scholarly journals Predicting survival function and identifying associated factors in patients with renal insufficiency in the metropolitan area of Maringá, Paraná State, Brazil

2018 ◽  
Vol 34 (1) ◽  
Author(s):  
Thiago G. Ramires ◽  
Luiz R. Nakamura ◽  
Ana J. Righetto ◽  
Edwin M. M. Ortega ◽  
Gauss M. Cordeiro
Keyword(s):  
Renal Insufficiency ◽  
Metropolitan Area ◽  
Associated Factors ◽  
Generalized Additive Models ◽  
Survival Function ◽  
National Health System ◽  
Public Health Problem ◽  
Additive Models ◽  
Factors Associated ◽  
Significant Factors

Renal insufficiency is a serious medical and public health problem worldwide. Recently, although many surveys have been developed to identify factors related to the lifetime of patients with renal insufficiency, controversial results from several studies suggest that researches should be conducted by region. Thus, in this study we aim to predict and identify factors associated with the lifetime of patients with chronic renal failure (CRF) in the metropolitan area of Maringá, Paraná State, Brazil, based on the generalized additive models for location, scale and shape (GAMLSS) framework. Data used in this study were collected from the Maringá Kidney Institute and comprehends 177 patients (classified with CRF and mostly being treated under the Brazilian Unified National Health System) enrolled in a hemodialysis program from 1978 up to 2010. By using this approach, we concluded that in other regions, gender, kidney transplant indicator, antibodies to hepatitis B and antibodies to hepatitis C are significant factors that affect the expected lifetime.

scholarly journals Colostrum Avoidance Practices and Its Associated Factors Among Mothers of Children Aged Less Than 12 Months in Jinka Town, South Ethiopia, 2019

2020 ◽  
Author(s):  
Elias Amaje Hadona ◽  
Feleke Gebremeskel Weldehawariat ◽  
Muluken Bekele Sorrie
Keyword(s):  
Developing Countries ◽  
Breast Feeding ◽  
Associated Factors ◽  
Public Health Problem ◽  
Home Delivery ◽  
Systematic Sampling ◽  
Feeding Practice ◽  
Factors Associated ◽  
South Ethiopia ◽  
Delayed Initiation

Abstract Background: Colostrum avoidance is the common nutritional malpractices in developing countries including Ethiopia. Discarding colostrum is the main causes of respiratory disease and diarrheal disease during childhood and contributes to over a million avoidable infant deaths each year and remains a public health problem in developing countries. Despite the fact that it has a negative effect on child health, little is known about the extent of the problem and its contributing factors in South Ethiopia particularly in study area. The aim of the study was to determine the prevalence of colostrum avoidance practices and associated factors among Mothers of children aged less than 12 months in Jinka Town, South Ethiopia. Methods: A community based cross-sectional study was conducted at Jinka Town from March 1 to 30, 2019. A total of 420 mothers having children less than 12 months of age were selected by systematic sampling technique. The data were collected by using pretested interviewer administered and semi-structured questionnaires. The data was entered using EPIDATA 3.1 and exported to SPSS version 23 for analysis. Descriptive statistics, Binary and multivariable logistic regression analysis were done. An adjusted odds ratio with 95% CI at a p-value < 0.05 was estimated to identify statistically significant variables with colostrum avoidance practices. Results: The prevalence of colostrum avoidance practice was 9.8% [95% CI: (6.9–12.5)]. Delayed initiation of breast feeding [AOR= 9.08(95% CI 4.16-19.83)], Lack of breast feeding counselling [AOR= 2.33(95% CI 1.11-4.87)], Home delivery of index child [AOR= 2.48 (95% CI 1.16-5.27)] and Poor knowledge on breast feeding [AOR=4.55(95% CI 1.95-10.63)] were factors associated with colostrum avoidance practices. Conclusions: Colostrum avoidance practice among mothers of children aged less than 12 months in Jinka town was high. Delayed initiation of Breas feeding, lack of breast feeding counselling, Home delivery and knowledge on breastfeeding feeding practice were factors associated with colostrum avoidance practice. Promoting institutional delivery services and strengthening of breast feeding counselling during antenatal and postnatal care were recommended for the promotion of the nutritional value of colostrum and its health benefits.

