Multinomial Regression Analysis Research Articles

Association Between Depressive Symptoms, Cognitive Status, and the Dual-Task Performance Index in Older Adults: A Cross-Sectional Study.

The Performance Index (P-Index) is a measure for evaluating mobility-related dual-task performance in older adults. The identification of specific clinicodemographic factors predictive of P-Index scores, however, remains unclear. This cross-sectional study analyzed data from 120 community-dwelling older adults (average age 71.3 ± 11.23years) to explore clinicodemographic variables that influence P-Index scores during the instrumented timed up and go test. Unadjusted analyses suggested several factors, including age, gender, body mass index, Mini-Mental Status Examination scores, functional reach test performance, history of falls, ethnicity, Geriatric Depression Scale scores, alcohol consumption, and educational levels, as potential predictors of P-Index. However, adjusted multinomial multiple regression analysis revealed Geriatric Depression Scale and Mini-Mental Status Examination scores as the exclusive independent predictors of P-Index classifications, segmented into high, intermediate, or low (percentiles ≤ 25, 26-74, or ≥ 75, respectively). A significant association was observed between the manifestation of depressive symptoms, lower Mini-Mental Status Examination scores, and reduced cognitive-motor performance. The findings implicate depressive symptoms and low cognitive performance as substantial impediments to optimal dual-task mobility within this cohort. Further studies are warranted to examine the efficacy of cognitive stimulation and antidepressant therapy, in augmenting mobility-related dual-task performance among older adults.

Patterns of Technology-Based Abuse Among Adult Intimate Partner Violence Survivors and Associations with Offline Abuse.

Research about technology-based abuse (TBA) has primarily relied on youth-focused survey research, leading to gaps in knowledge about the experiences of TBA among adult populations. However, studies among adult intimate partner violence (IPV) survivors suggest that TBA is a pervasive problem warranting attention. This study builds on the limited existing literature about adult experiences of TBA by examining patterns of TBA among adult abuse survivors (n = 377). Latent class analysis showed three distinct patterns of TBA: technology-based emotional abuse, technology-based monitoring, and technology-based control. Multinomial regression analyses demonstrated that TBA co-occurs with offline IPV. Findings reinforce the significant role of TBA in adult IPV survivors' lives and highlight the importance of assessing for TBA among survivors.

Determininants of Diarrhea-Related Health Care Seeking Behavior among Indonesian Mothers with Under-five Children during the COVID-19 Pandemic

This study investigated factors influencing healthcare-seeking behaviours of Indonesian mothers during the COVID-19 pandemic when their children had diarrhea. The 117 participants completed a self-report which measured the socio-demographic condition, knowledge about diarrhea, illness perception, anxiety, and health care seeking behavior for diarrhea. The data were analyzed with the descriptive statistics, Chi-square, and logistic multinomial regression analysis. Analysis revealed critical determinants including child age, maternal occupation, education, transportation, knowledge of diarrhea, and illness perception. The model accurately predicted 84.6% of healthcare-seeking behaviours, with mothers favoring formal care for younger children and education positively influencing formal healthcare utilization. The type of public transportation significantly influenced healthcare-seeking behavior. While accurate knowledge of diarrhea increased professional care seeking, the model explained only 5.61% of behavior variation, suggesting unexplored factors. Addressing these factors could improve child health outcomes during pandemics. Policy enhancements and cultural sensitivity in health education are vital for efficacy. Deepening understanding and developing effective interventions amidst pandemics require further research.

Intakes of Lean Proteins and Processed Meats and Differences in Mental Health between Rural and Metro Adults 50 Years and Older.

Mental health disparities exist between rural and metro areas of the United States. Differences in dietary intake may contribute to these disparities. We examined differences in dietary intake and mental health between those 50 years and older (n = 637) living in rural counties to those living in metro counties in North Dakota and the relationship between dietary intake to days with depression or anxiety. A survey was conducted throughout North Dakota. Items were modified from other surveys, such as the Behavioral Risk Factor Surveillance System questionnaires and the National Health Interview Survey Cancer Control Supplement Dietary Screener Questionnaire. Comparing medians, individuals more likely to be unable to perform normal daily activities due to mental health (p = 0.009) resided in rural areas instead of metro areas. Those living rurally also ate more processed meats (p = 0.005), while trending toward less lean protein intake (p = 0.056). Multinomial regression analyses controlling for covariates revealed that lean protein intake and fruit intake were inversely associated with days with depression and anxiety (all p < 0.05), whereas processed meat intake was positively associated with anxiety (p = 0.005). Clinicians working with older adults residing in rural areas should emphasize substituting lean proteins for processed meats.

