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Sample records for factors affecting adherence

  1. Factors affecting medication adherence in elderly people

    Directory of Open Access Journals (Sweden)

    Jin HK

    2016-10-01

    Full Text Available Hyekyung Jin,1 Yeonhee Kim,2 Sandy Jeong Rhie1,3 1College of Pharmacy, 2Center for Excellence in Teaching & Learning, 3Division of Life and Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea Background: Little is known about the functional health literacy (FHL associated with medication adherence in elderly patients. The aim of this study was to examine the FHL among older adults and identify influencing factors that can predict medication adherence. Methods: This was a cross-sectional survey. Participants (n=160 aged 65 years and older were selected from outpatient clinics of 3 tertiary care hospitals, 6 community pharmacies, and 2 senior centers between November 1 and 30, 2014. The participants’ FHL was measured using the Korean Functional Health Literacy Test, which consists of 15 items including 8 numeracy and 7 reading comprehension items. Medication adherence was measured by the Adherence to Refills and Medication Scale. Descriptive statistics, chi-square or Fisher’s exact test, and multiple regression analyses were used to analyze the data. Results: The mean score of the total FHL was 7.72±3.51 (range 0–15. The percentage of the total number of correct answers for the reading comprehension subtest and numeracy subtest were 48.1% and 54.4%, respectively. Among 160 participants, 52.5% showed low adherence to medication. The factors affecting medication adherence included the patient’s degree of satisfaction with the service (β=-0.215, P=0.022, sufficient explanation of medication counseling (β=-0.335, P=0.000, education level (β=-0.153, P=0.045, health-related problems (β=-0.239, P=0.004, and dosing frequency (β=0.189, P=0.018. Conclusion: In this study, we found medication adherence of elderly patients was associated with education level, health-related problems, dosing frequency, satisfaction with patient counseling, and explanation of medication, but no association was found with FHL. Pharmacists

  2. Evaluation of factors affecting adherence to asthma controller ...

    African Journals Online (AJOL)

    Evaluation of factors affecting adherence to asthma controller therapy in chest clinics in a sub-Saharan African setting: a cross-sectional study. ... Background: Adherence to controller therapy in asthma is a major concern during the management of the disease. Objective: To determine the adherence rate and identify the ...

  3. Socio-demographic and clinical factors affecting adherence to ...

    African Journals Online (AJOL)

    Socio-demographic and clinical factors affecting adherence to antihypertensive medications and blood pressure control among patients attending the family practice clinic in a tertiary hospital in northern Nigeria.

  4. Evaluation of factors affecting adherence to asthma controller ...

    African Journals Online (AJOL)

    Background: Adherence to controller therapy in asthma is a major concern during the management of the disease. ... The adherence to asthma treatment was rated using Morisky Medication Adherence Scale. A ..... in an outpatient setting.

  5. Factors affecting adherence to a raw vegan diet.

    Science.gov (United States)

    Link, Lilli B; Jacobson, Judith S

    2008-02-01

    The purpose of this study was to evaluate adherence and identify predictors of adherence to a raw vegan diet (i.e., uncooked plant foods) following a stay at a raw vegan institute. In this cohort study of guests at a raw vegan institute, subjects completed written questionnaires upon arrival and 12 weeks later. Of 107 eligible guests, 84 participated. Mean age was 54 years, 23 were male, and 73 white. Fifty-one completed the 12-week follow-up. Eight (16%) reported their diet to be 80% raw vegan at baseline and 14 (28%) at follow-up. Based on a raw vegan dietary adherence score (range 0-42) created for this study, mean adherence (SD) increased from 15.1 (5.4) to 17.0 (5.8) over 12 weeks (p=0.03). Baseline predictors of adherence included: education (beta=0.95), severity of disease (beta=0.98), and self-efficacy to adhere (beta=0.72). Future interventions that evaluate this diet should address self-efficacy, an important, potentially remediable predictor of adherence.

  6. Factors affecting adherence to a raw vegan diet

    Science.gov (United States)

    Link, Lilli B.; Jacobson, Judith S.

    2008-01-01

    The purpose of this study was to evaluate adherence and identify predictors of adherence to a raw vegan diet (i.e., uncooked plant foods) following a stay at a raw vegan institute. In this cohort study of guests at a raw vegan institute, subjects completed written questionnaires upon arrival and 12 weeks later. Of 107 eligible guests, 84 participated. Mean age was 54 years, 23 were male, and 73 white. Fifty-one completed the 12-week follow-up. Eight (16%) reported their diet to be ≥80% raw vegan at baseline and 14 (28%) at follow-up. Based on a raw vegan dietary adherence score (range 0-42) created for this study, mean adherence (SD) increased from 15.1 (5.4) to 17.0 (5.8) over 12 weeks (p=0.03). Baseline predictors of adherence included: education (β=0.95), severity of disease (β=0.98), and self-efficacy to adhere (β=0.72). Future interventions that evaluate this diet should address self-efficacy, an important, potentially remediable predictor of adherence. PMID:18243943

  7. Factors affecting adherence to a raw vegan diet

    OpenAIRE

    Link, Lilli B.; Jacobson, Judith S.

    2007-01-01

    The purpose of this study was to evaluate adherence and identify predictors of adherence to a raw vegan diet (i.e., uncooked plant foods) following a stay at a raw vegan institute. In this cohort study of guests at a raw vegan institute, subjects completed written questionnaires upon arrival and 12 weeks later. Of 107 eligible guests, 84 participated. Mean age was 54 years, 23 were male, and 73 white. Fifty-one completed the 12-week follow-up. Eight (16%) reported their diet to be ≥80% raw ve...

  8. Factors affecting HIV-infected mothers' ability to adhere to ...

    African Journals Online (AJOL)

    The postnatal feeding practices of 222 HIV-infected mothers were compared with their prenatal intentions and ... categorical data and Student's t-test for continuous data. Factors ... give an excuse, such as ill health (including breast cancer,.

  9. Factors affecting treatment adherence to atomoxetine in ADHD: a systematic review

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    Treuer T

    2016-05-01

    Full Text Available Tamás Treuer,1 Luis Méndez,2 William Montgomery,3 Shenghu Wu4 1Neuroscience Research, Eli Lilly and Company, Budapest, Hungary; 2Eli Lilly de Mexico, Mexico City, Mexico; 3Global Patient Outcomes and Real World Evidence, Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia; 4Neuroscience Research, Eli Lilly Asia, Inc, Shanghai, People’s Republic of China Abstract: The purpose of this paper was to systematically review the literature related to research about the factors affecting treatment adherence and discontinuation of atomoxetine in pediatric, adolescent, and adult patients with attention-deficit/hyperactivity disorder (ADHD. Medline was systematically searched using the following prespecified terms: “ADHD”, “Adherence”, “Compliance”, “Discontinuation”, and “Atomoxetine”. We identified 31 articles that met all inclusion and exclusion criteria. The findings from this review indicate that persistence and adherence to atomoxetine treatment were generally high. Factors found to influence adherence and nonadherence to atomoxetine treatment in ADHD in this review include age, sex, the definition of response used, length of treatment, initial dose of treatment, comorbid conditions, and reimbursement. Tolerability was cited as an important reason for treatment discontinuation. More research is needed to understand those factors that can help to identify patients at risk for poor adherence and interventions that could improve treatment adherence early in the stage of this illness to secure a better long-term prognosis. Keywords: atomoxetine, treatment discontinuation, adherence, compliance, ADHD medication, relapse

  10. The guardians' perspective on paediatric cancer treatment in Malawi and factors affecting adherence

    NARCIS (Netherlands)

    Israëls, Trijn; Chirambo, Chawanangwa; Caron, Huib; de Kraker, Jan; Molyneux, Elizabeth; Reis, Ria

    2008-01-01

    Abandonment of paediatric cancer treatment is a common problem in developing countries. Little is known about the guardians' perspective on cancer treatment in these countries, especially the factors that affect adherence. Following a pilot study enquiring into the possible causes of abandonment, a

  11. The guardians' perspective on paediatric cancer treatment in Malawi and factors affecting adherence

    NARCIS (Netherlands)

    Israels, T.; Chirambo, C.; Caron, H.; de Kraker, J.; Molyneux, E.; Reis, R.

    2008-01-01

    Background: Abandonment of paediatric cancer treatment is a common problem in developing countries. Little is known about the guardians' perspective on cancer treatment in these countries, especially the factors that affect adherence. Methods: Following a pilot study enquiring into the possible

  12. Adherence to diet and fluid restriction of individuals on hemodialysis treatment and affecting factors in Turkey.

    Science.gov (United States)

    Efe, Dilek; Kocaöz, Semra

    2015-04-01

    This study was conducted to determine adherence to diet and fluid restriction in hemodialysis-treated individuals and the affecting factors in Turkey. This descriptive study was conducted between 15 October 2010 and 15 January 2011 in subjects who voluntarily agreed to participate in the study from three dialysis centers in a city located in the Central Anatolia Region of Turkey. One hundred and twenty-one individuals treated with hemodialysis made up the study sample. The data were collected using a questionnaire consisting of 41 questions and the Dialysis Diet and Fluid Non-adherence Questionnaire. The data were evaluated with percentage, median, Mann-Whitney U-test, Kruskal-Wallis test, Student's t-test in independent samples and Spearman's rank correlation coefficient. The authors found that 98.3% of the individuals experienced non-adherence to diet and 95.0% with fluid restriction. The authors found a weak and negative relationship between calcium levels and non-adherence to fluid restriction, a weak relationship between phosphorus levels and diet non-adherence frequency and degree and the fluid non-adherence frequency scores, and a moderate positive relationship between phosphorus levels and fluid restriction non-adherence degree scores (P < 0.05). Based on these results, regular training and information regarding diet and fluid restriction must be provided to individuals aged 21-35 years with no one in the family to help with their care, those who consumed salted food, or had interdialytic weight gain of 4.5 kg or more. © 2014 The Authors. Japan Journal of Nursing Science © 2014 Japan Academy of Nursing Science.

  13. An ontology for factors affecting tuberculosis treatment adherence behavior in sub-Saharan Africa.

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    Ogundele, Olukunle Ayodeji; Moodley, Deshendran; Pillay, Anban W; Seebregts, Christopher J

    2016-01-01

    Adherence behavior is a complex phenomenon influenced by diverse personal, cultural, and socioeconomic factors that may vary between communities in different regions. Understanding the factors that influence adherence behavior is essential in predicting which individuals and communities are at risk of nonadherence. This is necessary for supporting resource allocation and intervention planning in disease control programs. Currently, there is no known concrete and unambiguous computational representation of factors that influence tuberculosis (TB) treatment adherence behavior that is useful for prediction. This study developed a computer-based conceptual model for capturing and structuring knowledge about the factors that influence TB treatment adherence behavior in sub-Saharan Africa (SSA). An extensive review of existing categorization systems in the literature was used to develop a conceptual model that captured scientific knowledge about TB adherence behavior in SSA. The model was formalized as an ontology using the web ontology language. The ontology was then evaluated for its comprehensiveness and applicability in building predictive models. The outcome of the study is a novel ontology-based approach for curating and structuring scientific knowledge of adherence behavior in patients with TB in SSA. The ontology takes an evidence-based approach by explicitly linking factors to published clinical studies. Factors are structured around five dimensions: factor type, type of effect, regional variation, cross-dependencies between factors, and treatment phase. The ontology is flexible and extendable and provides new insights into the nature of and interrelationship between factors that influence TB adherence.

  14. An ontology for factors affecting tuberculosis treatment adherence behavior in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Ogundele OA

    2016-04-01

    Full Text Available Olukunle Ayodeji Ogundele,1 Deshendran Moodley,1 Anban W Pillay,1 Christopher J Seebregts1,2 1UKZN/CSIR Meraka Centre for Artificial Intelligence Research and Health Architecture Laboratory, School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, KwaZulu-Natal, 2Jembi Health Systems NPC, Cape Town, South Africa Purpose: Adherence behavior is a complex phenomenon influenced by diverse personal, cultural, and socioeconomic factors that may vary between communities in different regions. Understanding the factors that influence adherence behavior is essential in predicting which individuals and communities are at risk of nonadherence. This is necessary for supporting resource allocation and intervention planning in disease control programs. Currently, there is no known concrete and unambiguous computational representation of factors that influence tuberculosis (TB treatment adherence behavior that is useful for prediction. This study developed a computer-based conceptual model for capturing and structuring knowledge about the factors that influence TB treatment adherence behavior in sub-Saharan Africa (SSA.Methods: An extensive review of existing categorization systems in the literature was used to develop a conceptual model that captured scientific knowledge about TB adherence behavior in SSA. The model was formalized as an ontology using the web ontology language. The ontology was then evaluated for its comprehensiveness and applicability in building predictive models. Conclusion: The outcome of the study is a novel ontology-based approach for curating and structuring scientific knowledge of adherence behavior in patients with TB in SSA. The ontology takes an evidence-based approach by explicitly linking factors to published clinical studies. Factors are structured around five dimensions: factor type, type of effect, regional variation, cross-dependencies between factors, and treatment phase. The ontology is

  15. Factors affecting adherence to antiretroviral therapy among pregnant women in the Eastern Cape, South Africa.

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    Adeniyi, Oladele Vincent; Ajayi, Anthony Idowu; Ter Goon, Daniel; Owolabi, Eyitayo Omolara; Eboh, Alfred; Lambert, John

    2018-04-13

    Context-specific factors influence adherence to antiretroviral therapy (ART) among pregnant women living with HIV. Gaps exist in the understanding of the reasons for the variable outcomes of the prevention of mother-to-child transmission (PMTCT) programme at the health facility level in South Africa. This study examined adherence levels and reasons for non-adherence during pregnancy in a cohort of parturient women enrolled in the PMTCT programme in the Eastern Cape, South Africa. This was a mixed-methods study involving 1709 parturient women in the Eastern Cape, South Africa. We conducted a multi-centre retrospective analysis of the mother-infant pair in the PMTCT electronic database in 2016. Semi-structured interviews of purposively selected parturient women with self-reported poor adherence (n = 177) were conducted to gain understanding of the main barriers to adherence. Binary logistic regression was used to determine the independent predictors of ART non-adherence. A high proportion (69.0%) of women reported perfect adherence. In the logistic regression analysis, after adjusting for confounding factors, marital status, cigarette smoking, alcohol use and non-disclosure to a family member were the independent predictors of non-adherence. Analysis of the qualitative data revealed that drug-related side-effects, being away from home, forgetfulness, non-disclosure, stigma and work-related demand were among the main reasons for non-adherence to ART. Non-adherence to the antiretroviral therapy among pregnant women in this setting is associated with lifestyle behaviours, HIV-related stigma and ART side-effects. In order to eliminate mother-to-child transmission of HIV, clinicians need to screen for these factors at every antenatal clinic visit.

  16. Factors affecting nebulised medicine adherence in adult patients with cystic fibrosis: a qualitative study.

    Science.gov (United States)

    Hogan, Alice; Bonney, Mary-Ann; Brien, Jo-Anne; Karamy, Rita; Aslani, Parisa

    2015-02-01

    Nebulised medicines contribute to the high treatment burden experienced by patients with cystic fibrosis (CF). This study explored experiences of adult patients with CF when using nebulised medicines, factors impacting on their adherence to nebulised therapy and strategies they used to facilitate adherence. Community setting, in Sydney, Australia. Ten patients with CF were recruited through a CF patient organisation. Semi-structured face-to-face interviews were conducted, addressing the study objectives. Interviews were audio-recorded, transcribed verbatim and content analysed for anticipated and emergent themes. Experiences with using nebulised medicines; and barriers and facilitators of adherence to nebulised medicines. Participants' age ranged from 22 to 45 years, with half being male. Four broad themes (with more specific sub-themes) were identified from the interviews: experiences with using nebulised medicines (cleaning nebuliser, time taken to use nebuliser medicine, flexibility in use of nebuliser); feelings about using nebulised medicines (necessary/important, dislike, part of life); factors impacting non-adherence (time consuming therapy, side effects/effects of medicine, work/social demands, lack of perceived importance); factors and strategies facilitating adherence (perceived medicine importance, habit/routine, support, health benefits, technology/medicine dose form, timetabling). Nebulised therapy for cystic fibrosis patients takes a substantial amount of time, with patients trying to alter their routine to incorporate nebulising into their daily lives. However there are still many factors that lead to low adherence, including work/social demands and travelling. Patients balance the necessity for nebulised therapy against the barriers, and engage in intentional non-adherence at times. Future strategies and resources should target and address specific factors identified by patients with CF as being important and impacting their adherence to nebulised

  17. The guardians' perspective on paediatric cancer treatment in Malawi and factors affecting adherence.

    Science.gov (United States)

    Israëls, Trijn; Chirambo, Chawanangwa; Caron, Huib; de Kraker, Jan; Molyneux, Elizabeth; Reis, Ria

    2008-11-01

    Abandonment of paediatric cancer treatment is a common problem in developing countries. Little is known about the guardians' perspective on cancer treatment in these countries, especially the factors that affect adherence. Following a pilot study enquiring into the possible causes of abandonment, a problem analysis diagram was drawn which helped to develop the questionnaires. Semi-structured interviews (n = 83) and focus group discussions (n = 8) were held with the guardians of 25 Burkitt lymphoma patients and 7 Wilms tumour patients at different phases of therapy in Malawi. Parents in Malawi are very motivated to continue treatment if they think that it will cure their child. Financial costs are important concerns. Not all tasks at home are assumed by other household members. The diagnosis of cancer was unknown before being told about it in hospital and caused fear of recurrence and death. Guardians are reluctant to ask the health personnel questions. They worry that taking frequent blood samples will weaken their child. The side effects of the chemotherapy are seen as a proof of efficacy. It is important to appreciate the guardians' concerns when offering treatment that requires their sustained commitment. It is necessary to provide not only medical treatment, but also travel allowances and adequate nutritional support during long hospital stays to impoverished families. Information should be given proactively. (c) 2008 Wiley-Liss, Inc.

  18. Factors Affecting Hand Hygiene Adherence at a Private Hospital in Turkey.

    Science.gov (United States)

    Teker, Bahri; Ogutlu, Aziz; Gozdas, Hasan Tahsin; Ruayercan, Saliha; Hacialioglu, Gulizar; Karabay, Oguz

    2015-10-01

    Nosocomial infections are the main problems rising morbidity and mortality in health care settings. Hand hygiene is the most effective method for preventing these infections. In this study, we aimed to investigate the factors related with hand hygiene adherence at a private hospital in Turkey. This study was conducted between March and June 2010 at a private hospital in Turkey. During the observation period, employees were informed about training, then posters and images were hanged in specific places of the hospital. After the initial observation, training on nosocomial infections and hand hygiene was provided to the hospital staff in March 2010. Contacts were classified according to occupational groups and whether invasive or not. These observations were evaluated in terms of compatibility with hand hygiene guidelines. Hand hygiene adherence rate of trained doctors was higher than untrained ones before patient contact and after environment contact [48% (35/73) versus 82% (92/113) pHand hygiene adherence rate of trained nurses was higher than untrained ones before patient contact [63% (50/79) versus 76% (37/49) pHand hygiene adherence rate of trained assistant health personnel was higher than untrained ones before asepsis [20% (2/10) versus 73% (16/22) phand antiseptics were used when hand washing was not possible. The increase at the rate of hand washing after training reveals the importance of feedback of the observations, as well as the training. One of the most important ways of preventing nosocomial infections is hand hygiene training that should be continued with feedbacks.

  19. Adherence to the Mediterranean Diet and Factors Affecting Obesity in High School Students

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    Aysun Yüksel

    2017-12-01

    Full Text Available The prevalence overweight and obese among children and adolescents increases gradually in the world and became an epidemic in both developing and developed countries. Overweight and obesity in the adolescent period are the main risk factors contributing to the development of cardiovascular diseases in the adulthood period. This study was planned to reveal the prevalence of obesity and association of healthy lifestyle behaviors with obesity in adolescents. Methods: This research was carried out 859 students studying at Istanbul Hezarfen High School between the dates 1 February to 31 March 2017. The general dietary habits and night eating statuses were determined using the Mediterranean Diet Quality Index (KIDMED and Night Eating Questionnaire (NEQ and anthropometric parameters such as height and body weight were measured. Results: The mean age of the students was 15.9 ± 1.3 years. Of the students, 19.2% had overweight, 13.7% had obese BMI values. In this study, 32.4% of all students had low and 13% of them had optimal nutritional quality. The difference between two genders was statistically significant (p<0.05. The Night Eating Syndrome was not present in 78.9% of all students whereas it was detected in 21.1% of them. Conclusions: In our study, there was no statistically significant relationship between obesity, adherence to Mediterranean Diet and Night Eating Syndrome.

  20. In what way do Nepalese cultural factors affect adherence to antiretroviral treatment in Nepal?

    OpenAIRE

    Wasti, Sharada Prasad; Randall, Julian; Simkhada, Padam; Van Teijlingen, Edwin

    2011-01-01

    Individuals’ self administration of medication is an essential component of disease management because incorrect and incomplete medication can result in increased morbidity, mortality and healthcare costs and also spreads drug resistance. Its impact is necessarily wider than just\\ud medical and includes the cultural and managerial considerations which govern success in medical interventions. This review paper is aimed at how Nepalese cultural factors (beliefs, religious practices, customs and...

  1. [An Investigation of Factors Associated with Emotional Exhaustion among Hospital Nurses: Adherence to "Maternal Affection" and Agreement with Stereotypical Gender Roles].

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    Takai, Rei; Nomura, Kyoko; Hiraike, Haruko; Murakami, Aya; Tanabe, Ayumi; Tsuchiya, Akiko; Okinaga, Hiroko

    2018-01-01

    To investigate factors including adherence to "maternal affection" and stereotypical gender roles associated with emotional exhaustion among hospital nurses. In 2014, among 2,690 workers recruited for this study, 891 participated with written informed consent. Of these, we investigated 464 hospital nurses. Adherence to maternal affection and emotional exhaustion were measured using valid and reliable scales developed by Egami (2005, 12 items) and Kubo (1992, 5 items), respectively. Stereotypical gender role was measured by asking "how much do you agree with the idea that women should stay home and men should work?". Workfamily conflict was measured in terms of the discrepancy in priority in life (i.e., a work or a private life) between the participant's ideal and the real world. The majority of our participants were women (86%), aged 39 or younger (80%), and single (70%). About one-quarter had workfamily conflict (26%) and agreed with the stereotypical gender role (28%). The mean scores of emotional exhaustion and adherence to maternal affection were 17.2 (out of 25) and 30.8 (out of 48), respectively. A stepwise multivariable model showed that being a woman (p=0.028), being young (p=0.022), being single (p=0.007), and having workfamily conflict (pgender role were not significantly associated with emotional exhaustion. This study demonstrated that adherence to "maternal affection" and stereotypical gender roles were not associated with psychological burnout. Special attention should be paid to hospital nurses who are women, young, or single, or who have workfamily conflict.

  2. Women's experiences of factors affecting treatment engagement and adherence in internet delivered Behavioural Activation for Postnatal Depression

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    Heather A. O'Mahen

    2015-03-01

    Discussion: Open access, self-help internet interventions are acceptable to women with postnatal depression, but it is critical to provide tailoring and support to help overcome barriers and improve treatment adherence.

  3. Factors affecting adherence to national malaria treatment guidelines in management of malaria among public healthcare workers in Kamuli District, Uganda.

    Science.gov (United States)

    Bawate, Charles; Callender-Carter, Sylvia T; Nsajju, Ben; Bwayo, Denis

    2016-02-24

    Malaria remains a major public health threat accounting for 30.4 % of disease morbidity in outpatient clinic visits across all age groups in Uganda. Consequently, malaria control remains a major public health priority in endemic countries such as Uganda. Experiences from other countries in Africa that revised their malaria case management suggest that health workers adherence may be problematic. A descriptive, cross-sectional design was used and collected information on health system, health workers and patients. Using log-binomial regression model, adjusted prevalence risk ratios (PRRs) and their associated 95 % confidence intervals were determined in line with adherence to new treatment guidelines of parasitological diagnosis and prompt treatment with artemisinin combination therapy (ACT). Nine health centres, 24 health workers and 240 patient consultations were evaluated. Overall adherence to national malaria treatment guidelines (NMTG) was 50.6 % (122/241). It was significantly high at HC III [115 (53 %)] than at HC IV (29 %) [PRR = 0.28 (95 % CI 0.148 0.52), p = 0.000]. Compared to the nursing aide, the adherence level was 1.57 times higher among enrolled nurses (p = 0.004) and 1.68 times higher among nursing officers, p = 0.238, with statistical significance among the former. No attendance of facility malaria-specific continuing medical education (CME) sessions [PRR = 1.9 (95 % CI 1.29 2.78), p = 0.001] and no display of malaria treatment job aides in consultation rooms [PRR = 0.64 (95 % CI 0.4 1.03), p = 0.07] was associated with increased adherence to guidelines with the former showing a statistical significance and the association of the latter borderline statistical significance. The adherence was higher when the laboratory was functional [PRR = 0.47 (95 % CI 0.35 0.63)] when the laboratory was functional in previous 6 months. Age of health worker, duration of employment, supervision, educational level, and age of patient were found not associated with

  4. Factors affecting medication adherence in community-managed patients with hypertension based on the principal component analysis: evidence from Xinjiang, China

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    Zhang YJ

    2018-05-01

    Full Text Available Yuji Zhang,* Xiaoju Li,* Lu Mao, Mei Zhang, Ke Li, Yinxia Zheng, Wangfei Cui, Hongpo Yin, Yanli He, Mingxia Jing Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China *These authors contributed equally to this work Purpose: The analysis of factors affecting the nonadherence to antihypertensive medications is important in the control of blood pressure among patients with hypertension. The purpose of this study was to assess the relationship between factors and medication adherence in Xinjiang community-managed patients with hypertension based on the principal component analysis.Patients and methods: A total of 1,916 community-managed patients with hypertension, selected randomly through a multi-stage sampling, participated in the survey. Self-designed questionnaires were used to classify the participants as either adherent or nonadherent to their medication regimen. A principal component analysis was used in order to eliminate the correlation between factors. Factors related to nonadherence were analyzed by using a χ2-test and a binary logistic regression model.Results: This study extracted nine common factors, with a cumulative variance contribution rate of 63.6%. Further analysis revealed that the following variables were significantly related to nonadherence: severity of disease, community management, diabetes, and taking traditional medications.Conclusion: Community management plays an important role in improving the patients’ medication-taking behavior. Regular medication regimen instruction and better community management services through community-level have the potential to reduce nonadherence. Mild hypertensive patients should be monitored by community health care providers. Keywords: hypertension, medication adherence, factors, principal component analysis, community management, China

  5. Factors affecting medication adherence in community-managed patients with hypertension based on the principal component analysis: evidence from Xinjiang, China.

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    Zhang, Yuji; Li, Xiaoju; Mao, Lu; Zhang, Mei; Li, Ke; Zheng, Yinxia; Cui, Wangfei; Yin, Hongpo; He, Yanli; Jing, Mingxia

    2018-01-01

    The analysis of factors affecting the nonadherence to antihypertensive medications is important in the control of blood pressure among patients with hypertension. The purpose of this study was to assess the relationship between factors and medication adherence in Xinjiang community-managed patients with hypertension based on the principal component analysis. A total of 1,916 community-managed patients with hypertension, selected randomly through a multi-stage sampling, participated in the survey. Self-designed questionnaires were used to classify the participants as either adherent or nonadherent to their medication regimen. A principal component analysis was used in order to eliminate the correlation between factors. Factors related to nonadherence were analyzed by using a χ 2 -test and a binary logistic regression model. This study extracted nine common factors, with a cumulative variance contribution rate of 63.6%. Further analysis revealed that the following variables were significantly related to nonadherence: severity of disease, community management, diabetes, and taking traditional medications. Community management plays an important role in improving the patients' medication-taking behavior. Regular medication regimen instruction and better community management services through community-level have the potential to reduce nonadherence. Mild hypertensive patients should be monitored by community health care providers.

  6. A systematic review of individual and contextual factors affecting ART initiation, adherence, and retention for HIV-infected pregnant and postpartum women.

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    Ian Hodgson

    Full Text Available Despite progress reducing maternal mortality, HIV-related maternal deaths remain high, accounting, for example, for up to 24 percent of all pregnancy-related deaths in sub-Saharan Africa. Antiretroviral therapy (ART is effective in improving outcomes among HIV-infected pregnant and postpartum women, yet rates of initiation, adherence, and retention remain low. This systematic literature review synthesized evidence about individual and contextual factors affecting ART use among HIV-infected pregnant and postpartum women.Searches were conducted for studies addressing the population (HIV-infected pregnant and postpartum women, intervention (ART, and outcomes of interest (initiation, adherence, and retention. Quantitative and qualitative studies published in English since January 2008 were included. Individual and contextual enablers and barriers to ART use were extracted and organized thematically within a framework of individual, interpersonal, community, and structural categories.Thirty-four studies were included in the review. Individual-level factors included both those within and outside a woman's awareness and control (e.g., commitment to child's health or age. Individual-level barriers included poor understanding of HIV, ART, and prevention of mother-to-child transmission, and difficulty managing practical demands of ART. At an interpersonal level, disclosure to a spouse and spousal involvement in treatment were associated with improved initiation, adherence, and retention. Fear of negative consequences was a barrier to disclosure. At a community level, stigma was a major barrier. Key structural barriers and enablers were related to health system use and engagement, including access to services and health worker attitudes.To be successful, programs seeking to expand access to and continued use of ART by integrating maternal health and HIV services must identify and address the relevant barriers and enablers in their own context that are

  7. Motivational factors of adherence to cardiac rehabilitation.

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    Shahsavari, Hooman; Shahriari, Mohsen; Alimohammadi, Nasrollah

    2012-05-01

    Main suggested theories about patients' adherence to treatment regimens recognize the importance of motivation in positive changes in behaviors. Since cardiac diseases are chronic and common, cardiac rehabilitation as an effective prevention program is crucial in management of these diseases. There is always concern about the patients' adherence to cardiac rehabilitation. The aim of this study was to describe the motivational factors affecting the patients' participation and compliance to cardiac rehabilitation by recognizing and understanding the nature of patients' experiences. The participants were selected among the patients with cardiac diseases who were referred to cardiac rehabilitation in Isfahan Cardiovascular Research Center, Iran. The purposive sampling method was used and data saturation achieved after 8 semi-structured interviews. The three main concepts obtained from this study are "beliefs", "supporters" and "group cohesion". In cardiac rehabilitation programs, emphasis on motivational factors affects the patient's adherence. It is suggested that in cardiac rehabilitation programs more attention should be paid to patients' beliefs, the role of patients' supporters and the role of group-based rehabilitation.

  8. Exercise, Affect, and Adherence: An Evolutionary Perspective

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    Harold Lee

    2016-08-01

    Full Text Available The low rates of regular exercise and overall physical activity (PA in the general population represent a significant public health challenge. Previous research suggests that, for many people, exercise leads to a negative affective response and, in turn, reduced likelihood of future exercise. The purpose of this paper is to examine this exercise-affect-adherence relationship from an evolutionary perspective. Specifically, we argue that low rates of physical exercise in the general population are a function of the evolved human tendency to avoid unnecessary physical exertion. This innate tendency evolved because it allowed our evolutionary ancestors to conserve energy for physical activities that had immediate adaptive utility such as pursuing prey, escaping predators, and engaging in social and reproductive behaviors. The commonly observed negative affective response to exercise is an evolved proximate psychological mechanism through which humans avoid unnecessary energy expenditure. The fact that the human tendencies toward negative affective response to and avoidance of unnecessary physical activities are innate does not mean that they are unchangeable. Indeed, it is only because of human-engineered changes in our environmental conditions (i.e., it is no longer necessary for us to work for our food that our predisposition to avoid unnecessary physical exertion has become a liability. Thus, it is well within our capabilities to reengineer our environments to once again make PA necessary or, at least, to serve an immediate functional purpose. We propose a two-pronged approach to PA promotion based on this evolutionary functional perspective: First, to promote exercise and other physical activities that are perceived to have an immediate purpose, and second, to instill greater perceived purpose for a wider range of physical activities. We posit that these strategies are more likely to result in more positive (or at least less negative affective

  9. Factors influencing adherence to routine iron supplementation ...

    African Journals Online (AJOL)

    Anemia in pregnancy is a common problem especially in developing countries. and has been linked with feotal and maternal complications. Taking iron supplements could reduce anaemia in pregnancy but some pregnant women do not adhere to this. The study identified some factors associated with non adherence ...

  10. he role of the affective temperament in the treatment adherence in ...

    African Journals Online (AJOL)

    Introduction: adherence to psychotropic medications is affected by factors related to the treatment, to the physician, to the environment and to the patient himself. The purpose of the present study was to investigate the influence of affective temperaments on treatment adherence. Methods: thirty six stabilized outpatients were ...

  11. Assessment of the prevalence and factors influencing adherence to ...

    African Journals Online (AJOL)

    admin

    adherence to exclusive breast feeding among HIV positive ... Despite its benefits, the practice of EBF among HIV positive mothers is low in Ethiopia. Objective: This study is intended to assess factors influencing adherence to exclusively breast ...

  12. Antidiabetic medication adherence and associated factors among ...

    African Journals Online (AJOL)

    Godfrey Mutashambara Rwegerera

    2017-03-06

    Mar 6, 2017 ... tive of the study was to determine current antidiabetic medication adherence in ...... A systematic review of adherence with medications for diabetes. .... Pascal IGU, Ofoedu JN, Uchenna NP, Nkwa AA, Uchamma GUE.

  13. Factors affecting adherence to short-course ARV prophylaxis for preventing mother-to-child transmission of HIV in sub-Saharan Africa: a review and lessons for future elimination.

    Science.gov (United States)

    Colombini, Manuela; Stöckl, Heidi; Watts, Charlotte; Zimmerman, Cathy; Agamasu, Enyonam; Mayhew, Susannah H

    2014-01-01

    Despite the biomedical potential to eliminate vertical HIV transmission, drug adherence to short regimens is often sub-optimal. To inform future programmes, we reviewed evidence on the factors influencing maternal and infant drug adherence to preventing MTCT drug regimens at delivery in sub-Saharan Africa. A literature review yielding 14 studies on adherence to drug regimes among HIV-positive pregnant women and mothers in sub-Saharan Africa was conducted. Rates of maternal adherence to preventive drug regimens at time of delivery varied widely across sites between 35 and 93.5%. Factors most commonly associated with low adherence to antiretroviral therapy (ARV) prophylaxis for preventing MTCT at the health system level include giving birth at home, quality and timing of HIV testing and counselling, and late distribution of nevirapine (NVP). Socio-demographic and demand-side factors include fear of stigma, lack of male involvement, fear of partner's reaction to disclosure, few antenatal (ANC) visits, young age and lack of education. With the implementation of the newly published WHO guidelines recommending triple-drug ARV regimen during pregnancy and breastfeeding for all women with HIV, it is important that women are able to adhere to recommended drug regimens. Service improvements should include clear and timely communication with women about the benefits of combined regimens and greater emphasis on patient confidentiality. Efforts must be made to help women overcome barriers that reduce adherence, such as financial logistical challenges, social stigma and women's fear of violence.

  14. Treating depression in HIV-positive patients affects adherence

    Directory of Open Access Journals (Sweden)

    M Y H Moosa

    2012-08-01

    of treatment and sociodemographic factors. It is necessary to identify HIV-positive patients at risk of depression, to initiate antidepressant treatment which may prevent ART non-adherence, and subsequent disease progression and increased morbidity.

  15. Review on Factors Influencing Physician Guideline Adherence in Cardiology.

    Science.gov (United States)

    Hoorn, C J G M; Crijns, H J G M; Dierick-van Daele, A T M; Dekker, L R C

    2018-04-09

    Cardiovascular disease is the most common cause of death in Western countries. Physician adherence to guidelines is often suboptimal, resulting in impaired patient outcome and prognosis. Multiple studies have been conducted to evaluate patterns and the influencing factors of patient adherence, but little is known about factors influencing physician guideline adherence. This review aims to identify factors influencing physician guideline adherence relevant to cardiology and to provide insights and suggestions for future improvement. Physician adherence was measured as adherence to standard local medical practice and applicable guidelines. Female gender and older age had a negative effect on physician guideline adherence. In addition, independent of the type of heart disease, physicians without cardiologic specialization were linked to physician noncompliance. Also, guideline adherence in primary care centers was at a lower level compared to secondary or tertiary care centers. The importance of guideline adherence increases as patients age, and complex diseases and comorbidity arise. Appropriate resources and interventions, taking important factors for nonadherence in account, are necessary to improve guideline adoption and adherence in every level of the chain. This in turn should improve patient outcome.

  16. Factors Influencing Adherence to Routine Iron Supplementation

    African Journals Online (AJOL)

    Fineprint

    2016-06-01

    Jun 1, 2016 ... adherence among pregnant women in three selected health centers in Akinyele. Local Government Area, Ibadan ... socioeconomic status, and illiteracy. [12]. .... 80.74% in India [24 ] Although the reason for this disparity is not ...

  17. Factors affecting nuclear development

    International Nuclear Information System (INIS)

    Stevens, G.H.; Girouard, P.

    1995-01-01

    Among the factors affecting nuclear development, some depend more or less on public authorities, but many are out of public authorities control (foreign policies, market and deregulation, socials and environmental impacts, public opinion). As far as possible, the following study tries to identify those factors. (D.L.). 2 photos

  18. Factors influencing long-term adherence to pelvic floor exercises in women with urinary incontinence.

    Science.gov (United States)

    Venegas, Mónica; Carrasco, Bernardita; Casas-Cordero, Romina

    2018-03-01

    To ensure the effectiveness of Physical Therapy for urinary incontinence (UI), it is crucial that patients adhere to treatment in both the long and the short term. Treatment adherence may prevent symptom progression and the need for surgery, which is associated with higher costs and potential complications. Adherence is defined as carrying out a recommended behavioral modification or change. The World Health Organization (WHO) has established that adherence is a multifactorial phenomenon determined by the interaction of five dimensions, which include diverse factors that affect long-term adherence on many levels. To identify the factors that influence long-term adherence to pelvic floor exercises in women with UI. Observational, descriptive, cross-sectional study. The sample was recruited from the "Centro Integral de Reeducación de Piso Pélvico" (CIREP), and included 61 women treated for UI at the center in 2014 and 2015. Participants completed a self-administered, 28-item questionnaire developed for this study based on the WHO five dimensions. Data analysis was performed using STATA 13.0 software. Having performed pelvic floor home exercises after discharge from Physical Therapy was significantly associated with self-rated treatment adherence (P pelvic floor exercise program (P pelvic floor exercises in women with UI; forgetting to do the exercises and boredom with the exercises were the factors most strongly related to low treatment adherence, while motivation and commitment were associated with high adherence in this population. © 2017 Wiley Periodicals, Inc.

  19. Factors Affecting Wound Healing

    OpenAIRE

    Guo, S.; DiPietro, L.A.

    2010-01-01

    Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutane...

  20. Factors influencing adherence to dietary guidelines: a qualitative ...

    African Journals Online (AJOL)

    2014-01-17

    Jan 17, 2014 ... Original Research: Factors influencing adherence to dietary guidelines. 76. 2014 Volume ..... eat, because they dik (tired) of giving you special food. Then they go .... patients in this study were satisfied with the advice received ...

  1. Factors relevant to medication non-adherence in kidney transplant: a systematic review.

    Science.gov (United States)

    Belaiche, Stephanie; Décaudin, Bertrand; Dharancy, Sébastien; Noel, Christian; Odou, Pascal; Hazzan, Marc

    2017-06-01

    Background Medication non-adherence is a major issue after transplant that can lead to misdiagnosis, rejection, poor health affecting quality of life, graft loss or death. Several estimations of adherence and related factors have previously been described but conclusions leave doubt as to the most accurate assessment method. Aim of the review To identify the factors most relevant to medication non-adherence in kidney transplant in current clinical practice. Method This systematic review is registered in the PROSPERO data base and follows the Prisma checklist. Articles in English in three databases from January 2009 to December 2014 were analysed. A synthesis was made to target adherence assessment methods, their prevalence and significance. Results Thirty-seven studies were analysed rates of non-adherence fluctuating from 1.6 to 96%. Assessment methods varied from one study to another, although self-reports were mainly used. It appears that youth (≤50 years old), male, low social support, unemployment, low education, ≥3 months post graft, living donor, ≥6 comorbidities, ≥5 drugs/d, ≥2 intakes/d, negative beliefs, negative behavior, depression and anxiety were the factors significantly related to non-adherence. Conclusion As there are no established guidelines, consideration should be given to more than one approach to identify medication non-adherence although self-reports should remain the cornerstone of adherence assessment.

  2. Genetic factors in exercise adoption, adherence and obesity.

    Science.gov (United States)

    Herring, M P; Sailors, M H; Bray, M S

    2014-01-01

    Physical activity and exercise play critical roles in energy balance. While many interventions targeted at increasing physical activity have demonstrated efficacy in promoting weight loss or maintenance in the short term, long term adherence to such programmes is not frequently observed. Numerous factors have been examined for their ability to predict and/or influence physical activity and exercise adherence. Although physical activity has been demonstrated to have a strong genetic component in both animals and humans, few studies have examined the association between genetic variation and exercise adherence. In this review, we provide a detailed overview of the non-genetic and genetic predictors of physical activity and adherence to exercise. In addition, we report the results of analysis of 26 single nucleotide polymorphisms in six candidate genes examined for association to exercise adherence, duration, intensity and total exercise dose in young adults from the Training Interventions and Genetics of Exercise Response (TIGER) Study. Based on both animal and human research, neural signalling and pleasure/reward systems in the brain may drive in large part the propensity to be physically active and to adhere to an exercise programme. Adherence/compliance research in other fields may inform future investigation of the genetics of exercise adherence. © 2013 The Authors. obesity reviews © 2013 International Association for the Study of Obesity.

  3. Factors influencing adherence to antiretroviral treatment in Nepal: a mixed-methods study.

    Science.gov (United States)

    Wasti, Sharada P; Simkhada, Padam; Randall, Julian; Freeman, Jennifer V; van Teijlingen, Edwin

    2012-01-01

    Antiretroviral therapy (ART) is a lifesaver for individual patients treated for Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). Maintaining optimal adherence to antiretroviral drugs is essential for HIV infection management. This study aimed to understand the factors influencing adherence amongst ART-prescribed patients and care providers in Nepal. A cross-sectional mixed-methods study surveying 330 ART-prescribed patients and 34 in-depth interviews with three different types of stakeholders: patients, care providers, and key people at policy level. Adherence was assessed through survey self-reporting and during the interviews. A multivariate logistic regression model was used to identify factors associated with adherence, supplemented with a thematic analysis of the interview transcripts. A total of 282 (85.5%) respondents reported complete adherence, i.e. no missed doses in the four-weeks prior to interview. Major factors influencing adherence were: non-disclosure of HIV status (OR = 17.99, p = 0.014); alcohol use (OR = 12.89, p = 1 hour (OR = 2.84, p = 0.035). Similarly, lack of knowledge and negative perception towards ART medications also significantly affected non-adherence. Transport costs (for repeat prescription), followed by pills running out, not wanting others to notice, side-effects, and being busy were the most common reasons for non-adherence. The interviews also revealed religious or ritual obstacles, stigma and discrimination, ART-associated costs, transport problems, lack of support, and side-effects as contributing to non-adherence. Improving adherence requires a supportive environment; accessible treatment; clear instructions about regimens; and regimens tailored to individual patients' lifestyles. Healthcare workers should address some of the practical and cultural issues around ART medicine whilst policy-makers should develop appropriate social policy to promote adherence among ART

  4. Factors influencing adherence to antiretroviral treatment in Nepal: a mixed-methods study.

    Directory of Open Access Journals (Sweden)

    Sharada P Wasti

    Full Text Available BACKGROUND: Antiretroviral therapy (ART is a lifesaver for individual patients treated for Human Immunodeficiency Virus (HIV and Acquired Immune Deficiency Syndrome (AIDS. Maintaining optimal adherence to antiretroviral drugs is essential for HIV infection management. This study aimed to understand the factors influencing adherence amongst ART-prescribed patients and care providers in Nepal. METHODS: A cross-sectional mixed-methods study surveying 330 ART-prescribed patients and 34 in-depth interviews with three different types of stakeholders: patients, care providers, and key people at policy level. Adherence was assessed through survey self-reporting and during the interviews. A multivariate logistic regression model was used to identify factors associated with adherence, supplemented with a thematic analysis of the interview transcripts. RESULTS: A total of 282 (85.5% respondents reported complete adherence, i.e. no missed doses in the four-weeks prior to interview. Major factors influencing adherence were: non-disclosure of HIV status (OR = 17.99, p = 0.014; alcohol use (OR = 12.89, p = 1 hour (OR = 2.84, p = 0.035. Similarly, lack of knowledge and negative perception towards ART medications also significantly affected non-adherence. Transport costs (for repeat prescription, followed by pills running out, not wanting others to notice, side-effects, and being busy were the most common reasons for non-adherence. The interviews also revealed religious or ritual obstacles, stigma and discrimination, ART-associated costs, transport problems, lack of support, and side-effects as contributing to non-adherence. CONCLUSION: Improving adherence requires a supportive environment; accessible treatment; clear instructions about regimens; and regimens tailored to individual patients' lifestyles. Healthcare workers should address some of the practical and cultural issues around ART medicine whilst policy-makers should develop

  5. Factors Influencing Adherence to Antiretroviral Treatment in Nepal: A Mixed-Methods Study

    Science.gov (United States)

    Wasti, Sharada P.; Simkhada, Padam; Randall, Julian; Freeman, Jennifer V.; van Teijlingen, Edwin

    2012-01-01

    Background Antiretroviral therapy (ART) is a lifesaver for individual patients treated for Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). Maintaining optimal adherence to antiretroviral drugs is essential for HIV infection management. This study aimed to understand the factors influencing adherence amongst ART-prescribed patients and care providers in Nepal. Methods A cross-sectional mixed-methods study surveying 330 ART-prescribed patients and 34 in-depth interviews with three different types of stakeholders: patients, care providers, and key people at policy level. Adherence was assessed through survey self-reporting and during the interviews. A multivariate logistic regression model was used to identify factors associated with adherence, supplemented with a thematic analysis of the interview transcripts. Results A total of 282 (85.5%) respondents reported complete adherence, i.e. no missed doses in the four-weeks prior to interview. Major factors influencing adherence were: non-disclosure of HIV status (OR = 17.99, p =  0.014); alcohol use (OR = 12.89, p = 1 hour (OR = 2.84, p = 0.035). Similarly, lack of knowledge and negative perception towards ART medications also significantly affected non-adherence. Transport costs (for repeat prescription), followed by pills running out, not wanting others to notice, side-effects, and being busy were the most common reasons for non-adherence. The interviews also revealed religious or ritual obstacles, stigma and discrimination, ART-associated costs, transport problems, lack of support, and side-effects as contributing to non-adherence. Conclusion Improving adherence requires a supportive environment; accessible treatment; clear instructions about regimens; and regimens tailored to individual patients’ lifestyles. Healthcare workers should address some of the practical and cultural issues around ART medicine whilst policy-makers should develop appropriate social

  6. Factors Affecting Wound Healing

    Science.gov (United States)

    Guo, S.; DiPietro, L.A.

    2010-01-01

    Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutaneous wound healing and the potential cellular and/or molecular mechanisms involved. The factors discussed include oxygenation, infection, age and sex hormones, stress, diabetes, obesity, medications, alcoholism, smoking, and nutrition. A better understanding of the influence of these factors on repair may lead to therapeutics that improve wound healing and resolve impaired wounds. PMID:20139336

  7. Adherence treatment factors in hypertensive African American women

    Directory of Open Access Journals (Sweden)

    Marie N Fongwa

    2008-02-01

    Full Text Available Marie N Fongwa1, Lorraines S Evangelista1, Ron D Hays2, David S Martins3, David Elashoff4, Marie J Cowan1, Donald E Morisky51University of California Los Angeles School of Nursing, Los Angeles, CA, USA; 2University of California Los Angeles School of Medicine, Division of General Internal Medicine and Health Services Research, Los Angeles, CA, USA; 3To Help Everyone Clinic Inc. Los Angeles, CA, USA; 4University of California Los Angeles Public Health, Los Angeles, CA, USA; 5University of California Los Angeles School of Public Health, CA, USABackground: Hypertension among African American women is of epidemic proportions. Nonadherence to treatment contributes to uncontrolled blood pressure in this population. Factors associated with adherence to treatment in African American women are unknown. The purpose of this study was to identify factors associated with adherence to hypertension treatment in African American women.Methods: Five audio-taped focus groups were conducted with hypertensive African American women, 35 years and older receiving treatment for hypertension from an inner-city free clinic. All transcripts from the tapes were analyzed for content describing adherence to treatment factors.Findings: Factors associated with adherence to treatment in hypertensive African American women were in three main categories including: beliefs about hypertension, facilitators of adherence to treatment, and barriers to adherence to treatment.Implications: The study supports the need for education on managing hypertension and medication side effects, early screening for depression in hypertensive African Americans, development of culturally sensitive hypertension educational material, and formation of support groups for promoting adherence to treatment among African American women with hypertension.Keywords: adherence, African American, hypertension treatment factors

  8. Barriers affecting adherence to radiation treatment and strategies to overcome those barriers.

    Science.gov (United States)

    Rangarajan, R; Jayaraman, K

    2017-01-01

    The WHO defines adherence as the extent to which a patient's behavior coincides with recommendations from a health-care provider. Nonadherence to cancer treatment has a major impact on the therapeutic outcome. To assess the prevalence of nonadherence to radiation regimen and to analyze the factors that affect adherence to cancer treatment. Patients receiving radiation treatment in our hospital were screened for adherence to appointment keeping and to the prescribed radiation regimen and patients who had unplanned treatment breaks during treatment were interviewed. Between January and July 2013, we identified 61 patients who had unplanned breaks during treatment. We analyzed the social, emotional, educational, economic, and therapeutic barriers that led to nonadherence. Of the 61 patients who had unplanned breaks during treatment, 54% were males and 46% were females. Fifty-seven percent of patients had head and neck cancers and 25% had gynecological cancers. Seventy-one percent of patients were planned for concurrent chemoradiation. The number of days of unplanned treatment breaks ranged from 3 to 27 days. Social and therapeutic barriers were found to be the most common factor that led to nonadherence in these patients. Identification of barriers that lead to nonadherence, designing strategies to overcome such barriers and effective communication becomes imperative to ensure uninterrupted treatment. Based on the above analysis, we have designed several strategies to improve adherence to treatment among our patients.

  9. Psychosocial factors associated with adherence for self-management behaviors in women with breast cancer-related lymphedema.

    Science.gov (United States)

    Alcorso, Jessica; Sherman, Kerry A; Koelmeyer, Louise; Mackie, Helen; Boyages, John

    2016-01-01

    Cognitive and affective psychosocial factors have been found to underlie adherence to preventive behaviors in women at risk of developing lymphedema following treatment for breast cancer. The aim of this study was to determine if these factors are associated with adherence to self-management behaviors for women diagnosed with breast cancer-related lymphedema (BCRL). Women with BCRL were recruited through a community-based breast cancer organization and three Australian lymphedema treatment clinics. Participants completed an online questionnaire assessing demographics, medical history, adherence to self-management behaviors, psychosocial variables (personal control, treatment control, consequences, distress, and self-regulation of affect), and knowledge about lymphedema self-management. A total of 166 women participated in the study. Participants reported adhering to a mean of five out of seven behaviors, with 19.5% of participants adhering to all seven behaviors. Adherence to individual behaviors ranged from 65% (self-lymphatic drainage) to 98.2% (skin care). Greater knowledge about lymphedema was significantly correlated with higher adherence. Hierarchical multiple linear regression analysis indicated that only medical history factors (time since diagnosis and having undergone hormone replacement therapy) predicted a significant amount of the variance in adherence. These findings highlight the importance of patient knowledge for optimal adherence to a self-management regimen. In addition, medical history factors may identify if a patient is at risk of nonadherence. The lack of association of adherence with other psychosocial factors considered in this study indicates that factors underlying adherence in affected women differ considerably from those factors prompting preventive behavior adherence in the at-risk population.

  10. Factors influencing medication knowledge and beliefs on warfarin adherence among patients with atrial fibrillation in China

    Science.gov (United States)

    Zhao, Shujuan; Zhao, Hongwei; Wang, Xianpei; Gao, Chuanyu; Qin, Yuhua; Cai, Haixia; Chen, Boya; Cao, Jingjing

    2017-01-01

    Objectives Warfarin is often used for ischemic stroke prevention in patients with atrial fibrillation (AF), but the factors affecting patient adherence to warfarin therapy have not been fully understood. Methods A cross-sectional survey was conducted in AF patients undergoing warfarin therapy at least 6 months prior to the study. The clinical data collected using questionnaires by phone interviews included the following: 1) self-reported adherence measured by the Morisky Medication Adherence Scale-8©; 2) beliefs about medicines surveyed by Beliefs about Medicines Questionnaire (BMQ); and 3) drug knowledge as measured by the Warfarin Related Knowledge Test (WRKT). Demographic and clinical factors associated with warfarin adherence were identified using a logistic regression model. Results Two hundred eighty-eight patients completed the survey and 93 (32.3%) of them were classified as nonadherent (Morisky Medication Adherence Scale-8 score <6). Major factors predicting warfarin adherence included age, cardiovascular disorders, WRKT, and BMQ; WRKT and BMQ were independently correlated with adherence to warfarin therapy by multivariate logistic regression analysis. Adherents were more likely to have greater knowledge scores and stronger beliefs in the necessity of their specific medications ([odds ratio {OR} =1.81, 95% confidence interval {CI} =1.51–2.15] and [OR =1.17, 95% CI =1.06–1.29], respectively). Patients with greater concerns about adverse reactions and more negative views of general harm were more likely to be nonadherent ([OR =0.76, 95% CI =0.69–0.84] and [OR =0.82, 95% CI =0.73–0.92], respectively). Conclusion BMK and WRKT are related with patient behavior toward warfarin adherence. BMQ can be applied to identify patients at increased risk of nonadherence. PMID:28223782

  11. Factors associated with suboptimal adherence to antiretroviral therapy in Asia

    Science.gov (United States)

    Jiamsakul, Awachana; Kumarasamy, Nagalingeswaran; Ditangco, Rossana; Li, Patrick CK; Phanuphak, Praphan; Sirisanthana, Thira; Sungkanuparph, Somnuek; Kantipong, Pacharee; Lee, Christopher KC; Mustafa, Mahiran; Merati, Tuti; Kamarulzaman, Adeeba; Singtoroj, Thida; Law, Matthew

    2014-01-01

    Introduction Adherence to antiretroviral therapy (ART) plays an important role in treatment outcomes. It is crucial to identify factors influencing adherence in order to optimize treatment responses. The aim of this study was to assess the rates of, and factors associated with, suboptimal adherence (SubAdh) in the first 24 months of ART in an Asian HIV cohort. Methods As part of a prospective resistance monitoring study, the TREAT Asia Studies to Evaluate Resistance Monitoring Study (TASER-M) collected patients’ adherence based on the World Health Organization-validated Adherence Visual Analogue Scale. SubAdh was defined in two ways: (i) 14 days. Time was divided into four intervals: 0–6, 6–12, 12–18 and 18–24 months. Factors associated with SubAdh were analysed using generalized estimating equations. Results Out of 1316 patients, 32% ever reported 2 assessments per patient per year had an odds ratio (OR)=0.7 (95% confidence interval (CI) (0.55 to 0.90), p=0.006), compared to sites with ≤2 assessments per patient per year. Compared to heterosexual exposure, SubAdh was higher in injecting drug users (IDUs) (OR=1.92, 95% CI (1.23 to 3.00), p=0.004) and lower in homosexual exposure (OR=0.52, 95% CI (0.38 to 0.71), p<0.001). Patients taking a nucleoside transcriptase inhibitor and protease inhibitor (NRTI+PI) combination were less likely to report adherence <100% (OR=0.36, 95% CI (0.20 to 0.67), p=0.001) compared to patients taking an NRTI and non-nucleoside transcriptase inhibitor (NRTI+NNRTI) combination. SubAdh decreased with increasing time on ART (all p<0.001). Similar associations were found with adherence <95% as the outcome. Conclusions We found that SubAdh, defined as either <100% and <95%, was associated with mode of HIV exposure, ART regimen, time on ART and frequency of adherence measurement. The more frequently sites assessed patients, the lower the SubAdh, possibly reflecting site resourcing for patient counselling. Although social

  12. Factors Associated with Adherence to Follow-up Colposcopy

    Science.gov (United States)

    Fish, Laura J.; Moorman, Patricia G.; Wordlaw-Stintson, Lashawn; Vidal, Adriana; Smith, Jennifer S.; Hoyo, Cathrine

    2013-01-01

    Background: Understanding the gaps in knowledge about human papilloma virus (HPV) infection, transmission, and health consequences and factors associated with the knowledge gap is an essential first step for the development of interventions to improve adherence to follow-up among women with abnormal Pap smears. Purpose: To examine the relationship…

  13. Treating depression in HIV-positive patients affects adherence

    African Journals Online (AJOL)

    2012-09-02

    Sep 2, 2012 ... reported that the number of people newly infected with HIV and the number .... and immunity. Subjects were ... of change in adherence as a response ..... retroviral drugs: Theorising contextual relationships. ... Drug-resistant HIV-1: The virus strikes back. ... persons with human immunodeficiency virus (HIV).

  14. Factors influencing medication knowledge and beliefs on warfarin adherence among patients with atrial fibrillation in China.

    Science.gov (United States)

    Zhao, Shujuan; Zhao, Hongwei; Wang, Xianpei; Gao, Chuanyu; Qin, Yuhua; Cai, Haixia; Chen, Boya; Cao, Jingjing

    2017-01-01

    Warfarin is often used for ischemic stroke prevention in patients with atrial fibrillation (AF), but the factors affecting patient adherence to warfarin therapy have not been fully understood. A cross-sectional survey was conducted in AF patients undergoing warfarin therapy at least 6 months prior to the study. The clinical data collected using questionnaires by phone interviews included the following: 1) self-reported adherence measured by the Morisky Medication Adherence Scale-8 © ; 2) beliefs about medicines surveyed by Beliefs about Medicines Questionnaire (BMQ); and 3) drug knowledge as measured by the Warfarin Related Knowledge Test (WRKT). Demographic and clinical factors associated with warfarin adherence were identified using a logistic regression model. Two hundred eighty-eight patients completed the survey and 93 (32.3%) of them were classified as nonadherent (Morisky Medication Adherence Scale-8 score beliefs in the necessity of their specific medications ([odds ratio {OR} =1.81, 95% confidence interval {CI} =1.51-2.15] and [OR =1.17, 95% CI =1.06-1.29], respectively). Patients with greater concerns about adverse reactions and more negative views of general harm were more likely to be nonadherent ([OR =0.76, 95% CI =0.69-0.84] and [OR =0.82, 95% CI =0.73-0.92], respectively). BMK and WRKT are related with patient behavior toward warfarin adherence. BMQ can be applied to identify patients at increased risk of nonadherence.

  15. Contributing factors for therapeutic diet adherence in patients receiving haemodialysis treatment: an integrative review.

    Science.gov (United States)

    Oquendo, Lissete González; Asencio, José Miguel Morales; de Las Nieves, Candela Bonill

    2017-12-01

    The objective of this integrative review is to identify the factors that contribute to diet adherence in people suffering from kidney disease who are receiving haemodialysis treatment. Adherence to the therapeutic regimen determines therapeutic success, quality of life and survival in patients on haemodialysis. Lack of diet adherence ranges from 25%-86% in patients receiving haemodialysis treatment and affects patient morbidity and mortality. An integrative literature review was conducted based on the criteria of Whittemore & Knafl. A literature review was performed by two members of the team using twelve databases including PubMed, CUIDEN, CINAHL, The Cochrane Library and ScienceDirect. The main issues identified after analysing the results were as follows: the intrinsic barriers (age, dialysis time, motivation, perceived benefit, distorted perception of adherence) and facilitators (self-efficacy, perception of disease, perception of control), extrinsic barriers (family dysfunction, lack of social support, cultural patterns of consumption of food) and facilitators (social support, relationship with healthcare providers), and interventions to encourage diet adherence, such as the use of motivational interviewing in educational interventions, and the training and education of relevant professionals in communication skills. Diet nonadherence remains a serious health problem and suffers from a lack of solid criteria to identify this condition. The onset of depression signs and the level of social support available to the patient should be assessed, because these are important factors that determine adherence to treatment. Professionals should be trained in health education and communication techniques to contribute to the patient's self-management and motivation for diet adherence. Controlled and randomised clinical studies involving predialysis stages should be performed to investigate the impact of the assessment and control of barriers to diet adherence. © 2017

  16. A Study on Adherence to Follow-up, Quality of Life, and Associated Factors Among Renal Transplant Recipients in China.

    Science.gov (United States)

    Zhao, L; Yan, J; Yang, G-L; Liu, Y

    Adherence to follow-up is vital for the medical surveillance of the postoperative blood concentration, but relatively little research has examined it, and there is less study on relationships between adherence to follow-up and quality of life (QoL). We investigated the status of adherence to follow-up and QoL and associated factors among kidney transplantation recipients in China. A cross-sectional study with the use of a Kidney Transplantation Recipient's Adherence to Follow-Up Questionnaire and a Quality of Life of Kidney Transplantation Recipients Questionnaire was conducted among 250 kidney transplantation recipients in Changsha, China, from January to March in 2015. The mean score for adherence to follow-up was 54.71 ± 6.46. Time after transplantation was the only factor affecting adherence to follow-up scores (β = -0.210; P adherence to follow-up, economic level, job status, donor source, and original disease affected with QoL. Adherence to follow-up decreases with time after transplantation, and better compliance is associated with better QoL in all areas. Improvements in adherence to follow-up, income and reimbursement, psychologic guidance, and social support may increase QoL of kidney transplantat recipients. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. A cohort study of possible risk factors for over-reporting of antihypertensive adherence

    Directory of Open Access Journals (Sweden)

    Lee Mei-Ling Ting

    2001-12-01

    Full Text Available Abstract Background The identification of poor medicinal adherence is difficult because direct observation of medication use is usually impractical. Up to 50% of individuals on chronic therapies may not be taking their medication as prescribed. This study is one of the first to explore possible risk factors for over-reporting of antihypertensive adherence using electronic medication monitoring. Methods The adherence of 286 individuals on single-drug antihypertensive therapy in a large managed care organization was electronically monitored for approximately three months. Questionnaires on socioeconomic background, adherence to therapy, health beliefs, and social support before and after adherence monitoring were completed. Over-reporting of antihypertensive adherence was assessed by comparing the self-reported frequency of noncompliance with that determined from electronic dosing records. Risk factors for over-reporting were identified by contingency table analysis and step-wise logistic regression. Results Although only 21% of participants acknowledged missing doses on one or more days per week, electronic monitoring documented nonadherence at this or a higher level in 42% of participants. The following variables were associated with over-reporting: >1 versus 1 daily dose (OR = 2.58; 95% CI = 1.50–4.41; p = .0006, lower perceived health risk from nonadherence (OR = 1.35; 95% CI = 1.10–1.64; p = .0035, and annual household income of $30,000 (OR = 2.64; 95% CI = 1.13–6.18; p = .025. Conclusions Over-reporting of adherence may be affected by factors related to dosing frequency, health beliefs and socioeconomic status. This topic deserves further investigation in other patient populations to elucidate possible underlying behavioral explanations.

  18. Factors affecting mining costs

    International Nuclear Information System (INIS)

    Lowell, A.F.

    1977-01-01

    The subject is discussed under the following headings: investment decision-making, unit cost factors (declining ore grade, low-price contracts, ore grade/output relationship, above average cost increases). Economic, environmental, sociological and political aspects are considered. (U.K.)

  19. Factors influencing long-term adherence to two previously implemented hospital guidelines

    NARCIS (Netherlands)

    Knops, A. M.; Storm-Versloot, M. N.; Mank, A. P. M.; Ubbink, D. T.; Vermeulen, H.; Bossuyt, P. M. M.; Goossens, A.

