OBJECTIVE: Identify the predictors of the use of antenatal care in Burundi.
METHODS: This were an analysis of secondary data from the 2016 - 2017 demographic and health surveys in Burundi. The survey population was women who gave birth in the last five (05) years prior to the survey and gave their informed consent. Our sample consisted of 7,372 women. The data were analyzed with Stata 15.1 software. In bivariate analysis, the Chi-2 test, and simple logistic regression allowed us to identify the candidate variables for modelling at the 20% threshold. Multilevel ordinal logistic regression identified individual and contextual predictors of prenatal care use.
RESULTS: The use of antenatal care by women who gave birth in Burundi was influenced by the area of residence (rural area : OR=1.25; 95% CI [1.05 - 1.49]), level of education (secondary level: OR=1.36; 95% CI [1.12 - 1.65]), parity (OR=0.77; 95% CI [0.68 - 0.87]), HIV transmission during pregnancy (OR=1.22; 95% CI [1.06 - 1.41]) and internet use frequency (OR=1.60; 95% CI [1.16 - 2.20]). The intraclass correlation coefficient was (Ii 3 = 0.0050083).
CONCLUSIONS: Consideration of these determinants in the development of strategies to improve antenatal care utilization is necessary.
OBJECTIVE: Identifier les facteurs prédictifs du recours aux soins prénatals au Burundi.
UNASSIGNED: Il s\'agissait d\'une analyse de données secondaires provenant des enquêtes de démographie et de santé 2016 – 2017 du Burundi. Notre échantillon était constitué de 7372 femmes. Les données ont été analysées avec le logiciel stata 15.1. La régression logistique ordinale multiniveau a permis d\'identifier les prédicteurs individuels et contextuels du recours aux soins prénatals.
UNASSIGNED: Le recours aux soins prénataux par les femmes ayant accouché au Burundi était influencé par le milieu de résidence (milieu rural : OR=1.25 ; IC 95% [1.05 – 1.49]), le niveau d\'éducation (niveau secondaire : OR=1.36 ; IC 95% [1.12 – 1.65]), la parité (OR=0.77 ; IC 95% [0.68 – 0.87]), la transmission du VIH pendant la grossesse (OR=1.22 ; IC 95% [1.06 – 1.41]) et la fréquence d\'utilisation de l\'internet (OR=1.60 ; IC 95% [1.16 – 2.20]). Le coefficient de corrélation intraclasse était (Ii 3 = 0.0050083).
CONCLUSIONS: La prise en compte de ces déterminants dans l\'élaboration des stratégies d\'amélioration de l\'utilisation des soins prénataux s\'avère nécessaire.

BACKGROUND: Cervical cancer (CC) patients receiving indwelling catheterization after radical hysterectomy (RH) are vulnerable to urinary tract infection (UTI). However, no model or method is available to predict the risk of UTIs. Therefore, our aim was to develop and verify a risk model to predict UTI for patients receiving indwelling catheterization after radical cervical cancer surgery (ICa-RCCS).
METHODS: We first collected clinical information of 380 patients receiving ICa-RCCS from January 2020 to December 2021 as a training cohort to develop the risk nomogram. UTI was then evaluated using 19 UTI predictor factors. The least absolute shrinkage and selection operator (LASSO) method was utilized for the extraction characteristics. Multivariable logistic regression analysis was then conducted to create the risk model for UTI prediction. The consistency coefficient and calibration curve were utilized to assess the model\'s fit accuracy. We performed bootstrapping with 1000 random samples for internal validation of the model, and decision curve analysis (DCA) for clinical application.
RESULTS: Predictors in the risk nomogram included indwelling catheterization duration, whether it is secondary indwelling catheterization, history of UTIs, age, and history of chemotherapy before surgery. The risk nomogram presented good discrimination and calibration (C-index: 0.810, 95% CI: 0.759-0.861). During interval validation, the model reached a high C-index up to 0.7930. DCA revealed the clinical utility of predictive model for UTI. Clinical benefit was initiated at the decision threshold≥3%.
CONCLUSIONS: We developed a novel UTI nomogram incorporating the age, history of chemotherapy before surgery, indwelling catheterization duration, whether it is secondary indwelling catheterization, and history of UTI to predict UTI risk for patients receiving ICa-RCCS.
METHODS: B: 3a.

