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Sample records for factors influencing adherence

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

    admin

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

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

    Science.gov (United States)

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

    2018-04-09

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

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

    African Journals Online (AJOL)

    2014-01-17

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

  5. Factors Influencing Adherence to Routine Iron Supplementation

    African Journals Online (AJOL)

    Fineprint

    2016-06-01

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

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

    Science.gov (United States)

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

    2008-12-01

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

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

    Science.gov (United States)

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

    2018-03-01

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

  8. Factors influencing adherence to guidelines in general practice

    NARCIS (Netherlands)

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

    2003-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sharada P Wasti

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Suma Uday

    2017-10-01

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

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

    Science.gov (United States)

    van Leer, Eva; Connor, Nadine P

    2015-05-01

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2014-07-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Thaís Helena Piai-Morais

    2015-06-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Anna R Gagliardi

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    De las Cuevas C

    2017-03-01

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

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

    Science.gov (United States)

    2013-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2018-01-12

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Zhao S

    2017-02-01

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

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

    Science.gov (United States)

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

    2018-05-01

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

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

    OpenAIRE

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

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

    Science.gov (United States)

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

    2009-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Janet Gare

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

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

    Directory of Open Access Journals (Sweden)

    Stefanie Frech

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

  14. Psychosocial influencers and mediators of treatment adherence in haemodialysis patients.

    Science.gov (United States)

    Oh, Hyun Soo; Park, Ji Suk; Seo, Wha Sook

    2013-09-01

    This article is a report of the development and testing of the hypothetical model that illustrates relationships between treatment adherence and its psychosocial influencing factors and to elucidate the direct and indirect (mediating) effects of factors on treatment adherence. Poor adherence has been consistently reported in haemodialysis patients. Much research has showed various influencing factors of adherence, but these studies have failed to identify consistent influencing factors. This study was performed using a non-experimental, cross-sectional design. The study subjects were 150 end-stage renal failure patients on haemodialysis at a university hospital located in Incheon, South Korea. Data were collected over 10 months (June 2010-April 2011). The hypothetical model provided a good fit with data. Haemodialysis-related knowledge, perceived barrier to adherence, self-efficacy on adherence, and healthcare provider support had significant effects on adherence. Self-efficacy was found to mediate barrier-adherence and family support-adherence relationships. Self-efficacy in combination with barrier, family support, and healthcare provider support was found to mediate the depression-adherence relationship. Strategies aimed at the development of successful adherence interventions should focus on reducing perceived barriers and enhancing self-efficacy and knowledge. It can be suggested that efforts to improve the healthcare provider-patient relationship would enhance adherence. In depressive patients, strategies that promote self-efficacy and the support of family or healthcare providers could diminish the negative impact of depression on adherence. © 2013 Blackwell Publishing Ltd.

  15. [Eating Disorder Treatment in Iceland - Treatment adherence, psychiatric co-morbidities and factors influencing drop-out].

    Science.gov (United States)

    Gunnarsdottir, Gudrun Mist; Palsson, Sigurdur Pall; Thorsteinsdottir, Gudlaug

    2015-05-01

    Treatment adherence in patients with eating disorders (ED) in Iceland is unknown. The aim of the study was to investigate treatment drop-out and explore factors that influence premature termination of treatment in a specialized ED treatment unit, at the University Hospital of Iceland, during the period of September 1, 2008 - May 1, 2012. The study is retrospective and naturalistic. Hospital records of referred patients were examined. Those meeting the ICD 10 criteria of anorexia nervosa (AN) (F50.0, F50.1), bulimia nervosa (BN) (F50.2, F50.3) and eating disorder not otherwise specified (EDNOS) (F50.9) were included. The total sample was 260 and 182 patients met inclusion criteria. No-shows were 7%. Drop-out was defined as premature termination of treatment without formal discharge. The sample consisted of 176 women and 6 men, mean age 26.3 years. BN was diagnosed in 52.7% of patients, EDNOS in 36.8% AN in 10.4%. 74.7% had one or more co-morbid psychiatric diagnosis. Anxiety- and/or depression were diagnosed in 72.5%, Attention hyperactivity deficiency disorder in 15.4% and personality disorders in 8.2%. Lifetime prevalence of substance use disorders (SUDs) was 30.8%. Drop-out from treatment occurred in 54.4% of cases (with approximately 1/3 returning to treatment), 27.5% finished treatment and 18.1% were still in treatment at the end of the follow up period. Treatment adherence was significantly higher in patients who had a university degree, in those who had themselves taken the initiative to seek ED treatment and in those with higher anxiety scores at assessment. AN patients did better than other ED patients while patients with SUDs showed a tendency for higher drop-out (p=0.079). The drop-out rates were similar to what has been reported from other western countries. Follow-up time was longer and AN patient did better than expected. Higher education, initiative in seeking treatment and higher anxiety scores on questionnaires were protective.

  16. Factors affecting medication adherence in elderly people

    Directory of Open Access Journals (Sweden)

    Jin HK

    2016-10-01

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

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

    Science.gov (United States)

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

    2017-07-01

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

  18. Factors influencing HAART adherence among private health care sector patients in a suburb of the Ethekwini Metro

    Directory of Open Access Journals (Sweden)

    Panjasaram Naidoo

    2009-05-01

    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 data was described using frequency tables and bar charts. Pearson’s chi-square tests or Fischer’s exact tests were used interchangeably as appropriate to assess associations between categorical variables. The study received ethics approval from the University of KwaZulu-Natal’s Nelson R Mandela School of Medicine Ethics Committee. Results: A total of 55 patients completed the questionnaires and 10 patients refused to participate. There was no statistical difference between adherence to treatment and demographics such as age, gender and marital status. In this study 89.1% of patients were classified as non-adherent and reasons for nonadherence included difficulty in swallowing medicines (67.3% (p = 0.01; side effects (61.8% (p = 0.03; forgetting to take medication (58.2% (p = 0.003; and not wanting to reveal their HIV status (41.8% (p = 0.03. Common side effects experienced were nausea, dizziness, insomnia, tiredness or weakness. Reasons for taking their medicines included tablets would save their lives (83.6%; understand how to take the medication (81.8%; tablets would help them feel better (80.0%; and were educated about their illness (78.2%. The majority of participants (65.5% were on two nucleoside reverse transcriptase inhibitors (NRTIs and one non-nucleoside reverse transcriptase inhibitor (NNRTI. All participants that were on a regimen that comprised protease inhibitors and two NRTIs were found to be non-adherent. Conclusion: Some barriers to adherence among this cohort of private sector

  19. The impact of using musculoskeletal ultrasound imaging and other influencing factors on medication adherence in patients with rheumatoid arthritis: a qualitative study

    Directory of Open Access Journals (Sweden)

    Kumar K

    2016-06-01

    Full Text Available Kanta Kumar,1,2 Karim Raza,3,4 Paramjit Gill,1 Sheila Greenfield1 1Primary Care Clinical Sciences, University of Birmingham, Birmingham, 2Faculty of Medical and Human Sciences, University of Manchester, Manchester, 3Institute of Inflammation and Ageing, University of Birmingham, 4Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK Background: Medication can ease symptoms and limit disease progression in rheumatoid arthritis (RA. Despite this, nonadherence to medication is common in RA. We explored the determinants of high and low adherence to disease-modifying antirheumatic drugs (DMARDs in patients with RA and provide suggestions on approaches to improving adherence to DMARDs.Methods: Patients with RA were identified from those who had previously participated in a questionnaire measuring levels of medication adherence. Twenty patients participated (ten high and ten low adherers, as determined by responses to the Medication Adherence Report Scale. In-depth individual semistructured interviews were undertaken until data saturation was reached. Interviews were transcribed and analyzed using a constant comparative method.Results: Four main themes related to adherence were identified: 1 symptom severity; 2 illness perception; 3 perceived benefits and risks of DMARDs; and 4 the quality and quantity of information about RA and DMARDs. In addition, patients’ suggestions about strategies to optimize adherence to DMARDs were captured and they fell within the following themes: 1 musculoskeletal ultrasound to explain the disease process and to provide objective feedback about the extent to which their disease activity is being effectively controlled; 2 better explanations of the consequences of poorly controlled RA; and 3 a good relationship with the health professional.Conclusion: Patients’ beliefs about medicines, perceptions about RA, and level of satisfaction with information about DMARDs influenced their adherence to DMARDs. The use

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

    Science.gov (United States)

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

    2014-01-01

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

  1. Motivational factors of adherence to cardiac rehabilitation.

    Science.gov (United States)

    Shahsavari, Hooman; Shahriari, Mohsen; Alimohammadi, Nasrollah

    2012-05-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    African Journals Online (AJOL)

    Godfrey Mutashambara Rwegerera

    2017-03-06

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    African Journals Online (AJOL)

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  7. The Influence of Goal Setting on Exercise Adherence.

    Science.gov (United States)

    Cobb, Lawrence E.; Stone, William J.; Anonsen, Lori J.; Klein, Diane A.

    2000-01-01

    Assessed the influence of fitness- and health-related goal setting on exercise adherence. Students in a college fitness program participated in goal setting, reading, or control groups. No significant differences in exercise adherence were found. Students enrolled for letter grades had more fitness center visits and hours of activity than students…

  8. Difference in adherence to and influencing factors of a healthy lifestyle between middle-aged and elderly people in Korea: A multilevel analysis.

    Science.gov (United States)

    Son, Ki Young; Park, Sang Min; Lee, Juhyun; Kim, Chang Yup

    2015-06-01

    Comprehensive research for factors related to healthy lifestyles of the elderly is limited. The present study aimed to elucidate the factors associated with adherence to a healthy lifestyle by age groups. The present study was based on data from the 2005 Korea National Health and Nutrition Examination Survey. We calculated crude proportions and adjusted proportions of cigarette smokers, problem alcohol drinkers, and physically inactive people in two age groups (40-59 years and ≥60 years). We carried out multilevel analysis to elucidate factors associated with healthy lifestyles. Of 3194 respondents included in the analysis, 1154 (36.13%) were aged 60 years or older. Older participants smoked less (23.0% vs 17.4%) and exercised less frequently (52.4% vs 66.9%; all P elderly (OR 1.037, 95% CI 1.005-1.070). Different factors were associated with healthy lifestyles of elderly people when compared with middle-aged people. In addition, local tax per capita, an area level variable, was more likely to be associated with smoking in the elderly than the middle-aged group. © 2014 Japan Geriatrics Society.

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

    Directory of Open Access Journals (Sweden)

    Ogundele OA

    2016-04-01

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

  10. Influence of intention to adhere, beliefs and satisfaction about medicines on adherence in solid organ transplant recipients.

    Science.gov (United States)

    Hugon, Amélie; Roustit, Matthieu; Lehmann, Audrey; Saint-Raymond, Christel; Borrel, Elisabeth; Hilleret, Marie-Noëlle; Malvezzi, Paolo; Bedouch, Pierrick; Pansu, Pascal; Allenet, Benoît

    2014-07-27

    Nonadherence to immunosuppressive (IS) therapy is associated with poor outcomes. Identifying factors predicting poor adherence is therefore essential. The primary objective of this study was to test whether parameters of a model adapted from the theory of planned behavior, and more specifically attitudes that are influenced by beliefs and satisfaction with medication, could predict adherence in solid organ transplant patients. Adherence was assessed with a self-reported medication adherence scale and IS blood trough concentrations over 6 months, in four transplant units. Satisfaction and beliefs were assessed using the Treatment Satisfaction with Medicines Questionnaire (SATMED-Q) and Beliefs about Medicines Questionnaire (BMQ), respectively. Theory of planned behavior was assessed with a specific questionnaire exploring intentions, subjective norms, attitudes and perceived behavioral control. Treatment characteristics and socioeconomic data were also collected. One hundred and fifty-three solid organ transplant patients were enrolled, including lung (n=33), heart (n=43), liver (n=42), and kidney (n=44) patients. Satisfaction and positive beliefs about medication were higher in adherent than those in nonadherent patients. Factors independently associated with an increased risk of nonadherence were negative general beliefs about medications (odds ratio [OR]=0.89 [0.83-0.97]), living alone (OR=2.78 [1.09-7.09]), heart transplantation (OR=3.49 [1.34-9.09]), and being on everolimus (OR=5.02 [1.21-20.8]). Negative beliefs toward medications were shown to be an independent risk factor of poor adherence. Therefore, the BMQ could be an effective, easy to implement tool, for use in everyday practice, to identify patients needing interventions to improve adherence to IS.

  11. The influence of adherent surface preparation on bond durability

    International Nuclear Information System (INIS)

    Rider, A.N.; Arnott, D.R.; Olsson-Jacques, C.L.

    1999-01-01

    Full text: One of the major factors limiting the use of adhesive bonding is the problem associated with the production of adhesive joints that can maintain their initial strength over long periods of time in hostile environments. It is well known that the adherent surface preparation method is critical to the formation of a durable adhesive bond. Work presented in this paper focuses on the critical aspects of the surface preparation of aluminium employed for the manufacture of aluminium-epoxy joints. The surface preparation procedure examined is currently employed by the RAAF for repairs requiring metal to adhesive bonding. The influence of each step in the surface preparation on the ultimate bond durability performance of the adhesive joint is examined by a combination of methods. Double cantilever wedge style adhesive joints are loaded in mode 1 opening and then exposed to a humid environment. X-ray photoelectron spectroscopy (XPS) and contact angle measurements of the aluminium adherent before bonding provides information about the adherent surface chemistry. XPS is also employed to analyse the surfaces of the bonded specimens post failure to establish the locus of fracture. This approach provides important information regarding the properties influencing bond durability as well as the bond failure mechanisms. A two step bond degradation model was developed to qualitatively describe the observed bond durability performance and fracture data. The first step involves controlled moisture ingress by stress induced microporosity of the adhesive in the interfacial region. The second step determines the locus of fracture through the relative dominance of one of three competitive processes, viz: oxide degradation, polymer desorption, or polymer degradation. A key element of the model is the control exercised over the interfacial microporosity by the combined interaction of stress and the relative densities of strong and weak linkages at the metal to adhesive interface

  12. Influence of irrigation regimens on the adherence of Enterococcus faecalis to root canal dentin.

    Science.gov (United States)

    Kishen, Anil; Sum, Chee-Peng; Mathew, Shibi; Lim, Chwee-Teck

    2008-07-01

    Enterococcus faecalis is frequently associated with post-treatment endodontic infections. Because adherence of bacteria to a substrate is the earliest stage in biofilm formation, eliciting the factors that links adherence of this bacterium to dentin would help in understanding its association with treatment-failed root canals. This investigation aimed to study the effects of endodontic irrigants on the adherence of E. faecalis to dentin. The bacteria adherence assay was conducted by using fluorescence microscopy, and the adhesion force was measured by using atomic force microscopy. There were significant increases in adherence and adhesion force after irrigation of dentin with ethylenediaminetetraacetic acid (EDTA), whereas sodium hypochlorite (NaOCl) reduced it. With the use of chlorhexidine (CHX), the force of adhesion increased, but the adherence assay showed a reduction in the number of adhering bacteria. The irrigation regimen of EDTA, NaOCl, and CHX resulted in the least number of adhering E. faecalis cells. This study highlighted that chemicals that alter the physicochemical properties of dentin will influence the nature of adherence, adhesion force, and subsequent biofilm formation of E. faecalis to dentin.

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

    African Journals Online (AJOL)

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

  14. Adherence treatment factors in hypertensive African American women

    Directory of Open Access Journals (Sweden)

    Marie N Fongwa

    2008-02-01

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

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

    Science.gov (United States)

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

    2008-12-01

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

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

    Science.gov (United States)

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

    2018-04-13

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

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

    Science.gov (United States)

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

    2014-01-01

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

  18. The influence of frailty syndrome on medication adherence among elderly patients with hypertension

    Directory of Open Access Journals (Sweden)

    Jankowska-Polańska B

    2016-12-01

    Full Text Available Beata Jankowska-Polańska,1 Krzysztof Dudek,2 Anna Szymanska-Chabowska,3 Izabella Uchmanowicz1 1Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, 2Department of Logistic and Transport Systems, Faculty of Mechanical Engineering, Wroclaw University of Technology, 3Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland Background: Hypertension affects about 80% of people older than 80 years; however, diagnosis and treatment are difficult because about 55% of them do not adhere to treatment recommendations due to low socioeconomic status, comorbidities, age, physical limitations, and frailty syndrome.Aims: The purposes of this study were to evaluate the influence of frailty on medication adherence among elderly hypertensive patients and to assess whether other factors influence adherence in this group of patients.Methods and results: The study included 296 patients (mean age 68.8±8.0 divided into frail (n=198 and non-frail (n=98 groups. The Polish versions of the Tilburg Frailty Indicator (TFI for frailty assessment and 8-item Morisky Medication Adherence Scale for adherence assessment were used. The frail patients had lower medication adherence in comparison to the non-frail subjects (6.60±1.89 vs 7.11±1.42; P=0.028. Spearman’s rank correlation coefficients showed that significant determinants with negative influence on the level of adherence were physical (rho =-0.117, psychological (rho =-0.183, and social domain (rho =-0.163 of TFI as well as the total score of the questionnaire (rho =-0.183. However, multiple regression analysis revealed that only knowledge about complications of untreated hypertension (β=0.395 and satisfaction with the home environment (β=0.897 were found to be independent stimulants of adherence level.Conclusion: Frailty is highly prevalent among elderly hypertensive patients. Higher level of frailty

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

    Science.gov (United States)

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

    1993-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Treuer T

    2016-05-01

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

  1. Factors Associated with Adherence to Follow-up Colposcopy

    Science.gov (United States)

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

    2013-01-01

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

  2. The influence of traditional and complementary and alternative medicine on medication adherence in Honduras.

    Science.gov (United States)

    Catalino, Michael Paul; Durón, Reyna Maria; Bailey, Julia Nancy; Holden, Kenton Roy

    2015-01-01

    Adherence to medication is a worldwide problem and deserves country-specific attention. Honduras, like many other countries, has allopathic providers, traditional medicine (TM), and complementary and alternative medicine (CAM). Understanding a population's health behaviors is essential to satisfactory integration of these systems and successful patient care. The objective was to identify factors that influence medication adherence in Honduras. The research team administered a cross-sectional, 25-item questionnaire to various neighborhoods based on national demographic statistics in order to obtain a quota sample. Setting • The survey took place in Tegucigalpa, Honduras, Central America. The research team surveyed 614 Hondurans, aged ≥ 18 y, within the general population of Tegucigalpa, the largest and capital city of Honduras, in neighborhoods representing areas where primarily the lower and middle classes lived. The primary outcome measure was a modified Medication Adherence Report Scale (MARS). Results • The research team collected 610 surveys that had complete answers to questions about adherence (610/614, 99.3%) total complete responses to other items varied. The prevalence of use of TM was 62.8% (381/607). Nearly one-half, 47.3% (287/607), of all the respondents had used herbs or teas for health in the prior year, and 26.1% (159/607) of all respondents had received a sobada (therapeutic rubbing). Respondents with daily private spiritual devotions (OR = 0.610, P = .018) and diabetes (OR = 0.154, P = .004) were less likely to report low adherence. Receiving a sobada and a history of fever were independently associated with low adherence (OR = 1.718, P = .017 and OR = 2.226, P < .001, respectively). Hondurans use both allopathic and TM. Although private spiritual devotion may help improve adherence to medication, only use of traditional massage therapy, the sobada, was associated with decreased adherence. Effective integration of alternative therapies in

  3. Adherence to cancer treatment guidelines: influence of general and cancer-specific guideline characteristics.

    NARCIS (Netherlands)

    Heins, M.J.; Jong, J.D. de; Spronk, I.; Ho, V.K.; Brink, M.; Korevaar, J.C.

    2017-01-01

    Background: Guideline adherence remains a challenge in clinical practice, despite guidelines’ ascribed potential to improve patient outcomes. We studied the level of adherence to recommendations from Dutch national cancer treatment guidelines, and the influence of general and

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Lidia Trachuk

    2016-09-01

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2014-09-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Al Jumah K

    2014-10-01

    patients in Saudi Arabia. Medication-taking behavior among depressed patients is influenced by several factors, mainly patients’ beliefs regarding antidepressants. This study has improved the understanding of the factors associated with adherence to antidepressants. Keywords: patient compliance, predictors, antidepressants, patients’ beliefs, depression, psychiatry

  11. [Natural factors influencing sleep].

    Science.gov (United States)

    Jurkowski, Marek K; Bobek-Billewicz, Barbara

    2007-01-01

    Sleep is a universal phenomenon of human and animal lives, although the importance of sleep for homeo-stasis is still unknown. Sleep disturbances influence many behavioral and physiologic processes, leading to health complications including death. On the other hand, sleep improvement can beneficially influence the course of healing of many disorders and can be a prognostic of health recovery. The factors influencing sleep have different biological and chemical origins. They are classical hormones, hypothalamic releasing and inhibitory hormones, neuropeptides, peptides and others as cytokines, prostaglandins, oleamid, adenosine, nitric oxide. These factors regulate most physiologic processes and are likely elements integrating sleep with physiology and physiology with sleep in health and disorders.

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

    Directory of Open Access Journals (Sweden)

    Amy H.Y. Chan

    2016-03-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  14. Eradication rate of Helicobacter Pylori infection is directly influenced by adherence to therapy in children.

    Science.gov (United States)

    Kotilea, Kallirroi; Mekhael, Joyce; Salame, Assaad; Mahler, Tania; Miendje-Deyi, Veronique Yvette; Cadranel, Samy; Bontems, Patrick

    2017-08-01

    Current commonly accepted strategies to eradicate Helicobacter pylori in children are a 10-day sequential treatment or a triple therapy for 7-14 days. To avoid further expensive and possibly risky investigations as well as induction of secondary antimicrobial resistance, a success rate of elimination strategies over 90% in a per-protocol analysis is the target goal but rates observed in clinical trials are lower. Antimicrobial resistance is a well-recognized risk factor for treatment failure; therefore, only a treatment tailored to susceptibility testing should be recommended. Adherence to therapy is also a risk factor for treatment failure but that has been poorly studied. The purpose of this study was to evaluate the influence of adherence to therapy on the elimination rates obtained with different treatment regimens. Cohort study analysis of children, aged 2-17 years, treated for Helicobacter pylori infection between October 2011 and December 2013. As a routine clinical practice, children infected with a strain susceptible to clarithromycin and to metronidazole received either a sequential regimen or a 10-day triple therapy while children infected with a strain resistant to clarithromycin or metronidazole received a 10-day triple regimen tailored to antimicrobial susceptibility. The eradication rate was assessed by a negative 13 C-urea breath test performed at least 8 weeks after the end of the treatment and adherence evaluated using a diary. One hundred forty-five children (67 girls/78 boys, median age 9.7 years) fulfilled the inclusion criteria, 118 being infected with a strain susceptible to both clarithromycin and metronidazole, 10 with a clarithromycin resistant, and 17 with a metronidazole resistant strain. A sequential regimen was prescribed in 44, a triple therapy containing clarithromycin in 84 and containing metronidazole in 17. Follow-up data were available for 130/145 and clearance of the infection observed in 105 of them. A concordance of more than

  15. Factors affecting adherence to a raw vegan diet.

    Science.gov (United States)

    Link, Lilli B; Jacobson, Judith S

    2008-02-01

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

  16. Factors affecting adherence to a raw vegan diet

    Science.gov (United States)

    Link, Lilli B.; Jacobson, Judith S.

    2008-01-01

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

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

    Science.gov (United States)

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

    2010-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Izabel Cristina Ribeiro da Silva Saccomann

    2014-02-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

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

    Science.gov (United States)

    Tedla, Y G; Bautista, L E

    2017-05-01

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

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

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    Wakibi Samwel N

    2011-12-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Madelon Novato Ribeiro

    2014-07-01

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

  4. Factors affecting adherence to a raw vegan diet

    OpenAIRE

    Link, Lilli B.; Jacobson, Judith S.

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Brett J

    2018-02-01

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

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

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    Brooke M Ramay

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

  7. What's in a setting?: Influence of organizational culture on provider adherence to clinical guidelines for treating tobacco use.

    Science.gov (United States)

    Hung, Dorothy Y; Leidig, Robynn; Shelley, Donna R

    2014-01-01

    Organizational culture is an important but underinvestigated feature of the work environment that can impact provider behavior, including adherence to clinical practice guidelines. There is substantial evidence that physician assistance to smokers can produce significant reductions in tobacco use. However, this evidence has not been well translated into practice, as only a small proportion of smokers receive recommended treatment during medical visits. This study examines organizational culture as a contextual feature of primary care clinics and its impact on adherence to evidence-based guidelines for treating tobacco use. Cross-sectional survey data were collected from 500 primary care providers in 60 community clinics located in New York City. Relationships between provider adherence to "5A" clinical guidelines, as recommended by the U.S. Public Health Service, and both provider and organizational covariates were described. We used hierarchical linear modeling to examine the associations between clinic culture and provider treatment patterns. Providers in clinics with stronger "group/clan," "hierarchical," and "rational" culture types, as compared with a "developmental" culture, reported greater adherence to 5A guidelines (p organizational culture can influence provider adherence to cessation treatment guidelines, even when controlling for other factors known to affect practice patterns. Specifically, cultures that emphasize human resources and performance standards are conducive to integrating 5A guidelines into routine practice. Understanding the role of organizational culture enables healthcare managers and practitioners to be strategic when implementing, and also sustaining, use of evidence-based guidelines.

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

    Science.gov (United States)

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

    2017-06-01

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

  9. Micronutrient supplementation adherence and influence on the prevalences of anemia and iron, zinc and vitamin A deficiencies in preemies with a corrected age of six months

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    Brunnella Alcantara Chagas de Freitas

    Full Text Available OBJECTIVE: To analyze adherence to the recommended iron, zinc and multivitamin supplementation guidelines for preemies, the factors associated with this adherence, and the influence of adherence on the occurrence of anemia and iron, zinc and vitamin A deficiencies. METHODS: This prospective cohort study followed 58 preemies born in 2014 until they reached six months corrected age. The preemies were followed at a referral secondary health service and represented 63.7% of the preterm infants born that year. Outcomes of interest included high or low adherence to iron, zinc and multivitamin supplementation guidelines; prevalence of anemia; and prevalences of iron, zinc, and vitamin A deficiencies. The prevalence ratios were calculated by Poisson regression. RESULTS: Thirty-eight (65.5% preemies presented high adherence to micronutrient supplementation guidelines. At six months of corrected age, no preemie had vitamin A deficiency. The prevalences of anemia, iron deficiency and zinc deficiency were higher in the low-adherence group but also concerning in the high-adherence group. Preemies with low adherence to micronutrient supplementation guidelines were 2.5 times more likely to develop anemia and 3.1 times more likely to develop zinc deficiency. Low maternal education level increased the likelihood of nonadherence to all three supplements by 2.2 times. CONCLUSIONS: Low maternal education level was independently associated with low adherence to iron, zinc and vitamin A supplementation guidelines in preemies, which impacted the prevalences of anemia and iron and zinc deficiencies at six months of corrected age.

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

    Science.gov (United States)

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

    2016-07-01

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

  11. Influence of the First Consultation on Adherence to Antiretroviral Therapy for HIV-infected Patients.

    Science.gov (United States)

    Peyre, Marion; Gauchet, Aurélie; Roustit, Matthieu; Leclercq, Pascale; Epaulard, Olivier

    2016-01-01

    Physician attitude influences the way patients cope with diagnosis and therapy in chronic severe diseases such as cancer. Previous studies showed that such an effect exists in HIV care; it is likely that it begins with the first contact with a physician. We aimed to explore in HIV-infected persons their perception of the first consultation they had with an HIV specialist (PFC-H), and whether this perception correlates with adherence to antiretroviral therapy. The study was conducted in Grenoble University Hospital, France, a tertiary care center. Every antiretroviral-experienced patient was asked to freely complete a self-reported, anonymous questionnaire concerning retrospective PFC-H, present adherence (Morisky scale), and present perceptions and beliefs about medicine (BMQ scale). One hundred and fifty-one questionnaires were available for evaluation. PFC-H score and adherence were correlated, independently from age, gender, and numbers of pill(s) and of pill intake(s) per day. BMQ score also correlated with adherence; structural equation analysis suggested that the effect of PFC-H on adherence is mediated by positive beliefs. These results suggest that for HIV-infected persons, the perceptions remaining from the first consultation with an HIV specialist physician influence important issues such as adherence and perception about medicine. Physicians must be aware of this potentially long-lasting effect.

  12. A theory led narrative review of one-to-one health interventions: the influence of attachment style and client-provider relationship on client adherence.

    Science.gov (United States)

    Nanjappa, S; Chambers, S; Marcenes, W; Richards, D; Freeman, R

    2014-10-01

    A theory-led narrative approach was used to unpack the complexities of the factors that enable successful client adherence following one-to-one health interventions. Understanding this could prepare the provider to anticipate different adherence behaviours by clients, allowing them to tailor their interventions to increase the likelihood of adherence. The review was done in two stages. A theoretical formulation was proposed to explore factors which influence the effectiveness of one-to-one interventions to result in client adherence. The second stage tested this theory using a narrative synthesis approach. Eleven studies across the health care arena were included in the synthesis and explored the interplay between client attachment style, client-provider interaction and client adherence with health interventions. It emerged that adherence results substantially because of the relationship that the client has with the provider, which is amplified or diminished by the client's own attachment style. This occurs because the client's attachment style shapes how they perceive and behave in relationships with the health-care providers, who become the 'secure base' from which the client accepts, assimilates and adheres with the recommended health intervention. The pathway from one-to-one interventions to adherence is explained using moderated mediation and mediated moderation models. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  13. Influence of marital status and employment status on long-term adherence with continuous positive airway pressure in sleep apnea patients.

    Science.gov (United States)

    Gagnadoux, Frédéric; Le Vaillant, Marc; Goupil, François; Pigeanne, Thierry; Chollet, Sylvaine; Masson, Philippe; Humeau, Marie-Pierre; Bizieux-Thaminy, Acya; Meslier, Nicole

    2011-01-01

    Long-term adherence is a major issue in patients receiving home continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea-hypopnea syndrome (OSAHS). In a multicenter prospective cohort (the Institut de Recherche en Santé Respiratoire des Pays de la Loire [IRSR] sleep cohort) of consecutive OSAHS patients in whom CPAP had been prescribed for at least 90 days, we studied the impact on long-term treatment adherence of socioeconomic factors, patients and disease characteristics prior to CPAP initiation. Among 1,141 patients in whom CPAP had been prescribed for an average of 504±251 days (range: 91 to 1035), 674 (59%) were adherent with a mean daily use of CPAP≥4 h (mean: 6.42±1.35 h). Stepwise regression analysis identified 4 independent factors of CPAP adherence including apnea-hypopnea index (AHI) (OR: 1.549, 95%CI 1.163 to 2.062 for AHI≥30 vs. AHIstatus (OR: 1.414, 95%CI 1.097-1.821 for retired vs. employed; p = 0.007) and marital status (OR: 1.482, 95%CI 1.088-2.019 for married or living as a couple vs. living alone; p = 0.01). Age, gender, Epworth sleepiness scale, depressive syndrome, associated cardiovascular morbidities, educational attainment and occupation category did not influence CPAP adherence. Marital status and employment status are independent factors of CPAP adherence in addition to BMI and disease severity. Patients living alone and/or working patients are at greater risk of non-adherence, whereas adherence is higher in married and retired patients. These findings suggest that the social context of daily life should be taken into account in risk screening for CPAP non-adherence. Future interventional studies targeting at-risk patients should be designed to address social motivating factors and work-related barriers to CPAP adherence.

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

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    Behzad Gholamaliei

    2016-03-01

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

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

    Science.gov (United States)

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

    2014-03-01

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

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

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    Lippert Dustin ND

    2012-04-01

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

  17. Influence of subinhibitory concentrations of antimicrobials on hydrophobicity, adherence and ultra-structure of Fusobacterium nucleatum

    Directory of Open Access Journals (Sweden)

    Okamoto Ana C.

    2002-01-01

    Full Text Available Fusobacterium nucleatum is considered a bridge organism between earlier and later colonizers in dental biofilms and a putative periodontopathogen. In Dentistry, antimicrobial agents are used for treatment and control of infectious diseases associated with dental plaque. Antiseptics have been used in association with antibiotics to reduce infections after oral surgeries. In this study, the influence of subinhibitory concentrations (SC of chlorhexidine, triclosan, penicillin G and metronidazole, on hydrophobicity, adherence to oral epithelial cells, and ultra-structure of F. nucleatum was examined. All isolates were susceptible to chlorhexidine, triclosan, and metronidazole; however, most of the isolates were susceptible to penicillin G, and all of them were hydrophilic when grown with or without antimicrobials. Adherence was decreased by all antimicrobials. Results suggest that adherence of F. nucleatum was influenced by adhesins because structures such as fimbries or capsule were not observed by transmission electronic microscope.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2015-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Sobha Pahari

    2015-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

  2. Human factors influencing decision making

    OpenAIRE

    Jacobs, Patricia A.

    1998-01-01

    This report supplies references and comments on literature that identifies human factors influencing decision making, particularly military decision making. The literature has been classified as follows (the classes are not mutually exclusive): features of human information processing; decision making models which are not mathematical models but rather are descriptive; non- personality factors influencing decision making; national characteristics influencing decision makin...

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

    Science.gov (United States)

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

    2017-10-01

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

  4. Patient adherence with COPD therapy

    Directory of Open Access Journals (Sweden)

    C. S. Rand

    2005-12-01

    Full Text Available Although there are very few published studies on adherence to treatment regimens in chronic obstructive pulmonary disease (COPD, the evidence that exists suggests that, as with asthma therapy, adherence is poor. Patient beliefs about COPD, as well as their motivation and expectations about the likelihood of success of medical interventions, can influence adherence rates. Other critical factors include the patient's understanding of their illness and therapy, and the complexity of the prescribed treatment regimen. Incorrect inhaler technique is also a common failing. When prescribing in primary or specialist care, healthcare professionals should address adherence as a vital part of the patient consultation. Improved patient education may also increase adherence rates.

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

    Science.gov (United States)

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

    2017-12-01

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

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

    Science.gov (United States)

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

    2013-02-01

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

  7. Pre-Participation Physical Fitness does not Influence Adherence to a Supervised Exercise Program

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    Fábio Akio Nishijuka

    2017-08-01

    Full Text Available Abstract Background: Exercise-based cardiac rehabilitation tends to reduce mortality. However, it requires medium/long-term adherence to regular physical exercise. It is relevant to identify the variables that affect adherence to an supervised exercise program (SEP. Objective: To evaluate the influence of pre-participation levels of aerobic and non-aerobic physical fitness components in medium-term adherence to SEP. Methods: A total of 567 SEP participants (65 ± 12 years (68% men were studied. Participants adherent to the program for less than 6 months (48% (non-adherent - NAD were compared with 52% of participants who were adherent for 6 months or more (adherents - AD. In the non-aerobic fitness, flexibility (FLX (Flexitest and muscle power (MPW/body weight in standing rowing (watts/kg were evaluated while aerobic fitness was obtained by direct measure of VO2max/body weight (VO2. These measurements were normatized for sex and age based on percentiles (P (P-FLX/P-MPW of reference data or percentages of predicted (P-VO2. Additionally, AD and NAD with extreme results (tertiles were simultaneously compared for the three variables. Results: There was no difference between AD and NAD for non-aerobic results, in median [P25-P75], P-FLX: 30 [13-56] and 31 [9-52], respectively, (p = 0.69 and P-MPW: 34 [17-58] and 36 [16-62], respectively (p = 0.96, and for aerobic results (mean ± standard error P-VO2 (75.9 ± 1.3% and 75.0 ± 1.3%, respectively (p = 0.83. When comparing extreme tertiles, a difference was found for P-MPW in the lower tertile only, with a slight advantage of AD over NAD- 9 [5-16] versus 4 [1-11] (p = 0.04. Conclusion: Although awareness of the pre-participation levels of aerobic and non-aerobic physical fitness components is useful for individualized exercise prescription, these variables do not seem to influence medium-term adherence to SEP.

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

    Directory of Open Access Journals (Sweden)

    Lee Mei-Ling Ting

    2001-12-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-11-17

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

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

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    Oluseun P. Ogunnubi

    2017-03-01

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

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

    African Journals Online (AJOL)

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

  13. Factors influencing plant invasiveness

    Science.gov (United States)

    Yvette Ortega; Dean Pearson

    2009-01-01

    Invasiveness of spotted knapweed and biological control agents. Dean and Yvette are examining the influence of drought on the invasiveness of spotted knapweed (Centaurea maculosa) and its susceptibility to herbivory by biological control agents. In collaboration with the University of Montana and Forest Health Protection, researchers have constructed 150...

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

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    Prisla Ücker Calvetti

    2014-03-01

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

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

    Science.gov (United States)

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

    2012-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Ala'a Alkerwi

    2015-03-01

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

  17. Influence of the First Consultation on Adherence to Antiretroviral Therapy for HIV-infected Patients

    OpenAIRE

    Peyre, Marion; Gauchet, Aur?lie; Roustit, Matthieu; Leclercq, Pascale; Epaulard, Olivier

    2016-01-01

    Background: Physician attitude influences the way patients cope with diagnosis and therapy in chronic severe diseases such as cancer. Previous studies showed that such an effect exists in HIV care; it is likely that it begins with the first contact with a physician. Objective: We aimed to explore in HIV-infected persons their perception of the first consultation they had with an HIV specialist (PFC-H), and whether this perception correlates with adherence to antiretroviral therapy. Method: Th...

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    Science.gov (United States)

    Efe, Dilek; Kocaöz, Semra

    2015-04-01

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

  1. Factors Influencing of Social Conflict

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    Suwandi Sumartias

    2013-07-01

    Full Text Available Social conflicts that occur in several areas in Indonesia lately, one of them is caused by the weakness of law certainty. This is feared to threaten the integration of the Republic of Indonesia. This study aims to determine the factors that affect social conflict in Manis Lor village in Kuningan district. The method used the explanatory quantitative methods, the statistical test Path Analysis. The study population was a formal and informal community leaders (village chief, clergy, and youth, and the people who involved in a conflict in Manis Lor village Kuningan regency. The result shows a There is no significant influence between social identity factors with social conflict anarchist. b There is significant influence between socio-economic factors with social conflict anarchists. c There is no significant influence between the credibility factor anarchist leaders with social conflict. d There is no significant influence between the motive factor with anarchist social conflict. e There is significant influence between personality factors/beliefs with anarchist social conflict. f There is significant influence of behavioral factors anarchist communication with social conflict.

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

    Science.gov (United States)

    Ali, Muhammed; Alemu, Tigestu; Sada, Oumer

    2017-12-04

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

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

    Directory of Open Access Journals (Sweden)

    Ishibashi Teruo

    2006-11-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Cugelman, Brian; Thelwall, Mike; Dawes, Phil

    2011-02-14

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

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

    Directory of Open Access Journals (Sweden)

    Natalia V. Likhodey

    2018-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Sabrina K Been

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

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

    Directory of Open Access Journals (Sweden)

    Lambert-Kerzner A

    2015-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Pierobon A

    2017-07-01

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

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

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    Nur Aishah Taib

    2017-12-01

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

  11. factors influencing adherence to arvs among patients attending

    African Journals Online (AJOL)

    2014-04-01

    Apr 1, 2014 ... Research Institute, P. O. Box 54840-00200, Nairobi and S.M. Karanja, BSc, MSc, PhD, College of ... (P=0.025); the number of meals respondents took in a day (P = 0.001); pill burden (P ... The study is important to health policy makers with ... characteristics, stigma, side effects associated with ... 210 (70.0).

  12. Influence of patients' disease knowledge and beliefs about medicines on medication adherence: findings from a cross-sectional survey among patients with type 2 diabetes mellitus in Palestine.