    2010-01-01

    After successful implementation, adherence to hospital guidelines should be sustained. Long-term adherence to two hospital guidelines was audited. The overall aim was to explore factors accounting for their long-term adherence or non-adherence. A fluid balance guideline (FBG) and body temperature

  20. Adherence to immunosuppression in adult lung transplant recipients : Prevalence and risk factors

    NARCIS (Netherlands)

    Bosma, Otto H.; Vermeulen, Karin M.; Verschuuren, Erik A.; Erasmus, Michiel E.; van der Bij, Wim

    2011-01-01

    BACKGROUND: Adherence to medication is a favourable with regard to survival after kidney, heart and liver transplantation. Little is known about adherence to medication in lung transplant recipients. To determine the prevalence of adherence and identify risk factors of non-adherence (NA) we

  1. Patient adherence to antihypertensive therapy and its individual psychological factors

    Directory of Open Access Journals (Sweden)

    Lidia Trachuk

    2016-09-01

    Full Text Available Background. In the treatment of chronic, especially asymptomatic pathology one of the main problem is the adherence to therapy. Patients with arterial hypertension need long-term, often lifelong medication, and how strictly they adhere to prescriptions often determines the course of the disease and the medical measures effectiveness. According to statistics, more than half of patients with hypertension are characterized by low compliance, which leads to complications of this disease. The objective of the research is to identify and analize the individual psychological factors that determine patient adherence to antihypertensive therapy. Methods and materials. This study was conducted during 2011-2013 at the cardiology departments of the Kyiv Alexander Hospital, polyclinics number 2 Shevchenko district in Kyiv, Desnyanskiy clinic №3 district in Kyiv, medical center "Adonis plus". We examined 203 patients with arterial hypertension (average age 53,5 ± 4,5 years. Methods: socio-demographic, clinical, clinical and psychological, psychodiagnostical, mathematical and statistical methods. Psychodiagnostical method included: 8-item Morisky medical adherence scale (Morisky D. E., 2008; self-assessment anxiety scale Charles D. Spielberger – Y.L Hanin (A.V. Batarshev, 2005; the Minnesota Multiphasic Personality Inventory questionnaire (MMRI (F.B. Berezin, 1994; "The level of subjective control" (A.A. Rean, 2001; "Index of attitudes to health" (S.D. Deryabo, VA Yasvin, 2000. Results. According to the results of 8-item Morisky medical adherence scale patients were divided into 3 groups according to the level of compliance - with high (26.11%, average (24.14% and low (49.75% levels of adherence to antihypertensive therapy. The individual-psychological predictors of poor adherence to antihypertensive therapy include the following personal characteristics of patients: a low level of intensity of attitude to health, internal type of subjective control, a

  2. Patients' views toward knee osteoarthritis exercise therapy and factors influencing adherence - a survey in China.

    Science.gov (United States)

    Zhou, Zhiwei; Hou, Yunfei; Lin, Jianhao; Wang, Kai; Liu, Qiang

    2018-05-01

    To understand the views toward exercise therapy for knee osteoarthritis (KOA) in China and to analyze factors affecting treatment adherence. A survey-based study, which included multiple choice and open-ended questions on knee OA exercise therapy was conducted in a Chinese population. The content included the respondents' attitudes and beliefs, willingness to receive treatment, and reasons why they could or could not adhere to the treatment. We used Chi-squared tests to compare cognitive differences between the patients and non-patient groups. A total of 1,069 people responded to the questionnaire, and the response rate was 81.8%. A total of 93.6% of the patients thought that they could adhere to the exercise treatment if they received professional advice and prescriptions. The following questionnaire items achieved consensus: 'Increasing the strength of the muscles around the knee stops the knee pain from getting worse,' 'It is the person's own responsibility to continue doing their exercise program,' 'How helpful the exercise program will be determines how well a person sticks to it,' 'Health professionals should educate patients with knee pain about how to change their lifestyle for the better,' and 'Exercise for knee pain is most helpful when it is designed for each person, to suit their own particular needs.' Patient adherence was affected by multiple factors, and some negative factors included 'forgetfulness,' 'getting joint symptoms improved after therapy,' 'professional guidance, subsequent monitoring and supervision,' 'willing to enhance overall health and quality of life,' 'having no time,' 'occupational factors,' 'considering that the pain would worsen while/after exercise,' and 'family factors.' A general Chinese population accepted exercise therapy for treating KOA in our survey. Education is necessary because patients were uncertain and had misunderstandings regarding the potential benefits of exercise therapy. Some factors related to treatment

  3. Cognitive-behavioral therapy for persistent pain: does adherence after treatment affect outcome?

    Science.gov (United States)

    Curran, Charlotte; Williams, Amanda C de C; Potts, Henry W W

    2009-02-01

    It is a tenet of cognitive behavioral treatment of persistent pain problems that ex-patients should adhere to treatment methods over the longer term, in order to maintain and to extend treatment gains. However, no research has quantified the causal influence of adherence on short-term outcome in this field. The aims of this study are to assess determinants of adherence to treatment recommendations in several domains, and to examine the extent to which cognitive and behavioral adherence predicts better outcome of cognitive behavioral treatment for persistent pain. Longitudinal data from a sample of 2345 persistent pain patients who attended a multicomponent treatment programme were subjected to structural equation modeling. Adherence emerged as a mediating factor linking post-treatment and follow-up treatment outcome, but contributed only 3% unique variance to follow-up outcomes. Combined end-of-treatment outcomes and adherence factors accounted for 72% of the variance in outcome at one-month follow-up. Notwithstanding shortcomings in the measurement of adherence, these findings question the emphasis normally given to adherence in the maintenance of behavioral and cognitive change, and clinical implications are discussed.

  4. Does the Number of Pharmacies a Patient Frequents Affect Adherence to Statins?

    Science.gov (United States)

    Christie, Russell; Sketris, Ingrid; Andreou, Pantalis; Holbrook, Anne; Levy, Adrian; Tamim, Hala

    2017-05-06

    We hypothesized that medication adherence is affected by the number of pharmacies a patient frequents. The objective was to estimate the strength of association between the number of pharmacies a patient frequents and adherence to statins. Using administrative data from the Nova Scotia Seniors' Pharmacare program, a retrospective cohort study was conducted among subjects aged 65 years and older first dispensed statin between 1998 and 2008. The Usual Provider of Care (UPC), was defined as the number of dispensation days from the most frequented pharmacy divided by the total number of dispensation days. Estimated adherence of over 80% of the Medication Possession Ratio was defined as adherent. Data were analyzed using hierarchical linear regression. The cohort of 25,641 subjects was 59% female with a mean age of 74 years. During follow-up, subjects filled prescriptions in a median of 2 (mean = 2; standard deviation = 0.88) pharmacies and visited pharmacies a median of 28 (mean = 30) times. During that time, 61% of patients used one pharmacy exclusively. Among subjects using 1 pharmacy, 59% were adherent while 58% using more than one pharmacy were adherent. However, upon adjustment for differences in distributions of age, sex, and other confounders, subjects who used more than one pharmacy had 10% decreased odds of statin adherence (odds ratio: 0.90, 95% confidence interval: 0.86-0.96). These results were robust in sensitivity analyses. Among seniors newly starting statin therapy, using a single community pharmacy was modestly associated with adherence.

  5. Factors influencing medication knowledge and beliefs on warfarin adherence among patients with atrial fibrillation in China

    Directory of Open Access Journals (Sweden)

    Zhao S

    2017-02-01

    Full Text Available Shujuan Zhao,1 Hongwei Zhao,1 Xianpei Wang,2 Chuanyu Gao,2 Yuhua Qin,1 Haixia Cai,1 Boya Chen,1 Jingjing Cao1 1Department of Pharmacy, 2Department of Cardiovascular Medicine, People’s Hospital of Henan Province, Zhengzhou, Henan, People’s Republic of China Objectives: Warfarin is often used for ischemic stroke prevention in patients with atrial fibrillation (AF, but the factors affecting patient adherence to warfarin therapy have not been fully understood. Methods: A cross-sectional survey was conducted in AF patients undergoing warfarin therapy at least 6 months prior to the study. The clinical data collected using questionnaires by phone interviews included the following: 1 self-reported adherence measured by the Morisky Medication Adherence Scale-8©; 2 beliefs about medicines surveyed by Beliefs about Medicines Questionnaire (BMQ; and 3 drug knowledge as measured by the Warfarin Related Knowledge Test (WRKT. Demographic and clinical factors associated with warfarin adherence were identified using a logistic regression model. Results: Two hundred eighty-eight patients completed the survey and 93 (32.3% of them were classified as nonadherent (Morisky Medication Adherence Scale-8 score <6. Major factors predicting warfarin adherence included age, cardiovascular disorders, WRKT, and BMQ; WRKT and BMQ were independently correlated with adherence to warfarin therapy by multivariate logistic regression analysis. Adherents were more likely to have greater knowledge scores and stronger beliefs in the necessity of their specific medications ([odds ratio {OR} =1.81, 95% confidence interval {CI} =1.51–2.15] and [OR =1.17, 95% CI =1.06–1.29], respectively. Patients with greater concerns about adverse reactions and more negative views of general harm were more likely to be nonadherent ([OR =0.76, 95% CI =0.69–0.84] and [OR =0.82, 95% CI =0.73–0.92], respectively. Conclusion: BMK and WRKT are related with patient behavior toward warfarin

  6. Factors influencing adherence to antiretroviral treatment in\\ud Asian developing countries: a systematic review

    OpenAIRE

    Wasti, Sharada Prasad; Van Teijlingen, Edwin; Simkhada, Padam; Randall, Julian; Baxter, Susan; Kirkpatrick, P.; Vijay Singh, G.C.

    2011-01-01

    Objective To systematically review the literature of factors affecting adherence to Antiretroviral treatment (ART) in Asian developing countries.\\ud Methods Database searches in Medline ⁄ Ovid, Cochrane library, CINAHL, Scopus and PsychINFO for studies published between 1996 and December 2010. The reference lists of included papers were also checked, with citation searching on key papers.\\ud Results A total of 437 studies were identified, and 18 articles met the inclusion criteria and were ex...

  7. Analysis of the factors that prevent adherence to treatment in patients with diabetes mellitus and the strategies that contribute to the improvement in adherence

    Directory of Open Access Journals (Sweden)

    Natalia V. Likhodey

    2018-03-01

    Full Text Available This review examined the current problem of low adherence to treatment in patients with chronic diseases, particularly type 2 diabetes mellitus. According to the definition of the World Health Organization, ‘adherence to treatment’ is the degree to which a patient’s behaviour corresponds to the doctor’s recommendations with respect to medications and implementation of dietary advice and/or lifestyle changes. The current medical literature includes a large number of scientific publications devoted to the study of various factors that lead to low adherence to treatment. The term ‘barriers’ is most often used to designate these factors. The first part of this work contains an analysis of the main factors that impede compliance to the doctor’s recommendations, such as socioeconomic and psychological (personal barriers related to the disease itself, the peculiarities of its treatment and the organisation of medical care (the health care system. The second part of this review examines the different theoretical models of patient behaviour and strategies that improve adherence to treatment. Most researchers believe that there is an unsatisfactory (low adherence to treatment and that none of the existing intervention strategies can improve adherence to treatment among all patients. The cornerstone of the entire diabetes management system is the training of patients within the framework of developed structured programmes. Conversely,, success depends on the individual approach, the course of the disease and the mandatory consideration of the individual psychological characteristics of each person. Establishment of a partnership built on trust between a doctor and a patient contributes to greater patient satisfaction with treatment and improved adherence, and this relationship ultimately affects the treatment efficacy and clinical outcomes.

  8. Use of protection motivation theory, affect, and barriers to understand and predict adherence to outpatient rehabilitation.

    Science.gov (United States)

    Grindley, Emma J; Zizzi, Samuel J; Nasypany, Alan M

    2008-12-01

    Protection motivation theory (PMT) has been used in more than 20 different health-related fields to study intentions and behavior, albeit primarily outside the area of injury rehabilitation. In order to examine and predict patient adherence behavior, this study was carried out to explore the use of PMT as a screening tool in a general sample of people with orthopedic conditions. New patients who were more than 18 years old and who were prescribed 4 to 8 weeks of physical therapy treatment (n=229) were administered a screening tool (Sports Injury Rehabilitation Beliefs Scale, Positive and Negative Affect Schedule, and a barriers checklist) prior to treatment. Participants' adherence was assessed with several attendance measures and an in-clinic assessment of behavior. Statistical analyses included correlation, chi-square, multiple regression, and discriminant function analyses. A variety of relationships among affect, barriers, and PMT components were evident. In-clinic behavior and attendance were influenced by affect, whereas dropout status was predicted by affect, severity, self-efficacy, and age. The screening tool used in this study may assist in identifying patients who are at risk for poor adherence and provide valuable information to enhance provider-patient relationships and foster patient adherence. However, it is recommended that more research be conducted to further understand the impact of variables on patient adherence and that the screening tool be enhanced to increase its predictive ability.

  9. Behavioral and Pharmacological Adherence in Pediatric Sickle Cell Disease: Parent-Child Agreement and Family Factors Associated With Adherence.

    Science.gov (United States)

    Klitzman, Page H; Carmody, Julia K; Belkin, Mary H; Janicke, David M

    2018-01-01

    This study aimed to evaluate agreement between children and parents on a measure of behavioral and pharmacological adherence in children with sickle cell disease (SCD), and the associations among family factors (i.e., problem-solving skills, routines, communication) and adherence behaviors. In all, 85 children (aged 8-18 years) with SCD and their parents completed questionnaires assessing individual and family factors. Overall parent-child agreement on an adherence measure was poor, particularly for boys and older children. Greater use of child routines was associated with better overall child-reported adherence. Open family communication was associated with higher overall parent-reported adherence. While further research is needed before definitive conclusions can be drawn, results suggest the need to assess child adherence behaviors via both child and parent reports. Findings also suggest that more daily family routines and open family communication may be protective factors for better disease management. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  10. Factors Affecting Medical Service Quality.

    Science.gov (United States)

    Mosadeghrad, Ali Mohammad

    2014-02-01

    A better understanding of factors influencing quality of medical service can pinpoint better strategies for quality assurance in medical services. This study aimed to identify factors affecting the quality of medical services provided by Iranian physicians. Exploratory in-depth individual interviews were conducted with sixty-four physicians working in various medical institutions in Iran. Individual, organizational and environmental factors enhance or inhibit the quality of medical services. Quality of medical services depends on the personal factors of the physician and patient, and factors pertaining to the healthcare setting and the broader environment. Differences in internal and external factors such as availability of resources, patient cooperation and collaboration among providers affect the quality of medical services and patient outcomes. Supportive leadership, proper planning, education and training and effective management of resources and processes improve the quality of medical services. This article contributes to healthcare theory and practice by developing a conceptual framework for understanding factors that influence medical services quality.

  11. [Factors associated with treatment adherence for tuberculosis infection].

    Science.gov (United States)

    Gallardo, Carmen R; Gea Velázquez de Castro, María Teresa; Requena Puche, Juana; Miralles Bueno, Juan José; Rigo Medrano, María Vicenta; Aranaz Andrés, Jesús M

    2014-01-01

    To analyze adherence to treatment of tuberculosis infection and to identify risk factors for its compliance. An observational historical cohort study. Hospital Universitari Sant Joan d'Alacant (Alicante). All patients with a tuberculin skin test (TST) done during tuberculosis contact tracing during 6 years. We included 764 tuberculosis contacts in the analysis. 59.7% of the 566 patients who completed the contact tracing, had tuberculosis infection (TI). Of the patients with TI, 45.6% had not started treatment for tuberculosis infection (TTBI). Factors associated with not starting TTBI were: age (36-65 years, RR: 5.8; 95% CI: 1.2-27.5, and > 65 years, RR: 11.3; 95% CI: 2.0-64.0), the social relationship with TB case (RR: 2.2; 95% CI 1.2-3.8), and the TST reaction (≥ 15mm; RR: 0.5; 95% CI: 0.3-0.9). The completion rate for TTBI was 80.4% among people who started therapy. The treatment regimen was associated with greater compliance to TTBT (7-9H, RR: 12.7; 95% CI: 1.5-107.3). The treatment compliance rate of Tuberculosis infection was high among people who started therapy. Almost a half of the contacts with TI did not start treatment, and associated factors were: age, social relationship, and the TST reaction. The treatment regimen was associated with greater compliance. It is important to know the factors associated with adherence to treatment of TI in each health area, and focus efforts on risk groups; thereby approaching the global control of tuberculosis. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  12. Factors Influencing Antiretroviral Adherence and Virological Outcomes in People Living with HIV in the Highlands of Papua New Guinea.

    Directory of Open Access Journals (Sweden)

    Janet Gare

    Full Text Available Adherence to antiretroviral therapy (ART is paramount for virological suppression and positive treatment outcomes. ART has been rapidly scaled up in Papua New Guinea (PNG in recent years, however clinical monitoring of HIV+ individuals on ART is limited. A cross-sectional study was conducted at two major sexual health clinics in high HIV prevalence provinces in the Highlands Region of PNG to assess ART adherence, factors affecting adherence and the relationship between ART adherence and virological outcomes. Ninety-five HIV+ individuals were recruited and administered a questionnaire to gather demographic and ART adherence information whilst clinical data and pill counts were extracted from patient charts and blood was collected for viral load testing. Bivariate analysis was performed to identify independent predictors of ART adherence. Fourteen percent (n = 12 of participants showed evidence of virological failure. Although the majority of participants self-reported excellent ART adherence in the last seven days (78.9%, 75/91, pill count measurements indicated only 40% (34/84 with >95% adherence in the last month. Taking other medications while on ART (p = 0.01 and taking ART for ≥1 year (p = 0.037 were positively associated with adherence by self-report and pill count, respectively. Participants who had never heard of drug resistance were more likely to show virological failure (p = 0.033. Misconception on routes of HIV transmission still persists in the studied population. These findings indicate that non-adherence to ART is high in this region of PNG and continued education and strategies to improve adherence are required to ensure the efficacy of ART and prevent HIV drug resistance.

  13. COPD patients’ self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation

    Directory of Open Access Journals (Sweden)

    Pierobon A

    2017-07-01

    Full Text Available Antonia Pierobon,1 Elisa Sini Bottelli,1 Laura Ranzini,1 Claudio Bruschi,2 Roberto Maestri,3 Giorgio Bertolotti,4 Marinella Sommaruga,5 Valeria Torlaschi,1 Simona Callegari,1 Anna Giardini1 1Psychology Unit, 2Department of Pulmonary Rehabilitation, 3Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri, IRCCS, Montescano, 4Psychology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Tratate, 5Clinical Psychology and Social Support Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Camaldoli, Italy Abstract: In addition to clinical comorbidities, psychological and neuropsychological problems are frequent in COPD and may affect pulmonary rehabilitation delivery and outcome. The aims of the study were to describe a COPD population in a rehabilitative setting as regards the patients depressive symptoms, anxiety, mild cognitive impairment (MCI and self-reported adherence and to analyze their relationships; to compare the COPD sample MCI scores with normative data; and to investigate which factors might predict adherence to prescribed physical exercise. This was a multicenter observational cross-sectional study. Of the 117 eligible stable COPD inpatients, 84 were enrolled according to Global initiative for chronic Obstructive Lung Disease (GOLD criteria (mainly in Stage III–IV. The assessment included Mini Mental State Examination (MMSE, Montreal Cognitive Assessment (MoCA, anxiety, depression and self-reported pharmacological and nonpharmacological adherence. From the MMSE, 3.6% of patients were found to be impaired, whereas from the MoCA 9.5% had a likely MCI. Patients referred had mild-severe depression (46.7%, anxiety (40.5%, good pharmacological adherence (80.3% and difficulties in following prescribed diet (24.1% and exercise (51.8%; they struggled with disease acceptance (30.9% and disease limitations acceptance (28.6%. Most of them received good family (89% or social (53% support. Nonpharmacological adherence

  14. Factors associated with medication adherence in school-aged children with asthma

    Directory of Open Access Journals (Sweden)

    Amy H.Y. Chan

    2016-03-01

    Full Text Available Adherence to preventive asthma treatment is poor, particularly in children, yet the factors associated with adherence in this age group are not well understood. Adherence was monitored electronically over 6 months in school-aged children who attended a regional emergency department in New Zealand for an asthma exacerbation and were prescribed twice-daily inhaled corticosteroids. Participants completed questionnaires including assessment of family demographics, asthma responsibility and learning style. Multivariable analysis of factors associated with adherence was conducted. 101 children (mean (range age 8.9 (6–15 years, 51% male participated. Median (interquartile range preventer adherence was 30% (17–48% of prescribed. Four explanatory factors were identified: female sex (+12% adherence, Asian ethnicity (+19% adherence, living in a smaller household (−3.0% adherence per person in the household, and younger age at diagnosis (+2.7% for every younger year of diagnosis (all p<0.02. In school-aged children attending the emergency department for asthma, males and non-Asian ethnic groups were at high risk for poor inhaled corticosteroid adherence and may benefit most from intervention. Four factors explained a small proportion of adherence behaviour indicating the difficulty in identifying adherence barriers. Further research is recommended in other similar populations.

  15. Factors that determine self-reported immunosuppressant adherence in kidney transplant recipients: a correlational study.

    Science.gov (United States)

    Weng, Li-Chueh; Yang, Ya-Chen; Huang, Hsiu-Li; Chiang, Yang-Jen; Tsai, Yu-Hsia

    2017-01-01

    To determine the factors related to immunosuppressant therapy adherence in kidney transplant recipients in Taiwan. Adherence to immunosuppressant treatment is critical after kidney transplantation. Thus, the factors associated with self-reported medication adherence in kidney transplant recipients warrant investigation. The study used a cross-sectional and correlation design. A convenience sample of 145 kidney transplant recipients was included. Structured questionnaires were used to collect data during 2012-2013. Multivariate linear regression was used to examine the factors related to immunosuppressant therapy adherence. Over half of the participants were female (54·5%), mean age was 45·5 years, and mean year after transplant was 7·4. The mean score for medication adherence was 29·73 (possible score range 7-35). The results of the multivariate linear regression analysis showed that gender (male), low income with a high school or college education, years after transplantation and concerns about medication taking were negatively associated with adherence. Medication self-efficacy was positively associated with adherence. Therapy-related factors, partnerships with healthcare professionals and having private healthcare insurance did not significantly relate to immunosuppressant therapy adherence. Kidney transplant recipients demonstrated a high level of adherence. Strategies to enhance patients' self-efficacy and alleviate concerns about medication may promote medication adherence. Male patients, those with a lower income and those with a higher education level, should be a focus of efforts to maintain adherence to the medication regimen. © 2016 John Wiley & Sons Ltd.

  16. Factors affecting construction performance: exploratory factor analysis

    Science.gov (United States)

    Soewin, E.; Chinda, T.

    2018-04-01

    The present work attempts to develop a multidimensional performance evaluation framework for a construction company by considering all relevant measures of performance. Based on the previous studies, this study hypothesizes nine key factors, with a total of 57 associated items. The hypothesized factors, with their associated items, are then used to develop questionnaire survey to gather data. The exploratory factor analysis (EFA) was applied to the collected data which gave rise 10 factors with 57 items affecting construction performance. The findings further reveal that the items constituting ten key performance factors (KPIs) namely; 1) Time, 2) Cost, 3) Quality, 4) Safety & Health, 5) Internal Stakeholder, 6) External Stakeholder, 7) Client Satisfaction, 8) Financial Performance, 9) Environment, and 10) Information, Technology & Innovation. The analysis helps to develop multi-dimensional performance evaluation framework for an effective measurement of the construction performance. The 10 key performance factors can be broadly categorized into economic aspect, social aspect, environmental aspect, and technology aspects. It is important to understand a multi-dimension performance evaluation framework by including all key factors affecting the construction performance of a company, so that the management level can effectively plan to implement an effective performance development plan to match with the mission and vision of the company.

  17. Perspectives of patients on factors relating to adherence to post-acute coronary syndrome medical regimens

    Directory of Open Access Journals (Sweden)

    Lambert-Kerzner A

    2015-07-01

    Full Text Available Anne Lambert-Kerzner,1,2 Edward P Havranek,2,3 Mary E Plomondon,1,2 Katherine M Fagan,1 Marina S McCreight,1 Kelty B Fehling,1 David J Williams,2 Alison B Hamilton,4 Karen Albright,2 Patrick J Blatchford,2 Renee Mihalko-Corbitt,5 Chris L Bryson,6 Hayden B Bosworth,7 Miriam A Kirshner,7 Eric J Del Giacco,5 P Michael Ho1,2 1Department of Cardiology, Veterans Health Administration (VA Eastern Colorado Health Care System, Denver, CO, 2School of Public Health or School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, 3Cardiology, Denver Health Medical Center, Denver, CO, 4Health Services Research, Veterans Health Administration (VA Greater Los Angeles Healthcare System, Los Angeles, CA, 5Internal Medicine, John L. McClellan Memorial Veterans Hospital, Little Rock, AR, 6Health Services Research, Veterans Health Administration (VA Puget Sound Health Care System, Seattle, WA, 7Health Services Research, Durham Veterans Affairs Medical Center, Durham, NC, USA Purpose: Poor adherence to cardioprotective medications after acute coronary syndrome (ACS hospitalization is associated with increased risk of rehospitalization and mortality. Clinical trials of multifaceted interventions have improved medication adherence with varying results. Patients’ perspectives on interventions could help researchers interpret inconsistent outcomes. Identifying factors that patients believe would improve adherence might inform the design of future interventions and make them more parsimonious and sustainable. The objective of this study was to obtain patients’ perspectives on adherence to medical regimens after experiencing an ACS event and their participation in a medication adherence randomized control trial following their hospitalization. Patients and methods: Sixty-four in-depth interviews were conducted with ACS patients who participated in an efficacious, multifaceted, medication adherence randomized control trial. Interview transcripts were

  18. Knowledge of HIV-AIDS a dominant factor of antiretroviral therapeutic adherence in women with HIV-AIDS

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    Surilena

    2015-08-01

    Full Text Available Background Antiretroviral therapy adherence (ART adherence is a factor significantly extending life expectancy of people living with HIV/AIDS. The objective of this study was determine several factors on ART adherence in women infected with HIV/AIDS. Methods A cross-sectional study involving 99 women with HIV/AIDS who were infected through their sexual partner or spouse was conducted in Dharmais Hospital between March and August 2014. The instruments used were demographic and self-esteem questionnaires, Hamilton rating scale for depression, Hamilton rating scale for anxiety, knowledge, perception of ART benefits and limitations, family support, peer support as well as assessment of ART adherence. The knowledge questionnaire has been validated with Cronbach’s alpha = 0.823. Data were analyzed using Chi-Square test and multivariate logistic regression. Results A total of 99 women with HIV/AIDS participated in the study, with an age range of 30- 60 years and mean age of 36 ± 3.72 years. A total of 57.58% of participants showed poor ART adherence. Multivariate logistic regression analysis showed that knowledge, ART side effects, depression, peer support and ARV availability significantly affected ART adherence (p<0.05. The most dominant factor affecting ART adherence was knowledge, with OR = 64.02 (95% CI 4.99-670.12. Conclusion With good knowledge about HIV/AIDS infection, ART benefits, and possible ARV side effects, women living with HIV/AIDS are expected to carry out ART adherence according to the recommended rules.

  19. COPD patients' self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation.

    Science.gov (United States)

    Pierobon, Antonia; Sini Bottelli, Elisa; Ranzini, Laura; Bruschi, Claudio; Maestri, Roberto; Bertolotti, Giorgio; Sommaruga, Marinella; Torlaschi, Valeria; Callegari, Simona; Giardini, Anna

    2017-01-01

    In addition to clinical comorbidities, psychological and neuropsychological problems are frequent in COPD and may affect pulmonary rehabilitation delivery and outcome. The aims of the study were to describe a COPD population in a rehabilitative setting as regards the patients depressive symptoms, anxiety, mild cognitive impairment (MCI) and self-reported adherence and to analyze their relationships; to compare the COPD sample MCI scores with normative data; and to investigate which factors might predict adherence to prescribed physical exercise. This was a multicenter observational cross-sectional study. Of the 117 eligible stable COPD inpatients, 84 were enrolled according to Global initiative for chronic Obstructive Lung Disease (GOLD) criteria (mainly in Stage III-IV). The assessment included Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), anxiety, depression and self-reported pharmacological and nonpharmacological adherence. From the MMSE, 3.6% of patients were found to be impaired, whereas from the MoCA 9.5% had a likely MCI. Patients referred had mild-severe depression (46.7%), anxiety (40.5%), good pharmacological adherence (80.3%) and difficulties in following prescribed diet (24.1%) and exercise (51.8%); they struggled with disease acceptance (30.9%) and disease limitations acceptance (28.6%). Most of them received good family (89%) or social (53%) support. Nonpharmacological adherence, depression, anxiety and MCI showed significant relations with 6-minute walking test, body mass index (BMI) and GOLD. Depression was related to autonomous long-term oxygen therapy modifications, disease perception, family support and MCI. In the multivariate logistic regression analysis, higher BMI, higher depression and lower anxiety predicted lower adherence to exercise prescriptions ( P =0.0004, odds ratio =0.796, 95% CI =0.701, 0.903; P =0.009, odds ratio =0.356, 95% CI =0.165, 0.770; and P =0.05, odds ratio =2.361, 95% CI =0.995, 5

  20. Psychological factors affecting equine performance

    OpenAIRE

    McBride, Sebastian D; Mills, Daniel S

    2012-01-01

    Abstract For optimal individual performance within any equestrian discipline horses must be in peak physical condition and have the correct psychological state. This review discusses the psychological factors that affect the performance of the horse and, in turn, identifies areas within the competition horse industry where current behavioral research and established behavioral modification techniques could be applied to further enhance the performance of animals. In particular, the role of af...

  1. [Factors that influence treatment adherence in chronic disease patients undergoing hemodialysis].

    Science.gov (United States)

    Maldaner, Cláudia Regina; Beuter, Margrid; Brondani, Cecília Maria; Budó, Maria de Lourdes Denardin; Pauletto, Macilene Regina

    2008-12-01

    The following bibliographical research wanted to identify the main factors that influence adherence to treatment in chronic disease. The study focused on patients undergoing hemodialysis, as well as on the support nurses require for the promotion of health education among individuals with low treatment adherence. The identification of bibliographical sources was conducted at Health Virtual Library and Scientific Electronic Library Online (SciELO) data bases. Some printed magazines were also used. The results indicated nine factors influencing treatment adherence or non-adherence: team trust, support nets, educational level; accepting disease, treatment side effects, lack of access to medicines, long-term treatment, complex therapeutic approach, and lack of symptoms. It is advisable that nurses take into account these factors when dealing with chronic-disease patients that present low treatment adherence, getting family and multidisciplinary team support seeking treatment adherence.

  2. Which psychosocial factors are related to chelation adherence in thalassemia? A systematic review.

    Science.gov (United States)

    Evangeli, Michael; Mughal, Kulsoom; Porter, John B

    2010-06-01

    Good adherence to iron chelation therapy in thalassemia is crucial. Although there is evidence that adherence is related to regimen factors, there has been less emphasis on the relationship between psychosocial (psychological, demographic and social) factors and adherence. We present a systematic review of psychosocial correlates of chelation adherence in thalassemia. Nine studies met the inclusion criteria. Information was extracted regarding the study characteristics and the relationship between psychosocial factors and chelation adherence. Methodological quality was rated. The studies took place in a range of countries, were mostly cross sectional in design, and examined adherence to deferoxamine (DFO) only. Sample sizes ranged from 15 to 1573. A variety of psychosocial variables were examined. Definitions of adherence varied between studies and non adherence rates were also variable (9 to 66%). Older age was consistently associated with lower levels of chelation adherence. There were few other consistent findings. The methodological quality of studies was variable. There is a need for more methodologically sophisticated and theoretically informed studies on psychosocial correlates of chelation adherence. We offer specific suggestions.

  3. Psychological factors affecting equine performance

    Directory of Open Access Journals (Sweden)

    McBride Sebastian D

    2012-09-01

    Full Text Available Abstract For optimal individual performance within any equestrian discipline horses must be in peak physical condition and have the correct psychological state. This review discusses the psychological factors that affect the performance of the horse and, in turn, identifies areas within the competition horse industry where current behavioral research and established behavioral modification techniques could be applied to further enhance the performance of animals. In particular, the role of affective processes underpinning temperament, mood and emotional reaction in determining discipline-specific performance is discussed. A comparison is then made between the training and the competition environment and the review completes with a discussion on how behavioral modification techniques and general husbandry can be used advantageously from a performance perspective.

  4. Factors associated with false-positive self-reported adherence to antihypertensive drugs.

    Science.gov (United States)

    Tedla, Y G; Bautista, L E

    2017-05-01

    Self-reported medication adherence is known to overestimate true adherence. However, little is known about patient factors that may contribute to the upward bias in self-reported medication adherence. The objective of this study is to examine whether demographic, behavioral, medication and mood factors are associated with being a false-positive self-reported adherer (FPA) to antihypertensive drug treatment. We studied 175 patients (mean age: 50 years; 57% men) from primary-care clinics starting antihypertensive drug treatment. Self-reported adherence (SRA) was measured with the Medication Adherence Report Scale (MARS) and by the number of drug doses missed in the previous week/month, and compared with pill count adherence ratio (PCAR) as gold standard. Data on adherence, demographic, behavioral, medication and mood factors were collected at baseline and every 3 months up to 1 year. FPA was defined as being a non-adherer by PCAR and an adherer by self-report. Mixed effect logistic regression was used for the analysis. Twenty percent of participants were FPA. Anxiety increased (odds ratio (OR): 3.00; P=0.01), whereas smoking (OR: 0.40; P=0.03) and drug side effects (OR: 0.46, P=0.03) decreased the probability for FPA by MARS. Education below high-school completion increased the probability of being an FPA as measured by missing doses in the last month (OR: 1.66; P=0.04) and last week (OR: 1.88; P=0.02). The validity of SRA varies significantly according to drug side effects, behavioral factors and patient's mood. Careful consideration should be given to the use of self-reported measures of adherence among patients likely to be false-positive adherers.

  5. Factors associated with non-adherence to highly active antiretroviral therapy in Nairobi, Kenya

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    Wakibi Samwel N

    2011-12-01

    Full Text Available Abstract Background Antiretroviral therapy (ART requires high-level (> 95% adherence. Kenya is rolling out ART access programmes and, issue of adherence to therapy is therefore imperative. However, published data on adherence to ART in Kenya is limited. This study assessed adherence to ART and identified factors responsible for non adherence in Nairobi. Methods This is a multiple facility-based cross-sectional study, where 416 patients aged over 18 years were systematically selected and interviewed using a structured questionnaire about their experience taking ART. Additional data was extracted from hospital records. Patients were grouped into adherent and non-adherent based on a composite score derived from a three questions adherence tool developed by Center for Adherence Support Evaluation (CASE. Multivariate regression model was used to determine predictors of non-adherence. Results Overall, 403 patients responded; 35% males and 65% females, 18% were non-adherent, and main (38% reason for missing therapy were being busy and forgetting. Accessing ART in a clinic within walking distance from home (OR = 2.387, CI.95 = 1.155-4.931; p = 0.019 and difficulty with dosing schedule (OR = 2.310, CI.95 = 1.211-4.408, p = 0.011 predicted non-adherence. Conclusions The study found better adherence to HAART in Nairobi compared to previous studies in Kenya. However, this can be improved further by employing fitting strategies to improve patients' ability to fit therapy in own lifestyle and cue-dose training to impact forgetfulness. Further work to determine why patients accessing therapy from ARV clinics within walking distance from their residence did not adhere is recommended.

  6. The role of Patient Health Engagement Model (PHE-model in affecting patient activation and medication adherence: A structural equation model.

    Directory of Open Access Journals (Sweden)

    Guendalina Graffigna

    Full Text Available Increasing bodies of scientific research today examines the factors and interventions affecting patients' ability to self-manage and adhere to treatment. Patient activation is considered the most reliable indicator of patients' ability to manage health autonomously. Only a few studies have tried to assess the role of psychosocial factors in promoting patient activation. A more systematic modeling of the psychosocial factors explaining the variance of patient activation is needed.To test the hypothesized effect of patient activation on medication adherence; to test the the hypothesized effects of positive emotions and of the quality of the patient/doctor relationship on patient activation; and to test the hypothesized mediating effect of Patient Health Engagement (PHE-model in this pathway.This cross-sectional study involved 352 Italian-speaking adult chronic patients. The survey included measures of i patient activation (Patient Activation Measure 13 -short form; ii Patient Health Engagement model (Patient Health Engagement Scale; iii patient adherence (4 item-Morinsky Medication Adherence Scale; iv the quality of the patients' emotional feelings (Manikin Self Assessment Scale; v the quality of the patient/doctor relationship (Health Care Climate Questionnaire. Structural equation modeling was used to test the hypotheses proposed.According to the theoretical model we hypothesized, research results confirmed that patients' activation significantly affects their reported medication adherence. Moreover, psychosocial factors, such as the patients' quality of the emotional feelings and the quality of the patient/doctor relationship were demonstrated to be factors affecting the level of patient activation. Finally, the mediation effect of the Patient Health Engagement model was confirmed by the analysis.Consistently with the results of previous studies, these findings demonstrate that the Patient Health Engagement Model is a critical factor in

  7. The role of Patient Health Engagement Model (PHE-model) in affecting patient activation and medication adherence: A structural equation model.

    Science.gov (United States)

    Graffigna, Guendalina; Barello, Serena; Bonanomi, Andrea

    2017-01-01

    Increasing bodies of scientific research today examines the factors and interventions affecting patients' ability to self-manage and adhere to treatment. Patient activation is considered the most reliable indicator of patients' ability to manage health autonomously. Only a few studies have tried to assess the role of psychosocial factors in promoting patient activation. A more systematic modeling of the psychosocial factors explaining the variance of patient activation is needed. To test the hypothesized effect of patient activation on medication adherence; to test the the hypothesized effects of positive emotions and of the quality of the patient/doctor relationship on patient activation; and to test the hypothesized mediating effect of Patient Health Engagement (PHE-model) in this pathway. This cross-sectional study involved 352 Italian-speaking adult chronic patients. The survey included measures of i) patient activation (Patient Activation Measure 13 -short form); ii) Patient Health Engagement model (Patient Health Engagement Scale); iii) patient adherence (4 item-Morinsky Medication Adherence Scale); iv) the quality of the patients' emotional feelings (Manikin Self Assessment Scale); v) the quality of the patient/doctor relationship (Health Care Climate Questionnaire). Structural equation modeling was used to test the hypotheses proposed. According to the theoretical model we hypothesized, research results confirmed that patients' activation significantly affects their reported medication adherence. Moreover, psychosocial factors, such as the patients' quality of the emotional feelings and the quality of the patient/doctor relationship were demonstrated to be factors affecting the level of patient activation. Finally, the mediation effect of the Patient Health Engagement model was confirmed by the analysis. Consistently with the results of previous studies, these findings demonstrate that the Patient Health Engagement Model is a critical factor in enhancing

  8. The effects of psychological factors in sports medicine rehabilitation adherence.

    Science.gov (United States)

    Lampton, C C; Lambert, M E; Yost, R

    1993-09-01

    This study investigated the influence of achievement motivation and self-esteem on injury treatment adherence in a general sample of injured patients receiving treatment in a sports medicine clinic. Subjects consisted of both injured athletes and workers who had incurred an on-the-job injury. Based on scales of self-esteem and achievement motivation, patients were categorized as either high or low in self-esteem certainty, self-esteem level, tendency to be task-involved, and tendency to ego-involved in tasks. Treatment adherence was measured by number of missed appointments and by physical therapist ratings of effort and progress. It was found that patients low in self-esteem certainty and high in ego-involvement tended to miss the most treatment appointments. Contrary to previous findings, task-involvement was not found to be related to treatment adherence.

  9. Generic substitution of antidiabetic drugs in the elderly does not affect adherence

    Directory of Open Access Journals (Sweden)

    Francesco Trotta

    2014-12-01

    Full Text Available INTRODUCTION: The possibility that variation in packaging and pill appearance may reduce adherence is a reason for concern, especially for chronic diseases. The objectives of the study were to quantify the extent of switches between generic antidiabetics and to verify whether switching between different products of the same substance affects adherence. MATERIALS AND METHODS: All elderly residents of the Umbria Region who received at least 2 prescriptions of antidiabetics in 2010 and 2011 were included in the study. Switching was defined as the dispensing of two different products of the same substance in a series of two prescriptions. Single and multiple switchers were identified according to the number of switches during 2011. Switching relevant to the three off-patent substances with generic use ≥ 5% (metformin, gliclazide and repaglinide was quantified. The effect of switching on adherence, defined as the proportion of days in 2011 covered by prescriptions (Medication Possession Ratio, MPR, was estimated. RESULTS: Among the 15 964 patients receiving antidiabetics (14.4% of the elderly population 9211 were prescribed at least one of the generic substances. Of these patients, 23.3% experienced a single switch and 15.7% were multiple switchers (61.0% never switched. The proportion of multiple switchers increased with the number of prescriptions, reaching 26% among patients with ≥ 11 prescriptions. MPR was 62%, 62% and 72%, respectively among non-switchers, single and multiple switchers. CONCLUSIONS: In elderly patients treated with antidiabetics, the substitution between branded and unbranded products (as well as between generics of the same substance, did not negatively affect adherence.

  10. Factors associated to acceptable treatment adherence among children with chronic kidney disease in Guatemala.

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    Brooke M Ramay

    Full Text Available Pediatric patients with Chronic Kidney Disease face several barriers to medication adherence that, if addressed, may improve clinical care outcomes. A cross sectional questionnaire was administered in the Foundation for Children with Kidney Disease (FUNDANIER, Guatemala City from September of 2015 to April of 2016 to identify the predisposing factors, enabling factors and need factors related to medication adherence. Sample size was calculated using simple random sampling with a confidence level of 95%, confidence interval of 0.05 and a proportion of 87%. A total of 103 participants responded to the questionnaire (calculated sample size was 96. Independent variables were defined and described, and the bivariate relationship to dependent variables was determined using Odds Ratio. Multivariate analysis was carried out using logistic regression. The mean adherence of study population was 78% (SD 0.08, max = 96%, min = 55%. The mean adherence in transplant patients was 82% (SD 7.8, max 96%, min 63%, and the mean adherence in dialysis patients was 76% (SD 7.8 max 90%, min 55%. Adherence was positively associated to the mother's educational level and to higher monthly household income. Together predisposing, enabling and need factors illustrate the complexities surrounding adherence in this pediatric CKD population. Public policy strategies aimed at improving access to comprehensive treatment regimens may facilitate treatment access, alleviating economic strain on caregivers and may improve adherence outcomes.

  11. Factors influencing adherence to guidelines in general practice

    NARCIS (Netherlands)

    Stewart, RE; Vroegop, S; van der Werf, GT; Meyboom-de Jong, B; Kamps, G.

    2003-01-01

    Objectives: To identify and assess the effects of general practitioner and patient characteristics on global adherence to pharmacotherapeutic guidelines. Methods: In a cross-sectional study in the northern Netherlands, a two-level multilevel model was applied to patients (n = 269,067) in 190

  12. Factors affecting dental service quality.

    Science.gov (United States)

    Bahadori, Mohammadkarim; Raadabadi, Mehdi; Ravangard, Ramin; Baldacchino, Donia

    2015-01-01

    Measuring dental clinic service quality is the first and most important factor in improving care. The quality provided plays an important role in patient satisfaction. The purpose of this paper is to identify factors affecting dental service quality from the patients' viewpoint. This cross-sectional, descriptive-analytical study was conducted in a dental clinic in Tehran between January and June 2014. A sample of 385 patients was selected from two work shifts using stratified sampling proportional to size and simple random sampling methods. The data were collected, a self-administered questionnaire designed for the purpose of the study, based on the Parasuraman and Zeithaml's model of service quality which consisted of two parts: the patients' demographic characteristics and a 30-item questionnaire to measure the five dimensions of the service quality. The collected data were analysed using SPSS 21.0 and Amos 18.0 through some descriptive statistics such as mean, standard deviation, as well as analytical methods, including confirmatory factor. Results showed that the correlation coefficients for all dimensions were higher than 0.5. In this model, assurance (regression weight=0.99) and tangibility (regression weight=0.86) had, respectively, the highest and lowest effects on dental service quality. The Parasuraman and Zeithaml's model is suitable to measure quality in dental services. The variables related to dental services quality have been made according to the model. This is a pioneering study that uses Parasuraman and Zeithaml's model and CFA in a dental setting. This study provides useful insights and guidance for dental service quality assurance.

  13. Risk factors for antipsychotic medication non-adherence behaviors and attitudes in adult-onset psychosis.

    Science.gov (United States)

    Hui, Christy Lai Ming; Poon, Venessa Wing Yan; Ko, Wai Tung; Miao, Ho Yee; Chang, Wing Chung; Lee, Edwin Ho Ming; Chan, Sherry Kit Wa; Lin, Jingxia; Chen, Eric Yu Hai

    2016-07-01

    Research on antipsychotic medication non-adherence in first-episode psychosis patients tends to examine non-adherence behaviors and attitudes together. Nonetheless, attitudes do not always directly translate into behaviors. We examined the baseline predictors for antipsychotics non-adherence behaviors and attitudes separately in a first-episode psychosis cohort. We also included cognitive impairments as one of the predictor variables as this domain is rarely explored in adherence studies. Participants were 313 adult-onset psychosis patients recruited from the Jockey Club Early Psychosis project in Hong Kong. Demographic, premorbid, clinical, and cognitive characteristics were first assessed at baseline. Six months later, participants completed a 14-item Medication Compliance Questionnaire, which was a modified and Cantonese-translated version of the Medication Adherence Rating Scale that includes items pertaining to both adherence behaviors and attitudes. Rates of poor adherence behaviors and negative adherence attitudes were 17.6% and 27.8%, respectively. Determinants of poor adherence behavior included more severe positive symptoms, hospitalization at onset of illness, and poorer engagement in extended social network. As for negative adherence attitude, determinants included more severe general psychopathology, poorer insight, more psychic medication side-effects, and poorer performance on backward digit span test and WAIS-R information test. The risk factors for non-adherence behaviors and attitudes are different and they should all be taken into careful consideration while formulating appropriate intervention programs to tackle the adherence problem in adult onset psychosis. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. A holistic approach to factors affecting depression in haemodialysis patients.

    Science.gov (United States)

    Gerogianni, Georgia; Kouzoupis, Anastasios; Grapsa, Eirini

    2018-05-19

    Depression in dialysis populations is affected by co-morbid diseases, such as cardiovascular disease, diabetes, and immune dysfunction, and it also includes high suicide risk and frequent hospitalizations. Depressive disorders have a close association with malnutrition and chronic inflammation, as well as with cognitive impairment. Impaired cognitive function may be manifested as low adherence to dialysis treatment, leading to malnutrition. Additionally, chronic pain and low quality of sleep lead to high rates of depressive symptoms in haemodialysis patients, while an untreated depression can cause sleep disturbances and increased mortality risk. Depression can also lead to sexual dysfunction and non-adherence, while unemployment can cause depressive disorders, due to patients' feelings of being a financial burden on their family. The present review provides a holistic approach to the factors affecting depression in haemodialysis, offering significant knowledge to renal professionals.

  15. Factors Affecting Aerosol Radiative Forcing

    Science.gov (United States)

    Wang, J.; Lin, J.; Ni, R.

    2016-12-01

    Rapid industrial and economic growth has meant large amount of aerosols in the atmosphere with strong radiative forcing (RF) upon the climate system. Over parts of the globe, the negative forcing of aerosols has overcompensated for the positive forcing of greenhouse gases. Aerosol RF is determined by emissions and various chemical-transport-radiative processes in the atmosphere, a multi-factor problem whose individual contributors have not been well quantified. In this study, we analyze the major factors affecting RF of secondary inorganic aerosols (SIOAs, including sulfate, nitrate and ammonium), primary organic aerosol (POA), and black carbon (BC). We analyze the RFof aerosols produced by 11 major regions across the globe, including but not limited to East Asia, Southeast Asia, South Asia, North America, and Western Europe. Factors analyzed include population size, per capita gross domestic production (GDP), emission intensity (i.e., emissionsper unit GDP), chemical efficiency (i.e., mass per unit emissions) and radiative efficiency (i.e., RF per unit mass). We find that among the 11 regions, East Asia produces the largest emissions and aerosol RF, due to relatively high emission intensity and a tremendous population size.South Asia produce the second largest RF of SIOA and BC and the highest RF of POA, in part due to its highest chemical efficiency among all regions. Although Southeast Asia also has large emissions,its aerosol RF is alleviated by its lowest chemical efficiency.The chemical efficiency and radiative efficiency of BC produced by the Middle East-North Africa are the highest across the regions, whereas its RF is loweredbyasmall per capita GDP.Both North America and Western Europe have low emission intensity, compensating for the effects on RF of large population sizes and per capita GDP. There has been a momentum to transfer industries to Southeast Asia and South Asia, and such transition is expected to continue in the coming years. The resulting

  16. Variations in infant and childhood vitamin D supplementation programmes across Europe and factors influencing adherence

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    Suma Uday

    2017-10-01

    Full Text Available Background: Nutritional rickets is a growing global public health concern despite existing prevention programmes and health policies. We aimed to compare infant and childhood vitamin D supplementation policies, implementation strategies and practices across Europe and explore factors influencing adherence. Methods: European Society for Paediatric Endocrinology Bone and Growth Plate Working Group members and other specialists completed a questionnaire on country-specific vitamin D supplementation policy and child health care programmes, socioeconomic factors, policy implementation strategies and adherence. Factors influencing adherence were assessed using Kendall’s tau-b correlation coefficient. Results: Responses were received from 29 of 30 European countries (97%. Ninety-six per cent had national policies for infant vitamin D supplementation. Supplements are commenced on day 1–5 in 48% (14/29 of countries, day 6–21 in 48% (14/29; only the UK (1/29 starts supplements at 6 months. Duration of supplementation varied widely (6 months to lifelong in at-risk populations. Good (≥80% of infants, moderate (50–79% and low adherence (<50% to supplements was reported by 59% (17/29, 31% (9/29 and 10% (3/29 of countries, respectively. UK reported lowest adherence (5–20%. Factors significantly associated with good adherence were universal supplementation independent of feeding mode (P = 0.007, providing information at neonatal unit (NNU discharge (P = 0.02, financial family support (P = 0.005; monitoring adherence at surveillance visits (P = 0.001 and the total number of factors adopted (P < 0.001. Conclusions: Good adherence to supplementation is a multi-task operation that works best when parents are informed at birth, all babies are supplemented, and adherence monitoring is incorporated into child health surveillance visits. Implementation strategies matter for delivering efficient prevention policies.

  17. Medication Adherence and its Related Factors in Patients with Type II Diabetes

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    Behzad Gholamaliei

    2016-03-01

    Full Text Available Background and Objectives: Low levels of medication adherence in patients with type 2 diabetes is one of the greatest challenges in the treatment and control of diabetes. This study was designed to determine medication adherence and its related factors in patients with type II diabetes. Materials and Methods: In this cross-sectional study, a total of 300patients with type 2diabetes records in the health centers of Tuyserkan city were randomly selected in 2015. Data collection instrument was a self-made questionnaire, which consisted of factors related to the medication adherence. Questionnaires were completed after confirmation of validity and reliability, by interviews. To analyze the data, descriptive and inferential statistics (T-test, AnOVA, Simple and multiple linear regression were applied, using SPSS software, version 19. Results: Overall, %26.3 of patients were male and %73.7 were female. Also, %65 of patients were illiterate, %24 had some degree of symptoms, and %59.4 had poor medication adherence. There was a significant relationship between age, education, patient care and treatment expenditure, health care team and health system, therapy-related factors and condition-related factors, beliefs about illness, efficacy, and concerns about drugs and medication adherence (P < 0.05. Conclusions: This study showed that medication adherence in patients with diabetes was not suitable and individual, economical and social factors were influential.Therefore, the role of these factors must be considered when designing intervention programs.

  18. Associations between alcohol use, other psychosocial factors, structural factors and antiretroviral therapy (ART) adherence among South African ART recipients.

    Science.gov (United States)

    Morojele, Neo K; Kekwaletswe, Connie T; Nkosi, Sebenzile

    2014-03-01

    We examined whether alcohol use is associated with antiretroviral therapy (ART) adherence independently of structural and psychosocial factors among 304 male and female ART recipients in ART sites in Tshwane, South Africa. ART adherence was assessed by the CASE Adherence Index. Independent variables were demographic, structural, psycho-social, and alcohol use (AUDIT score) factors. In hierarchical multiple regression, demographic variables (Step 1) explained 4 % of variance in ART adherence (p ≤ 0.01). Variance explained increased to 16 % (p ≤ 0.001) after entering structural variables (Step 2); 19 % (p ≤ 0.001) after entering psychosocial variables (Step 3); and 24 % (p ≤ 0.001) after entering AUDIT score (Step 4). Alcohol use is independently associated with ART adherence.

  19. Risk factors for non-adherence to antidepressant treatment in patients with mood disorders.

    Science.gov (United States)

    De las Cuevas, Carlos; Peñate, Wenceslao; Sanz, Emilio J

    2014-01-01

    Adherence to antidepressant therapy by patients with depressive disorders is essential not only to achieve a positive patient outcome but also to prevent a relapse. The aim of this study was to identify potential modelling factors influencing adherence to antidepressant treatment by patients with mood disorders in the community mental health care setting A total of 160 consecutive psychiatric outpatients attending two Community Mental Health Centres on Tenerife Island between September 2011 and May 2012 were asked to participate in the study; of these, 145 accepted. The Morisky self-report scale was used to assess adherence. The potential predictors examined included socio-demographic, clinical and therapeutic variables. The Clinical Global Impression-Severity and -Improvement scales and the Beck Depression Inventory were used for clinical assessment. Drug treatment side-effects were assessed using the "Self-report Antidepressant Side-Effect Checklist." All participants were also asked to complete the "Drug Attitude Inventory" (DAI), "Beliefs about Medicine Questionnaire" (BMQ), and "Leeds Attitude towards concordance Scale". Discriminant analyses were performed to predict non-adherence. There was no clear correlation between adherence and the socio-demographic variables examined, but adherence was related to a positive attitude of the patients towards his/her treatment (DAI) and low scores in the BMQ-Harm and -Concern subscales. Non-adherence was also related to an increasing severity of depression and to the presence and severity of side-effects. Among our study cohort, the profiles of adherent patients to antidepressant treatment were more closely associated with each patient's attitudes and beliefs than to objective socio-demographic variables. The severity of depression played a relevant role in adherence, but whether this role is direct or an interaction with several concurrent factors is not yet clear. Side-effects were also closely related to adherence, as

  20. Factors related to high and low levels of drug adherence according to patients with type 2 diabetes

    NARCIS (Netherlands)

    Borgsteede, S.D.; Westerman, M.J.; Kok, I.L.; Meeuse, J.C.; de Vries, T.P.G.M.; Hugtenburg, J.G.

    2011-01-01

    Objective Adherence to medication in patients with type 2 diabetes varies widely, yet the factors that influence adherence according to patients are not fully known. The aim of this study is to explore both factors related to high and lower levels of adherence that patients with type 2 diabetes

  1. Factors influencing ambulance nurses' adherence to a national protocol ambulance care: an implementation study in the Netherlands

    NARCIS (Netherlands)

    Ebben, R.H.; Vloet, L.C.M.; Grunsven, P.M. van; Breeman, W.; Goosselink, B.; Lichtveld, R.A.; Groot, J. de; Achterberg, T. van

    2015-01-01

    OBJECTIVES: Adherence to prehospital guidelines and protocols is suboptimal. Insight into influencing factors is necessary to improve adherence. The aim of this study was to identify factors that influence ambulance nurses' adherence to a National Protocol Ambulance Care (NPAC). METHODS: A

  2. Antiretroviral treatment adherence as a mediating factor between psychosocial variables and HIV viral load.

    Science.gov (United States)

    Attonito, Jennifer; Dévieux, Jessy G; Lerner, Brenda D G; Hospital, Michelle M; Rosenberg, Rhonda

    2014-01-01

    Psychosocial factors may directly impact HIV health measures such as viral load (VL) whether or not patients are taking antiretroviral treatment (ART) consistently. Structural equation modeling plus Baron and Kenny's (1986) four-step approach were used to test a mediated model predicting VL among 246 HIV-infected adults who were on ART. Exogenous variables were social support, barriers to adherence, and stress. Moderators were alcohol use, marijuana use, and neurocognitive impairment. A small positive association between marijuana use and ART adherence approached significance. Only barriers to adherence predicted a decrease in adherence rates and an increase in VL. No other factors were significantly associated with either VL or adherence, and no interaction effects between exogenous variables and moderators were identified. The association between barriers to adherence and VL was partially mediated by ART adherence. Findings provide modest support for a direct link between psychosocial variables and a virologic response to ART. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  3. The Effect of Psychosocial Factors and Patients' Perception of Tuberculosis Treatment Non-Adherence in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Tola, Habteyes Hailu; Garmaroudi, Gholamreza; Shojaeizadeh, Davoud; Tol, Azar; Yekaninejad, Mir Saeed; Ejeta, Luche Tadesse; Kebede, Abebaw; Kassa, Desta

    2017-09-01

    Although there are several studies reported on factors affecting tuberculosis (TB) treatment non-adherence, there is information gap on psychosocial and patients' perceptions aspects. Therefore, this study was aimed to investigate the effect of psychosocial factors and patients' perceptions on TB treatment non-adherence in Ethiopia. A cross sectional study was conducted in Addis Ababa from May to December, 2014. Thirty one health facilities were randomly selected and 698 TB patients, who had been on treatment, were enrolled consecutively using patient registration number. Structured questionnaire was used to collect data on demographics, knowledge, psychological distress, alcohol use, tobacco smoking and six HBM domains. Treatment adherence level was the main outcome variable, and it measured using visual analog scale. Statistical Package for Social Sciences version 20 was used for data analysis. Non-adherence level within last one month prior to the study was 19.5%. After controlling for all potential confounding variables, Antiretroviral Therapy (ART) status (Adjusted Odds Ratio (AOR) = 1.79, 95% Confidence interval (CI) (1.09 -2.95)), alcohol use (AOR = 2.11, 95% CI (1.33-3.37)), economic status (AOR = 0.53, 95% CI (0.33-0.82)), perceived barriers (AOR = 1.21, 95% CI (1.10-1.47)) and psychological distress (AOR = 1.83, 95% CI (1.47-2.29)) were independently associated with TB treatment non-adherence. ART status, economic status, alcohol use, perceived barrier and psychological distress are the major areas that need to be targeted with health promotion intervention to enhance TB treatment adherence.

  4. A nationwide survey of factors influencing adherence to ocular hypotensive eyedrops in Japan.

    Science.gov (United States)

    Tsumura, Toyoaki; Kashiwagi, Kenji; Suzuki, Yasuyuki; Yoshikawa, Keiji; Suzumura, Hirotaka; Maeda, Toshine; Takeda, Ryuji; Saito, Hitomi; Araie, Makoto

    2018-01-12

    Few reports have investigated the status of adherence in Japan on a large scale. We aimed to investigate the status of adherence to topical glaucoma treatment and its associated factors. A nationwide survey was conducted as a prospective fashion. Participants in this survey were subjects with primary open-angle glaucoma, normal-tension glaucoma, or ocular hypertension or pseudoexfoliation glaucoma who had been prescribed anti-glaucoma ophthalmic eyedrops and whose ophthalmologist considered prescribing any fixed combination of ocular hypotensive eyedrops for the first time between 2011 and 2012. Subjects and their attending ophthalmologists independently completed a questionnaire by utilizing a fixed combination of ocular hypotensive eyedrops. A total of 1358 ophthalmologists from 1071 medical institutions participated in this survey. We registered 4430 subjects (2049 males and 2381 females). In total, data from 3853 subjects (87.6%) were analyzed after inclusion of subjects based on inclusion and exclusion criteria. Good adherence was defined as not forgetting instillation during the past week. Rates of good adherence reported by subjects and ophthalmologists were 72.4 and 78.5%, respectively (P < 0.0001). The consistency of adherence evaluation between subjects and ophthalmologists was moderate [kappa score 0.5025 (95% confidence interval 0.4740-0.5309)]. Significant factors associated with adherence were size of clinic, age, gender, number of types of ocular hypotensive eyedrops, ease of instillation, preferred number of eyedrops, preferred frequency of instillation of eyedrops, and knowledge of glaucoma. Adherence to ocular hypotensive eyedrops among Japanese subjects was relatively good. Concordance of adherence between subjects' reports and ophthalmologists' responses was moderate. Size of clinic, number of types of ocular hypotensive eyedrops, ease of instillation, preferred number of eyedrops, preferred frequency of instillation of eyedrops, and knowledge

  5. Non-adherence to life-style modification and its factors among type 2 diabetic patients

    OpenAIRE

    Shirin Jahan Mumu; Farzana Saleh; Ferdous Ara; Fadia Afnan; Liaquat Ali

    2014-01-01

    Non-adherence to preventive and therapeutic life-style recommendations among patients with diabetes is special challenge in the management of these patients. This study aimed to measure the proportion of non-adherence to life-style modification and factors associated with these among a group of Bangladeshi type 2 diabetic patients. Under an analytical cross-sectional design 374 type 2 diabetic patients (age >20 years), diagnosed for at least 1 year, were selected from different health care ce...

  6. Predicting and influencing voice therapy adherence using social-cognitive factors and mobile video.

    Science.gov (United States)

    van Leer, Eva; Connor, Nadine P

    2015-05-01

    Patient adherence to voice therapy is an established challenge. The purpose of this study was (a) to examine whether adherence to treatment could be predicted from three social-cognitive factors measured at treatment onset: self-efficacy, goal commitment, and the therapeutic alliance, and (b) to test whether the provision of clinician, self-, and peer model mobile treatment videos on MP4 players would influence the same triad of social cognitive factors and the adherence behavior of patients. Forty adults with adducted hyperfunction with and without benign lesions were prospectively randomized to either 4 sessions of voice therapy enhanced by MP4 support or without MP4 support. Adherence between sessions was assessed through self-report. Social cognitive factors and voice outcomes were assessed at the beginning and end of therapy. Utility of MP4 support was assessed via interviews. Self-efficacy and the therapeutic alliance predicted a significant amount of adherence variance. MP4 support significantly increased generalization, self-efficacy for generalization, and the therapeutic alliance. An interaction effect demonstrated that MP4 support was particularly effective for patients who started therapy with poor self-efficacy for generalization. Adherence may be predicted and influenced via social-cognitive means. Mobile technology can extend therapy to extraclinical settings.

  7. Factors influencing non-adherence to tuberculosis treatment in Jepara, central Java, Indonesia.

    Science.gov (United States)

    Rondags, Angelique; Himawan, Ari Budi; Metsemakers, Job Fm; Kristina, Tri Nur

    2014-07-01

    One of the most serious problems for tuberculosis (TB) control is non-adherence to TB treatment. We studied the factors influencing non-adherence to TB treatment in Indonesia to inform TB treatment adherence strategies. We con- ducted semi-structured interviews with non-adherent patients and key informants in Jepara, Central Java, Indonesia. Three major themes were found in reasons for non-adherence to TB treatment: 1) knowledge about TB, 2) knowledge about TB treatment and 3) choosing and changing a health care treatment facility. Respondents had an inadequate knowledge about TB and its treatment. Feeling healthy and having financial problems were the most common reasons for TB treatment non-adherence. Respondents sought treatment from many different health care providers, and often changed the treatment facility location. TB treatment adherence might improve by providing better education about the disease and its treatment to those undergoing treatment. Providing information about where to receive treatment and that treatment is free could also improve compliance.

  8. Factors influencing adherence to psychopharmacological medications in psychiatric patients: a structural equation modeling approach.

    Science.gov (United States)

    De Las Cuevas, Carlos; de Leon, Jose; Peñate, Wenceslao; Betancort, Moisés

    2017-01-01

    To evaluate pathways through which sociodemographic, clinical, attitudinal, and perceived health control variables impact psychiatric patients' adherence to psychopharmacological medications. A sample of 966 consecutive psychiatric outpatients was studied. The variables were sociodemographic (age, gender, and education), clinical (diagnoses, drug treatment, and treatment duration), attitudinal (attitudes toward psychopharmacological medication and preferences regarding participation in decision-making), perception of control over health (health locus of control, self-efficacy, and psychological reactance), and level of adherence to psychopharmacological medications. Structural equation modeling was applied to examine the nonstraightforward relationships and the interactive effects among the analyzed variables. Structural equation modeling demonstrated that psychiatric patients' treatment adherence was associated: 1) negatively with cognitive psychological reactance (adherence decreased as cognitive psychological reactance increased), 2) positively with patients' trust in their psychiatrists (doctors' subscale), 3) negatively with patients' belief that they are in control of their mental health and that their mental health depends on their own actions (internal subscale), and 4) positively (although weakly) with age. Self-efficacy indirectly influenced treatment adherence through internal health locus of control. This study provides support for the hypothesis that perceived health control variables play a relevant role in psychiatric patients' adherence to psychopharmacological medications. The findings highlight the importance of considering prospective studies of patients' psychological reactance and health locus of control as they may be clinically relevant factors contributing to adherence to psychopharmacological medications.

  9. Culicoides antigen extract stimulates equine blood mononuclear (BMN) cell proliferation and the release of eosinophil adherence-inducing factor(s).

