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1.
J Psychol ; 155(2): 210-237, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33539273

RESUMO

The objective of this study is twofold: first, to analyze whether the daily level of energy in terms of vigor at work could explain the way in which workers psychologically detach from their work, relax, practice challenging activities, and have the feeling of having control over their leisure time when arriving home. Second, to check if the daily emotional job demands could hinder that relationship, reversing the positive effect of vigor in recovery. For this purpose, a multilevel study with a diary methodology was designed. In total, 94 nurses from various hospital and primary care centers in Madrid and Basque Country (Spain) participated in this study. They completed daily questionnaires twice a day (in the afternoon after work and at night before going to bed) for five consecutive workdays from Monday to Friday (N = 94*5 = 470). The results revealed that on days that vigor at work was high, nurses experienced more psychological detachment, relaxation, feelings of mastery, and time control at home. Moreover, on days that emotional job demands were high, vigor was more negatively related to psychological detachment and time control at home. Additionally, vigor was more positively related to all recovery experiences at home in days that emotional demands were low. Therefore, daily vigor can act as an energy resource that helps the worker to recover. However, this effect can occur in situations in which stressors are not present in high intensity. These results have clear practical implications for both health organizations and workers.


Assuntos
Emoções , Recursos Humanos de Enfermagem , Estresse Ocupacional , Humanos , Análise Multinível , Recursos Humanos de Enfermagem/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Estresse Ocupacional/psicologia , Enfermagem de Atenção Primária/psicologia , Espanha , Inquéritos e Questionários , Equilíbrio Trabalho-Vida
2.
Artigo em Inglês | MEDLINE | ID: mdl-33477290

RESUMO

Background: In low-income countries such as Benin, most people have poor access to healthcare services. There is scarcity of evidence about barriers to accessing healthcare services in Benin. Therefore, we examined the magnitude of the problem of access to healthcare services and its associated factors. Methods: We utilized data from the 2017-2018 Benin Demographic and Health Survey (n = 15,928). We examined the associations between the demographic and socioeconomic characteristics of women using multilevel logistic regression. The outcome variable for the study was problem of access to healthcare service. Adjusted odds ratios (AORs) with 95% confidence intervals (95% CI) were estimated. Results: Overall, 60.4% of surveyed women had problems in accessing healthcare services. Partner's education (AOR = 0.70; 95% CI; 0.55-0.89), economic status (AOR = 0.59; 95% CI; 0.47-0.73), marital status (AOR = 0.44; 95% CI; 0.39-0.51), and parity (AOR = 1.85; 95% CI; 1.45-2.35) were significant individual-level factors associated with problem of access to healthcare. Region (AOR = 5.24; 95% CI; 3.18-8.64) and community literacy level (AOR = 0.69; 95% CI; 0.51-0.94) were the main community-level risk factors. Conclusions: Enhancing husband education through adult education programs, economic empowerment of women, enhancing national education coverage, and providing priority for unmarried and multipara women need to be considered. Additionally, there is the need to ensure equity-based access to healthcare services across regions.


Assuntos
Assistência à Saúde/organização & administração , Acesso aos Serviços de Saúde , Serviços de Saúde Reprodutiva/organização & administração , Adulto , Atitude Frente a Saúde , Teorema de Bayes , Benin , Feminino , Pesquisas sobre Serviços de Saúde , Instalações de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Serviços de Saúde , Humanos , Análise Multinível , Gravidez , Fatores Socioeconômicos
3.
Artigo em Inglês | MEDLINE | ID: mdl-33401745

RESUMO

Creative employees are treasured assets for organizations. However, relatively little is known about what specific actions employees can take to manage their own creative process. Taking a motivational perspective, this study examined how job crafting behaviors positively link to employee creative performance through work engagement, and whether perceived work group status diversity moderates this relationship. We conducted a weekly diary study in which 55 employees from a Chinese energy company were asked to fill in diaries over four consecutive weeks (176 observations in total). Results of the multilevel analyses showed that weekly job crafting behaviors were positively related to weekly creative performance through increasing weekly work engagement. In contrast to our expectation, we found that weekly job crafting behaviors were more positively related to weekly creative performance when perceived work group status diversity was high. In summary, our study suggests that job crafting behaviors are effective actions employees can take to manage their creative processes through increasing work engagement. In addition, we stress that status diversity in existing work environments is an important contextual factor that shapes the job crafting process.


