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Sample records for factors influencing patient

  1. Patient factors that influence warfarin dose response.

    Science.gov (United States)

    White, Pamela J

    2010-06-01

    Warfarin has long been the mainstay of oral anticoagulation therapy for the treatment and prevention of venous and arterial thrombosis. The narrow therapeutic index of warfarin, and the complex number of factors that influence international normalized ratio (INR) response, makes optimization of warfarin therapy challenging. Determination of the appropriate warfarin dose during initiation and maintenance therapy requires an understanding of patient factors that influence dose response: age, body weight, nutritional status, acute and chronic disease states, and changes in concomitant drug therapy and diet. This review will examine specific clinical factors that can affect the pharmacokinetics and pharmacodynamics of warfarin, as well as the role of pharmacogenetics in optimizing warfarin therapy.

  2. Using mixed methods to identify factors influencing patient flow.

    Science.gov (United States)

    Van Vaerenbergh, Cindy

    2009-11-01

    An effective method of identifying operational factors that influence patient flow can potentially lead to improvements and thus have huge benefits on the efficiency of hospital departments. This paper presents a new inductive mixed-method approach to identify operational factors that influence patient flow through an accident and emergency (A&E) department. Preliminary explorative observations were conducted, followed by semi-structured interviews with key stakeholders. A questionnaire survey of all medical, nursing, porter and clerical staff was then conducted. The observations provided factors for further exploration: skill-mix, long working hours, equipment availability, lack of orientation programmes, inefficient IT use and issues regarding communication structures. Interviewees highlighted several factors, including availability of medical supervision and senior nursing staff, nursing documentation issues, lack of morale due to overcrowding, personality differences and factors relating to the department layout. The questionnaire respondents strongly supported the importance of the previously identified factors. This paper demonstrates an effective mixed-method approach that can be replicated by other health-care managers to identify factors influencing patient flow. Further benefits include increased volume and quality of data, increased staff awareness for the influence of internal factors on patient flow and enhancing the evidence base for future decision making when prioritizing A&E projects.

  3. Information Booklets about Cancer: Factors Influencing Patient Satisfaction and Utilisation.

    Science.gov (United States)

    Butow, Phyllis; Brindle, Elizabeth; McConnell, David; Boakes, Robert; Tattersall, Martin

    1998-01-01

    Explored factors influencing patient satisfaction with and utilization of information booklets. Patients (N=36) rated five booklets, and strongly preferred one with a grade-eight reading level. The relationship of preference and recall was investigated. No difference between those who seek or avoid information was found. Additional findings are…

  4. Factors influencing prehospital delay for patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    Shujuan CHENG; Lufen GUO; Juyuan LIU; Xiaoling ZHU; Hongbing YAN

    2007-01-01

    Objective To investigate the influencing factors for prehospital delay in patients with acute myocardial infarction (AMI).Methods A total of 807 consecutive patients with AMI who presented to the emergency department of Beijing Anzhen Hospital were analyzed. The influence of several potential risk factors on the prehospital delay time (PDT) was evaluated by comparing patients admitted more than 2 hours after onset of chese pain with those admitted within 2 hours after onset. Results Among 807 patients, 402 came to the hospital within 2 hours while the others arrived at the hospital after 2 hours. The median PDT was 130 min. Among the potential variables, advanced age, history of diabetes mellitus, occurrence of symptom at night and use of emergency medical service significantly affected PDT by multivariate analysis. Conclusion Interventions aimed at reducing the prehospital delay in AMI should primarily focus on the awareness of the risk and help-seeking behavior of patients.

  5. Factors influencing the stigmatization of patients with epilepsy

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    I. A. Grigoryeva

    2015-01-01

    Full Text Available Objective: to identify the factors influencing the stigmatization in patients with epilepsy. Patients and methods. The investigation enrolled 71 epileptic patients aged 14 to 50 years. They were divided into two age groups: 30 adolescents aged 14–17 years and 41 adults aged 18–50 years. Results and discussion. Examinations of 71 patients with epilepsy could identify 4 factors influencing their stigmatization: individual traits; activity and relations in the group; the effect of a drug and its adherence in patients; relationships in the family and its response to the disease. The authors’ new screening procedure was employed to determine the leading causes of stigmatization for each age group and to show differences in the specific features of stigmatization (the leading factor of stigmatization in patients of different age. The major factor of stigmatization in the epileptic adolescents was found to be relationships in the family and its response to the disease. Its chief cause in the adults was their principal activity (studies at a higher education establishment or work and group relations. The epileptic patients were shown to need psychological care. The developed screening procedure will be useful in planning psycho-correction measures and rehabilitation programs. 

  6. Spine Surgeon Selection Criteria: Factors Influencing Patient Choice.

    Science.gov (United States)

    Manning, Blaine T; Ahn, Junyoung; Bohl, Daniel D; Mayo, Benjamin C; Louie, Philip K; Singh, Kern

    2016-07-01

    A prospective questionnaire. The aim of this study was to evaluate factors that patients consider when selecting a spine surgeon. The rise in consumer-driven health insurance plans has increased the role of patients in provider selection. The purpose of this study is to identify factors that may influence a patient's criteria for selecting a spine surgeon. Two hundred thirty-one patients who sought treatment by one spine surgeon completed an anonymous questionnaire consisting of 26 questions. Four questions regarded demographic information; 16 questions asked respondents to rate the importance of specific criteria regarding spine surgeon selection (scale 1-10, with 10 being the most important); and six questions were multiple-choice regarding patient preferences toward aspects of their surgeon (age, training background, etc.). Patients rated board certification (9.26 ± 1.67), in-network provider status (8.10 ± 3.04), and friendliness/bedside manner (8.01 ± 2.35) highest among factors considered when selecting a spine surgeon. Most patients (92%) reported that 30 minutes or less should pass between check-in and seeing their surgeon during a clinic appointment. Regarding whether their spine surgeon underwent training as a neurosurgeon versus an orthopedic surgeon, 25% reported no preference, 52% preferred neurosurgical training, and 23% preferred orthopedic training. Our findings suggest that board certification and in-network health insurance plans may be most important in patients' criteria for choosing a spine surgeon. Advertisements were rated least important by patients. Patients expressed varying preferences regarding ideal surgeon age, training background, proximity, medical student/resident involvement, and clinic appointment availability. The surgeon from whom patients sought treatment completed an orthopedic surgery residency; hence, it is notable that 52% of patients preferred a spine surgeon with a neurosurgical background. In the context

  7. Factors Influencing the Surgical Success in Patients with Infantile Esotropia

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    Fatma Gül Yılmaz Çınar

    2013-12-01

    Full Text Available Purpose: To determine the factors that influence the surgical success in patients with infantile esotropia and to evaluate the relationship between amount of bilateral medial rectus recession and convergence. Material and Method: We retrospectively investigated the records of 188 patients with infantile esotropia who were operated on. The surgical success rate, the factors that influence the surgical success, and the relationship between amount of bilateral medial rectus recession and convergence deficiency were evaluated. Successful outcome was defined as deviation amount lower than 10 prism diopters postoperatively. Results: The mean age of the 188 patients included in the study at presentation was 54.9±56.8 (5-276 months, and the mean surgical age was 60.7±54.8 (7-276 months. Success was provided in 70.7% of patients after the first surgery and in 86.7% of patients after repeated surgeries. It was seen that gender, surgical age, refractive error, surgical procedure and the presence of fusion before surgery did not affect surgical success. Residual esotropia was found more frequently in patients with large-angle preoperative deviation, whilst both residual esotropia and consecutive exotropia were found more frequently in patients with amblyopia. It was observed that augmented bilateral medial rectus recession did not cause an increase in postoperative convergence deficiency. Discussion: Since the presence of amblyopia affects the surgical success negatively, it must be identified and treated preoperative. Residual esotropia is more frequently seen in patients with large-angle deviation preoperative, and more than one surgery may be required to provide orthophoria. In these cases, augmented bilateral medial rectus recession is a safe and effective method that rescues the patient from repeated surgeries and may be preferred to three-or four-muscle surgeries. (Turk J Ophthalmol 2013; 43: 413-8

  8. Factors Influencing the Surgical Success in Patients with Intermittent Exotropia

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    Uğur Acar

    2013-04-01

    Full Text Available Pur po se: To determine the factors that influence surgical success in patients with intermittent exotropia. Ma te ri al and Met hod: We retrospectively evaluated the records of patients with intermittent exotropia who were diagnosed, operated, and followed up. Successful outcome was defined as alignment ≤10 prism diopters (PD esophoria or exophoria at the last follow-up visit. The clinical findings, exodeviation types, surgical ages, operation types, preoperative and postoperative deviation amounts, presence of anisometropia and amblyopia, presence of A- or V-pattern, and presence of binocular vision and stereoacuity of patients were evaluated. We investigated the independent variables that affected the surgical success in intermittent exotropia patients. Re sults: Among the 379 patients included in the study, 266 (70.18% underwent surgery, and the success rate was 68.05% (181 patients. In this successful surgery group, mean deviation was 25.82±11.27 PD at near and 30.80±10.59 PD at distance versus 30.93±12.47 PD and 34.92±11.02 PD, respectively, in the unsuccessful surgery group. There was a statistically significant difference between the two groups. Preoperative factors, such as presence of binocular vision preoperatively, and postoperative factors, such as followup period and the patients' deviation amount in the 1st week and 6th month, were found to affect the surgical outcome. Dis cus si on: The success rate of surgical treatment of intermittent exotropia increases in the patients with presence of fusion and low preoperative deviation amounts. Also, in the early postoperative period, orthophoric or ≤10 PD esophoric patients have a higher final surgical success rate. (Turk J Ophthalmol 2013; 43: 107-12

  9. Factors influencing intercultural doctor-patient communication: a realist review.

    Science.gov (United States)

    Paternotte, Emma; van Dulmen, Sandra; van der Lee, Nadine; Scherpbier, Albert J J A; Scheele, Fedde

    2015-04-01

    Due to migration, doctors see patients from different ethnic backgrounds. This causes challenges for the communication. To develop training programs for doctors in intercultural communication (ICC), it is important to know which barriers and facilitators determine the quality of ICC. This study aimed to provide an overview of the literature and to explore how ICC works. A systematic search was performed to find literature published before October 2012. The search terms used were cultural, communication, healthcare worker. A realist synthesis allowed us to use an explanatory focus to understand the interplay of communication. In total, 145 articles met the inclusion criteria. We found ICC challenges due to language, cultural and social differences, and doctors' assumptions. The mechanisms were described as factors influencing the process of ICC and divided into objectives, core skills and specific skills. The results were synthesized in a framework for the development of training. The quality of ICC is influenced by the context and by the mechanisms. These mechanisms translate into practical points for training, which seem to have similarities with patient-centered communication. Training for improving ICC can be developed as an extension of the existing training for patient-centered communication. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Factors influencing obstacle crossing performance in patients with Parkinson's disease.

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    Ying-Yi Liao

    Full Text Available BACKGROUND: Tripping over obstacles is the major cause of falls in community-dwelling patients with Parkinson's disease (PD. Understanding the factors associated with the obstacle crossing behavior may help to develop possible training programs for crossing performance. This study aimed to identify the relationships and important factors determining obstacle crossing performance in patients with PD. METHODS: Forty-two idiopathic patients with PD (Hoehn and Yahr stages I to III participated in this study. Obstacle crossing performance was recorded by the Liberty system, a three-dimensional motion capture device. Maximal isometric strength of the lower extremity was measured by a handheld dynamometer. Dynamic balance and sensory integration ability were assessed using the Balance Master system. Movement velocity (MV, maximal excursion (ME, and directional control (DC were obtained during the limits of stability test to quantify dynamic balance. The sum of sensory organization test (SOT scores was used to quantify sensory organization ability. RESULTS: Both crossing stride length and stride velocity correlated significantly with lower extremity muscle strength, dynamic balance control (forward and sideward, and sum of SOT scores. From the regression model, forward DC and ankle dorsiflexor strength were identified as two major determinants for crossing performance (R(2 = .37 to.41 for the crossing stride length, R(2 = .43 to.44 for the crossing stride velocity. CONCLUSIONS: Lower extremity muscle strength, dynamic balance control and sensory integration ability significantly influence obstacle crossing performance. We suggest an emphasis on muscle strengthening exercises (especially ankle dorsiflexors, balance training (especially forward DC, and sensory integration training to improve obstacle crossing performance in patients with PD.

  11. Understanding the factors that influence patient satisfaction with ambulance services.

    Science.gov (United States)

    Bogomolova, Svetlana; Tan, P J; Dunn, S P; Bizjak-Mikic, M

    2016-01-01

    The quality of ambulance services has an immense impact on patients' future well-being and quality of life. Patient satisfaction is one of the key metrics for evaluating the quality of this service. Yet, the patient satisfaction measurement may be limited in its ability to accurately reflect this service quality, and even reflect factors beyond the patient experiences. We analyze 10 years of survey data to reveal a number of factors that systematically bias ambulance satisfaction ratings. Taking into account these biases provides more robust comparison of ambulance performance over time or across different jurisdictions.

  12. Factors Influencing the Outcomes in Extradural Haematoma Patients ...

    African Journals Online (AJOL)

    This study aimed at evaluating the current management and factors that ... patients who were admitted to the neurosurgical unit at the Kenyatta National Hospital and ... abnormalities and those older than age 61 are poor prognostic indicators.

  13. factors influencing choice of oral hygiene products by dental patients ...

    African Journals Online (AJOL)

    Materials and methods: Two-hundred and two patients were interviewed on factors that ... choice of both the toothbrush and toothpaste in this study, which suggest that for as ..... streptococcus mutans count in urban preschool children - An in ...

  14. Evaluation of Factors Influencing Sensory Disability in Cerebral Stroke Patients

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    K Ghandehari

    2010-06-01

    Full Text Available Introduction: Clinical findings affecting disability in stroke patients are important as presence of these factors determines the prognosis and future course of these patients. Methods: Consecutive stroke patients admitted at Ghaem hospital, Mashhad were enrolled in this prospective study in 2008. Hemihyposthesia, hemianesthesia, hemineglect and homonymous hemianopsia was evaluated in these patients. Disability score was based on the Modified Ranking Disability Score (MRDS, 72 hours post stroke. Mean of MRDS was analyzed by T test and Fisher tests and p<0.05 was considered as significant. Results: A total of 329 stroke patients were investigated. Hemihyposthesia, hemianesthesia, hemineglect and homonymous hemianopsia was found in 37.4%, 13.8%, 7.9% and 7.3% of the patients, respectively. MRDS was significantly higher in patients with hemianesthesia as compared to other stroke patients, (p<0.001. MRDS of patients with hemihypoestheisa, hemineglect and homonyous hemianopsia was not significantly different than patients without these abnormalities (p=0.44, p=023 and p=0.83. Patients with triad of hemianesthesia, hemineglect and homonymous hemianopsia had significantly higher MRDS than others (p<0.001. Conclusion: Hemianesthesia is a clinical factor affecting sensory disability in cerebral stroke patients. Presence of the above triad could increase MRDS in these patients.

  15. Factors influencing skin autofluorescence of patients with peritoneal dialysis.

    Science.gov (United States)

    Mácsai, Emília; Benke, A; Cseh, A; Vásárhelyi, B

    2012-06-01

    Skin autofluorescence (SAF) measurement is a simple, noninvasive method to assess tissue advanced glycation end products (AGE). In patients with end-stage renal disease and in those on hemodialysis AGE production is increased. Less is known about those treated with peritoneal dialysis (PD). In this study we tested if SAF is influenced by clinical and treatment characteristics in PD patients.This cross-sectional study included 198 PD patients (of those, 128 were on traditional glucose-based solutions and 70 patients were partially switched to icodextrin-based PD). SAF measurements were done with a specific AGE Reader device. The impact of patients' age, gender, current diabetes, duration of PD, cumulative glucose exposure, body mass index, smoking habits and use of icodextrin on SAF values were tested with multiple regression analysis.Our analysis revealed that patients' age, current diabetes and icodextrin use significantly increase patients' SAF values (p = 0.015, 0.012, 0.005, respectively). AGE exposure of PD patients with diabetes and on icodextrin solution is increased. Further investigation is required whether this finding is due to the icodextrin itself or for a still unspecified clinical characteristic of PD population treated with icodextrin.

  16. Selecting a provider: what factors influence patients' decision making?

    Science.gov (United States)

    Abraham, Jean; Sick, Brian; Anderson, Joseph; Berg, Andrea; Dehmer, Chad; Tufano, Amanda

    2011-01-01

    Each year consumers make a variety of decisions relating to their healthcare. Some experts argue that stronger consumer engagement in decisions about where to obtain medical care is an important mechanism for improving efficiency in healthcare delivery and financing. Consumers' ability and motivation to become more active decision makers are affected by several factors, including financial incentives and access to information. This study investigates the set of factors that consumers consider when selecting a provider, including attributes of the provider and the care experience and the reputation of the provider. Additionally, the study evaluates consumers awareness and use of formal sources of provider selection information. Our results from analyzing data from a survey of 467 patients at four clinics in Minnesota suggest that the factors considered of greatest importance include reputation of the physician and reputation of the healthcare organization. Contractual and logistical factors also play a role, with respondents highlighting the importance of seeing a provider affiliated with their health plan and appointment availability. Few respondents indicated that advertisements or formal sources of quality information affected their decision making. The key implication for provider organizations is to carefully manage referral sources to ensure that they consistently meet the needs of referrers. Excellent service to existing patients and to the network of referring physicians yields patient and referrer satisfaction that is critical to attracting new patients. Finally, organizations more generally may want to explore the capabilities of new media and social networking sites for building reputation.

  17. Factors influencing shunt malfunction in patients with tuberculous meningitis

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    Sudheer Ambekar

    2013-01-01

    Full Text Available Background: Hydrocephalus secondary to tuberculous meningitis (TBM is a challenging condition to treat. Though ventriculo-peritoneal (VP shunt is an accepted modality of treatment for hydrocephalus in TBM, there is a high rate of complications associated with the same. Objective: The study was planned to evaluate various factors associated with shunt malfunction in patients undergoing VP shunt surgery for hydrocephalus due to TBM. Materials and Methods: A retrospective review of all the patients undergoing VP shunt and shunt revision for TBM between 2004 and 2008 was performed. 449 VP shunt surgeries were performed in 432 patients for hydrocephalus due to TBM. Among these 70 shunt revisions were performed in 53 patients. Results: Shunt malfunction rate in our series was 16.2%. High cerebrospinal fluid (CSF protein concentration (>200 mg/dL was associated with 5 times increased incidence of shunt malfunction. Patients with hyponatremia (Na + <130 mEq/dL prior to surgery had a 3 times increased incidence of shunt malfunction (P < 0.05. Other factors such as duration of symptoms, presence of neurological deficits, Evan′s index, third ventricular diameter, thickness of exudates, presence of infarcts, anemia, CSF cellularity and CSF glucose concentration were not associated with increased incidence of shunt malfunction. Analysis showed that shunt viability was longest in patients with normal serum sodium levels and CSF protein concentration less than 200 mg/dL and shortest in patients with low serum sodium and CSF protein concentration more than 200 mg/dL. Conclusions: Patients with pre-operative hyponatremia and high CSF protein concentration have a higher incidence of shunt malfunction and need to be followed-up closely.

  18. Assessment of patients' awareness and factors influencing patients' demands for sedation in endodontics.

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    Huh, Yoo Kyeom; Montagnese, Thomas A; Harding, Jarrod; Aminoshariae, Anita; Mickel, Andre

    2015-02-01

    Endodontic therapy is perceived by many as a procedure to be feared. Many studies have reported that fear and anxiety are major deterrents to seeking dental care in general, but only a few deal with the use of sedation in endodontic therapies. The purpose of this study was to assess patients' awareness of and factors influencing the potential demand for sedation in endodontics. We hypothesized that there is an association between demographic factors and the demand for sedation in endodontics. A survey consisting of 24 questions was given to patients 18 years and older who presented to the graduate endodontic clinic. Results were collected and statistically analyzed. Thirty-six percent of patients reported that their perception of sedation was being put to sleep, and 27% perceived it as related to or reducing pain. Concerns associated with endodontic therapy were the fear of pain (35%), fear of needles (16%), difficulty getting numb (10%), and anxiety (7%). The 2 major demographic factors that influenced the demand for sedation were cost and the level of anxiety (P endodontic therapy if the option of sedation was available. The demand for sedation in endodontics is high. Patients' understanding of sedation varies. More patients would consider having endodontic procedures if sedation was available. The provision of sedation by endodontists could result in more patients accepting endodontic therapies. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  19. Factors Influencing Chemotherapy Goal Perception in Newly Diagnosed Cancer Patients.

    Science.gov (United States)

    Gumusay, Ozge; Cetin, Bulent; Benekli, Mustafa; Gurcan, Gamze; Ilhan, Mustafa N; Bostankolu, Basak; Ozet, Ahmet; Uner, Aytug; Coskun, Ugur; Buyukberber, Suleyman

    2016-06-01

    Cancer patients who start receiving chemotherapy have difficulty in understanding the state of their disease, the prognosis, and the purpose of treatment. We used a survey to evaluate the extent of perception of chemotherapy goal among cancer patients. Two hundred sixteen cancer patients who received chemotherapy for the first time participated in the study. The presence of depression and anxiety was assessed using the "Hospital Anxiety and Depression Scale" (HAD). The consistency between the patients' perception of the chemotherapy goal and the physician's perception was described as "right," and the inconsistency was described as "wrong." Among the patients who participated in the survey, 53.2 % (n = 115) were receiving adjuvant treatment and 46.8 % (n = 101) were receiving palliative treatment for metastatic disease. The rate of right and wrong perception of the chemotherapy goal was 51.9 % (n = 108) and 32.2 % (n = 67), respectively, and the rate of confused patients was 18.9 % (n = 41). The level of education was shown to be the only parameter involved in accurate perception of the treatment purpose (hazard ratio (HR) = 0.444, p = 0.025, 95 % confidence interval (CI) 0.219-0.903). In this study, there was a 51.9 % consistency between the physician's perception and that of the patient regarding the purpose of treatment. We demonstrated that the level of education was the unique factor in accurate perception of chemotherapy goal among cancer patients.

  20. Factors influencing quality of life in patients with active tuberculosis

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    Cox Victoria C

    2004-10-01

    Full Text Available Abstract Background With effective treatment strategies, the focus of tuberculosis (TB management has shifted from the prevention of mortality to the avoidance of morbidity. As such, there should be an increased focus on quality of life (QoL experienced by individuals being treated for TB. The objective of our study was to identify areas of QoL that are affected by active TB using focus groups and individual interviews. Methods English, Cantonese, and Punjabi-speaking subjects with active TB who were receiving treatment were eligible for recruitment into the study. Gender-based focus group sessions were conducted for the inner city participants but individual interviews were conducted for those who came to the main TB clinic or were hospitalized. Facilitators used open-ended questions and participants were asked to discuss their experiences of being diagnosed with tuberculosis, what impact it had on their lives, issues around adherence to anti-TB medications and information pertaining to their experience with side effects to these medications. All data were audio-recorded, transcribed verbatim, and analyzed using constant comparative analysis. Results 39 patients with active TB participated. The mean age was 46.2 years (SD 18.4 and 62% were male. Most were Canadian-born being either Caucasian or Aboriginal. Four themes emerged from the focus groups and interviews. The first describes issues related to the diagnosis of tuberculosis and sub-themes were identified as 'symptoms', 'health care provision', and 'emotional impact'. The second theme discusses TB medication factors and the sub-themes identified were 'adverse effects', 'ease of administration', and 'adherence'. The third theme describes social support and functioning issues for the individuals with TB. The fourth theme describes health behavior issues for the individuals with TB and the identified sub-themes were "behavior modification" and "TB knowledge." Conclusion Despite the ability to

  1. Factors influencing resilience in patients with burns during rehabilitation period

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    Zhen Yang

    2014-03-01

    Conclusion: During psychological crisis intervention, medical staff should guide burn patients according to their individual coping styles. Such guidance would achieve a better effect, improve patient resilience, and promote positive psychological adaptation.

  2. Factors influencing bladder management in male patients with spinal cord injury: a qualitative study.

    Science.gov (United States)

    Engkasan, J P; Ng, C J; Low, W Y

    2014-02-01

    Qualitative study using individual in-depth interviews. The objective of this study was to explore the factors influencing the choice of bladder management for male patients with spinal cord injury (SCI). Public hospitals in Malaysia. Semistructured (one-on-one) interviews of 17 patients with SCI; 7 were in-patients with a recent injury and 10 lived in the community. All had a neurogenic bladder and were on various methods of bladder drainage. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analyses. The choice of bladder management was influenced by treatment attributes, patients' physical and psychological attributes, health practitioners' influences and social attributes. Participants were more likely to choose a treatment option that was perceived to be convenient to execute and helped maintain continence. The influence of potential treatment complications on decision making was more variable. Health professionals' and peers' opinions on treatment options had a significant influence on participants' decision. In addition, patients' choices depended on their physical ability to carry out the task, the level of family support received and the anticipated level of social activities. Psychological factors such as embarrassment with using urine bags, confidence in self-catheterization and satisfaction with the current method also influenced the choice of bladder management method. The choice of bladder management in people with SCI is influenced by a variety of factors and must be individualized. Health professionals should consider these factors when supporting patients in making decisions about their treatment options.

  3. Factors influencing nutrition education for patients with low literacy skills.

    Science.gov (United States)

    Macario, E; Emmons, K M; Sorensen, G; Hunt, M K; Rudd, R E

    1998-05-01

    Although there has been increasing attention to cancer prevention among low-income and minority populations, only a few nutrition interventions have addressed the special needs of people with low literacy skills. To determine the best provider and the most effective format for a nutrition intervention targeting patients with low literacy skills, we conducted interviews with literacy experts and health care providers and focus groups with members of adult basic education classes. Thirty-five literacy experts and health-center-based physicians, nurses, and nutritionists in Boston, Mass, were interviewed. In addition, 50 volunteer clients from 4 Boston-based adult basic education programs participated in 6 focus groups. Results suggested that health care providers consider nutrition to be a fundamental health education topic, but that its successful inculcation in patients with limited literacy skills is hindered mostly by insufficient provider time. Almost all providers agreed that patients need to be referred to nutritionists for nutrition education. Although most providers and patients acknowledged that patients perceive physicians to be the authorities on health, patients with low literacy skills turned first to family members and friends for health information. These results suggest that effective nutrition interventions must build on patients' social networks; appear in a visually based, interactive format; and be culturally appropriate.

  4. Examination of patient factors and contrast medium factors that exert influence on contrast enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Yamaguchi, Isao; Morimoto, Akira; Shouga, Kazuhiko; Suzuki, Noriyuki [Kure Kyosai Hospital, Hiroshima (Japan)

    2002-04-01

    The purpose of this study was to determine the relationship between patient factors and contrast medium factors, both of which influence contrast enhancement. Our goal was to achieve improved standardization and reproducibility of enhancement based on the findings of this study. Enhancement units (EU) and the contrast enhancement index (CE index) were calculated in the areas of the hepatic parenchyma and abdominal aorta in 370 subjects who underwent our hepatic dynamic study. We analyzed the obtained values in terms of differences in age, sex, body weight, iodine volume per body weight, and volume and concentration of contrast medium. Changes in EU values were dependent on total iodine volume and body weight, showing a positive correlation with iodine volume per body weight. When assessed in terms of fixed total volume, the values were found to show a negative correlation with body weight. The obtained CE index values were closely distributed on a fixed iodine volume per weight, with slight variations that were related to sex, body weight, and age. Particularly, in the analysis of changes in enhancement levels according to age, a notable increase in contrast enhancement in inverse relationship with decline in glomerular filtration rate (GFR) with aging was observed. (author)

  5. Factors influencing intercultural doctor-patient communication: a realist review.

    NARCIS (Netherlands)

    Paternotte, E.; Dulmen, S. van; Lee, N. van der; Scherpbier, A.J.J.A.; Scheele, F.

    2015-01-01

    Objective: Due to migration, doctors see patients from different ethnic backgrounds. This causes challenges for the communication. To develop training programs for doctors in intercultural communication (ICC), it is important to know which barriers and facilitators determine the quality of ICC. This

  6. Factors influencing intercultural doctor-patient communication: A realist review

    NARCIS (Netherlands)

    Paternotte, E.; Dulmen, S. van; Lee, N. van der; Scherpbier, A.J.; Scheele, F.

    2015-01-01

    OBJECTIVE: Due to migration, doctors see patients from different ethnic backgrounds. This causes challenges for the communication. To develop training programs for doctors in intercultural communication (ICC), it is important to know which barriers and facilitators determine the quality of ICC. This

  7. Factors influencing intercultural doctor-patient communication: A realist review

    NARCIS (Netherlands)

    Paternotte, E.; Dulmen, S. van; Lee, N. van der; Scherpbier, A.J.; Scheele, F.

    2015-01-01

    OBJECTIVE: Due to migration, doctors see patients from different ethnic backgrounds. This causes challenges for the communication. To develop training programs for doctors in intercultural communication (ICC), it is important to know which barriers and facilitators determine the quality of ICC. This

  8. Influence of social factors on patient-reported late symptoms

    DEFF Research Database (Denmark)

    Kjaer, Trille Kristina; Johansen, Christoffer; Andersen, Elo;

    2016-01-01

    BACKGROUND: The incidence of head and neck cancer and morbidity and mortality after treatment are associated with social factors. Whether social factors also play a role in the prevalence of late-onset symptoms after treatment for head and neck cancer is not clear. METHODS: Three hundred sixty...... ratio [OR] = 3.20; 95% confidence interval [CI] = 1.18-8.63). For survivors who lived alone, the adjusted ORs were significantly increased for physical functioning (2.17; 95% CI = 1.01-4.68) and trouble with social eating (OR = 2.26; 95% CI = 1.14-4.47). CONCLUSION: Self-reported severe late symptoms...... were more prevalent in survivors with short education and in those living alone, suggesting differences in perception of late symptoms between social groups. © 2015 Wiley Periodicals, Inc. Head Neck, 2015....

  9. Oral health of patients with HIV-AIDS: influence of local and systemic factors

    OpenAIRE

    Batista, Anne Margareth

    2013-01-01

    ABSTRACT The research entitled "Oral Health of HIV-AIDS patients: influence of local and systemic factors" was held during the year 2012 in Diamantina, Minas Gerais. The aim of this research was to evaluate the oral and systemic conditions of patients with HIV / AIDS attended by Municipal DST-AIDS of Diamantina, from 24 cities of Jequitinhonha Valley. To do this, 118 patients with HIV-AIDS were evaluated. The patients were observed about their conditions of oral and general health, socioecono...

  10. [FACTORS WHICH INFLUENCE THE LEAN MASS LOSS IN CANCER PATIENTS].

    Science.gov (United States)

    Sánchez Sánchez, Eduardo; Muñoz Alferez, Maria José

    2015-10-01

    Introducción: el cáncer es una enfermedad de gran importancia sanitaria debido a las consecuencias físicas y funcionales que conlleva. Entre estas consecuencias está la desnutrición, que puede provocar una pérdida de masa magra y con ello una disminución de la calidad de vida, aumento de las estancias hospitalarias, costes sanitarios, etc. El objetivo de este estudio es conocer qué factores influyen en la pérdida de masa magra. Material y métodos: se trata de un estudio transversal en una muestra de 72 pacientes que reciben tratamiento radioterápico con finalidad curativa en un período comprendido entre el 7 de febrero y el 14 de mayo de 2014. Resultados: del total de pacientes se estudiaron 64, de los cuales el 43,7% presentan pérdida de masa magra, siendo el porcentaje de 21,8% los pacientes que pierden 5%, el 17,2% de los pacientes. De entre los factores estudiados que pueden influir en la pérdida de masa magra, solo la presencia de síntomas digestivos poseen significación estadísitca (OR = 3,3 o 6,6, según tomemos como referencia el porcentaje de pérdida). Conclusiones: el objetivo del personal sanitario que trabaja con estos pacientes de evitar las consecuencias que acompañan a la pérdida de masa magra. Por todo esto, es importante actuar antes de la aparición de síntomas digestivos, mediante la prevención de los mismos, o la aplicación precoz de una intervención nutricional individualizada.

  11. The incidence of aspirin resistance and relevant influencing factors in patients on maintenance hemodialysis

    Institute of Scientific and Technical Information of China (English)

    张春华

    2014-01-01

    Objective To explore aspirin resistance(AR)and its relevant influencing factors in patients on maintenance hemodialysis(MHD).Methods Patients on MHD who visited Beijing Chaoyang Hospital from June 1 to 30,2011 were enrolled in this study.A total of 150 age and gender matched individuals with normal renal function were taken as control group.Anthropometric data,bio-

  12. Factors Influencing Adherence in Cancer Patients Taking Oral Tyrosine Kinase Inhibitors: A Qualitative Study.

    Science.gov (United States)

    Verbrugghe, Mathieu; Duprez, Veerle; Beeckman, Dimitri; Grypdonck, Mieke; Quaghebeur, Marijke; Verschueren, Caroline; Verhaeghe, Sofie; Van Hecke, Ann

    2016-01-01

    Nonadherence in cancer patients taking oral anticancer drugs is common. Reasons for nonadherence are still not really understood as influencing factors are often complex, dynamic, and interrelated. A qualitative study was conducted to gain insight into (non-)adherence behavior in patients taking oral tyrosine kinase inhibitors by exploring (1) processes and factors influencing (non-)adherence and (2) their interrelatedness. Semistructured interviews were held with 30 patients of different ages and with different types of cancer. A grounded theory approach was used. Three foci were found when dealing with oral tyrosine kinase inhibitors: (1) a focus on survival, (2) a focus on quality of life, and (3) a balance between survival and quality of life. The process of adherence was determined by a set of complex and interrelated influencing factors: treatment-related side effects, hope, anxiety, trust, and feedback mechanisms. This qualitative study gives insight into processes and factors influencing (non-)adherence behavior in patients taking oral tyrosine kinase inhibitors. The results of this study can help healthcare professionals understand why patients taking oral tyrosine kinase inhibitors do not always adhere to their therapy. Conditions should be created by which patients get maximum opportunity to establish a balance between survival and quality of life. An open climate and a trust-based relationship should be established in which patients feel comfortable to openly discuss their therapy and the difficulties they experience.

  13. Factors influencing patient safety in Sweden: perceptions of patient safety officers in the county councils

    OpenAIRE

    Nygren, Mikaela; Roback, Kerstin; Öhrn, Annica; Rutberg, Hans; Rahmqvist, Mikael; Nilsen, Per

    2013-01-01

    Background National, regional and local activities to improve patient safety in Sweden have increased over the last decade. There are high ambitions for improved patient safety in Sweden. This study surveyed health care professionals who held key positions in their county council’s patient safety work to investigate their perceptions of the conditions for this work, factors they believe have been most important in reaching the current level of patient safety and factors they believe would be ...

  14. Factors influencing patient safety in Sweden: perceptions of patient safety officers in the county councils

    OpenAIRE

    Nygren Mikaela; Roback Kerstin; Öhrn Annica; Rutberg Hans; Rahmqvist Mikael; Nilsen Per

    2013-01-01

    Abstract Background National, regional and local activities to improve patient safety in Sweden have increased over the last decade. There are high ambitions for improved patient safety in Sweden. This study surveyed health care professionals who held key positions in their county council’s patient safety work to investigate their perceptions of the conditions for this work, factors they believe have been most important in reaching the current level of patient safety and factors they believe ...

  15. How health system factors influence referral decisions in patients that may have cancer: European symposium report

    OpenAIRE

    Harris, Michael; Frey, Peter; Esteva, Magdalena; Gašparović-Babić, Svjetlana; Marzo-Castillejo, Mercè; Petek, Davorina; Petek Ster, Marija; Thulesius, Hans

    2016-01-01

    Abstract Objective: To identify the system and other non-clinical factors that may influence a General Practitioners’ decision on whether to refer a patient who may have cancer. Study design: Expert group discussion and consensus formation. Methods: A group of eight General Practitioner (GP) researchers from Croatia, England, Slovenia, Spain, Sweden and Switzerland used brainstorming to identify the non-clinical factors that could affect GPs’ decision-making when faced with patients that ...

  16. How health system factors influence referral decisions in patients that may have cancer: European symposium report

    OpenAIRE

    Harris M; Frey P; Esteva M; Gasparovic-Babic S; Marzo-Castillejo M; Petek D; Petek Ster M; Thulesius H

    2016-01-01

    Objective: To identify the system and other non-clinical factors that may influence a General Practitioners’ decision on whether to refer a patient who may have cancer. Study design: Expert group discussion and consensus formation. Methods: A group of eight General Practitioner (GP) researchers from Croatia, England, Slovenia, Spain, Sweden and Switzerland used brainstorming to identify the non-clinical factors that could affect GPs’ decision-making when faced with patients that might have ca...

  17. Non-genetic risk factors and their influence on the management of patients in the clinic.

    Science.gov (United States)

    Álvarez, Teresa; Soto, Immaculada; Astermark, Jan

    2015-02-01

    The development of inhibitors is the most serious iatrogenic complication affecting patients with haemophilia. This complication is associated with impaired vital or functional prognosis, reduced quality of life and increased cost of treatment. The reasons why some patients develop antibodies to factor replacement and others do not remain unclear. It is however clear that inhibitor development results from a complex multifactorial interaction between genetic and non-genetic risk factors. Environmental influences implicated in increasing the risk of inhibitor formation can be viewed as modifiable risk factors. Therefore, identification of the non-genetic risk factors may offer the possibility of personalising haemophilia therapy by modifying treatment strategies in high-risk patients in the critical early phase of factor VIII exposure. In this article, we review the non-genetic factors reported as well as the potential impact of danger signals and the different scores for inhibitor development risk stratification.

  18. Insight of patients and their parents into schizophrenia: Exploring agreement and the influence of parental factors.

    Science.gov (United States)

    Macgregor, Alexandra; Norton, Joanna; Bortolon, Catherine; Robichon, Melissa; Rolland, Camille; Boulenger, Jean-Philippe; Raffard, Stéphane; Capdevielle, Delphine

    2015-08-30

    Poor insight is found in up to 80% of schizophrenia patients and has been associated with multiple factors of which cognitive functioning, social and environmental factors. Few studies have explored associations between patient insight and that of their biological parents', and the influence of parental factors. Insight was assessed in 41 patients and their biological parents with Amador's Scale for the assessment of Unawareness of Mental Disorder (SUMD). Parents' knowledge about schizophrenia and critical attitudes were assessed with validated self-report questionnaires. Both groups underwent cognitive assessments for working memory and executive functioning. Insight in patients and their parents was not associated for any of the SUMD dimensions but a significant correlation was found between patient and parent awareness of treatment effect for patient-parent dyads with frequent daily contact. Low parental critical attitude was associated with higher patient awareness of symptoms and a high parental memory task score with high patient insight. Our study is the first to suggest a possible influence of parental factors such as critical attitudes and cognitive performance on patient insight.

  19. Influencing factors for posttraumatic hydrocephalus in patients suffering from severe traumatic brain injuries

    Institute of Scientific and Technical Information of China (English)

    JIAO Qing-fang; LIU Zhan; LI Song; ZHOU Liang-xue; LI San-zhong; TIAN Wei; YOU Chao

    2007-01-01

    Objective: To detect the influencing factors for posttraumatic hydrocephalus in patients with severe traumatic brain injuries and provide theoretical reference for clinical treatment. Methods:Retrospective study was made on 139 patients with severe traumatic brain injuries in our hospital. The patients were divided into two groups: hydrocephalus group and non-hydrocephalus group. Single factor analysis and multiple factor analysis were used to determine the related factors and hydrocephalus. Multiple factor analysis was conducted with logistic regression. Results:Posttraumatic hydrocephalus was found in 19.42% of patients. Age(OR=1.050, 95% CI: 1.012-1.090), decompressive craniectomy (OR=4.312, 95% CI: 1.127-16.503), subarachnoid hemorrhage(OR=43.421, 95% CI: 7.835-240.652) and continuous lumbar drainage of cerebrospinal fluid (OR=0.045, 95% CI: 0.011-0.175) were screened out from nine factors as the influencing factors for posttraumatic hydrocephalus. Conclusions:Risk factors for PTH are as follows: age, decompressive craniectomy and subarachnoid hemorrhage (SAH). Continuous lumbar drainage of cerebrospinal fluid can greatly reduce posttraumatic hydrocephalus.

  20. [Anxiety disorders and influence factors in adolescent patients with cleft lip and palate].

    Science.gov (United States)

    Liu, Chao; Ran, Hao; Jiang, Chang-wei; Zhou, Meng

    2015-10-01

    To investigate the anxiety disorders and influence factors that occur in adolescent patients with cleft lip and palate and to provide theoretical foundation for mental intervention. A total of 120 adolescent patients with cleft lip and palate were investigated using a general information questionnaire, the self-rating anxiety scale, and the social support rating scale (SSRS). The influence factors of anxiety disorders were analyzed. The effective questionnaires were 119. The occurrence rate of anxiety disorder in adolescent patients was 49.6% (59/119), and the occurrence rates of mild, moderate, and severe anxieties were 41.2% (49/119), 7.6% (9/119), and 0.8% (1/119), respectively. The gender, residential area, disease category, family status (one child or no children), and incidence rate of anxiety disorder in patients were statistically different (Panxiety disorder were lower than those of patients without anxiety disorder (Panxiety disorder (R=0.318). A high anxiety disorder rate occurred in adolescent patients with cleft lip and palate. dender and social support were important influencing factors for anxiety disorder. In the after-mental intervention, considerable attention should be given to the anxiety disorders of patients and improve their mental health.

  1. Patient-related factors influencing patency of autogenous brachiocephalic haemodialysis fistulas

    NARCIS (Netherlands)

    Lamprou, Alexander A.; de Bruin, Cor; van Roon, Arie; Loonstra, Jan; van der Laan, Maarten; Tielliu, Ignace; Zeebregts, Clark

    2017-01-01

    Objective: The objective of this study was to analyse the outcome of autogenous brachiocephalic fistula for dialysis purposes and to determine modifiable and non-modifiable patient-related factors of influence on the patency of a newly created fistula. Design of study: A single-centre retrospective

  2. Factors Influencing communication between the patients with cancer and their nurses in oncology wards

    Directory of Open Access Journals (Sweden)

    Vahid Zamanzadeh

    2014-01-01

    Full Text Available Aims: The purpose of this study was to demonstrate the factors influencing nurse-patient communication in cancer care in Iran. Materials and Methods: This study was conducted with a qualitative conventional content analysis approach in oncology wards of hospitals in Tabriz. Data was collected through purposive sampling by semi-structured deep interviews with nine patients, three family members and five nurses and analyzed simultaneously. Robustness of data analysis was evaluated by the participants and external control. Results: The main theme of the research emerged as "three-factor effects" that demonstrates all the factors related to the patient, nurse, and the organization and includes three categories of "Patient as the center of communication", "Nurse as a human factor", and "Organizational structures". The first category consists of two sub-categories of "Imposed changes by the disease" and "the patient′s particular characteristics". The second category includes sub-categories of "sense of vulnerability" and "perception of professional self: Pre-requisite of patient-centered communication". The third category consists of the sub-categories of "workload and time imbalance", "lack of supervision", and "impose duties in context of neglecting nurse and patient needs". Characteristics of the patients, nurses, and care environment seemed to be the influential factors on the communication. Conclusions: In order to communicate with cancer patients effectively, changes in philosophy and culture of the care environment are essential. Nurses must receive proper trainings which meet their needs and which focus on holistic and patient-centered approach.

  3. A Research on Factors Influencing the Clinical Prognosis of Acute Stroke Patie.patients

    Institute of Scientific and Technical Information of China (English)

    Luo Zuming; Li Manli

    2000-01-01

    Object: To search for the factors significantly influencing the clinical prognosis of acute stroke patients. Background: There are lack of prospective multivariate analysis research m acute stroke in the world. Method: We chose 17 factors possibly influencing the prognosis of acute patients, took Barthel′s Index at the end of 2 months after stroke onset and decreased percentage of neurological deficit scores (MESSS) between 72h after hospitalization and 2 months after onset as gold standard, to have a prospective, multivariate analysis research combined with univariate analysis. Results: Multivariate analysis of 106 acute stroke patients combined with univariate analysis showed the factors significantly influencing the clinical prognosis of acute stroke patients were: initial MESSS score、 age、 complication、 mass effect、 stroke location、 time of delay before emergency arrival (BDT). Time of delay after emergency arrival was not found to be a significant prognostic factor. Discussion: Barthel Index at the end of 1 month after stroke onset was strongly related to that at the end of 2 month after onset, as was the same with MESSS score. It showed there was no significant difference between 1 month and 2 months after stroke onset when we choose time interval in evaluating prognosis of acute stroke patients.Conclusion: BDT、 initial MESSS score、 age、 stroke location、 mass effect、 complication were important factors of acute stroke patients. Avoid the delay before emergency arrival after onset, prevent and treat complications after stroke, more carefully treat acute stroke patients with advanced age, advanced age, high initial MESSS scores and those with mass effect reported by CT, we can improve the outcome of stroke patients.

  4. A prospective analysis of factors that influence weight loss in patients undergoing radiotherapy

    Institute of Scientific and Technical Information of China (English)

    Jon Cacicedo; Francisco Casquero; Lorea Martinez-Indart; Olga del Hoyo; Alfonso Gomez de Iturriaga; Arturo Navarro; Pedro Bilbao

    2014-01-01

    Malnutrition occurs frequently in patients with cancer. Indeed, a variety of nutritional and tumor-related factors must be taken into account in these patients. Recognizing this relationship, we aimed to prospectively evaluate the risk factors that influence weight loss in patients undergoing radiotherapy with oral nutritional supplementation and dietetic counseling. Weight loss of 74 patients during radiotherapy and 1 month after treatment was analyzed. Parameters such as age, gender, tumor location, tumor stage, Eastern Cooperative Oncology Group performance status (ECOG PS) score, and the use of chemotherapy were analyzed to evaluate their influence on weight loss. All patients underwent oral nutritional supplementation and dietetic counseling. Forty-six (65.7%) patients lost weight, with a mean weight loss of (4.73 ± 3.91) kg, during radiotherapy. At 1 month after treatment, 45 (66.2%) patients lost weight, presenting a mean weight loss of (4.96 ± 4.04) kg, corresponding to a (6.84 ± 5.24)% net reduction from their baseline weight. Head and neck cancer patients had a mean weight loss of (3.25 ± 5.30) kg, whereas the remaining patients had a mean weight loss of (0.64 ± 2.39) kg (P=0.028) during radiotherapy. In the multivariate analysis, the head and neck tumor location (P = 0.005), use of chemotherapy (P = 0.011), and ECOG PS score of 2-3 (P = 0.026) were considered independent risk factors. Nutritional status and parameters, such as tumor location (especially the head and neck), the use of chemotherapy, and the ECOG PS score, should be evaluated before radiotherapy because these factors can influence weight loss during radiotherapy and 1 month after treatment.

  5. A prospective analysis of factors that influence weight loss in patients undergoing radiotherapy.

    Science.gov (United States)

    Cacicedo, Jon; Casquero, Francisco; Martinez-Indart, Lorea; del Hoyo, Olga; Gomez de Iturriaga, Alfonso; Navarro, Arturo; Bilbao, Pedro

    2014-04-01

    Malnutrition occurs frequently in patients with cancer. Indeed, a variety of nutritional and tumor-related factors must be taken into account in these patients. Recognizing this relationship, we aimed to prospectively evaluate the risk factors that influence weight loss in patients undergoing radiotherapy with oral nutritional supplementation and dietetic counseling. Weight loss of 74 patients during radiotherapy and 1 month after treatment was analyzed. Parameters such as age, gender, tumor location, tumor stage, Eastern Cooperative Oncology Group performance status (ECOG PS) score, and the use of chemotherapy were analyzed to evaluate their influence on weight loss. All patients underwent oral nutritional supplementation and dietetic counseling. Forty-six (65.7%) patients lost weight, with a mean weight loss of (4.73 ± 3.91) kg, during radiotherapy. At 1 month after treatment, 45 (66.2%) patients lost weight, presenting a mean weight loss of (4.96 ± 4.04) kg, corresponding to a (6.84 ± 5.24)% net reduction from their baseline weight. Head and neck cancer patients had a mean weight loss of (3.25 ± 5.30) kg, whereas the remaining patients had a mean weight loss of (0.64 ± 2.39) kg (P = 0.028) during radiotherapy. In the multivariate analysis, the head and neck tumor location (P = 0.005), use of chemotherapy (P = 0.011), and ECOG PS score of 2-3 (P = 0.026) were considered independent risk factors. Nutritional status and parameters, such as tumor location (especially the head and neck), the use of chemotherapy, and the ECOG PS score, should be evaluated before radiotherapy because these factors can influence weight loss during radiotherapy and 1 month after treatment.

  6. Factors Influencing Pre-hospital Patient Delay in Patients with Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    La Xie; Su-Fang Huang∗; You-Zhen Hu

    2015-01-01

    Acute myocardial infarction ( AMI) is a dangerous disease with a high mortality rate. For AMI patients, the outcome of the patients depends on time to beginning of effective treatment in addition to other factors such as severity of disease and involved vessels etc. The key is whether reperfusion therapy is started early enough after the onset of symptoms, and the benefit of reperfu-sion therapy depends on the time, too. The delay of AMI treatment is divided into pre-hospital de-lay and in-hospital delay. In-hospital delay, Door-to-Balloon Time, has been well controlled. Pre-hospital delay, accounting for 75% of the total delay time, is the most important factor affect-ing AMI treatment. Patient delay ( PD) time for AMI patients is summarised in this study.

  7. Factors influencing satisfaction with emergency department medical service: Patients' and their companions' perspectives.

    Science.gov (United States)

    Son, Heesook; Yom, Young-Hee

    2017-01-01

    To examine the individual determinants that influence satisfaction with medical services at the emergency department and to compare the factors that influence satisfaction for the patients, compared with their companions. Using data from the 2009 Korea Health Panel Survey, Andersen's behavioral model was used to examine the factors that affect satisfaction with service. A logistic regression analysis was conducted with the data. Patients who were older, female, and employed were more satisfied with the service, as were patients who visited more frequently and those who had non-surgical treatment. Companions who had less education, were accompanying non-Medicaid-holders, and spent a longer time in the emergency department were less likely to be satisfied. This was in contrast to those who spent a shorter amount of time in the emergency department and who visited due to illness, rather than injury; these companions were more satisfied with the service. When all the factors were analyzed simultaneously, they differed significantly between the two groups of patients and companions. Different factors contributed to the satisfaction with the services for the patients and their companions. In order to increase the satisfaction levels and improve the quality of care in emergency departments, it is necessary to consider more specific approaches that reflect the different perspectives of the visitors to the emergency department. © 2016 Japan Academy of Nursing Science.

  8. Factors influencing medication adherence in patients with gout: A descriptive correlational study.

    Science.gov (United States)

    Chua, Xin Hui Jasmine; Lim, Siriwan; Lim, Fui Ping; Lim, Yee Nah Anita; He, Hong-Gu; Teng, Gim Gee

    2017-06-15

    To examine the factors influencing adherence to urate-lowering therapy in patients with gout in Singapore. Gout is the most common type of chronic inflammatory arthritis. Urate-lowering therapy (ULT) is used to treat gout by reducing serum uric acid levels. However, adherence to ULT among patients remains poor. To date, there have been no available studies based on a conceptual framework that examined factors influencing medication adherence in patients with gout. Cross-sectional, descriptive correlational study. A convenience sample of outpatients (n = 108) was recruited between October 2014 and January 2015 from a tertiary hospital in Singapore. Outcomes were measured by relevant valid and reliable instruments. Descriptive statistics and parametric tests including multiple linear regression were used to analyse the data. Although 44.4% of the participants were high adherers to urate-lowering therapy, the mean adherence level was moderate. Significant differences in medication adherence scores were found among the subgroups of gender, ethnicity, marital status, employment status, and presence of comorbidity. Medication adherence was positively significantly correlated with age, number of comorbidities, and beliefs about medicines. Linear regression showed that higher level of beliefs about medicines, presence of comorbidity, and being married were factors positively influencing medication adherence. This study revealed moderate adherence to ULT in patients with gout in Singapore, indicating the need for strategies to improve adherence by considering its main influencing factors. Future research should be conducted to develop interventions targeted at modifying patients' beliefs about medicines in order to improve medication adherence. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  9. Effects of different factors influencing clinical compliance of Chinese patients with chronic periodontitis.

    Science.gov (United States)

    Si, Wei; Wang, Hongyan; Li, Qian; Zhao, Xida; Pan, Yaping

    2016-01-01

    The aims of this study were to determine the relationship between compliance in patients with chronic periodontitis and the efficacy of nonsurgical periodontal treatment as well as to investigate the factors that influence the compliance of patients with chronic periodontitis. These aims may be useful for determining the prognosis and improving the efficacy of treatment. Four hundred patients with chronic periodontitis were classified into three groups: the complete compliance group (S1), the erratic compliance group (S2), and the failing compliance group (S3). The patients who were in group S1 received supportive periodontal therapy (SPT) on time: they presented for their appointments within 2 months of the scheduled date; the patients who missed their appointments by more than 2 months or who completely missed a return visit one or more times, were placed in group S2; and the patients who never returned to receive SPT were assigned to group S3. They completed a questionnaire about compliance and underwent a clinical periodontal examination. SPSS 13.0 was used for the statistical analysis. Groups S2 (49.4%) and S3 (34.1%) were significantly different from group S1 (87.0%) (P periodontal disease is always associated with other diseases. The analysis of severe pain during the treatment revealed significant differences (P periodontitis and comfort during treatment are important factors influencing patient compliance. The distance of the patient's residence from the hospital, working hours, and attitudes of family members also affect patient compliance. Doctors should educate patients about oral health and manage their patients' comfort as much as possible during treatment, thereby enhancing patient compliance and achieving better treatment efficacy.

  10. Factors that influence patient preferences for prostate cancer management options: A systematic review

    Science.gov (United States)

    Showalter, Timothy N; Mishra, Mark V; Bridges, John FP

    2015-01-01

    Purpose We performed a systematic review to evaluate evidence regarding factors that influence patient preferences for management options for localized prostate cancer. Methods We followed a prespecified search protocol (PROSPERO identifier CRD42014009173) to identify studies that evaluated patient preferences for prostate cancer management options for localized prostate cancer. We queried PubMed, the Cochrane Database of Systematic Reviews, Embase, Cumulative Index to Nursing & Allied Health Literature (CINAHL) Plus, and Econ-Lit databases. Two separate reviewers completed the article selection process and review, including coding of study characteristics. Study quality was scored according to the PREFS checklist, which consists of five criteria: Purpose, Respondents, Explanation, Findings, and Significance. Reviewers summarized the primary findings of each article included in the analysis. Results Of the 606 citations identified in the literature search, there were a total of 21 articles that met all selection criteria, reporting results for a total of 4,131 subjects. Themes identified in the studies included: the importance of patient perceptions of treatment efficacy and side effects; the influence of physician recommendations on patient decision-making; and the prioritization of concerns regarding treatment side effects among those men who prefer radiation therapy or active surveillance. The articles had an average PREFS score of 3.4 (standard deviation [SD] 1.0), which is similar to a recent study for breast cancer treatment preferences. Conclusion This systematic review of factors that influence patient preferences for prostate cancer management options identified a small, but high quality, group of articles that satisfied the selection criteria. The available evidence suggests that interventions aimed at informing patients regarding the comparative effectiveness of prostate cancer management alternatives should include the influence of physician

  11. Depression, anxiety and influencing factors in patients with acute pulmonary embolism

    Institute of Scientific and Technical Information of China (English)

    LIU Chun-ping; LI Xiao-mei; CHEN Hang-wei; CUI Jun-yu; NIU Li-li; HE Yu-bin; TIAN Xin-li

    2011-01-01

    Background Psychological distress has been widely studied in many cardiovascular and pulmonary diseases, but the condition in acute pulmonary embolism (APE) is unknown. The purpose of this study was to investigate levels of depression and anxiety and their influencing factors in APE patients.Methods Sixty consecutive patients with APE were subjected to investigation of depression and anxiety by the Beck Depression Inventory and State-Trait Anxiety Inventory, and 60 community-based subjects were enrolled as controls.APE patients were stratified as high-risk, intermediate-risk and low-risk according to the disease severity. Scores of depression and anxiety were compared by statistical analysis using paired t tests between APE patients and controls,and by analysis of variance within the APE patients with the three risk stratification. Factors influencing depression and anxiety were evaluated.Results The mean age of the patients (38 males and 22 females) was (52+12) years. APE patients displayed higher scores of depression (P=0.04) and anxiety (P=0.001) compared with controls. Patients in the high-risk group displayed higher scores of depression (P=0.004) and anxiety (P=0.001) compared with those in the intermediate- and low-risk groups. Depression scores were highly correlated with anxiety scores (r=0.60, P <0.001). Both depression and anxiety inversely related to risk stratification (P <0.01), age (P <0.05), and arterial blood oxygen pressure (PaO2) (P <0.05).Linear regression analysis showed that PaO2 was independently inversely related to both depression (P <0.01) and anxiety (P <0.05); risk stratification and age were independently inversely related to anxiety (P <0.05).Conclusions Patients of APE suffered high levels of depression and anxiety, which were negatively influenced by PaO2,risk stratification and age.

  12. Diagnostic value and influencing factors of fractional exhaled nitric oxide in suspected asthma patients

    OpenAIRE

    Wang, Yubo; LI, Li; Han, Rui; Lei, Wenhui; Li, Zhongyan; Li, Kunlin; Kang, Jun; CHEN, HENGYI; He, Yong

    2015-01-01

    Objective: To explore the critical value and possible influencing factors of fractional exhaled nitric oxide (FeNO) in suspected asthma patients. Methods: 923 suspected asthmatics consecutively referred to our hospital during December 2012 to July 2014 were selected. All cases were carried out FeNO measurement at first; next, spirometry, bronchoprovocation tests or bronchodilation tests were used to confirm or exclude asthma. Receiver operating characteristic curve (ROC) was used to determine...

  13. FACTORS INFLUENCING THE OCCURRENCE OF HYPERTROPHIC SCARS AMONG POSTOPERATIVE PATIENTS IN GARUT, INDONESIA

    Directory of Open Access Journals (Sweden)

    Andri Nugraha

    2017-02-01

    Full Text Available Background: Hypertrophic scar causes physical and psychological problems. Thus understanding the factors related to the occurrence of hypertrophic scar tissue is needed. Little is known about its influencing factors in Indonesia, especially in Garut. Objective: This study aims to examine the relationships between hypertrophic scar and its influencing factors, and identify the most dominant factor of the occurrence of hypertrophic scars. Methods: This was an observational case control study using retrospective approach in Polyclinic of Surgery of Regional Public Hospital of dr. Slamet of Garut Regency. There were 40 samples recruited in this study by purposive sampling, which was divided to be case group (20 patients and control group (20 patients. Data were collected using Stony Brook Scar Evaluation Scale by observation and documentation of the medical records of patients. Data were analyzed using logistic regression analysis Results: Findings indicated that there were significant relationships between the surgical wound infection (p = 0.02, family history (p = 0.026, and type of suture (p = 0.043 with the occurrence of hypertrophic scars. The most dominant factor on the occurrence of hypertrophic scars was type of suture, acid polyglactin 910. The variables that had no significant relationships with the occurrence of hypertrophic scar tissue were age (p = 0.34, area of surgical wound (p = 0.177, and smoking habit (p = 0.479. Conclusion: There were significant relationships between infection of surgical wound, genetic history, the type of suture, and the occurrence of hypertrophic scar tissue. The most dominant factor that influenced the occurrence of hypertrophic scar tissue was the type of suture. Therefore, it is suggested to health professionals to modify the using of acid polyglactin 910 sutures, and nurses particularly need to provide the information regarding the family history and genetic-related hypertrophic scar, and prevent the

  14. Study on the Influencing Factors of Blood Pressure Variability in Patients Undergoing Maintenance Hemodialysis

    Directory of Open Access Journals (Sweden)

    Xiao-hui BAI

    2016-09-01

    Full Text Available Objective: To investigate the influencing factors of blood pressure variability (BPV in patients with maintenance hemodialysis (MHD, so as to improve the patients’ prognosis.Methods: The clinical data of 107 MHD patients were retrospectively analyzed. According to intradialytic systolic pressure (SBP-BPV, the patients were assigned into high SBP-BPV group (n=52 and low SBP-BPV group (n=55. According to intradialytic diastolic pressure (DBP-BPV, they were divided into high DBP-BPV group (n=49 and low DBP-BPV group (n=58. The basic characteristics of patients in high and low SBP-BPV groups and DBP-BPV groups were compared, and the influencing factors of both SBP-BPV and DBP-BPV were also analyzed.Results: The differences were statistically significant between high and low SBP-BPV groups by comparison to the age, dry weight, body mass index (BMI, dialysis age, interdialysis weight gain (IDWG rate, pre-dialysis SBP, albumin (ALB, hemoglobin (Hb, total cholesterol (TC and calcium-phosphorus product (P<0.05 or P<0.01. The differences were also statistically significant between high and low DBP-BPV groups by comparison to the age, dry weight, BMI, IDWG rate, pre-dialysis SBP and DBP, Hb and calcium-phosphorus product (P<0.05 or P<0.01. Multiple linear regression analysis revealed that SBP-BPV was positively correlated with the age, IDWG rate and pre-dialysis SBP (P=0.002, P=0.001, P=0.006, while negatively with Hb (P=0.021. They were all regarded as independent influencing factors of SBP-BPV. Both IDWG rate and pre-dialysis DBP were positively correlated with DBP-BPV (P=0.019, P=0.004, and could be considered as independent influencing factors of DBP-BPV.Conclusion: Advanced age, increased IDWG%, pre-dialysis high SBP and decreased Hb are independent risk factors of SBP-BPV, and both increased IDWG rate and pre-dialysis high DBP are independent risk factors of DBP-BPV in intradialytic MHD patients. Pre-dialysis patients should positively control the

  15. How health system factors influence referral decisions in patients that may have cancer: European symposium report

    Directory of Open Access Journals (Sweden)

    Harris M

    2016-01-01

    Full Text Available Objective: To identify the system and other non-clinical factors that may influence a General Practitioners’ decision on whether to refer a patient who may have cancer. Study design: Expert group discussion and consensus formation. Methods: A group of eight General Practitioner (GP researchers from Croatia, England, Slovenia, Spain, Sweden and Switzerland used brainstorming to identify the non-clinical factors that could affect GPs’ decision-making when faced with patients that might have cancer. The group refined and came to a consensus on these factors. Results: Many non-clinical factors are likely to have a significant impact on referral decisions. These include levels of gatekeeping responsibility, funding systems, access to special investigations, fear of litigation, and relationships with specialist colleagues. Conclusions: Many patients with cancer present without red-flag symptoms, but nevertheless still cause a feeling of concern in their GPs. How a health system is organised is likely to influence on how GPs act on those concerns.

  16. Factors with independent influence on the 'timed up and go' test in patients with hip fracture

    DEFF Research Database (Denmark)

    Kristensen, Morten Tange; Foss, Nicolai Bang; Kehlet, Henrik

    2009-01-01

    be used as references, to which individuals can expect to perform. Multivariate testing suggests that clinicians should use age, pre-fracture function, fracture type and walking-aid specific data when interpreting the TUG test results. Physiotherapists should be aware of this if TUG scores are to be used......BACKGROUND AND PURPOSE: Data on performance times for the 'timed up and go' (TUG) test with analyses of factors, that eventually could affect the result in patients with hip fracture, have not been published to date. The aims of the present study, therefore, were to assess normative reference...... values of TUG performances and determine the influence of individual and clinical factors on TUG-test scores in patients with hip fracture. METHOD: In this prospective, descriptive study, a total of 196 consecutive patients over the age of 60, and able to perform the TUG when discharged directly...

  17. 'Hidden' factors influencing quality of life in patients with multiple sclerosis.

    Science.gov (United States)

    Lysandropoulos, A P; Havrdova, E

    2015-10-01

    Traditional outcome measures for patients with multiple sclerosis (MS), whether in clinical trials or clinical practice, are currently in question. The combination of relapses, physical disability progression and magnetic resonance imaging (MRI) disease activity reflect only part of the impact that MS has on a patient's daily life. Quality of life (QoL) is considered by many to be the ideal outcome measure. Since it captures the patient's own perspective of well-being, QoL should be the primary focus when evaluating a patient and the main objective of MS management. Nevertheless, whilst numerous instruments to measure QoL in MS patients are available or proposed, there is no current consensus regarding which is the best tool to use and under what circumstances. QoL in patients with MS is determined by several factors beyond the more obvious; these include coping with the MS diagnosis, understanding the disease and the disease process, dealing with so-called 'hidden' symptoms such as fatigue, cognitive impairment and sexual disturbances, and managing the many associated personal challenges such as social isolation, family issues and working difficulties. Evidence is emerging that psychological interventions may be beneficial in MS patients although more research is required to confirm their utility. This article examines some factors that influence QoL in MS patients which may be overlooked in the general busyness of routine clinical practice. © 2015 The Author(s) European Journal of Neurology © 2015 EAN.

  18. Quality of life and its influencing factors in patients with posttraumatic epilepsy

    Institute of Scientific and Technical Information of China (English)

    LIU Song-yan; HAN Xue-mei; YAN Ya-yun; SUN Bo-jian; CHANG Ying

    2011-01-01

    Objective: To observe the quality of life in patients with post-traumatic epilepsy and discuss the influencing factors.Methods: We assessed 105 patients with post-traumatic epilepsy and 100 healthy people as control using Quality of Life Scale-31 (QOL-31), Self-rating Depressing Scale (SDS) and Self-rating Anxiety Scale (SAS), and conducted retrospective analysis on the depression, anxiety, site of trauma, control of seizure, EEG and therapeutic compliance.Results: Patients with post-traumatic epilepsy scored much lower than the control group on QOL-31 (P<0.01), but higher than the control group on SDS and SAS (P<0.01).Multiple regression analysis indicated that major influencing factors on the quality of life were anxiety, therapeutic compliance, depression, poor control of epileptic seizure and site of trauma.Conclusions: The quality of life in patients with posttraumatic epilepsy has significantly declined. Doctors should pay attention to psychological and mental problems of patients with epilepsy, such as depression and anxiety,enhancing therapeutic compliance and controlling epileptic seizure, which are the keys to improving prognosis.

  19. Cultural factors influencing dietary and fluid restriction behaviour: perceptions of older Chinese patients with heart failure.

    Science.gov (United States)

    Rong, Xiaoshan; Peng, Youqing; Yu, Hai-Ping; Li, Dan

    2017-03-01

    To explore the cultural factors related to dietary and fluid restriction behaviours among older Chinese patients. Excess dietary sodium and fluid intake are risk factors contributing to the worsening and rehospitalisation for heart failure in older patients. Managing the complex fluid and diet requirements of heart failure patients is challenging and is made more complicated by cultural variations in self-management behaviours in response to a health threat. Qualitative study using semi-structured in interviews and framework analysis. The design of this study is qualitative descriptive. Semi-structured in-depth interviews were conducted with 15 heart failure patients. Data were analysed through content analysis. Seven cultural themes emerged from the qualitative data: the values placed on health and illness, customary way of life, preference for folk care and the Chinese healthcare system, and factors related to kinship and social ties, religion, economics and education. Dietary change and management in response to illness, including heart failure, is closely related to individuals' cultural background. Healthcare providers should have a good understanding of cultural aspects that can influence patients' conformity to medical recommendations. Heart failure patients need support that considers their cultural needs. Healthcare providers must have a good understanding of the experiences of people from diverse cultural backgrounds. © 2016 John Wiley & Sons Ltd.

