Relationship of Hospital Star Ratings to Race, Education, and Community Income

INTRODUCTION: The Centers for Medicare & Medicaid Services (CMS) publishes hospital quality ratings to provide more transparent and useable quality information to patients and stakeholders. However, there is a gap in the literature regarding the geographic distribution of the hospitals with higher star ratings. In this paper, we focus on the associations between star ratings and community characteristics, including racial/ethnic mix, household income, educational attainment, and regional difference. METHODS: A retrospective study and cross-sectional logistic and multinomial logistic regression analyses. RESULTS: According to the multivariate regression results, hospitals in areas with lower income, lower educational attainment, and higher minority population shares have lower quality ratings (lower income: odds ratio [OR] 0.67; 95% CI, 0.49-0.91; lower education: OR 0.66; 95% CI, 0.51-0.85; higher minority: OR 0.52; 95% CI, 0.40-0.69). Compared with hospitals in the Midwest, hospitals in Northeast, South, and West regions have lower quality ratings (Northeast: OR 0.37; 95% CI, 0.25-0.56; South: OR 0.68; 95% CI, 0.51-0.91; West: OR 0.69; 95% CI, 0.49-0.97). DISCUSSION AND CONCLUSION: Overall, our results show that hospitals with higher star ratings are less likely to be located in communities with higher minority populations, lower income, and lower levels of educational attainment. Findings contribute to the discussion of integrating social factors in hospital quality star rating calculation methodologies.

Download Full-text

Frequency of Seeing People Walk and Aerobic Physical Activity Among Latino Adults

Journal of Physical Activity and Health ◽

10.1123/jpah.2019-0200 ◽

2020 ◽

Vol 17 (2) ◽

pp. 211-216 ◽

Cited By ~ 1

Author(s):

Rosenda Murillo ◽

Pooja Agrawal ◽

Sheila Berenji-Jalaei ◽

Elizabeth Vasquez ◽

Sandra Echeverria

Keyword(s):

Physical Activity ◽

Multinomial Logistic Regression ◽

Neighborhood Context ◽

Cross Sectional ◽

Latino Men ◽

Behavioral Norms ◽

Logistic Regression Models ◽

Aerobic Activity ◽

Interview Survey ◽

Racial Ethnic

Background: Little research has examined gender differences in the association of seeing others exercise, in the neighborhood context, with physical activity, particularly for diverse racial/ethnic groups. The authors examined the association between frequency of seeing people walk and aerobic activity by gender among Latinos. Methods: The authors used cross-sectional 2015 National Health Interview Survey data on Latino participants ≥18 years (n = 5147). Multinomial logistic regression models estimated the association between seeing people walk and level of aerobic physical activity. Results: Men reporting seeing people walk every 2 to 3 days and every day were more likely to meet the aerobic activity recommendation (odds ratio [OR] 2.02; 95% confidence interval [CI], 1.05–3.89 and OR 1.96; 95% CI, 1.23–3.14, respectively). Among women, those seeing people walk every day and every 2 to 3 days were likely to engage in some aerobic activity (OR 1.88; 95% CI, 1.26–2.80 and OR 2.16; 95% CI, 1.23–3.18, respectively) and meet the recommendation (OR 1.73; 95% CI, 1.24–2.42 and OR 1.66; 95% CI, 1.03–2.67, respectively). Women seeing people walk about once a week were also likely to engage in some activity (OR 3.06; 95% CI, 1.59–5.89). Conclusions: Among Latino men and women, seeing people walk is associated with meeting the aerobic activity guideline. Results suggest that adoption of physical activity may in part be driven by neighborhood-level behavioral norms and by inference characteristics of the neighborhood that support walking.

