Multiple Binary Logistic Regression Analysis Research Articles

Disclosure of HIV/AIDS status to infected children in Ghana – A north-south comparison of barriers and enablers

Disclosure of HIV status to infected children plays critical role in child health and wellbeing. This study identifies and compares child HIV disclosure barriers and facilitators in Upper East, Northern and Ashanti regions of Ghana. Prospective data was collected through a questionnaire on 180 caregivers of HIV-infected children 5–18 years from 12 antiretroviral treatment (ART) centres from May 2017 to November 2018 enrolling 89 (49.5%) males and 91 (50.5%) female children. A bivariate and binary multiple logistic regression analysis was performed to test child and caregiver related variable with disclosure. A total of 42 (23.3%) children with a median age of 12 years had been disclosed to. The median age of 138 undisclosed children was 7 (IQR = 5–11) years. The median age at disclosure was 9.5 (IQR = 6–11) years in contrast to 16.3 years, which was proposed as the intended age of disclosure by caregivers. Approval for child status disclosure to be facilitated by only child’s family member differed significantly between caregivers from northern Ghana and southern Ghana (17% vs 83%, p < 0.03). In the multivariate binary logistic regression, a child questioning caregiver frequently about continuous medication intake (AOR = 19.0, p < 0.01) increased the odds of disclosure. Enablers to disclosure were child age, ART start age and resident region of the care giver. The barriers to disclosure involved limited caregiver knowledge and caregiver notion of non-disclosure as a best interest and child protection decision. Difference in region of residence of the child contributes to enhance or impede child HIV disclosure. This calls for developing appropriate age specific child disclosure-promoting guideline to facilitate disclosure.

Mother's education level is associated with anthropometric failure among 3- to 12-year-old rural children in Purba Medinipur, West Bengal, India.

Maternal education plays a central role in children's health and nutrition. Living conditions and socioeconomic status are linked with mother's education, which in turn determines the health and development of a child. The Composite Index of Anthropometric Failure (CIAF) is a single indicator that reflects overall rate of three conventional indices of undernutrition: underweight, stunting and wasting. The study was undertaken among 621 rural Bengalee children (308 boys and 313 girls) aged 3-12 years from the Purba Medinipur district of West Bengal, India. Height (cm) and weight (kg) were recorded and NCHS standard values used to calculate z-scores (<-2SD). The same data were used to calculate CIAF as an indicator of 'anthropometric failure' (AF) or undernutrition. The prevalence of AF among the children was 59.40%. Chi-squared analysis was employed to evaluate the significance of differences in the prevalence of CIAF between the sexes and the association between nutritional indicators and socioeconomic parameters in the two sexes. Multiple binary logistic regression (MBLR) analyses (including the forward stepwise method) were also performed. Odds ratios with 95% confidence intervals were used to assess the risk of having AF. Results showed that mother's education was significantly associated with undernutrition (AF) controlling for the other factors considered. A very high prevalence of undernutrition is persisting in this region of India despite national nutritional supplementation programmes being operational. More attention to the improvement of living conditions and hygiene, and more particularly the education of women, in this population might be effective in attaining improved child growth and health.

Limited health literacy increases the risk of orthorexia nervosa among urban schoolteachers

Background Orthorexia nervosa (ON) describes a pathological obsession with proper nutrition that is characterized by a restrictive diet, ritualized patterns of eating, and rigid avoidance of foods believed to be unhealthy or impure. Limited health literacy may play a role in the onset and progression of orthorexia. The aim of this study was to determine the relationship between health literacy and ON among urban schoolteachers.MethodsThis cross-sectional study was conducted in central Black Sea region of Turkey with 420 primary and secondary schoolteachers aged between 18 and 51 years. A questionnaire form including socio-demographic characteristics was used. The Orthorexia Nervosa Questionnaire (ORTO-15) was used to assess orthorexia nervosa behavior and the Turkey Health Literacy Scale (TSOY-32) to assess health literacy. Simple binary and multiple binary logistic regression analyses were carried out to verify the associations between the variables.ResultsOf the study group 46.4% were in the 40-49 year age group, 53.8% were male, 78.6% had ON and 93.6% had limited health literacy. Nearly all of the orthorexics (96.4%) had limited health literacy. Female gender, Instagram use and limited health literacy was significantly associated with ON. Limited health literacy increases the risk of ON 4.85 times among teachers (aOR=4.85;95% C.I. : 2.15-10.94;p=0.000).ConclusionThe current findings suggest that limited health literacy is the strongest risk factor for ON among urban schoolteachers. School health literacy and social media literacy programs can open a new window into revealing ON.

