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Sample records for non-adherent population give

  1. Non-adherence to drug therapy and drug acquisition costs in a national population - a patient-based register study

    Science.gov (United States)

    2011-01-01

    Background Patients' non-adherence to drug therapy is a major problem for society as it is associated with reduced health outcomes. Generally, approximately only 50% of patients with chronic disease in developed countries adhere to prescribed therapy, and the most common non-adherence refers to chronic under-use, i.e. patients use less medication than prescribed or prematurely stop the therapy. Patients' non-adherence leads to high additional costs for society in terms of poor health. Non-adherence is also related to the unnecessary sale of drugs. The aim of the present study was to estimate the drug acquisition cost related to non-adherence to drug therapy in a national population. Methods We constructed a model of the drug acquisition cost related to non-adherence to drug therapy based on patient register data of dispensed out-patient prescriptions in the entire Swedish population during a 12-month period. In the model, the total drug acquisition cost was successively adjusted for the assumed different rates of primary non-adherence (prescriptions not being filled by the patient), and secondary non-adherence (medication not being taken as prescribed) according to the patient's age, therapies, and the number of dispensed drugs per patient. Results With an assumption of a general primary non-adherence rate of 3%, and a general secondary non-adherence rate of 50%, for all types of drugs, the acquisition cost related to non-adherence totalled SEK 11.2 billion (€ 1.2 billion), or 48.5% of total drug acquisition costs in Sweden 2006. With the assumption of varying primary non-adherence rates for different age groups and different secondary non-adherence rates for varying types of drug therapies, the acquisition cost related to non-adherence totalled SEK 9.3 billion (€ 1.0 billion), or 40.2% of the total drug acquisition costs. When the assumption of varying primary and secondary non-adherence rates for a different number of dispensed drugs per patient was added to

  2. Self-reported intentional and unintentional non-adherence to medication in a general practice population.

    NARCIS (Netherlands)

    Dijk, L. van; Dulmen, S. van; Sluijs, E.; Heerdink, R.; Ridder, D. de; Bensing, J.

    2006-01-01

    Background: Non-adherence to medication is a major public health problem all over the world. Poor adherence to medication regimes accounts for substantial worsening of disease and an increase in health care costs. Few studies on non-adherence distinguished between intentional and unintentional

  3. Factors related to non-adherence to mammography in a city of the Brazilian Amazonian area: A population-based study

    Directory of Open Access Journals (Sweden)

    Camila Iasmim de Andrade Souza

    Full Text Available Summary Objective: To assess the prevalence of mammography use and factors related to non-adherence in Boa Vista, capital of Roraima, Brazil. Method: A cross sectional study, quantitative analysis, based on household survey was performed between June and August 2013, using a face-to-face interview with a pre-tested form. Target population was women between 40 and 69 years. The sample size target was 240 participants, and the sampling method was random cluster sampling. The study was approved by the Institutional Review Board of Federal University of Roraima. Results: 241 women were included without refusals. The prevalence of non-use of mammography in the past two years was 55.6% (95CI 49.1-61.9. In univariate analysis, the risk factors for non-adherence to mammography were having low educational level, family income below three minimum wages, receiving government assistance, not having consulted with a doctor and no health insurance. In multivariate analysis, only low educational level and receiving government assistance remained as risk factors. Medical consultation or health worker visiting were protective factors. Conclusion: Adherence to mammography is unsatisfactory in Boa Vista, Roraima, and has a predominantly opportunistic character. Low educational level is confirmed as an independent risk factor, but belonging to a family that receives government assistance can be interpreted as a social marker of families and/or areas lacking of government intervention to increase access to breast cancer control programs.

  4. Cost-effectiveness of a tailored intervention designed to increase breast cancer screening among a non-adherent population: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ishikawa Yoshiki

    2012-09-01

    Full Text Available Abstract Background Although the percentage of women who initiate breast cancer screening is rising, the rate of continued adherence is poor. The purpose of this study was to examine the effectiveness and cost-effectiveness of a tailored print intervention compared with a non-tailored print intervention for increasing the breast cancer screening rate among a non-adherent population. Methods In total, 1859 participants aged 51–59 years (except those aged 55 years were recruited from a Japanese urban community setting. Participants were randomly assigned to receive either a tailored print reminder (tailored intervention group or non-tailored print reminder (non-tailored intervention group. The primary outcome was improvement in the breast cancer screening rate. The screening rates and cost-effectiveness were examined for each treatment group (tailored vs. non-tailored and each intervention subgroup during a follow-up period of five months. All analyses followed the intention-to-treat principle. Results The number of women who underwent a screening mammogram following the reminder was 277 (19.9% in the tailored reminder group and 27 (5.8% in the non-tailored reminder group. A logistic regression model revealed that the odds of a woman who received a tailored print reminder undergoing mammography was 4.02 times those of a women who had received a non-tailored print reminder (95% confidence interval, 2.67–6.06. The cost of one mammography screening increase was 2,544 JPY or 30 USD in the tailored intervention group and 4,366 JPY or 52 USD in the non-tailored intervention group. Conclusions Providing a tailored print reminder was an effective and cost-effective strategy for improving breast cancer screening rates among non-adherent women.

  5. Interruption and non-adherence to long-term adjuvant hormone therapy is associated with adverse survival outcome of breast cancer women--an Asian population-based study.

    Directory of Open Access Journals (Sweden)

    Kun-Pin Hsieh

    Full Text Available This study aimed to evaluate the survival rate of women with breast cancer (BC comparing persistence versus interruption and adherence versus non-adherence to adjuvant hormonal therapy (HT in Asian population. Newly-diagnosed BC women from 2003 to 2010 were retrospectively identified from the Taiwan National Health Insurance Research Database. HT prescriptions were extracted to define treatment interruption and medication possession ratio. Their impacts on mortality were estimated by Cox regression with time dependent covariates. Interruption (HR: 1.32; 95% CI: 1.20, 1.46; P<0.0001 and non-adherence (HR: 1.45; 95% CI: 1.32, 1.59; P<0.0001 to adjuvant HT were significantly associated with increased mortality. Interruption to tamoxifen in younger patients and in patients receiving surgery (OP with adjuvant chemotherapy (CT was associated with increasing mortality rate when compared with their counterparts. Non-adherence to AIs in both younger and senior age groups and in OP with CT group also resulted in increasing risk. Treatment interruption and non-adherence to adjuvant HT were found to be associated with the increasing all-cause mortality of the Asian BC women; a greater impact of interruption and non-adherence on mortality was especially found in the younger BC population.

