Multiple Negative Binomial Regression Models Research Articles

Visiting crowded places during the COVID-19 pandemic. A panel study among adult Norwegians.

Non-pharmaceutical interventions, including promotion of social distancing, have been applied extensively in managing the COVID-19 pandemic. Understanding cognitive and psychological factors regulating precautionary behavior is important for future management. The present study examines the importance of selected factors as predictors of having visited or intended to visit crowded places. Six online questionnaire-based waves of data collection were conducted in April-October 2020 in a Norwegian panel (≥18 years). Sample size at Wave 1 was 1,400. In the present study, "Visited or intended to visit crowded places" for different types of locations were the dependent variables. Predictors included the following categories of items: Perceived response effectiveness, Self-efficacy, Vulnerability, Facilitating factors and Barriers. Data were analyzed with frequency and percentage distributions, descriptives, correlations, principal components analysis, negative binomial-, binary logistic-, and multiple linear regression, and cross-lagged panel models. Analyses of dimensionality revealed that a distinction had to be made between Grocery stores, a location visited by most, and locations visited by few (e.g., "Pub," "Restaurants," "Sports event"). We merged the latter set of variables into a countscore denoted as "Crowded places." On the predictor side, 25 items were reduced to eight meanscores. Analyses of data from Wave 1 revealed a rather strong prediction of "Crowded places" and weaker associations with "Supermarket or other store for food." Across waves, in multiple negative binomial regression models, three meanscore predictors turned out to be consistently associated with "Crowded places." These include "Response effectiveness of individual action," "Self-efficacy with regard to avoiding people," and "Barriers." In a prospective cross-lagged model, a combined Response effectiveness and Self-efficacy score (Cognition) predicted behavior ("Visited or intended to visit crowded places") prospectively and vice versa. The results of this study suggest some potential to reduce people's visits to crowded locations during the pandemic through health education and behavior change approaches that focus on strengthening individuals' perceived response effectiveness and self-efficacy.

Discrimination, resilience, and HIV testing frequency among black women seeking services from STD clinics

RationaleIn the United States, Black women are disproportionately affected by HIV, accounting for most new HIV infections diagnosed among women. Socio-structural barriers to HIV testing include stigma and discrimination but may be mitigated by resilience. ObjectiveWe aimed to examine the effect of discrimination and resilience on HIV testing behaviors among Black women. MethodsBetween 2016 and 2018, we conducted The ESSENCE Project, a retrospective cohort study on the role of physiological and environmental factors on the association between sexual assault and HIV risk among Black women in Baltimore, Maryland, USA. Black women aged 18-44 were recruited from public health STD clinics and completed an audio-computer-assisted self-interview survey. Hierarchical multiple negative binomial regression models were used to examine the associations of everyday discrimination (subtle and overt) and resilience on HIV testing frequency; resilience and its subscales (relational maintenance, personal fortitude, positive coping, independence and insight) were also examined as moderators. ResultsAmong 236 Black women reporting HIV testing history, the median number of lifetime HIV tests was 4 (IQR = 2, 6). Mean everyday discrimination was 2.3 (SD = 1.2). Mean resilience was 5.3 (SD = 0.8). Everyday discrimination and its subscales (overt and subtle) were negatively associated with lifetime HIV testing frequency, while overall resilience was not associated with lifetime HIV testing frequency. Accounting for demographics, overall resilience moderated the association of subtle discrimination and lifetime HIV testing frequency. For the resilience subscales, more specifically: (1) associations of subtle discrimination and HIV testing frequency were significant at the lowest relational maintenance and lowest positive coping resilience; and (2) the association of subtle discrimination and HIV testing frequency was significant at the highest resilience for all four subscales. ConclusionsThese findings highlight the need for provider- and community-level interventions addressing the deleterious effects of everyday discrimination and more specifically subtle everyday discrimination to encourage HIV testing.

An Online Tool Using Basal or Activated Ovarian Reserve Markers to Predict the Number of Oocytes Retrieved Following Controlled Ovarian Stimulation: A Prospective Observational Cohort Study.

