Analysis Of National Dataset Research Articles

Approaching the SDG targets with sustained political commitment: drivers of the notable decline in maternal and neonatal mortality in Morocco

BackgroundBetween 2000 and 2017/2018, Morocco reduced its maternal mortality ratio by 68% and its neonatal mortality rate by 52%—a higher improvement than other North African countries. We conducted the Exemplars...

The double burden of maternal overweight and short stature and the likelihood of cesarean deliveries in South Asia: An analysis of national datasets from Bangladesh, India, Maldives, Nepal, and Pakistan.

The aim was to investigate: (a) whether there is an association between the maternal double burden of overweight and short stature and the risk of cesarean delivery and (b) whether socioeconomic status (SES) acts as a moderator in the association between the maternal double burden of overweight and short stature and the risk of cesarean birth (CB). The data for this study were obtained from the nationally representative Demographic and Health Survey databases of five South Asian countries. The analyses were based on responses from married women between 15 and 49years of age. The risk of CB was the primary outcome, while the maternal double burden of overweight and short stature (coexistence of overweight and short stature) was the exposure of interest. Maternal double burden of overweight and short stature was significantly associated with 179% higher likelihood of undergoing CB in South Asia (SA), with 304%, 200%, 167%, 155%, and 125% higher likelihood of undergoing CB in Nepal, Pakistan, India, Maldives, and Bangladesh, respectively. Findings also demonstrated that mothers belonging to low SES groups with a double overweight and short stature burden were not uniquely disadvantaged. A significant marker in SA of higher risk of CB is the maternal double burden of overweight and short stature. The negative effect of the maternal double burden of overweight and short stature extends across all economic backgrounds in relation to the risk of CB. It is not limited to poor mothers who suffer from the double burden of overweight and short stature.

How COVID-19 increased antipsychotic prescribing in care homes

Care home residents have been affected more by the COVID-19 pandemic than any other patient group; analysis of national datasets from 25 countries showed that care home deaths account for 30% of the total COVID-19 deaths​[1]​. The pandemic further exacerbated existing issues within the care sector — including underfunding, staffing issues and lack of training […]

Prevalence and performance of private equity-affiliated fertility practices in the United States

To quantify the proportion of annual assisted reproductive technology (ART) cycles performed at private equity-affiliated fertility practices and to test for differences in services and success rates between private equity-affiliated and nonaffiliated practices. Cross-sectional analysis of national data set. Not applicable. None. Not applicable. The primary outcome measures were the volume of ART cycles performed, the percentage of retrievals resulting in live births, and the percentage of transfers resulting in live births. The secondary outcomes included the median income of the practice location, the use of preimplantation genetic testing, the clinical service availability, and the patient reasons for seeking treatment. Of the practices listed on the Centers for Disease Control's 2018 Fertility Clinic Success Rates Report, 14.7% had a private equity affiliation. Of the 305,883 ART cycles performed in 2018, 29.3% (89,535) occurred at private equity-affiliated practices. Patients at private equity-affiliated practices were 6.75% (95% confidence interval [CI], -10.15%, -3.36%) less likely to initiate a cycle due to male factor infertility, and 10.60% (95% CI, 3.49, 17.76) more likely to use preimplantation genetic testing before embryo transfer. No statistically significant differences were found in success rates among women aged <35 years. The average median household income (standard error) in zip codes with private equity-affiliated practices compared with nonaffiliated practices was $83,610 ($35,990) and $72,161 ($32,314), respectively. A major portion of fertility practices in the United States are private equity-affiliated, and these practices perform an even greater portion of ART cycles in the United States each year. Fertility appears to be the medical specialty with the greatest market share owned by private equity. Our findings corroborate preliminary research, which forecasts the increasing involvement and consolidation by private equity in fertility. Future research should continue monitoring for differences in outcomes, financing, case mix, service use, and accessibility.

