed that cross-sectional studies were the dominant design (55%), whereas observational investigations accounted for 13%, and interventions/clinical trials for 32%. Reporting on quality characteristics was low for all variables: random allocation (15%), sample size calculation (7%), confounding issues/possible confounders (38%), effect measurements (16%), and multivariate analysis (21%). Eighty-four percent of the published articles reported a statistically significant main finding and only 13% presented confidence intervals. The Journal of Clinical Periodontology showed the highest probability of including quality characteristics in reporting results among all dental journals. Copyright © 2011 Elsevier Inc. All rights reserved.

Exceeding parents' expectations in Ear-Nose-Throat outpatient facilities: the development and analysis of a questionnaire.

PubMed

Margaritis, Eleftherios; Katharaki, Maria; Katharakis, George

2012-05-01

The study attempts to develop an outpatient service quality scale by investigating the key dimensions which assess parental satisfaction and provides a recommendation on an improved health service delivery system. The survey was conducted in an Ear-Nose-Throat outpatient clinic of a Greek public pediatric hospital. A total of 127 parents in outpatient waiting areas were chosen; 74.8% of the sampled parents were under 40, and 78% were mothers. A factor analysis was performed; while a Fischer's exact test and multinomial logistic regression analysis was conducted. All Cronbach's α exceeded 0.70 and all factor loadings exceeded 0.50. Twenty-three items were retained through the scale development process and seven factors were formed that appear to be statistically valid and clinically meaningful: access and convenience, doctor's attention, customization, reliability, assurance, satisfaction and loyalty. Findings were discussed in relation to parents' overall satisfaction and intention of reusing and recommending outpatient clinic. Satisfaction was found to be positively affected by access and convenience and doctors' attention. Staff attitude and the telephone procedure of scheduling the child's examination found positively correlated to the likelihood of recommending services to friends and relatives. Time and communication in the waiting room influenced parents' satisfaction. Overall, results reveal the measures that need to be taken in order to improve outpatient service quality. Copyright © 2011 Elsevier Ltd. All rights reserved.

Symptoms of prolonged grief and posttraumatic stress following loss: A latent class analysis.

PubMed

Maccallum, Fiona; Bryant, Richard A

2018-04-01

Individuals vary in how they respond to bereavement. Those who experience poor bereavement outcomes often report symptoms from more than one diagnostic category. This study sought to identify groups of individuals who share similar patterns of prolonged grief disorder and posttraumatic stress disorder symptoms to determine whether these profiles are differentially related to negative appraisals thought to contribute to prolonged grief disorder and posttraumatic stress disorder symptomatology. Participants were 185 bereaved adults. Latent class analysis was used to identify subgroups of individuals who showed similar patterns of co-occurrence of prolonged grief disorder and posttraumatic stress disorder symptoms. Multinomial regression was used to examine the extent to which appraisal domains and sociodemographic and loss factors predicted class membership. Latent class analysis revealed three classes of participants: a low symptom group, a high prolonged grief disorder symptom group, and a high prolonged grief disorder and posttraumatic stress disorder symptom group. Membership of the prolonged grief disorder group and prolonged grief disorder and posttraumatic stress disorder group was predicted by higher mean negative self-related appraisals. Demographic and loss-related factors did not predict group membership. These findings have implications for understanding co-occurrence of prolonged grief disorder and posttraumatic stress disorder symptoms following bereavement. Findings are consistent with theoretical models highlighting the importance of negative self-related beliefs in prolonged grief disorder.

A crash-prediction model for multilane roads.

PubMed

Caliendo, Ciro; Guida, Maurizio; Parisi, Alessandra

2007-07-01

Considerable research has been carried out in recent years to establish relationships between crashes and traffic flow, geometric infrastructure characteristics and environmental factors for two-lane rural roads. Crash-prediction models focused on multilane rural roads, however, have rarely been investigated. In addition, most research has paid but little attention to the safety effects of variables such as stopping sight distance and pavement surface characteristics. Moreover, the statistical approaches have generally included Poisson and Negative Binomial regression models, whilst Negative Multinomial regression model has been used to a lesser extent. Finally, as far as the authors are aware, prediction models involving all the above-mentioned factors have still not been developed in Italy for multilane roads, such as motorways. Thus, in this paper crash-prediction models for a four-lane median-divided Italian motorway were set up on the basis of accident data observed during a 5-year monitoring period extending between 1999 and 2003. The Poisson, Negative Binomial and Negative Multinomial regression models, applied separately to tangents and curves, were used to model the frequency of accident occurrence. Model parameters were estimated by the Maximum Likelihood Method, and the Generalized Likelihood Ratio Test was applied to detect the significant variables to be included in the model equation. Goodness-of-fit was measured by means of both the explained fraction of total variation and the explained fraction of systematic variation. The Cumulative Residuals Method was also used to test the adequacy of a regression model throughout the range of each variable. The candidate set of explanatory variables was: length (L), curvature (1/R), annual average daily traffic (AADT), sight distance (SD), side friction coefficient (SFC), longitudinal slope (LS) and the presence of a junction (J). Separate prediction models for total crashes and for fatal and injury crashes only were considered. For curves it is shown that significant variables are L, 1/R and AADT, whereas for tangents they are L, AADT and junctions. The effect of rain precipitation was analysed on the basis of hourly rainfall data and assumptions about drying time. It is shown that a wet pavement significantly increases the number of crashes. The models developed in this paper for Italian motorways appear to be useful for many applications such as the detection of critical factors, the estimation of accident reduction due to infrastructure and pavement improvement, and the predictions of accidents counts when comparing different design options. Thus this research may represent a point of reference for engineers in adjusting or designing multilane roads.

A Dirichlet-Multinomial Bayes Classifier for Disease Diagnosis with Microbial Compositions.

PubMed

Gao, Xiang; Lin, Huaiying; Dong, Qunfeng

2017-01-01

Dysbiosis of microbial communities is associated with various human diseases, raising the possibility of using microbial compositions as biomarkers for disease diagnosis. We have developed a Bayes classifier by modeling microbial compositions with Dirichlet-multinomial distributions, which are widely used to model multicategorical count data with extra variation. The parameters of the Dirichlet-multinomial distributions are estimated from training microbiome data sets based on maximum likelihood. The posterior probability of a microbiome sample belonging to a disease or healthy category is calculated based on Bayes' theorem, using the likelihood values computed from the estimated Dirichlet-multinomial distribution, as well as a prior probability estimated from the training microbiome data set or previously published information on disease prevalence. When tested on real-world microbiome data sets, our method, called DMBC (for Dirichlet-multinomial Bayes classifier), shows better classification accuracy than the only existing Bayesian microbiome classifier based on a Dirichlet-multinomial mixture model and the popular random forest method. The advantage of DMBC is its built-in automatic feature selection, capable of identifying a subset of microbial taxa with the best classification accuracy between different classes of samples based on cross-validation. This unique ability enables DMBC to maintain and even improve its accuracy at modeling species-level taxa. The R package for DMBC is freely available at https://github.com/qunfengdong/DMBC. IMPORTANCE By incorporating prior information on disease prevalence, Bayes classifiers have the potential to estimate disease probability better than other common machine-learning methods. Thus, it is important to develop Bayes classifiers specifically tailored for microbiome data. Our method shows higher classification accuracy than the only existing Bayesian classifier and the popular random forest method, and thus provides an alternative option for using microbial compositions for disease diagnosis.

Skin autofluorescence associates with vascular calcification in chronic kidney disease.

PubMed

Wang, Angela Yee-Moon; Wong, Chun-Kwok; Yau, Yat-Yin; Wong, Sharon; Chan, Iris Hiu-Shuen; Lam, Christopher Wai-Kei

2014-08-01

This study aims to evaluate the relationship between tissue advanced glycation end products, as reflected by skin autofluorescence, and vascular calcification in chronic kidney disease. Three hundred patients with stage 3 to 5 chronic kidney disease underwent multislice computed tomography to estimate total coronary artery calcium score (CACS) and had tissue advanced glycation end product assessed using a skin autofluorescence reader. Intact parathyroid hormone (P<0.001) displaced estimated glomerular filtration rate as third most significant factor associated with skin autofluorescence after age (P<0.001) and diabetes mellitus (P<0.001) in multiple regression analysis. On univariate multinomial logistic regression analysis, every 1-U increase in skin autofluorescence was associated with a 7.43-fold (95% confidence intervals, 3.59-15.37; P<0.001) increased odds of having CACS ≥400 compared with those with zero CACS. Skin autofluorescence retained significance in predicting CACS ≥400 (odds ratio, 3.63; 95% confidence intervals, 1.44-9.18; P=0.006) when adjusting for age, sex, serum calcium, phosphate, albumin, C-reactive protein, lipids, blood pressure, estimated glomerular filtration rate, and intact parathyroid hormone but marginally lost significance when additionally adjusting for diabetes mellitus (odds ratio, 2.23; 95% confidence intervals, 0.81-6.14; P=0.1). Combination of diabetes mellitus and higher intact parathyroid hormone was associated with greater skin autofluorescence and CACS versus those without diabetes mellitus and having lower intact parathyroid hormone. Tissue advanced glycation end product, as reflected by skin autofluorescence, showed a significant novel association with vascular calcification in chronic kidney disease. These data suggest that increased tissue advanced glycation end product may contribute to vascular calcification in chronic kidney disease and diabetes mellitus and warrant further experimental investigation. © 2014 American Heart Association, Inc.

The influence of marital status on the stage at diagnosis, treatment, and survival of adult patients with gastric cancer: a population-based study.

PubMed

Zhang, Jieyun; Gan, Lu; Wu, Zhenhua; Yan, Shican; Liu, Xiyu; Guo, Weijian

2017-04-04

Marital status was reported as a prognostic factor in many cancers. However, its role in gastric cancer (GC) hasn't been thoroughly explored. In this study, we aimed to investigate the effect of marital status on survival, stage, treatment, and survival in subgroups. We used the Surveillance, Epidemiology and End Results (SEER) database and identified 16910 GC patients. These patients were categorized into married (58.44%) and unmarred (41.56%) groups. Pearson chi-square, Wilcoxon-Mann-Whitney, Log-rank, multivariate Cox regression, univariate and multivariate binomial or multinomial logistic regression analysis were used in our analysis. Subgroup analyses of married versus unmarried patients were summarized in a forest plot. Married patients had better 5-year overall survival (OS) (32.09% VS 24.61%, P<0.001) and 5-year cancer-caused special survival (CSS) (37.74% VS 32.79%, P<0.001) than unmarried ones. Then we studied several underlying mechanisms. Firstly, married patients weren't in earlier stage at diagnosis (P=0.159). Secondly, married patients were more likely to receive surgery (P < 0.001) or radiotherapy (P < 0.001) compared with the unmarried. Thirdly, in subgroup analyses, married patients still had survival advantage in subgroups with stage II-IV and no radiotherapy. These results showed that marital status was an independently prognostic factor for both OS and CSS in GC patients. Undertreatment and lack of social support in unmarried patients were potential explanations. With the knowledge of heterogeneous effects of marriage in subgroups, we can target unmarried patients with better social support, especially who are diagnosed at late stage and undergo no treatment.

The influence of marital status on the stage at diagnosis, treatment, and survival of adult patients with gastric cancer: a population-based study

PubMed Central

Yan, Shican; Liu, Xiyu; Guo, Weijian

2017-01-01

Background & Aims Marital status was reported as a prognostic factor in many cancers. However, its role in gastric cancer (GC) hasn't been thoroughly explored. In this study, we aimed to investigate the effect of marital status on survival, stage, treatment, and survival in subgroups. Methods We used the Surveillance, Epidemiology and End Results (SEER) database and identified 16910 GC patients. These patients were categorized into married (58.44%) and unmarred (41.56%) groups. Pearson chi-square, Wilcoxon-Mann-Whitney, Log-rank, multivariate Cox regression, univariate and multivariate binomial or multinomial logistic regression analysis were used in our analysis. Subgroup analyses of married versus unmarried patients were summarized in a forest plot. Results Married patients had better 5-year overall survival (OS) (32.09% VS 24.61%, P<0.001) and 5-year cancer-caused special survival (CSS) (37.74% VS 32.79%, P<0.001) than unmarried ones. Then we studied several underlying mechanisms. Firstly, married patients weren't in earlier stage at diagnosis (P=0.159). Secondly, married patients were more likely to receive surgery (P < 0.001) or radiotherapy (P < 0.001) compared with the unmarried. Thirdly, in subgroup analyses, married patients still had survival advantage in subgroups with stage II-IV and no radiotherapy. Conclusions These results showed that marital status was an independently prognostic factor for both OS and CSS in GC patients. Undertreatment and lack of social support in unmarried patients were potential explanations. With the knowledge of heterogeneous effects of marriage in subgroups, we can target unmarried patients with better social support, especially who are diagnosed at late stage and undergo no treatment. PMID:26894860

Analysis of age as a factor in NASA astronaut selection and career landmarks.

PubMed

Kovacs, Gregory T A; Shadden, Mark

2017-01-01

NASA's periodic selection of astronauts is a highly selective process accepting applications from the general population, wherein the mechanics of selection are not made public. This research was an effort to determine if biases (specifically age) exist in the process and, if so, at which points they might manifest. Two sets of analyses were conducted. The first utilized data requested via the Freedom of Information Act (FOIA) on NASA astronaut applicants for the 2009 and 2013 selection years. Using a series of multinomial and logistic regressions, the data were analyzed to uncover whether age of the applicants linearly or nonlinearly affected their likelihood of receiving an invitation, as well as their likelihood of being selected into the astronaut program. The second used public data on age at selection and age at other career milestones for every astronaut selected from 1959 to 2013 to analyze trends in age over time using ordinary least-squares (OLS) regression and Pearson's correlation. The results for the FOIA data revealed a nonlinear relationship between age and receiving an interview, as well as age and selection into the astronaut program, but the most striking observation was the loss of age diversity at each stage of selection. Applicants younger or older than approximately 40 years were significantly less likely to receive invitations for interviews and were significantly less likely to be selected as an astronaut. Analysis of the public-source data for all selections since the beginning of the astronaut program revealed significant age trends over time including a gradual increase in selectee age and decreased tenure at NASA after last flight, with average age at retirement steady over the entire history of the astronaut program at approximately 48 years.

Analysis of age as a factor in NASA astronaut selection and career landmarks

PubMed Central

Shadden, Mark

2017-01-01

NASA’s periodic selection of astronauts is a highly selective process accepting applications from the general population, wherein the mechanics of selection are not made public. This research was an effort to determine if biases (specifically age) exist in the process and, if so, at which points they might manifest. Two sets of analyses were conducted. The first utilized data requested via the Freedom of Information Act (FOIA) on NASA astronaut applicants for the 2009 and 2013 selection years. Using a series of multinomial and logistic regressions, the data were analyzed to uncover whether age of the applicants linearly or nonlinearly affected their likelihood of receiving an invitation, as well as their likelihood of being selected into the astronaut program. The second used public data on age at selection and age at other career milestones for every astronaut selected from 1959 to 2013 to analyze trends in age over time using ordinary least-squares (OLS) regression and Pearson’s correlation. The results for the FOIA data revealed a nonlinear relationship between age and receiving an interview, as well as age and selection into the astronaut program, but the most striking observation was the loss of age diversity at each stage of selection. Applicants younger or older than approximately 40 years were significantly less likely to receive invitations for interviews and were significantly less likely to be selected as an astronaut. Analysis of the public-source data for all selections since the beginning of the astronaut program revealed significant age trends over time including a gradual increase in selectee age and decreased tenure at NASA after last flight, with average age at retirement steady over the entire history of the astronaut program at approximately 48 years. PMID:28749968

Willingness to Exchange Health Information via Mobile Devices: Findings From a Population-Based Survey.

PubMed

Serrano, Katrina J; Yu, Mandi; Riley, William T; Patel, Vaishali; Hughes, Penelope; Marchesini, Kathryn; Atienza, Audie A

2016-01-01

The rapid proliferation of mobile devices offers unprecedented opportunities for patients and health care professionals to exchange health information electronically, but little is known about patients' willingness to exchange various types of health information using these devices. We examined willingness to exchange different types of health information via mobile devices, and assessed whether sociodemographic characteristics and trust in clinicians were associated with willingness in a nationally representative sample. We analyzed data for 3,165 patients captured in the 2013 Health Information National Trends Survey. Multinomial logistic regression analysis was conducted to test differences in willingness. Ordinal logistic regression analysis assessed correlates of willingness to exchange 9 types of information separately. Participants were very willing to exchange appointment reminders (odds ratio [OR] = 6.66; 95% CI, 5.68-7.81), general health tips (OR = 2.03; 95% CI, 1.74-2.38), medication reminders (OR = 2.73; 95% CI, 2.35-3.19), laboratory/test results (OR = 1.76; 95% CI, 1.62-1.92), vital signs (OR = 1.63; 95% CI, 1.48-1.80), lifestyle behaviors (OR = 1.40; 95% CI, 1.24-1.58), and symptoms (OR = 1.62; 95% CI, 1.46-1.79) as compared with diagnostic information. Older adults had lower odds of being more willing to exchange any type of information. Education, income, and trust in health care professional information correlated with willingness to exchange certain types of information. Respondents were less willing to exchange via mobile devices information that may be considered sensitive or complex. Age, socioeconomic factors, and trust in professional information were associated with willingness to engage in mobile health information exchange. Both information type and demographic group should be considered when developing and tailoring mobile technologies for patient-clinician communication. © 2016 Annals of Family Medicine, Inc.

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.

Son Preference and Family Limitation in Pakistan: A Parity- and Contraceptive Method-Specific Analysis.

PubMed

Channon, Melanie Dawn

2017-09-01

Son preference exerts a strong influence over contraceptive and fertility decisions in many South Asian countries. In Pakistan, where fertility remains high and contraceptive use low, research on son preference has been limited. Data from Pakistan Demographic and Health Surveys conducted in 1990-1991, 2006-2007 and 2012-2013 were used to examine potential indicators and outcomes of son preference. Descriptive analyses looked at sex composition preferences of men and women, as well as the sex ratio at last birth. Multivariate logistic regression analyses examined parity progression by birth order, while multinomial logistic regression was used to identify associations between sex composition and use of permanent, temporary and traditional contraceptive methods. Parity progression and choice of contraceptive method are increasingly associated with the sex composition of children. Many respondents wanted at least two sons, though most also wanted at least one daughter. Analyses suggest that the prevalence of modern contraceptive use among parous women would have been 19% higher in 2012-2013 in the absence of son preference. Permanent method use was extremely low among women with no sons and increased significantly with number of sons. The association between number of sons and use of temporary methods was weaker, while son preference had little relationship with traditional method use. The association of son preference with parity progression and modern contraceptive use has become stronger in Pakistan. Continuation of the fertility transition may be difficult unless the degrees of differential stopping behavior and differential contraceptive use decline.

Neighborhood Social Cohesion and Sleep Outcomes in the Native Hawaiian and Pacific Islander National Health Interview Survey.

PubMed

Young, Marielle C; Gerber, Monica W; Ash, Tayla; Horan, Christine M; Taveras, Elsie M

2018-05-16

Native Hawaiians and Pacific Islanders (NHPIs) have the lowest attainment of healthy sleep duration among all racial and ethnic groups in the United States. We examined associations of neighborhood social cohesion with sleep duration and quality. Cross-sectional analysis of 2,464 adults in the NHPI National Health Interview Survey (2014). Neighborhood social cohesion was categorized as a continuous and categorical variable into low (<12), medium (12-14) and high (>15) according to tertiles of the distribution of responses. We used multinomial logistic regression to examine the adjusted odds ratio of short and long sleep duration relative to intermediate sleep duration. We used binary logistic regression for dichotomous sleep quality outcomes. Sleep outcomes were modeled as categorical variables. 40% of the cohort reported short (<7 hours) sleep duration and only 4% reported long (>9 hours) duration. Mean (SE, range) social cohesion score was 12.4 units (0.11, 4-16) and 23% reported low social cohesion. In multivariable models, each 1 SD decrease in neighborhood social cohesion score was associated with higher odds of short sleep duration (OR: 1.14, 95% CI: 1.02, 1.29). Additionally, low social cohesion was associated with increased odds of short sleep duration (OR: 1.53, 95% CI: 1.10, 2.13). No associations between neighborhood social cohesion and having trouble falling or staying asleep and feeling well rested were found. Low neighborhood social cohesion is associated with short sleep duration in NHPIs.

Cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people: a cross-sectional study.

PubMed

Tavares, Darlene Mara Dos Santos; Colamego, Camila Gigante; Pegorari, Maycon Sousa; Ferreira, Pollyana Cristina Dos Santos; Dias, Flávia Aparecida; Bolina, Alisson Fernandes

2016-01-01

Identification of frailty syndrome and its relationship with cardiovascular risk factors among hospitalized elderly people is important, since this may contribute towards broadening of knowledge regarding this association within tertiary-level services. This study aimed to evaluate the cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people. Observational cross-sectional study in a public teaching hospital. The participants were elderly patients admitted to clinical and surgical wards. The cardiovascular risk factors assessed were: body mass index (BMI), waist circumference, systemic arterial hypertension (SAH), blood glucose, total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides. To identify frailty syndrome, the method proposed by Fried was used. The data were analyzed through descriptive statistics, chi-square test (P < 0.10) and multinomial logistic regression (P < 0.05). A total of 205 individuals were evaluated. It was found that 26.3% (n = 54) of the elderly people were frail, 51.7% (n = 106) were pre-frail and 22% (n = 45) were non-frail. The preliminary bivariate analysis (P < 0.10) for the regression model showed that frailty was associated with BMI (P = 0.016), LDL cholesterol (P = 0.028) and triglycerides (P = 0.093). However, in the final multivariate model, only overweight remained associated with the pre-frail condition (odds ratio, OR = 0.44; 95% confidence interval, CI = 0.20-0.98; P = 0.045). States of frailty were highly present in the hospital environment. The pre-frail condition was inversely associated with overweight.

Identification of nonclassical properties of light with multiplexing layouts

NASA Astrophysics Data System (ADS)

Sperling, J.; Eckstein, A.; Clements, W. R.; Moore, M.; Renema, J. J.; Kolthammer, W. S.; Nam, S. W.; Lita, A.; Gerrits, T.; Walmsley, I. A.; Agarwal, G. S.; Vogel, W.

2017-07-01

In Sperling et al. [Phys. Rev. Lett. 118, 163602 (2017), 10.1103/PhysRevLett.118.163602], we introduced and applied a detector-independent method to uncover nonclassicality. Here, we extend those techniques and give more details on the performed analysis. We derive a general theory of the positive-operator-valued measure that describes multiplexing layouts with arbitrary detectors. From the resulting quantum version of a multinomial statistics, we infer nonclassicality probes based on a matrix of normally ordered moments. We discuss these criteria and apply the theory to our data which are measured with superconducting transition-edge sensors. Our experiment produces heralded multiphoton states from a parametric down-conversion light source. We show that the known notions of sub-Poisson and sub-binomial light can be deduced from our general approach, and we establish the concept of sub-multinomial light, which is shown to outperform the former two concepts of nonclassicality for our data.

Identification of nonclassical properties of light with multiplexing layouts

PubMed Central

Sperling, J.; Eckstein, A.; Clements, W. R.; Moore, M.; Renema, J. J.; Kolthammer, W. S.; Nam, S. W.; Lita, A.; Gerrits, T.; Walmsley, I. A.; Agarwal, G. S.; Vogel, W.

2018-01-01

In Sperling et al. [Phys. Rev. Lett. 118, 163602 (2017)], we introduced and applied a detector-independent method to uncover nonclassicality. Here, we extend those techniques and give more details on the performed analysis. We derive a general theory of the positive-operator-valued measure that describes multiplexing layouts with arbitrary detectors. From the resulting quantum version of a multinomial statistics, we infer nonclassicality probes based on a matrix of normally ordered moments. We discuss these criteria and apply the theory to our data which are measured with superconducting transition-edge sensors. Our experiment produces heralded multiphoton states from a parametric down-conversion light source. We show that the known notions of sub-Poisson and sub-binomial light can be deduced from our general approach, and we establish the concept of sub-multinomial light, which is shown to outperform the former two concepts of nonclassicality for our data. PMID:29670949

Estimation from incomplete multinomial data. Ph.D. Thesis - Harvard Univ.

