Random Effects Logistic Regression Research Articles

Toothache and its Determinants in 12-Year-Old Iranian Children: A Cross-sectional Study

Background: Toothache is a common condition among children that often leads to school absenteeism. However, there is limited information on the prevalence of toothache and its associated factors in Iranian children. Objectives: This study aimed to assess the prevalence of toothache and related factors in 12-year-old Iranian children. Methods: This was a cross-sectional population-based study. Multistage cluster sampling was used to recruit the participants from three provinces (Tehran, Kerman, and Fars). Parents of 1,468 students aged 12 years completed a valid questionnaire that assessed their socioeconomic status and the children’s oral hygiene behavior, toothache, and absenteeism in the last 6 months. A multivariate random effects logistic regression model was adopted to analyze the effect of demographic, geographic, and oral hygiene practice factors on toothache prevalence. Results: The prevalence of toothache in children was high, with 41% (95% CI = 38.4, 43.5) of the children reporting toothache. Of the children who had a toothache, 12.8% missed 1 to 7 school days. The prevalence of toothache was significantly higher in children living in cities compared to those living in towns (P < 0.001). Additionally, toothache prevalence had a significant association with the fathers’ educational level (P = 0.003) and the children’s toothbrushing and flossing practices (P < 0.001). Conclusions: The high prevalence of toothache among Iranian children highlights the need for effective health interventions to control this condition. These interventions can focus on improving oral hygiene practices and increasing access to dental care in both urban and rural areas. Moreover, targeting families with lower educational levels could be an effective approach to reducing the prevalence of toothache in children.

Adverse childhood experiences in early life increase the odds of depression among adults with multiple sclerosis.

Adverse childhood experiences are demonstrated risk factors for depression, a common co-morbidity of multiple sclerosis, but are understudied among people with multiple sclerosis. Estimate the association between adverse childhood experiences and depression among 1,990 adults with multiple sclerosis. Participants were members of Kaiser Permanente Northern California from two studies between 2006 and 2021 and were diagnosed with multiple sclerosis by a neurologist. Adverse childhood experiences were assessed using two instruments, including the Behavioral Risk Factor Surveillance System. Participants self-reported ever experiencing a major depressive episode. Meta-analysis random effects models and logistic regression were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to assess the relationship between adverse childhood experiences and a history of depression across study samples. Adverse childhood experiences were expressed as any/none, individual events, and counts. Models adjusted for sex, birth year, race, and ethnicity. Exposure to any adverse childhood experiences increased the odds of depression in people with multiple sclerosis (OR: 1.71, 95% CI: 1.21-2.42). Several individual adverse childhood experiences were also strongly associated with depression, including "significant abuse or neglect" (OR: 2.79, 95% CI: 2.11-3.68). Findings suggest that adverse childhood experiences are associated with depression among people with multiple sclerosis. Screening for depression should be done regularly, especially among people with multiple sclerosis with a history of adverse childhood experiences.

Anemia prevalence and its predictors among children under-five years in Ghana. A multilevel analysis of the cross-sectional 2019 Ghana Malaria Indicator Survey.

Despite the implementation of anemia control interventions in Ghana, anemia prevalence is still high in children under-fives. Reducing the prevalence of anemia requires identifying and targeting associated critical risk factors. This study seeks to identify predictors of anemia among children under-fives in Ghana. Nationally representative data from the 2019 Ghana Malaria Indicator Survey was used in this study. Both fixed and random effects (multilevel) logistic regression models were applied to 2434 children to identify critical factors associated with anemia. In this study, 54% (95% confidence interval [CI] 52.0-57.0) of children under-5 years were anemic. Infants were more likely to be anemic (66.7%) compared with other children below 5 years. In the multivariable multilevel model, the risk of anemia was found to be higher in younger children especially 6-11 months old (adjusted odds ratio [aOR] = 3.59, CI: 2.54-5.08) and 12-23 months old (aOR = 2.97, CI: 2.08-4.23), children who had malaria (aOR = 1.53, CI: 1.13-2.06), children whose mothers were not registered but not covered with health insurance (aOR = 1.45, CI: 1.21-1.74) or were not even registered for insurance (aOR = 1.49, CI: 1.15-1.93), children born to adolescent mothers (aOR = 2.21, CI: 1.36-3.57), children born to non-Christian mothers (Islam [aOR = 1.53, CI: 1.17-2.00]), children born to families of poorer households (poorest [aOR = 3.01, CI: 1.64-5.51]; poorer [aOR = 2.56, CI: 1.65-3.98]); middle (aOR = 2.03, CI: 1.32-3.11) and richer (aOR = 1.78, CI: 1.19-2.64), and children who lived in either Upper East (aOR = 2.03, CI: 1.26-3.26) or Central (aOR = 2.52, CI: 1.42-4.47) regions. Significant unobserved community-level differences in anemia prevalence were observed. The probability of anemia in children under-fives differs substantially from one community to another, and the prevalence remains high. The identified critical risk factors should be addressed. Multifaceted and targeted approaches are needed to help reduce the anemia prevalence in this setting to achieve the multiple United Nation's Sustainable Development Goals, which are related to risk and prevalence of anemia by 2030.

