Multinominal Logistic Regression Research Articles

재난피해자의 사회적 자본이 외상후스트레스장애의 변화궤적 유형에 미치는 영향: 잠재계층성장분석을 중심으로

The purpose of this study was to investigate the trajectory of posttraumatic stress disorder among disaster victims for four years, and examine the effect of social capital on the trajectory types of posttraumatic stress disorder. For this, this study used panel data from the Disaster Victim Panel Survey (wave 1-4) conducted by the National Disaster Management Research Institute, and classified trajectory types of posttraumatic stress disorder using latent class growth analysis. In addition, multinominal logistic regression analysis was conducted to examine socio-demographic, disaster victim, and social capital factors associated with latent groups. The main results are as follows. First, according to the trajectory of posttraumatic stress disorder among disaster victims, the latent groups were classified into three groups, which includes low-risk group (74.2%), moderate-risk group (20.4%), and high-risk group (5.5%). Second, the more level of social solidarity as one of social capital, the study participants were likely to be in a low-risk group rather than a high-risk group or a moderate-risk group. Third, the more having damage of human life, the study participants tended to be in a high-risk group than a low-risk group. Fourth, the worse the subjective health prior to the disaster, the study participants were likely to be in a moderate-risk group than a low-risk group. Based on these results, the study discussed social welfare practice and policy implications for prevention and intervention of posttaumatic stress disorder among disaster victims.

Exposure of ambient PM2.5 during gametogenesis period affects the birth outcome: Results from the project ELEFANT

Various environmental and behavioural factors influence neonatal health. Gamete formation (gametogenesis) is a crucial period which affects embryo development and neonatal health and ambient air pollution exposure at this stage may lead to an adverse birth outcome. Previous epidemiological and toxicological research demonstrated a strong association between maternal ambient air pollution exposure and adverse birth outcomes. However, the joint exposure-outcome of paternal exposure (76 days before the last menstruation and 14 days after the last menstruation) and maternal exposure (14 days after the last menstruation) when exploring the mechanism of the influence of air pollutants on pregnancy outcome and neonatal health remains unexplored. Here, in the Project Environmental and LifEstyle FActors iN metabolic health throughout life-course Trajectories (ELEFANT), we collected the data of 10,960 singleton pregnant women with 24–42 completed gestational weeks and included them in this study. A multinominal logistic regression model was applied to investigate the association between adverse birth outcomes and ambient PM2.5 exposure levels during spermatogenesis and oogenesis. Results from the binary classification of ambient PM2.5 exposure showed that the risk of abnormal birthweight was significantly greater when ambient PM2.5 exposure was both higher during spermatogenesis and oogenesis, with RRs of 1.86 (95% CI: 1.02, 3.39). The risk of macrosomia (RR: 1.88 (95% CI: 1.13, 3.12)) increased significantly when ambient PM2.5 levels were higher during spermatogenesis. Primiparity and primigravity are more likely to be influenced by higher ambient PM2.5 levels during spermatogenesis. In conclusion, more attention should be paid to higher exposure level of ambient PM2.5 during spermatogenesis.

Regular, intermittent, and spontaneous: Patterns of preschool Children's nap behavior and their correlates

BackgroundDaytime sleep during the preschool years (i.e., 1-5-years-old) is characterized by high inter-child variability in several components of nap behavior, including nap duration, nap timing, and the proportion of sleep during daytime. We used an empirical approach to examine variations amongst children in these aspects of napping and investigated correlates of these components of nap behavior. MethodsA large, nationally representative sample (N = 702) of Canadian parents completed an online survey, including a one-month retrospective report of their 1.5–5 year old's daytime and nighttime sleep behavior and other questionnaires. To understand patterns of children's nap behaviors we applied Latent Profile Analysis (LPA) to typical nap duration, typical timing of naps, frequency of naps, proportion of sleep during the daytime, and the proportion of naps which were spontaneous (i.e., child just fell asleep). Then, multinominal logistic regression was used to examine correlates of profile membership. ResultsFour profiles of children emerged: (1) regular nappers; (2) intermittent nappers; (3) spontaneous nappers; and (4) non-nappers. After controlling for demographic variables (e.g., child age, sex, ethnicity) and known correlates of napping behaviors (e.g., birthweight, nighttime sleep duration), profile membership was related to parents' beliefs about napping, parents’ own nap behaviors, family functioning, and child nighttime sleep problems in a multinominal logistic regression. ConclusionsAn empirical approach aided in understanding the inter-child variability in napping amongst preschool-age children. Parental beliefs about napping and the home environment were shown to be critical factors influencing this variability.

