Multinomial Logistic Regression Analysis Research Articles

Survival and Risk Factors for Late Preterm and Early Term Neonates Compared to Full-Term Infants at Garissa County Referral Hospital, Kenya

Preterm birth constitutes a significant health burden in Kenya, yet there is hardly any targeted research looking at the survival and specific risk factors associated with birth of late preterm neonates (LPNs) and early term neonates (ETNs), particularly in Garissa County. While studies on preterm birth determinants have been done in Kenya, factors specifically influencing LPNs and ETNs births and their survival relative to their full-term counterparts remain understudied. Studies done on preterm in general have identified maternal age, history of preterm birth, pregnancy-induced hypertension, and prolonged premature rapture of the membrane among others as significant risk factors, but their relevance to LPNs and ETNs specifically has not been fully investigated. This study aimed to address these gaps by determining maternal as well as fetal risk factors associated with LPN and ETN births compared to full-term neonates (FTNs) born at Garissa County Referral Hospital. Further, it sought to identify predictors of survival across these neonatal groups. The study conducted at Garissa County Referral Hospital employed a prospective cohort design. Mother-neonate dyads were enrolled using convenience sampling method until the required sample was achieved. Data was collected using pretested and validated questionnaires. STATA version 17 was used for analysis. Multinomial logistic regression analysis was performed to determine Relative Risk Ratio. The P-value was set α=0.05 and P<0.05 was considered statistically significant. Survival rates were estimated using Kaplan-Meier survival analysis. Bivariate Cox regression analysis was employed to identify independent predictors at p<0.20. However, since all variables had p-values >0.02, multivariate Cox regression was not conducted. The study revealed that maternal age (P=0.042), occupation (P=0.024), ethnicity (P=0.021), religion (P=0.016) and absence of previous abortion/still birth/premature deliveries (P=0.015) were maternal related factors associated with birth of LPN, ETN and FTN. Birth weight was associated with LPN (P<0.001), while FTN had higher likelihood of delayed initiation of breastfeeding (P=0.038) but were less likely to have feeding difficulties compared to LPN and ETN (P=0.012). A comparison of fit model with the complete set of predictors with an intercept-only, or null model revealed that P-values for maternal (P=0.0175) and fetal (P<0.001) related risk factors were less than Fisher’s value of 0.05, hence the null hypothesis was rejected. The Kaplan-Meier survival analysis revealed high survival rates across all gestational age categories, with 100% survival among LPNs. In conclusion, the study showed that maternal- and fetal-related risk factors associated with LPNs and ETNs are distinct from those of FTNs.

Effect of Local Fire Risks and Preventive Measures on the Installation of Residential Firefighting Systems in Detached House

This study analyzes the major factors affecting the installation of residential firefighting systems in detached houses. In particular, it investigates the dependence of local fire risk and local government prevention efforts, along with housing and household characteristics, on the type of installation. This study used data from the 2020 Population and Housing Census, the first nationwide survey on residential firefighter system installation, and employed multinomial logistic regression analysis. The analysis results revealed that less than half of households had installed all firefighting systems, where the installation rate differed significantly by region. Housing and household characteristics also influenced the installation type. Local fire risk as well as the local government’s fire prevention policies positively affect the installation of residential firefighting systems.

CCN5/WISP2 serum levels in patients with coronary artery disease and type 2 diabetes and its correlation with inflammation and insulin resistance; a machine learning approach