Interpersonal communication, cultural norms, and community perceptions associated with care-seeking for fever among children under age five in Magoé district, Mozambique

BackgroundMalaria is endemic throughout Mozambique, contributing significantly to the country’s burden of disease. Prompt and effective treatment for fevers in children can limit the mortality and morbidity impacts of the disease but many children in the country are not taken for formal care when ill. Using an ideational model of behaviour, this study assesses the magnitude of the relationships for potential drivers of care-seeking, including interpersonal communication, malaria messaging, and knowledge and attitudes about malaria, with actual care-seeking behaviours for under-five children with fever in Magoé district, Mozambique.MethodsData on the care-seeking behaviours for fever come from a 2019 household malaria survey in Magoé district. Households were randomly selected for interview from among those with at least one child under age five and one net for every two household members. From 1621 mother-child dyads, the analytical sample consists of 300 children under age five with a fever in the 2 weeks prior to the survey. Multilevel random effects logistic regression models are estimated to test for associations between care-seeking behaviours and hypothesized behavioural determinants, including interpersonal communication (IPC), malaria messaging, ideational factors (e.g., norms, attitudes, beliefs, risk perceptions), and community characteristics.ResultsOverall, 18.5% of children under age five (N = 300) were reported to have fever in the previous 2 weeks and, of these, 68.5% were taken to a formal sector health care provider. Multivariate models highlight significant roles for interpersonal communication; care-seeking was highest among mothers who spoke only with friends/community members about malaria (94.0%, p < 0.001), followed by those who spoke only with their husband (78.6%, p = 0.015), relative to 63.3% who spoke with no one. Care-seeking decisions made by a child’s grandmother were associated with a 25.0% point (p = 0.001) greater likelihood of seeking care relative to decisions made by the mother alone. Exposure to any malaria messaging was also positively associated with care-seeking (90.5% versus 62.7%, p < 0.001). In contrast, among all individual- and community-level ideational factors, only perceptions of self-efficacy to seek care were related to care-seeking behaviours.ConclusionsThese results suggest that social and behaviour change interventions that focus on encouraging families and community members to talk about malaria and the need to promptly seek treatment for fevers in children may be particularly effective at increasing this behaviour in this and similar settings. Such messaging and IPC should consider grandmothers as a target audience, as they appear to be perceived as highly influential in care-seeking decision-making in this community.

Multilevel analysis of trends and predictors of concurrent wasting and stunting among children 6-59 months in Ethiopia from 2000 to 2019.

