Binomial Logistic Regression Research Articles

Socioeconomic Determinants of Household Access to HIV/AIDS Healthcare in Kibra Sub-County, Nairobi County, Kenya

This study examined the impact of social and economic factors on the uptake of HIV/AIDS care in Kibra Sub County, Nairobi. The research was grounded in Behavioral theory and focused on how household income, literacy levels, and access to health information influenced the adoption of HIV/AIDS treatment. A descriptive survey design approach was employed, involving a sample of 365 households chosen through simple random and stratified sampling techniques from target population of 61,690 households, as outlined by Krejcie and Morgan's formula. Data collection was carried out using key informant interviews and self-administered questionnaires. Descriptive techniques, such as frequency and median analysis, as well as inferential techniques, such as bivariate correlation analysis, chi-square testing, and binomial logistic regression, were used. The results were displayed using tables, graphs, and percentages. Thematic analysis was also used to examine qualitative data in order to find new topics. The analysis revealed a strong positive relationship between access to health information and the likelihood of seeking treatment. Households with higher income and literacy levels were more likely to pursue HIV/AIDS care. Quantitative results showed that access to HIV-related information increased the likelihood of treatment uptake by 6.666 times. Additionally, increased household income and higher literacy levels were linked to a 7.434-fold and 3.554-fold rise, respectively, in the probability of seeking care. The study concluded that socio-economic factors, particularly income, literacy, and information access, significantly influenced healthcare-seeking behaviors in Kibra. To enhance access to HIV/AIDS treatment, it is recommended that policymakers, NGOs, and other stakeholders implement targeted interventions, including income-generating programs and comprehensive health education, to address the socio-economic barriers that hinder healthcare uptake.

Using the Health Belief Model to Understand Why Making Oral HIV Self-Testing Available to Truck Drivers in Kenya Had Little Impact on Six-Month Testing.

Research has found that offering HIV self-testing (HIVST) to truckers in Kenya increased testing rates at baseline but not over 6-month follow-up. We explored possible explanations based on the Health Belief Model by assessing HIV risk perception, self-efficacy, and fatalism as possible effect modifiers of the impact of offering HIVST (intervention n = 150) versus standard of care (SOC n = 155) on 6-month testing on the multiplicative and additive scales using log binomial and linear binomial regression and stratifying on significant modifiers. We found significant interaction between the intervention and fatalism on both the multiplicative (p = 0.020) and additive (p = 0.020) scales. In the stratified models, the HIVST intervention was associated with higher HIV testing among participants with low fatalism but lower testing among those with high fatalism (risk ratio [RR] = 1.30, p = 0.065 versus RR = 0.74, p = 0.072; risk difference [RD] per 100 = 14.00, p = 0.080 versus RD=-14.69, p = 0.086). Truckers in Kenya are described as being highly fatalistic, feeling lack of control over their lives and health. We found that fatalistic views negated the potential benefit of offering HIVST to truckers. For HIVST to have an impact among truckers, psychosocial interventions may be needed that address fatalistic views.

Rebozo and advanced maternal postures: A promising set of intrapartum interventions to reduce persistent occiput posterior position of the fetal head.

Spinning Babies® procedures and the Rebozo technique have been recently implemented as additional interventions in laboring women with a fetus in occiput posterior position (OPP) to favor the rotation to an anterior position, which improve birth experience and health outcomes. Our study aimed to compare the probability of occurrence of persistent OPP (POPP) of the fetal head at the second stage of labor between retrospective and prospective cohorts and to assess associated sociodemographic, obstetric and intrapartum factors. We conducted a combined prospective and retrospective cohort study including 1500 women giving birth in 2017 (retrospective cohort) and 779 between 15 May and 15 December 2023 (prospective cohort). Each cohort was divided into two sub-cohorts depending on presence of OPP. Primary outcomes were compared the probability of occurrence of POPP in the two OPP sub-cohorts by a log binomial regression and logistic regression. A p<0.05 was considered statistically significant. Data analysis was performed using Stata/MP18.0. The proportion of OPP at the onset of labor was similar between the two cohorts (34.9% vs 35.1%). The probability of occurrence of POPP was significantly lower in the prospective OPP sub-cohort (27.7%, n=65/235) compared to the retrospective OPP sub-cohort (35.8%, n=154/430) (risk difference, RD= -0.081; 95% CI: -0.15 - -0.008; p=0.031). In the retrospective OPP sub-cohort, maternal age ≥35 years (RD=0.096; 95% CI: 0.001-0.190, p=0.044) and nulliparity (RD= -0.100; 95% CI: -0.190 - -0.001, p=0.036) were significantly associated with the probability of POPP. Our findings suggest a potential benefit of a set of interventions combining Spinning Babies® and the Rebozo technique in decreasing the probability of POPP.

