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Multilevel analysis

Yoshitaka Nishikawa, Ayako Kohno, Yoshimitsu Takahashi, Chiaki Suzuki, Hirokatsu Kinoshita, Takeo Nakayama, Masaharu Tsubokura
Context: Intake of stable iodine helps prevent childhood thyroid cancer in nuclear emergencies but there is limited case information. Objective: We identified the intake rate and the factors associated with no intake among children who did not take stable iodine after the Fukushima disaster. Design: Retrospective observational study. Setting: Data were obtained from thyroid cancer screening performed in August-November 2017...
December 10, 2018: Journal of Clinical Endocrinology and Metabolism
Jennyfer Wolf, Richard Johnston, Matthew C Freeman, Pavani K Ram, Tom Slaymaker, Eric Laurenz, Annette Prüss-Ustün
Background: Limited data have been available on the global practice of handwashing with soap (HWWS). To better appreciate global HWWS frequency, which plays a role in disease transmission, our objectives were to: (i) quantify the presence of designated handwashing facilities; (ii) assess the association between handwashing facility presence and observed HWWS; and (iii) derive country, regional and global HWWS estimates after potential faecal contact. Methods: First, using data from national surveys, we applied multilevel linear modelling to estimate national handwashing facility presence...
December 10, 2018: International Journal of Epidemiology
Yusuke Kondo, Chihiro Masaki, Akiko Tamura, Shintaro Tsuka, Taro Mukaibo, Masanori Iwasaki, Tashihiro Ansai, Ryuji Hosakawa
No abstract text is available yet for this article.
October 2018: Journal of Indian Prosthodontic Society
Aránzazu Hernández-Yumar, Maria Wemrell, Ignacio Abásolo Alessón, Beatriz González López-Valcárcel, George Leckie, Juan Merlo
Many studies have demonstrated the existence of simple, unidimensional socioeconomic gradients in body mass index (BMI). However, in the present paper we move beyond such traditional analyses by simultaneously considering multiple demographic and socioeconomic dimensions. Using the Spanish National Health Survey 2011-2012, we apply intersectionality theory and multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to analyze 14,190 adults nested within 108 intersectional strata defined by combining categories of gender, age, income, educational achievement and living situation...
2018: PloS One
Oyvind Bjertnaes, Hilde Hestad Iversen
OBJECTIVES: The objective was to assess the importance of different types of predictors for patient-reported outcome, both background factors at the patient level and healthcare predictors related to structure and processes of healthcare. DESIGN: Cross-sectional patient experience survey. SETTING: All 280 secondary care institutions in Norway providing inpatient care for adult psychiatric patients. PARTICIPANTS: 1683 inpatients responded to the questionnaire on-site (73...
December 9, 2018: BMJ Open
Cauane Blumenberg, Daniela Zugna, Maja Popovic, Costanza Pizzi, Aluisio J D Barros, Lorenzo Richiardi
BACKGROUND: Web-based questionnaires are increasingly used in epidemiologic studies, as traditional methods are facing a decrease in response rates and an increase in costs. However, few studies have investigated factors related to the level of completion of internet-based epidemiologic questionnaires. OBJECTIVE: Our objective was to identify person-level characteristics and item design factors associated with breakoff (not finishing the questionnaire) and item nonresponse in a Web-based questionnaire...
December 7, 2018: Journal of Medical Internet Research
N Hallensleben, H Glaesmer, T Forkmann, D Rath, M Strauss, A Kersting, L Spangenberg
OBJECTIVE: To extend evidence on the short-term variability of passive and active suicidal ideation (SI) and the association with suggested proximal risk factors such as interpersonal variables (perceived burdensomeness [PB], thwarted belongingness [TB], hopelessness, and depression) in real-time. METHODS: This is an observational study using a prospective design applying ecological momentary assessments (EMA). Eligible for study inclusion were inpatients with unipolar depression, current or lifetime suicidal ideation, and fluent German...
