scholarly journals Modification of empirical antimicrobial regimens in large animal medicine

2020 ◽  
Vol 187 (9) ◽  
pp. e78-e78
Author(s):  
Laurel Redding ◽  
Haley Grunwald ◽  
Stephen Cole ◽  
Shelley Rankin ◽  
Rose Nolen-Walston
Keyword(s):  
Disease Prevention ◽  
Multinomial Logistic Regression ◽  
Care Service ◽  
Empirical Therapy ◽  
Antimicrobial Use ◽  
Large Animal ◽  
Disease Treatment ◽  
Factors Associated ◽  
Lengths Of Stay ◽  
Animal Medicine

BackgroundEmpirical antimicrobial regimens can be modified following new diagnostic information or when empirical treatment fails. Little is known about the frequency or clinical context in which these modifications occur. We characterised these modifications in a large animal hospital to identify when antimicrobial use could be optimised.MethodsChart reviews were performed for all inpatients and outpatients administered antimicrobials at a large animal veterinary referral and teaching hospital in 2017–2018 (n=1163 visits) to determine when and why empirical regimens were modified. Multinomial logistic regression was performed to identify factors associated with reasons for modification.ResultsEmpirical antimicrobial regimens were modified in 17.3 per cent of visits. The main reasons were parenteral-oral conversions in horses and failure of disease prevention or treatment in ruminants. Empirical therapy for disease prevention was more likely to be modified because of complications in ruminants and in animals on the emergency/critical care service. Empirical therapy for disease treatment was more often modified for reasons other than de-escalation in ruminants and in animals with longer lengths of stay.ConclusionsEmpirical antimicrobial regimens were modified infrequently and mostly for purposes of parenteral-oral conversion in horses and lack of response in ruminants. De-escalation of antimicrobials administered for disease treatment, when guided by diagnostics, is a major tenet of judicious antimicrobial use. However, more research is needed to determine when and how antimicrobial regimens administered for disease prevention should be modified.

scholarly journals Sources of Health Care Among Under-5 Malawian Children With Diarrhea Episodes: An Analysis of the 2017 Demographic and Health Survey

2019 ◽  
Vol 6 ◽  
pp. 2333794X1985546
Author(s):  
Peter Suwirakwenda Nyasulu ◽  
Emery Ngamasana ◽  
Ngianga-Bakwin Kandala
Keyword(s):  
Health Care ◽  
Health Survey ◽  
Rural Areas ◽  
Multinomial Logistic Regression ◽  
Care Service ◽  
Data Extraction ◽  
Health Care Service ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Factors Associated

Diarrhea is a leading cause of morbidity and mortality in the world but mostly in Sub-Saharan Africa. These could be prevented if universal coverage of current available interventions were implemented. The study aimed to identify factors associated with the choice of health care source among caretakers seeking treatment for under-5 children with diarrhea illness. Using women’s questionnaire we extracted a subset of data of children aged 0 to 59 months from the 2017 Demographic & Health Survey. Questions regarding history of childhood diarrhea for the past 24 hours or last 2 weeks prior to the survey were key in data extraction. Caregivers were asked to report the place where they sought treatment. In this study, 4 types of health facilities were defined: public, private, pharmacies, and other unspecified sources. A multinomial logistic regression model was used to identify sources of health facility used and corresponding factors associated with the choice. Factors associated with choice of health care source included education (educated women were less likely to self-medicate their children [relative risk ration (RRR) = 0.46; 95% confidence interval (CI) = 0.22-0.94]), income (better income earning families were more likely to seek care from private facility such as pharmacy [RRR = 1.87; 95% CI = 1.14-3.09]), and rural living (those in rural areas were more likely to seek treatment from other unspecified sources [RRR = 7.33, 95% CI = 1.40-38.36]). Public health facilities (79.9%) were the main source of health care service; however, reducing under-5 mortality due to diarrhea illness would require significant efforts to address other inequalities in accessing and utilizing health care services.

scholarly journals Factors associated with higher healthcare costs in a cohort of homeless adults with a mental illness and a general cohort of adults with a history of homelessness

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathryn Wiens ◽  
Laura C. Rosella ◽  
Paul Kurdyak ◽  
Simon Chen ◽  
Tim Aubry ◽  
...  
Keyword(s):  
Mental Illness ◽  
Healthcare Costs ◽  
Service Use ◽  
Multinomial Logistic Regression ◽  
Service Planning ◽  
Inpatient Service ◽  
Homeless Adults ◽  
Targeted Interventions ◽  
Factors Associated ◽  
History Of