    Science.gov (United States)

    Sweileh, Waleed M; Zyoud, Sa'ed H; Abu Nab'a, Rawan J; Deleq, Mohammed I; Enaia, Mohammed I; Nassar, Sana'a M; Al-Jabi, Samah W

    2014-01-30

    Diabetes mellitus (DM) is a common serious health problem. Medication adherence is a key determinant of therapeutic success in patients with diabetes mellitus. The purpose of this study was to assess medication adherence and its potential association with beliefs and diabetes - related knowledge in patients with type II DM. This study was carried out at Al-Makhfia governmental diabetes primary healthcare clinic in Nablus, Palestine. Main outcome of interest in the study was medication adherence. The Beliefs about Medicines Questionnaire (BMQ) was used to assess beliefs. Morisky Medication Adherence Scale (MMSA-8©) was used to assess medication adherence. The Michigan diabetes knowledge test (MDKT) was used to assess diabetes - related knowledge. Univariate and multivariate analysis were carried out using Statistical Package for Social Sciences (SPSS 20). Four hundred and five patients were interviewed. The mean ± SD age of the participants was 58.3 ± 10.4 (range = 28 - 90) years. More than half (53.3%) of the participants were females. Approximately 42.7% of the study sample were considered non-adherent (MMAS-8© score of knowledge, beliefs about necessity of anti-diabetic medications, concerns about adverse consequences of anti-diabetic medications and beliefs that medicines in general are essentially harmful. Diabetic patients with high knowledge score and those with strong beliefs in the necessity of their anti-diabetic medications were less likely to be non-adherent ([O.R = 0.87, 95% CI of 0.78 - 0.97] and [O.R = 0.93, 95% of 0.88 - 0.99] respectively). However, diabetic patients with high concerns about adverse consequences of anti-diabetic medications and those with high belief that all medicines are harmful were more likely to be non-adherent ([O.R = 1.09; 95% C.I of 1.04 - 1.16] and [O.R = 1.09, 95% C.I of 1.02 - 1.16] respectively). Beliefs and knowledge are important factors in understanding variations in medication

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  15. Factors influencing women's decisions to purchase specific ...

    African Journals Online (AJOL)

    aimed at identifying the factors that influence women's decisions to purchase specific .... influence of all the factors influencing their decision to purchase a selected .... one free” promotions seemed to have had the greatest influence on this ...

  16. FACTORS INFLUENCING SECOND LANGUAGE ACQUISITION

    Directory of Open Access Journals (Sweden)

    Siti Khasinah

    2014-05-01

    Full Text Available Motivation, attitude, age, intelligence, aptitude, cognitive style, and personality are considered as factors that greatly influence someone in the process of his or her second language acquisition. Experts state that those factors give a more dominant contribution in SLA to learners variedly, depend on who the learners are, their age, how they behave toward the language, their cognitive ability, and also the way they learn.

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

    Science.gov (United States)

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

    2015-09-01

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

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

    Science.gov (United States)

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

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

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  1. Factors influencing bone scan quality

    International Nuclear Information System (INIS)

    Adams, F.G.; Shirley, A.W.

    1983-01-01

    A reliable subjective method of assessing bone scan quality is described. A large number of variables which theoretically could influence scan quality were submitted to regression and factor analysis. Obesity, age, sex and abnormality of scan were found to be significant but weak variables. (orig.)

  2. Patients’ perception regarding the influence of individual and social vulnerabilities on the adherence to tuberculosis treatment: a qualitative study

    Directory of Open Access Journals (Sweden)

    Rosiane Davina da Silva

    2017-09-01

    Full Text Available Abstract Background Tuberculosis remains an important disease which mainly affects the majority of vulnerable individuals in society, who are subjected to poor living conditions and difficulties to access the services of public health. Under these circumstances, the present study aims to understand patients’ perception in relation to the influence of individual and social vulnerabilities on the adherence to tuberculosis treatment. Methods A qualitative descriptive cross sectional study was conducted in one large municipality at the state of Paraíba, Northeast of Brazil. The study subjects, who were residents of the study site, covered all tuberculosis cases diagnosed between March and June 2015. The sample was defined by the criteria of response saturation. All interviews were audio recorded, and data analysis was developed through the hermeneutic dialectic method and the theory of Generative Route Sense. The project was approved by the Research Ethics Committee of the University of São Paulo (USP. Results A total of 13 individuals were interviewed and the responses were identified into two analytical categories: the difficulties they had and the enabling factors they could mention during their tuberculosis treatment. Patients brought up social exclusion as an obstacle to treatment adherence, which, along with stigmatization, weakened their link with family members and health professionals. Moreover, economic precariousness was a major hindrance to the maintenance of a proper diet and transportation access to health centers. However, social support and directly observed treatment helped to break down barriers of prejudice and to promote individual and family empowerment. Finally, patients also reported that their will to live and faith gave them the strength to continue with the treatment. Conclusions According to patients in this study, social support and the strengthening of links with family members and health professionals may reduce

  3. Patients' perception regarding the influence of individual and social vulnerabilities on the adherence to tuberculosis treatment: a qualitative study.

    Science.gov (United States)

    da Silva, Rosiane Davina; de Luna, Fernanda Darliane Tavares; de Araújo, Aguinaldo José; Camêlo, Edwirde Luiz Silva; Bertolozzi, Maria Rita; Hino, Paula; Lacerda, Sheylla Nadjane Batista; Fook, Sayonara Maria Lia; de Figueiredo, Tânia Maria Ribeiro Monteiro

    2017-09-19

    Tuberculosis remains an important disease which mainly affects the majority of vulnerable individuals in society, who are subjected to poor living conditions and difficulties to access the services of public health. Under these circumstances, the present study aims to understand patients' perception in relation to the influence of individual and social vulnerabilities on the adherence to tuberculosis treatment. A qualitative descriptive cross sectional study was conducted in one large municipality at the state of Paraíba, Northeast of Brazil. The study subjects, who were residents of the study site, covered all tuberculosis cases diagnosed between March and June 2015. The sample was defined by the criteria of response saturation. All interviews were audio recorded, and data analysis was developed through the hermeneutic dialectic method and the theory of Generative Route Sense. The project was approved by the Research Ethics Committee of the University of São Paulo (USP). A total of 13 individuals were interviewed and the responses were identified into two analytical categories: the difficulties they had and the enabling factors they could mention during their tuberculosis treatment. Patients brought up social exclusion as an obstacle to treatment adherence, which, along with stigmatization, weakened their link with family members and health professionals. Moreover, economic precariousness was a major hindrance to the maintenance of a proper diet and transportation access to health centers. However, social support and directly observed treatment helped to break down barriers of prejudice and to promote individual and family empowerment. Finally, patients also reported that their will to live and faith gave them the strength to continue with the treatment. According to patients in this study, social support and the strengthening of links with family members and health professionals may reduce social exclusion and other difficulties they face, thus encouraging them

  4. Major drivers influencing adherence and quality of life during antiviral triple therapy in patients with chronic hepatitis C

    Directory of Open Access Journals (Sweden)

    Suceveanu Andra I.

    2016-05-01

    Full Text Available Background & Aims. Triple therapy with Peg-IFNs, Ribavirin and protease inhibitors raise the treatment success for hepatitis C up to 83%, but also bring together with the significantly higher rates of sustained virologic response (SVR more side effects, interfering with patient’s quality of life (QoL and work productivity. We aimed to analyze the factors influencing the adherence and the QoL during triple therapy using Peg-IFNs, Ribavirin and protease inhibitors in 50 patients diagnosed with chronic hepatitis C with first line therapy failure. Multivariate Cox proportional hazards regression was used to analyze determinants of retreatment initiation and treatment compliance, according to patient features. Results: We identified as major drivers of retreatment initiation the younger age, the female gender, the urban provenience, the high income, and the psychiatric and alcohol or drugs abuse history. The adherence and the QoL during retreatment therapy were similar, despite the regimen used, and obvious lower in patients with history of previous abandon, drugs and alcohol abuse or hematologic/ psychiatric decompensation. A lower capacity to work and a temporary withdrawal from job necessary to continue the therapy were seen similar in patients taking Boceprevir/Telaprevir. Abandon of therapy without a known reason was more frequent in males, with alcohol and drugs intake history, from rural region, with low income, and with psychiatric disturbances in personal history. Conclusion. Physicians should focus to develop medical strategies or drugs to increase the adherence and to provide a better QoL for patients with chronic hepatitis C making antiviral therapy.

  5. What factors influence mitigative capacity?

    International Nuclear Information System (INIS)

    Winkler, Harald; Baumert, Kevin; Blanchard, Odile; Burch, Sarah; Robinson, John

    2007-01-01

    This article builds on Yohe's seminal piece on mitigative capacity, which elaborates 'determinants' of mitigative capacity, also reflected in the IPCC's third assessment report. We propose a revised definition, where mitigative capacity is a country's ability to reduce anthropogenic greenhouse gas emissions or enhance natural sinks. By 'ability' we mean skills, competencies, fitness, and proficiencies that a country has attained which can contribute to GHG emissions mitigation. A conceptual framework is proposed, linking mitigative capacity to a country's sustainable development path, and grouping the factors influencing mitigative capacity into three main sets: economic factors, institutional ones, and technology. Both quantitative and qualitative analysis of factors is presented, showing how these factors vary across countries. We suggest that it is the interplay between the three economic factors-income, abatement cost and opportunity cost-that shape mitigative capacity. We find that income is an important economic factor influencing mitigative capacity, while abatement cost is important in turning mitigative capacity into actual mitigation. Technology is a critical mitigative capacity, including the ability to absorb existing climate-friendly technologies or to develop innovative ones. Institutional factors that promote mitigative capacity include the effectiveness of government regulation, clear market rules, a skilled work force and public awareness. We briefly investigate such as high abatement cost or lack of political willingness that prevent mitigative capacity from being translated into mitigation

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

    Science.gov (United States)

    Kioko, Mary T; Pertet, Anne M

    2017-07-31

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

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

    Science.gov (United States)

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

    2014-03-01

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

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

    Science.gov (United States)

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

    2017-10-26

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

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

    Science.gov (United States)

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

    2015-10-01

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

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

    Science.gov (United States)

    Thelwall, Mike; Dawes, Phil

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Salem Gugsa

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

  12. The influence of cultural and religious orientations on social support and its potential impact on medication adherence

    Directory of Open Access Journals (Sweden)

    Hatah E

    2015-04-01

    Full Text Available Ernieda Hatah,1 Kien Ping Lim,1,2 Adliah Mohd Ali,1 Noraida Mohamed Shah,1 Farida Islahudin1 1Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 2Pharmacy Department, Kuala Lumpur General Hospital, Jalan Pahang, Kuala Lumpur, Malaysia Purpose: Social support can positively influence patients’ health outcomes through a number of mechanisms, such as increases in patients’ adherence to medication. Although there have been studies on the influence of social support on medication adherence, these studies were conducted in Western settings, not in Asian settings where cultural and religious orientations may be different. The objective of this study was to assess the effects of cultural orientation and religiosity on social support and its relation to patients’ medication adherence. Methods: This was a cross-sectional study of patients with chronic diseases in two tertiary hospitals in Selangor, Malaysia. Patients who agreed to participate in the study were asked to answer questions in the following areas: 1 perceived group and higher authority cultural orientations; 2 religiosity: organizational and non-organizational religious activities, and intrinsic religiosity; 3 perceived social support; and 4 self-reported medication adherence. Patients’ medication adherence was modeled using multiple logistic regressions, and only variables with a P-value of <0.25 were included in the analysis. Results: A total of 300 patients completed the questionnaire, with the exception of 40 participants who did not complete the cultural orientation question. The mean age of the patients was 57.6±13.5. Group cultural orientation, organizational religious activity, non-organizational religious activity, and intrinsic religiosity demonstrated significant associations with patients’ perceived social support (r=0.181, P=0.003; r=0.230, P<0.001; r=0.135, P=0.019; and r=0.156, P=0.007, respectively. In the medication adherence model

  13. College factors that influence drinking.

    Science.gov (United States)

    Presley, Cheryl A; Meilman, Philip W; Leichliter, Jami S

    2002-03-01

    The purpose of this article is to examine the aspects of collegiate environments, rather than student characteristics, that influence drinking. Unfortunately, the existing literature is scant on this topic. A literature review of articles primarily published within the last 10 years, along with some earlier "landmark" studies of collegiate drinking in the United States, was conducted to determine institutional factors that influence the consumption of alcohol. In addition, a demonstration analysis of Core Alcohol and Drug Survey research findings was conducted to further elucidate the issues. Several factors have been shown to relate to drinking: (1) organizational property variables of campuses, including affiliations (historically black institutions, women's institutions), presence of a Greek system, athletics and 2- or 4-year designation; (2) physical and behavioral property variables of campuses, including type of residence, institution size, location and quantity of heavy episodic drinking; and (3) campus community property variables, including pricing and availability and outlet density. Studies, however, tend to look at individual variables one at a time rather than in combination (multivariate analyses). Some new analyses, using Core Alcohol and Drug Survey data sets, are presented as examples of promising approaches to future research. Given the complexities of campus environments, it continues to be a challenge to the field to firmly establish the most compelling institutional and environmental factors relating to high-risk collegiate drinking.

  14. Factors Influencing Healthcare Service Quality

    Directory of Open Access Journals (Sweden)

    Ali Mohammad Mosadeghrad

    2014-07-01

    Full Text Available Background The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality.

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

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    Fatemeh Bazarganipour

    2017-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Maria Letícia Santos Cruz

    2016-06-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-06-21

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

  19. Factors associated with non-adherence to antiretroviral therapy in adults with AIDS in the first six months of treatment in Salvador, Bahia State, Brazil.

    Science.gov (United States)

    Silva, José Adriano Góes; Dourado, Inês; Brito, Ana Maria de; Silva, Carlos Alberto Lima da

    2015-06-01

    The control of viral replication is essential in the highly active antiretroviral therapy (HAART), and adherence to therapy is instrumental for such control. Individual and external factors influence adhesion to the use of antiretroviral (ARV) drugs. This is a cross-sectional study to investigate factors associated with non-adherence to HAART in AIDS patients in Salvador, Bahia State, Brazil, with age ≥ 13 years and first prescription in 2009. Data was collected from patient charts and pharmacy records. From a total of 216 patients, 65.3% were males; mean age 37.8 ± 9.5 years; single, 67.9%; heterosexual, 64%; more than 8 years of school education, 65.3%; alcohol users, 61.5%; non-smokers, 75,1% or non-illicit drug users, 93.7%. A proportion of 94% started ARV therapy with TCD4+ drug reaction. The prevalence of non-adherence was 25%. The variables associated were: longer time between HIV infection and AIDS (aOR = 3.9), adverse drug reaction (aOR = 2.4), under 34 years of age (aOR = 2.2), less than 8 years of school education (aOR = 2.2) and illicit drugs use (aOR = 2.6). A high-non-adherence rate is an important problem within the first six months of HAART.

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

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    Silva Vilma A da

    2003-01-01

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

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

    OpenAIRE

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

    2017-01-01

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

  2. Systematic review with meta-analysis: Dietary adherence influences normalization of health-related quality of life in coeliac disease

    NARCIS (Netherlands)

    Burger, J.P.; Brouwer, B. de; Hout, J. in't; Wahab, P.J.; Tummers, M.J.; Drenth, J.P.H.

    2017-01-01

    BACKGROUND & AIMS: Gluten-free diet is the keystone of coeliac disease treatment. Despite adherence, some patients continue to suffer from symptoms that negatively influence health-related quality of life (HRQoL). Therefore we performed a systematic review and meta-analysis to assess the effect of

  3. Factors Influencing Learner Permit Duration

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    Johnathon P. Ehsani

    2016-12-01

    Full Text Available An increasing number of countries are requiring an extended learner permit prior to independent driving. The question of when drivers begin the learner permit period, and how long they hold the permit before advancing to independent licensure has received little research attention. Licensure timing is likely to be related to “push” and “pull” factors which may encourage or inhibit the process. To examine this question, we recruited a sample of 90 novice drivers (49 females and 41 males, average age of 15.6 years soon after they obtained a learner permit and instrumented their vehicles to collect a range of driving data. Participants completed a series of surveys at recruitment related to factors that may influence licensure timing. Two distinct findings emerged from the time-to-event analysis that tested these push and pull factors in relation to licensure timing. The first can be conceptualized as teens’ motivation to drive (push, reflected in a younger age when obtaining a learner permit and extensive pre-permit driving experience. The second finding was teens’ perceptions of their parents’ knowledge of their activities (pull; a proxy for a parents’ attentiveness to their teens’ lives. Teens who reported higher levels of their parents’ knowledge of their activities took longer to advance to independent driving. These findings suggest time-to-licensure may be related to teens’ internal motivation to drive, and the ability of parents to facilitate or impede early licensure.

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

    Directory of Open Access Journals (Sweden)

    Shirley A. Wells

    2015-03-01

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

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

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    Surilena

    2015-08-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  7. Factors influencing knowledge and practice of exclusive ...

    African Journals Online (AJOL)

    Factors influencing knowledge and practice of exclusive breastfeeding in Nyando ... The overall objective of this study was to determine factors influencing the ... EBF and its benefits), pre lacteal feeds and exclusive breastfeeding consistency.

  8. Factors influencing bacterial adhesion to contact lenses.

    Science.gov (United States)

    Dutta, Debarun; Cole, Nerida; Willcox, Mark

    2012-01-01

    The process of any contact lens related keratitis generally starts with the adhesion of opportunistic pathogens to contact lens surface. This article focuses on identifying the factors which have been reported to affect bacterial adhesion to contact lenses. Adhesion to lenses differs between various genera/species/strains of bacteria. Pseudomonas aeruginosa, which is the predominant causative organism, adheres in the highest numbers to both hydrogel and silicone hydrogel lenses in vitro. The adhesion of this strain reaches maximum numbers within 1h in most in vitro studies and a biofilm has generally formed within 24 h of cells adhering to the lens surface. Physical and chemical properties of contact lens material affect bacterial adhesion. The water content of hydroxyethylmethacrylate (HEMA)-based lenses and their iconicity affect the ability of bacteria to adhere. The higher hydrophobicity of silicone hydrogel lenses compared to HEMA-based lenses has been implicated in the higher numbers of bacteria that can adhere to their surfaces. Lens wear has different effects on bacterial adhesion, partly due to differences between wearers, responses of bacterial strains and the ability of certain tear film proteins when bound to a lens surface to kill certain types of bacteria.

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

    Science.gov (United States)

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

    2010-12-01

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

  10. How should a virtual agent present psychoeducation? Influence of verbal and textual presentation on adherence

    NARCIS (Netherlands)

    Tielman, M.L.; Neerincx, M.A.; Meggelen, M. van; Franken, I.; Brinkman, W.P.

    2017-01-01

    BACKGROUND AND OBJECTIVE: With the rise of autonomous e-mental health applications, virtual agents can play a major role in improving trustworthiness, therapy outcome and adherence. In these applications, it is important that patients adhere in the sense that they perform the tasks, but also that

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

    Science.gov (United States)

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

    2016-12-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  13. Factors influencing bacterial adhesion to contact lenses

    OpenAIRE

    Dutta, Debarun; Cole, Nerida; Willcox, Mark

    2012-01-01

    The process of any contact lens related keratitis generally starts with the adhesion of opportunistic pathogens to contact lens surface. This article focuses on identifying the factors which have been reported to affect bacterial adhesion to contact lenses. Adhesion to lenses differs between various genera/species/strains of bacteria. Pseudomonas aeruginosa, which is the predominant causative organism, adheres in the highest numbers to both hydrogel and silicone hydrogel lenses in vitro. The ...

  14. Parents of children with physical disabilities perceive that characteristics of home exercise programs and physiotherapists' teaching styles influence adherence: a qualitative study.

    Science.gov (United States)

    Lillo-Navarro, Carmen; Medina-Mirapeix, Francesc; Escolar-Reina, Pilar; Montilla-Herrador, Joaquina; Gomez-Arnaldos, Francisco; Oliveira-Sousa, Silvana L

    2015-04-01

    What are the perceptions of parents of children with physical disabilities about the home exercise programs that physiotherapists prescribe? How do these perceptions affect adherence to home exercise programs? Qualitative study using focus groups and a modified grounded theory approach. Parents of children with physical disabilities who have been prescribed a home exercise program by physiotherapists. Twenty-eight parents participated in the focus groups. Two key themes that related to adherence to home exercise programs in young children with physical disabilities were identified: the characteristics of the home exercise program; and the characteristics of the physiotherapist's teaching style. In the first theme, the participants described their experiences regarding their preference for exercises, which was related to the perceived effects of the exercises, their complexity, and the number of exercises undertaken. These factors determined the amount of time spent performing the exercises, the effect of the exercises on the family's relationships, and any sense of related burden. In the second theme, participants revealed that they adhered better to prescribed exercises when their physiotherapist made an effort to build their confidence in the exercises, helped the parents to incorporate the home exercise program into their daily routine, provided incentives and increased motivation. Parents perceive that their children's adherence to home-based exercises, which are supervised by the parents, is more successful when the physiotherapist's style and the content of the exercise program are positively experienced. These findings reveal which issues should be considered when prescribing home exercise programs to children with physical disabilities. [Lillo-Navarro C, Medina-Mirapeix F, Escolar-Reina P, Montilla-Herrador J, Gomez-Arnaldos F, Oliveira-Sousa SL (2015) Parents of children with physical disabilities perceive that characteristics of home exercise programs and

  15. Assessing the influence of health systems on Type 2 Diabetes Mellitus awareness, treatment, adherence, and control: A systematic review.

    Science.gov (United States)

    Ong, Suan Ee; Koh, Joel Jun Kai; Toh, Sue-Anne Ee Shiow; Chia, Kee Seng; Balabanova, Dina; McKee, Martin; Perel, Pablo; Legido-Quigley, Helena

    2018-01-01

    Type 2 Diabetes Mellitus (T2DM) is reported to affect one in 11 adults worldwide, with over 80% of T2DM patients residing in low-to-middle-income countries. Health systems play an integral role in responding to this increasing global prevalence, and are key to ensuring effective diabetes management. We conducted a systematic review to examine the health system-level factors influencing T2DM awareness, treatment, adherence, and control. A protocol for this study was published on the PROSPERO international prospective register of systematic reviews (PROSPERO 2016: CRD42016048185). Studies included in this review reported the effects of health systems factors, interventions, policies, or programmes on T2DM control, awareness, treatment, and adherence. The following databases were searched on 22 February 2017: Medline, Embase, Global health, LILACS, Africa-Wide, IMSEAR, IMEMR, and WPRIM. There were no restrictions on date, language, or study designs. Two reviewers independently screened studies for eligibility, extracted the data, and screened for risk of bias. Thereafter, we performed a narrative synthesis. A meta-analysis was not conducted due to methodological heterogeneity across different aspects of included studies. 93 studies were included for qualitative synthesis; 7 were conducted in LMICs. Through this review, we found two key health system barriers to effective T2DM care and management: financial constraints faced by the patient and limited access to health services and medication. We also found three health system factors that facilitate effective T2DM care and management: the use of innovative care models, increased pharmacist involvement in care delivery, and education programmes led by healthcare professionals. This review points to the importance of reducing, or possibly eliminating, out-of-pocket costs for diabetes medication and self-monitoring supplies. It also points to the potential of adopting more innovative and integrated models of care, and the

  16. Physiological factors influencing capillary growth.

    Science.gov (United States)

    Egginton, S

    2011-07-01

    (1) Angiogenesis (growth of new capillaries from an existing capillary bed) may result from a mismatch in microvascular supply and metabolic demand (metabolic error signal). Krogh examined the distribution and number of capillaries to explore the correlation between O(2) delivery and O(2) consumption. Subsequently, the heterogeneity in angiogenic response within a muscle has been shown to reflect either differences in fibre type composition or mechanical load. However, local control leads to targetted angiogenesis in the vicinity of glycolytic fibre types following muscle stimulation, or oxidative fibres following endurance training, while heterogeneity of capillary spacing is maintained during ontogenetic growth. (2) Despite limited microscopy resolution and lack of specific markers, Krogh's interest in the structure of the capillary wall paved the way for understanding the mechanisms of capillary growth. Angiogenesis may be influenced by the response of perivascular or stromal cells (fibroblasts, macrophages and pericytes) to altered activity, likely acting as a source for chemical signals modulating capillary growth such as vascular endothelial growth factor. In addition, haemodynamic factors such as shear stress and muscle stretch play a significant role in adaptive remodelling of the microcirculation. (3) Most indices of capillarity are highly dependent on fibre size, resulting in possible bias because of scaling. To examine the consequences of capillary distribution, it is therefore helpful to quantify the area of tissue supplied by individual capillaries. This allows the spatial limitations inherent in most models of tissue oxygenation to be overcome generating an alternative approach to Krogh's tissue cylinder, the capillary domain, to improve descriptions of intracellular oxygen diffusion. © 2010 The Author. Acta Physiologica © 2010 Scandinavian Physiological Society.

  17. Factors Influencing HEPA Filter Performance

    International Nuclear Information System (INIS)

    Parsons, M.S.; Waggoner, Ch.A.

    2009-01-01

    Properly functioning HEPA air filtration systems depend on a variety of factors that start with the use of fully characterized challenge conditions for system design and then process control during operation. This paper addresses factors that should be considered during the design phase as well as operating parameters that can be monitored to ensure filter function and lifetime. HEPA filters used in nuclear applications are expected to meet design, fabrication, and performance requirements set forth in the ASME AG-1 standard. The DOE publication Nuclear Air Cleaning Handbook (NACH) is an additional guidance document for design and operation HEPA filter systems in DOE facilities. These two guidelines establish basic maximum operating parameters for temperature, maximum aerosol particle size, maximum particulate matter mass concentration, acceptable differential pressure range, and filter media velocity. Each of these parameters is discussed along with data linking variability of each parameter with filter function and lifetime. Temporal uncertainty associated with gas composition, temperature, and absolute pressure of the air flow can have a direct impact on the volumetric flow rate of the system with a corresponding impact on filter media velocity. Correlations between standard units of flow rate (standard meters per minute or cubic feet per minute) versus actual units of volumetric flow rate are shown for variations in relative humidity for a 70 deg. C to 200 deg. C temperature range as an example of gas composition that, uncorrected, will influence media velocity. The AG-1 standard establishes a 2.5 cm/s (5 feet per minute) ceiling for media velocities of nuclear grade HEPA filters. Data are presented that show the impact of media velocities from 2.0 to 4.0 cm/s media velocities (4 to 8 fpm) on differential pressure, filter efficiency, and filter lifetime. Data will also be presented correlating media velocity effects with two different particle size

  18. FACTORS INFLUENCING THE EVOLUTION OF YOUTH TRAVEL

    Directory of Open Access Journals (Sweden)

    Student Claudia MOISĂ

    2010-01-01

    Full Text Available Youth travel is an important part of global tourism, consequently, getting to know the evolution of this form of tourism requires an approach of the aspects regarding the permissive and restrictive factors that influence the youth travel dynamic worldwide. In terms of the factors that influence youth travel, we highlighted these two categories of factors (permissive and restrictive and, within each category, we tried to singularize the influence of every factor over youth travel.

  19. Factors influencing boar sperm cryosurvival.

    Science.gov (United States)

    Roca, J; Hernández, M; Carvajal, G; Vázquez, J M; Martínez, E A

    2006-10-01

    Optimal sperm cryopreservation is a prerequisite for the sustainable commercial application of frozen-thawed boar semen for AI. Three experiments were performed to identify factors influencing variability of postthaw sperm survival among 464 boar ejaculates. Sperm-rich ejaculate fractions were cryopre-served using a standard freezing-thawing procedure for 0.5-mL plastic straws and computer-controlled freezing equipment. Postthaw sperm motility (assessed with a computer-assisted semen analysis system) and viability (simultaneously probed by flow cytometry analysis after triple-fluorescent stain), evaluated 30 and 150 min postthaw, were used to estimate the success of cryopreservation. In the first experiment, 168 unselected ejaculates (1 ejaculate/boar), from boars of 6 breeds with a wide age range (8 to 48 mo), were cryopreserved over a 12-mo period to evaluate the predictive value of boar (breed and age), semen collection, transport variables (season of ejaculate collection, interval between collections, and ejaculate temperature exposure), initial semen traits, and sperm quality before freezing on sperm survival after freezing-thawing. In Exp. 2, 4 ejaculates from each of 29 boars, preselected according to their initial semen traits and sperm quality before freezing, were collected and frozen over a 6-mo period to evaluate the influence of interboar and intraboar ejaculate variability in the survival of sperm after cryopreservation. In Exp. 3, 12 ejaculates preselected as for Exp. 2, from each of 15 boars with known good sperm cryosurvival, were collected and frozen over a 12-mo period to estimate the sustainability of sperm cryosurvival between ejaculates over time. Boar and semen collection and transport variables were not predictive of sperm cryosurvival among ejaculates. Initial semen traits and sperm quality variables observed before freezing explained 23.2 and 10.9%, respectively, of the variation in postthaw sperm motility and viability. However, more that

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

    Science.gov (United States)

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

    2016-03-01

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

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

    Science.gov (United States)

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

    2012-02-01

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

  2. Factors that negatively influence consumption of traditionally ...

    African Journals Online (AJOL)

    Factors that negatively influence consumption of traditionally fermented milk ... in various countries of sub-Saharan Africa and a number of health benefits to human ... influence consumption of Mursik, a traditionally fermented milk product from ...

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

    Science.gov (United States)

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

    2017-06-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Hajime Orimo

    2017-12-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    2017-01-01

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

  8. The Influence of Chronic Ego Depletion on Goal Adherence: An Experience Sampling Study.

    Science.gov (United States)

    Wang, Ligang; Tao, Ting; Fan, Chunlei; Gao, Wenbin; Wei, Chuguang

    2015-01-01

    Although ego depletion effects have been widely observed in experiments in which participants perform consecutive self-control tasks, the process of ego depletion remains poorly understood. Using the strength model of self-control, we hypothesized that chronic ego depletion adversely affects goal adherence and that mental effort and motivation are involved in the process of ego depletion. In this study, 203 students reported their daily performance, mental effort, and motivation with respect to goal directed behavior across a 3-week time period. People with high levels of chronic ego depletion were less successful in goal adherence than those with less chronic ego depletion. Although daily effort devoted to goal adherence increased with chronic ego depletion, motivation to adhere to goals was not affected. Participants with high levels of chronic ego depletion showed a stronger positive association between mental effort and performance, but chronic ego depletion did not play a regulatory role in the effect of motivation on performance. Chronic ego depletion increased the likelihood of behavior regulation failure, suggesting that it is difficult for people in an ego-depletion state to adhere to goals. We integrate our results with the findings of previous studies and discuss possible theoretical implications.

  9. Adolescents' perspectives of parental practices influence diabetic adherence and quality of life.

    Science.gov (United States)

    Mlynarczyk, Susan M

    2013-01-01

    This study investigated whether perceived parental support and different parenting styles were related to adherence to diabetes management, metabolic control, and perceived quality of life of adolescents diagnosed with type 1 diabetes. Adolescents between 12 and 18 years of age (N = 102) diagnosed with type 1 diabetes for at least one year participated. Parents were classified into one of four groups (authoritative, authoritarian, permissive, or neglectful) based on their adolescents' surveyed perceptions of their general support and their overall responsiveness and demandingness. Perceived parental support was significantly correlated with adherence. Adolescents who perceived their parents to have authoritative parenting styles also had better adherence to their prescribed treatment plan as well as better perceived quality of life. Adolescents experience better management outcomes when adolescents and parents become interdependent by working together to achieve these outcomes.

  10. Influence of the number of daily pills and doses on adherence to antiretroviral treatment: a 7-year study.

    Science.gov (United States)

    Hernández Arroyo, M J; Cabrera Figueroa, S E; Sepúlveda Correa, R; Valverde Merino, M P; Luna Rodrigo, G; Domínguez-Gil Hurlé, A

    2016-02-01

    Antiretroviral treatment (ART) is hampered by complicated regimens, high pill burden, drug-drug interactions, and frequent short- and long-term adverse effects, leading to decreased adherence. Over recent years, considerable effort has been directed at developing regimens that are less burdening. We undertook a 7-year retrospective study of the records of 264 HIV-infected subjects enrolled in a pharmaceutical care programme to document the progress made and to study the influence of the number of ART pills and doses on the level of treatment adherence. Antiretroviral dispensing records were analysed for the number of pills and doses administered and the ART adherence rate estimated. In 2005, the patients took a mean of 6·2 pills daily (CI 95%: 5·9-6·6), and 92·9% of them were on a twice-a-day (BID) dosage regimen. By 2012, the mean number of pills was reduced to 4·1 (CI 95%: 3·8-4·4), and only 50·9% were on a BID regimen. No statistically significant relation was observed between number of daily pills and doses and ART adherence reached by the patients in any of the analyses performed. There has been a continuous reduction in the number of pills and doses of antiretrovirals taken by individual patients over the last 7 years due largely to the introduction of improved treatments and regimens. More daily pills or doses was not associated with worse ART adherence in our pharmaceutical care programme. © 2015 John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2018-02-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  13. Demotivating factors influencing rubber production workers

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Iravani

    2012-01-01

    Full Text Available Motivation is one of the most important factors influencing workers' productivity. An increase in workers' motivation could add more value to organizations' structure and influence the profitability, significantly. In this paper, we study different factors on demotivating workers using questionnaire consist of various questions. The questionnaire is distributed among some employees who work for rubber production units located in Esfahan, Iran. The results of this survey indicate that discrimination on annual job compensation, entrusting responsibilities and unpleasant relationship with family partner are some of the most important factors influencing employees' motivation. While financial factors play important role on increasing employees' motivation, non-financial factors are considered more important.

  14. Influence of human milk oligosaccharides on adherence of bifidobacteria and clostridia to cell lines.

    Science.gov (United States)

    Musilova, Sarka; Modrackova, Nikol; Doskocil, Ivo; Svejstil, Roman; Rada, Vojtech

    2017-12-01

    Adhesion of gut bacteria to the intestinal epithelium is the first step in their colonization of the neonatal immature gut. Bacterial colonization of the infant gut is influenced by several factors, of which the most important are the mode of delivery and breast-feeding. Breast-fed infants ingest several grams of human milk oligosaccharides (HMOs) per day, which can become receptor decoys for intestinal bacteria. The most abundant intestinal bacteria in vaginally delivered infants are bifidobacteria, whereas infants born by cesarean section are colonized by clostridia. The influence of HMOs on the adhesion of five strains of intestinal bacteria (three bifidobacterial strains and two clostridial strains) to mucus-secreting and non-mucus-secreting human epithelial cells was investigated. Bifidobacterium bifidum 1 and Bifidobacterium longum displayed almost the same level of adhesion in the presence and absence of HMOs. By contrast, adhesion of Clostridium butyricum 1 and 2 decreased from 14.41% to 6.72% and from 41.54% to 30.91%, respectively, in the presence of HMOs. The results of this study indicate that HMOs affect bacterial adhesion and are an important factor influencing bacterial colonization of the gut. Adhesion of the tested bacteria correlates with their ability to autoaggregate.

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

    Directory of Open Access Journals (Sweden)

    Adriana Cristina de Oliveira

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

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

    Directory of Open Access Journals (Sweden)

    Aysun Yüksel

    2017-12-01

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

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

    Science.gov (United States)

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

    2008-11-01

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

  18. Observational study of adherence to a traditional Mediterranean diet, sociocultural characteristics and cardiovascular disease risk factors of older Greek Australians from MEDiterranean ISlands (MEDIS-Australia Study): Protocol and rationale.

    Science.gov (United States)

    Thodis, Antonia; Itsiopoulos, Catherine; Kouris-Blazos, Antigone; Brazionis, Laima; Tyrovolas, Stefanos; Polychronopoulos, Evangelos; Panagiotakos, Demosthenes B

    2018-02-01

    To describe the study protocol of the MEDiterranean ISlands-Australia (MEDIS-Australia) Study modelled on the MEDIS Study conducted in Greece. The present study aims to explore adherence to the traditional Mediterranean diet pattern, determine enablers and barriers to adherence, explore the definition of Greek cuisine, and associations between adherence to the diet pattern and risk factors for cardiovascular disease (CVD) and metabolic syndrome in older Greek Australians originally from Greek islands and Cyprus. Now long-term immigrants, with at least 50 years in Australia, characteristics and risk factor profiles of older Greek islander-born Australians will be compared and contrasted to their counterparts living on Greek islands to evaluate the influence of migration on adherence. The present study is an observational study of cross-sectional design using a modified lifestyle and semi-quantitative food frequency questionnaire to capture sociodemographic, health, psychosocial and dietary characteristics, including cuisine, of 150 older Greek islander-born Australians. Anthropometric measures and medical history will be collected. Participants will be aged over 65 years, live independently, are originally from a Greek island and are free from CVD. Data collection is underway. Characteristics and behaviours associated with adherence, if identified, could be evaluated in future studies. For example, exploration of enablers or barriers to adherence to a Mediterranean dietary pattern in an Australian population. © 2017 Dietitians Association of Australia.

  19. Factors Influencing Substance Abuse among Undergraduate ...

    African Journals Online (AJOL)

    The study investigated the factors influencing substance abuse amongundergraduate students in Osun State; Nigeria. A sample of 1, 200undergraduate students were randomly selected from three tertiaryinstitution in Osun State. Factors Influencing Substance Abuse Questionnaire (FISA) was developed by the researcher ...

  20. Factors influencing customer satisfaction with reference and ...

    African Journals Online (AJOL)

    This paper examines factors influencing customer satisfaction with reference and information services in an academic environment. The paper identifies types of reference services in libraries, factors influencing customer satisfaction and dissatisfaction with reference and information services and suggested the way forward ...

  1. Factors Influencing Livelihood Diversification among Rural Farmers ...

    African Journals Online (AJOL)

    This research study was set out to analyze factors influencing rural farmer's engagement in livelihood diversification in the study area. The specific objectives were; to identify the different levels of farmers' engagement in livelihood diversification, determine the socio-demographic factors or forces that influence farmers' ...

  2. Factors Influencing Endometrial Thickness in Postmenopausal Women

    African Journals Online (AJOL)

    Background: Cut‑off values for endometrial thickness (ET) in asymptomatic postmenopausal woman have been standardized. However, there are no comprehensive studies to document how various factors can influence the ET after the age of menopause. Aim: To study the various factors influencing the ET in ...

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

    DEFF Research Database (Denmark)

    Kovács, Eva; Hunsberger, Monica; Reisch, Lucia

    2015-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Yadmila Rosa Matos La

    2007-03-01

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

  6. Psychological and behavioral barriers to ART adherence among PLWH in China: role of self-efficacy.

    Science.gov (United States)

    Zhou, Guangyu; Li, Xiaoming; Qiao, Shan; Zhou, Yuejiao; Shen, Zhiyong

    2017-12-01

    Globally, optimal adherence to antiretroviral therapy (ART) is insufficient despite it is critical for maximum clinical benefits and treatment success among people living with HIV (PLWH). Many factors have been evidenced to influence medication adherence, including perceived barriers and self-efficacy. However, limited data are available regarding to psychological and behavioral barriers to ART adherence in China. Moreover, few studies have examined the mechanism of these two factors underlying HIV medication adherence. The aim of the current study is to examine the mediating role of adherence self-efficacy between perceived barriers and ART adherence among PLWH. Cross-sectional data were obtained from 2095 PLWH in Guangxi China who provided data on ART adherence. Participants reported their medication adherence, self-efficacy, barriers to ART adherence, as well as background characteristics. Results indicated a significant indirect effect from perceived barriers to medication adherence through adherence self-efficacy. Higher perceived psychological and behavioral barriers to ART adherence were related to lower adherence self-efficacy, which in turn was related to lower ART adherence. Self-efficacy could buffer the negative effects of perceived barriers on ART adherence. Future interventions to promote HIV medication adherence are recommended to focus on eliminating psychological and behavioral barriers, as well as increasing adherence self-efficacy.