IntroductionStudies have shown various effects of CCN5/WISP2 on metabolic pathways, yet no prior investigation has established a link between its serum levels and CAD and/or T2DM. Therefore, this study seeks to explore the relation between CCN5 and the risk factor of CAD and/or diabetes, in comparison to individuals with good health, marking a pioneering endeavor in this field. MethodsThis case-control study investigates serum levels of CCN5, TNF-α, IL-6, adiponectin, and fasting insulin in a population of 160 individuals recruited into four equal groups (T2DM, CAD, CAD-T2DM, and healthy controls). Statistical tests comprise Chi-square tests, ANOVA, Spearman correlation, and logistic regression. ROC curves were used to represent the diagnostic potential of CCN5. Disease states are predicted by machine learning algorithms: Decision Tree, Gradient Boosted Trees, Random Forest, Naïve Bayes, and KNN. These models' performance was evaluated by various metrics, all of which were ensured to be robust by applying 10-fold cross-validation. Analyses were done in SPSS and GraphPad Prism and RapidMiner software. ResultsThe CAD, T2DM, and CAD-T2DM groups had significantly higher CCN5 concentrations compared to the healthy control group (CAD: 336.87 ± 107.36 ng/mL, T2DM: 367.46 ± 102.15 ng/mL, CAD-T2DM: 404.68 ± 108.15 ng/mL, control: 205.62 ± 63.34 ng/mL; P < 0.001). A positive and significant correlation was observed between CCN5 and cytokines (IL-6 and TNF-α) in all patient groups (P < 0.05). Multinomial logistic regression analysis indicated a significant association between CCN5 and T2DM-CAD, T2DM, and CAD conditions (P < 0.001) even after adjusting for gender, BMI, and age (P < 0.001). Regarding the machine learning models, the Naïve Bayes model showed the best performance for classifying cases of T2DM, achieving an AUC value of 0.938±0.066. For predicting CAD, the Random Forest classifier achieved the highest AUC value of 0.994±0.020. In the case of CAD-T2DM prediction, the Naïve Bayes model demonstrated the highest AUC of 0.981±0.059, along with an Accuracy of 97.50 % ± 7.91 % and an F-measure of 96.67 % ± 10.54 %. ConclusionOur study has revealed, for the first time, a positive connection between CCN5 serum levels and the risk of developing T2DM and CAD. Nonetheless, more research is needed to ascertain whether CCN5 can serve as a predictive marker.

Occupational Well-Being Profiles and Learning Climate as an Organizational Resource: A Latent Transition Analysis

AbstractThe aim of the present longitudinal study was to profile the occupational well-being (burnout, work engagement) of highly educated employees (n=442) at three measurement points: in 2017 (T1), 2019 (T2), and 2021 (T3). We were interested in whether profile transitions would occur during the follow-up, and if so, whether the three dimensions of perceived learning climate (facilitation, appreciation, and error avoidance) predict these transitions, and hence function as an organizational-level resource that could help highly educated employees to sustain or improve their occupational well-being. We identified three profiles at each measurement point: (1) burnout, lowered engagement; (2) average exhaustion, high engagement; and (3) low burnout, very high engagement. Latent Transition Analysis indicated that employees both maintained their profiles and made transitions during the follow-up. The findings for the second study period (T2-T3) showed a somewhat less favorable development of occupational well-being. Multinomial Logistic Regression Analysis revealed that perceived learning climate predicted the T2-T3 but not T1-T2 transitions. We conclude that employee well-being can simultaneously comprise both positive and negative states. Although the organizational resource perspective gained some support, this tentative evidence also raises the question of whether employees perceive an appreciative learning climate as more stressful than helpful. Overall, the longitudinal relationship of occupational well-being with the dimensions of perceived learning climate warrants further study.

Multinomial Logistic Regression Analysis in Determining Factors That Affect Social Media Selection Among Students of Faculty of Mathematics and Natural Science, Universitas Brawijaya

Multinomial Logistic Regression Analysis in Determining Factors That Affect Social Media Selection Among Students of Faculty of Mathematics and Natural Science, Universitas Brawijaya

Analyzing the Risk Factors of Early Neonatal Deaths in Kupang District, Rural Eastern Indonesia

The neonatal mortality rate in East Nusa Tenggara (NTT) remains high, with 80% of neonatal deaths occurring in the early period. This study aims to analyze the risk factors contributing to early neonatal death in Kupang District. A retrospective case-control study was conducted, involving 31 cases of early neonatal death and 69 controls from medical records from January 2023 to June 2024. Multinomial logistic regression analysis was used to identify the influence of maternal health, birth, neonatal factors, and healthcare facility readiness. The results showed that birth weight, frequency of antenatal visits, and the completeness of medical equipment were significant predictors of early neonatal death. More frequent antenatal visits were found to reduce the risk of death by 24%, while low birth weight increased the risk by 30%. In conclusion, interventions focusing on preventing low birth weight, ensuring compliance with minimum antenatal visits, and improving the readiness of basic healthcare facilities could reduce early neonatal death in this region.