December 5, 2018: European Psychiatry: the Journal of the Association of European Psychiatrists
Cedric Mabire, Stefanie Bachnick, Dietmar Ausserhofer, Michael Simon
BACKGROUND: Nursing discharge preparation is vital to successful hospital-to-home transitions. However, despite a wealth of evidence on its effectiveness, little is known of the structure- and process-related factors that facilitate or impede its use in clinical practice. Specifically, the associations between unit size and type, leadership support, skill mix, staffing, nurse and patient characteristics, discharge teaching and patient readiness for discharge have rarely been studied. OBJECTIVES: This study aimed to explore the associations between structure-individual characteristics (i...
November 19, 2018: International Journal of Nursing Studies
Alison Chopel, Danielle Soto, Bre'Jaynae Joiner, Tina Benitez, Ruth Konoff, Lucy Rios, Elva Castellanos
BACKGROUND: Young mothers (age 14-24 years), who are often low income, are less likely than other mothers to breastfeed for 6 months. They also are more likely to be diagnosed with aggressive forms of breast cancer; breastfeeding significantly reduces this risk. While adolescent breastfeeding has been investigated from the perspective of the individual, the social ecological model recognizes the influence of factors at multiple levels. RESEARCH AIM: The aim was to identify social and structural barriers to and motivators of breastfeeding that young mothers may encounter...
December 5, 2018: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
Peter Austin Morton Ntenda, Jane Flora Kazambwe
Background: Overweight and obesity are well-known risk factors for non-communicable diseases such as cardiovascular disease, diabetes, some cancers and musculoskeletal disorders. In Malawi, the proportion of women who are overweight/obese has doubled, from 10% in 1992 to 21% in 2015-16. Therefore we aimed to explore the individual- and community-level factors associated with overweight and obesity among non-pregnant women of child-bearing age. Methods: Secondary analysis of the 2015-16 Malawi Demographic and Health Survey was conducted...
December 4, 2018: International Health
Monalisa Cesarino Gomes, Érick Tássio Neves, Matheus França Perazzo, Saul Martins Paiva, Fernanda Morais Ferreira, Ana Flávia Granville-Garcia
The objective of the present study was to evaluate the influence of individual and contextual factors on the occurrence of toothache in five-year-old children. A cross-sectional study was conducted with 756 five-year-old children from public and private preschools in a city in the countryside of the northeast of Brazil. The sample was determined through probabilistic sampling in two stages (preschools and children). The children included could not have systematic diseases, permanent tooth or orthodontic treatment...
November 2018: Brazilian Dental Journal
Andrew P Stringer, Rob M Christley, Catriona E Bell, Feseha Gebreab, Gebre Tefera, Karen Reed, Andrew Trawford, Gina L Pinchbeck
The objectives of this study were to evaluate the efficacy of several knowledge-transfer interventions about donkey health, utilizing a cluster-randomized controlled trial (c-RCT), on the long-term knowledge change (~6 months post intervention) of Ethiopian rural working equid owners. Knowledge transfer interventions included: an audio programme, a village meeting and a diagrammatic hand-out, which were also compared to a control group, which received no intervention. All interventions addressed identical learning objectives...
2018: Frontiers in Veterinary Science
Gianluca Milano, Michael Luebben, Zheng Ma, Rafal Dunin-Borkowski, Luca Boarino, Candido F Pirri, Rainer Waser, Carlo Ricciardi, Ilia Valov
The ability for artificially reproducing human brain type signals' processing is one of the main challenges in modern information technology, being one of the milestones for developing global communicating networks and artificial intelligence. Electronic devices termed memristors have been proposed as effective artificial synapses able to emulate the plasticity of biological counterparts. Here we report for the first time a single crystalline nanowire based model system capable of combining all memristive functions - non-volatile bipolar memory, multilevel switching, selector and synaptic operations imitating Ca2+ dynamics of biological synapses...
December 4, 2018: Nature Communications
Bu-Shun Tang, Cheng Yan, Xiao-Ke Zhang, Yi-Bing Liu, Chao Wang, Bing Wei
OBJECTIVE: To compare the clinical effects and complications of two hybrid decompression techniques in treating multilevel (>=3) cervical spondylotic myelopathy(MCSM). METHODS: The clinical data of 124 patients with multilevel (>=3) cervical spondylotic myelopathy treated by surgery and follow-up from January 2008 to December 2016 were retrospectively analyzed. According to the different operative methods, the patients were divided into group A and group B...
