Relationship between support for workers with illness and work functioning impairment in Japan during the COVID-19 pandemic

Objective: This study examined the relationship between support for workers with illness and work functioning impairment during the COVID-19 pandemic. Methods: An internet survey was conducted on December, 2020. We included 22,388 subjects for analysis. A question was used to determine whether subjects need support from their company to continue working in their current health condition. The odds ratios (ORs) of relation between work functioning impairment and necessary of support for sick workers were estimated using multilevel logistic regression analysis. Results: The OR of work functioning impairment among sick workers not receiving support was 5.61 (95% confidence interval (CI) 5.19-6.06, p<0.001) and those receiving support was 1.82 (95% CI 1.64-2.03, p<0.001) compared to healthy workers. Conclusions: This study suggests that providing support to workers with illness may improve their work functioning impairment.

Prevalence of multimorbidity in Thailand: a multilevel analysis of a population-based survey

Background: The objective of the study was to estimate the prevalence of multimorbidity and to analyze the factors related to multimorbidity using multilevel analysis.Methods: The data from the 2017 National Health and Welfare Survey was used. In total, 27,960 families and 65,781 participants were analyzed. Multilevel logistic regression analysis with 2-levels was performed to assess independent risk factors for the multimorbidity.Results: Of 14,353 participants analyzed, 20.4% (95% confidence interval (CI): 20.1, 20.7) of those showed multimorbidity. 59% were females; 74.4% were 56-66 years, 68.7% had primary school level education, and 63.8% were reported being married. Multilevel multiple logistic regression results showed that the prevalence of multimorbidity was higher in females (adjusted OR (AOR): 1.2, 95% CI: 1.1, 1.3), older participants had higher risk of multimorbidity than younger people (p value for trend <0.01), married (AOR: 1.2; 95% CI: 1.0, 1.4), widowed or divorced (AOR: 1.3; 95% CI: 1.1, 1.5).Conclusions: A high prevalence of multimorbidity in older patients was found. Tailored disease prevention programs and health care provider are needed to design and service for multimorbidity patients.

Individual and community level factors associated with delayed first postnatal care attendance among reproductive age group women in Ethiopia

Background Postnatal care (PNC) visits provide a huge benefit for ensuring appropriate breastfeeding practices, to monitor the overall health status of the newborn, to timely diagnose and intervene birth-related complications, and to plan future family planning options. Despite delayed PNC attendance have a great impact on the survival of the mother and the newborn it still receives less emphasis. As a result, most mothers do not receive PNC services early. We, therefore, aimed to determine individual and community level factors associated with delayed first Postnatal Care attendance among reproductive age group women in Ethiopia. Methods We used the most recent Ethiopian Demographic and Health Survey (EDHS 2016) data to determine associated factors of delayed first PNC in Ethiopia. A weighted sample of 4308 women with a live birth in the two years preceding the survey was included. A multilevel logistic regression analysis was used to analyze the data. Variables with p-value < 0.05 in the multivariable multilevel logistic regression analysis were declared significantly associated with delayed first PNC attendance. Results In this study, both individual level and community level factors were associated with delayed PNC attendance. Among the individual level factors: having four or more antenatal care visit [Adjusted Odd Ratio (AOR) = 0.73; 95% CI: 0.59, 0.92], delivery at a health facility [AOR = 0.04; 95% CI: 0.03, 0.05], and perceiving distance from the health facility as not a big problem [AOR = 0.73; 95% CI: 0.58, 0.91] were associated with lower odds of delayed first PNC attendance. Of community level factors: being in Oromia [AOR = 2.31; 95% CI: 1.38, 3.83] and Gambela [AOR = 2.01; 95% CI: 1.13, 3.56] regions were associated higher odds of delayed first PNC attendance. Conclusions Both individual level and community level factors were found to be associated with delayed PNC attendance. Strengthening antenatal care utilization, institutional delivery, and appropriate distributions of maternal health services in each region and areas far apart from the health facility are recommended.

