Quality of life of childbearing age women and its associated factors: an application of seemingly unrelated regression (SUR) models

Does foreign direct investment matter for environmental innovation in African economies?

This study investigates the role of foreign direct investment (FDI) in environmental innovation in Africa during 1990–2019. It utilizes the endogenous growth theory to specify an innovation production function, estimated using the seemingly unrelated regression (SURE) method. The study employs four indicators of environmental innovation and also controls for the influence of resource abundance. Key findings from the study show evidence that FDI inflow enhances environmental innovation practices by improving resource efficiency outcomes. In particular, FDI is found to reduce greenhouse gas emission intensity of output and carbon intensity of energy. Further, the effect of FDI on resource utilization and energy productivity is insignificant. Estimates confirm the learning and imitation, and demonstration effects of FDI on resource utilization, though the formal effect is detrimental. The labour market effect is revealed to promote resource efficiency, while resource abundance plays negligible role in environmental innovation in all models. Policy implications are derived.

Seemingly unrelated clusterwise linear regression for contaminated data

Clusterwise regression is an approach to regression analysis based on finite mixtures which is generally employed when sample observations come from a population composed of several unknown sub-populations. Whenever the response is continuous, Gaussian clusterwise linear regression models are usually employed. Such models have been recently robustified with respect to the possible presence of mild outliers in the sub-populations. However, in some fields of research, especially in the modelling of multivariate economic data or data from the social sciences, there may be prior information on the specific covariates to be considered in the linear term employed in the prediction of a certain response. As a consequence, covariates may not be the same for all responses. Thus, a novel class of multivariate Gaussian linear clusterwise regression models is proposed. This class provides an extension to mixture-based regression analysis for modelling multivariate and correlated responses in the presence of mild outliers that let the researcher free to use a different vector of covariates for each response. Details about the model identification and maximum likelihood estimation via an expectation-conditional maximisation algorithm are given. The performance of the new models is studied by simulation in comparison with other clusterwise linear regression models. A comparative evaluation of their effectiveness and usefulness is provided through the analysis of a real dataset.

The impact of elevated blood lead levels in children on maternal health-related quality of life

Kabwe is a mining town in Zambia that has been ranked among "the ten most polluted places in the world" with previous findings of serious lead (Pb) pollution. In this study, we aim to examine the impact of childhood Pb poisoning on the health-related quality of life (HRQoL) of mothers in Kabwe. The HRQoL was assessed using the Short-Form 36 survey for 404 mothers coming from residences in 40 randomly selected standard enumeration areas (SEAs). Blood lead levels (BLLs) of the household members including the mothers themselves were measured. We found a significant positive correlation between the BLLs of the mothers and their children (R = 0.6385, p < 0.0001), while the BLLs of preschool-aged and school-aged children were significantly higher than those of their mothers and fathers. Using the data sets containing the BLLs of the household members, the age of the mothers, the household income, and the household SEA, we performed stepwise multiple linear regression analyses. The results showed significant negative associations between the representative BLL of household children and the BLL of preschool-aged children with the vitality and mental health scores of their mothers. Additionally, the BLL of school-aged children was only significantly associated with the mental health score of their mothers. By contrast, there was a significant negative association between the BLLs of the mothers with the social role functioning score. This suggests that elevated BLLs in children have a negative impact on the mental health conditions of their mothers regardless of the mothers' BLL.

Gender differences in the longitudinal association between husbands' and wives' depressive symptoms among Korean older adults: the moderating effects of the spousal relationship

PURPOSE

The mutual effects of depressive symptoms between couples have long been reported; however, it remains unknown whether the spousal concordance in depressive symptoms differs depending on spousal relationships.

METHOD

Data on 291 married couples from the Korean Social Life, Health, and Aging Project (KSHAP) were examined. The KSHAP collected global network data from the target population living in one Korean village over eight years and across five waves. A seemingly unrelated regression (SUR) model in the panel data was employed to address correlations and heterogeneity.

RESULTS

If one spouse (husband or wife) had depressive symptoms, the other spouse tended to have depressive symptoms. However, the effect of marital relations on spousal concordance in depressive symptoms was different among husbands and wives. This study demonstrated both spousal support and spousal network aspects of spousal relationships. Depression concordance was stronger for couples with more negative marital relationship. A supportive marital relationship was associated with less concordance between spouses' depressive symptoms for wives but not for husbands. Spousal network overlap was associated with less depression concordance for husbands; however, for wives, spousal network overlap was directly associated with more depressive symptoms and did not mediate the association with depression concordance.

