Perceived discrimination during the childbirth hospitalization and postpartum visit attendance and content: Evidence from the Listening to Mothers in California survey

Objective Postpartum visits are an important opportunity to address ongoing maternal health. Experiences of discrimination in healthcare can impact healthcare use, including postpartum visits. However, it is unknown whether discrimination is associated with postpartum visit content. This study aimed to examine the relationship between perceived discrimination during the childbirth hospitalization and postpartum visit attendance and content. Research design Data were from Listening to Mothers in California, a population-based survey of people with a singleton hospital birth in California in 2016. Adjusted logistic regression models estimated the association between perceived discrimination during the childbirth hospitalization and 1) postpartum visit attendance, and 2) topics addressed at the postpartum visit (birth control, depression and breastfeeding) for those who attended. Results 90.6% of women attended a postpartum visit, and 8.6% reported discrimination during the childbirth hospitalization. In adjusted models, any discrimination and insurance-based discrimination were associated with 7 and 10 percentage point (pp) lower predicted probabilities of attending a postpartum visit, respectively. There was a 7pp lower predicted probability of discussing birth control for women who had experienced discrimination (81% vs. 88%), a 15pp lower predicted probability of being asked about depression (64% vs. 79%), and a 9 pp lower predicted probability of being asked about breastfeeding (57% vs. 66%). Conclusions Amid heightened attention to the importance of postpartum care, there is a need to better understand determinants of postpartum care quality. Our findings highlight the potential consequences of healthcare discrimination in the perinatal period, including lower quality of postpartum care.

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Abstract 12069: Long-Term Trends in the Incidence and Outcome of Refractory and Non-Refractory Ventricular Fibrillation Cardiac Arrest

Circulation ◽

10.1161/circ.144.suppl_2.12069 ◽

2021 ◽

Vol 144 (Suppl_2) ◽

Author(s):

Ziad Nehme ◽

Emily Andrew ◽

Jocasta Ball ◽

Karen L Smith

Keyword(s):

Cardiac Arrest ◽

Ventricular Fibrillation ◽

Hospital Discharge ◽

Temporal Trends ◽

Developed Countries ◽

Population Based ◽

Logistic Regression Models ◽

Shockable Rhythm ◽

Adjusted Logistic Regression ◽

Population Based Registry

Introduction: Although many developed countries are reporting temporal improvements in out-of-hospital cardiac arrest (OHCA) outcomes from initial shockable rhythms, trends in the incidence and outcome of refractory ventricular fibrillation are not well understood. Methods: Between 2010 and 2019, we performed a retrospective observational study of OHCA from a population-based registry in Victoria, Australia. We included all adult, non-traumatic OHCA with an initial shockable rhythm. Temporal trends in incidence and survival to hospital discharge were compared across non-refractory and refractory OHCA, defined as cases receiving 3 or more consecutive shocks for a persistent shockable rhythm. Risk-adjusted logistic regression models were used to describe the year-on-year change in the likelihood of refractory OHCA and survival to hospital discharge. Results: Of the 7,267 initial shockable OHCA with an attempted resuscitation, 4168 (57.4%) and 3,099 (42.6%) were non-refractory and refractory OHCA, respectively. The proportion of cases with refractory OHCA declined over the study period from 48.4% in 2010 to 40.2% in 2019 (p trend <0.001). Unadjusted survival to hospital discharge was higher in non-refractory OHCA (46.3% vs. 25.8%, p<0.001), although both populations experienced increases in survival over time (p trend <0.05 for both). After adjustment for arrest confounders, the likelihood of refractory VF decreased by 4.4% every year (adjusted odds ratio [AOR]: 0.96, 95% CI: 0.94, 0.97; p<0.001). Factors reducing the likelihood of refractory OHCA were female sex, bystander CPR, arrest witnessed by emergency medical services, and public location. In the survival model, refractory OHCA was independently associated with a reduction in survival to hospital discharge (AOR 0.50, 95% CI: 0.45, 0.56; p<0.001). Temporal improvements in survival were observed year-on-year (AOR 1.03, 95% CI: 1.02, 1.05; p<0.001) and this did not differ between non-refractory and refractory OHCA (group interaction, p = 0.51). Conclusions: The incidence of refractory OHCA is declining in our region and survival outcomes are improving. Further research identifying factors contributing to the decline in refractory OHCA may help to improve outcomes further.