Emerging evidence indicates that children can be concurrently wasted and stunted (WaSt), increasing their mortality risk. However, more is needed to know about WaSt in Ethiopia. Therefore, this study aimed to determine the trends and predictors of WaSt using Ethiopian Demographic and Health Survey datasets from 2000 and 2019. The study included a total weighted sample of 34,930 children aged 6-59 months. Descriptive and weighted multilevel mixed-effects (fixed and random effects) logistic regression analyses were carried out. The Intraclass Correlation Coefficient (ICC) and the Median Odds Ratio (MOR) were calculated. The prevalence of WaSt was 1,682 (4.82%) with a significantly decreasing trend, yielding a percent change of -57.51% (-69.37% to -23.52%) from 2000 to 2019. In the adjusted model, the odds of WaSt increased in boys, children with a shorter preceding birth interval, small birth size, delayed initiation of complementary foods, diarrhea, fever, and anemia, mother's lack of formal education, and being a farmer, and poor/middle wealth index, and lack of mass media exposure. WaSt was inversely related to the child's age. Adjusted ICC and MOR were 31.16% and 3.20%, respectively. The study highlights the importance of considering individual and community-level factors to address WaSt, such as timely initiation of complementary foods, improving access to health services, quality diet, and prevention of communicable diseases. Furthermore, programs that have positive impacts on formal education and employment opportunities for girls, as well as that increase access to mass media, are required.

Chest CT features and functional correlates of COVID-19 at 3 months and 12 months follow-up

Long-term pulmonary sequelae of Coronavirus 2019 (COVID-19) remain unclear. Thus, we aimed to establish post-COVID-19 temporal changes in chest computed tomography (CT) features of pulmonary fibrosis and to investigate associations with respiratory symptoms and physiological parameters at 3 and 12 months' follow-up. Adult patients who attended our initial COVID-19 follow-up service and developed chest CT features of interstitial lung disease, in addition to cases identified using British Society of Thoracic Imaging codes, were evaluated retrospectively. Clinical data were gathered on respiratory symptoms and physiological parameters at baseline, 3 months, and 12 months. Corresponding chest CT scans were reviewed by two thoracic radiologists. Associations between CT features and functional correlates were estimated using random effects logistic or linear regression adjusted for age, sex and body mass index. In total, 58 patients were assessed. No changes in reticular pattern, honeycombing, traction bronchiectasis/bronchiolectasis index or pulmonary distortion were observed. Subpleural curvilinear lines were associated with lower odds of breathlessness over time. Parenchymal bands were not associated with breathlessness or impaired lung function overall. Based on our results, we conclude that post-COVID-19 chest CT features of irreversible pulmonary fibrosis remain static over time; other features either resolve or remain unchanged. Subpleural curvilinear lines do not correlate with breathlessness. Parenchymal bands are not functionally significant. An awareness of the different potential functional implications of post-COVID-19 chest CT changes is important in the assessment of patients who present with multi-systemic sequelae of COVID-19 infection.

Patient and Clinician Sociodemographics and Sexual History Screening at a Multisite Federally Qualified Health Center: A Mixed Methods Study.

In 2018, there were 68 million sexually transmitted infections in the United States. Sexual history screening is an evidence-based practice endorsed by guidelines to identify risk of these infections and adverse sexual health outcomes. In this mixed methods study, we investigated patient- and clinician-level characteristics associated with receipt of sexual history screening, and contextualized these differences in more depth. We collected sociodemographics of patients from the electronic health record and sociodemographics of their primary care clinicians via a census survey. Semistructured interviews were conducted with key practice staff. We conducted multilevel crossed random effects logistic regression analysis and thematic analysis on quantitative and qualitative data, respectively. A total of 53,246 patients and 56 clinicians from 13 clinical sites participated. Less than one-half (42.4%) of the patients had any sexual history screening documented in their health record. Patients had significantly higher odds of documented screening if they were gay or lesbian (OR = 1.23), were cisgender women (OR = 1.10), or had clinicians who were cisgender women (OR = 1.80). Conversely, patients' odds of documented screening fell significantly with age (OR per year = 0.99) and with the number of patients their clinicians had on their panels (OR per patient = 0.99), and their odds were significantly lower if their primary language was not English (OR = 0.91). In interviews, key staff expressed discomfort discussing sexual health and noted assumptions about patients who are older, in long-term relationships, or from other cultures. Discordance of patient-clinician gender and patients' sexual orientation were also noted as barriers. Interventions are needed to address the interplay between the social and contextual factors identified in this study, especially those that elicited discomfort, and the implementation of sexual history screening.

Changes in Polypharmacy and Potentially Inappropriate Medications in Homebound Older Adults in Japan, 2015-2019: a Nationwide Study.

