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Sample records for multilevel survival analysis

  1. Multilevel survival analysis of health inequalities in life expectancy

    Directory of Open Access Journals (Sweden)

    Merlo Juan

    2009-08-01

    Full Text Available Abstract Background The health status of individuals is determined by multiple factors operating at both micro and macro levels and the interactive effects of them. Measures of health inequalities should reflect such determinants explicitly through sources of levels and combining mean differences at group levels and the variation of individuals, for the benefits of decision making and intervention planning. Measures derived recently from marginal models such as beta-binomial and frailty survival, address this issue to some extent, but are limited in handling data with complex structures. Beta-binomial models were also limited in relation to measuring inequalities of life expectancy (LE directly. Methods We propose a multilevel survival model analysis that estimates life expectancy based on survival time with censored data. The model explicitly disentangles total health inequalities in terms of variance components of life expectancy compared to the source of variation at the level of individuals in households and parishes and so on, and estimates group differences of inequalities at the same time. Adjusted distributions of life expectancy by gender and by household socioeconomic level are calculated. Relative and absolute health inequality indices are derived based on model estimates. The model based analysis is illustrated on a large Swedish cohort of 22,680 men and 26,474 women aged 65–69 in 1970 and followed up for 30 years. Model based inequality measures are compared to the conventional calculations. Results Much variation of life expectancy is observed at individual and household levels. Contextual effects at Parish and Municipality level are negligible. Women have longer life expectancy than men and lower inequality. There is marked inequality by the level of household socioeconomic status measured by the median life expectancy in each socio-economic group and the variation in life expectancy within each group. Conclusion Multilevel

  2. Examining the Influence of Campus Climate on Students' Time to Degree: A Multilevel Discrete-Time Survival Analysis

    Science.gov (United States)

    Zhou, Ji; Castellanos, Michelle

    2013-01-01

    Utilizing longitudinal data of 3477 students from 28 institutions, we examine the effects of structural diversity and quality of interracial relation on students' persistence towards graduation within six years. We utilize multilevel discrete-time survival analysis to account for the longitudinal persistence patterns as well as the nested…

  3. The tourism and travel industry and its effect on the Great Recession: A multilevel survival analysis

    Directory of Open Access Journals (Sweden)

    Zdravko Šergo

    2017-12-01

    Full Text Available Does a country with a heavy dependence on a tourism economy have a tendency to succumb to more risk in a recession? With the shift from manufacturing-based economies in the developing world toward service-based industries, including tourism, a reliance on the tourism industry may erode economic stability in tourism-based countries, making them more prone to fall into a recession due to higher risks. In this paper, we wish to emphasise the positive impact of tourism specialisation indices in the international economy on the probability occurrence of a so-called Great Recession. This article uses a multilevel survival analysis and a generalised linear mixed-effect (GLMM structure modelling to investigate the impact of tourism development on the probability of recession frequency (risk in terms of months of duration and severity, by using data collected from 2007 to 2013 from 71 countries around the world, to see if recession frequency is positively correlated with the various indicators of tourism development. Two GLMMs were fitted to this data: logistic regression and count regression with a Poisson distribution. Results for both regressions show considerable evidence that the ratio between the number of overnight stays and the resident population and travel services as a percentage of commercial service exports positively impacts the probability for a country (from our sample to experience a recession event and can make recession worse in terms of severity, measured in months.

  4. Bruxism and dental implant failures: a multilevel mixed effects parametric survival analysis approach.

    Science.gov (United States)

    Chrcanovic, B R; Kisch, J; Albrektsson, T; Wennerberg, A

    2016-11-01

    Recent studies have suggested that the insertion of dental implants in patients being diagnosed with bruxism negatively affected the implant failure rates. The aim of the present study was to investigate the association between the bruxism and the risk of dental implant failure. This retrospective study is based on 2670 patients who received 10 096 implants at one specialist clinic. Implant- and patient-related data were collected. Descriptive statistics were used to describe the patients and implants. Multilevel mixed effects parametric survival analysis was used to test the association between bruxism and risk of implant failure adjusting for several potential confounders. Criteria from a recent international consensus (Lobbezoo et al., J Oral Rehabil, 40, 2013, 2) and from the International Classification of Sleep Disorders (International classification of sleep disorders, revised: diagnostic and coding manual, American Academy of Sleep Medicine, Chicago, 2014) were used to define and diagnose the condition. The number of implants with information available for all variables totalled 3549, placed in 994 patients, with 179 implants reported as failures. The implant failure rates were 13·0% (24/185) for bruxers and 4·6% (155/3364) for non-bruxers (P bruxism was a statistically significantly risk factor to implant failure (HR 3·396; 95% CI 1·314, 8·777; P = 0·012), as well as implant length, implant diameter, implant surface, bone quantity D in relation to quantity A, bone quality 4 in relation to quality 1 (Lekholm and Zarb classification), smoking and the intake of proton pump inhibitors. It is suggested that the bruxism may be associated with an increased risk of dental implant failure. © 2016 John Wiley & Sons Ltd.

  5. The median hazard ratio: a useful measure of variance and general contextual effects in multilevel survival analysis.

    Science.gov (United States)

    Austin, Peter C; Wagner, Philippe; Merlo, Juan

    2017-03-15

    Multilevel data occurs frequently in many research areas like health services research and epidemiology. A suitable way to analyze such data is through the use of multilevel regression models (MLRM). MLRM incorporate cluster-specific random effects which allow one to partition the total individual variance into between-cluster variation and between-individual variation. Statistically, MLRM account for the dependency of the data within clusters and provide correct estimates of uncertainty around regression coefficients. Substantively, the magnitude of the effect of clustering provides a measure of the General Contextual Effect (GCE). When outcomes are binary, the GCE can also be quantified by measures of heterogeneity like the Median Odds Ratio (MOR) calculated from a multilevel logistic regression model. Time-to-event outcomes within a multilevel structure occur commonly in epidemiological and medical research. However, the Median Hazard Ratio (MHR) that corresponds to the MOR in multilevel (i.e., 'frailty') Cox proportional hazards regression is rarely used. Analogously to the MOR, the MHR is the median relative change in the hazard of the occurrence of the outcome when comparing identical subjects from two randomly selected different clusters that are ordered by risk. We illustrate the application and interpretation of the MHR in a case study analyzing the hazard of mortality in patients hospitalized for acute myocardial infarction at hospitals in Ontario, Canada. We provide R code for computing the MHR. The MHR is a useful and intuitive measure for expressing cluster heterogeneity in the outcome and, thereby, estimating general contextual effects in multilevel survival analysis. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.

  6. Effects of Racial Prejudice on the Health of Communities: A Multilevel Survival Analysis.

    Science.gov (United States)

    Lee, Yeonjin; Muennig, Peter; Kawachi, Ichiro; Hatzenbuehler, Mark L

    2015-11-01

    We examined whether and how racial prejudice at both the individual and community levels contributes to mortality risk among majority as well as minority group members. We used data on racial attitudes from the General Social Survey (1993-2002) prospectively linked to mortality data from the National Death Index through 2008. Whites and Blacks living in communities with higher levels of racial prejudice were at an elevated risk of mortality, independent of individual and community sociodemographic characteristics and individually held racist beliefs (odds ratio = 1.24; 95% confidence interval = 1.04, 1.49). Living in a highly prejudiced community had similar harmful effects among both Blacks and Whites. Furthermore, the interaction observed between individual- and community-level racial prejudice indicated that respondents with higher levels of racial prejudice had lower survival rates if they lived in communities with low degrees of racial prejudice. Community-level social capital explained the relationship between community racial prejudice and mortality. Community-level racial prejudice may disrupt social capital, and reduced social capital is associated with increased mortality risk among both Whites and Blacks. Our results contribute to an emerging body of literature documenting the negative consequences of prejudice for population health.

  7. Effects of Racial Prejudice on the Health of Communities: A Multilevel Survival Analysis

    Science.gov (United States)

    Muennig, Peter; Kawachi, Ichiro; Hatzenbuehler, Mark L.

    2015-01-01

    Objectives. We examined whether and how racial prejudice at both the individual and community levels contributes to mortality risk among majority as well as minority group members. Methods. We used data on racial attitudes from the General Social Survey (1993–2002) prospectively linked to mortality data from the National Death Index through 2008. Results. Whites and Blacks living in communities with higher levels of racial prejudice were at an elevated risk of mortality, independent of individual and community sociodemographic characteristics and individually held racist beliefs (odds ratio = 1.24; 95% confidence interval = 1.04, 1.49). Living in a highly prejudiced community had similar harmful effects among both Blacks and Whites. Furthermore, the interaction observed between individual- and community-level racial prejudice indicated that respondents with higher levels of racial prejudice had lower survival rates if they lived in communities with low degrees of racial prejudice. Community-level social capital explained the relationship between community racial prejudice and mortality. Conclusions. Community-level racial prejudice may disrupt social capital, and reduced social capital is associated with increased mortality risk among both Whites and Blacks. Our results contribute to an emerging body of literature documenting the negative consequences of prejudice for population health. PMID:26378850

  8. Geographic remoteness, area-level socioeconomic disadvantage and inequalities in colorectal cancer survival in Queensland: a multilevel analysis

    Science.gov (United States)

    2013-01-01

    Background To explore the impact of geographical remoteness and area-level socioeconomic disadvantage on colorectal cancer (CRC) survival. Methods Multilevel logistic regression and Markov chain Monte Carlo simulations were used to analyze geographical variations in five-year all-cause and CRC-specific survival across 478 regions in Queensland Australia for 22,727 CRC cases aged 20–84 years diagnosed from 1997–2007. Results Area-level disadvantage and geographic remoteness were independently associated with CRC survival. After full multivariate adjustment (both levels), patients from remote (odds Ratio [OR]: 1.24, 95%CrI: 1.07-1.42) and more disadvantaged quintiles (OR = 1.12, 1.15, 1.20, 1.23 for Quintiles 4, 3, 2 and 1 respectively) had lower CRC-specific survival than major cities and least disadvantaged areas. Similar associations were found for all-cause survival. Area disadvantage accounted for a substantial amount of the all-cause variation between areas. Conclusions We have demonstrated that the area-level inequalities in survival of colorectal cancer patients cannot be explained by the measured individual-level characteristics of the patients or their cancer and remain after adjusting for cancer stage. Further research is urgently needed to clarify the factors that underlie the survival differences, including the importance of geographical differences in clinical management of CRC. PMID:24152961

  9. An exploratory discrete-time multilevel analysis of the effect of social support on the survival of elderly people in China

    Science.gov (United States)

    Feng, Zhixin; Jones, Kelvyn; Wang, Wenfei Winnie

    2015-01-01

    This study undertakes a survival analysis of elderly persons in China using Chinese Longitudinal Healthy Longevity Survey 2002–2008. Employing discrete-time multilevel models, we explored the effect of social support on the survival of elderly people in China. This study focuses on objective (living arrangements and received support) and subjective activities (perceived support) of social support, finding that the effect of different activities of social support on the survival of elderly people varies according to the availability of different support resources. Specifically, living with a spouse, financial independence, perceiving care support from any resource is associated with higher survival rates for elderly people. Separate analysis focusing on urban elderly and rural elderly revealed broadly similar results. There is a larger difference between those perceiving care support from family or social service and not perceiving care support in urban areas comparing to those in rural areas. Those who cannot pay medical expenses are the least likely to survive. The higher level of economic development in province has no significant effect on the survival of elderly people for the whole sample model and the elderly people in urban areas; however, there is a negative influence on the survival of the rural elderly people. PMID:25703671

  10. Does Prison Crowding Predict Higher Rates of Substance Use Related Parole Violations? A Recurrent Events Multi-Level Survival Analysis.

    Directory of Open Access Journals (Sweden)

    Michael A Ruderman

    Full Text Available This administrative data-linkage cohort study examines the association between prison crowding and the rate of post-release parole violations in a random sample of prisoners released with parole conditions in California, for an observation period of two years (January 2003 through December 2004.Crowding overextends prison resources needed to adequately protect inmates and provide drug rehabilitation services. Violence and lack of access to treatment are known risk factors for drug use and substance use disorders. These and other psychosocial effects of crowding may lead to higher rates of recidivism in California parolees.Rates of parole violation for parolees exposed to high and medium levels of prison crowding were compared to parolees with low prison crowding exposure. Hazard ratios (HRs with 95% confidence intervals (CIs were estimated using a Cox model for recurrent events. Our dataset included 13070 parolees in California, combining individual level parolee data with aggregate level crowding data for multilevel analysis.Comparing parolees exposed to high crowding with those exposed to low crowding, the effect sizes from greatest to least were absconding violations (HR 3.56 95% CI: 3.05-4.17, drug violations (HR 2.44 95% CI: 2.00-2.98, non-violent violations (HR 2.14 95% CI: 1.73-2.64, violent and serious violations (HR 1.88 95% CI: 1.45-2.43, and technical violations (HR 1.86 95% CI: 1.37-2.53.Prison crowding predicted higher rates of parole violations after release from prison. The effect was magnitude-dependent and particularly strong for drug charges. Further research into whether adverse prison experiences, such as crowding, are associated with recidivism and drug use in particular may be warranted.

  11. Does Prison Crowding Predict Higher Rates of Substance Use Related Parole Violations? A Recurrent Events Multi-Level Survival Analysis.

    Science.gov (United States)

    Ruderman, Michael A; Wilson, Deirdra F; Reid, Savanna

    2015-01-01

    This administrative data-linkage cohort study examines the association between prison crowding and the rate of post-release parole violations in a random sample of prisoners released with parole conditions in California, for an observation period of two years (January 2003 through December 2004). Crowding overextends prison resources needed to adequately protect inmates and provide drug rehabilitation services. Violence and lack of access to treatment are known risk factors for drug use and substance use disorders. These and other psychosocial effects of crowding may lead to higher rates of recidivism in California parolees. Rates of parole violation for parolees exposed to high and medium levels of prison crowding were compared to parolees with low prison crowding exposure. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using a Cox model for recurrent events. Our dataset included 13070 parolees in California, combining individual level parolee data with aggregate level crowding data for multilevel analysis. Comparing parolees exposed to high crowding with those exposed to low crowding, the effect sizes from greatest to least were absconding violations (HR 3.56 95% CI: 3.05-4.17), drug violations (HR 2.44 95% CI: 2.00-2.98), non-violent violations (HR 2.14 95% CI: 1.73-2.64), violent and serious violations (HR 1.88 95% CI: 1.45-2.43), and technical violations (HR 1.86 95% CI: 1.37-2.53). Prison crowding predicted higher rates of parole violations after release from prison. The effect was magnitude-dependent and particularly strong for drug charges. Further research into whether adverse prison experiences, such as crowding, are associated with recidivism and drug use in particular may be warranted.

  12. Does Prison Crowding Predict Higher Rates of Substance Use Related Parole Violations? A Recurrent Events Multi-Level Survival Analysis

    Science.gov (United States)

    Ruderman, Michael A.; Wilson, Deirdra F.; Reid, Savanna

    2015-01-01

    Objective This administrative data-linkage cohort study examines the association between prison crowding and the rate of post-release parole violations in a random sample of prisoners released with parole conditions in California, for an observation period of two years (January 2003 through December 2004). Background Crowding overextends prison resources needed to adequately protect inmates and provide drug rehabilitation services. Violence and lack of access to treatment are known risk factors for drug use and substance use disorders. These and other psychosocial effects of crowding may lead to higher rates of recidivism in California parolees. Methods Rates of parole violation for parolees exposed to high and medium levels of prison crowding were compared to parolees with low prison crowding exposure. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using a Cox model for recurrent events. Our dataset included 13070 parolees in California, combining individual level parolee data with aggregate level crowding data for multilevel analysis. Results Comparing parolees exposed to high crowding with those exposed to low crowding, the effect sizes from greatest to least were absconding violations (HR 3.56 95% CI: 3.05–4.17), drug violations (HR 2.44 95% CI: 2.00–2.98), non-violent violations (HR 2.14 95% CI: 1.73–2.64), violent and serious violations (HR 1.88 95% CI: 1.45–2.43), and technical violations (HR 1.86 95% CI: 1.37–2.53). Conclusions Prison crowding predicted higher rates of parole violations after release from prison. The effect was magnitude-dependent and particularly strong for drug charges. Further research into whether adverse prison experiences, such as crowding, are associated with recidivism and drug use in particular may be warranted. PMID:26492490

  13. Handbook of multilevel analysis

    National Research Council Canada - National Science Library

    Leeuw, Jan de; Meijer, Erik

    2008-01-01

    ... appropriate and efficient model-based methods have become available to deal with this issue, that we have come to appreciate the power that more complex models provide for describing the world and providing new insights. This book sets out to present some of the most recent developments in what has come to be known as multilevel modelling. An...

  14. Survival analysis

    International Nuclear Information System (INIS)

    Badwe, R.A.

    1999-01-01

    The primary endpoint in the majority of the studies has been either disease recurrence or death. This kind of analysis requires a special method since all patients in the study experience the endpoint. The standard method for estimating such survival distribution is Kaplan Meier method. The survival function is defined as the proportion of individuals who survive beyond certain time. Multi-variate comparison for survival has been carried out with Cox's proportional hazard model

  15. Associations of all-cause mortality with census-based neighbourhood deprivation and population density in Japan: a multilevel survival analysis.

    Directory of Open Access Journals (Sweden)

    Tomoki Nakaya

    Full Text Available BACKGROUND: Despite evidence that neighbourhood conditions affect residents' health, no prospective studies of the association between neighbourhood socio-demographic factors and all-cause mortality have been conducted in non-Western societies. Thus, we examined the effects of areal deprivation and population density on all-cause mortality in Japan. METHODS: We employed census and survival data from the Japan Public Health Center-based Prospective Study, Cohort I (n = 37,455, consisting of middle-aged residents (40 to 59 years at the baseline in 1990 living in four public health centre districts. Data spanned between 1990 and 2010. A multilevel parametric proportional-hazard regression model was applied to estimate the hazard ratios (HRs of all-cause mortality by two census-based areal variables--areal deprivation index and population density--as well as individualistic variables such as socioeconomic status and various risk factors. RESULTS: We found that areal deprivation and population density had moderate associations with all-cause mortality at the neighbourhood level based on the survival data with 21 years of follow-ups. Even when controlling for individualistic socio-economic status and behavioural factors, the HRs of the two areal factors (using quartile categorical variables significantly predicted mortality. Further, this analysis indicated an interaction effect of the two factors: areal deprivation prominently affects the health of residents in neighbourhoods with high population density. CONCLUSIONS: We confirmed that neighbourhood socio-demographic factors are significant predictors of all-cause death in Japanese non-metropolitan settings. Although further study is needed to clarify the cause-effect relationship of this association, the present findings suggest that health promotion policies should consider health disparities between neighbourhoods and possibly direct interventions towards reducing mortality in densely

  16. Survival Analysis

    CERN Document Server

    Miller, Rupert G

    2011-01-01

    A concise summary of the statistical methods used in the analysis of survival data with censoring. Emphasizes recently developed nonparametric techniques. Outlines methods in detail and illustrates them with actual data. Discusses the theory behind each method. Includes numerous worked problems and numerical exercises.

  17. Multilevel index decomposition analysis: Approaches and application

    International Nuclear Information System (INIS)

    Xu, X.Y.; Ang, B.W.

    2014-01-01

    With the growing interest in using the technique of index decomposition analysis (IDA) in energy and energy-related emission studies, such as to analyze the impacts of activity structure change or to track economy-wide energy efficiency trends, the conventional single-level IDA may not be able to meet certain needs in policy analysis. In this paper, some limitations of single-level IDA studies which can be addressed through applying multilevel decomposition analysis are discussed. We then introduce and compare two multilevel decomposition procedures, which are referred to as the multilevel-parallel (M-P) model and the multilevel-hierarchical (M-H) model. The former uses a similar decomposition procedure as in the single-level IDA, while the latter uses a stepwise decomposition procedure. Since the stepwise decomposition procedure is new in the IDA literature, the applicability of the popular IDA methods in the M-H model is discussed and cases where modifications are needed are explained. Numerical examples and application studies using the energy consumption data of the US and China are presented. - Highlights: • We discuss the limitations of single-level decomposition in IDA applied to energy study. • We introduce two multilevel decomposition models, study their features and discuss how they can address the limitations. • To extend from single-level to multilevel analysis, necessary modifications to some popular IDA methods are discussed. • We further discuss the practical significance of the multilevel models and present examples and cases to illustrate

  18. Single-Level and Multilevel Mediation Analysis

    Science.gov (United States)

    Tofighi, Davood; Thoemmes, Felix

    2014-01-01

    Mediation analysis is a statistical approach used to examine how the effect of an independent variable on an outcome is transmitted through an intervening variable (mediator). In this article, we provide a gentle introduction to single-level and multilevel mediation analyses. Using single-level data, we demonstrate an application of structural…

  19. Power analysis of trials with multilevel data

    CERN Document Server

    Moerbeek, Mirjam

    2015-01-01

    Power Analysis of Trials with Multilevel Data covers using power and sample size calculations to design trials that involve nested data structures. The book gives a thorough overview of power analysis that details terminology and notation, outlines key concepts of statistical power and power analysis, and explains why they are necessary in trial design. It guides you in performing power calculations with hierarchical data, which enables more effective trial design.The authors are leading experts in the field who recognize that power analysis has attracted attention from applied statisticians i

  20. Multilevel sparse functional principal component analysis.

    Science.gov (United States)

    Di, Chongzhi; Crainiceanu, Ciprian M; Jank, Wolfgang S

    2014-01-29

    We consider analysis of sparsely sampled multilevel functional data, where the basic observational unit is a function and data have a natural hierarchy of basic units. An example is when functions are recorded at multiple visits for each subject. Multilevel functional principal component analysis (MFPCA; Di et al. 2009) was proposed for such data when functions are densely recorded. Here we consider the case when functions are sparsely sampled and may contain only a few observations per function. We exploit the multilevel structure of covariance operators and achieve data reduction by principal component decompositions at both between and within subject levels. We address inherent methodological differences in the sparse sampling context to: 1) estimate the covariance operators; 2) estimate the functional principal component scores; 3) predict the underlying curves. Through simulations the proposed method is able to discover dominating modes of variations and reconstruct underlying curves well even in sparse settings. Our approach is illustrated by two applications, the Sleep Heart Health Study and eBay auctions.

  1. EUROPEAN INTEGRATION: A MULTILEVEL PROCESS THAT REQUIRES A MULTILEVEL STATISTICAL ANALYSIS

    Directory of Open Access Journals (Sweden)

    Roxana-Otilia-Sonia HRITCU

    2015-11-01

    Full Text Available A process of market regulation and a system of multi-level governance and several supranational, national and subnational levels of decision making, European integration subscribes to being a multilevel phenomenon. The individual characteristics of citizens, as well as the environment where the integration process takes place, are important. To understand the European integration and its consequences it is important to develop and test multi-level theories that consider individual-level characteristics, as well as the overall context where individuals act and express their characteristics. A central argument of this paper is that support for European integration is influenced by factors operating at different levels. We review and present theories and related research on the use of multilevel analysis in the European area. This paper draws insights on various aspects and consequences of the European integration to take stock of what we know about how and why to use multilevel modeling.

  2. An Original Stepwise Multilevel Logistic Regression Analysis of Discriminatory Accuracy

    DEFF Research Database (Denmark)

    Merlo, Juan; Wagner, Philippe; Ghith, Nermin

    2016-01-01

    BACKGROUND AND AIM: Many multilevel logistic regression analyses of "neighbourhood and health" focus on interpreting measures of associations (e.g., odds ratio, OR). In contrast, multilevel analysis of variance is rarely considered. We propose an original stepwise analytical approach that disting...

  3. A multilevel evolutionary framework for sustainability analysis

    Directory of Open Access Journals (Sweden)

    Timothy M. Waring

    2015-06-01

    Full Text Available Sustainability theory can help achieve desirable social-ecological states by generalizing lessons across contexts and improving the design of sustainability interventions. To accomplish these goals, we argue that theory in sustainability science must (1 explain the emergence and persistence of social-ecological states, (2 account for endogenous cultural change, (3 incorporate cooperation dynamics, and (4 address the complexities of multilevel social-ecological interactions. We suggest that cultural evolutionary theory broadly, and cultural multilevel selection in particular, can improve on these fronts. We outline a multilevel evolutionary framework for describing social-ecological change and detail how multilevel cooperative dynamics can determine outcomes in environmental dilemmas. We show how this framework complements existing sustainability frameworks with a description of the emergence and persistence of sustainable institutions and behavior, a means to generalize causal patterns across social-ecological contexts, and a heuristic for designing and evaluating effective sustainability interventions. We support these assertions with case examples from developed and developing countries in which we track cooperative change at multiple levels of social organization as they impact social-ecological outcomes. Finally, we make suggestions for further theoretical development, empirical testing, and application.

  4. Survival analysis models and applications

    CERN Document Server

    Liu, Xian

    2012-01-01

    Survival analysis concerns sequential occurrences of events governed by probabilistic laws.  Recent decades have witnessed many applications of survival analysis in various disciplines. This book introduces both classic survival models and theories along with newly developed techniques. Readers will learn how to perform analysis of survival data by following numerous empirical illustrations in SAS. Survival Analysis: Models and Applications: Presents basic techniques before leading onto some of the most advanced topics in survival analysis.Assumes only a minimal knowledge of SAS whilst enablin

  5. The use of simple reparameterizations to improve the efficiency of Markov chain Monte Carlo estimation for multilevel models with applications to discrete time survival models.

    Science.gov (United States)

    Browne, William J; Steele, Fiona; Golalizadeh, Mousa; Green, Martin J

    2009-06-01

    We consider the application of Markov chain Monte Carlo (MCMC) estimation methods to random-effects models and in particular the family of discrete time survival models. Survival models can be used in many situations in the medical and social sciences and we illustrate their use through two examples that differ in terms of both substantive area and data structure. A multilevel discrete time survival analysis involves expanding the data set so that the model can be cast as a standard multilevel binary response model. For such models it has been shown that MCMC methods have advantages in terms of reducing estimate bias. However, the data expansion results in very large data sets for which MCMC estimation is often slow and can produce chains that exhibit poor mixing. Any way of improving the mixing will result in both speeding up the methods and more confidence in the estimates that are produced. The MCMC methodological literature is full of alternative algorithms designed to improve mixing of chains and we describe three reparameterization techniques that are easy to implement in available software. We consider two examples of multilevel survival analysis: incidence of mastitis in dairy cattle and contraceptive use dynamics in Indonesia. For each application we show where the reparameterization techniques can be used and assess their performance.

  6. A multilevel shape fit analysis of neutron transmission data

    International Nuclear Information System (INIS)

    Naguib, K.; Sallam, O.H.; Adib, M.

    1989-01-01

    A multilevel shape fit analysis of neutron transmission data is presented. A multilevel computer code SHAPE is used to analyse clean transmission data obtained from time-of-flight (TOF) measurements. The shape analysis deduces the parameters of the observed resonances in the energy region considered in the measurements. The shape code is based upon a least square fit of a multilevel Breit-Wigner formula and includes both instrumental resolution and Doppler broadenings. Operating the SHAPE code on a test example of a measured transmission data of 151 Eu, 153 Eu and natural Eu in the energy range 0.025-1 eV acquired a good result for the used technique of analysis. (author)

  7. Applied survival analysis using R

    CERN Document Server

    Moore, Dirk F

    2016-01-01

    Applied Survival Analysis Using R covers the main principles of survival analysis, gives examples of how it is applied, and teaches how to put those principles to use to analyze data using R as a vehicle. Survival data, where the primary outcome is time to a specific event, arise in many areas of biomedical research, including clinical trials, epidemiological studies, and studies of animals. Many survival methods are extensions of techniques used in linear regression and categorical data, while other aspects of this field are unique to survival data. This text employs numerous actual examples to illustrate survival curve estimation, comparison of survivals of different groups, proper accounting for censoring and truncation, model variable selection, and residual analysis. Because explaining survival analysis requires more advanced mathematics than many other statistical topics, this book is organized with basic concepts and most frequently used procedures covered in earlier chapters, with more advanced topics...

  8. Help Seeking in Online Collaborative Groupwork: A Multilevel Analysis

    Science.gov (United States)

    Du, Jianxia; Xu, Jianzhong; Fan, Xitao

    2015-01-01

    This study examined predictive models for students' help seeking in the context of online collaborative groupwork. Results from multilevel analysis revealed that most of the variance in help seeking was at the individual student level, and multiple variables at the individual level were predictive of help-seeking behaviour. Help seeking was…

  9. Multilevel component analysis of time-resolved metabolic fingerprinting data

    NARCIS (Netherlands)

    Jansen, J.J.; Hoefsloot, H.C.J.; Greef, J. van der; Timmerman, M.E.; Smilde, A.K.

    2005-01-01

    Genomics-based technologies in systems biology have gained a lot of popularity in recent years. These technologies generate large amounts of data. To obtain information from this data, multivariate data analysis methods are required. Many of the datasets generated in genomics are multilevel

  10. Detecting bots using multi-level traffic analysis

    DEFF Research Database (Denmark)

    Stevanovic, Matija; Pedersen, Jens Myrup

    2016-01-01

    introduces a novel multi-level botnet detection approach that performs network traffic analysis of three protocols widely considered as the main carriers of botnet Command and Control (C&C) and attack traffic, i.e. TCP, UDP and DNS. The proposed method relies on supervised machine learning for identifying...

  11. A Multilevel Shape Fit Analysis of Neutron Transmission Data

    Science.gov (United States)

    Naguib, K.; Sallam, O. H.; Adib, M.; Ashry, A.

    A multilevel shape fit analysis of neutron transmission data is presented. A multilevel computer code SHAPE is used to analyse clean transmission data obtained from time-of-flight (TOF) measurements. The shape analysis deduces the parameters of the observed resonances in the energy region considered in the measurements. The shape code is based upon a least square fit of a multilevel Briet-Wigner formula and includes both instrumental resolution and Doppler broadenings. Operating the SHAPE code on a test example of a measured transmission data of 151Eu, 153Eu and natural Eu in the energy range 0.025-1 eV accquired a good result for the used technique of analysis.Translated AbstractAnalyse von Neutronentransmissionsdaten mittels einer VielniveauformanpassungNeutronentransmissionsdaten werden in einer Vielniveauformanpassung analysiert. Dazu werden bereinigte Daten aus Flugzeitmessungen mit dem Rechnerprogramm SHAPE bearbeitet. Man erhält die Parameter der beobachteten Resonanzen im gemessenen Energiebereich. Die Formanpassung benutzt eine Briet-Wignerformel und berücksichtigt Linienverbreiterungen infolge sowohl der Meßeinrichtung als auch des Dopplereffekts. Als praktisches Beispiel werden 151Eu, 153Eu und natürliches Eu im Energiebereich 0.025 bis 1 eV mit guter Übereinstimmung theoretischer und experimenteller Werte behandelt.

  12. Multi-level approach for parametric roll analysis

    Science.gov (United States)

    Kim, Taeyoung; Kim, Yonghwan

    2011-03-01

    The present study considers multi-level approach for the analysis of parametric roll phenomena. Three kinds of computation method, GM variation, impulse response function (IRF), and Rankine panel method, are applied for the multi-level approach. IRF and Rankine panel method are based on the weakly nonlinear formulation which includes nonlinear Froude- Krylov and restoring forces. In the computation result of parametric roll occurrence test in regular waves, IRF and Rankine panel method show similar tendency. Although the GM variation approach predicts the occurrence of parametric roll at twice roll natural frequency, its frequency criteria shows a little difference. Nonlinear roll motion in bichromatic wave is also considered in this study. To prove the unstable roll motion in bichromatic waves, theoretical and numerical approaches are applied. The occurrence of parametric roll is theoretically examined by introducing the quasi-periodic Mathieu equation. Instability criteria are well predicted from stability analysis in theoretical approach. From the Fourier analysis, it has been verified that difference-frequency effects create the unstable roll motion. The occurrence of unstable roll motion in bichromatic wave is also observed in the experiment.

  13. Optimizing survivability of multi-state systems with multi-level protection by multi-processor genetic algorithm

    International Nuclear Information System (INIS)

    Levitin, Gregory; Dai Yuanshun; Xie Min; Leng Poh, Kim

    2003-01-01

    In this paper we consider vulnerable systems which can have different states corresponding to different combinations of available elements composing the system. Each state can be characterized by a performance rate, which is the quantitative measure of a system's ability to perform its task. Both the impact of external factors (stress) and internal causes (failures) affect system survivability, which is determined as probability of meeting a given demand. In order to increase the survivability of the system, a multi-level protection is applied to its subsystems. This means that a subsystem and its inner level of protection are in their turn protected by the protection of an outer level. This double-protected subsystem has its outer protection and so forth. In such systems, the protected subsystems can be destroyed only if all of the levels of their protection are destroyed. Each level of protection can be destroyed only if all of the outer levels of protection are destroyed. We formulate the problem of finding the structure of series-parallel multi-state system (including choice of system elements, choice of structure of multi-level protection and choice of protection methods) in order to achieve a desired level of system survivability by the minimal cost. An algorithm based on the universal generating function method is used for determination of the system survivability. A multi-processor version of genetic algorithm is used as optimization tool in order to solve the structure optimization problem. An application example is presented to illustrate the procedure presented in this paper

  14. Motivation and Self-Regulated Learning: A Multivariate Multilevel Analysis

    Directory of Open Access Journals (Sweden)

    Wondimu Ahmed

    2017-09-01

    Full Text Available This study investigated the relationship between motivation and self-regulated learning (SRL in a nationally representative sample of 5245, 15-year-old students in the USA. A multivariate multilevel analysis was conducted to examine the role of three motivational variables (self-efficacy, intrinsic value & instrumental value in predicting three SRL strategies (memorization, elaboration & control. The results showed that compared to self-efficacy, intrinsic value and instrumental value of math were stronger predictors of memorization, elaboration and control strategies. None of the motivational variables had a stronger effect on one strategy than the other. The findings suggest that the development of self-regulatory skills in math can be greatly enhanced by helping students develop positive value of and realistic expectancy for success in math.

  15. Multilevel predictors of adolescent physical activity: a longitudinal analysis

    Directory of Open Access Journals (Sweden)

    Hearst Mary O

    2012-02-01

    Full Text Available Abstract Background To examine how factors from a social ecologic model predict physical activity (PA among adolescents using a longitudinal analysis. Methods Participants in this longitudinal study were adolescents (ages 10-16 at baseline and one parent enrolled in the Transdisciplinary Research on Energetics and Cancer-Identifying Determinants of Eating and Activity (TREC-IDEA and the Etiology of Childhood Obesity (ECHO. Both studies were designed to assess a socio-ecologic model of adolescent obesity risk. PA was collected using ActiGraph activity monitors at two time points 24 months apart. Other measures included objective height and weight, adolescent and parent questionnaires on multilevel psychological, behavioral and social determinants of PA, and a home PA equipment inventory. Analysis was conducted using SAS, including descriptive characteristics, bivariate and stepped multivariate mixed models, using baseline adjustment. Models were stratified by gender. Results There were 578 adolescents with complete data. Results suggest few statistically significant longitudinal associations with physical activity measured as minutes of MVPA or total counts from accelerometers. For boys, greater self-efficacy (B = 0.75, p = 0.01 and baseline MVPA (B = 0.55, p p = 0.01 and barriers (B = -0.32, p = 0.05 significantly predicted MVPA at follow-up in the full model. The full multilevel model explained 30% of the variance in PA among boys and 24% among girls. Conclusions PA change in adolescents is a complex issue that is not easily understood. Our findings suggest early PA habits are the most important predictor of PA levels in adolescence. Intervention may be necessary prior to middle school to maintain PA through adolescence.

  16. Analysis of Harmonic Injection to the Modulation of Multi-Level ...

    African Journals Online (AJOL)

    This paper explores the analysis of third and ninth harmonic injection to the modulation of a multilevel diode clamped converter (DCC) at a varying modulation index. The spectral distributions of the various multi-level waveforms obtained under normal modulation index of 0.8 and over modulation index of 1.15 were ...

  17. Multilevel structural equation models for assessing moderation within and across levels of analysis.

    Science.gov (United States)

    Preacher, Kristopher J; Zhang, Zhen; Zyphur, Michael J

    2016-06-01

    Social scientists are increasingly interested in multilevel hypotheses, data, and statistical models as well as moderation or interactions among predictors. The result is a focus on hypotheses and tests of multilevel moderation within and across levels of analysis. Unfortunately, existing approaches to multilevel moderation have a variety of shortcomings, including conflated effects across levels of analysis and bias due to using observed cluster averages instead of latent variables (i.e., "random intercepts") to represent higher-level constructs. To overcome these problems and elucidate the nature of multilevel moderation effects, we introduce a multilevel structural equation modeling (MSEM) logic that clarifies the nature of the problems with existing practices and remedies them with latent variable interactions. This remedy uses random coefficients and/or latent moderated structural equations (LMS) for unbiased tests of multilevel moderation. We describe our approach and provide an example using the publicly available High School and Beyond data with Mplus syntax in Appendix. Our MSEM method eliminates problems of conflated multilevel effects and reduces bias in parameter estimates while offering a coherent framework for conceptualizing and testing multilevel moderation effects. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  18. A multilevel Lab on chip platform for DNA analysis.

    Science.gov (United States)

    Marasso, Simone Luigi; Giuri, Eros; Canavese, Giancarlo; Castagna, Riccardo; Quaglio, Marzia; Ferrante, Ivan; Perrone, Denis; Cocuzza, Matteo

    2011-02-01

    Lab-on-chips (LOCs) are critical systems that have been introduced to speed up and reduce the cost of traditional, laborious and extensive analyses in biological and biomedical fields. These ambitious and challenging issues ask for multi-disciplinary competences that range from engineering to biology. Starting from the aim to integrate microarray technology and microfluidic devices, a complex multilevel analysis platform has been designed, fabricated and tested (All rights reserved-IT Patent number TO2009A000915). This LOC successfully manages to interface microfluidic channels with standard DNA microarray glass slides, in order to implement a complete biological protocol. Typical Micro Electro Mechanical Systems (MEMS) materials and process technologies were employed. A silicon/glass microfluidic chip and a Polydimethylsiloxane (PDMS) reaction chamber were fabricated and interfaced with a standard microarray glass slide. In order to have a high disposable system all micro-elements were passive and an external apparatus provided fluidic driving and thermal control. The major microfluidic and handling problems were investigated and innovative solutions were found. Finally, an entirely automated DNA hybridization protocol was successfully tested with a significant reduction in analysis time and reagent consumption with respect to a conventional protocol.

  19. Multilevel analysis of elastic morphology: The mantis shrimp's spring.

    Science.gov (United States)

    Rosario, M V; Patek, S N

    2015-09-01

    Spring systems, whether natural or engineered, are composed of compliant and rigid regions. Biological springs are often similar to monolithic structures that distribute compliance and rigidity across the whole system. For example, to confer different amounts of compliance in distinct regions within a single structure, biological systems typically vary regional morphology through thickening or elongation. Here, we analyze the monolithic spring in mantis shrimp (Stomatopoda) raptorial appendages to rapidly acquire or process prey. We quantified the shape of cross-sections of the merus segment of the raptorial appendage. We also examined specific regions of the merus that are hypothesized to either store elastic energy or provide structural support to permit energy storage in other regions of the system. We found that while all mantis shrimp contain thicker ventral bars in distal cross-sections, differences in thickness are more pronounced in high-impact "smasher" mantis shrimp than in the slower-striking "spearer" mantis shrimp. We also found that spearer cross-sections are more circular while those of smashers are more eccentric with elongation along the dorso-ventral axis. The results suggest that the regional thickening of ventral bars provides structural support for resisting spring compression and also reduces flexural stiffness along the system's long axis. This multilevel morphological analysis offers a foundation for understanding the evolution and mechanics of monolithic systems in biology. © 2015 Wiley Periodicals, Inc.

  20. Intermediate and advanced topics in multilevel logistic regression analysis.

    Science.gov (United States)

    Austin, Peter C; Merlo, Juan

    2017-09-10

    Multilevel data occur frequently in health services, population and public health, and epidemiologic research. In such research, binary outcomes are common. Multilevel logistic regression models allow one to account for the clustering of subjects within clusters of higher-level units when estimating the effect of subject and cluster characteristics on subject outcomes. A search of the PubMed database demonstrated that the use of multilevel or hierarchical regression models is increasing rapidly. However, our impression is that many analysts simply use multilevel regression models to account for the nuisance of within-cluster homogeneity that is induced by clustering. In this article, we describe a suite of analyses that can complement the fitting of multilevel logistic regression models. These ancillary analyses permit analysts to estimate the marginal or population-average effect of covariates measured at the subject and cluster level, in contrast to the within-cluster or cluster-specific effects arising from the original multilevel logistic regression model. We describe the interval odds ratio and the proportion of opposed odds ratios, which are summary measures of effect for cluster-level covariates. We describe the variance partition coefficient and the median odds ratio which are measures of components of variance and heterogeneity in outcomes. These measures allow one to quantify the magnitude of the general contextual effect. We describe an R 2 measure that allows analysts to quantify the proportion of variation explained by different multilevel logistic regression models. We illustrate the application and interpretation of these measures by analyzing mortality in patients hospitalized with a diagnosis of acute myocardial infarction. © 2017 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. © 2017 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd.

  1. Adjusting to Social Change - A Multi-Level Analysis in Three Cultures

    Science.gov (United States)

    2013-08-01

    example, coping may be more collective in collectivist , compared to individualist , societies (Chang & Sivam, 2004). Some cultures have a greater sense...AFRL-AFOSR-UK-TR-2013-0041 Adjusting to Social Change - A multi-level Analysis in three cultures Prof Robin Goodwin...COVERED (From – To) 23 May 2012 – 22 May 2013 4. TITLE AND SUBTITLE Adjusting to Social Change - A multi-level Analysis in three cultures

  2. Implementation and analysis of an adaptive multilevel Monte Carlo algorithm

    KAUST Repository

    Hoel, Hakon; Von Schwerin, Erik; Szepessy, Anders; Tempone, Raul

    2014-01-01

    We present an adaptive multilevel Monte Carlo (MLMC) method for weak approximations of solutions to Itô stochastic dierential equations (SDE). The work [11] proposed and analyzed an MLMC method based on a hierarchy of uniform time discretizations and control variates to reduce the computational effort required by a single level Euler-Maruyama Monte Carlo method from O(TOL-3) to O(TOL-2 log(TOL-1)2) for a mean square error of O(TOL2). Later, the work [17] presented an MLMC method using a hierarchy of adaptively re ned, non-uniform time discretizations, and, as such, it may be considered a generalization of the uniform time discretizationMLMC method. This work improves the adaptiveMLMC algorithms presented in [17] and it also provides mathematical analysis of the improved algorithms. In particular, we show that under some assumptions our adaptive MLMC algorithms are asymptotically accurate and essentially have the correct complexity but with improved control of the complexity constant factor in the asymptotic analysis. Numerical tests include one case with singular drift and one with stopped diusion, where the complexity of a uniform single level method is O(TOL-4). For both these cases the results con rm the theory, exhibiting savings in the computational cost for achieving the accuracy O(TOL) from O(TOL-3) for the adaptive single level algorithm to essentially O(TOL-2 log(TOL-1)2) for the adaptive MLMC algorithm. © 2014 by Walter de Gruyter Berlin/Boston 2014.

  3. Contextual risk factors for low birth weight: a multilevel analysis.

    Directory of Open Access Journals (Sweden)

    Gbenga A Kayode

    Full Text Available Low birth weight (LBW remains to be a leading cause of neonatal death and a major contributor to infant and under-five mortality. Its prevalence has not declined in the last decade in sub-Saharan Africa (SSA and Asia. Some individual level factors have been identified as risk factors for LBW but knowledge is limited on contextual risk factors for LBW especially in SSA.Contextual risk factors for LBW in Ghana were identified by performing multivariable multilevel logistic regression analysis of 6,900 mothers dwelling in 412 communities that participated in the 2003 and 2008 Demographic and Health Surveys in Ghana.Contextual-level factors were significantly associated with LBW: Being a rural dweller increased the likelihood of having a LBW infant by 43% (OR 1.43; 95% CI 1.01-2.01; P-value <0.05 while living in poverty-concentrated communities increased the risk of having a LBW infant twofold (OR 2.16; 95% CI 1.29-3.61; P-value <0.01. In neighbourhoods with a high coverage of safe water supply the odds of having a LBW infant reduced by 28% (OR 0.74; 95% CI 0.57-0.96; P-value <0.05.This study showed contextual risk factors to have independent effects on the prevalence of LBW infants. Being a rural dweller, living in a community with a high concentration of poverty and a low coverage of safe water supply were found to increase the prevalence of LBW infants. Implementing appropriate community-based intervention programmes will likely reduce the occurrence of LBW infants.

  4. Women's status and depressive symptoms: a multilevel analysis.

    Science.gov (United States)

    Chen, Ying-Yeh; Subramanian, S V; Acevedo-Garcia, Doloros; Kawachi, Ichiro

    2005-01-01

    The effects of state-level women's status and autonomy on individual-level women's depressive symptoms were examined. We conducted a multi-level analysis of the 1991 longitudinal follow up of the 1988 National Maternal Infant Health Survey (NMIHS), with 7789 women nested within the fifty American states. State-level women's status was assessed by four composite indices measuring women's political participation, economic autonomy, employment & earnings, and reproductive rights. The main outcome measure was symptoms of depression (Center for Epidemiologic Studies Depression Scale, CES-D). The participants were a nationally representative stratified random sample of women in the USA aged between 17 and 40 years old who gave birth to live babies in 1988, were successfully contacted again in 1991 and provided complete information on depressive symptoms. Women who were younger, non-white, not currently married, less educated or had lower household income tended to report higher levels of depressive symptoms. Compared with states ranking low on the employment & earnings index, women residing in states that were high on the same index scored 0.85 points lower on the CES-D (peconomic autonomy index scored 0.83 points lower in depressive symptoms (p<0.01), compared with women who lived in states low on the same index. Finally, women who resided in states with high reproductive rights scored 0.62 points lower on the CES-D (p<0.05) compared with women who lived in states with lower reproductive rights. Gender inequality appears to contribute to depressive symptoms in women.

  5. College on Credit: A Multilevel Analysis of Student Loan Default

    Science.gov (United States)

    Hillman, Nicholas W.

    2014-01-01

    This study updates and expands the literature on student loan default. By applying multilevel regression to the Beginning Postsecondary Students survey, four key findings emerge. First, attending proprietary institutions is strongly associated with default, even after accounting for students' socioeconomic and academic backgrounds. Second,…

  6. Multi-level analysis in information systems research: the case of enterprise resource planning system usage in China

    Science.gov (United States)

    Sun, Yuan; Bhattacherjee, Anol

    2011-11-01

    Information technology (IT) usage within organisations is a multi-level phenomenon that is influenced by individual-level and organisational-level variables. Yet, current theories, such as the unified theory of acceptance and use of technology, describe IT usage as solely an individual-level phenomenon. This article postulates a model of organisational IT usage that integrates salient organisational-level variables such as user training, top management support and technical support within an individual-level model to postulate a multi-level model of IT usage. The multi-level model was then empirically validated using multi-level data collected from 128 end users and 26 managers in 26 firms in China regarding their use of enterprise resource planning systems and analysed using the multi-level structural equation modelling (MSEM) technique. We demonstrate the utility of MSEM analysis of multi-level data relative to the more common structural equation modelling analysis of single-level data and show how single-level data can be aggregated to approximate multi-level analysis when multi-level data collection is not possible. We hope that this article will motivate future scholars to employ multi-level data and multi-level analysis for understanding organisational phenomena that are truly multi-level in nature.

  7. On the Multilevel Nature of Meta-Analysis: A Tutorial, Comparison of Software Programs, and Discussion of Analytic Choices.

    Science.gov (United States)

    Pastor, Dena A; Lazowski, Rory A

    2018-01-01

    The term "multilevel meta-analysis" is encountered not only in applied research studies, but in multilevel resources comparing traditional meta-analysis to multilevel meta-analysis. In this tutorial, we argue that the term "multilevel meta-analysis" is redundant since all meta-analysis can be formulated as a special kind of multilevel model. To clarify the multilevel nature of meta-analysis the four standard meta-analytic models are presented using multilevel equations and fit to an example data set using four software programs: two specific to meta-analysis (metafor in R and SPSS macros) and two specific to multilevel modeling (PROC MIXED in SAS and HLM). The same parameter estimates are obtained across programs underscoring that all meta-analyses are multilevel in nature. Despite the equivalent results, not all software programs are alike and differences are noted in the output provided and estimators available. This tutorial also recasts distinctions made in the literature between traditional and multilevel meta-analysis as differences between meta-analytic choices, not between meta-analytic models, and provides guidance to inform choices in estimators, significance tests, moderator analyses, and modeling sequence. The extent to which the software programs allow flexibility with respect to these decisions is noted, with metafor emerging as the most favorable program reviewed.

  8. The Readability of Malaysian English Children Books: A Multilevel Analysis

    Directory of Open Access Journals (Sweden)

    Adlina Ismail

    2016-11-01

    Full Text Available These days, there are more English books for children published by local publishers in Malaysia. It is a positive development because the books will be more accessible to the children. However, the books have never been studied and evaluated in depth yet. One important factor in assessing reading materials is readability. Readability determines whether a text is easy or difficult to understand and a balanced mix of both can promote learning and language development. Various researchers mentioned a multilevel framework of discourse that any language assessment on a text should take into account. The levels that were proposed were word, syntax, textbase, situation model and genre and rhetorical structures. Traditional readability measures such as Flesh Reading Ease Formula, Gunning Readability Index, Fog Count, and Fry Grade Level are not able to address the multilevel because they are based on shallow variables. In contrast, Coh-metrix TERA provided five indices that are correlated to grade level and aligned to the multilevel framework. This study analyzed ten Malaysian English chapter books for children using this Coh-metrix TERA. The result revealed that the Malaysian English children books were easy in shallow level but there was a possible difficulty in textbase and situation model level because of the lack of cohesion. In conclusion, more attention should be given on deeper level of text rather than just word and syntax level.

  9. Survival analysis II: Cox regression

    NARCIS (Netherlands)

    Stel, Vianda S.; Dekker, Friedo W.; Tripepi, Giovanni; Zoccali, Carmine; Jager, Kitty J.

    2011-01-01

    In contrast to the Kaplan-Meier method, Cox proportional hazards regression can provide an effect estimate by quantifying the difference in survival between patient groups and can adjust for confounding effects of other variables. The purpose of this article is to explain the basic concepts of the

  10. The multi-level perspective analysis: Indonesia geothermal energy transition study

    Science.gov (United States)

    Wisaksono, A.; Murphy, J.; Sharp, J. H.; Younger, P. L.

    2018-01-01

    The study adopts a multi-level perspective in technology transition to analyse how the transition process in the development of geothermal energy in Indonesia is able to compete against the incumbent fossil-fuelled energy sources. Three levels of multi-level perspective are socio-technical landscape (ST-landscape), socio-technical regime (ST-regime) and niche innovations in Indonesia geothermal development. The identification, mapping and analysis of the dynamic relationship between each level are the important pillars of the multi-level perspective framework. The analysis considers the set of rules, actors and controversies that may arise in the technological transition process. The identified geothermal resource risks are the basis of the emerging geothermal technological innovations in Indonesian geothermal. The analysis of this study reveals the transition pathway, which yields a forecast for the Indonesian geothermal technology transition in the form of scenarios and probable impacts.

  11. Multivariate survival analysis and competing risks

    CERN Document Server

    Crowder, Martin J

    2012-01-01

    Multivariate Survival Analysis and Competing Risks introduces univariate survival analysis and extends it to the multivariate case. It covers competing risks and counting processes and provides many real-world examples, exercises, and R code. The text discusses survival data, survival distributions, frailty models, parametric methods, multivariate data and distributions, copulas, continuous failure, parametric likelihood inference, and non- and semi-parametric methods. There are many books covering survival analysis, but very few that cover the multivariate case in any depth. Written for a graduate-level audience in statistics/biostatistics, this book includes practical exercises and R code for the examples. The author is renowned for his clear writing style, and this book continues that trend. It is an excellent reference for graduate students and researchers looking for grounding in this burgeoning field of research.

  12. Friendship Dissolution Within Social Networks Modeled Through Multilevel Event History Analysis

    Science.gov (United States)

    Dean, Danielle O.; Bauer, Daniel J.; Prinstein, Mitchell J.

    2018-01-01

    A social network perspective can bring important insight into the processes that shape human behavior. Longitudinal social network data, measuring relations between individuals over time, has become increasingly common—as have the methods available to analyze such data. A friendship duration model utilizing discrete-time multilevel survival analysis with a multiple membership random effect structure is developed and applied here to study the processes leading to undirected friendship dissolution within a larger social network. While the modeling framework is introduced in terms of understanding friendship dissolution, it can be used to understand microlevel dynamics of a social network more generally. These models can be fit with standard generalized linear mixed-model software, after transforming the data to a pair-period data set. An empirical example highlights how the model can be applied to understand the processes leading to friendship dissolution between high school students, and a simulation study is used to test the use of the modeling framework under representative conditions that would be found in social network data. Advantages of the modeling framework are highlighted, and potential limitations and future directions are discussed. PMID:28463022

  13. An open stylometric system based on multilevel text analysis

    Directory of Open Access Journals (Sweden)

    Maciej Eder

    2017-12-01

    Full Text Available An open stylometric system based on multilevel text analysis Stylometric techniques are usually applied to a limited number of typical tasks, such as authorship attribution, genre analysis, or gender studies. However, they could be applied to several tasks beyond this canonical set, if only stylometric tools were more accessible to users from different areas of the humanities and social sciences. This paper presents a general idea, followed by a fully functional prototype of an open stylometric system that facilitates its wide use through to two aspects: technical and research flexibility. The system relies on a server installation combined with a web-based user interface. This frees the user from the necessity of installing any additional software. At the same time, the system offers a variety of ways in which the input texts can be analysed: they include not only the usual lexical level, but also deep-level linguistic features. This enables a range of possible applications, from typical stylometric tasks to the semantic analysis of text documents. The internal architecture of the system relies on several well-known software packages: a collection of language tools (for text pre-processing, Stylo (for stylometric analysis and Cluto (for text clustering. The paper presents: (1 The idea behind the system from the user’s perspective. (2 The architecture of the system, with a focus on data processing. (3 Features for text description. (4 The use of analytical systems such as Stylo and Cluto. The presentation is illustrated with example applications.   Otwarty system stylometryczny wykorzystujący wielopoziomową analizę języka  Zastosowania metod stylometrycznych na ogół ograniczają się do kilku typowych problemów badawczych, takich jak atrybucja autorska, styl gatunków literackich czy studia nad zróżnicowaniem stylistycznym kobiet i mężczyzn. Z pewnością dałoby się je z powodzeniem zastosować również do wielu innych problem

  14. Additive interaction in survival analysis

    DEFF Research Database (Denmark)

    Rod, Naja Hulvej; Lange, Theis; Andersen, Ingelise

    2012-01-01

    It is a widely held belief in public health and clinical decision-making that interventions or preventive strategies should be aimed at patients or population subgroups where most cases could potentially be prevented. To identify such subgroups, deviation from additivity of absolute effects...... an empirical example of interaction between education and smoking on risk of lung cancer. We argue that deviations from additivity of effects are important for public health interventions and clinical decision-making, and such estimations should be encouraged in prospective studies on health. A detailed...... is the relevant measure of interest. Multiplicative survival models, such as the Cox proportional hazards model, are often used to estimate the association between exposure and risk of disease in prospective studies. In Cox models, deviations from additivity have usually been assessed by surrogate measures...

  15. Simulation and Analysis of a Grid Connected Multi-level Converter Topologies and their Comparison

    Directory of Open Access Journals (Sweden)

    Mohammad Shadab Mirza

    2014-09-01

    Full Text Available This paper presents simulation and analysis of a grid connected multi-level converter topologies. In this paper, converter circuit works as an inverter by controlling the switching angle (α. This paper, presents a MATLAB/SIMULINK model of multi-level converter topologies (topology1 & topology2. Topology1 is without transformer while topology2 with transformer. Both the topologies are simulated and analyzed for three level converters in order to reduce the total harmonic distortion (THD. A comparative study of topology1 and topology2 is also presented in this paper for different switching angles (α and battery voltages. The results have been tabulated and discussed.

  16. Brief Report: Multilevel Analysis of School Smoking Policy and Pupil Smoking Behaviour in Wales

    Science.gov (United States)

    Wiium, Nora; Burgess, Stephen; Moore, Laurence

    2011-01-01

    A multilevel analysis of cross-sectional data from a survey involving 1941 pupils (in grades 10 and 11) and policy indicators developed from interviews with staff from 45 secondary schools in Wales examined the hypotheses that pupil smoking prevalence would be associated with: restrictive staff and pupil smoking policies; dissemination of school…

  17. Computational Tools for Probing Interactions in Multiple Linear Regression, Multilevel Modeling, and Latent Curve Analysis

    Science.gov (United States)

    Preacher, Kristopher J.; Curran, Patrick J.; Bauer, Daniel J.

    2006-01-01

    Simple slopes, regions of significance, and confidence bands are commonly used to evaluate interactions in multiple linear regression (MLR) models, and the use of these techniques has recently been extended to multilevel or hierarchical linear modeling (HLM) and latent curve analysis (LCA). However, conducting these tests and plotting the…

  18. Explaining Technology Integration in K-12 Classrooms: A Multilevel Path Analysis Model

    Science.gov (United States)

    Liu, Feng; Ritzhaupt, Albert D.; Dawson, Kara; Barron, Ann E.

    2017-01-01

    The purpose of this research was to design and test a model of classroom technology integration in the context of K-12 schools. The proposed multilevel path analysis model includes teacher, contextual, and school related variables on a teacher's use of technology and confidence and comfort using technology as mediators of classroom technology…

  19. A Multilevel Analysis of Japanese Middle School Student and School Socioeconomic Status Influence on Mathematics Achievement

    Science.gov (United States)

    Takashiro, Naomi

    2017-01-01

    The author examined the simultaneous influence of Japanese middle school student and school socioeconomic status (SES) on student math achievement with two-level multilevel analysis models by utilizing the Trends in International Mathematics and Science Study (TIMSS) Japan data sets. The theoretical framework used in this study was…

  20. Streaming, Tracking and Reading Achievement: A Multilevel Analysis of Students in 40 Countries

    Science.gov (United States)

    Chiu, Ming Ming; Chow, Bonnie Wing-Yin; Joh, Sung Wook

    2017-01-01

    Grouping similar students together within schools ("streaming") or classrooms ("tracking") based on past literacy skills (reported by parents), family socioeconomic status (SES) or reading attitudes might affect their reading achievement. Our multilevel analysis of the reading tests of 208,057 fourth-grade students across 40…

  1. Understanding survival analysis: Kaplan-Meier estimate.

    Science.gov (United States)

    Goel, Manish Kumar; Khanna, Pardeep; Kishore, Jugal

    2010-10-01

    Kaplan-Meier estimate is one of the best options to be used to measure the fraction of subjects living for a certain amount of time after treatment. In clinical trials or community trials, the effect of an intervention is assessed by measuring the number of subjects survived or saved after that intervention over a period of time. The time starting from a defined point to the occurrence of a given event, for example death is called as survival time and the analysis of group data as survival analysis. This can be affected by subjects under study that are uncooperative and refused to be remained in the study or when some of the subjects may not experience the event or death before the end of the study, although they would have experienced or died if observation continued, or we lose touch with them midway in the study. We label these situations as censored observations. The Kaplan-Meier estimate is the simplest way of computing the survival over time in spite of all these difficulties associated with subjects or situations. The survival curve can be created assuming various situations. It involves computing of probabilities of occurrence of event at a certain point of time and multiplying these successive probabilities by any earlier computed probabilities to get the final estimate. This can be calculated for two groups of subjects and also their statistical difference in the survivals. This can be used in Ayurveda research when they are comparing two drugs and looking for survival of subjects.

  2. Individual relocation decisions after tornadoes: a multi-level analysis.

    Science.gov (United States)

    Cong, Zhen; Nejat, Ali; Liang, Daan; Pei, Yaolin; Javid, Roxana J

    2018-04-01

    This study examines how multi-level factors affected individuals' relocation decisions after EF4 and EF5 (Enhanced Fujita Tornado Intensity Scale) tornadoes struck the United States in 2013. A telephone survey was conducted with 536 respondents, including oversampled older adults, one year after these two disaster events. Respondents' addresses were used to associate individual information with block group-level variables recorded by the American Community Survey. Logistic regression revealed that residential damage and homeownership are important predictors of relocation. There was also significant interaction between these two variables, indicating less difference between homeowners and renters at higher damage levels. Homeownership diminished the likelihood of relocation among younger respondents. Random effects logistic regression found that the percentage of homeownership and of higher income households in the community buffered the effect of damage on relocation; the percentage of older adults reduced the likelihood of this group relocating. The findings are assessed from the standpoint of age difference, policy implications, and social capital and vulnerability. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

  3. School Leadership and Cyberbullying-A Multilevel Analysis.

    Science.gov (United States)

    Låftman, Sara B; Östberg, Viveca; Modin, Bitte

    2017-10-15

    Cyberbullying is a relatively new form of bullying, with both similarities and differences to traditional bullying. While earlier research has examined associations between school-contextual characteristics and traditional bullying, fewer studies have focused on the links to students' involvement in cyberbullying behavior. The aim of the present study is to assess whether school-contextual conditions in terms of teachers' ratings of the school leadership are associated with the occurrence of cyberbullying victimization and perpetration among students. The data are derived from two separate data collections performed in 2016: The Stockholm School Survey conducted among students in the second grade of upper secondary school (ages 17-18 years) in Stockholm municipality, and the Stockholm Teacher Survey which was carried out among teachers in the same schools. The data include information from 6067 students distributed across 58 schools, linked with school-contextual information based on reports from 1251 teachers. Cyberbullying victimization and perpetration are measured by students' self-reports. Teachers' ratings of the school leadership are captured by an index based on 10 items; the mean value of this index was aggregated to the school level. Results from binary logistic multilevel regression models show that high teacher ratings of the school leadership are associated with less cyberbullying victimization and perpetration. We conclude that a strong school leadership potentially prevents cyberbullying behavior among students.

  4. School Leadership and Cyberbullying—A Multilevel Analysis

    Directory of Open Access Journals (Sweden)

    Sara B. Låftman

    2017-10-01

    Full Text Available Cyberbullying is a relatively new form of bullying, with both similarities and differences to traditional bullying. While earlier research has examined associations between school-contextual characteristics and traditional bullying, fewer studies have focused on the links to students’ involvement in cyberbullying behavior. The aim of the present study is to assess whether school-contextual conditions in terms of teachers’ ratings of the school leadership are associated with the occurrence of cyberbullying victimization and perpetration among students. The data are derived from two separate data collections performed in 2016: The Stockholm School Survey conducted among students in the second grade of upper secondary school (ages 17–18 years in Stockholm municipality, and the Stockholm Teacher Survey which was carried out among teachers in the same schools. The data include information from 6067 students distributed across 58 schools, linked with school-contextual information based on reports from 1251 teachers. Cyberbullying victimization and perpetration are measured by students’ self-reports. Teachers’ ratings of the school leadership are captured by an index based on 10 items; the mean value of this index was aggregated to the school level. Results from binary logistic multilevel regression models show that high teacher ratings of the school leadership are associated with less cyberbullying victimization and perpetration. We conclude that a strong school leadership potentially prevents cyberbullying behavior among students.

  5. School Leadership and Cyberbullying—A Multilevel Analysis

    Science.gov (United States)

    Låftman, Sara B.; Östberg, Viveca; Modin, Bitte

    2017-01-01

    Cyberbullying is a relatively new form of bullying, with both similarities and differences to traditional bullying. While earlier research has examined associations between school-contextual characteristics and traditional bullying, fewer studies have focused on the links to students’ involvement in cyberbullying behavior. The aim of the present study is to assess whether school-contextual conditions in terms of teachers’ ratings of the school leadership are associated with the occurrence of cyberbullying victimization and perpetration among students. The data are derived from two separate data collections performed in 2016: The Stockholm School Survey conducted among students in the second grade of upper secondary school (ages 17–18 years) in Stockholm municipality, and the Stockholm Teacher Survey which was carried out among teachers in the same schools. The data include information from 6067 students distributed across 58 schools, linked with school-contextual information based on reports from 1251 teachers. Cyberbullying victimization and perpetration are measured by students’ self-reports. Teachers’ ratings of the school leadership are captured by an index based on 10 items; the mean value of this index was aggregated to the school level. Results from binary logistic multilevel regression models show that high teacher ratings of the school leadership are associated with less cyberbullying victimization and perpetration. We conclude that a strong school leadership potentially prevents cyberbullying behavior among students. PMID:29036933

  6. Hospital Variation in Cesarean Delivery: A Multilevel Analysis.

    Science.gov (United States)

    Vecino-Ortiz, Andres I; Bardey, David; Castano-Yepes, Ramon

    2015-12-01

    To assess the issue of hospital variations in Colombia and to contribute to the methodology on health care variations by using a model that clusters the variance between hospitals while accounting for individual-level reimbursement rates and objective health-status variables. We used data on all births (N = 11,954) taking place in a contributory-regimen insurer network in Colombia during 2007. A multilevel logistic regression model was used to account for the share of unexplained variance between hospitals. In addition, an alternative variance decomposition specification was further carried out to measure the proportion of such unexplained variance due to the region effect. Hospitals account for 20% of the variation in performing cesarean sections, whereas region explains only one-third of such variance. Variables accounting for preferences on the demand side as well as reimbursement rates are found to predict the probability of performing cesarean sections. Hospital variations explain large variances within a single-payer's network. Because this insurer company is highly regarded in terms of performance and finance, these results might provide a lower bound for the scale of hospital variation in the Colombian health care market. Such lower bound provides guidance on the relevance of this issue for Colombia. Some factors such as demand-side preferences and physician reimbursement rates increase variations in health care even within a single-payer network. This is a source of inefficiencies, threatening the quality of health care and financial sustainability. The proposed methodology should be considered in further research on health care variations. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  7. Biostatistics series module 9: Survival analysis

    Directory of Open Access Journals (Sweden)

    Avijit Hazra

    2017-01-01

    Full Text Available Survival analysis is concerned with “time to event“ data. Conventionally, it dealt with cancer death as the event in question, but it can handle any event occurring over a time frame, and this need not be always adverse in nature. When the outcome of a study is the time to an event, it is often not possible to wait until the event in question has happened to all the subjects, for example, until all are dead. In addition, subjects may leave the study prematurely. Such situations lead to what is called censored observations as complete information is not available for these subjects. The data set is thus an assemblage of times to the event in question and times after which no more information on the individual is available. Survival analysis methods are the only techniques capable of handling censored observations without treating them as missing data. They also make no assumption regarding normal distribution of time to event data. Descriptive methods for exploring survival times in a sample include life table and Kaplan–Meier techniques as well as various kinds of distribution fitting as advanced modeling techniques. The Kaplan–Meier cumulative survival probability over time plot has become the signature plot for biomedical survival analysis. Several techniques are available for comparing the survival experience in two or more groups – the log-rank test is popularly used. This test can also be used to produce an odds ratio as an estimate of risk of the event in the test group; this is called hazard ratio (HR. Limitations of the traditional log-rank test have led to various modifications and enhancements. Finally, survival analysis offers different regression models for estimating the impact of multiple predictors on survival. Cox's proportional hazard model is the most general of the regression methods that allows the hazard function to be modeled on a set of explanatory variables without making restrictive assumptions concerning the

  8. Ecological causes of multilevel covariance between size and first-year survival in a wild bird population

    NARCIS (Netherlands)

    Bouwhuis, Sandra; Vedder, Oscar; Garroway, Colin J.; Sheldon, Ben C.

    Estimates of selection in natural populations are frequent but our understanding of ecological causes of selection, and causes of variation in the direction, strength and form of selection is limited. Here, we apply a multilevel framework to partition effects of great tit fledging mass on first-year

  9. SURVIVAL ANALYSIS AND LENGTH-BIASED SAMPLING

    Directory of Open Access Journals (Sweden)

    Masoud Asgharian

    2010-12-01

    Full Text Available When survival data are colleted as part of a prevalent cohort study, the recruited cases have already experienced their initiating event. These prevalent cases are then followed for a fixed period of time at the end of which the subjects will either have failed or have been censored. When interests lies in estimating the survival distribution, from onset, of subjects with the disease, one must take into account that the survival times of the cases in a prevalent cohort study are left truncated. When it is possible to assume that there has not been any epidemic of the disease over the past period of time that covers the onset times of the subjects, one may assume that the underlying incidence process that generates the initiating event times is a stationary Poisson process. Under such assumption, the survival times of the recruited subjects are called “lengthbiased”. I discuss the challenges one is faced with in analyzing these type of data. To address the theoretical aspects of the work, I present asymptotic results for the NPMLE of the length-biased as well as the unbiased survival distribution. I also discuss estimating the unbiased survival function using only the follow-up time. This addresses the case that the onset times are either unknown or known with uncertainty. Some of our most recent work and open questions will be presented. These include some aspects of analysis of covariates, strong approximation, functional LIL and density estimation under length-biased sampling with right censoring. The results will be illustrated with survival data from patients with dementia, collected as part of the Canadian Study of Health and Aging (CSHA.

  10. A taylor series approach to survival analysis

    International Nuclear Information System (INIS)

    Brodsky, J.B.; Groer, P.G.

    1984-09-01

    A method of survival analysis using hazard functions is developed. The method uses the well known mathematical theory for Taylor Series. Hypothesis tests of the adequacy of many statistical models, including proportional hazards and linear and/or quadratic dose responses, are obtained. A partial analysis of leukemia mortality in the Life Span Study cohort is used as an example. Furthermore, a relatively robust estimation procedure for the proportional hazards model is proposed. (author)

  11. Taking Advertising Literacy to a Higher Level: An Exploratory Multilevel Analysis of Children's Advertising Literacy

    OpenAIRE

    De Pauw, Pieter; Cauberghe, Veroline; Hudders, Liselot

    2017-01-01

    As few studies focus on how children’s coping with advertising is affected by their environment, the present study uses multilevel analysis to explore the role of both primary (i.e. parents) and secondary socializing agents (i.e. classmates, teachers) in children’s advertising literacy. The results show that children’s cognitive advertising literacy and attitudes toward advertising are to a large extent determined by class-level processes. Their moral advertising literacy is a more individual...