Periprosthetic Fractures in Long Versus Short Proximal Femoral Nailing for Intertrochanteric Fractures: A 10-Year Single-Centre Cohort Study.

Background Neck of femur (NOF) fractures, including intertrochanteric fractures, are common fragility fractures seen in the elderly population and are often amenable to fixation with a proximal femoral nail (PFN). However, there is conflicting evidence regarding the incidence of peri-prosthetic fractures with each device. Several studies from the 1990s and a recent meta-analysis have shown a higher incidence of peri-prosthetic fractures in the short PFN cohort. Other studies have shown a lower reoperation rate with short PFNs, and no statistically significant differences have been quoted in the rates of peri-prosthetic fractures in systematic reviews. Aim The purpose of this retrospective study, therefore, was to assess the peri-prosthetic fracture rate and failure rates of elderly neck of femur (NOF) fractures implanted with either a short or long proximal femoral nail (PFN). Materials and methods A retrospective study was conducted in a single orthopaedic department (University Hospital Dorset, Poole, GBR) using collected data on all extracapsular neck of femur fracture patients from the national hip fracture database (NHFD) from January 1, 2011, to December 23, 2021. The data collected included patient age, sex, the American Society of Anesthesiologists (ASA) type of neck of femur fracture, type of surgery performed, any further peri-prosthetic fractures, and time to re-operation in that subset of the group. The implants used were the Stryker Gamma 3 Nail and the Smith Nephew (Trigen and Intertan). All patients were allowed to fully weight bear as tolerated and received both orthopaedic and elderly medical care. Failure was defined as a cut-out or implant fracture. Results From January 1, 2011, to December 23, 2021, there were 1010 extracapsular neck of femur fractures recorded on the National Hip Fracture Database (NHFD) treated with a PFN from the study centre. Of those patients, 11 had pathological fractures and were excluded. 649 patients had long PFNs, and 350 had short PFNs. Of the total of 999 patients, 254 (25%) were male and 745 (75%) were female. More than 80% of the patients in the sample were over the age of 75. The majority of patients in both groups had A1/A2 fractures (short 84.3%, long 49.1%). The rate of periprosthetic fractures in the short PFNs was 1.71%, and the failure rate was 0.57%. The rate of periprosthetic fractures in the long PFNs was 0.62%, with a failure rate of 0.92%. The multi-nominal logistic regression model did not show statistically significant odds ratios (OR) for the following variables: long/short nails, male/female gender, age, ASA, or type of fracture. The female gender was associated with a higher risk of both periprosthetic fractures and failures (OR of 2.232 and 2.95), but this was not found to be statistically significant. Similarly, unstable A3 fractures had a much higher risk of failure (OR of 2.691) compared to periprosthetic fractures (OR of 0.985). However, this was not statistically significant. Conclusion Overall, this study has identified that in a patient population that is predominantly female and over the age of 75, the risk of periprosthetic fracture rate and the failure rate is similar in both the use of a short or a long PFN for intertrochanteric fractures.

CHANGING FAMILY DESTINIES, DIVERGENT FAMILY CAREGIVING PATTERNS: DO BIRTH COHORTS, GENDER, RACE, AND SES MATTER?