  20. Factors influencing outcomes of intra-aortic balloon counterpulsation in elderly patients

    Institute of Scientific and Technical Information of China (English)

    WU Xue-ping; LIU Hong-wei; ZHAO Xiao-ning; CAO Jian; ZHU Ping

    2013-01-01

    Background Intra-aortic balloon counterpulsation (IABP) is a mechanical cardiac-assist device that is used for cardiac support.There are no published reports about the use of IABP in eldedy Chinese patients,especially for those over 80 years old.The aim of this study was to describe the clinical outcomes,influencing factors,and complications in patients ≥80 years old and requiring IABP.Methods We performed a retrospective study of 134 consecutive patients who received IABP therapy.Based on age,we defined two groups; those ≥80 years old and those <80 years old.Results The overall mortality was 41.8%.Patients ≥80 years old had higher mortality rates than those <80 years old (47.9% vs.30.2%).Patients ≥80 years old had fewer successful revascularizations (45.8%) and more pulmonary infections(47.9%) than patients <80 years old (60.3% and 30.2%,respectively); these differences were statistically significant.The most common non-cardiac complication was pulmonary infection.Cardiogenic shock and pulmonary infection were risk factors for all-cause,in-hospital mortality,whereas revascularization success was a negative risk factor for the ≥80 years old patients.Conclusions IABP may be successfully and safely employed in patients ≥80 years old,having severe heart disease,with few complications.Patients ≥80 years old who need IABP therapy are less likely to have a successful revascularization and are more likely to develop pulmonary infections than patients <80 years old.

  1. Factors influencing patient satisfaction with dental appearance and treatments they desire to improve aesthetics

    Directory of Open Access Journals (Sweden)

    Hassan Nurhidayati

    2011-02-01

    Full Text Available Abstract Background We assessed factors influencing patients' satisfaction with their dental appearance and the treatments they desired to improve dental aesthetics. Methods A cross-sectional study was performed out among 235 adult patients who visited the Hospital Universiti Sains Malaysia dental clinic. A structured, interviewer-guided questionnaire was used to identify patient satisfaction with their general dental appearance, cosmetic elements and desired treatments. Results The 235 patients consisted of 70 males (29.8% and 165 females (70.2%, of mean age 31.5 years (SD 13.0. Of these patients, 124 (52.8% were not satisfied with their general dental appearance. In addition, 132 patients (56.2% were not happy with the color of their teeth, 76 (32.3%, regarded their teeth were poorly aligned, 62 (26.4%, as crowded and 56 (23.4% protruded. Dissatisfaction with tooth color was significantly higher in female than in male patients (odds ratio [OR] of 1.99 (95% confidence interval [CI] 1.13-3.50. Tooth whitening was the treatment most desired by patients (48.1%. Results of multiple logistic regression analysis showed that patient dissatisfaction with general dental appearance was significantly associated with female gender (OR = 2.18; 95% CI: 1.18-4.03, unhappiness with tooth color (OR = 3.05; 95% CI: 1.74-5.34 and the opinion that their teeth protruded (OR = 2.91, 95% CI: 1.44-5.91. Conclusions Most patients in this study were not satisfied with their dental appearance with a greater percentage of females expressing dissatisfaction than males. An age was not associated with satisfaction. Unhappiness with tooth color and feelings of having protruding teeth also had a significant negative influence on patient satisfaction with general dental appearance.

  2. Diagnostic value and influencing factors of fractional exhaled nitric oxide in suspected asthma patients.

    Science.gov (United States)

    Wang, Yubo; Li, Li; Han, Rui; Lei, Wenhui; Li, Zhongyan; Li, Kunlin; Kang, Jun; Chen, Hengyi; He, Yong

    2015-01-01

    To explore the critical value and possible influencing factors of fractional exhaled nitric oxide (FeNO) in suspected asthma patients. 923 suspected asthmatics consecutively referred to our hospital during December 2012 to July 2014 were selected. All cases were carried out FeNO measurement at first; next, spirometry, bronchoprovocation tests or bronchodilation tests were used to confirm or exclude asthma. Receiver operating characteristic curve (ROC) was used to determine the best cut-off value of FeNO for asthma diagnosis. In bronchoprovocation test, 125 cases were diagnosed as asthma, other 283 were non-asthmatics. FeNO levels of asthmatics were significantly higher than non-asthmatics (median, 64.8 ppb vs. 27.9 ppb, Pgroup of patients, 64 ppb was the best cut-off value of FeNO to identify asthma with sensitivity of 52.0% and specificity of 94.35%. In bronchodilation test, 185 patients were diagnosed as asthma, other 330 were non-asthmatics. FeNO levels of asthmatics were significantly higher than non-asthmatics (median, 60.6 ppb vs. 29.05 ppb, Pppb was the best cut-off value of FeNO to identify asthma with sensitivity of 72.43% and specificity of 74.85%. Influencing factors analysis showed that sex was an independent factor affecting patients' FeNO level. FeNO was an effective auxiliary diagnosis method for bronchial asthma. 64 ppb and 41 ppb was the best cut-off value of FeNO to identify asthma in bronchoprovocation test or bronchodilation test, respectively. Sex was an independent factor affecting patients' FeNO level.

  3. Factors influencing pre-hospital delay among patients with acute myocardial infarction in Iran

    Institute of Scientific and Technical Information of China (English)

    Maryam Momeni; Arsalan Salari; Shora Shafighnia; Atefeh Ghanbari; Fardin Mirbolouk

    2012-01-01

    Background Acute myocardial infarction (AMI) is the leading cause of morbidity and disability among Iranian population.Pre-hospital delay is an important cause of increasing early and also late mortality in AMI.Thus the aim of the present study was to identify the factors influencing pre-hospital delay among patients with AMI in Iran.Methods Between August 2010 and May 2011,a cross-sectional and single-center survey was conducted on 162 consecutive patients with ST-elevation myocardial infarction (STEMI) admitted to Cardiac Care Unit (CCU) of Dr.Heshmat Hospital,Rasht.All patients were interviewed by the third author within 7 days after admission by using a four-part questionnaire including socio-demographic,clinical,situational and cognitive factors.Data were analyzed by descriptive and Logistic regression model at P < 0.05 using SPSS 16.Results Mean age was (60.11±12.29) years in all patients.Majority of patients (65.4%) were male.The median of pre-hospital delay was 2 hours,with a mean delay of 7.4 hours (±16.25 hours).Regression analysis showed that admission in weekend (P <0.04,OR=1.033,95% Cl=1.187-2.006) and misinterpretation of symptoms as cardiac origin (P <0.002,OR=1.986,95% Cl=1.254-3.155) and perceiving symptoms to not be so serious (P <0.003,OR=3.264,95%Cl=1.492-7.142) were factors influencing pre-hospital delay > 2 hours.Conclusions Our findings highlight the importance of cognitive factors on decision-making process and pre-hospital delays.Health care providers can educate the public on AMI to enable them recognize the signs and symptoms of AMI correctly and realize the benefits of early treatment.

  4. Factors that influence patient preferences for prostate cancer management options: a systematic review

    Directory of Open Access Journals (Sweden)

    Showalter TN

    2015-07-01

    Full Text Available Timothy N Showalter,1 Mark V Mishra,2 John FP Bridges31Department of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, VA, USA; 2Department of Radiation Oncology, University of Maryland School of Medicine, 3Department of Health Care Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USAPurpose: We performed a systematic review to evaluate evidence regarding factors that influence patient preferences for management options for localized prostate cancer.Methods: We followed a prespecified search protocol (PROSPERO identifier CRD42014009173 to identify studies that evaluated patient preferences for prostate cancer management options for localized prostate cancer. We queried PubMed, the Cochrane Database of Systematic Reviews, Embase, Cumulative Index to Nursing & Allied Health Literature (CINAHL Plus, and Econ-Lit databases. Two separate reviewers completed the article selection process and review, including coding of study characteristics. Study quality was scored according to the PREFS checklist, which consists of five criteria: Purpose, Respondents, Explanation, Findings, and Significance. Reviewers summarized the primary findings of each article included in the analysis.Results: Of the 606 citations identified in the literature search, there were a total of 21 articles that met all selection criteria, reporting results for a total of 4,131 subjects. Themes identified in the studies included: the importance of patient perceptions of treatment efficacy and side effects; the influence of physician recommendations on patient decision-making; and the prioritization of concerns regarding treatment side effects among those men who prefer radiation therapy or active surveillance. The articles had an average PREFS score of 3.4 (standard deviation [SD] 1.0, which is similar to a recent study for breast cancer treatment preferences. Conclusion: This systematic review of factors

  5. Detection of risk factors that influence weight loss in patients undergoing radiotherapy.

    Science.gov (United States)

    Cacicedo, Jon; Casquero, Francisco; Martinez-Indart, Lorea; Del Hoyo, Olga; Iturriaga, Alfonso Gómez de; Muruzabal, Irma; Carvajal, Claudia; Bóveda, Elsira; Ruiz, Blanca; Loayza, Armando; Usategui, Begoña; Lasso, Aurora; Hortelano, Eduardo; Bilbao, Pedro

    2012-09-01

    To identify risk factors that influence weight loss in patients receiving radiotherapy. It is a well-known fact that cancer patients can be affected by malnutrition at the onset of the disease and during treatment due to the toxicity. Pretreatment weight loss alone does not predict those who will need nutritional supplementation. Instead, a variety of nutritional and tumor related factors needs to be taken into account. A retrospective study was conducted on 129 patients with different tumor locations. Weight loss was evaluated during radiotherapy and one month after treatment. The impact of age, ECOG, chemotherapy, pretreatment weight loss, tumor location, previous surgery and TNM were analyzed. We aimed to identify a high-risk group of patients before starting treatment. The average net weight loss during radiotherapy and one month after treatment for this group of patients was 0.68 kg and 1.6 kg, respectively. Median weight loss during radiotherapy was 2.6 kg for head and neck (HN) patients and 0.27  kg for other tumor sites (p = 0.028). Median weight loss one month after radiotherapy was 3.7 kg for HN patients and 1.1 kg for the rest of the patients (p = 0.034). The median weight loss one month after treatment was 3.2 kg for patients receiving chemotherapy and 0.5 kg for those patients who did not receive chemotherapy (p < 0.001). A regression analysis determined that HN tumor location and the use of chemotherapy were independent risk factors. Nutritional status must be monitored and managed before, during and after treatment. A variety of nutritional and tumor-related factors must be considered. According to our results, head and neck tumors and the use of chemotherapy are the only two factors considered statistically significant. Because patients continue to lose weight after treatment, we recommend close surveillance after radiotherapy.

  6. Factors influencing survival in patients with multidrug-resistant Acinetobacter baumannii infection

    Directory of Open Access Journals (Sweden)

    Mariana Lima Prata-Rocha

    2012-06-01

    Full Text Available Multidrug-resistant (MDR Acinetobacter baumannii (Acb is a rapidly emerging pathogen in healthcare settings. The aim of this study was to evaluate the predictors of poor outcome in patients with MDR Acb. This is the first report documenting factors influencing survival in patients with MDR Acb in this tertiary hospital. This study is a prospective of the hospital epidemiology database. A total of 73 patients with 84 Acb isolates were obtained between August 2009 and October 2010 in this hospital. In the present study, the 30-day mortality rate was 39.7%. Of 84 Acb isolates, 50 (59% were MDR, nine (11% were pan-resistant, and 25 (30% were non-MDR. The non-MDR isolates were used as the control group. The factors significantly associated with multidrug resistance included previous surgeries, presence of comorbidity (renal disease, use of more than two devices, parenteral nutrition, and inappropriate antimicrobial therapy. Significant predictors of 30-day mortality in the univariate analysis included pneumonia, diabetes mellitus, renal disease, use of more than two devices, and inappropriate antimicrobial therapy administered within two days of the onset of infection. The factors associated with mortality in patients with MDR Acb infection in this study were: age > 60 years, pneumonia, diabetes mellitus, renal disease, use of more than two invasive procedures, and inappropriate antimicrobial therapy. Vigilance is needed to prevent outbreaks of this opportunistic and deadly pathogen.

  7. Factors influencing survival in patients with multidrug-resistant Acinetobacter baumannii infection

    Directory of Open Access Journals (Sweden)

    Mariana Lima Prata-Rocha

    Full Text Available Multidrug-resistant (MDR Acinetobacter baumannii (Acb is a rapidly emerging pathogen in healthcare settings. The aim of this study was to evaluate the predictors of poor outcome in patients with MDR Acb. This is the first report documenting factors influencing survival in patients with MDR Acb in this tertiary hospital. This study is a prospective of the hospital epidemiology database. A total of 73 patients with 84 Acb isolates were obtained between August 2009 and October 2010 in this hospital. In the present study, the 30-day mortality rate was 39.7%. Of 84 Acb isolates, 50 (59% were MDR, nine (11% were pan-resistant, and 25 (30% were non-MDR. The non-MDR isolates were used as the control group. The factors significantly associated with multidrug resistance included previous surgeries, presence of comorbidity (renal disease, use of more than two devices, parenteral nutrition, and inappropriate antimicrobial therapy. Significant predictors of 30-day mortality in the univariate analysis included pneumonia, diabetes mellitus, renal disease, use of more than two devices, and inappropriate antimicrobial therapy administered within two days of the onset of infection. The factors associated with mortality in patients with MDR Acb infection in this study were: age > 60 years, pneumonia, diabetes mellitus, renal disease, use of more than two invasive procedures, and inappropriate antimicrobial therapy. Vigilance is needed to prevent outbreaks of this opportunistic and deadly pathogen.

  8. The Outcomes and Influencing Factors of Telecare Managing Patients with Type 2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    Yan-Ru Cheng

    2015-01-01

    Objective: This review aimed to examine the outcomes and influencing factors of telecare man-agement of type 2 diabetes, to provide some advice for medical staff and to inform decision mak-ers to promote the development of telecare in specific areas. Sources of information: The reference articles were mainly selected from the CNKI, Wanfang Database, PubMed, Science Direct and other resources. Following a systematic, comprehensive search of databases, a total of 1 062 qualitative, quantitative or mixed studies were initially select-ed; after careful review and screening, 45 studies were coded and analysed. Inclusion criteria: The articles were selected using the words "diabetic", "type 2 diabetes","telecare, telenursing, remote care or telemedicine", "outcomes or effect" and "influencing fac-tors". Type 2 diabetic who were intervened by electronic equipment are included. The patients who just have type1 diabetes are excluded, and those who were treated without using electronic equipment also are excluded. Results: Telecare produces positive results with a variety of outcomes, such as an improvement in the overall status of patients with type 2 diabetes, making full use of the medical staff resources and promoting the popularity of the hospital remotely; however, the factors which may prevent the development of telecare are various. Conclusions: Telecare has a positive effect in all aspects. With the development of technology and gradual changes in the people' s concept of e-health, telecare may have a brilliant future and may play a more important role in promoting human health.

  9. A study on factors influencing customer satisfaction: A case study of hospital dialysis patients

    Directory of Open Access Journals (Sweden)

    Zahra Jamalizadeh

    2013-10-01

    Full Text Available Quality of services is considered as one of the most important factors for customer retention as well as having a healthy business. In this paper, we present an empirical investigation to determine the most important factors influencing patients’ satisfaction in one of Iranian hospitals. The proposed model of this paper uses fuzzy analytical network process (FANP to rank different factors. The proposed model considers four major criteria including employee, management as well as organization, physicians and nurses. Our survey indicates that management and organizational issues are the most important factors followed by issues associated with physicians, nurses and employees. In terms of management and organization, waiting time to receive services is the most important factor followed by geographic location of the hospital, peaceful and quiet environment and quality of services. In addition, our surveyed patients expected their patients to listen to them very carefully and this is the most important item. They also expect nurses to provide a fast and reliable response while they expect employees to treat them with respect.

  10. Smoking and Histological Factors Influencing Long-term Survival of Gastric Carcinoma in Consecutive Patient Series

    Directory of Open Access Journals (Sweden)

    Ali Delpisheh

    2014-06-01

    Full Text Available Background: There is little information about the possible influence of lifestyle and etiologic risk factors on survival amongst patients with gastric cancer. Methods: We recruited a consecutive series of 249 patients with definite diagnosis of gastric cancer who had been hospitalized in Towhid Hospital, Sanandaj, Kurdistan Province in Western Iran during a five-year period from 2006 until 2011. Survival rate was calculated according to the Kaplan-Meier and log rank statistical methods. Cox hazard regression was used to investigate the effect of the variables and adjust for the effect of age. Results: According to univariate analysis, related variables that included age, gender, Residence, histology grade, histology type, familial history of gastrointestinal cancer and mental illness during the disease had no significant effects on survival rate variation. Significant independent factors on survival included past medical history of gastrointestinal diseases (P-value = 0.010, tobacco smoking (P-value = 0.012, and early diagnosis (P-value = 0.008. Cox-regression analysis of demographic, lifestyle and histological factors with >45 years of age as the reference revealed that patients 46-65 years of age at diagnosis (HR=0.602; 95% CI=0.250-1.44; P=0.256 and those >66 years of age (HR=1.07, 95% CI=0.46-2.50, P≤0.001 had an increased risk for disease progression and death. Conclusions: Past medical history of gastrointestinal diseases, tobacco smoking and early stage diagnosis might influence the long-term survival of patients with gastric cancer.

  11. Factors influencing referral of patients with voice disorders from primary care to otolaryngology.

    Science.gov (United States)

    Cohen, Seth M; Kim, Jaewhan; Roy, Nelson; Courey, Mark

    2014-01-01

    To evaluate the frequency, timing, and factors that influence referral of patients with laryngeal/voice disorders to otolaryngology following initial evaluation by a primary care physician (PCP). Retrospective analysis of a large, national administrative US claims database. Patients with a laryngeal disorder based on International Classification of Diseases, Ninth Revision, Clinical Modification codes from January 1, 2004 to December 31, 2008, seen by a PCP as an outpatient (with or without otolaryngology involvement), and continuously enrolled for 12 months were included. Patient age, gender, geographic region, last PCP laryngeal diagnosis, comorbid conditions, time from first PCP visit to first otolaryngology visit, number of PCP outpatient visits, and number of PCP laryngeal diagnoses were collected. Cox and generalized linear regressions were performed. A total of 149,653 unique patients saw a PCP as an outpatient for a laryngeal/voice disorder, with 136,152 (90.9%) only seeing a PCP, 6,013 (4.0%) referred by a PCP to an otolaryngologist, and 3,820 (2.6%) self-referred to an otolaryngologist. Acute laryngitis had a lower hazard ratio (HR) for otolaryngology referral than chronic laryngitis, nonspecific dysphonia, and laryngeal cancer. Having multiple comorbid conditions was associated with a greater HR for otolaryngology referral than having no comorbidities. Patient age, gender, and geographic region also affected otolaryngology referral. The time to otolaryngology evaluation ranged from 3 months. PCP-referred patients had less time to the otolaryngology evaluation than self-referred patients. Multiple factors affected otolaryngology referral for patients with laryngeal/voice disorders. Further education of PCPs regarding appropriate otolaryngology referral for laryngeal/voice disorders is needed. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  12. [Features and influencing factors of self-discrimination among HIV/AIDS patients according to sex].

    Science.gov (United States)

    Ju, L H; Lyu, P; Xu, P; Chen, W Y; He, H J; Ma, L P

    2016-10-06

    Objective: To investigate the features and influencing factors of self-discrimination among patients with HIV/AIDS according to sex. Methods: A total of 2 432 HIV/AIDS patients were recruited in Yunnan, Henan, Hubei, Jiangsu, Shanxi, Jilin, and Inner Mongolia provinces by a multistage stratified cluster sampling method, based on HIV epidemic and transmission modes, from May 2013 to October 2013. All participants were ≥18 years old, and we excluded those with mental disorders, hearing loss or other factors that prevented them from properly answering questions, and those who were unwilling to participate. A self-designed questionnaire was conducted to collect information about self-discrimination features and social behavior changes among HIV/AIDS patients. Differences in performance and self-discrimination features between participants of different sexes were compared using the chi-squared test. Factors influencing self-discrimination were analyzed by sex, using unconditional logistic regression. Results: Of the 2 432 cases, 78.9%(1 918 cases)were male and 21.1%(514 cases)female. The proportion of self-discrimination overall was 76.1%(1 850 cases); this proportion among female HIV/AIDS patients was 80.5%(414 cases), which was higher than that among men(74.9%, 1 436 cases)(χ(2)=7.17, P=0.007). Of the 11 forms of self-discrimination performance, proportions of feeling guilt, shame, and self-abasement among participants were greater than 50%. Proportions of feeling shame, inferiority, and blaming others among females were 61.3%, 59.5%, and 45.3%, respectively, which were higher than these among males(49.8%, 50.0%, 28.4%, respectively)(Pdiscrimination among those with HIV confirmatory testing time ≥1 year was higher than those with HIV confirmatory testing time discrimination among male farm workers was higher(OR=1.62, 95% CI:1.03-2.54). The risks of self-discrimination in males who had been infected with HIV by transmission routes of blood transfusion or blood

  13. Subjective Factors of the Hospital Environment and Their Influence on Psychological Well-being of Patients

    Directory of Open Access Journals (Sweden)

    Agalarova K.N.

    2015-06-01

    Full Text Available The article is devoted to the study of the relationship between man and the space around him, namely between the patient and hospital environment. The article gives a little insight into the history of the issue. The study held in a number of hospitals explored the influence of hospital environment on the psychological state of patients and their recovery, as well as the searching of behavior patterns of patients staying in the hospital. There are several main factors in the right treatment: the doctor’s qualification, quality of medical equipment, novelty of medical technology and medicines prescribed to patients but also the conditions of the hospital environment and trusting relationship between patient and doctor as well. This theme is insufficiently explored especially in Russian medicine. Its studying will serve as a referral base for a more effective treatment of patients, and also for a creating a conducive hospital environment. This theme is interdisciplinary in nature. Mainly it refers to the subject of environmental psychology, also located at the junction of personality, health psychology and rehabilitation psychology.

  14. Favorable prognostic influence of T-box transcription factor Eomesodermin in metastatic renal cell cancer patients.

    Science.gov (United States)

    Dielmann, Anastasia; Letsch, Anne; Nonnenmacher, Anika; Miller, Kurt; Keilholz, Ulrich; Busse, Antonia

    2016-02-01

    T-box transcription factors, T-box expressed in T cells (T-bet) encoded by Tbx21 and Eomesodermin (Eomes), drive the differentiation of effector/memory T cell lineages and NK cells. The aim of the study was to determine the prognostic influence of the expression of these transcription factors in peripheral blood (pB) in a cohort of 41 metastatic (m) RCC patients before receiving sorafenib treatment and to analyze their association with the immunophenotype in pB. In contrast to Tbx21, in the multivariate analysis including clinical features, Eomes mRNA expression was identified as an independent good prognostic factor for progression-free survival (PFS, p = 0.042) and overall survival (OS, p = 0.001) in addition to a favorable ECOG performance status (p = 0.01 and p = 0.008, respectively). Eomes expression correlated positively not only with expression of Tbx21 and TGFβ1 mRNA, but also with mRNA expression of the activation marker ICOS, and with in vivo activated HLA-DR(+) T cells. Eomes expression was negatively associated with TNFα-producing T cells. On protein level, Eomes was mainly expressed by CD56(+)CD3(-) NK cells in pB. In conclusion, we identified a higher Eomes mRNA expression as an independent good prognostic factor for OS and PFS in mRCC patients treated with sorafenib.

  15. Factors influencing outcomes after medial hamstring lengthening with semitendinosus transfer in patients with cerebral palsy.

    Science.gov (United States)

    Sung, Ki Hyuk; Lee, Jaebong; Chung, Chin Youb; Lee, Kyoung Min; Cho, Byung Chae; Moon, Seung Jun; Kim, Jaeyoung; Park, Moon Seok

    2017-08-14

    Although several studies have investigated the outcomes after distal hamstring lengthening (DHL), no study has undertaken an approach that included all or most of the important factors that could influence the results. This study was performed to evaluate the outcomes after DHL and analyze the factors that influence the improvement and serial change in knee motion after surgery in patients with cerebral palsy (CP), using a linear mixed model (LMM). The study included 314 ambulatory CP patients (594 limbs) with spsastic diplegia who were followed up after undergoing DHL as part of a single-event multilevel surgery and who underwent preoperative and postoperative 3-dimensional (3D) gait analyses. Relevant kinematic values, including knee flexion at initial contact, minimum knee flexion in the stance phase, knee range of motion (ROM), mean pelvic tilt and gait deviation index (GDI) score, were the outcome measures. Changes in knee motion and the GDI score were adjusted for multiple factors, such as sex, the Gross Motor Function Classification System (GMFCS) level, and concomitant surgeries as fixed effects, and follow-up duration, laterality, and each subject as random effects, using a LMM. We found significant improvements in knee flexion at initial contact, minimum knee flexion in the stance phase, knee ROM, and GDI score 2 years after DHL. In patients with GMFCS level I and II, improvement in all sagittal knee kinematics was maintained during follow-up. In addition, GDI score, which represents overall gait pathology, consistently improved throughout the follow-up duration (1.2 per year, p = 0.008). Medial hamstring lengthening with semitendinosus transfer, as a part of a SEMLS, was effective procedure in treating flexed knee gait with regard to sagittal knee kinematics and GDI score in spastic CP with flexed knee gait.

  16. Factors influencing the incidence of sinusitis in nasopharyngeal carcinoma patients after intensity-modulated radiation therapy.

    Science.gov (United States)

    Su, Yan-xia; Liu, Lan-ping; Li, Lei; Li, Xu; Cao, Xiu-juan; Dong, Wei; Yang, Xin-hua; Xu, Jin; Yu, Shui; Hao, Jun-fang

    2014-12-01

    The aim of the study was to investigate the incidence of sinusitis in nasopharyngeal carcinoma (NPC) patients before and after intensity-modulated radiation therapy (IMRT) and to analyze factors associated with the incidence of sinusitis following IMRT. We retrospectively analyzed 283 NPC patients who received IMRT in our hospital from March 2009 to May 2011. The diagnostic criteria for sinusitis are based on computed tomography (CT) or magnetic resonance imaging (MRI) findings. CT or MRI scans were performed before and after IMRT to evaluate the incidence of sinusitis. Factors influencing the incidence of sinusitis were analyzed by log-rank univariate and logistic multivariate analyses. Among the 283 NPC patients, 128 (45.2 %) suffered from sinusitis before radiotherapy. The incidence rates of sinusitis in patients with T1, T2, T3, and T4 NPC before radiotherapy were 22.6, 37.5, 46.8, and 61.3 %, respectively (χ 2 = 14.548, p = 0.002). Among the 155 NPC patients without sinusitis before radiotherapy, the incidence rates of sinusitis at the end of radiotherapy and at 1, 3, 6, 9, 12, and 18 months after radiotherapy were 32.9, 43.2, 61.3, 68.4, 73.5, 69.7, and 61.3 %, respectively (χ 2 = 86.461, p sinusitis in NPC patients after IMRT (p = 0.003, 0.006, 0.002, and 0.020). Multivariate analysis showed that T stage, invasion of the nasal cavity, and nasal irrigation were influential factors for the incidence of sinusitis in NPC patients after IMRT (p = 0.002, 0.002, and 0.000). There was a higher incidence of sinusitis with higher T stage among NPC patients before radiotherapy, and the incidence of sinusitis in NPC patients after IMRT was high (45.2 %). The incidence of sinusitis increased rapidly within the first 3 months after IMRT, and the number of sinusitis cases peaked at 6-9 months after IMRT and showed a trend toward stabilization after 1 year. Advanced T stage, invasion of the nasal cavity, and nasal irrigation were positively associated with the incidence

  17. Factors influencing the quality of life in patients with HIV in Malaysia.

    Science.gov (United States)

    Hasanah, C I; Zaliha, A R; Mahiran, M

    2011-02-01

    The aim of this study was to determine the socio-demographic, clinical and psychological factors influencing the quality of life (QOL) in patients with human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS). This was a cross-sectional study on 271 patients with HIV infection attending an HIV clinic in Kota Bharu, Malaysia. Participants completed the Malay version of the Functional Assessment of HIV Infection (FAHI) and Malay Hospital Anxiety Depression Scale (HADS). The patients functioned satisfactorily in the physical domain. They were mostly impaired in the social domain. Those who acquired the HIV infection via a heterosexual route seemed to have a significantly lower social well-being, while those who acquired HIV via drug injection were not associated with losses in the overall QOL or any of its domains. Non-disclosure paradoxically had a greater effect on social well-being. About 38% had possible anxiety, depression or both, and these emotional disturbances were significantly associated with total FAHI and its five domains. Psychological and social well-beings were more affected than physical well-being in out-patients with HIV infection in Kota Bharu, Malaysia. The study suggests that the patients with HIV infection should receive better psycho-education and psychological intervention.

  18. Factors that influence outcome in non-invasive and invasive treatment in polycystic liver disease patients

    Institute of Scientific and Technical Information of China (English)

    Josué Barahona-Garrido; Jesús Camacho-Escobedo; Eduardo Cerda-Contreras; Jorge Hernández-Calleros; Jesús K Yamamoto-Furusho; Aldo Torre; Misael Uribe

    2008-01-01

    AIM:To evaluate the factors that influence outcome of both non-invasive and invasive treatment of polycystic liver disease.METHODS:Analysis of clinical files of patients with complete follow-up from ]uly 1986 to June 2006.RESULTS:Forty-one patients (male,7;female,34),47.8 + 11.9 years age,and 5.7±6.7 years follow-up,were studied.Alkaline phosphatase (AP) elevation (25% of patients) was associated with the requirement of invasive treatment (IT,P = 0.005).IT rate was higher in symptomatic than non-symptomatic patients (65.4% vs 14.3%,P = 0.002),and in women taking hormonal replacement therapy (HRT) (P = 0.001).Cysts complications (CO) were more frequent (22%) in the symptomatic patients group (P = 0.023).Patients with body mass index (BMI) > 25 (59%) had a trend to complications after IT (P = 0.075).Abdominal pain was the most common symptom (56%) and indication for IT (78%).Nineteen patients (46%) required a first IT:12 open fenestration (OF),4 laparoscopic fenestration (LF) and 3 fenestration with hepatic resection (FHR).Three required a second IT,and one required a third procedure.Complications due to first IT were found in 32% (OF 16.7%,LF 25%,FHR 66.7%),and in the second IT in 66.7% (OF 100%).Follow-up mortality rate was 0.COMCLUSlON:Presence of symptoms,elevatedAP,and CC are associated with IT requirement.HRT is associated with presence of symptoms and IT requirement.Patients with BMI > 25 have a trend be susceptible to IT complications.The proportions of complications are higher in FHR and second IT groups.RS is more frequent after OF.

  19. Factors influencing hearing outcomes in pediatric patients undergoing ossicular chain reconstruction.

    Science.gov (United States)

    Govil, Nandini; Kaffenberger, Thomas M; Shaffer, Amber D; Chi, David H

    2017-08-01

    Ossicular chain disruption in children leads to conductive hearing loss. Few studies have focused on factors influencing successful results in pediatric ossicular chain reconstruction (OCR). We aim to determine whether demographic or surgical factors affect hearing outcomes in pediatric OCR. We conducted a retrospective chart review of 120 patients undergoing OCR at our institution, a tertiary care hospital, between 2003 and 2014, with median length of follow-up of 2.2 years (range 0.1-9.3 years). Pediatric patients (hearing (PTA ≤25 dB) post-operatively. Post-operative SRT and ABG were significantly better in patients with partial ossicular replacement prosthesis (PORP) compared with those with total ossicular replacement prosthesis (TORP) (p = 0.016, 0.027). Titanium prostheses resulted in better post-operative PTA and larger changes in PTA compared with all other materials (p = 0.034, p = 0.038). In our experience, children with titanium prostheses had better hearing outcomes than those with other materials, and children with PORP had better hearing outcomes than those with TORP. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Prospective analysis of the factors influencing the antibody response to hepatitis B vaccine in hemodialysis patients.

    Science.gov (United States)

    Peces, R; de la Torre, M; Alcázar, R; Urra, J M

    1997-02-01

    Hepatitis B vaccine is effective in producing protection against hepatitis B virus (HBV) infection in hemodialysis (HD) patients, but the antibody response is variable. To identify those factors implicated in the vaccine response, in a prospective study over a 24-month period, we vaccinated 80 seronegative patients on HD (group A) and monitored clinical, biochemical, and immunologic parameters. The protective immunity acquired by vaccination was compared with that developed through HBV infection in 22 age-matched HD patients (group B). The anti-HBs antibody-seronegative patients followed a four-dose vaccination schedule (0, 1, 2, and 6 months) with 40 microg DNA-recombinant hepatitis B vaccine. One month after vaccination, 77.5% of the patients had seroconverted, and 72.5% achieved high antibody response, whereas 22.5% were nonresponders. Patients aged younger than 40 years seroconverted 100%; those aged 40 to 60 years, 75% (P < 0.01); and patients older than 60 years, 74% (P < 0.001). No differences between responders and nonresponders concerning sex, time on HD, HD dose, nutritional status, hemoglobin level, HD membrane, iPTH level, calcitriol treatment, or number of transfusions during vaccination were found. The presence of other factors, such as recombinant human erythropoietin (rHuEPO) therapy or hepatitis C virus (HCV) infection, did not significantly influence antibody responses to hepatitis B immunization. A greater frequency of DR3 (53.8% v 25.7%, P < 0.05), DR7 (53.8% v 18.6%, P < 0.01), and DQ2 (76.9% v 44.1%, P < 0.05), and a lesser frequency of A2 (7.7% v 37.2%, P < 0.05) were found in nonresponders compared with responders. Eighteen months after vaccination, the analysis showed similar antibody titers but lower seroconversion rates in group A as compared with group B. In conclusion, unresponsiveness to hepatitis B vaccine in HD patients was related to factors such as older age, the presence of DR3, DR7, and DQ2, and the absence of A2 alleles

  1. The influence of contextual factors on patient involvement during follow-up consultations after colorectal cancer surgery

    DEFF Research Database (Denmark)

    Thomsen, Thora G; Soelver, Lisbeth; Hølge-Hazelton, Bibi

    2017-01-01

    AIMS AND OBJECTIVES: To identify the contextual factors that influence individual patient involvement during colorectal cancer surgical follow-up consultations. BACKGROUND: The healthcare system is subject to the requirement and expectation of greater involvement of patients and relatives...... the identification of current contextual factors. RESULTS: The results showed five contextual factors that seemed to have an impact on patient involvement. The first, 'Two dimensions of patient involvement: treatment-oriented and person-oriented' highlighted a dual interpretation of patient involvement...... in the consultation situation. The two dimensions seemed to be influenced by four additional factors: 'Doctors leading the agenda', 'Traditional health professional roles', 'Unclear responsibilities' and 'Guidance primarily focused on treatment'. CONCLUSION: The results showed how patient involvement in clinical...

  2. Factors influencing the missed nursing care in patients from a private hospital.

    Science.gov (United States)

    Hernández-Cruz, Raúl; Moreno-Monsiváis, María Guadalupe; Cheverría-Rivera, Sofía; Díaz-Oviedo, Aracely

    2017-07-10

    to determine the factors that influence the missed nursing care in hospitalized patients. descriptive correlational study developed at a private hospital in Mexico. To identify the missed nursing care and related factors, the MISSCARE survey was used, which measures the care missed and associated factors. The care missed and the factors were grouped in global and dimension rates. For the analysis, descriptive statistics, Spearman's correlation and simple linear regression were used. Approval for the study was obtained from the ethics committee. the participants were 71 nurses from emergency, intensive care and inpatient services. The global missed care index corresponded to M=7.45 (SD=10.74); the highest missed care index was found in the dimension basic care interventions (M=13.02, SD=17.60). The main factor contributing to the care missed was human resources (M=56.13, SD=21.38). The factors related to the care missed were human resources (rs=0.408, precursos humanos (M=56,13, DE=21,38). Os fatores relacionados ao cuidado omitido foram os recursos humanos (rs=0,408, precursos humanos; com base nos resultados deste estudo pode-se fortalecer a continuidade do cuidado de enfermagem. determinar los factores que influyen en el cuidado de enfermería perdido en pacientes hospitalizados. estudio descriptivo correlacional, se realizó en un hospital privado de México. Para identificar el cuidado perdido y factores relacionados se utilizó el instrumento MISSCARE que mide el cuidado perdido y los factores asociados. El cuidado perdido y los factores se agruparon en índices globales y por dimensiones. Para el análisis se utilizó estadística descriptiva, correlación de Spearman y regresión lineal simple. El estudio fue aprobado por el comité de ética. participaron 71 enfermeras de los servicios de urgencias, terapia intensiva y hospitalización. El índice global de cuidado perdido mostró una M=7,45 (DE=10,74); el índice con mayor cuidado perdido correspondió a

  3. Malignant bowel obstruction in advanced cancer patients: epidemiology, management, and factors influencing spontaneous resolution

    Directory of Open Access Journals (Sweden)

    Tuca A

    2012-06-01

    Full Text Available Albert Tuca1, Ernest Guell2, Emilio Martinez-Losada3, Nuria Codorniu41Cancer and Hematological Diseases Institute, Hospital Clínic de Barcelona, Barcelona, Spain; 2Palliative Care Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; 3Palliative Care Unit, Institut Català Oncologia Badalona, Barcelona, Spain; 4Medical Oncology Department, Institut Català Oncologia L'Hospitalet, Barcelona, SpainAbstract: Malignant bowel obstruction (MBO is a frequent complication in advanced cancer patients, especially in those with abdominal tumors. Clinical management of MBO requires a specific and individualized approach that is based on disease prognosis and the objectives of care. The global prevalence of MBO is estimated to be 3% to 15% of cancer patients. Surgery should always be considered for patients in the initial stages of the disease with a preserved general status and a single level of occlusion. Less invasive approaches such as duodenal or colonic stenting should be considered when surgery is contraindicated in obstructions at the single level. The priority of care for inoperable and consolidated MBO is to control symptoms and promote the maximum level of comfort possible. The spontaneous resolution of an inoperable obstructive process is observed in more than one third of patients. The mean survival is of no longer than 4–5 weeks in patients with consolidated MBO. Polymodal medical treatment based on a combination of glucocorticoids, strong opioids, antiemetics, and antisecretory drugs achieves very high symptomatic control. This review focuses on the epidemiological aspects, diagnosis, surgical criteria, medical management, and factors influencing the spontaneous resolution of MBO in advanced cancer patients.Keywords: malignant bowel obstruction, cancer, intestinal obstruction, bowel occlusion

  4. Delayed High-dose Methotrexate Excretion and Influencing Factors in Osteosarcoma Patients

    Institute of Scientific and Technical Information of China (English)

    Wei Zhang; Qing Zhang; Ting-Ting Zheng; Jian-Cun Zhen; Xiao-Hui Niu

    2016-01-01

    Background:High-dose methotrexate (HD-MTX) with folinic acid (leucovorin) rescue is "gold standard" therapy for osteosarcoma.Plasma concentrations of methotrexate (MTX) are closely related to its efficacy and toxicity.Delayed excretion of MTX can lead to serious adverse reactions that may result in treatment cessation,irreversible organ damage,and death.This study focused on the incidence of delayed excretion of MTX in Chinese osteosarcoma patients.Methods:A total of 1277 osteosarcoma patients were treated with HD-MTX chemotherapy (4291 cycles) from 2010 to 2015.Factors that could influence delayed excretion of MTX (gender,age,number of chemotherapy cycles,and serum concentration of MTX) were analyzed.Results:The incidence of delayed excretion of MTX (serum concentrations at 24 h [C24 h] >5 μmol/L) and severe delayed excretion of MTX (C24 h >20 μmol/L) were 6.19% and 0.86% per patient,and 2.31% and 0.26% per cycle of treatment,respectively.The incidence of severe delayed excretion of MTX was associated with gender,age,and C24 h.Conclusions:Precaution of delayed excretion of MTX is needed during osteosarcoma treatment using HD-MTX.An optimal individualized rescue strategy can be created with consideration of gender,age,and C24 h.

  5. Factors influencing treatment default among tuberculosis patients in a high burden province of South Africa.

    Science.gov (United States)

    Kigozi, G; Heunis, C; Chikobvu, P; Botha, S; van Rensburg, D

    2017-01-01

    To determine and describe the factors influencing treatment default of tuberculosis (TB) patients in the Free State Province of South Africa. A retrospective records review of pulmonary TB cases captured in the ETR.Net electronic TB register between 2003 and 2012 was performed. Subjects were >15 years of age and had a recorded pre-treatment smear result. The demographic and clinical characteristics of defaulters were described. Multivariate logistic regression analysis was used to determine factors associated with treatment default. The odds ratios (OR) together with their corresponding 95% confidence intervals (CI) were estimated. Statistical significance was considered at 0.05. A total of 7980 out of 110 349 (7.2%) cases defaulted treatment. Significantly higher proportions of cases were male (8.3% vs. female: 5.8%; p64 years: 3.9%; ptreatment sputum smear result (7.8% vs. positive smear results: 7.1%; ptreatment (95.5% vs. >2 months: 4.8%; ptreatment when being retreated compared to being treated for the first time for TB (adjusted OR (AOR) 2.0, 95% CI 1.85-2.25). Female cases were 40% less likely to default treatment compared to their male counterparts (AOR 0.6, 95% CI 0.51-0.71). Treatment default was less likely among cases >24 years old compared to younger cases (25-34 years: AOR 0.8, 95% CI 0.77-0.87; 35-44 years: AOR 0.6, 95% CI 0.50-0.64; 45-54 years: AOR 0.4, 95% CI 0.32-0.49; 55-64 years: AOR 0.3, 95% CI 0.21-0.43; >64 years: AOR 0.3, 95% CI 0.19-0.35). Co-infected cases receiving antiretroviral therapy (ART) were 40% less likely to default TB treatment relative to those whose ART status was unknown (AOR 0.6, 95% CI 0.46-0.57). Salient factors influence TB patient treatment default in the Free State Province. Therefore, the strengthening of clinical and programmatic interventions for patients at high risk of treatment default is recommended. In particular, ART provision to co-infected cases facilitates TB treatment adherence and outcomes. Copyright

  6. Patient factors that influence clinicians' decision making in self-management support: A clinical vignette study.

    Science.gov (United States)

    Bos-Touwen, Irene D; Trappenburg, Jaap C A; van der Wulp, Ineke; Schuurmans, Marieke J; de Wit, Niek J

    2017-01-01

    Self-management support is an integral part of current chronic care guidelines. The success of self-management interventions varies between individual patients, suggesting a need for tailored self-management support. Understanding the role of patient factors in the current decision making of health professionals can support future tailoring of self-management interventions. The aim of this study is to identify the relative importance of patient factors in health professionals' decision making regarding self-management support. A factorial survey was presented to primary care physicians and nurses. The survey consisted of clinical vignettes (case descriptions), in which 11 patient factors were systematically varied. Each care provider received a set of 12 vignettes. For each vignette, they decided whether they would give this patient self-management support and whether they expected this support to be successful. The associations between respondent decisions and patient factors were explored using ordered logit regression. The survey was completed by 60 general practitioners and 80 nurses. Self-management support was unlikely to be provided in a third of the vignettes. The most important patient factor in the decision to provide self-management support as well as in the expectation that self-management support would be successful was motivation, followed by patient-provider relationship and illness perception. Other factors, such as depression or anxiety, education level, self-efficacy and social support, had a small impact on decisions. Disease, disease severity, knowledge of disease, and age were relatively unimportant factors. This is the first study to explore the relative importance of patient factors in decision making and the expectations regarding the provision of self-management support to chronic disease patients. By far, the most important factor considered was patient's motivation; unmotivated patients were less likely to receive self-management support

  7. [Factors Influencing Quality of Life during Chemotherapy for Colorectal Cancer Patients in South Korea].

    Science.gov (United States)

    Baek, Yongae; Yi, Myungsun

    2015-08-01

    The purpose of this study was to investigate the levels of physical symptoms, anxiety, depression, and quality of life (QOL) during chemotherapy for colorectal cancer patients in South Korea and to identify factors influencing their QOL. Data were collected from 144 colorectal cancer patients receiving chemotherapy during 2012 at one general hospital located in Seoul. Physical symptoms were measured by the M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module, and anxiety and depression were measured by the Hospital Anxiety Depression Scale. QOL was measured by the Functional Assessment of Cancer Therapy-Colorectal. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Scheffé post hoc test, Pearson correlation and stepwise multiple regression. Mean age of the participants was 56.6 and most of them were not employed. In terms of cancer stage, 38.2% were in stage 3, followed by stage 4 (34.7%). The most frequent symptom was lack of appetite, followed by sleep disturbance and fatigue. The mean score for anxiety was 5.40 with a prevalence of 23% and that of depression 8.85 with a prevalence of 64.6%. The mean score for quality of life was 81.93 out of 136 and 75.3% of the variance in QOL was explained by depression, symptoms, anxiety, treatment place, and occupational status. Depression was the strongest predictive factor. Oncology professionals need to pay special attention to relieving depression as well as physical symptoms to improve QOL during chemotherapy for colorectal cancer patients.

  8. Influence of nutritional factors and hemodialysis adequacy on the survival of 1,610 French patients.

    Science.gov (United States)

    Combe, C; Chauveau, P; Laville, M; Fouque, D; Azar, R; Cano, N; Canaud, B; Roth, H; Leverve, X; Aparicio, M

    2001-01-01

    Nutritional factors and dialysis adequacy are associated with outcome in hemodialyzed patients, but their relative contribution remains controversial, particularly when dialysis adequacy complies with current recommendations (Kt/V >1.2). Survival, clinical, and nutritional data from a cohort of prevalent 1,610 patients treated by hemodialysis in 20 centers in France have been collected over a 2.5-year period, from January 1996 to July 1998. Data including age, sex, cause of end-stage renal disease (ESRD), clinical outcome, time on dialysis, body mass index (BMI), blood levels of midweek predialysis albumin, prealbumin, and bicarbonate were analyzed. Normalized protein catabolic rate (nPCR), dialysis adequacy parameters, and estimation of lean body mass (LBM) from creatinine generation were computed from pre- and postdialysis urea and creatinine levels. The characteristics of the patients were as follows: age 59.6 +/- 16.5 years, 58.8% males, 11% of diabetics, time on dialysis 63.2 +/- 64.5 m. Weekly dialysis time was 12.18 +/- 1.78 hrs, Kt/V 1.34 +/- 0.34, nPCR 1.10 +/- 0.35 g/kg body weight/day. Albumin concentration was 39.4 +/- 5.3 g/L, prealbumin was 0.33 +/- 0.09 g/L, BMI was 23.0 +/- 4.5 kg/m(2). Overall survival was 89.7% +/- 0.8% and 78.4% +/- 1.1% after 1 and 2 years. In the Cox proportional hazard model, survival was significantly influenced by age, the presence of diabetes, and by concentrations of albumin and prealbumin, but not by other variables, including Kt/V and urea reduction ratio. These results indicate that nutritional protein concentrations were predictive of dialysis outcome, whereas variables reflecting actual body composition and dialysis dose were not. Furthermore, in this well-dialyzed population, dialysis adequacy had no influence on survival. In conclusion, when adequacy targets are met in hemodialyzed patients, survival is mainly dependent on age and nutritional status. Efforts should be focused on the most efficient ways to maintain

  9. Factors influencing transfusion requirement in patients undergoing first-time, elective coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Ailin Mazuita Mazlan

    2017-01-01

    Conclusions: By stratifying patients according to their risk factor for red cell transfusion, the high-risk patients could be recognized and should be enrolled into effective patient blood management program to minimize their risk of exposure to allogeneic blood transfusion.

  10. Genetic factors influencing inhibitor development in a cohort of South African haemophilia A patients.

    Science.gov (United States)

    Lochan, A; Macaulay, S; Chen, W C; Mahlangu, J N; Krause, A

    2014-09-01

    A critical complication of factor VIII (FVIII) replacement therapy in Haemophilia A (HA) treatment is inhibitor development. Known genetic factors predisposing to inhibitor development include FVIII (F8) gene mutations, ethnicity, a family history of inhibitors and FVIII haplotype mismatch. The aim of this study was to characterize and correlate these genetic factors in a cohort of South African HA patients. This was a retrospective study that included 229 patients and involved the analysis of patient files, HA molecular and clinical databases and molecular analysis of the F8 gene haplotype. Of the 229 patients, 51% were of black ethnicity, 49% were white, 5% had mild HA, 4% were moderate and 91% were severe, 36% were int22 positive and 13% were inhibitor positive. Of the inhibitor positive patients, 72% were black patients. Inhibitors were reported in 27% of black int22 positive patients, 13% of black int22 negative patients, 9% of white int22 positive patients and 7% of white int22 negative. The H1 haplotype was more common in whites (75%) and H2 was more common in blacks (74%). H3 and H5 were only found in black patients and had a higher frequency of inhibitor development than H1 and H2. In this small HA cohort, black patients had a significantly higher frequency of inhibitor development and the results were indicative of an association between inhibitor development, ethnicity and haplotype. © 2014 John Wiley & Sons Ltd.

  11. Factors influencing preoperative stress response in coronary artery bypass graft patients

    Directory of Open Access Journals (Sweden)

    Wulf Hinnerk

    2004-09-01

    Full Text Available Abstract Background In many studies investigating measures to attenuate the hemodynamic and humoral stress response during induction of anaesthesia, primary attention was paid to the period of endotracheal intubation since it has been shown that even short-lasting sympathetic cardiovascular stimulation may have detrimental effects on patients with coronary artery disease. The aim of this analysis was, however, to identify the influencing factors on high catecholamine levels before induction of anaesthesia. Methods Various potential risk factors that could impact the humoral stress response before induction of anaesthesia were recorded in 84 males undergoing coronary aortic bypass surgery, and were entered into a stepwise linear regression analysis. The plasma level of norepinephrine measured immediately after radial artery canulation was chosen as a surrogate marker for the humoral stress response, and it was used as the dependent variable in the regression model. Accordingly, the mean arterial blood pressure, heart rate and the calculated pressure-rate product were taken as parameters of the hemodynamic situation. Results Stepwise regression analysis revealed that the oral administration of low-dose clonidine (mean dose 1.75 μg·kg-1 on the morning of surgery was the only significant predictor (p = 0.004 of the high variation in preoperative norepinephrine plasma levels. This intervention decreased norepinephrine levels by more than 40% compared to no clonidine administration, from 1.26 to 0.75 nmol·l-1. There was no evidence for dose-responsiveness of clonidine. All other potential predictors were removed from the model as insignificant (p > 0.05. The use of beta-blocker, ace-inhibitors, ejection fraction, and body mass index were significant determinants for the hemodynamic situation (heart rate, mean arterial pressure, pressure rate product of the patient during the pre-induction period. Conclusion The oral administration of clonidine is

  12. Discharge Planning for Dementia Patients: Factors Influencing Caregiver Decisions and Satisfaction.

    Science.gov (United States)

    Cox, Carole B.

    1996-01-01

    Data on discharge process and caregiver satisfaction were collected from 179 caregivers of hospitalized dementia patients. Findings indicate that social workers are important influences in discharge decisions especially when discharge is to a nursing home. Findings from regression analyses indicate that caregiver satisfaction is dependent on the…

  13. Facility-Level Factors Influencing Retention of Patients in HIV Care in East Africa

    Science.gov (United States)

    Easterbrook, Philippa; Genberg, Becky; Braithwaite, Ronald Scott; Cohen, Craig R.; Bukusi, Elizabeth A.; Kambugu, Andrew; Bwana, Mwebesa Bosco; Somi, Geoffrey R.; Geng, Elvin H.; Musick, Beverly; Yiannoutsos, Constantin T.; Wools-Kaloustian, Kara; Braitstein, Paula

    2016-01-01

    Losses to follow-up (LTFU) remain an important programmatic challenge. While numerous patient-level factors have been associated with LTFU, less is known about facility-level factors. Data from the East African International epidemiologic Databases to Evaluate AIDS (EA-IeDEA) Consortium was used to identify facility-level factors associated with LTFU in Kenya, Tanzania and Uganda. Patients were defined as LTFU if they had no visit within 12 months of the study endpoint for pre-ART patients or 6 months for patients on ART. Adjusting for patient factors, shared frailty proportional hazard models were used to identify the facility-level factors associated with LTFU for the pre- and post-ART periods. Data from 77,362 patients and 29 facilities were analyzed. Median age at enrolment was 36.0 years (Interquartile Range: 30.1, 43.1), 63.9% were women and 58.3% initiated ART. Rates (95% Confidence Interval) of LTFU were 25.1 (24.7–25.6) and 16.7 (16.3–17.2) per 100 person-years in the pre-ART and post-ART periods, respectively. Facility-level factors associated with increased LTFU included secondary-level care, HIV RNA PCR turnaround time >14 days, and no onsite availability of CD4 testing. Increased LTFU was also observed when no nutritional supplements were provided (pre-ART only), when TB patients were treated within the HIV program (pre-ART only), and when the facility was open ≤4 mornings per week (ART only). Our findings suggest that facility-based strategies such as point of care laboratory testing and separate clinic spaces for TB patients may improve retention. PMID:27509182

  14. Influence of psychosocial factors on treatment of elderly Chinese patients with hypertension

    Institute of Scientific and Technical Information of China (English)

    Guolong Yu; Tianlun Yang; Cesar V. Borlongan; Christine E. Stahl; Xiumei Xie; Jin He; Biefei Li; Ke Xia

    2007-01-01

    Objective The aim of the study is to investigate the effects of psychosocial factors on the treatment of elderly patients with hypertension. Methods Atotalof 260 elderly Chinese patients with hypertension were treated with benazepril alone or benazepril combined with amlodipine for 8 weeks. The target blood pressure (BP) (both <140 mmHg systolic, SBP, and <90 mmHg diastolic, DBP)was achieved in 180 patients, who were then assigned to the well-controlled BP group; the rest were placed in the modestly controlled BP group. The psychosocial factors present in both groups were assessed by the Hamilton depression scale, Hamilton anxiety scale, life event scale and social support evaluation list before and after anti-hypertensive treatment. Results There were no significant differences in gender, mean age, hist ory of hypertension, education and smoking habit, or in SBP and DBP between the groups before treatment.Significant differences were also not found in all psychosocial factors before and after treatment in the patients. However, significant differences were found between the groups with respect to post-treatment SBP and marital status. The patients with modestly controlled BP had significantly higher scores, as well as incidents, on the depressive, anxiety, and stressful life event scales than those with well-controlled BP. The patients with well-controlled BP had significantly higher scores in tangible support, subjective support,and social support compared to the patients with modestly controlled BP. Logistic regression analysis showed the independent contribution of psychosocial factors in reaching the goal of lowering BP at treatment endpoint in these hypertensive patients. Conclusions The results suggest that psychosocial factors stand as a main barrier to achieving the BP-lowering target in the management of elderly Chinese patients with hypertension.

  15. Factors Influencing Depression Endpoints Research (FINDER: baseline results of Italian patients with depression

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    Grassi Luigi

    2009-05-01

    Full Text Available Abstract Background Factors Influencing Depression Endpoints Research (FINDER is a 6-month, prospective, observational study carried out in 12 European countries aimed at investigating health-related quality of life (HRQoL in outpatients receiving pharmacological treatment for a first or new depressive episode. Baseline characteristics of patients enrolled in Italy are presented. Methods All treatment decisions were at the discretion of the investigator. Data were collected at baseline and after 3 and 6 months of treatment. Baseline evaluations included demographics, medical and psychiatric history, and medications used in the last 24 months and prescribed at enrolment. The Hospital Anxiety and Depression Scale (HADS, was adopted to evaluate depressive symptoms, while somatic and painful physical symptoms were assessed by using the Somatic Symptom Inventory (SSI and a 0 to 100 mm visual analogue scale (VAS, HRQoL via 36-item Short Form Health Survey (SF-36, and the European Quality of Life 5-Dimensions (EQ-5D instrument. Results A total of 513 patients were recruited across 38 sites. The mean ± standard deviation (SD age at first depressive episode was 38.7 ± 15.9 years, the mean duration of depression 10.6 ± 12.3 years. The most common psychiatric comorbidities in the previous 24 months were anxiety/panic (72.6% and obsessive/compulsive disorders (13.4%, while 35.9% had functional somatic syndromes. Most patients (65.1% reported pain from any cause. Monotherapy with selective serotonin reuptake inhibitors (SSRIs and tricyclic antidepressants (TCAs was prescribed at enrolment in 64.5% and 6.4% of the cases, respectively. The most commonly prescribed agents were sertraline (17.3%, escitalopram (16.2%, venlaflaxine (15.6% and paroxetine (14.8%. The mean HADS subscores for depression and anxiety were 13.3 ± 4.2 and 12.2 ± 3.9, respectively; 76.4% of patients could be defined as being 'probable cases' for depression and 66.2% for anxiety. The

  16. Adherence to treatment and influencing factors in a sample of Chinese epilepsy patients.

    Science.gov (United States)

    Liu, Jianming; Liu, Zhiliang; Ding, Hu; Yang, Xiaohong

    2013-09-01

    To assess adherence to antiepileptic drugs (AEDs) and factors associated with non-adherence in a sample of Chinese patients with epilepsy. A cross-sectional descriptive study was carried out on patients who had no change in treatment regimen over the last six months. Data on adherence to medication and related factors for each patient were gathered using a questionnaire. Of a total of 368 patients studied, 48.1% of patients were non-adherent with regards to AEDs. There were no demographic differences (based on gender, age, seizure type, and rural or urban location) between adherent and non-adherent patients. Adherence was positively and significantly correlated with duration of illness (p=0.007). The primary reason for non-adherence was forgetfulness or not having medication on hand (69.6%), followed by a negative attitude (12.8%), a bad patient-prescriber relationship (9.5%), side effects (5.4%), inability to buy drugs (1.9%), and other reasons (0.8%). The non-adherence of epilepsy patients is common in China. Targeted management programs and communication strategies are necessary to improve adherence to AED treatments in patients with epilepsy and avoid the clinical consequences of poor adherence.

  17. Factors influencing the implementation of a lifestyle counseling program in patients with venous leg ulcers: a multiple case study

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    van de Glind Irene M

    2012-10-01

    Full Text Available Abstract Background Implementation of lifestyle interventions in patient care is a major challenge. Understanding factors that influence implementation is a first step in programs to enhance uptake of these interventions. A lifestyle-counseling intervention, Lively Legs, delivered by trained nurses, can effectively improve the lifestyle in patients with venous leg ulcers. The aim of this study was to identify factors that hindered or facilitated implementation of this intervention in outpatient dermatology clinics and in home care. Methods A mixed-methods multiple case study in five purposefully selected healthcare settings in the Netherlands was conducted. Measurements to identify influencing factors before and after implementation of Lively Legs included interviews, focus groups, questionnaires, and nurses’ registration. Analyses focused on qualitative data as the main data source. All data were compared across multiple cases to draw conclusions from the study as a whole. Results A total of 53 patients enrolled in the Lively Legs program, which was delivered by 12 trained nurses. Barriers for implementation were mainly organizational. It was difficult to effectively organize reaching and recruiting patients for the program, especially in home care. Main barriers were a lack of a standardized healthcare delivery process, insufficient nursing time, and a lack of motivated nurses to deliver the program. Facilitating factors were nurse-driven coordination of care and a standardized care process to tie Lively Legs into, as this resulted in better patient recruitment and better program implementation. Conclusions This study identified a range of factors influencing the implementation of a lifestyle-counseling program, mainly related to the organization of healthcare. Using a case study method proved valuable in obtaining insight into influencing factors for implementation. This study also shed light on a more general issue, which is that leg ulcer

  18. Receipt of physical therapy among osteoarthritis patients and its influencing factors.

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    Yeh, Huan-Jui; Chou, Yiing-Jenq; Yang, Nan-Ping; Huang, Nicole

    2015-06-01

    To explore major patient and provider characteristics influencing the receipt of physical therapy (PT) among patients newly diagnosed with osteoarthritis. A population-based, cross-sectional study on outpatient PT for patients newly diagnosed with osteoarthritis within the period of 2005 to 2010. Sample of 1 million National Health Insurance enrollees. People aged ≥18 years with an incidence of osteoarthritis and receiving initial outpatient treatment. A total of 29,012 patients were included (N=29,012). Not applicable. The outcome variable of interest was the probability of receiving PT within 1 year of osteoarthritis diagnosis. Both individual and provider characteristics were investigated to determine their influence on PT receipt. Of the 29,012 included patients with osteoarthritis, only 24.8% of them received PT within the first year of diagnosis. Men and older adults were less likely to receive PT. In addition, low-income patients with osteoarthritis were less likely to receive PT. Furthermore, PT receipt was increased in patients treated by physicians who were women and by physicians who specialized in rehabilitation medicine. In addition, we observed a pattern indicating that the lower the accreditation level of the practice setting, the greater the probability of receiving PT. Because of the National Health Insurance program in Taiwan, direct medical costs of PT have been substantially reduced; however, variations are still observed among different patient and provider characteristics. The major role of providers in PT receipt for patients with osteoarthritis should not be ignored. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Factors influencing a patient's decision to choose the type of treatment to improve dental esthetics

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    Gržić Renata

    2012-01-01

    Full Text Available Backgroung/Aim. Interest in dental esthetics has increased rapidly during the last few decades among both patients and dentists, and the creation of a natural dental appearance has become an important task in all fields of dentistry, especially in prosthodontics and restorative dentistry. The aim of this research was to investigate factors influencing a patient's decision to choose the type of treatment to improve dental esthetics. Methods. A total of 700 Caucasian subjects participated in the crosssectional study (261 men, 439 women, aged 18-86 years, mean age 46.2 ± 18.6. The study included clinical examination and a self-administrated questionnaire based on self-perceived esthetics, satisfaction with the appearance of their maxillary anterior teeth and previous dental experience. Multiple logistic regression was used in statistical analysis. Results. Hiding teeth during smile was the most important predictor for choosing fixed prosthetic restorations (OR 9.1, followed by self-perceived bad fixed prosthesis, malpositioned teeth and female gender (OR 2.9, 2.4, and 1.5, respectively. The increase in satisfaction with dental appearance and previous orthodontic therapy reduced chances for seeking prosthetic therapy (each OR 0.4. The significant predictors for bleaching choosing were hiding teeth during smiling, already done bleaching, female gender, lower levels of satisfaction with dental appearance and the absence of the previous orthodontic therapy (OR 5.8, 2.4, 1.8, 0.5 and 0.4, respecitively. Hiding teeth during smile, self-perceived malposition and crowding, and lower levels of satisfaction, were significant predictors for choosing orthodontic treatment (OR 3.1, 2.4, 2.2 and 0.6, respectively. None of current dental statuses was statistically significant predictor for choosing prosthodontic, bleeching nor orthodontic therapy. Conclusion. The psychological elements and female gender are the main predictors of seeking dental therapy

  20. Socioeconomic position and mortality among patients with prostate cancer - influence of mediating factors

    DEFF Research Database (Denmark)

    Larsen, Signe Benzon; Brasso, Klaus; Christensen, Jane;

    2017-01-01

    (interquartile range 6.4-11.2 years). Patients with low socioeconomic position were more often overweight or obese at baseline. Low socioeconomic position was associated with increased prostate cancer-specific and all-cause death. The increased mortality could largely be explained by tumor aggressiveness......INTRODUCTION: Men with low socioeconomic position experience higher mortality after a prostate cancer diagnosis compared to men with a higher socioeconomic position, however, the specific mediators of this association are unclear. We therefore evaluated the influence of potential mediators...... on the association between socioeconomic position, and prostate cancer-specific and all-cause death in prostate cancer patients. MATERIALS AND METHODS: We conducted a cohort study of prostate cancer patients in the Danish Diet, Cancer and Health study. All patients completed questionnaires and anthropometric...

  1. Patient and Family Member Factors Influencing Outcomes of Poststroke Inpatient Rehabilitation.

    Science.gov (United States)

    Fang, Yunhua; Tao, Qian; Zhou, Xiaoxuan; Chen, Shanjia; Huang, Jia; Jiang, Yingping; Wu, Yi; Chen, Lidian; Tao, Jing; Chan, Chetwyn C

    2017-02-01

    To investigate how family members' attitudes toward functional regain, and patients' knowledge and intention of independence influence poststroke rehabilitation. Cross-sectional study. Three rehabilitation inpatient settings. Younger (n=79) and older (n=84) poststroke patients, along with their family members (spouses, n=104; children, n=59). Not applicable. Custom-designed questionnaires were used to tap into the patients' knowledge about rehabilitation (Patient's Rehabilitation Questionnaire-Knowledge About Rehabilitation) and intention of independence (Patient's Rehabilitation Questionnaire-Intention of Independence), and family members' attitudes toward patients in performing basic activities of daily living (BADL) (Family Member Attitudes Questionnaire-BADL) and instrumental activities of daily living (Family Member Attitudes Questionnaire-instrumental activities of daily living). The rehabilitation outcomes included gains in motor, cognitive, and emotional functions, and self-care independence, measured with common clinical instruments. The Family Member Attitudes Questionnaire-BADL predicted cognitive outcome and the Patient's Rehabilitation Questionnaire-Intention of Independence predicted motor outcome for both groups. Differential age-related effects were revealed for the Patient's Rehabilitation Questionnaire-Intention of Independence in predicting emotional outcome only for the younger group, and self-care independence only for the older group. Patients' intention of independence positively affected motor recovery, while family members' positive attitudes promoted cognitive regain. The findings suggested plausible age-related differences in how patients' intentions affect emotion versus self-care independence outcomes. Future studies should explore strategies for promoting positive attitudes toward independence among patients and family members during poststroke rehabilitation. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by

  2. Factors influencing the length of stay in patients with lumbar pedicle screw fixation

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    Matt El-Kadi

    2016-01-01

    Conclusions: There is an effect of age, ASA, and BMI on LOS. However, the significance of this effect is small. Future studies aiming to identify additional factors, which could potentially be modifiable, in order to work on decreasing LOS in lumbar spinal fusion patients.

  3. Influence of patient and treatment factors on adherence to adjuvant endocrine therapy in breast cancer.

    Science.gov (United States)

    Bender, Catherine M; Gentry, Amanda L; Brufsky, Adam M; Casillo, Frances E; Cohen, Susan M; Dailey, Meredith M; Donovan, Heidi S; Dunbar-Jacob, Jacqueline; Jankowitz, Rachel C; Rosenzweig, Margaret Q; Sherwood, Paula R; Sereika, Susan M

    2014-05-01

    To comprehensively assess the patient and illness or treatment factors that may predict nonadherence to adjuvant endocrine therapy and to explore whether an interaction occurs between these factors in women with breast cancer. Repeated-measures design. The Outpatient Services of the Women's Cancer Program at the University of Pittsburgh Cancer Institute and participants' homes. 91 women with early-stage breast cancer who received endocrine therapy. Adherence was assessed continuously for the first 18 months of endocrine therapy. Patient and illness or treatment factors were assessed at four time points (Time 1 to Time 4). Time 1 (baseline) was within two weeks prior to the initiation of endocrine therapy. Times 2-4 occurred at six-month intervals, as many as 18 months after Time 1. Adherence, patient factors, and illness or treatment factors. Adherence to endocrine therapy declined significantly during the first 18 months of treatment in women with breast cancer. The presence of negative mood and symptoms before starting treatment predicted nonadherence to endocrine therapy over time. Perceptions of financial hardship, symptoms, disease stage, and more complex medication regimens intensified the effect of negative mood on adherence over time. Women with breast cancer may be at risk for nonadherence to prescribed endocrine therapy if they experience depression or anxiety and symptoms prior to initiating therapy. Oncology nurses should be alert to women with breast cancer who are depressed or anxious or who are experiencing symptoms. Management of negative mood and symptoms may result in better adherence.