Download Full-text

Physical Exercise to Combat Academic Burnout in Students

THE SKY-International Journal of Physical Education and Sports Sciences (IJPESS) ◽

10.51846/the-sky.v4i1.821 ◽

2020 ◽

pp. 118-134

Author(s):

Asif Ali ◽

Muhammad Azam ◽

Asad Hussain Shaikh

Keyword(s):

Physical Activity ◽

Analytical Study ◽

Cross Sectional ◽

Academic Burnout ◽

Quality Ratings ◽

Cross Sectional Studies ◽

Relationship Of ◽

Negative Relationships ◽

Satisfactory Quality ◽

Final Synthesis

The purpose of this analytical study was to synthesize existing evidence relating to the association of exercise or physical activity with academic burnout in students. Relevant articles were systematically and rigorously searched using ten research databases. Following screening for relevancy, ten studies (eight cross-sectional, one cohort, and one interventional) were selected to include for final synthesis. All of the cross-sectional studies had good or satisfactory quality ratings, and the cohort and interventional studies included in this review had moderate to strong quality ratings. Six out of eight cross-sectional studies showed an inverse relationship of physical activity or exercise with academic burnout with the exception of two studies showed no significant associations. The cohort and interventional studies also demonstrated negative relationships of physical activity with academic burnout. The findings are likely to provide some evidence that physical activity may be capable to reduce academic burnout in students.

Download Full-text

Wisdom of the Experts versus Wisdom of the Crowd in Hospital Quality Ratings: Cross-Sectional Analyses of Google Ratings (Preprint)

10.2196/preprints.34030 ◽

2021 ◽

Author(s):

Hari Ramasubramanian ◽

Satish Joshi ◽

Ranjani Krishnan

Keyword(s):

Application Programming Interface ◽

Hospital Quality ◽

Rating System ◽

Cross Sectional ◽

Quality Performance ◽

Quality Ratings ◽

Before And After ◽

Fractional Response ◽

The Individual ◽

Hospital Compare

BACKGROUND Popular online portals provide free and convenient access to user-generated quality reviews. Centers for Medicare and Medicaid Services (CMS) also provide patients with Hospital Compare Star Ratings (HCSR), a single public measure of hospital quality aggregating multiple quality dimensions. Consumers often use crowdsourced hospital ratings on platforms such as Google to select hospitals, but it is unknown if these ratings reflect a comprehensive measure of clinical quality. OBJECTIVE We analyze if Google online quality ratings, which reflect the wisdom of the crowd, are associated with HCSR, which reflect the wisdom of the experts. CMS revised the methodology of assigning star ratings to hospitals. Therefore, we analyze these associations before and after the 2021 revisions of the CMS rating system. METHODS We extracted Google ratings using Application Programming Interface (API) in June 2020. The HCSR data of April 2020 (before the revision of HCSR methodology) and April 2021 (after the revision of HCSR methodology) were obtained from CMS’ Hospital Compare (HC) website. We also extracted scores for the individual components of hospital quality for each of the hospitals in our sample using the code provided by HC. Fractional Response Model (FRM) was used to estimate the association between Google Ratings and HCSR and individual components of quality. RESULTS Results indicate that Google ratings are statistically associated with HCSR (P<.001) after controlling for hospital level effects. A one star improvement in CMS ratings before the change in methodology (after the change in methodology) is expected to increase the Google ratings by 0.145 (0.135) on average (95% CI 0.127- 0.163; P<.001, 95% CI 0.116-0.153; P<.001). The analyses with individual components of hospital quality reveal that Google ratings are not associated with components of HCSR that require medical expertise such as ‘Safety of care’ or ‘Readmissions’. The revised CMS rating system ameliorates previous partial inconsistencies in association between Google ratings and component scores of HCSR. CONCLUSIONS Overall, crowd sourced Google hospital ratings are informative about expert CMS hospital quality ratings and several individual quality components that are easier for patients to evaluate. Therefore, hospitals should not expect improvements in quality metrics that require expertise to assess such as safety of care and readmission to result in improved Google star ratings. Hospitals can benefit from using crowd-sourced ratings as timely, easily available, and dynamic indicators of their quality performance.

