Younger age, female sex, and high number of awakenings and arousals predict fatigue in patients with sleep disorders: a retrospective polysomnographic observational study

PubMed Central

Veauthier, Christian

2013-01-01

Background The Fatigue Severity Scale (FSS) is widely used to assess fatigue, not only in the context of multiple sclerosis-related fatigue, but also in many other medical conditions. Some polysomnographic studies have shown high FSS values in sleep-disordered patients without multiple sclerosis. The Modified Fatigue Impact Scale (MFIS) has increasingly been used in order to assess fatigue, but polysomnographic data investigating sleep-disordered patients are thus far unavailable. Moreover, the pathophysiological link between sleep architecture and fatigue measured with the MFIS and the FSS has not been previously investigated. Methods This was a retrospective observational study (n = 410) with subgroups classified according to sleep diagnosis. The statistical analysis included nonparametric correlation between questionnaire results and polysomnographic data, age and sex, and univariate and multiple logistic regression. Results The multiple logistic regression showed a significant relationship between FSS/MFIS values and younger age and female sex. Moreover, there was a significant relationship between FSS values and number of arousals and between MFIS values and number of awakenings. Conclusion Younger age, female sex, and high number of awakenings and arousals are predictive of fatigue in sleep-disordered patients. Further investigations are needed to find the pathophysiological explanation for these relationships. PMID:24109185

Risk of multiple myeloma following medication use and medical conditions: a case-control study in Connecticut women.

PubMed

Landgren, Ola; Zhang, Yawei; Zahm, Sheila Hoar; Inskip, Peter; Zheng, Tongzhang; Baris, Dalsu

2006-12-01

Certain commonly used drugs and medical conditions characterized by chronic immune dysfunction and/or antigen stimulation have been suggested to affect important pathways in multiple myeloma tumor cell growth and survival. We conducted a population-based case-control study to investigate the role of medical history in the etiology of multiple myeloma among Connecticut women. A total of 179 incident multiple myeloma cases (21-84 years, diagnosed 1996-2002) and 691 population-based controls was included in this study. Information on medical conditions, medications, and medical radiation was obtained by in-person interviews. We calculated odds ratios (OR) as measures of relative risks using logistic regression models. A reduced multiple myeloma risk was found among women who had used antilipid statin therapy [OR, 0.4; 95% confidence interval (95% CI), 0.2-0.8] or estrogen replacement therapy (OR, 0.6; 95% CI, 0.4-0.99) or who had a medical history of allergy (OR, 0.4; 95% CI, 0.3-0.7), scarlet fever (OR, 0.5; 95% CI, 0.2-0.9), or bursitis (OR, 0.4; 95% CI, 0.2-0.7). An increased risk of multiple myeloma was found among women who used prednisone (OR, 5.1; 95% CI, 1.8-14.4), insulin (OR, 3.1; 95% CI, 1.1-9.0), or gout medication (OR, 6.7; 95% CI, 1.2-38.0). If our results are confirmed, mechanistic studies examining how prior use of insulin, prednisone, and, perhaps, gout medication might promote increased occurrence of multiple myeloma and how antilipid statins, estrogen replacement therapy, and certain medical conditions might protect against multiple myeloma may provide insights to the as yet unknown etiology of multiple myeloma.

Factors associated with preventable infant death: a multiple logistic regression

PubMed Central

Vidal e Silva, Sandra Maria Cunha; Tuon, Rogério Antonio; Probst, Livia Fernandes; Gondinho, Brunna Verna Castro; Pereira, Antonio Carlos; Meneghim, Marcelo de Castro; Cortellazzi, Karine Laura; Ambrosano, Glaucia Maria Bovi

2018-01-01

ABSTRACT OBJECTIVE To identify and analyze factors associated with preventable child deaths. METHODS This analytical cross-sectional study had preventable child mortality as dependent variable. From a population of 34,284 live births, we have selected a systematic sample of 4,402 children who did not die compared to 272 children who died from preventable causes during the period studied. The independent variables were analyzed in four hierarchical blocks: sociodemographic factors, the characteristics of the mother, prenatal and delivery care, and health conditions of the patient and neonatal care. We performed a descriptive statistical analysis and estimated multiple hierarchical logistic regression models. RESULTS Approximatelly 35.3% of the deaths could have been prevented with the early diagnosis and treatment of diseases during pregnancy and 26.8% of them could have been prevented with better care conditions for pregnant women. CONCLUSIONS The following characteristics of the mother are determinant for the higher mortality of children before the first year of life: living in neighborhoods with an average family income lower than four minimum wages, being aged ≤ 19 years, having one or more alive children, having a child with low APGAR level at the fifth minute of life, and having a child with low birth weight. PMID:29723389

Impact of clinical status and salivary conditions on xerostomia and oral health-related quality of life of adolescents with type 1 diabetes mellitus.

PubMed

Busato, Ivana Maria Saes; Ignácio, Sérgio Aparecido; Brancher, João Armando; Moysés, Simone Tetu; Azevedo-Alanis, Luciana Reis

2012-02-01

To investigate the influence of clinical status and salivary conditions on the presence of xerostomia on adolescents with and without type 1 diabetes mellitus (DM1), and further to investigate the influence of clinical status, salivary conditions and xerostomia on oral health-related quality of life (OHQoL) of those with DM1. A cross-sectional study was performed on 102 adolescents, 51 with DM1 and 51 nondiabetics. Xerostomia was detected by asking a question about the sensation of having 'dry mouth', and Oral Health Impact Profile-14 was used to measure the impact of xerostomia on OHQoL. The clinical status was assessed by using decayed, missing or filled and Community Periodontal indices, and by evaluating oral manifestations; and the following salivary conditions were evaluated: stimulated salivary flow, pH, buffer capacity, total protein, amylase, urea, calcium, and glucose salivary concentrations. Multiple logistic regression analysis was used to evaluate the influence of clinical status and salivary conditions on xerostomia and the impact of xerostomia on the OHQoL of adolescents with DM1. Clinical status and salivary conditions was shown to have no influence on the presence of xerostomia. Bivariate (P = 0.00) and logistic regression (P = 0.01) analysis showed a significant association between DM1 and xerostomia. Logistic regression analysis showed association between xerostomia (P = 0.00) and OHQoL, and caries experience (P = 0.03) and OHQoL. DM1 showed to be predictive of a high prevalence of xerostomia in adolescents. Caries experience and xerostomia showed to have a negative impact on the OHQoL of adolescents with DM1. © 2011 John Wiley & Sons A/S.

Logistic Stick-Breaking Process

PubMed Central

Ren, Lu; Du, Lan; Carin, Lawrence; Dunson, David B.

2013-01-01

A logistic stick-breaking process (LSBP) is proposed for non-parametric clustering of general spatially- or temporally-dependent data, imposing the belief that proximate data are more likely to be clustered together. The sticks in the LSBP are realized via multiple logistic regression functions, with shrinkage priors employed to favor contiguous and spatially localized segments. The LSBP is also extended for the simultaneous processing of multiple data sets, yielding a hierarchical logistic stick-breaking process (H-LSBP). The model parameters (atoms) within the H-LSBP are shared across the multiple learning tasks. Efficient variational Bayesian inference is derived, and comparisons are made to related techniques in the literature. Experimental analysis is performed for audio waveforms and images, and it is demonstrated that for segmentation applications the LSBP yields generally homogeneous segments with sharp boundaries. PMID:25258593

Vascular Surgery in the Pacific Theaters of World War II: The Persistence of Ligation Amid Unique Military Medical Conditions.

PubMed

Barr, Justin; Cherry, Kenneth J; Rich, Norman M

2018-06-18

: Although multiple sources chronicle the practice of vascular surgery in the North African, Mediterranean, and European theaters of World War II, that of the Pacific campaign remains undescribed. Relying on primary source documents from the war, this article provides the first discussion of the management of vascular injuries in the island-hopping battles of the Pacific. It explains how the particular military, logistic, and geographic conditions of this theater influenced medical and surgical care, prompting a continued emphasis on ligation when surgeons in Europe had already transitioned to repairing arteries.

Association between bullous pemphigoid and neurologic diseases: a case-control study.

PubMed

Casas-de-la-Asunción, E; Ruano-Ruiz, J; Rodríguez-Martín, A M; Vélez García-Nieto, A; Moreno-Giménez, J C

2014-11-01

In the past 10 years, bullous pemphigoid has been associated with other comorbidities and neurologic and psychiatric conditions in particular. Case series, small case-control studies, and large population-based studies in different Asian populations, mainland Europe, and the United Kingdom have confirmed this association. However, no data are available for the Spanish population. This was an observational, retrospective, case-control study with 1:2 matching. Fifty-four patients with bullous pemphigoid were selected. We compared the percentage of patients in each group with concurrent neurologic conditions, ischemic heart disease, diabetes, chronic obstructive pulmonary disease, and solid tumors using univariate logistic regression. An association model was constructed with conditional multiple logistic regression. The case group had a significantly higher percentage of patients with cerebrovascular accident and/or transient ischemic attack (odds ratio [OR], 3.06; 95% CI, 1.19-7.87], dementia (OR, 5.52; 95% CI, 2.19-13.93), and Parkinson disease (OR, 5; 95% CI, 1.57-15.94). A significantly higher percentage of cases had neurologic conditions (OR, 6.34; 95% CI, 2.89-13.91). Dementia and Parkinson disease were independently associated with bullous pemphigoid in the multivariate analysis. Patients with bullous pemphigoid have a higher frequency of neurologic conditions. Copyright © 2013 Elsevier España, S.L.U. and AEDV. All rights reserved.

Multiple mating and its relationship to brood size in pregnant fishes versus pregnant mammals and other viviparous vertebrates

PubMed Central

Avise, John C.; Liu, Jin-Xian

2011-01-01

We summarize the literature on rates of multiple paternity and sire numbers per clutch in viviparous fishes vs. mammals, two vertebrate groups in which pregnancy is common but entails very different numbers of embryos (for species surveyed, piscine broods averaged >10-fold larger than mammalian litters). As deduced from genetic parentage analyses, multiple mating by the pregnant sex proved to be common in assayed species but averaged significantly higher in fish than mammals. However, within either of these groups we found no significant correlations between brood size and genetically deduced incidence of multiple mating by females. Overall, these findings offer little support for the hypothesis that clutch size in pregnant species predicts the outcome of selection for multiple mating by brooders. Instead, whatever factors promote multiple mating by members of the gestating sex seem to do so in surprisingly similar ways in live-bearing vertebrates otherwise as different as fish and mammals. Similar conclusions emerged when we extended the survey to viviparous amphibians and reptiles. One notion consistent with these empirical observations is that although several fitness benefits probably accrue from multiple mating, logistical constraints on mate-encounter rates routinely truncate multiple mating far below levels that otherwise could be accommodated, especially in species with larger broods. We develop this concept into a “logistical constraint hypothesis” that may help to explain these mating outcomes in viviparous vertebrates. Under the logistical constraint hypothesis, propensities for multiple mating in each species register a balance between near-universal fitness benefits from multiple mating and species-idiosyncratic logistical limits on polygamy. PMID:21482777

The influence of demographics and working conditions on self-reported injuries among Latino day laborers

PubMed Central

Fernández-Esquer, Maria Eugenia; Fernández-Espada, Natalie; Atkinson, John A; Montano, Cecilia F

2015-01-01

Background: The majority of day laborers in the USA are Latinos. They are engaged in high-risk occupations and suffer high occupational injury rates. Objectives: To describe on-the-job injuries reported by Latino day laborers, explore the extent that demographic and occupational factors predict injuries, and whether summative measures for total job types, job conditions, and personal protective equipment (PPE) predict injuries. Methods: A community survey was conducted with 327 participants at 15 corners in Houston, Texas. Hierarchical and multiple logistic regressions explored predictors of occupational injury odds in the last year. Results: Thirty-four percent of respondents reported an occupational injury in the previous year. Education, exposure to loud noises, cold temperatures, vibrating machinery, use of hard hats, total number of job conditions, and total PPE significantly predicted injury odds. Conclusion: Risk for injury among day laborers is not only the product of a specific hazard, but also the result of their exposure to multiple occupational hazards. PMID:25291983

Trash-to-Gas: Converting Space Trash into Useful Products

NASA Technical Reports Server (NTRS)

Caraccio, Anne J.; Hintze, Paul E.

2013-01-01

NASA's Logistical Reduction and Repurposing (LRR) project is a collaborative effort in which NASA is determined to reduce total logistical mass through reduction, reuse and recycling of various wastes and components of long duration space missions and habitats. LRR is focusing on four distinct advanced areas of study: Advanced Clothing System, Logistics-to-Living, Heat Melt Compactor and Trash to Supply Gas (TtSG). The objective of TtSG is to develop technologies that convert material waste, human waste and food waste into high-value products. High-value products include life support oxygen and water, rocket fuels, raw material production feedstocks, and other energy sources. There are multiple pathways for converting waste to products involving single or multi-step processes. This paper discusses thermal oxidation methods of converting waste to methane. Different wastes, including food, food packaging, Maximum Absorbent Garments (MAGs), human waste simulants, and cotton washcloths have been evaluated in a thermal degradation reactor under conditions promoting pyrolysis, gasification or incineration. The goal was to evaluate the degradation processes at varying temperatures and ramp cycles and to maximize production of desirable products and minimize high molecular weight hydrocarbon (tar) production. Catalytic cracking was also evaluated to minimize tar production. The quantities of CO2, CO, CH4, and H2O were measured under the different thermal degradation conditions. The conversion efficiencies of these products were used to determine the best methods for producing desired products.

Trash to Gas: Converting Space Trash into Useful Products

NASA Technical Reports Server (NTRS)

Nur, Mononita

2013-01-01

NASA's Logistical Reduction and Repurposing (LRR) project is a collaborative effort in which NASA is determined to reduce total logistical mass through reduction, reuse and recycling of various wastes and components of long duration space missions and habitats. LRR is focusing on four distinct advanced areas of study: Advanced Clothing System, Logistics-to-Living, Heat Melt Compactor and Trash to Supply Gas (TtSG). The objective of TtSG is to develop technologies that convert material waste, human waste and food waste into high-value products. High-value products include life support oxygen and water, rocket fuels, raw material production feedstocks, and other energy sources. There are multiple pathways for converting waste to products involving single or multi-step processes. This paper discusses thermal oxidation methods of converting waste to methane. Different wastes, including food, food packaging, Maximum Absorbent Garments (MAGs), human waste simulants, and cotton washcloths have been evaluated in a thermal degradation reactor under conditions promoting pyrolysis, gasification or incineration. The goal was to evaluate the degradation processes at varying temperatures and ramp cycles and to maximize production of desirable products and minimize high molecular weight hydrocarbon (tar) production. Catalytic cracking was also evaluated to minimize tar production. The quantities of C02, CO, CH4, and H20 were measured under the different thermal degradation conditions. The conversion efficiencies of these products were used to determine the best methods for producing desired products.

Scenario and multiple criteria decision analysis for energy and environmental security of military and industrial installations.

PubMed

Karvetski, Christopher W; Lambert, James H; Linkov, Igor

2011-04-01

Military and industrial facilities need secure and reliable power generation. Grid outages can result in cascading infrastructure failures as well as security breaches and should be avoided. Adding redundancy and increasing reliability can require additional environmental, financial, logistical, and other considerations and resources. Uncertain scenarios consisting of emergent environmental conditions, regulatory changes, growth of regional energy demands, and other concerns result in further complications. Decisions on selecting energy alternatives are made on an ad hoc basis. The present work integrates scenario analysis and multiple criteria decision analysis (MCDA) to identify combinations of impactful emergent conditions and to perform a preliminary benefits analysis of energy and environmental security investments for industrial and military installations. Application of a traditional MCDA approach would require significant stakeholder elicitations under multiple uncertain scenarios. The approach proposed in this study develops and iteratively adjusts a scoring function for investment alternatives to find the scenarios with the most significant impacts on installation security. A robust prioritization of investment alternatives can be achieved by integrating stakeholder preferences and focusing modeling and decision-analytical tools on a few key emergent conditions and scenarios. The approach is described and demonstrated for a campus of several dozen interconnected industrial buildings within a major installation. Copyright © 2010 SETAC.

Multiple Chronic Conditions and Disparities in 30-Day Hospital Readmissions Among Nonelderly Adults.

PubMed

Basu, Jayasree; Hanchate, Amresh; Koroukian, Siran

2018-05-15

This study examines the patterns of 30-day hospital readmissions by race/ethnicity and multiple chronic conditions (MCC) burden among nonelderly adult patients. We used hospital discharge data of patients in the 18- to 64-year age group in 5 US states, California, Florida, Missouri, New York, and Tennessee, for 2009 from the Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) of the Agency for Healthcare Research and Quality, linked to contextual and provider data from the Health Resources and Services Administration. A multilevel logistic regression model was used for data pooled over 5 states, adjusting for patient, hospital, and community characteristics. Controlling for other covariates, the study found that a higher MCC burden was associated with a higher all-cause 30-day readmission risk. We found considerable heterogeneity in levels of readmission risk among racial/ethnic subgroups stratified by chronic conditions. Among patients with a lowest MCC burden, African Americans had the highest risk of readmission, but with a higher MCC burden, the risk of readmission increased most for Hispanics.

Depression and Chronic Health Conditions Among Latinos: The Role of Social Networks.

PubMed

Soto, Sandra; Arredondo, Elva M; Villodas, Miguel T; Elder, John P; Quintanar, Elena; Madanat, Hala

2016-12-01

The purpose of this study was to examine the "buffering hypothesis" of social network characteristics in the association between chronic conditions and depression among Latinos. Cross-sectional self-report data from the San Diego Prevention Research Center's community survey of Latinos were used (n = 393). Separate multiple logistic regression models tested the role of chronic conditions and social network characteristics in the likelihood of moderate-to-severe depressive symptoms. Having a greater proportion of the network comprised of friends increased the likelihood of depression among those with high cholesterol. Having a greater proportion of women in the social network was directly related to the increased likelihood of depression, regardless of the presence of chronic health conditions. Findings suggest that network characteristics may play a role in the link between chronic conditions and depression among Latinos. Future research should explore strategies targeting the social networks of Latinos to improve health outcomes.

Predictors of Dropout by Female Obese Patients Treated with a Group Cognitive Behavioral Therapy to Promote Weight Loss.

PubMed

Sawamoto, Ryoko; Nozaki, Takehiro; Furukawa, Tomokazu; Tanahashi, Tokusei; Morita, Chihiro; Hata, Tomokazu; Komaki, Gen; Sudo, Nobuyuki

2016-01-01

To investigate predictors of dropout from a group cognitive behavioral therapy (CBT) intervention for overweight or obese women. 119 overweight and obese Japanese women aged 25-65 years who attended an outpatient weight loss intervention were followed throughout the 7-month weight loss phase. Somatic characteristics, socioeconomic status, obesity-related diseases, diet and exercise habits, and psychological variables (depression, anxiety, self-esteem, alexithymia, parenting style, perfectionism, and eating attitude) were assessed at baseline. Significant variables, extracted by univariate statistical analysis, were then used as independent variables in a stepwise multiple logistic regression analysis with dropout as the dependent variable. 90 participants completed the weight loss phase, giving a dropout rate of 24.4%. The multiple logistic regression analysis demonstrated that compared to completers the dropouts had significantly stronger body shape concern, tended to not have jobs, perceived their mothers to be less caring, and were more disorganized in temperament. Of all these factors, the best predictor of dropout was shape concern. Shape concern, job condition, parenting care, and organization predicted dropout from the group CBT weight loss intervention for overweight or obese Japanese women. © 2016 S. Karger GmbH, Freiburg.

Predictors of Dropout by Female Obese Patients Treated with a Group Cognitive Behavioral Therapy to Promote Weight Loss

PubMed Central

Sawamoto, Ryoko; Nozaki, Takehiro; Furukawa, Tomokazu; Tanahashi, Tokusei; Morita, Chihiro; Hata, Tomokazu; Komaki, Gen; Sudo, Nobuyuki

2016-01-01

Objective To investigate predictors of dropout from a group cognitive behavioral therapy (CBT) intervention for overweight or obese women. Methods 119 overweight and obese Japanese women aged 25-65 years who attended an outpatient weight loss intervention were followed throughout the 7-month weight loss phase. Somatic characteristics, socioeconomic status, obesity-related diseases, diet and exercise habits, and psychological variables (depression, anxiety, self-esteem, alexithymia, parenting style, perfectionism, and eating attitude) were assessed at baseline. Significant variables, extracted by univariate statistical analysis, were then used as independent variables in a stepwise multiple logistic regression analysis with dropout as the dependent variable. Results 90 participants completed the weight loss phase, giving a dropout rate of 24.4%. The multiple logistic regression analysis demonstrated that compared to completers the dropouts had significantly stronger body shape concern, tended to not have jobs, perceived their mothers to be less caring, and were more disorganized in temperament. Of all these factors, the best predictor of dropout was shape concern. Conclusion Shape concern, job condition, parenting care, and organization predicted dropout from the group CBT weight loss intervention for overweight or obese Japanese women. PMID:26745715

The Overall Odds Ratio as an Intuitive Effect Size Index for Multiple Logistic Regression: Examination of Further Refinements

ERIC Educational Resources Information Center

Le, Huy; Marcus, Justin

2012-01-01

This study used Monte Carlo simulation to examine the properties of the overall odds ratio (OOR), which was recently introduced as an index for overall effect size in multiple logistic regression. It was found that the OOR was relatively independent of study base rate and performed better than most commonly used R-square analogs in indexing model…

Vehicle coordinated transportation dispatching model base on multiple crisis locations

NASA Astrophysics Data System (ADS)

Tian, Ran; Li, Shanwei; Yang, Guoying

2018-05-01

Many disastrous events are often caused after unconventional emergencies occur, and the requirements of disasters are often different. It is difficult for a single emergency resource center to satisfy such requirements at the same time. Therefore, how to coordinate the emergency resources stored by multiple emergency resource centers to various disaster sites requires the coordinated transportation of emergency vehicles. In this paper, according to the problem of emergency logistics coordination scheduling, based on the related constraints of emergency logistics transportation, an emergency resource scheduling model based on multiple disasters is established.

An investigation of the speeding-related crash designation through crash narrative reviews sampled via logistic regression.

PubMed

Fitzpatrick, Cole D; Rakasi, Saritha; Knodler, Michael A

2017-01-01

Speed is one of the most important factors in traffic safety as higher speeds are linked to increased crash risk and higher injury severities. Nearly a third of fatal crashes in the United States are designated as "speeding-related", which is defined as either "the driver behavior of exceeding the posted speed limit or driving too fast for conditions." While many studies have utilized the speeding-related designation in safety analyses, no studies have examined the underlying accuracy of this designation. Herein, we investigate the speeding-related crash designation through the development of a series of logistic regression models that were derived from the established speeding-related crash typologies and validated using a blind review, by multiple researchers, of 604 crash narratives. The developed logistic regression model accurately identified crashes which were not originally designated as speeding-related but had crash narratives that suggested speeding as a causative factor. Only 53.4% of crashes designated as speeding-related contained narratives which described speeding as a causative factor. Further investigation of these crashes revealed that the driver contributing code (DCC) of "driving too fast for conditions" was being used in three separate situations. Additionally, this DCC was also incorrectly used when "exceeding the posted speed limit" would likely have been a more appropriate designation. Finally, it was determined that the responding officer only utilized one DCC in 82% of crashes not designated as speeding-related but contained a narrative indicating speed as a contributing causal factor. The use of logistic regression models based upon speeding-related crash typologies offers a promising method by which all possible speeding-related crashes could be identified. Published by Elsevier Ltd.

Conditional Poisson models: a flexible alternative to conditional logistic case cross-over analysis.

PubMed

Armstrong, Ben G; Gasparrini, Antonio; Tobias, Aurelio

2014-11-24

The time stratified case cross-over approach is a popular alternative to conventional time series regression for analysing associations between time series of environmental exposures (air pollution, weather) and counts of health outcomes. These are almost always analyzed using conditional logistic regression on data expanded to case-control (case crossover) format, but this has some limitations. In particular adjusting for overdispersion and auto-correlation in the counts is not possible. It has been established that a Poisson model for counts with stratum indicators gives identical estimates to those from conditional logistic regression and does not have these limitations, but it is little used, probably because of the overheads in estimating many stratum parameters. The conditional Poisson model avoids estimating stratum parameters by conditioning on the total event count in each stratum, thus simplifying the computing and increasing the number of strata for which fitting is feasible compared with the standard unconditional Poisson model. Unlike the conditional logistic model, the conditional Poisson model does not require expanding the data, and can adjust for overdispersion and auto-correlation. It is available in Stata, R, and other packages. By applying to some real data and using simulations, we demonstrate that conditional Poisson models were simpler to code and shorter to run than are conditional logistic analyses and can be fitted to larger data sets than possible with standard Poisson models. Allowing for overdispersion or autocorrelation was possible with the conditional Poisson model but when not required this model gave identical estimates to those from conditional logistic regression. Conditional Poisson regression models provide an alternative to case crossover analysis of stratified time series data with some advantages. The conditional Poisson model can also be used in other contexts in which primary control for confounding is by fine stratification.

Predictors of postoperative outcomes of cubital tunnel syndrome treatments using multiple logistic regression analysis.

PubMed

Suzuki, Taku; Iwamoto, Takuji; Shizu, Kanae; Suzuki, Katsuji; Yamada, Harumoto; Sato, Kazuki

2017-05-01

This retrospective study was designed to investigate prognostic factors for postoperative outcomes for cubital tunnel syndrome (CubTS) using multiple logistic regression analysis with a large number of patients. Eighty-three patients with CubTS who underwent surgeries were enrolled. The following potential prognostic factors for disease severity were selected according to previous reports: sex, age, type of surgery, disease duration, body mass index, cervical lesion, presence of diabetes mellitus, Workers' Compensation status, preoperative severity, and preoperative electrodiagnostic testing. Postoperative severity of disease was assessed 2 years after surgery by Messina's criteria which is an outcome measure specifically for CubTS. Bivariate analysis was performed to select candidate prognostic factors for multiple linear regression analyses. Multiple logistic regression analysis was conducted to identify the association between postoperative severity and selected prognostic factors. Both bivariate and multiple linear regression analysis revealed only preoperative severity as an independent risk factor for poor prognosis, while other factors did not show any significant association. Although conflicting results exist regarding prognosis of CubTS, this study supports evidence from previous studies and concludes early surgical intervention portends the most favorable prognosis. Copyright © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Fusing Data Mining, Machine Learning and Traditional Statistics to Detect Biomarkers Associated with Depression

PubMed Central

Dipnall, Joanna F.

2016-01-01

Background Atheoretical large-scale data mining techniques using machine learning algorithms have promise in the analysis of large epidemiological datasets. This study illustrates the use of a hybrid methodology for variable selection that took account of missing data and complex survey design to identify key biomarkers associated with depression from a large epidemiological study. Methods The study used a three-step methodology amalgamating multiple imputation, a machine learning boosted regression algorithm and logistic regression, to identify key biomarkers associated with depression in the National Health and Nutrition Examination Study (2009–2010). Depression was measured using the Patient Health Questionnaire-9 and 67 biomarkers were analysed. Covariates in this study included gender, age, race, smoking, food security, Poverty Income Ratio, Body Mass Index, physical activity, alcohol use, medical conditions and medications. The final imputed weighted multiple logistic regression model included possible confounders and moderators. Results After the creation of 20 imputation data sets from multiple chained regression sequences, machine learning boosted regression initially identified 21 biomarkers associated with depression. Using traditional logistic regression methods, including controlling for possible confounders and moderators, a final set of three biomarkers were selected. The final three biomarkers from the novel hybrid variable selection methodology were red cell distribution width (OR 1.15; 95% CI 1.01, 1.30), serum glucose (OR 1.01; 95% CI 1.00, 1.01) and total bilirubin (OR 0.12; 95% CI 0.05, 0.28). Significant interactions were found between total bilirubin with Mexican American/Hispanic group (p = 0.016), and current smokers (p<0.001). Conclusion The systematic use of a hybrid methodology for variable selection, fusing data mining techniques using a machine learning algorithm with traditional statistical modelling, accounted for missing data and complex survey sampling methodology and was demonstrated to be a useful tool for detecting three biomarkers associated with depression for future hypothesis generation: red cell distribution width, serum glucose and total bilirubin. PMID:26848571

Fusing Data Mining, Machine Learning and Traditional Statistics to Detect Biomarkers Associated with Depression.

PubMed

Dipnall, Joanna F; Pasco, Julie A; Berk, Michael; Williams, Lana J; Dodd, Seetal; Jacka, Felice N; Meyer, Denny

2016-01-01

Atheoretical large-scale data mining techniques using machine learning algorithms have promise in the analysis of large epidemiological datasets. This study illustrates the use of a hybrid methodology for variable selection that took account of missing data and complex survey design to identify key biomarkers associated with depression from a large epidemiological study. The study used a three-step methodology amalgamating multiple imputation, a machine learning boosted regression algorithm and logistic regression, to identify key biomarkers associated with depression in the National Health and Nutrition Examination Study (2009-2010). Depression was measured using the Patient Health Questionnaire-9 and 67 biomarkers were analysed. Covariates in this study included gender, age, race, smoking, food security, Poverty Income Ratio, Body Mass Index, physical activity, alcohol use, medical conditions and medications. The final imputed weighted multiple logistic regression model included possible confounders and moderators. After the creation of 20 imputation data sets from multiple chained regression sequences, machine learning boosted regression initially identified 21 biomarkers associated with depression. Using traditional logistic regression methods, including controlling for possible confounders and moderators, a final set of three biomarkers were selected. The final three biomarkers from the novel hybrid variable selection methodology were red cell distribution width (OR 1.15; 95% CI 1.01, 1.30), serum glucose (OR 1.01; 95% CI 1.00, 1.01) and total bilirubin (OR 0.12; 95% CI 0.05, 0.28). Significant interactions were found between total bilirubin with Mexican American/Hispanic group (p = 0.016), and current smokers (p<0.001). The systematic use of a hybrid methodology for variable selection, fusing data mining techniques using a machine learning algorithm with traditional statistical modelling, accounted for missing data and complex survey sampling methodology and was demonstrated to be a useful tool for detecting three biomarkers associated with depression for future hypothesis generation: red cell distribution width, serum glucose and total bilirubin.

Disparities in chronic conditions and health status by type of disability

PubMed Central

Horner-Johnson, Willi; Dobbertin, Konrad; Lee, Jae Chul; Andresen, Elena M.

2013-01-01

Background Prior research has established health disparities between people with and without disabilities. However, disparities within the disability population, such as those related to type of disability, have been much less studied. Objective To examine differences in chronic conditions and health status between subgroups of people with different types of disability. Methods We analyzed Medical Expenditure Panel Survey annual data files from 2002-2008. Logistic regression analyses considered disparity from three perspectives: 1) basic differences, unadjusted for other factors; 2) controlling for key demographic and health covariates; and 3) controlling for a larger set of demographic variables and socioeconomic status as well as health and access to healthcare. Results Individuals with vision, physical, cognitive, or multiple disability types fared worse than people with hearing impairment on most health outcomes. This was most consistently true for people with multiple disabilities. Even when all covariates were accounted for, people with multiple types of disability were significantly more likely (p < 0.05) than those with hearing impairment (reference group) to report every poor health outcome with the exception of BMI ≥ 25 and lung disease. Conclusions While many of the differences between disability types were reduced when controlling for other factors, some differences remained significant. This argues for a more individualized approach to understanding and preventing chronic conditions and poor health in specific disability groups. PMID:24060250

[Incidence of fall related injury in people aged 50 and above and risk factors in 8 provinces in China: a cross-sectional study].

PubMed

Guo, Y F; Ma, W J; Zhang, Q J; Yu, M; Xiao, Y Z; Guo, X L; Zhu, Y L; Liu, F; Ruan, Y; Sun, S Y; Huang, Z Z; Zheng, Y; Wu, F

2018-03-10

Objective: To estimate the incidence and distribution characteristics of fall related injury in people aged ≥50 years in 8 provinces in China and related physiological, psychological and social risk factors. Methods: Cross-sectional data were collected from adults aged ≥50 years participating in the World Health Organization (WHO) study on global ageing and adult health (SAGE) round 1 in China. Two-level hierarchical logistic model was used to identify the related factors for fall-related injury. All the models were stratified by living area (urban/rural). Results: Estimated incidence of fall related injury (road traffic injury was not included) was 3.2 %. Ageing and multiple chronic conditions ( OR =2.55, 95 %CI : 1.41-4.64) was significantly associated with the incidence of fall related injury in urban area. In rural area, depression ( OR =4.33, 95 % CI : 2.52-7.42) and multiple chronic conditions ( OR =2.46, 95 %CI : 1.37-4.41) were associated with the incidence of fall related injury. Conclusions: This study estimated the incidence of fall related injury in adults aged ≥50 years in 8 provinces in China. A significant association between multiple chronic conditions and fall related injury were found in both urban and rural residents. Targeted measures should be taken for the prevention and control of chronic diseases in elderly population.

Multiple sclerosis in pregnancy: prevalence, sociodemographic features, and obstetrical outcomes.

PubMed

Fong, Alex; Chau, Cindy T; Quant, Cara; Duffy, Jennifer; Pan, Deyu; Ogunyemi, Dotun A

2018-02-01

We sought to describe the prevalence, sociodemographic features, and antenatal/peripartum outcomes of multiple sclerosis (MS) in pregnancy. A retrospective cohort study was performed using deliveries in California from 2001 to 2009. Cases of MS as well as other morbidities were identified via ICD-9-CM code. Logistic regression was performed to adjust for potential confounders. About 1185 out of 4,424,049 deliveries were complicated by MS. MS prevalence increased with maternal age, with Caucasians comprising a higher proportion of MS subjects. MS subjects were older and more likely to have private insurance. Women with MS were more likely to have preexisting medical conditions such as asthma, chronic hypertension, thyroid disease, or cardiac disease. However, no significant antepartum and peripartum morbidities were found to be increased in patients with MS. Urinary tract infection, cesarean delivery, and induction of labor were slightly increased in MS patients. MS is a rare condition which is more likely to affect older Caucasian women of higher socioeconomic status and is associated with several preexisting medical conditions. MS, however, does not appear to pose significant increases in adverse pregnancy outcome. This suggests that pregnant patients with MS may likely experience an uneventful pregnancy.

Prevalence of Depressive Symptoms and Related Factors in Korean Employees: The Third Korean Working Conditions Survey (2011).

PubMed

Park, Ji Nam; Han, Mi Ah; Park, Jong; Ryu, So Yeon

2016-04-14

The aim of this study was to analyze the association between general working conditions and depressive symptoms among Korean employees. The target population of the study was native employees nationwide who were at least 15 years old, and 50,032 such individuals were enrolled in the study. Depressive symptoms was assessed using the WHO-5 wellbeing index. Associations between general characteristics, job-related characteristics, work environment, and depressive symptoms were tested using chi-square tests, t-tests, and multiple logistic regression analysis. The prevalence of depressive symptoms was 39% (40.7% in males and 36.5% in females). Multiple regression analysis revealed that male subjects, older subjects, subjects with higher education status, subjects with lower monthly income, current smokers, and frequent drinkers were more likely to have depressive symptoms. In addition, longer weekly work hours, occupation type (skilled, unskilled, operative, or economic sector), shift work, working to tight deadlines, exposure to stress at work, and hazard exposure were associated with depressive symptoms. This representative study will be a guide to help manage depression among Korean employees. We expect that further research will identify additional causal relationships between general or specific working conditions and depression.

Race and Ethnic Group Differences in Comorbid Major Depressive Disorder, Generalized Anxiety Disorder, and Chronic Medical Conditions.

PubMed

Watkins, Daphne C; Assari, Shervin; Johnson-Lawrence, Vicki

2015-09-01

This study tested whether race and ethnic group differences exist for lifetime major depressive disorder and/or general anxiety disorder with one or more chronic medical conditions. Data from the National Survey of American Life, which included 3570 African American, 1438 Caribbean Black, and 891 non-Hispanic White adults were analyzed. Outcomes included at least one and multiple chronic medical conditions, from a list of 14 medical conditions (e.g., arthritis, cancer, diabetes, kidney disease, stroke, heart disease, etc.). Logistic regressions were fitted to data to determine how the association between major depressive disorder, general anxiety disorder, and one or more chronic medical conditions vary across race and ethnicity. Lifetime major depressive disorder (but not lifetime general anxiety disorder) was associated with at least one chronic medical condition among African Americans and Caribbean Blacks, but not non-Hispanic Whites. Lifetime major depressive disorder was similarly associated with multiple chronic medical conditions among African Americans, Caribbean Blacks, and non-Hispanic Whites. For Caribbean Blacks, stronger associations were found between major depressive disorder and general anxiety disorder with one or more chronic medical conditions compared to African Americans and non-Hispanic Whites. Findings suggest that race and ethnicity may shape the links between comorbid psychiatric disorders and chronic medical conditions. Mental health screening of individuals with chronic medical conditions in primary health-care settings may benefit from tailoring based on race and ethnicity. More research is needed to understand why associations between physical and mental health vary among race and ethnic groups.

The effect of multiple chronic conditions on self-rated health, disability and quality of life among the older populations of Northern Ireland and the Republic of Ireland: a comparison of two nationally representative cross-sectional surveys

PubMed Central

McDaid, Olga; Hanly, Mark J; Richardson, Kathryn; Kee, Frank; Kenny, Rose Anne; Savva, George M

2013-01-01

Objectives Multimorbidity is common in the older population, but the impact of combinations of chronic conditions on disability and quality of life (QoL) is not well known. This analysis explores the effect of specific combinations of chronic diseases on disability, QoL and self-rated health (SRH). Design We used data from two population representative cross-sectional studies, the Northern Ireland Health and Social Wellbeing Survey (NIHSWS) 2005 and the Survey of Lifestyle, Attitudes and Nutrition (SLAN) 2007 (conducted in the Republic of Ireland). Setting Randomly selected community-living participants were interviewed at home. Participants A total of 6159 participants aged 50 years and older were included in the analysis. Outcome measures Chronic conditions were classified as cardiovascular disease, chronic pain, diabetes or respiratory disease. Interaction terms estimated by logistic regression were used to examine the effects of multiple chronic conditions on disability, SRH and QoL. Results Each chronic condition group was correlated with each of the others after adjusting for sociodemographic factors. Those from Northern Ireland were more likely to report a limitation in daily activities (45%) compared to those from the Republic of Ireland (21%). Each condition had an independent effect on disability, SRH and QoL, and those with multiple chronic conditions reported the worst outcomes. However, there were no statistically significant positive interactions between chronic condition groups with respect to any outcome. Conclusions Chronic conditions affect individuals largely independent of each other with respect to their effect on disability, SRH and QoL. However, a significant proportion of the population aged 50 years and over across the island of Ireland lives with multimorbidity, and this group is at the highest risk of disability, poor SRH and poor QoL. PMID:23794595

Stability and Hopf Bifurcation in a Reaction-Diffusion Model with Chemotaxis and Nonlocal Delay Effect

NASA Astrophysics Data System (ADS)

Li, Dong; Guo, Shangjiang

Chemotaxis is an observed phenomenon in which a biological individual moves preferentially toward a relatively high concentration, which is contrary to the process of natural diffusion. In this paper, we study a reaction-diffusion model with chemotaxis and nonlocal delay effect under Dirichlet boundary condition by using Lyapunov-Schmidt reduction and the implicit function theorem. The existence, multiplicity, stability and Hopf bifurcation of spatially nonhomogeneous steady state solutions are investigated. Moreover, our results are illustrated by an application to the model with a logistic source, homogeneous kernel and one-dimensional spatial domain.

Combinations of Multiple Neuroimaging Markers using Logistic Regression for Auxiliary Diagnosis of Alzheimer Disease and Mild Cognitive Impairment.

PubMed

Mao, Nini; Liu, Yunting; Chen, Kewei; Yao, Li; Wu, Xia

2018-06-05

Multiple neuroimaging modalities have been developed providing various aspects of information on the human brain. Used together and properly, these complementary multimodal neuroimaging data integrate multisource information which can facilitate a diagnosis and improve the diagnostic accuracy. In this study, 3 types of brain imaging data (sMRI, FDG-PET, and florbetapir-PET) were fused in the hope to improve diagnostic accuracy, and multivariate methods (logistic regression) were applied to these trimodal neuroimaging indices. Then, the receiver-operating characteristic (ROC) method was used to analyze the outcomes of the logistic classifier, with either each index, multiples from each modality, or all indices from all 3 modalities, to investigate their differential abilities to identify the disease. With increasing numbers of indices within each modality and across modalities, the accuracy of identifying Alzheimer disease (AD) increases to varying degrees. For example, the area under the ROC curve is above 0.98 when all the indices from the 3 imaging data types are combined. Using a combination of different indices, the results confirmed the initial hypothesis that different biomarkers were potentially complementary, and thus the conjoint analysis of multiple information from multiple sources would improve the capability to identify diseases such as AD and mild cognitive impairment. © 2018 S. Karger AG, Basel.

A comparison of multiple imputation methods for incomplete longitudinal binary data.

PubMed

Yamaguchi, Yusuke; Misumi, Toshihiro; Maruo, Kazushi

2018-01-01

Longitudinal binary data are commonly encountered in clinical trials. Multiple imputation is an approach for getting a valid estimation of treatment effects under an assumption of missing at random mechanism. Although there are a variety of multiple imputation methods for the longitudinal binary data, a limited number of researches have reported on relative performances of the methods. Moreover, when focusing on the treatment effect throughout a period that has often been used in clinical evaluations of specific disease areas, no definite investigations comparing the methods have been available. We conducted an extensive simulation study to examine comparative performances of six multiple imputation methods available in the SAS MI procedure for longitudinal binary data, where two endpoints of responder rates at a specified time point and throughout a period were assessed. The simulation study suggested that results from naive approaches of a single imputation with non-responders and a complete case analysis could be very sensitive against missing data. The multiple imputation methods using a monotone method and a full conditional specification with a logistic regression imputation model were recommended for obtaining unbiased and robust estimations of the treatment effect. The methods were illustrated with data from a mental health research.

Rate and Predictors of Employment among Formerly Polysubstance Dependent Urban Individuals in Recovery

PubMed Central

Laudet, Alexandre B

2012-01-01

Employment is a key functioning index in addiction services and consistently emerges as a goal among persons in recovery. Research on employment in the addictions has focused on treatment populations and/or welfare recipients; little is known of employment rates or their predictors among persons in recovery. This study seeks to fill this gap, capitalizing on a sample (N = 311) of urban individuals at various stages of recovery. Fewer than half (44.5%) were employed; in logistic regressions, male gender and Caucasian race enhanced the odds of employment whereas having a comorbid chronic physical and/or mental health condition halved the odds. Implications center on the need to identify effective strategies to enhance employability among women and minorities, and for integrated care for persons with multiple chronic conditions. PMID:22873190

[Research on the methods for multi-class kernel CSP-based feature extraction].

PubMed

Wang, Jinjia; Zhang, Lingzhi; Hu, Bei

2012-04-01

To relax the presumption of strictly linear patterns in the common spatial patterns (CSP), we studied the kernel CSP (KCSP). A new multi-class KCSP (MKCSP) approach was proposed in this paper, which combines the kernel approach with multi-class CSP technique. In this approach, we used kernel spatial patterns for each class against all others, and extracted signal components specific to one condition from EEG data sets of multiple conditions. Then we performed classification using the Logistic linear classifier. Brain computer interface (BCI) competition III_3a was used in the experiment. Through the experiment, it can be proved that this approach could decompose the raw EEG singles into spatial patterns extracted from multi-class of single trial EEG, and could obtain good classification results.

A Solution to Separation and Multicollinearity in Multiple Logistic Regression

PubMed Central

Shen, Jianzhao; Gao, Sujuan

2010-01-01

In dementia screening tests, item selection for shortening an existing screening test can be achieved using multiple logistic regression. However, maximum likelihood estimates for such logistic regression models often experience serious bias or even non-existence because of separation and multicollinearity problems resulting from a large number of highly correlated items. Firth (1993, Biometrika, 80(1), 27–38) proposed a penalized likelihood estimator for generalized linear models and it was shown to reduce bias and the non-existence problems. The ridge regression has been used in logistic regression to stabilize the estimates in cases of multicollinearity. However, neither solves the problems for each other. In this paper, we propose a double penalized maximum likelihood estimator combining Firth’s penalized likelihood equation with a ridge parameter. We present a simulation study evaluating the empirical performance of the double penalized likelihood estimator in small to moderate sample sizes. We demonstrate the proposed approach using a current screening data from a community-based dementia study. PMID:20376286

A Solution to Separation and Multicollinearity in Multiple Logistic Regression.

PubMed

Shen, Jianzhao; Gao, Sujuan

2008-10-01

In dementia screening tests, item selection for shortening an existing screening test can be achieved using multiple logistic regression. However, maximum likelihood estimates for such logistic regression models often experience serious bias or even non-existence because of separation and multicollinearity problems resulting from a large number of highly correlated items. Firth (1993, Biometrika, 80(1), 27-38) proposed a penalized likelihood estimator for generalized linear models and it was shown to reduce bias and the non-existence problems. The ridge regression has been used in logistic regression to stabilize the estimates in cases of multicollinearity. However, neither solves the problems for each other. In this paper, we propose a double penalized maximum likelihood estimator combining Firth's penalized likelihood equation with a ridge parameter. We present a simulation study evaluating the empirical performance of the double penalized likelihood estimator in small to moderate sample sizes. We demonstrate the proposed approach using a current screening data from a community-based dementia study.

Multiple Chronic Conditions and Limitations in Activities of Daily Living in a Community-Based Sample of Older Adults in New York City, 2009

PubMed Central

Mielenz, Thelma J.; Parton, Hilary; Flatley, Anne-Marie; Thorpe, Lorna E.

2013-01-01

Introduction Nationally, 60% to 75% of older adults have multiple (2 or more) chronic conditions (MCCs), and the burden is even higher among low-income, racial/ethnic minority populations. MCCs limit activities of daily living (ADLs), yet this association is not well characterized outside of clinical populations. We examined the association of MCCs with ADLs in a racially/ethnically diverse population of low-income older adults living in New York City public housing. Methods A representative sample of 1,036 New York City Housing Authority residents aged 65 or older completed a telephone survey in June 2009. We examined the association of up to 5 chronic conditions with basic ADL (BADL) limitations, adjusting for potential confounders by using logistic regression. Results Of respondents, 28.7% had at least 1 BADL limitation; 92.9% had at least 1 chronic condition, and 79.0% had MCCs. We observed a graded association between at least 1 BADL limitation and number of chronic conditions (using 0 or 1 condition as the reference group): adjusted odds ratio (AOR) for 3 conditions was 2.2 (95% confidence interval [CI], 1.3–3.9); AOR for 4 conditions, 4.3 (95% CI, 2.5–7.6); and AOR for 5 conditions, 9.2 (95% CI, 4.3–19.5). Conclusion Prevalence of BADL limitations is high among low-income older adults and increases with number of chronic conditions. Initiating prevention of additional conditions and treating disease constellations earlier to decrease BADL limitations may improve aging outcomes in this population. PMID:24286273

Breast arterial calcification is associated with reproductive factors in asymptomatic postmenopausal women.

PubMed

Bielak, Lawrence F; Whaley, Dana H; Sheedy, Patrick F; Peyser, Patricia A

2010-09-01

The etiology of breast arterial calcification (BAC) is not well understood. We examined reproductive history and cardiovascular disease (CVD) risk factor associations with the presence of detectable BAC in asymptomatic postmenopausal women. Reproductive history and CVD risk factors were obtained in 240 asymptomatic postmenopausal women from a community-based research study who had a screening mammogram within 2 years of their participation in the study. The mammograms were reviewed for the presence of detectable BAC. Age-adjusted logistic regression models were fit to assess the association between each risk factor and the presence of BAC. Multiple variable logistic regression models were used to identify the most parsimonious model for the presence of BAC. The prevalence of BAC increased with increased age (p < 0.0001). The most parsimonious logistic regression model for BAC presence included age at time of examination, increased parity (p = 0.01), earlier age at first birth (p = 0.002), weight, and an age-by-weight interaction term (p = 0.004). Older women with a smaller body size had a higher probability of having BAC than women of the same age with a larger body size. The presence or absence of BAC at mammography may provide an assessment of a postmenopausal woman's lifetime estrogen exposure and indicate women who could be at risk for hormonally related conditions.

Multiple Imputation of a Randomly Censored Covariate Improves Logistic Regression Analysis.

PubMed

Atem, Folefac D; Qian, Jing; Maye, Jacqueline E; Johnson, Keith A; Betensky, Rebecca A

2016-01-01

Randomly censored covariates arise frequently in epidemiologic studies. The most commonly used methods, including complete case and single imputation or substitution, suffer from inefficiency and bias. They make strong parametric assumptions or they consider limit of detection censoring only. We employ multiple imputation, in conjunction with semi-parametric modeling of the censored covariate, to overcome these shortcomings and to facilitate robust estimation. We develop a multiple imputation approach for randomly censored covariates within the framework of a logistic regression model. We use the non-parametric estimate of the covariate distribution or the semiparametric Cox model estimate in the presence of additional covariates in the model. We evaluate this procedure in simulations, and compare its operating characteristics to those from the complete case analysis and a survival regression approach. We apply the procedures to an Alzheimer's study of the association between amyloid positivity and maternal age of onset of dementia. Multiple imputation achieves lower standard errors and higher power than the complete case approach under heavy and moderate censoring and is comparable under light censoring. The survival regression approach achieves the highest power among all procedures, but does not produce interpretable estimates of association. Multiple imputation offers a favorable alternative to complete case analysis and ad hoc substitution methods in the presence of randomly censored covariates within the framework of logistic regression.

Assessing the Role of Environmental Conditions on Efficacy Rates of Heterorhabditis indica (Nematoda: Heterorhabditidae) for Controlling Aethina tumida (Coleoptera: Nitidulidae) in Honey Bee (Hymenoptera: Apidae) Colonies: a Citizen Science Approach.

PubMed

Hill, Elizabeth S; Smythe, Ashleigh B; Delaney, Deborah A

2016-02-01

Certain species of entomopathogenic nematodes, such as Heterorhabditis indica Poinar, Karunakar & David, have the potential to be effective controls for Aethina tumida (Murray), or small hive beetles, when applied to the soil surrounding honey bee (Apis mellifera L.) hives. Despite the efficacy of H. indica, beekeepers have struggled to use them successfully as a biocontrol. It is believed that the sensitivity of H. indica to certain environmental conditions is the primary reason for this lack of success. Although research has been conducted to explore the impact of specific environmental conditions--such as soil moisture or soil temperature-on entomopathogenic nematode infectivity, no study to date has taken a comprehensive approach that considers the impact of multiple environmental conditions simultaneously. In exploring this, a multivariate logistic regression model was used to determine what environmental conditions resulted in reductions of A. tumida populations in honey bee colonies. To obtain the sample sizes necessary to run a multivariate logistic regression, this study utilized citizen scientist beekeepers and their hives from across the mid-Atlantic region of the United States. Results suggest that soil moisture, soil temperatures, sunlight exposure, and groundcover contribute to the efficacy of H. indica in reducing A. tumida populations in A. mellifera colonies. The results of this study offer direction for future research on the environmental preferences of H. indica and can be used to educate beekeepers about methods for better utilizing H. indica as a biological control. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A broader view of family caregiving: effects of caregiving and caregiver conditions on depressive symptoms, health, work, and social isolation.

PubMed

Robison, Julie; Fortinsky, Richard; Kleppinger, Alison; Shugrue, Noreen; Porter, Martha

2009-11-01

Informal caregivers provide the majority of long-term care. This study examined six health and psychosocial outcomes of caregiving, in the context of multiple characteristics of the caregiving situation, in a representative, statewide sample. Data came from 4,041 respondents to the 2007 Connecticut Long-Term Care Needs Assessment. Analyses investigated whether caregiving negatively affects depressive symptoms, health, missing work, and social isolation. Logistic regressions tested the independent effects of caregiver characteristics and conditions of the caregiving situation on these health and psychosocial outcomes. Caregivers rate their health better than noncaregivers and do not report more depressive symptoms or social isolation. Living with the care receiver, inadequate income, and care receivers' unmet need for community-based long-term care services relate to multiple negative outcomes. Care receiver memory problems and caregiver/care receiver relationship do not relate to health or psychosocial outcomes when these other factors are considered. Caregiving per se does not lead to symptoms of depression, poor health, or social isolation. Many caregivers do need supports in training and education, respite, and physical and mental health care. Such programs should provide outreach to caregivers facing specific stressful conditions, as not all caregivers experience negative consequences.

Genetic risk factors for ovarian cancer and their role for endometriosis risk.

PubMed

Burghaus, Stefanie; Fasching, Peter A; Häberle, Lothar; Rübner, Matthias; Büchner, Kathrin; Blum, Simon; Engel, Anne; Ekici, Arif B; Hartmann, Arndt; Hein, Alexander; Beckmann, Matthias W; Renner, Stefan P

2017-04-01

Several genetic variants have been validated as risk factors for ovarian cancer. Endometriosis has also been described as a risk factor for ovarian cancer. Identifying genetic risk factors that are common to the two diseases might help improve our understanding of the molecular pathogenesis potentially linking the two conditions. In a hospital-based case-control analysis, 12 single nucleotide polymorphisms (SNPs), validated by the Ovarian Cancer Association Consortium (OCAC) and the Collaborative Oncological Gene-environment Study (COGS) project, were genotyped using TaqMan® OpenArray™ analysis. The cases consisted of patients with endometriosis, and the controls were healthy individuals without endometriosis. A total of 385 cases and 484 controls were analyzed. Odds ratios and P values were obtained using simple logistic regression models, as well as from multiple logistic regression models with adjustment for clinical predictors. rs11651755 in HNF1B was found to be associated with endometriosis in this case-control study. The OR was 0.66 (95% CI, 0.51 to 0.84) and the P value after correction for multiple testing was 0.01. None of the other genotypes was associated with a risk for endometriosis. As rs11651755 in HNF1B modified both the ovarian cancer risk and also the risk for endometriosis, HNF1B may be causally involved in the pathogenetic pathway leading from endometriosis to ovarian cancer. Copyright © 2017 Elsevier Inc. All rights reserved.

Biomass bale stack and field outlet locations assessment for efficient infield logistics

USDA-ARS?s Scientific Manuscript database

Harvested hay or biomass are traditionally baled for better handling and they are transported to the outlet for final utilization. For better management of bale logistics, producers often aggregate bales into stacks so that bale-hauling equipment can haul multiple bales for improved efficiency. Obje...

77 FR 39662 - Hazardous Materials; Reverse Logistics (RRR)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-05

... used batteries from multiple shippers for the purposes of recycling. The petition also notes that, when... recycling falls within the realm of ``reverse logistics.'' Currently Sec. 173.159(e)(4) prevents a battery... comment on how the retail industry should handle the recycling or disposal of these batteries for use in...

Sociodemographic risk factors associated with low birthweight in United Arab Emirates.

PubMed

Bener, A; Abdulrazzaq, Y M; Dawodu, A

1996-07-01

This case-control study was undertaken to determine sociodemographic risk factors for low birth weight in Al-Ain (United Arab Emirates) over a 12-month period in 1992-93. A total of 3485 live births occurred of which 293 (8.4%) were low birth weight. The risk factors considered were mother's occupation, house conditions, place of residence (urban or rural), maternal smoking habits, antenatal care, availability of help in the home, maternal BMI and educational status. Multiple logistic regression analysis showed that mother's occupation, maternal smoking, antenatal care, and lack of help in the home were associated with increased risk of low birth weight.

Lessons learned from a colocation model using psychiatrists in urban primary care settings.

PubMed

Weiss, Meredith; Schwartz, Bruce J

2013-07-01

Comorbid psychiatric illness has been identified as a major driver of health care costs. The colocation of psychiatrists in primary care practices has been proposed as a model to improve mental health and medical care as well as a model to reduce health care costs. Financial models were developed to determine the sustainability of colocation. We found that the population studied had substantial psychiatric and medical burdens, and multiple practice logistical issues were identified. The providers found the experience highly rewarding and colocation was financially sustainable under certain conditions. The colocation model was effective in identifying and treating psychiatric comorbidities.

Cluster Analysis of Campylobacter jejuni Genotypes Isolated from Small and Medium-Sized Mammalian Wildlife and Bovine Livestock from Ontario Farms.

PubMed

Viswanathan, M; Pearl, D L; Taboada, E N; Parmley, E J; Mutschall, S K; Jardine, C M

2017-05-01

Using data collected from a cross-sectional study of 25 farms (eight beef, eight swine and nine dairy) in 2010, we assessed clustering of molecular subtypes of C. jejuni based on a Campylobacter-specific 40 gene comparative genomic fingerprinting assay (CGF40) subtypes, using unweighted pair-group method with arithmetic mean (UPGMA) analysis, and multiple correspondence analysis. Exact logistic regression was used to determine which genes differentiate wildlife and livestock subtypes in our study population. A total of 33 bovine livestock (17 beef and 16 dairy), 26 wildlife (20 raccoon (Procyon lotor), five skunk (Mephitis mephitis) and one mouse (Peromyscus spp.) C. jejuni isolates were subtyped using CGF40. Dendrogram analysis, based on UPGMA, showed distinct branches separating bovine livestock and mammalian wildlife isolates. Furthermore, two-dimensional multiple correspondence analysis was highly concordant with dendrogram analysis showing clear differentiation between livestock and wildlife CGF40 subtypes. Based on multilevel logistic regression models with a random intercept for farm of origin, we found that isolates in general, and raccoons more specifically, were significantly more likely to be part of the wildlife branch. Exact logistic regression conducted gene by gene revealed 15 genes that were predictive of whether an isolate was of wildlife or bovine livestock isolate origin. Both multiple correspondence analysis and exact logistic regression revealed that in most cases, the presence of a particular gene (13 of 15) was associated with an isolate being of livestock rather than wildlife origin. In conclusion, the evidence gained from dendrogram analysis, multiple correspondence analysis and exact logistic regression indicates that mammalian wildlife carry CGF40 subtypes of C. jejuni distinct from those carried by bovine livestock. Future studies focused on source attribution of C. jejuni in human infections will help determine whether wildlife transmit Campylobacter jejuni directly to humans. © 2016 Blackwell Verlag GmbH.

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.

Exposure to the dental environment and prevalence of respiratory illness in dental student populations.

PubMed

Scannapieco, Frank A; Ho, Alex W; DiTolla, Maris; Chen, Casey; Dentino, Andrew R

2004-03-01

To determine if the prevalence of respiratory disease among dental students and dental residents varies with their exposure to the clinical dental environment. A detailed questionnaire was administered to 817 students at 3 dental schools. The questionnaire sought information concerning demographic characteristics, school year, exposure to the dental environment and dental procedures, and history of respiratory disease. The data obtained were subjected to bivariate and multiple logistic regression analysis. Respondents reported experiencing the following respiratory conditions during the previous year: asthma (26 cases), bronchitis (11 cases), chronic lung disease (6 cases), pneumonia (5 cases) and streptococcal pharyngitis (50 cases). Bivariate statistical analyses indicated no significant associations between the prevalence of any of the respiratory conditions and year in dental school, except for asthma, for which there was a significantly higher prevalence at 1 school compared to the other 2 schools. When all cases of respiratory disease were combined as a composite variable and subjected to multivariate logistic regression analysis controlling for age, sex, race, dental school, smoking history and alcohol consumption, no statistically significant association was observed between respiratory condition and year in dental school or exposure to the dental environment as a dental patient. No association was found between the prevalence of respiratory disease and a student's year in dental school or previous exposure to the dental environment as a patient. These results suggest that exposure to the dental environment does not increase the risk for respiratory infection in healthy dental health care workers.

Suicidal ideation, plans and attempts among medical college students in china: The effect of their parental characteristics.

PubMed

Sun, Long; Zhou, Chengchao; Xu, Lingzhong; Li, Shixue; Kong, Fanlei; Chu, Jie

2017-01-01

Medical college students are a high-risk population of suicidal ideation, plan and attempt. However, few studies discuss the effect of parental characteristics on suicidal ideation, plans and attempts among medical college students in China. A total of 2198 respondents answered the questionnaires referring social-demographic characteristics, psychological conditions, parental characteristics, suicidal ideation, plan and attempt. The prevalence of suicidal ideation, plan and attempt among the subjects were 17.9%, 5.2% and 4.3%, respectively. The results of multiple logistic regression showed that male, mother's education level, mother's parenting style, relationship in parents and psychological condition were associated with lifetime suicidal ideation. Male, mother's vocation, mother's parenting style, relationship in parents and psychological conditions were associated with suicide plan. Male, relationship in parents and psychological condition were associated with suicide attempt. Those imply that mother may play more roles on suicidal ideation and plan than father among medical college students in China. Psychological condition has a very strong association with suicidal ideation, plan and attempt. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Rate and predictors of employment among formerly polysubstance dependent urban individuals in recovery.

PubMed

Laudet, Alexandre B

2012-01-01

Employment is a key functioning index in addiction services and consistently emerges as a goal among individuals in recovery. Research on the employment status in the addiction field has focused on treatment populations or welfare recipients; little is known of employment rates or their predictors among individuals in recovery. This study seeks to fill this gap, capitalizing on a sample (N = 311) of urban individuals at various stages of recovery. Fewer than half (44.5%) of participants were employed; in logistic regressions, male gender and Caucasian race enhanced the odds of employment, whereas having a comorbid chronic physical or mental health condition decreased the odds by half. Implications center on the need to identify effective strategies to enhance employability among women and minorities and for integrated care for individuals with multiple chronic conditions.

Exploring the role of multiple chronic conditions in traditional Chinese medicine use and three types of traditional Chinese medicine therapy among adults in Taiwan.

PubMed

Cheng, Ting-Yi; Chou, Yiing-Jenq; Huang, Nicole; Pu, Christy; Chou, Yu-Ju; Chou, Pesus

2015-06-01

Numerous people with chronic conditions like to use traditional Chinese medicine (TCM) treatment, or integrated treatment of TCM and Western medicine (WM). Our study explored the associations between multiple chronic conditions (MCC) and TCM use and the use of specific types of TCM therapy among adults in Taiwan. In addition, we explored the TCM use of adults with seven common types of chronic conditions. In our study, a national representative sample in 2005 was used. The Chronic Condition Indicator and the Clinical Classifications System created by the U.S. Agency for Healthcare Research and Quality were used to define the number of chronic conditions of adults. Logistic regressions adjusted for demographic characteristics were used to analyze the associations. The frequency of TCM use among adults with different numbers of chronic conditions was quantified. TCM use for adults with ≥5 chronic conditions (odds ratio [OR] 1.86) was higher than TCM use for adults with 2-4 chronic conditions (OR 1.51) and TCM use for adults with one chronic condition (OR 1.48). The increase in the OR of the use of Chinese herbs and traumatology manipulative therapy according to the number of chronic conditions was not as substantial as that of acupuncture-moxibustion. The frequency of TCM use exhibited an increasing trend with the increase in the number of chronic conditions (p<.001). Among the seven common types of chronic conditions for adults, TCM use for adults with arthropathy (OR 2.01) was the highest. The probability and frequency of TCM use increased as the number of chronic conditions increased. The probability of Chinese herbs use, traumatology manipulative therapy use, and, particularly, acupuncture-moxibustion use increased as the number of chronic conditions increased. We suggest that government policy makers emphasize administering integrated TCM and WM care to people with chronic conditions or MCC.

Statistical Methods for Generalized Linear Models with Covariates Subject to Detection Limits.

PubMed

Bernhardt, Paul W; Wang, Huixia J; Zhang, Daowen

2015-05-01

Censored observations are a common occurrence in biomedical data sets. Although a large amount of research has been devoted to estimation and inference for data with censored responses, very little research has focused on proper statistical procedures when predictors are censored. In this paper, we consider statistical methods for dealing with multiple predictors subject to detection limits within the context of generalized linear models. We investigate and adapt several conventional methods and develop a new multiple imputation approach for analyzing data sets with predictors censored due to detection limits. We establish the consistency and asymptotic normality of the proposed multiple imputation estimator and suggest a computationally simple and consistent variance estimator. We also demonstrate that the conditional mean imputation method often leads to inconsistent estimates in generalized linear models, while several other methods are either computationally intensive or lead to parameter estimates that are biased or more variable compared to the proposed multiple imputation estimator. In an extensive simulation study, we assess the bias and variability of different approaches within the context of a logistic regression model and compare variance estimation methods for the proposed multiple imputation estimator. Lastly, we apply several methods to analyze the data set from a recently-conducted GenIMS study.

The impact of multi-morbidity on disability among older adults in South Africa: do hypertension and socio-demographic characteristics matter?

PubMed

Waterhouse, Philippa; van der Wielen, Nele; Banda, Pamela Chirwa; Channon, Andrew Amos

2017-04-08

Alongside the global population ageing phenomenon, there has been a rise in the number of individuals who suffer from multiple chronic conditions. Taking the case of South Africa, this study aims, first, to investigate the association between multi-morbidity and disability among older adults; and second, to examine whether hypertension (both diagnosed and undiagnosed) mediates this relationship. Lastly, we consider whether the impact of the multi-morbidity on disability varies by socio-demographic characteristics. Data were drawn from Wave 1 (2007-08) of the South African Study on Global Ageing and Adult Health. Disability was measured using the 12-item World Health Organisation Disability Assessment Schedule (WHODAS) 2.0. Scores were transformed into a binary variable whereby those over the 90 th percentile were classified as having a severe disability. The measure of multi-morbidity was based on a simple count of self-reported diagnosis of selected chronic conditions. Self-reports of diagnosed hypertension, in addition to blood pressure measurements at the time of interview, were used to create a three category hypertension variable: no hypertension (diagnosed or measured), diagnosed hypertension, hypertension not diagnosed but hypertensive measured blood pressure. Interactions between the number of chronic diseases with sex, ethnicity and wealth were tested. Logistic regression was used to analyze the relationships. 25.4% of the final sample had one and 13.2% two or more chronic diseases. Nearly half of the respondents had a hypertensive blood pressure when measured during the interview, but had not been previously diagnosed. A further third self-reported they had been told by a health professional they had hypertension. The logistic regression showed in comparison to those with no chronic conditions, those with one or two or more had significantly higher odds of severe disability. Hypertension was insignificant and did not change the direction or size of the effect of the multi-morbidity measure substantially. The interactions between number of chronic conditions with wealth were significant at the 5% level. The diagnosis of multiple chronic conditions, can be used to identify those most at risk of severe disability. Limited resources should be prioritized for such individuals in terms of preventative, rehabilitative and palliative care.

Estimation of a Nonlinear Intervention Phase Trajectory for Multiple-Baseline Design Data

ERIC Educational Resources Information Center

Hembry, Ian; Bunuan, Rommel; Beretvas, S. Natasha; Ferron, John M.; Van den Noortgate, Wim

2015-01-01

A multilevel logistic model for estimating a nonlinear trajectory in a multiple-baseline design is introduced. The model is applied to data from a real multiple-baseline design study to demonstrate interpretation of relevant parameters. A simple change-in-levels (?"Levels") model and a model involving a quadratic function…

Mixed conditional logistic regression for habitat selection studies.

PubMed

Duchesne, Thierry; Fortin, Daniel; Courbin, Nicolas

2010-05-01

1. Resource selection functions (RSFs) are becoming a dominant tool in habitat selection studies. RSF coefficients can be estimated with unconditional (standard) and conditional logistic regressions. While the advantage of mixed-effects models is recognized for standard logistic regression, mixed conditional logistic regression remains largely overlooked in ecological studies. 2. We demonstrate the significance of mixed conditional logistic regression for habitat selection studies. First, we use spatially explicit models to illustrate how mixed-effects RSFs can be useful in the presence of inter-individual heterogeneity in selection and when the assumption of independence from irrelevant alternatives (IIA) is violated. The IIA hypothesis states that the strength of preference for habitat type A over habitat type B does not depend on the other habitat types also available. Secondly, we demonstrate the significance of mixed-effects models to evaluate habitat selection of free-ranging bison Bison bison. 3. When movement rules were homogeneous among individuals and the IIA assumption was respected, fixed-effects RSFs adequately described habitat selection by simulated animals. In situations violating the inter-individual homogeneity and IIA assumptions, however, RSFs were best estimated with mixed-effects regressions, and fixed-effects models could even provide faulty conclusions. 4. Mixed-effects models indicate that bison did not select farmlands, but exhibited strong inter-individual variations in their response to farmlands. Less than half of the bison preferred farmlands over forests. Conversely, the fixed-effect model simply suggested an overall selection for farmlands. 5. Conditional logistic regression is recognized as a powerful approach to evaluate habitat selection when resource availability changes. This regression is increasingly used in ecological studies, but almost exclusively in the context of fixed-effects models. Fitness maximization can imply differences in trade-offs among individuals, which can yield inter-individual differences in selection and lead to departure from IIA. These situations are best modelled with mixed-effects models. Mixed-effects conditional logistic regression should become a valuable tool for ecological research.

Multiple Logistic Regression Analysis of Cigarette Use among High School Students

ERIC Educational Resources Information Center

Adwere-Boamah, Joseph

2011-01-01

A binary logistic regression analysis was performed to predict high school students' cigarette smoking behavior from selected predictors from 2009 CDC Youth Risk Behavior Surveillance Survey. The specific target student behavior of interest was frequent cigarette use. Five predictor variables included in the model were: a) race, b) frequency of…

Logistics Modeling for Lunar Exploration Systems

NASA Technical Reports Server (NTRS)

Andraschko, Mark R.; Merrill, R. Gabe; Earle, Kevin D.

2008-01-01

The extensive logistics required to support extended crewed operations in space make effective modeling of logistics requirements and deployment critical to predicting the behavior of human lunar exploration systems. This paper discusses the software that has been developed as part of the Campaign Manifest Analysis Tool in support of strategic analysis activities under the Constellation Architecture Team - Lunar. The described logistics module enables definition of logistics requirements across multiple surface locations and allows for the transfer of logistics between those locations. A key feature of the module is the loading algorithm that is used to efficiently load logistics by type into carriers and then onto landers. Attention is given to the capabilities and limitations of this loading algorithm, particularly with regard to surface transfers. These capabilities are described within the context of the object-oriented software implementation, with details provided on the applicability of using this approach to model other human exploration scenarios. Some challenges of incorporating probabilistics into this type of logistics analysis model are discussed at a high level.

Matched samples logistic regression in case-control studies with missing values: when to break the matches.

PubMed

Hansson, Lisbeth; Khamis, Harry J

2008-12-01

Simulated data sets are used to evaluate conditional and unconditional maximum likelihood estimation in an individual case-control design with continuous covariates when there are different rates of excluded cases and different levels of other design parameters. The effectiveness of the estimation procedures is measured by method bias, variance of the estimators, root mean square error (RMSE) for logistic regression and the percentage of explained variation. Conditional estimation leads to higher RMSE than unconditional estimation in the presence of missing observations, especially for 1:1 matching. The RMSE is higher for the smaller stratum size, especially for the 1:1 matching. The percentage of explained variation appears to be insensitive to missing data, but is generally higher for the conditional estimation than for the unconditional estimation. It is particularly good for the 1:2 matching design. For minimizing RMSE, a high matching ratio is recommended; in this case, conditional and unconditional logistic regression models yield comparable levels of effectiveness. For maximizing the percentage of explained variation, the 1:2 matching design with the conditional logistic regression model is recommended.

Physical and mental health status of survivors of multiple cancer diagnoses: findings from the National Health Interview Survey.