Diagnostic pathways and outcomes by comorbidity in cancer patients: a study in Northern Italy

Abstract Background Pre-existing chronic conditions can influence cancer diagnosis and outcomes. The study aimed to examine variations in diagnostic pathways and outcomes in colorectal cancer (CRC) patients by comorbidity status and socio-demographic characteristics in the provinces of Milan and Lodi, Northern Italy. Methods A population-based cohort study using linked administrative health data from the Agency for Health Protection (ATS) of Milan was conducted on individuals aged ≥18 years diagnosed with CRC in 2014-2017. We examined pathways to cancer diagnosis, stage at diagnosis and short-term mortality by specific comorbidities and sociodemographic factors. Results Among the 5,272 colon cancer and 2,120 rectal cancer patients, 43.9% and 61.5%, respectively, had at least one pre-existing comorbidity, most frequently hypertension (52.7% and 49.9%) and cardiovascular disease (CVD, 23.2% and 18.5%). Cancer diagnostic pathways included screening (4.1% colon and 4.4% rectal cancer patients), EP (22.8% and 12.6%) and inpatient/outpatient admission (73.1% and 82.9%). At multivariable logistic regression, patients with pre-existing cerebrovascular or neurological diseases had significantly higher odds of EP for CRC. In the multinomial logistic regression analysis, the odds of EP were significantly higher for patients aged &amp;lt;50 or ≥ 80 (vs 60-69), belonging to the highest deprivation group and being widowed (vs married). The odds of screen-detected CRC were lower for patients with multimorbidity (2 vs 0 comorbidities: adjusted OR = 0.32, 95% CI 0.14-0.75). 30-day and one-year mortality were higher in colon cancer patients with EP vs inpatient/outpatient (aOR=2.46, 95%CI 1.95-3.09; aOR=2.02, 95%CI 1.74-2.35 respectively). As the number of chronic conditions increased, mortality increased especially at one year. One-year mortality was also higher for rectal cancer patients with 3+ comorbidities (vs no comorbidities). Key messages • Patients with pre-existing chronic conditions had a lower likelihood of screening, higher odds of emergency CRC diagnosis and higher mortality. EPs occur in one in five CRC patients. • Tailored interventions might be needed to facilitate CRC screening, reducing emergency diagnoses and improving health outcomes for the large number of patients with chronic conditions.

The association of schooling, sibling life situation, and dietary habits with the estimated 24-h urinary salt excretion and sodium-to-potassium ratio in 3-year-old children

ABSTRACT Objectives We examined the association of schooling, sibling life situation, and dietary habits with the estimated 24-h urinary salt excretion and the urinary sodium-to-potassium (Na/K) ratio in 3-year-old children. Methods The subjects were 639 children who underwent a health checkup in four cities and towns in Kyoto Prefecture from January to November 2019. The children’s parents answered questionnaires about weekday childcare places, the birth order, and the awareness of reducing the salt intake. The questions on food intake frequency included 10 items. The estimated 24-h salt excretion and Na/K ratio were calculated from the participants’ first voiding urine in the morning. Results Data were available for 294 children. The median (interquartile range (IQR)) of salt excretion (g/day) was 2.6 (1.7–3.4), and urinary Na/K ratio (mmol ratio) was 2.6 (1.6–4.1). Multinomial logistic regression analysis showed that the group with older siblings was significantly associated with high salt (odds ratio 1.89 (95% confidence interval 1.04 to 3.46)). In the urinary Na/K ratio, the nursery group had a significantly lower Na/K (odds ratio 0.32 (0.17 to 0.60)). High processed meat products intake was associated with a higher Na/K (odds ratio 1.96 (1.05–3.66)), whereas high vegetable intake was associated with a lower Na/K (odds ratio 0.45 (0.23–0.87)). Other factors showed no significant associations. Conclusions In Japanese 3-year-old children, the estimated 24-h urinary salt excretion was associated with older siblings, and the urinary Na/K ratios were associated with schooling situation and the intake of processed meat products and vegetables.

The role of class stigma in socioeconomic inequalities in type 2 diabetes: The Maastricht Study