Self-perceived barriers to healthcare access for patients with post COVID-19 condition

BackgroundMany patients with post COVID-19 condition (PCC) require healthcare services. However, qualitative studies indicate that patients with PCC encounter many barriers to healthcare access. This cross-sectional study aimed to determine how many PCC patients report barriers to healthcare access and which barriers are reported, and to explore differences between subgroups.MethodsData were collected via an online survey from 10,462 adult patients with a confirmed or suspected COVID-19 infection in the Netherlands, who experienced persisting symptoms ≥ 3 months after the initial infection. To study self-perceived barriers, a list of eleven possible barriers was used, covering multiple aspects of healthcare access. Differences between subgroups based on sociodemographic characteristics, medical characteristics, PCC symptoms (fatigue, dyspnoea, cognitive problems, anxiety and depression), and healthcare use (general practitioner, paramedical professional, medical specialist, occupational physician and mental health professional) were studied through multivariable multinomial (0 vs. 1 vs. > 1 barrier) and binomial regression analyses (for each individual barrier).ResultsA total of 83.2% of respondents reported at least one barrier to healthcare access. Respondents reported a median of 2.0 (IQR = 3.0) barriers. The barriers “I didn’t know who to turn to for help” (50.9%) and “No one with the right knowledge/skills was available” (36.8%) were most frequently reported. Respondents with younger age, higher educational level, not hospitalized during acute COVID-19 infection, longer disease duration, who had more severe PCC symptoms, and who did not consult an occupational physician or paramedical professional, were more likely to report barriers. Analyses per barrier showed that women were more likely to report financial and help-seeking barriers, while men were more likely to report barriers related to availability of care. Hospitalized respondents were less likely to report barriers related to availability of care, but not less likely to report financial or help-seeking barriers.ConclusionsThis study shows that the majority of patients with PCC experiences barriers to healthcare access. Particular attention should be paid to younger, non-hospitalized patients with a long disease duration and severe PCC symptoms. Efforts to remove barriers should focus not only on improving availability of care, but also on helping patients navigate care pathways.

Severe early graft dysfunction post-heart transplantation: Two clinical trajectories and diastolic perfusion pressure as a predictor of mechanical circulatory support

BackgroundSevere early graft dysfunction (EGD) is defined by mechanical circulatory support (MCS) <24 hours of heart transplantation (HT). We classified severe EGD based on timing of post-HT MCS: ‘Immediate’ intra-operative vs ‘Delayed’ post-operative MCS (after admission into intensive care unit (ICU) from operating theatre). We hypothesised that (i) risk factors and clinical course differ between ‘Immediate’ and ‘Delayed’ MCS; and (ii) diastolic perfusion pressure (DPP=diastolic blood pressure-central venous pressure) and Norepinephrine equivalents (NE=sum of vasopressor doses), as measures of vasoplegia are related to ‘Delayed’ MCS. MethodsTwo-centre study of 216 consecutive patients who underwent HT. Recipient, donor, vasopressor doses and hemodynamic data at T0 and T6 (on admission and 6 hours after admission into ICU) were collected. ResultsOf the 216 patients, 67 patients had severe EGD (‘Immediate’ MCS: n=43, ‘Delayed’ MCS: n=24). The likelihood of ‘immediate’ MCS but not 'delayed' MCS increased with increasing warm ischemic and cardiopulmonary bypass times on multinomial regression analysis with ‘no MCS’ as the referent group. One-year mortality was highest in ’Immediate’ MCS vs ’no MCS’ and ‘delayed’ MCS (34.9% vs 3.4% and 8% respectively, P<0.001). Of the patients who had no immediate post-transplant MCS, DPP and NE at T6 were independently associated with subsequent 'delayed' MCS’. Sensitivity and specificity of NE ≥0.2mcg/kg/min for ‘Delayed’ MCS were 71% and 81%. Sensitivity and specificity of DPP of ≥40mmHg for No MCS were 83% and 74%. The discriminatory value of systemic vascular resistance for ‘Delayed’ MCS was poor. ConclusionRisk factors and one-year survival differed significantly between ‘Immediate’ and ‘Delayed’ post-HT MCS. The latter is related to lower DPP and higher NE, which is consistent with vasoplegia as the dominant pathophysiology.

