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Multivariate Linear Regression Models (multivariate + linear_regression_models)
Selected AbstractsNursing care quality and adverse events in US hospitalsJOURNAL OF CLINICAL NURSING, Issue 15-16 2010Robert J Lucero Aim., To examine the association between nurses' reports of unmet nursing care needs and their reports of patients' receipt of the wrong medication or dose, nosocomial infections and patient falls with injury in hospitals. Background., Because nursing activities are often difficult to measure, and data are typically not collected by health care organisations, there are few studies that have addressed the association between nursing activities and patient outcomes. Design., Secondary analysis of cross-sectional data collected in 1999 from 10,184 staff nurses and 168 acute care hospitals in the US. Methods., Multivariate linear regression models estimated the effect of unmet nursing care needs on adverse events given the influence of patient factors and the care environment. Results., The proportion of necessary nursing care left undone ranged from 26% for preparing patients and families for discharge to as high as 74% for developing or updating nursing care plans. A majority of nurses reported that patients received the wrong medication or dose, acquired nosocomial infections, or had a fall with injury infrequently. However, nurses who reported that these adverse events occurred frequently varied considerably [i.e. medication errors (15%), patient falls with injury (20%), nosocomial infection (31%)]. After adjusting for patient factors and the care environment, there remained a significant association between unmet nursing care needs and each adverse event. Conclusion., The findings suggest that attention to optimising patient care delivery could result in a reduction in the occurrence of adverse events in hospitals. Relevance to clinical practice., The occurrence of adverse events may be mitigated when nurses complete care activities that require them to spend time with their patients. Hospitals should engage staff nurses in the creation of policies that influence human resources management to enhance their awareness of the care environment and patient care delivery. [source] Cerebellar morphology in Tourette syndrome and obsessive-compulsive disorderANNALS OF NEUROLOGY, Issue 4 2010Russell H. Tobe MD Objective Neuroanatomical and functional imaging studies have identified the cerebellum as an integral component of motor and language control. Few studies, however, have investigated the role of the cerebellum in Tourette syndrome (TS), a condition defined by the presence of semi-involuntary movements and sounds. Methods Magnetic resonance imaging was conducted in 163 persons with TS and 147 control participants. Multivariate linear regression models were used to explore effects on cerebellar surface morphology and underlying volumes for the main diagnosis effects of TS as well as comorbid obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder. Additionally, the correlations of symptom severity with cerebellar morphology were also assessed. Results The TS group demonstrated reduced volumes of the cerebellar hemispheres bilaterally that derived primarily from reduced gray matter in crus I and lobules VI, VIIB, and VIIIA. These decreased regional volumes accompanied increasing tic symptom severity and motoric disinhibition as demonstrated by a finger tapping test. Males had reduced volumes of these same regions compared with females, irrespective of diagnosis. Comorbid OCD was associated with relative enlargement of these regions in proportion to the increasing severity of OCD symptoms. Interpretation The cerebellum is involved in the pathogenesis of TS and tic-related OCD. Baseline gender differences in cerebellar morphology may in part account for the more prevalent expression of TS in males. ANN NEUROL 2010;67:479,487 [source] Association between stature, ocular biometry and refraction in an adult population in rural Myanmar: the Meiktila eye studyCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 9 2007Hui Min Wu MD PhD Abstract Purpose:, To study the association between adult stature and ocular biometric parameters and refraction. Methods:, In a population-based cross-sectional ophthalmic survey of 2418 adults (,40 years old) living in the rural villages in central Myanmar, height and weight were measured using a standardized protocol, and body mass index was calculated. Non-cycloplegic refraction and corneal curvature were determined by an autorefractor. Ultrasound pachymetry was performed and ocular biometry, including axial length, anterior chamber depth, lens thickness and vitreous chamber length were measured using A-mode ocular ultrasonography. Results:, Height and weight were significantly correlated with age, gender and all the ocular biometric parameters, except lens thickness. After adjusting for age and gender, taller and heavier persons had eyes with longer axial length, deeper anterior and vitreous chambers, and flatter and thicker corneas than shorter persons. Height was not significantly correlated with refraction, and heavier persons tended to be less myopic (P < 0.001). Multivariate linear regression models revealed consistent results with the findings for association between height, weight and ocular biometry and refractive error. Conclusions:, Adult stature is independently associated with vitreous chamber length and corneal radius in this Burmese population. Heavier persons were slightly hyperopic. [source] Urological symptom clusters and health-related quality-of-life: results from the Boston Area Community Health SurveyBJU INTERNATIONAL, Issue 11 2009Susan A. Hall OBJECTIVE To determine whether urological symptom clusters, as identified in previous studies, were associated with health-related quality-of-life (HRQoL) and use of healthcare. SUBJECTS AND METHODS The Boston Area Community Health Survey is a population-based epidemiological study of 2301 male and 3201 female residents of Boston, MA, USA, aged 30,79 years. Baseline data collected from 2002 to 2005 were used in this analysis. Data on 14 urological symptoms were used for the cluster analysis, and five derived symptom clusters among men and four among women were used in multivariate linear regression models (adjusted for age group, race/ethnicity, and comorbidity) to determine their association with physical (PCS-12) and mental health component scores (MCS-12) calculated from the Medical Outcomes Study 12-item Short Form Survey. RESULTS For both men and women, being in the most symptomatic cluster was associated with decrements in the PCS-12 score (men, cluster 5, ,10.42; women, cluster 4, ,9.80; both P < 0.001) and the MCS-12 score (men, cluster 5, ,9.35; women, cluster 4, ,6.24; both P < 0.001) compared with the asymptomatic groups. Both men and women in these most symptomatic clusters appeared to have adequate access to healthcare. CONCLUSION For men and women, those with the most urological symptoms reported poorer HRQoL in two domains after adjusting for age and comorbidity, and despite adequate access to care. [source] The Impact of Input and Output Factors on Emergency Department ThroughputACADEMIC EMERGENCY MEDICINE, Issue 3 2007Phillip V. Asaro MD Objectives: To quantify the impact of input and output factors on emergency department (ED) process outcomes while controlling for patient-level variables. Methods: Using patient- and system-level data from multiple sources, multivariate linear regression models were constructed with length of stay (LOS), wait time, treatment time, and boarding time as dependent variables. The products of the 20th to 80th percentile ranges of the input and output factor variables and their regression coefficients demonstrate the actual impact (in minutes) of each of these factors on throughput outcomes. Results: An increase from the 20th to the 80th percentile in ED arrivals resulted in increases of 42 minutes in wait time, 49 minutes in LOS (admitted patients), and 24 minutes in ED boarding time (admitted patients). For admit percentage (20th to 80th percentile), the increases were 12 minutes in wait time, 15 minutes in LOS, and 1 minute in boarding time. For inpatient bed utilization as of 7 am (20th to 80th percentile), the increases were 4 minutes in wait time, 19 minutes in LOS, and 16 minutes in boarding time. For admitted patients boarded in the ED as of 7 am (20th to 80th percentile), the increases were 35 minutes in wait time, 94 minutes in LOS, and 75 minutes in boarding time. Conclusions: Achieving significant improvement in ED throughput is unlikely without determining the most important factors on process outcomes and taking measures to address variations in ED input and bottlenecks in the ED output stream. [source] | ||||||||||