Structural Equation Modeling to Detect Correlates of Childhood Vaccination: A Moderated Mediation Analysis

OBJECTIVES: This study used a health belief theory derived framework and structural equation model to examine moderators, mediators, and direct and indirect predictors of childhood vaccination. METHODS: A secondary analysis was conducted using data collected from a cross-sectional survey of a random sample of 1599 parents living in urban and rural areas of Mysore district, India. Applying two-stage probability proportionate-to-size sampling, adolescent girls attending 7th through 10th grades in 23 schools were selected to take home a questionnaire to be answered by their parents to primarily assess HPV vaccine intentions. Parents were also asked whether their children had received one dose of Bacillus Calmette-Guérin; three doses of Diphtheria, Pertussis, Tetanus; three doses of oral Polio vaccine; and one dose of Measles vaccine. In addition, parents were asked about their attitudes towards childhood vaccination. RESULTS: Out of the 1599 parents, 52.2% reported that their children had received all the routine vaccines (fully vaccinated); 42.7% reported their children had missed at least one routine vaccine, and 5.2% reported that their children had missed all routine vaccinations. Perceptions about the benefits/facilitators to childhood vaccination significantly predicted the full vaccination rate (standardized regression coefficient (β) = 0.29) directly and mediated the effect of parental education (β = 0.11) and employment (β = -0.06) on the rate of full vaccination. Parental education was significantly associated indirectly with higher rates of full vaccination (β = 0.11). Parental employment was significantly associated indirectly with decreasing rates of full vaccination (β = -0.05). Area of residence moderated the role of religion (β = 0.24) and the \u27number of children\u27 in a family (β = 0.33) on parental perceptions about barriers to childhood vaccination. The model to data fit was acceptable (Root Mean Square Error of Approximation = 0.02, 95% CI 0.018 to 0.023; Comparative Fit Index = 0.92; Tucker-Lewis Index = 0.91). CONCLUSIONS: Full vaccination rate was relatively low among children in Mysore, especially among parents who were unsure about the benefits of routine vaccination and those with low educational levels. Interventions increasing awareness of the benefits of childhood vaccination that target rural parents with lower levels of education may help increase the rate of full childhood vaccination in India

Hypertension among adults in Bangladesh: evidence from a national cross-sectional survey

Background Hypertension is an increasing problem in Southeast Asia, particularly in Bangladesh. Although some epidemiological studies on hypertension have been conducted in Bangladesh, the factors associated with hypertension in this nation remain unclear. We aimed to determine the factors associated with hypertension among the adults in Bangladesh. Methods We conducted a cross-sectional study using data from the nationally representative 2011 Bangladesh Demographic and Health Survey (BDHS). A total of 7,839 (3,964 women and 3,875 men) adults aged 35æyears and older who participated in the survey was included. Hypertension was defined by a systolic blood pressure???140æmmHg and/or, diastolic blood pressure???90æmmHg and/or, receipt of an anti-hypertensive medication at time of the survey. The degree of association between the risk factors and the outcome was assessed by the odd ratio (OR) obtained from the bivariate and multivariable logistic regression models. Results The overall prevalence of hypertension was 26.4æ%, and the prevalence was higher in women (32.4æ%) than men (20.3æ%). Study participants with the age group of 60?69 years had higher odds of having hypertension (AOR: 3.77, 95æ% CI: 3.01?4.72) than the age group 35?39 years. Moreover, individuals who had higher educational attainment (AOR: 1.63, 95æ% C.I: 1.25?2.14) and higher wealth status (AOR?=?1.91, 95æ% CI: 1.54?2.38) had higher odds of having hypertension than the individuals with no education and lower social status, respectively. The analysis also showed that high BMI (AOR: 2.19, 95æ% C.I: 1.87?2.57) and having diabetes (AOR: 1.54, 95æ% C.I: 1.31?1.83) were associated with the increasing risk of hypertension. Conclusions Our study shows that the risk of hypertension was significantly associated with older age, sex, education, place of residence, working status, wealth index, BMI, and diabetes. Moreover, hypertension is largely untreated, especially in rural settings. The health system needs to develop appropriate strategies including early diagnosis, awareness via mass media, and health education programs for changing lifestyles should be initiated for older age, wealthy, and/or higher educated individuals in Bangladesh. Moreover, area-specific longitudinal research is necessary to find out the underlying causes of regional variations

Exposures in the indoor environment and prevalence of allergic conditions in the United States of America

Our study examines the association of the presence of mildew, cockroaches, and pets in homes as well as household dust allergens with the prevalence and/or severity of allergic diseases. No study has concurrently assessed home environment exposures in relation to allergic conditions in the general US population. Data from 5409 participants from the 2005–2006 National Health and Nutrition Examination Survey (NHANES) living in their current homes for ≥one year were analyzed. Multivariate logistic regression analyses between home exposures and allergic diseases prevalence and severity were performed. In adjusted analyses, mildew was associated with higher current asthma, allergies, and allergic rhinitis prevalence; endotoxin, with higher current asthma prevalence; and dust Canis familiaris (Can f) 1, with higher allergic rhinitis prevalence. However, presence of cockroaches and dust Dermatophagoides farinae (Der f) 1 were associated, respectively, with lower current asthma and allergies prevalence. Presence of mildew, dust Der f1, Dermatophagoides pteronyssinus (Der p) 1, Felis domesticus (Fel d) 1, and endotoxin were all associated with asthma and/or wheeze severity. Non-atopic asthma was more frequent with mildew and/or musty smell dust and higher dust Fel d1 concentration, while atopic asthma was more prevalent with higher Can f1 and endotoxin concentrations in dust. This study confirms previous relationships and reports novel associations, generating hypotheses for future research

