Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses.

PubMed

Faul, Franz; Erdfelder, Edgar; Buchner, Axel; Lang, Albert-Georg

2009-11-01

G*Power is a free power analysis program for a variety of statistical tests. We present extensions and improvements of the version introduced by Faul, Erdfelder, Lang, and Buchner (2007) in the domain of correlation and regression analyses. In the new version, we have added procedures to analyze the power of tests based on (1) single-sample tetrachoric correlations, (2) comparisons of dependent correlations, (3) bivariate linear regression, (4) multiple linear regression based on the random predictor model, (5) logistic regression, and (6) Poisson regression. We describe these new features and provide a brief introduction to their scope and handling.

Relationships among personality traits, metabolic syndrome, and metabolic syndrome scores: The Kakegawa cohort study.

PubMed

Ohseto, Hisashi; Ishikuro, Mami; Kikuya, Masahiro; Obara, Taku; Igarashi, Yuko; Takahashi, Satomi; Kikuchi, Daisuke; Shigihara, Michiko; Yamanaka, Chizuru; Miyashita, Masako; Mizuno, Satoshi; Nagai, Masato; Matsubara, Hiroko; Sato, Yuki; Metoki, Hirohito; Tachibana, Hirofumi; Maeda-Yamamoto, Mari; Kuriyama, Shinichi

2018-04-01

Metabolic syndrome and the presence of metabolic syndrome components are risk factors for cardiovascular disease (CVD). However, the association between personality traits and metabolic syndrome remains controversial, and few studies have been conducted in East Asian populations. We measured personality traits using the Japanese version of the Eysenck Personality Questionnaire (Revised Short Form) and five metabolic syndrome components-elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose-in 1322 participants aged 51.1±12.7years old from Kakegawa city, Japan. Metabolic syndrome score (MS score) was defined as the number of metabolic syndrome components present, and metabolic syndrome as having the MS score of 3 or higher. We performed multiple logistic regression analyses to examine the relationship between personality traits and metabolic syndrome components and multiple regression analyses to examine the relationship between personality traits and MS scores adjusted for age, sex, education, income, smoking status, alcohol use, and family history of CVD and diabetes mellitus. We also examine the relationship between personality traits and metabolic syndrome presence by multiple logistic regression analyses. "Extraversion" scores were higher in those with metabolic syndrome components (elevated waist circumference: P=0.001; elevated triglycerides: P=0.01; elevated blood pressure: P=0.004; elevated fasting glucose: P=0.002). "Extraversion" was associated with the MS score (coefficient=0.12, P=0.0003). No personality trait was significantly associated with the presence of metabolic syndrome. Higher "extraversion" scores were related to higher MS scores, but no personality trait was significantly associated with the presence of metabolic syndrome. Copyright © 2018 Elsevier Inc. All rights reserved.

Deadlines at work and sleep quality. Cross-sectional and longitudinal findings among Danish knowledge workers.

PubMed

Rugulies, Reiner; Martin, Marie H T; Garde, Anne Helene; Persson, Roger; Albertsen, Karen

2012-03-01

Exposure to deadlines at work is increasing in several countries and may affect health. We aimed to investigate cross-sectional and longitudinal associations between frequency of difficult deadlines at work and sleep quality. Study participants were knowledge workers, drawn from a representative sample of Danish employees who responded to a baseline questionnaire in 2006 (n = 363) and a follow-up questionnaire in 2007 (n = 302). Frequency of difficult deadlines was measured by self-report and categorized into low, intermediate, and high. Sleep quality was measured with a Total Sleep Quality Score and two indexes (Awakening Index and Disturbed Sleep Index) derived from the Karolinska Sleep Questionnaire. Analyses on the association between frequency of deadlines and sleep quality scores were conducted with multiple linear regression models, adjusted for potential confounders. In addition, we used multiple logistic regression models to analyze whether frequency of deadlines at baseline predicted caseness of sleep problems at follow-up among participants free of sleep problems at baseline. Frequent deadlines were cross-sectionally and longitudinally associated with poorer sleep quality on all three sleep quality measures. Associations in the longitudinal analyses were greatly attenuated when we adjusted for baseline sleep quality. The logistic regression analyses showed that frequent deadlines at baseline were associated with elevated odds ratios for caseness of sleep problems at follow-up, however, confidence intervals were wide in these analyses. Frequent deadlines at work were associated with poorer sleep quality among Danish knowledge workers. We recommend investigating the relation between deadlines and health endpoints in large-scale epidemiologic studies. Copyright © 2011 Wiley Periodicals, Inc.

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.

Financial ties and concordance between results and conclusions in meta-analyses: retrospective cohort study.

PubMed

Yank, Veronica; Rennie, Drummond; Bero, Lisa A

2007-12-08

To determine whether financial ties to one drug company are associated with favourable results or conclusions in meta-analyses on antihypertensive drugs. Retrospective cohort study. Meta-analyses published up to December 2004 that were not duplicates and evaluated the effects of antihypertensive drugs compared with any comparator on clinical end points in adults. Financial ties were categorised as one drug company compared with all others. The main outcomes were the results and conclusions of meta-analyses, with both outcomes separately categorised as being favourable or not favourable towards the study drug. We also collected data on characteristics of meta-analyses that the literature suggested might be associated with favourable results or conclusions. 124 meta-analyses were included in the study, 49 (40%) of which had financial ties to one drug company. On univariate logistic regression analyses, meta-analyses of better methodological quality were more likely to have favourable results (odds ratio 1.16, 95% confidence interval 1.07 to 1.27). Although financial ties to one drug company were not associated with favourable results, such ties constituted the only characteristic significantly associated with favourable conclusions (4.09, 1.30 to 12.83). When controlling for other characteristics of meta-analyses in multiple logistic regression analyses, meta-analyses that had financial ties to one drug company remained more likely to report favourable conclusions (5.11, 1.54 to 16.92). Meta-analyses on antihypertensive drugs and with financial ties to one drug company are not associated with favourable results but are associated with favourable conclusions.

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.

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

PubMed

Kim, Seongho; Heath, Elisabeth; Heilbrun, Lance

2017-06-01

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

The impact of attachment and depression symptoms on multiple risk behaviors in post-war adolescents in northern Uganda.

PubMed

Okello, J; Nakimuli-Mpungu, E; Klasen, F; Voss, C; Musisi, S; Broekaert, E; Derluyn, I

2015-07-15

We have previously shown that depression symptoms are associated with multiple risk behaviors and that parental attachments are protective against depression symptoms in post-war adolescents. Accumulating literature indicates that low levels of attachment may sensitize individuals to increased multiple risk behaviors when depression symptoms exist. This investigation examined the interactive effects of attachment and depression symptoms on multiple risk behavior. We conducted hierarchical logistic regression analyses to examine the impact of attachment and depression symptoms on multiple risk behavior in our post-war sample of 551 adolescents in Gulu district. Analyses revealed interactive effects for only maternal attachment-by-depression interaction. Interestingly, high levels of maternal attachment exacerbated the relationship between depression symptoms and multiple risk behaviors while low levels of maternal attachment attenuated this relationship. It is possible that this analysis could be biased by a common underlying factor that influences self-reporting and therefore is correlated with each of self-reported attachment security, depressive symptoms, and multiple risk behaviors. These findings suggest that maternal attachment serves as a protective factor at low levels while serving as an additional risk factor at high levels. Findings support and expand current knowledge about the roles that attachment and depression symptoms play in the development of multiple risk behaviors and suggest a more complex etiology for post-war adolescents. Copyright © 2015 Elsevier B.V. All rights reserved.

Classification and regression tree analysis vs. multivariable linear and logistic regression methods as statistical tools for studying haemophilia.

PubMed

Henrard, S; Speybroeck, N; Hermans, C

2015-11-01

Haemophilia is a rare genetic haemorrhagic disease characterized by partial or complete deficiency of coagulation factor VIII, for haemophilia A, or IX, for haemophilia B. As in any other medical research domain, the field of haemophilia research is increasingly concerned with finding factors associated with binary or continuous outcomes through multivariable models. Traditional models include multiple logistic regressions, for binary outcomes, and multiple linear regressions for continuous outcomes. Yet these regression models are at times difficult to implement, especially for non-statisticians, and can be difficult to interpret. The present paper sought to didactically explain how, why, and when to use classification and regression tree (CART) analysis for haemophilia research. The CART method is non-parametric and non-linear, based on the repeated partitioning of a sample into subgroups based on a certain criterion. Breiman developed this method in 1984. Classification trees (CTs) are used to analyse categorical outcomes and regression trees (RTs) to analyse continuous ones. The CART methodology has become increasingly popular in the medical field, yet only a few examples of studies using this methodology specifically in haemophilia have to date been published. Two examples using CART analysis and previously published in this field are didactically explained in details. There is increasing interest in using CART analysis in the health domain, primarily due to its ease of implementation, use, and interpretation, thus facilitating medical decision-making. This method should be promoted for analysing continuous or categorical outcomes in haemophilia, when applicable. © 2015 John Wiley & Sons Ltd.

The effect of playing tactics and situational variables on achieving score-box possessions in a professional soccer team.

PubMed

Lago-Ballesteros, Joaquin; Lago-Peñas, Carlos; Rey, Ezequiel

2012-01-01

The aim of this study was to analyse the influence of playing tactics, opponent interaction and situational variables on achieving score-box possessions in professional soccer. The sample was constituted by 908 possessions obtained by a team from the Spanish soccer league in 12 matches played during the 2009-2010 season. Multidimensional qualitative data obtained from 12 ordered categorical variables were used. Sampled matches were registered by the AMISCO PRO system. Data were analysed using chi-square analysis and multiple logistic regression analysis. Of 908 possessions, 303 (33.4%) produced score-box possessions, 477 (52.5%) achieved progression and 128 (14.1%) failed to reach any sort of progression. Multiple logistic regression showed that, for the main variable "team possession type", direct attacks and counterattacks were three times more effective than elaborate attacks for producing a score-box possession (P < 0.05). Team possession originating from the middle zones and playing against less than six defending players (P < 0.001) registered a higher success than those started in the defensive zone with a balanced defence. When the team was drawing or winning, the probability of reaching the score-box decreased by 43 and 53 percent, respectively, compared with the losing situation (P < 0.05). Accounting for opponent interactions and situational variables is critical to evaluate the effectiveness of offensive playing tactics on producing score-box possessions.

Predictors of dental visits among primary school children in the rural Australian community of Lithgow.

PubMed

John, James Rufus; Mannan, Haider; Nargundkar, Subrat; D'Souza, Mario; Do, Loc Giang; Arora, Amit

2017-04-11

Regular dental attendance is significant in maintaining and improving children's oral health and well-being. This study aims to determine the factors that predict and influence dental visits in primary school children residing in the rural community of Lithgow, New South Wales (NSW), Australia. All six primary schools of Lithgow were approached to participate in a cross-sectional survey prior to implementing water fluoridation in 2014. Children aged 6-13 years (n = 667) were clinically examined for their oral health status and parents were requested to complete a questionnaire on fluoride history, diet, last dental visit, and socio-demographic characteristics. Multiple logistic regression analyses were employed to examine the independent predictors of a 6-monthly and a yearly dental visit. Overall, 53% of children visited a dentist within six months and 77% within twelve months. In multiple logistic regression analyses, age of the child and private health insurance coverage were significantly associated with both 6-monthly and twelve-month dental visits. In addition, each serve of chocolate consumption was significantly associated with a 27% higher odds (OR = 1.27, 95% CI: 1.05-1.54) of a 6-monthly dental visit. It is imperative that the socio-demographic and dietary factors that influence child oral health must be effectively addressed when developing the oral health promotion policies to ensure better oral health outcomes.

Exposure to child abuse and risk for mental health problems in women.

PubMed

Schneider, Renee; Baumrind, Nikki; Kimerling, Rachel

2007-01-01

Risk for adult mental health problems associated with child sexual, physical, or emotional abuse and multiple types of child abuse was examined. Logistic regression analyses were used to test study hypotheses in a population-based sample of women (N = 3,936). As expected, child sexual, physical, and emotional abuse were independently associated with increased risk for mental health problems. History of multiple types of child abuse was also associated with elevated risk for mental health problems. In particular, exposure to all three types of child abuse was linked to a 23-fold increase in risk for probable posttraumatic stress disorder (PTSD). Findings underscore relations between child emotional abuse and adult mental health problems and highlight the need for mental health services for survivors of multiple types of child abuse.

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.

Modeling Polytomous Item Responses Using Simultaneously Estimated Multinomial Logistic Regression Models

ERIC Educational Resources Information Center

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

2010-01-01

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

Exploring improvements in patient logistics in Dutch hospitals with a survey.

PubMed

van Lent, Wineke A M; Sanders, E Marloes; van Harten, Wim H

2012-08-01

Research showed that promising approaches such as benchmarking, operations research, lean management and six sigma, could be adopted to improve patient logistics in healthcare. To our knowledge, little research has been conducted to obtain an overview on the use, combination and effects of approaches to improve patient logistics in hospitals. We therefore examined the approaches and tools used to improve patient logistics in Dutch hospitals, the reported effects of these approaches on performance, the applied support structure and the methods used to evaluate the effects. A survey among experts on patient logistics in 94 Dutch hospitals. The survey data were analysed using cross tables. Forty-eight percent of all hospitals participated. Ninety-eight percent reported to have used multiple approaches, 39% of them used five or more approaches. Care pathways were the preferred approach by 43% of the hospitals, followed by business process re-engineering and lean six sigma (both 13%). Flowcharts were the most commonly used tool, they were used on a regular basis by 94% of the hospitals. Less than 10% of the hospitals used data envelopment analysis and critical path analysis on a regular basis. Most hospitals (68%) relied on external support for process analyses and education on patient logistics, only 24% had permanent internal training programs on patient logistics. Approximately 50% of the hospitals that evaluated the effects of approaches on efficiency, throughput times and financial results, reported that they had accomplished their goals. Goal accomplishment in general hospitals ranged from 63% to 67%, in academic teaching hospitals from 0% to 50%, and in teaching hospitals from 25% to 44%. More than 86% performed an evaluation, 53% performed a post-intervention measurement. Patient logistics appeared to be a rather new subject as most hospitals had not selected a single approach, they relied on external support and they did not have permanent training programs. Hospitals used a combination of approaches and tools, about half of the hospitals reported goal accomplishment and no approach seemed to outperform the others. To make improvement efforts more successful, research should be conducted into the selection and application of approaches, their contingency factors, and goal-setting procedures.

Exploring improvements in patient logistics in Dutch hospitals with a survey

PubMed Central

2012-01-01

Background Research showed that promising approaches such as benchmarking, operations research, lean management and six sigma, could be adopted to improve patient logistics in healthcare. To our knowledge, little research has been conducted to obtain an overview on the use, combination and effects of approaches to improve patient logistics in hospitals. We therefore examined the approaches and tools used to improve patient logistics in Dutch hospitals, the reported effects of these approaches on performance, the applied support structure and the methods used to evaluate the effects. Methods A survey among experts on patient logistics in 94 Dutch hospitals. The survey data were analysed using cross tables. Results Forty-eight percent of all hospitals participated. Ninety-eight percent reported to have used multiple approaches, 39% of them used five or more approaches. Care pathways were the preferred approach by 43% of the hospitals, followed by business process re-engineering and lean six sigma (both 13%). Flowcharts were the most commonly used tool, they were used on a regular basis by 94% of the hospitals. Less than 10% of the hospitals used data envelopment analysis and critical path analysis on a regular basis. Most hospitals (68%) relied on external support for process analyses and education on patient logistics, only 24% had permanent internal training programs on patient logistics. Approximately 50% of the hospitals that evaluated the effects of approaches on efficiency, throughput times and financial results, reported that they had accomplished their goals. Goal accomplishment in general hospitals ranged from 63% to 67%, in academic teaching hospitals from 0% to 50%, and in teaching hospitals from 25% to 44%. More than 86% performed an evaluation, 53% performed a post-intervention measurement. Conclusions Patient logistics appeared to be a rather new subject as most hospitals had not selected a single approach, they relied on external support and they did not have permanent training programs. Hospitals used a combination of approaches and tools, about half of the hospitals reported goal accomplishment and no approach seemed to outperform the others. To make improvement efforts more successful, research should be conducted into the selection and application of approaches, their contingency factors, and goal-setting procedures. PMID:22852880

[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.

A guide to onboard checkout. Volume 7: RF communications

NASA Technical Reports Server (NTRS)

1971-01-01

The radio frequency communications subsystem for a space station is considered, with respect to onboard checkout requirements. The subsystem comprises all equipment necessary for transmitting and receiving, tracking and ranging, command, multiple voice and television information, and broadband experiment data. The communications subsystem provides a radio frequency interface between the space station and ground stations, either directly or indirectly, through a data relay satellite system, independent free-flying experiment modules, and logistics vehicles. Reliability, maintenance, and failure analyses are discussed, and computer programming techniques are presented.

Parenting styles and alcohol consumption among Brazilian adolescents.

PubMed

Paiva, Fernando Santana; Bastos, Ronaldo Rocha; Ronzani, Telmo Mota

2012-10-01

This study evaluates the correlation between alcohol consumption in adolescence and parenting styles of socialization among Brazilian adolescents. The sample was composed of 273 adolescents, 58% whom were males. Instruments were: 1) Sociodemographic Questionnaire; 2) Demand and Responsiveness Scales; 3) Drug Use Screening Inventory (DUSI). Study analyses employed multiple correspondence analysis and logistic regression. Maternal, but not paternal, authoritative and authoritarian parenting styles were directly related to adolescent alcohol intake. The style that mothers use to interact with their children may influence uptake of high-risk behaviors.

Using Multiple and Logistic Regression to Estimate the Median WillCost and Probability of Cost and Schedule Overrun for Program Managers

DTIC Science & Technology

2017-03-23

PUBLIC RELEASE; DISTRIBUTION UNLIMITED Using Multiple and Logistic Regression to Estimate the Median Will- Cost and Probability of Cost and... Cost and Probability of Cost and Schedule Overrun for Program Managers Ryan C. Trudelle Follow this and additional works at: https://scholar.afit.edu...afit.edu. Recommended Citation Trudelle, Ryan C., "Using Multiple and Logistic Regression to Estimate the Median Will- Cost and Probability of Cost and

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.

The association between alcohol use and problematic internet use: A large-scale nationwide cross-sectional study of adolescents in Japan.

PubMed

Morioka, Hisayoshi; Itani, Osamu; Osaki, Yoneatsu; Higuchi, Susumu; Jike, Maki; Kaneita, Yoshitaka; Kanda, Hideyuki; Nakagome, Sachi; Ohida, Takashi

2017-03-01

This study aimed to clarify the associations between the frequency and amount of alcohol consumption and problematic Internet use, such as Internet addiction and excessive Internet use. A self-administered questionnaire survey was administered to students enrolled in randomly selected junior and senior high schools throughout Japan, and responses from 100,050 students (51,587 males and 48,463 females) were obtained. Multiple logistic regression analyses were performed in order to examine the associations between alcohol use and problematic Internet, use such as Internet addiction (Young Diagnostic Questionnaire for Internet Addiction ≥5) and excessive Internet use (≥5 h/day). The results of multiple logistic regression analyses indicated that the adjusted odds ratios for Internet addiction (YDQ ≥5) and excessive Internet use (≥5 h/day) became higher as the number of days in which alcohol had been consumed during the previous 30 days increased. In addition, the adjusted odds ratio for excessive Internet use (≥5 h/day) indicated a dose-dependent association with the amount of alcohol consumed per session. This study revealed that adolescents showing problematic Internet use consumed alcohol more frequently and consumed a greater amount of alcohol than those without problematic Internet use. These findings suggest a close association between drinking and problematic Internet use among Japanese adolescents. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

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.

Bacterial infections of Chinook salmon, Oncorhynchus tshawytscha (Walbaum), returning to gamete collecting weirs in Michigan.

PubMed

Loch, T P; Scribner, K; Tempelman, R; Whelan, G; Faisal, M

2012-01-01

Herein, we describe the prevalence of bacterial infections in Chinook salmon, Oncorhynchus tshawytscha (Walbaum), returning to spawn in two tributaries within the Lake Michigan watershed. Ten bacterial genera, including Renibacterium, Aeromonas, Carnobacterium, Serratia, Proteus, Pseudomonas, Hafnia, Salmonella, Shewanella and Morganella, were detected in the kidneys of Chinook salmon (n = 480) using culture, serological and molecular analyses. Among these, Aeromonas salmonicida was detected at a prevalence of ∼15%. Analyses revealed significant interactions between location/time of collection and gender for these infections, whereby overall infection prevalence increased greatly later in the spawning run and was significantly higher in females. Renibacterium salmoninarum was detected in fish kidneys at an overall prevalence of >25%. Logistic regression analyses revealed that R. salmoninarum prevalence differed significantly by location/time of collection and gender, with a higher likelihood of infection later in the spawning season and in females vs. males. Chi-square analyses quantifying non-independence of infection by multiple pathogens revealed a significant association between R. salmoninarum and motile aeromonad infections. Additionally, greater numbers of fish were found to be co-infected by multiple bacterial species than would be expected by chance alone. The findings of this study suggest a potential synergism between bacteria infecting spawning Chinook salmon. © 2011 Blackwell Publishing Ltd.

Common genetic variants in the 9p21 region and their associations with multiple tumours.

PubMed

Gu, F; Pfeiffer, R M; Bhattacharjee, S; Han, S S; Taylor, P R; Berndt, S; Yang, H; Sigurdson, A J; Toro, J; Mirabello, L; Greene, M H; Freedman, N D; Abnet, C C; Dawsey, S M; Hu, N; Qiao, Y-L; Ding, T; Brenner, A V; Garcia-Closas, M; Hayes, R; Brinton, L A; Lissowska, J; Wentzensen, N; Kratz, C; Moore, L E; Ziegler, R G; Chow, W-H; Savage, S A; Burdette, L; Yeager, M; Chanock, S J; Chatterjee, N; Tucker, M A; Goldstein, A M; Yang, X R

2013-04-02

The chromosome 9p21.3 region has been implicated in the pathogenesis of multiple cancers. We systematically examined up to 203 tagging SNPs of 22 genes on 9p21.3 (19.9-32.8 Mb) in eight case-control studies: thyroid cancer, endometrial cancer (EC), renal cell carcinoma, colorectal cancer (CRC), colorectal adenoma (CA), oesophageal squamous cell carcinoma (ESCC), gastric cardia adenocarcinoma and osteosarcoma (OS). We used logistic regression to perform single SNP analyses for each study separately, adjusting for study-specific covariates. We combined SNP results across studies by fixed-effect meta-analyses and a newly developed subset-based statistical approach (ASSET). Gene-based P-values were obtained by the minP method using the Adaptive Rank Truncated Product program. We adjusted for multiple comparisons by Bonferroni correction. Rs3731239 in cyclin-dependent kinase inhibitors 2A (CDKN2A) was significantly associated with ESCC (P=7 × 10(-6)). The CDKN2A-ESCC association was further supported by gene-based analyses (Pgene=0.0001). In the meta-analyses by ASSET, four SNPs (rs3731239 in CDKN2A, rs615552 and rs573687 in CDKN2B and rs564398 in CDKN2BAS) showed significant associations with ESCC and EC (P<2.46 × 10(-4)). One SNP in MTAP (methylthioadenosine phosphorylase) (rs7023329) that was previously associated with melanoma and nevi in multiple genome-wide association studies was associated with CRC, CA and OS by ASSET (P=0.007). Our data indicate that genetic variants in CDKN2A, and possibly nearby genes, may be associated with ESCC and several other tumours, further highlighting the importance of 9p21.3 genetic variants in carcinogenesis.

The Air Quality Model Evaluation International Initiative ...

EPA Pesticide Factsheets

This presentation provides an overview of the Air Quality Model Evaluation International Initiative (AQMEII). It contains a synopsis of the three phases of AQMEII, including objectives, logistics, and timelines. It also provides a number of examples of analyses conducted through AQMEII with a particular focus on past and future analyses of deposition. The National Exposure Research Laboratory (NERL) Computational Exposure Division (CED) develops and evaluates data, decision-support tools, and models to be applied to media-specific or receptor-specific problem areas. CED uses modeling-based approaches to characterize exposures, evaluate fate and transport, and support environmental diagnostics/forensics with input from multiple data sources. It also develops media- and receptor-specific models, process models, and decision support tools for use both within and outside of EPA.

Diagnostic and psychosocial differences in psychiatrically hospitalized military service members with single versus multiple suicide attempts.

PubMed

Kochanski-Ruscio, Kristen M; Carreno-Ponce, Jaime T; DeYoung, Kathryn; Grammer, Geoffrey; Ghahramanlou-Holloway, Marjan

2014-04-01

Individuals with multiple versus single suicide attempts present a more severe clinical picture and may be at greater risk for suicide. Yet group differences within military samples have been vastly understudied. The objective is to determine demographic, diagnostic, and psychosocial differences, based on suicide attempt status, among military inpatients admitted for suicide-related events. A retrospective chart review design was used with a total of 423 randomly selected medical records of psychiatric admissions to a military hospital from 2001 to 2006. Chi-square analyses indicated that individuals with multiple versus single suicide attempts were significantly more likely to have documented childhood sexual abuse (p =.025); problem substance use (p=.001); mood disorder diagnosis (p=.005); substance disorder diagnosis (p =.050); personality disorder not otherwise specified diagnosis (p =.018); and Axis II traits or diagnosis (p=.038) when compared to those with a single attempt history. Logistic regression analyses showed that males with multiple suicide attempts were more likely to have problem substance use (p=.005) and a mood disorder diagnosis (p =.002), while females with a multiple attempt history were more likely to have a history of childhood sexual (p =.027). Clinically meaningful differences among military inpatients with single versus multiple suicide attempts exist. Targeted Department of Defense suicide prevention and intervention efforts that address the unique needs of these two specific at-risk subgroups are additionally needed. Published by Elsevier Inc.

Osm-Oriented Method of Multimodal Route Planning

NASA Astrophysics Data System (ADS)

Li, X.; Wu, Q.; Chen, L.; Xiong, W.; Jing, N.

2015-07-01

With the increasing pervasiveness of basic facilitate of transportation and information, the need of multimodal route planning is becoming more essential in the fields of communication and transportation, urban planning, logistics management, etc. This article mainly described an OSM-oriented method of multimodal route planning. Firstly, it introduced how to extract the information we need from OSM data and build proper network model and storage model; then it analysed the accustomed cost standard adopted by most travellers; finally, we used shortest path algorithm to calculate the best route with multiple traffic means.

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.

Poor anaerobic power/capability and static balance predicted prospective musculoskeletal injuries among Soldiers of the 101st Airborne (Air Assault) Division.

PubMed

Nagai, Takashi; Lovalekar, Mita; Wohleber, Meleesa F; Perlsweig, Katherine A; Wirt, Michael D; Beals, Kim

2017-11-01

Musculoskeletal injuries have negatively impacted tactical readiness. The identification of prospective and modifiable risk factors of preventable musculoskeletal injuries can guide specific injury prevention strategies for Soldiers and health care providers. To analyze physiological and neuromuscular characteristics as predictors of preventable musculoskeletal injuries. Prospective-cohort study. A total of 491 Soldiers were enrolled and participated in the baseline laboratory testing, including body composition, aerobic capacity, anaerobic power/capacity, muscular strength, flexibility, static balance, and landing biomechanics. After reviewing their medical charts, 275 male Soldiers who met the criteria were divided into two groups: with injuries (INJ) and no injuries (NOI). Simple and multiple logistic regression analyses were used to calculate the odds ratio (OR) and significant predictors of musculoskeletal injuries (p<0.05). The final multiple logistic regression model included the static balance with eyes-closed and peak anaerobic power as predictors of future injuries (p<0.001). The current results highlighted the importance of anaerobic power/capacity and static balance. High intensity training and balance exercise should be incorporated in their physical training as countermeasures. Copyright © 2017 Sports Medicine Australia. 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.

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

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.

Pediatric Irritable Bowel Syndrome Patient and Parental Characteristics Differ by Care Management Type.

PubMed

Hollier, John M; Czyzewski, Danita I; Self, Mariella M; Weidler, Erica M; Smith, E O'Brian; Shulman, Robert J

2017-03-01

This study evaluates whether certain patient or parental characteristics are associated with gastroenterology (GI) referral versus primary pediatrics care for pediatric irritable bowel syndrome (IBS). A retrospective clinical trial sample of patients meeting pediatric Rome III IBS criteria was assembled from a single metropolitan health care system. Baseline socioeconomic status (SES) and clinical symptom measures were gathered. Various instruments measured participant and parental psychosocial traits. Study outcomes were stratified by GI referral versus primary pediatrics care. Two separate analyses of SES measures and GI clinical symptoms and psychosocial measures identified key factors by univariate and multiple logistic regression analyses. For each analysis, identified factors were placed in unadjusted and adjusted multivariate logistic regression models to assess their impact in predicting GI referral. Of the 239 participants, 152 were referred to pediatric GI, and 87 were managed in primary pediatrics care. Of the SES and clinical symptom factors, child self-assessment of abdominal pain duration and lower percentage of people living in poverty were the strongest predictors of GI referral. Among the psychosocial measures, parental assessment of their child's functional disability was the sole predictor of GI referral. In multivariate logistic regression models, all selected factors continued to predict GI referral in each model. Socioeconomic environment, clinical symptoms, and functional disability are associated with GI referral. Future interventions designed to ameliorate the effect of these identified factors could reduce unnecessary specialty consultations and health care overutilization for IBS.

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

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.

Factors predicting work outcome in Japanese patients with schizophrenia: role of multiple functioning levels.

PubMed

Sumiyoshi, Chika; Harvey, Philip D; Takaki, Manabu; Okahisa, Yuko; Sato, Taku; Sora, Ichiro; Nuechterlein, Keith H; Subotnik, Kenneth L; Sumiyoshi, Tomiki

2015-09-01

Functional outcomes in individuals with schizophrenia suggest recovery of cognitive, everyday, and social functioning. Specifically improvement of work status is considered to be most important for their independent living and self-efficacy. The main purposes of the present study were 1) to identify which outcome factors predict occupational functioning, quantified as work hours, and 2) to provide cut-offs on the scales for those factors to attain better work status. Forty-five Japanese patients with schizophrenia and 111 healthy controls entered the study. Cognition, capacity for everyday activities, and social functioning were assessed by the Japanese versions of the MATRICS Cognitive Consensus Battery (MCCB), the UCSD Performance-based Skills Assessment-Brief (UPSA-B), and the Social Functioning Scale Individuals' version modified for the MATRICS-PASS (Modified SFS for PASS), respectively. Potential factors for work outcome were estimated by multiple linear regression analyses (predicting work hours directly) and a multiple logistic regression analyses (predicting dichotomized work status based on work hours). ROC curve analyses were performed to determine cut-off points for differentiating between the better- and poor work status. The results showed that a cognitive component, comprising visual/verbal learning and emotional management, and a social functioning component, comprising independent living and vocational functioning, were potential factors for predicting work hours/status. Cut-off points obtained in ROC analyses indicated that 60-70% achievements on the measures of those factors were expected to maintain the better work status. Our findings suggest that improvement on specific aspects of cognitive and social functioning are important for work outcome in patients with schizophrenia.

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.

Patterns of adverse childhood experiences and substance use among young adults: A latent class analysis.

PubMed

Shin, Sunny H; McDonald, Shelby Elaine; Conley, David

2018-03-01

Adverse childhood experiences (ACEs) have been strongly linked with subsequent substance use. The aim of this study was to investigate how different patterns of ACEs influence substance use in young adulthood. Using a community sample of young individuals (N=336; ages 18-25), we performed latent class analyses (LCA) to identify homogenous groups of young people with similar patterns of ACEs. Exposure to ACEs incorporates 13 childhood adversities including childhood maltreatment, household dysfunction, and community violence. Multiple linear and logistic regression models were used in an effort to examine the associations between ACEs classes and four young adult outcomes such as alcohol-related problems, current tobacco use, drug dependence symptoms, and psychological distress. LCA identified four heterogeneous classes of young people distinguished by different patterns of ACEs exposure: Low ACEs (56%), Household Dysfunction/Community Violence (14%), Emotional ACEs (14%), and High/Multiple ACEs (16%). Multiple regression analyses found that compared to those in the Low ACEs class, young adults in the High/Multiple ACEs class reported more alcohol-related problems, current tobacco use, and psychological symptoms, controlling for sociodemographic characteristics and common risk factors for substance use such as peer substance use. Our findings confirm that for many young people, ACEs occur as multiple rather than single experiences. The results of this research suggest that exposure to poly-victimization during childhood is particularly related to substance use during young adulthood. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

Urinary symptoms following external beam radiotherapy of the prostate: Dose-symptom correlates with multiple-event and event-count models.

PubMed

Yahya, Noorazrul; Ebert, Martin A; Bulsara, Max; House, Michael J; Kennedy, Angel; Joseph, David J; Denham, James W

2015-11-01

This study aimed to compare urinary dose-symptom correlates after external beam radiotherapy of the prostate using commonly utilised peak-symptom models to multiple-event and event-count models which account for repeated events. Urinary symptoms (dysuria, haematuria, incontinence and frequency) from 754 participants from TROG 03.04-RADAR trial were analysed. Relative (R1-R75 Gy) and absolute (A60-A75Gy) bladder dose-surface area receiving more than a threshold dose and equivalent uniform dose using exponent a (range: a ∈[1 … 100]) were derived. The dose-symptom correlates were analysed using; peak-symptom (logistic), multiple-event (generalised estimating equation) and event-count (negative binomial regression) models. Stronger dose-symptom correlates were found for incontinence and frequency using multiple-event and/or event-count models. For dysuria and haematuria, similar or better relationships were found using peak-symptom models. Dysuria, haematuria and high grade (⩾ 2) incontinence were associated to high dose (R61-R71 Gy). Frequency and low grade (⩾ 1) incontinence were associated to low and intermediate dose-surface parameters (R13-R41Gy). Frequency showed a parallel behaviour (a=1) while dysuria, haematuria and incontinence showed a more serial behaviour (a=4 to a ⩾ 100). Relative dose-surface showed stronger dose-symptom associations. For certain endpoints, the multiple-event and event-count models provide stronger correlates over peak-symptom models. Accounting for multiple events may be advantageous for a more complete understanding of urinary dose-symptom relationships. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[Application of SAS macro to evaluated multiplicative and additive interaction in logistic and Cox regression in clinical practices].

PubMed

Nie, Z Q; Ou, Y Q; Zhuang, J; Qu, Y J; Mai, J Z; Chen, J M; Liu, X Q

2016-05-01

Conditional logistic regression analysis and unconditional logistic regression analysis are commonly used in case control study, but Cox proportional hazard model is often used in survival data analysis. Most literature only refer to main effect model, however, generalized linear model differs from general linear model, and the interaction was composed of multiplicative interaction and additive interaction. The former is only statistical significant, but the latter has biological significance. In this paper, macros was written by using SAS 9.4 and the contrast ratio, attributable proportion due to interaction and synergy index were calculated while calculating the items of logistic and Cox regression interactions, and the confidence intervals of Wald, delta and profile likelihood were used to evaluate additive interaction for the reference in big data analysis in clinical epidemiology and in analysis of genetic multiplicative and additive interactions.

Victimization and health risk factors among weapon-carrying youth.

PubMed

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

2011-11-01

To compare health risks of 2 subgroups of weapon carriers: victimized and nonvictimized youth. 2003-2007 NYC Youth Risk Behavior Surveys were analyzed using bivariate analyses and multinomial logistic regression. Among NYC teens, 7.5% reported weapon carrying without victimization; 6.9% reported it with victimization. Both subgroups were more likely than non-weapon carriers to binge drink, use marijuana, smoke, fight, and have multiple sex partners; weapon carriers with victimization also experienced persistent sadness and attempted suicide. Subgroups of weapon carriers have distinct profiles. Optimal response should pair disciplinary action with screening for behavioral and mental health concerns and victimization.

Hybrids do it better: Lessons from websites of hybrid organizations in modern health movements.

PubMed

Striley, Katie Margavio; Field-Springer, Kimberly

2016-01-01

Hybrid organizations in modern health movements adopt multiple organizational logistics, allowing them to more effectively achieve social change. We conducted an analysis of 152 probreastfeeding organization websites categorized as institutionalized organizations, grassroots organizations, or hybrid organizations. Through a series of ANOVA analyses, we found that hybrid's websites provide significantly more useful health care information, better maintained dialogue with members, more efficiently mobilized members, commoditized health care issues less, and created member identity while maintaining institutional ties. Ultimately, hybrids tended to incorporate the positive elements from both grassroots and institutional organizations, while rejecting many of the negative elements.

Exposure to Multiple Pesticides and Risk of Non-Hodgkin Lymphoma in Men from Six Canadian Provinces

PubMed Central

Hohenadel, Karin; Harris, Shelley A.; McLaughlin, John R.; Spinelli, John J.; Pahwa, Punam; Dosman, James A.; Demers, Paul A.; Blair, Aaron

2011-01-01

Non-Hodgkin lymphoma (NHL) has been linked to several agricultural exposures, including some commonly used pesticides. Although there is a significant body of literature examining the effects of exposure to individual pesticides on NHL, the impact of exposure to multiple pesticides or specific pesticide combinations has not been explored in depth. Data from a six-province Canadian case-control study conducted between 1991 and 1994 were analyzed to investigate the relationship between NHL, the total number of pesticides used and some common pesticide combinations. Cases (n = 513) were identified through hospital records and provincial cancer registries and controls (n = 1,506), frequency matched to cases by age and province of residence, were obtained through provincial health records, telephone listings, or voter lists. In multiple logistic regression analyses, risk of NHL increased with the number of pesticides used. Similar results were obtained in analyses restricted to herbicides, insecticides and several pesticide classes. Odds ratios increased further when only ‘potentially carcinogenic’ pesticides were considered (OR[one pesticide] = 1.30, 95% CI = 0.90–1.88; OR[two to four] = 1.54, CI = 1.11–2.12; OR[five or more] = 1.94, CI = 1.17–3.23). Elevated risks were also found among those reporting use of malathion in combination with several other pesticides. These analyses support and extend previous findings that the risk of NHL increases with the number of pesticides used and some pesticide combinations. PMID:21776232

A Combined Pathway and Regional Heritability Analysis Indicates NETRIN1 Pathway Is Associated With Major Depressive Disorder.

PubMed

Zeng, Yanni; Navarro, Pau; Fernandez-Pujals, Ana M; Hall, Lynsey S; Clarke, Toni-Kim; Thomson, Pippa A; Smith, Blair H; Hocking, Lynne J; Padmanabhan, Sandosh; Hayward, Caroline; MacIntyre, Donald J; Wray, Naomi R; Deary, Ian J; Porteous, David J; Haley, Chris S; McIntosh, Andrew M

2017-02-15

Genome-wide association studies (GWASs) of major depressive disorder (MDD) have identified few significant associations. Testing the aggregation of genetic variants, in particular biological pathways, may be more powerful. Regional heritability analysis can be used to detect genomic regions that contribute to disease risk. We integrated pathway analysis and multilevel regional heritability analyses in a pipeline designed to identify MDD-associated pathways. The pipeline was applied to two independent GWAS samples [Generation Scotland: The Scottish Family Health Study (GS:SFHS, N = 6455) and Psychiatric Genomics Consortium (PGC:MDD) (N = 18,759)]. A polygenic risk score (PRS) composed of single nucleotide polymorphisms from the pathway most consistently associated with MDD was created, and its accuracy to predict MDD, using area under the curve, logistic regression, and linear mixed model analyses, was tested. In GS:SFHS, four pathways were significantly associated with MDD, and two of these explained a significant amount of pathway-level regional heritability. In PGC:MDD, one pathway was significantly associated with MDD. Pathway-level regional heritability was significant in this pathway in one subset of PGC:MDD. For both samples the regional heritabilities were further localized to the gene and subregion levels. The NETRIN1 signaling pathway showed the most consistent association with MDD across the two samples. PRSs from this pathway showed competitive predictive accuracy compared with the whole-genome PRSs when using area under the curve statistics, logistic regression, and linear mixed model. These post-GWAS analyses highlight the value of combining multiple methods on multiple GWAS data for the identification of risk pathways for MDD. The NETRIN1 signaling pathway is identified as a candidate pathway for MDD and should be explored in further large population studies. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Associations between Distal Upper Extremity Job Physical Factors and Psychosocial Measures in a Pooled Study

PubMed Central

2015-01-01

Introduction. There is an increasing body of literature relating musculoskeletal diseases to both job physical exposures and psychosocial outcomes. Relationships between job physical exposure measures and psychosocial factors have not been well examined or quantified. These exploratory analyses evaluate relationships between quantified exposures and psychosocial outcomes. Methods. Individualized quantification of duration, repetition, and force and composite scores of the Strain Index (SI) and the Threshold Limit Value for Hand Activity Level (TLV for HAL) were compared to 10 psychosocial measures. Relationships and predicted probabilities were assessed using ordered logistic regression. Analyses were adjusted for age, BMI, and gender. Results and Discussion. Among 1834 study participants there were multiple statistically significant relationships. In general, as duration, repetition, and force increased, psychosocial factors worsened. However, general health and mental exhaustion improved with increasing job exposures. Depression was most strongly associated with increased repetition, while physical exhaustion was most strongly associated with increased force. SI and TLV for HAL were significantly related to multiple psychosocial factors. These relationships persisted after adjustment for strong confounders. Conclusion. This study quantified multiple associations between job physical exposures and occupational and nonoccupational psychosocial factors. Further research is needed to quantify the impacts on occupational health outcomes. PMID:26557686

Factors associated with active commuting to work among women.

PubMed

Bopp, Melissa; Child, Stephanie; Campbell, Matthew

2014-01-01

Active commuting (AC), the act of walking or biking to work, has notable health benefits though rates of AC remain low among women. This study used a social-ecological framework to examine the factors associated with AC among women. A convenience sample of employed, working women (n = 709) completed an online survey about their mode of travel to work. Individual, interpersonal, institutional, community, and environmental influences were assessed. Basic descriptive statistics and frequencies described the sample. Simple logistic regression models examined associations with the independent variables with AC participation and multiple logistic regression analysis determined the relative influence of social ecological factors on AC participation. The sample was primarily middle-aged (44.09±11.38 years) and non-Hispanic White (92%). Univariate analyses revealed several individual, interpersonal, institutional, community and environmental factors significantly associated with AC. The multivariable logistic regression analysis results indicated that significant factors associated with AC included number of children, income, perceived behavioral control, coworker AC, coworker AC normative beliefs, employer and community supports for AC, and traffic. The results of this study contribute to the limited body of knowledge on AC participation for women and may help to inform gender-tailored interventions to enhance AC behavior and improve health.

Examining the Link Between Public Transit Use and Active Commuting

PubMed Central

Bopp, Melissa; Gayah, Vikash V.; Campbell, Matthew E.

2015-01-01

Background: An established relationship exists between public transportation (PT) use and physical activity. However, there is limited literature that examines the link between PT use and active commuting (AC) behavior. This study examines this link to determine if PT users commute more by active modes. Methods: A volunteer, convenience sample of adults (n = 748) completed an online survey about AC/PT patterns, demographic, psychosocial, community and environmental factors. t-test compared differences between PT riders and non-PT riders. Binary logistic regression analyses examined the effect of multiple factors on AC and a full logistic regression model was conducted to examine AC. Results: Non-PT riders (n = 596) reported less AC than PT riders. There were several significant relationships with AC for demographic, interpersonal, worksite, community and environmental factors when considering PT use. The logistic multivariate analysis for included age, number of children and perceived distance to work as negative predictors and PT use, feelings of bad weather and lack of on-street bike lanes as a barrier to AC, perceived behavioral control and spouse AC were positive predictors. Conclusions: This study revealed the complex relationship between AC and PT use. Further research should investigate how AC and public transit use are related. PMID:25898405

Examining the link between public transit use and active commuting.

PubMed

Bopp, Melissa; Gayah, Vikash V; Campbell, Matthew E

2015-04-17

An established relationship exists between public transportation (PT) use and physical activity. However, there is limited literature that examines the link between PT use and active commuting (AC) behavior. This study examines this link to determine if PT users commute more by active modes. A volunteer, convenience sample of adults (n = 748) completed an online survey about AC/PT patterns, demographic, psychosocial, community and environmental factors. t-test compared differences between PT riders and non-PT riders. Binary logistic regression analyses examined the effect of multiple factors on AC and a full logistic regression model was conducted to examine AC. Non-PT riders (n = 596) reported less AC than PT riders. There were several significant relationships with AC for demographic, interpersonal, worksite, community and environmental factors when considering PT use. The logistic multivariate analysis for included age, number of children and perceived distance to work as negative predictors and PT use, feelings of bad weather and lack of on-street bike lanes as a barrier to AC, perceived behavioral control and spouse AC were positive predictors. This study revealed the complex relationship between AC and PT use. Further research should investigate how AC and public transit use are related.

[Retinopathy of prematurity in multiple births: risk analysis for plus disease].

PubMed

García-Serrano, J L; Ramírez-García, M C; Piñar-Molina, R

2009-04-01

To analyze the risk factors associated with plus disease in retinopathy of prematurity (ROP). Over a period of 8.5 years we carried out a prospective study of ROP in twins and triplets. Fifty-four multiple-birth infants with low birth weight (< or =1500 g) and low gestational age (32< or = weeks) were admitted to the University Hospital of Granada. Logistic regression analyses showed the following variables to be associated with an increased risk of plus disease: severe ROP, large area of avascular retina, low gestational age, low birth weight, a patent ductus arteriosus, length of mechanical ventilation, adverse events increase, low 5 min Apgar scores and poor postnatal weight gain (in the first 4 to 6 weeks of life). Using multiple logistic regression, only the grade of ROP (OR: 5.5; p < 0.009) and poor postnatal weight gain (OR: 0.58; p < 0.04) were predictive factors of development of plus disease. Infants with disease gained an average 3.9 +/- 3.1 g/day in the first 6 weeks of life, compared to a mean of 11.84 +/- 8.3 g/day for those without plus disease (p < 0.0001). Advanced ROP stages and poor weight gain were the most significant factors associated with plus disease. Twins who gained weight at more than 7 g/day in the first 4-6 weeks of life had a significantly reduced risk of plus disease. A good weight gain is an effective strategy against avoidable blindness due to ROP.

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

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.

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.

Predictors of transitions from single to multiple job holding: Results of a longitudinal study among employees aged 45-64 in the Netherlands.

PubMed

Bouwhuis, Stef; Geuskens, Goedele A; Boot, Cécile R L; Bongers, Paulien M; van der Beek, Allard J

2017-08-01

To construct prediction models for transitions to combination multiple job holding (MJH) (multiple jobs as an employee) and hybrid MJH (being an employee and self-employed), among employees aged 45-64. A total of 5187 employees in the Netherlands completed online questionnaires annually between 2010 and 2013. We applied logistic regression analyses with a backward elimination strategy to construct prediction models. Transitions to combination MJH and hybrid MJH were best predicted by a combination of factors including: demographics, health and mastery, work characteristics, work history, skills and knowledge, social factors, and financial factors. Not having a permanent contract and a poor household financial situation predicted both transitions. Some predictors only predicted combination MJH, e.g., working part-time, or hybrid MJH, e.g., work-home interference. A wide variety of factors predict combination MJH and/or hybrid MJH. The prediction model approach allowed for the identification of predictors that have not been previously studied. © 2017 Wiley Periodicals, Inc.

Bayesian Estimation of Pneumonia Etiology: Epidemiologic Considerations and Applications to the Pneumonia Etiology Research for Child Health Study

PubMed Central

Fu, Wei; Shi, Qiyuan; Prosperi, Christine; Wu, Zhenke; Hammitt, Laura L.; Feikin, Daniel R.; Baggett, Henry C.; Howie, Stephen R.C.; Scott, J. Anthony G.; Murdoch, David R.; Madhi, Shabir A.; Thea, Donald M.; Brooks, W. Abdullah; Kotloff, Karen L.; Li, Mengying; Park, Daniel E.; Lin, Wenyi; Levine, Orin S.; O’Brien, Katherine L.; Zeger, Scott L.

2017-01-01

Abstract In pneumonia, specimens are rarely obtained directly from the infection site, the lung, so the pathogen causing infection is determined indirectly from multiple tests on peripheral clinical specimens, which may have imperfect and uncertain sensitivity and specificity, so inference about the cause is complex. Analytic approaches have included expert review of case-only results, case–control logistic regression, latent class analysis, and attributable fraction, but each has serious limitations and none naturally integrate multiple test results. The Pneumonia Etiology Research for Child Health (PERCH) study required an analytic solution appropriate for a case–control design that could incorporate evidence from multiple specimens from cases and controls and that accounted for measurement error. We describe a Bayesian integrated approach we developed that combined and extended elements of attributable fraction and latent class analyses to meet some of these challenges and illustrate the advantage it confers regarding the challenges identified for other methods. PMID:28575370

Cardiovascular disease and cognitive dysfunction in systemic lupus erythematosus.

PubMed

Murray, Sara G; Yazdany, Jinoos; Kaiser, Rachel; Criswell, Lindsey A; Trupin, Laura; Yelin, Edward H; Katz, Patricia P; Julian, Laura J

2012-09-01

Cognitive dysfunction and cardiovascular disease are common and debilitating manifestations of systemic lupus erythematosus (SLE). In this study, we evaluated the relationship between cardiovascular events, traditional cardiovascular risk factors, and SLE-specific risk factors as predictors of cognitive dysfunction in a large cohort of participants with SLE. Subjects included 694 participants from the Lupus Outcomes Study (LOS), a longitudinal study of SLE outcomes based on an annual telephone survey querying demographic and clinical variables. The Hopkins Verbal Learning Test-Revised and the Controlled Oral Word Association Test were administered to assess cognitive function. Multiple logistic regression was used to identify cardiovascular events (myocardial infarction, stroke), traditional cardiovascular risk factors (hypertension, hyperlipidemia, diabetes mellitus, obesity, smoking), and SLE-specific risk factors (antiphospholipid antibodies [aPL], disease activity, disease duration) associated with cognitive impairment in year 7 of the LOS. The prevalence of cognitive impairment as measured by verbal memory and verbal fluency metrics was 15%. In adjusted multiple logistic regression analyses, aPL (odds ratio [OR] 2.10, 95% confidence interval [95% CI] 1.3-3.41), hypertension (OR 2.06, 95% CI 1.19-3.56), and a history of stroke (OR 2.27, 95% CI 1.16-4.43) were significantly associated with cognitive dysfunction. In additional analyses evaluating the association between these predictors and severity of cognitive impairment, stroke was significantly more prevalent in participants with severe impairment when compared to those with mild or moderate impairment (P = 0.036). These results suggest that the presence of aPL, hypertension, and stroke are key variables associated with cognitive impairment, which may aid in identification of patients at greatest risk. Copyright © 2012 by the American College of Rheumatology.

Does hypervascularity of liver metastases as detected on MRI predict disease progression in breast cancer patients?

PubMed

Braga, Larissa; Semelka, Richard C; Pietrobon, Ricardo; Martin, Diego; de Barros, Nestor; Guller, Ulrich

2004-05-01

The aim of our study was to evaluate the association of the vascularity of liver metastases, as characterized by MRI, and disease progression in breast cancer patients. Sixteen breast cancer patients with liver metastases who underwent MRI before and after systemic therapy were retrospectively identified. On the basis of comparison of each MRI examination with the previous examination, disease status of the patients was classified as complete response, partial response, stable disease, or progressive disease. Liver metastases were characterized as hyper- or hypovascular on the basis of the degree of enhancement in the arterial, portal, and interstitial phases of imaging after administration of a contrast agent. Fisher's exact test and ordinal logistic regression models, including the type of systemic therapy, presence of multiple metastases, and hormone receptor status, were used to estimate the unadjusted and risk-adjusted association between the presence of hypervascular liver metastases and disease progression. All patients in our sample (n = 16) were women and most (12/16, 75%) were white. Their median age was 51.5 years. In unadjusted analyses, the association between the presence of hypervascular liver metastases and disease progression was statistically significant (p < 0.0001). In multiple logistic regression analyses, hypervascular liver metastases were found to be an independent predictor of disease progression. Patients with hypervascular liver lesions were 20.5 times more likely to experience disease progression than patients without hypervascular metastases (odds ratio, 20.5; 95% confidence interval, 5.1-83.5; p < 0.0001). Our analysis provides suggestive evidence that disease progression can be predicted through MRI assessment of the vascularity of liver metastases in patients with breast cancer.

Incidence of skin tears in the extremities among elderly patients at a long-term medical facility in Japan: A prospective cohort study.

PubMed

Sanada, Hiromi; Nakagami, Gojiro; Koyano, Yuiko; Iizaka, Shinji; Sugama, Junko

2015-08-01

There is a lack of data from cohort studies for the incidence of skin tears among an elderly population in an Asian country. We estimated the cumulative incidence of skin tear, and identify its risk factor. The present prospective cohort study was carried out at a long-term medical facility in Japan. Participants included patients (n = 368) aged 65 years or older receiving hospital care. The 3-month cumulative incidence of skin tears was estimated by identifying them using direct inspection of the extremities. In order to find the risk factors for the skin tear incidence, odds ratios and their 95% confidence intervals of skin tear development in association with the factors were estimated using logistic regression analyses. A total of 14 patients developed skin tears, and their cumulative incidence was 3.8%. No patients with skin tears developed multiple wounds on their extremities. Half of the skin tears occurred on the outside of the right forearm, and just three skin tears were found in the lower legs. Multiple logistic analyses showed that pre-existing skin tears (odds ratio 15.42, 95% confidence interval 3.53-67.43, P < 0.001) and a 6-point decrease in the total score of the Braden Scale (odds ratio 0.10, 95% confidence interval 0.01-0.83, P < 0.033) were significantly associated with skin tear development. Patients with pre-existing skin tears and a low score of the Braden Scale have a higher risk of skin tear development during 3 months. These factors could be used to identify patients requiring prevention care for skin tears. © 2014 Japan Geriatrics Society.

Clinical Phenotype Classifications Based on Static Varus Alignment and Varus Thrust in Japanese Patients With Medial Knee Osteoarthritis

PubMed Central

Iijima, Hirotaka; Fukutani, Naoto; Fukumoto, Takahiko; Uritani, Daisuke; Kaneda, Eishi; Ota, Kazuo; Kuroki, Hiroshi; Matsuda, Shuichi

2015-01-01

Objective To investigate the association between knee pain during gait and 4 clinical phenotypes based on static varus alignment and varus thrust in patients with medial knee osteoarthritis (OA). Methods Patients in an orthopedic clinic (n = 266) diagnosed as having knee OA (Kellgren/Lawrence [K/L] grade ≥1) were divided into 4 phenotype groups according to the presence or absence of static varus alignment and varus thrust (dynamic varus): no varus (n = 173), dynamic varus (n = 17), static varus (n = 50), and static varus + dynamic varus (n = 26). The knee range of motion, spatiotemporal gait parameters, visual analog scale scores for knee pain, and scores on the Japanese Knee Osteoarthritis Measure were used to assess clinical outcomes. Multiple logistic regression analyses identified the relationship between knee pain during gait and the 4 phenotypes, adjusted for possible risk factors, including age, sex, body mass index, K/L grade, and gait velocity. Results Multiple logistic regression analysis showed that varus thrust without varus alignment was associated with knee pain during gait (odds ratio [OR] 3.30, 95% confidence interval [95% CI] 1.08–12.4), and that varus thrust combined with varus alignment was strongly associated with knee pain during gait (OR 17.1, 95% CI 3.19–320.0). Sensitivity analyses applying alternative cutoff values for defining static varus alignment showed comparable results. Conclusion Varus thrust with or without static varus alignment was associated with the occurrence of knee pain during gait. Tailored interventions based on individual malalignment phenotypes may improve clinical outcomes in patients with knee OA. PMID:26017348

Serum Vitamin D Status in Iranian Fibromyalgia Patients: according to the Symptom Severity and Illness Invalidation

PubMed Central

Maafi, Alireza Amir; Haghdoost, Afrooz; Aarabi, Yasaman; Hajiabbasi, Asghar; Shenavar Masooleh, Irandokht; Zayeni, Habib; Ghalebaghi, Babak; Hassankhani, Amir; Bidari, Ali

2016-01-01

Background This study was designed to assess serum vitamin D status (25-OHD) in the fibromyalgia (FM) patients and to compare it with a healthy control group. It also aimed to investigate the correlation of serum vitamin D level with FM symptom severity and invalidation experiences. Methods A total of 74 consecutive patients with FM and 68 healthy control participants were enrolled. The eligible FM patients completed the Illness Invalidation Inventory (3*I), the Revised Fibromyalgia Impact Questionnaire (FIQR) and a short-form health survey (SF-12). Venous blood samples were drawn from all participants to evaluate serum 25-OHD levels. Mann-Whitney tests and multiple logistic regression analyses were performed and Spearman's correlations were calculated. Results 88.4% of FM patients had low levels of serum 25-OHD. FM patients had significantly higher level of serum 25-OHD than the control group (17.24 ± 13.50 and 9.91 ± 6.47 respectively, P = 0.0001). There were no significant correlations between serum 25-OHD levels and the clinical measures of disease impact, invalidation dimensions, and health status. Multiple logistic regression analyses revealed that an increased discounting of the disease by the patient's spouse was associated with a 4-fold increased risk for vitamin D deficiency (OR = 4.36; 95% CI, 0.95–19.87, P = 0.05). Conclusions This study showed that although high rates of vitamin D insufficiency or deficiency were seen among FM patients and healthy non-FM participants, but it seems there was no intrinsic association between FM and vitamin D deficiency. Addressing of invalidation experience especially by the patient's spouse is important in management of FM. PMID:27413482

Risk factors of indoor fall injuries in community-dwelling older women: a prospective cohort study.

PubMed

Hu, Jia; Xia, Qinghua; Jiang, Yu; Zhou, Peng; Li, Yuhua

2015-01-01

The aims of the study were to explore the characteristics and the potential risk factors of indoor fall injuries in community-dwelling older women, and to provide evidence for the future intervention strategy. A prospective cohort of 3043 women aged 60 years old and above from 3 selected counties in Shanghai was followed up on the outcomes of indoor fall injuries for up to 1 year. Demographic and health data were collected during admission; the physical function, balance ability and home-living environment were examined by a structured questionnaire when admitted. The outcome of indoor fall injury was investigated by a visit in month 3, month 6 and month 12 after baseline survey. Univariate analysis and Multiple Logistic Regression Model were used to examine the associations between potential risk factors and outcomes of indoor fall injuries. Two hundred and thirty-one of the 3043 women (7.6%) eventually suffered indoor fall injuries at least once during the 1-year follow-up. The injurious falls of women were significantly associated with age, educational level, marital status, health status, balance ability, physical activity and home-living environment in the univariate analyses. Women who worried about falls and restrained activities for it were more likely to suffer fall injury. Younger women, with less chronic disease, with good balance ability and living in good corridor environment, were less likely to receive fall injury in multiple logistic regression analyses. Multidimensional factors were associated with indoor fall injuries for community-dwelling older women. Proper clinical treatment of chronic disease and improvement of women's balance ability, as well as reducing the risk factor of indoor environment, which will play vital roles in preventing indoor fall injuries, should be prioritized for the intervention strategy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Predictors of pharmacological treatment outcomes with atomoxetine or methylphenidate in patients with attention-deficit/hyperactivity disorder from China, Egypt, Lebanon, Russian Federation, Taiwan, and United Arab Emirates.

PubMed

Treuer, T; Feng, Q; Desaiah, D; Altin, M; Wu, S; El-Shafei, A; Serebryakova, E; Gado, M; Faries, D

2014-09-01

The reduced availability of data from non-Western countries limits our ability to understand attention-deficit/hyperactivity disorder (ADHD) treatment outcomes, specifically, adherence and persistence of ADHD in children and adolescents. This analysis assessed predictors of treatment outcomes in a non-Western cohort of patients with ADHD treated with atomoxetine or methylphenidate. Data from a 12-month, prospective, observational study in outpatients aged 6-17 years treated with atomoxetine (N = 234) or methylphenidate (N = 221) were analysed post hoc to determine potential predictors of treatment outcomes. Participating countries included the Russian Federation, China, Taiwan, Egypt, United Arab Emirates and Lebanon. Factors associated with remission were analysed with stepwise multiple logistic regression and classification and regression trees (CART). Cox proportional hazards models with propensity score adjustment assessed differences in atomoxetine persistence among initial-dose cohorts. In patients treated with atomoxetine who had available dosing information (N = 134), Cox proportional hazards revealed lower (< 0.5 mg/kg) initial dose was significantly associated with shorter medication persistence (p < 0.01). multiple logistic regression analysis revealed greater rates of remission for atomoxetine-treated patients were associated with age (older), country (United Arab Emirates) and gender (female) (all p < 0.05). CART analysis confirmed older age and lack of specific phobias were associated with greater remission rates. For methylphenidate, greater baseline weight (highly correlated with the age factor found for atomoxetine) and prior atomoxetine use were associated with greater remission rates. These findings may help clinicians assess factors upon initiation of ADHD treatment to improve course prediction, proper dosing and treatment adherence and persistence. Observational study, therefore no registration. © 2014 John Wiley & Sons Ltd.

Sex differences in attachment to spouses among older Japanese couples.

PubMed

Yokoyama, Katsunori; Shirakawa, Kazutoyo; Hirao, Tomohiro; Nakatsu, Morihito; Yoda, Takeshi; Suzuki, Hiromi; Okabe, Yugo; Shirakami, Gotaro

2017-05-01

Attachment among older adults can partially explain sex differences in bereavement outcomes, but there is currently little evidence regarding this. The aim was to quantify sex differences in the proportion of spouses as attachment figures among older couples. We carried out a secondary analysis of cross-sectional questionnaire survey data. The dataset included information about 5137 respondents aged 65 years or older in Kanonji and Mitoyo, two rural cities in Kagawa prefecture, Japan; those who were never married or were widowed or divorced were excluded. The questionnaire asked participants whom they most want to be close by when they die (this person was defined as an "attachment figure"), and compared the proportion of older people of each sex who named their spouse. We used multiple logistic regression analyses to examine the independent association of sex with the proportion of spouses as attachment figures. Of the 2513 male respondents, 1494 (59.5%) answered "spouse." Of the 2624 female respondents, 904 (34.5%) answered "spouse." Multiple logistic regression analyses adjusted for age, live-in children, annual income, participation in community activities, presence of a long-term primary care doctor, anxiety about death and preferences for place of death showed that men had a higher probability of attachment to spouses than women (odds ratio 2.83, 95% confidence interval 2.43-3.31). Spouses are more likely to be attachment figures for men than for women. The present study supports the theory that sex differences in attachment might partially explain the differences in the bereavement effect between sexes among older people. Geriatr Gerontol Int 2017; 17: 834-838. © 2016 Japan Geriatrics Society.

Poor sleep quality and nightmares are associated with non-suicidal self-injury in adolescents.

PubMed

Liu, Xianchen; Chen, Hua; Bo, Qi-Gui; Fan, Fang; Jia, Cun-Xian

2017-03-01

Non-suicidal self-injury (NSSI) is prevalent and is associated with increased risk of suicidal behavior in adolescents. This study examined which sleep variables are associated with NSSI, independently from demographics and mental health problems in Chinese adolescents. Participants consisted of 2090 students sampled from three high schools in Shandong, China and had a mean age of 15.49 years. Participants completed a sleep and health questionnaire to report their demographic and family information, sleep duration and sleep problems, impulsiveness, hopelessness, internalizing and externalizing problems, and NSSI. A series of regression analyses were conducted to examine the associations between sleep variables and NSSI. Of the sample, 12.6 % reported having ever engaged in NSSI and 8.8 % engaged during the last year. Univariate logistic analyses demonstrated that multiple sleep variables including short sleep duration, insomnia symptoms, poor sleep quality, sleep insufficiency, unrefreshed sleep, sleep dissatisfaction, daytime sleepiness, fatigue, snoring, and nightmares were associated with increased risk of NSSI. After adjusting for demographic and mental health variables, NSSI was significantly associated with sleeping <6 h per night, poor sleep quality, sleep dissatisfaction, daytime sleepiness, and frequent nightmares. Stepwise logistic regression model demonstrated that poor sleep quality (OR = 2.18, 95 % CI = 1.37-3.47) and frequent nightmares (OR = 2.88, 95 % CI = 1.45-5.70) were significantly independently associated with NSSI. In conclusion, while multiple sleep variables are associated with NSSI, poor sleep quality and frequent nightmares are independent risk factors of NSSI. These findings may have important implications for further research of sleep self-harm mechanisms and early detection and prevention of NSSI in adolescents.

Identification of an Interaction between VWF rs7965413 and Platelet Count as a Novel Risk Marker for Metabolic Syndrome: An Extensive Search of Candidate Polymorphisms in a Case-Control Study

PubMed Central

Nakatochi, Masahiro; Ushida, Yasunori; Yasuda, Yoshinari; Yoshida, Yasuko; Kawai, Shun; Kato, Ryuji; Nakashima, Toru; Iwata, Masamitsu; Kuwatsuka, Yachiyo; Ando, Masahiko; Hamajima, Nobuyuki; Kondo, Takaaki; Oda, Hiroaki; Hayashi, Mutsuharu; Kato, Sawako; Yamaguchi, Makoto; Maruyama, Shoichi; Matsuo, Seiichi; Honda, Hiroyuki

2015-01-01

Although many single nucleotide polymorphisms (SNPs) have been identified to be associated with metabolic syndrome (MetS), there was only a slight improvement in the ability to predict future MetS by the simply addition of SNPs to clinical risk markers. To improve the ability to predict future MetS, combinational effects, such as SNP—SNP interaction, SNP—environment interaction, and SNP—clinical parameter (SNP × CP) interaction should be also considered. We performed a case-control study to explore novel SNP × CP interactions as risk markers for MetS based on health check-up data of Japanese male employees. We selected 99 SNPs that were previously reported to be associated with MetS and components of MetS; subsequently, we genotyped these SNPs from 360 cases and 1983 control subjects. First, we performed logistic regression analyses to assess the association of each SNP with MetS. Of these SNPs, five SNPs were significantly associated with MetS (P < 0.05): LRP2 rs2544390, rs1800592 between UCP1 and TBC1D9, APOA5 rs662799, VWF rs7965413, and rs1411766 between MYO16 and IRS2. Furthermore, we performed multiple logistic regression analyses, including an SNP term, a CP term, and an SNP × CP interaction term for each CP and SNP that was significantly associated with MetS. We identified a novel SNP × CP interaction between rs7965413 and platelet count that was significantly associated with MetS [SNP term: odds ratio (OR) = 0.78, P = 0.004; SNP × CP interaction term: OR = 1.33, P = 0.001]. This association of the SNP × CP interaction with MetS remained nominally significant in multiple logistic regression analysis after adjustment for either the number of MetS components or MetS components excluding obesity. Our results reveal new insight into platelet count as a risk marker for MetS. PMID:25646961

Identification of an interaction between VWF rs7965413 and platelet count as a novel risk marker for metabolic syndrome: an extensive search of candidate polymorphisms in a case-control study.

PubMed

Nakatochi, Masahiro; Ushida, Yasunori; Yasuda, Yoshinari; Yoshida, Yasuko; Kawai, Shun; Kato, Ryuji; Nakashima, Toru; Iwata, Masamitsu; Kuwatsuka, Yachiyo; Ando, Masahiko; Hamajima, Nobuyuki; Kondo, Takaaki; Oda, Hiroaki; Hayashi, Mutsuharu; Kato, Sawako; Yamaguchi, Makoto; Maruyama, Shoichi; Matsuo, Seiichi; Honda, Hiroyuki

2015-01-01

Although many single nucleotide polymorphisms (SNPs) have been identified to be associated with metabolic syndrome (MetS), there was only a slight improvement in the ability to predict future MetS by the simply addition of SNPs to clinical risk markers. To improve the ability to predict future MetS, combinational effects, such as SNP-SNP interaction, SNP-environment interaction, and SNP-clinical parameter (SNP × CP) interaction should be also considered. We performed a case-control study to explore novel SNP × CP interactions as risk markers for MetS based on health check-up data of Japanese male employees. We selected 99 SNPs that were previously reported to be associated with MetS and components of MetS; subsequently, we genotyped these SNPs from 360 cases and 1983 control subjects. First, we performed logistic regression analyses to assess the association of each SNP with MetS. Of these SNPs, five SNPs were significantly associated with MetS (P < 0.05): LRP2 rs2544390, rs1800592 between UCP1 and TBC1D9, APOA5 rs662799, VWF rs7965413, and rs1411766 between MYO16 and IRS2. Furthermore, we performed multiple logistic regression analyses, including an SNP term, a CP term, and an SNP × CP interaction term for each CP and SNP that was significantly associated with MetS. We identified a novel SNP × CP interaction between rs7965413 and platelet count that was significantly associated with MetS [SNP term: odds ratio (OR) = 0.78, P = 0.004; SNP × CP interaction term: OR = 1.33, P = 0.001]. This association of the SNP × CP interaction with MetS remained nominally significant in multiple logistic regression analysis after adjustment for either the number of MetS components or MetS components excluding obesity. Our results reveal new insight into platelet count as a risk marker for MetS.

Factors associated with mortality and length of stay in the Oporto burn unit (2006-2009).

PubMed

Bartosch, Isabel; Bartosch, Carla; Egipto, Paula; Silva, Alvaro

2013-05-01

Retrospective studies are essential to evaluate and improve the efficiency of care of burned patients. This study analyses the work done in the burn unit of Hospital de S. João in the north of Portugal. A retrospective review was performed in patients admitted from 2006 to 2009. The study population was characterised regarding patient demographics, admissions profile, burn aetiology, burn site, extension and treatment. Multiple linear and logistic regression models were done in order to elucidate which of these factors influenced the mortality and length of stay. The characteristics before and after the creation of the burn unit, as well as the similarities and differences with the published data of other national and international burn units, are analysed. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

A Pilot Study of Reasons and Risk Factors for "No-Shows" in a Pediatric Neurology Clinic.

