Multinomial Logistic Analysis Research Articles

Factors Affecting Postoperative Complications of Suction-Curettage by Arthroscopic Shaver for Bromhidrosis.

Suction-curettage by arthroscopic shaver is the most effective treatment for bromhidrosis; however, postoperative complications require wound management and exhibit a high risk of hypertrophic scarring. We investigated factors affecting postoperative complications. We retrospectively evaluated data for 215 patients (430 axillae) with bromhidrosis treated with suction-curettage by arthroscopic shaver between 2011 and 2019. Cases followed for less than 1 year were excluded. Complications of hematoma or seroma, epidermis decortication, skin necrosis, and infection were recorded. Multinomial logistic analysis was used to calculate odds ratios and corresponding 95% confidence intervals for the complication of the surgery, adjusting for relevant statistically significant variables. Complications occurred in 52 axillae (12.1%). Epidermis decortication occurred in 24 axillae (5.6%), with a significant difference for age (P < 0.001). Hematoma occurred in 10 axillae (2.3%) with a significant difference in tumescent infiltration use (P = 0.039). Skin necrosis occurred in 16 axillae (3.7%) with a significant difference for age (P = 0.001). Infection occurred in 2 axillae (0.5%). Severe scarring occurred in 15 axillae (3.5%), with complications related to more severe skin scarring (P < 0.05). Older age was a risk factor for complications. Use of tumescent infiltration resulted in good postoperative pain control and less hematoma. Patients with complications presented with more severe skin scarring, but none experienced limited range of motion after massage.

Developmental trajectories of successful aging among older adults in China: Evidence from the China Health and Retirement Longitudinal Study

This study aimed to identify potential trajectory groups of successful aging in older adults and to explore the influencing factors of each trajectory group. We used four waves of longitudinal data from the China Health and Retirement Longitudinal Study from 2011 to 2018, which involved 1,949 older adults. The developmental trajectories were determined using growth mixture modeling (GMM), and the influencing factors of each trajectory group were identified using multinomial logistic analysis. We identified three different groups of successful aging trajectories: high level-declining group (45%), medium level-declining group (39%), and low level-steady group (16%). Gender, education, marital status, place of residence, self-rated health, life satisfaction, and retirement pension were the influencing factors for the high level-declining group. Influencing factors for the medium level-declining group included gender, education, self-rated health, life satisfaction, and retirement pension. Healthcare professionals should formulate targeted measures according to different trajectory categories to promote successful aging in older adults.

Determinants of the choice of adaptation strategies to climate variability and extremes among pastoralist and agro-pastoralist households in Yabello and Arero Districts, Southeast Ethiopia

Climate variability and extremes adversely affect the livestock sector by reducing pasture availability, polluting and depleting water resources, aggravating livestock diseases, and distorting the production systems. The cumulative effect of climate variability undermines the adaptive capacity of pastoralists and worsens food insecurity. This study assesses the impact of climate variability and the determinants of pastoralists and agro-pastoralists adaptation strategies in Yabello and Arero Districts, southern Ethiopia. Accordingly, data were collected from randomly selected 296 sample households using a questionnaire survey. Data were also gathered from a purposively selected key informants and focus group discussion participants. Areal gridded dikadal rainfall and temperature data were collected from the National Meteorological Institute. Descriptive statistics and multinomial logistic regression data analysis methods were used. The results show that all seasons were significantly warming, while rainfall declined at various degrees and the distribution was highly variable across the study period. The ever rising minimum and maximum temperature and the erratic nature of rainfall has undermined the availability of pasture and water resources, especially during drought years resulting in the prevalence of livestock diseases. The age of the household head, poor access to information, lack of credit and saving services, limited knowledge, and erratic rainfall were found to be the determinant factors in the choice of adaptation options to climate variability and extremes. The study also found that lack of appropriate intervention and support mechanisms by government and non-government actors as well as the reluctance of pastoralists and agro-pastoralists to accept the stakeholders’ advice were the barriers to climate variability adaptation. Thus, it is clear that pastoralists’ and agro-pastoralists’ livelihood is at risk for climate variability and extremes and hence, requires context specific adaptive capacity building intervention that ranges from awareness creation to strengthening basic infrastructures and rangeland management.