  6. Errors and Non-adherence in Pediatric Oral Chemotherapy Use

    Science.gov (United States)

    Walsh, Kathleen; Ryan, Jamie; Daraiseh, Nancy; Pai, Ahna

    2016-01-01

    Background Non-adherence and medication error both limit the effectiveness of oral chemotherapy. The overlap between non-adherence and medication error is not well studied in children, and interventions strategies differ for each. Our objective was to describe non-adherence and errors in children with cancer to inform future interventions. Methods Non-adherence was measured using two self-report tools. Medication error was measured using medication review and observation of administration at home. Two clinicians made judgments about whether each error also represented an episode of non-adherence. Results Of 72 errors detected in 92 home visits, 27 were also instances of non-adherence. For example, parents gave a child 1 tablet of mercaptopurine every day rather than the prescribed 1 tablet 5 days a week and ½ tablet on weekends. Clinician reviewers judged that family interventions and health system interventions would be most effective in preventing the errors and non-adherence identified in this population of children with cancer. Discussion The relationship between medication errors and non-adherence is not well described in the literature. Our data indicate that medication error and non-adherence co-exist in the same population and in the same patient. Interventions should address both to most effectively support self-management. PMID:27487185

  7. Characterization of a distinct population of circulating human non-adherent endothelial forming cells and their recruitment via intercellular adhesion molecule-3.

    Directory of Open Access Journals (Sweden)

    Sarah L Appleby

    Full Text Available Circulating vascular progenitor cells contribute to the pathological vasculogenesis of cancer whilst on the other hand offer much promise in therapeutic revascularization in post-occlusion intervention in cardiovascular disease. However, their characterization has been hampered by the many variables to produce them as well as their described phenotypic and functional heterogeneity. Herein we have isolated, enriched for and then characterized a human umbilical cord blood derived CD133(+ population of non-adherent endothelial forming cells (naEFCs which expressed the hematopoietic progenitor cell markers (CD133, CD34, CD117, CD90 and CD38 together with mature endothelial cell markers (VEGFR2, CD144 and CD31. These cells also expressed low levels of CD45 but did not express the lymphoid markers (CD3, CD4, CD8 or myeloid markers (CD11b and CD14 which distinguishes them from 'early' endothelial progenitor cells (EPCs. Functional studies demonstrated that these naEFCs (i bound Ulex europaeus lectin, (ii demonstrated acetylated-low density lipoprotein uptake, (iii increased vascular cell adhesion molecule (VCAM-1 surface expression in response to tumor necrosis factor and (iv in co-culture with mature endothelial cells increased the number of tubes, tubule branching and loops in a 3-dimensional in vitro matrix. More importantly, naEFCs placed in vivo generated new lumen containing vasculature lined by CD144 expressing human endothelial cells (ECs. Extensive genomic and proteomic analyses of the naEFCs showed that intercellular adhesion molecule (ICAM-3 is expressed on their cell surface but not on mature endothelial cells. Furthermore, functional analysis demonstrated that ICAM-3 mediated the rolling and adhesive events of the naEFCs under shear stress. We suggest that the distinct population of naEFCs identified and characterized here represents a new valuable therapeutic target to control aberrant vasculogenesis.

  8. Characterization of a distinct population of circulating human non-adherent endothelial forming cells and their recruitment via intercellular adhesion molecule-3.

    Science.gov (United States)

    Appleby, Sarah L; Cockshell, Michaelia P; Pippal, Jyotsna B; Thompson, Emma J; Barrett, Jeffrey M; Tooley, Katie; Sen, Shaundeep; Sun, Wai Yan; Grose, Randall; Nicholson, Ian; Levina, Vitalina; Cooke, Ira; Talbo, Gert; Lopez, Angel F; Bonder, Claudine S

    2012-01-01

    Circulating vascular progenitor cells contribute to the pathological vasculogenesis of cancer whilst on the other hand offer much promise in therapeutic revascularization in post-occlusion intervention in cardiovascular disease. However, their characterization has been hampered by the many variables to produce them as well as their described phenotypic and functional heterogeneity. Herein we have isolated, enriched for and then characterized a human umbilical cord blood derived CD133(+) population of non-adherent endothelial forming cells (naEFCs) which expressed the hematopoietic progenitor cell markers (CD133, CD34, CD117, CD90 and CD38) together with mature endothelial cell markers (VEGFR2, CD144 and CD31). These cells also expressed low levels of CD45 but did not express the lymphoid markers (CD3, CD4, CD8) or myeloid markers (CD11b and CD14) which distinguishes them from 'early' endothelial progenitor cells (EPCs). Functional studies demonstrated that these naEFCs (i) bound Ulex europaeus lectin, (ii) demonstrated acetylated-low density lipoprotein uptake, (iii) increased vascular cell adhesion molecule (VCAM-1) surface expression in response to tumor necrosis factor and (iv) in co-culture with mature endothelial cells increased the number of tubes, tubule branching and loops in a 3-dimensional in vitro matrix. More importantly, naEFCs placed in vivo generated new lumen containing vasculature lined by CD144 expressing human endothelial cells (ECs). Extensive genomic and proteomic analyses of the naEFCs showed that intercellular adhesion molecule (ICAM)-3 is expressed on their cell surface but not on mature endothelial cells. Furthermore, functional analysis demonstrated that ICAM-3 mediated the rolling and adhesive events of the naEFCs under shear stress. We suggest that the distinct population of naEFCs identified and characterized here represents a new valuable therapeutic target to control aberrant vasculogenesis.

  9. Primary non-adherence to prescribed medication in general practice

    DEFF Research Database (Denmark)

    Linnet, Kristján; Halldórsson, Matthías; Thengilsdóttir, Gudrún

    2013-01-01

    prescriptions issued electronically by 140 physicians at 16 primary health care centres in the Reykjavik capital area during two periods before and after increases in copayment were matched with those dispensed in pharmacies, the difference constituting primary non-adherence (population: 200&emsp14......;000; patients: 21 571; prescriptions: 22 991). Eight drug classes were selected to reflect symptom relief and degree of copayment. Two-tailed chi-square test and odds ratios for non-adherence by patient copayment groups were calculated. RESULTS: The rate of primary non-adherence was 6...

  10. Factors associated with non-adherence to Artemisinin-based combination therapy (ACT) to malaria in a rural population from holoendemic region of western Kenya.

