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
Nozaki, Ikuma; Dube, Christopher; Kakimoto, Kazuhiro; Yamada, Norio; Simpungwe, James B.
The purpose of this study was to assess the factors that influence ART adherence arising in rural settings in Zambia. A survey was conducted with face-to-face interviews using a semi-structured questionnaire and written informed consent was obtained at ART sites in Mumbwa District in rural Zambia. The questionnaire included items such as the socio-demographic characteristics of respondents, support for adherence, ways to remember when to take ARVs at scheduled times, and the current status of adherence. Valid responses were obtained from 518 research participants. The mean age of the respondents was 38.3 years and the average treatment period was 12.5 months. More than half of the respondents (51%) were farmers, about half (49%) did not own a watch, and 10% of them used the position of the sun to remember when to take ARVs. Sixteen percent of respondents experienced fear of stigma resulting from taking ARVs at work or home, and 10% felt pressured to share ARVs with someone. Eighty-eight percent of the participants reported that they had never missed ARVs in the past four days. Multivariable logistic regression analysis identified age (38 years old or less, odds ratio (OR) = 2.5, 95% confidence interval (CI): 1.3–4.8, p = 0.005), “remembering when to take ARVs based on the position of the sun” (OR = 3.3, 95% CI: 1.3–8.8, p = 0.016), and “feeling pressured to share ARVs with someone” (OR = 4.4, 95% CI: 1.6–12.0, p = 0.004) as independent factors for low adherence. As ART services expand to rural areas, program implementers should pay more attention to more specific factors arising in rural settings since they may differ from those in urban settings. PMID:21400314
The adherence to asthma treatment was rated using Morisky Medication Adherence Scale. A ... The prevalence of low adherence rate to asthma controller therapy was 44.8% and the absence of any .... Obesity (BMI ≥ 30 kg/m2). No. Yes.
Link, Lilli B; Jacobson, Judith S
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.
opportunity to determine maternal HIV disease progression, nutritional status, feeding ... variables affecting the change from formula feeding intent to actual breast feeding ... excluded women did not differ in terms of feeding intention at the first ...
Full Text Available Vassiliki Tsiantou1, Polina Pantzou2, Elpida Pavi1, George Koulierakis2, John Kyriopoulos11Department of Health Economics, National School of Public Health, Athens, Greece; 2Department of Sociology, National School of Public Health, Athens, GreeceIntroduction: Although hypertension constitutes a major risk factor for cardiovascular morbidity and mortality, research on adherence to antihypertensive treatment has shown that at least 75% of patients are not adherent because of the combined demographic, organizational, psychological, and disease- and medication-related factors. This study aimed to elicit hypertensive patients’ beliefs on hypertension and antihypertensive treatment, and their role to adherence.Methods: Transcripts from semistructured interviews and focus groups were content analyzed to extract participants’ beliefs about hypertension and antihypertensive treatment, and attitudes toward patient–physician and patient–pharmacist relationships.Results: Hypertension was considered a very serious disease, responsible for stroke and myocardial infarction. Participants expressed concerns regarding the use of medicines and the adverse drug reactions. Previous experience with hypertension, fear of complications, systematic disease management, acceptance of hypertension as a chronic disease, incorporation of the role of the patient and a more personal relationship with the doctor facilitated adherence to the treatment. On the other hand, some patients discontinued treatment when they believed that they had controlled their blood pressure.Conclusion: Cognitive and communication factors affect medication adherence. Results could be used to develop intervention techniques to improve medication adherence.Keywords: hypertension, medication adherence, patient compliance, doctor–patient communication, antihypertensive medicine
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
Israels, T.; Chirambo, C.; Caron, H.; de Kraker, J.; Molyneux, E.; Reis, R.
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 caus
Israels, T.; Chirambo, C.; Caron, H.; de Kraker, J.; Molyneux, E.; Reis, R.
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
Smith, S G; Sestak, I; Forster, A; Partridge, A; Side, L; Wolf, M S; Horne, R; Wardle, J; Cuzick, J
Preventive therapy is a risk reduction option for women who have an increased risk of breast cancer. The effectiveness of preventive therapy to reduce breast cancer incidence depends on adequate levels of uptake and adherence to therapy. We aimed to systematically review articles reporting uptake and adherence to therapeutic agents to prevent breast cancer among women at increased risk, and identify the psychological, clinical and demographic factors affecting these outcomes. Searches were carried out in PubMed, CINAHL, EMBASE and PsychInfo, yielding 3851 unique articles. Title, abstract and full text screening left 53 articles, and a further 4 studies were identified from reference lists, giving a total of 57. This review was prospectively registered with PROSPERO (CRD42014014957). Twenty-four articles reporting 26 studies of uptake in 21 423 women were included in a meta-analysis. The pooled uptake estimate was 16.3% [95% confidence interval (CI) 13.6-19.0], with high heterogeneity (I(2) = 98.9%, P Adherence (day-to-day use or persistence) over the first year was adequate. However, only one study reported a persistence of ≥ 80% by 5 years. Factors associated with lower adherence included allocation to tamoxifen (versus placebo or raloxifene), depression, smoking and older age. Risk of breast cancer was discussed in all qualitative studies. Uptake of therapeutic agents for the prevention of breast cancer is low, and long-term persistence is often insufficient for women to experience the full preventive effect. Uptake is higher in trials, suggesting further work should focus on implementing preventive therapy within routine care. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology.
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
Fahlén, Elin; Davidsson, Julia
Background: Diabetes is an increasing global health problem and this puts high demands on the health care system. Patients with diabetes demand continuous treatment and monitoring in order to control the disease and avoid complications. Adherence to recommended treatment was important in order for the treatment to give positive effect. In this context adherence was defined as the extent to which the patients follow medical instructions.Aim: The aim of this study was to identify factors that c...
Full Text Available The first antenatal clinic (ANC visit helps to distinguish pregnant women who require standard care, from those with specific problems and so require special attention. There are protocols to guide care providers to provide optimal care to women during ANC. Our objectives were to determine the level of provider adherence to first antenatal visit guidelines in the Safe Motherhood Protocol (SMP, and assess patient factors that determine complete provider adherence.This cross-sectional study is part of a cohort study that recruited women who delivered in eleven health facilities and who had utilized antenatal care services during their pregnancy in the Greater Accra region of Ghana. A record review of the first antenatal visit of participants was carried out to assess the level of adherence to the SMP, using a thirteen-point checklist. Information on their socio-demographic characteristics and previous pregnancy history was collected using a questionnaire. Percentages of adherence levels and baseline characteristics were estimated and cluster-adjusted odds ratios (OR calculated to identify determinants.A total of 948 women who had delivered in eleven public facilities were recruited with a mean age (SD of 28.2 (5.4 years. Overall, complete adherence to guidelines pertained to only 48.1% of pregnant women. Providers were significantly more likely to completely adhere to guidelines when caring for multiparous women [OR = 5.43 (1.69-17.44, p<0.01] but less likely to do so when attending to women with history of previous pregnancy complications [OR = 0.50 (0.33-0.75, p<0.01].Complete provider adherence to first antenatal visit guidelines is low across different facility types in the Greater Accra region of Ghana and is determined by parity and history of previous pregnancy complication. Providers should be trained and supported to adhere to the guidelines during provision of care to all pregnant women.
Nguyen Truax, Fayette Khue
ABSTRACT OF THE DISSERTATIONFactors Affecting Medication Adherence among Vietnamese Immigrantswith Latent Tuberculosis Infection: A Mixed DesignbyFayette Nguyen TruaxDoctor of Philosophy in NursingUniversity of California, Los Angeles, 2016Professor Adeline M. Nyamathi, Chair Completion of latent tuberculosis infection (LTBI) treatment among foreign-born Asians in the United States (US) is suboptimal, thus leading to high rates of reactivation tuberculosis (TB) among this population. Approxi...
Pandya, Ekta Y; Bajorek, Beata
The role of the direct oral anticoagulants (DOACs) in practice has been given extensive consideration recently, albeit largely from the clinician's perspective. However, the effectiveness and safety of using anticoagulants is highly dependent on the patient's ability to manage and take these complex, high-risk medicines. This structured narrative review explores the published literature to identify the factors underpinning patients' non-adherence to anticoagulants in atrial fibrillation (AF), and subsequently contemplates to what extent the DOACs might overcome the known challenges with traditional warfarin therapy. This review comprised a two-tier search of various databases and search platforms (CINAHL, Cochrane, Current Contents Connect, EMBASE, MEDLINE Ovid, EBSCO, PubMed, Google, Google Scholar) to yield 47 articles reporting patients perspectives on, and patients adherence to, anticoagulant therapy. The findings from the literature were synthesised under five interacting dimensions of adherence: therapy-related factors, patient-related factors, condition-related factors, social-economic factors and health system factors. Factors negatively affecting patients' day-to-day lives (especially regular therapeutic drug monitoring, dose adjustments, dietary considerations) predominantly underpin a patient's reluctance to take warfarin therapy, leading to non-adherence. Other patient-related factors underpinning non-adherence include patients' perceptions and knowledge about the purpose of anticoagulation; understanding of the risks and benefits of therapy; socioeconomic status; and expectations of care from health professionals. In considering these findings, it is apparent that the DOACs may overcome some of the barriers to traditional warfarin therapy at least to an extent, particularly the need for regular monitoring, frequent dose adjustment and dietary considerations. However, their high cost, twice-daily dosing and gastrointestinal adverse effects may present
Full Text Available Background: Diabetes mellitus is a major global health problem covering approximately 347 million persons worldwide. Glycemic control has a main role in its management which mainly depends upon patient adherence to the treatment plan. Accurate assessment of medication adherence is necessary for effective management of diabetes. Objective: To assess nonadherence and factors affecting adherence of diabetic patients to anti-diabetic medication in Assela General Hospital (AGH, Oromia Region, Ethiopia. Materials and Methods: A descriptive cross-sectional study was conducted on patients seeking anti-diabetic drug treatment and follow-up at AGH using structured questionnaire and reviewing the patient record card using check list from January 24, 2014 to February 7, 2014. Descriptive analysis was used to describe the percentages and number of distributions of the variables in the study; and association was identified for categorical data. P ≤ 0.05 was considered as statistically significant. Result: Of all respondents, 149 (52.3% and 136 (47.7% were female and male, respectively. The majority of the study participants 189 (66.3% were in the age group of 30–60 years. Two-hundred nineteen (76.8% of respondents were married currently. The majority, 237 (83.2% of respondents did not have blood glucose self-monitoring equipment (glucometer. A total of 196 (68.8% respondents were adhered to anti-diabetic medication. There was a significant association between adherence to the medication and side effect, level of education, monthly income and presence of glucometer at home (P < 0.05. Conclusion: The participants in the area of study were moderately adherent to their anti-diabetic medications with nonadherence rate of 31.2%. Different factors of medication nonadherence were identified such as side effect and complexity of regimen, failure to remember, and sociodemographic factors such as educational level and monthly income.
Full Text Available Background: Low adherence to the treatment regimen in tuberculosis patients has been recognized as a major threat for tuberculosis (TB control program. Thus, the present study was conducted to assess the factors affecting adherence to the treatment regimen of TB patients via Health Belief Model (HBM. Methods: In this cross-sectional study,110 tuberculosis patients attending anti-TB center in Zabol were selected and included in the study using census method. Data were collected using Health Belief Model (HBM questionnaire and reviewing the patients' medical files. The collected data were analyzed by SPSS software using t-test, ANOVA and multiple regression analysis with 95 % confidence level. Results: The mean age of the participants was 55.7±18.6 years. 89% of the patients had pulmonary tuberculosis and 11% had extra-pulmonary tuberculosis. The multiple regression analysis showed knowledge, self-efficacy, perceived benefits and perceived threat were significant predictors of adherence to the treatment regimen. The HBM constructs accounted for 29% of the variance observed in adherence to the treatment regimen. Conclusion: The findings of the study highlight the need to increase awareness and change the patients’ beliefs about the risks of low adherence to the treatment regimen in patients.
Jankowska-Polańska, Beata; Chudiak, Anna; Uchmanowicz, Izabella; Dudek, Krzysztof; Mazur, Grzegorz
Background Low adherence to hypertension (HT) management is one of the major contributors to poor blood pressure (BP) control. Approximately 40%–60% of patients with HT do not follow the prescribed treatment. The aim of the study was to analyze the relationship between selected variables and adherence to hypotensive pharmacological treatment. Besides socioclinical variables, the study focused on the role of illness acceptance. Participants and methods The study included 602 patients with HT. Adherence and acceptance of illness were assessed using the following validated instruments: the Acceptance of Illness Scale (AIS) and the Morisky Medication Adherence Scale (MMAS). Results The high-adherence group comprised a significantly higher percentage of patients with high illness acceptance scale scores than that of patients with low-to-moderate scores (42.4 vs 31.8%; P=0.0081.5 times as likely to occur in the high acceptance group as in the low-to-moderate acceptance group (OR =1.58, 95% CI 1.14–2.19). Spearman’s rank correlation coefficients showed statistically significant correlations between adherence and sex (men ρ=−0.101; P=0.012), age >45–66 years (ρ=0.098; P=0.015), higher education level (ρ=0.132; P=0.001), grade ESC of HT (ρ=−0.037; P=0.057), receiving one-tablet polytherapy (ρ=0.131; P=0.015), and illness acceptance (ρ=0.090; P=0.024). Conclusion Acceptance of illness is correlated with adherence to pharmacological treatment, and consideration should be given to more widespread assessment of illness acceptance in daily practice. Male sex, age >45–66 years, duration of illness grade ESC of HT, and receiving one-tablet polytherapy are significant determinants of adherence to pharmacological treatment in HT. PMID:28280309
Full Text Available Beata Jankowska-Polańska,1 Anna Chudiak,1 Izabella Uchmanowicz,1 Krzysztof Dudek,2 Grzegorz Mazur3 1Department of Clinical Nursing, Wroclaw Medical University, 2Department of Logistics and Transport Systems, Faculty of Mechanical Engineering, Wroclaw University of Technology, 3Department and Clinic of Internal and Occupational Diseases and Hypertension, Wroclaw Medical University, Wroclaw, Poland Background: Low adherence to hypertension (HT management is one of the major contributors to poor blood pressure (BP control. Approximately 40%–60% of patients with HT do not follow the prescribed treatment. The aim of the study was to analyze the relationship between selected variables and adherence to hypotensive pharmacological treatment. Besides socioclinical variables, the study focused on the role of illness acceptance.Participants and methods: The study included 602 patients with HT. Adherence and acceptance of illness were assessed using the following validated instruments: the Acceptance of Illness Scale (AIS and the Morisky Medication Adherence Scale (MMAS.Results: The high-adherence group comprised a significantly higher percentage of patients with high illness acceptance scale scores than that of patients with low-to-moderate scores (42.4 vs 31.8%; P=0.008<0.01. The odds ratio (OR showed that high adherence to pharmacological treatment was >1.5 times as likely to occur in the high acceptance group as in the low-to-moderate acceptance group (OR =1.58, 95% CI 1.14–2.19. Spearman’s rank correlation coefficients showed statistically significant correlations between adherence and sex (men ρ=–0.101; P=0.012, age >45–66 years (ρ=0.098; P=0.015, higher education level (ρ=0.132; P=0.001, grade ESC of HT (ρ=–0.037; P=0.057, receiving one-tablet polytherapy (ρ=0.131; P=0.015, and illness acceptance (ρ=0.090; P=0.024.Conclusion: Acceptance of illness is correlated with adherence to pharmacological treatment, and consideration should
Gurumurthy, Ranjana; Chanda, Kulkarni; Sarma, GRK
INTRODUCTION Adherence to antiepileptic drug (AED) therapy is important for controlling seizures in patients with epilepsy (PWE). It is vital to identify the factors influencing adherence to AED therapy using validated tools. This study aimed to evaluate the pattern and extent of AED adherence among PWE and to identify the factors that influence adherence. METHODS This was a cross-sectional study involving PWE who had a confirmed diagnosis. Treatment adherence was assessed using the four-item Morisky Medication Adherence Scale. Univariate analysis with chi-square test was used to observe the association between different variables and AED adherence. Binary logistic regression analysis was used to identify the predictors of adherence. RESULTS 451 PWE (mean age 27.3 ± 8.1 years) were enrolled in the study; 251 (55.7%) were male and 198 (43.9%) were from the lower socioeconomic class. 326 (72.3%) patients had high adherence to AED therapy, while 125 (27.7%) had low adherence. AED adherence was significantly associated with socioeconomic status (p = 0.043) and type of epilepsy (p = 0.033). However, no significant difference was observed between adherence and age, gender, marital status, epilepsy duration, number and type of AEDs, and occurrence of adverse drug reactions. Patients with focal epilepsy and those from the middle/lower-middle socioeconomic classes were less likely to be nonadherent. The primary reason for nonadherence was forgetfulness. CONCLUSION This study found that a majority of PWE have optimal rates of AED adherence and that forgetfulness is the primary reason for nonadherence among PWE. PMID:26805666
Lenti, Marco Vincenzo; Selinger, Christian P
Achieving adherence to medications can be a serious challenge for patients affected by inflammatory bowel disease (IBD). Medical treatment is fundamental for inducing and maintaining remission, preventing flares and reducing the risk of colorectal cancer. Non-adherence may affect patients' quality of life resulting in unfavourable treatment outcomes, more hospitalizations and higher healthcare-related costs. Recognising and improving adherence is therefore a primary aim for the treatment of IBD. Areas covered: We critically discuss the current knowledge on medication non-adherence in adult patients affected by IBD, also mentioning a few issues concerning the paediatric and adolescent populations. In particular, we reviewed the literature focusing on the definition and detection of non-adherence, on its extent and on the possible non-modifiable and modifiable factors involved (patient-centred, therapy-related, disease-related and physician-related). Furthermore, we analysed the interventional studies performed so far. The literature review was conducted through PubMed addressing medication non-adherence in IBD, using the keywords 'adherence' and related terms and 'IBD, ulcerative colitis or Crohn's disease'. Expert commentary: Adherence to therapy for IBD is a complex yet fundamental issue that cannot be solved by addressing a single aspect only. Future studies should focus on patient-tailored and multidimensional interventions.
O'Shea, Simone D; Taylor, Nicholas F; Paratz, Jennifer D
Exercise is an important treatment modality for persons with chronic obstructive pulmonary disease (COPD), but factors influencing adherence have been examined infrequently. The purpose of this investigation was to explore adherence factors to a progressive resistance exercise program for persons with COPD. Persons with COPD enrolled in a 12-week trial of progressive resistance exercise were invited to participate in 2 semistructured qualitative interviews exploring program adherence. Interviews were audio-taped, transcribed, and then coded independently by 2 researchers. Themes relating to short-term and long-term adherence were then developed and described. Twenty-two participants were interviewed at the conclusion of the intervention (12 weeks), and 19 completed a second interview at 24 weeks. Short-term exercise adherence was facilitated by expected outcomes, self-motivation, supervision, and group support, whereas health and weather factors were the major barriers to adherence. The barriers to exercise remained unchanged at 24 weeks despite a large decline in exercise adherence. Removal of environmental support at 12 weeks may have contributed to poor long-term exercise maintenance, with participants identifying group support and regular monitoring by a therapist as the most important strategies for maintaining exercise. The provision of external support in training program design appears important for persons with COPD. Longer-term adherence declined when group support and regular monitoring by a therapist was removed, despite the major perceived exercise barriers remaining unchanged. Therefore, further investigation is required to determine effective strategies for maximizing longer-term exercise adherence in this population.
Iwai, Masaru; Fuchikami, Hiromi; Mizuno, Yoshio; Takeda, Naoko; Inoue, Yuko; Seto, Hiroshi; Kudo, Takuya; Sato, Kazuhiko
The long-term use of hormonal therapy is important for the treatment of patients with breast cancer. Therefore, we evaluated the methods used for measuring adherence and examined factors that influence compliance. Our goal was to improve overall adherence to the treatment. Retrospective analyses by using electronic medical records and questionnaires were performed on 294 patients with breast cancer. The patients were classified into 2 groups based on the mean number of days when a dose was missed over a period of 28 days: group A(range, 0-3 days, n=272)and group B (range, B4 days, n=22). Factors that may influence adherence, including age, duration of hormonal therapy, the drug administered in hormonal therapy, the surgical method, axillary lymph node dissection, and adjuvant chemotherapy, were compared between both groups. The adherence rates calculated from electronic medical records and questionnaires were similar. The proportion of patients younger than 50 years was 30% in group A and 50% in group B(pcancer-related procedures, such as breast conserving surgery, may also be linked to poor adherence. Young age and long duration of hormonal therapy are possibly related to poor adherence. Therefore, pharmacists should identify and manage these patients to increase adherence.
Do, Natalie T; Phiri, Kelesitse; Bussmann, Hermann; Gaolathe, Tendani; Marlink, Richard G; Wester, C William
As increasing numbers of persons are placed on potentially life-saving combination antiretroviral therapy (cART) in sub-Saharan Africa, it is imperative to identify the psychosocial and social factors that may influence antiretroviral (ARV) medication adherence. Using an 87 question survey, the following data were collected from patients on cART in Botswana: demographics, performance (Karnofsky) score, perceived stigma and level of HIV disclosure, attitudes and beliefs concerning HIV/AIDS, substance and/or drug use, depression, and pharmacy and healthcare provider-related factors. Overall adherence rates were determined by patient self-report, institutional adherence, and a culturally modified Morisky scale. Three hundred adult patients were recruited between April and May 2005. The overall cART adherence rate was 81.3% based on 4 day and 1 month patient recall and on clinic attendance for ARV medication refills during the previous 3 months. Adults receiving cART for 1-6 months were the least adherent (77%) followed by those receiving cART for greater than 12 months (79%). Alcohol use, depression, and nondisclosure of positive HIV status to their partner were predictive of poor adherence rates (p value HIV disclosure to "at-risk" partners and provide ongoing counseling and education to help patients recognize and overcome HIV-associated stigma, alcohol abuse, and depression.
Heather A. O'Mahen
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.
Shahsavari, Hooman; Shahriari, Mohsen; Alimohammadi, Nasrollah
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.
Loew, Laurianne; Brosseau, Lucie; Kenny, Glen P; Durand-Bush, Natalie; Poitras, Stéphane; De Angelis, Gino; Wells, George A
This study aims to identify potential factors that could affect adherence and influence the implementation of an evidence-based structured walking program, among older adults diagnosed with knee osteoarthritis. A total of 69 participants with mild to moderate osteoarthritis of the knee fulfilled an online survey on potential factors that could affect their adherence to an evidence-based structured walking program. Adherence with regard to the influencing factors was explored using a logistic regression model. Results tend to show higher odds of adhering to the evidence-based walking program if the participants were supervised (more than 2.9 times as high), supported by family/friends (more than 3.7 times as high), and not influenced by emotional involvement (more than 11 times as high). The odds of adhering were 3.6 times lower for participants who indicated a change in their medication intake and 3.1 times lower for individuals who considered themselves as less physically active (95 % confidence interval (CI)). Our exploratory findings identified and defined potential adherence factors that could guide health professionals in their practice to better identify positive influences and obstacles to treatment adherence, which would lead to the adoption of a more patient-centered approach. A large-scale study is required to clearly delineate the key factors that would influence adherence. We addressed a new knowledge gap by identifying the main strategies to promote the long-term adherence of community-based walking program.
Basheti, Iman A; Hait, Sami Saqf El; Qunaibi, Eyad A; Aburuz, Salah; Bulatova, Nailya
To explore the effect of patient characteristics and health beliefs on their medication adherence. Patients (n=167) with chronic conditions (mean age 58.9; SD=13.54, 53% males) were recruited from March 2009- to March 2010 using a cross sectional study design. Data collected included patients' demographics, medical conditions, medications therapeutic regimen, frequency of physician visits and health beliefs. Patient self-reported adherence to medications was assessed by the researcher using a validated and published scale. Treatment related problems (TRPs) were evaluated for each patient by competent clinical pharmacists. Associations between patient characteristics/health beliefs with adherence were explored. About half of the patients (46.1%) were non-adherent. A significant association was found between lower adherence and higher number of disease states (pPatient adherence was positively affected by older age, higher educational level, and higher number of physician visits per month, while it was negatively affected by reporting difficulties with getting prescription refills on time. This study identified different factors that may negatively affect adherence, including higher number of medications and disease states, higher number of identified TRPs and inability to getting prescription refills on time. Hence, more care needs to be provided to patients with complex therapeutic regimens in order to enhance adherence.
Full Text Available Objective: To explore the effect of patient characteristics and health beliefs on their medication adherence. Methods: Patients (n=167 with chronic conditions (mean age 58.9; SD=13.54, 53% males were recruited from March 2009- to March 2010 using a cross sectional study design. Data collected included patients’ demographics, medical conditions, medications therapeutic regimen, frequency of physician visits and health beliefs. Patient self-reported adherence to medications was assessed by the researcher using a validated and published scale. Treatment related problems (TRPs were evaluated for each patient by competent clinical pharmacists. Associations between patient characteristics/health beliefs with adherence were explored. Results: About half of the patients (46.1% were non-adherent. A significant association was found between lower adherence and higher number of disease states (p<0.001, higher number of medications (p=0.001, and higher number of identified TRPs (p = 0.003. Patient adherence was positively affected by older age, higher educational level, and higher number of physician visits per month, while it was negatively affected by reporting difficulties with getting prescription refills on time. Conclusion: This study identified different factors that may negatively affect adherence, including higher number of medications and disease states, higher number of identified TRPs and inability to getting prescription refills on time. Hence, more care needs to be provided to patients with complex therapeutic regimens in order to enhance adherence.
Sohini Banerjee; Ravi Prasad Varma
Non-adherence to depression treatment is a common clinical problem globally. However, limited research is available from India. This cross-sectional study aimed to assess non-adherence to prescribed treatment among patients with unipolar depression at a psychiatric out-patient department (OPD) of a tertiary hospital in Kolkata, India. The Morisky Medication Adherence Scale (MMAS) was used and a questionnaire designed by the Principal Investigator (PI) was administered. A total of 239 patients...
19,20-22 maintain CD4 cell counts; prevent clinical ... affecting ART adherence in HIV-positive patients,32-35 ... 99.5%, and of those who received psychotherapy increased .... children (chi2=5.022; p=0.285); past history.
M Y H Moosa
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.
Zschocke, Ina; Mrowietz, Ulrich; Lotzin, Annett; Karakasili, Eleni; Reich, Kristian
Medication adherence rates strongly depend on favorable disease outcomes. It is known that medication adherence rates are lower for topical treatment than for systemic treatment. However, to date no validated instrument for the assessment of adherence factors in topical treatment is available. The aim of this study was to develop a new questionnaire to assess adherence risk factors in topical treatment. The development of the Topical Therapy Adherence Questionnaire (TTAQ) and Patient Preference Questionnaire (PPQ) was based on a systematic literature review, and qualitative patient focus interviews and expert focus groups' input. The psychometric properties and comprehensibility of the TTAQ and PPQ were assessed in a feasibility study with 59 psoriasis patients. Our first preliminary results indicate that the TTAQ and PPQ are psychometrically sound and reliable measures for the assessment of factors influencing topical treatment adherence. The questionnaires are currently being further developed and various parameters (e.g., time point of assessment) are currently being tested in an exploratory pilot study with ca. 2,000 psoriasis patients receiving topical treatment in a European clinical trial. The use of the final versions of TTAQ and PPQ in clinical practice may facilitate the early identification of specific non-adherence factors in patients under topical treatment, which could enable designing and applying adherence-enhancing interventions according to the patient's individual needs.
Park, Kwan Kyu; Choi, Choong Hyeok; Ha, Chul-Won; Lee, Myung Chul
We aimed to compare the clinical outcomes of knee osteoarthritis patients according to drug adherence; and to find out the factors the affecting those outcomes. We analyzed the drug adherence and clinical outcomes in 1,334 primary knee osteoarthritis patients who took non-steroidal anti-inflammatory drugs (NSAIDs) for 3 weeks. Clinical outcomes of Pain Numeric Rating Scale (NRS), Knee injury and Osteoarthritis Outcome Score (KOOS) and EQ-5D were compared at baseline and 3 weeks' follow-up between the two groups of adherent group and non-adherent group (1,167 vs. 167 patients). Logistic regression analysis was performed to examine the factors affecting the adherence, and the reasons for the non-adherence were asked. The follow-up clinical outcomes of NRS and KOOS symptom, pain and activity of daily life were significantly higher in the adherence group (P = 0.003, P = 0.048, P = 0.005, and P = 0.003, respectively). The adherence was better in the elderly and in the male group (P = 0.042 and P = 0.034, respectively) and the top reason for no strict adherence was "symptom improved" (21.5%) followed by side effects. In this study, the patients with better adherence to NSAIDs showed better outcomes compared to those with poor adherence. This study can contribute to the patient education for the pharmacological treatment in knee OA patients.
Puts, M. T. E.; Tu, H. A.; Tourangeau, A.; Howell, D.; Fitch, M.; Springall, E.; Alibhai, S. M. H.
Background Cancer is a disease that mostly affects older adults. Treatment adherence is crucial to obtain optimal outcomes such as cure or improvement in quality of life. Older adults have numerous comorbidites as well as cognitive and sensory impairments that may affect adherence. The aim of this systematic review was to examine factors that influence adherence to cancer treatment in older adults with cancer. Patients and Methods Systematic review of the literature published between inception of the databases and February 2013. English, Dutch, French and German-language articles reporting cross-sectional or longitudinal, intervention or observational studies of cancer treatment adherence were included. Data sources included MEDLINE, EMBASE, PsychINFO, Cumulative Index to Nursing and Allied Health (CINAHL), Web of Science, ASSIA, Ageline, Allied and Complementary Medicine (AMED), SocAbstracts and the Cochrane Library. Two reviewers reviewed abstracts and abstracted data using standardized forms. Study quality was assessed using the Mixed Methods Appraisal Tool 2011. Results Twenty-two manuscripts were identified reporting on 18 unique studies. The quality of most studies was good. Most studies focused on women with breast cancer and adherence to adjuvant hormonal therapy. More than half of the studies used data from administrative or clinical databases or chart reviews. The adherence rate varied from 52% to 100%. Only one qualitative study asked older adults about reasons for non-adherence. Factors associated with non-adherence varied widely across studies. Conclusion Non-adherence was common across studies but little is known about the factors influencing non-adherence. More research is needed to investigate why older adults choose to adhere or not adhere to their treatment regimens taking into account their multimorbidity. PMID:24285020
Naar-King, S; Arfken, C; Frey, M; Harris, M; Secord, E; Ellis, D
A social ecological model provides a promising framework for understanding the individual, family, and societal factors contributing to non-adherence to treatment of paediatric HIV. This study explored which factors relevant to this model are associated with caregivers' adherence and child health outcomes. A cross-sectional design was utilized to assess relationships among current individual, familial, extra-familial factors, caregiver adherence, and viral load. Data were collected from 43 caregivers, and viral load data were obtained from the medical records of their HIV+ children. Caregiver drug and alcohol use and HIV+ status were associated with non-adherence and elevated viral load. Negative outcome expectancy was associated with lower adherence but was not significant in the multivariate analyses. Family factors were not significant, but these measures had low reliability in this sample. Extra-familial factors such as dissatisfaction with medical specialty care and more stressful life events were not directly associated with adherence but were related to increased caregiver substance use. Results of this first study to explore multiple predictors of adherence and health outcomes in paediatric HIV require replication with larger samples, but findings suggest caregiver characteristics that place children at risk for disease progression due to poor adherence to treatment.
Factors that Affect the Adherence to ADHD Medications during a Treatment Continuation Period in Children and Adolescents: A Nationwide Retrospective Cohort Study Using Korean Health Insurance Data from 2007 to 2011
Bhang, Soo-Young; Kwack, Young Sook; Joung, Yoo-Sook; Lee, Soyoung Irene; Kim, Bongseog; Sohn, Seok Han; Chung, Un-Sun; Yang, Jaewon; Hong, Minha; Bahn, Geon Ho; Choi, Hyung-yun; Oh, In Hwan; Lee, Yeon Jung
Objective Several factors, such as male gender, older age, type of insurance, comorbid conditions, and medication type, have been associated with attention-deficit/hyperactivity disorder (ADHD) medication adherence rates, but the results have been inconsistent. We analyzed data to answer several questions: 1) How old were patients who first refilled their treatment medications used primarily for ADHD, regardless of the medication type? 2) What socio-demographic factors are associated with medication adherence? 3) What medical conditions, such as medication type and comorbid diagnosis, influence adherence? Methods We analyzed National Health Insurance data, which comprised continuously enrolled Korean National Medical Insurance children (6–18 years) with at least 2 ADHD prescription claims (January 2008–December 2011). The persistence of use regarding the days of continuous therapy without a 30-day gap were measured continuously and dichotomously. Adherence, using a medication possession ratio (MPR), was measured dichotomously (80% cut-off). Results The cumulative incidence of index cases that initiated medication refills for ADHD treatment during the 4 year period was 0.85%. The patients who exhibited a MPR greater than 80 comprised approximately 66%. The medication type, high school age groups, physician speciality, treatment at a private clinic, and comorbid conditions were associated with medication adherence during continuous treatment using a multivariate analysis. Conclusion A better understanding of ADHD treatment patterns may lead to initiatives targeted at the improvement of treatment adherence and persistence. Other factors, including the severity, family history, costs, type of comorbidities, and switching patterns, will be analyzed in future studies.
Silvana Maria Coelho Leite Fava
Full Text Available This study aimed to seek the evidence available in the literature regarding the factors related to adherence to treatment for systemic hypertension. It used the method of integrative review in the databases MEDLINE, CINAHL, and LILACS, using the keywords: hypertension, compliance, non-compliance, adherence, non-adherence, patient compliance, in the period 2004 – 2008, and articles in Portuguese, English and Spanish, with the use of a validated instrument and content analysis. 28 studies were selected, 64.3% of which had level of evidence VI. The following were identified as factors related to adherence to treatment: treatment costs, educational activities, sex, physician-patient relationship, physiological and behavioral aspects, drug therapy, attending checkups and lifestyle. The use of combined strategies is suggested in order to increase the individuals’ adherence to the treatment. Gaps point to the valorization of dialogic relationships for integrated and more efficacious health practices.
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
Herring, M P; Sailors, M H; Bray, M S
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.
Guo, S.; DiPietro, L A
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...
Affective factors seem to play a crucial role in success or failure in second language acquisition. Negative attitudes can reduce learners' motivation and harm language learning, while positive attitudes can do the reverse. Discovering students' attitudes about language will help both teacher and student in teaching learning process. Anxiety is…
Marie N Fongwa
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
Guo, S.; DiPietro, L.A.
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
Alcorso, Jessica; Sherman, Kerry A; Koelmeyer, Louise; Mackie, Helen; Boyages, John
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.
Archiopoli, Ashley; Ginossar, Tamar; Wilcox, Bryan; Avila, Magdalena; Hill, Ricky; Oetzel, John
Despite devastating effects on health outcomes and disease progression, many people living with HIV (PLWH) are non-adherent to their medications. Medication self-efficacy is a pivotal factor in medication adherence, yet its formation and relationship with other factors are understudied. This study examines a model that considers the role of three communicative factors (patient-provider communication, social support, and social undermining) and two behavioral health factors (depression and alcohol abuse) and medication self-efficacy impacting medication adherence. Methods included a cross-sectional design using a survey questionnaire of 344 PLWH. Findings indicated that 25% of variance in medication adherence can be explained by a mediation model where depression (B = -.18) and provider-patient communication (B = .21) affect medication self-efficacy, which in turn impacts medication adherence (B = .64). Other variables, including demographics, did not add any explanatory power. These findings demonstrate the complex nature of medication adherence and the formation of medication self-efficacy.
Full Text Available 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
Ebben, R.H.A.; Vloet, L.C.M.; Groot, J.M. de; Achterberg, T. van
The objective of this study was to identify factors that influence emergency nurses' adherence to an emergency department national protocol (EDNP). A survey of emergency nurses (n=200) and physicians with medical end responsibility on an emergency department (n=103) was carried out. Emergency nurses
Van Wijk, Boris L G; Klungel, Olaf H; Heerdink, Eibert R; de Boer, Anthonius
BACKGROUND: Generic substitution is an important opportunity to reduce the costs of pharmaceutical care. However, pharmacists and physicians often find that patients and brand-name manufacturers have doubt about the equivalence of the substituted drug. This may be reflected by decreased adherence to
Ebben, R.H.A.; Vloet, L.C.M.; Schalk, D.M.; Mintjes-de Groot, J.; Achterberg, T. van
INTRODUCTION: Adherence to ambulance and ED protocols is often suboptimal. Insight into factors influencing adherence is a requisite for improvement of adherence. This study aims to gain an in-depth understanding of factors that influence ambulance and emergency nurses' adherence to protocols.
Ebben, Remco; Vloet, Lilian; Mintjes, Joke; Achterberg, Theo van
Adherence to ambulance and ED protocols is often suboptimal. Insight into factors influencing adherence is a requisite for improvement of adherence. This study aims to gain an in-depth understanding of factors that influence ambulance and emergency nurses’ adherence to protocols.
Remco Ebben; Lilian Vloet; Theo van Achterberg; Joke Mintjes
Adherence to ambulance and ED protocols is often suboptimal. Insight into factors influencing adherence is a requisite for improvement of adherence. This study aims to gain an in-depth understanding of factors that influence ambulance and emergency nurses’ adherence to protocols.
M Y H Moosa; F Y Jeenah
Aim. To determine changes in adherence to antiretroviral therapy (ART) in HIV-positive patients with depression, following treatment with an antidepressant or psychotherapy. Methods. The study was prospective, randomised and controlled. Consenting volunteers aged ≥18 years and stable on ART for ≥6 months were included in the study. Sociodemographic data were obtained, and a clinical diagnostic evaluation and the Hamilton Depression rating scale (HAMD) were performed on all subjects at en...
Terra, Mauro Barbosa; Barros, Helena Maria Tannhauser; Stein, Airton Tetelbom; Figueira, Ivan; Palermo, Luiz Henrique; Athayde, Luciana Dias; de Souza Gonçalves, Marcelo; da Silveira, Dartiu Xavier
This study was designed to determine factors affecting adherence to Alcoholics Anonymous (AA) groups. This cohort involved 300 alcoholics committed to three hospitals in Porto Alegre, Brazil. They were interviewed again in their homes after six months. The SCID-I and a questionnaire focusing on patient relationship with AA groups were used. The responses obtained through the questionnaire were independently evaluated by two researchers. AA adherence was below 20%. The main factors reported by patients as reasons for non-adherence to AA were relapse, lack of identification with the method, lack of need, and lack of credibility. The factors reported by patients as reasons for adherence were identification with the method and a way to avoid relapse. Although AA is considered an effective intervention for alcoholism, its adherence rate was excessively low. The identification of these nonadherence factors could help health professionals in referring certain alcoholic patients to therapeutic interventions other than AA.