NASA Technical Reports Server (NTRS)

Credeur, K. R.

1978-01-01

The vector of multinomial cell probabilities was estimated from incomplete data, incomplete in that it contains partially classified observations. Each such partially classified observation was observed to fall in one of two or more selected categories but was not classified further into a single category. The data were assumed to be incomplete at random. The estimation criterion was minimization of risk for quadratic loss. The estimators were the classical maximum likelihood estimate, the Bayesian posterior mode, and the posterior mean. An approximation was developed for the posterior mean. The Dirichlet, the conjugate prior for the multinomial distribution, was assumed for the prior distribution.

History of family violence, childhood behavior problems, and adolescent high-risk behaviors as predictors of girls' repeated patterns of dating victimization in two developmental periods.

PubMed

Vézina, Johanne; Hébert, Martine; Poulin, François; Lavoie, Francine; Vitaro, Frank; Tremblay, Richard E

2015-04-01

This study aims to document the prevalence of repeated patterns of dating victimization and to examine, within the frameworks of an ecological model and lifestyle/routine activities theories, associations between such patterns and family, peer, and individual factors. Dating victimization in adolescence (age 15) and early adulthood (age 21) was evaluated in 443 female participants. Multinomial logistic regression analyses revealed that history of family violence, childhood behavior problems, and adolescent high-risk behaviors were associated with an increased risk for girls of being victimized (psychologically and/or physically/sexually) in their dating relationships, either in adolescence or early adulthood, or at both developmental periods. © The Author(s) 2015.

The effect of major income sources on rural household food (in)security: Evidence from Swaziland and implications for policy.

PubMed

Mabuza, Majola L; Ortmann, Gerald F; Wale, Edilegnaw; Mutenje, Munyaradzi J

2016-01-01

The aim of this article was to investigate the food (in)security effect of household income generated from major economic activities in rural Swaziland. From a sample of 979 households, the results of a multinomial treatment regression model indicated that gender of household head, labor endowment, education, size of arable land, and location significantly influenced the households' choice of primary economic activity. Further results suggested that off-farm-income-dependent households were less likely to be food insecure when compared with on-farm-income-dependent households. However, on-farm-income-dependent households had a better food security status than their counterparts who depended on remittances and nonfarm economic activities.

Domestic Violence Reported to the Police: Correlates of Victims' Reporting Behavior and Support to Legal Proceedings.

PubMed

Boivin, Rémi; Leclerc, Chloé

2016-01-01

This article analyzes reported incidents of domestic violence according to the source of the complaint and whether the victim initially supported judicial action against the offender. Almost three quarters of incidents studied were reported by the victim (72%), and a little more than half of victims initially wanted to press charges (55%). Using multinomial logistic regression models, situational and individual factors are used to distinguish 4 incident profiles. Incidents in which the victim made the initial report to the police and wished to press charges are the most distinct and involve partners who were already separated at the time of the incident or had a history of domestic violence. The other profiles also show important differences.

Prediction of Nursing Workload in Hospital.

PubMed

Fiebig, Madlen; Hunstein, Dirk; Bartholomeyczik, Sabine

2018-01-01

A dissertation project at the Witten/Herdecke University [1] is investigating which (nursing sensitive) patient characteristics are suitable for predicting a higher or lower degree of nursing workload. For this research project four predictive modelling methods were selected. In a first step, SUPPORT VECTOR MACHINE, RANDOM FOREST, and GRADIENT BOOSTING were used to identify potential predictors from the nursing sensitive patient characteristics. The results were compared via FEATURE IMPORTANCE. To predict nursing workload the predictors identified in step 1 were modelled using MULTINOMIAL LOGISTIC REGRESSION. First results from the data mining process will be presented. A prognostic determination of nursing workload can be used not only as a basis for human resource planning in hospital, but also to respond to health policy issues.

Promoting Informal and Professional Help-Seeking for Adolescent Dating Violence

PubMed Central

Hedge, Jasmine M.; Hudson-Flege, Matthew D.; McDonell, James R.

2016-01-01

The present study examined factors that differentiate adolescents with varied intentions of informal and professional help-seeking for dating violence. Help-seeking intentions among 518 ethnically diverse adolescents from a rural, southern county who participated in a longitudinal study of teen dating violence were categorized into three groups: adolescents unlikely to seek any help, adolescents likely to seek only informal help, and adolescents likely to seek informal and professional help. Multinomial logistic regression found that gender, family functioning, problem-solving competency, dating status, having an adult to talk to about a dating relationship, and acceptability of family violence significantly predicted membership in the help-seeking groups. Implications for promoting informal and professional help-seeking and recommendations for future research are discussed. PMID:28584387

Promoting Informal and Professional Help-Seeking for Adolescent Dating Violence.

PubMed

Hedge, Jasmine M; Hudson-Flege, Matthew D; McDonell, James R

2017-05-01

The present study examined factors that differentiate adolescents with varied intentions of informal and professional help-seeking for dating violence. Help-seeking intentions among 518 ethnically diverse adolescents from a rural, southern county who participated in a longitudinal study of teen dating violence were categorized into three groups: adolescents unlikely to seek any help, adolescents likely to seek only informal help, and adolescents likely to seek informal and professional help. Multinomial logistic regression found that gender, family functioning, problem-solving competency, dating status, having an adult to talk to about a dating relationship, and acceptability of family violence significantly predicted membership in the help-seeking groups. Implications for promoting informal and professional help-seeking and recommendations for future research are discussed.

Comparison of discriminant analysis methods: Application to occupational exposure to particulate matter

NASA Astrophysics Data System (ADS)

Ramos, M. Rosário; Carolino, E.; Viegas, Carla; Viegas, Sandra

2016-06-01

Health effects associated with occupational exposure to particulate matter have been studied by several authors. In this study were selected six industries of five different areas: Cork company 1, Cork company 2, poultry, slaughterhouse for cattle, riding arena and production of animal feed. The measurements tool was a portable device for direct reading. This tool provides information on the particle number concentration for six different diameters, namely 0.3 µm, 0.5 µm, 1 µm, 2.5 µm, 5 µm and 10 µm. The focus on these features is because they might be more closely related with adverse health effects. The aim is to identify the particles that better discriminate the industries, with the ultimate goal of classifying industries regarding potential negative effects on workers' health. Several methods of discriminant analysis were applied to data of occupational exposure to particulate matter and compared with respect to classification accuracy. The selected methods were linear discriminant analyses (LDA); linear quadratic discriminant analysis (QDA), robust linear discriminant analysis with selected estimators (MLE (Maximum Likelihood Estimators), MVE (Minimum Volume Elipsoid), "t", MCD (Minimum Covariance Determinant), MCD-A, MCD-B), multinomial logistic regression and artificial neural networks (ANN). The predictive accuracy of the methods was accessed through a simulation study. ANN yielded the highest rate of classification accuracy in the data set under study. Results indicate that the particle number concentration of diameter size 0.5 µm is the parameter that better discriminates industries.

The association between maternal antioxidant levels in midpregnancy and preeclampsia.

PubMed

Cohen, Jacqueline M; Kramer, Michael S; Platt, Robert W; Basso, Olga; Evans, Rhobert W; Kahn, Susan R

2015-11-01

We sought to determine whether midpregnancy antioxidant levels are associated with preeclampsia, overall and by timing of onset. We carried out a case-control study, nested within a cohort of 5337 pregnant women in Montreal, Quebec, Canada. Blood samples obtained at 24-26 weeks were assayed for nonenzymatic antioxidant levels among cases of preeclampsia (n = 111) and unaffected controls (n = 441). We excluded women diagnosed with gestational hypertension only. We used logistic regression with the z-score of each antioxidant level as the main predictor variable for preeclampsia risk. We further stratified early-onset (<34 weeks) and late-onset preeclampsia and carried out multinomial logistic regression. Finally, we assessed associations between antioxidant biomarkers and timing of onset (in weeks) by Cox regression, with appropriate selection weights. We summed levels of correlated biomarkers (r(2) > 0.3) and log-transformed positively skewed distributions. We adjusted for body mass index, nulliparity, preexisting diabetes, hypertension, smoking, and proxies for ethnicity and socioeconomic status. The odds ratios for α-tocopherol, α-tocopherol:cholesterol, lycopene, lutein, and carotenoids (sum of α-carotene, β-carotene, anhydrolutein, α-cryptoxanthin, and β-cryptoxanthin) suggested an inverse association between antioxidant levels and overall preeclampsia risk; however, only lutein was significantly associated with overall preeclampsia in adjusted models (odds ratio, 0.60; 95% confidence interval, 0.46-0.77) per SD. In multinomial logistic models, the relative risk ratio (RRR) estimates for the early-onset subgroup were farther from the null than those for the late-onset subgroup. The ratio of α-tocopherol to cholesterol and retinol were significantly associated with early- but not late-onset preeclampsia: RRRs (95% confidence intervals) for early-onset preeclampsia 0.67 (0.46-0.99) and 1.61 (1.12-2.33), respectively. Lutein was significantly associated with both early- and late-onset subtypes in adjusted models; RRRs 0.53 (0.35-0.80) and 0.62 (0.47-0.82), respectively. Survival analyses confirmed these trends. Most antioxidants were more strongly associated with early-onset preeclampsia, suggesting that oxidative stress may play a greater role in the pathophysiology of early-onset preeclampsia. Alternatively, reverse causality may explain this pattern. Lutein was associated with both early- and late-onset preeclampsia and may be a promising nutrient to consider in preeclampsia prevention trials, if this finding is corroborated. Copyright © 2015 Elsevier Inc. All rights reserved.

Bayesian multinomial probit modeling of daily windows of susceptibility for maternal PM2.5 exposure and congenital heart defects

EPA Science Inventory

Past epidemiologic studies suggest maternal ambient air pollution exposure during critical periods of the pregnancy is associated with fetal development. We introduce a multinomial probit model that allows for the joint identification of susceptible daily periods during the pregn...

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…

On the development of a semi-nonparametric generalized multinomial logit model for travel-related choices

PubMed Central

Ye, Xin; Pendyala, Ram M.; Zou, Yajie

2017-01-01

A semi-nonparametric generalized multinomial logit model, formulated using orthonormal Legendre polynomials to extend the standard Gumbel distribution, is presented in this paper. The resulting semi-nonparametric function can represent a probability density function for a large family of multimodal distributions. The model has a closed-form log-likelihood function that facilitates model estimation. The proposed method is applied to model commute mode choice among four alternatives (auto, transit, bicycle and walk) using travel behavior data from Argau, Switzerland. Comparisons between the multinomial logit model and the proposed semi-nonparametric model show that violations of the standard Gumbel distribution assumption lead to considerable inconsistency in parameter estimates and model inferences. PMID:29073152

On the development of a semi-nonparametric generalized multinomial logit model for travel-related choices.

PubMed

Wang, Ke; Ye, Xin; Pendyala, Ram M; Zou, Yajie

2017-01-01

A semi-nonparametric generalized multinomial logit model, formulated using orthonormal Legendre polynomials to extend the standard Gumbel distribution, is presented in this paper. The resulting semi-nonparametric function can represent a probability density function for a large family of multimodal distributions. The model has a closed-form log-likelihood function that facilitates model estimation. The proposed method is applied to model commute mode choice among four alternatives (auto, transit, bicycle and walk) using travel behavior data from Argau, Switzerland. Comparisons between the multinomial logit model and the proposed semi-nonparametric model show that violations of the standard Gumbel distribution assumption lead to considerable inconsistency in parameter estimates and model inferences.

Public funding of pharmaceuticals in The Netherlands: investigating the effect of evidence, process and context on CVZ decision-making.

PubMed

Cerri, Karin H; Knapp, Martin; Fernandez, Jose-Luis

2014-09-01

The College Voor Zorgverzekeringen (CVZ) provides guidance to the Dutch healthcare system on funding and use of new pharmaceutical technologies. This study examined the impact of evidence, process and context factors on CVZ decisions in 2004-2009. A data set of CVZ decisions pertaining to pharmaceutical technologies was created, including 29 variables extracted from published information. A three-category outcome variable was used, defined as the decision to 'recommend', 'restrict' or 'not recommend' a technology. Technologies included in list 1A/1B or on the expensive drug list were considered recommended; those included in list 2 or for which patient co-payment is required were considered restricted; technologies not included on any reimbursement list were classified as 'not recommended'. Using multinomial logistic regression, the relative contribution of explanatory variables on CVZ decisions was assessed. In all, 244 technology appraisals (256 technologies) were analysed, with 51%, of technologies recommended, 33% restricted and 16% not recommended by CVZ for funding. The multinomial model showed significant associations (p ≤ 0.10) between CVZ outcome and several variables, including: (1) use of an active comparator and demonstration of statistical superiority of the primary endpoint in clinical trials, (2) pharmaceutical budget impact associated with introduction of the technology, (3) therapeutic indication and (4) prevalence of the target population. Results confirm the value of a comprehensive and multivariate approach to understanding CVZ decision-making.

A General Family of Limited Information Goodness-of-Fit Statistics for Multinomial Data

ERIC Educational Resources Information Center

Joe, Harry; Maydeu-Olivares, Alberto

2010-01-01

Maydeu-Olivares and Joe (J. Am. Stat. Assoc. 100:1009-1020, "2005"; Psychometrika 71:713-732, "2006") introduced classes of chi-square tests for (sparse) multidimensional multinomial data based on low-order marginal proportions. Our extension provides general conditions under which quadratic forms in linear functions of cell residuals are…

Hierarchical Multinomial Processing Tree Models: A Latent-Trait Approach

ERIC Educational Resources Information Center

Klauer, Karl Christoph

2010-01-01

Multinomial processing tree models are widely used in many areas of psychology. A hierarchical extension of the model class is proposed, using a multivariate normal distribution of person-level parameters with the mean and covariance matrix to be estimated from the data. The hierarchical model allows one to take variability between persons into…

Institutional Climate and Student Departure: A Multinomial Multilevel Modeling Approach

ERIC Educational Resources Information Center

Yi, Pyong-sik

2008-01-01

This study applied a multinomial HOLM technique to examine the extent to which the institutional climate for diversity influences the different types of college student withdrawal, such as stop out, drop out, and transfer. Based on a reformulation of Tinto's model along with the conceptualization of institutional climate for diversity by Hurtado…

A Multinomial Model of Event-Based Prospective Memory

ERIC Educational Resources Information Center

Smith, Rebekah E.; Bayen, Ute J.

2004-01-01

Prospective memory is remembering to perform an action in the future. The authors introduce the 1st formal model of event-based prospective memory, namely, a multinomial model that includes 2 separate parameters related to prospective memory processes. The 1st measures preparatory attentional processes, and the 2nd measures retrospective memory…

Ethnicity and Deprivation are Associated With Blindness Among Adults With Primary Glaucoma in Nigeria: Results From the Nigeria National Blindness and Visual Impairment Survey.

PubMed

Kyari, Fatima; Wormald, Richard; Murthy, Gudlavalleti V S; Evans, Jennifer R; Gilbert, Clare E

2016-10-01

We explored the risk factors for glaucoma blindness among adults aged 40 years and above with primary glaucoma in Nigeria. A total of 13,591 participants aged 40 years and above were examined in the Nigeria Blindness Survey; 682 (5.02%; 95 CI, 4.60%-5.47%) had glaucoma by ISGEO's criteria. This was a case-control study (n=890 eyes of 629 persons): glaucoma blind persons were cases and glaucoma not-blind were controls. Education and occupation were used to determine socioeconomic status scores, which were divided into 3 tertiles (affluent, medium, deprived). We assessed sociodemographic, biophysical, and ocular factors by logistic regression analysis for association with glaucoma blindness. Multinomial regression analysis was also performed with nonglaucoma as the reference category. A total of 119/629 (18.9%; 95% CI, 15.9%-22.4%) persons were blind in both eyes; 510 were controls. There was interethnic variation in odds of blindness; age, male sex, socioeconomic status, prior diagnosis of glaucoma, hypertension, intraocular pressure, and lens opacity were associated with glaucoma blindness. Axial length, mean ocular perfusion pressure, and angle-closure glaucoma were associated with blind glaucoma eyes. In multivariate analysis, Igbo ethnicity (OR=2.79; 95% CI, 1.03-7.57) had higher risk as was being male (OR=4.59; 95% CI, 1.73-12.16) and unmarried (OR=2.50; 95% CI, 1.03-6.07). Deprivation (OR=3.57; 95% CI, 1.46-8.72), prior glaucoma diagnosis (OR=5.89; 95% CI, 1.79-19.40), and intraocular pressure (OR=1.07; 95% CI, 1.04-1.09) were also independent risk factors for glaucoma blindness. Approximately 1 in 5 people with primary glaucoma were blind. Male sex, ethnicity and deprivation were strongly associated with blindness. Services for glaucoma need to improve in Nigeria, focusing on poor communities and men.

Awareness and attitude of the public toward personalized medicine in Korea

PubMed Central

Lee, Iyn-Hyang; Kang, Hye-Young; Suh, Hae Sun; Lee, Sukhyang; Oh, Eun Sil

2018-01-01

Objectives As personalized medicine (PM) is expected to greatly improve health outcomes, efforts have recently been made for its clinical implementation in Korea. We aimed to evaluate public awareness and attitude regarding PM. Methods We performed a self-administered questionnaire survey to 703 adults, who participated in the survey on a voluntary basis. The primary outcome measures included public knowledge, attitude, and acceptance of PM. We conducted multinomial multivariate logistic analysis for outcome variables with three response categories and performed multivariate logistic regression analyses for dichotomous outcome variables. Results Only 28% of participants had knowledge that genetic factors can contribute to inter-individual variations in drug response and the definition of PM (199 out of 702). Higher family income was correlated with greater knowledge concerning PM (OR = 3.76, p = 0.034). A majority of respondents preferred integrated pharmacogenomic testing over drug-specific testing and agreed to inclusion of pharmacogenomic testing in the national health examination (64% and 77%, respectively), but only 51% were willing to pay for it. Discussion Our results identify the urgent need for public education as well as the potential health disparities in access to PM. This study helps to frame policies for implementing PM in clinical practice. PMID:29451916

Assessing childhood maltreatment and mental health correlates of disordered eating profiles in a nationally representative sample of English females.

PubMed

Armour, Cherie; Műllerová, Jana; Fletcher, Shelley; Lagdon, Susan; Burns, Carol Rhonda; Robinson, Martin; Robinson, Jake

2016-03-01

Previous research suggests that childhood maltreatment is associated with the onset of eating disorders (ED). In turn, EDs are associated with alternative psychopathologies such as depression and posttraumatic stress disorder (PTSD), and with suicidality. Moreover, it has been reported that various ED profiles may exist. The aim of the current study was to examine the profiles of disordered eating and the associations of these with childhood maltreatment and with mental health psychopathology. The current study utilised a representative sample of English females (N = 4206) and assessed for the presence of disordered eating profiles using Latent Class Analysis. Multinomial logistic regression was implemented to examine the associations of childhood sexual and physical abuse with the disordered eating profiles and the associations of these with PTSD, depression and suicidality. Results supported those of previous findings in that we found five latent classes of which three were regarded as disordered eating classes. Significant relationships were found between these and measures of childhood trauma and mental health outcomes. Childhood sexual and physical abuse increased the likelihood of membership in disordered eating classes and these in turn increased the likelihood of adverse mental health and suicidal outcomes.

Prevalence of body image dissatisfaction and associated factors among physical education students.

PubMed

Ferrari, Elisa Pinheiro; Petroski, Edio Luiz; Silva, Diego Augusto Santos

2013-01-01

To determine the prevalence of and factors associated with body image dissatisfaction among physical education students enrolled in a public university. This study evaluated 236 students and assessed body image perception (silhouette scale), sociodemographic variables (sex, age, parental education, marital status, university course, work, living arrangement, study shift, and income), physical activity level (International Physical Activity Questionnaire - Short Version), dietary habits, tobacco use, excessive intake of alcohol (questions from the tobacco, alcohol and drugs, and nutrition domains of the FANTASTIC instrument), and nutritional status (body mass index [BMI]). Descriptive analysis, the chi-square test, Fisher's exact test, and crude and adjusted multinomial regression were used. The prevalence of body image dissatisfaction was 69.5%; 44.1% were dissatisfied with excess weight. BMI ≥ 25.0 kg/m² was associated with dissatisfaction with excess weight; factors associated with dissatisfaction with slimness were being male, eating an unhealthy diet, and smoking tobacco. Our findings suggest that female college students with a BMI ≥ 25.0 kg/m² are more likely to present dissatisfaction with excess weight. Being male, eating an unhealthy diet, engaging in physical activity for < 739.61 min/week and smoking tobacco were the variables associated with dissatisfaction with thinness.

The Variety of Ecstasy/MDMA Users: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Wu, Li-Tzy; Parrott, Andy C.; Ringwalt, Christopher L.; Yang, Chongming; Blazer, Dan G.

2011-01-01

This study investigates the potential heterogeneity of ecstasy or MDMA (3,4-methylenedioxy-N-methylamphetamine) users. Data came from the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Latent class analysis (LCA) and multinomial logistic regression procedures were used to identify subtypes of ecstasy users. Approximately 1.6% (n=562) of adult participants (N=43,093) reported lifetime ecstasy use. LCA identified three subtypes of ecstasy users. Class 1 exhibited pervasive use of most drug classes (ecstasy–polydrug users, 37%). Class 2 reported a high rate of use of marijuana and cocaine and a moderate use of amphetamines (ecstasy–marijuana–stimulant users, 29%). Class 3 was characterized by a high rate of use of marijuana and a low use of primarily prescription-type drugs (ecstasy– marijuana users, 34%). Subtypes were distinguished by family income, history of substance abuse treatment, and familial substance abuse. Class 1 exhibited the highest prevalence of disorders related to the use of marijuana (77%), tobacco (66%), amphetamines (36%), opioids (35%), sedatives (31%), and tranquilizers (30%). The recent resurgence in ecstasy use among adults underscores the need to monitor trends in its use. PMID:19874166

Tobacco use and friendship networks: a cross-sectional study among Brazilian adolescents.

PubMed

Jorge, Kelly Oliva; Cota, Luís Otavio; e Ferreira, Efigênia Ferreira; do Vale, Miriam Pimenta; Kawachi, Ichiro; Zarzar, Patrícia Maria

2015-05-01

To determine the prevalence of tobacco use and its association with types of friendship networks, socioeconomic status and gender among Brazilian adolescents. A cross-sectional study was carried out with a representative sample of 905 students aged 15 to 19 years. Information on social networks and tobacco use was collected by the self-administered questionnaire 'Alcohol, Smoking and Substance Involvement Screening Test" and the question "What is your most important group of close friends?'. Socioeconomic status was assessed using an area-based social vulnerability index and type of school. Multinomial logistic regression analysis was employed to test associations between tobacco use and the independent variables. The overall prevalence of tobacco use was 18.9%. Female adolescents had 3.80-fold greater odds of reporting weekly to daily tobacco use compared to male adolescents. Participants who reported that their most important groups of close friends were from church had a lower risk of reporting weekly to daily tobacco use in comparison to those who reported that their best friends were from school. The prevalence of tobacco use was high and was associated with school-based (as compared to church-based) friendship networks, female gender and higher area-level socioeconomic status.

Risk Factors Associated with Peer Victimization and Bystander Behaviors among Adolescent Students.