  12. Measuring the Effects of Trade Liberalization: Multilevel Analysis Tool for Agriculture

    OpenAIRE

    Gerard, Francoise; Marty, Isabelle; Lancon, Frederic; Versapuech, Marion

    1998-01-01

    This book is the product of the projects "Farmers' Strategies Regarding Agricultural Diversification" (1993-1995) and "Agricultural Diversification and Food Crop Trade: Their Implications to Agricultural Policies in Southeast Asia" (1994-1996), both supported by CIRAD and the Government of France. It describes the first project attempting to apply the MATA methodology in a country like Indonesia. As constructed, the Multilevel Analysis Tool for Agriculture is able to answer various policy que...

  13. Multi-level human motion analysis for surveillance applications

    NARCIS (Netherlands)

    Lao, W.; Han, Jungong; With, de P.H.N.; Rabbani, M.; Stevenson, R.L.

    2009-01-01

    In this paper, we study a flexible framework for semantic analysis of human motion from a monocular surveillance video. Successful trajectory estimation and human-body modeling facilitate the semantic analysis of human activities in video sequences. As a first contribution, we propose a flexible

  14. Neyman, Markov processes and survival analysis.

    Science.gov (United States)

    Yang, Grace

    2013-07-01

    J. Neyman used stochastic processes extensively in his applied work. One example is the Fix and Neyman (F-N) competing risks model (1951) that uses finite homogeneous Markov processes to analyse clinical trials with breast cancer patients. We revisit the F-N model, and compare it with the Kaplan-Meier (K-M) formulation for right censored data. The comparison offers a way to generalize the K-M formulation to include risks of recovery and relapses in the calculation of a patient's survival probability. The generalization is to extend the F-N model to a nonhomogeneous Markov process. Closed-form solutions of the survival probability are available in special cases of the nonhomogeneous processes, like the popular multiple decrement model (including the K-M model) and Chiang's staging model, but these models do not consider recovery and relapses while the F-N model does. An analysis of sero-epidemiology current status data with recurrent events is illustrated. Fix and Neyman used Neyman's RBAN (regular best asymptotic normal) estimates for the risks, and provided a numerical example showing the importance of considering both the survival probability and the length of time of a patient living a normal life in the evaluation of clinical trials. The said extension would result in a complicated model and it is unlikely to find analytical closed-form solutions for survival analysis. With ever increasing computing power, numerical methods offer a viable way of investigating the problem.

  15. Control of modular multilevel converters based on time-scale analysis and orthogonal functions

    DEFF Research Database (Denmark)

    Zarri, L.; Tani, A.; Mengoni, M.

    2014-01-01

    current is still a complex task and cannot be fully tackled with traditional linear control techniques. In this paper a multiple time-scale analysis is proposed to determine an approximated model of the MMC that can be used to solve the control problem of the capacitor voltages. In addition, it is shown...... that the reference signal of the circulating current can be built by combining orthogonal functions of the measured voltages and currents. Numerical simulations are used to test the feasibility of the developed approach.......Modular multilevel converter (MMC) is a promising multilevel topology for high-voltage applications that has been developed in recent years. The control of MMCs has been analyzed in detail in many papers, showing that the converter capacitors can be kept charged and balanced by controlling...

  16. Evaluating Technical Efficiency of Nursing Care Using Data Envelopment Analysis and Multilevel Modeling.

    Science.gov (United States)

    Min, Ari; Park, Chang Gi; Scott, Linda D

    2016-05-23

    Data envelopment analysis (DEA) is an advantageous non-parametric technique for evaluating relative efficiency of performance. This article describes use of DEA to estimate technical efficiency of nursing care and demonstrates the benefits of using multilevel modeling to identify characteristics of efficient facilities in the second stage of analysis. Data were drawn from LTCFocUS.org, a secondary database including nursing home data from the Online Survey Certification and Reporting System and Minimum Data Set. In this example, 2,267 non-hospital-based nursing homes were evaluated. Use of DEA with nurse staffing levels as inputs and quality of care as outputs allowed estimation of the relative technical efficiency of nursing care in these facilities. In the second stage, multilevel modeling was applied to identify organizational factors contributing to technical efficiency. Use of multilevel modeling avoided biased estimation of findings for nested data and provided comprehensive information on differences in technical efficiency among counties and states. © The Author(s) 2016.

  17. Multilevel Latent Class Analysis: Parametric and Nonparametric Models

    Science.gov (United States)

    Finch, W. Holmes; French, Brian F.

    2014-01-01

    Latent class analysis is an analytic technique often used in educational and psychological research to identify meaningful groups of individuals within a larger heterogeneous population based on a set of variables. This technique is flexible, encompassing not only a static set of variables but also longitudinal data in the form of growth mixture…

  18. Survival Function Analysis of Planet Size Distribution

    OpenAIRE

    Zeng, Li; Jacobsen, Stein B.; Sasselov, Dimitar D.; Vanderburg, Andrew

    2018-01-01

    Applying the survival function analysis to the planet radius distribution of the Kepler exoplanet candidates, we have identified two natural divisions of planet radius at 4 Earth radii and 10 Earth radii. These divisions place constraints on planet formation and interior structure model. The division at 4 Earth radii separates small exoplanets from large exoplanets above. When combined with the recently-discovered radius gap at 2 Earth radii, it supports the treatment of planets 2-4 Earth rad...

  19. Thermo-mechanical analysis for multi-level HLW repository concept

    International Nuclear Information System (INIS)

    Kwon, Sang Ki; Choi, Jong Won

    2004-01-01

    This work aims to investigate the influence of design parameters for the underground high-level nuclear waste repository with multi-level concept. B. Necessity o In order to construct an HLW repository in deep underground, it is required to select a site, which is far from major discontinuities. To dispose the whole spent fuels generated from the Korean nuclear power plants in a repository, the underground area of about 4km 2 is required. This would be a constraints for selecting an adequate repository site. It is recommended to dispose the two different spent fuels, PWR and CANDU, in different areas at the operation efficiency point of view. It is necessary to investigate the influence of parameters, which can affect the stability of multi-level repository. It is also needed to consider the influence of heat generated from the HLW and the high in situ stress in deep location. Therefore, thermo-mechanical coupling analysis should be carried out and the results should be compared with the results from single-level repository concept. Three-dimensional analysis is required to model the disposal tunnel and deposition hole. It is recommended to use the Korean geological condition and actually measured rock properties in Korea in order to achieve reliable modeling results. A FISH routine developed for effective modeling of Thermal-Mechanical coupling was implemented in the modeling using FLAC3D, which is a commercial three-dimensional FDM code. The thermal and mechanical properties of rock and rock mass achieved from Yusung drilling site, were used for the computer modeling. Different parameters such as level distance, waste type disposed on different levels, and time interval between the operation on different levels, were considered in the three-dimensional analysis. From the analysis, it was possible to derive adequate multi-level repository concept. Results and recommendations for application From the thermal-mechanical analysis for the multi-level repository

  20. Multilevel Analysis of Continuous AE from Helicopter Gearbox

    Czech Academy of Sciences Publication Activity Database

    Chlada, Milan; Převorovský, Zdeněk; Heřmánek, Jan; Krofta, Josef

    2014-01-01

    Roč. 19, č. 12 (2014) ISSN 1435-4934. [European Conference on Non-Destructive Testing (ECNDT 2014) /11./. Praha, 06.10.2014-10.10.2014] R&D Projects: GA MPO FR-TI3/755 Institutional support: RVO:61388998 Keywords : structural health monitoring (SHM) * signal processing * acoustic emission (AE) * diagnostics of helicopter gearbox * wavelet analysis * continuous acoustic emission Subject RIV: JU - Aeronautics, Aerodynamics, Aircrafts http://www.ndt.net/events/ECNDT2014/app/content/Paper/630_Chlada_Rev1.pdf

  1. Analysis and integration of multilevel inverter configuration with boost converters in a photovoltaic system

    International Nuclear Information System (INIS)

    Prabaharan, N.; Palanisamy, K.

    2016-01-01

    Highlights: • Integration of MLI with boost converters in photovoltaic system including MPPT. • Results are taken for different irradiations and different temperature condition. • Proposed system is tested with sudden step changes from standard test condition. • Analysis of switching losses and conduction loss is discussed. • Theoretical calculation of % THD using asymptotic formula is discussed. - Abstract: This paper proposes a single phase multilevel inverter configuration that conjoins three series connected full bridge inverter and a single half bridge inverter for renewable energy application especially photo-voltaic system. This configuration of multilevel inverter reduces the value of total harmonic distortion. The half bridge inverter utilized in the proposed configuration increases the output voltage level to nearly twice the output voltage level of a conventional cascaded H-bridge multilevel inverter. This higher output voltage level is generated with lesser number of power semiconductor switches compared to conventional configuration, thus reducing the total harmonic distortion and switching losses. The effectiveness of the proposed configuration is illustrated by replacing the isolated DC sources in multilevel inverter with individual photo-voltaic panels using separate perturb and observer based maximum power point tracking and boost converters. The verification of the proposed system is demonstrated successfully using MATLAB/Simulink based simulation with different irradiation and temperature conditions. Also, the transient operation of the system is verified with results depicted using step change in standard test condition. In the proposed system, total harmonic distortion of the output voltage is 9.85% without using passive filters and 3.91% with filter inductance. Theoretical calculation of the power losses and total harmonic distortion with mathematical equations are discussed. Selective experimental results are presented to prove the

  2. Multi-level governance-perspective on management of nuclear waste disposal. A comparative analysis

    Energy Technology Data Exchange (ETDEWEB)

    Brunnengraeber, Achim; Haefner, Daniel

    2015-07-01

    The primary aim of the project is to conduct a detailed social and political analysis of the preconditions for the development of an acceptable strategy for nuclear waste disposal in Germany. This includes the identification of stakeholders and their interests, responsibilities, value systems, views and expectations as well as paths for a constructive approach to dialogue and problem-solving. A focus of the research project will be an international comparative multi-level governance analysis of acceptance patterns and steering mechanisms for conflict resolution.

  3. Multi-level governance-perspective on management of nuclear waste disposal. A comparative analysis

    International Nuclear Information System (INIS)

    Brunnengraeber, Achim; Haefner, Daniel

    2015-01-01

    The primary aim of the project is to conduct a detailed social and political analysis of the preconditions for the development of an acceptable strategy for nuclear waste disposal in Germany. This includes the identification of stakeholders and their interests, responsibilities, value systems, views and expectations as well as paths for a constructive approach to dialogue and problem-solving. A focus of the research project will be an international comparative multi-level governance analysis of acceptance patterns and steering mechanisms for conflict resolution.

  4. Regional Guanxi Culture and Entrepreneurs' Action Logic: A Multilevel Analysis

    Institute of Scientific and Technical Information of China (English)

    Xinchun Li; Wenping Ye; Pengxiang Zhang; Xiao Xiao

    2016-01-01

    At the beginning of the reform period,though informal institutions as a substitute for formal institutions efficiently promoted the development of private enterprises,it eroded and destroyed the authority and execution efficiency of formal institutions with guanxi behaviors and implicit rules.With the progress of marketization,how to restrain and guide the evolution of informal institutions is an unavoidable obstacle for the development of private enterprises-transforming their competitive strategy from “non-market” dominance to “market” dominance.Based on survey data of 2,628 private enterprises from 31 provinces in China,we establish a regional commercial culture index to empirically investigate the different influences of guanxi behavior between entrepreneurs of different ages and regional guanxi culture.The results show that,compared with entrepreneurs who started businesses in recent years,i.e.,after the 1990s,those who started businesses during the 1970s and the 1980s are more dependent on guanxi behaviors.Meanwhile,the higher the level of education,the less an entrepreneur is likely to be dependent on guanxi behaviors.However,compared with the constraint of the degree of regional marketization,regional guanxi culture promotes entrepreneurs' guanxi behaviors.Further research indicates that the more enterprises depart from regional guanxi culture,the stronger the ability to innovation.This study can not only enrich the institutional analysis of entrepreneurs' guanxi behaviors,but also provide a theoretical foundation for further expansion and deepening of reform.

  5. Study of visualized simulation and analysis of nuclear fuel cycle system based on multilevel flow model

    International Nuclear Information System (INIS)

    Liu Jingquan; Yoshikawa, H.; Zhou Yangping

    2005-01-01

    Complex energy and environment system, especially nuclear fuel cycle system recently raised social concerns about the issues of economic competitiveness, environmental effect and nuclear proliferation. Only under the condition that those conflicting issues are gotten a consensus between stakeholders with different knowledge background, can nuclear power industry be continuingly developed. In this paper, a new analysis platform has been developed to help stakeholders to recognize and analyze various socio-technical issues in the nuclear fuel cycle sys- tem based on the functional modeling method named Multilevel Flow Models (MFM) according to the cognition theory of human being, Its character is that MFM models define a set of mass, energy and information flow structures on multiple levels of abstraction to describe the functional structure of a process system and its graphical symbol representation and the means-end and part-whole hierarchical flow structure to make the represented process easy to be understood. Based upon this methodology, a micro-process and a macro-process of nuclear fuel cycle system were selected to be simulated and some analysis processes such as economics analysis, environmental analysis and energy balance analysis related to those flows were also integrated to help stakeholders to understand the process of decision-making with the introduction of some new functions for the improved Multilevel Flow Models Studio, and finally the simple simulation such as spent fuel management process simulation and money flow of nuclear fuel cycle and its levelised cost analysis will be represented as feasible examples. (authors)

  6. Study of visualized simulation and analysis of nuclear fuel cycle system based on multilevel flow model

    Institute of Scientific and Technical Information of China (English)

    LIU Jing-Quan; YOSHIKAWA Hidekazu; ZHOU Yang-Ping

    2005-01-01

    Complex energy and environment system, especially nuclear fuel cycle system recently raised social concerns about the issues of economic competitiveness, environmental effect and nuclear proliferation. Only under the condition that those conflicting issues are gotten a consensus between stakeholders with different knowledge background, can nuclear power industry be continuingly developed. In this paper, a new analysis platform has been developed to help stakeholders to recognize and analyze various socio-technical issues in the nuclear fuel cycle system based on the functional modeling method named Multilevel Flow Models (MFM) according to the cognition theory of human being. Its character is that MFM models define a set of mass, energy and information flow structures on multiple levels of abstraction to describe the functional structure of a process system and its graphical symbol representation and the means-end and part-whole hierarchical flow structure to make the represented process easy to be understood. Based upon this methodology, a micro-process and a macro-process of nuclear fuel cycle system were selected to be simulated and some analysis processes such as economics analysis, environmental analysis and energy balance analysis related to those flows were also integrated to help stakeholders to understand the process of decision-making with the introduction of some new functions for the improved Multilevel Flow Models Studio, and finally the simple simulation such as spent fuel management process simulation and money flow of nuclear fuel cycle and its levelised cost analysis will be represented as feasible examples.

  7. The multilevel analysis of surface acting and mental health: A moderation of positive group affective tone

    Science.gov (United States)

    Lee, Meng-Shiu; Huang, Jui-Chan; Wu, Tzu-Jung

    2017-06-01

    The purpose of this study is to investigate the relationship among surface acting, mental health, and positive group affective tone. According to the prior theory, this study attempts to establish a comprehensive research framework among these variables, and furthermore tests the moderating effect of positive group affective tone. Data were collected from 435 employees in 52 service industrial companies by questionnaire, and this study conducted multilevel analysis. The results showed that surface acting will negatively affect the mental health. In addition, the positive group affective tone have significant moderating effect on the relationship among surface acting and mental health. Finally, this study discusses managerial implications and highlights future research suggestions.

  8. ANALYSIS OF THE STRATEGY OF BREEDING OF TOMATO WITH DGENES FOR MULTILEVEL NARROWSHELVE HYDROPONIC SYSTEM

    OpenAIRE

    I. T. Balashova; S. M. Sirota; E. G. Kozar

    2015-01-01

    Using the sporophyte selection accelerates in three times the breeding process of new tomato forms with dgenes for the multilevel narrow-shelve hydroponic technology. Analysis two breeding approaches is presented in this paper: the individual selection of recombinant forms from populations and the target hybridization. The target hybridization increases the productivity of the plant and the weight of one fruit in two times.

  9. Characterization of deep aquifer dynamics using principal component analysis of sequential multilevel data

    Directory of Open Access Journals (Sweden)

    D. Kurtzman

    2012-03-01

    Full Text Available Two sequential multilevel profiles were obtained in an observation well opened to a 130-m thick, unconfined, contaminated aquifer in Tel Aviv, Israel. While the general profile characteristics of major ions, trace elements, and volatile organic compounds were maintained in the two sampling campaigns conducted 295 days apart, the vertical locations of high concentration gradients were shifted between the two profiles. Principal component analysis (PCA of the chemical variables resulted in a first principal component which was responsible for ∼60% of the variability, and was highly correlated with depth. PCA revealed three distinct depth-dependent water bodies in both multilevel profiles, which were found to have shifted vertically between the sampling events. This shift cut across a clayey bed which separated the top and intermediate water bodies in the first profile, and was located entirely within the intermediate water body in the second profile. Continuous electrical conductivity monitoring in a packed-off section of the observation well revealed an event in which a distinct water body flowed through the monitored section (v ∼ 150 m yr−1. It was concluded that the observed changes in the profiles result from dominantly lateral flow of water bodies in the aquifer rather than vertical flow. The significance of this study is twofold: (a it demonstrates the utility of sequential multilevel observations from deep wells and the efficacy of PCA for evaluating the data; (b the fact that distinct water bodies of 10 to 100 m vertical and horizontal dimensions flow under contaminated sites, which has implications for monitoring and remediation.

  10. cudaBayesreg: Parallel Implementation of a Bayesian Multilevel Model for fMRI Data Analysis

    Directory of Open Access Journals (Sweden)

    Adelino R. Ferreira da Silva

    2011-10-01

    Full Text Available Graphic processing units (GPUs are rapidly gaining maturity as powerful general parallel computing devices. A key feature in the development of modern GPUs has been the advancement of the programming model and programming tools. Compute Unified Device Architecture (CUDA is a software platform for massively parallel high-performance computing on Nvidia many-core GPUs. In functional magnetic resonance imaging (fMRI, the volume of the data to be processed, and the type of statistical analysis to perform call for high-performance computing strategies. In this work, we present the main features of the R-CUDA package cudaBayesreg which implements in CUDA the core of a Bayesian multilevel model for the analysis of brain fMRI data. The statistical model implements a Gibbs sampler for multilevel/hierarchical linear models with a normal prior. The main contribution for the increased performance comes from the use of separate threads for fitting the linear regression model at each voxel in parallel. The R-CUDA implementation of the Bayesian model proposed here has been able to reduce significantly the run-time processing of Markov chain Monte Carlo (MCMC simulations used in Bayesian fMRI data analyses. Presently, cudaBayesreg is only configured for Linux systems with Nvidia CUDA support.

  11. Variation in plasma calcium analysis in primary care in Sweden - a multilevel analysis

    Directory of Open Access Journals (Sweden)

    Eggertsen Robert

    2010-05-01

    Full Text Available Abstract Background Primary hyperparathyroidism (pHPT is a common disease that often remains undetected and causes severe disturbance especially in postmenopausal women. Therefore, national recommendations promoting early pHPT detection by plasma calcium (P-Ca have been issued in Sweden. In this study we aimed to investigate variation of P-Ca analysis between physicians and health care centres (HCCs in primary care in county of Skaraborg, Sweden. Methods In this cross sectional study of patients' records during 2005 we analysed records from 154 629 patients attending 457 physicians at 24 HCCs. We used multilevel logistic regression analysis (MLRA and adjusted for patient, physician and HCC characteristics. Differences were expressed as median odds ratio (MOR. Results There was a substantial variation in number of P-Ca analyses between both HCCs (MORHCC 1.65 [1.44-2.07] and physicians (MORphysician 1.95 [1.85-2.08]. The odds for a P-Ca analysis were lower for male patients (OR 0.80 [0.77-0.83] and increased with the number of diagnoses (OR 25.8 [23.5-28.5]. Sex of the physician had no influence on P-Ca test ordering (OR 0.93 [0.78-1.09]. Physicians under education ordered most P-Ca analyses (OR 1.69 [1.35-2.24] and locum least (OR 0.73 [0.57-0.94]. More of the variance was attributed to the physician level than the HCC level. Different mix of patients did not explain this variance between physicians. Theoretically, if a patient were able to change both GP and HCC, the odds of a P-Ca analysis would in median increase by 2.45. Including characteristics of the patients, physicians and HCCs in the MLRA model did not explain the variance. Conclusions The physician level was more important than the HCC level for the variation in P-Ca analysis, but further exploration of unidentified contextual factors is crucial for future monitoring of practice variation.

  12. An Airline-Based Multilevel Analysis of Airfare Elasticity for Passenger Demand

    Science.gov (United States)

    Castelli, Lorenzo; Ukovich, Walter; Pesenti, Raffaele

    2003-01-01

    Price elasticity of passenger demand for a specific airline is estimated. The main drivers affecting passenger demand for air transportation are identified. First, an Ordinary Least Squares regression analysis is performed. Then, a multilevel analysis-based methodology to investigate the pattern of variation of price elasticity of demand among the various routes of the airline under study is proposed. The experienced daily passenger demands on each fare-class are grouped for each considered route. 9 routes were studied for the months of February and May in years from 1999 to 2002, and two fare-classes were defined (business and economy). The analysis has revealed that the airfare elasticity of passenger demand significantly varies among the different routes of the airline.

  13. Study on reliability analysis based on multilevel flow models and fault tree method

    International Nuclear Information System (INIS)

    Chen Qiang; Yang Ming

    2014-01-01

    Multilevel flow models (MFM) and fault tree method describe the system knowledge in different forms, so the two methods express an equivalent logic of the system reliability under the same boundary conditions and assumptions. Based on this and combined with the characteristics of MFM, a method mapping MFM to fault tree was put forward, thus providing a way to establish fault tree rapidly and realizing qualitative reliability analysis based on MFM. Taking the safety injection system of pressurized water reactor nuclear power plant as an example, its MFM was established and its reliability was analyzed qualitatively. The analysis result shows that the logic of mapping MFM to fault tree is correct. The MFM is easily understood, created and modified. Compared with the traditional fault tree analysis, the workload is greatly reduced and the modeling time is saved. (authors)

  14. The role of supervisor emotional support on individual job satisfaction: A multilevel analysis.

    Science.gov (United States)

    Pohl, Sabine; Galletta, Maura

    2017-02-01

    Supervisor emotional support is a strong determinant of job satisfaction. There is no study examining the effect of supervisor emotional support at the group level on job satisfaction. Multilevel statistical techniques can help disentangle the effects of subjective assessments from those of group factors. The study's aim was to examine the moderating role of supervisor emotional support (group-level variable) on the relationship between work engagement and job satisfaction (individual-level variables). A cross-sectional study was performed in 39units from three Belgian hospitals. A total of 323 nurses completed a self-reported questionnaire. We carried out a multilevel analysis by using Hierarchical Linear Modeling. The results showed that the cross-level interaction was significant. Hence, at individual-level, the nurses with high levels of work engagement showed high levels of job satisfaction and this relationship was stronger when supervisor emotional support at group-level was high. Contextual differences among groups had an impact on the form of the work engagement-job satisfaction relationship. This relationship between work engagement and job satisfaction is an individual and group level phenomenon. Ways to enhance emotional supervisor support include training supervisors in providing support and enhancing communication between nurses and supervisors. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. [A multilevel model analysis of correlation between population characteristics and work ability of employees].

    Science.gov (United States)

    Zhang, Lei; Huang, Chunping; Lan, Yajia; Wang, Mianzhen

    2015-12-01

    To analyze the correlation between population characteristics and work ability of employees with a multilevel model, to investigate the important influencing factors for work ability, and to provide a basis for improvement in work ability. Work ability index (WAI)was applied to measure the work ability of 1686 subjects from different companies (n=6). MLwi N2.0 software was applied for two-level variance component model fitting. The WAI of employees showed differences between various companies (χ2=3.378 6, P=0.0660); working years was negatively correlated with WAI (χ2=38.229 2, P=0.0001), and the WAI of the employees with 20 or more working years was 1.63 lower than that of the employees with less than 20 working years; the work ability of manual workers was lower than that of mental-manual workers (χ2=8.2726, P=0.0040), and the work ability showed no significant difference between mental workers and mental-manual workers (χ2=2.086 0, P=0.148 7). From the perspective of probability, the multilevel model analysis reveals the differences in work ability of employees between different companies, and suggests that company, work type, and working years are the important influencing factors for work ability of employees. These factors should be improved and adjusted to protect or enhance the work ability of employees.

  16. Lean production tools and decision latitude enable conditions for innovative learning in organizations: a multilevel analysis.

    Science.gov (United States)

    Fagerlind Ståhl, Anna-Carin; Gustavsson, Maria; Karlsson, Nadine; Johansson, Gun; Ekberg, Kerstin

    2015-03-01

    The effect of lean production on conditions for learning is debated. This study aimed to investigate how tools inspired by lean production (standardization, resource reduction, visual monitoring, housekeeping, value flow analysis) were associated with an innovative learning climate and with collective dispersion of ideas in organizations, and whether decision latitude contributed to these associations. A questionnaire was sent out to employees in public, private, production and service organizations (n = 4442). Multilevel linear regression analyses were used. Use of lean tools and decision latitude were positively associated with an innovative learning climate and collective dispersion of ideas. A low degree of decision latitude was a modifier in the association to collective dispersion of ideas. Lean tools can enable shared understanding and collective spreading of ideas, needed for the development of work processes, especially when decision latitude is low. Value flow analysis played a pivotal role in the associations. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  17. Mental health, places and people: a multilevel analysis of economic inactivity and social deprivation.

    Science.gov (United States)

    Fone, David L; Dunstan, Frank

    2006-09-01

    Using data on 24,975 respondents to the Welsh Health Survey 1998 aged 17-74 years, we investigated associations between individual mental health status measured using the SF-36 instrument, social class, economic inactivity and the electoral division Townsend deprivation score. In a multilevel modelling analysis, we found mental health was significantly associated with the Townsend score after adjusting for composition, and this effect was strongest in respondents who were economically inactive. Further contextual effects were shown by significant random variability in the slopes of the relation between mental health and economic inactivity at the electoral division level. Our results suggest that the places in which people live affect their mental health, supporting NHS policy that multi-agency planning to reduce inequalities in mental health status should address the wider determinants of health, as well as services for individual patients.

  18. Social Network Community Detection for DMA Creation: Criteria Analysis through Multilevel Optimization

    Directory of Open Access Journals (Sweden)

    Bruno M. Brentan

    2017-01-01

    Full Text Available Management of large water distribution systems can be improved by dividing their networks into so-called district metered areas (DMAs. However, such divisions must be based on appropriated technical criteria. Considering the importance of deeply understanding the relationship between DMA creation and these criteria, this work proposes a performance analysis of DMA generation that takes into account such indicators as resilience index, demand similarity, pressure uniformity, water age (and thus water quality, solution implantation costs, and electrical consumption. To cope with the complexity of the problem, suitable mathematical techniques are proposed in this paper. We use a social community detection technique to define the sectors, and then a multilevel particle swarm optimization approach is applied to find the optimal placement and operating point of the necessary devices. The results obtained by implementing the methodology in a real water supply network show its validity and the meaningful influence on the final result of, especially, elevation and pipe length.

  19. The Effect of Family Factors on Intense Alcohol Use among European Adolescents: A Multilevel Analysis

    Directory of Open Access Journals (Sweden)

    Kristjan Kask

    2013-01-01

    multilevel analysis, it was found that overall, complete family and high social control by parents were lowering the intense alcohol use whereas negative life events in the family and high family affluence were increasing youngsters' intense alcohol use. Differences between regions of Europe were present for all family factors except affluence. Namely, in Northern Europe the impact of family structure and social control on intense alcohol use was stronger than that in other regions (e.g., Western Europe, Mediterranean, and Postsocialist countries. Also, in Northern Europe where the proportion of adolescents who have not experienced negative life events is the highest, the impact of negative life events on intense alcohol use was stronger; that is, negative life events increased the alcohol use. We conclude that family plays a significant role in adolescents' risky alcohol use.

  20. Coherent population transfer in multilevel systems with magnetic sublevels. II. Algebraic analysis

    International Nuclear Information System (INIS)

    Martin, J.; Shore, B.W.; Bergmann, K.

    1995-01-01

    We extend previous theoretical work on coherent population transfer by stimulated Raman adiabatic passage for states involving nonzero angular momentum. The pump and Stokes fields are either copropagating or counterpropagating with the corresponding linearly polarized electric-field vectors lying in a common plane with the magnetic-field direction. Zeeman splitting lifts the magnetic sublevel degeneracy. We present an algebraic analysis of dressed-state properties to explain the behavior noted in numerical studies. In particular, we discuss conditions which are likely to lead to a failure of complete population transfer. The applied strategy, based on simple methods of linear algebra, will also be successful for other types of discrete multilevel systems, provided the rotating-wave and adiabatic approximation are valid

  1. Coherent population transfer in multilevel systems with magnetic sublevels. II. Algebraic analysis

    Science.gov (United States)

    Martin, J.; Shore, B. W.; Bergmann, K.

    1995-07-01

    We extend previous theoretical work on coherent population transfer by stimulated Raman adiabatic passage for states involving nonzero angular momentum. The pump and Stokes fields are either copropagating or counterpropagating with the corresponding linearly polarized electric-field vectors lying in a common plane with the magnetic-field direction. Zeeman splitting lifts the magnetic sublevel degeneracy. We present an algebraic analysis of dressed-state properties to explain the behavior noted in numerical studies. In particular, we discuss conditions which are likely to lead to a failure of complete population transfer. The applied strategy, based on simple methods of linear algebra, will also be successful for other types of discrete multilevel systems, provided the rotating-wave and adiabatic approximation are valid.

  2. Multilevel Analysis of the Impact of School-Level Tobacco Policies on Adolescent Smoking: The Case of Michigan

    Science.gov (United States)

    Paek, Hye-Jin; Hove, Thomas; Oh, Hyun Jung

    2013-01-01

    Background: In efforts to curb and prevent youth smoking, school tobacco policies have become an important and effective strategy. This study explores the degrees and types of tobacco-free school policy (TFSP) enforcement that are associated with adolescent smoking. Methods: A multilevel analysis was performed using 983 students who are nested in…

  3. Employees' Willingness to Participate in Work-Related Learning: A Multilevel Analysis of Employees' Learning Intentions

    Science.gov (United States)

    Kyndt, Eva; Onghena, Patrick; Smet, Kelly; Dochy, Filip

    2014-01-01

    The current study focuses on employees' learning intentions, or the willingness to undertake formal work-related learning. This cross-sectional survey study included a sample of 1,243 employees that are nested within 21 organisations. The results of the multilevel analysis show that self-directedness in career processes, time management,…

  4. School staff perpetration of physical violence against students in Uganda: a multilevel analysis of risk factors.

    Science.gov (United States)

    Merrill, Katherine G; Knight, Louise; Glynn, Judith R; Allen, Elizabeth; Naker, Dipak; Devries, Karen M

    2017-08-18

    To conduct a multilevel analysis of risk factors for physical violence perpetration by school staff against Ugandan students. Multilevel logistic regression analysis of cross-sectional survey data from 499 staff and 828 caregivers of students at 38 primary schools, collected in 2012 and 2014 during the Good Schools Study. Luwero District, Uganda. Past-week use of physical violence by school staff against students was measured using the International Society for the Prevention of Child Abuse and Neglect 'Child Abuse Screening Tool- Child International' and the WHO Multi-Country Study on Women's Health and Domestic Violence against Women. Of 499 staff, 215 (43%) reported perpetration of physical violence against students in the past week. Individual risk factors associated with physical violence perpetration included being a teacher versus another type of staff member (pviolence against non-students (pviolence (IPV) (pviolence perpetration compared with male staff who had not been a victim of IPV. No evidence was observed for school- or community-level risk factors. Physical violence perpetration from school staff is widespread, and interventions are needed to address this issue. Staff who have been victims of violence and who use violence against people other than students may benefit from additional interventions. Researchers should further investigate how school and community contexts influence staff's physical violence usage, given a lack of associations observed in this study. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Adolescents' utilisation of psychiatric care, neighbourhoods and neighbourhood socioeconomic deprivation: a multilevel analysis.

    Directory of Open Access Journals (Sweden)

    Anna-Karin Ivert

    Full Text Available Mental health problems among adolescents have become a major public health issue, and it is therefore important to increase knowledge on the contextual determinants of adolescent mental health. One such determinant is the socioeconomic structure of the neighbourhood. The present study has two central objectives, (i to examine if neighbourhood socioeconomic deprivation is associated to individual variations in utilisation of psychiatric care in a Swedish context, and (ii to investigate if neighbourhood boundaries are a valid construct for identifying contexts that influence individual variations in psychiatric care utilization. Data were obtained from the Longitudinal Multilevel Analysis in Scania (LOMAS database. The study population consists of all boys and girls aged 13-18 years (N=18,417, who were living in the city of Malmö, Sweden, in 2005. Multilevel logistic regression analysis was applied to estimate the probability of psychiatric care utilisation. The results from the study indicate that the neighbourhood of residence had little influence on psychiatric care utilisation. Although we initially found a variation between neighbourhoods, this general contextual effect was very small (i.e. 1.6%. The initial conclusive association between the neighbourhood level of disadvantage and psychiatric care utilisation (specific contextual effect disappeared following adjustment for individual and family level variables. Our results suggest the neighbourhoods in Malmö (at least measured in terms of SAMS-areas, do not provide accurate information for discriminating adolescents utilisation of psychiatric care. The SAMS-areas appears to be an inappropriate construct of the social environment that influences adolescent utilisation of psychiatric care. Therefore, public health interventions should be directed to the whole city rather than to specific neighbourhoods. However, since geographical, social or cultural contexts may be important for our

  6. Mathematical Methods in Survival Analysis, Reliability and Quality of Life

    CERN Document Server

    Huber, Catherine; Mesbah, Mounir

    2008-01-01

    Reliability and survival analysis are important applications of stochastic mathematics (probability, statistics and stochastic processes) that are usually covered separately in spite of the similarity of the involved mathematical theory. This title aims to redress this situation: it includes 21 chapters divided into four parts: Survival analysis, Reliability, Quality of life, and Related topics. Many of these chapters were presented at the European Seminar on Mathematical Methods for Survival Analysis, Reliability and Quality of Life in 2006.

  7. Power and type I error of local fit statistics in multilevel latent class analysis

    NARCIS (Netherlands)

    Nagelkerke, E.; Oberski, D.L.; Vermunt, J.K.

    2017-01-01

    In the social and behavioral sciences, variables are often categorical and people are often nested in groups. Models for such data, such as multilevel logistic regression or the multilevel latent class model, should account for not only the categorical nature of the variables, but also the nested

  8. Area-level poverty and preterm birth risk: A population-based multilevel analysis

    Science.gov (United States)

    DeFranco, Emily A; Lian, Min; Muglia, Louis A; Schootman, Mario

    2008-01-01

    Background Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate. Methods Population-based study utilizing Missouri's birth certificate database (1989–1997). We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990). Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty) was the reference group. Results PTB rate of PTB poverty and increased through the 4th quartile (4.9%), p poverty was significantly associated with PTB risk. PTB risk (poverty, adjusted odds ratio (adjOR) 1.18 (95% CI 1.03, 1.35), with a similar effect at earlier gestational ages (birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies. PMID:18793437

  9. Area-level poverty and preterm birth risk: A population-based multilevel analysis

    Directory of Open Access Journals (Sweden)

    Muglia Louis A

    2008-09-01

    Full Text Available Abstract Background Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate. Methods Population-based study utilizing Missouri's birth certificate database (1989–1997. We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990. Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty was the reference group. Results PTB th quartile (4.9%, p adjOR 1.18 (95% CI 1.03, 1.35, with a similar effect at earlier gestational ages (adjOR 1.27 (95% CI 1.06, 1.52. Conclusion Women residing in socioeconomically deprived areas are at increased risk of preterm birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies.

  10. Multi-level tree analysis of pulmonary artery/vein trees in non-contrast CT images

    Science.gov (United States)

    Gao, Zhiyun; Grout, Randall W.; Hoffman, Eric A.; Saha, Punam K.

    2012-02-01

    Diseases like pulmonary embolism and pulmonary hypertension are associated with vascular dystrophy. Identifying such pulmonary artery/vein (A/V) tree dystrophy in terms of quantitative measures via CT imaging significantly facilitates early detection of disease or a treatment monitoring process. A tree structure, consisting of nodes and connected arcs, linked to the volumetric representation allows multi-level geometric and volumetric analysis of A/V trees. Here, a new theory and method is presented to generate multi-level A/V tree representation of volumetric data and to compute quantitative measures of A/V tree geometry and topology at various tree hierarchies. The new method is primarily designed on arc skeleton computation followed by a tree construction based topologic and geometric analysis of the skeleton. The method starts with a volumetric A/V representation as input and generates its topologic and multi-level volumetric tree representations long with different multi-level morphometric measures. A new recursive merging and pruning algorithms are introduced to detect bad junctions and noisy branches often associated with digital geometric and topologic analysis. Also, a new notion of shortest axial path is introduced to improve the skeletal arc joining two junctions. The accuracy of the multi-level tree analysis algorithm has been evaluated using computer generated phantoms and pulmonary CT images of a pig vessel cast phantom while the reproducibility of method is evaluated using multi-user A/V separation of in vivo contrast-enhanced CT images of a pig lung at different respiratory volumes.

  11. Chronic Obstructive Pulmonary Disease in Sweden: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy

    Directory of Open Access Journals (Sweden)

    Sten Axelsson Fisk

    2018-04-01

    Full Text Available Socioeconomic, ethnic and gender disparities in Chronic Obstructive Pulmonary Disease (COPD risk are well established but no studies have applied multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA within an intersectional framework to study this outcome. We study individuals at the first level of analysis and combinations of multiple social and demographic categorizations (i.e., intersectional strata at the second level of analysis. Here we used MAIHDA to assess to what extent individual differences in the propensity of developing COPD are at the intersectional strata level. We also used MAIHDA to determine the degree of similarity in COPD incidence of individuals in the same intersectional stratum. This leads to an improved understanding of risk heterogeneity and of the social dynamics driving socioeconomic and demographic disparities in COPD incidence. Using data from 2,445,501 residents in Sweden aged 45–65, we constructed 96 intersectional strata combining categories of age, gender, income, education, civil- and migration status. The incidences of COPD ranged from 0.02% for young, native males with high income and high education who cohabited to 0.98% for older native females with low income and low education who lived alone. We calculated the intra-class correlation coefficient (ICC that informs on the discriminatory accuracy of the categorizations. In a model that conflated additive and interaction effects, the ICC was good (20.0%. In contrast, in a model that measured only interaction effects, the ICC was poor (1.1% suggesting that most of the observed differences in COPD incidence across strata are due to the main effects of the categories used to construct the intersectional matrix while only a minor share of the differences are attributable to intersectional interactions. We found conclusive interaction effects. The intersectional MAIHDA approach offers improved information to guide public health

  12. Factors affecting public prejudice and social distance on mental illness: analysis of contextual effect by multi-level analysis.

    Science.gov (United States)

    Jang, Hyeongap; Lim, Jun-Tae; Oh, Juhwan; Lee, Seon-Young; Kim, Yong-Ik; Lee, Jin-Seok

    2012-03-01

    While there have been many quantitative studies on the public's attitude towards mental illnesses, it is hard to find quantitative study which focused on the contextual effect on the public's attitude. The purpose of this study was to identify factors that affect the public's beliefs and attitudes including contextual effects. We analyzed survey on the public's beliefs and attitudes towards mental illness in Korea with multi-level analysis. We analyzed the public's beliefs and attitudes in terms of prejudice as an intermediate outcome and social distance as a final outcome. Then, we focused on the associations of factors, which were individual and regional socio-economic factors, familiarity, and knowledge based on the comparison of the intermediate and final outcomes. Prejudice was not explained by regional variables but was only correlated with individual factors. Prejudice increased with age and decreased by high education level. However, social distance controlling for prejudice increased in females, in people with a high education level, and in regions with a high education level and a high proportion of the old. Therefore, social distance without controlling for prejudice increased in females, in the elderly, in highly educated people, and in regions with a high education and aged community. The result of the multi-level analysis for the regional variables suggests that social distance for mental illness are not only determined by individual factors but also influenced by the surroundings so that it could be tackled sufficiently with appropriate considering of the relevant regional context with individual characteristics.

  13. Explaining ethnic polarization over attitudes towards minority rights in Eastern Europe : a multilevel analysis

    NARCIS (Netherlands)

    Evans, Geoffrey; Need, Ariana

    2002-01-01

    This paper examines divisions between majority and minority ethnic groups over attitudes towards minority rights in 13 East European societies. Using national sample surveys and multilevel models, we test the effectiveness of competing explanations of ethnic polarization in attitudes towards

  14. CASAS: Cancer Survival Analysis Suite, a web based application.

    Science.gov (United States)

    Rupji, Manali; Zhang, Xinyan; Kowalski, Jeanne

    2017-01-01

    We present CASAS, a shiny R based tool for interactive survival analysis and visualization of results. The tool provides a web-based one stop shop to perform the following types of survival analysis:  quantile, landmark and competing risks, in addition to standard survival analysis.  The interface makes it easy to perform such survival analyses and obtain results using the interactive Kaplan-Meier and cumulative incidence plots.  Univariate analysis can be performed on one or several user specified variable(s) simultaneously, the results of which are displayed in a single table that includes log rank p-values and hazard ratios along with their significance. For several quantile survival analyses from multiple cancer types, a single summary grid is constructed. The CASAS package has been implemented in R and is available via http://shinygispa.winship.emory.edu/CASAS/. The developmental repository is available at https://github.com/manalirupji/CASAS/.

  15. Prevalence and correlates of hypertension in Maharashtra, India: A multilevel analysis.

    Directory of Open Access Journals (Sweden)

    Mahadev D Bhise

    Full Text Available In the last few decades, the prevalence of hypertension has been drastically increased in India. The present study estimates the current prevalence of hypertension and its correlates in the state of Maharashtra. The variation in the prevalence of hypertension associated with individual-level characteristics is explained at the community and district level.Data is used from the recent round of District Level Household & Facility Survey (DLHS-4, 2012-13. The DLHS-4 has used the nationally representative sample, collected through multistage stratified sampling procedure. A similar sampling frame, used in NSSO-2007-08, has been followed. The chi-square test is used to show the significance level of the association between the estimated prevalence of hypertension and its correlates. Multilevel regression analysis is carried out to investigate the effects of individual and community level factors on the prevalence of hypertension.The overall prevalence of hypertension is 25% in Maharashtra, and a huge variation in the prevalence of hypertension is found across the districts. Dhule, Gadchiroli (with a low HDI rank, Mumbai and Satara (with higher HDI rank are the districts with the higher (above 30% prevalence of high blood pressure. The prevalence also significantly varies according to different correlates. The prevalence of high blood pressure is higher among elderly population (40%, among males (28%, in the urban areas (27% and in the richest wealth quintile (28%. The prevalence is also higher among cigarette smokers (31%, alcohol consumers (30% and people with obesity (38% as compared to their counterparts. The results of the multilevel analysis show that the older and obese persons are at four-time higher risk of hypertension. Again, age, sex, marital status, place of residence, wealth status, unhealthy habits (i.e. smoking and alcohol consumption and BMI are significantly associated with hypertension. The results of VPC statistics show that 14% of

  16. Area-Level and Individual-Level Factors for Teenage Motherhood: A Multilevel Analysis in Japan.

    Science.gov (United States)

    Baba, Sachiko; Iso, Hiroyasu; Fujiwara, Takeo

    2016-01-01

    Teenage motherhood is strongly associated with a range of disadvantages for both the mother and the child. No epidemiological studies have examined related factors for teenage motherhood at both area and individual levels among Japanese women. Therefore, we performed a multilevel analysis of nationwide data in Japan to explore the association of area- and individual-level factors with teenage motherhood. The study population comprised 21,177 mothers living in 47 prefectures who had their first, singleton baby between 10 and 17 January or between 10 and 17 July, 2001. Information on the prefecture in which the mothers resided was linked to prefecture-level variables. Primary outcomes were area-level characteristics (single-mother households, three-generation households, college enrollment, abortions, juvenile crime, and per capita income) and individual-level characteristics, and divided into tertiles or quintiles based on their variable distributions. Multilevel logistic regression analysis was then performed. There were 440 teenage mothers (2.1%) in this study. In addition to individual low level of education [adjusted odds ratio (OR), 7.40; 95% confidence interval (CI), 5.59-9.78], low income [4.23 (2.95-6.08)], and smoking [1.65 (1.31-2.07)], high proportions of single-mother households [1.72 (1.05-2.80)] and three-generation household [1.81 (1.17-2.78)], and per capita income [2.19 (1.06-3.81)] at an area level were positively associated, and high level of college enrollment [0.46 (0.25-0.83)] and lower crime rate [0.62 (0.40-0.98)] at area level were inversely associated with teenage motherhood compared with the corresponding women living in prefectures with the lowest levels of these variables. Our findings suggest that encouraging the completion of higher education and reducing the number of single-mother household at an area level may be important public health strategies to reduce teenage motherhood.

  17. The influence of regional deprivation index on personal happiness using multilevel analysis

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    Kil Hun Kim

    2015-04-01

    Full Text Available OBJECTIVES: The objective of the present study was to identify the factors that influence the happiness index of community residents, by considering personal and regional aspects, and to use as evidence of efforts for improvement of the happiness index. METHODS: The study was conducted based on information from 16,270 participants who met the data requirement among those who participated in the 2011 South Gyeongsang Community Health Survey. Of the factors that can influence the happiness index, socioeconomic characteristics, health behavior, morbidity, and healthcare use, social contact, and participation in social activities were classified as personal factors; for regional factors, data from the 2010 census were used to extrapolate the regional deprivation indices at the submunicipal-level (eup, myeon, and dong in South Gyeongsang Province. The happiness index for each characteristic was compared to that for others via t-test and ANOVA, and multilevel analysis was performed, using four models: a basic model for identification of only random effects, model 1 for identification of personal factors, model 2 for identification of regional factors, and model 3 for simultaneous consideration of both personal and regional factors. RESULTS: The mean happiness index was 63.2 points (64.6 points in males and 62.0 points in females, while the mean deprivation index was -1.58 points. In the multilevel analysis, the regional-level variance ratio of the basic model was 10.8%, confirming interregional differences. At the personal level, higher happiness indices were seen in groups consisting of males with high educational level, high income, high degree of physical activity, sufficient sleep, active social contact, and participation in social activities; whereas lower happiness indices were seen in people who frequently skipped breakfast, had unmet healthcare needs, and had accompanying diseases, as well as those with higher deprivation index. CONCLUSIONS

  18. The influence of regional deprivation index on personal happiness using multilevel analysis.

    Science.gov (United States)

    Kim, Kil Hun; Chun, Jin-Ho; Sohn, Hae Sook

    2015-01-01

    The objective of the present study was to identify the factors that influence the happiness index of community residents, by considering personal and regional aspects, and to use as evidence of efforts for improvement of the happiness index. The study was conducted based on information from 16,270 participants who met the data requirement among those who participated in the 2011 South Gyeongsang Community Health Survey. Of the factors that can influence the happiness index, socioeconomic characteristics, health behavior, morbidity, and healthcare use, social contact, and participation in social activities were classified as personal factors; for regional factors, data from the 2010 census were used to extrapolate the regional deprivation indices at the submunicipal-level (eup, myeon, and dong) in South Gyeongsang Province. The happiness index for each characteristic was compared to that for others via t-test and ANOVA, and multilevel analysis was performed, using four models: a basic model for identification of only random effects, model 1 for identification of personal factors, model 2 for identification of regional factors, and model 3 for simultaneous consideration of both personal and regional factors. The mean happiness index was 63.2 points (64.6 points in males and 62.0 points in females), while the mean deprivation index was -1.58 points. In the multilevel analysis, the regional-level variance ratio of the basic model was 10.8%, confirming interregional differences. At the personal level, higher happiness indices were seen in groups consisting of males with high educational level, high income, high degree of physical activity, sufficient sleep, active social contact, and participation in social activities; whereas lower happiness indices were seen in people who frequently skipped breakfast, had unmet healthcare needs, and had accompanying diseases, as well as those with higher deprivation index. The study confirmed that the happiness index of community

  19. Social phenotype extended to communities: expanded multilevel social selection analysis reveals fitness consequences of interspecific interactions.

    Science.gov (United States)

    Campobello, Daniela; Hare, James F; Sarà, Maurizio

    2015-04-01

    In social species, fitness consequences are associated with both individual and social phenotypes. Social selection analysis has quantified the contribution of conspecific social traits to individual fitness. There has been no attempt, however, to apply a social selection approach to quantify the fitness implications of heterospecific social phenotypes. Here, we propose a novel social selection based approach integrating the role of all social interactions at the community level. We extended multilevel selection analysis by including a term accounting for the group phenotype of heterospecifics. We analyzed nest activity as a model social trait common to two species, the lesser kestrel (Falco naumanni) and jackdaw (Corvus monedula), nesting in either single- or mixed-species colonies. By recording reproductive outcome as a measure of relative fitness, our results reveal an asymmetric system wherein only jackdaw breeding performance was affected by the activity phenotypes of both conspecific and heterospecific neighbors. Our model incorporating heterospecific social phenotypes is applicable to animal communities where interacting species share a common social trait, thus allowing an assessment of the selection pressure imposed by interspecific interactions in nature. Finally, we discuss the potential role of ecological limitations accounting for random or preferential assortments among interspecific social phenotypes, and the implications of such processes to community evolution. © 2015 The Author(s).

  20. Multilevel Models for the Analysis of Angle-Specific Torque Curves with Application to Master Athletes

    Directory of Open Access Journals (Sweden)

    Carvalho Humberto M.

    2015-12-01

    Full Text Available The aim of this paper was to outline a multilevel modeling approach to fit individual angle-specific torque curves describing concentric knee extension and flexion isokinetic muscular actions in Master athletes. The potential of the analytical approach to examine between individual differences across the angle-specific torque curves was illustrated including between-individuals variation due to gender differences at a higher level. Torques in concentric muscular actions of knee extension and knee extension at 60°·s-1 were considered within a range of motion between 5°and 85° (only torques “truly” isokinetic. Multilevel time series models with autoregressive covariance structures with standard multilevel models were superior fits compared with standard multilevel models for repeated measures to fit anglespecific torque curves. Third and fourth order polynomial models were the best fits to describe angle-specific torque curves of isokinetic knee flexion and extension concentric actions, respectively. The fixed exponents allow interpretations for initial acceleration, the angle at peak torque and the decrement of torque after peak torque. Also, the multilevel models were flexible to illustrate the influence of gender differences on the shape of torque throughout the range of motion and in the shape of the curves. The presented multilevel regression models may afford a general framework to examine angle-specific moment curves by isokinetic dynamometry, and add to the understanding mechanisms of strength development, particularly the force-length relationship, both related to performance and injury prevention.

  1. Fast food purchasing and access to fast food restaurants: a multilevel analysis of VicLANES

    Science.gov (United States)

    Thornton, Lukar E; Bentley, Rebecca J; Kavanagh, Anne M

    2009-01-01

    Background While previous research on fast food access and purchasing has not found evidence of an association, these studies have had methodological problems including aggregation error, lack of specificity between the exposures and outcomes, and lack of adjustment for potential confounding. In this paper we attempt to address these methodological problems using data from the Victorian Lifestyle and Neighbourhood Environments Study (VicLANES) – a cross-sectional multilevel study conducted within metropolitan Melbourne, Australia in 2003. Methods The VicLANES data used in this analysis included 2547 participants from 49 census collector districts in metropolitan Melbourne, Australia. The outcome of interest was the total frequency of fast food purchased for consumption at home within the previous month (never, monthly and weekly) from five major fast food chains (Red Rooster, McDonalds, Kentucky Fried Chicken, Hungry Jacks and Pizza Hut). Three measures of fast food access were created: density and variety, defined as the number of fast food restaurants and the number of different fast food chains within 3 kilometres of road network distance respectively, and proximity defined as the road network distance to the closest fast food restaurant. Multilevel multinomial models were used to estimate the associations between fast food restaurant access and purchasing with never purchased as the reference category. Models were adjusted for confounders including determinants of demand (attitudes and tastes that influence food purchasing decisions) as well as individual and area socio-economic characteristics. Results Purchasing fast food on a monthly basis was related to the variety of fast food restaurants (odds ratio 1.13; 95% confidence interval 1.02 – 1.25) after adjusting for individual and area characteristics. Density and proximity were not found to be significant predictors of fast food purchasing after adjustment for individual socio-economic predictors

  2. Fast food purchasing and access to fast food restaurants: a multilevel analysis of VicLANES.

    Science.gov (United States)

    Thornton, Lukar E; Bentley, Rebecca J; Kavanagh, Anne M

    2009-05-27

    While previous research on fast food access and purchasing has not found evidence of an association, these studies have had methodological problems including aggregation error, lack of specificity between the exposures and outcomes, and lack of adjustment for potential confounding. In this paper we attempt to address these methodological problems using data from the Victorian Lifestyle and Neighbourhood Environments Study (VicLANES) - a cross-sectional multilevel study conducted within metropolitan Melbourne, Australia in 2003. The VicLANES data used in this analysis included 2547 participants from 49 census collector districts in metropolitan Melbourne, Australia. The outcome of interest was the total frequency of fast food purchased for consumption at home within the previous month (never, monthly and weekly) from five major fast food chains (Red Rooster, McDonalds, Kentucky Fried Chicken, Hungry Jacks and Pizza Hut). Three measures of fast food access were created: density and variety, defined as the number of fast food restaurants and the number of different fast food chains within 3 kilometres of road network distance respectively, and proximity defined as the road network distance to the closest fast food restaurant.Multilevel multinomial models were used to estimate the associations between fast food restaurant access and purchasing with never purchased as the reference category. Models were adjusted for confounders including determinants of demand (attitudes and tastes that influence food purchasing decisions) as well as individual and area socio-economic characteristics. Purchasing fast food on a monthly basis was related to the variety of fast food restaurants (odds ratio 1.13; 95% confidence interval 1.02 - 1.25) after adjusting for individual and area characteristics. Density and proximity were not found to be significant predictors of fast food purchasing after adjustment for individual socio-economic predictors. Although we found an independent

  3. Fast food purchasing and access to fast food restaurants: a multilevel analysis of VicLANES

    Directory of Open Access Journals (Sweden)

    Kavanagh Anne M

    2009-05-01

    Full Text Available Abstract Background While previous research on fast food access and purchasing has not found evidence of an association, these studies have had methodological problems including aggregation error, lack of specificity between the exposures and outcomes, and lack of adjustment for potential confounding. In this paper we attempt to address these methodological problems using data from the Victorian Lifestyle and Neighbourhood Environments Study (VicLANES – a cross-sectional multilevel study conducted within metropolitan Melbourne, Australia in 2003. Methods The VicLANES data used in this analysis included 2547 participants from 49 census collector districts in metropolitan Melbourne, Australia. The outcome of interest was the total frequency of fast food purchased for consumption at home within the previous month (never, monthly and weekly from five major fast food chains (Red Rooster, McDonalds, Kentucky Fried Chicken, Hungry Jacks and Pizza Hut. Three measures of fast food access were created: density and variety, defined as the number of fast food restaurants and the number of different fast food chains within 3 kilometres of road network distance respectively, and proximity defined as the road network distance to the closest fast food restaurant. Multilevel multinomial models were used to estimate the associations between fast food restaurant access and purchasing with never purchased as the reference category. Models were adjusted for confounders including determinants of demand (attitudes and tastes that influence food purchasing decisions as well as individual and area socio-economic characteristics. Results Purchasing fast food on a monthly basis was related to the variety of fast food restaurants (odds ratio 1.13; 95% confidence interval 1.02 – 1.25 after adjusting for individual and area characteristics. Density and proximity were not found to be significant predictors of fast food purchasing after adjustment for individual socio

  4. Multilevel models applications using SAS

    CERN Document Server

    Wang, Jichuan; Fisher, James F

    2011-01-01

    This book covers a broad range of topics about multilevel modeling. The goal is to help readers to understand the basic concepts, theoretical frameworks, and application methods of multilevel modeling. It is at a level also accessible to non-mathematicians, focusing on the methods and applications of various multilevel models and using the widely used statistical software SAS®. Examples are drawn from analysis of real-world research data.

  5. A multilevel path analysis of contact frequency between social network members

    Science.gov (United States)

    van den Berg, Pauline; Arentze, Theo; Timmermans, Harry

    2012-04-01

    Recently, there has been an increasing interest in the role of social networks in spatial-choice and travel behavior. It has been acknowledged that social activities and the travel for these activities can emerge from individuals' social networks and that social activities are responsible for an important portion of travel demand. The influence of information and communication technologies (ICT's) is also important in this respect. The purpose of the paper is to examine the effects of characteristics of egos and ego-alter relationships on the frequency of social interaction by different communication modes, using multilevel path analysis. The analyses are based on social network data collected in 2008 in the Eindhoven region in the Netherlands among 116 respondents. The results indicate a complementary relationship between contact frequencies by different modes. The contact frequencies of the different modes, especially face-to-face and telephone, can also be largely explained by the ego's personal characteristics and the type of relationship and the distance between ego and alter.

  6. A systematic fault tree analysis based on multi-level flow modeling

    International Nuclear Information System (INIS)

    Gofuku, Akio; Ohara, Ai

    2010-01-01

    The fault tree analysis (FTA) is widely applied for the safety evaluation of a large-scale and mission-critical system. Because the potential of the FTA, however, strongly depends on human skill of analyzers, problems are pointed out in (1) education and training, (2) unreliable quality, (3) necessity of expertise knowledge, and (4) update of FTA results after the reconstruction of a target system. To get rid of these problems, many techniques to systematize FTA activities by applying computer technologies have been proposed. However, these techniques only use structural information of a target system and do not use functional information that is one of important properties of an artifact. The principle of FTA is to trace comprehensively cause-effect relations from a top undesirable effect to anomaly causes. The tracing is similar to the causality estimation technique that the authors proposed to find plausible counter actions to prevent or to mitigate the undesirable behavior of plants based on the model by a functional modeling technique, Multilevel Flow Modeling (MFM). The authors have extended this systematic technique to construct a fault tree (FT). This paper presents an algorithm of systematic construction of FT based on MFM models and demonstrates the applicability of the extended technique by the FT construction result of a cooling plant of nitric acid. (author)

  7. Treatment Effect on Recidivism for Juveniles Who Have Sexually Offended: a Multilevel Meta-Analysis.

    Science.gov (United States)

    Ter Beek, Ellis; Spruit, Anouk; Kuiper, Chris H Z; van der Rijken, Rachel E A; Hendriks, Jan; Stams, Geert Jan J M

    2018-04-01

    The current study investigated the effect on recidivism of treatment aimed at juveniles who have sexually offended. It also assessed the potential moderating effect of type of recidivism, and several treatment, participant and study characteristics. In total, 14 published and unpublished primary studies, making use of a comparison group and reporting on official recidivism rates, were included in a multilevel meta-analysis. This resulted in the use of 77 effect sizes, and 1726 participants. A three-level meta-analytic model was used to calculate the combined effect sizes (Cohens d) and to perform moderator analyses. Study quality was assessed with the EPHPP Quality Assessment Tool for Quantitative Studies. A moderate effect size was found (d = 0.37), indicating that the treatment groups achieved an estimated relative reduction in recidivism of 20.5% as compared to comparison groups. However, after controlling for publication bias, a significant treatment effect was no longer found. Type of recidivism did not moderate the effect of treatment, indicating that treatment groups were equally effective for all types of recidivism. Also, no moderating effects of participant or treatment characteristics were found. Regarding study characteristics, a shorter follow up time showed a trend for larger effect sizes, and the effect size calculation based on proportions yielded larger effect sizes than calculation via mean frequency of offending. Implications for future research and clinical practice are discussed.

  8. Drinking Water in Transition: A Multilevel Cross-sectional Analysis of Sachet Water Consumption in Accra.

    Science.gov (United States)

    Stoler, Justin; Weeks, John R; Appiah Otoo, Richard

    2013-01-01

    Rapid population growth in developing cities often outpaces improvements to drinking water supplies, and sub-Saharan Africa as a region has the highest percentage of urban population without piped water access, a figure that continues to grow. Accra, Ghana, implements a rationing system to distribute limited piped water resources within the city, and privately-vended sachet water-sealed single-use plastic sleeves-has filled an important gap in urban drinking water security. This study utilizes household survey data from 2,814 Ghanaian women to analyze the sociodemographic characteristics of those who resort to sachet water as their primary drinking water source. In multilevel analysis, sachet use is statistically significantly associated with lower overall self-reported health, younger age, and living in a lower-class enumeration area. Sachet use is marginally associated with more days of neighborhood water rationing, and significantly associated with the proportion of vegetated land cover. Cross-level interactions between rationing and proxies for poverty are not associated with sachet consumption after adjusting for individual-level sociodemographic, socioeconomic, health, and environmental factors. These findings are generally consistent with two other recent analyses of sachet water in Accra and may indicate a recent transition of sachet consumption from higher to lower socioeconomic classes. Overall, the allure of sachet water displays substantial heterogeneity in Accra and will be an important consideration in planning for future drinking water demand throughout West Africa.

  9. How school climate relates to chronic absence: A multi-level latent profile analysis.

    Science.gov (United States)

    Van Eck, Kathryn; Johnson, Stacy R; Bettencourt, Amie; Johnson, Sarah Lindstrom

    2017-04-01

    Chronic absence is a significant problem in schools. School climate may play an important role in influencing chronic absence rates among schools, yet little research has evaluated how school climate constructs relate to chronic absence. Using multilevel latent profile analysis, we evaluated how profiles of student perceptions of school climate at both the student and school level differentiated school-level rates of chronic absence. Participants included 25,776 middle and high school students from 106 schools who completed a district administered school climate survey. Students attended schools in a large urban school district where 89% of 6th through 12th grade students were African-American and 61% were eligible for the federally subsidized school meals program. Three student-level profiles of perceptions of school climate emerged that corresponded to "positive," "moderate," and "negative" climate. Two predominant patterns regarding the distribution of these profiles within schools emerged that corresponded to the two school-level profiles of "marginal climate" and "climate challenged" schools. Students reporting "moderate" and "negative" climate in their schools were more likely to attend schools with higher chronic absence rates than students reporting that their school had "positive" climate. Likewise, "climate challenged" schools had significantly higher chronic absence rates than "marginal climate" schools. These results suggest that school climate shares an important relation with chronic absence among adolescent students attending urban schools. Implications for prevention and intervention programs are discussed. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  10. A multilevel analysis of individual and community effect on chronic childhood malnutrition in rural Nigeria.

    Science.gov (United States)

    Uthman, Olalekan A

    2009-04-01

    Protein energy malnutrition is the second most important cause of childhood morbidity and mortality in Nigeria after infections. The purpose of this article was to develop and test a model of childhood malnutrition that includes individual-level characteristics along with contextual characteristics defined at the community level. Multilevel logistic regression analysis. A total of 4007 children resident in 96 rural villages in Nigeria. Stunting: height-for-age that is less than the international reference value by >2 standard deviations (SDs). Independent of other factors, children born to underweight mothers were 1.32-times more likely to be stunted [adjusted odds ratio (aOR) 1.32; 95% confidence interval (CI) 1.07-1.64]. For each additional month of breastfeeding the odds of being stunted increased by 4% (aOR 1.04; 95% CI 1.03-1.06). Each SD increase in the household wealth index and maternal health-seeking behaviour index decreased the odds of being stunted by 16% (aOR 0.84; 95% CI 0.76-0.94) and 29% (aOR 0.71; 95% CI 0.60 -0.82), respectively. The study has provided evidence that both individual and community characteristics are important predictors of childhood malnutrition in rural Nigeria; and that scholars trying to understand variation in childhood malnutrition should pay attention to the characteristics of both children and place of residence.

  11. Childhood Vitamin A Capsule Supplementation Coverage in Nigeria: A Multilevel Analysis of Geographic and Socioeconomic Inequities

    Directory of Open Access Journals (Sweden)

    Olatunde Aremu

    2010-01-01

    Full Text Available Vitamin A deficiency (VAD is a huge public health burden among preschool-aged children in sub-Saharan Africa, and is associated with a high level of susceptibility to infectious diseases and pediatric blindness. We examined the Nigerian national vitamin A capsule (VAC supplementation program, a short-term cost-effective intervention for prevention of VAD-associated morbidity for equity in terms of socioeconomic and geographic coverage. Using the most current, nationally representative data from the 2008 Nigerian Demographic and Health Survey, we applied multilevel regression analysis on 19,555 children nested within 888 communities across the six regions of Nigeria. The results indicate that there was variability in uptake of VAC supplement among the children, which could be attributed to several characteristics at individual, household, and community levels. Individual-level characteristics, such as maternal occupation, were shown to be associated with receipt of VAC supplement. The results also reveal that household wealth status is the only household-level characteristic that is significantly associated with receipt of VAC, while neighborhood socioeconomic disadvantage and geographic location were the community-level characteristics that determined receipt of VAC. The findings from this study have shown that both individual and contextual socioeconomic status, together with geographic location, is important for uptake of VAC. These findings underscore the need to accord the VAC supplementation program the much needed priority with focus on characteristics of neighborhoods (communities, in addition to individual-level characteristics.

  12. Drinking Water in Transition: A Multilevel Cross-sectional Analysis of Sachet Water Consumption in Accra.

    Directory of Open Access Journals (Sweden)

    Justin Stoler

    Full Text Available Rapid population growth in developing cities often outpaces improvements to drinking water supplies, and sub-Saharan Africa as a region has the highest percentage of urban population without piped water access, a figure that continues to grow. Accra, Ghana, implements a rationing system to distribute limited piped water resources within the city, and privately-vended sachet water-sealed single-use plastic sleeves-has filled an important gap in urban drinking water security. This study utilizes household survey data from 2,814 Ghanaian women to analyze the sociodemographic characteristics of those who resort to sachet water as their primary drinking water source. In multilevel analysis, sachet use is statistically significantly associated with lower overall self-reported health, younger age, and living in a lower-class enumeration area. Sachet use is marginally associated with more days of neighborhood water rationing, and significantly associated with the proportion of vegetated land cover. Cross-level interactions between rationing and proxies for poverty are not associated with sachet consumption after adjusting for individual-level sociodemographic, socioeconomic, health, and environmental factors. These findings are generally consistent with two other recent analyses of sachet water in Accra and may indicate a recent transition of sachet consumption from higher to lower socioeconomic classes. Overall, the allure of sachet water displays substantial heterogeneity in Accra and will be an important consideration in planning for future drinking water demand throughout West Africa.

  13. Toward a Theory of Industrial Supply Networks: A Multi-Level Perspective via Network Analysis

    Directory of Open Access Journals (Sweden)

    Yi Zuo

    2017-07-01

    Full Text Available In most supply chains (SCs, transaction relationships between suppliers and customers are commonly considered to be an extrapolation from a linear perspective. However, this traditional linear concept of an SC is egotistic and oversimplified and does not sufficiently reflect the complex and cyclical structure of supplier-customer relationships in current economic and industrial situations. The interactional relationships and topological characteristics between suppliers and customers should be analyzed using supply networks (SNs rather than traditional linear SCs. Therefore, this paper reconceptualizes SCs as SNs in complex adaptive systems (CAS, and presents three main contributions. First, we propose an integrated framework of CAS network by synthesizing multi-level network analysis from the network-, community- and vertex-perspective. The CAS perspective enables us to understand the advances of SN properties. Second, in order to emphasize the CAS properties of SNs, we conducted a real-world SN based on the Japanese industry and describe an advanced investigation of SN theory. The CAS properties help in enriching the SN theory, which can benefit SN management, community economics and industrial resilience. Third, we propose a quantitative metric of entropy to measure the complexity and robustness of SNs. The results not only support a specific understanding of the structural outcomes relevant to SNs, but also deliver efficient and effective support to the management and design of SNs.

  14. Prevalence of cardiovascular risk factors among Latin American adolescents: a multilevel analysis.

    Science.gov (United States)

    de Moraes, A C F; Musso, C; Graffigna, M N; Soutelo, J; Migliano, M; Carvalho, H B; Berg, G

    2014-03-01

    High blood pressure (HBP) and obesity is a well-established major risk factor for stroke and coronary heart disease. However, the literatures are scarce about these informations in adolescents from low-and-middle income countries. This school-based survey was carried out among students from Maringá (Brazil) and Buenos Aires (Argentina) selected random sampling. We studied 991 Brazilian adolescents (54.5% girls) in the age range of 14-18 years. In Argentina, we studied 933 adolescents (45.9% female) in the age range of 11-17 years. The outcomes of this study are general obesity, abdominal obesity and HBP. The associated factors analysed were gender, age and health behaviours. The prevalence of obesity was 5.8% in Brazil and 2.8% in Argentina, the prevalence of abdominal obesity was 32.7% in Brazil and 11.1% in Argentina, the prevalence of HBP was 14.9% in Brazil and 13.5% in Argentina. The multilevel analysis showed that older adolescents (>14 years old) have a little likelihood of being overweight, whereas male adolescents are more likely to be obese and have HBP. The abdominal obesity in both indicators were not associated with the independent variables. The prevalence of cardiovascular risk factors is high in Latin American adolescents independent of each country, and was associated with male gender.

  15. Athletes' perceptions of role ambiguity and coaching competency in sport teams: a multilevel analysis.

    Science.gov (United States)

    Bosselut, Grégoire; Heuzé, Jean-Philippe; Eys, Mark A; Fontayne, Paul; Sarrazin, Philippe

    2012-06-01

    The purpose of this study was to examine the relationship between athletes' perceptions of role ambiguity and two theoretically derived dimensions of coaching competency (i.e., game strategy and technique competencies). A total of 243 players from 26 teams representing various interdependent sports completed French versions of the Role Ambiguity Scale and the Coaching Competency Scale. Multilevel analyses supported the existence of relationships between the four dimensions of role ambiguity and the two dimensions of coaching competency at both individual and team levels. When the levels were considered jointly, athletes perceiving greater ambiguity in their role in both offensive and defensive contexts were more critical of their coach's capacities to lead their team during competitions and to diagnose or formulate instructions during training sessions. The results also indicated that the dimension of scope of responsibilities was the main contributor to the relationship with coaching competency at an individual level, whereas role evaluation was the main contributor to this relationship at a group level. Findings are discussed in relation to the role episode model, the role ambiguity dimensions involved in the relationships according to the level of analysis considered, and the salience of ambiguity perceptions in the offensive context.

