Physician Perceptions on Quality of Life and Resuscitation Preferences for Extremely Early Newborns

2021 ◽  
Author(s):  
Danielle LoRe ◽  
Christopher Mattson ◽  
Dalia M. Feltman ◽  
Jessica T. Fry ◽  
Kathleen G. Brennan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Logistic Regression ◽  
Regression Models ◽  
Mixed Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Comfort Care ◽  
Logistic Regression Models ◽  
Extremely Preterm

Objective The study aimed to explore physician views on whether extremely early newborns will have an acceptable quality of life (QOL), and if these views are associated with physician resuscitation preferences. Study Design We performed a cross-sectional survey of neonatologists and maternal fetal medicine (MFM) attendings, fellows, and residents at four U.S. medical centers exploring physician views on future QOL of extremely early newborns and physician resuscitation preferences. Mixed-effects logistic regression models examined association of perceived QOL and resuscitation preferences when adjusting for specialty, level of training, gender, and experience with ex-premature infants. Results A total of 254 of 544 (47%) physicians were responded. A minority of physicians had interacted with surviving extremely early newborns when they were ≥3 years old (23% of physicians in pediatrics/neonatology and 6% in obstetrics/MFM). The majority of physicians did not believe an extremely early newborn would have an acceptable QOL at the earliest gestational ages (11% at 22 and 23% at 23 weeks). The majority of physicians (73%) believed that having an extremely preterm infant would have negative effects on the family's QOL. Mixed-effects logistic regression models (odds ratio [OR], 95% confidence interval [CI]) revealed that physicians who believed infants would have an acceptable QOL were less likely to offer comfort care only at 22 (OR: 0.19, 95% CI: 0.05–0.65, p < 0.01) and 23 weeks (OR: 0.24, 95% CI: 0.07–0.78, p < 0.02). They were also more likely to offer active treatment only at 24 weeks (OR: 9.66, 95% CI: 2.56–38.87, p < 0.01) and 25 weeks (OR: 19.51, 95% CI: 3.33–126.72, p < 0.01). Conclusion Physician views of extremely early newborns' future QOL correlated with self-reported resuscitation preferences. Residents and obstetric physicians reported more pessimistic views on QOL. Key Points

scholarly journals Ordinal logistic regression models: application in quality of life studies

2008 ◽  
Vol 24 (suppl 4) ◽  
pp. s581-s591 ◽  
Author(s):  
Mery Natali Silva Abreu ◽  
Arminda Lucia Siqueira ◽  
Clareci Silva Cardoso ◽  
Waleska Teixeira Caiaffa
Keyword(s):  
Quality Of Life ◽  
Logistic Regression ◽  
Regression Models ◽  
Goodness Of Fit ◽  
Ordinal Logistic Regression ◽  
Proportional Odds Model ◽  
Outcome Variable ◽  
Proportional Odds ◽  
Logistic Regression Models

Quality of life has been increasingly emphasized in public health research in recent years. Typically, the results of quality of life are measured by means of ordinal scales. In these situations, specific statistical methods are necessary because procedures such as either dichotomization or misinformation on the distribution of the outcome variable may complicate the inferential process. Ordinal logistic regression models are appropriate in many of these situations. This article presents a review of the proportional odds model, partial proportional odds model, continuation ratio model, and stereotype model. The fit, statistical inference, and comparisons between models are illustrated with data from a study on quality of life in 273 patients with schizophrenia. All tested models showed good fit, but the proportional odds or partial proportional odds models proved to be the best choice due to the nature of the data and ease of interpretation of the results. Ordinal logistic models perform differently depending on categorization of outcome, adequacy in relation to assumptions, goodness-of-fit, and parsimony.

scholarly journals The Effect of Various Police Enforcement Actions on Violent Crime: Evidence From a Saturation Foot-Patrol Intervention

2018 ◽  
Vol 29 (6-7) ◽  
pp. 611-629 ◽  
Author(s):  
Eric L. Piza
Keyword(s):  
Quality Of Life ◽  
Logistic Regression ◽  
Crime Prevention ◽  
Regression Models ◽  
Policy Implications ◽  
Target Area ◽  
Spatial Displacement ◽  
Foot Patrol ◽  
Logistic Regression Models

