Is the place of birth related to the mother’s satisfaction with childbirth? A cross-sectional study in a rural district of the Lao People’s Democratic Republic (Lao PDR)

Abstract Background The place of birth has been rapidly changing from home to health facility in Lao People’s Democratic Republic (Lao PDR) following the strategy to improve the maternal and neonatal mortality. This change in the place of birth might affect the mother’s satisfaction with childbirth. The objective of this study was to assess whether the place of birth is related to the mother’s satisfaction with childbirth in a rural district of the Lao PDR. Methods A community-based survey was implemented in 21 randomly selected hamlets in Xepon district, Savannakhet province, between February and March, 2016. Questionnaire-based interviews were conducted with mothers who experienced a normal vaginal birth in the past 2 years. Satisfaction with childbirth was measured by the Satisfaction with Childbirth Experience Questionnaire. Using the median, the outcome variable was dichotomized into “high satisfaction group” and “low satisfaction group”. Logistic regression was performed to assess the association between place of birth and satisfaction with childbirth. Three models were examined: In Model 1, only the predictor of interest (i.e., place of birth) was included. In Model 2, the predictor of interest and the obstetrical predictors were included. In Model 3, in addition to these predictors, socio-demographic and economic predictors were included. A mixed-effects model was used to account for the hierarchical structure. Results Among the 226 mothers who were included in data analysis, 60.2% gave birth at the health facility and the remaining 39.8% gave birth at home. Logistic regression analysis showed that the mothers who gave birth at the health facility were significantly more likely to have a higher level of satisfaction compared to the mothers who gave birth at home (crude odds ratio: 5.44, 95% confidence interval: 3.03 to 9.75). This association remained even after adjusting for other predictors (adjusted odds ratio: 6.05, 95% confidence interval: 2.81 to 13.03). Conclusion Facility-based birth was significantly associated with a higher level of satisfaction with childbirth among the mothers in the study district where maternal and neonatal mortalities are relatively high. The findings of the present study support the promotion of facility-based birth in a rural district of the Lao PDR.

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Prediction of Hospital Mortality Rates by Admission Laboratory Tests

Clinical Chemistry ◽

10.1373/clinchem.2005.059030 ◽

2006 ◽

Vol 52 (2) ◽

pp. 325-328 ◽

Cited By ~ 53

Author(s):

Paul Froom ◽

Zvi Shimoni

Keyword(s):

Internal Medicine ◽

Logistic Regression ◽

Confidence Interval ◽

Regression Model ◽

Odds Ratio ◽

Laboratory Tests ◽

Logistic Regression Model ◽

Complete Blood Count ◽

Laboratory Data ◽

Regional Hospital

Abstract Background: The aim of this study was to explore whether electronically retrieved laboratory data can predict mortality in internal medicine departments in a regional hospital. Methods: All 10 308 patients hospitalized in internal medicine departments over a 1-year period were included in the cohort. Nearly all patients had a complete blood count and basic clinical chemistries on admission. We used logistic regression analysis to predict the 573 deaths (5.6%), including all variables that added significantly to the model. Results: Eight laboratory variables and age significantly and independently contributed to a logistic regression model (area under the ROC curve, 88.7%). The odds ratio for the final model per quartile of risk was 6.44 (95% confidence interval, 5.42–7.64), whereas for age alone, the odds ratio per quartile was 2.01 (95% confidence interval, 1.84–2.19). Conclusions: A logistic regression model including only age and electronically retrieved laboratory data highly predicted mortality in internal medicine departments in a regional hospital, suggesting that age and routine admission laboratory tests might be used to ensure a fair comparison when using mortality monitoring for hospital quality control.

