Multiple Binary Logistic Regression Analysis Research Articles

Prevalence of dental caries and associated risk factors among People Living with HIV/AIDS and HIV uninfected adults at an HIV clinic in Kigali, Rwanda.

Dental caries is among the most frequent oral conditions in People Living with HIV/AIDS (PLWHA). There is a lack of baseline information on dental caries prevalence and associated risk factors among PLWHA in comparison to HIV uninfected people in Rwanda. This study was conducted to determine the prevalence of dental caries and associated risk factors among PLWHA and HIV uninfected adults at an HIV clinic of Kigali Teaching Hospital (CHUK) in Kigali, Rwanda. A comparative cross-sectional study was conducted among 200 PLWHA and 200 HIV uninfected adults aged 18 years and above attending an HIV clinic of CHUK. An oral examination was performed by a calibrated examiner. Dental caries were assessed using the WHO Decayed (D), Missing (M), and Filled Teeth (F) index (DMFT). Descriptive statistics, Chi-square, t-tests, and multiple binary logistic regression were used to analyze data. Overall, a higher prevalence (50.5%) of PLWHA had experienced dental caries (DMFT>0) compared to HIV uninfected counterparts (40.5%) (p = 0.045). The prevalence of Decayed teeth (D) was also higher (23.5%) among PLWHA compared to HIV uninfected persons (13.6%) (p = 0.011). The Mean(SD) DMFT scores among PLWHA and HIV uninfected participants were 2.28 (3.68) and 1.29 (2.21) respectively (p = 0.001). After performing multiple binary logistic regression analysis, the predictors of dental caries in PLWHA were being female (OR = 2.33; 95%CI = 1.14-4.75), frequent dental visits (OR = 4.50; 95% CI = 1.46-13.86) and detectable RNA viral load (OR = 4.50; 95% CI = 1.46-13.86). In HIV uninfected participants, the middle age range (36-45 years), and frequent dental visits were significantly associated with dental caries (OR = 6.61; 95%CI = 2.14-20.37) and (OR = 3.42; 95%CI: 1.337-8.760) respectively. The prevalence of dental caries was higher in PLWHA than in HIV uninfected counterparts. The reported higher prevalence of caries in PLWHA was associated with being female, detectable viral load, and frequent dental visits. Therefore, there is a need for effective oral health interventions specific to PLWHA in Rwanda to raise awareness of the risk of dental caries and provide preventive oral health services among this population. To ensure timely oral health care amongPLWHA, there is a need for an effort from policymakers and other stakeholders to integrate oral health care services within the HIV treatment program in Rwanda.

Relationship between pain, nerve injury and clinical outcomes after flexor tendon injuries in zones 1-2: a retrospective cohort study.

The influence of pain and a concomitant digital nerve injury on the course of rehabilitation after flexor tendon injury remains ambiguous. The objectives of the study were to: i) analyse the evolution of pain spanning one year after a primary flexor tendon repair in zones 1-3; ii) examine the differences in pain levels in patients with and without digital nerve injury; and iii) evaluate the relationship between pain, digital nerve injury and pain medication, total active motion (TAM), DASH scores and patient satisfaction. Data from 189 patients were retrieved from a flexor tendon registry between 2014 and 2020. Differences in pain, TAM, DASH and patient satisfaction were analysed. Multiple linear and binary logistic regression analyses were performed to determine the relationship between clinical outcomes. Pain significantly decreased in the course of rehabilitation (p < 0.001 to 0.006). No relationship could be identified between nerve injury and pain (p = 0.21-0.97). In week 6, the presence of pain and a nerve injury were significantly associated with lower TAM scores (p = 0.001). In week 13, pain during motion (p < 0.001) and the presence of a nerve injury (p = 0.036) were significantly associated with worse DASH scores. Patient satisfaction was significantly inversely correlated to pain during motion in weeks 13 and 26 (p < 0.001). We found a significant relationship between pain during motion and pain medication intake, TAM, DASH scores and patient satisfaction. It is therefore advisable to closely monitor this parameter after flexor tendon injuries. This multi-center cohort study is registered under https://clinicaltrials.gov: NCT04312412.