PHQ-9, CES-D, health insurance data—who is identified with depression? A Population-based study in persons with diabetes

AimsSeveral instruments are used to identify depression among patients with diabetes and have been compared for their test criteria, but, not for the overlaps and differences, for example, in the sociodemographic and clinical characteristics of the individuals identified with different instruments.MethodsWe conducted a cross-sectional survey among a random sample of a statutory health insurance (SHI) (n = 1,579) with diabetes and linked it with longitudinal SHI data. Depression symptoms were identified using either the Centre for Epidemiological Studies Depression (CES-D) scale or the Patient Health Questionnaire-9 (PHQ-9), and a depressive disorder was identified with a diagnosis in SHI data, resulting in 8 possible groups. Groups were compared using a multinomial logistic model.ResultsIn total 33·0% of our analysis sample were identified with depression by at least one method. 5·0% were identified with depression by all methods. Multinomial logistic analysis showed that identification through SHI data only compared to the group with no depression was associated with gender (women). Identification through at least SHI data was associated with taking antidepressants and previous depression. Health related quality of life, especially the mental summary score was associated with depression but not when identified through SHI data only.ConclusionThe methods overlapped less than expected. We did not find a clear pattern between methods used and characteristics of individuals identified. However, we found first indications that the choice of method is related to specific underlying characteristics in the identified population. These findings need to be confirmed by further studies with larger study samples.

Characteristic association of symbol coding test score with occupational function in Japanese patients with schizophrenia.

Studies showed that cognitive function affects occupational function in patients with schizophrenia. This study aimed to determine the effects of cognitive function on occupational function in Japanese patients with schizophrenia using the Brief Assessment of Cognition in Schizophrenia (BACS). Participants were 198 outpatients with schizophrenia or schizoaffective disorder (66 females; mean age 34.5 ± 6.8 years). Occupational function was assessed using the work subscale of the Life Assessment Scale for Mental Ill (LASMI-w). Multiple regression analysis was performed using the BACS as the independent variable and LASMI-w as the dependent variable. Furthermore, we divided the LASMI-w score into three groups, <11, 11-20, and >21, and performed a multinomial logistic regression analysis. Multiple regression analysis revealed that LASMI-w score was negatively associated with BACS composite score (β=-0.20, p < 0.01). Among the sub-items of the BACS, only the symbol-coding score showed a significant negative association (β=-0.19, p < 0.05). Multinomial logistic analysis showed that the better the composite and symbol coding scores, the smaller the impairment of the occupational function (composite score: β=2.39 between mild and moderate occupational impairments, p < 0.05; symbol coding score: β=2.44 between mild and severe impairments, p < 0.05). The occupational function of patients with schizophrenia was associated with overall cognitive function (composite score). In particular, the symbol coding score of the BACS was suggested to be related to work ability. These results might be useful in the assessment and training of cognitive rehabilitation aimed at employment support.

Access to medicines among the Brazilian population based on the 2019 National Health Survey.

Access to medicines is a challenge, especially in developing countries, highlighting the need of population-based research to evaluate access and related factors. This study aimed to assess access to medicines and identify associated factors using data from the 2019 Brazilian National Health Survey (PNS). This population-based cross-sectional study used data from the 2019 PNS and considered access to prescription medicines as the primary outcome. The sample included 24,753 individuals aged 15 years or older who looked for medical care in the last 15 days and received a medicine prescription. Andersen's behavioral model was used to select independent variables. After descriptive analysis, a multinomial logistic regression multilevel analysis was performed using the independent variables with a significance level lower than 0.20 in the bivariate analysis. The lowest chances of getting access to medicines were observed in individuals aged between 40 and 59 years, women, with complete middle and high school, with lower-income families, who attended public services, with worse self-assessed health, and those who looked for health care for disease prevention and health promotion. Access to medicines among the Brazilian population is associated with social, economic, and health perception factors. Our findings may update and guide the development of public policies on medication and pharmaceutical care, facilitating medication purchases by the care user and promoting health equity.

Place of death from dementia as an underlying cause during the COVID-19 pandemic in Japan: a cross-sectional study from national death certificates.