    Science.gov (United States)

    Mckelvie, J; Foster, A P; Hamblin, A S; Cunningham, F M

    2001-04-01

    Intradermal injection of a Culicoides antigen extract (CAgX) induces T lymphocyte and eosinophil accumulation in the skin of horses with sweet itch. Blood mononuclear (BMN) cells from normal ponies proliferate when stimulated by mitogen (phytohaemagglutinin, PHA) or antigen (tetanus toxoid, TT) and, as shown here, release soluble factor(s) that induce eosinophil adherence. CAgX also caused concentration dependent proliferation of BMN cells from sweet itch and normal ponies [stimulation index: 29 (13) and 17 (7) for BMN cells from sweet itch and normal ponies, respectively during the active phase of disease; 4 microg protein ml(-1)CAgX; 168 h]. A heat labile factor(s) which caused eosinophil adherence was also released [sweet itch ponies: 6.0 (1.6) per cent adherence versus 1.3 (0.4) per cent; normal ponies: 6.6 (0.5) per cent adherence versus 0.9 (0.1) per cent for supernatants from CAgX (4 microg protein ml(-1); 48 hours) stimulated versus unstimulated BMN cells, respectively]. These results suggest that soluble proteins released from T lymphocytes could affect eosinophil function in the lesional skin of sweet itch horses. Copyright 2001 Harcourt Publishers Ltd.

  10. Subjective reasons for adherence to psychotropic medication and associated factors among older adults with schizophrenia.

    Science.gov (United States)

    Sapra, Mamta; Vahia, Ipsit V; Reyes, Pia N; Ramirez, Paul; Cohen, Carl I

    2008-12-01

    There are limited data examining subjective influences on medication adherence among older persons with schizophrenia. The subjective reasons for adherence to antipsychotic medication and associated clinical and psychosocial factors in this population are examined. The sample consisted of 198 community dwelling persons aged >or=55 who developed schizophrenia before age 45. Using the Rating of Medication Influences Scale (ROMI), a principal component factor analysis with varimax rotation yielded three subscales: Medication Affinity and Prevention, Influence of Others, and Impact of Authority. These subscales were dichotomized into high and low based on a median split. We also created an ordinal High Adherence measure based on the summed scores of each person's three dichotomized ROMI subscales. A modified Health Belief Model was used to examine the association between 18 predictor variables and the ROMI subscales and the adherence scale. The mean subscale rankings were Medication Affinity and Prevention > Impact of Authority > Influence of Others. In logistic regression, lower education, more side effects, higher depression scores, and more mental health services were associated with higher scores on Influence of Others subscale. More side effects and more entitlements were associated with higher scores on the Medication Affinity and Prevention subscale. The Impact of Authority subscale had no significant associations. More side effects and higher depression scores were associated with higher scores on High Adherence measure. We identified a three-dimensional model for explaining the subjective reasons for medication adherence in older persons with schizophrenia. Our findings suggest that cognitive approaches and use of authority figures may be useful for promoting adherence in older adults. Independent variables associated with these subscales may provide guidance for improving adherence in this population.

  11. Asthma medication adherence: the role of God and other health locus of control factors.

    Science.gov (United States)

    Ahmedani, Brian K; Peterson, Edward L; Wells, Karen E; Rand, Cynthia S; Williams, L Keoki

    2013-02-01

    Medication adherence is an important determinant of disease outcomes, yet medication use on average tends to be low among patients with chronic conditions, including asthma. Although several predictors of non-adherence have been assessed, more research is needed on patients' beliefs about God and how these relate to medication use. To examine the relationship between perceptions about "God's" role in health and other locus of control factors with inhaled corticosteroid (ICS) adherence among asthma patients. Participants were from a clinical trial to improve ICS adherence and were 5-56 years old, had a diagnosis of asthma, and were receiving ICS medication. Baseline adherence was estimated from electronic prescription and pharmacy fill records. Patients were considered to be adherent if ICS use was ≥80% of prescribed. A baseline survey with the Multidimensional Health Locus of Control scale was used to assess five sources (God, doctors, other people, chance, and internal). Medication adherence was low (36%). Patients' who had a stronger belief that God determined asthma control were less likely to be adherent (odds ratio [OR] 0.82, 95% confidence interval [CI] 0.70-0.96). This relationship was stronger among African American (OR 0.68, 95% CI0.47-0.99) compared to white patients (OR 0.89, 95% CI 0.75-1.04), and among adults (OR 0.81, 95% CI 0.69-0.96) compared to children (OR 0.84, 95% CI 0.58-1.22). Patients' belief in God's control of health appears to be a factor in asthma controller use, and therefore should be considered in physician-patient discussions concerning course of treatment. ClinicalTrials.gov: NCT00459368. Copyright © 2013 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  12. Contingent factors affecting network learning

    OpenAIRE

    Peters, Linda D.; Pressey, Andrew D.; Johnston, Wesley J.

    2016-01-01

    To increase understanding of the impact of individuals on organizational learning processes, this paper explores the impact of individual cognition and action on the absorptive capacity process of the wider network. In particular this study shows how contingent factors such as social integration mechanisms and power relationships influence how network members engage in, and benefit from, learning. The use of cognitive consistency and sensemaking theory enables examination of how these conting...

  13. Column: Factors Affecting Data Decay

    Directory of Open Access Journals (Sweden)

    Kevin Fairbanks

    2012-06-01

    Full Text Available In nuclear physics, the phrase decay rate is used to denote the rate that atoms and other particles spontaneously decompose. Uranium-235 famously decays into a variety of daughter isotopes including Thorium and Neptunium, which themselves decay to others. Decay rates are widely observed and wildly different depending on many factors, both internal and external. U-235 has a half-life of 703,800,000 years, for example, while free neutrons have a half-life of 611 seconds and neutrons in an atomic nucleus are stable.We posit that data in computer systems also experiences some kind of statistical decay process and thus also has a discernible decay rate. Like atomic decay, data decay fluctuates wildly. But unlike atomic decay, data decay rates are the result of so many different interplaying processes that we currently do not understand them well enough to come up with quantifiable numbers. Nevertheless, we believe that it is useful to discuss some of the factors that impact the data decay rate, for these factors frequently determine whether useful data about a subject can be recovered by forensic investigation.(see PDF for full column

  14. Factors Associated With Adherence to Methylphenidate Treatment in Adult Patients With Attention-Deficit/Hyperactivity Disorder and Substance Use Disorders.

    Science.gov (United States)

    Skoglund, Charlotte; Brandt, Lena; Almqvist, Catarina; DʼOnofrio, Brian M; Konstenius, Maija; Franck, Johan; Larsson, Henrik

    2016-06-01

    Adherence to treatment is one of the most consistent factors associated with a favorable addiction treatment outcome. Little is known about factors associated with treatment adherence in individuals affected with comorbid attention-deficit/hyperactivity disorder and substance use disorders (SUD). This study aimed to explore whether treatment-associated factors, such as the prescribing physician's (sub)specialty and methylphenidate (MPH) dose, or patient-related factors, such as sex, age, SUD subtype, and psychiatric comorbidity, were associated with adherence to MPH treatment. Swedish national registers were used to identify adult individuals with prescriptions of MPH and medications specifically used in the treatment of SUD or a diagnosis of SUD and/or coexisting psychiatric diagnoses. Primary outcome measure was days in active MPH treatment in stratified dose groups (≤36 mg, ≥37 mg to ≤54 mg, ≥55 mg to ≤72 mg, ≥73 mg to ≤90 mg, ≥91 mg to ≤108 mg, and ≥109 mg). Lower MPH doses (ie, ≤36 mg day 100) were associated with treatment discontinuation between days 101 and 830 (HR≤36 mg, 1.67; HR37-54mg, 1.37; HR55-72mg, 1.36; HR73-90mg, 1.19; HR≥108mg, 1.09). The results showed a linear trend (P attention-deficit/hyperactivity disorder and SUD.

  15. Factors Affecting University Library Website Design

    OpenAIRE

    Kim, Yongi-Mi; University of Oklahoma

    2011-01-01

    Existing studies have extensively explored factors that affect users’ intentions to use university library website resources (ULWR); yet little attention has been given to factors affecting university library website design. This paper investigates factors that affect university library website design and assesses the success of the university library website from both designers’ and users’ perspectives. The findings show that when planning a website, university web designers consider univers...

  16. Factors That Affect Software Testability

    Science.gov (United States)

    Voas, Jeffrey M.

    1991-01-01

    Software faults that infrequently affect software's output are dangerous. When a software fault causes frequent software failures, testing is likely to reveal the fault before the software is releases; when the fault remains undetected during testing, it can cause disaster after the software is installed. A technique for predicting whether a particular piece of software is likely to reveal faults within itself during testing is found in [Voas91b]. A piece of software that is likely to reveal faults within itself during testing is said to have high testability. A piece of software that is not likely to reveal faults within itself during testing is said to have low testability. It is preferable to design software with higher testabilities from the outset, i.e., create software with as high of a degree of testability as possible to avoid the problems of having undetected faults that are associated with low testability. Information loss is a phenomenon that occurs during program execution that increases the likelihood that a fault will remain undetected. In this paper, I identify two brad classes of information loss, define them, and suggest ways of predicting the potential for information loss to occur. We do this in order to decrease the likelihood that faults will remain undetected during testing.

  17. Non-adherence to life-style modification and its factors among type 2 diabetic patients.

    Science.gov (United States)

    Mumu, Shirin Jahan; Saleh, Farzana; Ara, Ferdous; Afnan, Fadia; Ali, Liaquat

    2014-01-01

    Non-adherence to preventive and therapeutic life-style recommendations among patients with diabetes is special challenge in the management of these patients. This study aimed to measure the proportion of non-adherence to life-style modification and factors associated with these among a group of Bangladeshi type 2 diabetic patients. Under an analytical cross-sectional design 374 type 2 diabetic patients (age >20 years), diagnosed for at least 1 year, were selected from different health care centers operated by the Diabetic Association of Bangladesh. Non-adherence rate were assessed for: Diet (88%), exercise (25%), routine blood glucose testing (32%), foot care (70%), smoking (6%) and betel quid chewing habit (25%). Binary logistic regression suggests that higher education group (P = 0.013), rural area (P = 0.013) and attendance to diabetes education classes (P = 0.043) showed good adherence to diet and non-attendance to diabetes education class (P = 0.014), older age (P = 0.037) are associated to non-adherence to exercise. Unemployed patients showed more non-adherence to blood glucose testing (P = 0.045) than others. Non-attendance to diabetes education class (P = 0.037) and business occupation group (P = 0.039) showed significant association to smoking and betel quid intake habit respectively.

  18. Psychosocial factors and adherence to drug treatment in patients on chronic haemodialysis.

    Science.gov (United States)

    Huertas-Vieco, María P; Pérez-García, Rafael; Albalate, Marta; de Sequera, Patricia; Ortega, Mayra; Puerta, Marta; Corchete, Elena; Alcázar, Roberto

    2014-11-17

    The daily pill burden in hemodialysis patients is one of the highest reported to date in any chronic disease. The adherence to prescribed treatment has implications on the quality of life, the survival of patients, and the economic cost of their treatment, this being a priority public health issue. To evaluate the adherence to pharmacological treatment examining, among the possible causes of non-adherence, psychosocial factors such as depression, anxiety, cognitive impairment and social support. Transversal-observational study of thirty five patients that suffer from chronic renal disease and who are on manteinance hemodialysis, evaluated by self-reported measures. Non-adherent patients have significant higher depression index than adherent patients. Anxiety, cognitive impairment and social support do not show a significant relation with the degree of adherence or compliance with farmacological treatment. These results suggest that psychological intervention in chronic haemodialysis patients with a severe depression index could increase the degree of fulfillment and general well-being of renal patients.

  19. Dissociative Identity Disorder CPAP Adherence: An Uncommon Factor in Obstructive Sleep Apnea.

    Science.gov (United States)

    Gandotra, Kamal; Golish, Joseph; Rosenberg, Carl; Strohl, Kingman

    2018-04-15

    We present a case of a patient with dissociative identity disorder and symptomatic sleep apnea who was treated with continuous positive airway pressure (CPAP). CPAP use depended upon which personality the patient exhibited but apnea reduction did not. This case illustrates in one individual how personality can positively or negatively affect CPAP adherence. © 2018 American Academy of Sleep Medicine.

  20. Factors influencing adherence to standard precautions among nursing professionals in psychiatric hospitals

    Directory of Open Access Journals (Sweden)

    Thaís Helena Piai-Morais

    2015-06-01

    Full Text Available OBJECTIVE Evaluate and correlate individual, work-related and organizational factors that influence adherence to standard precautions among nursing professionals of psychiatric hospitals in São Paulo. METHOD An exploratory cross-sectional study conducted with 35 nursing professionals, using the assessment tool for adherence to standard precautions through the Likert scale, ranging from 1 to 5. RESULTS Knowledge of the precautions received a high score (4.69; adherence received (3.86 and obstacles (3.78, while intermediaries and the scales of organizational factors received low scores (2.61. There was a strong correlation between the magnitude adherence scale and the personal protective equipment availability (r = 0.643; p = 0.000. The training scale for prevention of HIV exposure (p = 0.007 was statistically different between the nurses and nursing assistants. CONCLUSION The organizational factors negatively contributed to adherence to standard precautions, indicating that psychiatric institutions lack safe working conditions, ongoing training and management actions to control infections.

  1. Medication adherence among Nigerians with schizophrenia: correlation between clinico-demographic factors and quality of life

    Directory of Open Access Journals (Sweden)

    Oluseun P. Ogunnubi

    2017-03-01

    Full Text Available Medication adherence contributes significantly to symptom remission, recovery and wellbeing in mental illnesses. We evaluated how medication adherence correlates with clinico-demographic factors and quality of life (QoL in a sample of Nigerians with schizophrenia. This descriptive crosssectional study involved 160 randomly selected participants with confirmed diagnosis of schizophrenia based on MINI International Neuropsychiatric Interview. Data on socio-demographic and clinical characteristics of participants were collected with a questionnaire. Medication adherence was assessed with Morisky Medication Adherence Questionnaire, and participants completed the World Health Organization Quality of Life Scale-BREF. The mean age of participants was 38.54 (±11.30 years, and all the participants were on antipsychotics, but only 45% were adherent to their medication. Out of all the participants, 45 (28.2% considered their overall QoL to be good, 97 (60.6% considered theirs to be fair, while 18 (11.2% reported poor QoL. Medication non-adherence correlated negatively with good QoL across multiple dimensions including overall QoL (r=- 0.175, health satisfaction (r=-0.161, physical (r=-0.186 and psychological domain (r=-0.175. Again, participant’s age (r=- 0.190 and age of onset of illness (r=-0.172 correlated negatively with medication nonadherence, and a trend towards relapse delay with medication adherence was also observed (r=-0.155. The effect size of these correlations were however small. Our findings suggest a link between medication adherence and QoL in schizophrenia, such that strategy that addresses medication nonadherence and its determinants may have potential benefits on wellbeing. Further hypotheses-driven studies are desirable.

  2. Factors related to medication non-adherence for patients with hypertension in Taiwan.

    Science.gov (United States)

    Li, Wen-Wen; Kuo, Chi-Tai; Hwang, Shiow-Li; Hsu, Hsin-Tien

    2012-07-01

    To characterise a Taiwanese population and to examine the prevalence of antihypertensive medication non-adherence and how the cultural/clinical factors were associated with non-adherence in Taiwan. Antihypertensive medication non-adherence is a significant clinical issue in the United States. However, little is known about hypertension (HTN) control and cultural/clinical factors related to non-adherence in Taiwan. A convenience sample survey design was used. Data were gathered from a convenience sample of 200 subjects recruited from a large teaching hospital. Medication non-adherence and cultural/clinical factors were recorded using various self-administered questionnaires, and blood pressure was taken twice for each participant. The mean age of the participants was 60.4 (SD 11.5 years) including 62% men. Two-thirds had less than a high school education (64.5%), and the majority of them were married (86·0%) and lived with family or close friends (93.5%). The average length of HTN diagnosis was 8.6 years (SD 9.0 years). Medication non-adherence rate was 47·5%, and uncontrolled HTN rate was 49.0%. Some participants (17.0%) used Chinese herbs for treating their disease (e.g. cough) and promoting health in addition to their regular antihypertensive medications. Two factors were found to be statistically significant for predicting medication non-adherence: Lower Perceived Susceptibility to Specific Diseases [OR = 1.15 (95%CI, 1.01-1.31)] and Longer Length of HTN Diagnosis [OR = 1.06 (95%CI, 1.01-1.12)]. Taiwanese at risk of non-adherence included those who perceived lower susceptibility to specific diseases and had been diagnosed with HTN for a longer time. Those using herbs need to be studied for an impact of herbs on their adherence behaviour. These findings can help guide the development of culturally sensitive and clinically appropriate nursing interventions for HTN management in Taiwan. © 2012 Blackwell Publishing Ltd.

  3. Contextual investigation of factors affecting sludge accumulation ...

    African Journals Online (AJOL)

    Pit latrines in slums areas of Uganda fill up faster than might be expected from some estimates owing to inappropriate use and failure to consider critical factors affecting sludge accumulation rates at the planning, design and construction stages. This study sought to investigate factors affecting filling rates of lined pit latrines ...

  4. Factors affecting endoglucanase production by Trichoderma reesei ...

    African Journals Online (AJOL)

    Jane

    2011-08-22

    Aug 22, 2011 ... from the ANOVA analysis have a significant value of Pmodel>F= 0.0008 and R2 .... there are various environmental and nutritional factors ... reported to affect cellulase production from wheat straw ... many factors affecting simultaneously the fermentation ..... and control its stability (Kalra and Sandhu, 1986).

  5. Factors influencing adherence to dietary guidelines: a qualitative ...

    African Journals Online (AJOL)

    The main identified factors at individual level were motivation, individual knowledge, perceptions of moderation, self- responsibility, taste concept or cravings, and temptations. At small group (family and friends) level, family relations with the patients were identified as the main support system used to manage the diabetes.

  6. Airway delivery of soluble factors from plastic-adherent bone marrow cells prevents murine asthma.

    Science.gov (United States)

    Ionescu, Lavinia I; Alphonse, Rajesh S; Arizmendi, Narcy; Morgan, Beverly; Abel, Melanie; Eaton, Farah; Duszyk, Marek; Vliagoftis, Harissios; Aprahamian, Tamar R; Walsh, Kenneth; Thébaud, Bernard

    2012-02-01

    Asthma affects an estimated 300 million people worldwide and accounts for 1 of 250 deaths and 15 million disability-adjusted life years lost annually. Plastic-adherent bone marrow-derived cell (BMC) administration holds therapeutic promise in regenerative medicine. However, given the low cell engraftment in target organs, including the lung, cell replacement cannot solely account for the reported therapeutic benefits. This suggests that BMCs may act by secreting soluble factors. BMCs also possess antiinflammatory and immunomodulatory properties and may therefore be beneficial for asthma. Our objective was to investigate the therapeutic potential of BMC-secreted factors in murine asthma. In a model of acute and chronic asthma, intranasal instillation of BMC conditioned medium (CdM) prevented airway hyperresponsiveness (AHR) and inflammation. In the chronic asthma model, CdM prevented airway smooth muscle thickening and peribronchial inflammation while restoring blunted salbutamol-induced bronchodilation. CdM reduced lung levels of the T(H)2 inflammatory cytokines IL-4 and IL-13 and increased levels of IL-10. CdM up-regulated an IL-10-induced and IL-10-secreting subset of T regulatory lymphocytes and promoted IL-10 expression by lung macrophages. Adiponectin (APN), an antiinflammatory adipokine found in CdM, prevented AHR, airway smooth muscle thickening, and peribronchial inflammation, whereas the effect of CdM in which APN was neutralized or from APN knock-out mice was attenuated compared with wild-type CdM. Our study provides evidence that BMC-derived soluble factors prevent murine asthma and suggests APN as one of the protective factors. Further identification of BMC-derived factors may hold promise for novel approaches in the treatment of asthma.

  7. Factors associated with low adherence to a Mediterranean diet in healthy children in northern Spain.

    Science.gov (United States)

    Arriscado, Daniel; Muros, José J; Zabala, Mikel; Dalmau, José M

    2014-09-01

    There is a tendency in Mediterranean countries to abandon the characteristic Mediterranean diet. This is especially apparent within younger populations. This could have negative consequences for health such as, cardiovascular diseases, obesity or metabolic syndrome. The aim of this study was to describe adherence to the Mediterranean diet within a population of school children and to examine the influence of different socio-demographic factors and lifestyle habits. The study was conducted on a representative sample of 321 school children aged 11-12 years from 31 schools in the city of Logroño (La Rioja). Socio-demographic variables, anthropometric variables, blood pressure, level of development, aerobic fitness, lifestyle, physical activity habits and adherence to the Mediterranean diet were recorded. High adherence to the Mediterranean diet was reported by 46.7% of school children, with low adherence being reported by 4.7% of them. Children attending state schools, immigrants and families from low-to-medium socio-economic strata reported significantly lower adherence to the Mediterranean diet (p = .039), but the results did not reveal any significant differences in terms of body composition. Correlations were found between adherence to the Mediterranean diet and other lifestyle habits, especially level of physical activity (r = .38) and screen time (r = -.18). Adherence to a Mediterranean diet differs according to the type of school attended by children, and the child's nationality and socio-economic status. Children who attended state schools, immigrants and those from families with a medium-to-low socio-economic status were less likely to follow healthy diets. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Interpersonal Factors Are Associated with Lower Therapist Adherence in Cognitive-Behavioural Therapy for Panic Disorder.

    Science.gov (United States)

    Zickgraf, Hana F; Chambless, Dianne L; McCarthy, Kevin S; Gallop, Robert; Sharpless, Brian A; Milrod, Barbara L; Barber, Jacques P

    2016-05-01

    , although whether this is true varies across therapists. Therapists' adherence to a structured protocol and borrowing from outside of the CBT model do not appear to be affected by disorder severity or Axis I comorbidity. Copyright © 2015 John Wiley & Sons, Ltd.

  9. Examining the Factors Affecting Student Dropout

    Directory of Open Access Journals (Sweden)

    Fethi Ahmet INAN

    2006-07-01

    Full Text Available This study examined the factors affecting student dropouts in an online certificate program. In this research, a combination of quantitative and qualitative methods was used. Online Course Dropout Survey was developed and used to determine which factors affect student attrition from the program. The dropout survey was sent by e-mail to 98 students who had dropped the program. Twenty-six students returned the survey. The findings show that the most important factor affecting student retention is finding sufficient time to study. Having personal problems and affordability of the program took second and third place.

  10. Medication adherence and its associated factors among diabetic patients at Zewditu Memorial Hospital, Addis Ababa, Ethiopia.

    Science.gov (United States)

    Ali, Muhammed; Alemu, Tigestu; Sada, Oumer

    2017-12-04

    Diabetes is a global problem with devastating human, social and economic impact. Anti-diabetic medications play a major role in the glycemic control of patients with diabetes. However, inadequate adherence compromises safety and treatment effectiveness, leading to increased mortality and morbidity. The aim of this study was to assess adherence to anti-diabetic medications and associated factors among patient with diabetes mellitus receiving care at Zewditu Memorial Hospital. Among the total of 146 diabetic patients (mean age 46.5 ± 14.7), the level of adherence to anti diabetic medication was 54.8% (80) whilst 45.2% (66) of the participants were non adherent. Multiple logistic regression showed that knowledge of medication (AOR = 4.905, 95% CI 1.64-14.62, medication availability (AOR = 0.175, 95% CI 0.031-0.987) and education level (AOR = 13.65, 95% CI 1.45-128.456) were reasons for non-adherence.

  11. Factors associated with intentions to adhere to colorectal cancer screening follow-up exams

    Directory of Open Access Journals (Sweden)

    Ishibashi Teruo

    2006-11-01

    Full Text Available Abstract Background To increase adherence rate to recommendations for follow-up after abnormal colorectal cancer (CRC screening results, factors that inhibit and facilitate follow-up must be identified. The purpose of this study was to identify the factors associated with intention to adhere to CRC screening follow-up exams. Methods During a 4-week period in October 2003, this survey was conducted with 426 subjects participating in a community-based CRC screening program in Nagano, Japan. Study measures included intention to adhere to recommendation for clinical follow-up in the event of an abnormal fecal occult blood test (FOBT result, perceived susceptibility and severity of CRC, perceived benefits and barriers related to undergoing follow-up examination, social support, knowledge of CRC risk factors, health status, previous CRC screening, personality and social demographic characteristics. Univariate and multivariate logistic regression analyses on intention to adhere to recommendations for follow-up were performed. Results Among the 288 individuals analyzed, approximately 74.7% indicated that they would definitely adhere to recommendations for follow-up. After controlling for age, gender, marital status, education, economic status, trait anxiety, bowel symptoms, family history of CRC, and previous screening FOBT, analyses revealed that lower levels of perceived barriers, higher levers of perceived benefits and knowledge of CRC risk factors were significantly associated with high intention respectively. Conclusion The results of this study suggest that future interventions should focus on reducing modifiable barriers by clarifying misperceptions about follow-up, promoting the acceptance of complete diagnostic evaluations, addressing psychological distress, and making follow-up testing more convenient and accessible. Moreover, educating the public regarding the risk factors of CRC and increasing understanding of the benefits of follow-up is

  12. Factors Affecting Tocopherol Concentrations in Soybean Seeds.

    Science.gov (United States)

    Carrera, Constanza S; Seguin, Philippe

    2016-12-21

    Soybean seeds contain several health-beneficial compounds, including tocopherols, which are used by the nutraceutical and functional food industries. Soybean tocopherol concentrations are, however, highly variable. Large differences observed in tocopherol concentrations among soybean genotypes together with the relatively simple biosynthetic pathway involving few genes support the feasibility of selecting for high-tocopherol soybean. Tocopherol concentrations are also highly influenced by environmental factors and field management. Temperature during seed filling and soil moisture appear to be the main factors affecting tocopherol concentrations; other factors such as soil fertility and solar radiation also affect concentrations and composition. Field management decisions including seeding date, row spacing, irrigation, and fertilization also affect tocopherols. Knowledge of factors affecting soybean tocopherols is essential to develop management strategies that will lead to the production of seeds with consistent target concentrations that will meet the needs of the nutraceutical and functional food industries.

  13. 7339 BASELINE SURVEY ON FACTORS AFFECTING SORGHUM ...

    African Journals Online (AJOL)

    muuicathy

    2013-01-01

    Jan 1, 2013 ... factors affecting sorghum production and the sorghum farming ... The informal seed system includes methods such as retaining seed on-farm from ..... Jaetzold R and H Schmidt Farm Management Handbook of Kenya, Ministry.

  14. SOCIO-ECONOMIC FACTORS AFFECTING APPLE PRODUCTION ...

    African Journals Online (AJOL)

    ACSS

    Research Organisation scientists working directly with apple farmers ... be productive up to 40 years, it was more realistic to consider .... to determine the factors that affect apple production. ..... profit maximising model using flexible production ...

  15. Organizational culture affecting quality of care: guideline adherence in perioperative antibiotic use.

    Science.gov (United States)

    Ukawa, Naoto; Tanaka, Masayuki; Morishima, Toshitaka; Imanaka, Yuichi

    2015-02-01

    The objective of this work was to elucidate aspects of organizational culture associated with hospital performance in perioperative antibiotic prophylaxis using quantitative data in a multicenter and multidimensional study. Cross-sectional retrospective study using a survey data and administrative data. Eighty-three acute hospitals in Japan. A total of 4856 respondents in the organizational culture study, and 23 172 patients for the quality indicator analysis. Multilevel models of various cultural dimensions were used to analyze the association between hospital organizational culture and guideline adherence. The dependent variable was adherence or non-adherence to Japanese and CDC guidelines at the patient level and main independent variable was hospital groups categorized according to organizational culture score. Other control variables included hospital characteristics such as ownership, bed capacity, region and urbanization level of location. The multilevel analysis showed that hospitals with a high score in organizational culture were more likely to adhere to the Japanese and CDC guidelines when compared with lower scoring hospitals. In particular, the hospital group with high scores in the 'collaboration' and 'professional growth' dimensions had three times the odds for Japanese guideline adherence in comparison with low-scoring hospitals. Our study revealed that various aspects of organizational culture were associated with adherence to guidelines for perioperative antibiotic use. Hospital managers aiming to improve quality of care may benefit from improving hospital organizational culture. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  16. Factor affecting Agrobacterium -mediated transformation of rice ...

    African Journals Online (AJOL)

    Potato is a very important food crop and is adversely affected by fungus. Agrobacterium-mediated transformation can play an important role in the improvement of potato. The present study was conducted to optimize the different factors affecting Agrobacterium-mediated transformation of chitinase gene. Nodes were used as ...

  17. Factors influencing adherence with therapeutic sunlight exposure in older people in intermediate care facilities.

    Science.gov (United States)

    Durvasula, Seeta; Sambrook, Philip N; Cameron, Ian D

    2012-01-01

    The purpose of this study was to investigate the factors influencing low adherence with therapeutic sunlight exposure in a randomized controlled trial conducted with older people living in intermediate care facilities. The study involved participants in the FREEDOM (Falls Risk Epidemiology: Effect of vitamin D on skeletal Outcomes and other Measures) study, a randomized controlled trial of therapeutic sun exposure to reduce falls in older people in intermediate care facilities. Semi-structured interviews were conducted with thirty participants in the FREEDOM trial, and with ten sunlight officers who were employed to facilitate the sun exposure. Two focus groups involving 10 participants in the FREEDOM trial were also held at the end of the intervention period. Common themes were derived from the interview and focus group transcripts. The study showed that the perceived health benefits did not influence adherence with the sun exposure. Factors such as socializing with others and being outdoors were more important in encouraging attendance. The main barriers to adherence included the perceived inflexibility and regimentation of daily attendance, clash with other activities, unsuitable timing and heat discomfort. This study showed that providing greater flexibility and autonomy to older people in how and when they receive sun exposure is likely to improve adherence. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. Multiple interacting factors influence adherence, and outcomes associated with surgical safety checklists: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Anna R Gagliardi

    Full Text Available The surgical safety checklist (SSC is meant to enhance patient safety but studies of its impact conflict. This study explored factors that influenced SSC adherence to suggest how its impact could be optimized.Participants were recruited purposively by profession, region, hospital type and time using the SSC. They were asked to describe how the SSC was adopted, associated challenges, perceived impact, and suggestions for improving its use. Grounded theory and thematic analysis were used to collect and analyse data. Findings were interpreted using an implementation fidelity conceptual framework.Fifty-one participants were interviewed (29 nurses, 13 surgeons, 9 anaesthetists; 18 small, 14 large and 19 teaching hospitals; 8 regions; 31 had used the SC for ≤12 months, 20 for 13+ months. The SSC was inconsistently reviewed, and often inaccurately documented as complete. Adherence was influenced by multiple issues. Extensive modification to accommodate existing practice patterns eliminated essential interaction at key time points to discuss patient management. Staff were often absent or not paying attention. They did not feel it was relevant to their work given limited evidence of its effectiveness, and because they were not engaged in its implementation. Organizations provided little support for implementation, training, monitoring and feedback, which are needed to overcome these, and other individual and team factors that challenged SSC adherence. Responses were similar across participants with different characteristics.Multiple processes and factors influenced SSC adherence. This may explain why, in studies evaluating SSC impact, outcomes were variable. Recommendations included continuing education, time for pilot-testing, and engaging all staff in SSC review. Others may use the implementation fidelity framework to plan SSC implementation or evaluate SSC adherence. Further research is needed to establish which SSC components can be modified

  19. Age Learning Factors Affecting Pilot Education.

    Science.gov (United States)

    Torbert, Brison

    This document, intended for pilot education and flight safety specialists, consists chiefly of a review of the literature on physiological factors that affect pilot education and an examination of environmental factors that should be scrutinized in order to improve the effectiveness of aviation learning facilities. The physiological factors…

  20. Economic and Cultural Factors Affecting University Excellence

    Science.gov (United States)

    Jabnoun, Naceur

    2009-01-01

    Purpose: The ranking of top universities in the world has generated increased interest in the factors that enhance university performance. The purpose of this paper is to identify economic and cultural factors that affect the number of top ranking universities in each country. Design/methodology/approach: This paper first identifies the number of…

  1. Environmental Factors Affecting Preschoolers' Motor Development

    Science.gov (United States)

    Venetsanou, Fotini; Kambas, Antonis

    2010-01-01

    The process of development occurs according to the pattern established by the genetic potential and also by the influence of environmental factors. The aim of the present study was to focus on the main environmental factors affecting motor development. The review of the literature revealed that family features, such as socioeconomic status,…

  2. Risk Factors for Non-Adherence to cART in Immigrants with HIV Living in the Netherlands: Results from the ROtterdam ADherence (ROAD Project.

    Directory of Open Access Journals (Sweden)

    Sabrina K Been

    Full Text Available In the Netherlands, immigrant people living with HIV (PLWH have poorer psychological and treatment outcomes than Dutch PLWH. This cross-sectional field study examined risk factors for non-adherence to combination Antiretroviral Therapy (cART among immigrant PLWH. First and second generation immigrant PLWH attending outpatient clinics at two HIV-treatment centers in Rotterdam were selected for this study. Socio-demographic and clinical characteristics for all eligible participants were collected from an existing database. Trained interviewers subsequently completed questionnaires together with consenting participants (n = 352 to gather additional data on socio-demographic characteristics, psychosocial variables, and self-reported adherence to cART. Univariable and multivariable logistic regression analyses were conducted among 301 participants who had used cART ≥6 months prior to inclusion. Independent risk factors for self-reported non-adherence were (I not having attended formal education or only primary school (OR = 3.25; 95% CI: 1.28-8.26, versus University, (II experiencing low levels of social support (OR = 2.56; 95% CI: 1.37-4.82, and (III reporting low treatment adherence self-efficacy (OR = 2.99; 95% CI: 1.59-5.64. Additionally, HIV-RNA >50 copies/ml and internalized HIV-related stigma were marginally associated (P<0.10 with non-adherence (OR = 2.53; 95% CI: 0.91-7.06 and OR = 1.82; 95% CI: 0.97-3.43. The findings that low educational attainment, lack of social support, and low treatment adherence self-efficacy are associated with non-adherence point to the need for tailored supportive interventions. Establishing contact with peer immigrant PLWH who serve as role models might be a successful intervention for this specific population.

  3. Factors influencing adherence to psychopharmacological medications in psychiatric patients: a structural equation modeling approach

    Directory of Open Access Journals (Sweden)

    De las Cuevas C

    2017-03-01

    positively (although weakly with age. Self-efficacy indirectly influenced treatment adherence through internal health locus of control.Conclusion: This study provides support for the hypothesis that perceived health control variables play a relevant role in psychiatric patients’ adherence to psychopharmacological medications. The findings highlight the importance of considering prospective studies of patients’ psychological reactance and health locus of control as they may be clinically relevant factors contributing to adherence to psychopharmacological medications. Keywords: attitude to health, medication adherence, health behavior, internal-external control, model, statistical, psychiatry

  4. The rate and factors associated with non-adherence to surgery, chemotherapy, radiotherapy and hormonal therapy among breast cancer patients attending public hospitals in Malaysia

    Directory of Open Access Journals (Sweden)

    Nur Aishah Taib

    2017-12-01

    Full Text Available Background: The role of breast cancer treatments in reducing recurrence and death has been established. However, the treatments side effects greatly impact on quality of life and little is known about the non-adherence rates. The purpose of this study was to determine the non-adherence rates to surgery, chemotherapy, radiotherapy and hormonal therapy, and factors that affect it in public hospitals in Malaysia. Methods: A multicentre cross-sectional study was conducted in six public hospitals involving all newly diagnosed breast cancer patients in 2012. Data were collected through medical record reviews and interview by using structured questionnaire. Non-adherence was categorized as any breast cancer patients refusing or discontinuing any treatment due to non-medical reasons. Univariable logistic regression and multiple logistic regressions were used for analysis. Results: A total of 340 breast cancer patients were included in the study. The proportion for non-adherence to surgery, chemotherapy, radiotherapy and hormonal therapy were 14%, 30.1%, 33.3% and 36.3% respectively. Factors associated with non-adherence to surgery were localities involving Kuala Lumpur (2 (OR: 3.41, Johor (OR: 8.38 and Kelantan (OR: 6.32, and those required mastectomy (OR: 5.66. No factors were found to be associated with non-adherence to chemotherapy, radiotherapy and hormonal therapy. These three treatment modalities were then combined as oncology therapy and the only independent factor associated with non-adherence to oncology therapy was Perak locality (OR: 1.42. Conclusion: Non-adherence to breast cancer treatments was high among breast cancer patients at public hospitals in Malaysia. Factors influencing non-adherence were locations and mastectomy implicating of socio-culture, body image issues, psychological disturbance and treatment navigation. Community educational programs focusing on correcting misconceptions, treatment outcomes and treatments’ side effects

  5. Risk factors for non-adherence to cART in immigrants with HIV living in the Netherlands: Results from the Rotterdam ADherence (ROAD) project

    NARCIS (Netherlands)

    S.K. Been; D.A.M.C. van de Vijver (David); P.T. Nieuwkerk (Pythia); Brito, I. (Inês); J. Stutterheim (Janine); A.E.R. Bos (Arjan); M.E.G. Wolfers (Mireille); K. Pogány (Katalin); A. Verbon (Annelies)

    2016-01-01

    textabstractIn the Netherlands, immigrant people living with HIV (PLWH) have poorer psychological and treatment outcomes than Dutch PLWH. This cross-sectional field study examined risk factors for non-adherence to combination Antiretroviral Therapy (cART) among immigrant PLWH. First and second

  6. Risk Factors for Non-Adherence to cART in Immigrants with HIV Living in the Netherlands: Results from the ROtterdam ADherence (ROAD) Project

    NARCIS (Netherlands)

    Been, Sabrina K.; van de Vijver, David A. M. C.; Nieuwkerk, Pythia T.; Brito, Inês; Stutterheim, Sarah E.; Bos, Arjan E. R.; Wolfers, Mireille E. G.; Pogány, Katalin; Verbon, Annelies

    2016-01-01

    In the Netherlands, immigrant people living with HIV (PLWH) have poorer psychological and treatment outcomes than Dutch PLWH. This cross-sectional field study examined risk factors for non-adherence to combination Antiretroviral Therapy (cART) among immigrant PLWH. First and second generation

  7. Factors Affecting University Library Website Design

    Directory of Open Access Journals (Sweden)

    Yongi-Mi Kim

    2011-09-01

    Full Text Available Existing studies have extensively explored factors that affect users’ intentions to use university library website resources (ULWR; yet little attention has been given to factors affecting university library website design. This paper investigates factors that affect university library website design and assesses the success of the university library website from both designers’ and users’ perspectives. The findings show that when planning a website, university web designers consider university guidelines, review other websites, and consult with experts and other divisions within the library; however, resources and training for the design process are lacking. While website designers assess their websites as highly successful, user evaluations are somewhat lower. Accordingly, use is low, and users rely heavily on commercial websites. Suggestions for enhancing the usage of ULWR are provided.

  8. Factors Affecting Entrepreneurship and Business Sustainability

    Directory of Open Access Journals (Sweden)

    Ana Tur-Porcar

    2018-02-01

    Full Text Available Sustainability is becoming increasingly important for society, and the creation of business ventures is one area where sustainability is critical. We examined the factors affecting actions that are designed to foster business sustainability. These factors are related to the environment, behavior, human relations, and business activity. Based on questionnaire responses from experts, the Analytic Hierarchy Process (AHP method was used to rank sustainable business criteria according to their importance for entrepreneurs starting sustainable businesses. The results indicate that the most important drivers of sustainable entrepreneurship are behavioral factors and business factors. Ethical principles and values, together with competitive intelligence, are crucial for undertaking actions that lead to sustainability.

  9. Factors governing long-term adherence to a gluten-free diet in adult patients with coeliac disease.

    Science.gov (United States)

    Villafuerte-Galvez, J; Vanga, R R; Dennis, M; Hansen, J; Leffler, D A; Kelly, C P; Mukherjee, R

    2015-09-01

    A strict gluten-free diet is the cornerstone of treatment for coeliac disease. Studies of gluten-free diet adherence have rarely used validated instruments. There is a paucity of data on long-term adherence to the gluten-free diet in the adult population. To determine the long-term adherence to the gluten-free diet and potential associated factors in a large coeliac disease referral centre population. We performed a mailed survey of adults with clinically, serologically and histologically confirmed coeliac disease diagnosed ≥5 years prior to survey. The previously validated Celiac Disease Adherence Test was used to determine adherence. Demographic, socio-economic and potentially associated factors were analysed with adherence as the outcome. The response rate was 50.1% of 709 surveyed, the mean time on a gluten-free diet 9.9 ± 6.4 years. Adequate adherence (celiac disease adherence test score 75% of respondents. Perceived cost remains a barrier to adherence. Perceptions of effectiveness of gluten-free diet as well as its knowledge, are potential areas for intervention. © 2015 John Wiley & Sons Ltd.

  10. Individual and contextual factors of influence on adherence to antiretrovirals among people attending public clinics in Rio de Janeiro, Brazil

    Science.gov (United States)

    2013-01-01

    Background There are inconsistencies in the determinants of adherence to antiretrovirals (ARVs) across settings as well as a lack of studies that take into consideration factors beyond the individual level. This makes it necessary to examine factors holistically in multiple settings and populations while taking into consideration the particularities of each context, in order to understand the patterns of ARV adherence. This research explored ARV adherence and individual, relational and environmental-structural factors. Methods A cross-sectional survey was conducted from August 2008 through July 2009 among participants currently on ARVs recruited from 6 public health clinics, selected to maximize diversity in terms of caseload and location, representing the range of clinics within Rio de Janeiro city, Brazil. Multivariate logistic regression analysis was used to assess the association between our multilevel factors with ARV adherence among participants with complete cases (n = 632). Results Eighty-four percent of respondents reported adherence to all of their ARV doses in the last 4 days. Of the socio-demographic variables, those who had one child were positively associated with adherence (AOR 2.29 CI [1.33-3.94]). On the relational level, those with high social support (AOR 2.85 CI [1.50-5.41]) were positively associated with adherence to ARVs. On the environmental-structural level, we found gender was significant with women negatively associated with adherence to ARVs (AOR 0.58 CI [0.38-0.88]) while those with a high asset index (AOR 2.47 CI [1.79-3.40]) were positively associated with adherence to ARVs. Conclusions This research highlights the importance of examining the multiple levels of influence on ARV adherence. Intervention research in lower and middle-income settings should address and evaluate the impact of attending to both gender and economic inequalities to improve ARV adherence, as well as relational areas such as the provision of social support. PMID

  11. Understanding Factors Associated with Early Therapeutic Alliance in PTSD Treatment: Adherence, Childhood Sexual Abuse History, and Social Support

    Science.gov (United States)

    Keller, Stephanie M.; Zoellner, Lori A.; Feeny, Norah C.

    2010-01-01

    Objective: Therapeutic alliance has been associated with better treatment engagement, better adherence, and less dropout across various treatments and disorders. In treatment of posttraumatic stress disorder (PTSD), it may be particularly important to establish a strong early alliance to facilitate treatment adherence. However, factors such as…

  12. Influencing factors on CPAP adherence and anatomic characteristics of upper airway in OSA subjects.

    Science.gov (United States)

    Park, Pona; Kim, Jinil; Song, Yoon Jae; Lim, Jae Hyun; Cho, Sung Woo; Won, Tae-Bin; Han, Doo Hee; Kim, Dong-Young; Rhee, Chae Seo; Kim, Hyun Jik

    2017-12-01

    Although continuous positive airway pressure (CPAP) is the most effective treatment modality, poor adherence still remains a problem for obstructive sleep apnea (OSA) treatment and there is little evidence regarding how this might be improved. This study aims to analyze the anatomic and clinical factors of OSA subjects who failed to comply with CPAP therapy.The medical records of 47 OSA subjects who received CPAP therapy as a first-line treatment modality were retrospectively reviewed. The medical records were reviewed for demographic and polysomnographic data and anatomic findings of the nasal cavity and oropharynx.24 patients who adhered to CPAP therapy and 23 patients who were nonadherent were enrolled in the study. There were no statistically significant differences in sleep parameters between CPAP-adherent patients and CPAP nonadherent subjects. Mean body mass index of CPAP nonadherent group was significantly higher than CPAP adherent group. Higher grades of septal deviation and hypertrophic change of the inferior turbinate were observed more in the CPAP nonadherent group. In addition, CPAP nonadherent subjects showed considerably bigger tonsils and higher grade palatal position comparing with the CPAP adherent subjects. Subjective discomfort including inconvenience, mouth dryness, and chest discomfort were the main problems for OSA subjects who did not comply with CPAP therapy.Excessive upper airway blockage in the nasal cavity and oropharynx was predominant in CPAP nonadherent subjects, which might cause the reported subjective discomfort that reduces CPAP compliance. Therefore, resolution of these issues is needed to enhance CPAP compliance for control of OSA. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  13. ANALYSIS OF THE FACTORS AFFECTING THE AVERAGE

    Directory of Open Access Journals (Sweden)

    Carmen BOGHEAN

    2013-12-01

    Full Text Available Productivity in agriculture most relevantly and concisely expresses the economic efficiency of using the factors of production. Labour productivity is affected by a considerable number of variables (including the relationship system and interdependence between factors, which differ in each economic sector and influence it, giving rise to a series of technical, economic and organizational idiosyncrasies. The purpose of this paper is to analyse the underlying factors of the average work productivity in agriculture, forestry and fishing. The analysis will take into account the data concerning the economically active population and the gross added value in agriculture, forestry and fishing in Romania during 2008-2011. The distribution of the average work productivity per factors affecting it is conducted by means of the u-substitution method.

  14. Factors Affecting the Productivity of Government Workers

    Directory of Open Access Journals (Sweden)

    Jerry P. Haenisch

    2012-01-01

    Full Text Available While there have been a variety of studies concerning government worker motivation and productivity, few, if any, studies have focused specifically on state government workers’ perceptions about what factors affect their productivity. With more than 5 million workers employed by state governments in the United States, any improvement in state workplace productivity could have significant financial and service impact for society. In this study, state government workers identified those factors perceived as most affecting their workplace productivity. Data were collected through a survey offered to state government workers in the state of Wyoming. Factor analysis was used to derive key productivity factors from survey responses. The results indicate that state government workers appreciate having freedom and autonomy, like their jobs and the sense of achievement, and welcome teamwork, but feel limited by poor supervision and management, poor communications, and insufficient budgets and staffing. To improve productivity, the workers would eliminate bureaucracy, supervise better, and improve communication.

  15. Analysis of Economic Factors Affecting Stock Market

    OpenAIRE

    Xie, Linyin

    2010-01-01

    This dissertation concentrates on analysis of economic factors affecting Chinese stock market through examining relationship between stock market index and economic factors. Six economic variables are examined: industrial production, money supply 1, money supply 2, exchange rate, long-term government bond yield and real estate total value. Stock market comprises fixed interest stocks and equities shares. In this dissertation, stock market is restricted to equity market. The stock price in thi...

  16. Factors affecting the effects of diuresis renography

    International Nuclear Information System (INIS)

    Zhao Deshan

    2006-01-01

    Diuresis renography is one of the classic methods for diagnosing upper urinary tract obstruction in both children and adults. However, in clinical practice, the results of diuresis renography were often influenced by many factors including diuretics, timing of diuretics injection, the status of renal function and hydration, the volume and compliance of collecting system, bladder fullness and so on. It is important to consider all the factors affecting diuresis renography during performing and interpreting diuresis renography. (authors)

  17. Factors Affecting Faculty Web Portal Usability

    Science.gov (United States)

    Bringula, Rex P.; Basa, Roselle S.

    2011-01-01

    The study investigated the factors that might significantly affect web portal usability. Results of the study were intended to serve as inputs for faculty web portal development of the University of the East-Manila. Descriptive statistics utilized questionnaire data from 82 faculty members. The data showed that most of the respondents were…

  18. ORIGINAL ARTICLES Factors affecting career preferences of ...

    African Journals Online (AJOL)

    College of Medicine prefer to work as doctors, and (ii) what factors may affect their long-term retention in their home country? Methods. We designed ... from rural areas and small towns, and whose parents were 'non- professionals', were .... needs – 5; city life can be difficult – 3; one is closer to family – 2; there is a sense of ...

  19. Workplace, Biographical and Motivation Factors Affecting ...

    African Journals Online (AJOL)

    This paper presents the findings of a survey on how workplace, biographical and motivational factors affect the organisational commitment of records officers in federal universities in Nigeria. Single stage random sampling, with equal allocation method, was used to administer questionnaire on 300 sampled participants from ...

  20. Factors affecting IUCD discontinuation in Nepal

    DEFF Research Database (Denmark)

    Thapa, Subash; Paudel, Ishwari Sharma; Bhattarai, Sailesh

    2015-01-01

    Information related to contraception discontinuation, especially in the context of Nepal is very limited. A nested case-control study was carried out to determine the factors affecting discontinuation of intrauterine contraceptive devices (IUCDs). A total of 115 cases (IUCD discontinuers) and 115...

  1. INTERNATIONAL DIFFERENCES IN FACTORS AFFECTING LABOUR MOBILITY.

    Science.gov (United States)

    SELLIER, F.; ZARKA, C.

    THE GEOGRAPHICAL, OCCUPATIONAL, AND INTERFIRM MOBILITY, AND THE FACTORS AFFECTING THESE MOVEMENTS FOR WORKERS IN FRANCE, ITALY, GERMANY, AND SWEDEN IN THE PERIOD SINCE THE SECOND WORLD WAR ARE STUDIED. DATA OBTAINED FROM INDUSTRIAL SURVEYS AND GENERAL CENSUSES WERE USED TO COMPARE THE FOUR COUNTRIES WITH EACH OTHER AND WITH THE UNITED STATES.…

  2. Personal factors affecting organizational commitment of records ...

    African Journals Online (AJOL)

    This study investigated personal factors affecting organizational commitment among records management personnel in the state universities in Nigeria. Simple cluster sampling with equal allocation method was used to select 180 records management personnel from the study population. A five item organizational ...

  3. Factors contributing to antiretroviral drug adherence among adults living with HIV or AIDS in a Kenyan rural community.

    Science.gov (United States)

    Kioko, Mary T; Pertet, Anne M

    2017-07-31

    Antiretroviral (ARV) adherence of ≥ 95% is recommended for suppressing HIV. However, studies have shown that the ≥ 95% recommended level is rarely achieved. This cross-sectional community-based study sought to assess factors contributing to ARV drug adherence among adults living with HIV or AIDS. The study was conducted in a rural community in Machakos County, Kenya. The questions used for the study were adapted from the Patient Medicine Adherence Questionnaire (PMAQ), a tool grounded in the Health Belief Model. Adherence to ARV was measured using self-reports and pill counts. The perception social support was measured with a 5-point Likert scale, whereas the type and the number of side effects experienced were recorded using 'yes' and 'no' questions. We used the chi-square test to test associations and binary logistic regression to assess factors explaining dose adherence to ARV. The levels of adherence of 86% using self-reports were significantly higher (p < 0.001) than the pill count of 58.6%. The immediate family was rated high in providing social support (3.7 ± 0.6) followed by social support groups (3.1 ± 0.8). A binary logistic regression analysis was conducted to predict ARV adherence (adherent, non-adherent) using social support, side effects and marital status as explanatory variables. The Wald criterion demonstrated that marital status (p = 0.019) and burden of side effects (p ≤ 0.001) made a significant contribution to the prediction of ARV adherence. The burden of side effects and being a divorcee are primary predictors of ARV adherence.

  4. Identification of factors affecting individual industries

    Directory of Open Access Journals (Sweden)

    Maryam Sadat Mirzadeh

    2017-10-01

    Full Text Available High knowledge and technology are rapidly becoming a competitive advantage in today’s world. Individual industries are considered one of the key sectors in the country’s industry. Ranking the factors that affect these industries makes us more familiar with their effectiveness and helps us take actions to improve such factors in knowledge-based companies. Consequently, based on previous research studies on Individual Industries, field observations, and a questionnaire prepared by the researchers, the current study explores and classifies the factors affecting the establishment of these industries. Regarding its purpose, this is an applied research, and regarding data collection, it is a descriptive survey. Using purposive sampling, 60 questionnaires were collected and effective factors were classified applying the SPSS software and the TOPSIS technique. This study suggests that content factors are ranked first place, while contextual and structural factors are ranked second and third, respectively. Therefore, executives and managers in single industries are recommended to strengthen joint enterprise norms and dominant values and beliefs in knowledge-based companies in order to help the growth and development of single industries.

  5. Factors associated with a low adherence to a Mediterranean diet pattern in healthy Spanish women before pregnancy.

    Science.gov (United States)

    Olmedo-Requena, Rocío; Fernández, Julia Gómez; Prieto, Carmen Amezcua; Moreno, Juan Mozas; Bueno-Cavanillas, Aurora; Jiménez-Moleón, José J

    2014-03-01

    To analyse the factors associated with the level of adherence to a Mediterranean dietary pattern in healthy Spanish women before pregnancy. A prospective series of 1175 women. An FFQ validated in Spanish populations served to collect dietary data. The Mediterranean Diet Adherence Index was used to assess the level of adherence to a Mediterranean diet pattern. Polytomic regression was performed to identify the associated factors. Catchment area of Virgen de las Nieves University Hospital, Andalusia, Spain. The women were invited to participate in the study at the 20th-22nd gestational week. The selection criteria were: Spanish nationality, 18 years of age or older, singleton pregnancy and absence of health problems that required modifying the diet or physical activity. An inverse relationship was found between women's age and level of adherence to a Mediterranean diet pattern, with a clear dose-response association: a younger age entailed worse adherence (P smoking and sedentary lifestyle had a positive relationship with low adherence, giving OR = 5·36 (95 % 1·91, 15·07) for women who smoked >20 cigarettes/d and OR = 2·07 (95 % CI 1·34, 3·17) for sedentary women. Higher age, higher educational level, and higher social class of the women were associated with a higher level of adherence to the Mediterranean diet (P smoking and lack of exercise were associated with low adherence to a Mediterranean diet.

  6. [Factors associated with adherence to school meals by adolescents in State public schools in Colombo, Paraná State, Brazil].

    Science.gov (United States)

    Valentim, Emanuele de Araujo; Almeida, Claudia Choma Bettega de; Taconeli, César Augusto; Osório, Mônica Maria; Schmidt, Suely Teresinha

    2017-10-26

    This study aimed to estimate the prevalence of adherence to school meals and associated factors among adolescent schoolchildren (N = 1,569). The adolescents completed an on-line questionnaire on adherence to school meals, and their parents answered another questionnaire on socioeconomic data. The chi-square test was used to assess the association between adherence to school meals and gender, nutritional status, per capita family income, maternal schooling, adolescents' opinions on the dining hall layout, whether they considered school meals healthy, and consumption of other foods. Variables with statistical significance for adherence to school meals were included in the multilevel proportional odds logistic regression model. The covariates for comprising the final model were defined by backward selection methods. The results of the adjusted model were presented as odds ratios with respective 95% confidence intervals (95%CI). Prevalence of adherence to school meals was low, especially effective adherence (19.8%). Adherence was associated with per capita family income less than one minimum wage, lower consumption of foods outside of school meals, the fact that adolescents considered the dining hall space adequate, and believing that school meals are healthy. Adherence to school meals in this study falls short of universal coverage for the program. Different factors contribute to incomplete program implementation, which may hinder achieving the food and nutritional security policy under the Brazilian National School Feeding Program (PNAE).

  7. Factors affecting patient dose in diagnostic radiology

    International Nuclear Information System (INIS)

    Poletti, J.L.

    1994-03-01

    The report, Factors Affecting Patient Dose in Diagnostic Radiology is divided into three main sections. Part one is introductory and covers the basic principles of x-ray production and image formation. It includes discussion of x-ray generators and x-ray tubes, radiation properties and units, specification and measurement of x-ray beams, methods of patient dose measurement, radiation effects, radiation protection philosophy and finally the essentials of imaging systems. Part two examines factors affecting the x-ray output of x-ray machines and the characteristics of x-ray beams. These include the influence of heat ratings, kVp, waveform, exposure timer, filtration, focus-film distance, beam intensity distribution, x-ray tube age and focal spot size. Part three examines x-ray machine, equipment and patient factors which affect the dose received by individual patients. The factors considered include justification of examinations, choice of examination method, film/screen combinations, kVp, mAs, focus-film distance, collimation and field size, exposure time, projection, scatter, generator calibration errors, waveform, filtration, film processing and patient size. The patient dose implications of fluoroscopy systems, CT scanners, special procedures and mammography are also discussed. The report concludes with a brief discussion of patient dose levels in New Zealand and dose optimisation. 104 refs., 32 figs., 27 tabs

  8. Factors associated with beliefs about adherence to non-pharmacological treatment of patients with heart failure

    Directory of Open Access Journals (Sweden)

    Izabel Cristina Ribeiro da Silva Saccomann

    2014-02-01

    Full Text Available This study aimed at assessing beliefs about the benefits and barriers to adherence to daily self-monitoring of weight/edema in patients with heart failure, and the influence of demographic and clinical variables on those beliefs. 105 patients were interviewed. The mean of the subscales Benefits and Barriers were 20.2 (± 5.7 and 30.1 (±7.1, respectively. Patients perceived that adherence to daily self-monitoring of weight/edema could keep them healthy, improve their quality of life and decrease the chances of readmission. Approximately half of patients (46.7% reported forgetting this measure. Those who controlled weight once a month were more likely to have barriers to adherence (OR= 6.6; IC 95% 1.9-13.8; p=0.01, showing this measure to be the main factor related to perceived barriers. Education in health can contribute with the development of strategies aimed at lowering barriers and increasing benefits of this control.

  9. Social factors and barriers to self-care adherence in Hispanic men and women with diabetes.

    Science.gov (United States)

    Mansyur, Carol L; Rustveld, Luis O; Nash, Susan G; Jibaja-Weiss, Maria L

    2015-06-01

    To explore quantitatively the extent to which social support, social norms and barriers are associated with self-efficacy and self-care adherence in Hispanic patients with diabetes and the extent to which these differ for men and women. Baseline survey data were collected from 248 low-SES, Hispanic men and women who were participants in a randomized controlled trial of a culturally targeted intervention for diabetes management. Student's t, Pearson correlations and multiple regression were used to analyze the data. Compared to men, women were less likely to receive support, faced more barriers, reported less self-efficacy and had lower levels of self-care adherence. Perceived support was consistently correlated with better self-efficacy in women but not men, even though men reported higher levels of support. The lack of adequate support seems to be a fundamental barrier for Hispanic women with diabetes. Health care providers should be sensitive to sociocultural influences in Hispanic groups that may facilitate men's self-care adherence, but could potentially hamper women's efforts. Interventions designed for Hispanics should augment women's support needs and address culture and social factors that may differentially impact the ability of men and women to manage their diabetes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Factors associated with adherence to medication among depressed patients from Saudi Arabia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Al Jumah K

    2014-10-01

    Full Text Available Khalaf Al Jumah,1 Mohamed Azmi Hassali,2 Dalal Al Qhatani,1 Kamal El Tahir3 1Department of Pharmacy, Al Amal Psychiatric Hospital, Riyadh, Saudi Arabia; 2School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; 3College of Pharmacy, King Saud University, Riyadh, Saudi Arabia Background: Several studies have investigated the factors associated with adherence to antidepressants, with inconsistent conclusions. However, no similar study has investigated this issue among patients diagnosed with major depressive disorder in Saudi Arabia. The aim of this study is to explore patients’ adherence to antidepressant medications, and the factors associated with adherence.Methods: A non-experimental cross-sectional design was used to measure adherence to antidepressants among major depressive disorder patients, and the factors associated with adherence. The patients were recruited from the outpatient clinic at the Al-Amal Complex for Mental Health in Riyadh, Saudi Arabia, between August 2013 and January 2014. Eligible participants met with one of the research coordinators for assessment of their adherence. Adherence was investigated indirectly by use of the Morisky Medication Adherence Scale, and patients’ beliefs were assessed through the Beliefs about Medicine Questionnaire. Information about the severity of their depression, demographics, and other study variables were collected.Results: A total of 403 patients met the inclusion criteria and participated in the study. Of those, 203 (50.37% were females, while the remaining 200 (49.6% were males. There was an average age of 39 years (standard deviation, ±11 years. Half of the patients (52.9% reported low adherence to their antidepressant medication, with statistically significant differences between the low adherence and high adherence scores relating to sex, age, and duration of illness. Conclusion: Low medication adherence is a common problem among major depressive disorder

  11. Factors affecting the rural domestic waste generation

    Directory of Open Access Journals (Sweden)

    A.R. Darban Astane

    2017-12-01

    Full Text Available The current study was carried out to evaluate the quantity and quality of rural domestic waste generation and to identify the factors affecting it in rural areas of Khodabandeh county in Zanjan Province, Iran. Waste samplings consisted of 318 rural households in 11 villages. In order to evaluate the quality and quantity of the rural domestic waste, waste production was classified into 12 groups and 2 main groups of organic waste and solid waste. Moreover, kriging interpolation technique in ARC-GIS software was used to evaluate the spatial distribution of the generated domestic waste and ultimately multiple regression analysis was used to evaluate the factors affecting the generation of domestic waste. The results of this study showed that the average waste generated by each person was 0.588 kilograms per day. with the share of organic waste generated by each person being 0.409 kilograms per day and the share of solid waste generated by each person being 0.179 kilograms per day. The results from spatial distribution of waste generation showed a certain pattern in three groups and a higher rate of waste generation in the northern and northwestern parts, especially in the subdistrict. The results of multiple regression analysis showed that the households’ income, assets, age, and personal attitude are respectively the most important variables affecting waste generation. The housholds’ attitude and indigenous knowledge on efficient use of materials are also the key factors which can help reducing waste generation.

  12. Insomnia complaints in lean patients with obstructive sleep apnea negatively affect positive airway pressure treatment adherence.

    Science.gov (United States)

    Eysteinsdottir, Bjorg; Gislason, Thorarinn; Pack, Allan I; Benediktsdottir, Bryndís; Arnardottir, Erna S; Kuna, Samuel T; Björnsdottir, Erla

    2017-04-01

    The objective of this study was to evaluate the determinants of long-term adherence to positive airway pressure treatment among patients with obstructive sleep apnea, with special emphasis on patients who stop positive airway pressure treatment within 1 year. This is a prospective long-term follow-up of subjects in the Icelandic Sleep Apnea Cohort who were diagnosed with obstructive sleep apnea between 2005 and 2009, and started on positive airway pressure treatment. In October 2014, positive airway pressure adherence was obtained by systematically evaluating available clinical files (n = 796; 644 males, 152 females) with moderate to severe obstructive sleep apnea (apnea-hypopnea index ≥15 events per h). The mean follow-up time was 6.7 ± 1.2 years. In total, 123 subjects (15.5%) returned their positive airway pressure device within the first year, 170 (21.4%) returned it later and 503 (63.2%) were still using positive airway pressure. The quitters within the first year had lower body mass index, milder obstructive sleep apnea, less sleepiness, and more often had symptoms of initial and late insomnia compared with long-term positive airway pressure users at baseline. Both initial and late insomnia were after adjustment still significantly associated with being an early quitter among subjects with body mass index insomnia are associated with early quitting on positive airway pressure among non-obese subjects. © 2016 European Sleep Research Society.

  13. Policy factors affecting broadband development in Poland

    DEFF Research Database (Denmark)

    Henten, Anders; Windekilde, Iwona Maria

    2014-01-01

    of telecommunications network development in Poland than other countries in the European Union is the reason that the circumstances and also the effects of the implementation of some solutions of the EU regulation model are different in Poland than in the most developed EU countries. The aim of the paper is to examine...... and discuss broadband access development in Poland and the policy factors influencing this development as well as to examine national strategies used to stimulate service and infrastructure competition in Poland. There are, indeed, many other factors affecting broadband development such as the income level....../distribution in the country and the infrastructural point of departure. The paper, therefore, analyses the implications of the policy initiatives in light of these basic conditions and the broader context of factors influencing broadband development. In the paper, different kinds of policy initiatives are examined...

  14. Household factors, family behavior patterns, and adherence to dietary and physical activity guidelines among children at risk for obesity.