    Science.gov (United States)

    Onyango, Elizabeth O; Ayodo, George; Watsierah, Carren A; Were, Tom; Okumu, Wilson; Anyona, Samuel B; Raballah, Evans; Okoth, John M; Gumo, Sussy; Orinda, George O; Ouma, Collins

    2012-06-24

    Over the years, reports implicate improper anti-malarial use as a major contributor of morbidity and mortality amongst millions of residents in malaria endemic areas, Kenya included. However, there are limited reports on improper use of Artemisinin-based Combination Therapy (ACT) which is a first-line drug in the treatment of malaria in Kenya. Knowing this is important for ensured sustainable cure rates and also protection against the emergence of resistant malarial parasites. We therefore investigated ACT adherence level, factors associated with non-adherence and accessibility in households (n = 297) in rural location of Southeast Alego location in Siaya County in western Kenya. ACT Adherence level was assessed with reference to the duration of treatment and number of tablets taken. Using systematic random sampling technique, a questionnaire was administered to a particular household member who had the most recent malaria episode ( 9000; OR, 0.340; 95% CI, 0.167-0.694; P = 0.003) were associated with ACT adherence. In addition, about 52.9% of the respondents reported that ACT was not always available at the source and that drug availability (P = 0.020) and distance to drug source (P < 0.01) significantly affected accessibility. This study demonstrates that more than half of those who get ACT prescription do not take recommended dose and that accessibility is of concern. The findings of this study suggest a potential need to improve accessibility and also initiate programmatic interventions to encourage patient-centred care.

  11. A systematic review of medication non-adherence in persons with dementia or cognitive impairment

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    Weller, Carolina; Kennedy, Briohny; Winbolt, Margaret; Young, Carmel

    2017-01-01

    Background Adherence to medication is vital for disease management while simultaneously reducing healthcare expenditure. Older persons with cognitive impairment (CI) are at risk for non-adherence as cognitive processes are needed to manage medications. This systematic review focuses on the relationship between medication non-adherence and specific cognitive domains in persons with CI, and explores determinants of medication non-adherence. When available, relationships and factors are compared with cognitively intact populations. Methods A seven database systematic search of studies published between 1 January 1949–31 December 2015 examining medication non-adherence in community dwelling persons with CI or dementia was conducted. Articles reporting medication non-adherence in people with CI or dementia in the community, with or without caregiver supports were eligible for inclusion. Papers reporting adherence to treatments in cognitively intact populations, populations from hospital or institutional settings, for non-prescribed medication or those describing dementia as a factor predicting medication non-adherence were excluded. Data on study and population characteristics, research design, data sources and analysis, specific cognitive domains, non-adherence prevalence, measurement of adherence, salient findings, factors associated with adherence and strategies to improve medication adherence were extracted. Study limitations included inconsistencies between data sources and definitions, resulting in a loss of fidelity in the value and comprehensiveness of data, as well as exclusion of non-pharmacological treatments and regimens. Findings Fifteen studies met inclusion criteria. Adherence among CI subjects ranged from 10.7%-38% with better rates of adherence in non-CI individuals. Medication non-adherence definitions varied considerably. New-learning, memory and executive functioning were associated with improved adherence and formed the focus of most studies

  12. Factors associated with antidiabetic medication non-adherence in patients with incident comorbid depression.

    Science.gov (United States)

    Lunghi, Carlotta; Zongo, Arsène; Moisan, Jocelyne; Grégoire, Jean-Pierre; Guénette, Line

    2017-07-01

    To identify factors associated with antidiabetic drug (AD) non-adherence among patients with type 2 diabetes and depression. We conducted a population-based retrospective cohort study among new AD users with a diagnosis of depression following AD initiation. We used public health insurance data from Quebec. The dependent variable was non-adherence (i.e., non-adherence to AD treatment. We performed univariate and multivariate logistic regressions. We identified 3106 new users of ADs with a diagnosis of depression between 2000 and 2006. Of these individuals, 52% were considered non-adherent to their ADs. Baseline non-adherence, younger age, the addition of another AD to the initial treatment, non-adherence. The factors identified in the present study may help clinicians recognize patients with type 2 diabetes and incident depression at increased risk for non-adherence. In these patients, close follow-up and targeted interventions could help improve adherence to AD treatment, improve glycemic control and reduce complications. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Patient Non-adherence and Cancellations Are Higher for Screening Colonoscopy Compared with Surveillance Colonoscopy.

    Science.gov (United States)

    Greenspan, Michael; Chehl, Navdeep; Shawron, Krista; Barnes, Lisa; Li, Hong; Avery, Elizabeth; Sims, Shannon; Losurdo, John; Mobarhan, Sohrab; Melson, Joshua

    2015-10-01

    A significant proportion of the eligible population is non-adherent to colonoscopy for colorectal cancer (CRC) screening. To define the demographic and clinical variables associated with non-adherence and multiple cancellations to scheduled colonoscopy within 1 year in a CRC screening and adenomatous polyp surveillance population. This was an observational cohort study of 617 consecutive patients scheduled to undergo colonoscopy at an outpatient academic tertiary care center for CRC screening or adenomatous polyp surveillance from January 2012 to September 2012. Overall, 551 patients (89.3%) were adherent and 66 (10.7%) were non-adherent to scheduled colonoscopy at 1 year. The relative risk for non-adherence was 5.42 [95% confidence interval (CI) 2.74-10.75] in patients undergoing colonoscopy for screening compared to those for surveillance (16.7 vs. 3.5% non-adherence, respectively, P non-adherence [odds ratio (OR) 12.69, 95% CI 4.18-38.51] and multiple cancellations (OR 2.33, 95% CI 1.27-4.31) by multiple regression analysis. Patients undergoing colonoscopy for CRC screening are significantly less likely to attend their scheduled procedure within a year and have more procedure cancellations than those undergoing surveillance colonoscopy.

  14. Non-adherence in difficult asthma and advances in detection.

    Science.gov (United States)

    Lindsay, John T; Heaney, Liam G

    2013-12-01

    Non-adherence to anti-inflammatory therapies is common in patients referred for specialist assessment at difficult-to-treat asthma services. In the difficult asthma setting, non-adherence to treatment is associated with poor baseline asthma control, increased frequency of exacerbations and asthma-related hospitalizations, as well as increased risk of death. Here, we present a review of the current literature surrounding the prevalence and risks of non-adherence in difficult asthma and we report on current methods of measuring treatment adherence and advances in the detection of non-adherence. We will also explore methods by which non-adherence in difficult asthma can be addressed.