The coronavirus disease (COVID-19) pandemic has challenged palliative end-of-life care for people with dementia. The site of death can be considered as an end-of-life care quality indicator. Most people with dementia prefer to die at nursing or private homes; however, in Japan, they are often hospitalized in psychiatric hospitals for management of neuropsychiatric symptoms. As palliative end-of-life care for older adults with Alzheimer's disease and related dementias has been further challenged by the COVID-19 pandemic, little is known about its effects on the place of death in patients with dementia. This study aimed to investigate the shifts in place of death from dementia during the COVID-19 pandemic in Japan. Changes throughout the pandemic were compared between deaths from dementia and from senility. Cross-sectional. Death certificate data of individuals aged 65 years or older who died in Japan between 1 January 2018, and 31 December 2021, were used to extract the cause and place of death. Differences in place of death between the periods were estimated using multinomial logistic analysis with reference to death in private homes. Deaths from dementia mostly occurred in hospitals (59%), while deaths from senility were most frequent in nursing homes (37%). After adjusting for patient characteristics, the likelihood of hospital deaths significantly increased for patients with dementia during the pandemic. Meanwhile, the likelihood of senility deaths decreased in hospitals but increased in nursing homes during the pandemic. The shift to hospital deaths since the onset of the COVID-19 pandemic was uniquely observed in deaths from dementia. This hospital shift likely involved increased transfers from nursing and private homes to psychiatric hospitals. Further investigation is needed to examine the association between the pandemic-related change in long-term care workforce and palliative care practice in people with dementia.

Double screening for syphilis and HIV in pregnant women in a priority municipality for the elimination of vertical transmission in Brazil: incidence, risk factors and spatial analysis.

The Brazilian Ministry of Health (MoH) recommends double screening (DS) for syphilis and HIV during the first and third trimesters of antenatal care (ANC) to mitigate vertical transmission. We surveyed DS outcomes and their associated factors in a priority Brazilian municipality with >100 000 inhabitants who face challenges for both health problems. A total of 399 women were followed up throughout pregnancy using medical records. Spatial and multinomial logistic analyses were performed. There was an incidence rate of 24.8%, 59.4% and 15.8% for 'full DS', 'partial DS' and 'without DS', respectively. Younger women and those with a history of both prematurity and multiparity were less likely to be in the 'full DS' category. There was an overlap of high-density clusters of 'full DS' and 'ANC in better quality basic health units', adherent to both the Family Health Strategy and the National Program for Access and Quality Improvement in Primary Care. The poor DS outcomes presented in 75% of the cases were mostly linked to delays in starting ANC appointments or their discontinuity. Thus, the MoH recommendations, accompanied by ongoing training, technical assistance and the periodic evaluation of their implementation, need to effectively reach providers and promote counseling and awareness about the importance of DS for pregnant women.

Farmer sales decisions and the sustainability of the coffee supply chain in Indonesia

The aims of this study: 1) analyze of Indonesian coffee farmers in determining the purpose of selling coffee; 2) analyze the factors that influence the decisions of Indonesian coffee farmers in determining coffee sales for improving the sustainability of the Indonesian coffee supply chain. This study uses data from the Indonesian Plantation Business Household Survey and multinomial logistic analysis methods. The number of respondents analyzed was 21 361 coffee farmers scattered throughout Indonesia. Coffee farmers in Indonesia sell to collectors, markets, village unit cooperatives, and plantation companies. The percentage of farmers coffee sales is through collectors due to distance, cost, ease of cash, and ease of transaction. In contrast, farmers who deal with the company will tend to sell coffee to the company because of the partnership. improvement of quality consistency and production continuity is carried out such as with Geographical Indications (GI) of production center areas. This can be done by various supply chain actors such as the Community Concerned for Geographical Indications (MPIG) in conducting counseling and mentoring for farmers. This can trigger the coffee supply chain in Indonesia.

