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Multilevel analysis

Markus R Konieczny, Rüdiger Krauspe
STUDY DESIGN: This study was a retrospective radiographic analysis of consecutive patients. OBJECTIVES: To analyze exposure to radiation of the surgeon and-separately-of patients in minimally invasive surgery (MIS) of multilevel posterior stabilization by percutaneous pedicle screw insertion guided by navigation (PIN) versus percutaneous pedicle screw insertion guided by fluoroscopy (PIF). SUMMARY OF BACKGROUND DATA: Spine surgeons are exposed to a 12-fold higher dose of radiation than other nonspinal musculoskeletal surgeons and PIF in MIS leads to a 2-fold higher dose of radiation than in open surgery...
February 12, 2019: Clinical Spine Surgery
Anthony D Mancini
Human beings are routinely exposed to varying forms of acute adversity. Our responses take varying forms too, ranging from chronic distress to resilience. Although this pronounced variability is widely recognized, one possible outcome of acute adversity has been invariably, though understandably, ignored: an improvement in psychological and social functioning. In this analysis, I argue that, under some conditions, people can experience marked psychological improvement after acute adversity. I describe this response pattern as psychosocial gains from adversity (PGA) and define it as favorable and reliable change on an index of psychological functioning from before to after exposure to adversity...
February 14, 2019: Psychological Review
Tanvir M Huda, Morseda Chowdhury, Shams El Arifeen, Michael J Dibley
INTRODUCTION: Improving maternal health remains one of the targets of sustainable development goals. A maternal death can occur at any time during pregnancy, but delivery is by far the most dangerous time for both the woman and her baby. Delivery at a health facility can avoid most maternal deaths occurring from preventable obstetric complications. The influence of both individual and community factors is critical to the use of health facility delivery services. In this study, we aim to examine the role of individual and community factors associated with health facility-based delivery in Bangladesh...
2019: PloS One
Yoonyoung Park, Panagiotis D Karampourniotis, Issa Sylla, Amar K Das
In clinical outcome studies, analysis has traditionally been performed using patient-level factors, with minor attention given to provider-level features. However, the nature of care coordination and collaboration between caregivers (providers) may also be important in determining patient outcomes. Using data from patients admitted to intensive care units at a large tertiary care hospital, we modeled the caregivers that provided medical service to a specific patient as patient-centric subnetwork embedded within larger caregiver networks of the institute...
2019: PloS One
Pier-Olivier Caron
Multilevel modeling has been considered a promising statistical tool in the field of the experimental analysis of behavior and may serve as a convenient statistical analysis for matching behavior because it structures data in groups (or levels) to account simultaneously for the within-subject and between-subject variances. Heretofore, researchers have sometimes pooled data erroneously from different subjects in a single analysis by using average ratios, average response and reinforcer rates, aggregation of subjects, etc...
February 13, 2019: Journal of the Experimental Analysis of Behavior
Anselm S Berde, Petra Bester, Iolanthé M Kruger
OBJECTIVE: The present study aimed to give an overall view of the pattern of high-dose vitamin A supplementation (VAS) coverage in twenty-three sub-Saharan African countries and factors associated with receipt of VAS among children aged 6-59 months. DESIGN: Cross-sectional data from the twenty-three Demographic and Health Surveys conducted from 2011 to 2015 in twenty-three sub-Saharan African countries were pooled. A multilevel logistic regression model was used to explore factors associated with VAS...
February 13, 2019: Public Health Nutrition
Emily L Tuthill, Lila A Sheira, Kartika Palar, Edward A Frongillo, Tracey E Wilson, Adebola Adedimeji, Daniel Merenstein, Mardge H Cohen, Eryka L Wentz, Adaora A Adimora, Ighovwerha Ofotokun, Lisa Metsch, Margot Kushel, Janet M Turan, Deborah Konkle-Parker, Phyllis C Tien, Sheri D Weiser
Background: Food insecurity and mental health negatively affect the lives of women in the United States. Participants in the Women's Interagency HIV Study (WIHS) provided the opportunity to understand the association of food insecurity with depression and mental well-being over time. Objective: We investigated the association between current and persistent food insecurity and depression among women at risk of or living with HIV in the United States. Methods: We used longitudinal data from the WIHS, a prospective cohort study in women at risk of or living with HIV from multiple sites in the United States...
February 8, 2019: Journal of Nutrition
Carles Ariza, Francesca Sánchez-Martínez, Gemma Serral, Sara Valmayor, Olga Juárez, María Isabel Pasarín, Conxa Castell, Luis Rajmil, María José López
Background: Childhood obesity is becoming a serious problem, and prevention programs are needed. Objective: The purpose of this study was to evaluate, after 1 y, the effectiveness of a multicomponent, school-based obesity intervention program. Methods: This intervention, conducted in Barcelona, Spain, was a quasi-experimental obesity primary prevention intervention targeting schoolchildren aged 9-10 y. Participants were assigned to an intervention group (IG) (1464 students) or to a comparison group (CG) (1609 students)...