  4. Factors influencing antibiotic treatment cost and outcome in critically ill patients: A “real-life” study

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    Perić Aneta

    2014-01-01

    Full Text Available Background/Aim. Critically ill patients are at very high risk of developing severe infections in intensive care units (ICUs. Procalcitonin (PCT levels are eleveted in the circulation in patients with bacterial sepsis and PCT might be useful in guiding antibiotic treatment. The aim of this study was to estimate factors influencing patients survival and treatment cost in ICU with special emphasis on the impact of PCT serum levels use in guiding antimicrobial therapy. Methods. The study was conducted from August 2010 to May 2012 in the Intensive Therapy Unit, Clinic of Anesthesiology and Intensive Therapy, Military Medical Academy (MMA, Belgrade, Serbia. All adult critically ill patients with sepsis and/or trauma admitted in the ICU were included in the study. This study included only the cost of antimicrobial therapy in the ICU and the cost for PCT analysis. We used prices valid in the MMA for the year 2012. PCT in serum was measured by homogeneous immunoassay on a Brahms Kryptor analyzer. Results. A total of 102 patients were enrolled. The mean patients age was 55 ± 19 years and 61.8% of patients were male. The mean length of stay (LOS in the ICU was 12 ± 21 days. There was a statistically significant difference (p < 0.001 between the sepsis and trauma group regarding outcome (higher mortality rate was in the sepsis group, particularly in the patients with peritonitis who were mostly women. The patients younger than 70 years had better chance of survival. LOS, the use of carbapenems and PCT-measurement influenced the cost of therapy in the ICU. Conclusions. The obtained results show that age, the diagnosis and gender were the main predictors of survival of critically ill patients in the ICU. The cost of ICU stay was dependent on LOS, use of carbapenems and PCT measurement although the influence of these three factors on the outcome in the patients did not reach a statistical significance.

  5. Factors influencing attitude toward care of dying patients in first-year nursing students.

    Science.gov (United States)

    Hagelin, Carina Lundh; Melin-Johansson, Christina; Henoch, Ingela; Bergh, Ingrid; Ek, Kristina; Hammarlund, Kina; Prahl, Charlotte; Strang, Susann; Westin, Lars; Österlind, Jane; Browall, Maria

    2016-01-01

    To describe Swedish first-year undergraduate nursing students' attitudes toward care of dying patients. Possible influences such as age, earlier care experiences, care education, experiences of meeting dying patients and place of birth were investigated. The Frommelt Attitude Toward Care of the Dying Scale (FATCOD) was used in six universities. Descriptive statistics and regression analysis were used. Some 371 students (67.3%) reported overall positive attitude toward caring for dying patients (total mean FATCOD 119.5, SD 10.6) early in their first semester. Older students, students with both earlier care experience and earlier education, those with experience of meeting a dying person, and students born in Sweden reported the highest scores, a more positive attitude. Age, earlier care experience and education, experiences of meeting a dying person and place of birth seems to affect students' attitudes toward care of the dying and need to be considered among nursing educators.

  6. The Factors Influencing Depression Endpoints Research (FINDER study: final results of Italian patients with depression

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    Quail Deborah

    2010-07-01

    Full Text Available Abstract Background Factors Influencing Depression Endpoints Research (FINDER is a 6-month, prospective, observational study carried out in 12 European countries aimed at investigating health-related quality of life (HRQoL in outpatients receiving treatment for a first or new depressive episode. The Italian HRQoL data at 6 months is described in this report, and the factors associated with HRQoL changes were determined. Methods Data were collected at baseline, 3 and 6 months of treatment. HRQoL was measured using components of the 36-item Short Form Health Survey (SF-36; mental component summary (MCS, physical component summary (PCS and the European Quality of Life-5 Dimensions (EQ-5D; visual analogue scale (VAS and health status index (HSI. The Hospital Anxiety and Depression Scale (HADS was adopted to evaluate depressive symptoms, while somatic and painful physical symptoms were assessed by using the 28-item Somatic Symptom Inventory (SSI-28 and a VAS. Results Of the initial 513 patients, 472 completed the 3-month observation and 466 the 6-month observation. The SF-36 and EQ-5D mean (± SD scores showed HRQoL improvements at 3 months and a further smaller improvement at 6 months, with the most positive effects for SF-36 MCS (baseline 22.0 ± 9.2, 3 months 34.6 ± 10.0; 6 months 39.3 ± 9.5 and EQ-5D HSI (baseline 0.4 ± 0.3; 3 months 0.7 ± 0.3; 6 months 0.7 ± 0.2. Depression and anxiety symptoms (HADS-D mean at baseline 13.3 ± 4.2; HADS-A mean at baseline 12.2 ± 3.9 consistently decreased during the first 3 months (8.7 ± 4.3; 7.5 ± 3.6 and showed a further positive change at 6 months (6.9 ± 4.3; 5.8 ± 3.4. Somatic and painful symptoms (SSI and VAS significantly decreased, with the most positive changes in the SSI-28 somatic item (mean at baseline 2.4 ± 0.7; mean change at 3 months: -0.5; 95% CI -0.6 to -0.5; mean change at 6 months: -0.7; 95% CI -0.8 to -0.7; in 'interference of overall pain with daily activities' (mean at baseline 45

  7. Factors influencing patient choice of dialysis versus conservative care to treat end-stage kidney disease.

    Science.gov (United States)

    Morton, Rachael L; Snelling, Paul; Webster, Angela C; Rose, John; Masterson, Rosemary; Johnson, David W; Howard, Kirsten

    2012-03-20

    For every patient with chronic kidney disease who undergoes renal-replacement therapy, there is one patient who undergoes conservative management of their disease. We aimed to determine the most important characteristics of dialysis and the trade-offs patients were willing to make in choosing dialysis instead of conservative care. We conducted a discrete choice experiment involving adults with stage 3-5 chronic kidney disease from eight renal clinics in Australia. We assessed the influence of treatment characteristics (life expectancy, number of visits to the hospital per week, ability to travel, time spent undergoing dialysis [i.e., time spent attached to a dialysis machine per treatment, measured in hours], time of day at which treatment occurred, availability of subsidized transport and flexibility of the treatment schedule) on patients' preferences for dialysis versus conservative care. Of 151 patients invited to participate, 105 completed our survey. Patients were more likely to choose dialysis than conservative care if dialysis involved an increased average life expectancy (odds ratio [OR] 1.84, 95% confidence interval [CI] 1.57-2.15), if they were able to dialyse during the day or evening rather than during the day only (OR 8.95, 95% CI 4.46-17.97), and if subsidized transport was available (OR 1.55, 95% CI 1.24-1.95). Patients were less likely to choose dialysis over conservative care if an increase in the number of visits to hospital was required (OR 0.70, 95% CI 0.56-0.88) and if there were more restrictions on their ability to travel (OR=0.47, 95%CI 0.36-0.61). Patients were willing to forgo 7 months of life expectancy to reduce the number of required visits to hospital and 15 months of life expectancy to increase their ability to travel. Patients approaching end-stage kidney disease are willing to trade considerable life expectancy to reduce the burden and restrictions imposed by dialysis.

  8. Systematic assessment of factors influencing preferences of Crohn's disease patients in selecting an anti-tumor necrosis factor agent (CHOOSE TNF TRIAL).

    Science.gov (United States)

    Vavricka, Stephan R; Bentele, Nicoletta; Scharl, Michael; Rogler, Gerhard; Zeitz, Jonas; Frei, Pascal; Straumann, Alex; Binek, Janek; Schoepfer, Alain M; Fried, Michael

    2012-08-01

    Infliximab (IFX), adalimumab (ADA), and certolizumab pegol (CZP) have similar efficacy in induction and maintenance of clinical remission in Crohn's disease (CD). Given the comparable nature of these drugs, patient preferences may influence the choice of the product. We aimed to identify factors that may contribute to CD patients' decision in selecting one anti-tumor necrosis factor (TNF) agent over the others. A prospective survey was performed among anti-TNF-naïve CD patients. Prior to completion of a questionnaire, patients were provided with a written description of the three anti-TNF agents, focusing on indications, mode of administration, side effects, and scientific evidence of efficacy and safety for each drug. One hundred patients (47 females, mean age 45 ± 16 years, range 19-81) with an ileal, colonic, or ileocolonic (33%, 40%, and 27%, respectively) disease location completed the questionnaire. Based on the information provided, 36% of patients preferred ADA, 28% CZP, and 25% IFX, whereas 11% were undecided. The patients' decision in selecting a specific anti-TNF drug was influenced by the following factors: ease of use (69%), time required for therapy (34%), time interval between application of the drug (31%), scientific evidence for efficacy (19%), and fear of syringes (10%). The majority of patients preferred anti-TNF medications that were administered by subcutaneous injection rather than by intravenous infusion. Ease of use and time required for therapy were two major factors influencing the patients' selection of a specific anti-TNF drug. Patients' individual preferences should be taken into account when prescribing anti-TNF drugs. Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.

  9. Factors influencing pain therapy for metastatic cancer patients in Bosnia and Herzegovina

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    Ivana Tica Sedlar

    2016-11-01

    Full Text Available Objective. To investigate cancer pain management and evaluate factors that could be addressed and lead to potential improvement of pain therapy. Materials and methods. Two hundred patients with metastatic cancer pain at the Department of Oncology, University Hospital Mostar, completed questionnaires about cancer pain treatment. Thirty oncologists from the Cancer Institute, University of Sarajevo and the Department of Oncology, Clinical Hospital, Mostar were asked to complete the questionnaire about cancer pain management. Results. Compliance for analgesics was statistically better (p=0.013 for patients who were regularly asked about pain than for those patients who were asked periodically. Nearly twice as many patients, whom the doctor always asked about pain, regularly took medication (65.5% versus 32.8%. There was a statistically significant, positive relationship between regular use of analgesics and the interest of the doctor about pain reduction after initiation of analgesic therapy (p=0.008. Almost half of the patients, 47%, stated that their doctor did not devote enough time to their pain problems during the interview. Statistically significantly more patients took analgesic medication regularly if they were not afraid of narcotics (p=0.006. Numerical or VAS scales in description of cancer pain were used by only 30% of interviewed oncologists. The vast majority of doctors, 86.7%, used opiates for the terminal phase of the illness. Conclusion. Assessment and the treatment of cancer pain in Bosnia and Herzegovina remains inadequate, emphasizing the need for changes to cancer pain patient care.

  10. Factors influencing the attitudes of Chinese cancer patients and their families toward the disclosure of a cancer diagnosis.

    Science.gov (United States)

    Sun, Wenwen; Wang, Zhehai; Fang, Shu; Li, Minmin

    2015-03-01

    The disclosure of a cancer diagnosis to patients has been a core topic in oncology departments. Previous studies have demonstrated that Chinese cancer patients and their families differ in their attitudes toward cancer diagnosis disclosure. However, the influencing factors regarding their different attitudes remain unknown. In the present study, a questionnaire was delivered to 266 cancer patients and 266 matched family members. The results showed that cancer patients were more likely to desire to be informed of their condition than family members (85 vs. 18%, P cancer, 16.5% expected to reduce the severity of their condition, and 4.9% expected to lengthen their lives. Therefore, physicians have a responsibility to appropriately provide knowledge regarding cancer to the patients' families if their educational level is lower and if they have no knowledge of recent treatments, which may improve their acceptability of a cancer diagnosis for patients.

  11. STUDY OF FACTORS INFLUENCING THE NONCLOSURE OF BRONCHOPLEURAL FISTULA IN PATIENTS WITH SPONTANEOUS PNEUMOTHORAX

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    Ejaj Ahmed

    2015-11-01

    pneumothorax; out of this 2 were MDR TB patients; 9 patients out of 54(17% had non-TB pneumothorax, in which 2 were carcinoma lung; 7(13% out of 54 patients, all men had diabetes, 2 of the 54 were HIV positive. There were 4 deaths, all of them due to aspiration pneumonia. CONCLUSIONS Men with TB pneumothorax, hydro- and pyo-pneumothorax seem to have delayed and non-closure of the bronchopleural fistula. Carcinoma lung seems to be associated with non-closure of the bronchopleural fistula more frequently. Diabetes and HIV do not influence the closure of the bronchopleural fistula according to our study

  12. Factors influencing sperm retrieval following testicular sperm extraction in nonobstructive azoospermia patients.

    Science.gov (United States)

    Salehi, Peyman; Derakhshan-Horeh, Marzieh; Nadeali, Zakiye; Hosseinzadeh, Majid; Sadeghi, Erfan; Izadpanahi, Mohammad Hossein; Salehi, Mansour

    2017-03-01

    Azoospermia owing to testicular disorders is the most severe manifestation of male infertility. The main concern for patients with nonobstructive azoospermia (NOA) is the probability of successful sperm retrieval following testicular sperm extraction (TESE). Therefore, the goal of this study was to determine predictive factors correlated with sperm retrieval. We assessed the testicular histopathological patterns, the choice of TESE surgical procedure, hormone levels, and chromosomal abnormalities in patients with NOA (n=170). The histopathology specimens were analyzed based on the histopathological patterns of hypospermatogenesis, maturation arrest, and Sertoli cell-only syndrome. The mean rate of sperm retrieval was 48.8%. The rate of sperm retrieval was significantly higher in the hypospermatogenesis group than in the other groups (p<0.001). There was a positive correlation between micro-TESE (vs. conventional TESE) and the sperm retrieval rate (odds ratio, 8.077; p<0.01). A logistic regression model demonstrated that high levels of follicle-stimulating hormone (FSH) and small testicular volume were significantly associated with lower chances of successful sperm retrieval. Some parameters, including testicular histopathology patterns, FSH levels, testicular volume, and method of TESE surgery, may be able to predict the chances of obtaining spermatozoa in patients with NOA. However, despite the efficiency of some predictive models, the hope of retrieving any functioning spermatozoa may be sufficient to disregard predictive factors of the success of intracytoplasmic sperm injection in these patients.

  13. Factors influencing ambulance use in patients with ST-elevation myocardial infarction in Beijing, China

    Institute of Scientific and Technical Information of China (English)

    YAN Hong-bing; HU Da-yi; SONG Li; CHEN Hui; ZHANG Jian; LI Shi-ying; LI Qing-xiang; CHENG Shu-juan; WANG Jian; ZHAO Han-jun

    2009-01-01

    Background Emergency medical service plays a key role in the early recognition and treatment of ST-elevation myocardial infarction (STEMI), but studies indicate that the patients experiencing STEMI symptoms often fail to call an ambulance as recommended. This study aimed to examine the current ambulance transport frequency and ascertain predictors and reasons for not choosing ambulance transportation by the patients with STEMI in Beijing.Methods A prospective, cross-sectional survey was conducted from January 1,2006 through until June 30, 2007 in two tertiary hospitals in Beijing and included consecutive patients with STEMI admitted within 24 hours of onset of symptoms. Data were collected by structured interviews and medical records review.Results Of the 572 patients, only 172 (30.1%) used an ambulance, and the remaining 400 (69.9%) presented by self-transport. Multivariate analysis showed that age <65 years (OR: 1.220; 95% CI: 1.001-2.043), lower education level (OR: 1.582; 95% CI: 1.003-2.512), presence of pre-infarction angina (OR: 1.595; 95% CI: 1.086-2.347), and attribution of symptoms to non-cardiac origin (OR: 1.519; 95% CI: 1.011-2.284) were independent predictors for not using an ambulance. However, history of coronary artery disease (CAD), dyspnea, perceiving symptoms to be serious, and knowing the meaning of cardiopulmonary resuscitation appeared to be independent predictors of ambulance use. The main reasons for not using an ambulance were convenience and quickness of self-transport and the decreased severity of symptoms.Conclusions A large proportion of patients in Beijing do not call for an ambulance after onset of STEMI symptoms. Several factors including demographics, previous CAD, symptoms and cognitive factors of patients are associated with the ambulance use. The public should be educated that an ambulance is not merely a transportation modality and that it also provides rapid diagnosis and treatment.

  14. Factors influencing the progress of mobilization in hip fracture patients during the early postsurgical period?-A prospective observational study.

    Science.gov (United States)

    Buecking, Benjamin; Bohl, Katharina; Eschbach, Daphne; Bliemel, Christopher; Aigner, Rene; Balzer-Geldsetzer, Monika; Dodel, Richard; Ruchholtz, Steffen; Debus, Florian

    2015-01-01

    The aim of the present study was to determine the independent factors influencing mobilization progress after geriatric hip fractures. 392 Hip fracture patients older than 60 years were included in this prospective, observational, cohort study. The progress of mobilization was measured with walking ability 4 days post-surgery, ability to climb stairs until discharge and the Tinetti test at discharge. Factors correlated with the progress of mobilization were determined using multivariate analyses. The independent factors influencing walking ability 4 days post-surgery were the pre-fracture Charlson Comorbidity Index (OR=0.834, p=0.005), the American Society of Anesthesiologists Score (OR=0.550, p=0.013), pre-fracture Barthel Index ([BI], OR=1.019, p=0.012) and risk for depression, as measured by the Geriatric Depression Scale, (OR=0.896, p=0.013). The probability of climbing stairs until discharge was influenced by the patient's age (OR=0.840, pTinetti test ad discharge. While pre-fracture co-morbidities and function cannot be changed, the treatment of patients with cognitive impairment and depressive symptoms should be optimized. Efforts should be undertaken to ensure early surgery for all hip fractures. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Patient understanding of moles and skin cancer, and factors influencing presentation in primary care: a qualitative study

    Directory of Open Access Journals (Sweden)

    Walter Fiona M

    2010-08-01

    Full Text Available Abstract Background Melanoma incidence in the UK has doubled over two decades, yet there is conflicting evidence about factors which prompt or delay patients seeking advice. Aim: To explore patient understanding of pigmented skin lesions (moles and skin cancer, and factors which influence seeking help in primary care. Method Semi-structured interviews with forty MoleMate Trial participants, analysed using the theoretical framework of the Safer-Andersen model of Total Patient Delay. Results Patient understanding and awareness was influenced by personal, family and friends' experiences of moles, skin cancer and other cancers, knowledge of risk factors, and the lay media. The route to consulting was complex and often iterative. For lesions that people could see, detecting and appraising change was influenced by comparisons with a normal mole on themselves, a family member, friend or image. Inferring illness came about with recognition of changes (particularly size as serious, and associated 'internal' symptoms such as pain. For lesions that people could not see, family, friends and health professionals detected and appraised changes. Deciding to seek help was often prompted by another person or triggered by rapid or multiple changes in a mole. Three of four people subsequently diagnosed with melanoma did not seek help; instead, their GP opportunistically noticed the lesion. Conclusions Changing moles are often perceived as trivial and not signifying possible skin cancer. This study contributes to current national strategies to improve patient awareness and earlier diagnosis of cancer by highlighting factors that can trigger or act as barriers to seeking help. (ISRCTN79932379

  16. K-ras genetic mutation and influencing factor analysis for Han and Uygur nationality colorectal cancer patients.

    Science.gov (United States)

    Eli, Mayinur; Mollayup, Ablikim; Muattar; Liu, Chao; Zheng, Chao; Bao, Yong-Xing

    2015-01-01

    To investigate the K-ras genetic mutation status in colorectal cancer patients, compare the difference of K-ras genetic mutation rate in Han and Uygur nationality and analyze the influencing factor. 91 cases (52 cases of Han nationality and 39 cases of Uygur nationality) of colorectal biopsy or surgical ablation pathology specimen from the first affiliated hospital of Xinjiang Medical University during January, 2010 to March, 2013 were collected to detect the 12th and 13th code mutation status of K-ras gene exon 2 with pyrosequencing method and compare the difference of K-ras gene mutation rate between Han and Uygur nationality patients. Single factor analysis and multiple factor logistic regression analysis were utilized to analyze the influencing factor for K-ras genetic mutation. 33 cases of patients with K-ras genetic mutation were found from the 91 cases colorectal cancer patients and the total mutation rate was 36.3%. Among them, 24 cases (72.7%) were found with mutation only in the 12th code, 9 cases (27.3%) were found with mutation only in the 13th code and no one case was found with mutation in both the two codes. Mutation rate of the 12th code in the Uygur nationality was significantly higher than that in the Han nationality (P0.05). There were no associativity (P>0.05) between the K-ras genetic mutation and sex, age, smoking history, drinking history, tumor location, macropathology type, differentiation level, staging, invasive depth, lymph nodes transferring and metastasis in colorectal cancer patients (P>0.05). K-ras genetic mutation rate is high in colorectal cancer patients. The mutation rate of 12th code in Uygur nationality is higher than that in Han nationality. There is no significant associativity between K-ras genetic mutation rate and patients' clinical pathology characteristic.

  17. [Prevalence and influence of risk factors on coronary shunting operations in patients with aterosclerosis of abdominal aorta and peripheral vessels].

    Science.gov (United States)

    Konstantinov, B A; Bazylev, V V; Belov, Iu V; Kizyma, A G

    2008-01-01

    Retrospective study analysis concerning the prevalence of risk factors for unfavorable outcomes after coronary operations in patients with peripheral arterial atherosclerosis is presented. Meta-analysis of individual risk factors was carried out. Frequency of complications after coronary shunting in patients with various concomitant diseases is evaluated. The multifactorial relative risk affecting hospital lethality is defined. The study includes 131 patients with generalized atherosclerosis, which have underwent myocardial revascularization at the first stage (the main group) and at the second stage have been operated on abdominal aorta and peripheral arteries. 1128 patients without peripheral arterial atherosclerosis have made the control group. They underwent only coronary shunting. All patients were treated from December of 1994 till June of 2006. Relying on the results of the study cumulative relative risk for unfavorable outcomes after revascularization is 1.8 times higher in patients from the main group than in patients from the control group, and the risk for primary complications is 2.03 times higher. Concomitant atherosclerotic arterial involvement among cardiosurgical patients is associated with high risk for stroke in postoperative period. In case of chronic renal failure risk factors are cumulated. In the main group lethality made 5% , which was higher as compared with the control group. Correlation of such risk factors as heart failure and renal failure (creatinine level more than 1.8 mg/dl) with lethality has been revealed among patients from the main group. Lethality risk raises in 5.30 times in the presence of heart failure in medical history, and raises in 13.15 times in case of initially elevated creatinine level. Age of patient didn't have any influence on lethality in early postoperative period.

  18. Factors influencing general practitioner referral of patients developing end-stage renal failure: a standardised case-analysis study.

    LENUS (Irish Health Repository)

    Montgomery, Anthony J

    2006-01-01

    BACKGROUND: To understand why treatment referral rates for ESRF are lower in Ireland than in other European countries, an investigation of factors influencing general practitioner referral of patients developing ESRF was conducted. METHOD: Randomly selected general practitioners (N = 51) were interviewed using 32 standardised written patient scenarios to elicit referral strategies. Main outcome measures: General practitioner referral levels and thresholds for patients developing end-stage renal disease; referral routes (nephrologist vs other physicians); influence of patient age, marital status and co-morbidity on referral. RESULTS: Referral levels varied widely with the full range of cases (0-32; median = 15) referred by different doctors after consideration of first laboratory results. Less than half (44%) of cases were referred to a nephrologist. Patient age (40 vs 70 years), marital status, co-morbidity (none vs rheumatoid arthritis) and general practitioner prior specialist renal training (yes or no) did not influence referral rates. Many patients were not referred to a specialist at creatinine levels of 129 micromol\\/l (47% not referred) or 250 micromol\\/l (45%). While all patients were referred at higher levels (350 and 480 micromol\\/l), referral to a nephrologist decreased in likelihood as scenarios became more complex; 28% at 129 micromol\\/l creatinine; 28% at 250 micromol\\/l; 18% at 350 micromol\\/l and 14% at 480 micromol\\/l. Referral levels and routes were not influenced by general practitioner age, sex or practice location. Most general practitioners had little current contact with chronic renal patients (mean number in practice = 0.7, s.d. = 1.3). CONCLUSION: The very divergent management patterns identified highlight the need for guidance to general practitioners on appropriate management of this serious condition.

  19. Factors influencing general practitioner referral of patients developing end-stage renal failure: a standardised case-analysis study

    Directory of Open Access Journals (Sweden)

    Shannon William

    2006-09-01

    Full Text Available Abstract Background To understand why treatment referral rates for ESRF are lower in Ireland than in other European countries, an investigation of factors influencing general practitioner referral of patients developing ESRF was conducted. Method Randomly selected general practitioners (N = 51 were interviewed using 32 standardised written patient scenarios to elicit referral strategies. Main outcome measures: General practitioner referral levels and thresholds for patients developing end-stage renal disease; referral routes (nephrologist vs other physicians; influence of patient age, marital status and co-morbidity on referral. Results Referral levels varied widely with the full range of cases (0–32; median = 15 referred by different doctors after consideration of first laboratory results. Less than half (44% of cases were referred to a nephrologist. Patient age (40 vs 70 years, marital status, co-morbidity (none vs rheumatoid arthritis and general practitioner prior specialist renal training (yes or no did not influence referral rates. Many patients were not referred to a specialist at creatinine levels of 129 μmol/l (47% not referred or 250 μmol/l (45%. While all patients were referred at higher levels (350 and 480 μmol/l, referral to a nephrologist decreased in likelihood as scenarios became more complex; 28% at 129 μmol/l creatinine; 28% at 250 μmol/l; 18% at 350 μmol/l and 14% at 480 μmol/l. Referral levels and routes were not influenced by general practitioner age, sex or practice location. Most general practitioners had little current contact with chronic renal patients (mean number in practice = 0.7, s.d. = 1.3. Conclusion The very divergent management patterns identified highlight the need for guidance to general practitioners on appropriate management of this serious condition.

  20. Medical equipment ordinance and lack of personnel: two contrary factors influencing anesthesia patient safety.

    Science.gov (United States)

    Peter, K; Dieterich, H J

    1991-01-01

    In January 1986, West German legislators enacted the Medical Equipment Ordinance (MedGV) to define specific regulations for both manufacturers and operators of medical equipment and to offer a measure of safety to patients. We describe the history of MedGV, its regulations, and the mechanisms developed to enforce those regulations. We also evaluate its impact on clinical practice in light of the current staff shortages in anesthesia practice and research in Germany. Finally, we focus our discussion on the distinction between improved equipment as a minor factor in critical-incidents and the inadequate manpower as a major factor in anesthesia mishaps. It is unclear what will develop after 1993, when the national states in Europe form a common market.

  1. Incidence of lipohypertrophy in diabetic patients and a study of influencing factors.

    Science.gov (United States)

    Vardar, Bahar; Kizilci, Sevgi

    2007-08-01

    This study examines the incidence of lipohypertrophy in diabetic individuals as well as the factors that have an influence on causing this condition. In consideration of the period of development of lipohypertrophy, the research sampling consisted of 215 diabetics who had been using insulin for at least 2 years. Observation and palpation techniques were used in assessing lipohypertrophy in these diabetics. Data were evaluated using percentages, chi(2) and logistic regression analysis. Results of the study established lipohypertrophy in 48.8% of the individuals comprising the sampling. It was seen that the incidence of lipohypertrophy in these individuals was affected by their level of education, the frequency that they changed needles, the frequency of changing their injection sites and the amount of time they had been using insulin, the difference proving to be statistically significant (plipohypertrophy. These results show that the amount of time insulin is used and the procedure for injection both affect the development of lipohypertrophy.

  2. Factors influencing the outcome of paediatric cardiac surgical patients during extracorporeal circulatory support

    Directory of Open Access Journals (Sweden)

    Peek Giles J

    2007-01-01

    Full Text Available Abstract Background Veno-arterial extracorporeal membrane oxygenation (ECMO is a common modality of circulatory assist device used in children. We assessed the outcome of children who had ECMO following repair of congenital cardiac defects (CCD and identified the risk factors associated with hospital mortality. Methods From April 1990 to December 2003, 53 patients required ECMO following surgical correction of CCD. Retrospectively collected data was analyzed with univariate and multivariate logistic regression analysis. Results Median age and weight of the patients were 150 days and 5.4 kgs respectively. The indications for ECMO were low cardiac output in 16, failure to wean cardiopulmonary bypass in 13, cardiac arrest in 10 and cardio-respiratory failure in 14 patients. The mean duration of ECMO was 143 hours. Weaning off from ECMO was successful in 66% and of these 83% were survival to hospital-discharge. 37.7% of patients were alive for the mean follow-up period of 75 months. On univariate analysis, arrhythmias, ECMO duration >168 hours, bleeding complications, renal replacement therapy on ECMO, arrhythmias and cardiac arrest after ECMO were associated with hospital mortality. On multivariate analysis, abnormal neurology, bleeding complications and arrhythmias after ECMO were associated with hospital mortality. Extra and intra-thoracic cannulations were used in 79% and 21% of patients respectively and extra-thoracic cannulation had significantly less bleeding complications (p = 0.031. Conclusion ECMO provides an effective circulatory support following surgical repair of CCD in children. Extra-thoracic cannulation is associated with less bleeding complications. Abnormal neurology, bleeding complications on ECMO and arrhythmias after ECMO are poor prognostic indicators for hospital survival.

  3. Factors Influencing Patients' Perspectives of Radiology Imaging Centers: Evaluation Using an Online Social Media Ratings Website.

    Science.gov (United States)

    Doshi, Ankur M; Somberg, Molly; Rosenkrantz, Andrew B

    2016-02-01

    The goal of this study was to use patient reviews posted on Yelp.com, an online ratings website, to identify factors most commonly associated with positive versus negative patient perceptions of radiology imaging centers across the United States. A total of 126 outpatient radiology centers from the 46 largest US cities were identified using Yelp.com; 1,009 patient reviews comprising 2,582 individual comments were evaluated. Comments were coded as pertaining to either the radiologist or other service items, and as expressing either a positive or negative opinion. Distribution of comments was compared with center ratings using Fisher's exact test. Overall, 14% of comments were radiologist related; 86% pertained to other aspects of service quality. Radiologist-related negative comments more frequent in low-performing centers (mean rating ≤2 on 1-5 scale) than high-performing centers (rating ≥4) pertained to imaging equipment (25% versus 7%), report content (25% versus 2%), and radiologist professionalism (25% versus 2%) (P culture throughout their practice. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  4. Comparison of quality of life between urban and rural gastric cancer patients and analysis of influencing factors

    Institute of Scientific and Technical Information of China (English)

    Jun Tian; Zhen-Chun Chen; Bin Wu; Xin Meng

    2004-01-01

    AIM: The conception of quality of life has been widely accepted by clinic doctors. Evaluations of the treatment effect of chronic diseases have been changed to depend not only on the survival time, but also on the quality of life of the patients. Fuzhou City and Changle County are highincidence areas of the gastric cancer in Fujian Province.The aims of this research were to compare the quality of life of urban patients with that of rural patients and analyze the factors influencing quality of life of gastric cancer patients in Fujian Province.METHODS: The samples were drawn with cluster sampling. The urban sample consisted of 162 patients aged 25 to 75 with 143 males and 19 females. The rural sample consisted of 200 patients aged 32 to 78 with 166 males and 34 females. The patients in both the urban and rural areas were investigated, and their scores on 21 items reflecting the quality of life were measured. The methods of ttest and stepwise regression were used to analyze the data.RESULTS: The average total scores of quality of life of the urban patients and rural patients were 64.11 and 68.69respectively. There was a significant difference between the means of two samples (P = 0.0004). Seven variables in the regression model estimated by the urban sample and 4 variables in the model by the rural sample were at the level of significance α = 0.05. Family income, nutrition and rehabilitating exercise were selected into both the urban and rural regression models.CONCLUSION: Most of the gastric cancer patients have poor quality of life in Fujian Province and the rural patients have lower quality of life than that of urban patients. The patients having more family income have better quality of life, and enhanced nutrition and doing rehabilitating exercise are helpful in improving the quality of life of the gastric cancer patients.

  5. Analysis of influence of dosimetric factors on the outcome of I-131 therapy in patients with hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Knapska-Kucharska, M.; Oszukowska, L.; Makarewicz, J. [Department of Nuclear Medecine and Oncological Endocrinology, Province Hospital, Zgierz (Poland); Lewinski, A. [Chair and Department of Endocrinology and Metabolic Diseases, Medical University, Lodz (Poland)

    2012-07-01

    The influence of dosimetric factors on the outcome of {sup 131}I therapy has been examined in hyperthyroid patients submitted to {sup 131}I treatment. The following factors - which could have influence on the effects of therapy with radioiodine - were analysed: the goitre volume, the thyroid radioiodine uptake after 24 h, and the effective half-life time of {sup 131}I (EHL). Five hundred (500) randomly selected patients with hyperthyroidism, treated with {sup 131}I, were studied. They were divided into three groups (based on clinical examination, hormonal and immunological tests, thyroid scintigraphy and ultrasound imaging). The study shows that the effectiveness of {sup 131}I therapy depends on the thyroid volume and absorbed dose in all the groups of patients and on the thyroid radioiodine uptake and EHL in patients with a single autonomously functioning thyroid nodule. We have failed to determine the borderline D, distinguishing between effective and ineffective therapy. The treatment outcome can be predicted with approximately 70% accuracy, based on minimal absorbed dose

  6. Data mining of audiology patient records: factors influencing the choice of hearing aid type.

    Science.gov (United States)

    Anwar, Muhammad N; Oakes, Michael P

    2012-04-30

    This paper describes the analysis of a database of over 180,000 patient records, collected from over 23,000 patients, by the hearing aid clinic at James Cook University Hospital in Middlesbrough, UK. These records consist of audiograms (graphs of the faintest sounds audible to the patient at six different pitches), categorical data (such as age, gender, diagnosis and hearing aid type) and brief free text notes made by the technicians. This data is mined to determine which factors contribute to the decision to fit a BTE (worn behind the ear) hearing aid as opposed to an ITE (worn in the ear) hearing aid. From PCA (principal component analysis) four main audiogram types are determined, and are related to the type of hearing aid chosen. The effects of age, gender, diagnosis, masker, mould and individual audiogram frequencies are combined into a single model by means of logistic regression. Some significant keywords are also discovered in the free text fields by using the chi-squared (χ(2)) test, which can also be used in the model. The final model can act a decision support tool to help decide whether an individual patient should be offered a BTE or an ITE hearing aid. The final model was tested using 5-fold cross validation, and was able to replicate the decisions of audiologists whether to fit an ITE or a BTE hearing aid with precision in the range 0.79 to 0.87. A decision support system was produced to predict the type of hearing aid which should be prescribed, with an explanation facility explaining how that decision was arrived at. This system should prove useful in providing a "second opinion" for audiologists.

  7. Data mining of audiology patient records: factors influencing the choice of hearing aid type

    Directory of Open Access Journals (Sweden)

    Anwar Muhammad N

    2012-04-01

    Full Text Available Abstract Background This paper describes the analysis of a database of over 180,000 patient records, collected from over 23,000 patients, by the hearing aid clinic at James Cook University Hospital in Middlesbrough, UK. These records consist of audiograms (graphs of the faintest sounds audible to the patient at six different pitches, categorical data (such as age, gender, diagnosis and hearing aid type and brief free text notes made by the technicians. This data is mined to determine which factors contribute to the decision to fit a BTE (worn behind the ear hearing aid as opposed to an ITE (worn in the ear hearing aid. Methods From PCA (principal component analysis four main audiogram types are determined, and are related to the type of hearing aid chosen. The effects of age, gender, diagnosis, masker, mould and individual audiogram frequencies are combined into a single model by means of logistic regression. Some significant keywords are also discovered in the free text fields by using the chi-squared (χ2 test, which can also be used in the model. The final model can act a decision support tool to help decide whether an individual patient should be offered a BTE or an ITE hearing aid. Results The final model was tested using 5-fold cross validation, and was able to replicate the decisions of audiologists whether to fit an ITE or a BTE hearing aid with precision in the range 0.79 to 0.87. Conclusions A decision support system was produced to predict the type of hearing aid which should be prescribed, with an explanation facility explaining how that decision was arrived at. This system should prove useful in providing a "second opinion" for audiologists.

  8. Factors that influence physicians' and medical students' confidence in counseling patients about physical activity.

    Science.gov (United States)

    Stanford, Fatima Cody; Durkin, Martin W; Stallworth, James Rast; Powell, Caroline Keller; Poston, Mary Beth; Blair, Steven N

    2014-06-01

    Less than half of US adults and two-thirds of US high school students do not meet current US guidelines for physical activity. We examined which factors promoted physicians' and medical students' confidence in counseling patients about physical activity. We established an online exercise survey targeting attending physicians, resident and fellow physicians, and medical students to determine their current level of physical activity and confidence in counseling patients about physical activity. We compared their personal level of physical activity with the 2008 Physical Activity Guidelines of the US Department of Health and Human Services (USDHHS). We administered a survey in 2009 and 2010 that used the short form of the International Physical Activity Questionnaire. A total of 1,949 individuals responded to the survey, of whom 1,751 (i.e., 566 attending physicians, 138 fellow physicians, 806 resident physicians, and 215 medical students) were included in this analysis. After adjusting for their BMI, the odds that physicians and medical students who met USDHHS guidelines for vigorous activity would express confidence in their ability to provide exercise counseling were more than twice that of physicians who did not meet these guidelines. Individuals who were overweight were less likely to be confident than those with normal BMI, after adjusting for whether they met the vigorous exercise guidelines. Physicians with obesity were even less likely to express confidence in regards to exercise counseling. We conclude that physicians and medical students who had a normal BMI and met vigorous USDHHS guidelines were more likely to feel confident about counseling their patients about physical activity. Our findings suggest that graduate medical school education should focus on health promotion in their students, as this will likely lead to improved health behaviors in their students' patient populations.

  9. Factors influencing recovery of left ventricular structure in patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    DUAN Hong-yan; WU Xue-si; HAN Zhi-hong; GUO Yong-fang; FANG Shan-juan; ZHANG Xiao-xia; WANG Chun-mei

    2011-01-01

    Background Angiotensin converting enzyme (ACE) inhibitors and β-blockers (βB) have beneficial effects on left ventricular (LV) remodeling, alleviate symptoms and reduce morbidity and mortality in patients with chronic heart failure (CHF). However the correlation between the d osages of ACE inhibitors, βB, and recovery of LV structure remains controversial. Clinical factors associated with recovery of normal ventricular structure in CHF patients receiving medical therapy are poorly defined. Here we aimed to identify variables associated with recovery of normal or near-normal structure in patients with CHF.Methods We recruited 231 consecutive CHF outpatients, left ventricular ejection fraction (LVEF) ≤40% and left ventricular end diastolic diameter (LVEDD) >55/50 mm (male/female), who were receiving optimal pharmacotherapy between January 2001 and June 2009, and followed them until December 31, 2009. They were divided into three groups according to LVEDD and whether they were still alive at final follow-up: group A, LVEDD <60/55 mm (male/female); group B, LVEDD >60/55 mm (male/female); and group C, those who died before final follow-up. Apart from group C, univariate analysis was performed followed by Logistic multivariate analysis to determine the predictors of recovery of LV structure.Results A total of 217 patients completed follow-up, and median follow-up time was 35 months (range 6-108).Twenty-five patients died during that period; the all-cause mortality rate was 11.5%. Group A showed clinical characteristics as follows: the shortest duration of disease and shortest QRS width, the lowest N-terminal brain natriuretic peptide (NT-proBNP) at baseline, the highest dose of βB usage, the highest systolic blood pressure (SBP), diastolic blood pressure (DBP) and the lowest New York Heart Association (NYHA) classification, serum creatinine, uric acid, total bilirubin and NT-proBNP after treatment. Logistic multivariate analysis was performed according to

  10. Influencing factors for the disappearance of hemispatial neglect in patients during acute stroke

    Institute of Scientific and Technical Information of China (English)

    Yaobin Long

    2006-01-01

    position were observed during acute period (within 1week) and recovery period (at 2 weeks after onset). Related factors with HSN disappearance contained time of physiotherapy, duration of sitting training (sitting in bed and near bedside: heels fallen to ground,feet loaded heavies, center of gravity located at middle line, head raised towards frontage) and hospitalized time. However, control group was not set up. Measurement data were expressed as Mean±SD and compared with ttest; enumeration data were compared with Chi-square test and Mann-Whitney Utest. P < 0.05 was regarded as significant difference.MAIN OUTCOME MEASURES: ① HSN disappearance; ② Numbers of body agnosia, left and right agnosia and difficult maintenance of supine position; ③ Correlation among therapeutic time, sitting-training time and hospitalized time.RESULTS: All 21 patients were involved in the final analysis. ① HSN disappearance: Among 21 cases, 2 patients had right HSN disappearance, 19 left HSN disappearance, 8 (38%, 8/21) HSN disappearance, and 13 (62%, 13/21) HSN remnant. Among 8 patients of HSN disappearance, symptoms of 4 cases lasted for 7 days and that of another 4 lasted for 8-12 days. ② Evaluation of HSN disappearance at various phases:Within 1 week, 19% (4/21) HSN patients had body agnosia, left and right agnosia; during recovery period,body agnosia of 20 cases was disappeared and that of 1 case was still survived. Within 1 week, cases with difficult maintenance of supine position were 67% (13/21), but 43% (17/21) during recovery period. ③ Analysis of effective factors on HSN disappearance and related intervention: At acute phase, HSN disappearance through sitting training lasted for (2.5±1.3) days, and remaining HSN symptoms were relieved for (5.0±3.7) days. There was significant difference between them (χ2 = 3.96, P = 0.039). The hospitalized time of patients with HSN disappearance and HSN remnant was (17.6±10.4), (16.2±4.9) days, but there was no significant

  11. Influence of Human Factor Issues on Patient-Centered mHealth Apps' Impact; Where Do We Stand?

    Science.gov (United States)

    Wildenbos, G A; Peute, L W; Jaspers, M W M

    2016-01-01

    This paper discusses the preliminary results of a literature review on studies published in 2014-2015 concerning patient-centered mHealth applications' (apps) impact. Abstracts were included when they described a mHealth app targeted at patients and reported on the effects of this app on patient care. From a total of 559 potentially relevant articles, 17 papers were finally included. Nine studies reported a positive impact of the patient-centered mHealth app on patient care; 4 of these studies were randomized controlled trials. Measured impacts in the 17 studies focused on improving patients' physical activity, self-efficacy and medication adherence. Human factors issues potentially mediating these effects were discussed in all studies. Transitions in the interaction between healthcare providers and their patients were most often discussed as influencing the impact of the mHealth app. More research is needed, focussing on human issues mediating the effect of patient-centered mHealth apps to precipitate knowledge on the effectiveness of mHealth. This research should preferably be guided by socio-technical models.

  12. Sensitivity to heat in MS patients: a factor strongly influencing symptomology - an explorative survey

    Directory of Open Access Journals (Sweden)

    Söderhamn Olle

    2011-02-01

    Full Text Available Abstract Background Many individuals diagnosed with Multiple Sclerosis (MS are sensitive to increased body temperature, which has been recognized as correlating with the symptom of fatigue. The need to explore this association has been highlighted. The aim of this study was to investigate the occurrence of heat sensitivity and its relations to disease course, disability, common MS-related symptoms and ongoing immunosuppressive treatments among individuals 65 years of age or younger diagnosed with MS. Methods A cross-sectional designed survey was undertaken. A questionnaire was sent to MS-patients with an Expanded Disability Status Score (EDSS in the interval of 0-6.5 and who were between 20 and 65 years of age, living in an eastern region of Sweden (n = 334. Besides occurrence of heat sensitivity (Yes/No and corresponding questions, the Fatigue Severity Scale (FSS, the MS-related symptom checklist and the Perceived Deficit Questionnaire (PDQ were included. Data were analysed in relation to data level using Chi-square, Mann Whitney U-test, and Student's t-test. Pearson's and Spearman's correlations were calculated. In the logistic regression analyses (enter dichotomized MS-symptoms were used as dependent variables, and EDSS, disease-course, time since onset, heat-sensitivity, age and sex (female/male were independent variables. In the linear regression analyses, enter, mean FSS and summarized PDQ were entered as dependent variables and EDSS, disease-course, time since onset, heat sensitivity, age and sex (female/male were independent variables. Results Of the responding patients (n = 256, 58% reported heat sensitivity. The regression analyses revealed heat sensitivity as a significant factor relating not only to fatigue (p Conclusions Heat sensitivity in MS patients is a key symptom that is highly correlated with disabling symptoms such as fatigue, pain, concentration difficulty and urination urgency.

  13. 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

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

  14. Factors influencing the use of ambulance among patients with acute coronary syndrome: results of two centers in Turkey.

    Science.gov (United States)

    Demirkan, Burcu; Ege, Meltem Refiker; Doğan, Pınar; İpek, Esra Gücük; Güray, Umit; Güray, Yeşim

    2013-09-01

    In this study, we aimed to identify the factors influencing the use of ambulance among patients admitted to two Turkish hospitals with acute coronary syndrome (ACS). Overall, 330 with a mean age of 55±13 years, hospitalized patients with ACS at 2 different hospitals were included in this prospective cohort study. The factors influencing the use of ambulance hospital were investigated through a questionnaire. The comparisons were made between two groups regarding use of ambulance. The predictors of the use of ambulance were determined using multiple logistic regression analysis. Despite the high rate of knowing the emergency service number of "112", of the 330 patents, only 96 (29%) used ambulance. Ambulance users had shorter arrival duration with median of 60 min vs 120 min (p=0.03). Presenting with ST elevation myocardial infarction (OR=3.127, 95% CI: 1.555-6.2877, pambulance (OR= 4.184, 95% CI: 2.528-6.926, pambulance use. Using ambulance was in a very low rate among our study patients with ACS. Severity of symptoms, type of ACS and knowledge are seemed to be related with increased ambulance use. Informative health educational programs can be organized to achieve a behavioral change in using of ambulance.

  15. The influence of environmental factors on sleep quality in hospitalized medical patients

    Directory of Open Access Journals (Sweden)

    Milena eBano

    2014-12-01

    Full Text Available Introduction. Sleep-wake disturbances are common in hospitalised patients but few studies have assessed them systematically. The aim of the present study was to assess sleep quality in a group of medical inpatients, in relation to environmental factors, and the switch to daylight saving time. Methods. Between March and April 2013, 132 consecutive inpatients were screened and 99 (76±11 yrs; hospitalization: 8±7 days enrolled. They slept in double or quadruple rooms, facing South/South-East, and were qualified as sleeping near/far from the window. They underwent daily sleep assessment by standard questionnaires/diaries. Illuminance was measured by a luxmeter at each patient’s eye-level, four times per day. Noise was measured at the same times by a phonometer. Information was recorded on room lighting, position of the rolling shutters and number/type of extra people in the room. Results. Compliance with sleep-wake assessment was poor, with a range of completion of 2-59%, depending on the questionnaires. Reported sleep quality was sufficient and sleep timing dictated by hospital routine; 33% of the patients reported one/more sleepless nights. Illuminance was generally low, and rolling shutters half way down for most of the 24 hours. Patients who slept near the window were exposed to more light in the morning (i.e. 222±72 vs. 174±85 lux, p<0.05 before the switch; 198±72 vs.141±137 lux, p<0.01 after the switch and tended to slept better (7.3±1.8 vs. 5.8±2.4 on a 1-10 scale, before the switch, p<0.05; 7.7±2.3 vs. 6.6±1.8, n.s. after the switch. Noise levels were higher than recommended for care units but substantially comparable across times/room types. No significant differences were observed in sleep parameters before/after the switch. Conclusions. Medical wards appear to be noisy environments, in which limited attention is paid to light/dark hygiene. An association was observed between sleep quality and bed position/light exposure, which

  16. Factors influencing survival in hemodialysis patients aged older than 75 years: 2.5-year outcome study.

    Science.gov (United States)

    Chauveau, P; Combe, C; Laville, M; Fouque, D; Azar, R; Cano, N; Canaud, B; Roth, H; Leverve, X; Aparicio, M

    2001-05-01

    The incidence of malnutrition is widely held to be greater in the elderly, but this specific factor has not been extensively studied in elderly dialysis patients. In a 30-month follow-up prospective study, we evaluated the role of nutrition on the outcome of 290 stable hemodialysis (HD) outpatients aged older than 75 years followed up in 20 French HD centers (167 men, 123 women; age, 79.8 +/- 4.2 years; previous time on dialysis, 41 +/- 38 months). On the same day in January 1996, predialysis and postdialysis blood samples were collected according to recommended procedures for dialysis quantification. Normalized protein catabolic rate, dialysis adequacy parameters, and estimation of lean body mass (LBM; expressed as observed/expected LBM values [obs/exp LBM]) were computed from predialysis and postdialysis urea and creatinine levels. Overall survival rates were 80% and 65% after 1 and 2 years of follow-up, respectively, and were significantly less in patients with the lower quartile of obs/exp LBM. In univariate analysis using the Cox proportional hazards model, survival was significantly influenced by age, albumin level, prealbumin level, body mass index, and diabetes, but not by sex, Kt/V, duration of dialysis, cholesterol level, hemoglobin level, or obs/exp LBM. In multivariate analysis, no variable remained significant. Cardiovascular mortality accounted for 52.1% of the patient deaths. We conclude that in elderly HD patients, malnutrition influences overall survival despite adequate dialysis treatment.

  17. Factors of influence on acute skin toxicity of breast cancer patients treated with standard three-dimensional conformal radiotherapy (3D-CRT) after breast conserving surgery (BCS)

    National Research Council Canada - National Science Library

    Kraus-Tiefenbacher, Uta; Sfintizky, Andreas; Welzel, Grit; Simeonova, Anna; Sperk, Elena; Siebenlist, Kerstin; Mai, Sabine; Wenz, Frederik

    2012-01-01

    .... In order to reduce these side effects it is mandatory to identify potential factors of influence in breast cancer patients undergoing standard three-dimensional conformal radiation therapy (3D-CRT...

  18. Factors influencing syphilis treatment failure and/or re-infection in HIV co-infected patients: immunosuppression or behaviors

    Institute of Scientific and Technical Information of China (English)

    Jong Hun Kim; George Psevdos Jr; Jin Suh; Victoria Sharp

    2011-01-01

    Background Recent studies have reported overall increasing rates of syphilis with a high rate of human immunodeficiency virus (HIV) co-infection. However, there is little information about factors influencing syphilis treatment failure and/or re-infection in HIV co-infected patients. We conducted a study to evaluate factors associated with syphilis treatment failure/re-infection in HIV co-infected patients.Methods We reviewed 3542 medical records of HIV-infected patients from January 2005 to December 2007 followed up at HIV Clinic in New York City. Patients were categorized by rapid plasma regain titer (RPR) into success/serofast (4-fold decrease in RPR by 12 months after treatment, RPR conversion to nonreactive, persistently stable reactive RPR with no 4-fold increase), and failure/re-infection (failure to decrease 4 folds in RPR by 12 months after treatment, 4-fold increase in RPR from baseline).Results Among a total of 156 patients who met the eligibility criteria, 122 (78.2%) were under success/serofast category,and 34 (21.8%) were under failure/re-infection category. HIV viral load, CD4 cell count, and use of highly active antiretroviral therapy (HAART) were not associated with syphilis treatment failure/re-infection. However, early syphilis stage (OR:11.036, 95% CI: 2.499-48.740, P=0.002) and high (>1∶64) RPR titers (OR: 715.921, 95% CI: 422.175-23 113.396, P <0.001) were significantly associated.Conclusions No correlations were seen with depressed immune states with syphilis treatment failure and/or re-infection. However, association with early stage syphilis suggests that risky psychological sexual behaviors may be the most important leading factor, emphasizing needs for safe sex education.

  19. Influence of glycemic excursion on urinary albumin excretion and inflammatory factor in early diabetes kidney disease patients

    Institute of Scientific and Technical Information of China (English)

    Xuan Cao; Ding-Ping Yang

    2016-01-01

    Objective:To research the influence of glycemic excursion on the level of urinary albumin excretion and inflammatory factor in early diabetes kidney disease patients.Methods:From January to December in 2015, 96 confirmed cases of early diabetes kidney disease were collected. Continuous Glucose Monito Ring System CGMS, produced by American MiniMed Inc) was used to monitor 72 h blood glucose. The influence of MAGE on the level of urinary albumin excretion, IGF-1, FKN, IL-6, TNF-α, hs-CRP and inflammatory indexes was compared.Results:Compared cases of stable blood sugar (MAGE<5.0 mmol/L) with unstable ones (MAGE≥5.0 mmol/L), the difference of UAER and 1,5-AG had statistical significance, while HbA1c and FA had no significant difference. Pearson correlation analysis between MAGE and UAER resulted in strong correlation. And also the front inflammatory factor including IGF-1, FKN, IL-6, TNF-α, hs-CRP all showed lower level than the cases of MAGE≥5.0 mmol/L.Conclusion:Glycemic excursion may accelerate development of kidney injury through inflammatory factors.

  20. Factors influencing the diagnostic accuracy and management in acute surgical patients

    Institute of Scientific and Technical Information of China (English)

    Muhammad; Shafique; Sajid; William; FA; Miles; Thaddeus; Hollingsworth; Mike; Mc; Glue

    2014-01-01

    AIM:To evaluate the diagnostic accuracy(DA) in acute surgical patients admitted to a District General Hospital.METHODS: The case notes of all acute surgical patients admitted under the surgical team for a period of two weeks were reviewed for the data pertaining to the admission diagnoses, relevant investigations and final diagnoses confirmed by either surgery or various other diagnostic modalities. The diagnostic pathway was recorded from the source of referral [general practitioner(GP), A and E, in-patient] to the correct final diagnosis by the surgical team. RESULTS: Forty-one patients(23 males) with acute surgical admissions during two weeks of study period were evaluated. The mean age of study group was 61.05 ± 23.24 years. There were 111 patient-doctor encounters. Final correct diagnosis was achieved in 85.4% patients. The DA was 46%, 44%, 50%, 33%,61%, 61%, and 75% by GP, A and E, in-patient referral, surgical foundation year-1, surgical senior house officer(SHO), surgical registrar, and surgical consultant respectively. The percentage of clinical consensus diagnosis was 12%. Surgery was performed in 48.8% of patients. Sixty-seven percent of GP-referred patients, 31% of A and E-referred, and 25% of the in-patient referrals underwent surgery. Surgical SHO made the most contributions to the primary diagnostic pathway.CONCLUSION: Approximately 85% of acute surgical patients can be diagnosed accurately along the diagnostic pathway. Patients referred by a GP are more likely to require surgery as compared to other referral sources. Surgical consultant was more likely to make correct surgical diagnosis, however it is the surgical SHO that contributes the most correct diagnoses along the diagnostic pathway.

  1. Upper gastrointestinal endoscopy for dyspepsia: Εxploratory study of factors influencing patient compliance in Greece

    Directory of Open Access Journals (Sweden)

    Kouroumalis Elias

    2011-02-01

    Full Text Available Abstract Background Upper gastrointestinal endoscopy is the most preferable diagnostic examination for patients over fifty when upper gastrointestinal symptoms appear. However, limited knowledge exists in concerns to the compliance of primary care patients' to the doctors' recommendations for endoscopy. Methods Patients who visited primary care practices in Greece and experienced upper gastrointestinal symptoms within a 10 days screening study, were referred for an upper endoscopy exam. The patients which refused to complete the endoscopy exam, were interviewed by the use of an open- ended translated and validated questionnaire, the Identification of Dyspepsia in General Population (IDGP questionnaire. A qualitative thematic analysis grounded on the theory of planned behavior was performed to reveal the reasons for patients' refusal, while socio-demographic predictors were also assessed. Results Nine hundred and ninety two patients were recorded, 159 of them (16% were found positive for dyspepsia and gastro-esophageal reflux disease according to the IDGP questionnaire. Out of the above, 131 (83.6% patients refused further investigation with endoscopy. Patients who refused upper endoscopy were predominantly female (87.8% (p = 0.036 and over the age of 50. The lack of severe symptoms, fear of pain, concerns of sedation, comorbidity and competing life demands were reported by patients as barriers to performing an endoscopic investigation. Conclusions Patients with dyspepsia in rural Greece tend to avoid upper gastrointestinal endoscopy, with two major axons considered to be the causes of patients' refusal: their beliefs towards endoscopy and their personal capability to cope with it. Future research examining reasons of low compliance should be carried out in combination with modern behavioral theories so as to investigate into the above.

  2. Contralateral prophylactic mastectomy (CPM): A systematic review of patient reported factors and psychological predictors influencing choice and satisfaction.

    Science.gov (United States)

    Ager, Brittany; Butow, Phyllis; Jansen, Jesse; Phillips, Kelly-Anne; Porter, David

    2016-08-01

    Conduct a systematic review of quantitative and qualitative studies exploring patient reported factors and psychological variables influencing the decision to have contralateral prophylactic mastectomy (CPM), and satisfaction with CPM, in women with early stage breast cancer. Studies were identified via databases: Medline, CINAHL, Embase and PsycINFO. Data were extracted by one author and crosschecked by two additional authors for accuracy. The quality of included articles was assessed using standardised criteria by three authors. Of the 1346 unique citations identified, 17 were studies that met the inclusion criteria. Studies included were primarily cross-sectional and retrospective. No study utilised a theoretical framework to guide research and few studies considered psychological predictors of CPM. Fear of breast cancer was the most commonly cited reason for CPM, followed by cosmetic reasons such as desire for symmetry. Overall, women appeared satisfied with CPM, however, adverse/diminished body image, poor cosmetic result, complications, diminished sense of sexuality, emotional issues and perceived lack of education regarding alternative surveillance/CPM efficacy were cited as reasons for dissatisfaction. Current literature has begun to identify patient-reported reasons for CPM; however, the relative importance of different factors and how these factors relate to the process underlying the decision to have CPM are unknown. Of women who considered CPM, limited information is available regarding differences between those who proceed with or ultimately decline CPM. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Factors influencing exacerbation-related self-management in patients with COPD : A qualitative study

    NARCIS (Netherlands)

    Korpershoek, Y. J G; Vervoort, S. C J M; Nijssen, L. I T; Trappenburg, J. C A; Schuurmans, M. J.

    2016-01-01

    Background: In patients with COPD, self-management skills are important to reduce the impact of exacerbations. However, both detection and adequate response to exacerbations appear to be difficult for some patients. Little is known about the underlying process of exacerbation-related self-management

  4. Causes of deaths and influencing factors in patients with atrial fibrillation

    DEFF Research Database (Denmark)

    Fauchier, Laurent; Villejoubert, Olivier; Clementy, Nicolas;

    2016-01-01

    BACKGROUND: Atrial fibrillation is associated with a higher mortality, but causes of death of atrial fibrillation patients and their specific predictors have been less well defined. We aimed to identify the causes of death among atrial fibrillation patients and secondly, clinical predictors for t...

  5. Factors influencing exacerbation-related self-management in patients with COPD : A qualitative study

    NARCIS (Netherlands)

    Korpershoek, Y. J G; Vervoort, S. C J M; Nijssen, L. I T; Trappenburg, J. C A; Schuurmans, M. J.

    2016-01-01

    Background: In patients with COPD, self-management skills are important to reduce the impact of exacerbations. However, both detection and adequate response to exacerbations appear to be difficult for some patients. Little is known about the underlying process of exacerbation-related

  6. Advance care planning preferences among dialysis patients and factors influencing their decisions

    Directory of Open Access Journals (Sweden)

    Al-Jahdali Hamdan

    2009-01-01

    Full Text Available To determine the resuscitation preferences of hemodialysis (HD Saudi patients, we con-ducted a cross-sectional, observational descriptive questionnaire study in two major tertiary hospitals in Saudi Arabia from March to December 2007. We enrolled all the patients on HD for two years or more, and excluded the patients who were transplant candidates, confused, or demented. The questionnaire was com-posed of 4 sections. The first 3 sections were concerned with demographic data, education levels, employ-ment, family size, number of children, and functionality status besides knowledge about cardiopulmonary resuscitation (CPR, mechanical ventilation, and ICU admission. The fourth section contained different sce-narios and questions on personal and preferences such as end of life decisions, medical interventions, CPR, ICU admission, and the decision maker in these events. A total of 100 patients (53% males, 67% Saudis, and 85% married were enrolled in the study. The mean duration on dialysis was 6.0 years (± 4.1. More than 70% of the patients viewed themselves as above average in the religiosity score, and 44% disclosed a good life quality. More than 95% had little or no knowledge about cardiac resuscitation, intubation, and mechanical ventilation. The majority of the patients authorized their treating physician to decide for them about cardiac resuscitation in case they did not make advanced directives and only 22% believed that this decision should be made by their family members. If their physician believed their condition was hopeless, 77% preferred to stay at home. We conclude that the majority of our patients had limited awareness about cardiac resuscitation measures. The majority of the patients trust their physicians to decide about the futility of resuscitation. Patients were able to decide reasonably well when they are well informed.

  7. Factors Influencing Readmission After Pancreaticoduodenectomy: A Multi-Institutional Study of 1302 Patients.

    NARCIS (Netherlands)

    Ahmad, S.A.; Edwards, M.J.R.; Sutton, J.M.; Grewal, S.S.; Hanseman, D.J.; Maithel, S.K.; Patel, S.H.; Bentram, D.J.; Weber, S.M.; Cho, C.S.; Winslow, E.R.; Scoggins, C.R.; Martin, R.C.; Kim, H.J.; Baker, J.J.; Merchant, N.B.; Parikh, A.A.; Kooby, D.A.

    2012-01-01

    OBJECTIVE AND BACKGROUND:: Morbidity, mortality, and length of hospital stay after pancreaticoduodenectomy (PD) have significantly decreased over recent decades. Despite this progress, early readmission rates after PD have been reported as high as 50%. Few reports have delineated factors associated

  8. Factors Influencing Rehospitalisation of Patients with Schizophrenia in Japan: A 1-year Longitudinal Study

    Directory of Open Access Journals (Sweden)

    Takeshi Shimada

    2016-12-01

    Conclusion: This study provided preliminary support for the finding that individualized occupational therapy and proper adherence to outpatient treatment and medication are associated with reducing the rehospitalisation of patients with schizophrenia in Japan.

  9. [Admission to intensive care of palliative care patients : the stakes and factors influencing the decision].

    Science.gov (United States)

    Escher, Monica; Nendaz, Mathieu; Ricou, Bara

    2017-02-01

    Palliative care patients have limited prospects of survival and the benefit of intensive care is uncertain. To make a decision there are considerations other than survival probabilities. Patients should receive appropriate care and be spared suffering. End of life in the intensive care unit has an impact on families, who may develop psychological problems or complicated grief. End of life care can be a source of conflicts and cause burnout in health providers. Finally, intensive care is an expensive resource, which must be fairly allocated. In these complex situations, patient preferences help make a decision. However, they have often not been discussed with the physicians. General practitioners have a role to play by promoting advance care planning with their patients.

  10. Factors influencing exacerbation-related self-management in patients with COPD : A qualitative study

    OpenAIRE

    Korpershoek, Y. J. G.; Vervoort, S.C.J.M.; Nijssen, L. I T; Trappenburg, J.C.A.; Schuurmans, M. J.

    2016-01-01

    Background: In patients with COPD, self-management skills are important to reduce the impact of exacerbations. However, both detection and adequate response to exacerbations appear to be difficult for some patients. Little is known about the underlying process of exacerbation-related self-management. Therefore, the objective of this study was to identify and explain the underlying process of exacerbation-related self-management behavior. Methods: A qualitative study using semi-structured in-d...

  11. [Assessing factors that influence patients' perception in returning to work using the brief version of Burns Specific Health Scale].

    Science.gov (United States)

    Dowda, Deborah J; Li, Frank

    2010-12-01

    To assess the factors that influence burn patients' perception in returning to work after discharge. Twenty-four patients hospitalized from March 1, 2007 to February 28, 2009, older than 18 years, and with total burn surface area equal to or more than 10% TBSA were enrolled in the study. Data of physical and psychological health status (PPH) of in-patients including hand function, simple function abilities, heat sensitivity, treatment antipathy, body image, sexuality, interpersonal relationships, affect, and perception in returning to work at discharge and 3 and 6 months after discharge were collected using the brief version of Burns Specific Health Scale in the form of questionnaire, which were analyzed coordinately. The correlation between returning to work and demographic data of patients were analyzed too. Data were processed with t test or Pearson correlation test. Respectively 19 and 16 valid questionnaires were sent back 3 and 6 months after discharge. No statistical difference was found between at discharge and 3 months after discharge in each item concerning PPH of patients (with t values from -4.87 to -2.16, P values all above 0.05). The perception of returning to work scored significantly higher 6 months after discharge than at discharge [(9 ± 5) score vs. (6 ± 3) score, t = -4.87, P burn surface area, and amount of workers compensation (with r value respectively -0.7000, -0.6844, -0.8003, P values all below 0.05). Patients' perception in returning to work is correlated with heat sensitivity, treatment antipathy, body image, affect, length of stay, total burn surface area, and amount workers compensation. Health professionals need to provide patients with ongoing education and necessary information to help them return to work.

  12. Multi-Cultural Long Term Care Nurses’ Perceptions of Factors Influencing Patient Dignity at the End of Life

    Science.gov (United States)

    Periyakoil, Vyjeyanthi S.; Stevens, Marguerite; Kraemer, Helena

    2012-01-01

    The goal of this mixed-methods study was to characterize the perceptions of multi-cultural long-term care nurses about patient dignity at the end-of-life (EOL). The study was conducted in a large, urban long-term care (LTC) facility. The participants were forty-five long-term care nurses and 26 terminally ill nursing home patients. Nurses completed an open-ended interview about their perceptions of the concept of dying with dignity and the data were analyzed using grounded theory methods. Main themes identified as promoting patient dignity at the EOL included treating them with respect, helping them prepare for their EOL, promoting shared decision making and providing high quality tenor of care. The nurses’ cultural and religious backgrounds influenced their perceptions of what constitutes dignity-conserving care. Foreign-born nurses stressed the need for end-of-life rituals but this was strikingly absent in the statements of US-born nurses. Foreign-born Catholic nurses stated that the dying experience should not be altered using analgesics to relieve suffering or by attempts to hasten death by forgoing curative therapy or by other means. Both nurses and terminally ill patients completed the Dignity Card-sort Tool (DCT). A comparison of the LTC nurses cohort to the terminally ill patient responses on the DCT revealed that the nurses felt that patient dignity was eroded when her/his wishes were not carried out and when s/he is treated without respect. In contrast, dying LTC patients felt that poor medical care and loss of ability to choose care options to be the most important factors leading to erosion of dignity. PMID:23496266

  13. Factors influencing coexistence of toenail onychomycosis with tinea pedis and other dermatomycoses: a survey of 2761 patients.

    Science.gov (United States)

    Szepietowski, Jacek C; Reich, Adam; Garlowska, Emilia; Kulig, Marzena; Baran, Eugeniusz

    2006-10-01

    To evaluate the prevalence and factors influencing the presence of concomitant dermatomycoses in patients with toenail onychomycosis. Prospective study based on a specially designed questionnaire completed by dermatologists. A total of 2761 patients with toenail onychomycosis. The diagnosis of fungal skin infections was confirmed by direct microscopic examination or by culture. In 1181 patients (42.8%) with toenail onychomycosis, concomitant fungal skin infections were noted. Tinea pedis was the most common and was found in 933 patients (33.8%). Other concomitant fungal skin infections were fingernail onychomycosis (7.4%), tinea cruris (4.2%), tinea corporis (2.1%), tinea manuum (1.6%), and tinea capitis (0.5%). The presence of concomitant fungal skin infections depended on number of involved toenails; duration of onychomycosis; sex, age, and education level; area of residence; and type of isolated fungus. The coexistence of toenail onychomycosis with other types of fungal skin infections is a frequent phenomenon. It could be hypothesized that infected toenails may be a site from which the fungal infections could spread to other body areas. Effective therapy for onychomycosis might therefore be essential not only to treat the lesional toenails but also to prevent spreading the infection to other sites of the skin.