With rising worldwide population aging, the number of homebound individuals with multimorbidity is increasing. Improvement in the quality of home medical care (HMC), including medications, contributes to meeting older adults' preference for "aging in place" and securing healthcare resources. To evaluate the changes in drug prescriptions, particularly potentially inappropriate medications (PIMs), among older adults receiving HMC in recent years, during which measures addressing inappropriate polypharmacy were implemented, including the introduction of clinical practice guidelines and medical fees for deprescribing. A cross-sectional study. Using data from the national claims database in Japan, this study included older adults aged ≥ 75years who received HMC in October 2015 (N = 499,850) and October 2019 (N = 657,051). Number of drugs, prevalence of polypharmacy (≥ 5 regular drugs), major drug categories/classes, and PIMs according to Japanese guidelines were analyzed. Random effects logistic regression models were used to evaluate the differences in medications between 2015 and 2019, considering the correlation within individuals who contributed to the analysis in both years. The number of drugs remained unchanged from 2015 to 2019 (median: 6; interquartile range: 4, 9). The prevalence of polypharmacy also remained unchanged at 70.0% in both years (P = 0.93). However, the prescription of some drugs (e.g., direct oral anticoagulants, new types of hypnotics, acetaminophen, proton pump inhibitors, and β-blockers) increased, whereas others (e.g., warfarin, vasodilators, H2 blockers, acetylcholinesterase inhibitors, and benzodiazepines) decreased. Among the frequently prescribed PIMs, benzodiazepines/Z-drugs (25.6% in 2015 to 21.1% in 2019; adjusted odds ratio: 0.52) and H2 blockers (11.2 to 7.3%; 0.45) decreased, whereas diuretics (23.8 to 23.6%; 0.90) and antipsychotics (9.7 to 10.5%; 1.11) remained unchanged. We observed some favorable changes but identified some continuous and new challenges. This study suggests that continued attention to medication optimization is required to achieve safe and effective HMC.

Building a predictive model for assessing the risk of Salmonella shedding at slaughter in fattening pigs.

Salmonellosis continues to be a major cause of foodborne outbreaks worldwide, and pigs are one of the main sources of human infection. Salmonella pork contamination is a major concern for abattoirs and is related to the presence of Salmonella in pigs' feces at slaughter. Being able to predict the risk of Salmonella shedding in pigs arriving at the slaughterhouse could help mitigate abattoir and carcass contamination. For this purpose, 30 batches of 50 pigs each were selected from 30 different fattening units. The pigs were tagged and bled for the detection of antibodies against Salmonella approximately one month before slaughter. Pooled floor fecal samples were also collected from 10 pens per unit for Salmonella detection, and a questionnaire on biosecurity was administered to each farm. At the abattoir, colon content was collected from each tagged pig for the Salmonella shedding assessment. A predictive model for Salmonella shedding at slaughter was built with two-third of the pigs by employing random-effects logistic regression analysis, with Salmonella shedding as the dependent variable and pig serology and other farm/environmental characteristics as the independent variables. The model included farm as the grouping factor. Data from the remaining one-third of the pigs were used for model validation. Out of 1,500 pigs initially selected, 1,341 were identified at the abattoir and analyzed. Salmonella was detected in 13 (43.3%; 95%CI = 27.4-60.8) of the fattening units. The mean batch seroprevalence (cut-off OD% ≥40) among the fattening units was 31.7% (95%CI = 21.8-41.0), and a total of 316 pigs (23.6%; 95%CI = 21.4-25.9) shed Salmonella at slaughter. The model predicted reasonably well (Area under the curve = 0.76; P < 0.05) whether a pig would shed Salmonella at slaughter, with estimates of sensitivity and specificity at 71.6% and 73.6%, respectively. Serology, the percentage of Salmonella-positive pens on the farm, and the internal biosecurity score were significantly associated (P < 0.05) with Salmonella shedding at the abattoir, and several scenarios were observed by the model. The study highlighted that although serology may be helpful for identifying batches of pigs at risk of shedding Salmonella upon their arrival at the abattoir, it may not be necessary in some scenarios.

Outcomes Associated With Esophageal Perforation Management: Results From a French Nationwide Population-based Cohort Study.