CONCLUSION

Our findings suggest that approaches to supporting older adults dealing with mental health disorders may involve support at both the individual and couple levels. Gender-specific strategies could also be devised to improve the mental well-being of the older population.

Stress, locus of control, hope and depression as determinants of quality of life of pregnant women: Croatian Islands' Birth Cohort Study (CRIBS)

The aims were to investigate determinants of the quality of life (QoL) of pregnant women. Total of 302 healthy women 18 to 28 weeks of gestation participated in prospective study. WHOQOL-bref, Multidimensional Health Locus of Control scales, Edinburgh Postnatal Depression Scale, and the perceived stress appraisals were administered. Various patterns of predictors for four domains of QoL were identified, for psychological (42% variance explained), social relationship (29%), environmental (29%) and physical health (25%). Depression and hope, together with the extent to which one's health is influenced by powerful other or chance should be targeted in health promotion strategies during pregnancy.

China's New Cooperative Medical Scheme's Impact on the Medical Expenses of Elderly Rural Migrants

Background: With rapid urbanization in China, the scale of elderly migrants from rural areas to urban cities has increased rapidly from 5.03 million in 2000 to 13.4 million people in 2015. Methods: Based on the unbalanced panel data obtained from the Chinese Longitudinal Healthy Longevity Survey, this study investigates the impact of changes to the New Cooperative Medical Scheme (NCMS) on the medical expenditure of Chinese elderly rural migrants by using seemingly unrelated regression models. Results: NCMS coverage for elderly rural migrants rose from 11.83% in 2005 to 87.33% in 2014. The effective reimbursement rate increased significantly from 4.53% in 2005 to 36.44% in 2014, and out-of-pocket/income fell by 50% between 2005 and 2014. The NCMS significantly increased the effective reimbursement rate by 12.4% and out-of-pocket medical expenditure/income by 7.5% during this decade but played an insignificant role in reducing out-of-pocket payments. Conclusions: Policy makers need to promote a two-pronged strategy, which involves controlling the excessive growth of urban medical expenses and continuing to reform NCMS reimbursements for medical treatment, so non-urban resident elderly rural migrants can fully enjoy the welfare benefits of migration and urbanization.

An investigation of the effects of infertility on Women's quality of life: a case-control study

BACKGROUND

Human instinctively desire to have offspring. Infertility can cause painful emotional experiences throughout the life mainly known as quality of life impairment. This study aimed to investigate the impact of infertility on a woman's quality of life.

METHODS

A number of 180 infertile and 540 fertile women participated in this matched case-control study. The cases were selected through a combination of multistage stratified and cluster sampling methods. For each infertile woman three fertile women were randomly selected. The data gathering instrument consisted of demographic variables and the WHOQOL-BREF questionnaire. Data collection was conducted through interview with participants. The multivariate marginal model and SPSS software 21 were used for data analyses with a significance level of 0.05.

RESULTS

The results of the multivariate modeling show infertility can potentially affect various aspects of women's quality of life such as physical health (p <  0.001), mental health (p <  0.001), social health (p <  0.001) and the total score of quality of life (p <  0.001) significantly.

CONCLUSION

An infertile woman practice a relatively lower scores in QOL sub-scales of mental, physical and environmental health; while they experience a higher social health score than a fertile woman.

Food consumption according to degree of processing and sociodemographic characteristics: Estudo Pró-Saúde, Brazil

OBJECTIVE

To investigate the food consumption according to the degree of processing and associations with sociodemographic characteristics.

METHODS

A cross-sectional study of the Estudo Pró-Saúde (Pro-Health Study), with 520 civil servants of university campuses, Rio de Janeiro, 2012-13. A food frequency questionnaire was used to classify food consumption: 1) in natura, minimally processed, food preparations based on these foods; 2) processed foods; 3) ultra-processed foods. The relative energy contribution of each group was determined, and a seemingly unrelated equations regression (SUR) regression model was used to estimate associations with sociodemographic characteristics.

RESULTS

The in natura food group (1) contributed with 59% of the energy consumption and was directly associated with age [45-49 years (β = 1.8 confidence interval of 95% - 95%CI -1.2; 4.8); 50-54 (β = 1.5 95%CI -1.5; 4.5); 55-59 (β = 2.9 95%CI -0.4; 6.3) and ≥ 60 (β = 4.6 95%CI 1.1; 8.2)], compared to age ≤ 44. In contrast, the group of ultra-processed foods contributed 27% and were inversely associated with age [45-49 (β = -1.7 95%CI -4.3; 0.9); 50-54 (β = -1.8 95%CI -4.3; 0.9); 55-59 (β = -4.9 95%CI -8.0; -2.0); ≥ 60 (β = -4.5 95%CI -7.6; -1.5)]. Gender, income and schooling were not associated with food consumption.