Emma Rosamond Nony Weaver
Full Text Available Although the number of people receiving antiretroviral therapy (ART in Indonesia has increased in recent years, little is known about the specific characteristics affecting adherence in this population. Indonesia is different from most of its neighbors given that it is a geographically and culturally diverse country, with a large Muslim population. We aimed to identify the current rate of adherence and explore factors that influence ART adherence.Data were collected from ART-prescribed outpatients on an HIV registry at a North Jakarta hospital in 2012. Socio-demographic and behavioral characteristics were explored as factors associated with adherence using logistics regression analyses. Chi squared test was used to compare the difference between proportions. Reasons for missing medication were analyzed descriptively.Two hundred and sixty-one patients participated, of whom 77% reported ART adherence in the last 3 months. The level of social support experienced was independently associated with adherence where some social support (p = 0.018 and good social support (p = 0.039 improved adherence compared to poor social support. Frequently cited reasons for not taking ART medication included forgetting to take medication (67%, busy with something else (63% and asleep at medication time (60%.This study identified that an increase in the level of social support experienced by ART-prescribed patients was positively associated with adherence. Social support may minimize the impact of stigma among ART prescribed patients. Based on these findings, if social support is not available, alternative support through community-based organizations is recommended to maximize treatment success.
Rivadeneyra, Jéssica; Cubo, Esther; Gil, Cecilia; Calvo, Sara; Mariscal, Natividad; Martínez, Asunción
Little is known about the importance of the Mediterranean Diet (MeDi) and dietary intake as environmental neuroprotective factors in Huntington's disease (HD); so, we evaluated and analyzed the prevalence and factors associated with MeDi adherence, and dietary intake in HD. Spanish participants of the European Huntington Disease Network (EHDN) Registry study diagnosed with HD or premanifest HD gene carriers were included from June 2012 to August 2013. Self-reported dietary intake was collected by 3-day dietary record, MeDi adherence was assessed by 0-9 range (proposed by Trichopoulou et al.) and, other contributing factors related to nutrition were collected by telephone. Demographics and clinical variables were obtained from the EHDN Registry study database. Association of HD with MeDi adherence and nutritional characteristics were performed using logistic regression models. Ninety eight participants were included in the study, median age of 48 years (38-60 range), and median total functional capacity (TFC) 9 (5-13 range). HD severity was similar between participants with low vs moderate/high MeDi; however, quality of life (P = 0.009) was significantly higher among participants with moderate/high MeDi adherence. In terms of nutrients, higher MUFA/SFA intake was moderately correlated with better TFC and Unified HD Rating Scale (UHDRS) cognitive. Better TFC was associated with having a caregiver (OR = 11.86, P adherence to MeDi, was associated with older participants (OR = 1.19, P = 0.031), lower comorbidity (OR = 0.18, P = 0.018), lower UHDRS motor (OR = 0.90, P = 0.041), and lower risk for abdominal obesity (OR = 0.02, P = 0.011). In HD the moderate MeDi adherence is associated with better quality of life, lower comorbidity, lower motor impairment and lower risk for abdominal obesity compared to those participants with low MeDi adherence. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All
Sherman, Kerry A.; Miller, Suzanne M.; Roussi, Pagona; Taylor, Alan
Purpose Lymphedema affects 20-30% of women following breast cancer treatment. However, even when women are informed, they do not necessarily adhere to recommended lymphedema self-management regimens. Utilizing the Cognitive-Social Health Information Processing framework, we assessed cognitive and emotional factors influencing adherence to lymphedema risk management. Methods Women with breast cancer who had undergone breast and lymph node surgery were recruited through the Fox Chase Cancer Centre breast clinic. Participants (N=103) completed measures of lymphedema-related perceived risk, beliefs and expectancies, distress, self-regulatory ability to manage distress, knowledge, and adherence to risk management behaviors. They then received the American Cancer Society publication “Lymphedema: What Every Woman with Breast Cancer Should Know”. Cognitive and affective variables were reassessed at 6- and 12-months post-baseline. Results Maximum likelihood multilevel model analyses indicated that overall adherence increased over time, with significant differences between baseline and 6- and 12- month assessments. Adherence to wearing gloves was significantly lower than that for all other behaviors except electric razor use. Distress significantly decreased, and knowledge significantly increased, over time. Greater knowledge, higher self-efficacy to enact behaviors, lower distress, and higher self-regulatory ability to manage distress were associated with increased adherence. Conclusions Women who understand lymphedema risk management and feel confident in managing this risk are more likely to adhere to recommended strategies. These factors should be rigorously assessed as part of routine care to ensure that women have the self-efficacy to seek treatment and the self-regulatory skills to manage distress, which may undermine attempts to seek medical assistance. PMID:24970542
Lee Mei-Ling Ting
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.
A.M. Knops; M.N. Storm-Versloot; A.P.M. Mank; D.T. Ubbink; H. Vermeulen; P.M.M. Bossuyt; A. Goossens
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 gu
Full Text Available Background: Antiretroviral therapy has transformed the HIV infection into a chronic manageably disease. Optimal adherence (≥ 95% has required to achieve treatment success; however, still non-adherence remains major problem among patients receiving antiretroviral therapy (ART. The aim of this study was to determine adherences rate and evaluate factors affecting adherence among patients on ART in Dessie Referral Hospital (DRH. Materials and Methods: A cross sectional study employing both qualitative and quantitative methods was used. A total of 130 people living with HIV/AIDS on ART were included. All patients who came to the hospital during study period were considered based on convenient sampling technique. Chi-Square test is used to examine the association of adherence with associated factors. Both data entry and analysis was done using SPSS version 16. Results: Of 130 respondents, 58(44.6% were males and 72(55.4% were females and 107 (82.3% had 100% adherences, 10(7.7% had 95 -100% and the rest, 13(10% had <95% adherences with overall adherence rate of 90% for last month prior to the study period. The main reasons for non-adherence were 12(37.5% forgetfulness, 7(21.8% being away from home and 4 (12.5% being extremely ill. Use of other medications in addition to antiretroviral drugs (p=0.01, treatment fit into daily routines (p=0.01, family disclosure (p=0.01, active substance use (p=0.04 and living condition (p=0.00 were significantly associated with adherence to ART. Conclusion: The self reported adherence rate to ART (90% was found to be relatively higher which needs inclusion of other methods to ensure consistency of this value. Forgetfulness, being away from home and being extremely ill were the foremost reasons for non-adherence. The patients should be encouraged to maintain this high level of adherence.
Soil erodibility is a measure of a soil’s resistance against erosive forces and is affected by both intrinsic (or inherent) soil property and the extrinsic condition at the time erodibility measurement is made. Since soil erodibility is usually calculated from results obtained from erosion experimen...
Christie, Russell; Sketris, Ingrid; Andreou, Pantalis; Holbrook, Anne; Levy, Adrian; Tamim, Hala
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.
Karim Said Shabanlou
Full Text Available Emotional Divorce is the most important factor in the rupture of the most fundamental structures of society, the family.Due to the sensitivity and position of the familyAnd its functions specifically to investigate the factors underlying emotional divorce has of particular importance.Emotional Divorce phenomenon is not a single factor, but rather a set of related factors together led to Emotional Divorce.In this paper the role of psychological factors such as early maladaptive schemas, negative body image, perfectionism is discussed on an emotional divorce.Also quality of life and family relationships of couples with emotional divorce,Such as quality of health, sexual dissatisfaction, ignoring the needs, expectations and opinions of women by men or vice versa,And also social and economic factors such as subcultures families, couples, the quality of social relationships, social networks couple,Economic situation of the families of the couple, financial crisis, unemployment and economic revenues couples studied and some suggestions are presented based on the findings.
Brett, J; Fenlon, D; Boulton, M; Hulbert-Williams, N J; Walter, F M; Donnelly, P; Lavery, B; Morgan, A; Morris, C; Watson, E
Adherence to adjuvant endocrine therapy (AET) following breast cancer is known to be suboptimal despite its known efficacy in reducing recurrence and mortality. This study aims to investigate factors associated with non-adherence and inform the development of interventions to support women and promote adherence. A questionnaire survey to measure level of adherence, side effects experienced, beliefs about medicine, support received and socio-demographic details was sent to 292 women 2-4 years post breast cancer diagnosis. Differences between non-adherers and adherers to AET were explored, and factors associated with intentional and unintentional non-adherence are reported. Approximately one quarter of respondents, 46 (22%), were non-adherers, comprising 29 (14%) intentional non-adherers and 17 (8%) unintentional non-adherers. Factors significantly associated with intentional non-adherence were the presence of side effects (p adherence were younger age (adherence and unintentional non-adherence. Differentiation between the two types of non-adherence may help tailor support and advice interventions. © 2016 John Wiley & Sons Ltd.
Aziz, Hamiza; Hatah, Ernieda; Makmor Bakry, Mohd; Islahudin, Farida
studies comparing factors that may influence patients’ adherence to medication among patients who received medication subsidies should be done to develop strategies to overcome medication nonadherence. PMID:27313448
Ma, Yifei; Xu, Wei; Liang, Zhigao; Li, Yiming; Yu, Hongyu; Yang, Chunshan; Li, Jidong; Liang, Shuang; Liu, Tielong; Xiao, Jianru
Patient-oncologist alliance and psychosocial well-being have strong associations with adherence to cancer management. For patients with cancer of unknown primary (CUP), adherence is crucial to treatment or occult primary screening plans. There has been no study investigating the relationship between alliance, psychosocial factors, and adherence in such patients or in Chinese sociocultural settings. The measures of alliance, psychosocial well-being, and adherence willingness were administered to patients with CUP, with a mean age of 58.33 ± 11.24 years. Multiple linear regression models were applied to investigate the independent relationship between alliance and adherence by controlling for socioeconomic and psychosocial confounders. Alliance was found to be independently and positively associated with greater adherence willingness and adherence to treatment and follow-up screening after controlling for significant confounders, including medical conditions, psychosocial well-being variables, and socioeconomic factors. Stronger patient-oncologist alliance may foster enhanced adherence to treatment and follow-up screening in patients with CUP. Patient-oncologist alliance seems affected by socioeconomic factors and psychosocial well-being in the Chinese sociocultural settings. Copyright © 2016 John Wiley & Sons, Ltd.
Full Text Available Stella Tilu Pihau-Tulo, Richard W Parsons, Jeffery D Hughes CHIRI and School of Pharmacy, Curtin University, Perth, WA, Australia Purpose: The aims of this study were to evaluate the extent of adherence to hypoglycemic medications, assess the relationship between adherence and glycemic control, and evaluate factors affecting adherence.Research design and methods: This was a cross-sectional study of patients with established type 2 diabetes attending the Port Moresby General Hospital Diabetes Clinic. Face-to-face interviews were conducted using a questionnaire designed for the study and data were collected concerning the 3 months prior to interview. The questionnaire covered demographic details, lifestyle, biochemical and physical measurements, and medication management. Glycemic control was investigated among patients adhering to their medications (not missing doses to different degrees (100%, 95%, 90%, and 80%. Results: Of a total of 356 participants who were prescribed hypoglycemic medications, 59.6% omitted some of their doses. Age appeared to have a significant impact on adherence at some levels of adherence, with those aged >60 years being more likely to be adherent (logistic regression. Those who were 95%–99% and those who were <80% adherent had a statistically significant risk of a high glycated hemoglobin of >10% (85.5 mmol/mol. Multiple factors were identified as contributors to nonadherence, with patient-based issues (86.0% and the health care system (21.7% being the most common.Conclusion: This study showed a significant level of nonadherence among patients with type 2 diabetes in Papua New Guinea. Nonadherence to medication appeared to be associated with poor glycemic control and was due to a variety of reasons. Future interventions aimed at improving adherence will need to take these into account. Keywords: adherence, type 2 diabetes, A1C, Papua New Guinea, age, sex, contributing factors
Ebben, Remco H A; Vloet, Lilian C M; Schalk, Donna M J; Mintjes-de Groot, Joke A J; van Achterberg, Theo
Adherence to ambulance and ED protocols is often suboptimal. Insight into factors influencing adherence is a requisite for improvement of adherence. This study aims to gain an in-depth understanding of factors that influence ambulance and emergency nurses' adherence to protocols. Semi-structured interviews were held with ambulance nurses, emergency nurses, and physicians (N = 20) with medical end responsibility in the Netherlands to explore influencing factors. Content analysis was used to identify influencing factors. The main influencing factors for adherence were individual factors, including individual (clinical) experience, awareness, and the preference of following local protocols instead of national protocols. Organizational or external factors were involvement in protocol development, training and education, control mechanisms for adherence, and physicians' interest. Also of influence were protocol characteristics including integration of the advanced trauma life support approach, being in accordance with daily practice, and the generality of the content. Influencing factors could be a barrier as well as a facilitator for adherence. Factors influencing ambulance and emergency nurses' protocol adherence could be assigned to individual, organizational, and external categories, as well as to protocol characteristics. To improve adherence, implementation strategies should be tailored to identified factors. Multifaceted implementation strategies will be needed to improve adherence. Copyright © 2014 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.
Lam, Sandi; Luerssen, Thomas G; Hadley, Caroline; Daniels, Bradley; Strickland, Ben A; Brookshier, Jim; Pan, I-Wen
for cranial orthosis therapy than families with commercial insurance, a child with a diagnosis of plagiocephaly, or an initial recommendation for repositioning or physical therapy. Factors associated with treatment completion included corrected age, insurance, diagnosis, recommended treatment, and distance to provider from patient's residence. Patients with commercial insurance (OR 1.49, 95% CI 1.10-2.02, p = 0.009), those diagnosed with both brachycephaly and plagiocephaly (OR 2.26, 95% CI 1.31-3.90, p = 0.003), those recommended for treatment with cranial orthosis (OR 4.55, 95% CI = 3.24-6.38, p < 0.001), and those living in proximity to the provider (OR 1.40, 95% CI 1.00-1.96, p = 0.047) were more likely to complete treatment. CONCLUSIONS Insurance type, degree of head shape deformity, and types of recommended treatment appear to affect rates of adherence to recommended treatments for positional skull deformation.
Gare, Janet; Kelly-Hanku, Angela; Ryan, Claire E; David, Matthew; Kaima, Petronia; Imara, Ulato; Lote, Namarola; Crowe, Suzanne M; Hearps, Anna C
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.
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.
Ugwu, Rosemary; Eneh, Augusta
Introduction The efficiency of antiretroviral therapy (ART) depends on a near-perfect level of patient's adherence. Adherence in children poses peculiar challenges. The aim of the study was to determine the adherence level and factors influencing adherence among HIV-infected children and adolescents in University of Port Harcourt Teaching Hospital, Nigeria. Methods A cross-sectional survey of HIV-infected children and adolescents on ART using self-report by the caregiver/child in the past one...
Phillips, L. Alison; Leventhal, Elaine A.; Leventhal, Howard
Objective Physicians are inaccurate in predicting non-adherence in patients, a problem that interferes with physicians’: 1) appropriate prescribing decisions and 2) effective prevention/intervention of non-adherence. The purpose of the current study is to investigate potential reasons for the poor accuracy of physicians’ adherence-predictions and conditions under which their predictions may be more accurate. Methods After the medical encounter, predictions of patient-adherence and other ratings from primary-care physicians (n=24) regarding patient-factors that may have influenced their predictions were collected. Patients (n=288) rated their agreement regarding the prescribed treatment after the encounter and reported adherence one month later. Results Several factors were related to physicians’ adherence-predictions, including physicians’ perceptions of patient-agreement regarding treatment. However, some factors were not related to adherence and agreement-perceptions were inaccurate overall, potentially contributing to the poor accuracy of adherence-predictions. The degree to which physicians discussed treatment-specifics with the patient moderated agreement-perception accuracy but not adherence-prediction accuracy. Conclusions Training providers to discuss certain treatment-specifics with patients may improve their ability to perceive patient-agreement regarding treatment and may directly improve patient-adherence. Practice Implications Discussing treatment-specifics with patients may directly improve adherence, but providers should not rely on these discussions to give them accurate estimates of the patients’ likely adherence. PMID:21501943
Bidzińska, E J
An investigation carried out on 97 patients with affective disorders and on 100 healthy control subjects, revealed that acute and chronic stress factors occurred more in the group of patients with affective disorders than among healthy control over a similar time period. The frequency of stressful life situations was the same before the first affective episode in patients with unipolar and bipolar illness. The possible participation of such factors in triggering the first phase of illness is discussed. Similar factors appeared in both types of affective disorders. Significantly more frequent among patients than in the control group were: marital and family conflicts, health problems, emotional and ambitional failures, lack of success and work overload.
In English teaching and learning, listening ability is an important part of communicative competence, is a very practical integrated skill. It has been a difficult skill in second language acquisition for many students. Many Chinese students are skilled in reading, but often they tend to neglect the listening. However, owing to the higher requirements of many English tests and the great importance in communication, students begin to pay attention to develop their English listening skills. But there are many factors affecting listening, the paper mainly focuses on linguistic factors and non-linguistic factors that affect listening, to provide a theoretical basis to help exploring ways of improving listening and comprehension skills.
Ali Mohammad Mosadeghrad
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. Qu...
Mosadeghrad, Ali Mohammad
Abstract Background 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. Methods Exploratory in-depth individual interviews were conducted with sixty-four physicians working in various medical institutions in Iran. Results Individual, organizational and environmental factors enhance or inhib...
Weng, Li-Chueh; Yang, Ya-Chen; Huang, Hsiu-Li; Chiang, Yang-Jen; Tsai, Yu-Hsia
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.
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.
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
Voorham, Jaco; Haaijer-Ruskamp, Flora M.; Wolffenbuttel, Bruce H. R.; Stolk, Ronald P.; Denig, Petra
Background: Low rates of treatment modification in patients with insufficiently controlled risk factors are common in type 2 diabetes. Although adherence problems are often mentioned in surveys as a reason for not intensifying treatment, observational studies have shown inconclusive results. Objecti
Antiretroviral therapy places extraordinarily high demands on adherence, since non-adherence affects both individuals and society due to the spread of resistant viral strains. The aims of the thesis were to investigate the prevalence of adherence in Swedish HIV-infected patients, changes in adherence over time, and factors associated with adherence, including patients’ readiness to adhere. Further, to investigate the collaboration between nurses, doctors and pharmacists after the introduction...
Liu, Jianming; Liu, Zhiliang; Ding, Hu; Yang, Xiaohong
To assess adherence to antiepileptic drugs (AEDs) and factors associated with non-adherence in a sample of Chinese patients with epilepsy. A cross-sectional descriptive study was carried out on patients who had no change in treatment regimen over the last six months. Data on adherence to medication and related factors for each patient were gathered using a questionnaire. Of a total of 368 patients studied, 48.1% of patients were non-adherent with regards to AEDs. There were no demographic differences (based on gender, age, seizure type, and rural or urban location) between adherent and non-adherent patients. Adherence was positively and significantly correlated with duration of illness (p=0.007). The primary reason for non-adherence was forgetfulness or not having medication on hand (69.6%), followed by a negative attitude (12.8%), a bad patient-prescriber relationship (9.5%), side effects (5.4%), inability to buy drugs (1.9%), and other reasons (0.8%). The non-adherence of epilepsy patients is common in China. Targeted management programs and communication strategies are necessary to improve adherence to AED treatments in patients with epilepsy and avoid the clinical consequences of poor adherence.
Evangeli, Michael; Mughal, Kulsoom; Porter, John B
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.
Carter, Stephen R; Moles, Rebekah; White, Lesley; Chen, Timothy F
This article explores medication information seeking behavior (MISB). We aimed to develop a scale for measuring MISB and use it to explore the relationships between MISB, adherence and factors, which drive information seeking. Patients (N=910) using multiple medicines completed questionnaires. Exploratory and confirmatory factor analyses were performed. Correlations and multivariate analyses were used to investigate the relationships between variables. Respondents sought medication information mainly from health professionals and written medicines information. The medication information seeking behavior scale (MISB) had acceptable reliability and validity. Information seeking was most intense among respondents who had recent changes in their medicine regimen and worries about their medicines. Those who sought medication information from autonomous sources were more likely to be non-adherent than those who never did (OR=2.00 [1.48, 2.70]). Seeking information from health professionals had no influence on adherence. Health practitioners should carefully attend to patients' questions about medicines information. When patients mention that they are worried about their medicines and have sought medication information from television, magazines, brochures or family and friends, this could be a sign that they tend towards non-adherent behavior. The MISB scale could be used to learn more about patients' use of medication information. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Van Liew, Julia R; Christensen, Alan J; de Moor, Janet S
For patients with hormone receptor positive breast cancer, survivorship entails prolonged self-management of adjuvant treatment in the form of daily hormone therapy. Although sustained daily adherence across the 5-year course of therapy is associated with improved recurrence-free survival outcomes, adherence is suboptimal and many women discontinue hormone therapy prematurely. Factors associated with breast cancer survivors' nonadherence and nonpersistence are not comprehensively understood. Furthermore, psychosocial variables have only received limited research attention, despite their documented relationships with adherence in other chronic illness populations. A systematic literature review identified 14 studies that analyzed relationships between psychosocial factors and breast cancer survivors' adherence and/or persistence with adjuvant hormone therapy. Although identified relationships were complex and at times inconsistent, salient conclusions emerged. Interpersonal factors, in the form of positive social support and patient-centered interactions with medical providers, as well as intrapersonal factors, such as anxiety and beliefs about the relative benefits of medication use, were reliably associated with better adherence and persistence. Depression did not demonstrate the negative impact on adherence that has been observed in other medical populations. No relationships between quality of life and adherence were identified. Adjuvant hormone therapy appears to be a unique context for medication adherence, which warrants further attention and more rigorous analysis in future research. Individual patients' psychosocial characteristics and health care preferences should be considered when striving to optimize medication adherence.
Wakibi Samwel N
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.
Uptake of, & Sustained Adherence to Lymphedema Symptom Minimization Practices in Breast Cancer Survivors PRINCIPAL INVESTIGATOR: Suzanne M. Miller...SUBTITLE 5a. CONTRACT NUMBER Cognitive-Affective Predictors of the Uptake of, & Sustained Adherence to Lymphedema Symptom Minimization Practices in...SUPPLEMENTARY NOTES 14. ABSTRACT Approximately 20-30% of women develop lymphedema (LE) following breast cancer treatment. Effective symptom management
Chang, Yuhua; Gu, Weimin; McLandsborough, Lynne
The distribution and survival of the food-borne pathogen Listeria monocytogenes is associated with its biofilm formation ability, which is affected by various environmental factors. Here we present the first evidence that EDTA at low concentration levels inhibits the biofilm formation of L. monocytogenes. This effect of EDTA is not caused by a general growth inhibition, as 0.1 mM EDTA efficiently reduced the biofilm formation of L. monocytogenes without affecting the planktonic growth. Adding 0.1 mM of EDTA at the starting time of biofilm formation had the strongest biofilm inhibitory effect, while the addition of EDTA after 8 h had no biofilm inhibitory effects. EDTA was shown to inhibit cell-to-surface interactions and cell-to-cell interactions, which at least partially contributed to the repressed initial adherence. The addition of sufficient amounts of cations to saturate EDTA did not restore the biofilm formation, indicating the biofilm inhibition was not due to the chelating properties of EDTA. The study suggests that EDTA functions in the early stage of biofilm process by affecting the initial adherence of L. monocytogenes cells onto abiotic surfaces.
Chua, Xin Hui Jasmine; Lim, Siriwan; Lim, Fui Ping; Lim, Yee Nah Anita; He, Hong-Gu; Teng, Gim Gee
To examine the factors influencing adherence to urate-lowering therapy in patients with gout in Singapore. Gout is the most common type of chronic inflammatory arthritis. Urate-lowering therapy (ULT) is used to treat gout by reducing serum uric acid levels. However, adherence to ULT among patients remains poor. To date, there have been no available studies based on a conceptual framework that examined factors influencing medication adherence in patients with gout. Cross-sectional, descriptive correlational study. A convenience sample of outpatients (n = 108) was recruited between October 2014 and January 2015 from a tertiary hospital in Singapore. Outcomes were measured by relevant valid and reliable instruments. Descriptive statistics and parametric tests including multiple linear regression were used to analyse the data. Although 44.4% of the participants were high adherers to urate-lowering therapy, the mean adherence level was moderate. Significant differences in medication adherence scores were found among the subgroups of gender, ethnicity, marital status, employment status, and presence of comorbidity. Medication adherence was positively significantly correlated with age, number of comorbidities, and beliefs about medicines. Linear regression showed that higher level of beliefs about medicines, presence of comorbidity, and being married were factors positively influencing medication adherence. This study revealed moderate adherence to ULT in patients with gout in Singapore, indicating the need for strategies to improve adherence by considering its main influencing factors. Future research should be conducted to develop interventions targeted at modifying patients' beliefs about medicines in order to improve medication adherence. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Ellis, Mesha L.; Weiss, Bahr; Han, Susan; Gallop, Robert
Therapist treatment adherence has received a great deal of attention in recent years, in part because of its relation to treatment outcomes. Although certain therapist behaviors have been found to be associated with treatment outcomes, little is known about client factors impacting on therapists' ability to adhere to treatment protocols. In this…
McBride Sebastian D
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.
Cheung, Winson Y
The number of anticancer drugs currently available in oral formulation has increased dramatically over the past 15 to 20 years, especially with the recent development of new hormonal and targeted therapies. At present, approximately 25% of all cancer drugs are available in oral formulation, with numbers expected to increase exponentially in the coming years. The convenience associated with the self-administration of oral therapy, the requirement of fewer trips to the physician's office, and the lack of infusion reactions are all benefits for patients, allowing them to potentially maintain their relative independence while undergoing active anticancer treatment. On the other hand, there are growing concerns regarding patients' poor adherence to oral therapy as well as the challenges of monitoring patient compliance when treatment administration does not occur in the presence of health care professional (HCPs). More importantly, poor adherence to proven therapies may detrimentally affect the patients' clinical outcomes, such as survival. Thus, there is an urgent need to identify more effective strategies to measure and monitor adherence to oral anticancer agents in an effort to maximize their therapeutic benefits.
Forsberg, Daniel; Rosipko, Beverly; Sunshine, Jeffrey L
The purpose of this study was to determine if any of the factors radiologist, examination category, time of week, and week effect PACS usage, with PACS usage defined as the sequential order of computer commands issued by a radiologist in a PACS during interpretation and dictation. We initially hypothesized that only radiologist and examination category would have significant effects on PACS usage. Command logs covering 8 weeks of PACS usage were analyzed. For each command trace (describing performed activities of an attending radiologist interpreting a single examination), the PACS usage variables number of commands, number of command classes, bigram repetitiveness, and time to read were extracted. Generalized linear models were used to determine the significance of the factors on the PACS usage variables. The statistical results confirmed the initial hypothesis that radiologist and examination category affect PACS usage and that the factors week and time of week to a large extent have no significant effect. As such, this work provides direction for continued efforts to analyze system data to better understand PACS utilization, which in turn can provide input to enable optimal utilization and configuration of corresponding systems. These continued efforts were, in this work, exemplified by a more detailed analysis using PACS usage profiles, which revealed insights directly applicable to improve PACS utilization through modified system configuration.
Renato Zambrano C
Full Text Available Objective: To identify the perceptions regarding adherence to treatment among patients with cardiovascular risk undergoing pharmacological or non-pharmacological treatment. Methodology: A transversal study using the instrument “issues influencing adherence to pharmacological or non-pharmacological treatments in patients with cardiovascular risk factors". The study assesses four major factors in 256 adults living in Medellín (Colombia, South America, namely: socio-economic factors, factors related to the healthcare service provider, factors related to the therapy itself, and patient-related factors. Results: In terms of the perception of treatment adherence, socio-economic factors had the lowest score. Additionally, the educational level of patients was found to be the factor with the strongest influence on adherence perception. Discussion: This study approaches the various aspects of the issue of treatment adherence with more extensive knowledge in order to contribute to the development of strategies for improving treatment adherence in patients with cardiovascular risk. The study also suggests communicating medical recommendations in different manners and in a patient-friendly language (i.e. a kind of language with no technical words. Likewise, establishing more effective strategies for diet management is suggested
Lunghi, Carlotta; Zongo, Arsène; Moisan, Jocelyne; Grégoire, Jean-Pierre; Guénette, Line
To identify factors associated with antidiabetic drug (AD) non-adherence among patients with type 2 diabetes and depression. We conducted a population-based retrospective cohort study among new AD users with a diagnosis of depression following AD initiation. We used public health insurance data from Quebec. The dependent variable was non-adherence (i.e., non-adherence to AD treatment. We performed univariate and multivariate logistic regressions. We identified 3106 new users of ADs with a diagnosis of depression between 2000 and 2006. Of these individuals, 52% were considered non-adherent to their ADs. Baseline non-adherence, younger age, the addition of another AD to the initial treatment, non-adherence. The factors identified in the present study may help clinicians recognize patients with type 2 diabetes and incident depression at increased risk for non-adherence. In these patients, close follow-up and targeted interventions could help improve adherence to AD treatment, improve glycemic control and reduce complications. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available AIM: This study was performed to determine the psychological factors affecting infertile women presenting at the infertility outpatients department. METHOD: The sample of this cross-sectional study consisted of 344 women who presented at the IVF center of a special branch hospital or a university hospital, March 2008 through September 2008, as determined by the non-random sampling method. All participating women gave their informed consent. The data were collected using the Data Form that consisted of questions on socio-demographic features and the Infertility Distress Scale (IDS. In the results, percentages were provided along with the Kruskal-Wallis H, Mann-Whitney U and Spearman correlation tests. RESULTS: The mean IDS was 39.01±9.6. There was a statistically significant linear relationship between the mean IDS score and age (r=0.106, p=0.048, marriage duration (r=0.232, p<0.001 and duration of desire to have a child (r=0.217, p<0.001. Women who were primary school graduates (X²=13.03, p=0.004, did not work (p=0.007, had no social security benefits (p=0.021 or from low socioeconomic status (X²=24.85, p<0.001 had significantly higher mean IDS scores. CONCLUSION: The results of this study show women become more adversely affected by infertility as their age, duration of marriage, and duration of desire to have a child increase. Women who are primary school graduates, do not work, have no social security benefits or have lower income are affected more negatively. We believe that taking these features into account when evaluating and planning supportive approaches for women presenting at the infertility treatment center and determining the psychological state of the women using the IDS will increase treatment success. [TAF Prev Med Bull 2010; 9(5.000: 481-486
Craig, J C; Kisner, J M
Tactile spatial acuity on the fingerpad was measured using a grating orientation task. In this task, subjects are required to identify the orientation of square-wave gratings placed on the skin. Previous studies have shown that performance varies as a function of the width of the grooves in the gratings. In the present study, both groove width and the overall size and configuration of the contactors were varied. Sensitivity improved with wider grooves and with larger contactors. Additional measurements showed that the improved sensitivity is not the result of the increase in total area contacted, but rather is due to two other factors associated with larger contactors. One is the greater linear extent of the larger contactors. The other appears to be due to the reduction in the interference produced by the outer edge of the contactor. Specifically, as the contactor increases in size, the distance between the outer edge and the center portion of the grooves also increases. It was also shown that subjects are more sensitive to a single, continuous groove as compared with two grooves of the same total length but spatially discontinuous. Similarly, subjects are more sensitive to a contactor with a continuous groove than to a contactor in which just the end points of the groove are presented. The results are generally consistent with the results of peripheral, neurophysiological recordings. The results are discussed in terms of the way in which both spatial and intensive factors may affect sensitivity to grating orientation.
Bahadori, Mohammadkarim; Raadabadi, Mehdi; Ravangard, Ramin; Baldacchino, Donia
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.
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.
Ebben, R.H.; Vloet, L.C.M.; Grunsven, P.M. van; Breeman, W.; Goosselink, B.; Lichtveld, R.A.; Groot, J. de; Achterberg, T. van
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
Full Text Available Rajesh Shigdel,1 Elise Klouman,2 Anita Bhandari,2 Luai A Ahmed11Department of Health and Care Sciences, 2Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, NorwayPurpose: There are a high number of HIV-infected patients receiving antiretroviral therapy (ART in the Kathmandu District of Nepal, but information on adherence and factors influencing it are scarce in this population. The present study aimed to estimate ART adherence among HIV-infected patients in the Kathmandu District of Nepal, and to determine the factors associated with ART adherence.Patients and methods: This study included 316 HIV-infected patients attending three ART centers in the Kathmandu District. Information on sociodemographic characteristics, socioeconomic status, and ART use for the previous 7 days was collected via interview. Participants were considered adherent if they reported taking ≥95% of their ART as prescribed. The association between explanatory variables and ART adherence was measured using logistic regression and reported as odds ratios (OR with 95% confidence intervals (CI.Results: Male participants accounted for 64.6% (n=204. Overall ART adherence was 86.7%. ART adherence in men and women were 84.3% and 91.1%, respectively. Age (OR 1.04; 95% CI 1.00–1.09, travel time to ART centers (OR 1.38; 95% CI 1.12–1.71, history of illegal drug use (OR 3.98; 95% CI 1.71–9.24, and adverse effects (OR 4.88; 95% CI 1.09–21.8, were all independently and negatively associated with ART adherence. Use of reminder tools (OR 3.45; 95% CI 1.33–8.91 was independently and positively associated with ART adherence.Conclusion: The observed ART adherence in this study is encouraging. Travel time to ART centers, self-reported adverse effects, illegal drug use, and not using reminder tools were the major determinants of ART adherence. Interventions that take these factors into account could further improve ART
Full Text Available Hypertension is an overwhelming global challenge. Despite the development of many effective anti hypertensive drugs, target to reduce morbidity and mortality due to high blood pressures are reached in only a minor of patients in clinical practice. Poor adherence is one of the biggest obstacles in therapeutic control of blood pressures. There are complaints from patients and physicians that the poor result of actual antihypertensive drug therapies. Many people with age indifference are attacked by this silent killer or which results in target organ damage as a complication. The aim of this study was to assess the magnitude of adherence and the factors associated with non-adherence to anti-hypertensive medication. Cross sectional exclusively convenient study was conducted by using structured questionnaires consisting of open and closed-ended questions on patients diagnosed for hypertension and have already been on anti hypertensive medications at least for three months at Dessie Referral hospital from 20/01/2012 to 29/01/2012. A total of hundred hypertensive patients were screened from hundred six cases by the exclusive criteria and the overall incidence of anti-hypertensive medication non adherence was 26%. The study identifies reasons why patients dont adherent with the drug regiments. Among Factors associated with non adherence were health system and health care provider poor interaction with patient and therapy factors like frustration and unwanted effect of the medication in the long run. There was indication of non adherence from the study area. Great emphasis should be placed on intervention strategies such as patient counseling and increasing awareness of the physicians, all other prescribers and health care providers at large about the non adherence of anti hypertensive drugs as well as the complication what comes due to this medication non adherence. [Int J Res Med Sci 2013; 1(3.000: 191-197
Wang, Jingxu; Lin, Jintai; Ni, Ruijing
Rapid industrial and economic growth has meant a 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 RF of 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., emissions per 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 lowered by a small 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
Wang, J.; Lin, J.; Ni, R.
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
Verbrugghe, M; Verhaeghe, S; Lauwaert, K; Beeckman, D; Van Hecke, A
The use of oral anticancer drugs has increased in modern oncology treatment. The move from intravenous treatments towards oral anticancer drugs has increased the patients' own responsibility to take oral anticancer drugs as being prescribed. High rates of non-adherence to oral anticancer drugs have been reported. A systematic literature review was conducted to gain insight into determinants and associated factors of non-adherence and non-persistence in patients taking oral anticancer therapy. PubMed, Cochrane, Web of Science and Cinahl were systematically searched for studies focusing on determinants and associated factors of medication non-adherence and non-persistence to oral anticancer drugs. The methodological quality of the included studies was assessed by two independent reviewers. No studies were excluded based on the quality assessment. Twenty-five studies were included and systematically reviewed. The quality of the studies was moderate. Associated factors influencing medication non-adherence and non-persistence to oral anticancer drugs are multifactorial and interrelated. Older and younger age, and the influence of therapy related side effects were found to be predominant factors. Non-adherence and non-persistence to oral anticancer drug therapy are complex phenomena. More qualitative research is needed to facilitate the development of patient tailored complex interventions by exploring patients' needs and underlying processes influencing medication non-adherence and non-persistence to oral anticancer drugs. Copyright © 2013 Elsevier Ltd. All rights reserved.
Mendelsohn, Joshua B; Schilperoord, Marian; Spiegel, Paul; Ross, David A
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. 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. 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 refugees, conflict-affected persons, internally-displaced persons (IDPs), and combinations of refugees, IDPs and other foreign-born persons. The reviewed reports showed promise for conflict-affected and forcibly-displaced populations; the range of optimal adherence prevalence reported was 87-99.5%. Treatment outcomes, measured using virological, immunological and mortality estimates, were good in relation to non-affected groups. Given the diversity of settings where forcibly-displaced and conflict-affected persons access ART, further studies on adherence and treatment outcomes are needed to support scale-up and provide evidence-based justifications for inclusion of these vulnerable groups in national treatment plans. Future studies and program evaluations should focus on systematic monitoring of adherence and treatment interruptions by using facility-based pharmacy records, understanding threats to optimal
Rondags, Angelique; Himawan, Ari Budi; Metsemakers, Job Fm; Kristina, Tri Nur
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.
De las Cuevas, Carlos; de Leon, Jose; Peñate, Wenceslao; Betancort, Moisés
Purpose To evaluate pathways through which sociodemographic, clinical, attitudinal, and perceived health control variables impact psychiatric patients’ adherence to psychopharmacological medications. Method 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. Results 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. 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.
Patino-Alonso, Maria C; Recio-Rodríguez, José I; Belio, Jose Felix Magdalena; Colominas-Garrido, Ruben; Lema-Bartolomé, Jorge; Arranz, Amparo Gómez; Agudo-Conde, Cristina; Gomez-Marcos, Manuel A; García-Ortiz, Luis
Our aim was to analyze the variables associated with adherence to the Mediterranean diet in the adult population. We conducted a cross-sectional study in an established cohort of 1,553 healthy study participants (mean age=55 ± 14 years; 60.3% women). Mediterranean diet adherence was evaluated based on a 14-item questionnaire and the Mediterranean diet adherence screener, which defines adequate adherence as a score of ≥ 9. Physical activity was evaluated using the 7-day physical activity record. Sociodemographic, biological, and anthropometric variables were also evaluated. The differences between Mediterranean diet compliers and noncompliers are defined by the consumption of fruit, red meats, carbonated beverages, wine, fish/shellfish, legumes, pasta, and rice (PMediterranean diet adherence: more physical exercise (odds ratio=1.588), older age (odds ratio=2.162), and moderate alcohol consumption (odds ratio=1.342). The factors associated with improved Mediterranean diet adherence included female sex, age older than 62 years, moderate alcohol consumption, and more than 17 metabolic equivalents (METs)/h/wk of physical exercise. Poorer adherence was associated with males and obesity.