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Corticosteroid injection for coccydynia

Bone & Joint Open ◽

10.1302/2633-1462.111.bjo-2020-0146 ◽

2020 ◽

Vol 1 (11) ◽

pp. 709-714

Author(s):

Vilhjalmur Finsen ◽

Ante M. Kalstad ◽

Rainer G. Knobloch

Keyword(s):

Logistic Regression ◽

Confidence Interval ◽

Odds Ratio ◽

Corticosteroid Injection ◽

Term Efficacy ◽

Early Success ◽

Cortisone Injection ◽

Short And Long Term ◽

Regression Tests

Aims We aimed to establish the short- and long-term efficacy of corticosteroid injection for coccydynia, and to determine if betamethasone or triamcinolone has the best effect. Methods During 2009 to 2016, we treated 277 patients with chronic coccydynia with either one 6 mg betamethasone or one 20 mg triamcinolone cortisone injection. A susequent injection was given to 62 (26%) of the patients. All were reviewed three to four months after injection, and 241 replied to a questionnaire a mean of 36 months (12 to 88) after the last injection. No pain at the early review was considered early success. When the patient had not been subsequently operated on, and indicated on the questionnaire that they were either well or much better, it was considered a long-term success. Results At the three- to four-month review, 22 (9%) reported that they had no pain. The long-term success of one injection was 15% and rose to 29% after a second injection. Logistic regression tests showed that both early success (odds ratio (OR) 5.5, 95% confidence interval (CI) 2.1 to 14.4; p = 0.001) and late success (OR 3.7, 95% CI 1.7 to 8.3; p = 0.001) was greater with triamcinolone than with betamethasone. Late success was greater for patients with symptoms for less than 12 months (OR 3.0, 95% CI 1.4 to 6.7; p = 0.006). We saw no complications of the injections. Conclusion We conclude that the effect of corticosteroid injection for coccygodynia is moderate, possibly because we used modest doses of the drugs. Even so, they seem worthwhile as they are easily and quickly performed, and complications are rare. If the choice is between injections of betamethasone or triamcinolone, the latter should be selected. Cite this article: Bone Joint Open 2020;1-11:709–714.

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Do physical activity levels differ by number of children at home in women aged 25–44 in the general population?

Women s Health ◽

10.1177/1745506519871186 ◽

2019 ◽

Vol 15 ◽

pp. 174550651987118 ◽

Cited By ~ 1

Author(s):

Laura P Abell ◽

Kelly A Tanase ◽

Madison L Gilmore ◽

Anna E Winnicki ◽

Victor L Holmes ◽

...

Keyword(s):

Physical Activity ◽

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Activity Level ◽

Activity Levels ◽

Related Factors ◽

Number Of Children ◽

Physical Activity Levels ◽

At Home

Objectives: While physical activity is important for health, many women do not meet recommended levels, particularly mothers. The purpose of this study was to assess whether physical activity levels differ by number of children at home in women aged 25–44 in the general US population. Methods: This cross-sectional analysis used 2017 Behavioral Risk Factor Surveillance System data for females aged 25–44 (N = 6266) from California, Colorado, New York, Texas, and Utah. Ordered logistic regression analysis assessed the relationship between physical activity levels and number of children at home while controlling for state and demographic, socioeconomic, and health-related factors. Results: About half of participants reported “inactive” or “insufficiently active” physical activity levels and about two-thirds reported having one or more children at home. The results of adjusted analysis indicated that physical activity level was significantly related to having one child (adjusted odds ratio = 0.75, 95% confidence interval = 0.63, 0.89), two children (adjusted odds ratio = 0.79; 95% confidence interval = 0.67, 0.93), and three or more children (adjusted odds ratio = 0.80, 95% confidence interval = 0.67, 0.94) at home. Conclusion: Overall, physical activity levels were significantly related to presence of children at home for women aged 25–44, but increasing number of children at home did not impact effect size. For women aged 25–44 in a primary care setting, a moderate prevalence of inactive or insufficiently active physical activity may be expected. Providers should address physical activity with all patients in this target population during well-visits, but particularly for women with children at home; educate patients about the health benefits of regular physical activity; and provide resources that will help them integrate physical activity into their daily lifestyles.