PubMed

Guzek, Lindsay M; Fadel, William F; Golomb, Meredith R

2015-09-01

Missed clinic appointments lead to decreased patient access, worse patient outcomes, and increased healthcare costs. The goal of this pilot study was to identify reasons for and risk factors associated with missed pediatric neurology outpatient appointments ("no-shows"). This was a prospective cohort study of patients scheduled for 1 week of clinic. Data on patient clinical and demographic information were collected by record review; data on reasons for missed appointments were collected by phone interviews. Univariate and multivariate analyses were conducted using chi-square tests and multiple logistic regression to assess risk factors for missed appointments. Fifty-nine (25%) of 236 scheduled patients were no-shows. Scheduling conflicts (25.9%) and forgetting (20.4%) were the most common reasons for missed appointments. When controlling for confounding factors in the logistic regression, Medicaid (odds ratio 2.36), distance from clinic, and time since appointment was scheduled were associated with missed appointments. Further work in this area is needed. © The Author(s) 2014.

Covariate Imbalance and Adjustment for Logistic Regression Analysis of Clinical Trial Data

PubMed Central

Ciolino, Jody D.; Martin, Reneé H.; Zhao, Wenle; Jauch, Edward C.; Hill, Michael D.; Palesch, Yuko Y.

2014-01-01

In logistic regression analysis for binary clinical trial data, adjusted treatment effect estimates are often not equivalent to unadjusted estimates in the presence of influential covariates. This paper uses simulation to quantify the benefit of covariate adjustment in logistic regression. However, International Conference on Harmonization guidelines suggest that covariate adjustment be pre-specified. Unplanned adjusted analyses should be considered secondary. Results suggest that that if adjustment is not possible or unplanned in a logistic setting, balance in continuous covariates can alleviate some (but never all) of the shortcomings of unadjusted analyses. The case of log binomial regression is also explored. PMID:24138438

Women's work stress and cortisol levels: a longitudinal study of the association between the psychosocial work environment and serum cortisol.

PubMed

Evolahti, Annika; Hultcrantz, Malou; Collins, Aila

2006-11-01

The aim of the present study was to investigate whether there is an association between serum cortisol and work-related stress, as defined by the demand-control model in a longitudinal design. One hundred ten women aged 47-53 years completed a health questionnaire, including the Swedish version of the Job Content Scale, and participated in a psychological interview at baseline and in a follow-up session 2 years later. Morning blood samples were drawn for analyses of cortisol. Multiple stepwise regression analyses and logistic regression analyses showed that work demands and lack of social support were significantly associated with cortisol. The results of this study showed that negative work characteristics in terms of high demands and low social support contributed significantly to the biological stress levels in middle-aged women. Participation in the study may have served as an intervention, increasing the women's awareness and thus improving their health profiles on follow-up.

Invariance levels across language versions of the PISA 2009 reading comprehension tests in Spain.

PubMed

Elosua Oliden, Paula; Mujika Lizaso, Josu

2013-01-01

The PISA project provides the basis for studying curriculum design and for comparing factors associated with school effectiveness. These studies are only valid if the different language versions are equivalent to each other. In Spain, the application of PISA in autonomous regions with their own languages means that equivalency must also be extended to the Spanish, Galician, Catalan and Basque versions of the test. The aim of this work was to analyse the equivalence among the four language versions of the Reading Comprehension Test (PISA 2009). After defining the testlet as the unit of analysis, equivalence among the language versions was analysed using two invariance testing procedures: multiple-group mean and covariance structure analyses for ordinal data and ordinal logistic regression. The procedures yielded concordant results supporting metric equivalence across all four language versions: Spanish, Basque, Galician and Catalan. The equivalence supports the estimated reading literacy score comparability among the language versions used in Spain.

Association between education and future leisure-time physical inactivity: a study of Finnish twins over a 35-year follow-up.

PubMed

Piirtola, Maarit; Kaprio, Jaakko; Kujala, Urho M; Heikkilä, Kauko; Koskenvuo, Markku; Svedberg, Pia; Silventoinen, Karri; Ropponen, Annina

2016-08-04

Education is associated with health related lifestyle choices including leisure-time physical inactivity. However, the longitudinal associations between education and inactivity merit further studies. We investigated the association between education and leisure-time physical inactivity over a 35-year follow-up with four time points controlling for multiple covariates including familial confounding. This study of the population-based Finnish Twin Cohort consisted of 5254 twin individuals born in 1945-1957 (59 % women), of which 1604 were complete same-sexed twin pairs. Data on leisure-time physical activity and multiple covariates was available from four surveys conducted in 1975, 1981, 1990 and 2011 (response rates 72 to 89 %). The association between years of education and leisure-time physical inactivity (<1.5 metabolic equivalent hours/day) was first analysed for each survey. Then, the role of education was investigated for 15-year and 35-year inactivity periods in the longitudinal analyses. The co-twin control design was used to analyse the potential familial confounding of the effects. All analyses were conducted with and without multiple covariates. Odds Ratios (OR) with 95 % Confidence Intervals (CI) were calculated using logistic and conditional (fixed-effects) regression models. Each additional year of education was associated with less inactivity (OR 0.94 to 0.95, 95 % CI 0.92, 0.99) in the cross-sectional age- and sex-adjusted analyses. The associations of education with inactivity in the 15- and 35-year follow-ups showed a similar trend: OR 0.97 (95 % CI 0.93, 1.00) and OR 0.94 (95 % CI 0.91, 0.98), respectively. In all co-twin control analyses, each year of higher education was associated with a reduced likelihood of inactivity suggesting direct effect (i.e. independent from familial confounding) of education on inactivity. However, the point estimates were lower than in the individual-level analyses. Adjustment for multiple covariates did not change these associations. Higher education is associated with lower odds of leisure-time physical inactivity during the three-decade follow-up. The association was found after adjusting for several confounders, including familial factors. Hence, the results point to the conclusion that education has an independent role in the development of long-term physical inactivity and tailored efforts to promote physical activity among lower educated people would be needed throughout adulthood.

Logistic regression applied to natural hazards: rare event logistic regression with replications

NASA Astrophysics Data System (ADS)

Guns, M.; Vanacker, V.

2012-06-01

Statistical analysis of natural hazards needs particular attention, as most of these phenomena are rare events. This study shows that the ordinary rare event logistic regression, as it is now commonly used in geomorphologic studies, does not always lead to a robust detection of controlling factors, as the results can be strongly sample-dependent. In this paper, we introduce some concepts of Monte Carlo simulations in rare event logistic regression. This technique, so-called rare event logistic regression with replications, combines the strength of probabilistic and statistical methods, and allows overcoming some of the limitations of previous developments through robust variable selection. This technique was here developed for the analyses of landslide controlling factors, but the concept is widely applicable for statistical analyses of natural hazards.

Predictors of anemia among pregnant women in Westmoreland, Jamaica

PubMed Central

Charles, Alyson M.; Campbell-Stennett, Dianne; Yatich, Nelly; Jolly, Pauline E.

2010-01-01

Anemia in pregnancy is a worldwide problem, but it is most prevalent in the developing world. This research project was conducted to determine the predictors of anemia in pregnant women in Westmoreland, Jamaica. A cross-sectional study design was conducted and descriptive, bivariate, and multiple logistic regression analyses were used. Body mass index, Mid-upper arm circumference, and the number of antenatal care visits showed a statistically significant association with anemia. Based on the results, we believe that maintaining a healthy body weight, and frequently visiting an antenatal clinic, will help to lower the prevalence of anemia among pregnant women in Westmoreland. PMID:20526925

Factors associated with physical inactivity among korean men and women.

PubMed

Lee, Chung Yul; Hwang, Seon Young; Ham, Ok Kyung

2007-01-01

To identify the independently associating factors on physical inactivity in Korean men and women. The data of 5554 men and women (18-74 years) were analyzed using national health and nutritional examination survey data that included questionnaires and physical examinations. Multiple logistic regression analyses showed that significant factors were low monthly income, low education, current smoking, increased waist-to-hip ratio, and low health concern among men; living in rural areas, low monthly income, low education, perceived poor health status, low health concern, and emotional stress among women. Health care providers should focus on education and counseling regarding the factors that influence physical inactivity.

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…

Multiple Peer Group Self-Identification and Adolescent Tobacco Use

PubMed Central

Fuqua, Juliana L.; Gallaher, Peggy E.; Unger, Jennifer B.; Trinidad, Dennis R.; Sussman, Steve; Ortega, Enrique; Johnson, C. Anderson

2014-01-01

Associations between peer group self-identification and smoking were examined among 2,698 ethnically diverse middle school students in Los Angeles who self-identified with groups such as Rockers, Skaters, and Gamers. The sample was 47.1% male, 54.7% Latino, 25.4% Asian, 10.8% White, 9.1% Other ethnicity, and 59.3% children of immigrant parents. Multiple group self-identification was common: 84% identified with two or more groups and 65% identified with three or more groups. Logistic regression analyses indicated that as students endorsed more high-risk groups, the greater their risk of tobacco use. A classification tree analysis identified risk groups based on interactions among ethnicity, gender, and group self-identification. Psychographic targeting based on group self-identification could be useful to design more relevant smoking prevention messages for adolescents who identify with high-risk peer groups. PMID:22458850

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.

Relationship between prosthodontic status and nutritional intake in the elderly in Korea: National Health and Nutrition Examination Survey (NHANES IV).

PubMed

Choi, Y K; Park, D Y; Kim, Y

2014-11-01

Many health issues have been reported to be associated with poor nutritional status. We sought to examine the association between nutritional intake and oral health status in elderly people. The association between perceived disability in mastication and prosthodontic status was analysed using multiple logistic regression. Multiple linear regression was used to analyse the association between prosthodontic status and nutritional intake. The elderly subjects with partial or full dentures reported chewing difficulties 1.62-fold more frequently (95% CI: 1.06-2.49) than those with natural teeth or a fixed prosthesis after adjusting for gender, TMD (temporomandibular disorder), household income and education level. Additionally, daily nutritional intakes of energy, protein, fat, ash, calcium, phosphorus and thiamine were decreased significantly in elderly with partial or full dentures compared with those with no prosthesis or with a fixed prosthesis (P < 0.05). Our findings underline oral health status and perceived disability in mastication are associated with dietary imbalances in the elderly. We suggest that the evaluation of patients' nutritional status should be considered as a part of an overall plan for dental hygiene care. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The psychological impact of terrorism: an epidemiologic study of posttraumatic stress disorder and associated factors in victims of the 1995-1996 bombings in France.

PubMed

Verger, Pierre; Dab, William; Lamping, Donna L; Loze, Jean-Yves; Deschaseaux-Voinet, Céline; Abenhaim, Lucien; Rouillon, Frédéric

2004-08-01

A wave of bombings struck France in 1995 and 1996, killing 12 people and injuring more than 200. The authors conducted follow-up evaluations with the victims in 1998 to determine the prevalence of and factors associated with posttraumatic stress disorder (PTSD). Victims directly exposed to the bombings (N=228) were recruited into a retrospective, cross-sectional study. Computer-assisted telephone interviews were conducted to evaluate PTSD, per DSM-IV criteria, and to assess health status before the attack, initial injury severity and perceived threat at the time of attack, and psychological symptoms, cosmetic impairment, hearing problems, and health service use at the time of the follow-up evaluation. Factors associated with PTSD were investigated with univariate logistic regression followed by multiple logistic regression analyses. A total of 196 respondents (86%) participated in the study. Of these, 19% had severe initial physical injuries (hospitalization exceeding 1 week). Problems reported at the follow-up evaluation included attack-related hearing problems (51%), cosmetic impairment (33%), and PTSD (31%) (95% confidence interval=24.5%-37.5%). Results of logistic regression analyses indicated that the risk of PTSD was significantly higher among women (odds ratio=2.54), participants age 35-54 (odds ratio=2.83), and those who had severe initial injuries (odds ratio=2.79) or cosmetic impairment (odds ratio=2.74) or who perceived substantial threat during the attack (odds ratio=3.99). The high prevalence of PTSD 2.6 years on average after a terrorist attack emphasizes the need for improved health services to address the intermediate and long-term consequences of terrorism.

The co-occurrence of AIDS and homelessness: results from the integration of administrative databases for AIDS surveillance and public shelter utilisation in Philadelphia.

PubMed

Culhane, D P; Gollub, E; Kuhn, R; Shpaner, M

2001-07-01

Administrative databases from the City of Philadelphia that track public shelter utilisation (n=44 337) and AIDS case reporting (n=7749) were merged to identify rates and risk factors for co-occurring homelessness and AIDS. Multiple decrement life tables analyses were conducted, and logistic regression analyses used to identify risk factors associated with AIDS among the homeless, and homelessness among people with AIDS. City of Philadelphia, Pennsylvania, USA. People admitted to public shelters had a three year rate of subsequent AIDS diagnosis of 1.8 per 100 person years; nine times the rate for the general population of Philadelphia. Logistic regression results show that substance abuse history (OR = 3.14), male gender (OR = 2.05), and a history of serious mental disorder (OR = 1.62) were significantly related to the risk for AIDS diagnosis among shelter users. Among people with AIDS, results show a three year rate of subsequent shelter admission of 6.9 per 100 person years, and a three year rate of prior shelter admission of 9%, three times the three year rate of shelter admission for the general population. Logistic regression results show that intravenous drug user history (OR = 3.14); no private insurance (OR = 2.93); black race (OR = 2.82); pulmonary or extra-pulmonary TB (OR = 1.43); and pneumocystis pneumonia (OR = 0.56) were all related to the risk for shelter admission. Homelessness prevention programmes should target people with HIV risk factors, and HIV prevention programmes should be targeted to homeless persons, as these populations have significant intersection. Reasons and implications for this intersection are discussed.

Lithium and neuroleptics in combination: is there enhancement of neurotoxicity leading to permanent sequelae?

PubMed

Goldman, S A

1996-10-01

Neurotoxicity in relation to concomitant administration of lithium and neuroleptic drugs, particularly haloperidol, has been an ongoing issue. This study examined whether use of lithium with neuroleptic drugs enhances neurotoxicity leading to permanent sequelae. The Spontaneous Reporting System database of the United States Food and Drug Administration and extant literature were reviewed for spectrum cases of lithium/neuroleptic neurotoxicity. Groups taking lithium alone (Li), lithium/haloperidol (LiHal) and lithium/ nonhaloperidol neuroleptics (LiNeuro), each paired for recovery and sequelae, were established for 237 cases. Statistical analyses included pairwise comparisons of lithium levels using the Wilcoxon Rank Sum procedure and logistic regression to analyze the relationship between independent variables and development of sequelae. The Li and Li-Neuro groups showed significant statistical differences in median lithium levels between recovery and sequelae pairs, whereas the LiHal pair did not differ significantly. Lithium level was associated with sequelae development overall and within the Li and LiNeuro groups; no such association was evident in the LiHal group. On multivariable logistic regression analysis, lithium level and taking lithium/haloperidol were significant factors in the development of sequelae, with multiple possibly confounding factors (e.g., age, sex) not statistically significant. Multivariable logistic regression analyses with neuroleptic dose as five discrete dose ranges or actual dose did not show an association between development of sequelae and dose. Database limitations notwithstanding, the lack of apparent impact of serum lithium level on the development of sequelae in patients treated with haloperidol contrasts notably with results in the Li and LiNeuro groups. These findings may suggest a possible effect of pharmacodynamic factors in lithium/neuroleptic combination therapy.

Predictors of Cervical Cancer Screening for Rarely or Never Screened Rural Appalachian Women

PubMed Central

Hatcher, Jennifer; Studts, Christina R.; Dignan, Mark; Turner, Lisa M.; Schoenberg, Nancy E.

2011-01-01

Background and Purpose Women who have not had a Papanicolaou test in five years or more have increased risk of developing invasive cervical cancer. This study compares Appalachian women whose last screening was more than one year ago but less than five years ago with those not screened for the previous five years or more. Methods Using PRECEDE/PROCEED as a guide, factors related to obtaining Pap tests were examined using cross-sectional data from 345 Appalachian Kentucky women. Bivariate and multivariate analyses were conducted to identify predictors of screening. Results Thirty-four percent of participants were rarely- or never-screened. In multiple logistic regression analyses, several factors increased those odds, including belief that cervical cancer has symptoms, and not having a regular source of medical care. Conclusion The findings from this study may lead to the development of effective intervention and policies that increase cervical cancer screening in this population. PMID:21317514

Perceived school safety is strongly associated with adolescent mental health problems.

PubMed

Nijs, Miesje M; Bun, Clothilde J E; Tempelaar, Wanda M; de Wit, Niek J; Burger, Huibert; Plevier, Carolien M; Boks, Marco P M

2014-02-01

School environment is an important determinant of psychosocial function and may also be related to mental health. We therefore investigated whether perceived school safety, a simple measure of this environment, is related to mental health problems. In a population-based sample of 11,130 secondary school students, we analysed the relationship of perceived school safety with mental health problems using multiple logistic regression analyses to adjust for potential confounders. Mental health problems were defined using the clinical cut-off of the self-reported Strengths and Difficulties Questionnaire. School safety showed an exposure-response relationship with mental health problems after adjustment for confounders. Odds ratios increased from 2.48 ("sometimes unsafe") to 8.05 ("very often unsafe"). The association was strongest in girls and young and middle-aged adolescents. Irrespective of the causal background of this association, school safety deserves attention either as a risk factor or as an indicator of mental health problems.

Hospitalizations Among Homeless Women: Are There Ethnic and Drug Abuse Disparities?

PubMed Central

Gelberg, Lillian; Andersen, Ronald; Longshore, Douglas; Leake, Barbara; Nyamathi, Adeline; Teruya, Cheryl; Arangua, Lisa

2013-01-01

This paper explores associations among the vulnerabilities of being female, being a member of a minority group, and being a drug abuser in homeless women’s hospitalizations. It uses a 1997 probability survey of 974 homeless females age 15–44 in Los Angeles. In unadjusted analyses, whites were more likely than other ethnic minority groups to be hospitalized, and drug abusers were more likely to be hospitalized than non-drug abusers. Multiple logistic regression analyses indicated that factors associated with hospitalization differed considerably among the ethnic and drug-abuse subgroups. For example, ethnic disparities in inpatient health care were found for drug-abusing women, but not for those who did not abuse drugs. Pregnancy was the only important determinant of hospitalization in all subgroups (OR, 2.9–17.4). Preventing unintended pregnancy appears to be the most inclusive means of reducing hospitalization and attendant costs among homeless women. PMID:18923904

Asbestos-related diseases in automobile mechanics.

PubMed

Ameille, Jacques; Rosenberg, Nicole; Matrat, Mireille; Descatha, Alexis; Mompoint, Dominique; Hamzi, Lounis; Atassi, Catherine; Vasile, Manuela; Garnier, Robert; Pairon, Jean-Claude

2012-01-01

Automobile mechanics have been exposed to asbestos in the past, mainly due to the presence of chrysotile asbestos in brakes and clutches. Despite the large number of automobile mechanics, little is known about the non-malignant respiratory diseases observed in this population. The aim of this retrospective multicenter study was to analyse the frequency of pleural and parenchymal abnormalities on high-resolution computed tomography (HRCT) in a population of automobile mechanics. The study population consisted of 103 automobile mechanics with no other source of occupational exposure to asbestos, referred to three occupational health departments in the Paris area for systematic screening of asbestos-related diseases. All subjects were examined by HRCT and all images were reviewed separately by two independent readers; who in the case of disagreement discussed until they reached agreement. Multiple logistic regression models were constructed to investigate factors associated with pleural plaques. Pleural plaques were observed in five cases (4.9%) and interstitial abnormalities consistent with asbestosis were observed in one case. After adjustment for age, smoking status, and a history of non-asbestos-related respiratory diseases, multiple logistic regression models showed a significant association between the duration of exposure to asbestos and pleural plaques. The asbestos exposure experienced by automobile mechanics may lead to pleural plaques. The low prevalence of non-malignant asbestos-related diseases, using a very sensitive diagnostic tool, is in favor of a low cumulative exposure to asbestos in this population of workers.

[Associations between dormitory environment/other factors and sleep quality of medical students].

PubMed

Zheng, Bang; Wang, Kailu; Pan, Ziqi; Li, Man; Pan, Yuting; Liu, Ting; Xu, Dan; Lyu, Jun

2016-03-01

To investigate the sleep quality and related factors among medical students in China, understand the association between dormitory environment and sleep quality, and provide evidence and recommendations for sleep hygiene intervention. A total of 555 undergraduate students were selected from a medical school of an university in Beijing through stratified-cluster random-sampling to conduct a questionnaire survey by using Chinese version of Pittsburgh Sleep Quality Index (PSQI) and self-designed questionnaire. Analyses were performed by using multiple logistic regression model as well as multilevel linear regression model. The prevalence of sleep disorder was 29.1%(149/512), and 39.1%(200/512) of the students reported that the sleep quality was influenced by dormitory environment. PSQI score was negatively correlated with self-reported rating of dormitory environment (γs=-0.310, P<0.001). Logistic regression analysis showed the related factors of sleep disorder included grade, sleep regularity, self-rated health status, pressures of school work and employment, as well as dormitory environment. RESULTS of multilevel regression analysis also indicated that perception on dormitory environment (individual level) was associated with sleep quality with the dormitory level random effects under control (b=-0.619, P<0.001). The prevalence of sleep disorder was high in medical students, which was associated with multiple factors. Dormitory environment should be taken into consideration when the interventions are taken to improve the sleep quality of students.

The effects of multiple interpersonal traumas on psychological maladjustment of sexually abused children in Korea.

PubMed

Choi, Ji Young; Oh, Kyung Ja

2013-02-01

The purpose of the present study was to explore the effects of multiple interpersonal traumas on psychiatric diagnosis and behavior problems of sexually abused children in Korea. With 495 children (ages 4-13 years) referred to a public counseling center for sexual abuse in Korea, we found significant differences in the rate of psychiatric diagnoses (r = .23) and severity of behavioral problems (internalizing d = 0.49, externalizing d = 0.40, total d = 0.52) between children who were victims of sexual abuse only (n = 362) and youth who were victims of interpersonal trauma experiences in addition to sexual abuse (n = 133). The effects of multiple interpersonal trauma experiences on single versus multiple diagnoses remained significant in the logistic regression analysis where demographic variables, family environmental factors, sexual abuse characteristics, and postincident factors were considered together, odds ratio (OR) = 0.44, 95% confidence interval (CI) = [0.25, 0.77], p < .01. Similarly, multiple regression analyses revealed a significant effect of multiple interpersonal trauma experiences on severity of behavioral problems above and beyond all aforementioned variables (internalizing β =.12, p = .019, externalizing β = .11, p = .036, total β = .14, p =.008). The results suggested that children with multiple interpersonal traumas are clearly at a greater risk for negative consequences following sexual abuse. Copyright © 2013 International Society for Traumatic Stress Studies.

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

On the Simulation-Based Reliability of Complex Emergency Logistics Networks in Post-Accident Rescues.

PubMed

Wang, Wei; Huang, Li; Liang, Xuedong

2018-01-06

This paper investigates the reliability of complex emergency logistics networks, as reliability is crucial to reducing environmental and public health losses in post-accident emergency rescues. Such networks' statistical characteristics are analyzed first. After the connected reliability and evaluation indices for complex emergency logistics networks are effectively defined, simulation analyses of network reliability are conducted under two different attack modes using a particular emergency logistics network as an example. The simulation analyses obtain the varying trends in emergency supply times and the ratio of effective nodes and validates the effects of network characteristics and different types of attacks on network reliability. The results demonstrate that this emergency logistics network is both a small-world and a scale-free network. When facing random attacks, the emergency logistics network steadily changes, whereas it is very fragile when facing selective attacks. Therefore, special attention should be paid to the protection of supply nodes and nodes with high connectivity. The simulation method provides a new tool for studying emergency logistics networks and a reference for similar studies.

On the Simulation-Based Reliability of Complex Emergency Logistics Networks in Post-Accident Rescues

PubMed Central

Wang, Wei; Huang, Li; Liang, Xuedong

2018-01-01

This paper investigates the reliability of complex emergency logistics networks, as reliability is crucial to reducing environmental and public health losses in post-accident emergency rescues. Such networks’ statistical characteristics are analyzed first. After the connected reliability and evaluation indices for complex emergency logistics networks are effectively defined, simulation analyses of network reliability are conducted under two different attack modes using a particular emergency logistics network as an example. The simulation analyses obtain the varying trends in emergency supply times and the ratio of effective nodes and validates the effects of network characteristics and different types of attacks on network reliability. The results demonstrate that this emergency logistics network is both a small-world and a scale-free network. When facing random attacks, the emergency logistics network steadily changes, whereas it is very fragile when facing selective attacks. Therefore, special attention should be paid to the protection of supply nodes and nodes with high connectivity. The simulation method provides a new tool for studying emergency logistics networks and a reference for similar studies. PMID:29316614

What are we missing? Risk behaviors among Arab-American adolescents and emerging adults.

PubMed

Munro-Kramer, Michelle L; Fava, Nicole M; Saftner, Melissa A; Darling-Fisher, Cynthia S; Tate, Nutrena H; Stoddard, Sarah A; Martyn, Kristy K

2016-09-01

Research on Arab-Americans as a distinct ethnic group is limited, especially when considering the health of Arab-American youth. This study describes health risk (substance use, violence); health promotive behaviors (hope, spirituality); and sexual activity (oral, vaginal, anal sex) of Arab-American adolescents and emerging adults (aged 15-23) within their life context, as well as the association between these behaviors. A secondary analysis of data on a subset of Arab-American participants obtained from a randomized-control trial was utilized to conduct mixed methods analyses. Qualitative analyses completed on the open-ended questions used the constant comparative method for a subsample (n = 24) of participants. Descriptive quantitative analyses of survey data utilized bivariate analyses and stepwise logistic regression to explore the relation between risk behaviors and sexual activity among the full sample (n = 57). Qualitative analyses revealed two groups of participants: (a) multiple risk behaviors and negative life-events, and (b) minimal risk behaviors and positive life-events. Quantitative analyses indicated older youth, smokers, and those with higher hope pathways were more likely to report vaginal sex. The unique cultural and social contexts of Arab-American youth provide a framework for recommendations for the prevention of risk behaviors. ©2016 American Association of Nurse Practitioners.

What are we missing? Risk behaviors among Arab-American adolescents and emerging adults

PubMed Central

Munro-Kramer, Michelle L.; Fava, Nicole M.; Saftner, Melissa A.; Darling-Fisher, Cynthia S.; Tate, Nutrena H.; Stoddard, Sarah A.; Martyn, Kristy K.

2016-01-01

Background and Purpose Research on Arab-Americans as a distinct ethnic group is limited, especially when considering the health of Arab-American youth. This study describes health risk (substance use, violence); health promotive behaviors (hope, spirituality); and sexual activity (oral, vaginal, anal sex) of Arab-American adolescents and emerging adults (15-23 years old) within their life context, as well as the association between these behaviors. Methods A secondary analysis of data on a subset of Arab-American participants obtained from a randomized control trial were utilized to conduct mixed methods analyses. Qualitative analyses completed on the open-ended questions used the constant comparative method for a subsample (n=24) of participants. Descriptive quantitative analyses of survey data utilized bivariate analyses and stepwise logistic regression to explore the relation between risk behaviors and sexual activity among the full sample (n=57). Conclusions Qualitative analyses revealed two groups of participants: (a) multiple risk behaviors and negative life events, and (b) minimal risk behaviors and positive life events. Quantitative analyses indicated older youth, smokers, and those with higher hope pathways were more likely to report vaginal sex. Implications for Practice The unique cultural and social contexts of Arab-American youth provide a framework for recommendations for the prevention of risk behaviors. PMID:26990394

Is Adolescent Poly-tobacco Use Associated with Alcohol and Other Drug Use?

PubMed Central

Creamer, MeLisa R.; Portillo, Gabriela V.; Clendennen, Stephanie L.; Perry, Cheryl L.

2016-01-01

Objectives To examine associations between current multiple tobacco product use, and current use of alcohol and marijuana, binge drinking, and lifetime use of marijuana, alcohol, and other drugs among US high school students. Methods Using 2013 Youth Risk Behavior Survey data (N = 13,583 high school students), logistic regression analyses were conducted to determine if single tobacco product or multiple tobacco product users are more likely to engage in other risk behaviors than zero tobacco product users, controlling for demographic variables. Results Overall, 23% of the sample used tobacco products and 10% of students reported current use of at least 2 tobacco products. Among single tobacco product users, the odds for engaging in risk behaviors ranged from 3.3 to 9.9 compared to non-tobacco users (p < .0001). Among multiple tobacco product users, the odds ranged from 1.5 to 4.7 (p < .01) compared to single tobacco product users. Conclusions Results suggest dual users are significantly more likely to engage in risk behavior than non-users and single product users. Future interventions should consider identifying dual-users as at higher risk, and targeting multiple risk behaviors. PMID:26685820

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.

Admixture mapping of pelvic organ prolapse in African Americans from the Women’s Health Initiative Hormone Therapy trial

PubMed Central

Hartmann, Katherine E.; Aldrich, Melinda C.; Ward, Renee M.; Wu, Jennifer M.; Park, Amy J.; Graff, Mariaelisa; Qi, Lihong; Nassir, Rami; Wallace, Robert B.; O'Sullivan, Mary J.; North, Kari E.; Velez Edwards, Digna R.; Edwards, Todd L.

2017-01-01

Evidence suggests European American (EA) women have two- to five-fold increased odds of having pelvic organ prolapse (POP) when compared with African American (AA) women. However, the role of genetic ancestry in relation to POP risk is not clear. Here we evaluate the association between genetic ancestry and POP in AA women from the Women’s Health Initiative Hormone Therapy trial. Women with grade 1 or higher classification, and grade 2 or higher classification for uterine prolapse, cystocele or rectocele at baseline or during follow-up were considered to have any POP (N = 805) and moderate/severe POP (N = 156), respectively. Women with at least two pelvic exams with no indication for POP served as controls (N = 344). We performed case-only, and case-control admixture-mapping analyses using multiple logistic regression while adjusting for age, BMI, parity and global ancestry. We evaluated the association between global ancestry and POP using multiple logistic regression. European ancestry at the individual level was not associated with POP risk. Case-only and case-control local ancestry analyses identified two ancestry-specific loci that may be associated with POP. One locus (Chromosome 15q26.2) achieved empirically-estimated statistical significance and was associated with decreased POP odds (considering grade ≥2 POP) with each unit increase in European ancestry (OR: 0.35; 95% CI: 0.30, 0.57; p-value = 1.48x10-5). This region includes RGMA, a potent regulator of the BMP family of genes. The second locus (Chromosome 1q42.1-q42.3) was associated with increased POP odds with each unit increase in European ancestry (Odds ratio [OR]: 1.69; 95% confidence interval [CI]: 1.28, 2.22; p-value = 1.93x10-4). Although this region did not reach statistical significance after considering multiple comparisons, it includes potentially relevant genes including TBCE, and ACTA1. Unique non-overlapping European and African ancestry-specific susceptibility loci may be associated with increased POP risk. PMID:28582460

Perineal body length and perineal lacerations during delivery in primigravid patients

PubMed Central

Lane, T. Lance; Chung, Christopher P.; Yandell, Paul M.; Kuehl, Thomas J.

2017-01-01

This study assessed the relation between perineal body length and the risk of perineal laceration extending into the anal sphincter during vaginal delivery in primigravid patients at an institution with a low utilization of episiotomy. This was a prospective study of primigravid patients in active labor. Primigravid women with singleton pregnancies who were in the first stage of labor at 37 weeks gestation or greater were recruited, and the admitting physician measured the length of the perineal body. The degree of perineal laceration and other delivery characteristics were recorded. Data were analyzed using univariate analyses, receiver-operator curve analyses, and multiple logistic regression for factors associated with increased severity of vaginal lacerations. The perineal body length, duration of second stage of labor, type of delivery, and patient age were associated (P < 0.1) with third- and fourth-degree (severe) perineal lacerations in primigravid women using receiver-operator curve analysis. Using logistic regression, only the duration of second stage of labor and length of the perineal body were significant (P < 0.04) predictors of third- and fourth-degree lacerations, with odds ratios of 32 (1.3 to 807 as 95% CI) and 24 (1.3 to 456), respectively. Both a perineal body length of ≤3.5 cm and a duration of second stage of labor >99 minutes were associated with an increased risk of third- and fourth-degree lacerations in primigravid patients. PMID:28405063

Risk factors for indications of intraoperative blood transfusion among patients undergoing surgical treatment for colorectal adenocarcinoma.

PubMed

Gonçalves, Iara; Linhares, Marcelo; Bordin, Jose; Matos, Delcio

2009-01-01

Identification of risk factors for requiring transfusions during surgery for colorectal cancer may lead to preventive actions or alternative measures, towards decreasing the use of blood components in these procedures, and also rationalization of resources use in hemotherapy services. This was a retrospective case-control study using data from 383 patients who were treated surgically for colorectal adenocarcinoma at 'Fundação Pio XII', in Barretos-SP, Brazil, between 1999 and 2003. To recognize significant risk factors for requiring intraoperative blood transfusion in colorectal cancer surgical procedures. Univariate analyses were performed using Fisher's exact test or the chi-squared test for dichotomous variables and Student's t test for continuous variables, followed by multivariate analysis using multiple logistic regression. In the univariate analyses, height (P = 0.06), glycemia (P = 0.05), previous abdominal or pelvic surgery (P = 0.031), abdominoperineal surgery (P<0.001), extended surgery (P<0.001) and intervention with radical intent (P<0.001) were considered significant. In the multivariate analysis using logistic regression, intervention with radical intent (OR = 10.249, P<0.001, 95% CI = 3.071-34.212) and abdominoperineal amputation (OR = 3.096, P = 0.04, 95% CI = 1.445-6.623) were considered to be independently significant. This investigation allows the conclusion that radical intervention and the abdominoperineal procedure in the surgical treatment of colorectal adenocarcinoma are risk factors for requiring intraoperative blood transfusion.

Family Medicine or Primary Care Residency Selection: Effects of Family Medicine Interest Groups, MD/MPH Dual Degrees, and Rural Medical Education.

PubMed

Wei McIntosh, Elizabeth; Morley, Christopher P

2016-05-01

If medical schools are to produce primary care physicians (family medicine, pediatrics, or general internal medicine), they must provide educational experiences that enable medical students to maintain existing or form new interests in such careers. This study examined three mechanisms for doing so, at one medical school: participation as an officer in a family medicine interest group (FMIG), completion of a dual medical/public health (MD/MPH) degree program, and participation in a rural medical education (RMED) clinical track. Specialty Match data for students who graduated from the study institution between 2006 and 2015 were included as dependent variables in bivariate analysis (c2) and logistic regression models, examining FMIG, MD/MPH, and RMED participation as independent predictors of specialty choice (family medicine yes/no, or any primary care (PC) yes/no), controlling for student demographic data. In bivariate c2 analyses, FMIG officership did not significantly predict matching with family medicine or any PC; RMED and MD/MPH education were significant predictors of both family medicine and PC. Binary logistic regression analyses replicated the bivariate findings, controlling for student demographics. Dual MD/MPH and rural medical education had stronger effects in producing primary care physicians than participation in a FMIG as an officer, at one institution. Further study at multiple institutions is warranted.

Selecting risk factors: a comparison of discriminant analysis, logistic regression and Cox's regression model using data from the Tromsø Heart Study.

PubMed

Brenn, T; Arnesen, E

1985-01-01

For comparative evaluation, discriminant analysis, logistic regression and Cox's model were used to select risk factors for total and coronary deaths among 6595 men aged 20-49 followed for 9 years. Groups with mortality between 5 and 93 per 1000 were considered. Discriminant analysis selected variable sets only marginally different from the logistic and Cox methods which always selected the same sets. A time-saving option, offered for both the logistic and Cox selection, showed no advantage compared with discriminant analysis. Analysing more than 3800 subjects, the logistic and Cox methods consumed, respectively, 80 and 10 times more computer time than discriminant analysis. When including the same set of variables in non-stepwise analyses, all methods estimated coefficients that in most cases were almost identical. In conclusion, discriminant analysis is advocated for preliminary or stepwise analysis, otherwise Cox's method should be used.

Bayesian Estimation of Pneumonia Etiology: Epidemiologic Considerations and Applications to the Pneumonia Etiology Research for Child Health Study.

PubMed

Deloria Knoll, Maria; Fu, Wei; Shi, Qiyuan; Prosperi, Christine; Wu, Zhenke; Hammitt, Laura L; Feikin, Daniel R; Baggett, Henry C; Howie, Stephen R C; Scott, J Anthony G; Murdoch, David R; Madhi, Shabir A; Thea, Donald M; Brooks, W Abdullah; Kotloff, Karen L; Li, Mengying; Park, Daniel E; Lin, Wenyi; Levine, Orin S; O'Brien, Katherine L; Zeger, Scott L

2017-06-15

In pneumonia, specimens are rarely obtained directly from the infection site, the lung, so the pathogen causing infection is determined indirectly from multiple tests on peripheral clinical specimens, which may have imperfect and uncertain sensitivity and specificity, so inference about the cause is complex. Analytic approaches have included expert review of case-only results, case-control logistic regression, latent class analysis, and attributable fraction, but each has serious limitations and none naturally integrate multiple test results. The Pneumonia Etiology Research for Child Health (PERCH) study required an analytic solution appropriate for a case-control design that could incorporate evidence from multiple specimens from cases and controls and that accounted for measurement error. We describe a Bayesian integrated approach we developed that combined and extended elements of attributable fraction and latent class analyses to meet some of these challenges and illustrate the advantage it confers regarding the challenges identified for other methods. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

[Psychoactive substances use and health-related quality of life among school age adolescents].

PubMed

Vilugrón Aravena, Fabiola; Hidalgo-Rasmussen, Carlos Alejandro; Molina G, Temístocles; Gras Pérez, María Eugenia; Font-Mayolas, Silvia

2017-12-01

Background The use of psychoactive substances among adolescents is a major social and public health concern. Aim To analyze association of substance abuse and multiple drug use with health-related quality of life (HRQOL) in adolescents attending a high school in Valparaiso, Chile. Material and Methods Analytical cross-sectional study conducted in a sample of adolescents attending high school. HRQOL was assessed using KIDSCREEN-52 questionnaire and substance use was measured using the Global school-based student health survey. Participants had to complete online, self-administered, anonymous questionnaires. Multiple logistic regression analyses were conducted to calculate Odd ratios. Results A total of 550 adolescents aged 16 ± 1 years old completed the questionnaires. Thirty nine percent consumed alcohol during the last month, 31% smoked, 33% used marijuana and 33% admitted the use of multiple drugs. High-risk alcohol consumption was associated with a lower perception of psychological well-being, self-perception and school environment. This last dimension was affected in those who admitted marijuana use during the last month. Multiple drug use (three substances) was associated with a lower perception of physical and psychological well-being, self-perception, relationship with parents, family life and school environment. Conclusions High-risk alcohol consumption and multiple drug use (three substances) have a negative impact on the HRQOL of school age adolescents.

Risk assessment of logistics outsourcing based on BP neural network

NASA Astrophysics Data System (ADS)

Liu, Xiaofeng; Tian, Zi-you

The purpose of this article is to evaluate the risk of the enterprises logistics outsourcing. To get this goal, the paper first analysed he main risks existing in the logistics outsourcing, and then set up a risk evaluation index system of the logistics outsourcing; second applied BP neural network into the logistics outsourcing risk evaluation and used MATLAB to the simulation. It proved that the network error is small and has strong practicability. And this method can be used by enterprises to evaluate the risks of logistics outsourcing.

Re-examining the link between prenatal maternal anxiety and child emotional difficulties, using a sibling design.

PubMed

Bekkhus, Mona; Lee, Yunsung; Nordhagen, Rannveig; Magnus, Per; Samuelsen, Sven O; Borge, Anne I H

2018-02-01

Prenatal exposure to maternal anxiety has been associated with child emotional difficulties in a number of epidemiological studies. One key concern, however, is that this link is vulnerable to confounding by pleiotropic genes or environmental family factors. Data on 82 383 mothers and children from the population-based Mother and Child Cohort Study and data on 21 980 siblings were used in this study. Mothers filled out questionnaires for each unique pregnancy, for infant difficulties at 6 months and for emotional difficulties at 36 months. The link between prenatal maternal anxiety and child difficulties were examined using logistic regression analyses and multiple linear regression analyses for the full study sample and the sibling sample. In the conventional full-cohort analyses, prenatal exposure to maternal anxiety was associated with child difficulties at both 6 months [odds ratio (OR) = 2.1 (1.94-2.27)] and 36 months [OR = 2.72 (2.47-2.99)]. The findings were essentially the same whether we examined difficulties at 6 months or at 36 months. However, these associations were no longer present once we controlled for potential social and genetic confounders in the sibling comparison analyses, either at 6 months [OR = 1.32 (0.91-1.90)] or at 36 months [OR = 1.28 (0.63-2.60)]. Findings from multiple regression analyses with continuous measures were essentially the same. Our finding lends little support for there being an independent prenatal effect on child emotional difficulties; rather, our findings suggest that the link between prenatal maternal anxiety and child difficulties could be confounded by pleiotropic genes or environmental family factors. © The Author 2017; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association

Suicidal ideation among suburban adolescents: The influence of school bullying and other mediating risk factors.

PubMed

Lardier, David T; Barrios, Veronica R; Garcia-Reid, Pauline; Reid, Robert J

2016-10-01

Prior research has identified multiple factors that influence suicidal ideation (SI) among bullied youth. The effects of school bullying on SI cannot be considered in isolation. In this study, we examined the influence of school bullying on SI, through a constellation of risks, which include depressive and anxiety symptoms, family conflict, and alcohol, tobacco, and other drug (ATOD) use. We also provide recommendations for therapists working with bullied youth. Our sample consisted of 488 adolescents (ages 10-18 years) from a northern New Jersey, United States suburban community. Students were recruited through the district's physical education and health classes. Students responded to multiple measures, which included family cohesion/conflict, ATOD use, mental health indicators, SI, and school bullying experiences. Following preliminary analyses, several logistic regression models were used to assess the direct influence of bullying on SI, as well as the unique effects of family conflict, depressive and anxiety symptoms, and substance use. In addition, a parallel multiple mediating model with the PROCESS macro in SPSS was used to further assess mediating effects. Logistic regression results indicated that school bullying increased the odds of SI among males and females and that when mediating variables were added to the model, bullying no longer had a significant influence on SI. Overall, these results display that for both males and females, school bullying was a significant contributor to SI. Results from the parallel multiple mediating model further illustrated the mediating effects that family conflict, depression, and ATOD use had between bullying and SI. Some variation was noted based on gender. This study draws attention to the multiple experiences associated with school bullying on SI, and how these results may differ by gender. The results of this study are particularly important for those working directly and indirectly with bullied youth. Therapists that engage bullied youth need to consider the multiple spheres of influence that may increase SI among male and female clients. To holistically and adequately assess SI among bullied youth, therapists must also consider how these mechanisms vary between gender groups.

Factor Analysis of Therapist-Identified Treatment Targets in Community-Based Children's Mental Health.

PubMed

Love, Allison R; Okado, Izumi; Orimoto, Trina E; Mueller, Charles W

2018-01-01

The present study used exploratory and confirmatory factor analyses to identify underlying latent factors affecting variation in community therapists' endorsement of treatment targets. As part of a statewide practice management program, therapist completed monthly reports of treatment targets (up to 10 per month) for a sample of youth (n = 790) receiving intensive in-home therapy. Nearly 75 % of youth were diagnosed with multiple co-occurring disorders. Five factors emerged: Disinhibition, Societal Rules Evasion, Social Engagement Deficits, Emotional Distress, and Management of Biodevelopmental Outcomes. Using logistic regression, primary diagnosis predicted therapist selection of Disinhibition and Emotional Distress targets. Client age predicted endorsement of Societal Rules Evasion targets. Practice-to-research implications are discussed.

Impact of the Medicare interim payment system on length of use in home care among patients with Medicare-only payment source.

PubMed

Han, Beth; Remsburg, Robin E

2005-01-01

Using data from the 1996 and 2000 National Home and Hospice Care Surveys (N = 2,455), we examined length of use in home care among patients with Medicare-only payment source before and during the Medicare interim payment system (IPS). Logistic regression analyses revealed that patients were 2.9 times more likely to be discharged within 60 days during IPS than before IPS. The impact of Medicare IPS on length of use in home care among patients with Medicare only was stronger than what the existing literature indicates, which combines Medicare patients with multiple payment sources and patients with Medicare-only together.

Sociodemographic factors associated with pregnant women's level of knowledge about oral health

PubMed Central

Barbieri, Wander; Peres, Stela Verzinhasse; Pereira, Carla de Britto; Peres, João; de Sousa, Maria da Luz Rosário; Cortellazzi, Karine Laura

2018-01-01

ABSTRACT Objective To evaluate knowledge on oral health and associated sociodemographic factors in pregnant women. Methods A cross-sectional study with a sample of 195 pregnant women seen at the Primary Care Unit Paraisópolis I, in São Paulo (SP), Brazil. For statistical analysis, χ2 or Fisher's exact test and multiple logistic regression were used. A significance level of 5% was used in all analyses. Results Schooling level equal to or greater than 8 years and having one or two children were associated with an adequate knowledge about oral health. Conclusion Oral health promotion strategies during prenatal care should take into account sociodemographic aspects. PMID:29694612

Survival Data and Regression Models

NASA Astrophysics Data System (ADS)

Grégoire, G.

2014-12-01

We start this chapter by introducing some basic elements for the analysis of censored survival data. Then we focus on right censored data and develop two types of regression models. The first one concerns the so-called accelerated failure time models (AFT), which are parametric models where a function of a parameter depends linearly on the covariables. The second one is a semiparametric model, where the covariables enter in a multiplicative form in the expression of the hazard rate function. The main statistical tool for analysing these regression models is the maximum likelihood methodology and, in spite we recall some essential results about the ML theory, we refer to the chapter "Logistic Regression" for a more detailed presentation.

The Associations Between Forced Sex and Severe Mental Health, Substance Use, and HIV Risk Behaviors Among Asian American Women

PubMed Central

Hahm, Hyeouk Chris; Augsberger, Astraea; Feranil, Mario; Jang, Jisun; Tagerman, Michelle

2017-01-01

We examined the association between forced sex history and mental health, sexual health, and substance use among Asian American women (n = 720); 14.3% of our sample (n = 103) reported forced sex experiences. Multiple logistic regression analyses revealed that participants with forced sex histories were 2-8 times more likely to have higher rates of mental health problems, HIV risk behavior, and substance use. Qualitative analysis was used to supplement the quantitative results and give depth to our findings. Our results suggest that interventions for Asian American women who experienced forced sex should integrate mental health, substance use, and sexual health treatments. PMID:27230614

The Persistence of the Gender Gap in Introductory Physics

NASA Astrophysics Data System (ADS)

Kost, Lauren E.; Pollock, Steven J.; Finkelstein, Noah D.

2008-10-01

We previously showed[l] that despite teaching with interactive engagement techniques, the gap in performance between males and females on conceptual learning surveys persisted from pre- to posttest, at our institution. Such findings were counter to previously published work[2]. Our current work analyzes factors that may influence the observed gender gap in our courses. Posttest conceptual assessment data are modeled using both multiple regression and logistic regression analyses to estimate the gender gap in posttest scores after controlling for background factors that vary by gender. We find that at our institution the gender gap persists in interactive physics classes, but is largely due to differences in physics and math preparation and incoming attitudes and beliefs.

Serum 25-hydroxyvitamin D level is associated with myopia in the Korea national health and nutrition examination survey.

PubMed

Kwon, Jin-Woo; Choi, Jin A; La, Tae Yoon

2016-11-01

The aim of this article was to assess the associations of serum 25-hydroxyvitamin D [25(OH)D] and daily sun exposure time with myopia in Korean adults.This study is based on the Korea National Health and Nutrition Examination Survey (KNHANES) of Korean adults in 2010-2012; multiple logistic regression analyses were performed to examine the associations of serum 25(OH)D levels and daily sun exposure time with myopia, defined as spherical equivalent ≤-0.5D, after adjustment for age, sex, household income, body mass index (BMI), exercise, intraocular pressure (IOP), and education level. Also, multiple linear regression analyses were performed to examine the relationship between serum 25(OH)D levels with spherical equivalent after adjustment for daily sun exposure time in addition to the confounding factors above.Between the nonmyopic and myopic groups, spherical equivalent, age, IOP, BMI, waist circumference, education level, household income, and area of residence differed significantly (all P < 0.05). Compared with subjects with daily sun exposure time <2 hour, subjects with sun exposure time ≥2 to <5 hour, and those with sun exposure time ≥5 hour had significantly less myopia (P < 0.001). In addition, compared with subjects were categorized into quartiles of serum 25(OH)D, the higher quartiles had gradually lower prevalences of myopia after adjustment for confounding factors (P < 0.001). In multiple linear regression analyses, spherical equivalent was significantly associated with serum 25(OH)D concentration after adjustment for confounding factors (P = 0.002).Low serum 25(OH)D levels and shorter daily sun exposure time may be independently associated with a high prevalence of myopia in Korean adults. These data suggest a direct role for vitamin D in the development of myopia.

Geographic information systems and logistic regression for high-resolution malaria risk mapping in a rural settlement of the southern Brazilian Amazon.

PubMed

de Oliveira, Elaine Cristina; dos Santos, Emerson Soares; Zeilhofer, Peter; Souza-Santos, Reinaldo; Atanaka-Santos, Marina

2013-11-15

In Brazil, 99% of the cases of malaria are concentrated in the Amazon region, with high level of transmission. The objectives of the study were to use geographic information systems (GIS) analysis and logistic regression as a tool to identify and analyse the relative likelihood and its socio-environmental determinants of malaria infection in the Vale do Amanhecer rural settlement, Brazil. A GIS database of georeferenced malaria cases, recorded in 2005, and multiple explanatory data layers was built, based on a multispectral Landsat 5 TM image, digital map of the settlement blocks and a SRTM digital elevation model. Satellite imagery was used to map the spatial patterns of land use and cover (LUC) and to derive spectral indices of vegetation density (NDVI) and soil/vegetation humidity (VSHI). An Euclidian distance operator was applied to measure proximity of domiciles to potential mosquito breeding habitats and gold mining areas. The malaria risk model was generated by multiple logistic regression, in which environmental factors were considered as independent variables and the number of cases, binarized by a threshold value was the dependent variable. Out of a total of 336 cases of malaria, 133 positive slides were from inhabitants at Road 08, which corresponds to 37.60% of the notifications. The southern region of the settlement presented 276 cases and a greater number of domiciles in which more than ten cases/home were notified. From these, 102 (30.36%) cases were caused by Plasmodium falciparum and 174 (51.79%) cases by Plasmodium vivax. Malaria risk is the highest in the south of the settlement, associated with proximity to gold mining sites, intense land use, high levels of soil/vegetation humidity and low vegetation density. Mid-resolution, remote sensing data and GIS-derived distance measures can be successfully combined with digital maps of the housing location of (non-) infected inhabitants to predict relative likelihood of disease infection through the analysis by logistic regression. Obtained findings on the relation between malaria cases and environmental factors should be applied in the future for land use planning in rural settlements in the Southern Amazon to minimize risks of disease transmission.

Levels, Trends and Disparities in Public-Health-Related Indicators among Reproductive-Age Women in Bangladesh by Urban-Rural and Richest-Poorest Groups, 1993-2011

PubMed Central

Khan, Md. Mobarak Hossain; Zanuzdana, Arina; Kraemer, Alexander

2013-01-01

Background And Objectives Although Bangladesh has already achieved noticeable progress in the field of development and health, disparities in public health indicators for several markers are still reported. To assess public health development in Bangladesh during the last two decades, firstly, we analysed levels, trends and disparities in public-health-related indicators by rural versus urban as well as by the richest versus poorest group of women who have ever been married. Secondly, using the most recent data set we performed multiple analyses to check whether urban-rural and richest-poorest disparities were still significant. Methods The analysis was based on six nationally representative data sets from the Bangladesh Demographic and Health Surveys (BDHS) conducted in 1993-94 (n=9,640), 1996-1997 (n=9,127), 1999-2000 (n=10,544), 2004 (n=11,440), 2007 (n=10,996) and 2011 (n=17,749). The outcome variables were six selected public-health-related indicators. We performed various types of analyses, including multiple logistic regressions. Results The trend of all indicators except being overweight (1993-2011) displayed gradual improvements for both markers. However, the urban and richest groups revealed a better situation than their counterparts in both simple and multiple analyses. Disparities between richest-poorest groups were more pronounced than urban-rural disparities. For instance, the prevalence of delivery at any healthcare facility in 2011 was 20.4% in rural areas and 46.5% in urban areas, whereas it was 9.1% in the poorest group and 57.6% in the richest group. Conclusion The public health sector in Bangladesh has achieved some successes over the last two decades. However, urban-rural and richest-poorest disparities are still considerable and therefore more public health strategies and efforts are clearly needed for the rural and poorest groups of women in order to reduce these gaps further. PMID:24086485

Regression Analysis of Optical Coherence Tomography Disc Variables for Glaucoma Diagnosis.

PubMed

Richter, Grace M; Zhang, Xinbo; Tan, Ou; Francis, Brian A; Chopra, Vikas; Greenfield, David S; Varma, Rohit; Schuman, Joel S; Huang, David

2016-08-01

To report diagnostic accuracy of optical coherence tomography (OCT) disc variables using both time-domain (TD) and Fourier-domain (FD) OCT, and to improve the use of OCT disc variable measurements for glaucoma diagnosis through regression analyses that adjust for optic disc size and axial length-based magnification error. Observational, cross-sectional. In total, 180 normal eyes of 112 participants and 180 eyes of 138 participants with perimetric glaucoma from the Advanced Imaging for Glaucoma Study. Diagnostic variables evaluated from TD-OCT and FD-OCT were: disc area, rim area, rim volume, optic nerve head volume, vertical cup-to-disc ratio (CDR), and horizontal CDR. These were compared with overall retinal nerve fiber layer thickness and ganglion cell complex. Regression analyses were performed that corrected for optic disc size and axial length. Area-under-receiver-operating curves (AUROC) were used to assess diagnostic accuracy before and after the adjustments. An index based on multiple logistic regression that combined optic disc variables with axial length was also explored with the aim of improving diagnostic accuracy of disc variables. Comparison of diagnostic accuracy of disc variables, as measured by AUROC. The unadjusted disc variables with the highest diagnostic accuracies were: rim volume for TD-OCT (AUROC=0.864) and vertical CDR (AUROC=0.874) for FD-OCT. Magnification correction significantly worsened diagnostic accuracy for rim variables, and while optic disc size adjustments partially restored diagnostic accuracy, the adjusted AUROCs were still lower. Axial length adjustments to disc variables in the form of multiple logistic regression indices led to a slight but insignificant improvement in diagnostic accuracy. Our various regression approaches were not able to significantly improve disc-based OCT glaucoma diagnosis. However, disc rim area and vertical CDR had very high diagnostic accuracy, and these disc variables can serve to complement additional OCT measurements for diagnosis of glaucoma.

Blood lead level association with lower body weight in NHANES 1999–2006

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

Scinicariello, Franco, E-mail: fes6@cdc.gov; Buser, Melanie C.; Mevissen, Meike

Background: Lead exposure is associated with low birth-weight. The objective of this study is to determine whether lead exposure is associated with lower body weight in children, adolescents and adults. Methods: We analyzed data from NHANES 1999–2006 for participants aged ≥ 3 using multiple logistic and multivariate linear regression. Using age- and sex-standardized BMI Z-scores, overweight and obese children (ages 3–19) were classified by BMI ≥ 85th and ≥ 95th percentiles, respectively. The adult population (age ≥ 20) was classified as overweight and obese with BMI measures of 25–29.9 and ≥ 30, respectively. Blood lead level (BLL) was categorized bymore » weighted quartiles. Results: Multivariate linear regressions revealed a lower BMI Z-score in children and adolescents when the highest lead quartile was compared to the lowest lead quartile (β (SE) = − 0.33 (0.07), p < 0.001), and a decreased BMI in adults (β (SE) = − 2.58 (0.25), p < 0.001). Multiple logistic analyses in children and adolescents found a negative association between BLL and the percentage of obese and overweight with BLL in the highest quartile compared to the lowest quartile (OR = 0.42, 95% CI: 0.30–0.59; and OR = 0.67, 95% CI: 0.52–0.88, respectively). Adults in the highest lead quartile were less likely to be obese (OR = 0.42, 95% CI: 0.35–0.50) compared to those in the lowest lead quartile. Further analyses with blood lead as restricted cubic splines, confirmed the dose-relationship between blood lead and body weight outcomes. Conclusions: BLLs are associated with lower body mass index and obesity in children, adolescents and adults. - Highlights: • NHANES analysis of BLL and body weight outcomes • Increased BLL associated with decreased body weight in children and adolescent • Increased BLL associated with decreased body weight in adults.« less

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.

The relationship between mental disorders, quality of life, and pregnancy: findings from a nationally representative sample.

PubMed

Mota, Natalie; Cox, Brian J; Enns, Murray W; Calhoun, Laura; Sareen, Jitender

2008-08-01

The present study examined health-related quality of life (HRQOL) and the prevalence of mental disorders in pregnant and past-year pregnant women compared to non-pregnant women. Data came from the National Epidemiologic Survey on Alcohol and Related Conditions. Three groups of women (ages 18-44) were compared: currently pregnant (n=451), past-year pregnant (n=1061), and not pregnant (n=10,544). Past-year mood, anxiety and substance use disorders were assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV version. HRQOL was measured by the Medical Outcomes Study Short Form (SF-12). All analyses included sociodemographics as covariates. Multiple logistic regression analyses showed that pregnant women were less likely than non-pregnant women to have depression and alcohol abuse or dependence; and less likely than past-year pregnant women to have depression and mania. Past-year pregnant women were less likely than non-pregnant women to have social phobia and alcohol dependence or abuse. Multiple linear regression analyses demonstrated that pregnant and non-pregnant women had higher mental component scores than past-year pregnant women. Physical component scores were lower in pregnant women than in non-pregnant and past-year pregnant groups. This was a cross-sectional survey and the causality of relationships cannot be inferred. Results suggest that pregnant women have a lower likelihood of mental disorder than both non-pregnant and past-year pregnant women.

Mental health selection and income support dynamics: multiple spell discrete-time survival analyses of welfare receipt.

PubMed

Kiely, Kim M; Butterworth, Peter

2014-04-01

The higher occurrence of common psychiatric disorders among welfare recipients has been attributed to health selection, social causation and underlying vulnerability. The aims of this study were to test for the selection effects of mental health problems on entry and re-entry to working-age welfare payments in respect to single parenthood, unemployment and disability. Nationally representative longitudinal data were drawn from the Household Income and Labour Dynamics in Australia survey. Multiple spell discrete-time survival analyses were conducted using multinomial logistic regression models to test if pre-existing mental health problems predicted transitions to welfare. Analyses were stratified by sex and multivariate adjusted for mental health problems, father's occupation, socioeconomic position, marital status, employment history, smoking status and alcohol consumption, physical function and financial hardship. All covariates were modelled as either lagged effects or when a respondent was first observed to be at risk of income support. Mental health problems were associated with increased risk of entry and re-entry to disability, unemployment and single parenting payments for women, and disability and unemployment payments for men. These associations were attenuated but remained significant after adjusting for contemporaneous risk factors. Although we do not control for reciprocal causation, our findings are consistent with a health selection hypothesis and indicate that mental illness may be a contributing factor to later receipt of different types of welfare payments. We argue that mental health warrants consideration in the design and targeting of social and economic policies.

Social capital, political trust, and health locus of control: a population-based study.

PubMed

Lindström, Martin

2011-02-01

To investigate the association between political trust in the Riksdag and lack of belief in the possibility to influence one's own health (external locus of control), taking horizontal trust into account. The 2008 public health survey in Skåne is a cross-sectional postal questionnaire study with a 55% participation rate. A random sample of 28,198 persons aged 18-80 years participated. Logistic regression models were used to investigate the associations between political trust in the Riksdag (an aspect of vertical trust) and lack of belief in the possibility to influence one's own health (external locus of control). The multiple regression analyses included age, country of birth, education, and horizontal trust in other people. A 33.7% of all men and 31.8% of all women lack internal locus of control. Low (external) health locus of control is more common in higher age groups, among people born outside Sweden, with lower education, low horizontal trust, low political trust, and no opinion concerning political trust. Respondents with not particularly strong political trust, no political trust at all and no opinion have significantly higher odds ratios of external locus of control throughout the multiple regression analyses. Low political trust in the Riksdag seems to be independently associated with external health locus of control.

Reporting quality of statistical methods in surgical observational studies: protocol for systematic review.

PubMed

Wu, Robert; Glen, Peter; Ramsay, Tim; Martel, Guillaume

2014-06-28

Observational studies dominate the surgical literature. Statistical adjustment is an important strategy to account for confounders in observational studies. Research has shown that published articles are often poor in statistical quality, which may jeopardize their conclusions. The Statistical Analyses and Methods in the Published Literature (SAMPL) guidelines have been published to help establish standards for statistical reporting.This study will seek to determine whether the quality of statistical adjustment and the reporting of these methods are adequate in surgical observational studies. We hypothesize that incomplete reporting will be found in all surgical observational studies, and that the quality and reporting of these methods will be of lower quality in surgical journals when compared with medical journals. Finally, this work will seek to identify predictors of high-quality reporting. This work will examine the top five general surgical and medical journals, based on a 5-year impact factor (2007-2012). All observational studies investigating an intervention related to an essential component area of general surgery (defined by the American Board of Surgery), with an exposure, outcome, and comparator, will be included in this systematic review. Essential elements related to statistical reporting and quality were extracted from the SAMPL guidelines and include domains such as intent of analysis, primary analysis, multiple comparisons, numbers and descriptive statistics, association and correlation analyses, linear regression, logistic regression, Cox proportional hazard analysis, analysis of variance, survival analysis, propensity analysis, and independent and correlated analyses. Each article will be scored as a proportion based on fulfilling criteria in relevant analyses used in the study. A logistic regression model will be built to identify variables associated with high-quality reporting. A comparison will be made between the scores of surgical observational studies published in medical versus surgical journals. Secondary outcomes will pertain to individual domains of analysis. Sensitivity analyses will be conducted. This study will explore the reporting and quality of statistical analyses in surgical observational studies published in the most referenced surgical and medical journals in 2013 and examine whether variables (including the type of journal) can predict high-quality reporting.

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.

Characterizing job satisfaction and intent to leave among nationally registered emergency medical technicians: an analysis of the 2005 LEADS survey.

PubMed

Patterson, P Daniel; Moore, Charity G; Sanddal, Nels D; Wingrove, Gary; LaCroix, Brian

2009-01-01

The primary purpose of this study was to characterize job satisfaction with opportunities for advancement, job satisfaction with pay and benefits, and intent to leave the EMS profession among Nationally Registered EMT-Basics and EMT-Paramedics. A secondary data analysis was performed on the National Registry of EMTs Longitudinal Emergency Medical Technician Attributes and Demographic Study Project (LEADS) 2005 core survey. We used chi-square and multiple logistic regression analyses to test for differences in job satisfaction with opportunities for advancement, job satisfaction with pay and benefits, and intent to leave the EMS profession across years of experience and work location. Among 11 measures of job satisfaction, NREMT-Basics and NREMT-Paramedics were least satisfied with opportunities for advancement and pay and benefits (67.8 and 55.2%, respectively). Nearly 6% of respondents reported intentions of leaving the profession within 12 months. In univariate analyses, job satisfaction with advancement opportunities varied across years of experience and work location. Job satisfaction with pay and benefits varied across years of experience and work location. The proportion reporting intentions of leaving the profession did not vary across the two independent variables of interest. In multivariable logistic regression, statistical differences observed in univariate analyses were attenuated to non-significance across all outcome models. Income, personal health, level of EMS certification, and type of EMS work were significant in several outcome models. EMS workforce research is at its infancy, thus our study adds to a limited but growing body of knowledge. In future and replicated research, one will need to consider different person and organizational variables in predicting different measures of job satisfaction among EMS personnel.

Cesarean delivery rates among family physicians versus obstetricians: a population-based cohort study using instrumental variable methods

PubMed Central

Dawe, Russell Eric; Bishop, Jessica; Pendergast, Amanda; Avery, Susan; Monaghan, Kelly; Duggan, Norah; Aubrey-Bassler, Kris

2017-01-01

Background: Previous research suggests that family physicians have rates of cesarean delivery that are lower than or equivalent to those for obstetricians, but adjustments for risk differences in these analyses may have been inadequate. We used an econometric method to adjust for observed and unobserved factors affecting the risk of cesarean delivery among women attended by family physicians versus obstetricians. Methods: This retrospective population-based cohort study included all Canadian (except Quebec) hospital deliveries by family physicians and obstetricians between Apr. 1, 2006, and Mar. 31, 2009. We excluded women with multiple gestations, and newborns with a birth weight less than 500 g or gestational age less than 20 weeks. We estimated the relative risk of cesarean delivery using instrumental-variable-adjusted and logistic regression. Results: The final cohort included 776 299 women who gave birth in 390 hospitals. The risk of cesarean delivery was 27.3%, and the mean proportion of deliveries by family physicians was 26.9% (standard deviation 23.8%). The relative risk of cesarean delivery for family physicians versus obstetricians was 0.48 (95% confidence interval [CI] 0.41-0.56) with logistic regression and 1.27 (95% CI 1.02-1.57) with instrumental-variable-adjusted regression. Interpretation: Our conventional analyses suggest that family physicians have a lower rate of cesarean delivery than obstetricians, but instrumental variable analyses suggest the opposite. Because instrumental variable methods adjust for unmeasured factors and traditional methods do not, the large discrepancy between these estimates of risk suggests that clinical and/or sociocultural factors affecting the decision to perform cesarean delivery may not be accounted for in our database. PMID:29233843

Employment program for patients with severe mental illness in Malaysia: a 3-month outcome.

PubMed

Wan Kasim, Syarifah Hafizah; Midin, Marhani; Abu Bakar, Abdul Kadir; Sidi, Hatta; Nik Jaafar, Nik Ruzyanei; Das, Srijit

2014-01-01

This study aimed to examine the rate and predictive factors of successful employment at 3 months upon enrolment into an employment program among patients with severe mental illness (SMI). A cross-sectional study using universal sampling technique was conducted on patients with SMI who completed a 3-month period of being employed at Hospital Permai, Malaysia. A total of 147 patients were approached and 126 were finally included in the statistical analyses. Successful employment was defined as the ability to work 40 or more hours per month. Factors significantly associated with successful employment from bivariate analyses were entered into a multiple logistic regression analysis to identify predictors of successful employment. The rate of successful employment at 3 months was 68.3% (n=81). Significant factors associated with successful employment from bivariate analyses were having past history of working, good family support, less number of psychiatric admissions, good compliance to medicine, good interest in work, living in hostel, being motivated to work, satisfied with the job or salary, getting a preferred job, being in competitive or supported employment and having higher than median scores of PANNS on the positive, negative and general psychopathology. Significant predictors of employment, from a logistic regression model were having good past history of working (p<0.021; OR 6.12; [95% CI 2.1-11.9]) and getting a preferred job (p<0.032; [OR 4.021; 95% CI 1.83-12.1]). Results showed a high employment rate among patients with SMI. Good past history of working and getting a preferred job were significant predictors of successful employment. Copyright © 2014 Elsevier Inc. All rights reserved.

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.

The influence of sexual harassment on mental health among female military personnel of the Republic of Korea Armed Forces

PubMed Central

Kim, Tae Kyung; Lee, H-C; Lee, S G; Han, K-T; Park, E-C

2017-01-01

Introduction Reports of sexual harassment are becoming more frequent in Republic of Korea (ROK) Armed Forces. This study aimed to analyse the impact of sexual harassment on mental health among female military personnel of the ROK Armed Forces. Methods Data from the 2014 Military Health Survey were used. Instances of sexual harassment were recorded as ‘yes’ or ‘no’. Analysis of variance (ANOVA) was carried out to compare Kessler Psychological Distress Scale 10 (K-10) scores. Multiple logistic regression analysis was performed to identify associations between sexual harassment and K-10 scores. Results Among 228 female military personnel, 13 (5.7%) individuals experienced sexual harassment. Multiple logistic regression analysis revealed that sexual harassment had a significantly negative impact on K-10 scores (3.486, p<0.04). Higher K-10 scores among individuals experiencing sexual harassment were identified in the unmarried (including never-married) group (6.761, p<0.04), the short-term military service group (12.014, p<0.03) and the group whose length of service was <2 years (11.067, p<0.02). Conclusions Sexual harassment has a negative impact on mental health. Factors associated with worse mental health scores included service classification and length of service. The results provide helpful information with which to develop measures for minimising the negative psychological effects from sexual harassment and promoting sexual harassment prevention policy. PMID:27084842

Employment barriers, skills, and aspirations among unemployed job seekers with and without social anxiety disorder.