  14. Individual and contextual factors influencing patient attrition from antiretroviral therapy care in an urban community of Lusaka, Zambia

    Directory of Open Access Journals (Sweden)

    Sonja Merten

    2012-06-01

    Full Text Available Background: Despite the relatively effective roll-out of free life-prolonging antiretroviral therapy (ART in public sector clinics in Zambia since 2005, and the proven efficacy of ART, some people living with HIV (PLHIV are abandoning the treatment. Drawing on a wider ethnographic study in a predominantly low-income, high-density residential area of Lusaka, this paper reports the reasons why PLHIV opted to discontinue their HIV treatment. Methods: Opened-ended, in-depth interviews were held with PLHIV who had stopped ART (n = 25, ART clinic staff (n = 5, religious leaders (n = 5, herbal medicine providers (n = 5 and lay home-based caregivers (n = 5. In addition, participant observations were conducted in the study setting for 18 months. Interview data were analysed using open coding first, and then interpreted using latent content analysis. The presentation of the results is guided by a social-ecological framework. Findings: Patient attrition from ART care is influenced by an interplay of personal, social, health system and structural-level factors. While improved corporeal health, side effects and need for normalcy diminished motivation to continue with treatment, individuals also weighed the social and economic costs of continued uptake of treatment. Long waiting times for medical care and placing “defaulters” on intensive adherence counselling in the context of insecure labour conditions and livelihood constraints not only imposed opportunity costs which patients were not willing to forego, but also forced individuals to balance physical health with social integrity, which sometimes forced them to opt for faith healing and traditional medicine. Conclusions: Complex and dynamic interplay of personal, social, health system and structural-level factors coalesces to influence patient attrition from ART care. Consequently, while patient-centred interventions are required, efforts should be made to improve ART care by

  15. Factors influencing new graduate nurse burnout development, job satisfaction and patient care quality: a time-lagged study.

    Science.gov (United States)

    Boamah, Sheila A; Read, Emily A; Spence Laschinger, Heather K

    2017-05-01

    To test a hypothesized model linking new graduate nurses' perceptions of their manager's authentic leadership behaviours to structural empowerment, short-staffing and work-life interference and subsequent burnout, job satisfaction and patient care quality. Authentic leadership and structural empowerment have been shown to reduce early career burnout among nurses. Short-staffing and work-life interference are also linked to burnout and may help explain the impact of positive, empowering leadership on burnout, which in turn influences job satisfaction and patient care quality. A time-lagged study of Canadian new graduate nurses was conducted. At Time 1, surveys were sent to 3,743 nurses (November 2012-March 2013) and 1,020 were returned (27·3% response rate). At Time 2 (May-July 2014), 406 nurses who responded at Time 1 completed surveys (39·8% response rate). Descriptive analysis was conducted in SPSS. Structural equation modelling in Mplus was used to test the hypothesized model. The hypothesized model was supported. Authentic leadership had a significant positive effect on structural empowerment, which in turn decreased both short-staffing and work-life interference. Short-staffing and work-life imbalance subsequently resulted in nurse burnout, lower job satisfaction and lower patient care quality 1 year later. The findings suggest that short-staffing and work-life interference are important factors influencing new graduate nurse burnout. Developing nurse managers' authentic leadership behaviours and working with them to create and sustain empowering work environments may help reduce burnout, increase nurse job satisfaction and improve patient care quality. © 2016 John Wiley & Sons Ltd.

  16. Patients' diagnosis decisions in Alzheimer's disease: the influence of family factors.

    Science.gov (United States)

    Rapp, Thomas

    2014-10-01

    It is surprising to observe that the number of patients receiving a late diagnosis for Alzheimer's disease (AD) remains high even in countries promoting early diagnosis campaigns. We explore the impact of family history and family support on the risks of receiving a delayed diagnosis. We use French data of 1131 patients diagnosed between 1991 and 2005. We find that the presence of AD history in the family increased the risks of receiving a delayed diagnosis. This was true especially when AD history involved brothers, sisters and other relatives (uncles or cousins). The presence of an informal caregiver at the time of the first warning signs reduced the risks of receiving a late diagnosis, regardless of the informal caregiver concerned (spouse, son, daughter etc.). We identify several opportunities for early detection campaigns. Families with history of disease should be targeted. Campaigns should also target isolated patients, who do not benefit from informal care. Our results underline the importance of improving the diagnosis access for old patients and for men. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. An examination of some factors influencing creatine kinase in the blood of patients with muscular dystrophy.

    Science.gov (United States)

    Jackson, M J; Round, J M; Newham, D J; Edwards, R H

    1987-01-01

    The natural variability of plasma creatine kinase activity has been examined in patients suffering from muscular dystrophy and in normal subjects. The coefficient of variation of the plasma creatine kinase activities was found to be large (approximately 35%) in both patients with Duchenne muscular dystrophy and normal control subjects. A comparison of the plasma activities of creatine kinase with other muscle-derived enzymes suggests that the cause of this variability is changes in the release of enzymes from muscle. Data obtained concerning the effect of physical activity on plasma creatine kinase activity are contradictory, but several young patients with Duchenne muscular dystrophy and a very high creatine kinase activity (greater than 5000 IU/liter) showed a decreased activity following admission to hospital. An estimate of the rate of efflux of certain kinase from muscle has been made, indicating that young ambulant patients with Duchenne muscular dystrophy have a grossly elevated muscle creatine kinase efflux (495.0 +/- 61.3 IU/kg muscle/hr) compared to control subjects (1.4 +/- 0.5 IU/kg muscle/hr).

  18. Factors influencing post abortion outcomes among high-risk patients in Zimbabwe

    Directory of Open Access Journals (Sweden)

    C Mudokwenuy-Rawdon

    2005-09-01

    Full Text Available Post abortion complications remain one of the major causes of mortality among women of child bearing age in Zimbabwe. Based on this problem, factors associated with mortalities due to abortion were investigated with the aim of improving post abortion outcomes for Zimbabwe’s women, and possibly also for women of other African countries. Cases and controls were selected from 4895 post abortion records to conduct a retrospective case-control study. Significant risk factors identified for reducing mortalities due to post abortion complications included the administration of oxytocic drugs and evacuation of the uterus whilst anaemia and sepsis apparently reduced these women’s chances of survival. Women who died (cases from post abortion complications apparently received better reported quantitative care than controls. Recommendations based on this research report include improved education of health care workers and enhanced in-service training, regular audits of patients’ records and changed policies for managing these conditions more effectively in Zimbabwe.

  19. Importance of physicians' attire: factors influencing the impression it makes on patients, a cross-sectional study.

    Science.gov (United States)

    Kurihara, Hiroshi; Maeno, Takami; Maeno, Tetsuhiro

    2014-01-08

    The aim of the present study was to determine the importance of physician attire in inspiring confidence in patients, patient preferences and factors influencing the impression made by the clothing worn by doctors. Self-administered questionnaires were distributed and completed in five pharmacies across Japan (April-October 2012) to patients or their carers (aged ≥20 years). The survey was performed over 2 consecutive days in each pharmacy. To estimate patient confidence in doctors, questions were asked addressing six items, namely doctors' attire, speech (way of speaking, volume, tone etc.), age, gender, title (professor, PhD etc.) and reputation. Participants were shown photographs of five different types of attire for male and female doctors (i.e. white coats, scrubs, semiformal, smart casual and casual wear) and asked to rate the appropriateness of each clothing style using a five-point Likert scale. Of the 1411 patients or carers who attended the pharmacies, 530 responded to the questionnaire, with 491 complete responses used in subsequent analyses. The mean age of respondents was 51.9 years and 40.3% were male. Speech was the most important factor (mean score 4.60) in determining confidence in doctors, followed by reputation (4.06) and attire (4.00). With regard to attire, regardless of a doctor's gender, the white coat was judged to be the most appropriate style of dress, followed by surgical scrubs. Only the preference for scrubs was significantly affected by age, gender and region (P 65 years of age who thought scrubs were inappropriate compared with those aged 20-34 years (adjusted odds ratios of 4.30 and 12.7 for male doctors, and 3.66 and 6.91 for female doctors). Attire is one of the important factor that inspires patient confidence in physicians. White coats were deemed the most appropriate clothing style for doctors, followed by scrubs. However, older participants perceived scrubs to be less appropriate attire than younger subjects.

  20. Factors influencing patient and graft survival in 300 cadaveric pediatric renal transplants.

    Science.gov (United States)

    Churchill, B M; Sheldon, C A; McLorie, G A; Arbus, G S

    1988-11-01

    We reviewed the results of 300 cadaveric pediatric renal transplantations performed at our institution. The procedures provided significant survival and improvement of the quality of life in the majority of children. Recipient and graft survival was better in patients more than 5 years old than in younger children. Early nontechnical thrombosis was a major specific problem in young recipients. The original disease did affect graft survival. Uncorrected congenital bladder storage and micturition inefficiency adversely affected graft survival.

  1. Factors Influencing Cognitive Functioning Following Mild Traumatic Brain Injury in OIF/OEF Burn Patients

    Science.gov (United States)

    2010-01-01

    Archives of Clinical Neuropsychology 19 (2004), 825–834. [5] H.G. Belanger, T. Kretzmer, R. Yoash-Gantz, T. Pickett and L.A. Tupler...Poppe, N. Davis, B. Schmaus and S.E. Hobbs, Cognitive functioning and postconcussive symptoms in trau- ma patients with and without mild TBI, Archives of Clinical Neuropsychology 21...Koffler, C.R. Reynolds and C.H. Silver, Neuropsychological evalua- tion in the diagnosis and management of sports-related con- cussion, Archives of

  2. Factors influencing exacerbation-related self-management in patients with COPD: a qualitative study

    OpenAIRE

    Korpershoek YJG; Vervoort SCJM; Nijssen LIT; Trappenburg JCA; Schuurmans MJ

    2016-01-01

    YJG Korpershoek,1,2 SCJM Vervoort,3 LIT Nijssen,2 JCA Trappenburg,2 MJ Schuurmans1,2 1Research Group Chronic Illnesses, Faculty of Health Care, University of Applied Sciences Utrecht, 2Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands Background: In patients with COPD, self-management skills are important to reduce the impact of exacerbations. However, both detection and adequate...

  3. [Factors influencing long-term survival in patients with nonoperable lung cancer: an analysis by Cox model].

    Science.gov (United States)

    Dong, W; Zhao, W; Sun, L

    1996-09-01

    This paper reports a prospective survey of 173 patients with nonoperable lung cancer between January. 1, 1983 to March. 1, 1985. The follow-up rate was 97.7% over five years. Fourteen factors including sex, age, course of disease before treatment, clinical stage, performance status, size of mass, metastatic status, hemoglobin before treatment, short-term response to treatment and so on which might influence long term survival were studied by univariate analysis (Kruskal-Wallis test for Kaplan-Meier survival curve) and by multivariate analysis (Cox's proportional hazad model and audio-visual chart test for goodness of fit). Multivariate analysis using Cox's model revealed 6 significant prognostic factors: performance status, short-term response to treatment, clinical stage, hemoglobin before treatment, smoking index and method of treatment. The survival prediction equation was chi 2 = 72.14, nu = 6, P < 0.0001. The results indicate that the performance status and the CR rate of the initial treatment, among other things, is the major factors affecting prognosis.

  4. 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

    2009-04-01

    Full Text Available Background: The advent of highly active antiretroviral therapy (HAART ushered in a new era in the management of the AIDS pandemic with new drugs, new strategies, new vigour from treating clinicians and enthusiasm on the part of their patients. What soon became evident, however, was the vital importance of patient adherence to prescribed medication in order to obtain full therapeutic benefits. Several factors can influence adherence to HIV drug regimens. Many treatment regimes are complex, requiring patients to take a number of drugs at set times during the day, some on a full stomach and others on an empty one. Other factors that could contribute to non-adherence include: forgetting to take medications, cost factor, side effects, incorrect use of drug, social reasons, denial or poor knowledge of drug regime. If the correct regimen is not prescribed and if patients do not adhere to therapy, then the possibility of resistant strains is high. Improving adherence is therefore arguably the single most important means of optimising overall therapeutic outcomes. Although several studies regarding patient adherence have been performed in the public health care sector, data on adherence in patients from the private health care sector of South Africa remain limited. Many factors influence compliance and identifying these factors may assist in the design of strategies to enhance adherence to such demanding regimens. This study aimed to identify these factors among private sector patients.Method: Descriptive cross-sectional study was conducted among all consenting patients with HIV who visited the rooms of participating private sector doctors from May to July 2005. A questionnaire was administered to consenting participants. Participants who reported missing any medication on any day were considered non-adherent. The data obtained was analysed using SPSS 11.5. A probability value of 5% or less was regarded as being statistically significant. Categorical

  5. Factors influencing soft tissue profile changes following orthodontic treatment in patients with Class II Division 1 malocclusion

    Directory of Open Access Journals (Sweden)

    Suhatcha Maetevorakul

    2016-05-01

    Full Text Available Abstract Background Several studies have shown soft tissue profile changes after orthodontic treatment in Class II Division 1 patients. However, a few studies have described factors influencing the soft tissue changes. The purpose of this study was to investigate the factors influencing the soft tissue profile changes following orthodontic treatment in Class II Division 1 patients. Methods The subjects comprised 104 Thai patients age 8–16 years who presented Class II Division 1 malocclusions and were treated with different orthodontic modalities comprising cervical headgear, Class II traction and extraction of the four first premolars. The profile changes were evaluated from the lateral cephalograms before and after treatment by means of the X-Y coordinate system. Significant soft tissue profile changes were evaluated by paired t test at a 0.05 significance level. The correlations among significant soft tissue changes and independent variables comprising treatment modality, age, sex, pretreatment skeletal, dental and soft tissue morphology were evaluated by stepwise multiple regression analysis at a 0.05 significance level. Results The multiple regression analysis indicated that different treatment modalities, age, sex, pretreatment skeletal, dental and soft tissue morphology were related to the profile changes. The predictive power of these variables on the soft tissue profile changes ranged from 9.9 to 40.3 %. Conclusions Prediction of the soft tissue profile changes following treatment of Class II Division 1 malocclusion from initial patient morphology, age, sex and types of treatment was complicated and required several variables to explain their variations. Upper lip change in horizontal direction could be found only at the stomion superius and was less predictable than those of the lower lip. Variations in upper lip retraction at the stomion superius were explained by types of treatment (R 2 = 0.099, whereas protrusion of the lower

  6. Factors that influence disease-specific quality of life or health status in patients with COPD : a systematic review and meta-analysis of Pearson correlations

    NARCIS (Netherlands)

    Tsiligianni, Ioanna; Kocks, Janwillem; Tzanakis, Nikolaos; Siafakas, Nikolaos; van der Molen, Thys

    Background: A major goal in the management of chronic obstructive pulmonary disease (COPD) is to ensure that the burden of the disease for patients with COPD is limited and that patients will have the best possible quality of life. Aims: To explore all the possible factors that could influence

  7. 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.

  8. Factors influencing the uptake of {sup 18}F-fluoroestradiol in patients with estrogen receptor positive breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, Lanell M. [Department of Radiology, University of Washington Medical Center, Seattle WA (United States); Department of Radiology, Seattle Cancer Care Alliance, Seattle WA (United States); Kurland, Brenda F. [Clinical Division, Fred Hutchinson Cancer Research Center, Seattle, WA (United States); Link, Jeanne M. [Department of Radiology, University of Washington Medical Center, Seattle WA (United States); Schubert, Erin K. [Department of Radiology, University of Washington Medical Center, Seattle WA (United States); Department of Radiology, Seattle Cancer Care Alliance, Seattle WA (United States); Stekhova, Svetlana [Department of Radiology, University of Washington Medical Center, Seattle WA (United States); Linden, Hannah M. [Department of Medical Oncology, University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, WA (United States); Mankoff, David A., E-mail: dam@u.washington.edu [Department of Radiology, University of Washington Medical Center, Seattle WA (United States); Department of Radiology, Seattle Cancer Care Alliance, Seattle WA (United States)

    2011-10-15

    Introduction: {sup 18}F-Fluoroestradiol (FES) PET imaging provides a non-invasive method to measure estrogen receptor (ER) expression in tumors. Assessment of factors that could affect the quantitative level of FES uptake is important as part of the validation of FES PET for evaluating regional ER expression in breast cancer. Methods: This study examines FES uptake in tumors from 312 FES PET scans (239 patients) with documented ER+ primary breast cancer. FES uptake was compared to clinical and laboratory data, treatment prior to or at time of scan, and properties of FES and its metabolism and transport. Linear mixed models were used to explore univariate, threshold-based and multivariate associations. Results: Sex hormone-binding globulin (SHBG) was inversely associated with FES SUV. Average FES uptake did not differ by levels of plasma estradiol, age or rate of FES metabolism. FES tumor uptake was greater for patients with a higher body mass index (BMI), but this effect did not persist when SUV was corrected for lean body mass (LBM). In multivariate analysis, only plasma SHBG binding was an independent predictor of LBM-adjusted FES SUV. Conclusions: Calculation of FES SUV, possibly adjusted for LBM, should be sufficient to assess FES uptake for the purpose of inferring ER expression. Pre-menopausal estradiol levels do not appear to interfere with FES uptake. The availability and binding properties of SHBG influence FES uptake and should be measured. Specific activity did not have a clear influence on FES uptake, except perhaps at higher injected mass per kilogram. These results suggest that FES imaging protocols may be simplified without sacrificing the validity of the results.

  9. Factors influencing insulin acceptance among type 2 diabetes mellitus patients in a primary care clinic: a qualitative exploration.

    Science.gov (United States)

    Abu Hassan, Hasliza; Tohid, Hizlinda; Mohd Amin, Rahmah; Long Bidin, Mohamed Badrulnizam; Muthupalaniappen, Leelavathi; Omar, Khairani

    2013-10-29

    Many Type 2 Diabetes Mellitus (T2DM) patients refuse insulin therapy even when they require this modality of treatment. However, some eventually accept insulin. This study aimed to explore the T2DM patients' reasons for accepting insulin therapy and their initial barriers to use insulin. This qualitative study interviewed twenty-one T2DM patients at a primary care clinic who had been on insulin for more than a year through three in-depth interviews and three focus group discussions. A semi structured interview protocol was used and the sessions were audio-recorded. Subsequently, thematic analysis was conducted to identify major themes. The participants' acceptance of insulin was influenced by their concerns and beliefs about diabetes and insulin. Concerns about complications of poorly controlled diabetes and side effects of other treatment regime had resulted in insulin acceptance among the participants. They also had a strong belief in insulin benefits and effectiveness. These concerns and beliefs were the results of having good knowledge about the diabetes and insulin, experiential learning, as well as doctors' practical and emotional support that helped them to accept insulin therapy and become efficient in self-care management. These factors also allayed their negative concerns and beliefs towards diabetes and insulin, which were their barriers for insulin acceptance as it caused fear to use insulin. These negative concerns were related to injection (self-injection, needle phobia, injection pain), and insulin use (inconvenience, embarrassment, lifestyle restriction, negative social stigma, and poor self-efficacy), whereas the negative beliefs were 'insulin could cause organ damage', 'their diabetes was not serious enough', 'insulin is for life-long', and 'insulin is for more severe disease only'. Exploring patients' concerns and beliefs about diabetes and insulin is crucial to assist physicians in delivering patient-centered care. By understanding this

  10. Factors influencing adherence in CML and ways to improvement: Results of a patient-driven survey of 2546 patients in 63 countries.

    Science.gov (United States)

    Geissler, Jan; Sharf, Giora; Bombaci, Felice; Daban, Mina; De Jong, Jan; Gavin, Tony; Pelouchova, Jana; Dziwinski, Euzebiusz; Hasford, Joerg; Hoffmann, Verena Sophia

    2017-07-01

    Optimal adherence to CML therapy is of key importance to maximize treatment effectiveness. Two clinical studies (ADAGIO and Hammersmith) have proven a clear correlation between adherence and achieving optimal treatment response and have revealed that non-adherence is common in CML patients (Marin et al. in J Clin Oncol 28(24):2381-2388, 2010, Noens et al. in Haematologica 99(33):437-447, 2014). The aim of this study is to assess the extent of suboptimal adherence and to investigate motivations and behavioural patterns of adherence in a worldwide patient sample. Questionnaires were provided by the CML Advocates Network and were filled in by patients online and offline. Patient characteristics, treatment and motivations were collected. Adherence was assessed by the 8-item Morisky Medication Adherence scale. Logistic regression models were fitted to investigate the influence of different factors on adherence. Overall, 2 546 questionnaires from 63 countries and 79 CML patient organisations were evaluable. 32.7% of participants were highly adherent, 46.5% were in the medium and 20.7% in the low adherence group. Factors increasing the probability of being in the high adherence group are older age, male sex, management of side effects, only one tablet per day and feeling well informed about CML by the doctor. More than 2 years since diagnosis were significantly lowering the chance as was the use of reminding tools. Living arrangements, multiple medication and personal payment obligations increased the probability to be at least in the medium adherent group. This is the most comprehensive study conducted to date to gain knowledge about factors causing non-adherence in CML. Better information on the disease, medication and management of side effects, supported by haematologists, is key to improve adherence.

  11. Multicultural long-term care nurses’ perceptions of factors influencing patient dignity at the end of life.

    Science.gov (United States)

    Periyakoil, Vyjeyanthi S; Stevens, Marguerite; Kraemer, Helena

    2013-03-01

    The goal of this mixed-methods study was to characterize the perceptions of multicultural long-term care nurses about patient dignity at the end-of-life (EOL). The study was conducted in a large, urban, long-term care (LTC) facility. Participants were 45 long-term care nurses and 26 terminally ill nursing home residents. Nurses completed an openended interview about their perceptions of the concept of dying with dignity, and the data were analyzed using grounded theory methods. Main themes identified as promoting resident dignity at the EOL included treating them with respect, helping them prepare for the EOL, promoting shared decision-making, and providing high-quality care. The nurses’ cultural and religious backgrounds influenced their perceptions of what constitutes dignity-conserving care. Foreign-born nurses stressed the need for EOL rituals, but this was strikingly absent in the statements of U.S.-born nurses. Foreign-born Catholic nurses stated that the dying experience should not be altered using analgesics to relieve suffering or by attempts to hasten death by forgoing curative therapy or by other means. Nurses and terminally ill individuals completed the Dignity Card-sort Tool (DCT). A comparison of the DCT responses of the LTC nurses cohort with those of the terminally ill participants revealed that the nurses felt patient dignity was eroded when patient wishes were not followed and when they were treated without respect. In contrast, dying LTC residents felt that poor medical care and loss of ability to choose care options were the most important factors leading to erosion of dignity.

  12. Reduction of Influence Factors

    NARCIS (Netherlands)

    Regtien, Paulus P.L.; Sydenham, Peter H.; Thorn, Richard

    Any measurement system has imperfections and any act of measurement is liable to errors. Measurement errors either originate from system deficiencies (for instance system noise, quantization, and drift), or are due to environmental influences such as thermal, electromagnetic, and mechanical

  13. Influence of obesity and other risk factors on survival outcomes in patients undergoing pancreaticoduodenectomy for pancreatic cancer.

    Science.gov (United States)

    Dandona, Monica; Linehan, David; Hawkins, William; Strasberg, Steven; Gao, Feng; Wang-Gillam, Andrea

    2011-08-01

    Established risk factors for the development of pancreatic cancer include tobacco use, family history of pancreatic cancer, personal history of diabetes, and obesity. The impact of risk factors on prognosis in patients with pancreatic cancer, particularly obesity, has recently become controversial. We conducted a retrospective analysis of patients with pancreatic adenocarcinoma who underwent pancreaticoduodenectomy between 1995 and 2009. Patients were categorized by body mass index (BMI) as normal (18.5-24.9 kg/m), overweight (25-29.9 kg/m), or obese (≥30 kg/m). Univariate analysis was performed to evaluate the association of obesity and other risk factors on overall survival. Of the 355 patients evaluated, 149 (42.0%) had normal BMI, 131 (36.9%) were overweight, and 75 (21.1%) were obese. Overall survival for normal, overweight, and obese groups was 17.3 months (95% confidence interval [CI], 14.2-20.8 months), 20.0 months (95% CI, 16.6-23.6 months), and 22.1 months (95% CI, 16.5-36.4 months), respectively (P = 0.58). Hazard ratios for tobacco use, family history of pancreatic cancer, and history of diabetes were 1.07, 1.38, and 0.87, respectively. Obesity and other risk factors have no impact on overall survival in patients with adenocarcinoma after pancreaticoduodenectomy. Further studies investigating the relationship between risk factors and their prognostic significance in patients with pancreatic cancer are warranted.

  14. Factors that influence cancer patients' anxiety following a medical consultation: impact of a communication skills training programme for physicians.

    Science.gov (United States)

    Liénard, A; Merckaert, I; Libert, Y; Delvaux, N; Marchal, S; Boniver, J; Etienne, A-M; Klastersky, J; Reynaert, C; Scalliet, P; Slachmuylder, J-L; Razavi, D

    2006-09-01

    No study has yet assessed the impact of physicians' skills acquisition after a communication skills training programme on the evolution of patients' anxiety following a medical consultation. This study aimed to compare the impact, on patients' anxiety, of a basic communication skills training programme (BT) and the same programme consolidated by consolidation workshops (CW), and to investigate physicians' communication variables associated with patients' anxiety. Physicians, after attending the BT, were randomly assigned to CW or to a waiting list. The control group was not a non-intervention group. Consultations with a cancer patient were recorded. Patients' anxiety was assessed with the State Trait Anxiety Inventory before and after a consultation. Communication skills were analysed according to the Cancer Research Campaign Workshop Evaluation Manual. No statistically significant change over time and between groups was observed. Mixed-effects modelling showed that a decrease in patients' anxiety was linked with screening questions (P = 0.045), physicians' satisfaction about support given (P = 0.004) and with patients' distress (P training programme was observed. This study shows the influence of some communication skills on the evolution of patients' anxiety. Physicians should be aware of these influences.

  15. Phonological Awareness: Factors of Influence

    Science.gov (United States)

    Frohlich, Linda Paulina; Petermann, Franz; Metz, Dorothee

    2013-01-01

    Early child development is influenced by various genetic and environmental factors. This study aims to identify factors that affect the phonological awareness of preschool and first grade children. Based on a sample of 330 German-speaking children (mean age = 6.2 years) the following domains were evaluated: Parent factors, birth and pregnancy,…

  16. Influence factors of salt-sensitive hypertension and responses of blood pressure and urinary sodium and potassium excretion to acute oral saline loading among essential hypertensive patients

    Institute of Scientific and Technical Information of China (English)

    刘叶舟

    2014-01-01

    Objective To explore the influence factors of saltsensitive hypertension and to observe changes of blood pressures and urinary sodium and potassium excretion in response to acute oral saline loading among essential hypertensive patients in China.Methods Essential hypertensive patients from Beijing Jinzhan second community were included in this study.Salt-sensitivity was determined via the improved Sullivan’s acute oral saline loading

  17. Prevalence rate and influencing factors of preoperative anxiety and depression in gastric cancer patients in China:A preliminary study

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Objective:We aimed to investigate the prevalence of, and factors inlfuencing, preoperative anxiety and depression in gastric cancer patients.Methods: We enrolled 53 gastric cancer patients from FujianMedical University Union Hospital, who were diagnosed by gastroscopy and would accept laparoscopic surgery. Each participant completed questionnaires to assess their anxiety and depression, coping modes, social support, type D personality and the values of Neutrophil to Lymphocyte Ratio (NLR).Results:The prevalence rate of preoperative anxiety and depression was 20.75% in the 53 gastric cancer patients. The factors were resigned dimensions of coping style, type D personality, NLR. There were no significant differences in confrontive and avoidant dimensions of coping mode and social support. Conclusion:The prevalence of preoperative anxiety and depression in gastric cancer patients is still high, and inlfuenced by the coping mode, type D personality and NLR.

  18. ASSESSMENT OF FACTORS INFLUENCING ADEQUACY OF NATIV E ARTERIOVENOUS FISTULA FOR LONG TERM VENOUS ACCESS I N HEMODIALYSIS PATIENTS

    OpenAIRE

    Shahid; Sharad; Riaz

    2013-01-01

    ABSTRACT: OBJECTIVE :-The aim of our study was to assess the factors af fecting adequacy of arteriovenous fistula (AVF) and to correlate it wit h clinical and demographic factors. MATERIAL AND METHODS: The prospectively designed study was conducted to det ermine adequacy of AVF in 130 patients over a period of tw o years. Adequacy of AVF was graded if the blood flow rate was higher or equal to 300 ml/ min on at least fifty percent of dialysis sessions in on...

  19. Application of Parametric Models of Survival Analysis in Determining the Cancer Influencing Factors in Patients with Thyroid Nodules

    OpenAIRE

    J.Yazdani Charati; O. Akha; AR Baghestani; F. Khosravi; Y Kavyani Charati

    2015-01-01

    Background & aim: One of the most common clinical problems among individuals is thyroid nodule diseases which are characterized by one or more nodules in the thyroid and are usually benign. It can be said that thyroid cancer is the most common endocrine cancer worldwide. This study aimed to determine the risk factors for cancer in patients with thyroid nodule in Mazandaran province,Iran, using parametric survival analysis. Methods: In the present historical cohort study, 26,730 patients w...

  20. Socioeconomic Factors Influencing Hospitalized Patients with Pneumonia Due to Influenza A(H1N1)pdm09 in Mexico

    Science.gov (United States)

    Manabe, Toshie; Higuera Iglesias, Anjarath Lorena; Vazquez Manriquez, Maria Eugenia; Martinez Valadez, Eduarda Leticia; Ramos, Leticia Alfaro; Izumi, Shinyu; Takasaki, Jin; Kudo, Koichiro

    2012-01-01

    Background In addition to clinical aspects and pathogen characteristics, people's health-related behavior and socioeconomic conditions can affect the occurrence and severity of diseases including influenza A(H1N1)pdm09. Methodology and Principal Findings A face-to-face interview survey was conducted in a hospital in Mexico City at the time of follow-up consultation for hospitalized patients with pneumonia due to influenza virus infection. In all, 302 subjects were enrolled and divided into two groups based on the period of hospitalization. Among them, 211 tested positive for influenza A(H1N1)pdm09 virus by real-time reverse-transcriptase-polymerase-chain-reaction during the pandemic period (Group-pdm) and 91 tested positive for influenza A virus in the post-pandemic period (Group-post). All subjects were treated with oseltamivir. Data on the demographic characteristics, socioeconomic status, living environment, and information relating to A(H1N1)pdm09, and related clinical data were compared between subjects in Group-pdm and those in Group-post. The ability of household income to pay for utilities, food, and health care services as well as housing quality in terms of construction materials and number of rooms revealed a significant difference: Group-post had lower socioeconomic status than Group-pdm. Group-post had lower availability of information regarding H1N1 influenza than Group-pdm. These results indicate that subjects in Group-post had difficulty receiving necessary information relating to influenza and were more likely to be impoverished than those in Group-pdm. Possible factors influencing time to seeking health care were number of household rooms, having received information on the necessity of quick access to health care, and house construction materials. Conclusions Health-care-seeking behavior, poverty level, and the distribution of information affect the occurrence and severity of pneumonia due to H1N1 virus from a socioeconomic point of view. These

  1. Socioeconomic factors influencing hospitalized patients with pneumonia due to influenza A(H1N1pdm09 in Mexico.

    Directory of Open Access Journals (Sweden)

    Toshie Manabe

    Full Text Available BACKGROUND: In addition to clinical aspects and pathogen characteristics, people's health-related behavior and socioeconomic conditions can affect the occurrence and severity of diseases including influenza A(H1N1pdm09. METHODOLOGY AND PRINCIPAL FINDINGS: A face-to-face interview survey was conducted in a hospital in Mexico City at the time of follow-up consultation for hospitalized patients with pneumonia due to influenza virus infection. In all, 302 subjects were enrolled and divided into two groups based on the period of hospitalization. Among them, 211 tested positive for influenza A(H1N1pdm09 virus by real-time reverse-transcriptase-polymerase-chain-reaction during the pandemic period (Group-pdm and 91 tested positive for influenza A virus in the post-pandemic period (Group-post. All subjects were treated with oseltamivir. Data on the demographic characteristics, socioeconomic status, living environment, and information relating to A(H1N1pdm09, and related clinical data were compared between subjects in Group-pdm and those in Group-post. The ability of household income to pay for utilities, food, and health care services as well as housing quality in terms of construction materials and number of rooms revealed a significant difference: Group-post had lower socioeconomic status than Group-pdm. Group-post had lower availability of information regarding H1N1 influenza than Group-pdm. These results indicate that subjects in Group-post had difficulty receiving necessary information relating to influenza and were more likely to be impoverished than those in Group-pdm. Possible factors influencing time to seeking health care were number of household rooms, having received information on the necessity of quick access to health care, and house construction materials. CONCLUSIONS: Health-care-seeking behavior, poverty level, and the distribution of information affect the occurrence and severity of pneumonia due to H1N1 virus from a socioeconomic

  2. Factors influencing access to education, decision making, and receipt of preferred dialysis modality in unplanned dialysis start patients

    Science.gov (United States)

    Machowska, Anna; Alscher, Mark Dominik; Reddy Vanga, Satyanarayana; Koch, Michael; Aarup, Michael; Qureshi, Abdul Rashid; Lindholm, Bengt; Rutherford, Peter A

    2016-01-01

    Objectives Unplanned dialysis start (UPS) leads to worse clinical outcomes than planned start, and only a minority of patients ever receive education on this topic and are able to make a modality choice, particularly for home dialysis. This study aimed to determine the predictive factors for patients receiving education, making a decision, and receiving their preferred modality choice in UPS patients following a UPS educational program (UPS-EP). Methods The Offering Patients Therapy Options in Unplanned Start (OPTiONS) study examined the impact of the implementation of a specific UPS-EP, including decision support tools and pathway improvement on dialysis modality choice. Linear regression models were used to examine the factors predicting three key steps: referral and receipt of UPS-EP, modality decision making, and actual delivery of preferred modality choice. A simple economic assessment was performed to examine the potential benefit of implementing UPS-EP in terms of dialysis costs. Results The majority of UPS patients could receive UPS-EP (214/270 patients) and were able to make a decision (177/214), although not all patients received their preferred choice (159/177). Regression analysis demonstrated that the initial dialysis modality was a predictive factor for referral and receipt of UPS-EP and modality decision making. In contrast, age was a predictor for referral and receipt of UPS-EP only, and comorbidity was not a predictor for any step, except for myocardial infarction, which was a weak predictor for lower likelihood of receiving preferred modality. Country practices predicted UPS-EP receipt and decision making. Economic analysis demonstrated the potential benefit of UPS-EP implementation because dialysis modality costs were associated with modality distribution driven by patient preference. Conclusion Education and decision support can allow UPS patients to understand their options and choose dialysis modality, and attention needs to be focused on

  3. Comparison of factors influencing patient choice of community pharmacy in Poland and in the UK, and identification of components of pharmaceutical care.

    Science.gov (United States)

    Merks, Piotr; Kaźmierczak, Justyna; Olszewska, Aleksandra Elzbieta; Kołtowska-Häggström, Maria

    2014-01-01

    Several factors, which are components of pharmaceutical care, can influence a patient's choice of a community pharmacy store and contribute to frequent visits to the same pharmacy. To compare factors that influence a patient's choice of pharmacy in Poland and in the UK, to identify which of them are components of pharmaceutical care, and to relate them to patient loyalty to the same pharmacy. A self-administered, anonymous questionnaire was distributed to clients visiting pharmacies in Poland and the UK January-August 2011. Comparisons were performed using chi-square tests and logistic regression. All statistical analyses were performed using SPSS 20.0. The response rate was 55.6% (n=417/750; 36 pharmacies) and 54.0% (n=405/750; 56 pharmacies) in Poland and in the UK, respectively. The most frequently reported factors, as defined by a percentage of responders, were in Poland: 1) location (84%); 2) professional and high-quality of service (82%); 3) good price of medicines (78%); and 4) promotions on medicines (66%). In the UK, the most commonly reported factors were: 1) professional and high quality of service (90%); 2) location (89%); 3) good advice received from the pharmacist (86%); and 4) option of discussing and consulting all health issues in a consultation room (80%). Good advice and an option of discussing personal concerns with a pharmacist are components of pharmaceutical care. Thirty-eight percent of patients in Poland and 61% in the UK declared visiting the same pharmacy. Components of pharmaceutical care are important factors influencing the patient's choice of pharmacy in the UK and, to a lesser degree, in Poland. Additionally, more patients in the UK than in Poland are committed to a single pharmacy. Therefore, implementing the full pharmaceutical care in Poland may contribute to an increase in patient loyalty and thus strengthen competitiveness of pharmacy businesses.

  4. Central Hypothyroidism and Its Replacement Have a Significant Influence on Cardiovascular Risk Factors in Adult Hypopituitary Patients

    DEFF Research Database (Denmark)

    Klose, M; Marina, Djordje; Hartoft-Nielsen, M-L

    2013-01-01

    Context: Thyroid dysfunction may have detrimental effects on patient outcomes. Few studies have assessed this issue in patients with secondary hypothyroidism. Objective: Our objective was to test the hypothesis that thyroid hormone status has an impact on cardiovascular risk factors in adult...... collected at baseline and a median 4.1 years after commencement of GH. Results: At baseline, fT4 was negatively associated with BMI and waist circumference, but positively with high-density lipoprotein, independent of age, gender, and IGF-I (SD score). Only first-tertile TSH-deficient patients had higher...... cholesterol persisted only in first-tertile TSH-deficient patients. Conclusion: This single-center study over a 20-year period has strengthened the importance of improved awareness of thyroid status and optimal thyroid replacement of hypopituitary patients to reduce cardiovascular risks in hypopituitary...

  5. Practice variation of vaginal birth after cesarean and the influence of risk factors at patient level : A retrospective cohort study

    NARCIS (Netherlands)

    Vankan, Emy; Schoorel, Ellen N. C.; van Kuijk, Sander M. J.; Mol, Ben-Willem J.; Nijhuis, Jan G.; Aardenburg, Robert; Alink, Marleen; de Boer, Karin; Delemarre, Friso M. C.; Dirksen, Carmen D.; Van Dooren, Ivo M. A.; Franssen, Maureen T. M.; Kaplan, Mesrure; Kleiverda, Gunilla; Kuppens, Simone M. I.; Kwee, Anneke; Langenveld, Josje; Lim, Frans T. H.; Melman, Sonja; Sikkema, Marko J.; Smits, Luc J.; Visser, Harry; Woiski, Mallory; Scheepers, Hubertina C.; Hermens, Rosella P. M. G.

    IntroductionLarge practice variation exists in mode of delivery after cesarean section, suggesting variation in implementation of contemporary guidelines. We aim to evaluate this practice variation and to what extent this can be explained by risk factors at patient level. Material and methodsThis

  6. Practice variation of vaginal birth after cesarean and the influence of risk factors at patient level: a retrospective cohort study

    NARCIS (Netherlands)

    Vankan, E.; Schoorel, E.N.; Kuijk, S.M. van; Mol, B.J.; Nijhuis, J.G.; Aardenburg, R.; Alink, M.; Boer, K. de; Delemarre, F.M.; Dirksen, C.D.; Dooren, I.M. van; Franssen, M.T.; Kaplan, M.; Kleiverda, G.; Kuppens, S.M.; Kwee, A.; Langenveld, J.; Lim, F.T.; Melman, S.; Sikkema, M.J.; Smits, L.J; Visser, H.; Woiski, M.D.; Scheepers, H.C.; Hermens, R.P.M.G.

    2017-01-01

    INTRODUCTION: Large practice variation exists in mode of delivery after cesarean section, suggesting variation in implementation of contemporary guidelines. We aim to evaluate this practice variation and to what extent this can be explained by risk factors at patient level. MATERIAL AND METHODS:

  7. Factors influencing access to education, decision making, and receipt of preferred dialysis modality in unplanned dialysis start patients

    DEFF Research Database (Denmark)

    Machowska, Anna; Alscher, Mark Dominik; Vanga, Satyanarayana Reddy

    2016-01-01

    Objectives: Unplanned dialysis start (UPS) leads to worse clinical outcomes than planned start, and only a minority of patients ever receive education on this topic and are able to make a modality choice, particularly for home dialysis. This study aimed to determine the predictive factors for pat...

  8. Subclavian central venous catheter-related thrombosis in trauma patients: incidence, risk factors and influence of polyurethane type.

    Science.gov (United States)

    Gentile, Ariane; Petit, Laurent; Masson, Françoise; Cottenceau, Vincent; Bertrand-Barat, Josseline; Freyburger, Geneviève; Pinaquy, Catherine; Léger, Alain; Cochard, Jean-François; Sztark, François

    2013-05-29

    The incidence of deep venous thrombosis (DVT) related to a central venous catheter varies considerably in ICUs depending on the population included. The aim of this study was to determine subclavian central venous catheter (SCVC)-related DVT risk factors in severely traumatized patients with regard to two kinds of polyurethane catheters. Critically ill trauma patients needing a SCVC for their usual care were prospectively included in an observational study. Depending on the month of inclusion, patients received one of the two available products in the emergency unit: either an aromatic polyurethane SCVC or an aliphatic polyurethane SCVC. Patients were screened weekly by ultrasound for SCVC-related DVT. Potential risk factors were collected, including history-related, trauma-related and SCVC-related characteristics. A total of 186 patients were included with a median Injury Severity Sore of 30 and a high rate of severe brain injuries (21% of high intracranial pressure). Incidence of SCVC-related DVT was 37% (95% confidence interval: 26 to 40) in patients or 20/1,000 catheter-days. SCVC-related DVT occurred within 8 days in 65% of cases. There was no significant difference in DVT rates between the aromatic polyurethane and aliphatic polyurethane SCVC groups (38% vs. 36%). SCVC-related DVT independent risk factors were age>30 years, intracranial hypertension, massive transfusion (>10 packed red blood cell units), SCVC tip position in the internal jugular or in the innominate vein, and ipsilateral jugular catheter. SCVC-related DVT concerned one-third of these severely traumatized patients and was mostly clinically silent. Incidence did not depend on the type of polyurethane but was related to age>30 years, intracranial hypertension or misplacement of the SCVC. Further studies are needed to assess the cost-effectiveness of routine screening in these patients in whom thromboprophylaxis may be hazardous.

  9. 医院患者安全文化影响因素研究进展%Research Progress of Influencing Factors of Hospital Patient Safety Culture

    Institute of Scientific and Technical Information of China (English)

    康敏; 黄照权; 石武祥

    2016-01-01

    本文阐述了国内外患者安全文化影响因素的研究现状,总结了医务人员的工作年限、职称和文化程度等个体特征以及医院规模、等级、组织管理等环境因素对患者安全文化的影响,指出了患者安全文化影响因素研究的不足及未来发展趋势,为患者安全文化建设的政策制定和进一步研究提供线索和理论依据.%This article is to review the research status on the influencing factors of hospital patient safety culture, and summarize the influ-ence of individual characteristics of the medical personnel such as working years, professionals and cultural levels and environmental factors such as hospital scale, grade, management on hospital patient safety culture.It tells about the achievements and shortcomings, and the future develop-ment trend of research on influencing factors of patient safety culture, and provides clues and theoretical basis for enriching and improving hospital patient safety culture.

  10. The efficacy and influencing factors of combination of prednisone and MTX in patients with IgA nephropathy

    Institute of Scientific and Technical Information of China (English)

    Xuan Cao; Jian Chen; Ya-Lin Hu

    2016-01-01

    Objective:To evaluate the efficacy and factors of prednisone combined with cyclophosphamide (CTX) treatment of primary immunoglobulin A (IgA).Methods:Ninty six cases of IgA nephropathy patients were treated with prednisone combined CTX from January 2013 to December 2014. Renal function before and after treatment was measured and the effects of prednisone combined CTX in patients with IgA nephropathy were analyzed.Results:Thirty eight cases were cured in 96 cases of IgA nephropathy patients (39.58%), 42 cases were effective (43.75%), 16 cases were ineffective (16.67%), totally, and 80 were was ffective (83.33%). After treatment, blood urea nitrogen (BUN), serum creatinine (blood Scr), 24 h urine protein (24 h Uab) were lower than before treatment, and endogenous creatinine clearance (Ccr) were significantly higher than before treatment (P<0.05). After logistic regression, 24 h urine protein levels, Ccr before treatment, LEE kidney tissue classification, hypertension were risk factors of prednisone combined with CTX treatment on prognosis of patients with IgA nephropathy.Conclusions:Prednisone combined CTX is effective in the treatment of IgA nephropathy, but clinical and pathological features of patients should be considered in the choice of the program.

  11. Factors influencing access to education, decision making, and receipt of preferred dialysis modality in unplanned dialysis start patients

    Directory of Open Access Journals (Sweden)

    Machowska A

    2016-11-01

    Full Text Available Anna Machowska,1 Mark Dominik Alscher,2 Satyanarayana Reddy Vanga,3 Michael Koch,4 Michael Aarup,5 Abdul Rashid Qureshi,1 Bengt Lindholm,1 Peter A Rutherford6 1Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden; 2Division of Nephrology, Department of Internal Medicine, Robert-Bosch-Krankenhaus, Stuttgart, Germany; 3Department of Renal Medicine, University Hospital of North Staffordshire, Stoke-on-Trent, Staffordshire, UK; 4Center of Nephrology, Nephrologisches Zentrum, Mettmann, Germany; 5Department of Nephrology, Odense University Hospital, Odense, Denmark; 6Baxter Healthcare SA, Zurich, Switzerland Objectives: Unplanned dialysis start (UPS leads to worse clinical outcomes than planned start, and only a minority of patients ever receive education on this topic and are able to make a modality choice, particularly for home dialysis. This study aimed to determine the predictive factors for patients receiving education, making a decision, and receiving their preferred modality choice in UPS patients following a UPS educational program (UPS-EP. Methods: The Offering Patients Therapy Options in Unplanned Start (OPTiONS study examined the impact of the implementation of a specific UPS-EP, including decision support tools and pathway improvement on dialysis modality choice. Linear regression models were used to examine the factors predicting three key steps: referral and receipt of UPS-EP, modality decision making, and actual delivery of preferred modality choice. A simple economic assessment was performed to examine the potential benefit of implementing UPS-EP in terms of dialysis costs. Results: The majority of UPS patients could receive UPS-EP (214/270 patients and were able to make a decision (177/214, although not all patients received their preferred choice (159/177. Regression analysis demonstrated that the initial dialysis modality was a predictive

  12. ASSESSMENT OF FACTORS INFLUENCING ADEQUACY OF NATIV E ARTERIOVENOUS FISTULA FOR LONG TERM VENOUS ACCESS I N HEMODIALYSIS PATIENTS

    Directory of Open Access Journals (Sweden)

    Shahid

    2013-04-01

    Full Text Available ABSTRACT: OBJECTIVE :-The aim of our study was to assess the factors af fecting adequacy of arteriovenous fistula (AVF and to correlate it wit h clinical and demographic factors. MATERIAL AND METHODS: The prospectively designed study was conducted to det ermine adequacy of AVF in 130 patients over a period of tw o years. Adequacy of AVF was graded if the blood flow rate was higher or equal to 300 ml/ min on at least fifty percent of dialysis sessions in one month. AV-fistula adequacy was correlated wi th clinical and demographic factors like age, gender, diabetic status, smoking status, body mass index (BMI, serum calcium, serum phosphorus and Ca×P product, serum albumin and an eval uation for peripheral vascular disease (PVD. RESULTS: The study included 130 patients (68 males and 42 fem ales. Early adequacy rate of 110 fistulas was 66% and 51% at end of 3 rd and 6 th months respectively. Diabetes was present in 41%, 32% were hypertensive and 27% of the patients were overweight (BMI ≥27 kg/m 2 . The adequacy rate was lower in older (age ≥ 65 patients (34.0 vs. 57.6%, P = 0.028, in overweight (BMI ≥ 27 kg/m 2 patients (33.3 vs. 57.5%, P = 0.026. It was also marginally lower in diabetics versus nondiabetics (40.0 vs. 58%, P = 0.058 and the presence of peripheral vascular disease and increase calcium phosphorus produ ct adversely affected AVF adequacy. The adequacy rate was not affected by patient smokin g status and serum albumin. The adequacy rate was substantially lower for forearm v ersus upper arm fistulas (40.0 vs. 64%, P = 0.0131. The adequacy of forearm fistulas was partic ularly poor in women (13%, patients age 65 or older (12.5%, and diabetics (24%. In contra st, upper arm fistulas were adequate in ORIGINAL ARTICLE Journal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 13/ April 1, 2013 Page- 2033 59.2% of women, 56.3% of older patients, 54% of diab etics, and 30% of those having moderate to severe PVD. CONCLUSIONS

  13. Factors influencing treatment success of negative pressure wound therapy in patients with postoperative infections after Osteosynthetic fracture fixation

    DEFF Research Database (Denmark)

    Izadpanah, Kaywan; Hansen, Stephanie; Six-Merker, Julia

    2017-01-01

    3 (OR 10.2 [CI 1.88-55.28]). Wounds were less likely to heal in conjunction with high CRP blood levels (>20 mg/l) at the time of discharge (OR 3.6 [95% CI 1.31-10.08]) or following a change of the infecting bacterial species under therapy (OR 3.2 [95% CI, 1.13-8.99]). CONCLUSIONS: These results......BACKGROUND: Negative Pressure Wound Therapy (NPWT) is being increasingly used to treat postoperative infections after osteosynthetic fracture fixation. The aim of the present study was to analyze the influence of epidemiological and microbiological parameters on outcome. METHODS: Infections...... logistic regression models based on data from 106 patients. RESULTS: Staged wound lavage in combination with NPWT allowed implant preservation in 44% and led to successful healing in 73% of patients. Fermentation characteristics, load and behavior after gram staining revealed no statistically significant...

  14. Factors influencing patients seeking oral health care in the oncology dental support clinic at an urban university dental school setting.

    Science.gov (United States)

    Corrigan, Dale M; Walker, Mary P; Liu, Ying; Mitchell, Tanya Villalpando

    2014-01-01

    The purpose of this study was to identify predictors and/or factors associated with medically compromised patients seeking dental care in the oncology dental support clinic (ODSC) at the University of Missouri-Kansas City (UMKC) School of Dentistry. An 18-item survey was mailed to 2,541 patients who were new patients to the clinic from 2006 to 2011. The response rate was approximately 18% (n = 450). Analyses included descriptive statistics of percentages/frequencies as well as predictors based on correlations. Fifty percent of participants, 100 females and 119 males, identified their primary medical diagnosis as cancer. Total household income (p dental care (p dental health. Perceived overall health (p < .001) also had a significant association with cancer status and the need for organ transplants. This study provided the ODSC at UMKC and other specialty clinics with vital information that can contribute to future planning efforts.

  15. Hepatitis B vaccination in haemodialysis patients: an underestimated problem. Factors influencing immune responses in ten years of observation in an Italian haemodialysis centre and literature review.

    Science.gov (United States)

    Cordova, E; Miglia, I; Festuccia, F; Sarlo, M G; Scornavacca, G; Punzo, G; Menè, P; Fofi, C

    2017-01-01

    Despite universal infection control precautions, the risk of hepatitis B virus (HBV) infection in patients on chronic haemodialysis (HD) remains high. For this reason anti-HBV vaccination is recommended in these subjects. In hemodialyzed patients vaccinal response is often suboptimal and it's not clear what factors may influence it. The aim of our study is to assess the influence of some clinical and laboratory factors on seroconversion rate after anti HBV vaccination in a cohort of patients on maintenance HD. We analysed 60 patients on regular HD, 40 men and 20 women (age 64±12 years, range 40-88 years), immunized with Engerix B ® vaccine, followed for an average time of 62 month (12-120 months). For each patient the following data were collected: age, serum albumin (sAlb), Blood urea nitrogen before HD session (BUN), age at vaccination, dialysis vintage, presence of systemic disease, type of vascular access, dialysis modality. Correlation between these factors and anti Hbs titer was estimated with multiple regression analysis. Anti-Hbs seroconversion rate ( Anti Hbs > 10 IU/l) was 77%. Better rate of seroconversion (86%) was observed in patients with arteriovenous fistula (AVF) and serum albumin > 3,5 g/dL (93%), while higher rate of not responders (50%) in patients with systemic diseases. The only parameter correlated to anti Hbs titer was sAlb (p =0,0012). sAlb was correlated to age in all patients (p=0,01) and age was correlated to higher anti Hbs titer in the responder group (p=0,018). In our experience an early vaccination, when patients on chronic HD are younger and in better nutritional conditions, improves anti-HBV response.

  16. Possible factors influencing high serum Prostate-specific Antigen (PSA in Indonesian patients with Benign Prostatic Hyperplasia (BPH

    Directory of Open Access Journals (Sweden)

    Djoko Rahardjo

    2001-03-01

    Full Text Available Benign prostatic hyperplasia (BPH cases in Indonesia frequently associated with high serum prostate specific antigen (PSA. To explore possible factors that could increase serum PSA level, we performed a retrospective, cross-sectional study on 805 consecutive patients in Sumber Waras and Dr. Cipto Mangunkusumo Hospitals from 1994 to 1997. Clinical manifestations were evaluated and prostate biopsies were performed if indicated. Complete histopathological data were only available in 82 BPH patients with no urinary retention from 1998-1999 and a thin section of paraffin blocks of BPH patients which still could be found from 1994-1999 was analyzed using flow cytometer to obtain the S-phase fraction as a parameter of proliferative activity, From 805 patients, 461 (57% presented with urinary retention and need to be catheteized. Catheteization significantly increased PSA level if compared to noncatheterized patients (16.3 vs. 6,8 ng/mL, p= 0,000. Another data of 82 uncatheteized patients from 1998-1999 has revealed that 79 patients (96.3% had chronic prostatitis and 19 (23.2% showed the presence of prostatic-intraepithelial neoplasia (PIN with an increase of PSA level (5.4 ng/mL. The S-phase fraction of BPH without PIN cases was significantly higher in cases with PSA > 4 ng/ml than patients with PSA ≤ 4 ng/ml (I3.1% vs. 8.9%, p=0,008. As conclusion, the high serum PSA level was mostly due to urethral catheteization and increased prostate volume. There was a tendency of increasing PSA in subclinical inflammation and PIN. Cases with high PSA also showed high proliferative activities which is suggestive of mitogenic activity. (Med J Indones 2001; 10:22-8Keywords: BPH, high PSA, PIN, proliferative activity, s-phase fraction

  17. Influencing factors for early acute cerebrovascular accidents in patients with stroke history following off-pump coronary artery bypass grafting.

    Science.gov (United States)

    Wang, Bin; Jia, Ming; Jia, Shijie; Wan, Jiuhe; Zhou, Xiao; Luo, Zhimin; Zhou, Ye; Zhang, Jianqun

    2014-06-01

    To analyse risk factors for early acute cerebrovascular accidents following off-pump coronary artery bypass grafting (OPCAB) in patients with stroke history, and to propose preventive measures to reduce the incidence of these events. A total of 468 patients with a history of stroke underwent OPCAB surgery in Beijing Anzhen Hospital of China from January 2010 to September 2012. They were retrospectively divided into two groups according to the occurrence of early acute cerebrovascular accidents within 48 hours following OPCAB. Multivariate logistic regression analysis was used to find risk or protective factors for early acute cerebrovascular accidents following the OPCAB. Fifty-two patients (11.1%) suffered from early acute cerebrovascular accidents in 468 patients, including 39 cases of cerebral infarction, two cases of cerebral haemorrhage, 11 cases of transient ischaemic attack (TIA). There were significant differences between the two groups in preoperative left ventricular ejection fraction ≤ 35%, severe bilateral carotid artery stenosis, poorly controlled hypertension, intraoperative application of Enclose® II proximal anastomotic device, postoperative acute myocardial infarction, atrial fibrillation, hypotension, ventilation time > 48h, ICU duration >48h and mortality. Multivariate logistic regression analysis showed that preoperative severe bilateral carotid stenosis (OR=6.378, 95%CI: 2.278-20.987) and preoperative left ventricular ejection fraction ≤ 35% (OR=2.737, 95%CI: 1.267-6.389), postoperative acute myocardial infarction (OR=3.644, 95%CI: 1.928-6.876), postoperative atrial fibrillation (OR=3.104, 95%CI:1.135∼8.016) and postoperative hypotension (OR=4.173, 95%CI: 1.836∼9.701) were independent risk factors for early acute cerebrovascular accidents in patients with a history of stroke following OPCAB procedures, while intraoperative application of Enclose® II proximal anastomotic device was protective factor (OR=0.556, 95%CI: 0.337-0.925). This

  18. Provider performance in treating poor patients - factors influencing prescribing practices in lao PDR: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Petzold Max

    2011-01-01

    Full Text Available Abstract Background Out-of-pocket payments make up about 80% of medical care spending at hospitals in Laos, thereby putting poor households at risk of catastrophic health expenditure. Social security schemes in the form of community-based health insurance and health equity funds have been introduced in some parts of the country. Drug and Therapeutics Committees (DTCs have been established to ensure rational use of drugs and improve quality of care. The objective was to assess the appropriateness and expenditure for treatment for poor patients by health care providers at hospitals in three selected provinces of Laos and to explore associated factors. Methods Cross-sectional study using four tracer conditions. Structured interviews with 828 in-patients at twelve provincial and district hospitals on the subject of insurance protection, income and expenditures for treatment, including informal payment. Evaluation of each patient's medical record for appropriateness of drug use using a checklist of treatment guidelines (maximum score = 10. Results No significant difference in appropriateness of care for patients at different income levels, but higher expenditures for patients with the highest income level. The score for appropriate drug use in insured patients was significantly higher than uninsured patients (5.9 vs. 4.9, and the length of stay in days significantly shorter (2.7 vs. 3.7. Insured patients paid significantly less than uninsured patients, both for medicines (USD 14.8 vs. 43.9 and diagnostic tests (USD 5.9 vs. 9.2. On the contrary the score for appropriateness of drug use in patients making informal payments was significantly lower than patients not making informal payments (3.5 vs. 5.1, and the length of stay significantly longer (6.8 vs. 3.2, while expenditures were significantly higher both for medicines (USD 124.5 vs. 28.8 and diagnostic tests (USD 14.1 vs. 7.7. Conclusions The lower expenditure for insured patients can help reduce

  19. Patient-Related Factors Influencing Satisfaction in the Patient-Doctor Encounters at the General Outpatient Clinic of the University of Calabar Teaching Hospital, Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    Ndifreke E. Udonwa

    2012-01-01

    Full Text Available Medical consultation is at the centre of clinical practice. Satisfaction of a patient with this process is a major determinant of the clinical outcome. This study sought to determine the proportion of patients who were satisfied with their doctor-patient encounter and the patient-related factors that affected patients’ satisfaction with the consultation process. A clinic-based, cross-sectional study using a modified version of the General Practice Assessment Questionnaire (GPAQ, which employed a systematic sampling technique, was used. The questionnaires were administered on 430 patients within the ages of 18 years and 65 years. Among the 430 subjects within the ages of 18 years and 65 years studied, 200 (46.5% were males and 230 (53.5% were females. Only 59.3% were satisfied with their patient-doctor encounter. The patient’s perception of time spent in the consultation, illness understanding after the visit, ability to cope with the illness after the visit, and ability to maintain health after visit were the only factors that affected patient’s satisfaction with the consultation. In our environment, nonsatisfaction with the patient-doctor encounter is high. Only few factors considered to encourage a patients satisfaction at primary care consultation contributed to end-of-consultation satisfaction. This calls for refocusing so as to improve the overall patient care in our cultural context and meet the patient needs in our environment.

  20. Practice variation of vaginal birth after cesarean and the influence of risk factors at patient level: a retrospective cohort study.

    Science.gov (United States)

    Vankan, Emy; Schoorel, Ellen N; van Kuijk, Sander M; Mol, Ben-Willem J; Nijhuis, Jan G; Aardenburg, Robert; Alink, Marleen; de Boer, Karin; Delemarre, Friso M C; Dirksen, Carmen D; van Dooren, Ivo M; Franssen, Maureen T M; Kaplan, Mesrure; Kleiverda, Gunilla; Kuppens, Simone M I; Kwee, Anneke; Langenveld, Josje; Lim, Frans T; Melman, Sonja; Sikkema, Marko J; Smits, Luc J; Visser, Harry; Woiski, Mallory; Scheepers, Hubertina C; Hermens, Rosella P

    2017-02-01

    Large practice variation exists in mode of delivery after cesarean section, suggesting variation in implementation of contemporary guidelines. We aim to evaluate this practice variation and to what extent this can be explained by risk factors at patient level. This retrospective cohort study was performed among 17 Dutch hospitals in 2010. Women with one prior cesarean section without a contraindication for a trial of labor were included. We used multivariate logistic regression analysis to develop models for risk factor adjustments. One model was derived to adjust the elective repeat cesarean section rates; a second model to adjust vaginal birth after cesarean rates. Standardized rates of elective repeat cesarean section and vaginal birth after cesarean per hospital were compared. Pseudo-R(2) measures were calculated to estimate the percentage of practice variation explained by the models. Secondary outcomes were differences in practice variation between hospital types and the correlation between standardized elective repeat cesarean section and vaginal birth after cesarean rates. In all, 1068 women had a history of cesarean section, of whom 71% were eligible for inclusion. A total of 515 women (67%) had a trial of labor, of whom 72% delivered vaginally. The elective repeat cesarean section rate at hospital level ranged from 6 to 54% (mean 29.8, standard deviation 11.8%). Vaginal birth after cesarean rates ranged from 50 to 90% (mean 71.8%, standard deviation 11.1%). More than 85% of this practice variation could not be explained by risk factors at patient level. A large practice variation exists in elective repeat cesarean section and vaginal birth after cesarean rates that can only partially be explained by risk factors at patient level. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  1. Factors Influencing Healthcare Service Quality

    OpenAIRE

    Ali Mohammad Mosadeghrad

    2014-01-01

    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 o...

  2. Patients with alcohol-related liver disease--beliefs about their illness and factors that influence their self-management.

    Science.gov (United States)

    Lau-Walker, Margaret; Presky, Jonathan; Webzell, Ian; Murrells, Trevor; Heaton, Nigel

    2016-01-01

    To determine the association between illness belief and self-efficacy to provide the evidence-base to develop a personalized framework to support self-management in patients with alcohol-related liver disease. Research in a variety of long-term illnesses suggests patients' illness beliefs are a more influential factor for patient recovery than the severity of the illness. However, research into illness belief and self-efficacy of patients with alcohol-related liver disease is sparse. A cross-sectional survey. A cohort of 159 patients with alcohol-related liver disease who attended the Liver Outpatient Clinics at a London Hospital (October 2012-November 2013) completed a set of validated instruments measuring illness beliefs, self-efficacy, emotional states and quality of life. The mean age of enrolled patients was 52 years, 67% male, 26% live on their own, 61% had no previous history of other chronic illness and average Model for End-Stage Liver Disease and The AUDIT Alcohol Consumption Questions scores were 11·0 and 3·5 respectively. After adjusting for demographic and illness characteristic components, multiple regression analysis shows that the three illness belief components 'Symptoms', 'Understanding' and 'Concerns' made a significant contribution to their confidence to self-manage their liver condition and the 'Symptoms' component makes a signification contribution across to all outcome measures: Anxiety, Depression, Quality of Life and Self-Efficacy. Interventions designed to improve these patients' understanding of their illness and strategies to manage their symptoms are likely to improve their self-management, quality of life and reduce anxiety and depression. © 2015 John Wiley & Sons Ltd.

  3. Factors influencing the development of antibiotic associated diarrhea in ED patients discharged home: risk of administering IV antibiotics.

    Science.gov (United States)

    Haran, John Patrick; Hayward, Gregory; Skinner, Stephen; Merritt, Chris; Hoaglin, David C; Hibberd, Patricia L; Lu, Shan; Boyer, Edward W

    2014-10-01

    Antibiotic-associated diarrhea (AAD) and Clostridium difficile infection (CDI) are well-known outcomes from antibiotic administration. Because emergency department (ED) visits frequently result in antibiotic use, we evaluated the frequency of AAD/CDI in adults treated and discharged home with new prescriptions for antibiotics to identify risk factors for acquiring AAD/CDI. This prospective multicenter cohort study enrolled adult patients who received antibiotics in the ED and were discharged with a new prescription for antibiotics. Antibiotic-associated diarrhea was defined as 3 or more loose stools for 2 days or more within 30 days of starting the antibiotic. C difficile infection was defined by the detection of toxin A or B within this same period. We used multivariate logistic regression to assess predictors of developing AAD. We enrolled and followed 247 patients; 45 (18%) developed AAD, and 2 (1%) developed CDI. Patients who received intravenous (IV) antibiotics in the ED were more likely to develop AAD/CDI than patients who did not: 25.7% (95% confidence interval [CI], 17.4-34.0) vs 12.3% (95% CI, 6.8-17.9). Intravenous antibiotics had adjusted odds ratio of 2.73 (95% CI, 1.38-5.43), and Hispanic ethnicity had adjusted odds ratio of 3.04 (95% CI, 1.40-6.58). Both patients with CDI had received IV doses of broad-spectrum antibiotics. Intravenous antibiotic therapy administered to ED patients before discharge was associated with higher rates of AAD and with 2 cases of CDI. Care should be taken when deciding to use broad-spectrum IV antibiotics to treat ED patients before discharge home. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. The influence of socio-demographic and environmental factors on the fall rate in geriatric patients in primary health care

    Directory of Open Access Journals (Sweden)

    Magdalena Sylwia Kamińska

    2017-06-01

    Full Text Available Background . A fall is defined as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level. Falls are the leading cause of injuries among geriatrics and a factor which significantly lowers their quality of life. Objectives. The aim of this study was to identify fall risk factors in the elderly with regard to their environmental situation and sociodemographic data. Material and methods. This epidemiological population-based study involved 304 patients from selected outpatient clinics. The median age was 79 years. Our study employed a diagnostic survey-based method using an environmental inquiry of our devising, as well as the Tinetti Test (TT. Results . A statistically significant correlation was found between the number of falls and such variables as age, the family structure and family care efficiency (p 0.05. Regardless of whether the respondents experienced falls or not, a vast majority of them showed a need for information support concerning the reduction of fall risk in the future. Conclusions . 1. Risk factors for falls among geriatric patients include age, falls in the medical history, solitude as an adverse social situation and the unpreparedness of the family for taking non-professional care of their elderly relatives. 2. According to the respondents, information support may improve their knowledge of fall prevention and ways of handling the situation with increasingly limited self- -reliance, and the preparation of their families for taking care of them may reduce the risk of falls.

  5. Proofs concerning the existence, in the blood of hypertensive patients, of some serum factors influencing the vascular smooth muscle and the myocardium physiology.

