Important Background Characteristics Research Articles

Predictors of neonatal mortality in Ghana: evidence from 2017 Ghana maternal health survey

BackgroundNeonatal mortality contributes about 47% of child mortality globally and over 50% of under-5 deaths in Ghana. There is limited population level analysis done in Ghana on predictors of neonatal mortality.ObjectivesThe objective of the study was to examine the predictors of neonatal mortality in Ghana.MethodThis study utilizes secondary data from the 2017 Ghana Maternal Health Survey (GMHS). The GMHS survey focuses on population and household characteristics, health, nutrition, and lifestyle with particular emphasis on topics that affect the lives of newborns and women, including mortality levels, fertility preferences and family planning methods. A total of 10,624 respondents were included in the study after data cleaning. Descriptive statistical techniques were used to describe important background characteristics of the women and Pearson’s Chi-squares (χ2) test used to assess association between the outcome (neonatal death) and independent variables. Multivariate logistic regression analysis was done to estimate odd ratios and potential confounders controlled. Confidence level was held at 95%, and a p < 0.05 was considered statistically significant. Data analysis was done using STATA 15.ResultsThe prevalence of neonatal mortality was 18 per 1000 live births. ANC attendance, sex of baby, and skin-to-skin contact immediately after birth were predictors of neonatal mortality. Women with at least one ANC visit were less likely to experience neonatal mortality as compared to women with no ANC visit prior to delivery (AOR = 0.11; CI = 0.02–0.56, p = 0.01). Girls were less likely (AOR = 0.68; CI = 0.47–0.98; p = 0.03) to die during the neonatal period as compared to boys. Neonates who were not put skin-to-skin contact immediately after birth were 2.6 times more likely to die within the neonatal period than those who were put skin-to-skin contact immediately after birth (AOR = 2.59; CI = 1.75–3.83, p = 0.00).ConclusionNeonatal mortality remains a public health concern in Ghana, with an estimated rate of 18 deaths per 1,000 live births. Maternal and neonatal factors such as the sex of the newborn, the number of antenatal care visits, and skin-to-skin contact between the newborn and mother immediately after birth are the predictors of neonatal mortality in Ghana.

Evaluation of the Integrated Child Development Services Scheme in a Hilly Tribal District of Manipur: A Cross-Sectional Study

Introduction: The Integrated Child Development Services (ICDS) Scheme, the largest program for promotion of maternal and child health nutrition in India, is operational for more than four decades. Objective: To evaluate Integrated Child Development Services Scheme in Kangpokpi District of Manipur in terms of input, process and outcome indicators. Method: A community-based cross-sectional study was conducted at a tribal hilly district of Kangpokpi in Manipur. The study included ICDS staff and beneficiaries of 35 randomly selected Anganwadi Centres (AWCs). Data related to ICDS was collected by using interview schedules and checklists. The descriptive data were expressed in terms of mean, standard deviation and percentage. Association between important background characteristics and Anganwadi centre attendance was analysed using chi-square test. Ethical clearance was obtained from the institutional Ethic Committee of JNIMS, Imphal before conducting the study (study period: May 2018 to April 2021) Results: Input indicators: The study found that86% anganwadi centres were run in anganwadi worker’s own house. Two-thirds of the anganwadi workers (65.7%) were found to have separate toilet and 22.9% had separate kitchen. Process indicators: Even though the proportions of beneficiaries accessing services from anganwadi centres were high, the number of days Supplementary Nutrition (SN) was provided in a month was comparatively low (mean: 2.97 and SD: 0.618 for under-6 children and mean: 1 and SD: 0.000 days for adolescent girls, pregnant women and lactating mother in a month) due to frequent interruption of supplementary nutrition supply. There was no supplementary nutrition stock in 74.3% of the anganwadi centres on the day of visit. Outcome indicators: Regarding the nutritional status 90% of Under-6 children were found to be normal, 9% underweight and 0.6% severely underweight. Conclusion: The Integrated Child Development Services Programme in the study area was found to have several short-comings both in terms of inputs and process. There were not only inadequate facilities and infrastructure, but the anganwadi centres also lacked essential equipment like weighing machines and medicine kits, rendering a vital activity like growth monitoring to be almost completely absent. Supervisory visits were far below satisfactory.

Readmission after index hospital discharge among patients with COVID-19: Protocol for a systematic review and meta-analysis.

