Additional file 1. List of prescribed drug for each minor ailment with their prices and markup. T... more Additional file 1. List of prescribed drug for each minor ailment with their prices and markup. This table contains list of all prescribed drug for 14 minor ailment along with their price and mark-up fee in PPMA.
Additional file 1: Table S1. Keyword search strategy to identify peer-reviewed articles. This tab... more Additional file 1: Table S1. Keyword search strategy to identify peer-reviewed articles. This table provides a description of the search terms we used in our review.
☯ These authors contributed equally to this work. ‡ These authors were co-principal investigators... more ☯ These authors contributed equally to this work. ‡ These authors were co-principal investigators on this work.
This study examines the importance of income in determining the diet quality of Canadian adults m... more This study examines the importance of income in determining the diet quality of Canadian adults measured based on Nutrient Rich Food Index version 9.3. We used the latest available data on Canadians' consumption of foods and nutrients from the Canadian Community Health Survey-Nutrition 2015. The Canada’ Food Guide classification was used for categorizing food groups based on types of food and their healthiness. Unsupervised and supervised machine learning models were employed in order to examine the links between income and the choice of foods. We first employed cluster analysis to identify the dietary patterns among individuals included in the sample and then we examined whether the intakes of various food groups across the identified clusters vary by income levels. Further, we evaluated the association between diet quality and income using Lasso Regression to determine the most important predictors of diet quality among adults in Canada. The results of both cluster analysis and regularized regression model suggested that behavioral factors and cultural backgrounds are more important determinants of diet quality among adults in Canada.
OBJECTIVES The value of chickenpox vaccination is still debated in the literature and by jurisdic... more OBJECTIVES The value of chickenpox vaccination is still debated in the literature and by jurisdictions worldwide. This uncertainty is reflected in the inconsistent uptake of the vaccine, where some countries offer routine childhood immunization programs, others have targeted programs, and in many the vaccine is only privately available. Even across the countries that have universal funding for the vaccine, there is a diversity of schedules and dosing intervals. Using an agent-based model of chickenpox and shingles, we conducted an economic evaluation of chickenpox vaccination in Alberta, Canada. METHODS We compared the cost-effectiveness of 2 common chickenpox vaccination schedules, specifically a long dosing interval (first dose: 12 months; second dose: 4-6 years) and a short dosing interval (first dose: 12 months; second dose: 18 months). RESULTS The economic evaluation demonstrated a shorter dosing interval may be marginally preferred, although it consistently led to higher costs from both the societal and healthcare perspectives. We found that chickenpox vaccination would be cost-saving and highly cost-effective from the societal and healthcare perspective, assuming there was no impact on shingles. CONCLUSION Chickenpox vaccine was cost-effective when not considering shingles and remained so even if there was a minor increase in shingles following vaccination. However, if chickenpox vaccination did lead to a substantial increase in shingles, then chickenpox vaccination was not cost-effective from the healthcare perspective.
Objective The analysis in this paper represents the first step of a multi-phase effort to underst... more Objective The analysis in this paper represents the first step of a multi-phase effort to understand the disease burden, and to develop strategies for tackling the health problems of Islamic populations. In this starting phase of the analysis, an overview of the burden of disease for selected Islamic populations is presented. Criteria Used for Country Selection Countries included in the analysis comprise two categories: Muslim countries and countries which have a sizeable Muslim population. Muslim countries are defined as countries in which Muslims comprise 50 percent or more of the population. Countries which have a sizeable Muslim population 2 are countries which have 2 Million Muslims or more. Selected countries must be classified as Low or Middle Income countries 3. Measure of Burden of Disease Disease burden in the analysis is measured using DALYs (Disability Adjusted Life Years) DALYs for a disease or health condition are calculated as the sum of the years of life lost due to ...
MANUSCRIPT_REVISED The Social determinants of Health Facility Delivery Among Reproductive Aged Wo... more MANUSCRIPT_REVISED The Social determinants of Health Facility Delivery Among Reproductive Aged Women in Ghana May 15, 2019 Thank you very much for the very helpful and detailed feedback on our paper. We found the comments very constructive and helpful. We believe that the quality of our manuscript is considerably improved as a result of incorporating the changes recommended by the reviewers. The explanation of what we have changed in response to the reviewer’s concerns is given point by point in the following pages.
