Multiple Binary Logistic Regression Models Research Articles

Healthy Eating Index-2015 and Predicted 10-Year Cardiovascular Disease Risk, as Well as Heart Age.

Background and AimsDietary factor plays an important role in the prevention of cardiovascular disease (CVD). The healthy eating index-2015 (HEI-2015), an indicator of the overall dietary quality, has been introduced to reflect adherence to the 2015–2020 Dietary Guidelines for Americans (DGA). This study aims to explore the associations of the HEI-2015 with predicted 10-year CVD risk and heart age among United States adults aged 30–74 years old using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014.Methods and ResultsWe conducted a cross-sectional analysis among 6,614 participants aged 30–74 years old. The HEI-2015 scores were calculated from 2-days 24-h dietary recall interviews. The 10-year CVD risk and heart age were derived from the sex-specific Framingham general cardiovascular disease risk score. We defined high cardiovascular disease risk as a predicted 10-year cardiovascular disease risk of > 20%. Multiple linear regression and binary logistic regression models were used to investigate the associations of the HEI-2015 with predicted 10-year CVD risk and heart age. Compared with participants in the lowest HEI-2015 quartile, those in the highest quartile had lower predicted 10-year CVD risk (β = −2.37, 95% CI: −3.09 to –1.65, P < 0.0001), lower heart age (β = −2.63, 95% CI: −3.29 to –1.96, P < 0.0001) and lower odds for high risk of CVD (OR = 0.62, 95% CI: 0.49 to 0.80, P-trend < 0.0001) after adjusting for multiple covariates.ConclusionHigher adherence to the 2015–2020 Dietary Guidelines for Americans is associated with lower predicted 10-year cardiovascular disease risk and lower heart age among United States adults.

The trend in delayed childbearing and its potential consequences on pregnancy outcomes: a single center 9-years retrospective cohort study in Hubei, China

BackgroundDue to the advancement of modern societies, the proportion of women who delay childbearing until or beyond 30 years has dramatically increased in the last three decades and has been linked with adverse maternal-neonatal outcomes.ObjectiveTo determine the trend in delayed childbearing and its negative impact on pregnancy outcomes.Material and methodsA tertiary hospital-based retrospective study was conducted in Wuhan University Renmin Hospital, Hubei Province, China, during the years 2011–2019. The joinpoint regression analysis was used to find a trend in the delayed childbearing and the multiple binary logistic regression model was used to estimate the association between maternal age and pregnancy outcomes.ResultsBetween 2011 and 2019, the trend in advanced maternal age (AMA ≥35 years) increased by 75% [AAPC 7.5% (95% CI: − 10.3, 28.9)]. Based on maternal education and occupation, trend in AMA increased by 130% [AAPC 11.8% (95% CI: 1.1, 23.7)] in women of higher education level, and 112.5% [AAPC 10.1% (95% CI: 9.4, 10.9)] in women of professional services. After adjusting for confounding factors, AMA was significantly associated with increased risk of gestational hypertension (aOR 1.5; 95% CI: 1.2, 2.1), preeclampsia (aOR 1.6; 95% CI: 1.4, 1.9), sever preeclampsia (aOR 1.7; 95% CI: 1.1, 2.6), placenta previa (aOR 1.8; 95% CI: 1.5, 2.2), gestational diabetes mellitus (aOR 2.5; 95% CI: 2.3, 2.9), preterm births (aOR 1.6; 95% CI: 1.4, 1.7), perinatal mortality (aOR 1.8; 95% CI: 1.3, 2.3), and low birth weight (aOR 1.3; 95% CI: 1.2, 1.4) compared with women aged < 30 years.ConclusionOur findings show a marked increase in delayed childbearing and its negative association with pregnancy outcomes.