Comparison of Serum Vitamin D Levels in Obese Subjects with and without Type 2 Diabetes Mellitus.

Although observational studies have reported a correlation between vitamin D deficiency and type 2 diabetes mellitus (T2DM), epidemiological evidence on the risk of obese subjects suffering T2DM due to a vitamin D deficiency is limited. Therefore, we investigated the correlation between T2DM and serum vitamin D, lipids, blood pressure, insulin indexes in an obese population. A total of 1440 participants including 450 healthy controls and 990 obese subjects, 470 without T2DM and 520 with T2DM. Serum vitamin D levels were measured, and the association between low levels and T2DM in obese subjects was examined using multinomial and linear regression analyses. Of the participants, 35% had deficient or insufficient vitamin D levels (ie, <20 ng/mL). Compared with healthy controls, obese subjects, particularly those with T2DM had lower vitamin D levels. Multinomial logistic regression analysis showed that obese subjects with T2DM had a gradually increasing risk for desirable (RO = 1.41, 95% CI 1.06-1.93, P = 0.027), insufficient (RO = 1.83, 95% CI 1.27-2.84, P < 0.001), or deficient ((RO = 2.14, 95% CI 1.15-3.75, P = 0.014) vitamin D levels. In obese subjects with T2DM, vitamin D levels correlated inversely with the risk indicators for diabetes, such as the levels of HbA1c (β = -0.16, P = 0.002), fasting insulin (Fins; β = -0.31, P = 0.008), and HOMA-IR (β = -0.19, P < 0.001). In obese subjects without T2DM, vitamin D was associated negatively with the risk of having T2DM at five-year follow-up (relative risk = 0.93, 95% CI 0.79-0.97, P = 0.037). This study demonstrates that low vitamin D levels correlate with the presence of T2DM in the obese population. This finding indicates that hypovitaminosis D may be a potential biological vulnerability factor for the development of T2DM in obese subjects.

Understanding residents’ choice of urban farming systems in the Kumasi metropolis of Ghana: Land use policy implications

The heightened food insecurity in urban settings has rekindled the debate over the promotion of urban agriculture (UA) as a sustainable alternative food supply source across the globe. This study, therefore, examines the determinants of urban residents’ decisions to engage in UA and their choice of agriculture practices. Cross-sectional data was solicited from 430 urban dwellers through a multi-stage sampling technique. The data was analysed using descriptive as well as binary and multinomial logit regression models. The descriptive analysis shows that the cultivation of crops (34.7 %) predominates urban agricultural practices before crop-livestock integration (32.6 %) and livestock farming (32.6 %). The study identifies gender, age, religious affiliation, years of formal education, location of residence, household size, food insecurity status, availability of vacant land, extension access, and household income as significant determinants of urban households’ decision to participate in UA. The multinomial logit regression analysis revealed that urban farmers’ decision to practice only crop production is invariant between livestock-only production and integrated crop-livestock systems. When compared to the base category of the integrated crop-livestock system, the findings indicate that farmers’ educational background, food insecurity, engagement in salaried jobs, location, extension, and credit access are the main drivers of the decision to practice either crop-only or sole livestock production systems. The findings of this study have useful implications for the formulation of UA programs based on the different farming systems practiced in the study location.