Assuntos
Criatividade , Satisfação no Emprego , Motivação , Engajamento no Trabalho , Local de Trabalho , China , Humanos , Análise Multinível
4.
Artigo em Inglês | MEDLINE | ID: mdl-33419076

RESUMO

By invoking self-determination theory, we proposed an integrated, multilevel model to investigate the impact of a high-performance work system (HPWS) on employees' job crafting through autonomous motivation, along with the moderation effect of initiative climate. Adopting a three-wave, time-lagged research design, we collected data from 615 employees of 54 Chinese companies. The results of multilevel path analysis revealed that (1) HPWS is positively related to employees' job crafting; (2) HPWS has a positive impact on employees' autonomous motivation; (3) employees' autonomous motivation positively affects their job crafting; (4) employees' autonomous motivation mediates the positive relationship between HPWS and employees' job crafting; (5) initiative climate moderates the relationship between employees' autonomous motivation and job crafting; and (6) the indirect relationship between HPWS and job crafting through autonomous motivation is also moderated by initiative climate. The findings of this study provided several implications for job crafting research and for human resource management in organizations.


Assuntos
Motivação , Negociação , Clima , Impulso (Psicologia) , Humanos , Análise Multinível
5.
J Med Internet Res ; 23(2): e23389, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33481759

RESUMO

BACKGROUND: Government responses to managing the COVID-19 pandemic may have impacted the way individuals were able to engage in physical activity. Digital platforms are a promising way to support physical activity levels and may have provided an alternative for people to maintain their activity while at home. OBJECTIVE: This study aimed to examine associations between the use of digital platforms and adherence to the physical activity guidelines among Australian adults and adolescents during the COVID-19 stay-at-home restrictions in April and May 2020. METHODS: A national online survey was distributed in May 2020. Participants included 1188 adults (mean age 37.4 years, SD 15.1; 980/1188, 82.5% female) and 963 adolescents (mean age 16.2 years, SD 1.2; 685/963, 71.1% female). Participants reported demographic characteristics, use of digital platforms for physical activity over the previous month, and adherence to moderate- to vigorous-intensity physical activity (MVPA) and muscle-strengthening exercise (MSE) guidelines. Multilevel logistic regression models examined differences in guideline adherence between those who used digital platforms (ie, users) to support their physical activity compared to those who did not (ie, nonusers). RESULTS: Digital platforms include streaming services for exercise (eg, YouTube, Instagram, and Facebook); subscriber fitness programs, via an app or online (eg, Centr and MyFitnessPal); facilitated online live or recorded classes, via platforms such as Zoom (eg, dance, sport training, and fitness class); sport- or activity-specific apps designed by sporting organizations for participants to keep up their skills (eg, TeamBuildr); active electronic games (eg, Xbox Kinect); and/or online or digital training or racing platforms (eg, Zwift, FullGaz, and Rouvy). Overall, 39.5% (469/1188) of adults and 26.5% (255/963) of adolescents reported using digital platforms for physical activity. Among adults, MVPA (odds ratio [OR] 2.0, 95% CI 1.5-2.7), MSE (OR 3.3, 95% CI 2.5-4.5), and combined (OR 2.7, 95% CI 2.0-3.8) guideline adherence were higher among digital platform users relative to nonusers. Adolescents' MVPA (OR 2.4, 95% CI 1.3-4.3), MSE (OR 3.1, 95% CI 2.1-4.4), and combined (OR 4.3, 95% CI 2.1-9.0) guideline adherence were also higher among users of digital platforms relative to nonusers. CONCLUSIONS: Digital platform users were more likely than nonusers to meet MVPA and MSE guidelines during the COVID-19 stay-at-home restrictions in April and May 2020. Digital platforms may play a critical role in helping to support physical activity engagement when access to facilities or opportunities for physical activity outside the home are restricted.


Assuntos
Exercício Físico , Fidelidade a Diretrizes , Treinamento de Resistência , Mídias Sociais , Jogos de Vídeo , Webcasts como Assunto , Adolescente , Adulto , Austrália , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis , Análise Multinível , Pandemias , Inquéritos e Questionários , Adulto Jovem
6.
Artigo em Inglês | MEDLINE | ID: mdl-33142745

RESUMO

The paper describes the study design, research questions and methods of a large, international intervention project aimed at improving employee mental health and well-being in SMEs and public organisations. The study is innovative in multiple ways. First, it goes beyond the current debate on whether individual- or organisational-level interventions are most effective in improving employee health and well-being and tests the cumulative effects of multilevel interventions, that is, interventions addressing individual, group, leader and organisational levels. Second, it tailors its interventions to address the aftermaths of the Covid-19 pandemic and develop suitable multilevel interventions for dealing with new ways of working. Third, it uses realist evaluation to explore and identify the working ingredients of and the conditions required for each level of intervention, and their outcomes. Finally, an economic evaluation will assess both the cost-effectiveness analysis and the affordability of the interventions from the employer perspective. The study integrates the training transfer and the organisational process evaluation literature to develop toolkits helping end-users to promote mental health and well-being in the workplace.