Examining the prevalence, correlates and inequalities of undiagnosed hypertension in Nepal: a population-based cross-sectional study

ObjectiveTo examine the prevalence, correlates and sociodemographic inequalities of undiagnosed hypertension in Nepal.DesignThis study used cross-sectional 2016 Nepal Demographic and Health Survey (NDHS) data. Undiagnosed patients with hypertension were defined...

The fourth decade of life: the age for preventive strategies?

Abstract Background Non-communicable diseases (NCDs) have been on the health agenda for decades. As the 2020's decade sets in, most of the set health strategies and targets are ending while new goals are expected. Investigating a European country hub known for its high prevalence of NCDs provides evidence-based data that can be used for these new strategies. The aim was to explore potential NCDs trends and associations that could provide evidence for new preventive strategies and goals. Methods Data was obtained from a national representative cross-sectional study through a health examination survey (2014-6). The self-reported data and the results of the examination were used to diagnose participants with type 2 diabetes, dyslipidaemia, hypertension, overweight and obesity. The study population was stratified by ten years and sex for both descriptive and analytic analyses. Results The male population was significantly more metabolically unhealthy that the female counterparts across all age groups (p = &amp;lt;0.01). The females had the highest newly diagnosed diabetes prevalence across all age groups. It was observed that type 2 diabetes, dyslipidaemia and hypertension were present as of the 30-39 years group. Conversely, on binary multiple logistic regression analysis, this age group was negatively associated with NCDs even after adjusting for confounders (Diabetes OR:0.06 CI95%:0.02-0.21 p = &amp;lt;0.01; hypertension OR: 0.16 CI 95%: 0.05-0.55 p = &amp;lt;0.01; overweight OR: 0.21 CI 95%: 0.11 - 0.40 p = &amp;lt;0.01). Conclusions The fourth decade of life might be the starting point for metabolic dysregulation. Hence, subject to long-term health and economic burdens, with a potential extension of the metabolic impact on their offspring. Although further research is recommended, this study sets the ball rolling whether preventive action including screening for dysglycaemia and dyslipidaemia should be implemented at a population level from a young age. Key messages Preventive action should start from fourth decade of life. Targeting the fourth decade of life would also ensure a healthier new generation.

Progression-free survival is a suboptimal predictor for overall survival among metastatic solid tumour clinical trials

BackgroundThe use of overall survival (OS) as the gold standard primary end-point (PEP) in metastatic oncologic randomised controlled trials (RCTs) has declined in favour of progression-free survival (PFS) without a complete understanding of the degree to which PFS reliably predicts for OS. MethodsUsing ClinicalTrials.gov, we identified 1239 phase III oncologic RCTs, 260 of which were metastatic solid tumour trials with a superiority-design investigating a therapeutic intervention by using either a PFS or OS PEP. Each individual trial was reviewed to quantify RCT design factors and disease-related outcomes. ResultsA total of 172,133 patients were enrolled from the year 1999 to 2015 in RCTs that used PFS (56.2%, 146/260) or OS (43.8%, 114/260) as the PEP. PFS trials were more likely to restrict patient eligibility by using molecular criteria (15.1% versus 4.4%, p = 0.005) use targeted therapy (80.1% versus 67.5%, p = 0.048), accrue fewer patients (median 495 versus 619, p = 0.03), and successfully meet the trial PEP (66.9% versus 33.3%, p < 0.0001). On multiple binary logistic regression analysis, factors that predicted for PFS or OS PEP trial success included choice of PFS PEP (p < 0.0001), molecular profile restriction (p = 0.02) and single agent therapy (p = 0.02). Notably, there was only a 38% (31/82) conversion rate of positive PFS-to-OS benefit; lack of industry sponsorship predicted for PFS-to-OS signal conversion (80.0% without industry sponsorship versus 35.1% with industry sponsorship, p = 0.045). ConclusionsA PFS PEP has suboptimal positive predictive value for OS among phase III metastatic solid tumour RCTs. Regulatory agency decisions should be judicious in using PFS results as the primary basis for approval.