Impacts of human behaviors involving sound and light exposure in sleep environments on sleep and mental disorders: A cross-sectional study

Creating an optimal sleeping environment is essential. Few studies have examined how common individual behaviors alter the daily sleep environment and the subsequent health impacts of these changes among the general population. This study presented a cross-sectional analysis of 13,157 Chinese college students, utilizing binomial logistic regression models and mediation effect analysis to elucidate the associations between human behaviors involving sound and light exposure in sleep environments and outcomes related to sleep disorders, depression, and anxiety. Our results indicated that noise exposure, listening to white noise and content-based audio (audiobooks, crosstalk, and radio) before sleep, watching electronic screens in a dim environment, using noise-canceling tools during sleep, adjusting room light to be on during sleep, and using light-blocking tools during sleep was associated with an increased risk of sleep disorders by 54.9–343.4 %. The risk of mental disorders increased by 0.325–4.379 times. Pathetic (odds ratio (OR) = 1.568) and stirring music (OR = 1.279) were associated with a higher risk of sleep disorders, while gentle music was correlated with a lower risk (OR = 0.842). Additionally, warm light and gentle/cheerful music were associated with lower depression and anxiety risks (OR = 0.635–0.733). Sleep quality was found to partially mediate the relationship between these human behaviors and mental disorders, and mental disorders also mediated the relationship between these behaviors and sleep disorders. The research findings offer a scientific foundation for optimizing sleeping environments through behavior control.

Chronic Overlapping Pain Conditions in people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): a sample from the Multi-site Clinical Assessment of ME/CFS (MCAM) study

BackgroundChronic overlapping pain conditions (COPCs), pain-related conditions that frequently occur together, may occur in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and could impact illness severity. This study aimed to identify comorbid COPCs in patients with ME/CFS and evaluate their impact on illness severity.MethodsWe used data from 923 participants in the Multi-Site Clinical Assessment of ME/CFS study, conducted in seven U.S. specialty clinics between 2012 and 2020, who completed the baseline assessment (595 ME/CFS and 328 healthy controls (HC)). COPCs included chronic low back pain (cLBP), chronic migraine/headache (cMHA), fibromyalgia (FM), interstitial cystitis/irritable bladder (IC/IB), irritable bowel syndrome (IBS), temporomandibular disorder (TMD). Illness severity was assessed through questionnaires measuring symptoms and functioning. Multivariate analysis of variance and analysis of covariance models were used for analyses. Log-binomial regression analyses were used to compute prevalence of COPCs and prevalence ratios (PR) between groups with 95% confidence intervals. Both unadjusted and adjusted results with age and sex are presented.Results76% of participants with ME/CFS had at least one COPCs compared to 17.4% of HC. Among ME/CFS participants, cMHA was most prevalent (48.1%), followed by FM (45.0%), cLBP (33.1%), and IBS (31.6%). All individual COPCs, except TMD, were significantly more frequent in females than males. The unadjusted PR (ME/CFS compared to HC) was highest for FM [147.74 (95% confidence interval (CI) = 20.83-1047.75], followed by cLBP [39.45 (12.73-122.27)], and IC/IB [13.78 (1.88-101.24)]. The significance and order did not change after age and sex adjustment. The COPC comorbidities of cLBP and FM each had a significant impact on most health measures, particularly in pain attributes (Cohen’s d effect size 0.8 or larger). While the impact of COPC comorbidities on non-pain attributes and quality of life measures was less pronounced than that on pain, statistically significant differences between ME/CFS participants with and without COPCs were still evident.ConclusionsMore than 75% of ME/CFS participants had one or more COPCs. Multiple COPCs further exacerbated illness severity, especially among females with ME/CFS. Assessment and management of COPCs may help improve the health and quality of life for patients with ME/CFS.