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The association of diabetes and BMI among Melanesian and Indian Fijians aged ≥ 40 years

British Journal Of Nutrition ◽

10.1017/s0007114510005258 ◽

2011 ◽

Vol 105 (10) ◽

pp. 1539-1545 ◽

Cited By ~ 1

Author(s):

Garry Brian ◽

Jacqueline Ramke ◽

Andrew Page ◽

Louise Maher ◽

John Szetu ◽

...

Keyword(s):

Regression Models ◽

Medical Practitioner ◽

Population Based ◽

Common Environment ◽

Logistic Regression Models ◽

Previous Diagnosis ◽

Males And Females ◽

Adjusted Logistic Regression ◽

Hb Concentration ◽

Population Based Survey

The present study examines the association of diabetes with BMI (kg/m2) in Asian-Indian and Melanesian Fijian populations sharing a common environment. A population-based survey was used to investigate the risk of diabetes (defined by glycosylated Hb concentration ≥ 6·5 % among participants who denied previous diagnosis of the disease by a medical practitioner) by sex, ethnicity and strata of BMI in a series of age-adjusted logistic regression models. Ethnicity and BMI interactions were compared using WHO and empirically derived BMI cut-off points. Indians had a greater risk (BMI and age adjusted) of undetected diabetes than Melanesians in both males (OR 2·99, 95 % CI 1·73, 5·17; P < 0·001) and females (OR 2·26, 95 % CI 1·56, 3·28; P < 0·001). BMI ≥ 25 to < 30 and ≥ 30 kg/m2 conferred a higher risk of diabetes compared with a BMI ≥ 18·5 to < 25 kg/m2. Risk was higher for males with a BMI ≥ 25 to < 30 kg/m2 (OR 2·35, 95 % CI 1·24, 4·46; P = 0·007) and BMI ≥ 30 kg/m2 (OR 6·08, 95 % CI 3·06, 12·07; P < 0·001) than for females with the same BMI (OR 1·85, 95 % CI 1·11, 3·08; P = 0·027 and OR 2·10, 95 % CI 1·28, 3·44; P = 0·002, respectively). However, the threshold that appeared to differentiate higher risk varied by ethnicity and sex. For Melanesians, BMI thresholds suggested were 25 kg/m2 for males and 32 kg/m2 for females. For Indo-Fijians, these were 24 and 22 kg/m2 for males and females, respectively. Disaggregating by ethnicity and sex, and applying specific evidence-based thresholds, may render BMI a more discriminating tool for assessing the risk of developing diabetes among Fiji adults.

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Evaluating the associations between obesity and age-related cataract: a Mendelian randomization study

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqz167 ◽

2019 ◽

Vol 110 (4) ◽

pp. 969-976 ◽

Cited By ~ 1

Author(s):

Ava Grace Tan ◽

Annette Kifley ◽

Victoria M Flood ◽

Elizabeth G Holliday ◽

Rodney J Scott ◽

...

Keyword(s):