Factors Influencing Selenium Concentration in Community-Dwelling Patients with Type 2 Diabetes Mellitus.

Selenium (Se) plays an important role in the pathogenesis of diabetes, and which factors affecting Se concentration in patients with type 2 diabetes mellitus (T2DM) are unknown. This study aimed to explore the factors influencing Se concentration in community-dwelling individuals with T2DM. A total of 176 patients with T2DM were involved, and their general information was collected through a self-designed questionnaire. Venous blood samples and hair samples were collected to detect Se concentration and biochemical parameters. Multiple linear regression and binary logistic regression analysis were used to analyze the factors influencing Se concentration in patients with T2DM. The factors influencing selenoprotein P concentration in patients with T2DM included alkaline phosphatase (β=-1.373; 95% CI: 0.087-0.736; P= 0.012), systolic blood pressure (SBP; β=-0.047; 95% CI: 0.930-0.978; P< 0.001), the duration of T2DM (β=-0.074; 95% CI: 0.877-0.983; P= 0.011), and clinical complications (β= 1.237; 95% CI: 1.465-8.109; P= 0.005). The factors influencing glutathione peroxidase activity in patients with T2DM were creatinine (CREA; β=-0.378; P< 0.001), uric acid (β=-0.069; P= 0.009), body mass index (β=-2.177; P= 0.002), SBP (β=-0.275; P= 0.031), and medical payment (β= 29.160; P< 0.001). The factors influencing serum Se concentration in patients with T2DM were albumin (β=-1.391; 95% CI: 0.065-0.959; P= 0.043) and CREA (β=-1.482; 95% CI: 0.072-0.718; P= 0.012). The factors influencing hair Se concentration in patients with T2DM were smoking (β=-1.151; 95% CI: 0.133-0.755; P= 0.010), drinking (β= 1.366; 95% CI: 1.191-12.909; P= 0.025), and hair dyeing (β=-1.113; 95% CI: 0.124-0.867; P= 0.025). In conclusion, the Se concentration in patients with T2DM was mainly affected by liver and renal function. When liver and/or renal function was impaired, the Se concentration in patients with T2DM was decreased.

The characteristics of an obesogenic small European country: results from a Malta cross-sectional study.

Obesity is a chronic disease and a global epidemic. The pathophysiology is well-documented; however, different countries are faced with different obesity characteristics. The aim was to establish the adult obesity characteristics of the obesogenic European country of Malta and explore for obesity links. A national representative health examination survey was conducted. A single-stage random stratified sample population (n = 4000) was obtained from a national register. Data on sociodemographic, comorbidities and lifestyle were collected. Body weight and height were measured, and blood collected for fasting glucose and lipid profile. Multiple binary logistic regression analyses through generalized linear models were performed to assess for associations between obesity, sociodemographic characteristics and dysglycaemic status. Out of the study population (n = 3947), 69.75% (confidence interval (CI) 95%: 68.32-71.18) were obese, with a male predominance (55%). The obese category sub-population resided mostly (25.80%, CI 95%: 23.53-28.21) within the highly densely populated district (Northern Harbour) of Malta and had a 'routine and manual' social position (55.76%, CI 95%: 53.10-58.40). On multiple logistic regression modelling, an obese status was linked with males (odds ratio (OR): 1.8, CI 95%: 1.53-2.12, p < .01), age (OR: 1.01, CI 95%: 1.01-1.02, p < .01), Northern Harbour district (OR: 1.11, CI 95%: 0.91-1.36, p < .02), type 2 diabetes (OR: 2.46, CI 95%: 1.79-3.38, p < .01) and impaired fasting blood glucose (IFG: 1.31, CI 95%: 1.17-1.90, p < .01) after adjusting for confounders. Obesity is a major health concern in Malta. Social determinants of health and metabolic changes appear to have a role in the obesity phenotype. Target actions that are gender-sensitive, social groups-focused and geographically oriented may be essential. The link between obesity and dysglycaemia brings forward the suggestion for incorporation of routine dysglycaemia screening during family doctors' consultations for patients with higher than normal body weight.