scholarly journals Colostrum Avoidance Practices and Its Associated Factors Among Mothers of Children Aged Less Than 12 Months in Jinka Town, South Ethiopia, 2019

2020 ◽  
Author(s):  
Elias Amaje Hadona ◽  
Feleke G/Meskel W/Hawariat ◽  
Muluken Bekele Sorrie
Keyword(s):  
Developing Countries ◽  
Breast Feeding ◽  
Associated Factors ◽  
Public Health Problem ◽  
Home Delivery ◽  
Systematic Sampling ◽  
Feeding Practice ◽  
Factors Associated ◽  
South Ethiopia ◽  
Delayed Initiation

Abstract Introduction: Colostrum avoidance is the common nutritional malpractices in developing countries including Ethiopia. Discarding colostrum is the main causes of respiratory disease and diarrheal disease during childhood and contributes to over a million avoidable infant deaths each year and remains a public health problem in developing countries. Despite the fact that it has a negative effect on child health, little is known about the extent of the problem and its contributing factors in South Ethiopia particularly in study area. The aim of the study was to determine the prevalence of colostrum avoidance practices and associated factors among Mothers of children aged less than 12 months in Jinka Town, South Ethiopia. Methods: A community based cross-sectional study was conducted at Jinka Town from March 1 to 30, 2019. A total of 420 mothers having children less than 12 months of age were selected by systematic sampling technique. The data were collected by using pretested interviewer administered and semi-structured questionnaires. The data was entered using EPIDATA 3.1 and exported to SPSS version 23 for analysis. Descriptive statistics, Binary and multivariable logistic regression analysis were done. An adjusted odds ratio with 95% CI at a p-value < 0.05 was estimated to identify statistically significant variables with colostrum avoidance practices. Results: The prevalence of colostrum avoidance practice was 9.8% [95% CI: (6.9–12.5)]. Delayed initiation of breast feeding [AOR= 9.08(95% CI 4.16-19.83)], Lack of breast feeding counselling [AOR= 2.33(95% CI 1.11-4.87)], Home delivery of index child [AOR= 2.48 (95% CI 1.16-5.27)] and Poor knowledge on breast feeding [AOR=4.55(95% CI 1.95-10.63)] were factors associated with colostrum avoidance practices. Conclusions: Colostrum avoidance practice among mothers of children aged less than 12 months in Jinka town was high. Delayed initiation of Breas feeding, lack of breast feeding counselling, Home delivery and knowledge on breastfeeding feeding practice were factors associated with colostrum avoidance practice. Promoting institutional delivery services and strengthening of breast feeding counselling during antenatal and postnatal care were recommended for the promotion of the nutritional value of colostrum and its health benefits.

scholarly journals Factors associated with the spatial heterogeneity of COVID-19 in France: a nationwide ecological study

2020 ◽  
Author(s):  
Jean Gaudart ◽  
Jordi Landier ◽  
laetitia huiart ◽  
Eva Legendre ◽  
Laurent Lehot ◽  
...  
Keyword(s):  
Spatial Heterogeneity ◽  
Ecological Study ◽  
Generalized Additive Models ◽  
Principal Component ◽  
Additive Models ◽  
Factors Associated ◽  
North East ◽  
The North ◽  
Incidence And Mortality ◽  
The Impact