Abstract Over the past few decades, Americans have experienced a series of demographic transitions include prolonged longevity and rise in the complexities of family structures. The Baby Boomer cohort is at the forefront of these transitions, which has profound implications on their later-life family relations and practices of family caregiving. Most caregiving literature has focused on static care experiences over a short time, while neglecting long-term care experiences. Using 10 waves of longitudinal data from HRS (2000-2018) and latent profile analysis, I identified five prominent long-term caregiving patterns: light parental caregivers (44.1%), intensive spousal caregivers (5.6%), sandwiched caregivers (5.5%), light grandchildren caregivers (38.7%), and heavy grandchildren caregivers (6.2%). Further, I conduct multinominal logistic regression to investigate how birth cohorts, gender, race, and education shaped these patterns. Results suggested that later cohorts have seen a decline in intensive spousal caregivers, light and heavy grandchildren caregivers, but an increase in light parental caregivers. Women are more likely to be sandwiched caregivers than men, and black caregivers are more likely to be intensive spousal caregivers, heavy grandchildren caregivers, and sandwiched caregivers than white. By contrast, white and more educated caregivers are more likely to be light parental caregivers, and this pattern becomes more pronounced in later cohorts. The findings suggest divergent destinies of family caregiving patterns among later cohorts. More disadvantaged groups are shouldering heavier care responsibilities than advantaged groups. Targeted care services should be implemented to ease the care burdens of the vulnerable population.

UNDER THE SAME ROOF: GRANDPARENTAL CO-RESIDENCE AND CO-PARENTING PATTERNS IN MODERN CHINESE FAMILIES

Abstract This study aimed to examine the role of grandparental co-residence in shaping coparenting patterns in the Chinese family context. Using a sample of 5,795 children (Mean age = 6.74 years; SD = 3.82) from the China Family Panel Studies 2012-2018, we offered a novel typology of six coparenting patterns based on daytime and nighttime childcare information: a) grandparental care only (15.4%); b) grandparent-parent coparenting (10.9%); c) parental care only (44.5%); d) grandparent-private coparenting (4.2%); e) parent-private coparenting (16%); and f) private care only (e.g., paid nanny, nursery schools/kindergartens, and others, 9.1%). Fixed-effects multinominal logistic regression was applied to investigate the effects of grandparental co-residence on daytime and nighttime childcare, and on daily coparenting patterns over time, controlling for a set of child and parental characteristics and family conditions. Grandmother co-residence contributed to both daytime and nighttime grandparenting, while grandfather co-residence increased the likelihood of grandparenting and private care during the daytime. In terms of daily coparenting, grandmother co-residence was associated with increased probability of grandparent-parent coparenting as well as grandparent-private coparenting, while grandfather co-residence merely increased the likelihood of parent-private coparenting. It also found that child’s experience of separation with mother during the last year and mother’s employment were two key determinants of coparenting behavior in Chinese families. Findings suggest that co-residing grandparents, particularly grandmothers, may function as a kind of supplementary care resource in response to the lack of maternal childcare resulted from migration and labor force participation.

Neighborhood segregation and cancer prevention guideline adherence in US Hispanic/Latino adults: Results from the HCHS/SOL.

Adherence to the American Cancer Society (ACS) guidelines for cancer prevention is associated with a lower risk of cancer and mortality. The role of neighborhood segregation on adherence to the guidelines among Hispanic/Latino adults is relatively unexplored. The Hispanic Community Health Study/Study of Latinos is a community-based prospective cohort of 16,462 Hispanic/Latino adults, ages 18-74 years enrolled in 2008-2011 from the Bronx, Chicago, Miami and San Diego. Dimensions of neighborhood segregation were measured using 2010 United States' census tracts:-evenness (the physical separation of a group), exposure (the propensity for contact between groups), and their joint effect (hypersegregation). ACS guideline adherence levels - low, moderate, high - were created from accelerometry-measured physical activity, dietary intake, alcohol intake, and body mass index. Weighted multinominal logistic regressions estimated relative risk ratios (RRR) and 95% confidence intervals (CI) for guideline adherence levels and its components. Hispanic/Latino adults were classified as low (13.7%), moderate (58.8%) or highly (27.5%) adherent to ACS guidelines. We found no evidence of an association between segregation and overall guideline adherence. Exposure segregation associated with lower likelihood of moderate adherence to alcohol recommendations (RRRmoderate vs. low:0.86, 95%CI:0.75-0.98) but higher likelihood for diet recommendations (RRRmoderate vs. low:1.07, 95%CI:1.01-1.14). Evenness segregation associated with lower likelihood of high adherence to the physical activity recommendations (RRRhigh vs. low:0.73, 95%CI:0.57-0.94). Hypersegregation was associated with individual guideline components. We found evidence of a cross-sectional relationship between neighborhood segregation and ACS cancer prevention guideline components, but not with overall ACS guideline adherence.