PubMed

Himle, Joseph A; Weaver, Addie; Bybee, Deborah; O'Donnell, Lisa; Vlnka, Sarah; Laviolette, Wayne; Steinberger, Edward; Golenberg, Zipora; Levine, Debra Siegel

2014-07-01

The literature has consistently demonstrated that social anxiety disorder has substantial negative impacts on occupational functioning. However, to date, no empirical work has focused on understanding the specific nature of vocational problems among persons with social anxiety disorder. This study examined the association between perceived barriers to employment, employment skills, and job aspirations and social anxiety among adults seeking vocational rehabilitation services. Data from intake assessments (June 2010-December 2011) of 265 low-income, unemployed adults who initiated vocational rehabilitation services in urban Michigan were examined to assess perceived barriers to employment, employment skills, job aspirations, and demographic characteristics among participants who did or did not screen positive for social anxiety disorder. Bivariate and multiple logistic regression analyses were performed. After adjustment for other factors, the multiple logistic regression analysis revealed that perceiving more employment barriers involving experience and skills, reporting fewer skills related to occupations requiring social skills, and having less education were significantly associated with social anxiety disorder. Participants who screened positive for social anxiety disorder were significantly less likely to aspire to social jobs. Employment-related characteristics that were likely to have an impact on occupational functioning were significantly different between persons with and without social anxiety problems. Identifying these differences in employment barriers, skills, and job aspirations revealed important information for designing psychosocial interventions for treatment of social anxiety disorder. The findings underscored the need for vocational services professionals to assess and address social anxiety among their clients.

The relationship between children's oral health-related behaviors and their caregiver's social support.

PubMed

Qiu, Rong Min; Tao, Ye; Zhou, Yan; Zhi, Qing Hui; Lin, Huan Cai

2016-09-01

Social support might play a role in helping people adopt healthy behaviors and improve their health. Stronger social support from mothers has been found to be positively related to higher tooth brushing frequency in 1- to 3-year-old children. However, little is known regarding the relationship between the caregiver's social support and the oral health-related behaviors of 5-year-old children in China. This study aimed to investigate this relationship. A cross-sectional study was conducted among 1332 5-year-old children and their caregivers in Guangzhou, southern China. Data were collected using questionnaires that were completed by the caregivers and the children's caries status were examined. The caregivers' social support was measured using the Social Support Rating Scale. The measurements of the children's oral health-related behaviors included the frequencies of sugary snack intake and tooth brushing, utilization of dental services, and patterns of dental visits. Univariate and multiple logistic regression analyses were used to analyze the relationships between the variables. No association was found between the caregiver's social support and the child's oral health-related behaviors in a multiple logistic regression analysis. However, other factors, particularly the oral health-related behaviors of the caregiver, were found to be significantly linked to the child's oral health-related behaviors. The oral health-related behaviors of 5-year-old children in Guangzhou are unrelated to the caregiver's social support but are related to other specific factors, particularly the caregiver's oral health-related behaviors.

[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.

Impulsivity, attention, memory, and decision-making among adolescent marijuana users.

PubMed

Dougherty, Donald M; Mathias, Charles W; Dawes, Michael A; Furr, R Michael; Charles, Nora E; Liguori, Anthony; Shannon, Erin E; Acheson, Ashley

2013-03-01

Marijuana is a popular drug of abuse among adolescents, and they may be uniquely vulnerable to resulting cognitive and behavioral impairments. Previous studies have found impairments among adolescent marijuana users. However, the majority of this research has examined measures individually rather than multiple domains in a single cohesive analysis. This study used a logistic regression model that combines performance on a range of tasks to identify which measures were most altered among adolescent marijuana users. The purpose of this research was to determine unique associations between adolescent marijuana use and performances on multiple cognitive and behavioral domains (attention, memory, decision-making, and impulsivity) in 14- to 17-year-olds while simultaneously controlling for performances across the measures to determine which measures most strongly distinguish marijuana users from nonusers. Marijuana-using adolescents (n = 45) and controls (n = 48) were tested. Logistic regression analyses were conducted to test for: (1) differences between marijuana users and nonusers on each measure, (2) associations between marijuana use and each measure after controlling for the other measures, and (3) the degree to which (1) and (2) together elucidated differences among marijuana users and nonusers. Of all the cognitive and behavioral domains tested, impaired short-term recall memory and consequence sensitivity impulsivity were associated with marijuana use after controlling for performances across all measures. This study extends previous findings by identifying cognitive and behavioral impairments most strongly associated with adolescent marijuana users. These specific deficits are potential targets of intervention for this at-risk population.

Clinical changes in terminally ill cancer patients and death within 48 h: when should we refer patients to a separate room?

PubMed

Hwang, In Cheol; Ahn, Hong Yup; Park, Sang Min; Shim, Jae Yong; Kim, Kyoung Kon

2013-03-01

There is scant research concerning the prediction of imminent death, and current studies simply list events "that have already occurred" around 48 h of the death. We sought to determine what events herald the onset of dying process using the length of time from "any change" to death. This is a prospective observational study with chart audit. Inclusion criteria were terminal cancer patients who passed away in a palliative care unit. The analysis was limited to 181 patients who had medical records for their final week. Commonly observed events in the terminally ill were determined and their significant changes were defined beforehand. We selected the statistically significant changes by multiple logistic regression analysis and evaluated their predictive values for "death within 48 h." The median age was 67 years and there were 103 male patients. After adjusting for age, sex, primary cancer site, metastatic site, and cancer treatment, multiple logistic regression analyses for association between the events and "death within 48 h" revealed some significant changes: confused mental state, decreased blood pressure, increased pulse pressure, low oxygen saturation, death rattle, and decreased conscious level. The events that had higher predictability for death within 48 h were decreased blood pressure and low oxygen saturation, and the positive and negative predictive values of their combination were 95.0 and 81.4%, respectively. The most reliable events to predict impending death were decreased blood pressure and low oxygen saturation.

Determinants of child maltreatment in Nepal: Results from the 2014 Nepal multiple indicator cluster survey (the 2014 NMICS).

PubMed

Atteraya, Madhu Sudhan; Ebrahim, Nasser B; Gnawali, Shreejana

2018-02-01

We examined the prevalence of child maltreatment as measured by the level of physical (moderate to severe) and emotional abuse and child labor, and the associated household level determinants of child maltreatment in Nepal. We used a nationally representative data set from the fifth round of the Nepal Multiple Indicator Cluster Survey (the 2014 NMICS). The main independent variables were household level characteristics. Dependent variables included child experience of moderate to severe physical abuse, emotional abuse, and child labor (domestic work and economic activities). Bivariate analyses and logistic regressions were used to examine the associations between independent and dependent variables. The results showed that nearly half of the children (49.8%) had experienced moderate physical abuse, 21.5% experienced severe physical abuse, and 77.3% experienced emotional abuse. About 27% of the children had engaged in domestic work and 46.7% in various economic activities. At bivariate level, educational level of household's head and household wealth status had shown significant statistical association with child maltreatment (p<0.001). Results from multivariate logistic regressions showed that higher education levels and higher household wealth status protected children from moderate to severe physical abuse, emotional abuse and child labor. In general, child maltreatment is a neglected social issue in Nepal and the high rates of child maltreatment calls for mass awareness programs focusing on parents, and involving all stakeholders including governments, local, and international organizations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Ergonomic practices within patient care units are associated with musculoskeletal pain and limitations

PubMed Central

Dennerlein, Jack T.; Hopcia, Karen; Sembajwe, Grace; Kenwood, Christopher; Stoddard, Anne M.; Tveito, T. Helene; Hashimoto, Dean M.; Sorensen, Glorian

2013-01-01

Background With the high prevalence of musculoskeletal disorders (MSDs) for patient care unit workers, prevention efforts through ergonomic practices within units may be related to symptoms associated with typical work-related MSDs. Methods We completed a cross-sectional survey of patient care workers (n=1572) in two large academic hospitals in order to evaluate relationships between self-reported musculoskeletal pain, work interference due to this pain, and limitations during activities of daily living (functional limitations) and with ergonomic practices and other organizational policy and practices metrics within the unit. Bivariate and multiple logistic regression analyses tested the significance of these associations. Results Prevalence of self-reported musculoskeletal symptoms in the past 3-months was 74% with 53% reporting pain in the low back. 32.8% reported that this pain interfered with their work duties and 17.7% reported functional limitations in the prior week. Decreased ergonomic practices were significantly associated with reporting pain in four body areas (low back, neck/shoulder, arms, and lower extremity) in the previous 3-months, interference with work caused by this pain, symptom severity and limitations in completing activities of daily living in the past week. Except for low back pain and work interference, these associations remained significant when psychosocial covariates such as psychological demands were included in multiple logistic regressions, Conclusions Ergonomic practices appear to be associated with many of the musculoskeletal symptoms denoting their importance for prevention efforts in acute health care settings. PMID:22113975

Association between red blood cell distribution width (RDW) and carotid artery atherosclerosis (CAS) in patients with primary ischemic stroke.

PubMed

Jia, He; Li, Huimian; Zhang, Yan; Li, Che; Hu, Yingyun; Xia, Chunfang

2015-01-01

The present study aimed to explore the association between RDW and CAS in patients with ischemic stroke, expecting to find a new and significant diagnosis index for clinical practice. This cross-sectional study involves 432 consecutive patients with primary ischemic stroke (within 72 h). All subjects were confirmed by magnetic resonance imaging, and underwent physical examination, laboratory tests and carotid ultrasonography check. Finally, 392 patients were included according to the exclusion criteria. The odds ratios of independent variables were calculated using stepwise multiple logistic regression. Carotid intimal-medial thickness (IMT) and RDW are both significantly different between CAS group and control group. Univariate analyses show that high-sensitive C-reactive protein (Hs-CRP) and RDW (r=0.436) are both in significantly positive association with IMT. Stepwise multiple logistic regression shows that RDW is an independent protective factor of CAS in patients with ischemic stroke. Compared with the lowest quartile, the second to fourth quartiles are 1.13 (95% CI: 1.13-3.05), 2.02 (95% CI: 1.66-4.67), and 3.10 (95% CI: 2.46-7.65), respectively. The present study suggested that RDW level were higher than non-CAS in patients with primary ischemic stroke. Our results facilitated a bridge to connect RDW with ischemic stroke and further confirmed the role of RDW in the progression of the ischemic stroke. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Prevalence and Correlates of School Bullying Victimization in Xi'an, China.

PubMed

Zhu, Yuhong; Chan, Ko Ling

2015-01-01

This study used the data from a representative sample to estimate the prevalence of child bullying victimization in Xi'an, China. Data on social demographic information and the experiences of different types of bullying victimization were collected from a randomly selected sample with 3,175 middle school students aged 15-17 years by self-administrated questionnaires. t Test, χ2 test, and multiple logistic regression analyses were used to test group differences and examine the correlates of bullying victimization. Results show that 54.9% and 44.6% of Chinese children have been bullied in a lifetime and in the preceding year, respectively. Correlates for direct and relational bullying victimization includes male participants, father's lower education level, father's unemployment, having one or more siblings, smoking, depression, borderline personality trait, posttraumatic stress disorder, and from rural schools. Overall, the prevalence of child bullying victimization in China is substantial. The multiple correlates suggest prevention and intervention of bullying victimization in a holistic and comprehensive way.

Moving Beyond Maximum Tolerated Dose for Targeted Oncology Drugs: Use of Clinical Utility Index to Optimize Venetoclax Dosage in Multiple Myeloma Patients.

PubMed

Freise, K J; Jones, A K; Verdugo, M E; Menon, R M; Maciag, P C; Salem, A H

2017-12-01

Exposure-response analyses of venetoclax in combination with bortezomib and dexamethasone in previously treated patients with multiple myeloma (MM) were performed on a phase Ib venetoclax dose-ranging study. Logistic regression models were utilized to determine relationships, identify subpopulations with different responses, and optimize the venetoclax dosage that balanced both efficacy and safety. Bortezomib refractory status and number of prior treatments were identified to impact the efficacy response to venetoclax treatment. Higher venetoclax exposures were estimated to increase the probability of achieving a very good partial response (VGPR) or better through venetoclax doses of 1,200 mg. However, the probability of neutropenia (grade ≥3) was estimated to increase at doses >800 mg. Using a clinical utility index, a venetoclax dosage of 800 mg daily was selected to optimally balance the VGPR or better rates and neutropenia rates in MM patients administered 1-3 prior lines of therapy and nonrefractory to bortezomib. © 2017 American Society for Clinical Pharmacology and Therapeutics.

Biopsychosocial Predictors of Fall Events among Older African Americans

PubMed Central

Nicklett, Emily Joy; Taylor, Robert Joseph; Rostant, Ola; Johnson, Kimson E.; Evans, Linnea

2016-01-01

This study identifies risk and protective factors for falls among older, community-dwelling African Americans. Drawing upon the biopsychosocial perspective (Engel, 1997), we conducted a series of sex- and age-adjusted multinomial logistic regression analyses to identify the correlates of fall events among older African Americans. Our sample consisted of 1,442 community-dwelling African Americans aged 65 and older, participating in the 2010-12 rounds of the Health and Retirement Study. Biophysical characteristics associated with greater relative risk of experiencing single and/or multiple falls included greater functional limitations, poorer self-rated health, poorer self-rated vision, chronic illnesses (high blood pressure, diabetes, cancer, lung disease, heart problems, stroke, and arthritis), greater chronic illness comorbidity, older age, and female sex. Physical activity was negatively associated with recurrent falls. Among the examined psychosocial characteristics, greater depressive symptoms were associated with greater relative risk of experiencing single and multiple fall events. Implications for clinicians and future studies are discussed. PMID:28285579

A comparison of Cox and logistic regression for use in genome-wide association studies of cohort and case-cohort design.

PubMed

Staley, James R; Jones, Edmund; Kaptoge, Stephen; Butterworth, Adam S; Sweeting, Michael J; Wood, Angela M; Howson, Joanna M M

2017-06-01

Logistic regression is often used instead of Cox regression to analyse genome-wide association studies (GWAS) of single-nucleotide polymorphisms (SNPs) and disease outcomes with cohort and case-cohort designs, as it is less computationally expensive. Although Cox and logistic regression models have been compared previously in cohort studies, this work does not completely cover the GWAS setting nor extend to the case-cohort study design. Here, we evaluated Cox and logistic regression applied to cohort and case-cohort genetic association studies using simulated data and genetic data from the EPIC-CVD study. In the cohort setting, there was a modest improvement in power to detect SNP-disease associations using Cox regression compared with logistic regression, which increased as the disease incidence increased. In contrast, logistic regression had more power than (Prentice weighted) Cox regression in the case-cohort setting. Logistic regression yielded inflated effect estimates (assuming the hazard ratio is the underlying measure of association) for both study designs, especially for SNPs with greater effect on disease. Given logistic regression is substantially more computationally efficient than Cox regression in both settings, we propose a two-step approach to GWAS in cohort and case-cohort studies. First to analyse all SNPs with logistic regression to identify associated variants below a pre-defined P-value threshold, and second to fit Cox regression (appropriately weighted in case-cohort studies) to those identified SNPs to ensure accurate estimation of association with disease.

Multiple mating and clutch size in invertebrate brooders versus pregnant vertebrates

PubMed Central

Avise, John C.; Tatarenkov, Andrey; Liu, Jin-Xian

2011-01-01

We summarize the genetic literature on polygamy rates and sire numbers per clutch in invertebrate animals that brood their offspring and then compare findings with analogous data previously compiled for vertebrate species displaying viviparity or other pregnancy-like syndromes. As deduced from molecular parentage analyses of several thousand broods from more than 100 “pregnant” species, invertebrate brooders had significantly higher mean incidences of multiple mating than pregnant vertebrates, a finding generally consistent with the postulate that clutch size constrains successful mate numbers in species with extended parental care. However, we uncovered no significant correlation in invertebrates between brood size and genetically deduced rates of multiple mating by the incubating sex. Instead, in embryo-gestating animals otherwise as different as mammals and mollusks, polygamy rates and histograms of successful mates per brooder proved to be strikingly similar. Most previous studies have sought to understand why gestating parents have so many mates and such high incidences of successful multiple mating; an alternative perspective based on logistical constraints turns the issue on its head by asking why mate numbers and polygamy rates are much lower than they theoretically could be, given the parentage-resolving power of molecular markers and the huge sizes of many invertebrate broods. PMID:21709247

Investigating Factors Associated with Depression of Type 2 Diabetic Retinopathy Patients in China

PubMed Central

Qian, Duo; Dong, Qing; Gu, Zhifeng

2015-01-01

Aims and objectives To assess the depression status of type 2 diabetic retinopathy patients in Nantong China and to identify factors associated with depression. Methods Two hundred and ninety-four patients with type 2 diabetic retinopathy were recruited from the Affiliated Hospital of Nantong University. The severity of DR was measured in the worse eye. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D); the quality of life was measured with the Medical Outcomes Study Short Form 36 (SF-36). The logistic regression analyses were used to identify the independent factors of depression. Results The mean age of the study subjects was 57.77 years (SD: 9.64). Approximately 35.7% of subjects reported depressive symptoms (n = 105).Multiple logistic regression analyses showed that female gender (p = 0.014), low monthly income (p = 0.01), poor vision in the better eye (P = 0.002), laser treatment history (p = 0.01) were significant risk factors for depression. The quality of life of individuals with CES-D score<16 was significantly better compared with individuals with CES-D score≥16. Conclusion The reported depressive symptoms among type 2 diabetic retinopathy population is higher in Nantong China. Gender, salary, vision acuity and treatment history were important risk factors linked to this disorder in the Chinese type 2 diabetic retinopathy population from Nantong. More attention by medical care personnel needs to be paid to the psychological health of this population. PMID:26151365

Work Outcomes in Patients Who Stay at Work Despite Musculoskeletal Pain.

PubMed

Cochrane, Andy; Higgins, Niamh M; Rothwell, Conor; Ashton, Jennifer; Breen, Roisin; Corcoran, Oriel; FitzGerald, Oliver; Gallagher, Pamela; Desmond, Deirdre

2017-12-13

Purpose To assess self-reported work impacts and associations between psychosocial risk factors and work impairment amongst workers seeking care for musculoskeletal pain while continuing to work. Methods Patients were recruited from Musculoskeletal Assessment Clinics at 5 hospitals across Ireland. Participants completed questionnaires including assessments of work impairment (Work Productivity and Activity Impairment Questionnaire), work ability (single item from the Work Ability Index) and work performance (Work Role Functioning Questionnaire; WRFQ). Logistic and hierarchical regressions were conducted to analyse the relation between psychosocial variables and work outcomes. Results 155 participants (53.5% female; mean age = 46.50 years) who were working at the time of assessment completed the questionnaires. Absenteeism was low, yet 62.6% were classified as functioning poorly according to the WRFQ; 52.3% reported having poor work ability. Logistic regression analyses indicated that higher work role functioning was associated with higher pain self-efficacy (OR 1.51); better work ability was associated with older age (OR 1.063) and lower functional restriction (OR 0.93); greater absenteeism was associated with lower pain self-efficacy (OR 0.65) and poorer work expectancy (OR 1.18). Multiple regression analysis indicated that greater presenteeism was associated with higher pain intensity (β = 0.259) and lower pain self-efficacy (β = - 0.385). Conclusions While individuals continue to work with musculoskeletal pain, their work performance can be adversely affected. Interventions that target mutable factors, such as pain self-efficacy, may help reduce the likelihood of work impairment.

High-risk versus low-risk football game weekends: differences in problem drinking and alcohol-related consequences on college campuses in the United States.

PubMed

Champion, Heather; Blocker, Jill N; Buettner, Cynthia K; Martin, Barbara A; Parries, Maria; Mccoy, Thomas P; Mitra, Ananda; Andrews, David W; Rhodes, Scott D

2009-01-01

Collegiate football games provide multiple social opportunities for alcohol use by students over the course of the weekend. The goal of this study was to examine alcohol use and alcohol-related consequences on football game weekends to determine differences based on characteristics of the game. A random sample of students from two large, public universities in the United States completed a survey on the Sunday-Friday following a high-risk weekend (HRW, important, home game) and low-risk weekend (LRW, no home game or game of importance) (N = 3,238 total). The survey measured the number of days students drank (0-3) and got drunk (0-3) over the weekend and whether 1+ consequences were experienced due to one's own drinking (yes/no) and due to others' drinking (yes/no). Ordinal logistic regression analyses revealed greater odds of drinking alcohol (OR = 1.70, CI = 1.46-1.97) and getting drunk (OR = 1.49, CI = 1.27-1.76) on HRW versus LRW. Logistic regression analyses revealed greater odds of experiencing 1+ consequences as a result of one's own drinking (OR = 1.38, CI = 1.16-1.63) and experiencing 1+ consequences as a result of others' drinking (OR = 1.52, CI = 1.30-1.78) on HRW versus LRW. These findings suggest that additional prevention efforts aimed at reducing risky drinking are needed over HRW and have implications for campus administrators, law enforcement, and substance abuse program coordinators.

Artificial Neural Network for the Prediction of Chromosomal Abnormalities in Azoospermic Males.

PubMed

Akinsal, Emre Can; Haznedar, Bulent; Baydilli, Numan; Kalinli, Adem; Ozturk, Ahmet; Ekmekçioğlu, Oğuz

2018-02-04

To evaluate whether an artifical neural network helps to diagnose any chromosomal abnormalities in azoospermic males. The data of azoospermic males attending to a tertiary academic referral center were evaluated retrospectively. Height, total testicular volume, follicle stimulating hormone, luteinising hormone, total testosterone and ejaculate volume of the patients were used for the analyses. In artificial neural network, the data of 310 azoospermics were used as the education and 115 as the test set. Logistic regression analyses and discriminant analyses were performed for statistical analyses. The tests were re-analysed with a neural network. Both logistic regression analyses and artificial neural network predicted the presence or absence of chromosomal abnormalities with more than 95% accuracy. The use of artificial neural network model has yielded satisfactory results in terms of distinguishing patients whether they have any chromosomal abnormality or not.

Stable isotope analyses of feather amino acids identify penguin migration strategies at ocean basin scales.

PubMed

Polito, Michael J; Hinke, Jefferson T; Hart, Tom; Santos, Mercedes; Houghton, Leah A; Thorrold, Simon R

2017-08-01

Identifying the at-sea distribution of wide-ranging marine predators is critical to understanding their ecology. Advances in electronic tracking devices and intrinsic biogeochemical markers have greatly improved our ability to track animal movements on ocean-wide scales. Here, we show that, in combination with direct tracking, stable carbon isotope analysis of essential amino acids in tail feathers provides the ability to track the movement patterns of two, wide-ranging penguin species over ocean basin scales. In addition, we use this isotopic approach across multiple breeding colonies in the Scotia Arc to evaluate migration trends at a regional scale that would be logistically challenging using direct tracking alone. © 2017 The Author(s).

Current active and passive smoking among adults living with same sex partners in Spain.

PubMed

Perales, Jaime; Checa, Irene; Espejo, Begoña

2017-05-19

To assess the association between current active and passive tobacco smoking and living with a same-sex partner in Spain. We analysed data from two cross-sectional national surveys of the Spanish population 15 years and older (2011-Encuesta Nacional de Salud en España and 2014-Encuesta Europea de Salud en España). Analyses included only people living with their partner. Associations were calculated using multiple logistic regressions adjusting for gender, social class and age. Current active and passive smoking were significantly associated with living with same sex partners (odds ratio: 2.71 and 2.88), and particularly strong among women. Spanish adults living with same-sex partners are at higher risk of active and passive smoking. This risk varies by gender. Spanish national surveys should include items on sexual orientation for improved data on health disparities. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Urinary inorganic arsenic concentrations and semen quality of male partners of subfertile couples in Tokyo.

PubMed

Oguri, Tomoko; Yoshinaga, Jun; Toshima, Hiroki; Mizumoto, Yoshifumi; Hatakeyama, Shota; Tokuoka, Susumu

2016-01-01

Inorganic arsenic (iAs) has been known as a testicular toxicant in experimental rodents. Possible association between iAs exposure and semen quality (semen volume, sperm concentration, and sperm motility) was explored in male partners of couples (n = 42) who visited a gynecology clinic in Tokyo for infertility consultation. Semen parameters were measured according to WHO guideline at the clinic, and urinary iAs and methylarsonic acid (MMA), and dimethylarsinic acid concentrations were determined by liquid chromatography-hydride generation-ICP mass spectrometry. Biological attributes, dietary habits, and exposure levels to other chemicals with known effects on semen parameters were taken into consideration as covariates. Multiple regression analyses and logistic regression analyses did not find iAs exposure as significant contributor to semen parameters. Lower exposure level of subjects (estimated to be 0.5 μg kg(-1) day(-1)) was considered a reason of the absence of adverse effects on semen parameters, which were seen in rodents dosed with 4-7.5 mg kg(-1).

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.

PARAMETRIC AND NON PARAMETRIC (MARS: MULTIVARIATE ADDITIVE REGRESSION SPLINES) LOGISTIC REGRESSIONS FOR PREDICTION OF A DICHOTOMOUS RESPONSE VARIABLE WITH AN EXAMPLE FOR PRESENCE/ABSENCE OF AMPHIBIANS

EPA Science Inventory

The purpose of this report is to provide a reference manual that could be used by investigators for making informed use of logistic regression using two methods (standard logistic regression and MARS). The details for analyses of relationships between a dependent binary response ...

Correlates of Suicidal Ideation and Attempt Among Female Sex Workers in China

PubMed Central

HONG, YAN; LI, XIAOMING; FANG, XIAOYI; ZHAO, RAN

2007-01-01

The purpose of this study was to explore the factors associated with suicidal ideation and attempt among female sex workers (FSWs) in China. A cross-sectional survey was administered among 454 FSWs in a rural county of Guangxi, China. About 14% of FSWs had thought of suicide and 8% had attempted suicide in the past 6 months. Multiple logistic regression analyses indicated that those FSWs who were dissatisfied with life, abused alcohol, were deceived or forced into commercial sex, and had stable sexual partners were more likely to report suicidal ideation. Female sex workers who had multiple stable partners, experienced sexual coercion, and worried about an inability to make enough money were more likely to report a suicide attempt. These FSWs who entered commercial sex because of financial needs or who were influenced by the peers were less likely to report a suicide attempt. Our data suggested that the rates of suicidal ideation and attempts were high among FSWs in China, and there were multiple factors associated with their suicidality. Future health education and promotion efforts among FSWs need to take into consideration substance abuse, interpartner conflict, and psychological stress. PMID:17469002

Protecting complex infrastructures against multiple strategic attackers

NASA Astrophysics Data System (ADS)

Hausken, Kjell

2011-01-01

Infrastructures are analysed subject to defence by a strategic defender and attack by multiple strategic attackers. A framework is developed where each agent determines how much to invest in defending versus attacking each of multiple targets. A target can have economic, human and symbolic values, which generally vary across agents. Investment expenditure functions for each agent can be linear in the investment effort, concave, convex, logistic, can increase incrementally, or can be subject to budget constraints. Contest success functions (e.g., ratio and difference forms) determine the probability of a successful attack on each target, dependent on the relative investments of the defender and attackers on each target, and on characteristics of the contest. Targets can be in parallel, in series, interlinked, interdependent or independent. The defender minimises the expected damage plus the defence expenditures. Each attacker maximises the expected damage minus the attack expenditures. The number of free choice variables equals the number of agents times the number of targets, or lower if there are budget constraints. Each agent is interested in how his investments vary across the targets, and the impact on his utilities. Alternative optimisation programmes are discussed, together with repeated games, dynamic games and incomplete information. An example is provided for illustration.

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.

Binomial outcomes in dataset with some clusters of size two: can the dependence of twins be accounted for? A simulation study comparing the reliability of statistical methods based on a dataset of preterm infants.

PubMed

Sauzet, Odile; Peacock, Janet L

2017-07-20

The analysis of perinatal outcomes often involves datasets with some multiple births. These are datasets mostly formed of independent observations and a limited number of clusters of size two (twins) and maybe of size three or more. This non-independence needs to be accounted for in the statistical analysis. Using simulated data based on a dataset of preterm infants we have previously investigated the performance of several approaches to the analysis of continuous outcomes in the presence of some clusters of size two. Mixed models have been developed for binomial outcomes but very little is known about their reliability when only a limited number of small clusters are present. Using simulated data based on a dataset of preterm infants we investigated the performance of several approaches to the analysis of binomial outcomes in the presence of some clusters of size two. Logistic models, several methods of estimation for the logistic random intercept models and generalised estimating equations were compared. The presence of even a small percentage of twins means that a logistic regression model will underestimate all parameters but a logistic random intercept model fails to estimate the correlation between siblings if the percentage of twins is too small and will provide similar estimates to logistic regression. The method which seems to provide the best balance between estimation of the standard error and the parameter for any percentage of twins is the generalised estimating equations. This study has shown that the number of covariates or the level two variance do not necessarily affect the performance of the various methods used to analyse datasets containing twins but when the percentage of small clusters is too small, mixed models cannot capture the dependence between siblings.

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.

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...

Determinants of spirometric abnormalities among silicotic patients in Hong Kong.

PubMed

Leung, Chi C; Chang, Kwok C; Law, Wing S; Yew, Wing W; Tam, Cheuk M; Chan, Chi K; Wong, Man Y

2005-09-01

Silicosis is the second commonest notified occupational disease in Hong Kong. To characterize the determinants of spirometric abnormalities in silicosis. The spirometric patterns of consecutive silicotic patients on confirmation by the Pneumoconiosis Medical Board from 1991 to 2002 were correlated with demographic characteristics, occupational history, smoking history, tuberculosis (TB) history and radiographic features by univariate and multiple regression analyses. Of 1576 silicotic patients included, 55.6% showed normal spirometry, 28.5% normal forced vital capacity (FVC>or=80% predicted) but reduced forced expiratory ratio (FER<70%), 7.6% reduced FVC but normal FER, and 8.4% reduced both FVC and FER. Age, ever-smoking, cigarette pack-years, industry, job type, history of TB, size of lung nodules and progressive massive fibrosis (PMF) were all significantly associated with airflow limitation on univariate analysis (all P<0.05), while sex and profusion of nodules were not. Only age, cigarette pack-years, history of TB, size of lung nodules and PMF remained as significant independent predictors of airflow obstruction in multiple logistic regression analysis. After controlling for airflow obstruction, only shorter exposure duration, history of TB and profusion of nodules were significant independent predictors of reduced FVC. As well as age, history of TB, cigarette pack-years, PMF and nodule size contributed comparable effects to airflow obstruction in multiple linear regression analyses, while profusion of nodules was the strongest factor for reduced vital capacity. In an occupational compensation setting, disease indices and history of tuberculosis are independent predictors of both airflow obstruction and reduced vital capacity for silicotic patients.

An Interactive Logistics Centre Information Integration System Using Virtual Reality

NASA Astrophysics Data System (ADS)

Hong, S.; Mao, B.

2018-04-01

The logistics industry plays a very important role in the operation of modern cities. Meanwhile, the development of logistics industry has derived various problems that are urgent to be solved, such as the safety of logistics products. This paper combines the study of logistics industry traceability and logistics centre environment safety supervision with virtual reality technology, creates an interactive logistics centre information integration system. The proposed system utilizes the immerse characteristic of virtual reality, to simulate the real logistics centre scene distinctly, which can make operation staff conduct safety supervision training at any time without regional restrictions. On the one hand, a large number of sensor data can be used to simulate a variety of disaster emergency situations. On the other hand, collecting personnel operation data, to analyse the improper operation, which can improve the training efficiency greatly.

A cross-sectional survey to evaluate knowledge, attitudes and practices (KAP) regarding seasonal influenza vaccination among European travellers to resource-limited destinations.

PubMed

Pfeil, Alena; Mütsch, Margot; Hatz, Christoph; Szucs, Thomas D

2010-07-07

Influenza is one of the most common vaccine-preventable diseases in travellers. By performing two cross-sectional questionnaire surveys during winter 2009 and winter 2010 among European travellers to resource-limited destinations, we aimed to investigate knowledge, attitudes and practices (KAP) regarding seasonal influenza vaccination. Questionnaires were distributed in the waiting room to the visitors of the University of Zurich Centre for Travel' Health (CTH) in January and February 2009 and January 2010 prior to travel health counselling (CTH09 and CTH10). Questions included demographic data, travel-related characteristics and KAP regarding influenza vaccination. Data were analysed by using SPSS version 14.0 for Windows. Differences in proportions were compared using the Chi-square test and the significance level was set at p 64 yrs (25, 21%) and recommendations of the family physician (27, 22.7%) were the most often reported reasons for being vaccinated. In the multiple logistic regression analyses of the pooled data increasing age (OR = 1.03, 95% CI 1.01 - 1.04), a business trip (OR = 0.39, 95% CI 0.17 - 0.92) and seasonal influenza vaccination in the previous winter seasons (OR = 12.91, 95% CI 8.09 - 20.58) were independent predictors for seasonal influenza vaccination in 2009 or 2010.Influenza vaccination recommended by the family doctor (327, 37.7%), travel to regions with known high risk of influenza (305, 35.1%), and influenza vaccination required for job purposes (233, 26.8%) were most frequently mentioned to consider influenza vaccination. Risk perception and vaccination coverage concerning seasonal and pandemic influenza was very poor among travellers to resource-limited destinations when compared to traditional at-risk groups. Previous access to influenza vaccination substantially facilitated vaccinations in the subsequent year. Information strategies about influenza should be intensified and include health professionals, e.g. family physicians, travel medicine practitioners and business enterprises.

Does substance misuse moderate the relationship between criminal thinking and recidivism?

PubMed Central

Caudy, Michael S.; Folk, Johanna B.; Stuewig, Jeffrey B.; Wooditch, Alese; Martinez, Andres; Maass, Stephanie; Tangney, June P.; Taxman, Faye S.

2014-01-01

Purpose Some differential intervention frameworks contend that substance use is less robustly related to recidivism outcomes than other criminogenic needs such as criminal thinking. The current study tested the hypothesis that substance use disorder severity moderates the relationship between criminal thinking and recidivism. Methods The study utilized two independent criminal justice samples. Study 1 included 226 drug-involved probationers. Study 2 included 337 jail inmates with varying levels of substance use disorder severity. Logistic regression was employed to test the main and interactive effects of criminal thinking and substance use on multiple dichotomous indicators of recidivism. Results Bivariate analyses revealed a significant correlation between criminal thinking and recidivism in the jail sample (r = .18, p < .05) but no significant relationship in the probation sample. Logistic regressions revealed that SUD symptoms moderated the relationship between criminal thinking and recidivism in the jail-based sample (B = −.58, p < .05). A significant moderation effect was not observed in the probation sample. Conclusions Study findings indicate that substance use disorder symptoms moderate the strength of the association between criminal thinking and recidivism. These findings demonstrate the need for further research into the interaction between various dynamic risk factors. PMID:25598559

Ethnic differences in correlates of suicidal behavior among women seeking help for intimate partner violence.

PubMed

Cavanaugh, Courtenay E; Messing, Jill T; Eyzerovich, Evelina; Campbell, Jacquelyn C

2015-01-01

Women abused by an intimate partner are at risk of engaging in nonfatal suicidal behavior and suicidal communication (NSBSC). No studies have examined ethnic differences in correlates of NSBSC among abused women. This secondary data analytic study examined whether correlates of NSBSC previously reported among a mixed ethnic sample of women seeking help for abuse by a male intimate partner differed for those who self-identified as Latina (N = 340), African American (N = 184), or European American (N = 67). Logistic regression was used to examine correlates of NSBSC separately among Latina, African American, and European American women. More severe violence by a male intimate partner, having a chronic or disabling illness, being younger, and being unemployed were positively associated with NSBSC in bivariate analyses among Latina women, but unemployment did not remain significantly associated with NSBSC in the multiple logistic regression. There were no significant correlates of NSBSC for African American women. Having a chronic illness was significantly associated with NSBSC among European American women. Findings suggest the need for culturally tailored suicide prevention interventions and studies that examine risk and protective factors for NSBSC among a diversity of women abused by male intimate partners.

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.

Cross-national differences in the gender gap in subjective health in Europe: does country-level gender equality matter?

PubMed

Dahlin, Johanna; Härkönen, Juho

2013-12-01

Multiple studies have found that women report being in worse health despite living longer. Gender gaps vary cross-nationally, but relatively little is known about the causes of comparative differences. Existing literature is inconclusive as to whether gender gaps in health are smaller in more gender equal societies. We analyze gender gaps in self-rated health (SRH) and limiting longstanding illness (LLI) with five waves of European Social Survey data for 191,104 respondents from 28 countries. We use means, odds ratios, logistic regressions, and multilevel random slopes logistic regressions. Gender gaps in subjective health vary visibly across Europe. In many countries (especially in Eastern and Southern Europe), women report distinctly worse health, while in others (such as Estonia, Finland, and Great Britain) there are small or no differences. Logistic regressions ran separately for each country revealed that individual-level socioeconomic and demographic variables explain a majority of these gaps in some countries, but contribute little to their understanding in most countries. In yet other countries, men had worse health when these variables were controlled for. Cross-national variation in the gender gaps exists after accounting for individual-level factors. Against expectations, the remaining gaps are not systematically related to societal-level gender inequality in the multilevel analyses. Our findings stress persistent cross-national variability in gender gaps in health and call for further analysis. Copyright © 2013 Elsevier Ltd. All rights reserved.

High stress, lack of sleep, low school performance, and suicide attempts are associated with high energy drink intake in adolescents.

PubMed

Kim, So Young; Sim, Songyong; Choi, Hyo Geun

2017-01-01

Although an association between energy drinks and suicide has been suggested, few prior studies have considered the role of emotional factors including stress, sleep, and school performance in adolescents. This study aimed to evaluate the association of energy drinks with suicide, independent of possible confounders including stress, sleep, and school performance. In total, 121,106 adolescents with 13-18 years olds from the 2014 and 2015 Korea Youth Risk Behavior Web-based Survey were surveyed for age, sex, region of residence, economic level, paternal and maternal education level, sleep time, stress level, school performance, frequency of energy drink intake, and suicide attempts. Subjective stress levels were classified into severe, moderate, mild, a little, and no stress. Sleep time was divided into 6 groups: < 6 h; 6 ≤ h < 7; 7 ≤ h < 8; 8 ≤ h < 9; and ≥ 9 h. School performance was classified into 5 levels: A (highest), B (middle, high), C (middle), D (middle, low), and E (lowest). Frequency of energy drink consumption was divided into 3 groups: ≥ 3, 1-2, and 0 times a week. The associations of sleep time, stress level, and school performance with suicide attempts and the frequency of energy drink intake were analyzed using multiple and ordinal logistic regression analysis, respectively, with complex sampling. The relationship between frequency of energy drink intake and suicide attempts was analyzed using multiple logistic regression analysis with complex sampling. Higher stress levels, lack of sleep, and low school performance were significantly associated with suicide attempts (each P < 0.001). These variables of high stress level, abnormal sleep time, and low school performance were also proportionally related with higher energy drink intake (P < 0.001). Frequent energy drink intake was significantly associated with suicide attempts in multiple logistic regression analyses (AOR for frequency of energy intake ≥ 3 times a week = 3.03, 95% CI = 2.64-3.49, P < 0.001). Severe stress, inadequate sleep, and low school performance were related with more energy drink intake and suicide attempts in Korean adolescents. Frequent energy drink intake was positively related with suicide attempts, even after adjusting for stress, sleep time, and school performance.

High stress, lack of sleep, low school performance, and suicide attempts are associated with high energy drink intake in adolescents

PubMed Central

Kim, So Young; Sim, Songyong

2017-01-01

Objective Although an association between energy drinks and suicide has been suggested, few prior studies have considered the role of emotional factors including stress, sleep, and school performance in adolescents. This study aimed to evaluate the association of energy drinks with suicide, independent of possible confounders including stress, sleep, and school performance. Methods In total, 121,106 adolescents with 13–18 years olds from the 2014 and 2015 Korea Youth Risk Behavior Web-based Survey were surveyed for age, sex, region of residence, economic level, paternal and maternal education level, sleep time, stress level, school performance, frequency of energy drink intake, and suicide attempts. Subjective stress levels were classified into severe, moderate, mild, a little, and no stress. Sleep time was divided into 6 groups: < 6 h; 6 ≤ h < 7; 7 ≤ h < 8; 8 ≤ h < 9; and ≥ 9 h. School performance was classified into 5 levels: A (highest), B (middle, high), C (middle), D (middle, low), and E (lowest). Frequency of energy drink consumption was divided into 3 groups: ≥ 3, 1–2, and 0 times a week. The associations of sleep time, stress level, and school performance with suicide attempts and the frequency of energy drink intake were analyzed using multiple and ordinal logistic regression analysis, respectively, with complex sampling. The relationship between frequency of energy drink intake and suicide attempts was analyzed using multiple logistic regression analysis with complex sampling. Results Higher stress levels, lack of sleep, and low school performance were significantly associated with suicide attempts (each P < 0.001). These variables of high stress level, abnormal sleep time, and low school performance were also proportionally related with higher energy drink intake (P < 0.001). Frequent energy drink intake was significantly associated with suicide attempts in multiple logistic regression analyses (AOR for frequency of energy intake ≥ 3 times a week = 3.03, 95% CI = 2.64–3.49, P < 0.001). Conclusion Severe stress, inadequate sleep, and low school performance were related with more energy drink intake and suicide attempts in Korean adolescents. Frequent energy drink intake was positively related with suicide attempts, even after adjusting for stress, sleep time, and school performance. PMID:29135989

Fundamentals of Petroleum.

ERIC Educational Resources Information Center

Bureau of Naval Personnel, Washington, DC.

Basic information on petroleum is presented in this book prepared for naval logistics officers. Petroleum in national defense is discussed in connection with consumption statistics, productive capacity, world's resources, and steps in logistics. Chemical and geological analyses are made in efforts to familiarize methods of refining, measuring,…

Patient and operative factors associated with complications following adolescent idiopathic scoliosis surgery: an analysis of 36,335 patients from the Nationwide Inpatient Sample.

PubMed

De la Garza Ramos, Rafael; Goodwin, C Rory; Abu-Bonsrah, Nancy; Jain, Amit; Miller, Emily K; Huang, Nicole; Kebaish, Khaled M; Sponseller, Paul D; Sciubba, Daniel M

2016-12-01

OBJECTIVE The aim of this study was to investigate the incidence of and factors associated with complications following idiopathic scoliosis surgery in adolescents. METHODS The Nationwide Inpatient Sample database was used to identify patients 10-18 years of age who had undergone spinal fusion for adolescent idiopathic scoliosis (AIS) from 2002 to 2011. Twenty-three unique in-hospital postoperative complications, including death, were examined. A series of logistic regressions was used to determine if any demographic, comorbid, or surgical parameter was associated with complication development. Results of multiple logistic regression analyses were reported as odds ratios with 95% confidence intervals. All analyses were performed after the application of discharge weights to produce national estimates. RESULTS A total of 36,335 patients met the study inclusion criteria, 7.6% of whom (95% CI 6.3%-8.9%) developed at least one in-hospital complication. The 3 most common complications were respiratory failure (3.47%), reintubation (1.27%), and implant related (1.14%). Major complications such as death, pancreatitis, disseminated intravascular coagulation, visual loss, spinal cord injury, cardiac arrest, sepsis, nerve root injury, deep vein thrombosis, pulmonary embolism, shock, malignant hyperthermia, myocardial infarction, and iatrogenic stroke each had an incidence ≤ 0.2%. On multiple logistic regression analysis, an increasing age (OR 0.80) was associated with significantly lower odds of complication development; patients who were male (OR 1.80) or who had anemia (OR 2.10), hypertension (OR 2.51), or hypothyroidism (OR 2.27) or underwent revision procedures (OR 5.55) were at a significantly increased risk for complication development. The rates of postoperative complications for posterior, anterior, and combined approaches were 6.7%, 10.0%, and 19.8%, respectively (p < 0.001). Length of fusion (< 8 vs ≥ 8 levels) was not associated with complication development (p = 0.311). CONCLUSIONS Analysis of 36,335 patients who had undergone surgery for AIS revealed that younger patients, male patients, patients with a history of anemia, hypertension, or hypothyroidism, as well as those undergoing revision or anterior or combined approaches may have higher rates of postoperative complications. However, the overall complication rate was low (7.6%), and major complications had a rate ≤ 0.2% for each event. These findings suggest that surgery for AIS remains relatively safe, and future prospective investigations may further help to decrease the postoperative morbidity rate.

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.

Psychiatric characteristics of homicide defendants.

PubMed

Martone, Christine A; Mulvey, Edward P; Yang, Suzanne; Nemoianu, Andrei; Shugarman, Ryan; Soliman, Layla

2013-09-01

The authors examined the rate of mental disorders in an unselected sample of homicide defendants in a U.S. jurisdiction, seeking to identify psychiatric factors associated with offense characteristics and court outcomes. Defendants charged with homicide in a U.S. urban county between 2001 and 2005 received a psychiatric evaluation after arrest. Demographic, historical, and psychiatric variables as well as offense characteristics and legal outcomes were described. Bivariate analyses examined differences by age group and by race, and logistic models examined predictors of multiple victims, firearm use, guilty plea, and guilty verdict. Fifty-eight percent of the sample had at least one axis I or II diagnosis, most often a substance use disorder (47%). Axis I or II diagnoses were more common (78%) among defendants over age 40. Although 37% of the sample had prior psychiatric treatment, only 8% of the defendants with diagnosed axis I disorders had outpatient treatment during the 3 months preceding the homicide; African Americans were less likely than non-African Americans to be in treatment. African American males were more likely to use a firearm and to have a male victim. In exploratory analyses, psychiatric factors did not predict multiple victims, firearm use in the crime, or a guilty verdict. Rates of axis I disorders were lower than reported in previous studies. Few homicide defendants were in psychiatric treatment at the time of the crime, suggesting limited opportunities for prevention by mental health providers.

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.

Impulsivity, Attention, Memory, and Decision-Making among Adolescent Marijuana Users

PubMed Central

Dougherty, Donald M.; Mathias, Charles W.; Dawes, Michael A.; Furr, R. Michael; Charles, Nora E.; Liguori, Anthony; Shannon, Erin E.; Acheson, Ashley

2012-01-01

Rationale Marijuana is a popular drug of abuse among adolescents, and they may be uniquely vulnerable to resulting cognitive and behavioral impairments. Previous studies have found impairments among adolescent marijuana users. However, the majority of this research has examined measures individually rather than multiple domains in a single cohesive analysis. This study used a logistic regression model that combines performance on a range of tasks to identify which measures were most altered among adolescent marijuana users. Objectives The purpose of this research was to determine unique associations between adolescent marijuana user and performances on multiple cognitive and behavioral domains (attention, memory, decision-making, and impulsivity) in 14- to 17-year-olds while simultaneously controlling for performances across the measures to determine which measures most strongly distinguish marijuana users from non-users. Methods Marijuana-using adolescents (n=45) and controls (n=48) were tested. Logistic regression analyses were conducted to test for: (a) differences between marijuana users and non-users on each measure, (b) associations between marijuana use and each measure after controlling for the other measures, and (c) the degree to which (a) and (b) together elucidated differences among marijuana users and non-users. Results Of all the cognitive and behavioral domains tested, impaired short-term recall memory and consequence sensitivity impulsivity were associated with marijuana use after controlling for performances across all measures. Conclusions This study extends previous findings by identifying cognitive and behavioral impairments most strongly associated with adolescent marijuana users. These specific deficits are potential targets of intervention for this at-risk population. PMID:23138434

The influence of sexual harassment on mental health among female military personnel of the Republic of Korea Armed Forces.

PubMed

Kim, Tae Kyung; Lee, H-C; Lee, S G; Han, K-T; Park, E-C

2017-04-01

Reports of sexual harassment are becoming more frequent in Republic of Korea (ROK) Armed Forces. This study aimed to analyse the impact of sexual harassment on mental health among female military personnel of the ROK Armed Forces. Data from the 2014 Military Health Survey were used. Instances of sexual harassment were recorded as 'yes' or 'no'. Analysis of variance (ANOVA) was carried out to compare Kessler Psychological Distress Scale 10 (K-10) scores. Multiple logistic regression analysis was performed to identify associations between sexual harassment and K-10 scores. Among 228 female military personnel, 13 (5.7%) individuals experienced sexual harassment. Multiple logistic regression analysis revealed that sexual harassment had a significantly negative impact on K-10 scores (3.486, p<0.04). Higher K-10 scores among individuals experiencing sexual harassment were identified in the unmarried (including never-married) group (6.761, p<0.04), the short-term military service group (12.014, p<0.03) and the group whose length of service was <2 years (11.067, p<0.02). Sexual harassment has a negative impact on mental health. Factors associated with worse mental health scores included service classification and length of service. The results provide helpful information with which to develop measures for minimising the negative psychological effects from sexual harassment and promoting sexual harassment prevention policy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Serum osteocalcin is significantly related to indices of obesity and lipid profile in Malaysian men.

PubMed

Chin, Kok-Yong; Ima-Nirwana, Soelaiman; Mohamed, Isa Naina; Ahmad, Fairus; Ramli, Elvy Suhana Mohd; Aminuddin, Amilia; Ngah, Wan Zurinah Wan

2014-01-01

Recent studies revealed a possible reciprocal relationship between the skeletal system and obesity and lipid metabolism, mediated by osteocalcin, an osteoblast-specific protein. This study aimed to validate the relationship between serum osteocalcin and indices of obesity and lipid parameters in a group of Malaysian men. A total of 373 men from the Malaysian Aging Male Study were included in the analysis. Data on subjects' demography, body mass index (BMI), body fat (BF) mass, waist circumference (WC), serum osteocalcin and fasting lipid levels were collected. Bioelectrical impendence (BIA) method was used to estimate BF. Multiple linear and binary logistic regression analyses were performed to analyze the association between serum osteocalcin and the aforementioned variables, with adjustment for age, ethnicity and BMI. Multiple regression results indicated that weight, BMI, BF mass, BF %, WC were significantly and negatively associated with serum osteocalcin (p < 0.001). There was a significant positive association between serum osteocalcin and high density lipoprotein (HDL) cholesterol (p = 0.032). Binary logistic results indicated that subjects with low serum osteocalcin level were more likely to be associated with high BMI (obese and overweight), high BF%, high WC and low HDL cholesterol (p < 0.05). Subjects with high osteocalcin level also demonstrated high total cholesterol level (p < 0.05) but this association was probably driven by high HDL level. These variables were not associated with serum C-terminal of telopeptide crosslinks in the subjects (p > 0.05). Serum osteocalcin is associated with indices of obesity and HDL level in men. These relationships should be validated by a longitudinal study, with comprehensive hormone profile testing.

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.

A comparison of unemployed job-seekers with and without social anxiety

PubMed Central

Himle, Joseph A; Weaver, Addie; Bybee, Deborah; O'Donnell, Lisa; Vlnka, Sarah; Laviolette, Wayne; Steinberger, Edward; Zipora, Golenberg; Levine, Debra Siegel

2014-01-01

Objective Literature consistently demonstrates that social anxiety disorder has substantial negative impacts on occupational functioning. However, to date, no identified empirical work has focused on understanding the specific nature of vocational problems among persons with social anxiety disorder. This study examines the association between employment-related factors (i.e., barriers to employment; skills related to employment; and job aspirations) and social anxiety among a sample of adults seeking vocational rehabilitation services. Methods Data from intake assessments, including a screen for social anxiety disorder, of 265 low-income, unemployed adults who initiated vocational rehabilitation services in urban Michigan was examined to assess differences in barriers to employment, employment skills, job aspirations, and demographic characteristics among participants who screened positive for social anxiety disorder compared to those who did not. Bivariate and multiple logistic regression analyses were performed. Results Multiple logistic regression analysis revealed that greater perceived experience and skill barriers to employment, fewer skills related to social-type occupations, and less education were significantly associated with social anxiety, after adjusting for other factors. Bivariate analysis also suggested that participants who screened positive for social anxiety disorder were significantly less likely to aspire to social jobs. Conclusions Employment-related factors likely impacting occupational functioning were significantly different between persons with and without social anxiety problems. Identifying these differences in employment barriers, skills, and job aspirations offer potentially important functional targets for psychosocial interventions aimed at social anxiety disorder and suggest the need for vocational service professionals to assess and address social anxiety among their clients. PMID:24733524

Prevalence and risk factors of non-carious cervical lesions related to occupational exposure to acid mists.

PubMed

Bomfim, Rafael Aiello; Crosato, Edgard; Mazzilli, Luiz Eugênio Nigro; Frias, Antonio Carlos

2015-01-01

This study evaluates the prevalence and risk factors of non-carious cervical lesions (NCCLs) in a Brazilian population of workers exposed and non-exposed to acid mists and chemical products. One hundred workers (46 exposed and 54 non-exposed) were evaluated in a Centro de Referência em Saúde do Trabalhador - CEREST (Worker's Health Reference Center). The workers responded to questionnaires regarding their personal information and about alcohol consumption and tobacco use. A clinical examination was conducted to evaluate the presence of NCCLs, according to WHO parameters. Statistical analyses were performed by unconditional logistic regression and multiple linear regression, with the critical level of p < 0.05. NCCLs were significantly associated with age groups (18-34, 35-44, 45-68 years). The unconditional logistic regression showed that the presence of NCCLs was better explained by age group (OR = 4.04; CI 95% 1.77-9.22) and occupational exposure to acid mists and chemical products (OR = 3.84; CI 95% 1.10-13.49), whereas the linear multiple regression revealed that NCCLs were better explained by years of smoking (p = 0.01) and age group (p = 0.04). The prevalence of NCCLs in the study population was particularly high (76.84%), and the risk factors for NCCLs were age, exposure to acid mists and smoking habit. Controlling risk factors through preventive and educative measures, allied to the use of personal protective equipment to prevent the occupational exposure to acid mists, may contribute to minimizing the prevalence of NCCLs.

Prevalence and Risk Factors of Chronic Constipation Among Women Aged 50 Years and Older in Shanghai, China.

PubMed

Huang, Ling; Jiang, Huihong; Zhu, Maoling; Wang, Baocai; Tong, Minsi; Li, Huaguang; Lin, Mou-Bin; Li, Li

2017-05-31

BACKGROUND Chronic constipation (CC) is a major public health problem worldwide, especially in elderly women. This study aimed to investigate the prevalence and risk factors of CC among women aged 50 years and older in Shanghai, China. MATERIAL AND METHODS A cross-sectional survey was conducted on 1950 women aged 50 years and older, randomly sampled in Yangpu District of Shanghai from April to October 2015. Information on demographic characteristics, lifestyle habits, medical history, and defecation situation was collected through in-person interviews. CC was defined according to Rome III criteria. The data were analyzed by chi-square test and multiple logistic regression analysis. RESULTS The response rate to the survey was 80.4%. Of the 1568 participants, 77 were diagnosed with CC, with a prevalence of 4.9%. Moreover, the prevalence increased with advancing age. Multiple logistic analyses showed that body mass index (BMI) ≥25.0 kg/m², non-manual occupation, premenopausal period, no delivery history, poor sleep quality, meat-based diet, and less physical exercise were significant risk factors for CC in the population of women aged 50 years and older. CONCLUSIONS CC was a common health problem among women aged 50 years and older in Shanghai, and the prevalence was positively associated with BMI ≥25.0 kg/m², non-manual occupation, premenopausal period, no delivery history, poor sleep quality, meat-based diet, and less physical exercise. Further studies are needed to identify the risk factors and potential interventions for CC.

Prevalence and Risk Factors of Chronic Constipation Among Women Aged 50 Years and Older in Shanghai, China

PubMed Central

Huang, Ling; Jiang, Huihong; Zhu, Maoling; Wang, Baocai; Tong, Minsi; Li, Huaguang; Lin, Mou-bin; Li, Li

2017-01-01

Background Chronic constipation (CC) is a major public health problem worldwide, especially in elderly women. This study aimed to investigate the prevalence and risk factors of CC among women aged 50 years and older in Shanghai, China. Material/Method A cross-sectional survey was conducted on 1950 women aged 50 years and older, randomly sampled in Yangpu District of Shanghai from April to October 2015. Information on demographic characteristics, lifestyle habits, medical history, and defecation situation was collected through in-person interviews. CC was defined according to Rome III criteria. The data were analyzed by chi-square test and multiple logistic regression analysis. Results The response rate to the survey was 80.4%. Of the 1568 participants, 77 were diagnosed with CC, with a prevalence of 4.9%. Moreover, the prevalence increased with advancing age. Multiple logistic analyses showed that body mass index (BMI) ≥25.0 kg/m2, non-manual occupation, premenopausal period, no delivery history, poor sleep quality, meat-based diet, and less physical exercise were significant risk factors for CC in the population of women aged 50 years and older. Conclusions CC was a common health problem among women aged 50 years and older in Shanghai, and the prevalence was positively associated with BMI ≥25.0 kg/m2, non-manual occupation, premenopausal period, no delivery history, poor sleep quality, meat-based diet, and less physical exercise. Further studies are needed to identify the risk factors and potential interventions for CC. PMID:28562581

The influence of family adaptability and cohesion on anxiety and depression of terminally ill cancer patients.

PubMed

Park, Young-Yoon; Jeong, Young-Jin; Lee, Junyong; Moon, Nayun; Bang, Inho; Kim, Hyunju; Yun, Kyung-Sook; Kim, Yong-I; Jeon, Tae-Hee

2018-01-01

This study investigated the effect of family members on terminally ill cancer patients by measuring the relationship of the presence of the family caregivers, visiting time by family and friends, and family adaptability and cohesion with patient's anxiety and depression. From June, 2016 to March, 2017, 100 terminally ill cancer patients who were admitted to a palliative care unit in Seoul, South Korea, were surveyed, and their medical records were reviewed. The Korean version of the Family Adaptability and Cohesion Evaluation Scales III and Hospital Anxiety-Depression Scale was used. Chi-square and multiple logistic regression analyses were used. The results of the chi-square analysis showed that the presence of family caregivers and family visit times did not have statistically significant effects on anxiety and depression in terminally ill cancer patients. In multiple logistic regression, when adjusted for age, sex, ECOG PS, and the monthly average income, the odds ratios (ORs) of the low family adaptability to anxiety and depression were 2.4 (1.03-5.83) and 5.4 (1.10-26.87), respectively. The OR of low family cohesion for depression was 5.4 (1.10-27.20) when adjusted for age, sex, ECOG PS, and monthly average household income. A higher family adaptability resulted in a lower degree of anxiety and depression in terminally ill cancer patients. The higher the family cohesion, the lower the degree of depression in the patient. The presence of the family caregiver and the visiting time by family and friends did not affect the patient's anxiety and depression.

Association of Sociodemographic Factors, Smoking-Related Beliefs, and Smoking Restrictions With Intention to Quit Smoking in Korean Adults: Findings From the ITC Korea Survey

PubMed Central

Myung, Seung-Kwon; Seo, Hong Gwan; Cheong, Yoo-Seock; Park, Sohee; Lee, Wonkyong B; Fong, Geoffrey T

2012-01-01

Background Few studies have reported the factors associated with intention to quit smoking among Korean adult smokers. This study aimed to examine sociodemographic characteristics, smoking-related beliefs, and smoking-restriction variables associated with intention to quit smoking among Korean adult smokers. Methods We used data from the International Tobacco Control Korea Survey, which was conducted from November through December 2005 by using random-digit dialing and computer-assisted telephone interviewing of male and female smokers aged 19 years or older in 16 metropolitan areas and provinces of Korea. We performed univariate analysis and multiple logistic regression analysis to identify predictors of intention to quit. Results A total of 995 respondents were included in the final analysis. Of those, 74.9% (n = 745) intended to quit smoking. In univariate analyses, smokers with an intention to quit were younger, smoked fewer cigarettes per day, had a higher annual income, were more educated, were more likely to have a religious affiliation, drank less alcohol per week, were less likely to have self-exempting beliefs, and were more likely to have self-efficacy beliefs regarding quitting, to believe that smoking had damaged their health, and to report that smoking was never allowed anywhere in their home. In multiple logistic regression analysis, higher education level, having a religious affiliation, and a higher self-efficacy regarding quitting were significantly associated with intention to quit. Conclusions Sociodemographic factors, smoking-related beliefs, and smoking restrictions at home were associated with intention to quit smoking among Korean adults. PMID:22186157

Association of sociodemographic factors, smoking-related beliefs, and smoking restrictions with intention to quit smoking in Korean adults: findings from the ITC Korea Survey.

PubMed

Myung, Seung-Kwon; Seo, Hong Gwan; Cheong, Yoo-Seock; Park, Sohee; Lee, Wonkyong B; Fong, Geoffrey T

2012-01-01

Few studies have reported the factors associated with intention to quit smoking among Korean adult smokers. This study aimed to examine sociodemographic characteristics, smoking-related beliefs, and smoking-restriction variables associated with intention to quit smoking among Korean adult smokers. We used data from the International Tobacco Control Korea Survey, which was conducted from November through December 2005 by using random-digit dialing and computer-assisted telephone interviewing of male and female smokers aged 19 years or older in 16 metropolitan areas and provinces of Korea. We performed univariate analysis and multiple logistic regression analysis to identify predictors of intention to quit. A total of 995 respondents were included in the final analysis. Of those, 74.9% (n = 745) intended to quit smoking. In univariate analyses, smokers with an intention to quit were younger, smoked fewer cigarettes per day, had a higher annual income, were more educated, were more likely to have a religious affiliation, drank less alcohol per week, were less likely to have self-exempting beliefs, and were more likely to have self-efficacy beliefs regarding quitting, to believe that smoking had damaged their health, and to report that smoking was never allowed anywhere in their home. In multiple logistic regression analysis, higher education level, having a religious affiliation, and a higher self-efficacy regarding quitting were significantly associated with intention to quit. Sociodemographic factors, smoking-related beliefs, and smoking restrictions at home were associated with intention to quit smoking among Korean adults.

Evidence-practice gap for dental sealant application: results from a dental practice-based research network in Japan.

PubMed

Yokoyama, Yoko; Kakudate, Naoki; Sumida, Futoshi; Matsumoto, Yuki; Gilbert, Gregg H; Gordan, Valeria V

2016-12-01

The study aims were: (i) to examine dentist practice patterns regarding treatment recommendations for dental sealants; and (ii) to identify characteristics associated with this recommendation. The study was performed using a cross-sectional questionnaire survey (Clinicaltrials.gov registration number NCT01680848). Participants were Japanese dentists (n = 282) recruited from the Dental Practice-based Research Network Japan. Three clinical photographs of the occlusal surface of a mandibular first molar were presented, portraying increasing depths of cavitation in a 12-year-old patient with high caries risk. Sealants would be an appropriate treatment in all three scenarios. We asked about the treatment decision for each case. We then performed multiple logistic regression analyses to evaluate associations between the decision to recommend sealants, and dentist, patient and practice characteristics. Responses were obtained from 189 dentists (response rate = 67%). In the hypothetical scenarios, dentists' recommendations for sealants for the 12-year-old patient varied from 16% to 26% across the three hypothetical clinical scenarios. Multiple logistic regression analysis indicated that dentist agreement with the efficacy of assessment for caries risk showed a significant association with the percentages of patients receiving sealants. Dentist practice patterns for sealant treatment recommendation show changes that are dependent on caries severity. The dentists' recommendations for sealants for the 12-year-old patient were low for all three selected scenarios, based on indications for sealants in the American Dental Association guidelines. Recommending a sealant showed a significant relationship with the dentist having a higher agreement with efficacy of caries risk assessment. © 2016 FDI World Dental Federation.

A general framework for the use of logistic regression models in meta-analysis.

PubMed

Simmonds, Mark C; Higgins, Julian Pt

2016-12-01

Where individual participant data are available for every randomised trial in a meta-analysis of dichotomous event outcomes, "one-stage" random-effects logistic regression models have been proposed as a way to analyse these data. Such models can also be used even when individual participant data are not available and we have only summary contingency table data. One benefit of this one-stage regression model over conventional meta-analysis methods is that it maximises the correct binomial likelihood for the data and so does not require the common assumption that effect estimates are normally distributed. A second benefit of using this model is that it may be applied, with only minor modification, in a range of meta-analytic scenarios, including meta-regression, network meta-analyses and meta-analyses of diagnostic test accuracy. This single model can potentially replace the variety of often complex methods used in these areas. This paper considers, with a range of meta-analysis examples, how random-effects logistic regression models may be used in a number of different types of meta-analyses. This one-stage approach is compared with widely used meta-analysis methods including Bayesian network meta-analysis and the bivariate and hierarchical summary receiver operating characteristic (ROC) models for meta-analyses of diagnostic test accuracy. © The Author(s) 2014.

Estimating time-varying exposure-outcome associations using case-control data: logistic and case-cohort analyses.

PubMed

Keogh, Ruth H; Mangtani, Punam; Rodrigues, Laura; Nguipdop Djomo, Patrick

2016-01-05

Traditional analyses of standard case-control studies using logistic regression do not allow estimation of time-varying associations between exposures and the outcome. We present two approaches which allow this. The motivation is a study of vaccine efficacy as a function of time since vaccination. Our first approach is to estimate time-varying exposure-outcome associations by fitting a series of logistic regressions within successive time periods, reusing controls across periods. Our second approach treats the case-control sample as a case-cohort study, with the controls forming the subcohort. In the case-cohort analysis, controls contribute information at all times they are at risk. Extensions allow left truncation, frequency matching and, using the case-cohort analysis, time-varying exposures. Simulations are used to investigate the methods. The simulation results show that both methods give correct estimates of time-varying effects of exposures using standard case-control data. Using the logistic approach there are efficiency gains by reusing controls over time and care should be taken over the definition of controls within time periods. However, using the case-cohort analysis there is no ambiguity over the definition of controls. The performance of the two analyses is very similar when controls are used most efficiently under the logistic approach. Using our methods, case-control studies can be used to estimate time-varying exposure-outcome associations where they may not previously have been considered. The case-cohort analysis has several advantages, including that it allows estimation of time-varying associations as a continuous function of time, while the logistic regression approach is restricted to assuming a step function form for the time-varying association.

Beyond discrimination: A comparison of calibration methods and clinical usefulness of predictive models of readmission risk.

PubMed

Walsh, Colin G; Sharman, Kavya; Hripcsak, George

2017-12-01

Prior to implementing predictive models in novel settings, analyses of calibration and clinical usefulness remain as important as discrimination, but they are not frequently discussed. Calibration is a model's reflection of actual outcome prevalence in its predictions. Clinical usefulness refers to the utilities, costs, and harms of using a predictive model in practice. A decision analytic approach to calibrating and selecting an optimal intervention threshold may help maximize the impact of readmission risk and other preventive interventions. To select a pragmatic means of calibrating predictive models that requires a minimum amount of validation data and that performs well in practice. To evaluate the impact of miscalibration on utility and cost via clinical usefulness analyses. Observational, retrospective cohort study with electronic health record data from 120,000 inpatient admissions at an urban, academic center in Manhattan. The primary outcome was thirty-day readmission for three causes: all-cause, congestive heart failure, and chronic coronary atherosclerotic disease. Predictive modeling was performed via L1-regularized logistic regression. Calibration methods were compared including Platt Scaling, Logistic Calibration, and Prevalence Adjustment. Performance of predictive modeling and calibration was assessed via discrimination (c-statistic), calibration (Spiegelhalter Z-statistic, Root Mean Square Error [RMSE] of binned predictions, Sanders and Murphy Resolutions of the Brier Score, Calibration Slope and Intercept), and clinical usefulness (utility terms represented as costs). The amount of validation data necessary to apply each calibration algorithm was also assessed. C-statistics by diagnosis ranged from 0.7 for all-cause readmission to 0.86 (0.78-0.93) for congestive heart failure. Logistic Calibration and Platt Scaling performed best and this difference required analyzing multiple metrics of calibration simultaneously, in particular Calibration Slopes and Intercepts. Clinical usefulness analyses provided optimal risk thresholds, which varied by reason for readmission, outcome prevalence, and calibration algorithm. Utility analyses also suggested maximum tolerable intervention costs, e.g., $1720 for all-cause readmissions based on a published cost of readmission of $11,862. Choice of calibration method depends on availability of validation data and on performance. Improperly calibrated models may contribute to higher costs of intervention as measured via clinical usefulness. Decision-makers must understand underlying utilities or costs inherent in the use-case at hand to assess usefulness and will obtain the optimal risk threshold to trigger intervention with intervention cost limits as a result. Copyright © 2017 Elsevier Inc. All rights reserved.

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…

Country logistics performance and disaster impact.

PubMed

Vaillancourt, Alain; Haavisto, Ira

2016-04-01

The aim of this paper is to deepen the understanding of the relationship between country logistics performance and disaster impact. The relationship is analysed through correlation analysis and regression models for 117 countries for the years 2007 to 2012 with disaster impact variables from the International Disaster Database (EM-DAT) and logistics performance indicators from the World Bank. The results show a significant relationship between country logistics performance and disaster impact overall and for five out of six specific logistic performance indicators. These specific indicators were further used to explore the relationship between country logistic performance and disaster impact for three specific disaster types (epidemic, flood and storm). The findings enhance the understanding of the role of logistics in a humanitarian context with empirical evidence of the importance of country logistics performance in disaster response operations. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

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…

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.

A Clinical Decision Support System for Breast Cancer Patients

NASA Astrophysics Data System (ADS)

Fernandes, Ana S.; Alves, Pedro; Jarman, Ian H.; Etchells, Terence A.; Fonseca, José M.; Lisboa, Paulo J. G.

This paper proposes a Web clinical decision support system for clinical oncologists and for breast cancer patients making prognostic assessments, using the particular characteristics of the individual patient. This system comprises three different prognostic modelling methodologies: the clinically widely used Nottingham prognostic index (NPI); the Cox regression modelling and a partial logistic artificial neural network with automatic relevance determination (PLANN-ARD). All three models yield a different prognostic index that can be analysed together in order to obtain a more accurate prognostic assessment of the patient. Missing data is incorporated in the mentioned models, a common issue in medical data that was overcome using multiple imputation techniques. Risk group assignments are also provided through a methodology based on regression trees, where Boolean rules can be obtained expressed with patient characteristics.

Are High-Lethality Suicide Attempters With Bipolar Disorder a Distinct Phenotype?