Assuntos
Pessoal Administrativo/psicologia , Infecções por Coronavirus/psicologia , Promoção da Saúde/métodos , Saúde Mental/estatística & dados numéricos , Serviços de Saúde do Trabalhador/organização & administração , Pandemias , Pneumonia Viral/psicologia , Local de Trabalho/estatística & dados numéricos , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Serviços de Saúde Mental , Análise Multinível , Pneumonia Viral/epidemiologia
7.
PLoS One ; 15(10): e0240163, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33007027

RESUMO

Evidence of risk assessment procedures is scarce and inconclusive. The aim of this study is to evaluate the effects of risk assessment on aggression and the use of coercive interventions in an acute psychiatric admission setting. In addition, we evaluated nurse behaviour before and after the use of risk assessment. To take the fluctuations with regard to aggression and coercive interventions into account, we allowed 26 weeks for baseline measurements, followed by a 26 weeks steady-state period after the implementation of the risk assessment instrument. Contrary to expectations, no positive effects of risk assessment were found on aggression or on coercive interventions. Time spent in seclusion increased significantly with more than 10 hours on average after implementation. Furthermore, there were only negative effects on nurse behaviour and experiences. Among other things, they felt more stressed, spent more time on administration tasks and spent less time with patients after the implementation. In conclusion, there is insufficient evidence to use structured short-term risk assessment to reduce aggression or coercive interventions.


Assuntos
Agressão , Atitude do Pessoal de Saúde , Enfermeiras e Enfermeiros , Unidade Hospitalar de Psiquiatria , Medição de Risco , Adulto , Feminino , Humanos , Masculino , Análise Multinível , Avaliação de Resultados em Cuidados de Saúde , Análise de Regressão
8.
Rev Bras Epidemiol ; 23: e200102, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027437

RESUMO

INTRODUCTION: The complexity of urbanization processes across Latin American societies encourages investigating its implications in health conditions, especially during childhood. One of the possible links between them is recreation, a component of the daily life of children and, therefore, essential to produce health and life itself. The objective of this study was to examine the associations between neighborhood context and active public park use among school-aged children in Cordoba, Argentina. METHODS: A cross-sectional study was conducted with 1466 children, aged 9 to 11, attending 19 schools and living in 110 neighborhoods. Multilevel models with Poisson distribution were used for the analyses, stratified by gender. Socio-demographic, behavioral, and physical covariates were included at the individual level, and socioeconomic neighborhood conditions at second level. RESULTS: Girls residing in neighborhoods with a worse socioeconomic context were less likely to report frequent public park use for physical activity, while those from neighborhoods with better socioeconomic conditions were more likely to, regardless of individual characteristics. CONCLUSION: This study suggests that socioeconomic conditions of neighborhoods are associated with public park use for physical activity in school-aged girls, demonstrating gender inequality in the use and appropriation of public spaces.


Assuntos
Exercício Físico , Parques Recreativos/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Argentina , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Análise Multinível , Fatores Socioeconômicos
9.
BMC Bioinformatics ; 21(1): 488, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126862

RESUMO

BACKGROUND: Microbiome/metagenomic data have specific characteristics, including varying total sequence reads, over-dispersion, and zero-inflation, which require tailored analytic tools. Many microbiome/metagenomic studies follow a longitudinal design to collect samples, which further complicates the analysis methods needed. A flexible and efficient R package is needed for analyzing processed multilevel or longitudinal microbiome/metagenomic data. RESULTS: NBZIMM is a freely available R package that provides functions for setting up and fitting negative binomial mixed models, zero-inflated negative binomial mixed models, and zero-inflated Gaussian mixed models. It also provides functions to summarize the results from fitted models, both numerically and graphically. The main functions are built on top of the commonly used R packages nlme and MASS, allowing us to incorporate the well-developed analytic procedures into the framework for analyzing over-dispersed and zero-inflated count or proportion data with multilevel structures (e.g., longitudinal studies). The statistical methods and their implementations in NBZIMM particularly address the data characteristics and the complex designs in microbiome/metagenomic studies. The package is freely available from the public GitHub repository https://github.com/nyiuab/NBZIMM . CONCLUSION: The NBZIMM package provides useful tools for complex microbiome/metagenomics data analysis.