Download Full-text

Relationship of Self-Compassion, Hope, and Emotional Control to Perceived Burdensomeness, Thwarted Belongingness, and Suicidal Ideation

Crisis ◽

10.1027/0227-5910/a000697 ◽

2020 ◽

pp. 1-7

Author(s):

Laura R. Umphrey ◽

John C. Sherblom ◽

Paulina Swiatkowski

Keyword(s):

College Students ◽

Suicidal Ideation ◽

Emotional Control ◽

Thwarted Belongingness ◽

Perceived Burdensomeness ◽

Cross Sectional ◽

Self Compassion ◽

Positive Feelings ◽

Cross Sectional Design ◽

Relationship Of

Abstract. Background: Cultivating positive feelings of self in relationships with others can affect perceptions of belongingness and burdensomeness. Aims: The present study examines the relationships of self-compassion, hope, and emotional control to thwarted belongingness, perceived burdensomeness, and suicidal ideation. Method: Participants were 481 college students who completed scales measuring self-compassion, hope, emotional control, thwarted belongingness, perceived burdensomeness, and suicidal ideation. Results: Correlation and parallel mediation analysis results show relationships between self-compassion, hope, and emotional control with perceived burdensomeness, thwarted belongingness, and suicidal ideation. Limitations: The study is limited by its cross-sectional design, sample demographics, and inability to distinguish between individuals with suicidal ideation and those who attempt suicide. Conclusion: The results show that the relationships of self-compassion, hope, and emotional control to perceived burdensomeness, thwarted belongingness, and suicidal ideation are worth further investigation.

Download Full-text

Hubungan Sikap dan Karakteristik Pasangan Usia Subur (PUS) dengan Keikutsertaan dalam Program KB di Wilayah Kerja UPT Puskesmas Sungai Raya Kecamatan Sungai Raya Kabupaten Aceh Timur

Serambi Saintia : Jurnal Sains dan Aplikasi ◽

10.32672/jss.v8i2.2424 ◽

2020 ◽

Vol 8 (2) ◽

pp. 105-114

Author(s):

Ainul Mardhiah ◽

Nova Hasbani Prima Dewi ◽

Aminy Aminy

Keyword(s):

Family Planning ◽

Family Planning Program ◽

The Elderly ◽

P Value ◽

Planning Program ◽

Elderly Age ◽

Chi Square ◽

Cross Sectional ◽

The Family ◽

Relationship Of

The family planning program also aims to improve the quality of the family in order to generate a sense of security, peace and hope of a better future in realizing the prosperity of birth and inner happiness. Allegedly the factor causing EFA participation in the family planning program is characteristic. The purpose of this research is to know the relationship of attitude and characteristic of Elderly Age Couple (PUS) with participation in family planning program at UPT Puskesmas Sungai Raya Sungai Raya District, East Aceh regency 2018. The research design used was analytic survey with cross sectional design. The population of this study is all Pairs Age of Fertile located in Work Area UPT Sungai Raya Public Health Service Center in January to December 2017 which amounted to 1897 people. Sampling using Slovin formula, obtained as many as 95 samples. The study was conducted from 7-17 July 2018 using questionnaires by interview. Statistical test using chi-square test. Result of research indicate that majority of fertile couple couples (PUS) participate in family planning program as much as 67 respondents (70,5%). Statistically there is relationship of attitude and characteristic of Elderly Age Couple (EFA) with non participation in family planning program in Working Area of UPT Puskesmas Sungai Raya Sungai Raya District of East Aceh Regency 2018 with p value <0,1. It is recommended that the family planning program holders in UPT Puskesmas Sungai Raya Sungai Raya District of East Aceh District to invite cross-sectoral figures to hold meetings to create mini workshop plans at least once a month to increase the participation of the Elderly Age Couple (PUS) in family planning programs. Keyword : Family Planning Program, Attitudes, CharacteristicsABSTRAKProgram KB juga bertujuan untuk meningkatkan kualitas keluarga agar dapat timbul rasa aman, tentram, dan harapan masa depan yang lebih baik dalam mewujudkan kesejahteraan lahir dan kebahagiaan batin. Diduga faktor yang menyebabkan ketidakikutsertaan PUS dalam program KB adalah karakteristik. Tujuan penelitian ini untuk mengetahui hubungan sikap dan karakteristik Pasangan Usia Subur (PUS) dengan keikutsertaan dalam program KB di Wilayah Kerja UPT Puskesmas Sungai Raya Kecamatan Sungai Raya Kabupaten Aceh Timur tahun 2018. Desain penelitian yang digunakan adalah survei analitik dengan rancangan bedah lintang. Populasi dari penelitian ini adalah seluruh Pasangan Usia Subur yang berada di Wilayah Kerja UPT Puskesmas Sungai Raya pada bulan Januari sampai dengan Desember tahun 2017 yang berjumlah 1.897 orang. Pengambilan sampel menggunakan rumus Slovin, didapatkan sebanyak 95 sampel. Penelitian dilaksanakan dari tanggal 7-17 Juli tahun 2018 menggunakan kuesioner dengan cara wawancara. Uji statistik menggunakan uji chi-square. Hasil penelitian menunjukkan bahwa mayoritas Pasangan Usia Subur (PUS) ikut serta dalam program KB yaitu sebanyak 67 responden (70,5%). Secara statistik ada hubungan sikap dan karakteristik Pasangan Usia Subur (PUS) dengan ketidakikutsertaan dalam program KB di Wilayah Kerja UPT Puskesmas Sungai Raya Kecamatan Sungai Raya Kabupaten Aceh Timur tahun 2018 dengan p value < 0,1. Sebaiknya pemegang program KB di UPT Puskesmas Sungai Raya Kecamatan Sungai Raya Kabupaten Aceh Timur agar mengajak tokoh lintas sektor agar mengadakan pertemuan untuk membuat rencana loka karya mini setidaknya satu bulan sekali untuk meningkatkan keikutsertaan Pasangan Usia Subur (PUS) dalam program KB.Kata Kunci : Program KB, Sikap, Karakteristik