Like in many countries and regions, spread of the COVID 19 pandemic has exhibited important spatial heterogeneity across France, one of the most affected countries so far. To better understand factors associated with incidence, mortality and lethality heterogeneity across the 96 administrative departments of metropolitan France, we thus conducted a geoepidemiological analysis based on publicly available data, using hierarchical ascendant classification (HAC) on principal component analysis (PCA) of multidimensional variables, and multivariate analyses with generalized additive models (GAM). Our results confirm a marked spatial heterogeneity of in-hospital COVID 19 incidence and mortality, following the North East / South West diffusion of the epidemic. The delay elapsed between the first COVID-19 associated death and the onset of the national lockdown on March 17th, 2020, appeared positively associated with in-hospital incidence, mortality and lethality. Mortality was also strongly associated with incidence. Mortality and lethality rates were significantly higher in departments with older population, but they were not significantly associated with the number of intensive-care beds available in 2018. We did not find any significant association between incidence, mortality or lethality rates and incidence of new chloroquine and hydroxychloroquine dispensations in pharmacies either, nor between COVID 19 incidence and climate, nor between economic indicators and in-hospital COVID 19 incidence or mortality. This ecological study highlights the impact of population age structure, epidemic spread and transmission mitigation policies in COVID-19 morbidity or mortality heterogeneity.

scholarly journals Job Satisfaction and Associated Factors Among Midwives Working in Health Centers of Central Zone, Ethiopia

2020 ◽  
Author(s):  
Belsity Temesgen Meselu ◽  
Asmare Talie Wondie ◽  
Tigist Adeb Shedie ◽  
Melaku Admas Tibebu
Keyword(s):  
Job Satisfaction ◽  
Management System ◽  
Associated Factors ◽  
Central Zone ◽  
Health Centers ◽  
Satisfaction Level ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
Significant Factors

Abstract Background: Job satisfaction depends on the interactions of employee’s personal characteristics, values and expectations with the work environment and the organization. Low job satisfaction among midwives is supposed to be a problem to achieve organizational goals. Due to this reason, it is a must to determine their level of satisfaction and the contributing factors. The objective is to assess job satisfaction and associated factors among midwives working in Health Centers of Central Zone of Tigray, Ethiopia, 2019Method: - An institution-based cross sectional study was conducted on March 2019 at Central Zone of Tigray among 140 midwives selected using simple random sampling. Logistic regression analysis was used to identify factors related to job satisfaction. Variables which have p-value less than or equal to 0.05 with corresponding AOR at 95 confidence interval was considered to declare the significance association.Result: This study revealed that job satisfaction of health professional working Central Zone of Tigray was 43.57%. Of which respondents’ 92 (65.7%) were females and 128(91.4%) were Orthodox region followers. Majority of the respondents 85(60.7%) were under the age of 30 and almost half 69(49.3%) of the respondents were married. Motivation, management system, and work were identified as significant factors associated with midwives’ job satisfaction level. Regarding motivation, the probability of being satisfied among midwives not motivated to do their job, were 76% times less likely compared to their counterpart, whereas the management system, the probability of not satisfied with the management system were 79.2% times less likely satisfied than who were satisfied with the management system. Work satisfaction, the probability of not satisfied with their work was 91.6% times less likely satisfied than those who were satisfied with their work. Conclusion: Job satisfaction of midwives in central zone health centers was found to be low. Motivation, management system, and work were identified as significant factors associated with midwives’ job satisfaction level.

Correlation between Agricultural Biodiversity, Dietary Diversity, Household Food Security and Associated Factors of Wasting among 6-59 Months old Children in Ambassel Woreda, North East Ethiopia

2020 ◽  
Author(s):  
Sisay Eshete Tadesse ◽  
Tefera Chane Mekonnen ◽  
Yitbarek Wasihun Feleke ◽  
Metadel Adane Mesfine ◽  
Nigus Cherie Bekele ◽  
...  
Keyword(s):  
Associated Factors ◽  
Dietary Diversity ◽  
Statistical Significance ◽  
Public Health Problem ◽  
Household Food Security ◽  
P Value ◽  
Agricultural Biodiversity ◽  
Dietary Diversity Score ◽  
Factors Associated ◽  
Household Food