Assuntos
Análise de Dados , Metagenômica , Microbiota/genética , Modelos Estatísticos , Algoritmos , Humanos , Metagenoma , Análise Multinível
10.
BMC Infect Dis ; 20(1): 751, 2020 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-33054788

RESUMO

BACKGROUND: HIV is a major public health issue, especially in developing countries. It is important to track and design successful intervention programs to explore the spatial pattern, distribution, and associated factors of HIV Seropositivity. This study therefore showed the spatial variation of HIV Seropositivity and related factors in Ethiopia. METHODS: A total sample of 25,774 individual data collected from the 2016 EDHS data were primarily HIV biomarkers, IR, MR, and GPS. Spatial heterogeneity analysis was used with methods such as Morans I, Interpolation, and Kulldorff 's scan statistic. Spatial analysis was conducted using open source tools (QGIS, GeoDa, SaTScan). Multilevel logistic regression analysis was performed using Stata14 to identify HIV-associated factors. Finally, the AOR with a 95% confidence interval was used to report the mixed-effect logistic regression result in the full model. RESULT: The prevalence of HIV / AIDS at national level was 0.93%. The highest prevalence regions were Gambela, Addis Abeba, Harari and Diredawa, accounting for 4.79, 3.36, 2.65 and 2.6%, respectively. Higher HIV seropositive spatial clusters have been established in the Gambela and Addis Ababa regions. Multilevel analysis at the individual level being married [AOR = 2.19 95% CI: (1.11-4.31)] and previously married [AOR = 6.45, 95% CI: (3.06-13.59)], female [AOR = 1.8, 95% CI: (1.19-2.72)], first-sex at age ≤15 [AOR = 4.39, 95% CI: (1.70-11.34)], 18-19 [AOR = 2.67 95% CI: (1.05-6.8)], middle age group (25-34) [AOR = 6.53, 95% CI: (3.67-11.75)], older age group (>34) [AOR = 2.67 95% CI: (1.05-6.8)], primary school [AOR = 3.03, 95% CI: (1.92-4.79)], secondary school [AOR = 3.37, 95% CI: (1.92-5.92) were significantly associated with serropositivity. Regarding household level, place of residence [urban: AOR = 6.13 CI: (3.12, 12.06)], female-headed households (AOR = 2.24 95% CI: (1.57-3.73), media exposure [low exposure (AOR = 0.53 95% CI: (0.33-0.86), no exposure AOR = 0.39 95% CI: (0.23-0.65)] and increased household size [AOR = 0.72 95% CI: (0.65-0.8)] were associated with HIV Seropositivity. CONCLUSION: High cluster HIV cases were found in Gambela, Addis Abeba, Harari, and Diredawa. Having a history of married, start sex at a younger age, female-headed household, urban residence, and lower household size is more affected by HIV/AIDS. So any concerned body work around this risk group and area can be effective in the reduction of transmission.


Assuntos
Soropositividade para HIV/epidemiologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multinível , Prevalência , Fatores de Risco , Análise Espacial , Adulto Jovem
11.
BMC Public Health ; 20(1): 1468, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993550

RESUMO

BACKGROUND: In Ethiopia, malaria is one of the public health problems, and it is still among the ten top leading causes of morbidity and mortality among under-five children. However, the studies conducted in the country have been inconclusive and inconsistent. Thus, this study aimed to assess factors associated with malaria among under-five children in Ethiopia. METHODS: We retrieved secondary data from the malaria indicator survey data collected from September 30 to December 10, 2015, in Ethiopia. A total of 8301 under-five-year-old children who had microscopy test results were included in the study. Bayesian multilevel logistic regression models were fitted and Markov chain Monte Carlo simulation was used to estimate the model parameters using Gibbs sampling. Adjusted Odd Ratio with 95% credible interval in the multivariable model was used to select variables that have a significant association with malaria. RESULTS: In this study, sleeping under the insecticide-treated bed nets during bed time (ITN) [AOR 0.58,95% CI, 0.31-0.97)], having 2 and more ITN for the household [AOR 0.43, (95% CI, 0.17-0.88)], have radio [AOR 0.41, (95% CI, 0.19-0.78)], have television [AOR 0.19, (95% CI, 0.01-0.89)] and altitude [AOR 0.05, (95% CI, 0.01-0.13)] were the predictors of malaria among under-five children. CONCLUSIONS: The study revealed that sleeping under ITN, having two and more ITN for the household, altitude, availability of radio, and television were the predictors of malaria among under-five children in Ethiopia. Thus, the government should strengthen the availability and utilization of ITN to halt under-five mortality due to malaria.


Assuntos
Saúde da Criança/estatística & dados numéricos , Mosquiteiros Tratados com Inseticida/estatística & dados numéricos , Malária/prevenção & controle , População Rural/estatística & dados numéricos , Teorema de Bayes , Criança , Pré-Escolar , Etiópia , Características da Família , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Análise Multinível , Estatísticas não Paramétricas , Inquéritos e Questionários
12.
BMC Public Health ; 20(1): 1444, 2020 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-32977789