The Added Value of Controlling Nutritional Status (Conut) Score for Preoperative Counselling on Significant Early Loss of Renal Function After Radical Nephrectomy for Renal Cell Carcinoma

Background and Objectives: We aimed at evaluating the impact of Controlling Nutritional Status (CONUT) score on clinically significant decline in estimated glomerular filtration rate (eGFR) in patients with non-metastatic Clear Cell Renal Cell Carcinoma (ccRCC) undergoing radical nephrectomy (RN). Materials and methods: We retrospectively analyzed a multi-institutional cohort of 140 patients with ccRCC who underwent RN between 2016 and 2018 at three Urological Centers. The CONUT score was calculated with an algorithm including serum albumin, total lymphocyte count, and cholesterol. Clinical and pathologic features were analyzed using Fisher’s exact test for categorical variables and a Mann–Whitney U test for continuous variables. To define the independent predictors of clinically significant eGFR decline, univariable (UVA) and multivariable (MVA) binomial logistic regression analyses were performed in order to assess the Odds Ratio (OR) with 95% Confidence Intervals (CIs). Results: The optimal cut-off value to discriminate between a low and high CONUT score was assessed by calculating the ROC curve. The area under the curve (AUC) was 0.67 (95%CI 0.59–0.78) with the most appropriate cut-off value at 2 points. Overall, 46 patients (32.9%) had a high CONUT score (&gt;2). Statistically significant variables associated with eGFR decline at 24 months were age ≥ 70 (OR 2.01; 95%CI 1.17–3.09; p 0.05), stage II–III chronic kidney disease (CKD) (OR 6.05; 95%CI 1.79–28.3; p 0.001), and a high CONUT score (OR 3.98; 95%CI 1.58–10.4; p 0.004). Conclusions: The CONUT score is a low-time-consuming, cost-effective, and promising tool able to preoperatively screen patients at risk of developing CKD after a RN.

Association of housing tenure and unaffordable housing with preterm birth and other adverse birth outcomes in Canada: a population-based study

BackgroundSocioeconomic risk factors are known drivers of adverse birth outcomes. Housing is a key target for policy interventions.ObjectiveTo estimate the associations of housing tenure (renting vs owning) and unaffordable housing...

Prevalence and predictors of indoor secondhand tobacco smoke exposure among Senegalese household population

ABSTRACT Indoor secondhand tobacco smoke (SHS) exposure imposes substantial health risks among all household members, including children. Earlier studies reported high tobacco use in West African country Senegal. Despite the high health risks, no recent study has presented the situation of indoor SHS exposure in Senegal. Using cross-sectional design, we assessed the prevalence and predictors of indoor SHS exposure in Senegal. We used recent demographic and health survey (DHS) 2023 data of 75,080 household members of all ages. Analyzing these data, the prevalence of indoor SHS was assessed, and binomial logistic regression was used to identify predictors of indoor SHS exposure. The prevalence of indoor SHS exposure in Senegal was 24% (95% CI 23.5–24.2). Females, compared to males, were less likely to get indoor SHS exposure (aOR 0.9; 95% CI 0.8–0.9). Compared to the urban population, rural residents were less likely to get indoor SHS exposure (aOR 0.8; 95% CI 0.7–0.8). Individuals lived in households where members experienced shock events (aOR 1.2; 95% CI 1.1–1.2) and had members with psychological issues (aOR 1.5; 95% CI 1.4–1.6) were more susceptible to indoor SHS exposure. We conclude that indoor SHS exposure is high, particularly among Senegalese males, urban residents, and the poorest wealth quintiles. Additionally, susceptibility to indoor SHS increases with the presence of stressors like past adverse shock events and mental health issues. Both of these stressors encourage indoor smoking and intensify the risk of indoor SHS exposure among all household members. Community-based interventions providing behavior change communication on quitting tobacco and preventing indoor smoking are recommended.