PubMed Central

Oquendo, Maria A.; Carballo, Juan Jose; Rajouria, Namita; Currier, Dianne; Tin, Adrienne; Merville, Jessica; Galfalvy, Hanga C.; Sher, Leo; Grunebaum, Michael F.; Burke, Ainsley K.; Mann, J. John

2013-01-01

Because Bipolar Disorder (BD) individuals making highly lethal suicide attempts have greater injury burden and risk for suicide, early identification is critical. BD patients were classified as high- or low-lethality attempters. High-lethality attempts required inpatient medical treatment. Mixed effects logistic regression models and permutation analyses examined correlations between lethality, number, and order of attempts. High-lethality attempters reported greater suicidal intent and more previous attempts. Multiple attempters showed no pattern of incremental lethality increase with subsequent attempts, but individuals with early high-lethality attempts more often made high-lethality attempts later. A subset of high-lethality attempters make only high-lethality attempts. However, presence of previous low-lethality attempts does not indicate that risk for more lethal, possibly successful, attempts is reduced. PMID:19590998

Risk factors for autistic regression: results of an ambispective cohort study.

PubMed

Zhang, Ying; Xu, Qiong; Liu, Jing; Li, She-chang; Xu, Xiu

2012-08-01

A subgroup of children diagnosed with autism experience developmental regression featured by a loss of previously acquired abilities. The pathogeny of autistic regression is unknown, although many risk factors likely exist. To better characterize autistic regression and investigate the association between autistic regression and potential influencing factors in Chinese autistic children, we conducted an ambispective study with a cohort of 170 autistic subjects. Analyses by multiple logistic regression showed significant correlations between autistic regression and febrile seizures (OR = 3.53, 95% CI = 1.17-10.65, P = .025), as well as with a family history of neuropsychiatric disorders (OR = 3.62, 95% CI = 1.35-9.71, P = .011). This study suggests that febrile seizures and family history of neuropsychiatric disorders are correlated with autistic regression.

Perceived discrimination, psychological distress, and current smoking status: results from the Behavioral Risk Factor Surveillance System Reactions to Race module, 2004-2008.

PubMed

Purnell, Jason Q; Peppone, Luke J; Alcaraz, Kassandra; McQueen, Amy; Guido, Joseph J; Carroll, Jennifer K; Shacham, Enbal; Morrow, Gary R

2012-05-01

We examined the association between perceived discrimination and smoking status and whether psychological distress mediated this relationship in a large, multiethnic sample. We used 2004 through 2008 data from the Behavioral Risk Factor Surveillance System Reactions to Race module to conduct multivariate logistic regression analyses and tests of mediation examining associations between perceived discrimination in health care and workplace settings, psychological distress, and current smoking status. Regardless of race/ethnicity, perceived discrimination was associated with increased odds of current smoking. Psychological distress was also a significant mediator of the discrimination-smoking association. Our results indicate that individuals who report discriminatory treatment in multiple domains may be more likely to smoke, in part, because of the psychological distress associated with such treatment.

Patterns of Movement in Foster Care: An Optimal Matching Analysis

PubMed Central

Havlicek, Judy

2011-01-01

Placement instability remains a vexing problem for child welfare agencies across the country. This study uses child welfare administrative data to retrospectively follow the entire placement histories (birth to age 17.5) of 474 foster youth who reached the age of majority in the state of Illinois and to search for patterns in their movement through the child welfare system. Patterns are identified through optimal matching and hierarchical cluster analyses. Multiple logistic regression is used to analyze administrative and survey data in order to examine covariates related to patterns. Five distinct patterns of movement are differentiated: Late Movers, Settled with Kin, Community Care, Institutionalized, and Early Entry. These patterns suggest high but variable rates of movement. Implications for child welfare policy and service provision are discussed. PMID:20873020

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.

Tehran Survey of Potential Risk Factors for Multiple Births.

PubMed

Omani Samani, Reza; Almasi-Hashiani, Amir; Vesali, Samira; Shokri, Fatemeh; Cheraghi, Rezvaneh; Torkestani, Farahnaz; Sepidarkish, Mahdi

2017-10-01

The multiple pregnancy incidence is increasing worldwide. This increased incidence is concerning to the health care system. This study aims to determine the frequency of multiple pregnancy and identify factors that affect this frequency in Tehran, Iran. This cross-sectional study included 5170 mothers in labor between July 6-21, 2015 from 103 hospitals with Obstetrics and Gynecology Wards. The questionnaire used in this study consisted of five parts: demographic characteristics; information related to pregnancy; information related to the infant; information regarding the multiple pregnancy; and information associated with infertility. We recruited 103 trained midwives to collect data related to the questionnaire from eligible participants through an interview and medical records review. Frequencies and odds ratios (OR) for the association between multiple pregnancy and the selected characteristics (maternal age, economic status, history of multiple pregnancy in first-degree relatives, and reproductive history) were computed by multiple logistic regression. Stata software, version 13 (Stata Corp, College Station, TX, USA) was used for all statistical analyses. Multiple pregnancy had a prevalence of 1.48% [95% confidence interval (CI): 1.19-1.85]. After controlling for confounding variables, we observed a significant association between frequency of multiple pregnancy and mother's age (OR=1.04, 95% CI: 1.001-1.09, P=0.044), assisted reproductive technique (ART, OR=6.11, 95% CI: 1.7- 21.97, P=0.006), and history of multiple pregnancy in the mother's family (OR=5.49, 95% CI: 3.55-9.93, P=0.001). The frequency of multiple pregnancy approximated results reported in previous studies in Iran. Based on the results, we observed significantly greater frequency of multiple pregnancy in older women, those with a history of ART, and a history of multiple pregnancy in the mother's family compared to the other variables. Copyright© by Royan Institute. All rights reserved.

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

PubMed

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

2017-05-01

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

Predictors of Recent Marijuana Use and Past Year Marijuana Use Among a National Sample of Hispanic Youth.

PubMed

King, Keith A; Vidourek, Rebecca A; Merianos, Ashley L; Bartsch, Lauren A

2015-01-01

Marijuana use rates remain higher among Hispanic youth compared to youth from other ethnic groups. The purpose of the study was to examine if sex, age, authoritarian parenting, perceived school experiences, lifetime depression, legal involvement, and perceived social norms of marijuana use predicted recent marijuana use and past year marijuana use among Hispanic youth. The participants of this study were a nationwide sample of Hispanic youth (n = 3,457) in the United States. A secondary data analysis of the 2012 National Survey on Drug Use and Health was performed. Unadjusted odds ratios were computed via univariate logistic regression analyses and all statistically significant variables were retained and included in the final multiple logistic regression analyses. Recent marijuana use was operationally defined as use within the past 30 days, and marijuana use in the past year was defined as use within the past year. Results indicated that 7.5% of Hispanic youth used within the past month and 14.5% of Hispanic youth used within the past year. Results revealed that significant predictors for recent use were age, authoritarian parenting, perceived school experiences, legal involvement, and perceived social norms of youth marijuana use. Predictors for past year were age, perceived school experiences, legal involvement, and perceived social norms of youth marijuana use. Findings from this study can be used to address the public health problem of marijuana use among Hispanic youth that is ultimately contributing to health disparities among this ethnic group nationwide. Recommendations for future studies are included.

Complete immunization coverage and its determinants among children in Malaysia: findings from the National Health and Morbidity Survey (NHMS) 2016.

PubMed

Lim, K K; Chan, Y Y; Noor Ani, A; Rohani, J; Siti Norfadhilah, Z A; Santhi, M R

2017-12-01

The success of the Expanded Program on Immunization among children will greatly reduce the burden of illness and disability from vaccine preventable diseases. The aim of the study was to evaluate the complete immunization coverage and its determinants among children aged 12-23 months in Malaysia. Cross-sectional study. Data on immunization were extracted from the 2016 National Health and Morbidity Survey. Complete immunization coverage was classified as received all recommended primary vaccine doses by the age of 12 months and verified by vaccination cards, and incompletely immunized if they received partially recommended vaccine dose or not received any recommended vaccine dose or had no vaccination card. The multiple logistic regression analyses were conducted to determine the sociodemographic factors associated with complete immunization coverage. The overall complete immunization coverage among children (verified by cards) was 86.4% (n = 8920, 95% confidence interval: 85.4-87.4). Multivariable logistic regression analyses model revealed that factors significantly associated with complete immunization coverage were ethnicity, occupation of the mother, head of household's education level, and head of household's occupation. While sex, citizenship, household income, mother's age, and marital status were not significantly associated with complete immunization coverage. According to the World Health Organization criteria, the present study demonstrated that the immunization coverage of 86.4% is still unsatisfactory. Thus, the current intervention program should be enhanced in order to achieve the 95% coverage for all antigens in the national vaccination program. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Estimating DoD Transportation Spending: Analyses of Contract and Payment Transactions

DTIC Science & Technology

2007-01-01

the Defense Logistics Agency (DLA) and of expenditures by shipment material and volume (or cube). The analysis of DLA expenditures appears in Appendix...Defense Logistics Agency (DLA) not completely captured in DD350 data. Limited implementation outside the United States confines inferences that can be...Defense Information Systems Agency DLA Defense Logistics Agency DoD U.S. Department of Defense DoDAAC U.S. Department of Defense Activity Address Code

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.

[Overload in the informal caregivers of patients with multiple comorbidities in an urban area].

PubMed

Álvarez-Tello, Margarita; Casado-Mejía, Rosa; Ortega-Calvo, Manuel; Ruiz-Arias, Esperanza

2012-01-01

The aim of the study was, to determine the profile of the family caregiver of patients with multiple pathologies, identify factors associated with overload, and construct predictive models using items from the Caregiver Strain Index (CSI). A cross-sectional study of caregivers of patients with multiple comorbidities who attended an urban health centre. Data were collected from health records and questionnaires (Barthel index, Pfeiffer index, and CSI). Statistical analysis was performed using measures of central tendency and dispersion, and by building multivariate models with binary logistic regression with the CSI items as predictors (program R version 2.14.0). The sample included 67 caregivers, with a mean age of 64.69 years (standard deviation=12.71, median 62 years), of whom 74.6% were women, 35.8% were wives, and 32.8% were daughters. The level of dependence of the patients cared for was total/severe in 77.6%, and moderate in 12% (Barthel), and 47.8% had some level of cognitive impairment (Pfeiffer). A CSI equal or greater than 7 was seen in 47.8% of caregivers, identifying life problems in more than 40% of them such as, restriction of social life, physical exertion, discomfort with change, bad behaviour, personal and family emotional changes, and sleep disturbances. Item 4 of the CSI, analysing the social restriction, was the one that showed a greater significance in the predictive multivariate model. Item 12 (economic burden) was the most significant with age in patients with cognitive impairment. Women tend to take the role of caregiver at an earlier age than men in the urban environment studied, and items from CSI showed that items 4 (social restrictions) and 12 (economic burden) have more significance in the predictive models constructed with Binary Logistic Regression. Copyright © 2012 Elsevier España, S.L. All rights reserved.

High doses of folic acid in the periconceptional period and risk of low weight for gestational age at birth in a population based cohort study.

PubMed

Navarrete-Muñoz, Eva María; Valera-Gran, Desirée; Garcia-de-la-Hera, Manuela; Gonzalez-Palacios, Sandra; Riaño, Isolina; Murcia, Mario; Lertxundi, Aitana; Guxens, Mònica; Tardón, Adonina; Amiano, Pilar; Vrijheid, Martine; Rebagliato, Marisa; Vioque, Jesus

2017-11-27

We investigated the association between maternal use of folic acid (FA) during pregnancy and child anthropometric measures at birth. We included 2302 mother-child pairs from a population-based birth cohort in Spain (INMA Project). FA dosages at first and third trimester of pregnancy were assessed using a specific battery questionnaire and were categorized in non-user, < 1000, 1000-4999, and ≥ 5000 µg/day. Anthropometric measures at birth (weight in grams, length and head circumference in centimetres) were obtained from medical records. Small for gestational age according to weight (SGA-w), length (SGA-l) and head circumference (SGA-hc) were defined using the 10th percentile based on Spanish standardized growth reference charts. Multiple linear and logistic regression analyses were used to explore the association between FA dosages in different stages of pregnancy and child anthropometric measures at birth. In the multiple linear regression analysis, we found a tendency for a negative association between the use of high dosages of FA (≥ 5000 µg/day) in the periconceptional period of pregnancy and weight at birth compared to mothers who were non-users of FA (β = - 73.83; 95% CI - 151.71, 4.06). In the multiple logistic regression, a greater risk of SGA-w was also evident among children whose mothers took FA dosages of 1000-4999 (OR = 2.21; 95% CI 1.17, 4.19) and of ≥ 5000 µg/day (OR = 2.32; 95% CI 1.06, 5.08) compared to mothers non-users of FA in the periconceptional period of pregnancy. Our findings suggest that a high dosage of FA (≥ 1000 µg/day) may be associated with an increased risk of SGA-w at birth.

Association between Triglyceride to HDL-C Ratio (TG/HDL-C) and Insulin Resistance in Chinese Patients with Newly Diagnosed Type 2 Diabetes Mellitus.

PubMed

Ren, Xingxing; Chen, Zeng Ai; Zheng, Shuang; Han, Tingting; Li, Yangxue; Liu, Wei; Hu, Yaomin

2016-01-01

To explore the association between the triglyceride to HDL-C ratio (TG/HDL-C) and insulin resistance in Chinese patients with newly diagnosed type 2 diabetes mellitus. Patients with newly diagnosed type 2 diabetes mellitus (272 men and 288 women) were enrolled and divided into three groups according to TG/HDL-C tertiles. Insulin resistance was defined by homeostatic model assessment of insulin resistance (HOMA-IR). Demographic information and clinical characteristics were obtained. Spearman's correlation was used to estimate the association between TG/HDL-C and other variables. Multiple logistic regression analyses were adopted to obtain probabilities of insulin resistance. A receiver operating characteristic analysis was conducted to evaluate the ability of TG/HDL-C to discriminate insulin resistance. TG/HDL-C was associated with insulin resistance in Chinese patients with newly diagnosed T2DM (Spearman's correlation coefficient = 0.21, P < 0.01). Patients in the higher tertiles of TG/HDL-C had significantly higher HOMA-IR values than patients in the lower tertiles [T1: 2.68(1.74-3.70); T2: 2.96(2.29-4.56); T3: 3.09(2.30-4.99)]. Multiple logistic regression analysis showed that TG/HDL-C was significantly associated with HOMA-IR, and patients in the higher TG/HDL-C tertile had a higher OR than those in the lower TG/HDL-C tertile, after adjusting for multiple covariates including indices for central obesity [T1: 1; T2: 4.02(1.86-8.71); T3: 4.30(1.99-9.29)]. Following stratification of waist circumference into quartiles, the effect of TG/HDL-C on insulin resistance remained significant irrespective of waist circumference. TG/HDL-C was associated with insulin resistance independent of waist circumference. Whether it could be a surrogate marker for insulin resistance in Chinese patients with newly diagnosed type 2 diabetes mellitus still needs to be confirmed by more researches.

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.

Neurocognitive functioning in children with developmental dyslexia and attention-deficit/hyperactivity disorder: Multiple deficits and diagnostic accuracy.

PubMed

Moura, Octávio; Pereira, Marcelino; Alfaiate, Cláudia; Fernandes, Eva; Fernandes, Boavida; Nogueira, Susana; Moreno, Joana; Simões, Mário R

2017-04-01

This study aimed to investigate the neurocognitive functioning of children with developmental dyslexia (DD) and attention-deficit/hyperactivity disorder (ADHD). Four groups of children between the ages of 8 and 10 years participated in the study: typically developing children (TDC; N = 34), children with DD-only (N = 32), children with ADHD-only (N = 32), and children with DD+ADHD (N = 18). Children with DD and ADHD exhibited significant weaknesses on almost all neurocognitive measures compared with TDC. Large effect sizes were observed for naming speed and phonological awareness. The comorbid group showed deficits consistent with both DD and ADHD without additional impairments. Results from binary logistic regression and receiver-operating characteristic (ROC) curve analyses suggested that some neurocognitive measures revealed an adequate sensitivity for the clinical diagnosis of both neurodevelopmental disorders. Specifically, naming speed and phonological awareness were the strongest predictors to correctly discriminate both disorders. Taken together, the results lend support to the multiple cognitive deficit hypothesis showing a considerable overlap of neurocognitive deficits between both disorders.

Porphyromonas gingivalis, Treponema denticola and toll-like receptor 2 are associated with hypertensive disorders in placental tissue: a case-control study.

PubMed

Chaparro, A; Blanlot, C; Ramírez, V; Sanz, A; Quintero, A; Inostroza, C; Bittner, M; Navarro, M; Illanes, S E

2013-12-01

To explore the associations between the presence of periodontal pathogens and the expression of toll-like receptors (TLR-2 and TLR-4) in the placental tissue of patients with hypertensive disorders compared to the placentas of healthy normotensive patients. A case-control study was performed. From a cohort composed of 126 pregnant women, 33 normotensive healthy pregnant women were randomly selected, and 25 cases of patients with hypertensive disorders of pregnancy, including gestational hypertension and pre-eclampsia, were selected. Placental biopsy was obtained after aseptic placental collection at the time of delivery. All of the samples were processed and analysed for the detection of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Treponema denticola and Tannerella forsythia using the polymerase chain reaction (PCR) technique. Determination of the expressions of TLR-2 and TLR-4 was performed in samples of total purified protein isolated from placental tissues and analysed by ELISA. The data were assessed using descriptive statistics. The associations among variables were estimated through multiple logistic regression models and the Mann-Whitney test to evaluate the differences between the two groups. A significant increase was observed in the expression of TLR-2 in the placentas of patients with hypertensive disorders (p = 0.04). Additionally, the multiple logistic regression models demonstrated an association between the presence of T. denticola and P. gingivalis in placental tissues and hypertensive disorders (OR: 9.39, p = 0.001, CI 95% 2.39-36.88 and OR: 7.59, p = 0.019, CI 95% 1.39-41.51, respectively). In the present study, pregnant women with periodontal disease presented an association in the placental tissue between the presence of T. denticola and P. gingivalis and hypertensive disorders. Additionally, increased expression of TLR-2 was observed. However, further studies are required to determine the specific roles of periodontal pathogens and TLRs in the placental tissue of patients with pregnancy-related hypertensive disorders. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Developmental Screening Referrals: Child and Family Factors that Predict Referral Completion

ERIC Educational Resources Information Center

Jennings, Danielle J.; Hanline, Mary Frances

2013-01-01

This study researched the predictive impact of developmental screening results and the effects of child and family characteristics on completion of referrals given for evaluation. Logistical and hierarchical logistic regression analyses were used to determine the significance of 10 independent variables on the predictor variable. The number of…

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.

Patterns of women's aggression against partners and others: broadening our understanding of violence.

PubMed

Rivera, Echo A; Kubiak, Sheryl P; Bybee, Deborah

2014-12-01

Research on women's aggression typically focuses on relational aggression. However, the study of violence must include multiple forms of violence such as aggression against partners and non-partner others, while also considering victimization experiences by partners and non-partners. The focus of this study is the multiple experiences of violence (perpetration and victimization) of women who are incarcerated. Incarcerated women are likely to experience higher rates of both than women in community settings, but most will be released in a brief period of time. Using a random sample (N = 580) we conducted cluster analyses to identify five patterns of women's aggression. Clusters varied depending on the target/s of aggression (i.e., partner and/or others), and type of aggression (i.e., physical and/or intimidation). Multinomial logistic regression was performed to determine the relationship between women's membership in a perpetration cluster and their victimization. Victimization history was related to an increased risk of perpetrating aggression, and varied depending on the target and type of aggression. Our findings provide support that research and interventions addressing women's use of aggression must also address their victimization history. Furthermore, results indicate that for some women, aggression towards partners and others is related. Future research should investigate multiple forms of aggression.

Suicidal ideation, risk factors, and communication with parents. An HBSC study on school children in Estonia, Lithuania, and Luxembourg.

PubMed

Mark, Lauraliisa; Samm, Algi; Tooding, Liina-Mai; Sisask, Merike; Aasvee, Katrin; Zaborskis, Apolinaras; Zemaitiene, Nida; Värnik, Airi

2013-01-01

Suicide is a leading cause of death among youth. In the year 2002, Lithuania had the 2nd, Luxembourg the 5th, and Estonia the 9th highest suicide rates among 15- to 19-year-olds across 90 countries worldwide. Suicidal ideation is a significant precursor to suicide. To report on the prevalence of and associations between suicidal ideation, smoking, alcohol consumption, physical fighting, bullying, and communication with parents among 15-year-old schoolchildren. The survey analyzes data from the 2005/2006 HBSC study from Estonia, Lithuania, and Luxembourg (N = 4,954). The risk factors were calculated through multinomial logistic regression analyses. The overall prevalence of suicidal ideation in the preceding year was 17%. Suicidal thoughts were associated with communication difficulties with parents (OR from 2.0 to 4.6) and other risk factors, especially multiple risks (OR for 4-5 concurrent risk factors from 4.5 to 13.6). Parent-child communication had a significant mediating effect by decreasing the odds for suicidality and multiple risks. The prevalence estimates were obtained by self-reports. The causal relationships need further investigation. The risk factors studied, particularly multiple risks, were associated with higher odds for suicidal ideation. Good parent-child communication is a significant resource for decreasing suicidal ideation among adolescents.

Remote sensing and GIS-based landslide hazard analysis and cross-validation using multivariate logistic regression model on three test areas in Malaysia

NASA Astrophysics Data System (ADS)

Pradhan, Biswajeet

2010-05-01

This paper presents the results of the cross-validation of a multivariate logistic regression model using remote sensing data and GIS for landslide hazard analysis on the Penang, Cameron, and Selangor areas in Malaysia. Landslide locations in the study areas were identified by interpreting aerial photographs and satellite images, supported by field surveys. SPOT 5 and Landsat TM satellite imagery were used to map landcover and vegetation index, respectively. Maps of topography, soil type, lineaments and land cover were constructed from the spatial datasets. Ten factors which influence landslide occurrence, i.e., slope, aspect, curvature, distance from drainage, lithology, distance from lineaments, soil type, landcover, rainfall precipitation, and normalized difference vegetation index (ndvi), were extracted from the spatial database and the logistic regression coefficient of each factor was computed. Then the landslide hazard was analysed using the multivariate logistic regression coefficients derived not only from the data for the respective area but also using the logistic regression coefficients calculated from each of the other two areas (nine hazard maps in all) as a cross-validation of the model. For verification of the model, the results of the analyses were then compared with the field-verified landslide locations. Among the three cases of the application of logistic regression coefficient in the same study area, the case of Selangor based on the Selangor logistic regression coefficients showed the highest accuracy (94%), where as Penang based on the Penang coefficients showed the lowest accuracy (86%). Similarly, among the six cases from the cross application of logistic regression coefficient in other two areas, the case of Selangor based on logistic coefficient of Cameron showed highest (90%) prediction accuracy where as the case of Penang based on the Selangor logistic regression coefficients showed the lowest accuracy (79%). Qualitatively, the cross application model yields reasonable results which can be used for preliminary landslide hazard mapping.

Accounting for Epistemic Uncertainty in Mission Supportability Assessment: A Necessary Step in Understanding Risk and Logistics Requirements

NASA Technical Reports Server (NTRS)

Owens, Andrew; De Weck, Olivier L.; Stromgren, Chel; Goodliff, Kandyce; Cirillo, William

2017-01-01

Future crewed missions to Mars present a maintenance logistics challenge that is unprecedented in human spaceflight. Mission endurance – defined as the time between resupply opportunities – will be significantly longer than previous missions, and therefore logistics planning horizons are longer and the impact of uncertainty is magnified. Maintenance logistics forecasting typically assumes that component failure rates are deterministically known and uses them to represent aleatory uncertainty, or uncertainty that is inherent to the process being examined. However, failure rates cannot be directly measured; rather, they are estimated based on similarity to other components or statistical analysis of observed failures. As a result, epistemic uncertainty – that is, uncertainty in knowledge of the process – exists in failure rate estimates that must be accounted for. Analyses that neglect epistemic uncertainty tend to significantly underestimate risk. Epistemic uncertainty can be reduced via operational experience; for example, the International Space Station (ISS) failure rate estimates are refined using a Bayesian update process. However, design changes may re-introduce epistemic uncertainty. Thus, there is a tradeoff between changing a design to reduce failure rates and operating a fixed design to reduce uncertainty. This paper examines the impact of epistemic uncertainty on maintenance logistics requirements for future Mars missions, using data from the ISS Environmental Control and Life Support System (ECLS) as a baseline for a case study. Sensitivity analyses are performed to investigate the impact of variations in failure rate estimates and epistemic uncertainty on spares mass. The results of these analyses and their implications for future system design and mission planning are discussed.

Resource predictability and specialization in avian malaria parasites.

PubMed

Svensson-Coelho, Maria; Loiselle, Bette A; Blake, John G; Ricklefs, Robert E

2016-09-01

We tested the hypothesis that avian haemosporidian (malaria) parasites specialize on hosts that can be characterized as predictable resources at a site in Amazonian Ecuador. We incorporated host phylogenetic relationship and relative abundance in assessing parasite specialization, and we examined associations between parasite specialization and three host characteristics - abundance, mass and longevity - using quantile regression, phylogenetic logistic regression and t-tests. Hosts of specialist malaria parasite lineages were on average more abundant than hosts of generalist parasite lineages, but the relationship between host abundance and parasite specialization was not consistent across analyses. We also found support for a positive association between parasite specialization and host longevity, but this also was not consistent across analyses. Nonetheless, our findings suggest that the predictability of a host resource may play a role in the evolution of specialization. However, we also discuss two alternative explanations to the resource predictability hypothesis for specialization: (i) that interspecific interactions among the parasites themselves might constrain some parasites to a specialist strategy, and (ii) that frequent encounters with multiple host species, mediated by blood-sucking insects, might promote generalization within this system. © 2016 John Wiley & Sons Ltd.

Preference-based Health status in a German outpatient cohort with multiple sclerosis

PubMed Central

2013-01-01

Background To prospectively determine health status and health utility and its predictors in patients with multiple sclerosis (MS). Methods A total of 144 MS patients (mean age: 41.0 ±11.3y) with different subtypes (patterns of progression) and severities of MS were recruited in an outpatient university clinic in Germany. Patients completed a questionnaire at baseline (n = 144), 6 months (n = 65) and 12 months (n = 55). Health utilities were assessed using the EuroQol instrument (EQ-5D, EQ VAS). Health status was assessed by several scales (Expanded Disability Severity Scale (EDSS), Modified Fatigue Impact Scale (M-FIS), Functional Assessment of MS (FAMS), Beck Depression Inventory (BDI-II) and Multiple Sclerosis Functional Composite (MSFC)). Additionally, demographic and socioeconomic parameters were assessed. Multivariate linear and logistic regressions were applied to reveal independent predictors of health status. Results Health status is substantially diminished in MS patients and the EQ VAS was considerably lower than that of the general German population. No significant change in health-status parameters was observed over a 12-months period. Multivariate analyses revealed M-FIS, BDI-II, MSFC, and EDSS to be significant predictors of reduced health status. Socioeconomic and socio-demographic parameters such as working status, family status, number of household inhabitants, age, and gender did not prove significant in multivariate analyses. Conclusion MS considerably impairs patients’ health status. Guidelines aiming to improve self-reported health status should include treatment options for depression and fatigue. Physicians should be aware of depression and fatigue as co-morbidities. Future studies should consider the minimal clinical difference when health status is a primary outcome. PMID:24089999

Dose-Dependent Negative Effects of Prior Multiple Vaccinations against Influenza A and Influenza B among School Children: A Study of Kamigoto Island in Japan during the 2011/12, 2012/13 and 2013/14 Influenza Seasons.

PubMed

Saito, Nobuo; Komori, Kazuhiro; Suzuki, Motoi; Kishikawa, Takayuki; Yasaka, Takahiro; Ariyoshi, Koya

2018-03-08

We investigated the negative effects of prior multiple vaccinations on influenza vaccine effectiveness (VE) and analysed the association of VE with prior vaccine doses. Patients aged 9-18 years presenting with influenza-like illness at a community hospital on a Japanese remote island during the 2011/12, 2012/13 and 2013/14 seasons were tested for influenza using a rapid diagnostic test (RDT). A test-negative case-control study design was used to estimate the VEs of trivalent inactivated influenza vaccine (TIV). Histories of vaccination and medically-attended influenza (MA-flu) A and B during three previous seasons were collected from registry systems. VE was calculated using multi-level mixed-effects logistic regression models adjusted for the history of RDT-confirmed MA-flu. During three influenza seasons, 1668 influenza-like illness episodes were analysed, including 421 and 358 episodes of MA-fluA and MA-fluB, respectively. The adjusted VE yielded significant dose-dependent attenuations by prior vaccinations against both MA-fluA [0 doses during previous three seasons: 96% (95% CI: 69%-100%), 1 dose: 48% (-7% to 74%), 2 doses: 52% (11%-74%), 3 doses: 21% (-25% to 51%); P for trend <0.05] and MA-fluB [0 doses: 66% (-5% to 89%), 1 dose: 48% (-14% to 76%), 2 doses: 34% (-33% to 67%), 3 doses: -7% (-83% to 37%); P for trend <0.05]. After excluding episodes of MA-flu during prior three seasons, similar trends were observed. Repeated previous vaccinations over multiple seasons had significant dose-dependent negative impacts on VE against both MA-fluA and MA-fluB. Further studies to confirm this finding are necessary.

Birth weight and stuttering: Evidence from three birth cohorts.

PubMed

McAllister, Jan; Collier, Jacqueline

2014-03-01

Previous studies have produced conflicting results with regard to the association between birth weight and developmental stuttering. This study sought to determine whether birth weight was associated with childhood and/or adolescent stuttering in three British birth cohort samples. Logistic regression analyses were carried out on data from the Millenium Cohort Study (MCS), British Cohort Study (BCS70) and National Child Development Study (NCDS), whose initial cohorts comprised over 56,000 individuals. The outcome variables were parent-reported stuttering in childhood or in adolescence; the predictors, based on prior research, were birth weight, sex, multiple birth status, vocabulary score and mother's level of education. Birth weight was analysed both as a categorical variable (low birth weight, <2500g; normal range; high birth weight, ≥4000g) and as a continuous variable. Separate analyses were carried out to determine the impact of birth weight and the other predictors on stuttering during childhood (age 3, 5 and 7 and MCS, BCS70 and NCDS, respectively) or at age 16, when developmental stuttering is likely to be persistent. None of the multivariate analyses revealed an association between birth weight and parent-reported stuttering. Sex was a significant predictor of stuttering in all the analyses, with males 1.6-3.6 times more likely than females to stutter. Our results suggest that birth weight is not a clinically useful predictor of childhood or persistent stuttering. Copyright © 2013 Elsevier Inc. All rights reserved.

Socioeconomic status, labour market connection, and self-rated psychological health: the role of social capital and economic stress.

PubMed

Lindström, Martin; Ali, Sadiq M; Rosvall, Maria

2012-02-01

To investigate the association between socioeconomic status, unemployment and self-rated psychological health, taking economic stress and horizontal trust into account. The 2008 public health survey in Skåne is a cross-sectional postal questionnaire study with a 55% participation rate. A random sample was invited and 28,198 persons aged 18-80 participated. Logistic regression models were used to investigate associations between socioeconomic status by occupation (SES), labour market connection and self-rated psychological health (GHQ12). The multiple regression analyses included age, country of birth, education, economic stress and generalized (horizontal) trust. 13.8% of the men and 18.2% of the women had poor psychological health. Poor psychological health was more common among the young, among those born abroad, among those with lower education, with economic stress, and low horizontal trust. There were no significant differences between the employed and self-employed groups. However, the people who had retired early, the unemployed and those on long-term sick leave had significantly higher odds ratios of poor psychological health than higher non-manual employees throughout the analyses. There were no differences in psychological health between non-manual employees in higher positions and other employed and self-employed SES groups among men or women. In contrast, the early retired, the unemployed and the category on long-term sick leave had significantly higher odds ratios of poor psychological health among both men and women throughout the multiple analyses. Both economic stress and trust affected this association (i.e., lowered the odds ratios of poor psychological health), but affected by economic stress to a somewhat higher extent.

Interrelation and independence of positive and negative psychological constructs in predicting general treatment adherence in coronary artery patients - Results from the THORESCI study.

PubMed

van Montfort, Eveline; Denollet, Johan; Widdershoven, Jos; Kupper, Nina

2016-09-01

In cardiac patients, positive psychological factors have been associated with improved medical and psychological outcomes. The current study examined the interrelation between and independence of multiple positive and negative psychological constructs. Furthermore, the potential added predictive value of positive psychological functioning regarding the prediction of patients' treatment adherence and participation in cardiac rehabilitation (CR) was investigated. 409 percutaneous coronary intervention (PCI) patients were included (mean age = 65.6 ± 9.5; 78% male). Self-report questionnaires were administered one month post-PCI. Positive psychological constructs included positive affect (GMS) and optimism (LOT-R); negative constructs were depression (PHQ-9, BDI), anxiety (GAD-7) and negative affect (GMS). Six months post-PCI self-reported general adherence (MOS) and CR participation were determined. Factor Analysis (Oblimin rotation) revealed two components (r = − 0.56), reflecting positive and negative psychological constructs. Linear regression analyses showed that in unadjusted analyses both optimism and positive affect were associated with better general treatment adherence at six months (p < 0.05). In adjusted analyses, optimism's predictive values remained, independent of sex, age, PCI indication, depression and anxiety. Univariate logistic regression analysis showed that in patients with a cardiac history, positive affect was significantly associated with CR participation. After controlling for multiple covariates, this relation was no longer significant. Positive and negative constructs should be considered as two distinct dimensions. Positive psychological constructs (i.e. optimism) may be of incremental value to negative psychological constructs in predicting patients' treatment adherence. A more complete view of a patients' psychological functioning will open new avenues for treatment. Additional research is needed to investigate the relationship between positive psychological factors and other cardiac outcomes, such as cardiac events and mortality.

Association between cardiovascular risk factors and carotid intima-media thickness in prepubertal Brazilian children.

PubMed

Gazolla, Fernanda Mussi; Neves Bordallo, Maria Alice; Madeira, Isabel Rey; de Miranda Carvalho, Cecilia Noronha; Vieira Monteiro, Alexandra Maria; Pinheiro Rodrigues, Nádia Cristina; Borges, Marcos Antonio; Collett-Solberg, Paulo Ferrez; Muniz, Bruna Moreira; de Oliveira, Cecilia Lacroix; Pinheiro, Suellen Martins; de Queiroz Ribeiro, Rebeca Mathias

2015-05-01

Early exposure to cardiovascular risk factors creates a chronic inflammatory state that could damage the endothelium followed by thickening of the carotid intima-media. To investigate the association of cardiovascular risk factors and thickening of the carotid intima. Media in prepubertal children. In this cross-sectional study, carotid intima-media thickness (cIMT) and cardiovascular risk factors were assessed in 129 prepubertal children aged from 5 to 10 year. Association was assessed by simple and multivariate logistic regression analyses. In simple logistic regression analyses, body mass index (BMI) z-score, waist circumference, and systolic blood pressure (SBP) were positively associated with increased left, right, and average cIMT, whereas diastolic blood pressure was positively associated only with increased left and average cIMT (p<0.05). In multivariate logistic regression analyses increased left cIMT was positively associated to BMI z-score and SBP, and increased average cIMT was only positively associated to SBP (p<0.05). BMI z-score and SBP were the strongest risk factors for increased cIMT.

Aspiration Thrombectomy and Drug-Eluting Stent Implantation Decrease the Occurrence of Angina Pectoris One Year After Acute Myocardial Infarction.

PubMed

Lee, Wei-Chieh; Fang, Chih-Yuan; Chen, Huang-Chung; Hsueh, Shu-Kai; Chen, Chien-Jen; Yang, Cheng-Hsu; Yip, Hon-Kan; Hang, Chi-Ling; Wu, Chiung-Jen; Fang, Hsiu-Yu

2016-04-01

Angina pectoris is a treatable symptom that is associated with mortality and decreased quality of life. Angina eradication is a primary care goal of care after an acute myocardial infarction (AMI). Our aim was to evaluate factors influencing angina pectoris 1 year after an AMI.From January 2005 to December 2013, 1547 patient received primary percutaneous intervention in our hospital for an acute ST-segment elevation myocardial infarction (MI). Of these patients, 1336 patients did not experience post-MI angina during a 1-year follow-up, and 211 patients did. Univariate and multivariate logistic regression analyses were performed to identify the factors influencing angina pectoris 1 year after an AMI. Propensity score matched analyses were performed for subgroups analyses.The average age of the patients was 61.08 ± 12.77 years, with a range of 25 to 97 years, and 82.9% of the patients were male. During 1-year follow-up, 13.6% of the patients experienced post-MI angina. There was a longer chest pain-to-reperfusion time in the post-MI angina group (P = 0.01), as well as a higher fasting sugar level, glycohemoglobin (HbA1C), serum creatinine, troponin-I and creatine kinase MB (CK-MB). The post-MI angina group also had a higher prevalence of multiple-vessel disease. Manual thrombectomy, and distal protective device and intracoronary glycoprotein IIb/IIIa inhibitor injection were used frequently in the no post-MI angina group. Antiplatelet agents and post-MI medication usage were similar between the 2 groups. Multivariate logistic regression analyses demonstrated that prior MI was a positive independent predictor of occurrence of post-MI angina. Manual thrombectomy use and drug-eluting stent implantation were negative independent predictors of post-MI angina. Higher troponin-I and longer chest pain-to-reperfusion time exhibited a trend toward predicting post-MI angina.Prior MIs were strong, independent predictors of post-MI angina. Manual thrombectomy and drug-eluting stent implantation could decrease the occurrence of angina pectoris 1 year after an AMI, decrease long-term healthy costs, and increase post-MI quality of life.

Aspiration Thrombectomy and Drug-Eluting Stent Implantation Decrease the Occurrence of Angina Pectoris One Year After Acute Myocardial Infarction

PubMed Central

Lee, Wei-Chieh; Fang, Chih-Yuan; Chen, Huang-Chung; Hsueh, Shu-Kai; Chen, Chien-Jen; Yang, Cheng-Hsu; Yip, Hon-Kan; Hang, Chi-Ling; Wu, Chiung-Jen; Fang, Hsiu-Yu

2016-01-01

Abstract Angina pectoris is a treatable symptom that is associated with mortality and decreased quality of life. Angina eradication is a primary care goal of care after an acute myocardial infarction (AMI). Our aim was to evaluate factors influencing angina pectoris 1 year after an AMI. From January 2005 to December 2013, 1547 patient received primary percutaneous intervention in our hospital for an acute ST-segment elevation myocardial infarction (MI). Of these patients, 1336 patients did not experience post-MI angina during a 1-year follow-up, and 211 patients did. Univariate and multivariate logistic regression analyses were performed to identify the factors influencing angina pectoris 1 year after an AMI. Propensity score matched analyses were performed for subgroups analyses. The average age of the patients was 61.08 ± 12.77 years, with a range of 25 to 97 years, and 82.9% of the patients were male. During 1-year follow-up, 13.6% of the patients experienced post-MI angina. There was a longer chest pain-to-reperfusion time in the post-MI angina group (P = 0.01), as well as a higher fasting sugar level, glycohemoglobin (HbA1C), serum creatinine, troponin-I and creatine kinase MB (CK-MB). The post-MI angina group also had a higher prevalence of multiple-vessel disease. Manual thrombectomy, and distal protective device and intracoronary glycoprotein IIb/IIIa inhibitor injection were used frequently in the no post-MI angina group. Antiplatelet agents and post-MI medication usage were similar between the 2 groups. Multivariate logistic regression analyses demonstrated that prior MI was a positive independent predictor of occurrence of post-MI angina. Manual thrombectomy use and drug-eluting stent implantation were negative independent predictors of post-MI angina. Higher troponin-I and longer chest pain-to-reperfusion time exhibited a trend toward predicting post-MI angina. Prior MIs were strong, independent predictors of post-MI angina. Manual thrombectomy and drug-eluting stent implantation could decrease the occurrence of angina pectoris 1 year after an AMI, decrease long-term healthy costs, and increase post-MI quality of life. PMID:27124029

Association of Cancer Susceptibility Variants with Risk of Multiple Primary Cancers: the Population Architecture using Genomics and Epidemiology Study

PubMed Central

Park, S. Lani; Caberto, Christian P.; Lin, Yi; Goodloe, Robert J.; Dumitrescu, Logan; Love, Shelly-Ann; Matise, Tara C.; Hindorff, Lucia A.; Fowke, Jay H.; Schumacher, Fredrick R.; Beebe-Dimmer, Jennifer; Chen, Chu; Hou, Lifang; Thomas, Fridtjof; Deelman, Ewa; Han, Ying; Peters, Ulrike; North, Kari E.; Heiss, Gerardo; Crawford, Dana C.; Haiman, Christopher A.; Wilkens, Lynne R.; Bush, William S.; Kooperberg, Charles; Cheng, Iona; Le Marchand, Loïc

2014-01-01

Background Multiple primary cancers account for ~16% of all incident cancers in the U.S.. While genome-wide association studies (GWAS) have identified many common genetic variants associated with various cancer sites, no study has examined the association of these genetic variants with risk of multiple primary cancers (MPC). Methods As part of the NHGRI Population Architecture using Genomics and Epidemiology (PAGE) study, we used data from the Multiethnic Cohort and Women’s Health Initiative. Incident MPC (IMPC) cases (n=1,385) were defined as participants diagnosed with >1 incident cancers after cohort entry. Participants diagnosed with only one incident cancer after cohort entry with follow-up equal to or longer than IMPC cases served as controls (single-index cancer controls; n= 9,626). Fixed-effects meta-analyses of unconditional logistic regression analyses were used to evaluate the association between cancer risk variants and IMPC risk. To account for multiple comparisons, we used the false positive report probability (FPRP) to determine statistical significance. Results A nicotine dependence-associated and lung cancer variant, CHRNA3 rs578776 (OR=1.16, 95% CI=1.05–1.26; p=0.004) and two breast cancer variants, EMBP1 rs11249433 and TOX3 rs3803662 (OR=1.16, 95% CI=1.04–1.28; p=0.005 and OR=1.13, 95% CI=1.03–1.23; p=0.006) were significantly associated with risk of IMPC. The associations for rs578776 and rs11249433 remained (p<0.05) after removing subjects who had lung or breast cancers, respectively (p-values≤0.046). These associations did not show significant heterogeneity by smoking status (p-heterogeneity≥0.53). Conclusions Our study has identified rs578776 and rs11249433 as risk variants for IMPC. Impact These findings may help to identify genetic regions associated with IMPC risk. PMID:25139936

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.

Power and sample size for multivariate logistic modeling of unmatched case-control studies.

PubMed

Gail, Mitchell H; Haneuse, Sebastien

2017-01-01

Sample size calculations are needed to design and assess the feasibility of case-control studies. Although such calculations are readily available for simple case-control designs and univariate analyses, there is limited theory and software for multivariate unconditional logistic analysis of case-control data. Here we outline the theory needed to detect scalar exposure effects or scalar interactions while controlling for other covariates in logistic regression. Both analytical and simulation methods are presented, together with links to the corresponding software.

The influence of seasons and lunar cycle on hospital outcomes following ascending aortic dissection repair.

PubMed

Shuhaiber, Jeffrey H; Fava, Joseph L; Shin, Tai; Dobrilovic, Nikola; Ehsan, Afshin; Bert, Arthur; Sellke, Frank

2013-11-01

The effect of the lunar cycle and seasonal variation on ascending aortic dissection surgery outcomes is unknown. We investigated these temporal effects on risk-adjusted hospital mortality and then on the length of stay (LOS) following surgery for survivors. We examined prospectively collected data from cardiac operations at two major centres within a single state between January 1996 and December 2011. We first examined the relationship between the lunar cycle and seasonal variation, along with demographic and risk profile covariates, with mortality using univariate analyses, followed by multiple logistic regression modelling that controlled for demographic and patient risk variables including age, gender, risk profile (diabetes, hypertension, dyslipidaemia and renal failure), and two surgical groups: Group A, consisting of patients having repair of ascending aorta dissection repair only, and Group B, with those having ascending aorta repair plus aortic valve surgery or coronary bypass surgery or both. We further examined the relationship with LOS using both univariate and multiple regression analyses. There were 210 patients who had repair of dissection in the study period, with 109 patients in Group A and 101 in Group B. The average age of this sample was 59.5 (standard deviation = 16.0), 65.7% were male and 18.1% died prior to discharge following repair. The greatest percentage of deaths occurred in winter (31.6%, n = 12), while the least were in summer (21.1%, n = 8) and fall (21.1%, n = 8). An overall χ(2) test found there was no difference in mortality for season (P = 0.55). Univariate analyses also found the age of patients who died vs lived was significantly higher (65.9 vs 58.1 years; P = 0.001), and a significantly greater (P = 0.029) percentage of patients with diabetes vs without diabetes died (41.7 vs 16.7%). Univariate analyses found all other covariates were not significantly related to mortality. In the multiple logistic regression model, there was no significant effect for season, while the odds of dying increased with age (odds ratio [OR] = 1.04, 95% confidence interval [95% CI] = 1.01-1.07, P = 0.012), and the odds of dying in the full-moon cycle vs the new moon cycle was significantly reduced (OR = 0.21, 95% CI = 0.05-0.81, P = 0.024). No other covariate significantly increased or decreased the odds of death, including diabetes risk, which had been significantly related to death in the univariate analysis. Within a linear regression model that examined the relationship with LOS, Group B (P = 0.020), male sex (P = 0.036) and the full-moon lunar phase (P = 0.001) were significantly related to shorter LOS. Season had no effect on mortality or LOS following aortic dissection repair, while patient age significantly increased the odds of death. The full-moon cycle appeared to reduce the odds of death, and the full-moon cycle, along with being male and requiring a concomitant cardiac procedure, was associated with shorter LOS.

Racial Differences in the Usage of Information Technology: Evidence from a National Physician Survey

PubMed Central

Lee, Doohee; Rutsohn, Phil

2012-01-01

Information technology (IT) is a key mechanism for improving the quality of healthcare and containing costs, but racial differences in the utilization of IT among practicing physicians are unknown. The current study, using a national physician survey (n = 6,628), investigated racial differences in the utilization of IT. White physicians and minority physicians were directly compared. We first conducted both descriptive and inferential analyses to detect the difference in IT utilization by race and then performed multiple logistic regressions to test whether race remains significant in relation to IT utilization. Results reveal racial differences in the usage of IT. Compared to their minority counterparts, white physicians underutilized a preventive service reminder system. On the other hand, white physicians favored utilizing electronic communications with patients and exchanging clinical data and images with other providers. PMID:22783155

Perceived Discrimination, Psychological Distress, and Current Smoking Status: Results From the Behavioral Risk Factor Surveillance System Reactions to Race Module, 2004–2008

PubMed Central

Peppone, Luke J.; Alcaraz, Kassandra; McQueen, Amy; Guido, Joseph J.; Carroll, Jennifer K.; Shacham, Enbal; Morrow, Gary R.

2012-01-01

Objectives. We examined the association between perceived discrimination and smoking status and whether psychological distress mediated this relationship in a large, multiethnic sample. Methods. We used 2004 through 2008 data from the Behavioral Risk Factor Surveillance System Reactions to Race module to conduct multivariate logistic regression analyses and tests of mediation examining associations between perceived discrimination in health care and workplace settings, psychological distress, and current smoking status. Results. Regardless of race/ethnicity, perceived discrimination was associated with increased odds of current smoking. Psychological distress was also a significant mediator of the discrimination–smoking association. Conclusions. Our results indicate that individuals who report discriminatory treatment in multiple domains may be more likely to smoke, in part, because of the psychological distress associated with such treatment. PMID:22420821

Seat Integrated and Conventional Restraints: A Study of Crash Injury/Fatality Rates in Rollovers

PubMed Central

Padmanaban, Jeya; Burnett, Roger A.

2008-01-01

This study used police-reported motor vehicle crash data from eleven states to determine ejection, fatality, and fatal/serious injury risks for belted drivers in vehicles with conventional seatbelts compared to belted drivers in vehicles with seat integrated restraint systems (SIRS). Risks were compared for 11,159 belted drivers involved in single- or multiple-vehicle rollover crashes. Simple driver ejection (partial and complete), fatality, and injury rates were derived, and logistic regression analyses were used to determine relative contribution of factors (including event calendar year, vehicle age, driver age/gender/alcohol use) that significantly influence the likelihood of fatality and fatal/serious injury to belted drivers in rollovers. Results show no statistically significant difference in driver ejection, fatality, or fatal/serious injury rates between vehicles with conventional belts and vehicles with SIRS. PMID:19026243

Physical and Sexual Violence and Incident Sexually Transmitted Infections

PubMed Central

Anand, Mallika; Redding, Colleen A.; Peipert, Jeffrey F.

2009-01-01

Abstract Objective To investigate whether women aged 13–35 who were victims of interpersonal violence were more likely than nonvictims to experience incident sexually transmitted infections (STIs). Methods We examined 542 women aged 13–35 enrolled in Project PROTECT, a randomized clinical trial that compared two different methods of computer-based intervention to promote the use of dual methods of contraception. Participants completed a baseline questionnaire that included questions about their history of interpersonal violence and were followed for incident STIs over the 2-year study period. We compared the incidence of STIs in women with and without a history of interpersonal violence using bivariate analyses and multiple logistic regression. Results In the bivariate analyses, STI incidence was found to be significantly associated with African American race/ethnicity, a higher number of sexual partners in the past month, and a lower likelihood of avoidance of sexual partners who pressure to have sex without a condom. In both crude and adjusted regression analyses, time to STI incidence was faster among women who reported physical or sexual abuse in the year before study enrollment (HRRadj = 1.68, 95% CI 1.06, 2.65). Conclusions Women with a recent history of abuse are at significantly increased risk of STI incidence than are nonvictims. PMID:19245303

Genetic variations in CYP17A1, CACNB2 and PLEKHA7 are associated with blood pressure and/or hypertension in She ethnic minority of China.

PubMed

Lin, Yinghua; Lai, Xiaolan; Chen, Bin; Xu, Yuan; Huang, Baoying; Chen, Zichun; Zhu, Shaoheng; Yao, Jin; Jiang, Qiqin; Huang, Huibin; Wen, Junping; Chen, Gang

2011-12-01

Two large-scale genome-wide association studies (GWAs) have identified multiple variants associated with blood pressure (BP) or hypertension. The present study was to investigate whether some variations were associated with BP traits and hypertension or even prehypertension in adult She ethnic minority of China. The population of the present study comprised 4460 (1979 males and 2481 females, respectively) unrelated she ethnic minority based on a cross-sectional study from Ningde City in Fujian province of China. There were 1692 hypertensives, 1600 prehypertensives and 1168 normotensive controls, respectively. We genotyped 7 variants in CYP17A1, PLEKHA7, CACNB2, ATP2B1, TBX3-TBX5, CSK-ULK3 and SH2B3 reported by the previous GWAs on Europeans. All analyses were performed in an additive genetic model. As the minor allele of rs653178 in/near SH2B3 was very rare with the frequency of 0.018, we excluded this single nucleotide polymorphism (SNP) in the further analyses. Of the other 6 loci, linear regression analyses revealed that rs11191548 in CYP17A1 and rs11014166 in CACNB2 were significantly associated with systolic BP (β = -1.17, P = 0.002 and β = -0.50, P = 0.006, respectively), while only SNP rs11191548 was significantly associated with diastolic BP (β = -0.56, P=0.002) after adjusted by age, sex and BMI. Two variants in CACNB2 and PLEKHA7 were found to be significantly related to hypertension (odds ratios [OR] and (95% confidence interval [CI]): 0.79 (0.65-0.97) and 1.19 (1.01-1.41), respectively) in logistic regression analyses after adjusted by age, sex and BMI. In addition, we found that combined risk alleles of the 6 SNPs increased risk of hypertension in a stepwise fashion (P for trend < 0.001). However, none of the 6 SNPs was significantly associated with BMI or prehypertension status. While logistic analysis showed that subjects with cumulative risk alleles more than 9 had significantly higher risk for prehypertension (adjusted OR: 3.10, P < 0.001) compared with those with risk alleles less than 4. We replicated that variations in CYP17A1, CACNB2 and PLEKHA7 were related to BP traits and/or hypertension in She population. In addition, although we failed to observe single gene associated with prehypertension, we first found that conjoint effect of multiple risk alleles on BP might increase the risk of progressing to prehypertension. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Coronary calcium in systemic lupus erythematosus is associated with traditional cardiovascular risk factors, but not with disease activity.

PubMed

Kiani, Adnan N; Magder, Laurence; Petri, Michelle

2008-07-01

Cardiovascular disease is a major cause of morbidity and mortality in systemic lupus erythematosus (SLE). The frequency of both subclinical and clinically evident atherosclerosis is greatly increased over healthy controls. We assessed cardiovascular risk factors present in patients with SLE at the baseline visit in a statin intervention trial and their correlation with coronary calcium. Coronary calcium was measured by helical computed tomography (continuous volumetric data acquisition in a single breath-hold) in 200 patients with SLE enrolled in the Lupus Atherosclerosis Prevention Study. Patients had a mean age of 44.3 +/- 11.4 years and were 92% women, 61% Caucasian, 34% African American, 2% Asian, and 2% Hispanic. Coronary calcium was found in 43%. In univariate analysis, coronary calcification was associated with age (p = 0.0001), hypertension (p = 0.0008), body mass index (BMI; p = 0.03), erythrocyte sedimentation rate (ESR; p = 0.03), anti-dsDNA (p = 0.067), and lipoprotein(a) (p = 0.03). Homocysteine (p = 0.050), high-sensitivity C-reactive protein (hsCRP; p = 0.053), and LDL (p = 0.048) had a stronger association when considered as quantitative predictors. In a multiple logistic regression model, only age (p 100. Based on a multiple logistic regression model, only age (p = 0.0017) and diabetes mellitus (p = 0.019) remained significant independent predictors of coronary calcium > 100. Inflammation, measured as ESR or hsCRP, is associated with coronary calcium only in univariate analyses. Age, BMI, and diabetes mellitus are more important associates of coronary calcium in SLE than inflammatory markers and SLE clinical activity.

Factors associated with women's autonomy regarding maternal and child health care utilization in Bale Zone: a community based cross-sectional study.

PubMed

Nigatu, Dabere; Gebremariam, Abebe; Abera, Muluemebet; Setegn, Tesfaye; Deribe, Kebede

2014-07-03

Women's autonomy in health-care decision is a prerequisite for improvements in maternal and child health. Little is known about women's autonomy and its influencing factors on maternal and child health care in Ethiopia. Therefore, this study was conducted to assess women's autonomy and identify associated factors in Southeast Ethiopia. A community based cross-sectional study was conducted from March 19th until March 28th, 2011. A total of 706 women were selected using stratified sampling technique from rural and urban kebeles. The quantitative data were collected by interviewer administered questionnaire and analyzed using SPSS for window version 16.0. Descriptive statistics, bivariate and multiple logistic regression analyses were carried out to identify factors associated with women's autonomy for health care utilization. Out of 706 women less than half (41.4%) had higher autonomy regarding their own and their children's health. In the multiple logistic regression model monthly household income >1000 ETB [adjusted odds ratio(AOR):3.32(95% C.I: 1.62-6.78)], having employed husband [AOR: 3.75 (95% C.I:1.24-11.32)], being in a nuclear family structure [AOR: 0.53(95% C.I: 0.33-0.87)], being in monogamous marriage [AOR: 3.18(95% C.I: 1.35-7.50)], being knowledgeable and having favorable attitude toward maternal and child health care services were independently associated with an increased odds of women's autonomy. Socio-demographic and maternal factors (knowledge and attitude) were found to influence women's autonomy. Interventions targeting women's autonomy with regards to maternal and child health care should focus on addressing increasing awareness and priority should be given to women with a lower socioeconomic status.

Frequency of early vascular aging and associated risk factors among an adult population in Latin America: the OPTIMO study.

PubMed

Botto, Fernando; Obregon, Sebastian; Rubinstein, Fernando; Scuteri, Angelo; Nilsson, Peter M; Kotliar, Carol

2018-03-01

The main objective was to estimate the frequency of early vascular aging (EVA) in a sample of subjects from Latin America, with emphasis in young adults. We included 1416 subjects from 12 countries in Latin America who provided information about lifestyle, cardiovascular risk factors (CVRF), and anthropometrics. We measured pulse wave velocity (PWV) as a marker of arterial stiffness, and blood pressure (BP) using an oscillometric device (Mobil-O-Graph). To determine the frequency of EVA, we used multiple linear regression to estimate each subject's PWV expected for his/her age and systolic BP, and compared with observed values to obtain standardized residuals (z-scores). We defined EVA when z-score was ≥1.96. Finally, a multivariable logistic regression analysis was performed to determine baseline characteristics associated with EVA. Mean age was 49.9 ± 15.5 years, male gender was 50.3%. Mean PWV was 7.52 m/s (SD 1.97), mean systolic BP was 125.3 mmHg (SD 16.7) and mean diastolic BP was 78.9 mmHg (SD 12.2). The frequency of EVA was 5.7% in the total population, 9.8% in adults of 40 years or less and 18.7% in those 30 years or less. In these young adults, multiple logistic regression analyses demonstrated that dyslipidemia and hypertension showed an independent association with EVA, and smoking a borderline association (p  =  0.07). In conclusion, the frequency of EVA in a sample from Latin America was around 6%, with higher rates in young adults. These results would support the search of CVRF and EVA during early adulthood.

Pregnant women with the sickle cell trait are not at increased risk for developing preeclampsia.

PubMed

Stamilio, David M; Sehdev, Harish M; Macones, George A

2003-01-01

The primary objective of this study was to determine whether having the sickle cell trait is independently associated with preeclampsia. We performed a retrospective cohort study of 1998 pregnant patients who either did or did not have the sickle cell trait. All patients were screened for the sickle trait using the "Sickledex" test. Data on neonatal and maternal outcome, including preeclampsia, and potential confounding variables were abstracted from medical records. Unadjusted, stratified, and multiple logistic regression analyses were used to identify interactions, and confounding between multiple variables and the association between sickle cell trait and preeclampsia. With an anticipated 6.5% rate of preeclampsia, and alpha = 0.05, this cohort study has 80% power to detect a relative risk (RR) of 2.3 for preeclampsia. Univariate analysis revealed that the two cohorts were similar with regard to primiparity, maternal age, chronic diseases, birth weight, and gestational age at delivery, but the sickle cell trait cohort was more likely to have gestational diabetes and had a higher mean body mass index (BMI). In the univariate analysis, the sickle cell trait cohort was not at increased risk for preeclampsia [unadjusted RR = 0.5, 95% CI (0.2-1.6)]. After controlling for potential confounding variables with logistic regression analysis, sickle trait was not independently associated with preeclampsia [adjusted RR = 0.5, 95% CI (0.2- 1.6)]. In contrast to prior work, these data suggest that the sickle cell trait is not an independent risk factor for preeclampsia or postpartum complications. In fact, the data are more consistent with the sickle trait being protective for developing preeclampsia.

Relationship between dental caries status, nutritional status, snack foods, and sugar-sweetened beverages consumption among primary schoolchildren grade 4-6 in Nongbua Khamsaen school, Na Klang district, Nongbua Lampoo Province, Thailand.

PubMed

Lueangpiansamut, Juthamas; Chatrchaiwiwatana, Supaporn; Muktabhant, Benja; Inthalohit, Warangkana

2012-08-01

To evaluate relationship between dental caries status, nutritional status, snack foods, and sugar-sweetened beverages consumption among primary schoolchildren grade 4-6 in Na Klang district, Nongbua Lampoo province, Thailand in 2011. The subjects included 111 children (57 boys and 54 girls), aged 11 and 12 years, who were studying in grades 4 to 6 in the year 2011. The data were collected through questionnaires, interview, and oral examination. Results were obtained by means of descriptive, bivariate, and multiple logistic regression analyses. Prevalence of dental caries in the children was 82.9% with the mean DMFT of 2.28. The dental caries prevalence in permanent and primary dentitions was 69.4% and 34.2%, respectively. About 10.2% of the children were underweight, 13.0% were obese, and 7.5% were stunting. Findings from the final multiple logistic regression models showed that weight-for-age malnutrition as well as eating sweets before bedtime were significantly related to dental caries in primary dentition, with the adjusted odds ratio (95% CI) being 6.68 (1.57, 28.41) and 5.34 (1.60, 17.77), respectively. Family income was significantly related to permanent dental caries with the odds ratio (95% CI) being 9.60 (1.89, 48.59). Nutritional status is associated with dental caries among these elementary schoolchildren. Larger studies extending to cover other elementary schools in Na Klang district should be conducted so that the results will be representative of all elementary schools in Na Klang district, Nongbua Lampoo province.

Resilience moderates the risk of depression and anxiety symptoms on suicidal ideation in patients with depression and/or anxiety disorders.

PubMed

Min, Jung-Ah; Lee, Chang-Uk; Chae, Jeong-Ho

2015-01-01

Few studies have investigated the role of protective factors for suicidal ideation, which include resilience and social support among psychiatric patients with depression and/or anxiety disorders who are at increased risk of suicide. Demographic data, history of childhood maltreatment, and levels of depression, anxiety, problematic alcohol use, resilience, perceived social support, and current suicidal ideation were collected from a total of 436 patients diagnosed with depression and/or anxiety disorders. Hierarchical multiple logistic regression analyses were used to identify the independent and interaction effects of potentially influencing factors. Moderate-severe suicidal ideation was reported in 24.5% of our sample. After controlling for relevant covariates, history of emotional neglect and sexual abuse, low resilience, and high depression and anxiety symptoms were sequentially included in the model. In the final model, high depression (adjusted odds ratio (OR)=9.33, confidence interval (CI) 3.99-21.77) and anxiety (adjusted OR=2.62, CI=1.24-5.53) were independently associated with moderate-severe suicidal ideation among risk factors whereas resilience was not. In the multiple logistic regression model that examined interaction effects between risk and protective factors, the interactions between resilience and depression (p<.001) and between resilience and anxiety were significant (p=.021). A higher level of resilience was protective against moderate-severe suicide ideation among those with higher levels of depression or anxiety symptoms. Our results indicate that resilience potentially moderates the risk of depression and anxiety symptoms on suicidal ideation in patients with depression and/or anxiety disorders. Assessment of resilience and intervention focused on resilience enhancement is suggested for suicide prevention. Copyright © 2014 Elsevier Inc. All rights reserved.

Principal component analysis of early alcohol, drug and tobacco use with major depressive disorder in US adults.

PubMed

Wang, Kesheng; Liu, Ying; Ouedraogo, Youssoufou; Wang, Nianyang; Xie, Xin; Xu, Chun; Luo, Xingguang

2018-05-01

Early alcohol, tobacco and drug use prior to 18 years old are comorbid and correlated. This study included 6239 adults with major depressive disorder (MDD) in the past year and 72,010 controls from the combined data of 2013 and 2014 National Survey on Drug Use and Health (NSDUH). To deal with multicollinearity existing among 17 variables related to early alcohol, tobacco and drug use prior to 18 years old, we used principal component analysis (PCA) to infer PC scores and then use weighted multiple logistic regression analyses to estimate the associations of potential factors and PC scores with MDD. The odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. The overall prevalence of MDD was 6.7%. The first four PCs could explain 57% of the total variance. Weighted multiple logistic regression showed that PC 1 (a measure of psychotherapeutic drugs and illicit drugs other than marijuana use), PC 2 (a measure of cocaine and hallucinogens), PC 3 (a measure of early alcohol, cigarettes, and marijuana use), and PC 4 (a measure of cigar, smokeless tobacco use and illicit drugs use) revealed significant associations with MDD (OR = 1.12, 95% CI = 1.08-1.16, OR = 1.08, 95% CI = 1.04-1.12, OR = 1.13, 95% CI = 1.07-1.18, and OR = 1.15, 95% CI = 1.09-1.21, respectively). In conclusion, PCA can be used to reduce the indicators in complex survey data. Early alcohol, tobacco and drug use prior to 18 years old were found to be associated with increased odds of adult MDD. Copyright © 2018 Elsevier Ltd. All rights reserved.

The association of alcohol consumption with patient survival after organophosphate poisoning: a multicenter retrospective study.

PubMed

Lee, Young Hwan; Oh, Young Taeck; Lee, Won Woong; Ahn, Hee Cheol; Sohn, You Dong; Ahn, Ji Yun; Min, Yong Hun; Kim, Hyun; Lim, Seung Wook; Lee, Kui Ja; Shin, Dong Hyuk; Park, Sang O; Park, Seung Min

2017-06-01

Organophosphate (OP) intoxication remains a serious worldwide health concern, and many patients with acute OP intoxication have also consumed alcohol. Therefore, we evaluated the association of blood alcohol concentration (BAC) with mortality among patients with OP intoxication. We retrospectively reviewed records from 135 patients who were admitted to an emergency department (ED) for OP intoxication between January 2000 and December 2012. Factors that were associated with patient survival were identified via receiver operating characteristic curve, multiple logistic regression, and Kaplan-Meier survival analyses. Among 135 patients with acute OP poisoning, 112 patients survived (overall mortality rate: 17 %). The non-survivors also exhibited a significantly higher BAC, compared to the survivors [non-survivors: 192 mg/dL, interquartile range (IQR) 97-263 mg/dL vs. survivors: 80 mg/dL, IQR 0-166.75 mg/dL; p < 0.001]. A BAC cut-off value of 173 mg/dL provided an area under the curve of 0.744 [95 % confidence interval (CI) 0.661-0.815], a sensitivity of 65.2 %, and a specificity of 81.2 %. A BAC of >173 mg/dL was associated with a significantly increased risk of 6-month mortality in the multiple logistic regression model (odds ratio 4.92, 95 % CI 1.45-16.67, p = 0.001). The Cox proportional hazard model revealed that a BAC of >173 mg/dL provided a hazard ratio of 3.07 (95 % CI 1.19-7.96, p = 0.021). A BAC of >173 mg/dL is a risk factor for mortality among patients with OP intoxication.

Factors associated with women’s autonomy regarding maternal and child health care utilization in Bale Zone: a community based cross-sectional study

PubMed Central

2014-01-01

Background Women's autonomy in health-care decision is a prerequisite for improvements in maternal and child health. Little is known about women’s autonomy and its influencing factors on maternal and child health care in Ethiopia. Therefore, this study was conducted to assess women’s autonomy and identify associated factors in Southeast Ethiopia. Method A community based cross-sectional study was conducted from March 19th until March 28th, 2011. A total of 706 women were selected using stratified sampling technique from rural and urban kebeles. The quantitative data were collected by interviewer administered questionnaire and analyzed using SPSS for window version 16.0. Descriptive statistics, bivariate and multiple logistic regression analyses were carried out to identify factors associated with women’s autonomy for health care utilization. Result Out of 706 women less than half (41.4%) had higher autonomy regarding their own and their children’s health. In the multiple logistic regression model monthly household income >1000 ETB [adjusted odds ratio(AOR):3.32(95% C.I: 1.62-6.78)], having employed husband [AOR: 3.75 (95% C.I:1.24-11.32)], being in a nuclear family structure [AOR: 0.53(95% C.I: 0.33-0.87)], being in monogamous marriage [AOR: 3.18(95% C.I: 1.35-7.50)], being knowledgeable and having favorable attitude toward maternal and child health care services were independently associated with an increased odds of women’s autonomy. Conclusion Socio-demographic and maternal factors (knowledge and attitude) were found to influence women’s autonomy. Interventions targeting women’s autonomy with regards to maternal and child health care should focus on addressing increasing awareness and priority should be given to women with a lower socioeconomic status. PMID:24990689

Explaining match outcome in elite Australian Rules football using team performance indicators.

PubMed

Robertson, Sam; Back, Nicole; Bartlett, Jonathan D

2016-01-01

The relationships between team performance indicators and match outcome have been examined in many team sports, however are limited in Australian Rules football. Using data from the 2013 and 2014 Australian Football League (AFL) regular seasons, this study assessed the ability of commonly reported discrete team performance indicators presented in their relative form (standardised against their opposition for a given match) to explain match outcome (Win/Loss). Logistic regression and decision tree (chi-squared automatic interaction detection (CHAID)) analyses both revealed relative differences between opposing teams for "kicks" and "goal conversion" as the most influential in explaining match outcome, with two models achieving 88.3% and 89.8% classification accuracies, respectively. Models incorporating a smaller performance indicator set displayed a slightly reduced ability to explain match outcome (81.0% and 81.5% for logistic regression and CHAID, respectively). However, both were fit to 2014 data with reduced error in comparison to the full models. Despite performance similarities across the two analysis approaches, the CHAID model revealed multiple winning performance indicator profiles, thereby increasing its comparative feasibility for use in the field. Coaches and analysts may find these results useful in informing strategy and game plan development in Australian Rules football, with the development of team-specific models recommended in future.

Variation in the prevalence of chronic bronchitis among smokers: a cross-sectional study.

PubMed

Mahesh, P A; Jayaraj, B S; Chaya, S K; Lokesh, K S; McKay, A J; Prabhakar, A K; Pape, U J

2014-07-01

Given the wide variations in prevalence of chronic obstructive pulmonary disease observed between populations with similar levels of exposure to tobacco smoke, we aimed to investigate the possibility of variations in prevalence of chronic bronchitis (CB) between two geographically distinct smoking populations in rural Karnataka, India. The Burden of Obstructive Lung Disease (BOLD) questionnaire was administered to all men aged >30 years in a cross-sectional survey. The χ(2) and Fisher's exact tests were used to compare CB prevalence in the two populations. Logistic regression was used to analyse the impact of multiple variables on the occurrence of CB. Two samples of 2322 and 2182 subjects were included in the study. In non-smokers, CB prevalence did not differ between the populations. However, it was significantly different between smoking populations (44.79% vs. 2.13%, P < 0.0001). Logistic regression indicated that, in addition to smoking, region, age, occupational dust exposure and type of house were associated with higher likelihood of CB. An interaction between smoking and area of residence was found (P < 0.001) and appeared to explain the effect of region (without interaction). A significant difference in CB prevalence was observed between male populations from two areas of Karnataka state, including when stratified by smoking status. No significant difference was observed between non-smokers.