PubMed

Andrykowski, Michael A

2012-07-15

Little research has identified the physical and mental health status of survivors of multiple primary cancer diagnoses. By using data from the population-based 2009 National Health Information Survey, 154 survivors of multiple primary cancer diagnoses, 1427 survivors of a single cancer diagnosis, and 25,004 individuals without a history of cancer diagnosis were identified. The multiple cancer group was compared with the single cancer and no cancer groups with regard to physical and mental health status using analysis of covariance and binary logistic regression. Relative to the no cancer group, the multiple cancer group reported significantly poorer mental health status, greater lifetime, recent, and current prevalence of a variety of medical conditions and comorbidities, and more health-related disability. Although observed group differences between the multiple cancer and single cancer groups were less pronounced than those between the multiple cancer and no cancer groups, a consistent pattern was also evident; the multiple cancer group reported significantly poorer status relative to the single cancer group across a range of mental and physical health and illness-related disability indices. Diagnosis of 2 or more primary cancers (excluding nonmelanoma skin cancers) is associated with increased risk for poorer physical and mental health status over and above that associated with diagnosis of a single primary cancer. Survivors of multiple and single primary cancer diagnoses should be considered as distinct subgroups, and increased attention should be devoted to the unique status and needs of survivors of multiple primary cancer diagnoses. Copyright © 2011 American Cancer Society.

Determination of osteoporosis risk factors using a multiple logistic regression model in postmenopausal Turkish women.

PubMed

Akkus, Zeki; Camdeviren, Handan; Celik, Fatma; Gur, Ali; Nas, Kemal

2005-09-01

To determine the risk factors of osteoporosis using a multiple binary logistic regression method and to assess the risk variables for osteoporosis, which is a major and growing health problem in many countries. We presented a case-control study, consisting of 126 postmenopausal healthy women as control group and 225 postmenopausal osteoporotic women as the case group. The study was carried out in the Department of Physical Medicine and Rehabilitation, Dicle University, Diyarbakir, Turkey between 1999-2002. The data from the 351 participants were collected using a standard questionnaire that contains 43 variables. A multiple logistic regression model was then used to evaluate the data and to find the best regression model. We classified 80.1% (281/351) of the participants using the regression model. Furthermore, the specificity value of the model was 67% (84/126) of the control group while the sensitivity value was 88% (197/225) of the case group. We found the distribution of residual values standardized for final model to be exponential using the Kolmogorow-Smirnow test (p=0.193). The receiver operating characteristic curve was found successful to predict patients with risk for osteoporosis. This study suggests that low levels of dietary calcium intake, physical activity, education, and longer duration of menopause are independent predictors of the risk of low bone density in our population. Adequate dietary calcium intake in combination with maintaining a daily physical activity, increasing educational level, decreasing birth rate, and duration of breast-feeding may contribute to healthy bones and play a role in practical prevention of osteoporosis in Southeast Anatolia. In addition, the findings of the present study indicate that the use of multivariate statistical method as a multiple logistic regression in osteoporosis, which maybe influenced by many variables, is better than univariate statistical evaluation.

HRCT findings of collagen vascular disease-related interstitial pneumonia (CVD-IP): a comparative study among individual underlying diseases.

PubMed

Tanaka, N; Kunihiro, Y; Kubo, M; Kawano, R; Oishi, K; Ueda, K; Gondo, T

2018-05-29

To identify characteristic high-resolution computed tomography (CT) findings for individual collagen vascular disease (CVD)-related interstitial pneumonias (IPs). The HRCT findings of 187 patients with CVD, including 55 patients with rheumatoid arthritis (RA), 50 with systemic sclerosis (SSc), 46 with polymyositis/dermatomyositis (PM/DM), 15 with mixed connective tissue disease, 11 with primary Sjögren's syndrome, and 10 with systemic lupus erythematosus, were evaluated. Lung parenchymal abnormalities were compared among CVDs using χ 2 test, Kruskal-Wallis test, and multiple logistic regression analysis. A CT-pathology correlation was performed in 23 patients. In RA-IP, honeycombing was identified as the significant indicator based on multiple logistic regression analyses. Traction bronchiectasis (81.8%) was further identified as the most frequent finding based on χ 2 test. In SSc IP, lymph node enlargement and oesophageal dilatation were identified as the indicators based on multiple logistic regression analyses, and ground-glass opacity (GGO) was the most extensive based on Kruskal-Wallis test, which reflects the higher frequency of the pathological nonspecific interstitial pneumonia (NSIP) pattern present in the CT-pathology correlation. In PM/DM IP, airspace consolidation and the absence of honeycombing were identified as the indicators based on multiple logistic regression analyses, and predominance of consolidation over GGO (32.6%) and predominant subpleural distribution of GGO/consolidation (41.3%) were further identified as the most frequent findings based on χ 2 test, which reflects the higher frequency of the pathological NSIP and/or the organising pneumonia patterns present in the CT-pathology correlation. Several characteristic high-resolution CT findings with utility for estimating underlying CVD were identified. Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Improving virtual screening predictive accuracy of Human kallikrein 5 inhibitors using machine learning models.

PubMed

Fang, Xingang; Bagui, Sikha; Bagui, Subhash

2017-08-01

The readily available high throughput screening (HTS) data from the PubChem database provides an opportunity for mining of small molecules in a variety of biological systems using machine learning techniques. From the thousands of available molecular descriptors developed to encode useful chemical information representing the characteristics of molecules, descriptor selection is an essential step in building an optimal quantitative structural-activity relationship (QSAR) model. For the development of a systematic descriptor selection strategy, we need the understanding of the relationship between: (i) the descriptor selection; (ii) the choice of the machine learning model; and (iii) the characteristics of the target bio-molecule. In this work, we employed the Signature descriptor to generate a dataset on the Human kallikrein 5 (hK 5) inhibition confirmatory assay data and compared multiple classification models including logistic regression, support vector machine, random forest and k-nearest neighbor. Under optimal conditions, the logistic regression model provided extremely high overall accuracy (98%) and precision (90%), with good sensitivity (65%) in the cross validation test. In testing the primary HTS screening data with more than 200K molecular structures, the logistic regression model exhibited the capability of eliminating more than 99.9% of the inactive structures. As part of our exploration of the descriptor-model-target relationship, the excellent predictive performance of the combination of the Signature descriptor and the logistic regression model on the assay data of the Human kallikrein 5 (hK 5) target suggested a feasible descriptor/model selection strategy on similar targets. Copyright © 2017 Elsevier Ltd. All rights reserved.

Logistics Reduction and Repurposing Beyond Low Earth Orbit

NASA Technical Reports Server (NTRS)

Ewert, Michael K.; Broyan, James L., Jr.

2012-01-01

All human space missions, regardless of destination, require significant logistical mass and volume that is strongly proportional to mission duration. Anything that can be done to reduce initial mass and volume of supplies or reuse items that have been launched will be very valuable. Often, the logistical items require disposal and represent a trash burden. Logistics contributions to total mission architecture mass can be minimized by considering potential reuse using systems engineering analysis. In NASA's Advanced Exploration Systems "Logistics Reduction and Repurposing Project," various tasks will reduce the intrinsic mass of logistical packaging, enable reuse and repurposing of logistical packaging and carriers for other habitation, life support, crew health, and propulsion functions, and reduce or eliminate the nuisance aspects of trash at the same time. Repurposing reduces the trash burden and eliminates the need for hardware whose function can be provided by use of spent logistical items. However, these reuse functions need to be identified and built into future logical systems to enable them to effectively have a secondary function. These technologies and innovations will help future logistics systems to support multiple exploration missions much more efficiently.

Bifurcation approach to a logistic elliptic equation with a homogeneous incoming flux boundary condition

NASA Astrophysics Data System (ADS)

Umezu, Kenichiro

In this paper, we consider a semilinear elliptic boundary value problem in a smooth bounded domain, having the so-called logistic nonlinearity that originates from population dynamics, with a nonlinear boundary condition. Although the logistic nonlinearity has an absorption effect in the problem, the nonlinear boundary condition is induced by the homogeneous incoming flux on the boundary. The objective of our study is to analyze the existence of a bifurcation component of positive solutions from trivial solutions and its asymptotic behavior and stability. We perform this analysis using the method developed by Lyapunov and Schmidt, based on a scaling argument.

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.

Logistics Reduction and Repurposing Beyond Low Earth Orbit

NASA Technical Reports Server (NTRS)

Broyan, James Lee, Jr.; Ewert, Michael K.

2011-01-01

All human space missions, regardless of destination, require significant logistical mass and volume that is strongly proportional to mission duration. Anything that can be done to reduce initial mass and volume of supplies or reuse items that have been launched will be very valuable. Often, the logistical items require disposal and represent a trash burden. Utilizing systems engineering to analyze logistics from cradle-to-grave and then to potential reuse, can minimize logistics contributions to total mission architecture mass. In NASA's Advanced Exploration Systems Logistics Reduction and Repurposing Project , various tasks will reduce the intrinsic mass of logistical packaging, enable reuse and repurposing of logistical packaging and carriers for other habitation, life support, crew health, and propulsion functions, and reduce or eliminate the nuisances aspects of trash at the same time. Repurposing reduces the trash burden and eliminates the need for hardware whose function can be provided by use of spent logistic items. However, these reuse functions need to be identified and built into future logical systems to enable them to effectively have a secondary function. These technologies and innovations will help future logistic systems to support multiple exploration missions much more efficiently.

Working conditions and leisure-time physical activity among waged workers in South Korea: A cross-sectional study.

PubMed

Kim, Chungah; Cho, Youngtae

2015-01-01

Although waged workers' working conditions have notably diversified in South Korea, there is little research addressing this issue. This study explores the relationship between working conditions and engagement in leisure-time physical activities (LTPA) among waged workers in South Korea. Data from 19- to 64-year-old waged workers (men=2,562, women=1,627) from the 11th wave of the Korean Income and Labor Panel Study were included in this study. Multiple logistic regression analyses were conducted to assess the association between LTPA and working conditions by gender. More than 75% of employed persons did not participate in any type of LTPA. For male workers, those in manual, precarious, overtime, and non-shift positions were less likely to engage in LTPA, while for female workers, only manual and overtime work positions were significant factors influencing a low level of LTPA. Some negative work-related factors were associated with low LTPA, especially for male workers. Further studies should be conducted to clarify the pathways and barriers precluding engagement in LTPA due to work-related factors.

Breast Arterial Calcification Is Associated with Reproductive Factors in Asymptomatic Postmenopausal Women

PubMed Central

Whaley, Dana H.; Sheedy, Patrick F.; Peyser, Patricia A.

2010-01-01

Abstract Objective The etiology of breast arterial calcification (BAC) is not well understood. We examined reproductive history and cardiovascular disease (CVD) risk factor associations with the presence of detectable BAC in asymptomatic postmenopausal women. Methods Reproductive history and CVD risk factors were obtained in 240 asymptomatic postmenopausal women from a community-based research study who had a screening mammogram within 2 years of their participation in the study. The mammograms were reviewed for the presence of detectable BAC. Age-adjusted logistic regression models were fit to assess the association between each risk factor and the presence of BAC. Multiple variable logistic regression models were used to identify the most parsimonious model for the presence of BAC. Results The prevalence of BAC increased with increased age (p < 0.0001). The most parsimonious logistic regression model for BAC presence included age at time of examination, increased parity (p = 0.01), earlier age at first birth (p = 0.002), weight, and an age-by-weight interaction term (p = 0.004). Older women with a smaller body size had a higher probability of having BAC than women of the same age with a larger body size. Conclusions The presence or absence of BAC at mammography may provide an assessment of a postmenopausal woman's lifetime estrogen exposure and indicate women who could be at risk for hormonally related conditions. PMID:20629578

Sample size estimation for alternating logistic regressions analysis of multilevel randomized community trials of under-age drinking.

PubMed

Reboussin, Beth A; Preisser, John S; Song, Eun-Young; Wolfson, Mark

2012-07-01

Under-age drinking is an enormous public health issue in the USA. Evidence that community level structures may impact on under-age drinking has led to a proliferation of efforts to change the environment surrounding the use of alcohol. Although the focus of these efforts is to reduce drinking by individual youths, environmental interventions are typically implemented at the community level with entire communities randomized to the same intervention condition. A distinct feature of these trials is the tendency of the behaviours of individuals residing in the same community to be more alike than that of others residing in different communities, which is herein called 'clustering'. Statistical analyses and sample size calculations must account for this clustering to avoid type I errors and to ensure an appropriately powered trial. Clustering itself may also be of scientific interest. We consider the alternating logistic regressions procedure within the population-averaged modelling framework to estimate the effect of a law enforcement intervention on the prevalence of under-age drinking behaviours while modelling the clustering at multiple levels, e.g. within communities and within neighbourhoods nested within communities, by using pairwise odds ratios. We then derive sample size formulae for estimating intervention effects when planning a post-test-only or repeated cross-sectional community-randomized trial using the alternating logistic regressions procedure.

76 FR 42119 - 36(b)(1) Arms Sales Notification

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-18

.... Government and contractor engineering and logistics support services, and other related elements of logistics... documentation, U.S. Government and contractor engineering and logistics support services, and other related... range of adverse battlefield conditions. The hardware itself is Unclassified. The engineering design and...

Driver Mortality in Paired Side Impact Collisions Due to Incompatible Vehicle Types

PubMed Central

Crandall, C.S.

2003-01-01

Using a matched case control design, this study measured the mortality associated with paired passenger car-sport utility vehicle side impact (‘T-bone’) collisions using FARS data. Survival versus fatal outcome within the matched crash pairs was measured with matched pair odds ratios. Conditional logistic regression adjusted for multiple effects. Overall, passenger car drivers experienced greater mortality than did SUV drivers, regardless if they were in the struck or striking vehicle (odds ratio: 10.0; 95% confidence interval: 7.9, 12.5). Differential mortality persisted after adjustment for confounders. Efforts should be sought to improve passenger car side impact crashworthiness and to reduce SUV aggressivity. PMID:12941243

[Prevalence and factors associated with peripheral artery disease in patients with type 2 diabetes mellitus in Primary Care].

PubMed

Montero-Monterroso, J L; Gascón-Jiménez, J A; Vargas-Rubio, M D; Quero-Salado, C; Villalba-Marín, P; Pérula-de Torres, L A

2015-01-01

Peripheral artery disease in the lower limbs (PAD) is a prevalent condition that entails high morbidity in diabetic patients; this study assesses PAD in these patients and its socio-demographic and clinic associated variables. Descriptive study in a systematic sample of diabetic patients (DM2) aged 50-80 years, in Primary Care settings. The dependent variable was the presence of PAD diagnosed by ankle-brachial index (ABI) ≤ 0.9; independent variables: socio-demographic, clinical and laboratory. bivariate and multiple logistic regression analyses were performed to determine the variables associated with low ABI. A sample of 251 patients, 52.6% women; mean age: 68.5 ±8.5. A low ABI was detected in 18.3% (95% Confidence Interval (95% CI):13.3-23.3%), with 6 subjets (2.4%) previously diagnosed as suffering PAD. Age (OR=1.07; 95% CI: 1.02-1.12) and retinopathy (OR=2.69; 95% CI: 1.06-6.81) were associated (multiple logistic regression analysis) with ABI. The percentage of patients diagnosed with PAD is very low, although PAD prevalence is high among DM2 patients attending Primary Care clinics, especially in older patients and those with retinopathy. We emphasize the recommendation of performing the ABI test in this population at risk. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Maximal bite force, facial morphology and sucking habits in young children with functional posterior crossbite.

PubMed

Castelo, Paula Midori; Gavião, Maria Beatriz Duarte; Pereira, Luciano José; Bonjardim, Leonardo Rigoldi

2010-01-01

The maintenance of normal conditions of the masticatory function is determinant for the correct growth and development of its structures. Thus, the aims of this study were to evaluate the influence of sucking habits on the presence of crossbite and its relationship with maximal bite force, facial morphology and body variables in 67 children of both genders (3.5-7 years) with primary or early mixed dentition. The children were divided in four groups: primary-normocclusion (PN, n=19), primary-crossbite (PC, n=19), mixed-normocclusion (MN, n=13), and mixed-crossbite (MC, n=16). Bite force was measured with a pressurized tube, and facial morphology was determined by standardized frontal photographs: AFH (anterior face height) and BFW (bizygomatic facial width). It was observed that MC group showed lower bite force than MN, and AFH/BFW was significantly smaller in PN than PC (t-test). Weight and height were only significantly correlated with bite force in PC group (Pearson's correlation test). In the primary dentition, AFH/BFW and breast-feeding (at least six months) were positive and negatively associated with crossbite, respectively (multiple logistic regression). In the mixed dentition, breast-feeding and bite force showed negative associations with crossbite (univariate regression), while nonnutritive sucking (up to 3 years) associated significantly with crossbite in all groups (multiple logistic regression). In the studied sample, sucking habits played an important role in the etiology of crossbite, which was associated with lower bite force and long-face tendency.

Do race, ethnicity, and psychiatric diagnoses matter in the prevalence of multiple chronic medical conditions?

PubMed

Cabassa, Leopoldo J; Humensky, Jennifer; Druss, Benjamin; Lewis-Fernández, Roberto; Gomes, Arminda P; Wang, Shuai; Blanco, Carlos

2013-06-01

The proportion of people in the United States with multiple chronic medical conditions (MCMC) is increasing. Yet, little is known about the relationship that race, ethnicity, and psychiatric disorders have on the prevalence of MCMCs in the general population. This study used data from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N=33,107). Multinomial logistic regression models adjusting for sociodemographic variables, body mass index, and quality of life were used to examine differences in the 12-month prevalence of MCMC by race/ethnicity, psychiatric diagnosis, and the interactions between race/ethnicity and psychiatric diagnosis. Compared to non-Hispanic Whites, Hispanics reported lower odds of MCMC and African Americans reported higher odds of MCMC after adjusting for covariates. People with psychiatric disorders reported higher odds of MCMC compared with people without psychiatric disorders. There were significant interactions between race and psychiatric diagnosis associated with rates of MCMC. In the presence of certain psychiatric disorders, the odds of MCMC were higher among African Americans with psychiatric disorders compared to non-Hispanic Whites with similar psychiatric disorders. Our study results indicate that race, ethnicity, and psychiatric disorders are associated with the prevalence of MCMC. As the rates of MCMC rise, it is critical to identify which populations are at increased risk and how to best direct services to address their health care needs.

Fluoride exposure and indicators of thyroid functioning in the Canadian population: implications for community water fluoridation

PubMed Central

Barberio, Amanda M; Hosein, F Shaun; Quiñonez, Carlos; McLaren, Lindsay

2017-01-01

Background There are concerns that altered thyroid functioning could be the result of ingesting too much fluoride. Community water fluoridation (CWF) is an important source of fluoride exposure. Our objectives were to examine the association between fluoride exposure and (1) diagnosis of a thyroid condition and (2) indicators of thyroid functioning among a national population-based sample of Canadians. Methods We analysed data from Cycles 2 and 3 of the Canadian Health Measures Survey (CHMS). Logistic regression was used to assess associations between fluoride from urine and tap water samples and the diagnosis of a thyroid condition. Multinomial logistic regression was used to examine the relationship between fluoride exposure and thyroid-stimulating hormone (TSH) level (low/normal/high). Other available variables permitted additional exploratory analyses among the subset of participants for whom we could discern some fluoride exposure from drinking water and/or dental products. Results There was no evidence of a relationship between fluoride exposure (from urine and tap water) and the diagnosis of a thyroid condition. There was no statistically significant association between fluoride exposure and abnormal (low or high) TSH levels relative to normal TSH levels. Rerunning the models with the sample constrained to the subset of participants for whom we could discern some source(s) of fluoride exposure from drinking water and/or dental products revealed no significant associations. Conclusion These analyses suggest that, at the population level, fluoride exposure is not associated with impaired thyroid functioning in a time and place where multiple sources of fluoride exposure, including CWF, exist. PMID:28839078

Computerized Classification Testing under the One-Parameter Logistic Response Model with Ability-Based Guessing

ERIC Educational Resources Information Center

Wang, Wen-Chung; Huang, Sheng-Yun

2011-01-01

The one-parameter logistic model with ability-based guessing (1PL-AG) has been recently developed to account for effect of ability on guessing behavior in multiple-choice items. In this study, the authors developed algorithms for computerized classification testing under the 1PL-AG and conducted a series of simulations to evaluate their…

A Generalized Logistic Regression Procedure to Detect Differential Item Functioning among Multiple Groups

ERIC Educational Resources Information Center

Magis, David; Raiche, Gilles; Beland, Sebastien; Gerard, Paul

2011-01-01

We present an extension of the logistic regression procedure to identify dichotomous differential item functioning (DIF) in the presence of more than two groups of respondents. Starting from the usual framework of a single focal group, we propose a general approach to estimate the item response functions in each group and to test for the presence…

Using multiple logistic regression and GIS technology to predict landslide hazard in northeast Kansas, USA

USGS Publications Warehouse

Ohlmacher, G.C.; Davis, J.C.

2003-01-01

Landslides in the hilly terrain along the Kansas and Missouri rivers in northeastern Kansas have caused millions of dollars in property damage during the last decade. To address this problem, a statistical method called multiple logistic regression has been used to create a landslide-hazard map for Atchison, Kansas, and surrounding areas. Data included digitized geology, slopes, and landslides, manipulated using ArcView GIS. Logistic regression relates predictor variables to the occurrence or nonoccurrence of landslides within geographic cells and uses the relationship to produce a map showing the probability of future landslides, given local slopes and geologic units. Results indicated that slope is the most important variable for estimating landslide hazard in the study area. Geologic units consisting mostly of shale, siltstone, and sandstone were most susceptible to landslides. Soil type and aspect ratio were considered but excluded from the final analysis because these variables did not significantly add to the predictive power of the logistic regression. Soil types were highly correlated with the geologic units, and no significant relationships existed between landslides and slope aspect. ?? 2003 Elsevier Science B.V. All rights reserved.

32 CFR 231.7 - Procedures-domestic credit unions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... of logistical support and space arrangements may be made through the Secretary of the Military... improvements and restore the land to its original condition. (d) Use of space, logistical support, and military...) Logistical support. When available, custodial and janitorial services to include garbage disposal and outdoor...

32 CFR 231.7 - Procedures-domestic credit unions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... of logistical support and space arrangements may be made through the Secretary of the Military... improvements and restore the land to its original condition. (d) Use of space, logistical support, and military...) Logistical support. When available, custodial and janitorial services to include garbage disposal and outdoor...

32 CFR 231.7 - Procedures-domestic credit unions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... of logistical support and space arrangements may be made through the Secretary of the Military... improvements and restore the land to its original condition. (d) Use of space, logistical support, and military...) Logistical support. When available, custodial and janitorial services to include garbage disposal and outdoor...

Regularization Paths for Conditional Logistic Regression: The clogitL1 Package.

PubMed

Reid, Stephen; Tibshirani, Rob

2014-07-01

We apply the cyclic coordinate descent algorithm of Friedman, Hastie, and Tibshirani (2010) to the fitting of a conditional logistic regression model with lasso [Formula: see text] and elastic net penalties. The sequential strong rules of Tibshirani, Bien, Hastie, Friedman, Taylor, Simon, and Tibshirani (2012) are also used in the algorithm and it is shown that these offer a considerable speed up over the standard coordinate descent algorithm with warm starts. Once implemented, the algorithm is used in simulation studies to compare the variable selection and prediction performance of the conditional logistic regression model against that of its unconditional (standard) counterpart. We find that the conditional model performs admirably on datasets drawn from a suitable conditional distribution, outperforming its unconditional counterpart at variable selection. The conditional model is also fit to a small real world dataset, demonstrating how we obtain regularization paths for the parameters of the model and how we apply cross validation for this method where natural unconditional prediction rules are hard to come by.

Regularization Paths for Conditional Logistic Regression: The clogitL1 Package

PubMed Central

Reid, Stephen; Tibshirani, Rob

2014-01-01

We apply the cyclic coordinate descent algorithm of Friedman, Hastie, and Tibshirani (2010) to the fitting of a conditional logistic regression model with lasso (ℓ1) and elastic net penalties. The sequential strong rules of Tibshirani, Bien, Hastie, Friedman, Taylor, Simon, and Tibshirani (2012) are also used in the algorithm and it is shown that these offer a considerable speed up over the standard coordinate descent algorithm with warm starts. Once implemented, the algorithm is used in simulation studies to compare the variable selection and prediction performance of the conditional logistic regression model against that of its unconditional (standard) counterpart. We find that the conditional model performs admirably on datasets drawn from a suitable conditional distribution, outperforming its unconditional counterpart at variable selection. The conditional model is also fit to a small real world dataset, demonstrating how we obtain regularization paths for the parameters of the model and how we apply cross validation for this method where natural unconditional prediction rules are hard to come by. PMID:26257587

Relating Factors for Depression in Korean Working Women: Secondary Analysis of the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V).

PubMed

Lee, Kyung-Jae; Kim, Jeung-Im

2015-09-01

The purpose of this study was to investigate the health behaviors and risk factors for self-reported depression in Korean working women. This study adopted a secondary analysis from the fifth Korean National Health and Nutrition Examination Survey (KNHANES-V) for the Health Examination Survey and Health Behavior Survey, using stratified, multi-stage, cluster-sampling design to obtain a nationally representative sample. Data were gathered on extensive information including sociodemographic, occupational characteristics, health behaviors and depression. Multiple logistic regression analysis was employed to compute the odds ratio (OR) between health behaviors and depression to identify the health behaviors and the risk factors for depression with adjustment for the complex sample design of the survey. The prevalence rate of depression was 15.5% among working women. Depression was more common in older female workers and in those with part-time job. Current smokers were significantly more likely to be depression-positive. In a multiple logistic regression analysis, significant variables of depression were marital status (OR = 2.02; 95% CI [1.05, 3.89]), smoking status (OR = 1.55; 95% CI [1.01, 2.38]), stress (OR = 0.20; 95% CI [0.15, 0.26]), employment condition (OR = 1.77; 95% CI [1.34, 2.33]) and health status (OR = 2.10; 95% CI [1.53, 2.87]). Based on the study, factors leading to depression were marital status, current smoking, stress, employment condition and self-reported health status. Further studies are expected to unravel the characteristics of stress. Health care providers for women need to evaluate underreported depression and change their associated health behaviors. Also it is necessary to establish preventive strategies for female workers to control the negative effect of depression in the workplace. Copyright © 2015. Published by Elsevier B.V.

Explaining, not just predicting, drives interest in personal genomics.

PubMed

Meisel, Susanne F; Carere, Deanna Alexis; Wardle, Jane; Kalia, Sarah S; Moreno, Tanya A; Mountain, Joanna L; Roberts, J Scott; Green, Robert C

2015-01-01

There is a widespread assumption that risk prediction is the major driver of customer interest in personal genomic testing (PGT). However, some customers may also be motivated by finding out whether their existing diseases have a genetic etiology. We evaluated the impact of an existing medical diagnosis on customer interest in condition-specific results from PGT. Using a prospective online survey of PGT customers, we measured customer interest prior to receiving PGT results for 11 health conditions, and examined the association between interest and personal medical history of these conditions using logistic regression. We analyzed data from 1,538 PGT customers, mean age 48.7 years, 61 % women, 90 % White, and 47 % college educated. The proportion of customers who were 'very interested' in condition-specific PGT varied considerably, from 28 % for ulcerative colitis to 68% for heart disease. After adjusting for demographic and personal characteristics including family history, having a diagnosis of the condition itself was significantly associated with interest in genetic testing for risk of that condition, with odds ratios ranging from 2.07 (95 % CI 1.28-3.37) for diabetes to 19.99 (95 % CI 4.57-87.35) for multiple sclerosis. PGT customers are particularly interested in genetic markers for their existing medical conditions, suggesting that the value of genetic testing is not only predictive, but also explanatory.

Incremental Benefit of a Home Visit Following Discharge for Patients with Multiple Chronic Conditions Receiving Transitional Care

PubMed Central

Jackson, Carlos; Kasper, Elizabeth W.; Williams, Christianna

2016-01-01

Abstract Transitional care management is effective at reducing hospital readmissions among patients with multiple chronic conditions, but evidence is lacking on the relative benefit of the home visit as a component of transitional care. The sample included non-dual Medicaid recipients with multiple chronic conditions enrolled in Community Care of North Carolina (CCNC), with a hospital discharge between July 2010 and December 2012. Using claims data and care management records, this study retrospectively examined whether home visits reduced the odds of 30-day readmission compared to less intensive transitional care support, using multivariate logistic regression to control for demographic and clinical characteristics. Additionally, the researchers examined group differences within clinical risk strata on inpatient admissions and total cost of care in the 6 months following hospital discharge. Of 35,174 discharges receiving transitional care from a CCNC care manager, 21% (N = 7468) included a home visit. In multivariate analysis, home visits significantly reduced the odds of readmission within 30 days (odds ratio = 0.52, 95% confidence interval 0.48–0.57). At the 6-month follow-up, home visits were associated with fewer inpatient admissions within 4 of 6 clinical risk strata, and lower total costs of care for highest risk patients (average per member per month cost difference $970; P < 0.01). For complex chronic patients, home visits reduced the likelihood of a 30-day readmission by almost half compared to less intensive forms of nurse-led transitional care support. Higher risk patients experienced the greatest benefit in terms of number of inpatient admissions and total cost of care in the 6 months following discharge. (Population Health Management 2016;19:163–170) PMID:26431255

Analysis Test of Understanding of Vectors with the Three-Parameter Logistic Model of Item Response Theory and Item Response Curves Technique

ERIC Educational Resources Information Center

Rakkapao, Suttida; Prasitpong, Singha; Arayathanitkul, Kwan

2016-01-01

This study investigated the multiple-choice test of understanding of vectors (TUV), by applying item response theory (IRT). The difficulty, discriminatory, and guessing parameters of the TUV items were fit with the three-parameter logistic model of IRT, using the parscale program. The TUV ability is an ability parameter, here estimated assuming…

Understanding logistic regression analysis.

PubMed

Sperandei, Sandro

2014-01-01

Logistic regression is used to obtain odds ratio in the presence of more than one explanatory variable. The procedure is quite similar to multiple linear regression, with the exception that the response variable is binomial. The result is the impact of each variable on the odds ratio of the observed event of interest. The main advantage is to avoid confounding effects by analyzing the association of all variables together. In this article, we explain the logistic regression procedure using examples to make it as simple as possible. After definition of the technique, the basic interpretation of the results is highlighted and then some special issues are discussed.

Improving link prediction in complex networks by adaptively exploiting multiple structural features of networks

NASA Astrophysics Data System (ADS)

Ma, Chuang; Bao, Zhong-Kui; Zhang, Hai-Feng

2017-10-01

So far, many network-structure-based link prediction methods have been proposed. However, these methods only highlight one or two structural features of networks, and then use the methods to predict missing links in different networks. The performances of these existing methods are not always satisfied in all cases since each network has its unique underlying structural features. In this paper, by analyzing different real networks, we find that the structural features of different networks are remarkably different. In particular, even in the same network, their inner structural features are utterly different. Therefore, more structural features should be considered. However, owing to the remarkably different structural features, the contributions of different features are hard to be given in advance. Inspired by these facts, an adaptive fusion model regarding link prediction is proposed to incorporate multiple structural features. In the model, a logistic function combing multiple structural features is defined, then the weight of each feature in the logistic function is adaptively determined by exploiting the known structure information. Last, we use the "learnt" logistic function to predict the connection probabilities of missing links. According to our experimental results, we find that the performance of our adaptive fusion model is better than many similarity indices.

Asymptotic behavior of degenerate logistic equations

NASA Astrophysics Data System (ADS)

Arrieta, José M.; Pardo, Rosa; Rodríguez-Bernal, Aníbal

2015-12-01

We analyze the asymptotic behavior of positive solutions of parabolic equations with a class of degenerate logistic nonlinearities of the type λu - n (x)uρ. An important characteristic of this work is that the region where the logistic term n (ṡ) vanishes, that is K0 = { x : n (x) = 0 }, may be non-smooth. We analyze conditions on λ, ρ, n (ṡ) and K0 guaranteeing that the solution starting at a positive initial condition remains bounded or blows up as time goes to infinity. The asymptotic behavior may not be the same in different parts of K0.

An Examination of the Likelihood of Home Discharge After General Hospitalizations Among Medicaid Recipients

PubMed Central

Mkanta, William N.; Chumbler, Neale R.; Yang, Kai; Saigal, Romesh; Abdollahi, Mohammad; Mejia de Grubb, Maria C.; Ezekekwu, Emmanuel U.

2017-01-01

Ability to predict discharge destination would be a useful way of optimizing posthospital care. We conducted a cross-sectional, multiple state study of inpatient services to assess the likelihood of home discharges in 2009 among Medicaid enrollees who were discharged following general hospitalizations. Analyses were conducted using hospitalization data from the states of California, Georgia, Michigan, and Mississippi. A total of 33 160 patients were included in the study among which 13 948 (42%) were discharged to their own homes and 19 212 (58%) were discharged to continue with institutional-based treatment. A multiple logistic regression model showed that gender, age, race, and having ambulatory care-sensitive conditions upon admission were significant predictors of home-based discharges. Females were at higher odds of home discharges in the sample (odds ratio [OR] = 1.631; 95% confidence interval [CI], 1.520-1.751), while patients with ambulatory care-sensitive conditions were less likely to get home discharges (OR = 0.739; 95% CI, 0.684-0.798). As the nation engages in the continued effort to improve the effectiveness of the health care system, cost savings are possible if providers and systems of care are able to identify admission factors with greater prospects for in-home services after discharge.

Multiple imputation: an application to income nonresponse in the National Survey on Recreation and the Environment

Treesearch

Stanley J. Zarnoch; H. Ken Cordell; Carter J. Betz; John C. Bergstrom

2010-01-01

Multiple imputation is used to create values for missing family income data in the National Survey on Recreation and the Environment. We present an overview of the survey and a description of the missingness pattern for family income and other key variables. We create a logistic model for the multiple imputation process and to impute data sets for family income. We...

Assessment of Risk Factors of Intrauterine Adhesions in Patients With Induced Abortion and the Curative Effect of Hysteroscopic Surgery.

PubMed

Mo, Xiaoliang; Qin, Guirong; Zhou, Zhoulin; Jiang, Xiaoli

2017-10-03

To explore the risk factors for intrauterine adhesions in patients with artificial abortion and clinical efficacy of hysteroscopic dissection. 1500 patients undergoing artificial abortion between January 2014 and June 2015 were enrolled into this study. The patients were divided into two groups with or without intrauterine adhesions. Univariate and Multiple logistic regression were conducted to assess the effects of multiple factors on the development of intrauterine adhesions following induced abortion. The incidence rate for intrauterine adhesions following induced abortion is 17.0%. Univariate showed that preoperative inflammation, multiple pregnancies and suction evacuation time are the influence risk factors of intrauterine adhesions. Multiple logistic regression demonstrates that multiple pregnancies, high intrauterine negative pressure, and long suction evacuation time are independent risk factors for the development of intrauterine adhesions following induced abortion. Additionally, intrauterine adhesions were observed in 105 mild, 80 moderate, and 70 severe cases. The cure rates for these three categories of intrauterine adhesions by hysteroscopic surgery were 100.0%, 93.8%, and 85.7%, respectively. Multiple pregnancies, high negative pressure suction evacuation and long suction evacuation time are independent risk factors for the development of intrauterine adhesions following induced abortions. Hysteroscopic surgery substantially improves the clinical outcomes of intrauterine adhesions.

Age-related risk factors with nonfatal traffic accidents in urban areas in Maringá, Paraná, Brazil.

PubMed

de Melo, Willian Augusto; Alarcão, Ana Carolina Jacinto; de Oliveira, Analice Paula Rocha; Pelloso, Sandra Marisa; Carvalho, Maria Dalva de Barros

2017-02-17

The present study aimed to analyze the factors associated with the occurrence of nonfatal traffic accidents regarding age. A retrospective, transversal, and analytical study was carried out in the municipality of Maringá, Paraná, Brazil, based on data from Boletins de Ocorrência de Acidente de Trânsito ("Police Occurrence Bulletins"; BOATs). Following probability sampling, the sociodemographic aspects, logistics, environmental conditions, and time of occurrence of 418 cases of accidents were analyzed. The age of the victims was considered to be the dependent variable. The data were analyzed using descriptive statistics and bivariate, multivariate, and variance analysis, considering a confidence interval of 95% and a significance level of 5% (P <.05). Results revealed that young people (15-29 years) were twice as likely to be hospitalized due to severe injuries. Young motorcyclists had a 2.5 times greater chance of suffering accidents (P <.001); the use of other vehicles such as cars, bicycles, buses, and trucks represented a protective factor for this group (P <.05). Multiple logistic regression revealed that the main predictors for the occurrence of accidents were being single, having over 8 years of education, having had a driver's license for less than 3 years, roads with low luminosity, and driving at night. Demographic, environmental, and logistical factors were associated with morbidity due to traffic accidents among young people. These results challenge society and policy makers to create more effective strategies to minimize this serious public health problem.

Ergonomic analyses within the French transport and logistics sector: first steps towards a new "act elsewhere" prevention approach.

PubMed

Wioland, Liên

2013-10-01

Statistics from the French Employee National Health Insurance Fund indicate high accident levels in the transport sector. This study represents initial thinking on a new approach to transport sector prevention based on the assumption that a work situation could be improved by acting on another interconnected work situation. Ergonomic analysis of two connected work situations, involving the road haulage drivers and cross-docking platform employees, was performed to test this assumption. Our results show that drivers are exposed to a number of identified risks, but their multiple tasks raise the question of activity intensification. The conditions, under which the drivers will perform their work and take to the road, are partly determined by the quality and organisation of the platform with which they interact. We make a number of recommendations (e.g. changing handling equipment, re-appraising certain jobs) to improve platform organisation and employee working conditions with the aim of also improving driver conditions. These initial steps in this prevention approach appear promising, but more detailed investigation is required. Copyright © 2013 Elsevier Ltd. All rights reserved.

Application of a Multidimensional Nested Logit Model to Multiple-Choice Test Items

ERIC Educational Resources Information Center

Bolt, Daniel M.; Wollack, James A.; Suh, Youngsuk

2012-01-01

Nested logit models have been presented as an alternative to multinomial logistic models for multiple-choice test items (Suh and Bolt in "Psychometrika" 75:454-473, 2010) and possess a mathematical structure that naturally lends itself to evaluating the incremental information provided by attending to distractor selection in scoring. One potential…

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…

The Effectiveness of Using a Multiple Gating Approach to Discriminate among ADHD Subtypes

ERIC Educational Resources Information Center

Simonsen, Brandi M.; Bullis, Michael D.

2007-01-01

This study explored the ability of Systematically Progressive Assessment (SPA), a multiple gating approach for assessing students with attention-deficit/hyperactivity disorder (ADHD), to discriminate between subtypes of ADHD. A total of 48 students with ADHD (ages 6-11) were evaluated with three "gates" of assessment. Logistic regression analysis…

Adverse Effects of Prolonged Sitting Behavior on the General Health of Office Workers.

PubMed

Daneshmandi, Hadi; Choobineh, Alireza; Ghaem, Haleh; Karimi, Mehran

2017-07-01

Excessive sitting behavior is a risk factor for many adverse health outcomes. This study aimed to survey the prevalence of sitting behavior and its adverse effects among Iranian office workers. This cross-sectional study included 447 Iranian office workers. A two-part questionnaire was used as the data collection tool. The first part surveyed the demographic characteristics and general health of the respondents, while the second part contained the Nordic Musculoskeletal Questionnaire (NMQ) to assess symptoms. Statistical analyses were performed using the Statistical Package for the Social Sciences software using Mann-Whitney U and Chi-square tests and multiple logistic regression analysis. The respondents spent an average of 6.29 hours of an 8-hour working shift in a sitting position. The results showed that 48.8% of the participants did not feel comfortable with their workstations and 73.6% felt exhausted during the workday. Additionally, 6.3% suffered from hypertension, and 11.2% of them reported hyperlipidemia. The results of the NMQ showed that neck (53.5%), lower back (53.2%) and shoulder (51.6%) symptoms were the most prevalent problem among office workers. Based upon a multiple logistic regression, only sex had a significant association with prolonged sitting behavior (odds ratio = 3.084). Our results indicated that long sitting times were associated with exhaustion during the working day, decreased job satisfaction, hypertension, and musculoskeletal disorder symptoms in the shoulders, lower back, thighs, and knees of office workers. Sitting behavior had adverse effects on office workers. Active workstations are therefore recommended to improve working conditions.

Maximal bite force, facial morphology and sucking habits in young children with functional posterior crossbite

PubMed Central

CASTELO, Paula Midori; GAVIÃO, Maria Beatriz Duarte; PEREIRA, Luciano José; BONJARDIM, Leonardo Rigoldi

2010-01-01

Objective The maintenance of normal conditions of the masticatory function is determinant for the correct growth and development of its structures. Thus, the aims of this study were to evaluate the influence of sucking habits on the presence of crossbite and its relationship with maximal bite force, facial morphology and body variables in 67 children of both genders (3.5-7 years) with primary or early mixed dentition. Material and methods The children were divided in four groups: primary-normocclusion (PN, n=19), primary-crossbite (PC, n=19), mixed-normocclusion (MN, n=13), and mixed-crossbite (MC, n=16). Bite force was measured with a pressurized tube, and facial morphology was determined by standardized frontal photographs: AFH (anterior face height) and BFW (bizygomatic facial width). Results It was observed that MC group showed lower bite force than MN, and AFH/ BFW was significantly smaller in PN than PC (t-test). Weight and height were only significantly correlated with bite force in PC group (Pearson’s correlation test). In the primary dentition, AFH/BFW and breast-feeding (at least six months) were positive and negatively associated with crossbite, respectively (multiple logistic regression). In the mixed dentition, breastfeeding and bite force showed negative associations with crossbite (univariate regression), while nonnutritive sucking (up to 3 years) associated significantly with crossbite in all groups (multiple logistic regression). Conclusions In the studied sample, sucking habits played an important role in the etiology of crossbite, which was associated with lower bite force and long-face tendency. PMID:20485925

The Use of Logistics n the Quality Parameters Control System of Material Flow

ERIC Educational Resources Information Center

Karpova, Natalia P.; Toymentseva, Irina A.; Shvetsova, Elena V.; Chichkina, Vera D.; Chubarkova, Elena V.

2016-01-01

The relevance of the research problem is conditioned on the need to justify the use of the logistics methodologies in the quality parameters control process of material flows. The goal of the article is to develop theoretical principles and practical recommendations for logistical system control in material flows quality parameters. A leading…

Fluoride exposure and indicators of thyroid functioning in the Canadian population: implications for community water fluoridation.

PubMed

Barberio, Amanda M; Hosein, F Shaun; Quiñonez, Carlos; McLaren, Lindsay

2017-10-01

There are concerns that altered thyroid functioning could be the result of ingesting too much fluoride. Community water fluoridation (CWF) is an important source of fluoride exposure. Our objectives were to examine the association between fluoride exposure and (1) diagnosis of a thyroid condition and (2) indicators of thyroid functioning among a national population-based sample of Canadians. We analysed data from Cycles 2 and 3 of the Canadian Health Measures Survey (CHMS). Logistic regression was used to assess associations between fluoride from urine and tap water samples and the diagnosis of a thyroid condition. Multinomial logistic regression was used to examine the relationship between fluoride exposure and thyroid-stimulating hormone (TSH) level (low/normal/high). Other available variables permitted additional exploratory analyses among the subset of participants for whom we could discern some fluoride exposure from drinking water and/or dental products. There was no evidence of a relationship between fluoride exposure (from urine and tap water) and the diagnosis of a thyroid condition. There was no statistically significant association between fluoride exposure and abnormal (low or high) TSH levels relative to normal TSH levels. Rerunning the models with the sample constrained to the subset of participants for whom we could discern some source(s) of fluoride exposure from drinking water and/or dental products revealed no significant associations. These analyses suggest that, at the population level, fluoride exposure is not associated with impaired thyroid functioning in a time and place where multiple sources of fluoride exposure, including CWF, exist. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Factors associated with vocal fold pathologies in teachers.

PubMed

Souza, Carla Lima de; Carvalho, Fernando Martins; Araújo, Tânia Maria de; Reis, Eduardo José Farias Borges Dos; Lima, Verônica Maria Cadena; Porto, Lauro Antonio

2011-10-01

To analyze factors associated with the prevalence of the medical diagnosis of vocal fold pathologies in teachers. A census-based epidemiological, cross-sectional study was conducted with 4,495 public primary and secondary school teachers in the city of Salvador, Northeastern Brazil, between March and April 2006. The dependent variable was the self-reported medical diagnosis of vocal fold pathologies and the independent variables were sociodemographic characteristics; professional activity; work organization/interpersonal relationships; physical work environment characteristics; frequency of common mental disorders, measured by the Self-Reporting Questionnaire-20 (SRQ-20 >7); and general health conditions. Descriptive statistical, bivariate and multiple logistic regression analysis techniques were used. The prevalence of self-reported medical diagnosis of vocal fold pathologies was 18.9%. In the logistic regression analysis, the variables that remained associated with this medical diagnosis were as follows: being female, having worked as a teacher for more than seven years, excessive voice use, reporting more than five unfavorable physical work environment characteristics and presence of common mental disorders. The presence of self-reported vocal fold pathologies was associated with factors that point out the need of actions that promote teachers' vocal health and changes in their work structure and organization.

Associations between headache and stress, alcohol drinking, exercise, sleep, and comorbid health conditions in a Japanese population.

PubMed

Yokoyama, Masako; Yokoyama, Tetsuji; Funazu, Kazuo; Yamashita, Takeshi; Kondo, Shuji; Hosoai, Hiroshi; Yokoyama, Akira; Nakamura, Haruo

2009-06-01

We conducted a cross-sectional survey of 12,988 subjects aged 20-79 years (5,908 men and 7,090 women) receiving health checkups at a Tokyo clinic. They filled out a self-administered structured questionnaire, and 5.4% of the men and 15.4% of the women reported having headaches. Younger subjects were more prone to having headaches. The likelihood of having headaches increased with stress level and decreased ability to relieve stress in both genders. There was an inverse dose-response relationship between having headaches and alcohol consumption, and less walking/exercise and sleep problems increased the likelihood of headaches in both genders. Headache sufferers of both genders were more likely to report multiple additional poor health conditions. A multivariate stepwise logistic analysis showed that age, self-estimated degree of stress, reported number of additional poor health conditions, and less alcohol consumption were independently correlated with having headaches. In conclusion, although women were more susceptible to headache, Japanese men and women in Tokyo shared factors associated with headache, including age, stress, having other poor health conditions, alcohol consumption, sleep, and exercise.

Quality of Disease Management and Risk of Mortality in English Primary Care Practices.

PubMed

Dusheiko, Mark; Gravelle, Hugh; Martin, Stephen; Smith, Peter C

2015-10-01

To investigate whether better management of chronic conditions by family practices reduces mortality risk. Two random samples of 5 million patients registered with over 8,000 English family practices followed up for 4 years (2004/5-2007/8). Measures of the quality of disease management for 10 conditions were constructed for each family practice for each year. The outcome measure was an indicator taking the value 1 if the patient died during a specified year, 0 otherwise. Cross-section and multilevel panel data multiple logistic regressions were estimated. Covariates included age, gender, morbidity, hospitalizations, attributed socio-economic characteristics, and local health care supply measures. Although a composite measure of the quality of disease management for all 10 conditions was significantly associated with lower mortality, only the quality of stroke care was significant when all 10 quality measures were entered in the regression. The panel data results suggest that a 1 percent improvement in the quality of stroke care could reduce the annual number of deaths in England by 782 [95 percent CI: 423, 1140]. A longer study period may be necessary to detect any mortality impact of better management of other conditions. © Health Research and Educational Trust.

Dynamics of a stochastic HIV-1 infection model with logistic growth

NASA Astrophysics Data System (ADS)

Jiang, Daqing; Liu, Qun; Shi, Ningzhong; Hayat, Tasawar; Alsaedi, Ahmed; Xia, Peiyan

2017-03-01

This paper is concerned with a stochastic HIV-1 infection model with logistic growth. Firstly, by constructing suitable stochastic Lyapunov functions, we establish sufficient conditions for the existence of ergodic stationary distribution of the solution to the HIV-1 infection model. Then we obtain sufficient conditions for extinction of the infection. The stationary distribution shows that the infection can become persistent in vivo.

NAVSUP Global Logistics Support

DTIC Science & Technology

2012-08-01

Support $3.5 M Ill SB Contracting Actions Ill SB Value 35% of total spend to Small Business ! NAVAL SUPPLY SYSTEMS COMMAND • Procurement • Barge...Other services now using as well • Awarded Aug 2011, Features: • 100% Sma II Business Set Aside ! • 25 multiple award task order contracts to 8...UP- GLOBAL LOGISTICS I · -~ --; •• ~.c. SUPPORT ,.. NAVAL SUPPLY SYSTEMS COMMAND Fiscal Year 2011 Small Business Contracting Spend: 28,000 actions

Interpretation of commonly used statistical regression models.

PubMed

Kasza, Jessica; Wolfe, Rory

2014-01-01

A review of some regression models commonly used in respiratory health applications is provided in this article. Simple linear regression, multiple linear regression, logistic regression and ordinal logistic regression are considered. The focus of this article is on the interpretation of the regression coefficients of each model, which are illustrated through the application of these models to a respiratory health research study. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

Using Logistic Regression To Predict the Probability of Debris Flows Occurring in Areas Recently Burned By Wildland Fires

USGS Publications Warehouse

Rupert, Michael G.; Cannon, Susan H.; Gartner, Joseph E.

2003-01-01

Logistic regression was used to predict the probability of debris flows occurring in areas recently burned by wildland fires. Multiple logistic regression is conceptually similar to multiple linear regression because statistical relations between one dependent variable and several independent variables are evaluated. In logistic regression, however, the dependent variable is transformed to a binary variable (debris flow did or did not occur), and the actual probability of the debris flow occurring is statistically modeled. Data from 399 basins located within 15 wildland fires that burned during 2000-2002 in Colorado, Idaho, Montana, and New Mexico were evaluated. More than 35 independent variables describing the burn severity, geology, land surface gradient, rainfall, and soil properties were evaluated. The models were developed as follows: (1) Basins that did and did not produce debris flows were delineated from National Elevation Data using a Geographic Information System (GIS). (2) Data describing the burn severity, geology, land surface gradient, rainfall, and soil properties were determined for each basin. These data were then downloaded to a statistics software package for analysis using logistic regression. (3) Relations between the occurrence/non-occurrence of debris flows and burn severity, geology, land surface gradient, rainfall, and soil properties were evaluated and several preliminary multivariate logistic regression models were constructed. All possible combinations of independent variables were evaluated to determine which combination produced the most effective model. The multivariate model that best predicted the occurrence of debris flows was selected. (4) The multivariate logistic regression model was entered into a GIS, and a map showing the probability of debris flows was constructed. The most effective model incorporates the percentage of each basin with slope greater than 30 percent, percentage of land burned at medium and high burn severity in each basin, particle size sorting, average storm intensity (millimeters per hour), soil organic matter content, soil permeability, and soil drainage. The results of this study demonstrate that logistic regression is a valuable tool for predicting the probability of debris flows occurring in recently-burned landscapes.

Predicting 30-day Hospital Readmission with Publicly Available Administrative Database. A Conditional Logistic Regression Modeling Approach.

PubMed

Zhu, K; Lou, Z; Zhou, J; Ballester, N; Kong, N; Parikh, P

2015-01-01

This article is part of the Focus Theme of Methods of Information in Medicine on "Big Data and Analytics in Healthcare". Hospital readmissions raise healthcare costs and cause significant distress to providers and patients. It is, therefore, of great interest to healthcare organizations to predict what patients are at risk to be readmitted to their hospitals. However, current logistic regression based risk prediction models have limited prediction power when applied to hospital administrative data. Meanwhile, although decision trees and random forests have been applied, they tend to be too complex to understand among the hospital practitioners. Explore the use of conditional logistic regression to increase the prediction accuracy. We analyzed an HCUP statewide inpatient discharge record dataset, which includes patient demographics, clinical and care utilization data from California. We extracted records of heart failure Medicare beneficiaries who had inpatient experience during an 11-month period. We corrected the data imbalance issue with under-sampling. In our study, we first applied standard logistic regression and decision tree to obtain influential variables and derive practically meaning decision rules. We then stratified the original data set accordingly and applied logistic regression on each data stratum. We further explored the effect of interacting variables in the logistic regression modeling. We conducted cross validation to assess the overall prediction performance of conditional logistic regression (CLR) and compared it with standard classification models. The developed CLR models outperformed several standard classification models (e.g., straightforward logistic regression, stepwise logistic regression, random forest, support vector machine). For example, the best CLR model improved the classification accuracy by nearly 20% over the straightforward logistic regression model. Furthermore, the developed CLR models tend to achieve better sensitivity of more than 10% over the standard classification models, which can be translated to correct labeling of additional 400 - 500 readmissions for heart failure patients in the state of California over a year. Lastly, several key predictor identified from the HCUP data include the disposition location from discharge, the number of chronic conditions, and the number of acute procedures. It would be beneficial to apply simple decision rules obtained from the decision tree in an ad-hoc manner to guide the cohort stratification. It could be potentially beneficial to explore the effect of pairwise interactions between influential predictors when building the logistic regression models for different data strata. Judicious use of the ad-hoc CLR models developed offers insights into future development of prediction models for hospital readmissions, which can lead to better intuition in identifying high-risk patients and developing effective post-discharge care strategies. Lastly, this paper is expected to raise the awareness of collecting data on additional markers and developing necessary database infrastructure for larger-scale exploratory studies on readmission risk prediction.

Human Space Exploration

NASA Technical Reports Server (NTRS)

Jeevarajan, Antony

2014-01-01

The Mars probe, launched by India a few months ago, is on its way to Mars. At this juncture, it is appropriate to talk about the opportunities presented to us for the Human Exploration of Mars. I am planning to highlight some of the challenges to take humans to Mars, descend, land, stay, ascend and return home safely. The logistics of carrying the necessary accessories to stay at Mars will be delivered in multiple stages using robotic missions. The primary ingredients for human survival is air, water, food and shelter and the necessity to recycle the primary ingredients will be articulated. Humans have to travel beyond the van Allen radiation belt under microgravity condition during this inter-planetary travel for about 6 months minimum one way. The deconditioning of human system under microgravity conditions and protection of humans from Galactic cosmic radiation during the travel should be taken into consideration. The multi-disciplinary effort to keep the humans safe and functional during this journey will be addressed.

Testing healthy immigrant effects among late life immigrants in the United States: using multiple indicators.

PubMed

Choi, Sunha H

2012-04-01

This study tested a healthy immigrant effect (HIE) and postimmigration health status changes among late life immigrants. Using three waves of the Second Longitudinal Study of Aging (1994-2000) and the linked mortality file through 2006, this study compared (a) chronic health conditions, (b) longitudinal trajectories of self-rated health, (c) longitudinal trajectories of functional impairments, and (d) mortality between three groups (age 70+): (i) late life immigrants with less than 15 years in the United States (n = 133), (ii) longer term immigrants (n = 672), and (iii) U.S.-born individuals (n = 8,642). Logistic and Poisson regression, hierarchical generalized linear modeling, and survival analyses were conducted. Late life immigrants were less likely to suffer from cancer, had lower numbers of chronic conditions at baseline, and displayed lower hazards of mortality during the 12-year follow-up. However, their self-rated health and functional status were worse than those of their counterparts over time. A HIE was only partially supported among older adults.

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…

A case control study of multiple myeloma at four nuclear facilities.

PubMed

Wing, S; Richardson, D; Wolf, S; Mihlan, G; Crawford-Brown, D; Wood, J

2000-04-01

Reported elevations of multiple myeloma among nuclear workers exposed to external penetrating ionizing radiation, based on small numbers of cases, prompted this multi-facility study of workers at US Department of Energy facilities. Ninety-eight multiple myeloma deaths and 391 age-matched controls were selected from the combined roster of 115,143 workers hired before 1979 at Hanford, Los Alamos National Laboratory, Oak Ridge National Laboratory, and the Savannah River site. These workers were followed for vital status through 1990 (1986 for Hanford). Demographic, work history, and occupational exposure data were derived from personnel, occupational medicine, industrial hygiene, and health physics records. Exposure-disease associations were evaluated using conditional logistic regression. Cases were disproportionately African American, male, and hired prior to 1948. Lifetime cumulative whole body ionizing radiation dose was not associated with multiple myeloma, however, there was a significant effect of age at exposure, with positive associations between multiple myeloma and doses received at older ages. Dose response associations increased in magnitude with exposure age (from 40 to 50) and lag assumption (from 5 to 15 years), while a likelihood ratio goodness of fit test reached the highest value for cumulative doses received at ages above 45 with a 5-year lag (X2=5.43,1 df; relative risk = 6.9% per 10 mSv). Dose response associations persisted with adjustment for potential confounders. Multiple myeloma was associated with low level whole body penetrating ionizing radiation doses at older ages. The exposure age effect is at odds with interpretations of A-bomb survivor studies but in agreement with several studies of cancer among nuclear workers.

Logistic Regression with Multiple Random Effects: A Simulation Study of Estimation Methods and Statistical Packages.

PubMed

Kim, Yoonsang; Choi, Young-Ku; Emery, Sherry

2013-08-01

Several statistical packages are capable of estimating generalized linear mixed models and these packages provide one or more of three estimation methods: penalized quasi-likelihood, Laplace, and Gauss-Hermite. Many studies have investigated these methods' performance for the mixed-effects logistic regression model. However, the authors focused on models with one or two random effects and assumed a simple covariance structure between them, which may not be realistic. When there are multiple correlated random effects in a model, the computation becomes intensive, and often an algorithm fails to converge. Moreover, in our analysis of smoking status and exposure to anti-tobacco advertisements, we have observed that when a model included multiple random effects, parameter estimates varied considerably from one statistical package to another even when using the same estimation method. This article presents a comprehensive review of the advantages and disadvantages of each estimation method. In addition, we compare the performances of the three methods across statistical packages via simulation, which involves two- and three-level logistic regression models with at least three correlated random effects. We apply our findings to a real dataset. Our results suggest that two packages-SAS GLIMMIX Laplace and SuperMix Gaussian quadrature-perform well in terms of accuracy, precision, convergence rates, and computing speed. We also discuss the strengths and weaknesses of the two packages in regard to sample sizes.

Logistic Regression with Multiple Random Effects: A Simulation Study of Estimation Methods and Statistical Packages

PubMed Central

Kim, Yoonsang; Emery, Sherry

2013-01-01

Several statistical packages are capable of estimating generalized linear mixed models and these packages provide one or more of three estimation methods: penalized quasi-likelihood, Laplace, and Gauss-Hermite. Many studies have investigated these methods’ performance for the mixed-effects logistic regression model. However, the authors focused on models with one or two random effects and assumed a simple covariance structure between them, which may not be realistic. When there are multiple correlated random effects in a model, the computation becomes intensive, and often an algorithm fails to converge. Moreover, in our analysis of smoking status and exposure to anti-tobacco advertisements, we have observed that when a model included multiple random effects, parameter estimates varied considerably from one statistical package to another even when using the same estimation method. This article presents a comprehensive review of the advantages and disadvantages of each estimation method. In addition, we compare the performances of the three methods across statistical packages via simulation, which involves two- and three-level logistic regression models with at least three correlated random effects. We apply our findings to a real dataset. Our results suggest that two packages—SAS GLIMMIX Laplace and SuperMix Gaussian quadrature—perform well in terms of accuracy, precision, convergence rates, and computing speed. We also discuss the strengths and weaknesses of the two packages in regard to sample sizes. PMID:24288415

Logistics system design for biomass-to-bioenergy industry with multiple types of feedstocks.

PubMed

Zhu, Xiaoyan; Yao, Qingzhu

2011-12-01

It is technologically possible for a biorefinery to use a variety of biomass as feedstock including native perennial grasses (e.g., switchgrass) and agricultural residues (e.g., corn stalk and wheat straw). Incorporating the distinct characteristics of various types of biomass feedstocks and taking into account their interaction in supplying the bioenergy production, this paper proposed a multi-commodity network flow model to design the logistics system for a multiple-feedstock biomass-to-bioenergy industry. The model was formulated as a mixed integer linear programming, determining the locations of warehouses, the size of harvesting team, the types and amounts of biomass harvested/purchased, stored, and processed in each month, the transportation of biomass in the system, and so on. This paper demonstrated the advantages of using multiple types of biomass feedstocks by comparing with the case of using a single feedstock (switchgrass) and analyzed the relationship of the supply capacity of biomass feedstocks to the output and cost of biofuel. Copyright © 2011 Elsevier Ltd. All rights reserved.

Delirium tremens and alcohol withdrawal nationally in the Veterans Health Administration.

PubMed

Moore, David Thomas; Fuehrlein, Brian Scott; Rosenheck, Robert Alan

2017-10-01

Alcohol withdrawal-especially delirium tremens (DT)-is a potentially life-threatening condition. While short-term treatment regimens and factors that predispose to more severe symptomatology have been extensively studied, little attention has been paid to the clinical epidemiology and long-term care of the chronic medical, addictive, psychiatric, and psychosocial problems faced by these patients. National Veterans Health Administration data from fiscal year 2012 were examined to identify veterans diagnosed with DT; with withdrawal but not DT (WNDT); and with Alcohol Use Disorder (AUD) but neither DT nor WNDT. They were compared on sociodemographic characteristics, psychiatric and medical co-morbidities, and health service and psychotropic medication use, first with bivariate analyses and then multiple logistic regression. Among the 345,297 veterans diagnosed with AUD, 2,341 (0.7%) were diagnosed with DT and 6,738 (2.0%) with WNDT. Veterans diagnosed with either WNDT or DT were more likely to have been homeless, had more comorbid medical and psychiatric disorders, were more likely to be diagnosed with drug use disorders, utilized more health services, received more psychotropic medications, and were more likely to receive naltrexone. They were more likely to receive specialized legal, housing, vocational, and psychosocial rehabilitation services, as well as intensive case management. Adults with WNDT and DT suffer from multiple chronic conditions and long-term service models are needed to coordinate the work of multiple specialists and to assure continuity of care. This national study identifies sociodemographic characteristics, comorbidities, and service utilization patterns associated with WNDT and DT.(Am J Addict 2017;26:722-730). © 2017 American Academy of Addiction Psychiatry.

Association between severe eczema in children and multiple comorbid conditions and increased healthcare utilization

PubMed Central

Silverberg, Jonathan I.; Simpson, Eric L.

2015-01-01

Background Atopic dermatitis (AD) is associated with multiple comorbid conditions, such as asthma and food allergy. We sought to determine the impact of eczema severity on the development of these disorders and other non-atopic comorbidities in AD. Methods We used the 2007 National Survey of Children's Health, a prospective questionnaire-based study of a nationally representative sample of 91,642 children age 0-17 years. Prevalence and severity of eczema, asthma, hay fever and food allergy, sleep impairment, healthcare utilization, recurrent ear infections, visual and dental problems were determined. Results In general, more severe eczema correlated with poorer overall health, impaired sleep and increased healthcare utilization, including seeing a specialist, compared to children with mild or moderate disease (Rao-Scott Chi-square, P<0.0001). Severe eczema was associated with higher prevalence of comorbid chronic health disorders, including asthma, hay fever and food allergies (P<0.0001). In addition, the severity of eczema was directly related to the severity of the comorbidities. These associations remained significant in multivariate logistic regression models that included age, sex and race/ethnicity. Severe eczema was also associated with recent dental problems, including bleeding gums (P<0.0001), toothache (P=0.0004), but not broken teeth (P=0.04) or tooth decay (P=0.13). Conclusions These data indicate that severe eczema is associated with multiple comorbid chronic health disorders, impaired overall health and increased healthcare utilization. Further, these data suggest that children with eczema are at risk for decreased oral health. Future studies are warranted to verify this novel association. PMID:23773154

Just Checking the Box: Do Our Airmen Value Their CCAF Degree

DTIC Science & Technology

2016-04-04

degree holders and that they spend multiple 80-hour weeks in an accredited classroom environment (most with 80 percent mini- mum passing scores) to...book- smart and can complete their CCAF quickly; however, when it comes to utilizing that learned professionalism from attending college, it doesn’t...threat analysis, and logistics. As a reservist, she serves as a logistics readiness officer. Major DaCosta-Paul is also a social entrepreneur who leads a

Racial/ethnic and educational differences in the estimated odds of recent nitrite use among adult household residents in the United States: an illustration of matching and conditional logistic regression.

PubMed

Delva, J; Spencer, M S; Lin, J K

2000-01-01

This article compares estimates of the relative odds of nitrite use obtained from weighted unconditional logistic regression with estimates obtained from conditional logistic regression after post-stratification and matching of cases with controls by neighborhood of residence. We illustrate these methods by comparing the odds associated with nitrite use among adults of four racial/ethnic groups, with and without a high school education. We used aggregated data from the 1994-B through 1996 National Household Survey on Drug Abuse (NHSDA). Difference between the methods and implications for analysis and inference are discussed.

Prevalence of multiple organ dysfunction in the pediatric intensive care unit: Pediatric Risk of Mortality III versus Pediatric Logistic Organ Dysfunction scores for mortality prediction

PubMed Central

Hamshary, Azza Abd Elkader El; Sherbini, Seham Awad El; Elgebaly, HebatAllah Fadel; Amin, Samah Abdelkrim

2017-01-01

Objectives To assess the frequency of primary multiple organ failure and the role of sepsis as a causative agent in critically ill pediatric patients; and calculate and evaluate the accuracy of the Pediatric Risk of Mortality III (PRISM III) and Pediatric Logistic Organ Dysfunction (PELOD) scores to predict the outcomes of critically ill children. Methods Retrospective study, which evaluated data from patients admitted from January to December 2011 in the pediatric intensive care unit of the Children's Hospital of the University of Cairo. Results Out of 237 patients in the study, 72% had multiple organ dysfunctions, and 45% had sepsis with multiple organ dysfunctions. The mortality rate in patients with multiple organ dysfunction was 73%. Independent risk factors for death were mechanical ventilation and neurological failure [OR: 36 and 3.3, respectively]. The PRISM III score was more accurate than the PELOD score in predicting death, with a Hosmer-Lemeshow X2 (Chi-square value) of 7.3 (df = 8, p = 0.5). The area under the curve was 0.723 for PRISM III and 0.78 for PELOD. Conclusion A multiple organ dysfunctions was associated with high mortality. Sepsis was the major cause. Pneumonia, diarrhea and central nervous system infections were the major causes of sepsis. PRISM III had a better calibration than the PELOD for prognosis of the patients, despite the high frequency of the multiple organ dysfunction syndrome. PMID:28977260

Evidence of poorer life-course mental health outcomes among veterans of the Korean War cohort.

PubMed

Brooks, Matthew Stephen; Fulton, Lawrence

2010-03-01

Comparing the outcomes of veterans who served in Korea and those who served elsewhere, we examined the treatment of post-traumatic stress disorder (PTSD), other mental health conditions, psychiatric treatment locations, and six mental health well-being measures. The analytic sample consisted of nationally representative data from the 2001 National Survey of Veterans (NSV). Analyses included multiple logistic regressions that controlled for sociodemographic characteristics. Korean era veterans in the NSV (n = 4030): 1498 served in Korea; 2532 elsewhere during the era. Veterans who served in Korea have notably poorer mental health than those who served elsewhere. These results suggest higher resource needs among aging Korean era veterans. Clinicians, policy makers and the Department of Veterans Affairs should focus on mental health services to older veterans.

Earthworks logistics in the high density urban development conditions - case study

NASA Astrophysics Data System (ADS)

Sobotka, A.; Blajer, M.

2017-10-01

Realisation of the construction projects on highly urbanised areas carries many difficulties and logistic problems. Earthworks conducted in such conditions constitute a good example of how important it is to properly plan the works and use the technical means of the logistics infrastructure. The construction processes on the observed construction site, in combination with their external logistics service are a complex system, difficult for mathematical modelling and achievement of appropriate data for planning the works. The paper shows describe and analysis of earthworks during construction of the Centre of Power Engineering of AGH in Krakow for two stages of a construction project. At the planning stage in the preparatory phase (before realization) and in the implementation phase of construction works (foundation). In the first case, an example of the use of queuing theory for prediction of excavation time under random work conditions of the excavator and the associated trucks is provided. In the second case there is a change of foundation works technology resulting as a consequence of changes in logistics earthworks. Observation of the construction has confirmed that the use of appropriate methods of construction works management, and in this case agile management, the time and cost of the project have not been exceeded. The success of a project depends on the ability of the contractor to react quickly when changes occur in the design, technology, environment, etc.

The parenting attitudes and the stress of mothers predict the asthmatic severity of their children: a prospective study.

PubMed

Nagano, Jun; Kakuta, Chikage; Motomura, Chikako; Odajima, Hiroshi; Sudo, Nobuyuki; Nishima, Sankei; Kubo, Chiharu

2010-10-07

To examine relationships between a mother's stress-related conditions and parenting attitudes and their children's asthmatic status. 274 mothers of an asthmatic child 2 to 12 years old completed a questionnaire including questions about their chronic stress/coping behaviors (the "Stress Inventory"), parenting attitudes (the "Ta-ken Diagnostic Test for Parent-Child Relationship, Parent Form"), and their children's disease status. One year later, a follow-up questionnaire was mailed to the mothers that included questions on the child's disease status. 223 mothers (81%) responded to the follow-up survey. After controlling for non-psychosocial factors including disease severity at baseline, multiple linear regression analysis followed by multiple logistic regression analysis found chronic irritation/anger and emotional suppression to be aggravating factors for children aged < 7 years; for children aged 7 and over, the mothers' egocentric behavior was a mitigating factor while interference was an aggravating factor. Different types of parental stress/coping behaviors and parenting styles may differently predict their children's asthmatic status, and such associations may change as children grow.

The quest for conditional independence in prospectivity modeling: weights-of-evidence, boost weights-of-evidence, and logistic regression

NASA Astrophysics Data System (ADS)

Schaeben, Helmut; Semmler, Georg

2016-09-01

The objective of prospectivity modeling is prediction of the conditional probability of the presence T = 1 or absence T = 0 of a target T given favorable or prohibitive predictors B, or construction of a two classes 0,1 classification of T. A special case of logistic regression called weights-of-evidence (WofE) is geologists' favorite method of prospectivity modeling due to its apparent simplicity. However, the numerical simplicity is deceiving as it is implied by the severe mathematical modeling assumption of joint conditional independence of all predictors given the target. General weights of evidence are explicitly introduced which are as simple to estimate as conventional weights, i.e., by counting, but do not require conditional independence. Complementary to the regression view is the classification view on prospectivity modeling. Boosting is the construction of a strong classifier from a set of weak classifiers. From the regression point of view it is closely related to logistic regression. Boost weights-of-evidence (BoostWofE) was introduced into prospectivity modeling to counterbalance violations of the assumption of conditional independence even though relaxation of modeling assumptions with respect to weak classifiers was not the (initial) purpose of boosting. In the original publication of BoostWofE a fabricated dataset was used to "validate" this approach. Using the same fabricated dataset it is shown that BoostWofE cannot generally compensate lacking conditional independence whatever the consecutively processing order of predictors. Thus the alleged features of BoostWofE are disproved by way of counterexamples, while theoretical findings are confirmed that logistic regression including interaction terms can exactly compensate violations of joint conditional independence if the predictors are indicators.