The role of stock markets on environmental degradation:A comparative study of developed and emerging market economies across the globe

It is well established in the literature that stock markets increase both economic activities and energy consumption across countries. Therefore, it is commonly believed that stock markets are expected to have a significant effect on CO2 emissions. However, it is not known whether these stock markets can contribute to more or less CO2 emissions. Hence, the goal of this study is to examine the impact of stock market indicators on CO2 emissions across a global panel of both developed and emerging market economies. The results establish that stock market indicators have a significant negative and positive impact on carbon emissions in developed and emerging market economies, respectively. Furthermore, the findings illustrate the presence of the Environmental Kuznets Curve (EKC) hypothesis, implying that stronger stock markets lead to a further decline in carbon emissions. Given these findings, the study argues that the role of stock markets in the abatement of CO2 emissions significantly varies across both developed and emerging market economies. Significant implications have to do with the fact that developed markets might have initiated effective policies on listed firms to minimize carbon emissions, while emerging markets are yet to achieve this.N/

Statistical Analysis and Modeling of PM\u3csub\u3e2.5\u3c/sub\u3e Speciation Metals and Their Mixtures

Exposure to fine particulate matter (PM2.5) in the ambient air is associated with various health effects. There is increasing evidence which implicates the central role played by specific chemical components such as heavy metals of PM2.5. Given the fact that humans are exposed to complex mixtures of environmental pollutants such as PM2.5, research efforts are intensifying to study the mixtures composition and the emission sources of ambient PM, and the exposure-related health effects. Factor analysis as well source apportionment models are statistical tools potentially useful for characterizing mixtures in PM2.5. However, classic factor analysis is designed to analyze samples of independent data. To handle (spatio-)temporally correlated PM2.5 data, a Bayesian approach is developed and using source apportionment, a latent factor is converted to a mixture by utilizing loadings to compute mixture coefficients. Additionally there have been intensified efforts in studying the metal composition and variation in ambient PM as well as its association with health outcomes. We use non parametric smoothing methods to study the spatio-temporal patterns and variation of common PM metals and their mixtures. Lastly the risk of low birth weight following exposure to metal mixtures during pregnancy is being investigated

Statistical Analysis and Modeling of PM\u3csub\u3e2.5\u3c/sub\u3e Speciation Metals and Their Mixtures

Exposure to fine particulate matter (PM2.5) in the ambient air is associated with various health effects. There is increasing evidence which implicates the central role played by specific chemical components such as heavy metals of PM2.5. Given the fact that humans are exposed to complex mixtures of environmental pollutants such as PM2.5, research efforts are intensifying to study the mixtures composition and the emission sources of ambient PM, and the exposure-related health effects. Factor analysis as well source apportionment models are statistical tools potentially useful for characterizing mixtures in PM2.5. However, classic factor analysis is designed to analyze samples of independent data. To handle (spatio-)temporally correlated PM2.5 data, a Bayesian approach is developed and using source apportionment, a latent factor is converted to a mixture by utilizing loadings to compute mixture coefficients. Additionally there have been intensified efforts in studying the metal composition and variation in ambient PM as well as its association with health outcomes. We use non parametric smoothing methods to study the spatio-temporal patterns and variation of common PM metals and their mixtures. Lastly the risk of low birth weight following exposure to metal mixtures during pregnancy is being investigated

Eigenvalue for Densely Defined Perturbations of Multivalued Maximal Monotone Operators in Reflexive Banach Spaces

Let be a real reflexive Banach space and let be its dual. Let be open and bounded such that . Let be maximal monotone with and . Using the topological degree theory developed by Kartsatos and Quarcoo we study the eigenvalue problem where the operator is a single-valued of class . The existence of continuous branches of eigenvectors of infinite length then could be easily extended to the case where the operator is multivalued and is investigated

The Leray-Schauder Approach for the Degree of Perturbed Maximal Monotone

In this work, we demonstrate that the Leray-Schauder topological degree theory can be used for the development of a topological degree theory for maximal monotone perturbations of demicontinuous operators of type (S+) in separable reflexive Banach spaces. This is an extension of Berkovits’ degree development for operators as the perturbations above. Berkovits has developed a topological degree for demicontinuous mappings of type (S+), and has shown that the degree mapping is unique under the assumption that it satisfies certain general properties. He proved that if f is a bounded demicontinous mapping of type (S+), G is an open bounded subset of X, and 0 ∈/ f(∂G), then there exists ε0 \u3e 0 such that for every ε ∈ (0, ε0) we have 0 ∈/ (I+ (1/ε)QQ∗ (f))(∂G). Here, Q is a compact linear injection from a Hilbert space H into X, such that Q(H) is dense in X, and Q∗ its adjoint. The map I+ 1 εQQ∗ (f) is a compact displacement of the identity, for which the Leray-Schauder degree is well defined. The Berkovits degree is obtained as the limit of this Leray-Schauder degree as ε tends to zero. We utilize a demicontinuous (S+)-approximation of the form Tt + f, where Tt is the Yosida approximant of T. Namely, we show that if G is an open bounded set in X and 0 ∈/ (T + f)(∂G), then there exist ε0 \u3e 0, t0 \u3e 0, such that for every ε ∈ (0, ε0), t ∈ (0, t0), we have 0 ∈/ (I + (1/ε)QQ∗ (Tt + f))(∂G). Our degree is the limit of the Leray-Schauder degree of the compact displacement of the identity I + (1/ε)QQ∗ (Tt + f) as ε, t → 0. Various extension of the degree has been considered. Finally some properties and applications in invariance of domain, eigenvalue and surjectivity results have also been discussed