RESUMO

BACKGROUND: Skilled birth attendant (SBA) delivery is vital for the health of mothers and newborns, as most maternal and newborn deaths occur at the time of childbirth or immediately after birth. This problem becomes worsen in Ethiopia in which only 28% of women give birth with the help of SBA. Therefore, this study aimed to explore the spatial variations of SBA delivery and its associated factors in Ethiopia. METHODS: A secondary analysis was carried out using the 2016 Ethiopian Demographic and Health Survey. A total weighted sample of 11,023 women who had a live birth in the 5 years preceding the survey was included in the analysis. Arc-GIS software was used to explore the spatial distribution of SBA and a Bernoulli model was fitted using SaTScan software to identify significant clusters of non-SBA delivery. The Geographic Weighted Regression (GWR) was employed in modeling spatial relationships. Moreover, a multilevel binary logistic regression model was fitted to identify factors associated with SBA delivery. RESULTS: In this study, SBA delivery had spatial variations across the country. The SaTScan spatial analysis identified the primary clusters' spatial window in southeastern Oromia and almost the entire Somalia. The GWR analysis identified different predictors of non- SBA delivery across regions of Ethiopia. In the multilevel analysis, mothers having primary and above educational status, health insurance coverage, and mothers from households with higher wealth status had higher odds of SBA delivery. Being multi and grand multiparous, perception of distance from the health facility as big problem, rural residence, women residing in communities with medium and higher poverty level, and women residing in communities with higher childcare burden had lower odds of SBA delivery. CONCLUSION: Skilled birth attendant delivery had spatial variations across the country. Areas with non-skilled birth attendant delivery and mothers who had no formal education, not health insured, mothers from poor households and communities, Primiparous women, mothers from remote areas, and mothers from communities with higher childcare burden could get special attention in terms of allocation of resources including skilled human power, and improved access to health facilities.


Assuntos
Parto Obstétrico/estatística & dados numéricos , Adolescente , Adulto , Etiópia , Feminino , Humanos , Recém-Nascido , Pessoa de Meia-Idade , Análise Multinível , Gravidez , Fatores Socioeconômicos , Regressão Espacial , Adulto Jovem
13.
Health Psychol ; 39(11): 945-955, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32940526

RESUMO

The study investigated adult outpatient Health Psychology Services appointment attendance, cancellation, and missed appointments (A/C/M). The first objective was to determine which demographic and process factors predicted the probability of A/C/M. The second objective was to determine whether there remained residual significant differences in A/C/M between therapists (i.e., a "therapist effect"), after controlling for explanatory variables. We conducted a practice-based retrospective 2-year cohort study. Three-level multilevel models were constructed and tested to analyze the probability of A/C/M at (1) assessment appointments (N = 1,175) and (2) follow-up appointments (N = 5,441). After controlling for predictor variables, significant therapist effects were found for attendance (10.0% to 13.0%) and cancellation (4.4%) at follow-up appointments (but not assessments), indicating significantly different attendance rates at follow-up between therapists. Predictors of attendance at follow-up included patient age, pretherapy symptom severity scores (including risk and symptom scores), and completion of intake questionnaires. Early morning follow-up appointments were least likely to be canceled, followed by late afternoon and finally midday appointments. Treatment intensity predicted attendance, but among qualified therapists, qualification type and pay level were nonsignificant. No significant predictors of attendance at assessment were detected. Attendance at Health Psychology Services outpatient appointments varies significantly according to patient, therapist, and appointment factors. Key routinely collected variables are predictive of attendance at follow-up. Clinical implications include the potential to identify patients at risk of nonattendance and target engagement interventions to these patients. Research directions include closer examination of variability in follow-up attendance between therapists. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Agendamento de Consultas , Medicina do Comportamento/métodos , Análise Multinível/métodos , Cooperação do Paciente/estatística & dados numéricos , Estudos de Coortes , Feminino , Humanos , Masculino , Estudos Retrospectivos
14.
PLoS One ; 15(9): e0238957, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915880

RESUMO

BACKGROUND: Anemia in women of reproductive age is a major public health challenge for low- and middle-income countries with a long-term negative impact on the health of women, their children, and the economic growth of the society. Even though the world health organization targeted a 50% global reduction of anemia among women of reproductive age by 2025, with the current trend it is unlikely to achieve this goal. OBJECTIVE: This study aimed to assess the prevalence and associated factors of anemia among women of reproductive age in eastern Africa. METHODS: A secondary data analysis, using demographic and health survey (DHS) data of 10 eastern African countries, was conducted. For our study, a total weighted sample of 101524 women of reproductive age was used. We employed a multilevel mixed-effects generalized linear model (using Poisson regression with robust error variance). Both unadjusted and adjusted prevalence ratios with their 95% confidence interval were reported. RESULTS: The prevalence of anemia in eastern Africa was 34.85 (95%CI: 34.56-35.14) ranging from 19.23% in Rwanda to 53.98% in Mozambique. In the multivariable multilevel analysis, being older age, having primary and above education, being from households with second to highest wealth quantiles, being currently working, not perceiving distance as a big problem, use of modern contraceptive methods, and rural residence was associated with a lower prevalence of anemia. While, being married and divorced/separated/widowed, women from female-headed households, women from households with unimproved toilet facility and unimproved water source, ever had of a terminated pregnancy, having high parity, and being from large household size was associated with a higher prevalence of anemia. CONCLUSION: The prevalence of anemia in eastern Africa was relatively high. Both individual level and community level factors were associated with the prevalence of anemia in women of reproductive age. Therefore, giving special attention to those women who are at a higher prevalence of anemia such as younger women, those who are from households with low socioeconomic status, unimproved toilet facility, and source of drinking water, as well as pregnant women could decrease anemia in women of reproductive age.