  15. Non-adherence in patients on peritoneal dialysis: a systematic review.

    Directory of Open Access Journals (Sweden)

    Konstadina Griva

    Full Text Available BACKGROUND: It has been increasingly recognized that non-adherence is an important factor that determines the outcome of peritoneal dialysis (PD therapy. There is therefore a need to establish the levels of non-adherence to different aspects of the PD regimen (dialysis procedures, medications, and dietary/fluid restrictions. METHODS: A systematic review of peer-reviewed literature was performed in PubMed, PsycINFO and CINAHL databases using PRISMA guidelines in May 2013. Publications on non-adherence in PD were selected by two reviewers independently according to predefined inclusion and exclusion criteria. Relevant data on patient characteristics, measures, rates and factors associated with non-adherence were extracted. The quality of studies was also evaluated independently by two reviewers according to a revised version of the Effective Public Health Practice Project assessment tool. RESULTS: The search retrieved 204 studies, of which a total of 25 studies met inclusion criteria. Reported rates of non-adherence varied across studies: 2.6-53% for dialysis exchanges, 3.9-85% for medication, and 14.4-67% for diet/fluid restrictions. Methodological differences in measurement and definition of non-adherence underlie the observed variation. Factors associated with non-adherence that showed a degree of consistency were mostly socio-demographical, such as age, employment status, ethnicity, sex, and time period on PD treatment. CONCLUSION: Non-adherence to different dimensions of the dialysis regimen appears to be prevalent in PD patients. There is a need for further, high-quality research to explore these factors in more detail, with the aim of informing intervention designs to facilitate adherence in this patient population.

  16. Non-Adherence in Patients on Peritoneal Dialysis: A Systematic Review

    Science.gov (United States)

    Griva, Konstadina; Lai, Alden Yuanhong; Lim, Haikel Asyraf; Yu, Zhenli; Foo, Marjorie Wai Yin; Newman, Stanton P.

    2014-01-01

    Background It has been increasingly recognized that non-adherence is an important factor that determines the outcome of peritoneal dialysis (PD) therapy. There is therefore a need to establish the levels of non-adherence to different aspects of the PD regimen (dialysis procedures, medications, and dietary/fluid restrictions). Methods A systematic review of peer-reviewed literature was performed in PubMed, PsycINFO and CINAHL databases using PRISMA guidelines in May 2013. Publications on non-adherence in PD were selected by two reviewers independently according to predefined inclusion and exclusion criteria. Relevant data on patient characteristics, measures, rates and factors associated with non-adherence were extracted. The quality of studies was also evaluated independently by two reviewers according to a revised version of the Effective Public Health Practice Project assessment tool. Results The search retrieved 204 studies, of which a total of 25 studies met inclusion criteria. Reported rates of non-adherence varied across studies: 2.6–53% for dialysis exchanges, 3.9–85% for medication, and 14.4–67% for diet/fluid restrictions. Methodological differences in measurement and definition of non-adherence underlie the observed variation. Factors associated with non-adherence that showed a degree of consistency were mostly socio-demographical, such as age, employment status, ethnicity, sex, and time period on PD treatment. Conclusion Non-adherence to different dimensions of the dialysis regimen appears to be prevalent in PD patients. There is a need for further, high-quality research to explore these factors in more detail, with the aim of informing intervention designs to facilitate adherence in this patient population. PMID:24586478

  17. Primary non-adherence to prescribed medication in general practice: lack of influence of moderate increases in patient copayment.

    Science.gov (United States)

    Linnet, Kristján; Halldórsson, Matthías; Thengilsdóttir, Gudrún; Einarsson, Ólafur B; Jónsson, Kristinn; Almarsdóttir, Anna B

    2013-02-01

    Primary non-adherence refers to the patient not redeeming a prescribed medication at some point during drug therapy. Research has mainly focused on secondary non-adherence. Prior to this study, the overall rate of primary non-adherence in general practice in Iceland was not known. To determine the prevalence of primary non-adherence, test whether it is influenced by a moderate increase in patient copayment implemented in 2010 and examine the difference between copayment groups (general versus concession patients). A population-based data linkage study, wherein prescriptions issued electronically by 140 physicians at 16 primary health care centres in the Reykjavik capital area during two periods before and after increases in copayment were matched with those dispensed in pharmacies, the difference constituting primary non-adherence (population: 200 000; patients: 21 571; prescriptions: 22 991). Eight drug classes were selected to reflect symptom relief and degree of copayment. Two-tailed chi-square test and odds ratios for non-adherence by patient copayment groups were calculated. The rate of primary non-adherence was 6.2%. It was lower after the increased copayment, reaching statistical significance for hypertensive agents, non-steroidal anti-inflammatory drugs (NSAIDs) and antipsychotics. Generally, primary non-adherence, except for antibacterials and NSAIDs, was highest in old-age pensioners. Primary non-adherence in Icelandic general practice was within the range of prior studies undertaken in other countries and was not adversely affected by the moderate increase in patient copayment. Older patients showed a different pattern of primary non-adherence. This may possibly be explained by higher prevalence of medicine use.

  18. Psychosocial predictors of non-adherence to chronic medication: systematic review of longitudinal studies

    Science.gov (United States)

    Zwikker, Hanneke E; van den Bemt, Bart J; Vriezekolk, Johanna E; van den Ende, Cornelia H; van Dulmen, Sandra

    2014-01-01

    Objectives Several cross-sectional studies suggest that psychosocial factors are associated with non-adherence to chronic preventive maintenance medication (CPMM); however, results from longitudinal associations have not yet been systematically summarized. Therefore, the objective of this study was to systematically synthesize evidence of longitudinal associations between psychosocial predictors and CPMM non-adherence. Materials and methods PUBMED, EMBASE, CINAHL, and PsychINFO databases were searched for studies meeting our inclusion criteria. The reference lists and the ISI Web of Knowledge of the included studies were checked. Studies were included if they had an English abstract, involved adult populations using CPMM living in Western countries, and if they investigated associations between psychosocial predictors and medication non-adherence using longitudinal designs. Data were extracted according to a literature-based extraction form. Study quality was independently judged by two researchers using a framework comprising six bias domains. Studies were considered to be of high quality if ≥four domains were free of bias. Psychosocial predictors for non-adherence were categorized into five pre-defined categories: beliefs/cognitions; coping styles; social influences and social support; personality traits; and psychosocial well-being. A qualitative best evidence synthesis was performed to synthesize evidence of longitudinal associations between psychosocial predictors and CPMM non-adherence. Results Of 4,732 initially-identified studies, 30 (low-quality) studies were included in the systematic review. The qualitative best evidence synthesis demonstrated limited evidence for absence of a longitudinal association between CPMM non-adherence and the psychosocial categories. The strength of evidence for the review’s findings is limited by the low quality of included studies. Conclusion The results do not provide psychosocial targets for the development of new

  19. Prevalence of non-adherence among psychiatric patients in Jordan, a cross sectional study.

    Science.gov (United States)