Knowledge, attitudes, and practices towards Coronavirus Disease (COVID-19) among Pakistani residents during the vigorous upsurge phase of the outbreak.

Background: To prevent the rapid rise of COVID-19, people’s adherence to control measures is affected by their knowledge, attitudes, and practices (KAP) towards COVID-19. In this study, we investigated Pakistani residents' KAP towards COVID-19 during the peak spread of this disease.&#x0D; Methodology: cross-sectional survey designed to evaluate the knowledge, attitudes, and practices during the COVID-19 epidemic using an online questionnaire. The knowledge section of the questionnaire had eight questions (K1-K8) regarding clinical presentations, transmission routes, prevention, and control of COVID-19. Attitudes towards COVID-19 were estimated by four questions (A1-A4) mainly focused on the agreement on the successful control of COVID-19. For practices (P1-P6), six questions were asked related to washing hands, covering the mouth, and social distancing practices.&#x0D; Results: A total of 139 completed forms were included in the analysis, of which 98 (70.5%) were females and 41(29.5%) were males. Results of multiple binary logistic regression analysis on factors significantly associated with attitude towards COVID-19, successful control of COVID-19 in Pakistan by gender OR (95% CI), 1.95(1.58, 0.80). As these findings were recruited from a small number of participants, they cannot be generalized to the entire population.&#x0D; Conclusion: The findings of our study suggest that the unequal distribution of knowledge may impede certain people from adopting healthy practices.

Prevalence of apical periodontitis in patients with autoimmune diseases: A case-control study.

The purpose of this case-control study was to compare the prevalence of apical periodontitis (AP) in patients affected by autoimmune disorders (AD) (inflammatory bowel disease [IBD], rheumatoid arthritis [RA] and psoriasis [Ps]) with the prevalence of AP in subjects without AD. The prevalences of AP in patients taking biologic medications, conventional medications and no medication were also compared. Eighty-nine patients (2145 teeth) with AD were investigated and the control group included 89 patients (2329 teeth) with no systemic diseases. Full dental panoramic tomograms were used to determine the periapical status of the teeth. Additional variables investigated included patient's socio-demographic characteristics, medications taken by AD patients, the decayed, missing and filled teeth (DMFT) index. The chi-square test and logistic regression analysis were used to evaluate the correlation between AD and AP. p-Values lower than .05 were considered to be statistically significant. The prevalence of AP was 89.9% in AD patients and 74.2% in control subjects (odds ratio [OR]=3.75, p=.015). The DMFT score was found to be significantly higher in the AD group (p=.004). Patients with RA had the highest risk of being affected by AP, whereas those with IBD had the lowest risk. Multiple binary logistic regression analysis indicated that the teeth of AD patients who were not taking any medication or were being treated with biologic disease-modifying anti-rheumatic drugs (bDMARDs) had a higher risk of being affected by AP than did the teeth of the control subjects (OR=1.42 and OR=2.03, respectively; p=.010). The teeth of patients taking conventional DMARDs (cDMARDs) were less affected by AP compared with those of patients taking bDMARDs. Patients with AD, whether treated or not with biologic medications, showed a higher prevalence of AP than did those in the control group. The DMFT index score, which was higher in AD patients compared with controls was identified as a significant predictor of AP prevalence.

Prevalence and associated factors of physical inactivity among adult diabetes mellitus patients in Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