UNDERSTANDING THE IMPACT OF TEACHER DEMOGRAPHICS ON ASSESSMENT FOR LEARNING STRATEGIES IN GHANA'S EDUCATIONAL SYSTEM

This study explores the implementation and effectiveness of Assessment for Learning (AfL) strategies among basic schoolteachers in Ghana, focusing on the influences of gender, teaching experience, and teaching division. Utilising a survey approach, data were collected through a 16-item Assessment for Learning Questionnaire (AfLQ) from a randomly selected sample of 100 teachers. The instrument's reliability and validity were confirmed through a pilot study and expert reviews, achieving a Cronbach's alpha of over 0.7 for all variables. Multinomial regression analysis provided key insights into the effectiveness, variability, and reliability of AfL practices, guiding professional development and future research. Multiple linear regression analyses identified significant correlations among AfL practices, with strong positive relationships between self-assessment, peer assessment, and immediate feedback. Variance plots showed higher variability in the implementation of certain practices among female and subject teachers, indicating a need for more tailored professional development. Additionally, the Test Information Function (TIF) plot revealed distinct proficiency levels, highlighting areas where teachers excel and potential gaps requiring intervention. These findings emphasise the critical role of demographic factors in the application and success of AfL strategies and offer actionable insights for enhancing teacher training programmes. By integrating advanced statistical techniques, the study provides a comprehensive understanding of AfL practices in diverse educational settings, contributing valuable knowledge to the field of educational assessment.&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0871/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Social-Emotional Profiles of Preschool Children: An Investigation of Demographic Disparities and Intersectionality.

This study aims to enhance our understanding of the diverse nature of social-emotional development and explore the demographic disparities and intersectionality of social determinants among children, with an emphasis on underserved populations of children in low-resource environments. Young children living in low-income families are exposed to a wide array of social and systemic risks that increase the propensity for poor learning and social-emotional development. Using data from the Head Start Family and Childhood Experiences Survey (FACES, this study focuses on the social-emotional development of a nationally representative sample of young children enrolled in the Head Start program (n = 1921, 50.18% male). Employing a person-centered approach, we assessed teacher-rated social-emotional competence, including approach to learning, social cooperation, aggression, hyperactivity, and anxiety/depression/withdrawal, to classify young children's social-emotional development. This study identified four distinct social-emotional profiles-Adaptive, Average, Moderate Risk, and High Risk-through latent profile analysis. Furthermore, multinomial regression analysis revealed demographic disparities within each social-emotional profile, and significant intersectionality was found between race/ethnicity, age, and disability status in the social-emotional profiles. This research provides valuable insights for better supporting each child's unique needs.

MRI features of breast cancer immunophenotypes with a focus on luminal estrogen receptor low positive invasive carcinomas

To compare the magnetic resonance imaging (MRI) features of different immunophenotypes of breast carcinoma of no special type (NST), with special attention to estrogen receptor (ER)-low-positive breast cancer. This retrospective, single-centre, Institutional Review Board (IRB)-approved study included 398 patients with invasive breast carcinoma. Breast carcinomas were classified as ER-low-positive when there was ER staining in 1–10% of tumour cells. Pretreatment MRI was reviewed to assess the tumour imaging features according to the 5th edition of the Breast Imaging Reporting and Data System (BI-RADS) lexicon. Of the 398 cases, 50 (12.6%) were luminal A, 191 (48.0%) were luminal B, 26 (6.5%) were luminal ER-low positive, 64 (16.1%) were HER2-overexpressing, and 67 (16.8%) were triple negative. Correlation analysis between MRI features and tumour immunophenotype showed statistically significant differences in mass shape, margins, internal enhancement and the delayed phase of the kinetic curve. An oval or round shape and rim enhancement were most frequently observed in triple-negative and luminal ER-low-positive tumours. Spiculated margins were most common in luminal A and luminal B tumours. A persistent kinetic curve was more frequent in luminal A tumours, while a washout curve was more common in the triple-negative, HER2-overexpressing and luminal ER-low-positive immunophenotypes. Multinomial regression analysis showed that luminal ER-low-positive tumours had similar results to triple-negative tumours for almost all variables. Luminal ER-low-positive tumours present with similar MRI findings to triple-negative tumours, which suggests that MRI can play a fundamental role in adequate radiopathological correlation and therapeutic planning in these patients.