By reviewing the literature, the author points out some theoretical defects of the CPH on which the policy was based. CPH is the conceptualization formulation of the maturational constraints for SLA. The paper, based on the reality of China, put forward some suggestion, which includes the time factor, the teacher's factor and the content factor.
Bender, Catherine M; Gentry, Amanda L; Brufsky, Adam M; Casillo, Frances E; Cohen, Susan M; Dailey, Meredith M; Donovan, Heidi S; Dunbar-Jacob, Jacqueline; Jankowitz, Rachel C; Rosenzweig, Margaret Q; Sherwood, Paula R; Sereika, Susan M
To comprehensively assess the patient and illness or treatment factors that may predict nonadherence to adjuvant endocrine therapy and to explore whether an interaction occurs between these factors in women with breast cancer. Repeated-measures design. The Outpatient Services of the Women's Cancer Program at the University of Pittsburgh Cancer Institute and participants' homes. 91 women with early-stage breast cancer who received endocrine therapy. Adherence was assessed continuously for the first 18 months of endocrine therapy. Patient and illness or treatment factors were assessed at four time points (Time 1 to Time 4). Time 1 (baseline) was within two weeks prior to the initiation of endocrine therapy. Times 2-4 occurred at six-month intervals, as many as 18 months after Time 1. Adherence, patient factors, and illness or treatment factors. Adherence to endocrine therapy declined significantly during the first 18 months of treatment in women with breast cancer. The presence of negative mood and symptoms before starting treatment predicted nonadherence to endocrine therapy over time. Perceptions of financial hardship, symptoms, disease stage, and more complex medication regimens intensified the effect of negative mood on adherence over time. Women with breast cancer may be at risk for nonadherence to prescribed endocrine therapy if they experience depression or anxiety and symptoms prior to initiating therapy. Oncology nurses should be alert to women with breast cancer who are depressed or anxious or who are experiencing symptoms. Management of negative mood and symptoms may result in better adherence.
Angela Frances Yap, BSc (Pharm (Hons
Full Text Available Medication adherence is a crucial component in the treatment of chronic diseases. In the elderly, clinicians are faced with a unique set of problems associated with adherence that they may not have been adequately trained for. In this paper, we demonstrate the importance of medication adherence in the elderly through a case study. The different factors affecting medication adherence in the elderly are highlighted: patient, medication, health care providers, health care system, and socioeconomic factors. Lastly, we have proposed various ways to address these factors. In doing so, clinicians can better understand the problems that the elderly face, thus achieving better therapeutic outcomes.
Munir, Kerim; Kanabkaew, Cheeraya; Le Coeur, Sophie
Background Existing studies have suggested decreased adherence and rebound in mortality in perinatally HIV-infected adolescents receiving antiretroviral therapy (ART) as compared to adults and young children. Methods We used both quantitative and qualitative approaches to identify factors influencing adherence among perinatally infected adolescents in Thailand. We analyzed data from 568 pairs of perinatally infected adolescents (aged 12–19) and their primary caregivers in the Teens Living With Antiretrovirals (TEEWA) study, a cross-sectional survey conducted in 2010–2012. We also conducted 12 in-depth interviews in 2014 with infected adolescents or their primary caregivers to elicit experiences of living with long-term ART. Results From the quantitative analysis, a total of 275 (48.4%) adolescents had evidence of suboptimal adherence based on this composite outcome: adolescents self-reported missing doses in the past 7 days, caregiver rating of overall adherence as suboptimal, or latest HIV-RNA viral load ≥1000 copies/ml. In multivariate logistic regression analysis, younger age, having grandparents or extended family members as the primary caregiver, caregiver-assessed poor intellectual ability, having a boy/girlfriend, frequent online chatting, self-reported unhappiness and easiness in asking doctors questions were significantly associated with suboptimal adherence. From the in-depth interviews, tensed relationships with caregivers, forgetfulness due to busy schedules, and fear of disclosing HIV status to others, especially boy/girlfriends, were important contributors to suboptimal adherence. Social and emotional support and counseling from peer group was consistently reported as a strong adherence-promoting factor. Conclusion Our findings highlight unique barriers of ART adherence among the perinatally infected adolescents. Future interventions should be targeted at helping adolescents to improve interpersonal relationships and build adaptive skills in
Skoglund, Charlotte; Brandt, Lena; Almqvist, Catarina; DʼOnofrio, Brian M; Konstenius, Maija; Franck, Johan; Larsson, Henrik
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.
Verbrugghe, Mathieu; Duprez, Veerle; Beeckman, Dimitri; Grypdonck, Mieke; Quaghebeur, Marijke; Verschueren, Caroline; Verhaeghe, Sofie; Van Hecke, Ann
Nonadherence in cancer patients taking oral anticancer drugs is common. Reasons for nonadherence are still not really understood as influencing factors are often complex, dynamic, and interrelated. A qualitative study was conducted to gain insight into (non-)adherence behavior in patients taking oral tyrosine kinase inhibitors by exploring (1) processes and factors influencing (non-)adherence and (2) their interrelatedness. Semistructured interviews were held with 30 patients of different ages and with different types of cancer. A grounded theory approach was used. Three foci were found when dealing with oral tyrosine kinase inhibitors: (1) a focus on survival, (2) a focus on quality of life, and (3) a balance between survival and quality of life. The process of adherence was determined by a set of complex and interrelated influencing factors: treatment-related side effects, hope, anxiety, trust, and feedback mechanisms. This qualitative study gives insight into processes and factors influencing (non-)adherence behavior in patients taking oral tyrosine kinase inhibitors. The results of this study can help healthcare professionals understand why patients taking oral tyrosine kinase inhibitors do not always adhere to their therapy. Conditions should be created by which patients get maximum opportunity to establish a balance between survival and quality of life. An open climate and a trust-based relationship should be established in which patients feel comfortable to openly discuss their therapy and the difficulties they experience.
Mumu, Shirin Jahan; Saleh, Farzana; Ara, Ferdous; Afnan, Fadia; Ali, Liaquat
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.
To assess adherence of Palestinian hypertensive patients to therapy and to investigate the effect of a range of demographic and psychosocial variables on medication adherence. A questionnaire-based, cross-sectional descriptive study was undertaken at a group of outpatient clinics of the Ministry of Health, in addition to a group of private clinics and pharmacies in the West Bank. Social and demographic variables and self-reported drug adherence (Morisky scale) were determined for each patient. Low adherence with medications was present in 244 (54.2%) of the patients. The multivariate logistic regression showed that younger age (risk of poor adherence who should be targeted for interventions to achieve better blood pressure control and hence prevent complications. This study should encourage the health policy makers in Palestine to implement strategies to reduce non-compliance, and thus contribute toward reducing national health care expenditures. Better patient education and communication with healthcare professionals could improve some factors that decrease adherence such as forgetfulness and dissatisfaction with treatment. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.
Shirin Jahan Mumu
Full Text Available 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.
Thaís Helena Piai-Morais
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.
Oluseun P. Ogunnubi
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.
Kim, Yongi-Mi; University of Oklahoma
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...
黄明孔; 吴晓庆; 付成善; 邹平; 高晓平; 黄强
To determine the factors which might affect the recover), of fertility after an accurate microsurgical vasovasostomy, we conducted a 3 year-follow-up study in 56 men after microsurgical vasovasostomy. Twenty-two variables as putative factors associated with recovery of fertility were measured. The results of Logistic regression and ather statistical analyses suggest that 8 factors including age of husband, age of wife, history of past pregnancies of current wife, number of vasovasostomies, serum FSH, LH and T before vasovasostomy, and sperm granuloma of vas nodule are of no significance in recovery of fertility, whereas 14 factors including years after vasectomy, sperm concentration, progressive motility, sperm motility, viability, normal morphology, sperm egg penetration rate, TAT and SIT before and after vasovasostomy, MAR, IBT adherent IgG and IgA after vasovasostomy are significantly, associated with repregnancy.
Önsel Ekici, Şule; Ekici, Ahmet
The purpose of this study is to take a macroethical perspective and study the relationships between various structural factors and ethical behavior of firms. Using the data obtained from the Global Competitiveness Network of the World Economic Forum-WEF, and through the Bayesian Causal Map (BCM) methodology, we study how ethical behaviors of firms in a given country group are shaped by how managers perceive the political, legislative, and protective environment of business in these countries....
AFECTAN LA SECURIDAD IBERICA FACTORES MARITIMOS QUE AFECTANJ LA SEGURIDAD IBE RICA Introduccion En lo que ataine a la seguridad ibe~rica, la realidad ...fuerzas naval.. sera~n de significado periferico. Aquella part. do la marina do guerra sovietica quo esta ya desplegada en el oce’ano sera/ aumentada ...nota de la realidad consabida de que tanto la hora de introduccion como la escala de emplec de las armas nlu- cleares en una guerra general anibas
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
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
ABSTRACT OBJECTIVE To analyze factors associated with low adherence to drug treatment for chronic diseases in Brazil. METHODS 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). RESULTS 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. CONCLUSIONS 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. PMID:27982378
Mariana Rotta Bonfim
Full Text Available Objective: To identify the adherence rate of a statin treatment and possible related factors in female users from the Unified Health System. Method: Seventy-one women were evaluated (64.2 ± 11.0 years regarding the socio-economic level, comorbidities, current medications, level of physical activity, self-report of muscular pain, adherence to the medical prescription, body composition and biochemical profile. The data were analyzed as frequencies, Chi-Squared test, and Mann Whitney test (p<0.05. Results: 15.5% of women did not adhere to the medical prescription for the statin treatment, whose had less comorbidities (p=0.01, consumed less quantities of medications (p=0.00, and tended to be younger (p=0.06. Those patients also presented higher values of lipid profile (CT: p=0.01; LDL-c: p=0.02. Musculoskeletal complains were not associated to the adherence rate to the medication. Conclusion: The associated factors to adherence of dyslipidemic women to statin medical prescription were age, quantity of comorbidities and quantity of current medication.
Kojima, Takuya; Asano, Shinya; Takahashi, Naoki
Chemical compounds are produced every day, many with adverse effects on human health, and hence it is vital to predict the risks to humans simply, rapidly, and accurately. Teratogens have a serious impact on fetal development. This has been studied mainly by phenotypic analysis of experimental animals. However, since phenotypes can vary within different species, we established a new evaluation system based on our recent finding that teratogens influence Hox gene expression in mice. Similarly to the Hox gene expression changes, the expression patterns of several transcription factors involved in development, including the Dlx, Irx, Sall, and T-box families, were altered after 6 h of exposure to retinoic acid (RA) or 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). The expression changes in Dlx4, Dlx6, Irx5, Sall2, Sall3, Sall4, Tbx10, and Tbx22 were linked to teratogen-induced phenotypes, and our results indicate that expression changes in developmental transcription factors can help to predict teratogenic risk.
Full Text Available Nowadays, traditional market is increasingly squeezed by the emergence of modern market that develops rapidly. The dominance shift in national retail is apparent when globalization can no longer be contained, let alone be banned. Middle class and small class (traditional market business retail seem to be in increasingly difficult condition to compete with upscale retail business (modern market. The purpose of this study is to analyze the factors influencing the competitiveness of traditional market and to develop policies to improve the competitiveness of traditional market. This study utilizes research strategy of case study in Bandung City, Serang City, and Surabaya City with qualitative descriptive approach. The study shows that the factors inhibiting the competitiveness of traditional market with modern stores are (1 Traditional market’s bad image, and (2 Traditional market’s sellers and managers are unprofessional. To improve the competitiveness of traditional market, this study recommends: (1 routine and regular maintenance of buildings and infrastructure of traditional market, (2 professionalism improvement of traditional market’s sellers and managers, and (3 the partiality of local government in traditional markets.
Seal, Brian S; Anderson, Sibyl; Shermock, Kenneth M
Over the past decade, oncology therapies have trended toward orally administered regimens, and there has been growing attention on evaluation of factors that affect adherence. There has not been a rigorous investigation of factors associated with adherence to intravenous (i.v.) and oral anticancer drugs in the setting of metastatic colorectal cancer (mCRC). To (a) assess potential patient-specific factors related to adherence to mCRC chemotherapy regimens and (b) compare adherence with IV versus oral dosage forms. A retrospective analysis was performed using the Optum Oncology Management claims database. Patients aged 18 years and older diagnosed with mCRC between July 1, 2004, and December 31, 2010, who were insured by a commercial health plan were included in the study. Adherence to i.v. and oral chemotherapy regimens was assessed using the National Comprehensive Cancer Network (NCCN) guidelines as the standard for expected cycle/regimen duration. The most commonly prescribed chemotherapy regimens were assessed. Adherence was evaluated using the medication possession ratio (MPR), calculated as the number of days a patient was covered by their chemotherapy regimen, according to NCCN guidelines, divided by the number of days elapsed from the first to the last infusion of that regimen. For most analyses, the MPR was considered a continuous variable that could take on values between 0 and 1. In other analyses, a dichotomous categorical variable designated if the MPR was at least 0.8 versus less than 0.8. The Wilcoxon rank sum, Kruskal-Wallis, and Student's t-test were used to detect differences in continuous measures between patients receiving oral capecitabine therapy versus i.v. chemotherapy. The chi square test (X(2) test) or Fisher's exact test was used to assess differences in the dichotomous MPR variable. Generalized estimating equation (GEE) models were used for regimen-level analyses to account for correlated responses within individuals. A total of 6
Full Text Available Significant advances have been made in our knowledge of forage seed physiology, technology, and stand establishment practices; however, stand establishment continues to be one of the most common production problems affecting forage crops in the USA. There is a need for research on stand establishment of forage crops under abiotic and biotic stress. Although the forage seed industry produces and markets seed of high quality, new methods of assessing seed vigor are needed and their use should be expanded in the industry to enable matching seed lot performance to specific environmental conditions where performance can be maximized. Seed treatment and seed coating are used in the forage seed industry, and studies have shown they are of benefit in some environments. There is an increase in no-tillage seeding of forage crops, but improvements in the no-tillage planting equipment are needed to make them better suited to small seeds. Other recent developments in seeding techniques include broadcasting seed with dry granular and fluid fertilizers, which improves the efficiency of the seeding operation.
Arriscado, Daniel; Muros, José J; Zabala, Mikel; Dalmau, José M
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.
Shigdel R; Klouman E; Bhandari A; Ahmed LA
Rajesh Shigdel,1 Elise Klouman,2 Anita Bhandari,2 Luai A Ahmed11Department of Health and Care Sciences, 2Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, NorwayPurpose: There are a high number of HIV-infected patients receiving antiretroviral therapy (ART) in the Kathmandu District of Nepal, but information on adherence and factors influencing it are scarce in this population. The present study aimed to estimate ART adherence am...
Ciotola, Mark P.
A detectable extraterrestrial civilization can be modeled as a series of successive regimes over time each of which is detectable for a certain proportion of its lifecycle. This methodology can be utilized to produce an estimate for L. Potential components of L include quantity of fossil fuel reserves, solar energy potential, quantity of regimes over time, lifecycle patterns of regimes, proportion of lifecycle regime is actually detectable, and downtime between regimes. Relationships between these components provide a means of calculating the lifetime of communicative species in a detectable state, L. An example of how these factors interact is provided, utilizing values that are reasonable given known astronomical data for components such as solar energy potential while existing knowledge about the terrestrial case is used as a baseline for other components including fossil fuel reserves, quantity of regimes over time, and lifecycle patterns of regimes, proportion of lifecycle regime is actually detectable, and gaps of time between regimes due to recovery from catastrophic war or resource exhaustion. A range of values is calculated for L when parameters are established for each component so as to determine the lowest and highest values of L. roadmap for SETI research at the SETI Institute for the next few decades. Three different approaches were identified. 1) Continue the radio search: build an affordable array incorporating consumer market technologies, expand the search frequency, and increase the target list to 100,000 stars. This array will also serve as a technology demonstration and enable the international radio astronomy community to realize an array that is a hundred times larger and capable (among other things) of searching a million stars. 2) Begin searches for very fast optical pulses from a million stars. 3) As Moore's Law delivers increased computational capacity, build an omni-directional sky survey array capable of detecting strong, transient
Konijnendijk, Annemieke A J; Boere-Boonekamp, Magda M; Fleuren, Margot A H; Haasnoot, Maria E; Need, Ariana
Guidelines to support health care professionals in early detection of, and responses to, suspected Child Abuse and Neglect (CAN) have become increasingly widely available. Yet little is known about professionals' adherence to these guidelines or the determinants that affect their uptake. This study used a cross-sectional design to assess the adherence of Dutch Child Health Care (CHC) professionals to seven key activities described in a national guideline on preventing CAN. This study also examined the presence and strengths of determinants of guideline adherence. Online questionnaires were filled in between May and July 2013 by 164 CHC professionals. Adherence was defined as the extent to which professionals performed each of seven key activities when they suspected CAN. Thirty-three determinants were measured in relation to the guideline, the health professional, the organisational context and the socio-political context. Bivariate and multivariate regression analyses tested associations between determinants and guideline adherence. Most of the responding CHC professionals were aware of the guideline and its content (83.7%). Self-reported rates of full adherence varied between 19.5% and 42.7%. Stronger habit to use the guideline was the only determinant associated with higher adherence rates in the multivariate analysis. Understanding guideline adherence and associated determinants is essential for developing implementation strategies that can stimulate adherence. Although CHC professionals in this sample were aware of the guideline, they did not always adhere to its key recommended activities. To increase adherence, tailored interventions should primarily focus on enhancing habit strength.
Ukawa, Naoto; Tanaka, Masayuki; Morishima, Toshitaka; Imanaka, Yuichi
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.
Full Text Available Introduction: In Belgium, an effective preventive program for breast cancer exists but as in many countries to few women participates in the screening. This study aims to describe the factors that affect the participation in the national breast cancer screening program. Methods: The participants were aged between 50 and 69 years and were recruited during an exhibition at the Brussels Exhibition Centre. Medical history and health-related parameters of the participants were recorded. Results: In total, 350 women aged between 50 and 69 years participated. After adjustment for age and region, 81.5% of the participants had a mammography during the past 2 years. The multivariate analysis confirms the association between not having had a mammography and (a having an older age (odds ratio [OR]: 0.25–0.87, (b having diabetes (OR: 0.08–0.80, (c having a family history of coronary heart disease (OR: 0.16–0.80, (d not following a cholesterol diet or treatment (OR: 0.10–0.91 and (e having a higher body mass index (OR: 0.39–0.97. Having had a mammogram was associated with adherence to cervical smear screening (OR: 2.74–11.21. Conclusions: Most of these associations are most likely related to socioeconomic status. However, the relationship with diabetes offers opportunities to increase the participation in breast cancer screening programs because these patients have regular contacts with their family physicians.
Durvasula, Seeta; Sambrook, Philip N; Cameron, Ian D
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 Â© 2011 Elsevier Ireland Ltd. All rights reserved.
Bullington, Pamela; Pawola, Larry; Walker, Rosemary; Valenta, Annette; Briars, Leslie; John, Eunice
Studies report a clear association between medication non-adherence and an unfavorable transplant outcome. The adolescent population, in particular, has difficulty adhering to post-transplant medication regimens. The purpose of this study is to identify, categorize and understand the opinions of adolescent transplant patients regarding why they may not take their medications as prescribed. From January to August 2005, nine adolescent kidney transplant patients at an urban medical center were surveyed and asked to rank-order 33 statements regarding their opinions on why adolescents may not take their medications as prescribed. Q-methodology, a powerful tool in subjective study, was used to identify and categorize the viewpoints of adolescents on this subject. Three factors emerged and were labeled to reflect their distinct viewpoints: (1) Medication Issues (e.g. taste, size, frequency, schedule), (2) Troubled Adolescent (e.g. poor home life, depression, overwhelming situation), and (3) Deliberate Non-Adherer (e.g. attention-seeker, infallible attitude). By understanding these different viewpoints and the factors that contribute to them, it may be easier to identify which management approach to non-adherence works best in specific subgroups of patients.
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
Safran, M.; Paul, T.L.; Roti, E.; Braverman, L.E.
A number of environmental factors affect the incidence and progression of autoimmune thyroid disease. Exposure to excess iodine, certain drugs, infectious agents and pollutants, and stress have all been implicated.
Factors affecting effective performance of rural producers' organizations in the ... Linkages are vital for effective achievement of purposes and most RPOs (80%), had established them ..... Success: Learning from Instructive Experiences in Ru-.
Roccas, Sonia; Moshinsky, Avital
Examined factors affecting the difficulty of verbal analogies in a psychometric examination by characterizing 104 analogies using 5 defined attributes. Both knowledge and process attributes were found to contribute to the difficulty of verbal analogies assessed by 10 judges. (SLD)
In this study, the factors that affect students’ mathematics achievement in secondary school mathematics grades of 6th, 7th and 8th were explored. For this purpose, the factors that affect mathematics education and mathematics achievement such as type of school, family income, studying time and students’ attitude towards mathematics and attendance to private courses have been investigated. The sample of the study consisted of 275 students from one private (n=58) and two state schools (n= 217)...
Individual learners' affective factors are very important for foreign language learning. In China foreign language learning mainly happens in the classroom. Foreign language teachers are the organizers and carriers of language classes, and thus they inevitably influence the students' affection. This study explores how EFL teachers influence…
Full Text Available The present study aimed to examine the factors associated with increased Mediterranean diet (MD adherence among a sample of Italian adolescents. A cross-sectional survey was conducted on 1135 students (13–16 years attending 13 secondary schools of Sicily, southern Italy. Validated instruments were used for dietary assessment and the KIDMED score to assess adolescents’ adherence to the MD. A higher adherence to the MD was associated with high socioeconomic status (Odds Ratio [OR] 1.53, 95% Confidence Interval [CI]: 1.03–2.26 and high physical activity (OR 1.19, 95% CI: 1.02–1.70, whereas lower adherence was associated with living in an urban environment (OR 0.65, 95% CI: 0.44–0.97 and being obese (OR 0.59, 95% CI: 0.37–0.94. The adolescents’ KIDMED scores were inversely associated with adolescents’ intake of sweets, fast foods, fried foods, and sugary drinks, and directly with fruit, vegetables, pasta, fish, and cheese intakes. Urban-living adolescents were less likely to eat fruit and more prone to consume meat, sugary drinks, and fast food than rural-living adolescents. The latter were more likely to eat sweets and snacks. A general poor quality of food consumption in Italian adolescents away from the MD was reported, especially among those living in urban areas.
Venetsanou, Fotini; Kambas, Antonis
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,…
Arun Kumar De
Full Text Available Background and Objectives: Mothers and children are biologically related and dependent. They should be considered as a single unit which is very important regarding adherence to anti-retroviral therapy (ART. Very high levels of adherence are required for effective ART. We therefore carried out this study to examine the adherence levels and different factors associated with adherence among human immunodeficiency virus (HIV-positive mothers and their HIV-positive children receiving ART. Design and Setting: A hospital-based cross-sectional study. Materials and Methods: Ninety-four HIV-positive mothers and their 94 HIV-positive children under ART attending the ART center of a tertiary care hospital were recruited in this study. Consenting mothers were asked to complete the "Case Study Form" containing socio-demographic and care-giving details. Mothers were also asked to complete the Beck′s depression inventory, State trait anxiety inventory, and Ways of coping inventory. Adherence was assessed using pill count. Criteria for good and poor adherence were defined. Current CD4 counts were retrieved from the hospital record. Results: Fifty-six percent of respondent mothers and 65.8% of respondent children showed good adherence to ART. Different factors were associated with poor adherence in both mothers and their children. Conclusion: Adherence of HIV-positive mothers and their HIV-positive children to ART is influenced by multiple factors and identification of these factors is necessary to get complete adherence to ART. There is statistically significant relationship between maternal and pediatric adherence to ART.
Ebben, Remco H A; Vloet, Lilian C M; van Grunsven, Pierre M; Breeman, Wim; Goosselink, Ben; Lichtveld, Rob A; Mintjes-De Groot, Joke A J; van Achterberg, Theo
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). A questionnaire was developed using the literature, a questionnaire and expert opinion. Ambulance nurses (n=452) from four geographically spread emergency medical services (EMSs) in the Netherlands were invited to fill out the questionnaire. The questionnaire included questions on influencing factors and self-reported adherence. Questionnaires were returned by 248 (55%) of the ambulance nurses. These ambulance nurses' adherence to the NPAC was 83.4% (95% confidence interval 81.9-85.0). Bivariate correlations showed 23 influencing factors that could be related to the individual professional, organization, protocol characteristics and social context. Multilevel regression analysis showed that 21% of the variation in adherence (R=0.208) was explained by protocol characteristics and social influences. Ambulance nurses' self-reported adherence to the NPAC seems high. To improve adherence, protocol characteristics (complexity, the degree of support for diagnosis and treatment, the relationship of the protocol with patient outcomes) and social influences (expectance of colleagues to work with the national protocol) should be addressed.
Vloet, Lilian C.M.; van Grunsven, Pierre M.; Breeman, Wim; Goosselink, Ben; Lichtveld, Rob A.; Mintjes-De Groot, Joke A.J.; van Achterberg, Theo
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 questionnaire was developed using the literature, a questionnaire and expert opinion. Ambulance nurses (n=452) from four geographically spread emergency medical services (EMSs) in the Netherlands were invited to fill out the questionnaire. The questionnaire included questions on influencing factors and self-reported adherence. Results Questionnaires were returned by 248 (55%) of the ambulance nurses. These ambulance nurses’ adherence to the NPAC was 83.4% (95% confidence interval 81.9–85.0). Bivariate correlations showed 23 influencing factors that could be related to the individual professional, organization, protocol characteristics and social context. Multilevel regression analysis showed that 21% of the variation in adherence (R2=0.208) was explained by protocol characteristics and social influences. Conclusion Ambulance nurses’ self-reported adherence to the NPAC seems high. To improve adherence, protocol characteristics (complexity, the degree of support for diagnosis and treatment, the relationship of the protocol with patient outcomes) and social influences (expectance of colleagues to work with the national protocol) should be addressed. PMID:24595355
Nomura, Sarah J O; Inoue-Choi, Maki; Lazovich, DeAnn; Robien, Kim
Taller height, family history of breast cancer, greater number of years of potential fertility and nulliparity are established non-modifiable risk factors for postmenopausal breast cancer. Greater adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) diet, physical activity and body weight recommendations has previously been shown to be associated with lower breast cancer risk. However, no prior studies have evaluated whether women with non-modifiable risk factors receive similar benefits from recommendation adherence compared to women without these risk factors. In the Iowa Women's Health Study prospective cohort, we investigated whether associations of WCRF/AICR recommendation adherence differed by the presence/absence of non-modifiable breast cancer risk factors. Baseline (1986) questionnaire data from 36,626 postmenopausal women were used to create adherence scores for the WCRF/AICR recommendations (maximum score = 8.0). Overall and single recommendation adherence in relation to breast cancer risk (n = 3,189 cases) across levels of non-modifiable risk factors were evaluated using proportional hazards regression. Mean adherence score was 5.0 points (range: 0.5-8.0). Higher adherence scores (score ≥ 6.0 vs. ≤ 3.5, HR = 0.76, 95% CI = 0.67-0.87), and adherence to the individual recommendations for body weight and alcohol intake were associated with a lower breast cancer incidence. While not statistically significant among women with more non-modifiable risk factors (score ≥ 6.0 vs. ≤ 3.5, HR = 0.76, 95% CI = 0.36-1.63), hazard ratios were comparable to women with the no non-modifiable risk factors (score ≥ 6.0 vs. ≤ 3.5, HR = 0.74, 95% CI = 0.49-0.93) (p-interaction = 0.57). WCRF/AICR recommendation adherence is associated with lower breast cancer risk, regardless of non-modifiable risk factor status.
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.
Pomeshkina, S A; Borovik, I V; Zavyrylina, I N; Kagan, E S; Barbarash, O L
to study the influence of the patients adherence to the recommended therapy after coronary artery bypass grafting (CABG) on prognosis of postoperative period. We examined 197 consecutive patients with stable coronary artery disease (CAD) who had undergone CABG. Age of patients was 38-75 years. Assessment of modifiable cardiovascular risk factors showed that about half of patients had smoked before CABG and only a few gave up smoking after surgery. Number of patients with abdominal obesity increased by 8% after surgery. Number of patients involved in physical trainings remained unchanged. Adherence to drug therapy before CABG was low. Less than half of the patients took antiplatelet agents, beta-blockers, angiotensin-converting enzyme inhibitors, only 25% took statins. One year after CABG number of patients taking appropriate medications significantly increased. However, only half of patients managed to achieve the main objectives of secondary prevention.
Based on the introduction of factors affecting the income level of farmers in China,a total of 31 provinces,autonomous regions and municipality cities are taken as samples to select 13 factors affecting the income level of farmers,which are arable land area(X1),disaster area(X2),effective irrigation area(X3),fertilizer application(X4),mobile phone(X5),personal computer(X6),people joining in the new rural cooperative medical care(X7),rural investment(X8),household-use machine(X9),agricultural product price(X10),proportion of labor force with above junior high school education(X11),rural delivery route(X12),and rural electricity consumption(X13).At the same time,factor analysis method is used to analyze the factors affecting the income level of farmers.Result shows that common factors affecting the income of farmers are the agricultural production factor F1,the expanded reproduction factor F2,the information use factor F3,and the output reduction factor F4.At present,education degree of farmers and ability of farmers in grasping information have relatively great impact on the income of farmers,and can effectively promote the income growth of farmers.Scores of F1 in Henan,Shandong and Hebei are generally higher;Jiangsu,Guangdong,Zhejiang and Shandong Provinces have relatively high scores of F2;Shanghai,Beijing and Guangdong have relatively high scores of F3;and Hunan,Hubei and Xinjiang have relatively high scores of F4.Finally,countermeasures are put forward to improve the income of farmers based on empirical study.
Van Herzeele, Charlotte; De Bruyne, Pauline; De Bruyne, Elke; Walle, Johan Vande
The evidence for organic pathogenetic factors in enuresis and the discovery of effective therapies targeting the bladder and/or nocturnal diuresis have overwhelmed every potential role of psychological factors in pathogenesis and treatment. However, psychopathology is still important in enuresis because according to the document of the International Children's Continence Society (ICCS) 20-30% of the children with enuresis have at least one psychological/psychiatric disorder at rates two times higher than non-wetting children. The most common comorbid disorder with enuresis is attention deficit hyperactivity disorder. The aim of this review is to translate the existing evidence on the importance of a psychological screening into daily clinical practice of the medical practitioner. The use of the minimal psychological screening tool should be considered mandatory in each primary setting. If psychological problems are indicated, referral of the patient to a multidisciplinary setting should be considered, not only to allow psychological assessment to screen for a possible psychopathology, but also since therapy resistance might be expected. This review concentrates on two items from psychopathology/psychotherapy that might predict insufficient treatment response: the psychological comorbidities as described according to the DSM-5 criteria and the underestimated importance of therapy adherence. Adherence is a cornerstone of effective therapy in enuresis. It is a problem involving the doctor, the patient, and the parents. Increasing adherence takes effort and is time-consuming. But it is worthwhile knowing that several studies have demonstrated that high adherence is associated with high therapy success of enuresis. Eventually, this is the ultimate goal of treatment.
Mary T. Kioko
Full Text Available Background: Antiretroviral (ARV adherence of ≥ 95% is recommended for suppressing HIV. However, studies have shown that the ≥ 95% recommended level is rarely achieved.Objective: This cross-sectional community-based study sought to assess factors contributing to ARV drug adherence among adults living with HIV or AIDS.Setting: The study was conducted in a rural community in Machakos County, Kenya.Methods: 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.Results: 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.Conclusion: The burden of side effects and being a divorcee are primary predictors of ARV adherence.
Jerry P. Haenisch
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.
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.
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...
Al Jumah K
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
Izabel Cristina Ribeiro da Silva Saccomann
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.
Van Wamel, Willem J B; Hendrickx, Antoni P A; Bonten, Marc J M; Top, Janetta; Posthuma, George; Willems, Rob J L
A genetic subpopulation of Enterococcus faecium, called clonal complex 17 (CC-17), is strongly associated with hospital outbreaks and invasive infections. Most CC-17 strains contain a putative pathogenicity island encoding the E. faecium variant of enterococcal surface protein (Esp). Western blotting, flow cytometric analyses, and electron microscopy showed that Esp is expressed and exposed on the surface of E. faecium, though Esp expression and surface exposure are highly varied among different strains. Furthermore, Esp expression depends on growth conditions like temperature and anaerobioses. When grown at 37 degrees C, five of six esp-positive E. faecium strains showed significantly increased levels of surface-exposed Esp compared to bacteria grown at 21 degrees C, which was confirmed at the transcriptional level by real-time PCR. In addition, a significant increase in surface-exposed Esp was found in half of these strains when grown at 37 degrees C under anaerobic conditions compared to the level in bacteria grown under aerobic conditions. Finally, amounts of surface-exposed Esp correlated with initial adherence to polystyrene (R(2) = 0.7146) and biofilm formation (R(2) = 0.7535). Polystyrene adherence was competitively inhibited by soluble recombinant N-terminal Esp. This study demonstrates that Esp expression on the surface of E. faecium (i) varies consistently between strains, (ii) is growth condition dependent, and (iii) is quantitatively correlated with initial adherence and biofilm formation. These data indicate that E. faecium senses and responds to changing environmental conditions, which might play a role in the early stages of infection when bacteria transit from oxygen-rich conditions at room temperature to anaerobic conditions at body temperature. In addition, variation of surface exposure may explain the contrasting findings reported on the role of Esp in biofilm formation.
Misri, Shaila; Eng, Andrea B; Abizadeh, Jasmin; Blackwell, Ekin; Spidel, Alicia; Oberlander, Tim F
To identify specific quantitative and qualitative factors that govern the decision to adhere or decline antidepressant medication in antenatal women with moderate-to-severe mood and anxiety disorders. Fifty women (30 adherers, 20 decliners) were recruited between 18 and 34 weeks gestation in a tertiary care clinic for perinatal mothers. They were prospectively monitored 4 weeks apart up to 1-month postpartum on the: Hamilton Anxiety Scale, Hamilton Depression Scale, Mood Disorders Insight Scale, Antidepressant Compliance Questionnaire, Penn State Worry Questionnaire, and NEO Personality Inventory. Qualitative interviews were conducted at baseline. Hierarchical linear modeling determined illness trajectories of the two groups. Significantly different course of illness was observed in adherers versus decliners. Adherers had healthier attitudes toward depression and compliance with medication (P antidepressant medication therapy for their illness. Risk perception, attitudes, and illness insight impacted decisions surrounding adherence and decline. © 2013 Wiley Periodicals, Inc.
It is one thing that currently in China English learning persists through a student's whole study life, but it is another how long his persistence, an important factor in any language learning, can last. The factors affecting a student's persistence in this regard practically merits our attention. This paper traces and observes twenty students chosen by random. The research conducted here included their study motivation, academic excellence, psychological aspects relating to language learning and established corresponding models showing how these factors affect a student's persistence in his English learning. Although a small sample number was taken,of different students in China.the twenty students were typical of different students in China. The students' backgrounds were varied including both educational and environmental. Some suggestions are given indicating three separate but inter-related ways in how to further develop a student's persistence.
The conclusion of the discussion of factors affecting childbearing aspirations is that both a micro and a macro perspective must be included in an empirical analysis which would be useful for policy decisions. Micro factors tend to the economic function of the family, the economic value of children, cost of labor training, women's occupation, social security, household consumption, and education level. Attention to micro factors is important in the link between individual interests and state family planning (FP) policy. Macro factors tend to be ignored, but also impact on childbearing decisions. Macro factors are economic conditions, social and political factors, culture, and environmental factors such as ecology, natural resources, employment, economic development, and education. Macro factors affect the population as a whole and indirectly impact on individuals and the family. China's achievements in FP policy have been identified as a reduction of 200 million people, a shift in the population reproduction cycle downwards, increased standard of living, reduction in the burden of working people, and stabilization of macro factors. Successful policy should not rely on forced implementation. The past and present policies were successful not because of forced implementation, but because of awareness of macro and micro factors and voluntary use of FP. The voluntary nature of acceptance of FP suggests support for the FP policies. The current focus is on rural areas, and farmers in particular who are only aware of their needs and may feel state policy may interfere with their own interests. Implementation of FP among the rural population would be enhanced with an emphasis on their concerns such as social security in old age, the practical issues of having only daughters, and educational status. Educational campaigns promoting awareness of population pressure are needed and will benefit all the people. Social democratic doctrines can be introduced only from the outside
Almeida, Eduardo Dias; Vieira, José Luiz Fernandes
INTRODUCTION We investigated the association between demographic and behavioral factors and non-adherence to antimalarial therapy. METHODS A demographic questionnaire and 5-item self-reported questionnaire regarding non-adherence were completed by 135 patients after treatment for Plasmodium vivax. RESULTS Treatment interruption, but not demographic factors, was significantly associated with non-adherence to therapy. The likelihood of non-adherence was 5.16 times higher when the patients felt better than when they felt worse. The relative risk of parasitic resurgence was 3.04 times higher in non-adherent patients. CONCLUSIONS Treatment interruption is significantly associated with treatment adherence.
Tseng, Juliana; Halperin, Lucila; Ritholz, Marilyn D; Hsu, William C
Diabetes has become a global pandemic and Chinese Americans are at least 60% more likely to develop type 2 diabetes than White Americans, despite having lower body weight, due to a combination of genetic and environmental factors. Because of the increased risk, it is vitally important to address the issues of treatment adherence and diabetes self-management in the Chinese American population. Many factors affect an individual's ability to manage diabetes, including cultural beliefs, immigration experience, language abilities/health literacy, educational background, employment, and accessibility of healthcare services. In treating Chinese American patients, these factors must be considered to determine appropriate treatment. Eastern cultural and individual beliefs differ greatly from Western beliefs and, therefore, may affect the presentation of the patients. If left unacknowledged, these differences might be misinterpreted by healthcare providers as merely treatment non-adherence or unwillingness to change. Suggestions for providing culturally competent healthcare are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.