Physical inactivity has been viewed as an emerging public health problem in developing countries including Ethiopia. Diabetes mellitus (DM) is a group metabolic disorder characterized by chronic hyperglycemia resulting from defects in insulin secretion, function, or both. Its prevalence increases with changing lifestyles including physical inactivity across the globe. However, there is limited research, and not yet received attention in Ethiopia. This study aimed to assess the prevalence and associated factors of physical inactivity among adult diabetic patients in Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia. An institutional-based cross-sectional study design was conducted among 308 participants from February to June 2018 at Felege Hiwot Referral Hospital. A face-to-face interview was conducted using a structured questionnaire by trained data collectors. Participants were selected through a systematic random sampling technique. Physical inactivity was assessed by the international physical activity questionnaire (IPAQ). Collected data were entered in Epi info version 7 and transferred to SPSS version 20 for analysis. A summary of descriptive statistics and multiple binary logistic regression analyses were computed to identify associated factors of physical inactivity among adult diabetic patients. P < 0.05 with 95% CI was considered statistically significant. The overall prevalence of physical inactivity among diabetic patients was 30.5% ( 95% CI: 22.8–33.5%). Gender (AOR = 1.5, 95% CI: 1.1, 3.62), Old age (AOR = 18.17, 95% CI: 22.7, 61.9) Residence (AOR = 4.24, 95% CI: 1,12,16.028), Low self-efficacy (AOR = 20.59, 95% CI: 10.598, 41.608), Poor attitude (AOR = 2.75, 95%CI: 1.44,5.28), and Lack of social support (AOR = 4.22, 95% CI: 1.28,4.07) were found significantly predictor factors of physical inactivity. The prevalence of physical inactivity in this study was high. Being female, old age, dwelling in an urban, having low efficacy, poor attitude, and lack of social support was greater risk factors for being physically inactive. Diabetic education should focus on engagement in physical activity by overcoming barriers to performing physical activity. Government and health professionals should emphasize that evidence-based physical activity important to change their attitudes and require reaching a consensus on social support by their families.

Systemic Immune-Inflammatory Index Is Associated with Residual SYNTAX Score in Patients with ST-Segment Elevation Myocardial Infarction.

Systemic immune-inflammatory index (platelet count × neutrophil-lymphocyte ratio) is a new marker that predicts adverse clinical outcomes in coronary artery diseases. Our aim was to investigate the relationship between the systemic immune-inflammatory index and residual SYNTAX score in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. In this retrospective study, 518 consecutive patients who underwent primary percutaneous coronary intervention (PCI) with the diagnosis of ST-segment elevation myocardial infarction were analyzed. The severity of coronary artery diseases was determined by residual SYNTAX score. In the receiver operating characteristic curve analysis, systemic immune-inflammatory index with an optimal threshold value of 1025.1 could detect the presence of a high residual SYNTAX score; the patients were divided into 2 groups as low (326) and high (192) according to the threshold value. In addition, binary multiple logistic regression analysis methods were used to evaluate independent predictors of high residual SYNTAX score. In binary multiple logistic regression analysis, systemic immune-inflammatory index [odds ratio = 6.910; 95% CI = 4.203-11.360; P <.001] was an independent predictor of high residual SYNTAX score. In addition, there was a positive correlation between the systemic immune-inflammatory index and residual SYNTAX score (r = 0.350, P <.001). In the receiver operating characteristic curve analysis, the systemic immune-inflammatory index with an optimal threshold value of 1025.1 could detect the presence of a high residual SYNTAX score with 73.8% sensitivity and 72.3% specificity. Systemic immune-inflammatory index, an inexpensive and easily measurable laboratory variable, was an independent predictor of the increased residual SYNTAX score in patients with ST-segment elevation myocardial infarction.

Prevalence and risk factors of low back pain among an adult population in Bisha: A Cross-sectional Study

Background: Worldwide, LBP prevalence in the general population has been reported to be between 15% and 45%. In the Kingdom of Saudi Arabia (KSA), LBP prevalence was reported to range from 18.8% to 53.5% in the general population. The aim of this study was to identify the prevalence of LBP and risk factors among the adult population in Bisha. Methods: A cross-sectional study of adults living in Bisha and the adjacent area in Saudi Arabia was conducted. The data were gathered via a self-administered online survey. The Mann‒Whitney test and the chi-square test were used to compare individuals with and without low back pain. The presence of low back discomfort (yes or no) was compared to risk factors using multiple binary logistic regression analysis. Odds ratio (OR) and 95% confidence interval (CI) calculations were made. Results: The total number of participants was 350. The prevalence of low back pain (LBP) among the participants was 242 individuals (69.1%). A history of LBP was statistically significantly associated with some sociodemographic characteristics, including sex (p value = 0.002) and age (p value= 0.002). Some risk factors were statistically significantly associated with a history of LBP: history of diabetes mellitus (p value=0.048) and thyroid disease (p value= 0.056). Conclusions: With more than a sixth of the sample reporting back discomfort, low back pain is very common in the Saudi adult population. This report urges action toward the creation of management, prevention, and education programs for society.