Assuntos
Anemia/epidemiologia , Adolescente , Adulto , África Oriental/epidemiologia , Fatores Etários , Água Potável , Feminino , Humanos , Modelos Lineares , Estado Civil , Casamento , Pessoa de Meia-Idade , Análise Multinível , Paridade , Gravidez , Prevalência , Fatores de Risco , Classe Social , Toaletes , Mulheres Trabalhadoras , Adulto Jovem
15.
An. psicol ; 36(2): 348-360, mayo 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-192072

RESUMO

The purpose of this research was to empirically test the hypothesis that the organizational psychological safety climate and the perception of organizational politics predict the extent to which employees feel engaged in their work. Using hierarchical linear modeling and data collected from 1,244 employees in 64 organizations, organizational level psychological safety climate and employee-level perception of organizational politics predicted employee work engagement. There was also significant cross-level interaction, so that the negative effect of the perception of organizational politics was amplified in organizations with a positive psychological safety climate. In other words, organizational psychological safety benefits the work engagement of individuals more when they perceive the existence of low organizational politics. The results offer insight into the mechanisms by which the perceived organizational context may influence employees' work engagement and highlight the importance for the perceived organizational consistency in the promotion of work engagement within their organization. Human Resource professionals and managers should promote frequent meetings with the workers and apply other practices that can boost a safe climate for the employees


El propósito de esta investigación fue probar empíricamente la hipótesis de que el clima de seguridad psicológica de la organización y la percepción de las políticas de la organización predicen hasta qué punto los empleados se sienten comprometidos con su trabajo. El uso de modelos jerárquicos lineales y los datos recopilados de 1,244 empleados en 64 organizaciones mostraron que el clima de seguridad psicológica a nivel organizativo y la percepción de la política organizacional a nivel de los empleados predijo el compromiso con el trabajo de los empleados. También hubo una inesperada interacción significativa entre los niveles, de modo que el efecto negativo de la percepción de las políticas organizacionales se amplificó en organizaciones con un clima de seguridad psicológica positivo. En otras palabras, la seguridad psicológica organizacional beneficia más el compromiso de los individuos cuando ellos perciben la existencia de políticas organizacionales bajas. Los resultados ofrecen información sobre los mecanismos por los cuales el contexto organizativo percibido puede influir en el compromiso laboral de los empleados y resaltar la importancia de la coherencia organizativa percibida en la promoción del compromiso laboral dentro de su organización


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Percepção , Política Organizacional , Engajamento no Trabalho , Gestão da Segurança , Análise Multinível , Emprego/psicologia , Local de Trabalho/psicologia
16.
PLoS One ; 15(8): e0237640, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804942

RESUMO

The child mortality rate is an essential measurement of socioeconomic growth and the quality of life in Ethiopia which is one among the six countries that account for half of the global under-five deaths. Therefore, this study aimed to identify the potential risk factors for child mortality in Ethiopia. Data for the study was drawn from the Ethiopian Demographic and Health Survey data conducted in 2016. A two-part random effects regression model was employed to identify the associated predictors of child mortality. The study found that 53.3% of mothers did not face any child death, while 46.7% lost at least one. Vaccinated child (IRR = 0.735, 95%CI: 0.647, 0.834), were currently using contraceptive (IRR = 0.885, 95%CI: 0.814, 0.962), who had antenatal care visit four or more times visit (IRR = 0.841, 95%CI: 0.737,0.960), fathers whose level of education is secondary or above(IRR = 0.695, 95%CI: 0.594, 0.814), mothers who completed their primary school(IRR = 0.785, 95%CI: 0.713, 0.864), mothers who have birth interval greater than 36 months (IRR = 0.728, 95%CI: 0.676, 0.783), where the age of the mother at first birth is greater than 16 years(IRR = 0.711, 95%CI: 0.674, 0.750) associated with the small number of child death. While multiple births (IRR = 1.355, 95%CI: 1.249, 1.471, four and above birth order (IRR = 1.487, 95%CI: 1.373, 1.612) and had working father (IRR = 1.125, 95%CI: 1.049, 1.206) associated with a higher number of child death. The variance components for the random effects showed significant variation of child mortality between enumeration areas. Policies and programs aimed at addressing enumeration area variations in child mortality need to be formulated and their implementation must be strongly pursued. Efforts are also needed to extend educational programmers aimed at educating mothers on the benefits of the antenatal checkup before first birth, spacing their birth interval, having their child vaccinated, and selecting a safe place of delivery to reduce child mortality.