To evaluate outcomes associated with esophageal perforation (EP) management at a national level and determine predictive factors of 90-day mortality (90dM), failure-to-rescue (FTR), and major morbidity (MM, Clavien-Dindo 3-4). EP remains a challenging clinical emergency. Previous population-based studies showed rates of 90dM up to 38.8% but were outdated or small-sized. Data from patients admitted to hospitals with EP were extracted from the French medico-administrative database (2012-2021). Etiology, management strategies, and short and long-term outcomes were analyzed. A cutoff value of the annual EP management caseload affecting FTR was determined using the "Chi-squared Automatic Interaction Detector" method. Random effects logistic regression model was performed to assess independent predictors of 90dM, FTR, and MM. Among 4765 patients with EP, 90dM and FTR rates were 28.0% and 19.4%, respectively. Both remained stable during the study period. EP was spontaneous in 68.2%, due to esophageal cancer in 19.7%, iatrogenic postendoscopy in 7.3%, and due to foreign body ingestion in 4.7%. Primary management consisted of surgery (n = 1447,30.4%), endoscopy (n = 590,12.4%), isolated drainage (n = 336,7.0%), and conservative management (n = 2392,50.2%). After multivariate analysis, besides age and comorbidity, esophageal cancer was predictive of both 90dM and FTR. An annual threshold of ≥8 EP managed annually was associated with a reduced 90dM and FTR rate. In France, only some university hospitals fulfilled this condition. Furthermore, primary surgery was associated with a lower 90dDM and FTR rate despite an increase in MM. We provide evidence for the referral of EP to high-volume centers with multidisciplinary expertise. Surgery remains an effective treatment for EP.

Bridging the knowledge gap of biomedical HIV prevention tools among sub-saharan african immigrants in France. Results from an empowerment-based intervention

IntroductionBiomedical HIV prevention tools are available in France to prevent new infections. However, evidence suggests a lack of knowledge of these tools among sub-Saharan African immigrants, who are particularly affected by HIV due to social hardship, an indirect factor of HIV acquisition. We analysed the impact of an empowerment-based intervention on the knowledge of treatment as prevention (TasP), pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) in a population of precarious sub-Saharan African immigrants. MethodsData were collected throughout the MAKASI project. Following an outreach approach, participants were recruited in public places based on their precarious situations and followed for six months (0, 3, 6 months) between 2018 and 2021. Participants were randomized into two groups and received an empowerment intervention sequentially (stepped wedge design). We used random-effects logistic regression models to evaluate the intervention effect on the knowledge of biomedical HIV prevention tools. ClinicalTrials.gov Identifier: NCT04468724. ResultsThe majority of the participants were men (77.5%), and almost half of them had arrived in France within 2 years prior to inclusion (49.3%). At baseline, 56% of participants knew about TasP, 6% knew about PEP and 4% knew about PrEP. Receiving the intervention increased the odds of knowing about PEP (aOR = 2.02 [1.09–3.75]; p < 0.026). Intervention effects were observed for TasP and PrEP only after 6 months. We found significant time effects for PEP (at 3 months, aOR = 4.26 [2.33–7.80]; p < 0.001; at 6 months, aOR = 18.28 [7.39–45.24]; p < 0.001) and PrEP (at 3 months, aOR = 4.02 [2.10–7.72]; p < 0.001; at 6 months, aOR = 28.33 [11.16–71.91]; p < 0.001). ConclusionsWe showed that the intervention increased the knowledge of biomedical HIV prevention tools. The effect of the intervention was coupled with an important time effect. This suggested that exposure to the intervention together with other sources of information contributed to increased knowledge of biomedical HIV prevention tools among precarious sub-Saharan African immigrants.

The socioeconomic context of stigma: examining the relationship between economic conditions and attitudes towards people with mental illness across European countries.

Efforts to reduce the stigma associated with mental illness have intensified over the past 30 years with a particular focus on improving public attitudes. Difficult economic circumstances can be harmful to intergroup relations, but little is known about whether there is a relationship between socioeconomic conditions and attitudes towards people with mental illnesses. Random effects logistic regression modelling was employed to explore the relationship between individual financial circumstances, contextual socioeconomic factors and difficulty speaking to a person with a significant mental illness across European countries. Lower GDP per capita and higher income inequality at the country level, alongside individual financial difficulties, were each associated with a greater likelihood of reporting difficulty speaking to a person with a significant mental illness. Micro and macro-economic factors are associated with public attitudes towards people with mental illness across Europe. With prolonged economic instability predicted over the coming years in Europe it is important that these findings are taken into consideration when designing mental health and social policies, in order to safeguard the progress that has been made in reducing mental health stigma to date.