    Science.gov (United States)

    Kunin-Batson, Alicia S; Seburg, Elisabeth M; Crain, A Lauren; Jaka, Meghan M; Langer, Shelby L; Levy, Rona L; Sherwood, Nancy E

    2015-01-01

    To describe the proportion of children adhering to recommended physical activity and dietary guidelines, and examine demographic and household correlates of guideline adherence. Cross-sectional (pre-randomization) data from a behavioral intervention trial designed to prevent unhealthy weight gain in children. A total of 421 children (aged 5-10 years) at risk for obesity (body mass index percentile, 70-95). Physical activity (accelerometry), screen time (parent survey), and fruit and vegetable and sugar-sweetened beverage intake (24-hour dietary recall). Proportions meeting guidelines were calculated. Logistic regression examined associations between demographic and household factors and whether children met recommended guidelines for (1) physical activity (≥ 60 min/d), (2) screen time (≤ 2 h/d), (3) fruit and vegetable intake (≥ 5 servings/d), and (4) sugar-sweetened beverage avoidance. Few children met more than 1 guideline. Only 2% met all 4 recommended guidelines and 19% met none. Each guideline had unique sociodemographic and domain-specific household predictors (ie, availability of certain foods and beverages, media, and active play and exercise equipment). Families equipped to promote healthy child behavior patterns in 1 activity or dietary domain may not be in others. Results have implications for the development of interventions to affect children's weight-related behaviors and growth trajectories. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  15. Adjuvant endocrine therapy after breast cancer: a qualitative study of factors associated with adherence

    Directory of Open Access Journals (Sweden)

    Brett J

    2018-02-01

    Full Text Available Jo Brett,1 Mary Boulton,1 Debbie Fenlon,2 Nick J Hulbert-Williams,3 Fiona M Walter,4 Peter Donnelly,5 Bernadette A Lavery,6 Adrienne Morgan,7 Carolyn Morris,7 Eila K Watson1 1Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, 2College of Human and Health Sciences, Swansea University, Swansea, Wales, 3Department of Psychology, Chester Research Unit for the Psychology of Health, University of Chester, Chester, 4Department of Public Health and Primary Care, University of Cambridge, Cambridge, 5South Devon Healthcare NHS Foundation Trust, Torbay Hospital, Torquay, 6Cancer Services, Oxford University Hospitals Foundation NHS Trust, Oxford, 7Independent Cancer Patients’ Voice, London, UK Introduction: Despite evidence of the efficacy of adjuvant endocrine therapy (AET in reducing the risk of recurrence and mortality after treatment for primary breast cancer, adherence to AET is suboptimal. This study aimed to explore factors that influence adherence and nonadherence to AET following breast cancer to inform the development of supportive interventions.Methods: Interviews were conducted with 32 women who had been prescribed AET, 2–4 years following their diagnosis of breast cancer. Both adherers (n=19 and nonadherers (n=13 were recruited. The analysis was conducted using the Framework approach.Results: Factors associated with adherence were as follows: managing side effects including information and advice on side effects and taking control of side effects, supportive relationships, and personal influences. Factors associated with nonadherence were as follows: burden of side effects, feeling unsupported, concerns about long-term AET use, regaining normality, including valuing the quality of life over length of life, and risk perception.Conclusion: Provision of timely information to prepare women for the potential side effects of AET and education on medication management strategies are needed, including provision of timely and

  16. Facilitating and inhibiting factors related to treatment adherence in women with polycystic ovary syndrome: A qualitative study

    Directory of Open Access Journals (Sweden)

    Fatemeh Bazarganipour

    2017-09-01

    Full Text Available Background: Adherence issues in polycystic ovary syndrome (PCOS patients have not been examined thoroughly. Patients report prolonged periods of treatment and side effects of the drug as the most common reason for withdrawal from treatment. To improve the effective management of PCOS patients, it is fundamental to understand facilitating and inhibiting factors to treatment adherence. Objective: To explore facilitating/inhibiting factors related to treatment adherence among PCOS patients. Materials and Methods: This was a qualitative study with a purposive sample of women with confirmed diagnosis of PCOS. The data were collected via 20 in-depth semi-structured interviews with women aged between 21-34 yr. A qualitative content analysis was used to analyze the data. Results: Five themes were identified which described different types of facilitating/ inhibiting factors to treatment adherence. Inhibiting factors included financial issues, patient-related, disease-related, and health care provider-related factors; while social factors were found to be both facilitating and inhibiting. Conclusion: The findings suggest that successful adherence to PCOS treatment is highly dependent on patients recognizing and adapting to financial, social, and health care related inhibiting factors. It is also crucial for clinicians and policy makers to recognize these key inhibiting factors in order to improve treatment outcomes.

  17. Chitosan nanoparticles affect acid tolerance response in adhered cells of strpetococcus mutans

    DEFF Research Database (Denmark)

    Neilands, Julia; Sutherland, Duncan S; Resin, Anton

    2011-01-01

    In this study we evaluated the effect of chitosan nanoparticles on the acid tolerance response (ATR) of adhered Streptococcus mutans. An ATR was induced by exposing S. mutans to pH 5.5 for 2 h and confirmed by exposing the acid-adapted cells to pH 3.5 for 30 min, with the majority of cells...... appearing viable according to the LIVE/DEAD (R) technique. However, when chitosan nanoparticles were present during the exposure to pH 5.5, no ATR occurred as most cells appeared dead after the pH 3.5 shock. We conclude that the chitosan nanoparticles tested had the ability to hinder ATR induction...

  18. Children and Adolescents with Perinatal HIV-1 Infection: Factors Associated with Adherence to Treatment in the Brazilian Context

    Directory of Open Access Journals (Sweden)

    Maria Letícia Santos Cruz

    2016-06-01

    Full Text Available Challenges to the adherence to combination antiretroviral therapy among the pediatric population should be understood in the context of the trajectories of families, their interaction with healthcare services, and their access to material and symbolic goods. The present study analyzed individual, institutional and social factors that might be associated with the caregivers’ role in the treatment adherence of children and adolescents living with HIV (CALHIV. Based on semi-structured interviews and questionnaires applied to 69 caregivers seen at pediatric AIDS services of five Brazilian macro-regions, we observed that adherent caregivers had better acceptance of diagnosis and treatment, were less likely to face discrimination and social isolation secondary to AIDS-related stigma and tended to believe in the efficacy of treatment, and to be more optimistic about life perspectives of CALHIV. Interventions aiming to improve adherence and to promote the health of CALHIV should take in consideration the interplay of such different factors.

  19. Children and Adolescents with Perinatal HIV-1 Infection: Factors Associated with Adherence to Treatment in the Brazilian Context

    Science.gov (United States)

    Cruz, Maria Letícia Santos; Cardoso, Claudete A. Araújo; Darmont, Mariana Q.; Dickstein, Paulo; Bastos, Francisco I.; Souza, Edvaldo; Andrade, Solange D.; Fabbro, Marcia D’All; Fonseca, Rosana; Monteiro, Simone

    2016-01-01

    Challenges to the adherence to combination antiretroviral therapy among the pediatric population should be understood in the context of the trajectories of families, their interaction with healthcare services, and their access to material and symbolic goods. The present study analyzed individual, institutional and social factors that might be associated with the caregivers’ role in the treatment adherence of children and adolescents living with HIV (CALHIV). Based on semi-structured interviews and questionnaires applied to 69 caregivers seen at pediatric AIDS services of five Brazilian macro-regions, we observed that adherent caregivers had better acceptance of diagnosis and treatment, were less likely to face discrimination and social isolation secondary to AIDS-related stigma and tended to believe in the efficacy of treatment, and to be more optimistic about life perspectives of CALHIV. Interventions aiming to improve adherence and to promote the health of CALHIV should take in consideration the interplay of such different factors. PMID:27338431

  20. Children and Adolescents with Perinatal HIV-1 Infection: Factors Associated with Adherence to Treatment in the Brazilian Context.

    Science.gov (United States)

    Cruz, Maria Letícia Santos; Cardoso, Claudete A Araújo; Darmont, Mariana Q; Dickstein, Paulo; Bastos, Francisco I; Souza, Edvaldo; Andrade, Solange D; Fabbro, Marcia D'All; Fonseca, Rosana; Monteiro, Simone

    2016-06-21

    Challenges to the adherence to combination antiretroviral therapy among the pediatric population should be understood in the context of the trajectories of families, their interaction with healthcare services, and their access to material and symbolic goods. The present study analyzed individual, institutional and social factors that might be associated with the caregivers' role in the treatment adherence of children and adolescents living with HIV (CALHIV). Based on semi-structured interviews and questionnaires applied to 69 caregivers seen at pediatric AIDS services of five Brazilian macro-regions, we observed that adherent caregivers had better acceptance of diagnosis and treatment, were less likely to face discrimination and social isolation secondary to AIDS-related stigma and tended to believe in the efficacy of treatment, and to be more optimistic about life perspectives of CALHIV. Interventions aiming to improve adherence and to promote the health of CALHIV should take in consideration the interplay of such different factors.

  1. Factors affecting academic leadership in dermatology.

    Science.gov (United States)

    Martires, Kathryn J; Aquino, Lisa L; Wu, Jashin J

    2015-02-01

    Although prior studies have examined methods by which to recruit and retain academic dermatologists, few have examined factors that are important for developing academic leaders in dermatology. This study sought to examine characteristics of dermatology residency programs that affect the odds of producing department or division chairs/chiefs and program directors (PDs). Data regarding program size, faculty, grants, alumni residency program attended, lectures, and publications for all accredited US dermatology residency programs were collected. Of the 103 programs examined, 46% had graduated at least 1 chair/chief, and 53% had graduated at least 1 PD. Results emphasize that faculty guidance and research may represent modifiable factors by which a dermatology residency program can increase its graduation of academic leaders.

  2. Reappraising factors affecting mourning dove perch coos

    Science.gov (United States)

    Sayre, M.W.; Atkinson, R.D.; Baskett, T.S.; Haas, G.H.

    1978-01-01

    Results confirmed pairing as the primary factor influencing perch-cooing rates of wild mourning doves (Zenaida macroura). Marked unmated males cooed at substantially higher rates (6.2x) than mated males, had greater probability of cooing (2.3x) during 3-minute periods, and continued cooing longer each morning than mated males. Population density was not a major factor affecting cooing. Unmated males cooed more frequently in the presence of other cooing doves (P < 0.05) than when alone, but the number of additional doves above 1 was unimportant. Cooing rates of both mated and unmated males on areas with dissimilar dove densities were not significantly different. Within limits of standard call-count procedure, weather exerted no detectable influence on cooing.

  3. Factors Affecting Gastrointestinal Microbiome Development in Neonates

    Directory of Open Access Journals (Sweden)

    Clara Yieh Lin Chong

    2018-02-01

    Full Text Available The gut microbiome is established in the newborn period and is recognised to interact with the host to influence metabolism. Different environmental factors that are encountered during this critical period may influence the gut microbial composition, potentially impacting upon later disease risk, such as asthma, metabolic disorder, and inflammatory bowel disease. The sterility dogma of the foetus in utero is challenged by studies that identified bacteria, bacterial DNA, or bacterial products in meconium, amniotic fluid, and the placenta; indicating the initiation of maternal-to-offspring microbial colonisation in utero. This narrative review aims to provide a better understanding of factors that affect the development of the gastrointestinal (GI microbiome during prenatal, perinatal to postnatal life, and their reciprocal relationship with GI tract development in neonates.

  4. Brazilian study on substance misuse in adolescents: associated factors and adherence to treatment

    Directory of Open Access Journals (Sweden)

    Silva Vilma A da

    2003-01-01

    Full Text Available OBJECTIVES: To investigate developmental and environmental factors associated to substance misuse in adolescents seen at a university day-hospital in Brazil and to verify the correlations between those factors and adherence to treatment. To compare factors associated to substance misuse in adolescents with the available scientific literature and to suggest specific preventive interventions for a national policy in Brazil. METHODS: Eighty-six adolescent's guardians were evaluated at admission to the service by using a semistructured interview including sociodemographic data, family relationship, perinatal and pregnancy histories, psychomotor and educational development, social relations, history of previous illnesses and family diseases, including drug abuse. RESULTS: The sample was predominantly male (90%. Adolescents referred from the criminal justice were older than those originating from other sources (16.4 x 15.4 years old p=.00. Forty-four percent of adolescents reported school failure, a level which is two times higher than Brazilian statistics. Forty percent of the sample had criminal involvement, mainly drug dealing. Cannabis was the most prevalent reported drug. Living with both parents was protective, delaying the age of initiation by one year. Domestic violence was more frequent among parents with illicit drugs abuse (38.1% x 12.5%, p<.05. Alcoholism and drug addiction in parents and relatives were about four times higher than those reported for the Brazilian population. No correlation was found between the investigated factors and adherence to treatment. CONCLUSION: Our results indicate that the programs must include treatment of adults and education of parents and parents to be. Withdrawal of treatment occurs in the first month, and seems to be related to factors extrinsic to the adolescent.

  5. Adherence to antiretroviral treatment and associated factors in people living with HIV/AIDS in Quindío, Colombia

    OpenAIRE

    Deisy Viviana Cardona-Duque; Oscar Adolfo Medina-Pérez; Sandra Milena Herrera-Castaño; Paula Andrea Orozco-Gómez

    2017-01-01

    Introduction: HIV/AIDS is a chronic disease; therefore, recognizing which factors favor adherence to antiretroviral treatment is necessary. Objective: To determine the association between adherence to antiretroviral treatment and depression, anxiety, perception of social support and sociodemographic variables in people living with HIV/AIDS in Quindío, Colombia. Materials and methods: An observational, cross-sectional study was performed in an intentional sample of 70 adults, who were ap...

  6. Glia maturation factor gamma regulates the migration and adherence of human T lymphocytes

    Directory of Open Access Journals (Sweden)

    Lippert Dustin ND

    2012-04-01

    Full Text Available Abstract Background Lymphocyte migration and chemotaxis are essential for effective immune surveillance. A critical aspect of migration is cell polarization and the extension of pseudopodia in the direction of movement. However, our knowledge of the underlying molecular mechanisms responsible for these events is incomplete. Proteomic analysis of the isolated leading edges of CXCL12 stimulated human T cell lines was used to identify glia maturation factor gamma (GMFG as a component of the pseudopodia. This protein is predominantly expressed in hematopoietic cells and it has been shown to regulate cytoskeletal branching. The present studies were undertaken to examine the role of GMFG in lymphocyte migration. Results Microscopic analysis of migrating T-cells demonstrated that GMFG was distributed along the axis of movement with enrichment in the leading edge and behind the nucleus of these cells. Inhibition of GMFG expression in T cell lines and IL-2 dependent human peripheral blood T cells with shRNAmir reduced cellular basal and chemokine induced migration responses. The failure of the cells with reduced GMFG to migrate was associated with an apparent inability to detach from the substrates that they were moving on. It was also noted that these cells had an increased adherence to extracellular matrix proteins such as fibronectin. These changes in adherence were associated with altered patterns of β1 integrin expression and increased levels of activated integrins as detected with the activation specific antibody HUTS4. GMFG loss was also shown to increase the expression of the β2 integrin LFA-1 and to increase the adhesion of these cells to ICAM-1. Conclusions The present studies demonstrate that GMFG is a component of human T cell pseudopodia required for migration. The reduction in migration and increased adherence properties associated with inhibition of GMFG expression suggest that GMFG activity influences the regulation of integrin mediated

  7. Factors affecting outcome in ocular myasthenia gravis.

    Science.gov (United States)

    Mazzoli, Marco; Ariatti, Alessandra; Valzania, Franco; Kaleci, Shaniko; Tondelli, Manuela; Nichelli, Paolo F; Galassi, Giuliana

    2018-01-01

    50%-60% of patients with ocular myasthenia gravis (OMG) progress to generalized myasthenia gravis (GMG) within two years. The aim of our study was to explore factors affecting prognosis of OMG and to test the predictive role of several independent clinical variables. We reviewed a cohort of 168 Caucasian patients followed from September 2000 to January 2016. Several independent variables were considered as prognostic factors: gender, age of onset, results on electrophysiological tests, presence and level of antibodies against acetylcholine receptors (AChR Abs), treatments, thymic abnormalities. The primary outcome was the progression to GMG and/or the presence of bulbar symptoms. Secondary outcomes were either achievement of sustained minimal manifestation status or worsening in ocular quantitative MG subscore (O-QMGS) or worsening in total QMG score (T-QMGS), assessed by Myasthenia Gravis Foundation of America (MGFA) quantitative scores. Changes in mental and physical subscores of health-related quality of life (HRQoL) were assessed with SF-36 questionnaire. Variance analysis was used to interpret the differences between AChR Ab titers at different times of follow up among the generalized and non-generalized patients. Conversion to GMG occurred in 18.4% of patients; it was significantly associated with sex, later onset of disease and anti-AChR Ab positivity. Antibody titer above the mean value of 25.8 pmol/mL showed no significant effect on generalization. Sex and late onset of disease significantly affected T-QMGS worsening. None of the other independent variables significantly affected O-QMGS and HRQoL. Sex, later onset and anti-AChR Ab positivity were significantly associated with clinical worsening.

  8. Lactoferrin affects the adherence and invasion of Streptococcus dysgalactiae ssp. dysgalactiae in mammary epithelial cells.

    Science.gov (United States)

    O'Halloran, Fiona; Beecher, Christine; Chaurin, Valerie; Sweeney, Torres; Giblin, Linda

    2016-06-01

    Streptococcus dysgalactiae ssp. dysgalactiae is an important causative agent of bovine mastitis worldwide. Lactoferrin is an innate immune protein that is associated with many functions including immunomodulatory, antiproliferative, and antimicrobial properties. This study aimed to investigate the interactions between lactoferrin and a clinical bovine mastitis isolate, Strep. dysgalactiae ssp. dysgalactiae DPC5345. Initially a deliberate in vivo bovine intramammary challenge was performed with Strep. dysgalactiae DPC5345. Results demonstrated a significant difference in lactoferrin mRNA levels in milk cells between the control and infused quarters 7h postinfusion. Milk lactoferrin levels in the Strep. dysgalactiae DPC5345 infused quarters were significantly increased compared with control quarters at 48h postinfusion. In vitro studies demonstrated that lactoferrin had a bacteriostatic effect on the growth of Strep. dysgalactiae DPC5345 and significantly decreased the ability of the bacteria to internalize into HC-11 mammary epithelial cells. Confocal microscopy images of HC-11 cells exposed to Strep. dysgalactiae and lactoferrin further supported this effect by demonstrating reduced invasion of bacteria to HC-11 cells. The combined data suggest that a bovine immune response to Strep. dysgalactiae infection includes a significant increase in lactoferrin expression in vivo, and based on in vitro data, lactoferrin limits mammary cell invasion of this pathogen by binding to the bacteria and preventing its adherence. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  9. Hypertension: adherence to treatment in rural Bangladesh – findings from a population-based study

    OpenAIRE

    Khanam, Masuma Akter; Lindeboom, Wietze; Koehlmoos, Tracey Lynn Perez; Alam, Dewan Shamsul; Niessen, Louis; Milton, Abul Hasnat

    2014-01-01

    Background: Poor adherence has been identified as the main cause of failure to control hypertension. Poor adherence to antihypertensive treatment is a significant cardiovascular risk factor, which often remains unrecognized. There are no previous studies that examined adherence with antihypertensive medication or the characteristics of the non-adherent patients in Bangladesh.Objective: This paper aims to describe hypertension and factors affecting adherence to treatment among hypertensive per...

  10. Factors affecting scholastic performances of adolescents.

    Science.gov (United States)

    Shashidhar, Saraswati; Rao, Chandrika; Hegde, Radhakrishna

    2009-05-01

    The present study aims at recognizing the social influence, study habits and health factors affecting scholastic performances of adolescents and to compare these factors among the adolescents between two categories of school. A total of 1230 adolescents (13-18 yrs) were screened. Data was collected by personal interview, using the teenage screening questionnaire, Trivandrum, between May 2004 and November 2005. A total 615 students from corporation and private schools were studied. 39.76% (489) were high achievers, 13.5% (166) were low achievers with p poor study habits and social factors were increased in low achievers of corporation schools. On multivariate analysis, the predictor variables for poor scholastic performance were adolescent having refractory error, not having help for study at home, not doing home work regularly, not solving question bank papers and reading only before examinations. It is feasible and worthwhile to identify the determinants of scholastic performance and plan intervention strategies at each school. The results of this study highlight the importance of implementing newer strategies, focusing on strict study patterns and creating the conducive school and home environment for study, so as to achieve better scholastic performances.

  11. Genetic factors affecting dental caries risk.

    Science.gov (United States)

    Opal, S; Garg, S; Jain, J; Walia, I

    2015-03-01

    This article reviews the literature on genetic aspects of dental caries and provides a framework for the rapidly changing disease model of caries. The scope is genetic aspects of various dental factors affecting dental caries. The PubMed database was searched for articles with keywords 'caries', 'genetics', 'taste', 'diet' and 'twins'. This was followed by extensive handsearching using reference lists from relevant articles. The post-genomic era will present many opportunities for improvement in oral health care but will also present a multitude of challenges. We can conclude from the literature that genes have a role to play in dental caries; however, both environmental and genetic factors have been implicated in the aetiology of caries. Additional studies will have to be conducted to replicate the findings in a different population. Identification of genetic risk factors will help screen and identify susceptible patients to better understand the contribution of genes in caries aetiopathogenesis. Information derived from these diverse studies will provide new tools to target individuals and/or populations for a more efficient and effective implementation of newer preventive measures and diagnostic and novel therapeutic approaches in the management of this disease. © 2015 Australian Dental Association.

  12. Understanding factors associated with early therapeutic alliance in PTSD treatment: adherence, childhood sexual abuse history, and social support.

    Science.gov (United States)

    Keller, Stephanie M; Zoellner, Lori A; Feeny, Norah C

    2010-12-01

    Therapeutic alliance has been associated with better treatment engagement, better adherence, and less dropout across various treatments and disorders. In treatment of posttraumatic stress disorder (PTSD), it may be particularly important to establish a strong early alliance to facilitate treatment adherence. However, factors such as childhood sexual abuse (CSA) history and poor social support may impede the development of early alliance in those receiving PTSD treatment. We sought to examine treatment adherence, CSA history, and social support as factors associated with early alliance in individuals with chronic PTSD who were receiving either prolonged exposure therapy (PE) or sertraline. At pretreatment, participants (76.6% female; 64.9% Caucasian; mean age = 37.1 years, SD = 11.3) completed measures of trauma history, general support (Inventory of Socially Supportive Behaviors), and trauma-related social support (Social Reactions Questionnaire). Over the course of 10 weeks of PE or sertraline, they completed early therapeutic alliance (Working Alliance Inventory) and treatment adherence measures. Early alliance was associated with PE adherence (r = .32, p history was not predictive of a lower early alliance. Given the associations with adherence, clinicians may find it useful to routinely assess alliance early in treatment. Positive trauma support, not CSA history, may be particularly important in the development of a strong early therapeutic alliance. (c) 2010 APA, all rights reserved.

  13. Adherence to antiretroviral therapy and treatment outcomes among conflict-affected and forcibly displaced populations: a systematic review

    Directory of Open Access Journals (Sweden)

    Mendelsohn Joshua B

    2012-10-01

    Full Text Available Abstract Background Optimal adherence to highly active antiretroviral therapy (HAART is required to promote viral suppression and to prevent disease progression and mortality. Forcibly displaced and conflict-affected populations may face challenges succeeding on HAART. We performed a systematic review of the literature on adherence to HAART and treatment outcomes in these groups, including refugees and internally-displaced persons (IDPs, assessed the quality of the evidence and suggest a future research program. Methods Medline, Embase, and Global Health databases for 1995–2011 were searched using the Ovid platform. A backward citation review of subsequent work that had cited the Ovid results was performed using the Web of Science database. ReliefWeb and Médecins Sans Frontières (MSF websites were searched for additional grey literature. Results and conclusion We screened 297 records and identified 17 reports covering 15 quantitative and two qualitative studies from 13 countries. Three-quarters (11/15 of the quantitative studies were retrospective studies based on chart review; five studies included

  14. CRITICAL THINKING AND ITS AFFECTING FACTORS

    Directory of Open Access Journals (Sweden)

    S Slameto

    2017-09-01

    Full Text Available The objectives of this research were to measure the success rate achieved by the alumni of Open/Distance Learning (O/DL, the Bachelor Education In-service Teachers Program (BEITP, Staya Jacana Christian University(SWCU, Salatiga in their critical thinking habit that lead to their success, and to find factors which determined their critical thinking habit. The factors concerned were student factor (learning motivation, alumni’s readiness to enter ICT community, prerequisite or teacher factor (teacher’s ability in creating and using a new instructional context. This quantitative research belongs to the causality ex-post facto research. The data source was one class of O/ DL, the BEITP, SWCUstudents, who were chosen out of four classes, as many as 32 alumni in the academic year 2015/2016. Data were screened using a self-rating scale, which consisted of 40 items tested valid and reliable, and then reduced to 5 variablas. The BEITP, SWCU Salatiga had graduated most of its alumni who owned critical thinking habit at a high rate. The critical thinking habit was affected by the instructional contexts which enabled a new situation (Model 1, alumni’s readiness to enter the ICT community (Model 2, pre-requisite, i.e., mastery of previous lecture materials (Model 3, and student’s learning motivation (Model 4 to reach 81%. The alumni’s critical thinking habit of 51.20% was determined by the teacher’s role in developing instructional contexts which made a new situation possible. This finding was useful for educational quality management for the effectiveness and productivity of higher education, which should have been focused on the teacher in developing an instructional strategy based on context, alumni readiness to enter the ICT community, prerequisite, and student’s learning motivation.

  15. Climatic factors and bipolar affective disorder

    DEFF Research Database (Denmark)

    Christensen, Ellen Margrethe; Larsen, Jens Knud; Gjerris, Annette

    2008-01-01

    In bipolar disorder, the factors provoking a new episode are unknown. As a seasonal variation has been noticed, it has been suggested that weather conditions may play a role. The aim of the study was to elucidate whether meteorological parameters influence the development of new bipolar phases....... A group of patients with at least three previous hospitalizations for bipolar disorder was examined every 3 months for up to 3 years. At each examination an evaluation of the affective phase was made according to the Hamilton Depression Scale (HAM-D(17)), and the Bech-Rafaelsen Mania Rating Scale (MAS......). In the same period, daily recordings from the Danish Meteorological Institute were received. We found no correlations between onset of bipolar episodes [defined as MAS score of 11 or more (mania) and as HAM-D(17) score of 12 or more (depression)] and any meteorological parameters. We found a statistical...

  16. Factors affecting assertiveness among student nurses.

    Science.gov (United States)

    Ibrahim, Sanaa Abd El Azim

    2011-05-01

    This study aimed to investigate the factors affecting assertiveness among student nurses. The study was carried out at Faculty of Nursing, Port-Said University, on 207 student nurses from four different grades. Rathus Assertiveness Schedule, consisted of 30 items, was used to measure the students' assertiveness level and a 12-item scale developed by Spreitzer was used to measure students' psychological empowerment. The study results showed that 60.4% of the students were assertive, while about half of the students were empowered. A positive relation between student assertiveness and psychological empowerment was detected. Moreover, positive relations regarding family income and students' assertiveness and psychological empowerment were determined. The study recommended introduction of specific courses aiming at enhancing the acquisition of assertiveness skills, in addition, nurse educators must motivate their students to express their opinion and personal rights and also they must pay attention for students' empowerment and enhance students' autonomy. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. Factors Affecting Fertility Desires in the Philippines

    Directory of Open Access Journals (Sweden)

    Clarissa C. David

    2014-12-01

    Full Text Available Factors affecting fertility desires in the Philippines were examined using data from a national survey and from individual and group qualitative interviews involving 143 respondents. Fertility goals usually range from two to three children, but evidence suggests that they are dynamic and may change over a person’s lifetime. Qualitative interviews reveal that when negotiating about family size, it is the partner who wants more children that will be followed. A strong demand for gender balance among offspring creates a willingness to have more children than originally desired. Fertility goals increase over time among women. While those who start childbirth at a very young age successfully space their children, they tend to want larger families than those who start late. Initial fertility goals among women are generally low but may increase because of higher fertility desires among men, a demand for gender balance in children, and the desire for babies once their children have grown.

  18. Factors affecting passive monitoring of radon

    International Nuclear Information System (INIS)

    Asano, Tomohiro; Kahn, B.

    1989-09-01

    In recent years, increasing cancer has been expressed as a possible health hazards associated with long-term exposures to a large population at a low level of radon in the environment. Because radon is ubiquitous nuclide, nation-wide monitoring is necessary to determine lung cancer risk. For such purpose, passive sampling methods with track etch detector or charcoal adsorption collector may have the advantage in lower cost and convenience. The charcoal adsorption collector is considered in this study. Various factors may significantly affect the charcoal adsorption mechanism on its practical application. Moisture effects are discussed here as having major impact on radon collection by charcoal. Set of equations are presented in this report to describe adsorption of radon including moisture effects. (author) 61 refs

  19. Factors associated with low adherence to medicine treatment for chronic diseases in Brazil.

    Science.gov (United States)

    Tavares, Noemia Urruth Leão; Bertoldi, Andréa Dâmaso; Mengue, Sotero Serrate; Arrais, Paulo Sergio Dourado; Luiza, Vera Lucia; Oliveira, Maria Auxiliadora; Ramos, Luiz Roberto; Farias, Mareni Rocha; Pizzol, Tatiane da Silva Dal

    2016-12-01

    To analyze factors associated with low adherence to drug treatment for chronic diseases in Brazil. Analysis of data from Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - Brazilian Survey on Access, Use and Promotion of Rational Use of Medicines), a population-based cross-sectional household survey, based on a probabilistic sample of the Brazilian population. We analyzed the association between low adherence to drug treatment measured by the Brief Medication Questionnaire and demographic, socioeconomic, health, care and prescription factors. We used Poisson regression model to estimate crude and adjusted prevalence ratios, their respective 95% confidence interval (95%CI) and p-value (Wald test). The prevalence of low adherence to drug treatment for chronic diseases was 30.8% (95%CI 28.8-33.0). The highest prevalence of low adherence was associated with individuals: young adults; no education; resident in the Northeast and Midwest Regions of Brazil; paying part of the treatment; poor self-perceived health; three or more diseases; reported limitations caused by a chronic disease; using five drugs or more. Low adherence to drug treatment for chronic diseases in Brazil is relevant, and regional and demographic differences and those related to patients' health care and therapy regime require coordinated action between health professionals, researchers, managers and policy makers. Analisar fatores associados à baixa adesão ao tratamento farmacológico de doenças crônicas no Brasil. Análise de dados oriundos da Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM), inquérito domiciliar de base populacional, de delineamento transversal, baseado em amostra probabilística da população brasileira. Analisou-se a associação entre baixa adesão ao tratamento medicamentoso mensurado pelo Brief Medication Questionnaire e fatores demográficos, socioeconômicos, de saúde, assist

  20. Emergency Nurses' Perspectives: Factors Affecting Caring.

    Science.gov (United States)

    Enns, Carol L; Sawatzky, Jo-Ann V

    2016-05-01

    Caring is a universal phenomenon. However, as a result of higher patient acuity and staff shortages within the chaotic ED environment, caring behaviors may be in peril. The purpose of this study was to gain insight into the meaning of caring from the perspective of emergency nurses. Exploring nurses' perspectives of caring is central to improving staffing and retention issues in this unique work environment. As part of a larger study, a subsample of emergency nurses who work in public hospitals in Manitoba, Canada (n = 17) were interviewed. A qualitative descriptive design was used to gain insight into the caring perspectives of nurses by asking them, "What does caring meaning to you?" and "What affects caring in your practice in the emergency department?" Emerging themes were extracted through analysis of audio tapes and transcripts. Advocacy and holistic care emerged as major themes in the meaning of caring for emergency nurses. Caring was affected by a number of factors, including workload, lack of time, staffing issues, shift work, and lack of self-care. However, lack of management support was the most consistent hindrance to caring identified by study participants. Caring continues to be a unifying concept in nursing; however, influencing factors continue to undermine caring for emergency nurses. Caring is not subsidiary to nursing; it is the central core of nursing. Therefore, fostering a caring working environment is essential for nurses to practice holistic nursing care. It is also imperative to job satisfaction and the retention of emergency nurses. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  1. Factors affecting medication-order processing time.

    Science.gov (United States)

    Beaman, M A; Kotzan, J A

    1982-11-01

    The factors affecting medication-order processing time at one hospital were studied. The order processing time was determined by directly observing the time to process randomly selected new drug orders on all three work shifts during two one-week periods. An order could list more than one drug for an individual patient. The observer recorded the nature, location, and cost of the drugs ordered, as well as the time to process the order. The time and type of interruptions also were noted. The time to process a drug order was classified as six dependent variables: (1) total time, (2) work time, (3) check time, (4) waiting time I--time from arrival on the dumbwaiter until work was initiated, (5) waiting time II--time between completion of the work and initiation of checking, and (6) waiting time III--time after the check was completed until the order left on the dumbwaiter. The significant predictors of each of the six dependent variables were determined using stepwise multiple regression. The total time to process a prescription order was 58.33 +/- 48.72 minutes; the urgency status of the order was the only significant determinant of total time. Urgency status also significantly predicted the three waiting-time variables. Interruptions and the number of drugs on the order were significant determinants of work time and check time. Each telephone interruption increased the work time by 1.72 minutes. While the results of this study cannot be generalized to other institutions, pharmacy managers can use the method of determining factors that affect medication-order processing time to identify problem areas in their institutions.

  2. Factors affecting hydrocarbon removal by air stripping

    International Nuclear Information System (INIS)

    McFarland, W.E.

    1992-01-01

    This paper includes an overview of the theory of air stripping design considerations and the factors affecting stripper performance. Effects of temperature, contaminant characteristics, stripping tower geometry and air/water ratios on removal performance are discussed. The discussion includes treatment of groundwater contaminated with petroleum hydrocarbons and chlorinated solvents such as TCE and PCE. Control of VOC emissions from air strippers has become a major concern in recent years, due to more stringent restrictions on air quality in many areas. This paper includes an overview of available technology to control air emissions (including activated carbon adsorption, catalytic oxidation and steam stripping) and the effects of air emission control on overall efficiency of the treatment process. The paper includes an overview of the relative performance of various packing materials for air strippers and explains the relative advantages and disadvantages of comparative packing materials. Field conditions affecting selection of packing materials are also discussed. Practical guidelines for the design of air stripping systems are presented, as well as actual case studies of full-scale air stripping projects

  3. Self-management of chronic illness: the role of 'habit' versus reflective factors in exercise and medication adherence.

    Science.gov (United States)

    Phillips, L Alison; Cohen, Joshua; Burns, Edith; Abrams, Jessica; Renninger, Steffi

    2016-12-01

    Non-adherence to health behaviors required for chronic illness self-management is pervasive. Advancing health-behavior theory to include behavioral initiation and maintenance factors, including reflective (e.g., belief- and feedback-based) and automatic (e.g., habit-based) mechanisms of adherence to different treatment-related behaviors could improve non-adherence prediction and intervention efforts. To test behavioral initiation and maintenance factors from an extended common sense self-regulation theoretical framework for predicting medication adherence and physical activity among patients with Type 2 diabetes. Patients (n = 133) in an in-person (n = 80) or online (n = 53) version of the study reported treatment-related (1) barriers, (2) beliefs and experiential feedback (reflective mechanisms of treatment-initiation and short-term repetition), and (3) habit strength (automatic mechanism of treatment-maintenance) for taking medication and engaging in regular physical activity at baseline. Behaviors were assessed via self-reports (n = 133) and objectively (electronic monitoring pill bottles, accelerometers; n = 80) in the subsequent month. Treatment-specific barriers and habit strength predicted self-reported and objective adherence for both behaviors. Beliefs were inconsistently related to behavior, even when habits were "weak". Experiential feedback from behavior was not related to adherence. Among patients with Type 2 diabetes diagnosis, medication and physical activity adherence were better predicted by their degree of automatic behavioral repetition than their beliefs/experiences with the treatment-actions. Habit strength should be an intervention target for chronic illness self-management; assessing it in practice settings may effectively detect non-adherence to existing treatment-regimens. However, future research and further refining of CS-SRM theory regarding the processes required for such habit development are needed.

  4. Factors Affecting the Underperformance of Employees

    Directory of Open Access Journals (Sweden)

    Nadeeka Amarasinghe

    2015-04-01

    Full Text Available BASL Intimate Apparel Mirigama is the largest factory of Brandix Group of Companies catering to VS Pink. It has a labour force of 1250 employees including a direct labour force of 659. Production capabilities have been extended to in-house printing and embroidery sections in addition to cutting and shipping facilities. Like other apparel manufacturers in the industry, BASL Intimate Apparel Mirigama also faces much competition and problems in its day to day business operations. One of the major issues so faced is On-Time-Delivery due to underperformance of the employees. Therefore, with the objectives of studying factors affecting the underperformance of the employees of the production department, analysing and identifying such factors, and providing recommendations, a few variables i.e. machines and methods, skill level, financial incentives, leadership practices and working conditions were identified as having a potential impact over the performance of the production employees. Stratified random sampling method was used to select 64 team members from the 32 production modules, and research work continued to collate primary data through administrating a structured questionnaire among selected associates. Null and alternative hypotheses were tested using correlations, and the data is presented as graphical pictures, tables, and in narrative form. However, there were a few limitations such as management influence, sample basis selection, service period, level of understating, time availability and commitment, time availability for the study etc. which may have had an impact over the research findings.

  5. Factors affecting seismic response of submarine slopes

    Directory of Open Access Journals (Sweden)

    G. Biscontin

    2006-01-01

    Full Text Available The response of submerged slopes on the continental shelf to seismic or storm loading has become an important element in the risk assessment for offshore structures and 'local' tsunami hazards worldwide. The geological profile of these slopes typically includes normally consolidated to lightly overconsolidated soft cohesive soils with layer thickness ranging from a few meters to hundreds of meters. The factor of safety obtained from pseudo-static analyses is not always a useful measure for evaluating the slope response, since values less than one do not necessarily imply slope failure with large movements of the soil mass. This paper addresses the relative importance of different factors affecting the response of submerged slopes during seismic loading. The analyses use a dynamic finite element code which includes a constitutive law describing the anisotropic stress-strain-strength behavior of normally consolidated to lightly overconsolidated clays. The model also incorporates anisotropic hardening to describe the effect of different shear strain and stress histories as well as bounding surface principles to provide realistic descriptions of the accumulation of the plastic strains and excess pore pressure during successive loading cycles. The paper presents results from parametric site response analyses on slope geometry and layering, soil material parameters, and input ground motion characteristics. The predicted maximum shear strains, permanent deformations, displacement time histories and maximum excess pore pressure development provide insight of slope performance during a seismic event.

  6. Factors Affecting Sugarcane Production in Pakistan

    Directory of Open Access Journals (Sweden)

    Adnan Nazir

    2013-05-01

    Full Text Available This study was undertaken to identify the factors affecting sugarcane production in Pakistan. Data were collected from 387 sugarcane growers from Sindh, Punjab and NWFP province. Data were collected during the period 2007-08. The study reveals that the costs of inputs of sugarcane i.e. urea, DAP, FYM, land preparation, seed and its application, weeding and cost of irrigation were the important factors which influenced on the returns of sugarcane growers. The effectiveness was examined by using the Cobb-Douglas production function; MVP and allocative efficiency were calculated. The coefficient of multiple determinations R2 was 0.9249, which indicated that 92% variation in the cost of inputs was explained by all explanatory variables and the adjusted R2 was 92%. The F-value was 666.94 and was highly significant at 5% level of significance, indicating that the regression model was well fitted. The high prices of inputs, low price of output, delay in payments and lack of scientific knowledge were the major problems in sugarcane production. In order to enhance the productivity of sugarcane in the country, government should solve the identified problems to increase the income of sugarcane growers.

  7. Research of Factors Affecting Pension Funds Efficiency

    Directory of Open Access Journals (Sweden)

    Virgilijus Sakalauskas

    2011-12-01

    Full Text Available Currently Lithuania has an old-age pension system of three pillars.Unfortunately, when making an investment decision, too few factors are used that affect strategy effectiveness. It is necessary to develop tools to better assess the risks and more accurately simulate the potential long-term investment scenarios.The article deals with the investment strategy to the second and third pillar pension funds in order to maximize investment returns and reduce risks. A smart software tool allows you to simulate an accrual depending on the rate of return, the accumulation period, the level of contributions, the fund’s profitability and other factors.The study shows that using the Social Insurance Fund contributions, personal contributions and the state provided additives can accumulate significantly greater amounts of money than collecting only the second pillar pension funds contributions. For implementation of the proposed methodology it is necessary to ensure a minimum level of personal pension scheme members fundraising to the third pillar pension funds. On the other hand, the study revealed that in some cases investment to private pension funds can be useless.Private pension funds have become popular between unprofessional investors who don’t have sufficient knowledge. Research shows that financial institutions do not always provide the optimal proposals. Advanced software tools can help make better investment decisions. Commercial tools usually show potential profits of investment, but not always pay sufficient attention to potential risks. This article analyzes both good and bad investment scenarios.

  8. Research of Factors Affecting Pension Funds Efficiency

    Directory of Open Access Journals (Sweden)

    Marius Liutvinavičius

    2013-08-01

    Full Text Available Currently Lithuania has an old-age pension system of three pillars. Unfortunately, when making an investment decision, too few factors are used that affect strategy effectiveness. It is necessary to develop tools to better assess the risks and more accurately simulate the potential long-term investment scenarios. The article deals with the investment strategy to the second and third pillar pension funds in order to maximize investment returns and reduce risks. A smart software tool allows you to simulate an accrual depending on the rate of return, the accumulation period, the level of contributions, the fund’s profitability and other factors. The study shows that using the Social Insurance Fund contributions, personal contributions and the state provided additives can accumulate significantly greater amounts of money than collecting only the second pillar pension funds contributions. For implementation of the proposed methodology it is necessary to ensure a minimum level of personal pension scheme members fundraising to the third pillar pension funds. On the other hand, the study revealed that in some cases investment to private pension funds can be useless. Private pension funds have become popular between unprofessional investors who don’t have sufficient knowledge. Research shows that financial institutions do not always provide the optimal proposals. Advanced software tools can help make better investment decisions. Commercial tools usually show potential profits of investment, but not always pay sufficient  attention to potential risks. This article analyzes both good and bad investment scenarios.

  9. Ranking agility factors affecting hospitals in Iran

    Directory of Open Access Journals (Sweden)

    M. Abdi Talarposht

    2017-04-01

    Full Text Available Background: Agility is an effective response to the changing and unpredictable environment and using these changes as opportunities for organizational improvement. Objective: The aim of the present study was to rank the factors affecting agile supply chain of hospitals of Iran. Methods: This applied study was conducted by cross sectional-descriptive method at some point of 2015 for one year. The research population included managers, administrators, faculty members and experts were selected hospitals. A total of 260 people were selected as sample from the health centers. The construct validity of the questionnaire was approved by confirmatory factor analysis test and its reliability was approved by Cronbach's alpha (α=0.97. All data were analyzed by Kolmogorov-Smirnov, Chi-square and Friedman tests. Findings: The development of staff skills, the use of information technology, the integration of processes, appropriate planning, and customer satisfaction and product quality had a significant impact on the agility of public hospitals of Iran (P<0.001. New product introductions had earned the highest ranking and the development of staff skills earned the lowest ranking. Conclusion: The new product introduction, market responsiveness and sensitivity, reduce costs, and the integration of organizational processes, ratings better to have acquired agility hospitals in Iran. Therefore, planners and officials of hospitals have to, through the promotion quality and variety of services customer-oriented, providing a basis for investing in the hospital and etc to apply for agility supply chain public hospitals of Iran.

  10. Environmental Factors Affecting Where People Geocache

    Directory of Open Access Journals (Sweden)

    Jennifer Golbeck

    2016-04-01

    Full Text Available Outdoor leisure activities are important for public health as well as family cohesiveness, yet environmental factors may easily affect someone’s ability to participate in such activities. We explored this with a focus on the social web-based treasure hunt game called Geocaching. We collected data on all US and Canadian geocaches from OpenCaching.com and conducted an online survey with twenty geocachers as a follow-up to our data analysis. Data analysis showed that geocaches were more often found in areas that were wealthier, better educated, younger, and more urban, and had higher population density and better weather. Survey results showed similar trends: Most people actively thought about where they would cache and tried to minimize risks, despite cache hiders thinking less about these concerns. These results further emphasize the importance of environmental factors when it comes to participation in outdoor activities and leads to Human–Computer Interaction design implications for location-based online social activities.

  11. Factors associated to adherence to different treatment schemes with meglumine antimoniate in a clinical trial for cutaneous leishmaniasis.

    Science.gov (United States)

    Ribeiro, Madelon Novato; Pimentel, Maria Inês Fernandes; Schubach, Armando de Oliveira; Oliveira, Raquel de Vasconcellos Carvalhães de; Teixeira, José Liporage; Leite, Madson Pedro da Silva; Fonseca, Monique; Santos, Ginelza Peres Lima dos; Salgueiro, Mariza Matos; Ferreira e Vasconcellos, Erica de Camargo; Lyra, Marcelo Rosandiski; Saheki, Mauricio Naoto; Valete-Rosalino, Claudia Maria

    2014-01-01

    The favorable outcome of the treatment of a disease is influenced by the adherence to therapy. Our objective was to assess factors associated with adherence to treatment of patients included in a clinical trial of equivalence between the standard and alternative treatment schemes with meglumine antimoniate (MA) in the treatment of cutaneous leishmaniasis (CL), in the state of Rio de Janeiro. Between 2008 and 2011, 57 patients with CL were interviewed using a questionnaire to collect socioeconomic data. The following methods were used for adherence monitoring: counting of vial surplus, monitoring card, Morisky test and modified Morisky test (without the question regarding the schedule); we observed 82.1% (vial return), 86.0% (monitoring card), 66.7% (Morisky test) and 86.0% (modified Morisky test) adherence. There was a strong correlation between the method of vial counting and the monitoring card and modified Morisky test. A significant association was observed between greater adherence to treatment and low dose of MA, as well as with a lower number of people sleeping in the same room. We recommend the use of the modified Morisky test to assess adherence to treatment of CL with MA, because it is a simple method and with a good performance, when compared to other methods.

  12. FACTORS ASSOCIATED TO ADHERENCE TO DIFFERENT TREATMENT SCHEMES WITH MEGLUMINE ANTIMONIATE IN A CLINICAL TRIAL FOR CUTANEOUS LEISHMANIASIS

    Directory of Open Access Journals (Sweden)

    Madelon Novato Ribeiro

    2014-07-01

    Full Text Available The favorable outcome of the treatment of a disease is influenced by the adherence to therapy. Our objective was to assess factors associated with adherence to treatment of patients included in a clinical trial of equivalence between the standard and alternative treatment schemes with meglumine antimoniate (MA in the treatment of cutaneous leishmaniasis (CL, in the state of Rio de Janeiro. Between 2008 and 2011, 57 patients with CL were interviewed using a questionnaire to collect socioeconomic data. The following methods were used for adherence monitoring: counting of vial surplus, monitoring card, Morisky test and modified Morisky test (without the question regarding the schedule; we observed 82.1% (vial return, 86.0% (monitoring card, 66.7% (Morisky test and 86.0% (modified Morisky test adherence. There was a strong correlation between the method of vial counting and the monitoring card and modified Morisky test. A significant association was observed between greater adherence to treatment and low dose of MA, as well as with a lower number of people sleeping in the same room. We recommend the use of the modified Morisky test to assess adherence to treatment of CL with MA, because it is a simple method and with a good performance, when compared to other methods.

  13. Factors that affecting mothers’ postnatal comfort

    Directory of Open Access Journals (Sweden)

    Gül Pınar

    2009-01-01

    Full Text Available Aim: The comfort is defined as; “an expected result of a complex conformation of providing peace and help about individual’s needs in a physical, psycho-spiritual, social and environmental entity to overcome the problems”. The aim of this study was to determine the mother’s postnatal comfort and the affecting factors of it.Materials and Methods: This is a sectional and descriptive study. The study was performed on the mothers (n=150 who applied to the delivery service of the Başkent University Ankara Hospital between the date of 30.07.2008 to 31.12.2008. A questionnaire was developed by the investigators to collect data and determine patients’ postnatal comfort scores. Results: The mean age of women was 26.4±3.5 years, the majority of patients had an educational level of high school (68.7% and were multipara (66.0%. It was determined that the mothers had problems and needed help with the fatigue, pain, in standing up, the adverse effect of anesthesia, personal and perineal hygiene that affect their postnatal comfort. The comfort score of the mothers who had spontaneous vaginal birth was higher than those of underwent cesarean delivery (p<0.05.Conclusion: The mothers’ needs and expectations about themselves and their babies were generally supplied by midwifes and the nurses in the postnatal period. Opinion of the mothers about their comfort were influenced to a positive view and the comfort scores increased while the mothers’ satisfaction were augmented (p<0.05.

  14. Factors Affecting Internationalization of Indonesia Franchise Companies

    Directory of Open Access Journals (Sweden)

    Erwin Halim

    2013-05-01

    Full Text Available Franchise is one of successful business strategies in business expansion. Franchise format has been already adopted in all countries. The success is proven in the world and also in Indonesia. Franchise system can be implemented not only in franchisor country but also in other countries. The spirit of internalization is not only because of market saturated, but also to increase reputation of franchise companies and to follow competitors or customers. Important thing discussed in this research is the franchise life-cycle, franchise growth model, and franchise companies’ profile.  It is found that the Indonesia franchise companies are in the introduction stage. The stage in life-cycle shows its reputation. This study used literature review as methodology, and the purpose of this study is to give a big picture for Indonesia franchise companies to make internationalization. There are some Indonesia franchise business profiles in the discussion part. The factors affecting franchise internationalization were analyzed by PESTEL analysis. Some strategies should be prepared in making decision to go international.  At the end, there are some recommendations and future research relating to internationalize franchise business.

  15. Factors Affecting Career Progress of MBA Students

    Directory of Open Access Journals (Sweden)

    Vivien T. Supangco

    2001-06-01

    Full Text Available This paper explored the factors that affect career progress of students in the MBA program of the University of the Philippines.To understand career progression, four measures of career progress were used in this study, namely: number of promotions, number of years in between promotions, total cash compensation, and number of administrative levels from the company president. On the other hand, the factors used to explain career progess included human capital, organizational, interpersonal and demographic variables.The results showed that the different measures of career progress had distinct determinants implying different dynamics. It appeared that measures of career progress that are sensitive to the value employers attach to the individual (Whitely, Dougherty, & Dreher, 1991 such as total compensation, total number of promotion and years per promotion were related with human capital factors such as work experience and number of companies worked for. On the other hand, measures that relate to centrality if the position, in which market forces have less impact, were associated with organizational variables such as organization size and the demographic variable gender.While gender did not explain variation in total compensation, number of promotions and number of uears between promotions, these null results are important for two reasons. First, it implies that the female MBA students were at par with their male counterparts as fas as these measures of career progress are concerned. Second, it challenges the generalizability of the finding of gender segregation at the organizational level-where men receive significantly higher wages that women-which is a common finding among studies done in the United States. The results using the MBA students as sample show that income and promotion parity may indeed be achievable and this brings hope to women in general.However, the statistical significance of gender in explaining career progress as centrality

  16. Factors Affecting SSR in Holstein Dairy Cows

    Directory of Open Access Journals (Sweden)

    Alireza Heravi Mosavi

    2016-08-01

    Full Text Available Introduction Secondary sex ratio (SSR is the proportion of males to females at birth. It has been shown in many different mammalian species, many factors are associated with SSR. Changes in secondary sex ratio in dairy cows is considered economically important and the ability to change it could affect the revenues and profitability of a dairy farm. Thus, sperm or embryo sexing techniques in recent years has attracted more attention. Most breed of dairy cattle are more likely to have female calf is born to use them as replacement heifers and in order to maintain their productive herd number. On the contrary, when the goal is the production of meat, bull calves due to higher growth rates and production efficiency, are more convenient and more economically efficient. The aim of present study was to investigate some key factors affecting SSR in Iranian Holstein cows. According to Fisher, the sex ratio in the population under the control of natural selection is not always the same. There is overwhelming evidence to support the theory that shows Fisher Primary and secondary sex ratio sex ratio can deviate from this balance and natural selection caused a change in this ratio can be in certain circumstances. For example, the secondary sex ratio of 52:48 has been reported in dairy cows. Studies on mammalian species suggest that several factors, including latitude of the location, the dominant regional climate model, time and frequency of mating to ovulation, diet, age of parents, physical score, breed and produced eggs from ovarian left or right can have a significant effect on the secondary sex ratio. Weather conditions may modify the internal environment and the effect on physiological mechanisms or through the impact on the frequency and type of foods available to parents, the secondary sex ratio is impressive. The impact on the quantity and quality of parent's access to food sources in many species of mammals, the sex ratio has been fixed. Previous

  17. Adherence to low-carbohydrate and low-fat diets in relation to weight loss and cardiovascular risk factors.

    Science.gov (United States)

    Hu, Tian; Yao, Lu; Reynolds, Kristi; Niu, Tianhua; Li, Shengxu; Whelton, Paul K; He, Jiang; Steffen, Lyn M; Bazzano, Lydia A

    2016-03-01

    A low-carbohydrate diet can reduce body weight and some cardiovascular disease (CVD) risk factors more than a low-fat diet, but differential adherence may play a role in these effects. Data were used from 148 adults who participated in a 12-month clinical trial examining the effect of a low-carbohydrate diet (fat diet (fat, fat) on weight and CVD risk factors. We compared attendance at counseling sessions, deviation from nutrient goals, urinary ketone presence, and composite scores representing the overall adherence based on the distribution of these individual indicators between two interventions. Composite scores were similar between the two groups. A one-interquartile-range increase in composite score representing better adherence to a low-carbohydrate diet was associated with 2.2 kg or 2.3 % greater weight loss, 1.1 greater reduction in percent fat mass, and 1.3 greater increase in proportion of lean mass. Indicators of adherence to a low-fat diet was not associated with changes in weight, fat mass or lean mass. Despite comparable adherence between groups, a low-carbohydrate diet was associated with greater reductions in body weight and improvement in body composition, while a low-fat diet was not associated with weight loss.

  18. Factors associated with adherence to antiretroviral therapy in HIV/AIDS patients: a cross-sectional study in Southern Brazil

    Directory of Open Access Journals (Sweden)

    C.A.T. Pinheiro

    2002-10-01

    Full Text Available A cross-sectional study was conducted on HIV-infected adults being treated with antiretroviral drugs at a reference service in Southern Brazil. Participants answered a sociodemographic questionnaire and were tested by scales assessing sociocognitive variables. Adherence to treatment was assessed by a self-report inventory developed for the study. Clinical information was obtained from the patients' records. Significance tests were conducted using univariate logistic regressions followed by multivariate logistic regression analysis. A total of 195 patients participated in the study and 56.9% of them reported > or = 95% adherence on the previous two days. In univariate analysis, the odds of adherence increased with self-efficacy (a person's conviction that he/she can successfully execute the behavior required to produce a certain desired outcome in taking medications as prescribed (OR = 3.50, 95% CI 1.90-6.55, and decreased with perception of negative affect and physical concerns (OR = 0.71, 95% CI 0.53-0.95. The odds were lower for taking antiretroviral medications >4 times a day (OR = 0.44, 95% CI 0.20-0.94 and higher for patients with 8 years of schooling (OR = 2.28, 95% CI 1.12-4.66. In the multivariate analysis, self-efficacy (OR = 3.33, 95% CI 1.69-6.56 and taking medication >4 times a day (OR = 0.34, 95% CI 0.14-0.80 were independently associated with adherence. Self-efficacy was the most important predictor of adherence, followed by number of times antiretroviral medication was taken per day. Among sociodemographic and clinical variables, only the number of years of schooling was associated with adherence. Motivational interventions based on self-efficacy may be useful for increasing treatment adherence.

  19. Stroke and TIA survivors’ cognitive beliefs and affective responses regarding treatment and future stroke risk differentially predict medication adherence and categorised stroke risk

    Science.gov (United States)

    Phillips, L. Alison; Diefenbach, Michael A.; Abrams, Jessica; Horowitz, Carol R.

    2014-01-01

    Cognitive beliefs and affective responses to illness and treatment are known to independently predict health behaviours. The purpose of the current study is to assess the relative importance of four psychological domains – specifically, affective illness, cognitive illness, affective treatment and cognitive treatment – for predicting stroke and transient ischemic attack (TIA) survivors’ adherence to stroke prevention medications as well as their objective, categorised stroke risk. We assessed these domains among stroke/TIA survivors (n = 600), and conducted correlation and regression analyses with concurrent and prospective outcomes to determine the relative importance of each cognitive and affective domain for adherence and stroke risk. As hypothesised, patients’ affective treatment responses explained the greatest unique variance in baseline and six-month adherence reports (8 and 5%, respectively, of the variance in adherence, compared to 1–3% explained by other domains). Counter to hypotheses, patients’ cognitive illness beliefs explained the greatest unique variance in baseline and six-month objective categorised stroke risk (3 and 2%, respectively, compared to 0–1% explained by other domains). Results indicate that domain type (i.e. cognitive and affective) and domain referent (illness and treatment) may be differentially important for providers to assess when treating patients for stroke/TIA. More research is required to further distinguish between these domains and their relative importance for stroke prevention. PMID:25220292

  20. Stroke and TIA survivors' cognitive beliefs and affective responses regarding treatment and future stroke risk differentially predict medication adherence and categorised stroke risk.

    Science.gov (United States)

    Phillips, L Alison; Diefenbach, Michael A; Abrams, Jessica; Horowitz, Carol R

    2015-01-01

    Cognitive beliefs and affective responses to illness and treatment are known to independently predict health behaviours. The purpose of the current study is to assess the relative importance of four psychological domains - specifically, affective illness, cognitive illness, affective treatment and cognitive treatment - for predicting stroke and transient ischemic attack (TIA) survivors' adherence to stroke prevention medications as well as their objective, categorised stroke risk. We assessed these domains among stroke/TIA survivors (n = 600), and conducted correlation and regression analyses with concurrent and prospective outcomes to determine the relative importance of each cognitive and affective domain for adherence and stroke risk. As hypothesised, patients' affective treatment responses explained the greatest unique variance in baseline and six-month adherence reports (8 and 5%, respectively, of the variance in adherence, compared to 1-3% explained by other domains). Counter to hypotheses, patients' cognitive illness beliefs explained the greatest unique variance in baseline and six-month objective categorised stroke risk (3 and 2%, respectively, compared to 0-1% explained by other domains). Results indicate that domain type (i.e. cognitive and affective) and domain referent (illness and treatment) may be differentially important for providers to assess when treating patients for stroke/TIA. More research is required to further distinguish between these domains and their relative importance for stroke prevention.

  1. Determinants of Adherence to Living on Dialysis for Mexican Americans

    Directory of Open Access Journals (Sweden)

    Shirley A. Wells

    2015-03-01

    Full Text Available This study explores perceptions that affect adherence behaviors among Mexican Americans living with dialysis. In-depth narrative interviews were conducted with 15 Mexican Americans with end-stage renal disease (ESRD living on dialysis, 15 family members, and 6 health care personnel who provided care to them. Four themes emerged: (a positive influences to adherence, (b obstacles to adherence, (c daily activity losses, and (d fears about living with dialysis. From the findings, the perceptions given for non-adherence with the dialysis regimen ranged from denial of the condition, lack of pre-education, to cultural factors. Those given for adherence included prolonged life, family, and hope of getting a transplant. Health care providers were the reminder to adhere. Several cultural factors influenced their adherence perceptions. Strategies to enhance adherence behaviors should focus on knowledge about dialysis, use of the collective efficacy of the family, and the inclusion of cultural values.

  2. Adhering Pasteuria penetrans endospores affect movements of root-knot nematode juveniles

    Directory of Open Access Journals (Sweden)

    Ioannis VAGELAS

    2013-01-01

    Full Text Available Pasteuria penetrans is a biological control agent of root-knot nematodes (Meloidogyne spp., preventing root invasion by second-stage juveniles (J2s, and eventually causing females sterility and death. greatest control effects for P. penetrans depend on the numbers of endospores attached to nematode cuticles. a method based on digital image analysis was used to record the effects of endospore attachment on the movements of juvenile root-knot nematodes, using a model based on the centroid point. Data showed that the numbers of endospores attached to the cuticle influenced nematode movement. At high endospore attachment levels (20‒30 per J2, nematodes did not show directional movement, whereas nematodes encumbered with five to eight spores showed limited directional movement, compared to those without endospores. nematode cephalic region turns were modelled using a markov chain, showing that P. penetrans endospores affected movements. Less nematodes invaded and established on tomato root systems when encumbered with low (five to eight or high numbers (20‒30 of P. penetrans endospores, compared with unencumbered nematodes.

  3. Low Calorie Diet Affects Aging-Related Factors

    Science.gov (United States)

    ... Current Issue Past Issues Research News From NIH Low Calorie Diet Affects Aging-Related Factors Past Issues / ... to learn more about the effects of sustained low-calorie diets in humans on factors affecting aging. ...

  4. Adherence to physical activity recommendations and its associated factors: an interregional population-based study

    Directory of Open Access Journals (Sweden)

    Ala'a Alkerwi

    2015-03-01

    Full Text Available Background. Though the influence of physical activity in preventing cardiovascular diseases is well documented, only a few comparative studies have determined the degree of adherence to physical activity recommendations among populations and identified the demographic, socioeconomic, behavioural and health-related factors associated with good compliance. Design and methods. Cross-sectional interregional NESCaV survey of 3133 subjects compared three populations, Luxembourg, Lorraine (France and Wallonia (Belgium, by using the International Physical Activity Questionnaire. Age and gender prevalence rates of physical activity were standardized to the European population. Results. The likelihood to meet the recommendations was higher in Luxembourg, after adjustment for age, gender, education, employment, weight status, morbidity score, health perception and level of importance attributed to the practice of physical activity (P<0.0001. The odds for meeting the recommendations were significantly higher among those with secondary than tertiary education. Compared to good self-health perception, subjects with poor or fair self-perceived health were less likely to meet the recommendations; this also applied to those attributing little or enough importance to physical activity compared with great importance. Conclusions. Region, education, self-perceived health and perception of importance of physical activity were emerged as independent determinants of meeting the recommendations. Awareness of the positive health effects of physical activity might thus be crucial for motivating the people to become more active. Further research is needed to explore potential region-specific factors which might explain the difference in population behaviours with respect to physical activity.

  5. Stroke and TIA survivors’ cognitive beliefs and affective responses regarding treatment and future stroke risk differentially predict medication adherence and categorised stroke risk

    OpenAIRE

    Phillips, L. Alison; Diefenbach, Michael A.; Abrams, Jessica; Horowitz, Carol R.

    2014-01-01

    Cognitive beliefs and affective responses to illness and treatment are known to independently predict health behaviours. The purpose of the current study is to assess the relative importance of four psychological domains – specifically, affective illness, cognitive illness, affective treatment and cognitive treatment – for predicting stroke and transient ischemic attack (TIA) survivors’ adherence to stroke prevention medications as well as their objective, categorised stroke risk. We assessed...

  6. Factors Associated with Adherence to and Treatment Duration of Erlotinib Among Patients with Non-Small Cell Lung Cancer.

    Science.gov (United States)

    Hess, Lisa M; Louder, Anthony; Winfree, Katherine; Zhu, Yajun E; Oton, Ana B; Nair, Radhika

    2017-06-01

    In lung cancer, there is an increasing number of oral agents available for patients; however, little is known about the factors associated with adherence to and treatment duration on oral medications in non-small cell lung cancer (NSCLC). To evaluate the clinical and demographic factors associated with adherence and treatment discontinuation, respectively, to oral oncolytics among patients with NSCLC. A retrospective, claims-based analysis of the Humana Research Database supplemented with medical chart review was conducted among patients with NSCLC who started an oral oncolytic between January 1, 2008, and June 30, 2013. Patients were required to be enrolled at least 1 year before the start of oral oncolytics and have no evidence of any oral oncolytic use during this period. Logistic regression models and Cox proportional hazard models were used to identify predictors associated with medication adherence and treatment duration, respectively. Among all oral oncolytics, only the cohort starting on erlotinib had sufficient sample size (n = 1,452). A wide variety of factors were found to be associated with adherence. Low-income subsidy status, previous use of intravenous chemotherapy, and lower total baseline health care costs were significantly related to decreasing adherence (each P cost was associated with decreasing adherence to erlotinib (P costs (P Company to Comprehensive Health Insights, a Humana company, as a collaborative research project involving employees of both companies. Hess, Winfree, Zhu, and Oton are employees of Eli Lilly and Company. Louder and Nair are employees of Comprehensive Health Insights, which received funding to complete this research. Study concept and design were contributed by Hess, Zhu, Winfree, and Oton. Nair and Louder collected the data, and data interpretation was performed by all the authors. The manuscript was written primarily by Hess, along with Nair, and revised by Hess, Nair, Louder, and Winfree, with assistance from Zhu and

  7. Effect of medication-related factors on adherence in people with schizophrenia: a European multi-centre study

    NARCIS (Netherlands)

    Meier, Johanna; Becker, Thomas; Patel, Anita; Robson, Debbie; Schene, Aart; Kikkert, Martijn; Barbui, Corrado; Burti, Lorenzo; Puschner, Bernd

    2010-01-01

    To investigate the relation between medication-related factors and adherence in people with schizophrenia in outpatient treatment. The sample comprised 409 outpatients (ICD-10 diagnosis of schizophrenia) with clinician-rated instability in four European cities (Amsterdam, The Netherlands; Verona,

  8. Understanding the factors associated with initiation and adherence of osteoporosis medication in Japan: An analysis of patient perceptions

    Directory of Open Access Journals (Sweden)

    Hajime Orimo

    2017-12-01

    Conclusions: Different factors were found to be associated with initiation and adherence of osteoporosis medication. Patient knowledge of their disease and the perception of barriers were found to be the most influential. Empowering patients with the knowledge to better understand their disease and decreasing the perception of barriers through education initiatives may be effective in improving patient outcomes.