    Science.gov (United States)

    Mocanu, M; Botea, S; Dragomir, C T

    1991-01-01

    Starting from the existence of some autoimmune diseases (i.e. bronchial asthma or miastenia gravis) we asked ourselves if some plasmatic factors do exist, influencing the receptor--mediator relations in cardiovascular system during some illnesses having unknown etiology, as arterial hypertension. For this reason, in this work was tested the hypothesis that, in some chronic cardiovascular diseases would exist factors circulating and affecting the functions of the cellular membranes of the arterial wall, particularly of the smooth muscle cells and myocardial cells. Our results show a significant modification of the calcium fluxes and of some neuromediators uptake at the hypertensive patients.

  6. Factors influencing the exit knowledge of patients for dispensed drugs at outpatient pharmacy of Hiwot Fana Specialized University Hospital, Eastern Ethiopia

    Directory of Open Access Journals (Sweden)

    Hirko N

    2017-02-01

    Full Text Available Nigatu Hirko,1 Dumessa Edessa2 1Department of Pharmacy, Bisidimo Hospital, East Hararghe Zone, Oromia, Ethiopia; 2Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia Background: A satisfactory counseling process between the patient and pharmacist is critical for rational use of dispensed drug(s and is highly influenced by many factors including the experience of pharmacist in dispensing process. To improve patients’ knowledge of dispensed drugs, it is necessary to understand the factors that optimize a pharmacist interaction with a patient in each activity of the dispensing process. Therefore, the aim of this study was to identify the pharmacist and patient factors that influence knowledge of dispensed drugs by ambulatory patients at Hiwot Fana Specialized University Hospital, Harar, Ethiopia.Materials and methods: A cross-sectional study was conducted on 422 respondents. Data were collected by interviews using a structured questionnaire that measures “exit knowledge” of the ambulatory patients for dispensed drugs. The collected data were analyzed using SPSS Version 20.0. Potential covariates were identified using χ2 test, and logistic regression analyses were undertaken to adjust for the covariates.Results: Our findings showed significant proportions of the patients did not recall the name of their dispensed medication (53.6%, major side effects (66.4%, and what to do in case of missed doses (65.4%. Patients’ knowledge of dispensed drugs was significantly associated with their educational level (adjusted odds ratio [AOR]: 1.97; 95% confidence interval [CI]: 1.01–3.84 [primary], AOR: 2.04; 95% CI: 1.04–4.04 [secondary], and AOR: 2.71; 95% CI: 1.35–5.46 [tertiary]; clear instruction from the pharmacist (AOR: 3.36; 95% CI: 1.16–9.72; and the politeness of the pharmacist (AOR: 2.02; 95% CI: 1.04–4.04.Conclusion: We found that the

  7. Relationship between serum carcinoembryonic antigen level and epidermal growth factor receptor mutations with the influence on the prognosis of non-small-cell lung cancer patients

    Directory of Open Access Journals (Sweden)

    Cai ZX

    2016-06-01

    Full Text Available Zuxun Cai Department of Thoracic Surgery, Henan Provincial Chest Hospital, Zhengzhou City, People’s Republic of China Objective: To investigate the relationship between serum carcinoembryonic antigen (CEA level and epidermal growth factor receptor (EGFR gene mutations in non-small-cell lung cancer (NSCLC patients and to analyze the influence of CEA level on postoperative survival time in lung cancer patients. Methods: A total of 296 patients who were treated in Thoracic Surgery Department of Henan Provincial Chest Hospital from September 2011 to September 2013 were recruited. The level of tumor markers, such as CEA, was determined before the surgery, and EGFR gene mutations were detected after surgery. Thereby, the relationship between tumor makers, including CEA, and EGFR mutation and its influence on prognosis could be investigated. Results: Among 296 patients, the positive rate of EGFR gene mutation was 37.84% (112/296; the mutation occurred more frequently in nonsmokers, adenocarcinoma patients, women, and patients aged <60 years (P<0.05. Both tumor markers and chemosensitivity indicators were related to the profile of EGFR mutations. Elevated squamous cell carcinoma and Cyfra21-1 as well as positively expressed ERCC1 were more common in patients with wild-type EGFR (P<0.05, whereas increased CEA level was observed more frequently in patients with EGFR gene mutation (P=0.012. The positive rate of EGFR gene mutations was higher as the serum CEA level increased, that is, the positive rate in patients with serum CEA level <5, 5–20, and >20 µg/L was 39.81%, 45.32%, and 65.47%, respectively (P=0.004. Logistic regression analysis showed that CEA level was an independent factor in predicting EGFR gene mutations, and serum CEA level was also an independent factor in affecting the prognosis of NSCLC patients, as the overall 2-year survival rate was 73.86% in elevated CEA group and 86.43% in normal group (P<0.01. Conclusion: The prognosis of

  8. Factors that influence the shedding of Blastocystis cysts in an irritable bowel syndrome (IBS) patient--an evidence-based case study.

    Science.gov (United States)

    Ragavan, Nanthiney Devi; Govind, Suresh Kumar; Chye, Tan Tian; Mahadeva, Sanjiv

    2015-08-01

    Blastocystis is one of the most common gut parasites found in the intestinal tract of humans and animals. We have previously reported the irregular shedding of Blastocystis cysts in stools from infected patients. In the present study, we assess the factors influencing shedding patterns from a Blastocystis ST3-infected IBS patient. The stools samples were voluntarily submitted for examination for a period of 30 days from Blastocystis ST3-infected IBS patient. A questionnaire on the factors that could influence the shedding pattern of the cysts was designed to assess the following information: (a) the frequency of frequenting the toilet in a day, (b) the timing of frequenting the toilet, (c) the stool forms, (d) the type of mood the patient was in when frequenting the toilet and (e) food intake. A total of 79 stool samples were collected for 30 days. The highest number of cysts recorded when the patient visited the toilet three times a day was 22.2 × 10(6) cysts/g. Frequenting the toilet between 6 a.m. to 11.59 a.m. showed the highest number of cysts, i.e. 21.7 × 10(6) cysts/g. Semi-solid forms showed the highest cyst count, i.e. 2.00 × 10(6) cysts/g. Irregular shedding of cysts was seen in 10 out of 30 days where the widest range recorded on day 17 was between 0 to 1.2 × 10(6) cysts/g. The average daily cyst count on days of emotional fluctuations was from 0 to 5.13 × 10(6) cysts/g. In conclusion, the study confirms that there are factors influencing shedding patterns of Blastocystis, and these have important implications when it comes to diagnosis and transmission of the parasite.

  9. The influence of genotype on vascular endothelial growth factor and regulation of myocardial collateral blood flow in patients with acute and chronic coronary heart disease

    DEFF Research Database (Denmark)

    Ripa, R.S.; Jorgensen, E.; Baldazzi, F.;

    2009-01-01

    OBJECTIVE: To test the hypothesis that mutations in the vascular endothelial growth factor (VEGF) gene are associated with plasma concentration of VEGF and subsequently the ability to influence coronary collateral arteries in patients with coronary heart disease (CHD). METHODS: Blood samples from...... patients with chronic ischemic heart disease (n=53) and acute coronary syndrome (n=61) were analysed. Coronary collaterals were scored from diagnostic biplane coronary angiograms. RESULTS: The plasma concentration of VEGF was increased in patients with acute compared to chronic CHD (p=0.01). The genotype......-1154 and coronary collateral size (p=0.03) and a significant association between the VEGF plasma concentration and the collateral size (p=0.03). CONCLUSION: VEGF plasma concentration seems related to coronary collateral function in patients with CHD. The results did not support the hypothesis...

  10. Influencing Factors on the Overestimation of Self-Reported Physical Activity: A Cross-Sectional Analysis of Low Back Pain Patients and Healthy Controls

    Directory of Open Access Journals (Sweden)

    Andrea Schaller

    2016-01-01

    Full Text Available Introduction. The aim of the present study was to determine the closeness of agreement between a self-reported and an objective measure of physical activity in low back pain patients and healthy controls. Beyond, influencing factors on overestimation were identified. Methods. 27 low back pain patients and 53 healthy controls wore an accelerometer (objective measure for seven consecutive days and answered a questionnaire on physical activity (self-report over the same period of time. Differences between self-reported and objective data were tested by Wilcoxon test. Bland-Altman analysis was conducted for describing the closeness of agreement. Linear regression models were calculated to identify the influence of age, sex, and body mass index on the overestimation by self-report. Results. Participants overestimated self-reported moderate activity in average by 42 min/day (p=0.003 and vigorous activity by 39 min/day (p<0.001. Self-reported sedentary time was underestimated by 122 min/day (p<0.001. No individual-related variables influenced the overestimation of physical activity. Low back pain patients were more likely to underestimate sedentary time compared to healthy controls. Discussion. In rehabilitation and health promotion, the application-oriented measurement of physical activity remains a challenge. The present results contradict other studies that had identified an influence of age, sex, and body mass index on the overestimation of physical activity.

  11. Influencing Factors on the Overestimation of Self-Reported Physical Activity: A Cross-Sectional Analysis of Low Back Pain Patients and Healthy Controls.

    Science.gov (United States)

    Schaller, Andrea; Rudolf, Kevin; Dejonghe, Lea; Grieben, Christopher; Froboese, Ingo

    2016-01-01

    Introduction. The aim of the present study was to determine the closeness of agreement between a self-reported and an objective measure of physical activity in low back pain patients and healthy controls. Beyond, influencing factors on overestimation were identified. Methods. 27 low back pain patients and 53 healthy controls wore an accelerometer (objective measure) for seven consecutive days and answered a questionnaire on physical activity (self-report) over the same period of time. Differences between self-reported and objective data were tested by Wilcoxon test. Bland-Altman analysis was conducted for describing the closeness of agreement. Linear regression models were calculated to identify the influence of age, sex, and body mass index on the overestimation by self-report. Results. Participants overestimated self-reported moderate activity in average by 42 min/day (p = 0.003) and vigorous activity by 39 min/day (p < 0.001). Self-reported sedentary time was underestimated by 122 min/day (p < 0.001). No individual-related variables influenced the overestimation of physical activity. Low back pain patients were more likely to underestimate sedentary time compared to healthy controls. Discussion. In rehabilitation and health promotion, the application-oriented measurement of physical activity remains a challenge. The present results contradict other studies that had identified an influence of age, sex, and body mass index on the overestimation of physical activity.

  12. Application of Parametric Models of Survival Analysis in Determining the Cancer Influencing Factors in Patients with Thyroid Nodules

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    J Yazdani Charati

    2015-06-01

    Full Text Available Background & aim: One of the most common clinical problems among individuals is thyroid nodule diseases which are characterized by one or more nodules in the thyroid and are usually benign. It can be said that thyroid cancer is the most common endocrine cancer worldwide. This study aimed to determine the risk factors for cancer in patients with thyroid nodule in Mazandaran province,Iran, using parametric survival analysis. Methods: In the present historical cohort study, 26,730 patients with thyroid nodules who were referred to health care centers from July 2002 to March 2008 were identified. Parametric log-normal and log-logistic models were compared with and without taking frailty into account. The criterion for comparing models was Akaike's criterion. All calculations were performed with the SPSS software and the significance level was considered 0.05. Results: The mean time of the conversion of thyroid nodules to cancer in patients was found to be 29.32 months. Using Kaplan-Meier method, survival rates of one year, five years and ten years of nodule conversion to cancer was calculated 94.6, 88.6 and respectively. According to the log rank test age (p=0.03, hypothyroidism (p=0.01, bilateral nodules (p <0.001, a multi-nodular goiter (p <0.001, TSH hormone (p <0.001, T4 hormones (p = 0.005, cholesterol (p = 0.03, creatinin levels (p = 0.001 a significant relationship was seen. Based on the Akaike's criterion, the lognormal model which takes frailty into account best fits to the data. Conclusion: Based on the log-normal model with frailty, It can be concluded that the thyroid nodule patients with abnormal TSH hormone are 6.55 times more likely to develop risk of thyroid cancer than patients who had normal TSH hormone overall. This model also indicated that patients who had heart palpitations are 5.52 times more likely to develop risk of cancer than patients who did not have heart palpitations.

  13. Influence of Age at Diagnosis and Time-Dependent Risk Factors on the Development of Diabetic Retinopathy in Patients with Type 1 Diabetes

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    Luis Forga

    2016-01-01

    Full Text Available Aim. To determine the influence of age at onset of type 1 diabetes and of traditional vascular risk factors on the development of diabetic retinopathy, in a cohort of patients who have been followed up after onset. Methods. Observational, retrospective study. The cohort consists of 989 patients who were followed up after diagnosis for a mean of 10.1 (SD: 6.8 years. The influence of age at diagnosis, glycemic control, duration of diabetes, sex, blood pressure, lipids, BMI, and smoking is analyzed using Cox univariate and multivariate models with fixed and time-dependent variables. Results. 135 patients (13.7% developed diabetic retinopathy. The cumulative incidence was 0.7, 5.9, and 21.8% at 5-, 10-, and 15-year follow-up, respectively. Compared to the group with onset at age 44 years, respectively. During follow-up we also observed an association between diabetic retinopathy and HbA1c levels, HDL-cholesterol, and diastolic blood pressure. Conclusion. The rate of diabetic retinopathy is higher in patients who were older at type 1 diabetes diagnosis. In addition, we confirmed the influence of glycemic control, HDL-cholesterol, and diastolic blood pressure on the occurrence of retinopathy.

  14. Factors influencing pacing in triathlon.

    Science.gov (United States)

    Wu, Sam Sx; Peiffer, Jeremiah J; Brisswalter, Jeanick; Nosaka, Kazunori; Abbiss, Chris R

    2014-01-01

    Triathlon is a multisport event consisting of sequential swim, cycle, and run disciplines performed over a variety of distances. This complex and unique sport requires athletes to appropriately distribute their speed or energy expenditure (ie, pacing) within each discipline as well as over the entire event. As with most physical activity, the regulation of pacing in triathlon may be influenced by a multitude of intrinsic and extrinsic factors. The majority of current research focuses mainly on the Olympic distance, whilst much less literature is available on other triathlon distances such as the sprint, half-Ironman, and Ironman distances. Furthermore, little is understood regarding the specific physiological, environmental, and interdisciplinary effects on pacing. Therefore, this article discusses the pacing strategies observed in triathlon across different distances, and elucidates the possible factors influencing pacing within the three specific disciplines of a triathlon.

  15. Factors influencing the process of medication (non-)adherence and (non-)persistence in breast cancer patients with adjuvant antihormonal therapy: a qualitative study.

    Science.gov (United States)

    Verbrugghe, M; Verhaeghe, S; Decoene, E; De Baere, S; Vandendorpe, B; Van Hecke, A

    2017-03-01

    Non-adherence and non-persistence in breast cancer patients taking antihormonal therapy (AHT) is common. However, the complex patterns and dynamics of adherence and persistence are still not fully understood. This study aims to give insight into the process of (non-)adherence and (non-)persistence by researching influencing factors and their interrelatedness in breast cancer patients taking AHT by means of a qualitative study with semi-structured interviews. The sample consisted of 31 breast cancer patients treated with AHT. Purposive and theoretical sampling and the constant comparison method based on a grounded theory approach were used. Expectations regarding the impact of AHT, social support from family and friends, and recognition from healthcare professionals were found to influence the process of non-adherence and non-persistence. The results of this study can help healthcare professionals understand why breast cancer patients taking AHT do not always adhere to or persist in taking the therapy and may facilitate patient-tailored interventions. © 2015 John Wiley & Sons Ltd.

  16. Towards large-cohort comparative studies to define the factors influencing the gut microbial community structure of ASD patients

    Directory of Open Access Journals (Sweden)

    Daniel McDonald

    2015-03-01

    Full Text Available Differences in the gut microbiota have been reported between individuals with autism spectrum disorders (ASD and neurotypical controls, although direct evidence that changes in the microbiome contribute to causing ASD has been scarce to date. Here we summarize some considerations of experimental design that can help untangle causality in this complex system. In particular, large cross-sectional studies that can factor out important variables such as diet, prospective longitudinal studies that remove some of the influence of interpersonal variation in the microbiome (which is generally high, especially in children, and studies transferring microbial communities into germ-free mice may be especially useful. Controlling for the effects of technical variables, which have complicated efforts to combine existing studies, is critical when biological effect sizes are small. Large citizen-science studies with thousands of participants such as the American Gut Project have been effective at uncovering subtle microbiome effects in self-collected samples and with self-reported diet and behavior data, and may provide a useful complement to other types of traditionally funded and conducted studies in the case of ASD, especially in the hypothesis generation phase.

  17. Factors Influencing the Adoption of Minimally Invasive Surgery

    African Journals Online (AJOL)

    of institutional, patient and surgeon-related factors ... Surgical site infections ... Factors influencing choice of open procedures over MIS are summarized in Table 1. The main .... written with pharmaceutical products in mind (25). ... JAMA Intern.

  18. 老年住院患者睡眠质量影响因素调查分析%Influencing Factors on Sleeping Quality of Hospitalized Elderly Patients

    Institute of Scientific and Technical Information of China (English)

    杨雪; 刘晓琴

    2012-01-01

    目的 了解老年患者住院期间睡眠影响因素及质量.方法 对2009年7月-12月入住老年科的108例患者运用匹兹保睡眠质量指数(PSQI)和自编影响睡眠因素调查表进行调查分析.结果 92.6%的老年患者有睡眠质量问题,病情不稳定患者比病情稳定者睡眠障碍发生率高,病房温湿度、气味、夜间光线、夜间查房等环境因素和担心家事、家人朋友不关心等社会因素,夜间喝浓茶、咖啡的不良习惯对睡眠质量的影响差异有统计学意义(P<0.05).结论 多数老年患者住院期间睡眠质量差,医护人员应对此予以高度重视,针对性地采取有效治疗、护理措施及健康指导方式,改善老年患者睡眠质量.%Objective To explore the influencing factors on sleeping quality of hospitalized elderly patients. Methods From July to December 2009, 108 patients were investigated and analyzed with Pitts Paul Sleep Quality Index (PSQI) and sleep factor questionnaire. Results About 92.6% of elderly patients had poor sleep quality, and the incidence of sleep disorders in patients with unstable condition was higher than that in patients with stabilized condition. The difference in influence of Environmental factors (including ward temperature and humidity, odor, light, circumstance and other factors), social factors (including concerns for the family, family and friends disinterest), and bad habits (including the night to drink tea and coffee) were statistically significant(P < 0.05). Conclusions The majority of hospitalized elderly patients have poor quality of sleep. We should improve the sleeping quality of elderly patients by effective treatment, care measures and health guidance.

  19. FACTORS INFLUENCING ADHERENCE TO ARVS AMONG PATIENTS ATTENDING COMPREHENSIVE CARE CLINIC WITHIN JOMO KENYATTA UNIVERSITY OF AGRICULTURE AND TECHNOLOGY, KIAMBU COUNTY, KENYA.

    Science.gov (United States)

    Mwangi, A N; Ng'ang'a, Z; Wanzala, P; Karanja, S M

    2014-04-01

    The efficacy of anti-retroviral Therapy (ART) depends on adherence to the prescribed regimen. However, lack of adherence leads to treatment failure and drug resistance among other negative outcomes. To determine factors influencing adherence to ARVS among patients attending the Comprehensive Care Clinic (CCC) within Jomo Kenyatta University of Agriculture and Technology (JKUAT). A descriptive cross sectional study. Comprehensive Care Clinic within JKUAT. Three hundred HIV positive patients, undergoing ART treatment and follow up at the JKUAT clinic for a minimum duration of one month before the study, were recruited. Of the 300 patients enrolled for the study (70% females and 30% males), 81% were adhering to ARV treatment. The factors that were significantly associated with adherence included; Support (encouragement and reminder to take drugs) (P = 0.025); the number of meals respondents took in a day (P = 0.001); pill burden (P = 0.002) and forgetfulness (P = 0.001). However, there was no significant relationship between adherence and age, marital status, education, employment status or time taken to travel to the clinic. This study concluded that, the observed level of sub-optimal adherence to ART (19%) is of public health concern. These patients are vulnerable to treatment failure and development of resistant viral strains. Consequently the modifiable factors (Support, Number of meals taken, pill burden, and forgetfulness, should be addressed to change the current tread.

  20. Factors influencing dyslipidemia in statin-treated patients in Lebanon and Jordan: results of the Dyslipidemia International Study

    Directory of Open Access Journals (Sweden)

    Azar ST

    2014-05-01

    Full Text Available Sami T Azar,1 Hadi Abu Hantash,2 Selim Jambart,3 Mohammad M El-Zaheri,4 Rachoin Rachoin,5 Amal Chalfoun,6 Layla Lahoud,6 Osama Okkeh,2 Peter Bramlage,7 Philippe Brudi,8 Baishali M Ambegaonkar81American University of Beirut Medical Center, Beirut, Lebanon; 2Istishari Hospital, Amman, Jordan; 3St Joseph University Faculty of Medicine, Beirut, Lebanon; 4Jordan Hospital, Amman, Jordan; 5Notre Dame des Secours Hospital, Jbeil, Lebanon; 6MSD Levant, Beirut, Lebanon; 7Institut für Pharmakologie und präventive Medizin, Mahlow, Germany; 8Merck and Co, Inc., Whitehouse Station, NJ, USABackground: Cardiovascular disease is the leading cause of death and disability worldwide. Therefore, as part of the Dyslipidemia International Study (DYSIS, we have analyzed the prevalence of lipid abnormalities and risk factors for dyslipidemia in statin-treated patients in Lebanon and Jordan.Methods: This cross-sectional, multicenter study enrolled 617 patients at 13 hospitals in Lebanon and Jordan. Patients were at least 45 years old and had been treated with statins for at least 3 months. Multivariate logistic regression analysis was used to determine patient characteristics contributing to dyslipidemia during statin therapy.Results: Our findings indicated that 55.9% of statin-treated patients (mean age 60.3 years, 47% female in Lebanon and Jordan did not achieve goal levels for low-density lipoprotein cholesterol which were dependent on Systematic Coronary Risk Evaluation (SCORE risk, and 70% of patients (76% men and 63.3% of women were at very high cardiovascular risk. Low-density lipoprotein cholesterol goals were not achieved in 67.2% of those with very high cardiovascular risk. The most commonly prescribed statin was atorvastatin (44.6%, followed by simvastatin (27.7%, rosuvastatin (21.2%, fluvastatin (3.3%, pravastatin (3%, and lovastatin (0.2%. Approximately half of the population was treated with a statin dose potency of 4, equaling 40 mg of simvastatin. In

  1. Influence of granulocyte colony-stimulating factor on cardiac function in patients with acute myocardial infarction and leukopenia after revascularization

    Institute of Scientific and Technical Information of China (English)

    GUO Shi-zun; WANG Ning-fu; ZHOU Liang; YE Xian-hua; PAN Hao; TONG Guo-xin; YANG Jian-min; XU Jian

    2010-01-01

    Background Granulocyte colony-stimulating factor (G-CSF) seems to improve cardiac function and perfusion when used systemically through mobilization of stem cells into peripheral blood, but results of previous clinical trials remain controversial. This study was designed to investigate safety and efficacy of subcutaneous injection of G-CSF on left ventricular function in patients with impaired left ventricular function after ST-segment elevation myocardial infarction (STEMI).Methods Thirty-three patients (22 men; age, (68.5±6.1) years) with STEMI and with comorbidity of leukopenia were included after successful primary percutaneous coronary intervention within 12 hours after symptom onset. Patients were randomized into G-CSF group who received G-CSF (10 μg/kg of body weight, daily) for continuous 7 days and control group. Results of blood analyses, echocardiography and angiography were documented as well as possibly occurred adverse events.Results No severe adverse events occurred in both groups. Mean segmental wall thickening in infract segments increased significantly at 6-month follow up compared with baseline in both groups, but the longitudinal variation between two groups had no significant difference (P >0.05). The same change could also be found in longitudinal variation of wall motion score index of infarct segments (P >0.05). At 6-month follow-up, left ventricular end-diastolic volume of both groups increased to a greater extent, but there were no significant differences between the two groups when comparing the longitudinal variations (P >0.05). In both groups, left ventricular ejection fraction measured by echocardiography ameliorated significantly at 6-month follow-up (P 0.05). When pay attention to left ventricular ejection fraction measured by angiocardiography,difference of the longitudinal variation between groups was significant (P=0.046). Early diastolic mitral flow velocity deceleration time changed significantly at 6-month follow-up in both

  2. Use of mTOR inhibitors in the treatment of breast cancer: an evaluation of factors that influence patient outcomes

    Directory of Open Access Journals (Sweden)

    Jerusalem G

    2014-04-01

    Full Text Available Guy Jerusalem, Andree Rorive, Joelle Collignon Medical Oncology, CHU Sart Tilman Liege, Domaine Universitaire du Sart Tilman, Liege, Belgium Abstract: Many systemic treatment options are available for advanced breast cancer, including endocrine therapy, chemotherapy, anti-human epidermal growth factor receptor 2 (HER2 therapy, and other targeted agents. Recently, everolimus, a mammalian target of rapamycin (mTOR inhibitor, combined with exemestane, an aromatase inhibitor, has been approved in Europe and the USA for patients suffering from estrogen receptor-positive, HER2-negative advanced breast cancer previously treated by a nonsteroidal aromatase inhibitor, based on the results of BOLERO-2 (Breast cancer trials of OraL EveROlimus. This study showed a statistically significant and clinically meaningful improvement in median progression-free survival. Results concerning the impact on overall survival are expected in the near future. This clinically oriented review focuses on the use of mTOR inhibitors in breast cancer. Results reported with first-generation mTOR inhibitors (ridaforolimus, temsirolimus, everolimus are discussed. The current and potential role of mTOR inhibitors is reported according to breast cancer subtype (estrogen receptor-positive HER2-negative, triple-negative, and HER2-positive ER-positive/negative disease. Everolimus is currently being evaluated in the adjuvant setting in high-risk estrogen receptor-positive, HER2-negative early breast cancer. Continuing mTOR inhibition or alternatively administering other drugs targeting the phosphatidylinositol-3-kinase/protein kinase B-mTOR pathway after progression on treatments including an mTOR inhibitor is under evaluation. Potential biomarkers to select patients showing a more pronounced benefit are reviewed, but we are not currently using these biomarkers in routine practice. Subgroup analysis of BOLERO 2 has shown that the benefit is consistent in all subgroups and that it is

  3. Bell's面瘫患者生存质量及影响因素研究%Life Quality of Patients with Bell's Palsy and Its Influencing Factors

    Institute of Scientific and Technical Information of China (English)

    黄波; 徐沙贝; 张晨艳; 王伟

    2011-01-01

    Objective: To evaluate the life quality of patients with Bell's palsy and to explore the influencing factors. Methods: Three hundred and sixteen patients with Bell's palsy were recruited for this study. House-Brackmann (HB) grading scale was used to assess the severity of facial paralysis, and World Health Organization Quality of Life-BREF (WHOQOL-BREF)was used to evaluate the life quality of patients with Bell's palsy. The patients were divided into acute phase group (within 72 h) and sub-acute phase group (72~168 h) according to the courses of the illness, and mild group (HB graded Ⅰ ~ Ⅲ) and severe group (HB graded Ⅳ ~ Ⅵ ) according to the severity of facial palsy. Independent samples t-test was employed to compare the mean HB and WHOQOL-BREF scores of patients in different groups; and Spearman rank correlation analysis and multiple regression analysis were employed to explore the influence factors for the life quality of the patients. Results: The WHOQOL-BREF scores of the patients were generally low. The WHOQOL-BREF scores of patients in the acute phase and the mild groups were higher than those in the sub-acute phase and the severe groups. HB scores were closely related to the WHOQOL-BREF scores in physical domain and psychological domain. The HB scores, course and severity of illness, gender, age, educational level and occupation of sufferers were the main influencing factors for the life quality of patients with facial paralysis. Conclusion: The life quality of patients with facial paralysis was not satisfactory. The course and severity of palsy, sex,age, educational level, and occupation of patients influence the life quality of patients.%目的:评价Bell's面瘫患者的生存质量状况并探讨其影响因素.方法:Bell's面瘫患者316例为研究对象,采用House-Brackmann(HB)分级量表评估患者面瘫程度,世界卫生组织生存质量简表(WHOQOL-BREF)中文版评价患者生存质量;根据病

  4. 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.

  5. Is trauma transfer influenced by factors other than medical need? An examination of insurance status and transfer in patients with mild head injury.

    Science.gov (United States)

    Babu, Maya A; Nahed, Brian V; Demoya, Marc A; Curry, William T

    2011-09-01

    The Emergency Medical Treatment and Active Labor Act was meant to provide access to emergency medical care irrespective of financial resources. Yet, many Level I trauma Centers have raised concerns about the financial drivers influencing transfer. : To study the relationship between insurance status and transfer, we focused on patients with mild head injury to tease apart the medical necessity for transfer from other potential drivers, such as financial factors. Using the 2002 to 2006 American College of Surgeons National Trauma Databank and Massachusetts General Hospital's Trauma Databank from 1993 to 2009, we conducted a retrospective study and limited our population to patients with mild head injuries and mild to moderate systemic injuries as determined by the Glasgow Coma Scale, Abbreviated Injury Scale, or Injury Severity Score. Statistical analyses were conducted with STATA software. In a nationalized database, (1) uninsured patients with mild head injury are more likely to be transferred out of a Level II or III facility (adjusted odds ratio [OR]: 2.07; P = .000) compared with privately insured patients and (2) uninsured patients are less likely to be accepted by a Level II or III facility for transfer compared with privately insured patients (adjusted OR: = .143; P = .000l). For transfers received by 1 Level I trauma center (Massachusetts General Hospital), uninsured patients are more likely to be transferred to (1) Massachusetts General Hospital between midnight and 6 am (adjusted OR: 5.201; P = .000) compared with other time periods throughout the day and (2) Massachusetts General Hospital on Sunday (adjusted OR: 1.09; P = .000) compared with other days of the week. Insurance status appears to influence transfer patterns.

  6. Factors influencing the health related quality of life in patients with systemic lupus erythematosus: long-term results (2001--2005) of patients in the German Lupus Erythematosus Self-Help Organization (LULA Study).

    Science.gov (United States)

    Tamayo, T; Fischer-Betz, R; Beer, S; Winkler-Rohlfing, B; Schneider, M

    2010-12-01

    The aim of this longitudinal study was to determine disease-specific and individual factors associated with health-related quality of life (HRQOL) in a cohort of patients with systemic lupus erythematosus (SLE) organized in the German Lupus Erythematosus Self-Help Organization. Three hundred and seventeen patients aged between 11 and 77 years participated annually in five surveys carried out between 2001 and 2005. Regression analyses were carried out for physical and mental HRQOL as dependent variables. Factors influencing HRQOL were the respective HRQOL scores of the previous year, SLE activity as measured by the Systemic Lupus Activity Questionnaire (SLAQ), and impairments in everyday life. Social support indicated by living in marriage or in a marriage-like partnership had a positive influence on both mental and physical HRQOL, whereas individual factors such as education seemed to be of minor importance.

  7. Factors influencing pacing in triathlon

    Directory of Open Access Journals (Sweden)

    Wu SSX

    2014-09-01

    Full Text Available Sam SX Wu,1 Jeremiah J Peiffer,2 Jeanick Brisswalter,3 Kazunori Nosaka,1 Chris R Abbiss1 1Centre for Exercise and Sports Science Research, School of Exercise and Health Sciences, Edith Cowan University, Perth, WA, Australia; 2School of Psychology and Exercise Science, Murdoch University, Perth, WA, Australia; 3Laboratory of Human Motricity, Education Sport and Health, University of Nice Sophia Antipolis, Nice, France Abstract: Triathlon is a multisport event consisting of sequential swim, cycle, and run disciplines performed over a variety of distances. This complex and unique sport requires athletes to appropriately distribute their speed or energy expenditure (ie, pacing within each discipline as well as over the entire event. As with most physical activity, the regulation of pacing in triathlon may be influenced by a multitude of intrinsic and extrinsic factors. The majority of current research focuses mainly on the Olympic distance, whilst much less literature is available on other triathlon distances such as the sprint, half-Ironman, and Ironman distances. Furthermore, little is understood regarding the specific physiological, environmental, and interdisciplinary effects on pacing. Therefore, this article discusses the pacing strategies observed in triathlon across different distances, and elucidates the possible factors influencing pacing within the three specific disciplines of a triathlon. Keywords: cycle, endurance, multisport, pacing strategy, run, swim

  8. Factors which influence the cardiac surgeon's decision not to operate on patients referred for consideration of surgery

    Directory of Open Access Journals (Sweden)

    Sivaprakasam Rajesh

    2008-02-01

    Full Text Available Abstract Background The aim of this study was to document what proportion of patients referred for consideration of cardiac surgery are turned down, the reasons given for not operating and also to evaluate what happens to those patients who do not undergo surgery. Methods 382 elective patients referred for consideration of cardiac surgery to one of six consultant cardiac surgeons at Wythenshawe Hospital during a one year period from were included in the study. Data for those patients who underwent an operation were collected prospectively in a cardiac surgery database. The case notes of those patients who did not undergo an operation were reviewed to establish reasons given by surgeons for not operating. Patients were followed up to determine vital status at the end of the study period. Results 333 (87.2% patients underwent an operation and 49 (12.8% did not. 68% of patients turned down were thought to be too high-risk. 14% of patients did not fulfill symptomatic or prognostic criteria for surgery and in 8% of patients coronary artery surgery was thought ineffective due to poor distal vessels. 6% of patients declined an operation and 4% were thought to be more suitable for coronary angioplasty. Patients turned down for surgery had more renal dysfunction (p = 0.017, respiratory disease (p Conclusion 12.8% of patients referred for consideration of cardiac surgery did not undergo an operation. Two thirds of patients not accepted for surgery were thought too high risk. Those patients who did not undergo an operation had a significantly worse mortality.

  9. Influence of live combined bifidobacterium, lactobacillus and enterococcus capsules inflammation factors and intestinal mucosal barrier function of severe acute pancreatitis patients

    Institute of Scientific and Technical Information of China (English)

    Ping-Ping Shi; Ling-Yun Wu; Jian-Jun Wang

    2015-01-01

    Objective:To explore the influence of inflammation factors and intestinal mucosal barrier function on severe acute pancreatitis patients treated with bifidobacterium triple viable capsules.Methods:88 cases severe acute pancreatitis patients were divided into observation group and control group according to admission order, 44 cases in each group, all patients were given conventional treatment, on this base, patients in observation group were treated by oral bifidobacterium triple viable capsules, they were treated for one week, detected the serum inflammatory factors: the tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and C-reactive protein (CRP) and intestinal mucosal barrier function index: endotoxin, diamine oxidase (DAO), D-lactic acid, urinary lactulose/mannitol (L/M) in the two groups before and after treatment.Results:The levels of TNF-α, IL-6 and CRP in two groups after treatment were significantly reduced than before treatment, and after treatment the levels of TNF-α, IL-6 and CRP in observation group was significantly lower than that of the control group, all the difference was statistically significant; The levels of endotoxin, DA, D-lactic acid, L/M in two groups after treatment were significantly reduced than before treatment, and the levels of endotoxin, DA, D-lactic acid,L/M after treatment in observation group was significantly lower than that of the control group, the difference was statistically significant.Conclusion: Based on conventional treatment combined bifidobacterium triple viable capsules can significantly reduce inflammation in patients with severe acute pancreatitis, it can protect the intestinal mucosal barrier function, and has important clinical significance.

  10. 影响护理人员护患沟通能力的因素%Factors influencing the nurses' communication ability of nurses and patients

    Institute of Scientific and Technical Information of China (English)

    杨美玲

    2014-01-01

    Objective: The factors influencing the nurses' communication ability of nurses and patients for this paper. Methods:selected from different departments of 200 clinical nurses as the research object, using\\"nurse communication ability questionnaire\\"research on the communication ability of nurses and patients, analysis influence factors. Results: The patients with different working fixed number of year, reproductie history of four dimensions scores and communication ability score is a significant difference (P <0.05). Conclusion:Working fixed number of year, reproductie history of nursing staff communication skills a larger impact, nurses and patients clinical by strengthening the training and education to improve their communication ability, etc.%目的:对影响护理人员护患沟通能力的因素进行研究分析。方法:选取我院不同科室的200名临床护士作为研究对象,采用“护患沟通能力调查问卷”对其护患沟通能力进行研究,分析调查影响因素。结果:工作年限不同、生育史患者的四个维度评分及沟通能力评分比较存在显著差异(P<0.05)。结论:工作年限、生育史等均可对护理人员护患沟通能力产生较大影响,临床可通过加强培训及教育等提高其沟通能力。

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

    African Journals Online (AJOL)

    Keywords: multi-nutrient supplements; survey; children; women's decisions. Factors influencing .... associations between level of education and various factors influencing women's ..... Social marketing improved the use of multivitamin and ...

  12. Predictive Factors of Mortality in Burn Patients

    OpenAIRE

    Fazeli; Karami-Matin; Kakaei; Pourghorban; Safari-Faramani

    2014-01-01

    Background: Burn injuries impose a considerable burden on healthcare systems in Iran. It is among the top ten causes of mortality and a main cause of disability. Objectives: This study aimed to examine factors influencing mortality in burn patients admitted to the main educational tertiary referral hospital in Kermanshah. Patients and Methods: All patients admitted to the Imam Khom...

  13. Factors Influencing Learner Permit Duration

    Directory of Open Access Journals (Sweden)

    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.

  14. Patient factors influencing the prescribing of lipid lowering drugs for primary prevention of cardiovascular disease in UK general practice: a national retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Jianhua Wu

    Full Text Available BACKGROUND: Guidelines indicate eligibility for lipid lowering drugs, but it is not known to what extent GPs' follow guidelines in routine clinical practice or whether additional clinical factors systematically influence their prescribing decisions. METHODS: A retrospective cohort analysis was undertaken using electronic primary care records from 421 UK general practices. At baseline (May 2008 patients were aged 30 to 74 years, free from cardiovascular disease and not taking lipid lowering drugs. The outcome was prescription of a lipid lowering drug within the next two years. The proportions of eligible and ineligible patients prescribed lipid lowering drugs were reported and multivariable logistic regression models were used to investigate associations between age, sex, cardiovascular risk factors and prescribing. RESULTS: Of 365,718 patients with complete data, 13.8% (50,558 were prescribed lipid lowering drugs: 28.5% (21,101/74,137 of those eligible and 10.1% (29,457/291,581 of those ineligible. Only 41.7% (21,101/50,558 of those prescribed lipid lowering drugs were eligible. In multivariable analysis prescribing was most strongly associated with increasing age (OR for age ≥ 65 years 4.21; 95% CI 4.05-4.39; diabetes (OR 4.49; 95% CI 4.35-4.64; total cholesterol level ≥ 7 mmol/L (OR 2.20; 95% CI 2.12-2.29; and ≥ 4 blood pressure measurements in the past year (OR 4.24; 95% CI 4.06-4.42. The predictors were similar in eligible and ineligible patients. CONCLUSIONS: Most lipid lowering drugs for primary prevention are prescribed to ineligible patients. There is underuse of lipid lowering drugs in eligible patients.

  15. In-Hospital Mortality among Rural Medicare Patients with Acute Myocardial Infarction: The Influence of Demographics, Transfer, and Health Factors

    Science.gov (United States)

    Muus, Kyle J.; Knudson, Alana D.; Klug, Marilyn G.; Wynne, Joshua

    2011-01-01

    Context/Purpose: Most rural hospitals can provide medical care to acute myocardial infarction (AMI) patients, but a need for advanced cardiac care requires timely transfer to a tertiary hospital. There is little information on AMI in-hospital mortality predictors among rural transfer patients. Methods: Cross-sectional retrospective analyses on…

  16. In-Hospital Mortality among Rural Medicare Patients with Acute Myocardial Infarction: The Influence of Demographics, Transfer, and Health Factors

    Science.gov (United States)

    Muus, Kyle J.; Knudson, Alana D.; Klug, Marilyn G.; Wynne, Joshua

    2011-01-01

    Context/Purpose: Most rural hospitals can provide medical care to acute myocardial infarction (AMI) patients, but a need for advanced cardiac care requires timely transfer to a tertiary hospital. There is little information on AMI in-hospital mortality predictors among rural transfer patients. Methods: Cross-sectional retrospective analyses on…

  17. 宫颈癌患者术后尿路感染的因素分析%Influencing factors for postoperative urinary tract infections in cervical cancer patients

    Institute of Scientific and Technical Information of China (English)

    闻强; 邵株燕; 王华

    2014-01-01

    OBJECTIVE To explore the influencing factors for urinary tract infections in the cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy so as to provide guidance for the clinical treatment . METHODS A total of 168 cervical cancer patients who underwent the radical hysterectomy and pelvic lymphade‐nectomy in the hospital from Jan 2011 to Jan 2014 were enrolled in the study and divided into the infection group with 35 cases and the non‐infection group with 133 cases ;the clinical data were collected from all the patients and statistically analyzed by using SPSS17 .0 software .RESULTS The urinary tract infections occurred in 35 cervical cancer patients undergoing the radical hysterectomy and pelvic lymphadenectomy , with the infection rate of 20 .8% .The univariate analysis indicated that the influencing factors for the urinary tract infections included the wide resection scope ,history of urinary tract infections or urethral dysfunction ,history of diabetic mellitus ,long‐term catheter indwelling ,no less than 60 years of age ,and long operation duration ,there was statistically signifi‐cant difference (P<0 .05) .CONCLUSION There are a variety of influencing factors for the postoperative urinary tract infections in the cervical cancer patients undergoing the radical hysterectomy and pelvic lymphadenectomy .It is necessary to take corresponding intervention measures in response to the influencing factors so as to reduce the risk of postoperative urinary tract infections in the cervical cancer patients .%目的:探讨影响宫颈癌行广泛性子宫切除及盆腔淋巴结清扫术后发生尿路感染的因素,为临床治疗提供参考依据。方法收集2011年1月-2014年1月在医院因宫颈癌行广泛性子宫切除及盆腔淋巴结清扫术患者168例,分为感染组35例,未感染组133例;收集所有患者的临床资料,采用SPSS17.0软件进行统计分析。结果35例宫颈癌行广泛子宫切

  18. Catecholamines influence myocardial 123I MIBG uptake in neuroblastoma patients

    NARCIS (Netherlands)

    Palen, R.L.F. van der; Bulten, B.F.; Mavinkurve-Groothuis, A.M.C.; Bellersen, L.; Laarhoven, H.W.M. van; Kapusta, L.; Geus-Oei, L.F. de

    2013-01-01

    Aim: Cardiac 123I metaiodobenzylguanidine (MIBG) imaging can be influenced by several factors. We evaluated the relationship between catecholamine measurements and cardiac 123I MIBG uptake in neuroblastoma patients. Patients, methods:30 neuroblastoma patients were retrospectively assessed on cardiac

  19. Host factors do not influence the colonization or infection by fluconazole resistant Candida species in hospitalized patients

    Directory of Open Access Journals (Sweden)

    Ho Yu-Huai

    2008-12-01

    Full Text Available Abstract Nosocomial yeast infections have significantly increased during the past two decades in industrialized countries, including Taiwan. This has been associated with the emergence of resistance to fluconazole and other antifungal drugs. The medical records of 88 patients, colonized or infected with Candida species, from nine of the 22 hospitals that provided clinical isolates to the Taiwan Surveillance of Antimicrobial Resistance of Yeasts (TSARY program in 1999 were reviewed. A total of 35 patients contributed fluconazole resistant strains [minimum inhibitory concentrations (MICs ≧ 64 mg/l], while the remaining 53 patients contributed susceptible ones (MICs ≦ 8 mg/l. Fluconazole resistance was more frequent among isolates of Candida tropicalis (46.5% than either C. albicans (36.8% or C. glabrata (30.8%. There was no significant difference in demographic characteristics or underlying diseases among patients contributing strains different in drug susceptibility.

  20. Outcome of patients in acute poisoning with ethylene glycol--factors which may have influence on evolution.

    Science.gov (United States)

    Tanasescu, A; Macovei, R A; Tudosie, M S

    2014-01-01

    Intoxication with ethylene glycol occurs as a result of intentional ingestion in suicide attempts or accidentally. Clinical ethylene glycol poisoning is not specific and occurs in many poisoning cases therefore the diagnosis is difficult. Early diagnostic and establishment of therapy are very important for a favorable evolution. The mortality rate of ethylene glycol intoxication ranges between 1 and 22% depending on the amount of alcohol ingestion and the time period between alcohol ingestion and initiation of therapy. Retrospectively analyzed data from 18 patients admitted with ethylene glycol poisoning in the emergency department between 2011 and 2012. The following were taken into consideration: incidence of intoxication in the group study, medical history, the amount ingested and the time since the ingestion of ethylene glycol and the admission to hospital, presence of metabolic acidosis and laboratory test results on admission (urea, creatinine osmolar or anion gaps), the treatment initiated and the outcome of the patient. 18 patients with ethylene glycol intoxication were admitted to hospital between 2011 and 2012. The initial diagnosis based on a detailed clinical history in combination with the presence of metabolic acidosis with elevation of the osmolar or anion gaps. 12 of the 18 patients were man (66%) and age range interval was between 23 and 77 years. The time from the ingestion of ethylene glycol and the admission to hospital was between 30 minutes and older than 24 hours. 14 patients have been presented earlier to the hospital, between 30 minutes and 12 hours (in the first part of the clinical stage) and 13 of the 14 patients had a favorable evolution. One of these patients had an unfavorable evolution. Regarding this patient, the amount ingested was unknown. 10 of the 18 patients had a voluntary ingestion (55,55%) and 6 of the 18 patients had an alcoholism medical history. The amount ingested by the patients was between 20 ml and 500 ml. Metabolic

  1. Influence factors of cough reflex sensitivity in patients with chronic cough%慢性咳嗽患者咳嗽敏感性的影响因素

    Institute of Scientific and Technical Information of China (English)

    陈如冲; 赖克方; 罗炜; 钟南山

    2008-01-01

    Objective To investigate the influence factors of cough reflex sensitivity in patients with chronic cough. Methods Patients with chronic cough were recruited by using a diagnostic program. Cough reflex sensitivity was examined through eapsaicin cough challenge and the LgC5 (C5, the concentration of capsaicin causing five or more coughs ) was used as the index of cough threshold. Score of the severity of cough, age,gender, course of disease, pulmonary ventilation function (FEV1/pred%, MMEF/pred% )and cell differential of induced sputum (the percent of neutrophils, macrophages, lymphocytes, eosinophils)were also recorded for analysis. Results One hundred and fifty patients with different etiology of chronic cough involved in the study. Cough threshold of the patients was correlated with cough score at daytime (r=0.175, P0.05 ). Regression analysis showed that only gender and disease course were significantly corrclated with LgC5 ( all P0.05.多元线性回归分析显示,咳嗽阈值仅与性别、咳嗽病程有关(P均<0.01).结论咳嗽敏感性与咳嗽症状积分反映咳嗽程度的不同特征,性别与咳嗽病程可能影响慢性咳嗽患者的咳嗽敏感性.

  2. Factors influencing patient disclosure to physicians in birth control clinics: an application of the communication privacy management theory.

    Science.gov (United States)

    Lewis, Cara C; Matheson, Deborah H; Brimacombe, C A Elizabeth

    2011-09-01

    The focus of the current study is whether, and why, female patients limit or alter their personal histories when discussing sensitive subject matter with their physician in birth control clinics. Fifty-six female patients (M = 21.6 years, SD = 3.05) completed anonymous questionnaires exploring their comfort with and ability to disclose personal histories in the immediately preceding interview with the physician. The present study used communication privacy management (CPM) as the theoretical lens through which to view the interaction. Approximately one-half of the sample (46%) reported limiting or altering information. Patients with a highly permeable privacy orientation, as evidenced by a history of open communication regarding sexual issues, were those who reported fully disclosing to their physicians. Of the physician characteristics considered to map onto patient privacy rules, the physician's gender, hurriedness, friendliness, use of a first-name introduction, and open-ended questions were significantly related to patients' reported ease in fully disclosing personal information (p communication regarding sexual issues.

  3. Factors influencing childhood cancer patients to participate in a combined physical and psychosocial intervention program : Quality of Life in Motion

    NARCIS (Netherlands)

    Van Dijk-Lokkart, Elisabeth M.; Braam, Katja I.; Huisman, Jaap; Kaspers, Gertjan Jl; Takken, Tim; Veening, Margreet A.; Bierings, MB; Merks, Hans; Grootenhuis, Martha A.; Eibrink, Marry; Streng, Isabelle C.; Van Dulmen-Den Broeder, Eline

    2015-01-01

    Background For a multi-center randomized trial investigating the effects of a 12-week physical and psychosocial intervention program for children with cancer, we invited 174 patients (8-18 years old) on treatment or within 1 year after treatment; about 40% participated. Reasons for non-participation

  4. Factors influencing childhood cancer patients to participate in a combined physical and psychosocial intervention program : Quality of Life in Motion

    NARCIS (Netherlands)

    Van Dijk-Lokkart, Elisabeth M.; Braam, Katja I.; Huisman, Jaap; Kaspers, Gertjan Jl; Takken, Tim; Veening, Margreet A.; Bierings, MB; Merks, Hans; Grootenhuis, Martha A.; Eibrink, Marry; Streng, Isabelle C.; Van Dulmen-Den Broeder, Eline

    Background For a multi-center randomized trial investigating the effects of a 12-week physical and psychosocial intervention program for children with cancer, we invited 174 patients (8-18 years old) on treatment or within 1 year after treatment; about 40% participated. Reasons for non-participation

  5. Factors influencing the use of a Web-based application for supporting the self-care of patients with type 2 diabetes: a longitudinal study.

    Science.gov (United States)

    Nijland, Nicol; van Gemert-Pijnen, Julia E W C; Kelders, Saskia M; Brandenburg, Bart J; Seydel, Erwin R

    2011-09-30

    The take-up of eHealth applications in general is still rather low and user attrition is often high. Only limited information is available about the use of eHealth technologies among specific patient groups. The aim of this study was to explore the factors that influence the initial and long-term use of a Web-based application (DiabetesCoach) for supporting the self-care of patients with type 2 diabetes. A mixed-methods research design was used for a process analysis of the actual usage of the Web application over a 2-year period and to identify user profiles. Research instruments included log files, interviews, usability tests, and a survey. The DiabetesCoach was predominantly used for interactive features like online monitoring, personal data, and patient-nurse email contact. It was the continuous, personal feedback that particularly appealed to the patients; they felt more closely monitored by their nurse and encouraged to play a more active role in self-managing their disease. Despite the positive outcomes, usage of the Web application was hindered by low enrollment and nonusage attrition. The main barrier to enrollment had to do with a lack of access to the Internet (146/226, 65%). Although 68% (34/50) of the enrollees were continuous users, of whom 32% (16/50) could be defined as hardcore users (highly active), the remaining 32% (16/50) did not continue using the Web application for the full duration of the study period. Barriers to long-term use were primarily due to poor user-friendliness of the Web application (the absence of "push" factors or reminders) and selection of the "wrong" users; the well-regulated patients were not the ones who could benefit the most from system use because of a ceiling effect. Patients with a greater need for care seemed to be more engaged in long-term use; highly active users were significantly more often medication users than low/inactive users (P = .005) and had a longer diabetes duration (P = .03). Innovations in health

  6. 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.

  7. Factors which influence treatment initiation for pulmonary non-tuberculous mycobacterium infection in HIV negative patients; a multicentre observational study.

    Science.gov (United States)

    Rawson, Timothy M; Abbara, Aula; Kranzer, Katharina; Ritchie, Andrew; Milburn, James; Brown, Tim; Adeboyeku, David; Buckley, Jim; Davidson, Robert N; Berry, Matthew; Kon, Onn Min; John, Laurence

    2016-11-01

    Clinical, radiological and microbiological criteria inform diagnosis of pulmonary Non-Tuberculous Mycobacteria (NTM) disease and treatment decisions. This multicentre, review aims to characterise NTM disease meeting ATS/IDSA criteria and define factors associated with initiation of treatment. Sputum samples growing NTM from 5 London hospitals between 2010 and 2014 were identified. Data for HIV-negative individuals meeting ATS/IDSA guidelines for pulmonary NTM disease were extracted. Associations between clinical variables and treatment decision were investigated using Chi-squared, Fishers-exact or Mann Whitney tests. Factors associated with treatment in univariate analysis (p < 0.150) were included in a multivariate logistic regression model. NTM were identified from 817 individuals' sputum samples. 108 met ATS/IDSA criteria. 42/108 (39%) were initiated on treatment. Median age was 68 (56-78) in the cohort. On multivariate analysis, factors significantly associated with treatment of pulmonary NTM infection were: Cavitation on HRCT (OR: 6.49; 95% CI: 2.36-17.81), presenting with night sweats (OR 4.18; 95% CI: 1.08-16.13), and presenting with weight loss (OR 3.02; 95% CI: 1.15-7.93). Of those treated, 18(43%) have completed treatment, 9(21%) remain on treatment, 10(24%) stopped due to side effects, 5(12%) died during treatment. Mortality was 31% (n = 13) in treated versus 21% (n = 14) in the non-treated cohort. Subgroup analysis of individual NTM species did not observe any differences in treatment initiation or outcomes between groups. Decision to treat pulmonary NTM infection requires clinical judgement when interpreting clinical guidelines. Factors independently associated with decision to treat in this HIV-negative cohort include cavitation on HRCT and presenting with night sweats or weight loss. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. ICU Nurses’ Knowledge, Attitude, and Practice Towards their Role in the Organ Donation Process from Brain-Dead Patients and Factors Influencing it in Iran

    Science.gov (United States)

    Masoumian Hoseini, S. T.; Manzari, Z.; Khaleghi, I.

    2015-01-01

    Background: Nowadays, ICU nurses play a significant role in the care of brain-dead patients and their families. Therefore, their knowledge, attitude and practice towards this issue are extremely important to the success of organ donation. Objective: To assess ICU nurses’ knowledge, attitude and practice towards their role in the organ donation process from brain-dead patients and factors influencing it in Iran. Methods: In a cross-sectional analytical study, 90 ICU nurses working in Ghaem and Emam Reza Hospitals affiliated to Mashhad University of Medical Sciences were selected through a stratified random sampling. Data were collected from the participants by a questionnaire included demographic information, and factors influencing the nurses knowledge, attitude, and practice towards their roles in the organ donation process. Results: 90 nurses participated in this study. 70% of the research subjects had spoken with their own families about organ donation; 20% had organ donation cards. The mean±SD score of nurses’ knowledge was 49.13±9.6, attitude 21.49±14.32, and practice was 3.66±6.04. 80% of nurses had a mean knowledge about their roles in the organ donation process; 82% agreed with their roles in this process, and 97% showed weak practice in this regard. Conclusion: Nurses did not have adequate knowledge, attitude, and practice towards their role in organ donation process. It is suggested to include nursing courses on the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the organ donation process. PMID:26306156

  9. ICU Nurses' Knowledge, Attitude, and Practice Towards their Role in the Organ Donation Process from Brain-Dead Patients and Factors Influencing it in Iran.

    Science.gov (United States)

    Masoumian Hoseini, S T; Manzari, Z; Khaleghi, I

    2015-01-01

    Nowadays, ICU nurses play a significant role in the care of brain-dead patients and their families. Therefore, their knowledge, attitude and practice towards this issue are extremely important to the success of organ donation. To assess ICU nurses' knowledge, attitude and practice towards their role in the organ donation process from brain-dead patients and factors influencing it in Iran. In a cross-sectional analytical study, 90 ICU nurses working in Ghaem and Emam Reza Hospitals affiliated to Mashhad University of Medical Sciences were selected through a stratified random sampling. Data were collected from the participants by a questionnaire included demographic information, and factors influencing the nurses knowledge, attitude, and practice towards their roles in the organ donation process. 90 nurses participated in this study. 70% of the research subjects had spoken with their own families about organ donation; 20% had organ donation cards. The mean±SD score of nurses' knowledge was 49.13±9.6, attitude 21.49±14.32, and practice was 3.66±6.04. 80% of nurses had a mean knowledge about their roles in the organ donation process; 82% agreed with their roles in this process, and 97% showed weak practice in this regard. Nurses did not have adequate knowledge, attitude, and practice towards their role in organ donation process. It is suggested to include nursing courses on the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the organ donation process.

  10. 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.

  11. No influence of brain-derived neurotrophic factor (BDNF) polymorphisms on treatment response in a naturalistic sample of patients with major depression.

    Science.gov (United States)

    Musil, Richard; Zill, Peter; Seemüller, Florian; Bondy, Brigitta; Obermeier, Michael; Spellmann, Ilja; Bender, Wolfram; Adli, Mazda; Heuser, Isabella; Zeiler, Joachim; Gaebel, Wolfgang; Maier, Wolfgang; Rietschel, Marcella; Rujescu, Dan; Schennach, Rebecca; Möller, Hans-Jürgen; Riedel, Michael

    2013-08-01

    The role of the brain-derived neurotrophic factor (BDNF) in the pathophysiology of major depressive disorder (MDD) remains to be elucidated. Recent post hoc analyses indicated a potential association of three polymorphisms in the BDNF gene with worse treatment outcome in patients with the subtype of melancholic depression. We aimed at replicating these findings in a German naturalistic multicenter follow-up. Three polymorphisms in the BDNF gene (rs7103411, rs6265 (Val66Met) and rs7124442) were genotyped in 324 patients with MDD and 470 healthy controls. We applied univariate tests and logistic regression models stratifying for depression subtype and gender. The three polymorphisms were not associated with MDD as diagnosis. Further, no associations were found in univariate tests. With logistic regression, we only found a tendency towards an association of the rs6265 (Val66Met) polymorphism with overall response to treatment (response rates: GG (val/val) < GA (val/met) < AA (met/met); p = 0.0129) and some gender differences for the rs6265 (Val66Met) and rs7103411 polymorphisms. Treatment outcome stratified for subtypes of depression did not differ significantly between the investigated polymorphisms or using haplotype analyses. However, results showed a tendency towards significance. At this stage, we cannot support an influence of these three polymorphisms. Further studies in larger patient samples to increase sample sizes of subgroups are warranted.

  12. PRISMA-Compliant Article: Clinical Characteristics and Factors Influencing Prognosis of Patients With Hepatoid Adenocarcinoma of the Stomach in China.

    Science.gov (United States)

    Qu, Bao-Ge; Bi, Wei-Min; Qu, Bao-Teng; Qu, Tao; Han, Xing-Hai; Wang, Hui; Liu, Yuan-Xun; Jia, Yi-Guo

    2016-04-01

    Most previous studies have been single case reports, and studies with large samples are presently lacking. In addition, no studies have investigated the associations between the clinical characteristics and prognosis of hepatoid adenocarcinoma of the stomach (HAS). The aim of this study was to explore the associations of different clinical characteristics with the ages, serum alpha-fetoprotein (AFP) levels, and survival times of HAS patients. The present study was conducted using the CBM disc, HowNet, Wanfang and VIP data resource systems, and PubMed. According to the PRISMA Flow Diagram, certain case reports from the same center, those that did not provide patient age or sex, and those that did not report serum AFP levels or AFP immunohistochemistry results were excluded. A total of 131 relevant articles, including 124 case reports, 5 reviews, and 2 postgraduate Master's theses, were reported in the above-mentioned five databases. We applied inclusion criteria to case reports on the clinical characteristics and prognosis of HAS, which resulted in the ultimate inclusion of 180 patients from 62 case reports for statistical analyses. The main finding was that the age of the men was significantly higher than that of the women (P = 0.004). In addition, the serum AFP levels of the participants with antral disease were significantly higher than those with nonantral disease (P = 0.001). The median serum AFP levels and survival times significantly differed among the patients with the three lesion types (P = 0.001 and 0.019, respectively). The serum AFP levels of the participants with ulcerative-upheaval-type tumors and purely ulcerative tumors were significantly higher than those with upheaval-type tumors (P = 0.000 and 0.017, respectively). In addition, the serum AFP levels of the participants with ulcerative-upheaval-type tumors were significantly higher than those with ulcerative-type tumors (P = 0.019), and their survival time was also significantly

  13. Altered biodistribution of gallium-67 in a patient with multiple factors influencing iron-transport protein saturation

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jeon Young; Kim, Sang Eun; Lee, Kyung Han; Kim, Byung Tae [College of Medicine, Samsung Medical Center, Seoul (Korea, Republic of)

    1998-01-01

    We present a case of a young female patient with fulminant hepatitis who showed an altered biodistribution of Ga-67, after being scanned twice at 10 month intervals. On initial scan, uptake of Ga-67 was increased in the liver, kidneys, and skeletons. Increased hepatic Ga-67 uptake may be explained by increased transferrin unbound Ga-67 that was taken up by the inflamed liver. The saturation of iron-binding proteins due to multiple transfusions may lead to increased renal and skeletal Ga-67 uptake. On follow-up scan hepatic Ga-67 uptake was markedly increased. Also increased Ga-67 uptake in the axial skeleton and normalized renal uptake were shown. The findings were consistent with iron deficiency anemia. This case demonstrates altered Ga-67 biodistribution associated with multiple transfusions, fulminant hepatitis, and iron deficiency anemia.

  14. Factors influencing fear of falling in patients with stroke%脑卒中患者跌倒恐惧的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    管强; 韩红杰; 靳令经; 聂志余

    2013-01-01

    Objective To analyze the factors influencing fear of falling in stroke patients .Methods Fear of falling , balance function , mobility function and lower-extremity motor function in 70 stroke patients who visited our outpatient department were assessed following the activities -specific balance confidence (ABC ) scale ,Berg balance scale ,timed up and going test ,and Fugl-Meyer assessment scale ,respectively .A median ABC scale score of 70 was used as a criterion for all patients .Patients with a history of falling were divided into high ABC score (≥70 )group(n=8) and low ABC score(<70) group(n=20) .Their age ,gender ,history of falling ,balance function ,mobility function and lower-extremity motor function were analyzed by multivariate regression analy -sis .Results A significant difference was found in age, history of falling , balance function and mobility function influencing fear of falling in stroke patients (P<0 .05 , P<0. 01 ) .The average Berg balance scale score was significantly higher and the timed up and going test time was signifi -cantly shorter in high ABC score group than in low ABC score group (P<0 .05) .Conclusion History of falling ,balance function ,mobility function and age are the major factors influencing fear of falling in stroke patients .%目的 研究脑卒中患者跌倒恐惧的影响因素.方法选择同济大学附属同济医院门诊就诊的脑卒中患者70例,采用活动平衡信心(activities-specific balance confidence,ABC)量表进行跌倒恐惧的评估,采用Berg平衡量表(Berg balance scale,BBS)、起立-行走计时试验(timed up and going test,TUGT)及Fugl-Meyer测评量表分别进行平衡功能、移动能力及下肢运动功能的评定.以所有患者ABC量表评分的中位数70分为标准,将有跌倒史的28例患者分为ABC高分组(≥70分)8例、ABC低分组(<70分)20例.应用多因素分析法评估年龄、性别、跌倒史、平衡功能、移动能力及下肢运动功能等因素

  15. 鼻咽癌患者抑郁症影响因素研究%Study on Influencing Factors of Depression in Patients with Nasopharyngeal Carcinoma

    Institute of Scientific and Technical Information of China (English)

    陈梅英; 肖水源; 刘萼莲; 刘晓红

    2012-01-01

    目的 探讨鼻咽癌患者抑郁症发病的影响因素,以便及时有效解决癌症患者的心理问题. 方法 应用Zung抑郁自评量表(SDS)及自制鼻咽癌患者抑郁症影响因素调查问卷进行调查. 结果 调查456例鼻咽癌患者抑郁症发生率为40.35%.年龄≤50岁者抑郁症发生率高于>50岁患者(x2=4.02,P<0.05).家庭经济状况条件越差,抑郁症发生也越高(x2=20.15,P<0.05).癌症发生转移患者和副反应程度越重患者,抑郁症发生率也越高(x2=19.19、21.81,P均<0.05),而鼻咽癌患者抑郁症发生率与性别、文化程度无关(P>0.05). 结论 影响鼻咽癌抑郁发病因素主要是年龄、经济状况、癌症有无转移及副反应程度等,对鼻咽癌患者应进行适当的心理疏导,让患者树立战胜疾病的信心是降低鼻咽癌患者抑郁症发生率的重要措施.%Objective To explore the factors influencing the development of depression among patients with nasopharyngeal carcinoma so as to solve the patients' psychological problems timely and effectively. Methods The survey was conducted using Zung Self - rating Depression Scale (SDS) and the self - designed questionnaire about factors associated with depression in patients with nasopharyngeal carcinoma. Results Among 456 patients with nasopharyngeal carcinoma, the incidence rate of depression was 40.35 %. The incidence rate of the patients aged ≤50 years was higher than that of the patients aged >50 years (X2=4.02, P0.05). Conclusions The main factors associated with the development of depression in patients with nasopharyngeal carcinoma are age, economic condition, the metastasis of nasopharyngeal carcinoma, the degree of side effects, etc. Giving proper psychological guidance and setting up the patient's confidence of overcoming the disease are the important measures to reduce the incidence rate of depression in patients with nasopharyngeal carcinoma.

  16. The investigation of influencing factors in quality of life of breast cancer patients%乳腺癌患者生活质量的调查研究

    Institute of Scientific and Technical Information of China (English)

    李倩; 李青; 张频; 徐兵河; 梅志红; 马飞; 袁芃; 王佳玉; 罗扬; 樊英; 蔡锐刚; 李俏

    2013-01-01

    目的 探讨影响乳腺癌患者生活质量的因素.方法 收集2008至2011年间在中国医学科学院肿瘤医院确诊的126例来自门诊及病房的乳腺癌患者.选择乳腺癌患者生命质量测定量表(FACT-B)进行横断面问卷调查.统计学方法采用ANOVA及独立样本t检验,检测组间各个变量之间的差异.结果 对126例乳腺癌患者根据年龄、婚姻和谐程度、受教育程度、工种、工作压力、工作年限、月收入、每天工作时长和确诊时间等因素进行分层.分别从生理状况、社会/家庭状况、情感状况、功能状况、附加关注等5个方面进行评分.最终发现年龄、受教育程度、月收入、婚姻和谐程度及确诊时间与患者生活质量明显相关.结论 在乳腺癌患者的社会人口学因素中,年龄、教育背景、月收入、婚姻和谐程度及确诊时间是影响患者生活质量的主要因素.认识这些差异,有助于今后更有针对性地对患者进行治疗和宣教.%Objective To explicit the influencing factors in quality of life of breast cancer patients. Methods Data were collected from 126 cases both from outpatients and inpatients who were diagnosed with breast cancer during 2008-2011 in Cancer Hospital Chinese Academy of Medical Sciences. FACT-B( functional assessment of cancer therapy - breast) questionnaire was used to conduct this cross-sectional survey. Analysis of variance ( ANOVA) and independent t-test were performed to compare different groups regarding QOL subscales. Results The items in FACT-B including physical well-being, social well-being, emotional well-being, functional well-being and breast cancer subscales were scored respectively according to the stratification by age, marriage harmonious degree, education status, type of work, work pressure, work seniority, monthly income, daily working time and time since diagnosis in 126 patients. We identified several factors including age, educational status, monthly

  17. The influence of number of high risk factors on clinical outcomes in patients with early-stage cervical cancer after radical hysterectomy and adjuvant chemoradiation

    Science.gov (United States)

    Lim, Soyi; Lee, Seok-Ho; Park, Chan-Yong

    2016-01-01

    Objective The purpose of this study was to evaluate the prognosis according to the number of high risk factors in patients with high risk factors after radical hysterectomy and adjuvant chemoradiation therapy for early stage cervical cancer. Methods Clinicopathological variables and clinical outcomes of patients with FIGO (International Federation of Gynecology and Obstetrics) stage IB1 to IIA cervical cancer who had one or more high risk factors after radical hysterectomy and adjuvant chemoradiation therapy were retrospectively analyzed. Patients were divided into two groups according to the number of high risk factors (group 1, single high risk factor; group 2, two or more high risk factors). Results A total of 93 patients were enrolled in the present study. Forty nine out of 93 (52.7%) patients had a single high risk factor, and 44 (47.3%) had two or more high risk factors. Statistically significant differences in stage and stromal invasion were observed between group 1 and group 2. However, age, histology, tumor size, and lymphovascular space invasion did not differ significantly between the groups. Distant recurrence occurred more frequently in group 2, and the probability of recurrence and death was higher in group 2. Conclusion Patients with two or more high risk factors had worse prognosis in early stage cervical cancer. For these patients, consideration of new strategies to improve survival may be worthwhile. Conduct of further clinical trials is warranted for development of adjuvant treatment strategies individualized to each risk group. PMID:27200308

  18. THE ANALYSIS OF FACTORS INFLUENCING THE TERMS OF HOSPITAL ADMISSION IN PATIENTS WITH ACUTE CORONARY SYNDROM (ACCORDING TO THE LIS STUDY DATA – LYUBERTSY STUDY ON MORTALITY RATE IN PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION

    Directory of Open Access Journals (Sweden)

    M. L. Ginzburg

    2015-12-01

    Full Text Available Aim. To evaluate main factors influencing admission time to cardiovascular care unit in patients with acute coronary syndrome (ACS. Material and methods. Anonymous questionnaire was used to study factors associated with prehospital delay. A total of 363 patients aged 63.2±12.3 (24-89 years were enrolled into the study: women – 132 (37%, men – 231 (63%. Results. The main reason for emergency call was typical pain syndrome (87%. 52% of the patients experienced the pain syndrome for the first time, the others noted change in the pain characteristics. 28% of the patients did nothing to relieve the chest pain; only one third of the patients used short-acting nitrates. The main reasons for delay in emergency call were the follows: hope that the symptoms will pass off aidless, unwillingness to disturb medical staff, various family circumstances and so on. Almost third part of the patients sought medical attention more than one hour after pain syndrome onset, about half of the patients called an ambulance within the first 40 minutes. Women sought medical advice later than men and used nitroglycerin less often. Experience of myocardial infarctions decreased in time before emergency call and increase in frequency of nitroglycerin intake before ambulance arrival but these correlations were weak (r≤0.25. Conclusion. Very high and high cardiovascular risk patients underestimate severity of possible complications of their disease and necessity for emergency call, they are also not familiar with the first aid algorithm in emergency cases. To reduce prehospital delay hospital and out-patient clinic doctors have to regularly inform high-risk patients and their relatives about the ACS symptoms and methods of the first aid.