Aim: To estimate factors associated with having ever had a Sexually Transmitted Disease (STDs) in... more Aim: To estimate factors associated with having ever had a Sexually Transmitted Disease (STDs) in Canada and explore provincial variation. Methods: The 2009-2010 Canadian Community Health Survey (CCHS) was used to examine demographic and behavioral factors associated with having ever had an STD. Univariate and multivariate analyses were conducted. Also, probit models were employed to estimate the probability of having ever had an STD in Canada. Results: People living in the Territories had the highest probability of having ever been diagnosed with an STD (OR = 2.11, 95% CI (1.76, 2.52)) and residents from Maritime Provinces were least likely to have been diagnosed with an STD (OR = .64, 95 % CI (.55, .74)). Women were more likely to have ever had an STD with an odds ratio of 2.06 (95% CI (1.90, 2.24)). In our study, income, marriage, and education were found to be protective factors. Behavioral factors such as smoking and binge drinking had significant harmful effects on sexual heal...
This study is to examine the cost-effectiveness of deployment strategies of oral cholera vaccines... more This study is to examine the cost-effectiveness of deployment strategies of oral cholera vaccines (OCVs) in controlling cholera in Bangladesh. We developed a dynamic compartment model to simulate costs and health outcomes for 12 years for four OCVs deployment scenarios: (1) vaccination of children aged one and above with two doses of OCVs, (2) vaccination of population aged 5 and above with a single dose of OCVs, (3) vaccination of children aged 1-4 with two doses of OCVs; and (4) combined strategy of (2) and (3). We obtained all parameters from the literature and performed a cost-effectiveness analysis from both health systems and societal perspectives, in comparison with the base scenario of no vaccination.The incremental cost-effectiveness ratios (ICERs) for the four strategies from the societal perspective were $2,236, $2,250, $1,109, and $2,112 per DALY averted, respectively, with herd immunity being considered. Without herd immunity, the ICERs increased substantially for all four scenarios except for the scenario that vaccinates children aged 1-4 only. The major determinants of ICERs were the case fatality rate and the incidence of cholera, as well as the efficacy of OCVs. The projection period and frequency of administering OCVs would also affect the cost-effectiveness of OCVs. With the cut-off of 1.5 times gross domestic product per capita, the four OCVs deployment strategies are cost-effective. The combined strategy is more efficient than the strategy of vaccinating the population aged one and above with two doses of OCVs and could be considered in the resource-limited settings.
Background Inequalities in the use of postnatal care services (PNC) in Ghana have been linked to ... more Background Inequalities in the use of postnatal care services (PNC) in Ghana have been linked to poor maternal and neonatal health outcomes. This has ignited a genuine concern that PNC interventions with a focus on influencing solely individual-level risk factors do not achieve the desired results. This study aimed to examine the community-level effect on the utilization of postnatal care services. Specifically, the research explored clusters of non-utilization of PNC services as well as the effect of community-level factors on the utilization of PNC services, with the aim of informing equity-oriented policies and initiatives. Methods The 2014 Ghana Demographic and Health Survey GDHS dataset was used in this study. Two statistical methods were used to analyze the data; spatial scan statistics were used to identify hotspots of non-use of PNC services and second two-level mixed logistic regression modeling was used to determine community-level factors associated with PNC services usag...
BackgroundThe increased risk of complications among diabetes patients poses a serious threat to p... more BackgroundThe increased risk of complications among diabetes patients poses a serious threat to population health. Pharmacy-based interventions can decrease the burden of diabetes and its related complications. This study evaluates the cost-effectiveness of pharmacy-based interventions and offers insights on the practicality of their adoption by health practitioners.MethodsWe developed population-based micro-simulation model using 2,931 patients with diabetes in Canada. We used the risk equations on the UK Prospective Diabetes Study (UKPDS) to estimate the incidence and mortality of four of the most common diabetes-related complications (heart failure, stroke, amputation, and blindness). We extrapolated the potential effects of pharmacy interventions on reducing time-varying risk factors for diabetes complications. Cost was quantified as the annual cost of complications; and, the cost associated with pharmacy-based interventions. The final outcomes were the incremental costs per qua...