Spontaneous remission of vision degrading myodesopsia of posterior vitreous detachment type.

The study aims to observe the spontaneous remission of posterior vitreous detachment (PVD)-type vision degrading myodesopsia (VDM) during long-term follow-up. We retrospectively reviewed VDM patients with PVD type that refused any treatment. The ratio and time of significant spontaneous remission of floater symptoms occurring were described. The associated factors with significant remission of floater symptoms were analyzed in the univariate and multivariate logistic regression analyses. In total, 179 patients with VDM were assessed. The mean age of all patients was 60.56 ± 0.47years old, and the mean duration of follow-up was 23.89 ± 6.63months. Of the patients, 40.78% have significant improvement in their floater symptoms after mean 16.55 ± 10.63-month follow-up. Myopia (OR = 0.280, 95% CI = 0.084-0.932, P = 0.038), the number of floaters > 3 (OR = 0.343, 95% CI = 0.172-0.683, P = 0.002), and floaters with string-like pattern (OR = 0.370, 95% CI = 0.166-0.824, P = 0.015) and blocky pattern (OR = 0.299, 95% CI = 0.090-0.993, P = 0.049) were negatively correlated with the significant spontaneous remission of VDM symptoms in the multiple binary logistic regression analysis. Approximately 40% of VDM patients with PVD may experience significant spontaneous remission during long-term follow-up. Patients that are non-myopic and with fewer floaters are more likely to feel relief from VDM symptoms. Floaters with string-like or blocky patterns are less likely to undergo spontaneous remission.

Prevalence of smoking among nurses and its association with blood pressure: A cross-sectional study in 11 cities of China.

Smoking is harmful to human health. However, the relationship between smoking and blood pressure (BP) has not been consistent. This study aimed to analyse nurses' smoking behaviours and their relationship with BP. This cross-sectional study recruited 128 009 nurses in 11 cities in China. They were surveyed with questionnaires including BP measurements. The main contents of the questionnaire included smoking status and other factors that might be associated with hypertension. Multiple linear regression analyses and binary logistic regression analyses were used to analyse the data. The results showed there was a significant difference in the smoking rate among nurses with different characteristics (P < 0.05). For both male and female nurses, smoking was associated with increased diastolic BP and mean arterial pressure, but only with increased systolic BP of male nurses. The prevalence of hypertension among male and female nurses was not related to smoking. Despite a relatively low overall smoking rate, rates among some groups are high. Different cities, hospitals, and departments can combine local data and conditions to formulate targeted tobacco control measures to improve nurses' physical and mental health.

Factors Associated with Tuberculosis Relapses Development

The objective: to identify socio-demographic, clinical and laboratory factors associated with tuberculosis recurrence.Subjects and Methods. Clinical and laboratory data of 208 TB patients treated at the National Scientific Center for Phthisiopulmonology of the Ministry of Health of the Republic of Kazakhstan were analyzed.IL-2 to the AlaDH was assessed using test platforms Lionex GmbH (Germany) according to the manufacturer's instructions. SPSS 23.0 software was used for statistical processing of obtained data. To assess the significance of differences in groups, the Pearson Chi-Square test was used. To determine the factors associated with of the tuberculosis relapse, а multiple binary logistic regression analysis was carried out.Results. Multivariate logistic regression analysis confirmed that male gender (OR = 2.086, 95% CI 1.001-4.350, p = 0.050), drug resistance (OR = 4.910, 95% CI 1.923-12.534, p = 0.001), fibrosis cavernous tuberculosis (OR = 6.362, 95% CI 2.178-18.585, p = 0.001) and low level of sensitized T cells that synthesize IL-2 in response to exposure to the AlaDH antigen in IGRA in vitro (OR = 2.155, 95% CI 1.060-4.379, p = 0.034) were significantly associated with tuberculosis recurrence.