Plasma carotenoids and risk of depressive symptomatology in a population-based cohort of older adults

BackgroundAs part of a healthy diet, higher carotenoid intakes have been associated with a reduced risk of depression, mainly in adults, while prospective studies on plasma carotenoids in older adults are lacking. The aim of this study was to assess the prospective association between plasma carotenoids and the risk of Depressive Symptomatology (DS) in older adults. MethodsThe study sample was based on the Three-City cohort of adults aged 65y+ free from DS at enrollment in 1999. Plasma carotenoids were measured at baseline. DS was assessed every 2–3 years over 17 years and defined by a Center for Epidemiologic Studies-Depression Scale score ≥ 16 and/or by antidepressant use. The association between plasma carotenoids or carotenoid/lipids (cholesterol and triglycerides) ratio and the risk for DS was assessed through multiple random-effect logistic regression. ResultsThe study sample was composed of 1010 participants (mean age 74 y (±4.9), 58 % of women) followed-up during a median time of 13.4 years. Plasma zeaxanthin and ratios of zeaxanthin/lipids, lutein+zeaxanthin/lipids and β-carotene/lipids were independently associated with a significant reduced risk of DS over time (Odds ratio (OR) = 0.81, 95 % Confidence Interval (CI) [0.67;0.99], OR = 0.79 [0.67;0.98], OR = 0.79 [0.64;0.94] and OR = 0.80 [0.66;0.97] for +1 standard deviation of each exposure respectively). LimitationsPlasma carotenoids were only available at study baseline. ConclusionFocusing on circulating carotenoids and considering lipids levels, the present results suggested an association between higher levels of plasma zeaxanthin, combined lutein+zeaxanthin and β-carotene and a decreased risk of DS over time in older adults.

The Association of ACGME Milestones With Performance on American Board of Surgery Assessments: A National Investigation of Surgical Trainees.

To determine the relationship between, and predictive utility of, milestone ratings and subsequent American Board of Surgery (ABS) vascular surgery in-training examination (VSITE), vascular qualifying examination (VQE), and vascular certifying examination (VCE) performance in a national cohort of vascular surgery trainees. Specialty board certification is an important indicator of physician competence. However, predicting future board certification examination performance during training continues to be challenging. This is a national longitudinal cohort study examining relational and predictive associations between Accreditation Council for Graduate Medical Education (ACGME) Milestone ratings and performance on VSITE, VQE, and VCE for all vascular surgery trainees from 2015 to 2021. Predictive associations between milestone ratings and VSITE were conducted using cross-classified random-effects regression. Cross-classified random-effects logistic regression was used to identify predictive associations between milestone ratings and VQE and VCE. Milestone ratings were obtained for all residents and fellows(n=1,118) from 164 programs during the study period (from July 2015 to June 2021), including 145,959 total trainee assessments. Medical knowledge (MK) and patient care (PC) milestone ratings were strongly predictive of VSITE performance across all postgraduate years (PGYs) of training, with MK ratings demonstrating a slightly stronger predictive association overall (MK coefficient 17.26 to 35.76, β = 0.15 to 0.23). All core competency ratings were predictive of VSITE performance in PGYs 4 and 5. PGY 5 MK was highly predictive of VQE performance [OR 4.73, (95% CI, 3.87-5.78), P <0.001]. PC subcompetencies were also highly predictive of VQE performance in the final year of training [OR 4.14, (95% CI, 3.17-5.41), P <0.001]. All other competencies were also significantly predictive of first-attempt VQE pass with ORs of 1.53 and higher. PGY 4 ICS ratings [OR 4.0, (95% CI, 3.06-5.21), P <0.001] emerged as the strongest predictor of VCE first-attempt pass. Again, all subcompetency ratings remained significant predictors of first-attempt pass on CE with ORs of 1.48 and higher. ACGME Milestone ratings are highly predictive of future VSITE performance, and first-attempt pass achievement on VQE and VCE in a national cohort of surgical trainees.