Abstract Background Worldwide there are up to 300,000 known plant species. But, only 2% are consumed by human. Under nutrition among under five children is still a public health problem. There is an information gap on the importance of agricultural biodiversity in relation to dietary intake and nutritional status. Objective to assess the correlation between agricultural bio-diversity, dietary diversity, household food insecurity and associated factors of wasting among 6-59 months old children. Method A community based cross-sectional study was employed among 367 systematically selected children aged 6-59 months from January to April 2018. The sample size was determined by Epi Info 7.2.5.1. Data were collected by open data kit. Height and weight were measured using height measuring board and SECA Germany. Data entry and analysis was done using Epi Data version 3.1 and STATA version 14. Descriptive statistics was computed and reported using frequency and percentage. Anthropometric measurements were analyzed using WHO Anthro 2005 software. Linear regression and correlation were done. A p-value of < 0.05 and 95% confidence intervals were used to see the statistical significance. Result The prevalence of wasting was 7.3%(95% C.I; 4.6, 10.0). Dietary diversity score is found to be correlated with height for weight Z score (r=-0.11, p-value=0.04) of children. Mother who are unable to read and write (B=-.126, 95% CI: -1.02, -.034) and dietary diversity score (B=.143, 95% CI: .14, 1.86) were factors associated with wasting. Conclusion and Recommendation Wasting is higher than the national target of Ethiopia. Educational status of mother and DDS were factors associated with wasting among children aged 6-59 months. Prevention of nutritional problem should include reducing illiteracy rate among mother/care-givers and promote diversified intake of diet among 6-59 months old.

scholarly journals Hotspots of childhood obesity in a large metropolitan area: does neighbourhood social and built environment play a part?

2019 ◽  
Vol 49 (3) ◽  
pp. 934-943 ◽  
Author(s):  
Ana Isabel Ribeiro ◽  
Ana Cristina Santos ◽  
Verónica M Vieira ◽  
Henrique Barros
Keyword(s):  
Childhood Obesity ◽  
Built Environment ◽  
Metropolitan Area ◽  
Fast Food ◽  
Generalized Additive Models ◽  
Geographic Area ◽  
Population Based ◽  
Additive Models ◽  
Individual Level ◽  
Neighbourhood Characteristics

Abstract Background Effective place-based interventions for childhood obesity call for the recognition of the high-risk neighbourhoods and an understanding of the determinants present locally. However, such an approach is uncommon. In this study, we identified neighbourhoods with elevated prevalence of childhood obesity (‘hotspots’) in the Porto Metropolitan Area and investigated to what extent the socio-economic and built environment characteristics of the neighbourhoods explained such hotspots. Methods We used data on 5203 7-year-old children from a population-based birth cohort, Generation XXI. To identify hotspots, we estimated local obesity odds ratios (OR) and 95% confidence intervals (95%CI) using generalized additive models with a non-parametric smooth for location. Measures of the socio-economic and built environment were determined using a Geographic Information System. Associations between obesity and neighbourhood characteristics were expressed as OR and 95%CI after accounting for individual-level variables. Results At 7 years of age, 803 (15.4%) children were obese. The prevalence of obesity varied across neighbourhoods and two hotspots were identified, partially explained by individual-level variables. Adjustment for neighbourhood characteristics attenuated the ORs and further explained the geographic variation. This model revealed an association between neighbourhood socio-economic deprivation score and obesity (OR = 1.014, 95%CI 1.004–1.025), as well as with the presence of fast-food restaurants at a walkable distance from the residence (OR = 1.37, 1.06–1.77). Conclusions In our geographic area it was possible to identify neighbourhoods with elevated prevalence of childhood obesity and to suggest that targeting such high-priority neighbourhoods and their environmental characteristics may help reduce childhood obesity.

scholarly journals Survival Data Analysis with Time-Dependent Covariates Using Generalized Additive Models