Factors associated with fibro-cavernous tuberculosis

&lt;b&gt;Objective:&lt;/b&gt; To identify socio-demographic, clinical and laboratory risk factors associated with fibro-cavernous tuberculosis.&lt;br /&gt; &lt;b&gt;Material and methods:&lt;/b&gt; Clinical and laboratory data of 184 patients with pulmonary tuberculosis who were treated at the National Scientific Center for Phthisiopulmonology of the Ministry of Healthcare of the Republic of Kazakhstan were analyzed. Specific antibodies to the lipoglycan of &lt;i&gt;M.tuberculosis&lt;/i&gt; (&lt;i&gt;MBT&lt;/i&gt;) were evaluated in an immunochromatographic assay. To assess the significance of differences in groups, the Pearson Chi-Square test was used. To determine factors associated with the fibro-cavernous tuberculosis, а multiple binary logistic regression analysis was carried out.&lt;br /&gt; &lt;b&gt;Results: &lt;/b&gt;Multivariate logistic regression analysis showed that low BMI (OR=5,719, 95% CI: 2,049–15,965, p=0,001), TB recurrence (OR=3.374, 95% CI: 1,191–9,561, p=0,022), and a negative specific production of antibodies to lipoglycan of &lt;i&gt;M.tuberculosis&lt;/i&gt; (&lt;i&gt;MBT&lt;/i&gt;) (OR=0,354, 95% CI: 0,126-0,995, p=0,049) were significantly associated with fibro-cavernous tuberculosis.&lt;br /&gt; &lt;b&gt;Conclusion:&lt;/b&gt; Weight deficiency, high antibodies levels and TB relapse are factors associated with fibro-cavernous tuberculosis.

Family functioning and health-related quality of life of inpatients with coronary heart disease: a cross-sectional study in Lanzhou city, China

BackgroundA key outcome in coronary heart disease (CHD) is Health Related Quality of Life (HRQoL), and family functioning is important in the management of CHD. But few studies have examined both together, and little is known about them among inpatients with CHD in less developed areas of China. Therefore, this study aimed to assess the HRQoL and family functioning status of inpatients with CHD in Lanzhou from Northwest China, and identify the factors that affect their HRQoL.MethodsA cross‑sectional study was conducted in 224 CHD inpatients at one major hospital. Sociodemographic data and disease information of CHD inpatients were collected by face-to-face using a structured questionnaire and data were also obtained from patient medical records. HRQoL was measured using the Sickness Impact Profile (SIP). Family functioning was measured using the family APGAR index. Multiple binary logistic regression analysis (MBLRA) was used to explore potential risk factors associated with HRQoL, and Pearson’s correlations were used to assess the relationship between family functioning and HRQoL.ResultsThe overall, physical and psychosocial SIP scores were 25.03 ± 8.52, 18.61 ± 9.90 and 28.08 ± 9.64, respectively. The total family APGAR score was 6.11 ± 2.45. MBLRA found older age, poorer cardiac function and more severe disease were associated with poorer HRQoL, while better family functioning, higher monthly income, and urban living were associated with better HRQoL. Family functioning was weakly to moderately correlated with total and psychosocial HRQoL.ConclusionsOlder and less affluent inpatients with lower educational level, less family support and more severe CHD have poorest quality of life, and health care providers should consider interventions to support them.

Incidence and Predictors of Pregnancy among HIV Positive Women on ART in North West Ethiopia, a Retrospective Cohort Study

Objective: The objective of this study was to identify the prevalence and significant factors of incidence of pregnancy among HIV positive women under ART follow up. Methods: A retrospective cohort study was employed and a sample size of 429 was selected using simple random sampling technique. Both chi-square test of association and multiple binary logistic regression analysis were used. Results: The study has shown that 21.2% of women were pregnant during the follow-up. Variables like, WHO clinical stage, spouse’s HIV status, marital status, contraception use, body weight, occupation, CD4 count, age and time of ART were significant predictors of incidence of pregnancy. Conclusion: Women with advance WHO clinical stage were less likely to be pregnant. Women, who are married, employed, had never used contraceptive methods were more likely to had pregnancy. When CD4 cell count and body weight increase, incidence of pregnancy also increases and women who had longer time on ART were more likely to be pregnant. Health institutions and clinicians should be cautious when the patients have faced advanced WHO clinical stage and low CD4 count. We would like to put remarks of increasing employment of HIV Positive women, providing effective services of ART health care, and studying further investigation for the general wellbeing of mothers and their respective potentially born children.