Abstract Background Low socioeconomic position (SEP) is a risk factor for type 2 diabetes mellitus (T2DM). An underlying mechanism behind socioeconomic health inequalities can be stigma, particularly classism. Studying the influence of class stigma in the context of (pre)diabetes and socioeconomic inequalities may shed light on the societal factors influencing diabetes. Methods Data from 1947 participants aged 49-88 who participated in the second phase of The Maastricht Study starting between November 2020 and April 2023 were used. SEP (education, income, occupation) and 6-item classism scale were measured through self-reported questionnaires. (Pre)diabetes was measured through an oral glucose tolerance test. We conducted multinomial logistic regression analyses to investigate the associations between SEP, classism, and diabetes status. Results 20.9% (N = 406) of the study sample had T2DM (Mage=69.8(±6.8) years; 31.3% women). People with low SEP had more often T2DM (e.g., income OR = 2.13, 95%CI:1.54-2.82) and reported perceived classism (e.g., education OR = 2.07, 95%CI:1.33-3.21) than people with high SEP. Classism was not statistically significantly associated with T2DM (OR = 0.78, 95%CI:0.48-1.29). Conclusions Social health inequalities are apparent in T2DM; however, our results suggest that class stigma might not be a major factor in underlying processes. Further research can investigate the role of chronic stress and intersection of multiple stigmas. Key messages • The underlying factors behind socioeconomic health disparities are complex. Social and psychological environment in low SEP should be investigated carefully. • Although low SEP is strongly associated with T2DM and perceived classism, class stigma might not be a major target in explaining socioeconomic pathways in diabetes.

An assessment of adequate quality antenatal care and its determinants in India

BackgroundAntenatal care (ANC) is an important component in the continuum of care. Providing adequate quality ANC is necessary to prevent maternal and newborn mortality. The coverage of ANC has increased significantly in the last decade in India, but a mere increase in coverage is insufficient if the issue of quality is not simultaneously addressed. This study examines the change in each component of quality ANC between 2015-16 and 2019-21, highlights the factors associated with adequate quality ANC, and observes the state- and district-level distribution of adequate quality ANC during 2019-21.MethodsThis study is based on data from the two most recent rounds of the National Family Health Survey (NFHS), the Indian equivalent of the Demographic and Health Surveys (DHS). These rounds were conducted in 2015-16 and 2019-21 in selected households of India with a total of 190,797 and 176,843 sampled births, respectively. The dependent variable was quality antenatal care, a composite variable consisting of skilled healthcare providers, timeliness, sufficiency, and appropriateness of content. The independent variables were mother’s age, education, wealth quintile, birth order, mass media exposure, health insurance coverage, relationship with the head of household, facility exposure, intended pregnancy, history of adverse pregnancy outcomes, and other socio-demographic variables. Change in each component and dimension of quality antenatal care was assessed using data from both rounds of the survey. A multivariate multinomial logistic regression analysis was employed to identify the determinants of adequate quality ANC using the NFHS-5 data.ResultsThe findings revealed that 32 per cent of mothers received adequate quality antenatal care in 2019–2021, an increase of only 9% points compared to the 2015-16 period. Two significant barriers to achieving adequate quality antenatal care, in terms of appropriateness of content, were the provision of Iron and Folic Acid (IFA) tablets and counselling. The highest utilisation of adequate quality antenatal care was observed in the southern states. The utilisation of quality ANC increased with an increase in women’s education and wealth status; and was more prevalent among those with health insurance coverage and exposure to mass media.ConclusionDespite some improvements in the coverage of antenatal care, the quality of antenatal care continues to be very low and needs urgent attention. Achieving quality antenatal care in both content and experience requires addressing service gaps and developing better measures to capture and improve women’s care experiences.

Adherence to Mediterranean diet in Moroccan school-age adolescents: sociodemographic, socioeconomic and lifestyle determinants

BackgroundDespite its benefits, the Mediterranean diet (MD) is abandoned or not adopted by the younger generations in most Mediterranean countries.ObjectiveThe aim here was to examine some factors determining adherence to MD in Moroccan school-age adolescents.Material and methodsA cross-sectional survey was conducted in a school setting among 386 students (148 boys and 238 girls), aged 14 to 18 years, randomly selected and from different socioeconomic strata. A structured questionnaire was used to collect sociodemographic, socioeconomic and lifestyle data. Physical activity was assessed using the short French version of the IPAQ questionnaire. The KIDMED test was used to assess adherence to the Mediterranean diet. Weight, height and waist circumference were measured according to WHO standards. Body mass index (BMI) and waist�to-height ratio (WHtR) were calculated. Statistical ANOVA test was used for to compare multiple means, Student’s t-test for independent samples, &lt;i&gt;Chi&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; test for categorical variables and multinomial logistic regression analysis to identify factors associated with adherence to the MD amongst adolescents sample.ResultsAdherence to the MD in this population was very low, with nearly 53% having poor adherence and only 7.7% reporting optimal adherence. Multinomial regression analyses showed that poor adherence is correlated with female gender (p=0.042), low paternal education (p=0.004), limited number of meals (p=0.006), advanced age (p=0.005) and inadequate sleep duration (p=0.027). In contrast, better adherence appears to be correlated with a high number of meals per day (p&lt;0.001) and a better socio-professional class of the father (p&lt;0.001).ConclusionsThis study revealed a low prevalence of good adherence to MD confirming a transition of the study adolescents towards a Westernized diet. Targeted nutritional intervention programs should be implemented to improve adherence to the MD among Moroccan adolescents, by promoting healthy eating habits.