Development and evaluation of an electromagnetic hypersensitivity questionnaire for Japanese people

PubMed Central

Tokiya, Mikiko; Mizuki, Masami; Miyata, Mikio; Kanatani, Kumiko T.; Takagi, Airi; Tsurikisawa, Naomi; Kame, Setsuko; Katoh, Takahiko; Tsujiuchi, Takuya; Kumano, Hiroaki

2016-01-01

The purpose of the present study was to evaluate the validity and reliability of a Japanese version of an electromagnetic hypersensitivity (EHS) questionnaire, originally developed by Eltiti et al. in the United Kingdom. Using this Japanese EHS questionnaire, surveys were conducted on 1306 controls and 127 self‐selected EHS subjects in Japan. Principal component analysis of controls revealed eight principal symptom groups, namely, nervous, skin‐related, head‐related, auditory and vestibular, musculoskeletal, allergy‐related, sensory, and heart/chest‐related. The reliability of the Japanese EHS questionnaire was confirmed by high to moderate intraclass correlation coefficients in a test–retest analysis, and high Cronbach's α coefficients (0.853–0.953) from each subscale. A comparison of scores of each subscale between self‐selected EHS subjects and age‐ and sex‐matched controls using bivariate logistic regression analysis, Mann–Whitney U‐ and χ 2 tests, verified the validity of the questionnaire. This study demonstrated that the Japanese EHS questionnaire is reliable and valid, and can be used for surveillance of EHS individuals in Japan. Furthermore, based on multiple logistic regression and receiver operating characteristic analyses, we propose specific preliminary criteria for screening EHS individuals in Japan. Bioelectromagnetics. 37:353–372, 2016. © 2016 The Authors. Bioelectromagnetics Published by Wiley Periodicals, Inc. PMID:27324106

Association between oral health behavior and periodontal disease among Korean adults

PubMed Central

Han, Kyungdo; Park, Jun-Beom

2017-01-01

Abstract This study was performed to assess the association between oral health behavior and periodontal disease using nationally representative data. This study involved a cross-sectional analysis and multivariable logistic regression analysis models using the data from the Korean National Health and Nutrition Examination Survey. A community periodontal index greater than or equal to code 3 was used to define periodontal disease. Adjusted odds ratios and their 95% confidence intervals of periodontitis for the toothbrushing after lunch group and the toothbrushing before bedtime group were 0.842 (0.758, 0.936) and 0.814 (0.728, 0.911), respectively, after adjustments for age, sex, body mass index, drinking, exercise, education, income, white blood cell count, and metabolic syndrome. Adjusted odds ratios and their 95% confidence intervals of periodontitis for the floss group and the powered toothbrush group after adjustment were 0.678 (0.588, 0.781) and 0.771 (0.610, 0.974), respectively. The association between oral health behavior and periodontitis was proven by multiple logistic regression analyses after adjusting for confounding factors among Korean adults. Brushing after lunch and before bedtime as well as the use of floss and a powered toothbrush may be considered independent risk indicators of periodontal disease among Korean adults. PMID:28207558

Habitat features and predictive habitat modeling for the Colorado chipmunk in southern New Mexico

USGS Publications Warehouse

Rivieccio, M.; Thompson, B.C.; Gould, W.R.; Boykin, K.G.

2003-01-01

Two subspecies of Colorado chipmunk (state threatened and federal species of concern) occur in southern New Mexico: Tamias quadrivittatus australis in the Organ Mountains and T. q. oscuraensis in the Oscura Mountains. We developed a GIS model of potentially suitable habitat based on vegetation and elevation features, evaluated site classifications of the GIS model, and determined vegetation and terrain features associated with chipmunk occurrence. We compared GIS model classifications with actual vegetation and elevation features measured at 37 sites. At 60 sites we measured 18 habitat variables regarding slope, aspect, tree species, shrub species, and ground cover. We used logistic regression to analyze habitat variables associated with chipmunk presence/absence. All (100%) 37 sample sites (28 predicted suitable, 9 predicted unsuitable) were classified correctly by the GIS model regarding elevation and vegetation. For 28 sites predicted suitable by the GIS model, 18 sites (64%) appeared visually suitable based on habitat variables selected from logistic regression analyses, of which 10 sites (36%) were specifically predicted as suitable habitat via logistic regression. We detected chipmunks at 70% of sites deemed suitable via the logistic regression models. Shrub cover, tree density, plant proximity, presence of logs, and presence of rock outcrop were retained in the logistic model for the Oscura Mountains; litter, shrub cover, and grass cover were retained in the logistic model for the Organ Mountains. Evaluation of predictive models illustrates the need for multi-stage analyses to best judge performance. Microhabitat analyses indicate prospective needs for different management strategies between the subspecies. Sensitivities of each population of the Colorado chipmunk to natural and prescribed fire suggest that partial burnings of areas inhabited by Colorado chipmunks in southern New Mexico may be beneficial. These partial burnings may later help avoid a fire that could substantially reduce habitat of chipmunks over a mountain range.

Nursing workload in intensive care unit trauma patients: analysis of associated factors.

PubMed

Nogueira, Lilia de Souza; Domingues, Cristiane de Alencar; Poggetti, Renato Sérgio; de Sousa, Regina Marcia Cardoso

2014-01-01

From the perspective of nurses, trauma patients in the Intensive Care Unit (ICU) demand a high degree of nursing workload due to hemodynamic instability and the severity of trauma injuries. This study aims to identify the factors related to the high nursing workload required for trauma victims admitted to the ICU. This is a prospective, cross-sectional study using descriptive and correlation analyses, conducted with 200 trauma patients admitted to an ICU in the city of São Paulo, Brazil. The nursing workload was measured using the Nursing Activities Score (NAS). The distribution of the NAS values into tertiles led to the identification of two research groups: medium/low workload and high workload. The Chi-square, Fisher's exact, Mann-Whitney and multiple logistic regression tests were utilized for the analyses. The majority of patients were male (82.0%) and suffered blunt trauma (94.5%), with traffic accidents (57.5%) and falls (31.0%) being prevalent. The mean age was 40.7 years (± 18.6) and the mean NAS was 71.3% (± 16.9). Patient gender, the presence of pulmonary failure, the number of injured body regions and the risk of death according to the Simplified Acute Physiology Score II were factors associated with a high degree of nursing workload in the first 24 hours following admission to the ICU. Workload demand was higher in male patients with physiological instability and multiple severe trauma injuries who developed pulmonary failure.

Alcohol dependence and physical comorbidity: Increased prevalence but reduced relevance of individual comorbidities for hospital-based mortality during a 12.5-year observation period in general hospital admissions in urban North-West England.

PubMed

Schoepf, D; Heun, R

2015-06-01

Alcohol dependence (AD) is associated with an increase in physical comorbidities. The effects of these diseases on general hospital-based mortality are unclear. Consequently, we conducted a mortality study in which we investigated if the burden of physical comorbidities and their relevance on general hospital-based mortality differs between individuals with and without AD during a 12.5-year observation period in general hospital admissions. During 1 January 2000 and 30 June 2012, 23,371 individuals with AD were admitted at least once to seven General Manchester Hospitals. Their physical comorbidities with a prevalence≥1% were compared to those of 233,710 randomly selected hospital controls, group-matched for age and gender (regardless of primary admission diagnosis or specialized treatments). Physical comorbidities that increased the risk of hospital-based mortality (but not outside of the hospital) during the observation period were identified using multiple logistic regression analyses. Hospital-based mortality rates were 20.4% in the AD sample and 8.3% in the control sample. Individuals with AD compared to controls had a higher burden of physical comorbidities, i.e. alcoholic liver and pancreatic diseases, diseases of the conducting airways, neurological and circulatory diseases, diseases of the upper gastrointestinal tract, renal diseases, cellulitis, iron deficiency anemia, fracture neck of femur, and peripheral vascular disease. In contrast, coronary heart related diseases, risk factors of cardiovascular disease, diverticular disease and cataracts were less frequent in individuals with AD than in controls. Thirty-two individual physical comorbidities contributed to the prediction of hospital-based mortality in univariate analyses in the AD sample; alcoholic liver disease (33.7%), hypertension (16.9%), chronic obstructive pulmonary disease (14.1%), and pneumonia (13.3%) were the most frequent diagnoses in deceased individuals with AD. Multiple forward logistic regression analysis, accounting for possible associations of diseases, identified twenty-three physical comorbidities contributing to hospital-based mortality in individuals with AD. However, all these comorbidities had an equal or even lower impact on hospital-based mortality than in the comparison sample. The excess of in-hospital deaths in general hospitals in individuals with AD is due to an increase of multiple physical comorbidities, even though individual diseases have an equal or even reduced impact on general hospital-based mortality in individuals with AD compared to controls. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Brucellosis in pregnant women from Pakistan: an observational study.

PubMed

Ali, Shahzad; Akhter, Shamim; Neubauer, Heinrich; Scherag, André; Kesselmeier, Miriam; Melzer, Falk; Khan, Iahtasham; El-Adawy, Hosny; Azam, Asima; Qadeer, Saima; Ali, Qurban

2016-09-02

Brucella species occasionally cause spontaneous human abortion. Brucella can be transmitted commonly through the ingestion of raw milk or milk products. The objective of this study was to determine the sero-prevalence of and to identify potential risk factors for brucellosis in pregnant women from Rawalpindi, Pakistan. We conducted a cross-sectional study at the Gynecology Outdoor Patient department of the Benazir Bhutto Hospital, Rawalpindi, Pakistan from March to June 2013. Data related to potential risk factors and clinical history was collected by individual interviews on the blood sampling day. The 429 serum samples collected were initially screened by Rose Bengal Plate Agglutination test for the detection of Brucella antibodies. We applied standard descriptive statistics and logistic regression analyses. Twenty five (5.8 %; 95 % confidence interval (CI): 3.8 % -8.5 %) serum samples were found to be seropositive. Brucellosis-related clinical symptoms were recorded in various seropositive cases. Animal contact, raw milk consumption, having an abortion history and the experience of an intrauterine fetal death were associated with seropositivity for brucellosis in univariate analyses (all p <0.05). In multiple logistic regression models only the contact with animals remained as independent and robust risk factor (odds ratio 5.21; 95 % CI: 1.88-13.75; p = 0.001) for seropositivity. Brucellosis is a serious threat for pregnant women and their unborn children in Pakistan. Pregnant women having brucellosis-related symptoms or previous history of abortions, miscarriages, intrauterine fetal death and other brucellosis-related manifestations should be screened for brucellosis - especially those exposed to animals given the increased risk - and medication should be administered according to state of the art.

Subjective quality of life and suicidal behavior among Taiwanese schizophrenia patients.

PubMed

Kao, Yu-Chen; Liu, Yia-Ping; Cheng, Tsung-Hsing; Chou, Ming-Kuen

2012-04-01

Research of suicidal behavior in individuals with schizophrenia has often suggested that clinical characteristics and symptoms likely influence a patient's suicidal risk. However, there is a lack of research describing the link between patients' subjective quality of life (SQOL) and suicidal behavior in non-Western countries. Therefore, the current study attempts to explore how schizophrenia patients' SQOL and their suicidal behavior are related in a Taiwanese sample. In this study, 102 schizophrenia outpatients were investigated using the Taiwanese World Health Organization Quality of Life Schedule-Brief Version (WHO-QOL-BREF-TW), several Beck-Related symptom rating scales, and the Positive and Negative Syndrome Scale (PANSS) for psychopathology. These patients were also evaluated for suicidal risk using the critical items of the Scale for Suicide Ideation (SSI) and lifetime suicide attempts. Statistical analyses, including independent sample t tests, analysis of covariance (ANCOVA) and logistic stepwise regression models were completed. Compared with the non-suicidal group, suicidal patients had significantly lower scores in SQOL domains. The differences in social domain remained significant after adjusting for depressive symptoms. In multiple logistic regression analyses, level of depressive and psychotic symptoms increased and poor social and psychological SQOL were significant contributors to suicidal behavior. Having removed depressive symptoms from the model, only dissatisfaction with social SQOL was associated with heightened suicidal risk. Schizophrenia is associated with a high suicidal risk, of which depressive and psychotic symptoms are the major correlates. Again, the present study confirms and extends previous research showing that dissatisfied SQOL, particularly dissatisfaction with social relationships, should be considered in the assessment of suicidal risk in outpatients with schizophrenia, even when accounting other possible confounding factor such as depression.

Coping Styles in Heart Failure Patients with Depressive Symptoms

PubMed Central

Trivedi, Ranak B.; Blumenthal, James A.; O'Connor, Christopher; Adams, Kirkwood; Hinderliter, Alan; Sueta-Dupree, Carla; Johnson, Kristy; Sherwood, Andrew

2009-01-01

Objective Elevated depressive symptoms have been linked to poorer prognosis in heart failure (HF) patients. Our objective was to identify coping styles associated with depressive symptoms in HF patients. Methods 222 stable HF patients (32.75% female, 45.4% non-Hispanic Black) completed multiple questionnaires. Beck Depression Inventory (BDI) assessed depressive symptoms, Life Orientation Test (LOT-R) assessed optimism, ENRICHD Social Support Inventory (ESSI) and Perceived Social Support Scale (PSSS) assessed social support, and COPE assessed coping styles. Linear regression analyses were employed to assess the association of coping styles with continuous BDI scores. Logistic regression analyses were performed using BDI scores dichotomized into BDI<10 versus BDI≥10, to identify coping styles accompanying clinically significant depressive symptoms. Results In linear regression models, higher BDI scores were associated with lower scores on the acceptance (β=-.14), humor (β=-.15), planning (β=-.15), and emotional support (β=-.14) subscales of the COPE, and higher scores on the behavioral disengagement (β=.41), denial (β=.33), venting (β=.25), and mental disengagement (β=.22) subscales. Higher PSSS and ESSI scores were associated with lower BDI scores (β=-.32 and -.25, respectively). Higher LOT-R scores were associated with higher BDI scores (β=.39, p<.001). In logistical regression models, BDI≥10 was associated with greater likelihood of behavioral disengagement (OR=1.3), denial (OR=1.2), mental disengagement (OR=1.3), venting (OR=1.2), and pessimism (OR=1.2), and lower perceived social support measured by PSSS (OR=.92) and ESSI (OR=.92). Conclusion Depressive symptoms in HF patients are associated with avoidant coping, lower perceived social support, and pessimism. Results raise the possibility that interventions designed to improve coping may reduce depressive symptoms. PMID:19773027

Different effort constructs and effort-reward imbalance: effects on employee well-being in ancillary health care workers.

PubMed

van Vegchel, N; de Jonge, J; Meijer, T; Hamers, J P

2001-04-01

The present study investigates the relationship between Effort-Reward Imbalance (ERI) and employee well-being, using three different concepts of efforts (i.e. psychological demands, physical demands and emotional demands). The ERI model had been used as a theoretical framework, indicating that work stress is related to high efforts (i.e. job demands) and low occupational rewards (e.g. money, esteem and security/career opportunities). The ERI model also predicts that, in overcommitted workers, effects of ERI on employee well-being are stronger compared with their less committed counterparts. A cross-sectional survey among 167 ancillary health care workers of two nursing homes was conducted. Multiple univariate logistic regression analyses were used to test the relationship between ERI and employee well-being. Results of the logistic regression analyses showed that employees with both high (psychological, physical and emotional) efforts and low rewards had higher risks of psychosomatic health complaints, physical health symptoms and job dissatisfaction (odds ratios (ORs) ranged from 5.09 to 18.55). Moreover, employees who reported both high efforts and high rewards had elevated risks of physical symptoms and exhaustion (ORs ranged from 6.17 to 9.39). No support was found for the hypothesis on the moderating effect of overcommitment. Results show some support for the ERI model; ancillary health care workers with high effort/low reward imbalance had elevated risks of poor employee well-being. In addition, results show that the combination of high efforts and high rewards is important for employee well-being. Finally, some practical implications are discussed to combat work stress in health care work.

The Association between Cumulative Psychosocial Risk and Cervical HPV Infection Among Female Adolescents in a Free Vaccination Program

PubMed Central

Linares, Lourdes Oriana; Shankar, Viswanathan; Diaz, Angela; Nucci-Sack, Anne; Strickler, Howard D.; Peake, Ken; Weiss, Jocelyn; Burk, Robert D.; Schlecht, Nicolas F.

2016-01-01

Objective This study investigated the association of cervical Human Papillomavirus (HPV) infection with cumulative psychosocial risk reflecting family disadvantage, psychological distress, and unhealthy life style. Methods The sample (N=745) was comprised of sexually-active female adolescent patients (12-19 years), primarily ethnic minorities, enrolled in a free HPV vaccination program. Subjects completed questionnaires and provided cervical swabs for HPV DNA testing. Unweighted and weighted Principal Component Analyses (PCA) for categorical data were used to derive multi-systemic psychosocial risk indices using nine indicators: low socioeconomic status, lack of adult involvement, not attending high-school/college, history of treatment for depression/anxiety, antisocial/delinquent behavior, number of recent sexual partners, use of alcohol, use of drugs, and dependency risk for alcohol/drugs. The association between cervical HPV (any-type, high risk-types, vaccine-types) assayed by polymerase chain reaction and self-reported number of psychosocial risk indicators was estimated using multivariable logistic regression. Results Subjects had a median of three psychosocial risk indicators. Multiple logistic regression analyses showed associations with unweighted and weighted number of psychosocial indicators for HPV any-type (adjusted odds ratio [aOR]=1.1; 95% confidence interval [CI]: 1.0-1.2 ); with the strongest associations between weighted drug/alcohol use, drug/alcohol dependency risk, and antisocial/delinquent behavior and detection of HPV vaccine-types (aOR=1.5; 95%CI: 1.1-2.0) independent of number of recent sexual partners and vaccine dose (0-3). Conclusion Increased HPV infections including HPV vaccine-types were associated with greater number of psychosocial risk indicators even after controlling for demographics, sexual behavior, history of chlamydia, and vaccine dose. PMID:25985216

Direct and indirect associations between the family physical activity environment and sports participation among 10-12 year-old European children: testing the EnRG framework in the ENERGY project.

PubMed

Timperio, Anna F; van Stralen, Maartje M; Brug, Johannes; Bere, Elling; Chinapaw, Mai J M; De Bourdeaudhuij, Ilse; Jan, Nataša; Maes, Lea; Manios, Yannis; Moreno, Luis A; Salmon, Jo; Te Velde, Saskia J

2013-02-03

Sport participation makes an important contribution to children's overall physical activity. Understanding influences on sports participation is important and the family environment is considered key, however few studies have explored the mechanisms by which the family environment influences children's sport participation. The purpose of this study was to examine whether attitude, perceived behavioural control, health belief and enjoyment mediate associations between the family environment and 10-12 year-old children's sports participation. Children aged 10-12 years ( = 7,234) and one of their parents (n = 6,002) were recruited from 175 schools in seven European countries in 2010. Children self-reported their weekly duration of sports participation, physical activity equipment items at home and the four potential mediator variables. Parents responded to items on financial, logistic and emotional support, reinforcement, modelling and co-participation in physical activity. Cross-sectional single and multiple mediation analyses were performed for 4952 children with complete data using multi-level regression analyses. Availability of equipment (OR = 1.16), financial (OR = 1.53), logistic (OR = 1.47) and emotional (OR = 1.51) support, and parental modelling (OR = 1.07) were positively associated with participation in ≥  30 mins/wk of sport. Attitude, beliefs, perceived behavioural control and enjoyment mediated and explained between 21-34% of these associations. Perceived behavioural control contributed the most to the mediated effect for each aspect of the family environment. Both direct (unmediated) and indirect (mediated) associations were found between most family environment variables and children's sports participation. Thus, family-based physical activity interventions that focus on enhancing the family environment to support children's sport participation are warranted.

Coping styles in heart failure patients with depressive symptoms.

PubMed

Trivedi, Ranak B; Blumenthal, James A; O'Connor, Christopher; Adams, Kirkwood; Hinderliter, Alan; Dupree, Carla; Johnson, Kristy; Sherwood, Andrew

2009-10-01

Elevated depressive symptoms have been linked to poorer prognosis in heart failure (HF) patients. Our objective was to identify coping styles associated with depressive symptoms in HF patients. A total of 222 stable HF patients (32.75% female, 45.4% non-Hispanic black) completed multiple questionnaires. Beck Depression Inventory (BDI) assessed depressive symptoms, Life Orientation Test (LOT-R) assessed optimism, ENRICHD Social Support Inventory (ESSI) and Perceived Social Support Scale (PSSS) assessed social support, and COPE assessed coping styles. Linear regression analyses were employed to assess the association of coping styles with continuous BDI scores. Logistic regression analyses were performed using BDI scores dichotomized into BDI<10 vs. BDI> or =10, to identify coping styles accompanying clinically significant depressive symptoms. In linear regression models, higher BDI scores were associated with lower scores on the acceptance (beta=-.14), humor (beta=-.15), planning (beta=-.15), and emotional support (beta=-.14) subscales of the COPE, and higher scores on the behavioral disengagement (beta=.41), denial (beta=.33), venting (beta=.25), and mental disengagement (beta=.22) subscales. Higher PSSS and ESSI scores were associated with lower BDI scores (beta=-.32 and -.25, respectively). Higher LOT-R scores were associated with higher BDI scores (beta=.39, P<.001). In logistical regression models, BDI> or =10 was associated with greater likelihood of behavioral disengagement (OR=1.3), denial (OR=1.2), mental disengagement (OR=1.3), venting (OR=1.2), and pessimism (OR=1.2), and lower perceived social support measured by PSSS (OR=.92) and ESSI (OR=.92). Depressive symptoms in HF patients are associated with avoidant coping, lower perceived social support, and pessimism. Results raise the possibility that interventions designed to improve coping may reduce depressive symptoms.

A cross-sectional survey to evaluate knowledge, attitudes and practices (KAP) regarding seasonal influenza vaccination among European travellers to resource-limited destinations

PubMed Central

2010-01-01

Background Influenza is one of the most common vaccine-preventable diseases in travellers. By performing two cross-sectional questionnaire surveys during winter 2009 and winter 2010 among European travellers to resource-limited destinations, we aimed to investigate knowledge, attitudes and practices (KAP) regarding seasonal influenza vaccination. Methods Questionnaires were distributed in the waiting room to the visitors of the University of Zurich Centre for Travel' Health (CTH) in January and February 2009 and January 2010 prior to travel health counselling (CTH09 and CTH10). Questions included demographic data, travel-related characteristics and KAP regarding influenza vaccination. Data were analysed by using SPSS® version 14.0 for Windows. Differences in proportions were compared using the Chi-square test and the significance level was set at p ≤ 0.05. Predictors for seasonal and pandemic influenza vaccination were determined by multiple logistic regression analyses. Results With a response rate of 96.6%, 906 individuals were enrolled and 868 (92.5%) provided complete data. Seasonal influenza vaccination coverage was 13.7% (n = 119). Only 43 (14.2%) participants were vaccinated against pandemic influenza A/H1N1, mostly having received both vaccines simultaneously, the seasonal and pandemic one. Job-related purposes (44, 37%), age > 64 yrs (25, 21%) and recommendations of the family physician (27, 22.7%) were the most often reported reasons for being vaccinated. In the multiple logistic regression analyses of the pooled data increasing age (OR = 1.03, 95% CI 1.01 - 1.04), a business trip (OR = 0.39, 95% CI 0.17 - 0.92) and seasonal influenza vaccination in the previous winter seasons (OR = 12.91, 95% CI 8.09 - 20.58) were independent predictors for seasonal influenza vaccination in 2009 or 2010. Influenza vaccination recommended by the family doctor (327, 37.7%), travel to regions with known high risk of influenza (305, 35.1%), and influenza vaccination required for job purposes (233, 26.8%) were most frequently mentioned to consider influenza vaccination. Conclusions Risk perception and vaccination coverage concerning seasonal and pandemic influenza was very poor among travellers to resource-limited destinations when compared to traditional at-risk groups. Previous access to influenza vaccination substantially facilitated vaccinations in the subsequent year. Information strategies about influenza should be intensified and include health professionals, e.g. family physicians, travel medicine practitioners and business enterprises. PMID:20609230

Age-disparate sex and HIV risk for young women from 2002 to 2012 in South Africa.

PubMed

Evan, Meredith; Risher, Kathryn; Zungu, Nompumelelo; Shisana, Olive; Moyo, Sizulu; Celentano, David D; Maughan-Brown, Brendan; Rehle, Thomas M

2016-12-26

Age-disparate sex has long been considered a factor that increases HIV risk for young women in South Africa. However, recent studies from specific regions in South Africa have found conflicting evidence. Few studies have assessed the association between age-disparate partnerships (those involving an age gap of 5 years or more) and HIV risk at the national level. This study investigates the relationship between age-disparate sex and HIV status among young women aged 15-24 in South Africa. Nationally representative weighted data from the 2002, 2005, 2008, and 2012 South African National HIV Surveys were analysed for young women aged 15-24 years using bivariate analyses and multiple logistic regressions. After conducting multiple logistic regression analyses and controlling for confounders, young women with age-disparate partners had greater odds of being HIV positive in every survey year: 2002 (aOR = 1.74, 95%CI: 0.81-3.76, p = 0.16); 2005 (aOR = 2.11, 95%CI: 1.22-3.66, p < 0.01); 2008 (aOR = 2.02, 95%CI: 1.24-3.29, p < 0.01); 2012 (aOR = 1.53, 95%CI: 0.92-2.54, p < 0.1). The odds of being HIV positive increased for each year increase in their male partner's age in 2002 (aOR = 1.10, 95%CI: 0.98-1.22, p = 0.11), 2005 (aOR = 1.10, 95%CI: 1.03-1.17, p < 0.01), 2008 (aOR = 1.08, 95%CI: 1.01-1.15, p < 0.05), and 2012 (aOR = 1.08, 95%CI: 1.01-1.16, p < 0.05). Findings were statistically significant (p < 0.1) for the years 2005, 2008, and 2012. Our findings suggest that age-disparate sex continues to be a risk factor for young women aged 15-24 in South Africa at a national level. These results may reflect variation in HIV risk at the national level compared to the differing results from recent studies in a demographic surveillance system and trial contexts. In light of recent contradictory study results, further research is required on the relationship between age-disparate sex and HIV for a more nuanced understanding of young women's HIV risk.

Age-disparate sex and HIV risk for young women from 2002 to 2012 in South Africa

PubMed Central

Evans, Meredith; Risher, Kathryn; Zungu, Nompumelelo; Shisana, Olive; Moyo, Sizulu; Celentano, David D; Maughan-Brown, Brendan; Rehle, Thomas M

2016-01-01

Abstract Introduction: Age-disparate sex has long been considered a factor that increases HIV risk for young women in South Africa. However, recent studies from specific regions in South Africa have found conflicting evidence. Few studies have assessed the association between age-disparate partnerships (those involving an age gap of 5 years or more) and HIV risk at the national level. This study investigates the relationship between age-disparate sex and HIV status among young women aged 15–24 in South Africa. Methods: Nationally representative weighted data from the 2002, 2005, 2008, and 2012 South African National HIV Surveys were analysed for young women aged 15–24 years using bivariate analyses and multiple logistic regressions. Results: After conducting multiple logistic regression analyses and controlling for confounders, young women with age-disparate partners had greater odds of being HIV positive in every survey year: 2002 (aOR = 1.74, 95%CI: 0.81–3.76, p = 0.16); 2005 (aOR = 2.11, 95%CI: 1.22–3.66, p < 0.01); 2008 (aOR = 2.02, 95%CI: 1.24–3.29, p < 0.01); 2012 (aOR = 1.53, 95%CI: 0.92–2.54, p < 0.1). The odds of being HIV positive increased for each year increase in their male partner’s age in 2002 (aOR = 1.10, 95%CI: 0.98–1.22, p = 0.11), 2005 (aOR = 1.10, 95%CI: 1.03–1.17, p < 0.01), 2008 (aOR = 1.08, 95%CI: 1.01–1.15, p < 0.05), and 2012 (aOR = 1.08, 95%CI: 1.01–1.16, p < 0.05). Findings were statistically significant (p < 0.1) for the years 2005, 2008, and 2012. Conclusions: Our findings suggest that age-disparate sex continues to be a risk factor for young women aged 15–24 in South Africa at a national level. These results may reflect variation in HIV risk at the national level compared to the differing results from recent studies in a demographic surveillance system and trial contexts. In light of recent contradictory study results, further research is required on the relationship between age-disparate sex and HIV for a more nuanced understanding of young women’s HIV risk. PMID:28364564

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…

Scale-invariance underlying the logistic equation and its social applications

NASA Astrophysics Data System (ADS)

Hernando, A.; Plastino, A.

2013-01-01

On the basis of dynamical principles we i) advance a derivation of the Logistic Equation (LE), widely employed (among multiple applications) in the simulation of population growth, and ii) demonstrate that scale-invariance and a mean-value constraint are sufficient and necessary conditions for obtaining it. We also generalize the LE to multi-component systems and show that the above dynamical mechanisms underlie a large number of scale-free processes. Examples are presented regarding city-populations, diffusion in complex networks, and popularity of technological products, all of them obeying the multi-component logistic equation in an either stochastic or deterministic way.

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.

Psychological status and quality of life among primary caregivers of individuals with mental illness: a hospital based study.

PubMed

Jeyagurunathan, Anitha; Sagayadevan, Vathsala; Abdin, Edimansyah; Zhang, YunJue; Chang, Sherilyn; Shafie, Saleha; Rahman, Restria Fauziana Abdul; Vaingankar, Janhavi Ajit; Chong, Siow Ann; Subramaniam, Mythily

2017-05-19

This study aimed to explore the psychological status and quality of life among primary caregivers of individuals suffering from various mental illnesses including early psychosis, chronic schizophrenia, depressive disorders, anxiety disorders and dementia. A total of 350 primary caregivers with relatives seeking treatment at a tertiary psychiatric hospital were recruited for this study. Socio-demographic data was obtained and the brief version of the World Health Organisation Quality of Life instrument was used to assess caregiver's quality of life (QOL). Psychological status among primary caregivers was assessed using the General Anxiety Disorder - 7 item (GAD-7) and Patient Health Questionnaire - 9 item (PHQ-9) scales. Family Interview Schedule (FIS) was used to assess the impact of caregiving relating to social problems, interpersonal strain among family members, work related problems and financial difficulties as a result of their relative's illness. The socio-demographic and clinical correlates of QOL, PHQ-9 and GAD-7 were examined using multiple linear and logistic regression analyses. Associations between QOL domains and psychological status was examined using multiple linear regression analyses. The mean age of the primary caregivers was 49.7 years (SD = 13.2), ranging from 21 to 82 years, with a preponderance of females (67.6%), aged 50-64 years old (45.7%). Majority were of Chinese ethnicity (57.5%), had secondary level education (43.1%), were married (65.2%), and employed (64.9%). 18.3% of primary caregivers had symptoms of depression (based on PHQ-9 cut-off point of 10 or greater) while 12.7% had symptoms of anxiety (based on GAD-7 cut-off point of 10 or greater). Multiple linear and logistic regression analyses revealed that primary caregivers aged between 35-49 years and 50-64 years, unemployed, living with others, providing care to those diagnosed with dementia and who had higher FIS scores were significantly more likely to report symptoms of depression whilst those who cared for their son/daughter were less likely to be associated with symptoms of depression. Primary caregivers who had lower education, were living with others, were single or divorced/separated, were unemployed and with higher FIS scores were associated with lower QOL domain scores. Those with symptoms of depression were significantly associated with low QOL across all four domains, whilst those with symptoms of anxiety were significantly associated with low QOL in the social relationships domain. Psychological status of caregivers in the current study was associated with the various domains of QOL. In particular, caregivers' symptoms of depression were significantly associated with lower QOL across all four domains of QOL whereas symptoms of anxiety were associated with lower scores in the social relationships domain. The study suggests a need to provide caregivers with social support and psycho-education to improve the QOL as well as aid in developing healthy coping strategies.

Multiple and concurrent sexual partnerships among men who have sex with men in Viet Nam: results from a National Internet-based Cross-sectional Survey.

PubMed

García, M C; Duong, Q L; Meyer, S B; Ward, P R

2016-03-01

Men who have sex with men (MSM) are one of the largest HIV risk groups in Viet Nam and have been understudied. Sexual concurrency and multiple sex partnerships may contribute to high HIV incidence among MSM in Viet Nam. Limited information is available on concurrency and multiple sexual partnerships among MSM in Viet Nam or on the extent to which this population engages in concurrent and multiple unprotected anal intercourse. Data are from a self-administered Internet-based survey of Vietnamese MSM aged 18 years or older, having sex with male partner(s) in the last 12 months and recruited from social networking MSM-specific websites in Viet Nam. Multiple partnerships and concurrency were measured using the UNAIDS-recommended sexual partner matrix, a key component in the questionnaire. Concurrent and multiple sexual partnerships were analyzed at the individual level. Logistic regression analyses were conducted to assess the demographic characteristics and behaviors associated with multiple sexual partnerships. A total of 1695 MSM reported on multiple sexual partnerships; 69.5% indicated multiple sexual partnerships in the last 6 months. A total of 257 MSM reported on concurrent sexual partnerships, with 51.0% reporting penetrative sex with concurrent partners in the last 6 months. Respondents were more likely to engage in multiple sexual partnerships if they were no longer a student, consumed alcohol before and/or during sex, used the Internet to meet casual sex partners and had never participated in a behavioral HIV intervention. Multiple sexual partnerships in the previous 6 months were common among MSM surveyed, as was sexual concurrency. High levels of multiple and concurrent sexual partnerships may be catalyzing the transmission of HIV among MSM in Viet Nam. Given the high prevalence of this high-risk sexual behavior, our findings underscore the urgent need for targeted prevention efforts, focusing on the reduction of multiple and concurrent sexual partners among this key population. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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...

Sex segregation in undergraduate engineering majors

NASA Astrophysics Data System (ADS)

Litzler, Elizabeth

Gender inequality in engineering persists in spite of women reaching parity in college enrollments and degrees granted. To date, no analyses of educational sex segregation have comprehensively examined segregation within one discipline. To move beyond traditional methods of studying the long-standing stratification by field of study in higher education, I explore gender stratification within one field: engineering. This dissertation investigates why some engineering disciplines have a greater representation of women than other engineering disciplines. I assess the individual and institutional factors and conditions associated with women's representation in certain engineering departments and compare the mechanisms affecting women's and men's choice of majors. I use national data from the Engineering Workforce Commission, survey data from 21 schools in the Project to Assess Climate in Engineering study, and Carnegie Foundation classification information to study sex segregation in engineering majors from multiple perspectives: the individual, major, institution, and country. I utilize correlations, t-tests, cross-tabulations, log-linear modeling, multilevel logistic regression and weighted least squares regression to test the relative utility of alternative explanations for women's disproportionate representation across engineering majors. As a whole, the analyses illustrate the importance of context and environment for women's representation in engineering majors. Hypotheses regarding hostile climate and discrimination find wide support across different analyses, suggesting that women's under-representation in certain engineering majors is not a question of choice or ability. However, individual level factors such as having engineering coursework prior to college show an especially strong association with student choice of major. Overall, the analyses indicate that institutions matter, albeit less for women, and women's under-representation in engineering is not reducible to individual choice. This dissertation provides a broad, descriptive view of the state of sex segregation in engineering as well as a careful analysis of how individual and institutional factors inhibit or encourage sex segregation. This study contributes to the research literature through the use of novel data, testing of occupational segregation theories, and the use of multiple levels of analysis. The analyses provide new insight into an enduring phenomenon, and suggest new avenues for understanding sex segregation in higher education.

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.

Comparative testing of reliability and audit utility of ordinal objective calculus complexity scores. Can we make an informed choice yet?

PubMed

Jaipuria, Jiten; Suryavanshi, Manav; Sen, Tridib K

2016-12-01

To assess the reliability of the Guy's Stone Score, the Seoul National University Renal Stone Complexity (S-ReSC) score and the S.T.O.N.E. scores in percutaneous nephrolithotomy (PCNL), and assess their utility in discriminating outcomes [stone free rate (SFR), complications, need for multiple PCNL sessions, and auxiliary procedures] valid across parameters of experience of surgeon, independence from surgical approach, and variations in institution-specific instrumentation. A prospectively maintained database of two tertiary institutions was analysed (606 cases). Institutes differed in instrumentation, while the overall surgical team comprised: two trainees (experience <100 cases), two junior consultants (experience 100-200 cases), and two senior surgeons (experience >1000 cases). Scores were assigned and re-assigned after 4 months by one trainee and an expert surgeon. Inter-rater and test-retest agreement were analysed by Cohen's κ and intraclass correlation coefficient. Multivariate logistic regression models were created adjusting outcomes for the institution, comorbidity, Amplatz size, access tract location, the number of punctures, the experience level of the surgeon, and individual scoring system, and receiver operating curves were analysed for comparison. Despite some areas of inconsistencies, individually all scores had excellent inter-rater and test-retest concordance. On multivariable analyses, while the experience of the surgeon and surgical approach characteristics (such as access tract location, Amplatz size, and number of punctures) remained independently associated with different outcomes in varying combinations, calculus complexity scores were found consistently to be independently associated with all outcomes. The S-ReSC score had a superior association with SFR, the need for multiple PCNL sessions, and auxiliary procedures. Individually all scoring systems performed well. On cross comparison, the S-ReSC score consistently emerged to be more superiorly associated with all outcomes, signifying the importance of the distributional complexity of the calculus (which also indirectly amalgamates the influence of stone number, size, and anatomical location) in discriminating outcomes. Our study proves the utility of scoring systems in prognosticating multiple outcomes and also clarifies important aspects of their practical application including future roles such as benchmarking, audit, training, and objective assessment of surgical technique modifications. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

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…

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.

Multiple exposures during a norovirus outbreak on a river-cruise sailing through Europe, 2006.

PubMed

Verhoef, L; Boxman, I L; Duizer, E; Rutjes, S A; Vennema, H; Friesema, I H M; de Roda Husman, A M; Koopmans, M

2008-06-12

In the summer of 2006, several cruise-related viral gastroenteritis outbreaks were reported in Europe. One report came from a river-cruise, belonging to a ship-owner who had two other ships with outbreaks. This situation warranted onsite investigation in order to identify a potential common source of infection. A retrospective cohort study was performed among 137 people on board. Epidemiological questionnaire data were analysed using logistic regression. Stool, food, water and surface samples were collected for norovirus detection. Norovirus GGII.4-2006b was responsible for 48 gastroenteritis cases on this ship as confirmed in six patients. Identical norovirus sequences were detected in stool samples, on surfaces and in tap water. Epidemiological and microbiological data indicated multiple exposures contributing to the outbreak. Microbiological results demonstrated person-to-person transmission to be clearly present. Epidemiological results indicated that consuming tap water was a risk factor; however, this could not be concluded definitively on the basis of the available data. A common source for all cruise-related outbreaks was unlikely. The ongoing outbreaks on this ship demonstrated that evidence based guidelines on effective disinfection strategies are needed.

Analysis of clinical risk factors associated with the prognosis of severe multiple-trauma patients with acute lung injury.

PubMed

Wu, Junsong; Sheng, Lei; Wang, Shenhua; Li, Qiang; Zhang, Mao; Xu, Shaowen; Gan, Jianxin

2012-09-01

Several clinical risk factors have been reported to be associated with the prognosis of acute lung injury (ALI). However, these studies have included a general trauma patient population, without singling out the severely injured multiple-trauma patient population. To identify the potential risk factors that could affect the prognosis of ALI in multiple-trauma patients and investigate the prognostic effects of certain risk factors among different patient subpopulations. In this retrospective cohort study, severely injured multiple-trauma patients with early onset of ALI from several trauma centers were studied. Potential risk factors affecting the prognosis of ALI were examined by univariate and multivariate logistic analyses. There were 609 multiple-trauma patients with ALI admitted to the emergency department and emergency intensive care unit during the study period. The nine risk factors that affected prognosis, as indicated by the unadjusted odds ratios with 95% confidence intervals, were the APACHE II (Acute Physiology and Chronic Health Evaluation II) score, duration of trauma, age, gastrointestinal hemorrhage, pulmonary contusion, disseminated intravascular coagulation (DIC), multiple blood transfusions in 6 h, Injury Severity Score (ISS), and aspiration of gastric contents. Specific risk factors also affected different patient subpopulations in different ways. Patients older than 65 years and with multiple (> 10 units) blood transfusions in the early stage after multiple trauma were found to be independent risk factors associated with deterioration of ALI. The other factors studied, including pulmonary contusion, APACHE II score ≥ 20, ISS ≥ 16, gastrointestinal hemorrhage, and aspiration of gastric contents, may predict the unfavorable prognosis of ALI in the early stage of trauma, with their effects attenuating in the later stage. Duration of trauma ≥ 1 h and the presence of DIC may also indicate unfavorable prognosis during the entire treatment period. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

Knowledge, risk perception of AIDS and reported sexual behaviour among students in secondary schools and colleges in Tanzania.

PubMed

Maswanya, E S; Moji, K; Horiguchi, I; Nagata, K; Aoyagi, K; Honda, S; Takemoto, T

1999-04-01

A questionnaire survey was carried out among 1041 students in secondary schools and colleges in Dar-es-Salaam, Tanzania to evaluate the relationship between HIV-risky sexual behaviour and anti-condom bias, as well as with AIDS-related information, knowledge, perceptions and attitudes. Self-reportedly, 54% of students (75% of the boys and 40% of the girls) were sexually active, 39% had a regular sexual partner and 13% had multiple partners in the previous year. The condom use rate was higher than previous reports. However, 30% of sexually active respondents did not always use condoms (Risk-1 behaviour) and 35% of those with multiple partners in the previous year did not always use condoms (Risk-2 behaviour). Multiple logistic regression analyses indicated that 'sex partner hates condom' had association with both Risk-1 behaviour (OR 2.47; 95% CI 1.58-3.85) and Risk-2 behaviour (OR 2.47; 95% CI 1.10-5.48). 'Use of condom prevents HIV infection' also had association with both Risk-1 behaviour (OR 2.09; 95% CI 1.19-3.67) and Risk-2 behaviour (OR 3.73; 95% CI 1.28-11.03). Students engaging in risky behaviour were aware of the risk, even though they failed to change their behaviour. Reasons for the AIDS epidemic among Tanzanian students and the importance of more effective AIDS education are also discussed.

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

Comparison of the abbreviated minimal assessment of cognitive function in multiple sclerosis (aMACFIMS) and the brief international cognitive assessment for multiple sclerosis (BICAMS).

PubMed

Gromisch, Elizabeth S; Portnoy, Jeffrey G; Foley, Frederick W

2018-05-15

Cognitive impairment is a prevalent and often intrusive problem among persons with multiple sclerosis (PwMS). Valid and reliable assessments, including quick screening measures, are crucial. The Brief International Cognitive Assessment for MS (BICAMS) was developed for this reason. While it lends itself to use in locations where formal neuropsychological resources might be limited, it does not include measures of verbal fluency or executive functioning, domains assessed as part of the Minimal Assessment of Cognitive Function in MS (MACFIMS). Given previous evidence that shortened MACFIMS measures have strong criterion validity, this study aimed to determine which of these should be included in the abbreviated MACFIMS (aMACFIMS), and how the aMACFIMS compares to the BICAMS. One hundred forty-seven PwMS were included in the analyses. A stepwise logistic regression was used to determine the measures in the aMACFIMS. Receiver-operating-characteristic (ROC) curves assessed the classification accuracy, sensitivity, and specificity. The batteries' sensitivity, specificity, and predictive values were then compared. Compared to the BICAMS, the final aMACFIMS had higher specificity (87% versus 72%) and positive predictive value (86% versus 77%), but lower sensitivity (71% versus 81%). The aMACFIMS has several benefits, including reduced administration time and the addition of a verbal fluency/executive functioning measure. Copyright © 2018 Elsevier B.V. All rights reserved.

Musculoskeletal pain and re-employment among unemployed job seekers: a three-year follow-up study.

PubMed

Nwaru, Chioma A; Nygård, Clas-Håkan; Virtanen, Pekka

2016-07-08

Poor health is a potential risk factor for not finding employment among unemployed individuals. We investigated the associations between localized and multiple-site musculoskeletal pain and re-employment in a three-year follow-up of unemployed job seekers. Unemployed people (n = 539) from six localities in southern Finland who participated in various active labour market policy measures at baseline in 2002/2003 were recruited into a three-year health service intervention trial. A questionnaire was used to collect data on musculoskeletal health and background characteristics at baseline and on employment status at the end of the follow-up. We conducted a complete case (n = 284) and multiple imputation analyses using logistic regression to investigate the association between baseline musculoskeletal pain and re-employment after three years. Participants with severe pain in the lower back were less likely to become re-employed. This was independent of potential confounding variables. Pain in the hands/upper extremities, neck/shoulders, lower extremities, as well as multiple site were not determinants of re-employment. Our findings lend some support to the hypothesis that poor health can potentially cause health selection into employment. There is the need to disentangle health problems in order to clearly appreciate their putative impact on employment. This will allow for more targeted interventions for the unemployed.

Perceptions of social support, empowerment and youth risk behaviors.

PubMed

Reininger, Belinda M; Pérez, Adriana; Aguirre Flores, Maria I; Chen, Zhongxue; Rahbar, Mohammad H

2012-02-01

This study examined the association of perceived social support and community empowerment among urban middle-school students living in Matamoros, Mexico and the risk behaviors of fighting, alcohol and tobacco use, and sexual activity. Middle school students (n = 1,181) from 32 public and private Mexican schools were surveyed. Weighted multiple logistic regression analyses were conducted. Among girls, lack of parent/teacher interactions regarding school increased odds for fighting, alcohol and tobacco use. Among boys, lack of empowerment increased odds of alcohol and tobacco use and lack of parent/teacher interactions regarding school increased odds for sexual activity. Community empowerment and perceived social support are uniquely associated with risk behaviors for girls and boys. Additionally, perceived social support from individuals most immediate to the youth are associated with protection against risk for some behaviors, while perceived social support from individuals more removed from youth have mixed association with risk behaviors.

Predictors of hopelessness among clinically depressed youth.

PubMed

Becker-Weidman, Emily G; Reinecke, Mark A; Jacobs, Rachel H; Martinovich, Zoran; Silva, Susan G; March, John S

2009-05-01

Factors that distinguish depressed individuals who become hopeless from those who do not are poorly understood. In this study, predictors of hopelessness were examined in a sample of 439 clinically depressed adolescents participating in the Treatment for Adolescents with Depression Study (TADS). The total score of the Beck Hopelessness Scale (BHS) was used to assess hopelessness at baseline. Multiple regression and logistic regression analyses were conducted to evaluate the extent to which variables were associated with hopelessness and determine which cluster of measures best predicted clinically significantly hopelessness. Hopelessness was associated with greater depression severity, poor social problem-solving, cognitive distortions, and family conflict. View of self, view of the world, internal attributional style, need for social approval, positive problem-solving orientation, and family problems consistently emerged as the best predictors of hopelessness in depressed youth. Cognitive and familial factors predict those depressed youth who have high levels of hopelessness.

Childhood maltreatment and threats with weapons.

PubMed

Casiano, Hygiea; Mota, Natalie; Afifi, Tracie O; Enns, Murray W; Sareen, Jitender

2009-11-01

The relationship between childhood maltreatment and future threats with weapons is unknown. We examined data from the nationally representative National Comorbidity Survey Replication (n = 5692) and conducted multiple logistic regression analyses to determine the association between childhood maltreatment and lifetime behavior of threatening others with a gun or other weapon. After adjusting for sociodemographic variables, physical abuse, sexual abuse, and witnessing domestic violence were significantly associated with threats made with a gun (adjusted odds ratios [AOR] ranging between 3.38 and 4.07) and other weapons (AOR ranging between 2.16 and 2.83). The greater the number of types of maltreatment experienced, the stronger the association with lifetime threats made to others with guns and any weapons. Over 94% of respondents who experienced maltreatment and made threats reported that the maltreatment occurred prior to threatening others with weapons. Prevention efforts that reduce exposure to maltreatment may reduce violent behavior in later life.

Possible health effects of living in proximity to mining sites near Potosí, Bolivia.

PubMed

Farag, Sara; Das, Riva; Strosnider, William H J; Wilson, Robin Taylor

2015-05-01

The goal of this study was to determine the health effects of living downstream from mines in the Potosí region of Bolivia. Histories, physical examinations, and urinalyses were completed on adults recruited from mining and nonmining villages in Bolivia. Blood concentrations of Cd, Hg, and Pb were determined in a subset of participants. Multiple logistic regression analyses were performed. Mining region participants had significantly higher frequencies of hypertension, hematuria, and ketonuria. Hematuria was significantly elevated among those watering livestock downstream from mines and eating grains from their own farm (odds ratio = 4.3; 95% confidence interval, 1.1 to 17.7). Significantly higher blood concentrations of Pb were observed in a subsample of participants with hematuria (4.80 μg/dL vs 10.91 μg/dL; P = 0.026). Efforts to abate environmental exposure to toxic metals seem warranted.

Gender power control, sexual experiences, safer sex practices, and potential HIV risk behaviors among young Asian-American women.

PubMed

Hahm, Hyeouk Chris; Lee, Jieha; Rough, Kathryn; Strathdee, Steffanie A

2012-01-01

We examined the prevalence of three domains of sexual behaviors among young Asian-American women: sexual experiences, safer sex practices, and potential HIV risk behaviors. We also investigated the impact of gender power control on these domains. Among sexually experienced women, 51% reported using condoms during their most recent sex act, 63% reported inconsistent condom use, and 18% reported ever having forced sex. Multiple logistic regression analyses revealed that women's perceived lower relationship power control was not associated with vaginal sex or safer sex practices, but it was powerfully associated with forced sex and all three potential HIV risk behaviors. This study demonstrates that control within young Asian-American women's intimate relationships exerts different associations depending on the type of sexual behavior. The application of the Theory of Gender and Power should be employed with prudence when designing HIV interventions for this population.

Gender Power Control, Sexual Experiences, Safer Sex Practices, and Potential HIV Risk Behaviors Among Young Asian-American Women

PubMed Central

Lee, Jieha; Rough, Kathryn; Strathdee, Steffanie A.

2012-01-01

We examined the prevalence of three domains of sexual behaviors among young Asian-American women: sexual experiences, safer sex practices, and potential HIV risk behaviors. We also investigated the impact of gender power control on these domains. Among sexually experienced women, 51% reported using condoms during their most recent sex act, 63% reported inconsistent condom use, and 18% reported ever having forced sex. Multiple logistic regression analyses revealed that women’s perceived lower relationship power control was not associated with vaginal sex or safer sex practices, but it was powerfully associated with forced sex and all three potential HIV risk behaviors. This study demonstrates that control within young Asian-American women’s intimate relationships exerts different associations depending on the type of sexual behavior. The application of the Theory of Gender and Power should be employed with prudence when designing HIV interventions for this population. PMID:21259042

Health-Related Quality of Life Among US Workers: Variability Across Occupation Groups.

PubMed

Shockey, Taylor M; Zack, Matthew; Sussell, Aaron

2017-08-01

To examine the health-related quality of life among workers in 22 standard occupation groups using data from the 2013-2014 US Behavioral Risk Factor Surveillance System. We examined the health-related quality of life measures of self-rated health, frequent physical distress, frequent mental distress, frequent activity limitation, and frequent overall unhealthy days by occupation group for 155 839 currently employed adults among 17 states. We performed multiple logistic regression analyses that accounted for the Behavioral Risk Factor Surveillance System's complex survey design to obtain prevalence estimates adjusted for potential confounders. Among all occupation groups, the arts, design, entertainment, sports, and media occupation group reported the highest adjusted prevalence of frequent physical distress, frequent mental distress, frequent activity limitation, and frequent overall unhealthy days. The personal care and service occupation group had the highest adjusted prevalence for fair or poor self-rated health. Workers' jobs affect their health-related quality of life.

US female college students' breast health knowledge, attitudes, and determinants of screening practices: new implications for health education.

PubMed

Early, Jody; Armstrong, Shelley Nicole; Burke, Sloane; Thompson, Doris Lee

2011-01-01

This study examined female college students' knowledge, attitudes, and breast cancer screening and determined significant predictors of breast self-examination, clinical breast examination, and mammography among this population. A convenience sample of 1,074 college women from 3 universities participated in the research. Respondents completed an online version of the Toronto Breast Self-examination Instrument as well as questions developed by the authors. Descriptive statistics showed gaps in college women's knowledge of breast health and negative attitudes toward screening that were relative to age. Multiple linear and logistic regression analyses revealed that knowledge, attitudes, and copay were significant predictors of screening, whereas family history and ethnicity were not. This study supported previous smaller-sample studies that showed college women to be a priority population for breast health education and revealed new significant factors that should be addressed in health education for this group.

Psycho-socioeconomic factors affecting complementary and alternative medicine use among selected rural communities in Malaysia: a cross-sectional study.

PubMed

Ganasegeran, Kurubaran; Rajendran, Anantha Kumar; Al-Dubai, Sami Abdo Radman

2014-01-01

The use of complementary and alternative medicine (CAM) as a source of cure has gained much spectrum worldwide, despite skeptics and advocates of evidence-based practice conceptualized such therapies as human nostrum. This study aimed to explore the factors affecting CAM use among rural communities in Malaysia. A cross-sectional study was carried out on 288 occupants across four rural villages within the District of Selama, Perak, Malaysia. A survey that consisted of socio-economic characteristics, history of CAM use and the validated Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) were used. The prevalence of self-reported CAM use over the past one year was 53.1%. Multiple logistic regression analyses yielded three significant predictors of CAM use: monthly household income of less than MYR 2500, higher education level, and positive attitude towards CAM. Psycho-socioeconomic factors were significantly associated with CAM use among rural communities in Malaysia.

Sexual violence, weight perception, and eating disorder indicators in college females.

PubMed

Groff Stephens, Sara; Wilke, Dina J

2016-01-01

To examine the relationships between sexual violence experiences, inaccurate body weight perceptions, and the presence of eating disorder (ED) indicators in a sample of female US college students. Participants were 6,090 college females 25 years of age and younger. A secondary analysis of National College Health Assessment data gathered annually at one institution from 2004 to 2013 was utilized. A model predicting ED indicators was tested using logistic regression analyses with multiple categorical variables representing severity of sexual violence, accuracy of body weight perception, and an interaction between the two. Sexual violence and inaccurate body weight perception significantly predicted ED indicators; sexual violence was the strongest predictor of purging behavior, whereas inaccurate body weight perception was best predicted by underweight status. Findings provide support to the relationship between purging behavior and severity of sexual violence and also to the link between inaccurate body weight perception and being underweight.

Correlational analysis of neck/shoulder pain and low back pain with the use of digital products, physical activity and psychological status among adolescents in Shanghai.

PubMed

Shan, Zhi; Deng, Guoying; Li, Jipeng; Li, Yangyang; Zhang, Yongxing; Zhao, Qinghua

2013-01-01

This study investigates the neck/shoulder pain (NSP) and low back pain (LBP) among current high school students in Shanghai and explores the relationship between these pains and their possible influences, including digital products, physical activity, and psychological status. An anonymous self-assessment was administered to 3,600 students across 30 high schools in Shanghai. This questionnaire examined the prevalence of NSP and LBP and the level of physical activity as well as the use of mobile phones, personal computers (PC) and tablet computers (Tablet). The CES-D (Center for Epidemiological Studies Depression) scale was also included in the survey. The survey data were analyzed using the chi-square test, univariate logistic analyses and a multivariate logistic regression model. Three thousand sixteen valid questionnaires were received including 1,460 (48.41%) from male respondents and 1,556 (51.59%) from female respondents. The high school students in this study showed NSP and LBP rates of 40.8% and 33.1%, respectively, and the prevalence of both influenced by the student's grade, use of digital products, and mental status; these factors affected the rates of NSP and LBP to varying degrees. The multivariate logistic regression analysis revealed that Gender, grade, soreness after exercise, PC using habits, tablet use, sitting time after school and academic stress entered the final model of NSP, while the final model of LBP consisted of gender, grade, soreness after exercise, PC using habits, mobile phone use, sitting time after school, academic stress and CES-D score. High school students in Shanghai showed high prevalence of NSP and LBP that were closely related to multiple factors. Appropriate interventions should be implemented to reduce the occurrences of NSP and LBP.

Socioeconomic determinants of childhood overweight and obesity in China: the long arm of institutional power

PubMed Central

Fu, Qiang; George, Linda K.

2018-01-01

Abstract Previous studies have widely reported that the association between socioeconomic status (SES) and childhood overweight and obesity in China is significant and positive, which lends little support to the fundamental-cause perspective. Using multiple waves (1997, 2000, 2004 and 2006) of the China Health and Nutrition Survey (CHNS) (N = 2,556, 2,063, 1,431 and 1,242, respectively) and continuous BMI cut-points obtained from a polynomial method, (mixed-effect) logistic regression analyses show that parental state-sector employment, an important, yet overlooked, indicator of political power during the market transformation has changed from a risk factor for childhood overweight/obesity in 1997 to a protective factor for childhood overweight/obesity in 2006. Results from quantile regression analyses generate the same conclusions and demonstrate that the protective effect of parental state sector employment at high percentiles of BMI is robust under different estimation strategies. By bridging the fundamental causes perspective and theories of market transformation, this research not only documents the effect of political power on childhood overweight/obesity but also calls for the use of multifaceted, culturally-relevant stratification measures in testing the fundamental cause perspective across time and space. PMID:26178452

Associations between yoga practice and joint problems: a cross-sectional survey among 9151 Australian women.

PubMed

Lauche, Romy; Schumann, Dania; Sibbritt, David; Adams, Jon; Cramer, Holger

2017-07-01

Yoga exercises have been associated with joint problems recently, indicating that yoga practice might be potentially dangerous for joint health. This study aimed to analyse whether regular yoga practice is associated with the frequency of joint problems in upper middle-aged Australian women. Women aged 62-67 years from the Australian Longitudinal Study on Women's Health (ALSWH) were questioned in 2013 whether they experienced regular joint pain or problems in the past 12 months and whether they regularly practiced yoga. Associations of joint problems with yoga practice were analysed using Chi-squared tests and multiple logistic regression modelling. Of 9151 women, 29.8% reported regular problems with stiff or painful joints, and 15.2, 11.9, 18.1 and 15.9% reported regular problems with shoulders, hips, knees and feet, respectively, in the past 12 months. Yoga was practiced sometimes by 10.1% and often by 8.4% of women. Practicing yoga was not associated with upper or lower limb joint problems. No association between yoga practice and joint problems has been identified. Further studies are warranted for conclusive judgement of benefits and safety of yoga in relation to joint problems.

Delinquency and sexual experiences across adolescence: does depression play a role?

PubMed

Savioja, Hanna; Helminen, Mika; Fröjd, Sari; Marttunen, Mauri; Kaltiala-Heino, Riittakerttu

2017-08-01

To elucidate a possible connection between delinquency and adolescent sexual behaviours in different age groups from 14 to 20 and the role of depression therein. Data were gathered from the cross-sectional Finnish School Health Promotion Study 2010 and 2011 with 186,632 respondents. We first examined the bivariate relationship between delinquency and sexual behaviour, and then proceeded to multivariate models accounting for self-reported depression. Analyses were conducted separately for girls and boys, in seven age groups. The main outcomes were analysed by χ 2 test and logistic regression. Delinquency was connected to having experienced sexual intercourse across all age groups, and was related to reporting multiple sexual partners among sexually active adolescents, in both boys and girls, before and after controlling for depression. Delinquency and depression were independently associated with the sexual behaviours studied. Being sexually active and engaging in risky sexual behaviours are related to delinquency in the adolescent population throughout the developmental phase, even in late adolescence when being sexually active is developmentally normative. Being sexually active is further connected to depression until middle adolescence, and risky sexual behaviours across adolescence. Clinicians working with adolescents presenting with delinquent behaviour with or without depression need to address their sexual health needs.

[Factors influencing users' destination upon discharge from a geriatric intermediate care facility in an urban area].

PubMed

Ishizaki, T; Kai, I; Hirayama, T

1995-02-01

Geriatric Intermediate Care Facilities (GICF) have been established to help the hospitalized elderly return home. Users of the GICF are elderly persons who do not need hospitalization, but are mentally or physically impaired. To determine what factors influence users' destinations upon discharge from GICF, we analyzed various characteristics such as age, sex, place of residence before admission, length of stay, intellectual impairment, ability to perform activities of daily living (ADL) among users (N = 389) in a GICF in Chiba City. Multiple logistic regression analyses revealed that, compared with the users who were hospitalized, users who were male, admitted for home, stayed for long periods, and had a high ability to perform ADL were more likely to return home. The analyses also revealed that, compared with the users who were institutionalized, users who came from home, stayed for short periods, and had a high ability to perform ADL were more likely to return home. Evaluating a user's physical, mental, and socioeconomical conditions at an early stage of admission to a GICF may allow us to predict whether the user can be successfully discharged to his or her home or will have to remain at the GICF for an extended period.

E-cigarette Dual Users, Exclusive Users and Perceptions of Tobacco Products.

PubMed

Cooper, Maria; Case, Kathleen R; Loukas, Alexandra; Creamer, Melisa R; Perry, Cheryl L

2016-01-01

We examined differences in the characteristics of youth non-users, cigarette-only, e-cigarette-only, and dual e-cigarette and cigarette users. Using weighted, representative data, logistic regression analyses were conducted to examine differences in demographic characteristics and tobacco use behaviors across tobacco usage groups. Multiple linear regression analyses were conducted to examine differences in harm perceptions of various tobacco products and perceived peer use of e-cigarettes by tobacco usage group. Compared to non-users, dual users were more likely to be white, male, and high school students. Dual users had significantly higher prevalence of current use of all products (except hookah) than e-cigarette-only users, and higher prevalence of current use of snus and hookah than the cigarette-only group. Dual users had significantly lower harm perceptions for all tobacco products except for e-cigarettes and hookah as compared to e-cigarette-only users. Dual users reported higher peer use of cigarettes as compared to both exclusive user groups. Findings highlight dual users' higher prevalence of use of most other tobacco products, their lower harm perceptions of most tobacco products compared to e-cigarette-only users, and their higher perceived peer use of cigarettes compared to exclusive users.

[Displaced people's healthcare use in Bucaramanga, Colombia].

PubMed

Ruiz-Rodríguez, Myriam; López-Moreno, Sergio; Avila-Burgos, Leticia; Acosta-Ramírez, Naydú

2006-01-01

Analysing the factors and barriers associated with the population displaced by armed conflict using medical services in Bucaramanga, Colombia. Data from the "Diagnosing the health of both displaced and non-displaced populations in Bucaramanga and its metropolitan area" study, designed and executed by the Industrial University of Santander and financed by the Pan-American Health Organisation, analysed medical service use in individuals aged over 15 years. This agreed with Andersen and Newman's model and evaluated the effect of associated factors by means of multiple logistical regression. One out of each five people who became ill during the fifteen days prior to the survey had used the medical services. This percentage was smaller than that found in the Colombian population as a whole. The type of social security regime (contributory health insurance), previous service use and being from the region were associated with greater service use. Displaced people having subsidised health insurance did not present differences in service use compared to those who had no access to such insurance. The distance from dwelling to institution was another barrier against using health services (RM = 0.64; IC 0.42-0.97). There was differential medical service use amongst the displaced population, determined by their health insurance coverage and economic position.

Suicidal Ideation and Mental Distress Among Adults With Military Service History: Results From 5 US States, 2010

PubMed Central

Gordon, Adam J.; Bossarte, Robert M.

2014-01-01

Objectives. We examined the association of military service history with past-year suicidal ideation and past-30-days mental distress in a probability-based sample of adults. Methods. We gathered 2010 Behavioral Risk Factor Surveillance System data from 5 states that asked about past-year suicidal ideation. Military service was defined as current or former active-duty service or National Guard or Reserves service. We stratified analyses into 18 to 39 years, 40 to 64 years, and 65 years and older age groups and used multiple logistic regression analyses, adjusted for demographic confounders, to discern the association of military service history with past-year suicidal ideation and past-30-days mental distress. Results. Among the 26 736 respondents, 13.1% indicated military service history. After adjusting for several confounders, we found military history status among those aged 40 to 64 years was associated with both past-year suicidal ideation and past-30-days mental distress. We found no significant associations among the younger or older age groups. Conclusions. Differences in suicidal ideation between military and nonmilitary individuals may occur in midlife. Future research should examine the possibility of cohort effects, service era effects, or both. PMID:25100426

Workplace bullying, working environment and health.

PubMed

Oxenstierna, Gabriel; Elofsson, Stig; Gjerde, Maria; Magnusson Hanson, Linda; Theorell, Töres

2012-01-01

Improved work organisation could be of importance for decreased bullying in workplaces. Participants in the Swedish Longitudinal Occupational Survey of Health (SLOSH) responded to questions about work and workplace and whether they had been bullied during the past year in 2006. Those in worksites with at least five employees who did not report that they had been bullied in 2006 and without workplace change between 2006 and 2008 constituted the final sample (n=1,021 men and 1,182 women). Work characteristics and workplace factors in 2006 were used in multiple logistic regression as predictors of bullying in 2008. Separate analyses were performed for work characteristics and workplace factors respectively. Adjustments for demographic factors were made in all analyses. The question used for bullying was: "Are you exposed to personal persecution by means of vicious words or actions from your superiors or your workmates?" Such persecution any time during the past year was defined as bullying. For both genders organisational change and conflicting demands were identified as risk factors, and good decision authority as a protective factor. Dictatorial leadership, lack of procedural justice and attitude of expendability were male and lack of humanity a female risk factor for bullying.

The Use of Online Modules and the Effect on Student Outcomes in a High School Chemistry Class

NASA Astrophysics Data System (ADS)

Lamb, Richard L.; Annetta, Len

2013-10-01

The purpose of the study was to review the efficacy of online chemistry simulations in a high school chemistry class and provide discussion of the factors that may affect student learning. The sample consisted of 351 high school students exposed to online simulations. Researchers administered a pretest, intermediate test and posttest to measure chemistry content knowledge acquired during the use of online chemistry laboratory simulations. The authors also analyzed student journal entries as an attitudinal measure of chemistry during the simulation experience. The four analyses conducted were Repeated Time Measures Analysis of Variance, a three-way Analysis of Variance, Logistic Regression and Multiple Analysis of Variance. Each of these analyses provides for a slightly different aspect of factors regarding student attitudes and outcomes. Results indicate that there is a statistically significant main effect across grouping type (experimental versus control, p = 0.042, α = 0.05). Analysis of student journal entries suggests that attitudinal factors may affect student outcomes concerning the use of online supplemental instruction. Implications for this study show that the use of online simulations promotes increased understanding of chemistry content through open-ended and interactive questioning.

Does activity limitation predict discharge destination for postacute care patients?

PubMed

Chang, Feng-Hang; Ni, Pengsheng; Jette, Alan M

2014-09-01

This study aimed to examine the ability of different domains of activity limitation to predict discharge destination (home vs. nonhome settings) 1 mo after hospital discharge for postacute rehabilitation patients. A secondary analysis was conducted using a data set of 518 adults with neurologic, lower extremity orthopedic, and complex medical conditions followed after discharge from a hospital into postacute care. Variables collected at baseline include activity limitations (basic mobility, daily activity, and applied cognitive function, measured by the Activity Measure for Post-Acute Care), demographics, diagnosis, and cognitive status. The discharge destination was recorded at 1 mo after being discharged from the hospital. Correlational analyses revealed that the 1-mo discharge destination was correlated with two domains of activity (basic mobility and daily activity) and cognitive status. However, multiple logistic regression and receiver operating characteristic curve analyses showed that basic mobility functioning performed the best in discriminating home vs. nonhome living. This study supported the evidence that basic mobility functioning is a critical determinant of discharge home for postacute rehabilitation patients. The Activity Measure for Post-Acute Care-basic mobility showed good usability in discriminating home vs. nonhome living. The findings shed light on the importance of basic mobility functioning in the discharge planning process.

Prescription of Benzodiazepines and Related Drugs in Patients with Mild Cognitive Deficits and Alzheimer's Disease.

PubMed

Hessmann, Philipp; Dodel, Richard; Baum, Erika; Müller, Matthias J; Paschke, Greta; Kis, Bernhard; Zeidler, Jan; Klora, Mike; Reese, Jens-Peter; Balzer-Geldsetzer, Monika

2018-01-31

Benzodiazepines and related drugs (BZDR) should be avoided in patients with cognitive impairment. We evaluated the relationship between a BZDR treatment and the health status of patients with Alzheimer's disease (AD). Cross-sectional study in 395 AD patients using bivariate and multiple logistic analyses to assess correlations between the prescription of BZDR and patients' characteristics (cognitive and functional capacity, health-related quality of life (HrQoL), neuropsychiatric symptoms). BZDR were used in 12.4% (n=49) of all participants. In bivariate analyses, the prescription was associated with a lower HrQoL, a higher need of care, and the presence of anxiety. Multivariate models revealed a higher risk of BZDR treatment in patients with depression (OR 3.85, 95% CI: 1.45 - 10.27). Community-dwelling participants and those treated by neurologists/psychiatrists had a lower risk of receiving BZDR (OR 0.33, 95% CI: 0.12 - 0.89 and OR 0.16, 95% CI: 0.07 - 0.36). The inappropriate use of BZDR conflicts with national and international guidelines. We suggest evaluating indications and treatment duration and improving the knowledge of alternative therapies in healthcare institutions. © Georg Thieme Verlag KG Stuttgart · New York.