  7. Influence of Spirituality and Religion on Adherence to Highly Active Antiretroviral Therapy in Adult HIV/AIDS Patients in Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    Agam Ebaji Ayuk

    2017-07-01

    Full Text Available The emergence of a chronic medical illness such as Human Immune Deficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS may be the time when people turn to the Sacred through spirituality and religion. HIV is a chronic illness that requires strict adherence to medication regimens that may be influenced by spirituality/religion. This study was aimed at finding the association between spirituality/religion and adherence to highly active antiretroviral therapy (HAART in adult HIV/AIDS patients. This is a cross-sectional descriptive study of 370 patients. Adherence was measured using an adapted adult AIDS clinical trial group (AACTG and visual analogue scale (VAS tools. Spirituality was assessed using Functional Assessment of Chronic Illness Therapy-Spirituality Expanded (FACIT-Sp-Ex scale, religiosity with Duke University Religion index (DUREL, and religious coping with Brief Religious Coping (RCOPE scale. Adherence rates were 86.2 and 43.8% using AACTG and VAS tools, respectively. Statistical significant correlation was found between spirituality and adherence to HAART (r = 0.265; p = 0.00. Also, significant correlation was found between positive religious coping and adherence (r = 0.15, p = 0.003. Odds ratio indicated that female respondents were 1.6 times more likely to be adherent, compared with males. Similarly, every unit rise in spirituality score yielded a 1.3 times increased likelihood of adherence to HAART on multiple logistic regression of adherence to HAART with relevant predictors. Both spirituality and positive religious coping have positive influence on optimal adherence. Therefore, the training of health care personnel to assess and provide spiritual care and involvement of chaplains/religious leaders is advocated for improved adherence.

  8. Socioeconomic and familial characteristics influence caretakers' adherence to the periodic vitamin A capsule supplementation program in Central Java, Indonesia.

    Science.gov (United States)

    Pangaribuan, Rosnani; Scherbaum, Veronika; Erhardt, Jürgen G; Sastroamidjojo, Soemilah; Biesalski, Hans K

    2004-06-01

    The adherence of program participants to periodic vitamin A capsule (VAC) supplementation among children aged 1-5 years (n = 677) in Central Java, Indonesia was assessed. Fourteen villages from five sub-districts and one ward from one sub-district in Central Java were included in the study to represent rural and suburban areas. All questions about demographic factors, socioeconomic conditions, current dietary practice and healthcare-seeking attitudes for common childhood illnesses, previous breastfeeding experience, their knowledge about vitamin A and adherence to the VAC program after capsule distribution (two periods in 2000) were asked. Caretakers with limited knowledge about the health benefits of vitamin A, households with more than one preschool child, and households with older children (> 36 months) were associated with a decreased likelihood of regular participation in the program with odds ratios of 0.38, 0.55, and 0.26, respectively (p program regularly with an odds ratio of 2.02 (p program.

  9. Long-term adherence to antimuscarinic drugs when treating overactive bladder in the older: Subjective reason and objective factors

    Directory of Open Access Journals (Sweden)

    Kirill Vladimirovich Kosilov

    2017-03-01

    Full Text Available Purpose: Comparison of subjective reasons for the refusal of antimuscarinic treatment and the state of objective economic, social, psychological and health status markers in the elderly with overactive bladder. Materials and Methods: One thousand seven hundred thirty-six (1,736 patients participated in the experiment: 1,036 or 59.7% of women, and 700 or 40.3% of men aged over 60 years (average age, 68.1 years who took antimuscarinic (AM drugs during the year. The control of objective parameters was carried out by studying patients’ medical records, the use of overactive bladder questionnaire short form and Medical Outcomes Study 36-item Shor-Form Health Survey, voiding diaries, uroflowmetry, as well as income certificates from the Tax Inspectorate, support documentation for expenses on drugs. Results: Fifty-two point six percent (52.6% of patients preserved adherence to treatment during the first 6 months, 30.1% – during the follow-up period. The average time of reaching a 30-day break in the AM drugs administration was 174 days. In 36.5% of cases of the refusal of treatment, patients referred to medical reasons for the refusal, in 31.6% of cases disturbance was established in objective health status markers (differences were significant in 30% of the follow-up time. The percentage of refusals of treatment for social and psychological reasons (13.2% was significantly lower (p≤0.05, than the percentage of individuals with statuses altered objectively (21.9%. Conclusions: A significant share of elderly patients taking AM drugs when treating overactive bladder is inclined to overestimate the importance of health factors influencing their decisions and to underestimate the importance of social and psychological factors, and an urologist should take it into account for the efficacy evaluation.

  10. Comparison of objective and subjective factors in the adherence to antimuscarinics when treating overactive bladder in employed persons.

    Science.gov (United States)

    Kosilov, Kirill Vladimirovich; Loparev, Sergey; Kuzina, Irina; Prokofyeva, Alexandra

    2017-12-01

    This study examines subjective reasons for the refusal of treatment and the state of objective status markers of various factors influencing the resistance of patients when treating overactive bladder by antimuscarinic drugs (AMs). The socioeconomic and medical parameters were studied in 2465 patients aged 18-60 years (1446 women (58.7%), 1019 men (41.3%); mean age was 52.1) taking AMs during the year. The study control was carried out by studying passport data, employers' income certificates, patients' ambulatory medical records, the use of OABq-SF and MOS SF-36 questionnaires, voiding diaries and uroflowmetry. The average time to reach the 30-day break in the AM administration was 177 days. During the 12-month follow up, 74.7% of patients discontinued their participation. In total, 35.9% of patients stated medical reasons for the refusal of AM treatment; in 31.9% of individuals in the group the deviation of objective health status markers from average sample values was established. Economic reasons for the refusal were given by 20.4% of patients; in 18.5% of individuals economic status markers were different from average sample values. In 24.1% of cases of refusal of treatment, patients indicated social and psychological reasons; objective social and psychological status markers were altered in 35.9%. The percentage of patients indicating economic and medical reasons for the refusal of AM treatment is statistically uniform with respect to the percentage of patients with objective disturbances of health and economic statuses. The percentage of patients indicating social and psychological factors as a reason for the refusal of treatment was significantly lower than the percentage of patients with altered social and psychological status markers. These results can be used in practical healthcare when predicting adherence to AM use.

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

    Science.gov (United States)

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

    2016-05-01

    The contributions of disorder severity, comorbidity and interpersonal variables to therapists' adherence to a cognitive-behavioural treatment (CBT) manual were tested. Thirty-eight patients received panic control therapy (PCT) for panic disorder. Trained observers watching videotapes of the sixth session of a 24-session protocol rated therapists' adherence to PCT and their use of interventions from outside the CBT model. Different observers rated patients' behavioural resistance to therapy in the same session using the client resistance code. Interview measures obtained before treatment included the Panic Disorder Severity Scale, the anxiety disorders interview schedule for Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV and the structured clinical interview for DSM-IV, Axis II. Questionnaire measures were the anxiety sensitivity index at intake, and, at session 2, the therapist and client versions of the working alliance inventory-short form. The higher the patients' resistance and the more Axis II traits a patient had, the less adherent the therapist. Moreover, the more resistant the client, the more therapists resorted to interventions from outside the CBT model. Stronger therapist and patient alliance was also generally related to better adherence, but these results were somewhat inconsistent across therapists. Pretreatment disorder severity and comorbidity were not related to adherence. Interpersonal variables, particularly behavioural resistance to therapy, are related to therapists' ability to adhere to a treatment manual and to their use of interventions from outside of the CBT model. Copyright © 2015 John Wiley & Sons, Ltd. Patients' behavioural resistance to therapy may make it more difficult for cognitive-behavioural clinicians to adhere to a structured treatment protocol and more likely for them to borrow interventions from outside the CBT model. Patients' Axis II traits may make adherence to treatment CBT protocol more difficult

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

    LENUS (Irish Health Repository)

    Agyapong, Vincent I O

    2010-01-01

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

  13. PREDICTION OF SPORT ADHERENCE THROUGH THE INFLUENCE OF AUTONOMY-SUPPORTIVE COACHING AMONG SPANISH ADOLESCENT ATHLETES

    Directory of Open Access Journals (Sweden)

    Bartolomé J. Almagro

    2010-03-01

    Full Text Available The purpose of this study was to test a motivational model of the coach-athlete relationship, based on self-determination theory and on the hierarchical model of intrinsic and extrinsic motivation. The sample comprised of 608 athletes (ages of 12-17 years completed the following measures: interest in athlete's input, praise for autonomous behavior, perceived autonomy, intrinsic motivation, and the intention to be physically active. Structural equation modeling results demonstrated that interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation. Finally, intrinsic motivation predicted the intention to be physically active in the future. The results are discussed in relation to the importance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes. Further, the results provide information related to the possible objectives of future interventions for the education of coaches, with the goal of providing them with tools and strategies to favor the development of intrinsic motivation among their athletes. In conclusion, the climate of autonomy support created by the coach can predict the autonomy perceived by the athletes which predicts the intrinsic motivation experienced by the athletes, and therefore, their adherence to athletic practice. Key words: Autonomy support, perceived autonomy, intrinsic motivation, sport adherence

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

    Science.gov (United States)

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

    2016-06-01

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

  15. Initiation and adherence to TB treatment in a Pakistani community influenced more by perceptions than by knowledge of tuberculosis

    Directory of Open Access Journals (Sweden)

    Mubashir Zafar

    2013-01-01

    Full Text Available Background: The tuberculosis (TB literature is written almost entirely from a biomedical perspective, while recent studies show that it is imperative to understand lay perception to determine why people seek treatment and may stop taking treatment. Aims: To investigate knowledge about TB, perceptions of (access to TB treatment, and adherence to treatment among a Pakistani population. Setting and Design: Descriptive cross-sectional study. Materials and Methods: A total of 175 participants were selected nonrandomly, 100 were TB patient and 75 were non-TB patient in proportion to the total number of participants in each ward of hospital. Statistical Analysis: Analysis of attitudes and perceptions toward TB, adherence to TB treatment, health seeking behavior, and TB treatment types done by frequency counts and percentages. Regression analysis and logistic regression analysis were performed to test whether differences in age, gender, and education level led to different knowledge scores and different attitudes and preferences toward TB, adherence to TB treatment, health seeking behavior, and TB treatment types. All statistical analyses were performed using Statistical Package for Social Sciences (SPSS 16.0. Result: TB knowledge can be considered fairly well among this community. Respondents′ perceptions suggest that stigma may influence TB patients′ decision in health seeking behavior and adherence to TB treatment. A full 95% of those interviewed believe people with TB tend to hide their TB status out of fear of what others may say. Conclusion: Most of the subjects were unaware of TB that seems to be due to their illiteracy and those who knew had got the knowledge from media, but the majority of the patients who were on directly observed treatment, short-course (DOTS were found to be satisfied.

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

    Directory of Open Access Journals (Sweden)

    Mbuagbaw Lawrence

    2012-12-01

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

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

    Science.gov (United States)

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

    2001-04-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  19. Community Factors Influencing Birth Spacing among Married ...

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    AJRH Managing Editor

    level factors on birth spacing behaviour in Uganda and Zimbabwe, to ... environments as potential influences on birth spacing ..... health: multivariable cross-country analysis, MACRO ... Equity monitoring for social marketing: Use of wealth.

  20. Factors Influencing Self Employment Media Service Providers ...

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    Factors Influencing Self Employment Media Service Providers among Tertiary ... role stereotype and common business practices on media self employment in ... Sex, Psycho-social Characteristics, self Employment, Providing Media Services.

  1. Influence of Macroeconomic Factors on Residential Property ...

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    Sultan

    exerted by macroeconomic factors on residential property returns in Abuja. The backward .... explanatory power and positive influence of employment and ...... Project. Management In Property Development: the Nigeria experience. Ibadan:.

  2. Factors Influencing Adoption of Cocoa Technologies Disseminated ...

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    Factors Influencing Adoption of Cocoa Technologies Disseminated by Olam Organisation in ... Journal of Agricultural Research and Development ... level, household size, no of farm family assisting on the farm, management system adopted, ...

  3. Assessment of Factors Influencing Beneficiary Participation in ...

    African Journals Online (AJOL)

    ISSN 0794-5698. Assessment of Factors Influencing Beneficiary Participation in Fadama II Project ... project implementation (80%) in the stages of project development. Women .... the project as they appeared to have more family burden to ...

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

    Science.gov (United States)

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

    2017-04-01

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

  5. Factors influencing detail detectability in radiologic imaging

    International Nuclear Information System (INIS)

    Gurvich, A.M.

    1985-01-01

    The detectability of various details is estimated quantitatively from the essential technical parameters of the imaging system and additional influencing factors including viewing of the image. The analysis implies the formation of the input radiation distribution (contrast formation, influence of kVp). Noise, image contrast (gamma), modulation transfer function and contrast threshold of the observer are of different influence on details of different size. Thus further optimization of imaging systems and their adaption to specific imaging tasks are facilitated

  6. ENERGY EFFICIENCY. TRENDS AND INFLUENCE FACTORS

    Directory of Open Access Journals (Sweden)

    Zizi GOSCHIN

    2006-12-01

    Full Text Available Energy efficiency is correlated with many factors of influence: Gross National Income per capita, energy imports (% of energy use, renewable combustible and waste (% of total, energy use per capita, services as % of GDP and others. In this paper we are testing a model of piecewise linear regression with breakpoint in order to measure the influence of these factors on the variation of GDP per unit of energy use in Europe in the year 2003.

  7. Factors Influencing Title VII Bilingual Program Institutionalization.

    Science.gov (United States)

    Lewis, Gerald R.; And Others

    1985-01-01

    This study of the primary restraining and driving forces that influence Title VII bilingual education programs found the external environment, the local community, to be the main factor influencing institutionalization and self-renewal. The internal environment--the local school, and the local school's organization or central office, school board,…

  8. Adherence to inhaled corticosteroids in children with asthma and their parents

    NARCIS (Netherlands)

    Dellen, Q.M. van; Stronks, K.; Bindels, P.J.E.; Öry, F.G.; Aalderen, W.M.C. van

    2006-01-01

    Poor adherence to inhaled corticosteroids (ICSs) may contribute to the recent rise in asthma morbidity. In general, appropriate adherence to ICSs is a complex process that is influenced by various determinants. The purpose of this study was to identify factors that were associated with adherence to

  9. Prediction of sport adherence through the influence of autonomy-supportive coaching among spanish adolescent athletes.

    Science.gov (United States)

    Almagro, Bartolomé J; Sáenz-López, Pedro; Moreno, Juan A

    2010-01-01

    The purpose of this study was to test a motivational model of the coach-athlete relationship, based on self-determination theory and on the hierarchical model of intrinsic and extrinsic motivation. The sample comprised of 608 athletes (ages of 12-17 years) completed the following measures: interest in athlete's input, praise for autonomous behavior, perceived autonomy, intrinsic motivation, and the intention to be physically active. Structural equation modeling results demonstrated that interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation. Finally, intrinsic motivation predicted the intention to be physically active in the future. The results are discussed in relation to the importance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes. Further, the results provide information related to the possible objectives of future interventions for the education of coaches, with the goal of providing them with tools and strategies to favor the development of intrinsic motivation among their athletes. In conclusion, the climate of autonomy support created by the coach can predict the autonomy perceived by the athletes which predicts the intrinsic motivation experienced by the athletes, and therefore, their adherence to athletic practice. Key pointsImportance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes.Interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation.Intrinsic motivation predicted the intention to be physically active in the future.

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

    Science.gov (United States)

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

    2018-04-15

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

  11. An Analysis of Patient Adherence to Treatment during a 1-Year, Open-Label Study of OROS[R] Methylphenidate in Children with ADHD

    Science.gov (United States)

    Faraone, Stephen V.; Biederman, Joseph; Zimmerman, Brenda

    2007-01-01

    Objective: Treatment adherence is an important aspect of ADHD symptom management, but there are many factors that may influence adherence. Method: This analysis assessed adherence to OROS methylphenidate during a 1-year, open-label study in children. Adherence was defined as the number of days medication was taken divided by the number of days in…

  12. What Factors Influence Wind Perceptions

    Science.gov (United States)

    Stein, Tatiana

    Over the last decade, wind power has emerged as a possible source of energy and has attracted the attention of homeowners and policy makers worldwide. Many technological hurdles have been overcome in the last few years that make this technology feasible and economical. The United States has added more wind power than any other type of electric generation in 2012. Depending on the location, wind resources have shown to have the potential to offer 20% of the nation's electricity; a single, large wind turbine has the capacity to produce enough electricity to power 350 homes. Throughout the development of wind turbines, however, energy companies have seen significant public opposition towards the tall white structures. The purpose of this research was to measure peoples' perceptions on wind turbine development throughout their growth, from proposal to existing phase. Three hypotheses were developed based on the participant's political affiliation, proximity and knowledge of wind turbines. To validate these hypotheses, participants were asked an array of questions regarding their perception on economic, environmental, and social impacts of wind turbines with an online service called Amazon Mechanical Turk. The responses were from residents living in the United States and required them to provide their zip code for subsequent analysis. The analysis from the data obtained suggests that participants are favorable towards wind turbine development and would be supportive of using the technology in their community. Political affiliation and proximity to the nearest wind turbine in any phase of development (proposal, construction, existing) were also analyzed to determine if they had an effect on a person's overall perception on wind turbines and their technology. From the analysis, political affiliation was seen to be an indirect factor to understanding favorability towards wind turbines; the more liberal you are, the more supportive you will be towards renewable energy use

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

    Science.gov (United States)

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

    2017-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Jimeno-Serrano Francisco J

    2009-12-01

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

  15. Factors That Influence the Extensional Rheological Property of Saliva.

    Directory of Open Access Journals (Sweden)

    Amrita Vijay

    Full Text Available The spinnbarkeit of saliva reflects the ability of saliva to adhere to surfaces within the mouth, thereby serving as a protective role and aiding in lubrication. Therefore, alterations in the extensional rheology of saliva may result in the loss in adhesiveness or the ability to bind onto surfaces. Mucin glycoproteins and their structures are known to be important factors for the extensional rheological properties of saliva. The conformation of mucin depends on factors such as pH and ionic strength. Chewing is one of the main stimuli for salivary secretion but creates significant sheer stress on the salivary film which could influence mouthfeel perceptions. The current study investigates the possible factors which affect the extensional rheological properties of saliva by comparing submandibular/sublingual saliva with different oral stimuli within the same group of subjects. Unstimulated and stimulated saliva (chew, smell and taste salivas were collected primarily from submandibular/sublingual glands. The saliva samples were measured for Spinnbarkeit followed by the measuring mucin, total protein, total calcium and bicarbonate concentrations. The results indicated correlations between rheological properties and mucin/ion concentrations. However, chewing stimulated submandibular/sublingual saliva is shown to have significantly lower Spinnbarkeit, but factors such as mucin, protein and calcium concentrations did not account for this variation. Analysis of the concentration of bicarbonate and pH appears to suggest that it has a prominent effect on extensional rheology of saliva.

  16. Factors influencing job satisfaction and organizational commitment.

    Science.gov (United States)

    Watson, Liana M

    2008-01-01

    To assess the relationship between intrinsic and extrinsic motivational factors influencing job satisfaction and the perspective of frontline medical imaging staff in acute care health care facilities in the United States. The sample consisted of 359 registered radiologic technologists who were working as staff technologists in acute care health care facilities in the United States. The results of the study suggest that satisfaction with intrinsic and extrinsic motivators influences overall satisfaction with the work environment and job and commitment to the employer.

  17. Illness perceptions of Libyans with T2DM and their influence on medication adherence: a study in a diabetes center in Tripoli.

    Science.gov (United States)

    Ashur, Sana Taher; Shah, Shamsul Azhar; Bosseri, Soad; Morisky, Donald E; Shamsuddin, Khadijah

    2015-01-01

    The surrounding environment influences the constitution of illness perceptions. Therefore, local research is needed to examine how Libyan diabetes patients perceive diabetes and how their perceptions influence their medication adherence. A cross-sectional study was conducted at the National Centre for Diabetes and Endocrinology in Tripoli, Libya, between October and December 2013. A total of 523 patients with type 2 diabetes participated in this study. A self-administered questionnaire was used for data collection; this included the Revised Illness Perception Questionnaire and the eight-item Morisky Medication Adherence Scale. The respondents showed moderately high personal control and treatment control perceptions and a moderate consequences perception. They reported a high perception of diabetes timeline as chronic and a moderate perception of the diabetes course as unstable. The most commonly perceived cause of diabetes was Allah's will. The prevalence of low medication adherence was 36.1%. The identified significant predictors of low medication adherence were the low treatment control perception (p=0.044), high diabetes identity perception (p=0.008), being male (p=0.026), and employed (p=0.008). Diabetes illness perceptions of type 2 diabetic Libyans play a role in guiding the medication adherence and could be considered in the development of medication adherence promotion plans.

  18. Illness perceptions of Libyans with T2DM and their influence on medication adherence: a study in a diabetes center in Tripoli

    Directory of Open Access Journals (Sweden)

    Sana Taher Ashur

    2015-12-01

    Full Text Available Background: The surrounding environment influences the constitution of illness perceptions. Therefore, local research is needed to examine how Libyan diabetes patients perceive diabetes and how their perceptions influence their medication adherence. Methods: A cross-sectional study was conducted at the National Centre for Diabetes and Endocrinology in Tripoli, Libya, between October and December 2013. A total of 523 patients with type 2 diabetes participated in this study. A self-administered questionnaire was used for data collection; this included the Revised Illness Perception Questionnaire and the eight-item Morisky Medication Adherence Scale. Results: The respondents showed moderately high personal control and treatment control perceptions and a moderate consequences perception. They reported a high perception of diabetes timeline as chronic and a moderate perception of the diabetes course as unstable. The most commonly perceived cause of diabetes was Allah's will. The prevalence of low medication adherence was 36.1%. The identified significant predictors of low medication adherence were the low treatment control perception (p=0.044, high diabetes identity perception (p=0.008, being male (p=0.026, and employed (p=0.008. Conclusion: Diabetes illness perceptions of type 2 diabetic Libyans play a role in guiding the medication adherence and could be considered in the development of medication adherence promotion plans.

  19. Overview of factors influencing the secondary market

    International Nuclear Information System (INIS)

    Bleistine, P.A.

    1982-01-01

    The major factor influencing secondary trading for the last few years has been the large contractural commitments built up by consumers for reactor programs which have proven to be unrealistic. The situation has intensified as a result of utilities needing to generate capital through inventory liquidation or reductions. The flexibilities in most contracts are inadequate to match the types of external and/or internal factors faced by the industry. This situation also suggests the need for secondary markets to help the industry adjust to unforeseen difficulties. They are very active markets at this time, but their influence in relation to the long-term method of doing business should not be exaggerated

  20. Design of a randomized trial to evaluate the influence of mobile phone reminders on adherence to first line antiretroviral treatment in South India - the HIVIND study protocol

    Directory of Open Access Journals (Sweden)

    Kumarasamy Nagalingeswaran

    2010-03-01

    Full Text Available Abstract Background Poor adherence to antiretroviral treatment has been a public health challenge associated with the treatment of HIV. Although different adherence-supporting interventions have been reported, their long term feasibility in low income settings remains uncertain. Thus, there is a need to explore sustainable contextual adherence aids in such settings, and to test these using rigorous scientific designs. The current ubiquity of mobile phones in many resource-constrained settings, make it a contextually appropriate and relatively low cost means of supporting adherence. In India, mobile phones have wide usage and acceptability and are potentially feasible tools for enhancing adherence to medications. This paper presents the study protocol for a trial, to evaluate the influence of mobile phone reminders on adherence to first-line antiretroviral treatment in South India. Methods/Design 600 treatment naïve patients eligible for first-line treatment as per the national antiretroviral treatment guidelines will be recruited into the trial at two clinics in South India. Patients will be randomized into control and intervention arms. The control arm will receive the standard of care; the intervention arm will receive the standard of care plus mobile phone reminders. Each reminder will take the form of an automated call and a picture message. Reminders will be delivered once a week, at a time chosen by the patient. Patients will be followed up for 24 months or till the primary outcome i.e. virological failure, is reached, whichever is earlier. Self-reported adherence is a secondary outcome. Analysis is by intention-to-treat. A cost-effectiveness study of the intervention will also be carried out. Discussion Stepping up telecommunications technology in resource-limited healthcare settings is a priority of the World Health Organization. The trial will evaluate if the use of mobile phone reminders can influence adherence to first

  1. Design of a randomized trial to evaluate the influence of mobile phone reminders on adherence to first line antiretroviral treatment in South India--the HIVIND study protocol.

    Science.gov (United States)

    De Costa, Ayesha; Shet, Anita; Kumarasamy, Nagalingeswaran; Ashorn, Per; Eriksson, Bo; Bogg, Lennart; Diwan, Vinod K

    2010-03-26

    Poor adherence to antiretroviral treatment has been a public health challenge associated with the treatment of HIV. Although different adherence-supporting interventions have been reported, their long term feasibility in low income settings remains uncertain. Thus, there is a need to explore sustainable contextual adherence aids in such settings, and to test these using rigorous scientific designs. The current ubiquity of mobile phones in many resource-constrained settings, make it a contextually appropriate and relatively low cost means of supporting adherence. In India, mobile phones have wide usage and acceptability and are potentially feasible tools for enhancing adherence to medications. This paper presents the study protocol for a trial, to evaluate the influence of mobile phone reminders on adherence to first-line antiretroviral treatment in South India. 600 treatment naïve patients eligible for first-line treatment as per the national antiretroviral treatment guidelines will be recruited into the trial at two clinics in South India. Patients will be randomized into control and intervention arms. The control arm will receive the standard of care; the intervention arm will receive the standard of care plus mobile phone reminders. Each reminder will take the form of an automated call and a picture message. Reminders will be delivered once a week, at a time chosen by the patient. Patients will be followed up for 24 months or till the primary outcome i.e. virological failure, is reached, whichever is earlier. Self-reported adherence is a secondary outcome. Analysis is by intention-to-treat. A cost-effectiveness study of the intervention will also be carried out. Stepping up telecommunications technology in resource-limited healthcare settings is a priority of the World Health Organization. The trial will evaluate if the use of mobile phone reminders can influence adherence to first-line antiretrovirals in an Indian context.

  2. INFLUENCE FACTORS FOR LEASING MARKET CONTRACTS

    Directory of Open Access Journals (Sweden)

    Oana BĂRBULESCU

    2016-11-01

    Full Text Available This paper aims to investigate the relationship between leasing contracts and some factors that influence the value of these contracts. In order to do this, we have decided on some quantitative marketing research by appealing to statistics for accomplishing the objectives that we have set: to find a correlation between the turnover percentage assigned to leasing expenses and several influence factors. This study indicated that the more contracts are signed by a firm, the more likely is to assign a bigger fraction of the income to each new leasing contract. The study confirmed that bigger companies are relying more on leasing as a way of financing than small companies. This study also discovered that companies with more employees are using larger contracts in order to sustain their activity. The findings are expected to contribute to adjusting the offers by the leasing companies, taking into consideration these factors and to using these factors in order to better predict the market evolution.

  3. Factors Influencing Medical Students' Choice of Specialty

    OpenAIRE

    Chang, Pei-Yeh; Hung, Chih-Young; Wang, Kuei-lng; Huang, Yuan-Huei; Chang, King-Jen

    2006-01-01

    Medical school graduates are the source of a country's physicians. Determining how the graduates of these schools select their areas of specialization is the key to achieving a balanced distribution of doctors among all specialties. The purposes of this study were to determine the factors that influence medical students' choice of medical specialty, and to derive the relative weight of each factor. Methods: We constructed a two-tiered analytic hierarchy process (AHP) model which was repres...

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

    Directory of Open Access Journals (Sweden)

    Krista J Siefried

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

  5. Adherence to antidepressants

    Directory of Open Access Journals (Sweden)

    Abimbola Farinde

    2013-01-01

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

  6. A Qualitative Study of Providers’ Perception of Adherence of Women Living with HIV/AIDS in Puerto Rico

    OpenAIRE

    Rivero-Méndez, Marta; Dawson-Rose, Carol S.; Solís-Báez, Solymar S.

    2010-01-01

    This study examines healthcare providers’ perceptions regarding experiences and factors that contribute to adherent and non-adherent behaviors to HIV treatment among women living with HIV infection in Puerto Rico and describes strategies implemented to improve adherence. Providers’ accounts revealed that women with HIV infection are living “beyond their strengths” attempting to reconcile the burden of the illness and keep adherent. Factors putting women beyond their strengths and influencing ...

  7. A factor analysis to detect factors influencing building national brand

    Directory of Open Access Journals (Sweden)

    Naser Azad

    Full Text Available Developing a national brand is one of the most important issues for development of a brand. In this study, we present factor analysis to detect the most important factors in building a national brand. The proposed study uses factor analysis to extract the most influencing factors and the sample size has been chosen from two major auto makers in Iran called Iran Khodro and Saipa. The questionnaire was designed in Likert scale and distributed among 235 experts. Cronbach alpha is calculated as 84%, which is well above the minimum desirable limit of 0.70. The implementation of factor analysis provides six factors including “cultural image of customers”, “exciting characteristics”, “competitive pricing strategies”, “perception image” and “previous perceptions”.

  8. Factors Influencing Donor Partnership Effectiveness | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2010-11-03

    Nov 3, 2010 ... A two-dimensional tool probing eight factors that influence partnership performance was developed, and used in conjunction with a Partnering Process Model, to guide the preparation of the case studies. The incorporation of the temporality dimension is quite novel and adds to the understanding and ...

  9. Factors influencing woodlands of southwestern North Dakota

    Science.gov (United States)

    Michele M. Girard; Harold Goetz; Ardell J. Bjugstad

    1987-01-01

    Literature pertaining to woodlands of southwestern North Dakota is reviewed. Woodland species composition and distribution, and factors influencing woodland ecosystems such as climate, logging, fire, and grazing are described. Potential management and improvement techniques using vegetation and livestock manipulation have been suggested.

  10. Factors influencing HIV seroprevalence rate among pregnant ...

    African Journals Online (AJOL)

    Human immune deficiency virus (HIV) seroprevalence among pregnant women in Calabar was studied. The aims were to establish HIV seroprevalence rate and to identify factors which influence this rate in our pregnant women. HIV seroprevalence rate of 2.7% among antenatal women in Calabar was recorded with a ...

  11. Factors influencing insulin secretion from encapsulated islets

    NARCIS (Netherlands)

    de Haan, BJ; Faas, MM; de Vos, P

    2003-01-01

    Adequate regulation of glucose levels by a microencapsulated pancreatic islet graft requires a minute-to-minute regulation of blood glucose. To design such a transplant, it is mandatory to have sufficient insight in factors influencing the kinetics of insulin secretion by encapsulated islets. The

  12. Socio-Economic Factors Influencing Entrepreneurship Among ...

    African Journals Online (AJOL)

    Socio-Economic Factors Influencing Entrepreneurship Among Women In Fishing Communities In Ondo State, Nigeria. ... The study found that overall entrepreneurial rating of the study group is low, essential input can not be easily gotten in the area, the respondents has large household size thereby had a large dependents ...

  13. Factors Influencing Information and Communication Technology ...

    African Journals Online (AJOL)

    Information and communication technology (ICT) is a veritable tool for sustainable agricultural development in Nigeria. This paper analyzed the factors that influenced ICT use by women research scientists in the Universities of Agriculture in Nigeria. Simple random sampling technique was used to select 40 respondents per ...

  14. Factors Influencing Examination Malpractice in Secondary Schools ...

    African Journals Online (AJOL)

    The main purpose of this study was to investigate factors influencing examination malpractice in some selected secondary schools in Cross River State, Nigeria. A sample of one thousand two hundred (1200) students were selected across the three educational zones of Ogoja, Ikom and Calabar using stratified, random ...

  15. Factors influencing laser cutting of wood

    Science.gov (United States)

    V.G. Barnekov; C.W. McMillin; H.A. Huber

    1986-01-01

    Factors influencing the ability of lasers to cut wood may be generally classified into these three areas: 1) characteristics of the laser beam; 2) equipment and processing variables; and 3) properties of the workpiece. Effects of beam power, mode, polarization, and stability are discussed as are aspects of optics, location of focal point, feed speed, gas-jet assist...

  16. Factors that influence advertising design ideation | Usman ...

    African Journals Online (AJOL)

    Factors that influence advertising design ideation. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... inevitably, more than ever before, on advertisement to take products to the doorsteps of potential consumers. Consequently, local and global corporations employ all manner of advertising media to achieve their end.

  17. Factors Influencing Smallholder Farmers Participation in IFAD ...

    African Journals Online (AJOL)

    USER

    2015-02-02

    Feb 2, 2015 ... This study assessed Factors Influencing smallholder farmers' ... percent of the population engaged in agricultural activities as a career and ... that the major source of income of the poor is agriculture and ... shown that farmers have different reasons for participation in agricultural ... 30 Dan gamau 534. 30.

  18. Exploring Factors That Influence Quality Literature Circles

    Science.gov (United States)

    Young, Chase; Mohr, Kathleen A. J.

    2018-01-01

    Research indicates that literature circles are an authentic means for literacy development that students typically enjoy. To better understand the potential value and to add to the research base regarding literature circles, this study, involving 17 fourth graders, explores factors that may influence the quality of literature discussions,…

  19. Social Factors Influencing Child Health in Ghana.

    Directory of Open Access Journals (Sweden)

    Emmanuel Quansah

    Full Text Available Social factors have profound effects on health. Children are especially vulnerable to social influences, particularly in their early years. Adverse social exposures in childhood can lead to chronic disorders later in life. Here, we sought to identify and evaluate the impact of social factors on child health in Ghana. As Ghana is unlikely to achieve the Millennium Development Goals' target of reducing child mortality by two-thirds between 1990 and 2015, we deemed it necessary to identify social determinants that might have contributed to the non-realisation of this goal.ScienceDirect, PubMed, MEDLINE via EBSCO and Google Scholar were searched for published articles reporting on the influence of social factors on child health in Ghana. After screening the 98 articles identified, 34 of them that met our inclusion criteria were selected for qualitative review.Major social factors influencing child health in the country include maternal education, rural-urban disparities (place of residence, family income (wealth/poverty and high dependency (multiparousity. These factors are associated with child mortality, nutritional status of children, completion of immunisation programmes, health-seeking behaviour and hygiene practices.Several social factors influence child health outcomes in Ghana. Developing more effective responses to these social determinants would require sustainable efforts from all stakeholders including the Government, healthcare providers and families. We recommend the development of interventions that would support families through direct social support initiatives aimed at alleviating poverty and inequality, and indirect approaches targeted at eliminating the dependence of poor health outcomes on social factors. Importantly, the expansion of quality free education interventions to improve would-be-mother's health knowledge is emphasised.

  20. Factors that influence women's dispositions toward science

    Science.gov (United States)

    Atria, Catherine Graczyk

    Females have been underrepresented in the study of science and science careers for decades although advancements have been made in closing this gender gap, the gap persists particularly in the physical sciences. Variables which influence a woman's desire to pursue and maintain a science course of study and career must be discovered. The United States lags behind other industrialized countries in the fields of science, math, and engineering. Females comprise an estimated half of the population; their potential contributions cannot be ignored or overlooked. This retrospective research study explores the personal experiences of ten women enrolled in science majors, with science related career plans. The goal of this study is to describe the factors that influence the participants' interest in science. The findings, the effect of science coursework, science teachers' personality and manner, other influential educational personnel, role models and mentors, external influences exclusive of school, parental influence, locus of control and positive attitudes toward science confirm what other researchers have found.

  1. Theoretical difference between impact factor and influence factor

    Directory of Open Access Journals (Sweden)

    Đilda Pečarić

    2010-06-01

    Full Text Available Bibliometric constructions of "knowledge maps" and "cognitive structures of science" do not differentiate between impact and influence factors. The difference can be constructedaccording to different meaning and interpretation of the terms reference and citation. Reference is "acknowledgment which one author gives to another", whereas citation is "acknowledgment which one document receives from another". Development of Information Science according to period and subject area is analyzed on the corpus of citation literature retrieved from doctoral dissertations in Information Science from 1978 to 2007 at Croatian universities. The research aim is to indicate the difference between document impact factor and author's influence factor (i.e. reference ability to produce effects on actions, behavior, and opinions of authors of doctoral theses. The influence factor serves to distinguish the key role of cited authors in time and according to the duration of the influence (the average age for cited papers of dominant authors in different periods is between eight and ten years. The difference between linear and interactive communication seems vital for the interpretation of cited half-life, i.e. the attitude of one science community towards used information resources and cognitive heritage. The analyzed corpus of 22,210 citations can be divided into three communication phases according to influence factor criteria: in the phase of dialogue and interactive communication 25% of bibliographic units are cited in the first four years; in the second phase another 25% of units are cited from the fifth to the ninth year; after ten years, in the dominant linear communication phase, approximately 30% of units are cited.

  2. Investigating important factors influencing purchasing from chains

    Directory of Open Access Journals (Sweden)

    Naser Azad

    2012-04-01

    Full Text Available In this paper, we survey important factors, influencing customers to buy more from one of well known food market operating in capital city of Iran named Shahrvand. The survey studies the effects of six factors including customer's perception, persuasive factors, brand, customers' expectations, product's characteristics and special features of store on attracting more customers. We have distributed questionnaire among 196 customers who regularly visit stores and analyzed details of the data. The results indicate that customers' perception is the most important item, which includes eight components. Years of experience is the most important item in our survey followed by impact of color and working hours. Diversity of services is another factor, which plays the most important role followed by quality of services. Next, fidelity and brand are other most important factors and the name of store and risk are in lower degree of importance.

  3. What Factors Influence Knowledge Sharing in Organizations?

    DEFF Research Database (Denmark)

    Razmerita, Liana; Kirchner, Kathrin; Nielsen, Pia

    2016-01-01

    factors drive employees’ participation and what factors hamper their participation in enterprise social media. Design/methodology/approach: Based on a literature review, a unified research model is derived integrating demographic, individual, organizational and technological factors that influence......Purpose: Enterprise social media platforms provide new ways of sharing knowledge and communicating within organizations to benefit from the social capital and valuable knowledge that employees have. Drawing on social dilemma and self-determination theory, the aim of the study is to understand what...... knowledge sharing framework helps to understand what factors impact engagement on social media. Furthermore the article suggests different types of interventions to overcome the social dilemma of knowledge sharing. Originality/value: The study contributes to an understanding of factors leading...

  4. Patient non-adherence: an interpretative phenomenological analysis.

    Science.gov (United States)

    Dalvi, Vidya; Mekoth, Nandakumar

    2017-04-18

    Purpose While interpretative phenomenological analysis (IPA) has been used in health psychology research, it has so far not been applied to seek deeper insights into the patients' experiences about treatment. The purpose of this paper is to address this gap by using IPA to understand patient non-adherence. Design/methodology/approach In total, 18 patients with chronic conditions seeking healthcare services in Goa and Karnataka, India, were selected by using the snowball sampling method. In-depth interviews were conducted face to face. A semi-structured questionnaire developed by the researchers was used to collect the data. IPA was used to explore the themes to predict patient non-adherence. Findings The study results indicate that economic factors, health system related factors, social factors and psychological factors impact patient non-adherence. Patient non-adherence includes medication non-adherence and lifestyle modification non-adherence. Research limitations/implications Being cross sectional in design, the results may not be as appropriate as the results derived from a longitudinal study given that non-adherence occurs over time. Practical implications Patient non-adherence is a global health issue. Multidisciplinary approach to enhance patient adherence to treatment should form part of public healthcare policy. Social implications Exploring the factors influencing patient non-adherence will help the health-care industry stakeholders to reduce healthcare cost and improve patient's quality of life. Originality/value Although there is extensive quantitative research on the prevalence of non-adherence, qualitative research is limited. This paper addresses this gap by using IPA to understand patient non-adherence and its factors and dimensions.

  5. Influence of organizational factors on safety

    International Nuclear Information System (INIS)

    Haber, S.B.; Metlay, D.S.; Crouch, D.A.