Psychological status of the staff in a general hospital during the outbreak of coronavirus disease 2019 and its influential factors.

To understand the psychological status of the staff in a general hospital during the coronavirus disease 2019 and its influential factors, and to provide references for the mental health services to hospital staff. Using star platform of questionnaire, the staff in the general hospital were investigated via Depression, Anxiety, Stress Scale (DASS-21), Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ). The influential factors were discussed by descriptive analysis, rank sum test, single factor analysis, correlation analysis and multiple factors binary logistic regression analysis. A total of 2 060 valid questionnaires were collected. The negative emotions of nurses and cleaners were the most obvious. The depression scores, anxiety scores and stress scores for nurses and cleaners were 5.06±7.47, 6.36±7.84, 9.75±8.65, and 6.72±8.84, 4.51±6.56, 9.69±9.56, respectively. Multivariate binary logistic regression analysis showed that staff types, education levels, job status, economic situation and concerns on the supplies of protective goods were the main influential factors for depression; staff types, contacting status with infected patients, economic situation, concerns on the supplies of protective goods, history of disease were the main influential factors for anxiety; contacting status with infected patients, economic situation, concerns on the supplies of protective goods were the main influential factors for stress. There are differences in psychological characteristics among different groups of staff in the general hospital under the outbreak. Thus psychological protection and intervention measures should be formulated according to different groups and work status.

Prevalence of Diabetic Retinopathy and Its Associated Factors among Diabetic Patients at Debre Markos Referral Hospital, Northwest Ethiopia, 2019: Hospital-Based Cross-Sectional Study.

BackgroundDiabetic retinopathy is a well-known sight-threatening microvascular complication of diabetes mellitus. Currently, 93 million people live with diabetic retinopathy worldwide. There are insufficient studies addressing the prevalence of diabetic retinopathy and risk factors in Ethiopia.ObjectiveTo assess the prevalence of diabetic retinopathy and its associated factors among diabetic patients on follow-up at Debre Markos Referral Hospital, northwest Ethiopia, 2019.MethodsThis institution- based cross-sectional study was conducted among 302 patients. They were selected through systematic sampling. Explanatory data were extracted from medical records and interviews. Blood pressure, weight, height, and visual acuity tests were assessed. Retinal examination was performed with a Topcon TRC-NW7SF fundus camera. Data were entered in EpiData 3.1 and exported in to SPSS 20 for analyses. Binary logistic regression with 95% CIs was used for analyses. Simple binary logistic regression followed by multiple binary logistic regression analysis was conducted to identify associated factors.ResultsThere were 302 patients in this study, of which 57 (18.9%) had diabetic retinopathy. Among the diabetic retinopathy patients, 75.4% had the preproliferative type. Four in ten (37.7%) of the patients had visual acuity problems. Poor glycemic control (AOR 4.58, 95% CI 1.86–11.31), > 10 years’ diabetes duration (AOR 3.91, 95% CI 1.86–8.23), body-mass index >25 kg/m2 (AOR 3.74, 95% CI 1.83–7.66), and hypertension (AOR 3.39, 95% CI 1.64–7.02) were factors significantly associated with diabetic retinopathy.ConclusionAbout a-fifth of diabetic patients had diabetic retinopathy. Diabetic retinopathy was significantly associated with glycemic control, hypertension, body-mass index, and duration of illness. Routine assessment and early control of those associated factors may be important in reducing both the prevalence and impact of diabetic retinopathy, as evidenced in the current study.