OBJECTIVE: Our aim in this study was to identify predictors for diabetes among the characteristics of the glycemic curve and glycated hemoglobin (A1C) in healthy, young adults.
METHODS: We used a cross-sectional study to establish predictors for diabetes based on earlier studies and evaluated occurrence of the condition in 81 healthy, young adult subjects. These volunteers underwent analysis of fasting plasma glucose, oral glucose tolerance test plasma glucose, A1C, and inflammatory markers (leukocytes, monocytes, and C-reactive protein). The nonparametric Mann-Whitney U test, Fisher\'s exact test, chi-square test, Kruskal-Wallis test, and multiple-comparisons test were used to analyze the data.
RESULTS: We studied 2 age groups, homogeneous in terms of family history of diabetes: one group ranged in age from ≥18 to <28 years (median 20 years; body mass index [BMI] 24 kg/m2) and the other group ranged in age from ≥28 to <45 years (median 35 years; BMI 24 kg/m2). The older group had a higher incidence of predictors (p=0.0005) and was associated with the predictors 30-minute blood glucose ≥164 mg/dL (p=0.0190), 60-minute blood glucose ≥125 mg/dL (p=0.0346), and A1C ≥5.5% (p=0.0162), with a monophasic glycemic curve (p=0.007). The younger group was associated with the 2-hour plasma glucose predictor ≥140 mg/dL (p=0.014). All subjects had fasting glucose in the normal range.
CONCLUSIONS: Healthy, young adults may already have predictors of diabetes, identified mainly by aspects of the glycemic curve and A1C, but at more modest levels than those with prediabetes.

OBJECTIVE: The cost of hospital treatment for anorexia nervosa (AN) is very high given its duration. Identifying factors related to length of hospital stay (LOS) would make it possible to consider targeted therapeutic strategies that, by optimizing care, would reduce their duration and costs. The objective of this work is to identify the factors related (predictive and associated) to LOS for AN.
METHODS: Systematic review of existing literature up to October 2020, based on Pubmed, according to PRISMA recommendations (Preferred Reported Items for Systematic reviews and Meta-Analysis). Factors related to LOS have been described in two categories: factors related to clinical aspects ; and factors related to therapeutic aspects and management modalities. We distinguished predictive factors (identified as pre-hospitalization or contemporaneous with hospital admission) and associated factors (observed during hospitalization) for each category.
RESULTS: Thirteen articles were selected. Samples from the selected studies ranged from 35 to 381 subjects, mostly women with restrictive type AN (R-AN), but some samples included all types of AN, or focused on purging-type forms. The mean age at admission ranged from 13.6 years (Standard Deviation-SD:±1.6) to 30.3 years (SD :±13.9), corresponding to adolescent, adult or mixed samples. Mean body mass indices at admission ranged from 12.3 (SD±1.4) to 16.6 (SD:±2.1). The duration of disease progression ranged from 11.7 months±2.2 to 9.7 years. Mean LOS are short for studies conducted in pediatrics or in medical services (ranging from 13.0 days [SD±7.3] to 22.1 days [SD±9.4]); they are more variable for studies conducted in psychiatry: from 15.6 days (SD±1.0) to 150.2 days (SD±80.8). Among the factors related to an increase in LOS, clinical predictors included: older age at onset or admission; longer duration of the disorder; low minimum body weight during AN; low BMI at admission; purgative form of anorexia nervosa; and high levels of dietary symptoms (asceticism and ineffectiveness dimensions on Eating Disorder Inventory-2). Therapeutic and management modality predictive factors were: a higher number of hospitalizations for AN; the use of enteral nutrition (nasogastric or percutaneous gastric tube) on admission or during hospitalization; the use of intravenous renutrition coupled with oral renutrition; hospitalization far from the patient\'s home; absence of hospital care in psychiatry after medical stabilization in a somatic unit; compulsory hospitalization. Associated factors were: the presence of psychiatric comorbidities; greater weight gain during hospitalization. Among the factors related to a decrease in LOS, the clinical predictive factor were: greater self-confidence at admission (measured by the Eating Disorder Recovery Self-Efficacy Questionnaire). Therapeutic and management modality predictors included: increased caloric intake of oral renutrition on admission; intake of oral nutritional supplements on admission; and hospitalization in urban areas. The associated factor was: compliance with the weight contract in the adolescent population.
CONCLUSIONS: Factors related to an increase in LOS are explained by: higher resistance to treatment, higher severity of the disease, the time required for weight gain in services using cognitive-behavioural therapy, complications associated with renutrition modalities such as parenteral renutrition, difficulties in organising outpatient follow-up which require better consolidation of inpatient treatment and the lack of multidisciplinary care in medical services. Factors related to a decrease in LOS are due to: faster weight gain, the presence of a greater number of outpatient follow-up structures close to the hospital and better adherence to treatment to complete the weight contract.
CONCLUSIONS: Taking these factors into account during hospitalization for AN would help optimize care, duration and costs. This situation therefore requires the development of therapeutic trials targeting the identified factors in order to reduce LOS in the treatment of AN.