  16. Athletes' perceptions of coaching competency and team conflict in sport teams: A multilevel analysis.

    Science.gov (United States)

    González-Ponce, I; Leo, F M; Jiménez, R; Sánchez-Oliva, D; Sarmento, H; Figueiredo, A; García-Calvo, T

    2018-04-23

    The purpose of this study was to examine the relationship between coaching competency and team conflict, at individual and team levels, over the season. The participants were professional female and male soccer players, who participated in the First and Second Division. A longitudinal study was performed. At Time 1, the sample of participants consisted of 581 soccer players aged between 15 and 39 years. At Time 2, 549 players were recruited from the original sample aged between 15 and 37 years. Finally, at Time 3, the sample comprised 576 players aged between 15 and 37 years. All participants completed a multi-section questionnaire assessing coaching competency (motivation, game strategy, technique competency, and character-building competency) and team conflict (task conflict and relationship conflict). Results showed that both task and relationship conflict increased significantly over time. Multilevel modelling analysis showed that game strategy and character-building competencies negatively predicted both task and relationship conflicts at the individual level, whereas motivation competency was also added as a significant predictor of task conflict at the team level. Moreover, technique competency positively predicted task conflict at the team level. The current study suggests the importance of coaching competency in group dynamics in sport.

  17. Covariate analysis of bivariate survival data

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, L.E.

    1992-01-01

    The methods developed are used to analyze the effects of covariates on bivariate survival data when censoring and ties are present. The proposed method provides models for bivariate survival data that include differential covariate effects and censored observations. The proposed models are based on an extension of the univariate Buckley-James estimators which replace censored data points by their expected values, conditional on the censoring time and the covariates. For the bivariate situation, it is necessary to determine the expectation of the failure times for one component conditional on the failure or censoring time of the other component. Two different methods have been developed to estimate these expectations. In the semiparametric approach these expectations are determined from a modification of Burke's estimate of the bivariate empirical survival function. In the parametric approach censored data points are also replaced by their conditional expected values where the expected values are determined from a specified parametric distribution. The model estimation will be based on the revised data set, comprised of uncensored components and expected values for the censored components. The variance-covariance matrix for the estimated covariate parameters has also been derived for both the semiparametric and parametric methods. Data from the Demographic and Health Survey was analyzed by these methods. The two outcome variables are post-partum amenorrhea and breastfeeding; education and parity were used as the covariates. Both the covariate parameter estimates and the variance-covariance estimates for the semiparametric and parametric models will be compared. In addition, a multivariate test statistic was used in the semiparametric model to examine contrasts. The significance of the statistic was determined from a bootstrap distribution of the test statistic.

  18. Risk Factors for Child Malnutrition in Bangladesh: A Multilevel Analysis of a Nationwide Population-Based Survey.

    Science.gov (United States)

    Chowdhury, Mohammad Rocky Khan; Rahman, Mohammad Shafiur; Khan, Mohammad Mubarak Hossain; Mondal, Mohammad Nazrul Islam; Rahman, Mohammad Mosiur; Billah, Baki

    2016-05-01

    To identify the prevalence and risk factors of child malnutrition in Bangladesh. Data was extracted from the Bangladesh Demographic Health Survey (2011). The outcome measures were stunting, wasting, and underweight. χ(2) analysis was performed to find the association of outcome variables with selected factors. Multilevel logistic regression models with a random intercept at each of the household and community levels were used to identify the risk factors of stunting, wasting, and underweight. From the 2011 survey, 7568 children less than 5 years of age were included in the current analysis. The overall prevalence of stunting, wasting, and underweight was 41.3% (95% CI 39.0-42.9). The χ(2) test and multilevel logistic regression analysis showed that the variables age, sex, mother's body mass index, mother's educational status, father's educational status, place of residence, socioeconomic status, community status, religion, region of residence, and food security are significant factors of child malnutrition. Children with poor socioeconomic and community status were at higher risk of malnutrition. Children from food insecure families were more likely to be malnourished. Significant community- and household-level variations were found. The prevalence of child malnutrition is still high in Bangladesh, and the risk was assessed at several multilevel factors. Therefore, prevention of malnutrition should be given top priority as a major public health intervention. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Distribution and Determinants of 90-Day Payments for Multilevel Posterior Lumbar Fusion: A Medicare Analysis.

    Science.gov (United States)

    Jain, Nikhil; Phillips, Frank M; Khan, Safdar N

    2018-04-01

    A retrospective, economic analysis. The objective of this article is to analyze the distribution of 90-day payments, sources of variation, and reimbursement for complications and readmissions for primary ≥3-level posterior lumbar fusion (PLF) from Medicare data. A secondary objective was to identify risk factors for complications. Bundled payments represent a single payment system to cover all costs associated with a single episode of care, typically over 90 days. The dollar amount spent on different health service providers and the variation in payments for ≥3-level PLF have not been analyzed from a bundled perspective. Administrative claims data were used to study 90-day Medicare (2005-2012) reimbursements for primary ≥3-level PLF for deformity and degenerative conditions of the lumbar spine. Distribution of payments, sources of variation, and reimbursements for managing complications were studied using linear regression models. Risk factors for complications were studied by stepwise multiple-variable logistic regression analysis. Hospital payments comprised 73.8% share of total 90-day payment. Adjusted analysis identified several factors for variation in index hospital payments. The average 90-day Medicare payment for all multilevel PLFs without complications was $35,878 per patient. The additional average cost of treating complications with/without revision surgery within 90 days period ranged from $17,284 to $68,963. A 90-day bundle for ≥3-level PLF with readmission ranges from $88,648 (3 levels) to $117,215 (8+ levels). Rates and risk factors for complications were also identified. The average 90-day payment per patient from Medicare was $35,878 with several factors such as levels of surgery, comorbidities, and development of complications influencing the cost. The study also identifies the risks and costs associated with complications and readmissions and emphasize the significant effect these would have on bundled payments (additional burden of up

  20. Economic and Sociological Correlates of Suicides: Multilevel Analysis of the Time Series Data in the United Kingdom.

    Science.gov (United States)

    Sun, Bruce Qiang; Zhang, Jie

    2016-03-01

    For the effects of social integration on suicides, there have been different and even contradictive conclusions. In this study, the selected economic and social risks of suicide for different age groups and genders in the United Kingdom were identified and the effects were estimated by the multilevel time series analyses. To our knowledge, there exist no previous studies that estimated a dynamic model of suicides on the time series data together with multilevel analysis and autoregressive distributed lags. The investigation indicated that unemployment rate, inflation rate, and divorce rate are all significantly and positively related to the national suicide rates in the United Kingdom from 1981 to 2011. Furthermore, the suicide rates of almost all groups above 40 years are significantly associated with the risk factors of unemployment and inflation rate, in comparison with the younger groups. © 2016 American Academy of Forensic Sciences.

  1. Risk factors of chronic periodontitis on healing response: a multilevel modelling analysis.

    Science.gov (United States)

    Song, J; Zhao, H; Pan, C; Li, C; Liu, J; Pan, Y

    2017-09-15

    Chronic periodontitis is a multifactorial polygenetic disease with an increasing number of associated factors that have been identified over recent decades. Longitudinal epidemiologic studies have demonstrated that the risk factors were related to the progression of the disease. A traditional multivariate regression model was used to find risk factors associated with chronic periodontitis. However, the approach requirement of standard statistical procedures demands individual independence. Multilevel modelling (MLM) data analysis has widely been used in recent years, regarding thorough hierarchical structuring of the data, decomposing the error terms into different levels, and providing a new analytic method and framework for solving this problem. The purpose of our study is to investigate the relationship of clinical periodontal index and the risk factors in chronic periodontitis through MLM analysis and to identify high-risk individuals in the clinical setting. Fifty-four patients with moderate to severe periodontitis were included. They were treated by means of non-surgical periodontal therapy, and then made follow-up visits regularly at 3, 6, and 12 months after therapy. Each patient answered a questionnaire survey and underwent measurement of clinical periodontal parameters. Compared with baseline, probing depth (PD) and clinical attachment loss (CAL) improved significantly after non-surgical periodontal therapy with regular follow-up visits at 3, 6, and 12 months after therapy. The null model and variance component models with no independent variables included were initially obtained to investigate the variance of the PD and CAL reductions across all three levels, and they showed a statistically significant difference (P periodontal therapy with regular follow-up visits had a remarkable curative effect. All three levels had a substantial influence on the reduction of PD and CAL. Site-level had the largest effect on PD and CAL reductions.

  2. Health at the borders: Bayesian multilevel analysis of women's malnutrition determinants in Ethiopia.

    Science.gov (United States)

    Delbiso, Tefera Darge; Rodriguez-Llanes, Jose Manuel; Altare, Chiara; Masquelier, Bruno; Guha-Sapir, Debarati

    2016-01-01

    Women's malnutrition, particularly undernutrition, remains an important public health challenge in Ethiopia. Although various studies examined the levels and determinants of women's nutritional status, the influence of living close to an international border on women's nutrition has not been investigated. Yet, Ethiopian borders are regularly affected by conflict and refugee flows, which might ultimately impact health. To investigate the impact of living close to borders in the nutritional status of women in Ethiopia, while considering other important covariates. Our analysis was based on the body mass index (BMI) of 6,334 adult women aged 20-49 years, obtained from the 2011 Ethiopian Demographic and Health Survey (EDHS). A Bayesian multilevel multinomial logistic regression analysis was used to capture the clustered structure of the data and the possible correlation that may exist within and between clusters. After controlling for potential confounders, women living close to borders (i.e. ≤100 km) in Ethiopia were 59% more likely to be underweight (posterior odds ratio [OR]=1.59; 95% credible interval [CrI]: 1.32-1.90) than their counterparts living far from the borders. This result was robust to different choices of border delineation (i.e. ≤50, ≤75, ≤125, and ≤150 km). Women from poor families, those who have no access to improved toilets, reside in lowland areas, and are Muslim, were independently associated with underweight. In contrast, more wealth, higher education, older age, access to improved toilets, being married, and living in urban or lowlands were independently associated with overweight. The problem of undernutrition among women in Ethiopia is most worrisome in the border areas. Targeted interventions to improve nutritional status in these areas, such as improved access to sanitation, economic and livelihood support, are recommended.

  3. Multilevel Control System of Regional Power Consumption: Analysis of Infrastructure Elements Interconnections, Efficiency Evaluation

    Directory of Open Access Journals (Sweden)

    Marina Nikolaevna Myznikova

    2016-10-01

    Full Text Available Fundamental strategic programs in the spheres of power and economics adopted at various levels of management, are not always capable to solve the problem of power efficiency. The changes of systemic connections of economy and power elements are one of the basic problems of management at the regional level. The development of market relations has caused the growth of uncertainty factors at all levels of power consumption management. An insufficient estimation of system infrastructural interrelations and an individualization of organizational-economic relations of economic subjects and their localization, have generated the intersystem conflictness in distribution of power resources and have aggravated the problem of estimating power consumption efficiency at a systemic level. The restriction of application of the traditional management methods based on the principles of technological efficiency of the processes of energy manufacture and consumption, is connected with the information ruptures caused by the growth of factors of uncertainty and inconsistency of efficiency criteria. Application of modern methods of power consumption forecasting has a number of essential restrictions. At the present stage the management of power consumption in multilevel systems is aimed at realisation of system integrity and economic coordination of manufacture elements, transfer and consumption at regional level and demands working out of the new effective management methods based on the analysis of system interrelations. Allocation of system interrelations depends on features of development of electropower sector, active and passive elements of the structure of consumption, power balance. The analysis and estimation of interrelations of power and economic sphere allow to improve methodology of management of power consumption at the regional level in the conditions of uncertainty.

  4. Multilevel corporate environmental responsibility.

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    Karassin, Orr; Bar-Haim, Aviad

    2016-12-01

    The multilevel empirical study of the antecedents of corporate social responsibility (CSR) has been identified as "the first knowledge gap" in CSR research. Based on an extensive literature review, the present study outlines a conceptual multilevel model of CSR, then designs and empirically validates an operational multilevel model of the principal driving factors affecting corporate environmental responsibility (CER), as a measure of CSR. Both conceptual and operational models incorporate three levels of analysis: institutional, organizational, and individual. The multilevel nature of the design allows for the assessment of the relative importance of the levels and of their components in the achievement of CER. Unweighted least squares (ULS) regression analysis reveals that the institutional-level variables have medium relationships with CER, some variables having a negative effect. The organizational level is revealed as having strong and positive significant relationships with CER, with organizational culture and managers' attitudes and behaviors as significant driving forces. The study demonstrates the importance of multilevel analysis in improving the understanding of CSR drivers, relative to single level models, even if the significance of specific drivers and levels may vary by context. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Cost-utility analysis of minimally invasive versus open multilevel hemilaminectomy for lumbar stenosis.

    Science.gov (United States)

    Parker, Scott L; Adogwa, Owoicho; Davis, Brandon J; Fulchiero, Erin; Aaronson, Oran; Cheng, Joseph; Devin, Clinton J; McGirt, Matthew J

    2013-02-01

    Two-year cost-utility study comparing minimally invasive (MIS) versus open multilevel hemilaminectomy in patients with degenerative lumbar spinal stenosis. The objective of the study was to determine whether MIS versus open multilevel hemilaminectomy for degenerative lumbar spinal stenosis is a cost-effective advancement in lumbar decompression surgery. MIS-multilevel hemilaminectomy for degenerative lumbar spinal stenosis allows for effective treatment of back and leg pain while theoretically minimizing blood loss, tissue injury, and postoperative recovery. No studies have evaluated comprehensive healthcare costs associated with multilevel hemilaminectomy procedures, nor assessed cost-effectiveness of MIS versus open multilevel hemilaminectomy. Fifty-four consecutive patients with lumbar stenosis undergoing multilevel hemilaminectomy through an MIS paramedian tubular approach (n=27) versus midline open approach (n=27) were included. Total back-related medical resource utilization, missed work, and health state values [quality adjusted life years (QALYs), calculated from EuroQuol-5D with US valuation] were assessed after 2-year follow-up. Two-year resource use was multiplied by unit costs based on Medicare national allowable payment amounts (direct cost) and work-day losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). Difference in mean total cost per QALY gained for MIS versus open hemilaminectomy was assessed as incremental cost-effectiveness ratio (ICER: COST(MIS)-COST(OPEN)/QALY(MIS)-QALY(OPEN)). MIS versus open cohorts were similar at baseline. MIS and open hemilaminectomy were associated with an equivalent cumulative gain of 0.72 QALYs 2 years after surgery. Mean direct medical costs, indirect societal costs, and total 2-year cost ($23,109 vs. $25,420; P=0.21) were similar between MIS and open hemilaminectomy. MIS versus open approach was associated with similar total costs and utility, making it a cost equivalent technology

  6. A Framework for RFID Survivability Requirement Analysis and Specification

    Science.gov (United States)

    Zuo, Yanjun; Pimple, Malvika; Lande, Suhas

    Many industries are becoming dependent on Radio Frequency Identification (RFID) technology for inventory management and asset tracking. The data collected about tagged objects though RFID is used in various high level business operations. The RFID system should hence be highly available, reliable, and dependable and secure. In addition, this system should be able to resist attacks and perform recovery in case of security incidents. Together these requirements give rise to the notion of a survivable RFID system. The main goal of this paper is to analyze and specify the requirements for an RFID system to become survivable. These requirements, if utilized, can assist the system in resisting against devastating attacks and recovering quickly from damages. This paper proposes the techniques and approaches for RFID survivability requirements analysis and specification. From the perspective of system acquisition and engineering, survivability requirement is the important first step in survivability specification, compliance formulation, and proof verification.

  7. Common mental disorders, neighbourhood income inequality and income deprivation: small-area multilevel analysis

    Science.gov (United States)

    Fone, David; Greene, Giles; Farewell, Daniel; White, James; Kelly, Mark; Dunstan, Frank

    2013-01-01

    Background Common mental disorders are more prevalent in areas of high neighbourhood socioeconomic deprivation but whether the prevalence varies with neighbourhood income inequality is not known. Aims To investigate the hypothesis that the interaction between small-area income deprivation and income inequality was associated with individual mental health. Method Multilevel analysis of population data from the Welsh Health Survey, 2003/04–2010. A total of 88 623 respondents aged 18–74 years were nested within 50 587 households within 1887 lower super output areas (neighbourhoods) and 22 unitary authorities (regions), linked to the Gini coefficient (income inequality) and the per cent of households living in poverty (income deprivation). Mental health was measured using the Mental Health Inventory MHI-5 as a discrete variable and as a ‘case’ of common mental disorder. Results High neighbourhood income inequality was associated with better mental health in low-deprivation neighbourhoods after adjusting for individual and household risk factors (parameter estimate +0.70 (s.e. = 0.33), P = 0.036; odds ratio (OR) for common mental disorder case 0.92, 95% CI 0.88–0.97). Income inequality at regional level was significantly associated with poorer mental health (parameter estimate -1.35 (s.e. = 0.54), P = 0.012; OR = 1.13, 95% CI 1.04–1.22). Conclusions The associations between common mental disorders, income inequality and income deprivation are complex. Income inequality at neighbourhood level is less important than income deprivation as a risk factor for common mental disorders. The adverse effect of income inequality starts to operate at the larger regional level. PMID:23470284

  8. Trust increases euthanasia acceptance: a multilevel analysis using the European Values Study.

    Science.gov (United States)

    Köneke, Vanessa

    2014-12-20

    This study tests how various kinds of trust impact attitudes toward euthanasia among the general public. The indication that trust might have an impact on euthanasia attitudes is based on the slippery slope argument, which asserts that allowing euthanasia might lead to abuses and involuntary deaths. Adopting this argument usually leads to less positive attitudes towards euthanasia. Tying in with this, it is assumed here that greater trust diminishes such slippery slope fears, and thereby increases euthanasia acceptance. The effects of various trust indicators on euthanasia acceptance were tested using multilevel analysis, and data from the European Values Study 2008 (N = 49,114, 44 countries). More precisely, the influence of people's general levels of trust in other people, and their confidence in the health care system, were measured--both at the individual and at the country level. Confidence in the state and the press were accounted for as well, since both institutions might monitor and safeguard euthanasia practices. It was shown that the level of trust in a country was strongly positively linked to euthanasia attitudes, both for general trust and for confidence in health care. In addition, within countries, people who perceived their fellow citizens as trustworthy, and who had confidence in the press, were more supportive of euthanasia than their less trusting counterparts. The pattern was, however, not true for confidence in the state and for confidence in the health care system at the individual level. Notably, all confirmative effects held, even when other variables such as religiosity, education, and values regarding autonomy were controlled for. Trust seems to be a noteworthy construct to explain differences in attitudes towards euthanasia, especially when drawing cross-country comparisons. Therefore, it should be added to the existing literature on correlates of euthanasia attitudes.

  9. Socioeconomic inequalities in adolescent depression in South Korea: a multilevel analysis.

    Science.gov (United States)

    Park, Hye Yin; Heo, Jongho; Subramanian, S V; Kawachi, Ichiro; Oh, Juhwan

    2012-01-01

    In recent years, South Korea has witnessed a sustained rise in the prevalence of adolescent depression. In the present study, we sought to investigate family and school environmental influences on adolescent depression. Middle and high school students (N = 75,066) were randomly selected respondents to a web-based survey and answered questions on their academic and socioeconomic backgrounds, parental support, parental education level, physical activities, lifestyle habits and their experience of depression in the past one year. Two-level multilevel analysis was used to investigate the relationship between depression and individual (level 1) and school (level 2) factors. Girls reported having experienced depression in greater numbers than boys (43.96% vs. 32.03%). A significant association was found between adolescent depression experience and gender, grade, self-rated academic achievement, family affluence scale, parental support, parental education level, lifestyle habits, physical activity and sleep dissatisfaction. The students living with rich parents were more likely to be depressive, and maternal higher education was significantly associated with higher probability of boys' depression experience. Low academic achievement was highly associated with the experience of depression. In school level contexts, girls were found to be less likely to be depressive in girls-only schools. The adolescent depression experience is not only an individual phenomenon but is highly associated with other factors such as parents, peers, academic achievement, and even gender mix in the school. Thus, prevention measures on youth depression need to focus on emphasizing less pressure from parents on academic performance, and establishing healthy inter-gender relationships within co-education schools.

  10. Common mental disorders, neighbourhood income inequality and income deprivation: small-area multilevel analysis.

    Science.gov (United States)

    Fone, David; Greene, Giles; Farewell, Daniel; White, James; Kelly, Mark; Dunstan, Frank

    2013-04-01

    Common mental disorders are more prevalent in areas of high neighbourhood socioeconomic deprivation but whether the prevalence varies with neighbourhood income inequality is not known. To investigate the hypothesis that the interaction between small-area income deprivation and income inequality was associated with individual mental health. Multilevel analysis of population data from the Welsh Health Survey, 2003/04-2010. A total of 88,623 respondents aged 18-74 years were nested within 50,587 households within 1887 lower super output areas (neighbourhoods) and 22 unitary authorities (regions), linked to the Gini coefficient (income inequality) and the per cent of households living in poverty (income deprivation). Mental health was measured using the Mental Health Inventory MHI-5 as a discrete variable and as a 'case' of common mental disorder. High neighbourhood income inequality was associated with better mental health in low-deprivation neighbourhoods after adjusting for individual and household risk factors (parameter estimate +0.70 (s.e. = 0.33), P = 0.036; odds ratio (OR) for common mental disorder case 0.92, 95% CI 0.88-0.97). Income inequality at regional level was significantly associated with poorer mental health (parameter estimate -1.35 (s.e. = 0.54), P = 0.012; OR = 1.13, 95% CI 1.04-1.22). The associations between common mental disorders, income inequality and income deprivation are complex. Income inequality at neighbourhood level is less important than income deprivation as a risk factor for common mental disorders. The adverse effect of income inequality starts to operate at the larger regional level.

  11. Socioeconomic inequalities in adolescent depression in South Korea: a multilevel analysis.

    Directory of Open Access Journals (Sweden)

    Hye Yin Park

    Full Text Available BACKGROUND: In recent years, South Korea has witnessed a sustained rise in the prevalence of adolescent depression. In the present study, we sought to investigate family and school environmental influences on adolescent depression. METHODS AND FINDINGS: Middle and high school students (N = 75,066 were randomly selected respondents to a web-based survey and answered questions on their academic and socioeconomic backgrounds, parental support, parental education level, physical activities, lifestyle habits and their experience of depression in the past one year. Two-level multilevel analysis was used to investigate the relationship between depression and individual (level 1 and school (level 2 factors. Girls reported having experienced depression in greater numbers than boys (43.96% vs. 32.03%. A significant association was found between adolescent depression experience and gender, grade, self-rated academic achievement, family affluence scale, parental support, parental education level, lifestyle habits, physical activity and sleep dissatisfaction. The students living with rich parents were more likely to be depressive, and maternal higher education was significantly associated with higher probability of boys' depression experience. Low academic achievement was highly associated with the experience of depression. In school level contexts, girls were found to be less likely to be depressive in girls-only schools. CONCLUSION: The adolescent depression experience is not only an individual phenomenon but is highly associated with other factors such as parents, peers, academic achievement, and even gender mix in the school. Thus, prevention measures on youth depression need to focus on emphasizing less pressure from parents on academic performance, and establishing healthy inter-gender relationships within co-education schools.

  12. Economic inequality and undernutrition in women: multilevel analysis of individual, household, and community levels in Cambodia.

    Science.gov (United States)

    Hong, Rathavuth; Hong, Rathmony

    2007-03-01

    Many people in developing countries are still struggling to emerge from the realm of extreme poverty, where economic improvements tend to benefit a small, affluent group of the population and cause growing inequality in health and nutrition that affects the most vulnerable groups of the population, including women and children. To examine how household and community economic inequality affects nutritional status in women using information on 6,922 nonpregnant women aged 15 to 49 years included in the 2000 Cambodia Demographic and Health Survey. Nutritional status is defined with the use of the body-mass index (BMI). BMI less than 18.5 kg/m2 is defined as undernourishment. The household wealth index was calculated from household ownership of durable assets and household characteristics. Community wealth is an average household wealth index at the community level. Household and community economic inequalities were measured by dividing the wealth index into quintiles. The effects of household and community economic inequality were estimated by multilevel analysis. Independently of community economic status and other risk factors, women in the poorest 20% of households are more likely to be undernourished than women in the richest 20% of households (RR = 1.63; p = .008). The results also show variation among communities in the nutritional status of women. Age, occupation, and access to safe sources of drinking water are significantly associated with women's nutritional status. Improving household income and creating employment opportunities for women, in particular poor women, may be a key to improving the nutritional status of women in Cambodia.

  13. Factors affecting utilization of skilled maternal care in Northwest Ethiopia: a multilevel analysis.

    Science.gov (United States)

    Worku, Abebaw Gebeyehu; Yalew, Alemayehu Worku; Afework, Mesganaw Fantahun

    2013-04-15

    The evaluation of all potential sources of low skilled maternal care utilization is crucial for Ethiopia. Previous studies have largely disregarded the contribution of different levels. This study was planned to assess the effect of individual, communal, and health facility characteristics in the utilization of antenatal, delivery, and postnatal care by a skilled provider. A linked facility and population-based survey was conducted over three months (January - March 2012) in twelve "kebeles" of North Gondar Zone, Amhara Region. A total of 1668 women who had births in the year preceding the survey were selected for analysis. Using a multilevel modelling, we examined the effect of cluster variation and a number of individual, communal (kebele), and facility-related variables for skilled maternal care utilization. About 32.3%, 13.8% and 6.3% of the women had the chance to get skilled providers for their antenatal, delivery and postnatal care, respectively. A significant heterogeneity was observed among clusters for each indicator of skilled maternal care utilization. At the individual level, variables related to awareness and perceptions were found to be much more relevant for skilled maternal service utilization. Preference for skilled providers and previous experience of antenatal care were consistently strong predictors of all indicators of skilled maternal health care utilizations. Birth order, maternal education, and awareness about health facilities to get skilled professionals were consistently strong predictors of skilled antenatal and delivery care use. Communal factors were relevant for both delivery and postnatal care, whereas the characteristics of a health facility were more relevant for use of skilled delivery care than other maternity services. Factors operating at individual and "kebele" levels play a significant role in determining utilization of skilled maternal health services. Interventions to create better community awareness and perception about

  14. A regional multilevel analysis: can skilled birth attendants uniformly decrease neonatal mortality?

    Science.gov (United States)

    Singh, Kavita; Brodish, Paul; Suchindran, Chirayath

    2014-01-01

    Globally 40 % of deaths to children under-five occur in the very first month of life with three-quarters of these deaths occurring during the first week of life. The promotion of delivery with a skilled birth attendant (SBA) is being promoted as a strategy to reduce neonatal mortality. This study explored whether SBAs had a protective effect against neonatal mortality in three different regions of the world. The analysis pooled data from nine diverse countries for which recent Demographic and Health Survey data were available. Multilevel logistic regression was used to understand the influence of skilled delivery on two outcomes-neonatal mortality during the first week of life and during the first day of life. Control variables included age, parity, education, wealth, residence (urban/rural), geographic region (Africa, Asia and Latin America/Caribbean), antenatal care and tetanus immunization. The direction of the effect of skilled delivery on neonatal mortality was dependent on geographic region. While having a SBA at delivery was protective against neonatal mortality in Latin America/Caribbean, in Asia there was only a protective effect for births in the first week of life. In Africa SBAs were associated with higher neonatal mortality for both outcomes, and the same was true for deaths on the first day of life in Asia. Many women in Africa and Asia deliver at home unless a complication occurs, and thus skilled birth attendants may be seeing more women with complications than their unskilled counterparts. In addition there are issues with the definition of a SBA with many attendants in both Africa and Asia not actually having the needed training and equipment to prevent neonatal mortality. Considerable investment is needed in terms of training and health infrastructure to enable these providers to save the youngest lives.

  15. Does the Organization Matter? A Multilevel Analysis of Organizational Effects in Homeless Service Innovations

    Science.gov (United States)

    Cronley, Courtney; Patterson, David A.

    2012-01-01

    This study examined the effects of organizational culture on staff members' use of management information systems ("N" = 142) within homeless service organizations ("N" = 24), using a multilevel model. The Organizational Social Context Questionnaire was used to measure organizational culture, defined by three sub-constructs: (1) proficiency, (2)…

  16. When Cannabis Is Available and Visible at School--A Multilevel Analysis of Students' Cannabis Use

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    Kuntsche, Emmanuel

    2010-01-01

    Aims: To investigate the links between the visibility of cannabis use in school (measured by teachers' reports of students being under the influence of cannabis on school premises), the proportion of cannabis users in the class, perceived availability of cannabis, as well as adolescent cannabis use. Methods: A multilevel regression model was…

  17. On the Usefulness of a Multilevel Logistic Regression Approach to Person-Fit Analysis

    Science.gov (United States)

    Conijn, Judith M.; Emons, Wilco H. M.; van Assen, Marcel A. L. M.; Sijtsma, Klaas

    2011-01-01

    The logistic person response function (PRF) models the probability of a correct response as a function of the item locations. Reise (2000) proposed to use the slope parameter of the logistic PRF as a person-fit measure. He reformulated the logistic PRF model as a multilevel logistic regression model and estimated the PRF parameters from this…

  18. School Climate for Academic Success: A Multilevel Analysis of School Climate and Student Outcomes

    Science.gov (United States)

    Kwong, Darren; Davis, Jonathan Ryan

    2015-01-01

    This multilevel study examined the relationship between school climate and academic achievement. Using the Educational Longitudinal Survey (ELS, 2002), and a sample of 16,258 students and 1954 schools nationwide, we found that student-level perception of school climate--especially the student learning environment--was highly predictive of academic…

  19. Multilevel Analysis of the Effects of Antidiscrimination Policies on Earnings by Sexual Orientation

    Science.gov (United States)

    Klawitter, Marieka

    2011-01-01

    This study uses the 2000 U.S. Census data to assess the impact of antidiscrimination policies for sexual orientation on earnings for gays and lesbians. Using a multilevel model allows estimation of the effects of state and local policies on earnings and of variation in the effects of sexual orientation across local labor markets. The results…

  20. School Climate as a Predictor of Incivility and Bullying among Public School Employees: A Multilevel Analysis

    Science.gov (United States)

    Powell, Joshua E.; Powell, Anna L.; Petrosko, Joseph M.

    2015-01-01

    We surveyed public school educators on the workplace incivility and workplace bullying they experienced and obtained their ratings of the organizational climate of the school. We used multilevel modeling to determine the effects of individual-level and school-level predictors. Ratings of school climate were significantly related to incivility and…

  1. Pre- and Postnatal Women's Leisure Time Physical Activity Patterns: A Multilevel Longitudinal Analysis

    Science.gov (United States)

    Cramp, Anita G.; Bray, Steven R.

    2009-01-01

    The purpose of this study was to examine women's leisure time physical activity (LTPA) before pregnancy, during pregnancy, and through the first 7 months postnatal. Pre- and postnatal women (n = 309) completed the 12-month Modifiable Activity Questionnaire and demographic information. Multilevel modeling was used to estimate a growth curve…

  2. Parent Involvement and Science Achievement: A Cross-Classified Multilevel Latent Growth Curve Analysis

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    Johnson, Ursula Y.; Hull, Darrell M.

    2014-01-01

    The authors examined science achievement growth at Grades 3, 5, and 8 and parent school involvement at the same time points using the Early Childhood Longitudinal Study-Kindergarten Class of 1998-1999. Data were analyzed using cross-classified multilevel latent growth curve modeling with time invariant and varying covariates. School-based…

  3. Prognostic and survival analysis of 837 Chinese colorectal cancer patients.

    Science.gov (United States)

    Yuan, Ying; Li, Mo-Dan; Hu, Han-Guang; Dong, Cai-Xia; Chen, Jia-Qi; Li, Xiao-Fen; Li, Jing-Jing; Shen, Hong

    2013-05-07

    To develop a prognostic model to predict survival of patients with colorectal cancer (CRC). Survival data of 837 CRC patients undergoing surgery between 1996 and 2006 were collected and analyzed by univariate analysis and Cox proportional hazard regression model to reveal the prognostic factors for CRC. All data were recorded using a standard data form and analyzed using SPSS version 18.0 (SPSS, Chicago, IL, United States). Survival curves were calculated by the Kaplan-Meier method. The log rank test was used to assess differences in survival. Univariate hazard ratios and significant and independent predictors of disease-specific survival and were identified by Cox proportional hazard analysis. The stepwise procedure was set to a threshold of 0.05. Statistical significance was defined as P analysis suggested age, preoperative obstruction, serum carcinoembryonic antigen level at diagnosis, status of resection, tumor size, histological grade, pathological type, lymphovascular invasion, invasion of adjacent organs, and tumor node metastasis (TNM) staging were positive prognostic factors (P analysis showed a significant statistical difference in 3-year survival among these groups: LNR1, 73%; LNR2, 55%; and LNR3, 42% (P analysis results showed that histological grade, depth of bowel wall invasion, and number of metastatic lymph nodes were the most important prognostic factors for CRC if we did not consider the interaction of the TNM staging system (P < 0.05). When the TNM staging was taken into account, histological grade lost its statistical significance, while the specific TNM staging system showed a statistically significant difference (P < 0.0001). The overall survival of CRC patients has improved between 1996 and 2006. LNR is a powerful factor for estimating the survival of stage III CRC patients.

  4. Breast cancer data analysis for survivability studies and prediction.

    Science.gov (United States)

    Shukla, Nagesh; Hagenbuchner, Markus; Win, Khin Than; Yang, Jack

    2018-03-01

    Breast cancer is the most common cancer affecting females worldwide. Breast cancer survivability prediction is challenging and a complex research task. Existing approaches engage statistical methods or supervised machine learning to assess/predict the survival prospects of patients. The main objectives of this paper is to develop a robust data analytical model which can assist in (i) a better understanding of breast cancer survivability in presence of missing data, (ii) providing better insights into factors associated with patient survivability, and (iii) establishing cohorts of patients that share similar properties. Unsupervised data mining methods viz. the self-organising map (SOM) and density-based spatial clustering of applications with noise (DBSCAN) is used to create patient cohort clusters. These clusters, with associated patterns, were used to train multilayer perceptron (MLP) model for improved patient survivability analysis. A large dataset available from SEER program is used in this study to identify patterns associated with the survivability of breast cancer patients. Information gain was computed for the purpose of variable selection. All of these methods are data-driven and require little (if any) input from users or experts. SOM consolidated patients into cohorts of patients with similar properties. From this, DBSCAN identified and extracted nine cohorts (clusters). It is found that patients in each of the nine clusters have different survivability time. The separation of patients into clusters improved the overall survival prediction accuracy based on MLP and revealed intricate conditions that affect the accuracy of a prediction. A new, entirely data driven approach based on unsupervised learning methods improves understanding and helps identify patterns associated with the survivability of patient. The results of the analysis can be used to segment the historical patient data into clusters or subsets, which share common variable values and

  5. Enhanced secondary analysis of survival data: reconstructing the data from published Kaplan-Meier survival curves

    Directory of Open Access Journals (Sweden)

    Guyot Patricia

    2012-02-01

    Full Text Available Abstract Background The results of Randomized Controlled Trials (RCTs on time-to-event outcomes that are usually reported are median time to events and Cox Hazard Ratio. These do not constitute the sufficient statistics required for meta-analysis or cost-effectiveness analysis, and their use in secondary analyses requires strong assumptions that may not have been adequately tested. In order to enhance the quality of secondary data analyses, we propose a method which derives from the published Kaplan Meier survival curves a close approximation to the original individual patient time-to-event data from which they were generated. Methods We develop an algorithm that maps from digitised curves back to KM data by finding numerical solutions to the inverted KM equations, using where available information on number of events and numbers at risk. The reproducibility and accuracy of survival probabilities, median survival times and hazard ratios based on reconstructed KM data was assessed by comparing published statistics (survival probabilities, medians and hazard ratios with statistics based on repeated reconstructions by multiple observers. Results The validation exercise established there was no material systematic error and that there was a high degree of reproducibility for all statistics. Accuracy was excellent for survival probabilities and medians, for hazard ratios reasonable accuracy can only be obtained if at least numbers at risk or total number of events are reported. Conclusion The algorithm is a reliable tool for meta-analysis and cost-effectiveness analyses of RCTs reporting time-to-event data. It is recommended that all RCTs should report information on numbers at risk and total number of events alongside KM curves.

  6. Enhanced secondary analysis of survival data: reconstructing the data from published Kaplan-Meier survival curves.

    Science.gov (United States)

    Guyot, Patricia; Ades, A E; Ouwens, Mario J N M; Welton, Nicky J

    2012-02-01

    The results of Randomized Controlled Trials (RCTs) on time-to-event outcomes that are usually reported are median time to events and Cox Hazard Ratio. These do not constitute the sufficient statistics required for meta-analysis or cost-effectiveness analysis, and their use in secondary analyses requires strong assumptions that may not have been adequately tested. In order to enhance the quality of secondary data analyses, we propose a method which derives from the published Kaplan Meier survival curves a close approximation to the original individual patient time-to-event data from which they were generated. We develop an algorithm that maps from digitised curves back to KM data by finding numerical solutions to the inverted KM equations, using where available information on number of events and numbers at risk. The reproducibility and accuracy of survival probabilities, median survival times and hazard ratios based on reconstructed KM data was assessed by comparing published statistics (survival probabilities, medians and hazard ratios) with statistics based on repeated reconstructions by multiple observers. The validation exercise established there was no material systematic error and that there was a high degree of reproducibility for all statistics. Accuracy was excellent for survival probabilities and medians, for hazard ratios reasonable accuracy can only be obtained if at least numbers at risk or total number of events are reported. The algorithm is a reliable tool for meta-analysis and cost-effectiveness analyses of RCTs reporting time-to-event data. It is recommended that all RCTs should report information on numbers at risk and total number of events alongside KM curves.

  7. Survival Analysis of Patients with End Stage Renal Disease

    Science.gov (United States)

    Urrutia, J. D.; Gayo, W. S.; Bautista, L. A.; Baccay, E. B.

    2015-06-01

    This paper provides a survival analysis of End Stage Renal Disease (ESRD) under Kaplan-Meier Estimates and Weibull Distribution. The data were obtained from the records of V. L. MakabaliMemorial Hospital with respect to time t (patient's age), covariates such as developed secondary disease (Pulmonary Congestion and Cardiovascular Disease), gender, and the event of interest: the death of ESRD patients. Survival and hazard rates were estimated using NCSS for Weibull Distribution and SPSS for Kaplan-Meier Estimates. These lead to the same conclusion that hazard rate increases and survival rate decreases of ESRD patient diagnosed with Pulmonary Congestion, Cardiovascular Disease and both diseases with respect to time. It also shows that female patients have a greater risk of death compared to males. The probability risk was given the equation R = 1 — e-H(t) where e-H(t) is the survival function, H(t) the cumulative hazard function which was created using Cox-Regression.

  8. Multilevel Cultural Issues

    NARCIS (Netherlands)

    van Herk, H.; Fischer, Ronald; van Herk, Hester; Torelli, Carlos J.

    2017-01-01

    Multi-level structures are omnipresent. Consumers live in geographical locations, shop in specific stores, or are members of clubs. Consumers who belong to the same group share characteristics and are expected to be more similar than consumers belonging to another group. In data analysis this

  9. Relationship satisfaction and interpartner agreement about acts of physical and psychological aggression: a multilevel analysis.

    Science.gov (United States)

    Graña, José Luis; Cuenca, María Luisa; Redondo, Natalia

    2017-08-15

    To analyze, in a multilevel context, the impact of individual-level relationship satisfaction on couples' mean reports of aggression and agreement about acts of physical and psychological aggression. We conducted a quota sampling method to recruit a community sample of 2.988 heterosexual adult couples from the Region of Madrid (Spain). The percentages of intimate partner aggression considering the highest report of aggression in the couple were around 60% of psychological aggression and 15% of physical aggression. Couples that used aggressive tactics showed low to moderate levels of agreement about physical and psychological aggression. Multilevel models confirm that women's relationship satisfaction had a significant influence on the level of agreement about acts of psychological aggression, but the same pattern of results was not observed for men. On the other hand, men and women's relationship satisfaction had no significant influence on the level of agreement about physical aggression. Psychological aggression plays a more relevant role in women's relationship satisfaction than physical aggression.

  10. Multilevel analysis of school anti-smoking education and current cigarette use among South African students.

    Science.gov (United States)

    Talley, Brandon; Masyn, Katherine; Chandora, Rachna; Vivolo-Kantor, Alana

    2017-01-01

    South Africa (SA) implemented the Global Youth Tobacco Survey (GYTS) four times between 1999 and 2011. Data from the four surveys indicated that downward trends in cigarette use among students may have stalled. Understanding the effect of school anti-smoking education on current smoking among students within schools and variability across schools may provide important insights into policies aimed at preventing or reducing tobacco use among students. The objective was to assess the student- and school-level effects of students' exposure to school anti-smoking education on current cigarette use among the study population using the most recent wave of GYTS data in SA (2011). An analytic sample of students 13-15 years of age was selected (n=3,068) from the SA GYTS 2011. A taxonomy of two-level logistic regression models was fit to assess the relationship of various tobacco use, control, and exposure predictor variables on current cigarette smoking among the study population. At the student-level in the full model, secondhand smoke (SHS) exposure, peer smoking, and ownership of a promotional item were significantly associated with higher risk of current smoking. At the school-level in the full model, average exposure to peer smoking was associated with significant increases in the prevalence of current cigarette use, while average family anti-smoking education was significantly associated with decreases in the outcome variable. School anti-smoking education was not a statistically significant predictor at the student- or school-levels. in this study, exposure to school anti-smoking education had no association with current cigarette smoking among the study population. Consistent with previous studies, having peers that smoked was highly associated with a student being a current smoker. Interestingly, at the school-level in the multilevel analysis, schools with higher rates of average family anti-smoking education had lower prevalence of current smoking. This finding has

  11. Determinants of gastric cancer screening attendance in Korea: a multi-level analysis

    OpenAIRE

    Chang, Yunryong; Cho, Belong; Son, Ki Young; Shin, Dong Wook; Shin, Hosung; Yang, Hyung-Kook; Shin, Aesun; Yoo, Keun-Young

    2015-01-01

    Background We aimed to assess individual and area-level determinants of gastric cancer screening participation. Method Data on gastric cancer screening and individual-level characteristics were obtained from the 2007?2009 Fourth Korea National Health and Nutrition Examination Survey. The area-level variables were collected from the 2005 National Population Census, 2008 Korea Medical Association, and 2010 National Health Insurance Corporation. The data were analyzed using multilevel logistic r...

  12. Migration, urbanization, and drug use and casual sex in China: a multilevel analysis

    OpenAIRE

    Xiushi Yang; Huasong Luo

    2009-01-01

    Using data from a survey conducted in 2003 and employing multilevel modeling, this paper examines the impact of migration and urbanization on drug abuse and casual sex in China. The results suggest that being a migrant predicts significantly higher odds of having casual sex but lower odds of drug abuse. Living in an urban place is a significant risk factor for both illicit drug use and casual sex. There are significant cross-community (primary sampling unit) variances in the random intercept ...

  13. Political regimes, political ideology, and self-rated health in Europe: a multilevel analysis

    OpenAIRE

    Huijts, T.; Perkins, J.M; Subramanian, S.V.

    2010-01-01

    Background: Studies on political ideology and health have found associations between individual ideology and health as well as between ecological measures of political ideology and health. Individual ideology and aggregate measures such as political regimes, however, were never examined simultaneously. Methodology/Principal Findings: Using adjusted logistic multilevel models to analyze data on individuals from 29 European countries and Israel, we found that individual ideology and political r...

  14. A multilevel cross-lagged structural equation analysis for reciprocal relationship between social capital and health

    OpenAIRE

    Sessions, John; Yu, Ge; Fu, Yu; Wall, Matin

    2015-01-01

    We investigated the reciprocal relationship between individual social capital and perceived mental and physical health in the UK. Using data from the British Household Panel Survey from 1991 to 2008, we fitted cross-lagged structural equation models that include three indicators of social capital vis. social participation, social network, and loneliness. Given that multiple measurement points (level 1) are nested within individuals (level 2), we also applied a multilevel model to allow for re...

  15. A multi-level qualitative analysis of Telehomecare in Ontario: challenges and opportunities

    OpenAIRE

    Hunting, Gemma; Shahid, Nida; Sahakyan, Yeva; Fan, Iris; Moneypenny, Crystal R.; Stanimirovic, Aleksandra; North, Taylor; Petrosyan, Yelena; Krahn, Murray D.; Rac, Valeria E.

    2015-01-01

    Background Despite research demonstrating the potential effectiveness of Telehomecare for people with Chronic Obstructive Pulmonary Disease and Heart Failure, broad-scale comprehensive evaluations are lacking. This article discusses the qualitative component of a mixed-method program evaluation of Telehomecare in Ontario, Canada. The objective of the qualitative component was to explore the multi-level factors and processes which facilitate or impede the implementation and adoption of the pro...

  16. Fast food purchasing and access to fast food restaurants: a multilevel analysis of VicLANES

    OpenAIRE

    Kavanagh Anne M; Bentley Rebecca J; Thornton Lukar E

    2009-01-01

    Abstract Background While previous research on fast food access and purchasing has not found evidence of an association, these studies have had methodological problems including aggregation error, lack of specificity between the exposures and outcomes, and lack of adjustment for potential confounding. In this paper we attempt to address these methodological problems using data from the Victorian Lifestyle and Neighbourhood Environments Study (VicLANES) – a cross-sectional multilevel study con...

  17. Study and Analysis of a Natural Reference Frame Current Controller for a Multi-Level H-Bridge Power Converter

    DEFF Research Database (Denmark)

    Ciobotaru, Mihai; Iov, Florin; Zanchetta, P.

    2008-01-01

    will be needed in order to control the power flow and to ensure proper and secure operation of this future grid with an increased level of renewable power. These power converters must be able to provide intelligent power management as well as ancillary services. This paper presents an analysis of the natural...... reference frame controller, based on proportional-resonant (PR) technique, for a multi-level H-bridge power converter for Universal and Flexible Power Management in Future Electricity Network. The proposed method is tested in terms of harmonic content in the Point of Common Coupling (PCC), voltage...

  18. A brief conceptual tutorial of multilevel analysis in social epidemiology: using measures of clustering in multilevel logistic regression to investigate contextual phenomena

    DEFF Research Database (Denmark)

    Merlo, J; Chaix, B; Ohlsson, H

    2006-01-01

    STUDY OBJECTIVE: In social epidemiology, it is easy to compute and interpret measures of variation in multilevel linear regression, but technical difficulties exist in the case of logistic regression. The aim of this study was to present measures of variation appropriate for the logistic case...... in a didactic rather than a mathematical way. Design and PARTICIPANTS: Data were used from the health survey conducted in 2000 in the county of Scania, Sweden, that comprised 10 723 persons aged 18-80 years living in 60 areas. Conducting multilevel logistic regression different techniques were applied...... propensity areas with the area educational level. The sorting out index was equal to 82%. CONCLUSION: Measures of variation in logistic regression should be promoted in social epidemiological and public health research as efficient means of quantifying the importance of the context of residence...

  19. Survival analysis for customer satisfaction: A case study

    Science.gov (United States)

    Hadiyat, M. A.; Wahyudi, R. D.; Sari, Y.

    2017-11-01

    Most customer satisfaction surveys are conducted periodically to track their dynamics. One of the goals of this survey was to evaluate the service design by recognizing the trend of satisfaction score. Many researchers recommended in redesigning the service when the satisfaction scores were decreasing, so that the service life cycle could be predicted qualitatively. However, these scores were usually set in Likert scale and had quantitative properties. Thus, they should also be analyzed in quantitative model so that the predicted service life cycle would be done by applying the survival analysis. This paper discussed a starting point for customer satisfaction survival analysis with a case study in healthcare service.

  20. Statistical models and methods for reliability and survival analysis

    CERN Document Server

    Couallier, Vincent; Huber-Carol, Catherine; Mesbah, Mounir; Huber -Carol, Catherine; Limnios, Nikolaos; Gerville-Reache, Leo

    2013-01-01

    Statistical Models and Methods for Reliability and Survival Analysis brings together contributions by specialists in statistical theory as they discuss their applications providing up-to-date developments in methods used in survival analysis, statistical goodness of fit, stochastic processes for system reliability, amongst others. Many of these are related to the work of Professor M. Nikulin in statistics over the past 30 years. The authors gather together various contributions with a broad array of techniques and results, divided into three parts - Statistical Models and Methods, Statistical

  1. Income inequality is associated with adolescent fertility in Brazil: a longitudinal multilevel analysis of 5,565 municipalities.

    Science.gov (United States)

    Chiavegatto Filho, Alexandre D P; Kawachi, Ichiro

    2015-02-07

    Brazil has one of the highest adolescent fertility rates in the world. Income inequality has been frequently linked to overall adolescent health, but studies that analyzed its association with adolescent fertility have been performed only in developed countries. Brazil, in the past decade, has presented a rare combination of increasing per capita income and decreasing income inequality, which could influence future desirable pathways for other countries. We analyzed every live birth from 2000 and from 2010 in each of the 5,565 municipalities of Brazil, a total of 6,049,864 births, which included 1,247,145 (20.6%) births from women aged 15 to 19. Income inequality was assessed by the Gini Coefficient and adolescent fertility by the ratio between the number of live births from women aged 15 to 19 and the number of women aged 15 to 19, calculated for each municipality. We first applied multilevel models separately for 2000 and 2010 to test the cross-sectional association between income inequality and adolescent fertility. We then fitted longitudinal first-differences multilevel models to control for time-invariant effects. We also performed a sensitivity analysis to include only municipality with satisfactory birth record coverage. Our results indicate a consistent and positive association between income inequality and adolescent fertility. After controlling for per capita income, college access, youth homicide rate and adult fertility, higher income inequality was significantly associated with higher adolescent fertility for both 2000 and 2010. The longitudinal multilevel models found similar results. The sensitivity analysis indicated that the results for the association between income inequality and adolescent fertility were robust. Adult fertility was also significantly associated with adolescent fertility in the cross-sectional and longitudinal models. Income inequality is expected to be a leading concern for most countries in the near future. Our results suggest

  2. [Multilevel analysis of the technical efficiency of hospitals in the Spanish National Health System by property and type of management].

    Science.gov (United States)

    Pérez-Romero, Carmen; Ortega-Díaz, M Isabel; Ocaña-Riola, Ricardo; Martín-Martín, José Jesús

    2018-05-11

    To analyze technical efficiency by type of property and management of general hospitals in the Spanish National Health System (2010-2012) and identify hospital and regional explanatory variables. 230 hospitals were analyzed combining data envelopment analysis and fixed effects multilevel linear models. Data envelopment analysis measured overall, technical and scale efficiency, and the analysis of explanatory factors was performed using multilevel models. The average rate of overall technical efficiency of hospitals without legal personality is lower than hospitals with legal personality (0.691 and 0.876 in 2012). There is a significant variability in efficiency under variable returns (TE) by direct, indirect and mixed forms of management. The 29% of the variability in TE es attributable to the Region. Legal personality increased the TE of the hospitals by 11.14 points. On the other hand, most of the forms of management (different to those of the traditional hospitals) increased TE in varying percentages. At regional level, according to the model considered, insularity and average annual income per household are explanatory variables of TE. Having legal personality favours technical efficiency. The regulatory and management framework of hospitals, more than public or private ownership, seem to explain technical efficiency. Regional characteristics explain the variability in TE. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. [Survival analysis with competing risks: estimating failure probability].

    Science.gov (United States)

    Llorca, Javier; Delgado-Rodríguez, Miguel

    2004-01-01

    To show the impact of competing risks of death on survival analysis. We provide an example of survival time without chronic rejection after heart transplantation, where death before rejection acts as a competing risk. Using a computer simulation, we compare the Kaplan-Meier estimator and the multiple decrement model. The Kaplan-Meier method overestimated the probability of rejection. Next, we illustrate the use of the multiple decrement model to analyze secondary end points (in our example: death after rejection). Finally, we discuss Kaplan-Meier assumptions and why they fail in the presence of competing risks. Survival analysis should be adjusted for competing risks of death to avoid overestimation of the risk of rejection produced with the Kaplan-Meier method.

  4. Development of an alarm analysis system based on multi-level flow models for nuclear power plant

    International Nuclear Information System (INIS)

    Zhang Jiande; Yang Ming; Zhang Zhijian

    2008-01-01

    An alarm analysis system based on Multi-level Flow Models (MFM) was developed for a PWR NPP. By automatically identifying the primary root causes in complex fault situations, the workload of the operators can be reduced. In addition, because MFM also provides a set of graphical symbols that implies causalities, operators can confirm diagnosis results by semiotic analysis, and hence the understandability of the process of alarm analysis as well as the reliability of maintenance task can be increased. 19 cases of simulation data from RELAP5/MOD2 code were utilized for evaluating the performance of the proposed system. The simulation results show that the proposed alarm analysis system has a good ability to detect and diagnose accidents earlier in time before reactor trip. (authors)

  5. Multi-level Discourse Analysis in a Physics Teaching Methods Course from the Psychological Perspective of Activity Theory

    Science.gov (United States)

    Vieira, Rodrigo Drumond; Kelly, Gregory J.

    2014-11-01

    In this paper, we present and apply a multi-level method for discourse analysis in science classrooms. This method is based on the structure of human activity (activity, actions, and operations) and it was applied to study a pre-service physics teacher methods course. We argue that such an approach, based on a cultural psychological perspective, affords opportunities for analysts to perform a theoretically based detailed analysis of discourse events. Along with the presentation of analysis, we show and discuss how the articulation of different levels offers interpretative criteria for analyzing instructional conversations. We synthesize the results into a model for a teacher's practice and discuss the implications and possibilities of this approach for the field of discourse analysis in science classrooms. Finally, we reflect on how the development of teachers' understanding of their activity structures can contribute to forms of progressive discourse of science education.

  6. Causal inference in survival analysis using pseudo-observations

    DEFF Research Database (Denmark)

    Andersen, Per K; Syriopoulou, Elisavet; Parner, Erik T

    2017-01-01

    Causal inference for non-censored response variables, such as binary or quantitative outcomes, is often based on either (1) direct standardization ('G-formula') or (2) inverse probability of treatment assignment weights ('propensity score'). To do causal inference in survival analysis, one needs ...

  7. A multilevel analysis of lifestyle variations in symptoms of acute respiratory infection among young children under five in Nigeria

    Directory of Open Access Journals (Sweden)

    Oluwafunmilade A. Adesanya

    2016-08-01

    Full Text Available Abstract Background Nigeria has the second highest estimated number of deaths due to acute respiratory infection (ARI among children under five in the world. A common hypothesis is that the inequitable distribution of socioeconomic resources shapes individual lifestyles and health behaviors, which leads to poorer health, including symptoms of ARI. This study examined whether lifestyle factors are associated with ARI risk among Nigerian children aged less than 5 years, taking individual-level and contextual-level risk factors into consideration. Methods Data were obtained from the nationally representative 2013 Nigeria Demographic and Health Survey. A total of 28,596 surviving children aged 5 years or younger living in 896 communities were analyzed. We employed two-level multilevel logistic regressions to model the relationship between lifestyle factors and ARI symptoms. Results The multivariate results from multilevel regressions indicated that the odds of having ARI symptoms were increased by a number of lifestyle factors such as in-house biomass cooking (OR = 2.30; p < 0.01 and no hand-washing (OR = 1.66; p < 0.001. An increased risk of ARI symptoms was also significantly associated with living in the North West region and the community with a high proportion of orphaned/vulnerable children (OR = 1.74; p < 0.001. Conclusions Our findings underscore the importance of Nigerian children’s lifestyle within the neighborhoods where they reside above their individual characteristics. Program-based strategies that are aimed at reducing ARI symptoms should consider policies that embrace making available basic housing standards, providing improved cooking stoves and enhancing healthy behaviors.

  8. Correlation analysis between change in thoracic kyphosis and multilevel facetectomy and screw density in main thoracic adolescent idiopathic scoliosis surgery.

    Science.gov (United States)

    Sudo, Hideki; Abe, Yuichiro; Kokabu, Terufumi; Ito, Manabu; Abumi, Kuniyoshi; Ito, Yoichi M; Iwasaki, Norimasa

    2016-09-01

    Controversy exists regarding the effects of multilevel facetectomy and screw density on deformity correction, especially thoracic kyphosis (TK) restoration in adolescent idiopathic scoliosis (AIS) surgery. This study aimed to evaluate the effects of multilevel facetectomy and screw density on sagittal plane correction in patients with main thoracic (MT) AIS curve. A retrospective correlation and comparative analysis of prospectively collected, consecutive, non-randomized series of patients at a single institution was undertaken. Sixty-four consecutive patients with Lenke type 1 AIS treated with posterior correction and fusion surgery using simultaneous double-rod rotation technique were included. Patient demographics and preoperative and 2-year postoperative radiographic measurements were the outcome measures for this study. Multiple stepwise linear regression analysis was conducted between change in TK (T5-T12) and the following factors: age at surgery, Risser sign, number of facetectomy level, screw density, preoperative main thoracic curve, flexibility in main thoracic curve, coronal correction rate, preoperative TK, and preoperative lumbar lordosis. Patients were classified into two groups: TKcorrect hypokyphosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Bernstein - Von Mises theorem and its application in survival analysis

    Czech Academy of Sciences Publication Activity Database

    Timková, Jana

    2010-01-01

    Roč. 22, č. 3 (2010), s. 115-122 ISSN 1210-8022. [16. letní škola JČMF Robust 2010. Králíky, 30.01.2010-05.02.2010] R&D Projects: GA AV ČR(CZ) IAA101120604 Institutional research plan: CEZ:AV0Z10750506 Keywords : Cox model * bayesian asymptotics * survival function Subject RIV: BB - Applied Statistics, Operational Research http://library.utia.cas.cz/separaty/2010/SI/timkova-bernstein - von mises theorem and its application in survival analysis.pdf

  10. Interdependence and organizational citizenship behavior: exploring the mediating effect of group cohesion in multilevel analysis.

    Science.gov (United States)

    Chen, Chun-Hsi Vivian; Tang, Ya-Yun; Wang, Shih-Jon

    2009-12-01

    The authors investigated the mechanism of group cohesion in the relationship between (a) task interdependence and goal interdependence and (b) individuals' organizational citizenship behavior (OCB). The authors adopted a multilevel perspective to facilitate understanding of the complex relations among variables. They collected data from 53 supervisors and 270 employees from R&D departments in Taiwan. The authors found that group cohesion fully mediated the effects of task interdependence and goal interdependence on employees' OCB. In addition, task interdependence had a greater effect on group cohesion than did goal interdependence. The authors discuss implications and suggestions for future research.

  11. Multilevel analysis of workplace and individual risk factors for long-term sickness absence

    DEFF Research Database (Denmark)

    Labriola, Merete; Christensen, Karl B; Lund, Thomas

    2006-01-01

    OBJECTIVE: The objective of this study was to examine if psychosocial and physical work-environment factors predict long-term sickness absence (>8 weeks) at both the individual and the workplace level. MATERIAL AND METHODS: Data were collected in a prospective study in 52 Danish workplaces....... Psychosocial factors were aggregated as workplace means. We used multilevel logistic regression models with psychosocial factors as predictors of long-term sickness absence over 5 years based on data from a national absence register. RESULTS: Long-term sickness absence was predicted by physical work...

  12. Using Survival Analysis to Evaluate Medical Equipment Battery Life.

    Science.gov (United States)

    Kuhajda, David

    2016-01-01

    As hospital medical device managers obtain more data, opportunities exist for using the data to improve medical device management, enhance patient safety, and evaluate costs of decisions. As a demonstration of the ability to use data analytics, this article applies survival analysis statistical techniques to assist in making decisions on medical equipment maintenance. The analysis was performed on a large amount of data related to failures of an infusion pump manufacturer's lithium battery and two aftermarket replacement lithium batteries from one hospital facility. The survival analysis resulted in statistical evidence showing that one of the third-party batteries had a lower survival curve than the infusion pump manufacturer's battery. This lower survival curve translates to a shorter expected life before replacement is needed. The data suggested that to limit unexpected failures, replacing batteries at a two-year interval, rather than the current industry recommendation of three years, may be warranted. For less than $5,400 in additional annual cost, the risk of unexpected battery failures can be reduced from an estimated 28% to an estimated 7%.

  13. Prognostic and survival analysis of presbyopia: The healthy twin study

    Science.gov (United States)

    Lira, Adiyani; Sung, Joohon

    2015-12-01

    Presbyopia, a vision condition in which the eye loses its flexibility to focus on near objects, is part of ageing process which mostly perceptible in the early or mid 40s. It is well known that age is its major risk factor, while sex, alcohol, poor nutrition, ocular and systemic diseases are known as common risk factors. However, many other variables might influence the prognosis. Therefore in this paper we developed a prognostic model to estimate survival from presbyopia. 1645 participants which part of the Healthy Twin Study, a prospective cohort study that has recruited Korean adult twins and their family members based on a nation-wide registry at public health agencies since 2005, were collected and analyzed by univariate analysis as well as Cox proportional hazard model to reveal the prognostic factors for presbyopia while survival curves were calculated by Kaplan-Meier method. Besides age, sex, diabetes, and myopia; the proposed model shows that education level (especially engineering program) also contribute to the occurrence of presbyopia as well. Generally, at 47 years old, the chance of getting presbyopia becomes higher with the survival probability is less than 50%. Furthermore, our study shows that by stratifying the survival curve, MZ has shorter survival with average onset time about 45.8 compare to DZ and siblings with 47.5 years old. By providing factors that have more effects and mainly associate with presbyopia, we expect that we could help to design an intervention to control or delay its onset time.

  14. Direct Survival Analysis: a new stock assessment method

    Directory of Open Access Journals (Sweden)

    Eduardo Ferrandis

    2007-03-01

    Full Text Available In this work, a new stock assessment method, Direct Survival Analysis, is proposed and described. The parameter estimation of the Weibull survival model proposed by Ferrandis (2007 is obtained using trawl survey data. This estimation is used to establish a baseline survival function, which is in turn used to estimate the specific survival functions in the different cohorts considered through an adaptation of the separable model of the fishing mortality rates introduced by Pope and Shepherd (1982. It is thus possible to test hypotheses on the evolution of survival during the period studied and to identify trends in recruitment. A link is established between the preceding analysis of trawl survey data and the commercial catch-at-age data that are generally obtained to evaluate the population using analytical models. The estimated baseline survival, with the proposed versions of the stock and catch equations and the adaptation of the Separable Model, may be applied to commercial catch-at-age data. This makes it possible to estimate the survival corresponding to the landing data, the initial size of the cohort and finally, an effective age of first capture, in order to complete the parameter model estimation and consequently the estimation of the whole survival and mortality, along with the reference parameters that are useful for management purposes. Alternatively, this estimation of an effective age of first capture may be obtained by adapting the demographic structure of trawl survey data to that of the commercial fleet through suitable selectivity models of the commercial gears. The complete model provides the evaluation of the stock at any age. The coherence (and hence the mutual “calibration” between the two kinds of information may be analysed and compared with results obtained by other methods, such as virtual population analysis (VPA, in order to improve the diagnosis of the state of exploitation of the population. The model may be

  15. Parental supply of alcohol and adolescent drinking: a multilevel analysis of nationally representative data.

    Science.gov (United States)

    Chan, Gary C K; Leung, Janni; Connor, Jason; Hall, Wayne; Kelly, Adrian B

    2017-06-09

    Existing research on parental supply of alcohol analyses the effects of self-reported parental supply on adolescent drinking using individual level data. This study examined the contextual effect of parental supply of alcohol on adolescent alcohol use by examining the association between the prevalence of parental supply in each Australian state and adolescent alcohol use using a multilevel analytic framework. Adolescent samples (Age: 12-17) were drawn from the four National Drug Strategy Household Surveys (2004, 2007, 2010 and 2013; N = 6803). The prevalence of parental supply of alcohol, defined as the weighted percentage of sample who reported obtaining alcohol from their parents, was estimated in each state and territory across the four surveys. Three multilevel logistic regressions were used to examine the contextual effects of parental supply prevalence on adolescents' alcohol use in the past 12 months, weekly drinking and heavy drinking. Overall, adolescents' rates of past 12 months alcohol use, heavy drinking and weekly drinking between 2004 and 2013 were 40.1, 14.4 and 6.4% respectively. The prevalence of parental supply was significantly associated with past 12 months alcohol use (OR = 1.06, p supply. A high prevalence of parental supply in a region was associated with heavier adolescent drinking, regardless of whether adolescents primarily obtained their alcohol from their own parents.

  16. Stages of syphilis in South China - a multilevel analysis of early diagnosis.

    Science.gov (United States)

    Wong, Ngai Sze; Huang, Shujie; Zheng, Heping; Chen, Lei; Zhao, Peizhen; Tucker, Joseph D; Yang, Li Gang; Goh, Beng Tin; Yang, Bin

    2017-01-31

    Early diagnosis of syphilis and timely treatment can effectively reduce ongoing syphilis transmission and morbidity. We examined the factors associated with the early diagnosis of syphilis to inform syphilis screening strategic planning. In an observational study, we analyzed reported syphilis cases in Guangdong Province, China (from 2014 to mid-2015) accessed from the national case-based surveillance system. We categorized primary and secondary syphilis cases as early diagnosis and categorized latent and tertiary syphilis as delayed diagnosis. Univariate analyses and multivariable logistic regressions were performed to identify the factors associated with early diagnosis. We also examined the factors associated with early diagnosis at the individual and city levels in multilevel logistic regression models with cases nested by city (n = 21), adjusted for age at diagnosis and gender. Among 83,944 diagnosed syphilis cases, 22% were early diagnoses. The city-level early diagnosis rate ranged from 7 to 46%, consistent with substantial geographic variation as shown in the multilevel model. Early diagnosis was associated with cases presenting to specialist clinics for screening, being male and attaining higher education level. Cases received syphilis testing in institutions and hospitals, and diagnosed in hospitals were less likely to be in early diagnosis. At the city-level, cases living in a city equipped with more hospitals per capita were less likely to be early diagnosis. To enhance early diagnosis of syphilis, city-specific syphilis screening strategies with a mix of passive and client/provider-initiated testing might be a useful approach.

  17. Multilevel multitrait-multimethod latent analysis of structurally different and interchangeable raters of school climate.

    Science.gov (United States)

    Konold, Timothy; Cornell, Dewey

    2015-09-01

    Informant-based systems of assessment are common platforms for measuring a variety of educational and psychological constructs where the use of multiple informants is considered best practice. In many instances, structurally different informant types (e.g., students and teachers) are solicited on the basis of their unique roles with the target of measurement. The use of multiple informants provides an opportunity to evaluate the degree to which the obtained ratings are influenced by the trait of focus and extraneous sources that can be attributed to the rater. Data from a multilevel multitrait-multimethod design in which students (N = 35,565) and teachers (N = 9,112), from 340 middle schools, responded to items measuring 3 dimensions of school climate were evaluated through a multilevel correlated trait-correlated method latent variable model. Results indicated that ratings of school climate obtained by students and teachers demonstrated high levels of convergent validity, and that school-level ratings obtained by students and teachers were equitable in the assessment of teasing and bullying. Student ratings of support and structure yielded somewhat stronger evidence of convergent validity than ratings obtained by teachers as revealed by their respective trait factor loadings. This was explained in part by the higher levels of common method effects that were observed for teachers. (c) 2015 APA, all rights reserved.

  18. A multilevel analysis of long-term psychological distress among Belarusians affected by the Chernobyl disaster.

    Science.gov (United States)

    Beehler, G P; Baker, J A; Falkner, K; Chegerova, T; Pryshchepava, A; Chegerov, V; Zevon, M; Bromet, E; Havenaar, J; Valdismarsdottir, H; Moysich, K B

    2008-11-01

    Radiation contamination and sociopolitical instability following the Chernobyl nuclear power plant disaster have had a profound impact on Belarus. To investigate the factors that impact long-term mental health outcomes of this population almost 20 years after the disaster. Cross-sectional study. In-person interviews were conducted with 381 men and women from two geographic areas of differing radiation contamination within Belarus. Participants completed surveys of demographics, psychosocial factors and psychological distress. Individual-level characteristics were combined with household-level measures of radiation contamination exposure and family characteristics to create multilevel predictive models of psychological distress. Between-household effects accounted for 20% of variability in depression and anxiety scores, but only 8% of variability in somatization scores. Degree of chronic daily stressors showed a significant positive relationship with psychological distress, whereas mastery/controllability showed a significant inverse relationship with distress. At household level, perceived family problems, but not level of residential radiation contamination, was the best predictor of distress. Multilevel modelling indicates that long-term psychological distress among Belarusians affected by the Chernobyl disaster is better predicted by stress-moderating psychosocial factors present in one's daily life than by level of residential radiation contamination.

  19. A multilevel analysis of factors affecting the difference in dental patients' and caregivers' evaluation of oral quality of life.

    Science.gov (United States)

    Sampogna, F; Johansson, V; Axtelius, B; Abeni, D; Söderfeldt, B

    2008-12-01

    In a previous study, we observed that the concordance between patients' and caregivers' evaluation of oral health-related quality of life (OHRQoL) was low. The aim of this study was to use multilevel analysis to investigate the possible determinants of the low concordance, taking into account different patients' demographic and clinical variables, the financial system used by patients to pay for dental treatment, and the role of the different caregivers and clinics. The OHRQoL of patients was assessed both by the patients and by their caregivers, using the Oral Health Impact Profile (OHIP)-14. Data were collected in four clinics, and patients were evaluated by one of 27 caregivers. We tested eight multilevel models, using the difference (caregivers OHIP - patients OHIP) as the dependent variable. Data were complete for 432 patients. The mean difference was 4.4 (standard deviation = 8.2; higher scores indicated a higher impact on OHRQoL). The variance due to patients was partly explained by their age, gender, and number of teeth, with a greater OHIP difference for older vs. younger patients, for women than for men, and in patients with fewer teeth. Almost 30% of the variance was due to caregivers, while the effect of clinics was not significant. It is important to study the possible causes of the different judgments concerning patients' OHRQoL by patients and caregivers, in order to improve the patients' satisfaction with care.

  20. Neighborhood contextual factors, maternal smoking, and birth outcomes: multilevel analysis of the South Carolina PRAMS survey, 2000-2003.