Introduction: The prostate-specific antigen (PSA) test is used in Canada to detect prostate cance... more Introduction: The prostate-specific antigen (PSA) test is used in Canada to detect prostate cancer (PCa) despite mixed recommendations. Complications arising from false-positives are common, posing as a cancer-screening concern. This work estimates some Canadian rates of PSA screening and identifies men at increased odds for PSA screening. Methods: The Canadian Community Health Survey (CCHS) from 2009/10 (Atlantic Canada; ATL), 2011/2012 (Ontario; ON), and 2013/2014 (Quebec; QC) were used. Lifetime and recent PSA screening with confidence intervals were constructed to estimate PSA screening in ATL, ON, and QC. Two logistic regression models (for men <50 and ≥50 years of age) were used to determine associations between factors and lifetime PSA screening. Results: PSA screening rates have increased in most age groups for ATL, ON, and QC since 2000/2001. Factors positively associated with lifetime PSA screening in men of all ages were: having a digital rectal exam, having a regular ...
OBJECTIVES The aim of this systematic review and meta-analysis was to evaluate the effects of pha... more OBJECTIVES The aim of this systematic review and meta-analysis was to evaluate the effects of pharmacy-based interventions on clinical outcomes associated with diabetes-related complications as well as on nonclinical outcomes in people with diabetes. METHODS We searched 4 main databases (MEDLINE, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials) for studies that considered clinical and nonclinical outcomes of pharmacy-based interventions among people with diabetes. Clinical outcomes included patients' mean reductions of glycated hemoglobin (A1C) levels and body mass indexes (BMIs). Nonclinical outcomes included patients' healthcare utilization and quality of life. A meta-analysis was conducted to estimate the pooled net mean difference in clinical outcomes between the pharmacy-intervention and the control groups. RESULTS Of the 44 studies included in the systematic review, 32 studies reported results from randomized controlled trials measuring reductions of A1C levels in 4,132 patients. Meta-analysis revealed that the standardized absolute mean difference in reduction of A1C levels from baseline to the time of the last follow up significantly favoured the pharmacy intervention versus the control group (0.96%; 95% CI 0.71 to 1.22; p<0.001). Of the studies, 13 reported BMI kg/m2 in 1,827 patients. The estimation of standardized absolute mean difference in reduction of BMI unit calculated through meta-analysis was 0.61 (95% CI 0.20 to 1.03; p=0.000) in favour of the pharmacy-intervention group. CONCLUSIONS Pharmacy-based interventions have significant positive effects on controlling 2 major risks factors associated with diabetes-related complications: A1C levels and BMI. However, there is a dearth of evidence about the effects of pharmacy-based intervention on nonclinical outcomes, including healthcare utilization and quality of life.
Background Inappropriate use of Caesarean Section (CS) delivery is partly to blame for Ghana’s hi... more Background Inappropriate use of Caesarean Section (CS) delivery is partly to blame for Ghana’s high maternal mortality rate. However, previous research offered mixed findings about factors associated with CS use. The goal of this study is to examine use of CS in Ghana and the socioeconomic factors associated with it. Methods Data from the nationally representative 2014 Ghana Demographic and Health Survey (GDHS) was used after permission from the Monitoring and Evaluation to Assess and Use Results (MEASURE) Demographic and Health Survey (DHS) program. Univariable and multivariable logistic regression models were fitted to examine the socioeconomic inequalities in CS use. The independent variables included maternal age, marital status, religion, ethnicity, education, place of residence, wealth quintile, and working status. Concentration index (CI) and rate-ratios were computed to ascertain the level of CS inequalities. Results Out of the 4294 women, 11.4% had CS delivery. However, the...
