Factors Associated With Delayed Concussion Reporting by United States Service Academy Cadets

Context Approximately half of individuals who sustain a concussion do not immediately report their injuries. Motivators for not reporting include thinking the suspected concussion was not a serious injury and wanting to continue participating in activity. Additionally, military personnel have concerns about how concussions may affect their careers. However, delayed reporting can prolong neurobehavioral recovery. Understanding the frequency of delayed reporting and contributing factors will aid in identifying individuals who may be more likely to delay reporting. Objective To describe the frequency of delayed concussion reporting by service academy cadets and determine if sex, injury setting, sport level, or medical history is capable of predicting delayed reporting. Design Cohort study. Setting Service academies. Patients or Other Participants A total of 316 patients with concussions were observed from January 2014 to August 2016. Main Outcome Measure(s) All cadets completed an annual concussion baseline collection of demographic, medical history, and sports participation information. Delayed concussion reporting served as the outcome variable. Predictor variables were sex, injury setting, and sport level, as well as concussion, headache, and learning disorder history. Frequencies were calculated to describe the proportion of participants who delayed reporting. Univariable and multivariable logistic regression models were used to assess if the predictor variables were associated with delayed concussion reporting. Odds ratios (ORs) and 95% confidence intervals were calculated for all variables included in the final model. Results Of the patients with concussion, 51% were classified as delayed reporting. In univariable models, females (OR = 1.70) and National Collegiate Athletic Association cadet-athletes (OR = 1.98) were more likely to delay reporting than males and intramural cadet-athletes, respectively. The multivariable model yielded similar findings. Conclusions Roughly half of the cadets who sustained a concussion failed to immediately report their injury. Specifically, our data suggested that female cadets, cadets injured outside of competition, and highly competitive cadet-athletes were almost twice as likely to delay reporting as others.

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The role of unintended pregnancy in internalized stigma among women living with HIV in Kenya

BMC Women s Health ◽

10.1186/s12905-021-01224-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sara Chace Dwyer ◽

Aparna Jain ◽

Wilson Liambila ◽

Charlotte E. Warren

Keyword(s):

Unintended Pregnancy ◽

Hiv Treatment ◽

Outcome Variable ◽

Internalized Stigma ◽

Health Seeking ◽

Logistic Regression Models ◽

Stigma And Discrimination ◽

Women Living With Hiv ◽

Related Stigma ◽

Living With Hiv

Abstract Background Kenya has successfully expanded HIV treatment, but HIV-related stigma and discrimination, and unintended pregnancy remain issues for many Kenyan women living with HIV. While HIV-related stigma can influence the health seeking behaviors of those living with HIV, less is known about how reproductive health outcomes influence internalized stigma among women living with HIV. Methods Baseline data only were used in this analysis and came from an implementation science study conducted in Kenya from 2015 to 2017. The analytic sample was limited to 1116 women who are living with HIV, between 18 to 44 years old, and have ever experienced a pregnancy. The outcome variable was constructed from 7 internalized stigma statements and agreement with at least 3 statements was categorized as medium/high levels of internalized stigma. Unintended pregnancy, categorized as unintended if the last pregnancy was mistimed or unwanted, was the key independent variable. Univariate and multivariate logistic regression models were used to assess the association between unintended pregnancy and internalized stigma. Associations between internalized stigma and HIV-related discrimination and violence/abuse were also explored. Results About 48% agreed with at least one internalized stigma statement and 19% agreed with at least three. Over half of women reported that their last pregnancy was unintended (59%). Within the year preceding the survey, 52% reported experiencing discrimination and 41% reported experiencing violence or abuse due to their HIV status. Women whose last pregnancy was unintended were 1.6 times (95% CI 1.2–2.3) more likely to have medium/high levels of internalized stigma compared to those whose pregnancy was wanted at the time, adjusting for respondents’ characteristics, experiences of discrimination, and experiences of violence and abuse. Women who experienced HIV-related discrimination in the past 12 months were 1.8 times (95% CI 1.3–2.6) more likely to have medium/high levels of internalized stigma compared to those who experienced no discrimination. Conclusions Results suggest that unintended pregnancy is associated with internalized stigma. Integrated HIV and FP programs in Kenya should continue to address stigma and discrimination while increasing access to comprehensive voluntary family planning services for women living with HIV.