The effect of Ramadan fasting on kidney function in patients with chronic kidney disease.

Because of the increase in globalization, clinicians all over the world are confronted the questions about safety of Ramadan fasting. However, there is no clear information about whether there is an obstacle for fasting patients with chronic disease. Hence, in the present study, we aimed to investigate the effects of Ramadan fasting on kidney and the factors affecting this relationship in patients with chronic kidney disease. This study involving 117 patients [36 females, 81 males; mean age, 60 (46.0-70.0) years] with stage 2-3 chronic kidney and fasting. Patients were evaluated every 10 days for acute kidney injury (AKI) in Ramadan month. And, patients with acute kidney injury and patients without AKI were grouped. When the patients were evaluated for AKI, we observed that in 27 patients had acute kidney injury. While patients without AKI fasted for more days (p<0.001), urea levels and frequency of hypertension were higher in the group with AKI (p=0.019; p=0.025 respectively). We also performed univariate and multiple binary logistic regression analysis to identify the risk factors of AKI. Hypertension and number of fasting day were found to be predictive of AKI (p=0.02; p<0.001 respectively). We found a significant relationship between hypertension, the number of fasting days and acute kidney injury. Patients with chronic kidney damage and hypertension should be evaluated more carefully, informed about the importance of hydration after fasting and should be followed frequently for AKI.

Psychiatric comorbidity in individuals at-risk for psychosis: Relationships with symptoms, cognition and psychosocial functioning.

Psychiatric comorbidity frequently occurs with at-risk mental state (ARMS) for psychosis. Its relationships with psychopathology, cognition and functioning, however, remain to be further clarified. We aimed to examine prevalence and correlates of psychiatric comorbidity, and its associations with psychosocial functioning and subjective quality-of-life (QoL) in a representative sample of Chinese ARMS individuals. One hundred ten help-seeking participants aged 15 to 40 years with ARMS were recruited from a specialized early psychosis service in Hong Kong. ARMS status was verified by comprehensive assessment of at-risk mental state (CAARMS). Comorbid Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition non-psychotic psychiatric disorders at baseline were ascertained using diagnostic interview and medical record review. Assessments encompassing symptom profiles, psychosocial functioning, subjective QoL and a brief cognitive battery were conducted. Forty-nine (44.5%) ARMS participants were diagnosed as having comorbid non-psychotic psychiatric disorders at baseline, primarily depressive and anxiety disorders. Binary multiple logistic regression analysis revealed that female gender, more severe depressive symptoms, higher suicidality and poorer global cognitive functioning were independently associated with comorbid diagnosis status. ARMS participants with psychiatric comorbidity displayed significantly more limited extended social networks and poorer subjective QoL than those without psychiatric comorbidity. Comorbid disorders were frequently observed in Chinese ARMS individuals, and were linked to poorer cognition and higher suicide risk. Our findings underscore a potential critical role of psychiatric comorbidity in determining social functioning and subjective QoL in at-risk individuals. Further longitudinal research is required to clarify trajectories of comorbid disorder status and its prospective impact on clinical and functional outcomes in ARMS populations.

Mediating Knowledge through Expressing Surprises: A Frame-based Analysis of Surprise Markers in Research Articles across Disciplines and Research Paradigms

ABSTRACT Taking a cognitive approach to genre-specific language, this corpus-based study investigated the disciplinary and paradigmatic effect on the use of a specific type of attitude markers—surprise markers—with an analytical framework informed by frame semantics. A Surprise frame was generated and then used to analyze the use of surprise markers in a 2,000,000-word corpus consisting of 320 full-length empirical research articles collected from two social sciences (applied linguistics vs. clinical psychology) cutting across two research paradigms (qualitative vs. quantitative). Results from multiple binary logistic regression analyses show that the research paradigm can reliably predict the absence or presence of five categories across four frame elements of the Surprise frame. This study not only extends the application of frame semantics to discourse analysis but also has the potential to create a new direction for research in English for academic purpose.

