Explanatory factors of the psychomotor development of infants aged 1-24 months in N'Djamena (Chad)

Introduction: Psychomotor development (PMD) reflects the cerebral maturation through sensory, motor and psychological acquisitions of an individual. Its evaluation allows an early diagnosis of delays in order to take care of them. The objective of this study was to determine the profile and explanatory factors of PMD of infants in N'Djamena. Methods: This was a cross-sectional study conducted at the “Notre Dame des Apôtres” Hospital in N'Djamena. It involved 428 infants aged 1 to 24 months received in preventive consultation between October 2017 and June 2018. The Denver II scale was used for the assessment of PMD. Data were analyzed with SPSS 21.0 software. Results: the sex ratio was 1.06. The most represented age group was under 3 months (35.5%). The items of gross motor skills were 95% completed, fine motor skills 93.8%, language 84.6% and sociability 68.8% at the 90th percentile. Development was advanced in 56.8% normal in 32.1% and delayed in 2.1%. Statistically significant differences in PMD were observed according to age group (p= 0.000), vaccination status (p= 0.002), feeding mode (p= 0.000), maternal exchange (p= 0.000) and pregnancy follow-up (p= 0.03). Conclusion: The psychomotor development of N'Djamenese infants is similar to that of other African children, although some variations are noted. It is influenced by certain factors related to the infant and the mother.

Inpatient COVID-19 mortality has reduced over time: Results from an observational cohort

Background The Covid-19 pandemic in the United Kingdom has seen two waves; the first starting in March 2020 and the second in late October 2020. It is not known whether outcomes for those admitted with severe Covid were different in the first and second waves. Methods The study population comprised all patients admitted to a 1,500-bed London Hospital Trust between March 2020 and March 2021, who tested positive for Covid-19 by PCR within 3-days of admissions. Primary outcome was death within 28-days of admission. Socio-demographics (age, sex, ethnicity), hypertension, diabetes, obesity, baseline physiological observations, CRP, neutrophil, chest x-ray abnormality, remdesivir and dexamethasone were incorporated as co-variates. Proportional subhazards models compared mortality risk between wave 1 and wave 2. Cox-proportional hazard model with propensity score adjustment were used to compare mortality in patients prescribed remdesivir and dexamethasone. Results There were 3,949 COVID-19 admissions, 3,195 hospital discharges and 733 deaths. There were notable differences in age, ethnicity, comorbidities, and admission disease severity between wave 1 and wave 2. Twenty-eight-day mortality was higher during wave 1 (26.1% versus 13.1%). Mortality risk adjusted for co-variates was significantly lower in wave 2 compared to wave 1 [adjSHR 0.49 (0.37, 0.65) p<0.001]. Analysis of treatment impact did not show statistically different effects of remdesivir [HR 0.84 (95%CI 0.65, 1.08), p = 0.17] or dexamethasone [HR 0.97 (95%CI 0.70, 1.35) p = 0.87]. Conclusion There has been substantial improvements in COVID-19 mortality in the second wave, even accounting for demographics, comorbidity, and disease severity. Neither dexamethasone nor remdesivir appeared to be key explanatory factors, although there may be unmeasured confounding present.

An Exploratory Analysis of Housing and the Distribution of COVID-19 in Sweden

The impact of COVID-19 on various aspects of our life is evident. Proximity and close contact with individuals infected with the virus, and the extent of such contact, contribute to the intensity of the spread of the virus. Healthy and infected household members who both require sanctuary and quarantine space come into close and extended contact in housing. In other words, housing and living conditions can impact the health of occupants and the spread of COVID-19. This study investigates the relationship between housing characteristics and variations in the spread of COVID-19 per capita across Sweden’s 290 municipalities. For this purpose, we have used the number of infected COVID-19 cases per capita during the pandemic period—February 2020 through April 2021—per municipality. The focus is on variables that measure housing and housing conditions in the municipalities. We use exploratory analysis and Principal Components Analysis to reduce highly correlated variables into a set of linearly uncorrelated variables. We then use the generated variables to estimate direct and indirect effects in a spatial regression analysis. The results indicate that housing and housing availability are important explanatory factors for the geographical spread of COVID-19. Overcrowding, availability, and quality are all critical explanatory factors.