The current study tests the crime prevention effect of different police actions conducted during a foot-patrol saturation initiative in Newark, New Jersey. Police actions were categorized into two typologies: enforcement actions (i.e., arrests, quality of life summonses and field interrogations) and guardian actions (i.e., business checks, citizen contacts, bus checks, and taxi inspections). Logistic regression models tested the effect of enforcement and guardian actions on crime during daily (i.e., 24-hr) periods as well as the intervention’s operational (6:00 p.m.-2:00 a.m.) and nonoperational (2:00 a.m.-5:00 p.m.) periods. Analyses were conducted twice, once for the Operation Impact target area and once for a surrounding catchment zone (to measure spatial displacement). Findings suggest that guardian actions had a greater crime prevention effect than enforcement actions on crime occurrence. Policy implications of the findings are discussed.

scholarly journals The Association Between Single-Child Status and Risk of Abdominal Obesity: Result From a Cross-Sectional Study of China

2021 ◽  
Vol 9 ◽  
Author(s):  
Di Gao ◽  
Yanhui Li ◽  
Zhaogeng Yang ◽  
Ying Ma ◽  
Manman Chen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Abdominal Obesity ◽  
Regression Models ◽  
Weight Status ◽  
Cross Sectional Study ◽  
High Risk Population ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Single Child

Background: Obesity has become a serious problem threatening the health of children and adolescents, and China's one-child policy has affected family structure and parenting practice, which may result in several adverse health outcomes. The present study aims to investigate the association between single-child status and the risk of abdominal obesity in Chinese adolescents and also to compare the differences in the risk of unideal energy-related behaviors.Methods: Data were obtained from a school-based cross-sectional survey conducted in seven provinces of China, in 2012. A total of 31,291 students aged 7–17 years were recruited in this study. Anthropometric measurements were conducted to assess height and waist circumference, and questionnaires were used to obtain information of single-child status, parental educational attainment, parental weight status, and offspring energy-related behaviors. Multivariate logistic regression models were used to estimate the odds ratio (OR) and 95% confidence intervals (95% CI) of single-child status and odds of childhood abdominal obesity and energy-related behaviors.Results: The prevalence of abdominal obesity was 18.2% in single children, which was higher than that of non-single children (13.7%). The prevalence was also higher in single children in different sex and residence subgroups. Logistic regression models showed that single children had 1.33 times (OR: 1.33, 95% CI: 1.24–1.43, P &lt; 0.001) higher odds of abdominal obesity compared to non-single children. Single children had 1.08 times higher odds of physical inactivity (OR: 1.08, 95% CI: 1.03–1.14, P = 0.004), 1.13 times higher odds of excessive sugar-sweetened beverages (SSBs) consumption (OR: 1.13, 95% CI: 1.05–1.23, P = 0.002), and 1.08 times more likely to eat out (OR: 1.08, 95% CI: 1.02–1.13, P = 0.006). Those associations were more remarkable in single girls.Conclusion: Being a single child may be associated with a higher odds of childhood abdominal obesity and unhealthy energy-related behaviors. Future interventions and strategies to prevent abdominal obesity should focus on this high-risk population.

Chronic disruptive pain in emerging adults with and without chronic health conditions and the moderating role of psychiatric disorders: Evidence from a population-based cross-sectional survey in Canada

2017 ◽  
Vol 17 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Rana A. Qadeer ◽  
Lilly Shanahan ◽  
Mark A. Ferro
Keyword(s):  
Mental Health ◽  
Psychiatric Disorders ◽  
Emerging Adults ◽  
Regression Models ◽  
Daily Functioning ◽  
Moderating Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Drug Disorders

