Backward Stepwise Multiple Regression Analysis Research Articles

Health Care Access, Socioeconomic Status, and Acute Kidney Injury Outcomes: A Prospective National Study

Acute kidney injury (AKI) incidence and outcome in Kuwait are unknown. Moreover, non-Kuwaitis, who represent 66% of the population, have lower income, and their access to public health services is restricted compared with Kuwaitis who have free full access. Observational prospective multicenter cohort study. Adult inpatients with AKI in 7 public hospitals from January 1 to December 31,2021. AKI identified using Kidney Disease: Improving Global Outcomes serum creatinine-based criteria. For hospitalized patients with AKI, the outcomes included 30-day outcomes of mortality, need for dialysis, kidney recovery rates, and differences in outcomes between Kuwaitis and non-Kuwaitis. A backward stepwise multiple logistic regression analysis was performed to assess possible independent risk factors for the outcomes. We recruited 3,744 patients (mean age: 63 years; mean baseline estimated glomerular filtration rate [eGFR]: 66.7mL/min; non-Kuwaitis: 42.3%), representing 3.2% of hospitalizations and 19.5% of intensive care unit (ICU) admissions. Non-Kuwaitis were significantly younger (57.6 vs 66.9 years), with higher baseline eGFR (73.1 vs. 62mL/min), more frequent community acquired AKI (53.8% vs 46.7%), and AKI in summer (34.7% vs 26.9%). Dialysis was provided to 33.5% of patients, with a higher need for non-Kuwaitis (35.5% vs 32.1%). At 30 days, 34.4% of patients died, representing 24.8% of hospital mortality and 59.8% of ICU mortality. No differences in mortality or kidney recovery were noted between Kuwaitis and non-Kuwaitis. Low eGFR did not affect the mortality rate. Observational nature and short follow-up period of 30 days only. AKI was associated with high dialysis need and mortality. Non-Kuwaitis accounted for less cases despite representing 66% of the population because they were younger with higher baseline eGFR and fewer comorbid conditions. Non-Kuwaitis had higher rates of community acquired AKI and AKI in summer and a higher need for dialysis but had similar mortality and complete kidney recovery rates.

The Effect of Obesity on Repolarization and Other ECG Parameters.

Background: Overweight and obesity are important risk factors in the development of cardiovascular diseases. New repolarization markers, such as the Tpeak-Tend interval and JTpeak intervals, have not yet been profoundly studied in obese patients. The study aims to analyze whether, in patients with obesity and overweight, repolarization markers, including the Tpeak-Tend interval, are prolonged and simultaneously check the frequency of other ECG pathologies in a 12-lead ECG in this group of patients. Methods: A study group consisted of 181 adults (90 females and 91 males) with overweight and first-class obesity. The participants completed a questionnaire, and the ECG was performed and analyzed. Results: When analyzing the classic markers, only QT dispersion was significantly higher in obese people. The Tpeak-Tend parameter (97.08 ms ± 23.38 vs. 89.74 ms ± 12.88, respectively), its dispersion, and JTpeak-JTend parameters were statistically significantly longer in the obese group than in the controls. There were also substantial differences in P-wave, QRS duration, and P-wave dispersion, which were the highest in obese people. Tpeak-Tend was positively correlated with body mass and waist circumference, while JTpeak was with BMI, hip circumference, and WHR. Tpeak/JT was positively correlated with WHR and BMI. In backward stepwise multiple regression analysis for JTpeak-WHR, type 2 diabetes and smoking had the highest statistical significance. Conclusions: Only selected repolarization markers are significantly prolonged in patients with class 1 obesity and, additionally, in this group, we identified more pathologies of P wave as well as prolonged QRS duration.

Patients' knowledge about dental emergencies, COVID-19 transmission, and required preparations in dental settings.