1137: FACTORS ASSOCIATED WITH FAVORABLE OUTCOMES IN CARDIAC ARREST AND TARGETED TEMPERATURE MANAGEMENT

Introduction: While guidelines strongly recommend targeted temperature management (TTM), whether early initiation of TTM or time-to-target temperature (TTT) are associated with better outcomes remains elucidated. To clarify if different target temperatures and shorter TTT are associated with favorable neurologic outcomes and reduced mortality in patients with coma after cardiac arrest undergoing TTM Methods: This is a retrospective observational study at a tertiary care hospital in Honolulu, Hawaii. Those who had an out-of-hospital or in-hospital cardiac arrest (OHCA or IHCA) undergoing TTM from November 1, 2020 to August 31, 2021 were included. Patients were dichotomized by the median time to TTM initiation, time from initiation of TTM to achieve target temperature, and TTT (into early and delayed groups). Results: 86 patients (53 with OHCA and 33 with IHCA), mainly including Asian and Native Hawaiian and Pacific Islanders, were included. In multinominal logistic regression analysis, the difference between the initial temperature to target temperature (Δ-temperature) and shorter TTT were identified as a factor positively associated with survival in the IHCA group. Conclusions: There may be specific groups of patients who are likely to benefit from the prompt initiation of TTM, focusing on Δ-temperature as a variable of interest. Further studies are warranted to identify underlying mechanisms associated with the results and response to TTM in different races/ethnicities.

초기 청소년이 지각한 어머니 양육태도에 대한 잠재집단 분류 : 집단별 영향요인과 집단에 따른 정서·행동문제, 삶의 만족도 차이

In order to prevent emotional and behavioral problems and increase life satisfaction in early adolescents, this study classified mothers’ parenting attitudes perceived by early adolescents as latent classes, and verified emotional and behavioral problems and life satisfaction of early adolescents according to the classified latent classes. For this study, 2019 year’s data from the Korean Children and Youth Panel Survey(KCYPS) of the National Youth Policy Institute were used. A total of 4,368 cases(2,184 fifth grade in elementary school and 2,184 mothers) were statistically analyzed using latent profile analysis, multinominal logistic regression, and Wald’s association test. As results of the study, the latent classes for the mothers' parenting attitude were divided into three classes. As factors affecting the latent class, conversation time with mother in children, mother’s health, self-esteem and happiness in mothers significantly influenced to three latent classes. Also, there were significant differences in emotional and behavioral problems and life satisfaction according to the latent classes of mothers’ parenting attitudes. Emotional and behavioral problems were low and life satisfaction was high in the 'positive parenting attitude dominant group'. This study is expected to be useful in parent education and counseling sites.

When is a postmortem examination carried out? A retrospective analysis of all Swedish deaths 1999–2018

The objective of this study was to assess who is merited an autopsy in Sweden. Data from the Swedish cause of death (COD) registry over a period of 20 years was retrieved and analysed. A multinominal logistic regression analysis was performed to identify the variables that were most strongly associated with the performance of a clinical or forensic autopsy (CA/FA).A definite COD, i.e. a COD based on autopsy findings, was registered in 12.6% of all deceased during the investigated period. In the remaining cases, the COD was presumed by the clinicians. Being male, born in the Nordic region, dying in a private residence, and unnatural death were most strongly associated with the performance of CA/FA. In contrast, being female, dying from dementia, dying at a nursing home, being born outside of Europe, or living in a small city or rural area seldom led to the performance of CA/FA.The above is certainly surprising as an autopsy provides an opportunity to investigate the cause of death, validate clinical diagnoses, detect unexpected aberrations, audit health care, and provide feedback to clinicians to facilitate their continuing education.