Antenatal Care Services Uptake and Associated Factors in Somaliland: Further Analysis of the 2020 Somaliland Demographic Health Survey

Purpose Antenatal care (ANC) is vital to maintain the health of pregnant women and their unborn babies. It was linked to a positive pregnancy experience. However, ANC uptake remained low in Somaliland, and no study has been conducted to assess possible predictors. Hence, the current study aimed to determine the level of ANC utilization and to identify its associated factors in Somaliland. Materials and Methods Somaliland Demographic Health Survey (SLDHS) Data 2020 were used. A weighted sample of 3,192 women aged 15-49 years participated in the study. The survey used a two-stage cluster design for sample selection. Descriptive statistics in the form of frequency and percentage and multilevel multinomial logistic regression analysis were carried out to determine associated factors and statistical significance was declared by p&lt; 0.05. Results The findings showed that 62.4% (95% CI: 60.7-64.1) of the women did not utilize ANC services, while 23.4% (95% CI: 21.9, 24.9) partially utilized and 14.2% (95% CI: 13.0, 15.4) adequately utilized ANC services. The odds of adequately utilizing ANC service decreased by a factor of 0.88 for women aged 35 and above compared to 15 - 24 year old women (AOR= 0.88, 95% CI: 0.61, 1.26). Women with higher educational levels had significantly higher odds (AOR=4.31, 95% CI: 1.54, 12.02) of adequately utilizing ANC compared to those with no formal education. The employment status, marital status, household wealth index, residence and region were also found to be associated with the utilization of Antenatal care. Conclusion The study showed low adequate utilization of ANC services in Somaliland. The variables, including age, education, wealth index, marital status, employment status, residence and region, were significantly associated with ANC utilization. Governmental and non-governmental organizations should enact a strategy with targeted intervention focusing on women from nomadic and rural communities, those from poor households, and low educational levels.

Enhanced multinomial logistic regression analysis of determinants influencing technical and vocational education and training (TVET) choices among Ghanaian youth: Implications for policy development

In Ghana, youth unemployment remains significant challenges, with technical and vocational education and training (TVET) emerging as a potential solution to equip young people with practical skills for the job market. However, the uptake of TVET programmes among Ghanaian youth remains low, particularly among females. This study therefore explores the determinants that influence TVET choices among Ghanaian youth, with the goal of informing policy development to enhance participation in vocational education. Applying an enhanced multinomial logistic regression (MLR) model, this research examines the influence of socio-economic, demographic, and attitudinal factors on career decisions. The enhanced model accounts for class imbalances in the dataset and improves classification accuracy, making it a robust tool for understanding the drivers behind TVET choices. A sample of 1600 Ghanaian youth engaged in vocational careers was used, ensuring diverse representation of the population. Key findings reveal that males are approximately three times more likely to choose TVET programs than females, despite females making up 50.13% of Ghana’s population. Specific determinants influencing TVET choices include financial constraints, parental influence, peer influence, teacher influence, self-motivation, and vocational limitations. In regions with limited vocational options, youth often pursue careers based on availability rather than preference, which highlights a gap in vocational opportunities. Parental and teacher influences were found to play a dominant role in steering youth towards specific careers. The study concludes with recommendations for policymakers, instructors, and stakeholders to increase the accessibility, relevance, and quality of TVET programmes to meet the socio-economic needs of Ghanaian youth.

One-year trajectories of physical and mental health-related quality of life, fatigue and dyspnoea in COVID-19 survivors.