The centrality of organisational factors in the growth of new technology-based firms

PurposeNew technology-based firms (NTBFs) are a great potential source of job creation and economic growth. In France, strong heterogeneity of their growth trajectories is observed yet many of them remain small. A better understanding of these trajectories is thus necessary. The purpose of this paper is to explore the influence of individual and organisational factors on 253 growth trajectories of NTBFs.Design/methodology/approachThe authors use a Heckman ordered probit model to study explanatory factors of growth trajectories in NTBFs created between 1999 and 2012. This method allows them to study the determinants of the presence of a growth dynamics at the same time as the determinants of growth intensity.FindingsThe model shows that entrepreneurs play a weak role in understanding the growth trajectories of their company. Rather, it is organisational factors – such as the level of innovation and the governance structure – that explain initiation of a growth trajectory and the intensity of the growth.Originality/valueBy using an original methodology, the authors highlight the importance of organisational factors and encourage entrepreneurs to develop a governance structure focused on internal stakeholders to support growth.

The Association Between Interpersonal Violence and Unstable Housing Among Veterans

ABSTRACT Background Despite programs to address housing for Veterans, they continue to be at high risk of unstable housing. Interpersonal violence is also highly prevalent among Veterans and may contribute to unstable housing. Our study aimed to determine whether interpersonal violence was associated with unstable housing among Veterans, and how this association was influenced by common co-occurring conditions such as substance use and mental illness. Methods Veterans in the Mind Your Heart Study (N = 741) completed survey data on history of interpersonal violence and access to housing in the prior year. Interpersonal violence was defined as experiencing sexual violence, physical violence, or mugging/physical attack using the Brief Trauma Questionnaire. Multivariable models examined associations between interpersonal violence and unstable housing. Primary models were adjusted for age and sex. Potential explanatory factors were added in subsequent models, including marital status, education, income, substance use disorder, PTSD, and other mental illness. Results Veterans who had experienced interpersonal violence had almost twice the odds of unstable housing after adjustment for age and sex (AOR 1.9, 95% CI 1.2–3.0). This association was attenuated in the fully adjusted model including substance use, PTSD, and other mental illness, illustrating the interdependence of these factors (AOR 1.5, 95% CI 0.91–2.5). Subtypes of interpersonal violence were individually associated with increased odds of unstable housing after adjustment for age and sex (physical abuse AOR 1.7, 95% CI 1.2–2.5; mugging/physical attack AOR 1.8, 95% CI 1.2–2.7; sexual violence AOR 1.4, 95% CI 0.89–2.2), but were no longer significant in the fully adjusted model. Conclusions Previous experiences of interpersonal violence were associated with unstable housing among Veterans. Substance use, PTSD, and other mental illness played an important role in this relationship—highlighting the potential to improve health outcomes through trauma informed approaches that address mental health, substance use, and housing concurrently.

What explains gender inequality in HIV infection among high-risk people? A Blinder-Oaxaca decomposition

Background Despite clear evidence on role of gender in vulnerability and exposure to HIV infection, information on gender-related inequalities in HIV and related factors are rarely documented. The aim of this study was to measure gender inequality in HIV infection and its determinates in Tehran city, the capital of Iran. Methods The study used the data of 20,156 medical records of high-risk people who were admitted to Imam Khomeini Voluntary Counseling and Testing site in Tehran from 2004 to 2018. The Blinder-Oaxaca decomposition was used to quantify the contribution of explanatory variables to the gap in the prevalence of HIV infection between female and male. Results The age-adjusted proportion of HIV infection was 9.45% (95%Cl: 9.02, 9.87). The absolute gap in the prevalence of HIV infection between male and female was 4.50% (95% CI: − 5.33, − 3.70%). The Blinder-Oaxaca decomposition indicated that most explanatory factors affecting the differences in HIV infection were job exposure, drug abuse, history of imprisonment, injection drug, heterosexual unsafe sex, and having an HIV-positive spouse. Conclusion The results can provide evidence for health policymakers to better planning and conducting gender-based preventive and screening programs. Policies aiming at promoting HIV preventive behaviors among male may reduce the gap in HIV infection between female and male in Iran.