  9. The combined impact of adherence to five lifestyle factors on all-cause, cancer and cardiovascular mortality

    DEFF Research Database (Denmark)

    Petersen, Kristina E N; Johnsen, Nina F; Olsen, Anja

    2015-01-01

    guidelines into account. The objective of the present prospective cohort study was to investigate the combined impact of adherence to five lifestyle factors (smoking, alcohol intake, physical activity, waist circumference and diet) on all-cause, cancer and cardiovascular mortality based on international...

  10. Socioeconomic factors explain suboptimal adherence to antiretroviral therapy among HIV-infected Australian adults with viral suppression

    NARCIS (Netherlands)

    Siefried, Krista J; Mao, Limin; Kerr, Stephen; Cysique, Lucette A; Gates, Thomas M; McAllister, John; Maynard, Anthony; de Wit, John; Carr, Andrew

    2017-01-01

    BACKGROUND: Missing more than one tablet of contemporary antiretroviral therapy (ART) per month increases the risk of virological failure. Recent studies evaluating a comprehensive range of potential risk factors for suboptimal adherence are not available for high-income settings. METHODS: Adults on

  11. Renal Transplant Recipients: The Factors Related to Immunosuppressive Medication Adherence Based on the Health Belief Model.

    Science.gov (United States)

    Kung, Pen-Chen; Yeh, Mei Chang; Lai, Ming-Kuen; Liu, Hsueh-Erh

    2017-10-01

    Kidney transplant failures are caused primarily by lack of adherence to immunosuppressive medication regimens by patients after transplantation. A number of studies have indicated that health-related beliefs are an effective predictor of health-related behavior. The aim of this study is to understand the influence of the personal characteristics and health-related beliefs of patients on adherence to treatment with immunosuppressive medication based on the Health Belief Model. This cross-sectional study distributed questionnaires to patients who had been recruited via purposive sampling at one medical center in Taipei. All of the potential participants had undergone kidney transplantation at least 6 months previously. The self-developed questionnaire collected data in three areas: personal characteristics, health-related beliefs regarding transplant rejection, and adherence to the immunosuppressive medication regimen. One hundred twenty-two valid questionnaires were received. The collected data were analyzed using descriptive statistics, independent t test, one-way analysis of variance, Pearson's correlation, and multiple regression. Participants who had received dialysis treatment or had experienced rejection perceived susceptibility to rejection more strongly than those who had not. Participants who had undergone transplantation in Taiwan, had experienced more drug-related symptoms, or had contracted severe to extremely severe infections in the past showed lower rates of adherence to treatment with immunosuppressive medication. Adherence to medication regimens correlated negatively with length of time since transplantation. Length of time since transplantation, drug-related symptoms, perceived susceptibility to rejection, and perceived benefits of treatment were identified as major predictors of adherence to immunosuppressive medication regimens. The results partially conformed to the concepts of the Health Belief Model. Perceived susceptibility to rejection and

  12. Factors associated to adherence to blood glucose self-monitoring in patients with diabetes treated with insulin. The dapa study.

    Science.gov (United States)

    Vidal Florc, Mercè; Jansà Morató, Margarita; Galindo Rubio, Mercedes; Penalba Martínez, Maite

    2018-02-01

    To assess adherence to self-monitoring of blood glucose and the main factors associated with it, particularly those related to self-perception of glycemia, in patients with diabetes on insulin therapy. An epidemiological, observational, prospective, multicenter study conducted in standard clinical practice in primary care, outpatient centers, and hospitals from different Spanish regions. Sociodemographic, clinical and treatment data were collected. Patients were considered adherent to self-monitoring if they performed the minimum number of controls recommended by the Spanish Society of Diabetes (SED). Adherence was shown in 61.6% of patients. Factors associated to adherence included treatment with less than three insulin injections daily (OR 2.678; 95% CI 2.048- 3.5029; p <0.001), presence of peripheral vascular disease (OR 1.529; 95% CI 1.077 - 2.171; p=0.018), alcohol abstinence (OR 1.442; 95% CI 1.118 - 1.858; p=0.005), and collection of the glucose test strips from the pharmacy (OR 1.275; 95% CI 1.026 - 1.584; p=0.028). Adequate self-perception of glycemia was found in 21.4% of patients. Our results show a suboptimal adherence to the recommended protocol for blood glucose self-monitoring in patients with diabetes on insulin therapy. Independent variables associated to good adherence were treatment with less than three insulin injections dailyu, presence of peripheral vascular disease, alcohol abstinence, and collection of glucose test strips from the pharmacy. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Living situation affects adherence to combination antiretroviral therapy in HIV-infected adolescents in Rwanda: a qualitative study

    NARCIS (Netherlands)

    Mutwa, Philippe R.; van Nuil, Jennifer Ilo; Asiimwe-Kateera, Brenda; Kestelyn, Evelyne; Vyankandondera, Joseph; Pool, Robert; Ruhirimbura, John; Kanakuze, Chantal; Reiss, Peter; Geelen, Sibyl; van de Wijgert, Janneke; Boer, Kimberly R.

    2013-01-01

    Adherence to combination antiretroviral therapy (cART) is vital for HIV-infected adolescents for survival and quality of life. However, this age group faces many challenges to remain adherent. We used multiple data sources (role-play, focus group discussions (FGD), and in-depth interviews (IDI)) to

  14. Living situation affects adherence to combination antiretroviral therapy in HIV-infected adolescents in Rwanda: a qualitative study

    NARCIS (Netherlands)

    Mutwa, P.R.; Ilo van Nuil, J.; Asiimwe-Kateera, B.; Kestelyn, E.; Vyankandondera, J.; Pool, R.; Ruhirimbura, J.; Kanakuze, C.; Reiss, P.; Geleen, S.; van de Wijgert, J.; Boer, K.R.

    2013-01-01

    Introduction Adherence to combination antiretroviral therapy (cART) is vital for HIV-infected adolescents for survival and quality of life. However, this age group faces many challenges to remain adherent. We used multiple data sources (role-play, focus group discussions (FGD), and in-depth

  15. Adherence and factors related to acceptance of alcohol for antiseptic hand rubbing among nursing professionals

    Directory of Open Access Journals (Sweden)

    Adriana Cristina de Oliveira

    Full Text Available Abstract OBJECTIVE Identify rates of adhesion and related factors to acceptance of an alcohol based preparation to hands antiseptic friction among nursing professionals in a unit of intensive therapy. METHOD A cross-sectional study, which involved direct observation of hand hygiene opportunities and nursing professionals’ completion of questionnaires, was conducted at a university hospital between January and July 2015. Descriptive and univariate analyses were performed, with a 5% significance level. RESULTS It was observed 956 opportunities of hand hygiene among 46 nursing professionals. The rate of adhesion to alcohol-based handrub (ABH was 34.8% and about 87.0% preferred handwashing. Nurses used ABH more frequently than nursing technicians (p <0.001, and the report of feeling of clean hands after using the alcohol product was directly related to higher rates of adherence to antiseptic friction through observation (P <0.05. CONCLUSION The finding indicating low ABH usage highlights the need for greater institutional investment in strategies that help health professionals to recognize the advantages of this type of HH with respect to time spent, ease of access to dispensers, effectiveness in eliminating microorganisms, and maintaining skin moisturization.

  16. Factors Affecting Turkish Students' Achievement in Mathematics

    Science.gov (United States)

    Demir, Ibrahim; Kilic, Serpil; Depren, Ozer

    2009-01-01

    Following past researches, student background, learning strategies, self-related cognitions in mathematics and school climate variables were important for achievement. The purpose of this study was to identify a number of factors that represent the relationship among sets of interrelated variables using principal component factor analysis and…

  17. Factors Affecting Success of Training Companies

    Science.gov (United States)

    Rogala, Piotr; Batko, Roman; Wawak, Slawomir

    2017-01-01

    This study aims to identify the key factors which influence the functioning quality and success of training companies. Based on an analysis of the requirements included in the quality management system standards for providers of education and training services, a set of twenty factors has been developed. This was followed by a survey for…

  18. Adherence to Combined Lifestyle Factors and Their Contribution to Obesity in the IDEFICS Study

    DEFF Research Database (Denmark)

    Kovács, Eva; Hunsberger, Monica; Reisch, Lucia

    2015-01-01

    to childhood obesity, namely water/sweetened drink, fruit/vegetable consumption, daily TV time, physical activity, family time and adequate sleep duration, was measured at baseline. Adherence to international recommendations was converted into a composite score ranging from 0 (none) to 6 (adhering to all......). Data on adherence were available for 7,444 to 15,084 children aged 2-9.9 years, depending on the behaviour. By means of multi-level logistic regression models adjusted for age, sex and country, we calculated odds ratios (OR) and 95% confidence intervals (CI) to estimate the relationship between.......65-1.01) compared with non-adherence (score = 0), while adhering to more than half of the key behaviours (score ≥ 4) halved the chance for overweight/obesity (OR = 0.54, CI: 0.37-0.80). Adherence to physical activity, TV and sleep recommendations was the main driver reducing the chance of being overweight...

  19. Predicting exercise adherence in cancer patients and survivors: a systematic review and meta-analysis of motivational and behavioural factors.

    Science.gov (United States)

    Husebø, Anne M Lunde; Dyrstad, Sindre M; Søreide, Jon A; Bru, Edvin

    2013-01-01

    To examine research findings regarding predictors of adherence to exercise programmes in cancer populations. Cancer patients are advised to participate in daily exercise. Whether they comply with the recommendations for physical activity or not remains unclear. A systematic review and meta-analysis. Empirical articles published in English between 1995 and 2011 were searched in electronic databases and in reference lists, using the search terms 'adherence', 'predictors', 'exercise', and 'cancer' in varying combinations. Twelve of 541 screened abstracts met the inclusion criteria. The included studies' eligibility considering predictors of exercise adherence were reviewed. A quality assessment process evaluating the studies methodological quality was performed. Eight of the reviewed studies were considered eligible for a meta-analysis involving Pearson's r correlations. Exercise stage of change, derived from the transtheoretical model of behaviour change (TTM) was found to be statistically significant and a strong predictor of exercise adherence. In addition, the theory of planned behaviour (TPB) construct; intention to engage in a health-changing behaviour and perceived behavioural control, demonstrated significant correlations with exercise adherence. The review identified that both the TPB and the TTM frameworks include aspects that predicts exercise adherence in cancer patients, and thus contributes to the understanding of motivational factors of change in exercise behaviour in cancer populations. However, the strengths of predictions were relatively weak. More research is needed to identify predictors of greater importance. Surveying the patients' readiness and intention to initiate and maintain exercise levels, as well as tailoring exercise programmes to individual needs may be important for nurses in order to help patients meet exercise guidelines and stay active. © 2012 Blackwell Publishing Ltd.

  20. Dietary factors that affect carotenoid bioavailability

    NARCIS (Netherlands)

    Hof, van het K.H.

    1999-01-01

    Carotenoids are thought to contribute to the beneficial effects of increased vegetable consumption. To better understand the potential benefits of carotenoids, we investigated the bioavailability of carotenoids from vegetables and dietary factors which might influence carotenoid

  1. Factors affecting endoglucanase production by Trichoderma reesei ...

    African Journals Online (AJOL)

    Factors involved in the screening process were peptone concentration, urea ... ammonium sulfate concentration, calcium nitrate concentration, yeast extract ... pH, incubation time, initial moisture content, inoculum size and substrate amount.

  2. The Factors affect equity investors in India

    Directory of Open Access Journals (Sweden)

    Hossein Niavand

    2017-11-01

    Full Text Available Financial specialist conduct is a focal idea in the behavioral fund which breaks down the impact of different factors on singular value speculator basic leadership. The nature and centrality of these factors on financial specialist basic leadership can be unique and intriguing in different nations. This investigation, thusly, looks at the impact of financial, and behavioral, factors in molding the venture conduct of value speculators in India. The factor incorporates advocate suggestion, unbiased data, individual back requirements, bookkeeping data, established riches expansion and mental self-view/firm-picture incident. The examination found the solid impact of mental self-portrait/firm-picture occurrence, unbiased data, and supporter suggestion on value speculator basic leadership. While, no impacts of variables like great riches amplification, bookkeeping data, and individual budgetary needs are found on value financial specialist's basic leadership with regards to India.

  3. Adherencia terapéutica y factores psicosociales en pacientes hipertensos Therapeutic adherence and psychosocial factors in hypertensive patients

    Directory of Open Access Journals (Sweden)

    Yadmila Rosa Matos La

    2007-03-01

    Full Text Available La terapéutica de las enfermedades cardiovasculares requiere de la modificación de ciertos hábitos y comportamientos, de ahí la importancia del cumplimiento de las prescripciones médicas. Con la finalidad de describir los factores psicosociales asociados a la adherencia terapéutica se realizó un estudio descriptivo, de corte transversal, en una muestra de 263 pacientes hipertensos distribuidos en 13 consultorios del Médico de Familia del Policlínico Docente “Edor de los Reyes Martínez”, en el Consejo Popular Sur, del área urbana del municipio Jiguaní, provincia Granma. La información se obtuvo a través de la aplicación de un cuestionario elaborado para este fin. Los resultados más relevantes fueron: las creencias que tiene el paciente acerca del tratamiento como beneficio para su salud, los conocimientos adecuados sobre las características de la enfermedad, los afrontamientos al tratamiento con autoeficacia y la percepción de suficientes redes de apoyo social, que son los que más se asocian a la adherencia terapéutica.The therapeutics of the cardiovascular diseases requires the modification of certain habits and behaviors, that's why the fulfillment of the medical prescriptions is so important. With the objective of describing the psychosical factors associated with therapeutical adherence, a descriptive, cross-sectional study was undertaken in a sample of 263 hypertensive patients distributed in 13 family physicians' offices of “Edor de los Reyes Martínez” Teaching Polyclinic in the Southern People's Council of the urban area of Jiguaní municipality, Granma province. The information was obtained by applying a questionnaire made to this end. The most relevant results were: the patient's belief that the treatment benefits his health, the adequate knowledge of the characteristics of the disease, the facing of the treatment with self-efficiency, and the perception of enough social support networks. These outcomes are

  4. Eating habits and factors affecting food choice of adolescents living in rural areas.

    Science.gov (United States)

    Bargiota, Alexandra; Pelekanou, Maria; Tsitouras, Andreas; Koukoulis, Georgios N

    2013-01-01

    To establish factors that affect food choices among adolescents living in rural areas and to identify their food choices. A random sample of adolescents living in a Greek rural area (n=382) aged 12-18 years were individually interviewed. Food consumption was assessed by a semi-quantitative food-frequency questionnaire and adherence to the Mediterranean diet was evaluated using the KIDMED questionnaire. Information was collected regarding self-perceived body size, dieting, dietary knowledge, parental control, meal and snack frequency, eating out of home, eating takeaways and precooked meals, eating from the school canteen. Body image concerns, dieting, education about food, parental control, maternal education level and eating with family and peers are factors that were found to affect food choices in this group of Greek adolescents. The adherence to the Mediterranean diet was low (KIDMED index was 4.5±2.7). Regular family meals at home were frequent in this group and 99% of the adolescents ate lunch daily at home. Eating out with peers and eating from the school canteen was related with higher consumption of 'junk type of food'. Girls and younger adolescents and those whose mothers had a higher education level seem to make healthier choices. Factors such as personal issues, family and peer pressure significantly affect food choices among adolescents living in a Greek rural area and highlight the importance of implementing multilevel strategies to promote healthy eating among adolescents.

  5. External risk factors affecting construction costs

    Science.gov (United States)

    Mubarak, Husin, Saiful; Oktaviati, Mutia

    2017-11-01

    Some risk factors can have impacts on the cost, time, and performance. Results of previous studies indicated that the external conditions are among the factors which give effect to the contractor in the completion of the project. The analysis in the study carried out by considering the conditions of the project in the last 15 years in Aceh province, divided into military conflict phase (2000-2004), post tsunami disaster rehabilitation and reconstruction phase (2005-2009), and post-rehabilitation and reconstruction phase (2010-present). This study intended to analyze the impact of external risk factors, primarily related to the impact on project costs and to investigate the influence of the risk factors and construction phases impacted the project cost. Data was collected by using a questionnaire distributed in 15 large companies qualification contractors in Aceh province. Factors analyzed consisted of socio-political, government policies, natural disasters, and monetary conditions. Data were analyzed using statistical application of severity index to measure the level of risk impact. The analysis results presented the tendency of impact on cost can generally be classified as low. There is only one variable classified as high-impact, variable `fuel price increases', which appear on the military conflict and post tsunami disaster rehabilitation and reconstruction periods. The risk impact on costs from the factors and variables classified with high intensity needs a serious attention, especially when the high level impact is followed by the high frequency of occurrences.

  6. Factors Affecting Organizational Commitment in Navy Corpsmen.

    Science.gov (United States)

    Booth-Kewley, Stephanie; Dell'Acqua, Renée G; Thomsen, Cynthia J

    2017-07-01

    Organizational commitment is a psychological state that has a strong impact on the likelihood that employees will remain with an organization. Among military personnel, organizational commitment is predictive of a number of important outcomes, including reenlistment intentions, job performance, morale, and perceived readiness. Because of the unique challenges and experiences associated with military service, it may be that organizational commitment is even more critical in the military than in civilian populations. Despite the essential role that they play in protecting the health of other service members, little is known about the factors that influence Navy Corpsmen's organizational commitment. This study investigated demographic and psychosocial factors that may be associated with organizational commitment among Corpsmen. Surveys of organizational commitment and possible demographic and psychosocial correlates of organizational commitment were completed by 1,597 male, active duty Navy Corpsmen attending Field Medical Training Battalion-West, Camp Pendleton, California. Bivariate correlations and hierarchical multiple regression analyses were used to determine significant predictors of organizational commitment. Of the 12 demographic and psychosocial factors examined, 6 factors emerged as significant predictors of organizational commitment in the final model: preservice motivation to be a Corpsman, positive perceptions of Corpsman training, confidence regarding promotions, occupational self-efficacy, social support for a Corpsman career, and lower depression. Importantly, a number of the factors that emerged as significant correlates of organizational commitment in this study are potentially modifiable. These factors include confidence regarding promotions, positive perceptions of Corpsman training, and occupational self-efficacy. It is recommended that military leaders and policy-makers take concrete steps to address these factors, thereby strengthening

  7. Identifying factors affecting optimal management of agricultural water

    Directory of Open Access Journals (Sweden)

    Masoud Samian

    2015-01-01

    In addition to quantitative methodology such as descriptive statistics and factor analysis a qualitative methodology was employed for dynamic simulation among variables through Vensim software. In this study, the factor analysis technique was used through the Kaiser-Meyer-Olkin (KMO and Bartlett tests. From the results, four key elements were identified as factors affecting the optimal management of agricultural water in Hamedan area. These factors were institutional and legal factors, technical and knowledge factors, economic factors and social factors.

  8. Reengineering in Australia: factors affecting success

    Directory of Open Access Journals (Sweden)

    Felicity Murphy

    1998-11-01

    Full Text Available Business process reengineering (BPR is being used in many organisations worldwide to realign operations. Most of the research undertaken has been focused on North American or European practices. The study reported here replicates a US reengineering study in an Australian context by surveying large public and private sector Australian organisations. The study makes three main contributions by: (1 presenting a picture of BPR practices in Australia, (2 clarifying factors critical to the success of reengineering projects in Australia, and (3 providing a comparison of factors leading to success in Australian BPR projects with those found in the US.

  9. Some factors affecting the distribution of radon

    International Nuclear Information System (INIS)

    Grainger, C.R.

    1986-01-01

    The importance of the distribution of radon in the natural background radiation exposures for man is stressed. Factors which effect the distribution include the origin of the rocks, the permeability of the rocks, fractures in the rocks and ground water flow. (U.K.)

  10. Factors Affecting the Internal Audit Effectiveness

    OpenAIRE

    Mustika, Adhista Cahya

    2015-01-01

    This study tests the factors that influence the internal audit effectiveness, including internal auditor competencies, internal auditor independence, auditee support to internal audit activity, and the internal and external auditor relationship. Using the internal auditor inspectorate in Java Province, Indonesia, we found that the internal audit effectiveness can be attained through increase internal audit competence, independence and strong relationship between internal and external auditor....

  11. Review: Factors affecting fouling in conventional pens for slaughter pigs

    DEFF Research Database (Denmark)

    Larsen, Mona Lilian Vestbjerg; Bertelsen, Maja; Pedersen, Lene Juul

    2018-01-01

    and pigs’ earlier experience. Further, these primary factors are affected by secondary factors such as the shape of the pen, the weight of the pigs and especially the heat balance of the pigs, which is affected by several tertiary factors including, for example, temperature, humidity and draught. Results...

  12. Factors predicting adherence with psychiatric follow-up appointments for patients assessed by the liaison psychiatric team in the emergency department.

    LENUS (Irish Health Repository)

    Agyapong, Vincent I O

    2010-01-01

    Several factors may predict adherence with psychiatric follow-up appointment for patients seen in the emergency department (ED) by liaison psychiatric teams. Awareness of these factors would allow for interventions targeted at vulnerable groups.

  13. Gender factors affecting female labour input in the Nigerian ...

    African Journals Online (AJOL)

    Gender factors affecting female labour input in the Nigerian University system. ... which mostly affect women‟s job performance in the Nigerian university system. ... are essential in building a gender-friendly university work environment.

  14. Coeliac disease in adolescence: Coping strategies and personality factors affecting compliance with gluten-free diet.

    Science.gov (United States)

    Wagner, Gudrun; Zeiler, Michael; Grylli, Vasileia; Berger, Gabriele; Huber, Wolf-Dietrich; Woeber, Christian; Rhind, Charlotte; Karwautz, Andreas

    2016-06-01

    Patients suffering from a chronic condition such as coeliac disease (CD) need to develop coping strategies in order to preserve emotional balance and psychosocial functioning while adhering to their obligatory life-long gluten free diet (GFD). However, this can be particularly challenging for adolescents and may lead to dietary transgressions. Little is currently known about the influence of coping strategies and personality factors on dietary compliance. This study aims to explore these factors for the first time in adolescents with biopsy-proven CD. We included 281 adolescents with CD and 95 healthy controls. We classified patients according to their GFD adherence status (adherent vs. non-adherent) and assessed coping strategies using the KIDCOPE and personality traits using the Junior-Temperament and Character Inventory (J-TCI). Adolescents with CD adherent to GFD used less emotional regulation and distraction as coping strategies than non-adherent patients. In terms of personality traits, adherent patients differed from non-adherent patients with respect to temperament, but not with respect to character, showing lower scores in novelty seeking, impulsivity and rule transgressions and higher scores in eagerness with work and perfectionism compared to non-adherent patients. No differences were found between healthy controls and adherent CD patients across these personality traits. Coping strategies and personality traits differ in adolescent patients with CD adherent to GFD from those not adherent, and may therefore relate to risk or protective factors in adherence. Targeting coping and temperament using psychological interventions may therefore be beneficial to support adolescents with CD and optimise their adherence to GFD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Factors Affecting the Thickness of Thermal Aureoles

    Directory of Open Access Journals (Sweden)

    Catherine Annen

    2017-10-01

    Full Text Available Intrusions of magma induce thermal aureoles in the country rock. Analytical solutions predict that the thickness of an aureole is proportional to the thickness of the intrusion. However, in the field, thermal aureoles are often significantly thinner or wider than predicted by simple thermal models. Numerical models show that thermal aureoles are wider if the heat transfer in the magma is faster than in the country rock due to contrasts in thermal diffusivities or the effect of magma convection. Large thermal aureoles can also be caused by repeated injection close to the contact. Aureoles are thin when heat transfer in the country rock is faster than heat transfer within the magma or in case of incrementally, slowly emplaced magma. Absorption of latent heat due to metamorphic reactions or water volatilization also affects thermal aureoles but to a lesser extent. The way these parameters affect the thickness of a thermal aureole depends on the isotherm under consideration, hence on which metamorphic phase is used to draw the limit of the aureole. Thermal aureoles provide insight on the dynamics of intrusions emplacement. Although available examples are limited, asymmetric aureoles point to magma emplacement by over-accretion for mafic cases and by under-accretion for felsic cases, consistent with geochronological data.

  16. Factors affecting reproductive performance of dairy cows.

    Science.gov (United States)

    Coleman, D A; Thayne, W V; Dailey, R A

    1985-07-01

    We conducted two studies to determine how herd management practices and traits of individual cows affect performance of the herd and of the cow within a herd. Management practices, reproductive performance of the herd, and relationships between management and reproductive performance were characterized on 83 dairy farms with 7596 cows. Data included 21 management variables (e.g., facilities, herd health program, estrous detection program) and 8 performance variables obtained from Dairy Herd Improvement or unofficial records (e.g., size of herd, production, days open). Although varying among herds, annual average herd incidences of reproductive disorders and reproductive performance were similar to those reported. Managerial practices influenced incidences of retained placenta and uterine infection, days open of cows not bred and of all cows, services per conception, and percentages of herd open more than 100 days and culled for low production. Veterinarian was the most consistent variable influencing herd reproductive performance. Data also were collected from production and lifetime records of 2532 cows in 19 herds. Reproductive performance was affected by season of calving, production, maturity, and reproductive disorders. Several cows with extremely poor reproductive records were maintained.

  17. Trends and determining factors associated with adherence to antiretroviral therapy (ART in Cameroon: a systematic review and analysis of the CAMPS trial

    Directory of Open Access Journals (Sweden)

    Mbuagbaw Lawrence

    2012-12-01

    Full Text Available Abstract Background The benefits of antiretroviral therapy (ART cannot be experienced if they are not taken as prescribed. Yet, not all causes of non-adherence are dependent on the patient. Having to pay for medication reduces adherence rates. Non- adherence has severe public health implications which must be addressed locally and globally. This paper seeks to describe the trends in adherence rates reported in Cameroon and to investigate the determinants of adherence to ART in the Cameroon Mobile Phone SMS (CAMPS trial. Methods We conducted a systematic review of electronic databases (PubMed, Google Scholar, Web of Science, CINAHL, EMBASE and PSYCINFO for publications on adherence to ART in Cameroon (from January 1999 to May 2012 and described the trend in reported adherence rates and the factors associated with adherence. Data were extracted in duplicate. We used multivariable analyses on the baseline data for 200 participants in the CAMPS trial to determine the factors associated with adherence in four models using different measures of adherence (more than 90% or 95% on the visual analogue scale, no missed doses and a composite measure: 100% on the visual analogue scale, no missed doses and all pills taken on time. Results We identified nine studies meeting our inclusion criteria. Adherence to ART in Cameroon has risen steadily between 2000 and 2010, corresponding to reductions in the cost of medication. The factors associated with adherence to ART in Cameroon are grouped into patient, medication and disease related factors. We also identified factors related to the health system and the patient-provider relationship. In the CAMPS trial, education, side effects experienced and number of reminder methods were found to improve adherence, but only using multiple reminder methods was associated with better adherence in all the regression models (Adjusted Odds Ratio [AOR] 4.11, 95% Confidence Interval [CI] 1.89, 8.93; p Conclusions Reducing the

  18. Factors Affecting Labour Productivity in Manufacturing Enterprises

    Directory of Open Access Journals (Sweden)

    Zbigniew Gołaś

    2011-07-01

    Full Text Available The article presents the results of the analysis of the factors influencing labour productivity in the manufacturing business sector in 20042008. Labour productivity was analyzed in the context of the assets productivity, technical equipment of work, labour intensity of production, wages, value added and depreciation costs, and using linear stepwise regression. The study shows that despite significant progress, the level of labour productivity in domestic manufacturing significantly lower than the average in the European Union. Lower than in Poland, the level of labour productivity gain only companies in Romania, Bulgaria, Lithuania, Latvia and Estonia. Estimated parameters of the regression function showed that the most important determinants of labour productivity in manufacturing are technical equipment of work, labour intensity of production, assets productivity, level of added value in relation to revenues. These factors explain the variability of labour productivity in 20042008 in a high degree.

  19. Trust Factors Affecting Cooperation in Construction

    DEFF Research Database (Denmark)

    Bohnstedt, Kristian Ditlev; Haugbølle, Kim; Bejder, Erik

    2013-01-01

    advisor was carried out. The analysis showed that the ability to be trustful can be developed through the experience of different factors (e.g. control mechanisms, mutual respect, repeated cooperation, shared understanding and communication). Furthermore, the ability to trust other parties depends...... on knowledge of others' skillsets. Interdisciplinary collaboration through education would limit the formation of negative stereotypes and the overall trust level increases, due to more and better knowledge of other disciplines....

  20. Overview of factors affecting the leachability of nuclear waste forms

    International Nuclear Information System (INIS)

    Stone, J.A.

    1980-01-01

    An overview of various factors that affect the leachability of nuclear waste forms is presented. The factors affect primarily the leaching system (temperature, for example), the leachant (pH, for example), or the solid being leached (surface condition, for example). A qualitative understanding exists of the major factors affecting leaching, but further studies are needed to establish leaching mechanisms and develop predictive models. 67 refs

  1. Do landscape factors affect brownfield carabid assemblages?

    International Nuclear Information System (INIS)

    Small, Emma; Sadler, Jon P.; Telfer, Mark

    2006-01-01

    The carabid fauna of 28 derelict sites in the West Midlands (England) were sampled over the course of one growing season (April-October, 1999). The study aimed to investigate the relationship between carabid assemblages and five measures of landscape structure pertinent to derelict habitat. At each site measurements of landscape features pertinent to derelict habitat were made: (i) the proximity of habitat corridors; (ii) the density of surrounding derelict land; (iii) the distance between the site and the rural fringe; and (iv) the size of the site. Concurrent surveys of the soil characteristics, vegetation type, and land use history were conducted. The data were analysed using a combination of ordination (DCA, RDA), variance partitioning (using pRDA) and binary linear regression. The results suggest that:1.There is very little evidence that the carabid assemblages of derelict sites were affected by landscape structure, with assemblages instead being principally related to within-site habitat variables, such as site age (since last disturbance), substrate type and vegetation community. 2.No evidence was found to support the hypothesis that sites away from railway corridors are more impoverished in their carabid fauna than sites on corridors. 3.There are some suggestions from this study that rarer and non-flying specialist species may be affected by isolation, taking longer to reach sites. We infer from this that older sites with retarded succession, and sites in higher densities of surrounding derelict land may eventually become more species rich and that these sites may be important for maintaining populations of rarer and flightless species. 4.Conservation efforts to maintain populations of these species should focus principally on habitat quality issues, such as maintaining early successional habitats that have a diversity of seed producing annuals and perennial plants and enhancing substrate variability rather than landscape issues

  2. Factors affecting accelerated testing of polymer photostability

    Czech Academy of Sciences Publication Activity Database

    Pospíšil, Jan; Pilař, Jan; Billingham, N. C.; Marek, Antonín; Horák, Zdeněk; Nešpůrek, Stanislav

    2006-01-01

    Roč. 91, č. 3 (2006), s. 417-422 ISSN 0141-3910. [International Conference on Modification, Degradation, Stabilization Conference /3./. Lyon, 29.08.2004-02.09.2004] R&D Projects: GA ČR GA203/02/1243; GA ČR GA202/01/0518; GA MŠk ME 543 Institutional research plan: CEZ:AV0Z40500505 Keywords : photodegradation * photostabilization * testing Subject RIV: CD - Macromolecular Chemistry Impact factor: 2.174, year: 2006

  3. Evolution of factors affecting placental oxygen transfer

    DEFF Research Database (Denmark)

    Carter, A M

    2009-01-01

    A review is given of the factors determining placental oxygen transfer and the oxygen supply to the fetus. In the case of continuous variables, such as the rate of placental blood flow, it is not possible to trace evolutionary trends. Discontinuous variables, for which we can define character sta......, where fetal and adult haemoglobin are not different, developmental regulation of 2, 3-diphosphoglycerate ensures the high oxygen affinity of fetal blood. Oxygen diffusing capacity is dependent on diffusion distance, which may vary with the type of interhaemal barrier. It has been shown...

  4. Adherence to phosphate binders in hemodialysis patients: prevalence and determinants.

    Science.gov (United States)

    Van Camp, Yoleen P M; Vrijens, Bernard; Abraham, Ivo; Van Rompaey, Bart; Elseviers, Monique M

    2014-12-01

    Phosphate control is a crucial treatment goal in end-stage renal disease, but poor patient adherence to phosphate binder therapy remains a challenge. This study aimed to estimate the extent of phosphate binder adherence in hemodialysis patients and to identify potential determinants. Phosphate binder adherence was measured blindly in 135 hemodialysis patients for 2 months using the medication event monitoring system. Patient data, gathered at inclusion through medical records, ad hoc questionnaires and the short form (SF)-36 health survey, included: (1) demographics, (2) perceived side-effects, belief in benefit, self-reported adherence to the therapy, (3) knowledge about phosphate binder therapy, (4) social support, and (5) quality of life (SF-36). Phosphatemia data was collected from charts. 'Being adherent' was defined as missing adherent' as missing adherent. Over the entire 8-week period, 22 % of patients were totally adherent. Mean phosphatemia levels were 0.55 mg/dl lower in adherent than nonadherent patients (4.76 vs. 5.31 mg/dl). Determinants for being totally adherent were living with a partner, higher social support (both were interrelated) and higher physical quality of life. Experiencing intake-related inconvenience negatively affected adherence. The social support and quality of life physical score explained 26 % of the variance in adherence. Phosphate binder nonadherence remains a major problem. Interventions should aim, at least, to improve social support. With few associated factors found and yet low adherence, an individualized approach seems indicated.

  5. The effects of Risk Factor-Targeted Lifestyle Counselling Intervention on working-age stroke patients' adherence to lifestyle change.

    Science.gov (United States)

    Oikarinen, Anne; Engblom, Janne; Kääriäinen, Maria; Kyngäs, Helvi

    2017-09-01

    Since a history of stroke or transient ischaemic attack is a major risk factor for a recurrent event, lifestyle counselling during the hospital phase is an essential component of treatment and may increase the probability of lifestyle change. To study the effect of risk factor-targeted lifestyle counselling intervention on working-age stroke patients' adherence to lifestyle changes. A quasi-experimental, nonequivalent control group pretest-post-test design. Stroke patients in an acute neurological unit were divided into a control group (n = 75) receiving standard counselling and an experimental group (n = 75) receiving risk factor-targeted counselling. Lifestyle data and clinical outcomes were collected at hospital between January 2010 and October 2011, while data on adherence to lifestyle changes 3, 6, and 12 months after discharge. The baseline lifestyle habits did not differ significantly other than in alcohol behaviour. Both groups increased their intake, but the intervention group to a lesser degree. However, the experimental group significantly lost their weight for the first 3 and 6 months; at 3 months reduction in cigarette consumption and at 6 months significant increases in smoking cessation were also achieved. All improved some of their lifestyle habits. Intervention was associated with support from nurses as well as from family and friends. Adherence scores were higher in the experimental group. Some short-term advantages in lifestyle habits due to the intervention were noted. Participants in both groups improved some of their lifestyle habits. © 2016 Nordic College of Caring Science.

  6. Factors affecting membership in specialty nursing organizations.

    Science.gov (United States)

    White, Mary Joe; Olson, Rhonda S

    2004-01-01

    A discouraging trend in many specialty nursing organizations is the stagnant or declining membership. The research committee of the Southeast Texas Chapter of the Association of Rehabilitation Nurses (ARN) collected data and studied this trend to determine what changes would be necessary to increase membership. Using Herzberg's motivational theory as a framework, a review of the literature was initiated. There were few current studies on this issue, but relevant information was found about nursing's emerging workforce, as well as implications of the growth of magnet hospitals, which affect whether nurses join specialty nursing organizations. A multifaceted data-collection approach using convenience samples was designed. First, relevant literature was reviewed. Second, a survey was sent by e-mail to other ARN chapters. Third, a telephone survey on other specialty organizations in the geographic region was completed. Finally, members of the local ARN chapter and four other specialty organizations, as well staff nurses in the geographic area, were given questionnaires to complete. Descriptive statistics and cross tabulations were used to determine why nurses do and do not join specialty organizations (N = 81). The most frequent reasons for joining an organization were to increase knowledge, benefit professionally, network, and earn continuing education units. Reasons for choosing not to participate were family responsibilities, lack of information about these organizations, and lack of time. Ways to reverse the decline in membership are discussed.

  7. Factors affecting the design of instrument flight procedures

    Directory of Open Access Journals (Sweden)

    Ivan FERENCZ

    2008-01-01

    Full Text Available The article highlights factors, which might affect the design of instrument flight procedures. Ishikawa diagram is used to distribute individual factors into classes, as are People, Methods, Regulations, Tools, Data and Environment.

  8. Investigation of Factors Affecting Microdialysis Probe Delivery and ...

    African Journals Online (AJOL)

    HP

    Purpose: To investigate in vitro the factors affecting microdialysis probe delivery and recovery of puerarin . Methods: ... methods. Factors such as drug concentration, stirring speed, additives and length of membrane were ... The high performance liquid chromatography ..... Pharmacokinetic Modeling to Investigate Regional.

  9. Ranking and evaluating the factors affecting the success of ...

    African Journals Online (AJOL)

    Ranking and evaluating the factors affecting the success of management team in construction projects. ... Journal of Fundamental and Applied Sciences. Journal Home ... The project management team is one of these important factors.

  10. Factors affecting the organization and management of emergency ...

    African Journals Online (AJOL)

    Factors affecting the organization and management of emergency mass casualty ... service all under a unified command of leadership with a specified job description. Factors identified were: Political will, human resource planning, appropriate ...

  11. Factors affecting radiocaesium transfer to ruminants

    International Nuclear Information System (INIS)

    Voigt, G.; Howard, B.J.; Vandecasteele, C.; Mayes, R.W.; Belli, M.; Sansone, U.; Stakelum, G.; Colgan, P.A.; Assimakopoulos, P.; Crout, N.M.J.; Jones, B.E.V., Hove, K.; ITE, Merlewood; CEN, Mol; MLURI, Aberdeen; ENEA-DISP, Rome; MPRC, Fermoy; RPII, Dublin; Ioannina Univ., Nuclear Physics; Nottingham Univ., Dept. of Environmental Sciences; Swedish Univ. of Agricultural Sciences, Uppsala; Agricultural Univ., Aas

    1993-01-01

    The studies performed in the 2 year CEG/DG XII Radiation Protection Programme described here have tried to identify and quantify some of the most important factors influencing the radiocaesium levels in animal food products. The programme involved 9 laboratories in 6 countries: Belgium, Ireland, Greece, Italy, Sweden and the UK. Scientists from Norway and Germany also participated on an informal basis and are formally involved in a subsequent project. Experimental studies have largely been conducted using sheep, although some comparative studies have been performed with dairy cattle. In parallel to the experimental studies, a number of research models have been developed by participants in Greece and the UK to be interactively used with a number of different aspects in the programme. This presentation gives a short overview and discussion of the main findings of this project. (orig./DG)

  12. Experimental Study of Factors Affecting Soil Erodibility

    Science.gov (United States)

    Larionov, G. A.; Bushueva, O. G.; Gorobets, A. V.; Dobrovolskaya, N. G.; Kiryukhina, Z. P.; Krasnov, S. F.; Litvin, L. F.; Maksimova, I. A.; Sudnitsyn, I. I.

    2018-03-01

    The effect of different factors and preparation conditions of monofraction samples from the arable horizon of leached chernozem on soil erodibility and its relationship with soil tensile strength (STS) has been studied. The exposure of samples at 38°C reduces their erodibility by two orders of magnitude. The drying of samples, on the contrary, increases their erodibility. It has been shown that erodibility decreases during the experiment. It has been found that the inoculation of soil with yeast cultures ( Naganishia albida, Lipomyces tetrasporus) reliably increases the STS value in 1.5-1.9 times. The sterile soil is eroded more intensively than the unsterile soil: at 4.9 and 0.3 g/(m2 s), respectively. The drying of soil followed by wetting to the initial water content (30%) has no significant effect on the STS value in almost all experimental treatments.

  13. Self-monitoring of blood glucose among patients with diabetes in Jordan: Perception, adherence, and influential factors.

    Science.gov (United States)

    Al-Keilani, Maha S; Almomani, Basima A; Al-Sawalha, Nour A; Shhabat, Batool A

    2017-04-01

    To investigate the self-monitoring of blood glucose (SMBG) adherence among Jordanian patients with diabetes and to identify the predictive factors. A cross-sectional survey was carried out in 18 hospitals and healthcare centers covering south, north, and middle of Jordan. All patients with diabetes attending endocrinology clinics from May to December, 2015 were approached. The questionnaires were distributed by trained pharmacists and were self-administered. A total of 1079 participants completed the survey. Only 59% of participants were SMBG adherent. Predictors of SMBG adherence were treatment regimen; insulin with oral hypoglycemic agents (p=0.044, CI 1.023-5.274, OR=2.323) or insulin only (p=0.005, CI 1.225-3.115, OR=1.953), and health education on how to use the SMBG meter (p<0.001, CI 10.538-32.497, OR=18.506). The frequency of SMBG was significantly associated with the treatment regimen, with patients who were taking oral hypoglycemic agents (p<0.001) or insulin therapy (p=0.004) tested more frequently as compared to others. Additionally, the frequency of testing was significantly associated with the reason of performing SMBG (p<0.001). Frequency of daily testing was the highest among patients who performed SMBG to know if they were hypoglycemic (48.9%) or hyperglycemic (48.0%), or to inform their doctors (28.4%). SMBG adherence was suboptimal. Predictors of SMBG adherence were treatment regimen and health education about the SMBG meter. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Factors Affecting Hypertension among the Malaysian Elderly

    Directory of Open Access Journals (Sweden)

    Sima Ataollahi Eshkoor

    2016-03-01

    Full Text Available Hypertension is a common chronic disease in the elderly. This study aimed to determine the effects of age, ethnicity, gender, education, marital status, nutritional parameters, and blood elements on the risk of high blood pressure in the Malaysian elderly. This research was conducted on a group of 2322 non-institutionalized Malaysian elderly. The hierarchy binary logistic regression analysis was applied to estimate the risk of hypertension in respondents. Approximately, 45.61% of subjects had hypertension. The findings indicated that the female gender (Odds ratio (OR = 1.54, an increase in body weight (OR = 1.61, and an increase in the blood levels of albumin (OR = 1.51, glucose (OR = 1.92, and triglycerides (OR = 1.27 significantly increased the risk of hypertension in subjects (p < 0.05. Conversely, an increase in both dietary carbohydrates (OR = 0.74, and blood cholesterol level (OR = 0.42 significantly reduced the risk of hypertension in samples (p < 0.05. Furthermore, the results showed that ethnicity was a non-relevant factor to increase the risk of hypertension in subjects. It was concluded that female gender, an increase in body weight, and an increase in the blood levels of glucose, triglycerides, and albumin enhanced the risk of high blood pressure in the Malaysian elderly. In addition, an increase in both dietary carbohydrates and blood cholesterol level decreased hypertension in subjects.

  15. Factors Affecting Patient Satisfaction During Endoscopic Procedures

    International Nuclear Information System (INIS)

    Qureshi, M. O.; Shafqat, F.; Ahmed, S.; Niazi, T. K.; Khokhar, N. K.

    2013-01-01

    Objective: To assess the quality and patient satisfaction in Endoscopy Unit of Shifa International Hospital. Study Design: Cross-sectional survey. Place and Duration of Study: Division of Gastroenterology, Shifa International Hospital, Islamabad, Pakistan, from July 2011 to January 2012. Methodology: Quality and patient satisfaction after the endoscopic procedure was assessed using a modified GHAA-9 questionnaire. Data was analyzed using SPSS version 16. Results: A total of 1028 patients were included with a mean age of 45 A+- 14.21 years. Out of all the procedures, 670 (65.17%) were gastroscopies, 181 (17.60%) were flexible sigmoidoscopies and 177 (17.21%) were colonoscopies. The maximum unsatisfactory responses were on the waiting time before the procedure (13.13 %), followed by unsatisfactory explanation of the procedure and answers to questions (7.58%). Overall, unsatisfied impression was 4.86%. The problem rate was 6.22%. Conclusion: The quality of procedures and level of satisfaction of patients undergoing a gastroscopy or colonoscopy was generally good. The factors that influence the satisfaction of these patients are related to communication between doctor and patient, doctor's manner and waiting time for the procedure. Feedback information in an endoscopy unit may be useful in improving standards, including the performance of endoscopists. (author)

  16. Improving adherence to antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Nischal K

    2005-01-01

    Full Text Available Antiretroviral therapy (ART has transformed HIV infection into a treatable, chronic condition. However, the need to continue treatment for decades rather than years, calls for a long-term perspective of ART. Adherence to the regimen is essential for successful treatment and sustained viral control. Studies have indicated that at least 95% adherence to ART regimens is optimal. It has been demonstrated that a 10% higher level of adherence results in a 21% reduction in disease progression. The various factors affecting success of ART are social aspects like motivation to begin therapy, ability to adhere to therapy, lifestyle pattern, financial support, family support, pros and cons of starting therapy and pharmacological aspects like tolerability of the regimen, availability of the drugs. Also, the regimen′s pill burden, dosing frequency, food requirements, convenience, toxicity and drug interaction profile compared with other regimens are to be considered before starting ART. The lack of trust between clinician and patient, active drug and alcohol use, active mental illness (e.g. depression, lack of patient education and inability of patients to identify their medications, lack of reliable access to primary medical care or medication are considered to be predictors of inadequate adherence. Interventions at various levels, viz. patient level, medication level, healthcare level and community level, boost adherence and overall outcome of ART.

  17. Factors affecting mechanical (nociceptive) thresholds in piglets.

    Science.gov (United States)

    Janczak, Andrew M; Ranheim, Birgit; Fosse, Torunn K; Hild, Sophie; Nordgreen, Janicke; Moe, Randi O; Zanella, Adroaldo J

    2012-11-01

    To evaluate the stability and repeatability of measures of mechanical (nociceptive) thresholds in piglets and to examine potentially confounding factors when using a hand held algometer. Descriptive, prospective cohort. Forty-four piglets from four litters, weighing 4.6 ± 1.0 kg (mean ± SD) at 2 weeks of age. Mechanical thresholds were measured twice on each of 2 days during the first and second week of life. Data were analyzed using a repeated measures design to test the effects of behavior prior to testing, sex, week, day within week, and repetition within day. The effect of body weight and the interaction between piglet weight and behaviour were also tested. Piglet was entered into the model as a random effect as an additional test of repeatability. The effect of repeated testing was used to test the stability of measures. Pearson correlations between repeated measures were used to test the repeatability of measures. Variance component analysis was used to describe the variability in the data. Variance component analysis indicated that piglet explained only 17% of the variance in the data. All variables in the model (behaviour prior to testing, sex, week, day within week, repetition within day, body weight, the interaction between body weight and behaviour, piglet identity) except sex had a significant effect (p testing and measures changed with repeated testing and increased with increasing piglet weight, indicating that time (age) and animal body weight should be taken into account when measuring mechanical (nociceptive) thresholds in piglets. Mechanical (nociceptive) thresholds can be used both for testing the efficacy of anaesthetics and analgesics, and for assessing hyperalgesia in chronic pain states in research and clinical settings. © 2012 The Authors. Veterinary Anaesthesia and Analgesia. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.

  18. Perceived Factors Affecting Performance Of Extension Workers In ...

    African Journals Online (AJOL)

    The study focused on perceived factors affecting performance of extension workers in Imo State, Nigeria. Data for the study was collected from 83 Extension agents from the Imo State Agricultural Development Programme (ADP). Results of the study revealed that the organizational factors that affect performance are ...

  19. Factors affecting the runoff response of watersheds to precipitation

    OpenAIRE

    DROZDOVÁ, Martina

    2013-01-01

    This bachelor thesis is focused on the factors that affect the drainage basin of the response. It contains a literature review, which deals with the hydrological cycle characteristics of precipitation, surface runoff and flood and erosion protection. The aim of the work is to evaluate the factors that adversely affect the runoff from the catchment.

  20. Factors Affecting Prenatal Care Utilization in East Wollega Zone ...

    African Journals Online (AJOL)

    The objective of the study was to identify factors affecting utilization of prenatal care and skilled birth attendant in East Wollega zone. Prenatal care and skilled birth attendant are crucial factor which affects the health and wellbeing of the mother and newborn and help the women to access skilled assistance, drugs, ...

  1. The relationship between affective factors and the academic ...

    African Journals Online (AJOL)

    The purpose of this study is to investigate the relationship between affective factors and the academic achievement of students at the University of Venda. To this end, self-concept, motivation and attitude are the affective factors selected for the study. The general aim of the study is to determine the role of self-concept, ...

  2. Psychosocial factors associated with adherence to treatment and quality of life in people living with HIV/AIDS in Brazil

    Directory of Open Access Journals (Sweden)

    Prisla Ücker Calvetti

    2014-03-01

    Full Text Available Objective: The objective of this article was to investigate the biopsychosocial factors that influence adherence to treatment and the quality of life of individuals who have been successfully following the HIV/AIDS treatment. Methods: It is a cross-sectional study carried out with 120 HIV positive participants in the south of Brazil. Among the variables studied, of note are: perceived stress, social support, symptoms of anxiety and depression and quality of life. Results: The results show that a moderate to high adherence to the treatment paired with a strong sense of social support indicate a higher quality of life. Conclusion: The combination of social support and antiretroviral treatment have an impact on physical conditions, improving immune response and quality of life.

  3. The rate of adherence to urate-lowering therapy and associated factors in Chinese gout patients: a cross-sectional study.

    Science.gov (United States)

    Yin, Rulan; Cao, Haixia; Fu, Ting; Zhang, Qiuxiang; Zhang, Lijuan; Li, Liren; Gu, Zhifeng

    2017-07-01

    The aim of this study was to assess adherence rate and predictors of non-adherence with urate-lowering therapy (ULT) in Chinese gout patients. A cross-sectional study was administered to 125 gout patients using the Compliance Questionnaire on Rheumatology (CQR) for adherence to ULT. Patients were asked to complete the Treatment Satisfaction Questionnaire for Medication version II, Health Assessment Questionnaire, Confidence in Gout Treatment Questionnaire, Gout Knowledge Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and 36-Item Short Form Health Survey. Data were analyzed by independent sample t test, rank sum test, Chi-square analysis as well as binary stepwise logistic regression modeling. The data showed that the rate of adherence (CQR ≥80%) to ULT was 9.6% in our investigated gout patients. Adherence was associated with functional capacity, gout-related knowledge, satisfaction with medication, confidence in gout treatment and mental components summary. Multivariable analysis of binary stepwise logistic regression identified gout-related knowledge and satisfaction of effectiveness with medication was the independent risk factors of medication non-adherence. Patients unaware of gout-related knowledge, or with low satisfaction of effectiveness with medication, were more likely not to adhere to ULT. Non-adherence to ULT among gout patients is exceedingly common, particularly in patients unaware of gout-related knowledge, or with low satisfaction of effectiveness with medication. These findings could help medical personnel develop useful interventions to improve gout patients' medication adherence.

  4. Influence of route of administration/drug formulation and other factors on adherence to treatment in rheumatoid arthritis (pain related) and dyslipidemia (non-pain related).

    Science.gov (United States)

    Fautrel, Bruno; Balsa, Alejandro; Van Riel, Piet; Casillas, Marta; Capron, Jean-Philippe; Cueille, Carine; de la Torre, Inmaculada

    2017-07-01

    A comprehensive review was performed to investigate the effect of route of administration on medication adherence and persistence in rheumatoid arthritis (RA) and to compare adherence/persistence with oral medications between RA and a non-painful disease (dyslipidemia). Comprehensive database searches were performed to identify studies investigating medication adherence and/or persistence in adults with RA receiving conventional synthetic or biologic agents. Similar searches were performed for studies of patients with dyslipidemia receiving statins. Studies had to be published after 1998 in English and involve ≥6 months' follow up. Adherence and persistence were compared between the different routes of drug administration in RA, and between the two diseases for oral medications. A total of 35 and 28 papers underwent data extraction for RA and dyslipidemia, respectively. Within the constraints of the analysis, adherence and persistence rates appeared broadly similar for the different routes of drug administration in RA. Adherence to oral medications was also broadly similar across the two diseases, but persistence was lower in dyslipidemia. Poor adherence has clinical consequences in both diseases: greater disease activity and risk of flare in RA, and increased serum cholesterol levels and risk of heart and cerebrovascular disease in dyslipidemia. Over 1-3 years, poor adherence to biologic RA medications led to increased resource use and medical costs but lower total direct costs due to reduced biologic drug costs. Conversely, poor adherence to dyslipidemia medications resulted in increased total direct costs. In both diseases, adherence improved with patient education/support. The route of drug administration and the symptomatic (pain) nature of the disease do not appear to be dominant factors for drug adherence or persistence in RA. The wide range of adherence and persistence values and definitions across studies made comparisons between drug formulations and

  5. Predictive factors of adherence to frequency and duration components in home exercise programs for neck and low back pain: an observational study

    Directory of Open Access Journals (Sweden)

    Jimeno-Serrano Francisco J

    2009-12-01

    Full Text Available Abstract Background Evidence suggests that to facilitate physical activity sedentary people may adhere to one component of exercise prescriptions (intensity, duration or frequency without adhering to other components. Some experts have provided evidence for determinants of adherence to different components among healthy people. However, our understanding remains scarce in this area for patients with neck or low back pain. The aims of this study are to determine whether patients with neck or low back pain have different rates of adherence to exercise components of frequency per week and duration per session when prescribed with a home exercise program, and to identify if adherence to both exercise components have distinct predictive factors. Methods A cohort of one hundred eighty-four patients with chronic neck or low back pain who attended physiotherapy in eight primary care centers were studied prospectively one month after intervention. The study had three measurement periods: at baseline (measuring characteristics of patients and pain, at the end of physiotherapy intervention (measuring characteristics of the home exercise program and a month later (measuring professional behaviors during clinical encounters, environmental factors and self-efficacy, and adherence behavior. Results Adherence to duration per session (70.9% ± 7.1 was more probable than adherence to frequency per week (60.7% ± 7.0. Self-efficacy was a relevant factor for both exercise components (p Conclusion We have shown in a clinic-based study that adherence to exercise prescription frequency and duration components have distinct levels and predictive factors. We recommend additional study, and advise that differential attention be given in clinical practice to each exercise component for improving adherence.

  6. Adherence to anti-retroviral therapy & factors associated with it: A community based cross-sectional study from West Bengal, India

    Directory of Open Access Journals (Sweden)

    Sobha Pahari

    2015-01-01

    Full Text Available Background & objectives: Failure to adhere to anti-retroviral therapy (ART can lead to a range of unfavourable consequences impacting upon people living with HIV (PLH and society. It is, therefore, paramount that ART adherence is measured in a reliable manner and factors associated with adherence are identified. Lack of such data from West Bengal necessitated undertaking the current study. Methods: Participants were included during August-October, 2011 from three Drop-In-Centres (DICs from the three districts of West Bengal, India. ART-adherence was calculated by using formula based on pill-count and records collected from ART-card in possession of each of the 128 consenting adult PLH. Information on self-reported adherence, socio-demography, and adherence influencing issues was also collected through interviewer-administered questionnaire. Results: Of the 128 PLH, 99 (77% and 93 (73% PLH had ≥90 per cent and ≥95 per cent adherence, respectively to ART. Conversely, subjective reporting captured much higher proportion of PLH as ′well adherent′; a finding having implications for ongoing ART programme. Factors, independently associated with poor adherence (<90%, were ′7 th to 12 th month period of ART intake′ (adjusted OR=9.5; 90% CI 1.9 - 47.3; p0 =0.02 and ′non-disclosure of HIV status to family members′ (adjusted OR=4; 90% CI 1.3 - 13; P=0.05. Results at 95 per cent adherence cut-off were similar. Interpretation & conclusions: Enabling environment, which would encourage people to disclose their HIV status and in turn seek adherence partners from families and beyond and ongoing adherence-counselling appear to be important issues in the programme. Relevance of these study findings in wider context is conceivable.

  7. Factors influencing adherence to referral advice following pre-referral treatment with artesunate suppositories in children in rural Tanzania.

    Science.gov (United States)

    Simba, Daudi O; Warsame, Marian; Kimbute, Omari; Kakoko, Deodatus; Petzold, Max; Tomson, Goran; Premji, Zul; Gomes, Melba

    2009-07-01

    WHO recommends artemisinin suppository formulations as pre-referral treatment for children who are unable to take oral medication and cannot rapidly reach a facility for parenteral treatment. We investigated factors influencing caretakers' adherence to referral advice following pre-referral treatment of their children with rectal artesunate suppositories. The study was nested within an intervention study that involved pre-referral treatment of all children who came to a community dispenser for treatment because they were unable to take oral medications because of repeated vomiting, lethargy, convulsions or altered consciousness. All patients who did not comply with referral advice were stratified by actions taken post-referral: taking their children to a drug shop, a traditional healer, or not seeking further treatment, and added to a random selection of patients who complied with referral advice. Caretakers of the children were interviewed about their socio-economic status (SES), knowledge about malaria, referral advice given and actions they took following pre-referral treatment. Interview data for 587 caretakers were matched with symptoms of the children, the time of treatment, arrival at a health facility or other actions taken post-pre-referral treatment. The majority (93.5%) of caretakers reported being given referral advice by the community drug dispenser. The odds of adherence with this advice were three times greater for children with altered consciousness and/or convulsions than for children with other symptoms [odds ratio (OR) 3.47, 95% confidence interval (CI) 2.32-5.17, P < 0.001]. When questioned, caretakers who remembered when (OR 2.19, 95% CI 1.48-3.23, P < 0.001) and why (OR 1.77, 95% CI 1.07-2.95, P = 0.026) they were advised to proceed to health facility - were more likely to follow referral advice. Cost did not influence adherence except within a catchment area of facilities that charged for services. In these areas, costs deterred adherence by

  8. Assessment of salient beliefs affecting mothers' intention to adherence to dietary diversity in their children's complementary feeding

    Directory of Open Access Journals (Sweden)

    Akram Karimi-Shahanjarini

    2017-01-01

    Full Text Available Background: Providing a variety of foods has been emphasized as one of the most important features of optimal complementary feeding. This study investigated key beliefs that guide mothers' intention to adherence to dietary diversity in their 1–2-year-old children's complementary feeding. Methods: This was a cross-sectional study involving 290 mothers (mean age = 27, standard deviation = 5.32 with child 1–2-year-old attending maternal and child health section of health centers in Rasht, Iran. To represent the socioeconomic status of the participants, 6 centers out of 15 were selected from three different socioeconomic areas (low-, middle-, and high-income areas. Mothers completed a questionnaire assessing intention and belief-based items of theory of planned behavior. Correlations and multiple regression analyses were performed. Results: The mean age of mothers was 27 ± 5.33 (27–43 years. Regression analyses revealed that among behavioral beliefs, the perception that adherence to dietary diversity would lead to improve children's growth was the significant predictor of intention (β = 0.13,P= 0.04. Regarding normative beliefs, perceived social pressure from health-care professionals to adherence to dietary diversity significantly predicted intention (β = 0.15,P= 0.01. Among control beliefs, the perception that daily pressures made difficult adherence to dietary diversity was the key determinant (β = 0.19,P= 0.01. Conclusions: Findings of this study represent the important beliefs that can be addressed in development planning aimed at modifying mothers' child complementary feeding practices.

  9. Assessment of Salient Beliefs Affecting Mothers' Intention to Adherence to Dietary Diversity in their Children's Complementary Feeding.

    Science.gov (United States)

    Karimi-Shahanjarini, Akram; Rahmani, Fatemeh; Roshanei, Ghodratollah; Mahdi Hazavehei, Seyyed M

    2017-01-01

    Providing a variety of foods has been emphasized as one of the most important features of optimal complementary feeding. This study investigated key beliefs that guide mothers' intention to adherence to dietary diversity in their 1-2-year-old children's complementary feeding. This was a cross-sectional study involving 290 mothers (mean age = 27, standard deviation = 5.32) with child 1-2-year-old attending maternal and child health section of health centers in Rasht, Iran. To represent the socioeconomic status of the participants, 6 centers out of 15 were selected from three different socioeconomic areas (low-, middle-, and high-income areas). Mothers completed a questionnaire assessing intention and belief-based items of theory of planned behavior. Correlations and multiple regression analyses were performed. The mean age of mothers was 27 ± 5.33 (27-43 years). Regression analyses revealed that among behavioral beliefs, the perception that adherence to dietary diversity would lead to improve children's growth was the significant predictor of intention (β = 0.13, P = 0.04). Regarding normative beliefs, perceived social pressure from health-care professionals to adherence to dietary diversity significantly predicted intention (β = 0.15, P = 0.01). Among control beliefs, the perception that daily pressures made difficult adherence to dietary diversity was the key determinant (β = 0.19, P = 0.01). Findings of this study represent the important beliefs that can be addressed in development planning aimed at modifying mothers' child complementary feeding practices.

  10. Assessment of Salient Beliefs Affecting Mothers’ Intention to Adherence to Dietary Diversity in their Children's Complementary Feeding

    Science.gov (United States)

    Karimi-Shahanjarini, Akram; Rahmani, Fatemeh; Roshanei, Ghodratollah; Mahdi Hazavehei, Seyyed M.

    2017-01-01

    Background: Providing a variety of foods has been emphasized as one of the most important features of optimal complementary feeding. This study investigated key beliefs that guide mothers’ intention to adherence to dietary diversity in their 1–2-year-old children's complementary feeding. Methods: This was a cross-sectional study involving 290 mothers (mean age = 27, standard deviation = 5.32) with child 1–2-year-old attending maternal and child health section of health centers in Rasht, Iran. To represent the socioeconomic status of the participants, 6 centers out of 15 were selected from three different socioeconomic areas (low-, middle-, and high-income areas). Mothers completed a questionnaire assessing intention and belief-based items of theory of planned behavior. Correlations and multiple regression analyses were performed. Results: The mean age of mothers was 27 ± 5.33 (27–43 years). Regression analyses revealed that among behavioral beliefs, the perception that adherence to dietary diversity would lead to improve children's growth was the significant predictor of intention (β = 0.13, P = 0.04). Regarding normative beliefs, perceived social pressure from health-care professionals to adherence to dietary diversity significantly predicted intention (β = 0.15, P = 0.01). Among control beliefs, the perception that daily pressures made difficult adherence to dietary diversity was the key determinant (β = 0.19, P = 0.01). Conclusions: Findings of this study represent the important beliefs that can be addressed in development planning aimed at modifying mothers’ child complementary feeding practices. PMID:28479970

  11. Socioeconomic factors explain suboptimal adherence to antiretroviral therapy among HIV-infected Australian adults with viral suppression.

    Directory of Open Access Journals (Sweden)

    Krista J Siefried

    Full Text Available Missing more than one tablet of contemporary antiretroviral therapy (ART per month increases the risk of virological failure. Recent studies evaluating a comprehensive range of potential risk factors for suboptimal adherence are not available for high-income settings.Adults on ART with undetectable viral load (UDVL were recruited into a national, multi-centre cohort, completing a comprehensive survey assessing demographics, socio-economic indicators, physical health, well-being, life stressors, social supports, HIV disclosure, HIV-related stigma and discrimination, healthcare access, ART regimen, adherence, side effects, costs and treatment beliefs. Baseline data were assessed, and suboptimal adherence was defined as self-reported missing ≥1 ART dose/month over the previous 3-months; associated factors were identified using bivariate and multivariate binary logistic regression.We assessed 522 participants (494 [94.5%] men, mean age = 50.8 years, median duration UDVL = 3.3 years [IQR = 1.2-6.8] at 17 sexual health, hospital, and general practice clinics across Australia. Seventy-eight participants (14.9% reported missing ≥1 dose/month over the previous three months, which was independently associated with: being Australian-born (AOR [adjusted odds ratio] = 2.4 [95%CI = 1.2-4.9], p = 0.014, not being in a relationship (AOR = 3.3 [95%CI = 1.5-7.3], p = 0.004, reaching the "Medicare safety net" (capping annual medical/pharmaceutical costs (AOR = 2.2 [95%CI = 1.1-4.5], p = 0.024, living in subsidised housing (AOR = 2.5 [95%CI = 1.0-6.2], p = 0.045, receiving home-care services (AOR = 4.4 [95%CI = 1.0-18.8], p = 0.046, HIV community/outreach services linkage (AOR = 2.4 [95%CI = 1.1-5.4], p = 0.033, and starting ART following self-request (AOR = 3.0 [95%CI = 1.3-7.0], p = 0.012.In this population, 15% reported recent suboptimal ART adherence at levels associated in prospective studies with subsequent virological failure, despite all having an

  12. Adaptive Measures for the Factors Affecting Marketing of Coffee ...

    African Journals Online (AJOL)

    Adaptive Measures for the Factors Affecting Marketing of Coffee ( Coffea robusta ... of coffee in the study area was poor pricing and marketing systems; this is as a ... of quality control and relevant information on improved coffee technologies.