Abstract Background Healthcare costs are disproportionately incurred by a relatively small group of people often described as high-cost users. Understanding the factors associated with high-cost use of health services among people experiencing homelessness could help guide service planning. Methods Survey data from a general cohort of adults with a history of homelessness and a cohort of homeless adults with mental illness were linked with administrative healthcare records in Ontario, Canada. Total costs were calculated using a validated costing algorithm and categorized based on population cut points for the top 5%, top 6–10%, top 11–50% and bottom 50% of users in Ontario. Multinomial logistic regression was used to identify the predisposing, enabling, and need factors associated with higher healthcare costs (with bottom 50% as the reference). Results Sixteen percent of the general homeless cohort and 30% percent of the cohort with a mental illness were in the top 5% of healthcare users in Ontario. Most healthcare costs for the top 5% of users were attributed to emergency department and inpatient service costs, while the costs from other strata were mostly for physician services, hospital outpatient clinics, and medications. The odds of being within the top 5% of users were higher for people who reported female gender, a regular medical doctor, past year acute service use, poor perceived general health and two or more diagnosed chronic conditions, and were lower for Black participants and other racialized groups. Older age was not consistently associated with higher cost use; the odds of being in the top 5% were highest for 35-to-49-year year age group in the cohort with a mental illness and similar for the 35–49 and ≥ 50-year age groups in the general homeless cohort. Conclusions This study combines survey and administrative data from two cohorts of homeless adults to describe the distribution of healthcare costs and identify factors associated with higher cost use. These findings can inform the development of targeted interventions to improve healthcare delivery and support for people experiencing homelessness.

scholarly journals Country compliance with WHO-recommended antenatal care guidelines: equity analysis of the 2015–2016 Demography and Health Survey in Myanmar

2020 ◽  
Vol 5 (12) ◽  
pp. e002169
Author(s):  
Ngatho Samuel Mugo ◽  
Kyaw Swa Mya ◽  
Camille Raynes-Greenow
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Adolescent Mothers ◽  
Health Survey ◽  
Rural Areas ◽  
Urban Areas ◽  
Multinomial Logistic Regression ◽  
Wealth Quintile ◽  
Adjusted Risk ◽  
Factors Associated

IntroductionEarly access to adequate antenatal care (ANC) from skilled providers is crucial for detecting and preventing obstetric complications of pregnancy. We aimed to assess factors associated with the utilisation of the new WHO ANC guidelines including the recommended number, on time initiation and adequate components of ANC contacts in Myanmar.MethodsWe examined data from 2943 mothers aged 15–49 years whose most recent birth occurred in the last 5 years prior to the 2015–2016 Myanmar Demographic and Health Survey. Factors associated with utilisation of the new WHO recommended ANC were explored using multinomial logistic regression and multivariate models. We used marginal standardisation methods to estimate the predicted probabilities of the factors significantly associated with the three measures of ANC.ResultsApproximately 18% of mothers met the new WHO recommended number of eight ANC contacts. About 58% of the mothers received adequate ANC components, and 47% initiated ANC within the first trimester of pregnancy. The predicted model shows that Myanmar could achieve 70% coverage of adequate components of ANC if all women were living in urban areas. Similarly, if ANC was through private health facilities, 63% would achieve adequate components of ANC. Pregnant women from urban areas (adjusted risk ratio (aRR): 4.86, 95% CI 2.44 to 9.68) were more than four times more likely to have adequate ANC components compared with women from rural areas. Pregnant women in the highest wealth quintile were three times more likely to receive eight or more ANC contacts (aRR: 3.20, 95% CI 1.61 to 6.36) relative to mothers from the lowest wealth quintile. On time initiation of the first ANC contact was fourfold for mothers aged 30–39 years relative to adolescent mothers (aRR: 4.07, 95% CI 1.53 to 10.84).ConclusionThe 2016 WHO ANC target is not yet being met by the majority of women in Myanmar. Our results highlight the need to address health access inequity for women who are from lower socioeconomic groups, or are younger, and those living in rural areas.

scholarly journals Factors associated with small- and large-for-gestational-age in socioeconomically vulnerable individuals in the 100 Million Brazilian Cohort

2021 ◽  
Author(s):  
Ila R Falcão ◽  
Rita de Cássia Ribeiro-Silva ◽  
Marcia Furquim de Almeida ◽  
Rosemeire L Fiaccone ◽  
Natanael J Silva ◽  
...  
Keyword(s):  
Gestational Age ◽  
Multinomial Logistic Regression ◽  
Mixed Race ◽  
Sociodemographic Factors ◽  
Reproductive Age ◽  
Large For Gestational Age ◽  
Maternal Characteristics ◽  
Factors Associated ◽  
Study Population ◽  
Brazilian Populations