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The relationship between socioeconomic position and health literacy among urban and rural adults in regional China

BMC Public Health ◽

10.1186/s12889-021-10600-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wei Chen ◽

Hongfu Ren ◽

Na Wang ◽

Yaqing Xiong ◽

Fei Xu

Keyword(s):

Health Literacy ◽

Educational Attainment ◽

Socioeconomic Position ◽

Population Based ◽

Outcome Variable ◽

Average Income ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Logistic Regression Models ◽

Rural Adults

Abstract Background To examine associations of socioeconomic position (SEP), separately indicated by education, monthly family average income (FAI) and occupation, with health literacy (HL) among adults in regional China. Methods A cross-sectional survey was conducted among urban and rural adults (aged 25–69 years) who were randomly selected, using the probability proportionate to size sampling approach, from Nanjing municipality of China during October and December of 2016. HL, the outcome variable, was assessed using the Chinese Resident Health Literacy Scale. SEP, our independent variable, was separately measured with educational attainment, monthly family average income and occupation. Logistic regression models were introduced to examine SEP-HL association with odds ratio (OR) and 95% confidence interval (CI). Results Totally, 8698 participants completed the survey. The proportion of participants with unweighted and weighted adequate HL was 18.0% (95%CI = 17.2, 18.8%) and 19.9% (95%CI = 16.6, 23.6%), respectively, in this study. After adjustment for possible confounding factors, each SEP indicator was in significantly positive relation to both unweighted and weight HL level. Participants who obtained 13+ and 10–12 years educational attainment, respectively, had 2.41 (95%CI = 1.60, 3.64) and 1.68 (95%CI = 1.23, 2.29) times odds to record weighted adequate HL compared to their counterparts who were with 0–9 years education. Subjects within upper (OR = 1.92, 95%CI = 1.24, 2.98) and middle FAI tertile (OR = 1.59, 95%CI = 1.19, 2.13), respectively, were more likely to report weighted adequate HL relative to those who were within lower FAI tertile. White collars were more likely to have weighted adequate HL (OR = 1.33, 95%CI = 1.09, 1.61) than blue collars. Conclusions Each of education, FAI and occupation was positively associated with health literacy among urban and rural adults in China. The findings have important implications that different SEP indicators can be used to identify vulnerable residents in population-based health literacy promotion campaigns.

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Excessive Daytime Sleepiness and Associated Factors in Military Search and Rescue Personnel

Aerospace Medicine and Human Performance ◽

10.3357/amhp.5946.2021 ◽

2021 ◽

Vol 92 (12) ◽

pp. 975-979

Author(s):

Rokshana Akter ◽

Tricia L. Larose ◽

Jannicke Sandvik ◽

Vivianne Fonne ◽

Anders Meland ◽

...

Keyword(s):

Excessive Daytime Sleepiness ◽

Daytime Sleepiness ◽

Associated Factors ◽

Lifestyle Factors ◽

Search And Rescue ◽

Outcome Variable ◽

Study Cohort ◽

Contributing Factors ◽

Cross Sectional ◽

Rescue Personnel

BACKGROUND: Abnormal excessive daytime sleepiness (EDS) has been reported worldwide, but too little is known about EDS and its determinants in Search and Rescue (SAR) populations. We aimed to determine the prevalence of abnormal EDS and contributing factors among Royal Norwegian Air Force (RNoAF) SAR helicopter personnel.METHODS: In this cross-sectional study, a total of N = 175 RNoAF SAR personnel completed an electronic survey including socio-demographic and lifestyle questions. The Epworth Sleepiness Scale (ESS) was used as both a continuous and categorical outcome variable to measure EDS.RESULTS: Abnormal EDS defined by ESS was found in 41% of the participants in this study. We observed no associations between socio-demographic and lifestyle factors and abnormal EDS in this study. DISCUSSION: There is a high prevalence of abnormal EDS in the current RNoAF SAR population. Despite this elevated level of fatigue, we did not find that the socio-demographic and lifestyle factors assessed in this study were associated with abnormal EDS in RNoAF SAR helicopter personnel. Also unusually, the study cohort did not demonstrate higher scores in factors found to change ESS scores in similar study populations (e.g., caffeine use, tobacco use, exercise level). Further research is required to investigate other factors (organizational, operational) that may be associated with abnormal EDS in this and other SAR populations.Akter R, Larose TL, Sandvik J, Fonne V, Meland A, Wagstaff AS. Excessive daytime sleepiness and associated factors in military search and rescue personnel. Aerosp Med Hum Perform. 2021; 92(12):975–979.