Download Full-text

STRATEGI KOPING ORANG TUA TERHADAP ANAK AUTIS DAN POLA ASUH ORANG TUA

Journal of Health Sciences ◽

10.33086/jhs.v11i2.113 ◽

2018 ◽

Vol 11 (2) ◽

pp. 196-204

Author(s):

Asirotul Ma’rifah ◽

Naning Puji Suryantini Suryantini ◽

Rina Mardiyana

Keyword(s):

Coping Strategies ◽

Sampling Technique ◽

Children With Autism ◽

Adaptive Coping ◽

Autistic Children ◽

Cross Sectional ◽

Authoritarian Parenting ◽

Cross Tabulation ◽

Relationship Of ◽

The Relationship

Autism is still a nightmare for most parents. Parents with autism can be very stressful when dealing with a hyperactive child's behavior, aggressive and passive. Stress experienced by parents of children with autism will affect the ability of parents in the parenting role, especially in relation to coping strategies have in dealing with problems of children. The participation of parents is crucial the success of socializing with children with autism in the general population. This study aims to determine the relationship of coping strategies parents of autistic children and parenting parents. This type of research is an analytic correlation with cross sectional approach. The population in this study were all parents of autistic children in SLB Muhammadiyah Mojokerto numbering 15 people. Samples in this study were all parents of autistic children in SLB Muhammadiyah Mojokerto which totaled 15 people by using total sampling technique. Collecting data using questionnaires. Data analized use cross tabulation, presented in a frequency distribution. On cross-tabulation obtained results tend to use maladaptive coping strategies permissive parenting that is 8 (53.3%), there are also respondents who use adaptive coping strategies using authoritarian parenting as much as one person (16.7%), and adaptive coping strategies tend using democratic parenting style as much as 5 people (33.3%). Expected parents still seeking information to broaden their parents on coping strategies of parents of autistic children and parenting parents as well as parents to give special attention for children with autism to the development and advancement of their lives because they have the same rights as any other normal child.