CONCLUSION

Younger adults had higher consumption of ultra-processed foods, indicating the need for interventions mainly in this age group. The absence of association with other sociodemographic characteristics may be due to the influence of contextual factors.

The effect of China's new cooperative medical scheme on health expenditures among the rural elderly

Background

The alarming progression of an increasingly aging population in China has attracted much attention within the country and abroad. In 2003, the Chinese central government launched the New Cooperative Medical Scheme (NCMS) to resolve problems of healthcare inequity in regions with inadequate infrastructure and relative poverty. The purpose of this study was to investigate the effect of NCMS on health expenditures by the Chinese rural elderly population.

Methods

The data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which was conducted in 2005, 2008, 2011 and 2014. Elderly people living in rural areas and 60 years old or above were screened for the investigation. The sample size was 7472 in 2005, 11,705 in 2008, 9239 in 2011, and 6059 in 2014. The OOP% and reimbursement ratio were the medical expenses paid by individuals accounting for their per capita annual income and the medical expenses paid by medical insurance accounting for their total medical expenses, respectively. By controlling for individuals’ sociodemographic characteristics, pensions, demands and utilization of health services, we estimated the effect of the NCMS on the OOP% and reimbursement ratio for the rural elderly using seemingly unrelated regression (SUR).

Results

The NCMS coverage ranged from 11.63% in 2005 to 80.34% in 2014. The medical expenses of the elderly also increased from an average of $204.77 in 2005 to $696.23 in 2014, which was more than three times as much as in 2005. From 2005 to 2014, the reimbursement ratio for medical expenses of rural elderly people with NCMS increased significantly from 30.6% in 2005 to 56.1% in 2014. The proportion of reimbursement ratio for rural seniors with NCMS increased by 6.4% across each survey cycle (every 3 years). However, the NCMS resulted in an insignificant decrease in OOP% by 1.4% across each survey cycle (every 3 years). Among other medical insurances, public insurance and private elder insurance had significant positive impacts on reimbursement ratio but did not influence OOP%.

Conclusions

NCMS remarkably increased the rural elderly’s reimbursement ratio but insignificantly decreased the rural elderly’s OOP%. In addition, the proportion of reimbursement ratio for NCMS participants increased by 6.4% every 3 years. Lower outpatient reimbursement, migration, limited reimbursement scope, an increasing demand for medical services and the rapid growth of medical expenses may be reasons for the gaps between the nominal reimbursement ratio and the actual reimbursement ratio and OOP%. Policymakers should further modify NCMS policies in rural China.

Quality of life and associated characteristics: application of WHOQOL-BREF in the context of Primary Health Care

This study aimed to identify the characteristics associated to quality of life (QOL) in users of four Basic Health Units (Unidades Básicas de Saúde, UBS) in Belo Horizonte, Minas Gerais. We conducted a cross-sectional study with 930 adult users enrolled in the selected UBS, using a questionnaire containing the WHOQOL-bref instrument and questions about sociodemographic characteristics, lifestyle and health conditions. Following descriptive analysis, we performed simple and multiple linear regression to evaluate the association between the exposure variables and the QOL domains. The highest mean values of QOL were observed in the social relationships domain. The lowest means were observed in the environment domain, with a statistically significant difference between some of the UBS. The worst perceptions of QOL were related to worse health, housing, education and income conditions, as well as problems in social relationships and psychological conditions. Actions are needed to improve QOL in Primary Health Care users through actions promoted by both health professionals and public managers.

Impact of long-term medical conditions on the outcomes of psychological therapy for depression and anxiety

BACKGROUND

Long-term conditions often coexist with depression and anxiety.

AIMS

To assess the effectiveness of stepped-care psychological therapies for patients with long-term conditions.

METHOD

Data from 28 498 patients were analysed using regression to model depression (Patient Health Questionnaire (PHQ-9)) and anxiety (Generalised Anxiety Disorder scale (GAD-7)) outcomes. Post-treatment symptoms and effect sizes (d) were estimated for individuals with and without long-term conditions, controlling for covariates. The likelihood of access and response to intensive psychological interventions was also examined.