Skipping breakfast during pregnancy and hypertensive disorders of pregnancy in Japanese women: the Tohoku medical megabank project birth and three-generation cohort study

BackgroundHypertensive disorders of pregnancy (HDP) adversely affect the prognosis of mother and child, and the prognosis depends on the subtype of HDP. Skipping breakfast may be associated with increased blood pressure due to disruption of the circadian clock, but the association with the development of HDP has not been studied. The purpose of this study was to examine the association between skipping breakfast and the development of HDP and HDP subtypes in Japanese pregnant women.MethodsOf the pregnant women who participated in the Tohoku Medical Megabank Project Three-Generation Cohort Study, 18,839 who answered the required questions were included in the analysis. This study had a cross-sectional design. The breakfast intake frequency from pre-pregnancy to early pregnancy was classified into four groups: daily, 5–6 times per week, 3–4 times per week, and 0–2 times per week. HDP was classified into gestational hypertension (GH), chronic hypertension (CH), preeclampsia (PE), and severe preeclampsia (SuPE). Multiple logistic regression analysis and multinomial logistic analysis were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for breakfast intake frequency and development of HDP or HDP subtypes. We performed a stratified analysis based on energy intake.ResultsOf the participants, 74.3% consumed breakfast daily, and 11.1% developed HDP. Women who consumed breakfast 0–2 times per week had a higher risk of HDP (OR: 1.33, 95% CI: 1.14–1.56), CH (OR: 1.63, 95% CI: 1.21–2.19), and PE (OR: 1.68, 95% CI: 1.27–2.21) than those who consumed breakfast daily. No association was found between skipping breakfast and the risk of developing GH (OR: 1.26, 95% CI: 0.99–1.61) and SuPE (OR: 0.91, 95% CI: 0.55–1.49). Stratified analysis showed that the risk of developing HDP due to skipping breakfast was highest in the group with the highest daily energy intake.ConclusionsSkipping breakfast during pre-to early pregnancy is associated with the development of HDP. Further longitudinal studies are required to clarify the causal association between skipping breakfast and HDP.

An Analysis of Livelihood-Diversification Strategies among Farmworker Households: A Case Study of the Tshiombo Irrigation Scheme, Vhembe District, South Africa

Rural livelihood diversification has become a central policy in rural development and poverty alleviation. Farmworkers in irrigation schemes are a typical poor sub-group that has received little attention in research regarding their livelihood status and the contribution of diversification. This paper provides evidence derived from a study that was carried out to examine whether farmworkers in the study area diversify their livelihoods and identify their choices of livelihood-diversification strategies and the determinants thereof. Data were collected from 191 randomly selected farmworkers and analyzed using the binary probit model and the multinomial logistic model. Variables considered in the binary probit model—gender, number of dependents, employment type, farming experience, land leasing, and market access—influenced livelihood diversification among irrigation farmworkers in a statistically significant way. The multinomial logistic model analysis considered age, marital status, household dependents, leasing land from employer, farming experience, agricultural training, and access to markets as the statistically significant factors that influence the choice of livelihood-diversification strategies in the study area. The study concluded that rural development policies should consider leasing land to irrigation farmworkers that is adequate to reduce poverty, achieve food security, and sustain the livelihoods of farmworkers in the study area, as it boosts the generation of income.

Impact of 420del (rs72552763) organic cation transporter 1 polymorphism on therapeutic response to metformin in type2 diabetic patients in the Iraqi population

Metformin is one of the most widely prescribed medications for the treatment of type 2 diabetes (T2DM) but metformin response varies greatly between individuals,polymorphisms in genes that regulate metformin’s pharmacokinetics and pharmacodynamics may be to blame for these phenotypic differences in drug disposition and action. Inthis study, we investigated the association between 420del (rs72552763) organic cation transporter 1 (OCT1) polymorphism and therapeutic response to metformin in type 2 diabetic patients, A total of 200 diabetic patients enrolled in this cross-sectional study, patients were chosen when they visit outpatient clinic for medical care. Fasting serum glucose, fasting serum insulin and HbA1c, which indicate metformin response were measured. The result of the study indicate there was a significant association between the presence of 420del (rs72552763) in diabetic patients and the variability response to metformin, the multinomial logistic regress analysis indicates that most patients with the reference allele (wild type) and heterozygous alleles of OCT1 (420del) had statistically significant metabolic responses to metformin, whereas patients with mutant alleles had less or no response. In conclusion, Genetic polymorphism of OCT1transporter 420del (rs72552763) contributed to the variability of therapeutic response to metformin treatment.