  13. Factors Affecting Behaviours that address HIV Risk among Nigerian ...

    African Journals Online (AJOL)

    Objective: The aim of this study was to identify factors affecting HIV risk reduction ... Main outcome measures: Sexual behavior and condom use, knowledge about ... attitudes, normative beliefs, and subjective norms about condoms, HIV/AIDS ...

  14. Motivation factors affecting employees job performance in selected ...

    African Journals Online (AJOL)

    Motivation can be intrinsic, such as satisfaction and feelings of achievement; or extrinsic, such as rewards, punishment, and goal obtainment. The study assessed the motivating factors affecting the job performance of two oil palm companies' ...

  15. Factors that affect South African Reading Literacy Achievement ...

    African Journals Online (AJOL)

    Factors that affect South African Reading Literacy Achievement: evidence from prePIRLS 2011. ... achievement among Grade 4 learners in South Africa by utilising aspects of Carroll's model of school learning. ... AJOL African Journals Online.

  16. Multiple factors affecting South African anchovy recruitment in the ...

    African Journals Online (AJOL)

    Multiple factors affecting South African anchovy recruitment in the spawning, transport and nursery. ... and are inversely linked to high rates of gonad atresia in anchovy and reduced subsequent recruitment. ... AJOL African Journals Online.

  17. Identifying factors affecting destination choice of medical tourists: a ...

    African Journals Online (AJOL)

    medical tourism”, has emerged as a new source of competitive advantage all over the world. The present study seeks to identify the factors that affect destination choice of medical tourists. Methods: We systematically searched relevant databases ...

  18. Factors affecting extension workers in their rendering of effective ...

    African Journals Online (AJOL)

    Factors affecting extension workers in their rendering of effective service to pre and ... Small, micro and medium entrepreneurs play an important role in economic ... such as production, marketing and management to adequately service the ...

  19. Environmental and genetic factors affecting faecal worm egg counts ...

    African Journals Online (AJOL)

    Environmental and genetic factors affecting faecal worm egg counts in Merinos divergently selected for reproduction. ... The fixed effect of birth year x sex interaction was significant, with rams showing higher mean values for FWEC than ewes ...

  20. Economic Analysis of Factors Affecting Technical Efficiency of ...

    African Journals Online (AJOL)

    Economic Analysis of Factors Affecting Technical Efficiency of Smallholders ... socio-economic characteristics which influence technical efficiency in maize production. ... Ministry of Agriculture and livestock, records, books, reports and internet.

  1. An Initial Investigation of Factors Affecting Multi-Task Performance

    National Research Council Canada - National Science Library

    Branscome, Tersa A; Swoboda, Jennifer C; Fatkin, Linda T

    2007-01-01

    This report presents the results of the first in a series of investigations designed to increase fundamental knowledge and understanding of the factors affecting multi-task performance in a military environment...

  2. Factors Affecting Community Participation in O and OD Planning ...

    African Journals Online (AJOL)

    Factors Affecting Community Participation in O and OD Planning and ... great success at start but later dropped in number of cattle taken for dipping. ... and to establish the measures taken by the district leadership in addressing the problems.

  3. Factors Affecting the Efficiency of Maize Marketing in Vandeikya ...

    African Journals Online (AJOL)

    Factors Affecting the Efficiency of Maize Marketing in Vandeikya Local Government Area of Benue State, Nigeria. ... Two hundred maize marketers were selected from Vandeikya Local Area (LGA) of ... EMAIL FULL TEXT EMAIL FULL TEXT

  4. Factors affecting the adoption and diffusion of Internet in higher ...

    African Journals Online (AJOL)

    Journal of Language, Technology & Entrepreneurship in Africa ... Factors affecting the adoption and diffusion of Internet in higher educational institutions in Kenya ... communication Technologies (ICTs) such as the Internet, Learning ...

  5. factors affecting antenatal care service utilization in yem special ...

    African Journals Online (AJOL)

    jhon

    assess antenatal care utilization and factors that affect it in Yem Special Woreda, South Western Ethiopia. METHODS: A ... A pre-tested structured questionnaire consisting of information on socio- ..... model and access to medical care: does it.

  6. Determining the Factors Affecting Labor Productivity of Nurses

    Directory of Open Access Journals (Sweden)

    Yurdanur Dikmen

    2016-12-01

    Results: It was found that the 45.5% of nurses participated in the study were in the 23-53 age group, 79.5% were women, 76.9% married, 41.1% associate degree graduates. 42.3% of nurses' durations of professional experience were 0-5 years, 22.4% of nurses were clinical chief, 69.2% were working as shifts. Participants believe that the factors affecting the labor productivity were respectively organizational factors, ergonomic factors and personal factors. When organizational factors was examined; nurses stated that the lack of working personnel in the section, the low wages and unequal wages for the same work, the long working hours and the system which based on personal relations instead of merit were affecting productivity. The factors affecting labor productivity of nurses were not different according to age, gender, education level and marital status (p>0.05, but different according to mode of operation and years of experience (p<0.05. Conclusion: According to this study, it was found that there are many factors that affect the efficiency of the nurses. The most important factors affecting nurses' efficiency were determined as wage and working conditions. [J Contemp Med 2016; 6(4.000: 334-342

  7. Adherence to antidepressants

    Directory of Open Access Journals (Sweden)

    Abimbola Farinde

    2013-01-01

    Full Text Available While major depression is considered a frequent mental illness there are ongoing reports of high non-adherence to antidepressant medications which places suffers at high risk for relapse, recurrence, or greater impairment,. The World Health Organization (WHO defines adherence as the extent to which a person′s behavior (e.g. taking medications can align with the agreed recommendations of a health care provider. Unfortunately while patient may recognize the importance of adherence to antidepressant medications the majority of patients do not adhere to their prescribed antidepressants. Some of the factors that may contribute to or lead to non-adherence include knowingly or unknowingly missing doses, taking extra doses, delaying administration times, or taking drug holidays. Pharmacists have the unique ability to deter non-adherence through the performance of continuous assessment and monitoring of adherence in this population given these accessibility. Additionally, pharmacists are able to develop therapeutic alliances with patients that can help to increase the likelihood of achieving positive patient outcomes. Antidepressant non-adherence can be viewed as a significant public health concern so it is important for patients to be educated about the importance of adherence, and health care professionals should be aware of factors or patient characteristics that can serve as barriers to non-adherence.

  8. FACTORS AFFECTING THE COMPLIANCE OF MYANMAR NURSES IN PERFORMING STANDARD PRECAUTION

    Directory of Open Access Journals (Sweden)

    Sa Sa Aung

    2017-06-01

    Full Text Available Introduction: Exposure to pathogens is a serious issue for nurses. The literature explains that standard precaution have not consistently done in nursing. The purpose of this study was to analyze the factors affecting the compliance of nurses in Myanmar in performing standard precautions. Methods: This study used a cross-sectional design. Samples included 34 nurses in Waibagi Specialist Hospital (SHW, Myanmar. The independent variables were the characteristics of nurses, knowledge of standard precaution, and exposure to blood / body fluids and needle puncture wounds. The dependent variable was the performance of standard prevention. Data analyzed using descriptive analysis and logistic regression. Results: The result showed that almost respondents (91.18% had a good knowledge about prevention standards and 73.5% of respondents had good adherence in performing standard precaution. However, in practice nurses have not been consistent in closing the needles that have been used correctly. The results showed that nurse characteristics did not significantly affect adherence to standard precaution with statistical test results as follows: age (p = 0.97, gender (p = 1.00, religion (p = 0.72, education (p = 0.85, work experience at SHW (p = 0, 84, education training program (p = 0.71, knowledge (p = 0.76, and needle stick injury (p = 0,17. But, there was a significant influence between adherence to standard precaution on the incidence of injury due to puncture needle with p value = 0.01. Discussion: The barriers to applying standard precautions by Myanmar nurses can be reduced by providing basic training, supervision and improvement of operational standard procedures.

  9. Living situation affects adherence to combination antiretroviral therapy in HIV-infected adolescents in Rwanda: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Philippe R Mutwa

    Full Text Available INTRODUCTION: Adherence to combination antiretroviral therapy (cART is vital for HIV-infected adolescents for survival and quality of life. However, this age group faces many challenges to remain adherent. We used multiple data sources (role-play, focus group discussions (FGD, and in-depth interviews (IDI to better understand adherence barriers for Rwandan adolescents. Forty-two HIV positive adolescents (ages 12-21 and a selection of their primary caregivers were interviewed. All were perinatally-infected and received (cART for ≥ 12 months. Topics discussed during FGDs and IDIs included learning HIV status, disclosure and stigma, care and treatment issues, cART adherence barriers. RESULTS: Median age was 17 years, 45% female, 45% orphaned, and 48% in boarding schools. We identified three overarching but inter-related themes that appeared to influence adherence. Stigma, perceived and experienced, and inadvertent disclosure of HIV status hampered adolescents from obtaining and taking their drugs, attending clinic visits, carrying their cARTs with them in public. The second major theme was the need for better support, in particular for adolescents with different living situations, (orphanages, foster-care, and boarding schools. Lack of privacy to keep and take medication came out as major barrier for adolescents living in congested households, as well the institutionalization of boarding schools where privacy is almost non-existent. The third important theme was the desire to be 'normal' and not be recognized as an HIV-infected individual, and to have a normal life not perturbed by taking a regimen of medications or being forced to disclose where others would treat them differently. CONCLUSIONS: We propose better management of HIV-infected adolescents integrated into boarding school, orphanages, and foster care; training of school-faculty on how to support students and allow them privacy for taking their medications. To provide better care and

  10. The quantum walk search algorithm: Factors affecting efficiency

    OpenAIRE

    Lovett, Neil B.; Everitt, Matthew; Heath, Robert M.; Kendon, Viv

    2011-01-01

    We numerically study the quantum walk search algorithm of Shenvi, Kempe and Whaley [PRA \\textbf{67} 052307] and the factors which affect its efficiency in finding an individual state from an unsorted set. Previous work has focused purely on the effects of the dimensionality of the dataset to be searched. Here, we consider the effects of interpolating between dimensions, connectivity of the dataset, and the possibility of disorder in the underlying substrate: all these factors affect the effic...

  11. Determining the Factors Affecting Labor Productivity of Nurses

    OpenAIRE

    Yurdanur Dikmen; Dilek Kara Yilmaz; Handenur Basaran; Nasibe Yagmur Filiz

    2016-01-01

    Aim: This study was conducted to determine the factors affecting the labor productivity of nurses. Material and Methods: The study which was planned as descriptive and analytical was carried out with 156 nurses who volunteered to participate in the study in a public hospital in the northwest of Turkey. Data was collected with the and ldquo;Participant Presentation Form and rdquo; and the questionnaire including the factors affecting labor productivity which was developed by Ozkoc (2005). ...

  12. Online interventions for social marketing health behavior change campaigns: a meta-analysis of psychological architectures and adherence factors.

    Science.gov (United States)

    Cugelman, Brian; Thelwall, Mike; Dawes, Phil

    2011-02-14

    Researchers and practitioners have developed numerous online interventions that encourage people to reduce their drinking, increase their exercise, and better manage their weight. Motivations to develop eHealth interventions may be driven by the Internet's reach, interactivity, cost-effectiveness, and studies that show online interventions work. However, when designing online interventions suitable for public campaigns, there are few evidence-based guidelines, taxonomies are difficult to apply, many studies lack impact data, and prior meta-analyses are not applicable to large-scale public campaigns targeting voluntary behavioral change. This meta-analysis assessed online intervention design features in order to inform the development of online campaigns, such as those employed by social marketers, that seek to encourage voluntary health behavior change. A further objective was to increase understanding of the relationships between intervention adherence, study adherence, and behavioral outcomes. Drawing on systematic review methods, a combination of 84 query terms were used in 5 bibliographic databases with additional gray literature searches. This resulted in 1271 abstracts and papers; 31 met the inclusion criteria. In total, 29 papers describing 30 interventions were included in the primary meta-analysis, with the 2 additional studies qualifying for the adherence analysis. Using a random effects model, the first analysis estimated the overall effect size, including groupings by control conditions and time factors. The second analysis assessed the impacts of psychological design features that were coded with taxonomies from evidence-based behavioral medicine, persuasive technology, and other behavioral influence fields. These separate systems were integrated into a coding framework model called the communication-based influence components model. Finally, the third analysis assessed the relationships between intervention adherence and behavioral outcomes. The

  13. Factors affecting dignity of patients with multiple sclerosis.

    Science.gov (United States)

    Sharifi, Simin; Borhani, Fariba; Abbaszadeh, Abbas

    2016-12-01

    MS is one of the most common chronic diseases of the nervous system. Apart from disease progression, other complications such as unemployment, separation and divorce could potentially threat patients' dignity. Most of the previous studies have been done of maintaining patients' dignity in interaction with healthcare team, but studies on affecting factors of dignity in chronic patients in the society and in interaction with usual people are scarce. We aimed to investigate factors affecting dignity of Iranian patients with MS in daily living and in interaction of them with the society. In this qualitative study, 13 patients with multiple sclerosis were chosen by purposive sampling and semi-structured interviews were conducted until data saturation. The study was done in Tehran, the capital city of Iran. Factors affecting dignity were classified as 'personal factors' and 'social factors'. Personal factors consist of the following subcategories: patients' communication with self, patients' knowledge, patients' values and beliefs and patients' resources. Social factors include others' communication with patients, social knowledge, social values and beliefs and social resources. Multiple personal and social factors interfere in perceived patient dignity. In fact, interaction between personal and social factors can be influential in final perceived dignity. By focusing on whole aspects of the patients' lives, we can identify dignity-promoting or dignity-threatening factors and help patients maintain their dignity by taking appropriate measures for moderating threatening factors and improving dignity enhancing ones. © 2016 Nordic College of Caring Science.

  14. Exploring Factors that Affect Purchase Intention of Athletic Team Merchandise

    Science.gov (United States)

    Lee, Donghun; Trail, Galen T.; Lee, Cindy; Schoenstedt, Linda J.

    2013-01-01

    The purpose of this study was to test a structural model to determine which psychosocial constructs affected the purchase intention of athletic team merchandise (ATM). Results from the analyses indicated that the twelve-factor ATM model fit the data from collegiate athletic events well, explaining the various impact factors that lead to purchase…

  15. Personality factors and adult attachment affecting job mobility

    NARCIS (Netherlands)

    van Vianen, A.E.M.; Feij, J.A.; Krausz, M.; Taris, R.

    2003-01-01

    Past research has revealed that individuals' job mobility is affected by factors such as job satisfaction, specific career enhancing attributes and job availability. This study examined personality factors predicting voluntary internal and external job mobility. Three types of voluntary job mobility

  16. Investigation of Factors Affecting Microdialysis Probe Delivery and ...

    African Journals Online (AJOL)

    Purpose: To investigate in vitro the factors affecting microdialysis probe delivery and recovery of puerarin. Methods: The recovery and delivery of puerarin were tested for extraction efficiency and retro-dialysis methods. Factors such as drug concentration, stirring speed, additives and length of membrane were studied to ...

  17. Factors Affecting Utilization of Skilled Birth Attendants by Women in ...

    African Journals Online (AJOL)

    This underscores the need to investigate factors responsible for low use of skilled attendants at birth. The main purpose of the study was to identify factors affecting utilization of skilled attendants at birth by pregnant women in Kasama district in order to help contribute to the reduction of maternal and child complications.

  18. Investigation of Factors Affecting Microdialysis Probe Delivery and ...

    African Journals Online (AJOL)

    Purpose: To investigate in vitro the factors affecting microdialysis probe delivery and recovery of puerarin . Methods: The recovery and delivery of puerarin were tested for extraction efficiency and retro-dialysis methods. Factors such as drug concentration, stirring speed, additives and length of membrane were studied to ...

  19. Physical factors affecting the electrically assisted thermal bitumen recovery

    Energy Technology Data Exchange (ETDEWEB)

    Bogdanov, I.I.; Torres, J.-A.; Kamp, A.M. [CHLOE, University of Pau (France); Corre, B. [CSTJF, Total (France)

    2011-07-01

    In the heavy oil industry, thermal processes are used to enhance oil recovery by increasing the reservoir temperature which results in better oil mobility. Low frequency heating (LFH) is a technology using electrical conductivity of connate water to propagate current between electrodes, thus generating heat in the reservoir through the Joule effect. During the preheating and production periods, many physical factors may affect the LFH process and the aim of this study was to determine which factors affect the process and how, using a particular pattern of electrodes. Simulations were conducted using the CMG Stars reservoir simulator under different configurations, conditions and parameters. Important physical properties and operational conditions affecting the LFH process were determined and results showed that convection heat, bulk electrical conductivity and power distribution can be improved by salt water circulation. This paper highlighted the physical factors affecting LFH efficiency and these findings will be useful for future process design.

  20. Factors Affecting Rural Facilitators’ Role: Iran

    OpenAIRE

    Azimi, Farideh; Kamali, Mohammad Bagher

    2011-01-01

    This study aimed to examine key factors affecting rural female facilitators’ role in participatory rural development in Tehran Province. Since the researchers intended to have a better insight into the facilitators’ role and employ inquiry as a learning forum for bringing about changes for all participants, they preferred to use a case study based upon an appreciative inquiry method. The study divided the factors affecting the facilitators’ role into two main categories: driving factors...

  1. Structural factors affecting prosthodontic decision making in Japan

    Directory of Open Access Journals (Sweden)

    Noriyuki Wakabayashi

    2015-11-01

    Full Text Available Prosthodontic treatment strategies, prosthetic designs and materials, and treatment procedures are not determined solely by the diagnosis. We discuss the major effect of structural factors surrounding prosthodontic care on treatment decisions in Japan. These structural factors are related to the dentist, such as the dentist's education, postgraduate courses, and access to the latest research, and to the health care support system, including the social insurance system. Education content from schools of dentistry has clear effects on dentists’ treatment decisions, and the specific modalities taught depend highly on the school faculty. The use of research, especially clinical studies, in treatment decisions is currently limited. Regarding the health care support system factors, the public health insurance system has a strong effect on the actual prosthodontic treatments performed in Japan. To maintain the current piecework payment system, efforts should be encouraged to preclude both overtreatment and undertreatment. New perspectives on treatment decisions associated with technological advancement and changes in health care needs should be established to ensure that the Japanese population can enjoy high-quality prosthodontic treatment that meets international standards. The development of a clinical pathway and decision-making model that adheres to academic-based clinical guidelines and the insurance system will be necessary.

  2. Factors affecting the performance of professional nurses in Namibia

    Directory of Open Access Journals (Sweden)

    Magdalene H. Awases

    2013-04-01

    Objectives: The aim of the present study was to identify factors affecting the performance of professional nurses in Namibia. Method: A quantitative, descriptive survey was used to collect data by means of a questionnaire. A random sample of 180 professional nurses was selected from six hospitals in three regions of Namibia. Results: Factors affecting the performance of nurses negatively were identified such as: lack of recognition of employees who are performing well, quality performance outcomes and an absence of a formal performance appraisal system and poor working conditions. Various factors contribute to both the positive and negative performance of professional nurses in Namibia. Strategies were developed for addressing the negative factors that could positively affect the performance of professional nurses in Namibia. Conclusions: This study emphasises the importance of developing strategies to promote the performance of nurses; build knowledge and expertise; develop mechanisms for improving the performance of nurses; expand leadership and management capacity; and generate information and knowledge through research.

  3. Web-based Factors Affecting Online Purchasing Behaviour

    Science.gov (United States)

    Ariff, Mohd Shoki Md; Sze Yan, Ng; Zakuan, Norhayati; Zaidi Bahari, Ahamad; Jusoh, Ahmad

    2013-06-01

    The growing use of internet and online purchasing among young consumers in Malaysia provides a huge prospect in e-commerce market, specifically for B2C segment. In this market, if E-marketers know the web-based factors affecting online buyers' behaviour, and the effect of these factors on behaviour of online consumers, then they can develop their marketing strategies to convert potential customers into active one, while retaining existing online customers. Review of previous studies related to the online purchasing behaviour in B2C market has point out that the conceptualization and empirical validation of the online purchasing behaviour of Information and Communication Technology (ICT) literate users, or ICT professional, in Malaysia has not been clearly addressed. This paper focuses on (i) web-based factors which online buyers (ICT professional) keep in mind while shopping online; and (ii) the effect of web-based factors on online purchasing behaviour. Based on the extensive literature review, a conceptual framework of 24 items of five factors was constructed to determine web-based factors affecting online purchasing behaviour of ICT professional. Analysis of data was performed based on the 310 questionnaires, which were collected using a stratified random sampling method, from ICT undergraduate students in a public university in Malaysia. The Exploratory factor analysis performed showed that five factors affecting online purchase behaviour are Information Quality, Fulfilment/Reliability/Customer Service, Website Design, Quick and Details, and Privacy/Security. The result of Multiple Regression Analysis indicated that Information Quality, Quick and Details, and Privacy/Security affect positively online purchase behaviour. The results provide a usable model for measuring web-based factors affecting buyers' online purchase behaviour in B2C market, as well as for online shopping companies to focus on the factors that will increase customers' online purchase.

  4. Web-based Factors Affecting Online Purchasing Behaviour

    International Nuclear Information System (INIS)

    Ariff, Mohd Shoki Md; Yan, Ng Sze; Zakuan, Norhayati; Bahari, Ahamad Zaidi; Jusoh, Ahmad

    2013-01-01

    The growing use of internet and online purchasing among young consumers in Malaysia provides a huge prospect in e-commerce market, specifically for B2C segment. In this market, if E-marketers know the web-based factors affecting online buyers' behaviour, and the effect of these factors on behaviour of online consumers, then they can develop their marketing strategies to convert potential customers into active one, while retaining existing online customers. Review of previous studies related to the online purchasing behaviour in B2C market has point out that the conceptualization and empirical validation of the online purchasing behaviour of Information and Communication Technology (ICT) literate users, or ICT professional, in Malaysia has not been clearly addressed. This paper focuses on (i) web-based factors which online buyers (ICT professional) keep in mind while shopping online; and (ii) the effect of web-based factors on online purchasing behaviour. Based on the extensive literature review, a conceptual framework of 24 items of five factors was constructed to determine web-based factors affecting online purchasing behaviour of ICT professional. Analysis of data was performed based on the 310 questionnaires, which were collected using a stratified random sampling method, from ICT undergraduate students in a public university in Malaysia. The Exploratory factor analysis performed showed that five factors affecting online purchase behaviour are Information Quality, Fulfilment/Reliability/Customer Service, Website Design, Quick and Details, and Privacy/Security. The result of Multiple Regression Analysis indicated that Information Quality, Quick and Details, and Privacy/Security affect positively online purchase behaviour. The results provide a usable model for measuring web-based factors affecting buyers' online purchase behaviour in B2C market, as well as for online shopping companies to focus on the factors that will increase customers' online purchase.

  5. Factors Affecting Customer Satisfaction in Mobile Telecommunication Industry in Bangladesh

    OpenAIRE

    Md. Rahman

    2014-01-01

    Identification of factors responsible for customer satisfaction is a key concern of marketing scholars and marketers in now a days and it will remain in the future. There is considerable evidence that quality factors affecting customer satisfaction in numerous ways. However, this empirical study is initiated to find out what particular factors responsible for customer satisfaction in the mobile tel- ecommunication industry in Bangladesh. 282 samples have been collected through structured ques...

  6. MAC-1 Glycoprotein Family mediates adherence of neutrophils to endothelial cells stimulated by leukotriene B/sub 4/ and platelet activating factor

    Energy Technology Data Exchange (ETDEWEB)

    Tonnesen, M.G.; Anderson, D.C.; Springer, T.A.; Knedler, A.; Avdi, N.; Henson, P.M.

    1986-03-01

    The process of neutrophil (N) adhesion to and migration through endothelium (EC), an early event in the induction of the acute inflammatory response, has been attributed to the generation of extravascular chemoattractant peptides and lipids. Although both leukotriene B/sub 4/ (LTB/sub 4/) and platelet activating factor (PAF) enhance N adherence to EC, the mechanisms involved in this interaction are still not completely understood. Since the MAC-1 Glycoprotein (GP) Family has recently been shown to be required for a variety of adherence-dependent functions of stimulated N, the authors questioned whether these adherence-associated GP might be involved in N adherence to EC stimulated by LTB/sub 4/ or PAF. Using a microtiter adherence assay with /sup 111/In labeled N, they assessed the ability of N from patients with MAC-1, LFA-1 Deficiency to adhere to monolayers of human omental microvascular or umbilical vein EC as well as to serum-coated plastic. Patient N exhibited markedly diminished adherence in response to LTB/sub 4/ or PAF compared to normal controls. LTB/sub 4/ and PAF enhanced expression of the MAC-1 GP Family on the surface of normal N as determined by flow cytofluorimetry using a monoclonal antibody (TS1/18) to the GP common beta subunit. In addition TS1/18 (20 ..mu..g/ml) completely inhibited N adherence stimulated by either LTB/sub 4/ (10/sup -8/M) or PAF(10/sup -11/M). Thus, the MAC-1 GP Family appears to be important in chemotactic factor regulation of N adherence to EC.

  7. Exploring factors associated with ART adherence and retention in care under Option B+ strategy in Malawi: A qualitative study.

    Directory of Open Access Journals (Sweden)

    Salem Gugsa

    Full Text Available Although several studies have documented challenges related to inadequate adherence to antiretroviral therapy (ART and high loss to follow-up (LTFU among Option B+ women, there is limited understanding of why these challenges occur and how to address them. This qualitative study examines women's experiences with ART adherence and retention in care. Between July and October 2015, in-depth interviews were conducted with 39 pregnant and lactating women who initiated ART at Bwaila Hospital in Lilongwe, Malawi. Study participants included 14 in care and 25 out of care women, according to facility records. Data were analyzed using an inductive, open-coding approach to thematic analysis. Ten of the respondents (7 out of care, 3 in-care had stopped and re-started treatment before the interview date. One of the most important factors influencing adherence and retention was the strength of women's support systems. In contrast to women in-care, most out-of-care women lacked emotional and financial support from male partners, received minimal counseling from providers at initiation, lacked designated guardians to assist with medication refills or clinic appointments, and were highly mobile. Mobility led to difficulties in accessing treatment in new settings. The most common reasons women re-started treatment following interruptions were due to providers' counseling and encouragement and the mother's desire to be healthy. Improved counseling at initiation, active follow-up counseling, women's economic empowerment interventions, promotion of peer counseling schemes and meaningful engagement of male partners can help in addressing the identified barriers and promoting sustained retention of Option B+ women.

  8. Prevalence and Factors Associated with Fixed-Dose Combination Antiretroviral Drugs Adherence among HIV-Positive Pregnant Women on Option B Treatment in Mpumalanga Province, South Africa

    Directory of Open Access Journals (Sweden)

    Shandir Ramlagan

    2018-01-01

    Full Text Available The possibility for all babies to be born and remain HIV-negative for the first year of life is achievable in South Africa. HIV-positive mothers’ adherence to their antiretroviral medication is one of the crucial factors to achieve this target. Cross-sectional data were collected at 12 community health centres, over 12 months (2014–2015, from 673 HIV-positive women, less than 6 months pregnant, attending antenatal care, and on Option B treatment. Adherence measures included the Adults AIDS Clinical Trials Group (AACTG four-day measure, as well as the Visual Analog Scale (VAS seven-day measure. Bivariate analyses and multivariate logistic regressions are presented. 78.8% of respondents were adherent on AACTG, while 68.8% reported VAS adherence. Bivariate analyses for increased adherence show significant associations with older age, less/no alcohol usage, disclosure of HIV status, higher HIV knowledge, no desire to avoid ARV side effects, low stigma, and low depression. AACTG showed a negative association with intimate partner violence. Multivariable logistic regression on AACTG and VAS adherence rates resulted in unique contributions to increased adherence of older age, less/no alcohol usage, higher HIV knowledge, lack of depression, and non-disclosure. Programs targeting closer side effect monitoring, HIV disclosure, pre-natal depression, alcohol intake, and HIV knowledge need consideration.

  9. Factors Affecting Green Residential Building Development: Social Network Analysis

    Directory of Open Access Journals (Sweden)

    Xiaodong Yang

    2018-05-01

    Full Text Available Green residential buildings (GRBs are one of the effective practices of energy saving and emission reduction in the construction industry. However, many real estate developers in China are less willing to develop GRBs, because of the factors affecting green residential building development (GRBD. In order to promote the sustainable development of GRBs in China, this paper, based on the perspective of real estate developers, identifies the influential and critical factors affecting GRBD, using the method of social network analysis (SNA. Firstly, 14 factors affecting GRBD are determined from 64 preliminary factors of three main elements, and the framework is established. Secondly, the relationships between the 14 factors are analyzed by SNA. Finally, four critical factors for GRBD, which are on the local economy development level, development strategy and innovation orientation, developer’s acknowledgement and positioning for GRBD, and experience and ability for GRBD, are identified by the social network centrality test. The findings illustrate the key issues that affect the development of GRBs, and provide references for policy making by the government and strategy formulation by real estate developers.

  10. Nutritional Factors Affecting Adult Neurogenesis and Cognitive Function.

    Science.gov (United States)

    Poulose, Shibu M; Miller, Marshall G; Scott, Tammy; Shukitt-Hale, Barbara

    2017-11-01

    Adult neurogenesis, a complex process by which stem cells in the hippocampal brain region differentiate and proliferate into new neurons and other resident brain cells, is known to be affected by many intrinsic and extrinsic factors, including diet. Neurogenesis plays a critical role in neural plasticity, brain homeostasis, and maintenance in the central nervous system and is a crucial factor in preserving the cognitive function and repair of damaged brain cells affected by aging and brain disorders. Intrinsic factors such as aging, neuroinflammation, oxidative stress, and brain injury, as well as lifestyle factors such as high-fat and high-sugar diets and alcohol and opioid addiction, negatively affect adult neurogenesis. Conversely, many dietary components such as curcumin, resveratrol, blueberry polyphenols, sulforaphane, salvionic acid, polyunsaturated fatty acids (PUFAs), and diets enriched with polyphenols and PUFAs, as well as caloric restriction, physical exercise, and learning, have been shown to induce neurogenesis in adult brains. Although many of the underlying mechanisms by which nutrients and dietary factors affect adult neurogenesis have yet to be determined, nutritional approaches provide promising prospects to stimulate adult neurogenesis and combat neurodegenerative diseases and cognitive decline. In this review, we summarize the evidence supporting the role of nutritional factors in modifying adult neurogenesis and their potential to preserve cognitive function during aging. © 2017 American Society for Nutrition.

  11. Factors affecting strategic plan implementation using interpretive structural modeling (ISM).

    Science.gov (United States)

    Bahadori, Mohammadkarim; Teymourzadeh, Ehsan; Tajik, Hamidreza; Ravangard, Ramin; Raadabadi, Mehdi; Hosseini, Seyed Mojtaba

    2018-06-11

    Purpose Strategic planning is the best tool for managers seeking an informed presence and participation in the market without surrendering to changes. Strategic planning enables managers to achieve their organizational goals and objectives. Hospital goals, such as improving service quality and increasing patient satisfaction cannot be achieved if agreed strategies are not implemented. The purpose of this paper is to investigate the factors affecting strategic plan implementation in one teaching hospital using interpretive structural modeling (ISM). Design/methodology/approach The authors used a descriptive study involving experts and senior managers; 16 were selected as the study sample using a purposive sampling method. Data were collected using a questionnaire designed and prepared based on previous studies. Data were analyzed using ISM. Findings Five main factors affected strategic plan implementation. Although all five variables and factors are top level, "senior manager awareness and participation in the strategic planning process" and "creating and maintaining team participation in the strategic planning process" had maximum drive power. "Organizational structure effects on the strategic planning process" and "Organizational culture effects on the strategic planning process" had maximum dependence power. Practical implications Identifying factors affecting strategic plan implementation is a basis for healthcare quality improvement by analyzing the relationship among factors and overcoming the barriers. Originality/value The authors used ISM to analyze the relationship between factors affecting strategic plan implementation.

  12. Pharmacoepidemiological assessment of adherence and influencing co-factors among primary open-angle glaucoma patients-An observational cohort study.

    Directory of Open Access Journals (Sweden)

    Stefanie Frech

    Full Text Available The goal of this study was to assess the adherence of primary open-angle glaucoma (POAG patients to medication, and to determine co-factors influencing adherence, using a representative sample of members of the largest German public health insurer. The observational cohort study was based on a longitudinal data set from 2010-2013 and included 250,000 insured persons aged 50 and older with 10,120 diagnosed POAG patients. Uni- and multivariate analysis was performed to investigate several aspects of glaucoma, such as prevalence, adherence, and co-factors influencing adherence. The main outcome measured adherence with prescriptions filled within a year. Multivariate panel regression analysis was used to determine the co-factors influencing this adherence. Prevalence of POAG was 3.36% [CI: 3.28-3.43%], with 2.91% [CI: 2.81-3.01%] for males and 3.71% [CI: 3.61-3.81%] for females, increasing with age. The mean level of adherence in terms of prescriptions filled was 66.5% [CI: 65.50-67.60%]. The results of this analysis revealed a significant influence of age, duration of the disease, care need, distance to death, and multimorbidity as co-factors of non-adherence, whereas gender had no influence. The analysis provided detailed information about POAG health care aspects concerning prevalence and adherence. The most endangered risk groups for non-adherence were patients aged 50-59, patients older than 80 years, patients with a longer duration of POAG, patients with care needs, and patients with three or more severe diseases in addition to glaucoma. To know the predictors responsible for an increased risk to develop POAG is of importance for all persons involved in health care management. Therefore effective strategies to increase awareness of patients and medical care personnel about non-adherence and the importance of a regular and continuous medication to avoid further nerve fiber damage and possible blindness have to be developed.

  13. Empirical Analysis on Factors Affecting User Behavior in Social Commerce

    Directory of Open Access Journals (Sweden)

    Xu Jiayi

    2017-02-01

    Full Text Available [Purpose/significance] This paper aims to discover the factors affecting user behavior in the derivative situation of e-commerce, social commerce, and explore the sustainable development and related marketing advice of it. [Method/process]This paper put forward a theoretical model of factors affecting user behavior in social commerce by integrating emotional state impact into the Stimulus-Organism-Response (S-O-R framework. 277 valid samples were collected by questionnaires and PLS. [Result/conclusion]The results show that information quality and tie strength significantly affect user emotional states, while emotional states positively affect user behavior. In addition, graphic features of business information have indirect effects on user emotional states, while it has direct effect on purchase intention.

  14. Online Interventions for Social Marketing Health Behavior Change Campaigns: A Meta-Analysis of Psychological Architectures and Adherence Factors

    Science.gov (United States)

    Thelwall, Mike; Dawes, Phil

    2011-01-01

    Background Researchers and practitioners have developed numerous online interventions that encourage people to reduce their drinking, increase their exercise, and better manage their weight. Motivations to develop eHealth interventions may be driven by the Internet’s reach, interactivity, cost-effectiveness, and studies that show online interventions work. However, when designing online interventions suitable for public campaigns, there are few evidence-based guidelines, taxonomies are difficult to apply, many studies lack impact data, and prior meta-analyses are not applicable to large-scale public campaigns targeting voluntary behavioral change. Objectives This meta-analysis assessed online intervention design features in order to inform the development of online campaigns, such as those employed by social marketers, that seek to encourage voluntary health behavior change. A further objective was to increase understanding of the relationships between intervention adherence, study adherence, and behavioral outcomes. Methods Drawing on systematic review methods, a combination of 84 query terms were used in 5 bibliographic databases with additional gray literature searches. This resulted in 1271 abstracts and papers; 31 met the inclusion criteria. In total, 29 papers describing 30 interventions were included in the primary meta-analysis, with the 2 additional studies qualifying for the adherence analysis. Using a random effects model, the first analysis estimated the overall effect size, including groupings by control conditions and time factors. The second analysis assessed the impacts of psychological design features that were coded with taxonomies from evidence-based behavioral medicine, persuasive technology, and other behavioral influence fields. These separate systems were integrated into a coding framework model called the communication-based influence components model. Finally, the third analysis assessed the relationships between intervention adherence

  15. Factors Affecting Furfural as a Nematicide on Turf

    OpenAIRE

    Luc, J. E.; Crow, W. T.

    2013-01-01

    Recently a furfural nematicide Multiguard Protect EC was launched for use on turfgrasses in the United States. A series of greenhouse experiments were conducted to determine the concentration and exposure time required for this formulation to irreversibly affect Belonolaimus longicaudatus, and to study factors that might affect the practicality of furfural use in turfgrass systems. One experiment exposed B. longicaudatus to increasing concentrations of furfural (0 to 990 ppm) in vitro for eit...

  16. Various factors affecting /sup 67/Ga scintigraphy of liver cancer

    Energy Technology Data Exchange (ETDEWEB)

    Motoki, T; Morinari, H; Oono, K [Tokyo Univ. (Japan). Faculty of Medicine

    1980-10-01

    Various factors affecting /sup 67/Ga accumulation in liver cancer were studied in 38 patients with liver cancer (19 with hepatocellular carcinoma and 19 with metastatic liver cancer) who had received /sup 67/Ga-scintigraphy and liver scintigraphy. Besides histological types, the size, necrosis, vascularity and treatments of liver cancer, concentrations of transferrin (/sup 67/Ga binding protein) and iron in blood probably affected /sup 67/Ga accumulation in liver cancer.

  17. A model of parental distress and factors that mediate its link with parental monitoring of youth diabetes care, adherence, and glycemic control.

    Science.gov (United States)

    Robinson, Elizabeth M; Weaver, Patrick; Chen, Rusan; Streisand, Randi; Holmes, Clarissa S

    2016-12-01

    Parental monitoring of adolescents' diabetes self-care is associated with better adherence and glycemic control (A1c). A number of parent-level factors are associated with higher levels of parental monitoring, including lower levels of parental distress (depressive symptoms, stress, anxiety), as well as higher levels of parental self-efficacy for diabetes management and authoritative parenting. Often studied in isolation, these factors may be best considered simultaneously as they are interrelated and are associated with parental monitoring and youth adherence. Structural equation modeling with a cross-sectional sample of 257 parent/youth (aged 11-14) dyads: (a) examined a broad model of parental factors (i.e., parental distress, parental diabetes self-efficacy, authoritative parenting), and (b) assessed their relation to parental monitoring, youth adherence, and A1c. Post hoc analyses of variance (ANOVAs) evaluated clinical implications of daily parental monitoring. Parental distress was not related directly to parental monitoring. Instead less distress related indirectly to more monitoring via higher parental self-efficacy and more authoritative parenting which, in turn, related to better adherence and A1c. Higher parental self-efficacy also related directly to better youth adherence and then to better A1c. Clinically, more parental monitoring related to more daily blood glucose checks and to better A1c (8.48% vs. 9.17%). A broad model of parent-level factors revealed more parental distress was linked only indirectly to less monitoring via lower parental self-efficacy and less authoritative parenting. Behaviorally, more parental monitoring related to better adherence and to clinically better A1c in adolescents. Further study of parent-level factors that relate to parental distress and monitoring of adherence appears warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  18. Up-regulation of intestinal vascular endothelial growth factor by Afa/Dr diffusely adhering Escherichia coli.

    Directory of Open Access Journals (Sweden)

    Gaëlle Cane

    Full Text Available BACKGROUND: Angiogenesis has been recently described as a novel component of inflammatory bowel disease pathogenesis. The level of vascular endothelial growth factor (VEGF has been found increased in Crohn's disease and ulcerative colitis mucosa. To question whether a pro-inflammatory Escherichia coli could regulate the expression of VEGF in human intestinal epithelial cells, we examine the response of cultured human colonic T84 cells to infection by E. coli strain C1845 that belongs to the typical Afa/Dr diffusely adhering E. coli family (Afa/Dr DAEC. METHODOLOGY: VEGF mRNA expression was examined by Northern blotting and q-PCR. VEGF protein levels were assayed by ELISA and its bioactivity was analysed in endothelial cells. The bacterial factor involved in VEGF induction was identified using recombinant E. coli expressing Dr adhesin, purified Dr adhesin and lipopolysaccharide. The signaling pathway activated for the up-regulation of VEGF was identified using a blocking monoclonal anti-DAF antibody, Western blot analysis and specific pharmacological inhibitors. PRINCIPAL FINDINGS: C1845 bacteria induce the production of VEGF protein which is bioactive. VEGF is induced by adhering C1845 in both a time- and bacteria concentration-dependent manner. This phenomenon is not cell line dependent since we reproduced this observation in intestinal LS174, Caco2/TC7 and INT407 cells. Up-regulation of VEGF production requires: (1 the interaction of the bacterial F1845 adhesin with the brush border-associated decay accelerating factor (DAF, CD55 acting as a bacterial receptor, and (2 the activation of a Src protein kinase upstream of the activation of the Erk and Akt signaling pathways. CONCLUSIONS: Results demonstrate that a Afa/Dr DAEC strain induces an adhesin-dependent activation of DAF signaling that leads to the up-regulation of bioactive VEGF in cultured human intestinal cells. Thus, these results suggest a link between an entero-adherent, pro

  19. Factors affecting pain relief in response to physical exercise interventions among healthcare workers.

    Science.gov (United States)

    Jakobsen, M D; Sundstrup, E; Brandt, M; Andersen, L L

    2017-12-01

    The aim of this study is to identify factors associated with musculo-skeletal pain reduction during workplace-based or home-based physical exercise interventions among healthcare workers. Two hundred female healthcare workers (age: 42.0, BMI: 24.1, average pain intensity: 3.1 on a scale of 0-10) from three hospitals participated. Participants were randomly allocated at the cluster level (18 departments) to 10 weeks of (i) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to five group-based coaching sessions on motivation for regular physical exercise, or (ii) home-based physical exercise (HOME) performed alone during leisure-time for 5 × 10 minutes per week. Linear mixed models accounting for cluster identified factors affecting pain reduction. On average 2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions were performed per week in WORK and HOME, respectively. The multi-adjusted analysis showed a significant effect on pain reduction of both training adherence (P=.04) and intervention group (P=.04) with participants in WORK experiencing greater reductions compared with HOME. Obesity at baseline was associated with better outcome. Leisure-time exercise, daily patient transfer, age, and chronic pain did not affect the changes in pain. In conclusion, even when adjusted for training adherence, performing physical exercise at the workplace is more effective than home-based exercise in reducing musculo-skeletal pain in healthcare workers. Noteworthy, obese individuals may especially benefit from physical exercise interventions targeting musculo-skeletal pain. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Investigating the factors affecting the investment decision in residential development.

    OpenAIRE

    Narang, Somil

    2007-01-01

    The purpose of this project is to provide a rare insight into the motivation behind residential property investors when looking to purchase an apartment. The factors driving demand preferences for housing are constantly changing, difficult to measure, and often deemed to be a complex bundle of attributes. The project attempts to answer the following questions: What are the factors affecting the investment decision in a Residential Development? To identify the significance and weight of su...

  1. Factors Which Affect Academic Achievement of University Students

    OpenAIRE

    RENÇBER, Bahman Alp

    2012-01-01

    The purpose of this study is to investigate by analysing factors affecting academic achievement of university students. Also effects of these factors are studied. For this purpose, the students attending “Statistics and Transport Technology” course at Gazi University, Industrial Arts Education and Arts Faculty, Industrial Technology Education Department, in the 2008-2009 academic year have been identified as the study universe. Analysis has been done by taking examples for this universe. The ...

  2. Associations between adherence to the Danish Food-Based Dietary Guidelines and cardiometabolic risk factors in a Danish adult population: the DIPI study

    DEFF Research Database (Denmark)

    Arentoft, Johanne Louise; Hoppe, Camilla; Andersen, Elisabeth Wreford

    2018-01-01

    Diet is recognised as one modifiable lifestyle factor for ischaemic heart disease (IHD). We aimed at investigating the associations between adherence to the Danish Food-Based Dietary Guidelines (FBDG) indicated by a Dietary Quality Index (DQI) and selected cardiometabolic risk factors in a cross-...

  3. Factors associated with adherence to diabetes care recommendations among children and adolescents with type 1 diabetes: a facility-based study in two urban diabetes clinics in Uganda

    Directory of Open Access Journals (Sweden)

    Kyokunzire C

    2018-03-01

    Full Text Available Catherine Kyokunzire,1 Nicholas Matovu2,3 1Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda; 2Department of Community Health, Division of Noncommunicable Diseases, Ministry of Health – Uganda, Kampala, Uganda; 3Global Health Corps Fellowship Program 2017/2018, New York, NY, USA Purpose: The purpose of this study was to determine the level of adherence and the factors associated with adherence to diabetes care recommendations among type 1 diabetic children and adolescents at two urban diabetes clinics in Kampala, Uganda.Research design and methods: A facility-based cross-sectional study was carried out among 200 children and adolescents with type 1 diabetes at two major diabetes clinics in Kampala. Caretakers of the children and adolescents were interviewed using pretested questionnaires to provide information on sociodemographic characteristics, diabetes care, knowledge, attitudes, and adherence to diabetes care recommendations in type 1 diabetes. Prevalence rate ratios (PRRs at the 95% confidence interval (CI were used to establish the factors associated with adherence using modified Poisson regression, with robust standard errors. The data were analyzed by using STATA Version 13.0.Results: The overall prevalence of adherence to diabetes care recommendations was at 37%. However, evaluating adherence to specific treatment parameters showed that 52%, 76.5%, and 29.5% of the children and adolescents adhered to insulin, blood glucose monitoring, and dietary recommendations, respectively. In the final adjusted model, active diet monitoring (adjusted PRR [APRR]: 1.95; 95% CI: 1.01, 3.78, being under care of a sibling (APRR: 1.66; 95% CI: 1.61, 1.71, being under care of a married caretaker (APRR: 1.10; 95% CI: 1.05, 1.14 and a separated or divorced caretaker (APRR: 1.60; 95% CI: 1.12, 2.27, taking three or less tests of blood glucose per day (APRR: 0

  4. Formal Classroom Observations: Factors That Affect Their Success

    Science.gov (United States)

    Zaidi, Zeba

    2017-01-01

    Formal class room observation is a very delicate topic in any educational institution. It involves a series of emotions and sentiments that come with the package. In this paper, the researcher will attempt to analyze the factors that affect the process in a relatively significant manner and thereby contribute greatly to the success or failure of…

  5. Factors Affecting School Choice: What Do Malaysian Chinese Parents Want?

    Science.gov (United States)

    Siah, Poh Chua; Christina Ong, Sook Beng; Tan, Swee Mee; Sim, Chzia Poaw; Xian Thoo, Raphael Yi

    2018-01-01

    Aiming to explore factors affecting Malaysian Chinese parents in sending their children to either national secondary schools or Chinese independent schools, 494 parents were surveyed using a questionnaire. Results showed that parents who sent their children to Chinese independent schools have different priorities compared to those who sent theirs…

  6. Factors Affecting Oil Palm Production in Ondo State of Nigeria ...

    African Journals Online (AJOL)

    The discovery of crude oil and the civil war adversely affected oil palm production in Nigeria. This has resulted in scarcity and high cost of palm products and palm oil. The study therefore investigated the factors influencing oil palm production in Ondo State, Nigeria. One hundred and fifty respondents were selected from ...

  7. Factors Affecting the Formation of Food Preferences in Preschool Children.

    Science.gov (United States)

    Alles-White, Monica L.; Welch, Patricia

    1985-01-01

    Identifies and discusses factors that affect the development of food preferences in preschool children, including familiarity, age, parents, peers, teachers, and programs designed to influence food habits. Makes recommendations to preschool and day care programs for creating an atmosphere conducive to trying new foods. (Author/DST)

  8. Factors Affecting Students' Grades in Principles of Economics

    Science.gov (United States)

    Kara, Orhan; Bagheri, Fathollah; Tolin, Thomas

    2009-01-01

    Factors affecting students' grades in principles of microeconomics and macroeconomics students are analyzed from the data collected in two public universities. Results indicate that gender, number of hours worked, SAT scores, number of missed classes, recommending the course to a friend, instructors, being a junior, number of economics courses…

  9. Nutritional Factors Affecting Adult Neurogenesis and Cognitive Function

    Science.gov (United States)

    Adult neurogenesis, a complex process by which stem cells in the hippocampal brain region differentiate and proliferate into new neurons and other resident brain cells, is known to be affected by many intrinsic and extrinsic factors, including diet. Neurogenesis plays a critical role in neural plas...

  10. Factors affecting sustainable animal trypanosomosis control in parts ...

    African Journals Online (AJOL)

    This study examined the factors affecting sustainable trypanosomiasis control in parts of Kaduna State within the sub-humid savannah ecological zone of Nigeria. Focus group discussions were ... More awareness and preference for pour-on and aerial spraying were higher than the use of traps, target or screens. Rearing of ...

  11. Factors affecting disclosure of serostatus to children attending Jinja ...

    African Journals Online (AJOL)

    Factors affecting disclosure of serostatus to children attending Jinja Hospital ... twenty children and all (ten) health workers at Jinja Hospital paediatric HIV clinic. ... and child attending psychosocial support group (OR 7.4 CI 3.6-15.3 p < 0.001).

  12. Factors Affecting Online Groupwork Interest: A Multilevel Analysis

    Science.gov (United States)

    Du, Jianxia; Xu, Jianzhong; Fan, Xitao

    2013-01-01

    The purpose of the present study is to examine the personal and contextual factors that may affect students' online groupwork interest. Using the data obtained from graduate students in an online course, both student- and group-level predictors for online groupwork interest were analyzed within the framework of hierarchical linear modeling…

  13. Factors Affecting the Effectiveness and Use of Moodle: Students' Perception

    Science.gov (United States)

    Damnjanovic, Vesna; Jednak, Sandra; Mijatovic, Ivana

    2015-01-01

    The purpose of this research paper is to identify the factors affecting the effectiveness of Moodle from the students' perspective. The research hypotheses derived from the suggested extended Seddon model have been empirically validated using the responses to a survey on e-learning usage among 255 users. We tested the model across higher education…

  14. Identifying factors affecting about outsourcing in paraclinical services

    African Journals Online (AJOL)

    Objective: Outsourcing refers to the transfer of services or functions to an outsider supplier, which controls them through a contract or cooperative. The main problem of senior managers in health organizations is determining the services which should be outsourced. The present study seeks to identify the factors that affect ...

  15. Factors Affecting English Language Teaching and Learning in Higher Education

    Science.gov (United States)

    Nguyen, Hong Thi; Warren, Wendy; Fehring, Heather

    2014-01-01

    This paper reports part of a study that aims to explore factors affecting the efficacy of non-major English teaching and learning in Vietnamese higher education through an investigation of classroom practices. Eight non-participant class observations were conducted at HUTECH University, Ho Chi Minh City, Vietnam. The study's findings show that…

  16. Factors Affecting Loan Utilization And Repayment Patterns By Small ...

    African Journals Online (AJOL)

    The study identified factors affecting loan utilization and repayment patterns by small holder farmers of the Nigerian Agricultural Co-operative and Rural Development Bank (NACRDB) Osogbo branch in Osun State. Two Local Government Areas with large number of loan beneficiaries from 2003 to 2008 in NACRDB were ...

  17. Unemployment in Kenya: Some economic factors affecting wage ...

    African Journals Online (AJOL)

    This article analyses the economic factors affecting wage employment in Kenya, where open unemployment fell from 15 per cent in 1998/1999 to 13 per cent in 2005/2006. As of 2005/2006, wage employment constituted 13 per cent of the total working population, which implies that doubling wage employment will absorb ...

  18. Examining the factors affecting willingness to use electronic banking ...

    African Journals Online (AJOL)

    Examining the factors affecting willingness to use electronic banking: the ... which information technologies are accepted are of the research studies. ... Customers' understanding of the ease of use of e-banking systems has a significant impact on perceived usefulness and their attitude had. ... AJOL African Journals Online.

  19. Factors affecting mortality and epidemiological data in patients ...

    African Journals Online (AJOL)

    Background. Burns continue to be responsible for significant morbidity and mortality in developing countries. In this study we aimed to determine the factors affecting mortality and epidemiological data by examining the records of burned patients. Method. The hospital records of 980 patients who were hospitalised in the ...

  20. Factors Affecting Teen Involvement in Pennsylvania 4-H Programming

    Science.gov (United States)

    Gill, Bart E.; Ewing, John C.; Bruce, Jacklyn A.

    2010-01-01

    The study reported here determined the factors that affect teen involvement in 4-H programming. The design of the study was descriptive and correlational in nature. Using a purposive sampling procedure, a survey questionnaire was distributed to all (N=214) 4-H members attending the 4-H State Leadership Conference. The major findings of the study…

  1. Factors Affecting Quality of Audit; Empirical Evidence from Iran ...

    African Journals Online (AJOL)

    This study examines factors affecting quality of audit using empirical evidence from Iran Quality of audit was seen as the degree to which an audit report is free from deficiencies and distortions which show up later on. The quality of an audit was measured in terms of an auditor's ability to report financial distortions willingly ...

  2. Factors Affecting the Adoption of Improved Rice Varieties in Borno ...

    African Journals Online (AJOL)

    USER

    The study investigated the factors that affect adoption of improved rice varieties in the ... give a good results and also a threat to food security. Keywords: ..... decision of the farmers, however, inappropriate chain of supply/distributing the input or ...

  3. The Impact of CLIL on Affective Factors and Vocabulary Learning

    Science.gov (United States)

    Heras, Arantxa; Lasagabaster, David

    2015-01-01

    The aim of this article is twofold: to assess the effectiveness of a CLIL (content and language integrated learning) module on affective factors (motivation and self-esteem), and to test the purported blurring effect of CLIL on gender differences in foreign language learning. Forty-six students in their fourth year of compulsory secondary…

  4. Factors Affecting Utilization of Cooking Banana among Households ...

    African Journals Online (AJOL)

    The study investigated factors affecting utilization of cooking banana among households in Oguta area of Imo State, Nigeria. Data were collected from 84 randomly selected respondents from six communities in the study area who were administered with structured questionnaire. Data analysis was by use of descriptive ...

  5. Factors affecting farmers' participation in irrigation schemes of the ...

    African Journals Online (AJOL)

    ... those factors affecting farmers' participation in irrigated agriculture at the Lower Niger River Basin Development Authority (LNRBDA) in Kwara State, Nigeria. One hundred and sixty (160) respondents were selected from communities around LNRBDA site at Oke Oyi for this study through a two-stage sampling procedures.

  6. Factors Affecting Academic Achievement of Students in Senior ...

    African Journals Online (AJOL)

    The study investigated the factors affecting academic achievement ofstudents in Senior School Certificate Examination (SSCE) in ChristianReligious Knowledge. A total of three hundred students in SS III from five secondary schools were randomly selected and used as sample for the study. Five hypotheses were tested, ...

  7. Teachers' Perception of the Factors Affecting Job Satisfaction in ...

    African Journals Online (AJOL)

    Toshiba

    perception of salary as a factor affecting job satisfaction. Also, there .... Thus workers now have higher purchasing power, are given opportunity to use their .... Z-Cal. Z-Crit Significant. Level decision. Female. 70 12.73 3.23. Teachers. 0.32. 1.96.

  8. Factors affecting sports participation among female students at ...

    African Journals Online (AJOL)

    The primary aim of this study was to examine factors affecting sport participation among resident and non- resident female students at Tshwane University of Technology (TUT), Pretoria, South Africa. The study targeted all students participating in 12 registered sports but due to the fact that only a limited number of the total ...

  9. Scrutinizing the Factors Affecting Fluency of English among Arab Learners

    Science.gov (United States)

    Al Ghazali, Fawzi

    2017-01-01

    This research study investigates the cognitive, psychological and personal factors affecting the accuracy and fluency of English language usage among Arab learners. Early research led by Chomsky (1965) and Krashen (1981) suggested that an individual's Language Acquisition Device once triggered at the appropriate time and supported with adequate…

  10. factors affecting particle retention in thermal field-flow fractionation

    African Journals Online (AJOL)

    In this paper, we report a range of factors which affect the retention of colloidal particles in thermal field-flow fractionation (ThFFF). These results are observed among different sizes of polystyrene (PS) latex particles suspended in both aqueous and nonaqueous liquid carriers and very low density lipoproteins in a phosphate ...

  11. Motivation and Factors Affecting It among Health Professionals in ...

    African Journals Online (AJOL)

    BACKGROUND: Motivation is an individual's degree of willingness to exert and maintain an effort towards organizational goals. This study assessed motivational status and factors affecting it among health professionals in public hospitals of West Shoa Zone, Oromia Region. METHOD: Facility based cross-sectional survey ...

  12. Factors affecting guidance and counseling programme in primary ...

    African Journals Online (AJOL)

    The objective of this study was to establish the factors that affect guidance and counseling in primary schools. Guidance and counseling seems not to be adequately helping pupils with physical and psychological problems in Nairobi province of Kenya. Many primary schools are faced with indiscipline and poor performance ...

  13. Factors affecting mortality of critical care trauma patients | Hefny ...

    African Journals Online (AJOL)

    The most common mechanism of injury was road traffic collisions (72.3 %). The overall mortality was 13.9%. A direct logistic regression model has shown that factors that affected mortality were decreased GCS (p < 0.0001), mechanism of injury (p = 0.004) with burns having the highest mortality, increased age (p = 0.004), ...

  14. Factors Affecting Performance of Undergraduate Students in Construction Related Disciplines

    Science.gov (United States)

    Olatunji, Samuel Olusola; Aghimien, Douglas Omoregie; Oke, Ayodeji Emmanuel; Olushola, Emmanuel

    2016-01-01

    Academic performance of students in Nigerian institutions has been of much concern to all and sundry hence the need to assess the factors affecting performance of undergraduate students in construction related discipline in Nigeria. A survey design was employed with questionnaires administered on students in the department of Quantity Surveying,…

  15. Factors Affecting Role Stress and Burnout among School Counselors

    Science.gov (United States)

    Willingham, Wendy Elizabeth

    2009-01-01

    The purpose of this study is to determine factors affecting role stress and burnout among practicing school counselors as measured by the Maslach Burnout Inventory-Educators Survey (MBI-ES) and the Role Conflict and Ambiguity Scale. The MBI-ES utilizes three subscales to measure burnout: emotional exhaustion, depersonalization, and personal…

  16. Factors affecting the utilisation of electronic medical records system ...

    African Journals Online (AJOL)

    Malawi Medical Journal 29 (3): September 2017. Electronic medical ... care, as they enable storage of large amounts of data and ... EMRs. This study assessed factors that affect the use of EMRs in Malawi, particularly at Queen Elizabeth and Kamuzu Central ..... paperless hospitals in Norway : A socio-technical perspective.

  17. Factors Affecting Conservation Practice Behavior of CRP Participants in Alabama

    Science.gov (United States)

    Okwudili Onianwa; Gerald Wheelock; Shannon Hendrix

    1999-01-01

    This study examines the factors that affect conservation practice choices of CRP farmers in Alabama. From over 9,000 contracts enrolled in the state between 1986 and 1995, 594 were randomly selected for the study. A multiple-regression analysis was employed to analyze the data. Results indicate that education, ratio ofcropland in CRP, farm size, gender, prior crop...

  18. Factors affecting sustainability of land reform projects in Ehlanzeni ...

    African Journals Online (AJOL)

    The study evaluated factors affecting sustainability of land reform projects in Mpumalanga Province in Bushbuckridge Local Municipality (BLM) of Ehlanzeni District. The study was conducted between July and September 2014. A random sampling technique was used in selecting 31 key informants from the projects.

  19. Factors affecting in sacco dietary degradation by Ankole cattle ...

    African Journals Online (AJOL)

    Factors affecting in sacco dietary degradation by Ankole cattle grazing natural range pastures in Uganda. ... Keywords: Ankole cattle, dietary selection, dry matter disappearance, free water intake, in sacco degradation, lignification, live weight change, predictive model, water solubility. African Journal of Range & Forage ...

  20. Factors affecting quality of life in cancer patients undergoing ...

    African Journals Online (AJOL)

    Factors affecting quality of life in cancer patients undergoing chemotherapy. ... Objective: The aim of this study was to evaluate the QoL in cancer patients with solid tumors and at the different chemotherapy cycles (CT). ... Results: A significant relationship between the cancer type, pain intensity, and fatigue was found.

  1. Factors affecting compliance to treatment among children with ...

    African Journals Online (AJOL)

    BACKGROUND:This study aimed to determine the factors affecting compliance to treatment among children with epilepsy in Enugu,Nigeria. METHODS: Children with diagnosis of epilepsy were consecutively recruited.Their 6 months retrospective and 1 month prospective data were collected;and analyzed using SPSS ...

  2. Kjell J. Nilssen; Factors affecting energy expenditure in reindeer

    Directory of Open Access Journals (Sweden)

    Sven Skjenneberg (ed.

    1984-05-01

    Full Text Available The thesis Factors affecting energy expenditure in reindeer by Kjell J. Nilssen was approved for the Phil, dr's degree at the University of Tromsø. The dissertation took place in Tromsø December 15.1984.

  3. Factors Affecting Time, Cost and Quality Management in Building ...

    African Journals Online (AJOL)

    The study is an assessment of time, cost and quality management in the Nigerian construction industry, and it aims to explore time cost and quality management in the construction industry. The objective of the study is to identify factors affecting time; cost and quality management in building construction projects. This study ...

  4. Factors Affecting Recruitment into Child and Adolescent Psychiatry Training

    Science.gov (United States)

    Shaw, Jon A.; Lewis, John E.; Katyal, Shalini

    2010-01-01

    Objective: The authors studied the factors affecting the recruitment into child and adolescent psychiatry training in the United States. Methods: Medical students (n = 154) and general and child and adolescent psychiatry residents (n = 111) completed a questionnaire to evaluate career choice in child psychiatry (n = 265). Results: Compared with…

  5. Oral anticancer agent medication adherence by outpatients.

    Science.gov (United States)

    Kimura, Michio; Usami, Eiseki; Iwai, Mina; Nakao, Toshiya; Yoshimura, Tomoaki; Mori, Hiromi; Sugiyama, Tadashi; Teramachi, Hitomi

    2014-11-01

    In the present study, medication adherence and factors affecting adherence were examined in patients taking oral anticancer agents. In June 2013, 172 outpatients who had been prescribed oral anticancer agents by Ogaki Municipal Hospital (Ogaki, Gifu, Japan) completed a questionnaire survey, with answers rated on a five-point Likert scale. The factors that affect medication adherence were evaluated using a customer satisfaction (CS) analysis. For patients with good and insufficient adherence to medication, the median ages were 66 years (range, 21-85 years) and 73 years (range, 30-90 years), respectively (P=0.0004), while the median dosing time was 131 days (range, 3-3,585 days) and 219 days (24-3,465 days), respectively (P=0.0447). In 36.0% (62 out of 172) of the cases, there was insufficient medication adherence; 64.5% of those cases (40 out of 62) showed good medication compliance (4-5 point rating score). However, these patients did not fully understand the effects or side-effects of the drugs, giving a score of three points or less. The percentage of patients with good medication compliance was 87.2% (150 out of 172). Through the CS analysis, three items, the interest in the drug, the desire to consult about the drug and the condition of the patient, were extracted as items for improvement. Overall, the medication compliance of the patients taking the oral anticancer agents was good, but the medication adherence was insufficient. To improve medication adherence, a better understanding of the effectiveness and necessity of drugs and their side-effects is required. In addition, the interest of patients in their medication should be encouraged and intervention should be tailored to the condition of the patient. These steps should lead to improved medication adherence.

  6. Relevant Affect Factors of Smartphone Mobile Data Traffic

    Directory of Open Access Journals (Sweden)

    Siniša Husnjak

    2016-08-01

    Full Text Available Smartphones are used to access a wide range of different information and communication services and perform functions based on data transfer. A number of subscription contracts for smartphones is rapidly increasing, and the development of mobile communications network provides higher speed of data transfer. The continuous increase in the average amount of data traffic per one subscriber contract leads to an increase in the total Mobile Data Traffic (MDT, globally. This research represents a summary of factors that affect the amount of smartphone MDT. Previous literature shows only a few of the factors individually that affect the realization of smartphone MDT. The results of the research clarify the ways which influence the amount of MDT generated by a smartphone. This paper increases the awareness of the users of the methods of generating smartphone MDT. The research also allows users to specify parameters that affect the prediction of generated MDT of a smartphone.

