Multilevel Logistic Regression Analysis Research Articles

Association Between Birth Weight and Risk of Pregnancy-Induced Hypertension and Gestational Diabetes in Japanese Women: JPHC-NEXT Study.

BackgroundAlthough prevalence of low birth weight has increased in the last 3 decades in Japan, no studies in Japanese women have investigated whether birth weight is associated with the risk of pregnancy complications, such as pregnancy-induced hypertension (PIH) and gestational diabetes mellitus (GDM).MethodsWe used data from the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT), a population-based cohort study in Japan that launched in 2011. In the main analysis, we included 46,365 women who had been pregnant at least once, for whom information on birth weight and events during their pregnancy was obtained using a self-administered questionnaire. Women were divided into five categories according to their birth weight, and the relationship between birth weight and risk of PIH and GDM was examined using multilevel logistic regression analyses with place of residence as a random effect.ResultsCompared to women born with birth weight of 3,000–3,999 grams, the risk of PIH was significantly higher among women born <1,500 grams (adjusted odd ratio [aOR] 1.60; 95% confidence interval [CI], 1.17–2.21), 1,500–2,499 grams (aOR 1.16; 95% CI, 1.03–1.30), and 2,500–2,999 grams (aOR 1.13; 95% CI, 1.04–1.22). The risk of GDM was significantly higher among women born 1,500–2,499 grams (aOR 1.20; 95% CI, 1.02–1.42), albeit non-significant association among women in other birthweight categories.ConclusionsWe observed an increased risk of PIH among women born with lower birth weight albeit non-significant increased risk of GDM among Japanese women.

Prevalence and determinants of maternal healthcare utilisation among young women in sub-Saharan Africa: cross-sectional analyses of demographic and health survey data

BackgroundMaternal health constitutes high priority agenda for governments across the world. Despite efforts by various governments in sub-Saharan Africa (SSA), the sub-region still records very high maternal mortality cases. Meanwhile, adequate utilization of maternal healthcare (antenatal care [ANC], skilled birth attendance [SBA], and Postnatal care [PNC]) plays a vital role in achieving improved maternal health outcomes. We examined the prevalence and determinants of maternal healthcare utilization among young women in 28 sub-Saharan African countries using data from demographic and health surveys.MethodsThis was a cross-sectional study of 43,786 young women aged 15–24 years from the most recent demographic and health surveys of 28 sub-Saharan African countries. We adopted a multilevel logistic regression analysis in examining the determinats of ANC, SBA, and PNC respectively. The results are presented as adjusted Odds Ratios (aOR) for the logistic regression analysis. Statistical significance was set at p < 0.05.ResultsThe prevalence of maternal healthcare utilisation among young women in SSA was 55.2%, 78.8%, and 40% for ANC, SBA, and PNC respectively with inter-country variations. The probability of utilising maternal healthcare increased with wealth status. Young women who were in the richest wealth quintile were, for instance, 2.03, 5.80, and 1.24 times respectively more likely to utilise ANC (95% CI = 1.80–2.29), SBA (95% CI = 4.67–7.20), and PNC (95% CI = 1.08–1.43) than young women in the poorest wealth quintile. Young women who indicated having a barrier to healthcare utilisation were, however, less likely to utilise maternal healthcare (ANC: aOR = 0.83, 95% CI = 0.78–0.88; SBA: aOR = 0.82, 95% CI = 0.75–0.88; PNC: aOR = 0.88, 95% CI = 0.83–0.94).ConclusionWhile SBA utilisation was high, we found ANC and PNC utilisation to be quite low among young women in SSA with inter-country variations. To accelerate progress towards the attainment of the Sustainable Development Goal (SDG) targets on reducing maternal mortality and achieving universal health coverage, our study recommends the adoption of interventions which have proven effective in some countries, by countries which recorded low maternal healthcare utilisation. The interventions include the implementation of free delivery services, training and integration of TBAs into orthodox maternal healthcare, improved accessibility of facilities, and consistent public health education. These interventions could particularly focus on young women in the lowest wealth quintile, those who experience barriers to maternal healthcare utilisation, uneducated women, and young women from rural areas.