Hidradenitis Suppurativa and Maternal and Offspring Outcomes

Hidradenitis suppurativa (HS) is associated with morbidity in persons of reproductive age, but the effect on maternal and offspring outcomes is understudied. To determine the association of HS with pregnancy outcomes and maternal and child morbidity in the long term. This population-based longitudinal cohort study with up to 16 years of follow-up took place between 2006 and 2022 in Quebec, Canada. . Maternal HS. Outcomes included hypertensive disorders of pregnancy, gestational diabetes, and other birth outcomes as well as the long-term risk of hospitalization up to 16 years after delivery. The study used adjusted log-binomial and Cox proportional hazards regression models to estimate the association between maternal HS and pregnancy outcomes or hospitalization following pregnancy. Outcomes in both mothers and offspring were assessed. There were 1 324 488 deliveries during the study, including 1332 (0.1%) among mothers with HS. Compared with patients without HS, patients with HS had a greater risk of hypertensive disorders of pregnancy (risk ratio [RR], 1.55 [95% CI, 1.29-1.87]), gestational diabetes (RR, 1.61 [95% CI, 1.40-1.85]), and severe maternal morbidity (RR, 1.38 [95% CI, 1.03-1.84]). In neonates, maternal HS was associated with risk of preterm birth (RR, 1.28 [95% CI, 1.07-1.53]) and birth defects (RR, 1.29 [95% CI, 1.07-1.56]). In the long term, HS was associated with 2.29 times the risk of maternal hospitalization (95% CI, 2.07-2.55) and 1.31 times the risk of childhood hospitalization (95% CI, 1.18-1.45), including hospitalization for respiratory, metabolic, psychiatric, and immune-related morbidity over time. This cohort study found that HS is associated with adverse maternal and offspring outcomes in the peripartum period and in the long term. Early detection and management of HS may help mitigate these outcomes.

Surgical removal of tonsils and risk of COVID-19: a nested case–control study using data from UK Biobank and AMORIS Cohort

BackgroundTo investigate the association between surgical removal of tonsils and risk of COVID-19 with different severity.MethodsThrough a nested case–control study during January 31st to December 31st 2020, including 58,888 participants of the UK Biobank, we investigated the association of tonsillectomy with the future risk of mild and severe COVID-19, using binomial logistic regression. We further examined the associations of such surgery with blood inflammatory, lipid and metabolic biomarkers to understand potential mechanisms. Finally, we replicated the analysis of severe COVID-19 in the Swedish AMORIS Cohort (n = 451,960).ResultsTonsillectomy was associated with a lower risk of mild (odds ratio [95% confidence interval]: 0.80 [0.75–0.86]) and severe (0.87 [0.77–0.98]) COVID-19 in the UK Biobank. The associations did not differ substantially by sex, age, Townsend deprivation index, or polygenic risk score for critically ill COVID-19. Levels of blood inflammatory, lipid and metabolic biomarkers did, however, not differ greatly by history of surgical removal of tonsils. An inverse association between tonsillectomy and severe COVID-19 was also observed in the AMORIS Cohort, primarily among older individuals (> 70 years) and those with ≤ 12 years of education.ConclusionsSurgical removal of tonsils may be associated with a lower risk of COVID-19. This association is unlikely attributed to alterations in common blood inflammatory, lipid and metabolic biomarkers.