PEMBELAJARAN MESIN UNTUK MENILAI KELAYAKAN KREDIT PROYEK RETROFIT: MULTINOMIAL LOGIT

Creditworthiness assessment was one of the first areas to apply machine learning techniques in economics. The creditworthiness of retrofit protection was vital for ESCO in determining the credit scoring. This study aimed to develop a retrofitting assessment model to utilize machine learning with multinomial logistic (MNL) and life cycle cost analysis (LCCA). This study aims to provide an evaluation of creditworthiness models from the evaluation of financing alternative in Indonesia's energy efficiency industry. The goal was to reduce the total of prediction error, which comprised bias, variance, and fundamental error. The findings demonstrated that machine learning approaches might yield significantly greater prediction accuracy. In addition, machine learning is also expected to automatically capture the nonlinear relationship between input features and selected results. This study is also expected to draw on ideas from machine learning to develop an enhanced model for retrofitting creditworthiness research and suggest new research directions.

Early Postoperative Pain Trajectories after Posterolateral and Axillary Approaches to Thoracic Surgery: A Prospective Monocentric Observational Study.

Less-invasive thoracotomies may reduce early postoperative pain. The aims of this study were to identify pain trajectories from postoperative days 0–5 after posterolateral and axillary thoracotomies and to identify potential factors related to the worst trajectory. Patients undergoing a posterolateral (92 patients) or axillary (89 patients) thoracotomy between July 2014 and November 2015 were analyzed in this prospective monocentric cohort study. The best-fitting model resulted in four pain trajectory groups: trajectory 1, the “worst”, with 29.8% of the patients with permanent significant pain; trajectory 2 with patients with low pain (32.6%); trajectory 3 with patients with a steep decrease in pain (22.7%); and trajectory 4 with patients with a steep increase (14.9%). According to a multinomial logistic model multivariable analysis, some predictive factors allow for differentiation between trajectory groups 1 and 2. Risk factors for permanent pain are the existence of preoperative pain (OR = 6.94, CI 95% (1.54–31.27)) and scar length (OR = 1.20 (1.05–1.38)). In contrast, ASA class III is a protective factor in group 1 (OR = 0.02 (0.001–0.52)). In conclusion, early postoperative pain can be characterized by four trajectories and preoperative pain is a major factor for the worst trajectory of early postoperative pain.

The association of serum phthalate metabolites with biomarkers of ovarian reserve in women of childbearing age

Phthalates (PAEs) are widely used plasticizers drawing increasing concern due to reproductive toxicity. However, studies on serum PAEs metabolites (mPAEs) and their associations with human ovarian function remain very scarce. In this study, from April 2019 to August 2020, a total of 297 women of childbearing age were recruited in Tianjin, China. Eleven mPAEs were analyzed in serum samples and eight mPAEs were detected at frequencies > 65% with median concentrations of 0.43–15.3 ng/mL. In multinomial logistic analysis, an increase in serum mono (2-isobutyl) phthalate (miBP) was associated with decline in antral follicle count (AFC) (OR=1.26, 95% CI: 0.99, 1.61) and 5-mono-(2-ethyl-5-hydroxyhexyl) phthalate (mEHHP) was significantly associated with AFC increase (OR=1.43, 95% CI: 1.06, 1.92), which were aligned with the associations found between mPAEs and AMH through generalized linear regression. In multiple linear regression models, per 10% increase in serum mono (2-ethylhexyl) phthalate (mEHP), mono (2-ethyl-5-oxohexyl) phthalate (mEOHP) (oxo-mEHP), and principal component 1 featured for high concentrations of mono-n-butyl phthalate (mBP), miBP and mEHP were associated with 0.15 (95% CI: −0.29, −0.02), 0.01 (95% CI: −0.01, 0.00) and 0.01 (95% CI: −0.02, 0.00) ln-unit decrease in estradiol (E2) levels, respectively, while mono-[(2-carboxymethyl) hexyl] phthalate (mCMHP) (carboxymethyl-mEHP) was positively associated with 0.05 ln-unit increase of E2 (95% CI: 0.02, 0.08). The observed negative associations between mPAEs and the Anti-Müllerian hormone (AMH) also aligned with the change in AFC. Generalized linear regression also revealed nonlinear associations between mono-ethyl phthalate (mEP), mCMHP and follicle-stimulating hormone (FSH). Overall, serum mEHP and its metabolites were negatively associated with E2. miBP was negatively associated with AFC. The nonlinear associations between mPAEs and FSH, and AMH need further study.