February 12, 2019: Journal of Nutrition
Myriam Calle Rubio, Joan B Soriano, José Luis López-Campos, Juan J Soler-Cataluña, Bernardino Alcázar Navarrete, José Miguel Rodríguez González-Moro, Marc Miravitlles, Miriam Barrecheguren, Manuel E Fuentes Ferrer, Juan Luis Rodriguez Hermosa
[This corrects the article DOI: 10.1371/journal.pone.0198777.].
2019: PloS One
Bernardo Antonio Agostini, Bruno Emmanuelli, Chaiana Piovesan, Fausto Medeiros Mendes, Thiago Machado Ardenghi
BACKGROUND: Besides the growth in Brazilian public oral health investments, no preschool children preventive policies were done, and surveys demonstrated lower prevalences of use of dental service. AIM: To verify trends in the use, type and reason for seeking dental services among preschool children considering time-variations. METHODS: This study used data of clinical examinations and structured interviews of three cross-sectional surveys of southern preschool children in Brazil, from 2008, 2010 and 2013...
February 12, 2019: International Journal of Paediatric Dentistry
Emma D Quach, Lewis E Kazis, Shibei Zhao, Sarah McDannold, Valerie Clark, Christine W Hartmann
OBJECTIVES: Improving nursing home safety is important to the quality of resident care. Increasing evidence points to the relationship between actual safety and a strong safety climate, i.e., staff agreement about safety norms. This national study focused on Veterans Health Administration nursing homes (Community Living Centers [CLCs]), assessing direct care staff and senior managers' agreement about safety norms. METHODS: We recruited all 134 CLCs to participate in the previously validated CLC Employee Survey of Attitudes about Resident Safety...
February 9, 2019: Journal of Patient Safety
Manuela Ferrario, Laura Brunelli, Fuhong Su, Antoine Herpain, Roberta Pastorelli
Septic shock is a medical emergency and is one of the main causes of mortality in critically ill patients. Given the pathophysiological complexity of sepsis spectrum and progression in clinical settings, animal models become essential tools to improve patient care, and to understand key mechanisms that may remain masked from the heterogeneity of clinical practice. Our aim was to verify whether the metabolic constellations we previously reported for septic shock patients appear also in our septic shock swine model as systemic markers of early disturbances in energy metabolism and hepatic homeostasis...
2019: Frontiers in Physiology
Natalie Cho, Laura Boland, Daniel I McIsaac
BACKGROUND: Sex and gender inequality is prevalent in health care, and affects receipt of health care services and outcomes. Our objective was to measure the association between sex and receipt of evidence-based perioperative care for hip fracture in Ontario. METHODS: This was a population-based retrospective cross-sectional analysis. We identified all Ontario residents aged 66 years and older who had hip fracture surgery between 2014 and 2016. After protocol registration, we measured the adjusted association between female sex and perioperative geriatric care (primary outcome), anesthesia consultations, regional analgesia and neuraxial anesthesia (secondary outcomes) using multilevel multivariable adjusted logistic regression...
February 11, 2019: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Sarah Geisbüsch, Andreas Kuehnl, Michael Salvermoser, Benedikt Reutersberg, Matthias Trenner, Hans-Henning Eckstein
OBJECTIVE: Hospital incidence, treatment modality, and in hospital mortality after surgery are reported for thoraco-abdominal aortic aneurysms (TAAAs) treated by endovascular or open means in Germany from 2005 to 2014. METHODS: Data were extracted from diagnosis related group statistics from the German Federal Statistical Office. All inpatient cases with a diagnosis of ruptured and non-ruptured TAAA (ICD-10 I71.5 and I71.6) and procedure codes for fenestrated or branched endovascular aortic repair (f/bEVAR 5-38a...
February 7, 2019: European Journal of Vascular and Endovascular Surgery
Anita B Amorim, Evangelos Pappas, Milena Simic, Manuela L Ferreira, Matthew Jennings, Anne Tiedemann, Ana Paula Carvalho-E-Silva, Eduardo Caputo, Alice Kongsted, Paulo H Ferreira
BACKGROUND: Low back pain is one of the most prevalent musculoskeletal conditions and the highest contributor to disability in the world. It is characterized by frequent relapses leading to additional care-seeking. Engagement in leisure physical activity is associated with lower recurrences and better prognosis and potentially reduced care-seeking. Our aim was to investigate the feasibility and preliminary efficacy of a patient-centred physical activity intervention, supported by health coaching and mobile health, to reduce care-seeking, pain and disability in patients with chronic low back pain after treatment discharge...