Background and AimsHospital readmissions among COVID‐19 patients have increased the load on the healthcare systems and added more pressure to hospital capacity. This affects the ability to accommodate newly diagnosed COVID‐19 patients and other non‐COVID‐19 patients who require hospitalization. Therefore, this systematic review aims to understand the rates of and risk factors for hospital readmissions and all‐cause mortality among COVID‐19 patients who were hospitalized after being discharged following index hospitalization.MethodsOur systematic review protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021232324) and prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis Protocols (PRISMA‐P) 2015 statement. We will search MEDLINE (Ovid), EMBASE (Ovid), MedRxiv, Web of Science (Science Citation Index), ProQuest Coronavirus research database, Cochrane Covid‐19 study register, and WHO COVID‐19: Global literature on coronavirus disease will be identified from December 31, 2019, to May 31, 2021. Two investigators will independently screen titles and abstracts and select studies reporting hospital readmissions among COVID‐19 patients. Further, data extraction and risk of bias assessment will be carried out separately by these independent reviewers. We will extract data on demographics, readmissions, all‐cause mortality, emergency department visits, comorbidities, and factors associated with hospitalization among COVID‐19 patients. Random‐effect meta‐analysis will be performed if homogeneous groups of studies are found. The combined evidence will be further stratified according to important background characteristics if the data allow.DiscussionThis systematic review will summarize the available epidemiological evidence regarding rates of hospital readmissions, comorbidities, and related factors among COVID‐19 patients who were readmitted after index hospitalization. A better understanding of the relationship between patient profiles and the rate of hospitalization will be helpful in the development of guidelines for patient management.

A National Survey on the characteristics of Iranian General Practitioners and Their Preferred Specialty: A Need to Transition toward Preventive Medicine.

Background:The shortage and unbalanced distribution of physicians has adverse effects on the provision of equitable services at all levels of health care and especially at the prevention and primary care levels. The choice of specialty can seriously change the structure and composition of the physician workforce. Therefore, this study aimed to investigate the relationship between background characteristics of Iranian general practitioners' (GPs) and their preferred specialty fields.Methods:In this mixed-method study, first, 12 medical doctors participated in a nominal group technique to determine the most important background characteristics that affect GPs' preferences for specialty selection. In the second phase, we conducted a survey among 680 GPs in six provinces from different geographic regions. We gathered data using a researcher-made checklist and analyzed them using an adjusted multivariate regression.Results:The adjusted analysis showed that being female, being married, being in an older age group, having children, graduation from universities located in the provincial centers, and decision for living and practicing in the less-populated areas were significantly associated with the Iranian GPs' preferences for non-surgical specialties.Conclusions:This study provided evidence that could inform national health workforce policy-makers to avoid unbalanced distribution of physicians and accordingly to ensure the provision of equitable services at all levels of healthcare and especially at the primary care level. Other effective factors on the selection of specialty should be evaluated at the national level using specific surveys and econometrics studies such as discrete selection experiment to move toward preventive medicine.

Coverage evaluation of the universal immunization program in Imphal-East district of Manipur: a cross-sectional study

Background: For the state of Manipur, the evaluated coverage among children as per NFHS-2, NFHS-3 and NFHS-4 were 42.3%, 46.8% and 65.9% respectively. But with the introduction of Mission Indradhanush in December 2014 which aimed in achieving the full immunization coverage to all eligible children over the next five years through special catch-up drives might have helped in improving the coverage. Hence, some improvement is expected by now. To ascertain the current status, the study was taken up. The current study was conducted to evaluate the primary vaccination coverage among children aged 12-23 months. The study also aimed to determine any association between important background characteristics with the vaccination status.Methods: A cross-sectional study was conducted in Imphal East District, Manipur during May 2017 to April 2020 among mothers having 12-23 months old children. 1,309 eligible study-women were selected by using multi-stage sampling technique. Data on their background characteristics, immunization status of the children and vaccination-related details were collected by using a pre-tested interview schedule.Results: The full immunization rate among children was found to be 93%. There was significant association between the immunization status and important background characteristics like place of delivery, order of birth, family income and mother’s educational status.Conclusions: Present study indicated that the full immunization coverage of the district was higher than the national and regional coverage findings. Place of delivery, order of birth, family income and mothers’ low educational status were found to be significantly associated with full immunization coverage.

Neighborhood perception and self-rated health among Mexican American older adults.