Instrumental Variable ◽

Protein Intake ◽

Mendelian Randomization ◽

Population Based ◽

Macronutrient Intake ◽

Logistic Regression Models ◽

Blue Mountains ◽

Age Related ◽

Blue Mountains Eye Study ◽

Adjusted Logistic Regression

ABSTRACT Background The obesity–cataract association has been inconsistently reported. The fat mass and obesity–related (FTO) single-nucleotide polymorphism (SNP) rs9939609 is a major SNP associated with obesity and has been used as an instrumental variable for obesity in a Mendelian randomization (MR) approach. An interaction between the FTO SNP and macronutrient intake for obesity was suggested previously. Objective The aim of this study was to assess the associations between obesity and cataract, using FTO SNP rs9939609 as an instrumental variable in an MR approach, and explore interactions of this SNP with macronutrient intake in relation to risk of cataract in a population-based cohort. Methods The Blue Mountains Eye Study (BMES) is a longitudinal population-based study of common eye disease. Of 3654 baseline participants of the BMES (1992–1994), 2334 (75.8% of survivors) and 1952 (76.7% of survivors) were followed 5 and 10 y later. During the 5-y follow-up, 1174 new participants were examined. Cumulative cataract was defined as the presence of cortical, nuclear, or posterior subcapsular (PSC) cataract at any visit, following the Wisconsin Cataract Grading System. Imputed dosage of the FTO SNP rs9939609 was used. Quintiles of macronutrient intake (carbohydrates, protein, fats) were derived from an FFQ. ORs and 95% CIs were estimated using multivariable-adjusted logistic regression models. Results After multivariable adjustment, there were no associations between BMI and any cataract types in MR models using rs9939609 as an instrumental variable. However, an interaction between rs9939609 and protein intake for PSC cataract risk was suggested (P = 0.03). In analyses stratified by quintiles of protein intake, each minor allele of rs9939609 was associated with increased odds of PSC (OR: 2.14; 95% CI: 1.27, 3.60) in the lowest quintile subgroup only. Conclusions Obesity was not causally associated with age-related cataract. However, among persons in the lowest quintile of protein intake, obesity may be associated with PSC cataract.

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Symptoms of COVID-19 in a population-based cohort study

10.1101/2021.03.20.21254040 ◽

2021 ◽

Author(s):

Sana M. Khan ◽

Leslie V. Farland ◽

Erika Austhof ◽

Melanie L. Bell ◽

Collin J. Catalfamo ◽

...

Keyword(s):

Cohort Study ◽

Regression Models ◽

Population Based ◽

Accurate Diagnosis ◽

Logistic Regression Models ◽

Runny Nose ◽

Symptom Profile ◽

Adjusted Logistic Regression ◽

Study Participants ◽

Taste And Smell

Accurate diagnosis of potential SARS-CoV-2 infections by symptoms is one strategy for continuing global surveillance, particularly in low-resource communities. We conducted a prospective, population-based cohort study, the Arizona CoVHORT, among Arizona residents to elucidate the symptom profile of laboratory-confirmed COVID-19 participants(16.2%) compared to laboratory-confirmed negative(22.4%) and untested general population participants(61.4%). Among the 1514 study participants, those who were COVID-19 positive were more likely to be Hispanic(33.5%) and more likely to report obesity > 30 kg/m2(34.7%) compared to COVID-19 negative participants(19.2%; 31.0%) and untested CoVHORT participants(13.8%; 23.8%). Of the 245 laboratory-confirmed COVID-19 cases, 15.0% reported having had no symptoms. Of those that did report symptoms, the most commonly-reported first symptoms were sore throat(19.0%), headache(15.5%), cough(12.7%), runny nose/cold-like symptoms(12.1%), and fatigue(12.0%). In adjusted logistic regression models, COVID-19 positive participants were more likely than negative participants to experience loss of taste and smell(OR:35.7; 95% CI 18.4-69.5); bone or nerve pain(OR:17.9; 95% CI 6.7-47.4), vomiting(OR:10.8; 95% CI 3.1-37.5), nausea(OR:10.5; 95% CI 5.5-19.9), and headache(OR:8.4; 95% CI 5.6-12.8). When comparing confirmed COVID-19 cases with confirmed negative or untested participants, the pattern of symptoms that discriminates SARS-CoV-2 infection from those arising from other potential circulating pathogens may differ from general reports of symptoms among cases alone.

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Wholegrain and legume consumption and the 5-year incidence of age-related cataract in the Blue Mountains Eye Study

British Journal Of Nutrition ◽

10.1017/s000711452000104x ◽

2020 ◽

Vol 124 (3) ◽

pp. 306-315

Author(s):

Ava Grace Tan ◽

Victoria M. Flood ◽

Annette Kifley ◽

Joanna Russell ◽

Robert G. Cumming ◽

...

