The Global Impact of COVID-19 on Craniomaxillofacial Surgeons

Study Design: The COrona VIrus Disease-19 (COVID-19) pandemic has disrupted craniomaxillofacial (CMF) surgeons practice worldwide. We implemented a cross-sectional study and enrolled a sample of CMF surgeons who completed a survey. Objective: To measure the impact that COVID-19 has had on CMF surgeons by (1) identifying variations that may exist by geographic region and specialty and (2) measuring access to adequate personal protective equipment (PPE) and identify factors associated with limited access to adequate PPE. Methods: Primary outcome variable was availability of adequate PPE for health-care workers (HCWs) in the front line and surgeons. Descriptive and analytic statistics were computed. Level of statistical significance was set at P < .05. Binary logistic regression models were created to identify variables associated with PPE status (adequate or inadequate). Results: Most of the respondents felt that hospitals did not provide adequate PPE to the HCWs (57.3%) with significant regional differences ( P = .04). Most adequate PPE was available to surgeons in North America with the least offered in Africa. Differences in PPE adequacy per region ( P < .001) and per country ( P < .001) were significant. In Africa and South America, regions reporting previous virus outbreaks, the differences in access to adequate PPE evaporated compared to Europe ( P = .18 and P = .15, respectively). Conclusion: The impact of COVID-19 among CMF surgeons is global and adversely affects both clinical practice and personal lives of CMF surgeons. Future surveys should capture what the mid- and long-term impact of the COVID-19 crisis will look like.

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The number of household members as a risk factor for peptic ulcer disease

Scientific Reports ◽

10.1038/s41598-021-84892-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Mi Hong Yim ◽

Keun Ho Kim ◽

Bum Ju Lee

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

Living Alone ◽

Cross Sectional ◽

Ulcer Disease ◽

Logistic Regression Models ◽

Household Members ◽

H Pylori

AbstractPeptic ulcer disease (PUD) is caused by many sociodemographic and economic risk factors other than H. pylori infection. However, no studies reported an association between PUD and the number of household members. We showed the number of family members affected by PUD based on sex in a Korean population. This cross-sectional study used 1998–2009 data from the Korea National Health and Nutrition Examination Survey of the Korea Centers for Disease Control and Prevention. Multiple binary logistic regression models adjusted for confounders were constructed to analyze the association of PUD with the number of household members. The number of household members was associated with PUD, age, body mass index (BMI), waist circumference, systolic blood pressure, hemoglobin, glucose, location (urban/rural), income, education level, stress, current drinking, and smoking in both sexes. Men with other household members had a higher PUD risk compared to men or women living alone (reference), and the opposite was observed for women. Men with 4 household members had a higher PUD risk than men living alone in the model adjusted for age, BMI, income, location, education, and stress (OR = 2.04 [95% CI 1.28–3.27], p value = .003). Women with more than 6 household members had a lower PUD risk than women living alone in the adjusted model (OR = 0.50 [0.33–0.75], p value = .001). Women with more household members had a lower PUD risk. However, more men had PUD than women regardless of the number of household members.

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Timely Initiation of Breast Feeding and Associated Factors among Caesarian Section Delivered Mothers in Health Facilities of Dessie City Administration, North Eastern Ethiopia

Pediatric Reports ◽

10.3390/pediatric13010001 ◽

2020 ◽

Vol 13 (1) ◽

pp. 1-8

Author(s):

Roza Shiferaw ◽

Sisay Eshete Tadesse ◽

Tefera Chane Mekonnen ◽

Aregash Abebayehu Zerga

Keyword(s):

Cesarean Section ◽

Breast Feeding ◽

Associated Factors ◽

Statistical Significance ◽

Data Entry ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

Cross Sectional ◽

Timely Initiation ◽

Eastern Ethiopia

Objective: To assess the magnitude and associated factors of timely initiation of breastfeeding among cesarean section delivered mothers. Methods: A health facility-based cross-sectional study was employed among 421 systematically selected mothers from February to June, 2017. Data were collected by a structured questionnaire. Data entry and analysis was done using Epi Data and SPSS version 24. Binary logistic regression was computed to identify factors. Adjusted odds ratio with a 95% confidence interval was used to declare statistical significance. Result: The magnitude of timely initiation of breast feeding (among mothers who gave birth by cesarean section was 57%. Counseling during antenatal care (AOR = 3.32; 95% CI: 1.80, 6.13), facility where cesarean section (CS) was performed (AOR = 2.55; 95% CI: 1.57, 4.14), and post-CS counseling (AOR = 6.93; 95% CI: 3.99, 12.02) were factors that contributed for the practice of timely initiation among cesarean section delivered mothers. Conclusions: The magnitude of TIBF was good. Counseling during ANC, the facility where CS was performed and post-natal advice were factors associated with TIBF. Implementation of baby-friendly hospital initiatives should be strengthened in order to promote timely initiation of breast feeding.