Vitamin A deficiency among children younger than 5 y in India: an analysis of national data sets to reflect on the need for vitamin A supplementation

Biochemical vitamin A deficiency (VAD) is believed to be a serious public health problem (low serum retinol prevalence>20%) in Indian children, justifying universal high-dose vitamin A supplementation (VAS). To evaluate in Indian children younger than 5 y the risk of biochemical VAD from the Comprehensive National Nutrition Survey, as well as dietary vitamin A inadequacy and excess over the tolerable upper limit of intake (TUL) from national and subnational surveys, factoring in fortification and VAS. Child serum retinol data, corrected for inflammation, were examined to evaluate national- and state-level prevalence of VAD. Simultaneously, dietary intakes from the National Sample Survey Office and the National Nutrition Monitoring Bureau were examined for risk of dietary vitamin A deficiency against its average requirement (AR) derived for Indian children. Theoretical estimates of risk reduction with oil and milk vitamin A fortification were evaluated along with the risk of exceeding the TUL, as well as when combined with intake from VAS. The national prevalence of biochemical VAD measured in 9563 children was 15.7% (95% CI: 15.2%, 16.3%), and only 3 states had prevalence significantly >20%. The AR of vitamin A was 198 and 191 µg/d for boys and girls; the risk of dietary inadequacy was ∼70%, which reduced to 25% with oil and milk fortification. Then, the risk of exceeding the TUL was 2% and 1% in 1- to 3-y-old and 4- to 5-y-old children, respectively, but when the VAS dose was added to this intake in a cumulative 6-mo framework, the risk of exceeding the TUL rose to 30% and 8%, respectively. The national prevalence of VAD risk is below 20% in Indian children. Because there is risk of excess intake with food fortification and VAS, serious consideration should be given to a targeted approach in place of the universal VAS program in India.

Racial/Ethnic variations in morbidity and mortality in Adult Onset Still's Disease: An analysis of national dataset

ObjectivesAdult Onset Still's Disease (AOSD) is a rare autoinflammatory disorder. There is relatively little known about the impact of social determinants of health on its outcomes. Our goal is to describe the racial/ethnic variations, morbidity and mortality of AOSD hospitalized patients in the US. Materials and MethodsAdult US hospitalized patients between 2009–13 from a nationwide inpatient sample (NIS) database with AOSD were identified using ICD-9 code 714.2. NIS is the largest all-payer US inpatient database with approximately 8 million hospitalizations yearly. Patients with other autoimmune diseases were excluded. We used descriptive statistics to summarize patient and hospital characteristics. We performed survey-weighted logistic regression models adjusting for confounders to study our primary outcome: in-hospital mortality. ResultsBetween 2009–13, 5,820 AOSD patients were hospitalized with a mean age of 53.6 (SE–0.61) years. 3817 (65.6%) were female, 56% white and 3% Asian. Macrophage Activating Syndrome (1.7%), Disseminated Intravascular Coagulation (DIC-1.1%) and Thrombotic Thrombocytopenic Purpura (0.4%), respectively, complicated the hospital course. There were 154 inpatient deaths in study period (mortality 2.6%). Mean age of patients who died in hospital was higher (62.4 years ± 3.1) and 13.9% were Asians. Patients of Asian origin had significantly higher odds of in-hospital death compared to whites (aOR = 6.39, 95% CI 1.77–23.1, p = 0.005). Mortality was significantly higher for patients whose hospital course was complicated by DIC (aOR = 29.69, 95% CI 5.5–160.41, p = 0.006). ConclusionsIn this national sample of patients hospitalized for AOSD, we found significant variations in In-hospital mortality.

Combining feminist intersectional and community-engaged research commitments: Adaptations for scoping reviews and secondary analyses of national data sets