Renal transplant biopsy complications: assessment of risk factors and potential of desmopressin to decrease risk of hemorrhage.

Renal transplant biopsies are essential in nephrology; however, they are invasive and complications can occur. To explore the risk of transplant kidney biopsy (TxB) complications in relation to possible preventive effects of desmopressin prophylaxis. A total of 515 consecutive TxB (375 patients, median age 53 years) were analyzed. In 252 TxB, the Resistive Index (RI) was measured right before the biopsy. A total of 282 patients had serum creatinine >150 µmol/L. In one of the six hospitals 39/282 patients consecutively received desmopressin (dose 0.3 µg/kg subcutaneously) as prophylaxis within 1 h before the biopsy. Fisher's exact and χ2 test were used (odds ratio [OR], 95% confidence interval [CI]). Univariate and multiple binary logistic regression analyses were performed. A two-sided P value <0.05 was considered significant. RI ≥ 0.8 was a risk factor for major TxB complications (OR 4.2, 95% CI 1.13-15.76). The risk for minor complications decreased with mean arterial blood pressure (MAP) (97.9 vs. 89.5 mmHg, OR 0.97, 95% CI 0.95-0.997). In a multiple regression analysis for overall biopsy complications, the risk remained increased for patients with RI ≥ 0.8 (OR 4.45, 95% CI 1.32-15.04). No patients (0/39) with desmopressin prophylaxis had a major complication versus 8/243 in the other group. In patients with serum creatinine >150 µmol/L, those with a higher MAP had more overall TxB complications (104.5 vs. 98.2 mmHg, OR 1.05, 95% CI 1.004-1.1). RI ≥ 0.8 was a risk factor for major and overall complications and a lower MAP for minor biopsy complications. Desmopressin prophylaxis showed yet no verified benefit as prophylaxis in TxB.

Intention to Screen for Cervical Cancer in Debre Berhan Town, Amhara Regional State, Ethiopia: Application of Theory of Planned Behavior

Background Cervical cancer is a major public health problem in many developing countries. Despite the value of screening to prevent morbidity and mortality from cervical cancer, little available literature shows early detection and treatment to be limited in Ethiopia. The aim of this study was to determine the magnitude of and identify factors associated with women's intention to screen for cervical cancer using the theory of planned behavior. Methods A community-based cross-sectional study design supplemented with a qualitative approach was employed. Using multistage sampling, a total of 821 women were used in the study. An interviewer-administered survey questionnaire was used to collect quantitative data, whereas purposively selected 12 female health care providers were included in in-depth interviews. Descriptive statistics and simple and multiple binary logistic regression analysis were used to determine the magnitude of women's intention, identify associated factors, and explore barriers for intention to cervical cancer screening among Debre Berhan women, Ethiopia. The statistical association was determined at a P value of less than 0.05. Moreover, thematic analysis was used to search the hindrances of women's intention to screen for cervical cancer. Results The median age of women who participated in this study was 39 years with IQR of 35 to 42 years. Three hundred sixty-one (361, 45.3%) of women had an intention to screen for cervical cancer within three months from the date of the interview. Positive attitude towards cervical cancer screening (AOR = 6.164; 95% CI: 4.048, 9.387), positive subjective norm (AOR = 2.001; 95% CI: 1.342, 2.982), and higher perceived behavioral control (AOR = 7.105; 95% CI: 4.671, 10.807) were predictors of the women's intention to screen for cervical cancer. The qualitative finding revealed that women did not like to be screened for cervical cancer because they thought that procedure pinch the cervix and it may result in perforating the uterus that would expose them for infertility. In addition, the qualitative findings supported quantitative results, where the constructs of the theory of planned behavior play an essential role in the betterment of women's intention. Conclusion This study showed that women's intention to screen for cervical cancer was low. Positive attitudes towards cervical cancer screening (CCS), subjective norms, and perceived behavioral control were predictors of women's intention to screen for cervical cancer. Thus, efforts should be exerted to improve the attitude of women involving influential people, which could improve women's intention for cervical cancer screening. Moreover, behavioral change communication focusing on the constructs of the theory of planned behavior is crucial.