November 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Yanan Luo, Chao Guo, Lei Zhang, Lihua Pang, Xin Zhao, Xiaoying Zheng
There is little evidence on the association between area-level social factors and schizophrenia in China. This study aimed to investigate the relationship between county-level social factors and schizophrenia in Chinese adults aged 18 years old and above. We obtained data from the Second China National Sample Survey on Disability, and selected 1,909,205 adults for analysis. Schizophrenia was ascertained according to the International Statistical Classification of Diseases, Tenth Revision. Multilevel logistic regressions showed that areas with higher urbanization rate was associated with increased risk of schizophrenia (areas with moderate urbanization rate: OR = 1...
August 17, 2018: Psychiatry Research
Xin Gu, Mohamed Abdel-Aty, Qiaojun Xiang, Qing Cai, Jinghui Yuan
The interchange merging area suffers a high crash risk in the freeway system, which is greatly related to the intense mandatory merging maneuvers. Ignoring such correlation may result in limited and biased conclusions and inefficient countermeasures. Recently, the availability of unmanned aerial vehicle (UAV) provides us an opportunity to collect individual vehicle's data to conduct traffic analysis at the microscopic level. Hence, this paper contributes to the literature by proposing a new framework to analyze crash risk at freeway interchange merging areas considering drivers' merging behavior...
December 1, 2018: Accident; Analysis and Prevention
Carla Santos, Ana Carolina Reyes, Marcos André Moura Dos Santos, Sara Pereira, Thayse Natacha Gomes, Go Tani, Olga Vasconcelos, Raquel N Chaves, Rui Garganta, Tiago V Barreira, Peter T Katzmarzyk, José Maia
BACKGROUND: Children's physical fitness is potentially influenced by biological, behavioural and environmental factors. AIM: To investigate the importance of individual-level and school-level characteristics in explaining variation in children's physical fitness. SUBJECTS AND METHODS: The sample comprised 354 Portuguese children, aged 5-10 years. Physical fitness [(handgrip (HG) strength, standing long jump (SLJ), shuttle-run (SR), total physical fitness score (PFz)], gross motor coordination (GMC), and body mass index (BMI) were assessed...
December 4, 2018: Annals of Human Biology
Rogelio Cruz-Martinez, Miguel Martínez-Rodríguez, Belén Nieto-Castro, Alma Gámez-Varela, Monica Cruz-Lemini, Jonahtan Luna-García, Israel Juárez-Martínez
OBJECTIVE: To evaluate longitudinal changes in lung size and intrapulmonary artery (IPa) Doppler in fetuses with congenital diaphragmatic hernia (CDH) and assess their contribution in predicting neonatal survival. METHODS: The observed/expected lung-to-head ratio (O/E-LHR) and IPa-Pulsatility Index (PI) and Peak Early Diastolic Reversed Flow (PEDRF) were evaluated in a cohort of left-sided CDH fetuses managed expectantly during pregnancy. Longitudinal changes were analyzed by multilevel analysis, and their value to predict survival using multiple logistic regression and decision-tree analysis was assessed...
December 4, 2018: Prenatal Diagnosis
Aaron L Schwartz, Anupam B Jena, Alan M Zaslavsky, J Michael McWilliams
Importance: Facing new financial incentives to reduce unnecessary spending, health care organizations may attempt to reduce wasteful care by influencing physician practices or selecting more cost-effective physicians. However, physicians' role in determining the use of low-value services has not been well described. Objectives: To quantify variation in provision of low-value health care services among primary care physicians and to estimate the proportion of variation attributable to physician characteristics that may be used to predict performance...
December 3, 2018: JAMA Internal Medicine
Robert J Asaro, Qiang Zhu, Pedro Cabrales
We demonstrate that erythrocyte deformations, specifically of a type as occur in splenic flow (Zhu et al., 2017), and of the type that promote vesiculation can be caused by simple, yet tailored, oscillatory shear flow. We show that such oscillatory shear flow provides an ideal environment to explore a wide variety of metabolic and biochemical effects that promote erythrocyte vesiculation. Deformation details, typical of splenic flow, such as in-folding and implications for membrane/skeleton interaction are demonstrated and quantitatively analyzed...
2018: Frontiers in Physiology
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