  7. Factors Affecting the Pharmacology of Antibody–Drug Conjugates

    Directory of Open Access Journals (Sweden)

    Andrew T. Lucas

    2018-02-01

    Full Text Available Major advances in therapeutic proteins, including antibody–drug conjugates (ADCs, have created revolutionary drug delivery systems in cancer over the past decade. While these immunoconjugate agents provide several advantages compared to their small-molecule counterparts, their clinical use is still in its infancy. The considerations in their development and clinical use are complex, and consist of multiple components and variables that can affect the pharmacologic characteristics. It is critical to understand the mechanisms employed by ADCs in navigating biological barriers and how these factors affect their biodistribution, delivery to tumors, efficacy, and toxicity. Thus, future studies are warranted to better understand the complex pharmacology and interaction between ADC carriers and biological systems, such as the mononuclear phagocyte system (MPS and tumor microenvironment. This review provides an overview of factors that affect the pharmacologic profiles of ADC therapies that are currently in clinical use and development.

  8. Factors affecting the carbon allowance market in the US

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Seok; Koo, Won W. [Center for Agricultural Policy and Trade Studies, Department of Agribusiness and Applied Economics, North Dakota State University, Dept 7610, P.O. Box 6050, Fargo, ND 58103-6050 (United States)

    2010-04-15

    The US carbon allowance market has different characteristic and price determination process from the EU ETS market, since emitting installations voluntarily participate in emission trading scheme. This paper examines factors affecting the US carbon allowance market. An autoregressive distributed lag model is used to examine the short- and long-run relationships between the US carbon allowance market and its determinant factors. In the long-run, the price of coal is a main factor in the determination of carbon allowance trading. In the short-run, on the other hand, the changes in crude oil and natural gas prices as well as coal price have significant effects on carbon allowance market. (author)

  9. Factors affecting the carbon allowance market in the US

    International Nuclear Information System (INIS)

    Kim, Hyun Seok; Koo, Won W.

    2010-01-01

    The US carbon allowance market has different characteristic and price determination process from the EU ETS market, since emitting installations voluntarily participate in emission trading scheme. This paper examines factors affecting the US carbon allowance market. An autoregressive distributed lag model is used to examine the short- and long-run relationships between the US carbon allowance market and its determinant factors. In the long-run, the price of coal is a main factor in the determination of carbon allowance trading. In the short-run, on the other hand, the changes in crude oil and natural gas prices as well as coal price have significant effects on carbon allowance market.

  10. The Effect of Mobile Messaging Apps on Cardiac Patient Knowledge of CAD Risk Factors and Adherence to a Healthy Lifestyle.

    Science.gov (United States)

    Tang, Yea Hung; Chong, Mei Chan; Chua, Yan Piaw; Chui, Ping Lei; Tang, Li Yoong; Rahmat, Norsiah

    2018-05-18

    This study aimed to determine the effect mobile messaging apps on coronary artery disease patient knowledge of and adherence to a healthy lifestyle. Due to the increasing incidence of coronary artery disease in recent years, interventions targeting coronary artery disease risk factors are urgent public priorities. The use of mobile technology in healthcare services and medical education is relatively new with promising future prospects. This study used a quasi-experimental design that included pre- and post-test for intervention and control groups. The study was conducted from January to April 2017 with both intervention and control group, in a teaching hospital in Klang Valley. Convenience sampling was used with inclusive criteria in choosing the 94 patients with coronary artery disease (intervention group: 47 patients; control group: 47 patients). The pre-test was conducted as a baseline measurement for both groups before they were given standard care from a hospital. However, only the intervention group was given a daily information update via WhatsApp for one month. After one month, both groups were assessed with a post-test. The split-plot ANOVA analysis indicates that there is a significant and positive effect of the intervention on coronary artery disease patients' knowledge on CAD risk factors [F(1, 92) = 168.15, p WhatsApp was an effective health intervention in increasing coronary artery disease patient's knowledge and subsequently increasing their adherence to healthy lifestyles. In clinical setting, mobile messaging apps is useful in information delivery and efficient patient monitory. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Arsenic in Drinking Water in Bangladesh: Factors Affecting Child Health

    Science.gov (United States)

    Aziz, Sonia N.; Aziz, Khwaja M. S.; Boyle, Kevin J.

    2014-01-01

    The focus of this paper is to present an empirical model of factors affecting child health by observing actions households take to avoid exposure to arsenic in drinking water. Millions of Bangladeshis face multiple health hazards from high levels of arsenic in drinking water. Safe water sources are either expensive or difficult to access, affecting people’s individuals’ time available for work and ultimately affecting the health of household members. Since children are particularly susceptible and live with parents who are primary decision makers for sustenance, parental actions linking child health outcomes is used in the empirical model. Empirical results suggest that child health is significantly affected by the age and gender of the household water procurer. Adults with a high degree of concern for children’s health risk from arsenic contamination, and who actively mitigate their arsenic contaminated water have a positive effect on child health. PMID:24982854

  12. Factors affecting farm diversification in rice-wheat

    International Nuclear Information System (INIS)

    Ashfaq, M.; Hassan, S.; Naseer, M.Z.; Baig, I.A.; Asma, J.

    2008-01-01

    The risk in agriculture sector is due to various factors like weather and market conditions, particularly the demand of the commodities. This uncertainty can result in variable returns (farm income) to the decisions that farmers make in a particular season. Diversification is a frequently used risk management strategy that involves participation in more than one activity. It has the added advantage of mitigating price risk as well as fluctuations in outputs. The main purpose of this paper was to determine the factors affecting crop diversification. For determining the effect of different factors on diversification a multiple regression model was used. The values of Entropy index computed for measuring horizontal diversification were taken as dependent variable and different factors affecting diversification were taken as independent variables. The results showed that the main factors affecting diversification were size of land holding, age of respondent, education level of respondent, farming experience of respondent, off farm income of respondent, distance of farm from main road, distance of farm from main market and farm machinery. (author)

  13. Factors affecting workers' delivery of good hygienic and sanitary ...

    African Journals Online (AJOL)

    ADEYEYE

    2015-03-06

    Mar 6, 2015 ... adhere to Good Manufacturing Practices (GMP) and. Good Hygiene Practices ... has resulted in meat contamination and poor waste disposal, with ... and other food animals arrive these slaughterhouses from various parts of ...

  14. Exploring paraprofessional and classroom factors affecting teacher supervision.

    Science.gov (United States)

    Irvin, Dwight W; Ingram, Paul; Huffman, Jonathan; Mason, Rose; Wills, Howard

    2018-02-01

    Paraprofessionals serve a primary role in supporting students with disabilities in the classroom, which necessitates teachers' supervision as a means to improve their practice. Yet, little is known regarding what factors affect teacher supervision. We sought to identify how paraprofessional competence and classroom type affected the levels of teacher direction. We administered an adapted version of the Paraprofessional Needs, Knowledge & Tasks Survey and the Survey for Teachers Supervising Paraprofessionals to teachers supervising paraprofessionals in elementary schools. Structural Equation Modeling was used to examine the link between paraprofessional competence and classroom factors affecting the level of teacher supervision. Our results indicated that when teachers perceived paraprofessionals as being more skilled, they provided more supervision, and when more supervision was provided the less they thought paraprofessionals should be doing their assigned tasks. Additionally, paraprofessionals working in classrooms with more students with mild disabilities received less supervision than paraprofessionals working in classrooms with more students with moderate-to-severe disabilities. Those paraprofessionals in classrooms serving mostly children with mild disabilities were also perceived as having lower levels of skill competence than those serving in classrooms with students with more moderate-to-severe disabilities. By understanding the factors that affect teacher supervision, policy and professional development opportunities can be refined/developed to better support both supervising teachers and paraprofessionals and, in turn, improve the outcomes of children with disabilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Exploring risk factors of non-adherence to immunosuppressive medication in kidney transplant recipients : improving methodology & reorienting research goals

    OpenAIRE

    Denhaerynck, Kris

    2006-01-01

    8.1. Background and aim of the research program Non-adherence to the immunosuppressive therapy is an important issue in kidney transplant patients. About 20% of the kidney transplant patients are non-adherent to the immunosuppressive regimen. Non-adherence contributes to 20% of late acute rejection episodes and 16% of the graft losses, and results in a decreased number of quality adjusted life years. A strategy to increase long-term successful outcome after transplantation i...

  16. Influential Factors Affecting Materials Management in Construction Projects

    Directory of Open Access Journals (Sweden)

    Jusoh Zairra Mat

    2017-12-01

    Full Text Available Construction projects are more often than not plagued by poor performances such as delays, cost overrun, low productivity, construction wastes and compromised quality. Amongst the critical contributory factors of poor project performances, is the ineffectiveness of materials management occurring in the construction sites. Indeed, materials management is a very important component for construction projects. However, there are only limited numbers of research available regarding this topic. Thus, this research focuses its study on materials management, specifically in identifying the influential factors that affect materials management in the construction project activities. Literatures from books, journal articles and conference papers related to poor project performances and materials management have been reviewed. Consequently, this study sorted the salient influential factors and categorized them based on their specific group. Out of 47 factors identified, they are classified into 8 groups. They are (1 site condition; (2 planning and handling on site; (3 management; (4 materials; (5 supplier and manufacturer default; (6 transportation; (7 contractual; and (8 governmental interferences. In conclusion, this study contends that by identifying the influential factors affecting materials management, it will help construction players to avoid the occurrence of those factors and will minimize the negative impacts on the overall performance of construction projects. Hence, the handling-over of project will be according to schedule and not delayed by materials mismanagement.

  17. A review of affecting factors on sexual satisfaction in women.

    Science.gov (United States)

    Shahhosseini, Zohreh; Gardeshi, Zeinab Hamzeh; Pourasghar, Mehdi; Salehi, Fariba

    2014-12-01

    Sex is a complex, important and sensitive issue in human being and interwoven with the whole of human existence. Given the serious changes in attitude, function and behavior in sex, the need to address sexual function, especially sexual satisfaction, is felt completely. Sexual satisfaction has a very important role in creating marital satisfaction and any defect in sexual satisfaction is significantly associated with risky sexual behaviors, serious mental illness, social crimes and ultimately divorce. The aim of this study was to explore affecting factors on sexual satisfaction in women based on an overview in scientific database. In this narrative review the researchers searched MEDLINE database, Google Scholar and Science Direct as well as Persian database like Scientific Information Database with search terms of sexual satisfaction and sexual function, restricted to English/ Persian language, during the 20 years ago. Then those articles written by renowned experts were selected. In this regard, 57 articles have been reviewed, which 30 articles related to this research have been extracted. The findings were divided in to four categories including: Demographic factors, Pathophysiological factors, Psychological factors and Sociocultural factors. Sexuality, especially sexual intimacy is sophisticated and yet elegant affair that the other persons has different definitions and different functions. Discrepancies in the results of the studies show that analysis of factors affecting sexual satisfaction regardless of the women's' sociocultural context, religious beliefs, and personal attitudes is undoubtedly inefficient, unscientific and irrational.

  18. Factors Affecting Adoption of Recommended Cauliflower Production Technology in Nepal

    Directory of Open Access Journals (Sweden)

    Pankaj Raj Dhital

    2016-05-01

    Full Text Available Binary logit regression model of econometrics was used to identify the factors affecting adoption of recommended agricultural technology by the commercial farmers of Nepal. A survey was carried out in 2012 in 120 households from Kavre district, Nepal. The objective was to appraise factors affecting adoption of recommended technology of cauliflower, finding out the level of adoption, identifying the constraints of cauliflower cultivation, assessing the perceived level of satisfaction and studying the relationship of certain selected variables on the adoption. Education, Occupation, contact with Personal Localite sources of information, Group membership and Experience were the most influencing factors for adoption of recommended technology. Though, other factors were not strong enough to contribute significantly but indirectly influence the adoption decision of farmers as combined effects. Occupation was found as negatively associated. Landholding size was strongly and positively influencing among the non significant factors. The level of satisfaction and the constraints of cauliflower production were also identified. Transfer of technology will be effective if and only if the client adopts the technology. For an effective transfer of technology, it is better to go for activities for the welfare of the socioeconomic factors of the farmers.

  19. Sialidases affect the host cell adherence and epsilon toxin-induced cytotoxicity of Clostridium perfringens type D strain CN3718.

    Directory of Open Access Journals (Sweden)

    Jihong Li

    2011-12-01

    Full Text Available Clostridium perfringens type B or D isolates, which cause enterotoxemias or enteritis in livestock, produce epsilon toxin (ETX. ETX is exceptionally potent, earning it a listing as a CDC class B select toxin. Most C. perfringens strains also express up to three different sialidases, although the possible contributions of those enzymes to type B or D pathogenesis remain unclear. Type D isolate CN3718 was found to carry two genes (nanI and nanJ encoding secreted sialidases and one gene (nanH encoding a cytoplasmic sialidase. Construction in CN3718 of single nanI, nanJ and nanH null mutants, as well as a nanI/nanJ double null mutant and a triple sialidase null mutant, identified NanI as the major secreted sialidase of this strain. Pretreating MDCK cells with NanI sialidase, or with culture supernatants of BMC206 (an isogenic CN3718 etx null mutant that still produces sialidases enhanced the subsequent binding and cytotoxic effects of purified ETX. Complementation of BMC207 (an etx/nanH/nanI/nanJ null mutant showed this effect is mainly attributable to NanI production. Contact between BMC206 and certain mammalian cells (e.g., enterocyte-like Caco-2 cells resulted in more rapid sialidase production and this effect involved increased transcription of BMC206 nanI gene. BMC206 was shown to adhere to some (e.g. Caco-2 cells, but not all mammalian cells, and this effect was dependent upon sialidase, particularly NanI, expression. Finally, the sialidase activity of NanI (but not NanJ or NanH could be enhanced by trypsin. Collectively these in vitro findings suggest that, during type D disease originating in the intestines, trypsin may activate NanI, which (in turn could contribute to intestinal colonization by C. perfringens type D isolates and also increase ETX action.

  20. Factors Affecting Zebra Mussel Kill by the Bacterium Pseudomonas fluorescens

    Energy Technology Data Exchange (ETDEWEB)

    Daniel P. Molloy

    2004-02-24

    The specific purpose of this research project was to identify factors that affect zebra mussel kill by the bacterium Pseudomonas fluorescens. Test results obtained during this three-year project identified the following key variables as affecting mussel kill: treatment concentration, treatment duration, mussel siphoning activity, dissolved oxygen concentration, water temperature, and naturally suspended particle load. Using this latter information, the project culminated in a series of pipe tests which achieved high mussel kill inside power plants under once-through conditions using service water in artificial pipes.

  1. Factors affecting the periapical healing process of endodontically treated teeth

    Directory of Open Access Journals (Sweden)

    Roberto Holland

    Full Text Available Abstract Tissue repair is an essential process that reestablishes tissue integrity and regular function. Nevertheless, different therapeutic factors and clinical conditions may interfere in this process of periapical healing. This review aims to discuss the important therapeutic factors associated with the clinical protocol used during root canal treatment and to highlight the systemic conditions associated with the periapical healing process of endodontically treated teeth. The antibacterial strategies indicated in the conventional treatment of an inflamed and infected pulp and the modulation of the host's immune response may assist in tissue repair, if wound healing has been hindered by infection. Systemic conditions, such as diabetes mellitus and hypertension, can also inhibit wound healing. The success of root canal treatment is affected by the correct choice of clinical protocol. These factors are dependent on the sanitization process (instrumentation, irrigant solution, irrigating strategies, and intracanal dressing, the apical limit of the root canal preparation and obturation, and the quality of the sealer. The challenges affecting the healing process of endodontically treated teeth include control of the inflammation of pulp or infectious processes and simultaneous neutralization of unpredictable provocations to the periapical tissue. Along with these factors, one must understand the local and general clinical conditions (systemic health of the patient that affect the outcome of root canal treatment prediction.

  2. Nurse aide decision making in nursing homes: factors affecting empowerment.

    Science.gov (United States)

    Chaudhuri, Tanni; Yeatts, Dale E; Cready, Cynthia M

    2013-09-01

    To evaluate factors affecting structural empowerment among nurse aides in nursing homes. Structural empowerment can be defined as the actual rather than perceived ability to make autonomous decisions within an organisation. Given the paucity of research on the subject, this study helps to close the gap by identifying factors that affect nurse aide empowerment, that is, decision-making among nurse aides. The data for the study come from self-administered questionnaires distributed to direct-care workers (nurse aides) in 11 nursing homes in a southern state in the USA. Ordinary least square regression models were estimated to analyse the effects of demographic predictors, personal factors (competency, emotional exhaustion and positive attitude) and structural characteristics (coworker and supervisor support, information availability and shared governance) on nurse aide decision-making. Findings suggest race among demographic predictors, emotional exhaustion among personal characteristics, and supervisor support, and shared governance among structural factors, significantly affect nurse aide decision-making. It is important to explore race as one of the central determinants of structural empowerment among nurse aides. In addition, the nature and type of emotional exhaustion that propels decision-making needs to be further examined. The study shows the importance of shared governance and supervisor support for fostering nurse aide empowerment. © 2013 Blackwell Publishing Ltd.

  3. Factors Affecting Successful Implementation of Hospital Information Systems.

    Science.gov (United States)

    Farzandipur, Mehrdad; Jeddi, Fatemeh Rangraz; Azimi, Esmaeil

    2016-02-01

    Today, the use of information systems in health environments, like any other fields, is necessary and organizational managers are convinced to use these systems. However, managers' satisfaction is not the only factor in successfully implementing these systems and failed information technology projects (IT) are reported despite the consent of the directors. Therefore, this study aims to determine the factors affecting the successful implementation of a hospital information system. The study was carried out as a descriptive method in 20 clinical hospitals that the hospital information system (HIS) was conducted in them. The clinical and paraclinical users of mentioned hospitals are the study group. 400 people were chosen as samples in scientific method and the data was collected using a questionnaire consisted of three main human, managerial and organizational, and technological factors, by questionnaire and interview. Then the data was scored in Likert scale (score of 1 to 5) and were analyzed using the SPSS software. About 75 percent of the population were female, with average work experience of 10 years and the mean age was 30 years. The human factors affecting the success of hospital information system implementation achieved the mean score of 3.5, both organizational and managerial factors 2.9 and technological factors the mean of 3. Human factors including computer skills, perceiving usefulness and perceiving the ease of a hospital information system use are more effective on the acceptance and successful implementation of hospital information systems; then the technological factors play a greater role. It is recommended that for the successful implementation of hospital information systems, most of these factors to be considered.

  4. Single-tooth replacement: factors affecting different prosthetic treatment modalities

    Directory of Open Access Journals (Sweden)

    Al-Quran Firas A

    2011-12-01

    Full Text Available Abstract Background The choice between several treatment options for replacing a single missing tooth is influenced by clinical, dentist- and patient-immanent factors. This study aimed to determine the patient factors that would affect the treatment decision to replace a single missing tooth and to assess the satisfaction with several options. Method 200 volunteers involved (121 females and 79 males divided into four groups, Group A: consisted of patients with conventional fixed partial dentures or patients with resin bonded fixed partial dentures. Group B: consisted of patients who received removable partial dentures while Group C: consisted of patients who received a single implant supported crown, and a control group D: consisted of patients who received no treatment. Data were collected using a questionnaire. Results The highest percentage of males within groups (58% was within the removable prostheses category. The majority of the subjects in the study reported that the main reason for replacing a missing tooth was for esthetic and function. Most important factor affecting the choice between treatment modalities was damaging the neighboring teeth. Pain, post operative sensitivity and dental phobia were important factors in choosing the prosthesis type and affected the control group patients not to have any treatment. The highest satisfaction percentage among groups studied was recorded for dental implants then FPD groups, while the least percentage were in both the control and RPD groups, for all aspects of function, esthetic and speech efficiency. Conclusions The final choice between FPD, RPD and implant depended on several factors which affected the decision making; among these is cost and patients' awareness of the different treatment options.

  5. Bio-social factors and perceptions of life with quality: a challenge to the adherence of h i v patients to the antirretroviral treatment

    Directory of Open Access Journals (Sweden)

    John Harold Estrada M

    2008-06-01

    Full Text Available In spite that antirretroviral therapy has contributed to improve life quality among people living with h i v, adherence to the treatment still persists as a major obstacle for therapeutic success. In order to assess the biosocial factors that contributes to adherence to this therapy by people with h i v. In order to evaluate the bio-social aspects that facilitate or obstruct the adherence to the treatment, a qualitative study combining ethnographic research, a hermeneutic approach to narratives, and a situational analysis of life experiences of people living with h i v in Colombia. Two theoretical categories were applied throughout the study: Victoria Camps’ life with quality and Saussure’s auto- and hetero-perception. All of the ten people who took part in the study were male patients who were attending an integral oral health program. The main factors that obstruct the adherence to the therapy were the following: 1 the discourse of the medical team loaded with biomedical jargon; 2 the dosages and side effects of the medications used in Colombia; 3 negative attitudes linked to a poor selfimage, a low social capital, and a low self-esteem; 4 low expectations in regards to a life with quality accompanied by the therapy. Among the factors that promote adherence the following were identified: 1 intra- and inter-personal negotiation processes based on the h i v serum status and the treatment; 2 knowledge about those negotiations by family members, friends, coworkers, and sentimental partners; 3 a positive perception of improvement in life quality while in treatment; 4 expectations of a life with quality depending on the adherence. Nevertheless, it was also found that those factors that contribute or impede adherence change rapidly and produce swinging in the person’s mood. This mood is here understood as a complex feeling concerning life with quality in constant change, both merging individual and social aspects implied in the experience of

  6. Factors affecting smartphone adoption for accessing information in medical settings.

    Science.gov (United States)

    Tahamtan, Iman; Pajouhanfar, Sara; Sedghi, Shahram; Azad, Mohsen; Roudbari, Masoud

    2017-06-01

    This study aimed to acquire knowledge about the factors affecting smartphone adoption for accessing information in medical settings in Iranian Hospitals. A qualitative and quantitative approach was used to conduct this study. Semi-structured interviews were conducted with 21 medical residents and interns in 2013 to identify determinant factors for smartphone adoption. Afterwards, nine relationships were hypothesised. We developed a questionnaire to test these hypotheses and to evaluate the importance of each factor. Structural equation modelling was used to analyse the causal relations between model parameters and to accurately identify determinant factors. Eight factors were identified in the qualitative phase of the study, including perceived usefulness, perceived ease of use, training, internal environment, personal experience, social impacts, observability and job related characteristics. Among the studied factors, perceived usefulness, personal experience and job related characteristics were significantly associated with attitude to use a smartphone which accounted for 64% of the variance in attitude. Perceived usefulness had the strongest impact on attitude to use a smartphone. The factors that emerged from interviews were consistent with the Technology Acceptance Model (TAM) and some previous studies. TAM is a reliable model for understanding the factors of smartphone acceptance in medical settings. © 2017 Health Libraries Group.

  7. Factors Affecting Sarcopenia in Korean Adults by Age Groups.

    Science.gov (United States)

    Bae, Eun-Jung; Kim, Yun-Hee

    2017-06-01

    This study aimed to investigate factors affecting sarcopenia in different age groups among Korean adults aged 20 years or older. In this secondary analysis, data were collected from records for 17,968, participants who participated in the Korea National Health and Nutrition Examination Survey during 2008-2011. Data were analyzed using multiple logistic regression to determine the associated factors of sarcopenia by age groups. The prevalence of sarcopenia increased significantly with age. Physical activity, blood pressure, waist circumference, triglycerides, vitamin D level were found to be factors significantly associated with sarcopenia in all age groups. Total energy intake was found to be a factor that is significantly associated with sarcopenia among the adults aged 20-39 years. Fasting glucose, suicidal ideation, perceived health status, mobility problem, pain/discomfort, total energy intake were found to be factors associated with sarcopenia in the adults aged 40-64 years. Sex, residential area, smoking, drinking, fasting glucose, osteoarthritis, fall experience, usual activity problem, protein intake were factors associated with sarcopenia in the adults over 65 years of age. The findings show that sarcopenia in adults and the associated factors were different by age groups. Thus, these factors should be considered in the development of intervention programs for the care and prevention of sarcopenia, and such programs should be modified according to different age groups.

  8. Factors Affecting Surgical Decision-making—A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Caroline Gunaratnam

    2018-01-01

    Full Text Available Background Guidelines and Class 1 evidence are strong factors that help guide surgeons’ decision-making, but dilemmas exist in selecting the best surgical option, usually without the benefit of guidelines or Class 1 evidence. A few studies have discussed the variability of surgical treatment options that are currently available, but no study has examined surgeons’ views on the influential factors that encourage them to choose one surgical treatment over another. This study examines the influential factors and the thought process that encourage surgeons to make these decisions in such circumstances. Methods Semi-structured face-to-face interviews were conducted with 32 senior consultant surgeons, surgical fellows, and senior surgical residents at the University of Toronto teaching hospitals. An e-mail was sent out for volunteers, and interviews were audio-recorded, transcribed verbatim, and subjected to thematic analysis using open and axial coding. Results Broadly speaking there are five groups of factors affecting surgeons’ decision-making: medical condition, information, institutional, patient, and surgeon factors. When information factors such as guidelines and Class 1 evidence are lacking, the other four groups of factors—medical condition, institutional, patient, and surgeon factors (the last-mentioned likely being the most powerful—play a significant role in guiding surgical decision-making. Conclusions This study is the first qualitative study on surgeons’ perspectives on the influential factors that help them choose one surgical treatment option over another for their patients.

  9. Factors affecting functional prognosis of patients with hip fracture

    DEFF Research Database (Denmark)

    Kristensen, M T

    2011-01-01

    to just one or two single factors. The current article reviews important factors affecting the functional prognosis, and clinicians are encouraged to include all factors potentially influencing the outcome of patients with hip fracture in their individualised treatment and rehabilitation plan. Especially......Having a hip fracture is considered one of the most fatal fractures for elderly people, resulting in impaired function, and increased morbidity and mortality. This challenges clinicians in identifying patients at risk of worse outcome, in order to optimise and intensify treatment in these patients....... A variety of factors such as age, prefracture function and health status, fracture type, pain, anaemia, muscle strength, and the early mobility level have been shown to influence patient outcome. Thus, the outcome of patients with hip fracture is considered multi-factorial, and can therefore not be related...

  10. Factors Affecting Customer Retention in the Airline Industry

    Directory of Open Access Journals (Sweden)

    Raghda Climis

    2017-01-01

    Full Text Available Purpose: This study empirically investigated the factors that affect customer retention in the airline industry in North Cyprus. These factors were service quality attributes, perceived safety, customer satisfaction, loyalty reward program, relationship commitment and customer loyalty. The study also investigated four different groups for purposes of travel (business, education, vacation and family visit in the empirical model. Methodology: A descriptive approach was chosen to conduct this research. A quanhip between customer retention and the related study factors; however, not all of these relations are signifcant. The results also showed that the different purposes of travel had different influences on the variables regarding the positive and signifcant relations between them. Some independent variables had a negative effect on the dependent variables. Conclusions: This research was limited to one group and place: the students of Eastern Mediterranean University in North Cyprus. Originality: This study connected the retention, loyalty, satisfaction and service quality factors as attributes. In addition, this research was the frst to include other independent factors affecting satisfaction and loyalty in a comparison between four different groups regarding the purpose of travel in the airline industry.

  11. Cognitive Factors Affecting Freeze-like Behavior in Humans.

    Science.gov (United States)

    Alban, Michael W; Pocknell, Victoria

    2017-01-01

    Contemporary research on survival-related defensive behaviors has identified physiological markers of freeze/flight/fight. Our research focused on cognitive factors associated with freeze-like behavior in humans. Study 1 tested if an explicit decision to freeze is associated with the psychophysiological state of freezing. Heart rate deceleration occurred when participants chose to freeze. Study 2 varied the efficacy of freezing relative to other defense options and found "freeze" was responsive to variations in the perceived effectiveness of alternative actions. Study 3 tested if individual differences in motivational orientation affect preference for a "freeze" option when the efficacy of options is held constant. A trend in the predicted direction suggested that naturally occurring cognitions led loss-avoiders to select "freeze" more often than reward-seekers. In combination, our attention to the cognitive factors affecting freeze-like behavior in humans represents a preliminary step in addressing an important but neglected research area.

  12. Socioeconomic Factors Affecting Adoption of Sunflower Varieties in Sindh

    Directory of Open Access Journals (Sweden)

    Ghulam Ali Jariko (Corresponding Author

    2011-09-01

    Full Text Available This research study is based on primary data collection from sunflower growers to assess the socioeconomic factors that are affecting the adoption of sunflower varieties in Sindh.Data samples have been selected from two districts; Badin and Thatta, as these districts are considered main sunflower growing areas in Sindh. The results reveal that Sunflower growers are using Hybrid varieties i.e. 43 percent planted Hysun-33, 29 percent Hysun-38 and 28 percent Hysun-37 varieties. The finding of research using multinomial logistic regression suggests that farm size and level of education significantly affected the adoption of sunflower varieties. These factors are statistically significant at p<0.05. Theother variables such as tenancy status and source of income are not statistically significant in the adoption of sunflower varieties in Sindh.

  13. Factors affecting the tissues composition of pork belly.

    Science.gov (United States)

    Duziński, K; Knecht, D; Lisiak, D; Janiszewski, P

    2015-11-01

    Bellies derived from the commercial population of pig carcasses are diverse in terms of tissue composition. Knowledge of the factors influencing it and the expected results, permits quick and easy evaluation of raw material. The study was designed to determine the factors affecting the tissues composition of pork bellies and to estimate their lean meat content. The research population (n=140 pig carcasses) was divided into groups according to sex (gilts, barrows), half-carcass mass (meat content class: S (⩾60%), E (55% to 60%), U (50% to 55%), R (meat content affected the growth of the fat and skin mass in a linear way. No differences were observed between class S and E in terms of belly muscle mass. A 0.37% higher share of belly in the half-carcass was found for barrows (Pmeat content in bellies, suggesting they may be used directly in the production line.

  14. Factors Affecting Microbial Contamination of Market Eggs: A Review

    Directory of Open Access Journals (Sweden)

    Svobodová J.

    2015-01-01

    Full Text Available The aim of the review was to analyze the ways of microbial contamination, the protective mechanism of egg, and factors that affect the quantity of contamination and microbial penetration. Eggs can be contaminated during their formation in the infected reproductive organs of hens or after laying, when eggs are exposed to contaminated environment. The eggs are equipped against microbial contamination by several protective mechanisms comprising the presence of cuticle, eggshell, eggshell membranes, occurrence of some antibacterial proteins, and high pH value of albumen. There are several factors that affect the quantity of microbial contamination and penetration such as species of bacteria, the amount of microorganisms, storage conditions, quality of eggshell or number of pores.

  15. Factors affecting metal and radionuclide pollution in the Baltic sea

    Directory of Open Access Journals (Sweden)

    Martin Lodenius

    2016-12-01

    Full Text Available External pollution load in the Baltic Sea originates from urban, agricultural and industrial sources. Emissions of heavy metals have decreased substantially in the catchment area but the temporal trends are not always significant and differ with sample, area and pollutant. The most significant source of anthropogenic radioactivity in the Baltic Sea is fallout from the Chernobyl accident in 1986. Many factors affect the future development of pollutant concentrations including anthropogenic emissions, political decisions and changes in salinity, temperature and water currents, in eutrophication and oxygen status, in fisheries and in atmospheric deposition of pollutants. Large scale changes like eutrophication and climate change affect ecosystems in many ways, directly and indirectly, causing biological and abiotic effects. These factors are interrelated and difficult to predict. Measures aiming to enhance the ecological status of the Baltic Sea will certainly give positive results but this will take at least several decades.

  16. Literature review of factors affecting continence after radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Dalibor Pacik

    2017-01-01

    Full Text Available Radical prostatectomy (RP is the most common cause of stress urinary incontinence (UI in men. Several anatomic structures affect or may affect urinary continence - urethral sphincter, levator ani muscle, puboprostatic ligaments, bladder neck, endopelvic fascia, neurovascular bundle - and understanding of the anatomy of pelvic floor and urethra is crucial for satisfactory functional outcome of the procedure. Surgical techniques implemented to improve continence rates include nerve-sparing procedure, bladder neck preservation/plication, urethral length preservation, musculofascial reconstruction, puboprostatic ligaments preservation or seminal vesicle preservation. Perioperative (preoperative and postoperative pelvic floor muscle training (PFMT aims to shorten the duration of postoperative UI and thus, improve early continence rates postoperatively. In the review, complex information regarding anatomical, intra- and perioperative factors affecting urinary continence after RP is provided, including description of important anatomical structures, possible implications for surgical technique and evaluation of different PFMT strategies in perioperative period.

  17. Factors affecting future specialty choice among medical students in Kuwait

    OpenAIRE

    Marwan, Yousef; Al-Fouzan, Rawan; Al-Ajlan, Sarah; Al-Saleh, Mervat

    2012-01-01

    Background: Choosing a medical specialty can be either a daunting and confusing experience for some medical students and junior doctors or a foregone conclusion to others. The aim of this study is to evaluate factors affecting future specialty choice among medical students in Kuwait University. Methods: A self-administered questionnaire was used to collect data from medical students registered in Kuwait University during the academic year 2011/2012. Chi-square test and logistic regression wer...

  18. Factors which affect the erosion of solids by liquid impact

    International Nuclear Information System (INIS)

    Gugan, M.A.

    1990-03-01

    The factors which affect the erosion of solids by liquid impact are considered. The nature of contaminated surfaces is described and the effect on the erosion rate (on non-active lead coupons) of varying jetting parameters is illustrated. Recommendations are made for future work to enhance the effectiveness of water jetting as a nuclear decontamination technique and the importance of containment and effluent treatment is outlined. (author)

  19. A STUDY OF FACTORS AFFECTING HEALING OF GASTROINTESTINAL TRACT ANASTOMOSIS

    OpenAIRE

    Anjani; Amit; Vikram Singh; Rajesh; Jalaj

    2014-01-01

    : Aim of this prospective study to identify the factor which affects the morbidity and mortality of gastrointestinal anastomosis. This prospective study was conducted in G.R. Medical College from November 2012 to October 2013. Our study plan was approved by Ethical Committee of our institute 80 patients were included in this study who underwent gastrointestinal anastomosis whether elective or emergency irrespective of age and gender. A detailed history and relevant preoper...

  20. Motivation-One of the Affective Factors and its Effect

    Institute of Scientific and Technical Information of China (English)

    LIN Fang-hua

    2014-01-01

    Affective factors play a positive role in English study and motivation is the most important. Higher motivation predicts better second language acquisition. The types of motivation are mainly divided into two:extrinsic motivation and intrinsic moti-vation. Teachers should study their students as well as the teaching materials and then select scientific methods and make good use of them to reinforce their students' motivation.

  1. Factors affecting customer satisfaction of online travel agencies in India

    OpenAIRE

    Dutta, Sabyasachi; Kumar Chauhan, Ram; Chauhan, Kavita

    2017-01-01

    Purpose – The purpose of this paper is to identify the factors affecting customer satisfaction for online travel agencies in India. It will help guide existing online travel agencies and future entrants to have an in-depth understanding of customer satisfaction and customer loyalty in their domain. It will also help to improve their business operations and investment focus, which in turn will lead to greater customer satisfaction and loyalty. Design – This paper defines the concept of cust...

  2. Factors affecting wood energy consumption by U.S. households

    Science.gov (United States)

    Nianfu Song; Francisco X. Aguilar; Stephen R. Shifley; Michael E. Goerndt

    2012-01-01

    About 23% of energy derived from woody sources in the U.S. was consumed by households, of which 70% was used by households in rural areas in 2005. We investigated factors affecting household-level wood energy consumption in the four continental U.S. regions using data from the U.S. Residential Energy Consumption Survey. To account for a large number of zero...

  3. Factors affecting polyamide prototypes design of Albedo dosemeters

    International Nuclear Information System (INIS)

    Martins, M.M.; Mauricio, C.L.P.; Fonseca, E.S.

    1996-01-01

    This work studies the most important factors which affect the response of albedo neutron dosemeters containing LiF TLDs with the aim to improve their sensitivity. It includes tests of thickness and shape of the polyamide moderator body prototypes, albedo window diameter and TLD position inside the moderator. Analyzing the results, an albedo neutron dosemeter prototype, B 4 C covered, was developed. The prototype has a response three times higher than the albedo dosemeter now in use in Brazil. (author)

  4. Factors Affecting Aggression in South Korean Middle School Students

    OpenAIRE

    MiJeong Park, PhD, RN; Jihea Choi, PhD, RN, CPNP; Seung-Joo Lim, PhD, RN

    2014-01-01

    Purpose: The study was undertaken to assess levels of aggression, and to determine factors affecting aggression among South Korean middle school students. Methods: A descriptive study was conducted using self-report questionnaires. The participants were 340 girls and boys from two middle schools and 302 questionnaires were used for the final data analysis. Aggression, academic stress, depression, self esteem, decision-making competency, and happiness were measured. Data were analyzed using...

  5. Control of exogenous factors affecting plasma homovanillic acid concentration.

    Science.gov (United States)

    Davidson, M; Giordani, A B; Mohs, R C; Mykytyn, V V; Platt, S; Aryan, Z S; Davis, K L

    1987-04-01

    Measurements of plasma homovanillic acid (pHVA) concentrations appear to be a valid research strategy in psychiatric disorders in which a central dopamine (DA) abnormality has been implicated. This study provides guidance about the control of some of the exogenous factors affecting pHVA concentrations. Fasting for 14 hours eliminates the dietary effects on pHVA in healthy human subjects. Changing position, walking for 30 minutes, or smoking two cigarettes has no effect on pHVA concentrations.

  6. Parallel factor analysis PARAFAC of process affected water

    Energy Technology Data Exchange (ETDEWEB)

    Ewanchuk, A.M.; Ulrich, A.C.; Sego, D. [Alberta Univ., Edmonton, AB (Canada). Dept. of Civil and Environmental Engineering; Alostaz, M. [Thurber Engineering Ltd., Calgary, AB (Canada)

    2010-07-01

    A parallel factor analysis (PARAFAC) of oil sands process-affected water was presented. Naphthenic acids (NA) are traditionally described as monobasic carboxylic acids. Research has indicated that oil sands NA do not fit classical definitions of NA. Oil sands organic acids have toxic and corrosive properties. When analyzed by fluorescence technology, oil sands process-affected water displays a characteristic peak at 290 nm excitation and approximately 346 nm emission. In this study, a parallel factor analysis (PARAFAC) was used to decompose process-affected water multi-way data into components representing analytes, chemical compounds, and groups of compounds. Water samples from various oil sands operations were analyzed in order to obtain EEMs. The EEMs were then arranged into a large matrix in decreasing process-affected water content for PARAFAC. Data were divided into 5 components. A comparison with commercially prepared NA samples suggested that oil sands NA is fundamentally different. Further research is needed to determine what each of the 5 components represent. tabs., figs.

  7. Factors affecting sustainability of rural water schemes in Swaziland

    Science.gov (United States)

    Peter, Graciana; Nkambule, Sizwe E.

    The Millennium Development Goal (MDG) target to reduce the proportion of people without sustainable access to safe drinking water by the year 2015 has been met as of 2010, but huge disparities exist. Some regions, particularly Sub-Saharan Africa are lagging behind it is also in this region where up to 30% of the rural schemes are not functional at any given time. There is need for more studies on factors affecting sustainability and necessary measures which when implemented will improve the sustainability of rural water schemes. The main objective of this study was to assess the main factors affecting the sustainability of rural water schemes in Swaziland using a Multi-Criteria Analysis Approach. The main factors considered were: financial, social, technical, environmental and institutional. The study was done in Lubombo region. Fifteen functional water schemes in 11 communities were studied. Data was collected using questionnaires, checklist and focused group discussion guide. A total of 174 heads of households were interviewed. Statistical Package for Social Sciences (SPSS) was used to analyse the data and to calculate sustainability scores for water schemes. SPSS was also used to classify sustainability scores according to sustainability categories: sustainable, partially sustainable and non-sustainable. The averages of the ratings for the different sub-factors studied and the results on the sustainability scores for the sustainable, partially sustainable and non-sustainable schemes were then computed and compared to establish the main factors influencing sustainability of the water schemes. The results indicated technical and social factors as most critical while financial and institutional, although important, played a lesser role. Factors which contributed to the sustainability of water schemes were: functionality; design flow; water fetching time; ability to meet additional demand; use by population; equity; participation in decision making on operation and

  8. Risk factors for suboptimal antiretroviral therapy adherence in HIV-infected adolescents in Gaborone, Botswana: a pilot cross-sectional study

    Directory of Open Access Journals (Sweden)

    Ndiaye M

    2013-09-01

    Full Text Available Maimouna Ndiaye,1,2 Peter Nyasulu,1 Hoang Nguyen,6,7 Elizabeth D Lowenthal,8,9 Robert Gross,10 Edward J Mills,3 Jean B Nachega4–6 1School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 2Central Medical Stores, Ministry of Health, Gaborone, Botswana; 3Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; 4Department of Medicine and Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; 5Department of Epidemiology, Infectious Disease Epidemiology Research Program, Pittsburgh University Graduate School of Public Health, Pittsburgh, PA, USA; 6Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 7Tay Ho Clinics, Department of Medicine, Hanoi Health Services, Hanoi, Vietnam; 8Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; 9Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, PA, USA; 10Departments of Medicine and Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Objective: Little is known about factors associated with suboptimal antiretroviral treatment (ART adherence among adolescents in Sub-Saharan Africa. Our objective was to determine the level of ART adherence and predictors of non-adherence among human immunodeficiency virus (HIV-infected adolescents at the Botswana-Baylor Children's Clinical Centre of Excellence in Gaborone, Botswana. Methods: In a cross-sectional study, 82 HIV-infected adolescents receiving ART and their caregivers were administered a structured questionnaire. The patient's clinical information was retrieved from medical records. Outcome measures included excellent pill count ART adherence (>95% and virologic suppression

  9. Lengths of Orthologous Prokaryotic Proteins Are Affected by Evolutionary Factors

    Directory of Open Access Journals (Sweden)

    Tatiana Tatarinova

    2015-01-01

    Full Text Available Proteins of the same functional family (for example, kinases may have significantly different lengths. It is an open question whether such variation in length is random or it appears as a response to some unknown evolutionary driving factors. The main purpose of this paper is to demonstrate existence of factors affecting prokaryotic gene lengths. We believe that the ranking of genomes according to lengths of their genes, followed by the calculation of coefficients of association between genome rank and genome property, is a reasonable approach in revealing such evolutionary driving factors. As we demonstrated earlier, our chosen approach, Bubble-sort, combines stability, accuracy, and computational efficiency as compared to other ranking methods. Application of Bubble Sort to the set of 1390 prokaryotic genomes confirmed that genes of Archaeal species are generally shorter than Bacterial ones. We observed that gene lengths are affected by various factors: within each domain, different phyla have preferences for short or long genes; thermophiles tend to have shorter genes than the soil-dwellers; halophiles tend to have longer genes. We also found that species with overrepresentation of cytosines and guanines in the third position of the codon (GC3 content tend to have longer genes than species with low GC3 content.

  10. Lengths of Orthologous Prokaryotic Proteins Are Affected by Evolutionary Factors.

    Science.gov (United States)

    Tatarinova, Tatiana; Salih, Bilal; Dien Bard, Jennifer; Cohen, Irit; Bolshoy, Alexander

    2015-01-01

    Proteins of the same functional family (for example, kinases) may have significantly different lengths. It is an open question whether such variation in length is random or it appears as a response to some unknown evolutionary driving factors. The main purpose of this paper is to demonstrate existence of factors affecting prokaryotic gene lengths. We believe that the ranking of genomes according to lengths of their genes, followed by the calculation of coefficients of association between genome rank and genome property, is a reasonable approach in revealing such evolutionary driving factors. As we demonstrated earlier, our chosen approach, Bubble-sort, combines stability, accuracy, and computational efficiency as compared to other ranking methods. Application of Bubble Sort to the set of 1390 prokaryotic genomes confirmed that genes of Archaeal species are generally shorter than Bacterial ones. We observed that gene lengths are affected by various factors: within each domain, different phyla have preferences for short or long genes; thermophiles tend to have shorter genes than the soil-dwellers; halophiles tend to have longer genes. We also found that species with overrepresentation of cytosines and guanines in the third position of the codon (GC3 content) tend to have longer genes than species with low GC3 content.

  11. EXPLORING THE FACTORS AFFECTING EMPLOYEES’ ADOPTION AND USE OF INNOVATION

    Directory of Open Access Journals (Sweden)

    Majharul Talukder

    2010-01-01

    Full Text Available This paper explores the factors affecting innovation adoption by individual employees within an organization in Australia. Following a qualitative research approach, this paper uses a series of in-depth interviews and focus group discussions involving academic and administrative employees at a tertiary educational institution in Australia. The qualitative approach is adopted to have a deeper insight into the complexities and dynamism associated with the factors influencing innovation adoption process in organizational settings. The findings of this research highlight the need for broadening an understanding of the key factors affecting employee’s decisions to uptake the adoption of innovation. The results provide important clues for comprehending the factors influencing and determining the employee’s adoption and continued use of innovation in the work environment. In the face of the current trend towards end-user applications of technological innovation, the results suggest some guidelines for management toward effective and efficient adoption and use of innovation in organizational settings. This paper has highlighted the above findings and their implications for management practices related to innovation management in an Australian organizational setting. This paper also identifies possible limitations and future research potential in the relevant field.

  12. Factors affecting midwives' confidence in intrapartum care: a phenomenological study.

    Science.gov (United States)

    Bedwell, Carol; McGowan, Linda; Lavender, Tina

    2015-01-01

    midwives are frequently the lead providers of care for women throughout labour and birth. In order to perform their role effectively and provide women with the choices they require midwives need to be confident in their practice. This study explores factors which may affect midwives' confidence in their practice. hermeneutic phenomenology formed the theoretical basis for the study. Prospective longitudinal data collection was completed using diaries and semi-structured interviews. Twelve midwives providing intrapartum care in a variety of settings were recruited to ensure a variety of experiences in different contexts were captured. the principal factor affecting workplace confidence, both positively and negatively, was the influence of colleagues. Perceived autonomy and a sense of familiarity could also enhance confidence. However, conflict in the workplace was a critical factor in reducing midwives' confidence. Confidence was an important, but fragile, phenomenon to midwives and they used a variety of coping strategies, emotional intelligence and presentation management to maintain it. this is the first study to highlight both the factors influencing midwives' workplace confidence and the strategies midwives employed to maintain their confidence. Confidence is important in maintaining well-being and workplace culture may play a role in explaining the current low morale within the midwifery workforce. This may have implications for women's choices and care. Support, effective leadership and education may help midwives develop and sustain a positive sense of confidence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Mothers recovering from cocaine addiction: factors affecting parenting skills.

    Science.gov (United States)

    Coyer, S M

    2001-01-01

    To identify factors that may influence parenting by mothers who are recovering from cocaine addiction. Exploratory descriptive, with in-depth unstructured interviews. Interviews were conducted in the woman's home or in a treatment center. A convenience sample of 11 women recovering from cocaine addiction who were mothers of children 3 years of age and younger. A content analysis was used to analyze the interview data. Two themes, personal/psychologic factors and environmental/contextual factors, and four subthemes emerged. They identify issues that may affect parenting by mothers being treated for cocaine addiction. Subthemes included low self-esteem, difficulty developing a maternal identity, isolation from friends and family, and chronic life stress. This study provides a better understanding of the sources contributing to vulnerability in the parenting role for mothers recovering from cocaine addiction and will assist nurses in providing care for these mothers and their children.

  14. Factors affecting aggression in South Korean middle school students.

    Science.gov (United States)

    Park, MiJeong; Choi, Jihea; Lim, Seung-Joo

    2014-12-01

    The study was undertaken to assess levels of aggression, and to determine factors affecting aggression among South Korean middle school students. A descriptive study was conducted using self-report questionnaires. The participants were 340 girls and boys from two middle schools and 302 questionnaires were used for the final data analysis. Aggression, academic stress, depression, self esteem, decision-making competency, and happiness were measured. Data were analyzed using descriptive statistics including t tests, one-way analysis of variance, Pearson's correlation coefficients and multiple regressions. Aggression had significant correlations with academic stress (r = .21, p decision-making competency (r = -.25, p emotional factors like depression and academic stress. Additionally, development of positive factors such as self esteem, decision-making skills, and happiness in middle school students is important to reduce aggression. Copyright © 2014. Published by Elsevier B.V.

  15. A Pattern to Evaluation of Motivational Factors Affecting Knowledge Sharing

    Directory of Open Access Journals (Sweden)

    Elnaz Hajian

    2017-09-01

    Full Text Available This study aimed to identify the motivational factors affecting the willingness of employees to share knowledge and examine intrinsic and extrinsic motivational factors and influences on attitudes toward knowledge sharing and explicit and implicit knowledge sharing intention. Planned behavior pattern is used as a theoretical framework. This research was conducted in two phases. First, factors were identified according to the literature review and exploratory interviews. Then the impact of each factor was evaluated in terms of structural equation modeling. This is an empirical research and the research method is descriptive survey. Data was collected using a questionnaire and interview. The study was on the staff working in administrative units of Tehran Municipality and the number of staff at the time of study was 2230. Cluster sampling method and sample size based on population and using Cochran formula of 328 people determined that 35 persons were not held accountable. To determine the reliability of questionnaires, Cronbach’s alpha coefficient was calculated to 0.824 which was found at a high level. Data was analyzed by SPSS and LISREL software. Finally, the proposed pattern was confirmed. The results showed that the intrinsic and extrinsic motivational factors influence on the attitude of employees and the attitude influence on tacit and explicit knowledge sharing intention. Also, extrinsic motivational factors influence on tacit knowledge sharing intention and intrinsic motivational factors influence on explicit knowledge sharing intention. Extrinsic motivational factors influence on explicit knowledge sharing intention and intrinsic motivational factors influence on tacit knowledge sharing intention by the attitude and tacit knowledge sharing intention influence on explicit knowledge sharing intention.

  16. Factors affecting 30-month survival in lung cancer patients.

    Science.gov (United States)

    Mahesh, P A; Archana, S; Jayaraj, B S; Patil, Shekar; Chaya, S K; Shashidhar, H P; Sunitha, B S; Prabhakar, A K

    2012-10-01

    Age adjusted incidence rate of lung cancer in India ranges from 7.4 to 13.1 per 100,000 among males and 3.9 to 5.8 per 100,000 among females. The factors affecting survival in lung cancer patients in India are not fully understood. The current study was undertaken to evaluate the factors affecting survival in patients diagnosed with lung cancer attending a tertiary care cancer institute in Bangalore, Karnataka, India. Consecutive patients with primary lung cancer attending Bangalore Institute of Oncology, a tertiary care centre at Bangalore, between 2006 and 2009 were included. Demographic, clinical, radiological data were collected retrospectively from the medical records. A total of 170 consecutive subjects (128 males, 42 females) diagnosed to have lung cancer; 151 non-small cell lung cancer (NSCLC) and 19 small cell lung cancer (SCLC) were included. A higher proportion of never-smokers (54.1%) were observed, mostly presenting below the age of 60 yr. Most subjects were in stage IV and III at the time of diagnosis. More than 50 per cent of patients presented with late stage lung cancer even though the duration of symptoms is less than 2 months. The 30-month overall survival rates for smokers and never-smokers were 32 and 49 per cent, respectively. No significant differences were observed in 30 month survival based on age at presentation, gender and type of lung cancer. Cox proportional hazards model identified never-smokers and duration of symptoms less than 1 month as factors adversely affecting survival. Our results showed that lung cancer in Indians involved younger subjects and associated with poorer survival as compared to other ethnic population. Studies on large sample need to be done to evaluate risk factors in lung cancer patients.

  17. CHILDREN'S ADHERENCE TO HAART ADHERENCE

    African Journals Online (AJOL)

    han or equal IQ 2 log" and in 64% of children wirh smaller man 2 log,o decrease in viral load. Secondly, i caregivers are not well prepared for adherence issues before starting HAART, or if regimens are too onerous to follow, treatment is likely to fail. Every effort should be made to see the burden of adherence from the.

  18. Transient improvement of urticaria induces poor adherence as assessed by Morisky Medication Adherence Scale-8.

    Science.gov (United States)

    Kaneko, Sakae; Masuda, Koji; Hiragun, Takaaki; Inomata, Naoko; Furue, Masutaka; Onozuka, Daisuke; Takeuchi, Satoshi; Murota, Hiroyuki; Sugaya, Makoto; Saeki, Hidehisa; Shintani, Yoichi; Tsunemi, Yuichiro; Abe, Shinya; Kobayashi, Miwa; Kitami, Yuki; Tanioka, Miki; Imafuku, Shinichi; Abe, Masatoshi; Hagihara, Akihito; Morisky, Donald E; Katoh, Norito

    2015-11-01

    Poor adherence to medication is a major public health challenge. Here, we aimed to determine the adherence to oral and topical medications and to analyze underlying associated factors using the translated Japanese version of Morisky Medication Adherence Scale-8 regarding urticaria treatment. Web-based questionnaires were performed for 3096 registered dermatological patients, along with a subanalysis of 751 registered urticaria patients in this study. The adherence to oral medication was significantly associated with the frequency of hospital visits. Variables that affected the adherence to topical medication included age and experience of drug effectiveness. The rate of responses that "It felt like the symptoms had improved" varied significantly among the dermatological diseases treated with oral medications. Dermatologists should be aware that adherence to the treatment of urticaria is quite low. Regular visits and active education for patients with urticaria are mandatory in order to achieve a good therapeutic outcome by increasing the adherence. © 2015 The Authors. The Journal of Dermatology published by Wiley Publishing Asia Pty Ltd on behalf of Japanese Dermatological Association.

  19. The extracellular adherence protein (Eap) of Staphylococcus aureus acts as a proliferation and migration repressing factor that alters the cell morphology of keratinocytes.

    Science.gov (United States)

    Eisenbeis, Janina; Peisker, Henrik; Backes, Christian S; Bur, Stephanie; Hölters, Sebastian; Thewes, Nicolas; Greiner, Markus; Junker, Christian; Schwarz, Eva C; Hoth, Markus; Junker, Kerstin; Preissner, Klaus T; Jacobs, Karin; Herrmann, Mathias; Bischoff, Markus

    2017-02-01

    Staphyloccocus aureus is a major human pathogen and a common cause for superficial and deep seated wound infections. The pathogen is equipped with a large arsenal of virulence factors, which facilitate attachment to various eukaryotic cell structures and modulate the host immune response. One of these factors is the extracellular adherence protein Eap, a member of the "secretable expanded repertoire adhesive molecules" (SERAM) protein family that possesses adhesive and immune modulatory properties. The secreted protein was previously shown to impair wound healing by interfering with host defense and neovascularization. However, its impact on keratinocyte proliferation and migration, two major steps in the re-epithelialization process of wounds, is not known. Here, we report that Eap affects the proliferation and migration capacities of keratinocytes by altering their morphology and adhesive properties. In particular, treatment of non-confluent HaCaT cell cultures with Eap resulted in cell morphology changes as well as a significant reduction in cell proliferation and migration. Eap-treated HaCaT cells changed their appearance from an oblong via a trapezoid to an astral-like shape, accompanied by decreases in cell volume and cell stiffness, and exhibited significantly increased cell adhesion. Eap had a similar influence on endothelial and cancer cells, indicative for a general effect of Eap on eukaryotic cell morphology and functions. Specifically, Eap was found to interfere with growth factor-stimulated activation of the mitogen-activated protein kinase (MAPK) pathway that is known to be responsible for cell shape modulation, induction of proliferation and migration of epithelial cells. Western blot analyses revealed that Eap blocked the phosphorylation of extracellular signal-regulated kinase 1 and 2 (Erk1/2) in keratinocyte growth factor (KGF)-stimulated HaCaT cells. Together, these data add another antagonistic mechanism of Eap in wound healing, whereby the

  20. An Improved Reinforcement Learning System Using Affective Factors

    Directory of Open Access Journals (Sweden)

    Takashi Kuremoto

    2013-07-01

    Full Text Available As a powerful and intelligent machine learning method, reinforcement learning (RL has been widely used in many fields such as game theory, adaptive control, multi-agent system, nonlinear forecasting, and so on. The main contribution of this technique is its exploration and exploitation approaches to find the optimal solution or semi-optimal solution of goal-directed problems. However, when RL is applied to multi-agent systems (MASs, problems such as “curse of dimension”, “perceptual aliasing problem”, and uncertainty of the environment constitute high hurdles to RL. Meanwhile, although RL is inspired by behavioral psychology and reward/punishment from the environment is used, higher mental factors such as affects, emotions, and motivations are rarely adopted in the learning procedure of RL. In this paper, to challenge agents learning in MASs, we propose a computational motivation function, which adopts two principle affective factors “Arousal” and “Pleasure” of Russell’s circumplex model of affects, to improve the learning performance of a conventional RL algorithm named Q-learning (QL. Compared with the conventional QL, computer simulations of pursuit problems with static and dynamic preys were carried out, and the results showed that the proposed method results in agents having a faster and more stable learning performance.

  1. Risk factors that influence suicidal behavior in affective disorders

    Directory of Open Access Journals (Sweden)

    Stanojević Albina

    2016-01-01

    Full Text Available It is known in the literature that the incidence and prevalence of suicide and attempted suicide in psychiatric patients is significantly higher than in the general population. The paper examined risk factors for suicidal behavior in the category of admitted patients hospitalized with the diagnosis of sleep disorders and affective (Unipolar resp. Bipolar depression. Study activated by 80 patients, 40 in both diagnostic groups received treatment at the Special Psychiatric Hospital in Gornja Toponica near Nis. The work methodology used are: psychiatric interview, Hamilton Depression Rating Scale (HAMD, and the C-SSRS (Columbia-Suicide Severity Rating Scale- assessment tool that assesses suicidal ideation and behavior. The study results show that there is a relationship between suicidal behavior (suicide attempts and suicidal ideation and the diagnosis of bipolar affective disorder, positive history of previous suicide attempts, so that these factors are stronger, to the degree of suicidality higher. On this sample, clearly suicidal behavior, with the same purpose, intensity of suicidal thoughts and medical impairment after suicide attempts were significantly more frequent in patients with Bipolar Affective Disorder in the depressive phase of the illness. Patients with a previous suicide attempt, and poor personal and social circumstances had a higher rate of attempted suicide.

  2. Factors affecting yearly and monthly visits to Taipei Zoo

    Science.gov (United States)

    Su, Ai-Tsen; Lin, Yann-Jou

    2018-02-01

    This study investigated factors affecting yearly and monthly numbers of visits to Taipei Zoo. Both linear and nonlinear regression models were used to estimate yearly visits. The results of both models showed that the "opening effect" and "animal star effect" had a significantly positive effect on yearly visits, while a SARS outbreak had a negative effect. The number of years had a significant influence on yearly visits. Results showed that the nonlinear model had better explanatory power and fitted the variations of visits better. Results of monthly model showed that monthly visits were significantly influenced by time fluctuations, weather conditions, and the animal star effect. Chinese New Year, summer vacation, numbers of holidays, and animal star exhibitions increased the number of monthly visits, while the number of days with temperatures at or below 15 °C, the number of days with temperatures at or above 30 °C, and the number of rainy days had significantly negative effects. Furthermore, the model of monthly visits showed that the animal star effect could last for over two quarters. The results of this study clarify the factors affecting visits to an outdoor recreation site and confirm the importance of meteorological factors to recreation use.

  3. A systematic study on factors affecting patient dose, (1)

    International Nuclear Information System (INIS)

    Otsuka, Akiyoshi; Higashida, Yoshiharu; Utsumi, Hiromoto; Ota, Masaji; Nakanishi, Takashi

    1979-01-01

    In the study of possible reduction in irradiation dose to patients during medical treatments, the following two methods can be considered: (1) To obtain absorbed doses for each part of a body in diagnostic X-ray examinations. (2) To obtain data on factors such as the tube voltage which may affect patient dose. There are a number of reports both at home and abroad concerning the above (1), but very few reports are available concerning the above (2). Moreover, most of them are on fragmentary aspects of each factor and no systematic reports have been made. For this reason, we have taken up, as factors affecting the patient dose, the field size, the tube voltage, and by checking them again, we wanted to obtain some systematic data. Our aim has been fully attained by conducting an experiment. In the ICRP's Publ. 26 issued last year, the idea of the critical organ which had not been fully elucidated in the Publ. 9 was abandoned. As a result, assessment of the irradiation doses has become more rational and the total risk for an individual was obtained. In Japan, the idea proposed in the Publ. 9 is adopted. Therefore, in this paper, we will raise some questions regarding the assessment of the irradiation doses, pointing out at the same time the rationality of the idea put forward in Publ. 26. (author)

  4. Factors affecting sexual function in menopause: A review article

    Directory of Open Access Journals (Sweden)

    Soheila Nazarpour

    2016-08-01

    Full Text Available This study aimed to systematically review the articles on factors affecting sexual function during menopause. Searching articles indexed in Pubmed, Science Direct, Iranmedex, EMBASE, Scopus, and Scientific Information Database databases, a total number of 42 studies published between 2003 and 2013 were selected. Age, estrogen deficiency, type of menopause, chronic medical problems, partner's sex problems, severity of menopause symptoms, dystocia history, and health status were the physical factors influencing sexual function of menopausal women. There were conflicting results regarding the amount of androgens, hormonal therapy, exercise/physical activity, and obstetric history. In the mental–emotional area, all studies confirmed the impact of depression and anxiety. Social factors, including smoking, alcohol consumption, the quality of relationship with husband, partner's loyalty, sexual knowledge, access to health care, a history of divorce or the death of a husband, living apart from a spouse, and a negative understanding of women's health were found to affect sexual function; however, there were conflicting results regarding the effects of education, occupation, socioeconomic status, marital duration, and frequency of sexual intercourse.

  5. Factors affecting sexual function in menopause: A review article.

    Science.gov (United States)

    Nazarpour, Soheila; Simbar, Masoumeh; Tehrani, Fahimeh Ramezani

    2016-08-01

    This study aimed to systematically review the articles on factors affecting sexual function during menopause. Searching articles indexed in Pubmed, Science Direct, Iranmedex, EMBASE, Scopus, and Scientific Information Database databases, a total number of 42 studies published between 2003 and 2013 were selected. Age, estrogen deficiency, type of menopause, chronic medical problems, partner's sex problems, severity of menopause symptoms, dystocia history, and health status were the physical factors influencing sexual function of menopausal women. There were conflicting results regarding the amount of androgens, hormonal therapy, exercise/physical activity, and obstetric history. In the mental-emotional area, all studies confirmed the impact of depression and anxiety. Social factors, including smoking, alcohol consumption, the quality of relationship with husband, partner's loyalty, sexual knowledge, access to health care, a history of divorce or the death of a husband, living apart from a spouse, and a negative understanding of women's health were found to affect sexual function; however, there were conflicting results regarding the effects of education, occupation, socioeconomic status, marital duration, and frequency of sexual intercourse. Copyright © 2016. Published by Elsevier B.V.

  6. External factors affecting data acquisition during corneal topography examination.

    Science.gov (United States)

    González-Méijome, José Manuel; Queirós, Antonio; Jorge, Jorge; Fernandes, Paulo; Cerviño, Alejandro; de Almeida, José Borges

    2007-03-01

    To analyze the factors affecting data acquisition during corneal topography examination with the Medmont E-300 videokeratoscope and to provide strategies to minimize their effects. Sixty eyes from thirty young adults were examined. A second observer registered incidences with the potential to affect data acquisition. Those factors were correlated with the difficulty of measurements as judged subjectively by the practitioner who performed the examination. Measurements of axial curvature were analyzed to evaluate the variability expressed as intrasession and intersession coefficient of variation and the standard error of the mean (SEM). The level of difficulty rated by the practitioner was in general low, with 70% of the eyes being easy or very easy to measure. For the remaining 30% of the eyes, corneal topography measurements were considered to be difficult (27%) or very difficult (3%). Of the external parameters investigated, only fixation instability (PSEM improved when three readings from each session were considered. The level of subjective difficulty found during videokeratoscopy examination is correlated strongly with fixation instability and the need for head reorientation in the chin rest, whereas tear-related events seem to be less relevant in the practitioner perception of test ease or difficulty. Those factors have relevance in measurement variability.