PubMed

Huang, Zepeng; Liu, Zhenni; Liu, Xiangxiang; Lv, Laiwen; Zhang, Yan; Ou, Limin; Li, Liping

2016-07-27

Despite the prevalence of the phenomena of peer victimization and bystander behaviors, little data has generated to describe their relationships and risk factors. In this paper, a self-administered survey using a cross-sectional cluster-random sampling method in a sample of 5450 participants (2734 girls and 2716 boys) between 4th and 11th grades was conducted at six schools (two primary schools and four middle schools) located in Shantou, China. Self-reported peer victimization, bystander behaviors and information regarding parents' risky behaviors and individual behavioral factors were collected. Multinomial logistic regression analysis was applied to evaluate risk factors affecting peer victimization and bystander behaviors. The results indicated that urban participants were more likely to become bullying victims but less likely to become passive bystanders. Contrarily, bullying victimization was related to the increasing of passive bystander behaviors. Father drinking and mother smoking as independent factors were risk factors for peer victimization. Participants who were smoking or drinking had a tendency to be involved in both peer victimization and passive bystander behaviors. This study suggested that bystander behaviors, victims' and parents' educations play a more important role in peer victimization than previously thought.

Behavioral Risk Profiles of Homeschooled Adolescents in the United States: A Nationally Representative Examination of Substance Use Related Outcomes.

PubMed

Hodge, David R; Salas-Wright, Christopher P; Vaughn, Michael G

2017-02-23

The homeschool population continues to grow in size and now accounts for 3.4% of all students in the United States. Given the heterogeneous nature of the population, this study examines the relationship between different types of homeschoolers and a number of substance use related outcomes. To conduct this study, we used pooled data (2002-2013) from the National Survey on Drug Use and Health (NSDUH). Respondents aged 12-17 who reported they had been homeschooled at any time during the previous 12 months were classified as homeschoolers (N = 1,321). Latent profile analysis (LPA) was conducted to identify latent subgroups of homeschoolers and multinomial regression was executed to assess the relationship between the subgroups and perceived substance use risk, availability, and past 12-month use. The LPA yielded four subgroups, which were summarized as (1) highly religious and engaged, (2) limited parental monitoring, (3) high parental warmth and support, and (4) secular permissive. Of these, the highly religious and engaged subgroup was the least likely to report using substances. The results underscore the variation that exists among homeschoolers and the importance of examining the relationship between different types of homeschoolers and outcomes of interest.

Turkish and Moroccan Young Adults in the Netherlands: The Relationship Between Acculturation and Psychological Problems.

PubMed

Özbek, Emel; Bongers, Ilja L; Lobbestael, Jill; van Nieuwenhuizen, Chijs

2015-12-01

This study investigated the relationship between acculturation and psychological problems in Turkish and Moroccan young adults living in the Netherlands. A sample of 131 healthy young adults aged between 18 and 24 years old, with a Turkish or Moroccan background was recruited using snowball sampling. Data on acculturation, internalizing and externalizing problems, beliefs about psychological problems, attributions of psychological problems and barriers to care were collected and analyzed using Latent Class Analysis and multinomial logistic regression. Three acculturation classes were identified in moderately to highly educated, healthy Turkish or Moroccan young adults: integration, separation and diffusion. None of the participants in the sample were marginalized or assimilated. Young adults reporting diffuse acculturation reported more internalizing and externalizing problems than those who were integrated or separated. Separated young adults reported experiencing more practical barriers to care than integrated young adults. Further research with a larger sample, including young adult migrants using mental health services, is required to improve our understanding of acculturation, psychological problems and barriers to care in this population. Including experiences of discrimination in the model might improve our understanding of the relationship between different forms of acculturation and psychological problems.

Factors affecting job satisfaction and their correlation with educational standards among dental assistants.

PubMed

Al Jazairy, Yousra H; Halawany, Hassan Suliman; Hussainan, Nawaf Al; Maflehi, Nassr Al; Abraham, Nimmi Biju; Jacob, Vimal

2014-01-01

A disparity exists in the educational qualifications of dental assistants working in various public and private institutions in Riyadh, Saudi Arabia. The aim of this study was to assess the influence of professional and personal characteristics on job satisfaction among dental assistants. A cross-sectional survey was performed among dental assistants using a 24-item self-administered questionnaire. Multinomial logistic regression was used to assess the relationship between overall job satisfaction and other variables. The overall response rate was 72.1%. Factor analysis suggested that five underlying factors were related to job satisfaction. The mean score for overall job satisfaction was 3.86 (satisfied) out of 5. Among the work environment factors, the highest mean score, 4.26 (satisfied), was obtained for quality of service, and the lowest mean score, 2.78 (neutral), was obtained for the perception of income. The income and general prospects of the profession was significantly associated with overall job satisfaction. This study suggests that for dental assistants, professional and personal life, quality of service, perception of income and prestige and self-respect are important factors for job satisfaction. Despite differences in professional formation standards, in general, the study participants were considerably satisfied with their jobs.

Pill-poppers and dopers: a comparison of non-medical prescription drug use and illicit/street drug use among college students.

PubMed

Ford, Jason A; Arrastia, Meagan C

2008-07-01

Data from the 2001 College Alcohol Study, a national sample of U.S. college students, were used to conduct multinomial logistic regression analysis examining correlates of substance use. Students were divided into three groups based on their lifetime substance use: non-users, non-medical prescription drug use only, and illicit/street drug use only. The purpose of this analytic strategy was to examine the similarities/differences in the correlates of non-medical prescription drug use and illicit/street drug use. Findings indicate that race, age, G.P.A., sexual activity, health, binge drinking, marijuana use, social bonding and social learning measures are correlates of non-medical prescription drug use. Correlates of illicit/street drug use include gender, Hispanic ethnicity, sexual activity, binge drinking, marijuana use, social bonding and social learning measures. Finally, the focus of the paper is a comparison of students who report only non-medical prescription drug use to students who report only illicit/street drug use. Findings indicate that gender, race, marital status, sexual activity, marijuana use, and social bonding measures significantly distinguish illicit/street drug use from non-medical prescription drug use. Important implications, limitations, and future research needs were discussed.

Problematic Internet use, well-being, self-esteem and self-control: Data from a high-school survey in China

PubMed Central

Mei, Songli; Yau, Yvonne H. C.; Chai, Jingxin; Guo, Jinhua; Potenza, Marc N.

2016-01-01

Given the prevalence of Internet use among youth, there is concern that a subset of Internet-using youth may exhibit problematic or addictive patterns of Internet use. The present study examines the association between problematic Internet use (PIU), demographic variables, and health-related measures among Chinese adolescents. Survey data from 1552 adolescents (male = 653, mean age = 15.43 years) from Jilin Province, China, were collected. According to the Young Diagnostic Questionnaire for Internet Addiction (YDQ), 77.8% (n=1,207), 16.8% (n=260), and 5.5% (n=85) showed adaptive, maladaptive, and problematic Internet use, respectively. Multinomial logistic regression analysis revealed that gender and family income per month differed between youth showing problematic and adaptive patterns of Internet use. Well-being, self-esteem, and self-control were related to severity of problematic Internet use, with greater severity typically associated with poorer measures in each domain. The findings that severity of problematic Internet use is associated with specific socio-demographic features and temperamental and well-being measures suggest that specific groups of youth may be particularly vulnerable to developing problematic Internet use. Early prevention/intervention programs targeting at-risk groups may help improve public health. PMID:27249805

Bloody traditional procedures performed during infancy in the oropharyngeal area among HIV+ children: implication from the perspective of mother-to-child transmission of HIV.

PubMed

Mitke, Yifru Berhan

2010-12-01

Although bloody traditional procedures are very common in Ethiopia, this is the first report on infants. None of the literature attributed such practices as risk factor for mother-to-child transmission (MTCT) of HIV. Analysis was done to 1,163 children and found that 552 (47.5%) bloody traditional procedures were performed in the oral cavity to 399 (34.3%): uvulectomy 41.8%, milk tooth extraction 33.7% and tonsillectomy 24.5%. Multinomial logistic regression showed strong association of uvulectomy with Tigray ethnicity. Milk teeth extractions were highest among girls, rural residence, Tigray and Amhara ethnicity. When procedures performed, children were under 1 month (88.9% of tonsillectomies), under 6 months (83.5% of uvulectomies) and 4-6 months (54.3% of milk tooth extractions) of age. More than 97% for whom procedures performed were breast fed, and about 88% were from the northern part of the country. Taking into account the deep invasiveness of the procedures, they are assumed as one of the strong risk factors for MTCT of HIV during lactation.

An emerging adolescent health risk: caffeinated energy drink consumption patterns among high school students.

PubMed

Azagba, Sunday; Langille, Donald; Asbridge, Mark

2014-05-01

To examine the prevalence, patterns, and correlates of energy drink use among adolescents, and determine whether more frequent use of energy drinks is associated with poorer health and behavioral outcomes. Data were from a 2012 cross-sectional survey of 8210 students in grades 7, 9, 10 and 12 attending public schools in Atlantic Canada. Multinomial logistic regression analysis was used to examine correlates of energy drink use patterns, including substance use, sensation seeking, risk of depression, and socioeconomic status. Nearly two-thirds of survey respondents (62%) reported consuming energy drinks at least once in the previous year, with about 20% reporting use once or more per month. Sensation seeking, depression, and substance use were all higher among energy drink users relative to non-users, and in higher frequency users relative to lower frequency users. The prevalence of energy drink consumption among high school students was high. The association of energy drinks with other potential negative health and behavioral outcomes suggests that use of these products may represent a marker for other activities that may negatively affect adolescent development, health and well-being. Copyright © 2014 Elsevier Inc. All rights reserved.

[Inactivity, obesity and mental health in the Spanish population from 4 to 15 years of age].

PubMed

Rodríguez-Hernández, Arturo; Cruz-Sánchez, Ernesto de la; Feu, Sebastián; Martínez-Santos, Raúl

2011-08-01

An active lifestyle and a good weight status are two major health determinants from a public health perspective. To evaluate the degree of association between physical activity, weight status and the emotional and mental health of Spanish schoolchildren. Mental health status was assessed through the Strengths and Difficulties Questionnaire (SDQ), also leisure time physical activity and body mass index (BMI) in a total of 6 803 children from 4 to 15 years participating in the Spanish National Health Survey 2006. The degree of association between. these variables was estimated by a multinomial logistic regression analysis. Among sedentary schoolchildren are more common mental health problems (OR 2.10), emotional problems (OR 1.84), conduct problems (OR 1.53), problems with peers (OR 2.35) and social relationship difficulties (OR 1.36). Obesity is associated with poor general mental health (OR 1.58), and obese schoolchildren show more often emotional problems (OR 1.52) and problems with peers (OR 2.43). In the Spanish schoolchildren, a healthy BMI is associated with increased mental well-being, although an active lifestyle is the best indicator of a good mental health status.

Factors associated with different smoking status in European adolescents: results of the SEYLE study.

PubMed

Banzer, Raphaela; Haring, C; Buchheim, A; Oehler, S; Carli, V; Wasserman, C; Kaess, M; Apter, A; Balazs, J; Bobes, J; Brunner, R; Corcoran, P; Cosman, D; Hoven, C W; Kahn, J P; Keeley, H S; Postuvan, V; Podlogar, T; Sisask, M; Värnik, A; Sarchiapone, M; Wasserman, D

2017-11-01

Early onset and long-term smoking are associated with physical and psychological health problems. The aim of the presented analysis was to investigate risk and influencing factors for different smoking status in a big sample of European adolescents. In the context of the "saving and empowering young lives in Europe" (SEYLE) study we surveyed 12,328 adolescents at the age of 13-17 from 11 countries. The survey took place in a school-based context using a questionnaire. Overall 58% reported the onset of ever-smoking under the age of 14 and 30.9% smoke on a daily basis. Multinomial logistic regression model showed significant positive associations between adolescent smoking and internalizing problems (suicidal behavior, direct self-injurious behavior, anxiety), externalizing problems (conduct problems, hyperactivity, substance consumption) and family problems (parental substance consumption, broken home). Our data show that smoking among adolescents is still a major public health problem and adolescents who smoke are at higher risk for mental problems. Further, adolescent smoking is associated with broken home families and parental behaviors. Therefore, early preventive measures are necessary not only for adolescents, but also for their parents.

Associations between Poor Sleep Quality and Stages of Change of Multiple Health Behaviors among Participants of Employee Wellness Program.

PubMed

Hui, Siu-Kuen Azor; Grandner, Michael A

2015-01-01

Using the Transtheoretical Model of behavioral change, this study evaluates the relationship between sleep quality and the motivation and maintenance processes of healthy behavior change. The current study is an analysis of data collected in 2008 from an online health risk assessment (HRA) survey completed by participants of the Kansas State employee wellness program (N=13,322). Using multinomial logistic regression, associations between self-reported sleep quality and stages of change (i.e. precontemplation, contemplation, preparation, action, maintenance) in five health behaviors (stress management, weight management, physical activities, alcohol use, and smoking) were analyzed. Adjusted for covariates, poor sleep quality was associated with an increased likelihood of contemplation, preparation, and in some cases action stage when engaging in the health behavior change process, but generally a lower likelihood of maintenance of the healthy behavior. The present study demonstrated that poor sleep quality was associated with an elevated likelihood of contemplating or initiating behavior change, but a decreased likelihood of maintaining healthy behavior change. It is important to include sleep improvement as one of the lifestyle management interventions offered in EWP to comprehensively reduce health risks and promote the health of a large employee population.

Significant Factors Related to Failed Pediatric Dental General Anesthesia Appointments at a Hospital-based Residency Program.

PubMed

Emhardt, John R; Yepes, Juan F; Vinson, LaQuia A; Jones, James E; Emhardt, John D; Kozlowski, Diana C; Eckert, George J; Maupome, Gerardo

2017-05-15

The purposes of this study were to: (1) evaluate the relationship between appointment failure and the factors of age, gender, race, insurance type, day of week, scheduled time of surgery, distance traveled, and weather; (2) investigate reasons for failure; and (3) explore the relationships between the factors and reasons for failure. Electronic medical records were accessed to obtain data for patients scheduled for dental care under general anesthesia from May 2012 to May 2015. Factors were analyzed for relation to appointment failure. Data from 3,513 appointments for 2,874 children were analyzed. Bivariate associations showed statistically significant (P<0.05) relationships between failed appointment and race, insurance type, scheduled time of surgery, distance traveled, snowfall, and temperature. Multinomial regression analysis showed the following associations between factors and the reason for failure (P<0.05): (1) decreased temperature and increased snowfall were associated with weather as reason for failure; (2) the African American population showed an association with family barriers; (3) Hispanic families were less likely to give advanced notice; and (4) the "additional races" category showed an association with fasting violation. Patients who have treatment under general anesthesia face specific barriers to care.

Factors Affecting Job Satisfaction and Their Correlation with Educational Standards among Dental Assistants

PubMed Central

JAZAIRY, Yousra H. AL; HALAWANY, Hassan Suliman; HUSSAINAN, Nawaf AL; MAFLEHI, Nassr AL; ABRAHAM, Nimmi Biju; JACOB, Vimal

2014-01-01

A disparity exists in the educational qualifications of dental assistants working in various public and private institutions in Riyadh, Saudi Arabia. The aim of this study was to assess the influence of professional and personal characteristics on job satisfaction among dental assistants. A cross-sectional survey was performed among dental assistants using a 24-item self-administered questionnaire. Multinomial logistic regression was used to assess the relationship between overall job satisfaction and other variables. The overall response rate was 72.1%. Factor analysis suggested that five underlying factors were related to job satisfaction. The mean score for overall job satisfaction was 3.86 (satisfied) out of 5. Among the work environment factors, the highest mean score, 4.26 (satisfied), was obtained for quality of service, and the lowest mean score, 2.78 (neutral), was obtained for the perception of income. The income and general prospects of the profession was significantly associated with overall job satisfaction. This study suggests that for dental assistants, professional and personal life, quality of service, perception of income and prestige and self-respect are important factors for job satisfaction. Despite differences in professional formation standards, in general, the study participants were considerably satisfied with their jobs. PMID:24747371

Classes of Physical Activity and Sedentary Behavior in 5th Grade Children

PubMed Central

Dowda, Marsha; Dishman, Rod K; Pate, Russell R.

2016-01-01

Objectives To identify classes of physical activity (PA) and sedentary behaviors (SB) in 5th grade children, associated factors, and trajectories of change into 7th grade. Methods This study included n=495 children (221 boys, 274 girls) who participated in the Transitions and Activity Changes in Kids (TRACK) Study. PA was assessed objectively and via self-report. Children, parents, and school administrators completed surveys to assess related factors. Latent class analysis, growth modeling, and adjusted multinomial logistic regression procedures were used to classify children based on self-reported PA and SB and examine associated factors. Results Three classes of behavior were identified: Class 1: Low PA/Low SB, Class 2: Moderate PA/High SB, and Class 3: High PA/High SB (boys) or Class 3: High PA (girls). Class 3 children had higher levels of self-efficacy (boys), and enjoyment, parental support, and physical activity equipment at home (girls). Class 2 boys and Class 3 girls did not experience decline in PA (accelerometer) over time. Conclusions Self-efficacy (boys) and home environment (girls) may play a role in shaping patterns of PA in children. Findings may help to inform future interventions to encourage children to meet national PA guidelines. PMID:27103414

Academic trajectories of newcomer immigrant youth.

PubMed

Suárez-Orozco, Carola; Gaytán, Francisco X; Bang, Hee Jin; Pakes, Juliana; O'Connor, Erin; Rhodes, Jean

2010-05-01

Immigration to the United States presents both challenges and opportunities that affect students' academic achievement. Using a 5-year longitudinal, mixed-methods approach, we identified varying academic trajectories of newcomer immigrant students from Central America, China, the Dominican Republic, Haiti, and Mexico. Latent class growth curve analysis revealed that although some newcomer students performed at high or improving levels over time, others showed diminishing performance. Multinomial logistic regressions identified significant group differences in academic trajectories, particularly between the high-achieving youth and the other groups. In keeping with ecological-developmental and stage-environment fit theories, School Characteristics (school segregation rate, school poverty rate, and student perceptions of school violence), Family Characteristics (maternal education, parental employment, and household structure), and Individual Characteristics (academic English proficiency, academic engagement, psychological symptoms, gender, and 2 age-related risk factors, number of school transitions and being overaged for grade placement) were associated with different trajectories of academic performance. A series of case studies triangulate many of the quantitative findings as well as illuminate patterns that were not detected in the quantitative data. Thus, the mixed-methods approach sheds light on the cumulative developmental challenges that immigrant students face as they adjust to their new educational settings. 2010 APA, all rights reserved

Microfinance participation and contraceptive decision-making: results from a national sample of women in Bangladesh.

PubMed

Murshid, N S; Ely, G E

2016-10-01

Our objective was to assess whether microfinance participation affords greater contraceptive decision-making power to women. Population based secondary data analysis. In this cross-sectional study using nationally representative data from the Bangladesh Demographic and Health Survey 2011 we conducted multinomial logistic regression to estimate the odds of contraceptive decision-making by respondents and their husbands based on microfinance participation. Microfinance participation was measured as a dichotomous variable and contraceptive decision-making was conceptualized based on who made decisions about contraceptive use: respondents only; their partners or husbands only; or both. The odds of decision-making by the respondent, with the reference case being joint decision-making, were higher for microfinance participants, but they were not significant. The odds of decision-making by the husband, with the reference case again being joint decision-making, were significantly lower among men who were partnered with women who participated in microfinance (RRR = 0.70, P < 0.01). Microfinance participation by women allowed men to share decision-making power with their wives that resulted in higher odds of joint decision-making. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

An Investigation of Diagnostic Accuracy and Confidence Associated with Diagnostic Checklists as Well as Gender Biases in Relation to Mental Disorders.

PubMed

Cwik, Jan C; Papen, Fabienne; Lemke, Jan-Erik; Margraf, Jürgen

2016-01-01

This study examines the utility of checklists in attaining more accurate diagnoses in the context of diagnostic decision-making for mental disorders. The study also aimed to replicate results from a meta-analysis indicating that there is no association between patients' gender and misdiagnoses. To this end, 475 psychotherapists were asked to judge three case vignettes describing patients with Major Depressive Disorder (MDD), Generalized Anxiety Disorder, and Borderline Personality Disorder. Therapists were randomly assigned to experimental conditions in a 2 (diagnostic method: with using diagnostic checklists vs. without using diagnostic checklists) × 2 (gender: male vs. female case vignettes) between-subjects design. Multinomial logistic and linear regression analyses were used to examine the association between the usage of diagnostic checklists as well as patients' gender and diagnostic decisions. The results showed that when checklists were used, fewer incorrect co-morbid diagnoses were made, but clinicians were less likely to diagnose MDD even when the criteria were met. Additionally, checklists improved therapists' confidence with diagnostic decisions, but were not associated with estimations of patients' characteristics. As expected, there were no significant associations between gender and diagnostic decisions.

Relation of socioeconomic status to overweight and obesity: a large population-based study of Chinese adults.

PubMed

Zhang, Hua; Xu, Hui; Song, Fei; Xu, Weili; Pallard-Borg, Stephanie; Qi, Xiuying

2017-09-01

China has been going through significant changes in social and economical aspects and with great socioeconomic disparity in different regions. However, data on the association between socioeconomic status (SES) and obesity are not available in Tianjin, China. This study aimed to investigate the association between SES and high adiposity among the adult population in Tianjin. A total of 7351 individuals aged 20-79 were included in this study. Socioeconomic information was collected through an interview following a structured questionnaire. Waist circumference, body weight and height were measured following standard procedures. Overweight and obesity were defined according to the criteria of the Working Group on Obesity in China. Data were analysed using multinomial logistic regression with adjustment for potential confounders. Stratified analysis showed that higher monthly income and education were related to decreased odds of abdominal overweight/obesity in women, while high education was associated with increased odds of general overweight/obesity in men. Retirement increased the odds of abdominal overweight and obesity and non-manual work was associated with low odds of abdominal obesity in women. SES was associated with general and abdominal overweight/obesity and sex may play a role in such an association.

Antecedents of obesity - analysis, interpretation, and use of longitudinal data.

PubMed

Gillman, Matthew W; Kleinman, Ken

2007-07-01

The obesity epidemic causes misery and death. Most epidemiologists accept the hypothesis that characteristics of the early stages of human development have lifelong influences on obesity-related health outcomes. Unfortunately, there is a dearth of data of sufficient scope and individual history to help unravel the associations of prenatal, postnatal, and childhood factors with adult obesity and health outcomes. Here the authors discuss analytic methods, the interpretation of models, and the use to which such rare and valuable data may be put in developing interventions to combat the epidemic. For example, analytic methods such as quantile and multinomial logistic regression can describe the effects on body mass index range rather than just its mean; structural equation models may allow comparison of the contributions of different factors at different periods in the life course. Interpretation of the data and model construction is complex, and it requires careful consideration of the biologic plausibility and statistical interpretation of putative causal factors. The goals of discovering modifiable determinants of obesity during the prenatal, postnatal, and childhood periods must be kept in sight, and analyses should be built to facilitate them. Ultimately, interventions in these factors may help prevent obesity-related adverse health outcomes for future generations.

[Social network, social support and feeding habits of infants in their fourth month of life].

PubMed

Morgado, Caroline Maria da Costa; Werneck, Guilherme Loureiro; Hasselmann, Maria Helena

2013-02-01

The scope of this study was to investigate the association between the social network, social support and the feeding habits of infants in their fourth month of life. A cross-sectional study was conducted among 294 children selected at 4 Primary Health Care Units in Rio de Janeiro/ Brazil. A 24-hour dietary recall was applied to the mothers to evaluate the feeding habits. Questions related to the number of people upon whom the woman can rely were asked as well as their participation in social activities to measure the social network. The scale in the Medical Outcomes Study was used to measure social support. The analysis was based on multinomial logistic regression models. Most of the infants (84%) received breast milk, but only 16% were exclusively breastfed. Children whose mothers had a small number of relatives to rely on and with low social support were more likely to be bottle-fed rather than exclusively breastfed. The need to integrate members of the social network of the woman during pre-natal care, birth and the after birth period should be encouraged, in such a way that social support can serve the mother's requirements, contributing to exclusive breastfeeding.