Assuntos
Mortalidade da Criança , Análise Multinível/métodos , Criança , Estudos Transversais , Etiópia/epidemiologia , Pai/estatística & dados numéricos , Feminino , Inquéritos Epidemiológicos , Humanos , Incidência , Masculino , Mães/estatística & dados numéricos , Análise de Regressão , Fatores de Risco , População Rural/estatística & dados numéricos , Vacinação/estatística & dados numéricos
17.
PLoS One ; 15(8): e0237602, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32845940

RESUMO

BACKGROUND: Short Birth Interval negatively affects the health of both mothers and children in developing nations, like, Ethiopia. However, studies conducted to date in Ethiopia upon short birth interval were inconclusive and they did not show the extent and determinants of short birth interval in developing (Afar, Somali, Gambella, and Benishangul-Gumuz) regions of the country. Thus, this study was intended to assess the short birth interval and its determinants in the four developing regions of the country. METHODS: Data were retrieved from the Demographic and Health Survey program official database website (http://dhsprogram.com). A sample of 2683 women of childbearing age group (15-49) who had at least two alive consecutive children in the four developing regions of Ethiopia was included in this study. A multilevel multivariable logistic regression model was fitted to identify the independent predictors of short birth interval and Akaike's Information Criterion (AIC) was used during the model selection procedure. RESULTS: In this study, the prevalence of short birth interval was 46% [95% CI; 43.7%, 47.9%]. The multilevel multivariable logistic regression model showed women living in rural area [AOR = 1.52, CI: 1.12, 2.05], women attended secondary education and above level [AOR = 0.27, CI: 0.05, 0.54], have no media exposure [AOR = 1.35, CI: 1.18, 1.56], female sex of the index child [AOR = 1.13, CI:1.07,1.20], breastfeeding duration [AOR = 0.79, CI: 0.77, 0.82], having six and more ideal number of children [AOR = 1.14, CI: 1.09, 1.20] and having preferred waiting time to birth two years and above [AOR = 0.86, CI: 0.78, 0.95] were the predictors of short birth interval. CONCLUSIONS: The prevalence of short birth intervals in the developing regions of Ethiopia is still high. Therefore, the government of Ethiopia should work on the access of family planning and education in rural parts of the developing regions where more than 90% of the population in these regions is pastoral.


Assuntos
Intervalo entre Nascimentos/estatística & dados numéricos , Reprodução , Fatores Socioeconômicos , Adolescente , Adulto , Estudos Transversais , Países em Desenvolvimento , Etiópia , Feminino , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Análise Multinível , Gravidez , Resultado da Gravidez , Prevalência , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-32823922

RESUMO

Objective: To evaluate the relationship between the ownership structure of hospitals and the possibility of their being positioned on the frontier of technical efficiency in the economic crisis period 2010-2012, adjusting for hospital variables and regional characteristics in the areas where the Spanish National Health System (SNHS) hospitals are located. Methods: 230 National Health System hospitals were studied over the two-year period 2010-2012 according to their ownership structure-public hospitals, private hospitals and public-private partnership (PPP)-data envelopment analysis orientated to inputs was used to measure the overall technical efficiency, pure efficiency and efficiency of scale. A generalised linear mixed model (GLMM) with binomial distribution and logit link function was used to analyse the hospital and regional variables associated with positioning on the frontier. Results: There are substantial differences between the average pure technical efficiency of public, private and PPP hospitals, as well as a greater number of PPP models being positioned on the efficiency frontier (91.67% in 2012). The odds of being positioned on the frontier are 41.7 times higher in PPP models than in public hospitals. The average annual household income per region is related to the greater odds of hospitals being positioned on the frontier of efficiency. Conclusions: During the most acute period of recession in the Spanish economy, PPP formulas favoured hospital efficiency, by increasing the odds of being positioned on the frontier of efficiency when compared to private and public hospitals. The position on the frontier of efficiency of a hospital is related to the wealth of its region.