    Science.gov (United States)

    Nkansah-Amankra, Stephen

    2010-08-01

    Previous studies investigating relationships among neighborhood contexts, maternal smoking behaviors, and birth outcomes (low birth weight [LBW] or preterm births) have produced mixed results. We evaluated independent effects of neighborhood contexts on maternal smoking behaviors and risks of LBW or preterm birth outcomes among mothers participating in the South Carolina Pregnancy Risk Assessment and Monitoring System (PRAMS) survey, 2000-2003. The PRAMS data were geocoded to 2000 U.S. Census data to create a multilevel data structure. We used a multilevel regression analysis (SAS PROC GLIMMIX) to estimate odds ratios (OR) and corresponding 95% confidence intervals (CI). In multivariable logistic regression models, high poverty, predominantly African American neighborhoods, upper quartiles of low education, and second quartile of neighborhood household crowding were significantly associated with LBW. However, only mothers resident in predominantly African American Census tract areas were statistically significantly at an increased risk of delivering preterm (OR 2.2, 95% CI 1.29-3.78). In addition, mothers resident in medium poverty neighborhoods remained modestly associated with smoking after adjustment for maternal-level covariates. The results also indicated that maternal smoking has more consistent effects on LBW than preterm births, particularly for mothers living in deprived neighborhoods. Interventions seeking to improve maternal and child health by reducing smoking during pregnancy need to engage specific community factors that encourage maternal quitting behaviors and reduce smoking relapse rates. Inclusion of maternal-level covariates in neighborhood models without careful consideration of the causal pathway might produce misleading interpretation of the results.

  1. Contributions of social context to blood pressure: findings from a multilevel analysis of social capital and systolic blood pressure.

    Science.gov (United States)

    Hamano, Tsuyoshi; Fujisawa, Yoshikazu; Yamasaki, Masayuki; Ito, Katsuhisa; Nabika, Toru; Shiwaku, Kuninori

    2011-06-01

    In recent years, few studies have quantified the effect of residential context on blood pressure. Although these studies have emphasized the importance of socioeconomic influences such as education or poverty levels, the association between the features of social structure such as social capital and blood pressure remain unclear. Therefore, we investigated whether social capital was associated with systolic blood pressure after controlling for individual potential confounders. We analyzed data from the Shimane Study conducted from 2006 to 2008 in rural mountainous regions of Japan. After excluding the missing data and data of participants taking hypertension medication, we conducted a multilevel analysis of the data for 335 individuals nested within 30 postcode sectors. Systolic blood pressure increased with increasing age and body mass index. We also found that a higher systolic blood pressure was observed among smokers and those taking medication for diabetes. Regarding the contextual effects of social capital, systolic blood pressure increased with an increasing proportion of lack of fairness, after adjustment for individual confounders. To the best of our knowledge, this study is the first to investigate the association between social capital and systolic blood pressure by using a multilevel methodological framework. Surprisingly, we found that lack of fairness had a strong effect on systolic blood pressure. However, we could not find any significant associations between other items of social capital and systolic blood pressure. Further studies are needed to clarify the mechanism by which lack of fairness may have an effect on systolic blood pressure.

  2. Poly-use multi-level sampling system for soil-gas transport analysis in the vadose zone.

    Science.gov (United States)

    Nauer, Philipp A; Chiri, Eleonora; Schroth, Martin H

    2013-10-01

    Soil-gas turnover is important in the global cycling of greenhouse gases. The analysis of soil-gas profiles provides quantitative information on below-ground turnover and fluxes. We developed a poly-use multi-level sampling system (PMLS) for soil-gas sampling, water-content and temperature measurement with high depth resolution and minimal soil disturbance. It is based on perforated access tubes (ATs) permanently installed in the soil. A multi-level sampler allows extraction of soil-gas samples from 20 locations within 1 m depth, while a capacitance probe is used to measure volumetric water contents. During idle times, the ATs are sealed and can be equipped with temperature sensors. Proof-of-concept experiments in a field lysimeter showed good agreement of soil-gas samples and water-content measurements compared with conventional techniques, while a successfully performed gas-tracer test demonstrated the feasibility of the PMLS to determine soil-gas diffusion coefficients in situ. A field application of the PMLS to quantify oxidation of atmospheric CH4 in a field lysimeter and in the forefield of a receding glacier yielded activity coefficients and soil-atmosphere fluxes well in agreement with previous studies. With numerous options for customization, the presented tool extends the methodological choices to investigate soil-gas transport in the vadose zone.

  3. A Solution to Modeling Multilevel Confirmatory Factor Analysis with Data Obtained from Complex Survey Sampling to Avoid Conflated Parameter Estimates

    Directory of Open Access Journals (Sweden)

    Jiun-Yu Wu

    2017-09-01

    Full Text Available The issue of equality in the between-and within-level structures in Multilevel Confirmatory Factor Analysis (MCFA models has been influential for obtaining unbiased parameter estimates and statistical inferences. A commonly seen condition is the inequality of factor loadings under equal level-varying structures. With mathematical investigation and Monte Carlo simulation, this study compared the robustness of five statistical models including two model-based (a true and a mis-specified models, one design-based, and two maximum models (two models where the full rank of variance-covariance matrix is estimated in between level and within level, respectively in analyzing complex survey measurement data with level-varying factor loadings. The empirical data of 120 3rd graders' (from 40 classrooms perceived Harter competence scale were modeled using MCFA and the parameter estimates were used as true parameters to perform the Monte Carlo simulation study. Results showed maximum models was robust to unequal factor loadings while the design-based and the miss-specified model-based approaches produced conflated results and spurious statistical inferences. We recommend the use of maximum models if researchers have limited information about the pattern of factor loadings and measurement structures. Measurement models are key components of Structural Equation Modeling (SEM; therefore, the findings can be generalized to multilevel SEM and CFA models. Mplus codes are provided for maximum models and other analytical models.

  4. Causal inference in survival analysis using pseudo-observations.

    Science.gov (United States)

    Andersen, Per K; Syriopoulou, Elisavet; Parner, Erik T

    2017-07-30

    Causal inference for non-censored response variables, such as binary or quantitative outcomes, is often based on either (1) direct standardization ('G-formula') or (2) inverse probability of treatment assignment weights ('propensity score'). To do causal inference in survival analysis, one needs to address right-censoring, and often, special techniques are required for that purpose. We will show how censoring can be dealt with 'once and for all' by means of so-called pseudo-observations when doing causal inference in survival analysis. The pseudo-observations can be used as a replacement of the outcomes without censoring when applying 'standard' causal inference methods, such as (1) or (2) earlier. We study this idea for estimating the average causal effect of a binary treatment on the survival probability, the restricted mean lifetime, and the cumulative incidence in a competing risks situation. The methods will be illustrated in a small simulation study and via a study of patients with acute myeloid leukemia who received either myeloablative or non-myeloablative conditioning before allogeneic hematopoetic cell transplantation. We will estimate the average causal effect of the conditioning regime on outcomes such as the 3-year overall survival probability and the 3-year risk of chronic graft-versus-host disease. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Comprehensive multilevel in vivo and in vitro analysis of heart rate fluctuations in mice by ECG telemetry and electrophysiology.

    Science.gov (United States)

    Fenske, Stefanie; Pröbstle, Rasmus; Auer, Franziska; Hassan, Sami; Marks, Vanessa; Pauza, Danius H; Biel, Martin; Wahl-Schott, Christian

    2016-01-01

    The normal heartbeat slightly fluctuates around a mean value; this phenomenon is called physiological heart rate variability (HRV). It is well known that altered HRV is a risk factor for sudden cardiac death. The availability of genetic mouse models makes it possible to experimentally dissect the mechanism of pathological changes in HRV and its relation to sudden cardiac death. Here we provide a protocol that allows for a comprehensive multilevel analysis of heart rate (HR) fluctuations. The protocol comprises a set of techniques that include in vivo telemetry and in vitro electrophysiology of intact sinoatrial network preparations or isolated single sinoatrial node (SAN) cells. In vitro preparations can be completed within a few hours, with data acquisition within 1 d. In vivo telemetric ECG requires 1 h for surgery and several weeks for data acquisition and analysis. This protocol is of interest to researchers investigating cardiovascular physiology and the pathophysiology of sudden cardiac death.

  6. A multi-level qualitative analysis of Telehomecare in Ontario: challenges and opportunities.

    Science.gov (United States)

    Hunting, Gemma; Shahid, Nida; Sahakyan, Yeva; Fan, Iris; Moneypenny, Crystal R; Stanimirovic, Aleksandra; North, Taylor; Petrosyan, Yelena; Krahn, Murray D; Rac, Valeria E

    2015-12-09

    Despite research demonstrating the potential effectiveness of Telehomecare for people with Chronic Obstructive Pulmonary Disease and Heart Failure, broad-scale comprehensive evaluations are lacking. This article discusses the qualitative component of a mixed-method program evaluation of Telehomecare in Ontario, Canada. The objective of the qualitative component was to explore the multi-level factors and processes which facilitate or impede the implementation and adoption of the program across three regions where it was first implemented. The study employs a multi-level framework as a conceptual guide to explore the facilitators and barriers to Telehomecare implementation and adoption across five levels: technology, patients, providers, organizations, and structures. In-depth semi-structured interviews and ethnographic observations with program stakeholders, as well as a Telehomecare document review were used to elicit key themes. Study participants (n = 89) included patients and/or informal caregivers (n = 39), health care providers (n = 23), technicians (n = 2), administrators (n = 12), and decision makers (n = 13) across three different Local Health Integration Networks in Ontario. Key facilitators to Telehomecare implementation and adoption at each level of the multi-level framework included: user-friendliness of Telehomecare technology, patient motivation to participate in the program, support for Telehomecare providers, the integration of Telehomecare into broader health service provision, and comprehensive program evaluation. Key barriers included: access-related issues to using the technology, patient language (if not English or French), Telehomecare provider time limitations, gaps in health care provision for patients, and structural barriers to patient participation related to geography and social location. Though Telehomecare has the potential to positively impact patient lives and strengthen models of health care provision, a

  7. Data Model Approach And Markov Chain Based Analysis Of Multi-Level Queue Scheduling

    Directory of Open Access Journals (Sweden)

    Diwakar Shukla

    2010-01-01

    Full Text Available There are many CPU scheduling algorithms inliterature like FIFO, Round Robin, Shortest-Job-First and so on.The Multilevel-Queue-Scheduling is superior to these due to itsbetter management of a variety of processes. In this paper, aMarkov chain model is used for a general setup of Multilevelqueue-scheduling and the scheduler is assumed to performrandom movement on queue over the quantum of time.Performance of scheduling is examined through a rowdependent data model. It is found that with increasing value of αand d, the chance of system going over the waiting state reduces.At some of the interesting combinations of α and d, it diminishesto zero, thereby, provides us some clue regarding better choice ofqueues over others for high priority jobs. It is found that ifqueue priorities are added in the scheduling intelligently thenbetter performance could be obtained. Data model helpschoosing appropriate preferences.

  8. PARALLEL ADAPTIVE MULTILEVEL SAMPLING ALGORITHMS FOR THE BAYESIAN ANALYSIS OF MATHEMATICAL MODELS

    KAUST Repository

    Prudencio, Ernesto; Cheung, Sai Hung

    2012-01-01

    In recent years, Bayesian model updating techniques based on measured data have been applied to many engineering and applied science problems. At the same time, parallel computational platforms are becoming increasingly more powerful and are being used more frequently by the engineering and scientific communities. Bayesian techniques usually require the evaluation of multi-dimensional integrals related to the posterior probability density function (PDF) of uncertain model parameters. The fact that such integrals cannot be computed analytically motivates the research of stochastic simulation methods for sampling posterior PDFs. One such algorithm is the adaptive multilevel stochastic simulation algorithm (AMSSA). In this paper we discuss the parallelization of AMSSA, formulating the necessary load balancing step as a binary integer programming problem. We present a variety of results showing the effectiveness of load balancing on the overall performance of AMSSA in a parallel computational environment.

  9. Three frameworks to predict physical activity behavior in middle school inclusive physical education: a multilevel analysis.

    Science.gov (United States)

    Jin, Jooyeon; Yun, Joonkoo

    2013-07-01

    The purpose of this study was to examine three frameworks, (a) process-product, (b) student mediation, and (c) classroom ecology, to understand physical activity (PA) behavior of adolescents with and without disabilities in middle school inclusive physical education (PE). A total of 13 physical educators teaching inclusive PE and their 503 students, including 22 students with different disabilities, participated in this study. A series of multilevel regression analyses indicated that physical educators' teaching behavior and students' implementation intentions play important roles in promoting the students' PA in middle school inclusive PE settings when gender, disability, lesson content, instructional model, and class location are considered simultaneously. The findings suggest that the ecological framework should be considered to effectively promote PA of adolescents with and without disabilities in middle school PE classes.

  10. Reciprocity and depressive symptoms in Belgian workers: a cross-sectional multilevel analysis.

    Science.gov (United States)

    De Clercq, Bart; Clays, Els; Janssens, Heidi; De Bacquer, Dirk; Casini, Annalisa; Kittel, France; Braeckman, Lutgart

    2013-07-01

    This study examines the multidimensional association between reciprocity at work and depressive symptoms. Data from the Belgian BELSTRESS survey (32 companies; N = 24,402) were analyzed. Multilevel statistical procedures were used to account for company-level associations while controlling for individual-level associations. Different dimensions of individual reciprocity were negatively associated with depressive symptoms. On the company level, only vertical emotional reciprocity was negatively associated (β = -4.660; SE = 1.117) independently from individual reciprocity (β = -0.557; SE = 0.042). Complex interactions were found such that workplace reciprocity (1) may not uniformly benefit individuals and (2) related differently to depressive symptoms, depending on occupational group. This study extends the existing literature with evidence on the multidimensional, contextual, and cross-level interaction associations of reciprocity as a key aspect of social capital on depressive symptoms.

  11. Survival analysis in hematologic malignancies: recommendations for clinicians

    Science.gov (United States)

    Delgado, Julio; Pereira, Arturo; Villamor, Neus; López-Guillermo, Armando; Rozman, Ciril

    2014-01-01

    The widespread availability of statistical packages has undoubtedly helped hematologists worldwide in the analysis of their data, but has also led to the inappropriate use of statistical methods. In this article, we review some basic concepts of survival analysis and also make recommendations about how and when to perform each particular test using SPSS, Stata and R. In particular, we describe a simple way of defining cut-off points for continuous variables and the appropriate and inappropriate uses of the Kaplan-Meier method and Cox proportional hazard regression models. We also provide practical advice on how to check the proportional hazards assumption and briefly review the role of relative survival and multiple imputation. PMID:25176982

  12. Stages of syphilis in South China – a multilevel analysis of early diagnosis

    Directory of Open Access Journals (Sweden)

    Ngai Sze Wong

    2017-01-01

    Full Text Available Abstract Background Early diagnosis of syphilis and timely treatment can effectively reduce ongoing syphilis transmission and morbidity. We examined the factors associated with the early diagnosis of syphilis to inform syphilis screening strategic planning. Methods In an observational study, we analyzed reported syphilis cases in Guangdong Province, China (from 2014 to mid-2015 accessed from the national case-based surveillance system. We categorized primary and secondary syphilis cases as early diagnosis and categorized latent and tertiary syphilis as delayed diagnosis. Univariate analyses and multivariable logistic regressions were performed to identify the factors associated with early diagnosis. We also examined the factors associated with early diagnosis at the individual and city levels in multilevel logistic regression models with cases nested by city (n = 21, adjusted for age at diagnosis and gender. Results Among 83,944 diagnosed syphilis cases, 22% were early diagnoses. The city-level early diagnosis rate ranged from 7 to 46%, consistent with substantial geographic variation as shown in the multilevel model. Early diagnosis was associated with cases presenting to specialist clinics for screening, being male and attaining higher education level. Cases received syphilis testing in institutions and hospitals, and diagnosed in hospitals were less likely to be in early diagnosis. At the city-level, cases living in a city equipped with more hospitals per capita were less likely to be early diagnosis. Conclusions To enhance early diagnosis of syphilis, city-specific syphilis screening strategies with a mix of passive and client/provider-initiated testing might be a useful approach.

  13. Social capital and social inequality in adolescents' health in 601 Flemish communities: a multilevel analysis.

    Science.gov (United States)

    De Clercq, B; Vyncke, V; Hublet, A; Elgar, F J; Ravens-Sieberer, U; Currie, C; Hooghe, M; Ieven, A; Maes, L

    2012-01-01

    Although it is widely acknowledged that community social capital plays an important role in young people's health, there is limited evidence on the effect of community social capital on the social gradient in child and adolescent health. Using data from the 2005-2006 Flemish (Belgium) Health Behavior among School-aged Children survey (601 communities, n = 10,915), this study investigated whether community social capital is an independent determinant of adolescents' perceived health and well-being after taking account of individual compositional characteristics (e.g. the gender composition within a certain community). Multilevel statistical procedures were used to estimate neighborhood effects while controlling for individual level effects. Results show that individual level factors (such as family affluence and individual social capital) are positively related to perceived health and well-being and that community level social capital predicted health better than individual social capital. A significant complex interaction effect was found, such that the social gradient in perceived health and well-being (i.e. the slope of family affluence on health) was flattened in communities with a high level of community social capital. Furthermore it seems that socioeconomic status differences in perceived health and well-being substantially narrow in communities where a certain (average) level of community social capital is present. This should mean that individuals living in communities with a low level of community social capital especially benefit from an increase in community social capital. The paper substantiates the need to connect individual health to their meso socioeconomic context and this being intrinsically within a multilevel framework. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Loading Analysis of Modular Multi-level Converter for Offshore High-voltage DC Application under Various Grid Faults

    DEFF Research Database (Denmark)

    Liu, Hui; Ma, Ke; Loh, Poh Chiang

    2016-01-01

    challenges but may also result in overstressed components for the modular multi-level converter. However, the thermal loading of the modular multi-level converter under various grid faults has not yet been clarified. In this article, the power loss and thermal performance of the modular multi-level converter...... low-voltage ride-through strongly depend on the types and severity values of grid voltage dips. The thermal distribution among the three phases of the modular multi-level converter may be quite uneven, and some devices are much more stressed than the normal operating condition, which may...

  15. Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis

    Directory of Open Access Journals (Sweden)

    Jahnavi Daru, MBBS

    2018-05-01

    Full Text Available Summary: Background: Anaemia affects as many as half of all pregnant women in low-income and middle-income countries, but the burden of disease and associated maternal mortality are not robustly quantified. We aimed to assess the association between severe anaemia and maternal death with data from the WHO Multicountry Survey on maternal and newborn health. Methods: We used multilevel and propensity score regression analyses to establish the relation between severe anaemia and maternal death in 359 health facilities in 29 countries across Latin America, Africa, the Western Pacific, eastern Mediterranean, and southeast Asia. Severe anaemia was defined as antenatal or postnatal haemoglobin concentrations of less than 70 g/L in a blood sample obtained before death. Maternal death was defined as death any time after admission until the seventh day post partum or discharge. In regression analyses, we adjusted for post-partum haemorrhage, general anaesthesia, admission to intensive care, sepsis, pre-eclampsia or eclampsia, thrombocytopenia, shock, massive transfusion, severe oliguria, failure to form clots, and severe acidosis as confounding variables. These variables were used to develop the propensity score. Findings: 312 281 women admitted in labour or with ectopic pregnancies were included in the adjusted multilevel logistic analysis, and 12 470 were included in the propensity score regression analysis. The adjusted odds ratio for maternal death in women with severe anaemia compared with those without severe anaemia was 2·36 (95% CI 1·60–3·48. In the propensity score analysis, severe anaemia was also associated with maternal death (adjusted odds ratio 1·86 [95% CI 1·39–2·49]. Interpretation: Prevention and treatment of anaemia during pregnancy and post partum should remain a global public health and research priority. Funding: Barts and the London Charity.

  16. A Multilevel Analysis of the Relationship Between Cell Sharing, Staff-Prisoner Relationships, and Prisoners' Perceptions of Prison Quality.

    Science.gov (United States)

    Molleman, Toon; van Ginneken, Esther F J C

    2015-09-01

    Prisons worldwide operate under crowded conditions, in which prisoners are forced to share a cell. Few studies have looked at the relationship between cell sharing and the quality of prison life in Europe. This study aims to fill this gap with a multilevel analysis on the link between cell sharing and quality of prison life, using results from a Dutch prisoner survey. Findings show that cell sharing is associated with lower perceived prison quality, which is partially mediated by reduced quality of staff-prisoner relationships. Cell sharing thus undermines the Dutch penological philosophy, which considers staff-prisoner relationships to be at the heart of prisoner treatment and rehabilitation. It is recommended that prisoners are held in single rather than double cells. © The Author(s) 2014.

  17. Approaches to learning as predictors of academic achievement: Results from a large scale, multi-level analysis

    DEFF Research Database (Denmark)

    Herrmann, Kim Jesper; McCune, Velda; Bager-Elsborg, Anna

    2017-01-01

    The relationships between university students’ academic achievement and their approaches to learning and studying continuously attract scholarly attention. We report the results of an analysis in which multilevel linear modelling was used to analyse data from 3,626 Danish university students....... Controlling for the effects of age, gender, and progression, we found that the students’ end-of-semester grade point averages were related negatively to a surface approach and positively to organised effort. Interestingly, the effect of the surface approach on academic achievement varied across programmes....... While there has been considerable interest in the ways in which academic programmes shape learning and teaching, the effects of these contexts on the relationship between approaches to learning and academic outcomes is under-researched. The results are discussed in relation to findings from recent meta...

  18. A cross-sectional study of workplace social capital and blood pressure: a multilevel analysis at Japanese manufacturing companies.

    Science.gov (United States)

    Fujino, Yoshihisa; Kubo, Tatsuhiko; Kunimoto, Masamizu; Tabata, Hidetoshi; Tsuchiya, Takuto; Kadowaki, Koji; Nakamura, Takehiro; Oyama, Ichiro

    2013-01-01

    We examined the contextual effect of workplace social capital on systolic blood pressure (SBP). Cross-sectional. A conglomerate from 58 workplaces in Japan. Of the 5844 workers at a Japanese conglomerate from 58 workplaces, 5368 were recruited. Individuals who received drugs for hypertension (n=531) and who lacked information on any variable (n=167) were excluded from the analyses, leaving 4735 individuals (3281 men and 1454 women) for inclusion. Systolic blood pressure. The contextual effect of workplace social capital on SBP was examined using a multilevel regression analysis with a random intercept. Coworker support had a contextual effect at the workplace level (coefficient=-1.97, p=0.043), while a lack of trust for coworkers (coefficient=0.27, p=0.039) and lack of helpfulness from coworkers were associated with SBP (coefficient=0.28, p=0.002). The present study suggested that social capital at the workplace level has beneficial effects on SBP.

  19. Do places matter? A multi-level analysis of regional variations in health-related behaviour in Britain.

    Science.gov (United States)

    Duncan, C; Jones, K; Moon, G

    1993-09-01

    A number of commentators have argued that there is a distinctive geography of health-related behaviour. Behaviour has to be understood not only in terms of individual characteristics, but also in relation to local cultures. Places matter, and the context in which behaviour takes place is crucial for understanding and policy. Previous empirical research has been unable to operationalize these ideas and take simultaneous account of both individual compositional and aggregate contextual factors. The present paper addresses this shortcoming through a multi-level analysis of smoking and drinking behaviours recorded in a large-scale national survey. It suggests that place, expressed as regional differences, may be less important than previously implied.

  20. The Association between Overweight and School Policies on Physical Activity: A Multilevel Analysis among Elementary School Youth in the PLAY-On Study

    Science.gov (United States)

    Leatherdale, Scott T.

    2010-01-01

    The objective is to examine school-level program and policy characteristics and student-level behavioural characteristics associated with being overweight. Multilevel logistic regression analysis were used to examine the school- and student-level characteristics associated with the odds of a student being overweight among 1264 Grade 5-8 students…

  1. A Multilevel Analysis of the Compositional and Contextual Association of Social Capital and Subjective Well-Being in Seoul, South Korea

    Science.gov (United States)

    Han, Sehee; Kim, Heaseung; Lee, Hee-Sun

    2013-01-01

    The purpose of this study is to examine the association between social capital and subjective well-being (life satisfaction) by using multilevel analysis considering both individual and area-level social capital while adjusting for various control variables at multiple-levels in Seoul, South Korea. The data was from the 2010 (Wave 2) Seoul Welfare…

  2. The Quadratic Relationship between Socioeconomic Status and Learning Performance in China by Multilevel Analysis: Implications for Policies to Foster Education Equity

    Science.gov (United States)

    Zhao, Ningning; Valcke, Martin; Desoete, Annemie; Verhaeghe, JeanPierre

    2012-01-01

    The purpose of the present study is to explore the relationship between family socioeconomic status and mathematics performance on the base of a multi-level analysis involving a large sample of Chinese primary school students. A weak relationship is found between socioeconomic status and performance in the Chinese context. The relationship does…

  3. Multilevel Latent Class Analysis for Large-Scale Educational Assessment Data: Exploring the Relation between the Curriculum and Students' Mathematical Strategies

    Science.gov (United States)

    Fagginger Auer, Marije F.; Hickendorff, Marian; Van Putten, Cornelis M.; Béguin, Anton A.; Heiser, Willem J.

    2016-01-01

    A first application of multilevel latent class analysis (MLCA) to educational large-scale assessment data is demonstrated. This statistical technique addresses several of the challenges that assessment data offers. Importantly, MLCA allows modeling of the often ignored teacher effects and of the joint influence of teacher and student variables.…

  4. Timely immunization completion among children in Vietnam from 2000 to 2011: a multilevel analysis of individual and contextual factors

    Directory of Open Access Journals (Sweden)

    Dao Thi Minh An

    2016-02-01

    Full Text Available Background: Since the beginning of 2014, there have been nearly 6,000 confirmed measles cases in northern Vietnam. Of these, more than 86% had neither been immunized nor was their vaccination status confirmed. Objective: To establish the likelihood that children under five in Vietnam had ‘timely immunization completion’ (2000–2011 and identify factors that account for variations in timely immunization completion. Design: Secondary data from the Multiple Indicator Cluster Survey (MICS, which sampled women aged 15–49 from the 1999 Vietnamese Population and Housing Census frame, were analyzed. Multilevel analysis using Poisson regression was undertaken. Results: Proportions of children under five who had timely immunization completion were low, especially for HBV dose 2 and HBV dose 3, which decreased between 2000 and 2011. Among seven vaccines used in the National Expanded Program of Immunization (EPI in 2000, 2006, and 2011, measles dose 1 had the highest timely immunization completion at 65.3%, 66.7%, and 73.6%, respectively, and hepatitis B dose 1 had the lowest at 17.5%, 19.3%, and 45.5%, respectively. Timely immunization completion was less common among children whose mothers had relatively less household wealth, were from ethnic minorities, lived in rural areas, and had less education. At the community level, the child's region of residence was the main predictor of timely immunization completion, and the availability of hospital delivery and community prenatal care in the local community were also determinants. Conclusion: The EPI should include ‘timely immunization completion’ as a quality indicator. There should also be greater focus and targeting in rural areas, and among women who have relatively low education, belong to minority groups, and have less household wealth. Further research on this topic using multilevel analysis is needed to better understand how these factors interact.

  5. Factors behind the success story of under-five stunting in Peru: a district ecological multilevel analysis.

    Science.gov (United States)

    Huicho, Luis; Huayanay-Espinoza, Carlos A; Herrera-Perez, Eder; Segura, Eddy R; Niño de Guzman, Jessica; Rivera-Ch, María; Barros, Aluisio J D

    2017-01-19

    Stunting prevalence in children less than 5 years has remained stagnated in Peru from 1992 to 2007, with a rapid reduction thereafter. We aimed to assess the role of different predictors on stunting reduction over time and across departments, from 2000 to 2012. We used various secondary data sources to describe time trends of stunting and of possible predictors that included distal to proximal determinants. We determined a ranking of departments by annual change of stunting and of different predictors. To account for variation over time and across departments, we used an ecological hierarchical approach based on a multilevel mixed-effects regression model, considering stunting as the outcome. Our unit of analysis was one department-year. Stunting followed a decreasing trend in all departments, with differing slopes. The reduction pace was higher from 2007-2008 onwards. The departments with the highest annual stunting reduction were Cusco (-2.31%), Amazonas (-1.57%), Puno (-1.54%), Huanuco (-1.52%), and Ancash (-1.44). Those with the lowest reduction were Ica (-0.67%), Ucayali (-0.64%), Tumbes (-0.45%), Lima (-0.37%), and Tacna (-0.31%). Amazon and Andean departments, with the highest baseline poverty rates and concentrating the highest rural populations, showed the highest stunting reduction. In the multilevel analysis, when accounting for confounding, social determinants seemed to be the most important factors influencing annual stunting reduction, with significant variation between departments. Stunting reduction may be explained by the adoption of anti-poverty policies and sustained implementation of equitable crosscutting interventions, with focus on poorest areas. Inclusion of quality indicators for reproductive, maternal, neonatal and child health interventions may enable further analyses to show the influence of these factors. After a long stagnation period, Peru reduced dramatically its national and departmental stunting prevalence, thanks to a combination

  6. Individual and contextual factors associated with community health workers' performance in Nyanza Province, Kenya: a multilevel analysis.

    Science.gov (United States)

    Kawakatsu, Yoshito; Sugishita, Tomohiko; Tsutsui, Junya; Oruenjo, Kennedy; Wakhule, Stephen; Kibosia, Kennedy; Were, Eric; Honda, Sumihisa

    2015-10-01

    Several African and South Asian countries are currently investing in new cadres of community health workers (CHWs) as a major part of strategies aimed at reaching the Millennium Development Goals. However, one review concluded that community health workers did not consistently provide services likely to have substantial effects on health and that quality was usually poor. The objective of this research was to assess the CHWs' performance in Western Kenya and describe determinants of that performance using a multilevel analysis of the two levels, individual and supervisor/community. This study conducted three surveys between August and September 2011 in Nyanza Province, Kenya. The participants of the three surveys were all 1,788 active CHWs, all their supervisors, and 2,560 randomly selected mothers who had children aged 12 to 23 months. CHW performance was generated by three indicators: reporting rate, health knowledge and household coverage. Multilevel analysis was performed to describe the determinants of that performance. The significant factors associated with the CHWs' performance were their marital status, educational level, the size of their household, their work experience, personal sanitation practice, number of supervisions received and the interaction between their supervisors' better health knowledge and the number of supervisions. A high quality of routine supervisions is one of the key interventions in sustaining a CHW's performance. In addition, decreasing the dropout rate of CHWs is important both for sustaining their performance and for avoiding the additional cost of replacing them. As for the selection criteria of new CHWs, good educational status, availability of supporters for household chores and good sanitation practices are all important in selecting CHWs who can maintain their high performance level.

  7. Evaluating disease management program effectiveness: an introduction to survival analysis.

    Science.gov (United States)

    Linden, Ariel; Adams, John L; Roberts, Nancy

    2004-01-01

    Currently, the most widely used method in the disease management industry for evaluating program effectiveness is the "total population approach." This model is a pretest-posttest design, with the most basic limitation being that without a control group, there may be sources of bias and/or competing extraneous confounding factors that offer plausible rationale explaining the change from baseline. Survival analysis allows for the inclusion of data from censored cases, those subjects who either "survived" the program without experiencing the event (e.g., achievement of target clinical levels, hospitalization) or left the program prematurely, due to disenrollement from the health plan or program, or were lost to follow-up. Additionally, independent variables may be included in the model to help explain the variability in the outcome measure. In order to maximize the potential of this statistical method, validity of the model and research design must be assured. This paper reviews survival analysis as an alternative, and more appropriate, approach to evaluating DM program effectiveness than the current total population approach.

  8. Multivariate Survival Mixed Models for Genetic Analysis of Longevity Traits

    DEFF Research Database (Denmark)

    Pimentel Maia, Rafael; Madsen, Per; Labouriau, Rodrigo

    2014-01-01

    A class of multivariate mixed survival models for continuous and discrete time with a complex covariance structure is introduced in a context of quantitative genetic applications. The methods introduced can be used in many applications in quantitative genetics although the discussion presented co...... applications. The methods presented are implemented in such a way that large and complex quantitative genetic data can be analyzed......A class of multivariate mixed survival models for continuous and discrete time with a complex covariance structure is introduced in a context of quantitative genetic applications. The methods introduced can be used in many applications in quantitative genetics although the discussion presented...... concentrates on longevity studies. The framework presented allows to combine models based on continuous time with models based on discrete time in a joint analysis. The continuous time models are approximations of the frailty model in which the hazard function will be assumed to be piece-wise constant...

  9. Multivariate Survival Mixed Models for Genetic Analysis of Longevity Traits

    DEFF Research Database (Denmark)

    Pimentel Maia, Rafael; Madsen, Per; Labouriau, Rodrigo

    2013-01-01

    A class of multivariate mixed survival models for continuous and discrete time with a complex covariance structure is introduced in a context of quantitative genetic applications. The methods introduced can be used in many applications in quantitative genetics although the discussion presented co...... applications. The methods presented are implemented in such a way that large and complex quantitative genetic data can be analyzed......A class of multivariate mixed survival models for continuous and discrete time with a complex covariance structure is introduced in a context of quantitative genetic applications. The methods introduced can be used in many applications in quantitative genetics although the discussion presented...... concentrates on longevity studies. The framework presented allows to combine models based on continuous time with models based on discrete time in a joint analysis. The continuous time models are approximations of the frailty model in which the hazard function will be assumed to be piece-wise constant...

  10. Civic Participation and Self-rated Health: A Cross-national Multi-level Analysis Using the World Value Survey

    Directory of Open Access Journals (Sweden)

    Saerom Kim

    2015-01-01

    Full Text Available Objectives: Civic participation, that which directly influences important decisions in our personal lives, is considered necessary for developing a society. We hypothesized that civic participation might be related to self-rated health status. Methods: We constructed a multi-level analysis using data from the World Value Survey (44 countries, n=50 859. Results: People who participated in voting and voluntary social activities tended to report better subjective health than those who did not vote or participate in social activities, after controlling for socio-demographic factors at the individual level. A negative association with unconventional political activity and subjective health was found, but this effect disappeared in a subset analysis of only the 18 Organization for Economic Cooperation and Development (OECD countries. Moreover, social participation and unconventional political participation had a statistically significant contextual association with subjective health status, but this relationship was not consistent throughout the analysis. In the analysis of the 44 countries, social participation was of borderline significance, while in the subset analysis of the OECD countries unconventional political participation was a stronger determinant of subjective health. The democratic index was a significant factor in determining self-rated health in both analyses, while public health expenditure was a significant factor in only the subset analysis. Conclusions: Despite the uncertainty of its mechanism, civic participation might be a significant determinant of the health status of a country.

  11. Democracy and self-rated health across 67 countries: A multilevel analysis.

    Science.gov (United States)

    Krueger, Patrick M; Dovel, Kathryn; Denney, Justin T

    2015-10-01

    Existing research has found a positive association between countries' level of democratic governance and the health of their populations, although that research is limited by the use of data from small numbers of high-income countries or aggregate data that do not assess individual-level health outcomes. We extend prior research by using multilevel World Health Survey (2002-2004) data on 313,554 individuals in 67 countries, and find that the positive association between democratic governance and self-rated health persists after adjusting for both individual- and country-level confounders. However, the mechanisms linking democracy and self-rated health remain unclear. Individual-level measures of socioeconomic status, and country-level measures of economic inequality and investments in public health and education, do not significantly mediate the association between democratic governance and self-rated health. The persistent association between democratic governance and health suggests that the political organization of societies may be an important upstream determinant of population health. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Episodic and semantic content of memory and imagination: A multilevel analysis.

    Science.gov (United States)

    Devitt, Aleea L; Addis, Donna Rose; Schacter, Daniel L

    2017-10-01

    Autobiographical memories of past events and imaginations of future scenarios comprise both episodic and semantic content. Correlating the amount of "internal" (episodic) and "external" (semantic) details generated when describing autobiographical events can illuminate the relationship between the processes supporting these constructs. Yet previous studies performing such correlations were limited by aggregating data across all events generated by an individual, potentially obscuring the underlying relationship within the events themselves. In the current article, we reanalyzed datasets from eight studies using a multilevel approach, allowing us to explore the relationship between internal and external details within events. We also examined whether this relationship changes with healthy aging. Our reanalyses demonstrated a largely negative relationship between the internal and external details produced when describing autobiographical memories and future imaginations. This negative relationship was stronger and more consistent for older adults and was evident both in direct and indirect measures of semantic content. Moreover, this relationship appears to be specific to episodic tasks, as no relationship was observed for a nonepisodic picture description task. This negative association suggests that people do not generate semantic information indiscriminately, but do so in a compensatory manner, to embellish episodically impoverished events. Our reanalysis further lends support for dissociable processes underpinning episodic and semantic information generation when remembering and imagining autobiographical events.

  13. CMT: a constrained multi-level thresholding approach for ChIP-Seq data analysis.

    Directory of Open Access Journals (Sweden)

    Iman Rezaeian

    Full Text Available Genome-wide profiling of DNA-binding proteins using ChIP-Seq has emerged as an alternative to ChIP-chip methods. ChIP-Seq technology offers many advantages over ChIP-chip arrays, including but not limited to less noise, higher resolution, and more coverage. Several algorithms have been developed to take advantage of these abilities and find enriched regions by analyzing ChIP-Seq data. However, the complexity of analyzing various patterns of ChIP-Seq signals still needs the development of new algorithms. Most current algorithms use various heuristics to detect regions accurately. However, despite how many formulations are available, it is still difficult to accurately determine individual peaks corresponding to each binding event. We developed Constrained Multi-level Thresholding (CMT, an algorithm used to detect enriched regions on ChIP-Seq data. CMT employs a constraint-based module that can target regions within a specific range. We show that CMT has higher accuracy in detecting enriched regions (peaks by objectively assessing its performance relative to other previously proposed peak finders. This is shown by testing three algorithms on the well-known FoxA1 Data set, four transcription factors (with a total of six antibodies for Drosophila melanogaster and the H3K4ac antibody dataset.

  14. Social and individual risk factors for suicide ideation among Chinese children and adolescents: A multilevel analysis.

    Science.gov (United States)

    Tan, Ling; Xia, Tiansheng; Reece, Christy

    2018-04-01

    The objective of this study was to investigate the prevalence and predictors of suicide ideation among primary, middle and high school students. We used multilevel modelling to investigate suicide ideation among 12,733 Chinese children and adolescents aged 9-18 years from wide range of areas across China. Approximately, 32.09% of children and adolescents reported suicide ideation, with females were more likely to report suicide ideation than males (38.09% vs. 29.95%). Our results showed that the risk factors in primary school students were different from middle and high school student groups, whereas significant risk factors for middle and high school students were similar. The city's standard of living as indicated by the Engel coefficient and the city's divorce rate were positively associated with the prevalence of suicide ideation; in contrast, the school's pupil-to-teacher ratio was negatively correlated with elevated suicide ideation. Significant risk factors for suicide ideation included study anxiety, self-accusation tendency, impulsive tendency, terror tendency and physical symptoms. These results have important implications for the prevention of suicide, suggesting that both contextual (city-level) and compositional (individual-level) factors could be important targets for prevention and intervention for children and adolescents at risk of suicide ideation. © 2016 International Union of Psychological Science.

  15. Small groups, contexts, and civic engagement: A multilevel analysis of United States Congregational Life Survey data.

    Science.gov (United States)

    Whitehead, Andrew L; Stroope, Samuel

    2015-07-01

    Prior research suggests that church-goers are more civically engaged than their non-church-going counterparts. Little is known, however, about how the popular phenomenon of small groups factors into this equation. In the present study, we examine relationships between small group participation at individual and congregation levels and civic engagement. Using multilevel modeling and national data on congregations and individuals from the U.S. Congregational Life Study (n=82,044), we find that: (1) individual-level small group involvement is associated with four measures of civic engagement; (2) congregation-level small group participation is associated with both lower and higher civic engagement in the case of two outcomes; and (3) in the case of three civic outcomes, congregation-level small group participation moderates individual-level small group involvement such that small group members' civic activity more closely resembles the lower civic engagement of small group nonparticipants. In the case of one civic outcome, at high levels of overall small group participation, small group members' civic engagement drops below that of small group nonparticipants. Explanations for these findings, including a "crowding out" effect, are examined including their complex implications for debates regarding small groups, religious involvement, and civic engagement. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. A multilevel cross-lagged structural equation analysis for reciprocal relationship between social capital and health.

    Science.gov (United States)

    Yu, Ge; Sessions, John G; Fu, Yu; Wall, Martin

    2015-10-01

    We investigated the reciprocal relationship between individual social capital and perceived mental and physical health in the UK. Using data from the British Household Panel Survey from 1991 to 2008, we fitted cross-lagged structural equation models that include three indicators of social capital vis. social participation, social network, and loneliness. Given that multiple measurement points (level 1) are nested within individuals (level 2), we also applied a multilevel model to allow for residual variation in the outcomes at the occasion and individual levels. Controlling for gender, age, employment status, educational attainment, marital status, household wealth, and region, our analyses suggest that social participation predicts subsequent change in perceived mental health, and vice versa. However, whilst loneliness is found to be significantly related to perceived mental and physical health, reciprocal causality is not found for perceived mental health. Furthermore, we find evidence for reverse effects with both perceived mental and physical health appearing to be the dominant causal factor with respect to the prospective level of social network. Our findings thus shed further light on the importance of social participation and social inclusion in health promotion and aid the development of more effective public health policies in the UK. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Sequence analysis in multilevel models. A study on different sources of patient cues in medical consultations.

    Science.gov (United States)

    Del Piccolo, Lidia; Mazzi, Maria Angela; Dunn, Graham; Sandri, Marco; Zimmermann, Christa

    2007-12-01

    The aims of the study were to explore the importance of macro (patient, physician, consultation) and micro (doctor-patient speech sequences) variables in promoting patient cues (unsolicited new information or expressions of feelings), and to describe the methodological implications related to the study of speech sequences. Patient characteristics, a consultation index of partnership and doctor-patient speech sequences were recorded for 246 primary care consultations in six primary care surgeries in Verona, Italy. Homogeneity and stationarity conditions of speech sequences allowed the creation of a hierarchy of multilevel logit models including micro and macro level variables, with the presence/absence of cues as the dependent variable. We found that emotional distress of the patient increased cues and that cues appeared among other patient expressions and were preceded by physicians' facilitations and handling of emotion. Partnership, in terms of open-ended inquiry, active listening skills and handling of emotion by the physician and active participation by the patient throughout the consultation, reduced cue frequency.

  18. Political Regimes, Political Ideology, and Self-Rated Health in Europe: A Multilevel Analysis

    Science.gov (United States)

    Huijts, Tim; Perkins, Jessica M.; Subramanian, S. V.

    2010-01-01

    Background Studies on political ideology and health have found associations between individual ideology and health as well as between ecological measures of political ideology and health. Individual ideology and aggregate measures such as political regimes, however, were never examined simultaneously. Methodology/Principal Findings Using adjusted logistic multilevel models to analyze data on individuals from 29 European countries and Israel, we found that individual ideology and political regime are independently associated with self-rated health. Individuals with rightwing ideologies report better health than leftwing individuals. Respondents from Eastern Europe and former Soviet republics report poorer health than individuals from social democratic, liberal, Christian conservative, and former Mediterranean dictatorship countries. In contrast to individual ideology and political regimes, country level aggregations of individual ideology are not related to reporting poor health. Conclusions/Significance This study shows that although both individual political ideology and contextual political regime are independently associated with individuals' self-rated health, individual political ideology appears to be more strongly associated with self-rated health than political regime. PMID:20661433

  19. Community Influences on Married Women's Safer Sex Negotiation Attitudes in Bangladesh: A Multilevel Analysis.

    Science.gov (United States)

    Jesmin, Syeda S; Cready, Cynthia M

    2016-02-01

    The influence of disadvantaged or deprived community on individuals' health risk-behaviors is increasingly being documented in a growing body of literature. However, little is known about the effects of community characteristics on women's sexual attitudes and behaviors. To examine community effects on married women's safer sex negotiation attitudes, we analyzed cross-sectional data from the 2011 Bangladesh Demographic and Health Surveys on a sample of 15,134 married women in 600 communities. We estimated two multilevel logistic regression models. Model 1, which included only individual-level variables, showed that women's autonomy/empowerment, age, and HIV knowledge had significant associations with their safer sex negotiation attitudes. We did not find any socioeconomic status gradient in safer sex negotiation attitudes at the individual level. Adding community-level variables in Model 2 significantly improved the fit of the model. Strikingly, we found that higher community-level poverty was associated with greater positive safer sex negotiation attitudes. Prevailing gender norms and overall women's empowerment in the community also had significant effects. While research on community influences calls for focusing on disadvantaged communities, our research highlights the importance of not underestimating the challenges that married women in economically privileged communities may face in negotiating safer sex. To have sufficient and equitable impact on married women's sexual and reproductive health, sexual and reproductive health promotion policies and programs need to be directed to women in wealthier communities as well.

  20. Geographic and Individual Differences in Healthcare Access for U.S. Transgender Adults: A Multilevel Analysis.

    Science.gov (United States)

    White Hughto, Jaclyn M; Murchison, Gabriel R; Clark, Kirsty; Pachankis, John E; Reisner, Sari L

    2016-12-01

    To identify geographic and individual-level factors associated with healthcare access among transgender people in the United States. Multilevel analyses were conducted to investigate lifetime healthcare refusal using national data from 5831 U.S. transgender adults. Hierarchical generalized linear models examined associations between individual (age, gender, race, income, insurance, and healthcare avoidance) and state-level factors (percent voting Republican, percent same-sex couple households, income inequality, and transgender protective laws) and lifetime refusal of care. Results show that individual-level factors (being older; trans feminine; Native American, multiracial, or other racial/ethnic minority; having low income; and avoiding care due to discrimination) are positively associated with care refusal (all P-values transgender residents at increased odds of experiencing care refusal, relative to other regions of the United States. When adjusting for state-level factors, the percentage of the state population voting Republican was positively associated with care refusal among the transgender adults sampled (P Transgender adults surveyed reported differential access to healthcare by geographic region. Identifying geographic and individual-level factors associated with healthcare barriers allows for the development of targeted educational and policy interventions to improve healthcare access for transgender people most in need of services.

  1. Geographic and Individual Differences in Healthcare Access for U.S. Transgender Adults: A Multilevel Analysis

    Science.gov (United States)

    Murchison, Gabriel R.; Clark, Kirsty; Pachankis, John E.; Reisner, Sari L.

    2016-01-01

    Abstract Purpose: To identify geographic and individual-level factors associated with healthcare access among transgender people in the United States. Methods: Multilevel analyses were conducted to investigate lifetime healthcare refusal using national data from 5831 U.S. transgender adults. Hierarchical generalized linear models examined associations between individual (age, gender, race, income, insurance, and healthcare avoidance) and state-level factors (percent voting Republican, percent same-sex couple households, income inequality, and transgender protective laws) and lifetime refusal of care. Results: Results show that individual-level factors (being older; trans feminine; Native American, multiracial, or other racial/ethnic minority; having low income; and avoiding care due to discrimination) are positively associated with care refusal (all P-values care refusal, relative to other regions of the United States. When adjusting for state-level factors, the percentage of the state population voting Republican was positively associated with care refusal among the transgender adults sampled (P < 0.01). Conclusion: Transgender adults surveyed reported differential access to healthcare by geographic region. Identifying geographic and individual-level factors associated with healthcare barriers allows for the development of targeted educational and policy interventions to improve healthcare access for transgender people most in need of services. PMID:27636030

  2. Contextual and individual determinants of periodontal disease: Multilevel analysis based on Andersen's model.

    Science.gov (United States)

    Valente, Maria I B; Vettore, Mario V

    2018-04-01

    To investigate the relationship of contextual and individual factors with periodontal disease in dentate adults and older people using the Andersen's behavioural model. Secondary individual data from 6011 adults and 2369 older people from the Brazilian Oral Health Survey (2010) were combined with contextual data for 27 cities. Attachment loss (AL) categories for each sextant were coded and summed to obtain the periodontal disease measure. The association of predisposing, enabling and need characteristics at city and individual level with periodontal disease was assessed using an adapted version of the Andersen's behavioural model. Multilevel Poisson regression was used to estimate rate ratios (RR) and 95% CIs. Periodontal disease was associated with contextual predisposing (RR 0.93; 95% CI = 0.87-0.99) and enabling factors (RR 0.99; 95% CI = 0.98-0.99) in adults. Contextual predisposing was also associated with periodontal disease in older people (RR 0.82; 95% CI = 0.73-0.92). Individual predisposing (age, sex and schooling) and need characteristics (perceived treatment need) were common predictors of periodontal disease in adults and older people. Periodontal disease was also associated with behaviours in the latter age group. Contextual predisposing factors and individual characteristics influenced periodontal disease experience in adults and older people. Contextual enabling factors were also meaningful determinants of periodontal disease in the former age group. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Income inequality and high blood pressure in Colombia: a multilevel analysis.

    Science.gov (United States)

    Lucumi, Diego I; Schulz, Amy J; Roux, Ana V Diez; Grogan-Kaylor, Andrew

    2017-11-21

    The objective of this research was to examine the association between income inequality and high blood pressure in Colombia. Using a nationally representative Colombian sample of adults, and data from departments and municipalities, we fit sex-stratified linear and logistic multilevel models with blood pressure as a continuous and binary variable, respectively. In adjusted models, women living in departments with the highest quintile of income inequality in 1997 had higher systolic blood pressure than their counterparts living in the lowest quintile of income inequality (mean difference 4.42mmHg; 95%CI: 1.46, 7.39). Women living in departments that were at the fourth and fifth quintile of income inequality in 1994 were more likely to have hypertension than those living in departments at the first quintile in the same year (OR: 1.56 and 1.48, respectively). For men, no associations of income inequality with either systolic blood pressure or hypertension were observed. Our findings are consistent with the hypothesis that income inequality is associated with increased risk of high blood pressure for women. Future studies to analyze pathways linking income inequality to high blood pressure in Colombia are needed.

  4. Contextual socioeconomic determinants of cardiovascular risk factors in rural south-west China: a multilevel analysis

    Directory of Open Access Journals (Sweden)

    Geater Alan

    2007-05-01

    Full Text Available Abstract Background We examined independent influences of contextual variables on cardiovascular risk factors in Shilin county, Yunnan province, South-west China. Methods Three villages were selected from each of the ten townships based on probability proportional to size. In each selected village, 200 individuals aged ≥ 45 years were chosen based on simple random sampling method. From 6006 individuals, information on demographic characteristics, smoking and drinking status was obtained by interview. Blood pressure, height, weight, and waist and hip girth were measured. Fasting blood sugar was measured in a 10-percent subsample. Contextual data were from official reports. Multi-level regression modelling with adjustment for individual and contextual variables was used. Results Contextual variables associated with CVD risk factors included: remoteness of village with higher blood pressure and fasting blood sugar, high proportion of Yi minority with drinking, high literacy rate with a lower rate of smoking and a lower mean waist-hip ratio, and high average income with lower systolic blood pressure and body mass index (BMI but higher FBS. Conclusion While contextual SES is associated with a few CVD risk factors, villages with high level of income are worse off in fasting blood sugar. Strategies of economic development should be reviewed to avoid adverse effects on health.

  5. The effects of community factors on school participation in Turkey: A multilevel analysis

    Science.gov (United States)

    Gumus, Sedat

    2014-05-01

    Turkey, like many developing countries, is facing considerable problems in terms of low school attendance rates, late enrolment and early dropout of girls in particular. Numerous studies have already been conducted, both in Turkey and elsewhere, to determine the factors affecting school enrolment of boys and girls. Existing studies in Turkey, however, have focused extensively on the association between household-level factors and school participation, ignoring the role of the broader environment in which children live. Using a recent, large-scale and nationally representative data set, this paper investigates school participation at both primary and secondary levels in Turkey, giving specific attention to community- level factors. In taking into account socioeconomic context variables using the multilevel modelling method, this study contributes significantly to current school participation literature in Turkey. The author's findings highlight the importance of community/context factors in explaining low school enrolment in Turkey. The results of the study can help policy makers develop a systematic understanding of the relationship between socioeconomic context and school participation, and enable them to make more appropriate decisions for improving school participation across the country.

  6. A Multilevel, Longitudinal Analysis of Middle School Math and Language Achievement

    Directory of Open Access Journals (Sweden)

    Keith Zvoch

    2003-07-01

    Full Text Available The performance of schools in a large urban school district was examined using achievement data from a longitudinally matched cohort of middle school students. Schools were evaluated in terms of the mean achievement and mean growth of students in mathematics and language arts. Application of multilevel, longitudinal models to student achievement data revealed that 1 school performance varied across both outcome measures in both subject areas, 2 significant proportions of variation were associated with school-to-school differences in performance, 3 evaluations of school performance differed depending on whether school mean achievement or school mean growth in achievement was examined, and 4 school mean achievement was a weak predictor of school mean growth. These results suggest that assessments of school performance depend on choices of how data are modeled and analyzed. In particular, the present study indicates that schools with low mean scores are not always “poor performing” schools. Use of student growth rates to evaluate school performance enables schools that would otherwise be deemed low performing to demonstrate positive effects on student achievement. Implications for state accountability systems are discussed.

  7. Individual and contextual factors influencing dental health care utilization by preschool children: a multilevel analysis

    Science.gov (United States)

    Piovesan, Chaiana; Ardenghi, Thiago Machado; Mendes, Fausto Medeiros; Agostini, Bernardo Antonio; Michel-Crosato, Edgard

    2017-03-30

    The effect of contextual factors on dental care utilization was evaluated after adjustment for individual characteristics of Brazilian preschool children. This cross-sectional study assessed 639 preschool children aged 1 to 5 years from Santa Maria, a town in Rio Grande do Sul State, located in southern Brazil. Participants were randomly selected from children attending the National Children's Vaccination Day and 15 health centers were selected for this research. Visual examinations followed the ICDAS criteria. Parents answered a questionnaire about demographic and socioeconomic characteristics. Contextual influences on children's dental care utilization were obtained from two community-related variables: presence of dentists and presence of workers' associations in the neighborhood. Unadjusted and adjusted multilevel logistic regression models were used to describe the association between outcome and predictor variables. A prevalence of 21.6% was found for regular use of dental services. The unadjusted assessment of the associations of dental health care utilization with individual and contextual factors included children's ages, family income, parents' schooling, mothers' participation in their children's school activities, dental caries, and presence of workers' associations in the neighborhood as the main outcome covariates. Individual variables remained associated with the outcome after adding contextual variables in the model. In conclusion, individual and contextual variables were associated with dental health care utilization by preschool children.

  8. Individual and contextual factors influencing dental health care utilization by preschool children: a multilevel analysis

    Directory of Open Access Journals (Sweden)

    Chaiana PIOVESAN

    2017-03-01

    Full Text Available Abstract The effect of contextual factors on dental care utilization was evaluated after adjustment for individual characteristics of Brazilian preschool children. This cross-sectional study assessed 639 preschool children aged 1 to 5 years from Santa Maria, a town in Rio Grande do Sul State, located in southern Brazil. Participants were randomly selected from children attending the National Children’s Vaccination Day and 15 health centers were selected for this research. Visual examinations followed the ICDAS criteria. Parents answered a questionnaire about demographic and socioeconomic characteristics. Contextual influences on children’s dental care utilization were obtained from two community-related variables: presence of dentists and presence of workers’ associations in the neighborhood. Unadjusted and adjusted multilevel logistic regression models were used to describe the association between outcome and predictor variables. A prevalence of 21.6% was found for regular use of dental services. The unadjusted assessment of the associations of dental health care utilization with individual and contextual factors included children’s ages, family income, parents’ schooling, mothers’ participation in their children’s school activities, dental caries, and presence of workers’ associations in the neighborhood as the main outcome covariates. Individual variables remained associated with the outcome after adding contextual variables in the model. In conclusion, individual and contextual variables were associated with dental health care utilization by preschool children.

  9. Validity and usefulness of the Line Drill test for adolescent basketball players: a Bayesian multilevel analysis.

    Science.gov (United States)

    Carvalho, Humberto M; Gonçalves, Carlos E; Grosgeorge, Bernard; Paes, Roberto R

    2017-01-01

    The study examined the validity of the Line Drill test (LD) in male adolescent basketball players (10-15 years). Sensitiveness of the LD to changes in performance across a training and competition season (4 months) was also considered. Age, maturation, body size and LD were measured (n = 57). Sensitiveness of the LD was examined pre- and post-competitive season in a sub-sample (n = 44). The time at each of the four shuttle sprints of the LD (i.e. four stages) was modelled with Bayesian multilevel models. We observed very large correlation of performance at stage 4 (full LD protocol) with stage 3, but lower correlations with the early LD stages. Players' performance by somatic maturity differed substantially only when considering full LD protocol performance. Substantial improvements in all stages of the protocol were observed across the 4-month competitive season. The LD protocol should be shortened by the last full court shuttle sprint, remaining sensitive to training exposure, and independent of maturity status and body size.

  10. Are coaches' health promotion activities beneficial for sport participants? A multilevel analysis.

    Science.gov (United States)

    Van Hoye, Aurélie; Heuzé, Jean-Philippe; Van den Broucke, Stephan; Sarrazin, Philippe

    2016-12-01

    As major actors in sports activities, sports coaches can play a significant role in health education and contribute to the psychological well-being of young people. However, not all participants in sports activities experience sports positively, which reduces the potential benefits for health. The present study investigates if coaches' efforts to promote health increase young athletes' enjoyment, self-esteem and perceived health in daily life and decrease sport dropout. To control for the variability between teams and between clubs, multilevel modeling was applied. A sample of 342 young football players completed questionnaires assessing their perceptions of coaches' Health Promotion (HP) activities, enjoyment of sports, dropout intentions, self-esteem and perceived health in daily life. HP general score was positively related to enjoyment and perceived health as well as negatively dropout intentions. Players perceiving their coaches as promoting fair and play (Respect for oneself and others) scored higher on their perceptions of enjoyment in sport, self-esteem and self-reported health, and lower on dropout intentions. Moreover, players recognizing their coaches as encouraging their healthy lifestyle also reported higher perceptions of sport enjoyment, whereas player's perceived coaches' activities on substance use were associated with lower participants' enjoyment. These results support the importance of developing HP in sports clubs. Especially, promoting respect of oneself and others seems to be the more beneficial to sport participants. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  11. Travel time to maternity care and its effect on utilization in rural Ghana: a multilevel analysis.

    Science.gov (United States)

    Masters, Samuel H; Burstein, Roy; Amofah, George; Abaogye, Patrick; Kumar, Santosh; Hanlon, Michael

    2013-09-01

    Rates of neonatal and maternal mortality are high in Ghana. In-facility delivery and other maternal services could reduce this burden, yet utilization rates of key maternal services are relatively low, especially in rural areas. We tested a theoretical implication that travel time negatively affects the use of in-facility delivery and other maternal services. Empirically, we used geospatial techniques to estimate travel times between populations and health facilities. To account for uncertainty in Ghana Demographic and Health Survey cluster locations, we adopted a novel approach of treating the location selection as an imputation problem. We estimated a multilevel random-intercept logistic regression model. For rural households, we found that travel time had a significant effect on the likelihood of in-facility delivery and antenatal care visits, holding constant education, wealth, maternal age, facility capacity, female autonomy, and the season of birth. In contrast, a facility's capacity to provide sophisticated maternity care had no detectable effect on utilization. As the Ghanaian health network expands, our results suggest that increasing the availability of basic obstetric services and improving transport infrastructure may be important interventions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Political regimes, political ideology, and self-rated health in Europe: a multilevel analysis.

    Science.gov (United States)

    Huijts, Tim; Perkins, Jessica M; Subramanian, S V

    2010-07-22

    Studies on political ideology and health have found associations between individual ideology and health as well as between ecological measures of political ideology and health. Individual ideology and aggregate measures such as political regimes, however, were never examined simultaneously. Using adjusted logistic multilevel models to analyze data on individuals from 29 European countries and Israel, we found that individual ideology and political regime are independently associated with self-rated health. Individuals with rightwing ideologies report better health than leftwing individuals. Respondents from Eastern Europe and former Soviet republics report poorer health than individuals from social democratic, liberal, Christian conservative, and former Mediterranean dictatorship countries. In contrast to individual ideology and political regimes, country level aggregations of individual ideology are not related to reporting poor health. This study shows that although both individual political ideology and contextual political regime are independently associated with individuals' self-rated health, individual political ideology appears to be more strongly associated with self-rated health than political regime.

  13. Country of residence, gender equality and victim blaming attitudes about partner violence: a multilevel analysis in EU.

    Science.gov (United States)

    Ivert, Anna-Karin; Merlo, Juan; Gracia, Enrique

    2017-09-27

    Intimate partner violence against women (IPVAW) is a global and preventable public health problem. Public attitudes, such as victim-blaming, are important for our understanding of differences in the occurrence of IPVAW, as they contribute to its justification. In this paper, we focus on victim-blaming attitudes regarding IPVAW within the EU and we apply multilevel analyses to identify contextual determinants of victim-blaming attitudes. We investigate both the general contextual effect of the country and the specific association between country level of gender equality and individual victim-blaming attitudes, as well as to what extend a possible general contextual effect was explained by county level gender equality. We analyzed data from 26 800 respondents from 27 member states of the European Union who responded to a survey on public perceptions of domestic violence. We applied multilevel logistic regression analysis and measures of variance (intra-class correlation (ICC)) were calculated, as well as the discriminatory accuracy by calculating the area under the receiver operator characteristic curve. Over and above individual characteristics, about 15% of the individual variance in the propensity for having victim-blaming attitudes was found at the country level, and country level of gender equality did not affect the general contextual effect (i.e. ICC) of the country on individual victim-blaming attitudes. The present study shows that there are important between-country differences in victim-blaming attitudes that cannot be explained by differences in individual-level demographics or in gender equality at the country level. More research on attitudes towards IPVAW is needed. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  14. Survival analysis of heart failure patients: A case study.

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    Tanvir Ahmad

    Full Text Available This study was focused on survival analysis of heart failure patients who were admitted to Institute of Cardiology and Allied hospital Faisalabad-Pakistan during April-December (2015. All the patients were aged 40 years or above, having left ventricular systolic dysfunction, belonging to NYHA class III and IV. Cox regression was used to model mortality considering age, ejection fraction, serum creatinine, serum sodium, anemia, platelets, creatinine phosphokinase, blood pressure, gender, diabetes and smoking status as potentially contributing for mortality. Kaplan Meier plot was used to study the general pattern of survival which showed high intensity of mortality in the initial days and then a gradual increase up to the end of study. Martingale residuals were used to assess functional form of variables. Results were validated computing calibration slope and discrimination ability of model via bootstrapping. For graphical prediction of survival probability, a nomogram was constructed. Age, renal dysfunction, blood pressure, ejection fraction and anemia were found as significant risk factors for mortality among heart failure patients.

  15. Survival analysis of heart failure patients: A case study.

    Science.gov (United States)

    Ahmad, Tanvir; Munir, Assia; Bhatti, Sajjad Haider; Aftab, Muhammad; Raza, Muhammad Ali

    2017-01-01

    This study was focused on survival analysis of heart failure patients who were admitted to Institute of Cardiology and Allied hospital Faisalabad-Pakistan during April-December (2015). All the patients were aged 40 years or above, having left ventricular systolic dysfunction, belonging to NYHA class III and IV. Cox regression was used to model mortality considering age, ejection fraction, serum creatinine, serum sodium, anemia, platelets, creatinine phosphokinase, blood pressure, gender, diabetes and smoking status as potentially contributing for mortality. Kaplan Meier plot was used to study the general pattern of survival which showed high intensity of mortality in the initial days and then a gradual increase up to the end of study. Martingale residuals were used to assess functional form of variables. Results were validated computing calibration slope and discrimination ability of model via bootstrapping. For graphical prediction of survival probability, a nomogram was constructed. Age, renal dysfunction, blood pressure, ejection fraction and anemia were found as significant risk factors for mortality among heart failure patients.

  16. Multilevel marketing společnosti Amway

    OpenAIRE

    Drozdková, Markéta

    2010-01-01

    This thesis analyses effectiveness and principles of multilevel marketing as a possible way of selling products and services. Theoretical part describes basis of marketing and direct selling, which is the basis of multilevel marketing. The thesis also states illegal forms of selling that misuse the advantages of multilevel marketing. Pracical part applies gained knowledge on Amway corporation and it atteds to operation of the company, which is evaluated by SWOT analysis.

  17. Unintended pregnancy in the amazon basin of Ecuador: a multilevel analysis

    Directory of Open Access Journals (Sweden)

    San Sebastian Miguel

    2010-06-01

    Full Text Available Abstract Background It has been estimated that each year 80 million women in the world experience an unintended pregnancy. In Ecuador, recent research has revealed that 36.3% of total births are unintended; the research also details significant geographical, ethnic and socioeconomic variations. These studies focused on individual risk factors and were based on large national surveys where local samples, particularly from rural remote areas, were small. The purpose of this study was to investigate the influence of contextual and individual factors on unintended pregnancies in the Amazon Basin of Ecuador. Methods Women aged 15-44 were selected through an ongoing community-based cross-sectional survey conducted in the Orellana province between May and December 2006. Data were fitted using multilevel logistic regression, adjusting for both individual-level and community-level factors as fixed effects and allowing for heterogeneity between communities. Results The overall prevalence of unintended pregnancy was 62.7%. Two-thirds (73.7% of indigenous women reported having had at least one unintended pregnancy. Being young, single, and indigenous were significant risk factors for unintended pregnancy, alongside having low access to education and having more than two children. No relationship was found between socioeconomic status and the use of contraceptives. All the variation between communities was explained by individual-level factors. Conclusions This study showed the significance of individual factors in increasing the risk of unintended pregnancy, while the role of community factors was found to be negligible. In order for all women to be able to realize their right to reproductive autonomy, there needs to be a diverse range of solutions, with particular attention paid to cultural issues.

  18. Factors associated with GPs' knowledge of their patients' socio-economic circumstances: a multilevel analysis.

    Science.gov (United States)

    Casanova, Ludovic; Ringa, Virginie; Bloy, Géraldine; Falcoff, Hector; Rigal, Laurent

    2015-12-01

    To determine appropriate management for individual patients, GPs are supposed to use their knowledge of the patient's socio-economic circumstances. To analyse factors associated with GPs' knowledge of these circumstances. Observational survey of GPs who were internship supervisors in the Paris metropolitan area. Each of 52 volunteer GPs completed a self-administered questionnaire about their own characteristics and randomly selected 70 patients from their patient list. Their knowledge was analysed as the agreement between the patients' and GPs' responses to questions about the patients' socio-economic characteristics in questionnaires completed by both groups. The association between agreement and the GPs' characteristics was analysed with a multilevel model adjusted for age, sex and the duration of the GP-patient relationship. Agreement varied according to the socio-economic characteristics considered (from 51% to 90%) and between GPs. Globally, the GPs overestimated their patients' socio-economic level. GP characteristics associated with better agreement were sex (female), long consultations, the use of paper records or an automatic reminder system and participation in continuing medical education and in meetings to discuss difficult cases. Knowledge of some patient characteristics, such as their complementary health insurance coverage or perceived financial situation, should be improved because their overestimation may lead to care that is too expensive and thus result in the patients' abandonment of the treatment. Besides determining ways to help GPs to organize their work more effectively, it is important to study methods to help doctors identify their patients' social-economic circumstances more accurately in daily practice. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Multi-level analysis of electronic health record adoption by health care professionals: A study protocol

    Directory of Open Access Journals (Sweden)

    Labrecque Michel

    2010-04-01

    Full Text Available Abstract Background The electronic health record (EHR is an important application of information and communication technologies to the healthcare sector. EHR implementation is expected to produce benefits for patients, professionals, organisations, and the population as a whole. These benefits cannot be achieved without the adoption of EHR by healthcare professionals. Nevertheless, the influence of individual and organisational factors in determining EHR adoption is still unclear. This study aims to assess the unique contribution of individual and organisational factors on EHR adoption in healthcare settings, as well as possible interrelations between these factors. Methods A prospective study will be conducted. A stratified random sampling method will be used to select 50 healthcare organisations in the Quebec City Health Region (Canada. At the individual level, a sample of 15 to 30 health professionals will be chosen within each organisation depending on its size. A semi-structured questionnaire will be administered to two key informants in each organisation to collect organisational data. A composite adoption score of EHR adoption will be developed based on a Delphi process and will be used as the outcome variable. Twelve to eighteen months after the first contact, depending on the pace of EHR implementation, key informants and clinicians will be contacted once again to monitor the evolution of EHR adoption. A multilevel regression model will be applied to identify the organisational and individual determinants of EHR adoption in clinical settings. Alternative analytical models would be applied if necessary. Results The study will assess the contribution of organisational and individual factors, as well as their interactions, to the implementation of EHR in clinical settings. Conclusions These results will be very relevant for decision makers and managers who are facing the challenge of implementing EHR in the healthcare system. In addition

  20. Traffic-related air pollution and obesity formation in children: a longitudinal, multilevel analysis.

    Science.gov (United States)

    Jerrett, Michael; McConnell, Rob; Wolch, Jennifer; Chang, Roger; Lam, Claudia; Dunton, Genevieve; Gilliland, Frank; Lurmann, Fred; Islam, Talat; Berhane, Kiros

    2014-06-09

    Biologically plausible mechanisms link traffic-related air pollution to metabolic disorders and potentially to obesity. Here we sought to determine whether traffic density and traffic-related air pollution were positively associated with growth in body mass index (BMI = kg/m2) in children aged 5-11 years. Participants were drawn from a prospective cohort of children who lived in 13 communities across Southern California (N = 4550). Children were enrolled while attending kindergarten and first grade and followed for 4 years, with height and weight measured annually. Dispersion models were used to estimate exposure to traffic-related air pollution. Multilevel models were used to estimate and test traffic density and traffic pollution related to BMI growth. Data were collected between 2002-2010 and analyzed in 2011-12. Traffic pollution was positively associated with growth in BMI and was robust to adjustment for many confounders. The effect size in the adjusted model indicated about a 13.6% increase in annual BMI growth when comparing the lowest to the highest tenth percentile of air pollution exposure, which resulted in an increase of nearly 0.4 BMI units on attained BMI at age 10. Traffic density also had a positive association with BMI growth, but this effect was less robust in multivariate models. Traffic pollution was positively associated with growth in BMI in children aged 5-11 years. Traffic pollution may be controlled via emission restrictions; changes in land use that promote jobs-housing balance and use of public transit and hence reduce vehicle miles traveled; promotion of zero emissions vehicles; transit and car-sharing programs; or by limiting high pollution traffic, such as diesel trucks, from residential areas or places where children play outdoors, such as schools and parks. These measures may have beneficial effects in terms of reduced obesity formation in children.