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Do Hospitals with a Higher Level of Maternal Care Designation Have Better Maternal Outcomes?

American Journal of Perinatology ◽

10.1055/s-0038-1672140 ◽

2018 ◽

Vol 36 (06) ◽

pp. 653-658 ◽

Cited By ~ 2

Author(s):

Sindhu Srinivas ◽

Katy Kozhimannil ◽

Peiyin Hung ◽

Laura Attanasio ◽

Judy Jou ◽

...

Keyword(s):

High Risk ◽

Maternal Care ◽

Maternal Morbidity ◽

Cross Sectional Study ◽

Severe Maternal Morbidity ◽

Maternal Outcomes ◽

Cross Sectional ◽

Discharge Data ◽

Logistic Regression Models ◽

The Impact

Background A recent document by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine introduced the concept of uniform levels of maternal care (LMCs). Objective We assessed LMC across hospitals and measured their association with maternal morbidity, focusing on women with high-risk conditions. Study Design We collected data from hospitals from May to November 2015 and linked survey responses to Statewide Inpatient Databases (SID) hospital discharge data in a retrospective cross-sectional study of 247,383 births admitted to 236 hospitals. Generalized logistic regression models were used to examine the associations between hospitals' LMC and the risk of severe maternal morbidity. Stratified analyses were conducted among women with high-risk conditions. Results High-risk pregnancies were more likely to be managed in hospitals with higher LMC (p < 0.001). Women with cardiac conditions had lower odds of maternal morbidity when delivered in level I compared with level IV units (adjusted odds ratio: 0.29; 95% confidence interval: 0.08–0.99; p = 0.049). There were no other significant associations between the LMC and severe maternal morbidity. Conclusion A higher proportion of high-risk pregnancies were managed within level IV units, although there was no overall evidence that these births had superior outcomes. Further prospective evaluation of LMC designation with patient outcomes is necessary to determine the impact of regionalization on maternal outcomes.

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Willingness to Accept COVID-19 Vaccine and Its Determinants among Nigeria Citizens: A Web-based Cross-sectional Study

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i830881 ◽

2021 ◽

pp. 13-22

Author(s):

Olanrewaju Davies Eniade ◽

Abayomi Olarinmoye ◽

Agofure Otovwe ◽

Funke E. Akintunde ◽

Omowumi O. Okedare ◽

...

Keyword(s):

Binary Logistic Regression ◽

Cross Sectional Study ◽

Outcome Variable ◽

Willingness To Accept ◽

Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Other Information ◽

Level Of Significance ◽

To Receive

Background: The peculiarity in Nigerians’ demographic, socio-economic and cultural pattern necessitated the need to explore potential COVID-19 vaccine acceptance. This study investigated the determinants of willingness to receive COVID-19 vaccine in Nigeria. Methods: An online cross-sectional study among the general population in Nigeria. Data were collected using an electronic questionnaire. A total of 368 individuals participated in the research. The outcome variable was willingness to accept COVID-19 vaccine coded as “Yes=1 and No=0.” Basic socio-demographic information of participants and other information related to COVID-19 were obtained. Stata MP 14 was used for the statistical analysis. Descriptive statistics were presented, test of association were carried out using chi square and a binary logistic regression was used to assess the determinants of willingness to accept COVID-19 vaccine. All analyses were performed at 5% level of significance. Results: The mean age of the respondents was 29.4 + 9.65 years. Majority of the study participants were female (58.9%), Yoruba (74.7%) and dwellers of urban area (68.5%). Also, 85.6% have attained tertiary level of education. Two-fifth (40.5%) of respondent reported their willingness to take the COVID-19 if made available. Majority (69.8%) of those that are willing to take the vaccine would prefer a live attenuated form and 39.6% would prefer the vaccine administered intramuscularly. Age group≥40 years (AOR: 5.20, CI: 1.02- 26.41), currently married (AOR: 2.81, CI: 1.05 – 7.53) and susceptibility to COVID 19 infection (AOR: 2.52, CI: 1.21 – 5.26) were associated with likelihood of willingness to accept COVID-19 vaccine. Conclusion: Despite the fact that majority were at risk of COVID-19 infection, willingness to receive COVID-19 vaccine was low among Nigerians. Level of maturity in terms of age and marriage as well as susceptibility to COVID-19 infection increased the likelihood of accepting COVID-19 infection. In Furtherance, younger ones, unmarried and non-susceptible individual may require more efforts tailored towards enrichment of understanding about the importance of COVID-19 vaccine in other to improve the acceptance of COVID-19 vaccine in Nigeria.