Economic costs of poor PSC manifest in sickness absence and voluntary turnover

Abstract Work-related stress is a major occupational health and safety (OHS) issue that has industrial relations origins. Aside from the moral and human rights imperatives to improve the corporate climate for worker psychological health (as per psychosocial safety climate, PSC), there are strong economic costs for not doing so. PSC refers to worker perceptions of the corporate safety system to protect and promote workers’ psychological health and wellbeing. It is a leading indicator of working conditions, which in turn affect workers’ health and work engagement. In this study, we estimate the attributable economic cost of low PSC due to sickness absence and turnover. Data were collected from a multinational company using survey at Time 1 (T1) and objective company data (i.e., sickness absence and turnover) after one year (T2). Using regression analysis and a matched sample of 617 responses, PSC was negatively related to future sickness absence. A binomial logistic regression with 1268 respondents (i.e., all responses at T1) showed that PSC was negatively related to future voluntary turnover. An economic analysis suggests that improving OHS via PSC could save an organisation with 5000 employees USD 0.6–2.7 million per year. Building PSC to protect and promote workers’ psychological health is a likely economic saving on organisational productivity.

Advancing Equity in Rare Disease Research: Insights From the Undiagnosed Disease Network.

Rare diseases affect 6%-8% of the population and present diagnostic challenges, particularly for historically marginalized ethnic and racial groups. The Undiagnosed Diseases Network (UDN) aims to enhance diagnosis rates and research participation among such minoritized groups. Aretrospective review was conducted from 2015 to 2023, analyzing2235 UDN participants to evaluate its progress toward this objective. Data on demographics, disease phenotypes, diagnostic outcomes, and socioeconomic factors were collected and statistical analyses assessed differences among ethnic and racial groups. This demonstrated that Hispanic and Black non-Hispanic groups were underrepresented, while White non-Hispanic participants were overrepresented in the UDN compared to the US population. Individuals whose primary language was not English were also significantly underrepresented. Diagnosis rates varied, with the highest rates among Asian non-Hispanic (39.5%) and Hispanic (35.3%) groups and the lowest rate in the White non-Hispanic group (26.8%) (p < 0.001). Binomial logistic regression found, however, that only participant age and disease phenotype predicted the likelihood of receiving a diagnosis (p < 0.001). Persistent ethnic and racial disparities in UDN participation appear to be associated with major differences in application rates. Under-enrollment of historically marginalized ethnic and racial groups may be due to economic hardships and language barriers. No differences in the diagnostic yield among ethnic and racial groups were observed after controlling for other factors. This work highlights the value of comprehensive genetic evaluations for addressing healthcare disparities and suggests priorities for advancing inclusion in rare disease research.

Epidural analgesia in the perioperative period and mean arterial pressure as risk factors for postoperative complications after pancreaticoduodenectomy

Objective. To study the influence of epidural analgesia and mean arterial pressure as risk factors for the development of postoperative pancreatic fistula, delayed evacuation of gastric contents and postpancreatic bleeding after pancreaticoduodenectomy. Materials and Methods. The retrospective study included 234 patients who underwent pancreaticoduodenectomy at the National Research Center of Surgery and Transplantation named after O. O. Shalimov from January 2022 to November 2023. The surgical intervention included a standard pancreaticoduodenectomy according to the modified Child's technique. The objective was to evaluate the optimal approach to anesthesia and blood pressure management to minimize the risk of postoperative complications. Data were collected on the type of anesthesia (general anesthesia or a combination of general anesthesia and epidural analgesia), mean arterial pressure, use of vasopressors, and the incidence of postoperative complications. The analysis was performed using logistic–binomial regression to assess the risk of complications depending on the level of blood pressure and the use of epidural analgesia. Results. The combined use of epidural analgesia and general anesthesia was associated with a decrease in the incidence of clinically significant postoperative pancreatic fistula, delayed evacuation of gastric contents, and other complications. Epidural analgesia, although associated with an increased risk of hemodynamic instability, contributed to better pain control and a reduction in the incidence of postoperative complications. A decrease in mean arterial pressure by each 1 mm Hg increases the risk of postoperative pancreatic fistula by 15.8%, which confirms the importance of maintaining an adequate level of pressure to ensure optimal tissue perfusion. Despite the hypothesis of a possible negative effect of vasopressors, their use did not show a statistically significant association with the incidence of postoperative pancreatic fistula. Thus, further studies are needed to clarify the optimal parameters of patient management after pancreaticoduodenectomy.