Child victimization in China: Prevalence and links to family contextual characteristics using a representative sample

This study used data from a cross-sectional household survey conducted in Wuhan (N = 985) to investigate child victimization in China. Multiple binary logistic regression analyses were performed to examine the effects of parental health and inter-parental relationship on different types of child victimization. Subsequently, two ordered logistic regressions were performed to examine the effects of parental health problems and inter-parental relationships on types of child victimization. Results indicate that 28.1% of parents in the current sample reported their children had experienced at least one type of victimization, and 14.6% reported two or more types. Furthermore, problematic inter-parental relationships and poor parental health increased the likelihood of children experiencing more than one type of victimization. Implications for policy and practice are discussed.

The Incidence and Risk Factors of Non-Alcoholic Fatty Liver Disease: A Cohort Study from Iran

Background: Non-alcoholic fatty liver disease (NAFLD) is a condition with a global prevalence of 24%. A broad spectrum of liver complications has been attributed to this condition. Objectives: This study was conducted to determine the incidence of NAFLD and its potential risk factors in a seven-year follow-up study in Iran. Methods: This is a prospective cohort population-based study conducted in the northern region of Iran. In phase I of the cohort study, 2,461 participants were selected, between 2009 and 2010, using the stratified randomization method based on the sex and age of individuals. Ultrasonographic examination was performed again after a seven-year follow-up between 2016 and 2017. The multiple binary regression analysis was applied to evaluate the association between the development of NAFLD and potential risk factors. Results: The incidence of NAFLD was 27.88% (95% CI: 25.41% - 30.35%) in men and 30.17% (95% CI: 27.40% - 32.94%) in women (P = 0.226) in a seven-year follow-up period. Based on the multiple binary logistic regression analysis, body mass index (BMI) [OR = 1.219 (95% CI: 1.162 - 1.278) P < 0.001], triglyceride (TG) [OR = 1.003 (95% CI: 1.001 - 1.005); P = 0.005] and high-density lipoprotein (HDL) [OR = 0.986 (95% CI: 0.972 - 0.999); P = 0.046] showed a significant association with the incidence of NAFLD in men. In contrast, the marital status [OR = 2.141 (95% CI: 1.286 - 3.565); P = 0.003], BMI [OR = 1.165 (95% CI: 1.121 - 1.211); P < 0.001] and homeostatic model assessment for insulin resistance (HOMA-IR) [OR = 1.164 (95% CI: 1.041 - 1.301); P = 0.007] had a significant relationship with the incidence of NAFLD in women. Conclusions: It seems that NAFLD is markedly rising in the northern part of Iran. Higher levels of BMI, TG, and HDL are considered independent risk factors for the development of NAFLD in men, while the marital status, BMI, and HOMA-IR exhibited independent risk factors with the incidence of NAFLD in women.

Prevalence and Predictors of Exclusive Breastfeeding among Mothers with Term Deliveries in Adventist Medical Center Manila (AMCM) Immediately Postpartum and at One Month Postpartum