BackgroundPredicting the number of oocytes retrieved (NOR) following controlled ovarian stimulation (COS) is the only way to ensure effective and safe treatment in assisted reproductive technology (ART). To date, there have been limited studies about predicting specific NOR, which hinders the development of individualized treatment in ART.ObjectiveTo establish an online tool for predicting NOR.Materials and MethodsIn total, 621 prospective routine gonadotropin releasing hormone (GnRH) antagonist COS cycles were studied. Independent variables included age, body mass index, antral follicle counts, basal FSH, basal and increment of anti-mullerian hormone, Luteinizing hormon, estradiol, testosterone, androstenedione, and inhibin B. The outcome variable was NOR. The independent variables underwent appropriate transformation to achieve a better fit for a linear relationship with NOR. Pruned forward selection with holdback validation was then used to establish predictive models. Corrected Akaike’s information criterion, Schwarz–Bayesian information criterion, scaled –log[likelihood], and the generalized coefficient of determination (R 2) were used for model evaluation.ResultsA multiple negative binomial regression model was used for predicting NOR because it fitted a negative binomial distribution. We established Model 1, using basal ovarian reserve markers, and Model 2, using both basal and early dynamic markers for predicting NOR following COS. The generalized R 2 values were 0.54 and 0.51 for Model 1 and 0.64 and 0.62 for Model 2 in the training and validation sets, respectively.ConclusionModels 1 and 2 could be applied to different scenarios. For directing the starting dose of recombinant follicle stimulation hormone (rFSH), Model 1 using basic predictors could be used prior to COS. Model 2 could be used for directing the adjustment of rFSH dosages during COS. An online tool (http://121.43.113.123:8002/) based on these two models is also developed. We anticipate that the clinical application of this tool could help the ART clinics to reduce iatrogenic ovarian under- or over-responses, and could reduce costs during COS for ART.

English

This research has demonstrated conflicting findings related to how environmental factors may affect the spread of tuberculosis (TB). A better understanding of this may have implications for health planning given the changing world climate. This study examines environmental factors, specifically elevation and temperature, demographic and income covariates and their association with TB incidence within the Appalachian region. County-wide TB incidence data were collected from the thirteen states within the Appalachian region for the most recent year available, 2017 or 2018, along with data from the American Community Survey for the corresponding year. A correlation analysis was performed followed by multiple negative binomial regression models to find models with the best fit. The analyses identified clusters of incident TB cases distributed throughout the Appalachian region. Hot spots (that is, highly positively autocorrelated geographic locations) utilizing Getis-Ord Gi* were found within the Southern portion of the Appalachian region while clusters utilizing Anselin local Moran’s I were more spread throughout the region. Temperature was found to be significantly associated with TB incidence in all models, but ethnic distribution explained some of the variation. Future research could benefit from replicating this study with longitudinal data to assess how temperature changes over time affect TB incidence. Key words: tuberculosis, Appalachia, temperature, elevation.

Use of alcohol associated with mental disorders in adult men

Abstract Background This study aimed to identify the use of alcohol in adult men and to verify the association with socioeconomic, demographic and mental disorders. Methods A cross-sectional analytical study was carried out on adults aged 20 to 59 years old in the city of Piracicaba registered in the Family Health Units (FHU) in 2018. The pattern of alcohol use was investigated in the population through the application of the AUDIT (The Alcohol Use Disorders Identification Test) instrument. Through the modified socioeconomic questionnaire by Meneghim et al, socioeconomic and demographic factors were investigated. The brief investigation of the main mental disorders: major depressive episode and generalized anxiety disorder, was carried out with the Mini International Neuropsychiatric Interview (MINI). The sample was selected “post-hoc” considering the sample, with a significance level of 5% and test power above 80% (β = 0.20) (effect size = 0, 33). After contacting the FHU and selecting participants, the interviews were conducted over the phone in one step. The eligible sample had 227 participants. After descriptive analyzes, variables with p-value <0.20 in simple analyzes were studied in multiple negative binomial regression models (95% confidence intervals). Results There was a high prevalence of alcohol consumption, 26.9%. The AUDIT score increased with age (RM: 1.02; 95% CI: 0.99-1.03). Protestants and evangelicals had an average AUDIT score lower than other religions (RM: 1.78; 95% CI: 1.14-2.79). People with mental disorders have an average AUDIT score higher than those without disorders (RM: 2.30; 95% CI: 1.28-4.11). Conclusions It is concluded that alcohol in the adult male population was prevalent, increases with age, and religion has a protective effect. We highlight the importance of the USF in the development of strategies that investigate the conditions of its population, as well as the discussion and approach of interventions Key messages The adult male population is more vulnerable to alcohol use and its consequences. Thus, early detection and the search for associated factors is necessary to avoid possible damage to men's health. The application of the Mini International Neuropsychiatric Interview instrument, can act preventively and with early interventions in mental disorders and in association with alcohol use.