  19. THE ANALYSIS OF FACTORS INFLUENCING THE TERMS OF HOSPITAL ADMISSION IN PATIENTS WITH ACUTE CORONARY SYNDROM (ACCORDING TO THE LIS STUDY DATA – LYUBERTSY STUDY ON MORTALITY RATE IN PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION

    Directory of Open Access Journals (Sweden)

    M. L. Ginzburg

    2012-01-01

    Full Text Available Aim. To evaluate main factors influencing admission time to cardiovascular care unit in patients with acute coronary syndrome (ACS. Material and methods. Anonymous questionnaire was used to study factors associated with prehospital delay. A total of 363 patients aged 63.2±12.3 (24-89 years were enrolled into the study: women – 132 (37%, men – 231 (63%. Results. The main reason for emergency call was typical pain syndrome (87%. 52% of the patients experienced the pain syndrome for the first time, the others noted change in the pain characteristics. 28% of the patients did nothing to relieve the chest pain; only one third of the patients used short-acting nitrates. The main reasons for delay in emergency call were the follows: hope that the symptoms will pass off aidless, unwillingness to disturb medical staff, various family circumstances and so on. Almost third part of the patients sought medical attention more than one hour after pain syndrome onset, about half of the patients called an ambulance within the first 40 minutes. Women sought medical advice later than men and used nitroglycerin less often. Experience of myocardial infarctions decreased in time before emergency call and increase in frequency of nitroglycerin intake before ambulance arrival but these correlations were weak (r≤0.25. Conclusion. Very high and high cardiovascular risk patients underestimate severity of possible complications of their disease and necessity for emergency call, they are also not familiar with the first aid algorithm in emergency cases. To reduce prehospital delay hospital and out-patient clinic doctors have to regularly inform high-risk patients and their relatives about the ACS symptoms and methods of the first aid.

  20. 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.

  1. 脑外伤所致抑郁障碍的影响因素分析%Analysis of influencing factors of depression in patients with cerebral trauma

    Institute of Scientific and Technical Information of China (English)

    朱子进; 程宝春; 胡建成; 詹结民; 冯春国

    2013-01-01

    Objective To analyse the influeneing factors of the occurrence and the severity of depression in patients with cerebral trauma, and to provide a theoretical basis for the pathogenesis and screening of patients at high risk for effective intervention measures. Methods Patients treated for acute cerebral trauma in a hospital of Anhui province in recent 3 years were collected. Psychiatrists diagnosed patients with depression according to DSM - Ⅳ and estimated the degree of depression with Hamilton Depression Rating Scale ( HAMD ). The general condition of patients and clinical information were collected by a self - designed questionnaire, and the influencing factors of the occurrence and the severity of depression were analyzed by multivariate logistic regression and multiple linear regression. Results Multivariate logistic regression results detected the association between GCS score, operation, disability, brain stem injury and depression in patients with cerebral trauma ( P<0.05 ). GCS score was negatively associated with the risk of depression. Operation, brain stem injury and disability could increase the risk of depression. Multiple linear regression results detected the association between GCS score, operation, disability and the severity of depression in patients with cerebral trauma ( P <0. 05 ). GCS score was negatively associated with the severity of depression. Operation and disability could increase the depressive symptoms. Conclusion The GCS score, operation, disability and brain stem injury are the influencing factors of depression in patients with cerebral trauma. GCS score, operation and disability are the influencing factors of the severity of depression in patients with cerebral trauma.%目的 探讨脑外伤后发生抑郁障碍以及抑郁症状严重程度的相关因素,为阐明其发病机制、筛选高危患者以及建立有效的干预措施提供理论依据.方法 以安徽省某医院近3年因急性颅脑损伤住院治疗后出

  2. Influence of hemoperfusion combined with hemodialysis on inflammatory factors, serum hcy, PTH and β2-MG of patients with chronic renal failure

    Institute of Scientific and Technical Information of China (English)

    Yu Yin; Rui Li; Jian-Rong Hao

    2015-01-01

    Objective:To analyze the influence of hemoperfusion combined with hemodialysis on serum inflammatory factors, homocysteine (Hcy), parathyroid hormone (PTH) andβ2microglobulin (β2-MG) and other indexes in patients with chronic renal failure.Methods:94 cases with chronic renal failure from December 2013 to January 2015 in our hospital were randomly divided into two groups, according to the order of treatment. The control group of 47 patients with regular hemodialysis treatment, the observation group of 47 cases with blood perfusion combined with hemodialysis treatment. The serum interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factorβ (TNF-β), high sensitive C reactive protein (hs-CRP), phosphorus (P), Hcy, PTH, BUN,β2-MG and Scr indexes of two groups of patients before and after treatment were detected.Results:After treatment, serum IL-1, IL-6, TNF-β and hs-CRP levels of observation group were (1.72±0.16) ng/L, (12.38±1.67) ng/L, (1.26±0.31) mg/L, (6.78±1.42) ng/mL, were significantly decreased compared with the group before treatmentand control group after treatment (P<0.05). After treatment, serum PTH, Hcy and P levels of observation group were (24.53±4.82) μmol/L, (21.65±2.38) pmol/L, (1.50±0.29) mmol/L, were significantly decreased compared with the group before treatment and control group after treatment (P<0.05). After treatment,β2-MG, BUN, Scr levels of observation group were (1.92±0.26) mg/L,(6.76±1.23) mmol/L, (410.62±13.20) μmol/L, were significantly decreased compared with the group before treatment and control group after treatment. The skin itching relieving rate of observation group was 91.49% (43/47) was significantly higher than the control groups’ 59.57% (19/47), the differences were statistically significant.Conclusion:The curative effect of blood perfusion combined with hemodialysis in the treatment of chronic renal failure is significant, can effectively reduce the serum level of inflammatory factors, can clean out

  3. 2型糖尿病患者自我效能影响因素分析%Influencing Factors of Diabetes Patients ’ Self-efficacy

    Institute of Scientific and Technical Information of China (English)

    嵇加佳; 陈玉凤; 楼青青; 袁晓丹; 姚平; 张丹毓; 赵心怡

    2013-01-01

    Objective To investigate influencing factors of self-efficacy of patients with type 2 diabetes mellitus. Methods Totally 435 type 2 diabetes patients under case management chosen by convenience sampling were investigated with the Chinese Version of Diabetes Management Self-efficacy Scale (C-DMSES). Results Score of self-efficacy of 435 patients was 132.28 ±38.66, and 63.9%of the patients’ self-efficacy was in moderate level;linear regression showed that diabetes education, quantity of complications, educational background were influencing factors of diabetes patients ’ self-efficacy. Conclusion Patients’ self-efficacy remains to be improved in the case management patients with diabetes, and self-management needs to be strengthened to improve their self-efficacy, which can improve patients ’ self management behavior, such as visiting a doctor, blood sugar monitoring, diet control and active exercise.%目的:探讨影响2型糖尿病患者自我效能的因素。方法于南京市某三级甲等医院门诊用便利抽样方法抽取435例个案管理2型糖尿病患者,用中文版糖尿病管理自我效能量表进行患者自我效能的测量。采用单因素分析影响自我效能的因素、将有统计学意义的因素运用线性回归分析。结果435例初次进入个案管理的2型糖尿病患者自我效能得分为(132.28±38.66)分,63.9%处于中等水平;多元逐步回归显示:糖尿病教育、并发症种类、文化程度为2型糖尿病患者自我效能的影响因素。结论初次进入个案管理的2型糖尿病患者自我效能有待改善;需加强文化程度较低患者的自我管理教育,尤其在糖尿病患病早期,提高患者对疾病的重视程度,改善自我效能,减少糖尿病并发症的发生,减轻患者的生理、心理、经济负担。

  4. Research progress on assessment tools of quality of life of hemodialysis patients and its influencing factors%血液透析病人生活质量测评工具及影响因素研究进展

    Institute of Scientific and Technical Information of China (English)

    李娟; 蔡益民

    2012-01-01

    介绍了血液透析病人生活质量现状、测评工具及人口学因素、躯体疾病相关因素、心理因素、生理因素、治疗因素、社会因素、个体自身因素、医务人员因素对血液透析病人生活质量的影响.%It introduced the status quo of quality of life of hemodialysis patients,assessment tools and influence of demographic factors, somatic disease related factors, psychological factors, physiological factors, treatment factors,social factors and individual factors and medical personnel factors on the quality of life of hemodialysis patients.

  5. 乳腺癌病人生命质量的影响因素调查%Survey of influencing factors of quality of life of breast cancer patients

    Institute of Scientific and Technical Information of China (English)

    赵海平; 马莉; 张艳君

    2012-01-01

    [目的]分析影响乳腺癌病人生命质量的因素,为改进乳腺癌病人的心理护理措施提供依据.[方法]对201例原发性乳腺癌术后化疗病人采用自设人口统计学和临床特征调查表、乳腺癌病人生命质量测定量表、医学应对问卷、中文版艾森克人格问卷简版进行调查.[结果]将病人生命质量总分作为应变量,社会人口学、临床特征、人格变量的4个维度和应对变量的3个维度作为自变量进行多元线性回归分析,结果表明,只有神经质维度和屈服应对维度进入方程,决定系数为0.542,即2个变量能联合预测生命质量54.2%的变异量.[结论]护理人员应关注乳腺癌病人的人格特征和应对方式特点,采取积极有效的心理护理措施,提高病人的生命质量.%Objective: To analyze the factors influencing the quality of life of breast cancer patients and to provide theoretical evidences for nursing care. Methods: A total of 201 breast cancer patients undergoing chemotherapy from the First Affiliated Hospital and Affiliated Shengjing Hospital of Chinese Medical U-niversity were investigated by using self - designed general information questionnaire including demographic variables and medical character, Measurement Scale of Quality of Life for Patients with Breast Cancer (FACT - B) ; Medical Coping Modes Questionnaire(MCMQ) and Chinese Version of the Eysenck Personality Questionnaire Short Scale (EPQ - RSC). Results: Multiple regression analysis demonstrated that when total score of FACT - B was identified as dependent variable, demographic variable,medical character ,subscales of EPQ - RSCCpsychoti-cism,neuroticism,extraversion and Lie) and subscales of MCMQ(confrontation, avoidance,and acceptance - resignation) were treated as independent variables, only neuroticism and resignation domains enter the multiple regression equation model with R2=0. 542. The results indicated that only the two psychosocial factors predicted

  6. Influencing factors of SYNTAX score in patients with coronary heart disease%冠状动脉病变SYNTAX积分影响因素分析

    Institute of Scientific and Technical Information of China (English)

    盛建龙; 王晓晨; 许邦龙; 吴继雄; 王敏; 胡章乐

    2015-01-01

    目的:探讨冠心病患者冠状动脉(冠脉)病变SYNTAX积分的影响因素.方法:选取101例接受择期冠脉造影并行经皮冠脉内支架植入术治疗的冠心病患者(包括稳定型心绞痛和不稳定型心绞痛患者),通过相关性分析及单因素方差分析其冠脉病变SYNTAX积分的影响因素.结果:101例患者SYNTAX积分为(11.38±6.61),相关性分析发现SYNTAX积分与总胆固醇(r=0.279,P=0.005)、低密度脂蛋白胆固醇(r=0.247,P=0.013)、载脂蛋白B(r=0.270,P=0.006)、载脂蛋白B/载脂蛋白A1比值(r=0.246,P=0.013)存在正相关性.与高密度脂蛋白胆固醇、载脂蛋白A1无统计学相关性.未发现性别、高血压、糖尿病、吸烟史、脑血管病史、冠脉造影术前应用阿司匹林应用超过1个月等因素对冠脉SYNTAX积分有影响.结论:冠脉病变复杂程度与总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B、载脂蛋白B/载脂蛋白A1比值水平有关,而与高密度脂蛋白胆固醇和载脂蛋白A1水平无明显相关性.%Objective:To investigate the influencing factors of SYNTAX scores in patients with coronary heart disease.Method:One hundred and one patients with coronary heart disease (including stable angina and unstable angina) underwent elective coronary angiography and percutaneous coronary stent implantation were participated.The influencing factors of SYNTAX score was analyzed by single-factor ANOVA analysis.Result:The SYNTAX score of 101 patients was 11.38 ± 6.61.Correlation analysis showed that there was a positive correlation between SYNTAX score and total cholesterol (r=0.279,P=0.005),low-density lipoprotein cholesterol (r=0.247,P=0.013),apolipoprotein B (r =0.270,P =0.006),apolipoprotein B / apolipoprotein A1 ratio (r =0.246,P =0.013).There was no statistical correlation between SYNTAX score and high-density lipoprotein cholesterol,apolipoprotein A1.Conclusion:The complexity of coronary artery correlates with the levels of total

  7. 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.

  8. Influencing factors of sleep disturbance in patients with depression%抑郁症患者伴发睡眠障碍的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    何小婷; 杨春霞; 李素萍; 张爱霞; 李业宁; 陈志璐; 张克让

    2016-01-01

    (SSS) were used to evaluate 409 patients with depression. According to sleep condition, the patients were divided into two groups: 276 patients with sleep disturbance and 133 patients without sleep disturbance. Whether or not comorbid sleep disorder as dependent variable, demographic data, clinical features, social psychological factors as independent variables, influencing factors were analyzed by Logistic regression. Results (1) Compared with the group without sleep disturbance, the sleep disturbance group had higher scores on age, age of first-episode, degree of depression, degree of anxiety, neuroticism and negative life events, but lower scores on educational years and subjective social support, all these differences were significant (P<0.05). (2)Age (OR=1.053, 95% CI: 1.020-1.086), degree of depression (OR=1.335, 95% CI: 1.226-1.455), negative life events (OR=1.011, 95% CI: 1.003-1.019) were the risk factors of sleep disturbance; age of first-episode (OR=0.970, 95% CI: 0.941-1.000), subjective social support (OR=0.926, 95% CI:0.879-0.975) were the protective factors of sleep disturbance. Conclusion Depression patients that older, earlier first-episode, with serious depression, experiencing more negative life events and obtaining less social support are more susceptible to sleep disturbance.

  9. Investigation and analysis of factors influencing rehabilitation of burn patients%影响烧伤患者康复因素的调查分析

    Institute of Scientific and Technical Information of China (English)

    李琳; 许乐; 吴伯瑜; 郑幼金

    2009-01-01

    Objective To study the factors influencing health of burn patients in rehabilitation peri-od. Methods One hundred and one patients hospitalized in burn department of Xiehe Hospital of Fujian Medical University from February 2008 to October 2008 were investigated by means of General Information Questionnaire,the Eysenck Personality Questionnaire,the Medical Coping Modes Questionnaire, and the Social Support Rating Scale.Their rehabilitation condition was scored according to the Abbreviated Burn-Specific Health Scale.Investigation data were processed by multiple linear regression analysis in order to find out the factors influencing rehabilitation of burn patients. Results Patients in this group were scored (57±16)points in physical function,rate[(actual score/possible highest score)×100%,the same be-low]71.1%(the lowest);(97±19) points in psychological function,rate 80.6%;(53±8)points in so-cial function,rate 88.4%(the highest);(45±11)points in general health,rate 74.5%;(251±44)points in comprehensive health[standard score(314±55)points],rate 78.5%(upper middle).The fac-tors included in the comprehensive health regression equation(F=11.602,P<0.001) were:monthly in-come,size of burn,number of operations,introverted/extroverted characteristics,lieing,degree of utiliza-tion of support,social support,and resignation.They accounted for 46.6%of the variance of comprehensive health. Conclusions Monthly income,size of burn,introverted/extroverted characteristics,lieing,social support,and resignation are the main factors influencing the rehabilitation level of burn patients.%目的 了解影响烧伤患者康复期综合健康状况的因素. 方法 采用一般资料问卷、艾森克人格问卷、医学应对方式问卷、社会支持评定量表、简明烧伤健康量表.对2008年2-10月在福建医科大学附属协和医院烧伤科住院的101例烧伤患者康复情况进行调查及评分.将调查数据行多元线性回归分析,找出影

  10. Supplementation with Eicosapentaenoic Omega-3 Fatty Acid Does Not Influence Serum Brain-Derived Neurotrophic Factor in Diabetes Mellitus Patients with Major Depression : A Randomized Controlled Pilot Study

    NARCIS (Netherlands)

    Bot, Mariska; Pouwer, Francois; Assies, Johanna; Jansen, Eugene H. J. M.; Beekman, Aartjan T. F.; de Jonge, Peter

    2011-01-01

    Background: Low brain-derived neurotrophic factor (BDNF) levels are observed in both depressed and diabetes patients. Animal research has shown that omega-3 polyunsaturated fatty acids increase BDNF levels. In this exploratory randomized double-blind placebo-controlled study in diabetes patients wit

  11. Supplementation with eicosapentaenoic omega-3 fatty acid does not influence serum brain-derived neurotrophic factor in diabetes mellitus patients with major depression

    DEFF Research Database (Denmark)

    Bot, Mariska; Pouwer, Francois; Assies, Johanna

    2011-01-01

    BACKGROUND: Low brain-derived neurotrophic factor (BDNF) levels are observed in both depressed and diabetes patients. Animal research has shown that omega-3 polyunsaturated fatty acids increase BDNF levels. In this exploratory randomized double-blind placebo-controlled study in diabetes patients...... severity were not significantly associated (Spearman's ρ = -0.115, p = 0.593). CONCLUSION: Our study does not provide evidence that supplementation with E-EPA improves BDNF levels in depressed diabetes patients already using antidepressants....

  12. Psychological Factors Influencing Consumer Behaviour

    OpenAIRE

    Vainikka, Bianca

    2015-01-01

    This paper’s aim is to provide an in-depth elucidation of the many aspects that influence consumer behaviour. The study of consumer behaviour emphasizes the “why” and “how” questions involved in decision making and buying behaviour. This exciting field visits a dynamic blend of themes of consumer marketing strategies, psychology and behavioural discipline. Consumer behaviour in this day and age is highly applicable to modern society as it is an integral part of our everyday lives. This paper ...

  13. Influencing factors of anxiety symptoms in patients with depression%抑郁症伴焦虑症状的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    何小婷; 孙宁; 杜巧荣; 杨春霞; 刘志芬; 王彦芳; 李素萍; 张克让

    2016-01-01

    Objective To investigate the status of depression with anxiety symptoms, and analyze the influencing factors of anxiety symptoms from demographic data and social psychological factors. Methods Hamilton depression rat⁃ing scale (HAMD), Hamilton anxiety rating scale (HAMA), Eysenck personality questionnaire (EPQ), life event scale (LES), trait coping style questionnaire (TCSQ) and social support scale (SSS) were used to evaluate 729 patients with de⁃pression. According to HAMA scores, patients were divided into non anxiety symptoms group (HAMA14). Social psychological factors were compared between two groups, and the influencing fac⁃tors of anxiety symptoms were analyzed. Results The incidence of anxiety symptoms in depression was 58.85% (429/729), and 119 cases (16.32%) were certainly without anxiety symptoms. Compared with the group without anxiety symp⁃toms, the anxiety symptoms group had higher scores on neuroticism, psychoticism, negative life events and negative cop⁃ing style (P14分),比较两组社会心理因素,并分析抑郁症伴焦虑症状的影响因素。结果抑郁症患者中焦虑症状(HAMA>14分)的发生率为58.85%(429/729),16.32%(119/729)肯定不伴焦虑症状(HAMA<7分)。伴焦虑症状组神经质、精神质、负性生活事件、消极应对方式的得分高于不伴焦虑症状组(P<0.001);外倾性的得分低于不伴焦虑症状组(P=0.010)。抑郁程度(OR=9.255,95%CI:4.726~18.127)、神经质(OR=1.595,95%CI:1.197~2.125)、负性生活事件(OR=1.009,95%CI:1.001~1.017)、消极应对方式(OR=1.046,95%CI:1.013~1.080)均是抑郁症患者伴焦虑症状的危险因素(P<0.05)。结论抑郁症患者焦虑症状的发生率高。抑郁症状严重、高神经质水平、经历更多负性生活事件、倾向于采用消极应对方式的抑郁症患者更有可能伴焦虑症状。

  14. Incidence and influencing factors of aldosterone breakthrough during therapy with angiotensin Ⅱ receptor bockers alone,or combined with angiotensin-converting enzyme inhibitors in patients with non-diabetic nephropathy

    Institute of Scientific and Technical Information of China (English)

    梁敏

    2013-01-01

    Objective To investigate the incidence and influen-cing factors of aldosterone breakthrough during therapy with angiotensin Ⅱ receptor blockers(ARB) alone,or combined with angiotensin-converting enzyme inhibitors(ACEI) in Chinese patients with non-diabetic

  15. 癫癎患者服药依从性调查及影响因素分析%Medication Compliance of Epileptic Patients and Its Influencing Factors

    Institute of Scientific and Technical Information of China (English)

    陈义彤; 曹春霞

    2012-01-01

    目的 了解癫疒间患者服药依从性,探讨其影响因素,为提出相应的护理干预措施提供依据.方法 采用Morisky的服药依从性问卷中文版对148例癫疒间患者进行服药依从性调查,分析年龄、文化程度、居住地、医疗保障情况、病程、药物不良反应、家庭社会支持程度等因素对患者服药依从性的影响.结果 50例癫疒间患者服药依从性好,依从率33.8%;64例对停药、换药、增减药物的注意事项不了解(占43.3%),51例对定期检查血药浓度及肝功能的意义不了解(占34.5%);多因素Logistic回归分析显示患者的年龄、居住地、病程、医疗保障、家庭社会支持程度对其服药依从性有不同程度的影响(P<0.05).结论 患者服药依从性较差,应加强健康教育,建立良好护患关系,加强心理护理,发挥社会家庭支持系统,指导合理使用抗癫疒间药物,从而提高癫疒间患者服药依从性.%Objective To analyze the medication compliance of epileptic patients and its influencing factors and to put forward appropriate nursing interventions. Methods Morisky Medication Adherence Questionnaire (Chinese version) was applied among 148 epilepsy patients. Information about age, educational background, residence, health insurance, duration, adverse drug reactions, family and social support and disease knowledge was collected and then multivariate Logistic regression analysis was conducted. Results Of the total, 50 cases were with good compliance, with a compliance rate of 33.8% while 64 paid little attention to drug precautions, accounting for 43.3%. In addition, 51 patients (34.5%) presented inadequate knowledge about the significance of regular plasma concentration checking and liver function. Patient's age, residence, duration of disease, health insurance, family and social support had different effects on their medication compliance (P<0.05). Conclusion In general, patients are with poor medication compliance

  16. Influence of Genetic Polymorphisms of Tumor Necrosis Factor Alpha and Interleukin 10 Genes on the Risk of Liver Cirrhosis in HIV-HCV Coinfected Patients.

    Directory of Open Access Journals (Sweden)

    Sara Corchado

    Full Text Available Analysis of the contribution of genetic (single nucleotide polymorphisms (SNP at position -238 and -308 of the tumor necrosis factor alpha (TNF-α and -592 of the interleukin-10 (IL-10 promotor genes and of classical factors (age, alcohol, immunodepression, antirretroviral therapy on the risk of liver cirrhosis in human immunodeficiency (HIV-hepatitis C (HCV virus coinfected patients.Ninety one HIV-HCV coinfected patients (50 of them with chronic hepatitis and 41 with liver cirrhosis and 55 healthy controls were studied. Demographic, risk factors for the HIV-HCV infection, HIV-related (CD4+ T cell count, antiretroviral therapy, HIV viral load and HCV-related (serum ALT concentration, HCV viral load, HCV genotype characteristics and polymorphisms at position -238 and -308 of the tumor necrosis factor alfa (TNF- α and -592 of the interleukin-10 (IL-10 promotor genes were studied.Evolution time of the infection was 21 years in both patients' groups (chronic hepatitis and liver cirrhosis. The group of patients with liver cirrhosis shows a lower CD4+ T cell count at the inclusion in the study (but not at diagnosis of HIV infection, a higher percentage of individuals with previous alcohol abuse, and a higher proportion of patients with the genotype GG at position -238 of the TNF-α promotor gene; polymorphism at -592 of the IL-10 promotor gene approaches to statistical significance. Serum concentrations of profibrogenic transforming growth factor beta1 were significantly higher in healthy controls with genotype GG at -238 TNF-α promotor gene. The linear regression analysis demonstrates that the genotype GG at -238 TNF-α promotor gene was the independent factor associated to liver cirrhosis.It is stressed the importance of immunogenetic factors (TNF-α polymorphism at -238 position, above other factors previously accepted (age, gender, alcohol, immunodepression, on the evolution to liver cirrhosis among HIV-infected patients with established chronic

  17. Analysis of factors associated with patient satisfaction in ophthalmology: the influence of demographic data, visit characteristics and perceptions of received care.

    Science.gov (United States)

    Schoenfelder, Tonio; Klewer, Joerg; Kugler, Joachim

    2011-11-01

    To identify factors associated with satisfaction among patients receiving ophthalmic services and to indicate the intensity of this relationship. The data used was obtained through a self-administered, post-visit questionnaire from randomly selected 507 patients treated in seven eye clinics in Germany. The instrument assessed satisfaction with several aspects of care and patient baseline and visit characteristics. Bivariate and multivariate techniques were used to reveal relations between indicators and overall satisfaction. Factor analysis yielded two factors, 'medical aspects of care' and 'performance of service', explaining 55% of total variance. Cronbach's α coefficient for both scales indicates acceptable internal consistency. Bivariate analysis showed strong relations between overall satisfaction and perceived care with weaker findings pertaining to visit characteristics. Not any of the demographic variables was associated with overall satisfaction. Perceived length of stay, intention to return to the clinic, and occurrence of complications were influential attributes on satisfaction ratings. The multivariate analysis identified seven factors associated with overall satisfaction including the treatment outcome (OR: 4.57), kindness of the nurses (OR: 5.27) and medical practitioners (OR: 2.23), room amenities (OR: 2.72), organization of procedures and operations (OR: 2.71), information about anaesthesia (OR: 1.95), and cleanliness (OR: 1.93). Factors associated with patient satisfaction in ophthalmology concern medical aspects like the organization of procedures and operations but also aspects that are not directly related to technical care, such as kindness of the nurses and cleanliness. Results show that patients' subjective experiences of received care and services relate more strongly and consistently to overall satisfaction than patient demographic data or visit characteristics. Revealed factors predicting patient satisfaction are alterable by health care

  18. Factors affecting patient education from cultural perspectives

    Directory of Open Access Journals (Sweden)

    MOHAMMAD REZA HEIDARI

    2013-10-01

    Full Text Available Introduction: Patient education is influenced by cultural factors. This study aims to find out the role of culture in patient education. Methods: A qualitative study was conducted on 23 Iranian nurses. Inclusion criteria were minimum 5 years of working experience in clinical nursing. Semistructured face to face interviews were used to collect the data. Interviews were taped, transcribed and analyzed using content analysis method. Results: The main theme of ‘cultural sensitivity’ was extracted from the interviews. Sub-themes were cultural divergence, cultural connection literacybased instruction. Conclusion: A dynamic process of patient education is influenced by various cultural factors. Nurses must be aware of the cultural norms in patient education to meet their expectations in a respectful manner.

  19. Factores que influyen en la adherencia a tratamientos en pacientes con riesgo de enfermedad cardiovascular Factors that influence in the adherence to treatments in patients with risk for cardiovascular disease

    Directory of Open Access Journals (Sweden)

    ARLETH HERRERA LIÁN

    2008-07-01

    Full Text Available Se realizó una investigación descriptivo-metodológica de los factores que influyen en la adherencia a tratamientos farmacológicos y no farmacológicos de 262 pacientes con factores de riesgo de enfermedad cardiovascular de la Caja de Previsión Social de la Universidad de Cartagena, y se determinó la validez facial y confiabilidad del instrumento utilizado. Los resultados de la validez facial del instrumento diseñado por Bonilla y De Reales indicaron que de la versión inicial de 72 ítems, 22 requirieron modificación y se eliminaron 15; la propuesta de rediseño del instrumento quedó con un total de 57 ítems; de esta propuesta las autoras aceptaron eliminar solo 10 ítems. La nueva versión del instrumento contó con un total de 62 ítems, el cual reportó un alfa de Cronbach de 0,797 y se utilizó para describir los factores que influyen en la adherencia. Del total de los pacientes con factores de riesgo de enfermedad cardiovascular seleccionados de la Caja de Previsión Social de la Universidad de Cartagena, el 92% se encuentra en la categoría sin riesgo de no adherirse, es decir, están adheridos a los tratamientos farmacológicos y no farmacológicos. Esto demuestra que las estrategias para llegar al paciente y comprometerlo con su cuidado han sido efectivas para mejorar significativamente las tasas de adherencia a tratamiento farmacológico y no farmacológico.A descriptive-methodological research was carried out on the factors that influence the adherence to pharmacologic and non-pharmacologic treatments of 262 patients with risk factors for cardiovascular disease of the Caja de Previsión Social of the University of Cartagena, and the facial validity and the reliability of the instrument used was determined. The results of the facial validity of the instrument designed by Bonilla and De Reales indicated that of the initial version of 72 items, 22 required modifications and 15 were eliminated; the proposal to redesign the

  20. Thymic Output: Influence Factors and Molecular Mechanism

    Institute of Scientific and Technical Information of China (English)

    Rong Jin; Jun Zhang; Weifeng Chen

    2006-01-01

    Thymus is a primary lymphoid organ, able to generate mature T cells that eventually colonize secondary lymphoid organs, and is therefore essential for peripheral T cell renewal. Recent data showed that normal thymocyte export can be altered by several influence factors including several chemokines,sphingosinel-phosphate (S1P),transcription factors such as Foxjl, Kruppel-like transcription factor 2 (KLF2) and antigen stimulation, etc. In this review, we summarized the recent reports about study strategies, influence factors and possible molecular mechanisms in thymic output.

  1. 31. FACTORS INFLUENCING UTILIZATION OF INTERMITTENT ...

    African Journals Online (AJOL)

    Esem

    treatment of malaria during pregnancy(IPTp), effective IPTp service utilization ... effective case management of malaria. Despite the ... Factors influencing IPTp utilization identified in the study included; educational status of a woman,. Medical ...

  2. Home Environmental Factors Influencing Performance and Progress ...

    African Journals Online (AJOL)

    ... Factors Influencing Performance and Progress of Primary School Pupils in ... found that parents' educational level and income level have a bearing on school ... on school progress and performance, however; home language did play a role.

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

    African Journals Online (AJOL)

    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.

  4. Age-Related Factors That Influence Fertility

    Science.gov (United States)

    ... can be found at the NICHD Pregnancy Loss topic page . Committee on Gynecologic Practice of American College of ... 2012, from http://www.nichd.nih.gov/health/topics/pregnancyloss/researchinfo/Pages/default.aspx [top] « Lifestyle Factors That Influence Fertility ...

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

    African Journals Online (AJOL)

    Factors that negatively influence consumption of traditionally fermented milk ... of sub-Saharan Africa and a number of health benefits to human beings are ... Key words: Mursik, Lactic acid bacteria (LAB), probiotic, Preschoolers, Focus group

  6. FACTORS INFLUENCING THE SELECTION OF DENTAL NURSING ...

    African Journals Online (AJOL)

    drclement

    FACTORS INFLUENCING THE SELECTION OF DENTAL NURSING AS A. PROFESSION ... Colleges of Health Technology undergoing external ... questionnaire requested information on age ... individual with good communication skills and ...

  7. Factors that Influence Adolescents to Smoke.

    Science.gov (United States)

    Smith, Karen H.; Stutts, Mary Ann

    1999-01-01

    A survey of the factors that influence adolescents (n=246) to smoke found that family smoking behavior, peer pressure, and prior beliefs were more important in predicting smoking level than were advertising and antismoking information. (Author/JOW)

  8. FACTORS INFLUENCING SUSTAINED MANAGERIAL EFFICIENCY

    Directory of Open Access Journals (Sweden)

    Alexandru Marius RIZESCU

    2017-04-01

    Full Text Available The concept of effectiveness is learnable in economic theory and practice with various forms of manifestation of the results obtained by the managers, such as profitability, the productivity of factors of production, capital efficiency, cost savings, etc. Regarded as the organizing principle and driving activity in the market economy, it has a much richer content and also favorable results of generalizing all derived by managers. Choosing effective in meeting needs with limited resources or powerlessness to maximize resource needs under restrains, are expressions through which efficiency is situated at the heart of economic theory and practice.

  9. 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.

  10. Variation properties of ionospheric eclipse factor and ionospheric influence factor

    Institute of Scientific and Technical Information of China (English)

    ZHAO Chunmei; YUAN Yunbin; OU Jikun; CHEN Jinping

    2005-01-01

    The concepts and calculation methods of ionospheric eclipse factor (IEF) and ionospheric influence factor (IFF) are further illustrated. The temporal and spacial variation properties of IEF and IFF are studied, which shows that the properties are influenced by the geographic position and season. The possibility of improving the precision of using GPS data to determine ionospheric delay based on the above variation properties is also analysed.

  11. The influence of patient, caregiver, and family factors on symptoms of anxiety and depression in children and adolescents with intractable epilepsy.

    Science.gov (United States)

    Puka, Klajdi; Widjaja, Elysa; Smith, Mary Lou

    2017-02-01

    The objective was to evaluate the association of caregiver and family factors with symptoms of anxiety and depression in children and adolescents with medically refractory localization-related epilepsy (i.e., failed at least two epilepsy medications). Forty-four children (ages 6-11years) and 65 adolescents (ages 12-18years) and their parents participated in this multicentered, observational, cross-sectional study. Univariable and multivariable linear regressions were used to evaluate the influence of multiple patient, caregiver, and family characteristics on self-reported symptoms of anxiety and depression in the children and adolescents. Among children, depressive symptoms were associated with a lower proportion of life with seizures (β=.344, p=.022), caregiver depression (β=.462, p=.002), poorer family relationships (β=.384, p=.010), and poorer family mastery and social support (β=.337, p=.025); in multivariable analysis, proportion of life with epilepsy and parental depression remained significant. No significant predictors of anxiety were found among children. Among adolescents, depressive symptoms were associated with caregiver unemployment (β=.345, p=.005) and anxiety (β=.359, p=.003), low household income (β=.321, p=.012), poorer family mastery and social support (β=.334, p=.007), and greater family demands (β=.326, p=.008); in multivariable analysis, caregiver unemployment and anxiety remained significant. Greater anxiety symptoms among adolescents were associated with females (β=.320, p=.009) and caregiver depression (β=.246, p=.048) and anxiety (β=.392, p=.001) and poorer family mastery and social support (β=.247, p=.047); in multivariable analysis, female sex and caregiver anxiety remained significant. These findings highlight the central role of caregiver psychopathology, which is amenable to intervention, on children and adolescents' symptoms of anxiety and depression. Addressing caregiver psychopathology may improve children and

  12. Factors influencing career choice in anaesthesiology

    Directory of Open Access Journals (Sweden)

    Asha Tyagi

    2012-01-01

    Full Text Available Background: There is a shortage of anaesthesiologists in India. The factors that prompt medical students to opt for anaesthesiology as their career are not known; neither do we have any mechanism to know a student′s stress-bearing ability before he/she opts for a stressful career like anaesthesiology. We conducted an anonymous, questionnaire-based, cross-sectional survey among 200 post-graduate anaesthesiology students to know various factors that they considered while opting for this speciality, and also evaluated their stress-bearing ability using Antonovsky′s 13-point sense of coherence scale. Methods: Two-hundred anaesthesiology students were asked to complete a questionnaire regarding the factors they considered important while opting for anaesthesiology, also enumerated in order of importance the three most important factors that led to opting this career. Students also answered the questions in Antonovsky′s sense of coherence (SOC scale. Results: Economic security was considered by maximum number of students (67.7%, while intellectual stimulation/challenge offered by anaesthesiology was rated first in order of importance. Influence of doctor−patient relationship was not considered by large number of students. The weak SOC score (55 (25 th percentile was not greatly different than the mean SOC score (60 in the survey. Conclusion: Increasing the exposure of students to anaesthesiology at undergraduate level and building public awareness about the speciality will prompt more students to opt for the speciality, while career counselling with regard to specific needs of a speciality and ability of a student will help in opting the speciality that best suits the student′s personality.

  13. FACTORS INFLUENCING COMPOSTING POULTRY WASTE

    Directory of Open Access Journals (Sweden)

    Michał Kopeć

    2015-11-01

    Full Text Available Organic recycling of waste, taking into account sanitary safety, should be a fundamental method for recovering the nutrients present in the waste for plants and organic matter. It also refers to by-products of animal origin, which are not intended for consumption by humans. In the present research , composting of hydrated poultry slaughterhouse waste with maize straw was carried out. A combination with fodder yeast and post-cellulose lime was also introduced, which modified chemical and physico-chemical properties of the mixtures. The experiment was carried out by recording the biomass temperature for 110 days in 1.2×1.0×0.8 m reactors with perforated bottoms enabling active aeration. The following parameters were taken into consideration in the composted material: carbon, nitrogen, sulfur, respiratory activity, microorganisms, fractions of compost obtained after washing on sieves. Small amounts of fodder yeast favoured the development of microorganisms and caused a sanitary risk in the final product. At the initial stage, the temperature of raw compost in that object was several degrees lower than in the case of the composted mass without yeast addition. The addition of post-cellulose lime at ratios 6.5:1:6.5 (maize straw: poultry slaughterhouse waste: post-cellulose lime caused a change in the time of microbiological activity, and led to its inhibition in the final process. In comparison to objects with poultry waste, the highest degree of hygienization was found in the compost with post-cellulose lime (with pH close to neutral. By adjusting the ratios of substrates we can influence the microbiological activity, but the amounts of individual substrates should be determined taking into account the quality of the obtained compost.

  14. Influencing Factors of Onset of Cataract Patients%年龄相关性白内障患者发病的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    刘欣; 郁文国

    2016-01-01

    [目的]探讨白内障患者发病的影响因素.[方法]回顾性分析2014年3月至2015年3月来本院治疗的82例患者临床资料,其中白内障确诊患者37例作为病例组,45例双眼无视力损伤人群作为对照组,通过单因素分析及多因素logistic回归分析两组人群年龄、职业、性别、生活行为、既往阳光照射时间、既往病史等方面的差异.[结果]单因素分析结果显示,年龄越大,白内障患病率越高;女性白内障患病率高于男性;受教育程度方面,小学、初中、高中及其以上白内障患病率低于文盲组;高血压、糖尿病、既往吸烟白内障患病率高于非高血压、非糖尿病、不吸烟人群;既往阳光照射时间3~4 h、4~5 h、≥5 h白内障发生率高于既往阳光照射时间<3 h人群.多因素logistic回归分析结果显示,受教育程度低、既往阳光照射时间长、既往吸烟、患有糖尿病、女性、高龄仍是白内障的危险因素.[结论]受教育程度低、既往阳光照射时间长、既往吸烟、患有糖尿病、女性、高龄是白内障的危险因素;形成良好的生活方式如不吸烟、避免过度阳光照射等是预防白内障最实用的方法.%[Objective]To explore the influence factors of the onset of cataract patients.[Methods]The clinical da-ta were retrospectively analyzed in March 2014 ~ March 2015 to the hospital treatment of 82 cases of patients,inclu-ding 37 patients with cataract diagnosis,45 cases of binocular vision damage people,through the single factor analysis and multiple factors logistic regression analysis of age,occupation,gender,life behavior,sunlighted time etc.,the differences between the medical history of two groups were compared.[Results]Single factor analysis results show that the older you get,the higher cataract prevalence is;Female cataract prevalence rate is higher than that of male;in the field of education,elementary school,j unior high school,high school and above

  15. Factors Influencing the Quality of Mobile Applications

    Directory of Open Access Journals (Sweden)

    Alin ZAMFIROIU

    2014-01-01

    Full Text Available Mobile applications are becoming increasingly used. Mobile devices are becoming indispensable for the user. In the material are claiming the sales of mobile devices internationally and the use of mobile applications compared to traditional internet use on desktop systems for the United States. Are presented influences the quality of mobile applications and based on these influencing factors built a model of choice for optimal application of mobile applications and traditional desktop application. At the end of the material presented methods to increase quality by tracking the influence factors during the development of mobile applications.

  16. Factors influencing alginate gel biocompatibility.

    Science.gov (United States)

    Tam, Susan K; Dusseault, Julie; Bilodeau, Stéphanie; Langlois, Geneviève; Hallé, Jean-Pierre; Yahia, L'Hocine

    2011-07-01

    Alginate remains the most popular polymer used for cell encapsulation, yet its biocompatibility is inconsistent. Two commercially available alginates were compared, one with 71% guluronate (HiG), and the other with 44% (IntG). Both alginates were purified, and their purities were verified. After 2 days in the peritoneal cavity of C57BL/6J mice, barium (Ba)-gel and calcium (Ca)-gel beads of IntG alginate were clean, while host cells were adhered to beads of HiG alginate. IntG gel beads, however, showed fragmentation in vivo while HiG gel beads stayed firm. The physicochemical properties of the sodium alginates and their gels were thoroughly characterized. The intrinsic viscosity of IntG alginate was 2.5-fold higher than that of HiG alginate, suggesting a greater molecular mass. X-ray photoelectron spectroscopy indicated that both alginates were similar in elemental composition, including low levels of counterions in all gels. The wettabilities of the alginates and gels were also identical, as measured by contact angles of water on dry films. Ba-gel beads of HiG alginate resisted swelling and degradation when immersed in water, much more than the other gel beads. These results suggest that the main factors contributing to the biocompatibility of gels of purified alginate are the mannuronate/guluronate content and/or intrinsic viscosity.

  17. Mobilization of Peripheral Blood Stem Cells and Changes in the Concentration of Plasma Factors Influencing their Movement in Patients with Panic Disorder.

    Science.gov (United States)

    Jabłoński, Marcin; Mazur, Jolanta Kucharska; Tarnowski, Maciej; Dołęgowska, Barbara; Pędziwiatr, Daniel; Kubiś, Ewa; Budkowska, Marta; Sałata, Daria; Wysiecka, Justyna Pełka; Kazimierczak, Arkadiusz; Reginia, Artur; Ratajczak, Mariusz Z; Samochowiec, Jerzy

    2017-04-01

    In this paper we examined whether stem cells and factors responsible for their movement may serve as new biological markers of anxiety disorders. The study was carried out on a group of 30 patients diagnosed with panic disorder (examined before and after treatment), compared to 30 healthy individuals forming the control group. We examined the number of circulating HSCs (hematopoetic stem cells) (Lin-/CD45 +/CD34 +) and HSCs (Lin-/CD45 +/AC133 +), the number of circulating VSELs (very small embryonic-like stem cells) (Lin-/CD45-/CD34 +) and VSELs (Lin-/CD45-/AC133 +), as well as the concentration of complement components: C3a, C5a and C5b-9, SDF-1 (stromal derived factor) and S1P (sphingosine-1-phosphate). Significantly lower levels of HSCs (Lin-/CD45 +/AC133 +) have been demonstrated in the patient group compared to the control group both before and after treatment. The level of VSELs (Lin-/CD45-/CD133 +) was significantly lower in the patient group before treatment as compared to the patient group after treatment.The levels of factors responsible for stem cell movement were significantly lower in the patient group compared to the control group before and after treatment. It was concluded that the study of stem cells and factors associated with their movement can be useful in the diagnostics of panic disorder, as well as differentiating between psychotic and anxiety disorders.

  18. 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

  19. Factors influencing catheter-related infections in the Dutch multicenter study on high-dose chemotherapy followed by peripheral SCT in high-risk breast cancer patients

    NARCIS (Netherlands)

    Nieboer, P; de Vries, Elisabeth G. E.; Mulder, Nanno; Rodenhuis, S; Bontenbal, M; van der Wall, E; van Hoesel, Q G; Smit, W M; Hupperets, P; Voest, E E; Nooij, M A; Boezen, H M; van der Graaf, W T A

    2008-01-01

    Neutropenia following high-dose chemotherapy leads to a high incidence of infectious complications, of which central venous catheter-related infections predominate. Catheter-related infections and associated risk factors in 392 patients participating in a randomized adjuvant breast cancer trial and

  20. Factors influencing catheter-related infections in the Dutch multicenter study on high-dose chemotherapy followed by peripheral SCT in high-risk breast cancer patients.

    NARCIS (Netherlands)

    Nieboer, P.; Vries, E.G. de; Mulder, N.H.; Rodenhuis, S.; Bontenbal, M.; Wall, E. van der; Hoesel, Q.G.C.M. van; Smit, W.M.; Hupperets, P.; Voest, E.E.; Nooij, M.A.; Boezen, H.M.; Graaf, W.T.A. van der

    2008-01-01

    Neutropenia following high-dose chemotherapy leads to a high incidence of infectious complications, of which central venous catheter-related infections predominate. Catheter-related infections and associated risk factors in 392 patients participating in a randomized adjuvant breast cancer trial and

  1. Evaluation of influence of stretching therapy and ergonomic factors on postural control in patients with chronic non-specific low back pain

    Directory of Open Access Journals (Sweden)

    Piotr Gawda

    2015-02-01

    Ergonomic factors are often accompanied by the appearance of LBP. The restrictions within the musculoskeletal system cause disorders in muscle synergies, which is expressed by an increase in the angular velocity of the COG. In patients with chronic back pain syndrome, selected stretching therapy techniques improves the range of motion of the spine and reduces pain.

  2. Infrapopliteal Percutaneous Transluminal Balloon Angioplasty: Clinical Results and Influence Factors

    Energy Technology Data Exchange (ETDEWEB)

    Song, Jang Hyeon; Lee, Seung Jin; Jung, Hye Doo; Lim, Jae Hoon; Chang, Nam Kyu; Yim, Nam Yeol; Kim, Jae Kyu [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Lee, Keun Bae [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2011-09-15

    To assess the efficacy of percutaneous transluminal angioplasty (PTA) in patients with infrapopliteal arterial disease, and to determine the influencing factor for prognosis. A total of 55 patients (60 limbs) with infrapopliteal arterial stenosis or occlusion underwent PTA. Atherosclerotic risk factors, clinical symptoms, TransAtlantic Inter-Society Consensus (TASC) classification, and vascular wall calcification were evaluated before PTA. The number of patent infrapopliteal arteries was estimated, and the outcome was evaluated by symptom relief and limb salvage. Technical success was achieved in 53/60 limbs (88.3%) and 81/93 arteries (87.1%), TASC classification (p = 0.038) and vascular calcification (p = 0.002) influenced on technical failure. During follow-up, 26 of 55 limbs (47%) achieved symptom relief and 42/55 limbs (76%) underwent limb salvage. Non-diabetic patients (9/12, 75%) were superior to diabetic patients (17/43, 40%) in terms of symptom relief (p = 0.024). TASC classification and vascular wall calcification influenced on symptom relief and limb salvage. The number of patent infrapopliteal arteries after PTA influenced symptom relief (p < 0.001) and limb amputation (p = 0.003). PTA in patients with chronic critical limb ischemia is worthwhile as a primary treatment. The influence factors should be considered before PTA, and PTA should be performed in as many involved arteries as possible.

  3. The Effects of Adherence to Non-Steroidal Anti-Inflammatory Drugs and Factors Influencing Drug Adherence in Patients with Knee Osteoarthritis.

    Science.gov (United States)

    Park, Kwan Kyu; Choi, Choong Hyeok; Ha, Chul-Won; Lee, Myung Chul

    2016-05-01

    We aimed to compare the clinical outcomes of knee osteoarthritis patients according to drug adherence; and to find out the factors the affecting those outcomes. We analyzed the drug adherence and clinical outcomes in 1,334 primary knee osteoarthritis patients who took non-steroidal anti-inflammatory drugs (NSAIDs) for 3 weeks. Clinical outcomes of Pain Numeric Rating Scale (NRS), Knee injury and Osteoarthritis Outcome Score (KOOS) and EQ-5D were compared at baseline and 3 weeks' follow-up between the two groups of adherent group and non-adherent group (1,167 vs. 167 patients). Logistic regression analysis was performed to examine the factors affecting the adherence, and the reasons for the non-adherence were asked. The follow-up clinical outcomes of NRS and KOOS symptom, pain and activity of daily life were significantly higher in the adherence group (P = 0.003, P = 0.048, P = 0.005, and P = 0.003, respectively). The adherence was better in the elderly and in the male group (P = 0.042 and P = 0.034, respectively) and the top reason for no strict adherence was "symptom improved" (21.5%) followed by side effects. In this study, the patients with better adherence to NSAIDs showed better outcomes compared to those with poor adherence. This study can contribute to the patient education for the pharmacological treatment in knee OA patients.

  4. Tissue-factor-bearing microparticles (MPs-TF) in patients with acute ischaemic stroke: the influence of stroke treatment on MPs-TF generation.

    Science.gov (United States)

    Świtońska, M; Słomka, A; Sinkiewicz, W; Żekanowska, E

    2015-02-01

    Stroke is an important cause of death and disability throughout the world. Microparticles play a cardinal role in vascular hemostasis. The primary aim of this study was to evaluate the procoagulant activity of microparticles and levels of tissue-factor-bearing microparticles (MPs-TF), tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in patients with acute ischaemic stroke. Seventy-three patients with a diagnosis of acute ischaemic stroke were included. Venous blood samples were drawn on the first day and the seventh day after stroke onset. Plasma microparticles, MPs-TF, TF and TFPI were determined by enzyme-linked immunosorbent assay. Assessment variables were timing of blood collection, type of stroke treatment, presence or absence of diabetes mellitus and hypertension, and scores on the National Institutes of Health Stroke Scale together with scores on the modified Rankin Scale. Whilst MPs-TF and TFPI levels of stroke subjects were significantly higher (median, 1.63 vs. 0.73 pg/ml; median, 114.26 vs. 78.60 ng/ml, respectively), TF levels in the plasma of stroke patients were significantly lower (median, 82.27 vs. 97.80 pg/ml) than those of healthy individuals. Lower levels of TF were detected in patients with severe stroke in comparison with patients with mild stroke. Moreover, the data also showed that in stroke patients not treated with alteplase the activity of microparticles was significantly higher 1 week after diagnosis in comparison with the activity at the time of diagnosis. Our findings suggest that patients with acute ischaemic stroke have increased generation of MPs-TF. Nevertheless, further studies are needed in order to confirm such inference. © 2014 EAN.

  5. Emotions Features Of Cancer Patients and the Influencing Factors%癌症患者情绪状况及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    杨智辉; 王建平

    2011-01-01

    目的:调查癌症患者的情绪状况,并分析其影响因素.方法:采用简明心境问卷一简式、医用应对问卷和艾森克人格问卷简式量表等测查工具对205名60岁以上的癌症病人进行调查.结果:①癌症病人负性情绪平均分都在1.5左右,有40%以上的患者在抑郁、焦虑和疲乏情绪上均分大于2,男性、高年龄组和离退休组的患者情绪状况更差.②屈服应对、精神质和神经质与负性情绪正相关显著,与正性情绪负相关显著;掩饰性和内外向与负性情绪负相关显著,与正性情绪正相关显著.③屈服应对和人格维度中的精神质、神经质和掩饰性对各类情绪最有预测作用.结论:癌症病人以抑郁、焦虑、疲乏三类负性情绪最为严重,采用屈服的应对策略和敏感、情绪不稳定的患者负性情绪最严重,外向和掩饰性高的患者情绪状况更好.%Objective: To explore the emotion features of cancer patients and the influencing factors.Methods: The Profile of Mood States-Short Form, Medical Coping Modes Questionnaire, Eysenck Personality Questionnaire-revised were administrated to a sample of 205 cancer patients.Results: ①The mean of the negative emotion were about 1.5, and there were more than 40% patients whose anxiety, depression and fatigue emotions scores were above 2.②The coping strategies of resignation, neuroticism and psychoticism dimensions had a significant positive correlation with negative emotion and negative correlation with positive emotion, Lie and Intraversion-Extraversion had significant negative correlation with negative emotion and positive correlation with positive emotion.③The coping strategies of resignation and personalities of neuroticism and psychoticism were the most significant predictors of emotion.Conclusion: Anxiety, depression and fatigue are the most serious emotion problems and those who are sensitive, unstable and taking the coping strategies of resignation have

  6. 反流性食管炎患者睡眠质量影响因素的临床研究%Influencing Factors of Sleep Quality Among Patients with Reflux Esophagitis

    Institute of Scientific and Technical Information of China (English)

    陈旭英; 王敏志; 潘婵

    2013-01-01

    Objective To explore the influencing factors of sleep quality among patients with reflux esophagitis ( RE ) . Methods A cross - sectional survey was conducted among 98 RE patients. First single factor analysis was performed to explore the influencing factors, and then Logistic multiple regression analysis was carried out by taking sleep quality as the dependent variable and the statistically significant factors from single factor analysis as independent variable. Results The prevalence rate of sleep disorder in RE patients was 46% ( 45/98 ). The Logistic multiple regression analysis showed that recurrence, improper diet, bad sleeping habits, incorrect method of medication and heartburn were the influencing factors of sleep disorder in RE patients ( P < 0. 05 ) . Conclusion Sleep disorder is more common in RE patients, which is influenced by multiple factors. Nurses should take proper measures based on the influencing factors.%目的 探讨反流性食管炎(RE)患者睡眠质量的影响因素.方法 对98例RE患者进行横断面调查,首先对可能影响因素进行单因素分析,然后以睡眠质量为因变量,以单因素分析有统计学意义的因素为自变量,进行Logistic多元回归分析.结果 (1)RE患者睡眠障碍发生率为46%(45/98);(2)Logistic多元回归分析显示:复发、饮食不合理、睡眠习惯差、服药方法错误和胃灼热对睡眠障碍的影响有统计学意义(P<0.05).结论 RE患者睡眠障碍较为常见,复发、饮食不合理、睡眠习惯差、服药方法错误和胃灼热是其睡眠障碍的影响因素,护理人员应根据影响因素进行针对性护理.

  7. 脑梗死患者自我感受负担影响因素的临床研究%Clinical research in influencing factors of self-perceived burden among patients with cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    颜雅伟

    2013-01-01

    Objective To explore the influencing factors of self-perceived burden(SPB) among patients with cerebral infarction.Methods A total of 108 patients were included in the study,they were investigated by a self-designed demographic questionnaire and Self-Perceived Burden Scale(SPBS).Chisquare analysis,t test and multiple regression analysis were used to explore the influencing factors of SPB.Results The SPB of patients with cerebral infarction was (36.72±4.23) points.Self-care ability,hemiple-gia,language barriers and times of hospitslization were the influencing factors of SPB according to the mul-tiple regression analysis.Conclusions The patients with cerebral infarction have obvious SPB,which is influenced by multiple factors.Nurses should take proper measures to alleviate the patients' SPB.%目的 探讨脑梗死患者自我感受负担(SPB)的影响因素.方法 采用自我感受负担量表对108例脑梗死患者进行横断面调查,首先对可能的影响因素进行单因素分析,然后以SPB为应变量,以单因素分析有统计学意义的因素为自变量,进行多元回归分析.结果 脑梗死患者SPB平均分为(36.72±4.23)分;多元回归分析显示,生活自理能力、偏瘫、语言障碍、住院次数是脑梗死患者SPB的影响因素.结论 脑梗死患者存在SPB,护理人员应采取相应护理措施.

  8. Factors that influence fatigue status in patients with severe rheumatoid arthritis (RA) and good disease outcome following 6 months of TNF inhibitor therapy: a comparative analysis.

    LENUS (Irish Health Repository)

    Minnock, Patricia

    2015-11-01

    The objective of the present study is to determine the factors associated with persistent fatigue in patients with severe rheumatoid arthritis (RA) and good disease response to 6 months of tumour necrosis factor inhibitor therapy. Eligible patients with either persistent (PF) or no fatigue (NF) were compared. Using validated questionnaires and bivariate analysis, this cross-sectional survey explored if clinical characteristics, pain, self-efficacy, sleep and mood\\/depression differed between groups. Patients with PF (PF; NF) (n = 28; 28) reported significantly more overall pain (11.3 ± 9.4 (0-33); 6.9 ± 8.9 (0-33)), more recent and current pain intensity (41.4 ± 26.6 (0-80) 24.4 ± 26.6 (0-100) and depression (11.8 ± 7.5 (1-35); 8.2 ± 6.6 (0-26)), than the NF group. There was no significant difference between groups in self-efficacy and both groups experienced poor sleep quality (Pittsburgh Sleep Quality Index >5). Despite having good disease response, the PF group had significantly higher rheumatoid factor incidence, disease activity score-28, early morning stiffness duration and lower incidence of ever-failing disease-modifying anti-rheumatic drugs than the NF group. These findings enhance the fatigue literature in patients with RA prescribed tumour necrosis factor (TNF) inhibition therapy, identifying the potentially modifiable factors of pain and depression, previously demonstrated to be strongly associated with fatigue in non-biologic populations. In addition, this study highlights the association between persistent fatigue and an on-going state of low disease activity. This infers that more judicious disease management could minimise the symptom burden of pain and depression and consequentially fatigue.

  9. Influence of socioeconomic factors on hospital readmissions for heart failure and acute myocardial infarction in patients 65 years and older: evidence from a systematic review

    Directory of Open Access Journals (Sweden)

    Damiani G

    2015-01-01

    Full Text Available Gianfranco Damiani,1 Eleonora Salvatori,1 Giulia Silvestrini,1 Ivana Ivanova,2 Luka Bojovic,3 Lanfranco Iodice,1 Walter Ricciardi1 1Department of Public Health, Università Cattolica Sacro Cuore, Rome, Italy; 2ERAWEB Project, Faculty of Medicine, Saints Cyril and Methodius University of Skopje, Skopje, Macedonia; 3ERAWEB Project, Faculty of Medicine, University of Nis, Nis, Serbia Purpose: Cardiovascular diseases are the leading cause of death and disability worldwide. Among these diseases, heart failure (HF and acute myocardial infarction (AMI are the most common causes of hospitalization. Therefore, readmission for HF and AMI is receiving increasing attention. Several socioeconomic factors could affect readmissions in this target group, and thus, a systematic review was conducted to identify the effect of socioeconomic factors on the risk for readmission in people aged 65 years and older with HF or AMI.Methods: The search was carried out by querying an electronic database and hand searching. Studies with an association between the risk for readmission and at least one socioeconomic factor in patients aged 65 years or older who are affected by HF or AMI were included. A quality assessment was conducted independently by two reviewers. The agreement was quantified by Cohen’s Kappa statistic. The outcomes of studies were categorized in the short-term and the long-term, according to the follow-up period of readmission. A positive association was reported if an increase in the risk for readmission among disadvantaged patients was found. A cumulative effect of socioeconomic factors was computed by considering the association for each study and the number of available studies.Results: A total of eleven articles were included in the review. They were mainly published in the United States. All the articles analyzed patients who were hospitalized for HF, and four of them also analyzed patients with AMI. Seven studies (63.6% were found for the short

  10. Prospective study of the influence of psychological and medical factors on quality of life and severity of symptoms among patients with oral squamous cell carcinoma.

    Science.gov (United States)

    Rana, M; Kanatas, A; Herzberg, P Y; Khoschdell, M; Kokemueller, H; Gellrich, N-C; Rana, M

    2015-04-01

    About 400,000 people worldwide are diagnosed with oral squamous cell carcinoma (SCC) annually, and the incidence is increasing. Many advanced carcinomas of the oral cavity require radical surgical treatment that can impair patient's quality of life (QoL) and severity of symptoms. We therefore aimed to identify coping strategies and disease-specific medical factors that affect QoL and severity of symptoms. Patients with oral SCC were asked to complete the Freiburg Questionnaire on Coping with Illness (FQCI), the University of Washington Quality of life Questionnaire (UW-QOL version 4), and the Brief Symptom Inventory (BSI) to measure psychological stress. We also assessed the impact of various factors on QoL and severity of symptoms, including stage and site of tumour, method of reconstruction, time of diagnosis, and social structure (age, sex, marital status, living arrangements, level of education, and employment). We enrolled a consecutive sample of 104 patients over a period of one year. Stepwise linear regression analyses indicated that both depressive coping and size of tumour had an adverse effect on QoL and severity of symptoms. Patients with high educational attainment and those who lived alone reported impaired QoL, and women experienced increased severity of symptoms. Impaired QoL and increased severity of symptoms were associated with a depressive style of coping, size of tumour, educational attainment, and living arrangements. It is important to identify these patients during treatment as they could benefit from psycho-oncological counselling.

  11. Influencing factors in MMR immunisation decision making.

    Science.gov (United States)

    Hill, Marie C; Cox, Carol L

    Immunisation decision making is not a straightforward process for parents. Many factors influence parental decision making on whether they immunise their child with the measles, mumps and rubella (MMR) vaccine. The feasibility study described in this article provides insight into influencing factors associated with decisions regarding the immunisation of children by parents. The study findings suggest that the practice nurse is a credible source of information for parents seeking informed decision making. At a time when the incidence of measles and mumps is rising in the UK, the provision of appropriate information by the practice nurse has the potential to increase uptake of the MMR vaccine.

  12. 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.

  13. Diagnostic, treatment, and demographic factors influencing survival in a population-based study of adult glioma patients in the San Francisco Bay Area1

    OpenAIRE

    Wrensch, Margaret; Rice, Terri; Miike, Rei; McMillan, Alex; Lamborn, Kathleen R.; Aldape, Kenneth; Prados, Michael D.

    2006-01-01

    We compare survival estimates for population-based glioma cases by using two diagnostic coding schemes, (1) the International Classification of Diseases, Oncology, second edition (ICD-O-2) as reported by the Surveillance, Epidemiology, and End Results (SEER) program and (2) central neuropathology review diagnosis based on the World Health Organization II classification. In addition, among review categories, we estimate survival in relation to several patient demographic and treatment factors....

  14. Influence of patient and provider factors on the workload of on-call physicians: A general internal medicine cohort observational study.

    Science.gov (United States)

    Hsu, Nin-Chieh; Huang, Chun-Che; Jerng, Jih-Shuin; Hsu, Chia-Hao; Yang, Ming-Chin; Chang, Ray-E; Ko, Wen-Je; Yu, Chong-Jen

    2016-08-01

    Factors associated with the physician workload are scarcely reported. The study aims to investigate the associated factors of on-call physician workload based on a published conceptual framework.The study was conducted in a general internal medicine unit of National Taiwan University Hospital. On-call physician workloads were recorded on a shift basis from 1198 hospitalized patients between May 2010 and April 2011. The proxy of on-call workloads included night calls, bedside evaluation/management (E/M), and performing clinical procedures in a shift. Multivariable logistic and negative binomial regression models were used to determine the factors associated with the workloads of on-call physicians.During the study period, 378 (31.6%) of patients had night calls with related workloads. Multivariate analysis showed that the number of patients with unstable conditions in a shift (odds ratio [OR] 1.89 and 1.66, respectively) and the intensive care unit (ICU) training of the nurse leader (OR 2.87 and 3.08, respectively) resulted in higher likelihood of night calls to and bedside E/M visits by the on-call physician. However, ICU training of nurses (OR = 0.37, 95% confidence interval: 0.16-0.86) decreased the demand of performing clinical procedures by the on-call physician. Moreover, number of patients with unstable conditions (risk ratio [RR] 1.52 and 1.55, respectively) had significantly increased the number of night calls and bedside E/M by on-call physicians by around 50%. Nurses with N1 level (RR 2.16 and 2.71, respectively) were more likely to place night calls and facilitate bedside E/M by the on-call physician compared to nurses with N0 level. In addition, the nurse leaders with ICU training (RR 1.72 and 3.07, respectively) had significant increases in night calls and bedside E/M by the on-call physician compared to those without ICU training.On-call physician workload is associated with patient factors and the training of nurses. Number of unstable patients

  15. What factors influence the health status of patients with rheumatoid arthritis measured by the SF-12v2 Health Survey and the Health Assessment Questionnaire?

    DEFF Research Database (Denmark)

    Linde, Louise; Sørensen, Jan; Østergaard, Mikkel

    2009-01-01

    OBJECTIVE: The Health Assessment Questionnaire Disability Index (HAQ) is a widely used outcome measure in rheumatoid arthritis (RA), whereas the SF-12v2 Health Survey (SF-12) was introduced recently. We investigated how the HAQ and SF-12 were associated with socio-demographic, lifestyle, and dise......OBJECTIVE: The Health Assessment Questionnaire Disability Index (HAQ) is a widely used outcome measure in rheumatoid arthritis (RA), whereas the SF-12v2 Health Survey (SF-12) was introduced recently. We investigated how the HAQ and SF-12 were associated with socio-demographic, lifestyle......, and disease- and treatment-related factors in patients with RA. METHODS: In RA patients from 11 Danish centers, clinical and patient-reported data, including the HAQ and SF-12, were collected. Three multiple linear regression models were estimated, with the HAQ, SF-12 physical component score (PCS), and SF-12...... mental component score (MCS) as outcome and sociodemographic, lifestyle, and RA-related treatment and comorbidity characteristics as explanatory variables. RESULTS: In total, 3156 (85%) of 3704 invited patients participated--75% women, 76% rheumatoid factor-positive, median age 61 years (range 15-93 yrs...