Full Text Available AimThe aim of this study was to evaluate the adherence to anti-diabetic medications among patients with type 2 diabetes mellitus (DM seeking medical care in the Gaza Strip, Palestine.MethodsA cross-sectional study was conducted among 369 primary care patients with type 2 DM from October to December 2016. Adherence to medications was measured using the Morisky Medication Adherence Scale (MMAS-4. Socio-demographic and clinical variables, provider–patient relationship, health literacy, and health belief were examined for each patient. Univariate, binary logistic regression and multiple linear regression were applied to determine the independent factors influencing adherence to anti-diabetic medications using SPSS version 22.ResultsOf all the respondents, 214 (58%, 146 (39.5%, and nine (2.5% had high (MMAS score = 0, medium (MMAS score = 1 + 2, and low (MMAS score ≥ 3 adherence to anti-diabetic medications, respectively. Factors that were independently associated with adherence to anti-diabetic medications were as follows: female gender [odds ratio (OR: 1.657, 95% confidence interval (CI: 1.065–2.578] and perception of disease’s severity (OR: 1.510, 95% CI: 0.410–5.560. Elderly (t = 1.345 and longer duration of DM (t = 0.899 were also predictors of adherence but showed no statistical significance (p > 0.05.ConclusionThe level of complete adherence to anti-diabetic medications was sub-optimal. New strategies that aim to improve patients’ adherence to their therapies are necessary taking into consideration the influencing factors and the importance of having diabetes educators in the primary care centers.
Elsous, Aymen; Radwan, Mahmoud; Al-Sharif, Hasnaa; Abu Mustafa, Ayman
The aim of this study was to evaluate the adherence to anti-diabetic medications among patients with type 2 diabetes mellitus (DM) seeking medical care in the Gaza Strip, Palestine. A cross-sectional study was conducted among 369 primary care patients with type 2 DM from October to December 2016. Adherence to medications was measured using the Morisky Medication Adherence Scale (MMAS-4). Socio-demographic and clinical variables, provider-patient relationship, health literacy, and health belief were examined for each patient. Univariate, binary logistic regression and multiple linear regression were applied to determine the independent factors influencing adherence to anti-diabetic medications using SPSS version 22. Of all the respondents, 214 (58%), 146 (39.5%), and nine (2.5%) had high (MMAS score = 0), medium (MMAS score = 1 + 2), and low (MMAS score ≥ 3) adherence to anti-diabetic medications, respectively. Factors that were independently associated with adherence to anti-diabetic medications were as follows: female gender [odds ratio (OR): 1.657, 95% confidence interval (CI): 1.065-2.578] and perception of disease's severity (OR: 1.510, 95% CI: 0.410-5.560). Elderly (t = 1.345) and longer duration of DM (t = 0.899) were also predictors of adherence but showed no statistical significance (p > 0.05). The level of complete adherence to anti-diabetic medications was sub-optimal. New strategies that aim to improve patients' adherence to their therapies are necessary taking into consideration the influencing factors and the importance of having diabetes educators in the primary care centers.
Full Text Available The potential benefits of Mass Drug Administration (MDA for malaria elimination are being considered in several malaria endemic countries where a decline in malaria transmission has been reported. For this strategy to work, it is important that a large proportion of the target population participates, requiring an in-depth understanding of factors that may affect participation and adherence to MDA programs.This social science study was ancillary to a one-round directly observed MDA campaign with dihydroartemisinin-piperaquine, carried out in 12 villages in rural Gambia between June and August 2014. The social science study employed a mixed-methods approach combining qualitative methods (participant observation and in-depth interviewing and quantitative methods (structured follow-up interviews among non-participating and non-adhering community members.Of 3942 people registered in the study villages, 67.9% adhered to the three consecutive daily doses. For the remaining villagers, 12.6% did not attend the screening, 3.5% was not eligible and 16% did not adhere to the treatment schedule. The main barriers for non-participation and adherence were long and short-term mobility of individuals and specific subgroups, perceived adverse drug reactions and rumors, inconveniences related to the logistics of MDA (e.g. waiting times and the perceived lack of information about MDA.While, there was no fundamental resistance from the target communities, adherence was 67.9%. This shows the necessity of understanding local perceptions and barriers to increase its effectiveness. Moreover, certain of the constraining factors were socio-spatially clustered which might prove problematic since focal areas of residual malaria transmission may remain allowing malaria to spread to adjacent areas where transmission had been temporarily interrupted.
Full Text Available BACKGROUND: Substantial resources and patient commitment are required to successfully scale-up antiretroviral therapy (ART and provide appropriate HIV management in resource-limited settings. We used pharmacy refill records to evaluate risk factors for loss to follow-up (LTFU and non-adherence to ART in a large treatment cohort in Nigeria. METHODS AND FINDINGS: We reviewed clinic records of adult patients initiating ART between March 2005 and July 2006 at five health facilities. Patients were classified as LTFU if they did not return >60 days from their expected visit. Pharmacy refill rates were calculated and used to assess non-adherence. We identified risk factors associated with LTFU and non-adherence using Cox and Generalized Estimating Equation (GEE regressions, respectively. Of 5,760 patients initiating ART, 26% were LTFU. Female gender (p 350 and 2 hours to the clinic (p = 0.03, had total ART duration of >6 months (p200 at ART initiation were at a higher risk of non-adherence. Patients who disclosed their HIV status to spouse/family (p = 0.01 and were treated with tenofovir-containing regimens (p < or = 0.001 were more likely to be adherent. CONCLUSIONS: These findings formed the basis for implementing multiple pre-treatment visit preparation that promote disclosure and active community outreaching to support retention and adherence. Expansion of treatment access points of care to communities to diminish travel time may have a positive impact on adherence.
Neilands, Julia; Sutherland, Duncan S; Resin, Anton
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...
Irina A. Kiseleva
Full Text Available The external factors influencing the process of formation of tariffs of commercial services are considered in the article. External environment is known to be very diverse and changeable. Currently, pricing has become one of the key processes of strategic development of a company. Pricing in the service sector, in turn, is highly susceptible to changes in the external environment. Its components directly or indirectly affect the market of services, changing it adopted economic processes. As a rule, firms providing services can’t influence the changes in external factors. However, the service market is very flexible, which enables businesses to reshape pricing strategy, to adapt it to the new environment.
Full Text Available The article presents the factors affecting the carburizing rates obtained (rate and efficiency during the process of melting cast iron. The analysis includes the recarburizer type (anthracite, natural and synthetic graphite, petroleum coke and particle size. Further factors considered in work are the methods of recarburization (recarburizer introduction to a solid charge and on the surface of the metal bath and the parameters of the melt (temperature and chemical composition. The analysis was based on experiments performed, the calculation results of computer simulations and literature data.
Full Text Available In this study, the factors that affect students’ mathematics achievement in secondary school mathematics grades of 6th, 7th and 8th were explored. For this purpose, the factors that affect mathematics education and mathematics achievement such as type of school, family income, studying time and students’ attitude towards mathematics and attendance to private courses have been investigated. The sample of the study consisted of 275 students from one private (n=58 and two state schools (n= 217 in Van. Data analysis involved descriptive statistics and Chi-Square analysis. The result of study showed that type of school, family income, studying time, students’ attitude towards mathematics and attendance to private courses had statistically significant effects on students’ mathematics achievement.
Molugulu, Nagashekhara; Gubbiyappa, Kumar Shiva; Vasudeva Murthy, C. R.; Lumae, Lim; Mruthyunjaya, Anil Tumkur
Introduction: Reports on medication adherence and its associated factors in patients with epilepsy in South East Asian countries are lacking. The primary purpose of this study was to assess the degree of medication adherence and its relationship with patient's satisfaction, psychosocial factors, quality of life and mental health in a sample of Malaysian epilepsy patients. Methodology: It is a cross-sectional study and was carried out in the outpatient Neurology Department of Hospital Kuala Lumpur, Malaysia (n=272). Data was collected by administering the structured questionnaire. Results and Discussion: Results showed that 49.3% of the epilepsy patients were non-adherent to their prescribed regimen. Univariate analysis showed significant associations between medication adherence and the following factors: race, seizure frequency, overall patient satisfaction, medication taste and smell, medication cost and physical appearance, medication effectiveness, complexity of medication regimen, patient barrier, patient understanding, patient role functioning, patient positivity, vitality and general interest. Multiple regression analysis indicated that factors that are influencing medication adherence are seizure frequency (P = 0.048), overall patient satisfaction (P = 0.043) and patient understanding about their illness (P = 0.001). The model chosen for testing the relationship between medication adherence and its associated factors give an R2 value of 25.2% with an adjusted R2 of 21.4%. The F value was also significant (P = 0.000). Based on the research findings, the researchers recommends that clinicians need to play a vital role in educating the patients on their disease conditions. By educating the patients on nature of epilepsy, different modalities of treatment and benefits of adherence to treatment will help in the better adherence and management. PMID:27999469
Molugulu, Nagashekhara; Gubbiyappa, Kumar Shiva; Vasudeva Murthy, C R; Lumae, Lim; Mruthyunjaya, Anil Tumkur
Reports on medication adherence and its associated factors in patients with epilepsy in South East Asian countries are lacking. The primary purpose of this study was to assess the degree of medication adherence and its relationship with patient's satisfaction, psychosocial factors, quality of life and mental health in a sample of Malaysian epilepsy patients. It is a cross-sectional study and was carried out in the outpatient Neurology Department of Hospital Kuala Lumpur, Malaysia (n=272). Data was collected by administering the structured questionnaire. Results showed that 49.3% of the epilepsy patients were non-adherent to their prescribed regimen. Univariate analysis showed significant associations between medication adherence and the following factors: race, seizure frequency, overall patient satisfaction, medication taste and smell, medication cost and physical appearance, medication effectiveness, complexity of medication regimen, patient barrier, patient understanding, patient role functioning, patient positivity, vitality and general interest. Multiple regression analysis indicated that factors that are influencing medication adherence are seizure frequency (P = 0.048), overall patient satisfaction (P = 0.043) and patient understanding about their illness (P = 0.001). The model chosen for testing the relationship between medication adherence and its associated factors give an R(2) value of 25.2% with an adjusted R(2) of 21.4%. The F value was also significant (P = 0.000). Based on the research findings, the researchers recommends that clinicians need to play a vital role in educating the patients on their disease conditions. By educating the patients on nature of epilepsy, different modalities of treatment and benefits of adherence to treatment will help in the better adherence and management.
James; X; Zhang; Jhee; U; Lee; David; O; Meltzer
AIM: To assess the risk factors for cost-related medication non-adherence(CRN) among older patients with diabetes in the United States. METHODS: We used data from the 2010 Health and Retirement Study to assess risk factors for CRN including age, drug insurance coverage, nursing home residence, functional limitations, and frequency of hospitalization. CRN was self-reported. We conducted multivariate regression analysis to assess the effect of each risk factor. RESULTS: Eight hundred and seventy-five(18%) of 4880 diabetes patients reported CRN. Age less than 65 years, lack of drug insurance coverage, and frequent hospitalization significantly increased risk for CRN. Limitation in both activities of daily living and instrumental activities of daily living were also generally associated with increased risk of CRN. Residence in a nursing home and Medicaid coverage significantly reduced risk.CONCLUSION: These results suggest that expandingprescription coverage to uninsured, sicker, and community-dwelling individuals is likely to produce the largest decreases in CRN.
Mrisho, Mwifadhi; Schellenberg, Joanna A; Mushi, Adiel K.; Obrist, Brigit; Mshinda, Hassan; Tanner, Marcel; Schellenberg, David
BACKGROUND Studies of factors affecting place of delivery have rarely considered the influence of gender roles and relations within the household. This study combines an understanding of gender issues relating to health and help-seeking behaviour with epidemiological knowledge concerning place of delivery. METHODS In-depth interviews, focus group discussions and participant observation were used to explore determinants of home delivery in southern Tanzania. Quantitative data were ...
Poultry meat belongs to the basic assortment of human nutrition. The meat of an intensively fattened poultry is a source of easily digestible proteins, lipids, mineral substances and vitamins. The aim of this bachelor´s thesis was to write out a literature review, which is focused on the intensity of growth, carcass yield, quality and composition of broiler chickens meat. The following describes the internal and external factors that affect them, i.e. genetic foundation, hybrid combination, s...
A.R. Darban Astane
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.
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
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
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
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.
Maria Letícia Santos Cruz
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.
Shabany Hamedan, Maryam; Mohamad Aliha, Jaleh
About organ transplant, immunosuppressive medications adherence is a critical issue, because non-adherence to these medications causes rejection, reduces quality of life and increases treatment cost and mortality rate. Among these, the quality of life is deemed very important to evaluate treatment result and also it can be useful for discovering non adherence. The aim this study was to assess the relationship between medication adherence and quality of life and some patient factors in renal transplant patients. The study was a descriptive-correlational design and was done on renal transplant patients over 18 who had undergone surgery for over 3 months, and were inclined to participate. Sample size was 230 people and sampling was convenience. Quality of life questionnaire in renal transplant patients and Immunosuppressant Therapy Adherence Scale were filled by patients and the data was analyzed by SPSS15 software. It showed that the mean score of quality of life in renal transplant patients was 21.65±4.03 and 57.8% of them did not adhere to immunosuppressive medications. Results of correlation between scores of immunosuppressive medication adherence and Quality of life showed that there were significant correlation in 3 dimensions of 4: health performance (p ≤ 0.0001 & rETA=0.23), social-economic (p=0.001 & rETA=0.15), psychological-spiritual (p=0.011 & rETA=0.15), also logistic test showed significant relationship between immunosuppressive medication adherence and number of transplantation (?=1.04, p= 0.048). According to the results, health care providers i.e. nurses must note to medication adherence as a health enhancement factor while treating and educating to these patients.
Mohammad Bagher Kamali
Full Text Available This study aimed to examine key factors affecting rural female facilitators’ role in participatory rural developmentin Tehran Province. Since the researchers intended to have abetter insight into the facilitators’ role and employ inquiry as alearning forum for bringing about changes for all participants,they preferred to use a case study based upon an appreciativeinquiry method. The study divided the factors affecting thefacilitators’ role into two main categories: driving factors andpreventing factors. The former are: two-way communication,election of rural eligible facilitators, participation, sense ofresponsibility, and the latter are: cultural and tribal fanaticism,lack of permanent female extension workers and frequentmanagement changes. Appreciative inquiry as a positive modeof action research could facilitate the process of education andcommunication for all stakeholders. We suggested that thereshould be a shift from the extension as a knowledge transfer tofacilitation as people’s own knowledge creation. This studyshowed that appreciative inquiry could facilitate the process ofchange and gender-awareness. This research method couldalso facilitate mutual communication between the rural facilitatorsand extension workers.
Fransen, G.A.J.; Mesters, I.; Janssen, M.J.R.; Knottnerus, J.A.; Muris, J.W.M.
Patient adherence to medical treatment for dyspepsia is disappointing, whereas adherence is crucial for a proper evaluation of treatment. This prospective study used elements of the Integrated Change Model and Weiner's Attribution Theory to describe patients' important cognitions and their
Lippert Dustin ND
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
Migliaccio, Silvia; Resmini, Giuseppina; Buffa, Angela; Fornari, Rachele; Di Pietro, Gioconda; Cerocchi, Irene; Dormi, Ada; Gimigliano, Francesca; Mulè, Rita; Celi, Monica; Frigato, Marilena; Lenzi, Andrea; Tarantino, Umberto; Iolascon, Giovanni; Malavolta, Nazzarena
Summary Introduction. Osteoporosis is a chronic condition leading to an increased risk of developing fractures, with high morbidity and mortality in aging population. Efficacy of anti-osteoporotic treatment is based on drug potency but also on compliance and persistence to treatment regimen, which is very low, as already described for other diseases. Teriparatide (TPTD) is the first anabolic agent developed for the treatment of osteoporosis. Since it appears that persistence to Teriparatide declines over time, aim of this pilot multicenter observational study was to evaluate persistence and adherence to TPTD (20 μg daily injection regimen for 18 months) treatment (PATT) in patients affected by severe osteoporosis in an every day clinical practice. Methods. Patients affected by severe osteoporosis were selected among those who referred to 5 different specialized centers for osteoporosis in North, Center and South of Italy. A sample of 475 women with severe postmenopausal osteoporosis treated with TPTD in accordance to the Italian osteoporosis guidelines was included. At the beginning of TPTD treatment patients were instructed on the use of the device by the referring specialist of the center, a resident fellow or a nurse. Bone biochemical markers were evaluated the same morning and after 1, 3, 6, 12 and 18 months. Patients were visited at time 0 and after 6, 12 and 18 months for clinical follow up. Results. The results included observations of 441/475 patients (98% women) who completed the 18 months treatment; mean age for women was 73±8 and for men 65±9. After 6 months of TPTD treatment persistence was of 89,79%, 87,75% after 12 months and 86,85% after 18 months. Adherence was of 100% at 6,12 and 18 months. Total dropouts were 13,15% (71/441), which was usually higher within the first 6 months of TPTD treatment. Most common adverse events (arthralgies 2,7%, dizziness 1,8%, migraine 1,8%, depression 1,6%, hypertension 1,1%) were reported in 62/441 patients (14
Maria Albertina Rocha Diógenes
Full Text Available The objective of this work was to verify the presence of risk factors for cervical cancer and identify adherence to Pap smears in nursing auxiliary and technicians to 20 primary health care, in Fortaleza, Brazil. A descriptive study was conducted from October 2008 to January 2009, involving 77 women. Data were collected using a structured interview, available on tables and treated with absolute and relative frequency. It was Shown that 71.43% of the Women were using oral contraceptives, 19.48% smoked or had smoked, 61.04% had first intercourse between 15 and 20 years of age, 77.92% did not make systematic use of condoms, 22.07% knew the importance of the examination and 84.40% would do so every year. Most joined the regular gynecological exam, but some had risk factors for cervical cancer. It is emphasized the need for an educational intervention directed at these women.
Mousnad, Mohamed Awad; Shafie, Asrul Akmal; Ibrahim, Mohamed Izham
To systematically identify the main factors contributing to the increase in pharmaceutical expenditures. A systematic search of published studies was conducted utilising major widely used electronic databases using the search terms 'factors,' 'financing,' 'pharmaceutical,' and 'expenditures.' To be included, the studies needed to: (1) measure at least one of the following outcomes: total growth in pharmaceutical expenditures, price growth or quantity growth; (2) mention a clear method for analysing the impact of factors affecting the increases in drug expenditures; (3) be written in English. Nonprimary articles that were published only as an abstract, a review, a commentary or a letter were excluded. From a total of 2039 studies, only 25 were included in the full review. The main determinant categories that were identified in the review were factors related to price, utilisation, therapeutic choice, demand and health care system. The major cost drivers were found to be changes in drug quantities and therapies as well as new drugs. It is important for policymakers to understand pharmaceutical spending trends and the factors that influence them in order to formulate effective cost containment strategies and design optimum drug policy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Mendelsohn Joshua B
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
Sikov, M.R.; Kelman, B.J. (Pacific Northwest Laboratory, Richland, WA (USA))
The primary goal of this paper is to consider factors that affect the availability and transport of actinides from maternal blood, through the placenta, to the conceptus. These factors, of particular importance in scaling results from animals to man, include the route and temporal pattern of administration, the mass and physicochemical state of material administered, metabolism of the pregnant animal and fetal organs or tissue, and species-specific changes in placental structure relative to stage of gestation at exposure. Preliminary concepts for descriptive and kinetic models are proposed to integrate these results, to identify additional information required for developing more comprehensive models, and to provide a basis for scaling to human pregnancies for purposes of radiation dosimetry.
Full Text Available This empirical research investigates state based factors affecting the inward FDI employment among fifty states of the United States, uses annual data for the period of time from 1997 to 2007 and identifies several state-specific determinants of FDI employment. The results indicate that the major factors exerting positive impact on inward US FDI employment are: real wages, infrastructure, unionization level, educational attainment, FDI stock and manufacturing density. In addition, the results show that gross state product growth rate, real per capita taxes and share of scientists and engineers have negative impact on FDI employment. Our findings indicate the importance of selected variables in evaluating the effects of FDI flow.Keywords: FDI, Growth, Employment, State, Economy
Phillips, L Alison; Cohen, Joshua; Burns, Edith; Abrams, Jessica; Renninger, Steffi
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.
Huang, Wen-Chuan; Chen, Chung-Yu; Lin, Shun-Jin; Chang, Chao-Sung
Many studies have demonstrated that non-adherence to oral anticancer drugs (OACDs) has challenged treatment efficacy. Otherwise, few validated tools exist to measure patients' adherence to medication regimen in clinical practice. To synthesize previous studies on adherence by cancer patients taking OACDs, especially in targeted therapy, a systematic search of several electronic databases was conducted. We analyzed existing scales' contents for various cancer patients and outcomes of studies assessing adherence. However, a well-validated scale designed particularly for OACD adherence is still lacking. Most adherence scales used in the studies reviewed contain items focused on measuring patients' medication-taking behavior more than their barriers to medication compliance and beliefs. However, non-adherence to OACDs is a complex phenomenon, and drug-taking barriers and patient beliefs significantly affect patients' non-adherence. To understand the key drivers and predisposing factors for non-adherence, we need to develop a well-validated, multidimensional scale.
Full Text Available Community Supported Agriculture (CSA is one of the widely used direct marketing strategies for small- and midsized farmers. CSA programs are an important option for sustainable production and consumption. It helps growers generate income (improve financial security and consumers obtain fresh local foods. Sustaining and growing CSA participation is critical in order to continue enjoying these benefits. We used a national online survey in conjunction with discrete choice models to investigate the impact of demographic characteristics, lifestyle preferences, and different information outlets on the probability that a consumer is or will become a CSA member. The results indicate that the factors affecting current and future CSA participation differ substantially. While none of the demographic characteristics has a significant impact on current CSA participation, some of them significantly affect the probability that a consumer will become a CSA member in the future. Lifestyle preferences have a significant impact on current and future CSA participation. Although none of the information outlets examined affect current CSA participation, word-of-mouth and online sources significantly influence the probability that a consumer will join a CSA program in the future. These findings may have important implications for policy makers’ and CSA farm managers’ efforts to sustain future CSA development.
VANDERWERFF, J; ZAAT, SAJ; JOLDERSMA, W; HESS, J
Platelets activated with thrombin release bactericidal factors. We studied the role of the susceptibility of viridans streptococci to these bactericidal factors in the development of infective endocarditis (IE). By using the experimental endocarditis rabbit model, the initial adherence and the devel
Onyango, Elizabeth O; Ayodo, George; Watsierah, Carren A; Were, Tom; Okumu, Wilson; Anyona, Samuel B; Raballah, Evans; Okoth, John M; Gumo, Sussy; Orinda, George O; Ouma, Collins
Over the years, reports implicate improper anti-malarial use as a major contributor of morbidity and mortality amongst millions of residents in malaria endemic areas, Kenya included. However, there are limited reports on improper use of Artemisinin-based Combination Therapy (ACT) which is a first-line drug in the treatment of malaria in Kenya. Knowing this is important for ensured sustainable cure rates and also protection against the emergence of resistant malarial parasites. We therefore investigated ACT adherence level, factors associated with non-adherence and accessibility in households (n = 297) in rural location of Southeast Alego location in Siaya County in western Kenya. ACT Adherence level was assessed with reference to the duration of treatment and number of tablets taken. Using systematic random sampling technique, a questionnaire was administered to a particular household member who had the most recent malaria episode ( 9000; OR, 0.340; 95% CI, 0.167-0.694; P = 0.003) were associated with ACT adherence. In addition, about 52.9% of the respondents reported that ACT was not always available at the source and that drug availability (P = 0.020) and distance to drug source (P < 0.01) significantly affected accessibility. This study demonstrates that more than half of those who get ACT prescription do not take recommended dose and that accessibility is of concern. The findings of this study suggest a potential need to improve accessibility and also initiate programmatic interventions to encourage patient-centred care.
Full Text Available Abstract Background While the factors for poor adherence for treatment with statins have been highlighted, the impact of their combination on adherence is not clear. Aims To estimate adherence for statins and whether it differs according to the number of cardiovascular risk factors. Methods A cohort study was conducted using data from the main French national health insurance system reimbursement database. Newly treated patients with statins between September 1 and December 31, 2004 were included. Patients were followed up 15 months. The cohort was split into three groups according to their number of additional cardiovascular risk factors that included age and gender, diabetes mellitus and cardiovascular disease (using co-medications as a proxy. Adherence was assessed for each group by using four parameters: (i proportion of days covered by statins, (ii regularity of the treatment over time, (iii persistence, and (iv the refill delay. Results 16,397 newly treated patients were identified. Of these statin users, 21.7% did not have additional cardiovascular risk factors. Thirty-one percent had two cardiovascular risk factors and 47% had at least three risk factors. All the parameters showed a sub-optimal adherence whatever the group: days covered ranged from 56% to 72%, regularity ranged from 23% to 33% and persistence ranged from 44% to 59%, but adherence was better for those with a higher number of cardiovascular risk factors. Conclusions The results confirm that long-term drug treatments are a difficult challenge, particularly in patients at lower risk and invite to the development of therapeutic education.
Jia-Kang Wang; Tzu-Lun Huang; Pei-Yuan Su; Pei-Yao Chang
Purpose: To investigate the correlation of various corneal hysteresis (CH) factors in Chinese adults. Methods: From January 2009 to November 2011, the healthy right eyes of a total of 292 adults were recruited into the study. Goldmann-correlated intraocular pressure (IOPG) and CH were measured using an ocular response analyzer (ORA). Central corneal thickness was measured using the ORA’s in-tegrated handheld ultrasonic pachymeter. The IOLMaster was used to obtain the ocular biometric measurements including axial length, anterior chamber depth, and keratometric values. The Pearson correlation coefficient was used to test correla-tions between CH and quantitative factors. The chi-square test was used to detect differences in categorical values. Results: Longer axial length (P=0.0001), lower IOPG (P=0.03), older age(P=0.003),and thinner central corneal thick-ness (P=0.0001) were significantly associated with lower CH. The anterior chamber depth (P=0.34), gender (P=0.23), and corneal curvature (P=0.18) had no relationship to CH. Conclusion:Various factors including axial length, intraocular pressure, age, and central corneal thickness can affect measure-ment of corneal biomechanical properties in Chinese adults. But the anterior chamber depth, gender, and corneal curvature were irrelevant to CH.
Opal, S; Garg, S; Jain, J; Walia, I
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.
Hudelson, Carly; Cluver, Lucie
Adolescents living in low- and middle-income countries (LMICs) are disproportionately burdened by the global HIV/AIDS pandemic. Maintaining medication adherence is vital to ensuring that adolescents living with HIV/AIDS receive the benefits of antiretroviral therapy (ART), although this group faces unique challenges to adherence. Knowledge of the factors influencing adherence among people during this unique developmental period is needed to develop more targeted and effective adherence-promoting strategies. This systematic review summarizes the literature on quantitative observational studies examining correlates, including risk and resilience-promoting factors, of ART adherence among adolescents living with HIV/AIDS in LMICs. A systematic search of major electronic databases, conference-specific databases, gray literature, and reference lists of relevant reviews and documents was conducted in May 2014. Included studies examined relationships between at least one factor and ART adherence as an outcome and were conducted in primarily an adolescent population (age 10-19) in LMICs. The search identified 7948 unique citations from which 15 studies fit the inclusion criteria. These 15 studies identified 35 factors significantly associated with ART adherence representing a total of 4363 participants across nine different LMICs. Relevant studies revealed few consistent relationships between measured factors and adherence while highlighting potentially important themes for ART adherence including the impact of (1) adolescent factors such as gender and knowledge of serostatus, (2) family structure, (3) the burdensome ART regimens, route of administration, and attitudes about medication, and (4) health care and environmental factors, such as rural versus urban location and missed clinic appointments. Rates of adherence across studies ranged from 16% to 99%. This review identifies unique factors significantly related to ART adherence among adolescents living in LMICs. More
Madelon Novato Ribeiro
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.
Aftab, Muhammad Tariq; Dharamshi, Hasnain Abbas; Faraz, Ahmed; Shakeel, Saba; Shakeel, Osama
Poor adherence with medicine declines the clinical outcome of pharmacotherapy. It may carry serious sequelae especially in case of antihypertensive drugs like cerebrovascular accident (CVA). This study has been planned to find the association of poor adherence with anti-hypertensive with CVA in diabetic and non- diabetic patients. One hundred CVA patients who were admitted through Emergency in Abbasi Shaheed hospital, a tertiary care hospital in Karachi, were recruited from Jun 2013 till Dec 2013. The criteria of inclusion was, diagnosed case of CVA, with primary hypertension, availability of patient's therapeutic record, consent of the patient or legal successor/heir. The criteria of exclusion was, secondary hypertension, newly diagnosed primary hypertensive patients and complete adherence with medication. Morisky medication adherence scale was applied. Therapeutic record was accessed. The mean age was 62.15 years with 3:1 male to female ratio. Adherence to medicine was graded 0.05) was seen in any combination (p>0.05). Thus it is concluded that poor adherence with ACE inhibitors may be a risk factor of CVA in diabetic patients using oral hypoglycemic agents.
Lynda H. Norton
Full Text Available Background. Low physical activity (PA levels are associated with poor health risk factor profiles. Intervention strategies to increase PA and quantify the rate and magnitude of change in risk factors are important. Methods. Interventions were conducted over 40 days to increase PA in 736 insufficiently active (<150 min/wk PA participants using either a pedometer or instructor-led group protocol. There were a further 135 active participants as controls. Major cardiovascular and metabolic risk factors, including fitness parameters, were measured before and after intervention. Results. Adherence to the interventions was higher for the group versus pedometer participants (87.1% versus 79.8% and compliance rates for achieving sufficient levels of PA (≥150 min/wk were also higher for the group participants (95.8% versus 77.6%. Total weekly PA patterns increased by 300 and 435 minutes, for the pedometer and group participants, respectively. Improvements were found for waist girth, total cholesterol, aerobic fitness, and flexibility relative to controls. The change in vigorous PA, but not moderate PA, was a significant predictor of the change in eight of 11 risk factor variables measured. Conclusions. Rapid and dramatic increases in PA among previously insufficiently active adults can result in important health benefits.
Full Text Available Problem statement: Layer hen enterprises suffer from low profitability or losses in many of developing countries all over the world. Jordan is not an acceptance. Approach: This study aimed at investigating the influence of ten main factors affecting the profitability of layer hen producers. The investigated factors include price of purchased pullet, feed price, cost of labor, cost of veterinary service and medicine, building and machinery depreciation, repairs and maintenance and miscellaneous costs, length of production cycle, feed conversion ratio, mortality rate, egg sale price and laying percentage. Results: The study used a multiple regression profit model to estimate the effect of the above mentioned factors on profit per kg egg produced. The direction and quantity of relationship between profit per kg egg and variables affecting profit were investigated. Data from 40 operating and randomly selected egg production enterprises in the country was collected. Data was obtained directly from the producers during April to mid August 2010. Semi structured interviews were conducted with a pre-tested questionnaire. The data obtained via interview surveys were processed to calculate profit per kg egg and other relevant information for inclusion in a profit function model. Fifteen eggs are registered to be 1 kg in the study. Cost and income items used to calculate profit in the study. The results of the study revealed that the feed price was found to be the factor which has the highest negative impact on the profitability showing the coefficient-3.01. The egg sale price was with high positive impact on profitability showing the coefficient 2.633. Conclusion/Recommendations: From the results of the study it could be concluded that higher prices of purchased or breeding pullet, higher feed price, higher cost of labor, higher cost of veterinary service and medicine, higher other costs including building and machinery depreciation, repairs and
Full Text Available Poor organisation of agricultural markets in Poland remains one of the biggest problems for agricultural sector. There are about 510 agricultural producer groups, but only 2% of Polish farmers selling for market are members. Knowledge on cooperation determinants and different aspects of producer groups performance is crucial to build references for policy makers and producer groups’ managers. The aim of the article was to discuss factors affecting success of producers groups understood as a level of members’ satisfaction. Data for 2006 and 2011 from 30 producers groups in fruit and vegetable sector were analysed using logit model. Three determinants occurred to be statistically important: scope of a group functions, informal cooperation with farmers before starting a formal cooperation and homogeneity of farms.
Full Text Available Although literature review supported the concept that customer loyalty, brand equity and perceived risk are significant factors to affect customer involvement, very limited studies have extensively examined the relationship among those variables. This research applied quantitative study to comprehensively explore the relationship between customer loyalty, brand equity, perceived risk and customer involvement for consumers. The population for this research was identified as consumers having the shopping experience for digital camera. The findings supported the hypothesis that customer loyalty, brand equity and perceived risk have significant and positive relationship to customer involvement. The findings identified the predictors of customer loyalty, brand equity and perceived risk on the customer involvement and generated the recommendations for corporate operations and future scholar studies.
Ibrahim, Sanaa Abd El Azim
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.
Clarissa C. David
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.
Christensen, Ellen Margrethe; Larsen, Jens Knud; Gjerris, Annette
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...
Ree, M; Riediger, N; Moghadasian, M H
To establish health-related reasons behind Canadian food choices, and how variables such as education, income, gender, ethnicity and age may affect food selection. Approximately 98 733 Canadians responded to the 12 questions regarding food choices in the Canadian Community Health Survey (CCHS) cycle 2.1, conducted by the Canadian Government in 2003. These included 13 727 adolescents (12-19 years), 19 089 young adults (20-34 years), 31 039 middle-aged adults (35-54 years), 25 338 older adults (55-74 years) and 9580 elderly (75+ years). Approximately 70% of Canadian adolescents in the sample indicated that their food choices were independent of health concerns. Body weight management was a major concern for food selection by adolescents and adults, while the elderly stated heart disease as their main concern. Among all participants, females, and individuals with high levels of education and income reported the highest response to choosing or avoiding foods due to health concerns and food content. Our data indicate that several factors significantly affect food choices for health-related reasons in the Canadian population. Among them, age- and gender-related gaps, particularly between adolescents and adults, are profound. This observation may urge authorities to implement effective strategies to educate Canadians, especially adolescents, that selection of appropriate foods may prevent chronic diseases.
Full Text Available Hideki Aoyagi, Charles U UgwuLife Science and Bioengineering, Graduate School of Life and Environmental Sciences, University of Tsukuba, Tsukuba, JapanAbstract: Adhesion of commercially produced fullerene fine particles to Cryptomeria japonica, Chamaecyparis obtusa and Camellia japonica pollen grains was investigated. The autofluorescence of pollen grains was affected by the adhesion of fullerene fine particles to the pollen grains. The degree of adhesion of fullerene fine particles to the pollen grains varied depending on the type of fullerene. Furthermore, germination of Camellia japonica pollen grains was inhibited by the adhesion of fullerene fine particles.Keywords: Cryptomeria japonica, Chamaecyparis obtusa, Camellia japonica, autofluorescence, pollen grains, fullerene fine particle
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
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.
Kovács, Eva; Hunsberger, Monica; Reisch, Lucia
adherence to these recommendations and the risk of being overweight/obese. Results: Adherence ranged from 15.0% (physical activity) to 51.9% (TV time). As adherence increased, a lower chance of being overweight/obese was observed; adhering to only one key behaviour (score = 1) meant an OR = 0.81 (CI: 0.......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...... 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...
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.
Mehta Hiren R
Full Text Available Absorption of drugs from the gastrointestinal tract is a complex process the variability of which is influenced by many physicochemical and physiologic factors. The two most important physicochemical factors that affect both the extent and the rate of absorption are lipophilicity and solubility. The rate and extent of absorption are governed by the solubility, permeability and stability of the drug, with solubility being a pH-dependent parameter for weak acids and bases. The gastrointestinal tract can be viewed as discrete sections with a variety of differential local pH environments ranging from the acidic stomach to the more basic small intestine. The multiple peaking, double peaking or secondary peaking phenomena can occur in the disposition of a variety of xenobiotics during drug development (the pre-clinical phase and in subsequent clinical studies and use. The physicochemical and physiological mechanisms underlying the occurrence of this phenomenon are often multi factorial and include but are not limited to solubility-limited absorption, modified-release formulations, complexation, enterohepatic recirculation, gastric emptying and the intestinal transit time, site-specific absorption, gastric secretion-enteral reabsorption. Double peak absorption has been described with several orally administered drugs such as cimetidine furosemide, piroxicam, ranitidine, talinolol, alprazolam and phenazopyridine.
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.
M. Abdi Talarposht
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.
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.
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.
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.
Hu, Tian; Yao, Lu; Reynolds, Kristi; Niu, Tianhua; Li, Shengxu; Whelton, Paul K; He, Jiang; Steffen, Lyn M; Bazzano, Lydia A
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.
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.
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.
Jacob Arriola, Kimberly R; Mason, Tamara A; Bannon, Kari Ann; Holmes, Carol; Powell, Cecil Lamonte; Horne, Kandra; O'Regan, Ruth
Breast cancer incidence and mortality are declining due to improvements in early detection and treatment. One advance in treatment is the development of adjuvant endocrine therapy (AET) for women with hormone receptor positive breast cancer. Despite strong evidence linking AET to better health outcomes, AET adherence continues to be suboptimal. This study tests the hypothesis that patient beliefs about medication mediate the relationship between frequency of physician communication and AET adherence. This cross-sectional study utilizes data from patient self-report and medical chart abstraction (N=200). Survey measures included frequency of physician communication, patient beliefs about medicine, AET adherence, and demographic characteristics. Necessity beliefs mediated the relationship between frequency of physician communication and medication adherence (necessity beliefs β=.18, p.05). There was no evidence of medication concerns mediating the relationship between frequency of physician communication and medication adherence. More frequent physician communication that shapes what patients believe about AET importance may be associated with greater AET adherence; however, frequent physician communication that shapes patient concerns about side effects may not be associated with greater AET adherence. Research is needed to enhance understanding of the type of physician communication that is most consistently associated with patient beliefs about medication and AET adherence. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Campos, Lorenza Nogueira; Guimarães, Mark Drew Crosland; Remien, Robert H
Depression and anxiety are common among HIV-infected people and rank among the strongest predictors of non-adherence to antiretroviral therapy (ART). This longitudinal study aimed to assess whether symptoms of anxiety and depression are predictors of non-adherence among patients initiating ART at two public referral centers (n = 293) in Belo Horizonte, Brazil. Prevalence of severe anxiety and depression symptoms before starting ART was 12.6% and 5.8%, respectively. Severe anxiety was a predictor of non-adherence to ART during follow-up period (RH = 1.87; 95% CI = 1.14-3.06) adjusted for low education, unemployment, alcohol use in the last month and symptoms of AIDS; while a history of injection drug use had borderline statistical significance with non-adherence. These findings suggest that using a brief screening procedure to assess anxiety and depression symptoms before initiating ART help identify individuals for interventions to improve adherence and quality of life.