Influenza-associated excess mortality in the Philippines, 2006-2015.

Influenza-associated mortality has not been quantified in the Philippines. Here, we constructed multiple negative binomial regression models to estimate the overall and age-specific excess mortality rates (EMRs) associated with influenza in the Philippines from 2006 to 2015. The regression analyses used all-cause mortality as the dependent variable and meteorological controls, time, influenza A and B positivity rates (lagged for up to two time periods), and annual and semiannual cyclical seasonality controls as independent variables. The regression models closely matched observed all-cause mortality. Influenza was estimated to account for a mean of 5,347 excess deaths per year (1.1% of annual all-cause deaths) in the Philippines, most of which (67.1%) occurred in adults aged ≥60 years. Influenza A accounted for 85.7% of all estimated excess influenza deaths. The annual estimated influenza-attributable EMR was 5.09 (95% CI: 2.20-5.09) per 100,000 individuals. The EMR was highest for individuals aged ≥60 years (44.63 [95% CI: 4.51-44.69] per 100,000), second highest for children aged less than 5 years (2.14 [95% CI: 0.44-2.19] per 100,000), and lowest for individuals aged 10 to 19 years (0.48 [95% CI: 0.10-0.50] per 100,000). Estimated numbers of excess influenza-associated deaths were considerably higher than the numbers of influenza deaths registered nationally. Our results suggest that influenza causes considerable mortality in the Philippines-to an extent far greater than observed from national statistics-especially among older adults and young children.

Analysis of the correlation of socioeconomic, sanitary, and demographic factors with homicide deaths - Bahia, Brazil, 2013-2015.

To analyze the correlation of socioeconomic, sanitary, and demographic factors with homicides in Bahia, from 2013 to 2015. Ecological study, using data from the Information System on Mortality and from the Superintendence of Economic and Social Studies. The depending variable is the corrected homicide rate. Explanatory variables were categorized in four axes. Simple and multiple negative binomial regression models were used. Positive associations were found between homicides and the Index of Economy and Finances (IEF), the Human Development Index, the Gini Index, population density, and legal intervention death rates (LIDR). The variables Index of Education Levels (IEL), rates of death with undetermined intentions (RDUI), and the proportion of ill-defined causes (IDC) presented a negative association with the homicide rates. The specific features of the context of each community, in addition to broader socioeconomic municipal factors, directly interfere in life conditions and increase the risk of dying by homicide.

Seasonal variation in cutaneous melanoma incidence, link with recent UV levels: a population-based study in Belgium (2006-2011).

Our objective was to test the hypothesis of a short-term late-promoting effect of ultraviolet (UV) exposure on the development of cutaneous melanoma as an explanation for the summer peak in melanoma incidence. Therefore, we studied seasonal variation in melanoma incidence in relation to recent UV levels by direct UV measurements. Data from the Belgian Cancer Registry on invasive cutaneous melanoma diagnosed during 2006-2011 were used for analysis. Daily data on UV measurements in Belgium were obtained from the Royal Meteorological Institute. Simple and multiple negative binomial regression models were used to investigate the influence of recent UV levels on melanoma incidence. The sum of the mean UV doses in the 2 months before diagnosis was used as a proxy for recent UV exposure in the population. To include variable sunburn risks during the year, the categorical variable 'semester' was created. The incidence of melanoma in Belgium shows a distinct seasonal variation, with peaks in June or July. We found that part of this variation could be explained by the variation in dermatologic activity and, therefore, used this as an offset in our models. We found a linear relationship between melanoma incidence and UV dose in the 2 months preceding the diagnosis. UV levels had more impact in the first semester. The effect of UV levels was not modified by sex nor age. The interaction between anatomical site and UV levels was significant (P=0.002) and showed a higher effect on the upper and lower limbs compared with the head and neck and trunk.