Compatibility of the Incompatible: How Does Asymmetric Power Lead to Coexistence of Trust and Distrust in Adversarial Policy Networks?

ABSTRACT Asymmetric power has been found to hinder the development of trust that is essential for structuring policy subsystems or networks. Using a multinomial logistic analysis of a local hydraulic fracturing policy network in New York, our findings indicate that (1) power imbalance affects the coexistence of trust and distrust and (2) power imbalance interacting with certain types of social relationships (policy communication, regulation, and knowledge exchange) leads to the coexistence of trust and distrust. We suggest three implications for the governance of policy networks and policy process literature: increasing levels of trust do not guarantee decreasing levels of distrust, asymmetric power has an impact on structuring “ambivalent” relations, and adversarial policy subsystems can take four structural forms depending on the levels of trust and distrust.

Application of Multinomial Logistic Regression Model on Factors that Affects the Need for Children Among Ethiopian Women

Background: Need for children (desire for children), is one of the major factors influencing the population dynamics. Like other fertility preferences, it is not fixed but changes over the family life course in respect to actual fertility experiences and outcomes. The objective of this study was to identify socio-economic and demographic factors that affect the need for another child (desire for more children) among Ethiopian women of reproductive age (15-49). Methods: The study was based on Ethiopian Demographic and Health Survey (EDHS), 2016 data. A total of 15,683 women with complete information were considered in the study. A Multinomial Logistic Regression Model, a family of generalized non-linear models, were used to identify determinant factors for the need to children (desire for children) among women in Ethiopia using STATA 14 and SPSS 23. Results: Results showed that among the reproductive age women’s 65.51% were need to have childe, and their average age was 25.05, 27.18% were don’t like to have child and their average age was 35.73, the rest 7.31% of the women were not decide where they need children or not and their average age was 24.8.From multinomial logistic regression model, Region, contraception using (for yes 0.658293 (0.58889, 0.73586) for undecided 0.6310024 (0.50151, 0.79394)), marital status, age of women(for yes 0.896552 (0.88968, 0.90348) for undecided 0.9282431 (0.91632, 0.94033)), number of living children, religion, age at first marriage ( for yes1.057528 (1.04363, 1.07161) for undecided 1.041 (1.01434,1.06836)), wealth index, women’s employment and women’s education were significant effect on the need for children among Ethiopian women. Conclusions: This study was based on a nationwide large sample demographic and survey conducted by the Ethiopian Statistical Agency. The study has empirically investigated and identified the determinants factors that affect the need for children among Ethiopian women. The multinomial logistic regression model analysis identified that variables such as marital status, contraception using, number of living children, age at first marriage and age of women play vital role in deciding on weather women need to have children or not. Region contraceptive using women’s employment, women’s education level and number of living children have negatively associated with outcome variable.

Associations between Children's Health-Related Characteristics, Self-Esteem, and Fathers' Parenting Practices and Media Addiction among Younger School-Aged Korean Children.