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.

MESSOC capabilities and results. [Model for Estimating Space Station Opertions Costs

NASA Technical Reports Server (NTRS)

Shishko, Robert

1990-01-01

MESSOC (Model for Estimating Space Station Operations Costs) is the result of a multi-year effort by NASA to understand and model the mature operations cost of Space Station Freedom. This paper focuses on MESSOC's ability to contribute to life-cycle cost analyses through its logistics equations and databases. Together, these afford MESSOC the capability to project not only annual logistics costs for a variety of Space Station scenarios, but critical non-cost logistics results such as annual Station maintenance crewhours, upweight/downweight, and on-orbit sparing availability as well. MESSOC results using current logistics databases and baseline scenario have already shown important implications for on-orbit maintenance approaches, space transportation systems, and international operations cost sharing.

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.

A generation at risk: a cross-sectional study on HIV/AIDS knowledge, exposure to mass media, and stigmatizing behaviors among young women aged 15-24 years in Ghana.

PubMed

Asamoah, Charity Konadu; Asamoah, Benedict Oppong; Agardh, Anette

2017-01-01

HIV/AIDS stigmatizing behaviors are a huge barrier to early detection and treatment of individuals with the AIDS virus. HIV/AIDS stigma and related consequences are debilitating, especially for vulnerable populations. This study sought to assess whether young women's HIV/AIDS knowledge levels and exposure to mass media (television and radio) have an influence on their stigmatizing behaviors and role as agents of stigma towards individuals living with HIV and AIDS. The data used for this study originated from the Ghana Multiple Indicator Cluster Survey 2011. Binary and multiple (stepwise) logistic regression analyses were used to examine the associations between HIV/AIDS knowledge, frequency of exposure to mass media, and HIV/AIDS stigmatizing behaviors among young women aged 15-24 years in Ghana. Of the 3573 young women, 80% of 15-19-year-olds and 76% of 20-24-year-olds had at least one stigmatizing behavior towards persons living with HIV/AIDS (PLHA). Young women with increased knowledge regarding HIV/AIDS and frequent exposure to mass media (television and radio) had lesser tendency to stigmatize or act as agents of stigma towards PLHA (proportion with at least one stigmatizing behavior per subgroup - HIV/AIDS knowledge: those with highest knowledge score 579 [70.1%], those with lowest knowledge score 28 [90.3%]; mass media: those with daily exposure 562 [73.4%], those not exposed at all 249 [89.2%]). There was a graded negative 'exposure-response' association between the ranked variables: HIV/AIDS knowledge, mass media, and HIV/AIDS stigmatizing behaviors. The significant inverse association between HIV/AIDS knowledge, frequency of exposure to mass media, and HIV/AIDS stigmatizing behaviors persisted even after adjusting for all other covariates in the multiple logistic regression models. It is extremely important to increase HIV/AIDS-related knowledge and reduce stigma among young women in Ghana through targeted HIV/AIDS factual knowledge transfer. The use of mass media for communication of issues regarding HIV/AIDS, its mode of transmission, and associated stigma should be emphasized among women in Ghana.

Fetal head circumference and subpubic angle are independent risk factors for unplanned cesarean and operative delivery.

PubMed

Rizzo, Giuseppe; Aiello, Elisa; Bosi, Costanza; D'Antonio, Francesco; Arduini, Domenico

2017-08-01

The aim of this study was to ascertain whether combined ultrasound assessment of fetal head circumference (HC) and maternal subpubic angle (SPA) prior to the onset of labor may predict the likelihood of an unplanned operative delivery (UOD) in nulliparous women at term. Prospective cohort study of singleton pregnancies in cephalic presentation. Pregnancies experiencing UOD secondary to fetal distress were excluded. HC was assessed transabdominally and SPA values were obtained from a reconstructed coronal plane on three-dimensional (3D) ultrasound performed translabially at 36-38 weeks of gestation. Maternal characteristics, HC expressed as multiple of median, and SPA were compared according to the mode of delivery. Logistic regression and receiver operating characteristics curve analyses were used to analyze the data. 597 pregnancies were included in the study. Spontaneous vaginal delivery occurred in 70.2% of the cases and UOD was required in 29.8%. There was no difference in pregnancy characteristics and birthweight between women who had a spontaneous vaginal birth compared with UOD. The HC multiple of median was larger (1.00 ± 0.02 vs. 1.03 ± 0.02, p ≤ 0.0001), whereas SPA was narrower in the UOD group (124.02 ± 13.64 vs. 102.61 ± 16.13, p ≤ 0.0001). At logistic regression, SPA (OR 0.91, 95% CI 0.89-0.93), HC multiple of median (OR 1.13, 95% CI 1.09-1.17) and maternal height (OR 0.95, 95% CI 0.92-0.99) were independently associated with UOD. When combined, the diagnostic accuracy of a predictive model integrating HC, SPA and maternal height was highly predictive of UOD with an area under the curve of 0.904 (95% CI 0.88-0.93). Ultrasound assessment of fetal HC and maternal SPA after 36 weeks of gestation can identify a subset of women at higher risk of UOD during labor, for whom early planned delivery might be beneficial. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Physical fitness of 9 year olds in England: related factors.

PubMed

Kikuchi, S; Rona, R J; Chinn, S

1995-04-01

To examine the influence of social factors, passive smoking, and other parental health related factors, as well as anthropometric and other measurements on children's cardiorespiratory fitness. This was a cross sectional study. The analysis was based on 22 health areas in England. The subjects were 299 boys and 282 girls aged 8 to 9 years. Parents did not give positive consent for 15% of the eligible sample. A further 25% of the eligible sample did not participate because the cycle-ergometer broke down, study time was insufficient, or they were excluded from the analysis because they were from ethnic minority groups or had missing data on one continuous variable. Cardiorespiratory fitness was determined using the cycle-ergometer test. It was measured in terms of PWC85%-that is, power output per body weight (watt/kg) assessed at 85% of maximum heart rate. The association between children's fitness and biological and social factors was analysed in two stages. Firstly, multiple logistic analysis was used to examine the factors associated with the children's ability to complete the test for at least four minutes. Secondly, multiple linear regression analysis was used to examine the independent association of the factors with PWC85%. In the logistic analysis, shorter children, children with higher blood pressure, and boys with a larger sibship size had poorer fitness. In the multiple regression analysis, only height (p < 0.001) was positively associated, and the sum of skinfold thicknesses at four sites (p = 0.001) was negatively associated with fitness in both sexes. In girls, a positive association was found with pre-exercise peak expiratory flow rate (p < 0.05), and there were negative associations with systolic blood pressure (p < 0.05) and family history of heart attack (p < 0.05). In boys an association was found with skinfold distribution and fitness (p < 0.05), so that children with relatively less body fat were fitter. Social and health behaviour factors such as father's social class, father's employment status, or parents' smoking habits were unrelated to child's fitness. Height and obesity are strongly associated, and systolic blood pressure to a small extent, with children's fitness, but social factors are unrelated.

Association between Triglyceride to HDL-C Ratio (TG/HDL-C) and Insulin Resistance in Chinese Patients with Newly Diagnosed Type 2 Diabetes Mellitus

PubMed Central

Ren, Xingxing; Chen, Zeng.ai; Zheng, Shuang; Han, Tingting; Li, Yangxue; Liu, Wei; Hu, Yaomin

2016-01-01

Objectives To explore the association between the triglyceride to HDL-C ratio (TG/HDL-C) and insulin resistance in Chinese patients with newly diagnosed type 2 diabetes mellitus. Methods Patients with newly diagnosed type 2 diabetes mellitus (272 men and 288 women) were enrolled and divided into three groups according to TG/HDL-C tertiles. Insulin resistance was defined by homeostatic model assessment of insulin resistance (HOMA-IR). Demographic information and clinical characteristics were obtained. Spearman’s correlation was used to estimate the association between TG/HDL-C and other variables. Multiple logistic regression analyses were adopted to obtain probabilities of insulin resistance. A receiver operating characteristic analysis was conducted to evaluate the ability of TG/HDL-C to discriminate insulin resistance. Results TG/HDL-C was associated with insulin resistance in Chinese patients with newly diagnosed T2DM (Spearman’s correlation coefficient = 0.21, P < 0.01). Patients in the higher tertiles of TG/HDL-C had significantly higher HOMA-IR values than patients in the lower tertiles [T1: 2.68(1.74–3.70); T2: 2.96(2.29–4.56); T3: 3.09(2.30–4.99)]. Multiple logistic regression analysis showed that TG/HDL-C was significantly associated with HOMA-IR, and patients in the higher TG/HDL-C tertile had a higher OR than those in the lower TG/HDL-C tertile, after adjusting for multiple covariates including indices for central obesity [T1: 1; T2: 4.02(1.86–8.71); T3: 4.30(1.99–9.29)]. Following stratification of waist circumference into quartiles, the effect of TG/HDL-C on insulin resistance remained significant irrespective of waist circumference. Conclusions TG/HDL-C was associated with insulin resistance independent of waist circumference. Whether it could be a surrogate marker for insulin resistance in Chinese patients with newly diagnosed type 2 diabetes mellitus still needs to be confirmed by more researches. PMID:27115999

Basic Diagnosis and Prediction of Persistent Contrail Occurrence using High-resolution Numerical Weather Analyses/Forecasts and Logistic Regression. Part II: Evaluation of Sample Models

NASA Technical Reports Server (NTRS)

Duda, David P.; Minnis, Patrick

2009-01-01

Previous studies have shown that probabilistic forecasting may be a useful method for predicting persistent contrail formation. A probabilistic forecast to accurately predict contrail formation over the contiguous United States (CONUS) is created by using meteorological data based on hourly meteorological analyses from the Advanced Regional Prediction System (ARPS) and from the Rapid Update Cycle (RUC) as well as GOES water vapor channel measurements, combined with surface and satellite observations of contrails. Two groups of logistic models were created. The first group of models (SURFACE models) is based on surface-based contrail observations supplemented with satellite observations of contrail occurrence. The second group of models (OUTBREAK models) is derived from a selected subgroup of satellite-based observations of widespread persistent contrails. The mean accuracies for both the SURFACE and OUTBREAK models typically exceeded 75 percent when based on the RUC or ARPS analysis data, but decreased when the logistic models were derived from ARPS forecast data.

78 FR 37971 - Security Zone; Naval Exercise; Pacific Ocean, Coronado, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-25

... this rule because an NPRM would have been impracticable. Logistical details surrounding this exercise.... Regulatory Analyses We developed this rule after considering numerous statutes and executive orders related to rulemaking. Below we summarize our analyses based on these statutes and executive orders. 1...

Impact of Contextual Factors on Prostate Cancer Risk and Outcomes

DTIC Science & Technology

2013-07-01

framework with random effects (“frailty models”) while the case-control analyses (Aim 4) will use multilevel unconditional logistic regression models...contextual-level SES on prostate cancer risk within racial/ethnic groups. The survival analyses (Aims 1-3) will utilize a proportional hazards regression

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

Racial/ethnic and sociodemographic factors associated with micronutrient intakes and inadequacies among pregnant women in an urban US population.

PubMed

Brunst, Kelly J; Wright, Robert O; DiGioia, Kimberly; Enlow, Michelle Bosquet; Fernandez, Harriet; Wright, Rosalind J; Kannan, Srimathi

2014-09-01

To assess sociodemographic correlates of micronutrient intakes from food and dietary supplements in an urban, ethnically diverse sample of pregnant women in the USA. Cross-sectional analyses of data collected using a validated semi-quantitative FFQ. Associations between racial, ethnic and sociodemographic factors and micronutrient intakes were examined using logistic regression controlling for pre-pregnancy BMI, maternal age and smoking status. Prenatal clinics, Boston, MA, USA. Analyses included pregnant women (n 274) in the PRogramming of Intergenerational Stress Mechanisms (PRISM) study, an urban longitudinal cohort designed to examine how stress influences respiratory health in children when controlling for other environmental exposures (chemical stressors, nutrition). High frequencies of vitamin E (52 %), Mg (38 %), Fe (57 %) and vitamin D (77 %) inadequacies as well as suboptimal intakes of choline (95 %) and K (99 %) were observed. Factors associated with multiple antioxidant inadequacies included being Hispanic or African American, lower education and self-reported economic-related food insecurity. Hispanics had a higher prevalence of multiple methyl-nutrient inadequacies compared with African Americans; both had suboptimal betaine intakes and higher odds for vitamin B₆ and Fe inadequacies compared with Caucasians. Nearly all women (98 %) reported Na intakes above the tolerable upper limit; excessive intakes of Mg (35 %), folate (37 %) and niacin (38 %) were also observed. Women reporting excessive intakes of these nutrients were more likely Caucasian or Hispanic, more highly educated, US-born and did not report food insecurity. Racial/ethnic and other sociodemographic factors should be considered when tailoring periconceptional dietary interventions for urban ethnic women in the USA.

Financial strain and cancer risk behaviors among African Americans.

PubMed

Advani, Pragati S; Reitzel, Lorraine R; Nguyen, Nga T; Fisher, Felicia D; Savoy, Elaine J; Cuevas, Adolfo G; Wetter, David W; McNeill, Lorna H

2014-06-01

African Americans suffer disproportionately from the adverse consequences of behavioral risk factors for cancer relative to other ethnic groups. Recent studies have assessed how financial strain might uniquely contribute to engagement in modifiable behavioral risk factors for cancer, but not among African Americans. The current study examined associations between financial strain and modifiable cancer risk factors (smoking, at-risk alcohol use, overweight/obesity, insufficient physical activity, inadequate fruit and vegetable intake, and multiple risk factors) among 1,278 African American adults (age, 46.5 ± 12.6 years; 77% female) and explored potential mediators (stress and depressive symptoms) of those associations. Logistic regression models were used to examine associations between financial strain and cancer risk factors. Analyses were adjusted for age, sex, partner status, income, educational level, and employment status. Analyses involving overweight/obesity status additionally controlled for fruit and vegetable intake and physical activity. Nonparametric bootstrapping procedures were used to assess mediation. Greater financial strain was associated with greater odds of insufficient physical activity (P < 0.003) and smoking (P = 0.005) and was positively associated with the total number of cancer risk factors (P < 0.0001). There was a significant indirect effect of both stress and depressive symptoms on the relations of financial strain with physical inactivity and multiple risk factors, respectively. Future interventions aimed at reducing cancer disparities should focus on African Americans experiencing higher financial strain while addressing their stress and depressive symptoms. Longitudinal studies are needed to assess the temporal and causal relations between financial strain and modifiable behavioral cancer risk factors among African Americans. ©2014 American Association for Cancer Research.

Short interpregnancy interval and low birth weight: A role of parity.

PubMed

Merklinger-Gruchala, Anna; Jasienska, Grazyna; Kapiszewska, Maria

2015-01-01

Short interpregnancy intervals (IPI) and high parity may be synergistically associated with the risk of unfavorable pregnancy outcomes. This study tests if the effect of short IPI on the odds ratio for low birth weight (LBW, <2,500 g) differs across parity status. The study was carried out on the birth registry sample of almost 40,000 singleton, live-born infants who were delivered between the years 1995 and 2009 to multiparous mothers whose residence at the time of infant's birth was the city of Krakow. Multiple logistic regression analyses were used for testing the effect of IPI on the odds ratio (OR) for LBW, after controlling for employment, educational and marital status, parity, sex of the child, maternal and gestational age. Stratified analyses (according to parity) and tests for interaction were performed. Very short IPI (0-5 months) was associated with an increased OR for LBW, but only among high parity mothers with three or more births (OR = 2.64; 95% CI 1.45-4.80). The test for interaction between very short IPI and parity on the OR for LBW was statistically significant after adjustment for multiple comparisons (P = 0.04). Among low parity mothers (two births) no statistically significant associations were found between IPI and LBW after standardization. Parity may modify the association between short birth spacing and LBW. Women with very short IPI and high parity may have a higher risk of having LBW infants than those with very short IPI but low parity. © 2015 Wiley Periodicals, Inc.

MULTIPLE NONSPECIFIC SITES OF JOINT PAIN OUTSIDE THE KNEES DEVELOP IN PERSONS WITH KNEE PAIN

PubMed Central

Felson, David T.; Niu, Jingbo; Quinn, Emily K; Neogi, Tuhina; Lewis, Cara; Lewis, Cora E.; Law, Laura Frey; McCulloch, Chuck; Nevitt, Michael; LaValley, Michael

2017-01-01

Objective Many persons with knee pain have joint pain outside the knee but despite the impact and high frequency of this pain, its distribution and causes have not been studied. Those studying gait abnormalities have suggested that knee pain causes pain in adjacent joints but pain adaptation strategies are highly individualized. Methods We studied persons age 50-79 years with or at high risk of knee osteoarthritis drawn from two community-based cohorts, the Multicenter Osteoarthritis Study and the Osteoarthritis Initiative and followed for 5-7 years. We excluded those with knee pain at baseline and compared those who developed and did not develop knee pain at the first follow-up examination (the index visit). We examined pain on most days at joint regions outside the knee in examinations after the index visit. Logistic regression analyses examined the risk of joint specific pain adjusted for age, sex, BMI, depression with sensitivity analyses excluding those with widespread pain. Results In the combined cohorts, there were 693 persons with index visit knee pain vs. 2793 without it. 79.6% of those with bilateral and 63.8% of those with unilateral knee pain had pain during follow-up in a joint region outside the knee vs. 49.9% of those without knee pain. An increased risk of pain was present in most extremity joint sites without a predilection for specific sites. Results were unchanged when those with widespread pain were excluded. Conclusions Persons with chronic knee pain are at increased risk of pain in multiple joints in no specific pattern. PMID:27589036

Trends and risk factors of stillbirths and neonatal deaths in Eastern Uganda (1982-2011): a cross-sectional, population-based study.

PubMed

Kujala, Sanni; Waiswa, Peter; Kadobera, Daniel; Akuze, Joseph; Pariyo, George; Hanson, Claudia

2017-01-01

To identify mortality trends and risk factors associated with stillbirths and neonatal deaths 1982-2011. Population-based cross-sectional study based on reported pregnancy history in Iganga-Mayuge Health and Demographic Surveillance Site (HDSS) in Uganda. A pregnancy history survey was conducted among women aged 15-49 years living in the HDSS during May-July 2011 (n = 10 540). Time trends were analysed with cubic splines and linear regression. Potential risk factors were examined with multilevel logistic regression with adjusted odds ratios (AOR) and 95% confidence intervals (CI). 34 073 births from 1982 to 2011 were analysed. The annual rate of decrease was 0.9% for stillbirths and 1.8% for neonatal mortality. Stillbirths were associated with several risk factors: multiple births (AOR 2.57, CI 1.66-3.99), previous adverse outcome (AOR 6.16, CI 4.26-8.88) and grand multiparity among 35- to 49-year-olds (AOR 1.97, CI 1.32-2.89). Neonatal deaths were associated with multiple births (AOR 6.16, CI 4.80-7.92) and advanced maternal age linked with parity of 1-4 (AOR 2.34, CI 1.28-4.25) and grand multiparity (AOR 1.44, CI 1.09-1.90). Education, marital status and household wealth were not associated with the outcomes. The slow decline in mortality rates and easily identifiable risk factors calls for improving quality of care at birth and a rethinking of how to address obstetric risks, potentially a revival of the risk approach in antenatal care. © 2016 John Wiley & Sons Ltd.

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.

Acute otitis media and sociomedical risk factors among unselected children in Greenland.

PubMed

Homøe, P; Christensen, R B; Bretlau, P

1999-06-15

To describe the sociomedical risk factors associated with episodes of acute otitis media (AOM), recurrent AOM (rAOM), and chronic otitis media (COM) in Greenlandic children and especially to point out children at high risk of rAOM (defined as > 5 AOM episodes since birth) and COM which are prevalent among Inuit children all over the Arctic. The study design was cross-sectional and included 740 unselected children, 3, 4, 5, and 8-years-old, living in two major Greenlandic towns, Nuuk and Sisimiut. All children were otologically examined and the parents answered a questionnaire containing sociomedical variables including ethnicity, family history of OM, housing, insulation, crowding, daycare, passive cigarette smoking, breast feeding, type of diet, allergy, and chronic diseases. Historical data were cross-checked in medical records which also formed the basis for the drop-out analyses. Statistical analyses included frequency tests, calculation of odds ratio (OR), and multiple logistic regression. The attendance rate was 86%. Former episode of AOM was reported by 2/3 of the children, rAOM by 20%, and COM by 9%. The following variables were found significantly more often in children with AOM by simple frequency testing: Parental (OR = 1.83), sibling (OR = 1.62), and parental plus sibling (OR = 2.56) history of OM, crowding (OR = 5.55), long period of exclusive breast feeding ( > 4 months) (OR = 2.47), and recent acute disease (P = 0.034). The following variables were found significantly more often in children with rAOM or COM by simple frequency testing: Parental history of OM (OR = 1.60; OR = 2.11, respectively) and no recall of breast feeding (P = 0.005; P = 0.003, respectively). Also, COM was found significantly more often in children with two Greenlandic parents (OR = 3.07). A multiple logistic regression test denoted only parental history of OM (OR = 1.82) and long period of exclusive breast feeding (OR = 1.14) as significant predictors of AOM. Many of the risk factors usually associated with AOM could not be confirmed as risk factors in this survey. Parental history of OM and long period of exclusive breast feeding were the strongest factors associated with AOM in Greenlandic children and ethnicity was associated with COM. However, the study confirms that AOM is a multifactorial disease determined by a number of genetic and environmental factors.

Bidirectional relationship between renal function and periodontal disease in older Japanese women.

PubMed

Yoshihara, Akihiro; Iwasaki, Masanori; Miyazaki, Hideo; Nakamura, Kazutoshi

2016-09-01

The purpose of this study was to evaluate the reciprocal effects of chronic kidney disease (CKD) and periodontal disease. A total of 332 postmenopausal never smoking women were enrolled, and their serum high-sensitivity C-reactive protein, serum osteocalcin and serum cystatin C levels were measured. Poor renal function was defined as serum cystatin C > 0.91 mg/l. Periodontal disease markers, including clinical attachment level and the periodontal inflamed surface area (PISA), were also evaluated. Logistic regression analysis was conducted to evaluate the relationships between renal function and periodontal disease markers, serum osteocalcin level and hsCRP level. The prevalence-rate ratios (PRRs) on multiple Poisson regression analyses were determined to evaluate the relationships between periodontal disease markers and serum osteocalcin, serum cystatin C and serum hsCRP levels. On logistic regression analysis, PISA was significantly associated with serum cystatin C level. The odds ratio for serum cystatin C level was 2.44 (p = 0.011). The PRR between serum cystatin C level and periodontal disease markers such as number of sites with clinical attachment level ≥6 mm was significantly positive (3.12, p < 0.001). Similar tendencies were shown for serum osteocalcin level. This study suggests that CKD and periodontal disease can have reciprocal effects. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Determinants of physician utilization, emergency room use, and hospitalizations among populations with multiple health vulnerabilities.

PubMed

Small, La Fleur F

2011-09-01

Understanding the factors that influence differing types of health care utilization within vulnerable groups can serve as a basis for projecting future health care needs, forecasting future health care expenditures, and influencing social policy. In this article the Behavioral Model for Vulnerable Populations is used to evaluate discretionary (physician visits) and non-discretionary (emergency room visits, and hospitalizations) health utilization patterns of a sample of 1466 respondents with one or more vulnerable health classification. Reported vulnerabilities include: (1) persons with substance disorders; (2) homeless persons; (3) persons with mental health problems; (4) victims of violent crime; (5) persons diagnosed with HIV/AIDS; (6) and persons in receipt of public benefits. Hierarchical logistic regression is used on three nested models to model factors that influence physician visits, emergency room visits, and hospitalizations. Additionally, bivariate logistic regression analyses are completed using a vulnerability index to evaluate the impact of increased numbers of vulnerability on all three forms of health care utilization. Findings from this study suggest the Behavioral Model of Vulnerable Populations be employed in future research regarding health care utilization patterns among vulnerable populations. This article encourages further research investigating the cumulative effect of health vulnerabilities on the use of non-discretionary services so that this behavior could be better understood and appropriate social policies and behavioral interventions implemented.

Higher direct bilirubin levels during mid-pregnancy are associated with lower risk of gestational diabetes mellitus.

PubMed

Liu, Chaoqun; Zhong, Chunrong; Zhou, Xuezhen; Chen, Renjuan; Wu, Jiangyue; Wang, Weiye; Li, Xiating; Ding, Huisi; Guo, Yanfang; Gao, Qin; Hu, Xingwen; Xiong, Guoping; Yang, Xuefeng; Hao, Liping; Xiao, Mei; Yang, Nianhong

2017-01-01

Bilirubin concentrations have been recently reported to be negatively associated with type 2 diabetes mellitus. We examined the association between bilirubin concentrations and gestational diabetes mellitus. In a prospective cohort study, 2969 pregnant women were recruited prior to 16 weeks of gestation and were followed up until delivery. The value of bilirubin was tested and oral glucose tolerance test was conducted to screen gestational diabetes mellitus. The relationship between serum bilirubin concentration and gestational weeks was studied by two-piecewise linear regression. A subsample of 1135 participants with serum bilirubin test during 16-18 weeks gestation was conducted to research the association between serum bilirubin levels and risk of gestational diabetes mellitus by logistic regression. Gestational diabetes mellitus developed in 8.5 % of the participants (223 of 2969). Two-piecewise linear regression analyses demonstrated that the levels of bilirubin decreased with gestational week up to the turning point 23 and after that point, levels of bilirubin were increased slightly. In multiple logistic regression analysis, the relative risk of developing gestational diabetes mellitus was lower in the highest tertile of direct bilirubin than that in the lowest tertile (RR 0.60; 95 % CI, 0.35-0.89). The results suggested that women with higher serum direct bilirubin levels during the second trimester of pregnancy have lower risk for development of gestational diabetes mellitus.

Arteriovenous fistula maturation in patients with permanent access created prior to or after hemodialysis initiation.

PubMed

Duque, Juan C; Martinez, Laisel; Tabbara, Marwan; Dvorquez, Denise; Mehandru, Sushil K; Asif, Arif; Vazquez-Padron, Roberto I; Salman, Loay H

2017-05-15

Multiple factors and comorbidities have been implicated in the ability of arteriovenous fistulas (AVF) to mature, including vessel anatomy, advanced age, and the presence of coronary artery disease or peripheral vascular disease. However, little is known about the role of uremia on AVF primary failure. In this study, we attempt to evaluate the effect of uremia on AVF maturation by comparing AVF outcomes between pre-dialysis chronic kidney disease (CKD) stage five patients and those who had their AVF created after hemodialysis (HD) initiation. We included 612 patients who underwent AVF creation between 2003 and 2015 at the University of Miami Hospital and Jackson Memorial Hospital. Effects of uremia on primary failure were evaluated using univariate statistical comparisons and multivariate logistic regression analyses. Primary failure occurred in 28.1% and 26.3% of patients with an AVF created prior to or after HD initiation, respectively (p = 0.73). The time of HD initiation was not associated with AVF maturation in multivariate logistic regression analysis (p = 0.57). In addition, pre-operative blood urea nitrogen (p = 0.78), estimated glomerular filtration rate (p = 0.66), and serum creatinine levels (p = 0.14) were not associated with AVF primary failure in pre-dialysis patients. Our results show that clearance of uremia with regular HD treatments prior to AVF creation does not improve the frequency of vascular access maturation.

Factors associated with sources, transport, and fate of chloroform and three other trihalomethanes in untreated groundwater used for drinking water

USGS Publications Warehouse

Carter, Janet M.; Moran, Michael J.; Zogorski, John S.; Price, Curtis V.

2012-01-01

Multiple lines of evidence for indicating factors associated with the sources, transport, and fate of chloroform and three other trihalomethanes (THMs) in untreated groundwater were revealed by evaluating low-level analytical results and logistic regression results for THMs. Samples of untreated groundwater from wells used for drinking water were collected from 1996-2007 from 2492 wells across the United States and analyzed for chloroform, bromodichloromethane, dibromochloromethane, and bromoform by a low-level analytical method implemented in April 1996. Using an assessment level of 0.02 μg/L, chloroform was detected in 36.5% of public-well samples and 17.6% of domestic-well samples, with most concentrations less than 1 μg/L. Brominated THMs occurred less frequently than chloroform but more frequently in public-well samples than domestic-well samples. For both public and domestic wells, THMs occurred most frequently in urban areas. Logistic regression analyses showed that the occurrence of THMs was related to nonpoint sources such as urban land use and to point sources like septic systems. The frequent occurrence and concentration distribution pattern of THMs, as well as their frequent co-occurrence with other organic compounds and nitrate, all known to have anthropogenic sources, and the positive associations between THM occurrence and dissolved oxygen and recharge indicate the recycling of water that contains THMs and other anthropogenic contaminants.

Peers, tobacco advertising, and secondhand smoke exposure influences smoking initiation in diverse adolescents.

PubMed

Voorhees, Carolyn C; Ye, Cong; Carter-Pokras, Olivia; MacPherson, Laura; Kanamori, Mariano; Zhang, Guangyu; Chen, Lu; Fiedler, Robert

2011-01-01

Identify demographic, social, and environmental factors associated with smoking initiation in a large, racially and ethnically diverse sample of underage youth participating in the 2006 Maryland Youth Tobacco Survey. Cross-sectional, multistage, probability sample survey. Schools (308 middle and high schools) in Maryland. Subjects were 12- to 17-year-old adolescents participating in a school-based survey. New smokers and nonsmokers were included in the analysis (n  =  57,072). Social and media influence, secondhand smoke exposure, tobacco product use, and demographic information including age, race/ethnicity, and geographic region. Chi-square and multiple logistic regression analyses controlling for clustering. Hispanic and Hawaiian/Pacific Islander youth were most likely and Asian and Black youth were least likely to be new smokers. Smoking initiation was positively associated with higher age, living with a current smoker, secondhand smoke exposure, exposure to advertisements for tobacco products, having more friends that smoke, tobacco products offered by friends, risk perceptions, and use of other tobacco products such as smokeless tobacco and cigars. Multivariate logistic regression results suggested that composite measures of peer influence, advertising exposure, and secondhand smoke exposure were independently associated with smoking initiation. Media, peer influence, and secondhand smoke exposure were the most important factors influencing smoking initiation and were common to all racial/ethnic groups in this study. Interventions combining targeted public awareness, education, and media campaigns directed at parents/guardians should be investigated.

Peripheral arterial stiffness is associated with higher baseline plasma uric acid: A prospective cohort study.

PubMed

Ding, Xiaohan; Ye, Ping; Wang, Xiaona; Cao, Ruihua; Yang, Xu; Xiao, Wenkai; Zhang, Yun; Bai, Yongyi; Wu, Hongmei

2017-03-01

This prospective cohort study aimed at identifying association between uric acid (UA) and peripheral arterial stiffness. A prospective cohort longitudinal study was performed according to an average of 4.8 years' follow-up. The demographic data, anthropometric parameters, peripheral arterial stiffness (carotid-radial pulse-wave velocity, cr-PWV) and biomarker variables including UA were examined at both baseline and follow-up. Pearson's correlations were used to identify the associations between UA and peripheral arterial stiffness. Further logistic regressions were employed to determine the associations between UA and arterial stiffness. At the end of follow-up, 1447 subjects were included in the analyses. At baseline, cr-PWV ( r  = 0.200, p  < 0.001) was closely associated with UA. Furthermore, the follow-up cr-PWV ( r  = 0.145, p  < 0.001) was also strongly correlated to baseline UA in Pearson's correlation analysis. Multiple regressions also indicated the association between follow-up cr-PWV ( β  = 0.493, p  = 0.013) and baseline UA level. Logistic regressions revealed that higher baseline UA level was an independent predictor of arterial stiffness severity assessed by cr-PWV at follow-up cross-section. Peripheral arterial stiffness is closely associated with higher baseline UA level. Furthermore, a higher baseline UA level is an independent risk factor and predictor for peripheral arterial stiffness.

Sexual abuse, sexual orientation, and obesity in women.

PubMed

Smith, Helen A; Markovic, Nina; Danielson, Michelle E; Matthews, Alicia; Youk, Ada; Talbott, Evelyn O; Larkby, Cynthia; Hughes, Tonda

2010-08-01

Among adult women an association between childhood sexual abuse (CSA) and obesity has been observed. Research with lesbian women has consistently identified high rates of obesity as well as frequent reports of CSA, but associations between sexual abuse and obesity have not been fully explored. Our aim was to investigate the relationship between sexual abuse (SA) history and obesity among heterosexual (n = 392) and lesbian (n = 475) women (age 35-64) who participated in the Epidemiologic STudy of HEalth Risk in Women (ESTHER) Project in Pittsburgh, Pennsylvania. Obesity was defined as body mass index (BMI) > or =30. Covariates included self-reported SA, sexual orientation, demographic factors, and history of a depression or anxiety diagnosis. SA history was assessed by three factors: (1) SA experienced under the age of 18 by a family member or (2) by a nonfamily member and (3) forced, unwanted sexual experience(s) at age > or =18. Data were analyzed using chi-square tests and logistic regression models. Multiple logistic regression analyses revealed that obesity was associated with African American race, lesbian sexual orientation, intrafamilial CSA, and history of mental health diagnosis. Protective factors were having a household income of at least $75,000 and having a bachelor's degree or higher. Results suggest that lesbian women may be at greater risk of obesity than heterosexual women and that intrafamilial CSA--regardless of sexual orientation--may play a role in the development of obesity.

Logistic Regression in the Identification of Hazards in Construction

NASA Astrophysics Data System (ADS)

Drozd, Wojciech

2017-10-01

The construction site and its elements create circumstances that are conducive to the formation of risks to safety during the execution of works. Analysis indicates the critical importance of these factors in the set of characteristics that describe the causes of accidents in the construction industry. This article attempts to analyse the characteristics related to the construction site, in order to indicate their importance in defining the circumstances of accidents at work. The study includes sites inspected in 2014 - 2016 by the employees of the District Labour Inspectorate in Krakow (Poland). The analysed set of detailed (disaggregated) data includes both quantitative and qualitative characteristics. The substantive task focused on classification modelling in the identification of hazards in construction and identifying those of the analysed characteristics that are important in an accident. In terms of methodology, resource data analysis using statistical classifiers, in the form of logistic regression, was the method used.

A dimensional approach to understanding severity estimates and risk correlates of marijuana abuse and dependence in adults

PubMed Central

WU, LI-TZY; WOODY, GEORGE E.; YANG, CHONGMING; PAN, JENG-JONG; REEVE, BRYCE B.; BLAZER, DAN G.

2012-01-01

While item response theory (IRT) research shows a latent severity trait underlying response patterns of substance abuse and dependence symptoms, little is known about IRT-based severity estimates in relation to clinically relevant measures. In response to increased prevalences of marijuana-related treatment admissions, an elevated level of marijuana potency, and the debate on medical marijuana use, we applied dimensional approaches to understand IRT-based severity estimates for marijuana use disorders (MUDs) and their correlates while simultaneously considering gender- and race/ethnicity-related differential item functioning (DIF). Using adult data from the 2008 National Survey on Drug Use and Health (N=37,897), DSM-IV criteria for MUDs among past-year marijuana users were examined by IRT, logistic regression, and multiple indicators–multiple causes (MIMIC) approaches. Among 6,917 marijuana users, 15% met criteria for a MUD; another 24% exhibited subthreshold dependence. Abuse criteria were highly correlated with dependence criteria (correlation=0.90), indicating unidimensionality; item information curves revealed redundancy in multiple criteria. MIMIC analyses showed that MUD criteria were positively associated with weekly marijuana use, early marijuana use, other substance use disorders, substance abuse treatment, and serious psychological distress. African Americans and Hispanics showed higher levels of MUDs than whites, even after adjusting for race/ethnicity-related DIF. The redundancy in multiple criteria suggests an opportunity to improve efficiency in measuring symptom-level manifestations by removing low-informative criteria. Elevated rates of MUDs among African Americans and Hispanics require research to elucidate risk factors and improve assessments of MUDs for different racial/ethnic groups. PMID:22351489

A population-based study on the association between rheumatoid arthritis and voice problems.

PubMed

Hah, J Hun; An, Soo-Youn; Sim, Songyong; Kim, So Young; Oh, Dong Jun; Park, Bumjung; Kim, Sung-Gyun; Choi, Hyo Geun

2016-07-01

The objective of this study was to investigate whether rheumatoid arthritis increases the frequency of organic laryngeal lesions and the subjective voice complaint rate in those with no organic laryngeal lesion. We performed a cross-sectional study using the data from 19,368 participants (418 rheumatoid arthritis patients and 18,950 controls) of the 2008-2011 Korea National Health and Nutrition Examination Survey. The associations between rheumatoid arthritis and organic laryngeal lesions/subjective voice complaints were analyzed using simple/multiple logistic regression analysis with complex sample adjusting for confounding factors, including age, sex, smoking status, stress level, and body mass index, which could provoke voice problems. Vocal nodules, vocal polyp, and vocal palsy were not associated with rheumatoid arthritis in a multiple regression analysis, and only laryngitis showed a positive association (adjusted odds ratio, 1.59; 95 % confidence interval, 1.01-2.52; P = 0.047). Rheumatoid arthritis was associated with subjective voice discomfort in a simple regression analysis, but not in a multiple regression analysis. Participants with rheumatoid arthritis were older, more often female, and had higher stress levels than those without rheumatoid arthritis. These factors were associated with subjective voice complaints in both simple and multiple regression analyses. Rheumatoid arthritis was not associated with organic laryngeal diseases except laryngitis. Rheumatoid arthritis did not increase the odds ratio for subjective voice complaints. Voice problems in participants with rheumatoid arthritis originated from the characteristics of the rheumatoid arthritis group (higher mean age, female sex, and stress level) rather than rheumatoid arthritis itself.

75 FR 2438 - Safety Zone; Havasu Landing Annual Regatta; Colorado River, Lake Havasu Landing, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... proposed rulemaking (NPRM) with respect to this rule because it was impracticable since the logistical... the Port, or his designated representative. Regulatory Analyses We developed this rule after considering numerous statutes and executive orders related to rulemaking. Below we summarize our analyses...

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

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

Association between childhood sexual abuse and transactional sex in youth aging out of foster care.

PubMed

Ahrens, Kym R; Katon, Wayne; McCarty, Carolyn; Richardson, Laura P; Courtney, Mark E

2012-01-01

To evaluate the association between history of childhood sexual abuse (CSA) and having transactional sex among adolescents who have been in foster care. We used an existing dataset of youth transitioning out of foster care. Independent CSA variables included self report of history of sexual molestation and rape when participants were, on average, 17 years of age. Our outcome variables were self-report of having transactional sex ever and in the past year, when participants were an average age of 19 years. Separate multiple logistic regression analyses were conducted to assess the associations between CSA variables and transactional sex variables. Initial analyses were performed on both genders; exploratory analyses were then performed evaluating each gender separately. Total N=732; 574 were included in the main analyses. History of sexual molestation was significantly associated with increased odds of having transactional sex, both ever and in the past year (OR [95% CI]: 3.21 [1.26-8.18] and 4.07 [1.33, 12.52], respectively). History of rape was also significantly associated with increased odds of having had transactional sex ever and in the past year (ORs [95% CI]: 3.62 [1.38-9.52] and 3.78 [1.19, 12.01], respectively). Odds ratios in female-only analyses remained significant and were larger in magnitude compared with the main, non-stratified analyses; odds ratios in male-only analyses were non-significant and smaller in magnitude when compared with the main analyses. Both CSA variables were associated with increased likelihood of transactional sex. This association appears to vary by gender. Our results suggest that policymakers for youth in foster care should consider the unique needs of young women with histories of CSA when developing programs to support healthy relationships. Health care providers should also consider adapting screening and counseling practices to reflect the increased risk of transactional sex for female youth in foster care with a history of CSA. Copyright © 2012 Elsevier Ltd. All rights reserved.

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.

Ten years of helicopter emergency medical services in Germany: do we still need the helicopter rescue in multiple traumatised patients?

PubMed

Andruszkow, Hagen; Hildebrand, Frank; Lefering, Rolf; Pape, Hans-Christoph; Hoffmann, Reinhard; Schweigkofler, Uwe

2014-10-01

Helicopter emergency medical service (HEMS) has been established in the preclinical treatment of multiple traumatised patients despite an ongoing controversy towards the potential benefit. Celebrating the 20th anniversary of TraumaRegister DGU(®) of the German Trauma Society (DGU) the presented study intended to provide an overview of HEMS rescue in Germany over the last 10 years analysing the potential beneficial impact of a nationwide helicopter rescue in multiple traumatised patients. We analysed TraumaRegister DGU(®) including multiple traumatised patients (ISS ≥ 16) between 2002 and 2012. In-hospital mortality was defined as main outcome. An adjusted, multivariate regression with 13 confounders was performed to evaluate the potential survival benefit. 42,788 patients were included in the present study. 14,275 (33.4%) patients were rescued by HEMS and 28,513 (66.6%) by GEMS. Overall, 66.8% (n=28,569) patients were transported to a level I trauma centre and 28.2% (n=12,052) to a level II trauma centre. Patients rescued by HEMS sustained a higher injury severity compared to GEMS (ISS HEMS: 29.5 ± 12.6 vs. 27.5 ± 11.8). Helicopter rescue teams performed more on-scene interventions, and mission times were increased in HEMS rescue (HEMS: 77.2 ± 28.7 min. vs. GEMS: 60.9 ± 26.9 min.). Linear regression analysis revealed that the frequency of HEMS rescue has decreased significantly between 2002 and 2012. In case of transportation to level I trauma centres a decrease of 1.7% per year was noted (p<0.001) while a decline of 1.6% per year (p<0.001) was measured for level II trauma centre admissions. According to multivariate logistic regression HEMS was proven a positive independent survival predictor between 2002 and 2012 (OR 0.863; 95%-CI 0.800-0.930; Nagelkerkes-R(2) 0.539) with only little differences between each year. This study was able to prove an independent survival benefit of HEMS in multiple traumatised patients during the last 10 years. Despite this fact, a constant decline of HEMS rescue missions was found in multiple trauma patients due to unknown reasons. We concluded that HEMS should be used more often in case of trauma in order to guarantee the proven benefit for multiple traumatised patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

Adherence to Rivaroxaban, Dabigatran, and Apixaban for Stroke Prevention for Newly Diagnosed and Treatment-Naive Atrial Fibrillation Patients: An Update Using 2013–2014 Data

PubMed Central

Brown, Joshua D.; Shewale, Anand R.; Talbert, Jeffery C.

2017-01-01

BACKGROUND Few studies have assessed adherence to non-vitamin K antagonist oral anticoagulants (NOACs), especially using contemporary data now that multiple NOACs are available. OBJECTIVE To compare adherence and treatment patterns among NOACs for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). METHODS Incident and treatment-naive NVAF patients were identified during 2013–2014 from a large claims database in this retrospective cohort study. Patients were included who initiated rivaroxaban, dabigatran, or apixaban within 30 days after diagnosis. Adherence to the index medication and adherence to any oral anticoagulant was assessed using the proportion of days covered (PDC) at 3, 6, and 9 months. The number of switches and gaps in therapy were also evaluated. Analyses were stratified by stroke risk scores, and a logistic regression model was used to control for factors that may predict high adherence. RESULTS Dabigatran had lower adherence (PDC = 0.76, 0.64, 0.57) compared with rivaroxaban (PDC = 0.83, 0.73, 0.66; P < 0.001) and apixaban (PDC = 0.82, 0.72, 0.66; P < 0.001) at 3, 6, and 9 months of follow-up and twice the number of switches to either other anticoagulants or antiplatelet therapy. Adherence was higher overall as stroke risk increased, and dabigatran had consistently lower adherence compared with the other NOACs. Multivariable logistic regression predicting PDC ≥ 0.80 showed rivaroxaban users with higher odds of high adherence compared with dabigatran or rivaroxaban across all time periods. Adjusted analyses showed that increasing age and comorbid hypertension and diabetes were associated with higher adherence. CONCLUSIONS In this real-world analysis of adherence to NOACs, rivaroxaban and apixaban had favorable unadjusted adherence profiles compared with dabigatran, while rivaroxaban users had higher odds of high adherence (PDC ≥ 0.80) among the NOACs in adjusted analyses. Clinicians and managed care organizations should consider the implications of lower adherence on clinical outcomes and quality assessment. PMID:28854077

Comparison of Xenon-Enhanced Area-Detector CT and Krypton Ventilation SPECT/CT for Assessment of Pulmonary Functional Loss and Disease Severity in Smokers.

PubMed

Ohno, Yoshiharu; Fujisawa, Yasuko; Takenaka, Daisuke; Kaminaga, Shigeo; Seki, Shinichiro; Sugihara, Naoki; Yoshikawa, Takeshi

2018-02-01

The objective of this study was to compare the capability of xenon-enhanced area-detector CT (ADCT) performed with a subtraction technique and coregistered 81m Kr-ventilation SPECT/CT for the assessment of pulmonary functional loss and disease severity in smokers. Forty-six consecutive smokers (32 men and 14 women; mean age, 67.0 years) underwent prospective unenhanced and xenon-enhanced ADCT, 81m Kr-ventilation SPECT/CT, and pulmonary function tests. Disease severity was evaluated according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. CT-based functional lung volume (FLV), the percentage of wall area to total airway area (WA%), and ventilated FLV on xenon-enhanced ADCT and SPECT/CT were calculated for each smoker. All indexes were correlated with percentage of forced expiratory volume in 1 second (%FEV 1 ) using step-wise regression analyses, and univariate and multivariate logistic regression analyses were performed. In addition, the diagnostic accuracy of the proposed model was compared with that of each radiologic index by means of McNemar analysis. Multivariate logistic regression showed that %FEV 1 was significantly affected (r = 0.77, r 2 = 0.59) by two factors: the first factor, ventilated FLV on xenon-enhanced ADCT (p < 0.0001); and the second factor, WA% (p = 0.004). Univariate logistic regression analyses indicated that all indexes significantly affected GOLD classification (p < 0.05). Multivariate logistic regression analyses revealed that ventilated FLV on xenon-enhanced ADCT and CT-based FLV significantly influenced GOLD classification (p < 0.0001). The diagnostic accuracy of the proposed model was significantly higher than that of ventilated FLV on SPECT/CT (p = 0.03) and WA% (p = 0.008). Xenon-enhanced ADCT is more effective than 81m Kr-ventilation SPECT/CT for the assessment of pulmonary functional loss and disease severity.

On the effects of nonlinear boundary conditions in diffusive logistic equations on bounded domains

NASA Astrophysics Data System (ADS)

Cantrell, Robert Stephen; Cosner, Chris

We study a diffusive logistic equation with nonlinear boundary conditions. The equation arises as a model for a population that grows logistically inside a patch and crosses the patch boundary at a rate that depends on the population density. Specifically, the rate at which the population crosses the boundary is assumed to decrease as the density of the population increases. The model is motivated by empirical work on the Glanville fritillary butterfly. We derive local and global bifurcation results which show that the model can have multiple equilibria and in some parameter ranges can support Allee effects. The analysis leads to eigenvalue problems with nonstandard boundary conditions.

Cervical human papillomavirus infection among young women engaged in sex work in Phnom Penh, Cambodia: prevalence, genotypes, risk factors and association with HIV infection.

PubMed

Couture, Marie-Claude; Page, Kimberly; Stein, Ellen S; Sansothy, Neth; Sichan, Keo; Kaldor, John; Evans, Jennifer L; Maher, Lisa; Palefsky, Joel

2012-07-28

Although cervical cancer is the leading cancer in Cambodia, most women receive no routine screening for cervical cancer and few treatment options exist. Moreover, nothing is known regarding the prevalence of cervical HPV or the genotypes present among women in the country. Young sexually active women, especially those with multiple sex partners are at highest risk of HPV infection. We examine the prevalence and genotypes of cervical HPV, as well as the associated risk factors among young women engaged in sex work in Phnom Penh, Cambodia. We conducted a cross-sectional study among 220 young women (15-29 years) engaged in sex work in different venues including brothels or entertainment establishments, and on a freelance basis in streets, parks and private apartments. Cervical specimens were collected using standard cytobrush technique. HPV DNA was tested for by polymerase chain reaction (PCR) and genotyping using type-specific probes for 29 individual HPV types, as well as for a mixture of 10 less common HPV types. All participants were also screened for HIV status using blood samples. Multivariate logistic regression analyses were conducted to assess risk factors for any or multiple HPV infection. The prevalence of cervical HPV 41.1%. HPV 51 and 70 were the most common (5.0%), followed by 16 (4.6%), 71 (4.1%) and 81 (3.7%). Thirty-six women (16.4%) were infected with multiple genotypes and 23.3% were infected with at least one oncogenic HPV type. In multivariate analyses, having HIV infection and a higher number of sexual partners were associated with cervical HPV infection. Risk factors for infection with multiple genotypes included working as freelance female sex workers (FSW) or in brothels, recent binge use of drugs, high number of sexual partners, and HIV infection. This is the first Cambodian study on cervical HPV prevalence and genotypes. We found that HPV infection was common among young FSW, especially among women infected with HIV. These results underscore the urgent need for accessible cervical cancer screening and treatment, as well as for a prophylactic vaccine that covers the HPV subtypes present in Cambodia.

Proposal of a Clinical Decision Tree Algorithm Using Factors Associated with Severe Dengue Infection.

PubMed

Tamibmaniam, Jayashamani; Hussin, Narwani; Cheah, Wee Kooi; Ng, Kee Sing; Muninathan, Prema

2016-01-01

WHO's new classification in 2009: dengue with or without warning signs and severe dengue, has necessitated large numbers of admissions to hospitals of dengue patients which in turn has been imposing a huge economical and physical burden on many hospitals around the globe, particularly South East Asia and Malaysia where the disease has seen a rapid surge in numbers in recent years. Lack of a simple tool to differentiate mild from life threatening infection has led to unnecessary hospitalization of dengue patients. We conducted a single-centre, retrospective study involving serologically confirmed dengue fever patients, admitted in a single ward, in Hospital Kuala Lumpur, Malaysia. Data was collected for 4 months from February to May 2014. Socio demography, co-morbidity, days of illness before admission, symptoms, warning signs, vital signs and laboratory result were all recorded. Descriptive statistics was tabulated and simple and multiple logistic regression analysis was done to determine significant risk factors associated with severe dengue. 657 patients with confirmed dengue were analysed, of which 59 (9.0%) had severe dengue. Overall, the commonest warning sign were vomiting (36.1%) and abdominal pain (32.1%). Previous co-morbid, vomiting, diarrhoea, pleural effusion, low systolic blood pressure, high haematocrit, low albumin and high urea were found as significant risk factors for severe dengue using simple logistic regression. However the significant risk factors for severe dengue with multiple logistic regressions were only vomiting, pleural effusion, and low systolic blood pressure. Using those 3 risk factors, we plotted an algorithm for predicting severe dengue. When compared to the classification of severe dengue based on the WHO criteria, the decision tree algorithm had a sensitivity of 0.81, specificity of 0.54, positive predictive value of 0.16 and negative predictive of 0.96. The decision tree algorithm proposed in this study showed high sensitivity and NPV in predicting patients with severe dengue that may warrant admission. This tool upon further validation study can be used to help clinicians decide on further managing a patient upon first encounter. It also will have a substantial impact on health resources as low risk patients can be managed as outpatients hence reserving the scarce hospital beds and medical resources for other patients in need.

The consumption of two or more fall risk-increasing drugs rather than polypharmacy is associated with falls.

PubMed

Zia, Anam; Kamaruzzaman, Shahrul B; Tan, Maw P

2017-03-01

The presemt study aimed to determine the association between the risk of recurrent and injurious falls with polypharmacy, fall risk-increasing drugs (FRID) and FRID count among community-dwelling older adults. Participants (n = 202) were aged ≥65 years with two or more falls or one injurious fall in the past year, whereas controls (n = 156) included volunteers aged ≥65 years with no falls in the past year. A detailed medication history was obtained alongside demographic data. Polypharmacy was defined as "regular use of five or more prescription drugs." FRID were identified as cardiovascular agents, central nervous system drugs, analgesics and endocrine drugs; multiple FRID were defined as two or more FRID. Multiple logistic regression analyses were used to adjust for confounders. The use of non-steroidal anti-inflammatory drugs was independently associated with an increased risk of falls. Univariate analyses showed both polypharmacy (OR 2.23, 95% CI 1.39-3.56; P = 0.001) and the use of two or more FRID (OR 2.9, 95% CI 1.9-4.5; P = 0.0001) were significantly more likely amongst fallers. After adjustment for age, sex and comorbidities, blood pressure, and physical performance scores, polypharmacy was no longer associated with falls (OR 1.6, 95% CI 0.9-2.9; P = 0.102), whereas the consumption of two or more FRID remained a significant predictor for falls (OR 2.8, 95% CI 1.4-5.3; P = 0.001). Among high risk fallers, the use of two or more FRID was an independent risk factor for falls instead of polypharmacy. Our findings will inform clinical practice in terms of medication reviews among older adults at higher risk of falls. Future intervention studies will seek to confirm whether avoidance or withdrawal of multiple FRID reduces the risk of future falls. Geriatr Gerontol Int 2017; 17: 463-470. © 2016 Japan Geriatrics Society.

Race, law, and health: Examination of 'Stand Your Ground' and defendant convictions in Florida.

PubMed

Ackermann, Nicole; Goodman, Melody S; Gilbert, Keon; Arroyo-Johnson, Cassandra; Pagano, Marcello

2015-10-01

Previous analyses of Stand Your Ground (SYG) cases have been primarily descriptive. We examine the relationship between race of the victim and conviction of the defendant in SYG cases in Florida from 2005 to 2013. Using a regression analytic approach, we allow for simultaneous examination of multiple factors to better understand existing interrelationships. Data was obtained from the Tampa Bay Times SYG database (237 cases) which was supplemented with available online court documents and/or news reports. After excluding cases which were, still pending as of January 2015; had multiple outcomes (because of multiple suspects); and missing information on race of victim and weapon of victim, our final analytic sample has 204 cases. We chose whether the case resulted in a conviction as the outcome. We develop logistic regression models using significant bivariate predictors as candidates. These include race of the victim (White, non-White), whether the defendant could have retreated from the situation, whether the defendant pursued the victim, if the victim was unarmed, and who was the initiator of the confrontation. We find race of the victim to be a significant predictor of case outcome in this data set. After controlling for other variables, the defendant is two times (OR = 2.1, 95% CI [1.07, 4.10]) more likely to be convicted in a case that involves White victims compared to those involving non-White victims. Our results depict a disturbing message: SYG legislation in Florida has a quantifiable racial bias that reveals a leniency in convictions if the victim is non-White, which provides evidence towards unequal treatment under the law. Rather than attempting to hide the outcomes of these laws, as was done in Florida, other states with SYG laws should carry out similar analyses to see if their manifestations are the same as those in Florida, and all should remediate any injustices found. Copyright © 2015 Elsevier Ltd. All rights reserved.

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…

Effects of the X:IT smoking intervention: a school-based cluster randomized trial.

PubMed

Andersen, Anette; Krølner, Rikker; Bast, Lotus Sofie; Thygesen, Lau Caspar; Due, Pernille

2015-12-01

Uptake of smoking in adolescence is still of major public health concern. Evaluations of school-based programmes for smoking prevention show mixed results. The aim of this study was to examine the effect of X:IT, a multi-component school-based programme to prevent adolescent smoking. Data from a Danish cluster randomized trial included 4041 year-7 students (mean age: 12.5) from 51 intervention and 43 control schools. Outcome measure 'current smoking' was dichotomized into smoking daily, weekly, monthly or more seldom vs do not smoke. Analyses were adjusted for baseline covariates: sex, family socioeconomic position (SEP), best friend's smoking and parental smoking. We performed multilevel, logistic regression analyses of available cases and intention-to-treat (ITT) analyses, replacing missing outcome values by multiple imputation. At baseline, 4.7% and 6.8% of the students at the intervention and the control schools smoked, respectively. After 1 year of the intervention, the prevalence was 7.9% and 10.7%, respectively. At follow-up, 553 students (13.7%) did not answer the question on smoking. Available case analyses: crude odds ratios (OR) for smoking at intervention schools compared with control schools: 0.65 (0.48-0.88) and adjusted: 0.70 (0.47-1.04). ITT analyses: crude OR for smoking at intervention schools compared with control schools: 0.67 (0.50-0.89) and adjusted: 0.61 (0.45-0.82). Students at intervention schools had a lower risk of smoking after a year of intervention in year 7. This multi-component intervention involving educational, parental and context-related intervention components seems to be efficient in lowering or postponing smoking uptake in Danish adolescents. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

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

Women's economic activity trajectories over the life course: implications for the self-rated health of women aged 64+ in England.

PubMed

Stone, Juliet; Evandrou, Maria; Falkingham, Jane; Vlachantoni, Athina

2015-09-01

Previous research has highlighted the importance of accumulated life-course labour market status and the balancing of multiple roles for understanding inequalities in health in later life. This may be particularly important for women, who are increasingly required to balance work and family life in liberal welfare contexts, such as in Britain. This study analyses retrospective life history data for 2160 women aged 64+ years (born 1909-1943) from the English Longitudinal Study of Ageing, collected in 2006-2007 as part of an ongoing panel study. Optimal matching and cluster analyses are used to produce a taxonomy of women's life-course economic activity trajectories based on their experiences between ages 16 and 64 years. This classification is then used in logistic regression analysis to investigate associations with self-rated health in later life. A set of five trajectories emerge as the dominant patterns of women's economic activity over the life course for those cohorts of English women born prior to 1943: (1) full-time workers; (2) family carers; (3) full-time returners; (4) part-time returners; (5) atypical/inactive. Regression analyses show that women who experience defined periods of full-time work both before and after focusing on family life appear to have the most favourable later life health outcomes. The findings are discussed with reference to the accumulation of social and economic resources over the life course and the balancing of multiple roles in work and family domains. In conclusion, the development of policies that facilitate women, if they wish, to successfully combine paid employment with family life could have a positive impact on their health in later life. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Assisted reproductive techniques and the risk of anorectal malformations: a German case-control study.

PubMed

Zwink, Nadine; Jenetzky, Ekkehart; Schmiedeke, Eberhard; Schmidt, Dominik; Märzheuser, Stefanie; Grasshoff-Derr, Sabine; Holland-Cunz, Stefan; Weih, Sandra; Hosie, Stuart; Reifferscheid, Peter; Ameis, Helen; Kujath, Christina; Rissmann, Anke; Obermayr, Florian; Schwarzer, Nicole; Bartels, Enrika; Reutter, Heiko; Brenner, Hermann

2012-09-15

The use of assisted reproductive techniques (ART) for treatment of infertility is increasing rapidly worldwide. However, various health effects have been reported including a higher risk of congenital malformations. Therefore, we assessed the risk of anorectal malformations (ARM) after in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Data of the German Network for Congenital Uro-REctal malformations (CURE-Net) were compared to nationwide data of the German IVF register and the Federal Statistical Office (DESTATIS). Odds ratios (95% confidence intervals) were determined to quantify associations using multivariable logistic regression accounting for potential confounding or interaction by plurality of births. In total, 295 ARM patients born between 1997 and 2011 in Germany, who were recruited through participating pediatric surgeries from all over Germany and the German self-help organisation SoMA, were included. Controls were all German live-births (n = 10,069,986) born between 1997 and 2010. Overall, 30 cases (10%) and 129,982 controls (1%) were born after IVF or ICSI, which translates to an odds ratio (95% confidence interval) of 8.7 (5.9-12.6) between ART and ARM in bivariate analyses. Separate analyses showed a significantly increased risk for ARM after IVF (OR, 10.9; 95% CI, 6.2-19.0; P < 0.0001) as well as after ICSI (OR, 7.5; 95% CI, 4.6-12.2; P < 0.0001). Furthermore, separate analyses of patients with isolated ARM, ARM with associated anomalies and those with a VATER/VACTERL association showed strong associations with ART (ORs 4.9, 11.9 and 7.9, respectively). After stratification for plurality of birth, the corresponding odds ratios (95% confidence intervals) were 7.7 (4.6-12.7) for singletons and 4.9 (2.4-10.1) for multiple births. There is a strongly increased risk for ARM among children born after ART. Elevations of risk were seen after both IVF and ICSI. Further, separate analyses of patients with isolated ARM, ARM with associated anomalies and those with a VATER/VACTERL association showed increased risks in each group. An increased risk of ARM was also seen among both singletons and multiple births.

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.

Association between coagulation function and patients with primary angle closure glaucoma: a 5-year retrospective case-control study.

PubMed

Li, Shengjie; Gao, Yanting; Shao, Mingxi; Tang, Binghua; Cao, Wenjun; Sun, Xinghuai

2017-11-04

To evaluate the association between coagulation function and patients with primary angle closure glaucoma (PACG). A retrospective, hospital-based, case-control study. Shanghai, China. A total of 1778 subjects were recruited from the Eye & ENT Hospital of Fudan University from January 2010 to December 2015, including patients with PACG (male=296; female=569) and control subjects (male=290; female=623). Sociodemographic data and clinical data were collected. The one-way analysis of variance test was used to compare the levels of laboratory parameters among the mild, moderate and severe PACG groups. Multivariate logistic regression analyses were performed to identify the independent risk factors for PACG. The nomogram was constructed based on the logistic regression model using the R project for statistical computing (R V.3.3.2). The activated partial thromboplastin time (APTT) of the PACG group was approximately 4% shorter (p<0.001) than that of the control group. The prothrombin time (PT) was approximately 2.40% shorter (p<0.001) in patients with PACG compared with the control group. The thrombin time was also approximately 2.14% shorter (p<0.001) in patients with PACG compared with the control group. The level of D-dimer was significantly higher (p=0.042) in patients with PACG. Moreover, the mean platelet volume (MPV) of the PACG group was significantly higher (p=0.013) than that of the control group. A similar trend was observed when coagulation parameters were compared between the PACG and control groups with respect to gender and/or age. Multiple logistic regression analyses revealed that APTT (OR=1.032, 95% CI 1.000 to 1.026), PT (OR=1.249, 95% CI 1.071 to 1.457) and MPV (OR=1.185, 95% CI 1.081 to 1.299) were independently associated with PACG. Patients with PACG had a shorter coagulation time. Our results suggest that coagulation function is significantly associated with patients with PACG and may play an important role in the onset and development of PACG. © 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.

Presenilin E318G variant and Alzheimer's disease risk: the Cache County study.

PubMed

Hippen, Ariel A; Ebbert, Mark T W; Norton, Maria C; Tschanz, JoAnn T; Munger, Ronald G; Corcoran, Christopher D; Kauwe, John S K

2016-06-29

Alzheimer's disease is the leading cause of dementia in the elderly and the third most common cause of death in the United States. A vast number of genes regulate Alzheimer's disease, including Presenilin 1 (PSEN1). Multiple studies have attempted to locate novel variants in the PSEN1 gene that affect Alzheimer's disease status. A recent study suggested that one of these variants, PSEN1 E318G (rs17125721), significantly affects Alzheimer's disease status in a large case-control dataset, particularly in connection with the APOEε4 allele. Our study looks at the same variant in the Cache County Study on Memory and Aging, a large population-based dataset. We tested for association between E318G genotype and Alzheimer's disease status by running a series of Fisher's exact tests. We also performed logistic regression to test for an additive effect of E318G genotype on Alzheimer's disease status and for the existence of an interaction between E318G and APOEε4. In our Fisher's exact test, it appeared that APOEε4 carriers with an E318G allele have slightly higher risk for AD than those without the allele (3.3 vs. 3.8); however, the 95 % confidence intervals of those estimates overlapped completely, indicating non-significance. Our logistic regression model found a positive but non-significant main effect for E318G (p = 0.895). The interaction term between E318G and APOEε4 was also non-significant (p = 0.689). Our findings do not provide significant support for E318G as a risk factor for AD in APOEε4 carriers. Our calculations indicated that the overall sample used in the logistic regression models was adequately powered to detect the sort of effect sizes observed previously. However, the power analyses of our Fisher's exact tests indicate that our partitioned data was underpowered, particularly in regards to the low number of E318G carriers, both AD cases and controls, in the Cache county dataset. Thus, the differences in types of datasets used may help to explain the difference in effect magnitudes seen. Analyses in additional case-control datasets will be required to understand fully the effect of E318G on Alzheimer's disease status.

Factors associated with seasonal influenza vaccination in pregnant women.

PubMed

Henninger, Michelle L; Irving, Stephanie A; Thompson, Mark; Avalos, Lyndsay Ammon; Ball, Sarah W; Shifflett, Pat; Naleway, Allison L

2015-05-01

This observational study followed a cohort of pregnant women during the 2010-2011 influenza season to determine factors associated with vaccination. Participants were 1105 pregnant women who completed a survey assessing health beliefs related to vaccination upon enrollment and were then followed to determine vaccination status by the end of the 2010-2011 influenza season. We conducted univariate and multivariate analyses to explore factors associated with vaccination status and a factor analysis of survey items to identify health beliefs associated with vaccination. Sixty-three percent (n=701) of the participants were vaccinated. In the univariate analyses, multiple factors were associated with vaccination status, including maternal age, race, marital status, educational level, and gravidity. Factor analysis identified two health belief factors associated with vaccination: participant's positive views (factor 1) and negative views (factor 2) of influenza vaccination. In a multivariate logistic regression model, factor 1 was associated with increased likelihood of vaccination (adjusted odds ratio [aOR]=2.18; 95% confidence interval [CI]=1.72-2.78), whereas factor 2 was associated with decreased likelihood of vaccination (aOR=0.36; 95% CI=0.28-0.46). After controlling for the two health belief factors in multivariate analyses, demographic factors significant in univariate analyses were no longer significant. Women who received a provider recommendation were about three times more likely to be vaccinated (aOR=3.14; 95% CI=1.99-4.96). Pregnant women's health beliefs about vaccination appear to be more important than demographic and maternal factors previously associated with vaccination status. Provider recommendation remains one of the most critical factors influencing vaccination during pregnancy.

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.

75 FR 26098 - Safety Zone; Under Water Clean Up of Copper Canyon, Lake Havasu, AZ

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

... rulemaking (NPRM) with respect to this rule because the logistical details of the event were not finalized or... Port, or his designated representative. Regulatory Analyses We developed this rule after considering numerous statutes and executive orders related to rulemaking. Below we summarize our analyses based on 13...

75 FR 27432 - Security Zone; Golden Guardian 2010 Regional Exercise; San Francisco Bay, San Francisco, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-17

... this rule because it is impracticable since the logistical details of the operations were not presented.... Regulatory Analyses We developed this rule after considering numerous statutes and executive orders related to rulemaking. Below we summarize our analyses based on 13 of these statutes or executive orders...

76 FR 9227 - Safety Zone; Havasu Landing Regatta, Colorado River, Lake Havasu Landing, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-17

... rulemaking (NPRM) with respect to this rule because doing so would be impracticable. The logistical details... designated representative. Regulatory Analyses We developed this rule after considering numerous statutes and executive orders related to rulemaking. Below we summarize our analyses based on 13 of these statutes or...

Alcohol and tobacco use and cognitive-motivational variables in school settings: effects on academic performance in Spanish adolescents.

PubMed

Inglés, Cándido J; Torregrosa, María S; Rodríguez-Marín, Jesús; García del Castillo, José A; Gázquez, José J; García-Fernández, José M; Delgado, Beatriz

2013-01-01

The aim of the present study was to analyze: (a) the relationship between alcohol and tobacco use and academic performance, and (b) the predictive role of psycho-educational factors and alcohol and tobacco abuse on academic performance in a sample of 352 Spanish adolescents from grades 8 to 10 of Compulsory Secondary Education. The Self-Description Questionnaire-II, the Sydney Attribution Scale, and the Achievement Goal Tendencies Questionnaire were administered in order to analyze cognitive-motivational variables. Alcohol and tobacco abuse, sex, and grade retention were also measured using self-reported questions. Academic performance was measured by school records. Frequency analyses and logistic regression analyses were used. Frequency analyses revealed that students who abuse of tobacco and alcohol show a higher rate of poor academic performance. Logistic regression analyses showed that health behaviours, and educational and cognitive-motivational variables exert a different effect on academic performance depending on the academic area analyzed. These results point out that not only academic, but also health variables should be address to improve academic performance in adolescence.

Comparative multivariate analyses of transient otoacoustic emissions and distorsion products in normal and impaired hearing.