    1990-01-01

    There is a need for a better understanding of exactly how organizational management factors at a nuclear power plant (NPP) affect plant safety performance, either directly or indirectly, and how these factors might be observed, measured, and evaluated. The purpose of this research project is to respond to that need by developing a general methodology for characterizing these organizational and management factors, systematically collecting information on their status and integrating that information into various types of evaluative activities. Research to date has included the development of the Nuclear Organization and Management Analysis Concept (NOMAC) of a NPP, the identification of key organizational and management factors, and the identification of the methods for systematically measuring and analyzing the influence of these factors on performance. Most recently, two field studies, one at a fossil fuel plant and the other at a NPP, were conducted using the developed methodology. Results are presented from both studies highlighting the acceptability, practicality, and usefulness of the methods used to assess the influence of various organizational and management factors including culture, communication, decision-making, standardization, and oversight. 6 refs., 3 figs., 1 tab

  6. Factors Influencing Colorectal Cancer Screening Participation

    Directory of Open Access Journals (Sweden)

    Antonio Z. Gimeno García

    2012-01-01

    Full Text Available Colorectal cancer (CRC is a major health problem worldwide. Although population-based CRC screening is strongly recommended in average-risk population, compliance rates are still far from the desirable rates. High levels of screening uptake are necessary for the success of any screening program. Therefore, the investigation of factors influencing participation is crucial prior to design and launches a population-based organized screening campaign. Several studies have identified screening behaviour factors related to potential participants, providers, or health care system. These influencing factors can also be classified in non-modifiable (i.e., demographic factors, education, health insurance, or income and modifiable factors (i.e., knowledge about CRC and screening, patient and provider attitudes or structural barriers for screening. Modifiable determinants are of great interest as they are plausible targets for interventions. Interventions at different levels (patient, providers or health care system have been tested across the studies with different results. This paper analyzes factors related to CRC screening behaviour and potential interventions designed to improve screening uptake.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1986-03-01

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

  8. TB treatment initiation and adherence in a South African community influenced more by perceptions than by knowledge of tuberculosis

    Directory of Open Access Journals (Sweden)

    Møller Valerie

    2010-02-01

    Full Text Available Abstract Background Tuberculosis (TB is a global health concern. Inadequate case finding and case holding has been cited as major barrier to the control of TB. The TB literature is written almost entirely from a biomedical perspective, while recent studies show that it is imperative to understand lay perception to determine why people seek treatment and may stop taking treatment. The Eastern Cape is known as a province with high TB incidence, prevalence and with one of the worst cure rates of South Africa. Its inhabitants can be considered lay experts when it comes to TB. Therefore, we investigated knowledge, perceptions of (access to TB treatment and adherence to treatment among an Eastern Cape population. Methods An area-stratified sampling design was applied. A total of 1020 households were selected randomly in proportion to the total number of households in each neighbourhood. Results TB knowledge can be considered fairly good among this community. Respondents' perceptions suggest that stigma may influence TB patients' decision in health seeking behavior and adherence to TB treatment. A full 95% of those interviewed believe people with TB tend to hide their TB status out of fear of what others may say. Regression analyses revealed that in this population young and old, men and women and the lower and higher educated share the same attitudes and perceptions. Our findings are therefore likely to reflect the actual situation of TB patients in this population. Conclusions The lay experts' perceptions suggests that stigma appears to effect case holding and case finding. Future interventions should be directed at improving attitudes and perceptions to potentially reduce stigma. This requires a patient-centered approach to empower TB patients and active involvement in the development and implementation of stigma reduction programs.

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

    Directory of Open Access Journals (Sweden)

    Shandir Ramlagan

    2018-01-01

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

  10. Factors Influencing Tacit Knowledge in Construction

    Directory of Open Access Journals (Sweden)

    Jawahar Nesan

    2012-11-01

    Full Text Available Increased complexity of the construction business and consequentuse of new management concepts and technologies ledconstruction organisations to focus more on the transfer of explicitknowledge. However, it is the tacit knowledge that determinesthe construction companies’ competitiveness in a business thatis driven by turbulent market conditions and customers’ everincreasingdemands. This paper highlights the importance of tacitknowledge sharing in construction, explores the challenges andopportunities to efficiently share tacit knowledge, and based on theliterature review identifies some critical factors that influence tacitknowledge in construction. It is argued that employees’ knowledgesharing (learning behaviours are influenced by work practices thatare borne by respective organisational behaviours. Organisational,cultural, and project characteristics that facilitate knowledgesharing among construction employees are explored and thepractices that influence the construction employee behaviour insharing tacit knowledge are highlighted.

  11. Investigating different factors influencing on brand equity

    Directory of Open Access Journals (Sweden)

    Afsane Zamanimoghadam

    2014-07-01

    Full Text Available The purpose of this paper is to determine and prioritize factors influencing on brand equity in consumer’s point of view for a case study of Samsung appliance consumers in city of Tehran, Iran. The study investigates the effects of four factors in terms of the customer's perspective, price, advertisement, family and brand image, by dimensions of brand equity, perceived quality, brand awareness, brand association, brand loyalty, on brand equity. The research method is based on a descriptive-survey research. The questionnaire includes Samsung consumers in city of Tehran, Iran. To test the hypotheses, SPSS and LISREL software packages are used. For data analysis, descriptive statistics and inferential statistical tests including structural equation modeling and path analysis are used. The results of the survey have indicated that family and brand image influence positively on brand equity but the effects of advertisement and price on brand equity were not confirmed.

  12. FACTORS INFLUENCING THE MANAGEMENT OF ADHD

    OpenAIRE

    S ARMAN; M SOLTANI

    2003-01-01

    Introduction: Attention deficit hyperactivity disorder (ADHD)is the most common psychiatric disorder among school age children. It consists of hyperactivity, inattention and impulsive behavior. The onset of the disorder is before the age of 7 years and it happens at least in two situations. It causes significant impairment in social and academic functioning. A determination of factors that influences the therapeutic response in ADHD is the aim of this study. Methods: This study is design...

  13. Factors influencing laser cutting of wood

    Energy Technology Data Exchange (ETDEWEB)

    Barnekov, V. G.; McMillin, C. W.; Huber, H. A.

    1986-07-01

    Factors influencing the ability of lasers to cut wood may be generally classified into these three areas: 1) characteristics of the laser beam; 2) equipment and processing variables; and 3) properties of the work piece. Effects of beam power, mode, polarization, and stability are discussed as are aspects of optics, location of focal point, feed speed, gas-jet assist system and work piece thickness, density, and moisture content. (author)

  14. Psychological Factors Influencing Life Satisfaction of Undergraduates

    OpenAIRE

    Ajayi, Olubukola; Adewumi, Bukunmi

    2017-01-01

    This study was designed to assess the psychological factors influencing life satisfaction of undergraduates. The instruments used were Perceived Stress Scale (PSS), Wong and Law Emotional Intelligence Scale (WLEIS), Rosenberge Self-esteem Scale (RSS), and Satisfaction with Life Scale (SWLS). A total number of 190 participants were purposively selected across various faculties in Ekiti State University. Four hypotheses were tested using Independent t-test to find the effects of perceived stres...

  15. Abiotic factors influencing tropical dry forests regeneration

    Directory of Open Access Journals (Sweden)

    Ceccon Eliane

    2006-01-01

    Full Text Available Tropical dry forests represent nearly half the tropical forests in the world and are the ecosystems registering the greatest deterioration from the anthropogenic exploitation of the land. This paper presents a review on the dynamics of tropical dry forests regeneration and the main abiotic factors influencing this regeneration, such as seasonal nature, soil fertility and humidity, and natural and anthropic disturbances. The main purpose is to clearly understand an important part of TDF succession dynamics.

  16. Modeling the influence of non-adherence on antibiotic efficacy: application to ciprofloxacin

    Czech Academy of Sciences Publication Activity Database

    Lánský, Petr; Šanda, Pavel; Weiss, M.

    2007-01-01

    Roč. 45, č. 8 (2007), s. 438-447 ISSN 0946-1965 R&D Projects: GA MZd NR7795 Institutional research plan: CEZ:AV0Z50110509 Keywords : nonadherance * ciprofloxacin * stochastic model Subject RIV: FR - Pharmacology ; Medidal Chemistry Impact factor: 1.281, year: 2007

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  19. [Factors influencing nurses' organizational citizenship behavior].

    Science.gov (United States)

    Park, Junhee; Yun, Eunkyung; Han, Sangsook

    2009-08-01

    This study was conducted to identify the factors that influence nurses' organizational citizenship behavior. A cross-sectional design was used, with a convenience sample of 547 nurses from four university hospitals in Seoul and Gyeonggi province. The data were collected through a questionnaire survey done from September 22 to October 10, 2008. The tools used for this study were scales on organizational citizenship behavior (14 items), self-leadership (14 items), empowerment (10 items), organizational commitment (7 items), job satisfaction (8 items) and transformational.transactional leadership (14 items). Cronbach's alpha and factor analysis were examined to test reliability and construct validity of the scale. The data collected were processed using SPSS Window 15.0 Program for actual numbers and percentages, differences in the dependent variable according to general characteristics, and means, standard deviations, correlation coefficients and multiple regression analysis. The factors influencing nurses' organizational citizenship behavior were identified as self-leadership(beta=.247), empowerment (beta=.233), job satisfaction (beta=.209), organizational commitment (beta=.158), and transactional leadership (beta=.142). Five factors explained 42.0% of nurses' organizational citizenship behavior. The results of this study can be used to develop further management strategies for enhancement of nurses' organizational citizenship behavior.

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

    Directory of Open Access Journals (Sweden)

    Gaëlle Cane

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

  1. Internal factors influencing the knowledge continuity ensuring

    Directory of Open Access Journals (Sweden)

    Hana Urbancová

    2012-01-01

    Full Text Available The aim of the systematic ensuring of knowledge continuity is the continuity of an organisation’s development, the quality of managerial positions and the continuity of decision-making. By ensuring knowledge continuity, organisations may gain a performance-enhancing factor. The objective of the article is to identify the level of impact of decisive internal factors determining knowledge continuity ensuring and contributing to the efficiency of the organisations. Knowledge continuity ensuring as an internal force, however, can together with the right employees, help adapt more quickly to external conditions that organisations can hardly control. Monitoring and ensuring knowledge continuity can contribute to a higher quality of processes in general, in particular processes exploiting knowledge, and thus help improve the level of management. The first part of the article presents theoretical views on the aspects of knowledge continuity ensuring in organisations while the second part analyses the findings of the surveys carried out among managers in organisations in the Czech Republic. Based on the summary of the outcomes obtained it is possible to say that internal factors influence knowledge continuity ensuring in organisations, however, the level of impact of individual factors is determined by their size. The findings regarding the impact of each of the factors show that the most significant barriers to knowledge continuity ensuring are those associated with the human factor.

  2. Evaluation of a pilot study to influence medication adherence of patients with diabetes mellitus type-2 by the pharmacy

    NARCIS (Netherlands)

    Adhien, P.; van Dijk, L.; de Vegter, M.; Westein, M.; Nijpels, G.; Hugtenburg, J.G.

    2013-01-01

    Background Interventions aimed to increase adherence to drug treatment usually are not tailored to the needs of individual patients. A modular pharmacy intervention, named 'Support for Diabetes', was developed to improve adherence to type 2 diabetes treatment. Objective To evaluate the

  3. Factors influencing internal color of cooked meats.

    Science.gov (United States)

    Suman, Surendranath P; Nair, Mahesh N; Joseph, Poulson; Hunt, Melvin C

    2016-10-01

    This manuscript overviews the pertinent research on internal color of uncured cooked meats, biochemical processes involved in meat cookery, and fundamental mechanisms governing myoglobin thermal stability. Heat-induced denaturation of myoglobin, responsible for the characteristic dull-brown color of cooked meats, is influenced by a multitude of endogenous (i.e., pH, muscle source, species, redox state) and exogenous (i.e., packaging, ingredients, storage) factors. The interactions between these factors critically influence the internal cooked color and can confuse the consumers, who often perceive cooked color to be a reliable indicator for doneness and safety. While certain phenomena in cooked meat color are cosmetic in nature, others can mislead consumers and result in foodborne illnesses. Research in meat color suggests that processing technologies and cooking practices in industry as well as households influence the internal cooked color. Additionally, the guidelines of many international public health and regulatory authorities recommend using meat thermometers to determine safe cooking endpoint temperature and to ensure product safety. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Patient-reported adverse drug reactions and their influence on adherence and quality of life of chronic myeloid leukemia patients on per oral tyrosine kinase inhibitor treatment

    Directory of Open Access Journals (Sweden)

    Kekäle M

    2015-12-01

    Full Text Available Meri Kekäle,1 Marikki Peltoniemi,2 Marja Airaksinen1 1Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, 2Division of Pharmaceutical Chemistry and Technology, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland Purpose: To evaluate adverse drug reactions (ADRs experienced by chronic myeloid leukemia (CML patients during per oral tyrosine kinase inhibitor (TKI treatment and correlation of ADR symptoms with medication adherence and perceived quality of life (QoL.Patients and methods: Eighty-six adult, chronic-phase CML patients who had been on TKI treatment (79% on imatinib, 10.5% dasatinib, and 10.5% nilotinib for at least 6 months participated in the study (mean age: 57.8 years, 52% males. The mean time from diagnosis was 5.1 years. All patients were interviewed, and patient-reported ADRs were obtained using a structured list. Adherence was assessed using Morisky’s 8-item Medication Adherence Scale (MMAS. The symptoms’ interference with patient’s daily QoL was measured by asking patients about the influence of symptom(s on their mood, general condition, enjoyment of life, walking, relationships, and work.Results: Ninety-seven percent of the patients were suffering from at least one ADR. The mean number of different symptoms was seven (range: 0–15, median 6. The most commonly perceived ADRs were muscle soreness or cramp (69/86, 80%; swelling of hands, legs, feet, or around the eyes (59/86, 69%; and fatigue (43/86, 50%. No correlation was found between adherence and ADRs, because symptoms were equally common in each MMAS adherence class. Half of the patients felt that the ADRs had a negative influence on their daily QoL. A quarter of the patients reported that ADRs affected either their mood, general condition, or enjoyment of life. The incidence of almost all ADRs was much higher among patients reporting negative influence of ADRs on their daily life compared to total study population (P=0.016.Conclusion

  5. Does Health Information in Mass Media Help or Hurt Patients? Investigation of Potential Negative Influence of Mass Media Health Information on Patients' Beliefs and Medication Regimen Adherence.

    Science.gov (United States)

    Im, Heewon; Huh, Jisu

    2017-03-01

    As an important public health issue, patient medication non-adherence has drawn much attention, but research on the impact of mass media as an information source on patient medication adherence has been scant. Given that mass media often provide confusing and contradicting information regarding health/medical issues, this study examined the potential negative influence of exposure to health information in mass media on patients' beliefs about their illnesses and medications, and medication adherence, in comparison with the effects of exposure to another primary medication information source, physicians. Survey data obtained from patients on blood thinner regimens revealed that the frequency of exposure to health information in mass media was negatively related to accuracy of patients' beliefs about their medication benefits and patient medication adherence. On the other hand, frequency of visits with physicians was positively associated with patients' beliefs about their medication benefits but had no significant relation to medication regimen adherence. The implications of the study findings are discussed, and methodological limitations and suggestion for future research are presented.

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

    DEFF Research Database (Denmark)

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

    2018-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kyokunzire C

    2018-03-01

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

  8. Influence of non-adherent yeast cells on electrical characteristics of diamond-based field-effect transistors

    Energy Technology Data Exchange (ETDEWEB)

    Procházka, Václav, E-mail: prochazkav@fzu.cz [Faculty of Electrical Engineering, Czech Technical University in Prague, Technická 2, 16627 Prague (Czech Republic); Institute of Physics, The Czech Academy of Sciences, Cukrovarnická 10/112, 162 00 Prague (Czech Republic); Cifra, Michal [Institute of Photonics and Electronics, The Czech Academy of Sciences, Chaberská 57, 182 51 Prague (Czech Republic); Kulha, Pavel [Faculty of Electrical Engineering, Czech Technical University in Prague, Technická 2, 16627 Prague (Czech Republic); Institute of Physics, The Czech Academy of Sciences, Cukrovarnická 10/112, 162 00 Prague (Czech Republic); Ižák, Tibor [Institute of Physics, The Czech Academy of Sciences, Cukrovarnická 10/112, 162 00 Prague (Czech Republic); Rezek, Bohuslav [Faculty of Electrical Engineering, Czech Technical University in Prague, Technická 2, 16627 Prague (Czech Republic); Institute of Physics, The Czech Academy of Sciences, Cukrovarnická 10/112, 162 00 Prague (Czech Republic); Kromka, Alexander [Institute of Physics, The Czech Academy of Sciences, Cukrovarnická 10/112, 162 00 Prague (Czech Republic); Faculty of Civil Engineering, Czech Technical University in Prague, Thákurova 7, 16629 Prague (Czech Republic)

    2017-02-15

    Highlights: • Interaction of non-adherent yeast cells with H-terminated diamond described. • Effect of cell culture solutions on H-diamond SGFET (positive potential shifts). • H-diamond sensitive to metabolic activity of yeast cells (negative potential shift). - Abstract: Diamond thin films provide unique features as substrates for cell cultures and as bio-electronic sensors. Here we employ solution-gated field effect transistors (SGFET) based on nanocrystalline diamond thin films with H-terminated surface which exhibits the sub-surface p-type conductive channel. We study an influence of yeast cells (Saccharomyces cerevisiae) on electrical characteristics of the diamond SGFETs. Two different cell culture solutions (sucrose and yeast peptone dextrose–YPD) are used, with and without the cells. We have found that transfer characteristics of the SGFETs exhibit a negative shift of the gate voltage by −26 mV and −42 mV for sucrose and YPD with cells in comparison to blank solutions without the cells. This effect is attributed to a local pH change in close vicinity of the H-terminated diamond surface due to metabolic processes of the yeast cells. The pH sensitivity of the diamond-based SGFETs, the role of cell and protein adhesion on the gate surface and the role of negative surface charge of yeast cells on the SGFETs electrical characteristics are discussed as well.

  9. Influence of non-adherent yeast cells on electrical characteristics of diamond-based field-effect transistors

    International Nuclear Information System (INIS)

    Procházka, Václav; Cifra, Michal; Kulha, Pavel; Ižák, Tibor; Rezek, Bohuslav; Kromka, Alexander

    2017-01-01

    Highlights: • Interaction of non-adherent yeast cells with H-terminated diamond described. • Effect of cell culture solutions on H-diamond SGFET (positive potential shifts). • H-diamond sensitive to metabolic activity of yeast cells (negative potential shift). - Abstract: Diamond thin films provide unique features as substrates for cell cultures and as bio-electronic sensors. Here we employ solution-gated field effect transistors (SGFET) based on nanocrystalline diamond thin films with H-terminated surface which exhibits the sub-surface p-type conductive channel. We study an influence of yeast cells (Saccharomyces cerevisiae) on electrical characteristics of the diamond SGFETs. Two different cell culture solutions (sucrose and yeast peptone dextrose–YPD) are used, with and without the cells. We have found that transfer characteristics of the SGFETs exhibit a negative shift of the gate voltage by −26 mV and −42 mV for sucrose and YPD with cells in comparison to blank solutions without the cells. This effect is attributed to a local pH change in close vicinity of the H-terminated diamond surface due to metabolic processes of the yeast cells. The pH sensitivity of the diamond-based SGFETs, the role of cell and protein adhesion on the gate surface and the role of negative surface charge of yeast cells on the SGFETs electrical characteristics are discussed as well.

  10. Factors influencing thermal tolerances of individual organisms

    International Nuclear Information System (INIS)

    Hutchison, V.H.

    1976-01-01

    The diversity of experimental methods and terminology employed by investigators to measure the effects of high temperatures on individual organisms, plus the often overlooked complexities of the holocoenotic environment, has often led to disconcerting conclusions. A plea is made for standardization of testing methods and for a wider appreciation of factors that may alter thermal tolerances. The influence of elevated temperature is grouped into three categories, lethal effects, controlling effects, and directive effects, all of which should be considered in assessing the impact of thermal effluent on organisms. In addition, the terminology (acclimation, acclimatization, adaptation, habituation, lethal temperature, critical thermal maximum, etc.) needs standardized definitions. The important factors influencing thermal effects on organisms include photoperiod, seasonal and daily cycles, geographic variation, diet, sex, breeding condition, age, life-cycle stage, salinity, chemicals, body water content and partitioning, oxygen supply, pH, innate and learned behavior, history of thermal exposure, sublethal exposure to limiting factors, and experimental methods. Examples of most of these are given to illustrate the role of temperature in the holocoenotic environmental complex of individual organisms

  11. The Effect of Mobile Messaging Apps on Cardiac Patient Knowledge of CAD Risk Factors and Adherence to a Healthy Lifestyle.

    Science.gov (United States)

    Tang, Yea Hung; Chong, Mei Chan; Chua, Yan Piaw; Chui, Ping Lei; Tang, Li Yoong; Rahmat, Norsiah

    2018-05-18

    This study aimed to determine the effect mobile messaging apps on coronary artery disease patient knowledge of and adherence to a healthy lifestyle. Due to the increasing incidence of coronary artery disease in recent years, interventions targeting coronary artery disease risk factors are urgent public priorities. The use of mobile technology in healthcare services and medical education is relatively new with promising future prospects. This study used a quasi-experimental design that included pre- and post-test for intervention and control groups. The study was conducted from January to April 2017 with both intervention and control group, in a teaching hospital in Klang Valley. Convenience sampling was used with inclusive criteria in choosing the 94 patients with coronary artery disease (intervention group: 47 patients; control group: 47 patients). The pre-test was conducted as a baseline measurement for both groups before they were given standard care from a hospital. However, only the intervention group was given a daily information update via WhatsApp for one month. After one month, both groups were assessed with a post-test. The split-plot ANOVA analysis indicates that there is a significant and positive effect of the intervention on coronary artery disease patients' knowledge on CAD risk factors [F(1, 92) = 168.15, p WhatsApp was an effective health intervention in increasing coronary artery disease patient's knowledge and subsequently increasing their adherence to healthy lifestyles. In clinical setting, mobile messaging apps is useful in information delivery and efficient patient monitory. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. Emergency Department Crowding: Factors Influencing Flow

    Directory of Open Access Journals (Sweden)

    Arkun, Alp

    2010-02-01

    Full Text Available Background: The objective of this study was to evaluate those factors, both intrinsic and extrinsic to the emergency department (ED that influence two specific components of throughput: “door-to-doctor” time and dwell time.Methods: We used a prospective observational study design to determine the variables that played a significant role in determining ED flow. All adult patients seen or waiting to be seen in the ED were observed at 8pm (Monday-Friday during a three-month period. Variables measured included daily ED volume, patient acuity, staffing, ED occupancy, daily admissions, ED boarder volume, hospital volume, and intensive care unit volume. Both log-rank tests and time-to-wait (survival proportional-hazard regression models were fitted to determine which variables were most significant in predicting “door-to-doctor” and dwell times, with full account of the censoring for some patients.Results: We captured 1,543 patients during our study period, representing 27% of total daily volume. The ED operated at an average of 85% capacity (61-102% with an average of 27% boarding. Median “door-to-doctor” time was 1.8 hours, with the biggest influence being triage category, day of the week, and ED occupancy. Median dwell time was 5.5 hours with similar variable influences.Conclusion: The largest contributors to decreased patient flow through the ED at our institution were triage category, ED occupancy, and day of the week. Although the statistically significant factors influencing patient throughput at our institution involve problems with inflow, an increase in ED occupancy could be due to substantial outflow obstruction and may indicate the necessity for increased capacity both within the ED and hospital. [West J Emerg Med. 2010; 11(1:10-15

  13. Emergency department crowding: factors influencing flow.

    Science.gov (United States)

    Arkun, Alp; Briggs, William M; Patel, Sweha; Datillo, Paris A; Bove, Joseph; Birkhahn, Robert H

    2010-02-01

    THE OBJECTIVE OF THIS STUDY WAS TO EVALUATE THOSE FACTORS, BOTH INTRINSIC AND EXTRINSIC TO THE EMERGENCY DEPARTMENT (ED) THAT INFLUENCE TWO SPECIFIC COMPONENTS OF THROUGHPUT: "door-to-doctor" time and dwell time. We used a prospective observational study design to determine the variables that played a significant role in determining ED flow. All adult patients seen or waiting to be seen in the ED were observed at 8pm (Monday-Friday) during a three-month period. Variables measured included daily ED volume, patient acuity, staffing, ED occupancy, daily admissions, ED boarder volume, hospital volume, and intensive care unit volume. Both log-rank tests and time-to-wait (survival) proportional-hazard regression models were fitted to determine which variables were most significant in predicting "door-to-doctor" and dwell times, with full account of the censoring for some patients. We captured 1,543 patients during our study period, representing 27% of total daily volume. The ED operated at an average of 85% capacity (61-102%) with an average of 27% boarding. Median "door-to-doctor" time was 1.8 hours, with the biggest influence being triage category, day of the week, and ED occupancy. Median dwell time was 5.5 hours with similar variable influences. The largest contributors to decreased patient flow through the ED at our institution were triage category, ED occupancy, and day of the week. Although the statistically significant factors influencing patient throughput at our institution involve problems with inflow, an increase in ED occupancy could be due to substantial outflow obstruction and may indicate the necessity for increased capacity both within the ED and hospital.

  14. [New nurse turnover intention and influencing factors].

    Science.gov (United States)

    Han, Sang Sook; Sohn, In Soon; Kim, Nam Eun

    2009-12-01

    The study was done to identify turnover intention in new nurses according to characteristics of the nurses and other factors affecting turnover and to provide data to set up a strategy to reduce the turnover. Data were collected from 1,077 new nurses who had less than 12 months employment experience and worked in one of 188 hospitals. Eight research instruments were used. Data analysis was done using SPSS WIN 15.0 program. Several factors influence new nurse turnover intention. The average score for turnover intention was 2.12. The scores for subscales were self efficacy, 3.76, nursing performance, 3.90, job satisfaction, 2.09, organization commitment, 1.28, stress, 1.32, burnout, 2.82 and nursing organizational culture, 3.29. Turnover intention was related to self efficacy, nursing performance, job satisfaction, organization commitment, stress, burnout, nursing organizational culture, duration of in-class training, duration of on the job training, number of hospital beds, length of employment and duration of employment in current workplace. The predicting factors for turnover intention were burnout, stress, duration of employment in the current workplace, self efficacy and nursing performance. Those factors explained 51.6% of turnover intention. New nurse turnover intention can be reduced by mitigating the factors affecting this intention.

  15. Health behavior change: can genomics improve behavioral adherence?

    Science.gov (United States)

    McBride, Colleen M; Bryan, Angela D; Bray, Molly S; Swan, Gary E; Green, Eric D

    2012-03-01

    The National Human Genome Research Institute recommends pursuing "genomic information to improve behavior change interventions" as part of its strategic vision for genomics. The limited effectiveness of current behavior change strategies may be explained, in part, by their insensitivity to individual variation in adherence responses. The first step in evaluating whether genomics can inform customization of behavioral recommendations is evidence reviews to identify adherence macrophenotypes common across behaviors and individuals that have genetic underpinnings. Conceptual models of how biological, psychological, and environmental factors influence adherence also are needed. Researchers could routinely collect biospecimens and standardized adherence measurements of intervention participants to enable understanding of genetic and environmental influences on adherence, to guide intervention customization and prospective comparative effectiveness studies.

  16. Candida albicans adherence to resin-composite restorative dental material: influence of whole human saliva.

    Science.gov (United States)

    Maza, José Luis; Elguezabal, Natalia; Prado, Carlota; Ellacuría, Joseba; Soler, Iñaki; Pontón, José

    2002-11-01

    Attachment of Candida albicans to oral surfaces is believed to be a critical event in the colonization of the oral cavity and in the development of oral diseases such as Candida-associated denture stomatitis. Although there is considerable information about the adhesion of C albicans to buccal epithelial cells and prosthetic materials, there is very little information about the adhesion of C albicans to composite restorative materials. The purpose of this study was to investigate the degree of adhesion of C albicans to a resin-composite restorative material (Herculite). The adhesion of 2 strains of C albicans, a germinative and a germ tube-deficient mutant, was studied by a visual method after incubating the fungus and the resin with and without human whole saliva. In absence of saliva, the adhesion of the C albicans germinative isolate to the resin showed an increase in parallel with the germination, reaching a maximum at the end of the experiment (120 minutes). However, no significant differences were observed in the adhesion of the agerminative mutant during the period of time studied. In the presence of saliva, the adhesion of both isolates to the resin was significantly lowered. Germination and the presence of human whole saliva are important factors in the adhesion of C albicans to the resin-composite restorative material Herculite.

  17. Emergency Department Crowding: Factors Influencing Flow

    OpenAIRE

    Arkun, Alp; Briggs, William M; Patel, Sweha; Datillo, Paris A; Bove, Joseph; Birkhahn, Robert H

    2010-01-01

    Background: The objective of this study was to evaluate those factors, both intrinsic and extrinsic to the emergency department (ED) that influence two specific components of throughput: “door-to-doctor” time and dwell time. Methods: We used a prospective observational study design to determine the variables that played a significant role in determining ED flow. All adult patients seen or waiting to be seen in the ED were observed at 8pm (Monday-Friday) during a three-month period. V...

  18. Factors influencing variation in dentist service rates.

    Science.gov (United States)

    Grembowski, D; Milgrom, P; Fiset, L

    1990-01-01

    In the previous article, we calculated dentist service rates for 200 general dentists based on a homogeneous, well-educated, upper-middle-class population of patients. Wide variations in the rates were detected. In this analysis, factors influencing variation in the rates were identified. Variation in rates for categories of dental services was explained by practice characteristics, patient exposure to fluoridated water supplies, and non-price competition in the dental market. Rates were greatest in large, busy practices in markets with high fees. Older practices consistently had lower rates across services. As a whole, these variables explained between 5 and 30 percent of the variation in the rates.

  19. Factors influencing the cardiac MIBG accumulation

    International Nuclear Information System (INIS)

    Takatsu, Hisato; Fujiwara, Hisayoshi

    1997-01-01

    Following factors possibly influencing the cardiac MIBG accumulation were examined mainly in mice. 1. The specific activity of the MIBG (meta-iodo-benzyl guanidine) on the neuronal and non-neuronal fractions. 2. Motor restriction stress on MIBG accumulation and washout. 3. Loading and restriction of sodium chloride on the accumulation and effect of suppression of renin-angiotensin system. 4. Examinations in Dahl rats. 125I- or 131I-MIBG was intravenously administered to mice at 74 kBq. At 30 min or 4 hr after administration, mice were sacrificed and their left ventricles were dissected out for measurement of radioactivity in a liquid scintillation counter. Salt-sensitive and -resistant Dahl rats were given with 37 MBq of 123I-MIBG and cardiac radioactivity was measured externally for calculation of washout. Factors examined were found highly correlated with the accumulation of MIBG and measurement of its washout was considered useful for evaluating sympathetic activity. (K.H.)

  20. A survey on factors influencing city branding

    Directory of Open Access Journals (Sweden)

    Seyed Mohsen Mahmoudzadeh

    2014-10-01

    Full Text Available Nowadays, the issue of “globalization” is entering to all areas in the world. In addition to products and companies, cities and countries also have the opportunity to see themselves as important actors in international arena. Places define their positions in different fields like business, leisure and recreation, educational opportunities, living, etc. This paper presents an empirical study to introduce city branding as one of the solutions to join globalization process. The method of this research is based on the “descriptive-analytic” and utilize the available literature and experts’ opinions to prioritize the influencing factors of city branding. We use Delphi consensus methods and technique of analytical hierarchy process to evaluate the factors. Finally, the results of the study indicate that security, transportation and mental creativity are the weakest fields and business and shopping facilities are strong fields of city branding in metropolitan of Tehran.

  1. Organizational factors influencing improvements in safety

    International Nuclear Information System (INIS)

    Marcus, A.; Nichols, M.L.; Olson, J.; Osborn, R.; Thurber, J.

    1992-01-01

    Research reported here seeks to identify the key organizational factors that influence safety-related performance indicators in nuclear power plants over time. It builds upon organizational factors identified in NUREG/CR-5437, and begins to develop a theory of safety-related performance and performance improvement based on economic and behavioral theories of the firm. Central to the theory are concepts of past performance, problem recognition, resource availability, resource allocation, and business strategies that focus attention. Variables which reflect those concepts are combined in statistical models and tested for their ability to explain scrams, safety system actuations, significant events, safety system failures, radiation exposure, and critical hours. Results show the performance indicators differ with respect to the sets of variables which serve as the best predictors of future performance, and past performance is the most consistent predictor of future performance

  2. Automation bias: empirical results assessing influencing factors.

    Science.gov (United States)

    Goddard, Kate; Roudsari, Abdul; Wyatt, Jeremy C

    2014-05-01

    To investigate the rate of automation bias - the propensity of people to over rely on automated advice and the factors associated with it. Tested factors were attitudinal - trust and confidence, non-attitudinal - decision support experience and clinical experience, and environmental - task difficulty. The paradigm of simulated decision support advice within a prescribing context was used. The study employed within participant before-after design, whereby 26 UK NHS General Practitioners were shown 20 hypothetical prescribing scenarios with prevalidated correct and incorrect answers - advice was incorrect in 6 scenarios. They were asked to prescribe for each case, followed by being shown simulated advice. Participants were then asked whether they wished to change their prescription, and the post-advice prescription was recorded. Rate of overall decision switching was captured. Automation bias was measured by negative consultations - correct to incorrect prescription switching. Participants changed prescriptions in 22.5% of scenarios. The pre-advice accuracy rate of the clinicians was 50.38%, which improved to 58.27% post-advice. The CDSS improved the decision accuracy in 13.1% of prescribing cases. The rate of automation bias, as measured by decision switches from correct pre-advice, to incorrect post-advice was 5.2% of all cases - a net improvement of 8%. More immediate factors such as trust in the specific CDSS, decision confidence, and task difficulty influenced rate of decision switching. Lower clinical experience was associated with more decision switching. Age, DSS experience and trust in CDSS generally were not significantly associated with decision switching. This study adds to the literature surrounding automation bias in terms of its potential frequency and influencing factors. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Factors influencing global antiretroviral procurement prices.

    Science.gov (United States)

    Wirtz, Veronika J; Forsythe, Steven; Valencia-Mendoza, Atanacio; Bautista-Arredondo, Sergio

    2009-11-18

    Antiretroviral medicines (ARVs) are one of the most costly parts of HIV/AIDS treatment. Many countries are struggling to provide universal access to ARVs for all people living with HIV and AIDS. Although substantial price reductions of ARVs have occurred, especially between 2002 and 2008, achieving sustainable access for the next several decades remains a major challenge for most low- and middle-income countries. The objectives of the present study were twofold: first, to analyze global ARV prices between 2005 and 2008 and associated factors, particularly procurement methods and key donor policies on ARV procurement efficiency; second, to discuss the options of procurement processes and policies that should be considered when implementing or reforming access to ARV programs. An ARV-medicines price-analysis was carried out using the Global Price Reporting Mechanism from the World Health Organization. For a selection of 12 ARVs, global median prices and price variation were calculated. Linear regression models for each ARV were used to identify factors that were associated with lower procurement prices. Logistic regression models were used to identify the characteristics of those countries which procure below the highest and lowest direct manufactured costs. Three key factors appear to have an influence on a country's ARV prices: (a) whether the product is generic or not; (b) the socioeconomic status of the country; (c) whether the country is a member of the Clinton HIV/AIDS Initiative. Factors which did not influence procurement below the highest direct manufactured costs were HIV prevalence, procurement volume, whether the country belongs to the least developed countries or a focus country of the United States President's Emergency Plan For AIDS Relief. One of the principal mechanisms that can help to lower prices for ARV over the next several decades is increasing procurement efficiency. Benchmarking prices could be one useful tool to achieve this.

  4. Exploring risk factors of non-adherence to immunosuppressive medication in kidney transplant recipients : improving methodology & reorienting research goals

    OpenAIRE

    Denhaerynck, Kris

    2006-01-01

    8.1. Background and aim of the research program Non-adherence to the immunosuppressive therapy is an important issue in kidney transplant patients. About 20% of the kidney transplant patients are non-adherent to the immunosuppressive regimen. Non-adherence contributes to 20% of late acute rejection episodes and 16% of the graft losses, and results in a decreased number of quality adjusted life years. A strategy to increase long-term successful outcome after transplantation i...

  5. Factors influencing seed germination in Cerrado grasses

    Directory of Open Access Journals (Sweden)

    Rosana Marta Kolb

    2016-03-01

    Full Text Available Few studies address the ecology of herbs of Cerrado grasslands, which are ecosystems where the long dry season, high temperatures, insolation, fire and invasive grasses greatly influencing germination and the establishment of plants. We assessed germination of 13 species of Poaceae from Cerrado grasslands under nursery conditions or in germination chambers, the latter with i recently collected seeds and seeds after six months storage, ii under constant and alternating temperatures, and iii in the presence and absence of light. Germinability, mean germination time (MGT and required light were quantified to elucidate factors involved in successful germination. Germinability was low for most grasses, probably because of low seed viability. For most species, germinability and MGT were not altered by seed storage. Germination percentages were higher at alternating temperatures and in the presence of light, factors that are more similar to natural environmental situations compared with constant temperature or the absence of light. Our findings indicate that alternating temperatures and light incidence are key factors for germination of species of Poaceae. The maintenance of these environmental factors, which are crucial for the conservation of Cerrado grasslands, depends on appropriate management interventions, such as fire management and the control of biological invasion.

  6. Factors that influence nurses' job satisfaction.

    Science.gov (United States)

    Ma, Chen-Chung; Samuels, Michael E; Alexander, Judith W

    2003-05-01

    To examine factors affecting the job satisfaction of registered nurses (RNs). A growing recognition of job dissatisfaction among RNs in South Carolina hospitals has contributed to current problems with recruitment and retention. If administrators identify factors influencing RNs' job satisfaction in hospitals and implement strategies to address these factors, RN turnover rates will decrease and recruiting and retention rates will increase. A cross-sectional study of secondary data was designed to identify the individual, work, and geographic factors that impact nursing job satisfaction at the state level. A 27-question self-administered survey was sent to 17,500 RNs in South Carolina with postage-paid envelopes for their responses. Surveys from 3472 nurses were completed anonymously. Univariate statistics were used to describe the study sample. One-way and multivariable Analysis of Variance were used to determine which variables contributed the most to job satisfaction. For about two thirds of the RNs, job satisfaction remained the same or had lessened over the past 2 years. In addition, statistically significant differences were found between job satisfaction and years of service, job position, hospital retirement plan, and geographic area. The findings have implications for nurse managers and hospital administrators for planning and implementing effective health policies that will meet the unique needs of their staffs and organizations. Such research is particularly relevant in this difficult time of nursing shortages throughout the healthcare industry.

  7. Factors Influencing Acceptance Of Contraceptive Methods

    Directory of Open Access Journals (Sweden)

    Anita Gupta

    1997-04-01

    Full Text Available Research Problem: What are the factors influencing acceptance of contraceptive methods. Objective: To study the determinants influencing contra­ceptive acceptance. Study design: Population based cross - sectional study. Setting: Rural area of East Delhi. Participants: Married women in the reproductive age group. Sample:Stratified sampling technique was used to draw the sample. Sample Size: 328 married women of reproductive age group. Study Variables: Socio-economic status, Type of contraceptive, Family size, Male child. Outcome Variables: Acceptance of contraceptives Statistical Analysis: By proportions. Result: Prevalence of use of contraception at the time of data collection was 40.5%. Tubectomy and vasectomy were most commonly used methods. (59.4%, n - 133. Educational status of the women positively influenced the contraceptive acceptance but income did not. Desire for more children was single most important deterrent for accepting contraception. Recommendations: (i             Traditional method of contraception should be given more attention. (ii            Couplesshould be brought in the contraceptive use net at the early stage of marriage.