  1. Correlates of Intra-Household ITN Use in Liberia: A Multilevel Analysis of Household Survey Data.

    Science.gov (United States)

    Babalola, Stella; Ricotta, Emily; Awantang, Grace; Lewicky, Nan; Koenker, Hannah; Toso, Michael

    2016-01-01

    Malaria is a major cause of morbidity and mortality in Liberia. At the same time, insecticide-treated net (ITN) ownership and use remain low. Access is a key determinant of ITN use but it is not the only one; prior studies have identified factors that affect the use of ITNs in households with at least one ITN. These factors operate at the individual, household, and community levels. However, studies have generally not assessed the psychosocial or ideational determinants of ITN use. Using 2014 household survey data, this manuscript examines the socio-demographic, ideational, household, and community factors associated with household member use of ITNs in Liberia. Multilevel modeling was used to assess fixed effects at the individual, household, and community levels, and random effects at the household and cluster levels. The data showed significant residual clustering at the household level, indicating that there were unmeasured factors operating at this level that are associated with ITN use. The association of age with ITN use was moderated by sex such that men, older children, and teenagers were less likely to sleep under an ITN compared to women and children under five years old. Female caregivers' perceived severity of malaria, perceived self-efficacy to detect a complicated case of malaria, and exposure to the "Take Cover" communication campaign were positively associated with ITN use by members of her household. The association with household size was negative, while the relationship with the number of ITNs was positive. Programs should seek to achieve universal coverage (that is, one ITN for every two household members) and promote the notion that everyone needs to sleep under an ITN every night. Programs should also seek to strengthen perceived severity of malaria and educate intended audience groups on the signs of malaria complications. Given the significance of residual clustering at the household level, interventions that engage men as heads of

  2. Economic burden and cost determinants of coronary heart disease in rural southwest China: a multilevel analysis.

    Science.gov (United States)

    Le, C; Fang, Y; Linxiong, W; Shulan, Z; Golden, A R

    2015-01-01

    To estimate the economic burden of coronary heart disease (CHD) in a given year (2010), including direct and indirect costs, and examine the impact of contextual and individual socio-economic (SES) predictors on the costs of CHD among adults in rural southwest China. Cross-sectional community survey. In total, 4595 adults (aged ≥18 years) participated in this study. A prevalence-based cost-of-illness approach was used to estimate the economic burden of CHD. Information on demographic characteristics of the study population and the economic consequences of CHD was obtained using a standard questionnaire. Multilevel linear regression was used to model the variation in costs of CHD. In the study population, the overall prevalence of CHD was 2.9% (3.5% for males, 2.3% for females). The total cost of CHD was estimated to be US$17 million. Inpatient hospitalizations represented the main component of direct costs of CHD, and direct costs accounted for the greatest proportion of the economic burden of CHD. Males were more likely to have a higher economic burden of CHD than females. A positive association was found between the individual's level of education and the economic burden of CHD. Residence in a higher-income community was associated with higher costs related to CHD. This study found that both contextual and individual SES were closely associated with the costs of CHD. Future strategies for CHD interventions and improved access to affordable medications to treat and control CHD should focus on less-educated individuals and communities with lower SES. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  3. Predicting post-traumatic stress disorder treatment response in refugees: Multilevel analysis.

    Science.gov (United States)

    Haagen, Joris F G; Ter Heide, F Jackie June; Mooren, Trudy M; Knipscheer, Jeroen W; Kleber, Rolf J

    2017-03-01

    Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of which are largely unknown. This study aimed at improving PTSD treatment for adult refugees by identifying PTSD treatment response predictors. A prospective longitudinal multilevel modelling design was used to predict PTSD severity scores over time. We analysed data from a randomized controlled trial with pre-, post-, and follow-up measurements of the safety and efficacy of eye movement desensitization and reprocessing and stabilization in asylum seekers and refugees suffering from PTSD. Lack of refugee status, comorbid depression, demographic, trauma-related and treatment-related variables were analysed as potential predictors of PTSD treatment outcome. Treatment outcome data from 72 participants were used. The presence (B = 6.5, p = .03) and severity (B = 6.3, p disorder predicted poor treatment response and explained 39% of the variance between individuals. Refugee patients who suffer from PTSD and severe comorbid depression benefit less from treatment aimed at alleviating PTSD. Results highlight the need for treatment adaptations for PTSD and comorbid severe depression in traumatized refugees, including testing whether initial targeting of severe depressive symptoms increases PTSD treatment effectiveness. There are differences in post-traumatic stress disorder (PTSD) treatment response between traumatized refugees. Comorbid depressive disorder and depression severity predict poor PTSD response. Refugees with PTSD and severe depression may not benefit from PTSD treatment. Targeting comorbid severe depression before PTSD treatment is warranted. This study did not correct for multiple hypothesis testing. Comorbid depression may differentially impact alternative PTSD treatments

  4. Contextual and individual factors associated with dental services utilisation by Brazilian adults: A multilevel analysis.

    Science.gov (United States)

    Herkrath, Fernando José; Vettore, Mario Vianna; Werneck, Guilherme Loureiro

    2018-01-01

    Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen's behavioural model. Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. Predisposing (OR = 0.89; 95% CI 0.81-0.97) and enabling (OR = 0.90; 95% CI 0.85-0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services.

  5. Patient and organisational variables associated with pressure ulcer prevalence in hospital settings: a multilevel analysis.

    Science.gov (United States)

    Bredesen, Ida Marie; Bjøro, Karen; Gunningberg, Lena; Hofoss, Dag

    2015-08-27

    To investigate the association of ward-level differences in the odds of hospital-acquired pressure ulcers (HAPUs) with selected ward organisational variables and patient risk factors. Multilevel approach to data from 2 cross-sectional studies. 4 hospitals in Norway were studied. 1056 patients at 84 somatic wards. HAPU. Significant variance in the odds of HAPUs was found across wards. A regression model using only organisational variables left a significant variance in the odds of HAPUs across wards but patient variables eliminated the across-ward variance. In the model including organisational and patient variables, significant ward-level HAPU variables were ward type (rehabilitation vs surgery/internal medicine: OR 0.17 (95% CI 0.04 to 0.66)), use of preventive measures (yes vs no: OR 2.02 (95% CI 1.12 to 3.64)) and ward patient safety culture (OR 0.97 (95% CI 0.96 to 0.99)). Significant patient-level predictors were age >70 vs organisation of care improvements, that is, by improving the patient safety culture and implementation of preventive measures. Some wards may prevent pressure ulcers better than other wards. The fact that ward-level variation was eliminated when patient-level HAPU variables were included in the model indicates that even wards with the best HAPU prevention will be challenged by an influx of high-risk patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Analysis of economic determinants of fertility in Iran: a multilevel approach.

    Science.gov (United States)

    Moeeni, Maryam; Pourreza, Abolghasem; Torabi, Fatemeh; Heydari, Hassan; Mahmoudi, Mahmood

    2014-08-01

    During the last three decades, the Total Fertility Rate (TFR) in Iran has fallen considerably; from 6.5 per woman in 1983 to 1.89 in 2010. This paper analyzes the extent to which economic determinants at the micro and macro levels are associated with the number of children in Iranian households. Household data from the 2010 Household Expenditure and Income Survey (HEIS) is linked to provincial data from the 2010 Iran Multiple-Indicator Demographic and Health Survey (IrMIDHS), the National Census of Population and Housing conducted in 1986, 1996, 2006 and 2011, and the 1985-2010 Iran statistical year books. Fertility is measured as the number of children in each household. A random intercept multilevel Poisson regression function is specified based on a collective model of intra-household bargaining power to investigate potential determinants of the number of children in Iranian households. Ceteris paribus (other things being equal), probability of having more children drops significantly as either real per capita educational expenditure or real total expenditure of each household increase. Both the low- and the high-income households show probabilities of having more children compared to the middle-income households. Living in provinces with either higher average amount of value added of manufacturing establishments or lower average rate of house rent is associated to higher probability of having larger number of children. Higher levels of gender gap indices, resulting in household's wife's limited power over household decision-making, positively affect the probability of having more children. Economic determinants at the micro and macro levels, distribution of intra-household bargaining power between spouses and demographic covariates determined fertility behavior of Iranian households.

  7. Factors associated with use of maternal health services in Haiti: a multilevel analysis

    Directory of Open Access Journals (Sweden)

    Stella O. Babalola

    2014-07-01

    Full Text Available OBJECTIVE: To assess factors associated with utilization of maternal health services (MHS among women giving birth in Haiti from 2007 - 2012. METHODS: Observational data derived from the 2012 Haiti Mortality, Morbidity and Service Use Survey are analyzed. Multilevel analytic methods are used to assess factors associated with use of antenatal services and skilled birth attendance (SBA. RESULTS: The strongest adjusted predictors include child's birth rank, household poverty, and community media saturation. The odds of obtaining four antenatal care visits decrease by 53% (odds ratio (OR = 0.47; 95% confidence interval (CI: 0.37-0.57 with high birth rank and by 37% (OR = 0.63; 95% CI: 0.51-0.78 with household poverty, and increase by 38% (OR = 1.38; 95% CI: 1.01-1.88 with high community media saturation. The odds of using SBA at delivery decrease by 72% (OR = 0.28; 95% CI: 0.22-0.34 with high birth rank and by 42% (OR = 0.58; 95% CI: 0.46-0.73 with household poverty, and increase by 92% (OR = 1.92; 95% CI: 1.41-2.61 with high community media saturation. Use of antenatal services is strongly associated with SBA (OR = 2.20; 95% CI: 1.85-2.61. Significant clustering of use of MHS exists at the community level. CONCLUSIONS: Factors associated with use of MHS operate at multiple levels. Efforts to promote such services should identify and pay special attention to the needs of multiparous and uneducated women, address the distance-decay phenomenon, and improve access for the poor. Community mobilization efforts designed to change norms hindering the use of MHS are also relevant.

  8. Is the "Glasgow effect" of cigarette smoking explained by socio-economic status?: A multilevel analysis

    Directory of Open Access Journals (Sweden)

    Leyland Alastair H

    2009-07-01

    Full Text Available Abstract Background The Glasgow area has elevated levels of deprivation and is known for its poor health and associated negative health-related behaviours, which are socially patterned. Of interest is whether high smoking rates are explained by the area's socio-economic profile. Methods Data on age, sex, current/previous smoking status, area deprivation, social class, education, economic activity, postcode sector, and health board region were available from Scottish Health Surveys conducted in 1995, 1998 and 2003. Multilevel logistic regression models were applied by sex, unadjusted and adjusted for age, survey year, and socio-economic factors, accounting for geographical hierarchy and missing data. Results Compared with the rest of Scotland, men living in Greater Glasgow were 30% and women 43% more likely to smoke [odds ratio (OR = 1.30, (95% CI = 1.08–1.56 and (OR = 1.43, CI = 1.22–1.68, respectively] before adjustment. In adjusted results, the association between living in Greater Glasgow and current smoking was attenuated [OR = 0.92, CI = 0.78–1.09 for men, and OR = 1.08, CI = 0.94–1.23 for women; results based on multiply imputed data to account for missing values remained borderline significant for women]. Accounting for individuals who had been told to give up smoking by a medical person/excluding ex-smokers did not alter results. Conclusion High levels of smoking in Greater Glasgow were attributable to its poorer socio-economic position and the strong social patterning of smoking. Tackling Glasgow's, and indeed Scotland's, poor health must involve policies to alleviate problems associated with poverty.

  9. Multilevel analysis of ADHD, anxiety and depression symptoms aggregation in families.

    Science.gov (United States)

    Segenreich, Daniel; Paez, Marina Silva; Regalla, Maria Angélica; Fortes, Dídia; Faraone, Stephen V; Sergeant, Joseph; Mattos, Paulo

    2015-05-01

    A strong genetic role in the etiology of attention-deficit hyperactivity disorder (ADHD) has been demonstrated by several studies using different methodologies. Shortcomings of genetic studies often include the lack of golden standard practices for diagnosis for ADHD, the use of categorical instead of a dimensional approach, and the disregard for assortative mating phenomenon in parents. The current study aimed to overcome these shortcomings and analyze data through a novel statistical approach, using multilevel analyses with Bayesian procedures and a specific mathematical model, which takes into account data with an elevated number of zero responses (expected in samples with few or no ADHD symptoms). Correlations of parental clinical variables (ADHD, anxiety and depression) to offspring psychopathology may vary according to gender and type of symptoms. We aimed to investigate how those variables interact within each other. One hundred families, comprising a proband child or adolescent with ADHD or a typically developing child or adolescent were included and all family members (both biological parents, the proband child or adolescent and their sibling) were examined through semi-structured interviews using DSM-IV criteria. Results indicated that: (a) maternal clinical variables (ADHD, anxiety and depression) were more correlated with offspring variables than paternal ones; (b) maternal inattention (but not hyperactivity) was correlated with both inattention and hyperactivity in the offspring; (c) maternal anxiety was correlated with offspring inattention; on the other hand, maternal inattention was correlated with anxiety in the offspring. Although a family study design limits the possibility of revealing causality and cannot disentangle genetic and environmental factors, our findings suggest that ADHD, anxiety and depression are variables that correlate in families and should be addressed together. Maternal variables significantly correlated with offspring

  10. Perceptions of neighborhood safety and asthma among children and adolescents in Los Angeles: a multilevel analysis.

    Directory of Open Access Journals (Sweden)

    Marlene Camacho-Rivera

    Full Text Available Research examining the impact of neighborhoods on asthma has shown an increased interest in the role of the psychosocial environment. We examined the associations between various measures of neighborhood safety, individual and family characteristics, and asthma outcomes among children in Los Angeles.Multilevel logistic regression models were used to analyze data on 3,114 children across 65 neighborhoods from Wave 1 of the Los Angeles Family and Neighborhood Survey (2000 to 2002. Primary caregivers reported asthma outcome and all individual covariates; home environmental characteristics were observed by the interviewer.In fully adjusted models, parents who reported their neighborhood fairly safe or somewhat dangerous had lower odds of reported lifetime asthma compared to those who reported their neighborhood completely safe (OR 0.71; 95% CI 0.52-0.96 and OR 0.60; 95% CI 0.42-0.88 respectively. Conversely, parents who reported they could not trust their neighbors to keep their children safe had a nearly 40% increase in lifetime asthma compared to those who reported they could trust their neighbors to keep their children safe (OR 1.39; 95% CI 1.07-1.81.The study demonstrates a complex pattern between various measures of neighborhood safety and asthma and suggests that these relationships may operate differently in Los Angeles. As an increasing proportion of children are growing up in newer Western and Southwestern cities, which have different physical layouts and residential segregation patterns compared to Northeast and Midwestern cities, future studies should continue to examine neighborhood psychosocial stressors and asthma in diverse contexts.

  11. Factors associated with use of maternal health services in Haiti: a multilevel analysis.

    Science.gov (United States)

    Babalola, Stella O

    2014-07-01

    To assess factors associated with utilization of maternal health services (MHS) among women giving birth in Haiti from 2007 - 2012. Observational data derived from the 2012 Haiti Mortality, Morbidity and Service Use Survey are analyzed. Multilevel analytic methods are used to assess factors associated with use of antenatal services and skilled birth attendance (SBA). The strongest adjusted predictors include child's birth rank, household poverty, and community media saturation. The odds of obtaining four antenatal care visits decrease by 53% (odds ratio (OR) = 0.47; 95% confidence interval (CI): 0.37-0.57) with high birth rank and by 37% (OR = 0.63; 95% CI: 0.51-0.78) with household poverty, and increase by 38% (OR = 1.38; 95% CI: 1.01-1.88) with high community media saturation. The odds of using SBA at delivery decrease by 72% (OR = 0.28; 95% CI: 0.22-0.34) with high birth rank and by 42% (OR = 0.58; 95% CI: 0.46-0.73) with household poverty, and increase by 92% (OR = 1.92; 95% CI: 1.41-2.61) with high community media saturation. Use of antenatal services is strongly associated with SBA (OR = 2.20; 95% CI: 1.85-2.61). Significant clustering of use of MHS exists at the community level. Factors associated with use of MHS operate at multiple levels. Efforts to promote such services should identify and pay special attention to the needs of multiparous and uneducated women, address the distance-decay phenomenon, and improve access for the poor. Community mobilization efforts designed to change norms hindering the use of MHS are also relevant.

  12. Determinants of unmet need for family planning in rural Burkina Faso: a multilevel logistic regression analysis.

    Science.gov (United States)

    Wulifan, Joseph K; Jahn, Albrecht; Hien, Hervé; Ilboudo, Patrick Christian; Meda, Nicolas; Robyn, Paul Jacob; Saidou Hamadou, T; Haidara, Ousmane; De Allegri, Manuela

    2017-12-19

    Unmet need for family planning has implications for women and their families, such as unsafe abortion, physical abuse, and poor maternal health. Contraceptive knowledge has increased across low-income settings, yet unmet need remains high with little information on the factors explaining it. This study assessed factors associated with unmet need among pregnant women in rural Burkina Faso. We collected data on pregnant women through a population-based survey conducted in 24 rural districts between October 2013 and March 2014. Multivariate multilevel logistic regression was used to assess the association between unmet need for family planning and a selection of relevant demand- and supply-side factors. Of the 1309 pregnant women covered in the survey, 239 (18.26%) reported experiencing unmet need for family planning. Pregnant women with more than three living children [OR = 1.80; 95% CI (1.11-2.91)], those with a child younger than 1 year [OR = 1.75; 95% CI (1.04-2.97)], pregnant women whose partners disapproves contraceptive use [OR = 1.51; 95% CI (1.03-2.21)] and women who desired fewer children compared to their partners preferred number of children [OR = 1.907; 95% CI (1.361-2.672)] were significantly more likely to experience unmet need for family planning, while health staff training in family planning logistics management (OR = 0.46; 95% CI (0.24-0.73)] was associated with a lower probability of experiencing unmet need for family planning. Findings suggest the need to strengthen family planning interventions in Burkina Faso to ensure greater uptake of contraceptive use and thus reduce unmet need for family planning.

  13. Progress and challenges in the development and qualification of multi-level multi-physics coupled methodologies for reactor analysis

    International Nuclear Information System (INIS)

    Ivanov, K.; Avramova, M.

    2007-01-01

    Current trends in nuclear power generation and regulation as well as the design of next generation reactor concepts along with the continuing computer technology progress stimulate the development, qualification and application of multi-physics multi-scale coupled code systems. The efforts have been focused on extending the analysis capabilities by coupling models, which simulate different phenomena or system components, as well as on refining the scale and level of detail of the coupling. This paper reviews the progress made in this area and outlines the remaining challenges. The discussion is illustrated with examples based on neutronics/thermohydraulics coupling in the reactor core modeling. In both fields recent advances and developments are towards more physics-based high-fidelity simulations, which require implementation of improved and flexible coupling methodologies. First, the progresses in coupling of different physics codes along with the advances in multi-level techniques for coupled code simulations are discussed. Second, the issues related to the consistent qualification of coupled multi-physics and multi-scale code systems for design and safety evaluation are presented. The increased importance of uncertainty and sensitivity analysis are discussed along with approaches to propagate the uncertainty quantification between the codes. The incoming OECD LWR Uncertainty Analysis in Modeling (UAM) benchmark is the first international activity to address this issue and it is described in the paper. Finally, the remaining challenges with multi-physics coupling are outlined. (authors)

  14. Progress and challenges in the development and qualification of multi-level multi-physics coupled methodologies for reactor analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ivanov, K.; Avramova, M. [Pennsylvania State Univ., University Park, PA (United States)

    2007-07-01

    Current trends in nuclear power generation and regulation as well as the design of next generation reactor concepts along with the continuing computer technology progress stimulate the development, qualification and application of multi-physics multi-scale coupled code systems. The efforts have been focused on extending the analysis capabilities by coupling models, which simulate different phenomena or system components, as well as on refining the scale and level of detail of the coupling. This paper reviews the progress made in this area and outlines the remaining challenges. The discussion is illustrated with examples based on neutronics/thermohydraulics coupling in the reactor core modeling. In both fields recent advances and developments are towards more physics-based high-fidelity simulations, which require implementation of improved and flexible coupling methodologies. First, the progresses in coupling of different physics codes along with the advances in multi-level techniques for coupled code simulations are discussed. Second, the issues related to the consistent qualification of coupled multi-physics and multi-scale code systems for design and safety evaluation are presented. The increased importance of uncertainty and sensitivity analysis are discussed along with approaches to propagate the uncertainty quantification between the codes. The incoming OECD LWR Uncertainty Analysis in Modeling (UAM) benchmark is the first international activity to address this issue and it is described in the paper. Finally, the remaining challenges with multi-physics coupling are outlined. (authors)

  15. Multi-focus and multi-level techniques for visualization and analysis of networks with thematic data

    Science.gov (United States)

    Cossalter, Michele; Mengshoel, Ole J.; Selker, Ted

    2013-01-01

    Information-rich data sets bring several challenges in the areas of visualization and analysis, even when associated with node-link network visualizations. This paper presents an integration of multi-focus and multi-level techniques that enable interactive, multi-step comparisons in node-link networks. We describe NetEx, a visualization tool that enables users to simultaneously explore different parts of a network and its thematic data, such as time series or conditional probability tables. NetEx, implemented as a Cytoscape plug-in, has been applied to the analysis of electrical power networks, Bayesian networks, and the Enron e-mail repository. In this paper we briefly discuss visualization and analysis of the Enron social network, but focus on data from an electrical power network. Specifically, we demonstrate how NetEx supports the analytical task of electrical power system fault diagnosis. Results from a user study with 25 subjects suggest that NetEx enables more accurate isolation of complex faults compared to an especially designed software tool.

  16. Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis.

    Science.gov (United States)

    Daru, Jahnavi; Zamora, Javier; Fernández-Félix, Borja M; Vogel, Joshua; Oladapo, Olufemi T; Morisaki, Naho; Tunçalp, Özge; Torloni, Maria Regina; Mittal, Suneeta; Jayaratne, Kapila; Lumbiganon, Pisake; Togoobaatar, Ganchimeg; Thangaratinam, Shakila; Khan, Khalid S

    2018-05-01

    Anaemia affects as many as half of all pregnant women in low-income and middle-income countries, but the burden of disease and associated maternal mortality are not robustly quantified. We aimed to assess the association between severe anaemia and maternal death with data from the WHO Multicountry Survey on maternal and newborn health. We used multilevel and propensity score regression analyses to establish the relation between severe anaemia and maternal death in 359 health facilities in 29 countries across Latin America, Africa, the Western Pacific, eastern Mediterranean, and southeast Asia. Severe anaemia was defined as antenatal or postnatal haemoglobin concentrations of less than 70 g/L in a blood sample obtained before death. Maternal death was defined as death any time after admission until the seventh day post partum or discharge. In regression analyses, we adjusted for post-partum haemorrhage, general anaesthesia, admission to intensive care, sepsis, pre-eclampsia or eclampsia, thrombocytopenia, shock, massive transfusion, severe oliguria, failure to form clots, and severe acidosis as confounding variables. These variables were used to develop the propensity score. 312 281 women admitted in labour or with ectopic pregnancies were included in the adjusted multilevel logistic analysis, and 12 470 were included in the propensity score regression analysis. The adjusted odds ratio for maternal death in women with severe anaemia compared with those without severe anaemia was 2·36 (95% CI 1·60-3·48). In the propensity score analysis, severe anaemia was also associated with maternal death (adjusted odds ratio 1·86 [95% CI 1·39-2·49]). Prevention and treatment of anaemia during pregnancy and post partum should remain a global public health and research priority. Barts and the London Charity. Copyright This is an Open Access article published under the CC BY 3.0 IGO license which permits unrestricted use, distribution, and reproduction in any medium

  17. Application of survival analysis methodology to the quantitative analysis of LC-MS proteomics data

    KAUST Repository

    Tekwe, C. D.; Carroll, R. J.; Dabney, A. R.

    2012-01-01

    positive, skewed and often left-censored, we propose using survival methodology to carry out differential expression analysis of proteins. Various standard statistical techniques including non-parametric tests such as the Kolmogorov-Smirnov and Wilcoxon

  18. Multilevel Models: Conceptual Framework and Applicability

    Directory of Open Access Journals (Sweden)

    Roxana-Otilia-Sonia Hrițcu

    2015-10-01

    Full Text Available Individuals and the social or organizational groups they belong to can be viewed as a hierarchical system situated on different levels. Individuals are situated on the first level of the hierarchy and they are nested together on the higher levels. Individuals interact with the social groups they belong to and are influenced by these groups. Traditional methods that study the relationships between data, like simple regression, do not take into account the hierarchical structure of the data and the effects of a group membership and, hence, results may be invalidated. Unlike standard regression modelling, the multilevel approach takes into account the individuals as well as the groups to which they belong. To take advantage of the multilevel analysis it is important that we recognize the multilevel characteristics of the data. In this article we introduce the outlines of multilevel data and we describe the models that work with such data. We introduce the basic multilevel model, the two-level model: students can be nested into classes, individuals into countries and the general two-level model can be extended very easily to several levels. Multilevel analysis has begun to be extensively used in many research areas. We present the most frequent study areas where multilevel models are used, such as sociological studies, education, psychological research, health studies, demography, epidemiology, biology, environmental studies and entrepreneurship. We support the idea that since hierarchies exist everywhere, multilevel data should be recognized and analyzed properly by using multilevel modelling.

  19. Eco-epidemiological analysis of rickettsial seropositivity in rural areas of Colombia: A multilevel approach.

    Directory of Open Access Journals (Sweden)

    Juan C Quintero V

    2017-09-01

    Full Text Available Rickettsiosis is a re-emergent infectious disease without epidemiological surveillance in Colombia. This disease is generally undiagnosed and several deadly outbreaks have been reported in the country in the last decade. The aim of this study is to analyze the eco-epidemiological aspects of rickettsial seropositivity in rural areas of Colombia where outbreaks of the disease were previously reported. A cross-sectional study, which included 597 people living in 246 households from nine hamlets in two municipalities of Colombia, was conducted from November 2015 to January 2016. The survey was conducted to collect sociodemographic and household characteristics (exposure data. Blood samples were collected to determine the rickettsial seropositivity in humans, horses and dogs (IFA, cut-off = 1/128. In addition, infections by rickettsiae were detected in ticks from humans and animals by real-time PCR targeting gltA and ompA genes. Data was analyzed by weighted multilevel clog-log regression model using three levels (person, household and hamlets and rickettsial seropositivity in humans was the main outcome. Overall prevalence of rickettsial seropositivity in humans was 25.62% (95%CI 22.11-29.12. Age in years (PR = 1.01 95%CI 1.01-1.02 and male sex (PR = 1.65 95%CI 1.43-1.90 were risk markers for rickettsial seropositivity. Working outdoors (PR = 1.20 95%CI 1.02-1.41, deforestation and forest fragmentation for agriculture use (PR = 1.75 95%CI 1.51-2.02, opossum in peridomiciliary area (PR = 1.56 95%CI 1.37-1.79 and a high proportion of seropositive domestic animals in the home (PR20-40% vs 40% vs <20% = 3.14 95%CI 2.43-4.04 were associated with rickettsial seropositivity in humans. This study showed the presence of Rickettsia antibodies in human populations and domestic animals. In addition, different species of rickettsiae were detected in ticks collected from humans and animals. Our results highlighted the role of domestic animals as sentinels of

  20. Incomplete childhood immunization in Nigeria: a multilevel analysis of individual and contextual factors

    Directory of Open Access Journals (Sweden)

    Sulaimon T. Adedokun

    2017-03-01

    Full Text Available Abstract Background Under-five mortality remains high in sub-Saharan Africa despite global decline. One quarter of these deaths are preventable through interventions such as immunization. The aim of this study was to examine the independent effects of individual-, community- and state-level factors on incomplete childhood immunization in Nigeria, which is one of the 10 countries where most of the incompletely immunised children in the world live. Methods The study was based on secondary analyses of cross-sectional data from the 2013 Nigeria Demographic and Health Survey (DHS. Multilevel multivariable logistic regression models were applied to the data on 5,754 children aged 12–23 months who were fully immunized or not (level 1, nested within 896 communities (level 2 from 37 states (level 3. Results More than three-quarter of the children (76.3% were not completely immunized. About 83% of children of young mothers (15–24 years and 94% of those whose mothers are illiterate did not receive full immunization. In the fully adjusted model, the chances of not being fully immunized reduced for children whose mothers attended antenatal clinic (adjusted odds ratio [aOR] = 0.49; 95% credible interval [CrI] = 0.39–0.60, delivered in health facility (aOR = 0.62; 95% CrI = 0.51–0.74 and lived in urban area (aOR = 0.66; 95% CrI = 0.50–0.82. Children whose mothers had difficulty getting to health facility (aOR = 1.28; 95% CrI = 1.02–1.57 and lived in socioeconomically disadvantaged communities (aOR = 2.93; 95% CrI = 1.60–4.71 and states (aOR = 2.69; 955 CrI =1.37–4.73 were more likely to be incompletely immunized. Conclusions This study has revealed that the risk of children being incompletely immunized in Nigeria was influenced by not only individual factors but also community- and state-level factors. Interventions to improve child immunization uptake should take into consideration these contextual

  1. Individual and classroom variables associated with relational aggression in elementary-school aged children : A multilevel analysis

    NARCIS (Netherlands)

    Kuppens, S.; Grietens, H.; Onghena, P.; Michiels, D.; Subramanian, S. V.

    2008-01-01

    Relational aggression was studied within classroom environments by examining individual and classroom correlates among 2731 children (3rd-5th graders) during two successive measurement years. Multilevel analyses yielded small gender differences for relational aggression, indicating that such

  2. Volumetric and MGMT parameters in glioblastoma patients: Survival analysis

    International Nuclear Information System (INIS)

    Iliadis, Georgios; Kotoula, Vassiliki; Chatzisotiriou, Athanasios; Televantou, Despina; Eleftheraki, Anastasia G; Lambaki, Sofia; Misailidou, Despina; Selviaridis, Panagiotis; Fountzilas, George

    2012-01-01

    In this study several tumor-related volumes were assessed by means of a computer-based application and a survival analysis was conducted to evaluate the prognostic significance of pre- and postoperative volumetric data in patients harboring glioblastomas. In addition, MGMT (O 6 -methylguanine methyltransferase) related parameters were compared with those of volumetry in order to observe possible relevance of this molecule in tumor development. We prospectively analyzed 65 patients suffering from glioblastoma (GBM) who underwent radiotherapy with concomitant adjuvant temozolomide. For the purpose of volumetry T1 and T2-weighted magnetic resonance (MR) sequences were used, acquired both pre- and postoperatively (pre-radiochemotherapy). The volumes measured on preoperative MR images were necrosis, enhancing tumor and edema (including the tumor) and on postoperative ones, net-enhancing tumor. Age, sex, performance status (PS) and type of operation were also included in the multivariate analysis. MGMT was assessed for promoter methylation with Multiplex Ligation-dependent Probe Amplification (MLPA), for RNA expression with real time PCR, and for protein expression with immunohistochemistry in a total of 44 cases with available histologic material. In the multivariate analysis a negative impact was shown for pre-radiochemotherapy net-enhancing tumor on the overall survival (OS) (p = 0.023) and for preoperative necrosis on progression-free survival (PFS) (p = 0.030). Furthermore, the multivariate analysis confirmed the importance of PS in PFS and OS of patients. MGMT promoter methylation was observed in 13/23 (43.5%) evaluable tumors; complete methylation was observed in 3/13 methylated tumors only. High rate of MGMT protein positivity (> 20% positive neoplastic nuclei) was inversely associated with pre-operative tumor necrosis (p = 0.021). Our findings implicate that volumetric parameters may have a significant role in the prognosis of GBM patients. Furthermore

  3. Micro-epidemiology and spatial heterogeneity of P. vivax parasitaemia in riverine communities of the Peruvian Amazon: A multilevel analysis.

    Science.gov (United States)

    Carrasco-Escobar, Gabriel; Gamboa, Dionicia; Castro, Marcia C; Bangdiwala, Shrikant I; Rodriguez, Hugo; Contreras-Mancilla, Juan; Alava, Freddy; Speybroeck, Niko; Lescano, Andres G; Vinetz, Joseph M; Rosas-Aguirre, Angel; Llanos-Cuentas, Alejandro

    2017-08-14

    Malaria has steadily increased in the Peruvian Amazon over the last five years. This study aimed to determine the parasite prevalence and micro-geographical heterogeneity of Plasmodium vivax parasitaemia in communities of the Peruvian Amazon. Four cross-sectional active case detection surveys were conducted between May and July 2015 in four riverine communities in Mazan district. Analysis of 2785 samples of 820 individuals nested within 154 households for Plasmodium parasitaemia was carried out using light microscopy and qPCR. The spatio-temporal distribution of Plasmodium parasitaemia, dominated by P. vivax, was shown to cluster at both household and community levels. Of enrolled individuals, 47% had at least one P. vivax parasitaemia and 10% P. falciparum, by qPCR, both of which were predominantly sub-microscopic and asymptomatic. Spatial analysis detected significant clustering in three communities. Our findings showed that communities at small-to-moderate spatial scales differed in P. vivax parasite prevalence, and multilevel Poisson regression models showed that such differences were influenced by factors such as age, education, and location of households within high-risk clusters, as well as factors linked to a local micro-geographic context, such as travel and occupation. Complex transmission patterns were found to be related to human mobility among communities in the same micro-basin.

  4. Individual and couple-level risk factors for hepatitis C infection among heterosexual drug users: a multilevel dyadic analysis.

    Science.gov (United States)

    McMahon, James M; Pouget, Enrique R; Tortu, Stephanie

    2007-06-01

    Hepatitis C virus (HCV) is the most common bloodborne pathogen in the United States and is a leading cause of liver-related morbidity and mortality. Although it is known that HCV is most commonly transmitted among injection drug users, the role of sexual transmission in the spread of HCV remains controversial because of inconsistent findings across studies involving heterosexual couples. A novel multilevel modeling technique designed to overcome the limitations of previous research was performed to assess multiple risk factors for HCV while partitioning the source of risk at the individual and couple level. The analysis was performed on risk exposure and HCV screening data obtained from 265 drug-using couples in East Harlem, New York City. In multivariable analysis, significant individual risk factors for HCV included a history of injection drug use, tattooing, and older age. At the couple level, HCV infection tended to cluster within couples, and this interdependence was accounted for by couples' drug-injection behavior. Individual and couple-level sexual behavior was not associated with HCV infection. Our results are consistent with prior research indicating that sexual contact plays little role in HCV transmission. Rather, couples' injection behavior appears to account for the clustering of HCV within heterosexual dyads.

  5. Multilevel Analysis of Factors Associated with Wasting and Underweight among Children Under-Five Years in Nigeria

    Directory of Open Access Journals (Sweden)

    Blessing J. Akombi

    2017-01-01

    Full Text Available Wasting and underweight reflect poor nutrition, which in children leads to retarded growth. The aim of this study is to determine the factors associated with wasting and underweight among children aged 0–59 months in Nigeria. A sample of 24,529 children aged 0–59 months from the 2013 Nigeria Demographic and Health Survey (NDHS was used. Multilevel logistic regression analysis that adjusted for cluster and survey weights was used to identify significant factors associated with wasting/severe wasting and underweight/severe underweight. The prevalence of wasting was 18% (95% Confidence Interval (CI: 17.1, 19.7 and severe wasting 9% (95% CI: 7.9, 9.8. The prevalence of underweight was 29% (95% CI: 27.1, 30.5 and severe underweight 12% (95% CI: 10.6, 12.9. Multivariable analysis revealed that the most consistent factors associated with wasting/severe wasting and underweight/severe underweight are: geopolitical zone (North East, North West and North Central, perceived birth size (small and average, sex of child (male, place/mode of delivery (home delivery and non-caesarean and a contraction of fever in the two weeks prior to the survey. In order to meet the WHO’s global nutrition target for 2025, interventions aimed at improving maternal health and access to health care services for children especially in the northern geopolitical zones of Nigeria are urgently needed.

  6. Survival analysis and classification methods for forest fire size.

    Science.gov (United States)

    Tremblay, Pier-Olivier; Duchesne, Thierry; Cumming, Steven G

    2018-01-01

    Factors affecting wildland-fire size distribution include weather, fuels, and fire suppression activities. We present a novel application of survival analysis to quantify the effects of these factors on a sample of sizes of lightning-caused fires from Alberta, Canada. Two events were observed for each fire: the size at initial assessment (by the first fire fighters to arrive at the scene) and the size at "being held" (a state when no further increase in size is expected). We developed a statistical classifier to try to predict cases where there will be a growth in fire size (i.e., the size at "being held" exceeds the size at initial assessment). Logistic regression was preferred over two alternative classifiers, with covariates consistent with similar past analyses. We conducted survival analysis on the group of fires exhibiting a size increase. A screening process selected three covariates: an index of fire weather at the day the fire started, the fuel type burning at initial assessment, and a factor for the type and capabilities of the method of initial attack. The Cox proportional hazards model performed better than three accelerated failure time alternatives. Both fire weather and fuel type were highly significant, with effects consistent with known fire behaviour. The effects of initial attack method were not statistically significant, but did suggest a reverse causality that could arise if fire management agencies were to dispatch resources based on a-priori assessment of fire growth potentials. We discuss how a more sophisticated analysis of larger data sets could produce unbiased estimates of fire suppression effect under such circumstances.

  7. Survival analysis and classification methods for forest fire size

    Science.gov (United States)

    2018-01-01

    Factors affecting wildland-fire size distribution include weather, fuels, and fire suppression activities. We present a novel application of survival analysis to quantify the effects of these factors on a sample of sizes of lightning-caused fires from Alberta, Canada. Two events were observed for each fire: the size at initial assessment (by the first fire fighters to arrive at the scene) and the size at “being held” (a state when no further increase in size is expected). We developed a statistical classifier to try to predict cases where there will be a growth in fire size (i.e., the size at “being held” exceeds the size at initial assessment). Logistic regression was preferred over two alternative classifiers, with covariates consistent with similar past analyses. We conducted survival analysis on the group of fires exhibiting a size increase. A screening process selected three covariates: an index of fire weather at the day the fire started, the fuel type burning at initial assessment, and a factor for the type and capabilities of the method of initial attack. The Cox proportional hazards model performed better than three accelerated failure time alternatives. Both fire weather and fuel type were highly significant, with effects consistent with known fire behaviour. The effects of initial attack method were not statistically significant, but did suggest a reverse causality that could arise if fire management agencies were to dispatch resources based on a-priori assessment of fire growth potentials. We discuss how a more sophisticated analysis of larger data sets could produce unbiased estimates of fire suppression effect under such circumstances. PMID:29320497

  8. Availability of convenience stores and adolescent alcohol use in Taiwan: a multi-level analysis of national surveys.

    Science.gov (United States)

    Wang, Shi-Heng; Lin, I-Chin; Chen, Chuan-Yu; Chen, Duan-Rung; Chan, Ta-Chien; Chen, Wei J

    2013-12-01

    To examine the association between alcohol in school environments and adolescent alcohol use over the previous 6 months. A multi-level logistic regression analysis was performed of cross-sectional surveys conducted in 2004, 2005 and 2006. A total of 52 214 students aged 11-19 years from 387 middle or high schools were selected from a nationally representative, multi-stage, stratified probability sampling across Taiwan. Information on socio-demographic features and substance use experiences was collected using self-administered questionnaires. The alcohol in the environment was measured using the availability of convenience stores surrounding the schools. Using geographical information systems, the weighted numbers of convenience stores within 1 km, a 12-15-minute walk, of a school were calculated. The schools were later categorized into three subgroups via the tertile of nearby convenience stores. Considering the compositional characteristics, the availability of convenience stores was found to account for 1.5% of the school-level variance of youthful drinking. The odds ratios (95% confidence interval) of alcohol use over the previous 6 months among youth attending schools with medium and high availability were 1.04 (0.96-1.13) and 1.08 (1.00-1.17), respectively, with a P-value of 0.04 in the trend test. The greater availability of convenience stores near a school is associated with an increased risk of alcohol use among adolescents over the previous 6 months. © 2013 Society for the Study of Addiction.

  9. Analysis of a Multilevel Dual Active Bridge (ML-DAB DC-DC Converter Using Symmetric Modulation

    Directory of Open Access Journals (Sweden)

    M. A. Moonem

    2015-04-01

    Full Text Available Dual active bridge (DAB converters have been popular in high voltage, low and medium power DC-DC applications, as well as an intermediate high frequency link in solid state transformers. In this paper, a multilevel DAB (ML-DAB has been proposed in which two active bridges produce two-level (2L-5L, 5L-2L and 3L-5L voltage waveforms across the high frequency transformer. The proposed ML-DAB has the advantage of being used in high step-up/down converters, which deal with higher voltages, as compared to conventional two-level DABs. A three-level neutral point diode clamped (NPC topology has been used in the high voltage bridge, which enables the semiconductor switches to be operated within a higher voltage range without the need for cascaded bridges or multiple two-level DAB converters. A symmetric modulation scheme, based on the least number of angular parameters rather than the duty-ratio, has been proposed for a different combination of bridge voltages. This ML-DAB is also suitable for maximum power point tracking (MPPT control in photovoltaic applications. Steady-state analysis of the converter with symmetric phase-shift modulation is presented and verified using simulation and hardware experiments.

  10. Social disorganization and history of child sexual abuse against girls in sub-Saharan Africa: a multilevel analysis.

    Science.gov (United States)

    Yahaya, Ismail; Uthman, Olalekan A; Soares, Joaquim; Macassa, Gloria

    2013-08-07

    Child sexual abuse (CSA) is a considerable public health problem. Less focus has been paid to the role of community level factors associated with CSA. The aim of this study was to examine the association between neighbourhood-level measures of social disorganization and CSA. We applied multiple multilevel logistic regression analysis on Demographic and Health Survey data for 6,351 adolescents from six countries in sub-Saharan Africa between 2006 and 2008. The percentage of adolescents that had experienced CSA ranged from 1.04% to 5.84%. There was a significant variation in the odds of reporting CSA across the communities, suggesting 18% of the variation in CSA could be attributed to community level factors. Respondents currently employed were more likely to have reported CSA than those who were unemployed (odds ratio [OR]=2.05, 95% confidence interval [CI] 1.48 to 2.83). Respondents from communities with a high family disruption rate were 57% more likely to have reported CSA (OR=1.57, 95% CI 1.14 to 2.16). We found that exposure to CSA was associated with high community level of family disruption, thus suggesting that neighbourhoods may indeed have significant important effects on exposure to CSA. Further studies are needed to explore pathways that connect the individual and neighbourhood levels, that is, means through which deleterious neighbourhood effects are transmitted to individuals.

  11. Comparative Analysis of Public Attitudes toward Nuclear Power Energy across 27 European Countries by Applying the Multilevel Model

    Directory of Open Access Journals (Sweden)

    Jaesun Wang

    2018-05-01

    Full Text Available Despite its potential risks, nuclear power energy offers some economic benefits including cheap electricity. This benefit clarifies part of the reason why people support nuclear energy. Our research examined whether there was a difference in the acceptance of nuclear energy across 27 European countries in 2009, before the Fukushima accident. In particular, we analyzed how each factor at the individual and contextual level influences the acceptance. To answer this question, we set up the acceptance of nuclear energy as a dependent variable, and 5 perception variables at the individual level and 11 structural ones at the contextual level as independent variables. We executed multilevel modeling by using a Eurobarometer survey, which covered 27 European countries. The analysis results showed that at the individual level, the perceived benefit explained the largest variance of the acceptance, followed by perceived risk and trust. At the contextual level, the share of the energy supply by nuclear power, environmentalism and ideology influenced the acceptance of nuclear energy. This study shows that individuals’ acceptance of nuclear energy is based on individual beliefs and perceptions, but it is also influenced by the institutional and socio-cultural context which each country faces.

  12. Venue-level correlates of female sex worker registration status: A multilevel analysis of bars in Tijuana, Mexico

    Science.gov (United States)

    Gaines, Tommi L.; Rusch, Melanie L.A.; Brouwer, Kimberly C.; Goldenberg, Shira M.; Lozada, Remedios; Robertson, Angela M.; Perkins, Emily; Strathdee, Steffanie A.; Patterson, Thomas L.

    2013-01-01

    In Tijuana, Mexico, sex work is regulated by the municipal government, through registration cards issued to female sex workers (FSWs) for an annual fee. Registration has been associated with decreased drug use and increase condom use and HIV testing. Previously, it was demonstrated that FSWs operating in bars were more likely than street-based FSWs to be registered. This implies that certain venues may be more accessible to local authorities for the enforcement of this type of programme. Taking a novel multilevel approach, we examined whether venue characteristics of bars reflecting greater organised management and visibility affect registration status of FSWs. In an analysis of venue-level characteristics, predictors of being registered were availability of free condoms at work and distance to the main sex strip; however, these were not independently associated after inclusion of FSWs’ income, illicit drug use and history of HIV testing. Our findings suggest that sex work regulations may inadvertently exclude venues in which the more vulnerable and less visible FSWs, such as injection drug users and those with limited financial resources, are situated. Efforts to revise or reconsider sex work regulations to ensure that they best promote FSWs’ health, human and labour rights are recommended. PMID:23534477

  13. Accumulation of health risk behaviours is associated with lower socioeconomic status and women's urban residence: a multilevel analysis in Japan

    Directory of Open Access Journals (Sweden)

    Takano Takehito

    2005-05-01

    Full Text Available Abstract Background Little is known about the socioeconomic differences in health-related behaviours in Japan. The present study was performed to elucidate the effects of individual and regional socioeconomic factors on selected health risk behaviours among Japanese adults, with a particular focus on regional variations. Methods In a nationally representative sample aged 25 to 59 years old (20,030 men and 21,076 women, the relationships between six risk behaviours (i.e., current smoking, excessive alcohol consumption, poor dietary habits, physical inactivity, stress and non-attendance of health check-ups, individual characteristics (i.e., age, marital status, occupation and household income and regional (N = 60 indicators (per capita income and unemployment rate were examined by multilevel analysis. Results Divorce, employment in women, lower occupational class and lower household income were generally associated with a higher likelihood of risk behaviour. The degrees of regional variation in risk behaviour and the influence of regional indicators were greater in women than in men: higher per capita income was significantly associated with current smoking, excessive alcohol consumption, stress and non-attendance of health check-ups in women. Conclusion Individual lower socioeconomic status was a substantial predictor of risk behaviour in both sexes, while a marked regional influence was observed only in women. The accumulation of risk behaviours in individuals with lower socioeconomic status and in women in areas with higher income, reflecting an urban context, may contribute to their higher mortality rates.

  14. Venue-level correlates of female sex worker registration status: a multilevel analysis of bars in Tijuana, Mexico.

    Science.gov (United States)

    Gaines, Tommi L; Rusch, Melanie L A; Brouwer, Kimberly C; Goldenberg, Shira M; Lozada, Remedios; Robertson, Angela M; Perkins, Emily; Strathdee, Steffanie A; Patterson, Thomas L

    2013-01-01

    In Tijuana, Mexico, sex work is regulated by the municipal government, through registration cards issued to female sex workers (FSWs) for an annual fee. Registration has been associated with decreased drug use and increase condom use and HIV testing. Previously, it was demonstrated that FSWs operating in bars were more likely than street-based FSWs to be registered. This implies that certain venues may be more accessible to local authorities for the enforcement of this type of programme. Taking a novel multilevel approach, we examined whether venue characteristics of bars reflecting greater organised management and visibility affect registration status of FSWs. In an analysis of venue-level characteristics, predictors of being registered were availability of free condoms at work and distance to the main sex strip; however, these were not independently associated after inclusion of FSWs' income, illicit drug use and history of HIV testing. Our findings suggest that sex work regulations may inadvertently exclude venues in which the more vulnerable and less visible FSWs, such as injection drug users and those with limited financial resources, are situated. Efforts to revise or reconsider sex work regulations to ensure that they best promote FSWs' health, human and labour rights are recommended.

  15. Does regional disadvantage affect health-related sport and physical activity level? A multi-level analysis of individual behaviour.

    Science.gov (United States)

    Wicker, Pamela; Downward, Paul; Lera-López, Fernando

    2017-11-01

    This study examines the role of regional government quality in health-related participation in sport and physical activity among adults (18-64 years) in 28 European countries. The importance of the analysis rests in the relative autonomy that regional and local governments have over policy decisions connected with sport and physical activity. While existing studies have focussed on economic and infrastructural investment and expenditure, this research investigates the quality of regional governments across 208 regions within 28 European countries. The individual-level data stem from the 2013 Eurobarometer 80.2 (n = 18,675) and were combined with regional-level data from Eurostat. An individual's level of participation in sport and physical activity was measured by three variables reflecting whether an individual's activity level is below, meets, or exceeds the recommendations of the World Health Organization. The results of multi-level analyses reveal that regional government quality has a significant and positive association with individual participation in sport and physical activity at a level meeting or exceeding the guidelines. The impact is much larger than that of regional gross domestic product per capita, indicating that regional disadvantage in terms of political quality is more relevant than being disadvantaged in terms of economic wealth.

  16. Job demands, burnout, and engagement among nurses: A multi-level analysis of ORCAB data investigating the moderating effect of teamwork

    OpenAIRE

    Montgomery, Anthony; Sp?nu, Florina; B?ban, Adriana; Panagopoulou, Efharis

    2015-01-01

    According to the Job Demands-Resources (JD-R) model, burnout and engagement are psychological reactions that develop when individual characteristics interact with work characteristics. This study tests the JD-R model using multilevel analysis to test the main and moderating effects of teamwork effectiveness among 1156 nurses in 93 departments from seven European countries. Workload, emotional and organizational demands were positively associated with emotional exhaustion, depersonalization, a...

  17. Multilevel modeling using R

    CERN Document Server

    Finch, W Holmes; Kelley, Ken

    2014-01-01

    A powerful tool for analyzing nested designs in a variety of fields, multilevel/hierarchical modeling allows researchers to account for data collected at multiple levels. Multilevel Modeling Using R provides you with a helpful guide to conducting multilevel data modeling using the R software environment.After reviewing standard linear models, the authors present the basics of multilevel models and explain how to fit these models using R. They then show how to employ multilevel modeling with longitudinal data and demonstrate the valuable graphical options in R. The book also describes models fo

  18. An Approach to Addressing Selection Bias in Survival Analysis

    Science.gov (United States)

    Carlin, Caroline S.; Solid, Craig A.

    2014-01-01

    This work proposes a frailty model that accounts for non-random treatment assignment in survival analysis. Using Monte Carlo simulation, we found that estimated treatment parameters from our proposed endogenous selection survival model (esSurv) closely parallel the consistent two-stage residual inclusion (2SRI) results, while offering computational and interpretive advantages. The esSurv method greatly enhances computational speed relative to 2SRI by eliminating the need for bootstrapped standard errors, and generally results in smaller standard errors than those estimated by 2SRI. In addition, esSurv explicitly estimates the correlation of unobservable factors contributing to both treatment assignment and the outcome of interest, providing an interpretive advantage over the residual parameter estimate in the 2SRI method. Comparisons with commonly used propensity score methods and with a model that does not account for non-random treatment assignment show clear bias in these methods that is not mitigated by increased sample size. We illustrate using actual dialysis patient data comparing mortality of patients with mature arteriovenous grafts for venous access to mortality of patients with grafts placed but not yet ready for use at the initiation of dialysis. We find strong evidence of endogeneity (with estimate of correlation in unobserved factors ρ̂ = 0.55), and estimate a mature-graft hazard ratio of 0.197 in our proposed method, with a similar 0.173 hazard ratio using 2SRI. The 0.630 hazard ratio from a frailty model without a correction for the non-random nature of treatment assignment illustrates the importance of accounting for endogeneity. PMID:24845211

  19. Modeling Multi-Level Systems

    CERN Document Server

    Iordache, Octavian

    2011-01-01

    This book is devoted to modeling of multi-level complex systems, a challenging domain for engineers, researchers and entrepreneurs, confronted with the transition from learning and adaptability to evolvability and autonomy for technologies, devices and problem solving methods. Chapter 1 introduces the multi-scale and multi-level systems and highlights their presence in different domains of science and technology. Methodologies as, random systems, non-Archimedean analysis, category theory and specific techniques as model categorification and integrative closure, are presented in chapter 2. Chapters 3 and 4 describe polystochastic models, PSM, and their developments. Categorical formulation of integrative closure offers the general PSM framework which serves as a flexible guideline for a large variety of multi-level modeling problems. Focusing on chemical engineering, pharmaceutical and environmental case studies, the chapters 5 to 8 analyze mixing, turbulent dispersion and entropy production for multi-scale sy...

  20. The Association of Workplace Social Capital With Work Engagement of Employees in Health Care Settings: A Multilevel Cross-Sectional Analysis.

    Science.gov (United States)

    Fujita, Sumiko; Kawakami, Norito; Ando, Emiko; Inoue, Akiomi; Tsuno, Kanami; Kurioka, Sumiko; Kawachi, Ichiro

    2016-03-01

    The aim of the study was to examine the cross-sectional multilevel association between unit-level workplace social capital and individual-level work engagement among employees in health care settings. The data were collected from employees of a Japanese health care corporation using a questionnaire. The analyses were limited to 440 respondents from 35 units comprising five or more respondents per unit. Unit-level workplace social capital was calculated as an average score of the Workplace Social Capital Scale for each unit. Multilevel regression analysis with a random intercept model was conducted. After adjusting for demographic variables, unit-level workplace social capital was significantly and positively associated with respondents' work engagement (P capital (P capital might exert a positive contextual effect on work engagement of employees in health care settings.

  1. A survival analysis on critical components of nuclear power plants

    International Nuclear Information System (INIS)

    Durbec, V.; Pitner, P.; Riffard, T.

    1995-06-01

    Some tubes of heat exchangers of nuclear power plants may be affected by Primary Water Stress Corrosion Cracking (PWSCC) in highly stressed areas. These defects can shorten the lifetime of the component and lead to its replacement. In order to reduce the risk of cracking, a preventive remedial operation called shot peening was applied on the French reactors between 1985 and 1988. To assess and investigate the effects of shot peening, a statistical analysis was carried on the tube degradation results obtained from in service inspection that are regularly conducted using non destructive tests. The statistical method used is based on the Cox proportional hazards model, a powerful tool in the analysis of survival data, implemented in PROC PHRED recently available in SAS/STAT. This technique has a number of major advantages including the ability to deal with censored failure times data and with the complication of time-dependant co-variables. The paper focus on the modelling and a presentation of the results given by SAS. They provide estimate of how the relative risk of degradation changes after peening and indicate for which values of the prognostic factors analyzed the treatment is likely to be most beneficial. (authors). 2 refs., 3 figs., 6 tabs

  2. Multilevel analysis of facial expressions of emotion and script: self-report (arousal and valence) and psychophysiological correlates.

    Science.gov (United States)

    Balconi, Michela; Vanutelli, Maria Elide; Finocchiaro, Roberta

    2014-09-26

    The paper explored emotion comprehension in children with regard to facial expression of emotion. The effect of valence and arousal evaluation, of context and of psychophysiological measures was monitored. Indeed subjective evaluation of valence (positive vs. negative) and arousal (high vs. low), and contextual (facial expression vs. facial expression and script) variables were supposed to modulate the psychophysiological responses. Self-report measures (in terms of correct recognition, arousal and valence attribution) and psychophysiological correlates (facial electromyography, EMG, skin conductance response, SCR, and heart rate, HR) were observed when children (N = 26; mean age = 8.75 y; range 6-11 y) looked at six facial expressions of emotions (happiness, anger, fear, sadness, surprise, and disgust) and six emotional scripts (contextualized facial expressions). The competencies about the recognition, the evaluation on valence and arousal was tested in concomitance with psychophysiological variations. Specifically, we tested for the congruence of these multiple measures. Log-linear analysis and repeated measure ANOVAs showed different representations across the subjects, as a function of emotion. Specifically, children' recognition and attribution were well developed for some emotions (such as anger, fear, surprise and happiness), whereas some other emotions (mainly disgust and sadness) were less clearly represented. SCR, HR and EMG measures were modulated by the evaluation based on valence and arousal, with increased psychophysiological values mainly in response to anger, fear and happiness. As shown by multiple regression analysis, a significant consonance was found between self-report measures and psychophysiological behavior, mainly for emotions rated as more arousing and negative in valence. The multilevel measures were discussed at light of dimensional attribution model.

  3. Trade liberalization and tuberculosis incidence: a longitudinal multi-level analysis in 22 high burden countries between 1990 and 2010.

    Science.gov (United States)

    Bozorgmehr, Kayvan; San Sebastian, Miguel

    2014-05-01

    Trade liberalization is promoted by the World Trade Organization (WTO) through a complex architecture of binding trade agreements. This type of trade, however, has the potential to modify the upstream and proximate determinants of tuberculosis (TB) infection. We aimed to analyse the association between trade liberalization and TB incidence in 22 high-burden TB countries between 1990 and 2010. and findings A longitudinal multi-level linear regression analysis was performed using five different measures of trade liberalization as exposure [WTO membership, duration of membership, trade as % of gross domestic product, and components of both the Economic Freedom of the World Index (EFI4) and the KOF Index of Globalization (KOF1)]. We adjusted for a wide range of factors, including differences in human development index (HDI), income inequality, debts, polity patterns, conflict, overcrowding, population stage transition, health system financing, case detection rates and HIV prevalence. None of the five trade indicators was significantly associated with TB incidence in the crude analysis. Any positive effect of EFI4 on (Log-) TB incidence over time was confounded by differences in socio-economic development (HDI), HIV prevalence and health financing indicators. The adjusted TB incidence rate ratio of WTO member countries was significantly higher [RR: 1.60; 95% confidence interval (CI): 1.12-2.29] when compared with non-member countries. We found no association between specific aggregate indicators of trade liberalization and TB incidence. Our analyses provide evidence of a significant association between WTO membership and higher TB incidence, which suggests a possible conflict between the architecture of WTO agreements and TB-related Millennium Development Goals. Further research is needed, particularly on the relation between the aggregate trade indices used in this study and the hypothesized mediators and also on sector-specific indices, specific trade agreements and

  4. Hybrid PV/diesel solar power system design using multi-level factor analysis optimization

    Science.gov (United States)

    Drake, Joshua P.

    Solar power systems represent a large area of interest across a spectrum of organizations at a global level. It was determined that a clear understanding of current state of the art software and design methods, as well as optimization methods, could be used to improve the design methodology. Solar power design literature was researched for an in depth understanding of solar power system design methods and algorithms. Multiple software packages for the design and optimization of solar power systems were analyzed for a critical understanding of their design workflow. In addition, several methods of optimization were studied, including brute force, Pareto analysis, Monte Carlo, linear and nonlinear programming, and multi-way factor analysis. Factor analysis was selected as the most efficient optimization method for engineering design as it applied to solar power system design. The solar power design algorithms, software work flow analysis, and factor analysis optimization were combined to develop a solar power system design optimization software package called FireDrake. This software was used for the design of multiple solar power systems in conjunction with an energy audit case study performed in seven Tibetan refugee camps located in Mainpat, India. A report of solar system designs for the camps, as well as a proposed schedule for future installations was generated. It was determined that there were several improvements that could be made to the state of the art in modern solar power system design, though the complexity of current applications is significant.

  5. A comparative analysis of multi-level computer-assisted decision making systems for traumatic injuries

    Directory of Open Access Journals (Sweden)

    Huynh Toan

    2009-01-01

    Full Text Available Abstract Background This paper focuses on the creation of a predictive computer-assisted decision making system for traumatic injury using machine learning algorithms. Trauma experts must make several difficult decisions based on a large number of patient attributes, usually in a short period of time. The aim is to compare the existing machine learning methods available for medical informatics, and develop reliable, rule-based computer-assisted decision-making systems that provide recommendations for the course of treatment for new patients, based on previously seen cases in trauma databases. Datasets of traumatic brain injury (TBI patients are used to train and test the decision making algorithm. The work is also applicable to patients with traumatic pelvic injuries. Methods Decision-making rules are created by processing patterns discovered in the datasets, using machine learning techniques. More specifically, CART and C4.5 are used, as they provide grammatical expressions of knowledge extracted by applying logical operations to the available features. The resulting rule sets are tested against other machine learning methods, including AdaBoost and SVM. The rule creation algorithm is applied to multiple datasets, both with and without prior filtering to discover significant variables. This filtering is performed via logistic regression prior to the rule discovery process. Results For survival prediction using all variables, CART outperformed the other machine learning methods. When using only significant variables, neural networks performed best. A reliable rule-base was generated using combined C4.5/CART. The average predictive rule performance was 82% when using all variables, and approximately 84% when using significant variables only. The average performance of the combined C4.5 and CART system using significant variables was 89.7% in predicting the exact outcome (home or rehabilitation, and 93.1% in predicting the ICU length of stay for

  6. Analysis of Functional Data with Focus on Multinomial Regression and Multilevel Data

    DEFF Research Database (Denmark)

    Mousavi, Seyed Nourollah

    Functional data analysis (FDA) is a fast growing area in statistical research with increasingly diverse range of application from economics, medicine, agriculture, chemometrics, etc. Functional regression is an area of FDA which has received the most attention both in aspects of application...... and methodological development. Our main Functional data analysis (FDA) is a fast growing area in statistical research with increasingly diverse range of application from economics, medicine, agriculture, chemometrics, etc. Functional regression is an area of FDA which has received the most attention both in aspects...

  7. Collinear Latent Variables in Multilevel Confirmatory Factor Analysis : A Comparison of Maximum Likelihood and Bayesian Estimation

    NARCIS (Netherlands)

    Can, Seda; van de Schoot, Rens|info:eu-repo/dai/nl/304833207; Hox, Joop|info:eu-repo/dai/nl/073351431

    2015-01-01

    Because variables may be correlated in the social and behavioral sciences, multicollinearity might be problematic. This study investigates the effect of collinearity manipulated in within and between levels of a two-level confirmatory factor analysis by Monte Carlo simulation. Furthermore, the

  8. School Health Promotion Policies and Adolescent Risk Behaviors in Israel: A Multilevel Analysis

    Science.gov (United States)

    Tesler, Riki; Harel-Fisch, Yossi; Baron-Epel, Orna

    2016-01-01

    Background: Health promotion policies targeting risk-taking behaviors are being implemented across schools in Israel. This study identified the most effective components of these policies influencing cigarette smoking and alcohol consumption among adolescents. Methods: Logistic hierarchical linear model (HLM) analysis of data for 5279 students in…

  9. Individual data meta-analysis for the study of survival after pulmonary metastasectomy in colorectal cancer patients: A history of resected liver metastases worsens the prognosis.

    Science.gov (United States)

    Zabaleta, Jon; Iida, Tomohiko; Falcoz, Pierre E; Salah, Samer; Jarabo, José R; Correa, Arlene M; Zampino, Maria G; Matsui, Takashi; Cho, Sukki; Ardissone, Francesco; Watanabe, Kazuhiro; Gonzalez, Michel; Gervaz, Pascal; Emparanza, Jose I; Abraira, Víctor

    2018-03-21

    To assess the impact of a history of liver metastases on survival in patients undergoing surgery for lung metastases from colorectal carcinoma. We reviewed recent studies identified by searching MEDLINE and EMBASE using the Ovid interface, with the following search terms: lung metastasectomy, pulmonary metastasectomy, lung metastases and lung metastasis, supplemented by manual searching. Inclusion criteria were that the research concerned patients with lung metastases from colorectal cancer undergoing surgery with curative intent, and had been published between 2007 and 2014. Exclusion criteria were that the paper was a review, concerned surgical techniques themselves (without follow-up), and included patients treated non-surgically. Using Stata 14, we performed aggregate data and individual data meta-analysis using random-effect and Cox multilevel models respectively. We collected data on 3501 patients from 17 studies. The overall median survival was 43 months. In aggregate data meta-analysis, the hazard ratio for patients with previous liver metastases was 1.19 (95% CI 0.90-1.47), with low heterogeneity (I 2 4.3%). In individual data meta-analysis, the hazard ratio for these patients was 1.37 (95% CI 1.14-1.64; p analysis identified the following factors significantly affecting survival: tumour-infiltrated pulmonary lymph nodes (p analysis protocol in PROSPERO (CRD42015017838). Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  10. Leaders in Interdependent Contexts Suppress Nonverbal Assertiveness: A Multilevel Analysis of Japanese University Club Leaders' and Members' Rank Signaling.

    Science.gov (United States)

    Ito, Atsuki; Gobel, Matthias S; Uchida, Yukiko

    2018-01-01

    Previous research has shown that leadership is signaled through nonverbal assertiveness. However, those studies have been mostly conducted in individualistic cultural contexts, such as in the U.S. Here, we suggest that one important strategy for goal attainment in collectivistic cultures is for leaders to self-regulate their behaviors. Thus, contrary to the previous evidence from individualistic cultural contexts, in collectivistic cultural contexts, leaders might suppress nonverbal assertiveness. To test this possibility, we assessed nonverbal behaviors (NVB) of Japanese leaders and members, and how they were evaluated by observers. We recruited Japanese leaders and members of university clubs and video-recorded them while introducing their club. Then, we coded their nonverbal rank signaling behavior. Finally, we asked a new set of naïve observers to watch these video-clips and to judge targets' suitability for being possible club leaders. Results of a multilevel analysis (level 1: individual participants, level 2: clubs) suggested that the more the club culture focused on tasks (rather than relationships), the more likely were leaders (but not members) of those clubs to suppress their nonverbal assertiveness. Naïve observers judged individuals who restrained from emitting nonverbal assertiveness as being more suitable and worthy club leaders. Thus, our findings demonstrate the cultural fit between contextual effects at the collective level (i.e., cultural orientation of a group) and the signaling and perceiving of social ranks at the individual level (i.e., suppression of nonverbal assertiveness). We discuss the importance of studying the cultural fit between the collective reality that people inhabit and people's psychology for future research in cultural psychology.

  11. Leaders in Interdependent Contexts Suppress Nonverbal Assertiveness: A Multilevel Analysis of Japanese University Club Leaders' and Members' Rank Signaling

    Directory of Open Access Journals (Sweden)

    Atsuki Ito

    2018-05-01

    Full Text Available Previous research has shown that leadership is signaled through nonverbal assertiveness. However, those studies have been mostly conducted in individualistic cultural contexts, such as in the U.S. Here, we suggest that one important strategy for goal attainment in collectivistic cultures is for leaders to self-regulate their behaviors. Thus, contrary to the previous evidence from individualistic cultural contexts, in collectivistic cultural contexts, leaders might suppress nonverbal assertiveness. To test this possibility, we assessed nonverbal behaviors (NVB of Japanese leaders and members, and how they were evaluated by observers. We recruited Japanese leaders and members of university clubs and video-recorded them while introducing their club. Then, we coded their nonverbal rank signaling behavior. Finally, we asked a new set of naïve observers to watch these video-clips and to judge targets' suitability for being possible club leaders. Results of a multilevel analysis (level 1: individual participants, level 2: clubs suggested that the more the club culture focused on tasks (rather than relationships, the more likely were leaders (but not members of those clubs to suppress their nonverbal assertiveness. Naïve observers judged individuals who restrained from emitting nonverbal assertiveness as being more suitable and worthy club leaders. Thus, our findings demonstrate the cultural fit between contextual effects at the collective level (i.e., cultural orientation of a group and the signaling and perceiving of social ranks at the individual level (i.e., suppression of nonverbal assertiveness. We discuss the importance of studying the cultural fit between the collective reality that people inhabit and people's psychology for future research in cultural psychology.

  12. Minimum Wage and Overweight and Obesity in Adult Women: A Multilevel Analysis of Low and Middle Income Countries.

    Science.gov (United States)

    Conklin, Annalijn I; Ponce, Ninez A; Frank, John; Nandi, Arijit; Heymann, Jody

    2016-01-01

    To describe the relationship between minimum wage and overweight and obesity across countries at different levels of development. A cross-sectional analysis of 27 countries with data on the legislated minimum wage level linked to socio-demographic and anthropometry data of non-pregnant 190,892 adult women (24-49 y) from the Demographic and Health Survey. We used multilevel logistic regression models to condition on country- and individual-level potential confounders, and post-estimation of average marginal effects to calculate the adjusted prevalence difference. We found the association between minimum wage and overweight/obesity was independent of individual-level SES and confounders, and showed a reversed pattern by country development stage. The adjusted overweight/obesity prevalence difference in low-income countries was an average increase of about 0.1 percentage points (PD 0.075 [0.065, 0.084]), and an average decrease of 0.01 percentage points in middle-income countries (PD -0.014 [-0.019, -0.009]). The adjusted obesity prevalence difference in low-income countries was an average increase of 0.03 percentage points (PD 0.032 [0.021, 0.042]) and an average decrease of 0.03 percentage points in middle-income countries (PD -0.032 [-0.036, -0.027]). This is among the first studies to examine the potential impact of improved wages on an important precursor of non-communicable diseases globally. Among countries with a modest level of economic development, higher minimum wage was associated with lower levels of obesity.

  13. Minimum Wage and Overweight and Obesity in Adult Women: A Multilevel Analysis of Low and Middle Income Countries.

    Directory of Open Access Journals (Sweden)

    Annalijn I Conklin

    Full Text Available To describe the relationship between minimum wage and overweight and obesity across countries at different levels of development.A cross-sectional analysis of 27 countries with data on the legislated minimum wage level linked to socio-demographic and anthropometry data of non-pregnant 190,892 adult women (24-49 y from the Demographic and Health Survey. We used multilevel logistic regression models to condition on country- and individual-level potential confounders, and post-estimation of average marginal effects to calculate the adjusted prevalence difference.We found the association between minimum wage and overweight/obesity was independent of individual-level SES and confounders, and showed a reversed pattern by country development stage. The adjusted overweight/obesity prevalence difference in low-income countries was an average increase of about 0.1 percentage points (PD 0.075 [0.065, 0.084], and an average decrease of 0.01 percentage points in middle-income countries (PD -0.014 [-0.019, -0.009]. The adjusted obesity prevalence difference in low-income countries was an average increase of 0.03 percentage points (PD 0.032 [0.021, 0.042] and an average decrease of 0.03 percentage points in middle-income countries (PD -0.032 [-0.036, -0.027].This is among the first studies to examine the potential impact of improved wages on an important precursor of non-communicable diseases globally. Among countries with a modest level of economic development, higher minimum wage was associated with lower levels of obesity.