The Coronavirus disease 2019 (COVID-19) pandemics negatively affected the delivery of dental care. The study objective was to assess the knowledge of emergency dental treatments, the transmission routes of COVID-19 in the dental settings, necessary precautions to prevent disease transmission, and the associations between demographic factors and the mentioned domains among Iranian dental patients. This was a cross-sectional study conducted in October 2021. A systematic random sampling approach was used to select 244 participants who had sought services at the dental clinic of Tehran University of Medical Sciences before and during the pandemic. Data was collected using a combination of interviewer-administered and self-administered questionnaire. Three backward stepwise multiple logistic regression analyses were conducted to determine the associations between background factors (age, sex, education level, living status, history of dental visits, history of COVID-19 vaccination, and past COVID-19 infection) and knowledge about emergency dental treatments, knowledge about COVID-19 transmission routes, and knowledge about necessary preparations in dental settings. The mean (SD) scores for knowledge of emergency dental treatments, COVID-19 transmission routes, and essential preparations in dental settings measured on a 100-point scale were 77 (15.4), 84.2 (12.3), and 93.3 (12.1), respectively. Good knowledge of emergency dental treatments was associated with being under 55 years old (p = 0.03). Good knowledge of COVID-19 transmission routes was associated with living with individuals at a high risk of COVID-19 (p = 0.014) and having received the COVID-19 vaccine (p = 0.013). After adjusting for age, among participants aged 30 years and older, good knowledge of necessary preparations in dental settings was associated with being female (p = 0.012) and having received the COVID-19 vaccine (p = 0.001). Patients who sought care at the dental clinic of Tehran University of Medical Sciences had good knowledge about the transmission routes of COVID-19 and the required preparations in dental settings, and limited knowledge about dental emergency treatments.

Decreased Serum Stromal Cell-Derived Factor-1 in Patients with Familial Hypercholesterolemia and Its Strong Correlation with Lipoprotein Subfractions.

Stromal cell-derived factor-1 (SDF-1) is a chemokine that exerts multifaceted roles in atherosclerosis. However, its association with hyperlipidemia is contradictory. To date, serum SDF-1 and its correlations with lipid fractions and subfractions in heterozygous familial hypercholesterolemia (HeFH) have not been investigated. Eighty-one untreated patients with HeFH and 32 healthy control subjects were enrolled in the study. Serum SDF-1, oxidized LDL (oxLDL) and myeloperoxidase (MPO) were determined by ELISA. Lipoprotein subfractions were detected by Lipoprint. We diagnosed FH using the Dutch Lipid Clinic Network criteria. Significantly lower serum SDF-1 was found in HeFH patients compared to healthy controls. Significant negative correlations were detected between serum total cholesterol, triglycerides, LDL-cholesterol (LDL-C), apolipoprotein B100 (ApoB100) and SDF-1. Furthermore, serum SDF-1 negatively correlated with VLDL and IDL, as well as large LDL and large and intermediate HDL subfractions, while there was a positive correlation between mean LDL-size, small HDL and SDF-1. SDF-1 negatively correlated with oxLDL and MPO. A backward stepwise multiple regression analysis showed that the best predictors of serum SDF-1 were VLDL and oxLDL. The strong correlation of SDF-1 with lipid fractions and subfractions highlights the potential common pathways of SDF-1 and lipoprotein metabolism, which supports the role of SDF-1 in atherogenesis.

Factors Affecting COVID-19 Vaccine Acceptance among Pregnant Women: A Cross Sectional Study from Abha City, Saudi Arabia.

Background: Pregnant women can get infected with COVID-19 with serious sequelae to them and their fetus. Concerns about COVID-19 vaccination safety to mothers and babies, and doubts about its effectiveness, have hindered vaccine acceptance throughout the COVID-19 crisis. The objective of the current investigation was to estimate COVID-19 acceptance rates among pregnant women in Abha city, Aseer region, Saudi Arabia, and determine its clinical and demographic correlates. Method: Descriptive questionnaire-based cross-sectional survey of a sample of pregnant women attending regular antenatal care services in Abha. We used backward stepwise multiple logistic regression analysis to evaluate the predictability of vaccine acceptance in terms of baseline clinical and demographic factors. Results: The survey included 572 pregnant women. The prevalence of acceptance of COVID-19 vaccine was high (93.7%; 95%CI: 91.7-95.7%). University graduates and women with a later gestational age were more likely to accept vaccination (OR = 6.120, p = 0.009), (t = 2.163, p = 0.036), respectively. Confidence in vaccine safety was associated with better acceptance (OR = 3.431, p = 0.001). Conclusions: The acceptance rate for vaccination among pregnant women in Abha, Saudi Arabia, is higher compared to international rate. However, our results indicate that confidence in vaccine safety was associated with better acceptance. Hence, vaccine safety was the overarching predictor for harboring positive attitudes towards it. Public health policies should capitalize on such positive attitudes and aim for total coverage of pregnant women with COVID-19 vaccination including booster dosages.