The Maintenance Costs of Aging Aircraft: Insights from Commercial Aviation

DTIC Science & Technology

2006-01-01

9 Ramsey , French, and Sperry (1998) Used Commercial Data to Estimate KC...Cross-sectional Stoll and Davis (NAMO) 1993 + Multiple Navy Multiple Cross-sectional and panel Ramsey (Oklahoma City Air Logistics Center [OC-ALC...in on-equipment2 workloads over approxi- mately the same period of time. Ramsey , French, and Sperry (1998) Used Commercial Data to Estimate KC-135

Item Response Theory with Covariates (IRT-C): Assessing Item Recovery and Differential Item Functioning for the Three-Parameter Logistic Model

ERIC Educational Resources Information Center

Tay, Louis; Huang, Qiming; Vermunt, Jeroen K.

2016-01-01

In large-scale testing, the use of multigroup approaches is limited for assessing differential item functioning (DIF) across multiple variables as DIF is examined for each variable separately. In contrast, the item response theory with covariate (IRT-C) procedure can be used to examine DIF across multiple variables (covariates) simultaneously. To…

Joint Logistics Commanders’ Workshop on Post Deployment Software Support (PDSS) for Mission-Critical Computer Software. Volume 2. Workshop Proceedings.

DTIC Science & Technology

1984-06-01

exist for the same item, as opposed to separate budget and fund codes for separate but related items. Multiple pro- cedures and fund codes can oe used...funds. If some funds are marked for multiple years and others must be obligated or outlaid witnin one year, contracting for PDSS tasks must be partitioned...Experience: PDSS requires both varied experience factors in multiple dis- ciplines and the sustaining of a critical mass of experience factors and

NASA Advanced Explorations Systems: Concepts for Logistics to Living

NASA Technical Reports Server (NTRS)

Shull, Sarah A.; Howe, A. Scott; Flynn, Michael T.; Howard, Robert

2012-01-01

The NASA Advanced Exploration Systems (AES) Logistics Reduction and Repurposing (LRR) project strives to enable a largely mission-independent cradle-to-grave-to-cradle approach to minimize logistics contributions to total mission architecture mass. The goals are to engineer logistics materials, common crew consumables, and container configurations to meet the following five basic goals: 1. Minimize intrinsic logistics mass and improve ground logistics flexibility. 2. Allow logistics components to be directly repurposed for on-orbit non-logistics functions (e.g., crew cabin outfitting) thereby indirectly reducing mass/volume. 3. Compact and process logistics that have not been directly repurposed to generate useful on-orbit components and/or compounds (e.g., radiation shielding, propellant, other usable chemical constituents). 4. Enable long-term stable storage and disposal of logistics end products that cannot be reused or repurposed (e.g., compaction for volume reduction, odor control, and maintenance of crew cabin hygienic conditions). 5. Allow vehicles in different mission phases to share logistics resources. This paper addresses the work being done to meet the second goal, the direct repurposing of logistics components to meet other on-orbit needs, through a strategy termed Logistics to Living (L2L). L2L has several areas but can be defined as repurposing or converting logistical items (bags, containers, foam, components, etc.) into useful crew items or life support augmentation on-orbit after they have provided their primary logistics function. The intent is that by repurposing items, dedicated crew items do not have to be launched and overall launch mass is decreased. For non-LEO missions, the vehicle interior volume will be relatively fixed so L2L will enable this volume to be used more effectively through reuse and rearrangement of logistical components. Past work in the area of L2L has already conceptually developed several potential technologies [Howe, Howard 2010]. Several of the L2L concepts that have shown the most potential in the past are based on NASA cargo transfer bags (CTBs) or their equivalents which are currently used to transfer cargo to and from the ISS. A high percentage of all logistics supplies are packaging mass and for a 6-month mission a crew of four might need over 100 CTBs. These CTBs are used for on-orbit transfer and storage but eventually becomes waste after use since down mass is very limited. The work being done in L2L also considering innovative interior habitat construction that integrate the CTBs into the walls of future habitats. The direct integration could provide multiple functions: launch packaging, stowage, radiation protection, water processing, life support augmentation, as well as structure. Reuse of these CTBs would reduce the amount of waste generated and also significantly reduce future up mass requirements for exploration missions. Also discussed here is the L2L water wall , an innovative reuse of an unfolded CTB as a passive water treatment system utilizing forward osmosis. The bags have been modified to have an inner membrane liner that allows them to purify wastewater. They may also provide a structural water-wall element that can be used to provide radiation protection and as a structural divider. Integration of the components into vehicle/habitat architecture and consideration of operations concepts and human factors will be discussed. In the future these bags could be designed to treat wastewater, concentrated brines, and solid wastes, and to dewater solid wastes and produce a bio-stabilized construction element. This paper will describe the follow-on work done in design, fabrication and demonstrations of various L2L concepts, including advanced CTBs for reuse/repurposing, internal outfitting studies and the CTB-based forward osmosis water wall.

Social support and amphetamine-type stimulant use among female sex workers in China.

PubMed

Zhao, Qun; Mao, Yuchen; Li, Xiaoming; Zhou, Yuejiao; Shen, Zhiyong

2017-10-01

Existing research has suggested a positive role of social support in reducing drug use among female sex workers (FSWs). However, there is limited research on the role of social support in amphetamine-type stimulant (ATS) use among FSWs in China. This study explored the present situation of ATS use among FSWs in Guangxi, China and examined the associations of different types of social support from different sources with ATS use. A sample of 1022 FSWs was recruited from 56 commercial sex venues in Guangxi Autonomous Region in China. Bivariate comparison was used to compare demographic characteristics and source of emotional or tangible social support across frequency of ATS use among FSWs. The relationship between social support and ATS use was examined using multiple ordinal logistic regression models controlling for the potential confounding effects of demographic variables. The multiple ordinal logistic regression indicated that FSWs who were from younger age groups (aOR = 10.88 for age group <20; aOR = 2.80 for age group 20-23), and from all higher-income venues (aOR = 1.96 for venue level 1; aOR = 2.28 for venue level 2; aOR = 1.81 for venue level 3) tended to use ATS more frequently. They also tended to use ATS more frequently when they depended on their boyfriends (aOR = 1.08) for emotional support or on their co-workers for tangible support (aOR = 1.17). Different types of social support from different sources can be either positively or negatively associated with ATS use among FSWs, therefore, the future intervention efforts should differentiate and target different types and different sources of social support in response to the living and work conditions of FSWs.

[Working conditions, living conditions and physical health problems declared among penitentiary administration personnel in France].

PubMed

Goldberg, P; Landre, M F; David, S; Goldberg, M; Dassa, S; Marne, M J

1996-06-01

A cross-sectional epidemiological survey was conducted among prison staff in France to investigate the relationships between working conditions and health. The sample included men and women 20 to 64 years old belonging to all categories of prison personnel: prison guards, administrative staff, socioeducational workers, technicians, health care workers, and managers (n = 4587, response rate 45.7%). A mailed self-administered questionnaire was used to assess sociodemographic characteristics, working conditions, and physical and mental disorders. Multiple logistic regression analyses were conducted to determine the effects of working conditions and social relationships on health of prison staff. However, the results reported here only concern 17 health disorders: body mass index, sick leave, medication use, accidents, digestive disorders, lower extremities and back disorders, hypertension, hemorrhoids, arthritis, skin disorders, urinary infections, chronic bronchitis, cholesterol, gastric ulcer, respiratory infections, ocular disorders. The living non professional conditions mostly associated with health disorders were financial difficulties (OR: 1.9 for digestive disorders, 1.8 for gastric ulcer, 1.7 for medication use) and irregularity of meals (OR = 1.5 for digestive disorders, and hypertension). In the occupational environment, the factors most associated with health disorders are seniority (OR = 4.2 for arthritis, 2.3 for cholesterol) and constraints (OR = 1.7 for lower extremities disorders). In spite of some limits associated to this kind of study, relationships between occupational and non occupational factors and physical health conditions were observed; the results also pointed out the protective role of the social relationships for health conditions.

Personal and family history of immune-related conditions increase the risk of plasma cell disorders: a population-based study

PubMed Central

Lindqvist, Ebba K.; Goldin, Lynn R.; Landgren, Ola; Blimark, Cecilie; Mellqvist, Ulf-Henrik; Turesson, Ingemar; Wahlin, Anders; Björkholm, Magnus

2011-01-01

The associations between immune-related conditions and multiple myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS) have previously been investigated with inconsistent results. In a large population-based study, we identified 19 112 patients with MM, 5403 patients with MGUS, 96 617 matched control subjects, and 262 931 first-degree relatives. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for the association of MM and MGUS with immune-related conditions by use of logistic regression. A personal history of all infections combined was associated with a significantly increased risk of MM (OR = 1.2; 95% CI, 1.1-1.3), and a personal history of all conditions in the categories infections (OR = 1.6; 95% CI, 1.5-1.7), inflammatory conditions (OR = 1.4; 95% CI, 1.2-1.5), and autoimmune diseases (OR = 2.1; 95% CI, 1.9-2.4) was associated with a significantly increased risk of MGUS. Several specific immune-related conditions elevated the risk of MM and/or MGUS. A family history of autoimmune disease was associated with a significantly increased risk of MGUS (OR = 1.1; 95% CI, 1.00-1.2), but not MM. Our findings suggest that immune-related conditions and/or their treatment are of importance in the etiology of MGUS and possibly MM. The association of both personal and family history of autoimmune disease with MGUS indicates the potential for shared susceptibility for these conditions. PMID:21998210

NASA Space Rocket Logistics Challenges

NASA Technical Reports Server (NTRS)

Neeley, James R.; Jones, James V.; Watson, Michael D.; Bramon, Christopher J.; Inman, Sharon K.; Tuttle, Loraine

2014-01-01

The Space Launch System (SLS) is the new NASA heavy lift launch vehicle and is scheduled for its first mission in 2017. The goal of the first mission, which will be uncrewed, is to demonstrate the integrated system performance of the SLS rocket and spacecraft before a crewed flight in 2021. SLS has many of the same logistics challenges as any other large scale program. Common logistics concerns for SLS include integration of discreet programs geographically separated, multiple prime contractors with distinct and different goals, schedule pressures and funding constraints. However, SLS also faces unique challenges. The new program is a confluence of new hardware and heritage, with heritage hardware constituting seventy-five percent of the program. This unique approach to design makes logistics concerns such as commonality especially problematic. Additionally, a very low manifest rate of one flight every four years makes logistics comparatively expensive. That, along with the SLS architecture being developed using a block upgrade evolutionary approach, exacerbates long-range planning for supportability considerations. These common and unique logistics challenges must be clearly identified and tackled to allow SLS to have a successful program. This paper will address the common and unique challenges facing the SLS programs, along with the analysis and decisions the NASA Logistics engineers are making to mitigate the threats posed by each.

Complementary and Conventional Medicine Use Among Youth With Recurrent Headaches

PubMed Central

Kemper, Kathi J.; Gombojav, Narangerel; Koch, Thomas K.

2013-01-01

OBJECTIVE: To identify prevalence and patterns of complementary and alternative medicine (CAM) use among youth with recurrent headaches (HA) and evaluate associations with co-occurring health problems and limitations as well as with the use and expenditures for conventional medical care. METHODS: Variables were constructed for youth aged 10 to 17 by using linked data from the 2007 National Health Interview Survey and the 2008 Medical Expenditures Panel Survey. Bivariate, logistic, and 2-part regression analyses were used. RESULTS: Of the 10.6% of youth experiencing HA, 29.6% used CAM, rising to 41% for the many HA sufferers who also experienced difficulties with emotions, concentration, behavior, school attendance, or daily activities. Biologically based products (16.2%) and mind-body therapies (13.3%) were most commonly used, especially by the 86.4% of youth with HA experiencing at least 1 other chronic condition. Compared with non-CAM users, youth with HA who used CAM also had higher expenditures for and use of most types of conventional care. CONCLUSIONS: CAM use is most common among youth with HA experiencing multiple chronic conditions and difficulties in daily functioning. Associations among CAM use, multiple chronic conditions, and higher use of conventional care highlight the need for medical providers to routinely ask about CAM use to meet the complex health needs of their patients and facilitate the optimal integration of care. Research is needed to identify models for coordinating complementary and conventional care within a medical home and to understand the health benefits or risks associated with CAM use in conjunction with conventional treatments for patients with HA. PMID:24127466

Unconditional or Conditional Logistic Regression Model for Age-Matched Case-Control Data?

PubMed

Kuo, Chia-Ling; Duan, Yinghui; Grady, James

2018-01-01

Matching on demographic variables is commonly used in case-control studies to adjust for confounding at the design stage. There is a presumption that matched data need to be analyzed by matched methods. Conditional logistic regression has become a standard for matched case-control data to tackle the sparse data problem. The sparse data problem, however, may not be a concern for loose-matching data when the matching between cases and controls is not unique, and one case can be matched to other controls without substantially changing the association. Data matched on a few demographic variables are clearly loose-matching data, and we hypothesize that unconditional logistic regression is a proper method to perform. To address the hypothesis, we compare unconditional and conditional logistic regression models by precision in estimates and hypothesis testing using simulated matched case-control data. Our results support our hypothesis; however, the unconditional model is not as robust as the conditional model to the matching distortion that the matching process not only makes cases and controls similar for matching variables but also for the exposure status. When the study design involves other complex features or the computational burden is high, matching in loose-matching data can be ignored for negligible loss in testing and estimation if the distributions of matching variables are not extremely different between cases and controls.

Unconditional or Conditional Logistic Regression Model for Age-Matched Case–Control Data?

PubMed Central

Kuo, Chia-Ling; Duan, Yinghui; Grady, James

2018-01-01

Matching on demographic variables is commonly used in case–control studies to adjust for confounding at the design stage. There is a presumption that matched data need to be analyzed by matched methods. Conditional logistic regression has become a standard for matched case–control data to tackle the sparse data problem. The sparse data problem, however, may not be a concern for loose-matching data when the matching between cases and controls is not unique, and one case can be matched to other controls without substantially changing the association. Data matched on a few demographic variables are clearly loose-matching data, and we hypothesize that unconditional logistic regression is a proper method to perform. To address the hypothesis, we compare unconditional and conditional logistic regression models by precision in estimates and hypothesis testing using simulated matched case–control data. Our results support our hypothesis; however, the unconditional model is not as robust as the conditional model to the matching distortion that the matching process not only makes cases and controls similar for matching variables but also for the exposure status. When the study design involves other complex features or the computational burden is high, matching in loose-matching data can be ignored for negligible loss in testing and estimation if the distributions of matching variables are not extremely different between cases and controls. PMID:29552553

Risk estimation using probability machines

PubMed Central

2014-01-01

Background Logistic regression has been the de facto, and often the only, model used in the description and analysis of relationships between a binary outcome and observed features. It is widely used to obtain the conditional probabilities of the outcome given predictors, as well as predictor effect size estimates using conditional odds ratios. Results We show how statistical learning machines for binary outcomes, provably consistent for the nonparametric regression problem, can be used to provide both consistent conditional probability estimation and conditional effect size estimates. Effect size estimates from learning machines leverage our understanding of counterfactual arguments central to the interpretation of such estimates. We show that, if the data generating model is logistic, we can recover accurate probability predictions and effect size estimates with nearly the same efficiency as a correct logistic model, both for main effects and interactions. We also propose a method using learning machines to scan for possible interaction effects quickly and efficiently. Simulations using random forest probability machines are presented. Conclusions The models we propose make no assumptions about the data structure, and capture the patterns in the data by just specifying the predictors involved and not any particular model structure. So they do not run the same risks of model mis-specification and the resultant estimation biases as a logistic model. This methodology, which we call a “risk machine”, will share properties from the statistical machine that it is derived from. PMID:24581306

Risk estimation using probability machines.

PubMed

Dasgupta, Abhijit; Szymczak, Silke; Moore, Jason H; Bailey-Wilson, Joan E; Malley, James D

2014-03-01

Logistic regression has been the de facto, and often the only, model used in the description and analysis of relationships between a binary outcome and observed features. It is widely used to obtain the conditional probabilities of the outcome given predictors, as well as predictor effect size estimates using conditional odds ratios. We show how statistical learning machines for binary outcomes, provably consistent for the nonparametric regression problem, can be used to provide both consistent conditional probability estimation and conditional effect size estimates. Effect size estimates from learning machines leverage our understanding of counterfactual arguments central to the interpretation of such estimates. We show that, if the data generating model is logistic, we can recover accurate probability predictions and effect size estimates with nearly the same efficiency as a correct logistic model, both for main effects and interactions. We also propose a method using learning machines to scan for possible interaction effects quickly and efficiently. Simulations using random forest probability machines are presented. The models we propose make no assumptions about the data structure, and capture the patterns in the data by just specifying the predictors involved and not any particular model structure. So they do not run the same risks of model mis-specification and the resultant estimation biases as a logistic model. This methodology, which we call a "risk machine", will share properties from the statistical machine that it is derived from.

Light therapy for multiple sclerosis-associated fatigue: Study protocol for a randomized controlled trial.

PubMed

Mateen, Farrah J; Manalo, Natalie C; Grundy, Sara J; Houghton, Melissa A; Hotan, Gladia C; Erickson, Hans; Videnovic, Aleksandar

2017-09-01

Fatigue is the most commonly reported symptom among multiple sclerosis (MS) patients, more than a quarter of whom consider fatigue to be their most disabling symptom. However, there are few effective treatment options for fatigue. We aim to investigate whether supplemental exposure to bright white light will reduce MS-associated fatigue. Eligible participants will have clinically confirmed multiple sclerosis based on the revised McDonald criteria (2010) and a score ≥36 on the Fatigue Severity Scale (FSS). Participants will be randomized 1:1 to bright white light (10,000 lux; active condition) or dim red light (<300 lux; control condition) self-administered for 1 hour twice daily. The study will include a 2-week baseline period, a 4-week treatment period, and a 4-week washout period. Participants will record their sleep duration, exercise, caffeine, and medication intake daily. Participants will record their fatigue using the Visual Analogue Fatigue Scale (VAFS) 4 times every third day, providing snapshots of their fatigue level at different times of day. Participants will self-report their fatigue severity using FSS on 3 separate visits: at baseline (week 0), following completion of the treatment phase (week 6), and at study completion (week 10). The primary outcome will be the change in the average FSS score after light therapy. We will perform an intention-to-treat analysis, comparing the active and control groups to assess the postintervention difference in fatigue levels reported on FSS. Secondary outcome measures include change in global VAFS scores during the light therapy and self-reported quality of life in the Multiple Sclerosis Quality of Life-54. We present a study design and rationale for randomizing a nonpharmacological intervention for MS-associated fatigue, using bright light therapy. The study limitations relate to the logistical issues of a self-administered intervention requiring frequent participant self-report in a relapsing condition. Ultimately, light therapy for the treatment of MS-associated fatigue may provide a low-cost, noninvasive, self-administered treatment for one of the most prevalent and burdensome symptoms experienced by people with MS.

Bayesian adjustment for measurement error in continuous exposures in an individually matched case-control study.

PubMed

Espino-Hernandez, Gabriela; Gustafson, Paul; Burstyn, Igor

2011-05-14

In epidemiological studies explanatory variables are frequently subject to measurement error. The aim of this paper is to develop a Bayesian method to correct for measurement error in multiple continuous exposures in individually matched case-control studies. This is a topic that has not been widely investigated. The new method is illustrated using data from an individually matched case-control study of the association between thyroid hormone levels during pregnancy and exposure to perfluorinated acids. The objective of the motivating study was to examine the risk of maternal hypothyroxinemia due to exposure to three perfluorinated acids measured on a continuous scale. Results from the proposed method are compared with those obtained from a naive analysis. Using a Bayesian approach, the developed method considers a classical measurement error model for the exposures, as well as the conditional logistic regression likelihood as the disease model, together with a random-effect exposure model. Proper and diffuse prior distributions are assigned, and results from a quality control experiment are used to estimate the perfluorinated acids' measurement error variability. As a result, posterior distributions and 95% credible intervals of the odds ratios are computed. A sensitivity analysis of method's performance in this particular application with different measurement error variability was performed. The proposed Bayesian method to correct for measurement error is feasible and can be implemented using statistical software. For the study on perfluorinated acids, a comparison of the inferences which are corrected for measurement error to those which ignore it indicates that little adjustment is manifested for the level of measurement error actually exhibited in the exposures. Nevertheless, a sensitivity analysis shows that more substantial adjustments arise if larger measurement errors are assumed. In individually matched case-control studies, the use of conditional logistic regression likelihood as a disease model in the presence of measurement error in multiple continuous exposures can be justified by having a random-effect exposure model. The proposed method can be successfully implemented in WinBUGS to correct individually matched case-control studies for several mismeasured continuous exposures under a classical measurement error model.

Logistic regression of family data from retrospective study designs.

PubMed

Whittemore, Alice S; Halpern, Jerry

2003-11-01

We wish to study the effects of genetic and environmental factors on disease risk, using data from families ascertained because they contain multiple cases of the disease. To do so, we must account for the way participants were ascertained, and for within-family correlations in both disease occurrences and covariates. We model the joint probability distribution of the covariates of ascertained family members, given family disease occurrence and pedigree structure. We describe two such covariate models: the random effects model and the marginal model. Both models assume a logistic form for the distribution of one person's covariates that involves a vector beta of regression parameters. The components of beta in the two models have different interpretations, and they differ in magnitude when the covariates are correlated within families. We describe ascertainment assumptions needed to estimate consistently the parameters beta(RE) in the random effects model and the parameters beta(M) in the marginal model. Under the ascertainment assumptions for the random effects model, we show that conditional logistic regression (CLR) of matched family data gives a consistent estimate beta(RE) for beta(RE) and a consistent estimate for the covariance matrix of beta(RE). Under the ascertainment assumptions for the marginal model, we show that unconditional logistic regression (ULR) gives a consistent estimate for beta(M), and we give a consistent estimator for its covariance matrix. The random effects/CLR approach is simple to use and to interpret, but it can use data only from families containing both affected and unaffected members. The marginal/ULR approach uses data from all individuals, but its variance estimates require special computations. A C program to compute these variance estimates is available at http://www.stanford.edu/dept/HRP/epidemiology. We illustrate these pros and cons by application to data on the effects of parity on ovarian cancer risk in mother/daughter pairs, and use simulations to study the performance of the estimates. Copyright 2003 Wiley-Liss, Inc.

Chronic condition combinations and health care expenditures and out-of-pocket spending burden among adults, Medical Expenditure Panel Survey, 2009 and 2011.

PubMed

Meraya, Abdulkarim M; Raval, Amit D; Sambamoorthi, Usha

2015-01-29

Little is known about how combinations of chronic conditions in adults affect total health care expenditures. Our objective was to estimate the annual average total expenditures and out-of-pocket spending burden among US adults by combinations of conditions. We conducted a cross-sectional study using 2009 and 2011 data from the Medical Expenditure Panel Survey. The sample consisted of 9,296 adults aged 21 years or older with at least 2 of the following 4 highly prevalent chronic conditions: arthritis, diabetes mellitus, heart disease, and hypertension. Unadjusted and adjusted regression techniques were used to examine the association between chronic condition combinations and log-transformed total expenditures. Logistic regressions were used to analyze the relationship between chronic condition combinations and high out-of-pocket spending burden. Among adults with chronic conditions, adults with all 4 conditions had the highest average total expenditures ($20,016), whereas adults with diabetes/hypertension had the lowest annual total expenditures ($7,116). In adjusted models, adults with diabetes/hypertension and hypertension/arthritis had lower health care expenditures than adults with diabetes/heart disease (P < .001). In adjusted models, adults with all 4 conditions had higher expenditures compared with those with diabetes and heart disease. However, the difference was only marginally significant (P = .04). Among adults with arthritis, diabetes, heart disease, and hypertension, total health care expenditures differed by type of chronic condition combinations. For individuals with multiple chronic conditions, such as heart disease and diabetes, new models of care management are needed to reduce the cost burden on the payers.

Prevalence and Determinants of Preterm Birth in Tehran, Iran: A Comparison between Logistic Regression and Decision Tree Methods.

PubMed

Amini, Payam; Maroufizadeh, Saman; Samani, Reza Omani; Hamidi, Omid; Sepidarkish, Mahdi

2017-06-01

Preterm birth (PTB) is a leading cause of neonatal death and the second biggest cause of death in children under five years of age. The objective of this study was to determine the prevalence of PTB and its associated factors using logistic regression and decision tree classification methods. This cross-sectional study was conducted on 4,415 pregnant women in Tehran, Iran, from July 6-21, 2015. Data were collected by a researcher-developed questionnaire through interviews with mothers and review of their medical records. To evaluate the accuracy of the logistic regression and decision tree methods, several indices such as sensitivity, specificity, and the area under the curve were used. The PTB rate was 5.5% in this study. The logistic regression outperformed the decision tree for the classification of PTB based on risk factors. Logistic regression showed that multiple pregnancies, mothers with preeclampsia, and those who conceived with assisted reproductive technology had an increased risk for PTB ( p < 0.05). Identifying and training mothers at risk as well as improving prenatal care may reduce the PTB rate. We also recommend that statisticians utilize the logistic regression model for the classification of risk groups for PTB.

Organizational Justice and Physiological Coronary Heart Disease Risk Factors in Japanese Employees: a Cross-Sectional Study.

PubMed

Inoue, Akiomi; Kawakami, Norito; Eguchi, Hisashi; Miyaki, Koichi; Tsutsumi, Akizumi

2015-12-01

Growing evidence has shown that lack of organizational justice (i.e., procedural justice and interactional justice) is associated with coronary heart disease (CHD) while biological mechanisms underlying this association have not yet been fully clarified. The purpose of the present study was to investigate the cross-sectional association of organizational justice with physiological CHD risk factors (i.e., blood pressure, high-density lipoprotein [HDL] cholesterol, low-density lipoprotein [LDL] cholesterol, and triglyceride) in Japanese employees. Overall, 3598 male and 901 female employees from two manufacturing companies in Japan completed self-administered questionnaires measuring organizational justice, demographic characteristics, and lifestyle factors. They completed health checkup, which included blood pressure and serum lipid measurements. Multiple logistic regression analyses and trend tests were conducted. Among male employees, multiple logistic regression analyses and trend tests showed significant associations of low procedural justice and low interactional justice with high triglyceride (defined as 150 mg/dL or greater) after adjusting for demographic characteristics and lifestyle factors. Among female employees, trend tests showed significant dose-response relationship between low interactional justice and high LDL cholesterol (defined as 140 mg/dL or greater) while multiple logistic regression analysis showed only marginally significant or insignificant odds ratio of high LDL cholesterol among the low interactional justice group. Neither procedural justice nor interactional justice was associated with blood pressure or HDL cholesterol. Organizational justice may be an important psychosocial factor associated with increased triglyceride at least among Japanese male employees.

Screening for ketosis using multiple logistic regression based on milk yield and composition.

PubMed

Kayano, Mitsunori; Kataoka, Tomoko

2015-11-01

Multiple logistic regression was applied to milk yield and composition data for 632 records of healthy cows and 61 records of ketotic cows in Hokkaido, Japan. The purpose was to diagnose ketosis based on milk yield and composition, simultaneously. The cows were divided into two groups: (1) multiparous, including 314 healthy cows and 45 ketotic cows and (2) primiparous, including 318 healthy cows and 16 ketotic cows, since nutritional status, milk yield and composition are affected by parity. Multiple logistic regression was applied to these groups separately. For multiparous cows, milk yield (kg/day/cow) and protein-to-fat (P/F) ratio in milk were significant factors (P<0.05) for the diagnosis of ketosis. For primiparous cows, lactose content (%), solid not fat (SNF) content (%) and milk urea nitrogen (MUN) content (mg/dl) were significantly associated with ketosis (P<0.01). A diagnostic rule was constructed for each group of cows: (1) 9.978 × P/F ratio + 0.085 × milk yield <10 and (2) 2.327 × SNF - 2.703 × lactose + 0.225 × MUN <10. The sensitivity, specificity and the area under the curve (AUC) of the diagnostic rules were (1) 0.800, 0.729 and 0.811; (2) 0.813, 0.730 and 0.787, respectively. The P/F ratio, which is a widely used measure of ketosis, provided the sensitivity, specificity and AUC values of (1) 0.711, 0.726 and 0.781; and (2) 0.678, 0.767 and 0.738, respectively.

Birth month affects lifetime disease risk: a phenome-wide method

PubMed Central

Boland, Mary Regina; Shahn, Zachary; Madigan, David; Hripcsak, George; Tatonetti, Nicholas P

2015-01-01

Objective An individual’s birth month has a significant impact on the diseases they develop during their lifetime. Previous studies reveal relationships between birth month and several diseases including atherothrombosis, asthma, attention deficit hyperactivity disorder, and myopia, leaving most diseases completely unexplored. This retrospective population study systematically explores the relationship between seasonal affects at birth and lifetime disease risk for 1688 conditions. Methods We developed a hypothesis-free method that minimizes publication and disease selection biases by systematically investigating disease-birth month patterns across all conditions. Our dataset includes 1 749 400 individuals with records at New York-Presbyterian/Columbia University Medical Center born between 1900 and 2000 inclusive. We modeled associations between birth month and 1688 diseases using logistic regression. Significance was tested using a chi-squared test with multiplicity correction. Results We found 55 diseases that were significantly dependent on birth month. Of these 19 were previously reported in the literature (P < .001), 20 were for conditions with close relationships to those reported, and 16 were previously unreported. We found distinct incidence patterns across disease categories. Conclusions Lifetime disease risk is affected by birth month. Seasonally dependent early developmental mechanisms may play a role in increasing lifetime risk of disease. PMID:26041386

Anesthesia Care Transitions and Risk of Postoperative Complications.

PubMed

Hyder, Joseph A; Bohman, J Kyle; Kor, Daryl J; Subramanian, Arun; Bittner, Edward A; Narr, Bradly J; Cima, Robert R; Montori, Victor M

2016-01-01

A patient undergoing surgery may receive anesthesia care from several anesthesia providers. The safety of anesthesia care transitions has not been evaluated. Using unconditional and conditional multivariable logistic regression models, we tested whether the number of attending anesthesiologists involved in an operation was associated with postoperative complications. In a cohort of patients undergoing elective colorectal surgical in an academic tertiary care center with a stable anesthesia care team model participating in the American College of Surgeons National Surgical Quality Improvement Program, using unconditional and conditional multivariable logistic regression models, we tested adjusted associations between numbers of attending anesthesiologists and occurrence of death or a major complication (acute renal failure, bleeding that required a transfusion of 4 units or more of red blood cells within 72 hours after surgery, cardiac arrest requiring cardiopulmonary resuscitation, coma of 24 hours or longer, myocardial infarction, unplanned intubation, ventilator use for 48 hours or more, pneumonia, stroke, wound disruption, deep or organ-space surgical-site infection, superficial surgical-site infection, sepsis, septic shock, systemic inflammatory response syndrome). We identified 927 patients who underwent elective colectomy of comparable surgical intensity. In all, 71 (7.7%) patients had major nonfatal complications or death. One anesthesiologist provided care for 530 (57%) patients, 2 anesthesiologists for 287 (31%), and 3 or more for 110 (12%). The number of attending anesthesiologists was associated with increased odds of postoperative complication (unadjusted odds ratio [OR] = 1.52, 95% confidence interval [CI] 1.18-1.96, P = 0.0013; adjusted OR = 1.44, 95% CI 1.09-1.91, P = 0.0106). In sensitivity analyses, occurrence of a complication was significantly associated with the number of in-room providers, defined as anesthesia residents and nurse anesthetists (adjusted OR = 1.39, 95% CI 1.01-1.92, P = 0.0446) and for all anesthesia providers (adjusted OR = 1.58, 95%CI 1.20-2.08, P = 0.0012). Findings persisted across multiple, alternative adjustments, sensitivity analyses, and conditional logistic regression with matching on operative duration. In our study, care by additional attending anesthesiologists and in-room providers was independently associated with an increased odds of postoperative complications. These findings challenge the assumption that anesthesia transitions are care neutral and not contributory to surgical outcomes.

Stressful working conditions and poor self-rated health among financial services employees.

PubMed

Silva, Luiz Sérgio; Barreto, Sandhi Maria

2012-06-01

To assess the association between exposure to adverse psychosocial working conditions and poor self-rated health among bank employees. A cross-sectional study including a sample of 2,054 employees of a government bank was conducted in 2008. Self-rated health was assessed by a single question: "In general, would you say your health is (...)." Exposure to adverse psychosocial working conditions was evaluated by the effort-reward imbalance model and the demand-control model. Information on other independent variables was obtained through a self-administered semi-structured questionnaire. A multiple logistic regression analysis was performed and odds ratio calculated to assess independent associations between adverse psychosocial working conditions and poor self-rated health. The overall prevalence of poor self-rated health was 9%, with no significant gender difference. Exposure to high demand and low control environment at work was associated with poor self-rated health. Employees with high effort-reward imbalance and overcommitment also reported poor self-rated health, with a dose-response relationship. Social support at work was inversely related to poor self-rated health, with a dose-response relationship. Exposure to adverse psychosocial work factors assessed based on the effort-reward imbalance model and the demand-control model is independently associated with poor self-rated health among the workers studied.

Self-reported health in mothers: the impact of age, and socioeconomic conditions.

PubMed

Floderus, Birgitta; Hagman, Maud; Aronsson, Gunnar; Marklund, Staffan; Wikman, Anders

2008-01-01

The aim of the present analysis was to study health and well-being in mothers compared to women without children, and to analyze potential interactions with age and socioeconomic conditions. The study comprised 5,368 Swedish women born in 1960-1979 who were interviewed in any of the population-based Surveys of Living Conditions during the period 1996-2003. Having children at home was related to self-reported health symptoms and long-standing illness in multiple logistic regression models. The impact of age, cohabitation status, full-time or part-time work, and income level were analyzed. While mothers were less burdened by long-standing illness, partly due to selection mechanisms (a "healthy mother effect"), they experienced worse self-rated health and more fatigue than women without children, and the odds of poor self-rated health and fatigue increased by number of children. Conditions that strengthened the association between motherhood and impaired health were young maternal age, full-time employment, high income, and being alone. The study indicates a need for improved negotiations between parents regarding a fair share of work and family duties and extended support for lone mothers to prevent adverse health effects in women combining children and work. The results may be useful to policy-makers and employers in developing new policies.

Quality of Disease Management and Risk of Mortality in English Primary Care Practices

PubMed Central

Dusheiko, Mark; Gravelle, Hugh; Martin, Stephen; Smith, Peter C

2015-01-01

Objective To investigate whether better management of chronic conditions by family practices reduces mortality risk. Data Two random samples of 5 million patients registered with over 8,000 English family practices followed up for 4 years (2004/5–2007/8). Measures of the quality of disease management for 10 conditions were constructed for each family practice for each year. The outcome measure was an indicator taking the value 1 if the patient died during a specified year, 0 otherwise. Study Design Cross-section and multilevel panel data multiple logistic regressions were estimated. Covariates included age, gender, morbidity, hospitalizations, attributed socio-economic characteristics, and local health care supply measures. Principal Findings Although a composite measure of the quality of disease management for all 10 conditions was significantly associated with lower mortality, only the quality of stroke care was significant when all 10 quality measures were entered in the regression. Conclusions The panel data results suggest that a 1 percent improvement in the quality of stroke care could reduce the annual number of deaths in England by 782 [95 percent CI: 423, 1140]. A longer study period may be necessary to detect any mortality impact of better management of other conditions. PMID:25597263

Aging, not menopause, is associated with higher prevalence of hyperuricemia among older women.

PubMed

Krishnan, Eswar; Bennett, Mihoko; Chen, Linjun

2014-11-01

This work aims to study the associations, if any, of hyperuricemia, gout, and menopause status in the US population. Using multiyear data from the National Health and Nutrition Examination Survey, we performed unmatched comparisons and one to three age-matched comparisons of women aged 20 to 70 years with and without hyperuricemia (serum urate ≥6 mg/dL). Analyses were performed using survey-weighted multiple logistic regression and conditional logistic regression, respectively. Overall, there were 1,477 women with hyperuricemia. Age and serum urate were significantly correlated. In unmatched analyses (n = 9,573 controls), postmenopausal women were older, were heavier, and had higher prevalence of renal impairment, hypertension, diabetes, and hyperlipidemia. In multivariable regression, after accounting for age, body mass index, glomerular filtration rate, and diuretic use, menopause was associated with hyperuricemia (odds ratio, 1.36; 95% CI, 1.05-1.76; P = 0.002). In corresponding multivariable regression using age-matched data (n = 4,431 controls), the odds ratio for menopause was 0.94 (95% CI, 0.83-1.06). Current use of hormone therapy was not associated with prevalent hyperuricemia in both unmatched and matched analyses. Age is a better statistical explanation for the higher prevalence of hyperuricemia among older women than menopause status.

Robust experimental design for optimizing the microbial inhibitor test for penicillin detection in milk.

PubMed

Nagel, O G; Molina, M P; Basílico, J C; Zapata, M L; Althaus, R L

2009-06-01

To use experimental design techniques and a multiple logistic regression model to optimize a microbiological inhibition test with dichotomous response for the detection of Penicillin G in milk. A 2(3) x 2(2) robust experimental design with two replications was used. The effects of three control factors (V: culture medium volume, S: spore concentration of Geobacillus stearothermophilus, I: indicator concentration), two noise factors (Dt: diffusion time, Ip: incubation period) and their interactions were studied. The V, S, Dt, Ip factors and V x S, V x Ip, S x Ip interactions showed significant effects. The use of 100 microl culture medium volume, 2 x 10(5) spores ml(-1), 60 min diffusion time and 3 h incubation period is recommended. In these elaboration conditions, the penicillin detection limit was of 3.9 microg l(-1), similar to the maximum residue limit (MRL). Of the two noise factors studied, the incubation period can be controlled by means of the culture medium volume and spore concentration. We were able to optimize bioassays of dichotomous response using an experimental design and logistic regression model for the detection of residues at the level of MRL, aiding in the avoidance of health problems in the consumer.

A case-control study evaluating relative risk factors for decompression sickness: a research report.

PubMed

Suzuki, Naoko; Yagishita, Kazuyosi; Togawa, Seiichiro; Okazaki, Fumihiro; Shibayama, Masaharu; Yamamoto, Kazuo; Mano, Yoshihiro

2014-01-01

Factors contributing to the pathogenesis of decompression sickness (DCS) in divers have been described in many studies. However, relative importance of these factors has not been reported. In this case-control study, we compared the diving profiles of divers experiencing DCS with those of a control group. The DCS group comprised 35 recreational scuba divers who were diagnosed by physicians as having DCS. The control group consisted of 324 apparently healthy recreational divers. All divers conducted their dives from 2009 to 2011. The questionnaire consisted of 33 items about an individual's diving profile, physical condition and activities before, during and just after the dive. To simplify dive parameters, the dive site was limited to Izu Osezaki. Odds ratios and multiple logistic regression were used for the analysis. Odds ratios revealed several items as dive and health factors associated with DCS. The major items were as follows: shortness of breath after heavy exercise during the dive (OR = 12.12), dehydration (OR = 10.63), and maximum dive depth > 30 msw (OR = 7.18). Results of logistic regression were similar to those by odds ratio analysis. We assessed the relative weights of the surveyed dive and health factors associated with DCS. Because results of several factors conflict with previous studies, future studies are needed.

Nonconvex Sparse Logistic Regression With Weakly Convex Regularization

NASA Astrophysics Data System (ADS)

Shen, Xinyue; Gu, Yuantao

2018-06-01

In this work we propose to fit a sparse logistic regression model by a weakly convex regularized nonconvex optimization problem. The idea is based on the finding that a weakly convex function as an approximation of the $\\ell_0$ pseudo norm is able to better induce sparsity than the commonly used $\\ell_1$ norm. For a class of weakly convex sparsity inducing functions, we prove the nonconvexity of the corresponding sparse logistic regression problem, and study its local optimality conditions and the choice of the regularization parameter to exclude trivial solutions. Despite the nonconvexity, a method based on proximal gradient descent is used to solve the general weakly convex sparse logistic regression, and its convergence behavior is studied theoretically. Then the general framework is applied to a specific weakly convex function, and a necessary and sufficient local optimality condition is provided. The solution method is instantiated in this case as an iterative firm-shrinkage algorithm, and its effectiveness is demonstrated in numerical experiments by both randomly generated and real datasets.

Modeling logistic performance in quantitative microbial risk assessment.

PubMed

Rijgersberg, Hajo; Tromp, Seth; Jacxsens, Liesbeth; Uyttendaele, Mieke

2010-01-01

In quantitative microbial risk assessment (QMRA), food safety in the food chain is modeled and simulated. In general, prevalences, concentrations, and numbers of microorganisms in media are investigated in the different steps from farm to fork. The underlying rates and conditions (such as storage times, temperatures, gas conditions, and their distributions) are determined. However, the logistic chain with its queues (storages, shelves) and mechanisms for ordering products is usually not taken into account. As a consequence, storage times-mutually dependent in successive steps in the chain-cannot be described adequately. This may have a great impact on the tails of risk distributions. Because food safety risks are generally very small, it is crucial to model the tails of (underlying) distributions as accurately as possible. Logistic performance can be modeled by describing the underlying planning and scheduling mechanisms in discrete-event modeling. This is common practice in operations research, specifically in supply chain management. In this article, we present the application of discrete-event modeling in the context of a QMRA for Listeria monocytogenes in fresh-cut iceberg lettuce. We show the potential value of discrete-event modeling in QMRA by calculating logistic interventions (modifications in the logistic chain) and determining their significance with respect to food safety.

Perceived weight discrimination and chronic medical conditions in adults with overweight and obesity.

PubMed

Udo, Tomoko; Purcell, Katherine; Grilo, Carlos M

2016-12-01

This study investigated whether perceived weight discrimination is associated with increased risk for major chronic medical conditions and whether the associations persist after adjusting for other stressful life events in addition to BMI, physical activity and sociodemographic variables. The study included 21 357 overweight/obese adults (52.9% women) from the 2001 to 2002 and 2004 to 2005 National Survey of Alcohol and Related Conditions. Perceived weight discrimination was significantly associated with risk for arteriosclerosis, diabetes, high cholesterol, myocardial infarction, minor heart conditions and stomach ulcers. Perceived weight discrimination was associated with reporting more stressful life events. After adjusting additionally for stressful life events in the final multiple logistic regression, associations with arteriosclerosis, diabetes and minor cardiac conditions remained significant. Gender-stratified analyses revealed that perceived weight discrimination was associated with different medical conditions in women than men, and many associations became non-significant when adjusting for stressful life events, particularly for women. Among overweight/obese adults, perceived weight discrimination is associated with significantly increased risk for obesity-related chronic medical conditions even after adjusting for BMI, physical activity and sociodemographic variables. Accounting for other acute stressful life events may also be important in understanding the health effects of perceived weight discrimination. Such added health risk of overweight/obesity posed by perceived weight discrimination warrants public health and policy interventions against weight discrimination to reduce the socioeconomic burden of obesity. © 2016 John Wiley & Sons Ltd.

Determine the optimal carrier selection for a logistics network based on multi-commodity reliability criterion

NASA Astrophysics Data System (ADS)

Lin, Yi-Kuei; Yeh, Cheng-Ta

2013-05-01

From the perspective of supply chain management, the selected carrier plays an important role in freight delivery. This article proposes a new criterion of multi-commodity reliability and optimises the carrier selection based on such a criterion for logistics networks with routes and nodes, over which multiple commodities are delivered. Carrier selection concerns the selection of exactly one carrier to deliver freight on each route. The capacity of each carrier has several available values associated with a probability distribution, since some of a carrier's capacity may be reserved for various orders. Therefore, the logistics network, given any carrier selection, is a multi-commodity multi-state logistics network. Multi-commodity reliability is defined as a probability that the logistics network can satisfy a customer's demand for various commodities, and is a performance indicator for freight delivery. To solve this problem, this study proposes an optimisation algorithm that integrates genetic algorithm, minimal paths and Recursive Sum of Disjoint Products. A practical example in which multi-sized LCD monitors are delivered from China to Germany is considered to illustrate the solution procedure.

Cardiovascular disease and perceived weight, racial, and gender discrimination in U.S. adults.

PubMed

Udo, Tomoko; Grilo, Carlos M

2017-09-01

To date, most research on perceived discrimination and cardiovascular disease (CVD) has examined racial discrimination although other forms of discrimination may also impact physical and mental health. The current study investigated the relationship between three forms of discrimination (weight, race, and gender) and 3-year incidence of CVD in a large national sample of U.S. adults. 26,992 adults (55.5% women) who participated in the 2001-2002 and 2004-2005 National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) were included in this study. Multiple logistic regression analyses were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for three forms of perceived discrimination (simultaneously included in equations after adjusting for relevant potential confounds) for predicting CVD incidence at Wave 2. Perceived weight and racial discrimination were associated with significantly greater likelihood of reporting myocardial infarction (OR=2.56 [95% CI=1.31-4.98], OR=1.84 [95% CI=1.19-2.84], respectively) and minor heart conditions (OR=1.48 [95% CI=1.11-1.98], OR=1.41 [95% CI=1.18-1.70], respectively). Perceived racial discrimination was also significantly associated with greater likelihood of reporting arteriosclerosis (OR=1.61 [95% CI=1.11-2.34]). Odds ratios for diagnoses of arteriosclerosis, myocardial infarction, and other minor heart disease were largest for individuals reporting multiple forms of discrimination. Adults who experience weight and racial discrimination, and especially multiple forms of discrimination, may be at heightened risk for CVD. Perceived discrimination may be important to consider during assessment of life stressors by health providers. Future research should address the mechanisms that link discrimination and CVD to assist public health and policy efforts to reduce discrimination. Copyright © 2017. Published by Elsevier Inc.

Comparing methods of analysing datasets with small clusters: case studies using four paediatric datasets.

PubMed

Marston, Louise; Peacock, Janet L; Yu, Keming; Brocklehurst, Peter; Calvert, Sandra A; Greenough, Anne; Marlow, Neil

2009-07-01

Studies of prematurely born infants contain a relatively large percentage of multiple births, so the resulting data have a hierarchical structure with small clusters of size 1, 2 or 3. Ignoring the clustering may lead to incorrect inferences. The aim of this study was to compare statistical methods which can be used to analyse such data: generalised estimating equations, multilevel models, multiple linear regression and logistic regression. Four datasets which differed in total size and in percentage of multiple births (n = 254, multiple 18%; n = 176, multiple 9%; n = 10 098, multiple 3%; n = 1585, multiple 8%) were analysed. With the continuous outcome, two-level models produced similar results in the larger dataset, while generalised least squares multilevel modelling (ML GLS 'xtreg' in Stata) and maximum likelihood multilevel modelling (ML MLE 'xtmixed' in Stata) produced divergent estimates using the smaller dataset. For the dichotomous outcome, most methods, except generalised least squares multilevel modelling (ML GH 'xtlogit' in Stata) gave similar odds ratios and 95% confidence intervals within datasets. For the continuous outcome, our results suggest using multilevel modelling. We conclude that generalised least squares multilevel modelling (ML GLS 'xtreg' in Stata) and maximum likelihood multilevel modelling (ML MLE 'xtmixed' in Stata) should be used with caution when the dataset is small. Where the outcome is dichotomous and there is a relatively large percentage of non-independent data, it is recommended that these are accounted for in analyses using logistic regression with adjusted standard errors or multilevel modelling. If, however, the dataset has a small percentage of clusters greater than size 1 (e.g. a population dataset of children where there are few multiples) there appears to be less need to adjust for clustering.

War-related trauma exposure and multiple risk behaviors among school-going adolescents in Northern Uganda: the mediating role of depression symptoms.

PubMed

Okello, James; Nakimuli-Mpungu, Etheldreda; Musisi, Seggane; Broekaert, Eric; Derluyn, Ilse

2013-11-01

The relationship between war-related trauma exposure, depressive symptoms and multiple risk behaviors among adolescents is less clear in sub-Saharan Africa. We analyzed data collected from a sample of school-going adolescents four years postwar. Participants completed interviews assessing various risk behaviors defined by the Youth Self Report (YSR) and a sexual risk behavior survey, and were screened for post-traumatic stress, anxiety and depression symptoms based on the Impact of Events Scale Revised (IESR) and Hopkins Symptom Checklist for Adolescents (HSCL-37A) respectively. Multivariate logistic regression was used to assess factors independently associated with multiple risk behaviors. The logistic regression model of Baron and Kenny (1986) was used to evaluate the mediating role of depression in the relationship between stressful war events and multiple risk behaviors. Of 551 participants, 139 (25%) reported multiple (three or more) risk behaviors in the past year. In the multivariate analyses, depression symptoms remained uniquely associated with multiple risk behavior after adjusting for potential confounders including socio-demographic characteristics, war-related trauma exposure variables, anxiety and post-traumatic stress symptoms. In mediation analysis, depression symptoms mediated the associations between stressful war events and multiple risk behaviors. The psychometric properties of the questionnaires used in this study are not well established in war affected African samples thus ethno cultural variation may decrease the validity of our measures. Adolescents with depression may be at a greater risk of increased engagement in multiple risk behaviors. Culturally sensitive and integrated interventions to treat and prevent depression among adolescents in post-conflict settings are urgently needed. © 2013 Elsevier B.V. All rights reserved.

A nonparametric multiple imputation approach for missing categorical data.

PubMed

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

2017-06-06

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

Exercise as an adjunct to nicotine gum in treating tobacco dependence among women.

PubMed

Kinnunen, Taru; Leeman, Robert F; Korhonen, Tellervo; Quiles, Zandra N; Terwal, Donna M; Garvey, Arthur J; Hartley, Howard L

2008-04-01

This was the first randomized, controlled smoking cessation trial assessing the efficacy of an exercise intervention as an adjunct to nicotine gum therapy in comparison with both equal contact control and standard care control conditions. Sedentary female smokers aged 18-55 years were provided with nicotine gum treatment along with brief behavioral counseling and were randomized into one of these three behavioral adjunct conditions. In the "intent-to-treat" sample (N = 182), at end of treatment and at 1-year follow-up, there were clear, but nonsignificant, trends in univariate analyses in which the exercise and equal contact control conditions both had higher rates of abstinence than the standard care control. However, when adjusting for other predictors of relapse in a multiple logistic regression, both exercise and equal contact control showed an advantage over standard care control in avoiding early relapse (i.e., after 1 week). In a multivariate survival model adjusting for other predictors, the equal contact condition had a significantly lower likelihood of relapse compared with the standard care condition and there was a near significant trend in which exercise offered an advantage over standard care as well. While these findings suggest a slightly improved likelihood of abstinence with exercise compared with standard care, exercise did not differ from equal contact control in its efficacy. Potential explanations for these equivalent levels of efficacy and implications for the findings are discussed.

(En)gendering Racial Disparities in Health Trajectories: A Life Course and Intersectional Analysis.

PubMed

Richardson, Liana J; Brown, Tyson H

2016-12-01

Historically, intersectionality has been an underutilized framework in sociological research on racial/ethnic and gender inequalities in health. To demonstrate its utility and importance, we conduct an intersectional analysis of the social stratification of health using the exemplar of hypertension-a health condition in which racial/ethnic and gender differences have been well-documented. Previous research has tended to examine these differences separately and ignore how the interaction of social status dimensions may influence health over time. Using seven waves of data from the Health and Retirement Study and multilevel logistic regression models, we found a multiplicative effect of race/ethnicity and gender on hypertension risk trajectories, consistent with both an intersectionality perspective and persistent inequality hypothesis. Group differences in past and contemporaneous socioeconomic and behavioral factors did not explain this effect.

Prevalence of hepatitis B virus markers among hospital personnel in Israel: correlation with some risk factors.

PubMed

Weiss, Y; Rabinovitch, M; Cahaner, Y; Noy, D; Siegman-Igra, Y

1994-03-01

During 1986-1987, 480 employees of the Tel-Aviv Medical Center were screened for hepatitis B virus (HBV) markers as a preliminary step in a vaccination campaign. One hundred and seventeen (24.4%) had evidence of previous infection, including nine (1.9%) carriers. The effect of potential risk factors on seropositivity was evaluated by multiple logistic regression analysis, which enabled assessment of the individual contribution of each risk factor under the specific environmental conditions. The following risk factors were found to influence seropositivity: origin from Third World countries as opposed to the Western World, employment as sanitary workers, age over 40 years, and history of accidental needle punctures. In the heterogeneous Israeli population, hospital workers had a relatively high prevalence of HBV markers, probably resulting from occupational exposure.

Computational tools for exact conditional logistic regression.

PubMed

Corcoran, C; Mehta, C; Patel, N; Senchaudhuri, P

Logistic regression analyses are often challenged by the inability of unconditional likelihood-based approximations to yield consistent, valid estimates and p-values for model parameters. This can be due to sparseness or separability in the data. Conditional logistic regression, though useful in such situations, can also be computationally unfeasible when the sample size or number of explanatory covariates is large. We review recent developments that allow efficient approximate conditional inference, including Monte Carlo sampling and saddlepoint approximations. We demonstrate through real examples that these methods enable the analysis of significantly larger and more complex data sets. We find in this investigation that for these moderately large data sets Monte Carlo seems a better alternative, as it provides unbiased estimates of the exact results and can be executed in less CPU time than can the single saddlepoint approximation. Moreover, the double saddlepoint approximation, while computationally the easiest to obtain, offers little practical advantage. It produces unreliable results and cannot be computed when a maximum likelihood solution does not exist. Copyright 2001 John Wiley & Sons, Ltd.

Posttraumatic stress disorder and chronic pain are associated with opioid use disorder: Results from a 2012-2013 American nationally representative survey.

PubMed

Bilevicius, Elena; Sommer, Jordana L; Asmundson, Gordon J G; El-Gabalawy, Renée

2018-07-01

Chronic pain conditions and posttraumatic stress disorder (PTSD) commonly co-occur and are associated with opioid use disorder (OUD). The aims of this paper were to identify prevalence estimates of OUD among individuals with and without PTSD and assess independent and combined contributions of PTSD and chronic pain conditions on OUD in a nationally representative sample. Data were extracted from 36,309 individuals from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions. Past-year PTSD and OUD were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-5 edition. Respondents reported physician-confirmed, past-year chronic pain conditions, categorized into musculoskeletal pain (e.g., arthritis), digestive pain (e.g., pancreatitis), and nerve pain (e.g., reflex sympathetic dystrophy). We examined the weighted prevalence of OUD among those with and without PTSD. Multiple logistic regressions examined the association between PTSD and chronic pain conditions on OUD. The prevalence of OUD was higher among those with PTSD than those without. Comorbid PTSD/musculoskeletal pain and PTSD/nerve pain conditions were associated with increased odds of OUD, compared to those with neither PTSD nor chronic pain conditions. Digestive pain conditions were not associated with OUD. Comorbid PTSD/musculoskeletal pain conditions demonstrated an additive relationship on OUD compared to musculoskeletal pain conditions and PTSD alone. Results reveal that musculoskeletal pain and nerve pain conditions are associated with increased odds of OUD, but only musculoskeletal pain conditions display an additive relationship on OUD when combined with PTSD. These findings have implications for opioid management and screening among those with comorbid conditions. Copyright © 2018 Elsevier B.V. All rights reserved.

Bioregional monitoring design and occupancy estimation for two Sierra Nevadan amphibian taxa

EPA Science Inventory

Land-management agencies need quantitative, statistically rigorous monitoring data, often at large spatial and temporal scales, to support resource-management decisions. Monitoring designs typically must accommodate multiple ecological, logistical, political, and economic objec...

Modeling brook trout presence and absence from landscape variables using four different analytical methods

USGS Publications Warehouse

Steen, Paul J.; Passino-Reader, Dora R.; Wiley, Michael J.

2006-01-01

As a part of the Great Lakes Regional Aquatic Gap Analysis Project, we evaluated methodologies for modeling associations between fish species and habitat characteristics at a landscape scale. To do this, we created brook trout Salvelinus fontinalis presence and absence models based on four different techniques: multiple linear regression, logistic regression, neural networks, and classification trees. The models were tested in two ways: by application to an independent validation database and cross-validation using the training data, and by visual comparison of statewide distribution maps with historically recorded occurrences from the Michigan Fish Atlas. Although differences in the accuracy of our models were slight, the logistic regression model predicted with the least error, followed by multiple regression, then classification trees, then the neural networks. These models will provide natural resource managers a way to identify habitats requiring protection for the conservation of fish species.

Development of Performance Assessments in Science: Conceptual, Practical, and Logistical Issues.

ERIC Educational Resources Information Center

Solano-Flores, Guillermo; Shavelson, Richard J.

1997-01-01

Conceptual, practical, and logistical issues in the development of science performance assessments (SPAs) are discussed. The conceptual framework identifies task, response format, and scoring system as components, and conceives of SPAs as tasks that attempt to recreate conditions in which scientists work. Developing SPAs is a sophisticated effort…

Enhancing healthcare sector coordination through infrastructure and logistics support.

PubMed

Zoraster, Richard M

2010-01-01

The International Response to the 2004 Southeast Asia Tsunami was noted to have multiple areas of poor coordination, and in 2005, the "Health Cluster"approach to coordination was formulated. However, the 2010 Haiti response suggests that many of the same problems continue and that there are significant limitations to the cluster meetings. These limitations include the inconsistent attendance, poor dissemination of information, and perceived lack of benefit to providers. This article proposes that healthcare coordination would be greatly improved with logistical support, leading to improved efficiency and outcomes for those affected by disasters.

Care Coordination for the Chronically Ill: Understanding the Patient's Perspective

PubMed Central

Maeng, Daniel D; Martsolf, Grant R; Scanlon, Dennis P; Christianson, Jon B

2012-01-01

Objective To identify factors associated with perception of care coordination problems among chronically ill patients. Methods Patient-level data were obtained from a random-digit dial telephone survey of adults with chronic conditions. The survey measured respondents' self-report of care coordination problems and level of patient activation, using the Patient Activation Measure (PAM-13). Logistic regression was used to assess association between respondents' self-report of care coordination problems and a set of patient characteristics. Results Respondents in the highest activation stage had roughly 30–40 percent lower odds of reporting care coordination problems compared to those in the lowest stage (p < .01). Respondents with multiple chronic conditions were significantly more likely to report coordination problems than those with hypertension only. Respondents' race/ethnicity, employment, insurance status, income, and length of illness were not significantly associated with self-reported care coordination problems. Conclusion We conclude that patient activation and complexity of chronic illness are strongly associated with patients' self-report of care coordination problems. Developing targeted strategies to improve care coordination around these patient characteristics may be an effective way to address the issue. PMID:22985032

Disparities in Confidence to Manage Chronic Diseases in Men.

PubMed

Elder, Keith; Gilbert, Keon; Hanke, Louise Meret; Dean, Caress; Rice, Shahida; Johns, Marquisha; Piper, Crystal; Wiltshire, Jacqueline; Moore, Tondra; Wang, Jing

2014-01-01

Chronic diseases are highly prevalent among men in the United States and chronic disease management is problematic for men, particularly for racial and ethnic minority men. This study examined the association between health information seeking and confidence to manage chronic diseases among men. Study data were drawn from the 2007 Health Tracking Household Survey and analyzed using multiple binary logistic regressions. The analytical sample included 2,653 men, 18 years and older with a chronic illness. Results: Health information seeking was not associated with confidence to manage chronic illnesses. African-American men had lower odds than White men to agree to take actions to prevent symptoms with their health. Hispanic men had lower odds than White men to agree to tell a doctor concerns they have, even when not asked. Racial and ethnic minority men with a chronic condition appear to be less confident to manage their health compared to white men. Chronic disease management needs greater exploration to understand the best ways to help racial and ethnic minority men successfully manage their chronic condition.

Resident Self-Assessment and Learning Goal Development: Evaluation of Resident-Reported Competence and Future Goals.

PubMed

Li, Su-Ting T; Paterniti, Debora A; Tancredi, Daniel J; Burke, Ann E; Trimm, R Franklin; Guillot, Ann; Guralnick, Susan; Mahan, John D

2015-01-01

To determine incidence of learning goals by competency area and to assess which goals fall into competency areas with lower self-assessment scores. Cross-sectional analysis of existing deidentified American Academy of Pediatrics' PediaLink individualized learning plan data for the academic year 2009-2010. Residents self-assessed competencies in the 6 Accreditation Council for Graduate Medical Education (ACGME) competency areas and wrote learning goals. Textual responses for goals were mapped to 6 ACGME competency areas, future practice, or personal attributes. Adjusted mean differences and associations were estimated using multiple linear and logistic regression. A total of 2254 residents reported 6078 goals. Residents self-assessed their systems-based practice (51.8) and medical knowledge (53.0) competencies lowest and professionalism (68.9) and interpersonal and communication skills (62.2) highest. Residents were most likely to identify goals involving medical knowledge (70.5%) and patient care (50.5%) and least likely to write goals on systems-based practice (11.0%) and professionalism (6.9%). In logistic regression analysis adjusting for postgraduate year (PGY), gender, and degree type (MD/DO), resident-reported goal area showed no association with the learner's relative self-assessment score for that competency area. In the conditional logistic regression analysis, with each learner serving as his or her own control, senior residents (PGY2/3+s) who rated themselves relatively lower in a competency area were more likely to write a learning goal in that area than were PGY1s. Senior residents appear to develop better skills and/or motivation to explicitly turn self-assessed learning gaps into learning goals, suggesting that individualized learning plans may help improve self-regulated learning during residency. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

What is different about workers' compensation patients? Socioeconomic predictors of baseline disability status among patients with lumbar radiculopathy.

PubMed

Atlas, Steven J; Tosteson, Tor D; Hanscom, Brett; Blood, Emily A; Pransky, Glenn S; Abdu, William A; Andersson, Gunnar B; Weinstein, James N

2007-08-15

Combined analysis of 2 prospective clinical studies. To identify socioeconomic characteristics associated with workers' compensation in patients with an intervertebral disc herniation (IDH) or spinal stenosis (SpS). Few studies have compared socioeconomic differences between those receiving or not receiving workers' compensation with the same underlying clinical conditions. Patients were identified from the Spine Patient Outcomes Research Trial (SPORT) and the National Spine Network (NSN) practice-based outcomes study. Patients with IDH and SpS within NSN were identified satisfying SPORT eligibility criteria. Information on disability and work status at baseline evaluation was used to categorize patients into 3 groups: workers' compensation, other disability compensation, or work-eligible controls. Enrollment rates of patients with disability in a clinical efficacy trial (SPORT) and practice-based network (NSN) were compared. Independent socioeconomic predictors of baseline workers' compensation status were identified in multivariate logistic regression models controlling for clinical condition, study cohort, and initial treatment designation. Among 3759 eligible patients (1480 in SPORT and 2279 in NSN), 564 (15%) were receiving workers' compensation, 317 (8%) were receiving other disability compensation, and 2878 (77%) were controls. Patients receiving workers' compensation were less common in SPORT than NSN (9.2% vs. 18.8%, P < 0.001), but patients receiving other disability compensation were similarly represented (8.9% vs. 7.7%, P = 0.19). In univariate analyses, many socioeconomic characteristics significantly differed according to baseline workers' compensation status. In multiple logistic regression analyses, gender, educational level, work characteristics, legal action, and expectations about ability to work without surgery were independently associated with receiving workers' compensation. Clinical trials involving conditions commonly seen in patients with workers' compensation may need special efforts to ensure adequate representation. Socioeconomic characteristics markedly differed between patients receiving and not receiving workers' compensation. Identifying the independent effects of workers' compensation on outcomes will require controlling for these baseline characteristics and other clinical features associated with disability status.

What Is Different About Worker’s Compensation Patients?

PubMed Central

Atlas, Steven J.; Tosteson, Tor D.; Hanscom, Brett; Blood, Emily A.; Pransky, Glenn S.; Abdu, William A.; Andersson, Gunnar B.; Weinstein, James N.

2010-01-01

Study Design Combined analysis of 2 prospective clinical studies. Objective To identify socioeconomic characteristics associated with workers’ compensation in patients with an intervertebral disc herniation (IDH) or spinal stenosis (SpS). Summary of Background Data Few studies have compared socioeconomic differences between those receiving or not receiving workers’ compensation with the same underlying clinical conditions. Methods Patients were identified from the Spine Patient Outcomes Research Trial (SPORT) and the National Spine Network (NSN) practice-based outcomes study. Patients with IDH and SpS within NSN were identified satisfying SPORT eligibility criteria. Information on disability and work status at baseline evaluation was used to categorize patients into 3 groups: workers’ compensation, other disability compensation, or work-eligible controls. Enrollment rates of patients with disability in a clinical efficacy trial (SPORT) and practice-based network (NSN) were compared. Independent socioeconomic predictors of baseline workers’ compensation status were identified in multivariate logistic regression models controlling for clinical condition, study cohort, and initial treatment designation. Results Among 3759 eligible patients (1480 in SPORT and 2279 in NSN), 564 (15%) were receiving workers’ compensation, 317 (8%) were receiving other disability compensation, and 2878 (77%) were controls. Patients receiving workers’ compensation were less common in SPORT than NSN (9.2% vs. 18.8%, P < 0.001), but patients receiving other disability compensation were similarly represented (8.9% vs. 7.7%, P = 0.19). In univariate analyses, many socioeconomic characteristics significantly differed according to baseline workers’ compensation status. In multiple logistic regression analyses, gender, educational level, work characteristics, legal action, and expectations about ability to work without surgery were independently associated with receiving workers’ compensation. Conclusion Clinical trials involving conditions commonly seen in patients with workers’ compensation may need special efforts to ensure adequate representation. Socioeconomic characteristics markedly differed between patients receiving and not receiving workers’ compensation. Identifying the independent effects of workers’ compensation on outcomes will require controlling for these baseline characteristics and other clinical features associated with disability status. PMID:17700451

Relationship between Sensory Perception and Frailty in a Community-Dwelling Elderly Population.

PubMed

Somekawa, S; Mine, T; Ono, K; Hayashi, N; Obuchi, S; Yoshida, H; Kawai, H; Fujiwara, Y; Hirano, H; Kojima, M; Ihara, K; Kim, H

2017-01-01

Aging anorexia, defined as loss of appetite and/or reduced food intake, has been postulated as a risk factor for frailty. Impairments of taste and smell perception in elderly people can lead to reduced enjoyment of food and contribute to the anorexia of aging. To evaluate the relationship between frailty and taste and smell perception in elderly people living in urban areas. Data from the baseline evaluation of 768 residents aged ≥ 65 years who enrolled in a comprehensive geriatric health examination survey was analyzed. Fourteen out of 29-items of Appetite, Hunger, Sensory Perception questionnaire (AHSP), frailty, age, sex, BMI, chronic conditions and IADL were evaluated. AHSP was analyzed as the total score of 8 taste items (T) and 6 smell items (S). Frailty was diagnosed using a modified Fried's frailty criteria. The area under the receiver operator curves for detection of frailty demonstrated that T (0.715) had moderate accuracy, but S (0.657) had low accuracy. The cutoffs, sensitivity, specificity and Youden Index (YI) values for each perception were T: Cutoff 26.5 (YI: 0.350, sensitivity: 0.639, specificity: 0.711) and S: Cutoff 18.5 (YI: 0.246, sensitivity: 0.690, specificity: 0.556). Results from multiple logistic regression models, after adjusting for age, sex, IADL and chronic conditions showed that participants under the T cutoff were associated with exhaustion and those below the S cutoff were associated with slow walking speed. The adjusted logistic models for age, sex, IADL and chronic conditions showed significant association between T and frailty (OR 2.81, 95% CI 1.29-6.12), but not between S and frailty (OR 1.73, 95% CI 0.83-3.63). Taste and smell perception, particularly taste perception, were associated with a greater risk of frailty in community-dwelling elderly people. These results suggest that lower taste and smell perception may be an indicator of frailty in old age.

The role of socio-economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey.