  14. From continental priorities to local conservation: a multi-level analysis for African tortoises.

    Directory of Open Access Journals (Sweden)

    Pierluigi Bombi

    Full Text Available Terrestrial tortoises are the most endangered group of vertebrates but they are still largely ignored for defining global conservation priorities. In this paper, we explored within a hierarchical framework the potential contribution of prioritization studies at the continental scale to the planning of local initiatives for the conservation of African tortoises at the regional level. First, we modeled the distribution of all the African tortoise species, we calculated three indicators of conservation priority (i.e., species richness, conservation value, and complementarity, and we carried out a gap analysis at continental scale. Second, we focused on the most important region for tortoise conservation and performed the same analyses at higher resolution. Finally, we compared the results from the two scales for understanding the degree to which they are complementary. Southern Africa emerged from the continental analysis as the most important region for tortoises. Within this area, the high-resolution analysis pointed out specific core sites for conservation. The relative degree of species protection was assessed similarly at the two different resolutions. Two species appeared particularly vulnerable at both scales. Priority indices calculated at high resolution were correlated to the values calculated for the corresponding cells at low resolution but the congruence was stronger for species richness. Our results suggest to integrate the calculation of conservation value and complementarity into a hierarchical framework driven by species richness. The advantages of large scale planning include its broad perspective on complementarity and the capability to identify regions with greatest conservation potential. In this light, continental analyses allow targeting fine scale studies toward regions with maximum priority. The regional analyses at fine scale allow planning conservation measure at a resolution similar to that required for the practical

  15. Multilevel modeling and panel data analysis in educational research (Case study: National examination data senior high school in West Java)

    Science.gov (United States)

    Zulvia, Pepi; Kurnia, Anang; Soleh, Agus M.

    2017-03-01

    Individual and environment are a hierarchical structure consist of units grouped at different levels. Hierarchical data structures are analyzed based on several levels, with the lowest level nested in the highest level. This modeling is commonly call multilevel modeling. Multilevel modeling is widely used in education research, for example, the average score of National Examination (UN). While in Indonesia UN for high school student is divided into natural science and social science. The purpose of this research is to develop multilevel and panel data modeling using linear mixed model on educational data. The first step is data exploration and identification relationships between independent and dependent variable by checking correlation coefficient and variance inflation factor (VIF). Furthermore, we use a simple model approach with highest level of the hierarchy (level-2) is regency/city while school is the lowest of hierarchy (level-1). The best model was determined by comparing goodness-of-fit and checking assumption from residual plots and predictions for each model. Our finding that for natural science and social science, the regression with random effects of regency/city and fixed effects of the time i.e multilevel model has better performance than the linear mixed model in explaining the variability of the dependent variable, which is the average scores of UN.

  16. Savings in Public Services after the Crisis: A Multilevel Analysis of Public Preferences in the EU27 (Working Paper 8)

    NARCIS (Netherlands)

    S.G.J. Van de Walle (Steven); S.R. Jilke (Sebastian)

    2012-01-01

    textabstractPolicy responses to the financial crisis can be divided into cyclical and anti-cyclical approaches. The former advocates reducing public spending in times of financial constraints. The latter approach advocates public spending to boost the economy. Using multinomial multilevel

  17. Individual and Classroom Variables Associated with Relational Aggression in Elementary-School Aged Children: A Multilevel Analysis

    Science.gov (United States)

    Kuppens, S.; Grietens, H.; Onghena, P.; Michiels, D.; Subramanian, S. V.

    2008-01-01

    Relational aggression was studied within classroom environments by examining individual and classroom correlates among 2731 children (3rd-5th graders) during two successive measurement years. Multilevel analyses yielded small gender differences for relational aggression, indicating that such aggressive behavior was more associated with girls as…

  18. Macroeconomic Knowledge of Higher Education Students in Germany and Japan--A Multilevel Analysis of Contextual and Personal Effects

    Science.gov (United States)

    Zlatkin-Troitschanskaia, Olga; Schmidt, Susanne; Brückner, Sebastian; Förster, Manuel; Yamaoka, Michio; Asano, Tadayoshi

    2016-01-01

    Recent trends towards harmonising and internationalising business and economics studies in higher education are affecting the structure and content of programmes and courses, and necessitate more transparent and comparable information on students' economic knowledge and skills. In this study, we examine by linear multilevel regression modelling…

  19. Immigrant Students’ Emotional and Cognitive Engagement at School: A Multilevel Analysis of Students in 41 countries

    Science.gov (United States)

    Chiu, Ming Ming; Pong, Suet-ling; Mori, Izumi; Chow, Bonnie Wing-Yin

    2014-01-01

    Central to student learning and academic success, the school engagement of immigrant children also reflects their adaptation to a primary institution in their new country. Analysis of questionnaire responses of 276,165 fifteen-year-olds (50 % female) and their 10,789 school principals in 41 countries showed that school engagement has distinct, weakly-linked cognitive and emotional components. Native students had weaker attitudes toward school (cognitive engagement) but greater sense of belonging at school (emotional engagement) than immigrant students or students who spoke a foreign language at home. Students with better teacher–student relationships, teacher support or a classroom disciplinary climate often had a greater sense of belonging at school and had better attitudes toward school than other students. While immigrant students often have solid attitudes toward school, teachers can help them feel a greater sense of belonging at school. PMID:22484548

  20. Multi-Level Simulated Fault Injection for Data Dependent Reliability Analysis of RTL Circuit Descriptions

    Directory of Open Access Journals (Sweden)

    NIMARA, S.

    2016-02-01

    Full Text Available This paper proposes data-dependent reliability evaluation methodology for digital systems described at Register Transfer Level (RTL. It uses a hybrid hierarchical approach, combining the accuracy provided by Gate Level (GL Simulated Fault Injection (SFI and the low simulation overhead required by RTL fault injection. The methodology comprises the following steps: the correct simulation of the RTL system, according to a set of input vectors, hierarchical decomposition of the system into basic RTL blocks, logic synthesis of basic RTL blocks, data-dependent SFI for the GL netlists, and RTL SFI. The proposed methodology has been validated in terms of accuracy on a medium sized circuit – the parallel comparator used in Check Node Unit (CNU of the Low-Density Parity-Check (LDPC decoders. The methodology has been applied for the reliability analysis of a 128-bit Advanced Encryption Standard (AES crypto-core, for which the GL simulation was prohibitive in terms of required computational resources.

  1. Coronary heart disease prevalence and occupational structure in U.S. metropolitan areas: a multilevel analysis.

    Science.gov (United States)

    Michimi, Akihiko; Ellis-Griffith, Gregory; Nagy, Christine; Peterson, Tina

    2013-05-01

    This research explored the link between coronary heart disease (CHD) prevalence and metropolitan-area level occupational structure among 137 metropolitan/micropolitan statistical areas (MMSA) in the United States. Using data from the 2006-2008 Behavioral Risk Factor Surveillance System and 2007 County Business Patterns, logistic mixed models were developed to estimate CHD prevalence between MMSAs controlling for individual-level socioeconomic characteristics and various types of occupational structure. Results showed that CHD prevalence was lower in MMSAs where their economy was dominated by 'tourism and resort' and 'the quaternary sector' and higher in MMSAs dominated by 'manufacturing', 'transportation and warehousing', and 'mining'. MMSA-level effects on CHD were found in 'tourism and resort' and 'the quaternary sector' having lower risk and 'mining' having higher risk of CHD. Although these effects prevailed in many MMSAs, some MMSAs did not fit into these effects. Additional analysis indicated a possible link between metropolitan population loss and higher CHD prevalence especially in the coal mining region of the Appalachian Mountains. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Bias due to selective dichotomization of multilevel exposure classes in risk analysis studies

    International Nuclear Information System (INIS)

    Peralta, S.B.

    1992-01-01

    General equations are developed for odds and risk ratio calculation in risk analysis studies with multiple exposure metrics, specifically for the four-level Wertheimer-Leeper (WL) code used in electromagnetic field (EMF) health studies. For an m-level code there are m-1 ways of categorizing subjects as exposed or unexposed: this dichotomization may be biased to maximize (or minimize) the risk parameter. This result is illustrated using Monte-Carlo simulation of health data. Results vary depending on the dichotomy used: indications of increased risk, decreased risk, window effects and inverse window effects are obtained, reflecting the range of conflicting results found in present-day EMF research. These results stress the need for care in the presentation and interpretation of health data in risk studies, especially where the exposure classification system is arbitrarily modifiable. This indication is especially urgent in the EMF field in view of recent proposals to base new epidemiological studies on subjectively modified WL codes. 8 refs., 7 tabs

  3. Organizational performance impacting patient satisfaction in Ontario hospitals: a multilevel analysis

    Science.gov (United States)

    2013-01-01

    Background Patient satisfaction in health care constitutes an important component of organizational performance in the hospital setting. Satisfaction measures have been developed and used to evaluate and improve hospital performance, quality of care and physician practice. In order to direct improvement strategies, it is necessary to evaluate both individual and organizational factors that can impact patients’ perception of care. The study aims were to determine the dimensions of patient satisfaction, and to analyze the individual and organizational determinants of satisfaction dimensions in hospitals. Methods We used patient and hospital survey data as well as administrative data collected for a 2008 public hospital report in Ontario, Canada. We evaluated the clustering of patient survey items with exploratory factor analysis and derived plausible dimensions of satisfaction. A two-level multivariate model was fitted to analyze the determinants of satisfaction. Results We found eight satisfaction factors, with acceptable to good level of loadings and good reliability. More than 95% of variation in patient satisfaction scores was attributable to patient-level variation, with less than 5% attributable to hospital-level variation. The hierarchical models explain 5 to 17% of variation at the patient level and up to 52% of variation between hospitals. Individual patient characteristics had the strongest association with all dimensions of satisfaction. Few organizational performance indicators are associated with patient satisfaction and significant determinants differ according to the satisfaction dimension. Conclusions The research findings highlight the importance of adjusting for both patient-level and organization-level characteristics when evaluating patient satisfaction. Better understanding and measurement of organization-level activities and processes associated with patient satisfaction could contribute to improved satisfaction ratings and care quality. PMID

  4. Study of Hip Fracture Risk using Tree Structured Survival Analysis

    Directory of Open Access Journals (Sweden)

    Lu Y

    2003-01-01

    Full Text Available In dieser Studie wird das Hüftfraktur-Risiko bei postmenopausalen Frauen untersucht, indem die Frauen in verschiedene Subgruppen hinsichtlich dieses Risikos klassifiziert werden. Frauen in einer gemeinsamen Subgruppe haben ein ähnliches Risiko, hingegen in verschiedenen Subgruppen ein unterschiedliches Hüftfraktur-Risiko. Die Subgruppen wurden mittels der Tree Structured Survival Analysis (TSSA aus den Daten von 7.665 Frauen der SOF (Study of Osteoporosis Fracture ermittelt. Bei allen Studienteilnehmerinnen wurde die Knochenmineraldichte (BMD von Unterarm, Oberschenkelhals, Hüfte und Wirbelsäule gemessen. Die Zeit von der BMD-Messung bis zur Hüftfraktur wurde als Endpunkt notiert. Eine Stichprobe von 75% der Teilnehmerinnen wurde verwendet, um die prognostischen Subgruppen zu bilden (Trainings-Datensatz, während die anderen 25% als Bestätigung der Ergebnisse diente (Validierungs-Datensatz. Aufgrund des Trainings-Datensatzes konnten mittels TSSA 4 Subgruppen identifiziert werden, deren Hüftfraktur-Risiko bei einem Follow-up von im Mittel 6,5 Jahren bei 19%, 9%, 4% und 1% lag. Die Einteilung in die Subgruppen erfolgte aufgrund der Bewertung der BMD des Ward'schen Dreiecks sowie des Oberschenkelhalses und nach dem Alter. Diese Ergebnisse konnten mittels des Validierungs-Datensatzes reproduziert werden, was die Sinnhaftigkeit der Klassifizierungregeln in einem klinischen Setting bestätigte. Mittels TSSA war eine sinnvolle, aussagekräftige und reproduzierbare Identifikation von prognostischen Subgruppen, die auf dem Alter und den BMD-Werten beruhen, möglich. In this paper we studied the risk of hip fracture for post-menopausal women by classifying women into different subgroups based on their risk of hip fracture. The subgroups were generated such that all the women in a particular subgroup had relatively similar risk while women belonging to two different subgroups had rather different risks of hip fracture. We used the Tree Structured

  5. Are neighborhood bonding and bridging social capital protective against depressive mood in old age? A multilevel analysis in Japan.

    Science.gov (United States)

    Murayama, Hiroshi; Nofuji, Yu; Matsuo, Eri; Nishi, Mariko; Taniguchi, Yu; Fujiwara, Yoshinori; Shinkai, Shoji

    2015-01-01

    While the importance of distinguishing between bonding and bridging social capital is now understood, evidence remains sparse on their contextual effects on health. We examined the associations of neighborhood bonding and bridging social capital with depressive mood among older Japanese. A questionnaire survey of all community residents aged 65 and older in the city of Yabu, Hyogo Prefecture, Japan was conducted in July and August 2012. Bonding and bridging social capital were assessed by evaluating individual homogeneous and heterogeneous social networks in relation to age, gender, and socioeconomic status. Individual responses in each neighborhood were aggregated to create an index of neighborhood-level bonding/bridging social capital. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the associations of such social capital with depressive mood using multilevel binomial logistic regression analysis. Of the 7271 questionnaires distributed, 6416 were analyzed (covering 152 administrative neighborhoods). Approximately 56.8% of respondents were women, and the mean age was 76.2 ± 7.1 years. Neighborhood-level bonding social capital was inversely associated with depressive mood (OR = 0.84, 95% CI = 0.75-0.94), but neighborhood-level bridging social capital was not. Gender-stratified analysis revealed that neighborhood-level bonding social capital was inversely associated with depressive mood in both genders (OR = 0.83, 95% CI = 0.72-0.96 for men; OR = 0.85, 95% CI = 0.72-0.99 for women), while neighborhood-level bridging social capital was positively associated with depressive mood in women (OR = 1.15, 95% CI = 1.00-1.34). There was also a significant interaction between individual- and neighborhood-level bonding social capital, indicating that people with a weaker homogeneous network and living in a neighborhood with weaker bonding social capital were more likely to have depressive mood. Our results suggest that neighborhood social

  6. Causal Mediation Analysis of Survival Outcome with Multiple Mediators.

    Science.gov (United States)

    Huang, Yen-Tsung; Yang, Hwai-I

    2017-05-01

    Mediation analyses have been a popular approach to investigate the effect of an exposure on an outcome through a mediator. Mediation models with multiple mediators have been proposed for continuous and dichotomous outcomes. However, development of multimediator models for survival outcomes is still limited. We present methods for multimediator analyses using three survival models: Aalen additive hazard models, Cox proportional hazard models, and semiparametric probit models. Effects through mediators can be characterized by path-specific effects, for which definitions and identifiability assumptions are provided. We derive closed-form expressions for path-specific effects for the three models, which are intuitively interpreted using a causal diagram. Mediation analyses using Cox models under the rare-outcome assumption and Aalen additive hazard models consider effects on log hazard ratio and hazard difference, respectively; analyses using semiparametric probit models consider effects on difference in transformed survival time and survival probability. The three models were applied to a hepatitis study where we investigated effects of hepatitis C on liver cancer incidence mediated through baseline and/or follow-up hepatitis B viral load. The three methods show consistent results on respective effect scales, which suggest an adverse estimated effect of hepatitis C on liver cancer not mediated through hepatitis B, and a protective estimated effect mediated through the baseline (and possibly follow-up) of hepatitis B viral load. Causal mediation analyses of survival outcome with multiple mediators are developed for additive hazard and proportional hazard and probit models with utility demonstrated in a hepatitis study.

  7. Analysis and implementation of power managment and control strategy for six-phase multilevel ac drive system in fault condition

    DEFF Research Database (Denmark)

    Sanjeevikumar, P.; Grandi, Gabriele; Blaabjerg, Frede

    2016-01-01

    sources. The developed post-fault algorithm is applied when there is a fault by one VSI and the load is fed from the remaining three healthy VSIs. In faulty conditions the multilevel outputs are reduced from 3-level to 2-level, but still the system propagates with degraded power. Numerical simulation......This research article exploits the power management algorithm in post-fault conditions for a six-phase (quad) multilevel inverter. The drive circuit consists of four 2-level, three-phase voltage source inverter (VSI) supplying a six-phase open-end windings motor or/impedance load......, with circumstantial failure of one VSI investigated. A simplified level-shifted pulse-width modulation (PWM) algorithm is developed to modulate each couple of three-phase VSI as 3-level output voltage generators in normal operation. The total power of the whole ac drive is shared equally among the four isolated DC...

  8. Association of workplace and population characteristics with prevalence of hypertension among Brazilian industry workers: a multilevel analysis.

    Science.gov (United States)

    Vinholes, Daniele B; Bassanesi, Sérgio L; Chaves Junior, Hilton de Castro; Machado, Carlos Alberto; Melo, Ione M F; Fuchs, Flavio Danni; Fuchs, Sandra Costa

    2017-08-21

    Exposure to risk factors for hypertension may be influenced by the characteristics of the workplace, where workers spend most of their daily time. To evaluate the association between features of the companies, particularly the presence of facilities to provide meals, and of population characteristics and the prevalence of hypertension, taking into account individual risk factors for hypertension. This multilevel analysis was based on a cross-sectional study with individual and company data from the SESI (Serviço Social da Indústria-Social Service of Industries) study and population-based data from the national census statistics. Workers aged ≥15 years were randomly selected from small (20-99), medium (100-499) and large (≥500 employees) companies per state using multistage sampling. Logistic regression was used to analyse the association between hypertension and individual, workplace and population variables, with odds ratios (ORs; 95% CI) adjusted for three-level variables. 4818 Workers from 157 companies were interviewed and their blood pressure, weight and height were measured. Overall, 77% were men, aged 35.4 ±10.7 years, with 8.7 ±4.1 years of schooling and mostly worked in companies with a staff canteen (66%). Besides individual characteristics-being male, ageing, low schooling, alcohol abuse and higher BMI-a workplace with no staff canteen (OR=1.28; 95% CI 1.08 to 1.52), small companies (OR=1.31; 95% CI 1.07 to 1.60) and living in cities with higher economic inequality (OR=1.47; 95% CI 1.23 to 1.76) were associated with a higher risk for hypertension. Among Brazilian workers, the prevalence of hypertension is associated with individual risk factors, lack of a canteen at the workplace, small companies and higher economic inequalities of cities. These three-level characteristics help to interpret differences in the prevalence of hypertension between regions or countries. © Article author(s) (or their employer(s) unless otherwise stated in the

  9. Cross-national and multilevel correlates of partner violence: an analysis of data from population-based surveys.

    Science.gov (United States)

    Heise, Lori L; Kotsadam, Andreas

    2015-06-01

    On average, intimate partner violence affects nearly one in three women worldwide within their lifetime. But the distribution of partner violence is highly uneven, with a prevalence of less than 4% in the past 12 months in many high-income countries compared with at least 40% in some low-income settings. Little is known about the factors that drive the geographical distribution of partner violence or how macro-level factors might combine with individual-level factors to affect individual women's risk of intimate partner violence. We aimed to assess the role that women's status and other gender-related factors might have in defining levels of partner violence among settings. We compiled data for the 12 month prevalence of partner violence from 66 surveys (88 survey years) from 44 countries, representing 481 205 women between Jan 1, 2000, and Apr 17, 2013. Only surveys with comparable questions and state-of-the-art methods to ensure safety and encourage violence disclosure were used. With linear and quantile regression, we examined associations between macro-level measures of socioeconomic development, women's status, gender inequality, and gender-related norms and the prevalence of current partner violence at a population level. Multilevel modelling and tests for interaction were used to explore whether and how macro-level factors affect individual-level risk. The outcome for this analysis was the population prevalence of current partner violence, defined as the percentage of ever-partnered women (excluding widows without a current partner), aged from 15 years to 49 years who were victims of at least one act of physical or sexual violence within the past 12 months. Gender-related factors at the national and subnational level help to predict the population prevalence of physical and sexual partner violence within the past 12 months. Especially predictive of the geographical distribution of partner violence are norms related to male authority over female behaviour

  10. Individual and setting level predictors of the implementation of a skin cancer prevention program: a multilevel analysis

    Directory of Open Access Journals (Sweden)

    Brownson Ross C

    2010-05-01

    Full Text Available Abstract Background To achieve widespread cancer control, a better understanding is needed of the factors that contribute to successful implementation of effective skin cancer prevention interventions. This study assessed the relative contributions of individual- and setting-level characteristics to implementation of a widely disseminated skin cancer prevention program. Methods A multilevel analysis was conducted using data from the Pool Cool Diffusion Trial from 2004 and replicated with data from 2005. Implementation of Pool Cool by lifeguards was measured using a composite score (implementation variable, range 0 to 10 that assessed whether the lifeguard performed different components of the intervention. Predictors included lifeguard background characteristics, lifeguard sun protection-related attitudes and behaviors, pool characteristics, and enhanced (i.e., more technical assistance, tailored materials, and incentives are provided versus basic treatment group. Results The mean value of the implementation variable was 4 in both years (2004 and 2005; SD = 2 in 2004 and SD = 3 in 2005 indicating a moderate implementation for most lifeguards. Several individual-level (lifeguard characteristics and setting-level (pool characteristics and treatment group factors were found to be significantly associated with implementation of Pool Cool by lifeguards. All three lifeguard-level domains (lifeguard background characteristics, lifeguard sun protection-related attitudes and behaviors and six pool-level predictors (number of weekly pool visitors, intervention intensity, geographic latitude, pool location, sun safety and/or skin cancer prevention programs, and sun safety programs and policies were included in the final model. The most important predictors of implementation were the number of weekly pool visitors (inverse association and enhanced treatment group (positive association. That is, pools with fewer weekly visitors and pools in the enhanced

  11. Is Preventative Long-Segment Surgery for Multi-Level Spondylolysis Necessary? A Finite Element Analysis Study.

    Directory of Open Access Journals (Sweden)

    Jianqiang Mo

    Full Text Available For multi-level spondylolysis patients, surgeons commonly choose to fix all the segments with pars interarticularis defect even those without slippage and not responsible for clinical symptoms. In this study, we tried to study the necessity of the preventative long-segment surgery for the defected segment without slippage in treatment of multi-level spondylolysis patients from a biomechanical perspective.We established a bi-level spondylolysis model with pars defects at L4 and L5 segments, and simulated posterior lumbar interbody fusion (PLIF and pedicle screw fixation at L5-S1 level. Then we compared the biomechanical changes at L4 segment before and after surgery in neutral, flexion, extension, lateral bending and axial rotation position.The stress on L4 pars interarticularis was very similar before and after surgery, and reached the highest in axial rotation. The L3-L4 intradiscal pressure was almost the same, while L4-L5 intradiscal pressure changed a little in lateral bending (increase from 1.993 to 2.160 MPa and axial rotation (decrease from 1.639 to 1.307 MPa after surgery. The PLIF surgery caused a little increase of range of motion at adjacent L4-L5 and L3-L4 levels, but the change is very tiny (1 degree.The PLIF surgery will not cause significant biomechanical change at adjacent segment with pars defect in multi-level spondylolysis. On the contrary, excessive long-segment surgery will damage surrounding soft tissues which are important for maintaining the stability of spine. So a preventative long-segment surgery is not necessary for multi-level spondylolysis as long as there are no soft tissue degeneration signs at adjacent level.

  12. Is Preventative Long-Segment Surgery for Multi-Level Spondylolysis Necessary? A Finite Element Analysis Study.

    Science.gov (United States)

    Mo, Jianqiang; Zhang, Wen; Zhong, Dongyan; Xu, Hao; Wang, Lan; Yu, Jia; Luo, Zongping

    2016-01-01

    For multi-level spondylolysis patients, surgeons commonly choose to fix all the segments with pars interarticularis defect even those without slippage and not responsible for clinical symptoms. In this study, we tried to study the necessity of the preventative long-segment surgery for the defected segment without slippage in treatment of multi-level spondylolysis patients from a biomechanical perspective. We established a bi-level spondylolysis model with pars defects at L4 and L5 segments, and simulated posterior lumbar interbody fusion (PLIF) and pedicle screw fixation at L5-S1 level. Then we compared the biomechanical changes at L4 segment before and after surgery in neutral, flexion, extension, lateral bending and axial rotation position. The stress on L4 pars interarticularis was very similar before and after surgery, and reached the highest in axial rotation. The L3-L4 intradiscal pressure was almost the same, while L4-L5 intradiscal pressure changed a little in lateral bending (increase from 1.993 to 2.160 MPa) and axial rotation (decrease from 1.639 to 1.307 MPa) after surgery. The PLIF surgery caused a little increase of range of motion at adjacent L4-L5 and L3-L4 levels, but the change is very tiny (1 degree). The PLIF surgery will not cause significant biomechanical change at adjacent segment with pars defect in multi-level spondylolysis. On the contrary, excessive long-segment surgery will damage surrounding soft tissues which are important for maintaining the stability of spine. So a preventative long-segment surgery is not necessary for multi-level spondylolysis as long as there are no soft tissue degeneration signs at adjacent level.

  13. Job demands, burnout, and engagement among nurses: A multi-level analysis of ORCAB data investigating the moderating effect of teamwork

    Science.gov (United States)

    Montgomery, Anthony; Spânu, Florina; Băban, Adriana; Panagopoulou, Efharis

    2015-01-01

    According to the Job Demands-Resources (JD-R) model, burnout and engagement are psychological reactions that develop when individual characteristics interact with work characteristics. This study tests the JD-R model using multilevel analysis to test the main and moderating effects of teamwork effectiveness among 1156 nurses in 93 departments from seven European countries. Workload, emotional and organizational demands were positively associated with emotional exhaustion, depersonalization, and negatively with vigor. Emotional and organizational demands were negatively associated with dedication. Teamwork effectiveness was positively associated with engagement. We found no evidence for the moderating effect of teamwork effectiveness in reducing individual perceptions of demands. PMID:26877971

  14. Job demands, burnout, and engagement among nurses: A multi-level analysis of ORCAB data investigating the moderating effect of teamwork.

    Science.gov (United States)

    Montgomery, Anthony; Spânu, Florina; Băban, Adriana; Panagopoulou, Efharis

    2015-09-01

    According to the Job Demands-Resources (JD-R) model, burnout and engagement are psychological reactions that develop when individual characteristics interact with work characteristics. This study tests the JD-R model using multilevel analysis to test the main and moderating effects of teamwork effectiveness among 1156 nurses in 93 departments from seven European countries. Workload, emotional and organizational demands were positively associated with emotional exhaustion, depersonalization, and negatively with vigor. Emotional and organizational demands were negatively associated with dedication. Teamwork effectiveness was positively associated with engagement. We found no evidence for the moderating effect of teamwork effectiveness in reducing individual perceptions of demands.

  15. Multilevel ensemble Kalman filter

    KAUST Repository

    Chernov, Alexey; Hoel, Haakon; Law, Kody; Nobile, Fabio; Tempone, Raul

    2016-01-01

    This work embeds a multilevel Monte Carlo (MLMC) sampling strategy into the Monte Carlo step of the ensemble Kalman filter (EnKF). In terms of computational cost vs. approximation error the asymptotic performance of the multilevel ensemble Kalman filter (MLEnKF) is superior to the EnKF s.

  16. Multilevel ensemble Kalman filter

    KAUST Repository

    Chernov, Alexey

    2016-01-06

    This work embeds a multilevel Monte Carlo (MLMC) sampling strategy into the Monte Carlo step of the ensemble Kalman filter (EnKF). In terms of computational cost vs. approximation error the asymptotic performance of the multilevel ensemble Kalman filter (MLEnKF) is superior to the EnKF s.

  17. Bayesian Analysis for EMP Survival Probability of Solid State Relay

    International Nuclear Information System (INIS)

    Sun Beiyun; Zhou Hui; Cheng Xiangyue; Mao Congguang

    2009-01-01

    The principle to estimate the parameter p of binomial distribution by Bayesian method and the several non-informative prior are introduced. The survival probability of DC solid state relay under current injection at certain amplitude is obtained by this method. (authors)

  18. Just how multi-level is leadership research? : A document co-citation analysis 1980–2013 on leadership constructs and outcomes

    NARCIS (Netherlands)

    Batistic, S.; Cerne, Matej; Vogel, Bernd

    2017-01-01

    The use of multi-level theories and methodologies in leadership has gained momentum in recent years. However, the leadership field still suffers from a fragmented and unclear evolution and practice of multi-level approaches. The questions of how and to what extent multi-level research has evolved in

  19. Public awareness and self-efficacy of cardiopulmonary resuscitation in communities and outcomes of out-of-hospital cardiac arrest: A multi-level analysis.

    Science.gov (United States)

    Ro, Young Sun; Shin, Sang Do; Song, Kyoung Jun; Hong, Sung Ok; Kim, Young Taek; Lee, Dong-Woo; Cho, Sung-Il

    2016-05-01

    This study aims to test the association between capacity of cardiopulmonary resuscitation (CPR) at community level and survival after out-of-hospital cardiac arrest (OHCA). Emergency medical service (EMS)-treated OHCAs with cardiac etiology in Korea between 2012 and 2013 were analyzed, excluding cases witnessed by EMS providers. Exposure variables were five indexes of community CPR capacity: awareness of CPR (CPR-Awareness), any training experience of CPR (CPR-Any-Training), recent CPR training within the last 2 years (CPR-Recent-Training), CPR training with a manikin (CPR-Manikin-Training), and CPR self-efficacy (CPR-Self-Efficacy). All measures of capacity were calculated as aggregated values for each county level using the national Korean Community Health Survey database of 228,921 responders sampled representatively from 253 counties in 2012. Endpoints were bystander CPR (BCPR) and survival to discharge. We calculated adjusted odds ratios (AORs) per 10% increment in community CPR capacity using multi-level logistic regression models, adjusting for potential confounders at individual levels. Of 29,052 eligible OHCAs, 11,079 (38.1%) received BCPR. Patients were more likely to receive BCPR in communities with higher proportions of residents with CPR-Awareness, CPR-Any-Training, CPR-Recent-Training, CPR-Manikin-Training, and CPR-Self-Efficacy (all pCPR-Awareness, 1.10 (1.04-1.15) for CPR-Any-Training, and 1.08 (1.03-1.13) for CPR-Self-Efficacy. For survival to discharge, AORs (95% CIs) were 1.34 (1.23-1.47) per 10% increment in CPR-Awareness, 1.36 (1.20-1.54) for CPR-Any-Training, and 1.29 (1.15-1.45) for CPR-Self-Efficacy. Higher CPR capacity at community level was associated with higher bystander CPR and survival to discharge rates after OHCA. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Survival analysis approach to account for non-exponential decay rate effects in lifetime experiments

    Energy Technology Data Exchange (ETDEWEB)

    Coakley, K.J., E-mail: kevincoakley@nist.gov [National Institute of Standards and Technology, 325 Broadway, Boulder, CO 80305 (United States); Dewey, M.S.; Huber, M.G. [National Institute of Standards and Technology, 100 Bureau Drive, Stop 8461, Gaithersburg, MD 20899 (United States); Huffer, C.R.; Huffman, P.R. [North Carolina State University, 2401 Stinson Drive, Box 8202, Raleigh, NC 27695 (United States); Triangle Universities Nuclear Laboratory, 116 Science Drive, Box 90308, Durham, NC 27708 (United States); Marley, D.E. [National Institute of Standards and Technology, 100 Bureau Drive, Stop 8461, Gaithersburg, MD 20899 (United States); North Carolina State University, 2401 Stinson Drive, Box 8202, Raleigh, NC 27695 (United States); Mumm, H.P. [National Institute of Standards and Technology, 100 Bureau Drive, Stop 8461, Gaithersburg, MD 20899 (United States); O' Shaughnessy, C.M. [University of North Carolina at Chapel Hill, 120 E. Cameron Ave., CB #3255, Chapel Hill, NC 27599 (United States); Triangle Universities Nuclear Laboratory, 116 Science Drive, Box 90308, Durham, NC 27708 (United States); Schelhammer, K.W. [North Carolina State University, 2401 Stinson Drive, Box 8202, Raleigh, NC 27695 (United States); Triangle Universities Nuclear Laboratory, 116 Science Drive, Box 90308, Durham, NC 27708 (United States); Thompson, A.K.; Yue, A.T. [National Institute of Standards and Technology, 100 Bureau Drive, Stop 8461, Gaithersburg, MD 20899 (United States)

    2016-03-21

    In experiments that measure the lifetime of trapped particles, in addition to loss mechanisms with exponential survival probability functions, particles can be lost by mechanisms with non-exponential survival probability functions. Failure to account for such loss mechanisms produces systematic measurement error and associated systematic uncertainties in these measurements. In this work, we develop a general competing risks survival analysis method to account for the joint effect of loss mechanisms with either exponential or non-exponential survival probability functions, and a method to quantify the size of systematic effects and associated uncertainties for lifetime estimates. As a case study, we apply our survival analysis formalism and method to the Ultra Cold Neutron lifetime experiment at NIST. In this experiment, neutrons can escape a magnetic trap before they decay due to a wall loss mechanism with an associated non-exponential survival probability function.

  1. Survival analysis approach to account for non-exponential decay rate effects in lifetime experiments

    International Nuclear Information System (INIS)

    Coakley, K.J.; Dewey, M.S.; Huber, M.G.; Huffer, C.R.; Huffman, P.R.; Marley, D.E.; Mumm, H.P.; O'Shaughnessy, C.M.; Schelhammer, K.W.; Thompson, A.K.; Yue, A.T.

    2016-01-01

    In experiments that measure the lifetime of trapped particles, in addition to loss mechanisms with exponential survival probability functions, particles can be lost by mechanisms with non-exponential survival probability functions. Failure to account for such loss mechanisms produces systematic measurement error and associated systematic uncertainties in these measurements. In this work, we develop a general competing risks survival analysis method to account for the joint effect of loss mechanisms with either exponential or non-exponential survival probability functions, and a method to quantify the size of systematic effects and associated uncertainties for lifetime estimates. As a case study, we apply our survival analysis formalism and method to the Ultra Cold Neutron lifetime experiment at NIST. In this experiment, neutrons can escape a magnetic trap before they decay due to a wall loss mechanism with an associated non-exponential survival probability function.

  2. Advanced Online Survival Analysis Tool for Predictive Modelling in Clinical Data Science.

    Science.gov (United States)

    Montes-Torres, Julio; Subirats, José Luis; Ribelles, Nuria; Urda, Daniel; Franco, Leonardo; Alba, Emilio; Jerez, José Manuel

    2016-01-01

    One of the prevailing applications of machine learning is the use of predictive modelling in clinical survival analysis. In this work, we present our view of the current situation of computer tools for survival analysis, stressing the need of transferring the latest results in the field of machine learning to biomedical researchers. We propose a web based software for survival analysis called OSA (Online Survival Analysis), which has been developed as an open access and user friendly option to obtain discrete time, predictive survival models at individual level using machine learning techniques, and to perform standard survival analysis. OSA employs an Artificial Neural Network (ANN) based method to produce the predictive survival models. Additionally, the software can easily generate survival and hazard curves with multiple options to personalise the plots, obtain contingency tables from the uploaded data to perform different tests, and fit a Cox regression model from a number of predictor variables. In the Materials and Methods section, we depict the general architecture of the application and introduce the mathematical background of each of the implemented methods. The study concludes with examples of use showing the results obtained with public datasets.

  3. Casein infusion rate influences feed intake differently depending on metabolizable protein balance in dairy cows: A multilevel meta-analysis.

    Science.gov (United States)

    Martineau, R; Ouellet, D R; Kebreab, E; Lapierre, H

    2016-04-01

    The effects of casein infusion have been investigated extensively in ruminant species. Its effect on responses in dry matter intake (DMI) has been reviewed and indicated no significant effect. The literature reviewed in the current meta-analysis is more extensive and limited to dairy cows fed ad libitum. A total of 51 studies were included in the meta-analysis and data were fitted to a multilevel model adjusting for the correlated nature of some studies. The effect size was the mean difference calculated by subtracting the means for the control from the casein-infused group. Overall, casein infusion [average of 333 g of dry matter (DM)/d; range: 91 to 1,092 g of DM/d] tended to increase responses in DMI by 0.18 kg/d (n=48 studies; 3 outliers). However, an interaction was observed between the casein infusion rate (IR) and the initial metabolizable protein (MP) balance [i.e., supply minus requirements (NRC, 2001)]. When control cows were in negative MP balance (n=27 studies), responses in DMI averaged 0.28 kg/d at mean MP balance (-264 g/d) and casein IR (336 g/d), and a 100g/d increment in the casein IR from its mean increased further responses by 0.14 kg/d (MP balance being constant), compared with cows not infused with casein. In contrast, when control cows were in positive MP balance (n=22 studies; 2 outliers), responses in DMI averaged -0.20 kg/d at mean casein IR (339 g/d), and a 100g/d increment in the casein IR from its mean further decreased responses by 0.33 kg/d, compared with cows not infused with casein. Responses in milk true protein yield at mean casein IR were greater (109 vs. 65 g/d) for cows in negative vs. positive MP balance, respectively, and the influence of the casein IR on responses was significant only for cows in negative MP balance. A 100g/d increment in the casein IR from its mean increased further responses in milk true protein yield by 25 g/d, compared with cows not infused with casein. Responses in blood urea concentration increased in

  4. Assessing community-based conservation projects: A systematic review and multilevel analysis of attitudinal, behavioral, ecological, and economic outcomes

    Directory of Open Access Journals (Sweden)

    Brooks Jeremy

    2013-01-01

    Full Text Available Abstract Background Community-based conservation (CBC promotes the idea that long-term conservation success requires engaging with, and providing benefits for local communities. Though widespread, CBC projects are not always successful or free of controversy. With criticisms on all sides of the conservation debates, it is critical to have a better understanding of (1 whether CBC is an effective conservation tool, and (2 of the factors associated with the success or failure of CBC projects, and the scale at which these factors operate. Recent CBC reviews have typically examined only a single resource domain, have limited geographic scope, consider only one outcome, or ignore the nested nature of socioecological systems. To remedy these issues, we use a newly coded global comparative database of CBC projects identified by systematic review to evaluate success in four outcome domains (attitudes, behaviors, ecological, economic and explore synergies and tradeoffs among these outcomes. We test hypotheses about how features of the national context (H-NC, project design (H-PD, and local community characteristics (H-CC affect these four measures of success. Methods To add to a sample of 62 projects that we used from previous systematic reviews, we systematically searched the conservation literature using six terms in four online databases. To increase the number of projects for each country in order to conduct a multilevel analysis, we also conducted a secondary search using the Advancing Conservation in a Social Context online library. We coded projects for 65 pieces of information. We conducted bivariate analyses using two-dimensional contingency tables and proportional odds logistic regression and conducted multivariate analyses by fitting reduced form proportional odds logistic regression models that were selected using a forward stepwise AIC approach. Results The primary and secondary searches produced 74 new projects to go along with the 62

  5. Survival analysis using S analysis of time-to-event data

    CERN Document Server

    Tableman, Mara

    2003-01-01

    Survival Analysis Using S: Analysis of Time-to-Event Data is designed as a text for a one-semester or one-quarter course in survival analysis for upper-level or graduate students in statistics, biostatistics, and epidemiology. Prerequisites are a standard pre-calculus first course in probability and statistics, and a course in applied linear regression models. No prior knowledge of S or R is assumed. A wide choice of exercises is included, some intended for more advanced students with a first course in mathematical statistics. The authors emphasize parametric log-linear models, while also detailing nonparametric procedures along with model building and data diagnostics. Medical and public health researchers will find the discussion of cut point analysis with bootstrap validation, competing risks and the cumulative incidence estimator, and the analysis of left-truncated and right-censored data invaluable. The bootstrap procedure checks robustness of cut point analysis and determines cut point(s). In a chapter ...

  6. Multilevel ensemble Kalman filtering

    KAUST Repository

    Hoel, Hakon

    2016-06-14

    This work embeds a multilevel Monte Carlo sampling strategy into the Monte Carlo step of the ensemble Kalman filter (EnKF) in the setting of finite dimensional signal evolution and noisy discrete-time observations. The signal dynamics is assumed to be governed by a stochastic differential equation (SDE), and a hierarchy of time grids is introduced for multilevel numerical integration of that SDE. The resulting multilevel EnKF is proved to asymptotically outperform EnKF in terms of computational cost versus approximation accuracy. The theoretical results are illustrated numerically.

  7. Multilevel ensemble Kalman filtering

    KAUST Repository

    Hoel, Hakon; Law, Kody J. H.; Tempone, Raul

    2016-01-01

    This work embeds a multilevel Monte Carlo sampling strategy into the Monte Carlo step of the ensemble Kalman filter (EnKF) in the setting of finite dimensional signal evolution and noisy discrete-time observations. The signal dynamics is assumed to be governed by a stochastic differential equation (SDE), and a hierarchy of time grids is introduced for multilevel numerical integration of that SDE. The resulting multilevel EnKF is proved to asymptotically outperform EnKF in terms of computational cost versus approximation accuracy. The theoretical results are illustrated numerically.

  8. Analysis and implementation of power management and control strategy for six-phase multilevel ac drive system in fault condition

    Directory of Open Access Journals (Sweden)

    Sanjeevikumar Padmanaban

    2016-03-01

    Full Text Available This research article exploits the power management algorithm in post-fault conditions for a six-phase (quad multilevel inverter. The drive circuit consists of four 2-level, three-phase voltage source inverter (VSI supplying a six-phase open-end windings motor or/impedance load, with circumstantial failure of one VSI investigated. A simplified level-shifted pulse-width modulation (PWM algorithm is developed to modulate each couple of three-phase VSI as 3-level output voltage generators in normal operation. The total power of the whole ac drive is shared equally among the four isolated DC sources. The developed post-fault algorithm is applied when there is a fault by one VSI and the load is fed from the remaining three healthy VSIs. In faulty conditions the multilevel outputs are reduced from 3-level to 2-level, but still the system propagates with degraded power. Numerical simulation modelling and experimental tests have been carried out with proposed post-fault control algorithm with three-phase open-end (asymmetrical induction motor/R-L impedance load. A complete set of simulation and experimental results provided in this paper shows close agreement with the developed theoretical background.

  9. The Effects of Socioeconomic Vulnerability, Psychosocial Services, and Social Service Spending on Family Reunification: A Multilevel Longitudinal Analysis.

    Science.gov (United States)

    Esposito, Tonino; Delaye, Ashleigh; Chabot, Martin; Trocmé, Nico; Rothwell, David; Hélie, Sonia; Robichaud, Marie-Joelle

    2017-09-09

    Socio-environmental factors such as poverty, psychosocial services, and social services spending all could influence the challenges faced by vulnerable families. This paper examines the extent to which socioeconomic vulnerability, psychosocial service consultations, and preventative social services spending impacts the reunification for children placed in out-of-home care. This study uses a multilevel longitudinal research design that draws data from three sources: (1) longitudinal administrative data from Quebec's child protection agencies; (2) 2006 and 2011 Canadian Census data; and, (3) intra-province health and social services data. The final data set included all children ( N = 39,882) placed in out-of-home care for the first time between 1 April 2002 and 31 March 2013, and followed from their initial out-of-home placement. Multilevel hazard results indicate that socioeconomic vulnerability, controlling for psychosocial services and social services spending, contributes to the decreased likelihood of reunification. Specifically, socioeconomic vulnerability, psychosocial services, and social services spending account for 24.0% of the variation in jurisdictional reunification for younger children less than 5 years of age, 12.5% for children age 5 to 11 years and 21.4% for older children age 12 to 17 years. These findings have implications for decision makers, funding agencies, and child protection agencies to improve jurisdictional resources to reduce the socioeconomic vulnerabilities of reunifying families.

  10. Cross-National Differences in the Association Between Parental Work Hours and Time with Children in Europe: A Multilevel Analysis.

    Science.gov (United States)

    Roeters, Anne

    2013-01-01

    This study investigates cross-national differences in the association between parental work hours and parent-child interaction time and explains differences in this individual-level association on the basis of country characteristics. It extends prior research by testing the moderating effects of country characteristics through multilevel analyses and by considering the possibility of selection effects. The presumption was that parents employ strategies to protect family life from work encroachments and that these strategies are enhanced by reconciliation policies, stronger parenthood ideologies, access to part-time work and higher income levels. Multilevel analyses were based on a subset of 5.183 parents in 23 countries from the 2005 European Working Conditions Survey that was complemented with country-level data. The negative association between parental work hours and parent-child time indeed varied significantly across countries and was weaker in countries where formal child care coverage was higher, part-time work was less prevalent, and earnings were lower. The effects of part-time work and earnings mainly applied to mothers. These findings suggest that child care coverage limits the availability of children and that differences in parent-child time between parents who work short and long hours are more pronounced when part-time work is more accessible and affordable.

  11. Analysis of survival data with dependent censoring copula-based approaches

    CERN Document Server

    Emura, Takeshi

    2018-01-01

    This book introduces readers to copula-based statistical methods for analyzing survival data involving dependent censoring. Primarily focusing on likelihood-based methods performed under copula models, it is the first book solely devoted to the problem of dependent censoring. The book demonstrates the advantages of the copula-based methods in the context of medical research, especially with regard to cancer patients’ survival data. Needless to say, the statistical methods presented here can also be applied to many other branches of science, especially in reliability, where survival analysis plays an important role. The book can be used as a textbook for graduate coursework or a short course aimed at (bio-) statisticians. To deepen readers’ understanding of copula-based approaches, the book provides an accessible introduction to basic survival analysis and explains the mathematical foundations of copula-based survival models.

  12. Federalism and multilevel governance

    NARCIS (Netherlands)

    van der Wusten, H.; Agnew, J.; Mamadouh, V.; Secor, A.J.; Sharp, J.

    2015-01-01

    Federalism and multilevel governance both emphasize polycentricity in governing arrangements. With their different intellectual pedigrees, these concepts are discussed in two separate sections. Fragments are now increasingly mixed up in hybrid forms of governance that also encompass originally

  13. Reporting and methodological quality of survival analysis in articles published in Chinese oncology journals.

    Science.gov (United States)

    Zhu, Xiaoyan; Zhou, Xiaobin; Zhang, Yuan; Sun, Xiao; Liu, Haihua; Zhang, Yingying

    2017-12-01

    Survival analysis methods have gained widespread use in the filed of oncology. For achievement of reliable results, the methodological process and report quality is crucial. This review provides the first examination of methodological characteristics and reporting quality of survival analysis in articles published in leading Chinese oncology journals.To examine methodological and reporting quality of survival analysis, to identify some common deficiencies, to desirable precautions in the analysis, and relate advice for authors, readers, and editors.A total of 242 survival analysis articles were included to be evaluated from 1492 articles published in 4 leading Chinese oncology journals in 2013. Articles were evaluated according to 16 established items for proper use and reporting of survival analysis.The application rates of Kaplan-Meier, life table, log-rank test, Breslow test, and Cox proportional hazards model (Cox model) were 91.74%, 3.72%, 78.51%, 0.41%, and 46.28%, respectively, no article used the parametric method for survival analysis. Multivariate Cox model was conducted in 112 articles (46.28%). Follow-up rates were mentioned in 155 articles (64.05%), of which 4 articles were under 80% and the lowest was 75.25%, 55 articles were100%. The report rates of all types of survival endpoint were lower than 10%. Eleven of 100 articles which reported a loss to follow-up had stated how to treat it in the analysis. One hundred thirty articles (53.72%) did not perform multivariate analysis. One hundred thirty-nine articles (57.44%) did not define the survival time. Violations and omissions of methodological guidelines included no mention of pertinent checks for proportional hazard assumption; no report of testing for interactions and collinearity between independent variables; no report of calculation method of sample size. Thirty-six articles (32.74%) reported the methods of independent variable selection. The above defects could make potentially inaccurate

  14. Bayesian linear regression with skew-symmetric error distributions with applications to survival analysis

    KAUST Repository

    Rubio, Francisco J.; Genton, Marc G.

    2016-01-01

    are censored. The latter scenario is of interest in the context of accelerated failure time models, which are relevant in survival analysis. We present a simulation study that demonstrates good frequentist properties of the posterior credible intervals

  15. Acute Myeloid Leukemia: analysis of epidemiological profile and survival rate.

    Science.gov (United States)

    de Lima, Mariana Cardoso; da Silva, Denise Bousfield; Freund, Ana Paula Ferreira; Dacoregio, Juliana Shmitz; Costa, Tatiana El Jaick Bonifácio; Costa, Imaruí; Faraco, Daniel; Silva, Maurício Laerte

    2016-01-01

    To describe the epidemiological profile and the survival rate of patients with acute myeloid leukemia (AML) in a state reference pediatric hospital. Clinical-epidemiological, observational, retrospective, descriptive study. The study included new cases of patients with AML, diagnosed between 2004 and 2012, younger than 15 years. Of the 51 patients studied, 84% were white; 45% were females and 55%, males. Regarding age, 8% were younger than 1 year, 47% were aged between 1 and 10 years, and 45% were older than 10 years. The main signs/symptoms were fever (41.1%), asthenia/lack of appetite (35.2%), and hemorrhagic manifestations (27.4%). The most affected extra-medullary site was the central nervous system (14%). In 47% of patients, the white blood cell (WBC) count was below 10,000/mm(3) at diagnosis. The minimal residual disease (MRD) was less than 0.1%, on the 15th day of treatment in 16% of the sample. Medullary relapse occurred in 14% of cases. When comparing the bone marrow MRD with the vital status, it was observed that 71.42% of the patients with type M3 AML were alive, as were 54.05% of those with non-M3 AML. The death rate was 43% and the main proximate cause was septic shock (63.6%). In this study, the majority of patients were male, white, and older than 1 year. Most patients with WBC count <10,000/mm(3) at diagnosis lived. Overall survival was higher in patients with MRD <0.1%. The prognosis was better in patients with AML-M3. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  16. Parametric and semiparametric models with applications to reliability, survival analysis, and quality of life

    CERN Document Server

    Nikulin, M; Mesbah, M; Limnios, N

    2004-01-01

    Parametric and semiparametric models are tools with a wide range of applications to reliability, survival analysis, and quality of life. This self-contained volume examines these tools in survey articles written by experts currently working on the development and evaluation of models and methods. While a number of chapters deal with general theory, several explore more specific connections and recent results in "real-world" reliability theory, survival analysis, and related fields.

  17. Application of survival analysis methodology to the quantitative analysis of LC-MS proteomics data.

    Science.gov (United States)

    Tekwe, Carmen D; Carroll, Raymond J; Dabney, Alan R

    2012-08-01

    Protein abundance in quantitative proteomics is often based on observed spectral features derived from liquid chromatography mass spectrometry (LC-MS) or LC-MS/MS experiments. Peak intensities are largely non-normal in distribution. Furthermore, LC-MS-based proteomics data frequently have large proportions of missing peak intensities due to censoring mechanisms on low-abundance spectral features. Recognizing that the observed peak intensities detected with the LC-MS method are all positive, skewed and often left-censored, we propose using survival methodology to carry out differential expression analysis of proteins. Various standard statistical techniques including non-parametric tests such as the Kolmogorov-Smirnov and Wilcoxon-Mann-Whitney rank sum tests, and the parametric survival model and accelerated failure time-model with log-normal, log-logistic and Weibull distributions were used to detect any differentially expressed proteins. The statistical operating characteristics of each method are explored using both real and simulated datasets. Survival methods generally have greater statistical power than standard differential expression methods when the proportion of missing protein level data is 5% or more. In particular, the AFT models we consider consistently achieve greater statistical power than standard testing procedures, with the discrepancy widening with increasing missingness in the proportions. The testing procedures discussed in this article can all be performed using readily available software such as R. The R codes are provided as supplemental materials. ctekwe@stat.tamu.edu.

  18. Application of survival analysis methodology to the quantitative analysis of LC-MS proteomics data

    KAUST Repository

    Tekwe, C. D.

    2012-05-24

    MOTIVATION: Protein abundance in quantitative proteomics is often based on observed spectral features derived from liquid chromatography mass spectrometry (LC-MS) or LC-MS/MS experiments. Peak intensities are largely non-normal in distribution. Furthermore, LC-MS-based proteomics data frequently have large proportions of missing peak intensities due to censoring mechanisms on low-abundance spectral features. Recognizing that the observed peak intensities detected with the LC-MS method are all positive, skewed and often left-censored, we propose using survival methodology to carry out differential expression analysis of proteins. Various standard statistical techniques including non-parametric tests such as the Kolmogorov-Smirnov and Wilcoxon-Mann-Whitney rank sum tests, and the parametric survival model and accelerated failure time-model with log-normal, log-logistic and Weibull distributions were used to detect any differentially expressed proteins. The statistical operating characteristics of each method are explored using both real and simulated datasets. RESULTS: Survival methods generally have greater statistical power than standard differential expression methods when the proportion of missing protein level data is 5% or more. In particular, the AFT models we consider consistently achieve greater statistical power than standard testing procedures, with the discrepancy widening with increasing missingness in the proportions. AVAILABILITY: The testing procedures discussed in this article can all be performed using readily available software such as R. The R codes are provided as supplemental materials. CONTACT: ctekwe@stat.tamu.edu.

  19. Prognostic classification index in Iranian colorectal cancer patients: Survival tree analysis

    Directory of Open Access Journals (Sweden)

    Amal Saki Malehi

    2016-01-01

    Full Text Available Aims: The aim of this study was to determine the prognostic index for separating homogenous subgroups in colorectal cancer (CRC patients based on clinicopathological characteristics using survival tree analysis. Methods: The current study was conducted at the Research Center of Gastroenterology and Liver Disease, Shahid Beheshti Medical University in Tehran, between January 2004 and January 2009. A total of 739 patients who already have been diagnosed with CRC based on pathologic report were enrolled. The data included demographic and clinical-pathological characteristic of patients. Tree-structured survival analysis based on a recursive partitioning algorithm was implemented to evaluate prognostic factors. The probability curves were calculated according to the Kaplan-Meier method, and the hazard ratio was estimated as an interest effect size. Result: There were 526 males (71.2% of these patients. The mean survival time (from diagnosis time was 42.46± (3.4. Survival tree identified three variables as main prognostic factors and based on their four prognostic subgroups was constructed. The log-rank test showed good separation of survival curves. Patients with Stage I-IIIA and treated with surgery as the first treatment showed low risk (median = 34 months whereas patients with stage IIIB, IV, and more than 68 years have the worse survival outcome (median = 9.5 months. Conclusion: Constructing the prognostic classification index via survival tree can aid the researchers to assess interaction between clinical variables and determining the cumulative effect of these variables on survival outcome.

  20. Testing Group Mean Differences of Latent Variables in Multilevel Data Using Multiple-Group Multilevel CFA and Multilevel MIMIC Modeling.

    Science.gov (United States)

    Kim, Eun Sook; Cao, Chunhua

    2015-01-01

    Considering that group comparisons are common in social science, we examined two latent group mean testing methods when groups of interest were either at the between or within level of multilevel data: multiple-group multilevel confirmatory factor analysis (MG ML CFA) and multilevel multiple-indicators multiple-causes modeling (ML MIMIC). The performance of these methods were investigated through three Monte Carlo studies. In Studies 1 and 2, either factor variances or residual variances were manipulated to be heterogeneous between groups. In Study 3, which focused on within-level multiple-group analysis, six different model specifications were considered depending on how to model the intra-class group correlation (i.e., correlation between random effect factors for groups within cluster). The results of simulations generally supported the adequacy of MG ML CFA and ML MIMIC for multiple-group analysis with multilevel data. The two methods did not show any notable difference in the latent group mean testing across three studies. Finally, a demonstration with real data and guidelines in selecting an appropriate approach to multilevel multiple-group analysis are provided.

  1. Just how multi-level is leadership research? A document co-citation analysis 1980–2013 on leadership constructs and outcomes

    OpenAIRE

    Batistic, S.; Cerne, M.; Vogel, Bernd

    2017-01-01

    The use of multi-level theories and methodologies in leadership has gained momentum in recent years. However, the leadership field still suffers from a fragmented and unclear evolution and practice of multi-level approaches. The questions of how and to what extent multi-level research has evolved in both leadership phenomena and leadership outcomes, and which informal research networks drove this evolution, remain vastly unexplored. In this study, the extent of literature published between 19...

  2. Statistical Model and Performance Analysis of a Novel Multilevel Polarization Modulation in Local “Twisted” Fibers

    Directory of Open Access Journals (Sweden)

    Pierluigi Perrone

    2017-01-01

    Full Text Available Transmission demand continues to grow and higher capacity optical communication systems are required to economically meet this ever-increasing need for communication services. This article expands and deepens the study of a novel optical communication system for high-capacity Local Area Networks (LANs, based on twisted optical fibers. The complete statistical behavior of this system is shown, designed for more efficient use of the fiber single-channel capacity by adopting an unconventional multilevel polarization modulation (called “bands of polarization”. Starting from simulative results, a possible reference mathematical model is proposed. Finally, the system performance is analyzed in the presence of shot-noise (coherent detection or thermal noise (direct detection.

  3. Perceptions of community, social capital, and how they affect self-reported health: a multilevel analysis.

    Science.gov (United States)

    Dziadkowiec, O; Meissen, G J; Merkle, E C

    2017-11-01

    The link between social capital and self-reported health has been widely explored. On the other hand, we know less about the relationship between social capital, community socioeconomic characteristics, and non-social capital-related individual differences, and about their impact on self-reported health in community settings. Cross-sectional study design with a proportional sample of 7965 individuals from 20 US communities were analyzed using multilevel linear regression models, where individuals were nested within communities. The response rates ranged from 13.5% to 25.4%. Findings suggest that perceptions of the community and individual level socioeconomic characteristics were stronger predictors of self-reported health than were social capital or community socioeconomic characteristics. Policy initiatives aimed at increasing social capital should first assess community member's perceptions of their communities to uncover potential assets to help increase social capital. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  4. Motivational predictors of physical education students' effort, exercise intentions, and leisure-time physical activity: a multilevel linear growth analysis.

    Science.gov (United States)

    Taylor, Ian M; Ntoumanis, Nikos; Standage, Martyn; Spray, Christopher M

    2010-02-01

    Grounded in self-determination theory (SDT; Deci & Ryan, 2000), the current study explored whether physical education (PE) students' psychological needs and their motivational regulations toward PE predicted mean differences and changes in effort in PE, exercise intentions, and leisure-time physical activity (LTPA) over the course of one UK school trimester. One hundred and seventy-eight students (69% male) aged between 11 and 16 years completed a multisection questionnaire at the beginning, middle, and end of a school trimester. Multilevel growth models revealed that students' perceived competence and self-determined regulations were the most consistent predictors of the outcome variables at the within- and between-person levels. The results of this work add to the extant SDT-based literature by examining change in PE students' motivational regulations and psychological needs, as well as underscoring the importance of disaggregating within- and between-student effects.

  5. Small Convenience Stores and the Local Food Environment: An Analysis of Resident Shopping Behavior Using Multilevel Modeling.

    Science.gov (United States)

    Ruff, Ryan Richard; Akhund, Ali; Adjoian, Tamar

    2016-01-01

    Local food environments can influence the diet and health of individuals through food availability, proximity to retail stores, pricing, and promotion. This study focused on how small convenience stores, known in New York City as bodegas, influence resident shopping behavior and the food environment. Using a cross-sectional design, 171 bodegas and 2118 shoppers were sampled. Small convenience stores in New York City. Any bodega shopper aged 18+ who purchased food or beverage from a participating store. Data collection consisted of a store assessment, a health and behavior survey given to exiting customers, and a bag check that recorded product information for all customer purchases. Descriptive statistics were generated for bodega store characteristics, shopper demographics, and purchase behavior. Multilevel models were used to assess the influence of product availability, placement, and advertising on consumer purchases of sugar-sweetened beverages (SSBs), water, and fruits and vegetables. Seventy-one percent of participants reported shopping at bodegas five or more times per week, and 35% reported purchasing all or most of their monthly food allotment at bodegas. Model results indicated that lower amounts of available fresh produce were significantly and independently associated with a higher likelihood of SSB purchases. A second, stratified multilevel model showed that the likelihood of purchasing an SSB increased with decreasing varieties of produce when produce was located at the front of the store. No significant effects were found for water placement and beverage advertising. Small convenience stores in New York City are an easily accessible source of foods and beverages. Bodegas may be suitable for interventions designed to improve food choice and diet.

  6. The effects of school policies and practices on eighth-grade science achievement: A multilevel analysis of TIMSS

    Science.gov (United States)

    Smyth, Carol Ann Mary

    Identifying the relative importance of both alterable school policies and fairly stable contextual factors as they relate to middle level science achievement, a domain of identified national concern, requires simultaneous investigation of multilevel predictors (i.e., student level and school level) specific to the grade level and academic subject area. The school level factors are predictors associated with both the school (e.g., average socioeconomic status, tracking, and instructional time) and the classroom (e.g., average academic press of peers, teacher collaboration, and instructional strategies). The current study assessed the effects of school policies, practices, and contextual factors on the science achievement of eighth grade students. These influences were considered to be both additive (i.e., influencing the mean achievement in a school after controlling for student characteristics) and interactive (i.e., affecting the relationships between student background characteristics and individual achievement). To account for the nested structure of predictors and cross level interactions among predictors, a multilevel model for middle level science achievement was estimated using hierarchical linear modeling (HLM) with data collected from eighth grade students, science teachers, and administrators in 1995 as part of the Third International Mathematics and Science Study (TIMSS). The major findings of this research suggest that although average eighth grade science achievement in a school was primarily associated with the contextual characteristics of the classroom and the school (e.g., average socioeconomic status and average academic press), both the academic differentiating influence of prior achievement and the social differentiating influence of parental education on the science achievement of eighth grade students were related not only to contextual characteristics of the classroom and the school, but also to the instructional policies of the classroom

  7. The impact of a disease management programme for type 2 diabetes on health-related quality of life: multilevel analysis of a cluster-randomised controlled trial.

    Science.gov (United States)

    Panisch, Sigrid; Johansson, Tim; Flamm, Maria; Winkler, Henrike; Weitgasser, Raimund; Sönnichsen, Andreas C

    2018-01-01

    Type 2 diabetes is a chronic disease associated with poorer health outcomes and decreased health related quality of life (HRQoL). The aim of this analysis was to explore the impact of a disease management programme (DMP) in type 2 diabetes on HRQoL. A multilevel model was used to explain the variation in EQ-VAS. A cluster-randomized controlled trial-analysis of the secondary endpoint HRQoL. Our study population were general practitioners and patients in the province of Salzburg. The DMP "Therapie-Aktiv" was implemented in the intervention group, and controls received usual care. Outcome measure was a change in EQ-VAS after 12 months. For comparison of rates, we used Fisher's Exact test; for continuous variables the independent T test or Welch test were used. In the multilevel modeling, we examined various models, continuously adding variables to explain the variation in the dependent variable, starting with an empty model, including only the random intercept. We analysed random effects parameters in order to disentangle variation of the final EQ-VAS. The EQ-VAS significantly increased within the intervention group (mean difference 2.19, p = 0.005). There was no significant difference in EQ-VAS between groups (mean difference 1.00, p = 0.339). In the intervention group the improvement was more distinct in women (2.46, p = 0.036) compared to men (1.92, p = 0.063). In multilevel modeling, sex, age, family and work circumstances, any macrovascular diabetic complication, duration of diabetes, baseline body mass index and baseline EQ-VAS significantly influence final EQ-VAS, while DMP does not. The final model explains 28.9% (EQ-VAS) of the total variance. Most of the unexplained variance was found on patient-level (95%) and less on GP-level (5%). DMP "Therapie-Aktiv" has no significant impact on final EQ-VAS. The impact of DMPs in type 2 diabetes on HRQoL is still unclear and future programmes should focus on patient specific needs and predictors in

  8. Spatial Random Effects Survival Models to Assess Geographical Inequalities in Dengue Fever Using Bayesian Approach: a Case Study

    Science.gov (United States)

    Astuti Thamrin, Sri; Taufik, Irfan

    2018-03-01

    Dengue haemorrhagic fever (DHF) is an infectious disease caused by dengue virus. The increasing number of people with DHF disease correlates with the neighbourhood, for example sub-districts, and the characteristics of the sub-districts are formed from individuals who are domiciled in the sub-districts. Data containing individuals and sub-districts is a hierarchical data structure, called multilevel analysis. Frequently encountered response variable of the data is the time until an event occurs. Multilevel and spatial models are being increasingly used to obtain substantive information on area-level inequalities in DHF survival. Using a case study approach, we report on the implications of using multilevel with spatial survival models to study geographical inequalities in all cause survival.

  9. Exposure, hazard, and survival analysis of diffusion on social networks.

    Science.gov (United States)

    Wu, Jiacheng; Crawford, Forrest W; Kim, David A; Stafford, Derek; Christakis, Nicholas A

    2018-04-29

    Sociologists, economists, epidemiologists, and others recognize the importance of social networks in the diffusion of ideas and behaviors through human societies. To measure the flow of information on real-world networks, researchers often conduct comprehensive sociometric mapping of social links between individuals and then follow the spread of an "innovation" from reports of adoption or change in behavior over time. The innovation is introduced to a small number of individuals who may also be encouraged to spread it to their network contacts. In conjunction with the known social network, the pattern of adoptions gives researchers insight into the spread of the innovation in the population and factors associated with successful diffusion. Researchers have used widely varying statistical tools to estimate these quantities, and there is disagreement about how to analyze diffusion on fully observed networks. Here, we describe a framework for measuring features of diffusion processes on social networks using the epidemiological concepts of exposure and competing risks. Given a realization of a diffusion process on a fully observed network, we show that classical survival regression models can be adapted to estimate the rate of diffusion, and actor/edge attributes associated with successful transmission or adoption, while accounting for the topology of the social network. We illustrate these tools by applying them to a randomized network intervention trial conducted in Honduras to estimate the rate of adoption of 2 health-related interventions-multivitamins and chlorine bleach for water purification-and determine factors associated with successful social transmission. Copyright © 2018 John Wiley & Sons, Ltd.

  10. Covariation in community- and individual-based community capacity and health behavior: a multilevel analysis of populations in Seoul, South Korea.

    Science.gov (United States)

    Jung, Minsoo

    2012-01-01

    Community capacity is defined as the degree to which the human, physical, and potential resources of a neighborhood are organized based on mutual solidarity among the residents. The aim of this study was to elucidate the relationship between community capacity and health behaviors in Seoul, South Korea. Multilevel models controlling for socioeconomic variables were used to measure the association between community capacity and health behaviors in 25 districts and 404 subdistricts (n = 14 228). Community capacity was determined to be significant at the more local community level, as it was a significant variable in the subdistrict analysis for explaining health behaviors such as smoking, drinking, and exercising. Community capacity exists not only at the individual level but also at the community level. High community capacity further enhanced the positive effects of individual capacity on health behavior and further weakened the negative effects.

  11. Life satisfaction in the new country: a multilevel longitudinal analysis of effects of culture and 5-HTT allele frequency distribution in country of origin.

    Science.gov (United States)

    Kashima, Emiko S; Kent, Stephen; Kashima, Yoshihisa

    2015-01-01

    Life satisfaction of migrants to Australia from 17 countries, assessed at 4-5 months, 16-17 months and 3½ years after arrival, was analyzed with a longitudinal, multilevel analysis. The results indicated that migrants were more satisfied, if the national average life satisfaction was higher in their country of origin, after adjustment for individual-level income, age, and sex and a linear temporal trend. Simultaneously, the migrants were also happier if people in their country of origin had a higher frequency of 5-HTT long allele, a genotype known to be associated with resilience under life stresses. These two relationships were independent, suggesting that both culture and gene matter in international transitions. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  12. The effects of workplace occupational mental health and related activities on psychological distress among workers: a multilevel cross-sectional analysis.

    Science.gov (United States)

    Eguchi, Hisashi; Tsuda, Yoko; Tsukahara, Teruomi; Washizuka, Shinsuke; Kawakami, Norito; Nomiyama, Tetsuo

    2012-08-01

    To investigate the association of workplace occupational mental health (OMH) and related activities with psychological distress of workers in Japan. A total of 121 workplaces and their 3540 workers were surveyed using questionnaires assessing selected workplace OMH activities, demographic characteristics, psychological distress, and psychosocial work environment of the workers. A multilevel analysis was conducted. Promotion of communication correlated significantly and negatively with psychological distress among workers after adjusting for the covariates (P health activities correlated marginally significantly and negatively with psychological distress (P = 0.06). Their moderating effect for the worker-level association between psychosocial work environment and psychological distress was not significant. The findings suggest that promotion of communication in the workplace is associated with reduced psychological distress among workers. In addition, OMH activities may also be useful in reducing psychological distress.

  13. The outcome of institutional youth care compared to non-institutional youth care for children of primary school age and early adolescence : A multi-level meta-analysis

    NARCIS (Netherlands)

    Strijbosch, E.L.L.; Huijs, J.A.M.; Stams, G.J.J.M.; Wissink, I.B.; van der Helm, G.H.P.; de Swart, J.J.W.; van der Veen, Z.

    2015-01-01

    Objective: The outcome of institutional youth care for children is heavily debated. This multilevel meta-analysis aims to address the outcome of institutional youth care compared to non-institutional youth care for children of primary school age and early adolescence in economically developed

  14. Gender inequalities in the association between area deprivation and perceived social support: a cross-sectional multilevel analysis at the municipality level in Germany.

    Science.gov (United States)

    Mena, Emily; Kroll, Lars Eric; Maier, Werner; Bolte, Gabriele

    2018-04-12

    To investigate the association between area deprivation at municipality level with low perceived social support, independent of individual socioeconomic position and demographic characteristics. To assess whether there are gender inequalities in this association. Cross-sectional multilevel analysis of survey data. Germany. 3350 men and 3665 women living in 167 municipalities throughout Germany participating in the 'German Health Interview and Examination Survey for Adults' (DEGS1 2008-2011) as part of the national health monitoring. Perceived social support as measured by Oslo-3 Social Support Scale. Prevalence of low perceived social support was 11.4% in men and 11.1% in women. Low social support was associated in men and women with sociodemographic characteristics that indicate more disadvantaged living situations. Taking these individual-level characteristics into account, municipal-level deprivation was independently associated with low perceived social support in men (OR for the most deprived quintile: 1.80 (95% CI 1.14 to 2.84)), but not in women (OR 1.22 (95% CI 0.78 to 1.90)). The results of our multilevel analysis suggest that there are gender inequalities in the association of municipal-level deprivation with the prevalence of low perceived social support in Germany independent of individual socioeconomic position. Community health interventions aiming at promotion of social support among residents might profit from a further understanding of the observed gender differences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. Does gender inequity increase men's mortality risk in the United States? A multilevel analysis of data from the National Longitudinal Mortality Study.