PubMed

Stamate, Mirela Cristina; Todor, Nicolae; Cosgarea, Marcel

2015-01-01

The clinical utility of otoacoustic emissions as a noninvasive objective test of cochlear function has been long studied. Both transient otoacoustic emissions and distorsion products can be used to identify hearing loss, but to what extent they can be used as predictors for hearing loss is still debated. Most studies agree that multivariate analyses have better test performances than univariate analyses. The aim of the study was to determine transient otoacoustic emissions and distorsion products performance in identifying normal and impaired hearing loss, using the pure tone audiogram as a gold standard procedure and different multivariate statistical approaches. The study included 105 adult subjects with normal hearing and hearing loss who underwent the same test battery: pure-tone audiometry, tympanometry, otoacoustic emission tests. We chose to use the logistic regression as a multivariate statistical technique. Three logistic regression models were developed to characterize the relations between different risk factors (age, sex, tinnitus, demographic features, cochlear status defined by otoacoustic emissions) and hearing status defined by pure-tone audiometry. The multivariate analyses allow the calculation of the logistic score, which is a combination of the inputs, weighted by coefficients, calculated within the analyses. The accuracy of each model was assessed using receiver operating characteristics curve analysis. We used the logistic score to generate receivers operating curves and to estimate the areas under the curves in order to compare different multivariate analyses. We compared the performance of each otoacoustic emission (transient, distorsion product) using three different multivariate analyses for each ear, when multi-frequency gold standards were used. We demonstrated that all multivariate analyses provided high values of the area under the curve proving the performance of the otoacoustic emissions. Each otoacoustic emission test presented high values of area under the curve, suggesting that implementing a multivariate approach to evaluate the performances of each otoacoustic emission test would serve to increase the accuracy in identifying the normal and impaired ears. We encountered the highest area under the curve value for the combined multivariate analysis suggesting that both otoacoustic emission tests should be used in assessing hearing status. Our multivariate analyses revealed that age is a constant predictor factor of the auditory status for both ears, but the presence of tinnitus was the most important predictor for the hearing level, only for the left ear. Age presented similar coefficients, but tinnitus coefficients, by their high value, produced the highest variations of the logistic scores, only for the left ear group, thus increasing the risk of hearing loss. We did not find gender differences between ears for any otoacoustic emission tests, but studies still debate this question as the results are contradictory. Neither gender, nor environment origin had any predictive value for the hearing status, according to the results of our study. Like any other audiological test, using otoacoustic emissions to identify hearing loss is not without error. Even when applying multivariate analysis, perfect test performance is never achieved. Although most studies demonstrated the benefit of using the multivariate analysis, it has not been incorporated into clinical decisions maybe because of the idiosyncratic nature of multivariate solutions or because of the lack of the validation studies.

Comparative multivariate analyses of transient otoacoustic emissions and distorsion products in normal and impaired hearing

PubMed Central

STAMATE, MIRELA CRISTINA; TODOR, NICOLAE; COSGAREA, MARCEL

2015-01-01

Background and aim The clinical utility of otoacoustic emissions as a noninvasive objective test of cochlear function has been long studied. Both transient otoacoustic emissions and distorsion products can be used to identify hearing loss, but to what extent they can be used as predictors for hearing loss is still debated. Most studies agree that multivariate analyses have better test performances than univariate analyses. The aim of the study was to determine transient otoacoustic emissions and distorsion products performance in identifying normal and impaired hearing loss, using the pure tone audiogram as a gold standard procedure and different multivariate statistical approaches. Methods The study included 105 adult subjects with normal hearing and hearing loss who underwent the same test battery: pure-tone audiometry, tympanometry, otoacoustic emission tests. We chose to use the logistic regression as a multivariate statistical technique. Three logistic regression models were developed to characterize the relations between different risk factors (age, sex, tinnitus, demographic features, cochlear status defined by otoacoustic emissions) and hearing status defined by pure-tone audiometry. The multivariate analyses allow the calculation of the logistic score, which is a combination of the inputs, weighted by coefficients, calculated within the analyses. The accuracy of each model was assessed using receiver operating characteristics curve analysis. We used the logistic score to generate receivers operating curves and to estimate the areas under the curves in order to compare different multivariate analyses. Results We compared the performance of each otoacoustic emission (transient, distorsion product) using three different multivariate analyses for each ear, when multi-frequency gold standards were used. We demonstrated that all multivariate analyses provided high values of the area under the curve proving the performance of the otoacoustic emissions. Each otoacoustic emission test presented high values of area under the curve, suggesting that implementing a multivariate approach to evaluate the performances of each otoacoustic emission test would serve to increase the accuracy in identifying the normal and impaired ears. We encountered the highest area under the curve value for the combined multivariate analysis suggesting that both otoacoustic emission tests should be used in assessing hearing status. Our multivariate analyses revealed that age is a constant predictor factor of the auditory status for both ears, but the presence of tinnitus was the most important predictor for the hearing level, only for the left ear. Age presented similar coefficients, but tinnitus coefficients, by their high value, produced the highest variations of the logistic scores, only for the left ear group, thus increasing the risk of hearing loss. We did not find gender differences between ears for any otoacoustic emission tests, but studies still debate this question as the results are contradictory. Neither gender, nor environment origin had any predictive value for the hearing status, according to the results of our study. Conclusion Like any other audiological test, using otoacoustic emissions to identify hearing loss is not without error. Even when applying multivariate analysis, perfect test performance is never achieved. Although most studies demonstrated the benefit of using the multivariate analysis, it has not been incorporated into clinical decisions maybe because of the idiosyncratic nature of multivariate solutions or because of the lack of the validation studies. PMID:26733749

The Role of Parent Communication and Connectedness in Dating Violence Victimization among Latino Adolescents.

PubMed

Kast, Nicole Rebecca; Eisenberg, Marla E; Sieving, Renee E

2016-06-01

Dating violence among U.S. adolescents is a substantial concern. Previous research indicates that Latino youth are at increased risk of dating violence victimization. This secondary data analysis examined the prevalence of physical and sexual dating violence victimization among subgroups of Latino adolescents and associations of parent communication, parent caring, and dating violence victimization using data from the 2010 Minnesota Student Survey (N = 4,814). Parallel analyses were conducted for Latino-only and multiple-race Latino adolescents, stratified by gender. Multivariate logistic regression models tested associations between race/ethnicity, parent communication, perceived parent caring, and adolescent dating violence experiences. Overall, 7.2% to 16.2% of Latinos reported physical or sexual dating violence. Both types of dating violence were more prevalent among multiple-race Latinos than among Latino-only adolescents, with prevalence rates highest among multiple-race Latino females (19.8% and 19.7% for physical and sexual dating violence victimization, respectively). In multivariate models, perceived parent caring was the most important protective factor against physical and sexual dating violence among males and females. High levels of mother and father communication were associated with less physical violence victimization among males and females and with less sexual violence victimization among females. Results highlight the importance of parent communication and parent caring as buffers against dating violence victimization for Latino youth. These findings indicate potential for preventive interventions with Latino adolescents targeting family connectedness to address dating violence victimization. © The Author(s) 2015.

Should I stay or should I go? A prospective investigation examining individual factors impacting employment status among individuals with multiple sclerosis (MS).

PubMed

Strober, Lauren B; Chiaravalloti, Nancy; DeLuca, John

2018-01-01

Rates of unemployment among individuals with multiple sclerosis (MS) are as high as 80%. While several factors for such high rates of unemployment have been identified, they do not account for the majority of the variance. This study examines person-specific factors such as personality and coping, which may better account for individuals leaving the workforce. Forty individuals with MS (20 considering reducing work hours or leaving the workforce and 20 remaining employed) were matched on age, gender, education, disease duration, and disease course, and administered a comprehensive survey of factors purported to be related to employment status. Based on multiple, logistic regression analyses certain disease factors and person-specific factors differentiate those who are considering leaving work or reducing work hours and those staying employed. In particular, those expressing the need to reduce work hours or leaving the workforce reported more fatigue, anxiety, depression, and use of behavioral disengagement as a means of coping. In contrast, those staying employed reported greater levels of extraversion, self-efficacy, and use of humor as a means of coping. Together, fatigue, use of humor, and use of behavioral disengagement as a means of coping were the most significant factors, accounting for 44% of the variance. Findings suggest that greater consideration be given to these factors and that interventions tailored to address these factors may assist individuals with MS staying employed and/or making appropriate accommodations.

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.

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.

Effects of interactions between common genetic variants and alcohol consumption on colorectal cancer risk

PubMed Central

Song, Nan; Shin, Aesun; Oh, Jae Hwan; Kim, Jeongseon

2018-01-01

Background Genome-wide association studies (GWAS) have identified approximately 40 common genetic loci associated with colorectal cancer risk. To investigate possible gene-environment interactions (GEIs) between GWAS-identified single-nucleotide polymorphisms (SNPs) and alcohol consumption with respect to colorectal cancer, a hospital-based case-control study was conducted. Results Higher levels of alcohol consumption as calculated based on a standardized definition of a drink (1 drink=12.5g of ethanol) were associated with increased risk of colorectal cancer (OR=2.47, 95% CI=1.62-3.76 for heavy drinkers [>50g/day] compared to never drinkers; ptrend<0.01). SNP rs6687758 near the DUSP10 gene at 1q41 had a statistically significant interaction with alcohol consumption in analyses of standardized drinks (p=4.6×10-3), although this did not surpass the corrected threshold for multiple testing. When stratified by alcohol consumption levels, in an additive model the risk of colorectal cancer associated with the G allele of rs6687758 tended to increase among individuals in the heavier alcohol consumption strata. A statistically significant association between rs6687758 and colorectal cancer risk was observed among moderate alcohol drinkers who consumed between >12.5 and ≤50g of alcohol per day (OR=1.46, 95% CI=1.01-2.11). Methods A total of 2,109 subjects (703 colorectal cancer patients and 1,406 healthy controls) were recruited from the Korean National Cancer Center. For genotyping, 30 GWAS-identified SNPs were selected. A logistic regression model was used to evaluate associations of SNPs and alcohol consumption with colorectal cancer risk. We also tested GEIs between SNPs and alcohol consumption using a logistic model with multiplicative interaction terms. Conclusions Our results suggest that SNP rs6687758 at 1q41 may interact with alcohol consumption in the etiology of colorectal cancer. PMID:29464080

Effects of interactions between common genetic variants and alcohol consumption on colorectal cancer risk.

PubMed

Song, Nan; Shin, Aesun; Oh, Jae Hwan; Kim, Jeongseon

2018-01-19

Genome-wide association studies (GWAS) have identified approximately 40 common genetic loci associated with colorectal cancer risk. To investigate possible gene-environment interactions (GEIs) between GWAS-identified single-nucleotide polymorphisms (SNPs) and alcohol consumption with respect to colorectal cancer, a hospital-based case-control study was conducted. Higher levels of alcohol consumption as calculated based on a standardized definition of a drink (1 drink=12.5g of ethanol) were associated with increased risk of colorectal cancer (OR=2.47, 95% CI=1.62-3.76 for heavy drinkers [>50g/day] compared to never drinkers; p trend <0.01). SNP rs6687758 near the DUSP10 gene at 1q41 had a statistically significant interaction with alcohol consumption in analyses of standardized drinks ( p =4.6×10 -3 ), although this did not surpass the corrected threshold for multiple testing. When stratified by alcohol consumption levels, in an additive model the risk of colorectal cancer associated with the G allele of rs6687758 tended to increase among individuals in the heavier alcohol consumption strata. A statistically significant association between rs6687758 and colorectal cancer risk was observed among moderate alcohol drinkers who consumed between >12.5 and ≤50g of alcohol per day (OR=1.46, 95% CI=1.01-2.11). A total of 2,109 subjects (703 colorectal cancer patients and 1,406 healthy controls) were recruited from the Korean National Cancer Center. For genotyping, 30 GWAS-identified SNPs were selected. A logistic regression model was used to evaluate associations of SNPs and alcohol consumption with colorectal cancer risk. We also tested GEIs between SNPs and alcohol consumption using a logistic model with multiplicative interaction terms. Our results suggest that SNP rs6687758 at 1q41 may interact with alcohol consumption in the etiology of colorectal cancer.

Peak oxygen consumption measured during the stair-climbing test in lung resection candidates.

PubMed

Brunelli, Alessandro; Xiumé, Francesco; Refai, Majed; Salati, Michele; Di Nunzio, Luca; Pompili, Cecilia; Sabbatini, Armando

2010-01-01

The stair-climbing test is commonly used in the preoperative evaluation of lung resection candidates, but it is difficult to standardize and provides little physiologic information on the performance. To verify the association between the altitude and the V(O2peak) measured during the stair-climbing test. 109 consecutive candidates for lung resection performed a symptom-limited stair-climbing test with direct breath-by-breath measurement of V(O2peak) by a portable gas analyzer. Stepwise logistic regression and bootstrap analyses were used to verify the association of several perioperative variables with a V(O2peak) <15 ml/kg/min. Subsequently, multiple regression analysis was also performed to develop an equation to estimate V(O2peak) from stair-climbing parameters and other patient-related variables. 56% of patients climbing <14 m had a V(O2peak) <15 ml/kg/min, whereas 98% of those climbing >22 m had a V(O2peak) >15 ml/kg/min. The altitude reached at stair-climbing test resulted in the only significant predictor of a V(O2peak) <15 ml/kg/min after logistic regression analysis. Multiple regression analysis yielded an equation to estimate V(O2peak) factoring altitude (p < 0.0001), speed of ascent (p = 0.005) and body mass index (p = 0.0008). There was an association between altitude and V(O2peak) measured during the stair-climbing test. Most of the patients climbing more than 22 m are able to generate high values of V(O2peak) and can proceed to surgery without any additional tests. All others need to be referred for a formal cardiopulmonary exercise test. In addition, we were able to generate an equation to estimate V(O2peak), which could assist in streamlining the preoperative workup and could be used across different settings to standardize this test. Copyright (c) 2010 S. Karger AG, Basel.

Risk factors for porcine reproductive and respiratory syndrome outbreaks in Vietnamese small stock farms.

PubMed

Truong, V M; Gummow, B

2014-07-01

To examine risk factors that could have played a role in the 2010 porcine reproductive and respiratory syndrome (PRRS) outbreak in Yenhung district, Quangninh province, North-Vietnam, with the purpose of establishing why existing control measures implemented after previous outbreaks had failed to prevent further outbreaks. A case-control study was carried out in Yenhung district. Data were obtained by an interview-based questionnaire survey. The sampling unit was households, which equated to small-scale pig farms. A total of 150 case and 150 control households were selected at communes affected by the 2010 PRRS epidemic during April to June. Risk factors were analysed using binary logistic regression and unconditional multiple logistic regression. Households infected with PRRS were significantly associated with multiple variables belonging to three main groups: (1) location of the farms: i.e. farms positioned <1,000 m from a pig abattoir or within 500 m of local markets or 100 m of main roads; (2) farm management: i.e. where there was non-application of weekly farm disinfection, feeding uncooked swill, new introduction of purchased pigs without isolation, or usage of water from irrigation systems for raising pigs; (3) people and animal contact: i.e. where households kept animals with either no confinement or partial confinement, had visits by family members to other affected farms or had frequent visits by neighbours. The use of water from irrigation systems was found to be the risk factor most strongly associated with infected households in the 2010 outbreak (OR=22; 95% CI=12-42). The results show that the epidemiology of PRRS in Quangninh province was linked to sociological and cultural practices, and that effective PRRS control needs an integrated approach coupled with behavioural changes in the pig raising practices of the general public. Failure to recognise this could explain why further outbreaks have occurred.

Complementary alternative medicine use among patients with type 2 diabetes mellitus in the primary care setting: a cross-sectional study in Malaysia

PubMed Central

2013-01-01

Background Limited study on the use of complementary alternative medicine (CAM) among patients with diabetes mellitus (DM), particularly in primary -care settings. This study seeks to understand the prevalence, types, expenditures, attitudes, beliefs, and perceptions of CAM use among patients with DM visiting outpatient primary care clinics. Methods This is a descriptive, cross-sectional study of 240 diabetic patients. CAM is defined as a group of diverse medical and healthcare systems, practices, and products that are not generally considered part of conventional Western medicine. Data analysis was done using SPSS v. 19 and multiple logistic regressions were used to identify predictors of CAM use. Results The prevalence of CAM use was 62.5 percent. Female were 1.8 times more likely than male in using CAM. Malays (75%) were the most frequent users, followed Indians (18%) and Chinese (6%). Biological therapy (50.0%) were the most widely used, followed by manipulative-body based systems (9.2%), energy system (8.8%), alternative medicine systems (4.6%) and mind-body system (1.7%). In biological therapy, a total of 30.4 percent, 24.2 percent, 13.3 percent, and 7.9 percent of diabetic patients consumed bitter gourd (Momordica Charantia), followed by Misai Kucing (Orthosiphon Stamineus Benth), garlic (Allium Sativum), and Sabah snake grass (Clinacanthus Nutans Lindau) respectively. The mean of the expenditure on CAM usage was RM 52.8 ± 101.9 (US $16.9 ± 32.5) per month. According to multiple logistic regression analyses, being Muslim (OR 5.258, 95 percent CI 2.952-9.368) had significant positive association with CAM use. Conclusions The prevalence of CAM use was high among diabetics. Islam faith is predictor for CAM use among Type 2 DM patients. The most-common herbs used were bitter gourd (Momordica Charantia) and Misai Kucing (Orthosiphon Stamineus, Benth). Further studies on the anti-glycemic activity of the isolated compound may be needed in the future. PMID:23802882

Generalized Linear Mixed Model Analysis of Urban-Rural Differences in Social and Behavioral Factors for Colorectal Cancer Screening

PubMed Central

Wang, Ke-Sheng; Liu, Xuefeng; Ategbole, Muyiwa; Xie, Xin; Liu, Ying; Xu, Chun; Xie, Changchun; Sha, Zhanxin

2017-01-01

Objective: Screening for colorectal cancer (CRC) can reduce disease incidence, morbidity, and mortality. However, few studies have investigated the urban-rural differences in social and behavioral factors influencing CRC screening. The objective of the study was to investigate the potential factors across urban-rural groups on the usage of CRC screening. Methods: A total of 38,505 adults (aged ≥40 years) were selected from the 2009 California Health Interview Survey (CHIS) data - the latest CHIS data on CRC screening. The weighted generalized linear mixed-model (WGLIMM) was used to deal with this hierarchical structure data. Weighted simple and multiple mixed logistic regression analyses in SAS ver. 9.4 were used to obtain the odds ratios (ORs) and their 95% confidence intervals (CIs). Results: The overall prevalence of CRC screening was 48.1% while the prevalence in four residence groups - urban, second city, suburban, and town/rural, were 45.8%, 46.9%, 53.7% and 50.1%, respectively. The results of WGLIMM analysis showed that there was residence effect (p<0.0001) and residence groups had significant interactions with gender, age group, education level, and employment status (p<0.05). Multiple logistic regression analysis revealed that age, race, marital status, education level, employment stats, binge drinking, and smoking status were associated with CRC screening (p<0.05). Stratified by residence regions, age and poverty level showed associations with CRC screening in all four residence groups. Education level was positively associated with CRC screening in second city and suburban. Infrequent binge drinking was associated with CRC screening in urban and suburban; while current smoking was a protective factor in urban and town/rural groups. Conclusions: Mixed models are useful to deal with the clustered survey data. Social factors and behavioral factors (binge drinking and smoking) were associated with CRC screening and the associations were affected by living areas such as urban and rural regions. PMID:28952708

Association between food insecurity and anemia among women of reproductive age.

PubMed

Ghose, Bishwajit; Tang, Shangfeng; Yaya, Sanni; Feng, Zhanchun

2016-01-01

Food insecurity and hidden hunger (micronutrient deficiency) affect about two billion people globally. Household food insecurity (HFI) has been shown to be associated with one or multiple micronutrient (MMN) deficiencies among women and children. Chronic food insecurity leads to various deficiency disorders, among which anemia stands out as the most prevalent one. As a high malnutrition prevalent country, Bangladesh has one of the highest rates of anemia among all Asian countries. In this study, we wanted to investigate for any association exists between HFI and anemia among women of reproductive age in Bangladesh. Information about demographics, socioeconomic and anemia status on 5,666 married women ageing between 13 and 40 years were collected from a nationally representative cross-sectional survey Bangladesh Demographic and Health Survey (BDHS 2011). Food security was measured by the Household Food Insecurity Access Scale (HFIAS). Capillary hemoglobin concentration (Hb) measured by HemoCue® was used as the biomarker of anemia. Data were analysed using cross-tabulation, chi-square tests and multiple logistic regression methods. Anemia prevalence was 41.7%. Logistic regression showed statistically significant association with anemia and type of residency (p = 0.459; OR = 0.953, 95%CI = 0.840-1.082), wealth status (Poorest: p < 0.001; OR = 1.369, 95%CI = 1.176-1.594; and average: p = 0.030; 95%CI = 1.017-1.398), educational attainment (p < 0.001; OR = 1.276, 95%CI = 1.132-1.439) and household food insecurity (p < 0.001; 95%CI = 1.348-1.830). Women who reported food insecurity were about 1.6 times more likely to suffer from anemia compared to their food secure counterparts. HFI is a significant predictor of anemia among women of reproductive age in Bangladesh. Programs targeting HFI could prove beneficial for anemia reduction strategies. Gender aspects of food and nutrition insecurity should be taken into consideration in designing national anemia prevention frameworks.

Impact of national smoke-free legislation on home smoking bans – Findings from the International Tobacco Control (ITC) Policy Evaluation Project Europe Surveys

PubMed Central

Mons, Ute; Nagelhout, Gera E.; Allwright, Shane; Guignard, Romain; van den Putte, Bas; Willemsen, Marc C.; Fong, Geoffrey T.; Brenner, Hermann; Pötschke-Langer, Martina; Breitling, Lutz P.

2014-01-01

Objectives To measure changes in prevalence and predictors of home smoking bans (HSB) among smokers in four European countries after the implementation of national smoke-free legislation. Design Two waves of the International Tobacco Control (ITC) Policy Evaluation Project Europe Surveys, which is a prospective panel study. Pre- and post-legislation data was used from Ireland, France, Germany, and the Netherlands. Two pre-legislation waves from UK were used as control. Participants 4,634 respondents from the intervention countries and 1,080 from the control country completed both baseline and follow-up, and were included in the present analyses. Methods Multiple logistic regression models to identify predictors of having or of adopting a total HSB, and Generalised Estimating Equation (GEE) models to compare patterns of change after implementation of smoke-free legislation to a control country without such legislation. Results Most smokers had at least partial smoking restrictions in their home, but the proportions varied significantly between countries. After implementation of national smoke-free legislation, the proportion of smokers with a total HSB increased significantly in all four countries. Among continuing smokers the number of cigarettes smoked per day either remained stable or decreased significantly. Multiple logistic regression models indicated that having a young child in the household and supporting smoking bans in bars were important correlates of having a pre-legislation HSB. Prospective predictors of imposing a HSB between survey waves were planning to quit smoking, supporting a total smoking ban in bars, and the birth of a child. GEE models indicated that the change in total HSB in the intervention countries was greater than in the control country. Conclusions The findings suggest that smoke-free legislation does not lead to more smoking in smokers’ homes. On the contrary, our findings demonstrate that smoke-free legislation may stimulate smokers to establish total smoking bans in their homes. PMID:22331456

Impact of national smoke-free legislation on home smoking bans: findings from the International Tobacco Control Policy Evaluation Project Europe Surveys.

PubMed

Mons, Ute; Nagelhout, Gera E; Allwright, Shane; Guignard, Romain; van den Putte, Bas; Willemsen, Marc C; Fong, Geoffrey T; Brenner, Hermann; Pötschke-Langer, Martina; Breitling, Lutz P

2013-05-01

To measure changes in prevalence and predictors of home smoking bans (HSBs) among smokers in four European countries after the implementation of national smoke-free legislation. Two waves of the International Tobacco Control Policy Evaluation Project Europe Surveys, which is a prospective panel study. Pre- and post-legislation data were used from Ireland, France, Germany and the Netherlands. Two pre-legislation waves from the UK were used as control. 4634 respondents from the intervention countries and 1080 from the control country completed both baseline and follow-up and were included in the present analyses. Multiple logistic regression models to identify predictors of having or of adopting a total HSB, and Generalised Estimating Equation models to compare patterns of change after implementation of smoke-free legislation to a control country without such legislation. Most smokers had at least partial smoking restrictions in their home, but the proportions varied significantly between countries. After implementation of national smoke-free legislation, the proportion of smokers with a total HSB increased significantly in all four countries. Among continuing smokers, the number of cigarettes smoked per day either remained stable or decreased significantly. Multiple logistic regression models indicated that having a young child in the household and supporting smoking bans in bars were important correlates of having a pre-legislation HSB. Prospective predictors of imposing a HSB between survey waves were planning to quit smoking, supporting a total smoking ban in bars and the birth of a child. Generalised Estimating Equation models indicated that the change in total HSB in the intervention countries was greater than that in the control country. The findings suggest that smoke-free legislation does not lead to more smoking in smokers' homes. On the contrary, our findings demonstrate that smoke-free legislation may stimulate smokers to establish total smoking bans in their homes.

Generalized Linear Mixed Model Analysis of Urban-Rural Differences in Social and Behavioral Factors for Colorectal Cancer Screening

PubMed

Wang, Ke-Sheng; Liu, Xuefeng; Ategbole, Muyiwa; Xie, Xin; Liu, Ying; Xu, Chun; Xie, Changchun; Sha, Zhanxin

2017-09-27

Objective: Screening for colorectal cancer (CRC) can reduce disease incidence, morbidity, and mortality. However, few studies have investigated the urban-rural differences in social and behavioral factors influencing CRC screening. The objective of the study was to investigate the potential factors across urban-rural groups on the usage of CRC screening. Methods: A total of 38,505 adults (aged ≥40 years) were selected from the 2009 California Health Interview Survey (CHIS) data - the latest CHIS data on CRC screening. The weighted generalized linear mixed-model (WGLIMM) was used to deal with this hierarchical structure data. Weighted simple and multiple mixed logistic regression analyses in SAS ver. 9.4 were used to obtain the odds ratios (ORs) and their 95% confidence intervals (CIs). Results: The overall prevalence of CRC screening was 48.1% while the prevalence in four residence groups - urban, second city, suburban, and town/rural, were 45.8%, 46.9%, 53.7% and 50.1%, respectively. The results of WGLIMM analysis showed that there was residence effect (p<0.0001) and residence groups had significant interactions with gender, age group, education level, and employment status (p<0.05). Multiple logistic regression analysis revealed that age, race, marital status, education level, employment stats, binge drinking, and smoking status were associated with CRC screening (p<0.05). Stratified by residence regions, age and poverty level showed associations with CRC screening in all four residence groups. Education level was positively associated with CRC screening in second city and suburban. Infrequent binge drinking was associated with CRC screening in urban and suburban; while current smoking was a protective factor in urban and town/rural groups. Conclusions: Mixed models are useful to deal with the clustered survey data. Social factors and behavioral factors (binge drinking and smoking) were associated with CRC screening and the associations were affected by living areas such as urban and rural regions. Creative Commons Attribution License

Associations of non-melanoma skin cancer and melanoma, extra-cutaneous cancers and smoking in adults: a US population-based study.

PubMed

Silverberg, J I; Ratner, D

2015-07-01

Non-melanoma skin cancer (NMSC) and melanoma are common malignancies in the US and may be associated with other types of cancer. We sought to determine whether NMSC and melanoma are associated with extra-cutaneous cancers and identify modifiable risk factors for such an association. We analysed data from 447,801 adult participants in the 1997-2011 National Health Interview Surveys. Survey logistic regression models were constructed that accounted for the complex sample weights. History of NMSC, melanoma and 27 primary extra-cutaneous cancers was assessed. NMSC was associated with increased odds of one (multinomial survey logistic regression, unadjusted odds ratio [95% CI]: 2.43 [2.20-2.68]) or multiple (2.94 [2.21-3.92]) extra-cutaneous malignancies. Melanoma was also associated with increased odds of one (3.25 [2.70-3.90]) or multiple (6.11 [4.34-8.61]) extra-cutaneous malignancies. Extra-cutaneous cancers were more common in younger patients (ages 18-39 and 40-49 years) and Caucasians with NMSC or melanoma (P < 0.0001). Smokers with a history of NMSC or melanoma had even higher odds of extra-cutaneous malignancy at ages 18-39 and 40-49 years compared to smokers without NMSC or melanoma (P < 0.0001). History of NMSC was associated with higher odds of malignancies of the bladder, brain, breast, colon, oesophagus, kidney, lung, lymphoma, melanoma, prostate, soft tissue, throat/pharynx, thyroid and uterus. Melanoma was associated with malignancies of the bladder, breast, colon, kidney, lung, pancreas, prostate, soft tissue, throat/pharynx, thyroid and uterus. The prevalence of extra-cutaneous cancers increased between 1997 and 2011 in all subjects (4.51% and 5.73%, P < 0.0001), with even higher rates of increase in those with history of NMSC or melanoma. Patients with history of NMSC and melanoma have increased odds of developing extra-cutaneous cancers, especially those with younger age and smoking history. © 2014 European Academy of Dermatology and Venereology.

Soccer and sexual health education: a promising approach for reducing adolescent births in Haiti.

PubMed

Kaplan, Kathryn C; Lewis, Judy; Gebrian, Bette; Theall, Katherine

2015-05-01

To explore the effect of an innovative, integrative program in female sexual reproductive health (SRH) and soccer (or fútbol, in Haitian Creole) in rural Haiti by measuring the rate of births among program participants 15-19 years old and their nonparticipant peers. A retrospective cohort study using 2006-2009 data from the computerized data-tracking system of the Haitian Health Foundation (HHF), a U.S.-based nongovernmental organization serving urban and rural populations in Haiti, was used to assess births among girls 15-19 years old who participated in HHF's GenNext program, a combination education-soccer program for youth, based on SRH classes HHF nurses and community workers had been conducting in Haiti for mothers, fathers, and youth; girl-centered health screenings; and an all-female summer soccer league, during 2006-2009 (n = 4 251). Bivariate and multiple logistic regression analyses were carried out to assess differences in the rate of births among program participants according to their level of participation (SRH component only ("EDU") versus both the SRH and soccer components ("SO") compared to their village peers who did not participate. Hazard ratios (HRs) of birth rates were estimated using Cox regression analysis of childbearing data for the three different groups. In the multiple logistic regression analysis, only the girls in the "EDU" group had significantly fewer births than the nonparticipants after adjusting for confounders (odds ratio = 0.535; 95% confidence interval (CI) = 0.304, 0.940). The Cox regression analysis demonstrated that those in the EDU group (HR = 0.893; 95% CI = 0.802, 0.994) and to a greater degree those in the SO group (HR = 0.631; 95% CI = 0.558, 0.714) were significantly protected against childbearing between the ages of 15 and 19 years. HHF's GenNext program demonstrates the effectiveness of utilizing nurse educators, community mobilization, and youth participation in sports, education, and structured youth groups to promote and sustain health for adolescent girls and young women.

Interest in dietary pattern, social capital, and psychological distress: a cross-sectional study in a rural Japanese community

PubMed Central

2013-01-01

Background Among life-style factors affecting mental health, dietary habits are becoming a public health concern in their relation to psychological distress and social capital. We examined associations between interest in dietary pattern, social capital, and psychological distress with a population-based cross-sectional study in rural Japan. Methods A total of 16,996 residents of a rural town in northern Japan aged 30–79 years participated in this questionnaire survey. The questionnaire gathered data about socio-demographic variables, psychological distress, issues related to dietary habits, including interest in dietary pattern, and the social capital factors of reciprocity and sense of community belonging. Factors related to psychological distress were analyzed by using multiple logistic regression analysis. Results A high interest in dietary pattern was significantly associated with a high level of social capital. In addition, an association between interest in dietary pattern and frequencies of intake of vegetables and fruits was confirmed. The multiple logistic regression analyses showed significant associations between interest in dietary pattern, social capital, frequency of intake of vegetables, and psychological distress after adjusting for socio-demographic variables. Low interest in dietary pattern was positively associated with psychological distress after adjusting for socio-demographic variables (OR = 2.18; 95%CI: 1.69-2.81). Low levels of both reciprocity and sense of community belonging were associated with psychological distress after adjusting for socio-demographic variables (OR = 3.46 with 95%CI of 2.10–5.71 for reciprocity, and OR = 7.42 with 95%CI of 4.64–11.87 for sense of community belonging). Conclusion Low interest in dietary pattern, low frequency of intake of vegetables, and low levels of social capital were significantly associated with psychological distress after adjusting for socio-demographic variables. PMID:24099097

Basic Diagnosis and Prediction of Persistent Contrail Occurrence using High-resolution Numerical Weather Analyses/Forecasts and Logistic Regression. Part I: Effects of Random Error

NASA Technical Reports Server (NTRS)

Duda, David P.; Minnis, Patrick

2009-01-01

Straightforward application of the Schmidt-Appleman contrail formation criteria to diagnose persistent contrail occurrence from numerical weather prediction data is hindered by significant bias errors in the upper tropospheric humidity. Logistic models of contrail occurrence have been proposed to overcome this problem, but basic questions remain about how random measurement error may affect their accuracy. A set of 5000 synthetic contrail observations is created to study the effects of random error in these probabilistic models. The simulated observations are based on distributions of temperature, humidity, and vertical velocity derived from Advanced Regional Prediction System (ARPS) weather analyses. The logistic models created from the simulated observations were evaluated using two common statistical measures of model accuracy, the percent correct (PC) and the Hanssen-Kuipers discriminant (HKD). To convert the probabilistic results of the logistic models into a dichotomous yes/no choice suitable for the statistical measures, two critical probability thresholds are considered. The HKD scores are higher when the climatological frequency of contrail occurrence is used as the critical threshold, while the PC scores are higher when the critical probability threshold is 0.5. For both thresholds, typical random errors in temperature, relative humidity, and vertical velocity are found to be small enough to allow for accurate logistic models of contrail occurrence. The accuracy of the models developed from synthetic data is over 85 percent for both the prediction of contrail occurrence and non-occurrence, although in practice, larger errors would be anticipated.

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.

Treatment of Non-Tuberculous Mycobacterial Lung Disease.

PubMed

Philley, Julie V; DeGroote, Mary Ann; Honda, Jennifer R; Chan, Michael M; Kasperbauer, Shannon; Walter, Nicholas D; Chan, Edward D

2016-12-01

Treatment of non-tuberculous mycobacterial lung disease (NTM-LD) is challenging for several reasons including the relative resistance of NTM to currently available drugs and the difficulty in tolerating prolonged treatment with multiple drugs. Yet-to-be-done, large, multicenter, prospective randomized studies to establish the best regimens will also be arduous because multiple NTM species are known to cause human lung disease, differences in virulence and response to treatment between different species and strains within a species will make randomization more difficult, the need to distinguish relapse from a new infection, and the difficulty in adhering to the prescribed treatment due to intolerance, toxicity, and/or drug-drug interactions, often necessitating modification of therapeutic regimens. Furthermore, the out-of-state resident status of many patients seen at the relatively few centers that care for large number of NTM-LD patients pose logistical issues in monitoring response to treatment. Thus, current treatment regimens for NTM-LD is largely based on small case series, retrospective analyses, and guidelines based on expert opinions. It has been nearly 10 years since the publication of a consensus guideline for the treatment of NTM-LD. This review is a summary of the available evidence on the treatment of the major NTM-LD until more definitive studies and guidelines become available.

Marijuana use and sex with multiple partners among lesbian, gay and bisexual youth: results from a national sample.

PubMed

Zhang, Xiaoyun; Wu, Li-Tzy

2017-01-05

Sex with multiple partners (SMP) is one of the important contributing factors for contracting sexually transmitted infections (STIs) among adolescents and young adults, especially among Lesbian, Gay, and Bisexual (LGB) youth. Past studies mainly focus on examining associations of alcohol or club drugs use with unprotected sexual behaviors among adult homo/bisexual men, while little is known about the temporal association between marijuana use (MU) and SMP among LGB youth. This study examined the relationship between MU and SMP among LGB adolescents and young adults. Generalized estimating equations (GEE) logistic regression analyses were utilized to analyze four waves' public-use Add Health data (N = 694, youth who reported a homo/bisexual status at any wave; Wave 1: aged 11-21; Wave 4: aged 24-32). After adjusting for other substance use, current depression, mother-child relationship quality at Wave 1, and socioeconomic variables, past-year MU was both concurrently and prospectively associated with past-year SMP. The moderating effect of age was not found. MU is concurrently and prospectively associated with increased odds of SMP in the adolescent sample and in the young adult sample. Findings imply that prevention/intervention on HIV risk behaviors may benefit from MU reduction not only in LGB adolescents but also in young adults.

Combined effect of Hashimoto's thyroiditis and BRAF(V600E) mutation status on aggressiveness in papillary thyroid cancer.

PubMed

Kim, Su-jin; Myong, Jun Pyo; Jee, Hyeon-Gun; Chai, Young Jun; Choi, June Young; Min, Hye Sook; Lee, Kyu Eun; Youn, Yeo-Kyu

2016-01-01

The purpose of this study was to evaluate the association between Hashimoto's thyroiditis and BRAF(V600E) mutation status in patients with papillary thyroid cancer (PTC) and to determine their combined association with tumor aggressiveness in PTC. A total of 1780 patients with PTC who underwent surgery were enrolled in this study. Simple and multiple analyses were performed to determine the association between Hashimoto's thyroiditis and the BRAF(V600E) mutation in PTC. Hashimoto's thyroiditis was present in 11.5% of patients (204/1780) with PTC. Multiple logistic regressions showed that BRAF(V600E) (odds ratio [OR] = 0.493; 95% confidence interval [CI] = 0.360-0.678) and the female sex (OR = 7.146; 95% CI = 3.408-18.347) were independent factors associated with Hashimoto's thyroiditis in PTC. BRAF(V600E) mutation and the Hashimoto's thyroiditis-negative PTC group were associated with aggressive disease (OR = 3.069; 95% CI = 1.654-5.916). Hashimoto's thyroiditis was associated less frequently with BRAF(V600E) , and frequently with the female sex in patients with PTC. Hashimoto's thyroiditis and BRAF(V600E) status may help to predict clinical outcome of PTC. © 2015 Wiley Periodicals, Inc.

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.

Delta neutrophil index: A reliable marker to differentiate perforated appendicitis from non-perforated appendicitis in the elderly.

PubMed

Shin, Dong Hyuk; Cho, Young Suk; Kim, Yoon Sung; Ahn, Hee Cheol; Oh, Young Taeck; Park, Sang O; Won, Moo-Ho; Cho, Jun Hwi; Kim, Young Myeong; Seo, Jeong Yeol; Lee, Young Hwan

2018-01-01

Delta neutrophil index (DNI) is a new inflammatory marker and the present study aimed to evaluate the predictive value of the DNI for the presence of a perforation in elderly with acute appendicitis. This retrospective observational study was conducted on 108 consecutive elderly patients (≥65 years old) with acute appendicitis treated over a 24-month period. Sixty-nine of the 108 patients (median, IQR: 72, 67-77 years) were allocated to the perforated appendicitis group (63.9%) and 39 to the non-perforated appendicitis group (36.1%). WBC, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and DNI were significantly higher in the perforated group. In multiple logistic regression analyses, initial DNI was the only independent marker that can significantly predict the presence of perforation in multiple regression [odds ratio 9.38, 95% confidence interval (2.51-35.00), P=.001]. Receiver operator characteristic curve analysis showed that DNI is a good predictor for the presence of appendiceal perforation at an optimal cut-off for DNI being 1.4% (sensitivity 67.7%, specificity 90.0%, AUC 0.807). Clinicians can reliably differentiate acute perforated appendicitis from non-perforated appendicitis by DNI level of 1.4 or more in elderly patients. © 2017 Wiley Periodicals, Inc.

Clinical Predictors of Multiple Organ Dysfunction Syndromes in Pediatric patients with Scrub Typhus.

PubMed

Zhao, Dongying; Zhang, Yongjun; Yin, Zhaoqing; Zhao, Jing; Yang, Defeng; Zhou, Qun

2017-06-01

Scrub typhus can produce multiple organ dysfunction syndrome (MODS). Early recognition of the patients at risk of MODS would be helpful in providing timely management and reducing the mortality. In all, 449 children with scrub typhus were enrolled at three hospitals in Yunnan, China from January 2010 to January 2015. The patients' clinical status of organ system dysfunction was evaluated on the day of discharge from hospital by using standard criteria. The patients were classified into MODS present (64 cases, 14.3%) or MODS absent (385 cases, 85.7%). Multivariate logistic regression analyses revealed that the prognostic factors for MODS included skin rash (odds ratio, OR = 3.3, p = 0.037), time interval form treatment to defervescence (OR = 1.2, p = 0.035), hemoglobin (OR = 0.54, p = 0.041), platelet counts (OR = 0.06, p < 0.001), aspartate-aminotransferase (OR = 4.7, p = 0.011) and total bilirubin (OR = 2.3, p = 0.013). By describing risk factors resulting in MODS in pediatric scrub typhus, our study provides clinicians with important information to improve the clinical monitoring and prognostication of MODS. © The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Sociodemographic factors associated with multiple cardiovascular risk factors among Malaysian adults.

PubMed

Ghazali, Sumarni Mohd; Seman, Zamtira; Cheong, Kee Chee; Hock, Lim Kuang; Manickam, Mala; Kuay, Lim Kuang; Yusoff, Ahmad Faudzi; Mustafa, Feisul Idzwan; Mustafa, Amal Nasir

2015-01-31

To determine the prevalence and sociodemographic correlates of multiple risk factors for cardiovascular disease (CVD) among Malaysian adults. We analysed data on 1044 men and 1528 women, aged 24-64 years, participants in the Non Communicable Disease Surveillance 2005/2006, a nationally representative, population-based, cross-sectional study. Prevalence of obesity, high blood pressure, dyslipidaemia, hyperglycemia, physical inactivity, smoking, risky drinking, low vegetable and fruit intake were determined and multivariable logistic regression was used to identify sociodemographic factors associated with having ≥3 of these cardiovascular disease risk factors. The response rate was 84.6% (2572/3040). Overall, 68.4% (95% CI: 63.2, 73.1) had at least three risk factors. Among men, older age and Indian ethnicity were independently associated with having ≥3 CVD risk factors; while among women, older age, low education, and housewives were more likely to have ≥3 CVD risk factors. The prevalence of cardiovascular risk factors clustering among Malaysian adults is high, raising concerns that cardiovascular disease incidence will rise steeply in the near future if no immediate preventive measures are taken. The current national health education and promotion programmes pertaining to modifiable risk factors can be further improved by taking into account the sociodemographic variation in CVD risk factors clustering.

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.

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.

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.

Association factor analysis between osteoporosis with cerebral artery disease: The STROBE study.

PubMed

Jin, Eun-Sun; Jeong, Je Hoon; Lee, Bora; Im, Soo Bin

2017-03-01

The purpose of this study was to determine the clinical association factors between osteoporosis and cerebral artery disease in Korean population. Two hundred nineteen postmenopausal women and men undergoing cerebral computed tomography angiography were enrolled in this study to evaluate the cerebral artery disease by cross-sectional study. Cerebral artery disease was diagnosed if there was narrowing of 50% higher diameter in one or more cerebral vessel artery or presence of vascular calcification. History of osteoporotic fracture was assessed using medical record, and radiographic data such as simple radiography, MRI, and bone scan. Bone mineral density was checked by dual-energy x-ray absorptiometry. We reviewed clinical characteristics in all patients and also performed subgroup analysis for total or extracranial/ intracranial cerebral artery disease group retrospectively. We performed statistical analysis by means of chi-square test or Fisher's exact test for categorical variables and Student's t-test or Wilcoxon's rank sum test for continuous variables. We also used univariate and multivariate logistic regression analyses were conducted to assess the factors associated with the prevalence of cerebral artery disease. A two-tailed p-value of less than 0.05 was considered as statistically significant. All statistical analyses were performed using R (version 3.1.3; The R Foundation for Statistical Computing, Vienna, Austria) and SPSS (version 14.0; SPSS, Inc, Chicago, Ill, USA). Of the 219 patients, 142 had cerebral artery disease. All vertebral fracture was observed in 29 (13.24%) patients. There was significant difference in hip fracture according to the presence or absence of cerebral artery disease. In logistic regression analysis, osteoporotic hip fracture was significantly associated with extracranial cerebral artery disease after adjusting for multiple risk factors. Females with osteoporotic hip fracture were associated with total calcified cerebral artery disease. Some clinical factors such as age, hypertension, and osteoporotic hip fracture, smoking history and anti-osteoporosis drug use were associated with cerebral artery disease.

Predictive capacity of sperm quality parameters and sperm subpopulations on field fertility after artificial insemination in sheep.

PubMed

Santolaria, P; Vicente-Fiel, S; Palacín, I; Fantova, E; Blasco, M E; Silvestre, M A; Yániz, J L

2015-12-01

This study was designed to evaluate the relevance of several sperm quality parameters and sperm population structure on the reproductive performance after cervical artificial insemination (AI) in sheep. One hundred and thirty-nine ejaculates from 56 adult rams were collected using an artificial vagina, processed for sperm quality assessment and used to perform 1319 AI. Analyses of sperm motility by computer-assisted sperm analysis (CASA), sperm nuclear morphometry by computer-assisted sperm morphometry analysis (CASMA), membrane integrity by acridine orange-propidium iodide combination and sperm DNA fragmentation using the sperm chromatin dispersion test (SCD) were performed. Clustering procedures using the sperm kinematic and morphometric data resulted in the classification of spermatozoa into three kinematic and three morphometric sperm subpopulations. Logistic regression procedures were used, including fertility at AI as the dependent variable (measured by lambing, 0 or 1) and farm, year, month of AI, female parity, female lambing-treatment interval, ram, AI technician and sperm quality parameters (including sperm subpopulations) as independent factors. Sperm quality variables remaining in the logistic regression model were viability and VCL. Fertility increased for each one-unit increase in viability (by a factor of 1.01) and in VCL (by a factor of 1.02). Multiple linear regression analyses were also performed to analyze the factors possibly influencing ejaculate fertility (N=139). The analysis yielded a significant (P<0.05) relationship between sperm viability and ejaculate fertility. The discriminant ability of the different semen variables to predict field fertility was analyzed using receiver operating characteristic (ROC) curve analysis. Sperm viability and VCL showed significant, albeit limited, predictive capacity on field fertility (0.57 and 0.54 Area Under Curve, respectively). The distribution of spermatozoa in the different subpopulations was not related to fertility. Copyright © 2015 Elsevier B.V. All rights reserved.

History of falls, gait, balance, and fall risks in older cancer survivors living in the community.

PubMed

Huang, Min H; Shilling, Tracy; Miller, Kara A; Smith, Kristin; LaVictoire, Kayle

2015-01-01

Older cancer survivors may be predisposed to falls because cancer-related sequelae affect virtually all body systems. The use of a history of falls, gait speed, and balance tests to assess fall risks remains to be investigated in this population. This study examined the relationship of previous falls, gait, and balance with falls in community-dwelling older cancer survivors. At the baseline, demographics, health information, and the history of falls in the past year were obtained through interviewing. Participants performed tests including gait speed, Balance Evaluation Systems Test, and short-version of Activities-specific Balance Confidence scale. Falls were tracked by mailing of monthly reports for 6 months. A "faller" was a person with ≥1 fall during follow-up. Univariate analyses, including independent sample t-tests and Fisher's exact tests, compared baseline demographics, gait speed, and balance between fallers and non-fallers. For univariate analyses, Bonferroni correction was applied for multiple comparisons. Baseline variables with P<0.15 were included in a forward logistic regression model to identify factors predictive of falls with age as covariate. Sensitivity and specificity of each predictor of falls in the model were calculated. Significance level for the regression analysis was P<0.05. During follow-up, 59% of participants had one or more falls. Baseline demographics, health information, history of falls, gaits speed, and balance tests did not differ significantly between fallers and non-fallers. Forward logistic regression revealed that a history of falls was a significant predictor of falls in the final model (odds ratio =6.81; 95% confidence interval =1.594-29.074) (P<0.05). Sensitivity and specificity for correctly identifying a faller using the positive history of falls were 74% and 69%, respectively. Current findings suggested that for community-dwelling older cancer survivors with mixed diagnoses, asking about the history of falls may help detect individuals at risk of falling.

Effect of Right Posterior Bile Duct Anatomy on Biliary Complications in Patients Undergoing Right Lobe Living Donor Liver Transplant.

PubMed

Tezcaner, Tugan; Dinç, Nadire; Y Karakayalı, Feza; Kırnap, Mahir; Coşkun, Mehmet; Moray, Gökhan; Haberal, Mehmet

2017-01-27

Our aim was to evaluate the influence of the localization of right posterior bile duct anatomy relative to portal vein of the donors on posttransplant bile duct complications. We retrospectively investigated 141 patients who had undergone living donor liver transplant using right hemiliver grafts. The patients were classified based on the pattern of the right posterior bile duct and divided into infraportal and supraportal types. Clinical donor and recipient risk factors and surgical outcomes were compared for their relationship with biliary complications using logistic regression analyses. The 2 groups were similar according to demographic and clinical features. The biliary complication rate was 23.7% (9/38) in the infraportal group and 47.4% (37/78) in the supraportal group (P = .014). An analysis of risk factors for the development of anastomotic bile leak using logistic regression showed that a supraportal right posterior bile duct anatomy was a statistically significant positive predictor, with odds ratio of 18.905 (P = .012; confidence interval, 1.922-185.967). The distance of the right posterior bile duct from confluence was significantly lower in patients with biliary complications than in those without (mean of 7.66 vs 0.40 mm; P = .044). According to receiver operating characteristic analyses, the cut-off point for the length of right bile duct to right posterior bile duct from the hepatic confluence was 9.5 mm regarding presence of complications. Factors influencing bile duct anastomosis leakage were supraportal-type donor bile duct anatomy and length of the right main bile duct from biliary confluence. Hepatic arterial complications were similarly a risk factor for biliary strictures. Because of the multiple factors leading to complications in living donor liver transplant, it is challenging to group these patients by operative risk; however, establishing risk models may facilitate the prediction of complications.

Performance on the adult rheumatology in-training examination and relationship to outcomes on the rheumatology certification examination.

PubMed

Lohr, Kristine M; Clauser, Amanda; Hess, Brian J; Gelber, Allan C; Valeriano-Marcet, Joanne; Lipner, Rebecca S; Haist, Steven A; Hawley, Janine L; Zirkle, Sarah; Bolster, Marcy B

2015-11-01

The American College of Rheumatology (ACR) Adult Rheumatology In-Training Examination (ITE) is a feedback tool designed to identify strengths and weaknesses in the content knowledge of individual fellows-in-training and the training program curricula. We determined whether scores on the ACR ITE, as well as scores on other major standardized medical examinations and competency-based ratings, could be used to predict performance on the American Board of Internal Medicine (ABIM) Rheumatology Certification Examination. Between 2008 and 2012, 629 second-year fellows took the ACR ITE. Bivariate correlation analyses of assessment scores and multiple linear regression analyses were used to determine whether ABIM Rheumatology Certification Examination scores could be predicted on the basis of ACR ITE scores, United States Medical Licensing Examination scores, ABIM Internal Medicine Certification Examination scores, fellowship directors' ratings of overall clinical competency, and demographic variables. Logistic regression was used to evaluate whether these assessments were predictive of a passing outcome on the Rheumatology Certification Examination. In the initial linear model, the strongest predictors of the Rheumatology Certification Examination score were the second-year fellows' ACR ITE scores (β = 0.438) and ABIM Internal Medicine Certification Examination scores (β = 0.273). Using a stepwise model, the strongest predictors of higher scores on the Rheumatology Certification Examination were second-year fellows' ACR ITE scores (β = 0.449) and ABIM Internal Medicine Certification Examination scores (β = 0.276). Based on the findings of logistic regression analysis, ACR ITE performance was predictive of a pass/fail outcome on the Rheumatology Certification Examination (odds ratio 1.016 [95% confidence interval 1.011-1.021]). The predictive value of the ACR ITE score with regard to predicting performance on the Rheumatology Certification Examination supports use of the Adult Rheumatology ITE as a valid feedback tool during fellowship training. © 2015, American College of Rheumatology.

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

Vascular and metabolic comorbidities in open-angle glaucoma with low- and high-teen intraocular pressure: a cross-sectional study from South Korea.

PubMed

Lee, Si Hyung; Kim, Gyu Ah; Lee, Wonseok; Bae, Hyoung Won; Seong, Gong Je; Kim, Chan Yun

2017-11-01

To assess the associations between vascular and metabolic comorbidities and the prevalence of open-angle glaucoma (OAG) with low-teen and high-teen intraocular pressure (IOP) in Korea. Cross-sectional data from the Korean National Health and Nutrition Examination Survey from 2008 to 2012 were analysed. Participants diagnosed with OAG with normal IOP were further classified into low-teen IOP (IOP ≤ 15 mmHg) and high-teen IOP (15 mmHg < IOP ≤ 21 mmHg) groups. Using multiple logistic regression analyses, the associations between vascular and metabolic comorbidities and the prevalence of glaucoma were investigated for the low- and high-teen IOP groups. The prevalences of hypertension, hyperlipidemia, ischaemic heart disease, stroke and metabolic syndrome were significantly higher among subjects with low-teen OAG compared with normal subjects, while only the prevalences of hypertension and stroke were higher among subjects with high-teen OAG compared with normal subjects. In multivariate logistic regression models adjusted for confounding factors, low-teen OAG was significantly associated with hypertension (OR, 1.68; 95% CI, 1.30-2.18), hyperlipidemia (OR, 1.49; 95% CI, 1.07-2.08), ischaemic heart disease (OR, 1.83; 95% CI, 1.07-3.11), stroke (OR, 1.91; 95% CI, 1.12-3.25) and metabolic syndrome (OR, 1.46; 95% CI, 1.12-1.90). High-teen OAG was only associated with stroke (OR, 2.58; 95% CI, 1.20-5.53). Various vascular and metabolic comorbidities were significantly associated with low-teen OAG, but not with high-teen OAG. These data support the hypothesis that vascular factors play a more significant role in the pathogenesis of OAG with low-teen baseline IOP. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Direct and indirect associations between the family physical activity environment and sports participation among 10–12 year-old European children: testing the EnRG framework in the ENERGY project

PubMed Central

2013-01-01

Background Sport participation makes an important contribution to children’s overall physical activity. Understanding influences on sports participation is important and the family environment is considered key, however few studies have explored the mechanisms by which the family environment influences children’s sport participation. The purpose of this study was to examine whether attitude, perceived behavioural control, health belief and enjoyment mediate associations between the family environment and 10–12 year-old children’s sports participation. Methods Children aged 10–12 years ( = 7234) and one of their parents (n = 6002) were recruited from 175 schools in seven European countries in 2010. Children self-reported their weekly duration of sports participation, physical activity equipment items at home and the four potential mediator variables. Parents responded to items on financial, logistic and emotional support, reinforcement, modelling and co-participation in physical activity. Cross-sectional single and multiple mediation analyses were performed for 4952 children with complete data using multi-level regression analyses. Results Availability of equipment (OR = 1.16), financial (OR = 1.53), logistic (OR = 1.47) and emotional (OR = 1.51) support, and parental modelling (OR = 1.07) were positively associated with participation in ≥ 30mins/wk of sport. Attitude, beliefs, perceived behavioural control and enjoyment mediated and explained between 21-34% of these associations. Perceived behavioural control contributed the most to the mediated effect for each aspect of the family environment. Conclusions Both direct (unmediated) and indirect (mediated) associations were found between most family environment variables and children’s sports participation. Thus, family-based physical activity interventions that focus on enhancing the family environment to support children’s sport participation are warranted. PMID:23374374

History of falls, gait, balance, and fall risks in older cancer survivors living in the community

PubMed Central

Huang, Min H; Shilling, Tracy; Miller, Kara A; Smith, Kristin; LaVictoire, Kayle

2015-01-01

Older cancer survivors may be predisposed to falls because cancer-related sequelae affect virtually all body systems. The use of a history of falls, gait speed, and balance tests to assess fall risks remains to be investigated in this population. This study examined the relationship of previous falls, gait, and balance with falls in community-dwelling older cancer survivors. At the baseline, demographics, health information, and the history of falls in the past year were obtained through interviewing. Participants performed tests including gait speed, Balance Evaluation Systems Test, and short-version of Activities-specific Balance Confidence scale. Falls were tracked by mailing of monthly reports for 6 months. A “faller” was a person with ≥1 fall during follow-up. Univariate analyses, including independent sample t-tests and Fisher’s exact tests, compared baseline demographics, gait speed, and balance between fallers and non-fallers. For univariate analyses, Bonferroni correction was applied for multiple comparisons. Baseline variables with P<0.15 were included in a forward logistic regression model to identify factors predictive of falls with age as covariate. Sensitivity and specificity of each predictor of falls in the model were calculated. Significance level for the regression analysis was P<0.05. During follow-up, 59% of participants had one or more falls. Baseline demographics, health information, history of falls, gaits speed, and balance tests did not differ significantly between fallers and non-fallers. Forward logistic regression revealed that a history of falls was a significant predictor of falls in the final model (odds ratio =6.81; 95% confidence interval =1.594–29.074) (P<0.05). Sensitivity and specificity for correctly identifying a faller using the positive history of falls were 74% and 69%, respectively. Current findings suggested that for community-dwelling older cancer survivors with mixed diagnoses, asking about the history of falls may help detect individuals at risk of falling. PMID:26425079

Vitamin D status among the elderly Chinese population: a cross-sectional analysis of the 2010-2013 China national nutrition and health survey (CNNHS).

PubMed

Chen, Jing; Yun, Chunfeng; He, Yuna; Piao, Jianhua; Yang, Lichen; Yang, Xiaoguang

2017-01-14

Vitamin D inadequacy is common among the elderly, especially within the Asian population. The vitamin D status among healthy adults in the elderly Chinese population was evaluated. A total of 6014 healthy adults aged 60 years or older (2948 men, 3066 women) participated in this descriptive cross-sectional analysis. Possible predictors of vitamin D inadequacy were evaluated via multiple logistic regression analyses. The median serum 25-hydroxyvitamin D (25(OH)D) levels were 61.0 nmol/l (interquartile range (IQR) 44.3-80.6, range 5.1-154.5) for men and 53.7 nmol/l (IQR 38.8-71.0, range 6.0-190.0) for women, with 34.1% (95% confidence interval (CI) 32.4-35.8) of men and 44.0% (95% CI 42.2-45.8) of women presenting vitamin D inadequacy (25(OH)D <50 nmol/l). According to the multivariate logistic regression analyses, vitamin D inadequacy was positively correlated with female gender (P <0.0001), underweight (P = 0.0259), the spring season (P <0.0001), low ambient UVB levels (P <0.0001) and living in large cities (P = 0.0026). For men, vitamin D inadequacy was positively correlated with the spring season (P = 0.0015), low ambient UVB levels (P <0.0001) and living in large cities (P = 0.0022); for women, vitamin D inadequacy was positively correlated with the spring season (P = 0.0005) and low ambient UVB levels (P <.0001). Vitamin D inadequacy is prevalent among the elderly population in China. Because residing in regions with low ambient UVB levels increases the risk of vitamin D inadequacy both for men and women, vitamin D supplementation and sensible sun exposure should be encouraged, especially during the cooler seasons. Further studies are required to determine the optimal vitamin D intake and sun exposure levels to maintain sufficient vitamin D levels in the elderly Chinese population.

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.

Regular analgesic use and risk of multiple myeloma.

PubMed

Moysich, Kirsten B; Bonner, Mathew R; Beehler, Gregory P; Marshall, James R; Menezes, Ravi J; Baker, Julie A; Weiss, Joli R; Chanan-Khan, Asher

2007-04-01

Analgesic use has been implicated in the chemoprevention of a number of solid tumors, but to date no previous research has focused on the role of analgesics in the etiology of multiple myeloma (MM). We conducted a hospital-based case-control study of 117 patients with primary, incident MM and 483 age and residence matched controls without benign or malignant neoplasms. All participants received medical services at Roswell Park Cancer Institute in Buffalo, NY, and completed a comprehensive epidemiological questionnaire. Participants who reported analgesic use at least once a week for at least 6 months were classified as regular users; individuals who did not use analgesics regularly served as the reference group throughout the analyses. We used unconditional logistic regression analyses to compute crude and adjusted odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Compared to non-users, regular aspirin users were not at reduced risk of MM (adjusted OR=0.99; 95% CI 0.65-1.49), nor were participants with the highest frequency or duration of aspirin use. A significant risk elevation was found for participants who were regular acetaminophen users (adjusted OR=2.95; 95% CI 1.72-5.08). Further, marked increases in risk of MM were noted with both greater frequency (>7 tablets weekly; adjusted OR=4.36; 95% CI 1.70-11.2) and greater duration (>10 years; adjusted OR=3.26; 95% CI 1.52-7.02) of acetaminophen use. We observed no evidence of a chemoprotective effect of aspirin on MM risk, but observed significant risk elevations with various measures of acetaminophen use. Our results warrant further investigation in population-based case-control and cohort studies and should be interpreted with caution in light of the limited sample size and biases inherent in hospital-based studies.

A difference in systolic blood pressure between arms and between lower limbs is a novel risk marker for diabetic nephropathy in patients with type 2 diabetes.

PubMed

Okada, Hiroshi; Fukui, Michiaki; Tanaka, Muhei; Matsumoto, Shinobu; Mineoka, Yusuke; Nakanishi, Naoko; Asano, Mai; Yamazaki, Masahiro; Hasegawa, Goji; Nakamura, Naoto

2013-05-01

Recent studies have demonstrated that a difference in systolic blood pressure (SBP) between arms is associated with both vascular disease and mortality. The aim of this study was to investigate the relationship between a difference in SBP between arms and between lower limbs and the degree of albuminuria, which is an established marker for cardiovascular disease and diabetic nephropathy in patients with Type 2 diabetes. We measured blood pressure in the arms and lower limbs of 314 consecutive patients with Type 2 diabetes, and we calculated a difference in SBP between arms and between lower limbs. We then evaluated the relationship of the difference in SBP between arms and between lower limbs to the degree of urinary albumin excretion (UAE). The average difference in SBP between arms and between lower limbs was 3.52±3.94 and 9.66±14.1 mm Hg, respectively. Multiple regression analyses demonstrated that a difference in SBP between arms (β=0.172, P=0.0239) and between lower limbs (β=0.238, P=0.0033) independently correlated with the logarithm of the UAE. Multiple logistic regression analyses showed that a difference in SBP of 10 mm Hg between arms (odds ratio 12.23 (95% CI 1.130-132.35), P<0.0393) and a difference in SBP of 15 mm Hg between lower limbs (odds ratio 4.291 (95% CI 1.403-13.123), P<0.0106) correlated with the risk of albuminuria. A difference in SBP between arms and between lower limbs, therefore, could be a novel risk marker for diabetic nephropathy in patients with Type 2 diabetes.

Multiple Nonspecific Sites of Joint Pain Outside the Knees Develop in Persons With Knee Pain.

PubMed

Felson, David T; Niu, Jingbo; Quinn, Emily K; Neogi, Tuhina; Lewis, Cara L; Lewis, Cora E; Frey Law, Laura; McCulloch, Chuck; Nevitt, Michael; LaValley, Michael

2017-02-01

Many persons with knee pain have joint pain outside the knee, but despite the impact and high frequency of this pain, its distribution and causes have not been studied. We undertook this study to test the hypothesis of those studying gait abnormalities who have suggested that knee pain causes pain in adjacent joints but that pain adaptation strategies are highly individualized. We studied persons ages 50-79 years with or at high risk of knee osteoarthritis who were recruited from 2 community-based cohorts, the Multicenter Osteoarthritis Study and the Osteoarthritis Initiative, and we followed them up for 5-7 years. We excluded those with knee pain at baseline and compared those who had developed knee pain at the first follow-up examination (the index visit) with those who had not. We examined pain on most days at joint regions outside the knee in examinations after the index visit. Logistic regression analyses examined the risk of joint-specific pain adjusted for age, sex, body mass index, and symptoms of depression, and we performed sensitivity analyses excluding those with widespread pain. In the combined cohorts, 693 persons had knee pain at the index visit and 2,793 did not. A total of 79.6% of those with bilateral knee pain and 63.8% of those with unilateral knee pain had pain during follow-up in a joint region outside the knee, compared with 49.9% of those without knee pain. There was an increased risk of pain at most extremity joint sites, without a predilection for specific sites. Results were unchanged when those with widespread pain were excluded. Persons with chronic knee pain are at increased risk of pain in multiple joints in no specific pattern. © 2016, American College of Rheumatology.

KIT polymorphisms were associated with the risk for head and neck squamous carcinoma in Chinese population.

PubMed

Hang, Dong; Yuan, Hua; Liu, Li; Wang, Lihua; Miao, Limin; Zhu, Meng; Du, Jiangbo; Dai, Juncheng; Hu, Zhibin; Chen, Ning; Shen, Hongbing; Ma, Hongxia

2017-01-01

KITLG/KIT pathway plays a vital role in multiple types of human cancer including head and neck squamous cell carcinoma (HNSCC). Genetic variations in KITLG and KIT may affect the expression or function of these genes, thereby modifying cancer risk. In this study, we evaluated the association of KITLG and KIT polymorphisms with HNSCC risk among Chinese population. Twenty-two tagging SNPs in KITLG and KIT genes were genotyped in a case-control study with 576 HNSCC patients and 1552 healthy controls. Logistic regression analyses revealed that an upstream SNP rs6554198 [additive model: adjusted odds ratio (OR) = 0.85, 95% confidence interval (CI) = 0.74-0.97, P = 0.019] and two intron SNPs rs2237025 (additive model: adjusted OR = 0.82, 95%CI = 0.70-0.95, P = 0.007), and rs17084687 (additive model: adjusted OR = 0.85, 95%CI = 0.73-0.99, P = 0.042) of KIT were significantly associated with the decreased risk of HNSCC. Combined analysis of the three SNPs showed that subjects carrying the protective alleles had decreased risk of HNSCC in a dose-response manner (P trend  = 0.001). Furthermore, interaction analyses revealed a significant multiplicative interaction between rs17084687 and drinking on HNSCC risk (P = 0.012). Luciferase activity assay indicated that the allele A of potentially functional rs6554198 led to significantly lower transcription activity of KIT compared to the risk allele G. Summarily, our findings suggested that SNPs in KIT gene may play a role in genetic susceptibility to HNSCC, which may improve our understanding of the pathogenic mechanisms of this disease. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Developmental sensitivity to cannabis use patterns and risk for major depressive disorder in mid-life: findings from 40 years of follow-up.

PubMed

Schoeler, Tabea; Theobald, Delphine; Pingault, Jean-Baptiste; Farrington, David P; Coid, Jeremy W; Bhattacharyya, Sagnik

2018-04-02

Evidence regarding the association between cannabis use and depression remain conflicting, especially as studies have not typically adopted a longitudinal design with a follow-up period that was long enough to adequately cover the risk period for onset of depression. Males from the Cambridge Study in Delinquent Development (CSDD) (N = 285) were assessed seven times from age 8 to 48 years to prospectively investigate the association between cannabis use and risk of major depressive disorder (MDD). A combination of multiple analyses (logistic regression, Cox regression, fixed-effects analysis) was employed to explore the strength and direction of effect within different developmental stages. Multiple regression analyses revealed that early-onset cannabis use (before age 18) but not late-onset cannabis use (after age 27) was associated with a higher risk and shorter time until a subsequent MDD diagnosis. This effect was present in high-frequency [(odds ratio (OR) 8.83, 95% confidence interval (CI) 1.29-70.79]; [hazard ratio (HR) 8.69, 95% CI 2.07-36.52)] and low-frequency early-onset users (OR 2.41, 95% CI 1.22-4.76; HR 2.09, 95% CI 1.16-3.74). Effect of increased frequency of cannabis use on increased risk of subsequent MDD was observed only for use during adolescence (age 14-18) but not at later life stages, while controlling for observed and non-unobserved time-invariant factors. Conversely, MDD in adulthood (age 18-32) was linked to a reduction in subsequent cannabis use (age 32-48). The present findings provide evidence implicating frequent cannabis use during adolescence as a risk factor for later life depression. Future studies should further examine causality of effects in larger samples.

Multi-psychotropic drug prescription and the association to neuropsychiatric symptoms in three Norwegian nursing home cohorts between 2004 and 2011.

PubMed

Gulla, Christine; Selbaek, Geir; Flo, Elisabeth; Kjome, Reidun; Kirkevold, Øyvind; Husebo, Bettina S

2016-06-01

Neuropsychiatric symptoms, such as affective symptoms, psychosis, agitation, and apathy are common among nursing home patients with and without dementia. Treatment with one or more psychotropic drug is often without explicit clinical indication, despite low treatment efficacy, and potential side effects. We aim to investigate the multi-psychotropic drug use to identify factors and patient characteristics associated with multi-use. We analysed three cohorts from 129 Norwegian nursing homes, collected between 2004 and 2011. Patients (N = 4739) were assessed with the Neuropsychiatric Inventory - Nursing Home version (NPI-NH), Clinical Dementia Rating scale, and Physical Self Maintenance Scale. We used ordinal logistic regression to analyse associations between psychotropics (antidepressants, antipsychotics, anxiolytics, hypnotics, and anti-dementia drugs), patient characteristics, and neuropsychiatric symptoms. Patients used on average 6.6 drugs; 27 % used no psychotropics, 32 % one, and 41 % multiple psychotropic drugs (24 % two, 17 % ≥3). Thirty-nine percent were prescribed antidepressants, 30 % sedatives, 24 % anxiolytics, and 20 % antipsychotics. The total NPI-NH score was associated with multi-use (OR 1.02, 95 % CI 1.02-1.03), and increased from a mean of 13.5 (SD 16.3) for patients using none, to 25.5 (21.8) for patients using ≥3 psychotropics. Affective symptoms (depression and anxiety) were most strongly associated with multi-psychotropic drug use (OR 1.10, 95 % CI: 1.09-1.12). Female gender, independency in daily living, younger age, dementia, and many regular drugs were also associated with multi-use. Forty-one percent were exposed to multi-psychotropic drug prescriptions. Contrary to current evidence and guidelines, there is an extensive use of multiple psychotropic drugs in patients with severe NPS and dementia.

75 FR 55975 - Safety Zone; San Diego Harbor Shark Fest Swim; San Diego Bay, San Diego, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-15

... Guard did not receive notification of the logistical details of the San Diego Bay swim in sufficient... the Captain of the Port, or designated representative. Regulatory Analyses We developed this rule... analyses based on 13 of these statutes or executive orders. Regulatory Planning and Review This rule is not...

75 FR 55270 - Safety Zone; NASSCO Launching of USNS Washington Chambers, San Diego Bay, San Diego, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-10

... rulemaking (NPRM) with respect to this rule because it was impracticable since the logistical details of the... will be subject to both criminal and civil penalties. Regulatory Analyses We developed this rule after considering numerous statutes and executive orders related to rulemaking. Below we summarize our analyses...