A substantial number of people experience a persisting impact on health-related quality of life (HRQoL) after COVID-19. The current study aims to identify different trajectories of physical and mental HRQoL, fatigue severity, and dyspnoea severity following hospitalisation with COVID-19, and associated factors of these trajectories. 500 patients with COVID-19 were followed for one year in a longitudinal cohort study. Self-reported outcomes were measured at 3, 6, 9, and 12 months after hospitalisation. Distinct trajectories were characterised using Growth Mixture Modelling. Sociodemographic and clinical correlates of trajectories were investigated using multivariable (multinomial) logistic regression analyses. Three trajectories ('stable high' (16%), 'improving' (40%), and 'stable low' (44%)) were found for physical HRQoL, and four ('stable high' (43%), 'improving' (14%), 'middle declining' (17%), and 'low' (26%)) for mental HRQoL. Older age, overweight and obesity, lower education, and comorbidities were associated with 'low' physical HRQoL. Younger age was associated with 'low' mental HRQoL. Four fatigue trajectories ('no fatigue' (15%), 'improving' (40%), 'low-severe' (27%), and 'high-severe' (18%)) were found. Participants either experienced almost never ('no dyspnoea', 75%) or almost always ('severe', 25%) dyspnoea. High co-occurrences between low HRQoL and severe fatigue and dyspnoea symptom trajectories were found. A substantial number of COVID-19 survivors continue to struggle with reduced HRQoL over time. However, large variations in these physical and mental HRQoL trajectories exist, and trajectories are associated with persisting COVID-19-related symptoms or pre-hospitalised health status. Regular measurement of HRQoL and post-COVID symptoms may help identify those that may benefit from timely interventions.

The role of parental consanguinity and familial aggregation in development of multiple sclerosis: a case–control study

BackgroundSeveral studies pointed out the importance of genetic risk factors such as parental consanguinity (PC) and familial multiple sclerosis (FMS) in the risk of MS. This study aimed to investigate the PC and FMS among people with MS (pwMS) in Isfahan, Iran.MethodsThis case–control study was conducted on pwMS from the MS clinic of Kashani Hospital, Isfahan, Iran, in October 2023. A group of healthy controls (HC) were also recruited. Data on demographic and clinical characteristics and history of PC and FMS were collected from participants. The relationships between PC, FMS, and developing MS were assessed using multinomial logistic regression analysis. The odds ratio (OR) with a 95% confidence interval (CI) was computed.ResultsA total number of 4264 pwMS and 400 HCs were included. The prevalence of PC and FMS among pwMS were 29.3% and 24%, respectively. Multinomial logistic regression adjusted for age and sex indicated that the odds of developing MS were significantly associated with a history of PC (OR = 3.03, 95% CI 2.23 to 4.13, p < 0.001) and FMS (OR = 5.42, 95% CI 3.51 to 8.38, p < 0.001).ConclusionPC and FMS can increase the risk of developing MS. They should be considered along with other risk factors for developing MS. A comprehensive conclusion requires further research.

Genetic polymorphism of IL-40 in male patients with ankylosing spondylitis

Background: Ankylosing spondylitis (AS) is a kind of arthritis marked by persistent inflammation in the spine's joints, usually at the point where the spine and pelvis meet. Such a disease has different causes, including immunological causes. Therefore, it is necessary to investigate the role of the immune system in this disease to improve a potential treatment strategy. In this context, the present study examined the single nucleotide polymorphisms (SNPs) of the IL-40 gene of IL-40 in a group of Iraqi males with AS to determine their associations in AS pathogenesis. Method: The study included a total of 200 Iraqi male participants (100 with AS and 100 healthy subjects). The detection of SNPs of IL-40 was performed using polymerase chain reaction (PCR) techniques followed by the Sanger sequencing method. Multinomial logistic regression analysis was used to analyze the SNPs under five genetic models (allele, recessive, dominant, and co-dominant). Results: Detected that the heterozygous genotype (GA and AA) and alleles (G and A) of rs72896265, the heterozygous genotype (AG and GG) and alleles (A and G) of rs60316778 and both heterozygous genotype (CC) and alleles (C and T) of rs9915090 were significantly associated with AS risk (p &lt; 0.001).

Sleep patterns and their associations with psychiatric symptoms among Chinese healthcare workers: a latent profile analysis.