    Mukattash, Tareq L; Alzoubi, Karem H; Abu El-Rub, Ejlal; Jarab, Anan S; Al-Azzam, Sayer I; Khdour, Maher; Shara, Mohd; Al Hamarneh, Yazid N

    2016-05-01

    It has been estimated that up to 50% of any patient population is at least partially non-adherent to their prescribed treatment. Identifying barriers to adherence is required to develop effective interventions for psychiatric patients. To explore the prevalence and factors of non-adherence among psychiatric patients present at four psychiatric clinics. A cross-sectional questionnaire-based study. A sample of psychiatric patients attending outpatient psychiatric clinics was enrolled between March and April 2011. A total of 243 psychiatric patients took part in this study with the majority of patients (92.5%) being prescribed more than one psychiatric disorder. The majority (64.2%) of the patients was classified as non-adherent according to the Morisky adherence questionnaire and forgetfulness was the most prevalent reason for that. Non-adherence is a common and important issue among psychiatric patients. Polypharmacy, safety concerns and lack of insight towards the prescribed treatment were reported as the main reasons of non-adherence. © 2016 Royal Pharmaceutical Society.

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

    Science.gov (United States)

    Dalvi, Vidya; Mekoth, Nandakumar

    2017-04-18

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

  1. Treatment non-adherence among patients with poorly controlled ...

    African Journals Online (AJOL)

    2014-03-01

    Mar 1, 2014 ... recommendations among patients with type 2 diabetes,. Treatment ... ance of economic instability, low literacy level, and re- stricted access to .... model22 to assess non-adherence behavior of patients. RIM model is a ...

  2. Non-adherence to topical treatments for actinic keratosis

    Science.gov (United States)

    Shergill, Bav; Zokaie, Simon; Carr, Alison J

    2014-01-01

    Background There is limited information on the patterns of use, adherence rates, and factors that impact adherence with topical treatments for actinic keratosis (AK). Objectives To establish patterns of use and adherence with topical treatments for AK and to identify treatment-related factors that impact on adherence. Methods A community-based, cross-sectional study was performed using a standardized questionnaire completed online or via telephone interview. Patients were stratified according to the presence of AK lesions on the scalp and/or other extremities; and presence of scarring resulting from treatment. Results This study included 305 patients with AK who were currently using a patient-applied topical therapy for AK or had used one within the previous 12 months. In total, 88% (n = 268/305) of patients were either non-adherent, non-persistent or both non-adherent and non-persistent to topical therapy. Duration of treatment was associated with increasing rates of non-adherence (adjusted odds ratio [OR]; for treatment durations greater than 4 weeks, 2.2, P < 0.01): 52% of patients were non-adherent with 3–4 week treatment duration; 69% of patients with 4–8 week treatment duration; and 71% of patients with 6–12 week treatment duration. There were similar increases in non-persistence with increasing treatment duration (adjusted OR; for treatment durations greater than 4 weeks, 2.1, P < 0.05). Conclusion This study found high rates of non-adherence and non-persistence in patients with AK. Duration of treatment was a significant factor contributing to non-adherence and non-persistence to topical treatments. Patient-applied topical therapies that require less frequent application and have shorter treatment duration may be associated with improved adherence rates. PMID:24379656

  3. Treatment non-adherence in pseudo-refractory epilepsy.

    Science.gov (United States)

    Brodtkorb, Eylert; Samsonsen, Christian; Sund, Janne Kutschera; Bråthen, Geir; Helde, Grethe; Reimers, Arne

    2016-05-01

    Non-adherence to antiepileptic drug treatment strongly affects the outcome of epilepsy and is frequently clinically unrecognized. This review addresses current knowledge on medication-taking behavior in people with epilepsy, as well as the importance of tailoring interventions to the individual patterns of non-adherence. Non-adherence can be categorized as non-initiation, poor execution (accidental or intentional) or non-persistence and are related to clinical characteristics and health care barriers. All available methods to assess adherence are hampered by shortcomings. Self-reports are indirect and subjective. Pill-counts, electronic bottle-tops and pharmacy records are objective, but indirect measures of drug ingestion. Therapeutic drug monitoring is both direct and objective, but pharmacokinetic and diurnal variability must be taken into account. Young adults with generalized epilepsy may be particularly vulnerable to non-adherence. The drug burden in the form of polytherapy, multiple dosing and side effects are obvious obstacles. Poor understanding of the principles of prophylactic treatment as well as drug costs may be important in people with low socioeconomic status. Depression is also associated with low adherence. In people with multihandicaps, failed oral intake may be due to behavioral or physical problems, as well as insufficient education of the caregivers. Non-adherence often results in seizure breakthrough and hospital admissions, but the consequences may be more dramatic. It is the leading cause of status epilepticus in people with epilepsy, and the association with sudden death (SUDEP) is clear. The management of poor drug-taking behavior should be based on the identification of the specific causes in each individual and corresponding multiprofessional interventions. Non-adherence to antiepileptic drugs needs more clinical and scientific attention.

  4. Comparing patient dissatisfaction and rational judgment in intentional medication non-adherence versus unintentional non-adherence.

    Science.gov (United States)

    Iihara, N; Nishio, T; Okura, M; Anzai, H; Kagawa, M; Houchi, H; Kirino, Y

    2014-02-01

    Patients' poor adherence to medications is reported to be related to the individual patients' beliefs and cognitions and their trust of the medical staff. However, the causes of the two forms of non-adherence, intentional and unintentional behaviours, have yet to be clarified. This study compared psychological latent factors associated with intentional and unintentional non-adherence to chronic medication regimens, focusing on the potential effects of (i) patients' dissatisfaction with treatment and their relationships with the medical staff and (ii) patients' subliminal rational thinking processes, which weighed the positive values such as their expectations of benefits from treatment against negative values such as their dissatisfaction. Two cross-sectional surveys were undertaken of patients given medications for chronic diseases, using a questionnaire developed and validated in this study. One survey was undertaken in three hospitals and the other survey, online throughout Japan. We scored the individual latent factors using the questionnaire and calculated the differential score between two negatively correlated latent factors to quantify patients' subliminal rational thinking process. We compared the adjusted odds ratio (OR) of latent factors between intentional and unintentional non-adherence to medication in both surveys. Of the eligible subjects, 149 hospitalized patients and 524 survey participants completed the questionnaire. Intentional non-adherence was associated with patient dissatisfaction with treatment including interpersonal relationships with medical staff in both hospitalized patients and online survey participants (95% confidence interval of adjusted OR for Dissatisfaction, 1·20-16·26 in the hospital-based survey and 1·33-3·45 in the online survey). In both surveys, intentional non-adherence was significantly associated with the differential score between two negatively correlated latent factors, Willingness and Dissatisfaction (P = 0

  5. Microfluidic bioreactors for culture of non-adherent cells

    DEFF Research Database (Denmark)

    Shah, Pranjul Jaykumar; Vedarethinam, Indumathi; Kwasny, Dorota

    2011-01-01

    Microfluidic bioreactors (μBR) are becoming increasingly popular for cell culture, sample preparation and analysis in case of routine genetic and clinical diagnostics. We present a novel μBR for non-adherent cells designed to mimic in vivo perfusion of cells based on diffusion of media through...