Built environment predictors of walking to school in a sprawled city

ABSTRACT Walking to school may provide a regular source of daily physical activity and help to reduce the prevalence of obesity, but walking has been on the decline for decades globally; this is particularly true in Saudi Arabia, especially with the major increase in auto-dependency. This cross-sectional study of students aged 6–18 from 57 schools collected 1218 responses to examine the potential associations between the built environment and walking to school in a sprawled city, namely Najran city, Saudi Arabia. Binomial logistic regression was used to highlight important built environment predictors of walking to school. The results showed that across all participating schools, the average proportion of students walking to school was 19%. Also, the findings of the study further revealed that several built environment attributes were associated with walking to school. Walking to school was positively associated with signalized intersections, distance to the central business district (CBD), increased commercial land use, the precence of a parking lot in front of the school and denser areas within the school neighborhood. However, walking to school is also negatively associated with commuting distance, the presence of industrial use, and the presence of hilly streets in school neighborhood. No significant correlations were found between walking to school and the population density of the individual student’s home neighborhood or the number of intersections, parks, streets, and speed bumps in the school neighborhood. Overall, the findings of this study can be used to guide and support the development of new policies to improve pedestrian infrastructure and establish new, smaller schools within some neighborhoods to increase active and safe commuting to schools in Najran city, Saudi Arabia.

Choosing a flat rate over a pay-per-use tariff for public transport: Do psychological factors matter?

We investigate the relationship between various psychological factors (taximeter effect, flexibility effect, cost control effect, pre-commitment effect), annual distance traveled, and public transport tariff preferences (pay-per-use vs. flat rate). While a pay-per-use tariff entails ticket prices depending on usage intensity, a flat rate involves an annual public transport subscription covering all journeys within a year. Drawing from a sample of 3,381 Swiss public transport customers utilizing either the pay-per-use option or holding a flat-rate subscription, a binomial logistic regression highlights that the number of passenger kilometers traveled (pkm) predominantly influences the choice of a flat rate. However, the examined psychological factors also significantly shape decision-making. Notably, these effects vary based on the quantity of the product consumed. Specifically, both the taximeter and cost-control effects tend to increase with pkm. Conducting a simulation using binomial logistic regression, we illustrate how different psychological factors are related to the likelihood of opting for a flat-rate subscription. The findings suggest that the level of importance of the psychological factors are relevant to predict the odds of selecting a flat-rate subscription. Hence, emphasizing product advantages in marketing communications and strategically adjusting product design to leverage these psychological factors emerge as effective strategies for enhancing sales promotion and fostering customer loyalty. These results offer insights into consumer psychology and decision-making within the transportation sector. The implications are particularly valuable for managers aiming to address barriers to public transport use. By strategically refining ticket product ranges, managers can actively contribute to reducing CO2 emissions through induced modal shifts.

Volleyball: similar game for men and women? Factors characterising successful performance in Olympic Games 2021 regarding genders

ABSTRACT The goal of this study was to survey the effectiveness of the factors characterising successful performance in volleyball between men and women in games played in the Olympic Games 2021 tournaments. Seventy-six matches (38 matches per gender) were sampled, and data were collected from N = 560 sets (N = 292 for men and N = 268 for women). Principal component analysis was conducted on 15 performance indicators with orthogonal rotation (varimax). The principal component scores saved from the analysis were run in binomial logistic regression (Win/Loss) forced entry regression analysis using a data splitting method on a random selection of 50% of the data (training and test sample). The models produced were then used to predict the probability of winning the set using the same variables for the remaining 50% data. The results provide evidence that between genders there are common important factors which affect the evolution of a set and therefore if improved can increase the probability of winning, however with the same level of improvement, the odds differentiate per gender. These findings and inferences can be used as guidelines for coaches of teams of both genders concerning the skills that require further improvement.