Healthcare workers often encounter inadequate sleep conditions. However, limited research has examined the underlying sleep patterns among healthcare workers. This study aimed to identify sleep patterns in healthcare workers, explore predictors associated with various sleep patterns, and investigate the relationship between sleep patterns and psychiatric symptoms. This cross-sectional study was conducted in Shenzhen, China, from April 2023 to June 2023. In total, data from 1,292 participants were included using a convenience sampling method. A latent profile analysis was conducted to identify sleep patterns based on the seven dimensions of the Pittsburgh Sleep Quality Index. Multinomial logistic regression analysis was conducted to investigate the influence of socio-demographic variables on each profile. A one-way ANOVA test was employed to examine the relationships between sleep patterns and psychiatric symptoms. Three distinct profiles were identified: good sleepers (63.9%), inefficient sleepers (30.3%), and poor sleepers (5.7%). Multinomial logistic regression analysis indicated that gender and marital status were predictors of various sleep patterns. The ANOVA revealed significant differences in psychiatric symptoms scores among the three sleep patterns; poor sleepers exhibited the highest levels of mental distress. This study identified three distinct sleep patterns in healthcare workers and their significant associations with psychiatric symptoms. These findings contribute to the development of targeted intervention strategies aimed at improving sleep and reducing psychiatric symptoms among healthcare workers.

Screening for Systemic Diseases Associated with Dental Self-Care in Japanese Adolescents

Background: Toothbrushing is important for maintaining oral health and preventing periodontal disease. However, the association between toothbrushing and systemic diseases remains unclear in adolescence. In this study, the association between dental self-care (frequency and duration of toothbrushing) and systemic diseases/disorders in adolescents was examined. Methods: We conducted a retrospective review of mandatory medical questionnaires administered during legally mandated freshman medical checkups between 2017 and 2019 at the University of Tokyo, Japan. Out of 9376 total responses, 9098 cases involving individuals under the age of 20 were included in the analysis. Respondents were classified into three groups based on their daily toothbrushing frequency: “1 time or less”, “twice”, and “3 times or more”. For the duration of each toothbrushing session, they were classified into three groups: “1 min or less”, “2–3 min”, and “4 min or more”. A statistical analysis was performed by Pearson’s χ2 test and multinomial logistic regression analysis. Results: Regarding frequency of daily toothbrushing: The χ2 test showed no significant relationship between frequency of toothbrushing and 17 systemic diseases/disorders. A multivariate analysis found that gingival bleeding and sex were independent factors. The risk of gingival bleeding decreased dramatically with increased frequency of toothbrushing (odds ratio (OR): 0.428; 95% confidence interval (CI), 0.366–0.501; p &lt; 0.001). Regarding the amount of time spent on toothbrushing: The χ2 test showed atopic dermatitis and arrhythmia were significantly associated with the duration of toothbrushing (p = 0.032 and p = 0.016, respectively). In the multivariate analysis, atopic dermatitis, gingival bleeding, and sex were independent factors regarding the duration of toothbrushing; longer brushing time was associated with a lower risk of atopic dermatitis (OR: 0.731, 95% CI: 0.578–0.924, p = 0.009) and a lower risk of gingival bleeding (OR: 0.643, 95% CI: 0.567–0.729, p &lt; 0.001). Conclusions: Dental self-care was most strongly associated with gingival bleeding, while the risk of atopic dermatitis was found to increase with shorter toothbrushing times. The results suggest that dental self-care during adolescence is important not only for oral health but also for general health.

Loneliness Trajectories in U.S. Military Veterans: A 3-Year Longitudinal Study of Risk and Protective Factors.

Loneliness is a significant public health concern associated with adverse mental and physical health outcomes in older adults. This study examined the nature and correlates of predominant loneliness trajectories in a nationally representative sample of older U.S. military veterans. Participants included 2,441 veterans (mean age = 63, 8% female, 80% white) from the National Health and Resilience in Veterans Study, a 3-year longitudinal cohort study. Growth mixture modeling (GMM) was used to identify distinct trajectory classes of loneliness based on self-reported ratings. Multinomial logistic three-step regression analyses examined potential psychosocial risk and protective factors associated with loneliness trajectories. GMM revealed three distinct loneliness trajectories: Low-decreasing loneliness (61.2%), moderate-increasing loneliness (31.6%), and high-increasing loneliness (7.2%). Being married/partnered and perceiving greater purpose in life emerged as protective factors against elevated levels of loneliness. Worse cognitive functioning was a risk factor for the moderate-increasing loneliness trajectory, while greater psychological distress and more adverse childhood experiences were risk factors for the high-increasing loneliness trajectory. Nearly 40% of older U.S. veterans exhibited trajectories characterized by moderate to high levels of loneliness, with both groups showing increases over time. Targeted interventions that promote social connectedness, enhance purpose in life, and address mental health concerns and early life adversities may help mitigate the negative health consequences associated with chronic loneliness in this vulnerable population.

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

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