PubMed

Gesuita, Rosaria; Skrami, Edlira; Bonfanti, Riccardo; Cipriano, Paola; Ferrito, Lucia; Frongia, Paola; Iafusco, Dario; Iannilli, Antonio; Lombardo, Fortunato; Mozzillo, Enza; Paleari, Renata; Rabbone, Ivana; Sabbion, Alberto; Salvatoni, Alessandro; Scaramuzza, Andrea; Schiaffini, Riccardo; Sulli, Nicoletta; Toni, Sonia; Carle, Flavia; Cherubini, Valentino

2017-05-01

To identify the role of the family's socio-economic and clinical characteristics on metabolic control in children and adolescents with type 1 diabetes. In this cross-sectional, multicentre study, 768 subjects with type 1 diabetes under 18 years of age were consecutively recruited from January 2008 to February 2009. Target condition was considered for HbA 1c values <7.5% (<58 mmol/mol). A multiple correspondence analysis (MCA) was performed to analyze the association between the socio-economic and clinical characteristics of the participants. A logistic regression analysis was performed to identify factors associated with the subjects metabolic control. In both analyses, the family's socio-economic status was represented, measured by the Hollingshead Four-Factor Index of Social Status (SES) or by parental years of education. A total of 28.1% of subjects reached target HbA1c values. The MCA identified a strong association between at-target condition and several factors: high levels of SES or high levels of parental education, the use of the carbohydrate counting system, the use of insulin pumps, the use of the insulin delivery system over a short period of time, a normal body mass index. The logistic regression analysis showed that SES and the mother's years of education were significantly associated with the target condition [odds ratio (OR): 1.01, 95% confidence interval (CI): 1.01-1.03, p = 0.029; OR: 1.05, 95% CI: 1.01-1.10, p = 0.027, respectively). Personal, clinical, and family characteristics were found to be associated with HbA 1c target. Their identification can be crucial in addressing strategies to optimize metabolic control and improve diabetes management. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Relative Impact of Multimorbid Chronic Conditions on Health-Related Quality of Life – Results from the MultiCare Cohort Study

PubMed Central

Brettschneider, Christian; Leicht, Hanna; Bickel, Horst; Dahlhaus, Anne; Fuchs, Angela; Gensichen, Jochen; Maier, Wolfgang; Riedel-Heller, Steffi; Schäfer, Ingmar; Schön, Gerhard; Weyerer, Siegfried; Wiese, Birgitt; König, Hans-Helmut; Altiner, Attila; Bickel, Horst; Blank, Wolfgang; Brettschneider, Christian; Bullinger, Monika; van den Bussche, Hendrik; Dahlhaus, Anne; Ehreke, Lena; Freitag, Michael; Fuchs, Angela; Gensichen, Jochen; Gerlach, Ferdinand; Hansen, Heike; Heinrich, Sven; Höfels, Susanne; von dem Knesebeck, Olaf; König, Hans-Helmut; Krause, Norbert; Leicht, Hanna; Luppa, Melanie; Maier, Wolfgang; Mayer, Manfred; Mellert, Christine; Nützel, Anna; Paschke, Thomas; Petersen, Juliana; Prokein, Jana; Riedel-Heller, Steffi; Romberg, Heinz-Peter; Schäfer, Ingmar; Scherer, Martin; Schön, Gerhard; Steinmann, Susanne; Schulz, Sven; Wegscheider, Karl; Weckbecker, Klaus; Werle, Jochen; Weyerer, Siegfried; Wiese, Birgitt; Zieger, Margrit

2013-01-01

Background Multimorbidity has a negative impact on health-related quality of life (HRQL). Previous studies included only a limited number of conditions. In this study, we analyse the impact of a large number of conditions on HRQL in multimorbid patients without preselecting particular diseases. We also explore the effects of these conditions on the specific dimensions of HRQL. Materials and Methods This analysis is based on a multicenter, prospective cohort study of 3189 multimorbid primary care patients aged 65 to 85. The impact of 45 conditions on HRQL was analysed. The severity of the conditions was rated. The EQ-5D, consisting of 5 dimensions and a visual-analogue-scale (EQ VAS), was employed. Data were analysed using multiple ordinary least squares and multiple logistic regressions. Multimorbidity measured by a weighted count score was significantly associated with lower overall HRQL (EQ VAS), b = −1.02 (SE: 0.06). Parkinson’s disease had the most pronounced negative effect on overall HRQL (EQ VAS), b = −12.29 (SE: 2.18), followed by rheumatism, depression, and obesity. With regard to the individual EQ-5D dimensions, depression (OR = 1.39 to 3.3) and obesity (OR = 1.44 to 1.95) affected all five dimensions of the EQ-5D negatively except for the dimension anxiety/depression. Obesity had a positive effect on this dimension, OR = 0.78 (SE: 0.07). The dimensions “self-care”, OR = 4.52 (SE: 1.37) and “usual activities”, OR = 3.59 (SE: 1.0), were most strongly affected by Parkinson’s disease. As a limitation our sample may only represent patients with at most moderate disease severity. Conclusions The overall HRQL of multimorbid patients decreases with an increasing count and severity of conditions. Parkinson’s disease, depression and obesity have the strongest impact on HRQL. Further studies should address the impact of disease combinations which require very large sample sizes as well as advanced statistical methods. PMID:23826124

Screening for ketosis using multiple logistic regression based on milk yield and composition

PubMed Central

KAYANO, Mitsunori; KATAOKA, Tomoko

2015-01-01

Multiple logistic regression was applied to milk yield and composition data for 632 records of healthy cows and 61 records of ketotic cows in Hokkaido, Japan. The purpose was to diagnose ketosis based on milk yield and composition, simultaneously. The cows were divided into two groups: (1) multiparous, including 314 healthy cows and 45 ketotic cows and (2) primiparous, including 318 healthy cows and 16 ketotic cows, since nutritional status, milk yield and composition are affected by parity. Multiple logistic regression was applied to these groups separately. For multiparous cows, milk yield (kg/day/cow) and protein-to-fat (P/F) ratio in milk were significant factors (P<0.05) for the diagnosis of ketosis. For primiparous cows, lactose content (%), solid not fat (SNF) content (%) and milk urea nitrogen (MUN) content (mg/dl) were significantly associated with ketosis (P<0.01). A diagnostic rule was constructed for each group of cows: (1) 9.978 × P/F ratio + 0.085 × milk yield <10 and (2) 2.327 × SNF − 2.703 × lactose + 0.225 × MUN <10. The sensitivity, specificity and the area under the curve (AUC) of the diagnostic rules were (1) 0.800, 0.729 and 0.811; (2) 0.813, 0.730 and 0.787, respectively. The P/F ratio, which is a widely used measure of ketosis, provided the sensitivity, specificity and AUC values of (1) 0.711, 0.726 and 0.781; and (2) 0.678, 0.767 and 0.738, respectively. PMID:26074408

Knowledge, attitudes and practices survey on organ donation among a selected adult population of Pakistan

PubMed Central

Saleem, Taimur; Ishaque, Sidra; Habib, Nida; Hussain, Syedda Saadia; Jawed, Areeba; Khan, Aamir Ali; Ahmad, Muhammad Imran; Iftikhar, Mian Omer; Mughal, Hamza Pervez; Jehan, Imtiaz

2009-01-01

Background To determine the knowledge, attitudes and practices regarding organ donation in a selected adult population in Pakistan. Methods Convenience sampling was used to generate a sample of 440; 408 interviews were successfully completed and used for analysis. Data collection was carried out via a face to face interview based on a pre-tested questionnaire in selected public areas of Karachi, Pakistan. Data was analyzed using SPSS v.15 and associations were tested using the Pearson's Chi square test. Multiple logistic regression was used to find independent predictors of knowledge status and motivation of organ donation. Results Knowledge about organ donation was significantly associated with education (p = 0.000) and socioeconomic status (p = 0.038). 70/198 (35.3%) people expressed a high motivation to donate. Allowance of organ donation in religion was significantly associated with the motivation to donate (p = 0.000). Multiple logistic regression analysis revealed that higher level of education and higher socioeconomic status were significant (p < 0.05) independent predictors of knowledge status of organ donation. For motivation, multiple logistic regression revealed that higher socioeconomic status, adequate knowledge score and belief that organ donation is allowed in religion were significant (p < 0.05) independent predictors. Television emerged as the major source of information. Only 3.5% had themselves donated an organ; with only one person being an actual kidney donor. Conclusion Better knowledge may ultimately translate into the act of donation. Effective measures should be taken to educate people with relevant information with the involvement of media, doctors and religious scholars. PMID:19534793

Relationship between accumulated heat stress during the dry period, body condition score, and reproduction parameters of Holstein cows in tropical conditions.

PubMed

Avendaño-Reyes, Leonel; Fuquay, John W; Moore, Reuben B; Liu, Zhanglin; Clark, Bruce L; Vierhout, C

2010-02-01

To estimate the relationship between heat stress during the last 60 days prepartum, body condition score and certain reproductive traits in the subsequent lactation of Holstein cows, 564 multiparous cows and 290 primiparous cows from four dairy herds were used in a hot, humid region. Maximum prepartum degree days were estimated to quantify the degree of heat stress. Multiple regressions analyses and logistic regression analysis were performed to determine the effect of prepartum heat stress and body condition change on reproductive parameters, which were obtained from DHIA forms at the end of the lactation. Multiparous and primiparous cows which gained body condition score from calving to 60 d postpartum exhibited 28 and 27 fewer days open (P < 0.05), respectively, than cows not gaining. There was no effect (P > 0.05) of heat stress measurement on days open or services per conception in either multiparous or primiparous cows. During hotter months of calving, multiparous cows showed higher services per conception and primiparous cows showed higher days open and services per conception (P < 0.05). Maximum prepartum degree-days were positively associated (P < 0.05) with calving difficulty score. Multiparous cows with high body condition score at calving were 1.47 times more likely to present a very difficult calving than cows that calved in October (P < 0.05). Collectively, these results suggest that reproductive performance was not affected by cumulative prepartum heat stress although it was associated with very difficult calving score.

An occupational health study of emergency physicians in Japan: health assessment by immune variables (CD4, CD8, CD56, and NK cell activity) at the beginning of work.

PubMed

Okamoto, Hiroteru; Tsunoda, Tooru; Teruya, Koji; Takeda, Nobuo; Uemura, Takamoto; Matsui, Tomoko; Fukazawa, Shinji; Ichikawa, Kaoru; Takemae, Rieko; Tsuchida, Kosuke; Takashima, Yutaka

2008-01-01

This study was conducted to evaluate the occupational health of Japanese physicians in emergency medicine. Subjects participating in this study were eighty-nine physicians working at 12 medical facilities (10 critical care emergency centers) in Japan. Participants were asked to complete a questionnaire of work conditions and to provide blood samples for immune variable measurements (CD4, CD8, CD56 and natural killer cell (NK cell) activity) before commencing their work. The data collected from seventy-four of 89 participating physicians were analyzed. The traditional work group comprised of 39 emergency physicians, who were significantly overworked compared to other two groups: the shift work group and the day work group. Among these three groups, no immune variable was significantly different except lymphocyte, number of CD4, and NK cell activity; and the NK cell activity of the shift work group was significantly lower than those of the traditional work group (p<0.01) and the day work group (p<0.01) in terms of Bonferroni's multiple comparison, probably due to circadian rhythm. It was indicated that NK cell activity was significantly lower in samples collected at night versus in the morning (OR=8.34, 95%CI: 1.95-35.6, p<0.01) through multiple logistic regression analyses. NK cell activity was significantly lower in individuals taking 0-3 days off per month, as compared to those taking 4 or more days off (OR=4.65, 95%CI: 1.27-17.0, p=0.02), according to multiple logistic regression analyses. Therefore, the low NK cell activity appears to have reflected the extent of fatigue arising from physicians' overwork. Overwork would have been a potential risk for the physicians' health, resulting in a lower quality of Japanese emergency medical services than that which could have been achieved otherwise. This study suggests that it would be better for the Japanese emergency physicians to take 4 or more days off per month for their health and the quality of their services.

Grey-Theory-Based Optimization Model of Emergency Logistics Considering Time Uncertainty.

PubMed

Qiu, Bao-Jian; Zhang, Jiang-Hua; Qi, Yuan-Tao; Liu, Yang

2015-01-01

Natural disasters occur frequently in recent years, causing huge casualties and property losses. Nowadays, people pay more and more attention to the emergency logistics problems. This paper studies the emergency logistics problem with multi-center, multi-commodity, and single-affected-point. Considering that the path near the disaster point may be damaged, the information of the state of the paths is not complete, and the travel time is uncertainty, we establish the nonlinear programming model that objective function is the maximization of time-satisfaction degree. To overcome these drawbacks: the incomplete information and uncertain time, this paper firstly evaluates the multiple roads of transportation network based on grey theory and selects the reliable and optimal path. Then simplify the original model under the scenario that the vehicle only follows the optimal path from the emergency logistics center to the affected point, and use Lingo software to solve it. The numerical experiments are presented to show the feasibility and effectiveness of the proposed method.

Grey-Theory-Based Optimization Model of Emergency Logistics Considering Time Uncertainty

PubMed Central

Qiu, Bao-Jian; Zhang, Jiang-Hua; Qi, Yuan-Tao; Liu, Yang

2015-01-01

Natural disasters occur frequently in recent years, causing huge casualties and property losses. Nowadays, people pay more and more attention to the emergency logistics problems. This paper studies the emergency logistics problem with multi-center, multi-commodity, and single-affected-point. Considering that the path near the disaster point may be damaged, the information of the state of the paths is not complete, and the travel time is uncertainty, we establish the nonlinear programming model that objective function is the maximization of time-satisfaction degree. To overcome these drawbacks: the incomplete information and uncertain time, this paper firstly evaluates the multiple roads of transportation network based on grey theory and selects the reliable and optimal path. Then simplify the original model under the scenario that the vehicle only follows the optimal path from the emergency logistics center to the affected point, and use Lingo software to solve it. The numerical experiments are presented to show the feasibility and effectiveness of the proposed method. PMID:26417946

Serious conditions for ED elderly fall patients: a secondary analysis of the Basel Non-Specific Complaints study.

PubMed

Liu, Shan W; Sri-On, Jiraporn; Tirrell, Gregory Philip; Nickel, Christian; Bingisser, Roland

2016-08-01

Falls among older adults are a public health problem and are multifactorial. We sought to determine whether falls predict more serious conditions in older adult patients presenting to the emergency department (ED) with a "nonspecific complaint" (NSC). A secondary objective was to examine what factors predicted serious conditions among older adult patients with a fall. This study was a secondary analysis of a prospective delayed-type cross-sectional diagnostic study that included a 30-day follow-up. We included patients 65 years and older who presented to the ED from May 2007 and July 2011 with a NSC and had an Emergency Severity Index score of 2 or 3. We then compared the serious conditions among older adults who presented to the ED with a fall with those who did not fall in a cohort of patients with NSC. We had 1111 patients enrolled in our study; 518 (47%) of them had fallen. We found that 310 (60%) of elderly fall patients vs 349 (59%) of nonfall patients had a 30-day serious condition (P=.74). In multiple logistic regression analysis, falls did not predict serious conditions or 30-day mortality among all NSC patients. Among fall patients, male sex, diuretic use, and generalized weakness predicted serious conditions. Fall patients share many features with nonfall NSC patient. However, falls did not increase the risk of serious conditions. Falls in the elderly could be considered under the broader entity of NSC. Copyright © 2016 Elsevier Inc. All rights reserved.

Medical home services for children with behavioral health conditions.

PubMed

Sheldrick, Radley C; Perrin, Ellen C

2010-01-01

Whether medical services received by children and youth with behavioral health conditions are consistent with a Medical Home has not been systematically studied. The objectives of this study were to examine the variation among four behavioral health conditions in regard to services related to the Medical Home. Cross-sectional analyses of the 2003 National Survey of Children's Health were conducted. Multiple logistic regression analyses tested the impact of behavioral health conditions on medical needs, on Medical Home components, and on likelihood of having a Medical Home overall. Autism, Depression/Anxiety, and Behavior/Conduct problems were associated with reduced likelihood of having a Medical Home, whereas Attention-Deficit Hyperactivity Disorder was associated with increased likelihood. All health conditions predicted increased access to a primary care physician (PCP) and a preventive visit in the past year. However, all were also associated with higher needs for specialty care and all behavioral health conditions except Attention-Deficit Hyperactivity Disorder were associated with difficulties accessing this care. A detailed examination of the receipt of services among children and youth with behavioral health conditions reveals two primary reasons why such care is less likely to be consistent with a Medical Home model: (1) parents are more likely to report needing specialty care; and (2) these needs are less likely to be met. These data suggest that the reason why services received by children and youth with behavioral health conditions are not consistent with the Medical Home has more to do with difficulty accessing specialty care than with problems accessing quality primary care.

Access to Electronic Personal Health Records Among Patients With Multiple Chronic Conditions: A Secondary Data Analysis

PubMed Central

Falisi, Angela L; Finney Rutten, Lila J; Chou, Wen-Ying Sylvia; Patel, Vaishali; Moser, Richard P; Hesse, Bradford W

2017-01-01

Background In the United States, national incentives for offering access to electronic personal health records (ePHRs) through electronic means are geared toward creating a culture of patient engagement. One group of patients who stand to benefit from online access to ePHRs is the growing population with multiple chronic conditions (MCC). However, little is known about the current availability and use of ePHRs and patient portals among those managing MCC. Objective The aim was to determine the associations between number of chronic conditions and sociodemographic characteristics and usage of ePHRs, and to assess how the public’s use of ePHRs varies across subpopulations, including those with MCC. Methods This study used data collected from the 2014 Health Information National Trends Survey (HINTS), and assessed differences in use of ePHRs between those with and without MCC (N=3497) using multiple logistic regression techniques. Variables associated with health care systems (insurance status, having a regular provider) and patient-reported self-efficacy were included in the statistical models. Results Those with MCC (n=1555) had significantly higher odds of accessing their records three or more times in the past year compared to those reporting no chronic conditions (n=1050; OR 2.46, 95% CI 1.37-4.45), but the overall percentage of those with MCC using ePHRs remained low (371 of 1529 item respondents, 25.63% weighted). No difference in odds of accessing their records was found between those reporting one chronic condition (n=892) and those reporting none (n=1050; OR 1.02, 95% CI 0.66-1.58). Significant differences in odds of accessing ePHRs were seen between income and age groups (P<.001 and P=.05, respectively), and by whether respondents had a regular provider (P=.03). Conclusions We conclude that ePHRs provide a unique opportunity to enhance MCC patient self-management, but additional effort is needed to ensure that these patients are able to access their ePHRs. An increase in availability of patient access to their ePHRs may provide an opportunity to increase patient engagement and support self-management for all patients and especially those with MCC. PMID:28576755

Chronic Condition Combinations and Health Care Expenditures and Out-of-Pocket Spending Burden Among Adults, Medical Expenditure Panel Survey, 2009 and 2011

PubMed Central

Raval, Amit D.; Sambamoorthi, Usha

2015-01-01

Introduction Little is known about how combinations of chronic conditions in adults affect total health care expenditures. Our objective was to estimate the annual average total expenditures and out-of-pocket spending burden among US adults by combinations of conditions. Methods We conducted a cross-sectional study using 2009 and 2011 data from the Medical Expenditure Panel Survey. The sample consisted of 9,296 adults aged 21 years or older with at least 2 of the following 4 highly prevalent chronic conditions: arthritis, diabetes mellitus, heart disease, and hypertension. Unadjusted and adjusted regression techniques were used to examine the association between chronic condition combinations and log-transformed total expenditures. Logistic regressions were used to analyze the relationship between chronic condition combinations and high out-of-pocket spending burden. Results Among adults with chronic conditions, adults with all 4 conditions had the highest average total expenditures ($20,016), whereas adults with diabetes/hypertension had the lowest annual total expenditures ($7,116). In adjusted models, adults with diabetes/hypertension and hypertension/arthritis had lower health care expenditures than adults with diabetes/heart disease (P < .001). In adjusted models, adults with all 4 conditions had higher expenditures compared with those with diabetes and heart disease. However, the difference was only marginally significant (P = .04). Conclusion Among adults with arthritis, diabetes, heart disease, and hypertension, total health care expenditures differed by type of chronic condition combinations. For individuals with multiple chronic conditions, such as heart disease and diabetes, new models of care management are needed to reduce the cost burden on the payers. PMID:25633487

[Influential factors for anemia in pregnancy based on a nested case-control study in Changsha].

PubMed

Tan, Shan; Li, Hongyan; Gao, Xiao; Xiang, Shiting; He, Qiong; Zhang, Li; Huang, Li; Xiong, Changhui; Yan, Qiang; Yan, Yan

2016-06-28

To explore the prevalence of anemia during pregnancy and the influential factors in changsha city, and to provide scientific evidence for prevention and intervention of anemia during pregnancy. 
 A cluster sampling of 713 mothers, who delivered baby between January 1, 2013 and December 31, 2013 in the three streets of kaifu district of Changsha, was selected to establish a retrospective cohort. The maternal health information during pregnancy was collected within 15 days after the delivery. The influential factors of anemia during pregnancy were analyzed by the method of retrospective nested case-control study and conditional logistic regression.
 The prevalence of anemia during pregnancy in Changsha was 9.96%. The multiple conditional logistic regression results show that high family income (OR=0.632, P=0.020), high education level (OR=0.276, P=0.033), folic acid supplement (OR =0.248, P=0.050), iron supplement (OR=0.272, P<0.001) and eating blood products (OR=0.588, P=0.044) were the beneficial factors for anemia during pregnancy, while multipara (OR=2.917, P=0.003), long duration of menstrual period before pregnancy (OR=1.335, P=0.041), living in new decoration housing (OR=3.690, P=0.045) and tea-drinking (OR=1.365, P=0.094) were the risk factors for anemia during pregnancy. 
 The prevalence of anemia during pregnancy in Changsha is below the average levels. The occurrence of anemia during pregnancy is closely related to the women's economic level and nutritional status. Women should strengthen maternal nutrition during pregnancy and bedroom environment monitor, drink little strong tea and improve the nutritional status of iron during pregnancy.

[Behaviours related to infectious disease and family factors in primary and middle school students].

PubMed

Feng, Na; Luo, Jiayou; Li, Huixia; Zhu, Na; Feng, Qi; Li, Xiongwei; Zhou, Haixiang

2015-06-01

To explore the behaviors related to infectious disease and family factors in primary and middle school students, and to provide evidence for improving behaviors related to infectious disease.
 A total of 8465 students were randomly surveyed by a standard questionnaire of behaviors related to infectious disease. Chi-square test was used to analyze the influential factors for behaviors related to infectious disease, and non conditional logistic regression analysis was used to analyze the multiple factors.
 The total formation rate of behaviors related to infectious disease was 66.4%. The rates for primary and middle school students were 69.4% and 62.8% respectively, with significant difference (P<0.05). There were significant differences in the following behaviors, such as washing hands before eating food, rarely buying snacks on outside stalls, informing teachers when showing infectious disease symptoms (all P<0.05), the degree for such behaviors in primary school students was higher than that in middle school students. There were also significant differences in the following behaviors, such as washing hands after using the toilet, blocking with a handkerchief, wiping while coughing and sneezing (all P<0.05), the degree for such behaviors in middle school students was higher than that in primary school students. Non conditional logistic regression analysis showed that the behaviors related to infectious disease in primary and middle school students were associated with parents' education degree, mother's occupation and living status with parents.
 Behaviors related to infectious disease in primary and middle school students need to be improved, and the formation of these behaviors may be related to many family factors.

Clinically observed chickenpox and the risk of childhood-onset multiple sclerosis.

PubMed

Mikaeloff, Yann; Caridade, Guillaume; Suissa, Samy; Tardieu, Marc

2009-05-15

The authors conducted a population-based case-control study to investigate whether clinically observed chickenpox, linked with a level of intensity for clinical expression, increases the risk of multiple sclerosis (MS) in childhood. The cases were MS patients whose disease onset occurred between 1994 and 2003, before age 16 years, in France. Each case was matched for age, sex, and geographic origin with as many as 12 controls randomly selected from the general population. Information about clinically observed chickenpox in cases and controls before the index date regarding onset of MS was collected with a standardized questionnaire and was checked against health certificates. Conditional logistic regression was used to estimate the odds ratio for an association between MS and chickenpox. The 137 MS cases were matched with 1,061 controls. Clinically observed chickenpox had occurred in 76.6% of the cases and 84.9% of their matched controls. The adjusted odds ratio of MS onset associated with chickenpox occurrence was 0.58 (95% confidence interval: 0.36, 0.92). The authors concluded that clinically observed chickenpox was associated with a lower risk of childhood-onset MS in a French population.

Depression and anxiety in multiple system atrophy.

PubMed

Zhang, L-Y; Cao, B; Zou, Y-T; Wei, Q-Q; Ou, R-W; Zhao, B; Wu, Y; Shang, H-F

2018-01-01

It has been noticed that the patients with multiple system atrophy (MSA) can accompany with depression and anxiety. This study aimed to establish the incidence and determinants of depression and anxiety symptoms in Chinese MSA patients. A total of 237 MSA patients were enrolled in the study. Neuropsychological assessment was performed using Hamilton Depression Rating Scale-24 items and Hamilton Anxiety Rating Scale. We found that 62.0% and 71.7% patients had at least mild depression and anxiety symptoms, respectively. The severity of depression of MSA patients was associated with lower educational years (P=.024), longer disease duration (P<.001), and disease severity (P<.001). The severity of anxiety was associated with increased disease duration (P<.001), disease severity (P=.013), and orthostatic hypotension (P=.005). Binary logistic regression showed the determinants of depression and anxiety were female gender, longer disease duration, and disease severity. Depression and anxiety symptoms are common in patients with MSA. Neurologists should pay attention to depression and anxiety in patients with MSA, especially in female patients and those with longer disease duration and severe disease condition. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

MRMPROBS: a data assessment and metabolite identification tool for large-scale multiple reaction monitoring based widely targeted metabolomics.

PubMed

Tsugawa, Hiroshi; Arita, Masanori; Kanazawa, Mitsuhiro; Ogiwara, Atsushi; Bamba, Takeshi; Fukusaki, Eiichiro

2013-05-21

We developed a new software program, MRMPROBS, for widely targeted metabolomics by using the large-scale multiple reaction monitoring (MRM) mode. The strategy became increasingly popular for the simultaneous analysis of up to several hundred metabolites at high sensitivity, selectivity, and quantitative capability. However, the traditional method of assessing measured metabolomics data without probabilistic criteria is not only time-consuming but is often subjective and makeshift work. Our program overcomes these problems by detecting and identifying metabolites automatically, by separating isomeric metabolites, and by removing background noise using a probabilistic score defined as the odds ratio from an optimized multivariate logistic regression model. Our software program also provides a user-friendly graphical interface to curate and organize data matrices and to apply principal component analyses and statistical tests. For a demonstration, we conducted a widely targeted metabolome analysis (152 metabolites) of propagating Saccharomyces cerevisiae measured at 15 time points by gas and liquid chromatography coupled to triple quadrupole mass spectrometry. MRMPROBS is a useful and practical tool for the assessment of large-scale MRM data available to any instrument or any experimental condition.

Night-shift work and hematological cancers: a population based case-control study in three Nordic countries.

PubMed

Talibov, Madar; Pukkala, Eero; Martinsen, Jan Ivar; Tryggvadottir, Laufey; Weiderpass, Elisabete; Hansen, Johnni

2018-05-01

Objective The aim of this case-control study was to assess the effect of night-shift work on the risk of hematological cancers. Methods The study included 39 371 leukemia, 56 713 non-Hodgkin lymphoma, 9322 Hodgkin lymphoma, and 26 188 multiple myeloma cases diagnosed between 1961 and 2005 in Finland, Sweden, and Iceland. Five controls for each case were selected from the Nordic Occupational Cancer Study (NOCCA) cohort, matched by year of birth, sex and country. Night-shift exposure was assessed by using the NOCCA job-exposure matrix (JEM). Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated from conditional logistic regression models. Results Overall, night work was not associated with a risk of hematological cancers. We observed a small but non-significantly increased risk for leukemia (OR 1.07, 95% CI 0.99-1.16), especially for acute myeloid leukemia (OR 1.15, 95% CI 0.97-1.36) among workers exposed to a high level of cumulative night work exposure. Night work exposure was not associated with lymphatic cancers and multiple myeloma. Conclusion This study did not support associations between night-shift work and hematological cancers.

Risk factors for retinal breaks in patients with symptom of floaters.

PubMed

Singalavanija, Apichart; Amornrattanapan, Chutiwan; Nitiruangjarus, Kanjanee; Tongsai, Sasima

2010-06-01

To identify the risk factors of retinal breaks in patients with the symptom of floaters, and to determine the association between those risk factors and retinal breaks. A retrospective analytic study of 184 patients (55 males and 129 females) that included 220 eyes was conducted. Patient information such as age, symptoms (multiple floaters, flashing), duration of symptom, refractive error, history of cataract surgery, family history of retinal detachment, and complete eye examination were recorded. The patients were divided into two groups, the first group (control group) had symptoms of floaters and no retinal breaks, the second group (retinal breaks group) had symptoms of floaters with retinal breaks. Chi-square test, and the multiple logistic regression were used for statistical analysis. Two hundred twenty eyes, 175 eyes of the control group and 45 eyes of the retinal breaks group were examined and included in this study. The multiple logistic regression analysis revealed that patients with multiple floaters, and floaters and flashing increased the risk of retinal breaks to 5.8 and 4.3 times, respectively, when compared to patients with single floater or floaters alone. Lattice degeneration increased the risk of retinal breaks to 5.9 times when compared to eyes that did not have lattice degeneration. Multiple floaters, flashing and lattice degeneration are risk factors of retinal breaks in patients with symptoms of floaters. Therefore, it is important for the ophthalmologists to be aware of these risk factors and the patients at risk should have follow-up examinations.

Comparison of Two Approaches for Handling Missing Covariates in Logistic Regression

ERIC Educational Resources Information Center

Peng, Chao-Ying Joanne; Zhu, Jin

2008-01-01

For the past 25 years, methodological advances have been made in missing data treatment. Most published work has focused on missing data in dependent variables under various conditions. The present study seeks to fill the void by comparing two approaches for handling missing data in categorical covariates in logistic regression: the…

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

ERIC Educational Resources Information Center

Atar, Burcu; Kamata, Akihito

2011-01-01

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

Classifying machinery condition using oil samples and binary logistic regression

NASA Astrophysics Data System (ADS)

Phillips, J.; Cripps, E.; Lau, John W.; Hodkiewicz, M. R.

2015-08-01

The era of big data has resulted in an explosion of condition monitoring information. The result is an increasing motivation to automate the costly and time consuming human elements involved in the classification of machine health. When working with industry it is important to build an understanding and hence some trust in the classification scheme for those who use the analysis to initiate maintenance tasks. Typically "black box" approaches such as artificial neural networks (ANN) and support vector machines (SVM) can be difficult to provide ease of interpretability. In contrast, this paper argues that logistic regression offers easy interpretability to industry experts, providing insight to the drivers of the human classification process and to the ramifications of potential misclassification. Of course, accuracy is of foremost importance in any automated classification scheme, so we also provide a comparative study based on predictive performance of logistic regression, ANN and SVM. A real world oil analysis data set from engines on mining trucks is presented and using cross-validation we demonstrate that logistic regression out-performs the ANN and SVM approaches in terms of prediction for healthy/not healthy engines.

Polymorphism Thr160Thr in SRD5A1, involved in the progesterone metabolism, modifies postmenopausal breast cancer risk associated with menopausal hormone therapy.

PubMed

Hein, R; Abbas, S; Seibold, P; Salazar, R; Flesch-Janys, D; Chang-Claude, J

2012-01-01

Menopausal hormone therapy (MHT) is associated with an increased breast cancer risk in postmenopausal women, with combined estrogen-progestagen therapy posing a greater risk than estrogen monotherapy. However, few studies focused on potential effect modification of MHT-associated breast cancer risk by genetic polymorphisms in the progesterone metabolism. We assessed effect modification of MHT use by five coding single nucleotide polymorphisms (SNPs) in the progesterone metabolizing enzymes AKR1C3 (rs7741), AKR1C4 (rs3829125, rs17134592), and SRD5A1 (rs248793, rs3736316) using a two-center population-based case-control study from Germany with 2,502 postmenopausal breast cancer patients and 4,833 matched controls. An empirical-Bayes procedure that tests for interaction using a weighted combination of the prospective and the retrospective case-control estimators as well as standard prospective logistic regression were applied to assess multiplicative statistical interaction between polymorphisms and duration of MHT use with regard to breast cancer risk assuming a log-additive mode of inheritance. No genetic marginal effects were observed. Breast cancer risk associated with duration of combined therapy was significantly modified by SRD5A1_rs3736316, showing a reduced risk elevation in carriers of the minor allele (p (interaction,empirical-Bayes) = 0.006 using the empirical-Bayes method, p (interaction,logistic regression) = 0.013 using logistic regression). The risk associated with duration of use of monotherapy was increased by AKR1C3_rs7741 in minor allele carriers (p (interaction,empirical-Bayes) = 0.083, p (interaction,logistic regression) = 0.029) and decreased in minor allele carriers of two SNPs in AKR1C4 (rs3829125: p (interaction,empirical-Bayes) = 0.07, p (interaction,logistic regression) = 0.021; rs17134592: p (interaction,empirical-Bayes) = 0.101, p (interaction,logistic regression) = 0.038). After Bonferroni correction for multiple testing only SRD5A1_rs3736316 assessed using the empirical-Bayes method remained significant. Postmenopausal breast cancer risk associated with combined therapy may be modified by genetic variation in SRD5A1. Further well-powered studies are, however, required to replicate our finding.

[Influences of environmental factors and interaction of several chemokines gene-environmental on systemic lupus erythematosus].

PubMed

Ye, Dong-qing; Hu, Yi-song; Li, Xiang-pei; Huang, Fen; Yang, Shi-gui; Hao, Jia-hu; Yin, Jing; Zhang, Guo-qing; Liu, Hui-hui

2004-11-01

To explore the impact of environmental factors, daily lifestyle, psycho-social factors and the interactions between environmental factors and chemokines genes on systemic lupus erythematosus (SLE). Case-control study was carried out and environmental factors for SLE were analyzed by univariate and multivariate unconditional logistic regression. Interactions between environmental factors and chemokines polymorphism contributing to systemic lupus erythematosus were also analyzed by logistic regression model. There were nineteen factors associated with SLE when univariate unconditional logistic regression was used. However, when multivariate unconditional logistic regression was used, only five factors showed having impacts on the disease, in which drinking well water (OR=0.099) was protective factor for SLE, and multiple drug allergy (OR=8.174), over-exposure to sunshine (OR=18.339), taking antibiotics (OR=9.630) and oral contraceptives were risk factors for SLE. When unconditional logistic regression model was used, results showed that there was interaction between eating irritable food and -2518MCP-1G/G genotype (OR=4.387). No interaction between environmental factors was found that contributing to SLE in this study. Many environmental factors were related to SLE, and there was an interaction between -2518MCP-1G/G genotype and eating irritable food.

Dietary consumption patterns and laryngeal cancer risk.

PubMed

Vlastarakos, Petros V; Vassileiou, Andrianna; Delicha, Evie; Kikidis, Dimitrios; Protopapas, Dimosthenis; Nikolopoulos, Thomas P

2016-06-01

We conducted a case-control study to investigate the effect of diet on laryngeal carcinogenesis. Our study population was made up of 140 participants-70 patients with laryngeal cancer (LC) and 70 controls with a non-neoplastic condition that was unrelated to diet, smoking, or alcohol. A food-frequency questionnaire determined the mean consumption of 113 different items during the 3 years prior to symptom onset. Total energy intake and cooking mode were also noted. The relative risk, odds ratio (OR), and 95% confidence interval (CI) were estimated by multiple logistic regression analysis. We found that the total energy intake was significantly higher in the LC group (p < 0.001), and that the difference remained statistically significant after logistic regression analysis (p < 0.001; OR: 118.70). Notably, meat consumption was higher in the LC group (p < 0.001), and the difference remained significant after logistic regression analysis (p = 0.029; OR: 1.16). LC patients also consumed significantly more fried food (p = 0.036); this difference also remained significant in the logistic regression model (p = 0.026; OR: 5.45). The LC group also consumed significantly more seafood (p = 0.012); the difference persisted after logistic regression analysis (p = 0.009; OR: 2.48), with the consumption of shrimp proving detrimental (p = 0.049; OR: 2.18). Finally, the intake of zinc was significantly higher in the LC group before and after logistic regression analysis (p = 0.034 and p = 0.011; OR: 30.15, respectively). Cereal consumption (including pastas) was also higher among the LC patients (p = 0.043), with logistic regression analysis showing that their negative effect was possibly associated with the sauces and dressings that traditionally accompany pasta dishes (p = 0.006; OR: 4.78). Conversely, a higher consumption of dairy products was found in controls (p < 0.05); logistic regression analysis showed that calcium appeared to be protective at the micronutrient level (p < 0.001; OR: 0.27). We found no difference in the overall consumption of fruits and vegetables between the LC patients and controls; however, the LC patients did have a greater consumption of cooked tomatoes and cooked root vegetables (p = 0.039 for both), and the controls had more consumption of leeks (p = 0.042) and, among controls younger than 65 years, cooked beans (p = 0.037). Lemon (p = 0.037), squeezed fruit juice (p = 0.032), and watermelon (p = 0.018) were also more frequently consumed by the controls. Other differences at the micronutrient level included greater consumption by the LC patients of retinol (p = 0.044), polyunsaturated fats (p = 0.041), and linoleic acid (p = 0.008); LC patients younger than 65 years also had greater intake of riboflavin (p = 0.045). We conclude that the differences in dietary consumption patterns between LC patients and controls indicate a possible role for lifestyle modifications involving nutritional factors as a means of decreasing the risk of laryngeal cancer.

Regression approaches in the test-negative study design for assessment of influenza vaccine effectiveness.

PubMed

Bond, H S; Sullivan, S G; Cowling, B J

2016-06-01

Influenza vaccination is the most practical means available for preventing influenza virus infection and is widely used in many countries. Because vaccine components and circulating strains frequently change, it is important to continually monitor vaccine effectiveness (VE). The test-negative design is frequently used to estimate VE. In this design, patients meeting the same clinical case definition are recruited and tested for influenza; those who test positive are the cases and those who test negative form the comparison group. When determining VE in these studies, the typical approach has been to use logistic regression, adjusting for potential confounders. Because vaccine coverage and influenza incidence change throughout the season, time is included among these confounders. While most studies use unconditional logistic regression, adjusting for time, an alternative approach is to use conditional logistic regression, matching on time. Here, we used simulation data to examine the potential for both regression approaches to permit accurate and robust estimates of VE. In situations where vaccine coverage changed during the influenza season, the conditional model and unconditional models adjusting for categorical week and using a spline function for week provided more accurate estimates. We illustrated the two approaches on data from a test-negative study of influenza VE against hospitalization in children in Hong Kong which resulted in the conditional logistic regression model providing the best fit to the data.

Parent-reported suicidal behavior and correlates among adolescents in China.

PubMed

Liu, Xianchen; Sun, Zhenxiao; Yang, Yanyun

2008-01-01

Suicidal risk begins to increase during adolescence and is associated with multiple biological, psychological, social, and cultural factors. This study examined the prevalence and psychosocial factors of parent-reported suicidal behavior in Chinese adolescents. A community sample of 1920 adolescents in China participated in an epidemiological study. Parents completed a structured questionnaire including child suicidal behavior, illness history, mental health problems, family history, parenting, and family environment. Multiple logistic regression was used for data analysis. Overall, 2.4% of the sample talked about suicide in the previous 6 months, 3.2% had deliberately hurt themselves or attempted suicide, and 5.1% had either suicidal talk or self-harm. The rate of suicidal behavior increased as adolescents aged. Multivariate logistic regression indicated that the following factors were significantly associated with elevated risk for suicidal behavior: depressive/anxious symptoms, poor maternal health, family conflict, and physical punishment of parental discipline style. Suicidal behavior was reported by parents. No causal relationships could be made based on cross-sectional data. The prevalence rate of parent-reported suicidal behavior is markedly lower than self-reported rate in previous research. Depressive/anxious symptoms and multiple family environmental factors are associated with suicidal behavior in Chinese adolescents.

Recent weapon carrying and substance use among United States Virgin Islands youth.

PubMed

Lloyd, J J; Delva, J; Arria, A M

2000-08-01

The objective of the present study was to estimate the strength of the associations between recent weapon carrying and alcohol, cigarette, and illicit drug use among US Virgin Islands (USVI) youth. Data from 1,124 students in Grades 7-12 were analyzed using the conditional form of multiple logistic regression. Compared with youth who did not carry a weapon. youth who carried a weapon were more likely to be male and recent cigarette, alcohol, and illicit drug users. After matching on school and controlling for age, sex, race, neigborhood characteristics, and affiliation with friends who use alcohol and illegal drugs, the associations with cigarette smoking and illicit drug use remained both moderate and statistically significant (odds ratio [OR] = 4.31, p < .001; OR = 2.99, p < .001, respectively). These findings identify a potentially high-risk population that could be targeted for interventions to reduce weapon carrying among youth.

Homogenization techniques for population dynamics in strongly heterogeneous landscapes.

PubMed

Yurk, Brian P; Cobbold, Christina A

2018-12-01

An important problem in spatial ecology is to understand how population-scale patterns emerge from individual-level birth, death, and movement processes. These processes, which depend on local landscape characteristics, vary spatially and may exhibit sharp transitions through behavioural responses to habitat edges, leading to discontinuous population densities. Such systems can be modelled using reaction-diffusion equations with interface conditions that capture local behaviour at patch boundaries. In this work we develop a novel homogenization technique to approximate the large-scale dynamics of the system. We illustrate our approach, which also generalizes to multiple species, with an example of logistic growth within a periodic environment. We find that population persistence and the large-scale population carrying capacity is influenced by patch residence times that depend on patch preference, as well as movement rates in adjacent patches. The forms of the homogenized coefficients yield key theoretical insights into how large-scale dynamics arise from the small-scale features.

Core OCD Symptoms: Exploration of Specificity and Relations with Psychopathology

PubMed Central

Stasik, Sara M.; Naragon-Gainey, Kristin; Chmielewski, Michael; Watson, David

2012-01-01

Obsessive-compulsive disorder (OCD) is a heterogeneous condition, comprised of multiple symptom domains. This study used aggregate composite scales representing three core OCD dimensions (Checking, Cleaning, Rituals), as well as Hoarding, to examine the discriminant validity, diagnostic specificity, and predictive ability of OCD symptom scales. The core OCD scales demonstrated strong patterns of convergent and discriminant validity – suggesting that these dimensions are distinct from other self-reported symptoms – whereas hoarding symptoms correlated just as strongly with OCD and non-OCD symptoms in most analyses. Across analyses, our results indicated that Checking is a particularly strong, specific marker of OCD diagnosis, whereas the specificity of Cleaning and Hoarding to OCD was less strong. Finally, the OCD Checking scale was the only significant predictor of OCD diagnosis in logistic regression analyses. Results are discussed with regard to the importance of assessing OCD symptom dimensions separately and implications for classification. PMID:23026094

Childhood adversity, mental disorder comorbidity, and suicidal behavior in schizotypal personality disorder.

PubMed

Lentz, Vanessa; Robinson, Jennifer; Bolton, James M

2010-11-01

Schizotypal personality disorder (SPD) is a serious and relatively common psychiatric disorder, yet remains understudied among the personality disorders. The current study examines the psychiatric correlates of SPD in a representative epidemiologic sample, utilizing data from the National Epidemiological Survey on Alcohol and Related Conditions (N = 34,653). Multiple logistic regression compared people with SPD to the general population across a broad range of childhood adversities, comorbid psychiatric disorders, and suicidal behavior. SPD was strongly associated with many adverse childhood experiences. After adjusting for confounding factors, SPD was independently associated with major depression and several anxiety disorders, including post-traumatic stress disorder. Interestingly, SPD was more strongly associated with borderline and narcissistic personality disorders than cluster A personality disorders. Individuals with SPD were also more likely to attempt suicide. As a whole, these results suggest that individuals with SPD experience significant morbidity and may be at increased risk of mortality.

The Combined Effect of Long Working Hours and Low Job Control on Self-Rated Health: An Interaction Analysis.

PubMed

Cho, Seong-Sik; Ju, Young-Su; Paek, Domyung; Kim, Hyunjoo; Jung-Choi, Kyunghee

2018-05-01

The aim of this study was to investigate the combined effects of long working hours and low job control on self-rated health. We analyzed employees' data obtained from the third Korean Working Conditions Survey (KWCS). Multiple survey logistic analysis and postestimation commands were employed to estimate the relative excess risk due to interaction (RERI). The odds ratio (OR) for poor self-rated health was 1.24 [95% confidence interval (95% CI): 1.13 to 1.35] for long working hours, 1.04 (95% CI: 0.97 to 1.13) for low job control, and 1.47 (95% CI: 1.33 to 1.62) for both long working hours and low job control. The RERI was 0.18 (95% CI: 0.02 to 0.34). These results imply that low job control may increase the negative influence of long working hours on self-rated health.

The Combined Effect of Long Working Hours and Low Job Control on Self-Rated Health

PubMed Central

Cho, Seong-Sik; Ju, Young-Su; Paek, Domyung; Kim, Hyunjoo; Jung-Choi, Kyunghee

2018-01-01

Objectives: The aim of this study was to investigate the combined effects of long working hours and low job control on self-rated health. Methods: We analyzed employees’ data obtained from the third Korean Working Conditions Survey (KWCS). Multiple survey logistic analysis and postestimation commands were employed to estimate the relative excess risk due to interaction (RERI). Results: The odds ratio (OR) for poor self-rated health was 1.24 [95% confidence interval (95% CI): 1.13 to 1.35] for long working hours, 1.04 (95% CI: 0.97 to 1.13) for low job control, and 1.47 (95% CI: 1.33 to 1.62) for both long working hours and low job control. The RERI was 0.18 (95% CI: 0.02 to 0.34). Conclusion: These results imply that low job control may increase the negative influence of long working hours on self-rated health. PMID:29200187

Adverse psychosocial working conditions and poor quality of life among financial service employees in Brazil.

PubMed

Silva, Luiz Sergio; Barreto, Sandhi Maria

2012-01-01

Workers in the financial services sector are exposed to great stress at work. This study investigates whether exposure to adverse psychosocial work conditions is independently associated with poor health-related physical and mental quality of life among financial services workers. We studied a nationwide representative sample of 2,054 workers of a large Brazilian state bank in 2008. Adverse psychosocial work conditions were investigated by the Effort-reward imbalance (ERI) scale and the Job content questionnaire (JCQ). Health-related quality of life (HRQL) was assessed using the Medical Outcomes Study Short-Form General Health Survey (SF-12). Poor mental and physical HRQL was defined by the lowest quartiles of the SF-12 final score distributions. Associations were investigated using multiple logistic regression analysis. In the multivariate analysis, exposures to low control and lack of social support at work (JCQ) were associated with poor HRQL in the physical domain. Increasing effort-reward imbalance and overcommitment (ERI), on the other hand, were associated with poor HRQL in the mental domain, with a significant statistical trend. Overcommitment was also associated with poor physical HRQL. The results suggest that exposure to adverse psychosocial work conditions has a negative impact on both domains of HRQL among financial service workers. They also indicate that ERI and DC models capture different aspects of job strain.

Reported gum disease as a cardiovascular risk factor in adults with intellectual disabilities.

PubMed

Hsieh, K; Murthy, S; Heller, T; Rimmer, J H; Yen, G

2018-03-01

Several risk factors for cardiovascular disease (CVD) have been identified among adults with intellectual disabilities (ID). Periodontitis has been reported to increase the risk of developing a CVD in the general population. Given that individuals with ID have been reported to have a higher prevalence of poor oral health than the general population, the purpose of this study was to determine whether adults with ID with informant reported gum disease present greater reported CVD than those who do not have reported gum disease and whether gum disease can be considered a risk factor for CVD. Using baseline data from the Longitudinal Health and Intellectual Disability Study from which informant survey data were collected, 128 participants with reported gum disease and 1252 subjects without reported gum disease were identified. A series of univariate logistic regressions was conducted to identify potential confounding factors for a multiple logistic regression. The series of univariate logistic regressions identified age, Down syndrome, hypercholesterolemia, hypertension, reported gum disease, daily consumption of fruits and vegetables and the addition of table salt as significant risk factors for reported CVD. When the significant factors from the univariate logistic regression were included in the multiple logistic analysis, reported gum disease remained as an independent risk factor for reported CVD after adjusting for the remaining risk factors. Compared with the adults with ID without reported gum disease, adults in the gum disease group demonstrated a significantly higher prevalence of reported CVD (19.5% vs. 9.7%; P = .001). After controlling for other risk factors, reported gum disease among adults with ID may be associated with a higher risk of CVD. However, further research that also includes clinical indices of periodontal disease and CVD for this population is needed to determine if there is a causal relationship between gum disease and CVD. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Testing Gene-Gene Interactions in the Case-Parents Design

PubMed Central

Yu, Zhaoxia

2011-01-01

The case-parents design has been widely used to detect genetic associations as it can prevent spurious association that could occur in population-based designs. When examining the effect of an individual genetic locus on a disease, logistic regressions developed by conditioning on parental genotypes provide complete protection from spurious association caused by population stratification. However, when testing gene-gene interactions, it is unknown whether conditional logistic regressions are still robust. Here we evaluate the robustness and efficiency of several gene-gene interaction tests that are derived from conditional logistic regressions. We found that in the presence of SNP genotype correlation due to population stratification or linkage disequilibrium, tests with incorrectly specified main-genetic-effect models can lead to inflated type I error rates. We also found that a test with fully flexible main genetic effects always maintains correct test size and its robustness can be achieved with negligible sacrifice of its power. When testing gene-gene interactions is the focus, the test allowing fully flexible main effects is recommended to be used. PMID:21778736

Birth month affects lifetime disease risk: a phenome-wide method.

PubMed

Boland, Mary Regina; Shahn, Zachary; Madigan, David; Hripcsak, George; Tatonetti, Nicholas P

2015-09-01

An individual's birth month has a significant impact on the diseases they develop during their lifetime. Previous studies reveal relationships between birth month and several diseases including atherothrombosis, asthma, attention deficit hyperactivity disorder, and myopia, leaving most diseases completely unexplored. This retrospective population study systematically explores the relationship between seasonal affects at birth and lifetime disease risk for 1688 conditions. We developed a hypothesis-free method that minimizes publication and disease selection biases by systematically investigating disease-birth month patterns across all conditions. Our dataset includes 1 749 400 individuals with records at New York-Presbyterian/Columbia University Medical Center born between 1900 and 2000 inclusive. We modeled associations between birth month and 1688 diseases using logistic regression. Significance was tested using a chi-squared test with multiplicity correction. We found 55 diseases that were significantly dependent on birth month. Of these 19 were previously reported in the literature (P < .001), 20 were for conditions with close relationships to those reported, and 16 were previously unreported. We found distinct incidence patterns across disease categories. Lifetime disease risk is affected by birth month. Seasonally dependent early developmental mechanisms may play a role in increasing lifetime risk of disease. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Relationship between concealment of emotions at work and musculoskeletal symptoms: results from the third Korean Working Conditions Survey.

PubMed

Jung, Kyungyong; Kim, Dae Hwan; Ryu, Ji Young

2018-05-11

In this study, we explored the relationship between concealing emotions at work and musculoskeletal symptoms in Korean workers using data from a national, population-based survey. Data were obtained from the third Korean Working Conditions Survey in 2011. We investigated the prevalence of three musculoskeletal symptoms ("back pain", "pain in the upper extremities", and "pain in the lower extremities"). Multiple logistic regression analysis was also performed to determine odds ratios (ORs) for musculoskeletal symptoms according to concealing emotions at work, adjusting for socioeconomic factors. In both sexes, the emotion-concealing group showed a significantly higher prevalence of "pain in the upper extremities" and "pain in the lower extremities" than the non-emotion-concealing group. For back pain, male - but not female - workers who concealed their emotions showed a higher prevalence than their non-emotion-concealing counterparts; the difference was statistically significant. Adjusted ORs for musculoskeletal symptoms (excluding "back pain" for female workers) in the emotion-concealing group were significantly higher. Our study suggests that concealment of emotions is closely associated with musculoskeletal symptoms, and the work environment should operate in consideration not only of the physical health work condition of workers but also of their emotional efforts including concealing emotion at work.

Studies of genes involved in craniofacial development and tumorigenesis: FGF3 contributes to isolated oral clefts and may interact with PAX9.

PubMed

Küchler, Erika C; Sabóia, Ticiana M; Vieira, Thays C; Lips, Andrea; Tannure, Patricia N; Deeley, Kathleen; Reis, Maria F; Ho, Bao; Rey, Ana C; Costa, Marcelo C; Granjeiro, José M; Vieira, Alexandre R

2014-11-01

Previous studies suggest individuals born with oral clefts and their families have a higher susceptibility for cancer, which raises the hypothesis that these two conditions share common molecular pathways. This study evaluated the association between oral clefts and polymorphisms in genes that play a role in craniofacial and tumor development. Four hundred and ninety-seven subjects born with oral clefts and 823 unaffected subjects were recruited. Twenty-nine markers in 13 genes were genotyped by the Taqman method. Chi-square was used to compare allele and genotype frequencies. Bonferroni correction for multiple testing was used and the established alpha was 0.0003. This study also used logistic regression to test if genetic variants were associated with oral clefts using positive family history of cancer and age as covariates. There was no association between family history of cancer and oral clefts (p = 0.51). None of the 1320 study participants had a diagnosis of cancer at the time of participation in the study. The marker rs4980700 in FGF3 was associated with oral clefts (p = 0.0002). Logistic regression analysis also provided evidence for gene-gene interaction between FGF3 (rs4980700) and PAX9 (rs2073242), increasing the risk for isolated oral clefts (p = 0.0003). FGF3 is associated with oral clefts and may interact with PAX9.

Emotional Distress as a Predictor of Work-Related Musculoskeletal Disorders in Malaysian Nursing Professionals.

PubMed

Amin, Nur Azma; Quek, Kia Fatt; Oxley, Jennifer Anne; Noah, Rahim; Nordin, Rusli

2018-04-01

Emotional distress is becoming a great concern and is more common in both developed and developing countries. It is associated with several disease conditions. To determine the prevalence of self-perceived emotional distress and its relation to work-related musculoskeletal disorders (WRMSDs) in nurses. A self-administered questionnaire survey was carried out on 660 female nurses working in public hospitals in the Klang Valley, Malaysia. The validated Malay version of the standardized Nordic musculoskeletal questionnaire (M-SNMQ) was used to identify the annual prevalence of WRMSDs; perceived emotional distress was assessed using the validated Malay short version, depression, anxiety, and stress (M-DASS) instrument. In addition, socio-demographic and occupational profiles of the participants were considered. Factors associated with WRMSDs were identified using logistic regression analysis. A total of 376 nurses completed the survey (response rate 83.3%). 73.1% of the nursing staffs experienced WRMSDs in at least one anatomical site 12 months prior to the study. 75% of nurses expressed emotional distress. Of these, over half also reported anxiety and stress. Multiple logistic regression analysis showed that stress and anxiety significantly increased the risk of WRMSDs by approximately twofold. There were significant associations between emotional distress and WRMSDs. Future longitudinal studies are therefore needed to investigate and identify the sources of emotional distress (non-occupational and occupational) to be used to establish preventive strategies to reduce the risk of WRMSDs.

Network-based regularization for matched case-control analysis of high-dimensional DNA methylation data.

PubMed

Sun, Hokeun; Wang, Shuang

2013-05-30

The matched case-control designs are commonly used to control for potential confounding factors in genetic epidemiology studies especially epigenetic studies with DNA methylation. Compared with unmatched case-control studies with high-dimensional genomic or epigenetic data, there have been few variable selection methods for matched sets. In an earlier paper, we proposed the penalized logistic regression model for the analysis of unmatched DNA methylation data using a network-based penalty. However, for popularly applied matched designs in epigenetic studies that compare DNA methylation between tumor and adjacent non-tumor tissues or between pre-treatment and post-treatment conditions, applying ordinary logistic regression ignoring matching is known to bring serious bias in estimation. In this paper, we developed a penalized conditional logistic model using the network-based penalty that encourages a grouping effect of (1) linked Cytosine-phosphate-Guanine (CpG) sites within a gene or (2) linked genes within a genetic pathway for analysis of matched DNA methylation data. In our simulation studies, we demonstrated the superiority of using conditional logistic model over unconditional logistic model in high-dimensional variable selection problems for matched case-control data. We further investigated the benefits of utilizing biological group or graph information for matched case-control data. We applied the proposed method to a genome-wide DNA methylation study on hepatocellular carcinoma (HCC) where we investigated the DNA methylation levels of tumor and adjacent non-tumor tissues from HCC patients by using the Illumina Infinium HumanMethylation27 Beadchip. Several new CpG sites and genes known to be related to HCC were identified but were missed by the standard method in the original paper. Copyright © 2012 John Wiley & Sons, Ltd.

Effects of Social Class and School Conditions on Educational Enrollment and Achievement of Boys and Girls in Rural Viet Nam

ERIC Educational Resources Information Center

Nguyen, Phuong L.

2006-01-01

This study examines the effects of parental SES, school quality, and community factors on children's enrollment and achievement in rural areas in Viet Nam, using logistic regression and ordered logistic regression. Multivariate analysis reveals significant differences in educational enrollment and outcomes by level of household expenditures and…

Application of fuzzy neural network technologies in management of transport and logistics processes in Arctic

NASA Astrophysics Data System (ADS)

Levchenko, N. G.; Glushkov, S. V.; Sobolevskaya, E. Yu; Orlov, A. P.

2018-05-01

The method of modeling the transport and logistics process using fuzzy neural network technologies has been considered. The analysis of the implemented fuzzy neural network model of the information management system of transnational multimodal transportation of the process showed the expediency of applying this method to the management of transport and logistics processes in the Arctic and Subarctic conditions. The modular architecture of this model can be expanded by incorporating additional modules, since the working conditions in the Arctic and the subarctic themselves will present more and more realistic tasks. The architecture allows increasing the information management system, without affecting the system or the method itself. The model has a wide range of application possibilities, including: analysis of the situation and behavior of interacting elements; dynamic monitoring and diagnostics of management processes; simulation of real events and processes; prediction and prevention of critical situations.

Effect of Initial Conditions on Reproducibility of Scientific Research

PubMed Central

Djulbegovic, Benjamin; Hozo, Iztok

2014-01-01

Background: It is estimated that about half of currently published research cannot be reproduced. Many reasons have been offered as explanations for failure to reproduce scientific research findings- from fraud to the issues related to design, conduct, analysis, or publishing scientific research. We also postulate a sensitive dependency on initial conditions by which small changes can result in the large differences in the research findings when attempted to be reproduced at later times. Methods: We employed a simple logistic regression equation to model the effect of covariates on the initial study findings. We then fed the input from the logistic equation into a logistic map function to model stability of the results in repeated experiments over time. We illustrate the approach by modeling effects of different factors on the choice of correct treatment. Results: We found that reproducibility of the study findings depended both on the initial values of all independent variables and the rate of change in the baseline conditions, the latter being more important. When the changes in the baseline conditions vary by about 3.5 to about 4 in between experiments, no research findings could be reproduced. However, when the rate of change between the experiments is ≤2.5 the results become highly predictable between the experiments. Conclusions: Many results cannot be reproduced because of the changes in the initial conditions between the experiments. Better control of the baseline conditions in-between the experiments may help improve reproducibility of scientific findings. PMID:25132705

Effect of initial conditions on reproducibility of scientific research.

PubMed

Djulbegovic, Benjamin; Hozo, Iztok

2014-06-01

It is estimated that about half of currently published research cannot be reproduced. Many reasons have been offered as explanations for failure to reproduce scientific research findings- from fraud to the issues related to design, conduct, analysis, or publishing scientific research. We also postulate a sensitive dependency on initial conditions by which small changes can result in the large differences in the research findings when attempted to be reproduced at later times. We employed a simple logistic regression equation to model the effect of covariates on the initial study findings. We then fed the input from the logistic equation into a logistic map function to model stability of the results in repeated experiments over time. We illustrate the approach by modeling effects of different factors on the choice of correct treatment. We found that reproducibility of the study findings depended both on the initial values of all independent variables and the rate of change in the baseline conditions, the latter being more important. When the changes in the baseline conditions vary by about 3.5 to about 4 in between experiments, no research findings could be reproduced. However, when the rate of change between the experiments is ≤2.5 the results become highly predictable between the experiments. Many results cannot be reproduced because of the changes in the initial conditions between the experiments. Better control of the baseline conditions in-between the experiments may help improve reproducibility of scientific findings.

Shared Decision Making in the Care of Children with Developmental and Behavioral Disorders.

PubMed

Lipstein, Ellen A; Lindly, Olivia J; Anixt, Julia S; Britto, Maria T; Zuckerman, Katharine E

2016-03-01

Shared decision making (SDM) is most needed when there are multiple treatment options and no "right" choice. As with quality and experience of care, frequency of SDM may vary by health condition. The objectives of this study were (1) to compare parent report of SDM between a physical and a behavioral health condition and; (2) to compare parent report of SDM between two different behavioral health conditions. Data on children age 3-17 years with asthma, attention deficit/hyperactivity disorder (ADHD), and/or autism spectrum disorder (ASD) were drawn from the 2009/10 National Survey of Children with Special Health Care Needs. Weighted logistic regression was used to compare a parent-reported, composite measure of SDM. Analyses controlled for sociodemographic factors that may influence experience of SDM. Compared to parents of children with asthma, parents of children with ADHD were significantly less likely to report experiencing consistent SDM (AOR 0.73). Compared to parents of children with ADHD, those of children with ASD had significantly lower odds of experiencing consistent SDM (AOR 0.59). Those with both ADHD and ASD had the same odds as those with ASD alone of experiencing consistent SDM. Use of SDM is particularly limited in developmental and behavioral conditions, such as ADHD and ASD. These data suggest that challenges to implementing SDM may include disease type, complexity, and use of specialty care. Research to identify specific barriers and facilitators of SDM is needed to inform interventions that will promote SDM in developmental and behavioral conditions.

Medically unexplained conditions considered by patients in general practice.

PubMed

Tschudi-Madsen, Hedda; Kjeldsberg, Mona; Natvig, Bård; Ihlebaek, Camilla; Straand, Jørund; Bruusgaard, Dag

2014-04-01

Patients frequently present with multiple and 'unexplained' symptoms, often resulting in complex consultations. To better understand these patients is a challenge to health care professionals, in general, and GPs, in particular. In our research on symptom reporting, we wanted to explore whether patients consider that they may suffer from conditions commonly regarded as unexplained, and we explored associations between these concerns and symptom load, life stressors and socio-demographic factors. Consecutive, unselected patients in general practice completed questionnaires addressing eight conditions commonly regarded as unexplained (amalgam poisoning, Candida syndrome, fibromyalgia, food intolerance, electromagnetic hypersensitivity, burnout syndrome, chronic fatigue syndrome and irritable bowel syndrome). With logistic regression, we analysed associations with symptom load, burden of life stressors with negative impact on present health and socio-demographic variables. Out of the 909 respondents (response rate = 88.8%), 863 had complete data. In total, 39.6% of patients had considered that they may suffer from one or more unexplained conditions (UCs). These concerns were strongly and positively associated with recent symptom load and number of life stressors. If we excluded burnout and food intolerance, corresponding associations were found. Patients frequently considered that they may suffer from UCs. The likelihood of such concerns strongly increased with an increasing symptom load and with the number of life stressors with negative impact on present health. Hence, the number of symptoms may be a strong indicator of whether patients consider their symptoms part of such often controversial multisymptom conditions.

Probability of detecting perchlorate under natural conditions in deep groundwater in California and the Southwestern United States

USGS Publications Warehouse

Fram, Miranda S.; Belitz, Kenneth

2011-01-01

We use data from 1626 groundwater samples collected in California, primarily from public drinking water supply wells, to investigate the distribution of perchlorate in deep groundwater under natural conditions. The wells were sampled for the California Groundwater Ambient Monitoring and Assessment Priority Basin Project. We develop a logistic regression model for predicting probabilities of detecting perchlorate at concentrations greater than multiple threshold concentrations as a function of climate (represented by an aridity index) and potential anthropogenic contributions of perchlorate (quantified as an anthropogenic score, AS). AS is a composite categorical variable including terms for nitrate, pesticides, and volatile organic compounds. Incorporating water-quality parameters in AS permits identification of perturbation of natural occurrence patterns by flushing of natural perchlorate salts from unsaturated zones by irrigation recharge as well as addition of perchlorate from industrial and agricultural sources. The data and model results indicate low concentrations (0.1-0.5 μg/L) of perchlorate occur under natural conditions in groundwater across a wide range of climates, beyond the arid to semiarid climates in which they mostly have been previously reported. The probability of detecting perchlorate at concentrations greater than 0.1 μg/L under natural conditions ranges from 50-70% in semiarid to arid regions of California and the Southwestern United States to 5-15% in the wettest regions sampled (the Northern California coast). The probability of concentrations above 1 μg/L under natural conditions is low (generally <3%).

Dysglycemia, Glycemic Variability, and Outcome After Cardiac Arrest and Temperature Management at 33°C and 36°C.

PubMed

Borgquist, Ola; Wise, Matt P; Nielsen, Niklas; Al-Subaie, Nawaf; Cranshaw, Julius; Cronberg, Tobias; Glover, Guy; Hassager, Christian; Kjaergaard, Jesper; Kuiper, Michael; Smid, Ondrej; Walden, Andrew; Friberg, Hans

2017-08-01

Dysglycemia and glycemic variability are associated with poor outcomes in critically ill patients. Targeted temperature management alters blood glucose homeostasis. We investigated the association between blood glucose concentrations and glycemic variability and the neurologic outcomes of patients randomized to targeted temperature management at 33°C or 36°C after cardiac arrest. Post hoc analysis of the multicenter TTM-trial. Primary outcome of this analysis was neurologic outcome after 6 months, referred to as "Cerebral Performance Category." Thirty-six sites in Europe and Australia. All 939 patients with out-of-hospital cardiac arrest of presumed cardiac cause that had been included in the TTM-trial. Targeted temperature management at 33°C or 36°C. Nonparametric tests as well as multiple logistic regression and mixed effects logistic regression models were used. Median glucose concentrations on hospital admission differed significantly between Cerebral Performance Category outcomes (p < 0.0001). Hyper- and hypoglycemia were associated with poor neurologic outcome (p = 0.001 and p = 0.054). In the multiple logistic regression models, the median glycemic level was an independent predictor of poor Cerebral Performance Category (Cerebral Performance Category, 3-5) with an odds ratio (OR) of 1.13 in the adjusted model (p = 0.008; 95% CI, 1.03-1.24). It was also a predictor in the mixed model, which served as a sensitivity analysis to adjust for the multiple time points. The proportion of hyperglycemia was higher in the 33°C group compared with the 36°C group. Higher blood glucose levels at admission and during the first 36 hours, and higher glycemic variability, were associated with poor neurologic outcome and death. More patients in the 33°C treatment arm had hyperglycemia.

Prevalence of consistent condom use with various types of sex partners and associated factors among money boys in Changsha, China.

PubMed

Wang, Lian-Hong; Yan, Jin; Yang, Guo-Li; Long, Shuo; Yu, Yong; Wu, Xi-Lin

2015-04-01

Money boys with inconsistent condom use (less than 100% of the time) are at high risk of infection by human immunodeficiency virus (HIV) or sexually transmitted infection (STI), but relatively little research has examined their risk behaviors. We investigated the prevalence of consistent condom use (100% of the time) and associated factors among money boys. A cross-sectional study using a structured questionnaire was conducted among money boys in Changsha, China, between July 2012 and January 2013. Independent variables included socio-demographic data, substance abuse history, work characteristics, and self-reported HIV and STI history. Dependent variables included the consistent condom use with different types of sex partners. Among the participants, 82.4% used condoms consistently with male clients, 80.2% with male sex partners, and 77.1% with female sex partners in the past 3 months. A multiple stepwise logistic regression model identified four statistically significant factors associated with lower likelihoods of consistent condom use with male clients: age group, substance abuse, lack of an "employment" arrangement, and having no HIV test within the prior 6 months. In a similar model, only one factor associated significantly with lower likelihoods of consistent condom use with male sex partners was identified in multiple stepwise logistic regression analyses: having no HIV test within the prior six months. As for female sex partners, two significant variables were statistically significant in the multiple stepwise logistic regression analysis: having no HIV test within the prior 6 months and having STI history. Interventions which are linked with more realistic and acceptable HIV prevention methods are greatly warranted and should increase risk awareness and the behavior of consistent condom use in both commercial and personal relationship. © 2015 International Society for Sexual Medicine.

Left atrial accessory appendages, diverticula, and left-sided septal pouch in multi-slice computed tomography. Association with atrial fibrillation and cerebrovascular accidents.

PubMed

Hołda, Mateusz K; Koziej, Mateusz; Wszołek, Karolina; Pawlik, Wiesław; Krawczyk-Ożóg, Agata; Sorysz, Danuta; Łoboda, Piotr; Kuźma, Katarzyna; Kuniewicz, Marcin; Lelakowski, Jacek; Dudek, Dariusz; Klimek-Piotrowska, Wiesława

2017-10-01

The aim of this study is to provide a morphometric description of the left-sided septal pouch (LSSP), left atrial accessory appendages, and diverticula using cardiac multi-slice computed tomography (MSCT) and to compare results between patient subgroups. Two hundred and ninety four patients (42.9% females) with a mean of 69.4±13.1years of age were investigated using MSCT. The presence of the LSSP, left atrial accessory appendages, and diverticula was evaluated. Multiple logistic regression analysis was performed to check whether the presence of additional left atrial structures is associated with increased risk of atrial fibrillation and cerebrovascular accidents. At least one additional left atrial structure was present in 51.7% of patients. A single LSSP, left atrial diverticulum, and accessory appendage were present in 35.7%, 16.0%, and 4.1% of patients, respectively. After adjusting for other risk factors via multiple logistic regression, patients with LSSP are more likely to have atrial fibrillation (OR=2.00, 95% CI=1.14-3.48, p=0.01). The presence of a LSSP was found to be associated with an increased risk of transient ischemic attack using multiple logistic regression analysis after adjustment for other risk factors (OR=3.88, 95% CI=1.10-13.69, p=0.03). In conclusion LSSPs, accessory appendages, and diverticula are highly prevalent anatomic structures within the left atrium, which could be easily identified by MSCT. The presence of LSSP is associated with increased risk for atrial fibrillation and transient ischemic attack. Copyright © 2017 Elsevier B.V. All rights reserved.

A regression tree for identifying combinations of fall risk factors associated to recurrent falling: a cross-sectional elderly population-based study.

PubMed

Kabeshova, A; Annweiler, C; Fantino, B; Philip, T; Gromov, V A; Launay, C P; Beauchet, O

2014-06-01

Regression tree (RT) analyses are particularly adapted to explore the risk of recurrent falling according to various combinations of fall risk factors compared to logistic regression models. The aims of this study were (1) to determine which combinations of fall risk factors were associated with the occurrence of recurrent falls in older community-dwellers, and (2) to compare the efficacy of RT and multiple logistic regression model for the identification of recurrent falls. A total of 1,760 community-dwelling volunteers (mean age ± standard deviation, 71.0 ± 5.1 years; 49.4 % female) were recruited prospectively in this cross-sectional study. Age, gender, polypharmacy, use of psychoactive drugs, fear of falling (FOF), cognitive disorders and sad mood were recorded. In addition, the history of falls within the past year was recorded using a standardized questionnaire. Among 1,760 participants, 19.7 % (n = 346) were recurrent fallers. The RT identified 14 nodes groups and 8 end nodes with FOF as the first major split. Among participants with FOF, those who had sad mood and polypharmacy formed the end node with the greatest OR for recurrent falls (OR = 6.06 with p < 0.001). Among participants without FOF, those who were male and not sad had the lowest OR for recurrent falls (OR = 0.25 with p < 0.001). The RT correctly classified 1,356 from 1,414 non-recurrent fallers (specificity = 95.6 %), and 65 from 346 recurrent fallers (sensitivity = 18.8 %). The overall classification accuracy was 81.0 %. The multiple logistic regression correctly classified 1,372 from 1,414 non-recurrent fallers (specificity = 97.0 %), and 61 from 346 recurrent fallers (sensitivity = 17.6 %). The overall classification accuracy was 81.4 %. Our results show that RT may identify specific combinations of risk factors for recurrent falls, the combination most associated with recurrent falls involving FOF, sad mood and polypharmacy. The FOF emerged as the risk factor strongly associated with recurrent falls. In addition, RT and multiple logistic regression were not sensitive enough to identify the majority of recurrent fallers but appeared efficient in detecting individuals not at risk of recurrent falls.

Use and interpretation of logistic regression in habitat-selection studies

USGS Publications Warehouse

Keating, Kim A.; Cherry, Steve

2004-01-01

 Logistic regression is an important tool for wildlife habitat-selection studies, but the method frequently has been misapplied due to an inadequate understanding of the logistic model, its interpretation, and the influence of sampling design. To promote better use of this method, we review its application and interpretation under 3 sampling designs: random, case-control, and use-availability. Logistic regression is appropriate for habitat use-nonuse studies employing random sampling and can be used to directly model the conditional probability of use in such cases. Logistic regression also is appropriate for studies employing case-control sampling designs, but careful attention is required to interpret results correctly. Unless bias can be estimated or probability of use is small for all habitats, results of case-control studies should be interpreted as odds ratios, rather than probability of use or relative probability of use. When data are gathered under a use-availability design, logistic regression can be used to estimate approximate odds ratios if probability of use is small, at least on average. More generally, however, logistic regression is inappropriate for modeling habitat selection in use-availability studies. In particular, using logistic regression to fit the exponential model of Manly et al. (2002:100) does not guarantee maximum-likelihood estimates, valid probabilities, or valid likelihoods. We show that the resource selection function (RSF) commonly used for the exponential model is proportional to a logistic discriminant function. Thus, it may be used to rank habitats with respect to probability of use and to identify important habitat characteristics or their surrogates, but it is not guaranteed to be proportional to probability of use. Other problems associated with the exponential model also are discussed. We describe an alternative model based on Lancaster and Imbens (1996) that offers a method for estimating conditional probability of use in use-availability studies. Although promising, this model fails to converge to a unique solution in some important situations. Further work is needed to obtain a robust method that is broadly applicable to use-availability studies.

The severity of Minamata disease declined in 25 years: temporal profile of the neurological findings analyzed by multiple logistic regression model.

PubMed

Uchino, Makoto; Hirano, Teruyuki; Satoh, Hiroshi; Arimura, Kimiyoshi; Nakagawa, Masanori; Wakamiya, Jyunji

2005-01-01

Minamata disease (MD) was caused by ingestion of seafood from the methylmercury-contaminated areas. Although 50 years have passed since the discovery of MD, there have been only a few studies on the temporal profile of neurological findings in certified MD patients. Thus, we evaluated changes in neurological symptoms and signs of MD using discriminants by multiple logistic regression analysis. The severity of predictive index declined in 25 years in most of the patients. Only a few patients showed aggravation of neurological findings, which was due to complications such as spino-cerebellar degeneration. Patients with chronic MD aged over 45 years had several concomitant diseases so that their clinical pictures were complicated. It was difficult to differentiate chronic MD using statistically established discriminants based on sensory disturbance alone. In conclusion, the severity of MD declined in 25 years along with the modification by age-related concomitant disorders.