Abstract Objective This study aims to estimate the prevalence of diabetes-related complications, ... more Abstract Objective This study aims to estimate the prevalence of diabetes-related complications, and the factors associated with them in the Canadian patients with diabetes. Methods Data from the 2011 Survey on Living with Chronic Diseases in Canada – Diabetes Component (SLCDC-DM-2011) were used to calculate the weighted prevalence of 16 diabetes-related complications. A multivariable sex-stratified logistic regression model was used to examine the association between each diabetes-related complication and select determinants. Results Among Canadian patients who self-reported having diabetes, 80.26 percent reported having at least one type of diabetes-related complications. The most frequently reported complications were high blood pressure (54.65%), cataracts (29.52%) and poor circulation (21.68%).Male patients were more associated to have at least one complication if they had an inappropriate BMI (OR=2.94 CI: 1.39-6.23),and had a high level of HbA1c (OR=2.32 CI: 1.05-5.13,) were older (OR=6.92 CI: 1.82-24.74), had diabetes for a longer period of time (OR=3.42 CI: 1.71-6.85) Among female patients more duration of having diabetes is significant variable associated with complication ( OR=2.00 CI: 1.05-3.81) Conclusion This study suggests that socio-economic factors including marital status, income and education had significant associations with most types of complications. Our findings also confirmed that low levels of physical activity and high levels of HbA1c were important determinant for many diabetes–related complications.
Adolescents and young adults are the main perpetrators and victims of violence in almost all part... more Adolescents and young adults are the main perpetrators and victims of violence in almost all parts of the world. Theories of human behavior predict that the intention to behave violently is formed in part by the individual’s attitude toward violent behavior. The purpose of this study was thus to investigate factors which both promote and protect against violent youth attitudes in Toronto, Canada’s largest urban center. Multinomial logit models were fit separately for males and females in Grades 7 to 9 using cross-sectional data from the 2006 International Youth Survey. Odds ratios were estimated for the associations between levels of attitude toward violence and select factors in each of the biological, familial, peer-related, school and community domains. A graded effect of school attachment on violent attitude was observed for both sexes; male and female students who do not like school at all are 9.89 (3.15-31.0) and 6.49 (2.19-19.2) times as likely as those who like school a lot ...
Additional file 1. List of prescribed drug for each minor ailment with their prices and markup. T... more Additional file 1. List of prescribed drug for each minor ailment with their prices and markup. This table contains list of all prescribed drug for 14 minor ailment along with their price and mark-up fee in PPMA.
Additional file 1: Table S1. Keyword search strategy to identify peer-reviewed articles. This tab... more Additional file 1: Table S1. Keyword search strategy to identify peer-reviewed articles. This table provides a description of the search terms we used in our review.
☯ These authors contributed equally to this work. ‡ These authors were co-principal investigators... more ☯ These authors contributed equally to this work. ‡ These authors were co-principal investigators on this work.
This study examines the importance of income in determining the diet quality of Canadian adults m... more This study examines the importance of income in determining the diet quality of Canadian adults measured based on Nutrient Rich Food Index version 9.3. We used the latest available data on Canadians' consumption of foods and nutrients from the Canadian Community Health Survey-Nutrition 2015. The Canada’ Food Guide classification was used for categorizing food groups based on types of food and their healthiness. Unsupervised and supervised machine learning models were employed in order to examine the links between income and the choice of foods. We first employed cluster analysis to identify the dietary patterns among individuals included in the sample and then we examined whether the intakes of various food groups across the identified clusters vary by income levels. Further, we evaluated the association between diet quality and income using Lasso Regression to determine the most important predictors of diet quality among adults in Canada. The results of both cluster analysis and regularized regression model suggested that behavioral factors and cultural backgrounds are more important determinants of diet quality among adults in Canada.