RESULTS

Higher post-treatment symptoms were predicted for patients with musculoskeletal problems (d = 0.22-0.27), chronic obstructive pulmonary disease (d = 0.26-0.33), diabetes (d = 0.05-0.13) and psychotic disorders (d = 0.50-0.58). Most long-term conditions were associated with greater odds of accessing high-intensity therapies, yet individuals who accessed these continued to have higher average post-treatment symptoms.

CONCLUSIONS

Some long-term conditions are associated with greater intensity of care and poorer outcomes after therapy.

Associations between beliefs about and reactions toward people who stutter

PURPOSE

This study sought to assess whether beliefs about people who stutter (PWS) predict intended behavioral and affective reactions toward them in a large and varied sample of respondents while taking into account familiarity with PWS and the demographic variables of age, education, and gender.

METHODS

Analyses were based on 2206 residents of the United States of America. The seemingly unrelated regression (SUR) technique was used to test the relationship between beliefs about PWS and behavioral and affective reactions toward PWS. Variables such as familiarity with PWS and demographic data were also controlled in the statistical model.

RESULTS

Findings indicated that, when demographic variables and familiarity were taken into account, the accuracy of participants' beliefs about PWS significantly predicted their intended behavioral and affective reactions toward PWS. The participants' gender and familiarity with PWS were also associated with these reactions toward PWS.

CONCLUSION

The finding of an association between beliefs and intended reactions validates attempts to improve public treatment of PWS through improving the accuracy of beliefs about PWS. Additionally, because familiarity with PWS is a significant predictor of helpful and positive reactions toward PWS, interventions involving PWS educating others through direct interpersonal interactions may be one effective way to improve public reactions toward individuals who stutter.

The impact of depression and malnutrition on health-related quality of life among the elderly Iranians

INTRODUCTION

The present study aimed to assess the association between nutritional status and depressive symptoms among elderly Iranians and to explore their impact on their Health-Related Quality of Life (HRQoL).

METHODS

In this cross-sectional study, 447 elders aging from 55 to 85 years were randomly selected and completed the Iranian version of Geriatric Depression Scale-15 (GDS), Mini Nutritional Assessment (MNA), and the Iranian version of Short Form Health Survey (SF-36).

RESULTS

Out of the 447 elderly, 72.1% were female with the mean age of 65.99 ± 7.89 years. The prevalence of depression was 38.1%. In addition, the SF-36 sub-scores tended to be lower among the elders with depressive symptoms according to GDS. The Physical Functioning (PF), Bodily Pain (BP), Role Physical (RP), Role Emotional (RE), and Mental Health (MH) dimensions of the SF-36 were also statistically poorer in the elders with depression. The mean MNA score was 24.6 ± 2.7; 35.4% of the participants were malnourished or at risk of malnutrition and 64.6% were adequately nourished. The sub scores of SF-36 were significantly lower in the elders with impaired nutritional status.

CONCLUSIONS

Considering the importance of the association among psychological and nutritional problems and HRQoL in caring for and promoting the welfare of the elders, this study provided fundamental information and a basis for further evaluation of this issue in developing and undeveloped countries.

Maternal quality of life during the transition to motherhood

BACKGROUND

One of the elements of the broadening focus of health care beyond its traditional and restricted concept has been the increasing adoption quality of life approach to health care research and practice.

OBJECTIVES

To investigate the QOL of women in the third trimester of pregnancy and at 8 weeks postpartum and factors associated with the overall QOL.

MATERIALS AND METHODS

Three hundred and fifty seven pregnant women attending urban health centers in Shahroud city, located in Northeast of Iran, completed the World Health Organization Quality of Life questionnaire (WHOQOL)-BREF and General Health Questionnaire (GHQ28) in the third trimester of pregnancy and at 8 weeks postpartum. Also, breastfeeding difficulties were assessed at 4 weeks postpartum. Statistical analysis was performed using SPSS 18 for descriptive statistics, paired t-test, linear regression and multiple regression analysis.

RESULTS

There were significant differences between the ante-and postnatal periods in mean scores in the physical (P < 0.001) and social relationship (P = 0.033) aspects of QOL. Multiple regression analysis revealed that factor adversely affected the global score of the QOL in the antenatal period was antepartum psychological disorders. Factors that adversely affected the global score of QOL in the postnatal period were postpartum psychological disorders, breastfeeding difficulties, multiparity, higher pregnancy weight gain, and cesarean.

CONCLUSIONS

Results indicated that in this low risk group of women physical health and social relationship improved from pregnancy to postpartum. Interventions to promote psychological status during pregnancy and early postpartum should be designed.