Download Full-text

Hubungan Motivasi dan Minat Masuk Program Studi DIII Kebidanan Dengan Prestasi Belajar Mahasiswa STIKES ICSADA Bojonegoro

Jurnal Ilmu Kesehatan MAKIA ◽

10.37413/jmakia.v1i1.6 ◽

2015 ◽

Vol 1 (1) ◽

Author(s):

Cholida Khusnul Chotimah

Keyword(s):

Student Achievement ◽

Learning Outcomes ◽

Behavior Changes ◽

Study Program ◽

Cross Sectional ◽

Learning Achievement ◽

Increase Student Achievement ◽

Learning Conditions ◽

Relationship Of ◽

The Relationship

ABSTRAKHasil belajar (prestasi belajar) merupakan perubahan perilaku yang diperoleh seseorang setelah mengalami aktivitas belajar. Perolehan aspek-aspek perubahan perilaku tersebut tergantung pada apa yang dipelajari oleh seseorang. Berhasil atau tidaknya seseorang untuk belajar disebabkan beberapa faktor yang mempengaruhi dalam pencapaian hasil belajar (prestasi belajar) yaitu berasal dari dalam diri orang yang belajar dan ada pula yang dari luar dirinya. Banyak faktor yang mempengaruhinya, diantaranya adalah motivasi dan minat. Tujuan dari penelitian ini adalah untuk mengetahui hubungan motivasi dan minat masuk Program Studi D III Kebidanan dengan prestasi belajar mahasiswa STIKES Insan Cendekia Husada Bojonegoro. Jenis penelitian ini adalah analitik korelasi. Penelitian ini menggunakan pendekatan cross sectional. Populasi dalam penelitian ini adalah semua mahasiswa Program Studi D III Kebidanan STIKES Insan Cendekia Husada Bojonegoro sebanyak 39 mahasiswa dengan teknik total sampling dengan jumlah sampel 39. Penelitian ini menggunakan instrumen berupa kuesioner. Analisis hubungan variabel dilakukan dengan menggunakan Yates Correction. Hasil penelitian ini menunjukkan bahwa ada hubungan antara motivasi masuk Program Studi D III Kebidanan dengan prestasi belajar mahasiswa (ρ =0,027) dan ada hubungan antara minat masuk Program Studi D III Kebidanan dengan prestasi belajar mahasiswa (ρ =0,044). Saran untuk Program Studi D III Kebidanan STIKES Insan Cendekia Husada Bojonegoro agar meningkatkan prestasi belajar mahasiswa Prodi D III kebidanan STIKES Insan Cendekia Husada Bojonegoro dengan cara dosen atau pembimbing akademik menciptakan kondisi pembelajaran yang menarik, sarana prasarana yang menunjang, hubungan antara dosen dan mahasiswa yang baik, sehingga mahasiswa terdorong untuk butuh dan terus belajar dan melakukan pemantauan dan pendekatan lebih dalam terhadap mahasiswa tentang tujuan mereka untuk masuk di Program Studi D III Kebidanan. Kata Kunci : Motivasi, minat, prestasi belajar ABSTRACT Results of learning (learning achievement) is obtained by a person's behavior changes after experiencing learning activities. Acquisition aspects of the behavior change depending on what is learned by someone. Success or failure of someone to learn due to several factors that affect the achievement of learning outcomes (learning achievement) that comes from within the person who studied and some are from outside himself. Many factors influence it, such as motivation and interest. The purpose of this study was to determine the relationship of motivation and interest in D III Midwifery Studies Program with student achievement STIKES Insan Scholar Husada Bojonegoro. This type of research is analytic correlation. This study used cross sectional approach. The population in this study were all students of the D III Midwifery STIKES Insan Husada Bojonegoro Scholar at least 39 students with a total sampling with a sample of 39. This study used a questionnaire instrument. Variable correlation analysis done using Yates Correction. Results of this study indicate that there is a relationship between motivation incoming D III Midwifery Studies Program with student achievement (ρ = 0.027) and there is a correlation between interest in D III Midwifery Studies Program with student achievement (ρ = 0.044). Suggestions for Study Program D III Midwifery STIKES Insan Scholar Husada Bojonegoro in order to increase student achievement Prodi DIII midwifery personnel STIKES Scholar Husada Bojonegoro by way of a professor or academic supervisor creates an attractive learning conditions, infrastructure that support, the relationship between faculty and students good , so that students are encouraged to take and continue to learn and perform monitoring and deeper approach to the students about their goals for entry in the D III Midwifery Studies Program. Key Words : Motivation, interests, academic achievement