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Is there an association between ageist attitudes and frailty?

BMC Geriatrics ◽

10.1186/s12877-019-1357-y ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Douglas Salguero ◽

Juliana Ferri-Guerra ◽

Nadeem Y. Mohammed ◽

Dhanya Baskaran ◽

Raquel Aparicio-Ugarriza ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Multinomial Logistic Regression ◽

Frailty Index ◽

Cross Sectional Study ◽

Community Dwelling ◽

Outcome Variable ◽

Cross Sectional ◽

Logistic Regression Models ◽

Frailty Status

Abstract Background Frailty is defined as a state of vulnerability to stressors that is associated with higher morbidity, mortality and healthcare utilization in older adults. Ageism is “a process of systematic stereotyping and discrimination against people because they are old.” Explicit biases involve deliberate or conscious controls, while implicit bias involve unconscious processes. Multiple studies show that self-directed ageism is a risk factor for increased morbidity and mortality. The purpose of this study was to determine whether explicit ageist attitudes are associated with frailty in Veterans. Methods This is a cross-sectional study of Veterans 50 years and older who completed the Kogan’s Attitudes towards Older People Scale (KAOP) scale to assess explicit ageist attitudes and the Implicit Association Test (IAT) to evaluate implicit ageist attitudes from July 2014 through April 2015. We constructed a frailty index (FI) of 44 variables (demographics, comorbidities, number of medications, laboratory tests, and activities of daily living) that was retrospectively applied to the time of completion of the KAOP and IAT. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multinomial logistic regression models with frailty status (robust, prefrail and frail) as the outcome variable, and with KAOP and IAT scores as the independent variables. Age, race, ethnicity, median household income and comorbidities were considered as covariates. Results Patients were 89.76% male, 48.03% White, 87.93% non-Hispanic and the mean age was 60.51 (SD = 7.16) years. The proportion of robust, pre-frail and frail patients was 11.02% (n = 42), 59.58% (n = 227) and 29.40% (n = 112) respectively. The KAOP was completed by 381 and the IAT by 339 participants. In multinomial logistic regression, neither explicit ageist attitudes (KAOP scale score) nor implicit ageist attitudes (IAT) were associated with frailty in community dwelling Veterans after adjusting for covariates: OR = .98 (95% CI = .95–1.01), p = .221, and OR:=.97 (95% CI = .37–2.53), p = .950 respectively. Conclusions This study shows that neither explicit nor implicit ageist attitudes were associated with frailty in community dwelling Veterans. Further longitudinal and larger studies with more diverse samples and measured with other ageism scales should evaluate the independent contribution of ageist attitudes to frailty in older adults.

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The impact of diabetes on multiple avoidable admissions: a cross-sectional study

BMC Health Services Research ◽

10.1186/s12913-019-4840-4 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Joana Seringa ◽

Ana Patrícia Marques ◽

Bruno Moita ◽

Cátia Gaspar ◽

João Filipe Raposo ◽

...

Keyword(s):