Entertainment or Health? Exploring the Internet Usage Patterns of the Urban Poor: A Secondary Analysis of a Randomized Controlled Trial.

BackgroundImportant gaps remain in our knowledge of how individuals from low socioeconomic position (SEP) use the Internet for resources and in understanding the full range of activities they perform online. Although self-report data indicate that low SEP individuals use the Internet less than high SEP people for health information and for other beneficial capital-enhancing activities, these results may not provide an accurate overall view of online use.ObjectiveThe aim of this study was to determine the ways in which low SEP individuals use the Internet, including for entertainment, social networking, and capital-enhancing functions, and how they are associated with health information seeking.MethodsDetailed Web tracking data were collected from 118 low SEP individuals who participated in the intervention group of a randomized controlled trial that provided Internet access. Websites were grouped by topic, including categories of capital-enhancing websites that provided access to resources and information. Different types of online activities were summed into an Internet use index. Single and multiple negative binomial regression models were fitted with the Internet use index as the predictor and health information seeking as the outcome. Next, models were fitted with low, medium, and high Web usage in capital-enhancing, entertainment, and social network categories to determine their associations with health information seeking.ResultsParticipants used the Web for diverse purposes, with 63.6% (75/118) accessing the Internet for all defined types of Internet use. Each additional category of Internet use was associated with 2.12 times the rate of health information seeking (95% CI 1.84-2.44, P<.001). Higher use of each type of capital-enhancing information was associated with higher rates of health information seeking, with high uses of government (incident rate ratio [IRR] 8.90, 95% CI 4.82-16.42, P<.001) and news (IRR 11.36, 95% CI 6.21-20.79, P<.001) websites associated with the highest rates of health information seeking compared to their lowest use categories. High entertainment website use (IRR 3.91, 95% CI 2.07-7.37, P<.001) and high social network use (IRR 2.06, 95% CI 1.08-3.92, P=.03) were also associated with higher health information seeking.ConclusionsThese data clearly show that familiarity and skills in using the Internet enhance the capacity to use it for diverse purposes, including health and to increase capital, and that Internet usage for specific activities is not a zero sum game. Using it for one type of topic, such as entertainment, does not detract from using it for other purposes. Findings may inform ways to engage low SEP groups with Internet resources.

Seasonal variation in cutaneous melanoma incidence: link with recent UV exposure. A Belgian population-based study

Our objective was to test the hypothesis of a short-term late-promoting effect of UV exposure on the development of cutaneous melanoma as explanation for the summer peak in melanoma incidence. Therefore, we studied seasonal variation in melanoma incidence in relation to recent UV exposure using direct UV measurements. Data from the Belgian Cancer Registry on invasive cutaneous melanoma diagnosed during 2006-2011 were used for analysis. Daily data on UV measurements in Belgium were obtained from the Royal Meteorological Institute. Simple and multiple negative binomial regression models were used to investigate the influence of recent UV exposure on melanoma incidence. The sum of the mean UV dose in the two months prior to diagnosis was used as a proxy for recent UV exposure in the population. To include variable sunburn risk during the year, the categorical variable ‘semester’ was created. The incidence of melanoma in Belgium shows a distinct seasonal variation with peaks in June or July. We found that part of this variation could be explained by the variation in dermatologic activity and therefore used this as an offset in our models. We found a linear relationship between melanoma incidence and UV dose in the two months preceding the diagnosis. UV exposure had more impact in the first semester. The effect of UV exposure was not modified by gender or age. The interaction between anatomical site and UV exposure was significant (p<0.001) and showed a higher effect on the upper and lower limbs compared to head and neck and trunk.