No associations between C-reactive protein and spinal pain trajectories in children and adolescents (CHAMPS study-DK)

Preliminary evidence points to a link between C-reactive protein (CRP) and spinal pain in adults. However, there is a paucity of research in younger populations. Therefore, we aimed to determine associations between CRP and spinal pain in childhood and adolescence. We identified trajectories of spinal pain from childhood to adolescence and investigated the associations between CRP and trajectory subgroups. Six- to 11-year-old children from 13 primary schools, were followed from October 2008 and until 2014. High-sensitivity CRP collected at baseline (2008) was measured using serum samples. The outcome was the number of weeks with non-traumatic spinal pain between November 2008 and June 2014. We constructed a trajectory model to identify different spinal pain trajectory subgroups. The associations between CRP and spinal pain trajectory subgroups were modelled using mixed-effects multinominal logistic regression. Data from 1556 participants (52% female), with a mean age of 8.4 years at baseline, identified five spinal pain trajectory subgroups: “no pain” (55.3%), “rare” (23.7%), “rare, increasing” (13.6%), “moderate, increasing” (6.1%), and “early onset, decreasing” (1.3%). There were no differences in baseline high-sensitivity CRP levels between spinal pain trajectory subgroups. Thus, the heterogeneous courses of spinal pain experienced were not defined by differences in CRP at baseline.

Complications during Delivery Hospitalizations in Women with Thalassemia: An Analysis of the National Inpatient Sample Database (2002-2019)

Background: Women with thalassemia generally have some degree of anemia that is exacerbated during pregnancy. A few studies have shown an association of thalassemia with adverse pregnancy outcomes like intrauterine growth restriction and low birth weight. However, there is a paucity of data regarding the burden of maternal complications during hospitalization for delivery. Methods: The National Inpatient Sample Database (NIS) was queried with the International Classification of Disease, Ninth Revision, and Tenth Revision (ICD-9, ICD-10) codes to identify delivery hospitalizations and thalassemia diagnosis. To strengthen the statistical analysis, case-control matching was performed for age, race, and general co-morbidities like diabetes, hypertension, hypothyroidism, liver disease, obesity, smoking, drug abuse, alcohol use disorder, and electrolyte abnormalities to match delivery hospitalizations with thalassemia to delivery hospitalizations without thalassemia. With the matched data, thalassemia hospitalizations were further subclassified into 'alpha-thalassemia', 'beta-thalassemia’ and 'thalassemia-other'. A secondary multinominal logistic regression was performed to account for median income, admission type, insurance type, preterm and/ or c-section deliveries in addition to the previously mentioned comorbidities to generate the odds ratio for the preselected outcomes. We also compared the cost-of-care for delivery hospitalization with among the three groups of thalassemia patients compared to those without thalassemia. Results: A data sample that constituted of 14,514,439 (14.5 million) delivery hospitalizations without thalassemia and 19,764 hospitalizations with thalassemia (0.1% of the sample) between 2002-2019 was taken. Unadjusted analysis revealed patients with thalassemia were older than those without thalassemia (30.1 years vs 28.3 years, p<0.001), had higher prevalence of obesity (4.7% vs 1.9%, p<0.001), hypothyroidism (4.6% vs 2.6%, p<0.001), liver disease (0.7% vs 0.2%, p<0.001), diabetes mellitus (1.2% vs 1.0%, p<0.001), chronic hypertension (0.4% vs 0.2%), and multiple gestation (2.7% vs 1.9%, p<0.001). Patients with thalassemia were also more likely to be black (24.4% vs 14.1%, p<0.001), or Asian/ Pacific Islanders (27.4% vs 5.5%, p<0.001) (Figure 1). A total of 17944 hospitalizations with thalassemia were matched with their 17944 counterparts by case-control matching. A multinominal logistic regression assessing for major outcomes revealed that patients with thalassemia of any type had higher odds of requiring a blood transfusion during the hospitalization- alpha thalassemia: odds ratio (OR)= 3.52, (95% CI: 2.57-4.83; p<0.001), beta-thalassemia: OR= 4.77, (95% CI: 3.62-6.28; p<0.001), thalassemia-unspecified: OR= 3.03, (95% CI: 2.58-3.55; p<0.001). Patients with thalassemia of any type also had a statistically higher risk of coagulopathy, preeclampsia, post-partum hemorrhage, and cardiac arrhythmias. An independent-samples Mann-Whitney U test revealed patients with thalassemia had a statistically higher median cost of hospitalization ($15,565 v $12,400; p<0.001). There was no statistical difference in length of stay or all cause mortality between patients with thalassemia compared to those without thalassemia. Conclusion: Despite an overall low prevalence of thalassemia in the US, these results suggest that pregnant women with thalassemia are at a higher risk of complications during hospitalization for delivery. This is especially important when considering that thalassemia is disproportionally more prevalent in minority groups. Though anemia is strongly associated with poor pregnancy outcomes, whether the genetic abnormalities with thalassemia confers additional risk merits further study. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Intimate Partner Violence Victimization During the COVID-19 Pandemic Among a Global Online Sample of Sexual Minority Men.