Role of Altered Metabolism of Triglyceride-Rich Lipoprotein Particles in the Development of Vascular Dysfunction in Systemic Lupus Erythematosus

Impaired lipid metabolism contributes to accelerated inflammatory responses in addition to promoting the formation of atherosclerosis in systemic lupus erythematosus (SLE). We aimed to evaluate the lipid profile, inflammatory markers, and vascular diagnostic tests in active SLE patients to clarify the association between dyslipidemia and early vascular damage. 51 clinically active SLE patients and 41 age- and gender-matched control subjects were enrolled in the study. Lipoprotein subfractions were detected by Lipoprint. Brachial artery flow-mediated dilation and common carotid intima-media thickness were detected by ultrasonography. Arterial stiffness indicated by augmentation index (Aix) and pulse wave velocity was measured by arteriography. We found significantly higher Aix, higher VLDL ratio, plasma triglyceride, ApoB100, and small HDL, as well as lower HDL-C, large HDL, and ApoA1 in patients with SLE. There was a significant positive correlation of Aix with triglyceride, VLDL, IDL-C, IDL-B, and LDL1. A backward stepwise multiple regression analysis showed IDL-C subfraction to be the best predictor of Aix. Our results indicate that in young patients with SLE, triglyceride-rich lipoproteins influence vascular function detected by Aix. These parameters may be assessed and integrated into the management plan for screening cardiovascular risk in patients with SLE.

Sphingosine 1-Phosphate and Apolipoprotein M Levels and Their Correlations with Inflammatory Biomarkers in Patients with Untreated Familial Hypercholesterolemia.

High-density lipoprotein (HDL)-bound apolipoprotein M/sphingosine 1-phosphate (ApoM/S1P) complex in cardiovascular diseases serves as a bridge between HDL and endothelial cells, maintaining a healthy endothelial barrier. To date, S1P and ApoM in patients with untreated heterozygous familial hypercholesterolemia (HeFH) have not been extensively studied. Eighty-one untreated patients with HeFH and 32 healthy control subjects were included in this study. Serum S1P, ApoM, sCD40L, sICAM-1, sVCAM-1, oxLDL, and TNFα concentrations were determined by ELISA. PON1 activities were measured spectrophotometrically. Lipoprotein subfractions were detected by Lipoprint. We diagnosed FH using the Dutch Lipid Clinic Network criteria. Significantly higher serum S1P and ApoM levels were found in HeFH patients compared to controls. S1P negatively correlated with large HDL and positively with small HDL subfractions in HeFH patients and the whole study population. S1P showed significant positive correlations with sCD40L and MMP-9 levels and PON1 arylesterase activity, while we found significant negative correlation between sVCAM-1 and S1P in HeFH patients. A backward stepwise multiple regression analysis showed that the best predictors of serum S1P were large HDL subfraction and arylesterase activity. Higher S1P and ApoM levels and their correlations with HDL subfractions and inflammatory markers in HeFH patients implied their possible role in endothelial protection.

Can Primary School Mathematics Performance Be Predicted by Longitudinal Changes in Physical Fitness and Activity Indicators?