  6. Identification of medication non-adherence factors in adolescent transplant patients: the patient's viewpoint.

    Science.gov (United States)

    Bullington, Pamela; Pawola, Larry; Walker, Rosemary; Valenta, Annette; Briars, Leslie; John, Eunice

    2007-12-01

    Studies report a clear association between medication non-adherence and an unfavorable transplant outcome. The adolescent population, in particular, has difficulty adhering to post-transplant medication regimens. The purpose of this study is to identify, categorize and understand the opinions of adolescent transplant patients regarding why they may not take their medications as prescribed. From January to August 2005, nine adolescent kidney transplant patients at an urban medical center were surveyed and asked to rank-order 33 statements regarding their opinions on why adolescents may not take their medications as prescribed. Q-methodology, a powerful tool in subjective study, was used to identify and categorize the viewpoints of adolescents on this subject. Three factors emerged and were labeled to reflect their distinct viewpoints: (1) Medication Issues (e.g. taste, size, frequency, schedule), (2) Troubled Adolescent (e.g. poor home life, depression, overwhelming situation), and (3) Deliberate Non-Adherer (e.g. attention-seeker, infallible attitude). By understanding these different viewpoints and the factors that contribute to them, it may be easier to identify which management approach to non-adherence works best in specific subgroups of patients.

  7. Non-adherence to topical treatments for actinic keratosis

    Directory of Open Access Journals (Sweden)

    Shergill B

    2013-12-01

    Full Text Available Bav Shergill,1 Simon Zokaie,2 Alison J Carr3 1Department of Dermatology, Brighton and Sussex University Hospitals, Elm Grove, Brighton, UK; 2Leo Pharma, Princes Risborough, 3Hamell, London, UK Background: There is limited information on the patterns of use, adherence rates, and factors that impact adherence with topical treatments for actinic keratosis (AK. Objectives: To establish patterns of use and adherence with topical treatments for AK and to identify treatment-related factors that impact on adherence. Methods: A community-based, cross-sectional study was performed using a standardized questionnaire completed online or via telephone interview. Patients were stratified according to the presence of AK lesions on the scalp and/or other extremities; and presence of scarring resulting from treatment. Results: This study included 305 patients with AK who were currently using a patient-applied topical therapy for AK or had used one within the previous 12 months. In total, 88% (n = 268/305 of patients were either non-adherent, non-persistent or both non-adherent and non-persistent to topical therapy. Duration of treatment was associated with increasing rates of non-adherence (adjusted odds ratio [OR]; for treatment durations greater than 4 weeks, 2.2, P < 0.01: 52% of patients were non-adherent with 3–4 week treatment duration; 69% of patients with 4–8 week treatment duration; and 71% of patients with 6–12 week treatment duration. There were similar increases in non-persistence with increasing treatment duration (adjusted OR; for treatment durations greater than 4 weeks, 2.1, P < 0.05. Conclusion: This study found high rates of non-adherence and non-persistence in patients with AK. Duration of treatment was a significant factor contributing to non-adherence and non-persistence to topical treatments. Patient-applied topical therapies that require less frequent application and have shorter treatment duration may be associated with improved

  8. Predictors of medication non-adherence for vasculitis patients

    Science.gov (United States)

    Hogan, Susan L.; DeVellis, Robert F.

    2013-01-01

    The primary purpose of this article is to document whether demographic, clinical, regimen-related, intrapersonal, and interpersonal factors predict medication non-adherence for vasculitis patients. A secondary purpose is to explore whether adherence varies by medication type and whether patients experienced drug-related side effects. Vasculitis patients (n=228) completed online baseline and 3-month follow-up surveys. Demographic (age, gender, education, race, marital status, and insurance status), clinical (perceived vasculitis severity, disease duration, vasculitis type, and relapse/remission status), regimen-related (experience of side effects), intrapersonal (depressive symptoms), and interpersonal (adherence-related support from family and friends) factors were measured at baseline. Medication non-adherence was assessed at follow-up using the Vasculitis Self-Management Survey medication adherence sub-scale (α=0.89). Variables that significantly correlated (pvasculitis medication types, patients who experienced side effects were less adherent than patients who did not experience side effects. Multiple factors are associated with medication non-adherence for vasculitis patients. Providers should discuss medication adherence and drug-related side effects with vasculitis patients. Providers may want to particularly target younger patients and patients with clinical signs of depression. PMID:23314654

  9. Do patients initiate therapy? Primary non-adherence to statins and antidepressants in Iceland

    NARCIS (Netherlands)

    Thengilsdõttir, G.; Pottegård, A.; Linnet, K.; Halldõrsson, M.; Almarsdõttir, A. B.; Gardarsdõttir, H.

    2015-01-01

    Background Primary non-adherence occurs when a drug has been prescribed but the patient fails to have it dispensed at the pharmacy. Aims To assess primary non-adherence to statins and antidepressants in Iceland, the association of demographic factors with primary non-adherence, and the time from whe

  10. Do patients initiate therapy? Primary non-adherence to statins and antidepressants in Iceland

    NARCIS (Netherlands)

    Thengilsdõttir, G.; Pottegård, A.; Linnet, K.; Halldõrsson, M.; Almarsdõttir, A. B.; Gardarsdõttir, H.

    BackgroundPrimary non-adherence occurs when a drug has been prescribed but the patient fails to have it dispensed at the pharmacy. AimsTo assess primary non-adherence to statins and antidepressants in Iceland, the association of demographic factors with primary non-adherence, and the time from when

  11. Development of new concepts of non-adherence measurements among users of antihypertensives medicines

    DEFF Research Database (Denmark)

    Kjeldsen, Lene Juel; Bjerrum, Lars; Herborg, Hanne;

    2011-01-01

    nonadherence (associated with aspects of self-regulation and effect concerns, respectively) and one measure of non-intentional non-adherence. Prevalence of the developed measures of behaviour related non-adherence ranged from 10.3 to 34.9% depending on which type of non-adherence measure was used. Established...... measures of non-adherence resulted in prevalence between 2.2 and 39.6%. CONCLUSIONS: The study showed that concepts of non-adherence measurements could be determined including self-efficacy aspects, unintentional non-adherence and intentional non-adherence related to self-regulation and effect concerns......: Users of antihypertensive medication were included in the study. 2,914 medication users received questionnaires by mail. Participating patients were asked to fill in two questionnaire regarding demographics, self-reported blood pressure, and various adherence measures. Two factor analyses were conducted...