Exclusive breastfeeding in infants provides an optimal nutrition in infants aged under six months. While the World Health Organization (WHO) recommends to exclusively breastfeed their infants even up to 2 years, prevalence and duration of breastfeeding among different countries are declining. The aim of this study is to compare the prevalence of exclusive breastfeeding immediately postpartum and one month postpartum and determine its associated factors and possible predictors in Adventist Medical Center Manila (AMCM). A total of 235 mothers who delivered in the hospital were interviewed using a questionnaire prior to discharge and was followed-up via telephone call at one month postpartum. All analyses were carried out using Statistical Package for the Social Sciences (SPSS) Version 21. All inferential analyses were performed at 5% level of significance, but the interpretation of the multiple binary logistic regression analysis at 10% level of significance and its implications was also considered. The prevalence of exclusive breastfeeding significantly decreased from 100% immediately postpartum to 74% at 1 month postpartum (p&lt;0.001). Among the possible associated factors, at 10% level of significance, 3 factors were considered as independent predictors of exclusive breastfeeding at 1 month postpartum namely: previous breastfeeding experience (OR = 3.70, p = 0.080) presence of lactation area at work (OR = 2.08, p = 0.087) and presence of refrigerator at work for breast milk storage (OR = 2.98, p = 0.057) [1-3]

Xerostomia in patients with sleep apnea-hypopnea syndrome: A prospective case-control study.

BackgroundTo describe the characteristics of xerostomia (dry mouth) in the population with sleep apnea-hypopnea syndrome (SAHS) and contrast its prevalence versus that found in healthy subjects, and to compare the frequency of xerostomia in SAHS patients with and without continuous positive airway pressure (CPAP) treatment. Material and MethodsA prospective comparative study was made between adults recently diagnosed with SAHS in a public hospital (n=60) and healthy individuals (n=54). The presence of xerostomia was assessed on waking up and during the day, using a frequency scale from 0 (“never”) to 3 (“always”). ResultsThe prevalence of xerostomia on waking up in the SAHS group was 45%, versus 20.4% among the controls. During the rest of the day the prevalence of the symptom decreased in both the SAHS group (21.7%) and among the controls (9.3%). Multiple binary logistic regression analysis found body mass index (BMI) to be correlated to the association SAHS-xerostomia on waking up (p=0.007). Patients with moderate SAHS had a greater frequency of xerostomia than those with mild SAHS (p=0.022). The frequency of xerostomia on waking up was significantly greater in patients using CPAP than in those without such treatment (57.1% versus 16.7%, respectively) (p=0.008). ConclusionsThe frequency of xerostomia was greater in patients with SAHS, particularly on waking up and in those receiving CPAP. The symptom was more prevalent in individuals with moderate to severe SAHS than in those with mild SAHS, and was significantly influenced by BMI. Key words:Sleep apnea, xerostomia, dry mouth, CPAP, side effects, body mass index, obesity.

Impacts of social welfare system on the employment status of low-income groups in urban China

Purpose Aiding employment is an important poverty reduction strategy in many countries’ social welfare systems, as this strategy can help empower the recipients with a better living standard, development and social inclusion. The purpose of this paper is to identify the most significant individual and systematic variables for the employment status of low-income groups in urban China. Design/methodology/approach The data of this study are drawn from “Social Policy Support System for Poverty-stricken Families in Urban and Rural China 2015” report. The Ministry of Civil Affairs of the People’s Republic of China appointed and funded the Institute of Social Science Survey (ISSS) at Peking University to deliver the related project and organize a research team to write the report. Multiple binary logistic regression analysis is adopted to identify both individual and systematic factors that affect the employment status among low-income groups in urban China. Findings According to the results of the binary logistic regression model, individual factors, including: gender; householder status; education; and self-rated health status, play a significant role in determining the employment status of low-income groups in urban China. Clearly, the impacts of individual factors are more influential to marginal families than to families entitled to receive Basic Living Allowance. In contrast, compared with marginal families, systematic factors are more influential to families entitled to receive Basic Living Allowance. Originality/value This study highlights the importance of precise poverty reduction strategy and the issue of “welfare dependence” among low-income groups in urban China. Policy recommendations derived from the findings are hence given, including: the promotion of family-friendly policies; the introduction of a smart healthcare system; the establishment of a Basic Living Allowance adjustment mechanism; and the provision of related social services.