Sex-specific association between placental inflammatory cytokine mRNA expression and preschoolers’ behavioral development: The Ma’anshan birth cohort study

BackgroundPlacental inflammation may contribute to brain abnormalities and childhood neuropsychiatric disorders, but limited knowledge is available on the association of placental inflammatory cytokine levels and offspring’s behavioral development. This study aimed to examine the sex-specific association between placental inflammatory cytokine mRNA expression and preschoolers’ behavioral development. Methods3474 pregnant women were recruited as the initial study population in the Ma’anshan birth cohort (MABC) study. Placentas (n = 2519) were collected during childbirth, and the mRNA expression of IL-8, IL-1β, CRP, TNF-α, IL-6, IL-10, and IL-4 was assessed. The Child Behavior Checklist 1.5–5 (CBCL 1.5–5) was used to assess children’s behavioral development at 4 years old. A T-score ≥ 60 on summary scales or a score ≥ 65 on syndrome scales was regarded as the borderline clinical range. Multiple linear regression models and binary logistic regression models were applied to explore the sex-specific associations between placental inflammatory cytokines mRNA transcript levels and preschoolers’ behavioral development. ResultsSex-specific associations between placental inflammatory cytokines mRNA expression and preschoolers’ behavioral development were observed. There was a positive association between IL-8 and CBCL scores for boys on anxious/depressed problems, aggressive behaviors, externalizing problems and total problems. Logistic regression models showed that high levels of IL-8 were associated with a higher risk of girls’ emotionally reactive problems and sleep problems compared to low/medium levels. High TNF-α was correlated with increased sleep problem scores in boys, and medium TNF-α (vs. low levels) was associated with an increased risk of girls’ externalizing problems. Medium levels of CRP, IL-1β, and IL-6 were found to be associated with a decreased risk of girls’ behavioral problems compared to low/high levels. For anti-inflammatory cytokines, medium IL-10 and IL-4 (vs. low levels) were observed to be associated with a lower risk of internalizing problems in boys and externalizing problems in girls, respectively. High IL-10 was correlated with decreased attention problem scores in boys. ConclusionThis study indicates that placental inflammatory cytokine mRNA expression of IL-8, CRP, TNF-α, IL-1β, IL-4 and IL-10 may be associated with preschoolers’ behavioral development in a sex-specific manner.

Technical Skill Assessments as a Predictor or Agriculture Students' Success after High School

This study was conducted using quantitative methods to determine if a relationship exists between former Agriculture Career and Technical Education (CTE) concentrators’ Technical Skills Assessment (TSA) performance and their attaining related placement after high school. The study included data from 13,581 agriculture students who graduated during the years 2015-2019. To investigate the relationship between TSA assessment performance and attaining related placement, multiple descriptive models were run and disaggregated by gender, race/ethnicity, Individuals Education Plan (IEP) status, and Socioeconomic Status (SES). The data revealed students who pass their TSA assessment are more likely to attain related placement compared to those not passing their assessment. Agriculture students’ rates of passing the TSA assessment and attaining related placement were high. Additional analysis to determine the relationship between TSA assessment performance and attaining related placement involved multiple binary logistic regression models. The logistic regression models helped determine how passing the TSA assessment and student demographics interacted and influenced students attaining related placement. Statistically significant findings were determined for TSA assessment, Black students, and those not disadvantaged in the SES category. The findings from this study may add merit to the numerous secondary CTE agriculture education programs in the United States. Keywords: Agriculture education, technical skill assessment, CTE accountability measures, industry-recognized credential

Depressive, Anxiety Symptom Frequency and Related Factors Among Prisoners During the COVID-19 Pandemic in Northeastern Ethiopia, a Cross-Sectional Study.

BackgroundAmong the more than 10 million people imprisoned around the world, the rate of mental illness is higher than among the general population for various reasons. Although rates of mental illnesses such as depression and anxiety in this population may have changed as a response to the coronavirus disease (COVID-19) outbreak and other factors, to our knowledge, no related studies have been conducted related to depression and anxiety in this population during the pandemic. Therefore, this study aimed to assess depression, anxiety, and associated factors among Dessie City prisoners during the 2020 COVID-19 outbreak.MethodsAn institution-based cross-sectional survey was conducted in October 2020. A total of 420 prisoners were selected via a systematic sampling technique. PHQ-9 depression scale, generalized anxiety disorder-7 questionnaire, Oslo 3-item social support scale, insomnia severity index, and Brief COPE scale were used. Data were entered by using Epi-Data version 3.1 and finally exported to Statistical Package for Social Science Software version 21 for analysis. We fitted a multiple binary logistic regression model. Finally, an adjusted odds ratio with 95% confidence interval was reported and factors with a p-value < 0.05 were considered as significant for depression and anxiety.ResultsThis study showed that 279 (66.4%) of imprisoned people had major depressive disorder with 95% CI of (61.4, 70.6), while 281 (66.9) had generalized anxiety disorder with 95% CI of (61.9, 71.9).ConclusionIn this study, the overall prevalence of depression and anxiety was significantly high, and was related to a number of factors including COVID-19. Therefore, designing and implementing strategies for COVID-19 prevention and control in prisons is highly recommended to reduce mental health problems among prisoners.