    Science.gov (United States)

    Kavanagh, Shane A; Shelley, Julia M; Stevenson, Christopher

    2017-12-01

    A number of theoretical approaches suggest that gender inequity may give rise to health risks for men. This study undertook a multilevel analysis to ascertain if state-level measures of gender inequity are predictors of men's mortality in the United States. Data for the analysis were taken primarily from the National Longitudinal Mortality Study, which is based on a random sample of the non-institutionalised population. The full data set included 174,703 individuals nested within 50 states and had a six-year follow-up for mortality. Gender inequity was measured by nine variables: higher education, reproductive rights, abortion provider access, elected office, management, business ownership, labour force participation, earnings and relative poverty. Covariates at the individual level were age, income, education, race/ethnicity, marital status and employment status. Covariates at the state level were income inequality and per capita gross domestic product. The results of logistic multilevel modelling showed a number of measures of state-level gender inequity were significantly associated with men's mortality. In all of these cases greater gender inequity was associated with an increased mortality risk. In fully adjusted models for all-age adult men the elected office (OR 1.05 95% CI 1.01-1.09), business ownership (OR 1.04 95% CI 1.01-1.08), earnings (OR 1.04 95% CI 1.01-1.08) and relative poverty (OR 1.07 95% CI 1.03-1.10) measures all showed statistically significant effects for each 1 standard deviation increase in the gender inequity z -score. Similar effects were seen for working-age men. In older men (65+ years) only the earnings and relative poverty measures were statistically significant. This study provides evidence that gender inequity may increase men's health risks. The effect sizes while small are large enough across the range of gender inequity identified to have important population health implications.

  16. Associations between neighbourhood characteristics, body mass index and health-related behaviours of adolescents in the Kiel Obesity Prevention Study: a multilevel analysis.

    Science.gov (United States)

    Lange, D; Wahrendorf, M; Siegrist, J; Plachta-Danielzik, S; Landsberg, B; Müller, M J

    2011-06-01

    To understand determinants of overweight, several studies addressed the association between neighbourhood characteristics and adult obesity. However, little is known about the association of such characteristics with adolescents' overweight. This study aims at the influence of neighbourhood characteristics on adolescent body mass index (BMI) and lifestyle and to what extent BMI and lifestyle variation between neighbourhoods can be explained by neighbourhood characteristics. We used cross-sectional data from the Kiel Obesity Prevention Study collected between 2004 and 2008 in 28 different residential districts of the city of Kiel (North Germany). Anthropometric data were available for 1675 boys and 1765 girls (n=3440) aged 13-15 years, and individual lifestyle factors and sociodemographic data were included in the analysis. At the macro level, six different neighbourhood characteristics were used: unemployment rate, population density, traffic density, prevalence of energy-dense food supply, number of sports fields and parks, and crime rate. To test our main hypothesis, linear and logistic multilevel regression analyses were performed to predict BMI and lifestyle factors in individuals nested in neighbourhoods. Findings of multilevel analysis show little between-neighbourhood variations in BMI and health-related behaviours. In all, 2% of BMI variation, 4% of media time variation and 3% of variation in snacking behaviour could be attributed to differences in neighbourhoods. Environmental factors are significantly associated with adolescent BMI and health-related behaviour; however, their total effect is small. Owing to these results, recommendations for structural policy measures as part of prevention of overweight in adolescents must be made cautiously.

  17. The association between the physical environment and the well-being of older people in residential care facilities: A multilevel analysis.

    Science.gov (United States)

    Nordin, Susanna; McKee, Kevin; Wijk, Helle; Elf, Marie

    2017-12-01

    To investigate the associations between the quality of the physical environment and the psychological and social well-being of older people living in residential care facilities. Many older people in care facilities have cognitive and physical frailties and are at risk of experiencing low levels of well-being. High-quality physical environments can support older people as frailty increases and promote their well-being. Although the importance of the physical environment for residents' well-being is recognized, more research is needed. A cross-sectional survey of 20 care facilities from each of which 10 residents were sampled. As the individual resident data were nested in the facilities, a multilevel analysis was conducted. Data were collected during 2013 and 2014. The care facilities were purposely sampled to ensure a high level of variation in their physical characteristics. Residents' demographic and health data were collected via medical records and interviews. Residents' well-being and perceived quality of care were assessed via questionnaires and interviews. Environmental quality was assessed with a structured observational instrument. Multilevel analysis indicated that cognitive support in the physical environment was associated with residents' social well-being, after controlling for independence and perceived care quality. However, no significant association was found between the physical environment and residents' psychological well-being. Our study demonstrates the role of the physical environment for enhancing the social well-being of frail older people. Professionals and practitioners involved in the design of care facilities have a responsibility to ensure that such facilities meet high-quality specifications. © 2017 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  18. Multilevel analysis of hepatitis A infection in children and adolescents: a household survey in the Northeast and Central-west regions of Brazil

    Science.gov (United States)

    de Alencar Ximenes, Ricardo Arraes; Martelli, Celina Maria Turchi; Merchán-Hamann, Edgar; Montarroyos, Ulisses Ramos; Braga, Maria Cynthia; de Lima, Maria Luíza Carvalho; Cardoso, Maria Regina Alves; Turchi, Marília Dalva; Costa, Marcelo Abrahão; de Alencar, Luiz Cláudio Arraes; Moreira, Regina Célia; Figueiredo, Gerusa Maria; Pereira, Leila Maria Moreira Beltrão

    2008-01-01

    Background The objectives were to estimate the prevalence of hepatitis A among children and adolescents from the Northeast and Midwest regions and the Federal District of Brazil and to identify individual-, household- and area-levels factors associated with hepatitis A infection. Methods This population-based survey was conducted in 2004–2005 and covered individuals aged between 5 and 19 years. A stratified multistage cluster sampling technique with probability proportional to size was used to select 1937 individuals aged between 5 and 19 years living in the Federal capital and in the State capitals of 12 states in the study regions. The sample was stratified according to age (5–9 and 10- to 19-years-old) and capital within each region. Individual- and household-level data were collected by interview at the home of the individual. Variables related to the area were retrieved from census tract data. The outcome was total antibodies to hepatitis A virus detected using commercial EIA. The age distribution of the susceptible population was estimated using a simple catalytic model. The associations between HAV infection and independent variables were assessed using the odds ratio and corrected for the random design effect and sampling weight. Multilevel analysis was performed by GLLAMM using Stata 9.2. Results The prevalence of hepatitis A infection in the 5–9 and 10–19 age-group was 41.5 and 57.4%, respectively for the Northeast, 32.3 and 56.0%, respectively for the Midwest and 33.8 and 65.1% for the Federal District. A trend for the prevalence of HAV infection to increase according to age was detected in all sites. By the age of 5, 31.5% of the children had already been infected with HAV in the Northeast region compared with 20.0% in the other sites. By the age of 19 years, seropositivity was ∼70% in all areas. The curves of susceptible populations differed from one area to another. Multilevel modeling showed that variables relating to different levels of

  19. Survival Analysis of US Air Force Officer Retention Rate

    Science.gov (United States)

    2017-03-23

    an independent global business research organization] has studied the timing of unemployment… the timing of this variable is designated as...retrieval, and management; report writing and graphics design; statistical and mathematical analysis; business forecasting and decision support; operations...less flexible to experimentation with the system’s variables and assumptions. Today , many researchers utilize simulation to model real world

  20. Multilevel analysis of the Be Active Eat Well intervention: environmental and behavioural influences on reductions in child obesity risk.

    Science.gov (United States)

    Johnson, B A; Kremer, P J; Swinburn, B A; de Silva-Sanigorski, A M

    2012-07-01

    The Be Active Eat Well (BAEW) community-based child obesity prevention intervention was successful in modestly reducing unhealthy weight gain in primary school children using a multi-strategy and multi-setting approach. To (1) examine the relationship between changes in obesity-related individual, household and school factors and changes in standardised child body mass index (zBMI), and (2) determine if the BAEW intervention moderated these effects. The longitudinal relationships between changes in individual, household and school variables and changes in zBMI were explored using multilevel modelling, with measurement time (baseline and follow-up) at level 1, individual (behaviours, n = 1812) at level 2 and households (n = 1318) and schools (n = 18) as higher levels (environments). The effect of the intervention was tested while controlling for child age, gender and maternal education level. This study confirmed that the BAEW intervention lowered child zBMI compared with the comparison group (-0.085 units, P = 0.03). The variation between household environments was found to be a large contributor to the percentage of unexplained change in child zBMI (59%), compared with contributions from the individual (23%) and school levels (1%). Across both groups, screen time (P = 0.03), sweet drink consumption (P = 0.03) and lack of household rules for television (TV) viewing (P = 0.05) were associated with increased zBMI, whereas there was a non-significant association with the frequency the TV was on during evening meals (P = 0.07). The moderating effect of the intervention was only evident for the relationship between the frequency of TV on during meals and zBMI, however, this effect was modest (P = 0.04). The development of childhood obesity involves multi-factorial and multi-level influences, some of which are amenable to change. Obesity prevention strategies should not only target individual behaviours but also the household environment and family practices. Although z

  1. Individual and community level socioeconomic inequalities in contraceptive use in 10 Newly Independent States: a multilevel cross-sectional analysis

    Directory of Open Access Journals (Sweden)

    Janevic Teresa

    2012-11-01

    Full Text Available Abstract Introduction Little is known regarding the association between socioeconomic factors and contraceptive use in the Newly Independent States (NIS, countries that have experienced profound changes in reproductive health services during the transition from socialism to a market economy. Methods Using 2005–2006 data from Demographic Health Surveys (Armenia, Azerbaijan, and Moldova and Multiple Indicator Cluster Surveys (Belarus, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Ukraine, and Uzbekistan, we examined associations between individual and community socioeconomic status with current modern contraceptive use (MCU among N = 55,204 women aged 15–49 married or in a union. Individual socioeconomic status was measured using quintiles of wealth index and education level (higher than secondary school, secondary school or less. Community socioeconomic status was measured as the percentage of households in the poorest quintile of the nationals household wealth index (0%, 0–25%, or greater than 25%. We used multilevel logistic regression to estimate associations adjusted for age, number of children, urban/rural, and socioeconomic variables. Results MCU varied by country from 14% (in Azerbaijan to 62% (in Belarus. Overall, women living in the poorest communities were less likely than those in the richest to use modern contraceptives (adjusted odds ratio (aOR = 0.82, 95% Confidence Interval = 0.76, 0.89. Similarly, there was an increasing odds of MCU with increasing individual-level wealth. Women with a lower level of education also had lower odds of MCU than those with a higher level of education (aOR = .75, 95%CI = 0.71, 0.79. In country-specific analyses, community-level socioeconomic inequalities were apparent in 4 of 10 countries; in contrast, inequalities by individual-level wealth were apparent in 7 countries and by education in 8 countries. All countries in which community-level socioeconomic status was associated with

  2. Individual and community level socioeconomic inequalities in contraceptive use in 10 Newly Independent States: a multilevel cross-sectional analysis.

    Science.gov (United States)

    Janevic, Teresa; Sarah, Pallas W; Leyla, Ismayilova; Elizabeth, Bradley H

    2012-11-16

    Little is known regarding the association between socioeconomic factors and contraceptive use in the Newly Independent States (NIS), countries that have experienced profound changes in reproductive health services during the transition from socialism to a market economy. Using 2005-2006 data from Demographic Health Surveys (Armenia, Azerbaijan, and Moldova) and Multiple Indicator Cluster Surveys (Belarus, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Ukraine, and Uzbekistan), we examined associations between individual and community socioeconomic status with current modern contraceptive use (MCU) among N = 55,204 women aged 15-49 married or in a union. Individual socioeconomic status was measured using quintiles of wealth index and education level (higher than secondary school, secondary school or less). Community socioeconomic status was measured as the percentage of households in the poorest quintile of the nationals household wealth index (0%, 0-25%, or greater than 25%). We used multilevel logistic regression to estimate associations adjusted for age, number of children, urban/rural, and socioeconomic variables. MCU varied by country from 14% (in Azerbaijan) to 62% (in Belarus). Overall, women living in the poorest communities were less likely than those in the richest to use modern contraceptives (adjusted odds ratio (aOR) = 0.82, 95% Confidence Interval = 0.76, 0.89). Similarly, there was an increasing odds of MCU with increasing individual-level wealth. Women with a lower level of education also had lower odds of MCU than those with a higher level of education (aOR = .75, 95%CI = 0.71, 0.79). In country-specific analyses, community-level socioeconomic inequalities were apparent in 4 of 10 countries; in contrast, inequalities by individual-level wealth were apparent in 7 countries and by education in 8 countries. All countries in which community-level socioeconomic status was associated with MCU were in Central Asia, whereas at the individual

  3. Physical activity as a possible mechanism behind the relationship between green space and health: A multilevel analysis

    Directory of Open Access Journals (Sweden)

    Spreeuwenberg Peter

    2008-06-01

    Full Text Available Abstract Background The aim of this study was to investigate whether physical activity (in general, and more specifically, walking and cycling during leisure time and for commuting purposes, sports and gardening is an underlying mechanism in the relationship between the amount of green space in people's direct living environment and self-perceived health. To study this, we first investigated whether the amount of green space in the living environment is related to the level of physical activity. When an association between green space and physical activity was found, we analysed whether this could explain the relationship between green space and health. Methods The study includes 4.899 Dutch people who were interviewed about physical activity, self-perceived health and demographic and socioeconomic background. The amount of green space within a one-kilometre and a three-kilometre radius around the postal code coordinates was calculated for each individual. Multivariate multilevel analyses and multilevel logistic regression analyses were performed at two levels and with controls for socio-demographic characteristics and urbanicity. Results No relationship was found between the amount of green space in the living environment and whether or not people meet the Dutch public health recommendations for physical activity, sports and walking for commuting purposes. People with more green space in their living environment walked and cycled less often and fewer minutes during leisure time; people with more green space garden more often and spend more time on gardening. Furthermore, if people cycle for commuting purposes they spend more time on this if they live in a greener living environment. Whether or not people garden, the time spent on gardening and time spent on cycling for commuting purposes did not explain the relationship between green space and health. Conclusion Our study indicates that the amount of green space in the living environment is

  4. Introduction to SURPH.1 analysis of release-recapture data for survival studies

    International Nuclear Information System (INIS)

    Smith, S.G.; Skalski, J.R.; Schlechte, J.W.; Hoffmann, A.; Cassen, V.

    1994-12-01

    Program SURPH is the culmination of several years of research to develop a comprehensive computer program to analyze survival studies of fish and wildlife populations. Development of this software was motivated by the advent of the PIT-tag (Passive Integrated Transponder) technology that permits the detection of salmonid smolt as they pass through hydroelectric facilities on the Snake and Columbia Rivers in the Pacific Northwest. Repeated detections of individually tagged smolt and analysis of their capture-histories permits estimates of downriver survival probabilities. Eventual installation of detection facilities at adult fish ladders will also permit estimation of ocean survival and upstream survival of returning salmon using the statistical methods incorporated in SURPH.1. However, the utility of SURPH.1 far exceeds solely the analysis of salmonid tagging studies. Release-recapture and radiotelemetry studies from a wide range of terrestrial and aquatic species have been analyzed using SURPH.1 to estimate discrete time survival probabilities and investigate survival relationships. The interactive computing environment of SURPH.1 was specifically developed to allow researchers to investigate the relationship between survival and capture processes and environmental, experimental and individual-based covariates. Program SURPH.1 represents a significant advancement in the ability of ecologists to investigate the interplay between morphologic, genetic, environmental and anthropogenic factors on the survival of wild species. It is hoped that this better understanding of risk factors affecting survival will lead to greater appreciation of the intricacies of nature and to improvements in the management of wild resources. This technical report is an introduction to SURPH.1 and provides a user guide for both the UNIX and MS-Windows reg-sign applications of the SURPH software

  5. Multilevel geometry optimization

    Science.gov (United States)

    Rodgers, Jocelyn M.; Fast, Patton L.; Truhlar, Donald G.

    2000-02-01

    Geometry optimization has been carried out for three test molecules using six multilevel electronic structure methods, in particular Gaussian-2, Gaussian-3, multicoefficient G2, multicoefficient G3, and two multicoefficient correlation methods based on correlation-consistent basis sets. In the Gaussian-2 and Gaussian-3 methods, various levels are added and subtracted with unit coefficients, whereas the multicoefficient Gaussian-x methods involve noninteger parameters as coefficients. The multilevel optimizations drop the average error in the geometry (averaged over the 18 cases) by a factor of about two when compared to the single most expensive component of a given multilevel calculation, and in all 18 cases the accuracy of the atomization energy for the three test molecules improves; with an average improvement of 16.7 kcal/mol.

  6. Multilevel geometry optimization

    Energy Technology Data Exchange (ETDEWEB)

    Rodgers, Jocelyn M. [Department of Chemistry and Supercomputer Institute, University of Minnesota, Minneapolis, Minnesota 55455-0431 (United States); Fast, Patton L. [Department of Chemistry and Supercomputer Institute, University of Minnesota, Minneapolis, Minnesota 55455-0431 (United States); Truhlar, Donald G. [Department of Chemistry and Supercomputer Institute, University of Minnesota, Minneapolis, Minnesota 55455-0431 (United States)

    2000-02-15

    Geometry optimization has been carried out for three test molecules using six multilevel electronic structure methods, in particular Gaussian-2, Gaussian-3, multicoefficient G2, multicoefficient G3, and two multicoefficient correlation methods based on correlation-consistent basis sets. In the Gaussian-2 and Gaussian-3 methods, various levels are added and subtracted with unit coefficients, whereas the multicoefficient Gaussian-x methods involve noninteger parameters as coefficients. The multilevel optimizations drop the average error in the geometry (averaged over the 18 cases) by a factor of about two when compared to the single most expensive component of a given multilevel calculation, and in all 18 cases the accuracy of the atomization energy for the three test molecules improves; with an average improvement of 16.7 kcal/mol. (c) 2000 American Institute of Physics.

  7. Survival after Second and Subsequent Recurrences in Osteosarcoma: A Retrospective Multicenter Analysis.

    Science.gov (United States)

    Tirtei, Elisa; Asaftei, Sebastian D; Manicone, Rosaria; Cesari, Marilena; Paioli, Anna; Rocca, Michele; Ferrari, Stefano; Fagioli, Franca

    2017-05-01

    Purpose Osteosarcoma (OS) is the most common primary bone tumor. Despite complete surgical removal and intensive chemotherapeutic treatment, 30%-35% of patients with OS have local or systemic recurrence. Some patients survive multiple recurrences, but overall survival after OS recurrence is poor. This analysis aims to describe and identify factors influencing post-relapse survival (PRS) after a second OS relapse. Methods This is a retrospective analysis of 60 patients with a second relapse of OS of the extremities in 2 Italian centers between 2003 and 2013. Results Treatment for first and subsequent relapses was planned according to institutional guidelines. After complete surgical remission (CSR) following the first recurrence, patients experienced a second OS relapse with a median disease-free interval (DFI) of 6 months. Lung disease was prevalent: 44 patients (76%) had pulmonary metastases. Survival after the second relapse was 22% at 5 years. Lung disease only correlated with better survival at 5 years (33.6%) compared with other sites of recurrence (5%; p = 0.008). Patients with a single pulmonary lesion had a better 5-year second PRS (42%; p = 0.02). Patients who achieved a second CSR had a 5-year second PRS of 33.4%. Chemotherapy (p<0.001) benefited patients without a third CSR. Conclusions This analysis confirms the importance of an aggressive, repeated surgical approach. Lung metastases only, the number of lesions, DFI and CSR influenced survival. It also confirms the importance of chemotherapy in patients in whom surgical treatment is not feasible.

  8. Mediation analysis of the relationship between institutional research activity and patient survival

    DEFF Research Database (Denmark)

    Rochon, Justine; du Bois, Andreas; Lange, Theis

    2014-01-01

    BACKGROUND: Recent studies have suggested that patients treated in research-active institutions have better outcomes than patients treated in research-inactive institutions. However, little attention has been paid to explaining such effects, probably because techniques for mediation analysis...... existing so far have not been applicable to survival data. METHODS: We investigated the underlying mechanisms using a recently developed method for mediation analysis of survival data. Our analysis of the effect of research activity on patient survival was based on 352 patients who had been diagnosed...... mediated through either optimal surgery or chemotherapy. Taken together, about 26% of the beneficial effect of research activity was mediated through the proposed pathways. CONCLUSIONS: Mediation analysis allows proceeding from the question "Does it work?" to the question "How does it work?" In particular...

  9. Associations of supermarket characteristics with weight status and body fat: a multilevel analysis of individuals within supermarkets (RECORD study.

    Directory of Open Access Journals (Sweden)

    Basile Chaix

    Full Text Available Previous research on the influence of the food environment on weight status has often used impersonal measures of the food environment defined for residential neighborhoods, which ignore whether people actually use the food outlets near their residence. To assess whether supermarkets are relevant contexts for interventions, the present study explored between-residential neighborhood and between-supermarket variations in body mass index (BMI and waist circumference (WC, and investigated associations between brands and characteristics of supermarkets and BMI or WC, after adjustment for individual and residential neighborhood characteristics.Participants in the RECORD Cohort Study (Paris Region, France, 2007-2008 were surveyed on the supermarket (brand and exact location where they conducted their food shopping. Overall, 7 131 participants shopped in 1 097 different supermarkets. Cross-classified multilevel linear models were estimated for BMI and WC.Just 11.4% of participants shopped for food primarily within their residential neighborhood. After accounting for participants' residential neighborhood, people shopping in the same supermarket had a more comparable BMI and WC than participants shopping in different supermarkets. After adjustment for individual and residential neighborhood characteristics, participants shopping in specific supermarket brands, in hard discount supermarkets (especially if they had a low education, and in supermarkets whose catchment area comprised low educated residents had a higher BMI/WC.A public health strategy to reduce excess weight may be to intervene on specific supermarkets to change food purchasing behavior, as supermarkets are where dietary preferences are materialized into definite purchased foods.

  10. [Multivariate and multilevel model analysis on factors that influencing the literacy of health among high school students in Guangdong province].

    Science.gov (United States)

    Ye, Xiao-hua; Xu, Ya; Zhou, Shu-dong; Gao, Yan-hui; Li, Yan-fen

    2011-09-01

    To analyze the awareness on health among high school students and its influencing factors in Guangdong. Multi-stage sampling and questionnaire "2009 health awareness survey of the Chinese citizens" developed by our Department of Health, were used. Data were analyzed by multivariate multilevel model under MLwinN 2.19 software. The mean scores on knowledge and ideas, behaviors and related skills among 1606 high school students of Guangdong province, were 69.08 ± 14.81, 60.05 ± 16.85 and 74.99 ± 21.17 respectively. Three items on health showed that they all related to each other and relations between grades (0.972, 0.715 and 0.855) were greater than the individuals (0.565, 0.426 and 0.438). Factors as students from outside the Pearl River Delta region or from the rural areas, being male, at general secondary schools, at grade one, with poor academic performance and more pocket money etc., had lower levels on those related information of health.

  11. Differential Exposure to Hazardous Air Pollution in the United States: A Multilevel Analysis of Urbanization and Neighborhood Socioeconomic Deprivation

    Directory of Open Access Journals (Sweden)

    Frank C. Curriero

    2012-06-01

    Full Text Available Population exposure to multiple chemicals in air presents significant challenges for environmental public health. Air quality regulations distinguish criteria air pollutants (CAPs (e.g., ozone, PM2.5 from hazardous air pollutants (HAPs—187 chemicals which include carcinogens and others that are associated with respiratory, cardiovascular, neurological and numerous other non-cancer health effects. Evidence of the public’s cumulative exposure and the health effects of HAPs are quite limited. A multilevel model is used to assess differential exposure to HAP respiratory, neurological, and cancer hazards (2005 related to the Townsend Index of Socioeconomic Deprivation (TSI, after adjustment for regional population size and economic activity, and local population density. We found significant positive associations between tract TSI and respiratory and cancer HAP exposure hazards, and smaller effects for neurological HAPs. Tracts in the top quintile of TSI have between 38%–60% higher HAP exposure than the bottom quintile; increasing population size from the bottom quintile to the top quintile modifies HAP exposure hazard related to TSI, increasing cancer HAP exposure hazard by 6% to 20% and increasing respiratory HAP exposure hazard by 12% to 27%. This study demonstrates the value of social epidemiological methods for analyzing differential exposure and advancing cumulative risk assessment.

  12. Insular pathways to health care in the city: a multilevel analysis of access to hospital care in urban Kerala, India.

    Science.gov (United States)

    Levesque, Jean-Frédéric; Haddad, Slim; Narayana, Delampady; Fournier, Pierre

    2007-07-01

    To identify individual and urban unit characteristics associated with access to inpatient care in public and private sectors in urban Kerala, and to discuss policy implications of inequalities in access. We analysed the NSSO survey (1995-1996) for urban Kerala with regard to source and trajectories of hospitalization. Multinomial multilevel regression models were built for 695 cases nested in 24 urban units. Private sector accounts for 62% of hospitalizations. Only 31% of hospitalizations are in free wards and 20% of public hospitalizations involve payment. Hospitalization pathways suggest a segmentation of public and private health markets. Members of poor and casual worker households have lower propensity of hospitalization in paying public wards or private hospitals. There were important variations between cities, with higher odds of private hospitalization in towns with fewer hospital beds overall and in districts with high private-public bed ratios. Cities from districts with better economic indicators and dominance of private services have higher proportion of private hospitalizations. The private sector is the predominant source of inpatient care in urban Kerala. The public sector has an important role in providing access to care for the poor. Investing in the quality of public services is essential to ensure equity in access.

  13. Does income inequality get under the skin? A multilevel analysis of depression, anxiety and mental disorders in Sao Paulo, Brazil.

    Science.gov (United States)

    Chiavegatto Filho, Alexandre Dias Porto; Kawachi, Ichiro; Wang, Yuan Pang; Viana, Maria Carmen; Andrade, Laura Helena Silveira Guerra

    2013-11-01

    Test the original income inequality theory, by analysing its association with depression, anxiety and any mental disorders. We analysed a sample of 3542 individuals aged 18 years and older selected through a stratified, multistage area probability sample of households from the São Paulo Metropolitan Area. Mental disorder symptoms were assessed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Bayesian multilevel logistic models were performed. Living in areas with medium and high-income inequality was statistically associated with increased risk of depression, relative to low-inequality areas (OR 1.76; 95% CI 1.21 to 2.55, and 1.53; 95% CI 1.07 to 2.19, respectively). The same was not true for anxiety (OR 1.25; 95% CI 0.90 to 1.73, and OR 1.07; 95% CI 0.79 to 1.46). In the case of any mental disorder, results were mixed. In general, our findings were consistent with the income inequality theory, that is, people living in places with higher income inequality had an overall higher odd of mental disorders, albeit not always statistically significant. The fact that depression, but not anxiety, was statistically significant could indicate a pathway by which inequality influences health.

  14. Spousal Violence in 5 Transitional Countries: A Population-Based Multilevel Analysis of Individual and Contextual Factors.

    Science.gov (United States)

    Ismayilova, Leyla

    2015-11-01

    I examined the individual- and community-level factors associated with spousal violence in post-Soviet countries. I used population-based data from the Demographic and Health Survey conducted between 2005 and 2012. My sample included currently married women of reproductive age (n = 3932 in Azerbaijan, n = 4053 in Moldova, n = 1932 in Ukraine, n = 4361 in Kyrgyzstan, and n = 4093 in Tajikistan). I selected respondents using stratified multistage cluster sampling. Because of the nested structure of the data, multilevel logistic regressions for survey data were fitted to examine factors associated with spousal violence in the last 12 months. Partner's problem drinking was the strongest risk factor associated with spousal violence in all 5 countries. In Moldova, Ukraine, and Kyrgyzstan, women with greater financial power than their spouses were more likely to experience violence. Effects of community economic deprivation and of empowerment status of women in the community on spousal violence differed across countries. Women living in communities with a high tolerance of violence faced a higher risk of spousal violence in Moldova and Ukraine. In more traditional countries (Azerbaijan, Kyrgyzstan, and Tajikistan), spousal violence was lower in conservative communities with patriarchal gender beliefs or higher financial dependency on husbands. My findings underscore the importance of examining individual risk factors in the context of community-level factors and developing individual- and community-level interventions.

  15. The downside of marketization: a multilevel analysis of housing tenure and types in reform-era urban China.

    Science.gov (United States)

    Fu, Qiang; Zhu, Yushu; Ren, Qiang

    2015-01-01

    Based on data from the 2005 National Population Sample Survey and compiled covariates of 205 prefectures, this research adopted principal-component and multilevel-logistic analyses to study homeownership in urban China. Although the housing reform has severed the link between work units and residence, working in state sectors (government, state-owned enterprises and collective firms) remained significant in determining a household's entitlement to reform-era housing with heavy subsidies or better qualities. While the prefecture-level index of marketization reduced local homeownership of self-built housing, affordable housing and privatized housing, its effect is moderated by cross-level interactions with income, education and working in state sectors across different types of housing. Meanwhile, the index of political and market connections promoted all types of homeownership except for self-built housing. By situating the downside of marketization within a context of urban transformation, this research not only challenges the teleological premise of the neoliberal market transition theory but calls for research on institutional dynamics and social consequences of urban transformation in China. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Does school social capital modify socioeconomic inequality in mental health? A multi-level analysis in Danish schools.

    Science.gov (United States)

    Nielsen, Line; Koushede, Vibeke; Vinther-Larsen, Mathilde; Bendtsen, Pernille; Ersbøll, Annette Kjær; Due, Pernille; Holstein, Bjørn E

    2015-09-01

    It seems that social capital in the neighbourhood has the potential to reduce socioeconomic differences in mental health among adolescents. Whether school social capital is a buffer in the association between socioeconomic position and mental health among adolescents remains uncertain. The aim of this study is therefore to examine if the association between socioeconomic position and emotional symptoms among adolescents is modified by school social capital. The Health Behaviour in School-aged Children Methodology Development Study 2012 provided data on 3549 adolescents aged 11-15 in two municipalities in Denmark. Trust in the school class was used as an indicator of school social capital. Prevalence of daily emotional symptoms in each socioeconomic group measured by parents' occupational class was calculated for each of the three categories of school classes: school classes with high trust, moderate trust and low trust. Multilevel logistic regression analyses with parents' occupational class as the independent variable and daily emotional symptoms as the dependent variable were conducted stratified by level of trust in the school class. The prevalence of emotional symptoms was higher among students in school classes with low trust (12.9%) compared to school classes with high trust (7.2%) (p social capital may reduce mental health problems and diminish socioeconomic inequality in mental health among adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Adolescents alcohol-use and economic conditions: a multilevel analysis of data from a period with big economic changes.

    Science.gov (United States)

    Svensson, Mikael; Hagquist, Curt

    2010-12-01

    This paper examines how the unemployment rate is related to adolescent alcohol use and experience of binge drinking during a time period characterized by big societal changes. The paper uses repeated cross-sectional adolescent survey data from a Swedish region, collected in 1988, 1991, 1995, 1998, 2002 and 2005, and merges this with data on local unemployment rates for the same time periods. Individual level frequency of alcohol use as well as experience of binge drinking is connected to local level unemployment rate to estimate the relationship using multilevel modeling. The model includes municipality effects controlling for time-invariant differences between municipalities as well as year fixed effects controlling for municipality-invariant changes over time in alcohol use. The results show that the unemployment rate is negatively associated with adolescents' alcohol use and the experience of binge drinking. When the unemployment rate increases, more adolescents do not drink at all. Regular drinking (twice per month or more) is, on the other hand, unrelated to the unemployment rate. Examining gender-differences in the relationship, it is shown that the results are driven by behavior in girls, whereas drinking among boys does not show any significant relationship with changes in the unemployment rate.

  18. Does social policy moderate the impact of unemployment on health? A multilevel analysis of 23 welfare states.

    Science.gov (United States)

    Vahid Shahidi, Faraz; Siddiqi, Arjumand; Muntaner, Carles

    2016-12-01

    The magnitude of observable health inequalities between the unemployed and their employed counterparts differs considerably across countries. Few attempts have been made to test theoretical explanations for this cross-national variation. Moreover, existing studies suffer from important theoretical and methodological limitations. This study addresses these limitations and investigates whether differences in the generosity of social protection policies and in public attitudes towards those policies explain why unemployment-related health inequalities are steeper in some societies than in others. Multilevel logistic modelling was used to link contextual-level variables on social protection policies and public attitudes in 23 European countries to individual-level data on self-rated health from the 2012 wave of the European Social Survey. The magnitude of inequalities in self-rated health between the unemployed and their employed counterparts varies significantly across countries as a function of cross-national differences in the level of social protection awarded to the unemployed and the level of public support for the welfare state. The results provide empirical support for the claim that governments can play a more active role in mitigating unemployment-related health inequalities by expanding the generosity and scope of social protection policies. Whether such an expansion of social protection will take place in the current climate of fiscal austerity is a political question whose implications merit the attention of population health scholars. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  19. Characteristic Analysis and Fault-Tolerant Control of Circulating Current for Modular Multilevel Converters under Sub-Module Faults

    Directory of Open Access Journals (Sweden)

    Wen Wu

    2017-11-01

    Full Text Available A modular multilevel converter (MMC is considered to be a promising topology for medium- or high-power applications. However, a significantly increased amount of sub-modules (SMs in each arm also increase the risk of failures. Focusing on the fault-tolerant operation issue for the MMC under SM faults, the operation characteristics of MMC with different numbers of faulty SMs in the arms are analyzed and summarized in this paper. Based on the characteristics, a novel circulating current-suppressing (CCS fault-tolerant control strategy comprised of a basic control unit (BCU and virtual resistance compensation control unit (VRCCU in two parts is proposed, which has three main features: (i it can suppress the multi-different frequency components of the circulating current under different SM fault types simultaneously; (ii it can help fast limiting of the transient fault current caused at the faulty SM bypassed moment; and (iii it does not need extra communication systems to acquire the information of the number of faulty SMs. Moreover, by analyzing the stability performance of the proposed controller using the Root-Locus criterion, the election principle of the value of virtual resistance is revealed. Finally, the efficiency of the control strategy is confirmed with the simulation and experiment studies under different fault conditions.

  20. Multilevel Bloom Filters for P2P Flows Identification Based on Cluster Analysis in Wireless Mesh Network

    Directory of Open Access Journals (Sweden)

    Xia-an Bi

    2015-01-01

    Full Text Available With the development of wireless mesh networks and distributed computing, lots of new P2P services have been deployed and enrich the Internet contents and applications. The rapid growth of P2P flows brings great pressure to the regular network operation. So the effective flow identification and management of P2P applications become increasingly urgent. In this paper, we build a multilevel bloom filters data structure to identify the P2P flows through researches on the locality characteristics of P2P flows. Different level structure stores different numbers of P2P flow rules. According to the characteristics values of the P2P flows, we adjust the parameters of the data structure of bloom filters. The searching steps of the scheme traverse from the first level to the last level. Compared with the traditional algorithms, our method solves the drawbacks of previous schemes. The simulation results demonstrate that our algorithm effectively enhances the performance of P2P flows identification. Then we deploy our flow identification algorithm in the traffic monitoring sensors which belong to the network traffic monitoring system at the export link in the campus network. In the real environment, the experiment results demonstrate that our algorithm has a fast speed and high accuracy to identify the P2P flows; therefore, it is suitable for actual deployment.

  1. Associations Between Peer Network Gender Norms and the Perpetration of Intimate Partner Violence Among Urban Tanzanian Men: a Multilevel Analysis.

    Science.gov (United States)

    Mulawa, Marta I; Reyes, H Luz McNaughton; Foshee, Vangie A; Halpern, Carolyn T; Martin, Sandra L; Kajula, Lusajo J; Maman, Suzanne

    2018-05-01

    Male perpetration of intimate partner violence (IPV) against women in sub-Saharan Africa is widespread. Theory and empirical evidence suggest peer networks may play an important role in shaping IPV perpetration, though research on this topic in the region is limited. We assessed the degree to which peer network gender norms are associated with Tanzanian men's perpetration of IPV and examined whether the social cohesion of peer networks moderates this relationship. Using baseline data from sexually active men (n = 1103) nested within 59 peer networks enrolled in an on-going cluster-randomized HIV and IPV prevention trial, we fit multilevel logistic regression models to examine peer network-level factors associated with past-year physical IPV perpetration. Peer network gender norms were significantly associated with men's risk of perpetrating IPV, even after adjusting for their own attitudes toward gender roles (OR = 1.53 , p =  . 04). Peer network social cohesion moderated this relationship (OR = 1.50 , p =  . 04); the positive relationship between increasingly inequitable (i.e., traditional) peer network gender norms and men's risk of perpetrating IPV became stronger, as peer network social cohesion increased. Characteristics of the peer network context are associated with men's IPV perpetration and should be targeted in future interventions. While many IPV prevention interventions focus on changing individual attitudes, our findings support a unique approach, focused on transforming the peer context.

  2. The socializing effect of classroom aggression on the development of aggression and social rejection: A two-wave multilevel analysis.

    Science.gov (United States)

    Rohlf, Helena; Krahé, Barbara; Busching, Robert

    2016-10-01

    The current study examined the moderating effect of classroom aggression on the development of individual aggression and on the path from individual aggression to social rejection over time. The study included 1,284 elementary school children and consisted of two data waves 10months apart. At both time points, teachers assessed the children's physical and relational aggression and their social rejection status. Multi-level analyses revealed that the classroom level of relational aggression moderated the link between individual relational aggression at T1 and T2 (b=-0.18, 95% CI [-0.32, -0.05], psocial rejection (b=-0.12, 95% CI [-0.23, -0.003], psocial rejection in classrooms with a low level of relational aggression. Children were mainly influenced by their same-gender peers. Boys as a group had a greater influence than girls on their peers of either gender in the domain of relational aggression, whereas girls as a group had a greater influence in the domain of physical aggression. The contributions of analyzing cross-level interaction to understanding the developmental patterns of aggression and social rejection in middle childhood are discussed. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  3. Violence Among Men and Women in Substance Use Disorder Treatment: A Multi-level Event-based Analysis

    Science.gov (United States)

    Chermack, Stephen T.; Grogan-Kaylor, Andy; Perron, Brian E.; Murray, Regan L.; De Chavez, Peter; Walton, Maureen A.

    2010-01-01

    Background This study examined associations between acute alcohol and drug use and violence towards others in conflict incidents (overall, partner, and non-partner conflict incidents) by men and women recruited from substance use disorder (SUD) treatment. Methods Semi-structured interviews were used to obtain details about interpersonal conflict incidents (substance use, whether specific conflicts were with intimate partners or non-partners) in the 180 days pre-treatment. Participants for this study were selected for screening positive for past-year violence (N = 160; 77% men, 23% women). Results Multilevel multinomial regression models showed that after adjusting for clustering within individual participants, the most consistent predictors of violence across models were acute cocaine use (significant for overall, intimate partner and non-partner models), acute heavy alcohol use (significant for overall and non-partner models), and male gender (significant in all models). Conclusions This study was the first to explicitly examine the role of acute alcohol and drug use across overall, partner and non-partner conflict incidents. Consistent with prior studies using a variety of methodologies, alcohol, cocaine use and male gender were most consistently and positively related to violence severity (e.g., resulting in injury). The results provide important and novel event-level information regarding the relationship between acute alcohol and specific drug use and the severity of violence in interpersonal conflict incidents. PMID:20667666

  4. Differential exposure to hazardous air pollution in the United States: a multilevel analysis of urbanization and neighborhood socioeconomic deprivation.

    Science.gov (United States)

    Young, Gary S; Fox, Mary A; Trush, Michael; Kanarek, Norma; Glass, Thomas A; Curriero, Frank C

    2012-06-01

    Population exposure to multiple chemicals in air presents significant challenges for environmental public health. Air quality regulations distinguish criteria air pollutants (CAPs) (e.g., ozone, PM2.5) from hazardous air pollutants (HAPs)-187 chemicals which include carcinogens and others that are associated with respiratory, cardiovascular, neurological and numerous other non-cancer health effects. Evidence of the public's cumulative exposure and the health effects of HAPs are quite limited. A multilevel model is used to assess differential exposure to HAP respiratory, neurological, and cancer hazards (2005) related to the Townsend Index of Socioeconomic Deprivation (TSI), after adjustment for regional population size and economic activity, and local population density. We found significant positive associations between tract TSI and respiratory and cancer HAP exposure hazards, and smaller effects for neurological HAPs. Tracts in the top quintile of TSI have between 38%-60% higher HAP exposure than the bottom quintile; increasing population size from the bottom quintile to the top quintile modifies HAP exposure hazard related to TSI, increasing cancer HAP exposure hazard by 6% to 20% and increasing respiratory HAP exposure hazard by 12% to 27%. This study demonstrates the value of social epidemiological methods for analyzing differential exposure and advancing cumulative risk assessment.

  5. Associations of supermarket characteristics with weight status and body fat: a multilevel analysis of individuals within supermarkets (RECORD study).

    Science.gov (United States)

    Chaix, Basile; Bean, Kathy; Daniel, Mark; Zenk, Shannon N; Kestens, Yan; Charreire, Hélène; Leal, Cinira; Thomas, Frédérique; Karusisi, Noëlla; Weber, Christiane; Oppert, Jean-Michel; Simon, Chantal; Merlo, Juan; Pannier, Bruno

    2012-01-01

    Previous research on the influence of the food environment on weight status has often used impersonal measures of the food environment defined for residential neighborhoods, which ignore whether people actually use the food outlets near their residence. To assess whether supermarkets are relevant contexts for interventions, the present study explored between-residential neighborhood and between-supermarket variations in body mass index (BMI) and waist circumference (WC), and investigated associations between brands and characteristics of supermarkets and BMI or WC, after adjustment for individual and residential neighborhood characteristics. Participants in the RECORD Cohort Study (Paris Region, France, 2007-2008) were surveyed on the supermarket (brand and exact location) where they conducted their food shopping. Overall, 7 131 participants shopped in 1 097 different supermarkets. Cross-classified multilevel linear models were estimated for BMI and WC. Just 11.4% of participants shopped for food primarily within their residential neighborhood. After accounting for participants' residential neighborhood, people shopping in the same supermarket had a more comparable BMI and WC than participants shopping in different supermarkets. After adjustment for individual and residential neighborhood characteristics, participants shopping in specific supermarket brands, in hard discount supermarkets (especially if they had a low education), and in supermarkets whose catchment area comprised low educated residents had a higher BMI/WC. A public health strategy to reduce excess weight may be to intervene on specific supermarkets to change food purchasing behavior, as supermarkets are where dietary preferences are materialized into definite purchased foods.

  6. A multilevel structural equation modeling analysis of vulnerabilities and resilience resources influencing affective adaptation to chronic pain.

    Science.gov (United States)

    Sturgeon, John A; Zautra, Alex J; Arewasikporn, Anne

    2014-02-01

    The processes of individual adaptation to chronic pain are complex and occur across multiple domains. We examined the social, cognitive, and affective context of daily pain adaptation in individuals with fibromyalgia and osteoarthritis. By using a sample of 260 women with fibromyalgia or osteoarthritis, we examined the contributions of pain catastrophizing, negative interpersonal events, and positive interpersonal events to daily negative and positive affect across 30days of daily diary data. Individual differences and daily fluctuations in predictor variables were estimated simultaneously by utilizing multilevel structural equation modeling techniques. The relationships between pain and negative and positive affect were mediated by stable and day-to-day levels of pain catastrophizing as well as day-to-day positive interpersonal events, but not negative interpersonal events. There were significant and independent contributions of pain catastrophizing and positive interpersonal events to adaptation to pain and pain-related affective dysregulation. These effects occur both between persons and within a person's everyday life. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  7. School Contextual Features of Social Disorder and Mental Health Complaints—A Multilevel Analysis of Swedish Sixth-Grade Students

    Directory of Open Access Journals (Sweden)

    Bitte Modin

    2018-01-01

    Full Text Available This study addressed school-contextual features of social disorder in relation to sixth-grade students’ experiences of bullying victimization and mental health complaints. It investigated, firstly, whether the school’s concentrations of behavioural problems were associated with individual students’ likelihood of being bullied, and secondly, whether the school’s concentrations of behavioural problems and bullying victimization predicted students’ emotional and psychosomatic health complaints. The data were derived from the Swedish National Survey of Mental Health among Children and Young People, carried out among sixth-grade students (approximately 12–13 years old in Sweden in 2009. The analyses were based on information from 59,510 students distributed across 1999 schools. The statistical method used was multilevel modelling. While students’ own behavioural problems were associated with an elevated risk of being bullied, attending a school with a higher concentration of students with behavioural problems also increased the likelihood of being bullied. Attending a school with higher levels of bullying victimization and behavioural problems predicted more emotional and psychosomatic complaints, even when adjusting for their individual level analogues. The findings indicate that school-level features of social disorder influence bullying victimization and mental health complaints among students.

  8. Linking Health System Responsiveness to Political Rights and Civil Liberties: A Multilevel Analysis Using Data From 44 Countries.

    Science.gov (United States)

    Witvliet, Margot I; Stronks, Karien; Kunst, Anton E; Mahapatra, Tanmay; Arah, Onyebuchi A

    2015-01-01

    Responsiveness is a dimension of health system functioning and might be dependent upon contextual factors related to politics. Given this, we performed cross-national comparisons with the aim of investigating: 1) the associations of political factors with patients' reports of health system responsiveness and 2) the extent to which health input and output might explain these associations. World Health Survey data were analyzed for 44 countries (n = 103 541). Main outcomes included, respectively, 8 and 7 responsiveness domains for inpatient and outpatient care. Linear multilevel regressions were used to assess the associations of politics (namely, civil liberties and political rights), socioeconomic development, health system input, and health system output (measured by maternal mortality) with responsiveness domains, adjusted for demographic factors. Political rights showed positive associations with dignity (regression coefficient = 0.086 [standard error = 0.039]), quality (0.092 [0.049]), and support (0.113 [0.048]) for inpatient care and with dignity (0.075 [0.040]), confidentiality (0.089 [0.043]), and quality (0.124 [0.053]) for outpatient care. Positive associations were observed for civil liberties as well. Health system input and output reduced observed associations. Results tentatively suggest that strengthening political rights and, to a certain extent, civil liberties might improve health system responsiveness, in part through their effect on health system input and output. © The Author(s) 2015.

  9. Societal characteristics and health in the former communist countries of Central and Eastern Europe and the former Soviet Union: a multilevel analysis.

    Science.gov (United States)

    Bobak, Martin; Murphy, Mike; Rose, Richard; Marmot, Michael

    2007-11-01

    To examine whether, in former communist countries that have undergone profound social and economic transformation, health status is associated with income inequality and other societal characteristics, and whether this represents something more than the association of health status with individual socioeconomic circumstances. Multilevel analysis of cross-sectional data. 13 Countries from Central and Eastern Europe and the former Soviet Union. Population samples aged 18+ years (a total of 15 331 respondents). Poor self-rated health. There were marked differences among participating countries in rates of poor health (a greater than twofold difference between the countries with the highest and lowest rates of poor health), gross domestic product per capita adjusted for purchasing power parity (a greater than threefold difference), the Gini coefficient of income inequality (twofold difference), corruption index (twofold difference) and homicide rates (20-fold difference). Ecologically, the age- and sex-standardised prevalence of poor self-rated health correlated strongly with life expectancy at age 15 (r = -0.73). In multilevel analyses, societal (country-level) measures of income inequality were not associated with poor health. Corruption and gross domestic product per capita were associated with poor health after controlling for individuals' socioeconomic circumstances (education, household income, marital status and ownership of household items); the odds ratios were 1.15 (95% confidence interval 1.03 to 1.29) per 1 unit (on a 10-point scale) increase in the corruption index and 0.79 (95% confidence interval 0.68 to 0.93) per $5000 increase in gross domestic product per capita. The effects of gross domestic product and corruption were virtually identical in people whose household income was below and above the median. Societal measures of prosperity and corruption, but not income inequalities, were associated with health independently of individual

  10. A Steady-State Analysis Method for Modular Multilevel Converters Connected to Permanent Magnet Synchronous Generator-Based Wind Energy Conversion Systems

    Directory of Open Access Journals (Sweden)

    Zhijie Liu

    2018-02-01

    Full Text Available Modular multilevel converters (MMCs have shown great potential in the area of multi-megawatt wind energy conversion system (WECS based on permanent magnet synchronous generators (PMSGs. However, the studies in this area are few, and most of them refer to the MMC used in high-voltage direct current (HVDC systems, and hence the characteristics of the PMSG are not considered. This paper proposes a steady-state analysis method for MMCs connected to a PMSG-based WECS. In the proposed method, only the wind speed (operating condition is required as input, and all the electrical quantities in the MMC, including the amplitudes, phase angles and their harmonics, can be calculated step by step. The analysis method is built on the proposed d-q frame mathematical model. Interactions of electrical quantities between the MMC and PMSG are comprehensively considered. Moreover, a new way to calculate the average switching functions are adopted in order to improve the accuracy of the analysis method. Applications of the proposed method are also presented, which includes the characteristic analysis of capacitor voltage ripples and the capacitor sizing. Finally, the accuracy of the method and the correctness of the analysis are verified by simulations and experiments.

  11. Multilevel- marketing v České republice

    OpenAIRE

    Prudičová, Petra

    2009-01-01

    Graduation Theses concerns an analysis and evaluation, of how a multi-level marketing, functions in the Czech Republic. Explaining its ideals and principals, while it theoretically applies on a specific company, which is involved with multi-level marketing. The target is to introduce such system in an objective way and evaluate it in practice.

  12. Fast Multilevel Panel Method for Wind Turbine Rotor Flow Simulations

    NARCIS (Netherlands)

    van Garrel, Arne; Venner, Cornelis H.; Hoeijmakers, Hendrik Willem Marie

    2017-01-01

    A fast multilevel integral transform method has been developed that enables the rapid analysis of unsteady inviscid flows around wind turbines rotors. A low order panel method is used and the new multi-level multi-integration cluster (MLMIC) method reduces the computational complexity for

  13. A retrospective analysis of survival and prognostic factors after stereotactic radiosurgery for aggressive meningiomas

    International Nuclear Information System (INIS)

    Ferraro, Daniel J; Zoberi, Imran; Simpson, Joseph R; Jaboin, Jerry J; Funk, Ryan K; Blackett, John William; Ju, Michelle R; DeWees, Todd A; Chicoine, Michael R; Dowling, Joshua L; Rich, Keith M; Drzymala, Robert E

    2014-01-01

    While most meningiomas are benign, aggressive meningiomas are associated with high levels of recurrence and mortality. A single institution’s Gamma Knife radiosurgical experience with atypical and malignant meningiomas is presented, stratified by the most recent WHO classification. Thirty-one patients with atypical and 4 patients with malignant meningiomas treated with Gamma Knife radiosurgery between July 2000 and July 2011 were retrospectively reviewed. All patients underwent prior surgical resection. Overall survival was the primary endpoint and rate of disease recurrence in the brain was a secondary endpoint. Patients who had previous radiotherapy or prior surgical resection were included. Kaplan-Meier and Cox proportional hazards models were used to estimate survival and identify factors predictive of recurrence and survival. Post-Gamma Knife recurrence was identified in 11 patients (31.4%) with a median overall survival of 36 months and progression-free survival of 25.8 months. Nine patients (25.7%) had died. Three-year overall survival (OS) and progression-free survival (PFS) rates were 78.0% and 65.0%, respectively. WHO grade II 3-year OS and PFS were 83.4% and 70.1%, while WHO grade III 3-year OS and PFS were 33.3% and 0%. Recurrence rate was significantly higher in patients with a prior history of benign meningioma, nuclear atypia, high mitotic rate, spontaneous necrosis, and WHO grade III diagnosis on univariate analysis; only WHO grade III diagnosis was significant on multivariate analysis. Overall survival was adversely affected in patients with WHO grade III diagnosis, prior history of benign meningioma, prior fractionated radiotherapy, larger tumor volume, and higher isocenter number on univariate analysis; WHO grade III diagnosis and larger treated tumor volume were significant on multivariate analysis. Atypical and anaplastic meningiomas remain difficult tumors to treat. WHO grade III diagnosis and treated tumor volume were significantly

  14. Survival analysis of cancer risk reduction strategies for BRCA1/2 mutation carriers.

    Science.gov (United States)

    Kurian, Allison W; Sigal, Bronislava M; Plevritis, Sylvia K

    2010-01-10

    Women with BRCA1/2 mutations inherit high risks of breast and ovarian cancer; options to reduce cancer mortality include prophylactic surgery or breast screening, but their efficacy has never been empirically compared. We used decision analysis to simulate risk-reducing strategies in BRCA1/2 mutation carriers and to compare resulting survival probability and causes of death. We developed a Monte Carlo model of breast screening with annual mammography plus magnetic resonance imaging (MRI) from ages 25 to 69 years, prophylactic mastectomy (PM) at various ages, and/or prophylactic oophorectomy (PO) at ages 40 or 50 years in 25-year-old BRCA1/2 mutation carriers. With no intervention, survival probability by age 70 is 53% for BRCA1 and 71% for BRCA2 mutation carriers. The most effective single intervention for BRCA1 mutation carriers is PO at age 40, yielding a 15% absolute survival gain; for BRCA2 mutation carriers, the most effective single intervention is PM, yielding a 7% survival gain if performed at age 40 years. The combination of PM and PO at age 40 improves survival more than any single intervention, yielding 24% survival gain for BRCA1 and 11% for BRCA2 mutation carriers. PM at age 25 instead of age 40 offers minimal incremental benefit (1% to 2%); substituting screening for PM yields a similarly minimal decrement in survival (2% to 3%). Although PM at age 25 plus PO at age 40 years maximizes survival probability, substituting mammography plus MRI screening for PM seems to offer comparable survival. These results may guide women with BRCA1/2 mutations in their choices between prophylactic surgery and breast screening.

  15. Pregnancy associated nasopharyngeal carcinoma: A retrospective case-control analysis of maternal survival outcomes

    International Nuclear Information System (INIS)

    Cheng, Yi-Kan; Zhang, Fan; Tang, Ling-Long; Chen, Lei; Zhou, Guan-Qun; Zeng, Mu-Sheng; Kang, Tie-Bang; Jia, Wei-Hua; Shao, Jian-Yong; Mai, Hai-Qiang; Guo, Ying; Ma, Jun

    2015-01-01

    Background: Pregnancy-associated nasopharyngeal carcinoma (PANPC) has been associated with poor survival. Recent advances in radiation technology and imaging techniques, and the introduction of chemotherapy have improved survival in nasopharyngeal carcinoma (NPC); however, it is not clear whether these changes have improved survival in PANPC. Therefore, the purpose of this study was to compare five-year maternal survival in patients with PANPC and non-pregnant patients with NPC. Methods: After adjusting for age, stage and chemotherapy mode, we conducted a retrospective case-control study among 36 non-metastatic PANPC patients and 36 non-pregnant NPC patients (control group) who were treated at our institution between 2000 and 2010. Results: The median age of both groups was 30 years (range, 23–35 years); median follow-up for all patients was 70 months. Locoregionally-advanced disease accounted for 83.3% of all patients with PANPC and 92.9% of patients who developed NPC during pregnancy. In both the PANPC and control groups, 31 patients (86.1%) received chemotherapy and all patients received definitive radiotherapy. The five-year rates for overall survival (70% vs. 78%, p = 0.72), distant metastasis-free survival (79% vs. 76%, p = 0.77), loco-regional relapse-free survival (97% vs. 91%, p = 0.69) and disease-free survival (69% vs. 74%, p = 0.98) were not significantly different between the PANPC and control groups. Multivariate analysis using a Cox proportional hazards model revealed that only N-classification was significantly associated with five-year OS. Conclusion: This study demonstrates that, in the modern treatment era, pregnancy itself may not negatively influence survival outcomes in patients with NPC; however, pregnancy may delay the diagnosis of NPC

  16. Survival Analysis and its Associated Factors of Beta Thalassemia Major in Hamadan Province

    Directory of Open Access Journals (Sweden)

    Reza Zamani

    2015-05-01

    Full Text Available Background: There currently is a lack of knowledge about the long-term survival of patients with beta thalassemia (BT, particularly in regions with low incidence of the disease. The aim of the present study was to determine the survival rate of the patients with BT major and the factors associated with the survival time. Methods: This retrospective cohort study was performed in Hamadan province, located in the west of Iran. The study included patients that referred to the provincial hospitals during 16 year period from 1997 to 2013. The follow up of each subject was calculated from the date of birth to the date of death. Demographic and clinical data were extracted from patients’ medical records using a checklist. Statistical analysis included the Kaplan-Meier method to analyze survivals, log-rank to compare curves between groups, and Cox regression for multivariate prognostic analysis. Results: A total of 133 patients with BT major were enrolled, 54.9% of whom were male and 66.2% were urban. The 10-, 20- and 30-year survival rate for all patients were 98.3%, 88.4% and 80.5%, respectively. Based on hazard ratio (HR, we found that accompanied diseases (P=0.01, blood type (P=0.03 and residency status (P=0.01 were significant predictors for the survival time of patients. Conclusion: The survival rate of BT patients has improved. Future researches such as prospective designs are required for the estimation of survival rate and to find other prognostic factors, which have reliable sources of data.

  17. The influence of the macro-environment on physical activity: a multilevel analysis of 38 countries worldwide.

    Science.gov (United States)

    Bosdriesz, Jizzo R; Witvliet, Margot I; Visscher, Tommy L S; Kunst, Anton E

    2012-09-11

    As indicated by the ANGELO framework and similar models, various environmental factors influence population levels of physical activity (PA). To date attention has focused on the micro-level environment, while evidence on the macro-level environment remains scarce and mostly limited to high-income countries. This study aims to investigate whether environmental factors at macro-level are associated with PA among a broader range of countries. Data from the World Health Survey (WHS) was used to analyze 177,035 adults from 38 (mostly low and middle income) countries. The International Physical Activity Questionnaire-Short Form (IPAQ-S) was used to measure PA. Respondents were classified as active or inactive for vigorous PA, moderate PA and walking. Multilevel logistic regression was performed to assess associations between macro-level environmental factors and the prevalence of PA, with control for individual-level socioeconomic factors. The prevalence of PA varied widely between countries and types of PA (5.0%-93.8%). A negative association was found between gross domestic product and PA, odds ratios for men were 0.76 (95% CI: 0.65-0.89) for moderate PA and 0.79 (95% CI: 0.63-0.98) for walking. A higher temperature was associated with less PA (all types) and higher urbanization was associated with less vigorous and moderate PA. More gender equality was also associated with more walking for women. Governmental functioning and literacy rate were not found to be associated with any type of PA. This exploratory study indicates that factors such as climate, economic development and cultural factors are determinants of the level of overall PA at national levels. This underlines the suggestion that the macro-environment should be regarded as an important influence on PA.

  18. Non-medical use of prescription pain relievers among high school students in China: a multilevel analysis.

    Science.gov (United States)

    Guo, Lan; Xu, Yan; Deng, Jianxiong; He, Yuan; Gao, Xue; Li, Pengsheng; Wu, Hong; Zhou, Jinhua; Lu, Ciyong

    2015-07-13

    Given the differences between general high school (GHS) and vocational high school (VHS) students, this study aimed to investigate the lifetime prevalence of non-medical use of prescription pain relievers (NMUPPR) among high school students as well as the associations between NMUPPR and individual-level factors and school category. A cross-sectional study was conducted in GHS and VHS students in 2012 in Chongqing, and 11 906 students' questionnaires were completed and qualified for the survey. Self-reported NMUPPR and information regarding individual-level determinants and school category were collected. A multilevel multivariate logistic regression model was fitted to explore independent predictors of NMUPPR. The total lifetime prevalence of NMUPPR was 11.3%, and NMUPPR was more prevalent among VHS students (15.8%) compared with GHS students (9.8%). Overall, the results indicated that VHS students were more likely to be involved in NMUPPR (adjusted OR (AOR)=1.64, 95% CI 1.42 to 1.89). Regarding the individual-level predictors of NMUPPR, below-average family economic status was negatively correlated with NMUPPR (AOR=0.77, 95% CI 0.60 to 0.98), and students with more pocket money were more likely to be engaged in NMUPPR. Students who had difficult family relationships, had poor relationships with teachers, had parents or friends who engaged in non-medical prescription drug use, and considered or attempted suicide were more likely to be engaged in NMUPPR. NMUPPR among high school students is a multidetermined phenomenon. The current findings indicate that VHS students are an important subgroup of adolescents and highlight the need for additional research as well as targeted prevention and intervention programmes for NMUPPR. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Community-level influences on women's experience of intimate partner violence and terminated pregnancy in Nigeria: a multilevel analysis

    Directory of Open Access Journals (Sweden)

    Antai Diddy

    2012-11-01

    Full Text Available Abstract Background Intimate partner violence (IPV is a major public health problem with serious consequences for women’s physical, mental, sexual and reproductive health. Reproductive health outcomes such as unwanted and terminated pregnancies, fetal loss or child loss during infancy, non-use of family planning methods, and high fertility are increasingly recognized. However, little is known about the role of community influences on women's experience of IPV and its effect on terminated pregnancy, given the increased awareness of IPV being a product of social context. This study sought to examine the role of community-level norms and characteristics in the association between IPV and terminated pregnancy in Nigeria. Methods Multilevel logistic regression analyses were performed on nationally-representative cross-sectional data including 19,226 women aged 15–49 years in Nigeria. Data were collected by a stratified two-stage sampling technique, with 888 primary sampling units (PSUs selected in the first sampling stage, and 7,864 households selected through probability sampling in the second sampling stage. Results Women who had experienced physical IPV, sexual IPV, and any IPV were more likely to have terminated a pregnancy compared to women who had not experienced these IPV types. IPV types were significantly associated with factors reflecting relationship control, relationship inequalities, and socio-demographic characteristics. Characteristics of the women aggregated at the community level (mean education, justifying wife beating, mean age at first marriage, and contraceptive use were significantly associated with IPV types and terminated pregnancy. Conclusion Findings indicate the role of community influence in the association between IPV-exposure and terminated pregnancy, and stress the need for screening women seeking abortions for a history of abuse.

  20. Associations of neighborhood-level workplace violence with workers' mental distress problems: a multilevel analysis of Taiwanese employees.

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    Pien, Li-Chung; Chen, Duan-Rung; Chen, Chiou-Jong; Liang, Kuei-Min; Cheng, Yawen

    2015-01-01

    Workplace violence is known to pose mental health risks. However, whether or not workplace violence in a surrounding area might further increase the risk of mental distress in workers has rarely been examined. The study subjects were 9,393 male and 7,716 female employees who participated in a nationwide survey in 2010. Their personal experiences of workplace violence over the past 1 year were ascertained by a standardized questionnaire. Also assessed were their psychosocial work characteristics and mental distress problems. Neighborhood-level workplace violence was computed based on aggregated data at the county level and was categorized into low-, medium-, and high-level categories. Multilevel logistic regression models were constructed to examine the associations between neighborhood-level workplace violence and individual-level mental distress problems, with adjustment of individual-level experience of workplace violence. The neighborhood-level prevalence of workplace violence ranged from 4.7 to 14.7% in men and from 6.4 to 14.8% in women across 22 counties. As compared with those who live in counties of the lowest tertile of workplace violence, female workers who lived in counties of the highest tertile of workplace violence had a 1.72-fold increased risk for mental distress problems after controlling for individual experience of workplace violence and other psychosocial work characteristics. Neighborhood-level workplace violence was associated with poor mental health in female workers. Preventative strategies targeting workplace violence should pay attention to neighborhood factors and gender-specific effects that might influence societal tolerance of abusive work practices and workers' vulnerability to mental health impacts of workplace violence.

  1. Utilization of focused antenatal care in Zambia: examining individual- and community-level factors using a multilevel analysis.

    Science.gov (United States)

    Chama-Chiliba, Chitalu M; Koch, Steven F

    2015-02-01

    We examine the individual- and community-level factors associated with the utilization of antenatal care, following the adoption of the focused antenatal care (FANC) approach in Zambia. Using the 2007 Zambia Demographic and Health Survey, linked with administrative and health facility census data, we specify two multilevel logistic models to assess the factors associated with (1) the inadequate use of antenatal care (ANC) (defined as three or fewer visits) and (2) the non-use of ANC in the first trimester of pregnancy. Although all women in the selected sample had at least one ANC visit, 40% did not have the minimum number required (four), whereas more than 80% of the initial check-ups did not occur in the first trimester. At the individual level, the woman's employment status, quality of ANC received and the husband's educational attainment are negatively associated, while parity, the household childcare burden and wealth are positively associated with inadequate utilization of ANC. Both individual- and community-level characteristics influence inadequate use and non-use of ANC in the first trimester; however, community-level factors are relatively stronger in rural areas. The results suggest that improving the content of care during ANC visits may foster adequate use of ANC and encourage early initiation of ANC visits. Furthermore, health promotion programmes need to further encourage male involvement in pregnant women's decision to seek ANC to encourage adequate use of services. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  2. A multilevel analysis of the determinants of high-risk sexual behaviour in sub-Saharan Africa.

    Science.gov (United States)

    Uchudi, Joseph; Magadi, Monica; Mostazir, Mohammod

    2012-05-01

    A number of authors have identified multiple concurrent sexual partnerships by both men and women to lie at the root of the HIV/AIDS epidemic in sub-Saharan Africa. This study applies multilevel models to Demographic and Health Survey data collected during 2003-2008 in 20 sub-Saharan African countries to examine the influence of social and cultural context on involvement with multiple sexual partnerships in the region, above and beyond the effects of individual characteristics. The findings provide support for the ecological argument that health behaviours are shaped and determined by societal conditions, in addition to the effects of individual and household characteristics. Involvement with multiple sex partners is most prevalent in societies in which sexual norms are widely permissive and where polygyny is common. Individual autonomy is substantial and attitudes towards sexuality are more liberal among men and women who live in communities in which sexual norms are widely permissive. Men and women who are most likely to have multiple sex partners in the sub-Saharan region are those who initiated sexual activity earlier and those who have the individual attributes (e.g. young age, urban residence, education, media exposure and working for cash and away from home) that bring to them more rights and/or decision-making autonomy, but not necessarily more financial resources and economic security (mostly among women). On the other hand, involvement with multiple partners is determined by cultural norms (i.e. permissive sexual norms) and social change (i.e. mass education, expansion of cash employment). The findings suggest a number of opportunities for more effective policy and programmatic responses to curb the prevalence of multiple partnerships in sub-Saharan Africa.

  3. Contextual herd factors associated with cow culling risk in Québec dairy herds: A multilevel analysis.

    Science.gov (United States)

    Haine, Denis; Delgado, Hector; Cue, Roger; Sewalem, Asheber; Wade, Kevin; Lacroix, René; Lefebvre, Daniel; Arsenault, Julie; Bouchard, Émile; Dubuc, Jocelyn

    2017-09-01

    Several health disorders, such as milk fever, displaced abomasum, and mastitis, as well as impaired reproductive performance, are known risk factors for the removal of affected cows from a dairy herd. While cow-level risk factors are well documented in the literature, herd-level associations have been less frequently investigated. The objective of this study was to investigate the effect of cow- and herd-level determinants on variations in culling risk in Québec dairy herds: whether herd influences a cow's culling risk. For this, we assessed the influence of herd membership on cow culling risk according to displaced abomasum, milk fever, and retained placenta. A retrospective longitudinal study was conducted on data from dairy herds in the Province of Québec, Canada, by extracting health information events from the dairy herd health management software used by most Québec dairy producers and their veterinarians. Data were extracted for all lactations starting between January 1st and December 31st, 2010. Using multilevel logistic regression, we analysed a total of 10,529 cows from 201 herds that met the inclusion criteria. Milk fever and displaced abomasum were demonstrated to increase the cow culling risk. A minor general herd effect was found for the culling risk (i.e. an intra-class correlation of 1.0% and median odds ratio [MOR] of 1.20). The proportion of first lactation cows was responsible for this significant, but weak herd effect on individual cow culling risk, after taking into account the cow-level factors. On the other hand, the herd's average milk production was a protective factor. The planning and management of forthcoming replacement animals has to be taken into consideration when assessing cow culling risks and herd culling rates. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Who is left behind on the road to universal facility delivery? A cross-sectional multilevel analysis in rural Tanzania.

    Science.gov (United States)

    Kruk, Margaret E; Hermosilla, Sabrina; Larson, Elysia; Vail, Daniel; Chen, Qixuan; Mazuguni, Festo; Byalugaba, Beatrice; Mbaruku, Godfrey

    2015-08-01

    To examine factors associated with home delivery among women in Pwani Region, Tanzania, which has experienced a rapid rise in facility delivery coverage. Cross-sectional data from a population-based survey of women residing in rural areas of Pwani Region were linked to health facility locations. We fitted multilevel logistic models to examine individual and community factors associated with home delivery. A total of 752 (27.95%) of the 2691 women who completed the survey delivered their last child at home. Women were less likely to deliver at home if they had any primary education [odds ratio (OR) 0.62; 95% confidence interval (CI): 0.50, 0.79], were primiparous (OR: 0.52; 95% CI: 0.37, 0.73), had more exposure to media (OR: 0.80; 95% CI: 0.66, 0.96) or had received more (OR: 0.78; 95% CI: 0.63, 0.96) or better quality antenatal care (ANC) services (OR: 0.48; 95% CI: 0.34, 0.67). Increased wealth was strongly associated with lower odds of home delivery (OR: 0.27; 95% CI: 0.18, 0.39), as was living in a village that grew cash crops (OR: 0.56; 95% CI: 0.35, 0.88). Farther distance to hospital, but not to lower level facilities, was associated with higher likelihood of home delivery (OR 2.49; 95% CI: 1.60, 3.88). Poverty, multiparity, weak ANC and distance to hospital were associated with persistence of home delivery in a region with high coverage of facility delivery. A pro-poor path to universal coverage of safe delivery requires a greater focus on quality of care and more intensive outreach to poor and multiparous women. © 2015 John Wiley & Sons Ltd.

  5. School and class-level variations and patterns of physical activity: a multilevel analysis of Danish high school students.

    Science.gov (United States)

    Steenholt, Carina Bjørnskov; Pisinger, Veronica Sofie Clara; Danquah, Ida Høgstedt; Tolstrup, Janne Schurmann

    2018-02-14

    There is limited knowledge of physical activity (PA) patterns among high school students. High schools plays an important role as context for the students, but it is uncertain to what extent schools influence student participation in PA during leisure time. The purpose of this study is to describe patterns of PA and assess variations between schools and classes in PA, in a large cohort of Danish high school students. Self-reported cross-sectional data came from The Danish National Youth Study, comprising a total of 70,674 students attending 119 different schools and 3213 classes. Multilevel logistic regressions were applied to evaluate the association between socio-demographic variables and patterns of PA, and to assess the impact of schools and classes on PA measures. Students whose parents have achieved a lower level of education, older students and girls of perceived ethnic minority generally participated less in several forms of PA during leisure time. Substantial variations between schools were observed in terms of participation in PA at school during leisure time and in terms of use of active transportation to and from school. The school-level accounted for 9% (intra-class correlation coefficient (ICC) = 0.09 (95% CI: 0.06-0.11)) and 8% (ICC = 0.08 (95% CI: 0.07-0.11)) of the variation for participation in PA during leisure time and active transportation. Overall, students whose parents achieved a lower level of education, older students and girls of perceived ethnic minority represent vulnerable groups in relation to participation in several forms of PA during leisure time. The ICCs indicate that schools, in particular, have the potential to influence participation in PA at school during leisure time and active transportation to and from school. Thus, high schools should encourage and facilitate activities aimed at engaging students in PA during leisure time as well as encourage active transportation.