Logistic Regression ◽

Age Groups ◽

Health Care Expenditures ◽

Cross Sectional Study ◽

Health Concern ◽

Diabetes Diagnosis ◽

Cross Sectional ◽

Younger Adults ◽

Logistic Regression Models ◽

The Impact

Abstract Background Multiple admissions for ambulatory care sensitive conditions (ACSC) are responsible for an important proportion of health care expenditures. Diabetes is one of the conditions consensually classified as an ACSC being considered a major public health concern. The aim of this study was to analyse the impact of diabetes on the occurrence of multiple admissions for ACSC. Methods We analysed inpatient data of all public Portuguese NHS hospitals from 2013 to 2015 on multiple admissions for ACSC among adults aged 18 or older. Multiple ACSC users were identified if they had two or more admissions for any ACSC during the period of analysis. Two logistic regression models were computed. A baseline model where a logistic regression was performed to assess the association between multiple admissions and the presence of diabetes, adjusting for age and sex. A full model to test if diabetes had no constant association with multiple admissions by any ACSC across age groups. Results Among 301,334 ACSC admissions, 144,209 (47.9%) were classified as multiple admissions and from those, 59,436 had diabetes diagnosis, which corresponded to 23,692 patients. Patients with diabetes were 1.49 times (p < 0,001) more likely to be admitted multiple times for any ACSC than patients without diabetes. Younger adults with diabetes (18–39 years old) were more likely to become multiple users. Conclusion Diabetes increases the risk of multiple admissions for ACSC, especially in younger adults. Diabetes presence is associated with a higher resource utilization, which highlights the need for the implementation of adequate management of chronic diseases policies.

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A predictive model for early diagnosis of keratoconus

10.21203/rs.2.21162/v2 ◽

2020 ◽

Author(s):

GRACIA CASTRO-LUNA ◽

ANTONIO PÉREZ-RUEDA

Keyword(s):

Logistic Regression ◽

Predictive Model ◽

Corneal Thickness ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

Bivariate Analysis ◽

Diagnostic Model ◽

Binary Logistic Regression Model ◽

Cross Sectional ◽

Logistic Regression Models

Abstract Background: The diagnosis of keratoconus in the early stages of the disease is necessary to initiate an early treatment of keratoconus. Furthermore to avoid possible refractive surgery that could produce ectasias. This study aims to describe the topographic, pachymetric and aberrometry characteristics in patients with keratoconus, subclinical keratoconus and normal corneas. Additionally to propose a diagnostic model of subclinical keratoconus based in binary logistic regression models Methods: The design was a cross-sectional study. It included 205 eyes from 205 patients distributed in 82 normal corneas, 40 subclinical keratoconus and 83 established keratoconus The rotary Scheimpflug camera (Pentacam® type) analyzed the topographic, pachymetric and aberrometry variables. It performed a descriptive and bivariate analysis of the recorded data. A diagnostic and predictive model of subclinical keratoconus was calculated with the statistically significant variables Results: Statistically significant differences were observed when comparing normal corneas with subclinical keratoconus/ in variables of the vertical asymmetry to 90º and the central corneal thickness. The binary logistic regression model included the minimal corneal thickness, the anterior coma to 90º and posterior coma to 90º. The model properly diagnosed 92% of cases Conclusions: The differential diagnosis between normal cases and subclinical keratoconus depends on the mínimum corneal thickness, the anterior coma to 90º and the posterior coma to 90º.

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Early implanon discontinuation and associated factors among women ever used implanon in Mettu district, Oromia regional state, southwest Ethiopia, 2021

Reproductive Health ◽

10.1186/s12978-021-01222-8 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Hana Tesfaye ◽

Ebissa Negara ◽

Kenbon Bayisa

Keyword(s):

Side Effects ◽

Associated Factors ◽

Statistical Significance ◽

Descriptive Analysis ◽

Sampling Technique ◽

Cross Sectional Study ◽

Relative Effect ◽

Outcome Variable ◽

P Value ◽

Cross Sectional

Abstract Background Implanon is an effective form of long-acting reversible contraceptive used to prevent conception with a clinical failure rate of less than one per 100 users. However, in sub-Saharan countries the utilization of implanon was very low. Regardless of low utilization; its early discontinuation is very common in most developing countries including Ethiopia. Objectives To assess the prevalence of early implanon discontinuation and associated factors among women ever used implanon in Mettu district. Methods A community based cross-sectional study design was conducted from October 11 to December 4, 2020 G C. A total of 430 women were included in the study by systematic random sampling technique. Data were entered into epi data version 3.1 and analyzed by SPSS version 25.0. Descriptive analysis was computed to describe descriptive results. Logistics regression was computed to see the relative effect of factors on the outcome variable. Adjusted odds ratio was calculated with 95% confidence intervals to show strength of association and p-value < 0.05 was used to declare statistical significance. The finding of the study was presented using narrations, tables and chart. Result The total proportion of early implanon discontinuation among 430 mothers was 19.3%. Women who did not counseled about the presence of alternatives methods [AOR = 2.28: 95% CI (1.22–4.26)], women who experienced dizziness after insertion of implanon [AOR = 1.90: 95% CI (1.06–3.43)] and being having menstrual disturbance after insertion of implanon [AOR = 2.17: 95% CI (1.16–4.08)] were significantly associated with early implanon discontinuation. Women who were counseled about the advantage of implanon [AOR: 0.49: 95% CI (0.28–0.87)] were protective from early implanon discontinuation. Conclusion and recommendation Early implanon discontinuation among mothers was found to be high. Hence, effective counseling on advantages and side effects of implanon and proper management of the side effects should be made to increase implanon retention.