  8. Factors influencing tinnitus loudness and annoyance.

    Science.gov (United States)

    Hiller, Wolfgang; Goebel, Gerhard

    2006-12-01

    To evaluate the 2 major components of tinnitus severity, loudness and annoyance, and their degree of dependence on characteristics of tinnitus manifestation, history, and etiology. Cross-sectional survey performed during the first months of 2004. Nonclinical population. A total of 4995 members of the German Tinnitus League. Comprehensive screening questionnaire, including the Klockhoff and Lindblom loudness grading system and the miniversion of the Tinnitus Questionnaire. A moderate correlation of 0.45 was found between tinnitus loudness and annoyance. Both factors were generally higher in men, those older than 50 years, those with binaural and centrally perceived tinnitus, those with increased noise sensitivity, and those who had continuous tinnitus without interruptions. Tinnitus that lasted 12 months or less had a stronger influence on annoyance (odds ratio [OR], 1.96) than on loudness (OR, 0.45), whereas the contrary was found for tinnitus of more than 5 years' duration (ORs, 0.72 and 2.11, respectively). Loudness and annoyance were increased in subjects with coexisting hearing loss, vertigo, and hyperacusis. The impact of hyperacusis on annoyance was clearly stronger than on loudness (ORs, 21.91 vs 9.47). Several clinical factors of tinnitus influence perceived loudness and annoyance. Both are distinguishable components of tinnitus severity.

  9. Factors influencing endometrial thickness in postmenopausal women.

    Science.gov (United States)

    Hebbar, S; Chaya, V; Rai, L; Ramachandran, A

    2014-07-01

    Cut-off values for endometrial thickness (ET) in asymptomatic postmenopausal woman have been standardized. However, there are no comprehensive studies to document how various factors can influence the ET after the age of menopause. To study the various factors influencing the ET in postmenopausal women. This was a prospective observational study. A total of 110 postmenopausal women underwent detailed history taking, clinical examination, and transvaginal scan for uterine volume and ovarian volume. The volumes were calculated by using ellipsoid formula: Width × thickness × height × 0.523. The variation in ET with respect to the influencing factors such as age, duration of menopause, parity, body mass index (BMI), medical illness like diabetes/hypertension, drugs like tamoxifen, presence of myoma, uterine volume, ovarian volume, and serum estradiol (in selected patients) were measured. Descriptive analysis was performed using SPSS software (version 16, Chicago II, USA) to obtain mean, standard deviation (SD), 95% confidence intervals (CIs) and inter quartile ranges. Comparison of means was carried out using analysis of variance. The mean (SD) age of the patients was 55.4 (6.91) years (95% CI, 54.1, 56.7). The mean (SD) age at menopause was 47.95 (3.90) years (95% CI, 47.2, 48.7) and the mean (SD) duration of menopause was 7.27 (6.65) years (95% CI, 6.01, 8.53). The mean (SD) ET was 3.8 (2.3) mm (95% CI, 3.36, 4.23). Medical illness like diabetes and hypertension did not alter the ET. ET increased as BMI increased and it was statistically significant. The presence of myoma increased uterine volume significantly and was associated with thick endometrial stripe. Similarly, whenever the ovaries were visualized and as the ovarian volume increased, there was an increase in ET. When ET was > 4 mm (n = 37), they were offered endocel, of which 16 agreed to undergo the procedure. None were found to have endometrial cancer. This study suggests that parity, BMI, presence of

  10. Factores influyentes en adherencia al tratamiento en pacientes con riesgo cardiovascular Fatores influentes na aderência ao tratamento em pacientes com risco cardiovascular Influential factors in adherence to treatment in patients with cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Alba Luz Rodríguez Acelas

    2010-06-01

    doença cardiovascular na Fundação Cardiovascular da Colômbia. Metodologia: estudo descritivo - metodológico realizado com 172 pacientes hospitalizados e de consulta ambulatória. O instrumento aplicado foi desenhado por Bonilla (8 e é útil para avaliar a aderência aos tratamentos farmacológicos e não farmacológicos em pacientes com fatores de risco de doença cardiovascular, tem provas de validez facial e conteúdo (0,91, consistência interna por test -retest estadisticamente significativo e coeficiente alfa de Cronbach (0,85; o qual foi conseguido no presente estudo. Resultados: 80,8% das pessoas apresentam alto risco de não aderência, 12,8% com vantagens e 6,4% não demonstra aderência aos tratamentos. As idades oscilaram entre 23-85, o comparecimento à instituição em mulheres foi 63,4% a respeito dos homens (36,6%. Igualmente, verificou-se que a aderência beneficia o fator relacionado com o paciente. Em contraposição, diminuem os fatores relacionados com o fornecedor: sistema e equipamento de saúde, com a terapia e o fator socioeconômico. Discussão e conclusões: entre os fatores que apóiam a aderência está o reconhecimento da doença, confiança no tratamento, e apoio das redes sociais e da instituição. Em contraste, as dificuldades econômicas, falta de permissões, dificuldades para mudar hábitos e o déficit de conhecimentos debilitam a aderência do paciente. Os resultados refletem a necessidade de fortalecer os profissionais da saúde no gerenciamento da aderência desde os âmbitos acadêmicos e a criação ou fortalecimento dos programas educativos nas instituições de saúde.Objective: describe and analyze factors that influence the adherence to pharmacological and non-pharmacological treatment in patients with risk of cardiovascular disease at Fundación Cardiovascular de Colombia. Methodology: descriptive-methodological study, carried out with 172 in and out patients. The instrument applied was designed by Bonilla (8; its

  11. Factores influyentes en adherencia al tratamiento en pacientes con riesgo cardiovascular Influential factors in adherence to treatment in patients with cardiovascular risk Fatores influentes na aderência ao tratamento em pacientes com risco cardiovascular

    Directory of Open Access Journals (Sweden)

    Gómez Ochoa Ana Maritza

    2010-04-01

    Full Text Available Objetivo: describir y analizar los factores que influyen en la adherencia al tratamiento farmacológico y no farmacológico en pacientes con riesgo de enfermedad cardiovascular en la Fundación Cardiovascular de Colombia. Metodología: estudio descriptivo-metodológico, realizado con 172 pacientes hospitalizados y de consulta ambulatoria. El instrumento aplicado fue diseñado por Bonilla (8, su utilidad es evaluar la adherencia a los tratamientos farmacológicos y no farmacológicos en pacientes con factores de riesgo de enfermedad cardiovascular, tiene pruebas de validez facial y contenido (0,91, consistencia interna por test-retest estadísticamente significativo y coeficiente alfa de Cronbach (0,85; este último hallado en el presente estudio. Resultados: 80,8% de las personas presentan alto riesgo de no adherirse, 12,8% con ventajas y 6,4% no muestra adherencia a los tratamientos. Las edades oscilaron entre 23-85, la asistencia a la institución en mujeres fue 63,4% respecto a hombres (36,6%. Asimismo, se evidenció que la adherencia beneficia el factor relacionado con el paciente. En contraste, disminuyen los factores relacionados con el proveedor: sistema y equipo de salud, con la terapia y el factor socioeconómico. Discusión y conclusiones: entre los factores que apoyan la adherencia se encuentra el reconocimiento de la enfermedad, confianza en el tratamiento, apoyo de redes sociales y respaldo de la institución. A diferencia, debilitan la adherencia las dificultades económicas, falta de permisos, dificultades en modificar hábitos y déficit de conocimientos. Los resultados reflejan la necesidad de fortalecer a los profesionales de la salud en el manejo de la adherencia desde los ámbitos académicos y la creación o fortalecimiento de los programas educativos en las instituciones de salud.Objective: describe and analyze factors that influence the adherence to pharmacological and non-pharmacological treatment in patients with risk

  12. Bio-social factors and perceptions of life with quality: a challenge to the adherence of h i v patients to the antirretroviral treatment

    Directory of Open Access Journals (Sweden)

    John Harold Estrada M

    2008-06-01

    Full Text Available In spite that antirretroviral therapy has contributed to improve life quality among people living with h i v, adherence to the treatment still persists as a major obstacle for therapeutic success. In order to assess the biosocial factors that contributes to adherence to this therapy by people with h i v. In order to evaluate the bio-social aspects that facilitate or obstruct the adherence to the treatment, a qualitative study combining ethnographic research, a hermeneutic approach to narratives, and a situational analysis of life experiences of people living with h i v in Colombia. Two theoretical categories were applied throughout the study: Victoria Camps’ life with quality and Saussure’s auto- and hetero-perception. All of the ten people who took part in the study were male patients who were attending an integral oral health program. The main factors that obstruct the adherence to the therapy were the following: 1 the discourse of the medical team loaded with biomedical jargon; 2 the dosages and side effects of the medications used in Colombia; 3 negative attitudes linked to a poor selfimage, a low social capital, and a low self-esteem; 4 low expectations in regards to a life with quality accompanied by the therapy. Among the factors that promote adherence the following were identified: 1 intra- and inter-personal negotiation processes based on the h i v serum status and the treatment; 2 knowledge about those negotiations by family members, friends, coworkers, and sentimental partners; 3 a positive perception of improvement in life quality while in treatment; 4 expectations of a life with quality depending on the adherence. Nevertheless, it was also found that those factors that contribute or impede adherence change rapidly and produce swinging in the person’s mood. This mood is here understood as a complex feeling concerning life with quality in constant change, both merging individual and social aspects implied in the experience of

  13. Factors influencing career decisions in internal medicine.

    Science.gov (United States)

    Macdonald, C; Cawood, T

    2012-08-01

    Numerous factors influence career decisions for internal medicine trainees and Fellows. There is a perception that a greater emphasis is placed on work-family balance by younger physicians. To determine the characteristics of the modern internal medicine workforce and ascertain whether job flexibility is important to career decision-making. We hypothesised that factors which reflect flexibility would be highly influential in decision-making, especially for women and those with young children. A questionnaire was mailed to 250 New Zealand internal medicine trainees and Fellows. It focused on factors, including job flexibility, interest and collegial support, and included demographic details which were primarily aimed at ascertaining family responsibilities. Response rate was 54%. The majority of female physicians are the main person responsible for their children (62%), and the majority of their partners work full-time (80%). This contrasts with male physicians, of whom only 4% are the main person responsible for their children. Flexibility was found to be more influential in women, those with young children, trainees and those working in outpatient-based subspecialties. However, contrary to our original hypothesis, flexibility was not reported to be highly influential in any group, with career choice being most influenced by interest and enjoyment, intellectual challenge and variety within the job. It is hoped that results will inform employers and those involved with training to enable them to better cater for the needs of the workforce and also encourage trainees to consider future family commitments when making career decisions. © 2012 The Authors. Internal Medicine Journal © 2012 Royal Australasian College of Physicians.

  14. Can Mindfulness Training Improve Medication Adherence? Integrative Review of the Current Evidence and Proposed Conceptual Model.

    Science.gov (United States)

    Salmoirago-Blotcher, Elena; Carey, Michael P

    Medication adherence is a complex, multi-determined behavior that is often influenced by system- (e.g., cost), drug- (e.g., regimen complexity), and patient-related (e.g., depression) factors. System-level approaches (e.g., making medications more affordable) are critically important but do not address patient-level factors that can undermine adherence. In this paper, we identify patient-level determinants of non-adherence and discuss whether mindfulness-training approaches that target these determinants can help to improve adherence to medical treatment. We highlight two chronic medical conditions (viz., heart failure and HIV) where poor adherence is a significant concern, and examine the evidence regarding the use of mindfulness interventions to improve medication adherence in these two conditions. We also discuss the theoretical underpinnings of mindfulness training with respect to medication adherence, and conclude by suggesting directions for future research. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. FACTORS INFLUENCING FOOD NEOPHOBIA. A BRIEF REVIEW

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    STOICA Maricica

    2016-12-01

    Full Text Available Nowadays, the number of new food products has increased considerably. Nevertheless, not all new food products are accepted and understood by consumers, the innovations in the food sector are often not well received by the market, partly due to a phenomenon known as food neophobia. Food neophobia, a general aversion to try new or unfamiliar foods, has a major impact on preferences, selection and food product acceptability. The neophobic consumers tend to display negative attitudes and less pleasure in relation to new food products. Food neophobia is based on three main reasons for rejection of a food, such as: dislike of its sensory characteristics, fear of negative consequences of eating it, and disgust arising from the idea of the food’s nature or origin. Phobia towards the introduction of unfamiliar foods in the diet can occur for several different factors, such as: socio-demographic characteristics, education level and lifestyle, degree of urbanization, income level, arousal, personal experiences, advertising, fashion, advices of other persons, and habits. This review paper was designed to provide up-to-date relevant information on factors influencing food neophobia, like social factors, type of new food, education, and arousal. The scientific information presented here could help food scientists in new food development, and food companies to develop the best marketing strategies that lead to a general decrease in neophobic consumers’ behaviour. The application of appropriate marketing strategies may allow the product to reach a competitive advantage and be successful.

  16. Influence of organizational factors on performance reliability

    International Nuclear Information System (INIS)

    Haber, S.B.; O'Brien, J.N.; Metlay, D.S.; Crouch, D.A.

    1991-12-01

    This is the first volume of a two-volume report. Volume 2 will be published at a later date. This report presents the results of a research project conducted by Brookhaven National Laboratory for the United States Nuclear Regulatory Commission, Office of Nuclear Regulatory Research. The purpose of the project was to develop a general methodology to be use in the assessment of the organizational factors which affect performance reliability (safety) in a nuclear power plant. The research described in this report includes the development of the Nuclear Organization and Management Analysis Concept (GNOMIC). This concept characterizes the organizational factors that impact safety performance in a nuclear power plant and identifies some methods for systematically measuring and analyzing the influence of these factors on safety performance. This report is divided into two parts; Part 1 presents an overview of the development of the methodology, while Part 2 provides more details and a technical analysis of the methodological development. Specifically, the results of two demonstration studies, the feasibility of the methodology, and a specific applications for which the methodology was developed are presented

  17. Evaluation of Factors Influencing Job Satisfaction

    Directory of Open Access Journals (Sweden)

    Barbara A. Sypniewska

    2014-03-01

    Full Text Available The term “job satisfaction” is derived from the humanities, psychology and sociology. In the field of psychology, it is a state where an employee has an emotional perception of his situation and reacts with feelings of pleasure or pain. In sociology, it is considered a variable in different categories related to how each employee evaluates and thinks about his work. Job satisfaction is closely related to the performance and quality of work performed by an employee and, consequently, translates into the success of an organization, because a satisfied employee builds and participates in the success of any organization. This article presents the results of the research conducted by the author in 2012 on a sample of 215 people. Respondents represented different organizations. The aim of the study was to identify and assess the significance of individual factors influencing satisfaction and dissatisfaction with work and demonstrate their impact on the overall assessment of job satisfaction. The study showed that between the weight attributed to individual factors and overall job satisfaction there are many statistically significant correlations referring mainly to selected on the basis of analysis respondents’ groups. The study confirms the raised thesis concerning the validity of research in the factors affecting the general feeling of satisfaction by the employees.

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

    OpenAIRE

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

    2011-01-01

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

  19. Influence of organizational culture on provider adherence to the diabetic clinical practice guideline: using the competing values framework in Palestinian Primary Healthcare Centers.

    Science.gov (United States)

    Radwan, Mahmoud; Akbari Sari, Ali; Rashidian, Arash; Takian, Amirhossein; Abou-Dagga, Sanaa; Elsous, Aymen

    2017-01-01

    Diabetes mellitus (DM) is a serious chronic disease and an important public health issue. This study aimed to identify the predominant culture within the Palestinian Primary Healthcare Centers of the Ministry of Health (PHC-MoH) and the Primary Healthcare Centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA) by using the competing values framework (CVF) and examining its influence on the adherence to the Clinical Practice Guideline (CPG) for DM. A cross-sectional design was employed with a census sample of all the Palestinian family doctors and nurses (n=323) who work within 71 PHC clinic. A cross-cultural adaptation framework was followed to develop the Arabic version of the CVF questionnaire. The overall adherence level to the diabetic guideline was disappointingly suboptimal (51.5%, p culture was the most predominant (mean =41.13; standard deviation [SD] =8.92), followed by hierarchical (mean =33.14; SD=5.96), while in the PHC-UNRWA, hierarchical was the prevailing culture (mean =48.43; SD =12.51), followed by clan/group (mean =29.73; SD =8.37). Although a positively significant association between the adherence to CPG and the rational culture and a negatively significant association with the developmental archetype were detected in the PHC-MoH, no significant associations were found in the PHC-UNRWA. Our study demonstrates that the organizational culture has a marginal influence on the adherence to the diabetic guideline. Future research should preferably mix quantitative and qualitative approaches and explore the use of more sensitive instruments to measure such a complex construct and its effects on guideline adherence in small-sized clinics.

  20. Intrinsic and extrinsic factors influencing large African herbivore movements

    NARCIS (Netherlands)

    Venter, J.A.; Prins, H.H.T.; Mashanova, A.; Boer, de W.F.; Slotow, R.

    2015-01-01

    Understanding environmental as well as anthropogenic factors that influence large herbivore ecological patterns and processes should underpin their conservation and management. We assessed the influence of intrinsic, extrinsic environmental and extrinsic anthropogenic factors on movement behaviour

  1. Habitat factors influencing the distribution of Cymbopogon validus in ...

    African Journals Online (AJOL)

    Habitat factors influencing the distribution of Cymbopogon validus in Mkambati Game Reserve, Transkei. ... disturbance; game reserve; grassland; grasslands; habitat conditions; habitat factors; mkambati game ... AJOL African Journals Online.

  2. Risk factors for suboptimal antiretroviral therapy adherence in HIV-infected adolescents in Gaborone, Botswana: a pilot cross-sectional study

    Directory of Open Access Journals (Sweden)

    Ndiaye M

    2013-09-01

    Full Text Available Maimouna Ndiaye,1,2 Peter Nyasulu,1 Hoang Nguyen,6,7 Elizabeth D Lowenthal,8,9 Robert Gross,10 Edward J Mills,3 Jean B Nachega4–6 1School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 2Central Medical Stores, Ministry of Health, Gaborone, Botswana; 3Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; 4Department of Medicine and Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; 5Department of Epidemiology, Infectious Disease Epidemiology Research Program, Pittsburgh University Graduate School of Public Health, Pittsburgh, PA, USA; 6Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 7Tay Ho Clinics, Department of Medicine, Hanoi Health Services, Hanoi, Vietnam; 8Departments of Pediatrics and Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; 9Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, PA, USA; 10Departments of Medicine and Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Objective: Little is known about factors associated with suboptimal antiretroviral treatment (ART adherence among adolescents in Sub-Saharan Africa. Our objective was to determine the level of ART adherence and predictors of non-adherence among human immunodeficiency virus (HIV-infected adolescents at the Botswana-Baylor Children's Clinical Centre of Excellence in Gaborone, Botswana. Methods: In a cross-sectional study, 82 HIV-infected adolescents receiving ART and their caregivers were administered a structured questionnaire. The patient's clinical information was retrieved from medical records. Outcome measures included excellent pill count ART adherence (>95% and virologic suppression

  3. [Bioavailability and factors influencing its rate].

    Science.gov (United States)

    Vraníková, Barbora; Gajdziok, Jan

    Bioavailability can be defined as the rate and range of active ingredient absorption, when it becomes available in the systemic circulation or at the desired site of drug action, respectively. Drug bioavailability after oral administration is affected by anumber of different factors, including physicochemical properties of the drug, physiological aspects, the type of dosage form, food intake, biorhythms, and intra- and interindividual variability of the human population. This article is the first from the series dealing with the bioavailability and methods leading to its improvement. The aim of the present paper is to provide an overview of aspects influencing the rate of bioavailability after oral administration of the active ingredient. Subsequentarticles will provide detailed descriptions of methods used for dug bioavailability improvement, which are here only summarized.

  4. Factors influencing initiation of breast-feeding.

    Science.gov (United States)

    Ekwo, E E; Dusdieker, L B; Booth, B M

    1983-04-01

    We used the critical incidence method to study factors motivating 33 primigravidas and 39 multigravidas to initiate breast-feeding of their infants. Women chose breast-feeding because they believed that it would provide protection to the infant against infection, establish maternal-infant bonding, was convenient, provided better nutrition than cow's milk formula, was emotionally satisfying, and was the natural way to feed infants. The decision to breast-feed was made well in advance of pregnancy by primigravidas and shortly before pregnancy by multigravidas. Friends who had successfully nursed infants were as influential as immediate family members in influencing our study subjects in their decision to breast-feed. Prenatal counseling, though important, may not be the optimal period for motivating women to breast-feed.

  5. Factors influencing presence in virtual worlds.

    Science.gov (United States)

    Chow, Meyrick C M

    2012-01-01

    Virtual worlds are showing potential as an effective platform for a variety of activities, including learning. The concept of presence (the sensation of "being there" in a mediated environment) has received substantial attention from the virtual reality community, and the effectiveness of virtual worlds has often been linked to the feelings of presence reported by their users. The present study examined the effects of attitude and perceived ease of use on sense of presence in Second Life, which is one of the most known and used virtual worlds. Based on data from a survey of 206 nursing students, hypotheses are empirically tested. Findings suggest that users' attitude toward using Second Life and their perceived ease of use of it have a positive effect on their sense of presence in the virtual environment. This study advances our understanding of factors influencing presence in virtual worlds.

  6. FACTORS INFLUENCING THE MANAGEMENT OF ADHD

    Directory of Open Access Journals (Sweden)

    S ARMAN

    2003-03-01

    Full Text Available Introduction: Attention deficit hyperactivity disorder (ADHDis the most common psychiatric disorder among school age children. It consists of hyperactivity, inattention and impulsive behavior. The onset of the disorder is before the age of 7 years and it happens at least in two situations. It causes significant impairment in social and academic functioning. A determination of factors that influences the therapeutic response in ADHD is the aim of this study. Methods: This study is designed as an analytic descriptive on hyperactive children. The tools that were used was the interview with parents and it provided CSI-4 checklist. Results: Methylphenidate was completely effective in ADHD and oppositional defiant disorder and was effective in majority sign of conduct disorder. There wasn't any relation between therapeutic response and demographic characteristics. Discussion: Methylphenidate is effective not only in ADHD but also in mixed ADHD and disruptive behavior.

  7. Factors influencing consumer dietary health preventative behaviours.

    Science.gov (United States)

    Petrovici, Dan A; Ritson, Christopher

    2006-09-01

    The deterioration of the health status of the Romanian population during the economic transition from a centrally planned to a free market economy has been linked to lifestyles factors (e.g. diet) regarded as a main determinants of the disparity in life expectancy between Eastern and Western Europe. Reforms in the health care system in this transition economy aim to focus on preventive action. The purpose of this study was to identify the factors that impact on the individual decision to engage in Dietary Health Preventive Behaviour (DHPB) and investigate their influence in the context of an adapted health cognition model. A population-based study recruited 485 adult respondents using random route sampling and face-to-face administered questionnaires. Respondents' health motivation, beliefs that diet can prevent disease, knowledge about nutrition, level of education attainment and age have a positive influence on DHPB. Perceived barriers to healthy eating have a negative impact on alcohol moderation. The information acquisition behaviour (frequency of reading food labels) is negatively predicted by age and positively predicted by health motivation, education, self-reported knowledge about nutrition and household financial status. A significant segment of respondents believe they are not susceptible to the elicited diseases. Health promotion strategies should aim to change the judgments of health risk. The adaptation of the Health Belief Model and the Theory of Health Preventive Behaviour represents a valid framework of predicting DHPB. The negative sign of perceived threat of disease on DHPB may suggest that, under an income constraint, consumers tend to trade off long-term health benefits for short-term benefits. This cautions against the use of negative messages in public health campaigns. Raising the awareness of diet-disease relationships, knowledge about nutrition (particularly sources and risks associated with dietary fat and cholesterol) may induce people to

  8. Geochemical factors influencing vault design and layout

    International Nuclear Information System (INIS)

    Gascoyne, M.; Stroes-Gascoyne, S.; Sargent, F.P.

    1995-01-01

    The design and construction of a vault for used nuclear fuel in crystalline rock may be influenced by a number of geochemical factors. During the siting stage, information is needed regarding the rock type, heterogeneities in its composition and the mineralogy of permeable zones because these will cause variations in thermal conductivity, strength and radionuclide sorptive properties of the rock. These factors may affect decisions regarding depth of vault construction, tunnel dimensions and spacing of panels and waste containers. The decision on whether groundwaters are allowed to flow freely into a planned excavation may depend on measurements of their chemical compositions, microbiological contents and presence of hazardous or corrosive constituents. During site characterization, borehole drilling from the surface and subsequent hydraulic testing will introduce both chemical and microbiological contaminants that may further influence this decision. During vault construction, the geochemistry of the rock may cause changes to the characterization, design and construction of the vault. For example, high salinity fluids in micropores in the rock could prevent the use of radar surveys to detect fractures in the surrounding rock. High rock salinity may also cause unacceptably high total dissolved solids loadings in water discharged from the facility. Again, the presence of toxic, corrosive or radioactive constituents in inflowing groundwater may require grouting or, if inflow is needed for service operations, development of treatment facilities both above and below ground. In addition, the use of explosives will cause high organic and nitrate loadings in service water as well as the possible impregnation of these chemicals in the damaged wall-rock surrounding an excavation. These chemicals may remain despite cleaning efforts and act as nutrients to promote microbial activity in the post-closure phase. In the operational phase, further design and construction, changes

  9. Factors influencing consumer dietary health preventative behaviours

    Directory of Open Access Journals (Sweden)

    Ritson Christopher

    2006-09-01

    Full Text Available Abstract Background The deterioration of the health status of the Romanian population during the economic transition from a centrally planned to a free market economy has been linked to lifestyles factors (e.g. diet regarded as a main determinants of the disparity in life expectancy between Eastern and Western Europe. Reforms in the health care system in this transition economy aim to focus on preventive action. The purpose of this study was to identify the factors that impact on the individual decision to engage in Dietary Health Preventive Behaviour (DHPB and investigate their influence in the context of an adapted health cognition model. Methods A population-based study recruited 485 adult respondents using random route sampling and face-to-face administered questionnaires. Results and discussion Respondents' health motivation, beliefs that diet can prevent disease, knowledge about nutrition, level of education attainment and age have a positive influence on DHPB. Perceived barriers to healthy eating have a negative impact on alcohol moderation. The information acquisition behaviour (frequency of reading food labels is negatively predicted by age and positively predicted by health motivation, education, self-reported knowledge about nutrition and household financial status. A significant segment of respondents believe they are not susceptible to the elicited diseases. Health promotion strategies should aim to change the judgments of health risk. Conclusion The adaptation of the Health Belief Model and the Theory of Health Preventive Behaviour represents a valid framework of predicting DHPB. The negative sign of perceived threat of disease on DHPB may suggest that, under an income constraint, consumers tend to trade off long-term health benefits for short-term benefits. This cautions against the use of negative messages in public health campaigns. Raising the awareness of diet-disease relationships, knowledge about nutrition (particularly

  10. Factors influencing choice of oral hygiene products by dental ...

    African Journals Online (AJOL)

    Background: Several factors, such as cost, branding, packaging and family influence, had been implicated as influencing the choice of toothpastes and toothbrushes by individuals. Media advertisement is also considered a very strong factor influencing consumer's choice. Aim: To assess the extent to which some factors ...

  11. The extracellular adherence protein (Eap) of Staphylococcus aureus acts as a proliferation and migration repressing factor that alters the cell morphology of keratinocytes.

    Science.gov (United States)

    Eisenbeis, Janina; Peisker, Henrik; Backes, Christian S; Bur, Stephanie; Hölters, Sebastian; Thewes, Nicolas; Greiner, Markus; Junker, Christian; Schwarz, Eva C; Hoth, Markus; Junker, Kerstin; Preissner, Klaus T; Jacobs, Karin; Herrmann, Mathias; Bischoff, Markus

    2017-02-01

    Staphyloccocus aureus is a major human pathogen and a common cause for superficial and deep seated wound infections. The pathogen is equipped with a large arsenal of virulence factors, which facilitate attachment to various eukaryotic cell structures and modulate the host immune response. One of these factors is the extracellular adherence protein Eap, a member of the "secretable expanded repertoire adhesive molecules" (SERAM) protein family that possesses adhesive and immune modulatory properties. The secreted protein was previously shown to impair wound healing by interfering with host defense and neovascularization. However, its impact on keratinocyte proliferation and migration, two major steps in the re-epithelialization process of wounds, is not known. Here, we report that Eap affects the proliferation and migration capacities of keratinocytes by altering their morphology and adhesive properties. In particular, treatment of non-confluent HaCaT cell cultures with Eap resulted in cell morphology changes as well as a significant reduction in cell proliferation and migration. Eap-treated HaCaT cells changed their appearance from an oblong via a trapezoid to an astral-like shape, accompanied by decreases in cell volume and cell stiffness, and exhibited significantly increased cell adhesion. Eap had a similar influence on endothelial and cancer cells, indicative for a general effect of Eap on eukaryotic cell morphology and functions. Specifically, Eap was found to interfere with growth factor-stimulated activation of the mitogen-activated protein kinase (MAPK) pathway that is known to be responsible for cell shape modulation, induction of proliferation and migration of epithelial cells. Western blot analyses revealed that Eap blocked the phosphorylation of extracellular signal-regulated kinase 1 and 2 (Erk1/2) in keratinocyte growth factor (KGF)-stimulated HaCaT cells. Together, these data add another antagonistic mechanism of Eap in wound healing, whereby the

  12. Factors Influencing Students’ Perceptions of Online Teamwork

    Directory of Open Access Journals (Sweden)

    Irina Falls

    2014-02-01

    Full Text Available The evolution of online teaching in higher education demands a change in the types of pedagogies used in those courses. An example of one of these important pedagogies includes online teamwork. Teamwork in this context is one in which the majority of the individual’s grade is dependent on the positive or negative group experiences. This study utilized the theoretical framework of social motivation and cohesion to identify the factors shaping students’ perceptions of teamwork in online college courses. In these courses, the pedagogical approach known as the Five Pillars of effective collaborative work was applied. An Online Teamwork Learning Survey was developed based on these principles and completed by 62 undergraduate students enrolled in semester-long online courses required in their early childhood education program of study. Using a comparison between pre–postsurveys and regression analysis, the results showed that although the students’ perceptions of teamwork did not significantly change, the factors influencing their responses during the posttest doubled in number. The results showed that through carefully designed virtual teamwork activities, students learned that essential team characteristics such as promotive interaction, individual accountability, and positive interdependence are an integral part of effective collaboration and strong predictors of teamwork perception.

  13. Factors Influencing Teamwork in Health Care

    Directory of Open Access Journals (Sweden)

    Mijal Michał

    2017-06-01

    Full Text Available The purpose of this paper is to analyse different views on interpersonal relations and team composition among managers and medical professionals with respect to the transition of professional roles in healthcare in Poland. To achieve that goal, a description based on a quantitative and qualitative questionnaire was conducted. Since the questionnaire covered various areas of health care, only its small fraction was used for the analysis. The main result is that most of the medical professionals and medical managers consider technology to be the single most important external factor influencing the team work efficiency and team composition in health care, and the managers consider skillset as the crucial factor determining whether a person would be a good team member. Based on the literature on professional roles in health care and their evolution in recent years, one can assume that constant development and lifelong learning would play a significant role in the healthcare systems reform. The findings are an important contribution to the discussion of the healthcare reform and its possible directions in future years as well a reference point for policy makers.

  14. Factors influencing performance within startup assistance organizations

    Directory of Open Access Journals (Sweden)

    Ceaușu Ioana

    2017-07-01

    Full Text Available Startup assistance organizations, and especially business accelerators have gained a lot of traction in the last years, captioning not only the attention of the public, but most importantly that of investors and other stakeholders. It has become a challenge for many all around the world to develop such programs, but many have failed or did not have their expected results, meaning medium to long-term sustainable and profitable alumni start-ups. As high amounts of resources, both human and financial, are being invested in the design and development of such programs, it is important to understand what sets apart the successful business acceleration programs from the ones that fail. The current paper is reviewing the up-to-date theoretical literature and studies on the matter at hand, in order to identify the most relevant factors influencing startup assistance organizations’ performance. The objective behind identifying these factors is to get a better understanding of best practices of such successful programs and set the basis for future research regarding the development of a set of metrics for more accurately measuring their performance.

  15. CHILDREN'S ADHERENCE TO HAART ADHERENCE

    African Journals Online (AJOL)

    han or equal IQ 2 log" and in 64% of children wirh smaller man 2 log,o decrease in viral load. Secondly, i caregivers are not well prepared for adherence issues before starting HAART, or if regimens are too onerous to follow, treatment is likely to fail. Every effort should be made to see the burden of adherence from the.

  16. Reasons Low-Income Parents Offer Snacks to Children: How Feeding Rationale Influences Snack Frequency and Adherence to Dietary Recommendations

    Directory of Open Access Journals (Sweden)

    Rachel E. Blaine

    2015-07-01

    Full Text Available Although American children snack more than ever before, the parental role in promoting snacking is not well understood. In 2012–2013 at baseline in an intervention study to prevent childhood obesity in low-income Massachusetts communities, n = 271 parents of children aged 2–12 years completed surveys regarding nutritive and non-nutritive reasons they offered children snacks, demographics, and dietary factors. An analysis of variance demonstrated that parents reported offering snacks (mean/week; standard deviation (SD for nutritive reasons like promoting growth (x̄ = 2.5; SD 2.2 or satisfying hunger (x̄ = 2.4; SD 2.1 almost twice as often as non-nutritive reasons like keeping a child quiet (x̄ = 0.7; SD 1.5 or celebrating events/holidays (x̄ = 0.8; SD 1.1. Parents reported giving young children (2–5 years more snacks to reward behavior (1.9 vs. 1.1, p < 0.001, keep quiet (1.0 vs. 0.5, p < 0.001, and celebrate achievements (1.7 vs. 1.0, p < 0.001 than parents of older children (6–12 years. Multivariable logistic regression models were used to obtain adjusted odds ratios, which indicated reduced child adherence to dietary recommendations when parents offered snacks to reward behavior (Odds Ratio (OR = 0.83; 95% Confidence Interval (CI 0.70–0.99, celebrate events/holidays (OR = 0.72; 95% CI 0.52–0.99, or achievements (OR = 0.82; 95% CI 0.68–0.98. Parental intentions around child snacking are likely important targets for obesity prevention efforts.

  17. Reasons Low-Income Parents Offer Snacks to Children: How Feeding Rationale Influences Snack Frequency and Adherence to Dietary Recommendations

    Science.gov (United States)

    Blaine, Rachel E.; Fisher, Jennifer Orlet; Taveras, Elsie M.; Geller, Alan C.; Rimm, Eric B.; Land, Thomas; Perkins, Meghan; Davison, Kirsten K.

    2015-01-01

    Although American children snack more than ever before, the parental role in promoting snacking is not well understood. In 2012–2013 at baseline in an intervention study to prevent childhood obesity in low-income Massachusetts communities, n = 271 parents of children aged 2–12 years completed surveys regarding nutritive and non-nutritive reasons they offered children snacks, demographics, and dietary factors. An analysis of variance demonstrated that parents reported offering snacks (mean/week; standard deviation (SD)) for nutritive reasons like promoting growth (x̄ = 2.5; SD 2.2) or satisfying hunger (x̄ = 2.4; SD 2.1) almost twice as often as non-nutritive reasons like keeping a child quiet (x̄ = 0.7; SD 1.5) or celebrating events/holidays (x̄ = 0.8; SD 1.1). Parents reported giving young children (2–5 years) more snacks to reward behavior (1.9 vs. 1.1, p parents of older children (6–12 years). Multivariable logistic regression models were used to obtain adjusted odds ratios, which indicated reduced child adherence to dietary recommendations when parents offered snacks to reward behavior (Odds Ratio (OR) = 0.83; 95% Confidence Interval (CI) 0.70–0.99), celebrate events/holidays (OR = 0.72; 95% CI 0.52–0.99), or achievements (OR = 0.82; 95% CI 0.68–0.98). Parental intentions around child snacking are likely important targets for obesity prevention efforts. PMID:26197335

  18. Preoperative factors influencing success in pterygium surgery.

    Science.gov (United States)

    Torres-Gimeno, Ana; Martínez-Costa, Lucía; Ayala, Guillermo

    2012-08-08

    To identify preoperative, perioperative and postoperative risk factors that influence the success of pterygium surgery. This is a prospective study of thirty-six patients with primary or recurrent pterygia. A detailed anamnesis and an ophthalmological examination were performed looking for the following factors: age, race, latitude and altitude of the main place of residence, hours of exposure to the sun, use of protective measures against UV-radiation, classification of pterygium, width of the pterygium at limbus, surgical technique (conjunctival autograft plus suturing versus tissue glue), graft alterations (misapposition, granuloma, haemorrhage, oedema, retraction or necrosis), and postoperative symptoms (foreign-body sensation, pain). The examinations were performed 2 and 7 days and 2, 6 and 12 months after surgery. In addition, recurrence was defined as any growth of conjunctiva into the cornea. A logistic regression and a survival analysis have been used to perform data analysis. A total number of 36 patients completed a one year follow-up. A total of 13 patients were born and lived in Spain, and 26 came from other countries, mostly Latin America. A total number of 8 males (no women) presented a recurrence, mainly between 2 and 6 months. The hours of sun exposure through their life was independently related to surgical success. Pterygia of less than 5 mm of base width showed a weak positive correlation with recurrence. None of the other factors considered were significantly related to recurrence. Male gender and high sun exposure are strongly and independently related to surgical success after the removal of pterygia.

  19. Preoperative factors influencing success in pterygium surgery

    Directory of Open Access Journals (Sweden)

    Torres-Gimeno Ana

    2012-08-01

    Full Text Available Abstract Background To identify preoperative, perioperative and postoperative risk factors that influence the success of pterygium surgery. Methods This is a prospective study of thirty-six patients with primary or recurrent pterygia. A detailed anamnesis and an ophthalmological examination were performed looking for the following factors: age, race, latitude and altitude of the main place of residence, hours of exposure to the sun, use of protective measures against UV-radiation, classification of pterygium, width of the pterygium at limbus, surgical technique (conjunctival autograft plus suturing versus tissue glue, graft alterations (misapposition, granuloma, haemorrhage, oedema, retraction or necrosis, and postoperative symptoms (foreign-body sensation, pain. The examinations were performed 2 and 7 days and 2, 6 and 12 months after surgery. In addition, recurrence was defined as any growth of conjunctiva into the cornea. Results A logistic regression and a survival analysis have been used to perform data analysis. A total number of 36 patients completed a one year follow-up. A total of 13 patients were born and lived in Spain, and 26 came from other countries, mostly Latin America. A total number of 8 males (no women presented a recurrence, mainly between 2 and 6 months. The hours of sun exposure through their life was independently related to surgical success. Pterygia of less than 5 mm of base width showed a weak positive correlation with recurrence. None of the other factors considered were significantly related to recurrence. Conclusions Male gender and high sun exposure are strongly and independently related to surgical success after the removal of pterygia.