P08-17 Physical activity according to migration status in adolescents living in French-speaking Belgium

BackgroundRising levels of childhood obesity is a worldwide concern, with physical inactivity considered to be amongst the many contributors. Worryingly, physical activity (PA) tends to decline throughout adolescence. Although there is extensive research on the sociodemographic disparities of adolescent PA participation, less evidence is available on the potential involvement of immigration status in such disparities. The aim of this study was to investigate PA levels according to migration status among adolescents aged 12-20 years in Belgium.MethodsThis study used the data from the cross-sectional 2018 Health Behaviour in School-aged Children (HBSC) survey in French-speaking Belgian schools (Brussels and Wallonia). A two-stage random sample was used to select participants. Data was collected using self-administrated questionnaires. Adolescents aged 12 to 20 were included in the analyses presented here (n = 8635, boys: n = 4179, girls: n = 4456). The association of global PA (GPA) and vigorous PA (VPA) with migration status (natives, 2nd and 1st-generation immigrants) was analysed using multiple binary logistic regression analyses. Interactions with gender were tested.ResultsThe prevalence of adolescents undertaking sufficient GPA (moderate to vigorous PA 60 minutes/day and VPA ≥3 times/week) was higher amongst 1st-generation immigrants (11.7%) compared to 2nd-generation immigrants (7.4%) and natives (8.9%) (p = 0.01). Vigorous PA ≥ 3 times/week was significantly more prevalent amongst natives (52.6%) than 2nd (44.9%) and 1st (48.8%) generation immigrants. After adjusting for sociodemographic variables, compared to natives, 2nd-generation immigrants were less likely to participate in sufficient GPA (aOR= 0.83, 95%CI: 0.69-1.00) and VPA (aOR= 0.77, 95%CI: 0.68-0.87). Conversely, 1st-generation immigrants were more likely to be sufficiently active compared to natives (GPA: aOR= 1.44, 95%CI: 1.03-2.01). An interaction between migration status and gender was found for VPA only (p > 0.001). Compared to natives, 1st-generation immigrant boys were more likely (aOR=1.42, 95%CI: 1.15-1.75) and immigrant girls were less likely to undertake VPA ≥3 times/week (2nd-generation: aOR= 0.66, 95%CI: 0.56-0.78; 1st-generation: aOR=0.72, 95%CI: 0.57-0.90).ConclusionsThis study shows disparities in PA participation according to migration status and gender, independently of sociodemographic characteristics, for adolescents living in French-speaking Belgium. These findings will enable to inform future public health initiatives promoting PA in adolescents on migration and gender-specific considerations.

Predictive Significance of High-Sensitivity C-Reactive Protein Combined with Homocysteine for Coronary Heart Disease in Patients with Anxiety Disorders.

Background Currently, there are few studies on biomarkers for predicting coronary heart disease (CHD) with anxiety disorders. Objective To explore risk factors and investigate the predictive value of common clinical peripheral blood indicators, such as high-sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) for CHD patients with anxiety disorders. Methods One hundred fifty-three hospitalized patients with chest pain as the main symptom and a Hamilton Anxiety Scale score > 14 were recruited from October 2020 to September 2021 in the hospital. Then, they were divided into an anxiety disorder with CHD group (observation group, n = 64) and a simple anxiety disorder group (control group, n = 89), according to coronary angiography (CAG) findings. Patients' demographic and clinical messages were collected and compared. Diabetes mellitus and hypertension, body mass index (BMI), and peripheral blood interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy), fibrinogen, D-dimer, cortisol, and norepinephrine expression levels were compared. Binary logistic regression analysis screened independent risk factors of CHD patients with anxiety disorders. The effectiveness of independent risk factors in predicting CHD with anxiety disorders was analyzed using receiver operating characteristic (ROC) curves. Results IL-6, hs-CRP, and Hcy levels of anxiety disorder in the CHD group were significantly higher than those in the simple anxiety disorder group. Binary multiple logistic regression analysis indicated that IL-6, hs-CRP, and Hcy were independent risk factors for CHD in patients with anxiety disorders. hs-CRP and Hcy levels were positively correlated with the Gensini score. ROC curve analysis indicated that the detection of hs-CRP or Hcy alone or the combined detection of the 2 had clinical predictive value for CHD in patients with anxiety disorders, and the area under the curve (AUC) of the combined detection of the 2 was significantly larger than that of any single factor alone (vs. hs-CRP, P = 0.045; vs. Hcy, P = 0.045). Conclusion IL-6, hs-CRP, and Hcy are related to CHD with anxiety disorders. Serum levels of the combined detection of hs-CRP and Hcy have a high clinical predictive value for CHD in patients with anxiety disorders.