Download Full-text

Hubungan Pengetahuan Dan Sikap Ibu Dengan Keputusan Waktu Penyapihan

Jurnal Endurance ◽

10.22216/jen.v3i3.3141 ◽

2018 ◽

Vol 3 (3) ◽

pp. 500

Author(s):

Desmariyenti Desmariyenti ◽

Nelfi Sarlis ◽

Rima Fitriani

Keyword(s):

Random Sampling ◽

Sampling Technique ◽

P Value ◽

Stratified Random Sampling ◽

Significant Relation ◽

Cross Sectional ◽

Work Area ◽

Knowledge And Attitude ◽

Relationship Of ◽

The Relationship

Good weaning time is done at the age of the child reaches 2 years. Weaning at less than 2 years of age can cause problems in children such as incidence of infectious diseases, especially increased diarrhea, nutritional effects that lead to malnutrition in children and cause the relationship of children and mothers is reduced closeness because bounding attachment process is disrupted. This study aims to determine the relationship between knowledge and attitude of the mother with the decision of weaning time in Tangkerang Timur Work Area Puskesmas Tenayan Raya. This research was conducted in Mei-Juni 2017 and this research using research type is quantitative data with research design using cross sectional. Sampling technique using Stratified random sampling, population in this study amounted to 368 people and samples 184 people in East Tangkerang Village. The analysis used is univariate and bivariate. The result of this research is can be concluded that there is significant relation between knowledge with time weaning (p-value 0,000 <0,05), there is significant relation between attitude with time weaning (p-value 0,000 <0,05). Mothers exclusively breastfeed to their babies until 6 months of age and and continue with breastfeeding until 24 months of age. Waktu penyapihan yang baik dilakukan pada usia anak mencapai 2 tahun. Penyapihan yang dilakukan pada usia kurang dari 2 tahun dapat menyebabkan masalah pada anak seperti insiden penyakit infeksi terutama diare meningkat, pengaruh gizi yang mengakibatkan malnutrisi pada anak dan menyebabkan hubungan anak dan ibu berkurang keeratannya karena proses bounding attachment terganggu. Penelitian ini bertujuan untuk mengetahui hubungan antara pengetahuan dan sikap ibu dengan keputusan waktu penyapihan di Keluraan Tangkerang Timur Wilayah Kerja Puskesmas Tenayan Raya. Penelitian ini dilakukan pada bulan Mei-Juni tahum 2017 dan penelitian ini menggunakan jenis penelitian adalah data kuantitatif dengan desain penelitian menggunakan cross sectional. Teknik sampling menggunakan Stratified random sampling, Populasi dalam penelitian ini berjumlah 368 orang dan sampel 184 orang di Kelurahan Tangkerang Timur. Analisa yang diunakan adalah univariat dan bivariat. Hasil penelitian didapatkan bahwa ada hubungan bermakna antara pengetahuan dengan waktu penyapihan (p-value 0,000< 0,05), ada hubungan bermakna antara sikap dengan waktu penyapihan (p-value 0,000 <0,05). Diharapkan ibu memberikan ASI eksklusif pada bayinya sampai usia 6 bulan dan dan dilanjutkan dengan MPASI sampai usia 24 bulan.

Download Full-text

Understanding the Impact of Bullying in a Unionized U.S. Public Sector Workforce

Workplace Health & Safety ◽

10.1177/2165079919883286 ◽

2019 ◽

Vol 68 (3) ◽

pp. 139-153 ◽

Cited By ~ 1

Author(s):

Mazen El Ghaziri ◽

Shellie Simons ◽

Jane Lipscomb ◽

Carla L. Storr ◽

Kathleen McPhaul ◽

...