78 FR 58878 - Safety Zone; San Diego Shark Fest Swim; San Diego Bay, San Diego, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-25

... this rule because the logistical details of the San Diego Shark Fest Swim were not finalized nor... Local Notice to Mariners and Broadcast Notice to Mariners. D. Regulatory Analyses We developed this rule... analyses based on a number of these statutes and executive orders. 1. Regulatory Planning and Review This...

NASA Supportability Engineering Implementation Utilizing DoD Practices and Processes

NASA Technical Reports Server (NTRS)

Smith, David A.; Smith, John V.

2010-01-01

The Ares I design and development program made the determination early in the System Design Review Phase to utilize DoD ILS and LSA approach for supportability engineering as an integral part of the system engineering process. This paper is to provide a review of the overall approach to design Ares-I with an emphasis on a more affordable, supportable, and sustainable launch vehicle. Discussions will include the requirements development, design influence, support concept alternatives, ILS and LSA planning, Logistics support analyses/trades performed, LSA tailoring for NASA Ares Program, support system infrastructure identification, ILS Design Review documentation, Working Group coordination, and overall ILS implementation. At the outset, the Ares I Project initiated the development of the Integrated Logistics Support Plan (ILSP) and a Logistics Support Analysis process to provide a path forward for the management of the Ares-I ILS program and supportability analysis activities. The ILSP provide the initial planning and coordination between the Ares-I Project Elements and Ground Operation Project. The LSA process provided a system engineering approach in the development of the Ares-I supportability requirements; influence the design for supportability and development of alternative support concepts that satisfies the program operability requirements. The LSA planning and analysis results are documented in the Logistics Support Analysis Report. This document was required during the Ares-I System Design Review (SDR) and Preliminary Design Review (PDR) review cycles. To help coordinate the LSA process across the Ares-I project and between programs, the LSA Report is updated and released quarterly. A System Requirement Analysis was performed to determine the supportability requirements and technical performance measurements (TPMs). Two working groups were established to provide support in the management and implement the Ares-I ILS program, the Integrated Logistics Support Working Group (ILSWG) and the Logistics Support Analysis Record Working Group (LSARWG). The Ares I ILSWG is established to assess the requirements and conduct, evaluate analyses and trade studies associated with acquisition logistic and supportability processes and to resolve Ares I integrated logistics and supportability issues. It established a strategic collaborative alliance for coordination of Logistics Support Analysis activates in support of the integrated Ares I vehicle design and development of logistics support infrastructure. A Joint Ares I - Orion LSAR Working Group was established to: 1) Guide the development of Ares-I and Orion LSAR data and serve as a model for future Constellation programs, 2) Develop rules and assumptions that will apply across the Constellation program with regards to the program's LSAR development, and 3) Maintain the Constellation LSAR Style Guide.

Logistic regression for circular data

NASA Astrophysics Data System (ADS)

Al-Daffaie, Kadhem; Khan, Shahjahan

2017-05-01

This paper considers the relationship between a binary response and a circular predictor. It develops the logistic regression model by employing the linear-circular regression approach. The maximum likelihood method is used to estimate the parameters. The Newton-Raphson numerical method is used to find the estimated values of the parameters. A data set from weather records of Toowoomba city is analysed by the proposed methods. Moreover, a simulation study is considered. The R software is used for all computations and simulations.

Analysing the New Taliban Code of Conduct (Layeha): An Assessment of Changing Perspectives and Strategies of the Afghan Taliban

DTIC Science & Technology

2012-03-01

Regarding Spies; 4. Enemy’s Logistics and Construction Activities; 5. Captured Enemy Equipment (War Booty ); 6. Regarding Commissions (i.e., Mujahedeen...Ordering fighters to blend in with the local population † Properly dividing war booty † Construction and logistics activities † Decision making on captured...detailed rules for pris- oners, the creation of provincial commissions and dividing war booty ) – also warrants a close examination. Actions prohibited by

Global Spent Fuel Logistics Systems Study (GSFLS). Volume 3A. GSFLS technical analysis (appendix). Interim report

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

Kriger, A.

1978-01-31

This report is a part of the interim report documentation for the Global Spent Fuel Logistics System (GSFLS) study. The technical and financial considerations underlying a global spent fuel logistics systems have been studied and are reported. The Pacific Basin is used as a model throughout this report; however the stated methodology and, in many cases, considerations and conclusions are applicable to other global regions. Spent fuel discharge profiles for Pacific Basin Countries were used to determine the technical systems requirements for alternative concepts. Functional analyses and flows were generated to define both system design requirements and logistics parameters. Amore » technology review was made to ascertain the state-of-the-art of relevant GSFLS technical systems. Modular GSFLS facility designs were developed using the information generated from the functional analysis and technology review. The modular facility designs were used as a basis for siting and cost estimates for various GSFLS alternatives. Various GSFLS concepts were analyzed from a financial and economic perspective in order to provide total concepts costs and ascertain financial and economic sensitivities to key GSFLS variations. Results of the study include quantification of GSFLS facility and hardware requirements; drawings of relevant GSFLS facility designs; system cost estimates; financial reports - including user service charges; and comparative analyses of various GSFLS alternatives.« less

Occupational factors and reproductive outcomes among a cohort of female veterinarians.

PubMed

Wilkins, J R; Steele, L L

1998-07-01

To estimate absolute and relative risks of preterm delivery (PTD) and small-for-gestational-age (SGA) births among a cohort of female veterinarians in relation to selected occupational factors, including clinical practice type (CPT). Retrospective cohort survey. 2,997 female graduates from US veterinary colleges between 1970 and 1980. Relevant health and occupational data were collected through a self-administered mail questionnaire with telephone follow-up of nonrespondents. Absolute and relative risks of PTD and SGA births were estimated in relation to maternal CPT at the time of conception and exposure to 13 occupational factors. Attempts were made to control confounding by use of multiple logistic regression analyses. Absolute and relative risks of PTD were highest for veterinarians employed in exclusively equine clinical practice. Although several increased, none of the CPT-specific relative risk estimates were significantly different from the null value of 1. Exposure-specific analyses indicated that occupational involvement with solvents among exclusively small animal practitioners was associated with the highest relative risk of PTD. A small number of SGA births limited information that could be obtained from these analyses. Overall absolute risks of PTD and SGA births among cohort members were much lower in comparison with the general female population. Given the large number of women currently practicing and entering the profession of veterinary medicine, clinical tasks associated with potential reproductive hazards should be approached with heightened awareness and increased caution, especially activities that may involve exposure to solvents.

Emotional support, education and self-rated health in 22 European countries.

PubMed

von dem Knesebeck, Olaf; Geyer, Siegfried

2007-10-01

The analyses focus on three aims: (1) to explore the associations between education and emotional support in 22 European countries, (2) to explore the associations between emotional support and self-rated health in the European countries, and (3) to analyse whether the association between education and self-rated health can be partly explained by emotional support. The study uses data from the European Social Survey 2003. Probability sampling from all private residents aged 15 years and older was applied in all countries. The European Social Survey includes 42,359 cases. Persons under age 25 were excluded to minimise the number of respondents whose education was not complete. Education was coded according to the International Standard Classification of Education. Perceived emotional support was assessed by the availability of a confidant with whom one can discuss intimate and personal matters with. Self-rated health was used as health indicator. Results of multiple logistic regression analyses show that emotional support is positively associated with education among women and men in most European countries. However, the magnitude of the association varies according to country and gender. Emotional support is positively associated with self-rated health. Again, gender and country differences in the association were observed. Emotional support explains little of the educational differences in self-rated health among women and men in most European countries. Results indicate that it is important to consider socio-economic factors like education and country-specific contexts in studies on health effects of emotional support.

Three Positive Parenting Practices and Their Correlation with Risk of Childhood Developmental, Social, or Behavioral Delays: An Analysis of the National Survey of Children's Health.

PubMed

Cprek, Sarah E; Williams, Corrine M; Asaolu, Ibitola; Alexander, Linda A; Vanderpool, Robin C

2015-11-01

(1) Investigate the relationship between three specific positive parenting practices (PPP)-reading to children, engaging in storytelling or singing, and eating meals together as a family-and parent-reported risk of developmental, behavioral, or social delays among children between the ages of 1-5 years in the US. (2) Determine if a combination of these parenting practices has an effect on the outcome. Chi square and multiple logistic regression analyses were used to analyze cross-sectional data from the National Survey of Children's Health 2011/2012 in regards to the relationship between each of the three individual PPP as well as a total PPP score and the child's risk of being developmentally, socially, or behaviorally delayed (N = 21,527). Risk of delay was calculated using the Parents' Evaluation of Developmental Status Questionnaire, which is a parental self-report measure that has been correlated with diagnosed child delays. These analyses controlled for poverty and parental education. All analyses were completed using SAS Version 9.3. A strong correlation was found between each of the three PPP as well as the total PPP score and the child's risk of developmental, social, or behavioral delays (p < 0.05 for each test). These associations were found to have a dose-response relationship (p < 0.05 in all but one analysis). Daily engagement in PPP could possibly reduce children's risk of delay, and specifically engaging in all three PPP may have greater benefit.

Vestibular vertigo is associated with abnormal sleep duration.

PubMed

Albathi, Monirah; Agrawal, Yuri

2017-01-01

Several small studies in animals and humans have suggested a relationship between vestibular function and sleep. In this study, we evaluate the association between vestibular vertigo and sleep duration in a large, representative sample of US adults. We used data from the National Health Interview Survey, which administered a Balance Supplement in 2008 in a sample of 20,950 adult respondents. We evaluated the cross-sectional association between vestibular vertigo (based on a well-validated definition) and sleep duration (defined as short <6 hours, normal 6-8 hours, and long >8 hours). We performed multiple and multinomial logistic regression analyses to estimate the odds ratio and relative risk ratio (RRR) of impaired sleep duration compared to normal sleep duration associated with vestibular vertigo. Analyses were adjusted for demographic, lifestyle and health behavior characteristics as well as relevant comorbid conditions. Thirty percent of individuals with vestibular vertigo reported abnormal sleep duration (15.5% short duration and 14.8% long duration). In adjusted analyses, individuals with vestibular vertigo had a 1.75 (95% CI 1.45-2.11) RRR of having short sleep duration compared to individuals without vestibular vertigo, and a 1.55 (95% CI 1.26-1.91) RRR of having long sleep duration compared to individuals without vestibular vertigo. This study presents epidemiologic evidence to support the association between vestibular function and sleep duration. Individuals with vestibular vertigo had a higher RRR for abnormally short or long sleep duration. Further work is needed to evaluate the causal direction(s) of this association.

Incidence of hospital-acquired pressure ulcers - a population-based cohort study.

PubMed

Gardiner, Joseph C; Reed, Philip L; Bonner, Joseph D; Haggerty, Diana K; Hale, Daniel G

2016-10-01

Our study sought to estimate the association between race, gender, comorbidity and body mass index (BMI) on the incidence of hospital-acquired pressure ulcer (PU) from a population-based retrospective cohort comprising 242 745 unique patient hospital discharges in two fiscal years from July 2009 to June 2010 from 15 general and tertiary care hospitals. Cases were patients with a single inpatient encounter that led to an incident PU. Controls were patients without a PU at any encounter during the two fiscal years with the earliest admission retained for analysis. Logistic regression models quantified the association of potential risk factors for PU incidence. Spline functions captured the non-linear effects of age and comorbidity. Overall 2·68% of patients experienced an incident PU during their inpatient stay. Unadjusted analyses revealed statistically significant associations by age, gender, race, comorbidity, BMI, admitted for a surgical procedure, source of admission and fiscal year, but differences by gender and race did not persist in adjusted analyses. Interactions between age, comorbidity and BMI contributed significantly to the likelihood of PU incidence. Patients who were older, with multiple comorbidities and admitted for a surgical diagnosis-related groups (DRG) were at greater risk of experiencing a PU during their stay. © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Analysis of threats to research validity introduced by audio recording clinic visits: Selection bias, Hawthorne effect, both, or neither?

PubMed Central

Henry, Stephen G.; Jerant, Anthony; Iosif, Ana-Maria; Feldman, Mitchell D.; Cipri, Camille; Kravitz, Richard L.

2015-01-01

Objective To identify factors associated with participant consent to record visits; to estimate effects of recording on patient-clinician interactions Methods Secondary analysis of data from a randomized trial studying communication about depression; participants were asked for optional consent to audio record study visits. Multiple logistic regression was used to model likelihood of patient and clinician consent. Multivariable regression and propensity score analyses were used to estimate effects of audio recording on 6 dependent variables: discussion of depressive symptoms, preventive health, and depression diagnosis; depression treatment recommendations; visit length; visit difficulty. Results Of 867 visits involving 135 primary care clinicians, 39% were recorded. For clinicians, only working in academic settings (P=0.003) and having worked longer at their current practice (P=0.02) were associated with increased likelihood of consent. For patients, white race (P=0.002) and diabetes (P=0.03) were associated with increased likelihood of consent. Neither multivariable regression nor propensity score analyses revealed any significant effects of recording on the variables examined. Conclusion Few clinician or patient characteristics were significantly associated with consent. Audio recording had no significant effect on any dependent variables. Practice Implications Benefits of recording clinic visits likely outweigh the risks of bias in this setting. PMID:25837372

[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.

Differences in recruitment and early retention among ethnic minority participants in a large pediatric cohort: The TEDDY Study

PubMed Central

Baxter, Judith; Vehik, Kendra; Johnson, Suzanne Bennett; Lernmark, Barbro; Roth, Roswith; Simell, Tuula

2013-01-01

Objective The TEDDY Study is an international, multi-center prospective study designed to identify the environmental triggers of type 1 diabetes (T1D) in genetically at-risk children. This report investigates ethnic minority (EM) differences in patterns of enrollment and retention in the US centers. Methods As of June 2009, 267,739 newborns had been screened at birth for high risk T1D genotypes. Data collected at the time of screening, enrollment and at the baseline visit were used. Descriptive and multiple-logistic regression analyses assessed differences between EM groups regarding exclusion, enrollment and early withdrawal. Results Of the 10,975 eligible subjects, 6,912 (67%) were invited to participate. EM subjects were more likely to be excluded because of an inability to contact. Of those invited 3,265 (47%) enrolled by the age of 4.5 months. Adjusted analyses showed that except for those classified as other EM, the odds of enrolling were similar across groups. EM subjects had elevated early withdrawal rates. Adjusted models demonstrated that this was significantly more likely among Hispanic subjects. Conclusion Understanding patterns associated with EM participation in research extends our ability to make more accurate inferences and permits assessment of strategies that promote inclusion of EM to better address health disparities. PMID:22484339

An exploration of alcohol use severity and route of drug administration among persons that use heroin and cocaine.

PubMed

Scherer, Michael; Harrell, Paul T; Trenz, Rebecca C; Canham, Sarah; Latimer, William W

2016-01-01

Alcohol use is prevalent among populations of persons that use illicit drugs. Problematic alcohol use among persons that use heroin and cocaine has been associated with poor treatment adherence, abstinence maintenance, and mental health concerns. Fully exploring how alcohol use severity interacts with route of administration (ROA) may be of notable importance in development of treatment protocols for persons that use heroin and cocaine. Data from a neurological and sociobehavioral assessment of risk factors among injection and noninjection drug users known as the NEURO-HIV Epidemiologic Study was used in the analyses. Participants (N = 551) included those who reported their level of past-30-day alcohol use and past-6-month heroin and cocaine use. Multiple logistic regression analyses found that both problematic and moderate alcohol users were significantly less likely than abstainers to report injecting heroin and cocaine. Both problematic and moderate alcohol users were significantly more likely than abstainers to snort substances. Alcohol use may play a role in promoting or impeding the use of substances through certain ROAs. Treatment protocols that transition persons that use injection heroin and cocaine to noninjection use of these substances may be used in conjunction with treatments that reduce alcohol consumption as a means to reduce noninjection drug use.

E-cigarette Dual Users, Exclusive Users and Perceptions of Tobacco Products

PubMed Central

Cooper, Maria; Case, Kathleen R.; Loukas, Alexandra; Creamer, MeLisa R.; Perry, Cheryl L.

2016-01-01

Objectives We examined differences in the characteristics of youth non-users, cigarette-only, e-cigarette-only, and dual e-cigarette and cigarette users. Methods Using weighted, representative data, logistic regression analyses were conducted to examine differences in demographic characteristics and tobacco use behaviors across tobacco usage groups. Multiple linear regression analyses were conducted to examine differences in harm perceptions of various tobacco products and perceived peer use of e-cigarettes by tobacco usage group. Results Compared to non-users, dual users were more likely to be white, male, and high school students. Dual users had significantly higher prevalence of current use of all products (except hookah) than e-cigarette-only users, and higher prevalence of current use of snus and hookah than the cigarette-only group. Dual users had significantly lower harm perceptions for all tobacco products except for e-cigarettes and hookah as compared to e-cigarette-only users. Dual users reported higher peer use of cigarettes as compared to both exclusive user groups. Conclusion Findings highlight dual users’ higher prevalence of use of most other tobacco products, their lower harm perceptions of most tobacco products compared to e-cigarette-only users, and their higher perceived peer use of cigarettes compared to exclusive users. PMID:26685819

Racial-ethnic Disparities in Postpartum Hemorrhage in Native Hawaiians, Pacific Islanders, and Asians.

PubMed

Harvey, Scott A; Lim, Eunjung; Gandhi, Krupa R; Miyamura, Jill; Nakagawa, Kazuma

2017-05-01

The objective of this study was to assess racial-ethnic differences in the prevalence of postpartum hemorrhage (PPH) among Native Hawaiians and other Pacific Islanders (NHOPI), Asians, and Whites. We performed a retrospective study on statewide inpatient data for delivery hospitalizations in Hawai'i between January 1995 and December 2013. A total of 243,693 in-hospital delivery discharges (35.0% NHOPI, 44.0% Asian, and 21.0% White) were studied. Among patients with PPH, there were more NHOPI (37.1%) and Asians (47.6%), compared to Whites (15.3%). Multivariable logistic regression was used to assess the impact of maternal race-ethnicity on the prevalence of PPH after adjusting for delivery type, labor induction, prolonged labor, multiple gestation, gestational hypertension, gestational diabetes, preeclampsia, chorioamnionitis, placental abruption, placenta previa, obesity, and period with different diagnostic criteria for preeclampsia. In the multivariable analyses, NHOPI (adjusted odds ratio [aOR], 1.40; 95% confidence interval [CI], 1.32-1.48) and Asians (aOR, 1.45; 95% CI, 1.37-1.53) were more likely to have PPH compared to Whites. In the secondary analyses of 12,142 discharges with PPH, NHOPI and Asians had higher prevalence of uterine atony than Whites (NHOPI: 77.2%, Asians: 73.9% vs Whites: 65.1%, P < .001 for both comparisons).

Socioeconomic determinants of childhood overweight and obesity in China: the long arm of institutional power.

PubMed

Fu, Qiang; George, Linda K

2015-07-01

Previous studies have widely reported that the association between socioeconomic status (SES) and childhood overweight and obesity in China is significant and positive, which lends little support to the fundamental-cause perspective. Using multiple waves (1997, 2000, 2004 and 2006) of the China Health and Nutrition Survey (CHNS) (N = 2,556, 2,063, 1,431 and 1,242, respectively) and continuous BMI cut-points obtained from a polynomial method, (mixed-effect) logistic regression analyses show that parental state-sector employment, an important, yet overlooked, indicator of political power during the market transformation has changed from a risk factor for childhood overweight/obesity in 1997 to a protective factor for childhood overweight/obesity in 2006. Results from quantile regression analyses generate the same conclusions and demonstrate that the protective effect of parental state sector employment at high percentiles of BMI is robust under different estimation strategies. By bridging the fundamental causes perspective and theories of market transformation, this research not only documents the effect of political power on childhood overweight/obesity but also calls for the use of multifaceted, culturally-relevant stratification measures in testing the fundamental cause perspective across time and space. © 2015 Foundation for the Sociology of Health & Illness.

A metabolomic study of low estimated GFR in non-proteinuric type 2 diabetes mellitus.

PubMed

Ng, D P K; Salim, A; Liu, Y; Zou, L; Xu, F G; Huang, S; Leong, H; Ong, C N

2012-02-01

We carried out a urinary metabolomic study to gain insight into low estimated GFR (eGFR) in patients with non-proteinuric type 2 diabetes. Patients were identified as being non-proteinuric using multiple urinalyses. Cases (n = 44) with low eGFR and controls (n = 46) had eGFR values <60 and ≥60 ml min(-1) 1.73 m(-2), respectively, as calculated using the Modification of Diet in Renal Disease formula. Urine samples were analysed by liquid chromatography/mass spectrometry (LC/MS) and GC/MS. False discovery rates were used to adjust for multiple hypotheses testing, and selection of metabolites that best predicted low eGFR status was achieved using least absolute shrinkage and selection operator logistic regression. Eleven GC/MS metabolites were strongly associated with low eGFR after correction for multiple hypotheses testing (smallest adjusted p value = 2.62 × 10(-14), largest adjusted p value = 3.84 × 10(-2)). In regression analysis, octanol, oxalic acid, phosphoric acid, benzamide, creatinine, 3,5-dimethoxymandelic amide and N-acetylglutamine were selected as the best subset for prediction and allowed excellent classification of low eGFR (AUC = 0.996). In LC/MS, 19 metabolites remained significant after multiple hypotheses testing had been taken into account (smallest adjusted p value = 2.04 × 10(-4), largest adjusted p value = 4.48 × 10(-2)), and several metabolites showed stronger evidence of association relative to the uraemic toxin, indoxyl sulphate (adjusted p value = 3.03 × 10(-2)). The potential effect of confounding on the association between metabolites was excluded. Our study has yielded substantial new insight into low eGFR and provided a collection of potential urinary biomarkers for its detection.

Neuropsychological tests for predicting cognitive decline in older adults

PubMed Central

Baerresen, Kimberly M; Miller, Karen J; Hanson, Eric R; Miller, Justin S; Dye, Richelin V; Hartman, Richard E; Vermeersch, David; Small, Gary W

2015-01-01

Summary Aim To determine neuropsychological tests likely to predict cognitive decline. Methods A sample of nonconverters (n = 106) was compared with those who declined in cognitive status (n = 24). Significant univariate logistic regression prediction models were used to create multivariate logistic regression models to predict decline based on initial neuropsychological testing. Results Rey–Osterrieth Complex Figure Test (RCFT) Retention predicted conversion to mild cognitive impairment (MCI) while baseline Buschke Delay predicted conversion to Alzheimer’s disease (AD). Due to group sample size differences, additional analyses were conducted using a subsample of demographically matched nonconverters. Analyses indicated RCFT Retention predicted conversion to MCI and AD, and Buschke Delay predicted conversion to AD. Conclusion Results suggest RCFT Retention and Buschke Delay may be useful in predicting cognitive decline. PMID:26107318

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

Media Use and Health Outcomes in Adolescents: Findings from a Nationally Representative Survey

PubMed Central

Casiano, Hygiea; Kinley, D. Jolene; Katz, Laurence Y.; Chartier, Mariette J.; Sareen, Jitender

2012-01-01

Objective: Examine the association between quantity of media use and health outcomes in adolescents. Method: Multiple logistic regression analyses were conducted with the Canadian Community Health Survey 1.1 (youth aged 12–19 (n=9137)) to determine the association between hours of use of television/videos, video games, and computers/Internet, and health outcomes including depression, alcohol dependence, binge drinking, suicidal ideation, help-seeking behaviour, risky sexual activity, and obesity. Results: Obesity was associated with frequent television/video use (Adjusted Odds Ratio (AOR) 1.10). Depression and risky sexual behaviour were less likely in frequent video game users (AOR 0.87 and 0.73). Binge drinking was less likely in frequent users of video games (AOR 0.92) and computers/Internet (AOR 0.90). Alcohol dependence was less likely in frequent computer/Internet users (AOR 0.89). Conclusions: Most health outcomes, except for obesity, were not associated with using media in youth. Further research into the appropriate role of media will help harness its full potential. PMID:23133464

Is social support universally adaptive in diabetes? A correlational study in an Arabic-speaking population with type 2 diabetes.

PubMed

Sukkarieh-Haraty, Ola; Howard, Elizabeth

2015-01-01

The purpose of this study was to assess the relationship between diabetes self-care, diabetes-specific emotional distress, and social support and glycemic control (hemoglobin A1C levels: HbA1c) among a sample of Lebanese adults with type 2 diabetes. A descriptive correlational design was adapted with descriptive statistics and multiple logistic regressions for analyses. A convenience sample of 140 adults diagnosed with type 2 diabetes was recruited from 2 diabetes clinics in Greater Beirut. Participants were asked to complete 4 questionnaires in Arabic. Significant associations (P < .05) were found between following a general diet for more than 3.5 days per week and higher social support and HbA1c levels of 7% or more. Social support was positively associated with HbA1c levels such that participants with uncontrolled glycemic levels, as evidenced by higher values for HbA1c, received more support from their social network.

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

PubMed

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

2018-05-01

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

Association of BPD and IVH with early neutrophil and white counts in VLBW neonates with gestational age <32 weeks

PubMed Central

Palta, Mari; Sadek-Badawi, Mona; Carlton, David P

2008-01-01

Objectives To investigate associations between early low neutrophil count from routine blood samples, white blood count (WBC), pregnancy complications and neonatal outcomes for very low birth weight infants (VLBW ≤1500g) with gestational age <32 weeks. Patients and Methods Information was abstracted on all infants admitted to level III NICUs in Wisconsin 2003-2004. 1002 (78%) had differential and corrected total white counts within 2 ½ hours of birth. Data analyses included frequency tables, binary logistic, ordinal logistc and ordinary regression. Results Low neutrophil count (<1000/μL) was strongly associated with low WBC, pregnancy complications and antenatal steroids. Low neutrophil count predicted bronchopulmonary dysplasia severity level (BPD) (OR: 1.7, 95% CI: 1.1-2.7) and intraventricular hemorrhage (IVH) grade (OR: 2.2, 95% CI: 1.3-3.8). Conclusions Early neutrophil counts may have multiple causes interfering with their routine use as an inflammatory marker. Nonetheless, low neutrophil count has consistent independent associations with outcomes. PMID:18563166

An economic production model for deteriorating items and time dependent demand with rework and multiple production setups

NASA Astrophysics Data System (ADS)

Uthayakumar, R.; Tharani, S.

2017-12-01

Recently, much emphasis has given to study the control and maintenance of production inventories of the deteriorating items. Rework is one of the main issues in reverse logistic and green supply chain, since it can reduce production cost and the environmental problem. Many researchers have focused on developing rework model, but few of them have developed model for deteriorating items. Due to this fact, we take up productivity and rework with deterioration as the major concern in this paper. In this paper, a production-inventory model with deteriorative items in which one cycle has n production setups and one rework setup (n, 1) policy is considered for deteriorating items with stock-dependent demand in case 1 and exponential demand in case 2. An effective iterative solution procedure is developed to achieve optimal time, so that the total cost of the system is minimized. Numerical and sensitivity analyses are discussed to examine the outcome of the proposed solution procedure presented in this research.

A cohort study found that white blood cell count and endocrine markers predicted preterm birth in symptomatic women.

PubMed

Campbell, M Karen; Challis, John R G; DaSilva, Orlando; Bocking, Alan D

2005-03-01

This cohort study investigated potential clinical and biochemical predictors of subsequent preterm birth in women presenting with threatened preterm labor. Subjects were 218 pregnant women admitted to hospital with a diagnosis of threatened preterm labor at 22-36 weeks gestation. Exclusion criteria were multiple pregnancy, fetal anomalies, diabetes mellitus, abruptio placenta, preeclampsia, intrauterine growth restriction, cervical dilatation > 4 cm, and clinical signs of infection. Analyses used logistic regression. The presence of ruptured membranes was the best predictor of birth within 48 hours. Other important predictors were maternal white blood cell count at 22-27 weeks gestation and maternal adrenocorticotropin and corticotropin-releasing hormone concentrations at 28-36 weeks gestation. Subclinical infection may be an important etiologic factor in preterm births of gestational age < 28 weeks. For those at > or = 28 weeks gestation, the findings support the etiologic role of activation of the fetal and/or maternal hypothalamic pituitary adrenal axis leading to preterm birth.

Decision Tree based Prediction and Rule Induction for Groundwater Trichloroethene (TCE) Pollution Vulnerability

NASA Astrophysics Data System (ADS)

Park, J.; Yoo, K.

2013-12-01

For groundwater resource conservation, it is important to accurately assess groundwater pollution sensitivity or vulnerability. In this work, we attempted to use data mining approach to assess groundwater pollution vulnerability in a TCE (trichloroethylene) contaminated Korean industrial site. The conventional DRASTIC method failed to describe TCE sensitivity data with a poor correlation with hydrogeological properties. Among the different data mining methods such as Artificial Neural Network (ANN), Multiple Logistic Regression (MLR), Case Base Reasoning (CBR), and Decision Tree (DT), the accuracy and consistency of Decision Tree (DT) was the best. According to the following tree analyses with the optimal DT model, the failure of the conventional DRASTIC method in fitting with TCE sensitivity data may be due to the use of inaccurate weight values of hydrogeological parameters for the study site. These findings provide a proof of concept that DT based data mining approach can be used in predicting and rule induction of groundwater TCE sensitivity without pre-existing information on weights of hydrogeological properties.

Long-term consequences of adolescent gang membership for adult functioning.

PubMed

Gilman, Amanda B; Hill, Karl G; Hawkins, J David

2014-05-01

We examined the possible public health consequences of adolescent gang membership for adult functioning. Data were drawn from the Seattle Social Development Project, a longitudinal study focusing on the development of positive and problem outcomes. Using propensity score matching and logistic regression analyses, we assessed the effects of adolescent gang membership on illegal behavior, educational and occupational attainment, and physical and mental health at the ages of 27, 30, and 33 years. In comparison with their nongang peers, who had been matched on 23 confounding risk variables known to be related to selection into gang membership, those who had joined a gang in adolescence had poorer outcomes in multiple areas of adult functioning, including higher rates of self-reported crime, receipt of illegal income, incarceration, drug abuse or dependence, poor general health, and welfare receipt and lower rates of high school graduation. The finding that adolescent gang membership has significant consequences in adulthood beyond criminal behavior indicates the public health importance of the development of effective gang prevention programs.

Bayesian multivariate hierarchical transformation models for ROC analysis.

PubMed

O'Malley, A James; Zou, Kelly H

2006-02-15

A Bayesian multivariate hierarchical transformation model (BMHTM) is developed for receiver operating characteristic (ROC) curve analysis based on clustered continuous diagnostic outcome data with covariates. Two special features of this model are that it incorporates non-linear monotone transformations of the outcomes and that multiple correlated outcomes may be analysed. The mean, variance, and transformation components are all modelled parametrically, enabling a wide range of inferences. The general framework is illustrated by focusing on two problems: (1) analysis of the diagnostic accuracy of a covariate-dependent univariate test outcome requiring a Box-Cox transformation within each cluster to map the test outcomes to a common family of distributions; (2) development of an optimal composite diagnostic test using multivariate clustered outcome data. In the second problem, the composite test is estimated using discriminant function analysis and compared to the test derived from logistic regression analysis where the gold standard is a binary outcome. The proposed methodology is illustrated on prostate cancer biopsy data from a multi-centre clinical trial.

Bayesian multivariate hierarchical transformation models for ROC analysis

PubMed Central

O'Malley, A. James; Zou, Kelly H.

2006-01-01

SUMMARY A Bayesian multivariate hierarchical transformation model (BMHTM) is developed for receiver operating characteristic (ROC) curve analysis based on clustered continuous diagnostic outcome data with covariates. Two special features of this model are that it incorporates non-linear monotone transformations of the outcomes and that multiple correlated outcomes may be analysed. The mean, variance, and transformation components are all modelled parametrically, enabling a wide range of inferences. The general framework is illustrated by focusing on two problems: (1) analysis of the diagnostic accuracy of a covariate-dependent univariate test outcome requiring a Box–Cox transformation within each cluster to map the test outcomes to a common family of distributions; (2) development of an optimal composite diagnostic test using multivariate clustered outcome data. In the second problem, the composite test is estimated using discriminant function analysis and compared to the test derived from logistic regression analysis where the gold standard is a binary outcome. The proposed methodology is illustrated on prostate cancer biopsy data from a multi-centre clinical trial. PMID:16217836

Smoking, Physical Activity, and Eating Habits Among Adolescents.

PubMed

Lee, Bokim; Yi, Yunjeong

2016-01-01

The purpose of this study was to compare physical activity and eating habits of adolescent smokers with those of adolescent non-smokers in South Korea. This was a secondary analysis of data collected from the 2012 Korean Youth Risk Behavior Web-Based Survey. The sample included 72,229 adolescents aged 12 to 18. A multiple logistic regression analysis was performed to examine the association between smoking status and physical activity and between smoking status and eating habits, while controlling for other factors. Boys and girls were analyzed separately for all analyses. The proportion of self-reporting smokers was 11%. Surprisingly, girl smokers exercised significantly more frequently than non-smokers. Adolescent smokers were significantly less likely to consume fruits, vegetables, and milk/dairy products, and they ate significantly more fast-food than non-smokers. Health care professionals who plan smoking cessation programs should pay attention to South Korean adolescents' specific characteristics and cultural values in terms of health behavior. © The Author(s) 2014.

Acculturation factors and metabolic syndrome among Japanese-Brazilian men in Japan: a cross-sectional descriptive study.

PubMed

Tashiro, Marie; Yasuoka, Junko; Poudel, Krishna C; Noto, Hiroshi; Masuo, Miho; Jimba, Masamine

2014-02-01

This study examines the acculturation effects on metabolic syndrome (MetS), and its related factors, among immigrant Japanese-Brazilian men in Japan. Quantitative and qualitative approaches were utilized. In the quantitative study (n = 149), multiple logistic regression analyses estimated the impact of length of residence and arrival age on MetS. For the qualitative study, five focus group discussions were conducted with participants (n = 26) from the quantitative study sample. The oldest arrival age group was more likely to have MetS (OR, 95% CI 4.41, 1.09-17.78) after adjusting for covariates; whereas, length of residence had no association with MetS. The oldest arrival age group, with shorter residence period, was also associated with increased MetS prevalence. Qualitative results identified participants' Brazilian dietary habits as being potential risk factors for MetS. Japanese-Brazilian immigrant men with older arrival age in Japan were more likely to suffer from MetS, especially shortly after arrival.

Gendered Cultural Identities: The Influences of Family and Privacy Boundaries, Subjective Norms, and Stigma Beliefs on Family Health History Communication.

PubMed

Hong, Soo Jung

2018-08-01

This study investigates the effects of cultural norms on family health history (FHH) communication in the American, Chinese, and Korean cultures. More particularly, this study focuses on perceived family boundaries, subjective norms, stigma beliefs, and privacy boundaries, including age and gender, that affect people's FHH communication. For data analyses, hierarchical multiple regression and logistic regression methods were employed. The results indicate that participants' subjective norms, stigma beliefs, and perceived family/privacy boundaries were positively associated with current FHH communication. Age- and gender-related privacy boundaries were negatively related to perceived privacy boundaries, however. Finally, the results show that gendered cultural identities have three-way interaction effects on two associations: (1) between perceived family boundaries and perceived privacy boundaries and (2) between perceived privacy boundaries and current FHH communication. The findings have meaningful implications for future cross-cultural studies on the roles of family systems, subjective norms, and stigma beliefs in FHH communication.

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.

Association of Lifestyle-Related Comorbidities With Periodontitis

PubMed Central

Lee, Jae-Hong; Lee, Jung-Seok; Park, Jin-Young; Choi, Jung-Kyu; Kim, Dong-Wook; Kim, Young-Taek; Choi, Seong-Ho

2015-01-01

Abstract The aim of this study was to determine the association of periodontitis with lifestyle-related comorbidities (LCs) using data in the Korean National Health Insurance Cohort Database from 2002 to 2013. This was a retrospective study involving a large national cohort with patient samples (representing 2% of the total Korean population) stratified on the basis of sociodemographic information. Using this precisely extracted database, the correlations between LCs (cerebral infarction, angina pectoris, myocardial infarction, hypertension, diabetes mellitus, rheumatoid arthritis, erectile dysfunction, osteoporosis, and obesity) and periodontitis were investigated while adjusting for confounding bias. Univariate and multiple logistic regression analyses were used to evaluate differences in variable factors. Among a total of 1,025,340 samples, 321,103 (31.3%) cases were diagnosed with periodontitis. Statistically significant associations were found between all LCs except myocardial infarction and periodontitis (P < 0.005). Periodontitis is significantly and positively correlated with LCs (except for myocardial infarction) after adjusting for confounding bias. In particular, lifestyle-related diseases, erectile dysfunction, and osteoporosis seem to be intimately related to periodontitis. PMID:26376407

Psycho-Socioeconomic Factors Affecting Complementary and Alternative Medicine Use among Selected Rural Communities in Malaysia: A Cross-Sectional Study

PubMed Central

Ganasegeran, Kurubaran; Rajendran, Anantha Kumar; Al-Dubai, Sami Abdo Radman

2014-01-01

Introduction The use of complementary and alternative medicine (CAM) as a source of cure has gained much spectrum worldwide, despite skeptics and advocates of evidence-based practice conceptualized such therapies as human nostrum. Objective This study aimed to explore the factors affecting CAM use among rural communities in Malaysia. Methods A cross-sectional study was carried out on 288 occupants across four rural villages within the District of Selama, Perak, Malaysia. A survey that consisted of socio-economic characteristics, history of CAM use and the validated Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) were used. Results The prevalence of self-reported CAM use over the past one year was 53.1%. Multiple logistic regression analyses yielded three significant predictors of CAM use: monthly household income of less than MYR 2500, higher education level, and positive attitude towards CAM. Conclusion Psycho-socioeconomic factors were significantly associated with CAM use among rural communities in Malaysia. PMID:25375256

Association between alcohol abuse during pregnancy and birth weight.

PubMed

Silva, Ivelissa da; Quevedo, Luciana de Avila; Silva, Ricardo Azevedo da; Oliveira, Sandro Schreiber de; Pinheiro, Ricardo Tavares

2011-10-01

To assess the association between alcohol abuse during gestation and low birth weight. Cross-sectional, population-based nested study from a cohort of 957 pregnant women who received prenatal assistance through Sistema Único de Saúde (National Health System) in the city of Pelotas, Southern Brazil, and delivered their babies between September 2007 and September 2008. The mothers were interviewed at two distinct moments: prenatal and postpartum periods. In order to verify alcohol abuse, the CAGE (Cut down, Annoyed by criticism, Guilty and Eye-opener) scale was used. Bivariate analyses were carried out, as well as multiple logistic regression adjusted by the variables prematurity and alcohol abuse. The level of significance that was adopted was 95%. Of the women who participated in the study, 2.1% abused alcohol during pregnancy and, among these, 26.3% had low birth weight children. There was an association between alcohol abuse and low birth weight (p<0.038). The findings indicate that alcohol abuse during pregnancy is associated with low birth weight.

Illness representation on H1N1 influenza and preventive behaviors in the Hong Kong general population.

PubMed

Mo, Phoenix K H; Lau, Joseph T F

2015-12-01

This study examined illness representations of new influenza Human Swine Influenza A (H1N1) and association with H1N1 preventive behaviors among 300 Chinese adults using a population-based randomized telephone survey. Results showed that relatively few participants thought H1N1 would have serious consequences (12%-15.7%) and few showed negative emotional responses toward H1N1 (9%-24.7%). The majority of the participants thought H1N1 could be controlled by treatment (70.4%-72.7%). Multiple logistic regression analyses showed that treatment control (odds ratio = 1.78) and psychological attribution (odds ratio = .75) were associated with intention to take up influenza vaccination. Emotional representations were associated with lower likelihood of wearing face mask (odds ratio = .77) and hand washing (odds ratio = .67). Results confirm that illness representation variables are associated with H1N1 preventive behaviors. © The Author(s) 2014.

Do lunar cycles influence in vitro fertilization results?

PubMed

Weigert, Monika; Kaali, Steven G; Kulin, Sandor; Feichtinger, Wilfried

2002-11-01

Our objective was to investigate the lunar influence on IVF-ET outcomes. Between 1992 and 1999 we have completed 7572 preprogrammed IVF-ET treatment cycles with the same stimulation protocol in two outpatient units. (Vienna, Austria and Budapest, Hungary) Multiple regression (SAS; proc Logistic) and two separate analyses were performed on pregnancy rates using a harmonic sinoidal trend based on the synodic and anomalistic lunar cycles respectively. The overall pregnancy rate was 30.9%. The amplitude of harmonic sinoidal, trend for the synodic lunar cycles was chi2 = 1.63,2d.f., p = 0.44 and chi2 = 6.27,2d.f., p = 0.044 for the anomalistic moon periods. For the anomalistic lunar months the amplitude of harmonic sinoidal trend was borderline in terms of higher pregnancy rates with the moon in Perigee. The cause of seasonal changes in IVF-ET outcomes is probably very complex. Our results indicate that lunar influence may only be one of the contributing factors. Further studies are needed to clarify unexplained fluctuations of pregnancy outcomes.

Interpreting Epidemiological Evidence in the Presence of Multiple Endpoints: An Alternative Analytic Approach using the 9-Year Follow-up of the Seychelles Child Development Study

PubMed Central

van Wijngaarden, Edwin; Myers, Gary J.; Thurston, Sally W.; Shamlaye, Conrad F.; Davidson, Philip W.

2012-01-01

Purpose The potential for ill-informed causal inference is a major concern in published longitudinal studies evaluating impaired neurological function in children prenatally exposed to background levels of methyl mercury (MeHg). These studies evaluate a large number of developmental tests. We propose an alternative analysis strategy that reduces the number of comparisons tested in these studies. Methods Using data from the 9-year follow-up of 643 children in the Seychelles Child Development Study (SCDS), we grouped 18 individual endpoints into one overall ordinal outcome variable as well as by developmental domains. Subsequently, ordinal logistic regression analyses were performed. Results We did not find an association between prenatal MeHg exposure and developmental outcomes at 9 years of age. Conclusion Our proposed framework is more likely to result in a balanced interpretation of a posteriori associations. In addition, this new strategy should facilitate the use of complex epidemiological data in quantitative risk assessment. PMID:19205720

Interpreting epidemiological evidence in the presence of multiple endpoints: an alternative analytic approach using the 9-year follow-up of the Seychelles child development study.

PubMed

van Wijngaarden, Edwin; Myers, Gary J; Thurston, Sally W; Shamlaye, Conrad F; Davidson, Philip W

2009-08-01

The potential for ill-informed causal inference is a major concern in published longitudinal studies evaluating impaired neurological function in children prenatally exposed to background levels of methyl mercury (MeHg). These studies evaluate a large number of developmental tests. We propose an alternative analysis strategy that reduces the number of comparisons tested in these studies. Using data from the 9-year follow-up of 643 children in the Seychelles child development study, we grouped 18 individual endpoints into one overall ordinal outcome variable as well as by developmental domains. Subsequently, ordinal logistic regression analyses were performed. We did not find an association between prenatal MeHg exposure and developmental outcomes at 9 years of age. Our proposed framework is more likely to result in a balanced interpretation of a posteriori associations. In addition, this new strategy should facilitate the use of complex epidemiological data in quantitative risk assessment.

Use of conservative and surgical foot care in an inception cohort of patients with rheumatoid arthritis.

PubMed

Backhouse, Michael R; Keenan, Anne-Maree; Hensor, Elizabeth M A; Young, Adam; James, David; Dixey, Josh; Williams, Peter; Prouse, Peter; Gough, Andrew; Helliwell, Philip S; Redmond, Anthony C

2011-09-01

To describe conservative and surgical foot care in patients with RA in England and explore factors that predict the type of foot care received. Use of podiatry and type of foot surgery were outcomes recorded in an inception cohort involving nine rheumatology centres that recruited patients with RA between 1986 and 1998 across England. Associations between patient-specific factors and service use were identified using univariate logistic regression analyses. The independence of these associations was then verified through multiple binary logistic regression modelling. Data were collected on 1237 patients with RA [66.9% females, mean (s.d.) age at disease onset = 54.36 (14.18) years, median DAS = 4.09 (1st quartile = 3.04, 3rd quartile = 5.26), median HAQ = 1 (0.50, 1.63)]. Interventions involving the feet in the cohort were low with only 364 (30%) out of 1218 receiving podiatry and 47 (4%) out of 1237 patients having surgery. At baseline, female gender, increasing age at onset, being RF positive and higher DAS scores were each independently associated with increased odds of seeing a podiatrist. Gender, age of onset and baseline DAS were independently associated with the odds of having foot surgery. Despite the known high prevalence of foot pathologies in RA, only one-third of this cohort accessed podiatry. While older females were more likely to access podiatry care and younger patients surgery, the majority of the RA population did not access any foot care.

Factors associated with HIV/AIDS treatment dropouts in a special care unit in the City of Rio de Janeiro, RJ, Brazil.

PubMed

Schilkowsky, Louise Bastos; Portela, Margareth Crisóstomo; Sá, Marilene de Castilho

2011-06-01

This study aimed to identify factors associated with the health care of patients with HIV/AIDS who drop out. The study was developed in a specialized health care unit of a University hospital in Rio de Janeiro, Brazil, considering a stratified sample of adult patients including all dropout cases (155) and 44.0% of 790 cases under regular follow-up. Bivariate analyses were used to identify associations between health care dropout and demographic, socioeconomic and clinical variables. Logistic and Cox regression models were used to identify the independent effects of the explanatory variables on risk for dropout, in the latter by incorporating information on the outcome over time. Patients were, on average, 35 years old, predominantly males (66.4%) and of a low socioeconomic level (45.0%). In both models, health care dropout was consistently associated with being unemployed or having an unstable job, using illicit drugs and having psychiatric background--positive association; and with age, having AIDS, and having used multiple antiretroviral regimens--negative association. In the logistic regression, dropping out was also positively associated with time between diagnosis and the first outpatient visit, while in the Cox model, the hazard for dropping out was positively associated with being single, and negatively associated with a higher educational level. The results of this work allow for the identification of HIV/AIDS patients more likely to drop out from health care.

Relationships between temperaments, occupational stress, and insomnia among Japanese workers.

PubMed

Deguchi, Yasuhiko; Iwasaki, Shinichi; Ishimoto, Hideyuki; Ogawa, Koichiro; Fukuda, Yuichi; Nitta, Tomoko; Mitake, Tomoe; Nogi, Yukako; Inoue, Koki

2017-01-01

Insomnia among workers reduces the quality of life, contributes toward the economic burden of healthcare costs and losses in work performance. The relationship between occupational stress and insomnia has been reported in previous studies, but there has been little attention to temperament in occupational safety and health research. The aim of this study was to clarify the relationships between temperament, occupational stress, and insomnia. The subjects were 133 Japanese daytime local government employees. Temperament was assessed using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A). Occupational stress was assessed using the Generic Job Stress Questionnaire (GJSQ). Insomnia was assessed using the Athens Insomnia Scale (AIS). Stepwise multiple logistic regression analyses were conducted. In a stepwise multivariate logistic regression analysis, it was found that the higher subdivided stress group by "role conflict" (OR = 5.29, 95% CI, 1.61-17.32) and anxious temperament score (OR = 1.33; 95% CI, 1.19-1.49) was associated with the presence of insomnia using an adjusted model, whereas other factors were excluded from the model. The study limitations were the sample size and the fact that only Japanese local government employees were surveyed. This study demonstrated the relationships between workers' anxious temperament, role conflict, and insomnia. Recognizing one's own anxious temperament would lead to self-insight, and the recognition of anxious temperament and reduction of role conflict by their supervisors or coworkers would reduce the prevalence of insomnia among workers in the workplace.

Academic and Demographic Predictors of NCLEX-RN Pass Rates in First- and Second-Degree Accelerated BSN Programs.

PubMed

Kaddoura, Mahmoud A; Flint, Elizabeth P; Van Dyke, Olga; Yang, Qing; Chiang, Li-Chi

Relatively few studies have addressed predictors of first-attempt outcomes (pass-fail) on the National Council Licensure Examination-Registered Nurses (NCLEX-RN) for accelerated BSN programs. The purpose of this study was to compare potential predictors of NCLEX outcomes in graduates of first-degree accelerated (FDA; n=62) and second-degree accelerated (SDA; n=173) BSN programs sharing a common nursing curriculum. In this retrospective study, bivariate analyses and multiple logistic regression assessed significance of selected demographic and academic characteristics as predictors of NCLEX-RN outcomes. FDA graduates were more likely than SDA graduates to fail the NCLEX-RN (P=.0013). FDA graduates were more likely to speak English as a second or additional language (P<.0001), have lower end-of-program GPA and HESI Exit Exam scores (both P<.0001), and have a higher proportions of grades ≤ C (P=.0023). All four variables were significant predictors of NCLEX-RN outcomes within both FDA and SDA programs. The only significant predictors in adjusted logistic regression of NCLEX-RN outcome for the pooled FDA+SDA graduate sample were proportion of grades ≤ C (a predictor of NCLEX-RN failure) and HESI Exit Exam score (a predictor of passing NCLEX-RN). Grades of C or lower on any course may indicate inadequate mastery of critical NCLEX-RN content and increased risk of NCLEX-RN failure. Copyright © 2016 Elsevier Inc. All rights reserved.

HFE C282Y mutations are associated with advanced hepatic fibrosis in Caucasians with nonalcoholic steatohepatitis.

PubMed

Nelson, James E; Bhattacharya, Renuka; Lindor, Keith D; Chalasani, Naga; Raaka, Stuart; Heathcote, E Jenny; Miskovsky, Emil; Shaffer, Eldon; Rulyak, Stephen J; Kowdley, Kris V

2007-09-01

Previous studies examining the relationship between HFE mutations and severity of nonalcoholic steatohepatitis (NASH) have been limited by small sample size or ascertainment bias. The aim of this study was to examine the relationship between HFE mutations and histological severity in a large North American multicenter cohort with NASH. Data from 126 NASH patients were collected from 6 North American centers. Liver biopsy and genotyping for the C282Y and H63D HFE mutations were performed in all subjects. Serum transferrin-iron saturation and ferritin levels as well as hepatic iron content were recorded whenever available. Univariate and multivariate logistic regression analyses were performed to identify factors associated with advanced hepatic fibrosis. The prevalence of heterozygous C282Y and H63D HFE mutations was 14.3% and 21.4%, respectively, in the overall cohort. Among Caucasians, C282Y heterozygotes were more likely to have bridging fibrosis or cirrhosis (44% versus 21% [P = 0.05]) and stainable hepatic iron (50% versus 16% [P = 0.011]) compared with patients with other genotypes. Diabetes mellitus was the only independent predictor of advanced hepatic fibrosis (OR 4.37, 95% CI 1.41-13.54 [P = 0.010]) using multiple logistic regression analysis adjusting for age, sex, ethnicity, body mass index, and HFE genotype status. The HFE C282Y heterozygous mutation is associated with advanced fibrosis among Caucasians with NASH. Additional studies are warranted to examine the possible mechanisms for this relationship.

Landscape Analysis of Global Health Tracks in United States Pediatric Residencies: Moving Toward Standards.

PubMed

Watts, Jennifer; Russ, Christiana; St Clair, Nicole E; Uwemedimo, Omolara Thomas

2018-03-28

The number of pediatric Global Health (GH) tracks has more than doubled in less than 10 years. The goal of this study was to describe the characteristics of the pediatric GH tracks to identify commonalities and differences in track structure, funding, and education. In addition, we also identified demographic, institutional, and residency-related factors that were significantly associated with educational offerings and logistical challenges. A cross-sectional survey was electronically administered to pediatric residency programs with GH tracks. Statistical analyses included frequencies to describe GH track characteristics. Fisher's exact tests were used to identify bivariate associations between track structure and funding with educational offerings and logistical challenges. Leaders of 32 pediatric GH tracks (67%) completed the survey. The majority of GH tracks were completed within the 3 years of residency (94%) and identified a GH track director (100%); however, tracks varied in size, enrollment methods, domestic and international partnerships, funding, and evaluations. Dedicated faculty time and GH track budget amounts were associated with more robust infrastructure pertaining to resident international electives, including funding and mentorship. Many tracks did not meet American Academy of Pediatrics recommended standards for clinical international rotations. Despite the presence of multiple similarities among pediatric GH tracks, there are large variations in track structure, education, and funding. The results from this study support the proposal of a formal definition and minimum standards for a GH track, which may provide a framework for quality, consistency, and comparison of GH tracks. Copyright © 2018. Published by Elsevier Inc.

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.

Traditional beliefs about the cause of AIDS and AIDS-related stigma in South Africa.

PubMed

Kalichman, S C; Simbayi, L

2004-07-01

AIDS-related stigmas are pervasive in some segments of South African society and stigmas can impede efforts to promote voluntary counselling and testing and other HIV-AIDS prevention efforts. The current study examined associations among the belief that AIDS is caused by spirits and supernatural forces, AIDS-related knowledge and AIDS-related stigmas. A street intercept survey with 487 men and women living in a Black township in Cape Town, South Africa showed that 11% (n=54) believed that AIDS is caused by spirits and supernatural forces, 21% (n=105) were unsure if AIDS is caused by spirits and the supernatural, and 68% (n=355) did not believe that AIDS is caused by spirits and supernatural forces. Multiple logistic regression analyses controlling for participant age, gender, years of education and survey venue showed that people who believed HIV-AIDS is caused by spirits and the supernatural demonstrated significantly more misinformation about AIDS and were significantly more likely to endorse repulsion and social sanction stigmatizing beliefs against people living with HIV-AIDS. However, nearly all associations between beliefs that AIDS is caused by spirits and AIDS stigmas were non-significant when logistic regressions were repeated with AIDS-related knowledge included as a control variable. This finding suggests that relationships between traditional beliefs about the cause of HIV-AIDS and AIDS stigmas are mediated by AIDS-related knowledge. AIDS education efforts are urgently needed to reach people who hold traditional beliefs about AIDS to remedy AIDS stigmas.

The relationship of gender and trauma characteristics to posttraumatic stress disorder in a community sample of traumatized northern plains American Indian adolescents and young adults.

PubMed

Gnanadesikan, Mukund; Novins, Douglas K; Beals, Janette

2005-09-01

Previous studies have identified a high prevalence (25%-80%) of trauma among American Indian and non-American Indian adolescents and adults. However, only a fraction of traumatized individuals develop posttraumatic stress disorder (PTSD). This article examines the relationships of gender and trauma characteristics to a diagnosis of PTSD among a community sample of traumatized American Indian adolescents and young adults. Complete data were collected from 349 American Indians aged 15 to 24 years who participated in a cross-sectional community-based study from July 1997 to December 1999 and reported experiencing at least 1 traumatic event. Traumatic events and PTSD were assessed using a version of the Composite International Diagnostic Interview. Logistic regression determined the relationships of gender, trauma type, age at first trauma, and number of traumas to the development of PTSD. Forty-two participants (12.0% of those who experienced a traumatic event) met criteria for lifetime PTSD. While all 4 of the independent variables noted above demonstrated univariate associations with PTSD, multivariate logistic regression analyses indicated that only experiencing a sexual trauma (odds ratio [OR] = 4.45, 95% confidence interval [CI] = 1.76 to 11.28) and having experienced 6 or more traumas (OR = 2.53, 95% CI = 1.06 to 6.04) were independent predictors of meeting criteria for PTSD. American Indian children and adolescents who experience sexual trauma and multiple traumatic experiences may be at particularly high risk for developing PTSD.

Relationships between temperaments, occupational stress, and insomnia among Japanese workers

PubMed Central

Ishimoto, Hideyuki; Ogawa, Koichiro; Fukuda, Yuichi; Nitta, Tomoko; Mitake, Tomoe; Nogi, Yukako; Inoue, Koki

2017-01-01

Insomnia among workers reduces the quality of life, contributes toward the economic burden of healthcare costs and losses in work performance. The relationship between occupational stress and insomnia has been reported in previous studies, but there has been little attention to temperament in occupational safety and health research. The aim of this study was to clarify the relationships between temperament, occupational stress, and insomnia. The subjects were 133 Japanese daytime local government employees. Temperament was assessed using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A). Occupational stress was assessed using the Generic Job Stress Questionnaire (GJSQ). Insomnia was assessed using the Athens Insomnia Scale (AIS). Stepwise multiple logistic regression analyses were conducted. In a stepwise multivariate logistic regression analysis, it was found that the higher subdivided stress group by “role conflict” (OR = 5.29, 95% CI, 1.61–17.32) and anxious temperament score (OR = 1.33; 95% CI, 1.19–1.49) was associated with the presence of insomnia using an adjusted model, whereas other factors were excluded from the model. The study limitations were the sample size and the fact that only Japanese local government employees were surveyed. This study demonstrated the relationships between workers’ anxious temperament, role conflict, and insomnia. Recognizing one’s own anxious temperament would lead to self-insight, and the recognition of anxious temperament and reduction of role conflict by their supervisors or coworkers would reduce the prevalence of insomnia among workers in the workplace. PMID:28407025

Perception of Risk for Developing Diabetes Among Foreign-Born Spanish-Speaking US Latinos.

PubMed

Joiner, Kevin L; Sternberg, Rosa Maria; Kennedy, Christine M; Fukuoka, Yoshimi; Chen, Jyu-Lin; Janson, Susan L

2016-08-01

The purpose of the study was to describe perception of risk for developing diabetes among foreign-born Spanish-speaking US Latinos. Participants (N = 146), recruited at food-pantry distribution events and free clinics, were surveyed using the Risk Perception Survey for Developing Diabetes in Spanish. Type 2 diabetes risk factors measured included body mass index, physical activity, and A1C. Sample characteristics were mean (SD) age of 39.5 (9.9) years, 58% with less than a high school graduate-level education, and 65% with a family income less than $15,000/year. Prevalence of risk factors was 81% overweight or obese, 47% less than 150 minutes/week moderate/vigorous-intensity physical activity, and 12% A1C consistent with prediabetes. Of the 135 participants with complete data, 31% perceived a high/moderate risk for developing diabetes. In univariate logistic regression analyses, 9 of 18 potential variables were significant (P < .05) predictors of perception of risk. When these 9 variables were entered into a multiple logistic regression model, 5 were significant predictors of perception of risk: history of gestational diabetes, high school graduate or above, optimistic bias, worry, and perceived personal disease risk. Use of the Spanish-language translation of the Risk Perception Survey for Developing Diabetes revealed factors influencing perception of risk for developing diabetes. Results can be used to promote culturally acceptable type 2 diabetes primary prevention strategies and provide a useful comparison to other populations. © 2016 The Author(s).

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.

Analyses of non-fatal accidents in an opencast mine by logistic regression model - a case study.

PubMed

Onder, Seyhan; Mutlu, Mert

2017-09-01

Accidents cause major damage for both workers and enterprises in the mining industry. To reduce the number of occupational accidents, these incidents should be properly registered and carefully analysed. This study efficiently examines the Aegean Lignite Enterprise (ELI) of Turkish Coal Enterprises (TKI) in Soma between 2006 and 2011, and opencast coal mine occupational accident records were used for statistical analyses. A total of 231 occupational accidents were analysed for this study. The accident records were categorized into seven groups: area, reason, occupation, part of body, age, shift hour and lost days. The SPSS package program was used in this study for logistic regression analyses, which predicted the probability of accidents resulting in greater or less than 3 lost workdays for non-fatal injuries. Social facilities-area of surface installations, workshops and opencast mining areas are the areas with the highest probability for accidents with greater than 3 lost workdays for non-fatal injuries, while the reasons with the highest probability for these types of accidents are transporting and manual handling. Additionally, the model was tested for such reported accidents that occurred in 2012 for the ELI in Soma and estimated the probability of exposure to accidents with lost workdays correctly by 70%.

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.

Reporting and methodological quality of meta-analyses in urological literature.

PubMed

Xia, Leilei; Xu, Jing; Guzzo, Thomas J

2017-01-01

To assess the overall quality of published urological meta-analyses and identify predictive factors for high quality. We systematically searched PubMed to identify meta-analyses published from January 1st, 2011 to December 31st, 2015 in 10 predetermined major paper-based urology journals. The characteristics of the included meta-analyses were collected, and their reporting and methodological qualities were assessed by the PRISMA checklist (27 items) and AMSTAR tool (11 items), respectively. Descriptive statistics were used for individual items as a measure of overall compliance, and PRISMA and AMSTAR scores were calculated as the sum of adequately reported domains. Logistic regression was used to identify predictive factors for high qualities. A total of 183 meta-analyses were included. The mean PRISMA and AMSTAR scores were 22.74 ± 2.04 and 7.57 ± 1.41, respectively. PRISMA item 5, protocol and registration, items 15 and 22, risk of bias across studies, items 16 and 23, additional analysis had less than 50% adherence. AMSTAR item 1, " a priori " design, item 5, list of studies and item 10, publication bias had less than 50% adherence. Logistic regression analyses showed that funding support and " a priori " design were associated with superior reporting quality, following PRISMA guideline and " a priori " design were associated with superior methodological quality. Reporting and methodological qualities of recently published meta-analyses in major paper-based urology journals are generally good. Further improvement could potentially be achieved by strictly adhering to PRISMA guideline and having " a priori " protocol.

Image encryption based on a delayed fractional-order chaotic logistic system

NASA Astrophysics Data System (ADS)

Wang, Zhen; Huang, Xia; Li, Ning; Song, Xiao-Na

2012-05-01

A new image encryption scheme is proposed based on a delayed fractional-order chaotic logistic system. In the process of generating a key stream, the time-varying delay and fractional derivative are embedded in the proposed scheme to improve the security. Such a scheme is described in detail with security analyses including correlation analysis, information entropy analysis, run statistic analysis, mean-variance gray value analysis, and key sensitivity analysis. Experimental results show that the newly proposed image encryption scheme possesses high security.

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

Factors That Contribute to the Completion of Programs of Study at Arkansas Institutions of Higher Education for African American Males

ERIC Educational Resources Information Center

Petty, Barrett Wade McCoy

2015-01-01

The study examined factors that predicted the completion of programs of study at Arkansas institutions of higher education for African American males. Astin's (1993a) Input-Environment-Output (I-E-O) Model was used as the theoretical foundation. Descriptive analyses and hierarchical logistic regression analyses were performed on the data. The…

Intermediate and advanced topics in multilevel logistic regression analysis

PubMed Central

Merlo, Juan

2017-01-01

Multilevel data occur frequently in health services, population and public health, and epidemiologic research. In such research, binary outcomes are common. Multilevel logistic regression models allow one to account for the clustering of subjects within clusters of higher‐level units when estimating the effect of subject and cluster characteristics on subject outcomes. A search of the PubMed database demonstrated that the use of multilevel or hierarchical regression models is increasing rapidly. However, our impression is that many analysts simply use multilevel regression models to account for the nuisance of within‐cluster homogeneity that is induced by clustering. In this article, we describe a suite of analyses that can complement the fitting of multilevel logistic regression models. These ancillary analyses permit analysts to estimate the marginal or population‐average effect of covariates measured at the subject and cluster level, in contrast to the within‐cluster or cluster‐specific effects arising from the original multilevel logistic regression model. We describe the interval odds ratio and the proportion of opposed odds ratios, which are summary measures of effect for cluster‐level covariates. We describe the variance partition coefficient and the median odds ratio which are measures of components of variance and heterogeneity in outcomes. These measures allow one to quantify the magnitude of the general contextual effect. We describe an R 2 measure that allows analysts to quantify the proportion of variation explained by different multilevel logistic regression models. We illustrate the application and interpretation of these measures by analyzing mortality in patients hospitalized with a diagnosis of acute myocardial infarction. © 2017 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. PMID:28543517

Intermediate and advanced topics in multilevel logistic regression analysis.

PubMed

Austin, Peter C; Merlo, Juan

2017-09-10

Multilevel data occur frequently in health services, population and public health, and epidemiologic research. In such research, binary outcomes are common. Multilevel logistic regression models allow one to account for the clustering of subjects within clusters of higher-level units when estimating the effect of subject and cluster characteristics on subject outcomes. A search of the PubMed database demonstrated that the use of multilevel or hierarchical regression models is increasing rapidly. However, our impression is that many analysts simply use multilevel regression models to account for the nuisance of within-cluster homogeneity that is induced by clustering. In this article, we describe a suite of analyses that can complement the fitting of multilevel logistic regression models. These ancillary analyses permit analysts to estimate the marginal or population-average effect of covariates measured at the subject and cluster level, in contrast to the within-cluster or cluster-specific effects arising from the original multilevel logistic regression model. We describe the interval odds ratio and the proportion of opposed odds ratios, which are summary measures of effect for cluster-level covariates. We describe the variance partition coefficient and the median odds ratio which are measures of components of variance and heterogeneity in outcomes. These measures allow one to quantify the magnitude of the general contextual effect. We describe an R 2 measure that allows analysts to quantify the proportion of variation explained by different multilevel logistic regression models. We illustrate the application and interpretation of these measures by analyzing mortality in patients hospitalized with a diagnosis of acute myocardial infarction. © 2017 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. © 2017 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.

Application of logistic regression for landslide susceptibility zoning of Cekmece Area, Istanbul, Turkey

NASA Astrophysics Data System (ADS)

Duman, T. Y.; Can, T.; Gokceoglu, C.; Nefeslioglu, H. A.; Sonmez, H.

2006-11-01

As a result of industrialization, throughout the world, cities have been growing rapidly for the last century. One typical example of these growing cities is Istanbul, the population of which is over 10 million. Due to rapid urbanization, new areas suitable for settlement and engineering structures are necessary. The Cekmece area located west of the Istanbul metropolitan area is studied, because the landslide activity is extensive in this area. The purpose of this study is to develop a model that can be used to characterize landslide susceptibility in map form using logistic regression analysis of an extensive landslide database. A database of landslide activity was constructed using both aerial-photography and field studies. About 19.2% of the selected study area is covered by deep-seated landslides. The landslides that occur in the area are primarily located in sandstones with interbedded permeable and impermeable layers such as claystone, siltstone and mudstone. About 31.95% of the total landslide area is located at this unit. To apply logistic regression analyses, a data matrix including 37 variables was constructed. The variables used in the forwards stepwise analyses are different measures of slope, aspect, elevation, stream power index (SPI), plan curvature, profile curvature, geology, geomorphology and relative permeability of lithological units. A total of 25 variables were identified as exerting strong influence on landslide occurrence, and included by the logistic regression equation. Wald statistics values indicate that lithology, SPI and slope are more important than the other parameters in the equation. Beta coefficients of the 25 variables included the logistic regression equation provide a model for landslide susceptibility in the Cekmece area. This model is used to generate a landslide susceptibility map that correctly classified 83.8% of the landslide-prone areas.

Multidrug-resistant pulmonary tuberculosis in Los Altos, Selva and Norte regions, Chiapas, Mexico.

PubMed

Sánchez-Pérez, H J; Díaz-Vázquez, A; Nájera-Ortiz, J C; Balandrano, S; Martín-Mateo, M

2010-01-01

To analyse the proportion of multidrug-resistant tuberculosis (MDR-TB) in cultures performed during the period 2000-2002 in Los Altos, Selva and Norte regions, Chiapas, Mexico, and to analyse MDR-TB in terms of clinical and sociodemographic indicators. Cross-sectional study of patients with pulmonary tuberculosis (PTB) from the above regions. Drug susceptibility testing results from two research projects were analysed, as were those of routine sputum samples sent in by health personnel for processing (n = 114). MDR-TB was analysed in terms of the various variables of interest using bivariate tests of association and logistic regression. The proportion of primary MDR-TB was 4.6% (2 of 43), that of secondary MDR-TB was 29.2% (7/24), while among those whose history of treatment was unknown the proportion was 14.3% (3/21). According to the logistic regression model, the variables most highly associated with MDR-TB were as follows: having received anti-tuberculosis treatment previously, cough of >3 years' duration and not being indigenous. The high proportion of MDR cases found in the regions studied shows that it is necessary to significantly improve the control and surveillance of PTB.

Correlational Analysis of neck/shoulder Pain and Low Back Pain with the Use of Digital Products, Physical Activity and Psychological Status among Adolescents in Shanghai

PubMed Central

Li, Jipeng; Li, Yangyang; Zhang, Yongxing; Zhao, Qinghua

2013-01-01

Purpose This study investigates the neck/shoulder pain (NSP) and low back pain (LBP) among current high school students in Shanghai and explores the relationship between these pains and their possible influences, including digital products, physical activity, and psychological status. Methods An anonymous self-assessment was administered to 3,600 students across 30 high schools in Shanghai. This questionnaire examined the prevalence of NSP and LBP and the level of physical activity as well as the use of mobile phones, personal computers (PC) and tablet computers (Tablet). The CES-D (Center for Epidemiological Studies Depression) scale was also included in the survey. The survey data were analyzed using the chi-square test, univariate logistic analyses and a multivariate logistic regression model. Results Three thousand sixteen valid questionnaires were received including 1,460 (48.41%) from male respondents and 1,556 (51.59%) from female respondents. The high school students in this study showed NSP and LBP rates of 40.8% and 33.1%, respectively, and the prevalence of both influenced by the student’s grade, use of digital products, and mental status; these factors affected the rates of NSP and LBP to varying degrees. The multivariate logistic regression analysis revealed that Gender, grade, soreness after exercise, PC using habits, tablet use, sitting time after school and academic stress entered the final model of NSP, while the final model of LBP consisted of gender, grade, soreness after exercise, PC using habits, mobile phone use, sitting time after school, academic stress and CES-D score. Conclusions High school students in Shanghai showed high prevalence of NSP and LBP that were closely related to multiple factors. Appropriate interventions should be implemented to reduce the occurrences of NSP and LBP. PMID:24147114