Perceived Supervisor Support for Health Affects Presenteeism: A Cross-Sectional Study.

We investigated the relationship between perceived supervisor support for health (PSSH) and presenteeism by adjusting for psychological distress and employee work engagement. These are the mediators of the two paths shown in the job demands-resources model. A cross-sectional study was conducted using a questionnaire survey among 15,158 non-managerial employees from seven companies in Japan considered to have relatively high perceived organizational support for health (POSH). PSSH was evaluated with a single question, “My supervisor supports employees to work vigorously and live a healthy life”, on a four-point scale. Presenteeism was estimated using the quantity and quality method. Multilevel logistic regression analyses nested by company were conducted. Lower PSSH was more likely to be associated with presenteeism, but after adjusting for psychological distress evaluated by K6 and for work engagement, the relationship between PSSH and presenteeism weakened. Our results suggested that lower PSSH is linked to presenteeism through both psychological states because of its role as a resource, and other independent factors, even with relatively high POSH. Increased PSSH could act as a measure against presenteeism in the workplace. To achieve this, it is important to create an environment where supervisors can easily encourage employees to improve their health.

Prevalence of metabolic syndrome among the adult population in western China and the association with socioeconomic and individual factors: four cross-sectional studies

ObjectivesThis study explored the prevalence of and individual influencing factors for metabolic syndrome (MS) as well as associated socioeconomic factors and regional aggregation.DesignFour cross-sectional surveys were analysed for trends in...

The COVID-19 pandemic and changes in the level of contact between older parents and their non-coresident children: A European study

Objective: The present study aims to investigate changes in the frequency of parent-child contact among Europeans aged 65 years and over within the context of the COVID-19 pandemic, while recognizing heterogeneity within the group of older adults.&#x0D; Background: Physical distancing measures have been implemented worldwide to curb the spread of the COVID-19 pandemic. Although this policy has proven to be effective in flattening the curve, it undoubtedly posed a serious challenge to intergenerational relations. Experts hinted that physical distancing measures may have reduced older adults’ level of contact with their non-coresident children. However, empirical evidence is lacking.&#x0D; Method: Data from the SHARE COVID-19 questionnaire and previous SHARE waves for 26,077 individuals from 26 European countries and Israel were used and analyzed using multilevel multinomial logistic regression analysis.&#x0D; Results: The analysis revealed that older adults’ level of intergenerational contact remained stable or even increased – rather than decreased – during the COVID-19 pandemic. Despite the overall positive outcome, some subgroups (i.e., older men, residents of nursing homes, less educated older adults and older adults living in countries with less stringent COVID-19 measures) were more likely to report reduced intergenerational contact.&#x0D; Conclusion: Although variation was observed among older adults, the pandemic generally did not pose a threat to their level of intergenerational contact with non-coresident children.

A Multilevel Analysis of Factors Associated With Stunting in Children Less Than 2 years Using Multiple Indicator Cluster Survey (MICS) 2017–18 of Punjab, Pakistan

Stunting is an important issue as it leads to many adverse consequences on children’s health. Pakistan is in public health crisis due to higher stunting rates in children. World Health Organization entails the prevalence of stunting to be less than 2.5% in a healthy population, but every third child is stunted in Punjab (largest province of Pakistan by area and population). By using the Multiple Indicator Cluster Survey (MICS) Punjab, 2018 and employing multilevel logistic regression analyses, this study finds that children whose mothers are educated and have better access to drinking water and antenatal care have lower odds of stunting. Access to better and accessible health care, education especially of girls/women, and clean water can reduce stunting in children. The government needs to give special attention to these factors to help children grow healthy.