ABSTRACT Background Evidence points to diverse risk factors associated with small- (SGA) and large-for-gestational-age (LGA) births. A more comprehensive understanding of these factors is imperative, especially in vulnerable populations. Objectives To estimate the occurrence of and sociodemographic factors associated with SGA and LGA births in poor and extremely poor populations of Brazil. Methods The study population consisted of women of reproductive age (14–49 y), whose last child was born between 2012 and 2015. INTERGROWTH 21st consortium criteria were used to classify weight for gestational age according to sex. Multinomial logistic regression modeling was performed to investigate associations of interest. Results Of 5,521,517 live births analyzed, SGA and LGA corresponded to 7.8% and 17.1%, respectively. Multivariate analysis revealed greater odds of SGA in children born to women who self-reported as black (OR: 1.21; 95% CI: 1.19, 1.22), mixed-race (parda) (OR: 1.08; 95% CI: 1.07, 1.09), or indigenous (OR: 1.11; 95% CI: 1.06, 1.15), were unmarried (OR: 1.08; 95% CI: 1.07, 1.08), illiterate (OR: 1.47; 95% CI: 1.42, 1.52), did not receive prenatal care (OR: 1.57; 95% CI: 1.53, 1.60), or were aged 14–20 y (OR: 1.21; 95% CI: 1.20, 1.22) or 35–49 y (OR: 1.12; 95% CI: 1.10, 1.13). Considering LGA children, higher odds were found in infants born to women living in households with ≥3 inadequate housing conditions (OR: 1.11; 95% CI: 1.10, 1.12), in indigenous women (OR: 1.22; 95% CI: 1.19, 1.25), those who had 1–3 y of schooling (OR: 1.18; 95% CI: 1.17, 1.19), 1–3 prenatal visits (OR: 1.16; CI 95%: 1.14, 1.17), or were older (OR: 1.26; 95% CI: 1.25, 1.27). Conclusions In poorer Brazilian populations, socioeconomic, racial, and maternal characteristics are consistently associated with the occurrence of SGA births, but remain less clearly linked to the occurrence of LGA births.

Factors Associated with Antimicrobial Use in Nursing Homes: A Multilevel Model

2008 ◽  
Vol 56 (11) ◽  
pp. 2039-2044 ◽  
Author(s):  
Stephen R. Benoit ◽  
Wato Nsa ◽  
Chesley L. Richards ◽  
Dale W. Bratzler ◽  
Abigail M. Shefer ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Multilevel Model ◽  
Antimicrobial Use ◽  
Factors Associated

scholarly journals Exploring Attitudes About the Legality of Self-Managed Abortion in the US: Results from a Nationally Representative Survey

2021 ◽  
Author(s):  
Sarah Raifman ◽  
M. Antonia Biggs ◽  
Lauren Ralph ◽  
Katherine Ehrenreich ◽  
Daniel Grossman
Keyword(s):  
Multinomial Logistic Regression ◽  
Public Attitudes ◽  
The United States ◽  
Public Affairs ◽  
Policy Implications ◽  
Reproductive Age ◽  
Factors Associated ◽  
The Us ◽  
The Law ◽  
Nationally Representative

Abstract Introduction Twenty-four states have at least one law in place that could be used to prosecute people for self-managed abortion (SMA), or the termination of a pregnancy outside of the formal healthcare system. We investigated factors associated with public attitudes about SMA legality and legal access to abortion more generally. Methods In August 2017, we surveyed a nationally representative sample of English- and Spanish-speaking women ages 18–49 years in the United States (US) using Ipsos Public Affairs’ KnowledgePanel. Unadjusted and adjusted multinomial logistic regression estimates identify characteristics associated with believing that SMA should not be against the law, compared to should be against the law, with weighting to account for sampling into the panel. Results Overall, 76% (95% CI: 74.3%-77.1%) and 59% (95% CI: 57.3%-60.4%) of participants (n = 7,022, completion rate 50%) reported that abortion and SMA, respectively, should not be against the law; 1% and 19% were unsure. Among those living in a state with at least one law that could be used to prosecute an individual for SMA, the majority (55%, 95% CI: 52.7%-57.9%) believed SMA should not be against the law. Factors associated with believing SMA should not be against the law, compared to should be against the law, included prior abortion experience and higher levels of education and income. Conclusion Most reproductive age women in the US believe that SMA should not be criminalized. There is more uncertainty about SMA legality than about the legality of abortion more generally. Policy Implications US laws that criminalize SMA are not supported by the majority of the people living in their jurisdictions.

scholarly journals Factors Associated with Frailty According to Gender of Older Adults Living Alone

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 475
Author(s):  
Hye-Young Jang ◽  
Ji-Hye Kim
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Nutritional Status ◽  
Chronic Diseases ◽  
Multinomial Logistic Regression ◽  
Living Alone ◽  
Factors Associated ◽  
Chi Squared ◽  
Korean Elderly