ObjectiveTo determine to what extent physical fitness indicators and/or moderate to vigorous physical activity (MVPA) may account for final mathematics academic performance (APmath) awarded at the end of primary school.MethodsSchool-aged youth were sampled in a repeated-measures, longitudinal design in Grade 6 (∼11 years), and again in Grade 9 (∼14 years). The youth (N = 231, 111 girls) completed a fitness test battery consisting of: flamingo balance test, standing long jump, backward obstacle course, plate tapping, sit ups, sit and reach, handgrip, and 20-m shuttle run. APmath scores were obtained for all children at the end of Grade 5, end of Grade 8, and end of Grade 9 (their final year of primary school). In a sub-sample of Grade 6 youth (N = 50, 29 girls), MVPA was measured objectively via SenseWear Pro Armbands (MVPAOB) for seven consecutive days, with measurements repeated in Grade 9.ResultsMath scores decreased from Grade 6 to 9 for both boys and girls (95%CI: −0.89 to −0.53, p < 0.001). MVPAOB was reduced by ∼45.7 min (−33%) from Grade 6 to 9 (p < 0.01). Significant main and interaction effects are noted for each fitness indicator (p < 0.05). A backward stepwise multiple regression analysis determined significant shared variance in final APmath grade to the change scores from Grade 6 to Grade 9 in: ΔAPmath, Δbackward obstacle course, Δsit and reach, and Δsit-ups [R2 = 0.494, F(4,180) = 43.67, p < 0.0001]. A second regression was performed only for the youth who completed MVPAOB measurements. In this sub-sample, MVPAOB did not significantly contribute to the model.ConclusionLongitudinal changes in youth fitness and their delta change in APmath score accounted for 49.4% of the variance in the final math grade awarded at the end of Grade 9. Aerobic power, upper body strength, and muscular endurance share more common variance to final math grade in boys, whereas whole-body coordination was the more relevant index in girls; this finding suggests that future research exploring the relationship of AP and PF should not be limited to cardiorespiratory fitness, instead encompassing muscular and neuro-muscular components of PF.

Bullying and coping with bullying among obese\\overweight and normal weight children

This study aimed to determine the obese\\overweight and normal weight children's status of encountering and coping with bullying and the correlational factors. This case-control study was conducted with 1.680 students in the second level (5th, 6th, 7th, 8th grades) from September 24, 2018 to May 31, 2019 in the Mediterranean Region in Turkey. The data were collected using a personal information form, the Traditional Peer Victimization Scale and the Coping with Bullying Scale. Data were analyzed using the Shapiro-Wilk test, Mann–Whitney U test, Binary Logistic Regression, Backward Wald Elimination, and Simple Linear and Backward Stepwise Multiple Linear Regression analyses. This study indicated that the risk of becoming victims, bullies or bully-victims increases among boys and 8th grade students. It also found that the risk of being victims and bully-victims increases among children whose father is illiterate. There was no significant difference between obese\\overweight and normal weight children in terms of being victims, bullies and bully-victims. Grade level, academic performance, father's education level and awareness of reporting bullying were effective in coping with bullying among the children, while weight was not. Further studies are needed to determine different factors that affect children's coping strategies against bullying.

The effect of somatic build on single-leg vertical jump performance in winter sport athletes

Aim of the study. The vertical jump test in winter sports is most often performed with both feet. In competitive sports, there is a need to determine parameters separately for each lower limb. This is related to the sport practiced and anatomical and functional asymmetry. Therefore, the aim of this study was to determine the effect of the somatic build of winter sports athletes on single-leg countermovement jump (CMJ) performance.Material and methods. The study group consisted of winter sports athletes, candidates for the high school in the Complex of Sports Championship Schools in Zakopane (ZSMS). The study was conducted in May 2019, with 121 participants including 56 girls (age: 13.981.76) and 65 boys (age: 13.892.09). Body build was determined based on 40 measurements of somatic characteristics which described body length and width, skeletal system mass, muscularity, body mass, and body fat. CMJ measurement was performed using the portable measurement system OptoJump. The relationships between somatic characteristics and CMJ results were determined using backward stepwise multiple regression analysis, whereas differences between the limbs were established using analysis of variance.Results. Analysis of variance did not confirm statistically significant differences between CMJ results for the right (RLL) and left (LLL) lower limbs. In the regression model for CMJ power, the coefficient of determination in girls was R2=33.53% for RLL and R2=43.69% for LLL. In boys, the range of explained total variance was higher with R2=39.64% for RLL and R2=61.36% for LLL. In the regression model for CMJ jump height, the coefficient of determination in girls was R2=44.63% for RLL and R2=38.53% for LLL. In boys, it was similar for both limbs (RLL: R2=57.36%; LLL: R2=58.53%)Conclusions. The power and height of CMJ obtained by both girls and boys did not confirm functional asymmetry. The study found significant relationships between CMJ results and athletes’ somatic build. However, body components were the most frequent explanatory variables in the regression models.