Parental insulin resistance is associated with unhealthy lifestyle behaviours independently of body mass index in children: The Feel4Diabetes study

Parental health is associated with children’s health and lifestyles. Thus, the aim of the present study was to assess lifestyle behaviours of children of parents with insulin resistance (IR) and at risk of type 2 diabetes. 2117 European families from the Feel4Diabetes-study were identified as being at risk for diabetes with the FINDRISC questionnaire and included in the present study. One parent and one child per family were included. Parental IR was considered when homeostasis model assessment (HOMA) was equal or higher than 2.5. Children’s screen-time, physical activity and diet were assessed and clustered by K-means. Weight and height were measured and children’s body mass index (BMI) was calculated. For children, a Healthy Diet Score (HDS) was calculated. Linear regression and multilevel logistic regression analyses were performed to assess the associations between parental IR and children’s lifestyle behaviours in 2021. Children of parents with IR had higher BMI (p < 0.001) and spent more screen time (p = 0.014) than those of non-IR parents. Children of parents with IR had a lower value in the breakfast and vegetable components of the HDS (p = 0.008 and p = 0.05). Four lifestyle clusters were found. Children of IR parents had higher odds of being in a non-healthy cluster (OR: 1.19; 95%CI: 1.001–1.437).Conclusion: Having an IR parent was associated with a high screen time and an increased probability of having an unhealthy lifestyle pattern in children. These data point out that children’s lifestyles should be assessed in families with IR parents to provide tailored interventions.What is Known:• Children with diabetic or insulin-resistant parents could also develop this condition.• Unhealthy lifestyles are directly related with insulin resistance even in children.What is New:• Children from parents with insulin resistance have higher chances of unhealthy lifestyles.• A higher BMI was found for those children with an insulin-resistant parent.

Prospective Study on CAD/CAM Nano-Ceramic (Composite) Restorations in the Treatment of Severe Tooth Wear.

The aim of this prospective study was to evaluate the clinical performance of minimally invasive, CAD/CAM nano-ceramic (composite) restorations in patients with severe tooth wear, the effect of the restorative treatment on the oral health-related quality of life (OHRQoL), and the etiology of tooth wear as a risk factor for restoration failure. Patients with generalized severe tooth wear were included. Restorations (LAVA Ultimate, 3M Oral Care) were cemented (RelyX Ultimate, 3M Oral Care) on all teeth and were evaluated after 1 month and 1 year. OHRQoL was assessed via questionnaires at baseline and after 1 year. Differences were evaluated (paired t-test). Two mechanical tooth-wear lesions resulting from tooth-tooth contact, and 3 chemical tooth wear lesions resulting from intrinsic or extrinsic acids dissolving natural hard tooth substance, were evaluated to assess the etiology of tooth wear in association with restoration failure using multilevel logistic regression analyses (p < 0.05). Twenty-one patients (age: 41.7 ± 10.4 years) were evaluated after 1 year (13.5 ± 1.2 months). 568 indirect CAD/CAM restorations were placed. None were replaced or lost. Twelve were repaired and 10 were refurbished. Success rates were 100% to 97.2%. Questionnaires showed a significant positive impact of the treatment on OHRQoL (p < 0.001). The presence of mechanical lesions did not pose a higher risk for restoration failure (p = 0.78). The presence of chemical lesions showed a lower risk of restoration failure (p = 0.002). The use of minimally invasive, CAD/CAM nano-ceramic (composite) restorations in the restorative treatment of severely worn dentitions showed satisfactory results in the short term.

The impact of performing gastric cancer surgery during holiday periods. A population-based study using Dutch upper gastrointestinal cancer audit (DUCA) data

Existing literature suggests inferior quality of oncologic surgery during holiday periods. This study aimed to investigate the impact of holiday periods on surgical treatment of gastric cancer in the Netherlands. This nationwide study included all gastric cancer patients undergoing potentially curative surgery registered in the Dutch Upper Gastrointestinal Cancer Audit (DUCA). For each patient it was established whether they underwent surgery during or outside the 11 Dutch holiday weeks, based on date and region of surgery. Separate, single-day holidays were not included. Baseline and treatment characteristics were compared using descriptive statistics. Time from diagnosis to treatment and short-term surgical outcomes were compared using multilevel multivariable logistic regression analyses. To prevent bias from recent advancements, analyses were repeated in a recent cohort of patients (2015-2018). Between 2011-2018, 3440 patients were included in the DUCA. Some 555 (16.1%) patients underwent surgery during 11 holiday weeks. There were no differences in patient, tumor and treatment characteristics and time to treatment between holidays and non-holidays. Tumor-positive resection margins (R1/R2 vs R0) occurred more frequent during holidays (aOR:1.47, 95%CI:1.07-2.04). Subgroup analyses in a recent cohort of patients also found higher tumor-positive resection margins (aOR:1.59, 95%CI:1.01-2.43) and higher failure-to-rescue rates (aOR:2.55, 95%CI:1.18-5.49) during holidays. Even though time to treatment and patient, tumor and treatment characteristics were comparable between holidays and non-holidays, tumor-positive resection margin and failure-to-rescue rates were higher during holidays. This suggests that steps must be taken to keep specialized and dedicated gastric cancer expertise up to standard during holiday periods.