Institutions' dynamics and homeownership aspirations in Ethiopia

The desire to own a home is a common aspiration amongst many. The role of institutions either by enabling or constraining the achievement of the aspirations is very crucial. Unfortunately, the study investigating the impact of these institutional factors on homeownership aspirations was not adequately adequate. Thus, the researchers motivated to analyze the role of institutions for homeownership aspirations. Researchers used qualitative and quantitative data analysis methods to explore the relationship between mortgage access, housing market prices, and homeownership in Sheger City, Ethiopia. The study involved 384 participants, and the results were analyzed using descriptive statistics and multinomial regression. The findings suggest that mortgage access and housing prices play a significant role in shaping homeownership aspirations. However, it was apparent that banks prioritize the wealthy, resulting in the housing market neglecting the needs of low-income individuals and families, leading to unaffordable housing options and findings revealed institutions’ dynamics are accompanied by dysfunctions. The multinomial regression analysis revealed that the likelihood of owning a home over renting one increases when housing becomes more affordable which shows market dysfunctions affect aspirations to homeownership. Obtaining a mortgage is also critical, as it significantly improves the chances of aspiring to own a home. The authors suggest that the Municipality reconsider the affordability of mortgage services and housing prices to ensure that homeownership opportunities are distributed fairly.

Endothelium-related biomarkers and cognitive decline in prevalent hemodialysis patients: A prospective cohort study.

Cognitive decline is prevalent in maintenance hemodialysis patients. The blood-brain barrier has been implicated in cognitive decline. In this prospective cohort study, we investigated the associations between endothelium-related biomarkers and steeper cognitive decline in this population. Cognitive function was assessed using the Portuguese-adapted Cambridge Cognitive Examination (CAMCOG) with items of the Mini-Mental State Examination (MMSE). Endothelium-related biomarkers included syndecan-1, ICAM-1, VCAM-1 and angiopoietin-2 (AGPT2). Patients were followed up for 4 years, and cognitive assessments were repeated. Multinomial regression analyses were performed to evaluate associations between biomarkers and cognitive decline. A total of 216 patients completed the test battery at baseline. After 4 years, 102 patients had follow-up data. There was a significant decrease in cognitive function according to the CAMCOG and MMSE scores: a change of -0.39 (95% CI -0.27 to -0.51) and -0.51 (95% CI -0.27 to -0.76) standard deviation (SD) of the baseline scores. Additionally, executive function but not memory significantly decreased. Syndecan-1 level was independently associated with steeper cognitive decline; each increase in the SD of the syndecan-1 level was associated with a decrease in the CAMCOG of 0.20 (95% CI 0.07-0.33) SD from baseline. Syndecan-1 was associated with a steeper decline in MMSE score (β 0.54, 95% CI 0.28-0.81) and executive function (β 0.17, 95% CI 0.02-0.32). Syndecan-1 predicted severe cognitive impairment with an area under the curve for receiver operating characteristic curves of 0.75 (95% CI 0.64-0.83). Our findings highlight the potential of syndecan-1, a biomarker of endothelium glycocalyx derangement, as a predictor of steeper cognitive decline in prevalent hemodialysis patients.

Exploring the association of serum prolactin with serum glucose levels and clinical findings in a cohort of patients with early rheumatoid arthritis

BackgroundIn the context of rheumatoid arthritis and its systemic inflammatory implications, there is an increasing interest in investigating the role of prolactin in the clinical and metabolic aspects of the disease. This study aimed to explore the potential links between serum prolactin levels, serum glucose levels, and the clinical manifestations of arthritis.MethodsThis exploratory, cross-sectional, observational study focused on women diagnosed with rheumatoid arthritis. The research involved assessing prolactin and blood glucose concentrations, alongside specific clinical traits such as disease-related inflammation, morning stiffness, and fatigue intensity. The presence of changes in serum prolactin (PRL) was initially compared among the groups based on disease activity intensity. Using a multinomial regression analysis, the study analyzed the impact of predetermined clinical and metabolic factors on various categories of prolactin concentration.ResultsOut of the 72 participants included in the study, hyperprolactinemia was detected in 9.1% of the sample. No differences in serum PRL were identified among the evaluated groups based on disease activity. Following multivariate analysis, no statistically significant differences were identified for the outcomes of inflammatory activity and morning stiffness within each PRL category when compared to the reference category for PRL. There was no increased likelihood of encountering blood glucose levels below 100 mg/dl among individuals with higher prolactin concentrations compared to those in the lowest prolactin category (OR 5.43, 95% CI 0.51–58.28). The presence of clinically significant fatigue revealed a higher likelihood of encountering this outcome among patients with intermediate PRL values (prolactin categories 7.76–10.35 with OR 5.18, 95% CI 1.01–26.38 and 10.36–15.29 with OR 6.25, 95% CI 1.2–32.51) when compared to the reference category.ConclusionsThe study found no discernible correlation between prolactin concentrations and worse scores for inflammatory activity of the disease, nor between prolactin concentrations and serum glucose levels. The findings regarding fatigue should be approached with caution given the exploratory nature of this study.