Socioeconomic Inequalities in Women's Undernutrition: Evidence from Nationally Representative Cross-Sectional Bangladesh Demographic and Health Survey 2017-2018.

The objective of this study was to explore the socioeconomic inequalities in undernutrition among ever-married women of reproductive age. We used nationally representative cross-sectional data from the Bangladesh Demographic and Health Survey, 2017–2018. Undernutrition was defined as a body mass index (BMI) of <18.5 kg/m2. The concentration index (C) was used to measure the socioeconomic inequality in the prevalence of women’s undernutrition. A multiple binary logistic regression model was carried out to find out the factors associated with women’s undernutrition. The prevalence of undernutrition among women of 15–49 years was 12%. Among them, 8.5% of women were from urban and 12.7% of women were from rural areas. The prevalence of undernutrition was highest (21.9%) among women who belonged to the adolescent age group (15–19 years). The C showed that undernutrition was more prevalent among the socioeconomically worst-off (poorest) group in Bangladesh (C = −0.26). An adjusted multiple logistic regression model indicated that women less than 19 years of age had higher odds (adjusted odds ratio, AOR: 2.81; 95% confidence interval, CI: 2.23, 3.55) of being undernourished. Women from the poorest wealth quintile (AOR: 3.93, 95% CI: 3.21, 4.81) had higher odds of being undernourished. On the other hand, women who had completed secondary or higher education (AOR: 0.55; 95% CI: 0.49, 0.61), married women who were living with their husbands (AOR: 0.72, 95% CI: 0.61, 0.86), and women exposed to mass media (AOR: 0.87, 95% CI: 0.79, 0.97) were less likely to be undernourished. Intervention strategies should be developed targeting the poorest to combat undernutrition in women of reproductive age in Bangladesh.

The Role of Hemogram and Inflammatory Markers in The Diagnosis of SARS-COV-2

Objective: In the last months of 2019, a new coronavirus was identified as the cause of a series of pneumonia cases in the city of Wuhan, China. It spread rapidly and caused a global epidemic. The disease has been termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) over time. This study aims to use it for diagnostic purposes by comparing hemogram (CBC) parameters, C-reactive protein (CRP) levels and inflammatory marker ratios such as Neutrophil/Lymphocyte (NLR), Thrombocyte/Lymphocyte (TLO) with the PCR test results of patients with a pre-diagnosis of SARS-CoV-2 in the outpatient clinic. Materials and Methods: PCR test was performed on 1329 patients who applied to the Internal Medicine outpatient clinic of Istanbul Medipol University Faculty of Medicine with symptoms similar to SARS-CoV-2, and simultaneous CBC and CRP were requested. 515 individuals with positive test results and 814 individuals with negative results were divided into two groups. CBC, CRP, NLR, TLR, Thrombocyte/Neutrophil (TNO) and CRP/Lymphocyte (CLO) ratios were evaluated retrospectively. Results: Age, CRP, TNO, TLO, CRP/Neutrophil (CNO), CLO, CRP/Thrombocyte (CTO) and CRP/Monocyte (CMO) were significantly higher in the group with positive PCR test, however, leukocytes, thrombocyte, neutrophil, lymphocyte, eosinophil, basophil and Thrombocyte/CRP (TCO) were found to be significantly lower. There was no significant difference between the two groups in terms of hemoglobin, monocytes and NLR (p˂0.05). When the multiple binary logistic regression model is applied, it is seen that leukocytes, thrombocyte, eosinophils, basophils, CMO and TCO show a significant decrease in PCR positive status, while hemoglobin, monocytes and TLR increase (the overall accuracy of the model is 78.3%). Conclusions: It was concluded that a total of nine parameters can be used for diagnosis in SARS-CoV-2 infection.