The aim of the present study was to assess the relationship between neighborhood perception and poor self-rated health among older Mexican Americans, adjusting for important background characteristics, such as neighborhood ethnic composition and other health conditions. Drawing on the 2004-2005 Hispanic Established Populations for the Epidemiologic Study of the Elderly data (n=1780), the present study used logistic regression to examine the effects of neighborhood perception on poor self-rated health of older Mexican Americans. The results show that participants with a greater positive perception of their neighborhood were less likely to report poor self-rated health, controlling for both socioeconomic status and health status covariates. The findings suggest that positive neighborhood perception serves as an important protective factor in overall health. Geriatr Gerontol Int 2017; 17: 2559-2564.

The prevalence and incidence of carpal tunnel syndrome in US working populations

In the September issue of the Scandinavian Journal of Work, Environment and Health , Dale et al (1) estimated the prevalence and incidence of carpal tunnel syndrome (CTS) by pooling the raw individual-level data of six diverse prospective studies in US working populations. Simply adding up the numbers of participants and events (CTS) from different studies is an inappropriate method to analyze individual participant data as it treats the data as if they were from one large study (2). The analysis should calculate a weighted average for each study and account for the clustering of participants within different studies (2, 3). There was significant between-study heterogeneity. I 2 statistic (4) was 93% [95% confidence interval (95% CI) 88–96%] for both prevalence and incidence. The six studies differed in regard to sample size, age, sex, education, occupation, race, ethnicity, employment duration, body mass index, presence of underlying diseases (such as diabetes, rheumatoid arthritis, and thyroid disease), follow-up length, and method of CTS assessment. The authors neither analyzed the data using an individual participant data meta-analysis (5) nor reported the prevalence and incidence of CTS according to important background characteristics, such as sex, age group, race/ethnicity, education, and occupation. In addition, the prevalence estimates for studies “C” and “E” were miscalculated. Using a random-effects meta-analysis, the pooled prevalence of CTS is 7.09% (95% CI 4.58–10.99%) and the pooled incidence of CTS is 2.94% (95% CI 1.68–5.14%) (figure 1). The point estimates from the aggregated data meta-analyses do not show a major difference with those from simple pooling, but the confidence intervals are wide, indicating major uncertainty.

Feasibility and effectiveness of a targeted diabetes prevention program for 18 to 60-year-old South Asian migrants: design and methods of the DH!AAN study

BackgroundSouth Asian migrants are at particularly high risk of type 2 diabetes. Previous studies have shown that intensive lifestyle interventions may prevent the onset of diabetes. Such interventions have not been culturally adapted and evaluated among South Asians in industrialized countries. Therefore, we have set up a randomized controlled trial to study the effectiveness of a targeted lifestyle intervention for the risk of type 2 diabetes and cardiovascular risk factors among 18 to 60-year-old Hindustani Surinamese (South Asians) in The Hague, the Netherlands. Here we present the study design and describe the characteristics of those recruited.MethodsBetween May 18, 2009 and October 11, 2010, we screened 2307 Hindustani Surinamese (18–60 years old) living in The Hague. We sent invitations to participate to those who had an impaired fasting glucose of 5.6-6.9 mmol/l, an impaired glucose tolerance of 7.8-11.0 mmol/L, a glycated hemoglobin level of 6.0% or more and/or a value of 2.39 or more for the homeostasis model assessment of estimated insulin resistance. In total, 536 people (56.1% of those eligible) participated. People with a higher level of education and a family history of type 2 diabetes were more likely to participate. The control and intervention groups were similar with regard to important background characteristics. The intervention group will receive a culturally targeted intervention consisting of dietary counseling using motivational interviewing and a supervised physical activity program. The control group will receive generic lifestyle advice. To determine the effectiveness, a physical examination (anthropometrics, cardiorespiratory test, lipid profile, and measures of oral glucose tolerance, glycated hemoglobin, and insulin) and interview (physical activity, diet, quality of life, and intermediate outcomes) were carried out at baseline and will be repeated at 1 year and 2 years. The process and the costs will be evaluated.DiscussionThis trial will provide insight into the feasibility and effectiveness of a targeted, intensive, lifestyle intervention for the risk of type 2 diabetes and cardiovascular risk factors among 18 to 60-year-old South Asians.Trial registrationDutch Trial Register: NTR1499

A new test of the construct validity of the CarerQol instrument: measuring the impact of informal care giving