As Hankivsky &amp; Cormier (2011) and Denis (2008) note, the theoretical evolution of intersectionality has outpaced its methodological development. While past work has contributed to our understanding of how to apply intersectionality in research (CRIAW-ICREF &amp; DAWN-RAFH 2014; Morris &amp; Bunjan 2007; Simpson 2009), gaps persist. Drawing on a four-year community-university research collaboration called ‘Changing public services: Women and intersectional analysis’, we explore the incorporation of feminist intersectional and community-engaged research commitments into secondary data analyses, specifically a scoping review and secondary analyses of two Statistics Canada data sets. We discuss our application of these commitments across all stages of designing and undertaking these analyses, in particular drawing into focus the importance of dialogue and deliberation throughout our process. Our application of feminist intersectional and community-engaged commitments – including prioritising community benefit and practising self-reflexivity – revealed gaps and silences in the data, in turn improving our understanding of differences in people’s experiences, our critiques of policies and our identification of new research questions. The lessons learned, we conclude, are valuable for scholars, whether or not community engagement is central to their scholarly commitment.&#x0D; Keywordsfeminist intersectionality, community-engaged research, scoping review, logistic regression, community-university partnerships, Canadian public services

Joint Commission releases first data‐driven estimate of U.S. hospital suicides

An analysis of national data sets found the numbers of suicides in U.S. hospitals fewer than widely cited estimates, according to a new report by The Joint Commission. The new study represents the first data‐driven estimate of the number of suicides in hospitals and inpatient settings in the United States. The findings are currently published online and will appear in the November issue of the Joint Commission Journal on Quality and Patient Safety.

Mixed Versus Pure Variants of Desmoplastic Melanoma: The Cleveland Clinic Experience.

Desmoplastic melanoma (DM) is a subvariant of spindle cell melanoma, accounting for less than 4% of all cutaneous melanomas. It occurs later in life and is associated with chronic sun exposure. Desmoplastic melanoma prognosis is considered more favorable than other variants, with lower rates of metastasis and higher survival. Recently, DM has been further subclassified into pure and mixed, calling into question surgical management and patient outcomes as well as viability of current nationwide databases without this distinction. We identified all patients with a histopathologic diagnosis of DM from the Cleveland Clinic electronic melanoma database (n = 58) from 1997 to 2013. Clinical and histopathologic data were collected. Comparison in clinical variables was performed between patients who had pure (n = 15) and mixed (n = 43) variants of DM. There were no differences in age, sex, location of lesion, Breslow depth, ulceration, or regression. Patients with mixed DM were more likely to have lymphovascular invasion (P = 0.03) compared with pure DM. There was no difference in performance of sentinel lymph node biopsy (P = 0.25) or sentinel lymph node positivity (P = 0.31) between the 2 groups. Recurrence was present in 13.3% of pure and 30.2% of mixed patients. Overall, Kaplan-Meier 3-year survival was 75% for pure and 80% for mixed DM (P = 0.53). Pure and mixed DMs seem to have similar clinical characteristics and outcomes. This indicates that analysis of national datasets without this subclassification remains viable.

The geomorphological context and impact of the linear emergent macrophyte, Sparganium erectum L.: a statistical analysis of observations from British rivers

ABSTRACTThis paper explores the geomorphological context and impact of the widely‐occurring, linear emergent macrophyte, Sparganium erectum.Forty‐seven sites across Britain were selected for field investigation, spanning the range of environmental conditions within which Sparganium erectum had been found to be present in previous analyses of national data sets. A combination of descriptive graphs and statistics, principal components analysis, and Kruskal–Wallis tests were used to explore the large multivariate data set collected at the 47 sites.The analyses showed that Sparganium erectum is present in significant quantities in relatively narrow and shallow (&lt; 18 m wide and &lt; 0.9 m deep to the limit of terrestrial vegetation), low gradient (maximum 0.004) channels of varying bed sediment calibre (cobble to silt). Within these environments, S. erectum stands (features) were associated with fine sediment retention, aggradation and submerged landform construction, leading to bench development and so, potentially, to adjustments in channel form and position. Sediment retention and landform construction within S. erectum features was most strongly apparent within reaches with a relatively high S. erectum cover and the presence of large area S. erectum features. It was also associated more weakly with S. erectum features that were comprised of relatively higher densities of plants with relatively smaller inter‐plant spacing and fewer leaves. The sediment retained in S. erectum features and associated bench and bank toe deposits showed larger numbers and species of viable seeds, indicating the potential for colonization and growth of other species on S. erectum features once they aggrade above the low flow water level and are no longer a suitable habitat for S. erectum. Copyright © 2013 John Wiley &amp; Sons, Ltd.