Keyword(s):

Regression Models ◽

Population Based ◽

Eye Diseases ◽

Australian Population ◽

Logistic Regression Models ◽

Blue Mountains ◽

High Consumption ◽

Age Related ◽

Blue Mountains Eye Study ◽

Adjusted Logistic Regression

AbstractThe present study aims to investigate the effect of wholegrain and legume consumption on the incidence of age-related cataract in an older Australian population-based cohort. The Blue Mountains Eye Study (BMES) is a population-based cohort study of eye diseases among older adults aged 49 years or older (1992–1994, n 3654). Of 2334 participants of the second examination of the BMES (BMES 2, 1997–2000), 1541 (78·3 % of survivors) were examined 5 years later (BMES 3) who had wholegrain and legume consumption estimated from the FFQ at BMES 2. Cataract was assessed using photographs taken during examinations following the Wisconsin cataract grading system. Multivariable-adjusted logistic regression models were used to assess associations with the 5-year incidence of cataract from BMES 2 (baseline) to BMES 3. The 5-year incidence of cortical, nuclear and posterior subcapsular (PSC) cataract was 18·2, 16·5 and 5·9 %, respectively. After adjustment for age, sex and other factors, total wholegrain consumption at baseline was not associated with incidence of any type of cataract. High consumption of legumes showed a protective association for incident PSC cataract (5th quintile: adjusted OR 0·37; 95 % CI 0·15, 0·92). There was no significant trend of this association across quintiles (P = 0·08). In this older Australian population, we found no associations between wholegrain intake at baseline and the 5-year incidence of three cataract types. However, intake of legumes in the highest quintile, compared with the lowest quintile, may protect against PSC formation, a finding needing replication in other studies.

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Migraine and restless legs syndrome in men

Cephalalgia ◽

10.1177/0333102412466965 ◽

2012 ◽

Vol 33 (2) ◽

pp. 130-135 ◽

Cited By ~ 30

Author(s):

Anke C Winter ◽

Markus Schürks ◽

Klaus Berger ◽

Julie E Buring ◽

J Michael Gaziano ◽

...

Keyword(s):

Restless Legs Syndrome ◽

Regression Models ◽

Population Based ◽

Cross Sectional Study ◽

Health Study ◽

Cross Sectional ◽

Logistic Regression Models ◽

Restless Legs ◽

Male Cohort ◽

Adjusted Logistic Regression

Background Previous studies suggest an association between migraine and restless legs syndrome (RLS). Population-based data, however, have been limited to women. The aim of this study is to evaluate the association between migraine and RLS in a male cohort. Methods We conducted a cross-sectional study among 22,926 participants in the Physicians’ Health Study. Migraine and RLS information was self-reported. RLS was classified according to four minimal diagnostic criteria. Age- and multivariable-adjusted logistic regression models were calculated. Results Of the 22,926 participants (mean age 67.8), 2816 (12.3%) reported migraine and 1717 (7.5%) RLS. Migraine was associated with an increased multivariable-adjusted odds ratio (OR) (95% confidence interval (CI)) of 1.20 (1.04–1.38) for having RLS. The association remained stable after excluding men with potential mimics of RLS and was not modified by age. Conclusions Results of our study indicate an association between migraine and RLS in men. The magnitude of effect is similar to what has been reported in women.

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Associations between Free Sugar and Sugary Beverage Intake in Early Childhood and Adult NAFLD in a Population-Based UK Cohort

Children ◽

10.3390/children8040290 ◽

2021 ◽

Vol 8 (4) ◽

pp. 290

Author(s):

Ahlia Sekkarie ◽

Jean A. Welsh ◽

Kate Northstone ◽

Aryeh D. Stein ◽

Usha Ramakrishnan ◽

...