This study aimed to investigate the relationship between media addiction levels among early school-aged children and their health status, self-esteem, and their fathers’ parenting practices. Therefore, we analyzed the data from a total of 1149 fathers and children from the 10th year (2017) survey of the Panel Study on Korean Children (PSKC), by the Korean Children’s Panel Research Institute. Specifically, a multinomial logistic analysis was conducted to identify the factors affecting children’s media addiction. The media addiction levels were 68.8%, 24.9%, and 6.3%, in general, high-risk, and potential-risk users, respectively. When media addiction levels were used as the reference group for general users, the pattern observed in the data revealed a direct positive association between media use time and the probability of becoming a potential-risk user (79.4%, OR = 1.79, 95% CI: 1.20, 2.68). Furthermore, when general users were used as the reference group, the male gender accounted for the majority of high-risk users, at 99% (OR = 1.99, 95% CI: 1.46, 2.71). Within this group, the children’s body mass index (BMI) was high (5%, OR = 1.05, 95% CI: 1.00, 1.11), their media use time increased by 1 h a day (145%, OR = 2.45, 95% CI: 1.93, 3.11), their self-esteem decreased (32%, OR = 0.68, 95% CI: 0.49, 0.95), the fathers’ authoritative parenting practices were low (37%, OR = 0.63, 95% CI: 0.43, 0.92), and the permissive parenting practices were high (92%, OR = 1.92, 95% CI: 1.09, 3.37). Therefore, the results of this study highlight children’s media use time and the risk factors related to high BMIs in order to prevent media addiction among early school-aged children. Our findings also suggest appropriate parenting practices and highlight the need to strengthen children’s self-esteem.

청소년의 진로개발역량 잠재전이유형과 관련 변인 연구

Objectives This study classified youths living in Busan into different latent groups depending on career development competencies and performed an analysis to identify what factors can be used to predict related patterns including a pattern of transition between latent groups. Methods In this study, we used the first wave (2016, first grade middle school students) and fifth wave (2020, second grade high school students) of data from Busan Education Longitudinal Study (BELS). The subjects are 1,915 youths, who responded to all of the 16 questionnaire items concerning career development competencies. We performed latent transition analysis to identify the latent profile types and transition between classes across two-time points. Subsequently, multinomial logistic analysis was applied to explore variables that can be used to predict a transition pattern. Results First, the first grade middle school students and second grade high school students were classified into two groups: active and passive career planning groups. Second, the patterns of profile transition between the two points in time were classified into two types: maintenance and change types. Generally, latent groups of career development competencies in middle school transitioned into similar latent groups. The probability of maintenance was higher in an active career planning group than in other types. Of the subjects, 29.4% showed negative change, while 36.4% showed positive change. Third, the analysis of factors affecting career development competencies of middle schoolers found that the first grade middle school students were more likely to belong to the active career planning group if they had visited an upper school, attended a school admission briefing session or collected information from media and online communities. For the second grade high school students, a consultation with the homeroom teacher was not a statistically significant variable. They were more likely to belong to the active career planning group if they had a consultation with the career teacher at school. Conclusions The variables having a significant effect on latent groups were different between middle and high schoolers, and there were no variables affecting the transition between the two points in time. What is emphasized in career experience needs to be different in each grade.

Characterization of Severity in Zellweger Spectrum Disorder by Clinical Findings: A Scoping Review, Meta-Analysis and Medical Chart Review.

Zellweger spectrum disorder (ZSD) is a rare, debilitating genetic disorder of peroxisome biogenesis that affects multiple organ systems and presents with broad clinical heterogeneity. Although severe, intermediate, and mild forms of ZSD have been described, these designations are often arbitrary, presenting difficulty in understanding individual prognosis and treatment effectiveness. The purpose of this study is to conduct a scoping review and meta-analysis of existing literature and a medical chart review to determine if characterization of clinical findings can predict severity in ZSD. Our PubMed search for articles describing severity, clinical findings, and survival in ZSD resulted in 107 studies (representing 307 patients) that were included in the review and meta-analysis. We also collected and analyzed these same parameters from medical records of 136 ZSD individuals from our natural history study. Common clinical findings that were significantly different across severity categories included seizures, hypotonia, reduced mobility, feeding difficulties, renal cysts, adrenal insufficiency, hearing and vision loss, and a shortened lifespan. Our primary data analysis also revealed significant differences across severity categories in failure to thrive, gastroesophageal reflux, bone fractures, global developmental delay, verbal communication difficulties, and cardiac abnormalities. Univariable multinomial logistic modeling analysis of clinical findings and very long chain fatty acid (VLCFA) hexacosanoic acid (C26:0) levels showed that the number of clinical findings present among seizures, abnormal EEG, renal cysts, and cardiac abnormalities, as well as plasma C26:0 fatty acid levels could differentiate severity categories. We report the largest characterization of clinical findings in relation to overall disease severity in ZSD. This information will be useful in determining appropriate outcomes for specific subjects in clinical trials for ZSD.