Food Insecurity and Women's Choice of Reversible Contraceptives: Differential Effects by Maternal Age.

We investigated the relationships between food insecurity (FI) and women's choice of reversible contraceptives, overall and according to the level of method effectiveness, among partnered women of reproductive age in Nigeria. This population-based cross-sectional analysis used nationally representative data from Round 6 of the UNICEF-supported Multiple Indicator Cluster Survey (MICS) conducted in Nigeria. The sample included married or in-union women aged 15-49 years who reported a live birth in the last 2 years preceding the survey (unweighted N = 8496). Survey-weighted multivariable binomial and multinomial logistic regression analyses were performed to generate estimates of the association between FI (none, moderate, and severe) and reversible contraceptive use (overall and by method effectiveness). A Bonferroni correction was used to account for multiple testing. We stratified the models by maternal age to describe the experiences of women aged 15-24 years, 25-34 years, and 35-49 years. Overall, 6438 (74.1%) of the women in the sample experienced food insecurity (moderate, n = 2559, 30.7%; severe, n = 3879, 43.4%). In the adjusted model, we observed no statistically significant association between experiencing MFI and SFI and the use of reversible contraceptives (overall and specific) after adjustment for multiple testing. The stratified analyses showed that among women aged 25-34 years in the sample, those experiencing SFI in the past 12 months, compared to their food-secure counterparts, had significantly lower odds of reporting the use of a least effective contraceptive method (OR, 0.53; 95% CI, 0.34-0.83; p = 0.0052). However, this failed to reach the significance threshold upon adjustment for multiple testing. We found no significant association between the FI levels and use of reversible contraceptives (overall and specific) among partnered women (15-49 years) in Nigeria who were 2 years postpartum following a live birth and who were at risk of pregnancy.

Influence of Household Socio-Economic, Demographic, And Cultural Factors on Women's Access to Maternal Healthcare in Malindi Sub County, Kilifi County, Kenya

Globally, maternal healthcare access remains a critical concern due to significant disparities, particularly in developing countries where access rates are notably lower. The Sustainable Development Goals underscore the importance of prioritizing maternal health, urging nations to improve access to maternal healthcare services. However, various factors hinder full access to such services. This study investigated the influence of social and economic factors on household access to maternal healthcare in Malindi Sub County, Kilifi County. Specifically, it examined the impact of income levels, literacy rates, parental age, and religious beliefs. The study, grounded in the Behavioral Model of Healthcare Service Utilization, Maternal Morbidity Measurement (MMM), and the Three Delay Theory, employed a descriptive survey design approach. A sample size of 382 respondents was determined using the Krejcie and Morgan’s (1970) formula from a population of 73,547 households. Stratified sampling was employed to divide the sub-county into five strata based on wards, selecting households with mothers accessing maternal health services using purposive sampling. Additionally, twenty respondents were purposively chosen for key informant interviews. Because the dependent variable in the questionnaire was binary (access to maternal healthcare was either yes or no), the study used binomial logistic regression modeling to ascertain the influence of income levels, literacy levels, parental age and religious beliefs on the access to maternal healthcare. Income levels, with a coefficient of 2.236 (p-value = 0.007), literacy levels, with a coefficient of 1.981 (p-value = 0.002), and religious beliefs, with a coefficient of 1.004 (p-value = 0.037), were identified as significant factors positively influencing access to maternal healthcare. Conversely, parental age demonstrated a significant negative impact on access, with a coefficient of -1.262 (p-value = 0.004). The study concludes that socioeconomic status, education, and religious beliefs significantly influence maternal healthcare access, with a particular concern regarding diminished access as parental age increases. Consequently, this research emphasizes the critical need for targeted interventions to alleviate these disparities, recommending economic empowerment for women with lower income levels, health literacy education initiatives for vulnerable populations, and a multimodal approach to address cultural barriers and support both younger and older mothers in accessing healthcare services.