AbstractBackground and aimsThere has been a growth in the proportion of emerging adults vulnerable to pain-related sequelae of chronic health conditions (CHCs). Given the paucity of research during this important developmental period, this study investigated the association between CHCs and chronic disruptive pain among emerging adults and the extent to which psychiatric disorders moderate this association.MethodsData come from the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH). This cross-sectional survey included 5987 participants that were 15-30 years of age and self-reported their CHCs (n = 2460,41%) and the extent to which pain impacted daily functioning using items from the Health Utilities Index Mark 3 (HUI 3). Group comparisons between respondents with CHCs and healthy controls were made using chi-square tests. Odds ratios (OR) and 95% confidence intervals (CI) were computed from ordinal logistic regression models adjusting for sociodemographic covariates. Product-term interactions between CHCs and psychiatric disorders were included in the models to explore moderating effects. All analyses were weighted to maintain representativeness of the study sample to the Canadian population.ResultsThe mean age of participants was 23.5 (SE 0.1) years and 48% were female. Compared to healthy controls, a greater proportion of participants with CHCs reported having chronic pain (20.3% vs. 4.5%, p < 0.001). Among those with chronic pain, respondents with CHCs reported a greater number of activities prevented because of chronic disruptive pain (χ2 = 222.28, p< 0.001). Similarly, in logistic regression models, participants with CHCs had greater odds of reporting chronic disruptive pain (OR = 4.94, 95% CI = 4.08-5.99). Alcohol (β = –0.66; p = 0.025) and drug abuse/dependence disorders (β = –1.24; p = 0.012) were found to moderate the association between CHCs and chronic disruptive pain. Specifically, the probability of chronic disruptive pain was higher for emerging adults without CHCs and with alcohol or drug disorders; however, among participants with CHCs, probability was higher for those without these disorders.ConclusionsThere is a robust association between CHCs and chronic disruptive pain. The moderating effects suggest that alcohol or drug disorders are especially harmful for emerging adults without CHCs and contribute to higher levels of chronic disruptive pain; however, among those with CHCs, alcohol and illicit drugs may be used as a numbing agent to blunt chronic disruptive pain.ImplicationsFindings from this study have implications for the integration and coordination of services to design strategies aimed at managing chronic disruptive pain and preventing pain-related disabilities later in life. Within the health system, healthcare providers should engage in dialogues about mental health and substance use regularly with emerging adults, be proactive in screening for psychiatric disorders, and continue to monitor the impact of pain on daily functioning. Given the age range of emerging adults, there is tremendous opportunity for clinicians to work cooperatively with colleagues in the education system to support emerging adults with and without CHCs. Overall, clinicians, researchers, educators, and those in social services should continue to be mindful of the complex interrelationships between physical and mental health and chronic disruptive pain and work cooperatively to optimize health outcomes and prevent pain-related disabilities among emerging adults.

Quality of Life in People Living With HIV: An Exploratory Cross-Sectional Survey in Belgium

2021 ◽  
Vol 33 (3) ◽  
pp. 249-264
Author(s):  
Gert Scheerder ◽  
Sandra Van den Eynde ◽  
Patrick Reyntiens ◽  
Ria Koeck ◽  
Jessika Deblonde ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Sexual Life ◽  
People Living With Hiv ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Related Stigma ◽  
Living With Hiv ◽  
The Impact

This cross-sectional survey explored the quality of life in 505 people living with HIV in Belgium. Several domains of quality of life were impaired: 26% had been diagnosed with depression and 43% had weak social support. HIV-related stigma is still widespread, with 49% believing most people with HIV are rejected and 65% having experienced discrimination due to HIV. The impact of HIV was limited on professional life, but 40% experienced a negative impact on life satisfaction and 41% a negative impact on sexual life. For several domains, people with a recent diagnosis of HIV and long-term survivors had significantly worse scores. This survey also uncovered strengths of people living with HIV, such as positive coping and HIV self-image. Expanding the scope of quality of life in people living with HIV may provide a more complete picture of relevant life domains that may be impacted by living with HIV, but this needs further validation.

scholarly journals Quality of Life in Patients with Osteoporosis: A Us Cross-Sectional Survey

2018 ◽  
Vol 21 ◽  
pp. S199-S200 ◽  
Author(s):  
DT Gold ◽  
SA Williams ◽  
RJ Weiss ◽  
Y Wang ◽  
C Watkins ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cross Sectional Survey ◽  
Cross Sectional
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