Day 2 neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios for prediction of delayed cerebral ischemia in subarachnoid hemorrhage.

Recent evidence has suggested that an admission neutrophil-to-lymphocyte ratio (NLR) of ≥ 5.9 predicts delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (aSAH). The primary aims of this study were to assess reproducibility and to ascertain the predictive ability of NLR on subsequent days postictus. Secondary aims included identification of additional inflammatory markers. A single-center, retrospective study of all patients aged ≥ 18 years with aSAH between May 2014 and July 2018 was performed. Patient characteristics, DCI incidence, operative features, and outcomes (on discharge and at 3 months postictus) were recorded. C-reactive protein (CRP) and full blood count differentials were recorded on admission and through day 8 postictus or at discharge. In total, 403 patients were included in the final analysis. Ninety-six patients (23.8%) developed DCI with a median time from ictus of 6 days (IQR 3.25-8 days). A platelet-to-lymphocyte ratio (PLR) cutoff ≥ 157 and CRP cutoff ≥ 27 was used in our cohort. In a multiple binary logistic regression model, after controlling for known DCI predictors, day 2 NLR ≥ 5.9 (OR 2.194, 95% CI 1.099-4.372; p = 0.026), day 1 PLR ≥ 157 (OR 2.398, 95% CI 1.1072-5.361; p = 0.033), day 2 PLR ≥ 157 (OR 2.676, 95% CI 1.344-5.329; p = 0.005), and CRP ≥ 27 on days 3, 4, and 5 were predictive of DCI. The results of this study have confirmed the association between NLR and DCI and have demonstrated the predictive potential of PLR and CRP, suggesting that NLR and PLR at day 2, and CRP from day 3 onward, may be better predictors of DCI than those measurements at the time of ictus.

Association between Accelerometer-Measured Light-Intensity Physical Activity and Cognitive Function in Older Adults.

This study aimed to investigate whether accelerometer-measured light physical activity (LPA) is associated with cognitive function and whether engaging in ≥3 h/day of LPA can reduce the chance of cognitive impairment among a sample of older adults in Taiwan. Cross-sectional study. An outpatient department in a medical center. Participants were community-dwelling older adults aged 65 years and older who were able to walk independently from September 2020 to March 2021. A tri-axial accelerometer was used to measure LPA for 7 consecutive days, and the Mini-Mental State Examination (MMSE) scale was used to assess the chance of cognitive impairment. Multiple linear regression model and binary logistic regression model were performed to examine the association between LPA and MMSE scores. 145 older Taiwanese adults (51.7% men; 81.2±6.8 years; 6.9% at chance of cognitive impairment) were included. After adjusting for moderate-to-vigorous physical activity (MVPA) and wear time, we found that there was a significant association between LPA and cognitive function (95% confidence interval [CI]: 0.64-1.65; P<0.001), and further found that those who engaged in LPA ≥3 h/day were at reduced chance of cognitive impairment compared with people who engaged in LPA <3 h/day (odds ratio [OR]: 0.16; 95% CI: 0.03-0.80; P=0.025). This study demonstrated that engaging in LPA ≥3 h/day could be viewed as a protective factor for maintaining cognitive function in older adults. We recommend further longitudinal research to elucidate the association between intensity-specific LPA and cognitive function.

Knowledge About HIV/AIDS and Its Transmission and Misconception Among Women in Bangladesh.