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Masaaki Tsujitani ◽  
Yusuke Tanaka ◽  
Masato Sakon
Keyword(s):  
Survival Data ◽  
Cross Validation ◽  
Proportional Hazards Model ◽  
Generalized Additive Models ◽  
Survival Function ◽  
Smoothing Splines ◽  
Additive Models ◽  
Cox Proportional Hazards Model ◽  
Biliary Cirrhosis ◽  
Long Term Study

We discuss a flexible method for modeling survival data using penalized smoothing splines when the values of covariates change for the duration of the study. The Cox proportional hazards model has been widely used for the analysis of treatment and prognostic effects with censored survival data. However, a number of theoretical problems with respect to the baseline survival function remain unsolved. We use the generalized additive models (GAMs) with B splines to estimate the survival function and select the optimum smoothing parameters based on a variant multifold cross-validation (CV) method. The methods are compared with the generalized cross-validation (GCV) method using data from a long-term study of patients with primary biliary cirrhosis (PBC).

scholarly journals Colostrum Avoidance and Associated Factors Among Mothers of Children Aged Less Than 12 Months in Jinka Town, South Ethiopia, 2019

2020 ◽  
Author(s):  
Elias Amaje Hadona ◽  
Feleke Gebremeskel Weldehawariat ◽  
Muluken Bekele Sorrie
Keyword(s):  
Developing Countries ◽  
Breast Feeding ◽  
Associated Factors ◽  
Public Health Problem ◽  
Home Delivery ◽  
Systematic Sampling ◽  
Feeding Practice ◽  
Factors Associated ◽  
South Ethiopia ◽  
Delayed Initiation

Abstract Background: Colostrum avoidance is the common nutritional malpractices in developing countries including Ethiopia. Discarding colostrum is the main causes of respiratory disease and diarrheal disease during childhood and contributes to over a million avoidable infant deaths each year and remains a public health problem in developing countries. Despite the fact that it has a negative effect on child health, little is known about the extent of the problem and its contributing factors in South Ethiopia particularly in study area. The aim of the study was to determine the prevalence of colostrum avoidance practices and associated factors among Mothers of children aged less than 12 months in Jinka Town, South Ethiopia. Methods: A community based cross-sectional study was conducted at Jinka Town from March 1 to 30, 2019. A total of 420 mothers having children less than 12 months of age were selected by systematic sampling technique. The data were collected by using pretested interviewer administered and semi-structured questionnaires. The data was entered using EPIDATA 3.1 and exported to SPSS version 23 for analysis. Descriptive statistics, Binary and multivariable logistic regression analysis were done. An adjusted odds ratio with 95% CI at a p-value < 0.05 was estimated to identify statistically significant variables with colostrum avoidance practices. Results: The prevalence of colostrum avoidance practice was 9.8% [95% CI: (6.9–12.5)]. Delayed initiation of breast feeding [AOR= 9.08(95% CI 4.16-19.83)], Lack of breast feeding counselling [AOR= 2.33(95% CI 1.11-4.87)], Home delivery of index child [AOR= 2.48 (95% CI 1.16-5.27)] and Poor knowledge on breast feeding [AOR=4.55(95% CI 1.95-10.63)] were factors associated with colostrum avoidance practices. Conclusions: Colostrum avoidance practice among mothers of children aged less than 12 months in Jinka town was high. Delayed initiation of Breas feeding, lack of breast feeding counselling, Home delivery and knowledge on breastfeeding feeding practice were factors associated with colostrum avoidance practice. Promoting institutional delivery services and strengthening of breast feeding counselling during antenatal and postnatal care were recommended for the promotion of the nutritional value of colostrum and its health benefits.

scholarly journals Associated factors to the perception of clinical coordination in the Catalan national health system

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Esteve Matalí ◽  
I Vargas ◽  
E Sánchez ◽  
F Cots ◽  
P Plaja ◽  
...  
Keyword(s):  
Health System ◽  
National Health ◽  
Care Coordination ◽  
Associated Factors ◽  
National Health System ◽  
Organizational Factors ◽  
The Other ◽  
Level Of Care ◽  
Factors Associated ◽  
Levels Of Care