Dissociative Experiences are Associated with Obsessive-Compulsive Symptoms in a Non-clinical Sample: A Latent Profile Analysis

PubMed Central

BOYSAN, Murat

2014-01-01

Introduction There has been a burgeoning literature considering the significant associations between obsessive-compulsive symptoms and dissociative experiences. In this study, the relationsips between dissociative symtomotology and dimensions of obsessive-compulsive symptoms were examined in homogeneous sub-groups obtained with latent class algorithm in an undergraduate Turkish sample. Method Latent profile analysis, a recently developed classification method based on latent class analysis, was applied to the Dissociative Experiences Scale (DES) item-response data from 2976 undergraduates. Differences in severity of obsessive-compulsive symptoms, anxiety and depression across groups were evaluated by running multinomial logistic regression analyses. Associations between latent class probabilities and psychological variables in terms of obsessive-compulsive sub-types, anxiety, and depression were assessed by computing Pearson’s product-moment correlation coefficients. Results The findings of the latent profile analysis supported further evidence for discontinuity model of dissociative experiences. The analysis empirically justified the distinction among three sub-groups based on the DES items. A marked proportion of the sample (42%) was assigned to the high dissociative class. In the further analyses, all sub-types of obsessive-compulsive symptoms significantly differed across latent classes. Regarding the relationships between obsessive-compulsive symptoms and dissociative symptomatology, low dissociation appeared to be a buffering factor dealing with obsessive-compulsive symptoms; whereas high dissociation appeared to be significantly associated with high levels of obsessive-compulsive symptoms. Conclusion It is concluded that the concept of dissociation can be best understood in a typological approach that dissociative symptomatology not only exacerbates obsessive-compulsive symptoms but also serves as an adaptive coping mechanism. PMID:28360635

Dissociative Experiences are Associated with Obsessive-Compulsive Symptoms in a Non-clinical Sample: A Latent Profile Analysis.

PubMed

Boysan, Murat

2014-09-01

There has been a burgeoning literature considering the significant associations between obsessive-compulsive symptoms and dissociative experiences. In this study, the relationsips between dissociative symtomotology and dimensions of obsessive-compulsive symptoms were examined in homogeneous sub-groups obtained with latent class algorithm in an undergraduate Turkish sample. Latent profile analysis, a recently developed classification method based on latent class analysis, was applied to the Dissociative Experiences Scale (DES) item-response data from 2976 undergraduates. Differences in severity of obsessive-compulsive symptoms, anxiety and depression across groups were evaluated by running multinomial logistic regression analyses. Associations between latent class probabilities and psychological variables in terms of obsessive-compulsive sub-types, anxiety, and depression were assessed by computing Pearson's product-moment correlation coefficients. The findings of the latent profile analysis supported further evidence for discontinuity model of dissociative experiences. The analysis empirically justified the distinction among three sub-groups based on the DES items. A marked proportion of the sample (42%) was assigned to the high dissociative class. In the further analyses, all sub-types of obsessive-compulsive symptoms significantly differed across latent classes. Regarding the relationships between obsessive-compulsive symptoms and dissociative symptomatology, low dissociation appeared to be a buffering factor dealing with obsessive-compulsive symptoms; whereas high dissociation appeared to be significantly associated with high levels of obsessive-compulsive symptoms. It is concluded that the concept of dissociation can be best understood in a typological approach that dissociative symptomatology not only exacerbates obsessive-compulsive symptoms but also serves as an adaptive coping mechanism.

Predicting Prostate Cancer Progression At Time of Diagnosis

DTIC Science & Technology

2016-09-01

greater or less than 50% pattern 4—is again arbitrary and may not capture biology adequately [see an unrelated paper we published during the study period...predictor of major upgrading (p=0.02 and p=0.18, respectively). On multinomial analysis, which we feel best reflects the spectrum of biology we are...predictive of outcomes, and that unique insights into tumor biology may be gleaned by analysis of both types of biomarkers. Task 6 As noted

The association between second-hand smoke exposure and depressive symptoms among pregnant women.

PubMed

Huang, Jingya; Wen, Guoming; Yang, Weikang; Yao, Zhenjiang; Wu, Chuan'an; Ye, Xiaohua

2017-10-01

Tobacco smoking and depression are strongly associated, but the possible association between second-hand smoke (SHS) exposure and depression is unclear. This study aimed to examine the possible relation between SHS exposure and depressive symptoms among pregnant women. A cross-sectional survey was conducted in Shenzhen, China, using a multistage sampling method. The univariable and multivariable logistic regression models were used to explore the associations between SHS exposure and depressive symptoms. Among 2176 pregnant women, 10.5% and 2.0% were classified as having probable and severe depressive symptoms. Both binary and multinomial logistic regression revealed that there were significantly increased risks of severe depressive symptoms corresponding to SHS exposure in homes or regular SHS exposure in workplaces using no exposure as reference. In addition, greater frequency of SHS exposure was significantly associated with the increased risk of severe depressive symptoms. Our findings suggest that SHS exposure is positively associated with depressive symptoms in a dose-response manner among the pregnant women. Copyright © 2017 Elsevier B.V. All rights reserved.

The Association Between Perceived Discrimination and Obesity in a Population-Based Multiracial and Multiethnic Adult Sample

PubMed Central

Williams, David R.

2009-01-01

Objectives. We examined whether perceived chronic discrimination was related to excess body fat accumulation in a random, multiethnic, population-based sample of US adults. Methods. We used multivariate multinomial logistic regression and logistic regression analyses to examine the relationship between interpersonal experiences of perceived chronic discrimination and body mass index and high-risk waist circumference. Results. Consistent with other studies, our analyses showed that perceived unfair treatment was associated with increased abdominal obesity. Compared with Irish, Jewish, Polish, and Italian Whites who did not experience perceived chronic discrimination, Irish, Jewish, Polish, and Italian Whites who perceived chronic discrimination were 2 to 6 times more likely to have a high-risk waist circumference. No significant relationship between perceived discrimination and the obesity measures was found among the other Whites, Blacks, or Hispanics. Conclusions. These findings are not completely unsupported. White ethnic groups including Polish, Italians, Jews, and Irish have historically been discriminated against in the United States, and other recent research suggests that they experience higher levels of perceived discrimination than do other Whites and that these experiences adversely affect their health. PMID:18923119

Automatic Classification of Users’ Health Information Need Context: Logistic Regression Analysis of Mouse-Click and Eye-Tracker Data

PubMed Central

Pian, Wenjing; Khoo, Christopher SG

2017-01-01

Background Users searching for health information on the Internet may be searching for their own health issue, searching for someone else’s health issue, or browsing with no particular health issue in mind. Previous research has found that these three categories of users focus on different types of health information. However, most health information websites provide static content for all users. If the three types of user health information need contexts can be identified by the Web application, the search results or information offered to the user can be customized to increase its relevance or usefulness to the user. Objective The aim of this study was to investigate the possibility of identifying the three user health information contexts (searching for self, searching for others, or browsing with no particular health issue in mind) using just hyperlink clicking behavior; using eye-tracking information; and using a combination of eye-tracking, demographic, and urgency information. Predictive models are developed using multinomial logistic regression. Methods A total of 74 participants (39 females and 35 males) who were mainly staff and students of a university were asked to browse a health discussion forum, Healthboards.com. An eye tracker recorded their examining (eye fixation) and skimming (quick eye movement) behaviors on 2 types of screens: summary result screen displaying a list of post headers, and detailed post screen. The following three types of predictive models were developed using logistic regression analysis: model 1 used only the time spent in scanning the summary result screen and reading the detailed post screen, which can be determined from the user’s mouse clicks; model 2 used the examining and skimming durations on each screen, recorded by an eye tracker; and model 3 added user demographic and urgency information to model 2. Results An analysis of variance (ANOVA) analysis found that users’ browsing durations were significantly different for the three health information contexts (P<.001). The logistic regression model 3 was able to predict the user’s type of health information context with a 10-fold cross validation mean accuracy of 84% (62/74), followed by model 2 at 73% (54/74) and model 1 at 71% (52/78). In addition, correlation analysis found that particular browsing durations were highly correlated with users’ age, education level, and the urgency of their information need. Conclusions A user’s type of health information need context (ie, searching for self, for others, or with no health issue in mind) can be identified with reasonable accuracy using just user mouse clicks that can easily be detected by Web applications. Higher accuracy can be obtained using Google glass or future computing devices with eye tracking function. PMID:29269342

Composite Linear Models | Division of Cancer Prevention

Cancer.gov

By Stuart G. Baker The composite linear models software is a matrix approach to compute maximum likelihood estimates and asymptotic standard errors for models for incomplete multinomial data. It implements the method described in Baker SG. Composite linear models for incomplete multinomial data. Statistics in Medicine 1994;13:609-622. The software includes a library of thirty

The Source of Adult Age Differences in Event-Based Prospective Memory: A Multinomial Modeling Approach

ERIC Educational Resources Information Center

Smith, Rebekah E.; Bayen, Ute J.

2006-01-01

Event-based prospective memory involves remembering to perform an action in response to a particular future event. Normal younger and older adults performed event-based prospective memory tasks in 2 experiments. The authors applied a formal multinomial processing tree model of prospective memory (Smith & Bayen, 2004) to disentangle age differences…

The analysis of the pilot's cognitive and decision processes

NASA Technical Reports Server (NTRS)

Curry, R. E.

1975-01-01

Articles are presented on pilot performance in zero-visibility precision approach, failure detection by pilots during automatic landing, experiments in pilot decision-making during simulated low visibility approaches, a multinomial maximum likelihood program, and a random search algorithm for laboratory computers. Other topics discussed include detection of system failures in multi-axis tasks and changes in pilot workload during an instrument landing.

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.

Examining the association between race, ethnicity, and health status: do assets matter?

PubMed

Boyas, Javier; Shobe, Marcia A; Hannam, Holly M

2009-10-01

The current study employs data from the 2004 Immigration and Intergenerational Mobility in Metropolitan Los Angeles (IIMMLA) study to examine the degree to which observed differences in self-reported health status between African Americans, Asians, Latinos, and non-Hispanic Whites in the United States can be attributed to differences in various indicators of socioeconomic status. Results of the multinomial logistic regression techniques suggest that socioeconomic indicators had varying significant effects in predicting self-reported health status among all racial and ethnic groups. Among African Americans, homeownership, income, and age played a significant role. Among Asian Americans, only income and age significantly predicted health status. Among Latinos, income, having a checking account, and age significantly shaped health status, while education, age, and homeownership significantly predicted health status among non-Hispanic Whites.

Sleep duration and health correlates among university students in 26 countries.

PubMed

Peltzer, Karl; Pengpid, Supa

2016-01-01

The aim of this study was to investigate sleep duration and its health correlates in university students from 26 low-, middle- and high-income countries. Using anonymous questionnaires and anthropometric measurements, data were collected from 19417 undergraduate university students (mean age 20.8, SD = 2.8) from 27 universities from 26 countries across Asia, Africa and the Americas. Results indicate that the average number of self-reported hours of sleep was 7.07 (CI = 7.04-7.09), with the prevalence of reporting ≤ 6, 7-8, and ≥ 9 h sleep duration of 39.2, 46.9, and 13.9%, respectively. Multinomial logistic regression found that sociodemographic variables, health risk behaviour and health status variables were found to be associated with short and long sleep duration.

Ecstasy Use and Suicidal Behavior Among Adolescents: Findings from a National Survey

PubMed Central

Kim, Jueun; Fan, Bin; Liu, Xinhua; Kerner, Nancy; Wu, Ping

2011-01-01

This study examines the relationship between ecstasy use and suicidal behaviors among adolescents in the United States. Data from the adolescent subsample (ages 12–17, N=19,301) of the 2000 NHSDA were used in the analyses. Information on adolescent substance use, suicidal behaviors and related socio-demographic, family and individual factors was obtained in the survey. The rate of past year suicide attempt among adolescents with lifetime ecstasy use was almost double that of adolescents who had used other drugs only, and nine times that of adolescents with no history of illicit drug use. In multinomial logistic regression analyses, controlling for related factors, the effect of ecstasy use remained significant. Adolescent ecstasy users may require enhanced suicide prevention and intervention efforts. PMID:21631573

Women's labor force participation in later life: the effects of early work and family experiences.

PubMed

Pienta, A M; Burr, J A; Mutchler, J E

1994-09-01

The purpose of this study was to develop and evaluate a model of labor force participation among a group of older women in the United States. A comprehensive measure of women's combined work and family experiences across the adult life course was created. Employing data from the 1984 Survey of Income and Program Participation, we applied multinomial logistic regression techniques to examine the association between work-family experiences and later life labor supply. Our findings generally support an attachment hypothesis, showing that women who were the most work-oriented throughout the life course were more likely than women who experienced family-related spells of nonlabor-market activity to participate in the labor force, either full-time or part-time, later in life.

The intersectionality of postsecondary pathways: the case of high school students with special education needs.

PubMed

Robson, Karen L; Anisef, Paul; Brown, Robert S; Parekh, Gillian

2014-08-01

Using data from the Toronto District School Board, we examine the postsecondary pathways of students with special education needs (SEN). We consider both university and college pathways, employing multilevel multinomial logistic regressions, conceptualizing our findings within a life course and intersectionality framework. Our findings reveal that having SEN reduces the likelihood of confirming university, but increases the likelihood of college confirmation. We examine a set of known determinants of postsecondary education (PSE) pathways that were derived from the literature and employ exploratory statistical interactions to examine if the intersection of various traits differentially impacts upon the PSE trajectories of students with SEN. Our findings reveal that parental education, neighborhood wealth, race, and streaming impact on the postsecondary pathways of students with SEN in Toronto.

Unmarried Mothers’ Postnatal School Enrollment: The Role and Intersection of Demographic and Socioeconomic Characteristics

PubMed Central

Radey, Melissa

2017-01-01

Drawing from a theoretical model of educational decisions and intersectionality theory, this study examined demographic, socioeconomic, and public assistance characteristics that influence unmarried mothers’ postnatal enrollment. Using the Fragile Families and Child Wellbeing Study (FFCWS), binomial and multinomial regression techniques were used to examine unmarried mothers’ enrollment in their child’s first nine years. Results showed unmarried mothers’ educational commitment coupled with the influence of race and class indicate that they need additional opportunities to optimize their educations and job opportunities. Targeting outreach and enrollment assistance to underrepresented groups can reduce social-origin inequalities. Important directions for future research include understanding unmarried mothers’ rationale for school enrollment and considering how race and class work in combination to support or deter enrollment. PMID:29151656

Longitudinal trajectories of peer relations in children with specific language impairment.

PubMed

Mok, Pearl L H; Pickles, Andrew; Durkin, Kevin; Conti-Ramsden, Gina

2014-05-01

Peer relations is a vulnerable area of functioning in children with specific language impairment (SLI), but little is known about the developmental trajectories of individuals. Peer problems were investigated over a 9-year period (from 7 to 16 years of age) in 171 children with a history of SLI. Discrete factor growth modelling was used to chart developmental trajectories. Multinomial logistic regression analysis was conducted to investigate factors associated with group membership. Four distinct developmental trajectories were identified: low-level/no problems in peer relations (22.2% of participants), childhood-limited problems (12.3%), childhood-onset persistent problems (39.2%) and adolescent-onset problems (26.3%). Risk of poor trajectories of peer relations was greater for those children with pragmatic language difficulties. Prosocial behaviour was the factor most strongly associated with trajectory group membership. Overall, the more prosocial children with better pragmatic language skills and lower levels of emotional problems had less difficulty in developing peer relations. Analysis of developmental trajectories enriches our understanding of social development. A sizeable minority in the present sample sustained positive relations through childhood and adolescence, and others overcame early difficulties to achieve low levels of problems by their early teens; the majority, however, showed childhood-onset persistent or adolescent-onset problems. © 2014 The Authors Journal of Child Psychology and Psychiatry published by John Wiley © Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

Tri-city study of Ecstasy use problems: a latent class analysis.

PubMed

Scheier, Lawrence M; Ben Abdallah, Arbi; Inciardi, James A; Copeland, Jan; Cottler, Linda B

2008-12-01

This study used latent class analysis to examine distinctive subtypes of Ecstasy users based on 24 abuse and dependence symptoms underlying standard DSM-IV criteria. Data came from a three site, population-based, epidemiological study to examine diagnostic nosology for Ecstasy use. Subject inclusion criteria included lifetime Ecstasy use exceeding five times and once in the past year, with participants ranging in age between 16 and 47 years of age from St. Louis, Miami, U.S. and Sydney, Australia. A satisfactory model typified four latent classes representing clearly differentiated diagnostic clusters including: (1) a group of sub-threshold users endorsing few abuse and dependence symptoms (negatives), (2) a group of 'diagnostic orphans' who had characteristic features of dependence for a select group of symptoms (mild dependent), (3) a 'transitional group' mimicking the orphans with regard to their profile of dependence also but reporting some abuse symptoms (moderate dependent), and (4) a 'severe dependent' group with a distinct profile of abuse and dependence symptoms. A multinomial logistic regression model indicated that certain latent classes showed unique associations with external non-diagnostic markers. Controlling for demographic characteristics and lifetime quantity of Ecstasy pill use, criminal behavior and motivational cues for Ecstasy use were the most efficient predictors of cluster membership. This study reinforces the heuristic utility of DSM-IV criteria applied to Ecstasy but with a different collage of symptoms that produced four distinct classes of Ecstasy users.

Modifiable lifestyle behavior patterns, sedentary time and physical activity contexts: a cluster analysis among middle school boys and girls in the SALTA study.

PubMed

Marques, Elisa A; Pizarro, Andreia N; Figueiredo, Pedro; Mota, Jorge; Santos, Maria P

2013-06-01

To analyze how modifiable health-related variables are clustered and associated with children's participation in play, active travel and structured exercise and sport among boys and girls. Data were collected from 9 middle-schools in Porto (Portugal) area. A total of 636 children in the 6th grade (340 girls and 296 boys) with a mean age of 11.64 years old participated in the study. Cluster analyses were used to identify patterns of lifestyle and healthy/unhealthy behaviors. Multinomial logistic regression analysis was used to estimate associations between cluster allocation, sedentary time and participation in three different physical activity (PA) contexts: play, active travel, and structured exercise/sport. Four distinct clusters were identified based on four lifestyle risk factors. The most disadvantaged cluster was characterized by high body mass index, low high-density lipoprotein cholesterol and cardiorespiratory fitness and a moderate level of moderate to vigorous PA. Everyday outdoor play (OR=1.85, 95%CI 0.318-0.915) and structured exercise/sport (OR=1.85, 95%CI 0.291-0.990) were associated with healthier lifestyle patterns. There were no significant associations between health patterns and sedentary time or travel mode. Outdoor play and sport/exercise participation seem more important than active travel from school in influencing children's healthy cluster profiles. Copyright © 2013 Elsevier Inc. All rights reserved.

Patterns of stigma toward schizophrenia among the general population: a latent profile analysis.

PubMed

Loch, Alexandre A; Wang, Yuan-Pang; Guarniero, Francisco B; Lawson, Fabio L; Hengartner, Michael P; Rössler, Wulf; Gattaz, Wagner F

2014-09-01

Our purpose was to assess stigma toward schizophrenia in a representative sample of the Brazilian general population. The sample consisted of 1015 individuals interviewed by telephone. A vignette describing someone with schizophrenia was read, and four stigma aspects regarding this hypothetical individual were assessed: stereotypes, restrictions, perceived prejudice and social distance. Latent profile analysis searched for stigma profiles among the sample. Multinomial logistic regression was used to find correlates of each class. Four stigma profiles were found; 'no stigma' individuals (n = 251) mostly displayed positive opinions. 'Labelers' (n = 222) scored high on social distance; they more often had familial contact with mental illness and more often labeled the vignette's disorder as schizophrenia. 'Discriminators', the group with the majority of individuals (n = 302), showed high levels of stigmatizing beliefs in all dimensions; discriminators were significantly older. 'Unobtrusive stigma' individuals (n = 240) seemed to demonstrate uncertainty or low commitment since they mostly answered items with the middle/impartial option. Some findings from the international literature were replicated; however, familial contact increased stigma, possibly denoting a locally modulated determinant. Hereby, our study also adds important cross-cultural data by showing that stigma toward schizophrenia is high in a Latin-American setting. We highlight the importance of analyzing the general population as a heterogeneous group, aiming to better elaborate anti-stigma campaigns. © The Author(s) 2013.

Relational event models for longitudinal network data with an application to interhospital patient transfers.

PubMed

Vu, Duy; Lomi, Alessandro; Mascia, Daniele; Pallotti, Francesca

2017-06-30

The main objective of this paper is to introduce and illustrate relational event models, a new class of statistical models for the analysis of time-stamped data with complex temporal and relational dependencies. We outline the main differences between recently proposed relational event models and more conventional network models based on the graph-theoretic formalism typically adopted in empirical studies of social networks. Our main contribution involves the definition and implementation of a marked point process extension of currently available models. According to this approach, the sequence of events of interest is decomposed into two components: (a) event time and (b) event destination. This decomposition transforms the problem of selection of event destination in relational event models into a conditional multinomial logistic regression problem. The main advantages of this formulation are the possibility of controlling for the effect of event-specific data and a significant reduction in the estimation time of currently available relational event models. We demonstrate the empirical value of the model in an analysis of interhospital patient transfers within a regional community of health care organizations. We conclude with a discussion of how the models we presented help to overcome some the limitations of statistical models for networks that are currently available. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

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.

Menstrual pain and risk of epithelial ovarian cancer: Results from the Ovarian Cancer Association Consortium.

PubMed

Babic, Ana; Harris, Holly R; Vitonis, Allison F; Titus, Linda J; Jordan, Susan J; Webb, Penelope M; Risch, Harvey A; Rossing, Mary Anne; Doherty, Jennifer A; Wicklund, Kristine; Goodman, Marc T; Modugno, Francesmary; Moysich, Kirsten B; Ness, Roberta B; Kjaer, Susanne K; Schildkraut, Joellen; Berchuck, Andrew; Pearce, Celeste L; Wu, Anna H; Cramer, Daniel W; Terry, Kathryn L

2018-02-01

Menstrual pain, a common gynecological condition, has been associated with increased risk of ovarian cancer in some, but not all studies. Furthermore, potential variations in the association between menstrual pain and ovarian cancer by histologic subtype have not been adequately evaluated due to lack of power. We assessed menstrual pain using either direct questions about having experienced menstrual pain, or indirect questions about menstrual pain as indication for use of hormones or medications. We used multivariate logistic regression to calculate the odds ratio (OR) for the association between severe menstrual pain and ovarian cancer, adjusting for potential confounders and multinomial logistic regression to calculate ORs for specific histologic subtypes. We observed no association between ovarian cancer and menstrual pain assessed by indirect questions. Among studies using direct question, severe pain was associated with a small but significant increase in overall risk of ovarian cancer (OR = 1.07, 95% CI: 1.01-1.13), after adjusting for endometriosis and other potential confounders. The association appeared to be more relevant for clear cell (OR = 1.48, 95% CI: 1.10-1.99) and serous borderline (OR = 1.31, 95% CI: 1.05-1.63) subtypes. In this large international pooled analysis of case-control studies, we observed a small increase in risk of ovarian cancer for women reporting severe menstrual pain. While we observed an increased ovarian cancer risk with severe menstrual pain, the possibility of recall bias and undiagnosed endometriosis cannot be excluded. Future validation in prospective studies with detailed information on endometriosis is needed. © 2017 UICC.