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Association of guideline publication and delays to treatment in pediatric status epilepticus

Neurology ◽

10.1212/wnl.0000000000010174 ◽

2020 ◽

Vol 95 (9) ◽

pp. e1222-e1235

Author(s):

Iván Sánchez Fernández ◽

Nicholas S. Abend ◽

Marta Amengual-Gual ◽

Anne Anderson ◽

Ravindra Arya ◽

...

Keyword(s):

Logistic Regression ◽

Status Epilepticus ◽

Confidence Interval ◽

Odds Ratio ◽

Pediatric Patients ◽

Convulsive Status Epilepticus ◽

Hospital Arrival ◽

Time To Treatment ◽

Patient Interviews ◽

Record Review

ObjectiveTo determine whether publication of evidence on delays in time to treatment shortens time to treatment in pediatric refractory convulsive status epilepticus (rSE), we compared time to treatment before (2011–2014) and after (2015–2019) publication of evidence of delays in treatment of rSE in the Pediatric Status Epilepticus Research Group (pSERG) as assessed by patient interviews and record review.MethodsWe performed a retrospective analysis of a prospectively collected dataset from June 2011 to September 2019 on pediatric patients (1 month–21 years of age) with rSE.ResultsWe studied 328 patients (56% male) with median (25th–75th percentile [p25–p75]) age of 3.8 (1.3–9.4) years. There were no differences in the median (p25–p75) time to first benzodiazepine (BZD) (20 [5–52.5] vs 15 [5–38] minutes, p = 0.3919), time to first non-BZD antiseizure medication (68 [34.5–163.5] vs 65 [33–142] minutes, p = 0.7328), and time to first continuous infusion (186 [124.2–571] vs 160 [89.5–495] minutes, p = 0.2236). Among 157 patients with out-of-hospital onset whose time to hospital arrival was available, the proportion who received at least 1 BZD before hospital arrival increased after publication of evidence of delays (41 of 81 [50.6%] vs 57 of 76 [75%], p = 0.0018), and the odds ratio (OR) was also increased in multivariable logistic regression (OR 4.35 [95% confidence interval 1.96–10.3], p = 0.0005).ConclusionPublication of evidence on delays in time to treatment was not associated with improvements in time to treatment of rSE, although it was associated with an increase in the proportion of patients who received at least 1 BZD before hospital arrival.

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Safety netting in routine primary care consultations: an observational study using video-recorded UK consultations

British Journal of General Practice ◽

10.3399/bjgp19x706601 ◽

2019 ◽

Vol 69 (689) ◽

pp. e878-e886 ◽

Cited By ~ 4

Author(s):

Peter J Edwards ◽

Matthew J Ridd ◽

Emily Sanderson ◽

Rebecca K Barnes

Keyword(s):

Primary Care ◽

Logistic Regression ◽

Observational Study ◽

Confidence Interval ◽

Treatment Planning ◽

Odds Ratio ◽

Adult Patients ◽

Specific Advice ◽

The Uk ◽

Safety Netting

BackgroundSafety-netting advice is information shared with a patient or their carer designed to help them identify the need to seek further medical help if their condition fails to improve, changes, or if they have concerns about their health.AimTo assess when and how safety-netting advice is delivered in routine GP consultations.Design and settingThis was an observational study using 318 recorded GP consultations with adult patients in the UK.MethodA safety-netting coding tool was applied to all consultations. Logistic regression for the presence or absence of safety-netting advice was compared between patient, clinician, and problem variables.ResultsA total of 390 episodes of safety-netting advice were observed in 205/318 (64.5%) consultations for 257/555 (46.3%) problems. Most advice was initiated by the GP (94.9%) and delivered in the treatment planning (52.1%) or closing (31.5%) consultation phases. Specific advice was delivered in almost half (47.2%) of episodes. Safety-netting advice was more likely to be present for problems that were acute (odds ratio [OR] 2.18, 95% confidence interval [CI] = 1.30 to 3.64), assessed first in the consultation (OR 2.94, 95% CI = 1.85 to 4.68) or assessed by GPs aged ≤49 years (OR 2.56, 95% CI = 1.45 to 4.51). Safety-netting advice was documented for only 109/242 (45.0%) problems.ConclusionGPs appear to commonly give safety-netting advice, but the contingencies or actions required on the patient’s part may not always be specific or documented. The likelihood of safety-netting advice being delivered may vary according to characteristics of the problem or the GP. How to assess safety-netting outcomes in terms of patient benefits and harms does warrant further exploration.