The need for cardiac surgery differential tariffs in Israel at the era of aging population and emerging technology: Importance of procedure type and patient complexity as assessed by EuroSCORE

BackgroundReimbursement for cardiac surgical procedures in Israel is uniform and does not account for diversity in costs of various procedures or for diversity in patient mix. In an era of new and costly technology coupled with higher risk patients needing more complex surgery, these tariffs may not adequately reflect the true financial burden on the caregivers. In the present study we attempt to determine whether case mix and complexity of procedures significantly affect cost to justify differential tariffs.MethodsWe included all patients undergoing cardiac surgery at Shaare Zedek Medical Center between the years 1993–2016. Patients were stratified according to (1) type of surgery and (2) clinical profile as reflected by the predicted operative risk according to the European System for Cardiac Operative Risk Evaluation (EuroSCORE). Approximate cost of each group of patients was estimated by the average number of days in the Intensive Care Unit and days in the postoperative ward multiplied by the respective daily costs as determined by the Ministry of Health. We then added the fixed cost of the components used in the operating room (manpower and disposables). The final estimated cost (the outcome variable) was then evaluated as it relates to type of surgery and clinical profile. ANOVA was used to analyze cost variability between groups, and backward regression analysis to determine the respective effect of the abovementioned variables on cost. Because of non-normal distribution, both costs and lengths of stay were Log-transformed.ResultsAltogether there were 5496 patients: 3863, 836, 685 and 112 in the isolated CABG, CABG + valve, 1 valve and 2 valves replacement groups. By ANOVA, the costs in all EuroSCORE subgroups were significantly different from each other, increasing with increased EuroSCORE subgroup. Cost was also significantly different among procedure groups, increasing from simple CABG to single valve surgery to CABG + valve surgery to 2-valve surgery. In backward stepwise multiple regression analysis, both type of procedure and EuroSCORE group significantly impacted cost. ICU stay and Ward stay were significantly but weakly related while EuroSCORE subgroup was highly predictive of both ICU stay and ward stay.ConclusionsThe cost of performing heart surgery today is directly influenced by both patient profile as well as type of surgery, both of which can be quantified. Modern day technology is costly yet has become mandatory. Thus reimbursement for heart surgery should be based on differential criteria, namely clinical risk profile as well as type of surgery. Our results suggest an urgent need for design and implementation of a differential tariff model in the Israeli reimbursement system. We suggest that a model using a fixed, average price according to the type of procedure costs, in addition to a variable hospitalization cost (ICU + ward) determined by the patient EuroSCORE or EuroSCORE subgroup should enable an equitable reimbursement to hospitals, based on their case mix.

Cartilage oligomeric matrix protein responses to a mechanical stimulus associate with ambulatory loading in individuals with anterior cruciate ligament reconstruction.

Mechanical factors have been implicated in the development of osteoarthritis after anterior cruciate ligament (ACL) reconstruction. This study tested for associations between ambulatory joint loading (total joint moment [TJM] and vertical ground reaction force [vGRF]) and changes in serum levels of cartilage oligomeric matrix protein (COMP) in response to a mechanical stimulus (30-min walk) in individuals with ACL reconstruction. Twenty-five subjects (mean age: 34.5 ± 9.8 years; 2.2 ± 0.2 years post-surgery) with primary unilateral ACL reconstruction underwent gait analysis for assessment of peak vGRF and TJM first (TJM1) and second (TJM2) peaks. Serum COMP concentrations were measured by enzyme-linked immunosorbent assay immediately before, 3.5 h, and 5.5 h after a 30-min walk. Pearson correlation coefficients and backward stepwise multiple linear regression analysis, with adjustments for age, sex, body mass index, and between-limb speed difference, assessed associations between changes in COMP and between-limb differences in joint loading parameters. Greater TJM1 (R = 0.542, p = 0.005), TJM2 (R = 0.460, p = 0.021), and vGRF (R = 0.577, p = 0.003) in the ACL-reconstructed limb as compared to the contralateral limb were associated with higher COMP values 3.5 h following the 30-min walk. Change in COMP at 5.5 h became a significant predictor of the between-limb difference in TJM1 and vGRF in multivariate analyses after accounting for the between-limb speed difference. These results demonstrate that higher TJM and vGRF in the ACLR limb as compared to the contralateral limb are associated with higher relative COMP levels 3.5 and 5.5 h after a 30-min walk. Future work should investigate the effect of therapies to alter joint loading on the biological response in individuals after ACL reconstruction.