  16. 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”.

  17. On factors influencing students’ listening abilities

    Institute of Scientific and Technical Information of China (English)

    胡天秀

    2012-01-01

    As we all know,listening,speaking,reading,and writing are four basic skills in language teaching and learning.Listening plays an important role in improving other skills.There are some factors influencing students’ listening abilities.So it’s important for teachers to improve students’ listening abilities.

  18. Factors Influencing High School Students' Career Aspirations

    Science.gov (United States)

    Tang, Mei; Pan, Wei; Newmeyer, Mark D.

    2008-01-01

    This article explores the factors influencing high school students' career aspirations with a study analyzing 141 high school students. The Social Cognitive Career Development Model was utilized to examine the interactive relationships among learning experiences, career self-efficacy, outcome expectations, career interests, and career choices. The…

  19. 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...

  20. Factors influencing the process of farm liquidation

    Directory of Open Access Journals (Sweden)

    Michał Dudek

    2010-01-01

    Full Text Available In the paper the logit analysis was used in order to define the factors influencing farm liquidation. The prevalence of this phenomenon and its regional differences were analysed. Significant and negative impact of the number of people in a family farm and the number of machinery and technical equipment, as well as the positive impact of the farmer’ age are reported.

  1. Factors influencing goal attainment in patients with post-stroke upper limb spasticity following treatment with botulinum toxin A in real-life clinical practice: sub-analyses from the Upper Limb International Spasticity (ULIS)-II Study.

    Science.gov (United States)

    Fheodoroff, Klemens; Ashford, Stephen; Jacinto, Jorge; Maisonobe, Pascal; Balcaitiene, Jovita; Turner-Stokes, Lynne

    2015-04-08

    In this post-hoc analysis of the ULIS-II study, we investigated factors influencing person-centred goal setting and achievement following botulinum toxin-A (BoNT-A) treatment in 456 adults with post-stroke upper limb spasticity (ULS). Patients with primary goals categorised as passive function had greater motor impairment (p 1 year)) post-stroke (80.0% vs. 79.2%) or presence or absence of severe contractures (76.7% vs. 80.6%), although goal types differed. Earlier BoNT-A intervention was associated with greater achievement of active function goals. Severe contractures impacted negatively on goal achievement except in pain and passive function. Goal setting by patients with ULS is influenced by impairment severity, age and time since stroke. Our findings resonate with clinical experience and may assist patients and clinicians in selecting realistic, achievable goals for treatment.

  2. 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.

  3. Factors Influencing the Success Rate of Cardiopulmonary Resuscitation

    Directory of Open Access Journals (Sweden)

    Aisyah Amanda Hanif

    2015-12-01

    Full Text Available Background: Cardiopulmonary resuscitation (CPR is a series of actions performed on cardiac arrest patients. Not all patients receiving CPR can survive. The outcome of CPR is influenced by several factors. This study was conducted to determine the success rate of CPR and the factors influencing it in Dr. Hasan Sadikin General Hospital in 2013. Methods: This study was conducted by using 168 patient medical records who underwent CPR and met the inclusion criteria in the Resuscitation Room of Dr. Hasan Sadikin General Hospital from January to December 2013. The collected data consisted of age, gender, pre-arrest diagnosis, initial rhythm, response time and clinical outcome of CPR. The results were expressed in frequencies and percentage. The data were analyzed using the chi-square test. Results: The Success rate of CPR was 15.5%. The success rate was higher in patients with cardiac prearrest diagnoses (8.33%, p=0.024. The most common initial rhythm was unshockable rhythms (83.92%, yet patients with shockable heart rhythms had higher success rates (40.74%, p<0.001. All of the surviving patients had response time within the first minute from cardiac arrest. Conclusions: Success rate of CPR in the resuscitation room of Dr. Hasan Sadikin General Hospital during 2013 is still low. The factors influencing the survival rate are the pre-arrest diagnosis and initial heart rhythm.

  4. Investigation of the status and influencing factors of social participation among colostomy patients%结肠造口患者社会参与状况及影响因素调查

    Institute of Scientific and Technical Information of China (English)

    王玉平

    2013-01-01

    目的 调查结肠造口患者社会参与状况,并分析其影响因素.方法 对164例结肠造口患者的社会参与状况及个人因素和环境因素进行评估,探讨影响社会参与的因素.结果 结肠造口患者社会参与的工作情况、家庭以外社会活动,责任心以及将来的计划性方面有待提高,影响社会参与的因素为经济状况、对支持的利用度、应对方式和年龄.结论 环境和个人因素对结肠造口患者的社会参与有显著影响,应加强对结肠造口患者社会参与的支持力度.%Objective To investigate the status and influencing factors of social participation among colostomy patients. Methods Totally 164 colostomy patients'status of social participation and background factors of social participation were assessed to explore the factors of social participation. Results Employment status, social activities outside familiy, responsibility and future plans of social participation among colostomy patients needed to be improved. The influencing factors included economic status, social support, coping style and age. Conclusions Environmental and individual factors have significant influence on colostomy patients'social participation. Their social support need to be strengthened.

  5. 影响乳腺癌术后患者舒适度的相关因素及护理对策%The Influence Factor of Comfortable in Patients with Mastectomy Modified Radical and Its Nursing Measures

    Institute of Scientific and Technical Information of China (English)

    闵晓萍

    2012-01-01

      Objective To analysis the influence factor of comfortable in patients with mastectomy modified radical and its nursing measures. Methods 220 patients with mastectomy modified radical were analyzed to find the influence factor of comfortable, and then personalized care measures were worked out, and the effects were tested. Results The influence factor of comfortable were psychological, physical, social, and environmental factors, after the personalized care measures, the FLIC were significantly better than before(P<0.01). Conclusion The comfortable in patients with mastectomy modified radical is influenced by the psychological, physical, social, and environmental factors, personalized care measures based on the above factors can improve the quality of life effectively of the patients.%  目的 分析乳腺癌术后患者舒适度的影响因素及护理对策.方法 调查220例乳腺癌术后患者的舒适度影响因素,制定个性化的护理对策并验证其效果.结果 乳腺癌术后患者舒适度影响因素主要有心理、生理、社会及环境等,给予患者个性化的护理措施可有效改善患者生活功能指数(P <0.01).结论 乳腺癌术后患者舒适度主要受心理、生理、社会及环境等因素的影响,根据上述因素给予个性化的舒适护理,可有效改善患者生活质量.

  6. Problem solving III: factors influencing classroom problem

    Directory of Open Access Journals (Sweden)

    Sayonara Salvador Cabral da Costa

    1997-05-01

    Full Text Available This paper presents a review of the literature in the area of problem solving, particularly in physics, focusing only on factors that influence classroom problem solving. Fifty-seven papers have been analyzed in terms of theoretical basis, investigated factors/methodology and findings/relevant factors, which were organized in a table that served as support for a synthesis made by the authors. It is the third of a four-paper series reviewing different aspects of the problem solving subject.

  7. 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.

  8. Lower Circulating Levels of Chemokine CXCL10 In Helicobacter Pylori-Infected Patients with Peptic Ulcer: Influence of the Bacterial Virulence Factor CagA

    Directory of Open Access Journals (Sweden)

    Abdollah Jafarzadeh

    2013-03-01

    Full Text Available Background and objectives: Alterations in CXCL10 (a Th1 chemokine expression have been associated with various diseases. The aim of this study was to evaluate the serum CXCL10 levels in H. pylori-infected patients with peptic ulcer (PU and to determine its association with bacterial virulence factor cytotoxin-associated gene A (CagA. Materials and Methods: Serum samples from 90 H. pylori infected patients (70 were anti-CagA+, 20 were anti-CagA-, 65 asymptomatic (AS carriers (40 were anti-CagA+, 25 were anti-CagA- and 30 healthy H. pylori-negative subjects (as a control were tested for the concentrations of CXCL10 by using ELISA method. Results: The mean serum levels of CXCL10 in PU patients (96.64 ± 20.85 Pg/mL was significantly lower than those observed in AS subjects (162.16 ± 53.31 Pg/mL, P < 0.01 and control group (193.93 ± 42.14 Pg/mL, P < 0.02. In the PU group, the levels of CXCL10 in anti-CagA+ subjects was significantly higher in comparison to anti-CagA- patients (P<0.04. Conclusion: These results showed that the mean concentrations of CXCL10 in H. pylori-infected-PU patients was lower than AS carriers and control group. In the PU group, the serum levels of CXCL10 were affected by bacterial factor CagA.

  9. Uncovering Factors Influencing Interpersonal Health Communication.

    Science.gov (United States)

    Donné, Lennie; Jansen, Carel; Hoeks, John

    2017-01-01

    Talking to friends, family, or peers about health issues might, among other things, increase knowledge of social norms and feelings of self-efficacy in adopting a healthier lifestyle. We often see interpersonal health communication as an important mediating factor in the effects of health campaigns on health behavior. No research has been done so far, however, on factors that influence whether and how people talk about health issues without being exposed to a health campaign first. In this exploratory study, we interviewed 12 participants about their communication behavior concerning six different health themes, like smoking and exercising. The results suggest that at least four types of interpersonal health communication can be distinguished, each influenced by different factors, like conversational partner and objective of the conversation. Future research should take this diversity of interpersonal health communication into account, and focus on designing health campaigns that aim to trigger dialogue within target populations.

  10. 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.

  11. Factors influencing the type, timing and severity of symptomatic responses to dietary gluten in patients with biopsy-proven coeliac disease.

    Science.gov (United States)

    Barratt, Stephen M; Leeds, John S; Sanders, David S

    2013-12-01

    There is a paucity of data reflecting the symptomatic responses to dietary gluten (SRDG) in patients with Coeliac Disease (CD). We aimed to determine the type, timing and severity of SRDG with reference to a range of disease-related factors. Postal survey of 224 biopsy-proven patients including gluten-free diet (GFD) adherence, symptom checklist, ROME II criteria and The Hospital Anxiety & Depression Scale. Case-note review was also conducted. 26% of respondents were male. Full GFD adherence: n=159 (70%). Irritable bowel syndrome (IBS): n=50 (22%). Anxiety: n=30 (13%); Depression: n=33 (14%); Anxiety & Depression: n=72 (32%). Pruritus, fatigue and bloating were a more common SRDG in the partial/none GFD adherent group (p=ns). Co-existing IBS was associated with a greater prevalence of nausea and fatigue in response to gluten (p=gluten in the fully GFD adherent group is more likely to result in a severe SRDG in comparison to symptoms arising prior to consistent GFD adherence (OR 2.3; p=0.01). IBS sufferers are also more likely to rate their SRDG as severe in nature (OR 1.4; p=0.038). Patients with consistent GFD adherence experience a SRDG faster and more severe in comparison to prior gluten exposure possibly demonstrating an adept immunological response. Anxiety and depression also enhance the speed of symptom onset and co-existing visceral hypersensitivity is a risk factor for severe reactions to dietary gluten.

  12. Nurse and patient factors that influence nursing time in chest tube management early after open heart surgery: A descriptive, correlational study.

    Science.gov (United States)

    Cook, Myra; Idzior, Laura; Bena, James F; Albert, Nancy M

    2017-04-27

    Determine nurse characteristics and patient factors that affect nurses' time in managing chest tubes in the first 24-hours of critical-care stay. Prospective, descriptive. Cardiovascular critical-care nurses and post-operative heart surgery patients with chest tubes were enrolled from a single center in Ohio. Nurses completed case report forms about themselves, comfort and time in managing chest tubes, chest tube placement and management factors. Analysis included correlational and comparative statistics; Bonferroni corrections were applied, as appropriate. Of 29 nurses, 86.2% were very comfortable managing chest tubes and oozing/non-secure dressings, but only 41.4% were very comfortable managing clogged chest tubes. Of 364 patients, mean age was 63.1 (±12.3) years and 36% had previous heart surgery. Total minutes of chest tube management was higher with≥3 chest tubes, tube size cardiac surgeries (p≤0.002), heart failure (pNurse comfort with chest tube-related tasks affected time spent on chest tube management. Published by Elsevier Ltd.

  13. 糖尿病患者不良饮食行为的影响因素%Influence Factors of Unhealthy Dietary Behaviors in Patients with Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    张达平

    2014-01-01

    Objective To study the behavior of diabetic patients the impact of poor dietary factors and countermeasures.Methods A self-designed questionnaire in 135 hospitalized patients with diabetes to survey and analyze the impact of unhealthy eating behavior factors and take action.Results The dietary treatment of patients with a lack of knowledge and self-control,do not at ach importance to diet therapy, and family members can not cope with the bad behavior of the main factors af ecting diet,and care interventions can improve patient adherence to diet therapy.Conclusion Diabetic patients and their families to enhance education,increase their awareness of the importance of diet therapy,the establishment of hospitals and family double oversight mechanisms is to improve the treatment compliance of patients with diabetes diet and ef ective way.%目的探讨糖尿病患者不良饮食行为的影响因素及对策。方法采用自行设计的问卷对135例住院糖尿病患者进行调查,分析不良饮食行为的影响因素并采取对策。结果患者缺乏饮食治疗知识和自控能力、不重视饮食治疗和家庭成员不能配合是不良饮食行为的主要影响因素,而护理干预可以提高患者饮食治疗的依从性。结论加强糖尿病患者和家属教育,提高其对饮食治疗重要性的认识,建立医院与家庭双重监督机制,是提高糖尿病患者饮食治疗依从性的有效方法。

  14. What Factors Influence Knowledge Sharing in Organizations?

    DEFF Research Database (Denmark)

    Razmerita, Liana; Kirchner, Kathrin; Nielsen, Pia

    2016-01-01

    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...... 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...... 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...

  15. 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.

  16. Choice of treatment with antidepressants: influencing factors.

    Science.gov (United States)

    Himmerich, Hubertus; Wranik, Dominika W

    2012-01-01

    Depressive disorders place a large burden on patients and on society. Although efficacious treatment options for unipolar depressive disorders exist, substantial gaps in care remain. In part, the challenge lies in the matching of individual patients with appropriate care. This is complicated by the steady increases in the variety of antidepressants available in the market. The goal of this study is to highlight the decision processes in the selection of antidepressants by clinicians, given that most treatments have similar clinical effectiveness profiles. We conducted a systematic literature review of studies that referred to the decisions surrounding treatment with antidepressants for the treatment of non-psychotic unipolar depression. Our analysis of the literature reveals that the choice of treatment is based on a variety of factors, of which clinical evidence is only one. These factors can be categorized into clinical factors such as illness and treatment characteristics, individual factors such as patient and physician characteristics, and contextual factors such as setting characteristics, decision supports and pharmacoeconomic aspects. Illness characteristics are defined by the type and severity of depression. Treatment characteristics include drug properties, efficacy, effectiveness and favorable as well as unintended adverse effects of the drug. Examples for patient characteristics are co-morbidities and individual preferences, and physician characteristics include knowledge, experience, values and beliefs, and the relationship with the patient. Treatment guidelines, algorithms, and most recently, computational supports and biological markers serve as decision supports.

  17. The influencing factors and countermeasures of nurse-patient communication in Emergency Room%急诊科护患沟通的影响因素及对策

    Institute of Scientific and Technical Information of China (English)

    昌子艳; 刘红; 戴莉

    2012-01-01

    针对急诊科护理工作中护患沟通的影响因素及应对策略进行综述.影响因素主要包括护士沟通技巧不足、就医环境嘈杂、患者处于应激状态、护士职业倦怠、人力资源不足等,急诊科护理人员应重视与患者进行沟通,工作中善于运用语言技巧,合理运用非语言技巧,管理者可通过开展多形式的沟通技巧培训,改善就医环境,合理配置护理人力等,提高急诊科护患沟通效果.%We summarized the influencing factors and countermeasures of nurse-patient communication in Emergency Room. The influencing factors included insufficient communication skills, noisy medical environment, patients in stress state, nurses' burnout, human resources deficiency and other factors. We suggested that the nursing staff should pay more attention to communicating with emergency patients, be good at using linguistic and extralinguistic communication skills reasonablely, receive multiple forms of communication skills training, improve hospital environment, and allocate human resource rationally to improve nurse-patient communication effect.

  18. Analysis of Factors Influencing Quality of Life of Patients with Permanent Colostomy with Fish-Bone Diagram%鱼骨图对永久性肠造口人生活质量的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    汤利萍; 李乐; 王霞

    2015-01-01

    目的:运用鱼骨图分析影响肠造口人生活质量的因素,为进一步提高其生活质量提供指导。方法动态追踪105例行永久性结肠造口人的资料。建立信息库,每月随访1次,持续追踪1年,了解造口人基本信息、术后并发症、造口护理情况、心理状况等,采用鱼骨图法对造口人肠造口术后生活质量的影响因素进行分析和评价。结果影响肠造口人生活质量的因素包括医生、护士、造口人及家属、社会支持。结论采用鱼骨图法能对生活质量的影响因素进行全面有效分析,了解肠造口人术后生活状态的原因,为其自我管理和护理提供全面、有效的指导。%Objective To analyze the factors influencing the quality of life of patients with per-manent colostomy using fish-bone diagram,and to provide guides for improving the quality of life of patients with permanent colostomy.Methods Data of 105 patients with permanent colostomy were dynamically tracked,and the database was established.The follow-up was performed once per month for 1 year to know the basic information,postoperative complications,nursing situation and psychological status of patients.In addition,the factors influencing the quality of life of pa-tients with permanent colostomy were analyzed and evaluated using fish-bone diagram.Results The factors influencing the quality of life of patients with permanent colostomy included doctors, nurses,patients and their families,and social supports.Conclusion Fish-bone diagram can be used for comprehensively and effectively analyzing the factors influencing the life of quality,un-derstanding the state of life and providing guides for self-management and nursing in patients with permanent colostomy.

  19. 肠造口病人生活质量影响因素研究现况%Research status quo of influencing factors of qual ity of l ife of patients with colostomy

    Institute of Scientific and Technical Information of China (English)

    王婷; 陈湘玉

    2014-01-01

    It summarized the definition and status quo of quality of life of patients with colostomy.It expounded the influence of demographic,physi-cal,psychological,social factors and self care ability on the quality of life of patients with colostomy.%简述了生活质量定义及肠造口病人的现状,综述了人口学因素、生理因素、心理因素、社会因素及自护能力对肠造口病人生活质量的影响。

  20. Factors Influencing Goal Attainment in Patients with Post-Stroke Upper Limb Spasticity Following Treatment with Botulinum Toxin A in Real-Life Clinical Practice: Sub-Analyses from the Upper Limb International Spasticity (ULIS)-II Study

    OpenAIRE

    Fheodoroff, Klemens; Ashford, Stephen; Jacinto, Jorge; Maisonobe, Pascal; Balcaitiene, Jovita; Turner-Stokes, Lynne

    2015-01-01

    In this post-hoc analysis of the ULIS-II study, we investigated factors influencing person-centred goal setting and achievement following botulinum toxin-A (BoNT-A) treatment in 456 adults with post-stroke upper limb spasticity (ULS). Patients with primary goals categorised as passive function had greater motor impairment (p < 0.001), contractures (soft tissue shortening [STS]) (p = 0.006) and spasticity (p = 0.02) than those setting other goal types. Patients with goals categorised as active...

  1. Factors Influencing Goal Attainment in Patients with Post-Stroke Upper Limb Spasticity Following Treatment with Botulinum Toxin A in Real-Life Clinical Practice: Sub-Analyses from the Upper Limb International Spasticity (ULIS)-II Study

    OpenAIRE

    Klemens Fheodoroff; Stephen Ashford; Jorge Jacinto; Pascal Maisonobe; Jovita Balcaitiene; Lynne Turner-Stokes

    2015-01-01

    In this post-hoc analysis of the ULIS-II study, we investigated factors influencing person-centred goal setting and achievement following botulinum toxin-A (BoNT-A) treatment in 456 adults with post-stroke upper limb spasticity (ULS). Patients with primary goals categorised as passive function had greater motor impairment (p < 0.001), contractures (soft tissue shortening [STS]) (p = 0.006) and spasticity (p = 0.02) than those setting other goal types. Patients with goals categorised as act...

  2. Factors Influencing the Placebo Effect in Patients with Primary Open-Angle Glaucoma or Ocular Hypertension: An Analysis of Two Randomized Clinical Trials.

    Directory of Open Access Journals (Sweden)

    Taichi Kawamura

    Full Text Available To explore factors related to the placebo effect in patients with primary open-angle glaucoma (POAG or ocular hypertension (OH.This was a retrospective cohort study of patients with POAG and patients with OH who were treated with placebo. The patients' data were extracted from two randomized, double-masked, parallel, multicenter clinical trials (trial 1 and trial 2 in Japan. We explored the baseline factors that were associated with the intraocular pressure (IOP-lowering effect of placebo ophthalmic solution after 4 weeks of instillation treatment at two time points by using multivariable models. The time points were Hour 0 (between 08:30 and 10:30 before instillation and Hour 2 (within 1.5 to 2.5 h after instillation and by 12:30 at the baseline date and after 4 weeks. The changes in IOP from baseline to 4 weeks at the two time points were evaluated for the IOP-lowering effect induced by placebo instillation.Of the 330 patients included in the two trials, 89 patients were eligible for the analysis. The results of the multivariable analysis for Hour 0 indicated a high IOP at the baseline date (coefficient: 0.24, 95% confidence interval (CI: 0.02 to 0.46, P = 0.03, and the magnitude of the IOP fluctuation at the baseline date (coefficient: 0.57, 95% CI: 0.24 to 0.90, P = 0.001 was associated with the IOP-lowering effect after 4 weeks. With respect to Hour 2, the trial type was associated with the IOP-lowering effect (coefficient: -1.15, 95% CI: -2.14 to -0.16, P = 0.02.A large fluctuation in IOP during the day is associated with the IOP-lowering effect induced by placebo in patients with POAG or OH. This finding would be helpful to researchers when designing studies related to glaucoma in the early stages of clinical development of drugs.

  3. Factors Influencing Uptake of Rapid HIV and Hepatitis C Screening Among Drug Misusing Adult Emergency Department Patients: Implications for Future HIV/HCV Screening Interventions.

    Science.gov (United States)

    Merchant, Roland C; DeLong, Allison K; Liu, Tao; Baird, Janette R

    2015-11-01

    In this randomized, controlled trial among 957 English- or Spanish-speaking drug misusing adult emergency department (ED) patients, we determined if a tailored brief intervention (BI) increased uptake of rapid HIV/HCV screening, and identified factors associated with greater screening uptake. Rapid HIV/HCV screening uptake was greater in the control than the BI arm (45 vs. 38 %; p Screening uptake depended on elapsed study time and which research staff member offered testing. In the control arm, uptake was lowest for those spending screening uptake generally increased over time. Tailored BI content specifically addressing participant HIV/HCV knowledge, HIV/HCV risk behaviors, or need for HIV/HCV screening was not associated with greater screening uptake. These study findings suggested factors that should be considered when designing future ED-based screening initiatives, such as elapsed study time, who offers testing, and the content of interventions.

  4. Influence of organizational factors on safety

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. Influence of glucoregulation quality on c-reactive protein, interleukin-6 and tumor necrosis factor-α level in patients with diabetes type 1

    Directory of Open Access Journals (Sweden)

    Mitrović Milena

    2011-01-01

    Full Text Available Background/Aim. Results of studies which have proved an increased inflammatory activity in diabetes type 1, have been published over recent years. One of possible mechanisms that are used to explain chronic inflammation in diabetes is the state of hyperglycemia leading to the enhanced synthesis of glycosylation end products (AGEs which activate macrophages, increase the oxidative stress and affect the synthesis of interleukins (IL-1, IL-6, tumor necrosis factor-α (TNF-α and C-reactive protein (CRP. The aim of the study was to determine the inflammatory markers (CRP, IL-6, TNF-α in patients with diabetes type 1 and to establish their correlation with glucoregulation parameters and other cardiovascular risk factors as well as to compare them with the healthy controls. Methods. The study included 76 patients with diabetes type 1 and 30 healthy controls. We determined values of inflammatory markers (CRP, IL-6, TNF-α and glucoregulation parameters (fasting glucose HbA1c. Results. The values of CRP (p = 0.014, IL-6 (p = 0.020 and TNF-α (p = 0.037 were statistically significantly higher in the diabetic patients than in the healthy controls. There was a positive correlation between CRP with postprandial glycemia (p = 0.004; the multivariate regression analysis revealed a statistically significant correlation between CRP and age (p = 0.001, smoking (p = 0.055, fasting glucose (p = 0.021 and triglycerides (p = 0.048 as well as between IL-6 and LDLcholesterol (p = 0,009. No statistically significant correlations were found between glycosilated hemoglobin (HbA1c and the inflammatory markers (CRP, IL-6 and TNF-α. Conclusion. The patients with type 1 diabetes were found to have a low level of inflammatory activity manifested by the increased values of CRP, IL-6 and TNF-α.

  6. Evaluation on trust degree of nurse - patient relationship and correlation analysis of influencing factors%护患关系信任度的评价方式与影响新因素相关度分析

    Institute of Scientific and Technical Information of China (English)

    洪婉媚; 彭秋燕; 黄哲梅

    2012-01-01

    目的 对护患关系信任度评价的方式进行总结,并对相关的影响因素进行分析.方法 抽取我院各科室的护士共80名,对其在过去一段时间所负责照顾的患者进行问卷调查,从而对护患关系进行了解.结果 专业知识欠缺、沟通技巧不佳、服务意识不强、配备不足、患者的因素是对护患关系造成影响的主要因素.结论 护患之间既相互依存,又相互矛盾.良好的护患关系会给整个医疗过程提供切实的保障.%Objective To summarize the evaluation methods of trust degree of the nurse-patient relationship,and analyze related influencing factors.Methods Eighty nurses were selected in different departments of our hospital,the patients that every nurse was responsible for were investigated with questionnaires,so as to explore the relationship of nurse-patient.Results It was found that these were main factors of influencing the relationship of nurse-patient including the lack of professional knowledge,communication skills,poor service consciousness,lack of equipment,patient factors.Conclusions The relationship of nurse - patient is hpth interdependent and contradictory.A good nurse-patient relationship will give the whole medical process to provide effective guarantee.

  7. Factors influencing adherence among older people with osteoarthritis.

    Science.gov (United States)

    Loew, Laurianne; Brosseau, Lucie; Kenny, Glen P; Durand-Bush, Natalie; Poitras, Stéphane; De Angelis, Gino; Wells, George A

    2016-09-01

    This study aims to identify potential factors that could affect adherence and influence the implementation of an evidence-based structured walking program, among older adults diagnosed with knee osteoarthritis. A total of 69 participants with mild to moderate osteoarthritis of the knee fulfilled an online survey on potential factors that could affect their adherence to an evidence-based structured walking program. Adherence with regard to the influencing factors was explored using a logistic regression model. Results tend to show higher odds of adhering to the evidence-based walking program if the participants were supervised (more than 2.9 times as high), supported by family/friends (more than 3.7 times as high), and not influenced by emotional involvement (more than 11 times as high). The odds of adhering were 3.6 times lower for participants who indicated a change in their medication intake and 3.1 times lower for individuals who considered themselves as less physically active (95 % confidence interval (CI)). Our exploratory findings identified and defined potential adherence factors that could guide health professionals in their practice to better identify positive influences and obstacles to treatment adherence, which would lead to the adoption of a more patient-centered approach. A large-scale study is required to clearly delineate the key factors that would influence adherence. We addressed a new knowledge gap by identifying the main strategies to promote the long-term adherence of community-based walking program.

  8. Influence of demographic factors, basic blood test parameters and opioid type on propofol pharmacokinetics and pharmacodynamics in ASA I-III patients.

    Science.gov (United States)

    Bienert, Agnieszka; Wiczling, Paweł; Zaba, Czesław; Zaba, Zbigniew; Wolc, Anna; Marciniak, Ryszard; Grześkowiak, Edmund; Kusza, Krzysztof

    2011-01-01

    The aim of the study was to examine population pharmacokinetics (PK) and pharmacodynamics (PD) of propofol (CAS 2078-54-8) during total intravenous anesthesia monitored by spectral frequency index (SFx). Twenty-eight patients of ASA physical status I-III (ASA: American Society of Anesthesiologists) scheduled for laparoscopic cholecystectomy were included. In group I an anesthesia was induced with a bolus of propofol (2 mg/kg) and remifentanil (CAS 132875-61-7) (1.0 microg/kg), followed by a continuous infusion of remifentanil. In group II, an alfentanil (CAS 71195-58-9) (10 microg/kg) bolus dose was followed by a continuous infusion of alfentanil. The general anesthetic technique included propofol, opioid and muscle relaxant. During anesthesia, the propofol infusion rate (3-8 mg/kg/h) was adjusted to the SFx value. Venous blood samples were collected from the patients during 240 min after termination of the infusion. A two compartment model was used to describe propofol PK. A standard effect compartment model was used to describe the delay between the effect and the concentration of propofol. The SFx index was linked to the effect site concentrations through a sigmoidal Emax model. The influence of continuous (body weight, age, blood pressure, heart rate and blood oxygenation, serum protein, the erythrocyte count, hemoglobin and hematocrit, serum creatinine and creatinine clearance) and categorical (gender and the type of opioid) covariates on the pharmacokinetic and pharmacodynamic parameters was investigated. PK/PD analysis was performed using NONMEM. All the screened covariates did not influence propofol PK and PD, except of the opioid type. The central compartment volume of propofol was larger in the presence of remifentanil than in the presence of alfentanil.

  9. 蚌埠市某医院住院患者满意度的影响因素%The Influence Factors of Patients Satisfaction in a Hospital in Bengbu

    Institute of Scientific and Technical Information of China (English)

    吴海峰; 周焕; 孙珊珊; 徐凌忠

    2015-01-01

    目的:分析住院患者满意度情况及其影响因素,为提高患者满意度提供建议。方法采用自行设计的调查表,随机抽取蚌埠市某医院2014年9月住院患者320人进行满意度调查,应用统计学分析方法,分析影响患者满意度的主要因素。结果住院患者总满意度为82.7%,责任心满意度最高为87%,医疗质量满意度最低为78%。单因素分析显示,不同年龄和职业的患者满意度差异有统计学意义。多因素分析显示,年龄是影响住院患者满意度的显著性因素。结论向不同年龄的患者提供个性化服务,提高患者对医疗服务的感知度。%Objective To analyze the influence factors of patients satisfaction for providing the suggestions improving pa-tient satisfaction.Methods A self-designed questionnaire was used to survey the satisfaction of 320 patients in September 2014 in a hospital in Bengbu.The main factors influencing the patients satisfaction were analyzed by using statistical analy-sis method. Results Overall satisfaction of hospitalized patients was 82.7%.The highest degree of responsibility satisfaction was 87%.Medical quality satisfaction was lowest, it was 78%. Single factor analysis showed that there was statistical signifi-cance between patients satisfaction and patient age,occupation. Multi factor analysis showed that age is a significant factor affecting the satisfaction of hospitalized patients.Conclusion To provide personalized service to patients with different age, improve the patient's perception of medical services.

  10. Influence of G308A polymorphism of tumor necrosis factor-alpha gene on inflammatory markers in postsurgical head and neck cancer patients with early enteral nutrition.

    Science.gov (United States)

    de Luis, Daniel Antonio; Sagrado, Manue Gonzalez; Vallejo, Luis Angel; Carcedo, Luis María Gil; Izaola, Olatz; Cuellar, Luis; Terroba, María Concepción; Aller, Rocío

    2007-01-01

    Although immune dysfunction in patients with cancer could be multifactorial, the immune system may be modulated by nutritional substrates and genetic background. Our study evaluated the effect of G308A polymorphism of the tumor necrosis factor-alpha (TNF-alpha) gene on inflammatory markers in patients after surgery for head and neck cancer who received early enteral nutrition. A population of 60 patients with oral and laryngeal cancer was enrolled. At surgery patients were treated with a hyperproteic enteral diet. Perioperatively and on postoperative day 6 the following parameters were evaluated: serum values of prealbumin, transferrin, total number of lymphocytes, interleukin-6, TNF-alpha, and C-reactive protein. In addition, genotyping of G308A gene polymorphism was assessed. Patients' mean age was 61.1 +/- 14.6 y (four women, 56 men) with a body mass index of 25.4 +/- 5.2 kg/m(2) and a previous weight loss of 0.35 +/- 0.2 kg. Forty patients (37 men, 3 women; 66.6%) had the genotype G308/G308 (wild group) and 20 patients (19 men, 1 woman; 23.4%) had the genotype G308/A308 (mutant group). A significant increase in prealbumin and transferrin levels was detected in both groups. C-reactive protein decreased in both groups (wild group: 105.1 +/- 60 versus 53.8 +/- 62.3 mg/dL, P < 0.05; mutant group: 99.5 +/- 46 versus 43.9 +/- 51.9 mg/dL, P < 0.05). Interleukin-6 decreased in both groups (wild group: 20.1 +/- 22 versus 6.2 +/- 4.1 pg/mL, P < 0.05; mutant group: 22.3 +/- 38 versus 9.2 +/- 7.4 pg/mL, P = NS). Lymphocytes increased in both groups (wild group: 1102 +/- 468 versus 1600 +/- 537 10(3)/mL, P = NS; mutant group: 1441 +/- 739 10(3)/mL versus 1669 +/- 614 10(6)/mL, P = NS). TNF-alpha showed no changes. The G308A polymorphism of the TNF-alpha gene did not affect levels of inflammatory markers in patients after surgery for head and neck cancer who were treated with early enteral nutrition.

  11. Factors influencing the feasibility of laparoscopy colectomy

    Institute of Scientific and Technical Information of China (English)

    He Zhiyun; Zhang Zhongtao

    2014-01-01

    Objective The objective was to review the factors affecting the feasibility of performing successful laparoscopic colectomy.Data sources The literatures about the risk factors closely related to the ability to perform laparoscopic colectomy on different surgical diseases of the colon cited in this review were obtained from PubMed published in English from 2006 to 2012.Study selection Original articles regarding the risk factors that affect the ability to perform laparoscopic colectomy were selected.Results Obesity,diabetes,inflammatory bowel diseases,advanced age,emergency operation,and pelvic anatomy are all important risk factors that increase the risk of developing serious complications such as hemorrhage,anastomotic leak,and skin and soft tissue infections following laparoscopic colectomy.These factors also increase the likelihood of conversion to an open operation.In this study,we reviewed the recent original articles about the relationship of laparoscopic colectomy with these risk factors.We also describe some strategies that limit the likelihood of these complications and the likelihood of conversion to an open operation.Conclusions Obesity,diabetes,inflammatory bowel diseases,age,emergency operation,and pelvic anatomy are all important risk factors that increase the risk of either serious complications or conversion to open operation with laparoscopic colectomy.Evaluation of these risk factors preoperatively should influence the decision to perform colectomy using laparoscopic techniques.

  12. Factors influencing early survival after liver transplantation.

    Science.gov (United States)

    Stock, P G; Estrin, J A; Fryd, D S; Payne, W D; Belani, K G; Elick, B A; Najarian, J S; Ascher, N L

    1989-02-01

    The purpose of this study was to analyze data from all adult and pediatric liver transplants performed between January 1, 1983 and January 15, 1986 at the University of Minnesota Hospital and identify perioperative variables that predict patient survival and could aid in patient selection. Charts, intraoperative anesthesia records, blood bank records, flow sheets, outpatient records, and autopsy reports were examined in 45 pediatric and 15 adult patients who underwent primary orthotopic liver transplantation. Analysis of the data can be summarized as follows: (1) Pediatric patients whose coagulation parameters could not be corrected prior to operation and who consequently required preoperative exchange transfusion had poorer outcomes than those not requiring an exchange to correct coagulation parameters. (2) The rapid infusion technique for massive blood transfusion resulted in significantly decreased blood loss and intraoperative blood product replacement. (3) Twenty-four hour postoperative factor V levels were good predictors of survival. Patients with poor factor V levels required rigorous replacement of coagulation factors. (4) Pediatric patients with uncorrectable coagulopathies requiring immediate postoperative exchange transfusion had extremely high mortality.

  13. Influence of HBcAg in liver cell plasma on expression of transforming growth factor-beta 1 in liver tissue of low-grade chronic hepatitis B patients

    Institute of Scientific and Technical Information of China (English)

    Yong-Gang Liu; Jun-Qiang Li; Chen-Zhao Song; Jian-Hua Lu; Xin-Xin Wang; Jian-Lin Yang; Zhen-Wei Lang; Xin Meng; Li-Jie Zhang; Lin Sun; Shi-Jie Zhang

    2006-01-01

    AIM: To study the influence of HBcAg on the expression of transforming growth factor-beta 1 (TGF-β1) in liver tissue of low-grade chronic hepatitis B (CHB) patients.METHODS: The expression of TGF-β1 and HBcAg in liver samples from 93 low-grade CHB patients was detected by immunohistochemistry and valuated by semi-quantitative scoring.RESULTS: In the 93 low-grade CHB patients, HBcAg was expressed in cell plasma but not in the liver tissue.There was no significant difference between the two groups.CONCLUSION: The expression of TGF-β1 is not related with HBcAg expressed as plasma type in the tissues of low-grade CHB patients.

  14. 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.

  15. 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.

  16. Microencapsulation techniques, factors influencing encapsulation efficiency.

    Science.gov (United States)

    Jyothi, N Venkata Naga; Prasanna, P Muthu; Sakarkar, Suhas Narayan; Prabha, K Surya; Ramaiah, P Seetha; Srawan, G Y

    2010-05-01

    Microencapsulation is one of the quality preservation techniques of sensitive substances and a method for production of materials with new valuable properties. Microencapsulation is a process of enclosing micron-sized particles in a polymeric shell. There are different techniques available for the encapsulation of drug entities. The encapsulation efficiency of the microparticle or microsphere or microcapsule depends upon different factors like concentration of the polymer, solubility of polymer in solvent, rate of solvent removal, solubility of organic solvent in water, etc. The present article provides a literature review of different microencapsulation techniques and different factors influencing the encapsulation efficiency of the microencapsulation technique.

  17. Factors Influencing Consumer Behavior of Smartphone Users

    OpenAIRE

    Nagarkoti, Bishal

    2014-01-01

    The aim of the study is to know about the factors influencing consumer behavior of Smartphone users. Under this study, the main focus is to identify whether Smartphone users buy Smartphone because of their need or wish, reasons to buy expensive smart phones, how social and personal factors affect them to make purchasing decision, for what purposes they use Smartphone, where and how long a day, change in usage of com-puters due to Smartphone and how high is the phone bill after using Smartphon...

  18. FACTORS INFLUENCING BENDING RIGIDITY OF SUBMERGED VEGETATION

    Institute of Scientific and Technical Information of China (English)

    WU Long-hua; YANG Xiao-li

    2011-01-01

    The bending rigidity of submerged vegetation is closely related with vegetative drag force.This work aims at determining the effects of flow conditions and characteristics of vegetation on the bending rigidity of submerged vegetation.Based on the dimensional analysis method,the factors influencing the bending rigidity of individual submerged vegetation were analyzed.The relationship between the relative bending rigidity and its influencing factors was investigated by experimental observation,and a relative bending rigidity expression for submerged vegetation was obtained by means of multiple linear regression method.The results show that the submerged vegetation has three states under different inflow conditions,and the each critical relative bending rigidity of individual submerged vegetation was determined for the different states of submerged vegetation.

  19. 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.

  20. Determination of factors influencing the outcome of radioiodine therapy in patients with Graves` disease; Bestimmung von Einflussgroessen fuer den Therapieerfolg der Radioiodtherapie bei Patienten mit Morbus Basedow

    Energy Technology Data Exchange (ETDEWEB)

    Sabri, O.; Schulz, G.; Zimny, M.; Schreckenberger, M.; Zimny, D.; Wagenknecht, G.; Kaiser, H.J.; Dohmen, B.M.; Bares, R.; Buell, U. [Rheinisch-Westfaelische Technische Hochschule (RWTH), Aachen (Germany). Klinik fuer Nuklearmedizin

    1998-05-01

    Aim of this study was to determine whether success of radioiodine therapy (RIT) in Graves` disease depends on thyroid volume, function, thyroideal receptor antibodies (TRAK), thyresotasis, therapeutic dosage, {sup 131}I uptake, or effective half-life. Method: 78 patients received an average of 626{+-}251 MBq of iodine-131 orally for tyroid ablation. 60 were assessed for successful therapy 3 months after RIT. Results: In patients showing hyperthyreosis or a TRAK value >11 U/l at the beginning of RIT, a significantly lower therapeutic doseage and effective iodine half-life were found than in non-hyperthyreotic patients or patients with TRAK{<=}11 U/l. Patients with a thyroid volume {<=}25 ml showed a significantly lower {sup 131}I uptake, but a significantly higher relative uptake ({sup 131}I uptake/volume) than patients with a tyroid volume >25 ml. All failures were treated thyreostatically during RIT and showed a signifiantly lower therapeutic iodine dosage and relative uptake, as well as a significantly higher thyroid volume than patients with a successful therapy. RIT caused a thyroid volume reduction of 44%, with therapy failures showing a significantly lower volume reduction. Patients who received a therapeutic doseage of {<=}250 Gy showed significantly worse results than did those who had received >250 Gy. Only one case of therapy failure received a dosage >250 Gy, while 50% of failures received dosages >200 Gy but <250 Gy. Multivariate analyses (MANOVA, factor analyses) showed thyreostasis as the decisive negative factor for a successful course of therapy. Conclusions: Since most treatment failures occurred in patients under thyreostatic medication, we recommend raising the target dosage to 250 Gy for these cases. (orig.) [Deutsch] Ziel der Studie war es, zu pruefen, inwieweit der Erfolg einer Radioiodtherapie (RIT) des Morbus Basedow (MB) von verschiedenen Parametern (Schilddruesenvolumen [SDVol], Funktion, TRAK, Thyreostase, Therapiedosis, {sup 131}I

  1. Factors Influencing Impulse Buying in Retail Stores

    OpenAIRE

    Giorgadze, Nino

    2014-01-01

    Impulse buying is a widely pervasive phenomenon. Statistics shows that more and more shoppers are experiencing irresistible urge to purchase unplanned and in most cases unnecessary product. Existing researches fall short in identifying most suitable tools that marketers can adopt in order to promote impulsive sales. Therefore, this thesis provides deep analysis of those, controllable factors that influence impulse buying. Particularly four external cues are examined: product display, promotio...

  2. Major Factors influences the 2008 Stock Market

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ 2007 was an unusual year for China's stock market, as the index climbed from 2675 points up to 6124 by the end of the year, setting new records again and again throughout 2007. What will happen to the stock market in the coming 2008? Let's havea look at some of the main factors that will influence the stock market this year, perhaps we can find out if 2008 will be another memorable year full of surprises.

  3. Prognostic factors influencing clinical outcomes of glioblastoma multiforme

    Institute of Scientific and Technical Information of China (English)

    LI Shou-wei; QIU Xiao-guang; CHEN Bao-shi; ZHANG Wei; REN Huan; WANG Zhong-cheng; JIANG Tao

    2009-01-01

    Background Glioblastoma multiforme (GBM) is the most malignant kind of astrocytic tumors and is associated with a poor prognosis. In this retrospective study, we assessed the clinical, radiological, genetic molecular and treatment factors that influence clinical outcomes of patients with GBM.Methods A total of 116 patients with GBM who received surgery and radiation between January 2006 and December 2007 were included in this study. Kaplan-Meier survival analysis and Cox regression analysis were used to find the factors independently influencing patients' progression free survival (PFS) time and overall survival (OS) time.Results Age, preoperative Kamofsky Performance Scale (KPS) score, KPS score change at 2 weeks after operation, neurological deficit symptoms, tumor resection extent, maximal tumor diameter, involvement of eloquent cortex or deep structure, involvement of brain lobe, Ki-67 expression level and adjuvant chemotherapy were statistically significant factors (P <0.05) for both PFS and OS in the univariate analysis. Cox proportional hazards modeling revealed that age ≤50 years, preoperative KPS score ≥80, KPS score change after operation ≥0, involvement of single frontal lobe,non-eloquent area or deep structure involvement, low Ki-67 expression and adjuvant chemotherapy were independent favorable factors (P <0.05) for patients' clinical outcomes.Conclusions Age at diagnosis, preoperative KPS score, KPS score change at 2 weeks postoperation, involvement of brain lobe, involvement of eloquent cortex or deep structure, Ki-67 expression level and adjuvant chemotherapy correlate significantly with the prognosis of patients with GBM.

  4. Analysis of self-efficacy and its influencing factors in adult patients with low vision%成人低视力患者自我效能水平及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    曾玉; 席淑新; 朱艳梅; 杨珍; 孙晶

    2013-01-01

    Objective To evaluate the status of self-efficacy and its influencing factors in adult patients with low vision,then explore an effective approach to improve their self-efficacy levels.Methods Seventy adult patients with low vision were sampled by random number table method.General social-demographic questionnaire and self-efficacy questionnaire were used to investigate these patients' general information and self-efficacy.Seventy pieces of questionnaires were issued and returned with the valid rate of 100%.Results The total score of self-efficacy in seventy adult patients with low vision was(16.25:±:1.93) points,92% of patients had a low level of self-efficacy.The influencing factors of self-efficacy in adult patients with low vision were the attitude toward disease,mental status and gender.Conclusions The selfefficacy in patients with low vision was affected by many factors at different levels,so we should focus on main influencing factors to adopt corresponding nursing measures in order to improve self-efficacy of adult patients with low vision.%目的 了解成人低视力患者的自我效能状况及其相关影响因素,探讨提高成人低视力患者自我效能的有效途径.方法 采用随机数字表法进行抽样,用一般资料问卷和一般自我效能感量表对70例符合纳入标准的成人低视力患者进行调查.发放问卷70份,回收有效问卷70份,有效问卷回收率为100%.结果 成人低视力患者自我效能感得分为(16.25±1.93)分;92%患者处于低自我效能水平.对疾病态度、心理状况、性别是成人低视力患者自我效能的影响因素.结论 诸多因素在不同层面影响成人低视力患者的自我效能水平,因此需针对其主要影响因素采取相应的护理措施,从而提高成人低视力患者的自我效能.

  5. Factors influencing the eicosanoids synthesis in vivo.

    Science.gov (United States)

    Szefel, Jarosław; Kruszewski, Wiesław Janusz; Sobczak, Ewa

    2015-01-01

    External factors activate a sequence of reactions involving the reception, transduction, and transmission of signals to effector cells. There are two main phases of the body's reaction to harmful factors: the first aims to neutralize the harmful factor, while in the second the inflammatory process is reduced in size and resolved. Secondary messengers such as eicosanoids are active in both phases. The discovery of lipoxins and epi-lipoxins demonstrated that not all arachidonic acid (AA) derivatives have proinflammatory activity. It was also revealed that metabolites of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) such as resolvins, protectins, and maresins also take part in the resolution of inflammation. Knowledge of the above properties has stimulated several clinical trials on the influence of EPA and DHA supplementation on various diseases. However, the equivocal results of those trials prevent the formulation of guidelines on EPA and DHA supplementation. Prescription drugs are among the substances with the strongest influence on the profile and quantity of the synthesized eicosanoids. The lack of knowledge about their influence on the conversion of EPA and DHA into eicosanoids may lead to erroneous conclusions from clinical trials.

  6. Factors influencing quality of bowel preparation for colonoscopy.

    Science.gov (United States)

    Romero, Ronald V; Mahadeva, Sanjiv

    2013-02-16

    Recent technological advances in colonoscopy have led to improvements in both image enhancement and procedural performance. However, the utility of these technological advancements remain dependent on the quality of bowel preparation during colonoscopy. Poor bowel preparation has been shown to be associated with lower quality indicators of colonoscopy performance, such as reduced cecal intubation rates, increased patient discomfort and lower adenoma detection. The most popular bowel preparation regimes currently used are based on either Polyethylene glycol-electrolyte, a non-absorbable solution, or aqueous sodium phosphate, a low-volume hyperosmotic solution. Statements from various international societies and several reviews have suggested that the efficacy of bowel preparation regimes based on both purgatives are similar, although patients' compliance with these regimes may differ somewhat. Many studies have now shown that factors other than the type of bowel preparation regime used, can influence the quality of bowel preparation among adult patients undergoing colonoscopy. These factors can be broadly categorized as either patient-related or procedure-related. Studies from both Asia and the West have identified patient-related factors such as an increased age, male gender, presence of co-morbidity and socio-economic status of patients to be associated with poor bowel preparation among adults undergoing routine out-patient colonoscopy. Additionally, procedure-related factors such as adherence to bowel preparation instructions, timing of bowel purgative administration and appointment waiting times for colonoscopy are recognized to influence the quality of colon cleansing. Knowledge of these factors should aid clinicians in modifying bowel preparation regimes accordingly, such that the quality of colonoscopy performance and delivery of service to patients can be optimised.

  7. A Review of Factors Influencing Health Inequalities

    Directory of Open Access Journals (Sweden)

    Hassan Almaspoor Khanghah

    2016-01-01

    Full Text Available ​Background and Objectives : Inequity in health is a universal term which is used for showing current differences, variations and inequalities of people in accessing to health services. The current study aimed to assess the factors influencing health inequalities to present the results to the researchers and health care professionals. Material and Methods : In this review, several databases including PubMed, Proquest, Scopus, Google Scholar search engine, SID and IranDoc were searched within 2000-2014 period. We found 746 articles and refined them step by step according to the aim of the study by reviewing the titles, abstracts and full texts. Finally, 16 articles were selected for further study Results: In the present study, identified determinants in health inequalities were as follows: 1- Economic and income factors 2- Political factors, social and public policy 3- Cultural and social values 4- social and demographic factors 5- Behavioral, psychological and biological factors. Although, other factors like governmental, international, social cohesion, incidents and even the health system itself were involved in health inequalities, but the listed determinants were among the most important determinants in health inequalities in the conducted studies. Conclusion : Given the importance of people's health and inequalities in health, the approach should focus on reducing the inequalities in all policies and development programs and the role of these factors should be taken into consideration by managers and policy-makers

  8. Influence of acute kidney injury on short- and long-term outcomes in patients undergoing cardiac surgery: risk factors and prognostic value of a modified RIFLE classification.

    Science.gov (United States)

    Lopez-Delgado, Juan C; Esteve, Francisco; Torrado, Herminia; Rodríguez-Castro, David; Carrio, Maria L; Farrero, Elisabet; Javierre, Casimiro; Ventura, Josep L; Manez, Rafael

    2013-12-13

    The development of acute kidney injury (AKI) is associated with poor outcome. The modified RIFLE (risk, injury, failure, loss of kidney function, and end-stage renal failure) classification for AKI, which classifies patients with renal replacement therapy needs according to RIFLE failure class, improves the predictive value of AKI in patients undergoing cardiac surgery. Our aim was to assess risk factors for post-operative AKI and the impact of renal function on short- and long-term survival among all AKI subgroups using the modified RIFLE classification. We prospectively studied 2,940 consecutive cardiosurgical patients between January 2004 and July 2009. AKI was defined according to the modified RIFLE system. Pre-operative, operative and post-operative variables usually measured on and during admission, which included main outcomes, were recorded together with cardiac surgery scores and ICU scores. These data were evaluated for association with AKI and staging in the different RIFLE groups by means of multivariable analyses. Survival was analyzed via Kaplan-Meier and a risk-adjusted Cox proportional hazards regression model. A complete follow-up (mean 6.9 ± 4.3 years) was performed in 2,840 patients up to April 2013. Of those patients studied, 14% (n = 409) were diagnosed with AKI. We identified one intra-operative (higher cardiopulmonary bypass time) and two post-operative (a longer need for vasoactive drugs and higher arterial lactate 24 hours after admission) predictors of AKI. The worst outcomes, including in-hospital mortality, were associated with the worst RIFLE class. Kaplan-Meier analysis showed survival of 74.9% in the RIFLE risk group, 42.9% in the RIFLE injury group and 22.3% in the RIFLE failure group (P RIFLE injury (Hazard ratio (HR) = 2.347, 95% confidence interval (CI) 1.122 to 4.907, P = 0.023) and RIFLE failure (HR = 3.093, 95% CI 1.460 to 6.550, P = 0.003) were independent predictors for long-term patient mortality

  9. CREDIT LEVEL INFLUENCING FACTORS AT HUNGARIAN FARMS

    Directory of Open Access Journals (Sweden)

    Toth Jozsef

    2012-12-01

    Full Text Available In this paper we estimate the impact of different factors on creditability of agricultural farms. According to the literature the collateral (tangible assets, the farm size, productivity, and subsidies should have significant effects on farm loans. We use data from the Hungarian Farm Accountancy Data Network to test our two hypotheses and theoretical assumptions for the period 2001-2010. Because of using panel data, we do our estimations using fixed effects econometrics model to test our assumptions. The results indicate that the chosen factors have significant influence on total liabilities and short- and long-term loans as well. With specially interest of subsidies the growing level of supports decrease the need of other financial tools. At output factors (inclusive farm size have significant and positive effect, same as collateral (tangible assets.

  10. 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.

  11. Factors influencing consumers' selection of a primary care physician.

    Science.gov (United States)

    McGlone, Teresa A; Butler, E Sonny; McGlone, Vernon L

    2002-01-01

    There is a growing body of literature regarding patient choice of health care plans, patient satisfaction, and patient evaluation of health care quality, but there is little information concerning the factors that influence the initial selection of a primary care physician (PCP). This exploratory study identifies and conceptualizes the physician selection dimensions which include: physician reputation/manner, physician record, physician search, consumer self-awareness, physician location, physician qualifications, physician demographics, office atmospherics, house calls/insurance, and valuing patient opinion. The study also develops and tests a scale for PCP selection using factor analysis which is demonstrated to be valid, and determines significant differences of variables, which include education level, gender, and age, using a summated scale. The study is of use to physicians in their targeting and communication strategies, and to researchers seeking to refine the scale.

  12. Research progress on influencing factors of self care capacity of patients with diabetes%糖尿病病人自护能力影响因素的研究进展

    Institute of Scientific and Technical Information of China (English)

    程彦如; 陈传波

    2014-01-01

    It introduced the self care needs and self care level of diabet-ic patients.The social and demographic factors,disease and treatment fac-tors,social and psychological factors were the influencing factors of self care ability of patients;it put forward that the nursing staff should assess the patients correctly and formulate the personalized nursing plan,so as to provide help and guidance,reduce the self care barriers,enhance patient self care level and improve the quality of life.%介绍糖尿病病人自我护理需求及自我护理水平,社会人口学因素、疾病与治疗因素、心理社会因素是影响病人自我护理能力的因素;提出护理人员应对病人进行正确评估,制定个性化的护理方案,以提供帮助和指导,减少自我护理障碍,提升病人自我护理水平,提高其生活质量。

  13. Environmental factors influencing the development of atherosclerosis

    Directory of Open Access Journals (Sweden)

    Andrzej Brodziak

    2013-12-01

    Full Text Available The aim of the paper is to present an overview of recent findings on the environmental and behavioral factors influencing the development of atherosclerosis. The authors primarily concentrated on deliberations of possibile main causes of the damage of the endothelium. At the same time the following pathogenic mechanisms as cellular dysfunction, inflammation and coagulation disorders have been enumerated. The links between the state of the vascular endothelium and life style have been emphasized. It is also important to note that the primary causes of the endothelial damage should be traced as originally suggested many years ago viewing such factors as anger, hostility, aggression, impulsiveness and depression but with a new approach. The authors supplement the comments, on the environmental factors influencing the development of atherosclerosis, with basic data on family predisposition to the development of this disease. They highlight that current genetic research have not determined genes responsible for atheroscelosis. According to the authors the considerations and conclusions presented in this overview are important for the educational purposes related to the most frequent disease process resulting in many diseases in medical disciplines.

  14. Status of post-traumatic growth of severe burn patients and its influencing factors%严重烧伤患者创伤后成长状况及对策

    Institute of Scientific and Technical Information of China (English)

    梁英; 肖文芳; 焦丹丹

    2016-01-01

    Objective To understand the status of post-traumatic growth of severe burn patients and analyze its influencing factors. Methods General information questionnaire and post-traumatic growth inventory (PTGI) were used to investigate thirty patients with severe burn. Multi-linear regression method was used to analyze the post-traumatic influencing factors. Results The average score of PTGI was (68.30 ± 10.90), which was in media level. The main influencing factors included burn area, active exercise, time and expense of treatment, marital status and sear proliferation. Conclusion In order to improve the post-traumatic growth,nurses should enhance psychological intervention, teach effective coping strategies and increase the social level to the burn patients.%目的 了解严重烧伤患者创伤后成长水平状况及探讨其护理对策.方法 采用一般情况调查表,创伤后成长量表(posttraumatic growth inventory,PTGI)对30例严重烧伤患者进行调查.结果 本组30例严重烧伤患者PTGI总分为(68.30±10.90)分,处于中等水平.结论 护理人员应加强对严重烧伤患者心理的疏导,指导其采取积极有效的应对策略,提高其创伤后成长水平.

  15. 大型综合医院患者就医选择影响因素的调查研究%Research and Analysis of Influencing Factors on the Patient's Medical Treatment Selection

    Institute of Scientific and Technical Information of China (English)

    陈燕凌; 穆云庆; 陈黎明; 李书章

    2012-01-01

    To evaluate the influencing factors of medical treatment selection of patients. Methods A series of surveys with self-made questionnaire were conducted. Results In all the influencing factors of medical treatment selection of patients, the proportions sorted by descending order were: quality of medical care, reasonable medical expenses, medical ethics, convenience of traffic and the service attitude. Conclusions Many aspects such as level of medical technology, medical ethics, quality of service, technical equipment and the hospital environment should be improved to attract patients.%目的 了解哪些因素会影响患者选择医院就医.方法采用自行设计的问卷调查表,对患者进行一系列的问卷调查.结果影响患者就医选择的因素中,医疗技术水平所占比例最高,其次是医院的收费是否合理、医德医风、交通便利性、医护人员服务态度等因素.结论为了吸引更多的患者前来就医,医院应注重医疗质量,加强医德医风教育和医患沟通,改善医院交通环境,加大宣传力度.

  16. Influencing Factors of Relations Between Nurses and Patient in Mental Department and Social Ethical Solution%精神科护患关系的影响因素及社会伦理对策

    Institute of Scientific and Technical Information of China (English)

    侯峰

    2001-01-01

    Alongside the steady advancement of reform,the accelerated pace of life and increasing competition,mental disease sufferers increase.Nursing mental patient has its specific and complicated characteristics.The relations between nurse and patient are influenced by a lot of factors.From the aspects of nurse,hospital and society,the article gives an objective analysis to the factors which influence the relations between nurse and patient.From the angle of social ethics the article provides some ways to deal with the problems.%精神科护理具有特殊性、复杂性、多变性等特点,其护患关系受诸多因素影响。本文从护士、医院、社会三方面就精神科护患关系的影响因素作了比较客观的分析,并提出了相应社会伦理对策。

  17. 老年肿瘤照顾者的心理状况及相关因素分析%Psychologic status of care givers of elderly cancer patients and its influencing factors

    Institute of Scientific and Technical Information of China (English)

    封燕

    2011-01-01

    Objective To investigate the psychologic status of care givers of elderly cancer patients and its influencing factors. Methods A total of 101 care givers of elderly cancer patients were investigated by Self-Rating Depression Scale ( SDS) and SelfRating Anxiety Scale (SAS). Results 89. 11% of care givers had symptoms of depression, with depression score as 63. 25 ± 10. 13, while 83. 17 percent of them had symptoms of anxiety, with anxiety score as 61. 09 ±9. 54. Conclusions Most of care givers of elderly cancer patients had symptoms of anxiety and depression. The main influencing factors include age, marriage, occupation, relationship with patients, self-care ability of patients and patients' condition.%目的 了解老年肿瘤照顾者的心理状况及相关因素.方法 用自评抑郁量表、自评焦虑量表等对101例住院老年肿瘤照顾者进行调查.结果 老年肿瘤照顾者的抑郁评分值为(63.25±10.13)分,90例(89.11%)照顾者有抑郁症状;焦虑评分值为(61.09±9.54)分,84例(83.17%)照顾者有焦虑症状.结论 多数老年肿瘤照顾者存在焦虑、抑郁症状,主要影响因素包括照顾者的年龄、婚姻状况、职业、与被照顾者的关系及患者生活自理能力、病情等.

  18. A real-time assessment of factors influencing medication events.

    Science.gov (United States)

    Dollarhide, Adrian W; Rutledge, Thomas; Weinger, Matthew B; Fisher, Erin Stucky; Jain, Sonia; Wolfson, Tanya; Dresselhaus, Timothy R

    2014-01-01

    Reducing medical error is critical to improving the safety and quality of healthcare. Physician stress, fatigue, and excessive workload are performance-shaping factors (PSFs) that may influence medical events (actual administration errors and near misses), but direct relationships between these factors and patient safety have not been clearly defined. This study assessed the real-time influence of emotional stress, workload, and sleep deprivation on self-reported medication events by physicians in academic hospitals. During an 18-month study period, 185 physician participants working at four university-affiliated teaching hospitals reported medication events using a confidential reporting application on handheld computers. Emotional stress scores, perceived workload, patient case volume, clinical experience, total sleep, and demographic variables were also captured via the handheld computers. Medication event reports (n = 11) were then correlated with these demographic and PSFs. Medication events were associated with 36.1% higher perceived workload (p sleep (p = .10). These results confirm the effect of factors influencing medication events, and support attention to both provider and hospital environmental characteristics for improving patient safety.

  19. Contextual factors influencing research use in nursing.

    Science.gov (United States)

    French, Beverley

    2005-01-01

    Contextual factors are perceived to be significant barriers to research-utilisation-related activity, but little is known about how context impacts on specific research-based decisions, or how the individual interacts with the organisation in the requirement for research-based change. This study describes the impact of contextual factors on the practical reasoning of nurse specialists in the construction of policy for practice. Three groups of clinical nurse specialists were observed during a series of meetings convened to construct evidence-based guidelines for nursing practice. Transcripts of the meetings were analysed to identify and categorise the physical, social, political, and economic influences on 31 nursing issues. Multiple contextual factors influenced each decision made, with decisions about nursing practice bounded by setting and system considerations, relationships with others in the care team, and resource constraints. Practitioners were involved in weighing up alternative scenarios, contexts, and contingencies for each decision, requiring strategies to adapt and reconstruct the nature of care, to influence others, and to affect organisational decision-making processes. The practical accomplishment of evidence-based practice required diverse skills: translating between evidence and practice; mediating the values, preferences, and working practices of multiple stakeholders; negotiating organisational complexity and the management of boundaries; and coordinating inter-organisational and inter-agency working. Nurse specialists in this study had a significant role in instigating, fuelling, and coordinating policy review, predominantly by communication across professional and organisational boundaries. Clinical specialists acting as organisational boundary spanners require skills in the informal cultural work of organising, facilitating, and maintaining links across professional, team, and organisational boundaries. If their role in the negotiation of

  20. Influence of selected factors on induced syneresis

    Directory of Open Access Journals (Sweden)

    Jovanović Snežana T.

    2004-01-01

    Full Text Available Syneresis is the process of whey separation induced by gel contraction resulting in rearranging or restructuring of casein matrix formed during enzymatic coagulation. Numerous factors can influence the process of syneresis. The influences of pH, calcium concentration, temperature of coagulation of milk and applied heat treatment on the syneresis induced by different intensity of centrifugal force have been investigated. Coagulated samples were centrifuged at 1000, 2000 and 3000 rpm for 5 min, respectively. Reconstituted skim milk powder (control sample and reconstituted non-fat milk heat treated at 87ºC/10 min (experimental sample are coagulated at temperatures of 30ºC and 35ºC, at pH value of 5.8 and 6.2, and with the addition of 100, 200 and 400 mg/l of CaCl2, respectively. Centrifugation at 1000 rpm of both control and experimental samples didn’t recover any sera, regardless of the applied coagulation conditions. This indicates that the intensity of centrifugal force wasn’t strong enough to disrupt gel structure and cause syneresis. When the intensity of centrifugal force was increased up to 2000 rpm, the syneresis was induced, but the degree of syneresis depended on the applied factors of coagulation, primary on the applied heat treatments and temperature of coagulation. The amount of added CaCl2 didn’t have a significant influence on the induced syneresis at 2000 rpm. The induced syneresis was very significant for both control and experimental samples when the intensity of centrifugal force of 3000 rpm was applied. It was also noted that curd produced from heat treated milk in which milk protein coaggregates were formed, released less sera regardless of the applied coagulation factors.

  1. 子宫全切术患者自我管理水平及影响因素调查%Self-management level and the influencing factors of patients with hysterectomies

    Institute of Scientific and Technical Information of China (English)

    吴鸿雁; 周辉; 陈琳

    2014-01-01

    目的:调查子宫全切术患者自我管理水平并分析其影响因素。方法对2011年1月-2013年12月行子宫全切术的142例患者进行问卷调查,问卷由一般资料问卷、自我管理量表、社会支持评定量表、医院焦虑抑郁量表4个部分组成。了解患者自我管理水平现状及其影响因素。结果患者自我管理水平总分为(135.20±22.05)分,处于中等水平;社会支持总分为(24.51±4.49)分,处于中等水平。社会支持、疾病知识了解程度、经济状况是患者自我管理的影响因素。结论护理人员应根据患者自我管理水平的影响因素,为其提供个性化护理,从而促进患者恢复,改善其生活质量及心理状况。%Objective To explore the self-management level and the influencing factors of patients with hysterectomies .Methods From January 2011 to December 2013 , totals of 142 patients with hysterectomies were surveyed by the questionnaire including general information , Self-Management Scale , Social Support Rrating Scale and Hospital Anxiety and Depression Scale , and the level and influencing factors of self-management were investigated .Results The score of self-management scale was ( 135 .20 ±22 .05 ) at the intermediate level.The total score of social support was (24.51 ±4.49) at the intermediate level.The social support, understanding of disease knowledge and the financial situation were the influencing factors of self -management level .Conclusions Nurses should provide individuation nursing for patients according to the influencing factors of self-management , so as to promote the recovery of disease and improve patients ’ quality of life.

  2. 帕金森病患者服药依从性现状及其影响因素的调查分析%Survey of medication compliance status and its influencing factors of patients with Parkinson disease

    Institute of Scientific and Technical Information of China (English)

    卢芳; 尹安春

    2016-01-01

    Objective To understand Parkinson disease (PD) medication compliance, and analyze its main influencing factors. Methods The questionnaire method was adopted to survey 130 cases of Parkinson disease patients general information, disease, drug, psychological status, social support and so on. Results The two average score of Parkinson patients medication compliance were (2.36 ± 1.16) points and (9.96 ± 2.60) points. Its influencing factors had personal monthly income, medication concept, PD drug adverse reaction,social support, mental state and anxiety disorder. Conclusions Parkinson patients medication compliance behavior overall is good, but these patients who can be in strict accordance with the doctor′s advice has very few. And the influencing factors are in the majority. According to the influencing factors of medication adherence, medical staff should implement targeted medication guide, in order to improve the medication complianceand their quality of life.%目的:了解帕金森病患者服药依从性行为,并分析其主要的影响因素。方法采用问卷法对117例帕金森病患者一般资料、疾病、药物、心理状态及社会支持等情况进行调查。结果帕金森病患者服药依从性的2次结果为(2.36±1.16)分和(9.96±2.60)分,影响因素有个人月收入、服药观念、药物不良反应、社会支持、智力状态、焦虑障碍。结论帕金森病患者服药依从性总体尚可,但能够严格按照规定正确服药的患者只占极少数,且影响因素颇多,医护人员应从影响因素出发,实施有针对性的服药指导,提高服药依从性的同时改善其生命质量。

  3. Factors influencing aircraft ground handling performance

    Science.gov (United States)

    Yager, T. J.