Investigating associated factors of primary and specialist health care utilization among people with selected nationalities: results of a multilingual survey in two German federal states

BackgroundApproximately every fourth person in Germany has a migration background. Health research on the use of primary and specialist health care in this group is still scarce. Few studies have suggested a difference in the use of primary and specialist health care among people with a migration background. Potential resources and barriers to health care access should be investigated as they are critical to health equity. This study investigates associated sociodemographic, migration-sensitive, and health-related factors of primary and specialist health care utilization among people with a migration background as defined by nationality.MethodsAnalyses are based on data from a feasibility study of the project “Improving Health Monitoring in Migrant Populations” (IMIRA), conducted by the Robert Koch Institute. The sample (n = 1055) included persons with Croatian, Polish, Romanian, Syrian, and Turkish nationalities living in the federal states of Berlin and Brandenburg, Germany. Descriptive and bivariate analyses as well as multiple binary logistic regression analyses were carried out to assess sociodemographic (sex, age, socioeconomic position), health-related (self-rated health), and migration-sensitive factors (duration of residence in Germany, residence status, German language proficiency) associated with the use of primary and specialist health care services in the past 12 months.ResultsOf the total study population, 79.62% visited a general practitioner and 59.53% a specialized physician in the past 12 months. Participants who were female sex, aged 65 and older, and with moderate/poor/very poor self-rated health had higher odds of visiting a general practitioner and a specialized physician, with the strongest impact from self-rated health. After controlling for sociodemographic and health-related factors, duration of residence in Germany and residence status were associated with primary but not with specialist health care utilization.ConclusionsOur results suggest that migration-sensitive characteristics, such as duration of residence, should be considered in a differentiated manner in health services research to gain detailed insights into health care utilization and its potential barriers among the heterogenous group of people with a migration background. Further research needs to be done to evaluate how to get people into contact with a general practitioner.

Prevalence of foot ulcers in diabetic patients in Punjab, Pakistan.

Diabetes-related foot ulceration is prevalent and disabling, usually resulting in the amputation of the limb. The mortality rate is significant, and healed ulcers frequently reoccur. The main purpose of this study was to explore the prevalence of foot ulcers and their associated factors among diabetic patients in Punjab, Pakistan. Multistage cluster random sampling procedure was applied to perform a cross-sectional analysis in the state of Punjab, Pakistan. A sample of 1,503 people with diabetes, including 504 men and 999 women, were selected from different clusters. Data were collected from December 18, 2018, to June 30, 2019. Individuals of 18 years or above were selected. A binary multiple logistic regression analysis was utilized to find the factors associated with a diabetic foot ulcer. The overall prevalence of diabetic foot ulcers was 16.83% (95% CI: 14.9–18.7%). The prevalence among the female was 17.52% (95% CI: 15.2–19.9%), and the male was 15.48% (95% CI: 12.3–18.6%). In rural areas, prevalence was 13.91% (95% CI: 10.6–17.2%) compared to the prevalence of 17.96% (95% CI: 15.7–20.2%) in the urban area. Individuals 75 years and above had the highest prevalence of 66.67% (95% CI: 51.9–81.5%). According to the income status, subjects with monthly income above Rs. 61,000 had a prevalence of 24.24% (95% CI: 15.8–32.7%), and among overweight subjects was 25.49% (95% CI: 21.3–29.7%). This study found a relatively high prevalence of foot ulcers in Punjab, Pakistan. The results indicate that diabetic foot ulcers have become a major health problem in diabetic patients, and better strategies and preventive measures should be opted to deal with the epidemic.

Effect of Sleep Disturbance on Cognitive Function in Elderly Individuals: A Prospective Cohort Study.