Asian and pacific region countries are high risk countries for human immunodeficiency virus/ acquired immune deficiency syndrome (HIV/AIDS). Although the prevalence of HIV/AIDS is low in Bangladesh but women in Bangladesh have been identified as susceptible due to associated socioeconomic exposures. There are various misconceptions associated with HIV/AIDS transmission among the women in low- and middle-income countries including Bangladesh, which lead to a negative attitude towards the HIV/AIDS-infected. The purpose of this study was to assess the overall knowledge, transmission, and misconception about HIV/AIDS among the women in Bangladesh as well as its spatial distribution across the country. The study used data from the UNICEF (United Nations Children's Fund) Multiple Indicator Cluster Survey (MICS) 2019, with a sample of 64 346 women. This was a cross-sectional, population-based survey of Bangladeshi women aged 15-49 conducted using a multistage, cluster sampling technique. Three binary outcome variables considered were knowledge about HIV/AIDS, knowledge about HIV/AIDS transmission and knowledge on myths and misconceptions on HIV/AIDS along with 10 predictors based on past literature. Bivariable analysis using chi-square tests of association was conducted to examine the unadjusted percentage differences of the outcome variables for each of the predictor variables and their associations. Multiple binary logistic regression models were then fitted to evaluate the association between the outcome variables and the predictors after adjusting for survey cluster, strata, and weights. All analysis was conducted in R software (V 2.5.0). The percentage of women who held knowledge about HIV/AIDS, knowledge about HIV/AIDS transmission and knowledge on misconceptions about transmission of HIV were on average 60.3%, 52.2% and 71.7% respectively. The models indicated that women regularly exposed to media were 79%, 18% and 19% significantly more likely (odds ratio, OR: [95% CI] = 1.79: [1.70, 1.89]; 1.18: [1.10 1.26] and 1.19: [1.11, 1.27]) to have heard about HIV, aware about HIV transmission, and have less misconceptions about HIV respectively compared to those who were not exposed to media. Overall results indicate that women from peripheral districts living far from metropolitan cities were most unaware of HIV and had higher misconceptions about AIDS. The findings of this study should assist policy-makers and program implementers to focus on raising awareness to educating women about how HIV/AIDS is transmitted. Furthermore, interventions should be made by targeting the most disadvantaged groups, including younger women with low education living in rural areas, from poor households and limited access to information. Also, education on HIV transmission in Bangladesh should integrate cultural and ethnic considerations of HIV/AIDS.

Prevalence and factors affecting the utilization of antenatal care in rural areas of Southwestern Ethiopia

BackgroundAntenatal care (ANC) is a health care intervention intended to ensure the safety of pregnancy. According to the World Health Organization, at least four ANC visits are recommended for a healthy pregnancy. However, whether this recommended number of visits was followed or not in the rural areas of Southwestern Ethiopia is not known. Therefore, the study aimed to investigate the prevalence of, and the associated factors of ANC utilization by pregnant women in the rural areas of Southwestern Ethiopia.MethodsA community-based cross-sectional study design was used in three rural zones. The data were collected from n = 978 women through a structured questionnaire with face-to-face interview. The collected data were analyzed using descriptive statistics and a multiple binary logistic regression model.ResultsThe results showed that 56% of women made the recommended minimum number of ANC visits and the remaining 44% of them underutilized the ANC service. The multiple binary logistic regression model identified zone, marital status of the woman, educational level of the husband, occupation of the husband, knowledge of danger signs of pregnancy, birth interval, source of information, timely visits, and transportation problem to be statistically significant factors affecting the prevalence of ANC visit utilization of women. Bench Maji zone had smaller odds ratio of ANC visit prevalence as compared to Kaffa zone. Women who lived in the rural area of Sheko zone are 2.67 times less likely to utilize ANC visit than those who lived in the rural area of Kaffa zone keeping other variables constant.ConclusionThe study results highlight the need to increase the number of ANC visits, and the importance of using an appropriate model to determine the important socio-demographic factors that ANC service providers shall focus on to improve the health of the unborn baby and the mother during pregnancy.

Eosinopenia as a biomarker for antibiotic use in COPD exacerbations: protocol for a retrospective hospital-based cohort study

IntroductionThe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has a seriously negative impact on patients’ healths condition and disease progression. Bacterial infection is closely related to AECOPD, and antibiotics...