Time trends in psychotropic drug prescriptions in Dutch nursing home residents with dementia between 2003 and 2018.

ObjectiveSeveral European studies investigated the trends in psychotropic drug prescriptions (PDPs) among nursing home (NH) residents and reported a decline in antipsychotics prescriptions. Since the Dutch long‐term care system differs from other European systems (e.g. higher threshold for NH admission and trained elderly care physicians), this study explores the trends in PDPs in Dutch NH residents with dementia.MethodsThe study used data from nine studies, comprising two cross‐sectional studies, one cohort study, and six cluster‐randomized controlled trials, collected in Dutch NHs between 2003 and 2018. With multilevel logistic regression analysis, NHs as a random effect, we estimated the trends in PDPs overall and for five specific psychotropic drug groups (antipsychotics, antidepressants, anxiolytics, hypnotics, and anti‐dementia drugs), adjusting for confounders: age, gender, severity of dementia, severity of neuropsychiatric symptoms, and length of stay in NHs.ResultsThe absolute prescription rate of antipsychotics was 37.5% in 2003 and decreased (OR = 0.947, 95% CI [0.926, 0.970]) every year. The absolute prescription rate of anti‐dementia drugs was 0.8% in 2003 and increased (OR = 1.162, 95% CI [1.105, 1.223]) per year. The absolute rate of overall PDPs declined from 62.7% in 2003 to 40.4% in 2018.ConclusionsAmong Dutch NH residents with dementia, the odds of antipsychotics prescriptions decreased by 5.3% per year while the odds of anti‐dementia drug prescriptions increased by 16.2%. There were no distinct trends in antidepressants, anxiolytics, and hypnotics prescriptions. However, overall PDPs were still high. The PDPs in NH residents remain an issue of concern.

Magnitude and determinants of intimate partner violence against women in East Africa: multilevel analysis of recent demographic and health survey

BackgroundViolence against women is a significant public health problem, and human rights abuse, and is associated with multiple adverse physical, mental, sexual, and reproductive health effects. The current study aimed to determine the magnitude of intimate partner violence (IPV) and its determinant factors in East African countries.MethodsWe utilized the most recent demographic and health survey data from 11 East African countries, which was comprised of a weighted sample of 55,501 ever-married women. A multilevel multivariable logistic regression analysis was applied. We used an adjusted odds ratio with a 95% CI and a p value ≤ 0.05 in the multilevel logistic model to declare significant factors associated with IPV.ResultsThe overall prevalence of all forms of IPV in East African countries was 32.66% [95% CI 32.27, 33.05], with the highest IPV occurring in Uganda (14.93%) and the lowest IPV recorded in Comoros (0.87%). In the multivariable multilevel logistic regression model, women’s education, residence, sex of household head, current pregnancy, husband drinking alcohol, attitude towards wife-beating husband controlling behavior, and women’s decision-making autonomy were significantly associated with IPV.ConclusionThe risk factors noted above increase the likelihood of a woman experiencing IPV. Therefore, we recommend establishing effective health and legal response services for IPV, raising awareness of the existing legislation service and improving its application, strengthening legislations on purchasing and selling of alcohol, strengthening joint (both husband and wife) decision-making power by empowering women, improving the educational level of women, and establishing measures to break the culture of societal tolerance towards IPV.