  7. Factors affecting cardiac rehabilitation referral by physician specialty.

    Science.gov (United States)

    Grace, Sherry L; Grewal, Keerat; Stewart, Donna E

    2008-01-01

    Cardiac rehabilitation (CR) is widely underutilized because of multiple factors including physician referral practices. Previous research has shown CR referral varies by type of provider, with cardiologists more likely to refer than primary care physicians. The objective of this study was to compare factors affecting CR referral in primary care physicians versus cardiac specialists. A cross-sectional survey of a stratified random sample of 510 primary care physicians and cardiac specialists (cardiologists or cardiovascular surgeons) in Ontario identified through the Canadian Medical Directory Online was administered. One hundred four primary care physicians and 81 cardiac specialists responded to the 26-item investigator-generated survey examining medical, demographic, attitudinal, and health system factors affecting CR referral. Primary care physicians were more likely to endorse lack of familiarity with CR site locations (P negatively impacting CR referral practices than cardiac specialists. Cardiac specialists were significantly more likely to perceive that their colleagues and department would regularly refer patients to CR than primary care physicians (P Marketing CR site locations, provision of standardized referral forms, and ensuring discharge summaries are communicated to primary care physicians may improve their willingness to refer to CR.

  8. Factors Affecting Customer Satisfaction in Mobile Telecommunication Industry in Bangladesh

    Directory of Open Access Journals (Sweden)

    Md. Rahman

    2014-06-01

    Full Text Available Identification of factors responsible for customer satisfaction is a key concern of marketing scholars and marketers in now a days and it will remain in the future. There is considerable evidence that quality factors affecting customer satisfaction in numerous ways. However, this empirical study is initiated to find out what particular factors responsible for customer satisfaction in the mobile tel- ecommunication industry in Bangladesh. 282 samples have been collected through structured questionnaire; study reveals that service innovativeness, service reli- ability, service competitiveness and service consistency have significant influence on making customer satisfied and the operator’s network/signal coverage, pricing, offering, fulfillment of customer demand, value added service, brand value and op - erators contribution for society have insignificant influences on making customer satisfied at five percent level of significant at multiple regression analysis. On the basis of these findings; study concludes that in promoting customer satisfaction mobile service providers should be concerned for factors responsible for insignifi- cant influence on customer satisfaction and care of those factors have significant influence on promoting customer satisfaction in telecommunication industry in Bangladesh.

  9. Patient adherence with COPD therapy

    Directory of Open Access Journals (Sweden)

    C. S. Rand

    2005-12-01

    Full Text Available Although there are very few published studies on adherence to treatment regimens in chronic obstructive pulmonary disease (COPD, the evidence that exists suggests that, as with asthma therapy, adherence is poor. Patient beliefs about COPD, as well as their motivation and expectations about the likelihood of success of medical interventions, can influence adherence rates. Other critical factors include the patient's understanding of their illness and therapy, and the complexity of the prescribed treatment regimen. Incorrect inhaler technique is also a common failing. When prescribing in primary or specialist care, healthcare professionals should address adherence as a vital part of the patient consultation. Improved patient education may also increase adherence rates.

  10. Investigation of factors affecting adhesion of 99Tcm labelled colloids to glass vials

    International Nuclear Information System (INIS)

    Elliott, A.T.; Murray, T.; Hilditch, T.E.; Whateley, T.L.

    1990-01-01

    Factors which may possibly influence the adhesion of 99 Tc m labelled colloid to glass vials were investigated. Of five colloids studied, two protein-free tin colloids were affected most by the problem, some 12-18% being lost by adhesion to the glass vial when the colloid was left resting on the bench, or 60-87% when it was rotated for a period of 4 h. The proportion of activity which adhered to the vial was dependent on the time the product had been contained within it, whether on the bench or rotated. Two of the colloids, both of which contained protein, were affected only slightly by the problem, one being a tin colloid and the other a sulphur colloid. An antimony sulphide colloid, which contained no added protein, was virtually unaffected by the problem. The degree of adhesion was not related to the pH of the product, or to the temperature at which the product was stored, nor to the tendency of the colloidal particles to grow in size upon vigorous agitation. (author)

  11. Genetic and physiological factors affecting repair and mutagenesis in yeast

    Energy Technology Data Exchange (ETDEWEB)

    Lemontt, J F

    1979-01-01

    Current views of DNA repair and mutagenesis in the yeast Saccharomyces cerevisiae are discussed in the light of recent data, and with emphasis on the isolation and characterization of genetically well-defined mutations that affect DNA metabolism in general (including replication and recombination). Various pathways of repair are described particularly in relation to their involvement in mutagenic mechanisms. In addition to genetic control, certain physiological factors such as cell age, DNA replication, and the regulatory state of the mating-type locus, are shown to also play a role in repair and mutagenesis.

  12. Genetic and physiological factors affecting repair and mutagenesis in yeast

    Energy Technology Data Exchange (ETDEWEB)

    Lemontt, J F

    1979-01-01

    Current views of DNA repair and mutagenesis in the yeast Saccharomyces cerevisiae are discussed in the light of recent data and with emphasis on the isolation and characterization of genetically well-defined mutations that affect DNA metabolism in general (including replication and recombination). Various pathways of repair are described, particularly in relation to their imvolvement in mutagenic mechanisms. In addition to genetic control, certain physiological factors such as cell age, DNA replication, and the regulatory state of the mating-type locus are shown to also play a role in repair and mutagenesis.

  13. The concept of and factors affecting transport accessibility of seaports

    Directory of Open Access Journals (Sweden)

    Janusz Dąbrowski

    2012-03-01

    Full Text Available Transport accessibility of seaports is a frequently studied area in economic research. In practice, port operators and authorities use it to promote their services and compete in the market. Up to this day, theoretical basis of seaports transport accessibility has not been properly described. The article attempts to systematize and expend the knowledge in this field. New definitions of transport availability from wider and narrower perspectives were suggested; different types of accessibility and their mutual relations were explained. These ideas were complemented by introducing classification of factors affecting transport accessibility of seaports.

  14. Factors That Affect Adolescent Drug Users' Suicide Attempts

    OpenAIRE

    Park, Subin; Song, Hokwang

    2016-01-01

    Drug abuse has been widely linked to suicide risk. We examined the factors that affect adolescent drug users' suicide attempts in South Korea. This study analyzed the data of 311 adolescents who had used drugs such as inhalants, psychotropic drugs, and marijuana (195 males and 116 females). Among 311 subjects, 109 (35.0%) had attempted suicide during the last 12 months. After adjusting for other variables, depressive mood (OR=19.79) and poly-drug use (OR=2.79), and low/middle levels of academ...

  15. Genetic and physiological factors affecting repair and mutagenesis in yeast

    International Nuclear Information System (INIS)

    Lemontt, J.F.

    1979-01-01

    Current views of DNA repair and mutagenesis in the yeast Saccharomyces cerevisiae are discussed in the light of recent data, and with emphasis on the isolation and characterization of genetically well-defined mutations that affect DNA metabolism in general (including replication and recombination). Various pathways of repair are described particularly in relation to their involvement in mutagenic mechanisms. In addition to genetic control, certain physiological factors such as cell age, DNA replication, and the regulatory state of the mating-type locus, are shown to also play a role in repair and mutagenesis

  16. Genetic and physiological factors affecting repair and mutagenesis in yeast

    International Nuclear Information System (INIS)

    Lemontt, J.F.

    1979-01-01

    Current views of DNA repair and mutagenesis in the yeast Saccharomyces cerevisiae are discussed in the light of recent data and with emphasis on the isolation and characterization of genetically well-defined mutations that affect DNA metabolism in general (including replication and recombination). Various pathways of repair are described, particularly in relation to their imvolvement in mutagenic mechanisms. In addition to genetic control, certain physiological factors such as cell age, DNA replication, and the regulatory state of the mating-type locus are shown to also play a role in repair and mutagenesis

  17. Job satisfaction and factors affecting motivation at Posti Oyj

    OpenAIRE

    Shah, Kapil

    2016-01-01

    The business trends and life style of humans are changing rapidly due to globalization and it visibly affects the work environment and employee’s attitude towards the work as the needs and desires of human being are changing too. In such circumstance, it is essential to have motivated team to survive in the market is vital agenda for the firms, where Posti Oyj is not an exception. It has become a challenge for HR officials to study about job satisfaction and motivation including factors affec...

  18. Factors Affecting Tourist Expenditure Coming To Mugla Region

    Directory of Open Access Journals (Sweden)

    Fehime Korkmaz Bingöl

    2012-12-01

    Full Text Available Increasing tourist expenditure is a means to increase tourism income, which is extremely important for local economies. The purpose of this study is to understand the expending pattern of tourists coming to Mugla Region and provide empirical background for the policies to increase per tourist expenditure. The survey conducted at Dalaman International Airport and the data has been analyzed using OLS method. Nationality, age, accommodation type, pension type, credit card usage, availability of shopping facilities, standard of night life and entertainment, quality of food and beverage, length of holiday and group size has been found as significant factors affecting tourist expenditure

  19. Risk factors for non-adherence and loss to follow-up in a three-year clinical trial in Botswana.

    Science.gov (United States)

    Gust, Deborah A; Mosimaneotsile, Barudi; Mathebula, Unami; Chingapane, Balladiah; Gaul, Zaneta; Pals, Sherri L; Samandari, Taraz

    2011-04-25

    Participant non-adherence and loss to follow-up can compromise the validity of clinical trial results. An assessment of these issues was made in a 3-year tuberculosis prevention trial among HIV-infected adults in Botswana. Between 11/2004-07/2006, 1995 participants were enrolled at eight public health clinics. They returned monthly to receive bottles of medication and were expected to take daily tablets of isoniazid or placebo for three years. Non-adherence was defined as refusing tablet ingestion but agreeing to quarterly physical examinations. Loss to follow-up was defined as not having returned for appointments in ≥60 days. Between 10/2008-04/2009, survey interviews were conducted with 83 participants identified as lost to follow-up and 127 identified as non-adherent. As a comparison, 252 randomly selected adherent participants were also surveyed. Multivariate logistic regression analysis was used to identify associations with selected risk factors. Men had higher odds of being non-adherent (adjusted odds ratio (AOR), 2.24; 95% confidence interval [95%CI] 1.24-4.04) and lost to follow-up (AOR 3.08; 95%CI 1.50-6.33). Non-adherent participants had higher odds of reporting difficulties taking the regimen or not knowing if they had difficulties (AOR 3.40; 95%CI 1.75-6.60) and lower odds associated with each year of age (AOR 0.95; 95%CI 0.91-0.98), but other variables such as employment, distance from clinic, alcohol use, and understanding study requirements were not significantly different than controls. Among participants who were non-adherent or lost to follow-up, 40/210 (19.0%) reported that they stopped the medication because of work commitments and 33/210 (15.7%) said they thought they had completed the study. Men had higher odds of non-adherence and loss to follow-up than women. Potential interventions that might improve adherence in trial participants may include:targeting health education for men, reducing barriers, clarifying study expectations, educating

  20. Risk factors for non-adherence and loss to follow-up in a three-year clinical trial in Botswana.

    Directory of Open Access Journals (Sweden)

    Deborah A Gust

    Full Text Available BACKGROUND: Participant non-adherence and loss to follow-up can compromise the validity of clinical trial results. An assessment of these issues was made in a 3-year tuberculosis prevention trial among HIV-infected adults in Botswana. METHODS AND FINDINGS: Between 11/2004-07/2006, 1995 participants were enrolled at eight public health clinics. They returned monthly to receive bottles of medication and were expected to take daily tablets of isoniazid or placebo for three years. Non-adherence was defined as refusing tablet ingestion but agreeing to quarterly physical examinations. Loss to follow-up was defined as not having returned for appointments in ≥60 days. Between 10/2008-04/2009, survey interviews were conducted with 83 participants identified as lost to follow-up and 127 identified as non-adherent. As a comparison, 252 randomly selected adherent participants were also surveyed. Multivariate logistic regression analysis was used to identify associations with selected risk factors. Men had higher odds of being non-adherent (adjusted odds ratio (AOR, 2.24; 95% confidence interval [95%CI] 1.24-4.04 and lost to follow-up (AOR 3.08; 95%CI 1.50-6.33. Non-adherent participants had higher odds of reporting difficulties taking the regimen or not knowing if they had difficulties (AOR 3.40; 95%CI 1.75-6.60 and lower odds associated with each year of age (AOR 0.95; 95%CI 0.91-0.98, but other variables such as employment, distance from clinic, alcohol use, and understanding study requirements were not significantly different than controls. Among participants who were non-adherent or lost to follow-up, 40/210 (19.0% reported that they stopped the medication because of work commitments and 33/210 (15.7% said they thought they had completed the study. CONCLUSIONS: Men had higher odds of non-adherence and loss to follow-up than women. Potential interventions that might improve adherence in trial participants may include:targeting health education for men

  1. 78 FR 46418 - Proposed Information Collection (Obligation To Report Factors Affecting Entitlement) Activity...

    Science.gov (United States)

    2013-07-31

    ... (Obligation To Report Factors Affecting Entitlement) Activity; Comment Request AGENCY: Veterans Benefits... use of other forms of information technology. Title: Obligation to Report Factors Affecting... entitlement factors. Individual factors such as income, marital status, and the beneficiary's number of...

  2. [Eating Disorder Treatment in Iceland - Treatment adherence, psychiatric co-morbidities and factors influencing drop-out].

    Science.gov (United States)

    Gunnarsdottir, Gudrun Mist; Palsson, Sigurdur Pall; Thorsteinsdottir, Gudlaug

    2015-05-01

    Treatment adherence in patients with eating disorders (ED) in Iceland is unknown. The aim of the study was to investigate treatment drop-out and explore factors that influence premature termination of treatment in a specialized ED treatment unit, at the University Hospital of Iceland, during the period of September 1, 2008 - May 1, 2012. The study is retrospective and naturalistic. Hospital records of referred patients were examined. Those meeting the ICD 10 criteria of anorexia nervosa (AN) (F50.0, F50.1), bulimia nervosa (BN) (F50.2, F50.3) and eating disorder not otherwise specified (EDNOS) (F50.9) were included. The total sample was 260 and 182 patients met inclusion criteria. No-shows were 7%. Drop-out was defined as premature termination of treatment without formal discharge. The sample consisted of 176 women and 6 men, mean age 26.3 years. BN was diagnosed in 52.7% of patients, EDNOS in 36.8% AN in 10.4%. 74.7% had one or more co-morbid psychiatric diagnosis. Anxiety- and/or depression were diagnosed in 72.5%, Attention hyperactivity deficiency disorder in 15.4% and personality disorders in 8.2%. Lifetime prevalence of substance use disorders (SUDs) was 30.8%. Drop-out from treatment occurred in 54.4% of cases (with approximately 1/3 returning to treatment), 27.5% finished treatment and 18.1% were still in treatment at the end of the follow up period. Treatment adherence was significantly higher in patients who had a university degree, in those who had themselves taken the initiative to seek ED treatment and in those with higher anxiety scores at assessment. AN patients did better than other ED patients while patients with SUDs showed a tendency for higher drop-out (p=0.079). The drop-out rates were similar to what has been reported from other western countries. Follow-up time was longer and AN patient did better than expected. Higher education, initiative in seeking treatment and higher anxiety scores on questionnaires were protective.

  3. Factors affecting intra-oral pH - a review.

    Science.gov (United States)

    Loke, C; Lee, J; Sander, S; Mei, L; Farella, M

    2016-10-01

    One of the greatest challenges to modern dentistry is the progressive destruction of tooth material due to chemical erosion. Dental erosion is the loss of dental hard tissue, without the action of bacteria, in which demineralisation of enamel and dentine results due to a decrease in intra-oral pH. The aim of this review was to appraise the scientific literature on the factors that can affect intra-oral pH. The review will examine (i) the protective role of human saliva, in terms of its mineral composition, flow rates and buffering systems and (ii) sources of in-mouth acids such as extrinsic acids, which are derived from the diet and environment, as well as intrinsic acids, which are related to disorders of the gastro-oesophageal tract. This review may assist clinicians to identify the risk factors for tooth wear and to recommend adequate preventive measures to patients. © 2016 John Wiley & Sons Ltd.

  4. Service-Oriented Factors Affecting the Adoption of Smartphones

    Directory of Open Access Journals (Sweden)

    Youngmo Kang

    2014-06-01

    Full Text Available This research investigates the adoption factors of smartphones focusing on the differences of smartphone and feature phone users. We used Technology Acceptance Model (TAM which incorporates service-oriented and device-oriented functional attributes as exogenous variables for a product-service system such as smartphones. In addition, Decision Tree (DT and customer surveys were conducted. As a study results, we found that the service-oriented functional attributes - ‘wireless internet’ and ‘mobile applications’ - affect the adoption of smartphones regardless of users. However, the DT results revealed that the more important factor is 'mobile applications' to smartphone users but 'wireless internet' for feature phone users. In conclusion, we discovered that a strategy emphasis on the service-oriented attributes is needed for the adoption of smartphones.

  5. Human Factors Affecting the Patient's Acceptance of Wireless Biomedical Sensors

    Science.gov (United States)

    Fensli, Rune; Boisen, Egil

    In monitoring arrhythmia, the quality of medical data from the ECG sensors may be enhanced by being based on everyday life situations. Hence, the development of wireless biomedical sensors is of growing interest, both to diagnose the heart patient, as well as to adjust the regimen. However, human factors such as emotional barriers and stigmatization, may affect the patient's behavior while wearing the equipment, which in turn may influence quality of data. The study of human factors and patient acceptance is important both in relation to the development of such equipment, as well as in evaluating the quality of data gathered from the individual patient. In this paper, we highlight some important aspects in patient acceptance by comparing results from a preliminary clinical trial with patients using a wireless ECG sensor for three days out-of-hospital service, to available published results from telehomecare projects, and discuss important aspects to be taken into account in future investigations.

  6. Extrinsic factors affecting accuracy of ultrasonic flowmeters for LMFBRs

    International Nuclear Information System (INIS)

    Managan, W.W.

    1976-08-01

    Assuming that ultrasonic flowmeters of suitable intrinsic accuracy are feasible, this report explores factors extrinsic to the flowmeter which affect the accuracy such as asymmetric flow profile, regions of high turbulence and thermal stratification. By integrating isovelocity flow profile maps, the predicted performance of various flowmeter configurations may be compared to experimental data. For the two pipe arrangements analyzed, the single diametral path flowmeter results were within 5 percent of true flow rate. Theoretical correction factors could reduce the error for the straight pipe but increased the error for asymmetrical flow. On the same pipe arrangements a four path ultrasonic flowmeter spaced for Gaussian integration gave less than 1 percent error. For more general conclusions a range of flow profiles produced by typical LMFBR piping arrangements must be analyzed

  7. Factors affecting the employability in people with epilepsy.

    Science.gov (United States)

    Wo, Monica Chen Mun; Lim, Kheng Seang; Choo, Wan Yuen; Tan, Chong Tin

    2016-12-01

    People with epilepsy (PWE) are negatively prejudiced in their ability to work. This study aimed to examine demographic, clinical and psychological factors associated with employability in PWE. This study recruited epilepsy patients from a neurology clinic in Malaysia. Employability was measured using employment ratio, with a ratio ≥90% (ER90) classified as high employability. Basic demographic data such as age, gender, marital status, religion, education level and household income was collected. Clinical measures consisted of age of seizure onset, seizure frequency, type of epilepsy, aura, polytherapy, nocturnal seizures and seizure control. Psychological measures included Work Self-Determination Index (WSDI), Rosenberg Self-Esteem Scale (SES), and Multidimensional Scale of Perceived Social Support (MSPSS). Of 146 PWE, 64.4% had high employability. The participants were predominantly female (52%), Chinese (50.7%), single (50%), having tertiary education (55.5%) and focal epilepsy (72.6%). Clinically, only type of epilepsy was significantly correlated to employability of PWE. Employability of PWE was associated with ability to work (indicated by education level, work performance affected by seizures, ability to travel independently and ability to cope with stress at work) and family overprotection. The high employability group was found to have lower self-perceived stigma (ESS), higher self-determined motivation (WSDI), self-esteem (SES) and perceived social support (MSPSS), than the low employability group. Logistic regression analysis showed that tertiary education level (AOR 3.42, CI: 1.46-8.00), higher self-determination (WSDI, AOR 1.09, CI: 1.012-1.17), lower family overprotection (AOR 0.76, CI: 0.61-0.95), and generalised epilepsy (AOR 4.17, CI: 1.37-12.70) were significant predictors for higher employability in PWE. Ability to work (education level), clinical factor (type of epilepsy) and psychological factor (self-determined motivation and family

  8. COLLABORATION PRACTICE BETWEEN NURSES AND PHYSICIAN AND THE AFFECTING FACTORS

    Directory of Open Access Journals (Sweden)

    Wiwin Martiningsih

    2017-04-01

    Full Text Available Introduction: Collaboration is basically discuss about togetherness, cooperation, sharing tasks, equality, responsibility, and accountability. Purpose of this research was to learn the collaboration practice beetwen nurses and physician and the factors affecting. Method: Design of this research was correlational and comparational study, and population were the physician who work in Ngudi Waluyo Blitar hospitals, intensive cooperation with the nurse in the room, not holding structural positions and not studying, there are 19 peoples taken by total population and nurses who work in Ngudi Waluyo hospitals, not holding structural positions (Head of Division or Head of Section, having relationship with the physician and the samples were 31 peoples taken by probability proportional to size (PPS. Methods of data collection by giving questionnaire about the characteristics of respondents (nurses and physician and practice of collaboration scale. Data characteristics and attitudes of nurses and physicians about the practice of collaboration is analyzed with descriptive statistics, to know the differences between nurses and physicians attitude using mann whitney u test. To know affecting characteristic with nurses and physician attitude by multivariate analysis. Result: Results of mann whitney test p value is 0.611, which means that there is no difference between nurses and physician attitude in practice collaboration, and result of multivariate analysis the influence of nurse characteristics (age, education, functional potition, length of working with attitude are 0.460 or 46%, while 54% influenced by other factors, and the influence of physician characteristics (age, education, length of working with attitude are 0.435 or 43.5%, while 56.5% influenced by other factors. Discussion: Further need to study other factors that influence and research by observation the impact of collaboration between the nurse with physician on the service quality.

  9. Group decision-making: Factors that affect group effectiveness

    Directory of Open Access Journals (Sweden)

    Juliana Osmani

    2016-03-01

    Full Text Available Organizations are operating in a dynamic and turbulent environment. In these conditions, they have to make decisions for new problems or situations. Most of decisions are therefore non-programmed and unstructured, accompanied by risk and uncertainty. Moreover, the problems and situations are complex. All organizations are oriented towards group decisionmaking processes, as useful tools to cope with uncertainty and complexity. Apart from the necessity, companies are turning towards participatory processes also to benefit from the important advantages that these processes offer. Organizations have realized the importance of group decision-making processes to contribute to the creation of sustainable competitive advantages. Main objective of this paper is to show that group decision-making processes do not offer guarantee for good decisions, because the effectiveness of group is affected by many factors. So, the first thing done in this paper is discussing about the benefits and limitations that accompany the use of groups with decision-making purpose. Afterwards, we stop on the different factors that influence the group’s ability to make good decisions. The aim is to emphasize that regardless of the many advantages of groups, some factors as group size, type of communication within the group, leadership style, the norms, the differentiation of roles and statuses, cohesion and compliance degree should be the main elements to keep into consideration because they affect the effectiveness of group. In this regard, is discussed how such factors influence the quality of decision and then we try to draw some conclusions that can improve and make better and easier group decision-making processes.

  10. The Factors that Affect Science Teachers' Participation in Professional Development

    Science.gov (United States)

    Roux, Judi Ann

    Scientific literacy for our students and the possibilities for careers available in Science, Technology, Engineering, and Mathematics (STEM) areas are important topics for economic growth as well as global competitiveness. The achievement of students in science learning is dependent upon the science teachers' effectiveness and experienced science teachers depend upon relevant professional development experiences to support their learning. In order to understand how to improve student learning in science, the learning of science teachers must also be understood. Previous research studies on teacher professional development have been conducted in other states, but Minnesota science teachers comprised a new and different population from those previously studied. The purpose of this two-phase mixed methods study was to identify the current types of professional development in which experienced, Minnesota secondary science teachers participated and the factors that affect their participation in professional development activities. The mixed-methods approach s utilized an initial online survey followed by qualitative interviews with five survey respondents. The results of the quantitative survey and the qualitative interviews indicated the quality of professional development experiences and the factors which affected the science teachers' participation in professional development activities. The supporting and inhibiting factors involved the availability of resources such as time and money, external relationships with school administrators, teacher colleagues, and family members, and personal intrinsic attributes such as desires to learn and help students. This study also describes implications for science teachers, school administrators, policymakers, and professional development providers. Recommendations for future research include the following areas: relationships between and among intrinsic and extrinsic factors, science-related professional development activities

  11. Factors Affecting Husband Participation in Antenatal Care Attendance and Delivery

    Science.gov (United States)

    Rumaseuw, R.; Berliana, S. M.; Nursalam, N.; Efendi, F.; Pradanie, R.; Rachmawati, P. D.; Aurizki, G. E.

    2018-02-01

    The government has implemented several programs to prevent and reduce a mother’s mortality rate by enhancing active role of the family. The most responsible family member on maintaining the pregnancy and delivery process is the husband. The husband must be active to take care of his wife. Active participation of the husband in accompanying his wife during pregnancy and the delivery process is one of the substantial factors, which helps the husband to take decisions related to the health of his wife. This study aimed to identify variables and its trends, which significantly affect a husband’s participation in accompanying his wife during pregnancy and the delivery process. The data used in this study was from an Indonesian Demographic Health Survey 2012. The study used binary logistic regression as the analysis method. The result showed as many as 8,237 husbands accompanied their wife in antenatal care and the delivery process. The significant variables affecting the husband participation are the age of the wife, the education of wife, the education of the husband, the occupational status of the wife and the husband, the number of children, pregnancy status, and residency region. The possibility for a husband to accompany his wife is larger in several factors, such as the wife being between the ages of 21 - 35 years old, a husband who minimally graduated from junior high school, a working husband, as well as a wife, and the number of children less than and equal to two and the expected pregnancy. The government should consider those factors to create policy related women’s health and integrate the factors into various sectors.

  12. Adherence to adjuvant endocrine therapy: is it a factor for ethnic differences in breast cancer outcomes in New Zealand?

    Science.gov (United States)

    Seneviratne, Sanjeewa; Campbell, Ian; Scott, Nina; Kuper-Hommel, Marion; Kim, Boa; Pillai, Avinesh; Lawrenson, Ross

    2015-02-01

    Despite the benefits of adjuvant endocrine therapy for hormone receptor positive breast cancer, many women are non-adherent or discontinue endocrine treatment early. We studied differences in adherence to adjuvant endocrine therapy by ethnicity in a cohort of New Zealand women with breast cancer and its impact on breast cancer outcomes. We analysed data on women (n = 1149) with newly diagnosed hormone receptor positive, non-metastatic, invasive breast cancer who were treated with adjuvant endocrine therapy in the Waikato during 2005-2011. Linked data from the Waikato Breast Cancer Registry and National Pharmaceutical Database were examined to identify differences by ethnicity in adherence to adjuvant endocrine therapy and the effect of sub-optimal adherence on cancer recurrence and mortality. Overall, a high level of adherence of ≥80% was observed among 70.4% of women, which declined from 76.8% to 59.3% from the first to fifth year of treatment. Māori women were significantly more likely to be sub-optimally adherent (breast cancer mortality (HR = 1.77, 95% CI 1.05-2.99) and recurrence (HR = 2.14, 95% CI 1.46-3.14). Sub-optimal adherence to adjuvant endocrine therapy was a likely contributor for breast cancer mortality inequity between Māori and European women, and highlights the need for future research to identify effective ways to increase adherence in Māori women. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Factors that affect coseismic folds in an overburden layer

    Science.gov (United States)

    Zeng, Shaogang; Cai, Yongen

    2018-03-01

    Coseismic folds induced by blind thrust faults have been observed in many earthquake zones, and they have received widespread attention from geologists and geophysicists. Numerous studies have been conducted regarding fold kinematics; however, few have studied fold dynamics quantitatively. In this paper, we establish a conceptual model with a thrust fault zone and tectonic stress load to study the factors that affect coseismic folds and their formation mechanisms using the finite element method. The numerical results show that the fault dip angle is a key factor that controls folding. The greater the dip angle is, the steeper the fold slope. The second most important factor is the overburden thickness. The thicker the overburden is, the more gradual the fold. In this case, folds are difficult to identify in field surveys. Therefore, if a fold can be easily identified with the naked eye, the overburden is likely shallow. The least important factors are the mechanical parameters of the overburden. The larger the Young's modulus of the overburden is, the smaller the displacement of the fold and the fold slope. Strong horizontal compression and vertical extension in the overburden near the fault zone are the main mechanisms that form coseismic folds.

  14. The main factor affecting the competitiveness of Contractor Company

    Science.gov (United States)

    Nurisra; Malahayati, Nurul; Mahmuddin

    2018-05-01

    Contractor companies must have the competitive advantage to compete in maintaining the survival of the company. Problems arise because quite a lot of advantages can be used and these advantages must be used appropriately to produce competitiveness for the company to continue to compete and to win the competition. This study aims to determine the main factors affecting the competitiveness of medium-class contractors in Banda Aceh. Data collection was obtained through questionnaires distributed to 31 middle-class contractors in Banda Aceh. Data processing and analysis is done by using descriptive analysis. Based on the result of descriptive analysis, it can be concluded that the most important competitiveness factor with a mean score value 4.52 is the relationship, and the factor that has the highest mean score value is the relationship with the government of 4.97, while the result of the ranking analysis is obtained 25 factor that is critical to the competitiveness of medium-class contractors in Banda Aceh.

  15. Association of adherence to therapy and complementary and alternative medicine use with demographic factors and disease phenotype in patients with inflammatory bowel disease.

    Science.gov (United States)

    Lakatos, Peter Laszlo; Czegledi, Zsofia; David, Gyula; Kispal, Zsofia; Kiss, Lajos S; Palatka, Karoly; Kristof, Tunde; Nagy, Ferenc; Salamon, Agnes; Demeter, Pal; Miheller, Pal; Szamosi, Tamas; Banai, Janos; Papp, Maria; Bene, Laszlo; Kovacs, Agota; Racz, Istvan; Lakatos, Laszlo

    2010-09-01

    Previous studies have suggested an increasing use of complementary and alternative medicine (CAM) in patients with inflammatory bowel disease (IBD). Furthermore, a significant number of IBD patients fail to comply with treatment. The aim of our study was to evaluate the prevalence of non-adherence and the use of CAM in Hungarian patients with IBD. A total of 655 consecutive IBD patients (CD: 344, age: 38.2 [SD 12.9]years; UC: 311, age: 44.9 [15.3]years) were interviewed during the specialist visit by self-administered questionnaire including demographic and disease-related data as well as items analyzing the extent of non-adherence and CAM use. Patients taking more than 80% of each prescribed medication were classified as adherent. The overall rate of self-reported non-adherence (CD: 20.9%, UC: 20.6%) and CAM (CD: 31.7%, UC: 30.9%) use did not differ between Crohn's disease (CD) and ulcerative colitis (UC). The most common causes of non-adherence were: forgetfulness (47.8%), too many/unnecessary pills (39.7%), being afraid of side effects (27.9%) and too frequent dosing. Most common forms of CAM were herbal tea (47.3%), homeopathy (14.6%), special diet (12.2%), and acupuncture (5.8%). In CD, disease duration, date of last follow-up visit, educational level and previous surgeries were predicting factors for non-adherence. Alternative medicine use was associated in both diseases with younger age, higher educational level, and immunosuppressant use. In addition, CAM use in UC was more common in females and in patients with supportive psychiatric/psychological therapy. Non-adherence and CAM use is common in patients with IBD. Special attention should be paid to explore the identified predictive factors during follow-up visits to improve adherence to therapy and improving patient-doctor relationship. Copyright © 2009 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  16. Factor affecting happiness among nursing students in South Korea.

    Science.gov (United States)

    Jun, W H; Jo, M J

    2016-08-01

    WHAT IS KNOWN ON THE SUBJECT?: Despite the increased interest in nursing students' happiness in South Korea, few studies have attempted to identify factors influencing their happiness. Therefore, nursing educators should consistently investigate the factors influencing happiness and develop strategies to improve happiness among Korean nursing students. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This study confirmed that there were positive correlations between grateful disposition, social support and happiness. In addition, grateful disposition and support from intimate people were identified as predictors of happiness in Korean nursing students. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Development of intervention programmes to help nursing students increase grateful disposition and support from intimate people may be helpful for improving happiness. These programmes can include activity, such as writing a gratitude journal, and extracurricular programmes, such as mentoring programmes between seniors and juniors and/or professor and student. Introduction Happiness is very important in the training and development of nursing students as future nurses. However, nursing students experience a high level of stress and low level of happiness in South Korea. Aim This study aimed to investigate factors that affect happiness among nursing students in South Korea. Method Data were collected from a total of 241 nursing enrolled in two 4-year baccalaureate nursing programmes in South Korea, using a self-administrated questionnaire. To identify predictors of happiness, stepwise regression analysis was conducted. Results The results indicated that grateful disposition and support from intimate people significantly predict happiness among Korean nursing students. These two factors accounted for 38.0% of the variance in happiness. Discussion This study indicated grateful disposition and support from intimate people as factors promoting happiness in nursing students. The findings

  17. Chesapeake Bay recovery and factors affecting trends: Long-termmonitoring, indicators, and insights

    Science.gov (United States)

    Tango, Peter J.; Batiuk, Richard A.

    2016-01-01

    Monitoring the outcome of restoration efforts is the only way to identify the status of a recovery and the most effective management strategies. In this paper, we discuss Chesapeake Bay and watershed recovery and factors influencing water quality trends. For over 30 years, the Chesapeake Bay Program Partnership’s long-term tidal and watershed water quality monitoring networks have measured physical, chemical and biological parameters throughout the bay and its surrounding watershed underpinning an adaptive management process to drive ecosystem recovery. There are many natural and anthropogenic factors operating and interacting to affect the watershed and bay water quality recovery responses to management actions. Across habitats and indicators, the bay and its watershed continue to express a diverse spatial and temporal fabric of multiscale conditions, stressors and trends that show a range of health conditions and impairments, as well as evidence of progress and degradation. Recurrent independent reviews of the monitoring program have driven a culture of continued adaptation of the monitoring networks to reflect ever evolving management information needs. The adherence to bay and watershed-wide consistent monitoring protocols provides monitoring data supporting analyses and development of scientific syntheses that underpin indicator and model development, regulatory assessments, targeting of management actions, evaluation of management effectiveness, and directing of priorities and policies.

  18. Patterns of Adherence of Helicobacter pylori Clinical Isolates to Epithelial Cells, and its Association with Disease and with Virulence Factors.

    Science.gov (United States)

    Vázquez-Jiménez, Flor Elizabeth; Torres, Javier; Flores-Luna, Lourdes; Cerezo, Silvia Giono; Camorlinga-Ponce, Margarita

    2016-02-01

    Adherence to the gastric epithelium is one of the most important steps of Helicobacter pylori to remain and cause disease. The aim of this study was to analyze whether H. pylori isolates from patients with different gastroduodenal diseases present differences in the pattern of adherence to gastric epithelial cells (AGS), in the ability to induce IL-8, and in the presence of virulence genes. We tested 75 H. pylori strains isolated from nonatrophic gastritis, gastric cancer, and duodenal ulcer patients. The adhesion pattern and IL-8 induction were determined in AGS cells, and invasion of AGS cells was studied using a gentamicin protection assay. The IL-8 levels induced were determined by ELISA. Helicobacter pylori strains presented diffuse adherence (DA) and localized (LA) adherence patterns, similar to those described for enteropathogenic E. coli (EPEC), were observed in AGS cells. A DA pattern was observed in 57% and LA in 43% of the strains, and DA was more frequent in isolates from patients with gastric cancer (p = 0.044). Strains with a LA pattern induced higher levels of IL-8 (p = 0.042) in AGS cells. The adherence pattern was not associated with neither invasiveness nor with the presence of virulence genes. Our study shows that H. pylori strains present adherence patterns to AGS cells resembling those observed in EPEC and that these patterns may be associated with disease and with activity on AGS cells. © 2015 John Wiley & Sons Ltd.

  19. Factors associated with high rates of antiretroviral medication adherence among youth living with perinatal HIV in Thailand.

    Science.gov (United States)

    Kang, Ezer; Delzell, Darcie A P; Chhabra, Manik; Oberdorfer, Peninnah

    2015-07-01

    Antiretroviral medication adherence behaviour among Thai youth with perinatal HIV in Thailand has received growing attention. However, few studies have examined individual predictors of antiretroviral adherence using multiple self-reports. A convenience sample of 89 Thai youth (interquartile range 14-16 years) with perinatal HIV at three paediatric programmes in Chiang Mai completed a structured questionnaire and reported their antiretroviral adherence in the past one, seven and 30 days using count-based recall and a visual analog scale. Mean self-reported adherence rates ranged from 83.5% (past 30 days) to 99.8% (yesterday) of the time. One-inflated beta regression models were used to examine the associations between antiretroviral adherence outcomes, treatment self-efficacy, depression, anxiety, social support and beliefs/attitudes about medications. Higher percentage of medications taken in the past 30 days was independently associated with higher treatment self-efficacy and fewer symptoms of depression. Adherence monitoring would benefit from focal assessment of youth depression and perceived capacity to follow their antiretroviral regimen. © The Author(s) 2014.

  20. Health Promotion Behaviors of Women and Affecting Factors

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    Naile Bilgili

    2009-12-01

    Full Text Available AIM: Women should be healthy and have health promotion behaviors, so they can accomplish both their maternal and social tasks. This descriptive study was conducted to determine the healthy life-style behaviors of married women and the factors which could affect those behaviors. METHOD: The population comprised all married women older than 15 years and who live in Ankara Kale region. Three hundred-sixty five married women were included in the study. The questionnaire form and the healthy life-style behaviors scale was used for data collection. RESULTS: The mean score taken from scale was 112.2±19.4. The scores of the women who graduated from middle school / high school, who have sufficient income and good socio-economic status, who have a perception of physical health fairly good and who have any chronic disease in their families, have significantly higher mean scores from healthy life-style behaviors scale and subgroups (p<0.05 CONCLUSION: Health promotion behaviors of the women was low and some factors like education level, income, socioeconomic status, perception of health, having any chronic illness and using regular medicine affected healthy life-style behaviors. It is recommended that nurses, who have education and consultation roles, should inform the women about health promotion behaviors and encourage them to use that information in their lives. [TAF Prev Med Bull 2009; 8(6.000: 497-502

  1. Identification and assessment of risk factors affecting construction projects

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    Mohamed Sayed Bassiony Ahmed Abd El-Karim

    2017-08-01

    Unexpected increase in cost and delays in construction projects are caused by owner, contractor, environments, etc. in which several types of risk factors may occur concurrently. The effect of cost overrun and schedule overrun do not only influence the construction industry but the overall economy as well. Even though construction project increasing in cost and schedule has received extensive attention of researchers, but because of continuous changes and development in the field, the study considered of added value to the construction industry in Egypt, in addition to risk strategy and plan analysis. In order to meet the deadline of a project and due to the complex nature of construction projects, cost and scheduling should be flexible enough to accommodate changes without negatively affecting the overall project cost and duration. As such, the objectives of the presented research in this paper are to identify, study, and assess the effect of the factors that affect cost and time contingency. Data are collected from sixteen construction companies in Egypt. The collected data, output charts and analyses spreadsheets will be used for the development of computerized model built by the authors with identification abbreviation RIAM.

  2. Demographic Factors Affecting Internet Using Purposes of High School Students

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    Abdullah Faruk Kılıç

    2017-01-01

    Full Text Available This study aimed at determining the impact of demographic factors on the Internet usage purposes of high school students. The population of the study consisted of students between 9th and 12th grades from the Anatolian high schools, science high schools, social sciences high schools, sports high schools and fine arts high schools in Turkey. The sample was chosen through the stratified and cluster sampling procedure. The students were chosen randomly depending on the regions of their school attendance. The sample for this research numbered 3170 students. The research was conducted in the second term of the 2014-2015 academic year. The data were obtained through online forms and the bases of participation are honesty, sincerity, and volunteerism. The data collection tool is a questionnaire and a demographic information form prepared by the researchers. Chi-square Automatic Interaction Detector (CHAID analysis was conducted through SPSS in order to determine the demographic factors affecting the purposes of internet usage among high school students. The results of this research show that 9th grade students in Turkey mostly use the Internet to do homework while students from other grades mostly use the Internet for social networking. The male students use the Internet for playing video games more frequently in comparison with female students. Also, socioeconomic status affects the purpose of Internet usage. Hence it is suggested that teachers talking to male students might use the examples of computers and games and with female students they might relate the topics to social media.

  3. Long-term adherence to antimuscarinic drugs when treating overactive bladder in the older: Subjective reason and objective factors

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    Kirill Vladimirovich Kosilov

    2017-03-01

    Full Text Available Purpose: Comparison of subjective reasons for the refusal of antimuscarinic treatment and the state of objective economic, social, psychological and health status markers in the elderly with overactive bladder. Materials and Methods: One thousand seven hundred thirty-six (1,736 patients participated in the experiment: 1,036 or 59.7% of women, and 700 or 40.3% of men aged over 60 years (average age, 68.1 years who took antimuscarinic (AM drugs during the year. The control of objective parameters was carried out by studying patients’ medical records, the use of overactive bladder questionnaire short form and Medical Outcomes Study 36-item Shor-Form Health Survey, voiding diaries, uroflowmetry, as well as income certificates from the Tax Inspectorate, support documentation for expenses on drugs. Results: Fifty-two point six percent (52.6% of patients preserved adherence to treatment during the first 6 months, 30.1% – during the follow-up period. The average time of reaching a 30-day break in the AM drugs administration was 174 days. In 36.5% of cases of the refusal of treatment, patients referred to medical reasons for the refusal, in 31.6% of cases disturbance was established in objective health status markers (differences were significant in 30% of the follow-up time. The percentage of refusals of treatment for social and psychological reasons (13.2% was significantly lower (p≤0.05, than the percentage of individuals with statuses altered objectively (21.9%. Conclusions: A significant share of elderly patients taking AM drugs when treating overactive bladder is inclined to overestimate the importance of health factors influencing their decisions and to underestimate the importance of social and psychological factors, and an urologist should take it into account for the efficacy evaluation.

  4. Comparison of objective and subjective factors in the adherence to antimuscarinics when treating overactive bladder in employed persons.

    Science.gov (United States)

    Kosilov, Kirill Vladimirovich; Loparev, Sergey; Kuzina, Irina; Prokofyeva, Alexandra

    2017-12-01

    This study examines subjective reasons for the refusal of treatment and the state of objective status markers of various factors influencing the resistance of patients when treating overactive bladder by antimuscarinic drugs (AMs). The socioeconomic and medical parameters were studied in 2465 patients aged 18-60 years (1446 women (58.7%), 1019 men (41.3%); mean age was 52.1) taking AMs during the year. The study control was carried out by studying passport data, employers' income certificates, patients' ambulatory medical records, the use of OABq-SF and MOS SF-36 questionnaires, voiding diaries and uroflowmetry. The average time to reach the 30-day break in the AM administration was 177 days. During the 12-month follow up, 74.7% of patients discontinued their participation. In total, 35.9% of patients stated medical reasons for the refusal of AM treatment; in 31.9% of individuals in the group the deviation of objective health status markers from average sample values was established. Economic reasons for the refusal were given by 20.4% of patients; in 18.5% of individuals economic status markers were different from average sample values. In 24.1% of cases of refusal of treatment, patients indicated social and psychological reasons; objective social and psychological status markers were altered in 35.9%. The percentage of patients indicating economic and medical reasons for the refusal of AM treatment is statistically uniform with respect to the percentage of patients with objective disturbances of health and economic statuses. The percentage of patients indicating social and psychological factors as a reason for the refusal of treatment was significantly lower than the percentage of patients with altered social and psychological status markers. These results can be used in practical healthcare when predicting adherence to AM use.

  5. Factors affecting translocation and sclerotial formation in Morchella esculenta

    International Nuclear Information System (INIS)

    Amir, R.; Levanon, D.; Hadar, Y.; Chet, I.

    1995-01-01

    Amir, R., Levanon, D., Hadar, Y., and Chet, I. 1995. Factors affecting translocation and sclerotial formation in Morchella esculenta. Experimental Mycology 19, 61-70. Morchella esculenta was grown on square split plates, forming sclerotia on one side and mycelium on the other. After the fungus ceased to colonize and before sclerotial initials appeared, [ 14 C]3-O-methyl glucose was added to the edge of the plate on the mycelial side. The effect of various activities in the mycelium (source) and sclerotia (sink) on sclerotial formation and translocation were examined using inhibitors and water potential changes of the media. Sodium azide or cycloheximide applied separately to both sides inhibited both sclerotial formation and translocation, showing that processes in the source and sink depend on metabolic activities as well as protein synthesis. The use of nikkomycin inhibited sclerotial formation, without affecting translocation to the sclerotia. Since the hyphal tips swelled and burst, the translocated compounds were lost to the media. In a strain defective in sclerotial formation, used as a control, no translocation took place, showing that there is a connection between sclerotial formation and translocation. Reversal of the water potential gradient between the two media (lower on the mycelial side), reduced the formation of sclerotia and translocation to them. Translocation to Morchella sclerotia takes place via turgor driven mass flow, but is nevertheless affected by activities in both the source and the sink. (author)

  6. Factors affecting the reproductive potential of dairy cows

    International Nuclear Information System (INIS)

    Folman, Y.; Rosenberg, M.; Kaim, M.

    1990-01-01

    Various factors that affect fertility were examined in high yielding dairy cows. In cows treated for the synchronization of oestrous cycles, manifestation of oestrus following synchronization treatment was affected by the body condition score in the winter; 74% of the cows had a low score. Primiparous cows that were thin or fat had a low conception rate. The conception rate of multiparous cows with different body condition scores did not differ in the winter. However, in the summer, thin, medium-low, medium-high and fat cows had a conception rate of 15, 36, 48 and 27%, respectively (P 4 ) levels five days before the first post-partum AI affected conception rates. Primiparous cows with low (≤2 ng/mL), medium (2.1-4.0 ng/mL) and high (≥4.1 ng/mL) P 4 levels had a conception rate of 28, 17 and 61%, respectively (P 4 had a conception rate of 25, 46 and 52%, respectively (P<0.02). Cows in their fifth or later lactation that were fed straw as their sole roughage had a conception rate of 23% and a 120 day pregnancy rate of 23%. Cows of the same parities that were fed hay had a conception rate of 50% (P<0.05) and a pregnancy rate of 80% (P<0.005). (author). 15 refs, 5 tabs

  7. Factors associated with non-adherence to antiretroviral therapy in adults with AIDS in the first six months of treatment in Salvador, Bahia State, Brazil.

    Science.gov (United States)

    Silva, José Adriano Góes; Dourado, Inês; Brito, Ana Maria de; Silva, Carlos Alberto Lima da

    2015-06-01

    The control of viral replication is essential in the highly active antiretroviral therapy (HAART), and adherence to therapy is instrumental for such control. Individual and external factors influence adhesion to the use of antiretroviral (ARV) drugs. This is a cross-sectional study to investigate factors associated with non-adherence to HAART in AIDS patients in Salvador, Bahia State, Brazil, with age ≥ 13 years and first prescription in 2009. Data was collected from patient charts and pharmacy records. From a total of 216 patients, 65.3% were males; mean age 37.8 ± 9.5 years; single, 67.9%; heterosexual, 64%; more than 8 years of school education, 65.3%; alcohol users, 61.5%; non-smokers, 75,1% or non-illicit drug users, 93.7%. A proportion of 94% started ARV therapy with TCD4+ drug reaction. The prevalence of non-adherence was 25%. The variables associated were: longer time between HIV infection and AIDS (aOR = 3.9), adverse drug reaction (aOR = 2.4), under 34 years of age (aOR = 2.2), less than 8 years of school education (aOR = 2.2) and illicit drugs use (aOR = 2.6). A high-non-adherence rate is an important problem within the first six months of HAART.

  8. Multiple Weather Factors Affect Apparent Survival of European Passerine Birds

    Science.gov (United States)

    Salewski, Volker; Hochachka, Wesley M.; Fiedler, Wolfgang

    2013-01-01

    Weather affects the demography of animals and thus climate change will cause local changes in demographic rates. In birds numerous studies have correlated demographic factors with weather but few of those examined variation in the impacts of weather in different seasons and, in the case of migrants, in different regions. Using capture-recapture models we correlated weather with apparent survival of seven passerine bird species with different migration strategies to assess the importance of selected facets of weather throughout the year on apparent survival. Contrary to our expectations weather experienced during the breeding season did not affect apparent survival of the target species. However, measures for winter severity were associated with apparent survival of a resident species, two short-distance/partial migrants and a long-distance migrant. Apparent survival of two short distance migrants as well as two long-distance migrants was further correlated with conditions experienced during the non-breeding season in Spain. Conditions in Africa had statistically significant but relatively minor effects on the apparent survival of the two long-distance migrants but also of a presumably short-distance migrant and a short-distance/partial migrant. In general several weather effects independently explained similar amounts of variation in apparent survival for the majority of species and single factors explained only relatively low amounts of temporal variation of apparent survival. Although the directions of the effects on apparent survival mostly met our expectations and there are clear predictions for effects of future climate we caution against simple extrapolations of present conditions to predict future population dynamics. Not only did weather explains limited amounts of variation in apparent survival, but future demographics will likely be affected by changing interspecific interactions, opposing effects of weather in different seasons, and the potential for

  9. Companion of choice at birth: factors affecting implementation.

    Science.gov (United States)

    Kabakian-Khasholian, Tamar; Portela, Anayda

    2017-08-31

    Two recent recommendations made by the World Health Organization confirm the benefits of companion of choice at birth on labour outcomes; however institutional practices and policies do not always support its implementation in different settings around the world. We conducted a review to determine factors that affect implementation of this intervention considering the perspectives and experiences of different stakeholders and other institutional, systemic barriers and facilitators. Forty one published studies were included in this review. Thirty one publications were identified from a 2013 Cochrane review on the effectiveness of companion of choice at birth. We also reviewed 10 qualitative studies conducted alongside the trials or other interventions on labour and birth companionship identified through electronic searches. The SURE (Supporting the Use of Research Evidence) framework was used to guide the thematic analysis of implementation factors. Women and their families expressed appreciation for the continuous presence of a person to provide support during childbirth. Health care providers were concerned about the role of the companion and possible interference with activities in the labour ward. Allocation of resources, organization of care, facility-related constraints and cultural inclinations were identified as implementation barriers. Prior to introducing companion of choice at birth, understanding providers' attitudes and sensitizing them to the evidence is necessary. The commitment of the management of health care facilities is also required to change policies, including allocation of appropriate physical space that respects women's privacy. Implementation research to develop models for different contexts which could be scaled up would be useful, including documentation of factors that affected implementation and how they were addressed. Future research should also focus on documenting the costs related to implementation, and on measuring the impact of

  10. [Factors affecting re-smoking in male workers].

    Science.gov (United States)

    Yang, Jin-Hoon; Ha, Hee-Sook; Kam, Sin; Lim, Ji-Seun; Kang, Yune-Sik; Lee, Duk-Hee; Chun, Byung-Yeol

    2005-05-01

    This study was performed to examine the factors affecting re-smoking in male workers. A self-administrated questionnaire survey was conducted during April 2003 to examine the smoking state of 1,154 employees of a company that launched a smoking cessation campaign in 1998. Five hundred and eighty seven persons, who had stopped smoking for at least one week, were selected as the final study subjects. This study collected data on smoking cessation success or failure for 6 months, and looked at the factors having an effect on resmoking within this period. This study employed the Health Belief Model as its theoretical basis. The re-smoking rate of the 587 study subjects who had stopped smoking for at least one week was 44.8% within the 6 month period. In a simple analysis, the resmoking rates were higher in workers with a low age, on day and night shifts, blue collar, of a low rank, where this was their second attempt at smoking cessation and for those with a shorter job duration (pHeath Belief Model, re-smoking was significantly related with the perceived susceptibility factor, economic advantages of smoking cessation among the perceived benefits factor, the degree of cessation trial's barrier of the perceived barriers factor, smoking symptom experience, recognition of the degree of harmfulness of environmental tobacco smoke and the existence of chronic disease due to smoking (psmoking, the significant variables were age, perceived susceptibility for disease, economic advantages due to smoking cessation, the perceived barrier for smoking cessation, recognition on the degree of harmfulness of environmental tobacco smoke, the existence of chronic disease due to smoking and the number of attempts at smoking cessation (psmoking ban policy within the work place, health education that improves the knowledge of the adverse health effects of smoking and the harmfulness of environmental tobacco smoke will be required, as well as counter plans to reduce the barriers for smoking

  11. Associations between patients' adherence and GPs' attitudes towards risk, statin therapy and management of non-adherence

    DEFF Research Database (Denmark)

    Barfoed, Benedicte L; Paulsen, Maja S; Christensen, Palle M

    2016-01-01

    BACKGROUND: Previous studies suggest that doctors' personal lifestyle, risk taking personality and beliefs about risk reducing therapies may affect their clinical decision-making. Whether such factors are further associated with patients' adherence with medication is largely unknown. OBJECTIVE...... statin treatment as important, how they managed non-adherence and whether non-adherence annoyed them. The Jackson Personality Inventory-revised was used to measure risk attitude. The GPs' responses were linked to register data on their patients' redeemed statin prescriptions. Mixed effect logistic...

  12. Factors Affecting Healthful Eating Among Touring Popular Musicians and Singers.

    Science.gov (United States)

    Cizek, Erin; Kelly, Patrick; Kress, Kathleen; Mattfeldt-Beman, Mildred

    2016-06-01

    Maintaining good health is essential for touring musicians and singers. The stressful demands of touring may impact food choices, leading to detrimental effects on health and performance. This exploratory pilot study aimed to assess factors affecting healthful eating of touring musicians and singers. A 46-item survey was used to assess food- and nutrition-related attitudes, knowledge and behaviors, and environmental factors, as well as lifestyle, musical background, and demographic data. Participants (n=35) were recruited from a musicians' assistance foundation as well as touring musical theater productions and a music festival. Results indicate that touring musicians and singers had positive attitudes regarding healthful foods. Of 35 respondents, 80.0% indicated eating healthful food was important to them. Respondents reported feeling confident selecting (76.5%) and preparing (82.4%) healthful foods; however, they showed uncertainty when determining if carbohydrate-containing foods should be consumed or avoided. Respondents indicated environmental factors including availability and cost of healthy food options and tour schedules limited access to healthful foods. Venues (73.5%), fast food restaurants (67.6%), and airports (64.7%) were the most frequently identified locations in need of offering more healthful food choices. Respondents (52.9%) indicated more support from others while touring would help them make healthier food choices. More research is needed to develop mobile wellness programs as well as performance-based nutrition guidelines for musicians and singers that address the unique demands associated with touring.

  13. A Study on Factors Affecting Airborne LiDAR Penetration

    Directory of Open Access Journals (Sweden)

    Wei-Chen Hsu

    2015-01-01

    Full Text Available This study uses data from different periods, areas and parameters of airborne LiDAR (light detection and ranging surveys to understand the factors that influence airborne LiDAR penetration rate. A discussion is presented on the relationships between these factors and LiDAR penetration rate. The results show that the flight height above ground level (AGL does not have any relationship with the penetration rate. There are some factors that should have larger influence. For example, the laser is affected by a wet ground surface by reducing the number of return echoes. The field of view (FOV has a slightly negative correlation with the penetration rate, which indicates that the laser incidence angle close to zero should achieve the best penetration. The vegetation cover rate also shows a negative correlation with the penetration rate, thus bare ground and reduced vegetation in the aftermath of a typhoon also cause high penetration rate. More return echoes could be extracted from the full-waveform system, thereby effectively improving the penetration rate. This study shows that full-waveform LiDAR is an effective method for increasing the number of surface reflected echoes. This study suggests avoiding LiDAR survey employment directly following precipitation to prevent laser echo reduction.

  14. Risk factors affecting chronic rupture of the plantar fascia.

    Science.gov (United States)

    Lee, Ho Seong; Choi, Young Rak; Kim, Sang Woo; Lee, Jin Yong; Seo, Jeong Ho; Jeong, Jae Jung

    2014-03-01

    Prior to 1994, plantar fascia ruptures were considered as an acute injury that occurred primarily in athletes. However, plantar fascia ruptures have recently been reported in the setting of preexisting plantar fasciitis. We analyzed risk factors causing plantar fascia rupture in the presence of preexisting plantar fasciitis. We retrospectively reviewed 286 patients with plantar fasciitis who were referred from private clinics between March 2004 and February 2008. Patients were divided into those with or without a plantar fascia rupture. There were 35 patients in the rupture group and 251 in the nonrupture group. The clinical characteristics and risk factors for plantar fascia rupture were compared between the 2 groups. We compared age, gender, the affected site, visual analog scale pain score, previous treatment regimen, body mass index, degree of ankle dorsiflexion, the use of steroid injections, the extent of activity, calcaneal pitch angle, the presence of a calcaneal spur, and heel alignment between the 2 groups. Of the assessed risk factors, only steroid injection was associated with the occurrence of a plantar fascia rupture. Among the 35 patients with a rupture, 33 had received steroid injections. The odds ratio of steroid injection was 33. Steroid injections for plantar fasciitis should be cautiously administered because of the higher risk for plantar fascia rupture. Level III, retrospective comparative study.

  15. Technological factors affecting biogenic amine content in foods: a review

    Directory of Open Access Journals (Sweden)

    Fausto Gardini

    2016-08-01

    Full Text Available Biogenic amines (BAs are molecules which can be present in foods and, due to their toxicity, can cause adverse effects on the consumers. BAs are generally produced by microbial decarboxylation of amino acids in food products. The most significant BAs occurring in foods are histamine, tyramine, putrescine, cadaverine, tryptamine, 2-phenylethylamine, spermine, spermidine and agmatine. The importance of preventing the excessive accumulation of BAs in food is related to their impact on human health and food quality. Quality criteria in connection with the presence of BAs in food and food products are necessary from a toxicological point of view. This is particularly important in fermented foods in which the massive microbial proliferation required for obtaining specific products is often relater with BA accumulation. In this review, up-to-date information and recent discoveries about technological factors affecting biogenic amine content in foods are reviewed. Specifically, BA forming-microorganism and decarboxylation activity, genetic and metabolic organization of decarboxylases, risk associated to BAs (histamine, tyramine toxicity and other BAs, environmental factors influencing BA formation (temperature, salt concentration, pH. In addition, the technological factors for controlling BA production (use of starter culture, technological additives, effects of packaging, other non-thermal treatments, metabolising BA by microorganisms, effects of pressure treatments on BA formation and antimicrobial substances are addressed.

  16. Factors affecting economies of scale in combined sewer systems.

    Science.gov (United States)

    Maurer, Max; Wolfram, Martin; Anja, Herlyn

    2010-01-01

    A generic model is introduced that represents the combined sewer infrastructure of a settlement quantitatively. A catchment area module first calculates the length and size distribution of the required sewer pipes on the basis of rain patterns, housing densities and area size. These results are fed into the sewer-cost module in order to estimate the combined sewer costs of the entire catchment area. A detailed analysis of the relevant input parameters for Swiss settlements is used to identify the influence of size on costs. The simulation results confirm that an economy of scale exists for combined sewer systems. This is the result of two main opposing cost factors: (i) increased construction costs for larger sewer systems due to larger pipes and increased rain runoff in larger settlements, and (ii) lower costs due to higher population and building densities in larger towns. In Switzerland, the more or less organically grown settlement structures and limited land availability emphasise the second factor to show an apparent economy of scale. This modelling approach proved to be a powerful tool for understanding the underlying factors affecting the cost structure for water infrastructures.

  17. Factors Affecting Accidents Risks among Truck Drivers In Egypt

    Directory of Open Access Journals (Sweden)

    Elshamly Ahmed Fathalla

    2017-01-01

    Full Text Available Egypt is ranked among the countries with the highest rates of road accidents. According to the American Chamber of Commerce more than 96% of Egypt's goods are transported by trucks and due to their large volume and excessive weight, the severity and number of truck accident fatalities are much higher than other vehicles in Egypt. The present study aims at identifying truck driver's behavior and its influence on crash involvement. Due to the shortage in recording accident data and the inaccurate road accident audit, data was collected from several governorates in Egypt through questionnaire. Questionnaire forms were filled out through personal interviews with truck drivers. The total number of respondents was 643. The final analysis was made on the 615 questionnaires with complete answers. The data was analyzed and logistic regression was applied to accident related data to examine the contributing factors affecting accident occurrence of truck drivers. Results showed that fatigue in terms of driving hours (continuous and total and lack of sleep, drug use during driving, and driver obesity are the most influencing factors on the occurrence of truck accidents in Egypt. The findings of this research highlight the important role human factors have on the risk of crash involvement amongst Egypt's truck drivers and the need to improve their work conditions.

  18. Adherence with Preventive Medication in Childhood Asthma

    Directory of Open Access Journals (Sweden)

    Scott Burgess

    2011-01-01

    Full Text Available Suboptimal adherence with preventive medication is common and often unrecognised as a cause of poor asthma control. A number of risk factors for nonadherence have emerged from well-conducted studies. Unfortunately, patient report a physician's estimation of adherence and knowledge of these risk factors may not assist in determining whether non-adherence is a significant factor. Electronic monitoring devices are likely to be more frequently used to remind patients to take medication, as a strategy to motivate patients to maintain adherence, and a tool to evaluate adherence in subjects with poor disease control. The aim of this paper is to review non-adherence with preventive medication in childhood asthma, its impact on asthma control, methods of evaluating non-adherence, risk factors for suboptimal adherence, and strategies to enhance adherence.

  19. Episodic medication adherence in adolescents and young adults with perinatally acquired HIV: a within-participants approach.

    Science.gov (United States)

    Hawkins, Amy; Evangeli, Michael; Sturgeon, Kate; Le Prevost, Marthe; Judd, Ali

    2016-01-01

    Due to the success of antiretroviral (ART) medications, young people living with perinatally acquired HIV (PHIV+) are now surviving into adolescence and young adulthood. Understanding factors influencing ART non-adherence in this group is important in developing effective adherence interventions. Most studies of ART adherence in HIV-positive populations assess differences in adherence levels and adherence predictors between participants, over a period of time (global adherence). Many individuals living with HIV, however, including PHIV+ young people, take medication inconsistently. To investigate this pattern of adherence, a within-participants design, focussing on specific episodes of adherence and non-adherence, is suitable (episodic adherence). A within-participants design was used with 29 PHIV+ young people (17 female, median age 17 years, range 14-22 years), enrolled in the UK Adolescents and Adults Living with Perinatal HIV cohort study. Participants were eligible if they could identify one dose of medication taken and one dose they had missed in the previous two months. For each of the two episodes (one adherent, one non-adherent), behavioural factors (whom they were with, location, routine, day, reminders) and psychological factors at the time of the episode (information about medication, adherence motivation, perceived behavioural skills to adhere to medication - derived from the Information-Motivation-Behavioural Skills (IMB) Model - and affect) were assessed in a questionnaire. Non-adherence was significantly associated with weekend days (Friday to Sunday versus Monday to Thursday, p = .001), lack of routine (p = .004), and being out of the home (p = .003), but not with whom the young person was with or whether they were reminded to take medication. Non-adherence was associated with lower levels of behavioural skills (p ART, or ART motivation. The use of situationally specific strategies to enhance adherence in young people who take their

  20. Type D Personality Predicts Poor Medication Adherence in Patients with Heart Failure in the USA

    Science.gov (United States)

    Wu, Jia-Rong; Moser, Debra K.

    2015-01-01

    Background Type D (distressed) personality and medication nonadherence have been associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease. However, the relationship between type D personality and medication adherence in patients with heart failure (HF) remains unknown. Purpose Therefore, the goal of this study was to examine the association between type D personality and medication adherence in patients with HF. Method This was a sub-analysis of baseline data from a randomized controlled trial with 84 patients with HF in the USA. Demographic, clinical, and psychological data were collected at baseline by interview, questionnaires, and medical record review. Type D personality was assessed using the Type D Personality Scale (DS14). Medication adherence was measured using both objective (Medication Event Monitoring System, MEMS) and self-reported (Morisky Medication Adherence Scale, MMAS-4) measures. Patients started medication adherence monitoring with the MEMS bottle at baseline and is used continuously for a month. Multiple regressions were used to explore the relationships between type D personality and medication adherence while adjusting for demographic, clinical, and psychological factors. Results Patients with type D personality were more likely to have poor medication adherence. Type D personality was associated with medication adherence before and after adjusting for covariates when it was analyzed as a categorical variable. However, type D personality was not associated with medication adherence when analyzed as a dimensional construct. Negative affectivity, a component of type D personality, was associated with medication adherence. Conclusion As a dimensional construct, type D personality may not reflect the components of the personality associated with poor outcomes. Negative affectivity was associated with medication adherence in patients with HF. Interventions aiming