Socio-demographic, clinical and health facility-related predictors of delayed HIV diagnosis among patients newly diagnosed with HIV in Northwest Ethiopia: a multilevel analysis

Background Ethiopia recently implemented the ‘test and treat’ strategy for all HIV-infected individuals receiving a diagnosis at the health facility level. However, the impact of this policy in terms of timely HIV diagnosis and factors associated with it were not evaluated. Therefore, this study aimed to determine the magnitude and predictors of delayed HIV diagnosis among newly diagnosed people living with HIV in the northwest, Ethiopia. Methods In this cross-sectional study, a total of 759 newly diagnosed patients were recruited consecutively. The multistage sampling technique was employed to select health facilities and all newly diagnosed patients were included. Delayed HIV diagnosis was defined when there is an established AIDS-defining clinical condition (WHO clinical stage III or IV), irrespective of CD4 count. Data were entered into Epi-Data version 3.5 and exported to STATA version 14 for further analysis. Taking into account the nested structure of the data, multilevel logistic regression analysis has been employed. Four models containing variables of interest were fitted. Multivariate multilevel logistic regression analysis was performed to estimate the adjusted odds ratios (AOR) at a 95% confidence interval (CI). Results A one-fourth of newly diagnosed HIV patients diagnosed at advanced disease stage. After controlling for other individual and health facility level factors, factors associated with delayed HIV diagnosis were: Patients who had completed secondary school or higher (AOR = 2.08, 95% CI = 1.06, 4.08), patients who presented to health facilities with HIV symptoms (AOR = 5.87, 95% CI = 3.57, 9.62), being non-working functional status (AOR = 4.80, 95% CI = 2.58, 8.92) and HIV diagnosis at hospitals (AOR = 2.16, 95% CI = 1.08, 4.31). Conclusion The magnitude of delayed HIV diagnosis was improved. In addition to individual-level factors, it is important to address health facility-related factors to improve earlier HIV diagnosis. Here, we recommend using both clinical and laboratory characteristics of a patient particularly, baseline CD4 count and viral load to identify patients diagnosed with advanced disease stage. Moreover, public health interventions are important targeted on factors associated with delayed HIV diagnosis.

Exploring Citizens’ Actions in Mitigating Climate Change and Moving toward Urban Circular Economy. A Multilevel Approach

Urbanization and climate change are requiring cities to find novel pathways to a sustainable future, and therefore the urban context may accelerate the conversion to a circular economy. In this sense, climate change is a considerable threat to the environment, affecting both human and natural systems, and in this context individuals have a very important role. Therefore, the paper aims to investigate, on the one hand, what determines people to undertake specific actions in fighting climate change and, on the other hand, what determines some people to engage in adopting multiple actions exhibiting extra mitigation behaviour compared to others, paving the way to an urban circular economy. In order to do that, multilevel logistic regression analysis using hierarchical data (individuals grouped in counties), reflecting group variability and group-level characteristics effects on outcomes at individual level has been applied. Special attention was given to modernisation thesis validation, stipulating that citizens from more developed and modernized countries are expected to manifest a higher level of extra mitigation compared to inhabitants of less-modernized nations. The empirical results revealed the positive association of pro-environmental factors, socio-demographic and economic factors with both specific and extra mitigation behaviour in fighting climate change. An important finding of the empirical research highlighted the validation of the modernisation thesis, even if partially, and the reinforcement of the modernisation thesis impact on the extra mitigation behaviour determined by the urban area segmentation. The extra commitment behaviour reflected by citizens’ multiple actions in fighting climate change ensures progress to a circular economy through its contribution to waste reduction, eco-shopping increase, on eco-friendly transportation increase or domestic energy reduction. We believe that a shift in citizens’ attitude towards climate change is needed, taking into account that a lot must be done” to effectively respond to climate change, paving the way for the circular economy.

Association between Anti-prejudice Norm and Attitudes towards Minority Groups

In this study we investigated the relationship between the anti-prejudice norm and the expression of attitudes towards minority groups. Participated 100 people who evaluated a list with 16 target groups of prejudice, answering two questions: indicate the groups that feel less prejudice; and which ones do you prefer. The results showed that there are different levels of prejudice depending on the target-group, with the women, blacks and people with disabilities being the most protected by the norm. A hierarchical analysis of clusters evidenced an organization of the groups, classified as naturalised, blamed, sexual and political minorities. The anti-prejudice norm and the attitudes presented a strong and positive relation (r = 0.65, p < 0.001). A multilevel logistic regression analysis showed that this relation was moderated by the type of group. These results contribute to the studies on the expression of prejudice, besides demonstrating the role of norms in the understanding of the phenomenon.