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An Empirical Study of Factors Influencing Consumer Attitudes towards SMS Advertising

International Journal of Online Marketing ◽

10.4018/ijom.2014070101 ◽

2014 ◽

Vol 4 (3) ◽

pp. 1-13 ◽

Cited By ~ 3

Author(s):

Pradeep Dharmadasa ◽

Thilini Alahakoon

Keyword(s):

Empirical Study ◽

Structural Equation ◽

Business Management ◽

Consumer Attitudes ◽

Predictor Variables ◽

Outcome Variable ◽

Factors Influencing ◽

Central Route ◽

Customer Attitudes ◽

The University

This article examines factors influencing consumer attitudes towards SMS advertising. The study's research framework was conceptualized using five predictor variables – informativeness, irritation, privacy, credibility, and incentives – and an outcome variable of consumer attitudes towards SMS advertising. The informativeness, irritation, and privacy was labelled as central route constructs and credibility and incentives were labelled as peripheral route constructs. Survey data collected from 251 mobile users selected from a cohort of undergraduates in business management from the University of Colombo, Sri Lanka, were analyzed using the Structural Equation Method (SEM). Results suggest that the informativeness and incentive variables are positively associated with customer attitudes towards SMS advertising, whereas irritation and privacy are found to be negatively associated with consumer attitudes towards SMS advertising. Surprisingly, credibility was found to be an insignificant factor predicting consumer attitudes towards SMS advertising. Several implications for consumer attitudes towards SMS advertising are discussed.

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Do Socioeconomic Conditions Explain Ethnic Inequalities in Tooth Loss among US Adults?

Ethnicity & Disease ◽

10.18865/ed.28.3.201 ◽

2018 ◽

Vol 28 (3) ◽

pp. 201

Author(s):

Fatma W. Nazer ◽

Wael Sabbah

Keyword(s):

Ethnic Differences ◽

Tooth Loss ◽

Family Income ◽

The United States ◽

Outcome Variable ◽

Behavioral Risk ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Logistic Regression Models ◽

Ethnic Inequalities

Objective: To assess whether there are ethnic differences in tooth loss among adult Americans aged <40 years and whether socioeconomic position attenuates these differences if they exist.Methods: Data were from the 2014 Behavioral Risk Factor Surveillance System, a health-related telephone cross-sectional survey of a nationally representative sample of US adults. Tooth loss (one tooth or more) was used as the outcome variable. Ethnicity was the main explanatory variable. Family income, education and health insurance were also used in the analysis. Logistic regression models for tooth loss were constructed adjusting for demographic (age, sex, and ethnicity), socioeconomic indicators (income and education), health insurance, dental visits, smoking and diabetes.Results: A total of 76,273 participants were included in the analysis. The prevalence of tooth loss was highest among Blacks (33.7%). Hispanics and other ethnic groups had a higher prevalence of tooth loss than Whites, 29.1% (95%CI: 27.7-30.6), 22.0% (95%CI: 20.3-23.8), and 20.8% (95%CI: 20.2-21.4), respectively. Blacks had odds ratios (OR) 1.98 (95%CI: 1.81-2.16) for tooth loss compared with Whites. After adjusting for socioeconomic positions (SEP), the relationship attenuated but remained significant with OR 1.71 (95%CI: 1.55-1.90).Conclusions: Despite recent changes in the health care system in the United States, ethnic inequalities in tooth loss still exist. Income and education partially explained ethnic differences in tooth loss among Americans aged <40 years.Ethn Dis. 2018;28(3):201-206; doi:10.18865/ ed.28.3.201

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Assessment of Influential Factors for Scours Associated with Cryptosporidium sp., Rotavirus and Coronavirus in Calves from Argentinean Dairy Farms

Animals ◽

10.3390/ani11092652 ◽

2021 ◽

Vol 11 (9) ◽

pp. 2652

Author(s):

Emiliano Bertoni ◽

Adrián A. Barragán ◽

Marina Bok ◽

Celina Vega ◽

Marcela Martínez ◽

...

Keyword(s):