Keyword(s):

Total Energy ◽

Hepatic Steatosis ◽

Population Based ◽

Free Sugar ◽

Alcoholic Fatty Liver ◽

Free Sugars ◽

Logistic Regression Models ◽

Sugar Intake ◽

Sugary Beverages ◽

Alcoholic Fatty Liver Disease

(1) Background: High sugar intake is prevalent among children and is associated with non-alcoholic fatty liver disease (NAFLD). The purpose of this study is to determine if a high intake of free sugars and sugary beverages (SB) in childhood is associated with NAFLD in adulthood; (2) Methods: At 24 years, 3095 participants were assessed for severe hepatic steatosis (controlled attenuation parameter >280 dB/m) and had dietary data collected via a food frequency questionnaire at age three years. Multiple logistic regression models adjusted for total energy intake, potential confounders, and a mediator (offspring body mass index (BMI) at 24 years); (3) Results: Per quintile increase of free sugar intake association with severe hepatic steatosis at 24 years after adjusting for total energy was odds ratio (OR):1.07 (95% CL: 0.99–1.17). Comparing the lowest vs. the highest free sugar consumers, the association was OR:1.28 (95% CL: 0.88–1.85) and 1.14 (0.72, 1.82) after full adjustment. The OR for high SB consumption (>2/day) compared to <1/day was 1.23 (95% CL: 0.82–1.84) and OR: 0.98 (95% CL: 0.60–1.60) after full adjustment; (4) Conclusions: High free sugar and SB intake at three years were positively but weakly associated with severe hepatic steatosis at 24 years. These associations were completely attenuated after adjusting for confounders and 24-year BMI.

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Dietary and lifestyle inflammatory scores are associated with increased risk of metabolic syndrome in Iranian adults

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00648-1 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Hossein Farhadnejad ◽

Karim Parastouei ◽

Hosein Rostami ◽

Parvin Mirmiran ◽

Fereidoun Azizi

Keyword(s):

Metabolic Syndrome ◽

Positive Association ◽

Population Based ◽

Population Based Study ◽

Logistic Regression Models ◽

Increased Risk ◽

Confounding Variables ◽

Adjusted Model ◽

Diet And Lifestyle

Abstract Background In the current study, we aimed to investigate the association of dietary inflammation scores (DIS) and lifestyle inflammation scores (LIS) with the risk of metabolic syndrome (MetS) in a prospective population-based study. Methods A total of 1625 participants without MetS were recruited from among participants of the Tehran Lipid and Glucose Study(2006–2008) and followed a mean of 6.1 years. Dietary data of subjects were collected using a food frequency questionnaire at baseline to determine LIS and DIS. Multivariable logistic regression models, were used to calculate the odds ratio (ORs) and 95 % confidence interval (CI) of MetS across tertiles of DIS and LIS. Results Mean ± SD age of individuals (45.8 % men) was 37.5 ± 13.4 years. Median (25–75 interquartile range) DIS and LIS for all participants was 0.80 (− 2.94, 3.64) and 0.48 (− 0.18, − 0.89), respectively. During the study follow-up, 291 (17.9 %) new cases of MetS were identified. Based on the age and sex-adjusted model, a positive association was found between LIS (OR = 7.56; 95% CI 5.10–11.22, P for trend < 0.001) and risk of MetS, however, the association of DIS and risk of MetS development was not statistically significant (OR = 1.30;95% CI 0.93–1.80, P for trend = 0.127). In the multivariable model, after adjustment for confounding variables, including age, sex, body mass index, physical activity, smoking, and energy intake, the risk of MetS is increased across tertiles of DIS (OR = 1.59; 95% CI 1.09–2.33, P for trend = 0.015) and LIS(OR = 8.38; 95% CI 5.51–12.7, P for trend < 0.001). Conclusions The findings of the current study showed that greater adherence to LIS and DIS, determined to indicate the inflammatory potential of diet and lifestyle, are associated with increased the risk of MetS.

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Neighbourhood maternal socioeconomic status indicators and risk of congenital heart disease

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03512-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Qun Miao ◽

Sandra Dunn ◽

Shi Wu Wen ◽

Jane Lougheed ◽

Jessica Reszel ◽

...