Content and form of original research articles in general major medical journals.

The title of an article is the main entrance for reading the full article. The aim of our work therefore is to examine differences of title content and form between original research articles and its changes over time. Using PubMed we examined title properties of 500 randomly chosen original research articles published in the general major medical journals BMJ, JAMA, Lancet, NEJM and PLOS Medicine between 2011 and 2020. Articles were manually evaluated with two independent raters. To analyze differences between journals and changes over time, we performed random effect meta-analyses and logistic regression models. Mentioning of results, providing any quantitative or semi-quantitative information, using a declarative title, a dash or a question mark were rarely used in the title in all considered journals. The use of a subtitle, methods-related items, such as mentioning of methods, clinical context or treatment increased over time (all p < 0.05), while the use of phrasal tiles decreased over time (p = 0.044). Not a single NEJM title contained a study name, while the Lancet had the highest usage of it (45%). The use of study names increased over time (per year odds ratio: 1.13 (95% CI: [1.03‒1.24]), p = 0.008). Investigating title content and form was time-consuming because some criteria could only be adequately evaluated by hand. Title content changed over time and differed substantially between the five major medical journals. Authors are advised to carefully study titles of journal articles in their target journal prior to manuscript submission.

Does corporate governance matter in the cleanup of reported oil spills? Evidence from Nigeria

PurposeThis study aims to examine whether corporate governance mechanisms – board size, board independence and CEO duality – influence the actions of oil companies operating in Nigeria to clean up oil spills from their facilities.Design/methodology/approachBoth binary logistic regression (linear) and random-effects logistic regression models were used to test three hypotheses using a unique data set of 1,262 oil spill events involving 24 oil companies from 2017 to 2019.FindingsThe study found that board size and board independence are positively related to oil spill cleanup.Practical implicationsPrivate oil companies in Nigeria should encourage larger and more independent boards in their corporate governance (CG) structures, as these boards may be more effective in serving the interests of stakeholders by bringing diverse knowledge and experience to the boards. Similarly, regulators should extend the enforcement of CG codes to private firms.Originality/valueTo the best of the authors’ knowledge, this is the first study that investigates the influence of CG attributes on oil spill cleanup.

Informal Caregiving Provision for Disabled or Elderly in the Families and Work Productivity: Evidence from 11 Waves of an Australian Population-Based Cohort.

Informal carers are family members, friends or neighbours who care for persons in need. In 2018, aroundone in ten Australians offered some informal care, most of which was unpaid. It is essential to comprehend how informal caregivers' productivity at work is affected by their caregiving responsibilities. We examine the association between informal caregiving and productivity loss in Australia. We utilised 11 waves of data drawn from theHousehold, Income and Labour Dynamics in Australia(HILDA) survey. Longitudinal random-effects logistic regression and random-effects Poisson regression techniques were used to assess the between-person differences in the association between informal caregiving and productivity loss (absenteeism, presenteeism and working hour tension). The results suggest informal caregiving is associated with a higher rate of absenteeism, presenteeism and working hour tension. We reveal that absence/leave rates at work are greater for those with lighter, moderate and intensive care responsibilities than those without caregiving responsibilities, given other covariates reference categories remain constant. Our findings also indicate that workers with intensive, moderate, and light caregiving responsibilities have considerably higher rates of working hour tension than their peers without caregiving commitments if other covariate reference categories are held constant. The result further shows that, on average, an individual with lighter, moderate and intensive caregiving roles had incurred AUD 276.13, AUD 246.81, and AUD 1927.16, respectively, in absenteeism costs annually compared with their counterparts without caregiving duties. Our study reveals that working-age caregivers experience greater absenteeism, presenteeism and working hour tension. Adverse effects of informal caregiving are required to perform the cost effectiveness of an intervention given to caregivers to improve carer and patient health. Our findings will assist health technology assessment (HTA) practitioners in performing an economic evaluation of interventions given to caregivers by providing the indirect cost (productivity loss) of caregiving.