Management Practices ◽

Dairy Farms ◽

Herd Size ◽

Influential Factors ◽

Dairy Calves ◽

Farm Size ◽

Common Disease ◽

Contributing Factors ◽

Fecal Samples ◽

Logistic Regression Models

Scours is the most common disease in dairy calves, and it is a multifactorial syndrome complex. Cryptosporidium sp. (C. sp.), rotavirus group A (RVA), and bovine coronavirus (BCoV) are the three main pathogens associated with scours. The objective of this study was to identify potential factors associated with scours, C. sp., RVA, and BCoV infections in preweaned dairy calves from Lerma Valley in Salta Province, Argentina. A total of 488 preweaned calves from 19 dairy farms located in the Lerma Valley were enrolled in this observational study. One fecal sample was collected from each calf between one week and two months of age for assessment of C. sp., RVA, and BCoV infection status. Cryptosporidium sp. oocysts and RVA and BCoV antigens in fecal samples were assessed using microscopic observation and indirect enzyme-linked immune sorbent assay (iELISA), respectively. A voluntary questionnaire was developed and used to collect data regarding management practices from the participants’ farms. The data were analyzed using multivariable logistic regression models. Scours incidence was 35.4%, and a greater proportion of calves younger than 20 days were affected. Of the fecal samples, 18% and 9.5% tested were positives for C. sp. and RVA, respectively, while BCoV was detected only in two calves. Furthermore, 84.2% and 63.1% of the farms tested positive for Cryptosporidium sp. and RVA, respectively. In addition, the following variables were associated with higher odds of having scours: (1) herd size (>300 milking cows; OR = 1.7), (2) calf age (<20 days of age; OR = 2.2), (3) RVA and C. sp. test (positive test; RVA OR = 2.6; C. sp. OR = 3), calf feeding practices (feeding milk replacer; OR = 1.81), and newborn calf management practices (calf moved from maternity pen <6 h after calving; OR = 1.7). Concerning RVA infection, calves less than 20 days of age (OR = 2.6) had a higher chance of testing positive for RVA, while calves that remained in the calving pen for less than 6 h after calving had a lower chance (OR = 0.3). On the other hand, for C. sp. infection, large farm size (>300 milking cows; OR = 1.2) and young calf age (<20 days of age; OR = 4.4) indicated a higher chance of testing positive for C. sp., while calves belonging to farms that fed frozen colostrum (OR = 0.2) had a lower chance of becoming infected with C. sp. The result of this study indicated that scours is a prevalent disease in farms of the Lerma Valley, Salta, Argentina, and that RVA and C. sp. infections, along with specific farm management practices, might be important contributing factors that could increase the chance of NCS in dairy farms.

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Vaccine hesitancy among paediatric nurses: Prevalence and associated factors

PLoS ONE ◽

10.1371/journal.pone.0251735 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0251735

Author(s):

Usue Elizondo-Alzola ◽

Mireia G. Carrasco ◽

Laia Pinós ◽

Camila Andrea Picchio ◽

Cristina Rius ◽

...

Keyword(s):

Whooping Cough ◽

Vaccination Schedule ◽

Childhood Vaccination ◽

Vaccine Hesitancy ◽

Outcome Variable ◽

Bivariate Analysis ◽

Cross Sectional ◽

Logistic Regression Models ◽

Perception Of Safety ◽

Adjusted Logistic Regression

Objective This study describes the prevalence of vaccine hesitancy associated with the Catalan systematic childhood vaccination calendar and some related psychosocial determinants among paediatric primary care nurses in Barcelona (Spain). Methods Cross-sectional descriptive study. In 2017 we invited the paediatric nurses (N = 165) working in Barcelona public primary health centres with paediatric departments (N = 41) to participate. They answered a questionnaire with sociodemographic and behavioural variables: severity and perceived probability of contracting the diseases of the vaccines in the vaccination schedule; safety and protection offered by each vaccine; and beliefs, social norms, and knowledge about vaccines. Outcome variable was vaccine hesitancy, dichotomized into not hesitant (nurses who would vaccinate their own offspring), and hesitant (including those who would not vaccinate them, those who had doubts and those who would delay the administration of one or more vaccines). We performed bivariate analysis and adjusted logistic regression models. Results 83% of paediatric nurses (N = 137) agreed to participate. 67.9% had the intention to vaccinate their children of all the vaccines in the systematic schedule. 32.1% of nurses experienced vaccine hesitancy, especially about the HPV (21.9%) and varicella (17.5%) vaccines. The multivariate analysis suggests associations between hesitancy and low perception of the severity of whooping cough (aOR: 3.88; 95%CI:1.32–11.4), low perception of safety of the HPV vaccine (aOR:8.5;95%CI:1.24–57.8), the belief that vaccines are administered too early (aOR:6.09;95%CI:1.98–18.8), and not having children (aOR:4.05;95%CI:1.22–13.3). Conclusions Although most paediatric nurses had the intention to vaccinate their own children, almost one-third reported some kind of vaccine hesitancy, mainly related to doubts about HPV and varicella vaccines, as well as some misconceptions. These factors should be addressed to enhance nurses’ fundamental role in promoting vaccination to families.