We aimed to describe the prevalence of IPV victimization, changes of experiencing IPV victimization, and examined factors associated with more severe or frequent IPV victimization since the COVID-19 crisis among a global sample of sexual minority men (SMM). Data were collected between October and November 2020 through a gay social networking (GSN) application. We used multinominal logistic regression to examine correlates of experiencing any IPV during the pandemic and experiencing more severe or frequent IPV since the pandemic began. Of all participants (n = 9420), IPV victimization prevalence in the past 6 months was 17.0%, 19.5% of whom reported experiencing more severe or frequent IPV and 55.7% reported experiencing IPV that stayed the same since the COVID-19 started. Experiencing more severe or frequent IPV victimization since the pandemic began was associated with having engaged in sex work, having an income reduction by more than 20% and cutting meals since the COVID-19 crisis began. Increased tobacco use and psychological distress were also associated with increased IPV victimization. Lastly, SMM who reported having met a sexual partner through GSN apps were more likely to say that their experience of IPV had been more severe or frequently. Our results demonstrate relatively high levels of reporting IPV victimization during the COVID-19 pandemic among a global sample of SMM. The findings illustrate an increasing need for IPV resources and programs as the pandemic continues to evolve. New technologies such as GSN apps have the potential to deliver confidential and safe IPV screening, services, and resources.

Functional disability trajectories at the end of life among Japanese older adults: findings from the Japan Gerontological Evaluation Study (JAGES).

this study aimed to identify distinct subgroups of trajectories of disability over time before 3years of death and examine the factors associated with trajectory group membership probabilities among community-dwelling Japanese older adults aged 65years and above. participants included 4,875 decedents from among community-dwelling Japanese older adults, aged ≥ 65years at baseline (men: 3,020; women: 1,855). The certified long-term care levels of the national long-term care insurance (LTCI) system were used as an index of functional disability. We combined data from the 2010 Japan Gerontological Evaluation Study and data from the 2010 to 2016 LTCI system. Group-based mixture models and multinominal logistic regression models were used for data analysis. five distinct trajectories of functional disability in the last 3years of life were identified: 'persistently severe disability' (10.3%), 'persistently mild disability' (13.0%), 'accelerated disability' (12.6%), 'catastrophic disability' (18.8%) and 'minimum disability' (45.2%). Multinominal logistic regression analysis found several factors associated with trajectory membership; self-rated health was a common predictor regardless of age and gender. The analysis also showed a paradoxical association; higher education was associated with trajectory group membership probabilities of more severe functional decline in men over 85years at death. individual perception of health was a strong predictor of trajectories, independent of demographic factors and socio-economic status. Our findings contribute to the development of policies for the long-term care system, particularly for end-of-life care, in Asian countries.

Physical activity level and associated factors among pregnant women: a population-based epidemiological study.

This research aimed to assess the level of physical activity and identify the associated factors in pregnant women assisted in primary health care in the city of Montes Claros, Minas Gerais (Brazil). This was an epidemiological, cross-sectional, analytical study, carried out with 1,279 pregnant women. Socioeconomic, occupational, obstetric, behavioral, social, health, and emotional variables were assessed using a questionnaire. The Physical Activity Questionnaire for Pregnant Women was also applied. Descriptive statistical analysis and multinominal logistic regression with a hierarchical model were performed. The prevalence of physical inactivity in the physical activity and leisure time dimensions was verified. A mild level of physical activity was associated with the variables such as age from 21 to 30 years and up to 20 years old, income above two minimum wages, salaried work, and maternal-fetal attachment at a medium/high level. Income from one to two minimum wages and above two wages, paid work and self-employment, anxiety and stress symptoms, and medium/high maternal-fetal attachment were associated with the moderate/vigorous level. Multifactorial aspects must be considered in health promotion strategies directed to the practice of physical activity by pregnant women.