Exploring different technology addiction types in young adults: a latent profile analysis

This study aimed to examine the different latent profiles of technology addiction in young adults, and the criteria for belonging to these profiles, in relation to sociodemographic factors (gender and SES) and technology use status (daily social network usage time, daily instant messaging usage time, daily online gaming usage time, daily website usage time, and connection location). Data were collected from a sample of 1,431 young adults [988 (69.1%) female, 443 (30.9%) male]. Latent Profile Analysis (LPA) was used to identify the latent profiles, and Multinomial Regression Analysis was employed to examine the relationships between the latent profiles and sociodemographic and technology use. The LPA revealed four latent profiles of technology addiction in young adults: “Non-Addicts (NA)”, “Moderate Technology Addicts-Gamers (MTAG)”, “High Technology Addicts-Non-Gamers (HTANG)”, and “High Technology Addicts-Gamers (HTAG)”. The criteria for belonging to these four profiles were statistically significantly related to sociodemographic and technology use factors, except for connection location, and age. These findings provided further support for our knowledge about planning programs or multi-layered intervention models to prevent technology addiction in young adults.

Liberal Arts Graduates in the Labour Market: A Comparative Study of Dutch University Colleges and Conventional Bachelor’s Programmes

AbstractThis paper compares the employment outcomes of liberal arts graduates from Dutch university colleges with those of their peers who pursued conventional, subject-specific bachelor’s degrees. Using data from the Dutch National Alumni Survey, the analysis includes 14,933 respondents who completed a master’s programme at a research university, with 210 of them holding a university college degree. Logistic, multinomial, and OLS regression analyses were performed on six labour market outcomes: employment status, time to first paid job, vertical match, horizontal match, vertical and horizontal match combination, and hourly wage from regular work. Propensity score matching was used as a robustness check. The results show that holding a university college degree is not associated with any distinct advantages or disadvantages in the job market. While a liberal arts bachelor’s degree has a negative effect on obtaining employment in STEM professions, no statistically significant differences, neither negative nor positive, were found in other outcomes. This suggests that university colleges do not lack the capacity to prepare students for the labour market.

Prevalence and risk factors of depressive symptoms in the postpartum period: An experience from urban West Bengal, India.

Postpartum depression (PPD) is a form of depression that affects new mothers within the first year after childbirth. PPD can negatively impact both the mother's quality of life and the child's development. Untreated PPD can lead to adverse outcomes, such as infant growth retardation, poor child survival, impaired development, and undernutrition. The burden of PPD is a significant public health concern, with a global prevalence increase of 18.4% from 2005 to 2015. Early detection and intervention of PPD can mitigate the severity and chronicity of symptoms. This study aimed to determine the prevalence of PPD among mothers in an urban area of Kolkata and identify any influencing factors. The study utilized a cross-sectional design, surveying 189 mothers within the postpartum period of 6 weeks to 1 year. Edinburg Postnatal Depression Scale was used to identify possible PPD. About 29% of the women had probable PPD, 19% had possible depression, and 15% had no depression. Factors associated with depression included low birth weight and primiparity, while financial independence served as a protective factor. Multinomial regression analysis revealed that low-birth-weight babies, marital conflict, lack of support at home, and primiparity had higher odds of depression, whereas financial independence was a protective factor. Age was not statistically significant. A high prevalence of PPD and significant associations with factors emphasized the importance of screening all mothers for PPD, providing medical care and counselling, and ensuring acceptance and support from partners, family, and society.

Social support and frailty progression in community-dwelling older adults.