This study was conducted to identify the factors associated with frailty according to gender of older adults living alone in Korea. Data from the National Survey of the Living Conditions of Korean Elderly in 2017 were used. Participants were 2340 older adults who live alone. Frailty was determined based on the frailty criteria developed by van Kan et al. that consist of fatigue, resistance, ambulation, and illness. The collected data were analyzed using descriptive statistics, chi-squared test, t-test, Jonckheere–Terpstra test and multinomial logistic regression. Among the older men living alone, 47.7% were in the pre-frail and 5.1% were in the frail. On the other hand, 51.8% were in the pre-frail and 12.2% were in the frail among the older women living alone. The factors associated with frailty according to gender are as follows. In males, depressive symptoms, limitation in IADL, and number of medications in pre-frail; BMI, limitation in IADL, and number of chronic diseases in frail. In females, depressive symptoms, number of chronic diseases, age, and nutritional status in pre-frail; limitation in IADL, depressive symptoms, age, number of chronic diseases, number of medications, nutritional status in frail. Based on the findings of this study, it is considered necessary to approach frailty management considering gender as well as the classification of frailty.

Factors Associated with Intermittent, Constant, and Mixed Pain in People with Knee Osteoarthritis

2021 ◽  
Author(s):  
Fatme Hoteit ◽  
Debbie Erhmann Feldman ◽  
Lisa C. Carlesso
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Function ◽  
Multinomial Logistic Regression ◽  
Secondary Analysis ◽  
Cross Sectional ◽  
System Sensitivity ◽  
Factors Associated ◽  
Lower Likelihood ◽  
Paindetect Questionnaire ◽  
Mixed Pain

Purpose: To explore factors associated with intermittent, constant, and mixed pain in people with knee osteoarthritis. Method: We conducted a secondary analysis of a cross-sectional multicenter study with adults ≥ 40 years with knee osteoarthritis. Participants completed questionnaires on personal (e.g., demographics, comorbidities), physical (e.g., physical function), psychological (e.g., depressive symptoms), pain (e.g., qualities), and tests for physical performance and nervous system sensitivity. We qualified patients’ pain as intermittent, constant, or mixed using the Modified painDETECT Questionnaire and assessed associations with the variables using multinomial logistic regression. Results: The 279 participants had an average age of 63.8 years (SD = 9.6), BMI of 31.5 kg/m2 (SD = 8.7), and 58.6% were female. Older age (odds ratio [OR] 0.95; 95% CI: 0.90, 1.00) and higher self-reported physical function ([OR] 0.94; 95% CI: 0.91, 0.98) were associated with a lower likelihood of mixed pain compared with intermittent pain. Higher pain intensity ([OR] 1.25; 95% CI: 1.07, 1.47) was related to a 25% higher likelihood of mixed pain compared with intermittent pain. Conclusions: This study provides initial data for associations of personal, pain, and physical function factors with different pain patterns. Awareness of these factors can help clinicians develop targeted strategies for managing patients’ pain.

scholarly journals Factors Associated with Nutritional Status of the Under Five Children

2010 ◽  
Vol 1 (1) ◽  
pp. 6-8 ◽  
Author(s):  
Amita Pradhan
Keyword(s):  
Body Mass Index ◽  
Nutritional Status ◽  
Body Mass ◽  
Multinomial Logistic Regression ◽  
Wealth Index ◽  
Significant Variable ◽  
Under Five ◽  
Factors Associated ◽  
Female Headed Households ◽  
Size At Birth

Objective: To identify factors associated to the nutritional status of under five children.Method: The data used in this analysis are from Demographic and Health Survey 2006 conducted in Nepal. Total 5262 cases are included in the present study. A multinomial logistic regression model is used to study the relation between various factors and nutritional status.Results: Increasing body mass index of mothers and wealth index shows decreasing likelihood of malnutrition among children. Rural children show insignificant higher likelihood of different forms of underweight and wasting as compared to urban area. Frequency of listening radio does not show significant association in case of mild and moderate wasting and shown very high unusual odds ratio in case of severe wasting.  Similarly, lower frequency of watching television also does not show significantly higher likeliness of different form of stunting, underweight and wasting. Female children are more likely to be stunted, underweight and wasted as compared to male. Female headed households are more likely to have moderately and mildly stunted children and mixed results are observed for underweight and wasting. The likelihood for all forms of malnutrition is higher among children with smaller than average size at birth as compared to average or bigger size at birth.  Mixed results are observed regarding likelihood of different forms of malnutrition among children with mothers having different educational level.Conclusion: Body mass index of mothers is found significant variable while explaining children's nutritional status. Similarly, Size at birth is significantly associated with nutrition during the childhood.Keywords: Stunting; wasting; under weight; under five childrenDOI: 10.3126/ajms.v1i1.2927Asian Journal of Medical Sciences Vol.1(1) 2010 p.6-8

Sign in / Sign up

Export Citation Format

Share Document