Deconcentrating Poverty With Housing Programs

Problem: Housing programs of the past have exacerbated the problems of concentrated poverty. Current housing programs serving very low-income households, including homebuyers as well as renters, should be examined to determine the extent to which they help households make entry into neighborhoods with low concentrations of poverty. Purpose: This research is designed to assist planners in understanding how well various approaches to resolving housing affordability problems can facilitate the poverty deconcentration process. Methods: Administrative data from the Department of Housing and Urban Development are used to assess the degree to which federal housing programs help lowincome homebuyers and renters locate in neighborhoods where less than 10% of the population is below poverty. Results and conclusions: Subsidizing households ought to be more effective than subsidizing housing units at helping lowincome households locate in low-poverty areas, and whether a household rents or buys should not matter to whether a program succeeds at deconcentration of the poor. Yet, analysis of national datasets across several housing programs finds neither of the previous propositions to be true. Housing vouchers suppliedto households are not helping renters locate in low-poverty areas any more effectively than are current project-based subsidies. It also turns out that tenure matters; a disproportionately higher share of low-income homebuyers are locating in low-poverty neighborhoods than are lowincome renters. Takeaway for practice: I recommend that housing planners seeking to make poverty deconcentration more effective use housing placement counselors, administer programs at the metropolitan scale, lease and broker market-rate housing directly, promote mixed-income LIHTC developments, practice inclusionary zoning, and monitor the impacts of these efforts. Research support: U.S. Department of Housing and Urban Development.

Costs of Occupational COPD and Asthma

To estimate the number of annual deaths, as well as the direct and indirect costs of occupational COPD and asthma, in the United States in 1996. Aggregation and analysis of national data sets collected by the National Center for Health Statistics, the Health Care Financing Administration, and other government bureaus and private firms. To assess mortality, we reviewed data from national surveys and applied a population attributable risk (PAR) of 15% for both asthma and COPD. We use a lower age limit of 35 years for occupational COPD and 20 years for occupational asthma. To calculate costs, we use the human capital method that decomposes costs into direct categories, such as medical expenses, as well as indirect categories, such as lost earnings and lost home production. We calculated proportionately adjusted costs for other plausible PARs. The 15% PARs result in costs of $5.0 billion for COPD and $1.6 billion for asthma. For COPD, 56% of costs were direct and 44% were indirect; for asthma, 74% were direct and 26% indirect. These estimates are conservative since we ignored costs associated with pain and suffering as well as the value of care rendered by family members. The proportionately adjusted costs for 10 to 20% PARs are $3.3 to $6.6 billion for COPD and $1.1 to $2.1 billion for asthma. The estimated $6.6 billion cost of occupational COPD and asthma in 1996 is likely to rise with the increasing prevalence of these diseases and warrants preventive intervention.

Costs of hepatitis C.

To estimate the direct and indirect costs of the hepatitis C virus (HCV) in the United States in 1997. Aggregation and analysis of national data sets collected by the National Center for Health Statistics, the Health Care Financing Administration, and other government bureaus and private firms. To estimate costs, we used the human capital method, which decomposes costs into direct categories, such as medical expenses, and indirect categories, such as lost earnings and lost home production. We consider HCV that results in chronic liver disease separate from HCV that results in primary liver cancer. We estimate $5.46 billion as the cost of HCV in 1997. Costs are split as follows: 33% for direct and 67% for indirect costs. Hepatitis C virus that results in chronic liver disease contributes roughly 92% of the costs, and HCV that results in primary liver cancer contributes the remaining 8%. The total estimate of $5.46 billion is conservative, because we ignore costs associated with pain and suffering and the value of care rendered by family members. To our knowledge, only one estimate of the annual costs of HCV in the 1990s has appeared in the literature, $0.6 billion. However, that estimate was not supported by an explanation of the methods. Our estimate, which relies on detailed methods, is nearly 10 times the original estimate. Our estimate of $5.46 billion is on a par with the cost of asthma ($5.8 billion [1994]).