To provide up-to-date evidence-based guidelines for the management of smoking cessation during pregnancy.
Systematic review of the international literature. We identified papers published between January 2003 and April 2019 in Cochrane PubMed, and Embase databases with predefined keywords. All reports published in French and English relevant to the areas of focus were included and classified according the level of evidence ranging from 1 (highest) to 4 (lowest). The strength of the recommendations was classified according to the Haute Autorité de santé, France (ranging from A, highest to C, lowest).
\"Counseling\", involving globally all kind of non-pharmacological interventions, has a modest benefit on smoking cessation, birth weight and prematurity. Moderate physical activity did not show a significant effect on smoking cessation. The systematic use of feedback by measuring the expired air carbon monoxide concentration do not influence smoking abstinence but it may be used in establishing a therapeutic alliance. The use of self-help interventions and health education are recommended in helping pregnant smokers quit. The prescription of nicotine replacement therapies (NRT) may be offered to any pregnant woman who has failed stopping smoking without medication This prescription can be initiated by the health care professional taking care of the pregnant woman in early pregnancy. There is no scientific evidence to propose the electronic cigarette for smoking cessation to pregnant smokers; it is recommended to provide the same advice and to use methods that have already been evaluated. The use of waterpipe (shisha/narghile) during pregnancy is associated with decreased fetal growth. It is recommended not to use waterpipe during pregnancy. Breastfeeding is possible in smokers, but less often initiated by them. Although its benefit for the child\'s development is not demonstrated to date, breastfeeding allows the mother to reduce or stop smoking. The risk of postpartum relapse is high (up to 82% at 1 year). The main factors associated with postpartum abstinence are breastfeeding, not having a smoker at home, and having no symptoms of postpartum depression.
Smoking during pregnancy concerns more than hundred thousand women and their children per year in France. It is a major public health burden. Health care professionals should be mobilized for reducing or even eradicating it.

OBJECTIVE: Because of disparities in incidence of diabetes in pregnancy (DIP) among First Nations (FN) and non-First Nations (non-FN) women in Saskatchewan, we compared predictors and early maternal/child complication rates of gestational diabetes (GDM) and pre-GDM between the 2 populations from 1980 to 2013.
METHODS: Using Ministry of Health administrative databases, we examined overall GDM and pre-GDM predictors among a cohort of FN and non-FN women using logistic regression models. We compared early birth complications by ethnicity and DIP status using chi-square analysis.
RESULTS: Deidentified data were obtained for 69,176 FN and 344,410 non-FN pregnancies. Important GDM and pre-GDM predictors for FN and non-FN pregnancies were increasing maternal age, a previous high birthweight (HBW) or stillborn infant, and, most importantly, previous maternal GDM. Both GDM and pre-GDM were over 2.3-fold as likely to occur among FN in multivariable analysis. FN and non-FN pregnancies with GDM and pre-GDM had higher rates of prematurity, shoulder dystocia, caesarean section, HBW and stillborn and infant death than those with no DIP. The largest rate disparities between FN and non-FN with DIP occurred with stillborn, HBW and shoulder dystocia.
CONCLUSIONS: Along with previously recognized predictors of GDM and pre-GDM, FN ethnicity was an independent determinant of DIP in Saskatchewan from 1980 to 2013. Early mother/child birth complications were increased in both FN and non-FN with DIP, but more so in FN. Effective DIP prevention strategies, and improvements in preconception, prenatal and perinatal care, are required to remove ethnicity-based disparities in DIP rates and outcomes.

OBJECTIVE: Bariatric surgery is an empirically supported treatment for severe obesity; however, it does not directly target underlying behavioural and psychological factors that potentially contribute to obesity. Mounting evidence supports the efficacy of cognitive behavioural therapy (CBT) for improving eating psychopathology and psychological distress among bariatric patients, and telephone-based CBT (Tele-CBT) is a novel delivery method that increases treatment accessibility.
METHODS: This study aimed to identify demographic and clinical predictors of response to Tele-CBT among 79 patients who received Tele-CBT in 3 previous studies. Listwise deletion was applied, after which 58 patients were included in a multivariate linear regression adjusted for age, sex and education status, to evaluate patient rurality index (urban or nonurban), and baseline binge eating, emotional eating and depression symptoms, as predictors of tele-CBT response.
RESULTS: The predictors explained 31% of the observed variance [R2=0.312, F(4,57)=3.238, p<0.01]. Patient rurality index (beta=0.341, p<0.01) was the only statistically significant predictor of Tele-CBT response.
CONCLUSIONS: Given the limited psychosocial resources available in many bariatric surgery programs, the findings suggest that Tele-CBT may be particularly beneficial for patients residing in nonurban communities with limited access to other health-care services.