OBJECTIVES The value of chickenpox vaccination is still debated in the literature and by jurisdic... more OBJECTIVES The value of chickenpox vaccination is still debated in the literature and by jurisdictions worldwide. This uncertainty is reflected in the inconsistent uptake of the vaccine, where some countries offer routine childhood immunization programs, others have targeted programs, and in many the vaccine is only privately available. Even across the countries that have universal funding for the vaccine, there is a diversity of schedules and dosing intervals. Using an agent-based model of chickenpox and shingles, we conducted an economic evaluation of chickenpox vaccination in Alberta, Canada. METHODS We compared the cost-effectiveness of 2 common chickenpox vaccination schedules, specifically a long dosing interval (first dose: 12 months; second dose: 4-6 years) and a short dosing interval (first dose: 12 months; second dose: 18 months). RESULTS The economic evaluation demonstrated a shorter dosing interval may be marginally preferred, although it consistently led to higher costs from both the societal and healthcare perspectives. We found that chickenpox vaccination would be cost-saving and highly cost-effective from the societal and healthcare perspective, assuming there was no impact on shingles. CONCLUSION Chickenpox vaccine was cost-effective when not considering shingles and remained so even if there was a minor increase in shingles following vaccination. However, if chickenpox vaccination did lead to a substantial increase in shingles, then chickenpox vaccination was not cost-effective from the healthcare perspective.
Objective The analysis in this paper represents the first step of a multi-phase effort to underst... more Objective The analysis in this paper represents the first step of a multi-phase effort to understand the disease burden, and to develop strategies for tackling the health problems of Islamic populations. In this starting phase of the analysis, an overview of the burden of disease for selected Islamic populations is presented. Criteria Used for Country Selection Countries included in the analysis comprise two categories: Muslim countries and countries which have a sizeable Muslim population. Muslim countries are defined as countries in which Muslims comprise 50 percent or more of the population. Countries which have a sizeable Muslim population 2 are countries which have 2 Million Muslims or more. Selected countries must be classified as Low or Middle Income countries 3. Measure of Burden of Disease Disease burden in the analysis is measured using DALYs (Disability Adjusted Life Years) DALYs for a disease or health condition are calculated as the sum of the years of life lost due to ...
MANUSCRIPT_REVISED The Social determinants of Health Facility Delivery Among Reproductive Aged Wo... more MANUSCRIPT_REVISED The Social determinants of Health Facility Delivery Among Reproductive Aged Women in Ghana May 15, 2019 Thank you very much for the very helpful and detailed feedback on our paper. We found the comments very constructive and helpful. We believe that the quality of our manuscript is considerably improved as a result of incorporating the changes recommended by the reviewers. The explanation of what we have changed in response to the reviewer’s concerns is given point by point in the following pages.
Aim: To estimate factors associated with having ever had a Sexually Transmitted Disease (STDs) in... more Aim: To estimate factors associated with having ever had a Sexually Transmitted Disease (STDs) in Canada and explore provincial variation. Methods: The 2009-2010 Canadian Community Health Survey (CCHS) was used to examine demographic and behavioral factors associated with having ever had an STD. Univariate and multivariate analyses were conducted. Also, probit models were employed to estimate the probability of having ever had an STD in Canada. Results: People living in the Territories had the highest probability of having ever been diagnosed with an STD (OR = 2.11, 95% CI (1.76, 2.52)) and residents from Maritime Provinces were least likely to have been diagnosed with an STD (OR = .64, 95 % CI (.55, .74)). Women were more likely to have ever had an STD with an odds ratio of 2.06 (95% CI (1.90, 2.24)). In our study, income, marriage, and education were found to be protective factors. Behavioral factors such as smoking and binge drinking had significant harmful effects on sexual heal...
This study is to examine the cost-effectiveness of deployment strategies of oral cholera vaccines... more This study is to examine the cost-effectiveness of deployment strategies of oral cholera vaccines (OCVs) in controlling cholera in Bangladesh. We developed a dynamic compartment model to simulate costs and health outcomes for 12 years for four OCVs deployment scenarios: (1) vaccination of children aged one and above with two doses of OCVs, (2) vaccination of population aged 5 and above with a single dose of OCVs, (3) vaccination of children aged 1-4 with two doses of OCVs; and (4) combined strategy of (2) and (3). We obtained all parameters from the literature and performed a cost-effectiveness analysis from both health systems and societal perspectives, in comparison with the base scenario of no vaccination.The incremental cost-effectiveness ratios (ICERs) for the four strategies from the societal perspective were $2,236, $2,250, $1,109, and $2,112 per DALY averted, respectively, with herd immunity being considered. Without herd immunity, the ICERs increased substantially for all four scenarios except for the scenario that vaccinates children aged 1-4 only. The major determinants of ICERs were the case fatality rate and the incidence of cholera, as well as the efficacy of OCVs. The projection period and frequency of administering OCVs would also affect the cost-effectiveness of OCVs. With the cut-off of 1.5 times gross domestic product per capita, the four OCVs deployment strategies are cost-effective. The combined strategy is more efficient than the strategy of vaccinating the population aged one and above with two doses of OCVs and could be considered in the resource-limited settings.