  12. Measuring and modelling the effects of systematic non-adherence to mass drug administration.

    Science.gov (United States)

    Dyson, Louise; Stolk, Wilma A; Farrell, Sam H; Hollingsworth, T Déirdre

    2017-03-01

    It is well understood that the success or failure of a mass drug administration campaign critically depends on the level of coverage achieved. To that end coverage levels are often closely scrutinised during campaigns and the response to underperforming campaigns is to attempt to improve coverage. Modelling work has indicated, however, that the quality of the coverage achieved may also have a significant impact on the outcome. If the coverage achieved is likely to miss similar people every round then this can have a serious detrimental effect on the campaign outcome. We begin by reviewing the current modelling descriptions of this effect and introduce a new modelling framework that can be used to simulate a given level of systematic non-adherence. We formalise the likelihood that people may miss several rounds of treatment using the correlation in the attendance of different rounds. Using two very simplified models of the infection of helminths and non-helminths, respectively, we demonstrate that the modelling description used and the correlation included between treatment rounds can have a profound effect on the time to elimination of disease in a population. It is therefore clear that more detailed coverage data is required to accurately predict the time to disease elimination. We review published coverage data in which individuals are asked how many previous rounds they have attended, and show how this information may be used to assess the level of systematic non-adherence. We note that while the coverages in the data found range from 40.5% to 95.5%, still the correlations found lie in a fairly narrow range (between 0.2806 and 0.5351). This indicates that the level of systematic non-adherence may be similar even in data from different years, countries, diseases and administered drugs. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  13. Assessment of "corticophobia" as an indicator of non-adherence to topical corticosteroids: A pilot study.

    Science.gov (United States)

    Mueller, Simon M; Itin, Peter; Vogt, Deborah R; Walter, Marc; Lang, Undine; Griffin, Liezel L; Euler, Sebastian

    2017-03-01

    Concerns regarding topical corticosteroid (TCS) use, broadly known as "corticophobia", are highly prevalent among dermatology patients and often result in non-adherence to TCS. This non-adherence contributes to poor disease control and increased health care costs. However, it is unknown if assessment of these concerns might help to identify patients at risk of TCS-non-adherence. Clinical tools indicating non-adherence could be helpful to improve management of this patient group. To assess whether the available tools for measuring concerns regarding corticosteroids, the TOPICOP scale and the 0-10 Visual Analogue Scale (VAS), could help to detect non-adherence to TCS. In 75 patients with concerns regarding TCS use both the TOPICOP scale and VAS were anonymously assessed. A comparison was made between TCS-adherent and non-adherent patients regarding the intensity and characteristics of their concerns. The intensity and quality of the concerns varied broadly among the patients. When using the VAS, a score of ≥5 detected 87% of non-adherent patients. The answers to the TOPICOP scale did not discriminate non-adherent from adherent patients. Using the VAS to assess concerns to use TCS could help identify patients at risk of TCS-non-adherence and facilitate discussion with the patient about potential non-adherence in a more substantiated, non-judgemental way.

  14. Forgiveness of non-adherence to HIV-1 antiretroviral therapy.

    Science.gov (United States)

    Shuter, Jonathan

    2008-04-01

    Superior adherence to HIV-1 antiretroviral therapy is a mainstay of successful HIV management. Studies performed in the early era of highly active antiretroviral therapy demonstrated the need for > or =95% adherence in order to achieve and sustain viral suppression. High rates of viral suppression have been observed at more moderate levels of adherence with newer antiretroviral regimens. The term 'forgiveness' is being used to describe the ability of a regimen to achieve and sustain viral suppression, despite suboptimal adherence. A variety of pharmacological, viral and host properties determine the level of forgiveness of any specific regimen. As the choice of treatment options continues to expand, forgiveness of non-adherence is likely to emerge as an increasingly important factor in therapeutic decision-making.

  15. Targeting Medication Non-Adherence Behavior in Selected Autoimmune Diseases: A Systematic Approach to Digital Health Program Development.

    Science.gov (United States)

    van Mierlo, Trevor; Fournier, Rachel; Ingham, Michael

    2015-01-01

    29 autoimmune diseases, including Rheumatoid Arthritis, gout, Crohn's Disease, and Systematic Lupus Erythematosus affect 7.6-9.4% of the population. While effective therapy is available, many patients do not follow treatment or use medications as directed. Digital health and Web 2.0 interventions have demonstrated much promise in increasing medication and treatment adherence, but to date many Internet tools have proven disappointing. In fact, most digital interventions continue to suffer from high attrition in patient populations, are burdensome for healthcare professionals, and have relatively short life spans. Digital health tools have traditionally centered on the transformation of existing interventions (such as diaries, trackers, stage-based or cognitive behavioral therapy programs, coupons, or symptom checklists) to electronic format. Advanced digital interventions have also incorporated attributes of Web 2.0 such as social networking, text messaging, and the use of video. Despite these efforts, there has not been little measurable impact in non-adherence for illnesses that require medical interventions, and research must look to other strategies or development methodologies. As a first step in investigating the feasibility of developing such a tool, the objective of the current study is to systematically rate factors of non-adherence that have been reported in past research studies. Grounded Theory, recognized as a rigorous method that facilitates the emergence of new themes through systematic analysis, data collection and coding, was used to analyze quantitative, qualitative and mixed method studies addressing the following autoimmune diseases: Rheumatoid Arthritis, gout, Crohn's Disease, Systematic Lupus Erythematosus, and inflammatory bowel disease. Studies were only included if they contained primary data addressing the relationship with non-adherence. Out of the 27 studies, four non-modifiable and 11 modifiable risk factors were discovered. Over one

  16. Unintentional non-adherence to chronic prescription medications: How unintentional is it really?

    Directory of Open Access Journals (Sweden)