Geissler, Jan; Sharf, Giora; Bombaci, Felice; Daban, Mina; De Jong, Jan; Gavin, Tony; Pelouchova, Jana; Dziwinski, Euzebiusz; Hasford, Joerg; Hoffmann, Verena Sophia
Optimal adherence to CML therapy is of key importance to maximize treatment effectiveness. Two clinical studies (ADAGIO and Hammersmith) have proven a clear correlation between adherence and achieving optimal treatment response and have revealed that non-adherence is common in CML patients (Marin et al. in J Clin Oncol 28(24):2381-2388, 2010, Noens et al. in Haematologica 99(33):437-447, 2014). The aim of this study is to assess the extent of suboptimal adherence and to investigate motivations and behavioural patterns of adherence in a worldwide patient sample. Questionnaires were provided by the CML Advocates Network and were filled in by patients online and offline. Patient characteristics, treatment and motivations were collected. Adherence was assessed by the 8-item Morisky Medication Adherence scale. Logistic regression models were fitted to investigate the influence of different factors on adherence. Overall, 2 546 questionnaires from 63 countries and 79 CML patient organisations were evaluable. 32.7% of participants were highly adherent, 46.5% were in the medium and 20.7% in the low adherence group. Factors increasing the probability of being in the high adherence group are older age, male sex, management of side effects, only one tablet per day and feeling well informed about CML by the doctor. More than 2 years since diagnosis were significantly lowering the chance as was the use of reminding tools. Living arrangements, multiple medication and personal payment obligations increased the probability to be at least in the medium adherent group. This is the most comprehensive study conducted to date to gain knowledge about factors causing non-adherence in CML. Better information on the disease, medication and management of side effects, supported by haematologists, is key to improve adherence.
Cahoon, D.R.; Phillips, S.W.
Opening paragraph: Tidal and nontidal wetlands in the Chesapeake Bay watershed provide vital hydrologic, water-quality, and ecological functions. Situated at the interface of land and water, these valuable habitats are vulnerable to alteration and loss by human activities including direct conversion to non-wetland habitat by dredge-and-fill activities from land development, and to the effects of excessive nutrients, altered hydrology and runoff, contaminants, prescribed fire management, and invasive species. Processes such as sea-level rise and climate change also impact wetlands. Although local, State, and Federal regulations provide for protection of wetland resources, the conversion and loss of wetland habitats continue in the Bay watershed. Given the critical values of wetlands, the Chesapeake 2000 Agreement has a goal to achieve a net gain in wetlands by restoring 25,000 acres of tidal and nontidal wetlands by 2010. The USGS has synthesized findings on three topics: (1) sea-level rise and wetland loss, (2) wetland restoration, and (3) factors affecting wetland diversity.
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.
Full Text Available The purpose of this study was to characterize factors affecting lactose quantities in raw cow's milk. This study combined the survey design with laboratory analysis. Selected farm members of Nong Poh Dairy Cooperatives, from Ban Pong and Photharam Districts, Ratchaburi Province, were sampled. From the selected farms, data collected included lactose quantities in the raw milk and dairy farming information. The raw milk of selected farms was sampled at the delivery site of Nong Poh dairy cooperatives in the morning during December 2003 till February 2004. Lactose in the raw milk was then quantified by the Fourier Transform Infrared Analysis (FTIR using the MilkoScan FT6000 at the Department of Livestock Development. The farm owners or managers of selected farms were in-depth interviewed on dairy farming information including cowsí health and cows' diet. The data revealed that all cows from the selected farms were fed with concentrate diet purchased from Nong Poh Dairy Cooperatives and grass as high fiber diets. Sample of eighteen farms also fed their cows with one of supplements: corn stem, soybean meal, or rice straw. All cows from these farms were Holstein-Friesian Hybrid. As supplemented high fiber diets, corn stem significantly increased the lactose quantities over soybean meal and rice straw (planned comparison, pvalue = 0.044. The study concluded that some high fiber diets, specifically corn stem, significantly contributed to the lactose quantities in raw milk.
Full Text Available Factors affecting gene transformation in mangosteen (Garcinia mangostana L. were investigated. Types of explants, strains and densities of Agrobacterium tumefaciens, and co-culture methods were examined to optimize gene transformation. The results showed that among strains of Agrobacterium tumefaciens tested, LBA 4404 containing pBI 121 gave the calli with the highest resistance to kanamycin. Kanamycin at the concentration of 50-100 mg/l was the best range for selection of transformants. Higher density of agrobacteria tended to promote higher frequency of transformation. The best co-culture method was dipping the explant in a solution of agrobacteria for 10 minutes, followed by culturing onto co-culture medium without antibiotic for 48 hours. Among the explants used to co- culture with bacteria, half leaf treatment gave the best result for transformation; however, callus proliferation and plantlet regeneration were inferior to whole leaf treatment. Activity of β-Glucuronidase (GUS could not be detected, thus resistance to kanamycin was used for detecting transformability. Shoot primordia could be induced from kanamycin-resistant calli grown in regeneration medium. After maintenance by subculturing to the same medium 2 to 3 times in 2-3 months, the developed shoots turned brown and finally died. Hence, the transformed plant of mangosteen was not obtained from this experiment.
Liu, Tung-Hsen; Lin, Mei-Ju; Ko, Wen-Hsiung
Novozym 234 was the most frequently used enzyme for production of Rhizoctonia solani protoplasts. Since manufacture of this enzyme was discontinued in the late 1990s, a new procedure was developed by testing lytic enzymes from Sigma and by examining factors affecting protoplast formation. The combination of 20 mg/mL Driselase and 10mg/mL lysing enzyme was effective in releasing protoplasts from R. solani. The optimal condition for enzyme treatment of mycelium was incubation at 37 degrees C for 15 min followed by 34 degrees C for 105 min. The amount of protoplasts produced was positively correlated with growth rate and negatively correlated with mycelial density. Under favorable conditions, R. solani mycelia released 1.68 x 10(6) protoplasts/mL that is comparable with that produced with Novozym 234. Among various media tested, the best solid medium for protoplast regeneration was 1% V-8 juice agar, while the best liquid medium was 10% potato dextrose broth. Copyright 2009 Elsevier B.V. All rights reserved.
Vivien T. Supangco
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
Alireza Heravi Mosavi
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
Petersen, Kristina E N; Johnsen, Nina F; Olsen, Anja
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......·70) for cardiovascular mortality. In the present study, adherence to merely one additional health recommendation had a protective effect on mortality risk, indicating a huge potential in enhancing healthy lifestyle behaviours of the population....... and national health recommendations. A Cox proportional hazards model was used to estimate hazard ratios (HR) with 95 % CI. During a median follow-up of 14 years, 3941 men and 2827 women died. Among men, adherence to one additional health recommendation was associated with an adjusted HR of 0·73 (95 % CI 0...
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.
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 intervie
... Education & Events Advocacy For Patients About ACOG The Rh Factor: How It Can Affect Your Pregnancy Home ... Your Pregnancy FAQ027, September 2013 PDF Format The Rh Factor: How It Can Affect Your Pregnancy Pregnancy ...
Djambas Khayat, Claudia
Regular prophylactic treatment in severe hemophilia should be considered an optimal treatment. There is no general agreement on the optimal prophylaxis regimen, and adherence to prophylaxis is a main challenge due to medical, psychosocial, and cost controversies. Improved approaches in prophylaxis regimen of hemophilia B are needed to make patients’ lives easier. There is some evidence to support the efficacy of once-weekly prophylaxis. Longer sampling schedules are required for the determination of pharmacokinetic (PK) properties of factor IX (FIX). The half-life of FIX seems to be longer than previously described and is expected to be 34 hours. The clinical significance of maintaining a 1% trough level is widely debated in hemophilia B. The overall relationship between factor concentrate levels and incidence of joint bleeding was found to be very weak. Data also indicate that the distribution of FIX into an extravascular FIX compartment may contribute to hemostasis independently of circulating plasma FIX levels. Clinical assessment of the frequency and severity of bleeds remain an important measure of the efficacy of treatment. Role of PK-guided therapy remains to be established. Two prospective randomized studies had evaluated the efficacy and safety of 100 IU/kg once-weekly prophylaxis with nonacog alfa, and this prophylaxis regimen was found to be associated with lower annual bleeding rate compared with on-demand treatment in adolescents and adults with moderately severe-to-severe hemophilia B. Secondary prophylaxis therapy with 100 IU/kg nonacog alfa once weekly reduced annual bleeding rate by 89.4% relative to on-demand treatment. Residual FIX may be supportive of effectiveness. Once-weekly prophylaxis was well tolerated in the two studies, with a safety profile similar to that reported during the on-demand treatment period. To individually tailor treatment to clinical response and to minimize costs of factor concentrate, it would be of interest to
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.
Bluett, James; Barton, Anne; Hyrich, Kimme L; Cordingley, Lis; Verstappen, Suzanne M M
Treatment response to methotrexate (MTX) for rheumatoid arthritis (RA) is not universal and non-adherence may partially explain this. The aims of this systematic review were to: (1) summarise existing rates of adherence to MTX, (2) identify predictors of adherence to MTX, and (3) assess the association between non-adherence and patient outcomes. The authors conducted a systematic search of papers published from January 1980 to February 2015 in PubMed, PsycINFO, EMBASE and CINAHL databases. Studies were eligible for inclusion if: (1) MTX was used as monotherapy or in combination with other therapies, (2) MTX was used in an RA or inflammatory polyarthritis population, (3) adherence was defined and measured as the extent to which patients followed their MTX regimen during the period of prescription, and (4) it was an original piece of research. In total, 10 studies met the inclusion criteria and 8 were evaluated as high quality. Rates of adherence ranged from 59% to 107%, and exposed differences in definitions of adherence, study methodologies and sample heterogeneity. A number of potential predictors of MTX adherence were identified; the strongest being related to beliefs in the necessity and efficacy of MTX, absence of low mood, mild disease and MTX monotherapy. Furthermore, 3 studies tested the association of adherence with disease activity as an outcome measure; all 3 found non-adherence associated with poor treatment response. This systematic review shows the importance of adherence to MTX treatment and summarises the associated modifiable factors. PMID:26848403
Full Text Available Background: Medication adherence has an important influence on health outcomes in patients with chronic diseases. However, few studies have been performed in Japan to determine factors related to medication non-adherence. Objective: The aim of this study was to identify prescription factors related to medication non-adherence by investigating patient characteristics, all prescriptions, and prescriptions for oral antidiabetic drugs (OADs.Methods: A retrospective cross-sectional survey of prescription data about implementation of dosing regimen was performed at community pharmacies engaged in appropriate use of leftover drugs. We evaluated the amount of drugs originally prescribed and the reduced amount after use of leftover drugs, and then calculated prescription reduction ratio (PRR. We analyzed prescription factors contributing to non-adherence based on the PRR.Results: Prescription information for 1,207 patients was reviewed, revealing that patients were non-adherent to 58% of prescriptions. Lack of a drug copayment, fewer concurrent drugs, and drugs not in single-dose packaging were associated with non-adherence. Among the 1,207 patients, 234 prescriptions for diabetes and 452 OAD formulations were included. Forty-seven percent of prescriptions and 29% of the formulations were non-adherent. A higher dosing frequency and preprandial administration were associated with non-adherence. Among the OADs, adherence was lower for α-glucosidase inhibitors and biguanides than for sulfonylureas. Conclusions: Several factors related to patient characteristics, general drug prescriptions, and OAD prescriptions were associated with non-adherence. Further consideration will be needed to improve adherence to medication in Japan. Health care providers should perform more careful monitoring of adherence in patients with the factors identified by this study.
Márcia Aparecida dos Santos Silva
Full Text Available Objective: to identify reasons for low adherence to the Papanicolaou test in women seeking care in primary health care. Methods: cross-sectional study. Data collection carried out during home visits, applying questionnaire to characterize sociodemographic aspects as well as the reasons for non-adherence to examination and suggestions for facilitating adherence. Results: among 169 women, 67% were of reproductive age and 73.9% have finished elementary school. The failure to previously scheduled examination was due mainly to the beliefs and attitudes (36.1% and service organization (25.4%. The feelings reported by women during the Papanicolaou test were shame (55.6%, discomfort (32.5% and pain (20.7%. Conclusion: Although the screening of cervical cancer is essential for timely intervention, a significant proportion of women still does not adhere to examination by myths and taboos, beliefs, and health attitudes, as well as service organization.
Huang, Hui-Ting; Kuo, Yu-Ming; Wang, Shiang-Ru; Wang, Chia-Fen; Tsai, Chung-Hung
.... Here, we used the health belief model as a foundation and integrated social psychological factors and investigated the factors influencing health examination behavioral intention among the public in Taiwan...
Zhao, Yunfei; Qi, Lin; Yang, Jun; Zhu, Xiaodong; Yang, Changwei; Li, Ming
Abstract Pelvic rotation (PR) is commonly seen in patients with idiopathic scoliosis (IS), but factors contributing to this phenomenon and its relationship with the surgical outcome are not well established. This retrospective study included 85 IS patients in 2 groups: thoracic curve dominance group (group A) and lumbar curve dominance group (group B). Pre- and postoperative PR was measured on standing posteroanterior radiographs by the left/right ratio (L/R ratio) of horizontal distance between the anterior superior iliac spine (ASIS) and the inferior ilium (SI) at the sacroiliac joint on the same side in both groups. Other radiographic data, age, sex, and Risser sign of each patient were recorded to analyze their correlations with PR before and after operation. The patients ranged in age from 10 to 35 years with a mean of 17.0 ± 5.2 years. The mean L/R ratio of PR before operation was 0.99 (0.73–1.40) versus 0.98 (0.87–1.26) after operation. The L/R ration was beyond the range of 1 ± 0.1 (indicating the presence of PR) in 17 (20%) patients before operation and in 14 (16.5%) patients after operation. There was no significant difference in PR between the 2 groups of patients either before (P = 0.468) or after (P = 0.944) surgery. The preoperative PR showed a very low correlation with Risser sign (r = 0.220, P = 0.043), apex vertebral rotation (AVR) in the proximal thoracic curve (r = 0.242, P = 0.026), and AVR in the lumbar curve (r = 0.213, P = 0.049), while the postoperative PR showed a very low correlation with Risser sign (r = −0.341, P = 0.001) and postoperative trunk shift (TS) (r = −0.282, P = 0.009). Multiple stepwise regression analysis showed that preoperative PR was affected by proximal thoracic curve AVR and lumbar curve AVR. There was no significant difference between PR before operation and 2 years after operation. Preoperative PR was mainly correlated with Risser sign and the rotation
Hess, Lisa M; Louder, Anthony; Winfree, Katherine; Zhu, Yajun E; Oton, Ana B; Nair, Radhika
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 patient out-of-pocket cost was associated with decreasing adherence to erlotinib (P patient outcomes that may be associated with low adherence to or shorter treatment duration on oral chemotherapy. This study was supported by funding from Eli Lilly and 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
The study identified the variables that tend to affect educational performance among ... The population for the study consisted of students of Lagos State University, ... These were: Circumstances, Parental Authority, Socio- Economic Label, Self ...
Yadmila Rosa Matos La
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
Agyapong, Vincent I O
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.
Key words: Massa Lagoon, zooplankton, environmental factors. ... and Lucena, 2001) have also mentioned the influence of .... positive correlation with water temperature (r = 0.41) and .... carnivore species copepod, Acanthocyclops robustus.
Hof, van het K.H.
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
Martins, Isabel Pavão; Loureiro, Clara; Rodrigues, Susana; Dias, Beatriz; Slade, Peter
Tests of famous faces are used to study language and memory. Yet, the effect of stimulus properties on performance has not been fully investigated. To identify factors influencing proper name retrieval and to probe stimulus-specific parameters within proper name lexicon, we analysed the results obtained by 300 healthy participants on a test of famous faces that includes 74 personalities. A factor analysis yielded five main factors that were characterized by language (national or foreign names), epoch of peak popularity (current, recent or past) and occupation (politicians, entertainment and sports) of the personalities. Multiple regression analysis showed that participants' education, age and gender accounted for 10-32% of the variance in factor scores. These results indicate that there are variables of the stimulus and participants' that must be taken into account in proper name testing and in designing tests aimed to differentiate age-associated difficulties from cognitive decline.
Department of Wildlife Science - Texas A & M University, College Station, Texas. ... The major factors considered are vegetation, water, fire, cattle grazing, ... reproduction of ungulates on three ranches and then to relate these data to ...
This paper briefly defines an active retail market, details the factors that influence market activity and their relative importance, compares activity in various retail energy markets to date, and predicts future retail energy market activity. Three primary factors translate into high market activity: supplier margins, translated into potential savings for actively shopping customers; market size; and market barriers. The author surveys activity nationwide and predicts hot spots for the coming year.
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.
Full Text Available Background: Bipolar Affective Disorder (BPAD is one of the leading causes of disability globally. Medication non-adherence and low quality of life (QOL are the major challenges associated with the treatment of BPAD patients.Objective: Aim of this study was to assess the impact of pharmacist–psychiatrist collaborative patient education on medication adherence and QOL of BPAD patients.Methodology: A prospective randomized control study was conducted in the psychiatry outpatient department in a tertiary care setting. The eligible patients were enrolled and randomized into test (collaborative care and control (usual care groups. Patient education was provided by pharmacists to the test group patients, along with the usual care provided to all the patients. Patients were followed for three follow-ups of nearly 1 month intervals. Medication adherence and QOL were assessed by Medication Adherence Rating Scale and WHOQOL-BREF questionnaire, respectively. T-test was used and P-values < 0.05 were considered statistically significant.Results: Out of 75 patients enrolled, 73 patients were followed for all the three follow-ups and completed the study. Thirty-eight patients belonged to test and 35 were in control group. The mean age of patients was 34.21 ± 10.91 years. Forty-eight (65.75% patients belonged to age group of 18–39 years. There were 41 males (56.16% and 32 female patients (43.83% in the study. Mean improvement in medication adherence and QOL of the test and control groups were found to be 2.06 ± 0.15 (<0.001 and 13.8 ± 10.5 (<0.05, respectively.Conclusion: This study concluded that pharmacist–psychiatrist collaborative patient education can significantly improve the medication adherence and QOL of the BPAD patients. Statistically significant results indicating improved patient care and outcomes were possible when pharmacists worked as a team with psychiatrists.
Full Text Available Background: The advent of highly active antiretroviral therapy (HAART ushered in a new era in the management of the AIDS pandemic with new drugs, new strategies, new vigour from treating clinicians and enthusiasm on the part of their patients. What soon became evident, however, was the vital importance of patient adherence to prescribed medication in order to obtain full therapeutic benefits. Several factors can influence adherence to HIV drug regimens. Many treatment regimes are complex, requiring patients to take a number of drugs at set times during the day, some on a full stomach and others on an empty one. Other factors that could contribute to non-adherence include: forgetting to take medications, cost factor, side effects, incorrect use of drug, social reasons, denial or poor knowledge of drug regime. If the correct regimen is not prescribed and if patients do not adhere to therapy, then the possibility of resistant strains is high. Improving adherence is therefore arguably the single most important means of optimising overall therapeutic outcomes. Although several studies regarding patient adherence have been performed in the public health care sector, data on adherence in patients from the private health care sector of South Africa remain limited. Many factors influence compliance and identifying these factors may assist in the design of strategies to enhance adherence to such demanding regimens. This study aimed to identify these factors among private sector patients.Method: Descriptive cross-sectional study was conducted among all consenting patients with HIV who visited the rooms of participating private sector doctors from May to July 2005. A questionnaire was administered to consenting participants. Participants who reported missing any medication on any day were considered non-adherent. The data obtained was analysed using SPSS 11.5. A probability value of 5% or less was regarded as being statistically significant. Categorical
Huang, Hui-Ting; Kuo, Yu-Ming; Wang, Shiang-Ru; Wang, Chia-Fen; Tsai, Chung-Hung
Disease screening instruments used for secondary prevention can facilitate early determination and treatment of pathogenic factors, effectively reducing disease incidence, mortality rates, and health complications. Therefore, people should be encouraged to receive health examinations for discovering potential pathogenic factors before symptoms occur. Here, we used the health belief model as a foundation and integrated social psychological factors and investigated the factors influencing health examination behavioral intention among the public in Taiwan. In total, 388 effective questionnaires were analyzed through structural model analysis. Consequently, this study yielded four crucial findings: (1) The established extended health belief model could effectively predict health examination behavioral intention; (2) Self-efficacy was the factor that most strongly influenced health examination behavioral intention, followed by health knowledge; (3) Self-efficacy substantially influenced perceived benefits and perceived barriers; (4) Health knowledge and social support indirectly influenced health examination behavioral intention. The preceding results can effectively increase the acceptance and use of health examination services among the public, thereby facilitating early diagnosis and treatment and ultimately reducing disease and mortality rates.
Full Text Available Levodopa is the gold standard for the treatment of Parkinson's disease (PD because of its outstanding clinical efficacy. However, the majority of patients experience various adverse reactions, including the wearing-off phenomenon, the on-off phenomenon, dyskinesia and psychiatric symptoms. The response to levodopa depends not only on the intrinsic responsiveness of the patients, but also on various other important factors including the type of levodopa preparation, its absorption/metabolism, the blood-brain barrier, age at onset of disease and concomitant use of anti-parkinsonian drugs. This review summarizes factors which influence the effects of levodopa in PD. To minimize levodopa-induced adverse reactions and to relieve long-term parkinsonian symptoms, levodopa therapy should be conducted by taking these factors into consideration.
Full Text Available After hip fracture surgery, patients seldom return to their prefracture functional state and there is a 43% rate of mortality and institutionalisation of postsurgery hip fracture patients. A systematic literature review was conducted to identify preoperative, perioperative, postoperative, and psychosocial factors that may hinder postsurgery hip fracture patients from returning to previous functionality. Factors that were identified as being associated with postsurgical outcomes were age, muscle strength, prefracture living arrangements, number of daily medications taken, oxygen levels, fracture type and location, haemoglobin (Hb level, wait time prior to surgery, length of hospital stay (LOS, and dementia or depression.
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.
Carter, A M
states, are more amenable to analysis. This is exemplified by factors contributing, respectively, to blood oxygen affinity and placental diffusing capacity. Comparative genomics has given fresh insight into the evolution of the beta-globin gene complex. In higher primates, duplication of an embryonic...
@@Ankylosing spondylitis (AS) occurs more frequently in young males than in females. The prevalence of AS in Taiwan, according to our previous study, is about 0.3%.1 AS mainly affects the spine, however, it can also result in peripheral arthritis that occurs in the toes, ankles, knees, hip joints and the tendon and ligaments around those joints.2 In addition, the spine of some AS patients may develop kyphoscoliosis due to late diagnosis or failure to cooperate in following the routine medication and exercises prescribed by their doctors.
Christensen, Ellen Margrethe; Larsen, Jens Knud; Gjerris, Annette;
. 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...
Yardley, John F.
External groups have a significant impact on NASA's programs. Ten groups affecting NASA are identified, and examples are given for some of the them. Methods of dealing with these external inputs are discussed, the most important being good and open two way communications and an objective attitude on the part of the NASA participants. The importance of planning ahead, of developing rapport with these groups, and of effective use of NASA contractors is covered. The need for an overall strategic plan for the U.S. space program is stressed.
Full Text Available The article is devoted to the analysis of socio-demographic and individual psychological characteristics that influence the verdict of jury. The study involved 38 men and women aged 25 to 64 years. With the help of a questionnaire, developed on the basis of legal development model by J. Tapp and F. Levine, we revealed levels of jury members’ legal conscience, which, together with socio-demographic characteristics and personality characteristics of the subjects, identified by R. Cattell 16PF Questionnaire, were related to the responses on the Questionnaire while returning verdict on specially selected criminal cases with implicit guilt of the defendant. According to the study, it was determined that the socio-demographic characteristics of the jurors did not significantly affect their verdict, and among the psychological characteristics of the jurors the greatest impact on their verdict has the level of legal development. Thus, depending on the nature of the crime (violent, non-violent or committed through negligence, the same level of legal conscience differently affect the decision of jurors.
MOHAMMAD REZA HEIDARI
Full Text Available Introduction: Patient education is influenced by cultural factors. This study aims to find out the role of culture in patient education. Methods: A qualitative study was conducted on 23 Iranian nurses. Inclusion criteria were minimum 5 years of working experience in clinical nursing. Semistructured face to face interviews were used to collect the data. Interviews were taped, transcribed and analyzed using content analysis method. Results: The main theme of ‘cultural sensitivity’ was extracted from the interviews. Sub-themes were cultural divergence, cultural connection literacybased instruction. Conclusion: A dynamic process of patient education is influenced by various cultural factors. Nurses must be aware of the cultural norms in patient education to meet their expectations in a respectful manner.
Yurdun Kuyucu; Ozgul Tap
Normal female fertility depends on normally occuring oogenesis and maturation progress. Oogenesis and folliculogenesis are different progresses but occure in a harmony and at the same time. Oogenesis includes the events that take place matur ovum produced from primordial germ cells. Although folliculogenesis includes the stages primordial, primary, secondary, matur (Graaf) follicules in the influece of gonadotropines and local growth factors. During oocyte maturation meiosis is distrupted til...
Sankhala, Shweta; Singh, H. S.; Singh, S. K.; Lalwani, Gautam
The lung is an external organ forming the site of unwanted material or particles. In order to protect it, the airways have to be highly effective filters and if the particle deposit they need to be cleared. Inhaled particles can cause a variety of diseases. There are various factors on which the prediction of depositing particles depends, such as age, particle size, flow rate gender, the physics of the particles, the anatomy of the respiratory tract etc.
Ernst, Darcy Fay Kato
Appropriate timing of reproduction is crucial to animals’ reproductive success and fitness. Animals living in unpredictable environments do not constrain their breeding to one season, but rather breed any time of the year in which good conditions occur. These animals, termed “opportunistic” breeders, cannot predict when good conditions will occur based on the seasons, and must instead respond quickly to proximate environmental factors to successfully breed and raise young. Animals may resp...
Yin, Rulan; Cao, Haixia; Fu, Ting; Zhang, Qiuxiang; Zhang, Lijuan; Li, Liren; Gu, Zhifeng
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.
Fautrel, Bruno; Balsa, Alejandro; Van Riel, Piet; Casillas, Marta; Capron, Jean-Philippe; Cueille, Carine; de la Torre, Inmaculada
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
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.
Ivan FERENCZ; František JÚN; Dušan KEVICKÝ
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.
Factors affecting anxiety-fear of surgical procedures in dentistry. ... the questions concerning previous dental experience, education level, and previous ... structure and gender are the significantly effective factors on dental anxiety and fear.
The objective of this paper is to determine the influence of circulation factors on precipitation in Bulgaria. The study succeeds investigation on the influence of circulation factors on air temperatures in Bulgaria, as the focus here is directed toward precipitation amounts. Circulation factors are represented through two circulation indices, showing west-east or south-north transport of air masses over Bulgaria and four teleconnection indices (patterns)—North Atlantic Oscillation, East Atlantic, East Atlantic/Western Russia, and Scandinavian. Omega values at 700-hPa level show vertical motions in the atmosphere. Annual precipitation trends are mixed and not statistically significant. A significant decrease of precipitation in Bulgaria is observed in November due to the strengthening of the eastward transport of air masses (strengthening of EA teleconnection pattern) and anticyclonal weather (increase of descending motions in the atmosphere). There is also a precipitation decrease in May and June due to the growing influence of the Azores High. An increase of precipitation happens in September. All this leads to a redistribution of annual precipitation course, but annual precipitation amounts remain the same. However, this redistribution has a negative impact on agriculture and winter ski tourism. Zonal circulation has a larger influence on precipitation in Bulgaria compared to meridional. Eastward transport throughout the year leads to lower than the normal precipitation, and vice versa. With regard to the four teleconnection patterns, winter precipitation in Bulgaria is determined mainly by EA/WR teleconnection pattern, spring and autumn by EA teleconnection pattern, and summer by SCAND teleconnection pattern.
Jimeno-Serrano Francisco J
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.
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.
Barfoed, Benedicte Marie Lind; Paulsen, Maja S; Christensen, Palle M
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: T...
White, Mary Joe; Olson, Rhonda S
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.
Certain habitat and social factors were investigated for their effect on home range size of mallard (Anas platyhynchos) pairs breeding in a forested region of north-central Minnesota during the spring of 1971--72. Data from 31 radio-marked hens and drakes were used, but primary emphasis was placed on 8 pairs (5 with both members of the pair marked). Pairs were radio-tracked on river marsh areas, river channels, and large sand lakes to provide comparative data for evaluating home range size differences. Home ranges varied from an average of 53 ha for pairs using primarily river habitat to 871 ha for pairs using only large sand lakes. River and lake shorelines varied considerably in species and density of vegetation. Interaction between pairs as well as density of flocked males appeared to be influenced by these habitat differences with resultant effects on home range sizes.
于心科; 王卫东; 等
A comparative study of rice paddies and the uncovered water field in Taoyuan(Hunan) showed that methane emission from rice-vegetated paddy fields in 1993 was different from that in 1992(I,e,lower in rates and irregular in pattern).Climate has obvious influence on methane emission .And ebullition made a considerable contribution to the total flux of methane emission from rice paddies (45%).This implies that the intensification of paddy cultivation of rice might not be,as was proposed,the main con-tributor to the observed gradual increasing of atmospheric methane.24-hour automatic measurements of atmospheric temperature,air temperature and methane concentration in the static sampling boxes revealed that temperature,in addition to fertilization and irrigation style,is one of the most important factors that control the emission of methane from rice paddies.
Full Text Available Normal female fertility depends on normally occuring oogenesis and maturation progress. Oogenesis and folliculogenesis are different progresses but occure in a harmony and at the same time. Oogenesis includes the events that take place matur ovum produced from primordial germ cells. Although folliculogenesis includes the stages primordial, primary, secondary, matur (Graaf follicules in the influece of gonadotropines and local growth factors. During oocyte maturation meiosis is distrupted till the puberty. Under LH influence it starts again and first meiosis completes before ovulation. Oocyte maturation can be regarded as the process of coming metaphase II from prophase I of oocyte at the puberty and can be studied as nuclear and cytoplasmic maturation. Meiosis is completed when fertilization occures and zygot is formed. In this article oogenesis, folliculogenesis and oocyte maturation process are summerized with related studies and reiews are revised. [Archives Medical Review Journal 2009; 18(4.000: 227-240
Noelker, Linda S; Ejaz, Farida K; Menne, Heather L; Bagaka's, Joshua G
Objective. This research was guided by a stress and support model to examine the effects of frontline workers' background characteristics, personal stressors, job-related stressors, and workplace support on satisfaction with supervision. Method. Survey data were collected from 644 workers in 49 long-term-care settings that employed them. Regression analysis were used to determine the effects of worker level and then Hierarchical Linear Modeling (HLM) and organizational factors on the outcome. Results. Although all four variable categories made significant contributions to explaining satisfaction with supervision, the most powerful were personal stressors and job-related stressors. Results from HLM analysis showed frontline workers in nursing homes and those employed in for-profit organizations had lower levels of satisfaction with supervision. Discussion. Findings suggest organizational interventions to address workers' financial and health issues and management practices such as better training programs and peer mentoring could enhance workers' satisfaction with supervision.
Schroeder, R L; Pendleton, P; Gerber, J P
Chloroquine is an antimalarial drug but is also prescribed for conditions such as rheumatoid arthritis. Long-term users risk toxic side effects, including retinopathy, thought to be caused by chloroquine accumulation on ocular melanin. Although the binding potential of chloroquine to melanin has been investigated previously, our study is the first to demonstrate clear links between chloroquine adsorption by melanin and system factors including temperature, pH, melanin type, and particle size. In the current work, two Sepia melanins were compared with bovine eye as a representative mammalian melanin. Increasing the surface anionic character due to a pH change from 4.7 to 7.4 increased each melanin's affinity for chloroquine. Although the chloroquine isotherms exhibited an apparently strong interaction with each melanin, isosteric heat analysis indicated a competitive interaction. Buffer solution cations competed effectively at low surface coverage; chloroquine adsorption occurs via buffer cation displacement and is promoted by temperature-influenced secondary structure swelling.
Yin, Jing; Zhang, Qian; Liu, Ailing; Du, Weijing; Wang, Xiaoyan; Hu, Xiaoqi; Ma, Guansheng
Chinese dietary reference intakes (DRIs) for calcium were developed mainly from studies conducted amongst Caucasians, yet a recent review showed that reference calcium intakes for Asians are likely to be different from those of Caucasians (Lee and Jiang, 2008). In order to develop calcium DRIs for Chinese adolescents, it is necessary to explore the characteristics and potential influencing factors of calcium metabolic balance in Chinese adolescents. A total of 80 students (15.1+/-0.8 years) were recruited stratified by gender from a 1-year calcium supplementation study. Subjects were randomly designed to four groups and supplemented with calcium carbonate tablets providing elemental calcium at 63, 354, 660, and 966 mg/day, respectively. Subjects consumed food from a 3-day cycle menu prepared by staff for 10 days. Elemental calcium in samples of foods, feces, and urine was determined in duplicates by inductively coupled plasma atomic emission spectrometry. The total calcium intake ranged from 352 to 1323 mg/day. The calcium apparent absorption efficiency and retention in boys were significantly higher than that in girls (68.7% vs. 46.4%, 480 mg/day vs. 204 mg/day, PCalcium retention increased with calcium intakes, but did not reach a plateau. Calcium absorption efficiency in boys increased with calcium intake up to 665 mg/day, and decreased after that. In girls, calcium absorption efficiency decreased with calcium intake. Calcium absorption efficiency increased within 1 year after first spermatorrhea in boys, but decreased with pubertal development in girls. Sex, calcium intake, age, and pubertal development were the most important determinants of calcium absorption (R(2)=0.508, Pcalcium intake, age, and pubertal development are important factors for calcium retention and absorption during growth, which should be considered for the development of calcium DRIs for Chinese adolescents.
Maria S. Bowman
Full Text Available In response to a shift toward specialization and mechanization during the 20th century, there has been momentum on the part of a vocal contingent of consumers, producers, researchers, and policy makers who call for a transition toward a new model of agriculture. This model employs fewer synthetic inputs, incorporates practices which enhance biodiversity and environmental services at local, regional, and global scales, and takes into account the social implications of production practices, market dynamics, and product mixes. Within this vision, diversified farming systems (DFS have emerged as a model that incorporates functional biodiversity at multiple temporal and spatial scales to maintain ecosystem services critical to agricultural production. Our aim is to provide an economists' perspective on the factors which make diversified farming systems (DFS economically attractive, or not-so-attractive, to farmers, and to discuss the potential for and roadblocks to widespread adoption. We focus on how a range of existing and emerging factors drive profitability and adoption of DFS. We believe that, in order for DFS to thrive, a number of structural changes are needed. These include: 1 public and private investment in the development of low-cost, practical technologies that reduce the costs of production in DFS, 2 support for and coordination of evolving markets for ecosystem services and products from DFS and 3 the elimination of subsidies and crop insurance programs that perpetuate the unsustainable production of staple crops. We suggest that subsidies and funding be directed, instead, toward points 1 and 2, as well as toward incentives for consumption of nutritious food.
Full Text Available Introduction: Alcohol is one of the major risk factors for individuals’ and society’s health. Alcohol consumption is present since ancient years in Europe, constituting tradition, with Europeans preferring different kinds of alcohol depending on the geographic location of their country. The economic crisis that European citizens are undergoing nowadays, has an impact on their health and more specifically there has been a significant increase in alcohol consumption. Material and Methods: The purpose of this study is to explore the factors which effect the alcohol consumption and consequences of this consumption in Europe. Literature review of relevant articles, published from 2005 to 2013, to these databases: WHO, Google scholar, PubMed. Finally, 42 studies were used to our review. Results: The alcohol consumption is connected with the economic situation of the country, the availability of alcohol, the restrictions and taxes of each country. Alcohol consumption is also related with the gender and age of each individual. In Central-eastern Europe, in contrast to the south Europe, the greatest percentage of mortality caused by the alcohol consumption is found. 35,95% is the mortality rate which is found in Europe. Regarding Greece in recent years, alcohol consumption has declined, while the rates of intoxication have shown as light increase. Conclusions: The lack of legislation, the non-existence of a minimum sale price and the increased availability, can lead to increased incidence of mortality caused by the alcohol consumption. Further research regarding the correlation of economic crisis and alcohol consumption is necessary.
Full Text Available Background. The prevalence of diabetes mellitus (DM is rising worldwide and is more in the developing countries which unfortunately are already suffering from communicable diseases. The aim of this study was to assess adherence and associated factors towards antidiabetic medication among type II diabetic patients in University of Gondar Hospital, Diabetic Clinic, Gondar, Northwest Ethiopia. Methods. Institutional based cross-sectional study was conducted. Systematic sampling technique was used. Morisky Medication Adherence Scale (MMAS scores were used for labeling patients as adherent or nonadherent. Data were entered and analyzed using SPSS version 20. To see the association of variables logistic regression with OR and 95% CI was done. Results. A total of 288 study participants were interviewed with response rate of 100%. The level of adherence was found to be 85.1%. Factors found to be significantly associated with antidiabetic medication adherence were level of education (AOR = 14.27, 95% CI = 3.0, 67.82, duration of diabetes (AOR = 6.10, 95% CI = 2.03, 18.34, and knowledge about DM and its medications (AOR = 28.05, 95% CI = 8.96, 87.8. Conclusions and Recommendations. Large proportion of respondents in this study were found to be adherent to their antidiabetic medications. Level of education, duration of diabetes, and knowledge about DM and its medication were significantly associated with antidiabetic medication adherence of patients. Health education including adherence counseling to create awareness towards DM and its medications is mandatory.
Cugelman, Brian; Thelwall, Mike; Dawes, Phil
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
Arage, Getachew; Tessema, Gizachew Assefa; Kassa, Hiwot
...)-related morbidity and mortality among children. This study assessed the level of adherence to antiretroviral therapy and its associated factors among children at hospitals in South Wollo Zone, Northeast Ethiopia...
Full Text Available Viktor Mravčík,1,2 Lisa Strada,3 Josef Štolfa,4,5 Vladimir Bencko,6 Teodora Groshkova,7 Jens Reimer,3 Bernd Schulte3 1National Monitoring Centre for Drugs and Drug Addiction, 2Department of Addictology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; 3Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany; 4Department of General Practice, Institute for Postgraduate Medical Education in Prague, 5Department of General Practice, Second Faculty of Medicine, 6Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; 7European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal Introduction and methods: Hepatitis C virus (HCV infections are highly prevalent amongst people who inject drugs (PWID. Despite well documented evidence of its effectiveness, suggested cost-effectiveness, and potential to reduce HCV prevalence rates, the uptake of antiviral HCV treatment by PWID is low. This nonsystematic literature review describes factors associated with the uptake, adherence, and efficacy of HCV treatment among PWID and discusses strategies to increase their uptake of treatment. Results: Low HCV treatment uptake among PWID is associated with a number of patient-related and provider-related barriers. Beliefs and fears about low efficacy and adverse effects on the patient’s part are common. A substantial number of factors are associated with the chaotic lifestyle and altered social functioning of PWID, which are often associated with decompensation or relapsing into drug addiction. This may lead to perceived low adherence with treatment and low efficacy on the provider’s part too, where lack of support, inadequate management of addiction, and other drug-related problems and poor treatment of side effects have been described. Practical issues such as the accessibility of treatment and finances also play a role
Sima Ataollahi Eshkoor
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.