Nível de atividade física e fatores associados entre gestantes: estudo epidemiológico de base populacional

Abstract This research aimed to assess the level of physical activity and identify the associated factors in pregnant women assisted in primary health care in the city of Montes Claros, Minas Gerais (Brazil). This was an epidemiological, cross-sectional, analytical study, carried out with 1,279 pregnant women. Socioeconomic, occupational, obstetric, behavioral, social, health, and emotional variables were assessed using a questionnaire. The Physical Activity Questionnaire for Pregnant Women was also applied. Descriptive statistical analysis and multinominal logistic regression with a hierarchical model were performed. The prevalence of physical inactivity in the physical activity and leisure time dimensions was verified. A mild level of physical activity was associated with the variables such as age from 21 to 30 years and up to 20 years old, income above two minimum wages, salaried work, and maternal-fetal attachment at a medium/high level. Income from one to two minimum wages and above two wages, paid work and self-employment, anxiety and stress symptoms, and medium/high maternal-fetal attachment were associated with the moderate/vigorous level. Multifactorial aspects must be considered in health promotion strategies directed to the practice of physical activity by pregnant women.

Association of ANGPTL8 gene polymorphism with the occurrence of coronary artery disease in Iraqi patients

OBJECTIVE: It has been shown that ANGPTL8 controls the metabolism of fatty acids and triglycerides (TG). Reduced adipogenesis, which was defined by decreased TG, was linked to decreased ANGPTL8. The aim of the present study was to evaluate the association of ANGPTL8 gene polymorphism with the occurrence of coronary artery disease in Iraqi population. RESEARCH DESIGN AND METHODS: two hundred coronary artery disease patients with &gt;70 blockage coronary artery as well as to 200 apparently individuals who were diagnosed as negative findings by coronary angiography (Control group) were investigated for several biochemical parameters as well as genotyping for rs892066 and rs2278426 of ANGPTL8 gene SNPs by ARM-PCR technique. RESULTS: The examinations of rs892066 approved significant varaition after the adjustment for age and sex under the codominant model in heterozygous genotype, and under the dominant model the GG+CG genotype in patients group was be higher than of control group. The assessment of the minor allele frequency (G) approved the association of rs892066 in the occurrence of CAD. Along with the most recent outcomes, Multinominal logistic regression analysis was used to analyze the genotype and allele frequencies of the rs2278426 ANGPTL8 gene polymorphism in CAD and control individuals under the codominant, dominant, recessive, and overdominant models. The examinations failed to explore significant varaition after the adjustment for age, sex and BMI and smoking status. The assessment of the minor allel frequency (T) indicated that no association between presence minor allel frequency (T) in CAD patients and the control group. CONCLUSIONS: SNP rs892066 may play unique role in the occurrence of CAD while rs2278426 of ANGPTL8 genes are not associated with CAD in Iraqi patients.

Disparities in Nicotine Addictiveness and Cancer Harm Perceptions Among U.S. Adults: A Trend Analysis Using the Health Information National Trends Survey.