Intimate partner assault and structural-level correlates of crime: exploring the relationship between contextual factors and intimate partner violence

Drawing from social disorganization theory, the relationship between correlates of social disorganization theory and intimate partner aggravated assaults are explored. Specifically, the current study presents a descriptive picture of intimate partner violence from a police perspective, and investigates the relationship between structural-level factors and the criminal offense intimate partner aggravated assault. A descriptive analysis of intimate partner assaults and multiple negative binomial regression models are estimated using the National Incident-Based Reporting System (NIBRS) and the American Community Survey (ACS) to explore the relationship between structural factors and intimate partner violence. The primary sample includes 7290 intimate partner aggravated assaults across 227 counties in two states, Tennessee and Virginia. Concentrated disadvantage, immigrant concentration, and urbanity were all significantly associated with intimate partner assaults in the expected directions. The results indicated that the more social disorganization within a given county, the higher the likelihood of intimate partner assaults. The findings provide evidence that structural-level factors associated with social disorganization theory contribute to increased intimate partner assaults. The findings suggest that specific correlates of social disorganization are positively associated with intimate partner assaults, and lend support for the theory of social disorganization in explaining intimate partner violence.

Television Viewing in Low-Income Latino Children: Variation by Ethnic Subgroup and English Proficiency

Television viewing is associated with an increased risk for obesity in children. Latino children are at high risk for obesity and yet little is known about differences in television viewing habits within this population. The purpose of this study is to determine if hours of television viewed by young children with low-income Latina mothers differs by maternal ethnic subgroup and English language proficiency. This was a cross-sectional analysis of data from the Welfare, Children, & Families: A Three City Study. Participants were 422 low-income Latina mothers of Mexican and Puerto Rican descent with children ages 0-4 years old. The dependent variable was hours of daily television viewed by the child. The independent variable was maternal ethnic subgroup and English language proficiency. Analyses involved the use of multiple negative binomial regression models, which were adjusted for demographic variables. Multivariable regression analyses showed that compared to children with mothers of Mexican descent, children of mothers of Puerto Rican descent watch more daily television (<2 years old, incidence rate ratio (IRR)=4.18, 95% confidence interval (CI) 1.68, 10.42; 2-4 years, IRR=1.54, 95% CI 1.06, 2.26). For children with mothers of Mexican descent, higher maternal English language proficiency was associated with higher amounts of child television viewing (IRR=1.29, 95% CI 1.04, 1.61). No relationship was found for children of Puerto Rican descent. Child television viewing varies in low-income Latino children by maternal ethnic subgroup and English language proficiency. Interventionists must consider the varying sociocultural contexts of Latino children and their influence on television viewing.

Homicide fall in São Paulo municipality, Brazil: the role of public security indicators

Throughout the first decade of the 21st century, homicide mortality rate (HMR) significantly decreased in the state of São Paulo. In the city of São Paulo (MSP), this rate dropped...

EXPLORATORY SPATIAL ANALYSIS OF SOCIAL AND ENVIRONMENTAL FACTORS ASSOCIATED WITH THE INCIDENCE OF ROSS RIVER VIRUS IN BRISBANE, AUSTRALIA

We used geographic information systems and a spatial analysis approach to explore the pattern of Ross River virus (RRV) incidence in Brisbane, Australia. Climate, vegetation and socioeconomic data in 2001 were obtained from the Australian Bureau of Meteorology, the Brisbane City Council and the Australian Bureau of Statistics, respectively. Information on the RRV cases was obtained from the Queensland Department of Health. Spatial and multiple negative binomial regression models were used to identify the socioeconomic and environmental determinants of RRV transmission. The results show that RRV activity was primarily concentrated in the northeastern, northwestern, and southeastern regions in Brisbane. Multiple negative binomial regression models showed that the spatial pattern of RRV disease in Brisbane seemed to be determined by a combination of local ecologic, socioeconomic, and environmental factors.