Rate and causes of noncompliance with disease-modifying antirheumatic drug regimens in patients with rheumatoid arthritis.

To determine the prevalence and factors associated with medication noncompliance by Thai patients with rheumatoid arthritis (RA). This prospective cohort study enrolled 443 adult RA patients (≥ 18years) who were followed up at the outpatient rheumatology clinics of Siriraj Hospital and Phramongkutklao Hospital between May 2018 and December 2019. Medication noncompliance was assessed using the Compliance Questionnaire for Rheumatology-19 (CQR-19). A score of 0 indicated complete noncompliance, whereas a score of 100 indicated a perfect compliance. An unsatisfactory compliance was arbitrarily defined as a taking compliance of ≤ 80%. The prevalence of medication noncompliance was 22.1%. The most common cause was forgetting to take medications due to a busy work schedule. In a univariate analysis, the factors that were significantly related to medication noncompliance were age, income, number of comorbidities, functional status as measured by the Health Assessment Questionnaire (HAQ), number of prescribed pills per day, and number of types of prescribed medications per day. In a subsequent backward stepwise multiple logistic regression analysis, only 2 factors were found to be negatively associated with medication noncompliance: age (risk ratio, 0.98; 95% CI, 0.96-0.99; p, 0.048) and HAQ (risk ratio, 0.62; 95% CI, 0.39-0.98; p, 0.041). Medication noncompliance is common in patients with RA. As this may lead to unfavorable outcomes, patient education related to drug compliance should be addressed and emphasized in daily practice. Key Points • Medication noncompliance is common in patients with RA. • Forgetting to take pills was the most frequent explanation offered for noncompliance. • All patients should be strongly encouraged to comply with the recommended drug regimens.

Complementary medicine use in US adults with a history of colorectal cancer: a nationally representative survey

BackgroundIn the USA, colorectal cancer is among the top diagnosed cancers. The current study specifically targets the US adult population that have a history of colorectal cancer.MethodsWe used the 2017 National Health Interview Survey (NHIS) to investigate the prevalence and predictors of colorectal cancer survivors using complementary medicine in the past 12 months in a representative sample of the US population (N = 26,742). We descriptively analyzed the 12-month prevalence of any complementary medicine use separately for individuals with a prior diagnosis of colorectal cancer and those without. Using chi-squared tests and backward stepwise multiple logistic regression analyses, we identified predictors of complementary medicine use in the past 12 months.ResultsA weighted total of 1,501,481 US adults (0.6%) had a history of colorectal cancer. More individuals without (weighted n = 76,550,503; 31.2%) than those with a history of colorectal cancer (weighted n = 410,086; 27.3%) had used complementary medicine. The most commonly used complementary medicine among colorectal cancer patients was mind-body medicine, followed by chiropractic. A higher prevalence of complementary medicine use was associated with being female, higher educated and/or living in the US Midwest or South.ConclusionsIn this study, over one fourth of the US colorectal cancer survivors had used complementary medicine. Mind-body medicine was found to be the most commonly used. With evidence supporting the effectiveness and safety of mind-body medicine use among colorectal cancer patients, promoting the use of evidence-based mind-body medicine for colorectal cancer management could be considered.