Psychological Distress Among Ethnically Diverse Participants From Eastern and Southern Africa

Psychological distress is characterized by anxiety and depressive symptoms. Although prior research has investigated the occurrence and factors associated with psychological distress in low- and middle-income countries, including those in Africa, these studies' findings are not very generalizable and have focused on different kinds of population groups. To investigate the prevalence and characteristics (sociodemographic, psychosocial, and clinical) associated with psychological distress among African participants. This case-control study analyzed data of participants in the Neuropsychiatric Genetics in African Populations-Psychosis (NeuroGAP-Psychosis) study, which recruited from general outpatient clinics in Eastern (Uganda, Kenya, and Ethiopia) and Southern (South Africa) Africa. Individuals who participated in the control group of NeuroGAP-Psychosis from 2018 to 2023 were analyzed as part of this study. Data were analyzed from May 2023 to January 2024. The prevalence of psychological distress was determined using the Kessler Psychological Distress Scale (K10), which measures distress on a scale of 10 to 50, with higher scores indicating more distress. Participants from the NeuroGAP-Psychosis study were categorized into cases as mild (score of 20-24), moderate (score of 25-29), and severe (score of 30-50), and participants with scores less than 20 were considered controls. Factors that were associated with psychological distress were examined using binomial logistic regression. From the data on 21 308 participants, the mean (SD) age was 36.5 (11.8) years, and 12 096 participants (56.8%) were male. The majority of the participants were married or cohabiting (10 279 participants [48.2%]), most had attained secondary education as their highest form of learning (9133 participants [42.9%]), and most lived with their families (17 231 participants [80.9%]). The prevalence of mild, moderate, and severe psychological distress was 4.2% (869 participants), 1.5% (308 participants), and 0.8% (170 participants), respectively. There were 19 961 participants (93.7%) who served as controls. Binomial logistic regression analyses indicated that the independent associations of psychological distress were experience of traumatic events, substance use (alcohol, tobacco, or cannabis), the physical comorbidity of arthritis, chronic neck or back pain, and frequent or severe headaches. In this case-control study among ethnically diverse African participants, psychological distress was associated with traumatic stress, substance use, and physical symptoms. These findings were observed to be consistent with previous research that emphasizes the importance of traumatic events as a factor associated with risk for psychopathology and notes the frequent co-occurrence of conditions such as physical symptoms, depression, and anxiety.

Effect of Work-related Stress on Breast Milk Feeding Beyond 6 Month of the Baby, among the Nursing Personnel: A Cross Sectional Study

Abstract Background: The largest drop in continuing breast milk feeding occurs with the return of the lactating mothers to work. Stress amongst the working mothers affects milk production. Nursing is a stressful job and work-related stress impacts nurses’ health-related quality of life. The effect of work-related stress on breast milk feeding beyond 6 months of the baby amongst nursing mothers is an unexplored area. Objectives: (a) To assess the work-related stress, (b) to estimate the proportion of discontinued breast milk feeding beyond 6 months of the baby and (c) to find out the association (if any) between work-related stress and discontinuation of breast milk feeding beyond 6 months, amongst the nursing personnel of Siliguri subdivision of Darjeeling district. Materials and Methods: A cross-sectional study was carried out amongst the eligible study population using a work-related stress questionnaire. Chi-square test was done as a test of association and binomial logistic regression was used to find out the adjusted odds ratio (AOR). Results: Work-related stress was present in 62.4% of the respondents, while 70.9% had discontinued breastfeeding beyond 6 months. 79.5% of respondents with work-related stress had discontinued breastfeeding. Nursing staffs having work-related stress had higher odds of discontinuing breastfeeding (AOR: 3.682; confidence interval: 1.4035–9.659). Conclusion: Work-related stress is present in a large proportion of nursing staffs and many of them have discontinued breast milk feeding beyond 6 months of age of their babies, which is influenced by work-related stress.