Keyword(s):

Public Sector ◽

Organizational Climate ◽

Negative Impact ◽

Multinomial Logistic Regression ◽

Female Gender ◽

Bargaining Unit ◽

Organizational Level ◽

Organizational Impact ◽

Cross Sectional ◽

The Impact

Background: Workplace Bullying (WPB) can have a tremendous, negative impact on the victims and the organization as a whole. The purpose of this study was to examine individual and organizational impact associated with exposure to bullying in a large U.S. unionized public sector workforce. Methods: A cross-sectional Web-based survey was conducted among 16,492 U.S. state government workers. Survey domains included demographics, negative acts (NAs) and bullying, supportiveness of the organizational climate, and individual and organizational impacts of bullying. Multinomial logistic regression was used to assess the impact among respondents who reported exposure to bullying. Findings: A total of 72% participants responded to the survey (n = 11,874), with 43.7% (n = 5,181) reporting exposure to NAs and bullying. A total of 40% (n = 4,711) participants who experienced WPB reported individual impact(s) while 42% ( n = 4,969) reported organization impact(s). Regular NA was associated with high individual impact (negatively impacted them personally; odds ratio [OR] = 5.03) when controlling for other covariates including: female gender (OR =1.89) and job tenure of 6 to 10 years (OR = 1.95); working in a supportive organizational climate and membership in a supportive bargaining unit were protective of high impact (OR = 0.04 and OR = 0.59, respectively). High organizational impact (transferring to another position) was associated with regular NA and bullying (OR = 16.26), female gender (OR = 1.55), providing health care and field service (OR = 1.68), and protective effect of organizational climate (OR = 0.39). We found a dose-response relationship between bullying and both individual and organizational-level impact. Conclusion/Application to Practice: Understanding the impacts of WPB should serve to motivate more workplaces and unions to implement effective interventions to ameliorate the problem by enhancing the organizational climate, as well as management and employee training on the nature of WPB and guidance on reporting.

Download Full-text

Elevated alanine aminotransferase and low aspartate aminotransferase/alanine aminotransferase ratio are associated with chronic kidney disease among middle-aged women: a cross-sectional study

BMC Nephrology ◽

10.1186/s12882-020-02144-6 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Hirotaka Ochiai ◽

Takako Shirasawa ◽

Takahiko Yoshimoto ◽

Satsue Nagahama ◽

Akihiro Watanabe ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Aspartate Aminotransferase ◽

Alanine Aminotransferase ◽

Venous Blood ◽

Cross Sectional Study ◽

Middle Aged ◽

Cross Sectional ◽

Alcoholic Fatty Liver ◽

Relationship Of

Abstract Background Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) to ALT ratio (AST/ALT ratio) have been shown to be related to non-alcoholic fatty liver disease or insulin resistance, which was associated with chronic kidney disease (CKD). However, it is unclear whether ALT and AST/ALT ratio are associated with CKD. In this study, we examined the relationship of ALT and AST/ALT ratio to CKD among middle-aged females in Japan. Methods The present study included 29,133 women aged 40 to 64 years who had an annual health checkup in Japan during April 2013 to March 2014. Venous blood samples were collected to measure ALT, AST, gamma-glutamyltransferase (GGT), and creatinine levels. In accordance with previous studies, ALT > 40 U/L and GGT > 50 U/L were determined as elevated, AST/ALT ratio < 1 was regarded as low, and CKD was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2 and/or proteinuria. Logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for CKD. Results “Elevated ALT and elevated GGT” and “elevated ALT and non-elevated GGT” significantly increased the OR for CKD when compared with “non-elevated ALT and non-elevated GGT” (OR: 2.56, 95% CI: 2.10–3.12 and OR: 2.24, 95% CI: 1.81–2.77). Compared with “AST/ALT ratio ≥ 1 and non-elevated GGT”, “AST/ALT ratio < 1 and elevated GGT” and “AST/ALT ratio < 1 and non-elevated GGT” significantly increased the OR for CKD (OR: 2.73, 95% CI: 2.36–3.15 and OR: 1.68, 95% CI: 1.52–1.87). These findings still remained after adjustment for confounders. Conclusions Elevated ALT was associated with CKD regardless of GGT elevation. Moreover, low AST/ALT ratio was also associated with CKD independent of GGT elevation.

Download Full-text