Prevalence of weight status and associated factors of underweight among the medical students in Iran

Background: Increasing weight abnormalities among university students is a challenging problem around the world. Published studies most researched overweight/obesity and its contributing variables in this population. However, underweight can threat health and wellbeing of the students during academic period. The Objective of the present study was to investigate the prevalence of weight status and to explore associated factors of underweight among the students from Yasuj University of Medical Sciences. Methods: In a cross-sectional study, a random sample including 455 students were recruited from Yasuj University of Medical Sciences, Iran, during 2018-2019. Academic, socio-demographic and anthropometric characteristics of the students were gathered through a structured questionnaire. Body mass index was determined and classified according to the World Health Organization reference. Descriptive statistics were used to summarize data in numbers and percentages. The relationships of students’ characteristics with their weight status were checked using Chi-square test. Factors associated with underweight occurrence in students were detected by analyzing multiple binary logistic regression model and adjusted odds ratio. Result: Of the total participated students 87.5% were 19-24 years old and 66.2% were female. The mean ± standard deviation of students’ weight and BMI were 61.42±11.51and 22.14±3.36, respectively. The prevalence of underweight, normal weight and overweight/obesity among students were 15%, 66.15 and 18.9%, respectively. Among the considered variables, age (OR: 0.78 95% CI: 0.63,0.97), gender (OR:2.o8 95% CI: 1.o8, 3.99), number of educational term (OR:1.25, 95% CI: 1.06, 1.47) and father’s occupation (Or:2.13 95% CI:1.14, 3.99) were significantly associated with the underweight occurrence in students. Conclusion. The prevalence of underweight and overweight/obesity among studied university students were high. The younger students, female students, students at higher number of educational term and students with fathers not an employee were at higher risk of being underweight. Suitable programs to promote healthy diets and practices among university students must be provided.

The relationship between health-related quality of life of students at Tehran University of Medical Sciences and their knowledge, attitudes, and practices regarding COVID-19 in 2020

BACKGROUND:Present study attempts to investigate health-related quality of life (HRQoL) and its relation with knowledge, attitudes, and practices (KAP) of students of Tehran University of Medical Sciences (TUMS) during this pandemic.MATERIALS AND METHODS:In this cross-sectional study which was conducted between 23 may to 21 June 2020, 470 students in different levels of TUMS were included to the study randomly. participants completed validate, designed online questionnaire which assessed KAP towards coronavirus disease 2019 (COVID-19) and HRQoL. All statistical tests were applied, including Chi-square and Fisher's exact test, Partial correlation, analysis of variance, multiple linear regression, multiple binary and multinomial logistic regression models (P < 0.05) and were performed in SPSS 16, R 4.0.2, and GraphPad Prism 6.0 softwares.RESULTS:A total of 470 students were included in the study. The overall correct answer rate of the COVID-19 knowledge questionnaire was 74.43% and total score of the HRQoL was 72.50 (14.85). 61.7% of the students were agreed that COVID-19 will finally be successfully controlled, 44.3% had confidence that Iran can win the battle against the COVID-19, and 92.6% agreed that Quarantine will reduce the prevalence of COVID-19. Most of them adhered to health protocols and about a relation between HRQoL and knowledge we have a weak positive and unsignificant correlation between them (r = 0.05, P = 0.27).CONCLUSIONS:TUMS students showed expected levels of knowledge, proper attitudes, and preemptive practices regarding COVID-19, whereas COVID-19 outbreak substantially affected the physical and mental health but, the students were in a way better physical health rather than mental. Therefore, motivational planning and other related intervention to improve mental health can be noticeable.

Dizziness and physical health are associated with pain in dizzy patients-A cross-sectional study.