    1983-01-01

    Problems associated with aircraft ground handling operations on wet runways are discussed and major factors which influence tire/runway braking and cornering traction capability are identified including runway characteristics, tire hydroplaning, brake system anomalies, and pilot inputs. Research results from tests with instrumented ground vehicles and aircraft, and aircraft wet runway accident investigation are summarized to indicate the effects of different aircraft, tire, and runway parameters. Several promising means are described for improving tire/runway water drainage capability, brake system efficiency, and pilot training to help optimize aircraft traction performance on wet runways.

  4. Self Management Status and Influencing Factors in Patients with Diabetes Mel-litus%糖尿病患者自我管理现状及影响因素

    Institute of Scientific and Technical Information of China (English)

    王彦

    2016-01-01

    糖尿病是一种慢性疾病,严重影响患者的身体健康,并降低患者的生活质量。治疗糖尿病患者时,不能仅仅依靠药物治疗,患者的自我管理有着十分重要的作用,从当前来看,糖尿病患者自我管理意识比较差,而且其中存在的影响因素比较多,该文对糖尿病患者的自我管理现状及影响因素做出综述。%Diabetes is a chronic disease that seriously affect the health of patients, and reduce the quality of life of patients. Treatment in patients with diabetes, not just rely on drug treatment, patient self management has a very important role, from the current point of view, the diabetes self-management consciousness is poor, and the factors affecting the existence of more, this paper on diabetic patients with self tube current situation and influence factors make a review.

  5. 'Trial and error…', '…happy patients' and '…an old toy in the cupboard': a qualitative investigation of factors that influence practitioners in their prescription of foot orthoses.

    Science.gov (United States)

    Williams, Anita Ellen; Martinez-Santos, Ana; McAdam, Jane; Nester, Christopher James

    2016-01-01

    Foot orthoses are used to manage of a plethora of lower limb conditions. However, whilst the theoretical foundations might be relatively consistent, actual practices and therefore the experience of patients is likely to be less so. The factors that affect the prescription decisions that practitioners make about individual patients is unknown and hence the way in which clinical experience interacts with knowledge from training is not understood. Further, other influences on orthotic practice may include the adoption (or not) of technology. Hence the aim of this study was to explore, for the first time, the influences on orthotic practice. A qualitative approach was adopted utilising two focus groups (16 consenting participants in total; 15 podiatrists and 1 orthotist) in order to collect the data. An opening question "What factors influence your orthotic practice?" was followed with trigger questions, which were used to maintain focus. The dialogue was recorded digitally, transcribed verbatim and a thematic framework was used to analyse the data. There were five themes: (i) influences on current practice, (ii) components of current practice, (iii) barriers to technology being used in clinical practice, (iv) how technology could enhance foot orthoses prescription and measurement of outcomes, and (v) how technology could provide information for practitioners and patients. A final global theme was agreed by the researchers and the participants: 'Current orthotic practice is variable and does not embrace technology as it is perceived as being not fit for purpose in the clinical environment. However, practitioners do have a desire for technology that is usable and enhances patient focussed assessment, the interventions, the clinical outcomes and the patient's engagement throughout these processes'. In relation to prescribing foot orthoses, practice varies considerably due to multiple influences. Measurement of outcomes from orthotic practice is a priority but there are

  6. Factors influencing the cardiac MIBG accumulation

    Energy Technology Data Exchange (ETDEWEB)

    Takatsu, Hisato; Fujiwara, Hisayoshi [Gifu Univ. (Japan). School of Medicine

    1997-02-01

    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.)

  7. 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.

  8. Analysis of risk factors with influence on urinary tract infection in urinary surgery patients%影响泌尿外科患者尿路感染的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    毛东方

    2015-01-01

    目的:探讨引起泌尿外科患者尿路感染的危险因素,以采取预防措施降低留置尿管患者尿路感染发生率。方法26例合并尿路感染者为研究组,同期无尿路感染的26例泌尿外科患者为对照组,使用单因素和多因素Logistic回归法分析可能引起尿路感染的因素。结果240例患者中,共有26例患者合并尿路感染,发生率为10.83%;单因素分析结果显示有9个影响因素;多因素logistic回归分析显示,其中的独立危险因素有年龄大、合并其他疾病、有创诊治措施、预防使用抗菌药物。结论泌尿外科住院患者尿道感染率高,影响因素多,需采取相应的措施进行积极预防。%Objective To investigate risk factors of urinary tract infection in urinary surgery patients, in order to take prevention measures for reducing incidence of urinary tract infection in patients with indwelling catheter.Methods There were 26 urinary tract infection patients as research group, and another 26 patients without urinary tract infection in the same period as control group. Single and multivariate Logistic regression methods were applied for analyzing possible factors of urinary tract infection.Results Among the 240 patients, there were 26 cases with combined urinary tract infection, and the occurrence rate was 10.83%. Single Logistic regression results showed 9 influencing factors, and multivariate Logistic regression showed that independent risk factors included old age, combined other disease, invasive treatment measures, and preventive administration of antibacterial agents.Conclusion Urinary surgery patients have high incidence of urinary tract infection with multiple influencing factors. Thus, corresponding measures are necessary for positive prevention.

  9. A study of factors influencing advanced puberty

    Directory of Open Access Journals (Sweden)

    Yong Jun Park

    2010-02-01

    Full Text Available Purpose : The purpose of this study was to evaluate the timing of puberty and the factors inducing advanced puberty in elemental school students of low grades. Methods : The 1st, 2nd, and 3rd grade elemental students from the Goyang province were randomly selected, and their sexual maturation rate was assessed by physical examination. After obtaining an informed consent, a questionnaire was administered to the parents; eating habits, lifestyle, use of growth-inducing medication, and present illness of the students were evaluated to determine the factors that induced advanced puberty. The data were statistically analyzed. Results : We selected 170 children and the girls:boys sex ratio was 1.2:1. Two 9-year-old boys were in genital stage 2. Two (14.3% 6-year-old girls, 6 (19.4% 7-year-old girls, 15 (39.6% 8-year-old girls, and 4 (57.1% 9-year-old girls were in breast stage 2. The average pubertal timing predicted for girls was 9.11¡?#?.86; years. The main factors influencing pubertal timing were obesity scale, frequency of eating fast food, and the use of growth-inducing medication. A high rating on the obesity scale and high frequency of eating fast food indicated advanced stage of puberty. Growth-inducing medication induced puberty through obesity. Conclusion : We proposed that predictive average pubertal timing in girls was 9.11¡?#?.86; years, which was consistent with the previously reported findings from abroad. The significant influencing factors in advanced puberty were obesity scale and frequency of fast food.

  10. 原发性肝癌患者照顾者反应及其影响因素%The reactions and its influencing factors of primary caregivers of liver cancer patients

    Institute of Scientific and Technical Information of China (English)

    刘香艳; 吴蓉; 李娟; 曹文婷; 徐燕

    2012-01-01

    目的 对肝癌患者主要照顾者反应进行调查,分析其影响因素.方法 使用照顾者反应评估量表(CRA)和抑郁自评量表( CES-D),对肝癌患者的主要照顾者进行调查.结果 CES-D与照顾者反应各维度及总体负担均相关,照顾者反应各维度的影响因素各不相同.结论 肝癌患者的照顾者有较高的抑郁水平,减轻照顾者负担首先要有效减轻抑郁,同时对经济收入等因素也要适当关注.%Objective To investigate the reactions of primary family caregivers of liver cancer patients and to analyze its influencing factors. Methods Totally 280 family caregivers of liver cancer patients were investigated with Caregiver Reaction Assessment(CRA) and the Center for Epidemiological Studies Depression Scale(CES-D). Results The score of CES-D was negatively correlated the total score and each factor scores of caregivers' reactions. The influencing factors of different factors of CRA were various. Conclusion Family caregivers of liver cancer patients have high level of depression. To relieve caregivers' burden should relieve the depression level first and also pay enough attention to their family incomes.

  11. Patient Dose During Carotid Artery Stenting With Embolic-Protection Devices: Evaluation With Radiochromic Films and Related Diagnostic Reference Levels According to Factors Influencing the Procedure

    Energy Technology Data Exchange (ETDEWEB)

    D' Ercole, Loredana, E-mail: l.dercole@smatteo.pv.it [Fondazione IRCCS Policlinico San Matteo, Department of Medical Physics (Italy); Quaretti, Pietro; Cionfoli, Nicola [Fondazione IRCCS Policlinico San Matteo, Department of Radiology (Italy); Klersy, Catherine [Fondazione IRCCS Policlinico San Matteo, Biometry and Clinical Epidemiology Service, Research Department, (Italy); Bocchiola, Milena [Fondazione IRCCS Policlinico San Matteo, Department of Medical Physics (Italy); Rodolico, Giuseppe; Azzaretti, Andrea [Fondazione IRCCS Policlinico San Matteo, Department of Radiology (Italy); Lisciandro, Francesco [Fondazione IRCCS Policlinico San Matteo, Department of Medical Physics (Italy); Cascella, Tommaso; Zappoli Thyrion, Federico [Fondazione IRCCS Policlinico San Matteo, Department of Radiology (Italy)

    2013-04-15

    To measure the maximum entrance skin dose (MESD) on patients undergoing carotid artery stenting (CAS) using embolic-protection devices, to analyze the dependence of dose and exposure parameters on anatomical, clinical, and technical factors affecting the procedure complexity, to obtain some local diagnostic reference levels (DRLs), and to evaluate whether overcoming DRLs is related to procedure complexity. MESD were evaluated with radiochromic films in 31 patients (mean age 72 {+-} 7 years). Five of 33 (15 %) procedures used proximal EPD, and 28 of 33 (85 %) procedures used distal EPD. Local DRLs were derived from the recorded exposure parameters in 93 patients (65 men and 28 women, mean age 73 {+-} 9 years) undergoing 96 CAS with proximal (33 %) or distal (67 %) EPD. Four bilateral lesions were included. MESD values (mean 0.96 {+-} 0.42 Gy) were <2 Gy without relevant dependence on procedure complexity. Local DRL values for kerma area product (KAP), fluoroscopy time (FT), and number of frames (N{sub FR}) were 269 Gy cm{sup 2}, 28 minutes, and 251, respectively. Only simultaneous bilateral treatment was associated with KAP (odds ratio [OR] 10.14, 95 % confidence interval [CI] 1-102.7, p < 0.05) and N{sub FR} overexposures (OR 10.8, 95 % CI 1.1-109.5, p < 0.05). Type I aortic arch decreased the risk of FT overexposure (OR 0.4, 95 % CI 0.1-0.9, p = 0.042), and stenosis {>=} 90 % increased the risk of N{sub FR} overexposure (OR 2.8, 95 % CI 1.1-7.4, p = 0.040). At multivariable analysis, stenosis {>=} 90 % (OR 2.8, 95 % CI 1.1-7.4, p = 0.040) and bilateral treatment (OR 10.8, 95 % CI 1.1-109.5, p = 0.027) were associated with overexposure for two or more parameters. Skin doses are not problematic in CAS with EPD because these procedures rarely lead to doses >2 Gy.

  12. Path analysis of the influencing factors of sdf-management behavior among coronary heart disease patients in Xinjiang%新疆地区冠心病患者自我管理行为影响因素分析

    Institute of Scientific and Technical Information of China (English)

    吴静; 伊小红; 王梦玉

    2011-01-01

    目的:了解新疆地区冠心病患者自我管理行为的影响因素.方法:采用冠心病自我管理行为问卷对520例冠心病患者进行问卷调查,通过通径分析探讨其影响因素及各因素的作用大小.结果:影响冠心病患者自我管理行为的因素按作用大小排序依次为:病程、民族、年龄、自我效能、职业、社会支持、生活质量、性别、个人月收入及医疗付费方式.结论:冠心病患者自我管理行为的影响因素是多方面的,护理人员应对患者进行有针对性的干预,以提高其自我管理水平,延缓和控制病情的发展,从而提高患者的生活质量.%Objective: To explore the influencing factors of self-management behavior among coronary heart disease (CHD) patients in Xinjiang. Methods: We investigated the influencing factors of self-management behavior among CHD patients by self-designed self-management scale and analysed by path analysis. Results: The influencing factors of self-management behavior among CHD patients were as follows: disease course, ethnic group,, age, self-efficacy, job, social support, quality of life, gender, individual income per month and medical payment. Conclusion: The self-management behavior among CHD patients is affected by many factors, So nurses should improve the level of self-management, delay and . control I their complications and improve the quality of life among CHD patients by tailored intervention.

  13. Analysis of Influencing Factors for the Occurence of Delirium in Patients with Severe Burns and Related Nursing Research%重度烧伤患者谵妄发生影响因素分析及护理研究

    Institute of Scientific and Technical Information of China (English)

    张海英; 曾郞平; 麦秋芳

    2014-01-01

    目的:分析重度烧伤患者谵妄发生的影响因素,并进行针对性的护理;研究针对性护理的效果。方法200例谵妄患者用传统护理的方法,并研究谵妄发生的影响因素。100例谵妄患者采用针对性护理,比较传统护理和针对性护理的效果。结果年龄、病因以及受损重要部位三者是重度烧伤患者谵妄发生的影响因素(P<0.05)。针对性护理的护理效果优于传统护理(P<0.05)。结论年龄、病因以及受损重要部位三者是重度烧伤患者谵妄发生的影响因素,而针对性护理为最佳护理策略。%Objective To analyze influencing factors of the occurrence of delirium in patients with severe burns, and to explore the efficacy of targeted care. Methods We assigned 200 cases of patients with delirium to traditional nursing care and studied the delirium risk factors. Another 100 cases of patients with delirium received targeted nursing care. The primary outcome was the comparison of the efficacy of traditional nursing and targeted care. Results Age, pathogenic factors, and damaged parts influenced the occurence of delirium in patients with severe burns (P <0.05). Targeted care was superior to the traditional nursing (P <0.05). Conclusions Age, pathogenic factors, and damaged parts influenced the occurence of delirium in patients with severe burns. Targeted nursing is the best care strategy to choose.

  14. 影响癫痫患者治疗依从性的因素及护理观察%Influence Factors of Treatment Adherence and Epileptic Patient Care

    Institute of Scientific and Technical Information of China (English)

    陈晓静

    2015-01-01

    目的:分析癫痫患者治疗依从性的影响因素以及相应的护理对策。方法收集我院2012年12月至2013年12月期间诊治的癫痫患者46例为研究对象,采用回顾性的方式分析患者的临床资料,总结患者依从性的影响因素及改善护理对策。结果研究结果显示,本组癫痫患者治疗依从性的影响因素主要包括头痛、精神障碍、药物不良反应、患者对医疗知识的了解程度、家庭支持情况等。结论癫痫患者会因为多种原因而降低了治疗依从性,对患者的治疗效果和预后都造成了严重的影响。因此癫痫患者在治疗过程中应加强对患者的心理护理,消除不良心理,采取有效的措施减轻患者的疼痛,提高用药合理性和患者家庭支持,综合提高患者的依从性,从而提高治疗效果。%Objective To analyze the influence factors of patients with epilepsy treatment adherence and corresponding nursing countermeasures.Methods Collected from December 2012 to December 2013 during the diagnosis and treatment of 46 patients with epilepsy as the research object, with the method of retrospective analysis the clinical data of patients, summarized the influence factors of patients' compliance and improve nursing countermeasures.Results The results showed that this group of people with epilepsy treatment adherence of the influencing factors mainly include headache, patients with mental disorders, drug adverse reactions, the degree of understanding of medical knowledge, family support, etc.Conclusion Epilepsy patients may reduce the treatment adherence, for a variety of reasons for the therapeutic effect and prognosis of patients has caused serious influence. Therefore in the process of treatment of epilepsy patients should strengthen the psychological care of patients, eliminate the adverse psychological, take effective measures to ease the pain of patients, improve the rationality and the patients family

  15. Study on Causes and Prognosis Influence Factors of Coma Patients in the Department of Emergency Internal Medicine%急诊内科昏迷患者的病因及预后影响因素探讨

    Institute of Scientific and Technical Information of China (English)

    杜林

    2016-01-01

    Objective To study the causes and prognosis influence factors of coma patients in the department of emergency internal medicine. Methods The clinical data of 156 cases of coma patients admitted and treated in the department of emer-gency internal medicine in our hospital from January 2013 to January 2015 were researched and analyzed, and the coma causes and prognosis influence factors were summarized. Results The main causes of coma patients in the department of e-mergency internal medicine included the cerebrovascular disorder (38.6%), poisoning (34.6%), serious trauma (14.7%), dia-betes disease (7.0%), and the ratio of cerebrovascular disorder was the highest, and the prognosis influence factors of coma patients in the department of emergency internal medicine is closely correlated to the admission time and coma degree after onset of patients, and the prognosis situation in 1h after onset was obviously better than that of patients after 1h of onset, and there was an obvious difference with statistical significance (P<0.05), and the prognosis situation of mild coma patients was obviously better than that of the severe coma patients with obvious difference and statistical significance(P<0.05). Con-clusion The main cause of coma of patients in the department of emergency internal medicine is the cerebrovascular disor-der, and the main influence factors of patients are the coma degree and admission time after onset.%目的:探讨急诊内科昏迷患者的病因及预后的影响因素。方法选取该院2013年1月—2015年1月收治的急诊内科昏迷的156例患者,对其临床资料进行研究分析,总结其昏迷的病因以及预后的影响因素。结果急诊内科患者昏迷的主要病因包括脑血管疾病(38.6%)、中毒(34.6%)、严重创伤(14.7%)、糖尿病疾病(7.0%)。脑血管疾病占比最高。急诊内科昏迷患者预后的影响因素和患者发病后的入院时间以及昏迷程度有密切的联系,发病后1h内入

  16. 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.

  17. Drug compliance influence factors and countermeasure of hypertension patients%高血压患者服药依从性影响因素与对策

    Institute of Scientific and Technical Information of China (English)

    赵莉; 李文

    2003-01-01

    @@ INTRODUCTION The first assembly international conference about patient' s discom-pliance suggested that patients not complying with therapy could beregarded as discompliance. Patients' non-compliance is a new topicof modern medicine. In clinical, Hypertension patients always tookdecompression drug orally and maintain small dosage after BP innormal range.

  18. 炎症性肠病患者治疗依从性影响因素调查与分析%A survey and analysis of the factors to influence treatment compliance of patients with inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    魏丽; 朱迎

    2015-01-01

    Objective:To investigate the treatment compliance of patients with inflammatory bowel disease( IBD)and analyze its influ-encing factors. Methods:A questionnaire survey was conducted to investigate the treatment compliance of 82 patients with IBD and the in-fluencing factors were analyzed. Results:The medication compliance and the lifestyle compliance of IBD patients were relatively better,but the compliance of having regular reexamination and doing proper exercise was poor. Participation in the education of self-management pro-gram or not and educational level of the patients are the main influencing factors of treatment compliance(P﹤0. 05). Conclusion:We should strengthen the health education of patients with IBD and especially strengthen the education of compliance-related knowledge of treatment in patients with low educational level.%目的:调查炎症性肠病( IBD)患者的治疗依从性现状,分析其影响因素。方法:采用问卷调查法对82例IBD患者发放自行设计的治疗依从性问卷,对其一般资料及影响因素进行调查。结果:IBD患者服药依从性和生活方式依从性相对较高,而定期复查和适当锻炼的依从性较差。患者是否参加自我管理项目的教育和患者的文化程度是其治疗依从性的主要影响因素(P﹤0.05)。结论:应加强对IBD患者的健康教育,尤其应加强对文化程度较低患者治疗依从性相关知识的宣教。

  19. 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 DelhiParticipants: 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 contraceptivesStatistical 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.

  20. Landslide forecasting and factors influencing predictability

    Science.gov (United States)

    Intrieri, Emanuele; Gigli, Giovanni

    2016-11-01

    Forecasting a catastrophic collapse is a key element in landslide risk reduction, but it is also a very difficult task owing to the scientific difficulties in predicting a complex natural event and also to the severe social repercussions caused by a false or missed alarm. A prediction is always affected by a certain error; however, when this error can imply evacuations or other severe consequences a high reliability in the forecast is, at least, desirable. In order to increase the confidence of predictions, a new methodology is presented here. In contrast to traditional approaches, this methodology iteratively applies several forecasting methods based on displacement data and, thanks to an innovative data representation, gives a valuation of the reliability of the prediction. This approach has been employed to back-analyse 15 landslide collapses. By introducing a predictability index, this study also contributes to the understanding of how geology and other factors influence the possibility of forecasting a slope failure. The results showed how kinematics, and all the factors influencing it, such as geomechanics, rainfall and other external agents, are key concerning landslide predictability.

  1. 工娱疗法对抑郁症患者疗效的影响因素分析%Influencing factors analysis of efficacy of occupation recreational therapy for patients with depression

    Institute of Scientific and Technical Information of China (English)

    张美英; 刘河; 杨君宏

    2014-01-01

    Objective:To explore influencing factors of efficacy of occupation recreational therapy for patients with depression. Methods:A total of 90 patients with depression receiving occupation recreational therapy were evaluated with the Hamilton depression scale ( HAMD) , coping methods inventory ( CMI) and social support rating scale ( SSRS) . The related factors which affected the effi-cacy were analyzed. Results:There were 73 patients (81. 11%) with good curative effect and 17 patients (18. 89%) with poor cura-tive effect. Through the single-factor analysis, between the two groups, there were significant differences in illness onset pattern, ill-ness attack times, hospitalizing time, accompanying chronic somatic disorders, compliance, and asking for help factor, solving problem factor, remorse factor and withdraw scores in CMI, as well as objective support factor, subjective support factor and using support de-gree factors in SSRS (P<0. 05). Logistic regression analysis showed that the main factors that influenced the efficacy of occupation rec-reational therapy were high compliance (r=53341. 926, P=0. 028), high subjective support factor score (r=62. 081, P=0. 040), and high using support degree factor score (r=13. 348, P=0. 038). Conclusions:The efficacy of occupation recreational therapy for the patients with depression is associated with compliance, subjective support and using support factors.%目的:探讨影响工娱疗法对抑郁症患者疗效的因素。方法:共有90例抑郁症患者接受工娱疗法干预,用24项汉密尔顿抑郁量表、应对方式问卷、社会支持量表对其疗效评定,分析影响工娱疗法对抑郁症疗效的因素。结果:90例患者中,工娱疗法效果好的占81.11%(73例),效果差占18.89%(17例),经单因素分析,两组患者在起病形式﹑发病次数﹑住院次数﹑是否伴有慢性躯体疾病﹑治疗依从性﹑应对方式问卷中求助因子分﹑解决问题因子分﹑自责因子分

  2. Investigation of the status and influencing factors of self efficacy in patients with blood dialysis%血液透析患者自我效能现状及影响因素调查

    Institute of Scientific and Technical Information of China (English)

    沈晓颖; 周郁秋; 赵秋利; 朱雪梅; 肖宁宁; 杨丽; 崔岩; 曹慧; 徐红梅

    2013-01-01

    Objective To explore the status and influencing factors of self efficacy in patients with blood dialysis,and provide the basis for the implementation of targeted nursing intervention.Methods Eighty-nine patients with blood dialysis were surveyed by the United States Stanford University chronic centers for Disease Education Research self-efficacy scale.Results The score of self-efficacy in hemodialysis patients was (38.51 ± 10.91),and its influencing factors were family support,occupation,cultural degree and economic burden.Conclusions Clinical workers should arouse the patient' s potential,pay attention to improve patients'self-efficacy,so as to effectively improve their levels of physical and mental health.%目的 探讨血液透析患者自我效能水平及影响因素,为实施有针对性的护理干预措施提供依据.方法 采用美国Stanford大学慢性疾病教育研究中心的自我效能量表,对89例血液透析患者进行调查.结果 血液透析患者自我效能水平为(38.51±10.91)分,其影响因素是家庭支持情况(F=6.908,P=0.002)、职业(F=4.823,P=0.004)、文化程度(F=5.843,P=0.004)、经济负担(F=5.858,P=0.004).结论 临床工作者应调动患者的自身潜能,重视提高患者的自我效能,从而更有效地提高其身心健康水平.

  3. Quality of Life and the Influencing Factors among Patients with Alzheimer Disease%阿尔茨海默病患者的生活质量及其影响因素研究

    Institute of Scientific and Technical Information of China (English)

    黄樱; 邹琴娓; 黄坚

    2011-01-01

    Objective To investigate the quality of life and the influencing factors among Alzheimer disease ( AD ) patients. Methods Life quality of 100 AD patients were investigated with quality of life scale ( QOL - AD ) through self - assessment. Results The QOL - AD score of AD patients, by self - assessment was ( 26. 9 ±3. 5 ). Multiple linear regression showed that the presence of behavioral and psychological symptoms, living situation, care giver status and age were the influencing factors of quality of life in AD patients by self - assessment, of which the presence or absence of behavioral and psychological symptoms were the most important. Conclusion Strict control of behavioral and psychological symptoms and strengthened concern and care for AD patients can improve their quality of life.%目的 研究阿尔茨海默病(Alzheimer disease,AD)患者的生活质量及影响因素.方法 采用AD患者生活质量 (quality of life-Alzheimer disease,QOL-AD) 量表,以患者自评的方式,对100例AD患者的生活质量进行调查.结果 AD患者自评QOL-AD量表得分为(26.9±3.5)分.多元线性回归显示,影响患者自评生活质量的因素为精神行为症状的有无、居住情况、照料者身份、年龄,其中最重要的因素为精神行为症状的有无.结论 严格控制精神行为症状,加大对AD患者的关心和爱护,可以提高其生活质量.

  4. Study on life of quality and influencing factors in patients with age-related macular degeneration%老年性黄斑变性患者的生活质量及影响因素的研究

    Institute of Scientific and Technical Information of China (English)

    熊艳华; 池晨; 刘汉忠

    2008-01-01

    目的 探讨老年性黄斑变性(AMD)的生活质量及影响因素.方法 采用中文版低视力者生活质量量表(CLVQOL)对105例AMD患者的生活质量进行评价.结果 AMD患者的生活质量得分普遍下降,尤以AMD病程的增加、AMD渗出增多、教育水平的降低、不良遵医行为以及有无婚姻支持较为突出;不同程度的视力损害严重影响着患者的生活质量得分;多因素逐步直线回归显示:生活质量的得分与视力、AMD病程的长短、有无婚姻支持及遵医行为有关;差异均有统计学意义(P<0.05).结论 在保护AMD患者视功能的同时,要重视社会,婚姻支持,做好健康教育和心理指导.%Objective To explore the life of quality and the influencing factors in patients with age-related maeular degeneration (AMD). Methods CLVQOL (Chinese Low Vision's Quality Of Life) was used to evaluate the life of quality in 105 AMD patients. Results The score of life quality of AMD patients generally declined, especially among the patients having the following factors, the progression of AMD, the increase of exudation of AMD, low level of education, bad compliance to doctor' s instructions, and whether the patient had or had not a marriage support ( P < 0. 05 ). Various degrees of vision damages in the patients heavily influenced the score of quality of life (P <0. 05). The gradual regression lines of multiple factors showed that the score of quality of life was related to the vision, the time of AMD disease, whether the patient had or had no marriage support, and the compliance to doctor' s prescription (P < 0. 05). Conclusions It needs to pay attention to the protection of the vision function of the AMD patients, and at the same time, it needs to stress the social support, the marriage support, as well as health education and mental guidelines.

  5. Why neurology? Factors which influence career choice in neurology.

    Science.gov (United States)

    Albert, Dara V; Hoyle, Chad; Yin, Han; McCoyd, Matthew; Lukas, Rimas V

    2016-01-01

    To evaluate the factors which influence the decision to pursue a career in neurology. An anonymous survey was developed using a Likert scale to rate responses. The survey was sent to adult and child neurology faculty, residents and fellows, as well as medical students applying for neurology. Descriptive statistics were used to analyse the factors of influence. Respondents were subsequently categorized into pre-neurology trainees, neurology trainees, child neurologists and adult neurologists, and differences between the groups were analysed using Pearson's chi-square test. One hundred and thirty-three anonymous responses were received. The respondents were neurologists across all levels of training and practice. Across all respondents, the most common factor of high importance was intellectual content of specialty, challenging diagnostic problems, type of patient encountered and interest in helping people. Responses were similar across the groups; however, the earliest trainees cited interest in helping people as most important, while those in neurology training and beyond cite intellectual content of the specialty as most important. As trainees transition from their earliest levels of clinical experience into working as residents and faculty, there is a shift in the cited important factors. Lifestyle and financial factors seem to be the least motivating across all groups. Encouragement from peers, mentors, faculty and practicing physicians is considered high influences in a smaller number of neurologists. This may present an opportunity for practicing neurologists to make connections with medical students early in their education in an effort to encourage and mentor candidates.

  6. 心肌梗死患者急性期与恢复期焦虑抑郁状况因素分析%Analysis of factors influencing anxiety and depression at different stages among patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    朱凌燕; 卢惠娟; 许燕玲

    2013-01-01

    Objective To investigate the levels of anxiety and depression at different stages among patients with acute myocardial infarction (AMI),to explore the influencing factors,and to improve the stress management of AMI patients.Methods A total of 100 AMI patients from Shanghai Sixth People's Hospital from February to June 2012 were evaluated with the Hospital Anxiety and Depression Scale (HADS) during hospitalization and 2-3 months of follow-up.Results Among 100 patients,the incidence of anxiety was 29%,38% and 44% during hospitalization,early rehabilitation and rehabilitation,respectively.The incidence of depression was 40%,50% and 53% during hospitalization,early rehabilitation and rehabilitation,respectively.The influencing factors during hospitalization were education background,profession and age.During early rehabilitation the per capita household monthly income,medical payment method,myocardial infarction area and history were the influencing factors.While during rehabilitation the family care,marriage status,sports habit,and household were the influencing factors (P < 0.05).Conclusion The incidence of anxiety and depression among AMI patients increases with time going on.It is influenced by various factors at different stages of AMI.The patients' status should be evaluated comprehensively,and the effective intervention should be provided to prevent and reduce the negative psychological impacts.%目的 了解急性心肌梗死(acute myocardial infarction,AMI)患者住院急性期、恢复初期和恢复期的焦虑抑郁状况及相关因素.方法 采用便利抽样法,选取2012年2-6月收治于上海交通大学附属第六人民医院的AMI患者100例,采用综合医院焦虑/抑郁情绪测定表(hospital anxiety and depression scale,HADS)对其发病的急性期、恢复初期和恢复期进行问卷调查.结果 AMI患者在住院急性期焦虑阳性检出率占29%,恢复初期占38%,恢复期占44%;在住院急

  7. 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

  8. 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 o

  9. 影响老年高血压病患者睡眠障碍的因素分析及护理%Analysis of influencing factors and nursing intervention strategies on elderly hypertensive patient's somnipathy

    Institute of Scientific and Technical Information of China (English)

    肖丽萍; 刘兰萍; 吕少芸

    2012-01-01

    Objective :To study the Influencing Factors and nursing intervention strategies on elderly hypertensive patient's somnipathy. Methods 380 eldly cases of our department suffered hypertension accompanied somnipathy were divided into two groups randomly every group have 190 patients. The control group accepted routine nursing procedures and the observation group accept mental nursing, health education and nursing strategies to improvement sleep quality based on the control group, respectively. Analysis of influencing factors on elderly hypertensive patient's somnipathy. Results: Psychological factors, physiological factors and environmental factor are the main factors influent the somnipathy in the elderly hypertensive patients. There have great changes on sleep latency and sleep time of the observation group(P<0.05). The SAS scores was lower after the nursing intervention and also lower than the control group after the basic care. The affected rate of blood pressare is higher than control group, with was higher than the control group (P <0.05). Conclusion: The effective nursing intervention could improve the quality of sleep, get rid the anxiety and improve the treatiment effect.%目的:探讨老年高血压病患者睡眠障碍的相关影响因素和护理效果.方法:将我科收治的380例伴有睡眠障碍的老年高血压病患者采用随机数字表法分为对照组和观察组,各190例.对照组采用常规护理;观察组在常规护理基础上给予心理护理、健康宣教和改善睡眠指导等护理对策.结果:生理、心理和环境因素是影响老年高血压病患者睡眠障碍的主要因素.观察组经护理干预后睡眠潜伏期与睡眠时间较对照组有显著改善(P<0.05),SAS评分显著低于对照组(P<0.05),且降压治疗的效果显著优于对照组(P<0.05).结论:有效的护理干预对策,可显著改善老年高血压病患者的睡眠质量,消除其焦虑情绪,提高治疗效果.

  10. Factores que influyen sobre la aparición de infecciones hospitalarias en los pacientes de cuidados intensivos Factors influencing hospital infection in patients in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Aurora Llanos-Méndez

    2004-06-01

    Full Text Available Objetivo: La acumulación de factores de riesgo en los pacientes atendidos en el hospital es uno de los elementos que condicionan el aumento de la infección nosocomial y su mayor frecuencia en las unidades de cuidados intensivos (UCI. Nuestro objetivo es la identificación de los factores de riesgo de la infección nosocomial en la UCI de nuestro hospital. Métodos: Se efectuó un estudio de cohortes prospectivo sobre los 1.134 pacientes ingresados, al menos durante 24 h en dicha UCI durante el año 2001. El seguimiento de los pacientes prosiguió 48 h tras el alta del paciente de la unidad. Los factores de riesgo se identificaron mediante un análisis multivariable de regresión de Cox. Resultados: Los factores de riesgo intrínsecos integrantes del modelo son el diagnóstico principal que motivó el ingreso del paciente en la unidad, la presencia de traumatismo craneoencefálico y la insuficiencia renal. Las técnicas invasivas que se asocian de forma independiente a la infección nosocomial son, de mayor a menor riesgo, el sondaje urinario, la traqueostomía, la ventilación mecánica, la inserción de un catéter de Swan-Ganz y la nutrición parenteral. Conclusiones: Si bien la mayor fuerza de asociación se encuentra entre los factores de riesgo endógenos, ya que son poco modificables, habrá que orientar las propuestas de mejora hacia los siguientes factores exógenos: ventilación mecánica, traqueostomía, sondaje urinario, catéter de Swan-Ganz y nutrición parenteral.Objective: The accumulation of risk factors in hospitalized patients is one of the elements contributing to the increase in the frequency of nosocomial infection in the intensive care unit (ICU. Our aim was to identify nosocomial infection risk factors in the ICU of our hospital. Methods: We performed a prospective cohort study of 1134 patients admitted to the ICU for at least 24 hours in 2001. The patients were followed-up for 48 hours after leaving the ICU

  11. PICC-related venous thrombosis time in cancer patients and its influencing factors%肿瘤患者 PICC 相关静脉血栓形成时间及其影响因素

    Institute of Scientific and Technical Information of China (English)

    李孝红

    2016-01-01

    目的:探讨肿瘤患者经外周静脉穿刺中心静脉置管(peripherally inserted central ve-nous catheters ,PICC)相关静脉血栓形成时间及其影响因素。方法回顾2010年10月-2014年12月224例恶性肿瘤PICC患者的临床资料,分析肿瘤患者PICC相关静脉血栓形成的影响因素。结果发生PICC相关静脉血栓34例患者中,PICC相关静脉血栓形成时间(17.20±2.21)d。单因素与多因素分析显示,使用红系造血刺激剂、治疗剂量抗凝、PICC相关感染、住院、穿刺静脉及血小板计数是肿瘤患者PICC相关静脉血栓形成的危险因素。结论影响肿瘤患者PICC相关静脉血栓的因素较多,应采取综合措施降低肿瘤患者P IC C相关静脉血栓发生率。%Objective To investigate the peripherally inserted central venous catheters (PICC)-related venous thrombosis time in cancer patients and its influencing factors .Methods A retrospective analysis of the clinical data of PICC placement of 224 patients with malignant tumors admitted to our hospital during October 2010 and December 2014 was conducted to find the influencing factors of PICC-related venous thrombosis in cancer patients .Results Among the 34 patients with venous thrombosis , the venous thrombosis time was (17 .20 ± 2 .21 )d . Pearson univariate and multivariate logistic regression analysis showed that using ESA or therapeutic dose of anticoagulant ,PICC-related infections ,hospitalization ,given veinpuncture and platelet count were risking factors of PICC-related venous thrombosis in cancer patients .Conclusion Quite a lot factors can lead to PICC-related venous thrombosis in cancer patients . Therefore , integrated measures should be taken to reduce rate of PICC related venous thrombosis .

  12. Influencing Factors for Dietary Behaviors of Patientswith Diabetic Nephropathy

    Directory of Open Access Journals (Sweden)

    Kawata,Chieko

    2010-02-01

    Full Text Available The aim of this study was to clarify the factors influencing the dietary behavior of patients with diabetic nephropathy. One hundred twenty-two patients with type 2 diabetes were recruited from the outpatients of Okayama University Hospital in Okayama, Japan. We performed a cross-sectional study using a questionnaire including 206 items among 18 categories as follows:background factors, coping behavior (coping scale, degree of uncertainty in illness (uncertainty scale, and dietary behavior. The data were analyzed by correlation analysis, t-test, one-way analysis of variance, Pearson correlation analysis, and multiple regression analysis. We found that those patients with microalbuminuria alone tended to recognize more mild about their kidney status than those with macroalbuminuria and chronic renal failure. We also found that common factors influencing the dietary behavior of diabetic patients with and without nephropathy are as follows:1. coping with the problem (beta0.342, p0.01;2. anxiety about prognosis (beta0.344, p0.01;3. sex (beta0.234, p0.05;4. uncertainty regarding treatment (beta0.377, p0.01;5. negative coping (beta0.354, p0.01;and 6. employment status (beta0.367, p0.01. Coping and uncertainty in illness had a significant relation to positive support and lack of support. To maintain appropriate dietary behavior in diabetic patients, medical staff need to determine what the social supports are important for the patient, and also to ensure good communication among healthcare personnel as well as positive support for patients and families.

  13. Influence of socio-demographic factors on distances travelled to access HIV services: enhanced surveillance of HIV patients in north west England

    Directory of Open Access Journals (Sweden)

    Tocque Karen

    2009-03-01

    Full Text Available Abstract Background Patient choice and access to health care is compromised by many barriers including travel distance. Individuals with the human immunodeficiency virus (HIV can seek free specialist care in Britain, without a referral, providing flexible access to care services. Willingness to travel beyond local services for preferred care has funding and service implications. Data from an enhanced HIV surveillance system were used to explore geodemographic and clinical factors associated with accessing treatment services. Methods We extracted data on the location, type and frequency of care services utilized by HIV positive persons (n = 3983 accessing treatment in north west England between January 1st 2005 and June 30th 2006. Individuals were allocated a deprivation score and grouped by urban/rural residence, and distance to care services was calculated. Analysis identified independent predictors of distance travelled (general linear modelling and, for those bypassing their nearest clinic, the probability of accessing a specialist service (logistic regression, SPSS ver 14. Inter-relationships between variables and distance travelled were visualised using detrended correspondence analysis (PC-ORD ver 4.1. Results HIV infected persons travelled an average of 4.8 km (95% confidence intervals (CI 4.6–4.9 per trip and had on average 6 visits (95% CI 5.9–6.2 annually for care. Longer trips were made by males (4.8 km vs 4.5 km, white people (6.2 km, the young (>15 years, 6.8 km and elderly (60+ years, 6.3 km, those on multiple therapy (5.3 km vs 4.0 km, and the more affluent living in rural areas (16.1 km, P Conclusion Distance travelled, and type of HIV services used, were associated with socioeconomic status, even after accounting for ethnicity, route of infection and age. Thus despite offering an 'equitable' service, travel costs may advantage those with higher income.

  14. ICU老年机械通气患者谵妄情况及其影响因素的调查%Influencing factors of delirium of elderly patients with mechanical ventilation in ICU

    Institute of Scientific and Technical Information of China (English)

    马洁葵; 李绮慈; 吕春梅

    2013-01-01

    Objectives To explore the influencing factors of delirium in elderly patients with mechanical ventilation in ICU. Methods Using a self-designed questionnaire,the investigation was done among 210 patients undergoing mechanical ventilation to evaluate the delirium condition and look into the influence factors of delirium.Results 112 cases(53.3%)of the elderly patients were affected with delirium.The major influencing factors included duration of mechanical ventilation,acute physiology and chronic health evaluation(APACHEⅡ),hypoxia,sleep deprivation.Conclusion The incidence of delirium is higher among the elderly patients with mechanical ventilation.As for nursing strategy,providence of family nursing,close observation of the disease changes, enhanced respiratory function and practical orientation cognitive training are important for the reduction of the incidence of delirium in the elderly patients with mechanical ventilation.%目的:了解ICU老年机械通气患者谵妄发生情况,并探讨其影响因素及采取相应的护理措施。方法采.用自行设计的调查问卷,对本科室210例机械通气老年患者进行调查,评估其发生谵妄情况,分析谵妄的影响因素。结果112例(53.3%)老年机械通气患者发生谵妄。机械通气时间、急性生理及慢性健康状况评分Ⅱ(acute physiology and chronic health evaluation,APACHEⅡ)、低氧血症、睡眠剥夺是影响老年机械通气患者谵妄发生的重要因素。结论老年机械通气患者谵妄发生率较高。提供亲情护理、密切观察病情变化、强化呼吸功能和现实定向认知能力训练对降低老年机械通气患者谵妄发生率具有重要意义。

  15. Examinations of factors influencing toe grip strength.

    Science.gov (United States)

    Soma, Masayuki; Murata, Shin; Kai, Yoshihiro; Nakae, Hideyuki; Satou, Yousuke; Murata, Jun; Miyazaki, Junya

    2016-11-01

    [Purpose] This study examined the relationship between toe grip strength and its associated factors by focusing on factors that were suggested to have a relationship with toe grip strength in previous studies, aiming to clarify the factors influencing the toe grip strength of healthy women. [Subjects and Methods] Twelve healthy young women were selected for this study. Their toe grip strength, angular changes in their ankle joint during toe grip, maximum voluntary contraction activities of the rectus femoris, biceps femoris, and tibialis anterior muscles, and the medial head of the gastrocnemius muscles were measured using electromyography. Their toe curl ability, foot-arch height ratio, and weight were also measured. [Results] Multiple regression analysis demonstrated that the predictors of toe grip strength in the resulting model were foot-arch height ratio and the percentage of integrated electromyography (%IEMG) of the tibialis anterior muscle, as the dependent variables. This reveals that women whose tibialis anterior muscle %IEMG values and foot-arch height ratio are high have greater %IEMG values have greater toe grip strength. [Conclusion] These findings suggest a significant relationship between foot-arch height ratio and toe grip strength, with a reciprocal interaction. These findings further indicate that the risk of falls by the elderly could be decreased if toe grip strength were enhanced, by increasing the height of a low foot-arch with the help of an inserted insole.

  16. Factors affecting functional prognosis of patients with hip fracture

    DEFF Research Database (Denmark)

    Kristensen, M T

    2011-01-01

    . A variety of factors such as age, prefracture function and health status, fracture type, pain, anaemia, muscle strength, and the early mobility level have been shown to influence patient outcome. Thus, the outcome of patients with hip fracture is considered multi-factorial, and can therefore not be related......Having a hip fracture is considered one of the most fatal fractures for elderly people, resulting in impaired function, and increased morbidity and mortality. This challenges clinicians in identifying patients at risk of worse outcome, in order to optimise and intensify treatment in these patients...... to just one or two single factors. The current article reviews important factors affecting the functional prognosis, and clinicians are encouraged to include all factors potentially influencing the outcome of patients with hip fracture in their individualised treatment and rehabilitation plan. Especially...

  17. 肺结核患者心理健康状况及其影响因素分析%Mental health and its influence factors among tuberculosis patients

    Institute of Scientific and Technical Information of China (English)

    成君; 张慧; 李仁忠; 骆颖慧

    2011-01-01

    Objective To explore mental health status and its influence factors among tuberculosis (TB) patients. Methods A cross-sectional study was carried out in the selected cities and counties in five provinces. Totally 176 TB patients were interviewed face-to-face with a self-designed questionnaire and Kessler Psychological Distress Scale(K10) to collect related information. Results The average score of K10 was 14. 20 ± 5.97 for all patients and 27. 3% of the patients had the scores of 16 - 50 indicating bad mental health status. The independent risk factors of high K10 score among the TB patients included non permanent resident, with debt due to TB treatment, and with longer period of having TB (R2 = 0. 104). Conclusion The mental health status of TB patients is poor and socioeconomic status is the most powerful influence factor for mental health of the patients.%目的 了解肺结核(TB)患者的心理健康状况及其影响因素.方法 在中国5个省(直辖市)中的1个地市级结核病专科医院及该市所辖的1个区(县)结防机构中抽取非耐药肺结核患者176例,采用自行设计的调查问卷和凯斯勒心理疾患量表10(K10)进行面对面问卷调查.结果 肺结核患者的K10分值平均为(14.20±5.97)分,27.3%的患者心理健康状况相对较差(K10分值在16-50分);单因素和多因素分析结果 显示,非当地户籍、因治疗TB贷款或借款、距初次确诊年限长是肺结核患者K10分值高的独立危险因素(均为P<0.05),R2为0.104.结论 肺结核患者的心理健康状况较差,经济状况是最主要的影响因素.

  18. Analysis of perception control and influencing factors in patients with lung cancer undergoing chemotherapy%肺癌化疗患者感知控制水平现状调查及影响因素分析

    Institute of Scientific and Technical Information of China (English)

    谭杏; 黄丽芳; 孙彩霞; 蒋睿; 曾谷清

    2016-01-01

    Objective To analyze the perceived control of lung cancer patients undergoing chemotherapy and to explore its influencing factors. Methods A total of 185 patients with lung cancer were recruited and assessed by homemade general information questionnaire and the Cancer Experience and Efficacy Scale. Results The total score of cancer experience during chemotherapy in patients with lung cancer was (62.50±6.99) points. The total score of efficacy during chemotherapy in patients with lung cancer was (42.52±8.08) points. Single factor analysis showed the influencing factors of perceived control were personal income, sex, education, metastasis, surgical treatment and stage of disease. Conclusions The cancer-related experience and efficacy of patients with lung cancer is at middle level. Health-care worker should pay attention to the impact of lung cancer patients and take effective measures to mitigate the negative cancer-related experience, thereby improving the perceived control of the lung cancer patients.%目的:探讨肺癌住院患者化疗期间感知控制能力现状及影响因素。方法采用自制的一般资料调查表和癌症经验与效能量表对185例肺癌化疗患者进行调查。结果肺癌患者化疗期间癌症经验总分为(62.50±6.99)分,癌症效能总分为(42.52±8.08)分。个人收入、性别、文化程度、是否转移、是否手术、疾病分期是肺癌患者感知控制能力的主要影响因素。结论肺癌住院患者化疗期间的患癌经验和控制效能呈中等水平。护理人员应重视感知控制能力对肺癌患者的影响,采取有效措施降低患者的患癌负面体验,提高其应对肺癌的控制效能。

  19. Survey and analysis on postoperative sleep quality and influencing factors for orthopedics patients%骨科患者术后睡眠质量及影响因素的调查与分析

    Institute of Scientific and Technical Information of China (English)

    王爱平; 梅卫婷; 王桂平

    2012-01-01

    Objective To observe the postoperative sleep quality and influencing factors for orthopedics patients. Method Investigate 350 patients by Pittsburgh Sleep Quality Index (PSQI) and self-designed questionnaire on risking factors of sleep quality. Analyze the underlying factors by Logistic regression model. Result The average score of PSQI is (8. 38 + 3. 52). 57. 4% patients suffering from dyssomnia. Risking factors of sleep quality arc pain, compulsive position, concern on prognosis, economic burden, noise in wards and change in living habits. Conclusion Orthopedics patients have poor sleep quality. Countermcasurcs on nursing should be taken to improve their sleep quality.%目的 调查骨科患者术后的睡眠质量及影响因素.方法 采用匹兹堡睡眠质量指数量表和自制的影响睡眠因素调查表,对350例患者进行问卷调查,对潜在影响因素应用Logistic 回归模型进行分析.结果 患者匹兹堡睡眠质量指数平均得分(8.38±3.52)分,57.4%患者睡眠不良,影响睡眠的因素分别为疼痛、被迫体位、担心预后、经济负担、病房噪声、生活习惯改变.结论 骨科患者术后睡眠质量差,需采取相应护理对策,改善患者睡眠质量.

  20. Factors Influencing Goal Attainment in Patients with Post-Stroke Upper Limb Spasticity Following Treatment with Botulinum Toxin A in Real-Life Clinical Practice: Sub-Analyses from the Upper Limb International Spasticity (ULIS-II Study

    Directory of Open Access Journals (Sweden)

    Klemens Fheodoroff

    2015-04-01

    Full Text Available In this post-hoc analysis of the ULIS-II study, we investigated factors influencing person-centred goal setting and achievement following botulinum toxin-A (BoNT-A treatment in 456 adults with post-stroke upper limb spasticity (ULS. Patients with primary goals categorised as passive function had greater motor impairment (p < 0.001, contractures (soft tissue shortening [STS] (p = 0.006 and spasticity (p = 0.02 than those setting other goal types. Patients with goals categorised as active function had less motor impairment (0.0001, contracture (p < 0.0001, spasticity (p < 0.001 and shorter time since stroke (p = 0.001. Patients setting goals for pain were older (p = 0.01 with more contractures (p = 0.008. The proportion of patients achieving their primary goal was not impacted by timing of first-ever BoNT-A injection (medium-term (≤1 year vs. longer-term (>1 year post-stroke (80.0% vs. 79.2% or presence or absence of severe contractures (76.7% vs. 80.6%, although goal types differed. Earlier BoNT-A intervention was associated with greater achievement of active function goals. Severe contractures impacted negatively on goal achievement except in pain and passive function. Goal setting by patients with ULS is influenced by impairment severity, age and time since stroke. Our findings resonate with clinical experience and may assist patients and clinicians in selecting realistic, achievable goals for treatment.

  1. Factors influencing nursing care in a surgical intensive care unit

    Directory of Open Access Journals (Sweden)

    Raj John

    2006-01-01

    Full Text Available Context: The total time spent in nursing care depends on the type of patient and the patient′s condition. We analysed factors that influenced the time spent in nursing a patient. Aims : To analyse the factors in a patient′s condition that influenced time spent in nursing a patient. Materials and Methods: This study was performed in the Surgical Intensive Care Unit of a tertiary referral centre, over a period of one month. The total time spent on a patient in nursing care for the first 24 hours of admission, was recorded. This time was divided into time for routine nursing care, time for interventions, time for monitoring and time for administering medications. Statistical analysis used: A backward stepwise linear regression analysis using the age, sex, diagnosis, type of admission and ventilatory status as variables, was done. Results: Patients admitted after elective surgery required less time (852.4 ± 234.1 minutes, than those admitted after either emergency surgery (1069.5 ± 187.3 minutes, or directly from the ward or the emergency room (1253.7 ± 42.1 minutes. Patients who were ventilated required more time (1111.5 ± 132.5 minutes, than those brought on a T-piece (732.2 ± 134.8 minutes or extubated (639.5 ± 155.6 minutes. The regression analysis showed that only the type of admission and the ventilatory status significantly affected the time. Conclusions : This study showed that the type of admission and ventilatory status significantly influenced the time spent in nursing care. This will help optimal utilization of nursing resources.

  2. 医保患者非计划性重复住院影响因素分析%The Analysis of the Factors Influencing Unplanned Readmission of the Insured The Analysis of the Factors Influencing Unplanned Readmission of the Insured Patients

    Institute of Scientific and Technical Information of China (English)

    郑彦如; 李益桑; 肖良成

    2014-01-01

    Objectives: To analyze the factors influencing unplanned readmission of the insured patients to the tertiary comprehensive hospitals, and to provide bases for the improvement of medical services, hospital management and insurance policy making. Methods: The medical records of 237 patients from July 1, 2012 to March 31, 2014 were selected and classified. Results: Multi-underlying diseases, deterioration of diseases, and, improper operation time are the main factors causing the unplanned re-hospitalization. Conclusion: Preventing human factors from causing repeated hospitalization is one of effective way to improve hospital management and medical insurance policy making.%目的:分析三甲综合医院医保患者非计划性重复住院的影响因素,为提升医疗质量、优化医院管理、完善医保政策提供依据。方法:将该医院2012年7月1日至2014年3月31日的237名医保非计划性重复住院患者资料进行归类分析。结果:合并多种基础疾病转科治疗导致的分解住院、病情变化、手术时间不当是影响医保患者非计划性重复住院的主要因素。结论:杜绝人为因素导致的非计划性重复住院,是优化医院管理、完善医保政策的有效办法之一。

  3. Factors influencing nurses' perceptions of occupational safety.

    Science.gov (United States)

    Samur, Menevse; Intepeler, Seyda Seren

    2017-01-02

    To determine nurses' perceptions of occupational safety and their work environment and examine the sociodemographic traits and job characteristics that influence their occupational safety, we studied a sample of 278 nurses. According to the nurses, the quality of their work environment is average, and occupational safety is insufficient. In the subdimensions of the work environment scale, it was determined that the nurses think "labor force and other resources" are insufficient. In the occupational safety subdimensions "occupational illnesses and complaints" and "administrative support and approaches," they considered occupational safety to be insufficient. "Doctor-nurse-colleague relationships," "exposure to violence," and "work unit" (eg, internal medicine, surgical, intensive care) are the main factors that affect occupational safety. This study determined that hospital administrations should develop and immediately implement plans to ameliorate communication and clinical precautions and to reduce exposure to violence.

  4. Factors Influencing Sulfinatodehalogenation Reactions of Perhalocarbons

    Institute of Scientific and Technical Information of China (English)

    WU,Kai(吴恺); CHEN,Qing-Yun(陈庆云)

    2004-01-01

    The study on the factors influencing sulfinatodehalogenation of perfluorohexyl chloride plus octene-1 by using Na2S2O4/NaHCO3 discovered that among the various solvents tested(e.g.Me2SO,NMP,DMAc,CH3CN,CH3CN/H2O)at different temperatures,Me2SO was found to be the most suitable solvent and the conversion of the chloride was very dependent on the reaction temperature.When Me2SO was used in the reaction of perfluoroalkyl iodides,the reaction temperature could be decreased by 20℃ as compared with that carried out in CH3CN/H2O to reach the comparable yields.

  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. Cognitive Function and Influencing Factors in Patients with Status Epilepticus%癫痫持续状态后患者的认知功能及其影响因素

    Institute of Scientific and Technical Information of China (English)

    王丹; 黄芩; 王文敏

    2011-01-01

    Objective To investigate the cognitive function and influencing factors in patients with status epilepticus. Methods We collected 20 cases of patients with status epilepticus, and compared them with the control group. We asscessed the cognitive function of them and analyzed the related influencing factors of cognitive function. Mini-mental state (MMSE) , Digital span test (DST) , Digital symbol test (DST) , Trail making test (TMT) , Verbal fluency test ( VFT) were applied to evaluate the cognitive function of patients with status epilepticus. Results (1) Cognitive features: Neuropsychologic test scores of patients with status epilepticus were lower than normal control group by applying with MMSE, DST of WAIS-R, DST, TMT and VFT, and the differences were statistically significant (P<0.0l). (2) Influencing factors of congnitive function: Level of education, age and the number of medication were, the main factors affecting cognitive function of patients with status epilepticus by multivariate stepwise regression analysis, particular level of education was the most evident. Conclusions Patients with status epilepticus have cognitive impairment. Level of education, age and the number of drugs have an impact on cognitive function, and education level is the major influencing factor of cognitive function.%目的 探讨癫痫持续状态后患者的认知功能及其影响因素.方法 收集20例癫痫持续状态后患者作认知功能评估,并与正常对照组对照,分析影响认知功能的相关因素.认知功能评估采用简明精神状态量表,韦氏成人智力量表(WAIS-R)中的数字广度,数字符号转换测验,连线测验,言语流畅性测验.结果 (1)认知功能特点:癫痫持续状态后患者的简明精神状态量表,WAIS-R中的数字广度测验,WAIS-中的数字符号转换测验,连线测验,言语流畅性测验得分均低于正常对照组,差异有统计学意义(P<0.05);(2)认知功能的影响因素:进行多重线性回归分

  7. Factors that influence cancer patients' and relatives' anxiety following a three-person medical consultation: impact of a communication skills training program for physicians.

    Science.gov (United States)

    Lienard, Aurore; Merckaert, Isabelle; Libert, Yves; Delvaux, Nicole; Marchal, Serge; Boniver, Jacques; Etienne, Anne-Marie; Klastersky, Jean; Reynaert, Christine; Scalliet, Pierre; Slachmuylder, Jean-Louis; Razavi, Darius

    2008-05-01

    No study has yet assessed the impact of physicians' skills acquisition after a communication skills training program on changes in patients' and relatives' anxiety following a three-person medical consultation. This study aimed at comparing, in a randomized study, the impact, on patients' and relatives' anxiety, of a basic communication skills training program and the same program consolidated by consolidation workshops and at investigating physicians' communication variables associated with patients' and relatives' anxiety. Consultations with a cancer patient and a relative were recorded and analyzed by the Cancer Research Campaign Workshop Evaluation Manual. Patients' and relatives' anxiety were assessed with the State-Trait Anxiety Inventory-State. No statistically significant change over time and between groups was observed. Mixed-effects modeling of changes in patients' and relatives' anxiety showed that decreases in both patients' and relatives' anxiety were linked with patients' and relatives' self-reported distress (p = 0.031 and 0.005), and that increases in both patients' and relatives' anxiety were linked with physicians' breaking bad news (p = 0.028 and 0.005). No impact of the training program was observed. Results indicate the need to further study communication skills which may help reduce patients' and relatives' anxiety especially when breaking bad news.

  8. 老年慢性病病人照顾者的负担及其影响因素%Analysis on burden of caregivers of elderly patients with chronic disease and its influencing factors

    Institute of Scientific and Technical Information of China (English)

    戈晓华; 陈沁涵; 章雅青; 陈海燕

    2014-01-01

    [目的]了解老年慢性病病人照顾者的照顾负担现状,分析照顾者负担的影响因素。[方法]以老年慢性病病人及其照顾者的一般资料调查表、照顾者负担量表为研究工具,采用方便抽样法对212例老年慢性病病人照顾者进行问卷调查。[结果]老年慢性病病人主要照顾者的负担总分为(34.55±17.78)分;影响照顾者负担的因素有照顾者与病人的关系、病人年龄、病人病程、家庭经济状况。[结论]老年慢性病病人照顾者存在不同程度的照顾负担,社会应重视老年慢性病病人照顾者的负担,并采取积极有效的应对措施。%Obj ective:To know about the status quo of care burden of care-givers of senile patients with chronic diseases,to analyze the influencing factors of caregivers’burden.Methods:General information questionnaire of senile chronic diseases patients and their caregivers,and caregivers’bur-den scale were taken as the research tool.And convenient sampling method was used to survey caregivers of a total of 2 1 2 elderly patients with chronic disease.Results:Burden score of primary caregivers of elderly patients with chronic disease was (34.55 ± 17.78).Influencing factors of caregivers’ burden included relationship between caregiver and the patients,the age and course of disease of patients,and family economic status.Conclusion:Caregivers of elderly patients with chronic disease have different degrees of care burden,so society should think highly of the burden of caregivers of elderly patients with chronic disease,and take some positive and effective coping measures.

  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 women's decision making in hysterectomy.

    Science.gov (United States)

    Janda, Monika; Armfield, Nigel R; Page, Katie; Kerr, Gayle; Kurz, Suzanne; Jackson, Graeme; Currie, Jason; Weaver, Edward; Yazdani, Anusch; Obermair, Andreas

    2017-09-12

    To explore factors influencing how well-informed women felt about hysterectomy, influences on their decision making, and on them receiving a less-invasive alternative to open surgery. Online questionnaire, conducted in 2015-2016, of women who had received a hysterectomy in Australia, in the preceding two years. Questionnaires were completed by 2319/6000 women (39% response). Most women (n=2225; 96%) felt well-informed about hysterectomy. Women were more aware of the open abdominal approach (n=1798; 77%), than of less-invasive vaginal (n=1552; 67%), laparoscopic (n=1540; 66%), laparoscopic-assisted (n=1303; 56%), and robotic approaches (n=289; 12%). Most women (n=1435; 62%) reported their gynaecologist was the most influential information source. Women who received information about hysterectomy from a GP (OR=1.47; 95% CI 1.15-1.90), or from a gynaecologist (OR=1.3; 95% CI 1.06-1.58), were more likely to feel better informed (p<0.01). This study is important because it helps clinicians, researchers and health policy makers to understand why many women still receive an open abdominal approach despite many learned societies recommending to avoid it if possible. Additional information, or education about avoiding open abdominal approach where possible may lead to a greater number of women receiving less-invasive types of hysterectomy in the future. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  11. Factors influencing cerebrospinal fluid and plasma HIV-1 RNA detection rate in patients with and without opportunistic neurological disease during the HAART era

    Directory of Open Access Journals (Sweden)

    Aleixo Agdemir W

    2007-12-01

    Full Text Available Abstract Background In the central nervous system, HIV replication can occur relatively independent of systemic infection, and intrathecal replication of HIV-1 has been observed in patients with HIV-related and opportunistic neurological diseases. The clinical usefulness of HIV-1 RNA detection in the cerebrospinal fluid (CSF of patients with opportunistic neurological diseases, or the effect of opportunistic diseases on CSF HIV levels in patients under HAART has not been well defined. We quantified CSF and plasma viral load in HIV-infected patients with and without different active opportunistic neurological diseases, determined the characteristics that led to a higher detection rate of HIV RNA in CSF, and compared these two compartments. Methods A prospective study was conducted on 90 HIV-infected patients submitted to lumbar puncture as part of a work-up for suspected neurological disease. Seventy-one patients had active neurological diseases while the remaining 19 did not. Results HIV-1 RNA was quantified in 90 CSF and 70 plasma samples. The HIV-1 RNA detection rate in CSF was higher in patients with neurological diseases, in those with a CD4 count lower than 200 cells/mm3, and in those not receiving antiretroviral therapy, as well as in patients with detectable plasma HIV-1 RNA. Median viral load was lower in CSF than in plasma in the total population, in patients without neurological diseases, and in patients with toxoplasmic encephalitis, while no significant difference between the two compartments was observed for patients with cryptococcal meningitis and HIV-associated dementia. CSF viral load was lower in patients with cryptococcal meningitis and neurotoxoplasmosis under HAART than in those not receiving HAART. Conclusion Detection of HIV-1 RNA in CSF was more frequent in patients with neurological disease, a CD4 count lower than 200 cells/mm3 and detectable plasma HIV-1. Median HIV-1 RNA levels were generally lower in CSF than in

  12. Hospitalization Expenses Influencing Factors Analysis of Non-emergency Caesarean Section Patients%非急诊剖宫产住院费用影响因素的分析

    Institute of Scientific and Technical Information of China (English)

    李凌; 黄利娟; 谭小燕; 欧辉

    2016-01-01

    Objectives To study the hospitalization expenses and influencing factors of non-emergency caesarean section patients, and provide new theoretical evidence for improving the current clinical pathways. Methods To select the hospitalized medical records of non-emergency caesarean section patients of a hospital in Abstract Objectives To study the hospitalization expenses and influencing factors of non-emergency caesarean section patients, and provide new theoretical evidence for improving the current clinical pathways. Methods To select the hospitalized medical records of non-emergency caesarean section patients of a hospital in 2015, establish database, compare the total expenses of different groups with the application of variance analysis, and make multiple linear regression analysis on the influencing factors of total expenses. Results The average total hospitalization expenses was 6807.00 ± 1952.12 yuan in 2015,the median was 6522.11 yuan.The total hospitalization expenses were high in patients with more operation, the expenses of medical insurance payment patients were lower than other payment mode. The influencing factors included principal diagnosis, hospitalization days, waiting time before operation,delay time after operation, operation numbers and payment modes. Conclusions The control of average length of stay was still an effective method to control total hospitalization expenses, we should treat differently according to the pregnant women of different state of diseases, and also make reasonable programming of clinical pathways to decrease the economic burden of the patients.%目的:研究非急诊剖宫产住院费用及影响因素为改进现有临床路径提供新的理论依据。方法抽取某院2015年的非急诊的,以剖宫产手术为分娩方式的住院病案,建立数据库,采用方差分析比较不同分组的住院总费用,并使用多元线性回归分析住院总费用到影响因素。结果2015年某院

  13. Influencing factors on the posttreatment serologic outcome of syphilis patients%梅毒患者治疗后血清学转归的影响因素研究

    Institute of Scientific and Technical Information of China (English)

    黄瑛; 施监勇

    2015-01-01

    目的:探讨影响梅毒患者治疗后血清学转归的因素。方法:对2010年1月至2013年1月期间我院接收治疗的128例梅毒患者进行回顾性分析,观察患者在驱梅治疗后1年的血清固定和血清转阴的情况。对影响血清固定的患者的年龄、性别、病期、治疗药物和 RPR 初始滴度等因素进行多因素 Logistic 分析。结果:128例患者中有89例(69.5%)患者发生血清转阴,39例(30.5%)患者发生血清固定,且血清固定的发生率随着患者病期的增长而增多。多因素 Logistic 分析结果显示,驱梅治疗后与血清转阴相关的临床特征包括:一期梅毒、二期梅毒患者以及年龄≤25岁的年轻患者。驱梅治疗后患者发生血清固定的因素包括:女性患者、非苄星青霉素治疗和初始 RPR 滴度≤1∶16。结论:梅毒患者经过驱梅治疗后血清学固定和转阴与患者的性别、年龄、病期、治疗药物和 RPR 基线滴度有关。%Objectives:To investigate the influencing factors on the posttreatment serologic outcome of syphilis patients.Methods:128 syphilis patients received treatment in our hospital from January 2010 to January 2013 were retrospectively analyzed,to observe the serologic outcome one year after treatment.Logistic analysis on the patient's age,gender multivariate,stage of disease,treatment,medications,RPR initial titers and other factors was conducted.Results:Of the 128 patients,89 (69.5%)patients seroconverted,and 39 (30.5%)patients had sero -resistance,whose incidence increased with the growth of disease.Multivariate logistic regression analysis showed that the seroconverted clinical features after treatment included:primary syphilis,secondary syphilis patients aged ≤ 25 years of age.Influencing factors of sero -resistance included:female patients,non -Benzedrine peni-cillin treatment and initial RPR titer ≤ 1:16.Conclusion:The influencing factors on the posttreatment serologic

  14. 肝硬化患者自我管理现状及其影响因素的研究进展%Self management status and its influencing factors in patients with cirrhosis

    Institute of Scientific and Technical Information of China (English)

    陈楠楠; 吴丹

    2016-01-01

    该文对国内外肝硬化患者自我管理现状及其影响因素的研究进行综述。笔者通过了解肝硬化患者自我管理的现状,探究关于肝硬化系统的、全病程的护理管理方案提供可能和科学依据,以帮助肝硬化患者实行终身自我管理,促进积极的行为变化和生活方式的改变,减少卫生服务利用,影响和改善肝硬化患者的健康和生活质量。%In this paper,the domestic and international research for the status of self management of patients with liver cirrhosis and its influencing factors are reviewed,i.e through understanding the status of self-management of patients with liver cirrhosis,to explore the possibility and scientific basis for the nursing management in the whole course of disease of patients with cirrhosis and to help the patients with cirrhosis of the liver to implement all life self-management,and promote positive behavior changes and changes in life style,so that to reduce health services,affect and improve the patient's health and quality of life.