Factors associated with prolonged psychiatric intensive care unit admission at Somdet Chaophraya Institute of Psychiatry, Thailand

Aim: Our objective is to determine factors associated with prolonged psychiatric intensive care unit (PICU) admission at Somdet Chaophraya Institute of Psychiatry (SCIP).&lt;br/&gt; Method: We reviewed the medical records of patients admitted to the PICU between 1 July 2016 and 31 December 2016 meeting PICU admission criteria. We defined prolonged admission as PICU clinical stay of longer than five days. We then performed univariate binary logistic regression analysis to analyse the association between factors and prolonged PICU admission. Factors with p-value &lt;0.25 were then included in backward stepwise multiple logistic regression analysis.&lt;br/&gt; Results: We included 293 cases then excluded 42 of them using our exclusion criteria (30 were discharged by other means and 12 cases were due to inability to obtain essential information). Of 251 studied cases, 112 cases (44.6%) had prolonged PICU admission. Univariate logistic regression analysis found that a history of prior PICU admission, compulsory admission, treatment with electroconvulsive therapy (ECT), and primary diagnosis were associated with prolonged PICU admission with p-value &lt;0.25. Using multiple logistic regression analysis, factors associated with prolonged PICU admission were: compulsory admission (adjusted odds ratio 2.45, 95% CI 1.06–5.69 when adjusted with treatment with ECT) and treatment with ECT during PICU admission (adjusted odds ratio 9.01, 95% CI 2.57–31.59 when adjusted with compulsory admission).&lt;br/&gt; Conclusions: Factors associated with prolonged PICU admission at SCIP were compulsory admission and treatment with ECT during PICU admission. We propose that further study of these two groups should provide clues on how to improve treatment in PICU.

Mind-body medicine use by women diagnosed with breast cancer: results of a nationally representative survey.

Worldwide breast cancer is the most commonly diagnosed cancer in women and often associated with a profound physiological stress reaction. Mind-body medicine modalities have been proven effective in reducing stress symptoms. This article will cover the prevalence of MBM use in women with and without breast cancer in the US population and detect predictors of MBM use in women diagnosed with breast cancer. The 2017 National Health Interview Survey (NHIS) was used to study the prevalence of breast cancer and the use of mind-body medicine (MBM) among individuals with breast cancer in the US population. Using chi-squared tests and backward stepwise multiple logistic regression analyses, predictors of MBM use in women with breast cancer in the past 12months were identified. The prevalence of breast cancer in women was 3.1%. Among women diagnosed with breast cancer, 25.2% had used MBM in the past 12months. Spiritual meditation (14.3%), followed by yoga (9.6%), and mindfulness meditation (4.3%) were the most commonly used MBM approaches for women with breast cancer diagnosis. Only higher education independently predicted the use of MBM among them. In this nationally representative sample of the USA, the most common used MBM approach was spiritual meditation, while this approach is much less researched than the evidence based approaches of yoga and mindfulness meditation. Especially stressed individuals worldwide could benefit from MBM the literature suggests. Particularly in the acute survivorship stage, influencing the initial stress reaction could be beneficial.

Applying the Conservation of Resources Theory to the Psychological Stress Experienced by a Random Sample of Americans With Multiple Sclerosis

Multiple sclerosis (MS) is a chronic, unpredictable neurological disorder whose wide ranging symptoms and capricious disease course are known to produce considerable psychological stress. This study applied the Conservation of Research theory in building a prediction model to explain variability in perceived stress and coping within a sample of Americans with MS. The study sample consisted of 1,114 people with MS, 219 men (20%) and 895 women (80%), who participated in a national survey of the employment and psychosocial concerns of Americans with MS. Primarily Caucasian (75%), participants ranged in age from 20 to 87 years (M= 50.57,SD= 10.31). A backward stepwise multiple regression analysis revealed that women; non-Caucasians; younger people; those who had more difficulties meeting their financial obligations and who were less satisfied with their housing situations; people who reported lower levels of community and social life engagement; and those whose MS resulted in higher numbers of reported symptoms, lower levels of residual cognitive functioning, and lower levels of mobility impairment reported higher levels of perceived stress than did other participants. The aggregated predictors explained 41% of the variability in participants' stress ratings. The findings demonstrate the complexity in predicting how the onset and progression of MS affects an individual's psychological functioning.