Assuntos
Eficiência Organizacional , Hospitais Privados/organização & administração , Hospitais Públicos/organização & administração , Análise Multinível , Propriedade , Humanos , Parcerias Público-Privadas , Espanha
19.
PLoS One ; 15(8): e0237349, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32776957

RESUMO

BACKGROUND: Dimensions of social location such as socioeconomic position or sex/gender are often associated with low response rates in epidemiological studies. We applied an intersectionality-informed approach to analyze non-response among population strata defined by combinations of multiple dimensions of social location and subjective health in a health survey in Germany. METHODS: We used data from the cross-sectional sample of the German Health Interview and Examination Survey for Adults (DEGS1) conducted between 2008 and 2011. Information about non-responders was available from a mailed non-responder questionnaire. Intersectional strata were constructed by combining all categories of age, sex/gender, marital status, and level of education in scenario 1. Subjective health was additionally used to construct intersectional strata in scenario 2. We applied multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to calculate measures of discriminatory accuracy, proportions of non-responders among intersectional strata, as well as stratum-specific total interaction effects (intersectional effects). Markov chain Monte Carlo methods were used to estimate multilevel logistic regression models. RESULTS: Data was available for 6,534 individuals of whom 36% were non-responders. In scenario 2, we found weak discriminatory accuracy (variance partition coefficient = 3.6%) of intersectional strata, while predicted proportions of non-response ranged from 20.6% (95% credible interval (CI) 17.0%-24.9%) to 57.5% (95% CI 48.8%-66.5%) among intersectional strata. No evidence for intersectional effects was found. These results did not differ substantially between scenarios 1 and 2. CONCLUSIONS: MAIHDA revealed that proportions of non-response varied widely between intersectional strata. However, poor discriminatory accuracy of intersectional strata and no evidence for intersectional effects indicate that there is no justification to exclusively target specific intersectional strata in order to increase response, but that a combination of targeted and population-based measures might be appropriate to achieve more equal representation.


Assuntos
Inquéritos Epidemiológicos/estatística & dados numéricos , Recusa de Participação/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos Transversais , Escolaridade , Feminino , Alemanha , Nível de Saúde , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Análise Multinível , Fatores Sexuais , Adulto Jovem
20.
PLoS One ; 15(8): e0236352, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760153

RESUMO

INTRODUCTION: Despite the desire of adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) to use contraceptives, the majority of them have challenges with access to contraceptive services. This is more evident in high fertility countries in SSA. The purpose of this study was to examine the predictors of unmet need for contraception among AGYW in selected high fertility countries in SSA. MATERIALS AND METHODS: Data from current Demographic and Health Surveys (DHS) carried out between 2010 and 2018 in 10 countries in SSA were analysed. A sample size of 24,898 AGYW who were either married or cohabiting was used. Unmet need for contraception was the outcome variable in this study. The explanatory variables were age, marital status, occupation, educational level, frequency of reading newspaper/magazine, frequency of listening to radio, frequency of watching television and parity (individual level variables) and wealth quintile, sex of household head, place of residence and decision-maker in healthcare (household/community level variables). Descriptive and multilevel logistic regression analyses were carried out. The results of the multilevel logistic regression analyses were reported using adjusted odds ratios at 95% confidence interval. RESULTS: The prevalence of unmet need for contraception in all the countries considered in this study was 24.9%, with Angola, recording the highest prevalence of 42.6% while Niger had the lowest prevalence of 17.8%. In terms of the individual level predictors, the likelihood of unmet need for contraception was low among AGYW aged 20-24 [aOR = 0.82; 95% CI = 0.76-0.88], those with primary [aOR = 1.22; 95% CI = 1.13-1.31] and secondary/higher levels of formal education [aOR = 1.18; 95% CI = 1.08-1.28, p < 0.001], cohabiting AGYW [aOR = 1.52; 95% CI = 1.42-1.63] and AGYW with three or more births [aOR = 3.41; 95% CI = 3.02-3.85]. At the household/community level, the odds of unmet need for contraception was highest among poorer AGYW [aOR = 1.36; 95% CI = 1.21-1.53], AGYW in female-headed households [aOR = 1.22; 95% CI = 1.13-1.33], urban AGYW [aOR = 1.21; 95% CI = 1.11-1.32] and AGYW who took healthcare decisions alone [aOR = 1.10; 95% CI = 1.01-1.21]. CONCLUSION: This study has identified disparities in unmet need for contraception among AGYW in high fertility countries in SSA, with AGYW in Angola having the highest prevalence. Both individual and household/community level factors predicted unmet need for contraception among AGYW in this study. However, based on the ICC values, household/community level factors prevailed the individual level factors. Enhancing access to contraception among poorer AGYW, those in female-headed households, those in urban areas and those who take healthcare decisions alone by both governmental and non-governmental organisations in high fertility countries is recommended.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos , Anticoncepcionais/provisão & distribução , Dispositivos Anticoncepcionais/provisão & distribução , Serviços de Planejamento Familiar/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Adolescente , África ao Sul do Saara , Feminino , Inquéritos Epidemiológicos , Humanos , Estado Civil/estatística & dados numéricos , Análise Multinível/métodos , Fatores Socioeconômicos , Adulto Jovem
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