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Frequency of Fits in Pregnant Women with Previously Controlled Epilepsy

10.53350/pjmhs211571843 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1843-1846

Author(s):

Jawad Hussain ◽

Muhammad Saqib ◽

Nadia Khan ◽

Sohail Khan ◽

Fawad Jan ◽

...

Keyword(s):

Sleep Deprivation ◽

Pregnant Women ◽

Statistical Significance ◽

Drug Regimen ◽

Cross Sectional Study ◽

Childbearing Age ◽

Keywords Epilepsy ◽

Cross Sectional ◽

The Impact ◽

Epileptic Women

Background: Epilepsy drug therapy advancements have resulted in an increasing number of childbearing age well-controlled epileptic women. It is not surprising then, that the impact of pregnancy on the progression of epilepsy has sparked renewed interest. Aim: The aim of current study was to evaluate the frequency of fits or seizure in pregnant women with previously controlled epilepsy. Materials and Methods: This cross-sectional study was carried out on 98 pregnancies of 84 epileptic women during the period between August 2019 and August 2021in the department of neurology and gynaecology of Ayub Teaching Hospital, Abbottabad. All the pregnant women with less than three verified epileptic fits, pregnancy ended with abortion and incomplete seizure or fit frequency were excluded. All the patients were referred to Gynaecology and Neurology department for early pregnancy and planning by a neurologist and gynaecologist. Data analysis was done with SPSS version 23 with p<0.05 as statistical significance. Results: The association of fits frequency on pregnancy was studied and monitored in 84 epileptic women out of 98pregnancies. About 49 (50%) pregnancies were not affected by fits frequency. The fits frequency was increased in 36 (37%) pregnancies or puerperium while decreased in 13 (13%) pregnancies. Sleep deprivation or drug regimen on-compliances associated was increased in 30 (30.6%) pregnancies. Out of 19pregnancies, eight (42%) had improvement with sleep deprivation correction during none months pre-gestation. Antiepileptic drugs with low plasma concentration of uncontrolled epilepsy during pregnancy were found in 47%. Conclusion: Sleep deprivation, Non-compliance during pregnancy, and before and after pregnancy inadequate therapy all have a significant impact on the course of epilepsy during pregnancy. With proper medical care, pregnancy appears to have only a minor impact on the course of epilepsy. Keywords: Epilepsy, Frequency fits, Sleep Deprivation.

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Association between Human Development Index and Delay on Arrival to Stroke Unit

10.5327/1516-3180.668 ◽

2021 ◽

Author(s):

Gabriel Souza Suzart ◽

Ingrid Sanchez ◽

Daniel Guimarães ◽

Pedro Augusto Assis Lopes ◽

Pedro Antonio Pereira de Jesus

Keyword(s):

Human Development ◽

Human Development Index ◽

Statistical Significance ◽

Cross Sectional Study ◽

Cross Sectional ◽

Development Index ◽

Specialized Service ◽

Time Of Admission ◽

The Impact ◽

Very High

Background: Stroke outcomes depend somehow on the time taken from the symptoms onset until arrival to the specialized service. However, as it lacks literature exploring the impact of socio-demographics factors on this time, we investigated the association between Human Development Index and delay on arrival to specialized service. Design and setting: Cross-sectional study from a prospective cohort (PMID=33719516) at Hospital Geral Roberto Santos. Methods: From a total of 454 stroke patients, 156 were included in this study because they had registered address, time of admission and of symptoms onset. Patients had HDI defined by their address and were grouped into HDI categories. Results: In our sample, 57 (36,5%) individuals had medium HDI, 70 (44,9%) high HDI and 29 (18,6%) very high HDI. Very high HDI patients’ delay (2:01; 1:22-2:57) was lower than high HDI (3:05; 2:05-5:26) and medium HDI (2:25;1:45-4:04) patients. There was statistical significance comparing these groups (X²=11,41;p<0,05), but a post-hoc test revealed statistical difference just between the very high HDI and high HDI groups (p<0.05). Conclusions: We expected to find a direct relation between delay on arrival to the stroke service and HDI categories. However, this was not observed. *Authors contributed equally.

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