Hospital pharmacists’ knowledge about and attitude toward HIV/AIDS and patients living with HIV/AIDS in Kedah, Malaysia

PubMed Central

Baig, Mirza Rafi

2012-01-01

Introduction The current study aims to explore the knowledge, attitude, and perception of hospital pharmacists towards HIV/AIDS and patients living with HIV/AIDS (PLWHA) in the state of Kedah, Malaysia. Material and methods This was a cross-sectional study conducted among the hospital pharmacists in three government hospitals in Kedah, using a self-administered 43-item questionnaire. Data analysis was done using non-parametric and multinomial regression. Results A total of 75 respondents participated in this study, resulting in a response rate of 60.8%. The majority were found to be well aware of the causes of HIV/AIDS. However, about 34 (45.3%) believed erroneously that HIV/AIDS cannot be transmitted through tattooing or body piercing. Nearly 25 (33.3%) of the respondents believed that preventing the use of intravenous drugs may not be effective to prevent HIV/AIDS and endorsed social isolation as a measure to prevent HIV/AIDS. The majority (66.6%) had negative attitudes and about 20% held extremely negative attitudes. Findings from regression modelling revealed that hospital (–2 log likelihood = 215.182, χ2 = 18.060, Df = 8, p = 0.021) and gender (–2 log likelihood = 213.643, χ2 = 16.521, Df = 8, p = 0.035) were more likely to affect the attitudes of respondents. Conclusions Overall, more than one third of the respondents were found to have negative attitudes towards PLWHA. Gender, job experience, and hospitals with more HIV/AIDS patient visits were the main factors affecting attitudes. PMID:24482660

Experiences of Racism and Breastfeeding Initiation and Duration Among First-Time Mothers of the Black Women's Health Study.

PubMed

Griswold, Michele K; Crawford, Sybil L; Perry, Donna J; Person, Sharina D; Rosenberg, Lynn; Cozier, Yvette C; Palmer, Julie R

2018-02-12

Breastfeeding rates are lower for black women in the USA compared with other groups. Breastfeeding and lactation are sensitive time points in the life course, centering breastfeeding as a health equity issue. In the USA, experiences of racism have been linked to poor health outcomes but racism relative to breastfeeding has not been extensively investigated. This study aims to investigate the association between experiences of racism, neighborhood segregation, and nativity with breastfeeding initiation and duration. This is a prospective secondary analysis of the Black Women's Health Study, based on data collected from 1995 through 2005. Daily and institutional (job, housing, police) racism, nativity, and neighborhood segregation in relation to breastfeeding were examined. Odds ratios and 95% confidence intervals were calculated using binomial logistic regression for the initiation outcomes (N = 2705) and multinomial logistic regression for the duration outcomes (N = 2172). Racism in the job setting was associated with lower odds of breastfeeding duration at 3-5 months. Racism with the police was associated with higher odds of breastfeeding initiation and duration at 3-5 and 6 months. Being born in the USA or having a parent born in the USA predicted lower odds of breastfeeding initiation and duration. Living in a segregated neighborhood (primarily black residents) as a child was associated with decreased breastfeeding initiation and duration relative to growing up in a predominantly white neighborhood. Experiences of institutionalized racism influenced breastfeeding initiation and duration. Structural-level interventions are critical to close the gap of racial inequity in breastfeeding rates in the USA.

Linkages between gender equity and intimate partner violence among urban Brazilian youth.

PubMed

Gomez, Anu Manchikanti; Speizer, Ilene S; Moracco, Kathryn E

2011-10-01

Gender inequity is a risk factor for intimate partner violence (IPV), although there is little research on this relationship that focuses on youth or males. Using survey data collected from 240 male and 198 female youth aged 15-24 in Rio de Janeiro, Brazil, we explore the association between individual-level support for gender equity and IPV experiences in the past 6 months and describe responses to and motivations for IPV. Factor analysis was used to construct gender equity scales for males and females. Logistic and multinomial logistic regression models were used to examine the relationship between gender equity and IPV. About half of female youth reported some form of recent IPV, including any victimization (32%), any perpetration (40%), and both victimization and perpetration (22%). A total of 18% of male youth reported recently perpetrating IPV. In logistic regression models, support for gender equity had a protective effect against any female IPV victimization and any male IPV perpetration and was not associated with female IPV perpetration. Female victims reported leaving the abusive partner, but later returning to him as the most frequent response to IPV. Male perpetrators said the most common response of their victims was to retaliate with violence. Jealousy was the most frequently reported motivation of females perpetrating IPV. Gender equity is an important predictor of IPV among youth. Examining the gendered context of IPV will be useful in the development of targeted interventions to promote gender equity and healthy relationships and to help reduce IPV among youth. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Diversity of leisure-time sport activities in adolescence as a predictor of leisure-time physical activity in adulthood.

PubMed

Mäkelä, S; Aaltonen, S; Korhonen, T; Rose, R J; Kaprio, J

2017-12-01

Because sustained physical activity is important for a healthy life, this paper examined whether a greater diversity of sport activities during adolescence predicts higher levels of leisure-time physical activity (LTPA) in adulthood. From sport activity participation reported by 17-year-old twins, we formed five groups: 1, 2, 3, 4, and 5+ different sport activities. At follow-up in their mid-thirties, twins were divided into four activity classes based on LTPA, including active commuting. Multinomial regression analyses, adjusted for several confounders, were conducted separately for male (N=1288) and female (N=1770) participants. Further, conditional logistic regression analysis included 23 twin pairs discordant for both diversity of sport activities in adolescence and LTPA in adulthood. The diversity of leisure-time sport activities in adolescence had a significant positive association with adulthood LTPA among females. Membership in the most active adult quartile, compared to the least active quartile, was predicted by participation in 2, 3, 4, and 5+ sport activities in adolescence with odds ratios: 1.52 (P=.11), 1.86 (P=.02), 1.29 (P=.39), and 3.12 (P=5.4e-05), respectively. Within-pair analyses, limited by the small sample of twins discordant for both adolescent activities and adult outcomes, did not replicate the association. A greater diversity of leisure-time sport activities in adolescence predicts higher levels of LTPA in adulthood in females, but the causal nature of this association remains unresolved. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Nutritional aspects of night eating and its association with weight status among Korean adolescents

PubMed Central

Hernandez, Emely; Kim, Meeyoung; Kim, Won Gyoung

2016-01-01

BACKGROUND/OBJECTIVES A growing body of research has indicated that night eating could be associated with poor diet quality and negative health outcomes. This study examined the nutritional aspects of night eating, its related factors, and the association between night eating and body weight among Korean adolescents. SUBJECTS/METHODS This study analysed the data from a one day 24-hour dietary recall as well as a demographic survey of 1,738 Korean adolescents aged 12 to 18-years-old obtained from the 2010-2012 Korea National Health and Nutrition Examination Survey. 'Night eating' was defined as consuming 25% or more of one's daily energy intake between 21:00 and 06:00. Subjects complying with the preceding condition were classified as 'night eaters', whereas the rest were considered 'non-night eaters'. Logistic regression analysis examined factors related to night eating. Multiple linear regression analyses were used to examine the relationship between night eating and BMI z-scores, whereas multinomial logistic regression analysis was used to examine the relationship between night eating and weight status. RESULTS About 21% of Korean adolescents appeared to be night eaters. Night eaters showed increased breakfast skipping (P = 0.001), higher energy intake from snacks (P < 0.001), greater proportion of energy intake from fat (P = 0.029), and lower Dietary Diversity Scores (P = 0.008) than non-night eaters. Male adolescents presented 1.9 times higher odds of being night eaters than females. Adolescents whose both parents were night eaters were 4.4 times as likely to be night eaters as those whose neither parents were. Female adolescents showed a significant relationship between night eating and BMI z-scores (β = 0.28, P = 0.004). However, night eating did not increase odds of being overweight or obese in adolescents. CONCLUSIONS Night eating in Korean adolescents was related to undesirable dietary behaviours and low diet quality in general as well as higher BMI z-scores in females. Male gender and parental night eating appeared to be the factors that significantly increased odds of night eating. These results suggest that night eating should be considered when designing nutrition education or intervention programs targeting adolescents. PMID:27478553

Who Is Overeducated and Why? Probit and Dynamic Mixed Multinomial Logit Analyses of Vertical Mismatch in East and West Germany

ERIC Educational Resources Information Center

Boll, Christina; Leppin, Julian Sebastian; Schömann, Klaus

2016-01-01

Overeducation potentially signals a productivity loss. With Socio-Economic Panel data from 1984 to 2011 we identify drivers of educational mismatch for East and West medium and highly educated Germans. Addressing measurement error, state dependence and unobserved heterogeneity, we run dynamic mixed multinomial logit models for three different…

Association of Brain-Derived Neurotrophic Factor and Vitamin D with Depression and Obesity: A Population-Based Study.

PubMed

Goltz, Annemarie; Janowitz, Deborah; Hannemann, Anke; Nauck, Matthias; Hoffmann, Johanna; Seyfart, Tom; Völzke, Henry; Terock, Jan; Grabe, Hans Jörgen

2018-06-19

Depression and obesity are widespread and closely linked. Brain-derived neurotrophic factor (BDNF) and vitamin D are both assumed to be associated with depression and obesity. Little is known about the interplay between vitamin D and BDNF. We explored the putative associations and interactions between serum BDNF and vitamin D levels with depressive symptoms and abdominal obesity in a large population-based cohort. Data were obtained from the population-based Study of Health in Pomerania (SHIP)-Trend (n = 3,926). The associations of serum BDNF and vitamin D levels with depressive symptoms (measured using the Patient Health Questionnaire) were assessed with binary and multinomial logistic regression models. The associations of serum BDNF and vitamin D levels with obesity (measured by the waist-to-hip ratio [WHR]) were assessed with binary logistic and linear regression models with restricted cubic splines. Logistic regression models revealed inverse associations of vitamin D with depression (OR = 0.966; 95% CI 0.951-0.981) and obesity (OR = 0.976; 95% CI 0.967-0.985). No linear association of serum BDNF with depression or obesity was found. However, linear regression models revealed a U-shaped association of BDNF with WHR (p < 0.001). Vitamin D was inversely associated with depression and obesity. BDNF was associated with abdominal obesity, but not with depression. At the population level, our results support the relevant roles of vitamin D and BDNF in mental and physical health-related outcomes. © 2018 S. Karger AG, Basel.

Trajectory analyses of sickness absence among industrial and municipal employees.

PubMed

Virtanen, P; Siukola, A; Lipiäinen, L; Liukkonen, V; Pentti, J; Vahtera, J

2017-03-01

Compared with the public sector, the private sector is more susceptible to changes in the economic environment and associated threats of downsizing, outsourcing and transfers of production. This might be assumed to be associated with more restrictive sickness absence practices. To investigate whether this difference is reflected in higher sickness absence rates in the public sector and to explore the potential of trajectory analysis in researching such absences. The sample consisted of industrial and municipal employees. Latent groups of differential sickness absence during a 6-year study period were searched with a two-response trajectory analysis that jointly captured the spells and the days. Multinomial logistic regressions were used to assess associations of the labour market sector with the set of trajectories obtained. There were 2207 industrial and 3477 municipal employees in the study group. The analysis assigned the employees to three trajectory groups, the 'low-level', 'middle-range' and 'high-range' groups. The relative risk ratios for the middle-range and the high-range trajectories of public sector employees were not higher after controlling for age, gender and occupational. In this study, the labour market sector was not a major independent determinant of sickness absence practices. Trajectory analysis can be recommended as a way to determine differential absence practices. The trajectory approach might help occupational health services to identify more accurately the employees who need support to maintain their work ability. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Predictors of mistimed, and unwanted pregnancies among women of childbearing age in Rufiji, Kilombero, and Ulanga districts of Tanzania.

PubMed

Exavery, Amon; Kanté, Almamy Malick; Njozi, Mustafa; Tani, Kassimu; Doctor, Henry V; Hingora, Ahmed; Phillips, James F

2014-08-08

While unintended pregnancies pose a serious threat to the health and well-being of families globally, characteristics of Tanzanian women who conceive unintentionally are rarely documented. This analysis identifies factors associated with unintended pregnancies-both mistimed and unwanted-in three rural districts of Tanzania. A cross-sectional survey of 2,183 random households was conducted in three Tanzanian districts of Rufiji, Kilombero, and Ulanga in 2011 to assess women's health behavior and service utilization patterns. These households produced 3,127 women age 15+ years from which 2,199 gravid women aged 15-49 were selected for the current analysis. Unintended pregnancies were identified as either mistimed (wanted later) or unwanted (not wanted at all). Correlates of mistimed, and unwanted pregnancies were identified through Chi-squared tests to assess associations and multinomial logistic regression for multivariate analysis. Mean age of the participants was 32.1 years. While 54.1% of the participants reported that their most recent pregnancy was intended, 32.5% indicated their most recent pregnancy as mistimed and 13.4% as unwanted. Multivariate analysis revealed that young age (<20 years), and single marital status were significant predictors of both mistimed and unwanted pregnancies. Lack of inter-partner communication about family planning increased the risk of mistimed pregnancy significantly, and multi-gravidity was shown to significantly increase the risk of unwanted pregnancy. About one half of women in Rufiji, Kilombero, and Ulanga districts of Tanzania conceive unintentionally. Women, especially the most vulnerable should be empowered to avoid pregnancy at their own will and discretion.

Chronic fatigue syndrome (CFS/ME) symptom-based phenotypes and 1-year treatment outcomes in two clinical cohorts of adult patients in the UK and The Netherlands.

PubMed

Collin, Simon M; Heron, Jon; Nikolaus, Stephanie; Knoop, Hans; Crawley, Esther

2018-01-01

We previously described symptom-based chronic fatigue syndrome (CFS/ME) phenotypes in clinical assessment data from 7041 UK and 1392 Dutch adult CFS/ME patients. Here we aim to replicate these phenotypes in a more recent UK patient cohort, and investigate whether phenotypes are associated with 1-year treatment outcome. 12 specialist CFS/ME services (11 UK, 1 NL) recorded the presence/absence of 5 symptoms (muscle pain, joint pain, headache, sore throat, and painful lymph nodes) which can occur in addition to the 3 symptoms (post-exertional malaise, cognitive dysfunction, and disturbed/unrefreshing sleep) that are present for almost all patients. Latent Class Analysis (LCA) was used to assign symptom profiles (phenotypes). Multinomial logistic regression models were fitted to quantify associations between phenotypes and overall change in health 1year after the start of treatment. Baseline data were available for N=918 UK and N=1392 Dutch patients, of whom 416 (45.3%) and 912 (65.5%) had 1-year follow-up data, respectively. 3- and 4-class phenotypes identified in the previous UK patient cohort were replicated in the new UK cohort. UK patients who presented with 'polysymptomatic' and 'pain-only' phenotypes were 57% and 67% less likely (multinomial odds ratio (MOR) 0.43 (95% CI 0.19-0.94) and 0.33 (95% CI 0.13-0.84)) to report that their health was "very much better" or "much better" than patients who presented with an 'oligosymptomatic' phenotype. For Dutch patients, polysymptomatic and pain-only phenotypes were associated with 72% and 55% lower odds of improvement (MOR 0.28 (95% CI 0.11, 0.69) and 0.45 (95% CI 0.21, 0.99)) compared with oligosymptomatic patients. Adult CFS/ME patients with multiple symptoms or pain symptoms who present for specialist treatment are much less likely to report favourable treatment outcomes than patients who present with few symptoms. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Multinomial Logistic Regression & Bootstrapping for Bayesian Estimation of Vertical Facies Prediction in Heterogeneous Sandstone Reservoirs

NASA Astrophysics Data System (ADS)

Al-Mudhafar, W. J.

2013-12-01

Precisely prediction of rock facies leads to adequate reservoir characterization by improving the porosity-permeability relationships to estimate the properties in non-cored intervals. It also helps to accurately identify the spatial facies distribution to perform an accurate reservoir model for optimal future reservoir performance. In this paper, the facies estimation has been done through Multinomial logistic regression (MLR) with respect to the well logs and core data in a well in upper sandstone formation of South Rumaila oil field. The entire independent variables are gamma rays, formation density, water saturation, shale volume, log porosity, core porosity, and core permeability. Firstly, Robust Sequential Imputation Algorithm has been considered to impute the missing data. This algorithm starts from a complete subset of the dataset and estimates sequentially the missing values in an incomplete observation by minimizing the determinant of the covariance of the augmented data matrix. Then, the observation is added to the complete data matrix and the algorithm continues with the next observation with missing values. The MLR has been chosen to estimate the maximum likelihood and minimize the standard error for the nonlinear relationships between facies & core and log data. The MLR is used to predict the probabilities of the different possible facies given each independent variable by constructing a linear predictor function having a set of weights that are linearly combined with the independent variables by using a dot product. Beta distribution of facies has been considered as prior knowledge and the resulted predicted probability (posterior) has been estimated from MLR based on Baye's theorem that represents the relationship between predicted probability (posterior) with the conditional probability and the prior knowledge. To assess the statistical accuracy of the model, the bootstrap should be carried out to estimate extra-sample prediction error by randomly drawing datasets with replacement from the training data. Each sample has the same size of the original training set and it can be conducted N times to produce N bootstrap datasets to re-fit the model accordingly to decrease the squared difference between the estimated and observed categorical variables (facies) leading to decrease the degree of uncertainty.

The Inaccuracy of Patient Recall for COPD Exacerbation Rate Estimation and Its Implications: Results from Central Adjudication.

PubMed

Frei, Anja; Siebeling, Lara; Wolters, Callista; Held, Leonhard; Muggensturm, Patrick; Strassmann, Alexandra; Zoller, Marco; Ter Riet, Gerben; Puhan, Milo A

2016-10-01

COPD exacerbation incidence rates are often ascertained retrospectively through patient recall and self-reports. We compared exacerbation ascertainment through patient self-reports and single-physician chart review to central adjudication by a committee and explored determinants and consequences of misclassification. Self-reported exacerbations (event-based definition) in 409 primary care patients with COPD participating in the International Collaborative Effort on Chronic Obstructive Lung Disease: Exacerbation Risk Index Cohorts (ICE COLD ERIC) cohort were ascertained every 6 months over 3 years. Exacerbations were adjudicated by single experienced physicians and an adjudication committee who had information from patient charts. We assessed the accuracy (sensitivities and specificities) of self-reports and single-physician chart review against a central adjudication committee (AC) (reference standard). We used multinomial logistic regression and bootstrap stability analyses to explore determinants of misclassifications. The AC identified 648 exacerbations, corresponding to an incidence rate of 0.60 ± 0.83 exacerbations/patient-year and a cumulative incidence proportion of 58.9%. Patients self-reported 841 exacerbations (incidence rate, 0.75 ± 1.01; incidence proportion, 59.7%). The sensitivity and specificity of self-reports were 84% and 76%, respectively, those of single-physician chart review were between 89% and 96% and 87% and 99%, respectively. The multinomial regression model and bootstrap selection showed that having experienced more exacerbations was the only factor consistently associated with underreporting and overreporting of exacerbations (underreporters: relative risk ratio [RRR], 2.16; 95% CI, 1.76-2.65 and overreporters: RRR, 1.67; 95% CI, 1.39-2.00). Patient 6-month recall of exacerbation events are inaccurate. This may lead to inaccurate estimates of incidence measures and underestimation of treatment effects. The use of multiple data sources combined with event adjudication could substantially reduce sample size requirements and possibly cost of studies. www.ClinicalTrials.gov, NCT00706602. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Help-Seeking in People with Exceptional Experiences: Results from a General Population Sample

PubMed Central

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

Background: 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. Methods: 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. Results: 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. Conclusion: 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. PMID:24904915

Association of childhood abuse with homeless women's social networks.

PubMed

Green, Harold D; Tucker, Joan S; Wenzel, Suzanne L; Golinelli, Daniela; Kennedy, David P; Ryan, Gery W; Zhou, Annie J

2012-01-01

Childhood abuse has been linked to negative sequelae for women later in life including drug and alcohol use and violence as victim or perpetrator and may also affect the development of women's social networks. Childhood abuse is prevalent among at-risk populations of women (such as the homeless) and thus may have a stronger impact on their social networks. We conducted a study to: (a) develop a typology of sheltered homeless women's social networks; (b) determine whether childhood abuse was associated with the social networks of sheltered homeless women; and (c) determine whether those associations remained after accounting for past-year substance abuse and recent intimate partner abuse. A probability sample of 428 homeless women from temporary shelter settings in Los Angeles County completed a personal network survey that provided respondent information as well as information about their network members' demographics and level of interaction with each other. Cluster analyses identified groups of women who shared specific social network characteristics. Multinomial logistic regressions revealed variables associated with group membership. We identified three groups of women with differing social network characteristics: low-risk networks, densely connected risky networks (dense, risky), and sparsely connected risky networks (sparse, risky). Multinomial logistic regressions indicated that membership in the sparse, risky network group, when compared to the low-risk group, was associated with history of childhood physical abuse (but not sexual or emotional abuse). Recent drug abuse was associated with membership in both risky network groups; however, the association of childhood physical abuse with sparse, risky network group membership remained. Although these findings support theories proposing that the experience of childhood abuse can shape women's social networks, they suggest that it may be childhood physical abuse that has the most impact among homeless women. The effects of childhood physical abuse should be more actively investigated in clinical settings, especially those frequented by homeless women, particularly with respect to the formation of social networks in social contexts that may expose these women to greater risks. Copyright © 2012. Published by Elsevier Ltd.

The prevalence of underweight, overweight and obesity and their related socio-demographic and lifestyle factors among adult women in Myanmar, 2015-16

PubMed Central

Hong, Seo Ah; Lwin, Kyi Tun; Aung, La Seng

2018-01-01

Background The aim of the study was to estimate the prevalence of underweight and overweight or obesity and their socio-demographic and lifestyle factors in a female adult population in Myanmar. Material and methods In a national cross-sectional population-based survey in the 2015–16 Myanmar Demographic and Health Survey, 12,160 women aged 18–49 years and not currently pregnant completed questionnaires and anthropometric measurements. Nutritional status was determined using Asian body mass index cut-offs: underweight (BMI<18.5 kg/m2), overweight (23.0–27.4 kg/m2), and obesity (≥27.5 kg/m2). Multinomial logistic regression modelling was used to determine the association between socio-demographic and lifestyle factors and weight status. Results The prevalence of underweight was 14.1%, overweight 28.1% and obesity 13.1%. Among different age groups, the prevalence of underweight was the highest among 18 to 29 year-olds (20.2%), while overweight or obesity was the highest in the age group 30 to 49 years (around 50%). In multinomial logistic regression, being 30 to 49 years old, poorer and richer wealth status, living in all the other regions of Myanmar and ever contraceptive use were inversely and current tobacco use, not working and having less than two children ever born were positively associated with underweight relative to normal weight. Older age, having secondary education, urban residence, wealthier economic status, living with a partner, living in the Northern and Southern regions of Myanmar, having less than two children ever born and having ever used contraceptives were positively and current tobacco use was negatively associated with overweight or obesity relative to normal weight. Conclusions A dual burden of both underweight and overweight or obesity among female adults was found in Myanmar. Sociodemographic and health risk behaviour factors were identified for underweight and overweight or obesity that can guide public health interventions to address both of these conditions. PMID:29547655

Dental caries clusters among adolescents.