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TP6.1.9 Prolonged post-operative stay following emergency and elective laparoscopic cholecystectomies and its contributing factors

British Journal of Surgery ◽

10.1093/bjs/znab362.030 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

James Lucocq ◽

Ganesh Radhakishnan ◽

John Scollay ◽

Pradeep Patil

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gallstone Disease ◽

Contributing Factors ◽

Surgical Decision ◽

Logistic Regression Models ◽

Factors Associated ◽

Surgical Units ◽

Emergency Group ◽

Elective Group ◽

Heterogenous Population

Abstract Aims Patients who undergo laparoscopic cholecystectomy (LC) for gallstone disease are a heterogenous population with many variables involved in their management. The aim was to identify the proportion of patients who have a prolonged post-operative stay (PPS; >3days) following elective and emergency LC and the variables that most contribute to PPS. Methods We retrospectively collected data for all patients who underwent an elective and emergency LC across three surgical units from 2015 to 2020. Rates of PPS were compared between elective and emergency groups and variables associated with PPS were identified using multivariate logistic regression models. Results 2769 patients were included in the study (median age, 53years(range, 13-92); M:F,1:2.7; emergency:elective,1:3.6) The rate of PPS was higher in the emergency versus elective group (25.1% versus 6.6%; p<0.0001). Pain was one of the major causes in both groups. In the elective group, factors associated with PPS included cholecystitis (OR,1.96; p=0.008), previous gallstone related admissions (OR,1.48; p=0.008), pre-operative ERCP (OR,3.58;p<0.0001), ASA (OR,1.82; p=0.001) and age (years) (OR,1.03;p=0.001). In the emergency group, factors associated with PPS include cholecystitis (OR,5.3;p<0.0001), ASA (OR,1.96; p = 0.01) and pre-operative ERCP (OR,4.44;p=0.001). Conclusions The rate of PPS following laparoscopic cholecystectomy is significant, particularly in the emergency group. Although the possibility of PPS cannot be avoided, patient information regarding the possibility of PPS is important, particularly for those at risk. The risk factors for PPS should be used to guide surgical decision making and should be followed by targeted management of these patients including optimised pain relief.

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Explaining differences in retirement timing preferences between the solo self-employed and employees

International Journal of Manpower ◽

10.1108/ijm-01-2019-0038 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Dieuwke Zwier ◽

Marleen Damman ◽

Swenne G. Van den Heuvel

Keyword(s):

Multinomial Logistic Regression ◽

Job Characteristics ◽

Outcome Variable ◽

Retirement Savings ◽

Explanatory Role ◽

Content Type ◽

Logistic Regression Models ◽

Work From Home ◽

Retirement Timing ◽

Underlying Mechanisms

PurposePrevious research has shown that self-employed workers are more likely than employees to retire late or to be uncertain about retirement timing. However, little is known about the underlying mechanisms. This study aims to fill this gap, by focusing on the explanatory role of various job characteristics – flexibility, autonomy, skills-job match and job security – for explaining differences in retirement preferences between the solo self-employed and employees.Design/methodology/approachData were used of 8,325 employees and 663 solo self-employed respondents (age 45–64) in the Netherlands, who participated in 2016 in the Study on Transitions in Employment, Ability, and Motivation (STREAM). The outcome variable distinguished between early, on-time, late and uncertain retirement preferences. Multinomial logistic regression models were estimated, and mediation was tested using the Karlson-Holm-Breen (KHB) method.FindingsThe solo self-employed are more likely than employees to prefer late retirement (vs “on-time”) and to be uncertain about their preferred retirement age. Job characteristics mediate 21% of the relationship between solo self-employment and late retirement preferences: the self-employed experience more possibilities than employees to work from home and to choose their own working times, which partly explains why they prefer to retire late.Originality/valueIn discussions about retirement, often reference is made to differences in retirement savings and retirement regulations between the solo self-employed and employees. The current study shows that differences in job characteristics also partly explain the relatively late preferred retirement timing of solo self-employed workers.

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The Global Impact of COVID-19 on Craniomaxillofacial Surgeons

Craniomaxillofacial Trauma & Reconstruction ◽

10.1177/1943387520929809 ◽

2020 ◽

Vol 13 (3) ◽

pp. 157-167 ◽

Cited By ~ 2

Author(s):

Justin van der Tas ◽

Thomas Dodson ◽

Daniel Buchbinder ◽

Stefano Fusetti ◽

Michael Grant ◽

...

Keyword(s):

Virus Disease ◽

Statistical Significance ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

Geographic Region ◽

Outcome Variable ◽

Cross Sectional ◽

Logistic Regression Models ◽

Long Term Impact ◽

The Impact

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

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