Optical image encryption scheme with multiple light paths based on compressive ghost imaging

NASA Astrophysics Data System (ADS)

Zhu, Jinan; Yang, Xiulun; Meng, Xiangfeng; Wang, Yurong; Yin, Yongkai; Sun, Xiaowen; Dong, Guoyan

2018-02-01

An optical image encryption method with multiple light paths is proposed based on compressive ghost imaging. In the encryption process, M random phase-only masks (POMs) are generated by means of logistic map algorithm, and these masks are then uploaded to the spatial light modulator (SLM). The collimated laser light is divided into several beams by beam splitters as it passes through the SLM, and the light beams illuminate the secret images, which are converted into sparse images by discrete wavelet transform beforehand. Thus, the secret images are simultaneously encrypted into intensity vectors by ghost imaging. The distances between the SLM and secret images vary and can be used as the main keys with original POM and the logistic map algorithm coefficient in the decryption process. In the proposed method, the storage space can be significantly decreased and the security of the system can be improved. The feasibility, security and robustness of the method are further analysed through computer simulations.

The effects of sleep quality, physical activity, and environmental quality on the risk of falls in dementia.

PubMed

Eshkoor, Sima Ataollahi; Hamid, Tengku Aizan; Nudin, Siti Sa'adiah Hassan; Mun, Chan Yoke

2013-06-01

This study aimed to identify the effects of sleep quality, physical activity, environmental quality, age, ethnicity, sex differences, marital status, and educational level on the risk of falls in the elderly individuals with dementia. Data were derived from a group of 1210 Malaysian elderly individuals who were noninstitutionalized and demented. The multiple logistic regression model was applied to estimate the risk of falls in respondents. Approximately the prevalence of falls was 17% among the individuals. The results of multiple logistic regression analysis revealed that age (odds ratio [OR] = 1.03), ethnicity (OR = 1.76), sleep quality (OR = 1.46), and environmental quality (OR = 0.62) significantly affected the risk of falls in individuals (P < .05). Furthermore, sex differences, marital status, educational level, and physical activity were not significant predictors of falls in samples (P > .05). It was found that age, ethnic non-Malay, and sleep disruption increased the risk of falls in respondents, but high environmental quality reduced the risk of falls.

A strategy for health promotion at multiple corporate sites.

PubMed

Alexy, B; Eynon, D

1991-02-01

1. The logistical problems associated with delivery of health promotion programs at multiple corporate sites can be addressed through the use of health education packets. 2. The role of the nurse or health coordinator is critical in assisting and guiding the employee as the health plan is executed. 3. Problematic areas related to implementation of programs at remote sites can be alleviated through careful planning and extensive communication. 4. Advertising, input from employees and staff, and follow up are important in the success of a program.

Prevalence and associations of symptoms of upper extremities, repetitive strain injuries (RSI) and 'RSI-like condition'. A cross sectional study of bank workers in Northeast Brazil.

PubMed

Lacerda, Eliana M; Nácul, Luis C; Augusto, Lia G da S; Olinto, Maria Teresa A; Rocha, Dyhanne C; Wanderley, Danielle C

2005-10-11

The repetitive strain injury syndrome (RSI) is a worldwide occupational health problem affecting all types of economic activities. We investigated the prevalence and some risk factors for RSI and related conditions, namely 'symptoms of upper limbs' and 'RSI-like condition'. We conducted a cross-sectional study with 395 bank workers in Recife, Northeast Brazil. Symptoms of upper limbs and 'RSI-like condition' were assessed by a simple questionnaire, which was used to screen probable cases of RSI. The diagnosis of RSI was confirmed by clinical examination. The associations of potential risk factors and the outcomes were assessed by multiple logistic regression analysis. We found prevalence rates of 56% for symptoms of the upper limbs and 30% for 'RSI-like condition'. The estimated prevalence of clinically confirmed cases of RSI was 22%. Female sex and occupation (as cashier or clerk) increased the risk of all conditions, but the associations were stronger for cases of RSI than for less specific diagnoses of 'RSI-like condition' and symptoms of upper limbs. Age was inversely related to the risk of symptoms of upper limbs but not to 'RSI-like' or RSI. The variation in the magnitude of risk according to the outcome assessed suggests that previous studies using different definitions may not be immediately comparable. We propose the use of a simple instrument to screen cases of RSI in population based studies, which still needs to be validated in other populations. The high prevalence of RSI and related conditions in this population suggests the need for urgent interventions to tackle the problem, which could be directed to individuals at higher risk and to changes in the work organization and environment of the general population.

Dynamic modeling and optimization for space logistics using time-expanded networks

NASA Astrophysics Data System (ADS)

Ho, Koki; de Weck, Olivier L.; Hoffman, Jeffrey A.; Shishko, Robert

2014-12-01

This research develops a dynamic logistics network formulation for lifecycle optimization of mission sequences as a system-level integrated method to find an optimal combination of technologies to be used at each stage of the campaign. This formulation can find the optimal transportation architecture considering its technology trades over time. The proposed methodologies are inspired by the ground logistics analysis techniques based on linear programming network optimization. Particularly, the time-expanded network and its extension are developed for dynamic space logistics network optimization trading the quality of the solution with the computational load. In this paper, the methodologies are applied to a human Mars exploration architecture design problem. The results reveal multiple dynamic system-level trades over time and give recommendation of the optimal strategy for the human Mars exploration architecture. The considered trades include those between In-Situ Resource Utilization (ISRU) and propulsion technologies as well as the orbit and depot location selections over time. This research serves as a precursor for eventual permanent settlement and colonization of other planets by humans and us becoming a multi-planet species.

Careful with Those Priors: A Note on Bayesian Estimation in Two-Parameter Logistic Item Response Theory Models

ERIC Educational Resources Information Center

Marcoulides, Katerina M.

2018-01-01

This study examined the use of Bayesian analysis methods for the estimation of item parameters in a two-parameter logistic item response theory model. Using simulated data under various design conditions with both informative and non-informative priors, the parameter recovery of Bayesian analysis methods were examined. Overall results showed that…

Estimation of Logistic Regression Models in Small Samples. A Simulation Study Using a Weakly Informative Default Prior Distribution

ERIC Educational Resources Information Center

Gordovil-Merino, Amalia; Guardia-Olmos, Joan; Pero-Cebollero, Maribel

2012-01-01

In this paper, we used simulations to compare the performance of classical and Bayesian estimations in logistic regression models using small samples. In the performed simulations, conditions were varied, including the type of relationship between independent and dependent variable values (i.e., unrelated and related values), the type of variable…

Health Status and Working Condition of Migrant Workers: Major Public Health Problems

PubMed Central

Bener, Abdulbari

2017-01-01

Background: Very little research and survey have been performed on the occupational health, hazards, and working condition of urban and rural of workers in Qatar. The aim of the current study is to identify the health status, lifestyle condition, working-related problems, and accidents experienced by Indian subcontinental migrants (ISCM) in Qatar and their access to health-care facilities. Methods: This is a cross-sectional study based on a representative sample of 1186 workers and study covering sociodemographic characteristics, medical conditions, and health-seeking behaviors and personal experience. Results: There were statistically significant differences between semi-urban and urban migrant workers in terms of educational, occupation, income, working hours, and accommodation type (P < 0.001). Furthermore, there were statistically significant differences between migrant workers in terms of body mass index, delay in receiving salary, the right to medical insurance and sick day entitlement, cigarettes and shisha smoking, amenities, having on-site safety measure, and sleeping hours (P < 0.01). Moreover, there were statistically significant differences between semi-urban and urban migrant workers in terms of pain, cardiopulmonary, gastrointestinal, and pseudoneurologic and medical symptoms (P < 0.01). Multiple logistic regression was used for predictors’ health problems in migrant workers such as the absence of drinking water, tap water availability, safety facility tools, occupational status, shisha smoking, toilet facility, working hours, and accommodation type were considered the strong predictors. Conclusions: The current study revealed that there is a lack of insufficient information for the migrants about their lifestyle, medical conditions, health risks, injury, and rights privilege in relation to legal working condition and health services. PMID:28966757

Health Status and Working Condition of Migrant Workers: Major Public Health Problems.

PubMed

Bener, Abdulbari

2017-01-01

Very little research and survey have been performed on the occupational health, hazards, and working condition of urban and rural of workers in Qatar. The aim of the current study is to identify the health status, lifestyle condition, working-related problems, and accidents experienced by Indian subcontinental migrants (ISCM) in Qatar and their access to health-care facilities. This is a cross-sectional study based on a representative sample of 1186 workers and study covering sociodemographic characteristics, medical conditions, and health-seeking behaviors and personal experience. There were statistically significant differences between semi-urban and urban migrant workers in terms of educational, occupation, income, working hours, and accommodation type ( P < 0.001). Furthermore, there were statistically significant differences between migrant workers in terms of body mass index, delay in receiving salary, the right to medical insurance and sick day entitlement, cigarettes and shisha smoking, amenities, having on-site safety measure, and sleeping hours ( P < 0.01). Moreover, there were statistically significant differences between semi-urban and urban migrant workers in terms of pain, cardiopulmonary, gastrointestinal, and pseudoneurologic and medical symptoms ( P < 0.01). Multiple logistic regression was used for predictors' health problems in migrant workers such as the absence of drinking water, tap water availability, safety facility tools, occupational status, shisha smoking, toilet facility, working hours, and accommodation type were considered the strong predictors. The current study revealed that there is a lack of insufficient information for the migrants about their lifestyle, medical conditions, health risks, injury, and rights privilege in relation to legal working condition and health services.

dLOGIS: Disaster Logistics Information System

NASA Astrophysics Data System (ADS)

Koesuma, Sorja; Riantana, Rio; Siswanto, Budi; Aji Purnomo, Fendi; Lelono, Sarjoko

2017-11-01

There are three timing of disaster mitigation which is pre-disaster, emergency response and post-disaster. All of those is important in disaster mitigation, but emergency response is important when we are talking about time. Emergency response has limited time when we should give help. Rapid assessment of kind of logistic, the number of survivors, number children and old people, their gender and also for difable person. It should be done in emergency response time. Therefore we make a mobile application for logistics management system. The name of application is dLOGIS, i.e. Disaster Logistics Information System. The application is based on Android system for mobile phone. Otherwise there is also website version. The website version is for maintenance, data input and registration. So the people or government can use it directly when there is a disaster. After login in dLOGIS, there is five main menus. The first main menu shows disaster information, refugees conditions, logistics needed, available logistics stock and already accepted logistics. In the second menu is used for entering survivors data. The field coordinator can enter survivors data based on the rapid assessment in disaster location. The third menu is used for entering kind of logistic. Number and kind of logistics are based on the BNPB needed standard for the survivor. The fourth menu displays the logistics stock available in field coordinator. And the last menu displays the logistics help that already accepted and sent by donation. By using this application when a disaster happened, field coordinator or local government can use maintenance distribution of logistics base on their needs. Also for donor people who will give help to survivor, they can give logistics with the corresponding of survivor needs.

The impact of a livelihood program on depressive symptoms among people living with HIV in Cambodia.

PubMed

Shimizu, Mayumi; Yi, Siyan; Tuot, Sovannary; Suong, Samedy; Sron, Samrithea; Shibanuma, Akira; Jimba, Masamine

2016-01-01

Psychological and social problems are major concerns in this era of successful antiretroviral therapy. Although livelihood programs have been implemented extensively to improve the daily living conditions of people living with HIV in Cambodia, no studies have yet investigated the impacts of these programs on the mental health of this vulnerable population. Therefore, we examined the impact of a livelihood program on depressive symptoms and associated factors among people living with HIV in Cambodia. A quasi-experimental, nonequivalent comparison group study was conducted in six provinces of Cambodia in 2014. Data were collected from an intervention group comprising 357 people living with HIV who had participated in the livelihood program and a comparison group comprising 328 people living with HIV who had not participated in this program. Multiple logistic regression analysis was carried out to examine the association between livelihood-program participation and depressive symptoms as measured by the depressive symptoms subscale of the 25-item Cambodian version of the Hopkins Symptom Checklist. A propensity score matching was used to examine the effect of the livelihood program on depressive symptoms while controlling for selection bias. Overall, 56.0% and 62.7% of the participants in the intervention and comparison groups, respectively, met the Hopkins Symptom Checklist threshold for depressive symptoms. The multiple logistic regression analysis showed that the participants in the intervention group had significantly lower odds of having depressive symptoms (adjusted odds ratio 0.68, 95% confidence interval 0.52-0.88). The analysis from propensity score matching indicated that the livelihood program helped mitigate depressive symptoms among the participants in the intervention group (T=-1.99). The livelihood program appeared to help mitigate the burden of depressive symptoms among people living with HIV in Cambodia. Thus, this program should be scaled up and modified to better improve participants' mental health.

Obstetric hemorrhage and shock management: using the low technology Non-pneumatic Anti-Shock Garment in Nigerian and Egyptian tertiary care facilities.

PubMed

Miller, Suellen; Fathalla, Mohamed M F; Ojengbede, Oladosu A; Camlin, Carol; Mourad-Youssif, Mohammed; Morhason-Bello, Imran O; Galadanci, Hadiza; Nsima, David; Butrick, Elizabeth; Al Hussaini, Tarek; Turan, Janet; Meyer, Carinne; Martin, Hilarie; Mohammed, Aminu I

2010-10-18

Obstetric hemorrhage is the leading cause of maternal mortality globally. The Non-pneumatic Anti-Shock Garment (NASG) is a low-technology, first-aid compression device which, when added to standard hypovolemic shock protocols, may improve outcomes for women with hypovolemic shock secondary to obstetric hemorrhage in tertiary facilities in low-resource settings. This study employed a pre-intervention/intervention design in four facilities in Nigeria and two in Egypt. Primary outcomes were measured mean and median blood loss, severe end-organ failure morbidity (renal failure, pulmonary failure, cardiac failure, or CNS dysfunctions), mortality, and emergency hysterectomy for 1442 women with ≥750 mL blood loss and at least one sign of hemodynamic instability. Comparisons of outcomes by study phase were assessed with rank sum tests, relative risks (RR), number needed to treat for benefit (NNTb), and multiple logistic regression. Women in the NASG phase (n = 835) were in worse condition on study entry, 38.5% with mean arterial pressure <60 mmHg vs. 29.9% in the pre-intervention phase (p = 0.001). Despite this, negative outcomes were significantly reduced in the NASG phase: mean measured blood loss decreased from 444 mL to 240 mL (p < 0.001), maternal mortality decreased from 6.3% to 3.5% (RR 0.56, 95% CI 0.35-0.89), severe morbidities from 3.7% to 0.7% (RR 0.20, 95% CI 0.08-0.50), and emergency hysterectomy from 8.9% to 4.0% (RR 0.44, 0.23-0.86). In multiple logistic regression, there was a 55% reduced odds of mortality during the NASG phase (aOR 0.45, 0.27-0.77). The NNTb to prevent either mortality or severe morbidity was 18 (12-36). Adding the NASG to standard shock and hemorrhage management may significantly improve maternal outcomes from hypovolemic shock secondary to obstetric hemorrhage at tertiary care facilities in low-resource settings.

The Effect of Work Characteristics on Dermatologic Symptoms in Hairdressers

PubMed Central

2014-01-01

Objectives Hairdressers in Korea perform various tasks and are exposed to health risk factors such as chemical substances or prolonged duration of wet work. The objective of this study is to provide descriptive statistics on the demographics and work characteristics of hairdressers in Korea and to identify work-related risk factors for dermatologic symptoms in hairdressers. Methods 1,054 hairdressers were selected and analyzed for this study. Independent variables were exposure to chemical substances, the training status of the hairdressers, and the main tasks required of them, and the dependent variable was the incidence of dermatologic symptoms. The relationships between work characteristics and dermatologic symptoms were evaluated by estimating odds ratios using multiple logistic regression analysis. Results Among the 1,054 study subjects, 212 hairdressers (20.1%) complained of dermatologic symptoms, and the symptoms were more prevalent in younger, unmarried or highly educated hairdressers. The main tasks that comprise the majority of the wet work were strictly determined by training status, since 96.5% of staff hairdressers identified washing as their main task, while only 1.5% and 2.0% of master and designer hairdressers, respectively, identified this as their main task. Multiple logistic regressions was performed to estimate odds ratios. While exposure to hairdressing chemicals showed no significant effect on the odds ratio for the incidence of dermatologic symptoms, higher odds ratios of dermatologic symptoms were shown in staff hairdressers (2.70, 95% CI: 1.32 - 5.51) and in hairdressers who perform washing as their main task (2.03, 95% CI: 1.22 - 3.37), after adjusting for general and work characteristics. Conclusions This study showed that the training status and main tasks of hairdressers are closely related to each other and that the training status and main tasks of hairdressers are related to the incidence of dermatologic symptoms. This suggests that in the future, regulations on working conditions and health management guidelines for hairdressers should be established. PMID:25028609

Occupational exposure to potentially infectious biological material in a dental teaching environment.

PubMed

Machado-Carvalhais, Helenaura P; Ramos-Jorge, Maria L; Auad, Sheyla M; Martins, Laura H P M; Paiva, Saul M; Pordeus, Isabela A

2008-10-01

The aims of this cross-sectional study were to determine the prevalence of occupational accidents with exposure to biological material among undergraduate students of dentistry and to estimate potential risk factors associated with exposure to blood. Data were collected through a self-administered questionnaire (86.4 percent return rate), which was completed by a sample of 286 undergraduate dental students (mean age 22.4 +/-2.4 years). The students were enrolled in the clinical component of the curriculum, which corresponds to the final six semesters of study. Descriptive, bivariate, simple logistic regression and multiple logistic regression (Forward Stepwise Procedure) analyses were performed. The level of statistical significance was set at 5 percent. Percutaneous and mucous exposures to potentially infectious biological material were reported by 102 individuals (35.6 percent); 26.8 percent reported the occurrence of multiple episodes of exposure. The logistic regression analyses revealed that the incomplete use of individual protection equipment (OR=3.7; 95 percent CI 1.5-9.3), disciplines where surgical procedures are carried out (OR=16.3; 95 percent CI 7.1-37.2), and handling sharp instruments (OR=4.4; 95 percent CI 2.1-9.1), more specifically, hollow-bore needles (OR=6.8; 95 percent CI 2.1-19.0), were independently associated with exposure to blood. Policies of reviewing the procedures during clinical practice are recommended in order to reduce occupational exposure.

Gene set differential analysis of time course expression profiles via sparse estimation in functional logistic model with application to time-dependent biomarker detection.

PubMed

Kayano, Mitsunori; Matsui, Hidetoshi; Yamaguchi, Rui; Imoto, Seiya; Miyano, Satoru

2016-04-01

High-throughput time course expression profiles have been available in the last decade due to developments in measurement techniques and devices. Functional data analysis, which treats smoothed curves instead of originally observed discrete data, is effective for the time course expression profiles in terms of dimension reduction, robustness, and applicability to data measured at small and irregularly spaced time points. However, the statistical method of differential analysis for time course expression profiles has not been well established. We propose a functional logistic model based on elastic net regularization (F-Logistic) in order to identify the genes with dynamic alterations in case/control study. We employ a mixed model as a smoothing method to obtain functional data; then F-Logistic is applied to time course profiles measured at small and irregularly spaced time points. We evaluate the performance of F-Logistic in comparison with another functional data approach, i.e. functional ANOVA test (F-ANOVA), by applying the methods to real and synthetic time course data sets. The real data sets consist of the time course gene expression profiles for long-term effects of recombinant interferon β on disease progression in multiple sclerosis. F-Logistic distinguishes dynamic alterations, which cannot be found by competitive approaches such as F-ANOVA, in case/control study based on time course expression profiles. F-Logistic is effective for time-dependent biomarker detection, diagnosis, and therapy. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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.

Successful Recovery and Transplantation of 11 Organs Including Face, Bilateral Upper Extremities, and Thoracic and Abdominal Organs From a Single Deceased Organ Donor.

PubMed

Tullius, Stefan G; Pomahac, Bohdan; Kim, Heung Bae; Carty, Matthew J; Talbot, Simon G; Nelson, Helen M; Delmonico, Francis L

2016-10-01

We report on the to date largest recovery of 11 organs from a single deceased donor with the transplantation of face, bilateral upper extremities, heart, 1 lung, liver (split for 2 recipients), kidneys, pancreas, and intestine. Although logistically challenging, this case demonstrates the feasibility and safety of the recovery of multiple thoracic and abdominal organs with multiple vascular composite allotransplants and tissues. Our experience of 8 additional successful multiple vascular composite allotransplants, thoracic, and abdominal organ recoveries suggests that such procedures are readily accomplishable from the same deceased donor.

Space Operations Center orbit altitude selection strategy

NASA Technical Reports Server (NTRS)

Indrikis, J.; Myers, H. L.

1982-01-01

The strategy for the operational altitude selection has to respond to the Space Operation Center's (SOC) maintenance requirements and the logistics demands of the missions to be supported by the SOC. Three orbit strategies are developed: two are constant altitude, and one variable altitude. In order to minimize the effect of atmospheric uncertainty the dynamic altitude method is recommended. In this approach the SOC will operate at the optimum altitude for the prevailing atmospheric conditions and logistics model, provided that mission safety constraints are not violated. Over a typical solar activity cycle this method produces significant savings in the overall logistics cost.

Multi-objective optimisation and decision-making of space station logistics strategies

NASA Astrophysics Data System (ADS)

Zhu, Yue-he; Luo, Ya-zhong

2016-10-01

Space station logistics strategy optimisation is a complex engineering problem with multiple objectives. Finding a decision-maker-preferred compromise solution becomes more significant when solving such a problem. However, the designer-preferred solution is not easy to determine using the traditional method. Thus, a hybrid approach that combines the multi-objective evolutionary algorithm, physical programming, and differential evolution (DE) algorithm is proposed to deal with the optimisation and decision-making of space station logistics strategies. A multi-objective evolutionary algorithm is used to acquire a Pareto frontier and help determine the range parameters of the physical programming. Physical programming is employed to convert the four-objective problem into a single-objective problem, and a DE algorithm is applied to solve the resulting physical programming-based optimisation problem. Five kinds of objective preference are simulated and compared. The simulation results indicate that the proposed approach can produce good compromise solutions corresponding to different decision-makers' preferences.

Predictors of Academic Procrastination in Asian International College Students

ERIC Educational Resources Information Center

Lowinger, Robert Jay; Kuo, Ben C. H.; Song, Hyun-A.; Mahadevan, Lakshmi; Kim, Eunyoung; Liao, Kelly Yu-Hsin; Chang, Catherine Y.; Kwon, Kyong-Ah; Han, Suejung

2016-01-01

This study examined the relationships among acculturative stress, coping styles, self-efficacy, English language proficiency, and various demographic characteristics as predictors of procrastination behavior in Asian International students (N = 255) studying in the United States. Results of multiple logistic regression indicated that a collective…

Impact of Collegiate Recreation on Academic Success

ERIC Educational Resources Information Center

Sanderson, Heather; DeRousie, Jason; Guistwite, Nicole

2018-01-01

This study examined the impact of collegiate recreation participation on academic success as measured by grade point average, course credit completion, and persistence or graduation. Logistic and multiple regressions were run to explore the relationship between total recreation contact hours and outcome variables. Results indicated a positive and…

Comparison of Health Information Technology Use Between American Adults With and Without Chronic Health Conditions: Findings From The National Health Interview Survey 2012

PubMed Central

Lauche, Romy; Sibbritt, David; Olaniran, Bolanle; Cook, Ronald; Adams, Jon

2017-01-01

Background Health information technology (HIT) is utilized by people with different chronic conditions such as diabetes and hypertension. However, there has been no comparison of HIT use between persons without a chronic condition, with one chronic condition, and multiple (≥2) chronic conditions (MCCs). Objective The aim of the study was to assess the difference in HIT use between persons without a chronic condition, with one chronic condition, and with MCCs, to describe the characteristics of HIT use among those with chronic conditions and to identify the predictors of HIT use of the persons with one chronic condition and MCCs. Methods A secondary data analysis was conducted in spring 2017 using the National Health Interview Survey (NHIS) 2012 Family Core and Sample Adult Core datasets that yielded 34,525 respondents aged 18 years and older. Measures included overall HIT use (ie, any use of the following five HIT on the Internet: seeking health information, ordering prescription, making appointment, emailing health provider, and using health chat groups), as well as sociodemographic and health-related characteristics. Sociodemographic and health characteristics were compared between HIT users and nonusers among those who reported having at least one chronic condition using chi-square tests. Independent predictors of HIT use were identified using multiple logistic regression analyses for those with one chronic condition, with MCCs, and without a chronic condition. Analyses were weighted and performed at significance level of .005. Results In 2012, adults with one health chronic condition (raw count 4147/8551, weighted percentage 48.54%) was significantly higher than among those with MCCs (3816/9637, 39.55%) and those with none of chronic condition (7254/16,337, 44.40%, P<.001). Seeking health information was the most prevalent HIT use. Chi-square tests revealed that among adults with chronic conditions, those who used HIT were significantly different from their counterpart peers who did not use HIT in terms of sociodemographic and health characteristics (P<.001). Overall, the significant factors related to HIT use were similar among the adults with one chronic condition, with MCCs, or without a chronic condition: younger age, female sex, non-Hispanic white, higher education level, and higher income level were shown to be positively related to the HIT use. Conclusions This study provides a snapshot of HIT use among those with chronic conditions and potential factors related to such use. Clinical care and public health communication efforts attempting to leverage more HIT use should acknowledge differential HIT usage as identified in this study to better address communication inequalities and persistent disparities in socioeconomic status. PMID:28982644

Comparison of Health Information Technology Use Between American Adults With and Without Chronic Health Conditions: Findings From The National Health Interview Survey 2012.

PubMed

Zhang, Yan; Lauche, Romy; Sibbritt, David; Olaniran, Bolanle; Cook, Ronald; Adams, Jon

2017-10-05

Health information technology (HIT) is utilized by people with different chronic conditions such as diabetes and hypertension. However, there has been no comparison of HIT use between persons without a chronic condition, with one chronic condition, and multiple (≥2) chronic conditions (MCCs). The aim of the study was to assess the difference in HIT use between persons without a chronic condition, with one chronic condition, and with MCCs, to describe the characteristics of HIT use among those with chronic conditions and to identify the predictors of HIT use of the persons with one chronic condition and MCCs. A secondary data analysis was conducted in spring 2017 using the National Health Interview Survey (NHIS) 2012 Family Core and Sample Adult Core datasets that yielded 34,525 respondents aged 18 years and older. Measures included overall HIT use (ie, any use of the following five HIT on the Internet: seeking health information, ordering prescription, making appointment, emailing health provider, and using health chat groups), as well as sociodemographic and health-related characteristics. Sociodemographic and health characteristics were compared between HIT users and nonusers among those who reported having at least one chronic condition using chi-square tests. Independent predictors of HIT use were identified using multiple logistic regression analyses for those with one chronic condition, with MCCs, and without a chronic condition. Analyses were weighted and performed at significance level of .005. In 2012, adults with one health chronic condition (raw count 4147/8551, weighted percentage 48.54%) was significantly higher than among those with MCCs (3816/9637, 39.55%) and those with none of chronic condition (7254/16,337, 44.40%, P<.001). Seeking health information was the most prevalent HIT use. Chi-square tests revealed that among adults with chronic conditions, those who used HIT were significantly different from their counterpart peers who did not use HIT in terms of sociodemographic and health characteristics (P<.001). Overall, the significant factors related to HIT use were similar among the adults with one chronic condition, with MCCs, or without a chronic condition: younger age, female sex, non-Hispanic white, higher education level, and higher income level were shown to be positively related to the HIT use. This study provides a snapshot of HIT use among those with chronic conditions and potential factors related to such use. Clinical care and public health communication efforts attempting to leverage more HIT use should acknowledge differential HIT usage as identified in this study to better address communication inequalities and persistent disparities in socioeconomic status. ©Yan Zhang, Romy Lauche, David Sibbritt, Bolanle Olaniran, Ronald Cook, Jon Adams. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.10.2017.

Project INTEGRATE: An integrative study of brief alcohol interventions for college students.

PubMed

Mun, Eun-Young; de la Torre, Jimmy; Atkins, David C; White, Helene R; Ray, Anne E; Kim, Su-Young; Jiao, Yang; Clarke, Nickeisha; Huo, Yan; Larimer, Mary E; Huh, David

2015-03-01

This article provides an overview of a study that synthesizes multiple, independently collected alcohol intervention studies for college students into a single, multisite longitudinal data set. This research embraced innovative analytic strategies (i.e., integrative data analysis or meta-analysis using individual participant-level data), with the overall goal of answering research questions that are difficult to address in individual studies such as moderation analysis, while providing a built-in replication for the reported efficacy of brief motivational interventions for college students. Data were pooled across 24 intervention studies, of which 21 included a comparison or control condition and all included one or more treatment conditions. This yielded a sample of 12,630 participants (42% men; 58% first-year or incoming students). The majority of the sample identified as White (74%), with 12% Asian, 7% Hispanic, 2% Black, and 5% other/mixed ethnic groups. Participants were assessed 2 or more times from baseline up to 12 months, with varying assessment schedules across studies. This article describes how we combined individual participant-level data from multiple studies, and discusses the steps taken to develop commensurate measures across studies via harmonization and newly developed Markov chain Monte Carlo (MCMC) algorithms for 2-parameter logistic item response theory models and a generalized partial credit model. This innovative approach has intriguing promises, but significant barriers exist. To lower the barriers, there is a need to increase overlap in measures and timing of follow-up assessments across studies, better define treatment and control groups, and improve transparency and documentation in future single intervention studies. (c) 2015 APA, all rights reserved).

Multiple Chronic Conditions, Resilience, and Workforce Transitions in Later Life: A Socio-Ecological Model.

PubMed

Jason, Kendra J; Carr, Dawn C; Washington, Tiffany R; Hilliard, Tandrea S; Mingo, Chivon A

2017-04-01

Despite the growing prevalence of multiple chronic conditions (MCC), a problem that disproportionally affects older adults, few studies have examined the impact of MCC status on changes in workforce participation in later life. Recent research suggests that resilience, the ability to recover from adversity, may buffer the negative impact of chronic disease. Guided by an adapted socio-ecological risk and resilience conceptual model, this study examined the buffering effect of resilience on the relationship between individual and contextual risks, including MCC, and workforce transitions (i.e., leaving the workforce, working fewer hours, working the same hours, or working more hours). Using the Health and Retirement Study, this study pooled a sample of 4,861 older workers aged 51 and older with 2 consecutive biannual waves of data. Nonnested multinomial logistic regression analysis was applied. MCC are related to higher risk of transitioning out of the workforce. Resilience buffered the negative effects of MCC on workforce engagement and remained independently associated with increased probability of working the same or more hours compared with leaving work. MCC are associated with movement out of the paid workforce in later life. Despite the challenges MCC impose on older workers, having higher levels of resilience may provide the psychological resources needed to sustain work engagement in the face of new deficits. These findings suggest that identifying ways to bolster resilience may enhance the longevity of productive workforce engagement. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Chaos theory for clinical manifestations in multiple sclerosis.

PubMed

Akaishi, Tetsuya; Takahashi, Toshiyuki; Nakashima, Ichiro

2018-06-01

Multiple sclerosis (MS) is a demyelinating disease which characteristically shows repeated relapses and remissions irregularly in the central nervous system. At present, the pathological mechanism of MS is unknown and we do not have any theories or mathematical models to explain its disseminated patterns in time and space. In this paper, we present a new theoretical model from a viewpoint of complex system with chaos model to reproduce and explain the non-linear clinical and pathological manifestations in MS. First, we adopted a discrete logistic equation with non-linear dynamics to prepare a scalar quantity for the strength of pathogenic factor at a specific location of the central nervous system at a specific time to reflect the negative feedback in immunity. Then, we set distinct minimum thresholds in the above-mentioned scalar quantity for demyelination possibly causing clinical relapses and for cerebral atrophy. With this simple model, we could theoretically reproduce all the subtypes of relapsing-remitting MS, primary progressive MS, and secondary progressive MS. With the sensitivity to initial conditions and sensitivity to minute change in parameters of the chaos theory, we could also reproduce the spatial dissemination. Such chaotic behavior could be reproduced with other similar upward-convex functions with appropriate set of initial conditions and parameters. In conclusion, by applying chaos theory to the three-dimensional scalar field of the central nervous system, we can reproduce the non-linear outcome of the clinical course and explain the unsolved disseminations in time and space of the MS patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

Project INTEGRATE: An Integrative Study of Brief Alcohol Interventions for College Students

PubMed Central

Mun, Eun-Young; de la Torre, Jimmy; Atkins, David C.; White, Helene R.; Ray, Anne E.; Kim, Su-Young; Jiao, Yang; Clarke, Nickeisha; Huo, Yan; Larimer, Mary E.; Huh, David

2014-01-01

This paper provides an overview of a study that synthesizes multiple, independently collected alcohol intervention studies for college students into a single, multisite longitudinal data set. This research embraced innovative analytic strategies (i.e., integrative data analysis or meta-analysis using individual participant-level data), with the overall goal of answering research questions that are difficult to address in individual studies such as moderation analysis, while providing a built-in replication for the reported efficacy of brief motivational interventions for college students. Data were pooled across 24 intervention studies, of which 21 included a comparison or control condition and all included one or more treatment conditions. This yielded a sample of 12,630 participants (42% men; 58% first-year or incoming students). The majority of the sample identified as White (74%), with 12% Asian, 7% Hispanic, 2% Black, and 5% other/mixed ethnic groups. Participants were assessed two or more times from baseline up to 12 months, with varying assessment schedules across studies. This paper describes how we combined individual participant-level data from multiple studies, and discusses the steps taken to develop commensurate measures across studies via harmonization and newly developed Markov chain Monte Carlo algorithms for two-parameter logistic item response theory models and a generalized partial credit model. This innovative approach has intriguing promises, but significant barriers exist. To lower the barriers, there is a need to increase overlap in measures and timing of follow-up assessments across studies, better define treatment and control groups, and improve transparency and documentation in future single, intervention studies. PMID:25546144

Chronic disease and chronic disease risk factors among First Nations, Inuit and Métis populations of northern Canada.

PubMed

Bruce, S G; Riediger, N D; Lix, L M

2014-11-01

Aboriginal populations in northern Canada are experiencing rapid changes in their environments, which may negatively impact on health status. The purpose of our study was to compare chronic conditions and risk factors in northern Aboriginal populations, including First Nations (FN), Inuit and Métis populations, and northern non-Aboriginal populations. Data were from the Canadian Community Health Survey for the period from 2005 to 2008. Weighted multiple logistic regression models tested the association between ethnic groups and health outcomes. Model covariates were age, sex, territory of residence, education and income. Odds ratios (ORs) are reported and a bootstrap method calculated 95% confidence intervals (CIs) and p values. Odds of having at least one chronic condition was significantly lower for the Inuit (OR = 0.59; 95% CI: 0.43-0.81) than for non-Aboriginal population, but similar among FN, Métis and non-Aboriginal populations. Prevalence of many risk factors was significantly different for Inuit, FN and Métis populations. Aboriginal populations in Canada's north have heterogeneous health status. Continued chronic disease and risk factor surveillance will be important to monitor changes over time and to evaluate the impact of public health interventions.

Factors associated with self-reported health: implications for ...

EPA Pesticide Factsheets

BACKGROUND: Advocates for environmental justice, local, state, and national public health officials, exposure scientists, need broad-based heath indices to identify vulnerable communities. Longitudinal studies show that perception of current health status predicts subsequent mortality, suggesting that self-reported health (SRH) may be useful in screening-level community assessments. This paper evaluates whether SRH is an appropriate surrogate indicator of health status by evaluating relationships between SRH and sociodemographic, lifestyle, and health care factors as well as serological indicators of nutrition, health risk, and environmental exposures.METHODS: Data were combined from the 2003-2006 National Health and Nutrition Examination Surveys for 1372 nonsmoking 20-50 year olds. Ordinal and binary logistic regression was used to estimate odds ratios and 95 % confidence intervals of reporting poorer health based on measures of nutrition, health condition, environmental contaminants, and sociodemographic, health care, and lifestyle factors.RESULTS: Poorer SRH was associated with several serological measures of nutrition, health condition, and biomarkers of toluene, cadmium, lead, and mercury exposure. Race/ethnicity, income, education, access to health care, food security, exercise, poor mental and physical health, prescription drug use, and multiple health outcome measures (e.g., diabetes, thyroid problems, asthma) were also associated with poorer SRH.CONCLUS

Forest harvest patterns on private lands in the Cascade Mountains, Washington, USA

USGS Publications Warehouse

Soulard, Christopher E.; Walker, Jessica; Griffith, Glenn E.

2017-01-01

Forests in Washington State generate substantial economic revenue from commercial timber harvesting on private lands. To investigate the rates, causes, and spatial and temporal patterns of forest harvest on private tracts throughout the Cascade Mountains, we relied on a new generation of annual land-use/land-cover (LULC) products created from the application of the Continuous Change Detection and Classification (CCDC) algorithm to Landsat satellite imagery collected from 1985 to 2014. We calculated metrics of landscape pattern using patches of intact and harvested forest in each annual layer to identify changes throughout the time series. Patch dynamics revealed four distinct eras of logging trends that align with prevailing regulations and economic conditions. We used multiple logistic regression to determine the biophysical and anthropogenic factors that influence fine-scale selection of harvest stands in each time period. Results show that private lands forest cover became significantly reduced and more fragmented from 1985 to 2014. Variables linked to parameters of site conditions, location, climate, and vegetation greenness consistently distinguished harvest selection for each distinct era. This study demonstrates the utility of annual LULC data for investigating the underlying factors that influence land cover change.

Polypharmacy as a risk for fall occurrence in geriatric outpatients.

PubMed

Kojima, Taro; Akishita, Masahiro; Nakamura, Tetsuro; Nomura, Kazushi; Ogawa, Sumito; Iijima, Katsuya; Eto, Masato; Ouchi, Yasuyoshi

2012-07-01

To investigate the predictors of falls, such as comorbidity and medication, in geriatric outpatients in a longitudinal observational study. A total of 172 outpatients (45 men and 126 women, mean age 76.9 ± 7.0 years) were evaluated. Physical examination, clinical history and medication profile were obtained from each patient at baseline. These patients were followed for up to 2 years and falls were self-reported to their physicians. The factors associated with falls were analyzed statistically. A total of 32 patients experienced falls within 2 years. On univariate analysis, older age, osteoporosis, number of comorbid conditions and number of drugs were significantly associated with falls within 2 years. On multiple logistic regression analysis, the number of drugs was associated with falls, independent of age, sex, number of comorbid conditions and other factors that were significantly associated in univariate analysis. A receiver-operator curve evaluating the optimal cut-off value for the number of drugs showed that taking five or more drugs was a significant risk. In geriatric outpatients, polypharmacy is associated with falls. Intervention studies are needed to clarify the causal relationship between polypharmacy, comorbidity and falls. © 2011 Japan Geriatrics Society.

Glitch in the gradient: additional education does not uniformly equal better health.

PubMed

Zajacova, Anna; Rogers, Richard G; Johnson-Lawrence, Vicki

2012-12-01

While the relationship between education and general health has been firmly established in the literature, surprisingly little research has analyzed individual components of the global health judgments, such as chronic conditions or pain. We present a systematic account of the health gradient for multiple health outcomes by detailed educational categories among U.S. working-age adults. Using the 1997-2010 National Health Interview Surveys (N = 204,764), we analyze individual health outcomes ranging from cardiovascular disease to vision problems with a series of logistic regression models. The results at the presecondary and baccalaureate levels are consistent with the health gradient. An unexpected finding occurs among adults with some college but no degree, and those with technical/vocational associate degrees: these groups report more pain and a higher prevalence of a broad range of conditions than high school graduates who never attended college. We discuss several explanations for the observed patterns. The findings challenge the broadly accepted educational gradient in health; additionally, the lower postsecondary groups comprise a quarter of American adults. Jointly, there is a clear research and policy impetus to understand the source of this 'glitch' in the health gradient. Copyright © 2012 Elsevier Ltd. All rights reserved.

Association of individual and work-related risk factors with musculoskeletal symptoms among Iranian sewing machine operators.

PubMed

Dianat, Iman; Kord, Madeh; Yahyazade, Parvin; Karimi, Mohammad Ali; Stedmon, Alex W

2015-11-01

This cross-sectional study evaluated working conditions and the occurrence of self-reported musculoskeletal symptoms among 251 Iranian sewing machine operators. A questionnaire and direct observations of working postures using the rapid upper limb assessment (RULA) method were used. A high prevalence of musculoskeletal symptoms, particularly in the neck/shoulders, back and hands/wrists were found. The mean RULA grand score of 5.7 highlighted a poor sewing workstation design and indicated that most operators (with posture assessed at action level 3) needed an investigation and changes in their working habits soon. Work-related factors (including number of years worked as an operator, prolonged working hours per shift, long duration of sitting work without a break, feeling pressure due to work and working postures) and individual factors (including age, gender, BMI and regular sport/physical activities) were associated with musculoskeletal symptoms in multiple logistic regression models. The findings add to the understanding of working conditions of those jobs involving sewing activities and emphasise the need for ergonomic interventions to reduce musculoskeletal symptoms in the future. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

On the intrinsic dynamics of bacteria in waterborne infections.

PubMed

Yang, Chayu; Wang, Jin

2018-02-01

The intrinsic dynamics of bacteria often play an important role in the transmission and spread of waterborne infectious diseases. In this paper, we construct mathematical models for waterborne infections and analyze two types of nontrivial bacterial dynamics: logistic growth, and growth with Allee effects. For the model with logistic growth, we find that regular threshold dynamics take place, and the basic reproduction number can be used to characterize disease extinction and persistence. In contrast, the model with Allee effects exhibits much more complex dynamics, including the existence of multiple endemic equilibria and the presence of backward bifurcation and forward hysteresis. Copyright © 2017 Elsevier Inc. All rights reserved.

Ergonomics, automation and logistics: practical and effective combination of working methods, a case study of a baking company.

PubMed

Quintana, Leonardo; Arias, Claudia; Cordoba, Jorge; Moroy, Magda; Pulido, Jean; Ramirez, Angela

2012-01-01

The aim of this study was to combine three different analytical methods from three different disciplines to diagnose the ergonomic conditions, manufacturing and supply chain operation of a baking company. The study explores a summary of comprehensive working methods that combines the ergonomics, automation and logistics study methods in the diagnosis of working conditions and productivity. The participatory approach of this type of study that involves the feelings and first-hand knowledge of workers of the operation are determining factors in defining points of action and ergonomic interventions, as well as defining opportunities in the automation of manufacturing and logistics, to cope with the needs of the company. The study identified an ergonomic situation (high prevalence of wrist-hand pain), and the combination of interdisciplinary techniques applied allowed to improve this condition in the company. This type of study allows a primary basis of the opportunities presented by the combination of specialized methods of different disciplines, for the definition of comprehensive action plans for the company. Additionally, it outlines opportunities for improvement and recommendations to mitigate the burden associated with occupational diseases and as an end result improve the quality of life and productivity of workers.

Collapse susceptibility mapping in karstified gypsum terrain (Sivas basin - Turkey) by conditional probability, logistic regression, artificial neural network models

NASA Astrophysics Data System (ADS)

Yilmaz, Isik; Keskin, Inan; Marschalko, Marian; Bednarik, Martin

2010-05-01

This study compares the GIS based collapse susceptibility mapping methods such as; conditional probability (CP), logistic regression (LR) and artificial neural networks (ANN) applied in gypsum rock masses in Sivas basin (Turkey). Digital Elevation Model (DEM) was first constructed using GIS software. Collapse-related factors, directly or indirectly related to the causes of collapse occurrence, such as distance from faults, slope angle and aspect, topographical elevation, distance from drainage, topographic wetness index- TWI, stream power index- SPI, Normalized Difference Vegetation Index (NDVI) by means of vegetation cover, distance from roads and settlements were used in the collapse susceptibility analyses. In the last stage of the analyses, collapse susceptibility maps were produced from CP, LR and ANN models, and they were then compared by means of their validations. Area Under Curve (AUC) values obtained from all three methodologies showed that the map obtained from ANN model looks like more accurate than the other models, and the results also showed that the artificial neural networks is a usefull tool in preparation of collapse susceptibility map and highly compatible with GIS operating features. Key words: Collapse; doline; susceptibility map; gypsum; GIS; conditional probability; logistic regression; artificial neural networks.

Self-reported quality of life in multiple sclerosis patients: preliminary results based on the Polish MS Registry.

PubMed

Brola, Waldemar; Sobolewski, Piotr; Fudala, Małgorzata; Flaga, Stanisław; Jantarski, Konrad; Ryglewicz, Danuta; Potemkowski, Andrzej

2016-01-01

The aim of the study was to analyze selected clinical and sociodemographic factors and their effects on the quality of life (QoL) of multiple sclerosis (MS) patients registered in the Polish MS Registry. This was a cross-sectional observational study performed in Poland. Data on personal and disease-specific factors were collected between January 1, 2011, and December 31, 2015, via the web portal of the Polish MS Registry. All patients were assessed by a physician and asked to complete the Polish language versions of the following self-evaluation questionnaires: EuroQol 5-Dimensions, EuroQoL Visual Analog Scale, and Multiple Sclerosis Impact Scale. Univariate analysis and logistic regression were performed to determine the factors associated with QoL. The study included 2,385 patients (female/male ratio 2.3:1) with clinically confirmed MS (mean age 37.8±9.2 years). Average EuroQol 5-Dimensions index was 0.72±0.24, and the mean EuroQoL Visual Analog Scale score was 64.2±22.8. The average Multiple Sclerosis Impact Scale score was 84.6±11.2 (62.2±18.4 for physical condition and 23.8±7.2 for mental condition). Lower QoL scores were significantly associated with higher level of disability (odds ratio [OR], 0.932; 95% confidence interval [CI], 0.876-0.984; P=0.001), age >40 years (OR, 1.042; 95% CI, 0.924-1.158; P=0.012), longer disease duration (OR, 0.482; 95% CI, 0.224-0.998; P=0.042), and lack of disease modifying therapies (OR, 0.024; 95% CI, 0.160-0.835; P=0.024). No significant associations were found between QoL, sex, type of MS course, patient's education, and marital status. The Polish MS Registry is the first national registry for long-term observation that allows for self-evaluation of the QoL. QoL of Polish patients with MS is significantly lower compared with the rest of the population. The parameter is mainly affected by the level of disability, duration of the disease, and limited access to immunomodulatory therapy.

A Bayesian goodness of fit test and semiparametric generalization of logistic regression with measurement data.

PubMed

Schörgendorfer, Angela; Branscum, Adam J; Hanson, Timothy E

2013-06-01

Logistic regression is a popular tool for risk analysis in medical and population health science. With continuous response data, it is common to create a dichotomous outcome for logistic regression analysis by specifying a threshold for positivity. Fitting a linear regression to the nondichotomized response variable assuming a logistic sampling model for the data has been empirically shown to yield more efficient estimates of odds ratios than ordinary logistic regression of the dichotomized endpoint. We illustrate that risk inference is not robust to departures from the parametric logistic distribution. Moreover, the model assumption of proportional odds is generally not satisfied when the condition of a logistic distribution for the data is violated, leading to biased inference from a parametric logistic analysis. We develop novel Bayesian semiparametric methodology for testing goodness of fit of parametric logistic regression with continuous measurement data. The testing procedures hold for any cutoff threshold and our approach simultaneously provides the ability to perform semiparametric risk estimation. Bayes factors are calculated using the Savage-Dickey ratio for testing the null hypothesis of logistic regression versus a semiparametric generalization. We propose a fully Bayesian and a computationally efficient empirical Bayesian approach to testing, and we present methods for semiparametric estimation of risks, relative risks, and odds ratios when parametric logistic regression fails. Theoretical results establish the consistency of the empirical Bayes test. Results from simulated data show that the proposed approach provides accurate inference irrespective of whether parametric assumptions hold or not. Evaluation of risk factors for obesity shows that different inferences are derived from an analysis of a real data set when deviations from a logistic distribution are permissible in a flexible semiparametric framework. © 2013, The International Biometric Society.

Age trends in 30 day hospital readmissions: US national retrospective analysis

PubMed Central

Berry, Jay G; Gay, James C; Joynt Maddox, Karen; Coleman, Eric A; Bucholz, Emily M; O’Neill, Margaret R; Blaine, Kevin; Hall, Matthew

2018-01-01

Abstract Objective To assess trends in and risk factors for readmission to hospital across the age continuum. Design Retrospective analysis. Setting and participants 31 729 762 index hospital admissions for all conditions in 2013 from the US Agency for Healthcare Research and Quality Nationwide Readmissions Database. Main outcome measure 30 day, all cause, unplanned hospital readmissions. Odds of readmission were compared by patients’ age in one year epochs with logistic regression, accounting for sex, payer, length of stay, discharge disposition, number of chronic conditions, reason for and severity of admission, and data clustering by hospital. The middle (45 years) of the age range (0-90+ years) was selected as the age reference group. Results The 30 day unplanned readmission rate following all US index admissions was 11.6% (n=3 678 018). Referenced by patients aged 45 years, the adjusted odds ratio for readmission increased between ages 16 and 20 years (from 0.70 (95% confidence interval 0.68 to 0.71) to 1.04 (1.02 to 1.06)), remained elevated between ages 21 and 44 years (range 1.02 (1.00 to 1.03) to 1.12 (1.10 to 1.14)), steadily decreased between ages 46 and 64 years (range 1.02 (1.00 to 1.04) to 0.91 (0.90 to 0.93)), and decreased abruptly at age 65 years (0.78 (0.77 to 0.79)), after which the odds remained relatively constant with advancing age. Across all ages, multiple chronic conditions were associated with the highest adjusted odds of readmission (for example, 3.67 (3.64 to 3.69) for six or more versus no chronic conditions). Among children, young adults, and middle aged adults, mental health was one of the most common reasons for index admissions that had high adjusted readmission rates (≥75th centile). Conclusions The likelihood of readmission was elevated for children transitioning to adulthood, children and younger adults with mental health disorders, and patients of all ages with multiple chronic conditions. Further attention to the measurement and causes of readmission and opportunities for its reduction in these groups is warranted. PMID:29487063

Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES).

PubMed

Karasek, R A; Theorell, T; Schwartz, J E; Schnall, P L; Pieper, C F; Michela, J L

1988-08-01

Associations between psychosocial job characteristics and past myocardial infarction (MI) prevalence for employed males were tested with the Health Examination Survey (HES) 1960-61, N = 2,409, and the Health and Nutrition Examination Survey (HANES) 1971-75, N = 2,424. A new estimation method is used which imputes to census occupation codes, job characteristic information from national surveys of job characteristics (US Department of Labor, Quality of Employment Surveys). Controlling for age, we find that employed males with jobs which are simultaneously low in decision latitude and high in psychological work load (a multiplicative product term isolating 20 per cent of the population) have a higher prevalence of myocardial infarction in both data bases. In a logistic regression analysis, using job measures adjusted for demographic factors and controlling for age, race, education, systolic blood pressure, serum cholesterol, smoking (HANES only), and physical exertion, we find a low decision latitude/high psychological demand multiplicative product term associated with MI in both data bases. Additional multiple logistic regressions show that low decision latitude is associated with increased prevalence of MI in both the HES and the HANES. Psychological workload and physical exertion are significant only in the HANES.

Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES).

PubMed Central

Karasek, R A; Theorell, T; Schwartz, J E; Schnall, P L; Pieper, C F; Michela, J L

1988-01-01

Associations between psychosocial job characteristics and past myocardial infarction (MI) prevalence for employed males were tested with the Health Examination Survey (HES) 1960-61, N = 2,409, and the Health and Nutrition Examination Survey (HANES) 1971-75, N = 2,424. A new estimation method is used which imputes to census occupation codes, job characteristic information from national surveys of job characteristics (US Department of Labor, Quality of Employment Surveys). Controlling for age, we find that employed males with jobs which are simultaneously low in decision latitude and high in psychological work load (a multiplicative product term isolating 20 per cent of the population) have a higher prevalence of myocardial infarction in both data bases. In a logistic regression analysis, using job measures adjusted for demographic factors and controlling for age, race, education, systolic blood pressure, serum cholesterol, smoking (HANES only), and physical exertion, we find a low decision latitude/high psychological demand multiplicative product term associated with MI in both data bases. Additional multiple logistic regressions show that low decision latitude is associated with increased prevalence of MI in both the HES and the HANES. Psychological workload and physical exertion are significant only in the HANES. PMID:3389427

Dual burden of chronic physical diseases and anxiety/mood disorders among São Paulo Megacity Mental Health Survey Sample, Brazil.

PubMed

Askari, Melanie S; Andrade, Laura Helena; Filho, Alexandre Chiavegatto; Silveira, Camila Magalhães; Siu, Erica; Wang, Yuan-Pang; Viana, Maria Carmen; Martins, Silvia S

2017-10-01

We assessed comorbid associations of 12-month DSM-IV mood/any anxiety disorders with chronic physical conditions within the São Paulo (SP) Megacity Mental Health cross-sectional survey of 5037 participants and explored whether strength of comorbid associations were modified when controlling for demographics. Chi-square tests and logistic regressions were used to examine comorbid associations of DSM-IV mood/anxiety disorders as measured by the WHO Composite International Diagnostic Interview (CIDI 3.0), and self-reported chronic physical conditions among adults from the SP Megacity Mental Health Survey. Among those with any mood or anxiety disorder, chronic pain disorder was the most common physical condition (48.9% and 44.9%, respectively). Significant unadjusted odds ratios (OR) of comorbidity were found between diagnosis of two or more physical conditions and any mood disorders (3.08, 95% CI: 2.27-4.17), and any anxiety disorders (2.49, 95% CI: 1.95-3.17). Comorbidities remained significant when stratified by gender and controlling for marital status, household income, and education (latter two only included within anxiety models). These results cannot be generalized to other cities or rural populations. Homeless and institutionalized populations were not surveyed. Due to cross-sectional study design, the direction of association between chronic disease/chronic disease risk factors and mood disorders is unclear. Dual burden of chronic physical conditions and mood/anxiety disorders is a notable problem among the São Paulo Megacity Survey population, with enhanced comorbidity experienced by community members with multiple physical conditions. Clinicians should consider these findings in understanding healthcare delivery for individuals suffering from both psychiatric disorders and chronic physical conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

Comparing Revictimization in Two Groups of Marginalized Women

ERIC Educational Resources Information Center

Tusher, Chantal Poister; Cook, Sarah L.

2010-01-01

This study examines physical and sexual revictimization in a random sample of incarcerated and poor, urban, nonincarcerated women using multiple measures of physical and sexual child abuse. Researchers used hierarchical logistic regression to compare rates of revictimization and the strength of the association between child abuse and adult…

76 FR 7491 - Certification of Factual Information to Import Administration During Antidumping and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-10

... unnecessary, but did not oppose it. Some commenters opposed the date requirement for company/government.... Further, they argued that this requirement could be burdensome to companies that are making multiple..., the Department will require it on the certification. The Department does not agree with the logistical...

Epidemiology of Injuries Associated With Physical Training Among Young Men in the Army

DTIC Science & Technology

1993-01-01

ratio (AOR), which was generated from "back- Achilles tendonitis. and patellofemoral syndrome. stepping" multiple logistic regression output (BMDP...categories of physical 6.3% ankle sprains, 5.9% overuse knee injuries, such activity and components of physical fitness and to as patellofemoral

Victimization by Bullying and Physical Symptoms among South Korean Schoolchildren

ERIC Educational Resources Information Center

Lee, Ji Hyeon

2018-01-01

This study examined the relationship between victimization by bullying and physical symptoms among South Korean school children. Data were analyzed from a nationally representative sample of 2006 schoolchildren across South Korea aged 9-17 years. Multiple logistic regression analysis was used to estimate the associations between victimization by…

Applied Statistics: From Bivariate through Multivariate Techniques [with CD-ROM

ERIC Educational Resources Information Center

Warner, Rebecca M.

2007-01-01

This book provides a clear introduction to widely used topics in bivariate and multivariate statistics, including multiple regression, discriminant analysis, MANOVA, factor analysis, and binary logistic regression. The approach is applied and does not require formal mathematics; equations are accompanied by verbal explanations. Students are asked…

Spotted Towhee population dynamics in a riparian restoration context

Treesearch

Stacy L. Small; Frank R., III Thompson; Geoffery R. Geupel; John Faaborg

2007-01-01

We investigated factors at multiple scales that might influence nest predation risk for Spotted Towhees (Pipilo maculates) along the Sacramento River, California, within the context of large-scale riparian habitat restoration. We used the logistic-exposure method and Akaike's information criterion (AIC) for model selection to compare predator...

Child Mortality in a Developing Country: A Statistical Analysis

ERIC Educational Resources Information Center

Uddin, Md. Jamal; Hossain, Md. Zakir; Ullah, Mohammad Ohid

2009-01-01

This study uses data from the "Bangladesh Demographic and Health Survey (BDHS] 1999-2000" to investigate the predictors of child (age 1-4 years) mortality in a developing country like Bangladesh. The cross-tabulation and multiple logistic regression techniques have been used to estimate the predictors of child mortality. The…

Identifying the Factors That Influence Change in SEBD Using Logistic Regression Analysis

ERIC Educational Resources Information Center

Camilleri, Liberato; Cefai, Carmel

2013-01-01

Multiple linear regression and ANOVA models are widely used in applications since they provide effective statistical tools for assessing the relationship between a continuous dependent variable and several predictors. However these models rely heavily on linearity and normality assumptions and they do not accommodate categorical dependent…

The Association of Family Influence and Initial Interest in Science

ERIC Educational Resources Information Center

Dabney, Katherine P.; Chakraverty, Devasmita; Tai, Robert H.

2013-01-01

With recent attention to improving scientific workforce development and student achievement, there has been a rise in effort to understand and encourage student engagement in physical science. This study examines the association of family influence and initial interest in science through multiple and logistic regression models. Research questions…

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…

Proximity to pollution sources and risk of amphibian limb malformation.

PubMed

Taylor, Brynn; Skelly, David; Demarchis, Livia K; Slade, Martin D; Galusha, Deron; Rabinowitz, Peter M

2005-11-01

The cause of limb deformities in wild amphibian populations remains unclear, even though the apparent increase in prevalence of this condition may have implications for human health. Few studies have simultaneously assessed the effect of multiple exposures on the risk of limb deformities. In a cross-sectional survey of 5,264 hylid and ranid metamorphs in 42 Vermont wetlands, we assessed independent risk factors for nontraumatic limb malformation. The rate of nontraumatic limb malformation varied by location from 0 to 10.2%. Analysis of a subsample did not demonstrate any evidence of infection with the parasite Ribeiroia. We used geographic information system (GIS) land-use/land-cover data to validate field observations of land use in the proximity of study wetlands. In a multiple logistic regression model that included land use as well as developmental stage, genus, and water-quality measures, proximity to agricultural land use was associated with an increased risk of limb malformation (odds ratio = 2.26; 95% confidence interval, 1.42-3.58; p < 0.001). The overall discriminant power of the statistical model was high (C = 0.79). These findings from one of the largest systematic surveys to date provide support for the role of chemical toxicants in the development of amphibian limb malformation and demonstrate the value of an epidemiologic approach to this problem.

Aging reduces the association between sleepiness and sleep-disordered breathing

PubMed Central

Morrell, Mary; Finn, Laurel; McMillian, Alison; Peppard, Paul E.

2013-01-01

Aim To investigate age-related changes in sleepiness symptoms associated with sleep disordered breathing (SDB). Methods Wisconsin Sleep Cohort participants were assessed with polysomnography, Epworth Sleepiness Scale (ESS) and Multiple Sleep Latency Test (MSLT). SDB was defined as an apnea/hypopnea index≥15 events/hour, sleepiness as ESS≥10 and MSLT≤5 minutes. Odds ratios were calculated using generalized estimating equations associating sleepiness with SDB, and conditional logistic regression examining changes in longitudinal sleepiness status (ESS only). Models were, a priori, stratified by gender. Results ESS was measured in 1281 participants and MSLT in 998, at multiple time points (ESS n=3695; MSLT n=1846). Significant interactions were found between SDB and age in men, but not women. The odds ratios (OR) modeled for sleepiness in a 40 year old male with SDB were significant, compared to a male without SDB (OR: ESS 2.1; MSLT 2.9); however, these associations were not significant at 60 years. The within-subject odds ratio for sleepiness was also significant at 40 years (OR: 3.4), but not at 60 years. Conclusion The age-related reductions in the association between sleepiness and SDB may have clinical implications for the diagnosis and treatment of SDB in older people since sleepiness is often used as a therapeutic marker. PMID:22241742

HPV and cofactors for invasive cervical cancer in Morocco: a multicentre case-control study.

PubMed

Berraho, Mohamed; Amarti-Riffi, Afaf; El-Mzibri, Mohammed; Bezad, Rachid; Benjaafar, Noureddine; Benideer, Abdelatif; Matar, Noureddine; Qmichou, Zinab; Abda, Naima; Attaleb, Mohammed; Znati, Kaoutar; El Fatemi, Hind; Bendahhou, Karima; Obtel, Majdouline; Filali Adib, Abdelhai; Mathoulin-Pelissier, Simone; Nejjari, Chakib

2017-06-20

Limited national information is available in Morocco on the prevalence and distribution of HPV-sub-types of cervical cancer and the role of other risk factors. The aim was to determine the frequency of HPV-sub-types of cervical cancer in Morocco and investigate risk factors for this disease. Between November 2009 and April 2012 a multicentre case-control study was carried out. A total of 144 cases of cervical cancer and 288 age-matched controls were included. Odds-ratios and corresponding confidence-intervals were computed by conditional logistic regression models. Current HPV infection was detected in 92.5% of cases and 13.9% of controls. HPV16 was the most common type for both cases and controls. Very strong associations between HPV-sub-types and cervical cancer were observed: total-HPV (OR = 39), HPV16 (OR = 49), HPV18 (OR = 31), and multiple infections (OR = 13). Education, high parity, sexual intercourse during menstruation, history of sexually transmitted infections, and husband's multiple sexual partners were also significantly associated with cervical cancer in the multivariate analysis. Our results could be used to establish a primary prevention program and to prioritize limited screening to women who have specific characteristics that may put them at an increased risk of cervical cancer.

Level of education and multiple sclerosis risk over a 50-year period: Registry-based sibling study.

PubMed

Bjørnevik, Kjetil; Riise, Trond; Benjaminsen, Espen; Celius, Elisabeth G; Dahl, Ole P; Kampman, Margitta T; Løken-Amsrud, Kristin I; Midgard, Rune; Myhr, Kjell-Morten; Torkildsen, Øivind; Vatne, Anita; Grytten, Nina

2017-02-01

The conflicting results from studies on socioeconomic status (SES) and multiple sclerosis (MS) risk might be due to a change in the distribution of environmental exposures over time or to methodological limitations in previous research. To examine the association between SES and MS risk during 50 years. We included patients registered in Norwegian MS registries and prevalence studies born between 1930 and 1979, and identified their siblings and parents using the Norwegian Population Registry. Information on education was retrieved from the National Education Registry, categorized into four levels (primary, secondary, undergraduate and graduate) and compared in patients and siblings using conditional logistic regression. A total of 4494 MS patients and 9193 of their siblings were included in the analyses. Level of education was inversely associated with MS risk ( p trend < 0.001) with an odds ratio (OR) of 0.73 (95% confidence interval (CI): 0.59-0.90) when comparing the highest and lowest levels. The effect estimates did not vary markedly between participants born before or after the median year of birth (1958), but we observed a significant effect modification by parental education ( p = 0.047). Level of education was inversely associated with MS risk, and the estimates were similar in the earliest and latest birth cohorts.

Two models for evaluating landslide hazards

USGS Publications Warehouse

Davis, J.C.; Chung, C.-J.; Ohlmacher, G.C.

2006-01-01

Two alternative procedures for estimating landslide hazards were evaluated using data on topographic digital elevation models (DEMs) and bedrock lithologies in an area adjacent to the Missouri River in Atchison County, Kansas, USA. The two procedures are based on the likelihood ratio model but utilize different assumptions. The empirical likelihood ratio model is based on non-parametric empirical univariate frequency distribution functions under an assumption of conditional independence while the multivariate logistic discriminant model assumes that likelihood ratios can be expressed in terms of logistic functions. The relative hazards of occurrence of landslides were estimated by an empirical likelihood ratio model and by multivariate logistic discriminant analysis. Predictor variables consisted of grids containing topographic elevations, slope angles, and slope aspects calculated from a 30-m DEM. An integer grid of coded bedrock lithologies taken from digitized geologic maps was also used as a predictor variable. Both statistical models yield relative estimates in the form of the proportion of total map area predicted to already contain or to be the site of future landslides. The stabilities of estimates were checked by cross-validation of results from random subsamples, using each of the two procedures. Cell-by-cell comparisons of hazard maps made by the two models show that the two sets of estimates are virtually identical. This suggests that the empirical likelihood ratio and the logistic discriminant analysis models are robust with respect to the conditional independent assumption and the logistic function assumption, respectively, and that either model can be used successfully to evaluate landslide hazards. ?? 2006.

The relationship between employment and health and health care among working-age adults with and without disabilities in the United States.

PubMed

Reichard, Amanda; Stransky, Michelle; Brucker, Debra; Houtenville, Andrew

2018-05-20

To better understand the relationship between employment and health and health care for people with disabilities in the United States (US). We pooled US Medical Expenditure Panel Survey (2004-2010) data to examine health status, and access to health care among working-age adults, comparing people with physical disabilities or multiple disabilities to people without disabilities, based on their employment status. Logistic regression and least squares regression were conducted, controlling for sociodemographics, health insurance (when not the outcome), multiple chronic conditions, and need for assistance. Employment was inversely related to access to care, insurance, and obesity. Yet, people with disabilities employed in the past year reported better general and mental health than their peers with the same disabilities who were not employed. Those who were employed were more likely to have delayed/forgone necessary care, across disability groups. Part-time employment, especially for people with multiple limitations, was associated with better health and health care outcomes than full-time employment. Findings highlight the importance of addressing employment-related causes of delayed or foregone receipt of necessary care (e.g., flex-time for attending appointments) that exist for all workers, especially those with physical or multiple disabilities. Implications for rehabilitation These findings demonstrate that rehabilitation professionals who are seeking to support employment for persons with physical limitations need to ensure that overall health concerns are adequately addressed, both for those seeking employment and for those who are currently employed. Assisting clients in prioritizing health equally with employment can ensure that both areas receive sufficient attention. Engaging with employers to develop innovative practices to improve health, health behaviors and access to care for employees with disabilities can decrease turnover, increase productivity, and ensure longer job tenure.

Multiple Chronic Conditions and Labor Force Outcomes: A Population Study of U.S. Adults

PubMed Central

Ward, Brian W.

2015-01-01

Background Although 1-in-5 adults have multiple (≥2) chronic conditions, limited attention has been given to the association between multiple chronic conditions and employment. Methods Cross-sectional data (2011 National Health Interview Survey) and multivariate regression analyses were used to examine the association among multiple chronic conditions, employment, and labor force outcomes for U.S. adults aged 18–64 years, controlling for covariates. Results Among U.S. adults aged 18–64 years (unweighted n=25,458), having multiple chronic conditions reduced employment probability by 11%–29%. Some individual chronic conditions decreased employment probability. Among employed adults (unweighted n=16,096), having multiple chronic conditions increased the average number of work days missed due to injury/illness in the past year by 3–9 days. Conclusions Multiple chronic conditions are be a barrier to employment and increase the number of work days missed, placing affected individuals at a financial disadvantage. Researchers interested in examining consequences of multiple chronic conditions should give consideration to labor force outcomes. PMID:26103096

An Experimental Realization of a Chaos-Based Secure Communication Using Arduino Microcontrollers.

PubMed

Zapateiro De la Hoz, Mauricio; Acho, Leonardo; Vidal, Yolanda

2015-01-01

Security and secrecy are some of the important concerns in the communications world. In the last years, several encryption techniques have been proposed in order to improve the secrecy of the information transmitted. Chaos-based encryption techniques are being widely studied as part of the problem because of the highly unpredictable and random-look nature of the chaotic signals. In this paper we propose a digital-based communication system that uses the logistic map which is a mathematically simple model that is chaotic under certain conditions. The input message signal is modulated using a simple Delta modulator and encrypted using a logistic map. The key signal is also encrypted using the same logistic map with different initial conditions. In the receiver side, the binary-coded message is decrypted using the encrypted key signal that is sent through one of the communication channels. The proposed scheme is experimentally tested using Arduino shields which are simple yet powerful development kits that allows for the implementation of the communication system for testing purposes.

The alarming problems of confounding equivalence using logistic regression models in the perspective of causal diagrams.

PubMed

Yu, Yuanyuan; Li, Hongkai; Sun, Xiaoru; Su, Ping; Wang, Tingting; Liu, Yi; Yuan, Zhongshang; Liu, Yanxun; Xue, Fuzhong

2017-12-28

Confounders can produce spurious associations between exposure and outcome in observational studies. For majority of epidemiologists, adjusting for confounders using logistic regression model is their habitual method, though it has some problems in accuracy and precision. It is, therefore, important to highlight the problems of logistic regression and search the alternative method. Four causal diagram models were defined to summarize confounding equivalence. Both theoretical proofs and simulation studies were performed to verify whether conditioning on different confounding equivalence sets had the same bias-reducing potential and then to select the optimum adjusting strategy, in which logistic regression model and inverse probability weighting based marginal structural model (IPW-based-MSM) were compared. The "do-calculus" was used to calculate the true causal effect of exposure on outcome, then the bias and standard error were used to evaluate the performances of different strategies. Adjusting for different sets of confounding equivalence, as judged by identical Markov boundaries, produced different bias-reducing potential in the logistic regression model. For the sets satisfied G-admissibility, adjusting for the set including all the confounders reduced the equivalent bias to the one containing the parent nodes of the outcome, while the bias after adjusting for the parent nodes of exposure was not equivalent to them. In addition, all causal effect estimations through logistic regression were biased, although the estimation after adjusting for the parent nodes of exposure was nearest to the true causal effect. However, conditioning on different confounding equivalence sets had the same bias-reducing potential under IPW-based-MSM. Compared with logistic regression, the IPW-based-MSM could obtain unbiased causal effect estimation when the adjusted confounders satisfied G-admissibility and the optimal strategy was to adjust for the parent nodes of outcome, which obtained the highest precision. All adjustment strategies through logistic regression were biased for causal effect estimation, while IPW-based-MSM could always obtain unbiased estimation when the adjusted set satisfied G-admissibility. Thus, IPW-based-MSM was recommended to adjust for confounders set.

Development of a protocol for improving the clinical utility of posturography as a fall-risk screening tool.