PubMed

Warren, John J; Van Buren, John M; Levy, Steven M; Marshall, Teresa A; Cavanaugh, Joseph E; Curtis, Alexandra M; Kolker, Justine L; Weber-Gasparoni, Karin

2017-12-01

There have been very few longitudinal studies of dental caries in adolescents, and little study of the caries risk factors in this age group. The purpose of this study was to describe different caries trajectories and associated risk factors among members of the Iowa Fluoride Study (IFS) cohort. The IFS recruited a birth cohort from 1992 to 1995, and has gathered dietary, fluoride and behavioural data at least twice yearly since recruitment. Examinations for dental caries were completed when participants were ages 5, 9, 13 and 17 years. For this study, only participants with decayed and filled surface (DFS) caries data at ages 9, 13 and 17 were included (N=396). The individual DFS counts at age 13 and the DFS increment from 13 to 17 were used to identify distinct caries trajectories using Ward's hierarchical clustering algorithm. A number of multinomial logistic regression models were developed to predict trajectory membership, using longitudinal dietary, fluoride and demographic/behavioural data from 9 to 17 years. Model selection was based on the akaike information criterion (AIC). Several different trajectory schemes were considered, and a three-trajectory scheme-no DFS at age 17 (n=142), low DFS (n=145) and high DFS (n=109)-was chosen to balance sample sizes and interpretability. The model selection process resulted in use of an arithmetic average for dietary variables across the period from 9 to 17 years. The multinomial logistic regression model with the best fit included the variables maternal education level, 100% juice consumption, brushing frequency and sex. Other favoured models also included water and milk consumption and home water fluoride concentration. The high caries cluster was most consistently associated with lower maternal education level, lower 100% juice consumption, lower brushing frequency and being female. The use of a clustering algorithm and use of Akaike's Information Criterion (AIC) to determine the best representation of the data were useful means in presenting longitudinal caries data. Findings suggest that high caries incidence in adolescence is associated with lower maternal educational level, less frequent tooth brushing, lower 100% juice consumption and being female. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Contraceptive Sterilization: Introducing A Couple Perspective to Examine Sociodemographic Differences in Use.

PubMed

Eeckhaut, Mieke C W

2017-09-01

Most studies of contraceptive use have relied solely on the woman's perspective, but because men's attitudes and preferences are also important, analytic approaches based on couples should also be explored. Data from the 2006-2010 and 2011-2013 rounds of the National Survey of Family Growth yielded a sample of 4,591 men and women who were married or cohabiting with an opposite-sex partner and who had completed their intended childbearing. Respondents' reports of both their own and their partners' characteristics and behaviors were employed in two sets of analyses examining educational and racial and ethnic differences in contraceptive use: an individualistic approach (using multinomial logistic regression) and a couple approach (using multinomial logistic diagonal reference models). In the full model using the individualistic approach, respondents with less than a high school education were less likely than those with at least a college degree to rely on male sterilization (odds ratios, 0.1-0.2) or a reversible method (0.4-0.5), as opposed to female sterilization. Parallel analyses limited to couples in which partners had the same educational levels (i.e., educationally homogamous couples) showed an even greater difference between those with the least and those with the most schooling (0.03 for male sterilization and 0.2 for a reversible method). When race and ethnicity, which had a much higher level of homogamy, were examined, the approaches yielded more similar results. Research on contraceptive use can benefit from a couple approach, particularly when focusing on partners' characteristics for which homogamy is relatively low. Copyright © 2017 by the Guttmacher Institute.

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.

Occupational outcomes of adult childhood cancer survivors: A report from the Childhood Cancer Survivor Study

PubMed Central

Kirchhoff, Anne C.; Krull, Kevin R.; Ness, Kirsten K.; Park, Elyse R.; Oeffinger, Kevin C.; Hudson, Melissa M.; Stovall, Marilyn; Robison, Leslie L.; Wickizer, Thomas; Leisenring, Wendy

2010-01-01

Background We examined whether survivors from the Childhood Cancer Survivor Study were less likely to be in higher skill occupations than a sibling comparison and whether certain survivors were at higher risk. Methods We created three mutually-exclusive occupational categories for participants aged ≥25 years: Managerial/Professional and Non-Physical and Physical Service/Blue Collar. We examined currently employed survivors (N=4845) and siblings (N=1727) in multivariable generalized linear models to evaluate the likelihood of being in the three occupational categories. Among all participants, we used multinomial logistic regression to examine the likelihood of these outcomes in comparison to being unemployed (survivors N=6671; siblings N=2129). Multivariable linear models were used to assess survivor occupational differences by cancer and treatment variables. Personal income was compared by occupation. Results Employed survivors were less often in higher skilled Managerial/Professional occupations (Relative Risk=0.93, 95% Confidence Interval 0.89–0.98) than siblings. Survivors who were Black, were diagnosed at a younger age, or had high-dose cranial radiation were less likely to hold Professional occupations than other survivors. In multinomial models, female survivors’ likelihood of being in full-time Professional occupations (27%) was lower than male survivors (42%) and female (41%) and male (50%) siblings. Survivors’ personal income was lower than siblings within each of the three occupational categories in models adjusted for sociodemographic variables. Conclusions Adult childhood cancer survivors are employed in lower skill jobs than siblings. Survivors with certain treatment histories are at higher risk and may require vocational assistance throughout adulthood. PMID:21246530

A possible dose-response association between distance to farmers' markets and roadside produce stands, frequency of shopping, fruit and vegetable consumption, and body mass index among customers in the Southern United States.

PubMed

Jilcott Pitts, Stephanie B; Hinkley, Jedediah; Wu, Qiang; McGuirt, Jared T; Lyonnais, Mary Jane; Rafferty, Ann P; Whitt, Olivia R; Winterbauer, Nancy; Phillips, Lisa

2017-01-11

The association between farmers' market characteristics and consumer shopping habits remains unclear. Our objective was to examine associations among distance to farmers' markets, amenities within farmers' markets, frequency of farmers' market shopping, fruit and vegetable consumption, and body mass index (BMI). We hypothesized that the relationship between frequency of farmers' market shopping and BMI would be mediated by fruit and vegetable consumption. In 15 farmers' markets in northeastern North Carolina, July-September 2015, we conducted a cross-sectional survey among 263 farmers' market customers (199 provided complete address data) and conducted farmers' market audits. To participate, customers had to be over 18 years of age, and English speaking. Dependent variables included farmers' market shopping frequency, fruit and vegetable consumption, and BMI. Analysis of variance, adjusted multinomial logistic regression, Poisson regression, and linear regression models, adjusted for age, race, sex, and education, were used to examine associations between distance to farmers' markets, amenities within farmers' markets, frequency of farmers' market shopping, fruit and vegetable consumption, and BMI. Those who reported shopping at farmers' markets a few times per year or less reported consuming 4.4 (standard deviation = 1.7) daily servings of fruits and vegetables, and those who reported shopping 2 or more times per week reported consuming 5.5 (2.2) daily servings. There was no association between farmers' market amenities, and shopping frequency or fruit and vegetable consumption. Those who shopped 2 or more times per week had a statistically significantly lower BMI than those who shopped less frequently. There was no evidence of mediation of the relationship between frequency of shopping and BMI by fruit and vegetable consumption. More work should be done to understand factors within farmers' markets that encourage fruit and vegetable purchases.

Guideline appraisal with AGREE II: Systematic review of the current evidence on how users handle the 2 overall assessments.

PubMed

Hoffmann-Eßer, Wiebke; Siering, Ulrich; Neugebauer, Edmund A M; Brockhaus, Anne Catharina; Lampert, Ulrike; Eikermann, Michaela

2017-01-01

The Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument is the most commonly used guideline appraisal tool. It includes 23 appraisal criteria (items) organized within 6 domains and 2 overall assessments (1. overall guideline quality; 2. recommendation for use). The aim of this systematic review was twofold. Firstly, to investigate how often AGREE II users conduct the 2 overall assessments. Secondly, to investigate the influence of the 6 domain scores on each of the 2 overall assessments. A systematic bibliographic search was conducted for publications reporting guideline appraisals with AGREE II. The impact of the 6 domain scores on the overall assessment of guideline quality was examined using a multiple linear regression model. Their impact on the recommendation for use (possible answers: "yes", "yes, with modifications", "no") was examined using a multinomial regression model. 118 relevant publications including 1453 guidelines were identified. 77.1% of the publications reported results for at least one overall assessment, but only 32.2% reported results for both overall assessments. The results of the regression analyses showed a statistically significant influence of all domains on overall guideline quality, with Domain 3 (rigour of development) having the strongest influence. For the recommendation for use, the results showed a significant influence of Domains 3 to 5 ("yes" vs. "no") and Domains 3 and 5 ("yes, with modifications" vs. "no"). The 2 overall assessments of AGREE II are underreported by guideline assessors. Domains 3 and 5 have the strongest influence on the results of the 2 overall assessments, while the other domains have a varying influence. Within a normative approach, our findings could be used as guidance for weighting individual domains in AGREE II to make the overall assessments more objective. Alternatively, a stronger content analysis of the individual domains could clarify their importance in terms of guideline quality. Moreover, AGREE II should require users to transparently present how they conducted the assessments.

Functional and Mental Health Outcomes of the Joint Effects of Spousal Health: The Potential Threats of "Concordant Frailty".

PubMed

Lu, Wan-Hsuan; Chiou, Shu-Ti; Chen, Liang-Kung; Hsiao, Fei-Yuan

2016-04-01

Existing studies have indicated that caring for a person with disabilities in a family could result in strong adverse impacts on the health of his or her spouse. However, little is known about the potential joint burden and interactive patterns in a family when both spouses are in poor health. The objective of this study was to evaluate the impacts of self and spousal health statuses on the physical and mental health outcomes of older people in Taiwan. Retrospective observational study. The Social Environment and Biomarkers of Aging Study (SEBAS), Taiwan. Data of 1123 study participants from the SEBAS were retrieved for analysis and all participants were divided into 4 groups based on their self-rated and spousal health status: good self-good spousal health (GG), good self-poor spousal health (GP), poor self-good spousal health (PG), and poor self-poor spousal health (PP). Multinomial logistic regression models were used to evaluate the associations of the different health statuses of couples to disabilities of physical function, daily activity disabilities (activities of daily living, or ADLs, and instrumental activities of daily living, or IADLs) and depressive symptoms. Subgroup analyses were conducted for middle-aged (aged 53 to 64) and older (aged 65 and older) adults to examine whether the impacts of spousal health statuses on the physical and mental health outcomes increased with age. The adjusted multinomial logistic regressions showed that people in the PP group were at the highest risk for difficulties in physical function, daily activities, and depressive symptoms. This association was more significant in the elderly population than the middle-aged group. Elderly PP couples were associated with a 7-fold increase in risk of acquiring a disability of physical function (adjusted odds ratio [aOR] 7.5, 95% confidence interval [CI] 2.4-23.6, P < .01), an 8-fold increase in risk of an IADL disability (aOR 8.5, 95% CI 4.1-17.5, P < .01), a 47-fold increase in risk of an ADL disability (aOR 47.3, 95% CI 5.8-387.7, P < .01), and a 10-fold increase in risk of depressive symptoms (aOR 10.6, 95% CI 4.8-23.4, P < .01), compared with the elderly GG groups. This is the first study to demonstrate that when both people in a couple have poor health status, it is a significant risk factor regarding difficulties in physical activities, daily activity disabilities, and depressive symptoms. This effect was particularly stronger in elderly couples compared with middle-aged couples. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

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.

New software for cervical vertebral geometry assessment and its relationship to skeletal maturation—a pilot study

PubMed Central

Cunha, A R; Júnior, G C; Fernandes, N; Campos, M J S; Costa, L F M; Vitral, R W F; Bolognese, A M

2014-01-01

Objectives: In the present study, we developed new software for quantitative analysis of cervical vertebrae maturation, and we evaluated its applicability through a multinomial logistic regression model (MLRM). Methods: Digitized images of the bodies of the second (C2), third (C3) and fourth (C4) cervical vertebrae were analysed in cephalometric radiographs of 236 subjects (116 boys and 120 girls) by using a software developed for digitized vertebrae analysis. The sample was initially distributed into 11 categories according to the Fishman's skeletal maturity indicators and were then grouped into four stages for quantitative cervical maturational changes (QCMC) analysis (QCMC I, II, III and IV). Seven variables of interest were measured and analysed to identify morphologic alterations of the vertebral bodies in each QCMC category. Results: Statistically significant differences (p < 0.05) were observed among all QCMC categories for the variables analysed. The MLRM used to calculate the probability that an individual belonged to each of the four cervical vertebrae maturation categories was constructed by taking into account gender, chronological age and four variables determined by digitized vertebrae analysis (Ang_C3, MP_C3, MP_C4 and SP_C4). The MLRM presented a predictability of 81.4%. The weighted κ test showed almost perfect agreement (κ = 0.832) between the categories defined initially by the method of Fishman and those allocated by the MLRM. Conclusions: Significant alterations in the morphologies of the C2, C3 and C4 vertebral bodies that were analysed through the digitized vertebrae analysis software occur during the different stages of skeletal maturation. The model that combines the four parameters measured on the vertebral bodies, the age and the gender showed an excellent prediction. PMID:24319125

Interlaboratory Evaluation of a Multiplexed High Information Content In Vitro Genotoxicity Assay

PubMed Central

Bryce, Steven M.; Bernacki, Derek T.; Bemis, Jeffrey C.; Spellman, Richard A.; Engel, Maria E.; Schuler, Maik; Lorge, Elisabeth; Heikkinen, Pekka T.; Hemmann, Ulrike; Thybaud, Véronique; Wilde, Sabrina; Queisser, Nina; Sutter, Andreas; Zeller, Andreas; Guérard, Melanie; Kirkland, David; Dertinger, Stephen D.

2017-01-01

We previously described a multiplexed in vitro genotoxicity assay based on flow cytometric analysis of detergent-liberated nuclei that are simultaneously stained with propidium iodide and labeled with fluorescent antibodies against p53, γH2AX, and phospho-histone H3. Inclusion of a known number of microspheres provides absolute nuclei counts. The work described herein was undertaken to evaluate the interlaboratory transferability of this assay, commercially known as MultiFlow™ DNA Damage Kit— p53, γH2AX, Phospho-histone H3. For these experiments seven laboratories studied reference chemicals from a group of 84 representing clastogens, aneugens, and non-genotoxicants. TK6 cells were exposed to chemicals in 96-well plates over a range of concentrations for 24 hrs. At 4 and 24 hrs cell aliquots were added to the MultiFlow reagent mix and following a brief incubation period flow cytometric analysis occurred, in most cases directly from a 96-well plate via a robotic walk-away data acquisition system. Multiplexed response data were evaluated using two analysis approaches, one based on global evaluation factors (i.e., cutoff values derived from all inter-laboratory data), and a second based on multinomial logistic regression that considers multiple biomarkers simultaneously. Both data analysis strategies were devised to categorize chemicals as predominately exhibiting a clastogenic, aneugenic, or non-genotoxic mode of action (MoA). Based on the aggregate 231 experiments that were performed, assay sensitivity, specificity, and concordance in relation to a priori MoA grouping were ≥ 92%. These results are encouraging as they suggest that two distinct data analysis strategies can rapidly and reliably predict new chemicals’ predominant genotoxic MoA based on data from an efficient and transferable multiplexed in vitro assay. PMID:28370322

New software for cervical vertebral geometry assessment and its relationship to skeletal maturation--a pilot study.

PubMed

Santiago, R C; Cunha, A R; Júnior, G C; Fernandes, N; Campos, M J S; Costa, L F M; Vitral, R W F; Bolognese, A M

2014-01-01

In the present study, we developed new software for quantitative analysis of cervical vertebrae maturation, and we evaluated its applicability through a multinomial logistic regression model (MLRM). Digitized images of the bodies of the second (C2), third (C3) and fourth (C4) cervical vertebrae were analysed in cephalometric radiographs of 236 subjects (116 boys and 120 girls) by using a software developed for digitized vertebrae analysis. The sample was initially distributed into 11 categories according to the Fishman's skeletal maturity indicators and were then grouped into four stages for quantitative cervical maturational changes (QCMC) analysis (QCMC I, II, III and IV). Seven variables of interest were measured and analysed to identify morphologic alterations of the vertebral bodies in each QCMC category. Statistically significant differences (p < 0.05) were observed among all QCMC categories for the variables analysed. The MLRM used to calculate the probability that an individual belonged to each of the four cervical vertebrae maturation categories was constructed by taking into account gender, chronological age and four variables determined by digitized vertebrae analysis (Ang_C3, MP_C3, MP_C4 and SP_C4). The MLRM presented a predictability of 81.4%. The weighted κ test showed almost perfect agreement (κ = 0.832) between the categories defined initially by the method of Fishman and those allocated by the MLRM. Significant alterations in the morphologies of the C2, C3 and C4 vertebral bodies that were analysed through the digitized vertebrae analysis software occur during the different stages of skeletal maturation. The model that combines the four parameters measured on the vertebral bodies, the age and the gender showed an excellent prediction.

Neighborhood Structural Inequality, Collective Efficacy, and Sexual Risk Behavior among Urban Youth

PubMed Central

BROWNING, CHRISTOPHER R.; BURRINGTON, LORI A.; LEVENTHAL, TAMA; BROOKS-GUNN, JEANNE

2011-01-01

We draw on collective efficacy theory to extend a contextual model of early adolescent sexual behavior. Specifically, we hypothesize that neighborhood structural disadvantage—as measured by levels of concentrated poverty, residential instability, and aspects of immigrant concentration—and diminished collective efficacy have consequences for the prevalence of early adolescent multiple sexual partnering. Findings from random effects multinomial logistic regression models of the number of sexual partners among a sample of youth, age 11 to 16, from the Project on Human Development in Chicago Neighborhoods (N = 768) reveal evidence of neighborhood effects on adolescent higher-risk sexual activity. Collective efficacy is negatively associated with having two or more sexual partners versus one (but not zero versus one) sexual partner. The effect of collective efficacy is dependent upon age: The regulatory effect of collective efficacy increases for older adolescents. PMID:18771063

Suicidal ideation and attempts in adolescents: associations with depression and six domains of self-esteem.

PubMed

Wild, Lauren G; Flisher, Alan J; Lombard, Carl

2004-12-01

This study aimed to disentangle the influence of depression and self-esteem on suicidal behaviour in adolescence. Grades 8 and 11 students in Cape Town, South Africa (n = 939) completed questionnaires assessing suicidal ideation and behaviour, depression, and self-esteem with respect to family, peers, school, sports/athletics, body image and global self-worth. Data were analysed using a series of multinomial logistic regression models adjusted for gender, grade, race and the sampling strategy. Results indicated that depression and low self-esteem in the family context were independently associated with suicide ideation and attempts. Moreover, low family self-esteem significantly differentiated suicide attempters from ideators. Screening for depression and low self-esteem in the family context is discussed as a possible strategy for helping to identify adolescents at risk for suicide attempts.

Classification of independent components of EEG into multiple artifact classes.

PubMed

Frølich, Laura; Andersen, Tobias S; Mørup, Morten

2015-01-01

In this study, we aim to automatically identify multiple artifact types in EEG. We used multinomial regression to classify independent components of EEG data, selecting from 65 spatial, spectral, and temporal features of independent components using forward selection. The classifier identified neural and five nonneural types of components. Between subjects within studies, high classification performances were obtained. Between studies, however, classification was more difficult. For neural versus nonneural classifications, performance was on par with previous results obtained by others. We found that automatic separation of multiple artifact classes is possible with a small feature set. Our method can reduce manual workload and allow for the selective removal of artifact classes. Identifying artifacts during EEG recording may be used to instruct subjects to refrain from activity causing them. Copyright © 2014 Society for Psychophysiological Research.

The impact of childhood experiences and family members outside the household on residential environment choices.

PubMed

Blaauboer, Marjolein

2011-01-01

Choices of urban, suburban or rural residential environments have often been studied from a life-course perspective. In this paper, an examination is made of the influence of childhood experiences and of residential environment choices of family members outside the household. It is argued that socialisation, location-specific capital and the wish to maintain close family ties may result in living in a similar residential environment later in life and in similar environments to siblings and parents. Results of multinomial logistic regression analyses of data from the Netherlands Kinship Panel Study show that the residential environment during childhood is indeed strongly associated with the current residential environment. Moreover, individuals show a strong similarity to their parents and siblings in their residential environment, even after accounting for residential inertia and return migration.

Town-Level Characteristics and Smoking Policy Adoption in Massachusetts: Are Local Restaurant Smoking Regulations Fostering Disparities in Health Protection?

PubMed Central

Skeer, Margie; George, Sarah; Hamilton, William L.; Cheng, Debbie M.; Siegel, Michael

2004-01-01

Objectives. We identified and quantified differences in sociodemographic characteristics of communities relative to the strength of local restaurant smoking regulations in Massachusetts. Methods. We examined the relationship between the strength of the 351 local restaurant smoking regulations in Massachusetts and a number of town-level characteristics, using a multinomial logistic regression model. Results. Characteristics important to the adoption of stronger restaurant smoking regulations included higher education and per capita income, geographic region, voter support for a state cigarette tax initiative, board of health funding to promote clean indoor air policymaking, and the presence of a bordering town with a strong regulation. Conclusions. The current pattern of smoke-free restaurant policy enactment fosters socioeconomic and geographic disparities in health protection, undermining an important national health goal. PMID:14759944

Configurations of Adolescents' Peer Experiences: Associations With Parent-Child Relationship Quality and Parental Problem Behavior.

PubMed

Kretschmer, Tina; Sentse, Miranda; Meeus, Wim; Verhulst, Frank C; Veenstra, René; Oldehinkel, Albertine J

2016-09-01

Adolescents' peer experiences embrace behavior, relationship quality, status, and victimization, but studies that account for multiple dimensions are rare. Using latent profile modeling and measures of peer behavior, relationship quality, peer status, and victimization assessed from 1,677 adolescents, four profiles were identified: High Quality, Low Quality, Low Quality Victimized, and Deviant Peers. Multinomial logistic regressions showed that negative parent-child relationships in preadolescence reduced the likelihood of High Quality peer relations in mid-adolescence but only partly differentiated between the other three profiles. Moderation by gender was partly found with girls showing greater sensitivity to parent-child relationship quality with respect to peer experiences. Results underline the multifaceted nature of peer experiences, and practical and theoretical implications are discussed. © 2015 The Authors. Journal of Research on Adolescence © 2015 Society for Research on Adolescence.

Parameter Estimation for the Dirichlet-Multinomial Distribution Using Supplementary Beta-Binomial Data.