Background Inequalities in the use of postnatal care services (PNC) in Ghana have been linked to ... more Background Inequalities in the use of postnatal care services (PNC) in Ghana have been linked to poor maternal and neonatal health outcomes. This has ignited a genuine concern that PNC interventions with a focus on influencing solely individual-level risk factors do not achieve the desired results. This study aimed to examine the community-level effect on the utilization of postnatal care services. Specifically, the research explored clusters of non-utilization of PNC services as well as the effect of community-level factors on the utilization of PNC services, with the aim of informing equity-oriented policies and initiatives. Methods The 2014 Ghana Demographic and Health Survey GDHS dataset was used in this study. Two statistical methods were used to analyze the data; spatial scan statistics were used to identify hotspots of non-use of PNC services and second two-level mixed logistic regression modeling was used to determine community-level factors associated with PNC services usag...
BackgroundThe increased risk of complications among diabetes patients poses a serious threat to p... more BackgroundThe increased risk of complications among diabetes patients poses a serious threat to population health. Pharmacy-based interventions can decrease the burden of diabetes and its related complications. This study evaluates the cost-effectiveness of pharmacy-based interventions and offers insights on the practicality of their adoption by health practitioners.MethodsWe developed population-based micro-simulation model using 2,931 patients with diabetes in Canada. We used the risk equations on the UK Prospective Diabetes Study (UKPDS) to estimate the incidence and mortality of four of the most common diabetes-related complications (heart failure, stroke, amputation, and blindness). We extrapolated the potential effects of pharmacy interventions on reducing time-varying risk factors for diabetes complications. Cost was quantified as the annual cost of complications; and, the cost associated with pharmacy-based interventions. The final outcomes were the incremental costs per qua...
Introduction: The prostate-specific antigen (PSA) test is used in Canada to detect prostate cance... more Introduction: The prostate-specific antigen (PSA) test is used in Canada to detect prostate cancer (PCa) despite mixed recommendations. Complications arising from false-positives are common, posing as a cancer-screening concern. This work estimates some Canadian rates of PSA screening and identifies men at increased odds for PSA screening. Methods: The Canadian Community Health Survey (CCHS) from 2009/10 (Atlantic Canada; ATL), 2011/2012 (Ontario; ON), and 2013/2014 (Quebec; QC) were used. Lifetime and recent PSA screening with confidence intervals were constructed to estimate PSA screening in ATL, ON, and QC. Two logistic regression models (for men <50 and ≥50 years of age) were used to determine associations between factors and lifetime PSA screening. Results: PSA screening rates have increased in most age groups for ATL, ON, and QC since 2000/2001. Factors positively associated with lifetime PSA screening in men of all ages were: having a digital rectal exam, having a regular ...