PurposeMost economic evaluations of health care programmes do not consider the effects of informal care, while this could lead to suboptimal policy decisions. This study investigates the construct validity of the CarerQol instrument, which measures and values carer effects, in a new population of informal caregivers.MethodsA questionnaire was distributed by mail (n = 1,100, net response rate = 21%) to regional informal care support centers throughout the Netherlands. Two types of construct validity, i.e., convergent and clinical validity, have been analyzed. Convergent validity was assessed with Spearman’s correlation coefficients and multivariate correlation between the burden dimensions (CarerQol-7D) and the valuation component (CarerQol-VAS) of the CarerQol. Additionally, convergent validity was analyzed with Spearman’s correlation coefficients between the CarerQol and other measures of subjective caregiver burden (SRB, PU). Clinical validity was evaluated with multivariate correlation between CarerQol-VAS and CarerQol-7D, characteristics of caregivers, care recipients and care situation among the whole sample of caregivers and subgroups.ResultsThe positive (negative) dimensions of CarerQol-7D were positively (negatively) related to CarerQol-VAS, and almost all had moderate strength of convergent validity. CarerQol-VAS was positively associated with PU and negatively with SRB. The CarerQol-VAS reflects differences in important background characteristics of informal care: type of relationship, age of the care recipient and duration of care giving were associated with higher CarerQol-VAS scores. These results confirmed earlier tests of the construct validity of the CarerQol. Furthermore, the dimensions of CarerQol-7D significantly explained differences in CarerQol-VAS scores among subgroups of carers.ConclusionNotwithstanding the limitations of our study, such as the low response rate, this study shows that the CarerQol provides a valid means to measure carer effects for use in economic evaluations. Future research should derive a valuation set for the CarerQol and further address the instrument’s content validity, sensitivity and reliability.

Exploring Predictors of Health Sciences Students’ Attitudes Towards Complementary-Alternative Medicine

This study demonstrated that a less scientific worldview predicted health science (HS) students' positive attitude towards complementary-alternative medicine (CAM), independently of important background characteristics as gender, pre-college science immersion, age, and type of HS education of the students. A total of 473 students in their final 3rd year of education in the health sciences (nursing, physiotherapy, social educator, and radiography) participated in teh study, which was based on a questionnaire consisting of items mapping student background characteristics and their attitudes towards worldview reflecting statements in constructs. The results showed that large fractions of the HS students were positive towards the use of CAM treatments. Multiple regression analysis demonstrated that 24 % of the total variance in HS students' positive attitude towards the use of CAM than the HS students' background characteristics alone, which accounted for only 2 % of the total variance. HS students' Paranormal beliefs, and their Willingness to include CAM in HS education were the most important predictors. The study results suggest stronger emphasis on teaching about epistemologies in HS educations.

Christian Religion and Ethnic Prejudice in Cross-National Perspective: A Comparative Analysis of the Netherlands and Flanders (Belgium)

Almost every student of religion has heard about the research thesis that Christian religious beliefs and behaviors are not barriers against but contributing factors to the development and dispersal of ethnic and racial prejudice. This cross-societal study examines this accusing finger of social research by using data from a 1985 Dutch survey and a 1991 Flemish survey conducted in the Dutch-speaking part of Belgium. The findings indicate that in both societies neither church involvement nor Christian belief have an effect on ethnic prejudice, independent of important background characteristics (education and age) and social correlates (social and cultural localism, authoritarianism, and anomie). Regression analysis also reveals that, next to authoritarianism, the most important predictor variable of ethnic prejudice in this comparative study is nationality per se. Implications of this finding for future research are discussed.

Black High School Students' Participation in School-Sponsored Sports Activities: Effects on School Engagement and Achievement