A Retrospective Combination Health Outcomes Study among Diabetic Patients with Chronic Kidney Disease: A Multi-Level Study

Diabetes is the prominent cause of the progression of chronic kidney diseases (CKD) worldwide. Effective implementation of healthcare services and healthcare delivery system to control glycemic level and slow annually declining eGFR remain a challenge in many countries including Thailand. The aims of this study were to investigate the association between individual and health service delivery factors on the combination health outcomes. This multi-level study applied case-control method was conducted. The 397 participants were recruited from 11 hospitals during December 2018 to May 2019 in Thailand. The samples were categorized into 4-group combination health outcome. Data analysis was performed by descriptive analysis and multi-level multinomial logistic regression analysis. The multinomial logistic regression in bivariate analysis showed that diabetes self-care activities score were more likely to control glycemic and CKD progression compared with those with a low-level of DSCA (OR 3.47; 95 % CI: 1.19 - 10.15). The rational drug uses (RDU) as the health service-level factors increased combination health outcomes 2 times (OR 2.41; 95 % CI: 1.05 - 5.53). The multi-level analysis found that performing with high-level of DSCA (OR 5.36; 95 % CI :1.99 - 14.46) and rational drug uses of metformin and NSAIDs (OR 2.33; 95 % CI: 1.25 - 4.36) increased probability to achieve combination health outcomes. Findings highlight the importance of diabetes self-care activities and health service delivery system to optimize the combination health outcomes among diabetic patients with CKD.&#x0D; HIGHLIGHTS&#x0D; &#x0D; The glycemic control and slow kidney disease progression could decrease diabetic complications&#x0D; The challenges of complicate diseases management involved patient-level and health service-level factors&#x0D; The high-level of DSCA showed the significant association with glycemic control and slow kidney disease progression&#x0D; This study encourages professional nurses promote the model of care that appropriate for individual person who had the difference of age, BMI and self-care activities level&#x0D; &#x0D; GRAPHICAL ABSTRACT

Hospitalizations and Mortality From Non–SARS-CoV-2 Causes Among Medicare Beneficiaries at US Hospitals During the SARS-CoV-2 Pandemic

The increased hospital mortality rates from non-SARS-CoV-2 causes during the SARS-CoV-2 pandemic are incompletely characterized. To describe changes in mortality rates after hospitalization for non-SARS-CoV-2 conditions during the COVID-19 pandemic and how mortality varies by characteristics of the admission and hospital. Retrospective cohort study from January 2019 through September 2021 using 100% of national Medicare claims, including 4626 US hospitals. Participants included 8 448 758 individuals with non-COVID-19 medical admissions with fee-for-service Medicare insurance. Outcome was mortality in the 30 days after admission with adjusted odds generated from a 3-level (admission, hospital, and county) logistic regression model that included diagnosis, demographic variables, comorbidities, hospital characteristics, and hospital prevalence of SARS-CoV-2. There were 8 448 758 non-SARS-CoV-2 medical admissions in 2019 and from April 2020 to September 2021 (mean [SD] age, 73.66 [12.88] years; 52.82% women; 821 569 [11.87%] Black, 438 453 [6.34%] Hispanic, 5 351 956 [77.35%] White, and 307 218 [4.44%] categorized as other). Mortality in the 30 days after admission increased from 9.43% in 2019 to 11.48% from April 1, 2020, to March 31, 2021 (odds ratio [OR], 1.20; 95% CI, 1.19-1.21) in multilevel logistic regression analyses including admission and hospital characteristics. The increase in mortality was maintained throughout the first 18 months of the pandemic and varied by race and ethnicity (OR, 1.27; 95% CI, 1.23-1.30 for Black enrollees; OR, 1.25; 95% CI, 1.23-1.27 for Hispanic enrollees; and OR, 1.18; 95% CI, 1.17-1.19 for White enrollees); Medicaid eligibility (OR, 1.25; 95% CI, 1.24-1.27 for Medicaid eligible vs OR, 1.18; 95% CI, 1.16-1.18 for noneligible); and hospital quality score, measured on a scale of 1 to 5 stars with 1 being the worst and 5 being the best (OR, 1.27; 95% CI, 1.22-1.31 for 1 star vs OR, 1.11; 95% CI, 1.08-1.15 for 5 stars). Greater hospital prevalence of SARS-CoV-2 was associated with greater increases in odds of death from the prepandemic period to the pandemic period; for example, comparing mortality in October through December 2020 with October through December 2019, the OR was 1.44 (95% CI, 1.39-1.49) for hospitals in the top quartile of SARS-CoV-2 admissions vs an OR of 1.19 (95% CI, 1.16-1.22) for admissions to hospitals in the lowest quartile. This association was mostly limited to admissions with high-severity diagnoses. The prolonged elevation in mortality rates after hospital admission in 2020 and 2021 for non-SARS-CoV-2 diagnoses contrasts with reports of improvement in hospital mortality during 2020 for SARS-CoV-2. The results of this cohort study suggest that, with the continued impact of SARS-CoV-2, it is important to implement interventions to improve access to high-quality hospital care for those with non-SARS-CoV-2 diseases.