PubMed

Bigelow, Kimberly Edginton; Berme, Necip

2011-02-01

The usefulness of posturography in the clinical screening of older adults for fall risk has been limited by a lack of standardization in testing methodology and data reporting. This study determines which testing condition and postural sway measures best differentiate recurrent fallers and nonrecurrent fallers. One hundred and fifty older adults were categorized based on their fall status in the past year. Participants performed four quiet-standing tasks, eyes open and eyes closed in both comfortable and narrow stance, for 60 seconds while standing on a force-measuring platform. Traditional and fractal measures were calculated from the center of pressure data. Logistic regression was performed to determine the model for each condition that best discriminated between recurrent fallers and nonrecurrent fallers. The eyes closed comfortable stance condition, with its associated model, best differentiated recurrent fallers and nonrecurrent fallers. Medial-lateral sway velocity, anterior-posterior short-term α-scaling exponent, medial-lateral short-term α-scaling exponent, mean frequency, body mass index, and age were included in this model. Sensitivity of the model was 75%, and specificity was 94%. This resulting model demonstrates potential to differentiate recurrent fallers and nonrecurrent fallers in an eyes closed comfortable stance condition. The inclusion of traditional sway parameters, fractal measures, and personal characteristics in this model demonstrates the importance of considering multiple descriptions of postural stability together rather than using only a single measure to establish fall risk.

Emergency department visits and primary care among adults with chronic conditions.

PubMed

McCusker, Jane; Roberge, Danièle; Lévesque, Jean-Frédéric; Ciampi, Antonio; Vadeboncoeur, Alain; Larouche, Danielle; Sanche, Steven

2010-11-01

An emergency department (ED) visit may be a marker for limited access to primary medical care, particularly among those with ambulatory care sensitive chronic conditions (ACSCC). In a population with universal health insurance, to examine the relationships between primary care characteristics and location of last general physician (GP) contact (in an ED vs. elsewhere) among those with and without an ACSCC. A cross-sectional survey using data from 2 cycles of the Canadian Community Health Survey carried out in 2003 and 2005. The study sample comprised Québec residents aged ≥18 who reported at least one GP contact during the previous 12 months, and were not hospitalized (n = 33,491). The primary outcome was place of last GP contact: in an ED versus elsewhere. Independent variables included the following: lack of a regular physician, perceived unmet healthcare needs, perceived availability of health care, number of contacts with doctors and nurses, and diagnosis of an ACSCC (hypertension, heart disease, chronic respiratory disease, diabetes). Using multiple logistic regression, with adjustment for sociodemographic, health status, and health services variables, lack of a regular GP and perceptions of unmet needs were associated with last GP contact in an ED; there was no interaction with ACSCC or other chronic conditions. Primary care characteristics associated with GP contact in an ED rather than another site reflect individual characteristics (affiliation with a primary GP and perceived needs) rather than the geographic availability of healthcare, both among those with and without chronic conditions.

Hormonal and reproductive risk factors associated with breast cancer in Isfahan patients

PubMed Central

Tazhibi, Mehdi; Dehghani, Mohsen; Babazadeh, Shadi; Makkarian, Fariborz; Tabatabaeian, Maryam; Sadeghi, Masoumeh; Rezaei, Parisa; Faghihi, Mehri

2014-01-01

Background: Breast cancer is the most prevalent type of cancer among Iranian females; it is noteworthy that the condition of this type of cancer among Iranian women does not significantly differ from what has been reported from other countries. Considering the importance of this issue, identification of the backgrounds factors and risk factors of the breast cancer risk are highly needed. Therefore, the present study is aimed to compare the risk factors of resident patients of Isfahan province, Iran, with accredited risk factors by other countries and also identify the importance of each factor in the incidence of cancer. Materials and Methods: The present work is a case-control study, which was conducted in 2011. In order to conduct the study, 216 women who had been clinically identified with breast cancer were selected from Seiedo-Shohada Hospital, Isfahan, Iran, as the case group. Moreover, 41 healthy women who were the relatives of the selected patients (i.e., sisters and aunts) were selected as the control group. The data and information of the patients from 1999 to 2010 were collected from either assessing the database system of the center for breast cancer research or interviewing the patients through phone. To analyze the data, multiple logistic regression method was applied. Results: The range of age among selected individuals in this study was from 20-75 years old. The determinant factors for odds of breast cancer included in the applied multiple logistic regression model were the use of oral contraceptive pills (OCPs) (odds ratio [OR] =0.18, 95% confidence interval [CI] = 0.04-0.75) as the protective factor, hormone replacement therapy (OR = 10.2, 95% CI = 1.18-88.89) and menopause at old age (OR = 1.26, 95% CI = 1.11-2.12) as the risk factors. Furthermore, there was not seen any significant relationship between age, vocation, and marital status with odds of breast cancer in multiple model. Conclusion: Based on the results, use of OCPs as protective factor, hormone replacement therapy, and menopause at old age are identified as the risk factors in developing breast cancer among women. Influencing and modifiable factors should be considered very important in society based interventions and preventive interventions planning. PMID:25077162

Retrospective Evaluation of Safety, Efficacy and Risk Factors for Pneumothorax in Simultaneous Localizations of Multiple Pulmonary Nodules Using Hook Wire System.

PubMed

Zhong, Yan; Xu, Xiao-Quan; Pan, Xiang-Long; Zhang, Wei; Xu, Hai; Yuan, Mei; Kong, Ling-Yan; Pu, Xue-Hui; Chen, Liang; Yu, Tong-Fu

2017-09-01

To evaluate the safety and efficacy of the hook wire system in the simultaneous localizations for multiple pulmonary nodules (PNs) before video-assisted thoracoscopic surgery (VATS), and to clarify the risk factors for pneumothorax associated with the localization procedure. Between January 2010 and February 2016, 67 patients (147 nodules, Group A) underwent simultaneous localizations for multiple PNs using a hook wire system. The demographic, localization procedure-related information and the occurrence rate of pneumothorax were assessed and compared with a control group (349 patients, 349 nodules, Group B). Multivariate logistic regression analyses were used to determine the risk factors for pneumothorax during the localization procedure. All the 147 nodules were successfully localized. Four (2.7%) hook wires dislodged before VATS procedure, but all these four lesions were successfully resected according to the insertion route of hook wire. Pathological diagnoses were acquired for all 147 nodules. Compared with Group B, Group A demonstrated significantly longer procedure time (p < 0.001) and higher occurrence rate of pneumothorax (p = 0.019). Multivariate logistic regression analysis indicated that position change during localization procedure (OR 2.675, p = 0.021) and the nodules located in the ipsilateral lung (OR 9.404, p < 0.001) were independent risk factors for pneumothorax. Simultaneous localizations for multiple PNs using a hook wire system before VATS procedure were safe and effective. Compared with localization for single PN, simultaneous localizations for multiple PNs were prone to the occurrence of pneumothorax. Position change during localization procedure and the nodules located in the ipsilateral lung were independent risk factors for pneumothorax.

Health care logistics: who has the ball during disaster?

PubMed

Vanvactor, Jerry D

2011-05-10

In contemporary organizations, a wide gamut of options is available for sustaining and supporting health care operations. When disaster strikes, despite having tenable plans for routine replenishment and operations, many organizations find themselves ill-prepared, ill-equipped, and without effective mechanisms in place to sustain operations during the immediate aftermath of a crisis. Health care operations can be abruptly halted due to the non-availability of supply. The purpose of this work is to add to a necessary, growing body of works related specifically to health care logistics preparedness and disaster mitigation. Logistics management is a specialized genre of expertise within the health care industry and is largely contributive to the success or failure of health care organizations. Logistics management requires extensive collaboration among multiple stakeholders-internal and external to an organization. Effective processes and procedures can be largely contributive to the success or failure of organizational operations. This article contributes to the closure of an obvious gap in professional and academic literature related to disaster health care logistics management and provides timely insight into a potential problem for leaders industry-wide. One critical aspect of disaster planning is regard for competent logistics management and the effective provision of necessary items when they are needed most. In many communities, there seems to be little evidence available regarding health care logistics involvement in disaster planning; at times, evidence of planning efforts perceptibly end at intra-organizational doors within facilities. Strategic planners are being continually reminded that health care organizations serve a principal role in emergency preparedness planning and must be prepared to fulfill the associated possibilities without notification. The concern is that not enough attention is being paid to repeated lessons being observed in disasters and emergency events.

Health care logistics: who has the ball during disaster?

PubMed Central

VanVactor, Jerry D.

2011-01-01

In contemporary organizations, a wide gamut of options is available for sustaining and supporting health care operations. When disaster strikes, despite having tenable plans for routine replenishment and operations, many organizations find themselves ill-prepared, ill-equipped, and without effective mechanisms in place to sustain operations during the immediate aftermath of a crisis. Health care operations can be abruptly halted due to the non-availability of supply. The purpose of this work is to add to a necessary, growing body of works related specifically to health care logistics preparedness and disaster mitigation. Logistics management is a specialized genre of expertise within the health care industry and is largely contributive to the success or failure of health care organizations. Logistics management requires extensive collaboration among multiple stakeholders—internal and external to an organization. Effective processes and procedures can be largely contributive to the success or failure of organizational operations. This article contributes to the closure of an obvious gap in professional and academic literature related to disaster health care logistics management and provides timely insight into a potential problem for leaders industry-wide. One critical aspect of disaster planning is regard for competent logistics management and the effective provision of necessary items when they are needed most. In many communities, there seems to be little evidence available regarding health care logistics involvement in disaster planning; at times, evidence of planning efforts perceptibly end at intra-organizational doors within facilities. Strategic planners are being continually reminded that health care organizations serve a principal role in emergency preparedness planning and must be prepared to fulfill the associated possibilities without notification. The concern is that not enough attention is being paid to repeated lessons being observed in disasters and emergency events. PMID:24149034

[Optimization for MSW logistics of new Xicheng and new Dongcheng districts in Beijing based on the maximum capacity of transfer stations].

PubMed

Yuan, Jing; Li, Guo-xue; Zhang, Hong-yu; Luo, Yi-ming

2013-09-01

It is necessary to achieve the optimization for MSW logistics based on the new Xicheng (combining the former Xicheng and the former Xuanwu districts) and the new Dongcheng (combining the former Dongcheng and the former Chongwen districts) districts of Beijing. Based on the analysis of current MSW logistics system, transfer station's processing capacity and the terminal treatment facilities' conditions of the four former districts and other districts, a MSW logistics system was built by GIS methods considering transregional treatment. This article analyzes the MSW material balance of current and new logistics systems. Results show that the optimization scheme could reduce the MSW collection distance of the new Xicheng and the new Dongcheng by 9.3 x 10(5) km x a(-1), reduced by 10% compared with current logistics. Under the new logistics solution, considering transregional treatment, can reduce landfill treatment of untreated MSW about 28.3%. If the construction of three incineration plants finished based on the new logistics, the system's optimal ratio of incineration: biochemical treatment: landfill can reach 3.8 : 4.5 : 1.7 compared with 1 : 4.8 : 4.2, which is the ratio of current MSW logistics. The ratio of the amount of incineration: biochemical treatment: landfill approximately reach 4 : 3 : 3 which is the target for 2015. The research results are benefit in increasing MSW utilization and reduction rate of the new Dongcheng and Xicheng districts and nearby districts.

Sleep Bruxism and Anxiety Impacts in Quality of Life Related to Oral Health of Brazilian Children and their Families.

PubMed

de Alencar, Nashalie Andrade; Leão, Cecília Sued; Leão, Anna Thereza Thomé; Luiz, Ronir Raggio; Fonseca-Gonçalves, Andréa; Maia, Lucianne Cople

This study aimed to assess the impact of parent reported sleep bruxism, trait anxiety and sociodemographic/socioeconomic features on quality of life related to oral health (OHRQoL) of children and their families. Healthy children aged 3-7 years, with (n=34) and without (n=32) bruxism were select for this study. Data was collected by applying the following instruments: The Early Childhood Oral Health Scale (B-ECOHIS) and Trait-anxiety Scale (TAS). The sociodemographic/socioeconomic characteristics were obtained by interviews with parents. Multiple logistic regression tests were performed to observe the influence of sociodemographic/socioeconomic characteristics, bruxism and trait-anxiety on the children's OHRQoL. No association between sleep bruxism and all evaluated sociodemographic/socioeconomic conditions, with exception of being the only child (p=0.029), were observed. Mean B-ECOHIS and TAS scores were different (p<0.05) between children with (3.41 ± 4.87; 45.09 ± 15.46, respectively) and without (0.63 ± 1.28; 29.53 ± 11.82, respectively) bruxism. Although an association between bruxism and OHRQoL (p=0.015) was observed, it was dropped (p=0.336; OR=1.77) in the logistic regression model. Trait anxiety was the variable responsible for the impact on the OHRQoL of children (p=0.012; OR=1.05). Our results indicated anxiety as the main factor that interfered in the OHRQoL of children with sleep bruxism.

Colonic diverticulosis is not a risk factor for colonic adenoma.

PubMed

Hong, Wandong; Dong, Lemei; Zippi, Maddalena; Stock, Simon; Geng, Wujun; Xu, Chunfang; Zhou, Mengtao

2018-01-01

Colonic diverticulosis may represent a risk factor for colonic adenomas by virtue of the fact that evolving data suggest that these 2 conditions may share common risk factors such as Western dietary pattern and physical inactivity. This study aims to investigate the association between colonic diverticulosis and colonic adenomas in mainland China. We conducted a cross-sectional study on patients who underwent colonoscopic examination between October 2013 and December 2014 in a university hospital in mainland China. Age, gender, colonic adenomas, advanced adenomas, and distribution of diverticulosis were recorded during the procedures. Multivariate logistic regression and stratified analysis were used to evaluate the associations between the prevalence of diverticulosis and age, sex, and presence of colonic adenomas and advanced adenomas. A total of 17,456 subjects were enrolled. The prevalence of colonic diverticulosis and adenoma was 2.4% and 13.2%, respectively. With regard to distribution of diverticula, most (365/424, 86.1%) were right-sided. Multiple logistic regression analysis suggested that age and male gender were independent risk factors for adenoma and advanced adenoma. There was no relationship between diverticulosis or location of diverticulosis and presence of adenoma and advanced adenoma adjusting by age and gender. In a stratified analysis according to age and gender, similar results were also noted. There was no statistical relationship between diverticulosis and the risk of adenoma and advanced adenoma. Our results may not be generalized to the Western population due to the fact that left-sided diverticular cases were very small in our study.

SCREENING FOR TYPE 2 DIABETES MELLITUS AND PREDIABETES USING POINT-OF-CARE TESTING FOR HBA1C AMONG THAI DENTAL PATIENTS.

PubMed

Tantipoj, Chanita; Sakoolnamarka, Serena Siraratna; Supa-amornkul, Sirirak; Lohsoonthorn, Vitool; Deerochanawong, Chaicharn; Khovidhunkit, Siribangon Piboonniyom; Hiransuthikul, Narin

2017-03-01

Diabetes mellitus type 2 (DM) is associated with oral diseases. Some studies indicated that patients who seek dental treatment could have undiagnosed hyperglycemic condition. The aim of this study was to assess the prevalence of undiagnosed hyperglycemia and selected associated factors among Thai dental patients. Dental patients without a history of hyperglycemia were recruited from the Special Clinic, Faculty of Dentistry, Mahidol University, Bangkok, Thailand and His Majesty the King’s Dental Service Unit, Thailand. The patients were randomly selected and a standardized questionnaire was used to collect demographic data from each patient. Blood pressure, body mass index (BMI), and waist circumference were recorded for each subject. The number of missing teeth, periodontal status, and salivary flow rate were also investigated. HbA1c was assessed using a finger prick blood sample and analyzed with a point-of-care testing machine. Hyperglycemia was defined as a HbA1c ≥5.7%. The prevalence of hyperglycemia among participants was calculated and multivariate logistic regression analysis was used to identify risk factors. A total of 724 participants were included in the study; 33.8% had hyperglycemia. On multiple logistic regression analysis, older age, family history of DM, being overweight (BMI ≥23 kg/m2), having central obesity and having severe periodontitis were significantly associated with hyperglycemia. The high prevalence of hyperglycemia in this study of dental patients suggests this setting may be appropriate to screen for patients with hyperglycemia.

Binary Logistic Regression Analysis for Detecting Differential Item Functioning: Effectiveness of R[superscript 2] and Delta Log Odds Ratio Effect Size Measures

ERIC Educational Resources Information Center

Hidalgo, Mª Dolores; Gómez-Benito, Juana; Zumbo, Bruno D.

2014-01-01

The authors analyze the effectiveness of the R[superscript 2] and delta log odds ratio effect size measures when using logistic regression analysis to detect differential item functioning (DIF) in dichotomous items. A simulation study was carried out, and the Type I error rate and power estimates under conditions in which only statistical testing…

Physical disability contributes to caregiver stress in dementia caregivers.

PubMed

Bruce, David G; Paley, Glenys A; Nichols, Pamela; Roberts, David; Underwood, Peter J; Schaper, Frank

2005-03-01

Previous findings of studies on the impact of physical illness on caregiver health have been inconsistent. The authors wanted to determine whether physical disability, as determined by the SF-12 survey that provides information on both physical and mental health problems, contributes to caregiver stress. The authors interviewed 91 primary caregivers (aged 38-85 years) of persons with dementia who had been referred by their family physicians for the first time for formal support services or memory evaluation. Caregivers completed the SF-12 version of the Medical Outcomes Study Short Form Health Survey that generates Mental Component Summary (MCS) and Physical Component Summary (PCS) scores and reported on caregiver stress and concurrent medical conditions and medications. Most caregivers reported stress (76.9%), having medical conditions (72.4%), or taking medications (67%). The MCS but not the PCS scores were significantly lower than community norms, indicating an excess of disability due to mental health problems. Nevertheless, 40.7% had PCS scores indicating some degree of physical disability. Using multiple logistic regression analysis, PCS scores but not the presence of medical problems were independently associated with caregiver stress. Chronic disability as assessed by SF-12 PCS scores is independently associated with caregiver stress. These data suggest that caregivers of persons with dementia should be assessed for disabling physical conditions and mental health problems. In addition, reducing the impact of physical disability could ameliorate caregiver stress.

Association between levels of physical activity and poor self-rated health in Korean adults: The Third Korea National Health and Nutrition Examination Survey (KNHANES), 2005.

PubMed

Han, M A; Kim, K S; Park, J; Kang, M G; Ryu, S Y

2009-10-01

To investigate the association between level of physical activity and poor self-rated health in Korean adults. A cross-sectional study was conducted on 7,800 adults aged > or =19 years who completed the Health Interview and the Health Behavior Surveys, issued during the Third National Health and Nutrition Examination Survey (2005). The association between self-rated health and physical activity was tested using Chi-squared test. Multiple logistic regression analysis was used to calculate the odds ratios of poor self-rated health for different levels of physical activity after adjusting for physical and chronic medical conditions. The prevalence of poor self-rated health was significantly lower as the level of physical activity increased, and odds ratios for poor self-rated health were significantly lower for higher levels of physical activity after adjusting for age, marital status, educational status, smoking, alcohol consumption, and the number of physical impairments and chronic medical conditions. The association was similar in different age groups and among healthy respondents and respondents with physical impairments or chronic medical conditions. Physical activity was positively associated with self-rated health in Koreans. The independent association between a lower level of physical activity and poor self-rated health supports public health programmes that encourage regular physical activity.

Multiple logistic regression model of signalling practices of drivers on urban highways

NASA Astrophysics Data System (ADS)

Puan, Othman Che; Ibrahim, Muttaka Na'iya; Zakaria, Rozana

2015-05-01

Giving signal is a way of informing other road users, especially to the conflicting drivers, the intention of a driver to change his/her movement course. Other users are exposed to hazard situation and risks of accident if the driver who changes his/her course failed to give signal as required. This paper describes the application of logistic regression model for the analysis of driver's signalling practices on multilane highways based on possible factors affecting driver's decision such as driver's gender, vehicle's type, vehicle's speed and traffic flow intensity. Data pertaining to the analysis of such factors were collected manually. More than 2000 drivers who have performed a lane changing manoeuvre while driving on two sections of multilane highways were observed. Finding from the study shows that relatively a large proportion of drivers failed to give any signals when changing lane. The result of the analysis indicates that although the proportion of the drivers who failed to provide signal prior to lane changing manoeuvre is high, the degree of compliances of the female drivers is better than the male drivers. A binary logistic model was developed to represent the probability of a driver to provide signal indication prior to lane changing manoeuvre. The model indicates that driver's gender, type of vehicle's driven, speed of vehicle and traffic volume influence the driver's decision to provide a signal indication prior to a lane changing manoeuvre on a multilane urban highway. In terms of types of vehicles driven, about 97% of motorcyclists failed to comply with the signal indication requirement. The proportion of non-compliance drivers under stable traffic flow conditions is much higher than when the flow is relatively heavy. This is consistent with the data which indicates a high degree of non-compliances when the average speed of the traffic stream is relatively high.

Explaining Match Outcome During The Men’s Basketball Tournament at The Olympic Games

PubMed Central

Leicht, Anthony S.; Gómez, Miguel A.; Woods, Carl T.

2017-01-01

In preparation for the Olympics, there is a limited opportunity for coaches and athletes to interact regularly with team performance indicators providing important guidance to coaches for enhanced match success at the elite level. This study examined the relationship between match outcome and team performance indicators during men’s basketball tournaments at the Olympic Games. Twelve team performance indicators were collated from all men’s teams and matches during the basketball tournament of the 2004-2016 Olympic Games (n = 156). Linear and non-linear analyses examined the relationship between match outcome and team performance indicator characteristics; namely, binary logistic regression and a conditional interference (CI) classification tree. The most parsimonious logistic regression model retained ‘assists’, ‘defensive rebounds’, ‘field-goal percentage’, ‘fouls’, ‘fouls against’, ‘steals’ and ‘turnovers’ (delta AIC <0.01; Akaike weight = 0.28) with a classification accuracy of 85.5%. Conversely, four performance indicators were retained with the CI classification tree with an average classification accuracy of 81.4%. However, it was the combination of ‘field-goal percentage’ and ‘defensive rebounds’ that provided the greatest probability of winning (93.2%). Match outcome during the men’s basketball tournaments at the Olympic Games was identified by a unique combination of performance indicators. Despite the average model accuracy being marginally higher for the logistic regression analysis, the CI classification tree offered a greater practical utility for coaches through its resolution of non-linear phenomena to guide team success. Key points A unique combination of team performance indicators explained 93.2% of winning observations in men’s basketball at the Olympics. Monitoring of these team performance indicators may provide coaches with the capability to devise multiple game plans or strategies to enhance their likelihood of winning. Incorporation of machine learning techniques with team performance indicators may provide a valuable and strategic approach to explain patterns within multivariate datasets in sport science. PMID:29238245

[Study on the correlation among adolescents' family function, negative life events stress amount and suicide ideation].

PubMed

Zhang, Dongdong; Chen, Ling; Yin, Dan; Miao, Jinping; Sun, Yehuan

2014-07-01

To explore the correlation between suicide ideation and family function & negative life events, as well as other influential factors in adolescents, thus present a theoretical base for clinicians and school staff to develop intervention for those problems. By adopting current situation random sampling method, Self-Rating Idea of Suicide Scale, Adolescent Self-Rating Life Events Check List and Family APGAR Index were used to assess adolescents at random in a hygiene vocational school in Changzhou City, Jiangsu Province and a collage in Wuhu City, Anhui Province. 3700 questionnaires were granted, 3675 questionnaires were collected, among which 3620 were valid. Chi-square test, t-test, and univariate logistic regression were employed in univariate analysis, multivariate logistic regression was used in multivariate analysis. The detection rate of suicide ideation is 7.0%, and the top five suicide ideation characteristics were: poor academic performance (33.6%), serious family functional impairment (25.8%), lower-middle academic performance (11.7%), bad economic conditions (10.8%) and study in Grade Three (9.9%). Multiple logistic regression showed that the following three high-level stress amount in negative life events are most crucial for suicide ideation. They are "relationships" (OR = 1.135, 95% CI 1.071 - 1. 202), "academic pressure" (OR = 1.169, 95% CI 1.101 - 1.241), and "external events" (OR = 1.278, 95% CI 1.187 - 1.376). What' s more, the stress of attending higher grades (OR = 1.980, 95% CI 1.302 - 3.008), poor academic performance (OR = 7.206, 95% CI 1.745 - 9.789), moderate family functional impairment (OR = 2.562, 95% CI 1.527 - 2.892) and its serious level (OR = 8.287, 95% CI 3.154 - 6.917) are also influential factors for suicide ideation. Severe family functional impairment and high-level stress amount of negative life events produced the main factors of suicide ideation. Therefore, necessary and sufficient support should be given to adolescents by families and schools.

Study on site selection of cold chain logistics in northwest territories

NASA Astrophysics Data System (ADS)

Liu, Yubin; Ren, Zongwei

2017-08-01

In this research, we mainly studied the Site selection problem of cold chain logistics in northwest of China. In the first place, we counted the demands of cold chain products in northwest territories, and then classified it into the Site selection problem in five provinces in northwest territories(Xinjiang, Qinghai, Gansu, Ningxia, Shanxi); Next, we used the Center of gravity Method to select initial location; Finally, we established the location of distribution by using Analytic Hierarchy Process (AHP)and fuzzy comprehensive evaluation method. Comparing with the traditional method, this method not only considered the cost of transportation and distance, but also deliberated the physical condition, social environment and economics condition which associated with Site selection problem.

A Method for Calculating the Probability of Successfully Completing a Rocket Propulsion Ground Test

NASA Technical Reports Server (NTRS)

Messer, Bradley

2007-01-01

Propulsion ground test facilities face the daily challenge of scheduling multiple customers into limited facility space and successfully completing their propulsion test projects. Over the last decade NASA s propulsion test facilities have performed hundreds of tests, collected thousands of seconds of test data, and exceeded the capabilities of numerous test facility and test article components. A logistic regression mathematical modeling technique has been developed to predict the probability of successfully completing a rocket propulsion test. A logistic regression model is a mathematical modeling approach that can be used to describe the relationship of several independent predictor variables X(sub 1), X(sub 2),.., X(sub k) to a binary or dichotomous dependent variable Y, where Y can only be one of two possible outcomes, in this case Success or Failure of accomplishing a full duration test. The use of logistic regression modeling is not new; however, modeling propulsion ground test facilities using logistic regression is both a new and unique application of the statistical technique. Results from this type of model provide project managers with insight and confidence into the effectiveness of rocket propulsion ground testing.

Protective Effect of HLA-DQB1 Alleles Against Alloimmunization in Patients with Sickle Cell Disease

PubMed Central

Tatari-Calderone, Zohreh; Gordish-Dressman, Heather; Fasano, Ross; Riggs, Michael; Fortier, Catherine; Andrew; Campbell, D.; Charron, Dominique; Gordeuk, Victor R.; Luban, Naomi L.C.; Vukmanovic, Stanislav; Tamouza, Ryad

2015-01-01

Background Alloimmunization or the development of alloantibodies to Red Blood Cell (RBC) antigens is considered one of the major complications after RBC transfusions in patients with sickle cell disease (SCD) and can lead to both acute and delayed hemolytic reactions. It has been suggested that polymorphisms in HLA genes, may play a role in alloimmunization. We conducted a retrospective study analyzing the influence of HLA-DRB1 and DQB1 genetic diversity on RBC-alloimmunization. Study design Two-hundred four multi-transfused SCD patients with and without RBC-alloimmunization were typed at low/medium resolution by PCR-SSO, using IMGT-HLA Database. HLA-DRB1 and DQB1 allele frequencies were analyzed using logistic regression models, and global p-value was calculated using multiple logistic regression. Results While only trends towards associations between HLA-DR diversity and alloimmunization were observed, analysis of HLA-DQ showed that HLA-DQ2 (p=0.02), -DQ3 (p=0.02) and -DQ5 (p=0.01) alleles were significantly higher in non-alloimmunized patients, likely behaving as protective alleles. In addition, multiple logistic regression analysis showed both HLA-DQ2/6 (p=0.01) and HLA-DQ5/5 (p=0.03) combinations constitute additional predictor of protective status. Conclusion Our data suggest that particular HLA-DQ alleles influence the clinical course of RBC transfusion in patients with SCD, which could pave the way towards predictive strategies. PMID:26476208

Impaired executive function can predict recurrent falls in Parkinson's disease.

PubMed

Mak, Margaret K; Wong, Adrian; Pang, Marco Y

2014-12-01

To examine whether impairment in executive function independently predicts recurrent falls in people with Parkinson's disease (PD). Prospective cohort study. University motor control research laboratory. A convenience sample of community-dwelling people with PD (N=144) was recruited from a patient self-help group and movement disorders clinics. Not applicable. Executive function was assessed with the Mattis Dementia Rating Scale Initiation/Perseveration (MDRS-IP) subtest, and fear of falling (FoF) with the Activities-specific Balance Confidence (ABC) Scale. All participants were followed up for 12 months to record the number of monthly fall events. Forty-two people with PD had at least 2 falls during the follow-up period and were classified as recurrent fallers. After accounting for demographic variables and fall history (P=.001), multiple logistic regression analysis showed that the ABC scores (P=.014) and MDRS-IP scores (P=.006) were significantly associated with future recurrent falls among people with PD. The overall accuracy of the prediction was 85.9%. With the use of the significant predictors identified in multiple logistic regression analysis, a prediction model determined by the logistic function was generated: Z = 1.544 + .378 (fall history) - .045 (ABC) - .145 (MDRS-IP). Impaired executive function is a significant predictor of future recurrent falls in people with PD. Participants with executive dysfunction and greater FoF at baseline had a significantly greater risk of sustaining a recurrent fall within the subsequent 12 months. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Analysis of occlusal variables, dental attrition, and age for distinguishing healthy controls from female patients with intracapsular temporomandibular disorders.

PubMed

Seligman, D A; Pullinger, A G

2000-01-01

Confusion about the relationship of occlusion to temporomandibular disorders (TMD) persists. This study attempted to identify occlusal and attrition factors plus age that would characterize asymptomatic normal female subjects. A total of 124 female patients with intracapsular TMD were compared with 47 asymptomatic female controls for associations to 9 occlusal factors, 3 attrition severity measures, and age using classification tree, multiple stepwise logistic regression, and univariate analyses. Models were tested for accuracy (sensitivity and specificity) and total contribution to the variance. The classification tree model had 4 terminal nodes that used only anterior attrition and age. "Normals" were mainly characterized by low attrition levels, whereas patients had higher attrition and tended to be younger. The tree model was only moderately useful (sensitivity 63%, specificity 94%) in predicting normals. The logistic regression model incorporated unilateral posterior crossbite and mediotrusive attrition severity in addition to the 2 factors in the tree, but was slightly less accurate than the tree (sensitivity 51%, specificity 90%). When only occlusal factors were considered in the analysis, normals were additionally characterized by a lack of anterior open bite, smaller overjet, and smaller RCP-ICP slides. The log likelihood accounted for was similar for both the tree (pseudo R(2) = 29.38%; mean deviance = 0.95) and the multiple logistic regression (Cox Snell R(2) = 30.3%, mean deviance = 0.84) models. The occlusal and attrition factors studied were only moderately useful in differentiating normals from TMD patients.

Association between workplace and housing conditions and use of pesticide safety practices and personal protective equipment among North Carolina farmworkers in 2010.

PubMed

Levesque, D L; Arif, A A; Shen, J

2012-04-01

There are inconsistencies about the effects of farmworker housing and workplace conditions and use of self-protective behavior practices and personal protective equipment (PPE). To investigate the association between workplace and housing conditions and farmworker use of pesticide safety practices and PPE. This study was conducted in 4 counties in North Carolina, USA, from July to October, 2010, during the agricultural growing season. Farmworkers working in agriculture aged 18 to 62 (n = 187) were administered a structured questionnaire to collect self-reported measures on housing and workplace conditions. Use of pesticide safety and PPE were examined by asking questions about wearing gloves, wearing socks, and wearing a hat. Chi-square and multiple logistic regression analyses were used for statistical analyses. Farmworkers reporting availability of enough hot and cold water for bathing and doing laundry were 13.6 times more likely to use pesticide safety practices (adjusted OR: 13.6, 95% CI: 1.4-135.4), whereas, those who reported that soap for handwashing was always or usually available while doing agricultural work were 7.8 times more likely to use pesticide safety practices (adjusted OR: 7.8, 95% CI: 3.3-18.5). Farmworkers that reported access to water to wash their hands with while performing agricultural work were more likely to use PPE (adjusted OR: 3.4, 95% CI: 1.3-9.2). Some migrant farmworker labor camps are not supplying acceptable housing conditions such as 1 handwashing sink per 6 people (n = 10, 5.4%). Use of pesticide safety practices and PPE is greater when farmers provide decontamination supplies. Improvement of housing and workplace conditions are crucial to increase use of pesticide safety practices and PPE.

Predictors of Employment Outcomes for Vocational Rehabilitation Consumers With HIV/AIDS: 2002-2007

ERIC Educational Resources Information Center

Jung, Youngoh; Bellini, James L.

2011-01-01

This study examined the predictability of two employment outcomes--employment status and weekly earnings at closure--from consumer demographic, medical, and service variables for multiple groups of vocational rehabilitation (VR) consumers with HIV/AIDS retrieved from the RSA-911 data for fiscal years 2002 through 2007. A logistic regression…

Who Is Going to College? Predicting Education Training from Pre-VR Consumer Characteristics

ERIC Educational Resources Information Center

Boutin, Daniel L.; Wilson, Keith B.

2012-01-01

The relationship of receiving college and university training within the state vocational rehabilitation (VR) program to pre-VR consumer characteristics was investigated with a multiple direct logistic regression technique. A model containing 11 pre-VR characteristics predict the reception of college and university training for a multidisability…

Trends and determinants of discretionary salt use: National Health and Nutrition Examination Survey, 2003-2012

USDA-ARS?s Scientific Manuscript database

The objective of this study was to examine the recent temporal trends and current determinants of discretionary salt use in the United States. We used data from the National Health and Nutrition Examination Survey (NHANES), 2003-2012. We used multiple logistic regression to assess temporal trends ...

Multiple Informants in the Assessment of Psychological, Behavioral, and Academic Correlates of Bullying and Victimization in Middle School

ERIC Educational Resources Information Center

Wienke Totura, Christine M.; Green, Amy E.; Karver, Marc S.; Gesten, Ellis L.

2009-01-01

The present study assessed agreement between student self-report and teacher ratings of bullying and victimization relative to psychological, behavioral, and academic correlates. Middle school students (N=1442) and teachers completed surveys evaluating peer relationships and psychosocial adjustment. Analyses of variance and logistic regressions…

Health Services Utilization among Children with and without Autism Spectrum Disorders

ERIC Educational Resources Information Center

Cummings, Janet R.; Lynch, Frances L.; Rust, Kristal C.; Coleman, Karen J.; Madden, Jeanne M.; Owen-Smith, Ashli A.; Yau, Vincent M.; Qian, Yinge; Pearson, Kathryn A.; Crawford, Phillip M.; Massolo, Maria L.; Quinn, Virginia P.; Croen, Lisa A.

2016-01-01

Using data from multiple health systems (2009-2010) and the largest sample to date, this study compares health services use among youth with and without an autism spectrum disorder (ASD)--including preventive services not previously studied. To examine these differences, we estimated logistic and count data models, controlling for demographic…

Modeling critical habitat for Flammulated Owls (Otus flammeolus)

Treesearch

David A. Christie; Astrid M. van Woudenberg

1997-01-01

Multiple logistic regression analysis was used to produce a prediction model for Flammulated Owl (Otus flammeolus) breeding habitat within the Kamloops Forest Region in south-central British Columbia. Using the model equation, a pilot habitat prediction map was created within a Geographic Information System (GIS) environment that had a 75.7 percent...

Intimate Partner Violence and Unintended Pregnancy among Bangladeshi Women

ERIC Educational Resources Information Center

Rahman, Mosfequr; Sasagawa, Toshiyuki; Fujii, Ryota; Tomizawa, Hideki; Makinoda, Satoru

2012-01-01

This study examined the relationship between intimate partner violence (IPV) and unintended pregnancy using data from women reporting IPV in the 2007 Bangladesh Demographic Health Survey. The analysis included 4,695 married women, aged 15 to 40 years, who had at least one birth in the last 5 years. Bivariate and multiple logistic regression…

Ethnicity and Economic Well-Being: The Case of Ghana

ERIC Educational Resources Information Center

Addai, Isaac; Pokimica, Jelena

2010-01-01

In the context of decades of successful economic reforms in Ghana, this study investigates whether ethnicity influences economic well-being (perceived and actual) among Ghanaians at the micro-level. Drawing on Afro-barometer 2008 data, the authors employs logistic and multiple regression techniques to explore the relative effect of ethnicity on…

Potential for Suicide and Aggression in Delinquents at Juvenile Court in a Southern City.

ERIC Educational Resources Information Center

Battile, Allen O.; And Others

1993-01-01

Questioned 263 Juvenile Court offenders about whether they wished to be dead, kill themselves, or kill others and about their existential experiences, thoughts, and feelings. Used stepwise multiple logistic regression to pinpoint experiences associated with high likelihood of verbalizing wish for destructive behavior. Found sexual abuse as risk…

Predictors of Child Molestation: Adult Attachment, Cognitive Distortions, and Empathy

ERIC Educational Resources Information Center

Wood, Eric; Riggs, Shelley

2008-01-01

A conceptual model derived from attachment theory was tested by examining adult attachment style, cognitive distortions, and both general and victim empathy in a sample of 61 paroled child molesters and 51 community controls. Results of logistic multiple regression showed that attachment anxiety, cognitive distortions, high general empathy but low…

The Impact of Sample Size and Other Factors When Estimating Multilevel Logistic Models

ERIC Educational Resources Information Center

Schoeneberger, Jason A.

2016-01-01

The design of research studies utilizing binary multilevel models must necessarily incorporate knowledge of multiple factors, including estimation method, variance component size, or number of predictors, in addition to sample sizes. This Monte Carlo study examined the performance of random effect binary outcome multilevel models under varying…

Predictors of Employment and Postsecondary Education of Youth with Autism

ERIC Educational Resources Information Center

Migliore, Alberto; Timmons, Jaimie; Butterworth, John; Lugas, Jaime

2012-01-01

Using logistic and multiple regressions, the authors investigated predictors of employment and postsecondary education outcomes of youth with autism in the Vocational Rehabilitation Program. Data were obtained from the RSA911 data set, fiscal year 2008. Findings showed that the odds of gaining employment were greater for youth who received job…

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 Multiple Logistic Regression Model for Predicting the Development of Phytophthora ramorum symptoms in Tanoak (Lithocarpus densiflorus)

Treesearch

Mark Spencer; Kevin O' Hara

2007-01-01

Phytophthora ramorum attacks tanoak (Lithocarpus densiflorus) in California and Oregon. We present a stand-level study examining the presence of disease symptoms in individual stems. Working with data from four plots in redwood (Sequoia sempervirens)/tanoak forests in Marin County, and three plots in Mendocino...

Sexual practices in Malaysia: determinants of sexual intercourse among unmarried youths.

PubMed

Zulkifli, S N; Low, W Y

2000-10-01

This paper describes findings on selected determinants of sexual intercourse among 468 unmarried adolescents from a survey in Malaysia. Data on respondents' background, sexual experience, contraceptive use, and sexual attitudes are provided. Based on multiple logistic regressions, factors significantly predictive of sexual experience are gender, employment, and sexual attitudes.

Hispanic Community College Students: Acculturation, Family Support, Perceived Educational Barriers, and Vocational Planning

ERIC Educational Resources Information Center

Fiebig, Jennifer Nepper; Braid, Barbara L.; Ross, Patricia A.; Tom, Matthew A.; Prinzo, Cara

2010-01-01

A multiple logistic regression model was used to determine the associations between the role of acculturation, perception of educational barriers, need for family kin support, vocational planning, and expectations for attaining future vocational goals against the demographic variables (gender, age, being the oldest child, the first to attend…

School Principals' Job Satisfaction: The Effects of Work Intensification

ERIC Educational Resources Information Center

Wang, Fei; Pollock, Katina; Hauseman, Cameron

2018-01-01

This study examines principals' job satisfaction in relation to their work intensification. Frederick Herzberg's two-factor theory was used to shed light on how motivating and maintenance factors affect principals' job satisfaction. Logistic multiple regressions were used in the analysis of survey data that were collected from 2,701 elementary and…

Self-Reported Weight Perceptions, Dieting Behavior, and Breakfast Eating among High School Adolescents

ERIC Educational Resources Information Center

Zullig, Keith; Ubbes, Valerie A.; Pyle, Jennifer; Valois, Robert F.

2006-01-01

This study explored the relationships among weight perceptions, dieting behavior, and breakfast eating in 4597 public high school adolescents using the Centers for Disease Control and Prevention Youth Risk Behavior Survey. Adjusted multiple logistic regression models were constructed separately for race and gender groups via SUDAAN (Survey Data…

Assistive Technologies for Second-Year Statistics Students Who Are Blind

ERIC Educational Resources Information Center

Erhardt, Robert J.; Shuman, Michael P.

2015-01-01

At Wake Forest University, a student who is blind enrolled in a second course in statistics. The course covered simple and multiple regression, model diagnostics, model selection, data visualization, and elementary logistic regression. These topics required that the student both interpret and produce three sets of materials: mathematical writing,…

Bullied Status and Physical Activity in Texas Adolescents

ERIC Educational Resources Information Center

Case, Kathleen R.; Pérez, Adriana; Saxton, Debra L.; Hoelscher, Deanna M.; Springer, Andrew E.

2016-01-01

This study examined the association between having been bullied at school during the past 6 months ("bullied status") and not meeting physical activity (PA) recommendations of 60 minutes of daily PA during the past week among 8th- and 11th-grade Texas adolescents. Multiple logistic regression analysis was conducted to examine this…

From Teachers to Students: What Influences Early Childhood Educators to Pursue College Education

ERIC Educational Resources Information Center

Deutsch, Francine M.; Riffin, Catherine A.

2013-01-01

Underpaid and overworked, preschool teachers face multiple barriers in pursuing higher education. In the present study, we explored how logistical and financial barriers hinder early childhood education teachers and teacher's aides from taking college courses, as well as how academic self-concept and social support influence current enrollment.…

Academic Advising and First-Generation College Students: A Quantitative Study on Student Retention

ERIC Educational Resources Information Center

Swecker, Hadyn K.; Fifolt, Matthew; Searby, Linda

2014-01-01

For this quantitative study, we used a multiple logistic regression technique to investigate the relationship between the number of meetings with an academic advisor and retention of first-generation students, as represented by enrollment status and academic standing at a large, public research institution in the Southeast. Consistent with…

Driving Privileges Facilitate Impaired Driving in Those Youths Who Use Alcohol or Marijuana

ERIC Educational Resources Information Center

Lewis, Todd F.; Scott Olds, R.; Thombs, Dennis L.; Ding, Kele

2009-01-01

The aim of this study was to determine whether possession of a driver's license increases the risk of impaired driving among adolescents who use alcohol or marijuana. An anonymous questionnaire was administered to secondary school students in northeast Ohio across multiple school districts. Logistic regression analyses revealed that after…

Design of a biomass-to-biorefinery logistics system through bio-inspired metaheuristic optimization considering multiple types of feedstocks

NASA Astrophysics Data System (ADS)

Trueba, Isidoro

Bioenergy has become an important alternative source of energy to alleviate the reliance on petroleum energy. Bioenergy offers significant potential to mitigate climate change by reducing life-cycle greenhouse gas emissions relative to fossil fuels. The Energy Independence and Security Act mandate the use of 21 billion gallons of advanced biofuels including 16 billion gallons of cellulosic biofuels by the year 2022. It is clear that Biomass can make a substantial contribution to supplying future energy demand in a sustainable way. However, the supply of sustainable energy is one of the main challenges that mankind will face over the coming decades. For instance, many logistical challenges will be faced in order to provide an efficient and reliable supply of quality feedstock to biorefineries. 700 million tons of biomass will be required to be sustainably delivered to biorefineries annually to meet the projected use of biofuels by the year of 2022. This thesis is motivated by the urgent need of advancing knowledge and understanding of the highly complex biofuel supply chain. While corn ethanol production has increased fast enough to keep up with the energy mandates, production of biofuels from different types of feedstocks has also been incremented. A number of pilot and demonstration scale advanced biofuel facilities have been set up, but commercial scale facilities are yet to become operational. Scaling up this new biofuel sector poses significant economic and logistical challenges for regional planners and biofuel entrepreneurs in terms of feedstock supply assurance, supply chain development, biorefinery establishment, and setting up transport, storage and distribution infrastructure. The literature also shows that the larger cost in the production of biomass to ethanol originates from the logistics operation therefore it is essential that an optimal logistics system is designed in order to keep low the costs of producing ethanol and make possible the shift from fossil fuels to biofuels. In many ways biomass is a unique renewable resource. It can be stored and transported relatively easily in contrast to renewable options such as wind and solar, which create intermittent electrical power that requires immediate consumption and a connection to the grid. This thesis presents two different models for the design optimization of a biomass-to-biorefinery logistics system through bio-inspired metaheuristic optimization considering multiple types of feedstocks. This work compares the performance and solutions obtained by two types of metaheuristic approaches; genetic algorithm and ant colony optimization. Compared to rigorous mathematical optimization methods or iterative algorithms, metaheuristics do not guarantee that a global optimal solution can be found on some class of problems. Problems with similar characteristics to the one presented in this thesis have been previously solved using linear programming, integer programming and mixed integer programming methods. However, depending on the type of problem, these mathematical or complete methods might need exponential computation time in the worst-case. This often leads to computation times too high for practical purposes. Therefore, this thesis develops two types of metaheuristic approaches for the design optimization of a biomass-to-biorefinery logistics system considering multiple types of feedstocks and shows that metaheuristics are highly suitable to solve hard combinatorial optimization problems such as the one addressed in this research work.

The weighted priors approach for combining expert opinions in logistic regression experiments

DOE PAGES

Quinlan, Kevin R.; Anderson-Cook, Christine M.; Myers, Kary L.

2017-04-24

When modeling the reliability of a system or component, it is not uncommon for more than one expert to provide very different prior estimates of the expected reliability as a function of an explanatory variable such as age or temperature. Our goal in this paper is to incorporate all information from the experts when choosing a design about which units to test. Bayesian design of experiments has been shown to be very successful for generalized linear models, including logistic regression models. We use this approach to develop methodology for the case where there are several potentially non-overlapping priors under consideration.more » While multiple priors have been used for analysis in the past, they have never been used in a design context. The Weighted Priors method performs well for a broad range of true underlying model parameter choices and is more robust when compared to other reasonable design choices. Finally, we illustrate the method through multiple scenarios and a motivating example. Additional figures for this article are available in the online supplementary information.« less

[The effect of self-foot reflexology on the relief of premenstrual syndrome and dysmenorrhea in high school girls].

PubMed

Kim, Yi-Soon; Kim, Min-Za; Jeong, Ihn-Sook

2004-08-01

This study was aimed to identify the effect of self-foot reflexology on the relief of premenstrual syndrome and dysmenorrhea in high school girls. Study subjects was 236 women residing in the community, teachers and nurses who were older than 45 were recruited. Data was collected with self administered questionnaires from July 1st to August 31st, 2003 and analysed using SPSS/WIN 10.0 with Xtest, t-test, and stepwise multiple logistic regression at a significant level of =.05. The breast cancer screening rate was 57.2%, and repeat screening rate was 15.3%. With the multiple logistic regression analysis, factors associated with mammography screening were age and perceived barriers of action, and factors related to the repeat mammography screening were education level and other cancer screening experience. Based on the results, we recommend the development of an intervention program to decrease the perceived barrier of action, to regard mammography as an essential test in regular check-up, and to give active advertisement and education to the public to improve the rates of breast cancer screening and repeat screening.

Factors Infuencing Women in Pap Smear Uptake

NASA Astrophysics Data System (ADS)

Wijayanti, K. E.; Alam, I. G.

2017-03-01

Objective: Pap smear has proven can decrease death caused by cervical cancer. However, in Indonesia, only few woman who already did pap smear. The aim of this study was to investigate women’s knowledge about pap smear cervical cancer, and to investigate factors influence women to do pap smear test. Methods: Quantitative data colected through questionairre towards 31 women who did pap smear and 55 women who did not do pap smear. Questionairre was made using Health Belief model as a guideline to examine percieved susceptibility, perceived serioussnes, perceived benefits and perceived barriers. Chi square and multiple logistic regresion were used to investigate difference in knowledge and what the most factor that influence women to take pap smear test. Results: There’s significance knowledge difference betweeen women who did and did not do pap smear. But furthermore, by using Multiple Logistic Regression test, appearantly knowledge was not a strong predictor factor for women to take pap smear test (koefisiensi β = -0,164) Conclusion: Perceived barriers were factors that affected pap smear uptake in women in Indonesia. Few respondents get the wrong informations about pap smear, cevical cancer and its symptoms

Risk factors for antepartum fetal death.

PubMed

Oron, T; Sheiner, E; Shoham-Vardi, I; Mazor, M; Katz, M; Hallak, M

2001-09-01

To determine the demographic, maternal, pregnancy-related and fetal risk factors for antepartum fetal death (APFD). From our perinatal database between the years 1990 and 1997, 68,870 singleton birth files were analyzed. Fetuses weighing < 1,000 g at birth and those with structural malformations and/or known chromosomal anomalies were excluded from the study. In order to determine independent factors contributing to APFD, a multiple logistic regression model was constructed. During the study period there were 246 cases of APFD (3.6 per 1,000 births). The following obstetric factors significantly correlated with APFD in a multiple logistic regression model: preterm deliveries: small size for gestational age (SGA), multiparity (> 5 deliveries), oligohydramnios, placental abruption, umbilical cord complications (cord around the neck and true knot of cord), pathologic presentations (nonvertex) and meconium-stained amniotic fluid. APFD was not significantly associated with advanced maternal age. APFD was significantly associated with several risk factors. Placental and umbilical cord pathologies might be the direct cause of death. Grand multiparity, oligohydramnios, meconium-stained amniotic fluid, pathologic presentations and suspected SGA should be carefully evaluated during pregnancy in order to decrease the incidence of APFD.

Vitamin D levels and their associations with survival and major disease outcomes in a large cohort of patients with chronic graft-vs-host disease

PubMed Central

Katić, Mašenjka; Pirsl, Filip; Steinberg, Seth M.; Dobbin, Marnie; Curtis, Lauren M.; Pulanić, Dražen; Desnica, Lana; Titarenko, Irina; Pavletic, Steven Z.

2016-01-01

Aim To identify the factors associated with vitamin D status in patients with chronic graft-vs-host disease (cGVHD) and evaluate the association between serum vitamin D (25(OH)D) levels and cGVHD characteristics and clinical outcomes defined by the National Institutes of Health (NIH) criteria. Methods 310 cGVHD patients enrolled in the NIH cGVHD natural history study (clinicaltrials.gov: NCT00092235) were analyzed. Univariate analysis and multiple logistic regression were used to determine the associations between various parameters and 25(OH)D levels, dichotomized into categorical variables: ≤20 and >20 ng/mL, and as a continuous parameter. Multiple logistic regression was used to develop a predictive model for low vitamin D. Survival analysis and association between cGVHD outcomes and 25(OH)D as a continuous as well as categorical variable: ≤20 and >20 ng/mL; <50 and ≥50 ng/mL, and among three ordered categories: ≤20, 20-50, and ≥50 ng/mL, was performed. PMID:27374829

The weighted priors approach for combining expert opinions in logistic regression experiments

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

Quinlan, Kevin R.; Anderson-Cook, Christine M.; Myers, Kary L.

When modeling the reliability of a system or component, it is not uncommon for more than one expert to provide very different prior estimates of the expected reliability as a function of an explanatory variable such as age or temperature. Our goal in this paper is to incorporate all information from the experts when choosing a design about which units to test. Bayesian design of experiments has been shown to be very successful for generalized linear models, including logistic regression models. We use this approach to develop methodology for the case where there are several potentially non-overlapping priors under consideration.more » While multiple priors have been used for analysis in the past, they have never been used in a design context. The Weighted Priors method performs well for a broad range of true underlying model parameter choices and is more robust when compared to other reasonable design choices. Finally, we illustrate the method through multiple scenarios and a motivating example. Additional figures for this article are available in the online supplementary information.« less

Metrics for measuring net-centric data strategy implementation

NASA Astrophysics Data System (ADS)

Kroculick, Joseph B.

2010-04-01

An enterprise data strategy outlines an organization's vision and objectives for improved collection and use of data. We propose generic metrics and quantifiable measures for each of the DoD Net-Centric Data Strategy (NCDS) data goals. Data strategy metrics can be adapted to the business processes of an enterprise and the needs of stakeholders in leveraging the organization's data assets to provide for more effective decision making. Generic metrics are applied to a specific application where logistics supply and transportation data is integrated across multiple functional groups. A dashboard presents a multidimensional view of the current progress to a state where logistics data shared in a timely and seamless manner among users, applications, and systems.

A comparison of clinical characteristics of older adults treated with antidepressants in general and psychiatric hospitals in Asia.

PubMed

Wang, Yuan-Yuan; Xiang, Yu-Tao; Ungvari, Gabor S; Ng, Chee H; Chiu, Helen F K; Yim, Larina C L; Si, Tian-Mei; Chee, Kok-Yoon; Avasthi, Ajit; Grover, Sandeep; Chong, Mian-Yoon; Sim, Kang; Kanba, Shigenobu; He, Yan-Ling; Lee, Min-Soo; Yang, Shu-Yu; Udomratn, Pichet; Kallivayalil, Roy A; Tanra, Andi J; Maramis, Margarita M; Shen, Winston W; Sartorius, Norman; Mahendran, Rathi; Teng, Jia-Ying; Tan, Chay-Hoon; Shinfuku, Naotaka

2017-11-01

This study compared the demographics, clinical characteristics, and antidepressant prescription patterns between Asian patients aged 50 years and older attending psychiatric hospitals and those attending general hospitals. In total, 955 patients (604 in general hospitals, 351 in psychiatric hospitals) aged 50 years or older treated with antidepressants in 10 Asian countries and territories were examined. Patients' demographics, clinical features, and prescriptions of psychotropic drugs were recorded using a standardized protocol and data collection procedure. Binary logistic regression revealed that high income and diagnosis of schizophrenia were independently associated with psychiatric hospital treatment, whereas outpatient care, diagnosis of anxiety disorders, and multiple major medical conditions were independently associated with general hospital treatment. In addition, tetracyclic and noradrenergic and specific serotonergic antidepressants were more likely to be prescribed in general hospitals. Older adults treated with antidepressants showed different demographic and clinical features between general hospitals and psychiatric hospitals in Asia. © 2017 Japanese Psychogeriatric Society.

Healthcare use and cost in dementia caregivers: Longitudinal results from the Predictors Caregiver Study

PubMed Central

Zhu, Carolyn W.; Scarmeas, Nikolaos; Ornstein, Katherine; Albert, Marilyn; Brandt, Jason; Blacker, Deborah; Sano, Mary; Stern, Yaakov

2014-01-01

OBJECTIVE: To examine the effects of caregiver and patient characteristics on caregivers’ medical care use and cost. METHODS: 147 caregiver/patient dyads were followed annually for 6 years in 3 academic AD centers in the US. Logistic, negative binomial, and generalized linear mixed models were used to examine overall effects of caregiver/patient characteristics on caregivers’ hospitalizations, doctor visits, outpatient tests and procedures, and prescription and over-the-counter medications. RESULTS: Patients’ comorbid conditions and dependence were associated with increased healthcare use and costs of caregivers. Increases in caregiver depressive symptoms are associated with increases in multiple domains of caregivers’ healthcare use and costs. DISCUSSION: Findings suggest that we should expand our focus on dementia patients to include family caregivers to obtain a fuller picture of effects of caregiving. Primary care providers should integrate caregivers’ needs in healthcare planning and delivery. Clinical interventions that treat patients and caregivers as a whole will likely achieve the greatest beneficial effects. PMID:24637299

Major Depressive Disorder and Dysthymia at the Intersection of Nativity and Racial-Ethnic Origins.

PubMed

Szaflarski, Magdalena; Cubbins, Lisa A; Bauldry, Shawn; Meganathan, Karthikeyan; Klepinger, Daniel H; Somoza, Eugene

2016-08-01

Immigrants often have lower rates of depression than US-natives, but longitudinal assessments across multiple racial-ethnic groups are limited. This study examined the rates of prevalent, acquired, and persisting major depression and dysthymia by nativity and racial-ethnic origin while considering levels of acculturation, stress, and social ties. Data from the National Epidemiologic Survey on Alcohol and Related Conditions were used to model prevalence and 3-year incidence/persistence of major depression and dysthymia (DSM-IV diagnoses) using logistic regression. Substantive factors were assessed using standardized measures. The rates of major depression were lower for most immigrants, but differences were noted by race-ethnicity and outcome. Furthermore, immigrants had higher prevalence but not incidence of dysthymia. The associations between substantive factors and outcomes were mixed. This study describes and begins to explain immigrant trajectories of major depression and dysthymia over a 3-year period. The continuing research challenges and future directions are discussed.

Prevalence of Metabolic Syndrome according to Sasang Constitutional Medicine in Korean Subjects

PubMed Central

Song, Kwang Hoon; Yu, Sung-Gon; Kim, Jong Yeol

2012-01-01

Metabolic syndrome (MS) is a complex disorder defined by a cluster of abdominal obesity, atherogenic dyslipidemia, hyperglycemia, and hypertension; the condition is recognized as a risk factor for diabetes and cardiovascular disease. This study assessed the effects of the Sasang constitution group (SCG) on the risk of MS in Korean subjects. We have analyzed 1,617 outpatients of Korean oriental medicine hospitals who were classified into three SCGs, So-Yang, So-Eum, and Tae-Eum. Significant differences were noted in the prevalence of MS and the frequencies of all MS risk factors among the three SCGs. The odds ratios for MS as determined via multiple logistic regression analysis were 2.004 for So-Yang and 4.521 for Tae-Eum compared with So-Eum. These results indicate that SCG may function as a significant risk factor of MS; comprehensive knowledge of Sasang constitutional medicine may prove helpful in predicting susceptibility and developing preventive care techniques for MS. PMID:22454673

Prevalence of Metabolic Syndrome according to Sasang Constitutional Medicine in Korean Subjects.

PubMed

Song, Kwang Hoon; Yu, Sung-Gon; Kim, Jong Yeol

2012-01-01

Metabolic syndrome (MS) is a complex disorder defined by a cluster of abdominal obesity, atherogenic dyslipidemia, hyperglycemia, and hypertension; the condition is recognized as a risk factor for diabetes and cardiovascular disease. This study assessed the effects of the Sasang constitution group (SCG) on the risk of MS in Korean subjects. We have analyzed 1,617 outpatients of Korean oriental medicine hospitals who were classified into three SCGs, So-Yang, So-Eum, and Tae-Eum. Significant differences were noted in the prevalence of MS and the frequencies of all MS risk factors among the three SCGs. The odds ratios for MS as determined via multiple logistic regression analysis were 2.004 for So-Yang and 4.521 for Tae-Eum compared with So-Eum. These results indicate that SCG may function as a significant risk factor of MS; comprehensive knowledge of Sasang constitutional medicine may prove helpful in predicting susceptibility and developing preventive care techniques for MS.

Work Related Psychosocial and Organizational Factors for Neck Pain in Workers in the United States

PubMed Central

Yang, Haiou; Hitchcock, Edward; Haldeman, Scott; Swanson, Naomi; Lu, Ming-Lun; Choi, BongKyoo; Nakata, Akinori; Baker, Dean

2016-01-01

Background Neck pain is a prevalent musculoskeletal condition among workers in the United States. This study explores a set of workplace psychosocial and organization-related factors for neck pain. Methods Data used for this study comes from the 2010 National Health interview Survey which provides a representative sample of the US population. To account for the complex sampling design, the Taylor linearized variance estimation method was used. Logistic regression models were constructed to measure the associations. Results This study demonstrated significant associations between neck pain and a set of workplace risk factors including work-family imbalance, exposure to a hostile work environment and job insecurity, non-standard work arrangements, multiple jobs and long work hours. Conclusion Workers with neck pain may benefit from intervention programs that address issues related to these workplace risk factors. Future studies exploring both psychosocial risk factors and physical risk factors with a longitudinal design will be important. PMID:27184340

Does workplace social capital buffer the effects of job stress? A cross-sectional, multilevel analysis of cigarette smoking among U.S. manufacturing workers

PubMed Central

Sapp, Amy L.; Kawachi, Ichiro; Sorensen, Glorian; LaMontagne, Anthony D.; Subramanian, S.V.

2010-01-01

Objective To investigate whether workplace social capital buffers the association between job stress and smoking status. Methods As part of the Harvard Cancer Prevention Project’s Healthy Directions-Small Business Study, interviewer-administered questionnaires were completed by 1740 workers and 288 managers in 26 manufacturing firms (84% and 85% response). Social capital was assessed by multiple items measured at the individual-level among workers, and contextual-level among managers. Job stress was operationalized by the demand-control model. Multilevel logistic regression was used to estimate associations between job stressors and smoking, and test for effect modification by social capital measures. Results Workplace social capital (both summary measures) buffered associations between high job demands and smoking. One compositional item—worker trust in managers—buffered associations between job strain and smoking. Conclusion Workplace social capital may modify the effects of psychosocial working conditions on health behaviors. PMID:20595910

Predictive variables for the occurrence of early clinical mastitis in primiparous Holstein cows under field conditions in France.

PubMed Central

Barnouin, J; Chassagne, M

2001-01-01

Holstein heifers from 47 dairy herds in France were enrolled in a field study to determine predictors for clinical mastitis within the first month of lactation. Precalving and calving variables (biochemical, hematological, hygienic, and disease indicators) were collected. Early clinical mastitis (ECM) predictive variables were analyzed by using a multiple logistic regression model (99 cows with ECM vs. 571 without clinical mastitis throughout the first lactation). Two variables were associated with a higher risk of ECM: a) difficult calving and b) medium and high white blood cell (WBC) counts in late gestation. Two prepartum indicators were associated with a lower ECM risk: a) medium and high serum concentrations of immunoglobulin G1 (IgG1) and b) high percentage of eosinophils among white blood cells. Calving difficulty and certain biological blood parameters (IgG1, eosinophils) could represent predictors that would merit further experimental studies, with the aim of designing programs for reducing the risk of clinical mastitis in the first lactation. PMID:11195522

Workplace psychosocial and organizational factors for neck pain in workers in the United States.

PubMed

Yang, Haiou; Hitchcock, Edward; Haldeman, Scott; Swanson, Naomi; Lu, Ming-Lun; Choi, BongKyoo; Nakata, Akinori; Baker, Dean

2016-07-01

Neck pain is a prevalent musculoskeletal condition among workers in the United States. This study explores a set of workplace psychosocial and organization-related factors for neck pain. Data used for this study come from the 2010 National Health Interview Survey which provides a representative sample of the US population. To account for the complex sampling design, the Taylor linearized variance estimation method was used. Logistic regression models were constructed to measure the associations. This study demonstrated significant associations between neck pain and a set of workplace risk factors, including work-family imbalance, exposure to a hostile work environment and job insecurity, non-standard work arrangements, multiple jobs, and long work hours. Workers with neck pain may benefit from intervention programs that address issues related to these workplace risk factors. Future studies exploring both psychosocial risk factors and physical risk factors with a longitudinal design will be important. Am. J. Ind. Med. 59:549-560, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Prevalence of Bluetongue virus serotype 4 in cattle in the State of Sao Paulo, Brazil.

PubMed

Hellmeister de Campos Nogueira, Adriana; De Stefano, Eliana; de Souza Nunes Martins, Maira; Okuda, Liria Hiromi; Dos Santos Lima, Michele; da Silva Garcia, Thais; Heinz Hellwig, Otto; Alves de Lima, José Eduardo; Savini, Giovanni; Pituco, Edviges Maristela

2016-09-30

Bluetongue (BT) is considered endemic in several regions of Brazil. The State of Sao Paulo was divided into 7 cattle production regions (circuits) according the different systems of breeding, operational and logistical capacity of the state veterinary service. At least 1 animal from each property (a total of 1,716 farms) was tested by competitive ELISA for the presence of antibodies against BTV. Sero‑positive sera were subsequently also tested by virus neutralization tests (VNT) using serial dilutions from 1:10 (cutoff) up to 1:640 (in MEM). BTV‑4 neutralizing antibodies were detected in 86% (1,483/1,716) of the animals tested. These results show that BTV‑4 is endemic and widespread in the State of San Paulo and indirectly confirm that in the State there are favourable conditions for the multiplication of competent vectors. However, as no clinical signs have ever been reported in cattle in the region, BTV‑4 infection is likely to occur silently in the State of Sao Paulo.

Association among depressive disorder, adjustment disorder, sleep disturbance, and suicidal ideation in Taiwanese adolescent.

PubMed

Chung, Ming-Shun; Chiu, Hsien-Jane; Sun, Wen-Jung; Lin, Chieh-Nan; Kuo, Chien-Cheng; Huang, Wei-Che; Chen, Ying-Sheue; Cheng, Hui-Ping; Chou, Pesus

2014-09-01

The aim of this study is to investigate the association among depressive disorder, adjustment disorder, sleep disturbance, and suicidal ideation in Taiwanese adolescent. We recruited 607 students (grades 5-9) to fill out the investigation of basic data and sleep disturbance. Psychiatrists then used the Mini International Neuropsychiatric Interview-Kid to interview these students to assess their suicidal ideation and psychiatric diagnosis. Multiple logistic regression with forward conditionals was used to find the risk factors for multivariate analysis. Female, age, depressive disorder, adjustment disorder, and poor sleep all contributed to adolescent suicidal ideation in univariate analysis. However, poor sleep became non-significant under the control of depressive disorder and adjustment disorder. We found that both depressive disorder and adjustment disorder play important roles in sleep and adolescent suicidal ideation. After controlling both depressive disorder and adjustment disorder, sleep disturbance was no longer a risk of adolescent suicidal ideation. We also confirm the indirect influence of sleep on suicidal ideation in adolescent. © 2013 Wiley Publishing Asia Pty Ltd.

Back disorders and health problems among subway train operators exposed to whole-body vibration.

PubMed

Johanning, E

1991-12-01

Back disease associated with whole-body vibration has not been evaluated for subway train operators. A recent study demonstrated that this group is exposed to whole-body vibration at levels above the international standard. To investigate this risk further, a self-administered questionnaire survey was conducted among subway train operators (N = 492) and a similar reference group (N = 92). The operators had a higher prevalence than the referents in all aspects of back problems, particularly for cervical and lower back pain. In a multiple logistic regression model, the odds ratio for sciatic pain among subway train operators was 3.9 (95% CI 1.7-8.6); the operators also had a higher risk of hearing-related problems (odds ratio 3.2, 95% CI 0.6-17.4) and of gastrointestinal problems (odds ratio 1.6, 95% CI 1.1-2.5). Although a cumulative dose-response relationship could not be statistically demonstrated, the findings appear to be related to exposure to whole-body vibration and inadequate ergonomic conditions.

Focused Logistics and Support for Force Projection in Force XXI and Beyond

DTIC Science & Technology

1999-12-09

business system linking trading partners with point of sale demand and real time manufacturing for clothing items.17 Quick Response achieved $1.7...be able to determine the real - time status and supply requirements of units. With "distributed logistics system software model hosts൨ and active...location, quantity, condition, and movement of assets. The system is designed to be fully automated, operate in near- real time with an open-architecture

Awareness, treatment, and control of dyslipidemia in rural South Africa: The HAALSI (Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa) study.

PubMed

Reiger, Sheridan; Jardim, Thiago Veiga; Abrahams-Gessel, Shafika; Crowther, Nigel J; Wade, Alisha; Gomez-Olive, F Xavier; Salomon, Joshua; Tollman, Stephen; Gaziano, Thomas A

2017-01-01

Dyslipidemia is a primary driver for chronic cardiovascular conditions and there is no comprehensive literature about its management in South Africa. The objective of this study was to assess the prevalence, awareness, treatment, and control of dyslipidemia in rural South Africa and how they are impacted by different behaviors and non-modifiable factors. To fulfill this objective we recruited for this cohort study adults aged ≥40 years residing in the Agincourt sub-district of Mpumalanga Province. Data collection included socioeconomic and clinical data, anthropometric measures, blood pressure (BP), HIV-status, point-of-care glucose and lipid levels. Framingham CVD Risk Score was ascribed to patients based upon categories for 10 year cardiovascular risk of low (<3%), moderate (≥3% and <15%), high (≥15% and <30%), and very high (≥30%).LDL cholesterol control by risk category was defined according to South African Guidelines. Multivariable logistic regression models were built to identify factors that were significantly associated with dyslipidemia and awareness of dyslipidemia From 5,059 respondents a total of 4247 subjects (83.9%) had their cholesterol levels measured and were included in our analysis. Overall, 67.3% (2860) of these met criteria for dyslipidemia, only 30 (1.05%) were aware of their condition, and only 21 subjects (0.73%) were on treatment. The majority have abnormalities in triglycerides (59.3%). As cardiovascular risk increased the rates of lipid control according to LDL level dropped. Multivariate logistic regression analyses showed that being overweight was predictive of dyslipidemia (OR 1.76; 95%CI 1.51-2.05, p<0.001) and dyslipidemia awareness (OR 2.58; 95%CI 1.19-5.58; p = 0.017). In conclusion, the very low awareness and treatment of dyslipidemia in this cohort indicate a greater need for systematic screening and education within the population and demonstrate that there are multiple opportunities to allay this burden.

Psychosocial health and suicidal ideation among people living with HIV/AIDS: A cross-sectional study in Nanjing, China.

PubMed

Wang, Wei; Xiao, Chenchang; Yao, Xing; Yang, Yinmei; Yan, Hong; Li, Shiyue

2018-01-01

Suicide is a serious cause of mortality worldwide and is considered as a psychiatric emergency. People living with HIV/AIDS (PLWHA) have higher rates of suicidal behavior than the general population. This study assessed the prevalence and verified the syndemic effect of psychosocial health conditions on suicidal ideation among PLWHA in China. An institutional-based cross-sectional study was conducted from July to August 2016 in Nanjing, China, using a self-report questionnaire. Sociodemographic characteristics, infection status, psychosocial variables and suicide ideation reports of participants were collected. Logistic regressions were used to identify potential factors associated with suicidal ideation and to verify the syndemic effect of psychosocial factors. Additionally, odds ratios (ORs) with 95% confidence intervals (95% CI) were computed. In total, four hundred sixty-five PLWHA participated, 31.6% (n = 147) of whom had suicidal ideation. The results from univariate analysis showed that older age, low education level, being married, having children, and psychosocial variables (high perceived stigma, depression, low self-esteem, social support and resilience) were significantly associated with increased suicidal ideation. Multiple logistic regression models revealed that depression (OR = 2.70, 95%CI = 1.62-4.51), perceived stigma (OR = 1.97, 95%CI = 1.17-3.32), and low social support (OR = 1.85, 95%CI = 1.08-3.20) and self-esteem (OR = 4.11, 95%CI = 2.06-8.16) were statistically significant. PLWHA with at least two psychosocial health problems were nearly 5 times more likely (OR = 4.72, 95% CI 3.11-7.17) to have had suicidal ideation. Suicidal ideation is frequent among PLWHA in China and is consistent with prevalence estimates from abroad. Psychosocial health problems were the determining factors associated with suicidal ideation, and a syndemic effect of psychosocial health conditions was confirmed in predicting suicidal ideation. Therefore, early screening of high-risk groups for suicidal ideation and more psychosocial health care among PLWHA are needed.