Associations between dizziness, health-related quality of life, and musculoskeletal pain have not been systematically explored in patients with vestibular disorders. Such knowledge may be important for choice of treatments. The study objectives were to examine the extent and localization of musculoskeletal pain and explore whether pain was associated with dizziness and health-related quality of life. The cross-sectional study investigated anonymized data from an earlier survey on patients with long-lasting dizziness (>3months) examined in an oto-rhino-laryngological department. The sample includes patient between 18 and 70years with Ménière's disease, vestibular schwannoma, benign positional paroxysmal vertigo, vestibular neuritis, non-otogenic dizziness, and cervicogenic dizziness. General musculoskeletal, that is, pain in muscles, tendons, and joints was registered by a yes/no question. A pain drawing registered localization of pain. Multiple binary logistic regression models were used to determine the association between pain and vertigo-balance and autonomic-anxiety related dizziness by the short Vertigo Symptom Scale (VSS) and sub-scales (VSS-V, VSS-A), and between pain and health-related quality of life by the SF-36, mental and physical component summary scale (SF-36 MCS, SF-36 PCS). The sample consisted of 503 patients, 60.2% were women, the median age was 50years. General musculoskeletal pain was reported by 72.8% of patients, neck pain by 59.2% and widespread pain by 21.9%. Multiple binary logistic regression models demonstrated that all the pain measures were significantly associated with VSS-V and VSS-A and SF-36 PCS, but not SF-36 MCS. Musculoskeletal pain is prevalent in patients with long-lasting dizziness. The strong associations between pain, VSS, and SF-36 PCS could result in a self-sustaining complex condition. The findings imply that in addition to assessing and treating the vestibular symptoms, musculoskeletal symptoms and physical health should be addressed.

Classification tree and random forest model to predict under-five malnutrition in Bangladesh

Malnutrition is one of the leading causes of morbidity and mortality in children under the age of five in most developing countries like Bangladesh. The main objective of this study is to design a model that predicts the nutritional status of under-five children using tree based model and classical approach. This study used secondary data from Bangladesh Demographic and Health Survey 2014 for 7,886 children. Decision tree based model like classification tree, random forest and classical model like multiple binary logistic regression model are fitted to assess the association of malnutrition of children with potential socioeconomic and demographic factors. In this study, predictive model is developed using random forest having an accuracy of 70.1% &amp; 72.4% and area under receiver operating characteristic curve of 69.8% and 70% for stunting and underweight respectively. The prevalence of stunting and underweight are found 36.5% and 33% respectively among under-five children and higher in rural setting than in urban areas. Similarly, wealth index, exposure of mother to the mass media, age of child, size of child at birth, and parents’ education are significantly associated with stunting and underweight of children.

Risk factors of suicidality among married adults: A cross-sectional survey in Rajshahi City, Bangladesh.

Suicide is a serious public health concern all over the world including Bangladesh. About 9% of the patients admitted with suicidal ideation (SI) or suicide attempt (SA) later complete suicide. To understand and prevent suicide, the study of SI and SA is necessary but research in this area is scanty in Bangladesh. Therefore, we studied suicidality (SI and SA) among married adults in Rajshahi City, Bangladesh. This was a household cross-sectional study. A total of 708 married adults were selected for this study using a multi-stage random sampling. Suicidality was measured based on two factors: (i) suicidal ideation, and (ii) suicide attempt. Frequency distribution, Chi-square test and multiple binary logistic regression model were used in this study according to our objectives. The prevalence of suicidal ideation, suicide attempt, and suicidality was 5.8%, 3.4%, and 8.3% respectively among married adults. A multiple binary logistic regression model provided the following risk factors of suicidality: (i) joint family (AOR = 0.310, p<0.01), (ii) ≥26 years of age at the first marriage (AOR = 0.379, p<0.05), (iii) twice or more marriage (AOR = 0.214, p<0.01), (iv) conjugal life of ≥16 years (AOR = 0.410, p<0.05), (v) having no child (AOR = 6.343, p<0.01) and (vi) having 1-2 children (AOR = 6.190, p<0.01), (vii) medical comorbidity (AOR = 0.421, p<0.01), (viii) mental comorbidity (AOR = 0.253, p<0.01), (ix) stress-anxiety (AOR = 0.311, p<0.01), (x) family history of mental disorders (AOR = 0.059, p<0.01), (xi) family history of suicide/suicide attempt (AOR = 0.009, p<0.01), (xii) substance abuse (AOR = 0.065, p<0.01), (xiii) poor relationship with spouse (AOR = 0.209, p<0.01), and (xiv) poor relationship with other family members (AOR = 0.347, p<0.05). The prevalence of suicidality is remarkable in Rajshahi city, Bangladesh. The government and non-government agencies can use the findings of this study to identify the vulnerable groups and undertake measures for preventing and reducing suicidality.

Role of Savings and Internal Lending Communities (SILCs) in improving household wealth and financial preparedness for birth in rural Zambia.