Full Text Available Objective: The increase in life quality and expectancy causes an increase in the elderly population. Improvements in burn treatment resulted in decreased mortality in children and young adults but in elderly patients burns are still an important trauma that should be handed differently than other age groups. The aim of this study was to evaluate the factors effecting mortality in patients with burns over 45 years old. Methods: Fifty-eight patients over 45 years of age, who were treated in our burns unit in the last 3 years were included in our study. Their age, burn percentage and depth, coexisting diseases and mortality rates were examined retrospectively. Results: The average age of surviving patients was 57.4 years while it was 70 years for nonsurviving patients (p=0.002. The width of burn area was 21.1 % in surviving and 50 % in nonsurviving patients (p<0.01. The effect of additional coexistent diseases on mortality was significant (p=0.001. The most common reasons of mortality were sepsis and congestive heart failure. Conclusion: We found out that the age, percentage of burns and coexistent diseases had a negative effect on success of treatment and mortality. Mortality rates will decrease in these cases with careful follow-up and a multidisciplinary approach. J Clin Exp Invest 2015; 6 (3: 240-243
Gibson, Troy J; Mason, Charles W; Spence, Jade Y; Barker, Heather; Gregory, Neville G
Captive bolt stunning is used for rendering livestock insensible at slaughter. The mechanical factors relating to performance of 6 penetrating captive bolt gun (CBG) models were examined. The Matador Super Sécurit 3000 and the .25 Cash Euro Stunner had the highest kinetic energy values (443 J and 412 J, respectively) of the CBGs tested. Ninety percent (27/30) of CBGs held at a government gun repository (United Kingdom) were found to have performed at a normal standard for the model, while 53% (10/19) of commercial contractor CBGs tested were found to underperform for the gun model. When the .22 Cash Special was fired 500 times at 4 shots per min, the gun reached a peak temperature of 88.8°C after 2.05 hr. Repeat firing during extended periods significantly reduced the performance of the CBG. When deciding on the appropriate CBG/cartridge combination, the kinetic energy delivered to the head of the nonhuman animal, bolt penetration depth, and species/animal type must be considered. It is recommended that CBGs are routinely checked for wear to the bolt and barrel if they are repeatedly fired in a session.
Kristy Iglay,; Tunceli, Kaan; Zhao, Changgeng; Davies, Michael J.; Brodovicz, Kimberly G.; Charles M. Alexander; Radican, Larry
Kaan Tunceli,1 Changgeng Zhao,1 Michael J Davies,2 Kimberly G Brodovicz,3 Charles M Alexander,4 Kristy Iglay,1 Larry Radican1 1Global Health Outcomes, Merck & Co, Inc, Whitehouse Station, NJ, USA; 2Global Scientific and Medical Publications, Merck & Co, Inc, Whitehouse Station, NJ, USA; 3Global Epidemiology, Merck & Co, Inc, Whitehouse Station, NJ, USA; 4Global Medical Affairs, Merck & Co, Inc, Whitehouse Station, NJ, USA Aim: To estimate the rate of adherence...
Tunceli K; Zhao C; Davies MJ; Brodovicz KG; Alexander CM; Iglay K; Radican L
Kaan Tunceli,1 Changgeng Zhao,1 Michael J Davies,2 Kimberly G Brodovicz,3 Charles M Alexander,4 Kristy Iglay,1 Larry Radican1 1Global Health Outcomes, Merck & Co, Inc, Whitehouse Station, NJ, USA; 2Global Scientific and Medical Publications, Merck & Co, Inc, Whitehouse Station, NJ, USA; 3Global Epidemiology, Merck & Co, Inc, Whitehouse Station, NJ, USA; 4Global Medical Affairs, Merck & Co, Inc, Whitehouse Station, NJ, USA Aim: To estimate the rate of adherence to oral antihyp...
style was isolation and participation in silence and meditation . Both systolic and diastolic pressures were taken every four years in the nuns and...took the meditation twice a day. Two women did not answer the prescribed frequency portion correctly so their adherence is not known. Hypertension...Table 7 for total of alI scales and each ind ,idua! suhs(al, of the lealth Promoting 1.i festv , c ’rof ,. Scjrc. vr ," .-iimmat ixe. which meant, that
Full Text Available Background and Objectives: Holy Quran is the greatest gift of God to mankind and is the most precious legacy of So, in order to govern a society guided by Quran and the teachings of Quran by life style based on it, it is necessary that academic community pays attention to Quran education on their pattern Aims: The aim of this study was to evaluate Quran literacy of the academic community. This study is intended to provide information to the student community planning principles for designing and implementing Quran based activities. Material and Methods: This study was a descriptive survey. A researcher-made questionnaire with content validation was used to collect data. The population consisted of 840 students of Tabriz University of Medical Sciences. Descriptive statistics by SPSSS 11 software was used for data analysis. Results: Analysis of the findings indicated that 37.2% of the participants were male and 62.8% were females. Thirty percent were non-native students and 69.6% of them were natives. More than 80% of the participants had Quran literacy. The results showed no significant relationship between academic major (p>%94, gender( p>%07 and familiarity with Quran and being native or non-native( p>%79 Individuals who had Tajvid voice and tone literacy with 35.5%, common meanings and interpretations with 23.1%, translation with 12.9%, sound and tone with 13.4% and Tajvid with 1.5%, respectively. Determinants affecting on Quran literacy includes father’s job, school education, high interest in Quran education and family members’ familiarity with Quran. The most frequent obstacle include: educational priorities, lack of time, apathy and no interest in Quran. Conclusion: Since Quran is for everyone and Quran activities are distributed among different academic majors, no significant relationship was found between gender (p>%07, academic major (p>%94 and being native or non-native (p>%79. As a result, paying attention to Quran verses
Rita Narriman Silva de Oliveira Boery
Full Text Available Proper adherence to antiretroviral therapy is essential for improving the quality of life and decreased mortality due to Acquired Immunodeficiency Syndrome (AIDS. Our objective was to analyze adherence to antiretroviral therapy of patients with HIV/AIDS living in the area covered by the 13th Regional Health Board (DIRES, whose seat is the city of Jequié – Bahia. It is an exploratory study with quantitative approach and the study setting was the city of Jequié. 34 patients with HIV/AIDS, of both sexes, registered in the center of reference and attended it regularly were informants of the study. Data were collected through a form with the information obtained processed with Microsoft Excel. The age of the respondents ranged from 24 to 60 years old. Most had low education, low income and were adept to Catholic religion. The time of diagnosis was 1 to 4 years. Concern in ensuring the confidentiality of HIV status was identified. We conclude it to be relevant promoting health education activities for treatment adherence, building and maintaining membership groups to discuss issues related to pathology and the legal aspects involved in the daily lives of patients living with HIV/AIDS.
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.
Full Text Available Background and Aim. The aim of this study was to investigate the effects of demographic characteristics, biochemical parameters, amount of blood transfusion, and trauma scores on morbidity in patients with solid organ injury following trauma. Material and Method. One hundred nine patients with solid organ injury due to abdominal trauma during January 2005 and October 2015 were examined retrospectively in the General Surgery Department of Dicle University Medical Faculty. Patients’ age, gender, trauma interval time, vital status (heart rate, arterial tension, and respiratory rate, hematocrit (HCT value, serum area aminotransferase (ALT and aspartate aminotransferase (AST values, presence of free abdominal fluid in USG, trauma mechanism, extra-abdominal system injuries, injured solid organs and their number, degree of injury in abdominal CT, number of blood transfusions, duration of hospital stay, time of operation (for those undergoing operation, trauma scores (ISS, RTS, Glasgow coma scale, and TRISS, and causes of morbidity and mortality were examined. In posttraumatic follow-up period, intra-abdominal hematoma infection, emboli, catheter infection, and deep vein thrombosis were monitored as factors of morbidity. Results. One hundred nine patients were followed up and treated due to isolated solid organ injury following abdominal trauma. There were 81 males (74.3% and 28 females (25.7%, and the mean age was 37.6±18.28 (15–78 years. When examining the mechanism of abdominal trauma in patients, the following results were obtained: 58 (53.3% traffic accidents (22 out-vehicle and 36 in-vehicle, 27 (24.7% falling from a height, 14 (12.9% assaults, 5 (4.5% sharp object injuries, and 5 (4.5% gunshot injuries. When evaluating 69 liver injuries scaled by CT the following was detected: 14 (20.3% of grade I, 32 (46.4% of grade II, 22 (31.8% of grade III, and 1 (1.5% of grade IV. In 63 spleen injuries scaled by CT the following was present: grade I in
Mwangi, A N; Ng'ang'a, Z; Wanzala, P; Karanja, S M
The efficacy of anti-retroviral Therapy (ART) depends on adherence to the prescribed regimen. However, lack of adherence leads to treatment failure and drug resistance among other negative outcomes. To determine factors influencing adherence to ARVS among patients attending the Comprehensive Care Clinic (CCC) within Jomo Kenyatta University of Agriculture and Technology (JKUAT). A descriptive cross sectional study. Comprehensive Care Clinic within JKUAT. Three hundred HIV positive patients, undergoing ART treatment and follow up at the JKUAT clinic for a minimum duration of one month before the study, were recruited. Of the 300 patients enrolled for the study (70% females and 30% males), 81% were adhering to ARV treatment. The factors that were significantly associated with adherence included; Support (encouragement and reminder to take drugs) (P = 0.025); the number of meals respondents took in a day (P = 0.001); pill burden (P = 0.002) and forgetfulness (P = 0.001). However, there was no significant relationship between adherence and age, marital status, education, employment status or time taken to travel to the clinic. This study concluded that, the observed level of sub-optimal adherence to ART (19%) is of public health concern. These patients are vulnerable to treatment failure and development of resistant viral strains. Consequently the modifiable factors (Support, Number of meals taken, pill burden, and forgetfulness, should be addressed to change the current tread.
Full Text Available Background The growing global elderly population is in need of more prescription medications. Objectives The present study assessed medication adherence with respect to demographic factors among elderly patients with cardiovascular disease who were admitted to a teaching hospital as well as outpatients referred to treatment centers in Bushehr, Iran. Patients and Methods The present study was a descriptive-analytic cross-sectional study using a simple random sampling method that investigated 125 elderly patients with cardiovascular disease. Data were collected through the Medication Adherence Questionnaire. Data were analyzed by using descriptive statistics, and Pearson and Cramer’s V correlation analyses, using SPSS version 18. Results Among the patients, 57.6% and 42.4% were female and male, respectively. Moreover, 62.4% had high adherence to their prescribed medications. Frequency of medication use, history of previous hospitalization, and sex were significantly associated with adherence to medication (P < 0.05. Conclusions More than half of elderly patients with cardiovascular disease had high adherence to their medications. Demographic factors including the frequency of daily medication use, history of hospitalization, and female sex were associated with adherence to medication. By considering these factors, doctors and nurses increase medication adherence, especially for older adults.
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
Siefried, Krista J.; Mao, Limin; Kerr, Stephen; Cysique, Lucette A.; Gates, Thomas M.; McAllister, John; Maynard, Anthony; de Wit, John; Carr, Andrew
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 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. Results 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). Conclusions In this population, 15% reported recent suboptimal ART adherence at levels associated in prospective studies with
Tucker, G. Richard; And Others
This paper examines the role of selected affective, cognitive and social factors in second language acquisition, in an attempt to define a group of factors associated with success in second language learning within the formal educational system. Also examined is the effect of different teaching programs on an optimal group of factors. (CLK)
Dean, Rebecca J.; Dagostino, Lorraine
This article explores the possible intrinsic and extrinsic motivational factors that community college students may bring with them into the classroom. It examines how these motivational factors affect students' learning inside and outside the community college classroom walls. The motivational factors such as mastery, self-determination,…
Robert L. Jr. Nevel; Robert L. Jr. Nevel
The continued use of hardwood flooring in urban rehabilitation is being threatened. A study of the influences that determine the choice of flooring indicates that economic, physical, or technological factors dominate. Most factors affecting the use of hardwood flooring are related to cost, availability, and compatibility. Of these factors, time and cost of installation...
Maher, Michelle A.; Timmerman, Briana Crotwell; Feldon, David F.; Strickland, Denise
Using faculty narratives, this study identifies factors affecting the occurrence of faculty-doctoral student coauthorship. Norms of the discipline, resources, faculty goals for students, faculty goals for themselves, and institutional expectations emerged as dominant factors. Each factor is explored separately and as part of an interlocking…
Education should aim at promoting students’all-round development and unifying cognitive and emotional aspects. However, the reality is that teachers pay too much attention on language cognitive factors and neglect the influence of emotional factors in language learning. This article tries to discuss how to use the affective factors in English teaching so as to enhance students’ comprehensive development.
Tucker, G. Richard; And Others
This paper examines the role of selected affective, cognitive and social factors in second language acquisition, in an attempt to define a group of factors associated with success in second language learning within the formal educational system. Also examined is the effect of different teaching programs on an optimal group of factors. (CLK)
Thelwall, Mike; Dawes, Phil
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
Doğu, Güler Ufuk
Ankara : Department of Interior Architecture and Environmental Design and Institute of Fine Arts, Bilkent University, 1997. Includes bibliographical refences. The aim of this thesis is to study the main factors which affect the wayfinding and orientation of individuals in a shopping mall and explain how their behaviors are influenced by these factors. The spatial and individual factors and their properties are defined. Among the spatiaf factors, shape and dimensions, light and color, bu...
The paper talks about the effective factors functioning in the field of education,psychology and foreign language teaching.And it also specifically elaborates the principles of helping language learners overcome negative affections and develop positive ones.
Factors affecting career preferences of medical students at the College of ... students, respondents from rural areas and small towns, and whose parents were ... between doctors' career expectations and the country's healthcare needs.
Regression analysis showed that only two of the variables; level of education ... were predicted to have significant relationship with the yield of oil palm. ..... Table 5: Multiple Regression analysis of factors affecting oil palm production in.
Factors affecting goat production in a communal farming system in the Eastern ... and for cash sales (23%), and only 15% kept goats for home meat consumption. ... is likely to increase to the detriment of other ruminant species in the future.
James Ariel Sánchez Alzate; Luz Alexandra Montoya Restrepo
In this article the main factors affecting consumer trust in online purchases are proposed, it demonstrates how consumers feel less fear and more willingness to purchase through electronic media...
The study examined the socio-economic factors affecting women's ... About 41% attended up to secondary school level of education while 4% attended tertiary ... would go a long way in removing some of the barriers to effective participation.
Factors Affecting Loan Utilization And Repayment Patterns By Small Holder Farmers ... 61.3% of the respondents had a minimum of secondary school education. ... Also, it can be inferred that effective utilization of loan is directly influenced by ...
Factors Affecting Students' Performance and Practice on Map Reading Skills: A ... In Ethiopia, the teaching and learning process of map reading skills is based on ... identifying effective study techniques, the students' willingness to do school ...
Assessment Of Factors Affecting Farmers' Adoption And Utilisation Of Major ... Level of respondents' education, participation in on-farm trials, contact with extension ... The study therefore recommended intensification of adequate and effective ...
Factors Affecting Behaviours that address HIV Risk among Nigerian University Students. ... Design: Cross-sectional survey. ... Main outcome measures: Sexual behavior and condom use, knowledge about correct condom use, intention of ...
Factors affecting extension workers in their rendering of effective service to pre ... the objective of achieving sustainable livelihoods for the poor and commonages. ... marketing and management to adequately service the land reform programs.
For a long time,Chinese EFL teaching has been following the teacher-centered model,which emphasizes the cognitive aspect but ignores the affective factors. So "emotional illiteracy" is a common phemenon and harmful to language learning and students' all-round development. This essay lays special stress on humanistic approach and analyzes the influence of some important affective factors on language learning,for the purpose of inviting teachers' attention to students' emotions in fulfilling their teaching task.
Reynolds, Nancy R; Testa, Marcia A; Marc, Linda G; Chesney, Margaret A; Neidig, Judith L; Smith, Scott R; Vella, Stefano; Robbins, Gregory K
It is widely recognized that adherence to antiretroviral therapy is critical to long-term treatment success, yet rates of adherence to antiretroviral medications are frequently subtherapeutic. Beliefs about antiretroviral therapy and psychosocial characteristics of HIV-positive persons naive to therapy may influence early experience with antiretroviral medication adherence and therefore could be important when designing programs to improve adherence to antiretroviral therapy. As part of a multicenter AIDS Clinical Trial Group (ACTG 384) study, 980 antiretroviral-naive subjects (82% male, 47% White, median age 36 years, and median CD4 cell count 278 cells/mm3) completed a self-administered questionnaire prior to random treatment assignment of initial antiretroviral medications. Measures of symptom distress, general health and well-being, and personal and situational factors including demographic characteristics, social support, self-efficacy, depression, stress, and current adherence to (nonantiretroviral) medications were recorded. Associations among variables were explored using correlation and regression analyses. Beliefs about the importance of antiretroviral adherence and ability to take antiretroviral medications as directed (adherence self-efficacy) were generally positive. Fifty-six percent of the participants were "extremely sure" of their ability to take all medications as directed and 48% were "extremely sure" that antiretroviral nonadherence would cause resistance, but only 37% were as sure that antiretroviral therapy would benefit their health. Less-positive beliefs about antiretroviral therapy adherence were associated with greater stress, depression, and symptom distress. More-positive beliefs about antiretroviral therapy adherence were associated with better scores on health perception, functional health, social-emotional-cognitive function, social support, role function, younger age, and higher education (r values = 0.09-0.24, all p < .001). Among
Affect is the related issues that influence the students' learning progress and result, including one's interest, emotion, self-confidence and so on. Affective factors are the motivation for the students' learning. In the past few decades, people have always been pursuing the effective methods of teaching, from the Grammar Translation Method, to Communicative Language Teaching. Now people start to focus on affective teaching and have got some good result.
The general objective of this study was to identify the extrinsic factors affect employee ... individual mechanisms that directly affect job performance in an organization(Colquitt, ... Benjamin (2010) posits that fringe benefits are significant and positive ... Mouly (2009) asserts that questionnaires add value to research because.
The article investigates factors affecting Chinese postgraduate EFL learners’ oral proficiency. Little practice, fear of errors and unscientific classroom management are found to be the major factors. Also an overemphasis on written English instruction seems to be another root cause. After the discussion of the results of this investigation a series of methods are suggested for reference.
L.E. Visser (Loes)
textabstractThis introductory chapter has illustrated that various factors, such as genetic factors, drugs, diet and intercurrent diseases may affect anticoagulation levels. Most of the clinical and pharmacological data related to coumarin anticoagulants have so far been obtained from studying warfa
Lee, Donghun; Trail, Galen T.; Lee, Cindy; Schoenstedt, Linda J.
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…
Bista, Krishna K.
This paper examines the relationship of age factor to second language acquisition. Age as an affective factor brings about different performance stages in second as well as first language learning. Traditionally, research in Critical Period Hypothesis and other variables has derived two major aspects of language learning--the younger = the better…
Bogdanov, I.I.; Torres, J.-A.; Kamp, A.M. [CHLOE, University of Pau (France); Corre, B. [CSTJF, Total (France)
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.
Ariff, Mohd Shoki Md; Sze Yan, Ng; Zakuan, Norhayati; Zaidi Bahari, Ahamad; Jusoh, Ahmad
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.
Kimura, Michio; Usami, Eiseki; Iwai, Mina; Nakao, Toshiya; Yoshimura, Tomoaki; Mori, Hiromi; Sugiyama, Tadashi; Teramachi, Hitomi
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.
Peng, Jie; Yin, Junhua; Cai, Shaohang; Yu, Tao; Zhong, Chunxiu
Little is known about the factors associated with patient compliance with nucleos(t)ide analog (NUC) treatment for chronic hepatitis B (CHB). The purpose of this study was to examine the association between sociodemographic and clinical characteristics and adherence to NUCs among patients with CHB. A total of 211 CHB patients receiving NUC monotherapy were asked to report the number of prescribed doses of medication they had taken during the last 90 days. A total of four 3-month adherence scores were averaged to obtain a combined rate of NUC adherence during a 1-year follow up period. The mean age of the patients was 29.6 years, 79% were men, and 68% had no prior NUC treatment for CHB. Females, patients without a previous NUC treatment, and those who had NUC drug resistance showed better adherence to NUC treatment, and compliance was better with telbivudine than with lamivudine and entecavir.
Full Text Available Purpose: The purpose of the paper is to identify the factors that affect the development of the models of financial market state supervision and to identify the factors that have influenced the evolution of the supervision model in Poland. Methodology: critical analysis of literature, legal provisions and documents. Findings: The completely integrated and the fully dispersed model of supervision are located at the opposite ends of the spectrum. A variety of the hybrid models can be identified between them. Factors that affect supervision organization are both economic and non-economic. Factors that have influenced the Polish model of supervision include political aspects, administration costs and, in due course, also the development of the financial market. Research implications: The variety of state supervision structures, combined with the ambiguity and multiplicity of factors that affect their evolution create a new research challenge. Significant problems in accessing documents have been identified. Originality: The author presents an overview of models of state supervision of financial markets and factors affecting the evolution and structure of supervision. Conclusions drawn from the analysis were used to identify factors that influence the evolution and supervision of the Polish financial market.
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
Rosen Marc I
Full Text Available Abstract Background Opiate substitution treatment has been associated with better adherence to lifesaving antiretroviral medications, but the impact of other substance abuse treatment on adherence is unknown. Findings In this study, 215 patients who had been in adherence-focused research studies provided electronically-measured adherence data and a measure of whether the patient had recently been in substance abuse treatment. Recent engagement in substance abuse treatment was independently associated with significantly higher adherence, after covarying for recent substance use and other factors potentially affecting adherence. Conclusions The findings suggest that substance abuse treatment is associated with better adherence. Potential mechanisms by which substance abuse treatment improves adherence, such as more stability or more future-orientation, require further study.
Chisolm, S S; Taylor, S L; Gryzwacz, J G; O'Neill, J L; Balkrishnan, R R; Feldman, S R
Atopic dermatitis (AD) is a common problem of childhood causing considerable distress. Effective topical treatments exist, yet poor adherence often results in poor outcomes. A framework is needed to better understand adherence behaviour. To provide a basis for this framework, we reviewed established models used to describe health behaviour. Structural elements of these models informed the development of an adherence model for AD that can be used to complement empirical AD treatment trials. Health behaviour models provide a means to describe factors that affect adherence and that can mediate the effects of different adherence interventions. Models of adherence behaviour are important for promoting better treatment outcomes for children with AD and their families. These models provide a means to identify new targets to improve adherence and a guide for refining adherence interventions.
Jeon, Eunjoo; Park, Hyeoun-Ae
The factors affecting the acceptance of mobile obesity-management applications (apps) by the public were analyzed using a mobile healthcare system (MHS) technology acceptance model (TAM). The subjects who participated in this study were Android smartphone users who had an intent to manage their weight. They used the obesity-management app for two weeks, and then completed an 18-item survey designed to determine the factors influencing the acceptance of the app. Three questions were asked pertaining to each of the following six factors: compatibility, self-efficacy, technical support and training, perceived usefulness, perceived ease of use, and behavior regarding intention to use. Cronbach's alpha was used to assess the reliability of the scales. Pathway analysis was also performed to evaluate the MHS acceptance model. A total of 94 subjects participated in this study. The results indicate that compatibility, perceived usefulness, and perceived ease of use significantly affected the behavioral intention to use the mobile obesity-management app. Technical support and training also significantly affected the perceived ease of use; however, the hypotheses that self-efficacy affects perceived usefulness and perceived ease of use were not supported in this study. This is the first attempt to analyze the factors influencing mobile obesity-management app acceptance using a TAM. Further studies should cover not only obesity but also other chronic diseases and should analyze the factors affecting the acceptance of apps among healthcare consumers in general.
Tesoriero, James; French, Tyler; Weiss, Linda; Waters, Mark; Finkelstein, Ruth; Agins, Bruce
Adherence to antiretroviral medications is essential to therapeutic success. Many published studies have investigated the degree of adherence or nonadherence, but sample sizes have generally been small, and adherence has seldom been viewed as a longitudinal process. This paper investigates the stability of adherence over time among HIV-infected individuals attending adherence support programs in New York State. The study cohort consists of 435 clients who were on HAART at baseline and who completed at least 2 follow-up interviews. Although cross-sectional nonadherence did not exceed 35%, nonadherence reached 54% when considered across all 3 interviews. Analysis of transition matricies revealed moderate stability in adherence over time (e.g., first follow-up adherence was 81.0% for clients adherent at baseline, compared with 58.3% for clients nonadherent at baseline). Second-order transition matricies offered additional predictive utility. Multivariate results indicated that, for some, it was the transition from a desirable to an undesirable state (e.g., from no illicit drug use to illicit drug use) that increased the likelihood of nonadherence, rather than the presence of these characteristics over time. Findings illustrate the importance of multiple, periodic assessments of adherence and the need to consider strategies to increase stability in the factors affecting adherence to HAART.
Luc, J. E.; Crow, W. T.
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...
Jakobsen, M D; Sundstrup, E; Brandt, M; Andersen, L L
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.
LIU Jing-tao; SONG Hai-jing; WANG Yu; KANG Yan; JIANG Li; LIN Si-han; DU Bin
Background Elevating the head of bed (HOB) 30°-45° has been widely supported as a means of ventilator associated pneumonia (VAP) prevention.However,it was poorly adhered in clinical practice.This observational study aimed to investigate the factors impeding this simple practice at the bedside.Methods This prospective study was conducted in 33 Chinese academic hospital intensive care units (ICUs).HOB angle was measured four times daily at 5-7 hour intervals.The predefined HOB elevation goal was an angle ＞30°.Results The overall rate of achieving the HOB goal was 27.8％ of the 8647 measurements in 314 patients during 2842 ventilation days.The HOB goal of ＞3 times/d was consistently achieved only in 15.9％ of the cases.Almost 60％ of patients had at least one 24 hours period during which the HOB goal was never documented.This low rate of protocol compliance was not associated with acute physiology and chronic health evaluation (APACHE) Ⅱ score or dependence on vasopressors.In a survey,"nurse workload" was identified as the most important factor for non-compliance with the HOB goal.In addition,the rates of compliance were significantly different (P ＜0.001) between physicians self-reporting that they either did or did not know the Institutes of Healthcare Improvement (IHI) ventilator bundle.Conclusions Low adherence to a HOB angle of ＞30° was found in this nationwide survey.Nursing workload and lack of knowledge on VAP prevention were important barriers to changing this practice.
Husebø, Anne Marie Lunde; Karlsen, Bjørg; Allan, Helen; Søreide, Jon Arne; Bru, Edvin
To explore factors influencing exercise adherence among women with breast cancer while following an exercise programme. Earlier research shows that women with breast cancer decrease physical activity following the cancer diagnosis and that adhering to exercise interventions can be a challenge. Research is needed to identify motivational factors and barriers for exercise adherence among women during treatment for breast cancer. This was a qualitative study to explore patient's perceptions of the challenges to exercise adherence during a randomised, controlled trial. Twenty-seven women with early-stage breast cancer were purposively sampled for focus group interviews during 2011-2012 from their participation in the exercise intervention group during 2010-2012. Five focus groups were performed, and data analysis was completed using the systematic text condensation method. During the focus group study, five main themes were identified, which described factors participants perceived to influence their adherence to exercise during chemotherapy: 'side effects of breast cancer treatment as a barrier to exercise', 'restoring and maintaining normality in daily life motivates exercise', 'other valued activities compete with exercise', 'constructive support enhances exercise' and 'positive beliefs about efficacy and outcomes motivate exercise'. Adherence to exercise in women with breast cancer is challenged by internal and external conditions and may be improved by attention to the impact of treatment side effects and by supporting patient self-efficacy towards changing health behaviour. Nurses should be aware that exercise adherence could be a challenge among women with breast cancer. They should help identify obstacles to exercise for women and ways to overcome them, as well as support them in their beliefs that they are capable of changing their health behaviour. © 2014 John Wiley & Sons Ltd.
Full Text Available Abstract Background The objective of this study was to develop scales measuring personal and environmental factors that affect dietary fat intake behavior, physical activity, and stress management in low-income mothers. Methods FADESM (factors affecting diet, exercise, and stress management scales were developed using the Social Cognitive Theory to measure personal (outcome expectancies, self-efficacy, emotional coping response and environmental (physical environment, social environment, situation factors affecting dietary fat intake behavior, physical activity, and stress management. Low-income African American and white mothers were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in three counties in Michigan. In Phase one, 45 mothers completed individual cognitive interviews. Content analyses were performed. In Phase two, items modified from the cognitive interviews were administered to 216 mothers. Factor analysis and multiple indicators/multiple causes were performed. Results Results of cognitive interviews were used to revise items for the instrument that was tested in Phase two. The factor solution revealed 19 dimensions to measure personal and environmental factors affecting dietary fat intake behavior (three dimensions, physical activity (eight dimensions, and stress management (eight dimensions. Results of multiple indicators/multiple causes model showed scale invariance. Of 19 dimensions, 15 had Cronbach alpha between 0.76 and 0.94 and four were between 0.66 and 0.69. All dimensions had composite construct reliability scores between 0.74 to 0.97 and satisfactory construct and discriminant validities. Conclusion The theory-based FADESM scales have documented good validity and reliability for measuring factors affecting dietary fat intake behavior, physical activity, and stress management in low-income women. Results of this study support the use of these scales with low-income African American
Full Text Available Management of chronic illness implies significant changing the lifestyle, taking medication, watching the diet, introducing and maintaining exercise in daily life, etc. These actions represent elements of adherence to treatment and they reflect the responsibility of patient’s participation to healthcare. The increase in adherence to treatment and in the quality of care, implicitly, may depend on allotting the resources necessary within therapeutic effort and on the effectiveness of the partnership between patient and doctor. Assuming the medical decision as a team may lead to solving the issue of non-adherence (Armstrong, 2014. Whereas the values of the functional parameters of the body represent an objective measurement of treatment efficiency and to some extent of adherence to it, implicitly, assessing the patient’s lifestyle involves understanding his experience, which is governed by subjectivity. This article has the following objectives: (1 to analyze the definitions of adherence to treatment from a biomedical perspective and from the perspective of Chronic Care Model (CCM; (2 to identify the characteristics specific to the roles of acting participants to healthcare and to analyze the modifications of roles by the choice of theoretical model and (3 to identify the determining factors of adherence to treatment.
Fong, Choi-ching; 方賽貞
Objective: Pregnancy has been recognized as a risk factor for severe pandemic influenza illness and this “vulnerable” group is suggested to be heightened alertness to the disease by WHO. This systemic review aims to identify the factors affecting the uptake of influenza vaccination among pregnant women as the immunization uptake among this particular group of population is low or suboptimal worldwide. Methods: Systematic literature reviews were conducted by using MEDLINE and PubMed with th...
Mahmoud Dehghan Nayeri; Ali Faal Ghayoumi; Mohammad Ali Bidari
The present study examines the factors affecting the value relevance of accounting information for investors in the Tehran Stock Exchange over the period of six years. In this study, the effect of four factors; being profitable or loss generating, company size, earnings stability and company growth on the value relevance of accounting information have been studied. For this purpose Ohlson model and the cumulative regression analysis is used in order to examine the hypotheses and as the basis ...
Zhang, Liying; Ellis, Deborah A; Naar-King, Sylvie; Moltz, Kathleen; Carcone, April I; Dekelbab, Bassem
Parental monitoring of adolescent diabetes care is an important predictor of adolescent regimen adherence. To date, no studies have investigated whether socio-demographic factors are associated with low levels of parental monitoring or differences in parental monitoring styles, and their moderating effects in families of adolescents with type 1 diabetes. The purpose of this cross-sectional study was to determine whether youth and family socio-demographic factors moderated the relationship between monitoring and youth regimen adherence (i.e., mean frequency of blood glucose testing [BGT]). Data were collected from 267 adolescents with type 1 diabetes and their parents. Hierarchical multiple regression analyses were employed. Socio-demographic factors accounted for 17.1% of the variance in adherence. After parental monitoring scales were entered, R(2) in all eight equations increased and R(2) change score in six of eight equations were significant. All models were significant after the interaction terms were entered. In the adolescent report models, parent age and family structure were both independently associated with adherence and also moderated the association between adolescent-report parental monitoring and adherence to diabetes care, in particular, adolescent report of parental direct observation/presence during diabetes care. In the parent report models, income was moderated the association between parent-report youth disclosure and adherence. Research should focus on identifying additional modifiable factors that place families at risk for low levels of parental monitoring of diabetes care. Future clinical research is needed to help identify risk factors for low levels of parental monitoring and develop interventions to promote optimal parenting skills that can support youth diabetes care.
Rasinkangas, Pia; Reunanen, Justus; Douillard, François P; Ritari, Jarmo; Uotinen, Virva; Palva, Airi; de Vos, Willem M
Lactobacillus rhamnosus GG is one of the best-characterized lactic acid bacteria and can be considered a probiotic paradigm. Comparative and functional genome analysis showed that L. rhamnosus GG harbors a genomic island including the spaCBA-srtC1 gene cluster, encoding the cell surface-decorating host-interacting pili. Here, induced mutagenesis was used to study pilus biogenesis in L. rhamnosus GG. A combination of two powerful approaches, mutation selection and next-generation sequencing, was applied to L. rhamnosus GG for the selection of pilus-deficient mutants from an enriched population. The isolated mutants were first screened by immuno-dot blot analysis using antiserum against pilin proteins. Relevant mutants were selected, and the lack of pili was confirmed by immunoelectron microscopy. The pilosotype of 10 mutant strains was further characterized by analyzing pilin expression using Western blot, dot blot, and immunofluorescence methods. A mucus binding assay showed that the mutants did not adhere to porcine intestinal mucus. Comparative genome sequence analysis using the Illumina MiSeq platform allowed us to determine the nature of the mutations in the obtained pilus-deficient derivatives. Three major classes of mutants with unique genotypes were observed: class I, with mutations in the srtC1 gene; class II, with a deletion containing the spaCBA-srtC1 gene cluster; and class III, with mutations in the spaA gene. Only a limited number of collateral mutations were observed, and one of the pilus-deficient derivatives with a deficient srtC1 gene contained 24 other mutations. This strain, PB12, can be considered a candidate for human trials addressing the impact of the absence of pili.
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.
Olave P, Guisela; Pérez V, Cristhian; Fasce H, Eduardo; Ortiz M, Liliana; Bastías V, Nancy; Márquez U, Carolina; Parra P, Paula; Ibáñez G, Pilar
Educational environment has an important effect on the quality of learning and student satisfaction in medicine. Most of previous studies have been conducted using questionnaires that assess the phenomenon considering overall dimensions, without paying attention to the specific manifestations of this topic, especially those aspects that are related to the protagonists of the learning process: teachers and students. To describe factors that affect the educational environment in the preclinical Medical formation, according to Medical teachers in Concepción, Chile. Qualitative study, using the Grounded theory method. Semi-structured interviews were performed to 10 medical teachers in Concepcion, Chile. They were selected by theoretical sampling. Data were analyzed using open coding. Four emerging categories about the factors that affect the learning environment were identified: Personal factors of students, academic factors of students, personal factors of teachers and academic factors of teachers. According to interviewed teachers, both personal factors in teachers and students that promote a positive learning environment are related with an attitude oriented towards others and communication skills. Academic factors are related with the responsible exercise of student and teacher roles and with the promotion of participation in the educational process.
Farias, Albert J; Hansen, Ryan N; Zeliadt, Steven B; Ornelas, India J; Li, Christopher I; Thompson, Beti
Adherence to adjuvant endocrine therapy (AET) for estrogen receptor-positive breast cancer remains suboptimal, which suggests that women are not getting the full benefit of the treatment to reduce breast cancer recurrence and mortality. The majority of studies on adherence to AET focus on identifying factors among those women at the highest levels of adherence and provide little insight on factors that influence medication use across the distribution of adherence. To understand how factors influence adherence among women across low and high levels of adherence. A retrospective evaluation was conducted using the Truven Health MarketScan Commercial Claims and Encounters Database from 2007-2011. Privately insured women aged 18-64 years who were recently diagnosed and treated for breast cancer and who initiated AET within 12 months of primary treatment were assessed. Adherence was measured as the proportion of days covered (PDC) over a 12-month period. Simultaneous multivariable quantile regression was used to assess the association between treatment and demographic factors, use of mail order pharmacies, medication switching, and out-of-pocket costs and adherence. The effect of each variable was examined at the 40th, 60th, 80th, and 95th quantiles. Among the 6,863 women in the cohort, mail order pharmacies had the greatest influence on adherence at the 40th quantile, associated with a 29.6% (95% CI = 22.2-37.0) higher PDC compared with retail pharmacies. Out-of-pocket cost for a 30-day supply of AET greater than $20 was associated with an 8.6% (95% CI = 2.8-14.4) lower PDC versus $0-$9.99. The main factors that influenced adherence at the 95th quantile were mail order pharmacies, associated with a 4.4% higher PDC (95% CI = 3.8-5.0) versus retail pharmacies, and switching AET medication 2 or more times, associated with a 5.6% lower PDC versus not switching (95% CI = 2.3-9.0). Factors associated with adherence differed across quantiles. Addressing the use of mail order
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...
John Harold Estrada M
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
Journal Home > Vol 10, No 2 (2011) > ... companies; and determine motivating factors affecting employees' job performance in selected oil ... promotion ( x = 4.86), random sack of workers ( x = 4.40) and absence of staff training ( x = 4.07).
Du, Jianxia; Xu, Jianzhong; Fan, Xitao
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…
Heras, Arantxa; Lasagabaster, David
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…
Akram, Muhammad Javaid; Raza, Syed Ahmad; Khaleeq, Abdur Rehman; Atika, Samrana
This study investigated the perception of principals on how the factors of subject mastery, teaching methodology, personal characteristics, and attitude toward students affect the performance of teachers at higher secondary level in the Punjab. All principals of higher secondary level in the Punjab were part of the population of the study. From…
Kolthof, E.D.; Berg, M.J. van den; Bakker, D.H. de
Background: Like in other countries, Dutch general practitioners (GPs) perceive an increase in workload. Too much work pressure will affect the quality of care and threats the accessibility of health care provided by GPs. Factors on organisational-level, patient-level as well as on GP-level may
Al Ghazali, Fawzi
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…
Kara, Orhan; Bagheri, Fathollah; Tolin, Thomas
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…
This paper describes two studies into teacher workplace learning. The first study aimed at developing a definition of teacher learning at the workplace and at exploring factors that may affect teacher learning at the workplace. Based on a conceptualization of teacher workplace learning as
Brockner, Joel; And Others
Conducted two studies to test the notion that various factors, i.e., situation-personal, may differentially affect degrees of entrapment (amount invested) depending upon the point in time at which they are introduced. The results of both studies suggest amount invested depends upon timing in the entrapment process. (RC)
Perceptions and factors affecting utilization of health services in a rural ... to gender (p=0.889, OR=1.04; 0.55-2.00), educational level (p=0.707, OR=1.16; 0.50-2.79) and ... Identified barriers to access and effective use of qualitative health care ...