Treatment of Nausea and Vomiting in Pregnancy: Factors Associated with ED Revisits

PubMed Central

Sharp, Brian R.; Sharp, Kristen M.; Patterson, Brian; Dooley-Hash, Suzanne

2016-01-01

Introduction Nausea and vomiting in pregnancy (NVP) is a condition that commonly affects women in the first trimester of pregnancy. Despite frequently leading to emergency department (ED) visits, little evidence exists to characterize the nature of ED visits or to guide its treatment in the ED. Our objectives were to evaluate the treatment of NVP in the ED and to identify factors that predict return visits to the ED for NVP. Methods We conducted a retrospective database analysis using the electronic medical record from a single, large academic hospital. Demographic and treatment variables were collected using a chart review of 113 ED patient visits with a billing diagnosis of “nausea and vomiting in pregnancy” or “hyperemesis gravidarum.” Logistic regression analysis was used with a primary outcome of return visit to the ED for the same diagnoses. Results There was wide treatment variability of nausea and vomiting in pregnancy patients in the ED. Of the 113 patient visits, 38 (33.6%) had a return ED visit for NVP. High gravidity (OR 1.31, 95% CI [1.06–1.61]), high parity (OR 1.50 95% CI [1.12–2.00]), and early gestational age (OR 0.74 95% CI [0.60–0.90]) were associated with an increase in return ED visits in univariate logistic regression models, while only early gestational age (OR 0.74 95% CI [0.59–0.91]) was associated with increased return ED visits in a multiple regression model. Admission to the hospital was found to decrease the likelihood of return ED visits (p=0.002). Conclusion NVP can be difficult to manage and has a high ED return visit rate. Optimizing care with aggressive, standardized treatment in the ED and upon discharge, particularly if factors predictive of return ED visits are present, may improve quality of care and reduce ED utilization for this condition. PMID:27625723

The polymorphisms of ATOH 7, ET-1 and ACE in non-arteritic anterior ischemic optic neuropathy.

PubMed

Chen, Ting; Ma, Jin; Shan, Guangliang; Zhong, Yong

2018-05-21

Non-arteritic anterior ischemic optic neuropathy (NAION) is a common cause of acute optic neuropathy in the elderly. The role of the genetic polymorphisms of Atonal Homolog 7 (ATOH7), Endothelin-1 (ET-1) and Angiotensin Converting Enzyme (ACE) in NAION and the combined effects of the gene-gene and gene-medical comorbidities on NAION were not clear. We conducted a perspective, case-control study. 71 NAION patients and 142 age and sex-matched healthy controls were enrolled. Single nucleotide polymorphisms of ATOH7 (rs1900004), ET-1 (rs5370) and ACE (rs1799752) were identified by polymerase chain reaction (PCR) method and all PCR products were screened with Sanger sequencing. The prevalence of genetic factors in NAION patients were compared to normal people, and assessed in conditional logistic regression models. The modified effects of gene-gene or gene-medical comorbidities on NAION development were assessed with a multiplicative model. A significant high risk was found in the T allele of ATOH7 in NAION, with an odds ratio (OR) of 1.55 (P = 0.04). Conditional logistic regression analysis, including diabetes and hypertension, revealed that ATOH7 TT genotype carriers conferred a significantly increased risk of NAION (TT/CC + CT, OR = 3.32, 95% confidence interval (CI) = 1.16-9.53, P = 0.03). Interaction analysis showed that ET-1 (P = 0.01), ACE (P = 0.046) and hypertension (P = 0.02) have modified effects on NAION development. Our results showed that the polymorphism of optic disc associated gene-ATOH7 conferred a significant risk of NAION. Combination of ATOH7 and ET-1, ATOH7 and ACE, as well as ATOH7 and hypertension, increased the susceptibility of NAION. Our data may be useful for NAION predicting. Copyright © 2018. Published by Elsevier Ltd.

Single and multiple objective biomass-to-biofuel supply chain optimization considering environmental impacts

NASA Astrophysics Data System (ADS)

Valles Sosa, Claudia Evangelina

Bioenergy has become an important alternative source of energy to alleviate the reliance on petroleum energy. Bioenergy offers diminishing climate change by reducing Green House Gas Emissions, as well as providing energy security and enhancing rural development. The Energy Independence and Security Act mandate the use of 21 billion gallons of advanced biofuels including 16 billion gallons of cellulosic biofuels by the year 2022. It is clear that Biomass can make a substantial contribution to supply future energy demand in a sustainable way. However, the supply of sustainable energy is one of the main challenges that mankind will face over the coming decades. For instance, many logistical challenges will be faced in order to provide an efficient and reliable supply of quality feedstock to biorefineries. 700 million tons of biomass will be required to be sustainably delivered to biorefineries annually to meet the projected use of biofuels by the year of 2022. Approaching this complex logistic problem as a multi-commodity network flow structure, the present work proposes the use of a genetic algorithm as a single objective optimization problem that considers the maximization of profit and the present work also proposes the use of a Multiple Objective Evolutionary Algorithm to simultaneously maximize profit while minimizing global warming potential. Most transportation optimization problems available in the literature have mostly considered the maximization of profit or the minimization of total travel time as potential objectives to be optimized. However, on this research work, we take a more conscious and sustainable approach for this logistic problem. Planners are increasingly expected to adopt a multi-disciplinary approach, especially due to the rising importance of environmental stewardship. The role of a transportation planner and designer is shifting from simple economic analysis to promoting sustainability through the integration of environmental objectives. To respond to these new challenges, the Modified Multiple Objective Evolutionary Algorithm for the design optimization of a biomass to bio-refinery logistic system that considers the simultaneous maximization of the total profit and the minimization of three environmental impacts is presented. Sustainability balances economic, social and environmental goals and objectives. There exist several works in the literature that have considered economic and environmental objectives for the presented supply chain problem. However, there is a lack of research performed in the social aspect of a sustainable logistics system. This work proposes a methodology to integrate social aspect assessment, based on employment creation. Finally, most of the assessment methodologies considered in the literature only contemplate deterministic values, when in realistic situations uncertainties in the supply chain are present. In this work, Value-at-Risk, an advanced risk measure commonly used in portfolio optimization is included to consider the uncertainties in biofuel prices, among the others.

Multiple network-constrained regressions expand insights into influenza vaccination responses.

PubMed

Avey, Stefan; Mohanty, Subhasis; Wilson, Jean; Zapata, Heidi; Joshi, Samit R; Siconolfi, Barbara; Tsang, Sui; Shaw, Albert C; Kleinstein, Steven H

2017-07-15

Systems immunology leverages recent technological advancements that enable broad profiling of the immune system to better understand the response to infection and vaccination, as well as the dysregulation that occurs in disease. An increasingly common approach to gain insights from these large-scale profiling experiments involves the application of statistical learning methods to predict disease states or the immune response to perturbations. However, the goal of many systems studies is not to maximize accuracy, but rather to gain biological insights. The predictors identified using current approaches can be biologically uninterpretable or present only one of many equally predictive models, leading to a narrow understanding of the underlying biology. Here we show that incorporating prior biological knowledge within a logistic modeling framework by using network-level constraints on transcriptional profiling data significantly improves interpretability. Moreover, incorporating different types of biological knowledge produces models that highlight distinct aspects of the underlying biology, while maintaining predictive accuracy. We propose a new framework, Logistic Multiple Network-constrained Regression (LogMiNeR), and apply it to understand the mechanisms underlying differential responses to influenza vaccination. Although standard logistic regression approaches were predictive, they were minimally interpretable. Incorporating prior knowledge using LogMiNeR led to models that were equally predictive yet highly interpretable. In this context, B cell-specific genes and mTOR signaling were associated with an effective vaccination response in young adults. Overall, our results demonstrate a new paradigm for analyzing high-dimensional immune profiling data in which multiple networks encoding prior knowledge are incorporated to improve model interpretability. The R source code described in this article is publicly available at https://bitbucket.org/kleinstein/logminer . steven.kleinstein@yale.edu or stefan.avey@yale.edu. Supplementary data are available at Bioinformatics online. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Determinants of postnatal care utilization in urban community among women in Debre Birhan Town, Northern Shewa, Ethiopia.

PubMed

Angore, Banchalem Nega; Tufa, Efrata Girma; Bisetegen, Fithamlak Solomon

2018-04-19

Reducing maternal mortality and improving maternal health care through increased utilization of postnatal care utilization is a global and local priority. However studies that have been carried out in Ethiopia regarding determinants are limited. So This study aims to assess the magnitude of postnatal care utilization and its determinants in Debre Birhan Town, North Ethiopia. A community-based cross-sectional study was conducted from March 1 to April 25, 2015, in Debre Birhan Town. Data were collected through face-to-face interviews using structured pre-tested questionnaires. The data were entered and cleaned in Epi Info version 3.5 and analyzed using SPSS version 20. Bivariate and multiple logistic regression analyses were used. Variable with p value less than or equal to 0.2 at bivariate analysis were entered into multiple logistic regression. Significance was declared at 0.05 in multiple logistic regressions and considered to be an independent factor. From the total respondents, we found that 327 (83.3%) mothers utilized the postnatal care services. Single mothers were less likely to utilize postnatal care services than those mothers who are married and live together [adjusted odds ratio (AOR) = 0.06, 95% CI (0.01, 0.45)]. This study revealed that respondent's knowledge about postnatal care services is an important predictor of postnatal care utilization [AOR = 0.03, 95% CI (0.00, 0.44)] and mothers who delivered in a health care facility were more likely to receive PNC than mothers who did not deliver in a health care facility [AOR = 0.65, 95% CI (0.58, 0.94)]. The postnatal care utilization rate in Debre Birhan town was 83.3%. Marital status, maternal knowledge, and place of delivery were predictors of postnatal care service utilization. So specific attention should be directed towards the improvement of women's education since the perception of the need for PNC services were positively correlated with the mother's education.

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.

Individual risk factors for deep infection and compromised fracture healing after intramedullary nailing of tibial shaft fractures: a single centre experience of 480 patients.

PubMed

Metsemakers, W-J; Handojo, K; Reynders, P; Sermon, A; Vanderschot, P; Nijs, S

2015-04-01

Despite modern advances in the treatment of tibial shaft fractures, complications including nonunion, malunion, and infection remain relatively frequent. A better understanding of these injuries and its complications could lead to prevention rather than treatment strategies. A retrospective study was performed to identify risk factors for deep infection and compromised fracture healing after intramedullary nailing (IMN) of tibial shaft fractures. Between January 2000 and January 2012, 480 consecutive patients with 486 tibial shaft fractures were enrolled in the study. Statistical analysis was performed to determine predictors of deep infection and compromised fracture healing. Compromised fracture healing was subdivided in delayed union and nonunion. The following independent variables were selected for analysis: age, sex, smoking, obesity, diabetes, American Society of Anaesthesiologists (ASA) classification, polytrauma, fracture type, open fractures, Gustilo type, primary external fixation (EF), time to nailing (TTN) and reaming. As primary statistical evaluation we performed a univariate analysis, followed by a multiple logistic regression model. Univariate regression analysis revealed similar risk factors for delayed union and nonunion, including fracture type, open fractures and Gustilo type. Factors affecting the occurrence of deep infection in this model were primary EF, a prolonged TTN, open fractures and Gustilo type. Multiple logistic regression analysis revealed polytrauma as the single risk factor for nonunion. With respect to delayed union, no risk factors could be identified. In the same statistical model, deep infection was correlated with primary EF. The purpose of this study was to evaluate risk factors of poor outcome after IMN of tibial shaft fractures. The univariate regression analysis showed that the nature of complications after tibial shaft nailing could be multifactorial. This was not confirmed in a multiple logistic regression model, which only revealed polytrauma and primary EF as risk factors for nonunion and deep infection, respectively. Future strategies should focus on prevention in high-risk populations such as polytrauma patients treated with EF. Copyright © 2014 Elsevier Ltd. All rights reserved.

Investigating the strategic antecedents of agility in humanitarian logistics.

PubMed

L'Hermitte, Cécile; Brooks, Benjamin; Bowles, Marcus; Tatham, Peter H

2017-10-01

This study investigates the strategic antecedents of operational agility in humanitarian logistics. It began by identifying the particular actions to be taken at the strategic level of a humanitarian organisation to support field-level agility. Next, quantitative data (n=59) were collected on four strategic-level capabilities (being purposeful, action-focused, collaborative, and learning-oriented) and on operational agility (field responsiveness and flexibility). Using a quantitative analysis, the study tested the relationship between organisational capacity building and operational agility and found that the four strategic-level capabilities are fundamental building blocks of agility. Collectively they account for 52 per cent of the ability of humanitarian logisticians to deal with ongoing changes and disruptions in the field. This study emphasises the need for researchers and practitioners to embrace a broader perspective of agility in humanitarian logistics. In addition, it highlights the inherently strategic nature of agility, the development of which involves focusing simultaneously on multiple drivers. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Older Adult Spouses with Multiple Chronic Conditions: Challenges, Rewards, and Coping Strategies.

PubMed

Peacock, Shelley; Sethi, Bharati; Williams, Allison; Duggleby, Wendy; Bayly, Melanie; Swindle, Jenny; Ploeg, Jenny; Markle-Reid, Maureen

2017-06-01

There is a paucity of research exploring how spouses to older adults with multiple chronic conditions make meaning of their caregiving experience. For this study, we asked: What is the experience of spousal caregivers to persons with multiple chronic conditions? We applied Thorne's interpretive description approach, interviewing 18 spouses who provided a rich description of their caregiving experience; interviews were transcribed verbatim and thematically analysed. Themes were categorized according to challenges encountered, rewards gleaned, and sustaining strategies employed by participants in caregiving to their spouse with multiple chronic conditions. Unique findings relate to the challenges inherent in decision-making within the context of multiple chronic conditions. This article begins to address the gap in the literature regarding the caregiving experience within the context of multiple chronic conditions.

Mental illness in metropolitan, urban and rural Georgia populations

PubMed Central

2013-01-01

Background Mental illness represents an important public health problem. Local-level data concerning mental illness in different populations (e.g., socio-demographics and residence – metropolitan/urban/rural) provides the evidence-base for public health authorities to plan, implement and evaluate control programs. This paper describes prevalence and covariates of psychiatric conditions in Georgia populations in three defined geographic areas. Methods Data came from the Georgia population-based random-digit-dialing study investigating unwellness and chronic fatigue syndrome (CFS) in Georgia populations of three defined geographic areas (metropolitan, urban, and rural). Respondents were screened for symptoms of fatigue, sleep, cognition, and pain at household screening interviews, and a randomly selected sample completed detailed individual phone interviews. Based on the detailed phone interviews, we conducted one-day clinical evaluations of 292 detailed interview participants classified as unwell with a probable CFS (i.e. CFS-like; a functional somatic syndrome), 268 classified as other unwell, and 223 well (matched to CFS-like). Clinical evaluation included psychiatric classification by means of the Structured Clinical Interview for DSM (SCID). To derive prevalence estimates we used sample weighting to account for the complexity of the multistage sampling design. We used 2- and 3-way table analyses to examine socio-demographic and urbanicity specific associations and multiple logistic regression to calculate adjusted odds ratios. Results Anxiety and mood disorders were the most common psychiatric conditions. Nineteen percent of participants suffered a current anxiety disorder, 18% a mood disorder and 10% had two or more conditions. There was a significant linear trend in occurrence of anxiety or mood disorders from well to CFS-like. The most common anxiety disorders were post-traumatic stress disorder (PTSD) (6.6%) and generalized anxiety disorder (GAD) (5.8%). Logistic regression showed that lower education and female sex contributed significantly to risk for both PTSD and GAD. In addition, rural/urban residence and Hispanic ethnicity were associated with PTSD. We defined moderate to severe depression as Major Depressive Disorder or a Zung score >60 and logistic regression found lower education to be significantly associated but sex, age and urbanicity were not. Conclusions Overall occurrence of anxiety and mood disorders in Georgia mirrored national findings. However, PTSD and GAD occurred at twice the published national rates (3.6 and 2.7%, respectively). State and local prevalence and associations with education, sex and urbanicity comprise important considerations for developing control programs. The increased prevalence of anxiety and mood disorders in people with a functional somatic syndrome (or CFS-like illness) is important for primary care providers, who should consider additional psychiatric screening or referral of individuals presenting with somatoform symptoms. PMID:23631737

The influence of talker and foreign-accent variability on spoken word identification.

PubMed

Bent, Tessa; Holt, Rachael Frush

2013-03-01

In spoken word identification and memory tasks, stimulus variability from numerous sources impairs performance. In the current study, the influence of foreign-accent variability on spoken word identification was evaluated in two experiments. Experiment 1 used a between-subjects design to test word identification in noise in single-talker and two multiple-talker conditions: multiple talkers with the same accent and multiple talkers with different accents. Identification performance was highest in the single-talker condition, but there was no difference between the single-accent and multiple-accent conditions. Experiment 2 further explored word recognition for multiple talkers in single-accent versus multiple-accent conditions using a mixed design. A detriment to word recognition was observed in the multiple-accent condition compared to the single-accent condition, but the effect differed across the language backgrounds tested. These results demonstrate that the processing of foreign-accent variation may influence word recognition in ways similar to other sources of variability (e.g., speaking rate or style) in that the inclusion of multiple foreign accents can result in a small but significant performance decrement beyond the multiple-talker effect.

Livestock transport from the perspective of the pre-slaughter logistic chain: a review.

PubMed

Miranda-de la Lama, G C; Villarroel, M; María, G A

2014-09-01

New developments in livestock transport within the pre-slaughter chain are discussed in terms of three logistic nodes: origin, stopovers and slaughterhouse. Factors as transport cost, haulier, truck specifications, micro-environment conditions, loading density, route planning, vehicle accidents and journey length are discussed as well as causes of morbidity, mortality, live weight and carcass damage. Taking into account current trends towards increased transport times, logistics stopovers and mixed transport, there is a need to develop systems of evaluation and decision-making that provide tools and protocols that can minimize the biological cost to animals, which may have been underestimated in the past. Copyright © 2014 Elsevier Ltd. All rights reserved.

Molybdenum Accumulation in Marine Sediments as an Indicator of Hypoxic Water Conditions (NACAETAC)

EPA Science Inventory

Direct monitoring of hypoxic water column conditions over large spatial and temporal extents is difficult due to the substantial logistical and financial investment required. Recent studies have indicated that concentrations of molybdenum (Mo) in marine sediments may serve as a u...

A prospective examination of disease management program use by complex cardiac outpatients.

PubMed

Gravely, Shannon; Reid, Robert D; Oh, Paul; Ross, Heather; Stewart, Donna E; Grace, Sherry L

2012-01-01

The use of disease management programs (DMPs) by patients with cardiovascular disease (CVD) is associated with improved outcomes. Although rates of cardiac rehabilitation (CR) use are well established, less is known about other DMPs. The objectives of this study were to describe the degree of DMP utilization by CVD outpatients, and examine factors related to use. This study represents a secondary analysis of a larger prospective cohort study. In hospital, 2635 CVD inpatients from 11 hospitals in Ontario Canada completed a survey that assessed factors affecting DMP utilization. One year later, 1803 participants completed a mailed survey that assessed DMP utilization. One thousand seventy-three (59.5%) participants reported using at least 1 DMP. Overall, 951 (52.7%) reported participating in cardiac rehabilitation, and among participants with a comorbid indication, 212 (41.2%) reported attending a diabetes education centre, 28 (25.9%) attended stroke rehabilitation, 35 (12.9%) used a heart failure clinic, and 13 (11.7%) attended a smoking cessation program. A multinomial logistic regression analysis showed that compared with no DMP use, participants that attended 1 or multiple programs were younger, married, diagnosed with a myocardial infarction, less likely to have had a percutaneous coronary intervention and had higher perceptions of personal control over their heart condition. There were few differences between participants that used 1 vs multiple DMPs, however, having diabetes or comorbid stroke significantly increased the likelihood of multiple DMP use. Approximately 40% of CVD outpatients do not access DMPs. An integrated approach to vascular disease management appears warranted. Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Women's health issues with fibromyalgia syndrome.

PubMed

Shaver, Joan L F; Wilbur, Joellen; Robinson, F Patrick; Wang, Edward; Buntin, Mary S

2006-11-01

Fibromyalgia syndrome (FMS) involves multiple sensory, somatic, and cognitive symptoms that are bound to affect or be affected by physical and mental health status and behavioral components of daily life. From a telephone survey of 442 women with and 205 women without FMS as volunteers, data were compared on (1) general health status, (2) reproductive and sleep-related diagnoses, and (3) lifestyle health behaviors. All multiple or logistics regression analyses for group differences were controlled for age, body mass index (BMI), race, employment status, marital status, having a college degree, low household income, and having ever been diagnosed with depression, with a Bonferroni p value correction for multiple indicators. Accordingly, FMS negatively impacted both perceived physical and mental health status, although relatively more so for physical (p < 0.017). Women with FMS were more likely to have had reproductive health or sleep-related diagnoses, including premenstrual syndrome, dysmenorrhea, breast cysts, bladder cystitis, sleep apnea, restless leg syndrome, and abnormal leg movements (p < 0.0125). They were calculated to use less than half as many calories per week as control women (689 +/- 1293 vs. 1499 +/- 1584 kcal/week, p < 0.05) and had more sleep pattern difficulties (p < 0.0125), more negative changes in sexual function (greater odds for 5 of 10 indicators at p < 0.005), and lower alcohol use (odds ratio = 0.39, p < 0.05). Patients with FMS deserve careful assessment for reproductive conditions and sleep-related functional disorders. Besides more research into mechanisms underlying symptoms, intervention testing specifically to alleviate sleep problems, low physical activity levels, and sexual dysfunction should be paramount.

Characteristics in childhood and adolescence associated with future multiple sclerosis risk in men: cohort study.

PubMed

Gunnarsson, M; Udumyan, R; Bahmanyar, S; Nilsagård, Y; Montgomery, S

2015-07-01

Associations with multiple sclerosis (MS) of living conditions in childhood and characteristics in adolescence including physical fitness, cognitive function and psychological stress resilience were investigated. A cohort of male Swedish residents born 1952-1956 who were included in the Swedish Military Conscription Register was used to create a nested case-control study comprising 628 MS cases and 6187 controls matched on birth year, county of residence and vital status at time of diagnosis. Conscription examination records were linked with other national register data. Conditional logistic regression was used to evaluate associations with MS subsequent to the conscription examination. Men with MS were less likely to be from more crowded households in childhood (>two persons per room) with an adjusted odds ratio of 0.67 (95% confidence interval 0.51-0.86, P = 0.023). They had lower physical working capacity in adolescence with adjusted odds ratio of 0.94 (95% confidence interval 0.89-0.99, P = 0.026). Cognitive function and stress resilience scores displayed no significant differences between cases and controls. Parental occupation in childhood and body mass index in adolescence were not associated with future MS risk. The inverse association of MS risk with higher levels of household crowding may reflect environmental factors such as the pattern of exposure to microorganisms. Lower physical fitness in men at MS risk may indicate a protective effect of exercise or could be due to prodromal disease activity, although there was no association with cognitive function. Poor psychological stress resilience (and thus risk of chronic stress arousal) was not associated with MS. © 2015 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

Is gestational hypertension protective against perinatal mortality in twin pregnancies?

PubMed

Luo, Qi-Guang; Zhang, Ji-Yan; Cheng, Wei-Wei; Audibert, Francois; Luo, Zhong-Cheng

2014-01-01

Pregnancy-induced or gestational hypertension is a common pregnancy complication. Paradoxically, gestational hypertension has been associated with a protective effect against perinatal mortality in twin pregnancies in analytic models (logistic regression) without accounting for survival time. Whether this effect is real remains uncertain. This study aimed to validate the impact of gestational hypertension on perinatal mortality in twin pregnancies using a survival analysis approach. This was a retrospective cohort study of 278,821 twin pregnancies, using the U.S. 1995-2000 matched multiple birth dataset (the largest dataset available for multiple births). Cox proportional hazard models were applied to estimate the adjusted hazard ratios (aHR) of perinatal death (stillbirth and neonatal death) comparing gestational hypertensive vs. non-hypertensive pregnancies controlling for maternal characteristics and twin cluster-level dependence. Comparing births in gestational hypertensive vs. non-hypertensive twin pregnancies, perinatal mortality rates were significantly lower (1.20% vs. 3.38%), so were neonatal mortality (0.72% vs. 2.30%) and stillbirth (0.48% vs. 1.10%) rates. The aHRs (95% confidence intervals) were 0.34 (0.31-0.38) for perinatal death, 0.31 (0.27-0.34) for neonatal death, and 0.45 (0.38-0.53) for stillbirth, respectively. The protective effect of gestational hypertension against perinatal death became weaker over advancing gestational age; the aHRs in very preterm (<32 weeks), mild preterm (32-36 weeks) and term (37+ weeks) births were 0.29, 0.48 and 0.76, respectively. The largest risk reductions in neonatal mortality were observed for infections and immaturity-related conditions. Gestational hypertension appears to be beneficial for fetal survival in twin pregnancies, especially in those ending more prematurely or for deaths due to infections and immaturity-related conditions. Prospective studies are required to rule out the possibility of unmeasured confounders.

Common and unique risk factors and comorbidity for 12-month mood and anxiety disorders among Canadians.

PubMed

Meng, Xiangfei; D'Arcy, Carl

2012-08-01

To explore the common and unique risk factors for mood and anxiety disorders. What sociodemographic, psychological, and physical risk factors are associated with mood and anxiety disorders and their comorbidities? What is the impact of multiple risk factors? Data from the Canadian Community Health Survey: Mental Health and Well-Being were analyzed. Appropriate sampling weights and bootstrap variance estimation were employed. Multiple logistic regression was used to estimate odds ratios and confidence intervals. The annual prevalence of any mood disorder was 5.2%, and of any anxiety disorder 4.7%. Major depressive episode was the most prevalent mood and anxiety disorder (4.8%), followed by social phobia, panic disorder, mania, and agoraphobia. Among people with mood and anxiety disorders, 22.4% had 2 or more disorders. Risk factors common to mood and anxiety disorders were being young, having lower household income, being unmarried, experiencing greater stress, having poorer mental health, and having a medical condition. Unique risk factors were found: major depressive episode and social phobia were associated with being born in Canada; panic disorder was associated with being Caucasian; lower education was associated with panic and agoraphobia; and poor physical health was associated with mania and agoraphobia. People who were young, unmarried, not fully employed, and had a medical condition, greater stress, poorer self-rated mental health, and dissatisfaction with life, were more likely to have a comorbid mood and (or) anxiety disorder. As the number of common risk factors increases, the probability of having mood and anxiety disorders also increases. Common and unique risk factors exist for mood and anxiety disorders. Risk factors are additive in increasing the likelihood of disease.

Integrated Systems Health Management as an Enabler for Condition Based Maintenance and Autonomic Logistics

DTIC Science & Technology

2015-09-17

turbines , SHM tools, maintenance scheduling, and performance of the SHM system determine the added value of the system of systems (A. Van Horenbeek...J. R., & Pintelon, L. (2013). Quantifying the added value of an imperfectly performing condition monitoring system— Application to a wind turbine ...INTEGRATED SYSTEMS HEALTH MANAGEMENT AS AN ENABLER FOR CONDITION BASED MAINTENANCE AND AUTONOMIC

A secure distributed logistic regression protocol for the detection of rare adverse drug events

PubMed Central

El Emam, Khaled; Samet, Saeed; Arbuckle, Luk; Tamblyn, Robyn; Earle, Craig; Kantarcioglu, Murat

2013-01-01

Background There is limited capacity to assess the comparative risks of medications after they enter the market. For rare adverse events, the pooling of data from multiple sources is necessary to have the power and sufficient population heterogeneity to detect differences in safety and effectiveness in genetic, ethnic and clinically defined subpopulations. However, combining datasets from different data custodians or jurisdictions to perform an analysis on the pooled data creates significant privacy concerns that would need to be addressed. Existing protocols for addressing these concerns can result in reduced analysis accuracy and can allow sensitive information to leak. Objective To develop a secure distributed multi-party computation protocol for logistic regression that provides strong privacy guarantees. Methods We developed a secure distributed logistic regression protocol using a single analysis center with multiple sites providing data. A theoretical security analysis demonstrates that the protocol is robust to plausible collusion attacks and does not allow the parties to gain new information from the data that are exchanged among them. The computational performance and accuracy of the protocol were evaluated on simulated datasets. Results The computational performance scales linearly as the dataset sizes increase. The addition of sites results in an exponential growth in computation time. However, for up to five sites, the time is still short and would not affect practical applications. The model parameters are the same as the results on pooled raw data analyzed in SAS, demonstrating high model accuracy. Conclusion The proposed protocol and prototype system would allow the development of logistic regression models in a secure manner without requiring the sharing of personal health information. This can alleviate one of the key barriers to the establishment of large-scale post-marketing surveillance programs. We extended the secure protocol to account for correlations among patients within sites through generalized estimating equations, and to accommodate other link functions by extending it to generalized linear models. PMID:22871397

A secure distributed logistic regression protocol for the detection of rare adverse drug events.

PubMed

El Emam, Khaled; Samet, Saeed; Arbuckle, Luk; Tamblyn, Robyn; Earle, Craig; Kantarcioglu, Murat

2013-05-01

There is limited capacity to assess the comparative risks of medications after they enter the market. For rare adverse events, the pooling of data from multiple sources is necessary to have the power and sufficient population heterogeneity to detect differences in safety and effectiveness in genetic, ethnic and clinically defined subpopulations. However, combining datasets from different data custodians or jurisdictions to perform an analysis on the pooled data creates significant privacy concerns that would need to be addressed. Existing protocols for addressing these concerns can result in reduced analysis accuracy and can allow sensitive information to leak. To develop a secure distributed multi-party computation protocol for logistic regression that provides strong privacy guarantees. We developed a secure distributed logistic regression protocol using a single analysis center with multiple sites providing data. A theoretical security analysis demonstrates that the protocol is robust to plausible collusion attacks and does not allow the parties to gain new information from the data that are exchanged among them. The computational performance and accuracy of the protocol were evaluated on simulated datasets. The computational performance scales linearly as the dataset sizes increase. The addition of sites results in an exponential growth in computation time. However, for up to five sites, the time is still short and would not affect practical applications. The model parameters are the same as the results on pooled raw data analyzed in SAS, demonstrating high model accuracy. The proposed protocol and prototype system would allow the development of logistic regression models in a secure manner without requiring the sharing of personal health information. This can alleviate one of the key barriers to the establishment of large-scale post-marketing surveillance programs. We extended the secure protocol to account for correlations among patients within sites through generalized estimating equations, and to accommodate other link functions by extending it to generalized linear models.

Carotid artery intima-media complex thickening in patients with relatively long-surviving type 1 diabetes mellitus.

PubMed

Distiller, Larry A; Joffe, Barry I; Melville, Vanessa; Welman, Tania; Distiller, Greg B

2006-01-01

The factors responsible for premature coronary atherosclerosis in patients with type 1 diabetes are ill defined. We therefore assessed carotid intima-media complex thickness (IMT) in relatively long-surviving patients with type 1 diabetes as a marker of atherosclerosis and correlated this with traditional risk factors. Cross-sectional study of 148 patients with relatively long-surviving (>18 years) type 1 diabetes (76 men and 72 women) attending the Centre for Diabetes and Endocrinology, Johannesburg. The mean common carotid artery IMT and presence or absence of plaque was evaluated by high-resolution B-mode ultrasound. Their median age was 48 years and duration of diabetes 26 years (range 18-59 years). Traditional risk factors (age, duration of diabetes, glycemic control, hypertension, smoking and lipoprotein concentrations) were recorded. Three response variables were defined and modeled. Standard multiple regression was used for a continuous IMT variable, logistic regression for the presence/absence of plaque and ordinal logistic regression to model three categories of "risk." The median common carotid IMT was 0.62 mm (range 0.44-1.23 mm) with plaque detected in 28 cases. The multiple regression model found significant associations between IMT and current age (P=.001), duration of diabetes (P=.033), BMI (P=.008) and diagnosed hypertension (P=.046) with HDL showing a protective effect (P=.022). Current age (P=.001) and diagnosed hypertension (P=.004), smoking (P=.008) and retinopathy (P=.033) were significant in the logistic regression model. Current age was also significant in the ordinal logistic regression model (P<.001), as was total cholesterol/HDL ratio (P<.001) and mean HbA(1c) concentration (P=.073). The major factors influencing common carotid IMT in patients with relatively long-surviving type 1 diabetes are age, duration of diabetes, existing hypertension and HDL (protective) with a relatively minor role ascribed to relatively long-standing glycemic control.

Associations between multimorbidity and additional burden for working-age adults with specific forms of musculoskeletal conditions: a cross-sectional study.

PubMed

Lowe, Dianne B; Taylor, Michael J; Hill, Sophie J

2017-04-04

Multiple health conditions are increasingly a problem for adults with musculoskeletal conditions. However, multimorbidity research has focused primarily on the elderly and those with a limited subset of musculoskeletal disorders. We sought to determine whether associations between multimorbidity and additional burden differ with specific forms of musculoskeletal conditions among working-age adults. Data were sourced from a nationally representative Australian survey. Specific musculoskeletal conditions examined were osteoarthritis; inflammatory arthritis; other forms of arthritis or arthropathies; musculoskeletal conditions not elsewhere specified; gout; back pain; soft tissue disorders; or osteoporosis. Multimorbidity was defined as the additional presence of one or more of the Australian National Health Priority Area conditions. Burden was assessed by self-reported measures of: (i) self-rated health (ii) musculoskeletal-related healthcare and medicines utilisation and, (iii) general healthcare utilisation. Associations between multimorbidity and additional health or healthcare utilisation burden among working-age adults (aged 18 - 64 years of age) with specific musculoskeletal conditions were estimated using logistic regression, adjusting for confounders. Interaction terms were fitted to identify whether there were specific musculoskeletal conditions where multimorbidity was more strongly associated with poorer health or greater healthcare utilisation than in the remaining musculoskeletal group. Among working-age adults, for each of the specified musculoskeletal conditions, multimorbidity was associated with similar, increased likelihood of additional self-rated health burden and certain types of healthcare utilisation. While there were differences in the relationships between multimorbidity and burden for each of the specific musculoskeletal conditions, no one specific musculoskeletal condition appeared to be consistently associated with greater additional health burden in the presence of multimorbidity across the majority of self-rated health burden and healthcare use measures. For working-age people with any musculoskeletal conditions examined here, multimorbidity increases self-reported health and healthcare utilisation burden. As no one musculoskeletal condition appears consistently worse off in the presence of multimorbidity, there is a need to better understand and identify strategies that acknowledge and address the additional burden of concomitant conditions for working-age adults with a range of musculoskeletal conditions.

On the multiple depots vehicle routing problem with heterogeneous fleet capacity and velocity

NASA Astrophysics Data System (ADS)

Hanum, F.; Hartono, A. P.; Bakhtiar, T.

2018-03-01

This current manuscript concerns with the optimization problem arising in a route determination of products distribution. The problem is formulated in the form of multiple depots and time windowed vehicle routing problem with heterogeneous capacity and velocity of fleet. Model includes a number of constraints such as route continuity, multiple depots availability and serving time in addition to generic constraints. In dealing with the unique feature of heterogeneous velocity, we generate a number of velocity profiles along the road segments, which then converted into traveling-time tables. An illustrative example of rice distribution among villages by bureau of logistics is provided. Exact approach is utilized to determine the optimal solution in term of vehicle routes and starting time of service.

Evaluating penalized logistic regression models to predict Heat-Related Electric grid stress days

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

Bramer, L. M.; Rounds, J.; Burleyson, C. D.

Understanding the conditions associated with stress on the electricity grid is important in the development of contingency plans for maintaining reliability during periods when the grid is stressed. In this paper, heat-related grid stress and the relationship with weather conditions is examined using data from the eastern United States. Penalized logistic regression models were developed and applied to predict stress on the electric grid using weather data. The inclusion of other weather variables, such as precipitation, in addition to temperature improved model performance. Several candidate models and datasets were examined. A penalized logistic regression model fit at the operation-zone levelmore » was found to provide predictive value and interpretability. Additionally, the importance of different weather variables observed at different time scales were examined. Maximum temperature and precipitation were identified as important across all zones while the importance of other weather variables was zone specific. The methods presented in this work are extensible to other regions and can be used to aid in planning and development of the electrical grid.« less

Evaluating penalized logistic regression models to predict Heat-Related Electric grid stress days

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

Bramer, Lisa M.; Rounds, J.; Burleyson, C. D.

Understanding the conditions associated with stress on the electricity grid is important in the development of contingency plans for maintaining reliability during periods when the grid is stressed. In this paper, heat-related grid stress and the relationship with weather conditions were examined using data from the eastern United States. Penalized logistic regression models were developed and applied to predict stress on the electric grid using weather data. The inclusion of other weather variables, such as precipitation, in addition to temperature improved model performance. Several candidate models and combinations of predictive variables were examined. A penalized logistic regression model which wasmore » fit at the operation-zone level was found to provide predictive value and interpretability. Additionally, the importance of different weather variables observed at various time scales were examined. Maximum temperature and precipitation were identified as important across all zones while the importance of other weather variables was zone specific. In conclusion, the methods presented in this work are extensible to other regions and can be used to aid in planning and development of the electrical grid.« less

Evaluating penalized logistic regression models to predict Heat-Related Electric grid stress days

DOE PAGES

Bramer, Lisa M.; Rounds, J.; Burleyson, C. D.; ...

2017-09-22

Understanding the conditions associated with stress on the electricity grid is important in the development of contingency plans for maintaining reliability during periods when the grid is stressed. In this paper, heat-related grid stress and the relationship with weather conditions were examined using data from the eastern United States. Penalized logistic regression models were developed and applied to predict stress on the electric grid using weather data. The inclusion of other weather variables, such as precipitation, in addition to temperature improved model performance. Several candidate models and combinations of predictive variables were examined. A penalized logistic regression model which wasmore » fit at the operation-zone level was found to provide predictive value and interpretability. Additionally, the importance of different weather variables observed at various time scales were examined. Maximum temperature and precipitation were identified as important across all zones while the importance of other weather variables was zone specific. In conclusion, the methods presented in this work are extensible to other regions and can be used to aid in planning and development of the electrical grid.« less

An Experimental Realization of a Chaos-Based Secure Communication Using Arduino Microcontrollers

PubMed Central

Zapateiro De la Hoz, Mauricio; Vidal, Yolanda

2015-01-01

Security and secrecy are some of the important concerns in the communications world. In the last years, several encryption techniques have been proposed in order to improve the secrecy of the information transmitted. Chaos-based encryption techniques are being widely studied as part of the problem because of the highly unpredictable and random-look nature of the chaotic signals. In this paper we propose a digital-based communication system that uses the logistic map which is a mathematically simple model that is chaotic under certain conditions. The input message signal is modulated using a simple Delta modulator and encrypted using a logistic map. The key signal is also encrypted using the same logistic map with different initial conditions. In the receiver side, the binary-coded message is decrypted using the encrypted key signal that is sent through one of the communication channels. The proposed scheme is experimentally tested using Arduino shields which are simple yet powerful development kits that allows for the implementation of the communication system for testing purposes. PMID:26413563

Attack to AN Image Encryption Based on Chaotic Logistic Map

NASA Astrophysics Data System (ADS)

Wang, Xing-Yuan; Chen, Feng; Wang, Tian; Xu, Dahai; Ma, Yutian

2013-10-01

This paper offers two different attacks on a freshly proposed image encryption based on chaotic logistic map. The cryptosystem under study first uses a secret key of 80-bit and employed two chaotic logistic maps. We derived the initial conditions of the logistic maps from using the secret key by providing different weights to all its bits. Additionally, in this paper eight different types of procedures are used to encrypt the pixels of an image in the proposed encryption process of which one of them will be used for a certain pixel which is determined by the product of the logistic map. The secret key is revised after encrypting each block which consisted of 16 pixels of the image. The encrypting process have weakness, worst of which is that every byte of plaintext is independent when substituted, so the cipher text of the byte will not change even the other bytes have changed. As a result of weakness, a chosen plaintext attack and a chosen cipher text attack can be completed without any knowledge of the key value to recuperate the ciphered image.

Vehicle Scheduling Schemes for Commercial and Emergency Logistics Integration

PubMed Central

Li, Xiaohui; Tan, Qingmei

2013-01-01

In modern logistics operations, large-scale logistics companies, besides active participation in profit-seeking commercial business, also play an essential role during an emergency relief process by dispatching urgently-required materials to disaster-affected areas. Therefore, an issue has been widely addressed by logistics practitioners and caught researchers' more attention as to how the logistics companies achieve maximum commercial profit on condition that emergency tasks are effectively and performed satisfactorily. In this paper, two vehicle scheduling models are proposed to solve the problem. One is a prediction-related scheme, which predicts the amounts of disaster-relief materials and commercial business and then accepts the business that will generate maximum profits; the other is a priority-directed scheme, which, firstly groups commercial and emergency business according to priority grades and then schedules both types of business jointly and simultaneously by arriving at the maximum priority in total. Moreover, computer-based simulations are carried out to evaluate the performance of these two models by comparing them with two traditional disaster-relief tactics in China. The results testify the feasibility and effectiveness of the proposed models. PMID:24391724

Vehicle scheduling schemes for commercial and emergency logistics integration.

PubMed

Li, Xiaohui; Tan, Qingmei

2013-01-01

In modern logistics operations, large-scale logistics companies, besides active participation in profit-seeking commercial business, also play an essential role during an emergency relief process by dispatching urgently-required materials to disaster-affected areas. Therefore, an issue has been widely addressed by logistics practitioners and caught researchers' more attention as to how the logistics companies achieve maximum commercial profit on condition that emergency tasks are effectively and performed satisfactorily. In this paper, two vehicle scheduling models are proposed to solve the problem. One is a prediction-related scheme, which predicts the amounts of disaster-relief materials and commercial business and then accepts the business that will generate maximum profits; the other is a priority-directed scheme, which, firstly groups commercial and emergency business according to priority grades and then schedules both types of business jointly and simultaneously by arriving at the maximum priority in total. Moreover, computer-based simulations are carried out to evaluate the performance of these two models by comparing them with two traditional disaster-relief tactics in China. The results testify the feasibility and effectiveness of the proposed models.

Combination of a Stressor-Response Model with a Conditional Probability Analysis Approach for Developing Candidate Criteria from MBSS

EPA Science Inventory

I show that a conditional probability analysis using a stressor-response model based on a logistic regression provides a useful approach for developing candidate water quality criteria from empirical data, such as the Maryland Biological Streams Survey (MBSS) data.

A Comparison of Strategies for Estimating Conditional DIF

ERIC Educational Resources Information Center

Moses, Tim; Miao, Jing; Dorans, Neil J.

2010-01-01

In this study, the accuracies of four strategies were compared for estimating conditional differential item functioning (DIF), including raw data, logistic regression, log-linear models, and kernel smoothing. Real data simulations were used to evaluate the estimation strategies across six items, DIF and No DIF situations, and four sample size…

Detection of Uniform and Nonuniform Differential Item Functioning by Item-Focused Trees

ERIC Educational Resources Information Center

Berger, Moritz; Tutz, Gerhard

2016-01-01

Detection of differential item functioning (DIF) by use of the logistic modeling approach has a long tradition. One big advantage of the approach is that it can be used to investigate nonuniform (NUDIF) as well as uniform DIF (UDIF). The classical approach allows one to detect DIF by distinguishing between multiple groups. We propose an…

A Comparison of Graded Response and Rasch Partial Credit Models with Subjective Well-Being.

ERIC Educational Resources Information Center

Baker, John G.; Rounds, James B.; Zevon, Michael A.

2000-01-01

Compared two multiple category item response theory models using a data set of 52 mood terms with 713 undergraduate psychology students. Comparative model fit for the Samejima (F. Samejima, 1966) logistic model for graded responses and the Masters (G. Masters, 1982) partial credit model favored the former model for this data set. (SLD)

Prospective Prediction of Functional Difficulties among Recently Separated Veterans

DTIC Science & Technology

2014-01-01

while factors following separation from the military have a primary role in predicting functional difficulties during reintegration into civilian...and protective factors for functional difficulties among Veterans. In a sample of recently separated Marines, we used stepwise logistic and multiple...military, posttraumatic stress disorder, prospective, PTSD, reintegration, risk factors , Veterans, work functioning . INTRODUCTION Studies suggest that Iraq

Effects of Parental Divorce or a Father's Death on High School Completion

ERIC Educational Resources Information Center

Sapharas, Nicole K.; Estell, David B.; Doran, Kelly A.; Waldron, Mary

2016-01-01

Associations between parental loss and high school (HS) completion were examined in data drawn from 1,761 male and 1,689 female offspring born in wedlock to mothers participating in a nationally representative study. Multiple logistic regression models were conducted predicting HS completion by age 19 among offspring whose parents divorced or…

Development and evaluation of habitat models for herpetofauna and small mammals

Treesearch

William M. Block; Michael L. Morrison; Peter E. Scott

1998-01-01

We evaluated the ability of discriminant analysis (DA), logistic regression (LR), and multiple regression (MR) to describe habitat use by amphibians, reptiles, and small mammals found in California oak woodlands. We also compared models derived from pitfall and live trapping data for several species. Habitat relations modeled by DA and LR produced similar results,...

A Nationwide Epidemiologic Modeling Study of LD: Risk, Protection, and Unintended Impact

ERIC Educational Resources Information Center

McDermott, Paul A.; Goldberg, Michelle M.; Watkins, Marley W.; Stanley, Jeanne L.; Glutting, Joseph J.

2006-01-01

Through multiple logistic regression modeling, this article explores the relative importance of risk and protective factors associated with learning disabilities (LD). A representative national sample of 6- to 17-year-old students (N = 1,268) was drawn by random stratification and classified by the presence versus absence of LD in reading,…

Characteristics and Psychosocial Predictors of Adolescent Nonsuicidal Self-Injury in Residential Care

ERIC Educational Resources Information Center

Gallant, Jason; Snyder, Gregory S.; von der Embse, Nathaniel P.

2014-01-01

This study examined characteristics and biopsychosocial predictors of nonsuicidal self-injury in a sample (N = 753) of youth in residential care admitted between 2005 and 2010. To model the data, the authors used t-tests, chi-square tests, and multiple logistic regressions stratified by gender. Results suggested that 12% of youth engaged in…

Multi scale habitat relationships of Martes americana in northern Idaho, U.S.A.

Treesearch

Tzeidle N. Wasserman; Samuel A. Cushman; David O. Wallin; Jim Hayden

2012-01-01

We used bivariate scaling and logistic regression to investigate multiple-scale habitat selection by American marten (Martes americana). Bivariate scaling reveals dramatic differences in the apparent nature and strength of relationships between marten occupancy and a number of habitat variables across a range of spatial scales. These differences include reversals in...

Sustainability Criteria for Contingency Bases

DTIC Science & Technology

2014-09-01

and construction sustainability pro - grams and identified concepts, guidelines, and practices relevant to mili- tary contingency infrastructure...incorporate best practices in force pro - tection, e.g., facility spacing to limit damage to multiple buildings from a single incoming rocket or mortar...The Logistics Civil Augmentation Program (LOGCAP) is a program administered by the US Army to pro - vide contingency support

SPSS Syntax for Missing Value Imputation in Test and Questionnaire Data

ERIC Educational Resources Information Center

van Ginkel, Joost R.; van der Ark, L. Andries

2005-01-01

A well-known problem in the analysis of test and questionnaire data is that some item scores may be missing. Advanced methods for the imputation of missing data are available, such as multiple imputation under the multivariate normal model and imputation under the saturated logistic model (Schafer, 1997). Accompanying software was made available…

Sociodemographic and social contextual predictors of multiple health behavior change: data from the Healthy Directions-Small Business study.

PubMed

Harley, Amy E; Sapp, Amy L; Li, Yi; Marino, Miguel; Quintiliani, Lisa M; Sorensen, Glorian

2013-03-01

Multiple modifiable health behaviors contribute to the chronic diseases that are the leading causes of death in the USA. Disparities for meeting recommended health behavior guidelines exist across occupational classes and socioeconomic levels. The purpose of this paper was to investigate sociodemographic and social contextual predictors of multiple health behavior change in a worksite intervention. We analyzed data on four diet and exercise variables from an intervention trial with worksite-level randomization. Eight hundred forty-one employees had complete data from baseline (response rate = 84 %) and follow-up surveys (response rate = 77 %). Multilevel logistic regression estimated associations between least absolute shrinkage and selection operator-selected sociodemographic and social contextual predictor variables and the multiple health behavior change outcome (changing 2+ versus 0 behaviors). Gender, being married/partnered, and perceived discrimination were significantly associated with multiple health behavior change. Sociodemographic and social contextual factors predict multiple health behavior change and could inform the design and delivery of worksite interventions targeting multiple health behaviors.

Advanced Statistics for Exotic Animal Practitioners.

PubMed

Hodsoll, John; Hellier, Jennifer M; Ryan, Elizabeth G

2017-09-01

Correlation and regression assess the association between 2 or more variables. This article reviews the core knowledge needed to understand these analyses, moving from visual analysis in scatter plots through correlation, simple and multiple linear regression, and logistic regression. Correlation estimates the strength and direction of a relationship between 2 variables. Regression can be considered more general and quantifies the numerical relationships between an outcome and 1 or multiple variables in terms of a best-fit line, allowing predictions to be made. Each technique is discussed with examples and the statistical assumptions underlying their correct application. Copyright © 2017 Elsevier Inc. All rights reserved.

Prevalence and psychosocial risk factors of upper extremity musculoskeletal pain in industries of Taiwan: a nationwide study.

PubMed

Lee, Hsin-Yi; Yeh, Wen-Yu; Chen, Chun-Wan; Wang, Jung-Der

2005-07-01

Prevalence of upper extremity disorders and their associations with psychosocial factors in the workplace have received more attention recently. A national survey of cross-sectional design was performed to determine the prevalence rates of upper extremity disorders among different industries. Trained interviewers administered questionnaires to 17,669 workers and data on musculoskeletal complaints were obtained along with information on risk factors. Overall the 1-year prevalence of neck (14.8%), shoulder (16.6%), and hand (12.4%) disorders were higher than those of the upper back (7.1%) and elbow (8.3%) among those who sought medical treatment due to the complaint. Workers in construction and agriculture-related industries showed a higher prevalence of upper extremity disorders. After multiple logistic regression adjusted for age, education, and employment duration, we found job content, physical working condition, a harmonious interpersonal relationship at the workplace and organizational problems were significant determinants of upper extremity disorders in manufacturing and service industries. Male workers in manufacturing industries showed more concern about physical working conditions while female workers in public administration emphasized problems of job content and interpersonal relationships. We concluded that these factors were major job stressors contributing to musculoskeletal pain of the upper extremity.

[Sanitation and racial inequality conditions in urban Brazil: an analysis focused on the indigenous population based on the 2010 Population Census].

PubMed

Raupp, Ludimila; Fávaro, Thatiana Regina; Cunha, Geraldo Marcelo; Santos, Ricardo Ventura

2017-01-01

The aims of this study were to analyze and describe the presence and infrastructure of basic sanitation in the urban areas of Brazil, contrasting indigenous with non-indigenous households. Methods: A cross-sectional study based on microdata from the 2010 Census was conducted. The analyses were based on descriptive statistics (prevalence) and the construction of multiple logistic regression models (adjusted by socioeconomic and demographic covariates). The odds ratios were estimated for the association between the explanatory variables (covariates) and the outcome variables (water supply, sewage, garbage collection, and adequate sanitation). The statistical significance level established was 5%. Among the analyzed services, sewage proved to be the most precarious. Regarding race or color, indigenous households presented the lowest rate of sanitary infrastructure in Urban Brazil. The adjusted regression showed that, in general, indigenous households were at a disadvantage when compared to other categories of race or color, especially in terms of the presence of garbage collection services. These inequalities were much more pronounced in the South and Southeastern regions. The analyses of this study not only confirm the profile of poor conditions and infrastructure of the basic sanitation of indigenous households in urban areas, but also demonstrate the persistence of inequalities associated with race or color in the country.

Health inequalities in later life in a social democratic welfare state.

PubMed

Dahl, E; Birkelund, G E

1997-03-01

The paper examines inequalities in mental health and "serious" illness, i.e. illness with significant consequences, among 964 men and women aged 65 and over in Norway. The aim is to analyse the extent to which the assumed class differentials in ill health in later life are accounted for by current socioeconomic circumstances and social and economic conditions during upbringing. Multiple logistic regression analyses suggest that the bivariate relationship between previous class location and present health condition among elderly men remains or may be attributed to current income. For women, their previous class location is not significantly related to either health outcome. However, women's current income and present economic difficulties are significantly related to both health measures in the expected direction. In addition, serious illness is related to long-standing illness in childhood, and poorer mental health is associated with economic hardship in childhood and dissension in the family of upbringing. For neither sex was father's social class during upbringing an important predictor of ill health. It is concluded that health inequalities in later life may, at least to some extent, be attributed to the "legacy of the past", and that the social democratic welfare state has not succeeded in eradicating health inequalities despite its egalitarian age pension policy.

Targeted Calorie Message Promotes Healthy Beverage Consumption Better than Charity Incentive.

PubMed

Policastro, Peggy; Palm, Taylor; Schwartz, Janet; Chapman, Gretchen

2017-08-01

Sugar-sweetened beverage (SSB) consumption is cited as a major contributor to the U.S. obesity epidemic. The objective of this paper was to leverage insights from behavioral economics to examine whether nudges would entice college students to save meal calories by choosing water over SSBs. Three message-based nudge interventions, with washout periods between, were used during the 7-week study. Calorie savings (self-interest), charity (prosocial), or charity-plus-calorie message posters were displayed in a college-based food franchise. Multilevel logistic regressions compared the proportions of students choosing water during three experimental conditions. This study assessed whether the frequency of dining establishment visits over the study period moderated effects of the experimental conditions on beverage choices. Multiple data points from the same customer were treated as repeated measures. A total of 2,393 unique students purchased 6,730 meals. Posters displaying calorie information increased water choice relative to washout periods, while the poster without calorie information (charity only) had no effect. Controlling for fixed effects produced the same results. The calorie message poster influenced less frequent diners more than frequent diners. Food-service operations can nudge college students to substitute water for SSBs with a simple calorie-based message to save hundreds of calories per meal. © 2017 The Obesity Society.

Health status of radiation exposed residents living near the Semipalatinsk Nuclear Test Site based on health assessment by interview.

PubMed

Hirabayashi, Kyoko; Kawano, Noriyuki; Ohtaki, Megu; Harada, Yuka; Harada, Hironori; Muldagaliyev, Talgat; Apsalikov, Kazbek; Hoshi, Masaharu

2008-03-01

The purpose of the present paper is to examine the aftereffects of radiation exposure on residents of villages near the Semipalatinsk Nuclear Test Site (SNTS) in Kazakhstan. Our Hiroshima University (Japan) research team began field research in 2002 by means of health assessments conducted via interviews. We focus on persons who responded to questions concerning their medical conditions and symptoms. In this paper, we summarize and analyze, using multiple linear logistic regression analysis, the answers obtained by questionnaire survey. The results show: (1) 31% of the residents reported that they felt bad or were in very poor health. (2) Residents living in villages having higher radiation levels were more likely to report having poor or very poor health, minor complaints such as loss of sleep, headaches, nighttime sweating and swollen arms or legs, and the need for nursing care in performing activities of daily living. (3) Symptoms reported by over 40% of the respondents included high blood pressure, heart disease and arthralgia/ lower back pain/ arthritis. Our results suggest that radiation exposure in the Semipalatinsk area is one of the causes of poor health in general among residents. There is also a possibility that radiation exposure has influenced the incidence of some specific medical conditions.

Wheezing conditions in early childhood: prevalence and risk factors in the city of São Paulo, Brazil.

PubMed Central

Benício, Maria Helena D.; Ferreira, Marcelo U.; Cardoso, Maria Regina A.; Konno, Sílvia C.; Monteiro, Carlos A.

2004-01-01

OBJECTIVE: To investigate the prevalence and risk factors for wheezing disorders in early childhood in São Paulo, Brazil, the largest metropolitan area of South America. METHODS: A population-based cross-sectional survey of 1132 children aged 6-59 months was carried out between 1995 and 1996 to obtain information on recent wheezing and on independent variables such as demographic, socioeconomic, environmental, maternal and nutritional variables and immunization status. Intestinal parasitic infections were diagnosed using standard techniques. Multiple unconditional logistic regression was used to describe associations between outcome and independent variables. FINDINGS: The prevalence of recent wheezing (one or more reported episodes in the past 12 months) was 12.5%; 93% of children with wheezing were also reported to have a medical diagnosis of asthma. Recent wheezing was associated with low per capita income, poor quality of housing, day-care attendance, low birth weight and infection with intestinal helminths. CONCLUSION: Wheezing in early childhood in São Paulo, although more common than in most developing countries, remains less prevalent than in urban areas of industrialized countries. Low income and conditions associated with poverty (poor housing, low birth weight and parasitic infections) are some of the main risk factors for wheezing disorders among young children in this city. PMID:15508196

Life Cycle Assessment Comparing the Use of Jatropha Biodiesel in the Indian Road and Rail Sectors

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

Whitaker, M.; Heath, G.

2010-05-01

This life cycle assessment of Jatropha biodiesel production and use evaluates the net greenhouse gas (GHG) emission (not considering land-use change), net energy value (NEV), and net petroleum consumption impacts of substituting Jatropha biodiesel for conventional petroleum diesel in India. Several blends of biodiesel with petroleum diesel are evaluated for the rail freight, rail passenger, road freight, and road-passenger transport sectors that currently rely heavily on petroleum diesel. For the base case, Jatropha cultivation, processing, and use conditions that were analyzed, the use of B20 results in a net reduction in GHG emissions and petroleum consumption of 14% and 17%,more » respectively, and a NEV increase of 58% compared with the use of 100% petroleum diesel. While the road-passenger transport sector provides the greatest sustainability benefits per 1000 gross tonne kilometers, the road freight sector eventually provides the greatest absolute benefits owing to substantially higher projected utilization by year 2020. Nevertheless, introduction of biodiesel to the rail sector might present the fewest logistic and capital expenditure challenges in the near term. Sensitivity analyses confirmed that the sustainability benefits are maintained under multiple plausible cultivation, processing, and distribution scenarios. However, the sustainability of any individual Jatropha plantation will depend on site-specific conditions.« less

Associations between gender-based violence and personality disorders in U.S. women.

PubMed

Walsh, Kate; Hasin, Deborah; Keyes, Katherine M; Koenen, Karestan C

2016-04-01

Gender-based violence (GBV) is prevalent and associated with deleterious outcomes including posttraumatic stress disorder, depression, and substance use disorders. Despite substantial comorbidity between these conditions and personality disorders (PDs), few, if any, studies have examined associations between lifetime exposure to GBV and risk for a range of PDs in nationally representative U.S. The current study addressed this gap in the literature by examining adjusted odds ratios (aORs) and population attributable fractions (PAFs) of 10 PDs by lifetime GBV exposure. Participants were 20,089 women who participated in wave 2 (2004-2005) of the National Epidemiologic Survey of Alcohol and Related Conditions. Lifetime GBV and PD were reported by 25% and 20% of women, respectively. Logistic regressions indicated that women with GBV had 3.5 times the odds of lifetime PD; aORs ranged from 2.3 to 6.3 for Schizoid and Borderline PD, respectively. GBV was associated with 38% of all PD cases, and women who had experienced all 3 GBV types had 8.5 times the odds of PD compared to nonvictims. Preventing GBV, particularly multitype GBV, may be critical to reducing the burden of PDs. Clinicians working with GBV victims should consider assessing PDs and providing treatment targeting multiple outcomes. (c) 2016 APA, all rights reserved).

Psychosocial work environment and its association with socioeconomic status. A comparison of Spain and Denmark.

PubMed

Moncada, Salvador; Pejtersen, Jan Hyld; Navarro, Albert; Llorens, Clara; Burr, Hermann; Hasle, Peter; Bjorner, Jakob Bue

2010-02-01

The purpose of this study was to describe psychosocial work environment inequalities among wage earners in Spain and Denmark. Data came from the Spanish COPSOQ (ISTAS 21) and the Danish COPSOQ II surveys both performed in 2004-05 and based on national representative samples of employees with a 60% response rate. Study population was 3,359 Danish and 6,685 Spanish women and men. Only identical items from both surveys were included to construct 18 psychosocial scales. Socioeconomic status was categorized according to the European Socioeconomic Classification System. Analysis included ordinal logistic regression and multiple correspondence analysis after categorizing all scales. A relationship between socioeconomic status and psychosocial work environment in both Denmark and Spain was observed, with wider social inequalities in Spain for many scales, describing a strong interaction effect between socioeconomic status and country. Socioeconomic status is related to psychosocial work environment and some adverse psychosocial conditions tend to cluster in lower socioeconomic status groups in both Spain and Denmark. This effect could be modified by a country's characteristics, such as economic and labour market structures, normative regulations and industrial relations including work organization. Hence, preventive strategies to reduce social inequalities in working conditions should consider the combination of actions at the macro and micro levels.

Real-world implications of apathy among older adults: Independent associations with activities of daily living and quality of life.

PubMed

Tierney, Savanna M; Woods, Steven Paul; Weinborn, Michael; Bucks, Romola S

2018-03-13

Apathy is common in older adults and has been linked to adverse health outcomes. The current study examined whether apathy contributes to problems managing activities of daily living (ADLs) and lower quality of life (QoL) in older adults. Participants included 83 community-dwelling older adults. Apathy was assessed using a composite of the self and family-rating scales from the Frontal Systems Behavioral Scale (FrSBe). A knowledgeable informant completed the Activities of Daily Living Questionnaire (ADLQ), and participants completed the World Health Organization Quality of Life (WHOQol) scale. Nominal logistic regressions controlling for age, anxiety and depression symptoms, chronic medical conditions, and global cognition revealed that higher levels of apathy were significantly associated with a wide range of mild ADL problems. In parallel, a multiple linear regression indicated that greater apathy was significantly associated with lower QoL independent of ADL problems, anxious and depressive symptomology, chronic medical conditions, global cognition and age. Findings suggest that apathy confers an increased risk of problems in the independent management of daily activities and poorer well-being among community-dwelling older adults. Neurobehavioral and pharmacological interventions to improve apathy may have beneficial effects on the daily lives of older adults.

Congruence or discrepancy? Comparing patients' health valuations and physicians' treatment goals for rehabilitation for patients with chronic conditions.

PubMed

Nagl, Michaela; Farin, Erik

2012-03-01

The aim of this study was to test the congruence of patients' health valuations and physicians' treatment goals for the rehabilitation of chronically ill patients. In addition, patient characteristics associated with greater or less congruence were to be determined. In a questionnaire study, patients' health valuations and physicians' goals were assessed in three chronic conditions [breast cancer (BC), chronic ischemic heart disease (CIHD), and chronic back pain (CBP)] using a ranking method. Sociodemographic variables and health-related quality of life were assessed as patient-related factors that influence congruence. Congruence was determined at the group (Spearman's ρ) and individual levels (percentage of congruence). Patient-related influencing factors were calculated after a simple imputation using multiple logistic regression analysis. At the group level, there were often only low correlations. The mean percentage of congruence was 34.7% (BC), 48.5% (CIHD), and 31.9% (CBP). Patients with BC or CIHD who have a higher level of education showed greater congruence. Our results indicate some high discrepancy rates between physicians' treatment goals and patients' health valuations. It is possible that patients have preferences that do not correspond well with realistic rehabilitation goals or that physicians do not take patients' individual health valuations sufficiently into consideration when setting goals.

Missing data treatments matter: an analysis of multiple imputation for anterior cervical discectomy and fusion procedures.

PubMed

Ondeck, Nathaniel T; Fu, Michael C; Skrip, Laura A; McLynn, Ryan P; Cui, Jonathan J; Basques, Bryce A; Albert, Todd J; Grauer, Jonathan N

2018-04-09

The presence of missing data is a limitation of large datasets, including the National Surgical Quality Improvement Program (NSQIP). In addressing this issue, most studies use complete case analysis, which excludes cases with missing data, thus potentially introducing selection bias. Multiple imputation, a statistically rigorous approach that approximates missing data and preserves sample size, may be an improvement over complete case analysis. The present study aims to evaluate the impact of using multiple imputation in comparison with complete case analysis for assessing the associations between preoperative laboratory values and adverse outcomes following anterior cervical discectomy and fusion (ACDF) procedures. This is a retrospective review of prospectively collected data. Patients undergoing one-level ACDF were identified in NSQIP 2012-2015. Perioperative adverse outcome variables assessed included the occurrence of any adverse event, severe adverse events, and hospital readmission. Missing preoperative albumin and hematocrit values were handled using complete case analysis and multiple imputation. These preoperative laboratory levels were then tested for associations with 30-day postoperative outcomes using logistic regression. A total of 11,999 patients were included. Of this cohort, 63.5% of patients had missing preoperative albumin and 9.9% had missing preoperative hematocrit. When using complete case analysis, only 4,311 patients were studied. The removed patients were significantly younger, healthier, of a common body mass index, and male. Logistic regression analysis failed to identify either preoperative hypoalbuminemia or preoperative anemia as significantly associated with adverse outcomes. When employing multiple imputation, all 11,999 patients were included. Preoperative hypoalbuminemia was significantly associated with the occurrence of any adverse event and severe adverse events. Preoperative anemia was significantly associated with the occurrence of any adverse event, severe adverse events, and hospital readmission. Multiple imputation is a rigorous statistical procedure that is being increasingly used to address missing values in large datasets. Using this technique for ACDF avoided the loss of cases that may have affected the representativeness and power of the study and led to different results than complete case analysis. Multiple imputation should be considered for future spine studies. Copyright © 2018 Elsevier Inc. All rights reserved.

Relating induced in situ conditions of raw chicken breast meat to pinking.

PubMed

Holownia, K; Chinnan, M S; Reynolds, A E; Davis, J W

2004-01-01

Our objective was to simulate the pink color defect in cooked chicken breast meat with treatment combinations that would induce measurable changes in the conditions of raw meat. In addition, the feasibility of using induced raw meat conditions to develop a logistic regression model for prediction of pinking was studied. Approximately 960 breast fillets from 2 plants with 2 replications were used for inducing in situ conditions with 16 combinations of sodium chloride, sodium tripolyphosphate, sodium erythorbate, and sodium nitrite (present and not present). Muscles in all treatments were subjected to individual injections, followed by tumbling, cooking, and chilling. Raw samples were analyzed for pH, oxidation-reduction potential, and pigment evaluation. Results indicated a significant role of induced in situ conditions of raw meat in the occurrence of pinking. Presence of 1 ppm or more of sodium nitrite in raw meat produced significant pinking of cooked meat. The light muscle color group was least affected and the dark group was most affected by induced pH, oxidation-reduction potential conditions, and metmyoglobin and nitrosopigment content. The predictive ability of the logistic model was more than 90% with nitrosopigment, pH, and reducing conditions being the most important factors. Moreover, validation of the model was confirmed by close association between observed pink samples and those predicted as pink.

Employment of persons with spinal cord lesions injured more than 20 years ago.

PubMed

Lidal, Ingeborg Beate; Hjeltnes, Nils; Røislien, Jo; Stanghelle, Johan Kvalvik; Biering-Sørensen, Fin

2009-01-01

The primary objective was to study factors influencing post-injury employment and withdrawal from work in persons who sustained traumatic spinal cord injury (SCI) more than 20 years ago. A secondary objective was to study life satisfaction in the same patients. A cross-sectional study with retrospective data of 165 SCI-patients admitted to Sunnaas Rehabilitation Hospital 1961-1982. Multiple logistic regression was used to identify predictors for obtaining work post-injury. A Cox proportional hazards regression model was used to study factors influencing early withdrawal from work, i.e. time from injury until discontinuing employment. Sixty-five percent of the participants were employed at some point after the injury. Thirty-five percent still had work at the time of the survey. The odds of obtaining work after injury were higher in persons of younger age at injury, higher in males versus females, higher for persons with paraplegia versus tetraplegia, and for persons classified as Frankel D-E compared to a more severe SCI. Factors associated with shorter time from injury until discontinuing employment were higher age at injury, incidence of injury after 1975 versus before, and a history of pre-injury medical condition(s). Life satisfaction was better for currently employed participants. The study indicates a low employment-rate in persons with SCI, even several years after injury. From the results, we suggest more support, especially to persons of older age at injury and/or with a history of pre-injury medical condition(s), to help them to obtain work and sustain employed for more years after injury.

A longitudinal study of youth assets, neighborhood conditions, and youth sexual behaviors.

PubMed

Oman, Roy F; Vesely, Sara K; Aspy, Cheryl B; Tolma, Eleni L; Gavin, Lorrie; Bensyl, Diana M; Mueller, Trisha; Fluhr, Janene D

2013-06-01

To prospectively determine whether individual, family, and community assets help youth to delay initiation of sexual intercourse (ISI); and for youth who do initiate intercourse, to use birth control and avoid pregnancy. The potential influence of neighborhood conditions was also investigated. The Youth Asset Study was a 4-year longitudinal study involving 1,089 youth (mean age = 14.2 years, standard deviation = 1.6; 53% female; 40% white, 28% Hispanic, 23% African American, 9% other race) and their parents. Participants were living in randomly selected census tracts. We accomplished recruitment via door-to-door canvassing. We interviewed one youth and one parent from each household annually. We assessed 17 youth assets (e.g., responsible choices, family communication) believed to influence behavior at multiple levels via in-person interviews methodology. Trained raters who conducted annual windshield tours assessed neighborhood conditions. Cox proportional hazard or marginal logistic regression modeling indicated that 11 assets (e.g., family communication, school connectedness) were significantly associated with reduced risk for ISI; seven assets (e.g., educational aspirations for the future, responsible choices) were significantly associated with increased use of birth control at last sex; and 10 assets (e.g., family communication, school connectedness) were significantly associated with reduced risk for pregnancy. Total asset score was significantly associated with all three outcomes. Positive neighborhood conditions were significantly associated with increased birth control use, but not with ISI or pregnancy. Programming to strengthen youth assets may be a promising strategy for reducing youth sexual risk behaviors. Copyright © 2013 Society for Adolescent Health and Medicine. All rights reserved.

Logistics Lessons Learned in NASA Space Flight

NASA Technical Reports Server (NTRS)

Evans, William A.; DeWeck, Olivier; Laufer, Deanna; Shull, Sarah

2006-01-01

The Vision for Space Exploration sets out a number of goals, involving both strategic and tactical objectives. These include returning the Space Shuttle to flight, completing the International Space Station, and conducting human expeditions to the Moon by 2020. Each of these goals has profound logistics implications. In the consideration of these objectives,a need for a study on NASA logistics lessons learned was recognized. The study endeavors to identify both needs for space exploration and challenges in the development of past logistics architectures, as well as in the design of space systems. This study may also be appropriately applied as guidance in the development of an integrated logistics architecture for future human missions to the Moon and Mars. This report first summarizes current logistics practices for the Space Shuttle Program (SSP) and the International Space Station (ISS) and examines the practices of manifesting, stowage, inventory tracking, waste disposal, and return logistics. The key findings of this examination are that while the current practices do have many positive aspects, there are also several shortcomings. These shortcomings include a high-level of excess complexity, redundancy of information/lack of a common database, and a large human-in-the-loop component. Later sections of this report describe the methodology and results of our work to systematically gather logistics lessons learned from past and current human spaceflight programs as well as validating these lessons through a survey of the opinions of current space logisticians. To consider the perspectives on logistics lessons, we searched several sources within NASA, including organizations with direct and indirect connections with the system flow in mission planning. We utilized crew debriefs, the John Commonsense lessons repository for the JSC Mission Operations Directorate, and the Skylab Lessons Learned. Additionally, we searched the public version of the Lessons Learned Information System (LLIS) and verified that we received the same result using the internal version of LLIS for our logistics lesson searches. In conducting the research, information from multiple databases was consolidated into a single spreadsheet of 300 lessons learned. Keywords were applied for the purpose of sorting and evaluation. Once the lessons had been compiled, an analysis of the resulting data was performed, first sorting it by keyword, then finding duplication and root cause, and finally sorting by root cause. The data was then distilled into the top 7 lessons learned across programs, centers, and activities.