Despite the growing evidence regarding the influence of social factors on frailty in older adults, the effect of social support remains unclear. This study aims to assess the association between social support and frailty progression (transition and incidence) in a sample of community-dwelling older adults. Using a cohort study design, 1,059 older adults from the Berlin Initiative Study were followed up for 2.1 years. Multinomial and logistic regression analyses were performed to assess the association of social support using Oslo Social Support Scale-3 with frailty transition and incidence, respectively. Gender differences were explored using stratified analyses. At baseline, frailty prevalence in the study population [mean (SD) age 84.3 (5.6) years; 55.8% women] reached 33.1% with 47.0, 29.4 and 23.6% of the participants reporting moderate, strong and poor social support, respectively. Over the follow-up period, social support was not significantly associated with the frailty transition categories in the adjusted model. Conversely, the adjusted logistic regression analysis showed that participants with poor social support had twice the odds of becoming frail compared to those with strong social support (OR 2.07; 95% CI 1.08-3.95). Gender-stratified analyses showed comparable estimates to the main analysis but were statistically non-significant. Our study results underpin the role of social factors in frailty incidence and highlight social support as a potential target for frailty-preventing interventions in older adults. Therefore, it is important to adopt a biopsychosocial model rather than a purely biomedical model to understand and holistically improve the health of community-dwelling older adults.

Relationship Between Disaster Literacy and the Factors Affecting it and the State-Trait Anxiety in the Elderly of West Turkey

The aim of this study is to measure the effect of anxiety levels and some sociodemographic characteristics of elderly individuals, who are a vulnerable group in disasters, on their disaster literacy. This study is a cross-sectional type study. March May 7 – 2, 2022 residents of the nursing home, located in Izmir Metropolitan Municipality Social Life Campus in Buca district of Izmir province, are the Decedents of the study. As a working group, 210 people were reached. In the questionnaire form created in the study, some sociodemographic characteristics of the participants and their knowledge about disasters were questioned, the State-Continuous Anxiety Scale, Disaster Literacy Scale (DLS) were used. Multinominal Logistic Regression Analysis model was established with categorized of DLS's total score. The mean score of the DLS was insufficient with a score of 27.9±9.41. According to the results of multinomial regression analysis, high trait anxiety state (OR: 1,058 (95% CI: 1,010-1,111)) were found to be risk factors for "insufficient" disaster literacy level (p&amp;lt;0.05). Disaster literacy is a very important concept in protecting against the risks and dangers of disasters. In order to achieve a successful disaster management, all vulnerabilities in the society should be identified and the level of literacy should be increased.

Persistent albuminuria and chronic kidney disease in adults with sickle cell anaemia: Results from a multicenter natural history study.

Clinical and laboratory correlates of chronic kidney disease (CKD) in sickle cell anaemia remain incompletely defined. In a multicenter cohort study, we evaluated the prevalence of persistent albuminuria (PA) and characteristics associated with PA, albumin-creatinine ratio (ACR) and decreased estimated glomerular filtration rate (eGFR) using logistic, linear and multinomial regression models, respectively. Of 269 participants (median age: 30 years; 57.2% females), the prevalence of PA was 35.7%. Using baseline ACR values of <100 and ≥100 mg/g, the probabilities of PA were 30.0% and 94.6%, respectively. In multivariable logistic regression analyses, male sex (β = 0.80 [SE = 0.36], p = 0.024) and ACE inhibitors/ARBs use (β = 1.54 [SE = 0.43], p < 0.001) were associated with higher likelihoods of PA, while higher haemoglobin (β = -0.33 [SE = 0.13], p = 0.009) and HbF (β = -0.04 [SE = 0.02], p = 0.041) were associated with lower likelihoods of PA. In multivariable multinomial regression analyses, older age (β = 0.06 [SE = 0.02], p = 0.004) and higher alkaline phosphatase (β = 0.01 [SE = 0.00], p = 0.004) were associated with higher odds of having eGFR 60-90 versus eGFR>90 mL/min/1.73 m2 using the cystatin C-based CKD-EPI-2012 equation. Additionally, higher systolic blood pressure (β = 0.11 [SE = 0.03], p = 0.001) and blood urea nitrogen (β = 0.45 [SE = 0.12], p < 0.001) were associated with higher odds, while higher haemoglobin (β = -1.22 [SE = 0.43], p = 0.004) was associated with lower odds of having eGFR<60 versus eGFR>90 mL/min/1.73 m2. PA and decreased eGFR are associated with measures of disease severity and comorbid conditions (Clinicaltrials.gov Identifier: NCT03277547).