  6. Parent-child inpatient treatment for children with behavioural and emotional disorders: a multilevel analysis of within-subjects effects.

    Science.gov (United States)

    Ise, Elena; Schröder, Sabine; Breuer, Dieter; Döpfner, Manfred

    2015-11-16

    The importance of parental involvement in child treatment is well-established. Several child psychiatric clinics have, therefore, set up inpatient family units where children and parents are both actively involved in the treatment. Unfortunately, evidence supporting the benefits of these units is sparse. We evaluated the effectiveness of inpatient treatment for families with severe parent-child interaction problems in a child psychiatric setting. Consecutive admissions to the parent-child ward (N = 66) were studied. A within-subjects design was used with four assessment points (baseline, admission, discharge, four-week follow-up). Outcome measures were 1) parent and teacher ratings of child behaviour, and 2) parent self-ratings of parenting practices, parental strains and parental mental health. Data were analyzed using multilevel modelling for longitudinal data (piecewise growth curve models). All parent-rated measures improved significantly during the four-week treatment period (d = 0.4 - 1.3). These improvements were significantly greater than those observed during the four-week pre-admission period. In addition, benefits were maintained during the four-week follow-up period. Only parents' self-efficacy in managing their child's behaviour showed continued improvement during follow-up. Teacher ratings of children's disruptive behaviour at school were stable during the pre-admission period and showed significant improvements at follow-up (d = 0.3 - 0.4). We conclude that parent-child inpatient treatment has positive effects on child and parent behaviour and mental health, and can therefore be recommended for children with behavioural and emotional disorders and severe parent-child interaction problems.

  7. The influence of the macro-environment on physical activity: a multilevel analysis of 38 countries worldwide

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    Bosdriesz Jizzo R

    2012-09-01

    Full Text Available Abstract Background As indicated by the ANGELO framework and similar models, various environmental factors influence population levels of physical activity (PA. To date attention has focused on the micro-level environment, while evidence on the macro-level environment remains scarce and mostly limited to high-income countries. This study aims to investigate whether environmental factors at macro-level are associated with PA among a broader range of countries. Methods Data from the World Health Survey (WHS was used to analyze 177,035 adults from 38 (mostly low and middle income countries. The International Physical Activity Questionnaire-Short Form (IPAQ-S was used to measure PA. Respondents were classified as active or inactive for vigorous PA, moderate PA and walking. Multilevel logistic regression was performed to assess associations between macro-level environmental factors and the prevalence of PA, with control for individual-level socioeconomic factors. Results The prevalence of PA varied widely between countries and types of PA (5.0%-93.8%. A negative association was found between gross domestic product and PA, odds ratios for men were 0.76 (95% CI: 0.65-0.89 for moderate PA and 0.79 (95% CI: 0.63-0.98 for walking. A higher temperature was associated with less PA (all types and higher urbanization was associated with less vigorous and moderate PA. More gender equality was also associated with more walking for women. Governmental functioning and literacy rate were not found to be associated with any type of PA. Conclusions This exploratory study indicates that factors such as climate, economic development and cultural factors are determinants of the level of overall PA at national levels. This underlines the suggestion that the macro-environment should be regarded as an important influence on PA.

  8. Macro-level gender equality and alcohol consumption: a multi-level analysis across U.S. States.

    Science.gov (United States)

    Roberts, Sarah C M

    2012-07-01

    Higher levels of women's alcohol consumption have long been attributed to increases in gender equality. However, only limited research examines the relationship between gender equality and alcohol consumption. This study examined associations between five measures of state-level gender equality and five alcohol consumption measures in the United States. Survey data regarding men's and women's alcohol consumption from the 2005 Behavioral Risk Factor Surveillance System were linked to state-level indicators of gender equality. Gender equality indicators included state-level women's socioeconomic status, gender equality in socioeconomic status, reproductive rights, policies relating to violence against women, and women's political participation. Alcohol consumption measures included past 30-day drinker status, drinking frequency, binge drinking, volume, and risky drinking. Other than drinker status, consumption is measured for drinkers only. Multi-level linear and logistic regression models adjusted for individual demographics as well as state-level income inequality, median income, and % Evangelical Protestant/Mormon. All gender equality indicators were positively associated with both women's and men's drinker status in models adjusting only for individual-level covariates; associations were not significant in models adjusting for other state-level characteristics. All other associations between gender equality and alcohol consumption were either negative or non-significant for both women and men in models adjusting for other state-level factors. Findings do not support the hypothesis that higher levels of gender equality are associated with higher levels of alcohol consumption by women or by men. In fact, most significant findings suggest that higher levels of equality are associated with less alcohol consumption overall. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. How do U.S. state residents form opinions about ‘fracking’ in social contexts? A multilevel analysis

    International Nuclear Information System (INIS)

    Howell, Emily L.; Li, Nan; Akin, Heather; Scheufele, Dietram A.; Xenos, Michael A.; Brossard, Dominique

    2017-01-01

    Increased hydraulic fracturing operations (also known as ‘fracking’) in the U.S. have introduced a larger portion of the public to new and more extensive risks and benefits: from concerns of impacts on water quality and human health to benefits from increased oil and gas production and local economic development. As most policy affecting fracking occurs at the state-level, it is important to understand how citizens’ support for the technology is shaped by their states’ industrial, environmental, and socioeconomic experiences. Using a nationally representative survey, we construct a multilevel model to understand how individuals’ support for fracking varies as a function of both individual- and state-level characteristics. At the state-level, we find that people residing in states with a higher poverty rate and higher ground water use for public drinking supply are more likely to support fracking. At the individual level, the relationships between risk/benefit perceptions and support vary as a function of the state people live in. Additionally, the positive relationship between conservatism and support for fracking is stronger for people residing in states with a higher poverty rate. Based on these findings, we discuss the dynamics of public opinion in social contexts and implications on energy policymaking. - Highlights: • Americans’ support for ‘fracking’ relates to their state's economic and industrial experience. • Percent ground water-use, active shale plays, and poverty rate predict support for fracking. • Individual-level predictors include gender, political ideology, and risk/benefit perceptions. • Conservative ideology's positive relationship to support is stronger for those in poorer states.

  10. Risk factors for disordered weight control behaviors among Korean adolescents: Multilevel analysis of the Korea Youth Risk Behavior Survey.

    Science.gov (United States)

    Kim, Yongjoo; Austin, S Bryn; Subramanian, S V; Thomas, Jennifer J; Eddy, Kamryn T; Franko, Debra L; Rodgers, Rachel F; Kawachi, Ichiro

    2018-02-01

    To investigate the prevalence and risk factors for disordered weight control behaviors (DWCB) in South Korean adolescents at multiple levels, including individual, family, school, and geographic area. We drew participants from the 11th Korea Youth Risk Behavior Web-based Survey, conducted in 2015, with 65,529 adolescents (31,687 girls, 33,842 boys) aged 12-18 years. DWCB was defined as engaging in any of the following behaviors for weight control over the past month: fasting, one-food diet (eating only one food over an extended period of time for weight control), vomiting, and taking laxatives/diuretics/unprescribed diet pills. Sex-stratified four-level multilevel logistic models examined potential predictors of DWCB, including age, body-mass index, puberty, perceived household economic status, parental education, living structure, school type and sex-composition, percentage of students participating in school nutrition programs, and urbanicity. Overall, 6.2% of Korean adolescents (8.9% of girls, 3.7% of boys) exhibited any DWCB. We found significant between-school variation among girls and boys and between-classroom variation among girls. Older age, overweight/obesity, pubertal maturity, high household economic status (vs. mid-range economic status), and vocational schooling (vs. general) were positively associated with DWCB among girls and boys. Low household economic status (vs. mid-range economic status), higher parental education, and coeducational schooling (vs. single-sex) were positively associated with DWCB among girls only. The findings suggest that DWCB are prevalent among Korean adolescents across age, sex, and socioeconomic status. Social contextual factors including school and familial environmental factors, as well as individual characteristics, should be considered when developing effective prevention strategies. © 2018 Wiley Periodicals, Inc.

  11. AIDS knowledge and sexual activity among Flemish secondary school students: a multilevel analysis of the effects of type of education.

    Science.gov (United States)

    Van Rossem, Ronan; Berten, Hans; Van Tuyckom, Charlotte

    2010-01-21

    The behavior of adolescents puts them at an increased risk for HIV and other STIs, and their knowledge about HIV/AIDS is often inadequate. An understanding of how AIDS knowledge and sexual activity co-vary among Flemish secondary school students and of how education type, specifically, affects these students is limited. This study addresses the question of whether the effects of education type on HIV/AIDS knowledge and sexual activity are independent of the socio-demographic characteristics of the students. Data from the Flemish Educational Assessment survey, which collected data from a large representative sample of third- and fifth-grade high school students (N = 11,872), were used. Data were analyzed using multilevel logistic and Poisson regression techniques. There is an indication that type of education affects both an adolescent's sexual activity and his/her AIDS knowledge; these effects prove robust for differences in socio-economic backgrounds. Students in lower status education types are more likely to be sexually active and to have poorer AIDS knowledge. The relationship between AIDS knowledge and sexual activity is, however, more complex. Although students in education types with poorer AIDS knowledge are more sexually active, within each of these groups the sexually active have better AIDS knowledge than the non-sexually active. There is also evidence of active information seeking by sexually active students, which leads to improved AIDS knowledge. These findings are consistent with the literature on the role of the educational system in the reproduction of social inequalities. Students from lower status education types are at increased sexual risk compared to those from higher status types. There is also evidence of active information seeking by sexually active students, which leads to improved AIDS knowledge.

  12. Modeling time-to-event (survival) data using classification tree analysis.

    Science.gov (United States)

    Linden, Ariel; Yarnold, Paul R

    2017-12-01

    Time to the occurrence of an event is often studied in health research. Survival analysis differs from other designs in that follow-up times for individuals who do not experience the event by the end of the study (called censored) are accounted for in the analysis. Cox regression is the standard method for analysing censored data, but the assumptions required of these models are easily violated. In this paper, we introduce classification tree analysis (CTA) as a flexible alternative for modelling censored data. Classification tree analysis is a "decision-tree"-like classification model that provides parsimonious, transparent (ie, easy to visually display and interpret) decision rules that maximize predictive accuracy, derives exact P values via permutation tests, and evaluates model cross-generalizability. Using empirical data, we identify all statistically valid, reproducible, longitudinally consistent, and cross-generalizable CTA survival models and then compare their predictive accuracy to estimates derived via Cox regression and an unadjusted naïve model. Model performance is assessed using integrated Brier scores and a comparison between estimated survival curves. The Cox regression model best predicts average incidence of the outcome over time, whereas CTA survival models best predict either relatively high, or low, incidence of the outcome over time. Classification tree analysis survival models offer many advantages over Cox regression, such as explicit maximization of predictive accuracy, parsimony, statistical robustness, and transparency. Therefore, researchers interested in accurate prognoses and clear decision rules should consider developing models using the CTA-survival framework. © 2017 John Wiley & Sons, Ltd.

  13. SURVIVAL ANALYSIS AND GROWTH OF Cordia trichotoma, BORAGINACEAE, LAMIALES, IN MATO GROSSO DO SUL STATE, BRAZIL

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    Sergio Luiz Salvadori

    2013-12-01

    Full Text Available http://dx.doi.org/10.5902/1980509812357The evaluation of a plant survival percentage and growth may reflect its competitive ability in plantcommunity. Cordia trichotoma is a common native tree in Mato Grosso do Sul State and one of the mostpromising for planting. This study monitored the survival percentage and growth of Cordia trichotomaunder different conditions such as weeding and receiving or not fertilization. The experiment started inSeptember 2008 and it was concluded in March 2010. The seeds collection and sowing were held in urbanarea of Mundo Novo Municipality and the area for permanent planting to measure seedlings survival andgrowth was set at Japorã Municipality, Fazenda Santa Clara. Seedlings were planted in two categories: theuse or not of fertilizer and crowing resulting in four distinct groups: block fertilizer bare earth (ATN, bareland block without fertilizer (BTN, fertilizer and crown block (AC and without fertilizer and crownedblock (BC. The results indicated high survival of Cordia trichotoma in the seedling transplant system from bed to bags. The BC block showed the highest percentage of survival, but the smaller increments in height.The AC, ATN and BTN blocks presented the same survival pattern and similar average growth. However,there may be differences in nutritional and chemical composition of the soil suggesting sector analysis forfuture studies.

  14. Re-analysis of survival data of cancer patients utilizing additive homeopathy.

    Science.gov (United States)

    Gleiss, Andreas; Frass, Michael; Gaertner, Katharina

    2016-08-01

    In this short communication we present a re-analysis of homeopathic patient data in comparison to control patient data from the same Outpatient´s Unit "Homeopathy in malignant diseases" of the Medical University of Vienna. In this analysis we took account of a probable immortal time bias. For patients suffering from advanced stages of cancer and surviving the first 6 or 12 months after diagnosis, respectively, the results show that utilizing homeopathy gives a statistically significant (p<0.001) advantage over control patients regarding survival time. In conclusion, bearing in mind all limitations, the results of this retrospective study suggest that patients with advanced stages of cancer might benefit from additional homeopathic treatment until a survival time of up to 12 months after diagnosis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. The role of gender and friends' gender on peer socialization of adolescent drinking: a prospective multilevel social network analysis.

    Science.gov (United States)

    Deutsch, Arielle R; Steinley, Douglas; Slutske, Wendy S

    2014-09-01

    Although socializing effects of friends' drinking on adolescent drinking behavior have been firmly established in previous literature, study results on the importance of gender, as well as the specific role that gender may play in peer socialization, are very mixed. Given the increasing importance of gender in friendships (particularly opposite-sex friendships) during adolescence, it is necessary to better understand the nuanced roles that gender can play in peer socialization effects on alcohol use. In addition, previous studies focusing on the interplay between individual gender and friends' gender have been largely dyadic; less is known about potential gendered effects of broader social networks. The current study sought to further investigate potential effects of gender on friends' influence on adolescent drinking behavior with particular emphasis on the number of same-sex and opposite-sex friends within one's friendship network, as well as closeness to these friends. Using Waves I and II of the saturated sample of the National Longitudinal Study of Adolescent Health (Add Health), adolescent friendship networks were used to calculate the mean drinking behaviors of adolescent friends. Multi-level models estimated the effects of individual drinking behaviors, friend drinking behaviors, and school-level drinking behaviors on adolescent drinking 1 year later, as well as moderating effects of gender composition of friendship groups and male and female friend closeness on the relationship between friends' drinking behaviors and adolescent drinking behavior. Results documented that gender composition of friendship groups did not influence the effect of friends' drinking on individual drinking 1 year later. However, closeness to friends did influence this relationship. As closeness to male friends decreased, the influence of their drinking behavior increased, for both boys and girls. A similar effect was found for female friends, but only for boys. Female friend

  16. Determinants and causes of neonatal mortality in Jimma Zone, Southwest Ethiopia: a multilevel analysis of prospective follow up study.

    Directory of Open Access Journals (Sweden)

    Gurmesa Tura Debelew

    Full Text Available BACKGROUND: Ethiopia is among the countries with the highest neonatal mortality with the rate of 37 deaths per 1000 live births. In spite of many efforts by the government and other partners, non-significant decline has been achieved in the last 15 years. Thus, identifying the determinants and causes are very crucial for policy and program improvement. However, studies are scarce in the country in general and in Jimma zone in particular. OBJECTIVE: To identify the determinants and causes of neonatal mortality in Jimma Zone, Southwest Ethiopia. METHODS: A prospective follow-up study was conducted among 3463 neonates from September 2012 to December 2013. The data were collected by interviewer-administered structured questionnaire and analyzed by SPSS V.20.0 and STATA 13. Verbal autopsies were conducted to identify causes of neonatal death. Mixed-effects multilevel logistic regression model was used to identify determinants of neonatal mortality. RESULTS: The status of neonatal mortality rate was 35.5 (95%CI: 28.3, 42.6 per 1000 live births. Though significant variation existed between clusters in relation to neonatal mortality, cluster-level variables were found to have non-significant effect on neonatal mortality. Individual-level variables such as birth order, frequency of antenatal care use, delivery place, gestation age at birth, premature rupture of membrane, complication during labor, twin births, size of neonate at birth and neonatal care practice were identified as determinants of neonatal mortality. Birth asphyxia (47.5%, neonatal infections (34.3% and prematurity (11.1% were the three leading causes of neonatal mortality accounting for 93%. CONCLUSIONS: This study revealed high status of neonatal mortality in the study area. Higher-level variables had less importance in determining neonatal mortality. Individual level variables related to care during pregnancy, intra-partum complications and care, neonatal conditions and the immediate

  17. Passengers at risk: a multi-level analysis of the decision to travel with a drunk driver.

    Science.gov (United States)

    Nazif-Muñoz, José Ignacio; Blank-Gomel, Aharon

    2017-06-01

    To assess the impact of demographic, intrapersonal and environmental factors on the likelihood in Chile of becoming a passenger of an alcohol-impaired driver (PAID). Multi-level cross-sectional study. Data were acquired from two large-scale household surveys of representative samples of Chile's Metropolitan Region. The study included 1341 individuals ≥ 16 years; 696 of them reported engaging in PAID. The primary outcome was self-reported frequencies of having accepted a ride with an alcohol-impaired driver. PAID was associated significantly with 'age' [odds ratio (OR) = 0.99, 95% confidence interval (CI) = 0.98-0.99, P = 0.03], 'traffic safety beliefs' (OR = 0.17, 95% CI = 0.078-0.44, P = 0.00), 'time exposure as passenger' (OR = 1.00, 95% CI = 1.00-1.01, P = 0.00) and 'sex' (OR = 0.67, 95% CI = 0.53-0.87, P = 0.00). In women, PAID was associated with 'age' (OR = 0.98, 95% CI = 0.97-0.99, P = 0.02), 'traffic safety beliefs' (OR = 0.17, 95% CI = 0.05-0.59, P = 0.00) and 'low quality of public bus stops' (OR = 0.97, 95% CI = 0.98-0.99, P = 0.01). Younger women with high education levels were more likely to engage in PAID than younger women with low education levels. In men, PAID was associated with 'traffic safety beliefs' (OR = 0.13, 95% CI = 0.02-0.63, P = 0.01) and 'time exposure as passenger' (OR = 1.00, 95% CI = 1.00-1.01, P = 0.02). In Chile, men are at higher risk of becoming a passenger of an alcohol-impaired driver (PAID) than women. In women, PAID appears to be associated with lower traffic safety beliefs, lower quality of public bus stations and an interaction between education and age. In men, PAID is associated with lower traffic safety beliefs and higher time exposure as passenger. © 2017 Society for the Study of Addiction.

  18. Multilevel models in international business research

    NARCIS (Netherlands)

    Peterson, M.F.; Arregle, J-L.; Martin, Xavier

    2012-01-01

    Multiple-level (or mixed linear) modeling (MLM) can simultaneously test hypotheses at several levels of analysis (usually two or three), or control for confounding effects at one level while testing hypotheses at others. Advances in multi-level modeling allow increased precision in quantitative

  19. Engineering applications of heuristic multilevel optimization methods

    Science.gov (United States)

    Barthelemy, Jean-Francois M.

    1989-01-01

    Some engineering applications of heuristic multilevel optimization methods are presented and the discussion focuses on the dependency matrix that indicates the relationship between problem functions and variables. Coordination of the subproblem optimizations is shown to be typically achieved through the use of exact or approximate sensitivity analysis. Areas for further development are identified.

  20. Does gender inequity increase men's mortality risk in the United States? A multilevel analysis of data from the National Longitudinal Mortality Study

    Directory of Open Access Journals (Sweden)

    Shane A. Kavanagh

    2017-12-01

    Full Text Available A number of theoretical approaches suggest that gender inequity may give rise to health risks for men. This study undertook a multilevel analysis to ascertain if state-level measures of gender inequity are predictors of men's mortality in the United States. Data for the analysis were taken primarily from the National Longitudinal Mortality Study, which is based on a random sample of the non-institutionalised population. The full data set included 174,703 individuals nested within 50 states and had a six-year follow-up for mortality. Gender inequity was measured by nine variables: higher education, reproductive rights, abortion provider access, elected office, management, business ownership, labour force participation, earnings and relative poverty. Covariates at the individual level were age, income, education, race/ethnicity, marital status and employment status. Covariates at the state level were income inequality and per capita gross domestic product. The results of logistic multilevel modelling showed a number of measures of state-level gender inequity were significantly associated with men's mortality. In all of these cases greater gender inequity was associated with an increased mortality risk. In fully adjusted models for all-age adult men the elected office (OR 1.05 95% CI 1.01–1.09, business ownership (OR 1.04 95% CI 1.01–1.08, earnings (OR 1.04 95% CI 1.01–1.08 and relative poverty (OR 1.07 95% CI 1.03–1.10 measures all showed statistically significant effects for each 1 standard deviation increase in the gender inequity z-score. Similar effects were seen for working-age men. In older men (65+ years only the earnings and relative poverty measures were statistically significant. This study provides evidence that gender inequity may increase men's health risks. The effect sizes while small are large enough across the range of gender inequity identified to have important population health implications.

  1. Perceived and Objective Measures of Neighborhood Walkability and Physical Activity among Adults in Japan: A Multilevel Analysis of a Nationally Representative Sample.

    Science.gov (United States)

    Hanibuchi, Tomoya; Nakaya, Tomoki; Yonejima, Mayuko; Honjo, Kaori

    2015-10-23

    Although associations between a person's neighborhood and their health have been studied internationally, most studies have been limited to a few cities or towns. Therefore, we used a nationally representative sample to explore whether perceived and objective neighborhood walkability was associated with the physical activity of residents. Data were analyzed from the Japanese General Social Surveys of 2010 (n = 2395; 1114 men and 1281 women). Perceived walkability was scored using factor analysis for the respondents' perceptions of neighborhood conditions, while objective walkability was measured using the geographic information system approach. Finally, multilevel logistic regression analysis was performed to examine whether neighborhood walkability was associated with the frequency of leisure-time physical activity (LTPA) among respondents. We found that perceived walkability was positively associated with the frequency of LTPA (odds ratio of the highest quartile was 1.53 (1.14-2.05) compared with the lowest quartile); however, objective walkability showed no association. When stratified by gender, an association between perceived walkability and LTPA was observed among women, but only a marginally significant association was present between objective walkability and LTPA among men. We conclude that the association between neighborhood walkability and LTPA can be partially generalized across Japan.

  2. Psychosocial interventions for reducing vocal challenging behavior in persons with autistic disorder: a multilevel meta-analysis of single-case experiments.

    Science.gov (United States)

    Vanderkerken, Lien; Heyvaert, Mieke; Maes, Bea; Onghena, Patrick

    2013-12-01

    Vocal challenging behavior (VCB) forms a common problem in individuals with autistic disorder. Since VCB is associated with negative outcomes for the individual and his or her environment, it is important to know how to manage this type of CB. To evaluate the effectiveness of several psychosocial interventions applied to decrease VCB in individuals with autistic disorder, we conducted a meta-analysis of single-case experiments (SCEs). Fifty-two SCEs, including 74 participants, were combined using a multilevel meta-analysis. The overall treatment effect was large and statistically significant. However, the effect varied significantly over the included studies and participants. Examining this variance, evidence was found for a moderator effect of VCB type and intervention type, with, on average, the largest effects for interventions used to reduce VCB including stereotypical VCB and for interventions containing both antecedent and consequence components. Age, gender, primary treatment setting, publication year, and study quality did not significantly moderate the intervention effect. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Difference in adherence to and influencing factors of a healthy lifestyle between middle-aged and elderly people in Korea: A multilevel analysis.

    Science.gov (United States)

    Son, Ki Young; Park, Sang Min; Lee, Juhyun; Kim, Chang Yup

    2015-06-01

    Comprehensive research for factors related to healthy lifestyles of the elderly is limited. The present study aimed to elucidate the factors associated with adherence to a healthy lifestyle by age groups. The present study was based on data from the 2005 Korea National Health and Nutrition Examination Survey. We calculated crude proportions and adjusted proportions of cigarette smokers, problem alcohol drinkers, and physically inactive people in two age groups (40-59 years and ≥60 years). We carried out multilevel analysis to elucidate factors associated with healthy lifestyles. Of 3194 respondents included in the analysis, 1154 (36.13%) were aged 60 years or older. Older participants smoked less (23.0% vs 17.4%) and exercised less frequently (52.4% vs 66.9%; all P elderly (OR 1.037, 95% CI 1.005-1.070). Different factors were associated with healthy lifestyles of elderly people when compared with middle-aged people. In addition, local tax per capita, an area level variable, was more likely to be associated with smoking in the elderly than the middle-aged group. © 2014 Japan Geriatrics Society.

  4. When will I succeed in my first-year diploma? Survival analysis in Dutch higher education

    NARCIS (Netherlands)

    Bruinsma, Marjon; Jansen, Ellen P. W. A.

    2009-01-01

    The goal of this study was to illustrate survival analysis with higher education data and gain insight into a limited set of factors that predict when students passed their first-year examination at a Dutch university. Study participants consisted of 565 first-year students in four departments. Data

  5. Use of a Survival Analysis Technique in Understanding Game Performance in Instructional Games. CRESST Report 812

    Science.gov (United States)

    Kim, Jinok; Chung, Gregory K. W. K.

    2012-01-01

    In this study we compared the effects of two math game designs on math and game performance, using discrete-time survival analysis (DTSA) to model players' risk of not advancing to the next level in the game. 137 students were randomly assigned to two game conditions. The game covered the concept of a unit and the addition of like-sized fractional…

  6. Revealing the equivalence of two clonal survival models by principal component analysis

    International Nuclear Information System (INIS)

    Lachet, Bernard; Dufour, Jacques

    1976-01-01

    The principal component analysis of 21 chlorella cell survival curves, adjusted by one-hit and two-hit target models, lead to quite similar projections on the principal plan: the homologous parameters of these models are linearly correlated; the reason for the statistical equivalence of these two models, in the present state of experimental inaccuracy, is revealed [fr

  7. Survival analysis of postoperative nausea and vomiting in patients receiving patient-controlled epidural analgesia

    Directory of Open Access Journals (Sweden)

    Shang-Yi Lee

    2014-11-01

    Conclusion: Survival analysis using Cox regression showed that the average consumption of opioids played an important role in postoperative nausea and vomiting, a result not found by logistic regression. Therefore, the incidence of postoperative nausea and vomiting in patients cannot be reliably determined on the basis of a single visit at one point in time.

  8. It's Deja Vu All over Again: Using Multiple-Spell Discrete-Time Survival Analysis.

    Science.gov (United States)

    Willett, John B.; Singer, Judith D.

    1995-01-01

    The multiple-spell discrete-time survival analysis method is introduced and illustrated using longitudinal data on exit from and reentry into the teaching profession. The method is applicable to many educational problems involving the sequential occurrence of disparate events or episodes. (SLD)

  9. On the analysis of clonogenic survival data: Statistical alternatives to the linear-quadratic model

    International Nuclear Information System (INIS)

    Unkel, Steffen; Belka, Claus; Lauber, Kirsten

    2016-01-01

    The most frequently used method to quantitatively describe the response to ionizing irradiation in terms of clonogenic survival is the linear-quadratic (LQ) model. In the LQ model, the logarithm of the surviving fraction is regressed linearly on the radiation dose by means of a second-degree polynomial. The ratio of the estimated parameters for the linear and quadratic term, respectively, represents the dose at which both terms have the same weight in the abrogation of clonogenic survival. This ratio is known as the α/β ratio. However, there are plausible scenarios in which the α/β ratio fails to sufficiently reflect differences between dose-response curves, for example when curves with similar α/β ratio but different overall steepness are being compared. In such situations, the interpretation of the LQ model is severely limited. Colony formation assays were performed in order to measure the clonogenic survival of nine human pancreatic cancer cell lines and immortalized human pancreatic ductal epithelial cells upon irradiation at 0-10 Gy. The resulting dataset was subjected to LQ regression and non-linear log-logistic regression. Dimensionality reduction of the data was performed by cluster analysis and principal component analysis. Both the LQ model and the non-linear log-logistic regression model resulted in accurate approximations of the observed dose-response relationships in the dataset of clonogenic survival. However, in contrast to the LQ model the non-linear regression model allowed the discrimination of curves with different overall steepness but similar α/β ratio and revealed an improved goodness-of-fit. Additionally, the estimated parameters in the non-linear model exhibit a more direct interpretation than the α/β ratio. Dimensionality reduction of clonogenic survival data by means of cluster analysis was shown to be a useful tool for classifying radioresistant and sensitive cell lines. More quantitatively, principal component analysis allowed

  10. Survival Rate and Associated Factors of Childhood Leukemia in Iran: A Systematic Review and Meta Analysis

    Directory of Open Access Journals (Sweden)

    Yousef Veisani

    2017-02-01

    Full Text Available Context Resent reviews have shown that about 18% of all child cancers are leukemia. Track of the survival rate can help researchers improve quality of life of patients through improving screening or discovery of better treatments. Objectives This review aimed at estimating the 5-year survival rates and associated factors of childhood leukemia in Iran. Data Sources We carried out a systematic review through search of relevant studies published in English (PubMed, Scopus, Google scholar, and ISI and Persian databases (Magiran, Medlib, SID, and Iran Medex. Study Selection The study included all epidemiologic studies that estimated survival rate in children with leukemia in Iran during years 2002 to 2015, and a standardized manner was used for extraction of information. Data Extraction The entire text or summary of all searched articles was extracted and then, related articles were selected, and irrelevant ones were excluded. Fixed and random effects models were calculated by the STATA using standard meta-analysis methods. Heterogeneity was assessed by I² statistics. Results The overall 5-year survival rate in patients with childhood leukemia in Iran was 0.65 (95% CI, 0.62 to 0.67, 10 studies, in the acute lymphoblastic leukemia (ALL subtype was 71.0% (95% CI: 68.0 to 74.0, and in the acute myeloid leukemia (AML subtype was 46.0%. Results of the meta analysis showed significant poor survival with relapse (heart rate (HR 1.59, 95% confidence interval (CI 1.27 to 1.98 and white blood count (WBC counts ≥ 50,000 (HR 2.92, 95% CI 1.23 to 4.60. Conclusions The results showed that 5-year survival rates in patients with AML were lower than patients with ALL. The results of this meta analysis strongly support the need for future research, action, and guidance for clinicians to improve health-related quality of life and outcomes for children with leukemia.

  11. Fissure sealants in caries prevention:a practice-based study using survival analysis

    OpenAIRE

    Leskinen, K. (Kaja)

    2010-01-01

    Abstract The purpose of this study was to analyse the effectiveness and cost of fissure sealant treatment in preventing dental caries in children in a practice-based research network using survival analysis. The survival times of first permanent molars in children were analysed in three countries: in Finland (age cohorts 1970–1972 and 1980–1982), in Sweden (1980–1982) and in Greece (1980–1982), and additionally at two municipal health centres in Finland (age cohorts 1988–1990 in Kemi...

  12. Multilevel particle filter

    KAUST Repository

    Law, Kody

    2016-01-06

    This talk will pertain to the filtering of partially observed diffusions, with discrete-time observations. It is assumed that only biased approximations of the diffusion can be obtained, for choice of an accuracy parameter indexed by l. A multilevel estimator is proposed, consisting of a telescopic sum of increment estimators associated to the successive levels. The work associated to O( 2) mean-square error between the multilevel estimator and average with respect to the filtering distribution is shown to scale optimally, for example as O( 2) for optimal rates of convergence of the underlying diffusion approximation. The method is illustrated on some toy examples as well as estimation of interest rate based on real S&P 500 stock price data.

  13. Thirty-day Readmission Rates and Associated Factors: A Multilevel Analysis of Practice Variations in French Public Psychiatry.

    Science.gov (United States)

    Gandré, Coralie; Gervaix, Jeanne; Thillard, Julien; Macé, Jean-Marc; Roelandt, Jean-Luc; Chevreul, Karine

    2018-03-01

    Inpatient psychiatric readmissions are often used as an indicator of the quality of care and their reduction is in line with international recommendations for mental health care. Research on variations in inpatient readmission rates among mental health care providers is therefore of key importance as these variations can impact equity, quality and efficiency of care when they do not result from differences in patients' needs. Our objectives were first to describe variations in inpatient readmission rates between public mental health care providers in France on a nationwide scale, and second, to identify their association with patient, health care providers and environment characteristics. We carried out a study for the year 2012 using data from ten administrative national databases. 30-day readmissions in inpatient care were identified in the French national psychiatric discharge database. Variations were described numerically and graphically between French psychiatric sectors and factors associated with these variations were identified by carrying out a multi-level logistic regression accounting for the hierarchical structure of the data. Significant practice variations in 30-day inpatient readmission rates were observed with a coefficient of variation above 50%. While a majority of those variations was related to differences within sectors, individual patient characteristics explained a lower part of the variations resulting from differences between sectors than the characteristics of sectors and of their environment. In particular, an increase in the mortality rate and in the acute admission rate for somatic disorders in sectors' catchment area was associated with a decrease in the probability of 30-day readmission. Similarly, an increase in the number of psychiatric inpatient beds in private for-profit hospitals per 1,000 inhabitants in sectors' catchment area was associated with a decrease in this probability, which also varied with overall sectors' case

  14. Mechanisms and mediation in survival analysis: towards an integrated analytical framework.

    LENUS (Irish Health Repository)

    Haase, Trutz

    2016-02-29

    A wide-ranging debate has taken place in recent years on mediation analysis and causal modelling, raising profound theoretical, philosophical and methodological questions. The authors build on the results of these discussions to work towards an integrated approach to the analysis of research questions that situate survival outcomes in relation to complex causal pathways with multiple mediators. The background to this contribution is the increasingly urgent need for policy-relevant research on the nature of inequalities in health and healthcare.

  15. Two-stage meta-analysis of survival data from individual participants using percentile ratios

    Science.gov (United States)

    Barrett, Jessica K; Farewell, Vern T; Siannis, Fotios; Tierney, Jayne; Higgins, Julian P T

    2012-01-01

    Methods for individual participant data meta-analysis of survival outcomes commonly focus on the hazard ratio as a measure of treatment effect. Recently, Siannis et al. (2010, Statistics in Medicine 29:3030–3045) proposed the use of percentile ratios as an alternative to hazard ratios. We describe a novel two-stage method for the meta-analysis of percentile ratios that avoids distributional assumptions at the study level. Copyright © 2012 John Wiley & Sons, Ltd. PMID:22825835

  16. Gene expression meta-analysis identifies chromosomal regions involved in ovarian cancer survival

    DEFF Research Database (Denmark)

    Thomassen, Mads; Jochumsen, Kirsten M; Mogensen, Ole

    2009-01-01

    the relation of gene expression and chromosomal position to identify chromosomal regions of importance for early recurrence of ovarian cancer. By use of *Gene Set Enrichment Analysis*, we have ranked chromosomal regions according to their association to survival. Over-representation analysis including 1...... using death (P = 0.015) and recurrence (P = 0.002) as outcome. The combined mutation score is strongly associated to upregulation of several growth factor pathways....

  17. Multilevel ensemble Kalman filtering

    KAUST Repository

    Hoel, Haakon

    2016-01-08

    The ensemble Kalman filter (EnKF) is a sequential filtering method that uses an ensemble of particle paths to estimate the means and covariances required by the Kalman filter by the use of sample moments, i.e., the Monte Carlo method. EnKF is often both robust and efficient, but its performance may suffer in settings where the computational cost of accurate simulations of particles is high. The multilevel Monte Carlo method (MLMC) is an extension of classical Monte Carlo methods which by sampling stochastic realizations on a hierarchy of resolutions may reduce the computational cost of moment approximations by orders of magnitude. In this work we have combined the ideas of MLMC and EnKF to construct the multilevel ensemble Kalman filter (MLEnKF) for the setting of finite dimensional state and observation spaces. The main ideas of this method is to compute particle paths on a hierarchy of resolutions and to apply multilevel estimators on the ensemble hierarchy of particles to compute Kalman filter means and covariances. Theoretical results and a numerical study of the performance gains of MLEnKF over EnKF will be presented. Some ideas on the extension of MLEnKF to settings with infinite dimensional state spaces will also be presented.

  18. Multilevel ensemble Kalman filtering

    KAUST Repository

    Hoel, Haakon; Chernov, Alexey; Law, Kody; Nobile, Fabio; Tempone, Raul

    2016-01-01

    The ensemble Kalman filter (EnKF) is a sequential filtering method that uses an ensemble of particle paths to estimate the means and covariances required by the Kalman filter by the use of sample moments, i.e., the Monte Carlo method. EnKF is often both robust and efficient, but its performance may suffer in settings where the computational cost of accurate simulations of particles is high. The multilevel Monte Carlo method (MLMC) is an extension of classical Monte Carlo methods which by sampling stochastic realizations on a hierarchy of resolutions may reduce the computational cost of moment approximations by orders of magnitude. In this work we have combined the ideas of MLMC and EnKF to construct the multilevel ensemble Kalman filter (MLEnKF) for the setting of finite dimensional state and observation spaces. The main ideas of this method is to compute particle paths on a hierarchy of resolutions and to apply multilevel estimators on the ensemble hierarchy of particles to compute Kalman filter means and covariances. Theoretical results and a numerical study of the performance gains of MLEnKF over EnKF will be presented. Some ideas on the extension of MLEnKF to settings with infinite dimensional state spaces will also be presented.

  19. Survival analysis of a treatment data for cancer of the larynx

    International Nuclear Information System (INIS)

    Khan, K.

    2002-01-01

    In this paper a survival analysis of the survival time is done. The Cox regression model is fitted to the survival time with the assumption of proportional hazard. A model is selected after inclusion and exclusion of factors and variables as explanatory variables. The assumption of proportional hazards is tested in the manner suggested by Harrell (1986). The assumption of proportional hazards is supported by these tests. However the plot of Schoenfeld residuals against dose gave a little evidence of non validity of the proportional hazard assumption. The assumption seems to be satisfied for variable time. The martingale residuals suggest no pattern for variable age. The functional form of dose is not linear. Hence the quadratic dose is used as an explanatory variable. A comparison of logistic regression analysis and survival analysis is also made in this paper. It can be concluded that Cox proportional hazards model is a better model than the logistic model as it is more parsimonious and utilizes more information. (author)

  20. Effects of non-surgical factors on digital replantation survival rate: a meta-analysis.

    Science.gov (United States)

    Ma, Z; Guo, F; Qi, J; Xiang, W; Zhang, J

    2016-02-01

    This study aimed to evaluate the risk factors affecting survival rate of digital replantation by a meta-analysis. A computer retrieval of MEDLINE, OVID, EMBASE, and CNKI databases was conducted to identify citations for digital replantation with digit or finger or thumb or digital or fingertip and replantation as keywords. RevMan 5.2 software was used to calculate the pooled odds ratios. In total, there were 4678 amputated digits in 2641 patients. Gender and ischemia time had no significant influence on the survival rate of amputation replantation (P > 0.05). Age, injured hand, injury type, zone, and the method of preservation the amputated digit significantly influence the survival rate of digital replantation (P < 0.05). Children, right hand, crush, or avulsion and little finger are the risk factors that adversely affect the outcome. Level 5*. © The Author(s) 2015.

  1. Clinicopathological analysis of recurrence patterns and prognostic factors for survival after hepatectomy for colorectal liver metastasis

    Directory of Open Access Journals (Sweden)

    Okuda Junji

    2010-09-01

    Full Text Available Abstract Background Hepatectomy is recommended as the most effective therapy for liver metastasis from colorectal cancer (CRCLM. It is crucial to elucidate the prognostic clinicopathological factors. Methods Eighty-three patients undergoing initial hepatectomy for CRCLM were retrospectively analyzed with respect to characteristics of primary colorectal and metastatic hepatic tumors, operation details and prognosis. Results The overall 5-year survival rate after initial hepatectomy for CRCLM was 57.5%, and the median survival time was 25 months. Univariate analysis clarified that the significant prognostic factors for poor survival were depth of primary colorectal cancer (≥ serosal invasion, hepatic resection margin ( Conclusions Optimal surgical strategies in conjunction with effective chemotherapeutic regimens need to be established in patients with risk factors for recurrence and poor outcomes as listed above.

  2. "Does anger regulation mediate the discrimination-mental health link among Mexican-origin adolescents? A longitudinal mediation analysis using multilevel modeling": Correction to Park et al. (2016).

    Science.gov (United States)

    2017-02-01

    Reports an error in "Does Anger Regulation Mediate the Discrimination-Mental Health Link Among Mexican-Origin Adolescents? A Longitudinal Mediation Analysis Using Multilevel Modeling" by Irene J. K. Park, Lijuan Wang, David R. Williams and Margarita Alegría ( Developmental Psychology , Advanced Online Publication, Nov 28, 2016, np). In the article, there were several typographical errors in the Recruitment and Procedures section. The percentage of mothers who responded to survey items should have been 99.3%. Additionally, the youths surveyed at T2 and T3 should have been n=246 . Accordingly, the percentage of youths surveyed in T2 and T3 should have been 91.4% and the percentage of mothers surveyed at T2 and T3 should have been 90.7%. Finally, the youths missing at T2 should have been n= 23, and therefore the attrition rate for youth participants should have been 8.6. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2016-57671-001.) Although prior research has consistently documented the association between racial/ethnic discrimination and poor mental health outcomes, the mechanisms that underlie this link are still unclear. The present 3-wave longitudinal study tested the mediating role of anger regulation in the discrimination-mental health link among 269 Mexican-origin adolescents ( M age = 14.1 years, SD = 1.6; 57% girls), 12 to 17 years old. Three competing anger regulation variables were tested as potential mediators: outward anger expression, anger suppression, and anger control. Longitudinal mediation analyses were conducted using multilevel modeling that disaggregated within-person effects from between-person effects. Results indicated that outward anger expression was a significant mediator; anger suppression and anger control were not significant mediators. Within a given individual, greater racial/ethnic discrimination was associated with more frequent outward anger expression. In turn

  3. The influence of compositional and contextual factors on non-receipt of basic vaccines among children of 12-23-month old in India: a multilevel analysis.

    Science.gov (United States)

    Sissoko, Daouda; Trottier, Helen; Malvy, Denis; Johri, Mira

    2014-01-01

    Children unreached by vaccination are at higher risk of poor health outcomes and India accounts for nearly a quarter of unvaccinated children worldwide. The objective of this study was to investigate compositional and contextual determinants of non-receipt of childhood vaccines in India using multilevel modelling. We studied characteristics of unvaccinated children using the District Level Health and Facility Survey 3, a nationally representative probability sample containing 65 617 children aged 12-23 months from 34 Indian states and territories. We developed four-level Bayesian binomial regression models to examine the determinants of non-vaccination. The analysis considered two outcomes: completely unvaccinated (CUV) children who had not received any of the eight vaccine doses recommended by India's Universal Immunization Programme, and children who had not received any dose from routine immunisation services (no RI). The no RI category includes CUV children and those who received only polio doses administered via mass campaigns. Overall, 4.83% (95% CI: 4.62-5.06) of children were CUV while 12.01% (11.68-12.35) had received no RI. Individual compositional factors strongly associated with CUV were: non-receipt of tetanus immunisation for mothers during pregnancy (OR = 3.65 [95% CrI: 3.30-4.02]), poorest household wealth index (OR = 2.44 [1.81-3.22] no maternal schooling (OR = 2.43 [1.41-4.05]) and no paternal schooling (OR = 1.83 [1.30-2.48]). In rural settings, the influence of maternal illiteracy disappeared whereas the role of household wealth index was reinforced. Factors associated with no RI were similar to those for CUV, but effect sizes for individual compositional factors were generally larger. Low maternal education was the strongest risk factor associated with no RI in all models. All multilevel models found significant variability at community, district, and state levels net of compositional factors. Non-vaccination in India is

  4. The influence of compositional and contextual factors on non-receipt of basic vaccines among children of 12-23-month old in India: a multilevel analysis.

    Directory of Open Access Journals (Sweden)

    Daouda Sissoko

    Full Text Available Children unreached by vaccination are at higher risk of poor health outcomes and India accounts for nearly a quarter of unvaccinated children worldwide. The objective of this study was to investigate compositional and contextual determinants of non-receipt of childhood vaccines in India using multilevel modelling.We studied characteristics of unvaccinated children using the District Level Health and Facility Survey 3, a nationally representative probability sample containing 65 617 children aged 12-23 months from 34 Indian states and territories. We developed four-level Bayesian binomial regression models to examine the determinants of non-vaccination. The analysis considered two outcomes: completely unvaccinated (CUV children who had not received any of the eight vaccine doses recommended by India's Universal Immunization Programme, and children who had not received any dose from routine immunisation services (no RI. The no RI category includes CUV children and those who received only polio doses administered via mass campaigns. Overall, 4.83% (95% CI: 4.62-5.06 of children were CUV while 12.01% (11.68-12.35 had received no RI. Individual compositional factors strongly associated with CUV were: non-receipt of tetanus immunisation for mothers during pregnancy (OR = 3.65 [95% CrI: 3.30-4.02], poorest household wealth index (OR = 2.44 [1.81-3.22] no maternal schooling (OR = 2.43 [1.41-4.05] and no paternal schooling (OR = 1.83 [1.30-2.48]. In rural settings, the influence of maternal illiteracy disappeared whereas the role of household wealth index was reinforced. Factors associated with no RI were similar to those for CUV, but effect sizes for individual compositional factors were generally larger. Low maternal education was the strongest risk factor associated with no RI in all models. All multilevel models found significant variability at community, district, and state levels net of compositional factors.Non-vaccination in India

  5. Relationships between neighbourhood characteristics and current STI status among HIV-infected and HIV-uninfected women living in the Southern USA: a cross-sectional multilevel analysis.

    Science.gov (United States)

    Haley, Danielle F; Kramer, Michael R; Adimora, Adaora A; Haardörfer, Regine; Wingood, Gina M; Ludema, Christina; Rubtsova, Anna; Hickson, DeMarc A; Ross, Zev; Golub, Elizabeth; Bolivar, Hector; Cooper, Hannah Lf

    2017-12-01

    Neighbourhood characteristics (eg, high poverty rates) are associated with STIs among HIV-uninfected women in the USA. However, no multilevel analyses investigating the associations between neighbourhood exposures and STIs have explored these relationships among women living with HIV infection. The objectives of this study were to: (1) examine relationships between neighbourhood characteristics and current STI status and (2) investigate whether the magnitudes and directions of these relationships varied by HIV status in a predominantly HIV-infected cohort of women living in the Southern USA. This cross-sectional multilevel analysis tests relationships between census tract characteristics and current STI status using data from 737 women enrolled at the Women's Interagency HIV Study's southern sites (530 HIV-infected and 207 HIV-uninfected women). Administrative data (eg, US Census) described the census tract-level social disorder (eg, violent crime rate) and social disadvantage (eg, alcohol outlet density) where women lived. Participant-level data were gathered via survey. Testing positive for a current STI was defined as a laboratory-confirmed diagnosis of chlamydia, gonorrhoea, trichomoniasis or syphilis. Hierarchical generalised linear models were used to determine relationships between tract-level characteristics and current STI status, and to test whether these relationships varied by HIV status. Eleven per cent of participants tested positive for at least one current STI. Greater tract-level social disorder (OR=1.34, 95% CI 0.99 to 1.87) and social disadvantage (OR=1.34, 95% CI 0.96 to 1.86) were associated with having a current STI. There was no evidence of additive or multiplicative interaction between tract-level characteristics and HIV status. Findings suggest that neighbourhood characteristics may be associated with current STIs among women living in the South, and that relationships do not vary by HIV status. Future research should establish the

  6. Nonparametric Bayesian inference for mean residual life functions in survival analysis.

    Science.gov (United States)

    Poynor, Valerie; Kottas, Athanasios

    2018-01-19

    Modeling and inference for survival analysis problems typically revolves around different functions related to the survival distribution. Here, we focus on the mean residual life (MRL) function, which provides the expected remaining lifetime given that a subject has survived (i.e. is event-free) up to a particular time. This function is of direct interest in reliability, medical, and actuarial fields. In addition to its practical interpretation, the MRL function characterizes the survival distribution. We develop general Bayesian nonparametric inference for MRL functions built from a Dirichlet process mixture model for the associated survival distribution. The resulting model for the MRL function admits a representation as a mixture of the kernel MRL functions with time-dependent mixture weights. This model structure allows for a wide range of shapes for the MRL function. Particular emphasis is placed on the selection of the mixture kernel, taken to be a gamma distribution, to obtain desirable properties for the MRL function arising from the mixture model. The inference method is illustrated with a data set of two experimental groups and a data set involving right censoring. The supplementary material available at Biostatistics online provides further results on empirical performance of the model, using simulated data examples. © The Author 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Survival Prediction in Pancreatic Ductal Adenocarcinoma by Quantitative Computed Tomography Image Analysis.

    Science.gov (United States)

    Attiyeh, Marc A; Chakraborty, Jayasree; Doussot, Alexandre; Langdon-Embry, Liana; Mainarich, Shiana; Gönen, Mithat; Balachandran, Vinod P; D'Angelica, Michael I; DeMatteo, Ronald P; Jarnagin, William R; Kingham, T Peter; Allen, Peter J; Simpson, Amber L; Do, Richard K

    2018-04-01

    Pancreatic cancer is a highly lethal cancer with no established a priori markers of survival. Existing nomograms rely mainly on post-resection data and are of limited utility in directing surgical management. This study investigated the use of quantitative computed tomography (CT) features to preoperatively assess survival for pancreatic ductal adenocarcinoma (PDAC) patients. A prospectively maintained database identified consecutive chemotherapy-naive patients with CT angiography and resected PDAC between 2009 and 2012. Variation in CT enhancement patterns was extracted from the tumor region using texture analysis, a quantitative image analysis tool previously described in the literature. Two continuous survival models were constructed, with 70% of the data (training set) using Cox regression, first based only on preoperative serum cancer antigen (CA) 19-9 levels and image features (model A), and then on CA19-9, image features, and the Brennan score (composite pathology score; model B). The remaining 30% of the data (test set) were reserved for independent validation. A total of 161 patients were included in the analysis. Training and test sets contained 113 and 48 patients, respectively. Quantitative image features combined with CA19-9 achieved a c-index of 0.69 [integrated Brier score (IBS) 0.224] on the test data, while combining CA19-9, imaging, and the Brennan score achieved a c-index of 0.74 (IBS 0.200) on the test data. We present two continuous survival prediction models for resected PDAC patients. Quantitative analysis of CT texture features is associated with overall survival. Further work includes applying the model to an external dataset to increase the sample size for training and to determine its applicability.

  8. Marital status independently predicts testis cancer survival--an analysis of the SEER database.

    Science.gov (United States)

    Abern, Michael R; Dude, Annie M; Coogan, Christopher L

    2012-01-01

    Previous reports have shown that married men with malignancies have improved 10-year survival over unmarried men. We sought to investigate the effect of marital status on 10-year survival in a U.S. population-based cohort of men with testis cancer. We examined 30,789 cases of testis cancer reported to the Surveillance, Epidemiology, and End Results (SEER 17) database between 1973 and 2005. All staging were converted to the 1997 AJCC TNM system. Patients less than 18 years of age at time of diagnosis were excluded. A subgroup analysis of patients with stages I or II non-seminomatous germ cell tumors (NSGCT) was performed. Univariate analysis using t-tests and χ(2) tests compared characteristics of patients separated by marital status. Multivariate analysis was performed using a Cox proportional hazard model to generate Kaplan-Meier survival curves, with all-cause and cancer-specific mortality as the primary endpoints. 20,245 cases met the inclusion criteria. Married men were more likely to be older (38.9 vs. 31.4 years), Caucasian (94.4% vs. 92.1%), stage I (73.1% vs. 61.4%), and have seminoma as the tumor histology (57.3% vs. 43.4%). On multivariate analysis, married status (HR 0.58, P married status (HR 0.60, P married and unmarried men (44.8% vs. 43.4%, P = 0.33). Marital status is an independent predictor of improved overall and cancer-specific survival in men with testis cancer. In men with stages I or II NSGCT, RPLND is an additional predictor of improved overall survival. Marital status does not appear to influence whether men undergo RPLND. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Chinese insurance agents in "bad barrels": a multilevel analysis of the relationship between ethical leadership, ethical climate and business ethical sensitivity.

    Science.gov (United States)

    Zhang, Na; Zhang, Jian

    2016-01-01

    The moral hazards and poor public image of the insurance industry, arising from insurance agents' unethical behavior, affect both the normal operation of an insurance company and decrease applicants' confidence in the company. Contrarily, these scandals may demonstrate that the organizations were "bad barrels" in which insurance agents' unethical decisions were supported or encouraged by the organization's leadership or climate. The present study brings two organization-level factors (ethical leadership and ethical climate) together and explores the role of ethical climate on the relationship between the ethical leadership and business ethical sensitivity of Chinese insurance agents. Through the multilevel analysis of 502 insurance agents from 56 organizations, it is found that organizational ethical leadership is positively related to the organizational ethical climate; organizational ethical climate is positively related to business ethical sensitivity, and organizational ethical climate fully mediates the relationship between organizational ethical leadership and business ethical sensitivity. Organizational ethical climate plays a completely mediating role in the relationship between organizational ethical leadership and business ethical sensitivity. The integrated model of ethical leadership, ethical climate and business ethical sensitivity makes several contributions to ethics theory, research and management.

  10. Relationships between Religion and Two Forms of Homonegativity in Europe—A Multilevel Analysis of Effects of Believing, Belonging and Religious Practice

    Science.gov (United States)

    Doebler, Stefanie

    2015-01-01

    This paper examines relationships between religion and two forms of homonegativity across 43 European countries using a bivariate response binary logistic multilevel model. The model analyzes effects of religious believing, belonging and practice on two response variables: a) a moral rejection of homosexuality as a practice and b) intolerance toward homosexuals as a group. The findings indicate that both forms of homonegativity are prevalent in Europe. Traditional doctrinal religious believing (belief in a personal God) is positively related to a moral rejection of homosexuality but to a much lesser extent associated with intolerance toward homosexuals as a group. Members of religious denominations are more likely than non-members to reject homosexuality as morally wrong and to reject homosexuals as neighbors. The analysis found significant differences between denominations that are likely context-dependent. Attendance at religious services is positively related to homonegativity in a majority of countries. The findings vary considerably across countries: Religion is more strongly related to homonegativity in Western than in Eastern Europe. In the post-soviet countries homonegativity appears to be largely a secular phenomenon. National contexts of high religiosity, high perceived government corruption, high income inequality and shortcomings in the implementation of gay rights in the countries’ legislations are statistically related to higher levels of both moralistic homonegativity and intolerance toward homosexuals as a group. PMID:26247352

  11. Relationships between Religion and Two Forms of Homonegativity in Europe--A Multilevel Analysis of Effects of Believing, Belonging and Religious Practice.

    Science.gov (United States)

    Doebler, Stefanie

    2015-01-01

    This paper examines relationships between religion and two forms of homonegativity across 43 European countries using a bivariate response binary logistic multilevel model. The model analyzes effects of religious believing, belonging and practice on two response variables: a) a moral rejection of homosexuality as a practice and b) intolerance toward homosexuals as a group. The findings indicate that both forms of homonegativity are prevalent in Europe. Traditional doctrinal religious believing (belief in a personal God) is positively related to a moral rejection of homosexuality but to a much lesser extent associated with intolerance toward homosexuals as a group. Members of religious denominations are more likely than non-members to reject homosexuality as morally wrong and to reject homosexuals as neighbors. The analysis found significant differences between denominations that are likely context-dependent. Attendance at religious services is positively related to homonegativity in a majority of countries. The findings vary considerably across countries: Religion is more strongly related to homonegativity in Western than in Eastern Europe. In the post-soviet countries homonegativity appears to be largely a secular phenomenon. National contexts of high religiosity, high perceived government corruption, high income inequality and shortcomings in the implementation of gay rights in the countries' legislations are statistically related to higher levels of both moralistic homonegativity and intolerance toward homosexuals as a group.

  12. The Triple P-Positive Parenting Program: a systematic review and meta-analysis of a multi-level system of parenting support.

    Science.gov (United States)

    Sanders, Matthew R; Kirby, James N; Tellegen, Cassandra L; Day, Jamin J

    2014-06-01

    This systematic review and meta-analysis examined the effects of the multilevel Triple P-Positive Parenting Program system on a broad range of child, parent and family outcomes. Multiple search strategies identified 116 eligible studies conducted over a 33-year period, with 101 studies comprising 16,099 families analyzed quantitatively. Moderator analyses were conducted using structural equation modeling. Risk of bias within and across studies was assessed. Significant short-term effects were found for: children's social, emotional and behavioral outcomes (d=0.473); parenting practices (d=0.578); parenting satisfaction and efficacy (d=0.519); parental adjustment (d=0.340); parental relationship (d=0.225) and child observational data (d=0.501). Significant effects were found for all outcomes at long-term including parent observational data (d=0.249). Moderator analyses found that study approach, study power, Triple P level, and severity of initial child problems produced significant effects in multiple moderator models when controlling for other significant moderators. Several putative moderators did not have significant effects after controlling for other significant moderators. The positive results for each level of the Triple P system provide empirical support for a blending of universal and targeted parenting interventions to promote child, parent and family wellbeing. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Socio-economic development and emotion-health connection revisited: a multilevel modeling analysis using data from 162 counties in China.

    Science.gov (United States)

    Yu, Zonghuo; Wang, Fei

    2016-03-12

    Substantial research has shown that emotions play a critical role in physical health. However, most of these studies were conducted in industrialized countries, and it is still an open question whether the emotion-health connection is a "first-world problem". In the current study, we examined socio-economic development's influence on emotion-health connection by performing multilevel-modeling analysis in a dataset of 33,600 individuals from 162 counties in China. Results showed that both positive emotions and negative emotions predicted level of physical health and regional Gross Domestic Product Per Capita (GDPPC) had some impact on the association between emotion and health through accessibility of medical resources and educational status. But these impacts were suppressed, and the total effects of GDPPC on emotion-health connections were not significant. These results support the universality of emotion-health connection across levels of GDPPC and provide new insight into how socio-economic development might affect these connections.

  14. “Strength of Weak Ties,” Neighborhood Ethnic Heterogeneity, and Depressive Symptoms among Adults: A Multilevel Analysis of Korean General Social Survey (KGSS 2012

    Directory of Open Access Journals (Sweden)

    Harris Hyun-soo Kim

    2017-06-01

    Full Text Available A substantial body of research, based largely on North American and European contexts, demonstrates that social networks play a critical role in protecting and promoting mental, as well as physical, health. The purpose of this study is to examine how “weak” and “strong” network relations are differentially related to individual mental health (depressive symptoms based on a nationally representative sample of South Korean adults. Using multilevel analysis, the current research also investigates the extent to which contextual or neighborhood-level factors moderate the associations between depression and social network. Findings show that regular interaction with weaker ties (acquaintances, neighbors, coworkers, etc. are associated with better mental health. The number of strong ties (family members and friends, on the other hand, is not a significant predictor of psychological distress. In addition, a cross-level interaction term is observed: The negative relationship between weak ties and depressive symptoms is diminished in neighborhoods with more foreign-born residents or immigrants. General implications beyond the empirical case under investigation are discussed, as to why weak ties can be “strong” in relation to mental health and how this phenomenon can vary according to residential characteristics such as ethnic heterogeneity.

  15. Neighborhood social capital is associated with participation in health checks of a general population: a multilevel analysis of a population-based lifestyle intervention- the Inter99 study.

    Science.gov (United States)

    Bender, Anne Mette; Kawachi, Ichiro; Jørgensen, Torben; Pisinger, Charlotta

    2015-07-22

    Participation in population-based preventive health check has declined over the past decades. More research is needed to determine factors enhancing participation. The objective of this study was to examine the association between two measures of neighborhood level social capital on participation in the health check phase of a population-based lifestyle intervention. The study population comprised 12,568 residents of 73 Danish neighborhoods in the intervention group of a large population-based lifestyle intervention study - the Inter99. Two measures of social capital were applied; informal socializing and voting turnout. In a multilevel analysis only adjusting for age and sex, a higher level of neighborhood social capital was associated with higher probability of participating in the health check. Inclusion of both individual socioeconomic position and neighborhood deprivation in the model attenuated the coefficients for informal socializing, while voting turnout became non-significant. Higher level of neighborhood social capital was associated with higher probability of participating in the health check phase of a population-based lifestyle intervention. Most of the association between neighborhood social capital and participation in preventive health checks can be explained by differences in individual socioeconomic position and level of neighborhood deprivation. Nonetheless, there seems to be some residual association between social capital and health check participation, suggesting that activating social relations in the community may be an avenue for boosting participation rates in population-based health checks. ClinicalTrials.gov (registration no. NCT00289237 ).

  16. Relationships between Religion and Two Forms of Homonegativity in Europe--A Multilevel Analysis of Effects of Believing, Belonging and Religious Practice.

    Directory of Open Access Journals (Sweden)

    Stefanie Doebler

    Full Text Available This paper examines relationships between religion and two forms of homonegativity across 43 European countries using a bivariate response binary logistic multilevel model. The model analyzes effects of religious believing, belonging and practice on two response variables: a a moral rejection of homosexuality as a practice and b intolerance toward homosexuals as a group. The findings indicate that both forms of homonegativity are prevalent in Europe. Traditional doctrinal religious believing (belief in a personal God is positively related to a moral rejection of homosexuality but to a much lesser extent associated with intolerance toward homosexuals as a group. Members of religious denominations are more likely than non-members to reject homosexuality as morally wrong and to reject homosexuals as neighbors. The analysis found significant differences between denominations that are likely context-dependent. Attendance at religious services is positively related to homonegativity in a majority of countries. The findings vary considerably across countries: Religion is more strongly related to homonegativity in Western than in Eastern Europe. In the post-soviet countries homonegativity appears to be largely a secular phenomenon. National contexts of high religiosity, high perceived government corruption, high income inequality and shortcomings in the implementation of gay rights in the countries' legislations are statistically related to higher levels of both moralistic homonegativity and intolerance toward homosexuals as a group.

  17. Associations between state minimum wage policy and health care access: a multi-level analysis of the 2004 Behavioral Risk Factor survey.

    Science.gov (United States)

    McCarrier, Kelly P; Martin, Diane P; Ralston, James D; Zimmerman, Frederick J

    2010-05-01

    Minimum wage policies have been advanced as mechanisms to improve the economic conditions of the working poor. Both positive and negative effects of such policies on health care access have been hypothesized, but associations have yet to be thoroughly tested. To examine whether the presence of minimum wage policies in excess of the federal standard of $5.15 per hour was associated with health care access indicators among low-skilled adults of working age, a cross-sectional analysis of 2004 Behavioral Risk Factor Surveillance System data was conducted. Self-reported health insurance status and experience with cost-related barriers to needed medical care were adjusted in multi-level logistic regression models to control for potential confounding at the state, county, and individual levels. State-level wage policy was not found to be associated with insurance status or unmet medical need in the models, providing early evidence that increased minimum wage rates may neither strengthen nor weaken access to care as previously predicted.

  18. Survival analysis of patients with uveal melanoma after organ preserving and liquidation treatment

    Directory of Open Access Journals (Sweden)

    E. E. Grishina

    2018-01-01

    Full Text Available Rationale: Uveal melanoma is the most common primary malignancy of the eye.Aim: To evaluate survival in patients with uveal melanoma stratified according to the type of treatment and to identify factors significantly associated with their survival.Materials and methods: The study was performed on the data extracted from medical files and follow-up forms of patients with uveal melanoma seen in the Ophthalmological Clinical Hospital of the Department of Healthcare, Moscow, from 1977 to 2012. Analysis of survival was used to assess the life longevity of patients with uveal melanoma. The analysis was censored at January 2013, when vital status (dead or alive of all patients was assessed. The factors included into the study analysis, were those taken from the follow-up forms. The incidence of uveal melanoma in Moscow (2012 was 0.9 per 100,000 of the population, whereas its prevalence was 11.1 per 100,000.Results: 698 patients with uveal melanoma were included into the study, among them 260 (37% men (aged from 19 to 87 years, median age 60 years and 438 (63% women (aged from 18 to 93 years, median age 63 years; therefore, the proportion of women under the follow-up monitoring was by 26% higher than that of men. The liquidation treatment (mostly enucleation was performed in 358 (51% of the patients, whereas the organ preserving treatment in 340 (49%. At 5, 7, and 10 years of the follow-up, the disease-specific survival of patients with uveal melanoma after the organ preserving treatment (median survival has not been reached and after the liquidation treatment (median, 88 months were 89 ± 2, 83 ± 3, and 75 ± 4% versus 63 ± 3, 52 ± 4, and 47 ± 5%, respectively (р = 0.001. Overall survival and disease-specific survival of the patients after the liquidation treatment were significantly lower than in the patients after the organ-preserving treatment. According to multiple regression analysis, this was associated not with the type of

  19. Multilevel models for longitudinal data

    OpenAIRE

    Fiona Steele

    2008-01-01

    Repeated measures and repeated events data have a hierarchical structure which can be analysed by using multilevel models. A growth curve model is an example of a multilevel random-coefficients model, whereas a discrete time event history model for recurrent events can be fitted as a multilevel logistic regression model. The paper describes extensions to the basic growth curve model to handle auto-correlated residuals, multiple-indicator latent variables and correlated growth processes, and e...

  20. Survival analysis of dialysis patients in selected hospitals of lahore city

    International Nuclear Information System (INIS)

    Ahmad, Z.; Shahzad, I.

    2015-01-01

    There are several reasons which are directly or indirectly relate to affect the survival time of End Stage Renal Disease (ESRD) patients. This study was done to analyse the survival rate of ESRD patients in Lahore city, and to evaluate the influence of various risk factors and prognostic factors on survival of these patients. Methods: A sample of 40 patients was taken from the Jinnah Hospital Lahore and Lahore General Hospital by using the convenience sampling technique. The Log Rank Test was used to determine the significant difference between the categories of qualitative variables of ESRD patients. Multivariate Cox Regression Analysis was used to analyse the effect of different clinical and socio-economic variables on the survival time of these patients. Results: Different qualitative variables like: age, marital status, BMI, comorbid factors, diabetes type, gender, income level, place, risk factor like diabetes, ischemic heart disease, hypertension and Hepatitis status were analysed on the basis of Log Rank Test. While age and comorbid factors were found to be statistically significant which showed that the distribution of age and comorbid factors were different. By using the Cox Regression analysis the coefficient of Mass, serum albumin and family history of diabetes were found to be significant. Conclusions: There were some of the factors which had been taken for the analysis came out less or more significant in patients of ESRD. So it was concluded that mostly clinical factors which were Mass of the Patient, Serum Albumin and Family History of Diabetes made significant contribution towards the survival status of patients. (author)

  1. ATM and p53 combined analysis predicts survival in glioblastoma multiforme patients: A clinicopathologic study.

    Science.gov (United States)

    Romano, Francesco Jacopo; Guadagno, Elia; Solari, Domenico; Borrelli, Giorgio; Pignatiello, Sara; Cappabianca, Paolo; Del Basso De Caro, Marialaura

    2018-06-01

    Glioblastoma is one of the most malignant cancers, with a distinguishing dismal prognosis: surgery followed by chemo- and radiotherapy represents the current standard of care, and chemo- and radioresistance underlie disease recurrence and short overall survival of patients suffering from this malignancy. ATM is a kinase activated by autophosphorylation upon DNA doublestrand breaks arising from errors during replication, byproducts of metabolism, chemotherapy or ionizing radiations; TP53 is one of the most popular tumor suppressor, with a preeminent role in DNA damage response and repair. To study the effects of the immunohistochemical expression of p-ATM and p53 in glioblastoma patients, 21 cases were retrospectively examined. In normal brain tissue, p-ATM was expressed only in neurons; conversely, in tumors cells, the protein showed a variable cytoplasmic expression (score: +,++,+++), with being completely undetectable in three cases. Statistical analysis revealed that high p-ATM score (++/+++) strongly correlated to shorter survival (P = 0.022). No difference in overall survival was registered between p53 normally expressed (NE) and overexpressed (OE) glioblastoma patients (P = 0.669). Survival analysis performed on the results from combined assessment of the two proteins showed that patients with NE p53 /low pATM score had longer overall survival than the NE p53/ high pATM score counterpart. Cox-regression analysis confirmed this finding (HR = 0.025; CI 95% = 0.002-0.284; P = 0.003). Our study outlined the immunohistochemical expression of p-ATM/p53 in glioblastomas and provided data on their possible prognostic/predictive of response role. A "non-oncogene addiction" to ATM for NEp53 glioblastoma could be postulated, strengthening the rationale for development of ATM inhibiting drugs. © 2018 Wiley Periodicals, Inc.

  2. Social Capital and Suicidal Ideation in Community-Dwelling Older Residents: A Multilevel Analysis of 10,094 Subjects in Japan.

    Science.gov (United States)

    Noguchi, Masayuki; Kobayashi, Tomoko; Iwase, Toshihide; Suzuki, Etsuji; Kawachi, Ichiro; Takao, Soshi

    2017-01-01

    Social capital, the collective resources of groups including perceptions of trust and reciprocity, is recognized as an important contributor to suicide. We examined the association of individual- and community-level social capital with suicidal ideation after adjusting for social support among older adults living in the community. In August 2010 we sent questionnaires to all residents aged 65 years and older living in 3 rural municipalities (N = 21,232) in Okayama Prefecture, Japan; 13,919 questionnaires were returned (response rate: 65.6%). The final analysis included 10,094 participants. The outcome variable was suicidal ideation. Exposure variables were individual-level mistrust and lack of reciprocity (level 1), and the aggregated responses of these variables from 35 communities in the municipalities (level 2). Covariates included age, sex, educational attainment, marital status, the number of cohabitants, years of residence, self-rated socioeconomic status, disability, social support, and psychological distress. Multilevel logistic regression analysis was performed to obtain odds ratios (ORs) and 95% confidence intervals (CIs). After adjusting for social support and psychological distress, we found that mistrust and lack of reciprocity were only associated with suicidal ideation at the individual level. Stratified analysis showed that among subjects with psychological distress, mistrust was associated with suicidal ideation at individual (OR: 1.88; 95% CI: 1.42-2.51) and community levels (OR: 1.98; 95% CI: 1.02-3.81). Our findings show that individual- and community-level social capital is a possible protective factor for suicidal ideation, particularly for people with psychological distress. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.