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Associations between Owners’ Reports of Unwanted Ridden Behaviour and In-Hand Behaviour in Horses

Animals ◽

10.3390/ani10122431 ◽

2020 ◽

Vol 10 (12) ◽

pp. 2431

Author(s):

Nicole Romness ◽

Kate Fenner ◽

Jessica McKenzie ◽

Ashley Anzulewicz ◽

Bibiana Burattini ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Confidence Interval ◽

Odds Ratio ◽

B Value ◽

Parallel Analysis ◽

Evidence Based ◽

Linear Modelling ◽

Reported Data ◽

First Time

An evidence-based understanding of dangerous or unwelcome behaviour in horses would greatly benefit both horses and humans who interact with them. Using owner-reported data from the Equine Behaviour Assessment and Research Questionnaire (E-BARQ), the current study investigated in-hand behaviours associated with dangerous or unwelcome ridden behaviours, notably bolting, rearing and bucking. Respondents (n = 1584) to the ridden horse section of the E-BARQ answered 42 demographic questions, followed by 268 behavioural items. Parallel analysis was conducted to group individual behaviours into rotated components to create independent and dependent indices. Multivariable general linear modelling and ordinal logistic regression were used to identify behaviours associated with bolting, rearing and bucking. Results revealed that safety-from-bolt increased as social confidence with horses (Odds ratio (OR) = 1.06; 95% confidence interval (cf = 1.02–1.09) and other animals (OR = 1.08; cf = 1.03–1.12), compliance in-hand (OR = 1.10; cf = 1.06–1.16) and tolerance of restraint (OR = 1.05; cf = 1.0–1.11) increased; and decreased as loading problems (OR = 0.95; cf = 0.92–0.99) increased. Safety-from-rear increased as tolerance of restraint (OR = 1.07; cf = 1.02–1.12) and social confidence with other animals (OR = 1.05; cf = 1.01–1.09) increased; and decreased as loading problems (OR = 0.94; cf = 0.91–0.98) increased. Safety-from-buck increased as social confidence with horses (b-value = 0.011, p < 0.001) and other animals (b-value = 0.010, p = 0.002), compliance in-hand (b-value = 0.015, p < 0.001), tolerance of restraint (b-value = 0.009, p = 0.027) and tolerance of haltering/bridling (b-value = 0.016, p = 0.010) increased, and it decreased as loading problems increased (b-value = −0.011, p < 0.001). By revealing, for the first time, that specific behaviours on the ground are associated with particular responses in the same horses when ridden, this study advances equitation science considerably. Identification of risk factors for dangerous behaviour while under saddle can improve safety for horses and riders and highlights the importance of effective and humane in-hand training.

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Relationship Between Line Bisection Test Time and Hemispatial Neglect Prognosis in Patients With Stroke: A Prospective Pilot Study

Annals of Rehabilitation Medicine ◽

10.5535/arm.19112 ◽

2020 ◽

Vol 44 (4) ◽

pp. 292-300

Author(s):

Shinyoung Kwon ◽

Wookyung Park ◽

MinYoung Kim ◽

Jong Moon Kim

Keyword(s):