OBJECTIVE: To identify predictors of cesarean delivery in the Kinkanda general hospital.
METHODS: Cross-sectional study conducted from 1st January 2012 to 31st December 2012, on women in labor who delivered at the maternity of Kinkanda. Predictors of cesarean delivery were identified by using binary logistic regression.
RESULTS: A uterine height of at least 33 cm at induction of labor (AOR 3.93 95% CI 2.04 to 7.59; p <0.001), primiparity (AOR 2.1 95%CI:1.06 to 4.15; p = 0.033), non-membership of the pregnant woman to this particular health center area (AOR 4.26 95%CI 2.16 to 8.42; p <0.001) and a weight of the newborn of at least 4000g (AOR 7.8 95%CI 2.3 to 26.44; p <0.001) were identified as risk factors for cesarean delivery.
CONCLUSIONS: Primiparity, uterine height of at least 33 cm, living in another health area than the Matadi area and fetal macrosomia are the main predictors of cesarean delivery during the year 2012 at the Kinkanda general hospital.
UNASSIGNED: Identifier les prédicteurs de l\'accouchement par césarienne à l\'Hôpital Général de Kinkanda.
UNASSIGNED: Etude transversale analytique réalisée du 01 janvier au 31 décembre 2012, auprès de parturientes ayant accouché à la maternité de l\'Hôpital Général de Kinkanda. Les variables prédictives de l\'accouchement par césarienne ont été mises en évidence à l\'aide d\'une régression logistique binaire.
UNASSIGNED: Une hauteur utérine d\'au moins 33 cm au déclenchement du travail (ORA : 3,93 IC95% : 2,04 – 7,59 ; p < 0,001), la primiparité (ORA :2,1 IC95% :1,06 – 4,15 ; p= 0,033), la non appartenance de la parturiente à la zone de santé (ORA : 4,26 IC95% : 2,16 – 8,42 ; p < 0,001) et le poids du nouveau- né avec au moins 4000g (ORA : 7,8 IC95% : 2,3 – 26,44 ; p< 0,001) ont été identifiés comme des facteurs prédictifs de l\'accouchement par césarienne.
CONCLUSIONS: La primiparité, la hauteur utérine d\'au moins 33 cm, l\'appartenance à une autre zone de santé que celle de l\'Hôpital Général de Kinkanda et la macrosomie fœtale sont les principaux prédicteurs de la césarienne au cours de l\'année 2012 à l\'Hôpital Général de Référence de Kinkanda.

To assess the level and predictors of physical activity at discharge among children recovering from severe acute malnutrition (SAM).
We conducted a prospective study among 69 children 6-59 months of age admitted with SAM for nutritional rehabilitation at Mulago National Referral Hospital, Uganda. Using hip-mounted triaxial accelerometers, we measured physical activity expressed as counts per minute (cpm) during the last three days of hospital treatment. As potential predictors, we assessed clinical and background characteristics, duration to transition phase and duration of hospitalisation, serum C-reactive protein and whole-blood docosahexaenoic acid (DHA). Multiple linear regression analyses were used to identify predictors of physical activity.
The median (IQR) age was 15.5 (12.6; 20.5) months. At discharge, the mean (SD) movement was 285 (126) cpm. Physical activity was 43 (19; 67) cpm higher for each unit increase in weight-for-height z-score (WHZ) and 72 (36; 108) cpm higher for each centimetre increase in MUAC. Whole-blood DHA on admission was also a positive predictor of physical activity, whereas duration to transition phase and duration of hospitalisation were both negative predictors.
The level of physical activity at discharge among children treated for SAM was low. WHZ, MUAC and DHA on admission were positive predictors of physical activity, whereas duration of stabilisation and hospitalisation was negative predictors of physical activity. These results suggest that assessment of physical activity may be used as a marker of recovery.

To determine the prevalence and predictors of gestational diabetes mellitus (GDM) as well as acceptability of returning for glucose tolerance testing among pregnant women in Moshi municipality, northern Tanzania.
Cross-sectional study from October 2015 to April 2016 among women with gestation age of 24-28 weeks of pregnancy attending at Kilimanjaro Christian Medical Centre (KCMC) referral hospital, Majengo and Pasua Health Centres. Women were interviewed and requested to return the next day (window within a month, depending on gestational age) for fasting plasma glucose (FPG) testing, followed immediately by a 75 g oral glucose tolerance test (OGTT). GDM was diagnosed using the 2013 WHO criteria. Logistic regression was conducted to reveal independent predictors for GDM.
Of 433 interviewed women, 100 (23%) did not return for FPG and OGTT testing. The prevalence of GDM among the 333 screened women was 19.5%, and 3% had diabetes in pregnancy (DIP). GDM was significantly associated with age ≥35 years (adjusted OR 6.75), pre-pregnancy obesity (AOR 2.22) and history of abortion (AOR 2.36).
Prevalence of GDM is high in Moshi. We recommend introduction of routine screening for hyperglycaemia during pregnancy along with strategies for follow-up to prevent long-term effects of GDM and DIP in women and their children.