DTIC Science & Technology

1987-07-01

multinomial distribution as a magazine exposure model. J. of Marketing Research . 21, 100-106. Lehmann, E.L. (1983). Theory of Point Estimation. John Wiley and... Marketing Research . 21, 89-99. V I flWflW WflW~WWMWSS tWN ,rw fl rwwrwwr-w~ w-. ~. - - -- .~ 𔃾 4’.) ~a 4’ ., 𔃾. ’-4. .4.: .4~ I .4. ~J3iAf a,’ -a’ 4

Spatial distribution of the risk of dengue fever in southeast Brazil, 2006-2007

PubMed Central

2011-01-01

Background Many factors have been associated with circulation of the dengue fever virus and vector, although the dynamics of transmission are not yet fully understood. The aim of this work is to estimate the spatial distribution of the risk of dengue fever in an area of continuous dengue occurrence. Methods This is a spatial population-based case-control study that analyzed 538 cases and 727 controls in one district of the municipality of Campinas, São Paulo, Brazil, from 2006-2007, considering socio-demographic, ecological, case severity, and household infestation variables. Information was collected by in-home interviews and inspection of living conditions in and around the homes studied. Cases were classified as mild or severe according to clinical data, and they were compared with controls through a multinomial logistic model. A generalized additive model was used in order to include space in a non-parametric fashion with cubic smoothing splines. Results Variables associated with increased incidence of all dengue cases in the multiple binomial regression model were: higher larval density (odds ratio (OR) = 2.3 (95%CI: 2.0-2.7)), reports of mosquito bites during the day (OR = 1.8 (95%CI: 1.4-2.4)), the practice of water storage at home (OR = 2.5 (95%CI: 1.4, 4.3)), low frequency of garbage collection (OR = 2.6 (95%CI: 1.6-4.5)) and lack of basic sanitation (OR = 2.9 (95%CI: 1.8-4.9)). Staying at home during the day was protective against the disease (OR = 0.5 (95%CI: 0.3-0.6)). When cases were analyzed by categories (mild and severe) in the multinomial model, age and number of breeding sites more than 10 were significant only for the occurrence of severe cases (OR = 0.97, (95%CI: 0.96-0.99) and OR = 2.1 (95%CI: 1.2-3.5), respectively. Spatial distribution of risks of mild and severe dengue fever differed from each other in the 2006/2007 epidemic, in the study area. Conclusions Age and presence of more than 10 breeding sites were significant only for severe cases. Other predictors of mild and severe cases were similar in the multiple models. The analyses of multinomial models and spatial distribution maps of dengue fever probabilities suggest an area-specific epidemic with varying clinical and demographic characteristics. PMID:21599980

Predictors of the number of under-five malnourished children in Bangladesh: application of the generalized poisson regression model

PubMed Central

2013-01-01

Background Malnutrition is one of the principal causes of child mortality in developing countries including Bangladesh. According to our knowledge, most of the available studies, that addressed the issue of malnutrition among under-five children, considered the categorical (dichotomous/polychotomous) outcome variables and applied logistic regression (binary/multinomial) to find their predictors. In this study malnutrition variable (i.e. outcome) is defined as the number of under-five malnourished children in a family, which is a non-negative count variable. The purposes of the study are (i) to demonstrate the applicability of the generalized Poisson regression (GPR) model as an alternative of other statistical methods and (ii) to find some predictors of this outcome variable. Methods The data is extracted from the Bangladesh Demographic and Health Survey (BDHS) 2007. Briefly, this survey employs a nationally representative sample which is based on a two-stage stratified sample of households. A total of 4,460 under-five children is analysed using various statistical techniques namely Chi-square test and GPR model. Results The GPR model (as compared to the standard Poisson regression and negative Binomial regression) is found to be justified to study the above-mentioned outcome variable because of its under-dispersion (variance < mean) property. Our study also identify several significant predictors of the outcome variable namely mother’s education, father’s education, wealth index, sanitation status, source of drinking water, and total number of children ever born to a woman. Conclusions Consistencies of our findings in light of many other studies suggest that the GPR model is an ideal alternative of other statistical models to analyse the number of under-five malnourished children in a family. Strategies based on significant predictors may improve the nutritional status of children in Bangladesh. PMID:23297699

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…

Modeling of orthotropic plate fracture under impact load using various strength criteria

NASA Astrophysics Data System (ADS)

Radchenko, Andrey; Krivosheina, Marina; Kobenko, Sergei; Radchenko, Pavel; Grebenyuk, Grigory

2017-01-01

The paper presents the comparative analysis of various tensor multinomial criteria of strength for modeling of orthotropic organic plastic plate fracture under impact load. Ashkenazi, Hoffman and Wu strength criteria were used. They allowed fracture modeling of orthotropic materials with various compressive and tensile strength properties. The modeling of organic plastic fracture was performed numerically within the impact velocity range of 700-1500 m/s.

Willingness to Exchange Health Information via Mobile Devices: Findings From a Population-Based Survey

PubMed Central

Serrano, Katrina J.; Yu, Mandi; Riley, William T.; Patel, Vaishali; Hughes, Penelope; Marchesini, Kathryn; Atienza, Audie A.

2016-01-01

PURPOSE The rapid proliferation of mobile devices offers unprecedented opportunities for patients and health care professionals to exchange health information electronically, but little is known about patients’ willingness to exchange various types of health information using these devices. We examined willingness to exchange different types of health information via mobile devices, and assessed whether sociodemographic characteristics and trust in clinicians were associated with willingness in a nationally representative sample. METHODS We analyzed data for 3,165 patients captured in the 2013 Health Information National Trends Survey. Multinomial logistic regression analysis was conducted to test differences in willingness. Ordinal logistic regression analysis assessed correlates of willingness to exchange 9 types of information separately. RESULTS Participants were very willing to exchange appointment reminders (odds ratio [OR] = 6.66; 95% CI, 5.68–7.81), general health tips (OR = 2.03; 95% CI, 1.74–2.38), medication reminders (OR = 2.73; 95% CI, 2.35–3.19), laboratory/test results (OR = 1.76; 95% CI, 1.62–1.92), vital signs (OR = 1.63; 95% CI, 1.48–1.80), lifestyle behaviors (OR = 1.40; 95% CI, 1.24–1.58), and symptoms (OR = 1.62; 95% CI, 1.46–1.79) as compared with diagnostic information. Older adults had lower odds of being more willing to exchange any type of information. Education, income, and trust in health care professional information correlated with willingness to exchange certain types of information. CONCLUSIONS Respondents were less willing to exchange via mobile devices information that may be considered sensitive or complex. Age, socioeconomic factors, and trust in professional information were associated with willingness to engage in mobile health information exchange. Both information type and demographic group should be considered when developing and tailoring mobile technologies for patient-clinician communication. PMID:26755781

Behavioral Risk Profiles of Homeschooled Adolescents in the United States: A Nationally Representative Examination of Substance Use Related Outcomes

PubMed Central

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

2016-01-01

Background The homeschool population continues to grow in size and now accounts for 3.4% of all students in the United States. Objective Given the heterogeneous nature of the population, this study examines the relationship between different types of homeschoolers and a number of substance use related outcomes. Methods To conduct this study, we used pooled data (2002–2013) from the National Survey on Drug Use and Health (NSDUH). Respondents aged 12–17 who reported they had been homeschooled at any time during the previous 12 months were classified as homeschoolers (N = 1,321). Latent profile analysis (LPA) was conducted to identify latent subgroups of homeschoolers and multinomial regression was executed to assess the relationship between the subgroups and perceived substance use risk, availability, and past 12-month use. Results The LPA yielded four subgroups, which were summarized as (1) highly religious and engaged, (2) limited parental monitoring, (3) high parental warmth and support, and (4) secular permissive. Of these, the highly religious and engaged subgroup was the least likely to report using substances. Conclusion The results underscore the variation that exists among homeschoolers and the importance of examining the relationship between different types of homeschoolers and outcomes of interest. PMID:27759472

Risk Factors for Recent Intimate Partner Violence among Methamphetamine-Using Men and Women

PubMed Central

Hayashi, Hitomi D.; Patterson, Thomas L.; Semple, Shirley J.; Fujimoto, Kayo; Stockman, Jamila K.

2016-01-01

The Substance Abuse, Violence, and HIV/AIDS (SAVA) syndemic model describes how the confluence of the three epidemics of substance abuse, violence, and HIV risk work synergistically to create excess burden among populations. We sought to identify risk factors associated with recent intimate partner violence (IPV) victimization among heterosexual methamphetamine (meth)-using men (n = 108) and women (n = 122) enrolled in FASTLANE-II, an HIV behavioral intervention in San Diego, CA. Women and men reported high rates of physical-only (women: 20%; men: 18%) and sexual (women: 25%; men: 23%) IPV. Multinomial regression analysis revealed that individuals who reported lower social support and individuals who reported a greater likelihood of engaging in risky sexual behaviors while high on meth were more likely to report IPV versus no IPV. Women who reported a greater likelihood of engaging in risky sexual behaviors while high on meth were 1.58 times more likely to report physical-only IPV versus no IPV, while men who reported similar behaviors were 1.15 times more likely to report physical-only IPV versus no IPV. Our findings highlight the influence of interpersonal factors on IPV. This research supports further study on gender-specific risk/protective factors and the development of gender-specific interventions targeting the SAVA syndemic among meth users. PMID:27163712

Cognitive-Affective Correlates of Suicide Ideation and Attempt: Mindfulness is Negatively Associated with Suicide Attempt History but Not State Suicidality.

PubMed

Chesin, Megan; Cascardi, Michele

2018-06-11

To test whether three cognitive-affective correlates, mindfulness, emotion reactivity, and depressive symptom severity, have different associations with current suicidal ideation (SI), a history of suicide attempt (SA) and SA+SI among emerging adults. To test whether impulsive-aggression (IA) moderates associations between cognitive-affective correlates of suicidal behavior and suicidality. Survey data on current SI, SA history, mindfulness, emotion reactivity, depressive symptom severity, and IA were collected from 780 emerging adults. Results from multinomial logistic regression analysis showed greater depressive symptom severity among emerging adults with current SI, regardless of SA history. Those with a history of SA reported greater depressive symptom severity and less mindfulness than controls. IA did not moderate relationships of SI and/or SA and mindfulness, emotion reactivity, or depressive symptom severity. Mindfulness is a marker of SA, and depressive symptom severity is associated with current SI and SA history in emerging adults. IA does not moderate these associations. To the extent that a history of SA is indicative of elevated trait-like suicide risk and SI indicates state suicidality, our findings suggest that mindfulness protects against longer-term vulnerability to SA while depressive symptom severity increases with increasing suicide state-trait risk.

The Association Between Electronic Bullying and School Absenteeism Among High School Students in the United States.

PubMed

Grinshteyn, Erin; Yang, Y T

2017-02-01

We examined the relationship between exposure to electronic bullying and absenteeism as a result of being afraid. 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 in the last month due to feeling unsafe at/in transit to school. The model controlled for other predictors of school absence including demographics, physical/behavioral health, and risk factors. Missing data were multiply imputed. Electronic bullying was significantly associated with absences. Controlling for model covariates, the relative risk of missing 1 day of school was 1.77 times higher, the relative risk of missing 2 to 3 days of school per month increased by a factor of 2.08, and the relative risk of missing 4 or more days of school per month increased by a factor of 1.77 for those who experienced electronic bullying in the past year compared with those who were not electronically bullied. Electronic bullying's association with absenteeism places it among already recognized negative influences such as depression and binge drinking, necessitating schools to implement policies to mediate the resulting harmful effects. © 2017, American School Health Association.

Young doctors' preferences for payment systems: the influence of gender and personality traits.

PubMed

Abelsen, Birgit; Olsen, Jan Abel

2015-08-19

Activity-based payment contracts are common among doctors, but to what extent are they preferred? The aim of this paper is to elicit young doctors' preferences for alternative payment systems before they have adapted to an existing system. We examine the existence of gender differences and the extent to which personality traits determine preferences. A cross-sectional survey of all final-year medical students and all interns in Norway examined the extent to which preferences for different payment systems depend on gender and personality traits. Data analysis relied on one-way ANOVA and multinomial logistic regression. The current activity-based payment systems were the least preferred, both in hospitals (16.6%) and in general practice (19.7%). The contrasting alternative "fixed salary" achieved similar relative support. Approximately half preferred the hybrid alternative. When certainty associated with a payment system increased, its appeal rose for women and individuals who are less prestige-oriented, risk-tolerant or effort-tolerant. Activity-based systems were preferred among status- and income-oriented respondents. The vast majority of young doctors prefer payment systems that are less activity-based than the current contracts offered in the Norwegian health service. Recruitment and retention in less prestigious medical specialities might improve if young doctors could choose payment systems corresponding with their diverse preferences.

Role-players in abortion decision-making in the Accra Metropolis, Ghana.

PubMed

Kumi-Kyereme, Akwasi; Gbagbo, Fred Yao; Amo-Adjei, Joshua

2014-09-16

Making the final decision to terminate a pregnancy can be influenced by different circumstances involving various individuals. This paper describes the key players involved in the decision-making process regarding abortions among women who elected to undergo an induced abortion in a cosmopolitan urban setting in Ghana. A retrospective cross-sectional mixed method study was conducted between January and December 2011. A total of 401 women with records in abortion logbooks were selected for an interviewer-administered questionnaire and an in-depth interview. Descriptive and multinomial logistic regression analyses were used to assess the quantitative data, and a thematic analysis was applied to the qualitative data. The findings of the study reveal that pregnant individuals, mothers of abortion-seekers, male partners, and "Others" (for example, friends, employers) were instrumental in making a decision to terminate unplanned/unwanted pregnancies. Several key factors influenced the decision-making processes, including aversion from the men responsible for the pregnancy, concerns about abnormalities/deformities in future births due to unprofessionally conducted abortions, and economic considerations. A number of individuals, such as friends, mothers, and male partners, influence the decision-making process regarding abortion among the participants of the study. Various targeted messages are needed for the various participants in the decision.

Immigrant children's reliance on public health insurance in the wake of immigration reform.

PubMed

Pati, Susmita; Danagoulian, Shooshan

2008-11-01

We sought to determine whether the reversal of the public charge rule of the Illegal Immigration Reform and Immigrant Responsibility Act, which may have required families to pay for benefits previously received at no cost, led to immigrant children becoming increasingly reliant on public health insurance programs. We conducted a secondary data analysis focusing on low-income children sampled in the 1997 through 2004 versions of the National Health Interview Survey. Between 1997 and 2004, public health insurance enrollments and the numbers of uninsured foreign-born children in the United States increased by 3.1% and 2.7%, respectively. Using multinomial logistic regression models to account for the substantial differences in socioeconomic status between foreign-born and US-born children, we found that low-income US-born children were just as likely as foreign-born children to have public health insurance coverage (odds ratio [OR] = 1.16; 95% confidence interval [CI] = 0.89, 1.52) and that, after 2000, foreign-born children were 1.59 times (95% CI = 1.24, 2.05) more likely than were US-born children to be uninsured (vs publicly insured). In the wake of the reversal of the public charge rule, immigrant children are increasingly likely to be uninsured as opposed to relying on public health insurance.

Associations between poor sleep quality and stages of change of multiple health behaviors among participants of employee wellness program

PubMed Central

Hui, Siu-kuen Azor; Grandner, Michael A.

2015-01-01

Objective Using the Transtheoretical Model of behavioral change, this study evaluates the relationship between sleep quality and the motivation and maintenance processes of healthy behavior change. Methods The current study is an analysis of data collected in 2008 from an online health risk assessment (HRA) survey completed by participants of the Kansas State employee wellness program (N = 13,322). Using multinomial logistic regression, associations between self-reported sleep quality and stages of change (i.e. precontemplation, contemplation, preparation, action, maintenance) in five health behaviors (stress management, weight management, physical activities, alcohol use, and smoking) were analyzed. Results Adjusted for covariates, poor sleep quality was associated with an increased likelihood of contemplation, preparation, and in some cases action stage when engaging in the health behavior change process, but generally a lower likelihood of maintenance of the healthy behavior. Conclusions The present study demonstrated that poor sleep quality was associated with an elevated likelihood of contemplating or initiating behavior change, but a decreased likelihood of maintaining healthy behavior change. It is important to include sleep improvement as one of the lifestyle management interventions offered in EWP to comprehensively reduce health risks and promote the health of a large employee population. PMID:26046013

Clustering of risk factors for noncommunicable diseases in Brazilian adolescents: prevalence and correlates.

PubMed

Cureau, Felipe Vogt; Duarte, Paola; dos Santos, Daniela Lopes; Reichert, Felipe Fossati

2014-07-01

Few studies have investigated the prevalence and correlates of risk factors for noncommunicable diseases among Brazilian adolescents. We evaluated the clustering of risk factors and their associations with sociodemographic variables. We used a cross-sectional study carried out in 2011 comprising 1132 students aged 14-19 years from Santa Maria, Brazil. The cluster index was created as the sum of the risk factors. For the correlates analysis, a multinomial logistic regression was used. Furthermore, the observed/expected ratio was calculated. Prevalence of individual risk factors studied was as follows: 85.8% unhealthy diets, 53.5% physical inactivity, 31.3% elevated blood pressure, 23.9% overweight, 22.3% excessive drinking alcohol, and 8.6% smoking. Only 2.8% of the adolescents did not present any risk factor, while 21.7%, 40.9%, 23.1%, and 11.5% presented 1, 2, 3, and 4 or more risk factors, respectively. The most prevalent combination was between unhealthy diets and physical inactivity (observed/expected ratio =1.32; 95% CI: 1.16-1.49). Clustering of risk factors was directly associated with age and inversely associated with socioeconomic status. Clustering of risk factors for noncommunicable diseases is high in Brazilian adolescents. Preventive strategies are more likely to be successful if focusing on multiple risk factors, instead of a single one.

Individual, Social, and Environmental Correlates of Active Transportation Patterns in French Women.

PubMed

Perchoux, Camille; Enaux, Christophe; Oppert, Jean-Michel; Menai, Mehdi; Charreire, Hélène; Salze, Paul; Weber, Christiane; Hercberg, Serge; Feuillet, Thierry; Hess, Franck; Roda, Célina; Simon, Chantal; Nazare, Julie-Anne

2017-01-01

The objectives were (1) to define physical activity (PA) and sedentary behaviors (SB) patterns in daily life contexts (work, leisure, and transportation) in French working women from NutriNet-Santé web-cohort and (2) to identify pattern(s) of active transportation and their individual, social, and environmental correlates. 23,432 participants completed two questionnaires to evaluate PA and SB in daily life contexts and individual representations of residential neighborhood and transportation modes. Hierarchical cluster analysis was performed which identified 6 distinct movement behavior patterns: (i) active occupation, high sedentary leisure, (ii) sedentary occupation, low leisure, (iii) sedentary transportation, (iv) sedentary occupation and leisure, (v) active transportation, and (vi) active leisure. Multinomial logistic regressions were performed to identify correlates of the "active transportation" cluster. The perceived environmental characteristics positively associated with "active transportation" included "high availability of destinations around home," "presence of bicycle paths," and "low traffic." A "positive image of walking/cycling," the "individual feeling of being physically active," and a "high use of active transport modes by relatives/friends" were positively related to "active transportation," identified as a unique pattern regarding individual and environmental correlates. Identification of PA and SB context-specific patterns will help to understand movement behaviors' complexity and to design interventions to promote active transportation in specific subgroups.

Problematic Internet use, well-being, self-esteem and self-control: Data from a high-school survey in China.

PubMed

Mei, Songli; Yau, Yvonne H C; Chai, Jingxin; Guo, Jinhua; Potenza, Marc N

2016-10-01

Given the prevalence of Internet use among youth, there is concern that a subset of Internet-using youth may exhibit problematic or addictive patterns of Internet use. The present study examines the association between problematic Internet use (PIU), demographic variables, and health-related measures among Chinese adolescents. Survey data from 1552 adolescents (male=653, mean age=15.43years) from Jilin Province, China, were collected. According to the Young Diagnostic Questionnaire for Internet Addiction (YDQ), 77.8% (n=1207), 16.8% (n=260), and 5.5% (n=85) showed adaptive, maladaptive, and problematic Internet use, respectively. Multinomial logistic regression analysis revealed that gender and family income per month differed between youth showing problematic and adaptive patterns of Internet use. Well-being, self-esteem, and self-control were related to severity of problematic Internet use, with greater severity typically associated with poorer measures in each domain. The findings that severity of problematic Internet use is associated with specific socio-demographic features and temperamental and well-being measures suggest that specific groups of youth may be particularly vulnerable to developing problematic Internet use. Early prevention/intervention programs targeting at-risk groups may help improve public health. Copyright © 2016 Elsevier Ltd. All rights reserved.

US Household Food Shopping Patterns: Dynamic Shifts Since 2000 And Socioeconomic Predictors.

PubMed

Stern, Dalia; Robinson, Whitney R; Ng, Shu Wen; Gordon-Larsen, Penny; Popkin, Barry M

2015-11-01

Under the assumption that differential food access might underlie nutritional disparities, programs and policies have focused on the need to build supermarkets in underserved areas, in an effort to improve dietary quality. However, there is limited evidence about which types of stores are used by households of different income levels and differing races/ethnicities. We used cross-sectional cluster analysis to derive shopping patterns from US households' volume food purchases by store from 2000 to 2012. Multinomial logistic regression identified household socioeconomic characteristics that were associated with shopping patterns in 2012. We found three food shopping patterns or clusters: households that primarily shopped at grocery stores, households that primarily shopped at mass merchandisers, and a combination cluster in which households split their purchases among multiple store types. In 2012 we found no income or race/ethnicity differences for the cluster of households that primarily shopped at grocery stores. However, low-income non-Hispanic blacks (versus non-Hispanic whites) had a significantly lower probability of belonging to the mass merchandise cluster. These varied shopping patterns must be considered in future policy initiatives. Furthermore, it is important to continue studying the complex rationales for people's food shopping patterns. Project HOPE—The People-to-People Health Foundation, Inc.

Insular pathways to health care in the city: a multilevel analysis of access to hospital care in urban Kerala, India.

PubMed

Levesque, Jean-Frédéric; Haddad, Slim; Narayana, Delampady; Fournier, Pierre

2007-07-01

To identify individual and urban unit characteristics associated with access to inpatient care in public and private sectors in urban Kerala, and to discuss policy implications of inequalities in access. We analysed the NSSO survey (1995-1996) for urban Kerala with regard to source and trajectories of hospitalization. Multinomial multilevel regression models were built for 695 cases nested in 24 urban units. Private sector accounts for 62% of hospitalizations. Only 31% of hospitalizations are in free wards and 20% of public hospitalizations involve payment. Hospitalization pathways suggest a segmentation of public and private health markets. Members of poor and casual worker households have lower propensity of hospitalization in paying public wards or private hospitals. There were important variations between cities, with higher odds of private hospitalization in towns with fewer hospital beds overall and in districts with high private-public bed ratios. Cities from districts with better economic indicators and dominance of private services have higher proportion of private hospitalizations. The private sector is the predominant source of inpatient care in urban Kerala. The public sector has an important role in providing access to care for the poor. Investing in the quality of public services is essential to ensure equity in access.

Biomass fuel use for household cooking in Swaziland: is there an association with anaemia and stunting in children aged 6-36 months?

PubMed

Machisa, Mercilene; Wichmann, Janine; Nyasulu, Peter S

2013-09-01

This study is the second to investigate the association between the use of biomass fuels (BMF) for household cooking and anaemia and stunting in children. Such fuels include coal, charcoal, wood, dung and crop residues. Data from the 2006-2007 Swaziland Demographic and Health Survey (a cross-sectional study design) were analysed. Childhood stunting was ascertained through age and height, and anaemia through haemoglobin measurement. The association between BMF use and health outcomes was determined in multinomial logistic regression analyses. Various confounders were considered in the analyses. A total of 1150 children aged 6-36 months were included in the statistical analyses, of these 596 (51.8%) and 317 (27.6%) were anaemic and stunted, respectively. BMF use was not significantly associated with childhood anaemia in univariate analysis. Independent risk factors for childhood anaemia were child's age, history of childhood diarrhoea and mother's anaemia status. No statistically significant association was observed between BMF use and childhood stunting, after adjusting for child's gender, age, birth weight and preceding birth interval. This study identified the need to prioritize childhood anaemia and stunting as health outcomes and the introduction of public health interventions in Swaziland. Further research is needed globally on the potential effects of BMF use on childhood anaemia and stunting.

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.

Relational stressors as predictors for repeat aggressive and self-harming incidents in child and adolescent psychiatric inpatient settings.

PubMed

Ulke, Christine; Klein, Annette M; von Klitzing, Kai

2014-01-01

This study examined whether relational stressors such as psychosocial stressors, the therapist's absence and a change of therapist are associated with repeat aggressive or self-harming incidents in child and adolescent psychiatric inpatient care. The study data were derived from critical incident reports and chart reviews of 107 inpatients. In multinomial regression analysis, patients with repeat aggressive or self-harming incidents were compared with patients with single incidents. Results suggested that a higher number of psychosocial stressors and a change of therapist, but not the therapist's absence are predictors for repeat aggressive and self-harming incidents. There was a high prevalence of therapist's absence during both, single and repeat, incidents. Repeat aggressive incidents were common in male children and adolescents with disruptive behavior disorders. Repeat self-harming incidents were common in adolescent females with trauma-related disorders. Patients with repeat aggressive or self-harming incidents had a higher number of abnormal intrafamilial relationships and acute life events than patients with single incidents. Interventions to reduce a change of therapist should in particular target children and adolescents with a higher number of psychosocial stressors and/or a known history of traumatic relational experiences. After a first incident, patients should have a psychosocial assessment to evaluate whether additional relational support is needed.

Assessing DSM-5 latent subtypes of acute stress disorder dissociative or intrusive?