February 11, 2019: BMC Musculoskeletal Disorders
Jaclyn Schwartz, Sarah J Ordaz, Katharina Kircanski, Tiffany C Ho, Elena G Davis, M Catalina Camacho, Ian H Gotlib
BACKGROUND: Major Depressive Disorder (MDD) is characterized by aberrant resting-state functional connectivity (FC) in anterior cingulate regions (e.g., subgenual anterior cingulate [sgACC]) and by negative emotional functioning that is inflexible or resistant to change. METHODS: MDD (N = 33) and control (CTL; N = 31) adults completed a resting-state scan, followed by a smartphone-based Experience Sampling Methodology (ESM) protocol surveying 10 positive and negative emotions 5 times per day for 21 days...
February 6, 2019: Journal of Affective Disorders
Ellis Voerman, Susana Santos, Bernadeta Patro Golab, Pilar Amiano, Ferran Ballester, Henrique Barros, Anna Bergström, Marie-Aline Charles, Leda Chatzi, Cécile Chevrier, George P Chrousos, Eva Corpeleijn, Nathalie Costet, Sarah Crozier, Graham Devereux, Merete Eggesbø, Sandra Ekström, Maria Pia Fantini, Sara Farchi, Francesco Forastiere, Vagelis Georgiu, Keith M Godfrey, Davide Gori, Veit Grote, Wojciech Hanke, Irva Hertz-Picciotto, Barbara Heude, Daniel Hryhorczuk, Rae-Chi Huang, Hazel Inskip, Nina Iszatt, Anne M Karvonen, Louise C Kenny, Berthold Koletzko, Leanne K Küpers, Hanna Lagström, Irina Lehmann, Per Magnus, Renata Majewska, Johanna Mäkelä, Yannis Manios, Fionnuala M McAuliffe, Sheila W McDonald, John Mehegan, Monique Mommers, Camilla S Morgen, Trevor A Mori, George Moschonis, Deirdre Murray, Carol Ní Chaoimh, Ellen A Nohr, Anne-Marie Nybo Andersen, Emily Oken, Adriëtte J J M Oostvogels, Agnieszka Pac, Eleni Papadopoulou, Juha Pekkanen, Costanza Pizzi, Kinga Polanska, Daniela Porta, Lorenzo Richiardi, Sheryl L Rifas-Shiman, Luca Ronfani, Ana C Santos, Marie Standl, Camilla Stoltenberg, Elisabeth Thiering, Carel Thijs, Maties Torrent, Suzanne C Tough, Tomas Trnovec, Steve Turner, Lenie van Rossem, Andrea von Berg, Martine Vrijheid, Tanja G M Vrijkotte, Jane West, Alet Wijga, John Wright, Oleksandr Zvinchuk, Thorkild I A Sørensen, Debbie A Lawlor, Romy Gaillard, Vincent W V Jaddoe
BACKGROUND: Maternal obesity and excessive gestational weight gain may have persistent effects on offspring fat development. However, it remains unclear whether these effects differ by severity of obesity, and whether these effects are restricted to the extremes of maternal body mass index (BMI) and gestational weight gain. We aimed to assess the separate and combined associations of maternal BMI and gestational weight gain with the risk of overweight/obesity throughout childhood, and their population impact...
February 2019: PLoS Medicine
Aaron C Weidman, Jessie Sun, Simine Vazire, Jordi Quoidbach, Lyle H Ungar, Elizabeth W Dunn
Recent popular claims surrounding virtual assistants suggest that computers will soon be able to hear our emotions. Supporting this possibility, promising work has harnessed big data and emergent technologies to automatically predict stable levels of one specific emotion, happiness, at the community (e.g., counties) and trait (i.e., people) levels. Furthermore, research in affective science has shown that nonverbal vocal bursts (e.g., sighs, gasps) and specific acoustic features (e.g., pitch, energy) can differentiate between distinct emotions (e...
February 11, 2019: Emotion
Yu-Ying Huang, Shou-Hsia Cheng
Due to the increasing prevalence of multimorbidity, the percentage of heavy users of health care services increased rapidly. To contain inappropriate outpatient visits and improve better medication management of high utilizers, the National Health Insurance Administration in Taiwan launched a community pharmacist home visit (CPHV) project for high utilizers in 2010. We employed a natural experimental design to evaluate the preliminary effects of the CPHV project. The intervention group consisted of patients enrolled in the CPHV project during 2010 and 2013...
January 30, 2019: Health Policy
Lianne Bakkum, Agnes Maresa Willemen, Lydia Zoetebier, Antonia H Bouts
OBJECTIVE: Steroid-sensitive nephrotic syndrome (SSNS) in children is often complicated by one or more relapses, as manifested by the appearance of proteinuria. Besides health-related triggers, psychological stress might be related to relapse. This longitudinal study examined the link between perceived stress, emotional valence (feeling happy vs. unhappy) and daily reported proteinuria, and investigated the temporal relation between stressful events and proteinuria. METHOD: Sixteen children (4-13 years) diagnosed with SSNS were included...
January 19, 2019: Journal of Psychosomatic Research
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