Savings and Internal Lending Communities (SILCs) are a type of informal microfinance mechanism adapted in many low- and middle-income countries (LMICs) to improve financial resources for poor and rural communities. Although SILCs are often paired with other health and non-health-related interventions, few studies have examined SILCs in the context of maternal health. This study examined the association between SILC participation, household wealth and financial preparedness for birth. The study also examined the association between sex and financial preparedness for birth. A secondary analysis was conducted on individual survey data collected from SILC participants in two rural districts of Zambia between October 2017 and February 2018. A convenience sample of 600 participants (Lundazi: n = 297; Mansa: n = 303) was analysed. Descriptive analyses were run to examine SILC participation and household wealth. Multiple binary logistic regression models were fit to assess the unadjusted and adjusted relationship between (1) SILC participation and household wealth, (2) SILC participation and financial preparedness for birth and (3) sex and financial preparedness for birth. The results show that SILC participation led to an average increase of 7.32 items of the 13 household wealth items. SILC participants who had their most recent childbirth after joining SILCs were more likely to be financially prepared for birth [adjusted odds ratio (AOR): 2.99; 95% confidence interval (95% CI): 1.70-5.26; P < 0.001] than participants who had their most recent childbirth before joining SILCs. Females were more likely to be financially prepared for birth than males if they had their most recent birth before joining an SILC (AOR: 1.79; 95% CI: 1.16-2.66; P < 0.01). SILC participation is shown to increase household wealth and financial preparedness for birth for both men and women. SILCs are a promising intervention that can help poor and rural populations by increasing financial resources and financially preparing parents for birth.

Prevalence of frailty and associated socio-demographic factors among community-dwelling older people in southwestern Iran: a cross-sectional study.

This community-based cross-sectional study aimed to identify the frailty prevalence and associated socio-demographic factors among older adults in five cities of the south west of Iran. We selected a random sample of adults aged 60years and above from five Southwest cities in Iran. Data for this study were retrospectively collected from 540 community-dwelling older adults. To measure frailty, we utilized the frailty index of cumulative deficit (FICD). Data were collected from medical records and socio-demographic factors, including gender, age, marital status, education level, lifestyle, income, and job status. The chi-square test and Spearman's correlation coefficient test were used to assess the relationship between the demographic variables and frailty status (SPSS version 22). Also, multiple binary logistic regression models were used to estimate the effects of demographic characteristics on the frailty recurrence. The overall frailty prevalence was as follows: 77 (14.3%) frail, 139 (25.7%) pre-frail, and 324 (60%) not frail. The findings showed that all variables except education level and marital status are significantly associated with frailty status (P < 0.05). Multiple ridge logistic regression model indicated that age, gender, marital status, job status have significant, and education level, living arrangement, and economic status have no considerable effect on the frailty. This study has shown that age and gender significantly contributed to the frailty process in older adults. The research also has shown the syndrome's occurrence affected by the aging process, and it supports the biological characteristics of frailty.

The number of household members as a risk factor for peptic ulcer disease

Peptic ulcer disease (PUD) is caused by many sociodemographic and economic risk factors other than H. pylori infection. However, no studies reported an association between PUD and the number of household members. We showed the number of family members affected by PUD based on sex in a Korean population. This cross-sectional study used 1998–2009 data from the Korea National Health and Nutrition Examination Survey of the Korea Centers for Disease Control and Prevention. Multiple binary logistic regression models adjusted for confounders were constructed to analyze the association of PUD with the number of household members. The number of household members was associated with PUD, age, body mass index (BMI), waist circumference, systolic blood pressure, hemoglobin, glucose, location (urban/rural), income, education level, stress, current drinking, and smoking in both sexes. Men with other household members had a higher PUD risk compared to men or women living alone (reference), and the opposite was observed for women. Men with 4 household members had a higher PUD risk than men living alone in the model adjusted for age, BMI, income, location, education, and stress (OR = 2.04 [95% CI 1.28–3.27], p value = .003). Women with more than 6 household members had a lower PUD risk than women living alone in the adjusted model (OR = 0.50 [0.33–0.75], p value = .001). Women with more household members had a lower PUD risk. However, more men had PUD than women regardless of the number of household members.