The Effects of Number of Fire Dispatches and Other Situational Factors on Voluntary Exercise Training Among Korean Firefighters: A Multilevel Logistic Regression Analysis

According to previous research, participation in exercise training (ET) by South Korean firefighters varies with shift type, and the effect of shift type is greater in large cities than in small towns. However, shift types differ among regions, depending on the number of dispatches. Therefore, the present study examined the impact of the number of fire dispatches and other situational factors on ET. A series of multilevel logistic regression analysis was applied to analyze the data collected from South Korean firefighters (N = 5219) in 2017. According to the firefighters, participation in ET is higher among those who have someone to instruct their ET (Coefficient (Coef) = 0.057, SE = 0.017, p < 0.001) and who can do ET while on duty (Coef = 0.048, SE = 0.014, p < 0.001). The number of fire dispatches had a significant effect on participation in ET (Coef = −0.000, SE = 0.000, p < 0.01), meaning that the firefighters’ participation in ET varies with the number of fire dispatches in each region. Our main findings indicate that the number of fire dispatches is a key factor affecting ET participation among firefighters, and the other situational factors also play a role. Therefore, ET programs that firefighters can participate in between calls should be established.

Influence of firms’ financial performance on disclosure of sustainability initiatives and assurance of sustainability reports

This study provides a better understanding of the possible influence of firms’ financial performance on the disclosure of sustainability initiatives and assurance of sustainability reports (Perego & Kolk, 2012). The study analyzes the use of Big4 accounting, engineering, and boutique/consultancy firms for assurance of sustainability reports. A total of 2084 sustainability reports from 42 different countries were retrieved from the Global Reporting Initiative and the corresponding financial variables were obtained from the S&P Capital IQ database. Multilevel logistic regression analysis was undertaken to investigate the issue. We hypothesize that companies with higher financial performance will be more likely to choose an assurance provider from the Big4 (Carey, Simnett, & Tanewski, 2000). While we find that higher financial performers are no different from other performers (as proxied by EVA, TEV, or ROS) when it comes to Big4, we do find that engineering firms are approximately seven times more likely to be chosen as an assurance provider, after controlling for other variables (when EVA and TEV (not ROS) is used as a proxy for financial performance). Importantly, the number of employees and being in the manufacturing industry are significantly related to choosing an engineering firm as an assurance provider when EVA or TEV is used as a proxy for financial performance, and significantly related to choosing a boutique/consultancy firm when ROS is used as a proxy for financial performance.

Use of preoperative haemostasis and ABO blood typing tests in children: a retrospective observational study using a nationwide claims database in Japan

ObjectivesTo describe the prevalence and factors associated with preoperative haemostasis and ABO blood typing tests for children because these tests might represent low-value care.DesignA retrospective observational study.SettingNationwide insurance claims database in Japan.ParticipantsPatients aged 1–17 years who underwent common non-cardiac surgeries between April 2012 and March 2018 were included. Patients with high-risk comorbidities for bleeding (n=175) and those with multiple eligible surgeries were excluded (n=2121).Main outcome measuresWe described the proportions of each preoperative test performed within 60 days before an index surgery, including platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT) and ABO blood typing tests. We also explored the associations between patient-level and institutional-level factors and any preoperative tests, using multilevel logistic regression analysis.ResultsWe included 13 018 patients (median (IQR) age, 5.2 (2.9–7.7) years; 8276 (63.6%) boys) from 1499 institutions. The overall proportion of each test was as follows: platelet count, 78.6%; PT, 54.4%; aPTT, 56.4% and ABO blood typing tests, 50.4%. The proportion of patients undergoing any preoperative tests in the overall sample was 79.3%. Multilevel logistic regression analysis indicated that preoperative tests were associated with type of anaesthesia (general anaesthesia: adjusted OR 7.06; 95% CI 4.94 to 10.11), type of surgery (tonsillectomy: adjusted OR 3.45; 95% CI 2.75 to 4.33) and surgical setting (inpatient procedure: adjusted OR 5.41; 95% CI 3.83 to 7.66). There was one postoperative transfusion event (0.008%) in the entire cohort and 37 postoperative reoperation events for surgical bleeding after tonsillectomy (0.90%).ConclusionsIn the largest Japanese cohort reported to date, preoperative haemostasis and ABO blood typing tests were performed in a majority of children prior to common paediatric surgeries. Preoperative tests were associated with anaesthesia, surgical type and surgical setting.