The use of mind-body medicine among US individuals with sleep problems: Analysis of the 2017 National Health Interview Survey data

Abstract Background Being a major health risk and very prevalent in the population, sleep problems are an important health care issue. Methods We used the 2017 National Health Interview Survey (NHIS) to study the prevalence of sleep problems and the use of mind body medicine (MBM) among individuals with sleep problems in a representative sample of the US population (N = 26,742). Using chi-squared tests and backward stepwise multiple logistic regression analyses, predictors of sleep problems and of MBM use in the past 12 months were identified. Results The prevalence of sleep problems was 49.3%, with higher prevalence being associated with higher age, being female, being non-Hispanic White, and higher education. Among individuals with sleep problems, 29.8% used MBM vs. only 17.5% without. Being less than 30 years of age, female, non-Hispanic White, living in the Western US, having a higher education, and being diagnosed with heart disease predicted MBM use among individual's with sleep problems. Yoga (16.3%), spiritual meditation (13.6%), and mindfulness meditation (7.5%) were the most used MBM approaches. Conclusion The characteristics of individuals with sleep problems were largely in line with the literature, while notably Whites were more prone to sleep problems than other ethnicities. MBM treatments commonly used were yoga, spiritual meditation and mindfulness meditation; although evidence supports its use for sleep problems, tai chi was used rarely by the wider population. Further studies should explore reasons for ethnical differences in MBM use and why some effective MBM approaches are not commonly used.

The use of mind-body medicine among US individuals with sleep problems: analysis of the 2017 National Health Interview Survey data

BackgroundBeing a major health risk and very prevalent in the population, sleep problems are an important health care issue. MethodsWe used the 2017 National Health Interview Survey (NHIS) to study the prevalence of sleep problems and the use of mind body medicine (MBM) among individuals with sleep problems in a representative sample of the US population (N = 26,742). Using chi-squared tests and backward stepwise multiple logistic regression analyses, predictors of sleep problems and of MBM use in the past 12 months were identified. ResultsThe prevalence of sleep problems was 49.3%, with higher prevalence being associated with higher age, being female, being non-Hispanic White, and higher education. Among individuals with sleep problems, 29.8% used MBM vs. only 17.5% without. Being less than 30 years of age, female, non-Hispanic White, living in the Western US, having a higher education, and being diagnosed with heart disease predicted MBM use among individual's with sleep problems. Yoga (16.3%), spiritual meditation (13.6%), and mindfulness meditation (7.5%) were the most used MBM approaches. ConclusionThe characteristics of individuals with sleep problems were largely in line with the literature, while notably Whites were more prone to sleep problems than other ethnicities. MBM treatments commonly used were yoga, spiritual meditation and mindfulness meditation; although evidence supports its use for sleep problems, tai chi was used rarely by the wider population. Further studies should explore reasons for ethnical differences in MBM use and why some effective MBM approaches are not commonly used.

Forest Structure and Composition Affect Bats in a Tropical Evergreen Broadleaf Forest

The lack of knowledge regarding many aerial insectivorous bats and their relationships with forest characteristics limits conservation decision-making for tropical rainforests and for this important bat group. Therefore, our objective was to understand the effects of forest structure and composition on these bats in the Neotropical evergreen broadleaf forest of Belize, Central America. We conducted bat monitoring and quantified 51 forest characteristics at 24 locations in the Chiquibul Forest Reserve (CFR) from May–July 2014. Simple linear and backward stepwise multiple regression analyses were used to examine relationships between bat richness and activity and forest characteristics. Bat genus richness and total activity were directly related to overstory canopy depth and inversely related to ≤4 structural characteristics. Lasiurus, Myotis, Promops, and Pteronotus spp. were affected by ≤7 forest characteristics; the responses were explained by preferences for less-cluttered, open space for flying and foraging and species-specific food and cover requirements. However, bat richness and activity were often unaffected by forest structure and composition in the CFR, suggesting that at this taxonomic level, bats may not be very sensitive to variation in forest characteristics, may not be very useful indicators of alteration, and may have some tolerance for disturbance and change.