Shaw, Jon A.; Lewis, John E.; Katyal, Shalini
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…
PROMOTING ACCESS TO AFRICAN RESEARCH ... The study investigated the factors affecting academic achievement ... The study established the following: Students who have positive attitude, interest and ... OTHER RESOURCES. ... Browse By Country · List All Titles · Open Access Titles This Journal is Open Access.
The social distance is the main social factor that influences language use.This paper explores how the social distance affects language use in different ways based on solidarity,status and formality,in order to achieve a better understanding of language use.
Gill, Bart E.; Ewing, John C.; Bruce, Jacklyn A.
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…
Nguyen, Hong Thi; Warren, Wendy; Fehring, Heather
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…
Karsli, Fethiye; Sahin, Cigdem
The purpose of this study is to develop a worksheet about the factors affecting solubility, which could be useful for the prospective science teachers (PST) to remind and regain their science process skills (SPS). The pilot study of the WS was carried out with 32 first grade PST during the 2007-2008 academic year in the education department at…
As far as academic reading comprehension is concerned, a network of linguistic skills and strategies operate in a complex and integrated matter. Since it is impossible to examine all the factors affecting reading comprehension all at once, it is more reasonable to compare and contrast the predictive effects of specific variables against each other…
Willingham, Wendy Elizabeth
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…
Current research shows that stress levels among the teaching personnel has ... to determine: (1) factors that affect stress levels of teachers in primary school as a ... and gender of teachers; (2) coping strategies that are used by these teachers ...
Heras, Arantxa; Lasagabaster, David
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…
Kwan, Eugene E.
A simple framework for evaluating experimental kinetic data to provide support for Specific Acid Catalysis (SAC) and General Acid Catalysis (GAC) is described based on the factors affecting their relative efficiency. Observations reveal that increasing the SAC-to-GAC rate constant ratio reduces the effective pH range for GAC.
Spencer, Herbert; Reynolds, Linda
Based on visits to representative microform users and an extensive survey of relevant literature, a study was undertaken to assess the relative importance of factors affecting the acceptability of microforms as reading mediums. The following variables were considered: (1) microform characteristics; (2) equipment design; (3) work station design;…
This study examines factors affecting students' performances in an Introductory Sociology course over five semesters. Employing simple and ordered logit regression models, the author explains final grades by focusing on individual demographic and educational characteristics that students bring into the classroom. The results show that a student's…
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.
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)
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)
Knox, Matthew C; Edye, Michael
Surgical antibiotic prophylaxis is frequently reported in the literature to be suboptimal, a finding having both clinical and public health implications. This study aimed to calculate rates and patterns of adherence to guidelines at two sites and identify extrinsic contributing factors. A retrospective analysis was conducted over two 12-mo periods during 2013-2014 at the metropolitan Blacktown Hospital and regional Lismore Base Hospital, New South Wales, Australia. A group of 400 patients undergoing abdominal general surgery was selected via simple random sampling (n = 200 per site). Medical records were reviewed, and prophylactic antibiotic regimens were compared with the Australian guideline, Therapeutic Guidelines: Antibiotic (v. 14) with respect to drug choice, dosage, timing of administration, and duration of administration. The overall rate of adherence to the guidelines was 16.5% at Blacktown Hospital and 19.5% at Lismore Base Hospital. At each site, prophylaxis was administered to more than 95% of patients and was inappropriately withheld in 4%. Drug choice was the most frequent error type, specifically involving inappropriate omission of metronidazole and use of newer-generation cephalosporins. Errors in the timing of administration also were frequent, with prophylaxis typically occurring excessively early. Logistic regression identified emergency surgery as independently associated with prophylactic errors in both the Blacktown Hospital (p antibiotic prophylactic guidelines was poor at both the metropolitan and regional sites. Choice of antibiotic and timing of administration were identified as major error types. Consideration should be given to multidisciplinary involvement of anesthetists, implementation of focused interventions with an emphasis on emergency settings, and further research correlating antibiotic use with clinical significance.
Magdalene H. Awases
Full Text Available Background: Professional nurses play a vital role in the provision of health care globally. The performance of health care workers, including professional nurses, link closely to the productivity and quality of care provision within health care organisations. It was important to identify factors influencing the performance of professional nurses if the quality of health care delivery was to improved.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.
Suhr, Karin Isabel; Haasum, I.; Steenstrup, L.D.;
Color formation, metabolite production and growth of Penicillium caseifulvum were studied in order to elucidate factors contributing to. yellow discoloration of Blue Cheese caused by the mold. A screening experiment was set up to study the effect of pH, concentration of salt (NaCl), P, K, N, S, Mg...... and the trace metals Fe, Cu, Zn, Mn on yellow color formation, metabolite production and mold growth. Multivariate statistical analysis showed that the most important factor affecting yellow color formation was pH. The most pronounced formation of yellow color, supported by highest amount of colored metabolites......, appeared at low pH (pH 4). Mold growth was not correlated to the yellow color formation. Salt concentration was the most important factor affecting mold growth and length of lag phase. Production of secondary metabolites was strongly influenced by both pH and salt concentration. The screening results were...
Álvarez Álvarez, Ismael; Aguinaga Ontoso, Inés; Marín Fernández, Blanca; Guillén Grima, Francisco; Niu, Hao
Introducción: La dieta mediterránea es un estilo de vida con efectos beneficiosos contrastados en el embarazo, tanto para la madre como para su descendencia. Sin embargo, se desconocen los factores que influyen en la adhesión a esta dieta. Objetivo: Investigar los factores (nivel educativo, ocupación, lugar de nacimiento, número de hijos previo y edad) que influyen en la adhesión a la dieta mediterránea en mujeres embarazadas de la comarca de Pamplona. Material y métodos: Utilizando los datos del Estudio Internacional de Sibilancias en Lactantes (EISL) en la comarca de Pamplona, se analizaron las asociaciones entre los alimentos y los factores. Se estableció una puntuación de dieta mediterránea y se estudiaron las puntuaciones de acuerdo a los factores. Resultados: Se encontraron diferencias significativas en la puntuación de dieta mediterránea según el nivel de estudios (p=embarazo.
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
Pankaj Raj Dhital
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.
Shahhosseini, Zohreh; Gardeshi, Zeinab Hamzeh; Pourasghar, Mehdi; Salehi, Fariba
Background: 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. Aim: The aim of this study was to explore affecting factors on sexual satisfaction in women based on an overview in scientific database. Methods: 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. Results: The findings were divided in to four categories including: Demographic factors, Pathophysiological factors, Psychological factors and Sociocultural factors. Conclusions: 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. PMID:25685081
Ozel, Murat; Caglak, Serdar; Erdogan, Mehmet
This study investigated how affective factors like attitude and motivation contribute to science achievement in PISA 2006 using linear structural modeling. The data set of PISA 2006 collected from 4942 fifteen-year-old Turkish students (2290 females, 2652 males) was used for the statistical analyses. A total of 42 selected items on a four point…
Meredith N Zozus
Full Text Available Medical record abstraction (MRA is often cited as a significant source of error in research data, yet MRA methodology has rarely been the subject of investigation. Lack of a common framework has hindered application of the extant literature in practice, and, until now, there were no evidence-based guidelines for ensuring data quality in MRA. We aimed to identify the factors affecting the accuracy of data abstracted from medical records and to generate a framework for data quality assurance and control in MRA.Candidate factors were identified from published reports of MRA. Content validity of the top candidate factors was assessed via a four-round two-group Delphi process with expert abstractors with experience in clinical research, registries, and quality improvement. The resulting coded factors were categorized into a control theory-based framework of MRA. Coverage of the framework was evaluated using the recent published literature.Analysis of the identified articles yielded 292 unique factors that affect the accuracy of abstracted data. Delphi processes overall refuted three of the top factors identified from the literature based on importance and five based on reliability (six total factors refuted. Four new factors were identified by the Delphi. The generated framework demonstrated comprehensive coverage. Significant underreporting of MRA methodology in recent studies was discovered.The framework generated from this research provides a guide for planning data quality assurance and control for studies using MRA. The large number and variability of factors indicate that while prospective quality assurance likely increases the accuracy of abstracted data, monitoring the accuracy during the abstraction process is also required. Recent studies reporting research results based on MRA rarely reported data quality assurance or control measures, and even less frequently reported data quality metrics with research results. Given the demonstrated
Full Text Available Background: Despite the positive impact of cardiac rehabilitation (CR on quality of life and mortality, the majority of people who could benefit from this program fail to participate in it. The lack of referral from the physician is a common reason that patients give for not seeking CR. The objective of this study was to compare factors affecting CR referral by cardiologists. Methods: A cross-sectional survey of 122 cardiologists, including 89 general cardiac specialists and 33 fellows in cardiology from 11 major cardiology training centers in Iran, was done in 2010. They responded to the 14- item investigator-generated survey, examining the physician’s attitudinal and knowledge factors affecting CR referral. Results: 47.9% of the subjects reported having available CR centers but only 6.6% reported continuous medical education on the topic. 90.7% of the physicians reported that less than 15% of patients are referred to CR centers. The main factor affecting the low referral rate was limited general knowledge about CR programs (79.5% such as program attributes and benefits, methods of reimbursement. Lack of insurance coverage, unavailability of CR centers in the community and low physicians’ fee were other factors reported by the physicians. Conclusion: Cardiologists’ inadequate general knowledge of and attitude toward CR programs seem to be a potential threat for cardiac prevention and rehabilitation in some societies.
胡慧娟; 张剑利; 陈旭霞
The purpose of this study is to analyze fitness center members adhere to physical activity,and to reduce the commercial fitness club membership loss,thus to promote the healthy development of commercial fitness center.On the basis of the sport commitment model proposed by Scanlan,summarizes the influence of the commercial fitness center members exercise adherence factors.The result shows that the fitness class service, fitness coach service,fitness center staff satisfaction,fitness effect,fitness project,fitness membership fee and other factors affect members’exercise adherence.%研究目的是通过分析会员的运动坚持，以减少商业性健身俱乐部会员流失，促进商业性健身俱乐部的良性发展。依据Scanlan提出的运动承诺模型，综述了影响商业性健身俱乐部会员锻炼坚持性的因素。分析认为健身课程服务、健身教练服务、健身俱乐部员工满足感、健身效果、健身项目、健身会费等因素影响会员运动坚持。
Daniel P. Molloy
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.
Al-Quran Firas A
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.
Ruiter Petrov, Megan E; Lichstein, Kenneth L; Huisingh, Carrie E; Bradley, Laurence A
Behavioral interventions for insomnia are effective in improving sleep, yet adherence is variable, and predictors of adherence have not been consistently replicated. The relationships between daily variations in state factors at the initiation of treatment and adherence have not been investigated. Using 2-week, self-report online logs, this study determined, among 53 college students with probable insomnia, the associations of pretreatment factors and daily factors during treatment on daily variations in adherence to one session of behavioral treatments for insomnia. These treatments included stimulus control therapy (SCT), sleep restriction therapy (SRT), and sleep hygiene (SH). Low self-efficacy was associated with poorer SCT and SH adherence. Participants with a "bed partner or pet" at least some of the time had better SCT adherence. Greater total sleep time and poorer sleep quality were associated with poor SCT and SRT adherence the following night. Greater sleep efficiency was related to greater next night SCT and SRT adherence. Alcohol consumption was related to poorer SRT and SH adherence the following night. Future studies should test the replicability of these findings. Adherence trials may want to test whether discouraging alcohol intake, enhancing treatment-related self-efficacy, and monitoring and providing feedback on sleep, early in treatment, affects adherence.
Full Text Available This study explores factors associated with virological detectability, and viral re-suppression after enhanced adherence counselling, in adults and children on antiretroviral therapy (ART in Swaziland.This descriptive study used laboratory data from 7/5/2012 to 30/9/2013, which were linked with the national ART database to provide information on time on ART and CD4 count; information on enhanced adherence counselling was obtained from file review in health facilities. Multivariable logistic regression was used to explore the relationship between viral load, gender, age, time on ART, CD4 count and receiving (or not receiving enhanced adherence counselling.From 12,063 patients undergoing routine viral load monitoring, 1941 (16% had detectable viral loads. Children were more likely to have detectable viral loads (AOR 2.6, 95%CI 1.5-4.5, as were adolescents (AOR 3.2, 95%CI 2.2-4.8, patients with last CD4 1000 copies/ml (AOR 0.3, 95%CI 0.1-0.7, and those with last CD4<350 cells/µl (AOR 0.4, 95%CI 0.2-0.7. Receiving (or not receiving enhanced adherence counselling was not associated with likelihood of re-suppression.Children, adolescents and those with advanced disease were most likely to have high viral loads and least likely to achieve viral suppression at retesting; receiving adherence counselling was not associated with higher likelihood of viral suppression. Although the level of viral resistance was not quantified, this study suggests the need for ART treatment support that addresses the adherence problems of younger people; and to define the elements of optimal enhanced adherence support for patients of all ages with detectable viral loads.
Della Camera, Pier A; Morselli, Simone; Cito, Gianmartin; Tasso, Giovanni; Cocci, Andrea; Laruccia, Nicola; Travaglini, Fabrizio; Del Fabbro, Dario; Mottola, Antonio R; Gacci, Mauro; Serni, Sergio; Carini, Marco; Natali, Alessandro
Mediterranean diet has shown a protective role against cardiovascular disease, diabetes, cancer onset, microvascular damage and dementia in many trials. Our purpose is the assessment of a correlation between physical activity, Mediterranean diet, body mass index (BMI), depression and erection disorder (ED). After having signed disclaimer to the study participation, we administered the IIEF 15 questionnaire (International Index of Erectil Function), the Hamilton questionnaire for major depression, the Med-Diet Questionnaire, the Ipaq Questionnaire (International Index of Physical Activity) to 245 patients and calculated the BMI. Only 141 were eligible. We excluded patients with a history of smoking, with obesity from the second grade to rise, anorexia, hyperlipidemia, Induratio Penis Plastica, diabetes, cardiovascular and neurological disease, hypogonadism, prostatitis, diabetes, hypertension, psychiatric diseases and the history of radical prostatectomy and finally age >72 and <50 years or who were taking cholesterol-lowering medication. Patients were divided into two groups: 65 patients without ED and 76 patients with ED. We found a statistically difference in BMI between the groups. Adherence to Med-Diet showed a significant difference between the two groups at Student t-test and the Chi-square test. The Ipaq test and Hamilton test did not show statistical differences between the two groups neither for Student t-test nor for Chi-square test, but high levels seem to be protective factors. Body weight and a healthy diet are protective factors against the ED, more than a sufficient physical activity. Depression has shown only a worsening tendency of the erection.
Kristensen, M T
. 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......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...... 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...
Grandy, Susan; Fox, Kathleen M; Hardy, Elise
Adherence to prescribed diabetes medications is suboptimal, which can lead to poor glycemic control and diabetic complications. Treatment-related weight gain is a side effect of some oral antidiabetic agents and insulin, which may negatively affect adherence to therapy. This study investigated whether adults with type 2 diabetes mellitus (T2DM) who lost weight had better medication adherence than those who gained weight. Weight change over 1 year (2007 to 2008) was assessed among respondents in the US Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD). Weight loss of >1.0%, ≥3%, and ≥5% of weight was compared with weight gain of ≥1.0%. Medication adherence was assessed using the Morisky 4-item questionnaire for medication-taking behavior, with lower scores representing better adherence. There were 746 T2DM respondents who lost >1.0%, 483 who lost ≥3%, 310 who lost ≥5%, and 670 who gained ≥1.0% of weight. Each weight-loss group had significantly lower Morisky scores than the weight-gain group; mean scores of 0.389 versus 0.473 (P = 0.050) for the >1.0% weight-loss group, 0.365 versus 0.473 (P = 0.026) for the ≥3% weight-loss group, and 0.334 versus 0.473 (P = 0.014) for the ≥5% weight-loss group. Significantly fewer respondents who lost weight had received insulin, sulfonylurea, or thiazolidinedione therapy (57%) compared with respondents who gained weight (64%) (P = 0.002). Demographics, exercise habits, and dieting were similar between weight-loss and weight-gain groups. T2DM respondents with weight loss had significantly better medication adherence and were less likely to be on treatment regimens that increase weight than T2DM respondents with weight gain. These findings suggest that strategies that lead to weight loss, including use of diabetes medications associated with weight loss, may improve medication adherence.
Juanes Ruiz, María
RESUMEN: El nivel de adherencia a la rehabilitación tras una lesión deportiva es considerado una de las variables más importantes para conseguir una buena recuperación, y está influenciado por múltiples factores, tanto cognitivos, como emocionales. Los objetivos del presente trabajo son comprobar la relación entre las características de los deportistas que tienen una mejor adherencia a la rehabilitación y sus percepciones, junto a la de los fisioterapeutas. Por otro lado, deter...
Fernández-Arias, Isabel; Kim, Hae Kyung
Introducción y objetivo: Recabar la experiencia de pacientes con hemofilia A con sus dispositivos de reconstitucion de factor de coagulacion, barreras para la adherencia y determinar sus preferencias, presentando una nueva jeringa de doble camara (JDC). Método: Investigacion transversal mediante encuesta dirigida y sesion de prueba de la JDC. Resultados: Participaron 74 pacientes, el 50% en tratamiento con profilaxis, y 7 anos (mediana) con su tratamiento habitual (RIC 17,25). En la encuesta, la JDC recibio la mayor puntuacion (75/100, p probabilidad de uso en profilaxis (p probabilidad de favorecer la profilaxis.
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.
Full Text Available Knowledge management is extensively used in large, medium and small firms. However, the larger the scale, the more knowledge management practices might be used in organizations. Unfortunately, application of knowledge management in new ventures is not sufficiently discussed in the extant literature. Thus this paper attempts to concentrate on this issue. Therefore, environmental, organizational and individual factors are enumerated and their effect on application of knowledge management in new ventures is examined. Findings revealed that all these factors significantly affect knowledge management application is new ventures.
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
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
Full Text Available Jie Peng, Junhua Yin, Shaohang Cai, Tao Yu, Chunxiu Zhong Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China Abstract: Little is known about the factors associated with patient compliance with nucleos(tide analog (NUC treatment for chronic hepatitis B (CHB. The purpose of this study was to examine the association between sociodemographic and clinical characteristics and adherence to NUCs among patients with CHB. A total of 211 CHB patients receiving NUC monotherapy were asked to report the number of prescribed doses of medication they had taken during the last 90 days. A total of four 3-month adherence scores were averaged to obtain a combined rate of NUC adherence during a 1-year follow up period. The mean age of the patients was 29.6 years, 79% were men, and 68% had no prior NUC treatment for CHB. Females, patients without a previous NUC treatment, and those who had NUC drug resistance showed better adherence to NUC treatment, and compliance was better with telbivudine than with lamivudine and entecavir. Keywords: chronic hepatitis B, nucleos(tide analogues, adherence, follow-up, resistance
Verbrugghe, M; Verhaeghe, S; Decoene, E; De Baere, S; Vandendorpe, B; Van Hecke, A
Non-adherence and non-persistence in breast cancer patients taking antihormonal therapy (AHT) is common. However, the complex patterns and dynamics of adherence and persistence are still not fully understood. This study aims to give insight into the process of (non-)adherence and (non-)persistence by researching influencing factors and their interrelatedness in breast cancer patients taking AHT by means of a qualitative study with semi-structured interviews. The sample consisted of 31 breast cancer patients treated with AHT. Purposive and theoretical sampling and the constant comparison method based on a grounded theory approach were used. Expectations regarding the impact of AHT, social support from family and friends, and recognition from healthcare professionals were found to influence the process of non-adherence and non-persistence. The results of this study can help healthcare professionals understand why breast cancer patients taking AHT do not always adhere to or persist in taking the therapy and may facilitate patient-tailored interventions. © 2015 John Wiley & Sons Ltd.
Full Text Available In order to combat adverse effects of farmland degradation it is necessary for farmers to adopt sustainable land management and conservation strategies like intercropping and conservation tillage. However, efforts to adopt these strategies are very minimal in Ethiopia. In an attempt to address the objectives of examining factors affecting use of intercropping and conservation tillage practices, this study utilized plot- and household-level data collected from 211 farm households and employed a bivariate probit model for its analysis. The study revealed that intercropping and conservation tillage decisions are interdependent, and that they are also significantly affected by various factors. In addition, conservation tillage and intercropping practices as short- term interventions are found to augment the long-term interventions like terraces, diversion ditches, and tree plantations. The paper highlights important policy implications that are required to encourage intercropping and conservation tillage measures.
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.
Ringbæk, Thomas Jørgen; Lange, Peter; Viskum, K
: Denmark. PATIENTS: In November 1994, 1,354 COPD patients were receiving LTOT in Denmark. MEASUREMENTS AND RESULTS: Among 16 counties, the prevalence of LTOT for COPD varied from 14 to 53 per 100,000. The prevalence was highest in counties where general practitioners (GPs) were prescribing LTOT. Adherence......: Marked geographic variations in compliance with LTOT guidelines are present even in a small country as Denmark. In general, the adherence to the guidelines is poor, especially when non-chest physicians prescribe LTOT. We therefore recommend that local and national thoracic societies together with health......STUDY OBJECTIVES: To evaluate regional differences in adherence to guidelines for long-term oxygen therapy (LTOT) in Denmark and to determine factors related to compliance with these guidelines. DESIGN: Cross-sectional study and analysis of a nationwide database (Danish Oxygen Register). SETTING...
Full Text Available The objective of this research was to study the operating factors of Thai threshers affecting corn shelling losses,which comprised rotor speed (RS, louver inclination (LI, grain moisture content (MC, feed rate (FR, and grain to materialother than grain ratio (GM. Seventeen Thai corn-shelling threshers were random-sampled during the late rainy season cropof 2008 and ten threshers were sampled in the early rainy season crop of 2009 in Loei province, Northeast of Thailand.The results of this study indicated that LI and MC affected shelling losses whereas RS, FR and GM did not affect losses.Increased LI or decreased MC tended to reduce shelling losses. In operating the Thai threshers for corn shelling, if shellinglosses have to be kept lower that 0.5%, the moisture content should not exceed 20%wb and the louver inclination should notbe less than 85 degrees.
E-business has aroused great concern and become a hot topic in both information technology and business field. With many companies’ success in doing e-business, there are also abundant of failure cases. Therefore, the purpose of this study was to investigate the success factors that can affect e-business so as to provide beneficial guidance to companies. Virtually, many researchers have also studied e-business relating to its success from different perspectives and in various areas. However, ...
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.
Nianfu Song; Francisco X. Aguilar; Stephen R. Shifley; Michael E. Goerndt
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...
Shaaban, K.; Pande, A
Qatar has experienced a significant population growth in the past decade. The growth has been accompanied by an increase in automobile ownership rates leading to parking problems especially in the capital city of Doha. The objective of this study was to find the factors affecting people's choice of parking in this rich developing country when different parking options are available. Two commercial centers located in the city of Doha, Qatar were selected for this study; the City Center mall an...
Martínez-de la Puente, J; Merino, S; Tomás, G; Moreno, J; Morales, J; Lobato, E; Talavera, S; Sarto I Monteys, V
Mechanisms affecting patterns of vector distribution among host individuals may influence the population and evolutionary dynamics of vectors, hosts and the parasites transmitted. We studied the role of different factors affecting the species composition and abundance of Culicoides found in nests of the blue tit (Cyanistes caeruleus). We identified 1531 females and 2 males of 7 different Culicoides species in nests, with C. simulator being the most abundant species, followed by C. kibunensis, C. festivipennis, C. segnis, C. truncorum, C. pictipennis and C. circumscriptus. We conducted a medicationxfumigation experiment randomly assigning bird's nests to different treatments, thereby generating groups of medicated and control pairs breeding in fumigated and control nests. Medicated pairs were injected with the anti-malarial drug Primaquine diluted in saline solution while control pairs were injected with saline solution. The fumigation treatment was carried out using insecticide solution or water for fumigated and control nests respectively. Brood size was the main factor associated with the abundance of biting midges probably because more nestlings may produce higher quantities of vector attractants. In addition, birds medicated against haemoparasites breeding in non-fumigated nests supported a higher abundance of C. festivipennis than the rest of the groups. Also, we found that the fumigation treatment reduced the abundance of engorged Culicoides in both medicated and control nests, thus indicating a reduction of feeding success produced by the insecticide. These results represent the first evidence for the role of different factors in affecting the Culicoides infracommunity in wild avian nests.
Sandoval, Daniela; Chacón, Javier; Muñoz, Reinaldo; Henríquez, Óscar; Koch, Elard; Romero, Tomás
Inadequate blood pressure control in hypertensive patients remains a persistent health problem in Chile and worldwide. Poor adherence to antihypertensive drug therapy is one of the frequently cited factors. To determine the influence of psychosocial factors in the adherence to drug therapy in hypertensive patients followed through a Cardiovascular Health Program (CHP) that provides free access to primary care centers located in the Metropolitan Region of Santiago, Chile. Cross sectional study. A randomized sample of 513 hypertensive patients (30 to 68 years) was obtained from a universe of 1.484 patients. Adherence to treatment was determined by the Morisky-Green-Levine test. Demographic, socioeconomic and average values of blood pressure were recorded. Validated questionnaires were utilized to assess the patient-physician relationship, awareness of being hypertensive, patient perception of social support, family cohesion, patient self-health assessment and symptoms of emotional stress and depression. The drug therapy adherence was 36.6%, higher in women (38.4% vs 28.9%; p < 0.001). After multivariate analysis, absence of adherence was associated with male gender (OR: 1.76 [95% CI 1.21-2.56]), low education (OR: 1.72 [95% CI 1.18 to 2.53]), inadequate patient-physician relationship (OR: 1.56 [95% CI 1.13 to 2.27]), and high level of emotional stress and depression (OR: 1.93 [95% CI 1.27 to 2.94]). Our study highlights the influence of inadequate patient-physician relation, high level of emotional stress and depression, low education level and income and male gender in the lack of adherence to antihypertensive drug therapy in hypertensive patients followed throughout the CHP.
Seneviratne, Sanjeewa; Campbell, Ian; Scott, Nina; Kuper-Hommel, Marion; Kim, Boa; Pillai, Avinesh; Lawrenson, Ross
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 (adherence was associated with a significantly higher risk of 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.
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
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.
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.
Tantranont, Kunlayanee; Srisuphan, Wichit; Kaewthummanukul, Thanee; Suthakorn, Weeraporn; Jormsri, Pantip; Salazar, Mary K
This study used an ecological model to examine Thai workers' beliefs and attitudes toward using occupational hearing protection. Data collection involved focus group sessions with 28 noise-exposed workers at four factories in Chiang Mai Province and an interview with a safety officer at each organization. Detailed content analysis resulted in the identification of three types of factors influencing the use of hearing protection: intrapersonal, including preventing impaired hearing, noise annoyance, personal discomfort, and interference with communication; interpersonal, including coworker modeling, supervisor support, and supervisor modeling; and organizational, including organizational rules and regulations, provision of hearing protection devices, dissemination of knowledge and information, noise monitoring, and hearing testing. Effective hearing protection programs depend on knowledge of all of these factors. Strategies to promote workers' use of hearing protection should include the complete range of factors having the potential to affect workers' hearing.
Oh, Won-Suck; Delong, Ralph; Anusavice, Kenneth J
Enamel wear by ceramics may adversely affect maintenance of the vertical dimension of occlusion and can increase the potential for thermal sensitivity. In this article, factors related to the abrasion of enamel by dental ceramics are critically reviewed. Concepts of physical, microstructural, chemical, and surface characteristics of dental ceramics on wear are presented based on research published since 1950. A PubMed search for key words (wear of enamel and ceramic) was supplemented with a hand search to identify relevant peer-reviewed articles published in English. Based on the literature, it can be concluded that material factors, their proper handling, and control of the patient's intrinsic risk factors related to wear are critically important to the reduction of enamel wear by dental ceramics.
Barfoed, Benedicte L; Paulsen, Maja S; Christensen, Palle M; Halvorsen, Peder A; Jarbøl, Dorte E; Larsen, Mogens L; Munch, Maria R; Søndergaard, Jens; Nielsen, Jesper B
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. To estimate associations between GPs' attitudes towards risk, statin therapy and management of non-adherence and their patients' adherence, and to identify subgroups of GPs with poor patient adherence. All Danish GPs were invited to participate in an online survey. We asked whether they regarded 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 regression was used to estimate associations between patient adherence and GPs' attitudes. Adherence was estimated by the proportion of days covered in a 1-year period using an 80% cut-off. We received responses from 1398 GPs (42.2%) who initiated statin therapy in 12 192 patients during the study period. In total 6590 (54.1%) of these patients were adherent. Patients who had GPs rarely assessing their treatment adherence were less likely to be adherent than those who had GPs assessing their patients' treatment adherence now and then, odds ratio (OR) 0.86 [confidence interval (CI) 0.77-0.96]. No other associations were found between patients' adherence and GPs' attitudes. Our findings suggest that GPs' attitudes to risk, statin therapy or management of non-adherence are not significantly associated with their patients' adherence. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: email@example.com.
WANG Wei; LI Xiao-bei; YIN Hang; YANG Xiao-yong; LIU Hang; REN Liang; HU Xiao-peng; WANG Yong; ZHANG Xiao-dong
Background In the past decades, the one-year graft survival of cadaveric renal allografts has been markedly improved,but their long-term survival has not kept pace. The attrition rate of renal allografts surviving after one year remains almost unchanged. The causes for late graft loss are multiple. The aim of this study was to analyze the predictive factors that impact long-term survival of grafts after kidney transplantation.Methods We retrospectively analyzed 524 kidney transplantation patients who were treated in our hospital between January 1991 and January 2000, including 254 patients who had lived more than 10 years with normal graft function (long survival group), and 270 cases whose renal graft had survived less than 10 years (control group). Specifically, we analyzed 10 factors that may potentially affect graft survival by both univariate and Logistic model multivariate analyses to pinpoint the independent risk factors.Results Univariate analyses showed that no significant differences existed in the age or gender of recipients, dialysis time, lymphotoxin levels, or cold ischemia time between the two groups. However, the ratio of delayed graft function and acute rejection, and the uric acid levels of patients in the long survival group were significantly lower than those in the control group (P ＜0.01). Furthermore, we found that the concentration of cyclosporin A at one year after transplantation and the histocompatibility antigen match of donor-recipients for patients within the long survival group were significantly higher than those in the control group (P ＜0.01 ). Furthermore, multivariate analyses showed that these four factors were independent risk factors that impact patient survival.Conclusions The ratios of delayed graft function and acute rejection, the concentration of cyclosporin A at one year after transplantation, and serum uric acid levels are very important factors that affect the long-term survival of renal grafts.
Full Text Available Background and Objective: Multiple sclerosis (MS is a chronic and progressive disease of the central nervous system. The identification of effective factors and patient education on the prevention of exposure to these factors can be effective in reducing relapses. Therefore, the present study aimed to investigate the factors that affect recurrence in patients with multiple sclerosis. Materials and Method: This cross-sectional study was conducted on 402 MS patients referred to the MS Association of Mashhad, Iran, in 2013. The study participants were selected using purposive sampling method. Data collection tools included a demographic questionnaire and a 40-item researcher-made questionnaire concerning factors affecting the recurrence of MS. The 40-item questionnaire consisted of 4 domains personal factors, medical condition, pharmaceutical conditions, and environmental factors. Data analysis was performed using SPSS software version 21 and Mann Whitney, Pearson correlation, Kruskal Wallis, and chi-square statistical tests. Results: Among the patients, 21/4% were male and 78/6% female. Most patients were 20-29 years old. The highest prevalence of recurrence of MS was observed in the summer (70.8% and in August (50.3%. There was no significant relationship between patient’s gender and their views about the relationship between infections, fatigue, and heat and recurrence of MS. However, a higher rate of women believed stress (P < 0.029 and sexual development (P < 0.001 to be effective on the incidence of MS recurrence, in comparison to men. Conclusion: Most patients with MS are women, and they believe stress to be more effective on the incidence of MS attack recurrence. Therefore, nurses, as the primary care educators, can improve the patients’ capability, disease management, and quality of life through training of stress management techniques.
Gunnarsdottir, Gudrun Mist; Palsson, Sigurdur Pall; Thorsteinsdottir, Gudlaug
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.
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.
Spong, Göran F; Hodge, Sarah J; Young, Andrew J; Clutton-Brock, Tim H
Identifying traits that affect the reproductive success of individuals is fundamental for our understanding of evolutionary processes. In cooperative breeders, a dominant male typically restricts mating access to the dominant female for extended periods, resulting in pronounced variation in reproductive success among males. This may result in strong selection for traits that increase the likelihood of dominance acquisition, dominance retention and reproductive rates while dominant. However, despite considerable research on reproductive skew, few studies have explored the factors that influence these three processes among males in cooperative species. Here we use genetic, behavioural and demographic data to investigate the factors affecting reproductive success in dominant male meerkats (Suricata suricatta). Our data show that dominant males sire the majority of all offspring surviving to 1 year. A male's likelihood of becoming dominant is strongly influenced by age, but not by weight. Tenure length and reproductive rate, both important components of dominant male reproductive success, are largely affected by group size and composition, rather than individual traits. Dominant males in large groups have longer tenures, but after this effect is controlled, male tenure length also correlates negatively to the number of adult females in the group. Male reproductive rate also declines as the number of intra- and extra-group competitors increases. As the time spent in the dominant position and reproductive rate while dominant explain > 80% of the total variance in reproductive success, group composition thus has major implications for male reproductive success.
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.
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.
LIN Jun; ZHENG Xin; XIE Ze-lin; SUN Wen; ZHANG Lei; TIAN Ye; GUO Yu-wen
Background Donor and recipient risk factors on graft function have been well characterized.The contribution of demographic factors,such as age,gender,and other potential factors of donor and recipient at the time of transplantation on the function of a graft is much less well understood.In this study,we analyzed the effects of factors such as age,gender,etc.,on the short-term and long-term graft function in kidney transplant recipients from living donor.Methods A total of 335 living donors and their recipients,who had kidney transplantation in our center from May 2004 to December 2009,were included.Serum creatinine level was used as the assessment criterion (serum creatinine level lower than 115 mmol/L is normal).Factors related to graft function such as age,gender,blood relation by consanguinity,human leukocyte antigen (HLA) mismatch,ABO type,etc.,were analyzed separately.Results Donor age is the key factor affecting both the short-term and long-term function of a grafted kidney from a living donor.The group with donors younger than 48 years showed the best kidney function post transplantation.Match of gender and age is another important factor that influences the function of grafted kidney from a living donor.The older donor to younger recipient group had the worst outcome after kidney transplantation.After 36 months post transplantation,female donor to male recipient group had worse kidney function compared to other groups.We also found that calcinerin inhibitor used in the maintenance period may influence the function of a grafted kidney.No significant statistical differences were found in consanguinity,blood type,and mismatch of HLA.Conclusions Donor age is an important factor affecting the function of a grafted kidney from a living donor.We also recommend taking nephron,immunology factor,infection,and demographic information all into consideration when assessing the outcome of kidney transplantation.
Vázquez-Jiménez, Flor Elizabeth; Torres, Javier; Flores-Luna, Lourdes; Cerezo, Silvia Giono; Camorlinga-Ponce, Margarita
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.
Williamson Avis J
Full Text Available Abstract Background Exhaled nitric oxide (FENO measurements are used as a surrogate marker for eosinophilic airway inflammation. However, many constitutional and environmental factors affect FENO, making it difficult to devise reference values. Our aim was to evaluate the relative importance of factors affecting FENO in a well characterised adult population. Methods Data were obtained from 895 members of the Dunedin Multidisciplinary Health and Development Study at age 32. The effects of sex, height, weight, lung function indices, smoking, atopy, asthma and rhinitis on FENO were explored by unadjusted and adjusted linear regression analyses. Results The effect of sex on FENO was both statistically and clinically significant, with FENO levels approximately 25% less in females. Overall, current smoking reduced FENO up to 50%, but this effect occurred predominantly in those who smoked on the day of the FENO measurement. Atopy increased FENO by 60%. The sex-related differences in FENO remained significant (p ENO. Conclusion Even after adjustment, FENO values are significantly different in males and females. The derivation of reference values and the interpretation of FENO in the clinical setting should be stratified by sex. Other common factors such as current smoking and atopy also require to be taken into account.
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.
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.
LI Xia; XUE Wei; JIANG Yu-rong; YU Zhi-nong; WANG Hua-qing
The factors affecting one dimensional (1D) and two dimensional (2D) photonic crystals (PhCs) are systemically analyzed in this paper by numerical simulation.Transfer matrix method (TMM) is employed for 1D PCs, both finite difference time domain method (FDTD) and plane wave expansion method (PWE) are employed for 2D PCs.The result shows that the photonic bandgaps (PBG) are directly affected by crystal type, crystal lattice constant, modulation of refractive index and periodicity, and it is should be useful for design of different type photonic crystals with the required PBG and functional devices.Finally, as an example, a near-IR 1D PCs narrow filter was designed.
Camila Iasmim de Andrade Souza
Full Text Available Summary Objective: To assess the prevalence of mammography use and factors related to non-adherence in Boa Vista, capital of Roraima, Brazil. Method: A cross sectional study, quantitative analysis, based on household survey was performed between June and August 2013, using a face-to-face interview with a pre-tested form. Target population was women between 40 and 69 years. The sample size target was 240 participants, and the sampling method was random cluster sampling. The study was approved by the Institutional Review Board of Federal University of Roraima. Results: 241 women were included without refusals. The prevalence of non-use of mammography in the past two years was 55.6% (95CI 49.1-61.9. In univariate analysis, the risk factors for non-adherence to mammography were having low educational level, family income below three minimum wages, receiving government assistance, not having consulted with a doctor and no health insurance. In multivariate analysis, only low educational level and receiving government assistance remained as risk factors. Medical consultation or health worker visiting were protective factors. Conclusion: Adherence to mammography is unsatisfactory in Boa Vista, Roraima, and has a predominantly opportunistic character. Low educational level is confirmed as an independent risk factor, but belonging to a family that receives government assistance can be interpreted as a social marker of families and/or areas lacking of government intervention to increase access to breast cancer control programs.