  20. Factors influencing induction of adaptive response

    International Nuclear Information System (INIS)

    Misonoh, Jun; Ojima, Mitsuaki; Yonezawa, Morio

    2000-01-01

    Exposure to low doses of X-rays makes ICR mice resistant to subsequent sublethal irradiation and decrease mortality from hematopoietic death. Many factors, however, influence the induction of radioresistance. For instances, in ICR mice, the priming irradiation with 0.50 Gy was effective in the induction of radioresistance, when it is given at 6-week old, 2 weeks prior to subsequent sublethal irradiation. One hundred-fifty kV X-ray filtered off the soft component through 1.0 mm aluminum and 0.2 mm copper induces radioadaptive response as well as the harder radiation such as 260 kV X-ray filtered through 0.5 mm aluminum and 0.3 mm copper. Dose rate of priming irradiation also seemed to influence the induction of radioresistance. Priming irradiation with 0.50 Gy at 0.50 Gy/min and 0.25 Gy/min induced adaptive response, while same 0.50 Gy given at 0.063 Gy/min didn't. To make the matter complicated, when mice were pre-irradiated with 0.50 Gy at 0.013 Gy/min in the irradiation cell which was 1.2 x 1.2 x 1.4 times larger than the usual one, adaptive response was induced again. These results suggested that mice felt more uncomfortable when they were packing in the irradiation cell with little free space even for several minutes than when they were placed in the cell with much free space for about 40 minutes, and such a stress might give the mice some resistance to the subsequent sublethal irradiation. (author)

  1. Risk factors for non-adherence and loss to follow-up in a three-year clinical trial in Botswana.

    Science.gov (United States)

    Gust, Deborah A; Mosimaneotsile, Barudi; Mathebula, Unami; Chingapane, Balladiah; Gaul, Zaneta; Pals, Sherri L; Samandari, Taraz

    2011-04-25

    Participant non-adherence and loss to follow-up can compromise the validity of clinical trial results. An assessment of these issues was made in a 3-year tuberculosis prevention trial among HIV-infected adults in Botswana. Between 11/2004-07/2006, 1995 participants were enrolled at eight public health clinics. They returned monthly to receive bottles of medication and were expected to take daily tablets of isoniazid or placebo for three years. Non-adherence was defined as refusing tablet ingestion but agreeing to quarterly physical examinations. Loss to follow-up was defined as not having returned for appointments in ≥60 days. Between 10/2008-04/2009, survey interviews were conducted with 83 participants identified as lost to follow-up and 127 identified as non-adherent. As a comparison, 252 randomly selected adherent participants were also surveyed. Multivariate logistic regression analysis was used to identify associations with selected risk factors. Men had higher odds of being non-adherent (adjusted odds ratio (AOR), 2.24; 95% confidence interval [95%CI] 1.24-4.04) and lost to follow-up (AOR 3.08; 95%CI 1.50-6.33). Non-adherent participants had higher odds of reporting difficulties taking the regimen or not knowing if they had difficulties (AOR 3.40; 95%CI 1.75-6.60) and lower odds associated with each year of age (AOR 0.95; 95%CI 0.91-0.98), but other variables such as employment, distance from clinic, alcohol use, and understanding study requirements were not significantly different than controls. Among participants who were non-adherent or lost to follow-up, 40/210 (19.0%) reported that they stopped the medication because of work commitments and 33/210 (15.7%) said they thought they had completed the study. Men had higher odds of non-adherence and loss to follow-up than women. Potential interventions that might improve adherence in trial participants may include:targeting health education for men, reducing barriers, clarifying study expectations, educating

  2. Risk factors for non-adherence and loss to follow-up in a three-year clinical trial in Botswana.

    Directory of Open Access Journals (Sweden)

    Deborah A Gust

    Full Text Available BACKGROUND: Participant non-adherence and loss to follow-up can compromise the validity of clinical trial results. An assessment of these issues was made in a 3-year tuberculosis prevention trial among HIV-infected adults in Botswana. METHODS AND FINDINGS: Between 11/2004-07/2006, 1995 participants were enrolled at eight public health clinics. They returned monthly to receive bottles of medication and were expected to take daily tablets of isoniazid or placebo for three years. Non-adherence was defined as refusing tablet ingestion but agreeing to quarterly physical examinations. Loss to follow-up was defined as not having returned for appointments in ≥60 days. Between 10/2008-04/2009, survey interviews were conducted with 83 participants identified as lost to follow-up and 127 identified as non-adherent. As a comparison, 252 randomly selected adherent participants were also surveyed. Multivariate logistic regression analysis was used to identify associations with selected risk factors. Men had higher odds of being non-adherent (adjusted odds ratio (AOR, 2.24; 95% confidence interval [95%CI] 1.24-4.04 and lost to follow-up (AOR 3.08; 95%CI 1.50-6.33. Non-adherent participants had higher odds of reporting difficulties taking the regimen or not knowing if they had difficulties (AOR 3.40; 95%CI 1.75-6.60 and lower odds associated with each year of age (AOR 0.95; 95%CI 0.91-0.98, but other variables such as employment, distance from clinic, alcohol use, and understanding study requirements were not significantly different than controls. Among participants who were non-adherent or lost to follow-up, 40/210 (19.0% reported that they stopped the medication because of work commitments and 33/210 (15.7% said they thought they had completed the study. CONCLUSIONS: Men had higher odds of non-adherence and loss to follow-up than women. Potential interventions that might improve adherence in trial participants may include:targeting health education for men

  3. Influence of a new surface modification of intraocular lenses with fluoroalkylsilan on the adherence of endophthalmitis-causing bacteria in vitro.

    Science.gov (United States)

    Kienast, Antonia; Kämmerer, Regine; Weiss, Claudia; Klinger, Matthias; Menz, Dirk-Henning; Dresp, Joachim; Ohgke, Helge; Solbach, Werner; Laqua, Horst; Hoerauf, Hans

    2006-09-01

    Dynasilan is a fluoroalkylsilan that is able to interact with surface active centres on intraocular lenses (IOL), offering a new way for surface modification of different IOL materials. The purpose of this in vitro study was to investigate the influence of this new surface modification on the adherence of two typical endophthalmitis causing bacteria (Staphylococcus epidermidis, Propionibacterium acnes). In a pilot experiment, the effect of Dynasilan coating on the adherence of S. epidermidis was tested on glass slides. Forty-two Dynasilan-modified and 42 unmodified IOL (14 PMMA, 14 silicone and 14 hydrogel) were incubated at 37 degrees C in brain heart infusion broth (10(8) CFU/ml) with either S. epidermidis for 24 h or with P. acnes for 1 h. Subsequently, the adherent bacteria were resuspended using ultrasonification at 35 kHz for 3x45 s. After dilution series and incubation at 37 degrees C on Petri dishes for 24 h and 3 days, respectively, the colonies were counted. In the pilot experiment, a markedly lower number of adherent S. epidermidis was observed on Dynasilan-modified glass slides. Of all IOL materials incubated with S. epidermidis, those modified with Dynasilan showed a lower mean number of adherent bacteria (mean 1.37x10(7); SD 2.37x10(7)) than those untreated (2.43x10(7); SD 3.04x10(7)). IOLs incubated with P. acnes showed a significantly lower mean number of adherent bacteria of 2.51x10(4) (SD 2.71x10(4)) on Dynasilan-modified IOLs versus 6.27x10(4) (SD 7.70x10(4)) on untreated IOLs. The presented in vitro results indicate that Dynasilan surface modification is able to reduce the adherence of S. epidermidis and P. acnes on all IOL materials tested. Further studies regarding the stability of this modification and its biocompatibility must be performed.

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

    Directory of Open Access Journals (Sweden)

    Heather A. O'Mahen

    2015-03-01

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

  5. Fundamental factors influencing portal image quality

    International Nuclear Information System (INIS)

    Jaffray, D.A.

    1995-01-01

    It has been recognized that improved methods of verifying radiation field placement in external beam radiotherapy are required in order to make frequent checks of field placement feasible. As a result, a large number of electronic portal imaging systems have been developed as possible replacements for film. These developments have produced digital systems with faster acquisition and improved display contrast, however, the quality of the images acquired with such systems is still disappointing. This presentation examines many of the fundamental factors which limit the quality of radiographs obtained with a megavoltage radiotherapy beam. The size and shape of the radiation sources (focal and extra-focal) in radiotherapy machines and their influence on the spatial resolution of portal images are examined. Monte Carlo simulations of x-ray interactions within the patient determined that a significant fraction of the x-ray scatter generated in the patient is due to bremsstrahlung and positron annihilation. Depending on the detector, the scatter signal can reduce the differential signal-to-noise by 20%. Furthermore, a Monte Carlo study of the interaction of x-rays within typical fluoroscopic imaging detectors (metal plate/phosphor screen) demonstrates the degrading effect of energy absorption noise on the detective quantum efficiency of fluoroscopic based imaging systems. Finally, the spatial frequency content in the x-ray shadowgram is demonstrated to change with x-ray energy, resulting in images that appear to have reduced spatial resolution at megavoltage energies. The relative magnitude of each of these factors will be presented and recommendations for the next generation of portal imaging systems will be made

  6. Adherence to a web-based pre-treatment for phobias in outpatient clinics

    DEFF Research Database (Denmark)

    Kok, Robin Niels; Beekman, Aartjan T F; Cuijpers, Pim

    2017-01-01

    Background Non-adherence in Internet interventions is a persistent and multifaceted issue and potentially limits the applicability and effectiveness of these interventions. Factors that influence non-adherence are poorly understood, especially in outpatient samples with more complex symptoms. Obj...

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

    African Journals Online (AJOL)

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

  8. What are the reasons for patients not adhering to their anti-TB ...

    African Journals Online (AJOL)

    2008-11-13

    Nov 13, 2008 ... patients started their anti-TB treatment, according to the known factors that influence TB adherence. The patients .... Inadequate relationship between health care provider and patient ..... on the Internet] [cited 2009 Jan. 12].

  9. Adherence to adjuvant endocrine therapy: is it a factor for ethnic differences in breast cancer outcomes in New Zealand?

    Science.gov (United States)

    Seneviratne, Sanjeewa; Campbell, Ian; Scott, Nina; Kuper-Hommel, Marion; Kim, Boa; Pillai, Avinesh; Lawrenson, Ross

    2015-02-01

    Despite the benefits of adjuvant endocrine therapy for hormone receptor positive breast cancer, many women are non-adherent or discontinue endocrine treatment early. We studied differences in adherence to adjuvant endocrine therapy by ethnicity in a cohort of New Zealand women with breast cancer and its impact on breast cancer outcomes. We analysed data on women (n = 1149) with newly diagnosed hormone receptor positive, non-metastatic, invasive breast cancer who were treated with adjuvant endocrine therapy in the Waikato during 2005-2011. Linked data from the Waikato Breast Cancer Registry and National Pharmaceutical Database were examined to identify differences by ethnicity in adherence to adjuvant endocrine therapy and the effect of sub-optimal adherence on cancer recurrence and mortality. Overall, a high level of adherence of ≥80% was observed among 70.4% of women, which declined from 76.8% to 59.3% from the first to fifth year of treatment. Māori women were significantly more likely to be sub-optimally adherent (breast cancer mortality (HR = 1.77, 95% CI 1.05-2.99) and recurrence (HR = 2.14, 95% CI 1.46-3.14). Sub-optimal adherence to adjuvant endocrine therapy was a likely contributor for breast cancer mortality inequity between Māori and European women, and highlights the need for future research to identify effective ways to increase adherence in Māori women. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Association of adherence to therapy and complementary and alternative medicine use with demographic factors and disease phenotype in patients with inflammatory bowel disease.

    Science.gov (United States)

    Lakatos, Peter Laszlo; Czegledi, Zsofia; David, Gyula; Kispal, Zsofia; Kiss, Lajos S; Palatka, Karoly; Kristof, Tunde; Nagy, Ferenc; Salamon, Agnes; Demeter, Pal; Miheller, Pal; Szamosi, Tamas; Banai, Janos; Papp, Maria; Bene, Laszlo; Kovacs, Agota; Racz, Istvan; Lakatos, Laszlo

    2010-09-01

    Previous studies have suggested an increasing use of complementary and alternative medicine (CAM) in patients with inflammatory bowel disease (IBD). Furthermore, a significant number of IBD patients fail to comply with treatment. The aim of our study was to evaluate the prevalence of non-adherence and the use of CAM in Hungarian patients with IBD. A total of 655 consecutive IBD patients (CD: 344, age: 38.2 [SD 12.9]years; UC: 311, age: 44.9 [15.3]years) were interviewed during the specialist visit by self-administered questionnaire including demographic and disease-related data as well as items analyzing the extent of non-adherence and CAM use. Patients taking more than 80% of each prescribed medication were classified as adherent. The overall rate of self-reported non-adherence (CD: 20.9%, UC: 20.6%) and CAM (CD: 31.7%, UC: 30.9%) use did not differ between Crohn's disease (CD) and ulcerative colitis (UC). The most common causes of non-adherence were: forgetfulness (47.8%), too many/unnecessary pills (39.7%), being afraid of side effects (27.9%) and too frequent dosing. Most common forms of CAM were herbal tea (47.3%), homeopathy (14.6%), special diet (12.2%), and acupuncture (5.8%). In CD, disease duration, date of last follow-up visit, educational level and previous surgeries were predicting factors for non-adherence. Alternative medicine use was associated in both diseases with younger age, higher educational level, and immunosuppressant use. In addition, CAM use in UC was more common in females and in patients with supportive psychiatric/psychological therapy. Non-adherence and CAM use is common in patients with IBD. Special attention should be paid to explore the identified predictive factors during follow-up visits to improve adherence to therapy and improving patient-doctor relationship. Copyright © 2009 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  11. Influence of organizational culture on provider adherence to the diabetic clinical practice guideline: using the competing values framework in Palestinian Primary Healthcare Centers

    Directory of Open Access Journals (Sweden)

    Radwan M

    2017-08-01

    Full Text Available Mahmoud Radwan,1 Ali Akbari Sari,1 Arash Rashidian,1 Amirhossein Takian,1 Sanaa Abou-Dagga,2 Aymen Elsous1 1Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Research Affairs and Graduates Studies, Islamic University of Gaza, Gaza Strip, Palestine Background: Diabetes mellitus (DM is a serious chronic disease and an important public health issue. This study aimed to identify the predominant culture within the Palestinian Primary Healthcare Centers of the Ministry of Health (PHC-MoH and the Primary Healthcare Centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA by using the competing values framework (CVF and examining its influence on the adherence to the Clinical Practice Guideline (CPG for DM.Methods: A cross-sectional design was employed with a census sample of all the Palestinian family doctors and nurses (n=323 who work within 71 PHC clinic. A cross-cultural adaptation framework was followed to develop the Arabic version of the CVF questionnaire. Results: The overall adherence level to the diabetic guideline was disappointingly suboptimal (51.5%, p<0.001; 47.3% in the PHC-MoH and 55.5% in the PHC-UNRWA. In the PHC-MoH, the clan/group culture was the most predominant (mean =41.13; standard deviation [SD] =8.92, followed by hierarchical (mean =33.14; SD=5.96, while in the PHC-UNRWA, hierarchical was the prevailing culture (mean =48.43; SD =12.51, followed by clan/group (mean =29.73; SD =8.37. Although a positively significant association between the adherence to CPG and the rational culture and a negatively significant association with the developmental archetype were detected in the PHC-MoH, no significant associations were found in the PHC-UNRWA. Conclusion: Our study demonstrates that the organizational culture has a marginal influence on the adherence to the diabetic guideline. Future research

  12. Factors influencing creep model equation selection

    International Nuclear Information System (INIS)

    Holdsworth, S.R.; Askins, M.; Baker, A.; Gariboldi, E.; Holmstroem, S.; Klenk, A.; Ringel, M.; Merckling, G.; Sandstrom, R.; Schwienheer, M.; Spigarelli, S.

    2008-01-01

    During the course of the EU-funded Advanced-Creep Thematic Network, ECCC-WG1 reviewed the applicability and effectiveness of a range of model equations to represent the accumulation of creep strain in various engineering alloys. In addition to considering the experience of network members, the ability of several models to describe the deformation characteristics of large single and multi-cast collations of ε(t,T,σ) creep curves have been evaluated in an intensive assessment inter-comparison activity involving three steels, 21/4 CrMo (P22), 9CrMoVNb (Steel-91) and 18Cr13NiMo (Type-316). The choice of the most appropriate creep model equation for a given application depends not only on the high-temperature deformation characteristics of the material under consideration, but also on the characteristics of the dataset, the number of casts for which creep curves are available and on the strain regime for which an analytical representation is required. The paper focuses on the factors which can influence creep model selection and model-fitting approach for multi-source, multi-cast datasets

  13. Patterns of Adherence of Helicobacter pylori Clinical Isolates to Epithelial Cells, and its Association with Disease and with Virulence Factors.

    Science.gov (United States)

    Vázquez-Jiménez, Flor Elizabeth; Torres, Javier; Flores-Luna, Lourdes; Cerezo, Silvia Giono; Camorlinga-Ponce, Margarita

    2016-02-01

    Adherence to the gastric epithelium is one of the most important steps of Helicobacter pylori to remain and cause disease. The aim of this study was to analyze whether H. pylori isolates from patients with different gastroduodenal diseases present differences in the pattern of adherence to gastric epithelial cells (AGS), in the ability to induce IL-8, and in the presence of virulence genes. We tested 75 H. pylori strains isolated from nonatrophic gastritis, gastric cancer, and duodenal ulcer patients. The adhesion pattern and IL-8 induction were determined in AGS cells, and invasion of AGS cells was studied using a gentamicin protection assay. The IL-8 levels induced were determined by ELISA. Helicobacter pylori strains presented diffuse adherence (DA) and localized (LA) adherence patterns, similar to those described for enteropathogenic E. coli (EPEC), were observed in AGS cells. A DA pattern was observed in 57% and LA in 43% of the strains, and DA was more frequent in isolates from patients with gastric cancer (p = 0.044). Strains with a LA pattern induced higher levels of IL-8 (p = 0.042) in AGS cells. The adherence pattern was not associated with neither invasiveness nor with the presence of virulence genes. Our study shows that H. pylori strains present adherence patterns to AGS cells resembling those observed in EPEC and that these patterns may be associated with disease and with activity on AGS cells. © 2015 John Wiley & Sons Ltd.

  14. Factors associated with high rates of antiretroviral medication adherence among youth living with perinatal HIV in Thailand.

    Science.gov (United States)

    Kang, Ezer; Delzell, Darcie A P; Chhabra, Manik; Oberdorfer, Peninnah

    2015-07-01

    Antiretroviral medication adherence behaviour among Thai youth with perinatal HIV in Thailand has received growing attention. However, few studies have examined individual predictors of antiretroviral adherence using multiple self-reports. A convenience sample of 89 Thai youth (interquartile range 14-16 years) with perinatal HIV at three paediatric programmes in Chiang Mai completed a structured questionnaire and reported their antiretroviral adherence in the past one, seven and 30 days using count-based recall and a visual analog scale. Mean self-reported adherence rates ranged from 83.5% (past 30 days) to 99.8% (yesterday) of the time. One-inflated beta regression models were used to examine the associations between antiretroviral adherence outcomes, treatment self-efficacy, depression, anxiety, social support and beliefs/attitudes about medications. Higher percentage of medications taken in the past 30 days was independently associated with higher treatment self-efficacy and fewer symptoms of depression. Adherence monitoring would benefit from focal assessment of youth depression and perceived capacity to follow their antiretroviral regimen. © The Author(s) 2014.

  15. The influence of different types of fixed orthodontic appliance on the growth and adherence of microorganisms (in vitro study).

    Science.gov (United States)

    Saloom, Hayder F; Mohammed-Salih, Harraa S; Rasheed, Shaymaa F

    2013-02-01

    Orthodontic appliances serve as different impact zones and modify microbial adherence and colonization, acting as foreign reserves and possible sources of infection. This study was conducted to investigate the effect of different types of fixed orthodontic appliances on the growth and adherence of microorganisms in oral flora which are Streptococcus mutans (S. mutans) and Candida albicans. Sixty-four of four different fixed orthodontic appliance-samples were used, divided into four groups of sixteen. Type I: Sapphire brackets- Coated wires, type II: Sapphire brackets- Stainless steel wires, type III: Stainless steel brackets- Coated wires and type IV: Stainless steel brackets- Stainless steel wires. Oral strains of S. mutans and Candida albicans were studied in the present study using biochemical test then microbial suspensions were prepared to do the tests of each microorganism including the antimicrobial effects of different appliance-samples on the growth of microorganisms and their adhesion tests. The results showed significant differences between the different appliances in terms of inhibition zone formation (PAppliance with high esthetic appearance, sapphire brackets and coated arch wire, showed the least adherence of S. mutans and Candida albicans in comparison to other appliances with less esthetic and more metal components. Key words:Orthodontic appliance, Adherence, Streptococcus mutans, Candida albicans.

  16. How the doc should (not) talk: When breaking bad news with negations influences patients' immediate responses and medical adherence intentions

    NARCIS (Netherlands)

    Burgers, C.F.; Beukeboom, C.J.; Sparks, L

    2012-01-01

    Objective: We investigate the role of specific formulations in a doctor's bad news delivery. We focus on the effects of negations and message framing on patients' immediate responses to the message and the doctor, and long-term consequences including quality of life and medical adherence intentions.

  17. [Mothers' adherence to "maternal love" influences emotional expression toward children: relation to maternal occupational status and satisfaction in the workplace].

    Science.gov (United States)

    Egami, Sonoko

    2007-06-01

    This study examined the impact of mothers' adherence to "maternal love" on maternal emotional expression toward their children. It was postulated that adherence to "maternal love" (defined as the tendency to accept and obey blindly the traditional maternal role and sociocultural belief in "desirable mothers") would have both positive and negative effects on maternal emotional expression, depending on the mothers' occupational status and satisfaction in workplace. The results showed an interaction between mothers' adherence to "maternal love" and the mothers' satisfaction in the workplace, which affected their expression of emotion. When satisfaction in the workplace was rated in the middle, it was positively associated with positive emotional expression. When satisfaction in the workplace was rated as high, it was both positively and negatively associated with positive emotional expression for full-time workers. Moreover, when satisfaction in the workplace was rated as in the middle, it was negatively associated with negative emotional expression, and when satisfaction in the workplace was rated as low or high, it was positively associated with negative emotional expression for all workers. These findings confirmed that mothers' adherence to "maternal love" is "the double-edged sword".

  18. [The influence of a new surface treatment of silicone intracoular lenses with fluoralkylsitan on the adherence of endophthalmitic bacteria in vitro

    Science.gov (United States)

    Kienast, A; Menz, D-H; Dresp, J; Klinger, M; Bunse, A; Ohgke, H; Solbach, W; Laqua, H; Kämmerer, R; Hoerauf, H

    2003-10-01

    Dynasilan is a fluoroalkylsilan which is able to bind to surface active molecules of intraocular lenses (IOLs), thereby offering a new option for surface modification of silicone lenses. The purpose of this in vitro study was to investigate the influence of this new surface treatment on the adherence of two typical endophthalmitis-inducing bacteria ( Staphylococcus epidermidis, Propionibacterium acnes). A total of 14 Dynasilan-treated and 14 untreated silicone lenses were incubated at 37 degrees C for 24 h in brain heart infusion broth (10(8) CFU/ml) either with Staphylococcus epidermidis or with Propionibacterium acnes for 1 h. Subsequently, the adherent bacteria were resuspended using ultrasonification at 35 kHz for 3 x 45 s. After a dilution series and incubation at 37 degrees C for 24 h or 3 days the colonies were counted. On untreated IOLs incubated with Staphylococcus epidermidis the average number of bacteria was 3.6 x 10(7)/ml, and on treated IOLs the number of counted colonies was reduced to 1.09 x 10(7)/ml. Incubated with Propionibacterium acnes the average number of adherent bacteria on untreated IOLs was 4.75 x 10(4)/ml and on modified IOLs the number was reduced to 2.94 x 10(4)/ml. Dynasilan surface treatment may reduce the adherence of Staphylococcus epidermidis and Propionibacterium acnes on silicone intraocular lenses. Further studies regarding the stability of this treatment, its biocompatibility and influence on lens epithelial cell adhesion are in progress.

  19. Adherencia a tratamientos en pacientes con factores de riesgo cardiovascular Aderência ao tratamento em pacientes com fatores de risco cardiovascular Adherence to treatments in patients with cardiovascular risk factors

    Directory of Open Access Journals (Sweden)

    INNA ELIDA FLÓREZ TORRES

    programas de hipertensão e diabetes. Aplicou-se um instrumento desenhado por Bonilla y De Reales para avaliar os fatores que influem na aderência aos tratamentos, depois, realizaram-se provas de validação que demonstraram uma boa confiabilidade dada por um alfa de Cronbach de 0,79 para a qualificação total do instrumento e um coeficiente de correlação teste -reteste (Sperman, estatisticamente significativo. Resultados: Globalmente, 88% dos pacientes encontrouse na categoria sem risco de não aderência aos tratamentos, o outro 12% apresentou um risco moderado. Conclusões: os fatores que facilitaram a aderência foram: a disponibilidade de recursos econômicos para atender as necessidades básicas, redes de apoio familiares e um sistema e equipe de saúde organizada. O risco moderado de não aderência esteve associado com as intervenções da equipe de saúde, entre elas, falta de orientações sobre a forma de ajustar os horários dos medicamentos, falta de recomendações escritas sobre o tratamento, confusão por câmbios do médico, e percepção de gravidade da doença. Esses achados apóiam a necessidade de implantar processos de formação e pesquisa no nível institucional e acadêmico que preparem aos profissionais a respeito da abordagem do problema verificado na falta de aderência em doenças crônicas.Objective: Describe the factors that influence adherence to treatments in patients with cardiovascular disease risk factors of a third level hospital in the city of Cartagena, Colombia. Methodology: Descriptive-methodological study carried out with 293 patients inscribed in the hypertension and diabetes programs. The instrument designed by Bonilla and De Rea-les was applied to evaluate the factors that influence adherence to treatments, on which validation tests were performed that yielded a good level of reliability given by a Cronbach alpha of 0,79 for the total qualification of the instrument and a correlation coefficient test-retest (Sperman

  20. A Systematic Review of CPAP Adherence Across Age Groups: Clinical and Empiric Insights for Developing CPAP Adherence Interventions

    Science.gov (United States)

    Sawyer, A.M.; Gooneratne, N.; Marcus, C.L.; Ofer, D.; Richards, K.C.; Weaver, T.E.

    2011-01-01

    Continuous positive airway pressure (CPAP) is a highly efficacious treatment for obstructive sleep apnea (OSA) but adherence to the treatment limits its overall effectiveness across all age groups of patients. Factors that influence adherence to CPAP include disease and patient characteristics, treatment titration procedures, technological device factors and side effects, and psychological and social factors. These influential factors have guided the development of interventions to promote CPAP adherence. Various intervention strategies have been described and include educational, technological, psychosocial, pharmacological, and multi-dimensional approaches. Though evidence to date has led to innovative strategies that address adherence in CPAP-treated children, adults, and older adults, significant opportunities exist to develop and test interventions that are clinically applicable, specific to subgroups of patients likely to demonstrate poor adherence, and address the multifactorial nature of CPAP adherence. The translation of CPAP adherence promotion interventions to clinical practice is imperative to improve health and functional outcomes in all persons with CPAP-treated OSA. PMID:21652236

  1. An Investigation into factors influencing the choice of business ...

    African Journals Online (AJOL)

    There was significant difference between male and female career influencing factors. There was no significant difference regarding the influence exercised by parent in the students' choice of Business Education. There is significant difference between male and female in the influence exerted by external factors in their ...

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

    Science.gov (United States)

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

    2016-02-24

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

  3. Barriers to ART adherence & follow ups among patients attending ART centres in Maharashtra, India.

    Science.gov (United States)

    Joglekar, N; Paranjape, R; Jain, R; Rahane, G; Potdar, R; Reddy, K S; Sahay, S

    2011-12-01

    Adherence to ART is a patient specific issue influenced by a variety of situations that a patient may encounter, especially in resource-limited settings. A study was conducted to understand factors and influencers of adherence to ART and their follow ups among patients attending ART centres in Maharashtra, India. Between January and March 2009, barriers to ART adherence among 32 patients at three selected ART centres functioning under national ART roll-out programme in Maharashtra, India, were studied using qualitative methods. Consenting patients were interviewed to assess barriers to ART adherence. Constant comparison method was used to identify grounded codes. Patients reported multiple barriers to ART adherence and follow up as (i) Financial barriers where the contributing factors were unemployment, economic dependency, and debt, (ii) social norm of attending family rituals, and fulfilling social obligations emerged as socio-cultural barriers, (iii) patients' belief, attitude and behaviour towards medication and self-perceived stigma were the reasons for sub-optimal adherence, and (iv) long waiting period, doctor-patient relationship and less time devoted in counselling at the center contributed to missed visits. Mainstreaming ART can facilitate access and address 'missed doses' due to travel and migration. A 'morning' and 'evening' ART centre/s hours may reduce work absenteeism and help in time management. Proactive 'adherence probing' and probing on internalized stigma might optimize adherence. Adherence probing to prevent transitioning to suboptimal adherence among patients stable on ART is recommended.

  4. Episodic medication adherence in adolescents and young adults with perinatally acquired HIV: a within-participants approach.

    Science.gov (United States)

    Hawkins, Amy; Evangeli, Michael; Sturgeon, Kate; Le Prevost, Marthe; Judd, Ali

    2016-01-01

    Due to the success of antiretroviral (ART) medications, young people living with perinatally acquired HIV (PHIV+) are now surviving into adolescence and young adulthood. Understanding factors influencing ART non-adherence in this group is important in developing effective adherence interventions. Most studies of ART adherence in HIV-positive populations assess differences in adherence levels and adherence predictors between participants, over a period of time (global adherence). Many individuals living with HIV, however, including PHIV+ young people, take medication inconsistently. To investigate this pattern of adherence, a within-participants design, focussing on specific episodes of adherence and non-adherence, is suitable (episodic adherence). A within-participants design was used with 29 PHIV+ young people (17 female, median age 17 years, range 14-22 years), enrolled in the UK Adolescents and Adults Living with Perinatal HIV cohort study. Participants were eligible if they could identify one dose of medication taken and one dose they had missed in the previous two months. For each of the two episodes (one adherent, one non-adherent), behavioural factors (whom they were with, location, routine, day, reminders) and psychological factors at the time of the episode (information about medication, adherence motivation, perceived behavioural skills to adhere to medication - derived from the Information-Motivation-Behavioural Skills (IMB) Model - and affect) were assessed in a questionnaire. Non-adherence was significantly associated with weekend days (Friday to Sunday versus Monday to Thursday, p = .001), lack of routine (p = .004), and being out of the home (p = .003), but not with whom the young person was with or whether they were reminded to take medication. Non-adherence was associated with lower levels of behavioural skills (p ART, or ART motivation. The use of situationally specific strategies to enhance adherence in young people who take their

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

    Directory of Open Access Journals (Sweden)

    C.A.T. Pinheiro

    2002-10-01

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

  6. Adherence with Preventive Medication in Childhood Asthma

    Directory of Open Access Journals (Sweden)

    Scott Burgess

    2011-01-01

    Full Text Available Suboptimal adherence with preventive medication is common and often unrecognised as a cause of poor asthma control. A number of risk factors for nonadherence have emerged from well-conducted studies. Unfortunately, patient report a physician's estimation of adherence and knowledge of these risk factors may not assist in determining whether non-adherence is a significant factor. Electronic monitoring devices are likely to be more frequently used to remind patients to take medication, as a strategy to motivate patients to maintain adherence, and a tool to evaluate adherence in subjects with poor disease control. The aim of this paper is to review non-adherence with preventive medication in childhood asthma, its impact on asthma control, methods of evaluating non-adherence, risk factors for suboptimal adherence, and strategies to enhance adherence.

  7. Urban water consumption and its influencing factors in China

    NARCIS (Netherlands)

    Fan, Liangxin; Gai, Lingtong; Tong, Yan; Li, Ruihua

    2017-01-01

    Factors that affect water consumption should be identified to develop effective public policies. However, factors influencing domestic water consumption in cities in China, particularly on a national scale, are unclear. In this study, urban water consumption and its influencing factors in 286

  8. Factors influencing choice of paediatrics as a career among medical ...

    African Journals Online (AJOL)

    None of the male students but 12 of the female students (30%) considered gender distribution to be a factor influencing their career choice (p=0.046). Conclusion. This study indicates that paediatrics is popular among female students and that several factors influence choice of this specialty. Understanding these factors may ...

  9. Factors Influencing Prevention and Control of Malaria among ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    investigate factors that influence malaria prevention and control practices among pregnant ... treatment of clinical cases and the promotion of ... influence their decision regarding malaria ..... have the ability to purchase anti-malaria drugs that.

  10. Factors influencing the adoption of mobile financial services in the ...

    African Journals Online (AJOL)

    Factors influencing the adoption of mobile financial services in the unbanked population. ... Inkanyiso: Journal of Humanities and Social Sciences ... the influences of the adoption behaviour at different level of market maturity and points of time.

  11. Factors influencing the usage of different types of malaria prevention ...

    African Journals Online (AJOL)

    Objective: To examine factors which influence the use of different types of malaria prevention ... risk areas, religion, education and income influenced ITN usage, whereas only age, malaria .... the uptake of IPTp given that the person would not.

  12. Factors influencing cassava - pulp fermentation period for gari ...

    African Journals Online (AJOL)

    Factors influencing cassava - pulp fermentation period for gari processing among ... Result of probit model analysis at 5% significance level shows an R value ... Marital status (2.236**) and respondents' cultural influences (1.960**) were ...

  13. Factors that influencing veterinary drug’s metabolisation

    Directory of Open Access Journals (Sweden)

    Cristina, Romeo T.

    2007-12-01

    Full Text Available The paper wants to make a recall for the vet practitioners, of the main veterinary drug's metabolism rate influencing factors. Among the most important physiological factors (pharmacokinetics, sanguine flow and urinary ones, plasmatic proteins binding, enzymatic induction and inhibition are essential. Between the animal’s bounded factors more important are: species, individuality, age, sex, pregnancy, alimentation, genetic factors, and health status and from exogenous factors, daily rhythm, influences of chemical compounds and of the stress are presented.

  14. A Comparison of Factors that Influence the Lyophilization Process

    OpenAIRE

    Mnerie, Dumitru; Anghel, Gabriela Victoria; Mnerie, Alin Vasile; Cheveresan, Constantin

    2007-01-01

    The lyophilization (or freeze drying) process for agro-foods products depends on a series of technological factors that are in an inter-dependence with the process performance. This paper presents an expert method and its application. This method characterizes the influence factors of the lyophilization process, after the importance level of some factors in correlation with other factors, is defined. Only the most important factors were considered; influence considerations were made in relati...

  15. Adherence to antidepressant treatment

    DEFF Research Database (Denmark)

    Hansen, Hanne Vibe; Kessing, Lars Vedel

    2007-01-01

    Depression is a common disorder with painful symptoms and, frequently, social impairment and decreased quality of life. The disorder has a tendency to be long lasting, often with frequent recurrence of symptoms. The risk of relapse and the severity of the symptoms may be reduced by correct...... of dependence of antidepressant medicine, have a great influence on adherence to treatment....

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

    Science.gov (United States)

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

    2018-01-01

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

  17. Factors for incomplete adherence to antiretroviral therapy including drug refill and clinic visits among older adults living with human immunodeficiency virus - cross-sectional study in South Africa.

    Science.gov (United States)

    Barry, Abbie; Ford, Nathan; El-Khatib, Ziad

    2018-03-01

    To assess adherence outcomes to antiretroviral therapy (ART) of recipients ≥50 years in Soweto, South Africa. This was a secondary data analysis for a cross-sectional study at two HIV clinics in Soweto. Data on ART adherence and covariates were gathered through structured interviews with HIV 878 persons living with HIV (PLHIV) receiving ART. Logistic regression analysis was used to assess associations. PLHIV ≥50 years (n = 103) were more likely to miss clinic visits during the last six months than PLHIV aged 25-49 (OR 2.15; 95%CI 1.10-4.18). PLHIV ≥50 years with no or primary-level education were less likely to have missed a clinic visit during the last six months than PLHIV with secondary- or tertiary-level education in the same age category (OR 0.3; 95%CI 0.1-1.1), as were PLHIV who did not disclose their status (OR 0.2; 95%CI 0-1.1). There was no evidence of increased risk for non-adherence to ART pills and drug refill visits among older PLHIV. Missing a clinic visit was more common among older PLHIV who were more financially vulnerable. Further studies are needed to verify these findings and identify new risk factors associated with ART adherence. © 2017 John Wiley & Sons Ltd.

  18. Adherence to multiple micronutrient powders and associated factors in children aged 6 to 35 months treated in sentinel health facilities, Ministry of Health of Peru.

    Science.gov (United States)

    Munares-García, Oscar; Gómez-Guizado, Guillermo

    2016-01-01

    Anemia in children is a public health issue, and the current strategies include treatment and iron supplementation, but their level of adherence or compliance is unknown. To consider the adherence to multiple micronutrient powders and the associated factors. Epidemiological study of active surveillance through sentinel facilities in 2,024 children aged 6 to 35 months treated in health facilities of the Ministry of Health of Peru, from October to December 2014. Household visits were conducted in which counting of multiple micronutrient powders was applied and determined an adherence of consumption ≥ 90% envelopes, besides a form on the associated factors (anemia knowledge, iron-rich food, side effects, dosage regimen, drugs used, and motivation) was applied. Descriptive statistics, χ² test, Odds Ratio with a 95% confidence interval (CI), and binary logistic regression or adjusted Odds Ratio (aOR) were used. Of all, 79.1% participants were aged 6 to 23 months; 75.9% received multiple micronutrient powders; and the adherence was equivalent to 24.4% (95%CI 22.3 - 26.6). The factors: continue supplementation (OR = 3.5; 95%CI 1.7 - 7.5); no nausea (OR = 3.0; 95%CI 2.0 - 4.3); no use of antibiotics (OR = 2.5; 95%CI 1.7 - 3.6); and intention to continue treatment (OR = 2.3; 95%CI 1.3 - 4.1) were associated with adherence. The variables: thought of continuing treatment (aOR = 2.6; 95%CI 1.1 - 6.1); presence of side effects, but no discontinuation of the treatment (aOR = 2.5; 95%CI 1.4 - 4.3); no use of antibiotics (aOR = 2.0; 95%CI 1.1 - 3.4); and belief that not only drugs cure anemia (aOR = 1.6; 95%CI 1.0 - 2.6) were associated in the multivariate analysis. There was a low prevalence of adherence to a demanding cut-off point (≥ 90% of envelopes of multiple micronutrient powders), and the associated factors are associated with absence of infections, side effects, and mother's beliefs.

  19. Refining Measurement of Social Cognitive Theory Factors Associated with Exercise Adherence in Head and Neck Cancer Patients.

    Science.gov (United States)

    Rogers, Laura Q; Fogleman, Amanda; Verhulst, Steven; Bhugra, Mudita; Rao, Krishna; Malone, James; Robbs, Randall; Robbins, K Thomas

    2015-01-01

    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.

  20. Factors influencing electric utility expansion. Volume II

    Energy Technology Data Exchange (ETDEWEB)

    Masud, E. [ed.

    1977-01-01

    This report, Vol. 2, submitted by the General Electric Co., identifies factors that should be considered in planning interconnected systems and discusses how these factors relate to one another. The objective is to identify all the factors and classify them by their use and importance in arriving at a decision. Chapter 2 discusses the utility system and its system behavior characteristics, emphasizing behavior that affects the planning of the bulk-power generation and transmission system. Chapter 3 introduces interconnection planning by discussing the new system characteristics brought to operation and planning. Forty-two factors associated with cost, reliability, constraints, and coordination are related to each other by factor trees. Factor trees display the relationship of one factor such as reliability to more-detailed factors which in turn are further related to individual characteristics of facilities. These factor trees provide a structure to the presentation. A questionnaire including the 42 factors was completed by 52 system planners from utility companies and government authorities. The results of these questionnaires are tabulated and presented with pertinent discussion of each factor. Chapter 4 deals with generation planning, recognizing the existence of interconnections. Chapter 5 addresses transmission planning, questions related to reliability and cost measures and constraints, and factors related to both analytical techniques and planning procedures. The chapter ends with a discussion of combined generation-transmission planning. (MCW)

  1. Unravelling adherence to prophylaxis in haemophilia: a patients' perspective.

    Science.gov (United States)

    Schrijvers, L H; Kars, M C; Beijlevelt-van der Zande, M; Peters, M; Schuurmans, M J; Fischer, K

    2015-09-01

    Given the lifelong therapy in haemophilia patients, insight in non-adherence behaviour from a patient perspective is important to understand patients' difficulties with the following treatment recommendations. The aim of this study was to clarify the process underlying adherence (behaviour) to prophylactic treatment, from a patients' perspective. To develop a grounded theory, a qualitative study using individual in-depth interviews was performed to understand experiences, perceptions and beliefs concerning adherence to prophylaxis. From two Dutch treatment centres, 21 adults with haemophilia using prophylaxis were interviewed. Patients were asked how they experience their task to administer prophylaxis and how they adhere to this. The interviews were transcribed, coded and analysed in an iterative process, leading to the development of the grounded theory. Adherence was determined by the position of prophylaxis in life. The position of prophylaxis was determined by the perception of prophylaxis and the ability to exert prophylaxis. Patients' perception was influenced by two main factors: acceptance of haemophilia and feeling/fearing symptoms. The ability to exert prophylaxis was influenced by understanding haemophilia and prophylaxis and planning/infusion skills. The combination of different perceptions and skills led to four main positions of prophylaxis in life: (i) prophylaxis integrated in life, (ii) prophylaxis according to doctors' advice, struggling with irregular situations, (iii) prophylaxis is too much to handle, (iv) prophylaxis is a confrontation with illness. The adherence level gradually decreased from position 1 to 4. This information can be used to design tailored interventions to promote adherence. © 2015 John Wiley & Sons Ltd.