Recent research has found widespread misperceptions about nicotine. This study tests perceptions among U.S. adults with respect to nicotine addictiveness and cancer harm, while distinguishing between nicotine misperceptions (ie an incorrect response) and "don't know" (DK) responses. Data from three cycles of the Health Information National Trends Survey, fielded in 2015, 2017, and 2019 were merged for analysis. Weighted multinominal logistic regression models were conducted where nicotine addictiveness and cancer harm beliefs (DK, incorrect, and correct responses) were regressed on survey year and demographic variables. We also tested for interactions between survey year and demographic variables to assess if previously identified disparities had evolved during these years. Analyses showed lower odds of misperceptions about nicotine addictiveness, but higher odds of misperceptions about nicotine cancer harm in 2019 compared to 2015. There was no change in DK responses during these years. Disparities by sociodemographics and tobacco use status were observed, mostly for cancer harm. Survey year significantly interacted with age in the model for cancer harm, which was driven primarily by increased incorrect responses and decreased DK responses over time among the youngest age group (18-34 years). There were no significant interactions between survey year and race and ethnicity or level of educational attainment. Disparities in nicotine addictiveness and cancer harm perceptions reflect the uneven distribution of knowledge in the U.S. adult population. Nicotine cancer harm misperceptions are increasing and educational efforts to address this misperception are warranted. Future educational efforts targeting nicotine addictiveness beliefs may benefit by focusing on DK responders. The growing trend of misperceptions of nicotine's role in cancer harm may negatively impact perceptions about nicotine replacement therapy and low nicotine content cigarettes. Future efforts should focus on correcting nicotine cancer harm misperception, particularly among young adults.

Psychiatric and somatic health of homeless individuals in the context of their migration history

Abstract Background Descriptions of homeless individuals’ somatic and psychiatric health status remain scarce. The heterogenicity of the population is increasing, with more people migrating within the European Union. Migration history has been described as a determinant of health and healthcare access. Methods A multicenter cross-sectional study design included homeless individuals in Germany. Using interview-based questionnaires, the prevalence of mental and somatic illnesses, as well as healthcare use and access, were determined. Multinominal logistic regression analysis was performed to examine the influence of the homeless migration history on health status. Results 306/635 (48.2%) of the homeless individuals were born outside Germany; 213/306 (69.6%) came from another EU country. Homeless people from EU countries frequently reported economic reasons for leaving their home country (51.0%) and entering Germany (64.4%). Compared to homeless individuals of German origin and homeless non-EU migrants, they stated to live rough (48.2% p = 0,03), not hold health insurance (62.4% p &amp;lt; 0,0001), and not receive state funds (82.6% p &amp;lt; 0,0001) more often. Prevalences of psychiatric and somatic illnesses among homeless people were high compared to the general German population. There were no differences observed between the prevalence of chronic diseases if stratified by the origin of the homeless individuals. Conclusions Homeless individuals report higher prevalences of psychiatric and somatic illnesses than the general population. Compared to homeless people of other origins, homeless EU migrants may be disadvantaged in their housing situation and integration into the German social security system. Key messages • Programs aiming to integrate homeless people into mainstream health care should focus on homeless EU migrants. • Our data underline the need for specific care services for homeless individuals.

Morbidity Patterns and Associated Factors among Elderly People: The Case of Sunkoshi Rural Municipality, Nepal

The rapidly increasing elderly population in Nepal is the most significant emerging demographic phenomenon. Multimorbidity is common among the elderly and its prevalence increases with age. This study aims to assess the chronic conditions and the demographic and socioeconomic factors that influence morbidity among the elderly. A cross-sectional study was carried out in the Sunkoshi rural municipality of Sindhuli district from December 2021 to January 2022 with 413 elderly people aged 60 and older using a structured questionnaire. Multinomial logistic regression was used for data analysis. About 27% of the elderly suffer from gastritis, followed by high blood pressure (27%), arthritis (24%), asthma (18%), and diabetes (10%). Seventy-seven percent of the elderly reported at least one morbidity and 41% have two or more morbidities. More than one-fifth of elderly people have no morbidity. In the multinominal logistic regression, moderate (RRR=3.31, 95% CI: 1.15-4.63) and poor (RRR=11.91, 95% CI: 1.00-141.83) self-reported health status was significantly associated with one morbidity. A joint family (RRR=2.01, 95% CI: 1.08-3.74), moderate (RRR=3.07, 95% CI: 1.52-6.21) or poor (RRR=32.05, 95% CI: 2.53-405.94) self-reported health status was significantly associated with two or more morbidity. Those aged 80 years or over, those who belonged to the hill Janajati, and those who consumed alcohol were less likely to have multimorbidity. Concerned authorities should consider expanding health services in order to improve the health status of the elderly.