CUSUM-Logistic Regression analysis for the rapid detection of errors in clinical laboratory test results.

PubMed

Sampson, Maureen L; Gounden, Verena; van Deventer, Hendrik E; Remaley, Alan T

2016-02-01

The main drawback of the periodic analysis of quality control (QC) material is that test performance is not monitored in time periods between QC analyses, potentially leading to the reporting of faulty test results. The objective of this study was to develop a patient based QC procedure for the more timely detection of test errors. Results from a Chem-14 panel measured on the Beckman LX20 analyzer were used to develop the model. Each test result was predicted from the other 13 members of the panel by multiple regression, which resulted in correlation coefficients between the predicted and measured result of >0.7 for 8 of the 14 tests. A logistic regression model, which utilized the measured test result, the predicted test result, the day of the week and time of day, was then developed for predicting test errors. The output of the logistic regression was tallied by a daily CUSUM approach and used to predict test errors, with a fixed specificity of 90%. The mean average run length (ARL) before error detection by CUSUM-Logistic Regression (CSLR) was 20 with a mean sensitivity of 97%, which was considerably shorter than the mean ARL of 53 (sensitivity 87.5%) for a simple prediction model that only used the measured result for error detection. A CUSUM-Logistic Regression analysis of patient laboratory data can be an effective approach for the rapid and sensitive detection of clinical laboratory errors. Published by Elsevier Inc.

Back problems, comorbidities, and their association with wealth.

PubMed

Schofield, Deborah J; Callander, Emily J; Shrestha, Rupendra N; Passey, Megan E; Kelly, Simon J; Percival, Richard

2015-01-01

Studies assessing the economic burden of back problems have given little consideration to the presence of comorbidities. To assess the difference in the value of wealth held by Australians who have back problems and varying numbers of chronic comorbidities. A cross-sectional study. Individuals aged 45 to 64 years in 2009: 4,388 with no chronic health conditions, 1,405 with back problems, and 3,018 with other health conditions. Total wealth (cash, shares, superannuation, investment property, and owner occupied home). Using a microsimulation model (Health&WealthMOD), logistic regression models were used to assess the odds of having any wealth. Linear regression models were used to assess the difference in the value of this wealth. Those with back problems and two comorbidities had 0.16 (95% confidence interval [CI]: 0.06-0.42) times the odds and those with back problems and three or more comorbidities had 0.20 (95% CI: 0.11-0.38) times the odds of having accumulated some wealth than those with no chronic health conditions. Those with back problems and three or more comorbidities had a median value of total wealth of around $150,000, whereas those with back problems only and back problems and one comorbidity had a median value of total wealth of around $250,500. There was no significant difference in the amount of wealth accumulated by those with back problems and at least one comorbidity and those with other health conditions and the same number of comorbidities. However, those with only one health condition (excluding back problems) had 65% more wealth than those with back problems only (95% CI: 5.1-161.2). This study highlights the importance of considering multiple morbidities when discussing the relationship between back problems and economic circumstances. Copyright © 2015 Elsevier Inc. All rights reserved.

Delayed and forgone care for families with chronic conditions in high-deductible health plans.

PubMed

Galbraith, Alison A; Soumerai, Stephen B; Ross-Degnan, Dennis; Rosenthal, Meredith B; Gay, Charlene; Lieu, Tracy A

2012-09-01

High-deductible health plans (HDHPs) are an increasingly common strategy to contain health care costs. Individuals with chronic conditions are at particular risk for increased out-of-pocket costs in HDHPs and resulting cost-related underuse of essential health care. To evaluate whether families with chronic conditions in HDHPs have higher rates of delayed or forgone care due to cost, compared with those in traditional health insurance plans. This mail and phone survey used multiple logistic regression to compare family-level rates of reporting delayed/forgone care in HDHPs vs. traditional plans. We selected families with children that had at least one member with a chronic condition. Families had employer-sponsored insurance in a Massachusetts health plan and >12 months of enrollment in an HDHP or a traditional plan. The primary outcome was report of any delayed or forgone care due to cost (acute care, emergency department visits, chronic care, checkups, or tests) for adults or children during the prior 12 months. Respondents included 208 families in HDHPs and 370 in traditional plans. Membership in an HDHP and lower income were each independently associated with higher probability of delayed/forgone care due to cost. For adult family members, the predicted probability of delayed/forgone care due to cost was higher in HDHPs than in traditional plans [40.0% vs 15.1% among families with incomes <400% of the federal poverty level (FPL) and 16.0% vs 4.8% among those with incomes ≥400% FPL]. Similar associations were observed for children. Among families with chronic conditions, reporting of delayed/forgone care due to cost is higher for both adults and children in HDHPs than in traditional plans. Families with lower incomes are also at higher risk for delayed/forgone care.

Patient-reported safety incidents in older patients with long-term conditions: a large cross-sectional study

PubMed Central

Panagioti, Maria; Blakeman, Thomas; Hann, Mark; Bower, Peter

2017-01-01

Background Increasing evidence suggests that patient safety is a serious concern for older patients with long-term conditions. Despite this, there is a lack of research on safety incidents encountered by this patient group. In this study, we sought to examine patient reports of safety incidents and factors associated with reports of safety incidents in older patients with long-term conditions. Methods The baseline cross-sectional data from a longitudinal cohort study were analysed. Older patients (n=3378 aged 65 years and over) with a long-term condition registered in general practices were included in the study. The main outcome was patient-reported safety incidents including availability and appropriateness of medical tests and prescription of wrong types or doses of medication. Binary univariate and multivariate logistic regression analyses were undertaken to examine factors associated with patient-reported safety incidents. Results Safety incidents were reported by 11% of the patients. Four factors were significantly associated with patient-reported safety incidents in multivariate analyses. The experience of multiple long-term conditions (OR=1.09, 95% CI 1.05 to 1.13), a probable diagnosis of depression (OR=1.36, 95% CI 1.06 to 1.74) and greater relational continuity of care (OR=1.28, 95% CI 1.08 to 1.52) were associated with increased odds for patient-reported safety incidents. Perceived greater support and involvement in self-management was associated with lower odds for patient-reported safety incidents (OR=0.95, 95% CI 0.93 to 0.97). Conclusions We found that older patients with multimorbidity and depression are more likely to report experiences of patient safety incidents. Improving perceived support and involvement of patients in their care may help prevent patient-reported safety incidents. PMID:28559454

Trends in Retail Clinic Use Among The Commercially Insured

PubMed Central

Ashwood, J. Scott; Reid, Rachel O.; Setodji, Claude M.; Weber, Ellerie; Gaynor, Martin; Mehrotra, Ateev

2012-01-01

Objective To describe trends in retail clinic usage among commercially insured patients and to identify which patient characteristics predict retail clinic use Study Design We performed a retrospective cohort analysis of commercial insurance claims sampled from a population of 13.3 million patients in 21 markets in 2007-9. Methods We identified 11 simple acute conditions that can be managed at a retail clinic. We described trends in retail clinic utilization for these conditions. We used multiple logistic regressions to identify predictors of retail clinic versus another care site for these conditions and assessed whether those predictors changed over time. Results Retail clinic use increased ten-fold from 2007 to 2009. By 2009 6.9% of all visits for the 11 conditions were to a retail clinic. Proximity to a retail clinic was the strongest predictor of use. Patients living within 1 mile of a retail clinic were 10.0% more likely to use one than those living 10-20 miles away (p-value <0.001). Women (+0.9%, p-value <0.001), young adults (+1.6%, p-value <0.001), those without a chronic condition (+1.1%, p-value <0.001), and high-income (+1.3%, p-value <0.001) patients were more likely to use retail clinics. All these associations became stronger over time. There was no association between primary care physician availability and retail clinic use. Conclusions If these trends continue health plans can expect to see a dramatic increase in retail clinic utilization. While usage is increasing on average, it is particularly increasing among young, healthy, and higher income patients who live close to retail clinics. PMID:22200061

Financial well-being of older Australians with multiple health conditions.

PubMed

Temple, Jeromey B; Williams, Ruth

2018-06-01

Given recent rises in out-of-pocket health expenses, we examined the financial well-being of older Australians with multiple health conditions and disabilities. The 2014 General Social Survey was used to measure the: (i) current financial position; (ii) propensity to experience financial difficulties; and (iii) types of behaviours older people with multiple health conditions engage in to improve financial resilience. Compared to older Australians with no health conditions, respondents with multiple health conditions had lower incomes and assets and a higher propensity to hold consumer debt (once controls were included). They were at a higher risk of cash flow difficulties, dissaving to meet day-to-day living expenses and exclusion from financial providers. However, the majority of people with multiple health conditions engaged in financially resilient behaviours. Many older Australians with multiple health conditions were in a financially precarious situation with implications for the ability to afford ongoing increases in out-of-pocket health-care costs. © 2018 AJA Inc.

Proximity to Pollution Sources and Risk of Amphibian Limb Malformation

PubMed Central

Taylor, Brynn; Skelly, David; Demarchis, Livia K.; Slade, Martin D.; Galusha, Deron; Rabinowitz, Peter M.

2005-01-01

The cause of limb deformities in wild amphibian populations remains unclear, even though the apparent increase in prevalence of this condition may have implications for human health. Few studies have simultaneously assessed the effect of multiple exposures on the risk of limb deformities. In a cross-sectional survey of 5,264 hylid and ranid metamorphs in 42 Vermont wetlands, we assessed independent risk factors for nontraumatic limb malformation. The rate of nontraumatic limb malformation varied by location from 0 to 10.2%. Analysis of a subsample did not demonstrate any evidence of infection with the parasite Ribeiroia. We used geographic information system (GIS) land-use/land-cover data to validate field observations of land use in the proximity of study wetlands. In a multiple logistic regression model that included land use as well as developmental stage, genus, and water-quality measures, proximity to agricultural land use was associated with an increased risk of limb malformation (odds ratio = 2.26; 95% confidence interval, 1.42–3.58; p < 0.001). The overall discriminant power of the statistical model was high (C = 0.79). These findings from one of the largest systematic surveys to date provide support for the role of chemical toxicants in the development of amphibian limb malformation and demonstrate the value of an epidemiologic approach to this problem. PMID:16263502

Association of genetic variations in the serotonin and dopamine systems with aggressive behavior in the Chinese adolescent population: Single- and multiple-risk genetic variants.

PubMed

Chang, Hongjuan; Yan, Qiuge; Tang, Lina; Huang, Juan; Ma, Yuqiao; Ye, Xiaozhou; Wu, Chunxia; Wu, Linguo; Yu, Yizhen

2018-01-01

Genetic predisposition is an important factor leading to aggressive behavior. However, the relationship between genetic polymorphisms and aggressive behavior has not been elucidated. We identified candidate genes located in the dopaminergic and serotonin system (DRD3, DRD4, and FEV) that had been previously reported to be associated with aggressive behavior. We investigated 14 tag single-nucleotide polymorphisms (SNPs) using a multi-analytic strategy combining logistic regression (LR) and classification and regression tree (CART) to explore higher-order interactions between these SNPs and aggressive behavior in 318 patients and 558 controls. Both LR and CART analyses suggested that the rs16859448 polymorphism is the strongest individual factor associated with aggressive behavior risk. In CART analysis, individuals carrying the combined genotypes of rs16859448TT/GT-rs11246228CT/TT-rs3773679TT had the highest risk, while rs16859448GG-rs2134655CT had the lowest risk (OR = 5.25, 95% CI: 2.53-10.86). This study adds to the growing evidence on the association of single- and multiple-risk variants in DRD3, DRD4, and FEV with aggressive behavior in Chinese adolescents. However, the aggressive behavior scale used to diagnose aggression in this study did not account for comorbid conditions; therefore, further studies are needed to confirm our observations. Copyright © 2017 Elsevier B.V. All rights reserved.

Marital status, social capital and health locus of control: a population-based study.

PubMed

Lindström, M; Rosvall, M

2012-09-01

To investigate the association between marital status and lack of internal health locus of control (HLC), taking economic stress and trust into account. Cross-sectional study. The public health survey Skåne 2008 is a postal questionnaire study (55% participation rate). A random sample was invited to participate, and 28,198 individuals aged 18-80 years agreed. Logistic regression models were used to discern associations between marital status and lack of internal HLC. The multiple regression analyses included age, country of birth, education, economic stress and 'horizontal' trust. In total, 33.7% of the men and 31.8% of the women lacked internal HLC. After age-adjustments, the unmarried and divorced men and the widowed women displayed significantly higher odds ratios of lack of internal HLC. The significantly higher odds ratios only remained for unmarried men throughout the multiple analyses. In contrast, divorced women had significantly lower odds ratios of lack of internal HLC than married women after adjustments for economic stress. Health promotion regarding HLC and related behaviours should consider men and women who are not cohabiting. Health promotion should particularly consider unmarried men due to their higher propensity to lack internal HLC. The economic conditions and exposure to economic stress among widowed and divorced women should also be highlighted. Copyright © 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Socioeconomic status and esophageal squamous cell carcinoma risk in Kashmir, India.

PubMed

Dar, Nazir A; Shah, Idrees A; Bhat, Gulzar A; Makhdoomi, Muzamil A; Iqbal, Beenish; Rafiq, Rumaisa; Nisar, Iqra; Bhat, Arshid B; Nabi, Sumaiya; Masood, Akbar; Shah, Sajad A; Lone, Mohd M; Zargar, Showkat A; Islami, Farhad; Boffetta, Paolo

2013-09-01

Studies have persistently associated esophageal squamous cell carcinoma (ESCC) risk with low socioeconomic status (SES), but this association is unexplored in Kashmir, an area with a high incidence of ESCC in the northernmost part of India. We carried out a case-control study to assess the association of multiple indicators of SES and ESCC risk in the Kashmir valley. A total number of 703 histologically confirmed ESCC cases and 1664 controls matched to the cases for age, sex, and district of residence were recruited from October 2008 to January 2012. Conditional logistic regression models were used to calculate unadjusted and adjusted odds ratios and 95% confidence intervals. Composite wealth scores were constructed based on the ownership of several appliances using multiple correspondence analyses. Higher education, living in a kiln brick or concrete house, use of liquefied petroleum gas and electricity for cooking, and higher wealth scores all showed an inverse association with ESCC risk. Compared to farmers, individuals who had government jobs or worked in the business sector were at lower risk of ESCC, but this association disappeared in fully adjusted models. Occupational strenuous physical activity was strongly associated with ESCC risk. In summary, we found a strong relationship of low SES and ESCC in Kashmir. The findings need to be studied further to understand the mechanisms through which such SES parameters increase ESCC risk. © 2013 Japanese Cancer Association.

Beta2-adrenergic agonist use and the risk of multiple sclerosis: a total population-based case-control study.

PubMed

Tsai, Ching-Piao; Lin, Feng-Cheng; Lee, Charles Tzu-Chi

2014-10-01

The aim of this study was to investigate whether the use of fenoterol, a beta2-adrenergic agonist, was associated with multiple sclerosis (MS) risk by conducting a total population-based case-control study in Taiwan. A total of 578 patients with newly diagnosed MS who had a severely disabling disease (SDD) certificate between January 1, 2002 and December 1, 2008 comprised the case group. These cases were compared with 2890 gender-, age-, residence-, and insurance premium-matched controls. Fenoterol use was analyzed using a conditional logistic regression model that controlled for asthma, chronic obstructive pulmonary disease (COPD), salbutamol and steroid use. Compared with the group of people who did not use fenoterol, the adjusted odds ratios were 0.67 (95% confidence interval (CI) = 0.48-0.93, p = 0.016) for the group prescribed fenoterol below 2.25 cumulative defined daily dose (cDDD) and 0.49 (95% CI = 0.33-0.71, p < 0.001) for the group with a cumulative fenoterol use of more than 2.25 cDDD. The dose-response relationship was similar within the non-asthma patients. The associations were similar between males and females, but differences between age groups were observed. The results of this study suggest that fenoterol use may reduce the risk of MS. © The Author(s), 2014.

Respiratory health effects associated with restoration work in post-Hurricane Katrina New Orleans.

PubMed

Rando, Roy J; Lefante, John J; Freyder, Laurie M; Jones, Robert N

2012-01-01

This study examines prevalence of respiratory conditions in New Orleans-area restoration workers after Hurricane Katrina. Between 2007 and 2010, spirometry and respiratory health and occupational questionnaire were administered to 791 New Orleans-area adults who mostly worked in the building construction and maintenance trades or custodial services. The associations between restoration work hours and lung function and prevalence of respiratory symptoms were examined by multiple linear regression, χ², or multiple logistic regression. 74% of participants performed post-Katrina restoration work (median time: 620 hours). Symptoms reported include episodes of transient fever/cough (29%), sinus symptoms (48%), pneumonia (3.7%), and new onset asthma (4.5%). Prevalence rate ratios for post-Katrina sinus symptoms (PRR = 1.3; CI: 1.1, 1.7) and fever and cough (PRR = 1.7; CI: 1.3, 2.4) were significantly elevated overall for those who did restoration work and prevalence increased with restoration work hours. Prevalence rate ratios with restoration work were also elevated for new onset asthma (PRR = 2.2; CI: 0.8, 6.2) and pneumonia (PRR = 1.3; CI: 0.5, 3.2) but were not statistically significant. Overall, lung function was slightly depressed but was not significantly different between those with and without restoration work exposure. Post-Katrina restoration work is associated with moderate adverse effects on respiratory health, including sinusitis and toxic pneumonitis.

Relationships between youth sport participation and selected health risk behaviors from 1999 to 2007.

PubMed

Taliaferro, Lindsay A; Rienzo, Barbara A; Donovan, Kristine A

2010-08-01

How adolescents spend their out-of-school time represents one of the most important factors for predicting positive youth development. Sport participation relates to many beneficial outcomes. However, current economic conditions threaten high school sport programs around the United States. This investigation examined relationships by year between sport participation and numerous health risk behaviors among high school students. Data were derived from the Centers for Disease Control and Prevention's Youth Risk Behavior Surveys administered every 2 years from 1999 through 2007. Items assessed were sport participation, vigorous physical activity, dietary habits, weight loss, sexual activity, interpersonal violence and suicidality, and substance use. Multiple logistic regression analyses were used to examine relationships between sport participation and each health behavior. Interaction effects tested whether relationships varied by year, sex, age, and/or race/ethnicity. Analyses revealed some consistencies across years in relationships between sport participation and health risk behaviors for both sexes. However, most relationships varied by race/ethnicity. Among White students, sport participation related to multiple positive health behaviors. Conversely, African American, Hispanic, and Other athletes showed fewer positive health behaviors and some negative behaviors. Findings suggest that participation in organized sports affords many health benefits to most adolescents, but relates to some negative health behaviors in certain subgroups. Information regarding sport participation and health risk behaviors among subgroups across years can inform school policy, practice, and future research.

Prevalence and associations of symptoms of upper extremities, repetitive strain injuries (RSI) and 'RSI-like condition'. A cross sectional study of bank workers in Northeast Brazil

PubMed Central

Lacerda, Eliana M; Nácul, Luis C; da S Augusto, Lia G; Olinto, Maria Teresa A; Rocha, Dyhanne C; Wanderley, Danielle C

2005-01-01

Background The repetitive strain injury syndrome (RSI) is a worldwide occupational health problem affecting all types of economic activities. We investigated the prevalence and some risk factors for RSI and related conditions, namely 'symptoms of upper limbs' and 'RSI-like condition'. Methods We conducted a cross-sectional study with 395 bank workers in Recife, Northeast Brazil. Symptoms of upper limbs and 'RSI-like condition' were assessed by a simple questionnaire, which was used to screen probable cases of RSI. The diagnosis of RSI was confirmed by clinical examination. The associations of potential risk factors and the outcomes were assessed by multiple logistic regression analysis. Results We found prevalence rates of 56% for symptoms of the upper limbs and 30% for 'RSI-like condition'. The estimated prevalence of clinically confirmed cases of RSI was 22%. Female sex and occupation (as cashier or clerk) increased the risk of all conditions, but the associations were stronger for cases of RSI than for less specific diagnoses of 'RSI-like condition' and symptoms of upper limbs. Age was inversely related to the risk of symptoms of upper limbs but not to 'RSI-like' or RSI. Conclusion The variation in the magnitude of risk according to the outcome assessed suggests that previous studies using different definitions may not be immediately comparable. We propose the use of a simple instrument to screen cases of RSI in population based studies, which still needs to be validated in other populations. The high prevalence of RSI and related conditions in this population suggests the need for urgent interventions to tackle the problem, which could be directed to individuals at higher risk and to changes in the work organization and environment of the general population. PMID:16219095

The base rates and factors associated with reported access to firearms in psychiatric inpatients.

PubMed

Kolla, Bhanu Prakash; O'Connor, Stephen S; Lineberry, Timothy W

2011-01-01

The aim of this study was to define whether specific patient demographic groups, diagnoses or other factors are associated with psychiatric inpatients reporting firearms access. A retrospective medical records review study was conducted using information on access to firearms from electronic medical records for all patients 16 years and older admitted between July 2007 and May 2008 at the Mayo Clinic Psychiatric Hospital in Rochester, MN. Data were obtained only on patients providing authorization for record review. Data were analyzed using univariate and multivariate logistic regression analyses accounting for gender, diagnostic groups, comorbid substance use, history of suicide attempts and family history of suicide/suicide attempts. Seventy-four percent (1169/1580) of patients provided research authorization. The ratio of men to women was identical in both research and nonresearch authorization groups. There were 14.6% of inpatients who reported firearms access. In univariate analysis, men were more likely (P<.0001) to report access than women, and a history of previous suicide attempt(s) was associated with decreased access (P=.02). Multiple logistic regression analyses controlling for other factors found females and patients with history of previous suicide attempt(s) less likely to report access, while patients with a family history of suicide or suicide attempts reported increased firearms access. Diagnostic groups were not associated with access on univariate or multiple logistic regression analyses. Men and inpatients with a family history of suicide/suicide attempts were more likely to report firearms access. Clinicians should develop standardized systems of identification of firearms access and provide guidance on removal. Copyright © 2011 Elsevier Inc. All rights reserved.

Risk Factors for 30-Day Complications After Thumb CMC Joint Arthroplasty: An American College of Surgeons National Surgery Quality Improvement Program Study.

PubMed

Shah, Kalpit N; Defroda, Steven F; Wang, Bo; Weiss, Arnold-Peter C

2017-12-01

The first carpometacarpal (CMC) joint is a common site of osteoarthritis, with arthroplasty being a common procedure to provide pain relief and improve function with low complications. However, little is known about risk factors that may predispose a patient for postoperative complications. All CMC joint arthroplasty from 2005 to 2015 in the prospectively collected American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database were identified. Bivariate testing and multiple logistic regressions were performed to determine which patient demographics, surgical variables and medical comorbidities were significant predictors for complications. These included wound related, cardiopulmonary, neurological and renal complications, return to the operating room (OR) and readmission. A total of 3344 patients were identified from the database. Of those, 45 patients (1.3%) experienced a complication including wound issues (0.66%), return to the OR (0.15%) and readmission (0.27%) amongst others. When performing bivariate analysis, age over 65, American Society of Anesthesiologists (ASA) Class, diabetes and renal dialysis were significant risk factors. Multiple logistic regression after adjusting for confounding factors demonstrated that insulin-dependent diabetes and ASA Class 4 had a strong trend while renal dialysis was a significant risk factor. CMC arthroplasty has a very low overall complication rate of 1.3% and wound complication rate of 0.66%. Diabetes requiring insulin and ASA Class 4 trended towards significance while renal dialysis was found to be a significant risk factors in logistic regression. This information may be useful for preoperative counseling and discussion with patients who have these risk factors.

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.

NASA Space Flight Vehicle Fault Isolation Challenges

NASA Technical Reports Server (NTRS)

Bramon, Christopher; Inman, Sharon K.; Neeley, James R.; Jones, James V.; Tuttle, Loraine

2016-01-01

The Space Launch System (SLS) is the new NASA heavy lift launch vehicle and is scheduled for its first mission in 2017. The goal of the first mission, which will be uncrewed, is to demonstrate the integrated system performance of the SLS rocket and spacecraft before a crewed flight in 2021. SLS has many of the same logistics challenges as any other large scale program. Common logistics concerns for SLS include integration of discrete programs geographically separated, multiple prime contractors with distinct and different goals, schedule pressures and funding constraints. However, SLS also faces unique challenges. The new program is a confluence of new hardware and heritage, with heritage hardware constituting seventy-five percent of the program. This unique approach to design makes logistics concerns such as testability of the integrated flight vehicle especially problematic. The cost of fully automated diagnostics can be completely justified for a large fleet, but not so for a single flight vehicle. Fault detection is mandatory to assure the vehicle is capable of a safe launch, but fault isolation is another issue. SLS has considered various methods for fault isolation which can provide a reasonable balance between adequacy, timeliness and cost. This paper will address the analyses and decisions the NASA Logistics engineers are making to mitigate risk while providing a reasonable testability solution for fault isolation.

Hierarchical Bayesian Logistic Regression to forecast metabolic control in type 2 DM patients.

PubMed

Dagliati, Arianna; Malovini, Alberto; Decata, Pasquale; Cogni, Giulia; Teliti, Marsida; Sacchi, Lucia; Cerra, Carlo; Chiovato, Luca; Bellazzi, Riccardo

2016-01-01

In this work we present our efforts in building a model able to forecast patients' changes in clinical conditions when repeated measurements are available. In this case the available risk calculators are typically not applicable. We propose a Hierarchical Bayesian Logistic Regression model, which allows taking into account individual and population variability in model parameters estimate. The model is used to predict metabolic control and its variation in type 2 diabetes mellitus. In particular we have analyzed a population of more than 1000 Italian type 2 diabetic patients, collected within the European project Mosaic. The results obtained in terms of Matthews Correlation Coefficient are significantly better than the ones gathered with standard logistic regression model, based on data pooling.

Medical Logistics Lessons Observed During Operations Enduring Freedom and Iraqi Freedom.

PubMed

Dole, Mark J; Kissane, Jonathan M

2016-01-01

Medical Logistics (MEDLOG) is a function of the Army's integrated System for Health that provides the medical products and specialized logistics services required to deliver health protection and care under all operational conditions. In unified land operations, MEDLOG is an inherent function of Health Service Support (HSS), which also includes casualty care and medical evacuation. This paper focuses on a few key lessons observed during Operations Enduring Freedom and Iraqi Freedom with direct implications for the support of HSS in future operations as envisioned in the Army Operating Concept and the Joint Concept for Health Services. It also examines a few key enablers that helped mitigate these challenges that are not yet fully acknowledged in Army Medical Department doctrine, policy, and planning.

Methodologic considerations in the design and analysis of nested case-control studies: association between cytokines and postoperative delirium.

PubMed

Ngo, Long H; Inouye, Sharon K; Jones, Richard N; Travison, Thomas G; Libermann, Towia A; Dillon, Simon T; Kuchel, George A; Vasunilashorn, Sarinnapha M; Alsop, David C; Marcantonio, Edward R

2017-06-06

The nested case-control study (NCC) design within a prospective cohort study is used when outcome data are available for all subjects, but the exposure of interest has not been collected, and is difficult or prohibitively expensive to obtain for all subjects. A NCC analysis with good matching procedures yields estimates that are as efficient and unbiased as estimates from the full cohort study. We present methodological considerations in a matched NCC design and analysis, which include the choice of match algorithms, analysis methods to evaluate the association of exposures of interest with outcomes, and consideration of overmatching. Matched, NCC design within a longitudinal observational prospective cohort study in the setting of two academic hospitals. Study participants are patients aged over 70 years who underwent scheduled major non-cardiac surgery. The primary outcome was postoperative delirium from in-hospital interviews and medical record review. The main exposure was IL-6 concentration (pg/ml) from blood sampled at three time points before delirium occurred. We used nonparametric signed ranked test to test for the median of the paired differences. We used conditional logistic regression to model the risk of IL-6 on delirium incidence. Simulation was used to generate a sample of cohort data on which unconditional multivariable logistic regression was used, and the results were compared to those of the conditional logistic regression. Partial R-square was used to assess the level of overmatching. We found that the optimal match algorithm yielded more matched pairs than the greedy algorithm. The choice of analytic strategy-whether to consider measured cytokine levels as the predictor or outcome-- yielded inferences that have different clinical interpretations but similar levels of statistical significance. Estimation results from NCC design using conditional logistic regression, and from simulated cohort design using unconditional logistic regression, were similar. We found minimal evidence for overmatching. Using a matched NCC approach introduces methodological challenges into the study design and data analysis. Nonetheless, with careful selection of the match algorithm, match factors, and analysis methods, this design is cost effective and, for our study, yields estimates that are similar to those from a prospective cohort study design.

Is suicide predictable?

PubMed

Seghatoleslam, T; Habi, H; Rashid, R Abdul; Mosavi, N; Asmaee, S; Naseri, A

2012-01-01

THE CURRENT STUDY AIMED TO TEST THE HYPOTHESIS: Is suicide predictable? And try to classify the predictive factors in multiple suicide attempts. A cross-sectional study was administered to 223 multiple attempters, women who came to a medical poison centre after a suicide attempt. The participants were young, poor, and single. A Logistic Regression Analiysis was used to classify the predictive factors of suicide. Women who had multiple suicide attempts exhibited a significant tendency to attempt suicide again. They had a history for more than two years of multiple suicide attempts, from three to as many as 18 times, plus mental illnesses such as depression and substance abuse. They also had a positive history of mental illnesses. Results indicate that contributing factors for another suicide attempt include previous suicide attempts, mental illness (depression), or a positive history of mental illnesses in the family affecting them at a young age, and substance abuse.

Global boundedness to a chemotaxis system with singular sensitivity and logistic source

NASA Astrophysics Data System (ADS)

Zhao, Xiangdong; Zheng, Sining

2017-02-01

We consider the parabolic-parabolic Keller-Segel system with singular sensitivity and logistic source: u_t=Δ u-χ nabla \\cdot (u/vnabla v) +ru-μ u^2, v_t=Δ v-v+u under the homogeneous Neumann boundary conditions in a smooth bounded domain Ω subset {R}^2, χ ,μ >0 and rin {R}. It is proved that the system exists globally bounded classical solutions if r>χ ^2/4 for 0<χ ≤ 2, or r>χ -1 for χ >2.

NDIA 34th Annual National Logistics Forum: Logistics Innovation to Ensure Global Readiness. Held in Tampa, Florida on 15-16 May 2018

DTIC Science & Technology

2018-05-16

KEYNOTE ADDRESS BAYSHORE 1-3 Ward Heinke Vice President, Strategic Alliances, Government Markets , Forcepoint 9:45 – 10:15 am NETWORKING BREAK GALLERIA B 6...or conditions of sale (including allowances, credit terms, and warranties); allocation of markets or customers or division of territories; or refusals...Army War College. 11 WARD HEINKE Vice President, Strategic Alliances, Government Markets Forcepoint Ward is VP for Strategic Alliances, Government

Addressing data privacy in matched studies via virtual pooling.

PubMed

Saha-Chaudhuri, P; Weinberg, C R

2017-09-07

Data confidentiality and shared use of research data are two desirable but sometimes conflicting goals in research with multi-center studies and distributed data. While ideal for straightforward analysis, confidentiality restrictions forbid creation of a single dataset that includes covariate information of all participants. Current approaches such as aggregate data sharing, distributed regression, meta-analysis and score-based methods can have important limitations. We propose a novel application of an existing epidemiologic tool, specimen pooling, to enable confidentiality-preserving analysis of data arising from a matched case-control, multi-center design. Instead of pooling specimens prior to assay, we apply the methodology to virtually pool (aggregate) covariates within nodes. Such virtual pooling retains most of the information used in an analysis with individual data and since individual participant data is not shared externally, within-node virtual pooling preserves data confidentiality. We show that aggregated covariate levels can be used in a conditional logistic regression model to estimate individual-level odds ratios of interest. The parameter estimates from the standard conditional logistic regression are compared to the estimates based on a conditional logistic regression model with aggregated data. The parameter estimates are shown to be similar to those without pooling and to have comparable standard errors and confidence interval coverage. Virtual data pooling can be used to maintain confidentiality of data from multi-center study and can be particularly useful in research with large-scale distributed data.

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.

Self-rated health is associated with subsequent functional decline among older adults in Japan.

PubMed

Hirosaki, Mayumi; Okumiya, Kiyohito; Wada, Taizo; Ishine, Masayuki; Sakamoto, Ryota; Ishimoto, Yasuko; Kasahara, Yoriko; Kimura, Yumi; Fukutomi, Eriko; Chen, Wen Ling; Nakatsuka, Masahiro; Fujisawa, Michiko; Otsuka, Kuniaki; Matsubayashi, Kozo

2017-09-01

Previous studies have reported that self-rated health (SRH) predicts subsequent mortality. However, less is known about the association between SRH and functional ability. The aim of this study was to examine whether SRH predicts decline in basic activities of daily living (ADL), even after adjustment for depression, among community-dwelling older adults in Japan. A three-year prospective cohort study was conducted among 654 residents aged 65 years and older without disability in performing basic ADL at baseline. SRH was assessed using a visual analogue scale (range; 0-100), and dichotomized into low and high groups. Information on functional ability, sociodemographic factors, depressive symptoms, and medical conditions were obtained using a self-administered questionnaire. Logistic regression analysis was used to examine the association between baseline SRH and functional decline three years later. One hundred and eight (16.5%) participants reported a decline in basic ADL at the three-year follow-up. Multiple logistic regression analysis showed that the low SRH group had a higher risk for functional decline compared to the high SRH group, even after controlling for potential confounding factors (odds ratio (OR) = 2.4; 95% confidence interval (CI) = 1.3-4.4). Furthermore, a 10-point difference in SRH score was associated with subsequent functional decline (OR = 1.37; 95% CI = 1.16-1.61). SRH was an independent predictor of functional decline. SRH could be a simple assessment tool for predicting the loss or maintenance of functional ability in community-dwelling older adults. Positive self-evaluation might be useful to maintain an active lifestyle and stay healthy.

Injury trends in sanctioned mixed martial arts competition: a 5-year review from 2002 to 2007.

PubMed

Ngai, K M; Levy, F; Hsu, E B

2008-08-01

Professional mixed martial arts (MMA) competition is a full-contact sport that has risen rapidly in popularity in recent years. However, there is limited information regarding the incidence of competition injuries after sanctioning by an athletic commission. We conducted a retrospective cohort study to examine MMA injury patterns during a 5 year period after sanctioning in the state of Nevada. Data from all regulated MMA competitions during the study period from March 2002 to September 2007 (1270 fight exposures) was obtained. Injury odds ratios were calculated by conditional logistic regression on match outcome, age, weight, and fight experience, using a pair-matched case-control design (n = 464) and by multiple logistic regression on match outcome, age, fight experience, weight, combat minutes, and scheduled rounds. During the 635 professional MMA matches, 300 of the 1270 athletes sustained documented injuries with an injury rate of 23.6 per 100 fight participations. Most common reported injuries were lacerations and upper limb injuries. Severe concussion rate was 15.4 per 1000 athlete exposures, or 3% of all matches. No deaths or critical sports-related injuries resulted from any of the regulated matches during the study period. Age, weight and fight experience did not statistically increase the likelihood of injuries after controlling for other covariates. Injury rates in regulated professional MMA competition are similar to other combat sports; the overall risk of critical sports-related injury seems to be low. Additional study is warranted to achieve a better understanding of injury trends and ways to further lower injury risk in MMA.

Linking emotional distress to unhealthy sleep duration: analysis of the 2009 National Health Interview Survey.

PubMed

Seixas, Azizi A; Nunes, Joao V; Airhihenbuwa, Collins O; Williams, Natasha J; Pandi-Perumal, Seithikurippu Ratnas; James, Caryl C; Jean-Louis, Girardin

2015-01-01

The objective of the study was to examine the independent association of emotional distress with unhealthy sleep duration (defined as <7 or >8 hours). Data from the 2009 National Health Interview Survey (NHIS), a cross-sectional household survey, were analyzed to investigate the associations of emotional distress with unhealthy sleep durations, adjusting for sociodemographic factors, health risks, and chronic diseases through hierarchical multiple logistic regression analysis. A total of 27,731 participants (age range 18-85 years) from the NHIS 2009 dataset were interviewed. Unhealthy sleep duration is defined as sleep duration <7 or >8 hours, whereas healthy sleep is defined as sleep duration lasting for 7-8 hours. Emotional distress is based on the Kessler 6 Non-Specific Distress Battery, which assesses the frequency of feeling sad, nervous, restless, hopeless, worthless, and burdened, over a 30-day period. Of the sample, 51.7% were female; 83.1% were white and 16.9% were black. Eleven percent experienced emotional distress and 37.6% reported unhealthy sleep. Adjusted logistic regression analysis revealed that individuals with emotional distress had 55% greater odds of reporting unhealthy sleep (odds ratio [OR] =1.55, 95% confidence interval [CI] =1.42, 1.68, P<0.001). Emotional distress, an important proxy for poor psychological health, was a significant predictor of unhealthy sleep, independent of the influences of several factors including demographic (age, education, sex, race/ethnicity, and family income), health risks (alcohol consumption and smoking status), and chronic diseases/conditions (diabetes, obesity, hypertension, heart disease, cancer, and arthritis).

Linking emotional distress to unhealthy sleep duration: analysis of the 2009 National Health Interview Survey

PubMed Central

Seixas, Azizi A; Nunes, Joao V; Airhihenbuwa, Collins O; Williams, Natasha J; Pandi-Perumal, Seithikurippu Ratnas; James, Caryl C; Jean-Louis, Girardin

2015-01-01

Objective The objective of the study was to examine the independent association of emotional distress with unhealthy sleep duration (defined as <7 or >8 hours). Methods Data from the 2009 National Health Interview Survey (NHIS), a cross-sectional household survey, were analyzed to investigate the associations of emotional distress with unhealthy sleep durations, adjusting for sociodemographic factors, health risks, and chronic diseases through hierarchical multiple logistic regression analysis. Participants A total of 27,731 participants (age range 18–85 years) from the NHIS 2009 dataset were interviewed. Measures Unhealthy sleep duration is defined as sleep duration <7 or >8 hours, whereas healthy sleep is defined as sleep duration lasting for 7–8 hours. Emotional distress is based on the Kessler 6 Non-Specific Distress Battery, which assesses the frequency of feeling sad, nervous, restless, hopeless, worthless, and burdened, over a 30-day period. Results Of the sample, 51.7% were female; 83.1% were white and 16.9% were black. Eleven percent experienced emotional distress and 37.6% reported unhealthy sleep. Adjusted logistic regression analysis revealed that individuals with emotional distress had 55% greater odds of reporting unhealthy sleep (odds ratio [OR] =1.55, 95% confidence interval [CI] =1.42, 1.68, P<0.001). Conclusion Emotional distress, an important proxy for poor psychological health, was a significant predictor of unhealthy sleep, independent of the influences of several factors including demographic (age, education, sex, race/ethnicity, and family income), health risks (alcohol consumption and smoking status), and chronic diseases/conditions (diabetes, obesity, hypertension, heart disease, cancer, and arthritis). PMID:26442563

Into the Deep Black Sea: The Icefin Modular AUV for Ice-Covered Ocean Exploration

NASA Astrophysics Data System (ADS)

Meister, M. R.; Schmidt, B. E.; West, M. E.; Walker, C. C.; Buffo, J.; Spears, A.

2015-12-01

The Icefin autonomous underwater vehicle (AUV) was designed to enable long-range oceanographic exploration of physical and biological ocean environments in ice-covered regions. The vehicle is capable of surveying under-ice geometry, ice and ice-ocean interface properties, as well as water column conditions beneath the ice interface. It was developed with both cryospheric and planetary-analog exploration in mind. The first Icefin prototype was successfully operated in Antarctica in Austral summer 2014. The vehicle was deployed through a borehole in the McMurdo Ice Shelf near Black Island and successfully collected sonar, imaging, video and water column data down to 450 m depth. Icefin was developed using a modular design. Each module is designed to perform specific tasks, dependent on the mission objective. Vehicle control and data systems can be stably developed, and power modules added or subtracted for mission flexibility. Multiple sensor bays can be developed in parallel to serve multiple science objectives. This design enables the vehicle to have greater depth capability as well as improved operational simplicity compared to larger vehicles with equivalent capabilities. As opposed to those vehicles that require greater logistics and associated costs, Icefin can be deployed through boreholes drilled in the ice. Thus, Icefin satisfies the demands of achieving sub-ice missions while maintaining a small form factor and easy deployment necessary for repeated, low-logistical impact field programs. The current Icefin prototype is 10.5 inches in diameter by 10 feet long and weighs 240 pounds. It is comprised of two thruster modules with hovering capabilities, an oceanographic sensing module, main control module and a forward-sensing module for obstacle avoidance. The oceanographic sensing module is fitted with a side scan sonar (SSS), CT sensor, altimetry profiler and Doplar Velocity Log (DVL) with current profiling. Icefin is depth-rated to 1500 m and is equipped with 3.5 km of fiber optic, Kevlar reinforced cable, which provides point-to-point communications as well as a stable recovery platform between missions. SUPPORT: Icefin was designed and built at Georgia Tech, under Dr. Britney Schmidt's startup funds with effort contributed from Georgia Tech Research Institute (GTRI).

Health-related lifestyle behaviors among male and female rural-to-urban migrant workers in Shanghai, China.

PubMed

Yang, Hua; He, Fang; Wang, Tianhao; Liu, Yao; Shen, Yao; Gong, Jian; Dai, Wei; Zhou, Jing; Gu, Jie; Tu, Yimin; Wang, Tianying; Shen, Lei; Wu, Yumiao; Xia, Xiuping; Xu, Donghao; Pan, Zhigang; Zhu, Shanzhu

2015-01-01

Lifestyle behaviors significantly impact health, yet remain poorly defined in Chinese rural-to-urban migrants. In a cross-sectional study of health-related behaviors of 5484 rural-to-urban migrants who had worked in Shanghai for at least six months, we assessed the contribution of demographics and physical and mental health to lifestyle behaviors in male and female participants by multiple stepwise cumulative odds logistic regression. Respondents were 51.3% male. 9.9% exhibited abnormal blood pressure; 27.0% were overweight or obese; 11.2% reported abnormal mental health; 36.9% reported healthy lifestyle. Multiple stepwise cumulative odds logistic regression indicated that men working in manufacturing reported less unhealthy lifestyle than those in hospitality (cumulative odds ratio (COR) = 1.806, 95%CI 1.275-2.559) or recreation/leisure (COR = 3.248, 95%CI 2.379-4.435); and women working in manufacturing and construction reported less unhealthy lifestyle than those in all other sectors. Unhealthy lifestyle was associated with small workplaces for men (COR = 1.422, 95%CI 1.154-1.752), working more than 8 or 11 hours per day for women and men, respectively, and earning over 3500 RMB in women (COR = 1.618, 95%CI 1.137-2.303). Single women and women who had previously resided in three or more cities were more likely to report unhealthy lifestyle (COR = 2.023, 95%CI 1.664-2.461, and COR = 1.311, 95%CI 1.072-1.602, respectively). Abnormal mental status was also correlated with unhealthy lifestyle in men (COR = 3.105, 95%CI 2.454-3.930) and women (COR = 2.566, 95%CI 2.024-3.252). There were different risk factors of unhealthy lifestyle score in male and female rural-to-urban migrants, especially in number of cities experienced, salary, marital status, work place scale. Several demographic groups: employment sectors (e.g. hospitality and recreation/leisure), working conditions (e.g. long hours) and abnormal mental status were associated with unhealthy lifestyle behaviors in Chinese rural-to-urban migrants, and health interventions should be targeted to these groups.

Health-Related Lifestyle Behaviors among Male and Female Rural-to-Urban Migrant Workers in Shanghai, China

PubMed Central

Yang, Hua; He, Fang; Wang, Tianhao; Liu, Yao; Shen, Yao; Gong, Jian; Dai, Wei; Zhou, Jing; Gu, Jie; Tu, Yimin; Wang, Tianying; Shen, Lei; Wu, Yumiao; Xia, Xiuping; Xu, Donghao; Pan, Zhigang; Zhu, Shanzhu

2015-01-01

Background Lifestyle behaviors significantly impact health, yet remain poorly defined in Chinese rural-to-urban migrants. Methods In a cross-sectional study of health-related behaviors of 5484 rural-to-urban migrants who had worked in Shanghai for at least six months, we assessed the contribution of demographics and physical and mental health to lifestyle behaviors in male and female participants by multiple stepwise cumulative odds logistic regression. Results Respondents were 51.3% male. 9.9% exhibited abnormal blood pressure; 27.0% were overweight or obese; 11.2% reported abnormal mental health; 36.9% reported healthy lifestyle. Multiple stepwise cumulative odds logistic regression indicated that men working in manufacturing reported less unhealthy lifestyle than those in hospitality (cumulative odds ratio (COR) = 1.806, 95%CI 1.275–2.559) or recreation/leisure (COR = 3.248, 95%CI 2.379–4.435); and women working in manufacturing and construction reported less unhealthy lifestyle than those in all other sectors. Unhealthy lifestyle was associated with small workplaces for men (COR = 1.422, 95%CI 1.154–1.752), working more than 8 or 11 hours per day for women and men, respectively, and earning over 3500 RMB in women (COR = 1.618, 95%CI 1.137–2.303). Single women and women who had previously resided in three or more cities were more likely to report unhealthy lifestyle (COR = 2.023, 95%CI 1.664–2.461, and COR = 1.311, 95%CI 1.072–1.602, respectively). Abnormal mental status was also correlated with unhealthy lifestyle in men (COR = 3.105, 95%CI 2.454–3.930) and women (COR = 2.566, 95%CI 2.024–3.252). Conclusions There were different risk factors of unhealthy lifestyle score in male and female rural-to-urban migrants, especially in number of cities experienced, salary, marital status, work place scale. Several demographic groups: employment sectors (e.g. hospitality and recreation/leisure), working conditions (e.g. long hours) and abnormal mental status were associated with unhealthy lifestyle behaviors in Chinese rural-to-urban migrants, and health interventions should be targeted to these groups. PMID:25710464

Impact of home remediation and household education on indoor air quality, respiratory visits and symptoms in Alaska Native children

PubMed Central

Singleton, Rosalyn; Salkoski, Aaron J.; Bulkow, Lisa; Fish, Chris; Dobson, Jennifer; Albertson, Leif; Skarada, Jennifer; Ritter, Troy; Kovesi, Thomas; Hennessy, Thomas W

2018-01-01

ABSTRACT Alaska Native children experience high rates of lower respiratory tract infections (LRTIs) and lung conditions, which are associated with substandard indoor air quality (IAQ). We conducted an intervention of home remediation and education to assess the impact on IAQ, respiratory symptoms and LRTI visits. We enrolled households of children 1–12 years of age with lung conditions. Home remediation included improving ventilation and replacing leaky woodstoves. We provided education about IAQ and respiratory health. We monitored indoor airborne particles (PM2.5), CO2, relative humidity and volatile organic compounds (VOCs), and interviewed caregivers about children’s symptoms before, and for 1 year after intervention. We evaluated the association between children’s respiratory visits, symptoms and IAQ indicators using multiple logistic regression. A total of 60 of 63 homes completed the study. VOCs decreased (coefficient = −0.20; p < 0.001); however, PM2.5 (coeff. = −0.010; p = 0.89) did not decrease. Burning wood for heat, VOCs and PM2.5 were associated with respiratory symptoms. After remediation, parents reported decreases in runny nose, cough between colds, wet cough, wheezing with colds, wheezing between colds and school absences. Children had an age-adjusted decrease in LRTI visits (coefficient = −0.33; p = 0.028). Home remediation and education reduced respiratory symptoms, LRTI visits and school absenteeism in children with lung conditions. PMID:29393004

Impact of home remediation and household education on indoor air quality, respiratory visits and symptoms in Alaska Native children.

PubMed

Singleton, Rosalyn; Salkoski, Aaron J; Bulkow, Lisa; Fish, Chris; Dobson, Jennifer; Albertson, Leif; Skarada, Jennifer; Ritter, Troy; Kovesi, Thomas; Hennessy, Thomas W

2018-12-01

Alaska Native children experience high rates of lower respiratory tract infections (LRTIs) and lung conditions, which are associated with substandard indoor air quality (IAQ). We conducted an intervention of home remediation and education to assess the impact on IAQ, respiratory symptoms and LRTI visits. We enrolled households of children 1-12 years of age with lung conditions. Home remediation included improving ventilation and replacing leaky woodstoves. We provided education about IAQ and respiratory health. We monitored indoor airborne particles (PM2.5), CO 2 , relative humidity and volatile organic compounds (VOCs), and interviewed caregivers about children's symptoms before, and for 1 year after intervention. We evaluated the association between children's respiratory visits, symptoms and IAQ indicators using multiple logistic regression. A total of 60 of 63 homes completed the study. VOCs decreased (coefficient = -0.20; p < 0.001); however, PM2.5 (coeff. = -0.010; p = 0.89) did not decrease. Burning wood for heat, VOCs and PM2.5 were associated with respiratory symptoms. After remediation, parents reported decreases in runny nose, cough between colds, wet cough, wheezing with colds, wheezing between colds and school absences. Children had an age-adjusted decrease in LRTI visits (coefficient = -0.33; p = 0.028). Home remediation and education reduced respiratory symptoms, LRTI visits and school absenteeism in children with lung conditions.

High Frequency Data Acquisition System for Modelling the Impact of Visitors on the Thermo-Hygrometric Conditions of Archaeological Sites: A Casa di Diana (Ostia Antica, Italy) Case Study.

PubMed

Merello, Paloma; García-Diego, Fernando-Juan; Beltrán, Pedro; Scatigno, Claudia

2018-01-25

The characterization of the microclimatic conditions is fundamental for the preventive conservation of archaeological sites. In this context, the identification of the factors that influence the thermo-hygrometric equilibrium is key to determine the causes of cultural heritage deterioration. In this work, a characterization of the thermo-hygrometric conditions of Casa di Diana (Ostia Antica, Italy) is carried out analyzing the data of temperature and relative humidity recorded by a system of sensors with high monitoring frequency. Sensors are installed in parallel, calibrated and synchronized with a microcontroller. A data set of 793,620 data, arranged in a matrix with 66,135 rows and 12 columns, was used. Furthermore, the influence of human impact (visitors) is evaluated through a multiple linear regression model and a logistic regression model. The visitors do not affect the environmental humidity as it is very high and constant all the year. The results show a significant influence of the visitors in the upset of the thermal balance. When a tourist guide takes place, the probability that the hourly temperature variation reaches values higher than its monthly average is 10.64 times higher than it remains equal or less to its monthly average. The analysis of the regression residuals shows the influence of outdoor climatic variables in the thermal balance, such as solar radiation or ventilation.

Serious delinquent behavior as part of a significantly handicapping condition: cures and supportive environments.

PubMed Central

Wolf, M M; Braukmann, C J; Ramp, K A

1987-01-01

The past 20 years have been productive ones for the field of applied behavior analysis. A brief review of our own efforts during this period reveals that we have accomplished several but not all of our goals for the Teaching-Family approach. In this context, we note that the setting of realistic and appropriate goals is important for the field and for society. Moreover, we suggest that the realistic goal for some persons with serious delinquent behavior may be extended supportive and socializing treatment rather than permanent cure from conventional short-term treatment programs. We base this suggestion on the accumulating evidence that serious delinquent behavior may often be part of a significantly disabling and durable condition that consists of multiple antisocial and dysfunctional behaviors, often runs in families, and robustly eludes effective short-term treatment. Like other significant disabilities such as retardation, autism, and blindness, the effects of this condition may be a function of an interaction of environmental and constitutional variables. We argue that our field has the wherewithal to construct effective and humane long-term supportive environments for seriously delinquent youths. In this regard, we explore the dimensions, rationales, logistics, and beginnings of a new treatment direction that involves long-term supportive family treatment. We contend that such supportive families may be able to provide long, perhaps even lifetime, socializing influences through models, values, and contingencies that seem essential for developing and maintaining prosocial behavior in these high-risk youths. PMID:3323156

High Frequency Data Acquisition System for Modelling the Impact of Visitors on the Thermo-Hygrometric Conditions of Archaeological Sites: A Casa di Diana (Ostia Antica, Italy) Case Study

PubMed Central

Merello, Paloma; García-Diego, Fernando-Juan; Beltrán, Pedro; Scatigno, Claudia

2018-01-01

The characterization of the microclimatic conditions is fundamental for the preventive conservation of archaeological sites. In this context, the identification of the factors that influence the thermo-hygrometric equilibrium is key to determine the causes of cultural heritage deterioration. In this work, a characterization of the thermo-hygrometric conditions of Casa di Diana (Ostia Antica, Italy) is carried out analyzing the data of temperature and relative humidity recorded by a system of sensors with high monitoring frequency. Sensors are installed in parallel, calibrated and synchronized with a microcontroller. A data set of 793,620 data, arranged in a matrix with 66,135 rows and 12 columns, was used. Furthermore, the influence of human impact (visitors) is evaluated through a multiple linear regression model and a logistic regression model. The visitors do not affect the environmental humidity as it is very high and constant all the year. The results show a significant influence of the visitors in the upset of the thermal balance. When a tourist guide takes place, the probability that the hourly temperature variation reaches values higher than its monthly average is 10.64 times higher than it remains equal or less to its monthly average. The analysis of the regression residuals shows the influence of outdoor climatic variables in the thermal balance, such as solar radiation or ventilation. PMID:29370142

Leavers, Movers, and Stayers: The Role of Workplace Conditions in Teacher Mobility Decisions

ERIC Educational Resources Information Center

Kukla-Acevedo, Sharon

2009-01-01

The author explored whether 3 workplace conditions were related to teacher mobility decisions. The modeling strategy incorporated a series of binomial and multinomial logistic models to estimate the effects of administrative support, classroom control, and behavioral climate on teachers' decisions to quit teaching or switch schools. The results…

Combination of a Stresor-Response Model with a Conditional Probability Anaylsis Approach to Develop Candidate Criteria from Empirical Data

EPA Science Inventory

We show that a conditional probability analysis that utilizes a stressor-response model based on a logistic regression provides a useful approach for developing candidate water quality criterai from empirical data. The critical step in this approach is transforming the response ...

Testing Genetic Pleiotropy with GWAS Summary Statistics for Marginal and Conditional Analyses.

PubMed

Deng, Yangqing; Pan, Wei

2017-12-01

There is growing interest in testing genetic pleiotropy, which is when a single genetic variant influences multiple traits. Several methods have been proposed; however, these methods have some limitations. First, all the proposed methods are based on the use of individual-level genotype and phenotype data; in contrast, for logistical, and other, reasons, summary statistics of univariate SNP-trait associations are typically only available based on meta- or mega-analyzed large genome-wide association study (GWAS) data. Second, existing tests are based on marginal pleiotropy, which cannot distinguish between direct and indirect associations of a single genetic variant with multiple traits due to correlations among the traits. Hence, it is useful to consider conditional analysis, in which a subset of traits is adjusted for another subset of traits. For example, in spite of substantial lowering of low-density lipoprotein cholesterol (LDL) with statin therapy, some patients still maintain high residual cardiovascular risk, and, for these patients, it might be helpful to reduce their triglyceride (TG) level. For this purpose, in order to identify new therapeutic targets, it would be useful to identify genetic variants with pleiotropic effects on LDL and TG after adjusting the latter for LDL; otherwise, a pleiotropic effect of a genetic variant detected by a marginal model could simply be due to its association with LDL only, given the well-known correlation between the two types of lipids. Here, we develop a new pleiotropy testing procedure based only on GWAS summary statistics that can be applied for both marginal analysis and conditional analysis. Although the main technical development is based on published union-intersection testing methods, care is needed in specifying conditional models to avoid invalid statistical estimation and inference. In addition to the previously used likelihood ratio test, we also propose using generalized estimating equations under the working independence model for robust inference. We provide numerical examples based on both simulated and real data, including two large lipid GWAS summary association datasets based on ∼100,000 and ∼189,000 samples, respectively, to demonstrate the difference between marginal and conditional analyses, as well as the effectiveness of our new approach. Copyright © 2017 by the Genetics Society of America.

Female sex workers use power over their day-to-day lives to meet the condition of a conditional cash transfer intervention to incentivize safe sex.

PubMed

Cooper, Jan E; Dow, William H; de Walque, Damien; Keller, Ann C; McCoy, Sandra I; Fernald, Lia C H; Balampama, Marianna P; Kalolella, Admirabilis; Packel, Laura J; Wechsberg, Wendee M; Ozer, Emily J

2017-05-01

Female Sex Workers are a core population in the HIV epidemic, and interventions such as conditional cash transfers (CCTs), effective in other health domains, are a promising new approach to reduce the spread of HIV. Here we investigate how a population of Tanzanian female sex workers, though constrained in many ways, experience and use their power in the context of a CCT intervention that incentivizes safe sex. We analyzed 20 qualitative in-depth interviews with female sex workers enrolled in a randomized-controlled CCT program, the RESPECT II pilot, and found that while such women have limited choices, they do have substantial power over their work logistics that they leveraged to meet the conditions of the CCT and receive the cash award. It was through these decisions over work logistics, such as reducing the number of workdays and clients, that the CCT intervention had its greatest impact on modifying female sex workers' behavior. Copyright © 2017. Published by Elsevier Ltd.

Infectious mononucleosis-linked HLA class I single nucleotide polymorphism is associated with multiple sclerosis.

PubMed

Jafari, Naghmeh; Broer, Linda; Hoppenbrouwers, Ilse A; van Duijn, Cornelia M; Hintzen, Rogier Q

2010-11-01

Multiple sclerosis is a presumed autoimmune disease associated with genetic and environmental risk factors such as infectious mononucleosis. Recent research has shown infectious mononucleosis to be associated with a specific HLA class I polymorphism. Our aim was to test if the infectious mononucleosis-linked HLA class I single nucleotide polymorphism (rs6457110) is also associated with multiple sclerosis. Genotyping of the HLA-A single nucleotide polymorphism rs6457110 using TaqMan was performed in 591 multiple sclerosis cases and 600 controls. The association of multiple sclerosis with the HLA-A single nucleotide polymorphism was tested using logistic regression adjusted for age, sex and HLA-DRB1*1501. HLA-A minor allele (A) is associated with multiple sclerosis (OR = 0.68; p = 4.08 × 10( -5)). After stratification for HLA-DRB1*1501 risk allele (T) carrier we showed a significant OR of 0.70 (p = 0.003) for HLA-A. HLA class I single nucleotide polymorphism rs6457110 is associated with infectious mononucleosis and multiple sclerosis, independent of the major class II allele, supporting the hypothesis that shared genetics may contribute to the association between infectious mononucleosis and multiple sclerosis.

Depressive disorder in pregnant Latin women: does intimate partner violence matter?

PubMed

Fonseca-Machado, Mariana de Oliveira; Alves, Lisiane Camargo; Monteiro, Juliana Cristina Dos Santos; Stefanello, Juliana; Nakano, Ana Márcia Spanó; Haas, Vanderlei José; Gomes-Sponholz, Flávia

2015-05-01

To identify the association of antenatal depressive symptoms with intimate partner violence during the current pregnancy in Brazilian women. Intimate partner violence is an important risk factor for antenatal depression. To the authors' knowledge, there has been no study to date that assessed the association between intimate partner violence during pregnancy and antenatal depressive symptoms among Brazilian women. Cross-sectional study. Three hundred and fifty-eight pregnant women were enrolled in the study. The Edinburgh Postnatal Depression Scale and an adapted version of the instrument used in the World Health Organization Multi-country Study on Women's Health and Domestic Violence were used to measure antenatal depressive symptoms and psychological, physical and sexual acts of intimate partner violence during the current pregnancy respectively. Multiple logistic regression and multiple linear regression were used for data analysis. The prevalence of antenatal depressive symptoms, as determined by the cut-off score of 12 in the Edinburgh Postnatal Depression Scale, was 28·2% (101). Of the participants, 63 (17·6%) reported some type of intimate partner violence during pregnancy. Among them, 60 (95·2%) reported suffering psychological violence, 23 (36·5%) physical violence and one (1·6%) sexual violence. Multiple logistic regression and multiple linear regression indicated that antenatal depressive symptoms are extremely associated with intimate partner violence during pregnancy. Among Brazilian women, exposure to intimate partner violence during pregnancy increases the chances of experiencing antenatal depressive symptoms. Clinical nurses and nurses midwifes should pay attention to the particularities of Brazilian women, especially with regard to the occurrence of intimate partner violence, whose impacts on the mental health of this population are extremely significant, both during the gestational period and postpartum. © 2015 John Wiley & Sons Ltd.

The association of corporate work environment factors, health risks, and medical conditions with presenteeism among Australian employees.

PubMed

Musich, Shirley; Hook, Dan; Baaner, Stephanie; Spooner, Michelle; Edington, Dee W

2006-01-01

To investigate the impact of selected corporate environment factors, health risks, and medical conditions on job performance using a self-reported measure of presenteeism. A cross-sectional survey utilizing health risk appraisal (HRA) data merging presenteeism with corporate environment factors, health risks, and medical conditions. Approximately 8000 employees across ten diverse Australian corporations. Employees (N = 1523; participation rate, 19%) who completed an HRA questionnaire. Self-reported HRA data were used to test associations of defined adverse corporate environment factors with presenteeism. Stepwise multivariate logistic regression modeling assessed the relative associations of corporate environment factors, health risks, and medical conditions with increased odds of any presenteeism. Increased presenteeism was significantly associated with poor working conditions, ineffective management/leadership, and work/life imbalance (adjusting for age, gender, health risks, and medical conditions). In multivariate logistic regression models, work/life imbalance, poor working conditions, life dissatisfaction, high stress, back pain, allergies, and younger age were significantly associated with presenteeism. Although the study has some limitations, including a possible response bias caused by the relatively low participation rate across the corporations, the study does demonstrate significant associations between corporate environment factors, health risks, and medical conditions and self-reported presenteeism. The study provides initial evidence that health management programming may benefit on-the-job productivity outcomes if expanded to include interventions targeting work environments.

Relationships between common forest metrics and realized impacts of Hurricane Katrina on forest resources in Mississippi

Treesearch

Sonja N. Oswalt; Christopher M. Oswalt

2008-01-01

This paper compares and contrasts hurricane-related damage recorded across the Mississippi landscape in the 2 years following Katrina with initial damage assessments based on modeled parameters by the USDA Forest Service. Logistic and multiple regressions are used to evaluate the influence of stand characteristics on tree damage probability. Specifically, this paper...

Application of Bayesian methods to habitat selection modeling of the northern spotted owl in California: new statistical methods for wildlife research

Treesearch

Howard B. Stauffer; Cynthia J. Zabel; Jeffrey R. Dunk

2005-01-01

We compared a set of competing logistic regression habitat selection models for Northern Spotted Owls (Strix occidentalis caurina) in California. The habitat selection models were estimated, compared, evaluated, and tested using multiple sample datasets collected on federal forestlands in northern California. We used Bayesian methods in interpreting...

An Alternative to the 3PL: Using Asymmetric Item Characteristic Curves to Address Guessing Effects

ERIC Educational Resources Information Center

Lee, Sora; Bolt, Daniel M.

2018-01-01

Both the statistical and interpretational shortcomings of the three-parameter logistic (3PL) model in accommodating guessing effects on multiple-choice items are well documented. We consider the use of a residual heteroscedasticity (RH) model as an alternative, and compare its performance to the 3PL with real test data sets and through simulation…

Cognitive and Behavioural Correlates of Non-Adherence to HIV Anti-Retroviral Therapy: Theoretical and Practical Insight for Clinical Psychology and Health Psychology

ERIC Educational Resources Information Center

Begley, Kim; McLaws, Mary-Louise; Ross, Michael W.; Gold, Julian

2008-01-01

This cross-sectional study identified variables associated with protease inhibitor (PI) non-adherence in 179 patients taking anti-retroviral therapy. Univariate analyses identified 11 variables associated with PI non-adherence. Multiple logistic regression modelling identified three predictors of PI non-adherence: low adherence self-efficacy and…

An Iterative Maximum a Posteriori Estimation of Proficiency Level to Detect Multiple Local Likelihood Maxima

ERIC Educational Resources Information Center

Magis, David; Raiche, Gilles

2010-01-01

In this article the authors focus on the issue of the nonuniqueness of the maximum likelihood (ML) estimator of proficiency level in item response theory (with special attention to logistic models). The usual maximum a posteriori (MAP) method offers a good alternative within that framework; however, this article highlights some drawbacks of its…

A Comparison of Health-Risk Behaviors of Rural Migrants with Rural Residents and Urban Residents in China

ERIC Educational Resources Information Center

Chen, Xinguang; Stanton, Bonita; Li, Xiaoming; Fang, Xiaoyi; Lin, Danhua; Xiong, Qing

2009-01-01

Objective: To determine whether rural-to-urban migrants in China are more likely than rural and urban residents to engage in risk behaviors. Methods: Comparative analysis of survey data between migrants and rural and urban residents using age standardized rate and multiple logistic regression. Results: The prevalence and frequency of tobacco…

A Normalized Direct Approach for Estimating the Parameters of the Normal Ogive Three-Parameter Model for Ability Tests.

ERIC Educational Resources Information Center

Gugel, John F.

A new method for estimating the parameters of the normal ogive three-parameter model for multiple-choice test items--the normalized direct (NDIR) procedure--is examined. The procedure is compared to a more commonly used estimation procedure, Lord's LOGIST, using computer simulations. The NDIR procedure uses the normalized (mid-percentile)…

Using Multiple Indicators of Cognitive State in Logistic Models that Predict Individual Performance in Machine-Mediated Learning Environments.

ERIC Educational Resources Information Center

Hancock, Thomas E.; And Others

1995-01-01

In machine-mediated learning environments, there is a need for more reliable methods of calculating the probability that a learner's response will be correct in future trials. A combination of domain-independent response-state measures of cognition along with two instructional variables for maximum predictive ability are demonstrated. (Author/LRW)

Reduction of Racial Disparities in Prostate Cancer

DTIC Science & Technology

2008-12-01

inhibitors, aspirin, anti-TNF medications), and other medications of interest (testosterone, finasteride , alpha receptor blockers). 12 We...0.01. There were 14 (7%) control-patients who had finasteride use, with an average of 398.6 doses per individual. None of the prostate cancer...patients had prior finasteride use. In a multiple logistic regression model (Table 2, see supporting materials), after adjustment for the matching

Self-perception and malocclusion and their relation to oral appearance and function.

PubMed

Peres, Sílvia Helena de Carvalho Sales; Goya, Suzana; Cortellazzi, Karine Laura; Ambrosano, Gláucia Maria Bovi; Meneghim, Marcelo de Castro; Pereira, Antonio Carlos

2011-10-01

The aim of this study was to evaluate the relationship between malocclusion and self-perception of oral appearance/function, in 12/15-year-old Brazilian adolescents. The cluster sample consisted of 717 teenagers attending 24 urban public (n=611) and 5 rural public (n=107) schools in Maringá/PR. Malocclusion was measured using the Dental Aesthetic Index (DAI), in accordance with WHO recommendations. A parental questionnaire was applied to collect information on esthetic perception level and oral variables related to oral health. Univariate and multiple logistic regression analyses were performed. Multiple logistic regression confirmed that for 12-year-old, missing teeth (OR=2.865) and presence of openbite (open occlusal relationship) (OR=2.865) were risk indicators for speech capability. With regard to 15-year-old, presence of mandibular overjet (horizontal overlap) (OR=4.016) was a risk indicator for speech capability and molar relationship (OR=1.661) was a risk indicator for chewing capability. The impact of malocclusion on adolescents' life was confirmed in this study. Speech and chewing capability were associated with orthodontic deviations, which should be taken into consideration in oral health planning, to identify risk groups and improve community health services.

Socio-demographic correlates of breast-feeding in urban slums of Chandigarh.

PubMed

Kumar, Dinesh; Agarwal, Neeraj; Swami, H M

2006-11-01

Whether socio-demographic factors are associated with initiation of breast-feeding in urban slums of Chandigarh. (1) To study the prevailing breast-feeding practices adopted by mothers, (2) To study the socio-demographic factors associated with initiation of breast-feeding. Cross-sectional. Mothers of infants willing to participate in the study in the selected area. A total of 270 respondents. Social and demographic characteristics like age, socioeconomic status, educational level, birth interval, parity, gender preference, natal care practices, etc.; and variables related to various aspects of breast-feeding practices like prelacteal feed, initiation of feeding, colostrum feeding, reasons of discarding colostrum, etc. Chi-square test and odd ratios along with their respective 95% confidence intervals, multiple logistic regression analysis. Out of all 270 respondents, 159 (58.9%) initiated breast-feeding within 6 h of birth, only 43 (15.9%) discarded colostrum and 108 (40.0%) mothers gave prelacteal feed. Illiterate/just literate mothers who delivered at home were found at significantly higher risk of delay in initiation of breast-feeding on the basis of multiple logistic regression analysis. Promotion of institutional deliveries and imparting health education to mothers for protecting and promoting optimal breast-feeding practices are suggested.

Can we "predict" long-term outcome for ambulatory transcutaneous electrical nerve stimulation in patients with chronic pain?

PubMed

Köke, Albère J; Smeets, Rob J E M; Perez, Roberto S; Kessels, Alphons; Winkens, Bjorn; van Kleef, Maarten; Patijn, Jacob

2015-03-01

Evidence for effectiveness of transcutaneous electrical nerve stimulation (TENS) is still inconclusive. As heterogeneity of chronic pain patients might be an important factor for this lack of efficacy, identifying factors for a successful long-term outcome is of great importance. A prospective study was performed to identify variables with potential predictive value for 2 outcome measures on long term (6 months); (1) continuation of TENS, and (2) a minimally clinical important pain reduction of ≥ 33%. At baseline, a set of risk factors including pain-related variables, psychological factors, and disability was measured. In a multiple logistic regression analysis, higher patient's expectations, neuropathic pain, no severe pain (< 80 mm visual analogue scale [VAS]) were independently related to long-term continuation of TENS. For the outcome "minimally clinical important pain reduction," the multiple logistic regression analysis indicated that no multisited pain (> 2 pain locations) and intermittent pain were positively and independently associated with a minimally clinical important pain reduction of ≥ 33%. The results showed that factors associated with a successful outcome in the long term are dependent on definition of successful outcome. © 2014 World Institute of Pain.

Cannabis use and destructive periodontal diseases among adolescents.

PubMed

López, Rodrigo; Baelum, Vibeke

2009-03-01

The aim of this experiment was to investigate the association between cannabis use and destructive periodontal disease among adolescents. Data from a population screening examination carried out among Chilean high school students from the Province of Santiago were used to determine whether there was an association between the use of cannabis and signs of periodontal diseases as defined by (1) the presence of necrotizing ulcerative gingival (NUG) lesions or (2) the presence of clinical attachment loss (CAL) > or =3 mm. The cannabis exposures variables considered were "Ever use of cannabis" (yes/no) and "Regular use of cannabis" (yes/no). The associations were investigated using multiple logistic regression analyses adjusted for age, gender, paternal income, paternal education, frequency of tooth-brushing and time since last dental visit. Multiple logistic regression analyses showed that "Ever use of cannabis" was significantly negatively associated with the presence of NUG lesions (OR=0.47 [0.2;0.9]) among non-smokers only. No significant associations were observed between the presence of CAL > or =3 mm and cannabis use in either of the smoking groups. There was no evidence to suggest that the use of cannabis is positively associated with periodontal diseases in this adolescent population.