Myths abound about the role of sports in schooling, particularly for Black student athletes. The literature affords little guidance on the specific relationship between participation in schoolsponsored sports and various outcomes for Black adolescents. Using a nationally representative sample, this study examines: (a) the effects of sports participation on various school engagement and student self evaluative variables, controlling for important background characteristics such as SES and gender; (b) the potential differential effects of sports participation for Black students; and (c) the degree to which sports participation affects Black students' academic achievement. Sports participation was found to improve the school engagement and academic self confidence of alI student athletes. Moreover, a positive intervening relationship was found between sports participation and academic achievement. INTRODUCTION As a key part of the social and cultural fabric of human life, sports permeate social realities at many levels, both globally and individually (Snyder & Spreitzer,1989). Few institutions in U.S. society are unaffected by sports (Edwards, 1973). Values reflected in athletic competition-striving for excellence, fair play, sportsmanship, hard work, and commitment to a goal-are inextricably linked to our nation's mainstream cultural values. Although much has been writter_ about the role of sports in society in a broad sense (Blanchard,1995; Lapchick,1986; Rees & Miracle,1986), the social function of professional and collegiate sports has often been the primary focus of this inquiry. The research literature affords little guidance on the specific relationship between participation in high school athletics and school-related outcomes for adolescents. Even less is known about specific benefits for African American students. To complicate matters, it is not uncommon for research on high school athletics to be combined with examination of other extracurricular activities in attempts to investigate their effects upon schooling (Crain,1981; Holland & Andre,1987; Otto,1982). The assumption that most extracurricular activities affect students similarly lacks empirical evidence. Although past research on sports and schooling has found small, positive effects for participation in athletics on various student outcome measures such as grade point averages, methodological problems have marred the results of many of these studies (Trent & Braddock, 1992). Much of the recent scholarly attention paid to the topic of sports and schooling has been theoretical and philosophical in its focus (Arnold,1997; Sadovskii & Sadovskii,1993). These studies have attempted to portray sports as valued human practices that have many analogues in other areas of social life. Further, they often examine the heuristic and moral qualities of sport, and focus on the degree to which sports reaffirm and break down social norms. Arnold contends, for example, that, like most social conventions, sport is valueneutral-that is, it can be viewed as either good or bad. On the one hand, sports teach perseverance and encourage respect for rules, fair play and teamwork. Indeed, Sadovskii and Sadovskii, in their study of the connections between sports and mathematics, assert that athletics can have a beneficial effect on students' intellectual growth, states of mind, and will power. However, these authors contend that sports can also breed rugged individualism, vanity, intense rivalries, intolerance, and a win-at-all-costs attitude. Purpose of the Study In light of the dearth of empirical research exploring the effects of participation in high school sports upon educational outcome measures for adolescents, the present study sets out to address three aspects of this topic. The first stage of the analysis explores the effects of participation in high school sports on various school engagement and student self-evaluative factors while holding constant important background characteristics such as socioeconomic status (SES) and gender. …

Releasee Characteristics and Parole Success

This study compared adult releasees who had vocational, or vocational and academic training, to a control group of releasees who chose not to enroll in vocational or academic training. A fourth group, those releasees who received only academic coursework while incarcerated, was also studied. A total of 760 releasees was studied for 12 months. Violation/nonviolation was the independent variable. It was cross tabulated with fourteen independent variables, focusing especially on education and/or vocational program involvement while incarcerated. Violation was defined as returned to prison because of parole violation, committing a new crime (also resulting in parole violation), or being absent without permission (nlso a parole violation). Chi- square analysis indicated that seeking and obtaining a job was essential to remaining on parole. Parolees who had no prior documented history of abusing alcohol or drugs were more successful on community release. Other important background characteristics related ...

Alcohol consumption and outcome of pregnancy.

In a prospective study 1256 pregnant women at their first antenatal visit were asked if they drank alcohol every day, occasionally, or not at all, both at that time and before the diagnosis of pregnancy. There were no significant differences, among the three alcohol groups, in the proportions having miscarriages, perinatal deaths, congenital anomalies, or premature births. Women who reported drinking every day before pregnancy was diagnosed had heavier babies than those who did not drink at all, but there were no differences in mean birth weight according to alcohol use at the first antenatal visit. There were statistically significant differences among the three groups in important background characteristics, such as social class, age, smoking, and marital status. When adjustment was made for these factors, both occasional and daily consumption of alcohol before pregnancy appeared to have significantly positive effects on birth weight. These results illustrate the difficulty of evaluating the effects of alcohol in observational studies, and imply a need for caution in attributing either negative or positive effects of alcohol on the outcome of pregnancy.

The negative side of social interaction: impact on psychological well-being.

Social exchange theory has long emphasized that social interaction entails both rewards and costs. Research on the effects of social relations on psychological well-being, however, has generally ignored the negative side of social interaction. This study examined the relative impact of positive and negative social outcomes on older women's well-being. The sample consisted of 120 widowed women between the ages of 60 and 89. Multiple regression analyses revealed that negative social outcomes were more consistently and more strongly related to well-being than were positive social outcomes. This effect of negative social involvement did not appear to be due to major differences among women with high versus moderate or low levels of problematic social ties. Analyses of variance indicated that these three groups of women differed neither in important background characteristics nor in indices of social competence. The results demonstrate the importance of assessing the specific content of social relations. Implications for the design of social network interventions are discussed.