Logistic Regression ◽

Visual Perception ◽

Confidence Interval ◽

Odds Ratio ◽

Line Bisection ◽

Test Time ◽

Hemispatial Neglect ◽

Stroke Patients ◽

Performance Time ◽

Performance Times

Objective To determine the relationship between line bisection test (LBT) performance time and prognosis of hemispatial neglect (HSN) in stroke patients.Methods Data on stroke patients with HSN were prospectively collected. After patient recruitment and eligibility screening, the LBT, Motor-Free Visual Perception Test 3rd edition, and Korean version of Mini-Mental State Examination were performed at the time of admission and 4 weeks thereafter. The LBT performance time was also measured. All patients received conventional rehabilitation for 4 weeks. Based on the improvements in their LBT grades, the patients were divided into improved and non-improved groups. The evaluation results of the two groups were compared using Mann–Whitney U-tests and logistic regression was performed to predict the independence of each outcome.Results In total, 26 stroke patients with HSN were included, with 13 patients in each group. Significant differences were observed in the baseline LBT performance times between the improved and non-improved groups (p<0.05). Logistic regression analysis revealed associations between HSN prognosis, and baseline LBT performance time (odds ratio=0.95; 95% confidence interval, 0.90–1.00; p<0.05) and baseline Motor-Free Visual Perception Test 3rd edition (odds ratio=1.20; 95% confidence interval, 1.01–1.43; p<0.05).Conclusion A significant relationship was observed between the baseline LBT performance time and HSN prognosis.

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Association between motoric cognitive risk syndrome and frailty among Chinese older adults

10.21203/rs.2.15390/v1 ◽

2019 ◽

Author(s):

Shanshan Shen ◽

Xingkun Zeng ◽

Liyu Xu ◽

Lingyan Chen ◽

Zixia Liu ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Regression Analysis ◽

Confidence Interval ◽

Logistic Regression Analysis ◽

Odds Ratio ◽

Cognitive Complaints ◽

Chinese Older Adults ◽

Cognitive Risk ◽

Subjective Cognitive Complaints

Abstract Background: Motoric cognitive risk syndrome (MCR) is a newly proposed pre-dementia syndrome incorporating subjective cognitive complaints and slow gait. Previous studies have shown that subjective cognitive complaints and slow gait are reported to be associated with frailty in cognitively unimpaired older adults, but little is known giving attention to the link between MCR and frailty in older adults. Therefore, the aim of the study was to explore the associations of MCR and its components and frailty in Chinese older adults. Methods: In an observation cross-sectional study, a total of 429 older adults aged 60 years and older were admitted to the geriatric department. According to MCR criteria, all participants were classified to 4 groups: 1) MCR group; 2) subjective cognitive complaints group; 3) slow gait group; 4) healthy control group. Physical frailty was assessed by Clinical Frailty Scale (CFS). The multivariate logistic regression analysis was used to examine the association between MCR and frailty in older adults. Results: The prevalence of subjective cognitive complaints, slow gait and MCR was 15.9%, 10.0% and 4.0%, respectively. After adjusting for confounding variables, the logistic regression analysis showed that slow gait (odds ratio [OR] 3.40, 95% confidence interval [CI] 1.40-8.23, P=0.007) and MCR (odds ratio [OR] 5.53, 95% confidence interval [CI] 1.46-20.89, P=0.012) were independently associated with frailty, but not subjective cognitive complaints. Conclusions: MCR and slow gait were significantly associated with frailty in Chinese older adults. Further study should prospectively determine the causal relationship between MCR and frailty.

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BOTTLENECK FACTOR AND HEIGHT-WIDTH RATIO

Neurosurgery ◽

10.1227/01.neu.0000298899.77097.bf ◽

2007 ◽

Vol 61 (4) ◽

pp. 716-723 ◽

Cited By ~ 83

Author(s):

Brian L. Hoh ◽

Christopher L. Sistrom ◽

Christopher S. Firment ◽

Gregory L. Fautheree ◽

Gregory J. Velat ◽

...