Six-year trajectories and associated factors of positive and negative symptoms in schizophrenia patients, siblings, and controls: Genetic Risk and Outcome of Psychosis (GROUP) study

Positive and negative symptoms are prominent but heterogeneous characteristics of schizophrenia spectrum disorder (SSD). Within the framework of the Genetic Risk and Outcome of Psychosis (GROUP) longitudinal cohort study, we aimed to distinguish and identify the genetic and non-genetics predictors of homogenous subgroups of the long-term course of positive and negative symptoms in SSD patients (n = 1119) and their unaffected siblings (n = 1059) in comparison to controls (n = 586). Data were collected at baseline, and after 3- and 6-year follow-ups. Group-based trajectory modeling was applied to identify latent subgroups using positive and negative symptoms or schizotypy scores. A multinomial random-effects logistic regression model was used to identify predictors of latent subgroups. Patients had decreasing, increasing, and relapsing symptoms course. Unaffected siblings and healthy controls had three to four subgroups characterized by stable, decreasing, or increasing schizotypy. PRSSCZ did not predict the latent subgroups. Baseline symptoms severity in patients, premorbid adjustment, depressive symptoms, and quality of life in siblings predicted long-term trajectories while were nonsignificant in controls. In conclusion, up to four homogenous latent subgroups of symptom course can be distinguished within patients, siblings, and controls, while non-genetic factors are the main factors associated with the latent subgroups.

A Statewide Analysis of the Impact of Restitution and Fees on Juvenile Recidivism in Florida Across Race &amp; Ethnicity

Whether the imposition of monetary sanctions is related to juvenile recidivism is explored overall and across race and ethnicity. Leveraging a statewide sample, logistic regression was used to predict fees and restitution assignment based on youth/case characteristics, hierarchical linear and logistic random-effects regression examined the association between neighborhood characteristics with fees and restitution, and propensity score matching examined whether fees and/or restitution are related to reoffending. No race/ethnic differences were found in the proportion of youth receiving court fees, yet when fees were administered both Black and Hispanic youth received higher fees. Neighborhood characteristics have minimal impact on whether (or the amounts) monetary sanctions were assigned. Post-matching, fees increased recidivism, as did being Black or Hispanic. Interactions between race/ethnicity and both fees and restitution showed Black youth with restitution had a higher recidivism likelihood. Monetary sanctions imposed on youth involved in the juvenile justice system has a potential deleterious impact on recidivism.

Herd and animal level seroprevalence and associated risk factors of bovine brucellosis in different agro-ecologies of southwest Ethiopia

Brucellosis is a zoonotic infection that commonly affects cattle in Ethiopia, causing significant negative economic impact. A cross-sectional study was carried out between November 2020 and November 2021 in southwest Ethiopia to determine the seroprevalence of brucellosis and its associated risk factors in cattle herds. Blood samples were taken from 461 randomly selected cattle to test for the presence of Brucella antibodies using the Rose Bengal Plate test, with positive serum confirmed through the complement fixation test. A multivariable random effect logistic regression analysis was used to identify potential risk factors for Brucella seropositivity. The study found 7.14% (95% CI: 4.44–9.01) seroprevalence at the animal level and 12.23% (95% CI: 6.52–16.05) at the herd level based on the complement fixation test. Age (OR = 6.9, 95%CI: 1.83–15.97), herd size (OR = 3.66, 95%CI: 1.39–9.61), introducing new animals (OR = 2.72, 95%CI: 1.17–6.29), management system (OR = 12.2, 95%CI: 1.53–26.80), species composition (OR = 4.24, 95%CI: 1.51–11.91), and abortion (OR = 7.1, 95%CI: 1.93–15.39) were found to be associated with Brucella seropositivity. The analysis also revealed two risk factors for Brucella infection at the herd level, including herd size (OR = 3.4, 95% CI: 1.05–10.68) and species composition (OR = 3.1, 95% CI: 1.20–7.88). The presence of Brucella antibodies in cattle highlights the need for increased awareness and measures to mitigate the identified risk factors of the disease to prevent its spread. Furthermore, further studies are necessary to investigate the zoonotic transmission of brucellosis to humans and its role in cattle reproduction disorders in the study area.