Correlates of engaging in sports and exercise volunteering among older adults in Japan

This study aimed to identify factors associated with engaging in sports and exercise volunteering among older adults. We used cross-sectional data from the Japan Gerontological Evaluation Study (JAGES), a nationwide mail survey of 20,877 older adults from 60 municipalities. Multilevel mixed-effects logistic regression analysis was used to investigate the correlation between engaging in sports and exercise volunteering and 39 variables classified into five factors: (1) demographic and biological, (2) behavioral, (3) psychological, cognitive, and emotional, (4) social and cultural, and (5) environmental factors. Among the analyzed samples, 1580 (7.6%) participants volunteered a few times/year or more often. Factors that showed positive association with the volunteering were older age, a current drinking habit, excellent self-rated health, high proportion of sports group participants in a living area, low municipal population density, and rich social and cultural features (i.e., social cohesion, support, network, and participation). Meanwhile, those that had a negative association were women, low level of education, deteriorated instrumental activities of daily living, having a past or current smoking habit, poor self-rated health, and depressive symptoms. We clarified the characteristics of the population that is more likely to participate in sports and exercise volunteering as well as those of the population that is less likely to participate and requires support.

Relationship between cooling time and neurological outcomes in targeted temperature management.

The relationship between cooling time (CT) variables and neurological outcomes is controversial. We evaluated the relationship between CT and neurological outcomes in out-of-hospital cardiac arrest (OHCA) patients treated with targeted temperature management (TTM). We conducted a multicenter, prospective, and registry-based study of OHCA survivors treated with TTM. CT was defined as the time from restoration of spontaneous circulation to achievement of the target temperature. The primary outcome was a favorable neurological outcome at 6months. Multilevel logistic regression analysis was performed to test the relationship between CT and the primary outcome. Overall, the favorable neurological outcome rates at 6months were 29.8% in 937 patients. When CT was stratified into categories of 0-3, 3.1-6, 6.1-9, 9.1-12, and >12h, according to 3-h intervals, the primary outcome rates were 8.2%, 22.7%, 35.5%, 44.7%, and 44.5%, respectively (p<0.001). Significant differences were not found in multilevel logistic regression analysis; the adjusted odds ratios (95% confidence interval) of each category for the primary outcome compared to the 0-3-h group were 0.81 (0.32 to 2.04), 0.77 (0.30 to 2.01), 1.26 (0.43 to 3.68), and 1.06 (0.37 to 3.06). We did not find a relationship between CT and neurological outcomes at 6months.

An exploratory social media intervention for perception and behavior on eating away from home: A cluster randomized trial in Chongqing, China

A modern diet with high energy density is harmful to health and negatively affects the environment. Eating out is particularly prevalent among young adults and has steadily increased in many countries over the last few decades. This study aims to assess the impact of nutrition education interventions on social media on cognitive and behavioral changes in the diet of university students. A cluster-randomized trial with an intervention group (n = 853) and a no-intervention control group (n = 846) was conducted in Chongqing. A two-month educational intervention was conducted through social media (WeChat official account, Sina Weblog, and Tencent Weibo) with participants of the intervention group. Self-reported eating-out-related knowledge and behaviors were assessed at baseline and six and eight months after randomization. Multilevel mixed-effects logistic regression and linear regression analyses accessed the outcomes between the intervention and control groups. The proportion of participants in the high-level knowledge and attitude group in the intervention group increased by 13% and 8.5% compared with the control group (p < 0.05). The effects of the intervention on the outcomes significantly changed over time, as demonstrated by the achieved statistical significance for knowledge and attitude score (p for group and time interaction <0.001) in the interaction between time and randomization groups. The high-frequency eating away from home/school at weekends decreased from 29.6% to 27.3% in the intervention group. In the control group, the high-frequency eating away from home/school at weekends in the increase was increased (26.3%–27.2%). A total of 73.6% of respondents in the intervention group reported that they consciously reduced their frequency of eating away from home/school. The possibility exists for narrowing the perception and behavior disparity gap through the effective use of social media, such as WeChat and Microblog, which could be a sustainable platform to provide health education or new food policies to promote healthy eating and reduce food waste among university students.