  2. Dermal factors influencing measurement of skin autofluorescence

    NARCIS (Netherlands)

    Noordzij, Margaretha J.; Lefrandt, Johan; Graaff, Reindert; Smit, Andries J.

    Background: Skin autofluorescence (SAF) is a noninvasive marker of accumulation of advanced glycation end products. It predicts cardiovascular complications and mortality in diabetes and renal failure. We assessed the influence of potential common confounders in SAF measurement, by determining the

  3. factors influencing condom use among nigerian undergraduates

    African Journals Online (AJOL)

    2012-12-01

    Dec 1, 2012 ... Nigeria. Study design: Both qualitative (focus group discussions) and quantitative (cross-sectional ... Keywords: Condom, unsafe sex, HIV, gender, undergraduates. ..... QUESTIONS: the following may influence condom.

  4. External factors influencing the environmental performance of South African firms

    CSIR Research Space (South Africa)

    Peart, R

    2001-01-01

    Full Text Available This article reviews the external factors that influence environmental performance of companies in South Africa, drawing on international and local literature. After considering factors within the natural, social, economic and institutional...

  5. Factors influencing women\\'s decisions to purchase specific children ...

    African Journals Online (AJOL)

    Factors influencing women\\'s decisions to purchase specific children\\'s ... they had selected a children's multi-nutrient supplement with the intention of buying it. ... Price, performance and brand loyalty, affect and normative factors were most ...

  6. Factors influencing the pattern of malnutrition among acutely ill ...

    African Journals Online (AJOL)

    Factors influencing the pattern of malnutrition among acutely ill children presenting in ... height/length) measurements and z-scores calculated for the individual nutritional ... The factors associated with malnutrition included early introduction of ...

  7. Effects of The Coach Approach Intervention on Adherence to Exercise in Obese Women: Assessing Mediation of Social Cognitive Theory Factors

    Science.gov (United States)

    Annesi, James J.; Unruh, Jennifer L.; Marti, C. Nathan; Gorjala, Srinivasa; Tennant, Gisele

    2011-01-01

    The link between physical activity and weight loss has precipitated interest in interventions to foster adherence to exercise. It has been suggested that treatment effects, when significant, should be analyzed to determine theory-based mediators. This research assessed possible mediation of changes in Physical Self-Concept, Exercise Self-Efficacy,…

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

    Directory of Open Access Journals (Sweden)

    Deisy Viviana Cardona-Duque

    2017-07-01

    Conclusion: Depression and self-report on compliance were associated with adherence to antiretroviral therapy. A comprehensive study on the perception of social support and cognitive variables, such as self-efficacy and risk perception, is highly recommended for people living with HIV/AIDS.

  9. Dietary Adherence, Glycemic Control, and Psychological Factors Associated with Binge Eating Among Indigenous and Non-Indigenous Chileans with Type 2 Diabetes.

    Science.gov (United States)

    Herbozo, Sylvia; Flynn, Patricia M; Stevens, Serena D; Betancourt, Hector

    2015-12-01

    Despite the strong association between obesity and binge eating, limited research has examined the implications of binge eating on dietary adherence and psychological factors in ethnically diverse type 2 diabetes patients. This study investigated the prevalence of binge eating and its association with dietary adherence, glycemic control, and psychological factors among indigenous and non-indigenous type 2 diabetes patients in Chile. Participants were 387 indigenous (Mapuche) and non-indigenous (non-Mapuche) adults with type 2 diabetes. Self-report measures of binge eating, dietary adherence, diet self-efficacy, body image dissatisfaction, and psychological well-being were administered. Participants' weight, height, and glycemic control (HbA(1c)) were also obtained. Approximately 8 % of the type 2 diabetes patients reported binge eating. The prevalence among Mapuche patients was 4.9 %, and among non-Mapuche patients, it was 9.9 %. Compared to non-binge eaters, binge eating diabetes patients had greater body mass index values, consumed more high-fat foods, were less likely to adhere to their eating plan, and reported poorer body image and emotional well-being. Results of this study extend previous research by examining the co-occurrence of binge eating and type 2 diabetes as well as the associated dietary behaviors, glycemic control, and psychological factors among indigenous and non-indigenous patients in Chile. These findings may increase our understanding of the health challenges faced by indigenous populations from other countries and highlight the need for additional research that may inform interventions addressing binge eating in diverse patients with type 2 diabetes.

  10. Influencing factors on compliance of timely visits among patients with proliferative diabetic retinopathy in southern China: a qualitative study

    Science.gov (United States)

    Duan, Fang; Liu, Yuhong; Chen, Xiang; Congdon, Nathan; Zhang, Jian; Chen, Qianyun; Chen, Lingling; Chen, Xi; Zhang, Xiulan; Yu, Chengpu; Liu, Yizhi

    2017-01-01

    Objective To identify the reasons for low adherence among patients with diabetic retinopathy (DR) in southern China using a qualitative method. Methods Exploratory indepth interviews were conducted in 27 diabetic patients with proliferative diabetic retinopathy who required vitrectomy surgery at Zhongshan Ophthalmic Centre, Sun Yat-sen University, from March to August 2015. Qualitative data analysis and research software (ATLAS.ti7) was used for data processing and analysis. Results Factors influencing the occurrence of timely visits included lack of DR related knowledge, fear and worries about insulin, interactions between patients and society combined with the complexity of emotions and social culture, and the economic burden of treatment. Conclusions Although the reasons for low adherence involved social, emotional, cultural and economic factors, the key issue was the lack of awareness and knowledge of DR. Our findings have several practical implications for health policymakers and programme planners in China. PMID:28348188

  11. Factors influencing quality of life in asthmatics

    DEFF Research Database (Denmark)

    Al-kalemji, Abir; Petersen, Karin Dam; Sørensen, Jan

    2013-01-01

    INTRODUCTION: The quality of life (QOL) in persons with asthma is reduced and different factors such as demography, asthma severity and psychiatric comorbidity play an influential role. However, little is known about the interplay of these factors. OBJECTIVE: To describe QOL in relation to asthma...

  12. Perspectives Regarding Adherence to Prescribed Treatment in Highly Adherent HIV-Infected Gay Men.

    Science.gov (United States)

    Brion, John M; Menke, Edna M

    2008-01-01

    Focus group methodology was used to describe the medication adherence experience of 24 HIV-infected gay men who reported being adherent to their medication regimens. A conceptualization of medication adherence as an evolving process consisted of challenges to adherence (learning the diagnosis, starting the medications, struggling with the medications, dealing with side effects, coping with stigma) as well as those factors supportive of adherence (believing in medications, finding motivating factors, using reminders, depending on others, owning the disease). Themes associated with challenges to adherence focused on diagnosis and the physical and emotional adjustments individuals made to incorporate antiretroviral medications into their daily lives and move toward medication adherence. The factors supportive of adherence were related to the ongoing behaviors identified with establishing and maintaining adherence behaviors. What can be taken from the study is that adherence is a complex and dynamic process rather than a static behavior.

  13. Factors influencing e-commerce development in Serbia

    OpenAIRE

    Kalinić, Zoran; Ranković, Vladimir; Kalinić, Ljubina

    2016-01-01

    In this paper, an overview of current state of e-commerce development in Serbia is presented. Also, some important factors influencing e-commerce diffusion are discussed. The factors are divided into four groups: technical factors, which cover e- commerce telecommunication and logistics infrastructure; legal factors, i.e. necessary laws and regulations on e-commerce; economic factors, and psychological factors and local culture. The study showed very strong correlation between broadband inter...

  14. Clinical factors influencing participation in society after successful kidney transplantation

    NARCIS (Netherlands)

    van der Mei, S.F.; Groothoff, J.W.; van Sonderen, E.L.P.; van den Heuvel, W.J.A.; de Jong, P.E.; van Son, W.J.

    2006-01-01

    Background. Little information is available on the degree of actual social functioning after successful kidney transplantation. Moreover, information on factors that influence participation in social activities is scarce. The aim of this study was to examine the influence of clinical factors on

  15. Factors influencing selection of office furniture by corporations and universities

    Science.gov (United States)

    R. Bruce Anderson

    1976-01-01

    Evaluation of the factors that influence the selection of office furniture by large corporations and universities shows that quality, appearance, and purchase price have the most important influence on the purchase decision. The intended use of the furniture and the appearance of the furniture were the key factors in the purchase of wooden furniture.

  16. Factors Influencing Pregnancy Desires among HIV Positive Women ...

    African Journals Online (AJOL)

    Factors Influencing Pregnancy Desires among HIV Positive Women in Sibande District in Mpumalanga, South Africa. ... Gender and Behaviour ... The objective of the study is to present findings on factors influencing pregnancy desires amongst HIV positive women that have participated in Prevention of Mother to child ...

  17. Psychosocial Factors Influencing Attitudes Towards Internet Piracy ...

    African Journals Online (AJOL)

    In all a total of two hundred and fifty participants were drawn through accidental sampling technique for this study. Their age ranged between 19-48 ... In the same view, consumers ethnic group was not found to significantly influence attitude towards Internet piracy (F(3,246) = .404, P> .05). Reasons were given why the ...

  18. Perceptions of Child Caregivers About Factors Influencing ...

    African Journals Online (AJOL)

    Nutrition, health education and measles immunization are crucial components of preventive eye health services in the prevention of corneal blindness. This study explores ... The interplay between nutrition and corneal blindness was unknown to mothers in this study. The strong influence ... effectiveness and sustainability.

  19. Factors Influencing Degradation of Mercaptans by Thiobacillus ...

    African Journals Online (AJOL)

    Degradation of methylmercaptans by Thiobacillus thioparus TK-m was influenced by pH of the reaction medium. Ratios of headspace concentrations in empty vials and those of acidified buffer solutions were less than 1.0. 95% of the H2S was in headspace with the remaining 5% in solution upon acidification. The values for ...

  20. Community Factors Influencing Birth Spacing among Married ...

    African Journals Online (AJOL)

    The significance of community-level demographic and fertility norms, gender norms, economic prosperity, and family planning behaviors demonstrate the broad influence of community variables on birth spacing outcomes. This analysis highlights the importance of moving beyond individual and household-level ...

  1. Adherence and competence in two manual-guided therapies for co-occurring substance use and posttraumatic stress disorders: clinician factors and patient outcomes.

    Science.gov (United States)

    Meier, Andrea; McGovern, Mark P; Lambert-Harris, Chantal; McLeman, Bethany; Franklin, Anna; Saunders, Elizabeth C; Xie, Haiyi

    2015-01-01

    The challenges of implementing and sustaining evidence-based therapies into routine practice have been well-documented. This study examines the relationship among clinician factors, quality of therapy delivery, and patient outcomes. Within a randomized controlled trial, 121 patients with current co-occurring substance use and posttraumatic stress disorders were allocated to receive either manualized Integrated Cognitive Behavioral Therapy (ICBT) or Individual Addiction Counseling (IAC). Twenty-two clinicians from seven addiction treatment programs were trained and supervised to deliver both therapies. Clinician characteristics were assessed at baseline; clinician adherence and competence were assessed over the course of delivering both therapies; and patient outcomes were measured at baseline and 6-month follow-up. Although ICBT was delivered at acceptable levels, clinicians were significantly more adherent to IAC (p drug problem severity. The differential impact of adherence and competence for both therapy types is consistent with their purported primary target: ICBT for PTSD and IAC for substance use. These findings also suggest the benefits of considering clinician factors when implementing manual-guided therapies. Future research should focus on diverse clinician samples, randomization of clinicians to therapy type, and prospective designs to evaluate models of supervision and quality monitoring.

  2. Geographic variation in long-term oxygen therapy in Denmark : factors related to adherence to guidelines for long-term oxygen therapy

    DEFF Research Database (Denmark)

    Ringbæk, Thomas Jørgen; Lange, Peter; Viskum, K

    2001-01-01

    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...... to national guidelines for LTOT was found in 34.4% of the patients for the whole of Denmark and varied regionally from 14 to 63%. Mean compliance with guidelines was 5.3 (range, 2.9 to 9.1) times as likely if the oxygen was prescribed by a pulmonary department compared to LTOT initiated by a GP. CONCLUSIONS......: 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...

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

    Directory of Open Access Journals (Sweden)

    Zhang YJ

    2018-05-01

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

  4. Pattern and Determinants of Antiretroviral Drug Adherence among Nigerian Pregnant Women

    Directory of Open Access Journals (Sweden)

    S. O. Ekama

    2012-01-01

    Full Text Available Background. The need for a high level of adherence to antiretroviral drugs has remained a major hurdle to achieving maximal benefit from its use in pregnancy. This study was designed to determine the level of adherence and identify factors that influence adherence during pregnancy. Method. This is a cross-sectional study utilizing a semistructured questionnaire. Bivariate and multiple logistic regression models were used to determine factors independently associated with good drug adherence during pregnancy. Result. 137 (80.6% of the interviewed 170 women achieved adherence level of ≥95% using 3 day recall. The desire to protect the unborn child was the greatest motivation (51.8% for good adherence. Fear of being identified as HIV positive (63.6% was the most common reason for nonadherence. Marital status, disclosure of HIV status, good knowledge of ART, and having a treatment supporter were found to be significantly associated with good adherence at bivariate analysis. However, after controlling for confounders, only HIV status disclosure and having a treatment partner retained their association with good adherence. Conclusion. Disclosure of HIV status and having treatment support are associated with good adherence. Maternal desire to protect the child was the greatest motivator for adherence.

  5. Ethno-Cultural Considerations in Cardiac Patients' Medication Adherence.

    Science.gov (United States)

    King-Shier, K M; Singh, S; Khan, N A; LeBlanc, P; Lowe, J C; Mather, C M; Chong, E; Quan, H

    2017-10-01

    We aimed to develop an in-depth understanding about factors that influence cardiac medication adherence among South Asian, Chinese, and European White cardiac patients. Sixty-four patients were purposively sampled from an ongoing study cohort. Interviews were audio-recorded and transcribed for analyses. Physicians' culturally sensitive communication and patients' motivation to live a symptom-free and longer life enhanced adherence. European Whites were motivated to enhance personal well-being and enjoy family life. South Asians' medication adherence was influenced by the desire to fulfill the will of God and family responsibilities. The Chinese were motivated to avoid pain, illness, and death, and to obey a health care provider. The South Asians and Chinese wanted to ultimately reduce medication use. Previous positive experiences, family support, and establishing a routine also influenced medication adherence. Deterrents to adherence were essentially the reverse of the motivators/facilitators. This analysis represents an essential first step forward in developing ethno-culturally tailored interventions to optimize adherence.

  6. Factors influencing the prevalence of primary dysmenorrhoea ...

    African Journals Online (AJOL)

    ... of primary dysmenorrhoea amongst Abia State university medical students, South ... its impact on school and social activities and the students' management strategies. ... is high, and not consistently associated with demographic risk factors.

  7. Determination of Mucosal Secretory Factors that Influence ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Understanding the complex factors that can lead to HIV infection is crucial to addressing the problem among vulnerable ... Related content ... Policy in Focus publishes a special issue profiling evidence to empower women in the labour market.

  8. Is Subjective Status Influenced by Psychosocial Factors?

    OpenAIRE

    Lundberg, Johanna; Kristenson, Margareta

    2008-01-01

    Objective Associations between subjective status and health are still relatively unexplored. This study aimed at testing whether subjective status is uniquely confounded by psychosocial factors compared to objective status, and what factors that may predict subjective status. Design A cross-sectional analysis of a population-based, random sample of 795 middle-aged men and women from the southeast of Sweden. Questionnaires included subjective status, objective measures of socioeconomic status,...

  9. Factors that influence peripheral nerve regeneration

    DEFF Research Database (Denmark)

    Krarup, Christian; Archibald, Simon J; Madison, Roger D

    2002-01-01

    median nerve lesions (n = 46) in nonhuman primates over 3 to 4 years, a time span comparable with such lesions in humans. Nerve gap distances of 5, 20, or 50mm were repaired with nerve grafts or collagen-based nerve guide tubes, and three electrophysiological outcome measures were followed: (1) compound...... muscle action potentials in the abductor pollicis brevis muscle, (2) the number and size of motor units in reinnervated muscle, and (3) compound sensory action potentials from digital nerve. A statistical model was used to assess the influence of three variables (repair type, nerve gap distance, and time...... to earliest muscle reinnervation) on the final recovery of the outcome measures. Nerve gap distance and the repair type, individually and concertedly, strongly influenced the time to earliest muscle reinnervation, and only time to reinnervation was significant when all three variables were included as outcome...

  10. Factors Influencing Organization Adoption Decision On Cloud Computing

    OpenAIRE

    Ailar Rahimli

    2013-01-01

    Cloud computing is a developing field, using by organization that require to computing resource to provide the organizational computing needs. The goal of this research is evaluate the factors that influence on organization decision to adopt the cloud computing in Malaysia. Factors that relate to cloud computing adoption that include : need for cloud computing, cost effectiveness, security effectiveness of cloud computing and reliability. This paper evaluated the factors that influence on ado...

  11. Factors influencing societal response of nanotechnology : an expert stakeholder analysis

    OpenAIRE

    Gupta, N.; Fischer, A.R.H.; Lans, van der, I.A.; Frewer, L.J.

    2012-01-01

    Nanotechnology can be described as an emerging technology and, as has been the case with other emerging technologies such as genetic modification, different socio-psychological factors will potentially influence societal responses to its development and application. These factors will play an important role in how nanotechnology is developed and commercialised. This article aims to identify expert opinion on factors influencing societal response to applications of nanotechnology. Structured i...

  12. Factors influencing societal response of nanotechnology: an expert stakeholder analysis

    OpenAIRE

    Gupta, Nidhi; Fischer, Arnout R. H.; van der Lans, Ivo A.; Frewer, Lynn J.

    2012-01-01

    Nanotechnology can be described as an emerging technology and, as has been the case with other emerging technologies such as genetic modification, different socio-psychological factors will potentially influence societal responses to its development and application. These factors will play an important role in how nanotechnology is developed and commercialised. This article aims to identify expert opinion on factors influencing societal response to applications of nanotechnology. Structured i...

  13. Influence Factors of the Economic Development Level Across European Countries

    OpenAIRE

    Diana Ioana POPA

    2016-01-01

    The economic development level of a country refers to the measure of the progress in an economy that could be measured, especially through GDP or GDP per capita. The level of these indicators can be influenced by many factors as a large scale, from social and economical to environmental and government policies factors. The paper aims to investigate some of these influence factors of the economic development level, represented in this case by GDP per capita, across European countries in the...

  14. Additional factors influencing resident satisfaction and dissatisfaction

    Directory of Open Access Journals (Sweden)

    Jalal SR

    2017-11-01

    Full Text Available Seyed Ramin Jalal, Abdirahman Osman, Saeed Azizi  Faculty of Medicine, St George’s Hospital Medical School, London, UK We have read the recent review article by Kahn et al1 with great interest. The original article was detailed and informative, and we felt it would be helpful to expand on the factors affecting resident satisfaction and dissatisfaction. As senior medical students in clinical years, we spend a significant portion of our time shadowing specialist trainees. Thus, we can offer a unique perspective on the factors affecting trainee satisfaction and well-being. View the original paper by Kahn and colleagues. 

  15. How does gender influence the recognition of cardiovascular risk and adherence to self-care recommendations?: A study in Polish primary care.

    Science.gov (United States)

    Szymczyk, Ireneusz; Wojtyna, Ewa; Lukas, Witold; Kępa, Joanna; Pawlikowska, Teresa

    2013-11-01

    Studies have shown a correlation between gender and an ability to change lifestyle to reduce the risk of disease. However, the results of these studies are ambiguous, especially where a healthy lifestyle is concerned. Additionally, health behaviors are strongly modified by culture and the environment. Psychological factors also substantially affect engagement with disease-related lifestyle interventions. This study aimed to examine whether there are differences between men and women in the frequency of health care behavior for the purpose of reducing cardiovascular risk (CVR), as well as cognitive appraisal of this type of risk. We also aimed to identify the psychological predictors of engaging in recommended behavior for reducing the risk of cardiovascular disease after providing information about this risk in men and women. A total of 134 consecutive eligible patients in a family practice entered a longitudinal study. At initial consultation, the individual's CVR and associated health burden was examined, and preventive measures were recommended by the physician. Self-care behavior, cognitive appraisal of risk, and coping styles were then assessed using psychological questionnaires. Six months after the initial data collection, the frequency of subjects' self-care behavior was examined. We found an increase in health care behavior after providing information regarding the rate of CVR in both sexes; this increase was greater for women than for men. Women followed self-care guidelines more often than men, particularly for preventive measures and dietary advice. Women were more inclined to recognize their CVR as a challenge. Coping style, cognitive appraisal, age, level of health behaviors at baseline and CVR values accounted for 48% of the variance in adherence to self-care guidelines in women and it was 52% in men. In women, total risk of CVD values were most important, while in men, cognitive appraisal of harm/loss was most important. Different predictors of

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

    Science.gov (United States)

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

    2018-01-01

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

  17. Maternal sociodemographic factors that influence full child ...

    African Journals Online (AJOL)

    single parenting, inadequate antenatal care, ethnicity and negative belief in vaccination to low immunisation uptake around the ... the maternal sociodemographic factors that are associated with child ... mothers <18 years old (odds ratio (OR) 0.53; confidence interval (CI) 0.34 - 0.84) and mothers residing in the northern ...

  18. Factors Influencing Medical Students' Choice of Specialty

    Directory of Open Access Journals (Sweden)

    Pei-Yeh Chang

    2006-01-01

    Conclusion: This study found that personal intelligence/ability preference and career opportunities were more important factors to the current generation of students in choosing a specialty. Knowledge of these students' attitudes could form the basis for the development of strategies to enhance the attractiveness of specialties facing the problem of a shortage of manpower.

  19. 122 Factors Influencing Information and Communication Technology ...

    African Journals Online (AJOL)

    Yemi Olojede

    Women Research Scientists in Universities of Agriculture in Nigeria ... recommends that researchers should restructure their work schedule to accommodate ICT practice and use in order to enhance ICT use. Keywords: Factors of ICT ... potential to reduce poverty and improve livelihoods by empowering users with timely.

  20. Home Environmental Factors Influencing Performance and Progress ...

    African Journals Online (AJOL)

    Our findings support other studies which found that parents' educational level and income level have a bearing on school progress and performance. Contrary to most research findings mother tongue instruction did not eme1rge as an important explanatory factor on school progress and performance, however; home ...

  1. Biodemographic And Health Seeking Behavior Factors Influencing ...

    African Journals Online (AJOL)

    This study findings show primarily - amongst the biodemographic and health seeking services factors, delivery-related maternal health complicacies, blindness, higher order births, twin births, lower household size and interaction effect of higher order live births and male child are significantly correlated with higher neonatal ...

  2. Home Environmental Factors Influencing Performance and Progress ...

    African Journals Online (AJOL)

    2010-05-11

    May 11, 2010 ... internal factors for low school performance, this study focused on the learners ... Namibia. Although numerous studies have confinned socio-economic ... Many studies support the view that family background is the strongest single predictor of ..... Windhoek is clearly stratified, mainly following income levels.

  3. Environmental Factors Influencing Artisanal Fishing in Eastern ...

    African Journals Online (AJOL)

    user

    The study identified the environmental factors affecting artisanal fishing in. Eastern Obolo local government area of Akwa ... colonial administration (Anko &Eyo, 2003). According to Olomola (1998), artisanal ... The problems faced by artisanal fishers in Nigeria are not far from what is experienced by artisanal fishermen in ...

  4. Adherence to internet-based mobile-supported stress management

    DEFF Research Database (Denmark)

    Zarski, A C; Lehr, D.; Berking, M.

    2016-01-01

    of this study was to investigate the influence of different guidance formats (content-focused guidance, adherence-focused guidance, and administrative guidance) on adherence and to identify predictors of nonadherence in an Internet-based mobile-supported stress management intervention (ie, GET.ON Stress......) for employees. Methods: The data from the groups who received the intervention were pooled from three randomized controlled trials (RCTs) that evaluated the efficacy of the same Internet-based mobile-supported stress management intervention (N=395). The RCTs only differed in terms of the guidance format...... of the predictors significantly predicted nonadherence. Conclusions: Guidance has been shown to be an influential factor in promoting adherence to an Internet-based mobile-supported stress management intervention. Adherence-focused guidance, which included email reminders and feedback on demand, was equivalent...

  5. Nutritional factors influencing milk urea in buffaloes

    Directory of Open Access Journals (Sweden)

    V. Proto

    2011-03-01

    Full Text Available Urea is the primary form in which N is excreted in ruminants. Milk urea (MU content was introduced as a means to monitor the efficiency of protein utilisation in dairy cattle (Baker et al., 1995; Roseler et al., 1993; Bertoni, 1995. In this study the effect of some nutrition factors on MU content in buffalo herds was analysed in order to examine the possibility that protein nutrition could be monitored by means of milk urea at herd level........

  6. Factors influencing eating attitudes in secondary-school girls in ...

    African Journals Online (AJOL)

    Family, especially maternal, factors play a role in determining eating attitudes. Peer and media (television) factors are not significantly influential. The findings provide preliminary data on factors that influence eating attrtudes in a group at risk for the development of eating disorders. The findings have implications for the ...

  7. Factors Influencing Stormwater Mitigation in Permeable Pavement

    Directory of Open Access Journals (Sweden)

    Chun Yan Liu

    2017-12-01

    Full Text Available Permeable pavement (PP is used worldwide to mitigate surface runoff in urban areas. Various studies have examined the factors governing the hydrologic performance of PP. However, relatively little is known about the relative importance of these governing factors and the long-term hydrologic performance of PP. This study applied numerical models—calibrated and validated using existing experimental results—to simulate hundreds of event-based and two long-term rainfall scenarios for two designs of PP. Based on the event-based simulation results, rainfall intensity, rainfall volume, thickness of the storage layer and the hydraulic conductivity of the subgrade were identified as the most influential factors in PP runoff reduction. Over the long term, PP performed significantly better in a relatively drier climate (e.g., New York, reducing nearly 90% of runoff volume compared to 70% in a relatively wetter climate (e.g., Hong Kong. The two designs of PP examined performed differently, and the difference was more apparent in the relatively wetter climate. This study generated insights that will help the design and implementation of PP to mitigate stormwater worldwide.

  8. Prevalence of and factors associated with antenatal care seeking and adherence to recommended iron-folic acid supplementation among pregnant women in Zinder, Niger.

    Science.gov (United States)

    Begum, Khadija; Ouédraogo, Césaire T; Wessells, K Ryan; Young, Rebecca R; Faye, M Thierno; Wuehler, Sara E; Hess, Sonja Y

    2018-02-01

    The World Health Organization recommends iron and folic acid (IFA) supplementation for pregnant women. The high prevalence of anaemia among pregnant women in Niger warrants better understanding of the utilization of antenatal care (ANC) and IFA. We aimed to assess the prevalence of and factors associated with ANC coverage and adherence to IFA recommendation among pregnant women. Pregnant women (n = 923) from 64 randomly selected villages within the catchment area of 12 health centres were interviewed during a baseline household survey in Zinder, Niger. ANC and IFA coverage were 60.1% and 43.6%, respectively. Only 71.7% of women who attended ANC received IFA. Of the 401 women who reportedly received any IFA supplements, 99.3% had attended any ANC during their current pregnancy and 68.6% reported adherence to recommended IFA supplementation (i.e., consumed IFA every day in the previous week). Women with gestational age ≥27 weeks were more likely to have attended ANC than women with gestational age ANC were more likely to attend ANC (OR: 1.48, 95% CI [1.03, 2.11]) and adhere to IFA recommendations (OR: 1.80, 95% CI [1.04, 3.13]) compared to those who did not receive any advice. ANC attendance is crucial to ensure distribution of IFA supplementation among pregnant women in Zinder. Interventions to improve ANC and IFA adherence will require promotion of early ANC, ensure availability of IFA at ANC, and involve husbands in ANC. © 2018 John Wiley & Sons Ltd.

  9. An investigation on factors influencing on human resources productivity

    Directory of Open Access Journals (Sweden)

    Masoumeh Seifi Divkolaii

    2014-05-01

    Full Text Available Human resources development is one of the most important components of any organization and detecting important factors influencing on human resources management plays essential role on the success of the firms. In this paper, we present an empirical investigation to determine different factors influencing productivity of human resources of Islamic Republic of Iran Broadcasting (IRIB in province of Mazandaran, Iran. The study uses analytical hierarchy process (AHP to rank 17 important factors and determines that personal characteristics were the most important factors followed by management related factors and environmental factors. In terms of personal characteristics, job satisfaction plays essential role on human resources development. In terms of managerial factors, paying attention on continuous job improvement by receiving appropriate training is the most important factor followed by welfare facilities for employees and using a system of reward/punishment in organization. Finally, in terms of environmental factors, occupational safety is number one priority followed by organizational rules and regulations.

  10. INFLUENCE FACTORS AND MANIFESTATIONS OF PRODUCTIVITY

    Directory of Open Access Journals (Sweden)

    Daniel DĂNECI-PĂTRĂU

    2014-09-01

    Full Text Available Notion almost unknown before 1950, labor productivity is now commonly used by economists, engineers, sociologists and politicians alike, influencing all the important issues of the time. Under these circumstances, if it is accepted that labor productivity is the driving variable that generates economic progress, it is justified that people need to increase their efforts to enhance, its value through various means. This article presents the findings of a theoretical research literature regarding landmarks in the evolution of labor productivity. Arguments justifying such an approach have been given by the fact that the labor issue presents an interest not only at the micro level, individual (the consequences it has on the individual work, but also at the macro level, societal (employment relations on the market labor, insurance systems and the offer educational services on the market today.

  11. Factors influencing radon attenuation by tailing covers

    International Nuclear Information System (INIS)

    Silker, W.B.; Rogers, V.C.

    1981-07-01

    The US NRC, in its Generic Environmental Impact Statement on uranium milling has specified that the radon flux escaping a uranium mill tailings pile will be reduced to pCi/m 2 s by application of covering layers of soils and clays. These covers present a radon diffusion barrier, which sufficiently increases the time required for radon passage from the tailings to the atmosphere to allow for decay of 222 Rn within the cover. The depth of cover necessary to reduce the escaping radon flux to the prescribed level is to be determined by calculation, and requires precise knowledge of the radon diffusion coefficient in the covering media. A Radon Attenuation Test Facility was developed to determine rates of radon diffusion through candidate cover materials. This paper describes this facility and its application for determining the influence of physical properties of the soil column on the radon diffusion coefficient

  12. Factors influencing incident reporting in surgical care.

    Science.gov (United States)

    Kreckler, S; Catchpole, K; McCulloch, P; Handa, A

    2009-04-01

    To evaluate the process of incident reporting in a surgical setting. In particular: the influence of event outcome on reporting behaviour; staff perception of surgical complications as reportable events. Anonymous web-based questionnaire survey. General Surgical Department in a UK teaching hospital. Of 203 eligible staff, 55 (76.4%) doctors and 82 (62.6%) nurses participated. Knowledge and use of local reporting system; propensity to report incidents which vary by outcome (harm, no harm, harm prevented); propensity to report surgical complications; practical and psychological barriers to reporting. Nurses were significantly more likely to know of the local reporting system and to have recently completed a report than doctors. The level of harm (F(1.8,246) = 254.2, pvs 53%, z = 4.633, psystems.

  13. Beliefs that influence cost-related medication non-adherence among the “haves” and “have nots” with chronic diseases

    Directory of Open Access Journals (Sweden)

    AM

    2011-08-01

    Full Text Available John D Piette1, Ashley Beard1, Ann Marie Rosland1, Colleen A McHorney21Ann Arbor VA Healthcare System, Ann Arbor, MI, USA and the University of Michigan Medical School, Department of Internal Medicine, Ann Arbor, MI, USA; 2US Outcomes Research, Merck and Co, Inc, North Wales, PA, USABackground and objective: Some patients continue taking their medication as prescribed despite serious financial pressures, while others with the ability to pay forego treatment due to cost concerns. The primary goal of this study was to explore how patients' beliefs about the necessity of treatment and treatment side effects, influence cost-related non-adherence (CRN.Methods: 27,302 participants in the Harris Interactive Chronic Illness Panel completed an internet survey. The current study focused on two subsamples representing: (a the most economically-vulnerable survey respondents (ie, individuals with household incomes of US$25,000 per year or less and monthly out-of-pocket medication costs of at least US$60, n = 1321; and (b respondents who were the most likely to have the financial resources to pay for medications (ie, those with incomes of US$125,000 or more and monthly medication costs of less than US$60.00, n = 1195. Multivariate models were constructed for each group to determine the independent impact on CRN of perceived need for medications and side-effect concerns. Increased risk for CRN associated with depression and asthma diagnoses also was examined.Results: Twenty-one percent of economically vulnerable respondents reported continuing to take their medication as prescribed despite serious cost pressures, while 14% of high-income respondents reported CRN despite apparently manageable out-of-pocket costs. Both low perceived need for medications and concerns about side-effects affected CRN risk in low-income and high-income groups. Within groups of both low-income and high-income respondents, depression and asthma significantly increased patients' odds

  14. Factors influencing workplace health promotion intervention: a qualitative systematic review.

    Science.gov (United States)

    Rojatz, Daniela; Merchant, Almas; Nitsch, Martina

    2017-10-01

    Although workplace health promotion (WHP) has evolved over the last 40 years, systematically collected knowledge on factors influencing the functioning of WHP is scarce. Therefore, a qualitative systematic literature review was carried out to systematically identify and synthesize factors influencing the phases of WHP interventions: needs assessment, planning, implementation and evaluation. Research evidence was identified by searching electronic databases (Scopus, PubMed, Social Sciences Citation Index, ASSIA, ERIC, IBBS and PsycINFO) from 1998 to 2013, as well as by cross-checking reference lists of included peer-reviewed articles. The inclusion criteria were: original empirical research, description of WHP, description of barriers to and/or facilitators of the planning, implementation and/or evaluation of WHP. Finally, 54 full texts were included. From these, influencing factors were extracted and summarized using thematic analysis. The majority of influencing factors referred to the implementation phase, few dealt with planning and/or evaluation and none with needs assessment. The influencing factors were condensed into topics with respect to factors at contextual level (e.g. economic crisis); factors at organizational level (e.g. management support); factors at intervention level (e.g. quality of intervention concept); factors at implementer level (e.g. resources); factors at participant level (e.g. commitment to intervention) and factors referring to methodological and data aspects (e.g. data-collection issues). Factors regarding contextual issues and organizational aspects were identified across three phases. Therefore, future research and practice should consider not only the influencing factors at different levels, but also at different phases of WHP interventions. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Factors that influence current tuberculosis epidemiology.

    Science.gov (United States)

    Millet, Juan-Pablo; Moreno, Antonio; Fina, Laia; del Baño, Lucía; Orcau, Angels; de Olalla, Patricia García; Caylà, Joan A

    2013-06-01

    According to WHO estimates, in 2010 there were 8.8 million new cases of tuberculosis (TB) and 1.5 million deaths. TB has been classically associated with poverty, overcrowding and malnutrition. Low income countries and deprived areas, within big cities in developed countries, present the highest TB incidences and TB mortality rates. These are the settings where immigration, important social inequalities, HIV infection and drug or alcohol abuse may coexist, all factors strongly associated with TB. In spite of the political, economical, research and community efforts, TB remains a major global health problem worldwide. Moreover, in this new century, new challenges such as multidrug-resistance extension, migration to big cities and the new treatments with anti-tumour necrosis alpha factor for inflammatory diseases have emerged and threaten the decreasing trend in the global number of TB cases in the last years. We must also be aware about the impact that smoking and diabetes pandemics may be having on the incidence of TB. The existence of a good TB Prevention and Control Program is essential to fight against TB. The coordination among clinicians, microbiologists, epidemiologists and others, and the link between surveillance, control and research should always be a priority for a TB Program. Each city and country should define their needs according to the epidemiological situation. Local TB control programs will have to adapt to any new challenge that arises in order to respond to the needs of their population.

  16. Factors influencing microinjection molding replication quality

    Science.gov (United States)

    Vera, Julie; Brulez, Anne-Catherine; Contraires, Elise; Larochette, Mathieu; Trannoy-Orban, Nathalie; Pignon, Maxime; Mauclair, Cyril; Valette, Stéphane; Benayoun, Stéphane

    2018-01-01

    In recent years, there has been increased interest in producing and providing high-precision plastic parts that can be manufactured by microinjection molding: gears, pumps, optical grating elements, and so on. For all of these applications, the replication quality is essential. This study has two goals: (1) fabrication of high-precision parts using the conventional injection molding machine; (2) identification of robust parameters that ensure production quality. Thus, different technological solutions have been used: cavity vacuuming and the use of a mold coated with DLC or CrN deposits. AFM and SEM analyses were carried out to characterize the replication profile. The replication quality was studied in terms of the process parameters, coated and uncoated molds and crystallinity of the polymer. Specific studies were processed to quantify the replicability of injection molded parts (ABS, PC and PP). Analysis of the Taguchi experimental designs permits prioritization of the impact of each parameter on the replication quality. A discussion taking into account these new parameters and the thermal and spreading properties on the coatings is proposed. It appeared that, in general, increasing the mold temperature improves the molten polymer fill in submicron features except for the steel insert (for which the presence of a vacuum is the most important factor). Moreover, the DLC coating was the best coating to increase the quality of the replication. This result could be explained by the lower thermal diffusivity of this coating. We noted that the viscosity of the polymers is not a primordial factor of the replication quality.

  17. Factors influencing EPR dosimetry in fingernails

    International Nuclear Information System (INIS)

    Dubner, D.L.; Spinella, M.R.; Bof, E.