OBJECTIVES The aim of this systematic review and meta-analysis was to evaluate the effects of pha... more OBJECTIVES The aim of this systematic review and meta-analysis was to evaluate the effects of pharmacy-based interventions on clinical outcomes associated with diabetes-related complications as well as on nonclinical outcomes in people with diabetes. METHODS We searched 4 main databases (MEDLINE, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials) for studies that considered clinical and nonclinical outcomes of pharmacy-based interventions among people with diabetes. Clinical outcomes included patients' mean reductions of glycated hemoglobin (A1C) levels and body mass indexes (BMIs). Nonclinical outcomes included patients' healthcare utilization and quality of life. A meta-analysis was conducted to estimate the pooled net mean difference in clinical outcomes between the pharmacy-intervention and the control groups. RESULTS Of the 44 studies included in the systematic review, 32 studies reported results from randomized controlled trials measuring reductions of A1C levels in 4,132 patients. Meta-analysis revealed that the standardized absolute mean difference in reduction of A1C levels from baseline to the time of the last follow up significantly favoured the pharmacy intervention versus the control group (0.96%; 95% CI 0.71 to 1.22; p<0.001). Of the studies, 13 reported BMI kg/m2 in 1,827 patients. The estimation of standardized absolute mean difference in reduction of BMI unit calculated through meta-analysis was 0.61 (95% CI 0.20 to 1.03; p=0.000) in favour of the pharmacy-intervention group. CONCLUSIONS Pharmacy-based interventions have significant positive effects on controlling 2 major risks factors associated with diabetes-related complications: A1C levels and BMI. However, there is a dearth of evidence about the effects of pharmacy-based intervention on nonclinical outcomes, including healthcare utilization and quality of life.
Background Inappropriate use of Caesarean Section (CS) delivery is partly to blame for Ghana’s hi... more Background Inappropriate use of Caesarean Section (CS) delivery is partly to blame for Ghana’s high maternal mortality rate. However, previous research offered mixed findings about factors associated with CS use. The goal of this study is to examine use of CS in Ghana and the socioeconomic factors associated with it. Methods Data from the nationally representative 2014 Ghana Demographic and Health Survey (GDHS) was used after permission from the Monitoring and Evaluation to Assess and Use Results (MEASURE) Demographic and Health Survey (DHS) program. Univariable and multivariable logistic regression models were fitted to examine the socioeconomic inequalities in CS use. The independent variables included maternal age, marital status, religion, ethnicity, education, place of residence, wealth quintile, and working status. Concentration index (CI) and rate-ratios were computed to ascertain the level of CS inequalities. Results Out of the 4294 women, 11.4% had CS delivery. However, the...
Abstract Objective This study aims to estimate the prevalence of diabetes-related complications, ... more Abstract Objective This study aims to estimate the prevalence of diabetes-related complications, and the factors associated with them in the Canadian patients with diabetes. Methods Data from the 2011 Survey on Living with Chronic Diseases in Canada – Diabetes Component (SLCDC-DM-2011) were used to calculate the weighted prevalence of 16 diabetes-related complications. A multivariable sex-stratified logistic regression model was used to examine the association between each diabetes-related complication and select determinants. Results Among Canadian patients who self-reported having diabetes, 80.26 percent reported having at least one type of diabetes-related complications. The most frequently reported complications were high blood pressure (54.65%), cataracts (29.52%) and poor circulation (21.68%).Male patients were more associated to have at least one complication if they had an inappropriate BMI (OR=2.94 CI: 1.39-6.23),and had a high level of HbA1c (OR=2.32 CI: 1.05-5.13,) were older (OR=6.92 CI: 1.82-24.74), had diabetes for a longer period of time (OR=3.42 CI: 1.71-6.85) Among female patients more duration of having diabetes is significant variable associated with complication ( OR=2.00 CI: 1.05-3.81) Conclusion This study suggests that socio-economic factors including marital status, income and education had significant associations with most types of complications. Our findings also confirmed that low levels of physical activity and high levels of HbA1c were important determinant for many diabetes–related complications.
Adolescents and young adults are the main perpetrators and victims of violence in almost all part... more Adolescents and young adults are the main perpetrators and victims of violence in almost all parts of the world. Theories of human behavior predict that the intention to behave violently is formed in part by the individual’s attitude toward violent behavior. The purpose of this study was thus to investigate factors which both promote and protect against violent youth attitudes in Toronto, Canada’s largest urban center. Multinomial logit models were fit separately for males and females in Grades 7 to 9 using cross-sectional data from the 2006 International Youth Survey. Odds ratios were estimated for the associations between levels of attitude toward violence and select factors in each of the biological, familial, peer-related, school and community domains. A graded effect of school attachment on violent attitude was observed for both sexes; male and female students who do not like school at all are 9.89 (3.15-31.0) and 6.49 (2.19-19.2) times as likely as those who like school a lot ...
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