Individual-level and community-level factors associated with eight or more antenatal care contacts in sub-Saharan Africa: evidence from 36 sub-Saharan African countries

ObjectiveTo reduce maternal mortality, the WHO has been introducing several antenatal care (ANC) measures. Pregnancy-related preventable morbidity and mortality, on the other hand, remain alarmingly high. This study was conducted...

Mother and newborn skin-to-skin contact in sub-Saharan Africa: prevalence and predictors

IntroductionSkin-to-skin contact is an evidence-based intervention that signifies a situation whereby a newborn is positioned directly on the mother’s abdomen or chest in order for them to have direct ventral-to-ventral...

A Smaller Pie with a Different Taste: The Evolution of the Western-European Religious Landscape (European Values Study, 1981–2017)

Background The thesis of religious decline, central to secularization theory, has become massively contested among social-scientific students of religion. Its critics observe not so much decline, but rather change in the religious landscape of Western Europe, in effect pointing out that the decline of Christianity's traditional institutional, doctrinal and ritual dimensions should not be mistaken for a decline of religion tout court. Purpose In this research note, we address this ongoing debate among sociologists of religion by studying whether traditional Christian religiosity has declined in Western Europe over the past four decades, and whether the same applies to religiosity more broadly conceived. Methods To examine these trends over time, we analyze data from the European Values Study (1981–2017) for nineteen Western-European countries. More specifically, we carry out multi-level linear- and multi-level logistic regression analyses. Results We demonstrate that both traditional Christian religiosity and religiosity more broadly conceived have declined, with the former declining at a much higher pace than the latter. We also find that those who continue to be religious and/or spiritual deviate increasingly from the traditional Christian model. Thus, when one does encounter religiosity, it is much more likely to be non-traditional religiosity than was true in the past. Conclusions and Implications We conclude that religion has declined, whether one understands it narrowly as traditional Christian religiosity, or more broadly. Even though new forms of religiosity and spirituality cannot compensate for the loss in traditional Christian religiosity, they do make up an increasing portion of the overall declining religious pie. Finally, we reflect on the limitations of the data from the European Values Study (1981–2017) and make an urgent call for better survey data, especially by including more suitable questions with which to measure types of religiosity and/or spirituality that deviate from the traditional Christian model.

Teen Birth Across Generations Among Non-Latino Whites and African-American Women: The Effect of Race and Neighborhood Income.

To examine the extent to which lifelong neighborhood income modifies the generational association of teen birth among White and AA women in Cook County, IL. Stratified and multilevel logistic regression analyses were conducted on the Illinois transgenerational dataset of singleton births (1989-1991) to non-Latina White and AA mothers (born 1956-1976) with appended U.S. census income information. We calculated rates and risks of teen births according to race, maternal age, and lifelong neighborhood economic environment. Teen birth occurred at a rate of 9.5% and 52.9% for White and AA women, respectively. White women whose mothers were teens when they were born had an over five-fold increased risk of becoming teen mothers themselves. For AA women, the risk was smaller, but statistically significant. For both races, women who experienced downward economic mobility had the highest risk of teen birth, while women with upward mobility had the lowest risk, even compared to women in lifelong high income neighborhoods. While White women exposed to lifelong low income had almost threefold increased risk of teen birth compared to those in lifelong high income neighborhoods, AA women in lifelong high and lifelong low income neighborhoods had similar risk of teen birth. Understanding the racial differences in intergenerational patterns of teen birth is important for effective program planning and policy making, given that interventions targeted at daughters of teen mothers may differ in effectiveness for White and AA teens.