Keyword(s):

Socioeconomic Status ◽

Congenital Heart Disease ◽

Heart Disease ◽

Household Income ◽

Congenital Heart ◽

Population Based ◽

Income Poverty ◽

Lower Odds ◽

Logistic Regression Models ◽

Chd Risk

Abstract Background This study aimed to examine the relationships between various maternal socioeconomic status (SES) indicators and the risk of congenital heart disease (CHD). Methods This was a population-based retrospective cohort study, including all singleton stillbirths and live births in Ontario hospitals from April 1, 2012 to March 31, 2018. Multivariable logistic regression models were performed to examine the relationships between maternal neighbourhood household income, poverty, education level, employment and unemployment status, immigration and minority status, and population density and the risk of CHD. All SES variables were estimated at a dissemination area level and categorized into quintiles. Adjustments were made for maternal age at birth, assisted reproductive technology, obesity, pre-existing maternal health conditions, substance use during pregnancy, rural or urban residence, and infant’s sex. Results Of 804,292 singletons, 9731 (1.21%) infants with CHD were identified. Compared to infants whose mothers lived in the highest income neighbourhoods, infants whose mothers lived in the lowest income neighbourhoods had higher likelihood of developing CHD (adjusted OR: 1.29, 95% CI: 1.20–1.38). Compared to infants whose mothers lived in the neighbourhoods with the highest percentage of people with a university or higher degree, infants whose mothers lived in the neighbourhoods with the lowest percentage of people with university or higher degree had higher chance of CHD (adjusted OR: 1.34, 95% CI: 1.24–1.44). Compared to infants whose mothers lived in the neighbourhoods with the highest employment rate, the odds of infants whose mothers resided in areas with the lowest employment having CHD was 18% higher (adjusted OR: 1.18, 95% CI: 1.10–1.26). Compared to infants whose mothers lived in the neighbourhoods with the lowest proportion of immigrants or minorities, infants whose mothers resided in areas with the highest proportions of immigrants or minorities had 18% lower odds (adjusted OR: 0.82, 95% CI: 0.77–0.88) and 16% lower odds (adjusted OR: 0.84, 95% CI: 0.78–0.91) of CHD, respectively. Conclusion Lower maternal neighbourhood household income, poverty, lower educational level and unemployment status had positive associations with CHD, highlighting a significant social inequity in Ontario. The findings of lower CHD risk in immigrant and minority neighbourhoods require further investigation.

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The association between subclinical hypothyroidism and TPOAb positivity with infertility in a population-based study: Tehran thyroid study (TTS)

BMC Endocrine Disorders ◽

10.1186/s12902-021-00773-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Batul Birjandi ◽

Fahimeh Ramezani Tehrani ◽

Atieh Amouzegar ◽

Maryam Tohidi ◽

Razieh Bidhendi Yarandi ◽

...

Keyword(s):

Thyroid Autoimmunity ◽

Population Based ◽

Cross Sectional Study ◽

Cross Sectional ◽

Population Based Study ◽

History Of ◽

Autoimmune Condition ◽

Biochemical Measurements ◽

Adverse Pregnancy ◽

Adjusted Logistic Regression

Abstract Background Thyroid autoimmunity(TAI) is the most prevalent autoimmune condition in women of fertile age. There are increasing data regarding the association of thyroid dysfunction and thyroid autoimmunity with adverse pregnancy outcomes but there is no consensus regarding infertility and TPOAb positivity; thus we aimed to evaluate the association between thyroid TPOAb positivity and infertility in females and males in a population-based study (TTS). Methods Cross-sectional study of 3197 female and male participants in Tehran Thyroid Study (TTS) at the framework of the Tehran Lipid and Glucose Study (TLGS). Data included biochemical measurements and a self-administered questionnaire. Results A total of 12,823 cases in phase 4, 3719 cases (2108 female and 1611 male) were analyzed. The mean TSH of the infertile female and male was 2.52 ± 2.68 μIU/ml and 3.24 ± 10.26 μIU/ml respectively. The TPO median(IQR) of women with and without a history of infertility were 6.05 (3.30–13.96)and 6.04 (3.17–11.15);(P = 0.613), they were 5.08 (3.20–125.68) and 5.31 (3.93–125.68);(P = 0.490) in male participants, respectively. Results of crude and adjusted logistic regression analysis of the development of infertility by thyroid function and TPOAb, except for fT4 in male subjects, depicted no association between infertility and other variables in both crude and adjusted models. Conclusion Based on the result, thyroid autoimmunity was not associated with infertility in both females and males.

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