Keyword(s):

Logistic Regression ◽

Confidence Interval ◽

Odds Ratio ◽

Cerebral Aneurysms ◽

Maximum Diameter ◽

Width Ratio ◽

Parent Artery ◽

Computed Tomographic ◽

Multivariable Logistic Regression ◽

Risk Of Rupture

Abstract OBJECTIVE Determining factors predictive of the natural risk of rupture of cerebral aneurysms is difficult because of the need to control for confounding variables. We studied factors associated with rupture in a study model of patients with multiple cerebral aneurysms, one aneurysm that had ruptured and one or more that had not, in which each patient served as their own internal control. METHODS We collected aneurysm location, one-dimensional measurements, and two-dimensional indices from the computed tomographic angiograms of patients in the proposed study model and compared ruptured versus unruptured aneurysms. Bivariate statistics were supplemented with multivariable logistic regression analysis to model ruptured status. A total of 40 candidate models were evaluated for predictive power and fit with Wald scoring, Cox and Snell R2, Hosmer and Lemeshow tests, case classification counting, and residual analysis to determine which of the computed tomographic angiographic measurements or indices were jointly associated with and predictive of aneurysm rupture. RESULTS Thirty patients with 67 aneurysms (30 ruptured, 37 unruptured) were studied. Maximum diameter, height, maximum width, bulge height, parent artery diameter, aspect ratio, bottleneck factor, and aneurysm/parent artery ratio were significantly (P < 0.05) associated with ruptured aneurysms on bivariate analysis. When best subsets and stepwise multivariable logistic regression was performed, bottleneck factor (odds ratio = 1.25, confidence interval = 1.11–1.41 for every 0.1 increase) and height-width ratio (odds ratio = 1.23, confidence interval = 1.03–1.47 for every 0.1 increase) were the only measures that were significantly predictive of rupture. CONCLUSION In a case-control study of patients with multiple cerebral aneurysms, increased bottleneck factor and height-width ratio were consistently associated with rupture.

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Association Between Use of Preoperative Antihypertensive Medication and 90-Day Mortality After Noncardiac Surgery: A Retrospective Cohort Study

American Journal of Hypertension ◽

10.1093/ajh/hpaa012 ◽

2020 ◽

Vol 33 (6) ◽

pp. 534-542

Author(s):

Chami Im ◽

Tak Kyu Oh ◽

In-Ae Song

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Cohort Study ◽

Confidence Interval ◽

Retrospective Cohort Study ◽

Odds Ratio ◽

Retrospective Cohort ◽

Antihypertensive Medication ◽

Noncardiac Surgery ◽

Hypertensive Patients

Abstract Background This study aimed to determine whether use of preoperative antihypertensive medication is associated with postoperative 90-day mortality in the hypertensive adult population that underwent elective noncardiac surgery. Methods In this retrospective cohort study, medical records of preoperative hypertensive patients who underwent noncardiac surgery at a single tertiary academic hospital from 2012 to 2018 were reviewed. Among the hypertensive patients, those prescribed to take antihypertensive medication continuously for more than 1 month before admission were defined as the HTN MED group; others were defined as the non-HTN MED group. Multiple imputation, propensity score (PS) matching, and logistic regression analysis were used for statistical analysis. Results Overall, 35,589 preoperative hypertensive adult patients (HTN MED group: 26,154 patients, non-HTN MED group: 9,435 patients) were included in the analysis. After PS matching, each group comprised 6,205 patients; thus, 12,410 patients were included in the final analysis. The odds for 90-day mortality of the HTN MED group in the PS-matched cohort were 41% lower (odds ratio: 0.59, 95% confidence interval: 0.41–0.85; P = 0.005) than those of the non-HTN MED group. Comparable results were obtained in the multivariable logistic regression analysis of the entire cohort (odds ratio: 0.54, 95% confidence interval: 0.41–0.72; P < 0.001). Conclusions This study showed that the use of preoperative antihypertensive medication was associated with lower 90-day mortality among hypertensive patients who underwent noncardiac surgery. Therefore, preoperative screening and treatment with appropriate antihypertensive medication are important for hypertensive patients.

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