PubMed

Armour, Cherie; Hansen, Maj

2015-02-28

Acute Stress Disorder (ASD) was first included in the DSM-IV in 1994. It was proposed to account for traumatic responding in the early post trauma phase and to act as an identifier for later Posttraumatic Stress Disorder (PTSD). Unlike PTSD it included a number of dissociative indicators. The revised DSM-5 PTSD criterion included a dissociative-PTSD subtype. The current study assessed if a dissociative-ASD subtype may be present for DSM-5 ASD. Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in symptomatic compared to a baseline ASD profile. We used data from 450 bank robbery victims. Latent profile analysis (LPA) was used to uncover latent profiles of ASD. Multinomial logistic regression was used to determine if female gender, age, social support, peritraumatic panic, somatization, and number of trauma exposures increased or decreased the probability of profile membership. Four latent profiles were uncovered and included an intrusion rather than dissociative subtype. Increased age and social support decreased the probability of individuals being grouped into the intrusion subtype whereas increased peritraumatic panic and somatization increased the probability of individuals being grouped into the intrusion subtype. Findings are discussed in regard to the ICD-11 and the DSM-5. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Variations in Social Network Type Membership Among Older African Americans, Caribbean Blacks, and Non-Hispanic Whites

PubMed Central

2017-01-01

Abstract Objectives: This study examined race differences in the probability of belonging to a specific social network typology of family, friends, and church members. Method: Samples of African Americans, Caribbean blacks, and non-Hispanic whites aged 55+ were drawn from the National Survey of American Life. Typology indicators related to social integration and negative interactions with family, friendship, and church networks were used. Latent class analysis was used to identify typologies, and latent class multinomial logistic regression was used to assess the influence of race, and interactions between race and age, and race and education on typology membership. Results: Four network typologies were identified: optimal (high social integration, low negative interaction), family-centered (high social integration within primarily the extended family network, low negative interaction), strained (low social integration, high negative interaction), and ambivalent (high social integration and high negative interaction). Findings for race and age and race and education interactions indicated that the effects of education and age on typology membership varied by race. Discussion: Overall, the findings demonstrate how race interacts with age and education to influence the probability of belonging to particular network types. A better understanding of the influence of race, education, and age on social network typologies will inform future research and theoretical developments in this area. PMID:28329871

Religiosity profiles of American youth in relation to substance use, violence, and delinquency.

PubMed

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

2012-12-01

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 the relationships between latent religiosity classes and substance use, violence, and delinquency. Results revealed a five class solution. Classes were identified as religiously disengaged (10.76 %), religiously infrequent (23.59 %), privately religious (6.55 %), religious regulars (40.85 %), and religiously devoted (18.25 %). Membership in the religiously devoted class was associated with the decreased likelihood of participation in a variety of substance use behaviors as well as decreases in the likelihood of fighting and theft. To a lesser extent, membership in the religious regulars class was also associated with the decreased likelihood of substance use and fighting. However, membership in the religiously infrequent and privately religious classes was only associated with the decreased likelihood of marijuana use. Findings suggest that private religiosity alone does not serve to buffer youth effectively against involvement in problem behavior, but rather that it is the combination of intrinsic and extrinsic adolescent religiosity factors that is associated with participation in fewer problem behaviors.

Motor fitness and preschooler children obesity status.

PubMed

Silva-Santos, Sandra; Santos, Amanda; Vale, Susana; Mota, Jorge

2017-09-01

The aim of this study was to examine the association between motor fitness (MF) and obesity status in preschool children. The sample comprised 467 children aged 3-6 years. Preschool children body mass index was classified according to International Obesity Task Force and categorised into three levels, normal, overweight and obesity. Total physical activity was assessed by accelerometer and MF test was assessed through two MF tests 10 × 5m shuttle run test (SRT) and a 7 m jumping distance on 2 feet test (J2F). Low MF was considered for MF if SD above 1. A single variable with three categories was created: low MF medium MF and high MF. The prevalence of normal weight, overweight and obesity was 67.6%, 22.7% and 9.7%, respectively. The prevalence of SD > 1 for SRT was 13.7% and 14.4% for J2F, for single variable was 19.2%. Multinomial logistic regression analysis showed that obese preschoolers were more likely six times classified as having low MF level than their non-overweight counterparts (OR: 6.4; IC: 1.3-36.6). This study showed a considerable prevalence of overweight and obesity among preschoolers. Obesity has already been associated with lower MF. Further longitudinal studies are needed to confirm this data.

Association of sugary foods and drinks consumption with behavioral risk and oral health status of 12- and 15-year-old Indian school children.

PubMed

Asawa, Kailash; Sen, Nandini; Bhat, Nagesh; Tak, Mridula; Sultane, Pratibha; Patil, Vishal

2018-01-01

This study aims to assess the association of sugary foods and drinks consumption with behavioral risk and oral health status of 12- and 15-year-old government school children in Udaipur. A descriptive cross-sectional study was conducted among of 12- and 15-year-old government schoolchildren of Udaipur. A survey pro forma designed based on HBSC (Health behaviour in School-aged Children) study protocol and WHO Oral Health Assessment Form for Children (2013) was used. Chi-Square test, Independent Sample t -test, and Multinomial Logistic Regression analysis were used with 95% confidence interval and 5% significance level. Out of 710 participants, 455 (64.1%) were males and 255 females (35.9%). Majority of 15 years age (57.3%) consumed more soft drinks than 12-year-old. Males showed a comparatively greater tendency to have sugar sweetened products than females. The decayed, missing, and filled teeth (dmft) and DMFT scores were relatively higher for subjects who consumed sugary substances more than once/day than who had less than once/day. Gingivitis was associated with high sugar diet. Sugary foods and drinks consumption is significantly associated with behavioral habits of children and is a clear behavioral risk for oral health.

Socioeconomic Gradients in Different Types of Tobacco Use in India: Evidence from Global Adult Tobacco Survey 2009-10.

PubMed

Singh, Ankur; Arora, Monika; English, Dallas R; Mathur, Manu R

2015-01-01

Socioeconomic differences in tobacco use have been reported, but there is a lack of evidence on how they vary according to types of tobacco use. This study explored socioeconomic differences associated with cigarette, bidi, smokeless tobacco (SLT), and dual use (smoking and smokeless tobacco use) in India and tested whether these differences vary by gender and residential area. Secondary analysis of Global Adult Tobacco Survey (GATS) 2009-10 (n = 69,296) was conducted. The primary outcomes were self-reported cigarette, bidi smoking, SLT, and dual use. The main explanatory variables were wealth, education, and occupation. Associations were assessed using multinomial logistic regressions. 69,030 adults participated in the study. Positive association was observed between wealth and prevalence of cigarette smoking while inverse associations were observed for bidi smoking, SLT, and dual use after adjustment for potential confounders. Inverse associations with education were observed for all four types after adjusting for confounders. Significant interactions were observed for gender and area in the association between cigarette, bidi, and smokeless tobacco use with wealth and education. The probability of cigarette smoking was higher for wealthier individuals while the probability of bidi smoking, smokeless tobacco use, and dual use was higher for those with lesser wealth and education.

Immigrant Children's Reliance on Public Health Insurance in the Wake of Immigration Reform

PubMed Central

Danagoulian, Shooshan

2008-01-01

Objectives. We sought to determine whether the reversal of the public charge rule of the Illegal Immigration Reform and Immigrant Responsibility Act, which may have required families to pay for benefits previously received at no cost, led to immigrant children becoming increasingly reliant on public health insurance programs. Methods. We conducted a secondary data analysis focusing on low-income children sampled in the 1997 through 2004 versions of the National Health Interview Survey. Results. Between 1997 and 2004, public health insurance enrollments and the numbers of uninsured foreign-born children in the United States increased by 3.1% and 2.7%, respectively. Using multinomial logistic regression models to account for the substantial differences in socioeconomic status between foreign-born and US-born children, we found that low-income US-born children were just as likely as foreign-born children to have public health insurance coverage (odds ratio [OR] = 1.16; 95% confidence interval [CI] = 0.89, 1.52) and that, after 2000, foreign-born children were 1.59 times (95% CI = 1.24, 2.05) more likely than were US-born children to be uninsured (vs publicly insured). Conclusions. In the wake of the reversal of the public charge rule, immigrant children are increasingly likely to be uninsured as opposed to relying on public health insurance. PMID:18799772

The Choice of Screening Instrument Matters: The Case of Problematic Cannabis Use Screening in Spanish Population of Adolescents

PubMed Central

Domingo-Salvany, Antónia; Barrio Anta, Gregorio; Sánchez Mañez, Amparo; Llorens Aleixandre, Noelia; Brime Beteta, Begoña; Vicente, Julián

2013-01-01

The aim of this study was to examine the feasibility of problem cannabis use screening instruments administration within wide school surveys, their psychometric properties, overlaps, and relationships with other variables. Students from 7 Spanish regions, aged 14–18, who attended secondary schools were sampled by two-stage cluster sampling (net sample 14,589). Standardized, anonymous questionnaire including DSM-IV cannabis abuse criteria, Cannabis Abuse Screening Test (CAST), and Severity of Dependence Scale (SDS) was self-completed with paper and pencil in the selected classrooms. Data was analysed using classical psychometric theory, bivariate tests, and multinomial logistic regression analysis. Not responding to instruments' items (10.5–12.3%) was associated with reporting less frequent cannabis use. The instruments overlapped partially, with 16.1% of positives being positive on all three. SDS was more likely to identify younger users with lower frequency of use who thought habitual cannabis use posed a considerable problem. CAST positivity was associated with frequent cannabis use and related problems. It is feasible to use short psychometric scales in wide school surveys, but one must carefully choose the screening instrument, as different instruments identify different groups of users. These may correspond to different types of problematic cannabis use; however, measurement bias seems to play a role too. PMID:25969832

A longitudinal examination of offending and specialization among a sample of Massachusetts domestic violence offenders.

PubMed

Richards, Tara N; Jennings, Wesley G; Tomsich, Elizabeth A; Gover, Angela R

2013-02-01

A paucity of existing research focuses on longitudinal examinations of criminal trajectories among reoffenses committed by domestic violence offenders. Specifically, few studies have longitudinally assessed whether domestic violence offenders specialize, recidivating in domestic violence assault, or generalize, committing a range of personal and property crimes. Acknowledging these research deficiencies, the current study uses longitudinal data from a cohort of 317 batterers who were processed in a domestic violence court to investigate the trajectories of domestic violence arrests and nondomestic violence arrests over a 10-year period. The degree of overlap between domestic and nondomestic violence arrest trajectory groups is examined through a cross-tabulation and chi-square analysis. Logistic and multinomial regression models are applied to identify risk factors that distinguish trajectory groups. A PROC TRAJ procedure identifies two trajectory groups for domestic violence arrests (low and high rate) and three trajectory groups for nondomestic violence arrests (very low, low, and high rate). Results indicate that specialization among domestic violence offenders is rare-prior alcohol and drug crimes predict membership in the high-rate domestic violence arrest trajectory group and prior domestic violence arrests predict membership in both the low-rate and high-rate nondomestic violence arrest trajectories. Implications for future research and policy are discussed in this article.

Occupational risks for voice disorders: Evidence from a Korea national cross-sectional survey.

PubMed

Byeon, Haewon

2017-04-01

This study aims to analyze the relationship between occupation and voice disorders using a national cross-sectional survey that represents the Korean population. Subjects were 5,407 members of the non-institutionalized population aged 19-59 (2,258 men, 3,149 women) who completed the laryngeal examination of the Korea National Health and Nutrition Examination Survey 2010-2012. Voice disorders were surveyed by classifying laryngeal pathologies and self-reported voice problems. Occupations were classified into 'managers & professionals', 'clerical support workers', 'service & sales workers', 'skilled agricultural & forestry & fishery workers', 'craft & plant and machine operators and assemblers', and 'unskilled laborers', based on the sixth Korean Standard Classification of Occupations. The results of the multinomial logistic regression analysis indicated that managers & professionals were 1.4 times (OR 1.42, 95% CI 1.01-2.01) more likely to have self-reported voice problems, and service & sales workers were 1.6 times (OR 1.62, 95% CI 1.14-2.30) more likely to have self-reported voice problems than economically inactive people (P < 0.05). Still, there was no significant association between the presence of laryngeal pathology and profession. Managers & professionals and service & sales workers may have a higher risk of voice problems than the economically inactive.

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.

Correlates of prediabetes and type II diabetes in US South Asians: findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study.

PubMed

Shah, Arti D; Vittinghoff, Eric; Kandula, Namratha R; Srivastava, Shweta; Kanaya, Alka M

2015-02-01

In this study, we aim to elucidate the role of sociodemographic, lifestyle, and cultural factors in prediabetes and diabetes in South Asian immigrants to the United States, a population at high risk of type II diabetes. We performed a cross-sectional analysis of a community-based cohort of 899 South Asians without known cardiovascular disease from the Mediators of Atherosclerosis in South Asians Living in America study. Glycemic status was determined by fasting glucose, 2-hour postchallenge glucose, and use of diabetes medication. We used multinomial logistic regression models to estimate the independent associations of sociodemographic, lifestyle, and cultural factors with prediabetes and diabetes, adjusting for confounders identified using directed acyclic graphs. Approximately 33% of participants had prediabetes and 25% had diabetes. In multivariate analyses, an independent correlate of prediabetes was low exercise. Additional covariates associated with diabetes included lower family income, less education, high chronic psychological burden score, and greater time spent watching television; and fasting monthly or annually was inversely associated with diabetes prevalence. We found several modifiable risk factors associated with prediabetes and diabetes that may help guide diabetes prevention interventions for South Asian immigrants to the United States. Copyright © 2015 Elsevier Inc. All rights reserved.

Multidimensional Patterns of Sexual Risk Behavior and Psychiatric Disorders in Men with Substance Use Disorders.

PubMed

Villalobos-Gallegos, Luis; Medina-Mora, María Elena; Benjet, Corina; Ruiz-Velasco, Silvia; Magis-Rodriguez, Carlos; Marín-Navarrete, Rodrigo

2018-05-29

Previous evidence links substance use disorders (SUD) to STI/HIV risk and suggests that comorbid psychiatric disorders increase the probability to engage in sexual risk behaviors. This study had two aims: (1) to identify subgroups based on sexual risk behavior using a person-centered approach in a sample of substance users and (2) to measure the association of psychiatric and SUD with subgroup membership. We assessed 402 male adults with SUD, reporting sexual intercourse in the previous 12 months using the HIV-Risk Behavior Scale and the Mini International Neuropsychiatric Interview. Latent class analysis was performed to determine multidimensional patterns of sexual risk behaviors and multinomial logistic regression was utilized to associate classes with disorders. The three-class model showed the best fit, and the classes were labeled: Relationship-Based (31.34% of the sample), Condom-Based (39.55%), and Multiple Risks (29.10%). Controlling for age and marital status, major depressive disorders, antisocial personality disorder, and any psychiatric disorder were associated with the Multiple Risks class. Results stress the importance of developing a personalized assessment and counseling for sexual risk behaviors in individuals with SUD, particularly when they endorse criteria for comorbid psychiatric disorders. Future studies should focus on evaluating differential response to preventive interventions.

The amount of television that infants and their parents watched influenced children's viewing habits when they got older.

PubMed

Chiu, Yu-Chan; Li, Yi-Fan; Wu, Wen-Chi; Chiang, Tung-Liang

2017-06-01

Excessive television (TV) exposure has negative impacts on a child's development, health and behaviour. This study examined the under-researched area of what impact infant and parental TV viewing during a child's infancy had on the child's later viewing habits. Data on 18 577 babies born in 2005 were collected from the Taiwan Birth Cohort Study, a prospective longitudinal study of a nationally representative cohort. Group-based trajectory analysis was conducted to identify childhood TV viewing trajectories at 18, 36 and 66 months of age. Multinomial logistic regression was used to examine the influence of parents' TV behaviour on their children's TV viewing trajectories. The percentage of children falling into the TV viewing trajectories that were identified were low (20%), increasing (46.5%) and high (33.5%). The child's TV viewing trajectory was significantly associated with the child's sex, parent's monthly household income, child's day care arrangements, maternal and paternal education, maternal and paternal TV viewing time and whether the child's TV viewing time was restricted. The amount of TV that children watched when they were older was associated with a range of factors, and the results particularly highlight the need to restrict child and parental viewing time in infancy. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Role of neutrophil to lymphocyte and monocyte to lymphocyte ratios in the diagnosis of bacterial infection in patients with fever.

PubMed

Naess, Are; Nilssen, Siri Saervold; Mo, Reidun; Eide, Geir Egil; Sjursen, Haakon

2017-06-01

To study the role of the neutrophil:lymphocyte ratio (NLR) and monocyte:lymphocyte ratio (MLR) in discriminating between different patient groups hospitalized for fever due to infection and those without infection. For 299 patients admitted to hospital for fever with unknown cause, a number of characteristics including NLR and MLR were recorded. These characteristics were used in a multiple multinomial regression analysis to estimate the probability of a final diagnostic group of bacterial, viral, clinically confirmed, or no infection. Both NLR and MLR significantly predicted final diagnostic group. Being highly correlated, however, both variables could not be retained in the same model. Both variables also interacted significantly with duration of fever. Generally, higher values of NLR and MLR indicated larger probabilities for bacterial infection and low probabilities for viral infection. Patients with septicemia had significantly higher NLR compared to patients with other bacterial infections with fever for less than one week. White blood cell counts, neutrophil counts, and C-reactive proteins did not differ significantly between septicemia and the other bacterial infection groups. NLR is a more useful diagnostic tool to identify patients with septicemia than other more commonly used diagnostic blood tests. NLR and MLR may be useful in the diagnosis of bacterial infection among patients hospitalized for fever.

Types of Adolescent Male Dating Violence Against Women, Self-Esteem, and Justification of Dominance and Aggression.

PubMed

Diaz-Aguado, Maria Jose; Martinez, Rosario

2015-09-01

The recognition of the seriousness of intimate partner violence (IPV) and the need to prevent it has led to the study of its inception in relationships established in adolescence. This study uses latent class analysis to establish a typology of male adolescents based on self-reports of violence against a girl in dating relationships. The participants were 4,147 boys in Spain aged 14 to 18 years from a probabilistic sample. Four discrete, identifiable groups were derived based on 12 indicators of emotional abuse, intimidation, coercion, threats, physical violence, and violence transmitted via communication technologies. The first group consists of non-violent adolescent boys. A second group comprises those boys who isolate and control their partners. Boys who exert only medium-level emotional abuse form the third group, whereas the fourth is formed by teenage boys who frequently engage in all types of violence. Compared with the non-violent adolescents in a multinomial logistic regression, the other groups show lower self-esteem and display a greater justification of male dominance and IPV against women; greater justification of aggression in conflict resolution; they have also received more dominance and violence messages from adults in their family environment; and they perceive IPV behaviors against women as abuse of lesser importance. © The Author(s) 2014.

The Role of Personality and Subjective Exposure Experiences in Posttraumatic Stress Disorder and Depression Symptoms among Children Following Wenchuan Earthquake.

PubMed

Chen, Xiacan; Xu, Jiajun; Li, Bin; Li, Na; Guo, Wanjun; Ran, Mao-Sheng; Zhang, Jun; Yang, Yanchun; Hu, Junmei

2017-12-08

This study aims to investigate the role of personality traits and subjective exposure experiences in posttraumatic stress disorder and depression symptoms. In Qingchuan, 21,652 children aged 7 to 15 years were assessed using face-to-face interviews one year after the Wenchuan earthquake in China. The Junior Eysenck Personality Questionnaire, a modified earthquake exposure scale, the UCLA Posttraumatic Stress Disorder Reaction Index (adolescent), and the Adolescent Depression Inventory were used to assess personality characteristics, trauma experiences, posttraumatic stress disorder and depression symptoms, respectively. The measurement was completed with 20,749 children. After adjusting for other factors by multinomial logistic regression analysis, neuroticism, having felt unable to escape from the disaster and having been trapped for a longer time were risk factors of posttraumatic stress disorder and depression symptoms. Socialization was a protective factor of them. Having felt extreme panic or fear was a risk factor of posttraumatic stress disorder symptoms. For depression symptoms, introversion and psychoticism were risk factors, and extraversion was a protective factor. This study was conducted with the largest representative sample of child survivors of a natural, devastating disaster in a developing country. These results could be useful for planning psychological intervention strategies for children and for influencing further research.

[The social vulnerability index regarding Medellín's disabled population].

PubMed

Cardona-Arango, Doris; Agudelo-Martínez, Alejandra; Restrepo-Molina, Lucas; Segura-Cardona, Angela M

2014-01-01

Constructing a social vulnerability index (SVI) for Medellín's disabled population during 2008 aimed at determining areas which were reducing opportunities for this population to use their tangible and intangible assets, thus impairing their quality of life. This descriptive cross-sectional study drew on a source of secondary information regarding people having some kind of limitation recorded in the Quality of Life Survey, 2008. Physical, human and social variables were grouped when constructing the SVI; the models were run in principal component analysis to determine their degree of vulnerability, defined by the number of negative factors identified (high category=4 or 5, medium=2 or 3 and low=1 or none). Such classification led to identifying non-causal relationships with demographic variables through Mann-Whitney, Chi-square and Kruskal-Wallis tests (5.0 % statistical significance level); multinomial logistic regression was used for calculating adjusted measures for epidemiological measurement, such as opportunity ratios and confidence intervals. A degree of medium vulnerability predominated in disabled people living in Medellín (60.3 %) followed by low vulnerability (28.7 %) and high vulnerability populations (11.0 %). The proposed ISV classified the city's communes according to high, medium or low vulnerability, supported by the use of statistical and spatial location techniques.

Nailfold capillaroscopy in systemic sclerosis: data from the EULAR scleroderma trials and research (EUSTAR) database.

PubMed

Ingegnoli, Francesca; Ardoino, Ilaria; Boracchi, Patrizia; Cutolo, Maurizio

2013-09-01

The aims of this study were to obtain cross-sectional data on capillaroscopy in an international multi-center cohort of Systemic Sclerosis (SSc) and to investigate the frequency of the capillaroscopic patterns and their disease-phenotype associations. Data collected between June 2004 and October 2011 in the EULAR Scleroderma Trials and Research (EUSTAR) registry were examined. Patients' profiles based on clinical and laboratory data were obtained by cluster analysis and the association between profiles and capillaroscopy was investigated by multinomial logistic regression. 62 of the 110 EUSTAR centers entered data on capillaroscopy in the EUSTAR database. 376 of the 2754 patients (13.65%) were classified as scleroderma pattern absent, but non-specific capillary abnormalities were noted in 55.48% of the cases. Four major patients' profiles were identified characterized by a progressive severity for skin involvement, as well as an increased number of systemic manifestations. The "early" and "active" scleroderma patterns were generally observed in patients with mild/moderate skin involvement and a low number of disease manifestations, while the "late" scleroderma pattern was found more frequently in the more severe forms of the disease. These data indicate the importance of capillaroscopy in SSc management and that capillaroscopic patterns are directly related to the extent of organ involvement. Copyright © 2013 Elsevier Inc. All rights reserved.

Access to continued-use medication among older adults, Brazil

PubMed Central

Viana, Karynna Pimentel; Brito, Alexandre dos Santos; Rodrigues, Claudia Soares; Luiz, Ronir Raggio

2015-01-01

OBJECTIVE To determine the prevalence and associated access factors for all continued-use prescription drugs and the ways in which they can be obtained. METHODS Data was obtained from the 2008 Household National Survey. The sample comprised 27,333 individuals above 60 years who reported that they used continued-use prescription drugs. A descriptive analysis and binary and multiple multinomial logistic regressions were performed. RESULTS 86.0% of the older adults had access to all the medication they needed, and among them, 50.7% purchased said medication. Those who obtained medication from the public health system were younger (60-64 years), did not have health insurance plans, and belonged to the lower income groups. It is remarkable that 14.0% of the subjects still had no access to any continued-use medication, and for those with more than four chronic diseases, this amount reached 22.0%. Those with a greater number of chronic diseases ran a higher risk of not having access to all the medication they needed. CONCLUSIONS There are some groups of older adults with an increased risk of not obtaining all the medication they need and of purchasing it. The results of this study are expected to contribute to guide programs and plans for access to medication in Brazil. PMID:25741646