Sub-optimal adherence to combination anti-retroviral therapy and its associated factors according to self-report, clinician-recorded and pharmacy-refill assessment methods among HIV-infected adults in Addis Ababa.
Mekuria, Legese A; Prins, Jan M; Yalew, Alemayehu W; Sprangers, Mirjam A G; Nieuwkerk, Pythia T
Adherence to combination antiretroviral therapy (cART) is generally high in most resource-limited settings. However, sub-optimal adherence occurs in a sizable proportion of patients, and is independently predictive of detectable viremia. We investigated sub-optimal adherence according to self-report, clinician-recorded, and pharmacy-refill assessment methods, and their associated factors among HIV-infected adults receiving cART in Addis Ababa, Ethiopia. Eight-hundred seventy patients who initiated cART between May 2009 and April 2012 were randomly selected, and 664 patients who were alive, had remained in clinical care and were receiving cART for at least six-months were included. Sub-optimal adherence was defined as patients' response of less than "all-of the time" to the self-report adherence question, or any clinician-recorded poor adherence during the six most recent clinic visits, or a pharmacy-refill of sub-optimal adherence. The average adherence level to cART, expressed as MPR, was nearly 97%. However, sub-optimal adherence occurred in 12%, 4%, and 27% of patients according to self-report, clinician-recorded, and pharmacy-refill measures, respectively. More satisfaction with social support was significantly associated with less sub-optimal adherence according to self-report and clinician-record. Younger age, lower educational level, and lower CD4 cell count at cART initiation were significantly associated with sub-optimal refill-based adherence. Findings from our large multi-center study suggest that sub-optimal adherence was present in up to a quarter of the patients, despite a high degree of average adherence to cART. Interventions aimed at preventing sub-optimal adherence should focus on improving social support, on younger patients, on patients with lower educational level, and on those who started cART at a lower CD4 cell count.
Mustafa Tolga Tolon
Full Text Available Current seafood consumption pattern, consumer profile and factors affecting seafood consumption amount and frequency of the consumers residing in coastal region (İzmir, mixed region (Adana and countryside region (Ankara of Turkey were researched in this study. It is aimed to provide source to researchers and relevant institutions who are willing to guide the future sectoral initiatives and conduct more extensive research on seafood consumer habits. In this context, the research population was determined according to their distance to the sea and their populations by purposive sampling method. 43 % of total 400 survey was conducted in Ankara, 36% in İzmir and 21% in Adana by face to face interviews. According to the survey results, 6% of respondents never consume seafood, 25% once a month, 28% once every two weeks, and 42% consume once and more than once in a week. The most seafood consumption frequency was identified in Izmir. Nearly 90% of consumers in the entire regions prefer to consume seafood in fresh type. According to the answers of all consumers 4 major factors affecting seafood consumption preferences and habits in a negative way were "high price, cannot be easily found in the market, not recognition of seafood varieties and disfavor of the flavor of seafood". The relationship between frequency of seafood consumption and education level of consumer’s variables is determined as linear and strong but the relationship between consumer age and seafood consumption frequency is determined as reverse. On the factors affecting choice of seafood consumption in a positive way, 71% of consumers stated the beneficial to health perception and taste of seafood as the most important reason for their preference. Therefore, the relationship between consumption trend and beneficial to health perception of seafood is determined as linear and strong.
Tango, Peter J.; Batiuk, Richard A.
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.
Lemontt, J F
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.
Full Text Available This research paper investigates long and short term determinants of fertility rates in Malaysia based on basic macroeconomic variables for the period 1980-2014 using Auto Regressive Distributed Lag (ARDL method. The study reveals that over a long term period, all the selected variables (GDP, infant mortality rate, females’ education and employment have had significant and negative impact on total fertility rates. Whilst during the short term period, only the infant mortality rate has had a positive impact. Since population growth is partly determined by fertility rates, efforts to increase population in Malaysia should consider factors that affect those rates.
Lemontt, J F
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.
Diego Quer Ramón
Full Text Available This paper analyses the impact of various host country institutional factors on the location patterns of 29 large Chinese multinationals. From a sample of 127 outward foreign direct investment (FDI decisions made in 52 countries, our findings suggest that a greater difficulty in doing business and a high political risk in the host country do not discourage Chinese multinationals. However, the presence of overseas Chinese in the host country, a larger absolute host market size and a higher volume of Chinese exports to that country affect positively.
Park, Subin; Song, Hokwang
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...
Wang Lanhui; Cai Fei
The forest estate is one of our most important natural resources. It is also the material foundation for sustainable forestry development in China. It is a timely topic of concern within the forestry community and touches the entire society. From a social economic point of view, the sustainable development has been promoted by the efficient use of the forest resources in a continuing improvement of the environment. The objective of the present analysis is to measure the effect of various factors, such as population, economic development and related policies on the use of the forest resources. The 29 provinces of Mainland China are classified in three regions, based largely on their level of economic development. For each region, the factors which affect the area of special purpose forests (SPF) are analyzed. Some recommendations are made for further improvement.
Landete-Castillejos, Tomas; Estevez, Jose A; Ceacero, Francisco; Garcia, Andres J; Gallego, Laureano
Antlers constitute the only mammal model for limb regeneration. A number of factors affect antler regeneration. In this review, we examine such factors and the potential consequences for organ regeneration. As body mineral stores are depleted to grow antlers, physiological exhaustion is shown in the mineral composition, mechanical performance and, according to preliminary studies, porosity of the antler bone material. Nutrition plays an important role in antler characteristics. Thus, antler composition can be used as a diagnostic tool to assess mineral deficiencies in deer. Studies on ecological effects of exceptional weather in plants suggest that minor minerals, particularly Mn, may play disproportionately roles in mechanical performance of bone material. This suggests that Mn (and perhaps other minerals) is essential to incorporate Ca and P from resorbed skeleton material in antlers. Apart from implications for game management, some effects may have applications for medicine.
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.
In order to increase its hardness and gravity as well as dimension stability, the technology of hotcompressing on Paulownia wood was studied. The main factors of affecting the spring back of the compressed Paulownia samples were discussed. It was discovered that every factor in the experiment had obvious effects on wood hardness and dimension stability of compressed wood. When the MC (Moisture Content) of experimental specimens was 13.89%, it was useful to spray water on the surface of samples before hot pressing. The best resuit was the recovery of compression set could decrease from 90.69% of untreated wood to 45.51% of soaking specimens into PF (Phenol Formaldehyde) water solution. The hot pressing time was 8 min at 190 ℃.
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
Claudia Troncoso Pantoja
Full Text Available OBJETIVES: To interpret the perception of the determining factors that inﬂuence the diet of a group of intern patients in a drug rehabilitation center in Concepción, Chile, during the year 2015. MATERIAL AND METHODS: Through a qualitative design with a phenomenological approach, intern patients of a drug rehabilitation facility, who fulﬁlled the study assigned criteria, were interviewed. The collection of data was conducted through semi structured interviews; which were validated by experts and subject to a pilot test. Nonprobability convenience sampling was performed. The sample size was determined through theoretical saturation, which was completed at the eighth interview. The results were subject to triangulation of informants, and were analyzed using the technique of discourse analysis. RESULTS: The participants identify positive and negative factors that condition their diet. They claim that having a ﬁxed schedule is positive since this helps them to have a more organized diet. However, some stressful situations within the facilities are described as limiting factors in their mood, thus affecting their appetite and reducing their food intake. Additionally, not being with their families, especially at the beginning of the treatment, is considered a negative aspect. The lack of variety in terms of food preparation is also negative since this does not correspond to their food preferences. During the drug withdrawal stage, the intake of food containing carbohydrates of rapid absorption was increased. CONCLUSIONS: It is interpreted that the interviewees at the drug rehabilitation facility identify conditioning factors that inﬂuence their diet, which promote or inhibit food intake, and affect the attitude they present towards their diet in the drug withdrawal stage.
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.
Camacho, Fabian T; Tan, Xi; Alcalá, Héctor E; Shah, Surbhi; Anderson, Roger T; Balkrishnan, Rajesh
To evaluate variations in the use of adjuvant endocrine therapy (AET) by race and geography, this research examined their influence on initiation and adherence to AET in female Medicare enrollees with breast cancer, diagnosed between 2007 and 2011.Using SEER (Surveillance, Epidemiology, and End Results Program)-Medicare data from 2007 to 2001, logistic regressions with random intercept for county of residence were used to predict AET initiation during 1st year and AET adherence assessed by the medication possession ratio (MPR) during year after initiation in a sample of fee-for-service medicare beneficiaries. Part D enrollment was required for the examination of adherence. Independent variables examined were race (black, white, or other) and geographical indicators (area deprivation, non-metropolitan status, and physician shortage).Overall, 23% of patients did not initiate AET within 1 year and 26% of the initiation sample was not adherent to AET, with average follow-up time among initiators of 141 days and an average MPR of 0.84. Significant heterogeneity (P adherence varied from 77% in New Jersey to 68% in Utah.Blacks had lower initiation, enrollees not in Medicaid had lower adherence, lower area deprivation counties had lower initiation, earlier SEER-Medicare years had both later initiation and nonadherence, and significant (P adherence for blacks in youngest age group, with stage III tumors, tamoxifen use and blacks/others in oldest age group.Black women and women living in states with more rurality in the United States were less likely to receive guideline-recommended AET, which necessitates future efforts to alleviate these disparities to improve AET use and ultimately pursue more survival gains through optimizing adjuvant treatment use among cancer survivors.
Full Text Available The main purpose of the study was to investigate the factors affecting the sustainable management of agricultural water in Hamedan. The study population included all wheat farmers possessing irrigated farms in Hamedan city (N=1800. Of these farmers a sample of 317 people has been selected by using randomized multi-stage sampling method. The data were collected through a questionnaire's tool with help of the interview technique. Accuracy of the questions in the questionnaire was face validated by a panel of specialists. To test the reliability of the questionnaires, the questionnaires were first given to 30 farmers and Cronbach's Alpha was calculated (Alpha=0.92 then the questionnaire was finalized. Data analyzing methods such as Multiple Regression and the coefficient of variation (CV= standard deviation /mean were used in this study. To determine the level of sustainability of the farms Bossel method proposed for classification and grading the fields was used. The results showed that variables agronomic factors, policy factors and institutional factors were able to explain 34 percent of the dependent variable's changes (sustainable management of agricultural water. According to the results, 95.3 percent of the farmers were categorized into unsustainable group, 4.1 percent into semi-sustainable and only 0.6 percent in sustainable group.
Shafaroodi, Narges; Kamali, Mohammad; Parvizy, Soroor; Mehraban, Afsoon Hassani; O’Toole, Giyn
Background: Clinical reasoning is generally defined as the numerous modes of thinking that guide clinical practice but little is known about the factors affecting how occupational therapists manage the decision-making process. The aim of this qualitative study was to explore the factors influencing the clinical reasoning of occupational therapists. Methods: Twelve occupational therapy practitioners working in mental and physical dysfunction fields participated in this study. The sampling method was purposeful and interviews were continued until data saturation. All the interviews were recorded and transcribed. The data were analyzed through a qualitative content analysis method. Results: There were three main themes. The first theme: socio-cultural conditions included three subthemes: 1- client beliefs; 2- therapist values and beliefs; 3- social attitude to disability. The second theme: individual attributions included two subthemes 1- client attributions; 2- therapist attributions. The final theme was the workplace environment with the three subthemes: 1- knowledge of the managers of rehabilitation services, 2- working in an inter-professional team; 3- limited clinical facilities and resources. Conclusion: In this study, the influence of the attitudes and beliefs of client, therapist and society about illness, abilities and disabilities upon reasoning was different to previous studies. Understanding these factors, especially the socio-cultural beliefs basis can play a significant role in the quality of occupational therapy services. Accurate understanding of these influential factors requires more extensive qualitative and quantitative studies. PMID:25250253
Hisham Jameel Bardesi
Full Text Available As internet use in Saudi Arabia are dramatically increasing, a powerful demand is being laid down on internet service purpose where this paper aims at identifying major factors that influence these demand pertaining to internet services. Within a selected theoretical model, such multiple factors are being conceptualized and interrelated. Using time series data, the Ordinary Least Square (OLS technique is employed to analyze the relationships. The results of the model indicated clearly that using the internet in Saudi Arabia is influenced most strongly by the number of educated people, the number of mobile subscribers, income, the number of fixed lines, and employment level. The results also suggest that demographic factors have a significant impact on the demand for internet, specifically, the number of educated people and levels of employment. This paper concludes with a recommendation on increasing the level of understanding of those the factors affecting practitioners who plan and promote new forms of internet services in the current competitive market.
Jun, W H; Jo, M J
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
Jerant, Anthony; Chapman, Benjamin; Duberstein, Paul; Robbins, John; Franks, Peter
Objectives Personality factors parsimoniously capture the variation in dispositional characteristics that affect behaviours, but their value in predicting medication non-adherence is unclear. We investigated the relationship between five-factor model personality factors (Conscientiousness, Neuroticism, Agreeableness, Extraversion, and Openness) and medication non-adherence among older participants during a six-year randomized placebo-controlled trial (RCT). Design Observational cohort data from 771 subjects aged ≥72 years enrolled in the Ginkgo Evaluation of Memory study, a RCT of Ginkgo biloba for prevention of dementia. Methods Random effects logistic regression analyses examined effects of NEO Five-Factor Inventory scores on medication non-adherence, determined via pill counts every 6 months (median follow-up 6.1 years) and defined as taking personality factor associated with non-adherence: a 1 SD increase was associated with a 3.8% increase in the probability of non-adherence (95% CI [0.4, 7.2]). Lower cognitive function was also associated with non-adherence: a 1 SD decrease in mental status exam score was associated with a 3.0% increase in the probability of non-adherence (95% CI [0.2, 5.9]). Conclusions Neuroticism was associated with medication non-adherence over 6 years of follow-up in a large sample of older RCT participants. Personality measurement in clinical and research settings might help to identify and guide interventions for older adults at risk for medication non-adherence. PMID:21226789
Park, Ji Won; Lee, Jong Min [Dept. of Radiology, Kyungpook National University Hospital, Daegu (Korea, Republic of)
To evaluate factors which affect the longevity of tunneled central venous catheters (T-CVCs). A retrospective study was conducted on 363 T-CVCs. We evaluated the relevant factors affecting the longevity of the T-CVCs, such as age, gender, indication for catheterization, site of entry vessel, diameter and type of T-CVC, catheter tip position, and underlying diseases. Of the 363 T-CVCs which had been inserted, 331 (91%) were placed through the right internal jugular vein (RIJV). The catheter tip position was the strongest predictor for the longevity of the T-CVC. The short limb of the catheter tip placed either at the cavoatrial junction (CA junction) or below the lower margin of the right main bronchus had a good prognosis. The vessel through which the T-CVC was placed significantly influenced the longevity of the T-CVC; the RIJV was associated with better results than the left internal jugular vein. Also, a split-type catheter was significantly associated with a better result. A two distinct and separate type T-CVC placed through the RIJV in which the short limb catheter tip position was at the level of the CA junction, significantly increased the longevity of T-CVCs.
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
Abdullah Faruk Kılıç
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.
Francis, G A; Gallone, A; Nychas, G J; Sofos, J N; Colelli, G; Amodio, M L; Spano, G
The quality of fresh-cut fruit and vegetable products includes a combination of attributes, such as appearance, texture, and flavor, as well as nutritional and safety aspects that determine their value to the consumer. Nutritionally, fruit and vegetables represent a good source of vitamins, minerals, and dietary fiber, and fresh-cut produce satisfies consumer demand for freshly prepared, convenient, healthy food. However, fresh-cut produce deteriorates faster than corresponding intact produce, as a result of damage caused by minimal processing, which accelerates many physiological changes that lead to a reduction in produce quality and shelf-life. The symptoms of produce deterioration include discoloration, increased oxidative browning at cut surfaces, flaccidity as a result of loss of water, and decreased nutritional value. Damaged plant tissues also represent a better substrate for growth of microorganisms, including spoilage microorganisms and foodborne pathogens. The risk of pathogen contamination and growth is one of the main safety concerns associated with fresh-cut produce, as highlighted by the increasing number of produce-linked foodborne outbreaks in recent years. The pathogens of major concern in fresh-cut produce are Listeria monocytogenes, pathogenic Escherichia coli mainly O157:H7, and Salmonella spp. This article describes the quality of fresh-cut produce, factors affecting quality, and various techniques for evaluating quality. In addition, the microbiological safety of fresh-cut produce and factors affecting pathogen survival and growth on fresh-cut produce are discussed in detail.
Mohamed Sayed Bassiony Ahmed Abd El-Karim
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.
Full Text Available Objective: The aim of the study was the evaluation of patients treated with a diagnosis of gastroschisis and to establish the factors which affected the morbidity and mortality.Methods: Twenty-nine patients, managed for gastroschisis during 2000-2010 were reviewed retrospectively.Patients were analysed in respect to gestational age, birth weight, associated anomalies, type of delivery,operative procedures, postoperative complications, total parenteral nutrition (TPN related complications.The factors affecting mortality and morbidity were determined.Findings: Associated abnormalities were present in 24% of the patients. Eleven patients underwent elective reduction in the incubator (Bianchi procedure without anesthesia. Eight patients had delayed reduction with silo and ten patients had primary closure. Although the type of delivery had an effect on morbidity but notmortality, gestational age, birth weight, and the operative procedure performed had no effect on morbidity or mortality. Duration until tolerance of oral intake, and of TPN and hospitalization were found to be statistically significantly shorter in the group of babies delivered by cesarean section.Conclusion: In our study the most important cause of mortality was the abdominal compartment syndrome and multi-organ failure in the early years. Long hospitalization periods and sepsis were the main causes of mortality in recent years.
Michael D. Cusimano
Full Text Available This cross-sectional study explores factors affecting the decision of basketball players to wear ankle support devices (ASDs. A questionnaire regarding attitudes towards ASD usage was developed based on the Health Belief Model (HBM. The questionnaire assessed HBM perceptions (susceptibility, severity, benefits, and barriers and modifying factors (demographic, personal history of ankle injury, influence of coach to preventive action that may affect an athlete’s decision to wear ASDs. One hundred forty basketball players competing at the recreational, high school, or university levels completed the questionnaire, with the questionnaires being completed at the basketball gymnasium or at home. It was found that athletes whose coaches enforced ASD use were significantly more likely to wear them (OR: 35.71; 95% CI: 10.01, 127.36, as were athletes who perceived ankle injuries to be severe (OR: 2.77; 95% CI: 1.04, 7.37. Previous injury did not significantly increase the odds of using an ASD. The combined influence of coach enforcement and previous injury had the greatest effect on increasing ASD use. The largest barrier to ASD use was a lack of aesthetic appeal. Strategies aimed at increasing players’ willingness to wear ankle protection should be emphasized among coaches and parents as this may increase use of ASDs.
The purpose of this study was to clarify the factors affecting the quality of life (QOL) of the elderly home-bound patients. Data were collected from 56 chronically disabled elderly persons (mean age of 76.7 years) who needed a long-term home-based care. They were assessed on QOL, range of activity, functional capacity, and capacity of family care functioning as well as socio-economic condition. The QOL was evaluated by using Philadelphia Geriatric Center Morale Scale (PGC Morale Scale). The activities of daily living (ADL) and handicaps were evaluated by the Barthel index and the ESCROW profile, respectively. The capacity of family care functioning was also recorded according to the "Family Care Scale" developed by Hamamura. As a result, there was a significant difference between PGC Morale Scale score and Barthel index score (P QOL of the home-bound elderly disabled were determined by the motivation, functional capacity, and capacity of family care functioning (P QOL, ADL must be improved, therefore, rehabilitation should be continued to maintain their function after discharging from hospitals and that we should take these factors into consideration, such as living environments and social conditions of the family care. The results also indicate how the patient's independence in the daily life influences social and economic status, and consequently it affects the quality of life.
Plaza, Vicente; López-Viña, Antolín; Entrenas, Luis Manuel; Fernández-Rodríguez, Concepción; Melero, Carlos; Pérez-Llano, Luis; Gutiérrez-Pereyra, Fernando; Tarragona, Eduard; Palomino, Rosa; Cosio, Borja G
Differences between COPD and asthma may also differentially affect adherence to inhaled drugs in each disease. We aimed to determine differences in behaviour patterns of adherence and non-adherence to inhaled therapy between patients with COPD and patients with asthma using the Test of Adherence to Inhalers (TAI) questionnaire. A total of 910 patients (55% with asthma, 45% with COPD) participated in a cross-sectional multicentre study. Data recorded included sociodemographics, education level, asthma or COPD history, TAI score, the Asthma Control Test (ACT), the COPD Assessment Test (CAT) and spirometry. Asthma patients were statistically significant less adherents, 140 (28%) vs. 201 (49%), and the pattern of non-adherence was more frequently erratic (66.8% vs. 47.8%) and deliberate (47.2% vs. 34.1%) than COPD patients; however unwitting non-adherence was more frequently observed in COPD group (31.2% vs. 22.8%). Moreover, taking together all sample studied, only being younger than 50 years of age (OR 1.88 [95% CI: 1.26-2.81]) and active working status (OR 1.45 [95% CI: 1.00-2.09]) were risk factors for non-adherence in the multivariate analysis, while having asthma remained in the limits of the significance (OR 1.44 [95%CI: 0.97-2.14]). Even though non-adherence to inhalers is more frequently observed in asthma than in COPD patients and exhibited a different non-adherence patterns, these differences are more likely to be related to sociodemographic characteristics. However, differences in non-adherence patterns should be considered when designing specific education programmes tailored to each disease.
Full Text Available 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
Salewski, Volker; Hochachka, Wesley M; Fiedler, Wolfgang
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
Reisacher, William R; Visaya, Jiovani M
This article reviews the literature on patient adherence to two different approaches to allergen-specific immunotherapy for allergic disease. Factors related to adherence in general, as well as the various methods used to measure adherence, will be discussed. Although a complex interaction of factors related to both the physician and the patient influence the adherence to a particular therapeutic regimen, effective communication between these two parties and the simplicity of the regimen are frequently noted to be of primary importance. Variability with respect to the definition of adherence, the method of measuring adherence, and the length of the measuring period has resulted in a wide range of adherence rates to allergy immunotherapy reported in the literature. Patients most often site inconvenience, side-effects, and poor efficacy as reasons for discontinuing allergy immunotherapy. Adherence to therapy not only improves individual patient outcomes, but also helps determine the best treatment modalities and reduces the burden of disease on society. As new methods of delivering immunotherapy are being developed, such as allergy immunotherapy tablets and oral mucosal immunotherapy, the factors associated with patient adherence should be carefully considered.
The authors explore factors that affect electricity trade between enterprises in the US and Canada and the US and Mexico. They look to those underlying policy and institutional factors that affect the relative costs of producing electricity in the three countries. In particular, they consider six factors that appear to have a significant impact on electricity trade in North America: differences in the types of economic regulation of power leading to differences in cost recovery for wholesale and retail power and wheeling charges; changing regulatory attitudes, placing more emphasis on demand-side management and environmental concerns; differences in energy and economic policies; differences in national and subnational environmental policies; changing organization of electric power industries which may foster uncertainty, change historical relationships, and provide other potentially important sources of power for distribution utilities; and differences in the ability of enterprises to gain access to electric power markets because of restrictions placed on transmission access. In Section 2, the authors discuss the regulation of electricity trade in North America and provide an overview of the recent trading experience for electricity between Canada and the US and between Mexico and the US, including the volume of that trade over the past decade and existing transmission capacity between regions of the three countries. In Section 3, they look at the benefits that accrue to trading counties and what those benefits are likely to be for the three countries. The discussion in Section 4 centers on the relevant provisions of the Canada Free Trade Agreement and the proposed North American Free Trade Agreement. In Section 5, they set the stage for the discussion of policy and institutional differences presented in Section 6 by outlining differences in the organization of the electric power sectors of Canada, the US, and Mexico. The study is synthesized in Section 7.
Full Text Available Background Cardiovascular diseases are a leading cause of morbidity and mortality in solid organ transplant recipients. In addition, low physical activity is a risk factor for cardiac and cerebrovascular complications. Objectives This study examined potential relationships between physical activity, health-related quality of life (HRQoL, risk factors for cardiovascular disease, and an exercise test in liver-graft recipients. Patients and Methods A total of 107 participants (62 men/45 women who had received a liver transplantation (LT at least 6 months previously were evaluated. Physical activity was assessed using three different questionnaires, while HRQoL was assessed using the medical outcomes study short form (SF-36 questionnaire, and health behaviors were evaluated using the health behavior inventory (HBI. The exercise test was performed in a standard manner. Results Seven participants (6.5% had a positive exercise test, and these individuals were older than those who had a negative exercise test (P = 0.04. A significant association between a negative exercise test and a higher level of physical activity was shown by the Seven-day physical activity recall questionnaire. In addition, HRQoL was improved in various domains of the SF-36 in participants who had a negative exercise test. No correlations between physical activity, the exercise test and healthy behaviors, as assessed via the HBI were observed. Conclusions Exercise test performance was affected by lower quality of life and lower physical activity after LT. With the exception of hypertension, well known factors that affect the risk of coronary artery disease had no effect on the exercise test results.
Maurer, Max; Wolfram, Martin; Anja, Herlyn
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.
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.
Gardini, Fausto; Özogul, Yesim; Suzzi, Giovanna; Tabanelli, Giulia; Özogul, Fatih
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 foods 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 BAs accumulation. In this review, up-to-date information and recent discoveries about technological factors affecting BA 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, and pH). In addition, the technological factors for controlling BA production (use of starter culture, technological additives, effects of packaging, other non-thermal treatments, metabolizing BA by microorganisms, effects of pressure treatments on BA formation and antimicrobial substances) are addressed. PMID:27570519
Cho, Young Ae; Kim, Jeongseon
Some dietary factors are proposed to affect thyroid carcinogenesis, but previous studies have reported inconsistent findings. Therefore, we performed a meta-analysis, including 18 eligible studies, to clarify the role of dietary factors in the risk of thyroid cancer. The relative risks (RRs) with 95% confidence intervals (95% CIs) were estimated to assess the association and heterogeneity tests and subgroup and sensitivity analyses, and bias assessments were performed. When the results from all studies were combined, dietary iodine, fish, and cruciferous vegetable intake were not associated with thyroid cancer. However, when the data were divided by geographic location based on iodine availability, a slight increase in the risk of thyroid cancer was observed among those consuming a high total amount of fish in iodine nondeficient areas (RR: 1.18; 95% CI: 1.03-1.35; P for heterogeneity = 0.282). When excluding the studies examining a single food item and hospital-based controls, a high intake of cruciferous vegetables was associated with an increased risk of thyroid cancer in iodine-deficient areas (RR: 1.43; 95% CI: 1.18-1.74; P for heterogeneity = 0.426). This meta-analysis implies that the role of dietary factors, such as fish and cruciferous vegetables, in thyroid cancer risk can differ based on iodine availability.
Northouse, L L; Dorris, G; Charron-Moore, C
The purpose of this study was to identify factors that affect the adjustment of women and their husbands to recurrent breast cancer and to examine the mutual effect that partners have on one another. An exploratory study was designed to determine the relationship between four predictor variables (support, uncertainty, symptom distress, hopelessness) and women's and husbands' adjustments. The sample consisted of 155 subjects; 81 women, who had a first recurrence of breast cancer, and 74 husbands. Multiple standardized instruments with established reliability and validity were used to measure the study variables. The independent variables were measured with the Social Support Questionnaire, the Mishel Uncertainty in Illness Scale, McCorkle Symptom Distress Scale and the Beck Hopelessness Scale. The dependent variable, psychosocial adjustment, was measured with the Brief Symptom Inventory and the Psychosocial Adjustment to Illness Scale. The results indicated that the independent variables accounted for 43% of the variance in women's distress and 32% of the variance in husbands' distress; they also explained 66% of the variance in women's role adjustment problems and 57% of the variance in husbands' role problems. Symptom distress and hopelessness accounted for the most variance in women's and husbands' levels of adjustment. A significant and positive relationship was found between women's and husbands' adjustment scores, indicating that partners have a mutual influence on one another. The findings suggest that there are multiple factors that influence couples' adjustment to recurrent breast cancer, and that these factors need to be taken into consideration when planning care for women and their partners.
Full Text Available The purpose of this research is to analyze the factors that affecting the work commitment of teachers.The research use descriptive quantitative method. The problem are the teachers who work without commitment, just to teach according to what was ordered by the principal. By having a high work commitment that is evident in the behavior of painstaking work, passionate, integrity of the work, responsibility, and maintain morale as educators. The results are: commitment to working both seen from the achievement an average score of 71.61, completion of the task is the highest factor in teachers' work commitment with an average score of 79.67, and development of self-efficacy is the lowest factor in teachers' work commitment with an average score of 73.00.Suggestions are: schools should give rewards to the teachers who complete the task on time and to sanction teachers who did not complete the task on time, provide education and training to the teachers continuously and sustainably as efforts to develop self-efficacy ofteachers, the teacher involvement in school activities further improved, so that the visible concern for the fate of school teachers and Teacher work program should be set up and executed in accordance with a predetermined plan.
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.
Dinc, Tolga; Polat Duzgun, Arife; Kayilioglu, Selami Ilgaz; Erdogan, Ahmet; Yavuz, Zeynep; Coskun, Faruk
Our aim was to evaluate the factors affecting the mortality of patients who underwent nontraumatic major lower limb amputation due to ischemic and/or diabetic causes. A total of 100 patients were included in the study. Among these patients, 70 (70%) underwent below-knee amputation, whereas 30 (30%) underwent above-knee amputation. Eleven (15.7%) of the 70 patients who underwent below-knee amputation and 12 (40%) of the 30 patients who underwent above-knee amputation (P = .008) were deceased. After multivariable Poisson regression analysis, female gender (risk ratio [RR] = 2.00, 95% CI = 1.07-3.74) and a neutrophil lymphocyte ratio (NLR) less than 6.8 (RR = 5.12, 95% CI = 1.86-14.08) were found to be independent risk factors for mortality. The value of 6.8 was used as a cutoff point for the NLR (area under the curve = 0.73, 95% CI = 0.62-0.85), with a sensitivity, specificity, positive predictive value, and negative predictive value of 83%, 66%, 57%, and 92%, respectively. The NLR and female gender were found to be independent factors that are related to increased mortality in patients who underwent lower limb amputation due to diabetic and/or ischemic causes. The coexistence of congestive heart failure and the amputation level (above knee) were found to be predictors of mortality in univariable analysis, but significance could not be demonstrated in multivariable analysis. © The Author(s) 2016.
Lee, Ho Seong; Choi, Young Rak; Kim, Sang Woo; Lee, Jin Yong; Seo, Jeong Ho; Jeong, Jae Jung
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.
Rogers, Laura Q; Fogleman, Amanda; Verhulst, Steven; Bhugra, Mudita; Rao, Krishna; Malone, James; Robbs, Randall; Robbins, K Thomas
Social cognitive theory (SCT) measures related to exercise adherence in head and neck cancer (HNCa) patients were developed. Enrolling 101 HNCa patients, psychometric properties and associations with exercise behavior were examined for barriers self-efficacy, perceived barriers interference, outcome expectations, enjoyment, and goal setting. Cronbach's alpha ranged from.84 to.95; only enjoyment demonstrated limited test-retest reliability. Subscales for barriers self-efficacy (motivational, physical health) and barriers interference (motivational, physical health, time, environment) were identified. Multiple SCT constructs were cross-sectional correlates and prospective predictors of exercise behavior. These measures can improve the application of the SCT to exercise adherence in HNCa patients.
Mosammod Mahamuda Parvin
Full Text Available The Pharmaceutical sector plays a vital role in underpinning the economic development of a country. This study attempts to evaluate job satisfaction of employees in different pharmaceutical companies. It focuses on the relative importance of job satisfaction factors and their impacts on the overall job satisfaction of employees. It also investigates the impacts of pharmaceutical type, work experience, age, and sex differences on the attitudes toward job Satisfaction. The result shows that salary, efficiency in work, fringe supervision, and co-worker relation are the most important factors contributing to job satisfaction. The overall job satisfaction of the employees in pharmaceutical sector is at the positive level. The nature of business operation, the work culture and the level of job satisfaction have undergone sea change for the pharmaceutical companies. As a business proposition initiated huge investment whereas majority of their stocks is going down bringing a high level of apprehension related to job security among its employees. This research paper highlights some of these problems and presents a picture of level of job satisfaction among employees of pharmaceutical companies. It also identifies unique issues of job satisfaction in the companies. Pharmaceuticals Companies are selected for the research because they are currently undergoing continued expansion. In order to gain competitive advantage and adapt to the dramatic changing environment, it is important for them to achieve management efficiency by increasing employee satisfaction in the organisation. Hence this research was mainly undertaken to investigate on the significance of factors such as working conditions, pay and promotion, job security, fairness, relationship with co-workers and supervisors in affecting the job satisfaction. This paper presents a comprehensive diagnosis of job satisfaction indices of pharmaceutical business, the factors causing the dissatisfaction
Full Text Available Recently, the system of care for endangered children has changed from the institutional as well as legislative point of view. In one of the partial areas of ongoing changes, research activities realised within the Students’ Grant Competition called The Factors Affecting the Form of Substitute Family Care are being focused. We deal with this topic because various forms of substitute family care are distinguished in the Czech Republic, where children are placed for various reasons, but we do not know the correct context of such placements. The main aim of the realised research was to find out the frequency of choosing a given form of placing children in substitute family care according to followed variables. The research sample of the quantitative research was consisted of children placed in one of the forms of substitute family care in the Moravian-Silesian region.
Ogata, Norichika; Iwabuchi, Kikuo
The primary culture of insect cells often suffers from problems with poor reproducibility in the quality of the final cell preparations. The cellular composition of the explants (cell number and cell types), surgical methods (surgical duration and surgical isolation), and physiological and genetic differences between donors may be critical factors affecting the reproducibility of culture. However, little is known about where biological variation (interindividual differences between donors) ends and technical variation (variance in replication of culture conditions) begins. In this study, we cultured larval fat bodies from the Japanese rhinoceros beetle, Allomyrina dichotoma, and evaluated, using linear mixed models, the effect of interindividual variation between donors on the reproducibility of the culture. We also performed transcriptome analysis of the hemocyte-like cells mainly seen in the cultures using RNA sequencing and ultrastructural analyses of hemocytes using a transmission electron microscope, revealing that the cultured cells have many characteristics of insect hemocytes.
Starbuck, Melanie J; Dailey, Robert A; Inskeep, E Keith
Potential factors affecting retention of pregnancy during weeks 5-9 of gestation were studied in dairy cows and heifers (N = 211) on two farms. Cows were examined by ultrasonography for presence of a viable embryo, and sizes of the corpus luteum (CL) and of follicles > or = 5mm were recorded. Blood samples were taken at each examination and assayed for progesterone and estradiol. Overall pregnancy loss was 11.4%. Cows with two CL did not have greater concentrations of progesterone than cows with one CL and they retained fewer pregnancies (P Embryos that were lost apparently died before CL regression. Retention of pregnancy declined in cows with high body condition and as age of the cow increased. Pregnancy retention was lower in cows bred to one of four frequently-used service sires (P body condition and service sire.
Hosseini, Seyed Mahmood; Rezaei, Rohollah
This descriptive survey research was undertaken to design appropriate programs for the creation of a positive perception of nanotechnology among their intended beneficiaries. In order to do that, the factors affecting positive perceptions were defined. A stratified random sample of 278 science board members was selected out of 984 researchers who were working in 22 National Agricultural Research Institutions (NARIs). Data were collected by using a mailed questionnaire. The descriptive results revealed that more than half of the respondents had "low" or "very low" familiarity with nanotechnology. Regression analysis indicated that the perceptions of Iranian NARI Science Board Members towards nanotechnology were explained by three variables: the level of their familiarity with emerging applications of nanotechnology in agriculture, the level of their familiarity with nanotechnology and their work experiences. The findings of this study can contribute to a better understanding of the present situation of the development of nanotechnology and the planning of appropriate programs for creating a positive perception of nanotechnology.
Ee Chop Ler
Full Text Available The purpose of this study is to the rural and the ‘cultural’ and to determine their problems effect on the learning of English. Twenty students from different ethnic backgrounds and English language proficiency in six rural schools in Terengganu, Malaysia were interviewed. In addition the teachers also from different rural schools and ethnic backgrounds responded to a questionnaire. The problems discussed by both the teacher and student respondents arose due to the rural cultural setting. The findings of this study show that 1 five major problem areas exist, namely peer pressure and motivation, attitudes towards English ,teaching methodology, school culture ,influence of Islamic teaching on the learning of English 2 the problems discussed by the teachers and students are similar and 3 most importantly all these identified problems are closely related to the rural setting. Therefore, one can conclude that rural cultural factors adversely affect English Proficiency of the rural students of this study.
<正>For us Chinese,a foreign language is something to be acquired as a kind of communicative tool,so we can infer that an effective way in SLA(Second Language Acquisition) must be learning the target language in a communicative context.A communicative context certainly concerns not only the interactional classroom activities designed in accordance with some stated curriculum tasks to lead the L2 students to learning swimming by swimming,but also other relevant elements which have a lot to do with all the situational,interactional and cultural contexts.In order to lessen some potential sources of conflict between L2 teacher and L2 learner,this article is an attempt to urge a careful study on the contextual factors affecting motivation in SLA.
Ye, Zhuoliang; Berson, R Eric
The rate of enzymatic hydrolysis of cellulose reaction is known to decrease significantly as the reaction proceeds. Factors such as reaction temperature, time, and surface area of substrate that affect cellulose conversion were analyzed relative to their role in a mechanistic model based on first order inactivation of adsorbed cellulases. The activation energies for the hydrolytic step and inactivation step were very close in magnitude: 16.3 kcal mol(-1) for hydrolysis and 18.0 kcal mol(-1) for inactivation, respectively. Therefore, increasing reaction temperature would cause a significant increase in the inactivation rate in addition to the catalytic reaction rate. Vmax,app was only 20% or less of the value at 72 h compared to at 2h as a result of inactivation of adsorbed cellulases, suggesting prolonged hydrolysis is not an efficient way to improve cellulose hydrolysis. Hydrolysis rate increased with corresponding increases in available substrate surface binding area. Copyright © 2014 Elsevier Ltd. All rights reserved.
Park, Subin; Song, Hokwang
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 academic achievement compared with a high level (OR=3.72 and 4.38) were independently associated with increased odds of a suicide attempt, while better perceived health (OR=0.32) was independently associated with reduced odds of a suicide attempt. For adolescent drug users, preventive work should be directed toward the active treatment of drug use, depression, and physical health and reinforcing proper coping strategies for academic and other stress.