Religion as a Protective Factor Against Adolescent Smoking Habits: Evidence from Spain

Background: There are a wide number of assessments suggesting that being a member of a religious community inhibits adolescents’ risky behaviours and, consequently, can act as a protective factor against the consumption of smoking substances. Methods: We have analysed a structured questionnaire answered by 1935 adolescents from Tarragona (Spain). Results: We have found that variables linked to family were the principal explanatory factors of adolescents’ smoking habits. Living with two parents was a protective factor against tobacco and cannabis use since its Incidence Rate Ratio (IRR) was clearly below 1 (p<0.01). So, whereas living with one parent showed an IRR>1 (p<0.05), adolescents that live without parents presented an IRR close 2 (p<0.05 for tobacco and p<0.01 for cannabis). However, having a religious confession also influence smoking substance use in adolescents (IRR close 0.85 with p<0.01). Conclusion: We found a clear preventive effect in belonging to a religious community. Moreover, this protective effect was less intense, but not statistically significant, for Catholics than for members of other confessions.

Pediatric Medication Noninitiation in Spain

OBJECTIVES To estimate medication noninitiation prevalence in the pediatric population and identify the explanatory factors underlying this behavior. METHODS Observational study of patients (&lt;18 years old) receiving at least 1 new prescription (28 pharmaceutical subgroups; July 2017 to June 2018) in Catalonia, Spain. A prescription was considered new when there was no prescription for the same pharmaceutical subgroup in the previous 6 months. Noninitiation occurred when a prescription was not filled within 1 month or 6 months (sensitivity analysis). Prevalence was estimated as the proportion of total prescriptions not initiated. To identify explanatory factors, a multivariable multilevel logistic regression model was used, and adjusted odds ratios were reported. RESULTS Overall, 1 539 003 new prescriptions were issued to 715 895 children. The overall prevalence of 1-month noninitiation was 9.0% (ranging from 2.6% [oral antibiotics] to 21.5% [proton pump inhibitors]), and the prevalence of 6-month noninitiation was 8.5%. Noninitiation was higher in the youngest and oldest population groups, in children from families with a 0% copayment rate (vulnerable populations) and those with conditions from external causes. Out-of-pocket costs of drugs increased the odds of noninitiation. The odds of noninitiation were lower when the prescription was issued by a pediatrician (compared with a primary or secondary care clinician). CONCLUSIONS The prevalence of noninitiation of medical treatments in pediatrics is high and varies according to patients’ ages and medical groups. Results suggest that there are inequities in access to pharmacologic treatments in this population that must be taken into account by health care planners and providers.

Financial Fraud Detection and the Importance of Internal Control

In an environment that is becoming increasingly unstable due, primarily, to new international requirements and rapid changes, the problem of financial fraud detection has grown in importance. One of the main causes is the growing dependence on new technologies. This environment has required companies to adapt to face the new constraints. In fact, financial fraud is a problem that has a profound impact on the financial industry, government, businesses and ordinary consumers. The objective of this paper is double: the first one is to study the explanatory factors and the main variables developed in order to better detect the existence of financial fraud and we have emphasized the importance of taking into account non-accounting variables in the detection of financial fraud which remains little treated by empirical studies. The second objective of this research is to emphasize the importance of internal control, through a literature review, in the fight against financial fraud.