Abstract Background Clinical coordination across levels of care is a priority for health systems. The aim is to analyse the factors associated to a high perception of clinical coordination of primary (PC) and secondary care (SC) doctors of the Catalan national health system (NHS). Methods Cross-sectional study based on the self-administered online questionnaire COORDENA-CAT. Data collection: October-December 2017. Study population: PC and SC (acute and long term) doctors of the public Catalan NHS that had been working for at least one year in the organization, had direct contact with patients and related with doctors of the other level of care. The participation rate was 20.5%, with a sample of 3308 doctors. Outcome variable: perception of clinical coordination across levels of care. Explanatory variables: socio-demographic, employment characteristics, attitude towards work, type of area (according to type of hospital and managing entity), interactional factors, organizational factors and knowledge of existing coordination mechanisms. Stratification variable: level of care. Descriptive and multivariate analysis by logistic regression. Results Only 32.13% of PC doctors and 35.72% of SC doctors found that patient care was coordinated across care levels within their area. In both levels of care, knowing the doctor of the other level; finding that their practice influences the other care level; finding that the organization’s management facilitates coordination; working in an area where the same entity manages SC and majority of PC and to hold joint clinical case conferences are factors positively associated to a high perception of clinical coordination. Besides, there are other positively associated factors exclusive for each level of care. Conclusions Several common interactional and organizational factors are positively associated to a high perception of care coordination. Introducing policies to enhance such factors can foster care coordination in the Catalan NHS. Key messages This study found out factors associated to clinical coordination across care levels in each level. It helps to develop specific coordination policies by level of care to address those factors.

Self reported fall and associated factors among adult people with visual impairment in Gondar, Ethiopia.

2019 ◽  
Author(s):  
Moges Gashaw Getnet ◽  
Balamurugan Janakiraman ◽  
Amare Minyihun ◽  
Gashaw Jember Belay ◽  
Kedir Sany
Keyword(s):  
Visual Impairment ◽  
Associated Factors ◽  
Public Health Problem ◽  
High Rate ◽  
Major Public Health Problem ◽  
Hospital Data ◽  
Binary Logistic Regression Model ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Associated

Abstract Background Fall is one of the most common and potentially disabling issues among people with visual impairment. Fall is a major public health problem and the leading cause of unintentional injury, disability and premature death worldwide. Several population based studies have reported poor vision as a frequent risk factor for falls yet large number of studies failed clarify the role of visual impairment in falls. Ethiopia lacked estimates of falls among both normal sighted and visual impaired persons. Therefore, this study aims to determine the prevalence of and visual related factors, other factors associated with falls among adult people with medically diagnosed visual impairment.Methods An institutional based cross-sectional study was conducted among visually impaired adults who were attended ophthalmology clinic in University of Gondar comprehensive specialized hospital. Data was collected by interview methods using structured questionnaire, patient record review and physical measurement. A bivariate and multivariable binary logistic regression model analysis was used to identify factors associated with fall. Adjusted Odds Ratio with corresponding 95% Confidence Interval was computed to show the strength of association.Results A total of 328 adults with visual impairment participated in the study (97.3% response rate). The age of the participants ranged from 25 to 89 years with mean age of (56.46±14.2 years). The overall cumulative prevalence of self-reported fall among adults with visual impairment was 26.8% with 95%CI (22.0-31.4). The major associated factors of fall identified by multivariate analysis were fear of falling; some concerned: (AOR, 4.12; 95%CI, 1.44-11.76), very concerned fear (AOR, 10.03; 95% CI, 3.03-33.21), medication: (AOR, 4.63; 95% CI 2.14-10.00) and self reported depression: (AOR, 3.46; 95%CI 1.11-10.79).Conclusion A moderate self-reported prevalence with high rate of fall related injuries was reported adult people with visual impairment participants in this study. The results indicate that strategies to provide fall prevention environment should be developed to reduce this impact of visual impairment and reduce fall and fall related injuries.

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