Many epidemiologic and clinical studies have shown significant links between the degree of sleep disturbance and severity of impairment of selective cognitive functions, including the risk of neurodegenerative diseases. However, the sleep parameters that affect cognitive function in old age are unclear. Therefore, we investigated the association between sleep parameters and cognitive function in older patients. Patients aged above 65 years who complained of sleep-disordered breathing were enrolled consecutively. The Mini-Mental-State Examination tool was used to evaluate cognitive function. Eighty patients (normal cognitive function, n = 32 and cognitive impairment, n = 42) were included in this study. Multiple linear regression and binary logistic regression analyses were performed to explain the relationship between sleep parameters and cognitive function. We found that the body mass index (BMI) was significantly lower in the cognitive impairment group than in the normal cognitive function group. Additionally, the cognitive impairment group showed significantly decreased sleep efficiency and an increased apnea index compared with normal subjects. Moreover, lower BMI, reduced sleep efficiency, and high frequency of apnea events during sleep were associated with an increased risk of cognitive impairment.

The Associations of Electronic Media Use With Sleep and Circadian Problems, Social, Emotional and Behavioral Difficulties in Adolescents.

BackgroundElectronic media use (EMU) becomes one of the most common activities in adolescents. The present study investigated the deleterious influence of excessive EMU and EMU before bedtime on social, emotional, and behavioral difficulties (SEBD) in adolescents. The role of sleep and circadian problems in mediating the association of EMU with SEBD was examined.MethodsA cross-sectional survey study was conducted with 3,455 adolescents (55.7% female, mean age = 14.8 ± 1.57 years, 36.6% monthly family income < HK$15,000) between December 2011 and March 2012 in Hong Kong. The associations of EMU with sleep and circadian problems and SEBD were analyzed using multiple binary logistic regression and path analysis. Sleep problems were measured by the Insomnia Severity Index and the reduced Horne and Östberg Morningness and Eveningness Questionnaire. Circadian problems were calculated based on established formulas. SEBD was measured using the Strengths and Difficulties Questionnaire. Participants' mental health status was assessed by the General Health Questionnaire.ResultsA longer duration of EMU, excessive EMU (daily duration ≥ 2 h), and bedtime EMU (an hour before bedtime) were associated with the risk of sleep and circadian problems, poor mental health, and SEBD (p < 0.05). Insomnia, eveningness, social jetlag, and sleep deprivation were found to mediate the associations of EMU (including bedtime EMU of computers, electronic game consoles, phones, and televisions, together with excessive EMU of computers for leisure purposes and phones) with mental health and SEBD.ConclusionsThe findings suggest the need for setting up guidelines and advocacy for education for appropriate EMU and intervention for the associated sleep and circadian problems to ameliorate EMU-related mental and behavioral health problems in adolescents.

Knowledge, attitudes, and practices regarding plagiarism of postgraduate students in Myanmar

ABSTRACT Information regarding the prevalence of plagiarism and its contributing factors are limited in Myanmar. We aimed to explore the knowledge, attitudes, and self-reported plagiarism practices of postgraduate students in Myanmar’s universities and determine the factors associated with plagiarism. We conducted a cross-sectional questionnaire study during 2019–2020. The questionnaire contained: 1) demographics, 2) knowledge on plagiarism, 3) attitudes toward plagiarism, and 4) self-reported plagiarism practices. We calculated attitudes and plagiarism severity scores (PSS). We conducted multiple linear regression analyses and binary logistic regression analyses. A p-value <0.05 denoted statistical significance. We enrolled 217 participants. Of our participants, 37.6% self-reported at least one plagiarism act. The mean attitude score (S.D.) was 62.24 (10.44), (maximum score was 92, higher scores represent disapproval of plagiarism). This attitude score reflects only a moderate attitude toward disapproval of plagiarism. The attitude score was significantly higher for doctoral students (9.2%) than master students (90.8%); p = 0.003; and for participants with publications (13.4%) compared with those without publications (86.6%); p = 0.005. The attitude score was a significant predictor of the PSS. We conclude that there is evidence to suggest that plagiarism represents a significant ethical issue in Myanmar and recommend that Myanmar universities provide training in responsible conduct of research.