    2010-01-01

    The technique based on the detection of ionizing radiation induced radicals by EPR in tooth enamel is an established method for the dosimetry of exposed persons in radiological emergencies. Dosimetry based on EPR spectral analysis of fingernail clippings, currently under development, has the practical advantage of the easier sample collection. A limiting factor is that overlapping the radiation induced signal (RIS), fingernails have shown the presence of two mechanically induced signals, called MIS1 and MIS2, due to elastic and plastic deformation respectively, at the time of fingernails cutting. With a water treatment, MIS1 is eliminated while MIS2 is considerably reduced. The calibration curves needed for radiation accident dosimetry should have 'universal' characteristics, ie. Represent the variability that can be found in different individuals. Early studies were directed to the analysis of factors affecting the development of such universal calibration curves. The peak to peak amplitude of the signal before and after the water treatment as well as the effect of size and number of clippings were studied. Furthermore, the interpersonal and intrapersonal variability were analyzed. Taking into account these previous studies, the optimal conditions for measurement were determined and EPR spectra of samples irradiated at different doses were used for the developing of dose-response curves. This paper presents the analysis of the results.(authors) [es

  18. Factors influencing surface roughness of polyimide film

    International Nuclear Information System (INIS)

    Yao Hong; Zhang Zhanwen; Huang Yong; Li Bo; Li Sai

    2011-01-01

    The polyimide (PI) films of pyromellitic dianhydride-oxydiamiline (PMDA-ODA) were fabricated using vapor deposition polymerization (VDP) method under high vacuum pressure of 10-4 Pa level. The influence of equipment, substrate temperature, the process of heating and deposition ratio of monomers on the surface roughness of the PI films was investigated. The surface topography of films was measured by interferometer microscopy and scanning electron microscopy(SEM), and the surface roughness was probed with atomic force microscopy(AFM). The results show that consecutive films can be formed when the distance from steering flow pipe to substrate is 74 cm. The surface roughnesses are 291.2 nm and 61.9 nm respectively for one-step heating process and multi-step heating process, and using fine mesh can effectively avoid the splash of materials. The surface roughness can be 3.3 nm when the deposition rate ratio of PMDA to ODA is 0.9:1, and keeping the temperature of substrate around 30 degree C is advantageous to form a film with planar micro-surface topography. (authors)

  19. Adherence and Quality of Life of Hypertension Patients in Gunung Jati Hospital, Cirebon, Indonesia

    Directory of Open Access Journals (Sweden)

    Dyah A.Perwitasari

    2015-12-01

    Full Text Available The treatment effectiveness of hypertension could be influenced by patients’ characteristics and patients’ adherence with medication. Besides reaching the goal of blood pressure decrease after the treatment, their quality of life has become the main concern regarding effectiveness of hypertension treatment. This study aimed to explore the hypertension patients’ adherence and quality of life. In addition, it was studied which factors associated with adherence and quality of life in hypertension patients treated with antihypertensive at Gunung Jati Hospital, Cirebon. We recruited 85 adult hypertension patients who were treated with antihypertensive agents for at least 6 months. The patients’ adherence was measured by Medication Adherence Report Scale and the patients’ quality of life was measured by Indonesian version of Short Form-36 questionnaire. The patients’ adherence was found as 24.03 (SD: 1.98 and there were no significant differences of patients’ adherence using monotherapy and combination therapy. The patients’ characteristics such as, age, gender and education level could not predict patients’ adherence (p>0.05. The average of Physical Component Summary (PCS and Mental Component Summary (MCS were 43.35 (SD: 9.4 and 52.13 (SD:5.59. Age and gender may predict PCS, however, education and comorbidity may predict MCS (p<0.05. Hypertension patients’ adherence in Gunung Jati hospital is good. The PCS and MCS scores in this study are comparable to the other previous studies. The patients’ characteristic could not be the predictor of patients’ adherence.

  20. Influence of socioeconomic factors in muscle dysmorphia

    Directory of Open Access Journals (Sweden)

    Mercedes Rizo-Baeza

    2018-05-01

    Full Text Available Abstract: Introduction and objective: In muscle dysmorphia (MD the patient thinks he is smaller and less muscular than he really is. As in other addictive diseases, its prevention and early diagnosis are the key to avoid associated disorders. It is established as an objective to determine if there are associated socio-demographic factors. Material and methods: Cross-sectional observational study of 140 men, between 16-45 years old, who practice bodybuilding in gyms of different socioeconomic levels, at least 6 months prior to the study, 4 days / week, 1 hour / day, who signed the informed consent and without chronic illness. The main variable was the presence of symptoms of DM using the muscle appearance satisfaction scale (44 patients and the secondary variables were age, coexistence, children, educational level and monthly income. Frequencies were used in the qualitative variables, and averages and standard deviations in the quantitative variables, in the bivariate analysis of the Chisquare test and the t-student test respectively and the binary logistic regression (presence / absence of MD to eliminate confounding factors, the probabilities were calculated associated Results: The gymnasts have an average age of 26.1 (SD = 7.1 years; the majority live with their parents (56.4%; they do not have children (89.3%; the academic levels are balanced and the economic income is mostly low / medium (79.3%. In the bivariate analysis, is observed a higher risk at a younger age (p = 0.027 and when they live with their parents (limit of significance. Significance is not observed with the variables having children, educational level or economic income. In the binary logistic regression these meanings are lost, although the graphic representation of the probability in relation with age seems to be a risk factor, as well as living with the parents or as a couple. Conclusion: Among men who practice bodybuilding, it is usually a risk to suffer MD, to be younger

  1. FACTORS THAT INFLUENCE THE INTENTION FOR

    Directory of Open Access Journals (Sweden)

    NICULIȚĂ ZENOBIA

    2015-10-01

    Full Text Available The present article presents the research results of an applied study regarding the impact of work style and organizational climate on teachers' intention to leave their workplace in the foreseeable future. A sample of 150 teachers aged 21-56, employees of 10 schools from Bucharest, Romania has been the focus of the research, aiming to identify the differences between the group of participants that expressed their intent to leave the organization (called the turnover group and the ones that stated their intention to remain employed in the school (non-fluctuation group regarding work style and its factors and the perceived traits of the organizational climate for the schools employing them at the time of the study. Teachers included in the turnover group revealed a more dynamic work style and a significantly more negative perception of the organizational climate.

  2. Organizational factors influencing improvements in safety

    International Nuclear Information System (INIS)

    Marcus, A.; Nichols, M.L.; Olson, J.; Osborn, R.; Thurber, J.

    1991-01-01

    Results of conceptual and empirical research conducted by this research team, and published in NUREG-CR 5437, suggested that processes of organizational problem solving and learning provide a promising area for understanding improvement in safety-related performance in nuclear power plants. In this paper the authors describe the way in which they have built upon that work and gone much further in empirically examining a range of potentially important organizational factors related to safety. The paper describes (1) overall trends in plant performance over time on the Nuclear Regulatory Commission performance indicators, (2) the major elements in the conceptual framework guiding the current work, which seeks among other things to explain those trends, (3) the specific variables used as measures of the central concepts, (4) the results to date of the quantitative empirical work and qualitative work in progress, and (5) conclusions from the research

  3. Factors influencing dependence on mobile phone

    Directory of Open Access Journals (Sweden)

    Mohammad-Hossein Biglu

    2016-08-01

    Full Text Available Introduction: The purpose of current study was to investigate the relationship between the problematic use of mobile phone and Big Five personality traits among students of Tabriz University of Medical Sciences in Tabriz, Iran. Methods: A total number of 120 students (80 females and 40 males were selected by applying proportional randomized classification sampling method from Tabriz University of Medical Sciences. The Mobile Phone Problematic Use Scale (MPPUS and demographic questionnaire were used to gather data. Data were analyzed using SPSS software. Results: Analysis of gathered data showed that gender, neuroticism, extraversion, and openness to experience had positive correlation with the problematic use of mobile phone, whereas conscientiousness and agreeableness were not correlated with the problematic use of mobile phone. Conclusion: The evaluation of Big Five personality traits would be a reliable factor for predicting the problematic use of mobile phone among students.

  4. Wheat Industry: Which Factors Influence Innovation?

    Directory of Open Access Journals (Sweden)

    Vitor Francisco Dalla Corte

    2015-10-01

    Full Text Available A change in the profile of food consumption is occurring because of the new context of demographic growth, the increase of income in developing economies, and urbanization. In Brazil, consumption patterns have trended from fresh to processed food and internal and external growth in demand has led to opportunities that require new and higher levels of technological innovation and associated managerial skill. The aim of this study was to evaluate the role of innovation on a key Brazilian food industry: wheat product markets. Results showed that while most firms did not innovate in the past year, new investments in R&D were important for innovation to occur compared to other factors such as the size of the company, the integration in supply chain, and the age of the company. These results demonstrate that innovation is not a random or unpredictable process, but a complex and diverse process that may be specific to each industry.

  5. Influence factors in the Knowledge Management

    Directory of Open Access Journals (Sweden)

    Antonio Sánchez Ramírez

    2010-05-01

    Full Text Available There are factors which impel or slow down the knowledge processes into the organizations which in turn affect the completion of its vision as an ideal planning. The organizational memory, repetition of unconscious acts and the extended practice plays an important role in the meaning of the action and the goal to transform the plans into attainment through the manifest knowledge which turns into conclusion and makes a systematic knowing infused with values as an important core source for the firm. They conceive maturity stages of development within the companies which interact mutually, starting with the organizational memory which embodies the past and present successes, passing towards unconscious acts which can risk the true knowledge content to an extended practice stage based in years of experience.

  6. Factors influencing message dissemination through social media

    Science.gov (United States)

    Zheng, Zeyu; Yang, Huancheng; Fu, Yang; Fu, Dianzheng; Podobnik, Boris; Stanley, H. Eugene

    2018-06-01

    Online social networks strongly impact our daily lives. An internet user (a "Netizen") wants messages to be efficiently disseminated. The susceptible-infected-recovered (SIR) dissemination model is the traditional tool for exploring the spreading mechanism of information diffusion. We here test our SIR-based dissemination model on open and real-world data collected from Twitter. We locate and identify phase transitions in the message dissemination process. We find that message content is a stronger factor than the popularity of the sender. We also find that the probability that a message will be forwarded has a threshold that affects its ability to spread, and when the probability is above the threshold the message quickly achieves mass dissemination.

  7. Influence of processing factors over concrete strength.

    Science.gov (United States)

    Kara, K. A.; Dolzhenko, A. V.; Zharikov, I. S.

    2018-03-01

    Construction of facilities of cast in-situ reinforced concrete poses additional requirements to quality of material, peculiarities of the construction process may sometimes lead to appearance of lamination planes and inhomogeneity of concrete, which reduce strength of the material and structure as a whole. Technology compliance while working with cast in-situ concrete has a significant impact onto the concrete strength. Such process factors as concrete curing, vibration and compaction of the concrete mixture, temperature treatment, etc., when they are countered or inadequately followed lead to a significant reduction in concrete strength. Here, the authors experimentally quantitatively determine the loss of strength in in-situ cast concrete structures due to inadequate following of process requirements, in comparison with full compliance.

  8. Factors influencing professional life satisfaction among neurologists.

    Science.gov (United States)

    Teixeira-Poit, Stephanie M; Halpern, Michael T; Kane, Heather L; Keating, Michael; Olmsted, Murrey

    2017-06-19

    Predicted shortages in the supply of neurologists may limit patients' access to and quality of care for neurological disorders. Retaining neurologists already in practice provides one opportunity to support the overall supply of practicing neurologists. Understanding factors associated with professional life satisfaction (and dissatisfaction) and implementing policies to enhance satisfaction may encourage neurologists to remain in clinical practice. In this paper, we present results from the first study examining factors associated with professional life satisfaction among a large sample of U.S, neurologists. We collaborated with the AAN to survey a sample of U.S. neurologists about their professional life satisfaction. Analyses examined the association of physician and practice characteristics with aspects of professional life satisfaction, including satisfaction with their career in medicine, medical specialty, current position, relationship with colleagues, relationship with patients, work/life balance, and pay. The study population consisted of 625 neurologists. In multivariate regression analyses, no single group or population stratum indicated high (or low) responses to all aspects of satisfaction. Older neurologists reported higher satisfaction with career, specialty, and relationship with patients than younger neurologists. Female neurologists had significantly lower satisfaction with pay than male neurologists. Neurologists who spent more time in research and teaching had greater satisfaction with specialty, relationship with colleagues, and relationship with patients than those spending no time in research. Neurologists who practiced in small cities/rural areas reported lower satisfaction across multiple dimensions than those practicing in large urban areas. Neurologists in solo practice had greater satisfaction with the relationship with their patients, but lower satisfaction with pay. Satisfaction is a multidimensional construct that is associated with

  9. Risk-factors for non-adherence to antiretroviral therapy Fatores preditivos de não-adesão à terapia antiretroviral

    Directory of Open Access Journals (Sweden)

    Márcia Cristina Fraga Silva

    2009-06-01

    Full Text Available Cross-sectional study analyzed as case-control to identify risk factors for non-adherence to antiretroviral therapy. We studied 412 out-clinics HIV infected subjects of three public hospitals of Recife, Pernambuco. The objective was to examine the association between non-adherence to the antiretroviral therapy and biological, social-behavior and demographics and economic factors, factors related to the disease and/or treatment, factors related to life habits and depression symptoms. Variables significantly associated with non-adherence to antiretroviral therapy were: time elapsed since HIV diagnosis (p = 0.002, daily dose (p = 0.046, use of alcohol (p = 0.030 and past drug use (p = 0.048, and borderline p-values were found for educational level (p = 0.093 and family monthly income (p = 0.08. In the multivariable analysis, the factors that remained in the final model were family monthly income, time period with HIV infection and use of alcohol. No association was observed between non-adherence to antiretroviral therapy and gender, age, sexual orientation, marital status, educational level and place of residence. Based on our results and the local situation we suggest: assessment of social needs; training of partners and/or families on supporting adherence, creation of "adherence groups" to motivate and to reassure patients on the benefits of treatment; counseling and/or psychotherapy for alcohol drinkers.Estudo transversal com análise tipo caso-controle, que avaliou 412 pacientes de hospitais públicos do Recife - PE, com o objetivo de identificar fatores preditivos de não adesão à terapia antiretroviral. Verificou-se associação entre não adesão à terapia antiretroviral e aspectos biológicos, sócio-comportamentais e demográficos, econômicos, relacionados à doença e ao tratamento, aos hábitos de vida e aos distúrbios do humor. Variáveis com associação estatisticamente significante com não adesão na análise univariada foram

  10. Factors influencing job satisfaction of oncology nurses over time.

    Science.gov (United States)

    Cummings, Greta; Olson, Karin; Raymond-Seniuk, Christy; Lo, Eliza; Masaoud, Elmabrok; Bakker, Debra; Fitch, Margaret; Green, Esther; Butler, Lorna; Conlon, Michael

    2013-01-01

    In this study, we tested a structural equation model to examine work environment factors related to changes in job satisfaction of oncology nurses between 2004 and 2006. Relational leadership and good physician/nurse relationships consistently influenced perceptions of enough RNs to provide quality care, and freedom to make patient care decisions, which, in turn, directly influenced nurses' job satisfaction over time. Supervisor support in resolving conflict and the ability to influence patient care outcomes were significant influences on job satisfaction in 2004, whereas, in 2006, a clear philosophy of nursing had a greater significant influence. Several factors that influence job satisfaction of oncology nurses in Canada have changed over time, which may reflect changes in work environments and work life. These findings suggest opportunities to modify work conditions that could improve nurses' job satisfaction and work life.

  11. Fish consumption preferences and factors influencing it

    Directory of Open Access Journals (Sweden)

    Mehmet Ferit Can

    2015-06-01

    Full Text Available Fish consumption preferences are affected by individuals’ socioeconomic characteristics. The aims of the present paper were (i to obtain information on fish consumption level and frequency; (ii to investigate the associations between the socioeconomic characteristics of consumers and their preferences; and (iii to examine the influence of determinants on fish consumption. Data were gathered through a questionnaire completed by a total of 127 randomly selected individuals from different socioeconomic backgrounds from the Antakya, Turkey. The average consumption was found to be 2.98 kg/person/year for fish. Anchovies, gilt-head sea bream, and sea bass were reported as the most consumed three species, respectively. Significant differences in fish consumption were found among age groups, gender groups, and education groups, as well as between marital statuses. A majority of the consumers eat fish once a month throughout the year or only during the winter months. Fish consumption level and frequency were significantly positively correlated with education (p<0.01, income (p<0.05 and total meat consumption (p<0.01. The stepwise multiple regression model explained 41.7% (p<0.01 of the total variance for fish consumption. The amount and frequency of the consumption in the region, which is very far below the world and Turkey average especially for lower socioeconomic groups and for less-consumed fish species, can be increased by certain policies, such as training, advertising and different marketing strategies. Moreover, consumption should be distributed equally throughout the year instead of consuming only in certain seasons.

  12. Assessing the Factors Influencing Women Attainment of Household ...

    African Journals Online (AJOL)

    This study assessed the factors influencing the attainment of household food security in Ikwuano ... Data analysis utilized descriptive statistics such as frequency counts, ... had no access to credits, 71.7% had no contact with extension service.

  13. The Influence of Psychological Factors in Meniere's Disease | Orji ...

    African Journals Online (AJOL)

    The Influence of Psychological Factors in Meniere's Disease. ... Annals of Medical and Health Sciences Research ... probably through disorders of the autonomic nervous system occasioned by the increased levels of stress‑related hormones.

  14. Influence of bioregion and environmental factors on the growth, size ...

    African Journals Online (AJOL)

    The influence of bioregion and important environmental factors in South Africa ... the production efficiency of cows through the implementation of management ... genetic component was not separated from the environmental components.

  15. Factors influencing recruitment and retention of professional nurses ...

    African Journals Online (AJOL)

    J. Lyn Haskins

    factors influencing recruitment and retention of three categories of HPs in KwaZulu-Natal and has ...... tion, with good career opportunities which were similar in both urban and rural .... attract nurses to rural areas: A multicountry discrete choice.

  16. Factors that influence doctors in the assessment of applicants for ...

    African Journals Online (AJOL)

    Factors that influence doctors in the assessment of applicants for disability grant. ... and the usefulness of the committees were important in decision making. ... assessment of applicants for a disability grant is a subjective and emotional task.

  17. Evaluation of some genetic factors influencing the phenotypic ...

    African Journals Online (AJOL)

    Evaluation of some genetic factors influencing the phenotypic severity of β thalassemia Egyptian patients. Ibtessam R Hussein, Amina M Medhat, Samir F Zohny, Alice K Abd El-Aleem, Ghada Y El-Kammah, Bardees M Foda ...

  18. Social Cultural Factors Influencing Women's Participation in Sports ...

    African Journals Online (AJOL)

    Social Cultural Factors Influencing Women's Participation in Sports as Perceived by Female Students of the University of Ilorin. ... sports competition while mass media should organize enlightenment programmes that will mitigate the ...

  19. Physico-chemical and biotic factors influencing microalgal seed ...

    African Journals Online (AJOL)

    Physico-chemical and biotic factors influencing microalgal seed culture propagation for inoculation of a ... African Journal of Biotechnology ... used to inoculate an open raceway pond for large scale biomass production for biodiesel production.

  20. Factors Influencing the Willingness to Pay User Fees

    OpenAIRE

    Morse, George W.

    2012-01-01

    In this Note I explore the factors which influence the demand side of program participation, or the willingness to pay (WTP). The WTP estimates can help you determine how many people will participate in an event at each fee level.

  1. 38 FACTORS THAT INFLUENCE IRON STATUS OF PREGNANT ...

    African Journals Online (AJOL)

    sys01

    The study investigated the factors that influence iron ... approaches employed for promotion of girl-child education and prevention of adolescent .... purchase food items rich in haem iron such as ... decision making, life style options, and control.

  2. factors influencing the choice of health care providing facility among

    African Journals Online (AJOL)

    In the public sector ... Objectives: This study aimed to assess the factors influencing choice and satisfaction with health service providers among local ... the consumer of healthcare services cannot control. ..... Acquisition of Stable Food.

  3. Factors influencing the adoption of smartphones by undergraduate ...

    African Journals Online (AJOL)

    Factors influencing the adoption of smartphones by undergraduate students at ... ha ve thus far c oncentrated on the adoption of mobile technologies especially ... who may also want to explore the implementation of mobile learning systems, ...

  4. Socio-Cultural Factors Influencing Consent For Research In Nigeria ...

    African Journals Online (AJOL)

    Socio-Cultural Factors Influencing Consent For Research In Nigeria: Lessons ... for Health Research Ethics in enforcing researchers' compliance with ethical standards in ... Genuine respect for human dignity requires deeper understanding of ...

  5. Factors influencing breastfeeding practices in Edo state, Nigeria ...

    African Journals Online (AJOL)

    In Nigeria however, young infants may not benefit from such a practice as a ... The purpose of this study was to determine factors influencing breastfeeding practices in Edo State, Nigeria. ... Only 20 per cent practiced exclusive breastfeeding.

  6. Factors Influencing Student Nurses' Performance in the Final ...

    African Journals Online (AJOL)

    Factors Influencing Student Nurses' Performance in the Final Practical Examination ... Staff development courses can be held to coordinate the work of the school ... to authentic individual nursing care of patients so that they use the individual ...

  7. Factors influencing perceived sustainability of Dutch community health programs

    NARCIS (Netherlands)

    Vermeer, A. J. M.; van Assema, P.; Hesdahl, B.; Harting, J.; de Vries, N. K.

    2015-01-01

    We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health

  8. Chapter 4. Radioactivity of waters and factors influencing its value

    International Nuclear Information System (INIS)

    Toelgyessy, J.; Harangozo, M.

    2000-01-01

    This is a chapter of textbook of radioecology for university students. In this chapter authors deal with radioactivity of waters and factors influencing its value. Chapter consists of next parts: (1) Natural radioactivity of hydrosphere; (2) Radioactive contamination of hydrosphere

  9. Factors influencing the teaching of physical education and sport in ...

    African Journals Online (AJOL)

    Factors influencing the teaching of physical education and sport in Cluster H Shools ... and nine heads of schools selected using the random sampling technique. ... the participation of children with disabilities in Physical Education and Sports.

  10. Factors influencing the density of aerobic granular sludge.

    NARCIS (Netherlands)

    Winkler, M.K.; Kleerebezem, R.; Strous, M.; Chandran, K.; Loosdrecht, M.C. van

    2013-01-01

    In the present study, the factors influencing density of granular sludge particles were evaluated. Granules consist of microbes, precipitates and of extracellular polymeric substance. The volume fractions of the bacterial layers were experimentally estimated by fluorescent in situ hybridisation

  11. Factors influencing Nigerian men's decision to undergo prostate ...

    African Journals Online (AJOL)

    Objective: This study explores the factors that influence a group of Nigerian men's decision to go for Prostate Specific ..... older they were in the habit of regularly visiting the hospi- .... friends with prostate cancer was an important stimulus.

  12. Factors influencing condom use among Nigerian undergraduates: A ...

    African Journals Online (AJOL)

    Factors influencing condom use among Nigerian undergraduates: A mixed method study. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... group discussions) and quantitative (cross-sectional survey) methods were utilised for this study.

  13. Methodology for studying of influence of fire factor on geosystems

    Directory of Open Access Journals (Sweden)

    Yuriy Vasilovyth Buts

    2013-07-01

    Full Text Available Materials about the impact of emergency situations of the technogenic and natural character, caused by fires, on geosystems are presented. Methodological features of researches on fire factor influence on geosystem components are shown.

  14. E-commerce factors influencing consumers‘ online shopping decision

    OpenAIRE

    Baubonienė, Živilė; Gulevičiūtė, Gintarė

    2015-01-01

    Purpose – The purpose of this paper is to look at the factors driving online shopping and to develop an understanding of the factors influencing the online shopping by the consumers. This is done by exploring the factors that encourage consumers to shop online through analysis of such advantages as security, fast delivery, comparable price, convenience, cheaper prices and a wider choice. At the same time, the research project reveals the factors that are discouraging for consumers and the ben...

  15. Factors that influence the outcome of information technology projects in South Africa: An empirical investigation

    Directory of Open Access Journals (Sweden)

    Carl Marnewick

    2009-12-01

    factors that influence project outcome. Organisations can use this information to improve their current practices. Conclusion: The value of the research results presented in this paper lies in the realisation that project success is not just determined by adherence to best practices or formal processes, but requires an environment and context conducive to business success.

  16. Factors influencing the intention to watch online video advertising.

    Science.gov (United States)

    Lee, Joonghwa; Lee, Mira

    2011-10-01

    This study examines the factors influencing consumer intention to watch online video ads, by applying the theory of reasoned action. The attitude toward watching online video ads, the subjective norm, and prior frequency of watching online video ads positively influence the intention to watch online video ads. Further, beliefs held about entertainment and information outcomes from watching online video ads and subjective norm influence attitude toward watching these ads.

  17. Factors That Influence Technology Integration in the Classroom

    Science.gov (United States)

    Montgomery, Maureen C.

    2017-01-01

    Education is one area where the use of technology has had great impact on student learning. The integration of technology in teaching and learning can significantly influence the outcome of education in the classroom. However, there are a myriad of factors that influence technology integration in the classroom. The purpose of this study was to…

  18. Factors Influencing Choice of Inguinal Hernia Repair Technique

    African Journals Online (AJOL)

    This study sought to highlight factors that may influence ... Experienced peers play a major role in training on the various repair ... Reasons influencing choice of repair technique include training ... (after appendectomy) accounting for 10 to 15% of all surgical ..... in medical school [as undergraduate students or as residents].

  19. Influence of breed and environmental factors on litter parameters of ...

    African Journals Online (AJOL)

    Influence of breed and environmental factors on litter parameters of rabbits ... There was a non-significant effect of season on litter site at birth, kits alive at birth and ... to rabbit reproduction as it influenced negatively more litter parameters than ...

  20. Factors influencing the, selection of state office furniture

    Science.gov (United States)

    R. Bruce Anderson; R. Bruce Anderson

    1973-01-01

    Evaluation of the factors influencing the selection of office furniture by nine state governments shows that quality and purchase price have the most important influence on the purchase decision. The intended use of the furniture and the purchasing regulations of the states were key f8CbrS in the use of wood furniture.

  1. Environmental factors influencing fluctuation of share prices on ...

    African Journals Online (AJOL)

    Environmental factors influencing fluctuation of share prices on Nigeria stock exchange market. ... What are these environmental variables that affect the fluctuation of share prices in Nigeria? ... The results show inflation, money supply, total deficits index of industrial production, interest rate and GDP influence stock prices.

  2. Factors that Influence Quality Service of Teachers

    Directory of Open Access Journals (Sweden)

    M. Nur Mustafa

    2013-07-01

    Full Text Available Education as a profession requires a thorough commitment and sincerity among educators in guiding and shaping the patterns of learning toward forming identities and lead change in the students. As an adult with a lot of knowledge and experience, classroom becomes an important medium for the delivery and access to knowledge to the students in an instructional condition that effectively and efficiently. Therefore, all educators need to prepare themselves to face challenges to deal with children as a leader in charge in constructing a conducive and persuasive educational relationship. Important characteristics in this context is how to create a memorable delivery systems that meet the standard qualities and aligned with the education laws enforced. As a teacher who has received training from experts and civil servants thus all actions taken should be sincere, open, meet the service specification that gives attention to the self-esteem of the students with a good service, quality, and meet their needs. Therefore, this study will discuss the main factors that affect the quality of service to the students among the teachers namely motivation and professional competence. Selected samples in this study were 327 teachers from Secondary School in Pekanbaru. This study has shown a clear interest in improving the quality of motivation and the quality of service of teachers to the students. The aspects of the professional competence of teachers are still experiencing problems in applying the knowledge and skills to lead and manage the classroom inrealizing   a conducive environment.

  3. Factors influencing the level of self-stigmatisation in people with mental illness.

    Science.gov (United States)

    Kalisova, Lucie; Michalec, Jiri; Hadjipapanicolaou, Demetra; Raboch, Jiri

    2018-06-01

    The aim of this study was to assess sociodemographic factors and factors connected with treatment of mental illness and to decide whether they can influence the level of self-stigma. Sociodemographic characteristics (age, gender, family status, level of employment, level of education) and characteristics related to illness and treatment (diagnosis, length of treatment, adherence to treatment) were gathered in a group of patients in stable mental condition, without acute symptoms of mental illness. Self-stigma was measured using the Self-stigma of Mental Illness Scale - short form (SSMIS-SF). The sample included 197 patients: 99 patients in group 1 (G1) with psychosis and 98 in group 2 (G2) with anxious and affective disorders. The average age was 44.15 ± 12.91 years, the length of illness was 11.67 ± 9.21 years and 48% of patients were men. The total average SSMIS-SF score was 61.54 ± 23.34. We found no statistically significant difference in the total level of self-stigmatisation between these groups ( t(197) = 0.77; p = .441). The level of self-stigmatisation (total score of SSMIS-SF) in patients in G1 (psychosis) increased with the length of illness r(99) = .253; p = .011. Employment status seems to correlate with the level of self-stigmatisation ( F(3, 184) = 5.27; p = .002). Patients unemployed and on disability pension had higher levels of self-stigmatisation than patients working full-time. Patients who took medication regularly (full medical adherence) had lower scores of SSMIS-SF total scores in comparison with patients with lower compliance ( t(195) = 3.476; p = .001; Cohen's d = .25). According to our results, with regard to the factors that were followed, self-stigmatisation correlates with the presence of employment (social inclusion), duration of illness in patients with psychosis and treatment adherence. We did not find a statistically significant influence of age, gender, marital status or clinical diagnosis on the level of self-stigma.

  4. Impact of organizational factors on adherence to laboratory testing protocols in adult HIV care in Lusaka, Zambia

    Directory of Open Access Journals (Sweden)

    Deo Sarang

    2012-05-01

    Full Text Available Abstract Background Previous operational research studies have demonstrated the feasibility of large-scale public sector ART programs in resource-limited settings. However, organizational and structural determinants of quality of care have not been studied. Methods We estimate multivariate regression models using data from 13 urban HIV treatment facilities in Zambia to assess the impact of structural determinants on health workers’ adherence to national guidelines for conducting laboratory tests such as CD4, hemoglobin and liver function and WHO staging during initial and follow-up visits as part of Zambian HIV care and treatment program. Results CD4 tests were more routinely ordered during initial history and physical (IHP than follow-up (FUP visits (93.0 % vs. 85.5 %; p  Conclusion Physical space plays an important role in ensuring high quality care in resource-limited setting. In the context of protocolized care, new staff members are likely to be more diligent in following the protocol verbatim rather than relying on memory and experience thereby improving adherence. Future studies should use prospective data to confirm the findings reported here.

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

    Directory of Open Access Journals (Sweden)

    Ian Hodgson

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

  6. Adherence to physical activity in adults with chronic diseases: ELSA-Brasil.

    Science.gov (United States)

    Forechi, Ludimila; Mill, José Geraldo; Griep, Rosane Härter; Santos, Itamar; Pitanga, Francisco; Molina, Maria Del Carmen Bisi

    2018-04-09

    The objective of this study is to investigate the adherence and the factors that influence adherence to physical activity in adults with dyslipidemia, hypertension, or diabetes. The analyses were based on data collected at the baseline of the 14,521 participants from the study ELSA-Brasil aged between 35 and 74 years. The level of leisure time physical activity was determined using the International Physical Activity Questionnaire. Logistic regression analyses were performed to examine the influence of the demographic data, socioeconomic conditions, perceived health status, and access to exercise facilities in the neighborhood on adherence to physical activity. Men with hypertension and dyslipidemia were more active than women. The results show that 17.8%, 15.1%, and 13.9% of the subjects who reported dyslipidemia, hypertension, and diabetes, respectively, adhere to the physical activity recommendations. The factors positively associated with adherence were higher education and income. Older individuals who reported poor perceived health, were overweight and obese, regularly smoked, and had fewer opportunities to exercise in the neighborhood presented lower adherence. The number of adults with dyslipidemia, hypertension, and diabetes who adhere to the physical activity recommendations is very low. Higher education and income are positively associated with adherence, while age, excess body weight, negative perceived health, regular smoking, and lack of opportunity to exercise in the neighborhood were considered barriers to physical activity.

  7. Adherence to physical activity in adults with chronic diseases: ELSA-Brasil

    Directory of Open Access Journals (Sweden)

    Ludimila Forechi

    2018-04-01

    Full Text Available ABSTRACT OBJECTIVE The objective of this study is to investigate the adherence and the factors that influence adherence to physical activity in adults with dyslipidemia, hypertension, or diabetes. METHODS The analyses were based on data collected at the baseline of the 14,521 participants from the study ELSA-Brasil aged between 35 and 74 years. The level of leisure time physical activity was determined using the International Physical Activity Questionnaire. Logistic regression analyses were performed to examine the influence of the demographic data, socioeconomic conditions, perceived health status, and access to exercise facilities in the neighborhood on adherence to physical activity. RESULTS Men with hypertension and dyslipidemia were more active than women. The results show that 17.8%, 15.1%, and 13.9% of the subjects who reported dyslipidemia, hypertension, and diabetes, respectively, adhere to the physical activity recommendations. The factors positively associated with adherence were higher education and income. Older individuals who reported poor perceived health, were overweight and obese, regularly smoked, and had fewer opportunities to exercise in the neighborhood presented lower adherence. CONCLUSIONS The number of adults with dyslipidemia, hypertension, and diabetes who adhere to the physical activity recommendations is very low. Higher education and income are positively associated with adherence, while age, excess body weight, negative perceived health, regular smoking, and lack of opportunity to exercise in the neighborhood were considered barriers to physical activity.

  8. The role of electronic assessment of adherence in the education and counseling of children taking growth hormone: progress and challenges.

    Science.gov (United States)

    Haverkamp, Fritz; Norgren, Svante; Horne, Rob; Gasteyger, Christoph

    There are numerous issues surrounding adherence in children taking recombinant human growth hormone (rh-GH). New technologies capable of accurately recording/monitoring may highlight some of these issues, and have value in optimizing adherence levels through education and counseling. The intention of this review is to guide healthcare professionals (HCPs). PubMed, Google Scholar and citations in published papers were used to substantiate the views expressed by the authors. Both perceptional and practical factors influence the adherence levels of children taking rh-GH. Understanding such factors may help to identify the characteristics of ideal rh-GH devices and their potential impact on adherence. New technologies, such as electronic monitors, may facilitate patient-provider discussions on adherence, and help identify barriers that are amenable to change. Monitoring adherence may also help differentiate nonadherence from biological low response to rh-GH therapy. However, the medical, psychological, social and ethical aspects of electronic assessment require further investigation.

  9. FACTORS INFLUENCING YIELD SPREADS OF THE MALAYSIAN BONDS

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    Norliza Ahmad

    2009-01-01

    Full Text Available Malaysian bond market is developing rapidly but not much is understood in terms of macroeconomic factors that could influence the yield spread of the Ringgit Malaysian denominated bonds. Based on a multifactor model, this paper examines the impact of four macroeconomic factors namely: Kuala Lumpur Composite Index (KLCI, Industry Production Index (IPI, Consumer Price Index (CPI and interest rates (IR on bond yield spread of the Malaysian Government Securities (MGS and Corporate Bonds (CBs for a period from January 2001 to December 2008. The findings support the expected hypotheses that CPI and IR are the major drivers that influence the changes in MGS yield spreads. However IPI and KLCI have weak and no influence on MGS yield spreads respectively Whilst IR, CPI and IPI have significant influence on the yield spreads of CB1, CB2 and CB3, KLCI has significant influence only on the CB1 yield spread but not on CB2 and CB3 yield spreads.

  10. Factors Influencing the Adoption of Minimally Invasive Surgery ...

    African Journals Online (AJOL)

    Background: Cost is a major concern for delivery of minimally invasive surgical technologies due to the nature of resources required. It is unclear whether factors extrinsic to technology availability impact on this uptake. Objectives: To establish the influence of institutional, patient and surgeon-related factors in the adoption of ...

  11. Factors influencing medical students in pursuing a career in surgery ...

    African Journals Online (AJOL)

    Background: Many factors play a role in the decision of a medical student to pursue a career in surgery. With a decline in numbers of applications into surgical programmes seen globally, the aim of this study was to determine the factors that influence medical students in pursuing a career in surgery. Methods: A descriptive ...

  12. Factors that Influence Students' Decision to Dropout of Online Courses

    Science.gov (United States)

    Willging, Pedro A.; Johnson, Scott D.

    2009-01-01

    Although there are many reasons why students dropout of college courses, those reasons may be unique for students who are enrolled in an online program. Issues of isolation, disconnectedness, and technological problems may be factors that influence a student to leave a course. To understand these factors, an online survey was developed to collect…

  13. Factors that influence household and individual clothing expenditure ...

    African Journals Online (AJOL)

    S Blignaut

    Contributing factors are the growth of low-priced apparel ... determine which factors influence household and individual ... explicitly deals with this concept. .... The income elasticity for clothing for the two-parent ..... Nelson (1989) found that mothers with less than a .... fashion consciousness and style preferences should.

  14. Alternative Administrative Certification: Socializing Factors Influencing Program Choice

    Science.gov (United States)

    Bickmore, Dana L.; Bickmore, Steven T.; Raines, Sarah

    2013-01-01

    This study used an organizational socialization lens to examine factors influencing participants' decision to pursue the principalship and choice to engage in an alternate administration certification program. Through an analysis of participant focus groups and interviews, factors emerged from the codes that were compared with dimensions of…

  15. Interrelated factors influence of current stock market on pricing

    Directory of Open Access Journals (Sweden)

    Наталія Петрівна Мацелюх

    2015-03-01

    Full Text Available Impacts on market prices of securities are generalized. It is found that in the process of price determination and its implementation exist a system of interrelated factors of influence, which are divided into objective and subjective; internal and external; traditional and specific. It is proved that the impact of factors associated with risk pricing in financial assets

  16. Hierarchical and coupling model of factors influencing vessel traffic flow.

    Directory of Open Access Journals (Sweden)

    Zhao Liu

    Full Text Available Understanding the characteristics of vessel traffic flow is crucial in maintaining navigation safety, efficiency, and overall waterway transportation management. Factors influencing vessel traffic flow possess diverse features such as hierarchy, uncertainty, nonlinearity, complexity, and interdependency. To reveal the impact mechanism of the factors influencing vessel traffic flow, a hierarchical model and a coupling model are proposed in this study based on the interpretative structural modeling method. The hierarchical model explains the hierarchies and relationships of the factors using a graph. The coupling model provides a quantitative method that explores interaction effects of factors using a coupling coefficient. The coupling coefficient is obtained by determining the quantitative indicators of the factors and their weights. Thereafter, the data obtained from Port of Tianjin is used to verify the proposed coupling model. The results show that the hierarchical model of the factors influencing vessel traffic flow can explain the level, structure, and interaction effect of the factors; the coupling model is efficient in analyzing factors influencing traffic volumes. The proposed method can be used for analyzing increases in vessel traffic flow in waterway transportation system.

  17. The influence of family factors on delinquent adolescents in ...

    African Journals Online (AJOL)

    This study was carried out with the aim of finding out the influence of family factors on delinquent adolescents in secondary schools in Edo South Senatorial District of Edo State. This study ascertained the extents to which family factors such as parent child rearing style, family type and parent socio economic background ...

  18. Factors influencing societal response of nanotechnology : an expert stakeholder analysis

    NARCIS (Netherlands)

    Gupta, N.; Fischer, A.R.H.; Lans, van der I.A.; Frewer, L.J.

    2012-01-01

    Nanotechnology can be described as an emerging technology and, as has been the case with other emerging technologies such as genetic modification, different socio-psychological factors will potentially influence societal responses to its development and application. These factors will play an

  19. Socio-economic factors influencing cassava production in Kuje and ...

    African Journals Online (AJOL)

    This study examined socio-economic factors influencing output level of cassava production in Kuje and Abaji Area Councils of Federal Capital Territory, Abuja. The specific objectives were to:identify the socio-economic characteristics of sampled cassava farmers in the study area; determine the socio-economic factors ...

  20. Hierarchical and coupling model of factors influencing vessel traffic flow.

    Science.gov (United States)

    Liu, Zhao; Liu, Jingxian; Li, Huanhuan; Li, Zongzhi; Tan, Zhirong; Liu, Ryan Wen; Liu, Yi

    2017-01-01

    Understanding the characteristics of vessel traffic flow is crucial in maintaining navigation safety, efficiency, and overall waterway transportation management. Factors influencing vessel traffic flow possess diverse features such as hierarchy, uncertainty, nonlinearity, complexity, and interdependency. To reveal the impact mechanism of the factors influencing vessel traffic flow, a hierarchical model and a coupling model are proposed in this study based on the interpretative structural modeling method. The hierarchical model explains the hierarchies and relationships of the factors using a graph. The coupling model provides a quantitative method that explores interaction effects of factors using a coupling coefficient. The coupling coefficient is obtained by determining the quantitative indicators of the factors and their weights. Thereafter, the data obtained from Port of Tianjin is used to verify the proposed coupling model. The results show that the hierarchical model of the factors influencing vessel traffic flow can explain the level, structure, and interaction effect of the factors; the coupling model is efficient in analyzing factors influencing traffic volumes. The proposed method can be used for analyzing increases in vessel traffic flow in waterway transportation system.