    Gadkari Abhijit S

    2012-06-01

    Full Text Available Abstract Background Unintentional non-adherence has been characterized as passively inconsistent medication-taking behavior (forgetfulness or carelessness. Our objectives were to: (1 study the prevalence and predictors of unintentional non-adherence; and (2 explore the interrelationship between intentional and unintentional non-adherence in relation to patients’ medication beliefs. Methods We conducted a cross-sectional survey of adults with asthma, hypertension, diabetes, hyperlipidemia, osteoporosis, or depression from the Harris Interactive Chronic Illness Panel. The analytic sample for this study included 24,017 adults who self-identified themselves as persistent to prescription medications for their index disease. They answered three questions on unintentional non-adherence (forgot, ran out, being careless, 11 questions on intentional non-adherence, and three multi-item scales assessing perceived need for medication (k = 10, perceived medication concerns (k = 6, and perceived medication affordability (k = 4. Logistic regression was used to model predictors of each unintentional non-adherence behavior. Baron and Kenny’s regression approach was used to test the mediational effect of unintentional non-adherence on the relationship between medication beliefs and intentional non-adherence. Bootstrapping was employed to confirm the statistical significance of these results. Results For the index disease, 62% forgot to take a medication, 37% had run out of the medication, and 23% were careless about taking the medication. Common multivariate predictors (p  Conclusions For our study sample, unintentional non-adherence does not appear to be random and is predicted by medication beliefs, chronic disease, and sociodemographics. The data suggests that the importance of unintentional non-adherence may lie in its potential prognostic significance for future intentional non-adherence. Health care providers may consider routinely

  17. Factors associated with intentional and unintentional non-adherence to adjuvant endocrine therapy following breast cancer.

    Science.gov (United States)

    Brett, J; Fenlon, D; Boulton, M; Hulbert-Williams, N J; Walter, F M; Donnelly, P; Lavery, B; Morgan, A; Morris, C; Watson, E

    2016-11-30

    Adherence to adjuvant endocrine therapy (AET) following breast cancer is known to be suboptimal despite its known efficacy in reducing recurrence and mortality. This study aims to investigate factors associated with non-adherence and inform the development of interventions to support women and promote adherence. A questionnaire survey to measure level of adherence, side effects experienced, beliefs about medicine, support received and socio-demographic details was sent to 292 women 2-4 years post breast cancer diagnosis. Differences between non-adherers and adherers to AET were explored, and factors associated with intentional and unintentional non-adherence are reported. Approximately one quarter of respondents, 46 (22%), were non-adherers, comprising 29 (14%) intentional non-adherers and 17 (8%) unintentional non-adherers. Factors significantly associated with intentional non-adherence were the presence of side effects (p adherence were younger age (adherence and unintentional non-adherence. Differentiation between the two types of non-adherence may help tailor support and advice interventions. © 2016 John Wiley & Sons Ltd.

  18. Personality and medication non-adherence among older adults enrolled in a six-year trial

    Science.gov (United States)

    Jerant, Anthony; Chapman, Benjamin; Duberstein, Paul; Robbins, John; Franks, Peter

    2011-01-01

    Objectives Personality factors parsimoniously capture the variation in dispositional characteristics that affect behaviours, but their value in predicting medication non-adherence is unclear. We investigated the relationship between five-factor model personality factors (Conscientiousness, Neuroticism, Agreeableness, Extraversion, and Openness) and medication non-adherence among older participants during a six-year randomized placebo-controlled trial (RCT). Design Observational cohort data from 771 subjects aged ≥72 years enrolled in the Ginkgo Evaluation of Memory study, a RCT of Ginkgo biloba for prevention of dementia. Methods Random effects logistic regression analyses examined effects of NEO Five-Factor Inventory scores on medication non-adherence, determined via pill counts every 6 months (median follow-up 6.1 years) and defined as taking personality factor associated with non-adherence: a 1 SD increase was associated with a 3.8% increase in the probability of non-adherence (95% CI [0.4, 7.2]). Lower cognitive function was also associated with non-adherence: a 1 SD decrease in mental status exam score was associated with a 3.0% increase in the probability of non-adherence (95% CI [0.2, 5.9]). Conclusions Neuroticism was associated with medication non-adherence over 6 years of follow-up in a large sample of older RCT participants. Personality measurement in clinical and research settings might help to identify and guide interventions for older adults at risk for medication non-adherence. PMID:21226789

  19. Self-efficacy beliefs, locus of control, religiosity and non-adherence to immunosuppressive medications in kidney transplant patients.

    Science.gov (United States)

    Silva, Andresa Nascimento; Moratelli, Lucas; Tavares, Paula Liziero; Marsicano, Elisa De Oliveira; Pinhati, Renata Romanholi; Colugnati, Fernando Antonio Basile; Lucchetti, Giancarlo; Sanders-Pinheiro, Helady

    2016-11-01

    Adherence to immunosuppressive medication is essential for favourable kidney transplant outcomes. The present study aims to investigate how self-efficacy beliefs, health locus of control and religiosity are associated with adherence to immunosuppressives in post kidney transplant recipients. This is a cross-sectional study with 88 recipients with more than 1 year after transplantation. Three methods were used to classify patients as adherent or non-adherent: Basel Assessment of Adherence Scale for Immunosuppressives - BAASIS, the collateral report and blood levels of immunosuppressive medications. Self-efficacy, health locus of control, and religiosity were evaluated applying General Perceived Self-Efficacy Scale, Multidimensional Health Locus of Control Scale and Duke University Religion Index, respectively. Non-adherence was modelled by uni- and multivariated analysis. Sixty-three percent of the patients were male, age 47.2 ± 12.9 years, and median post-transplant time 108.71 (49.0-266.0) months. We found 70.5% of patients were non-adherent through at least one method. Adherent patients presented higher self-efficacy scores (45.1 ± 4.9 vs 38.3 ± 8.6; P non-adherents. Organizational and non-organizational religiosity did not differ between these groups. By logistic regression, non-adherence was associated with lower self-efficacy (OR 0.81, IC 0.70-0.92, P = 0.002), chance locus of control (OR 1.23, IC 1.04-1.45, P = 0.016) and lower intrinsic religiosity (OR 0.56, IC 0.38-0.84, P = 0.006). Our study showed that self-efficacy, chance locus of control, and intrinsic religiosity were associated with non-adherence to immunosuppressives. A broader perception of the kidney transplant patient´s integrality can help health professionals to design strategies to promote adherence in this population. © 2015 Asian Pacific Society of Nephrology.

  20. Effectiveness of a television advertisement campaign on giving cigarettes in a chinese population.

    Science.gov (United States)

    Qin, Yu; Su, Jian; Xiang, Quanyong; Hu, Yihe; Xu, Guanqun; Ma, Jiuhua; Shi, Zumin

    2014-01-01

    Anti-tobacco television advertisement campaigns may convey messages on smoking-related health consequences and create norms against giving cigarettes. Altogether, 156 and 112 slots of a television advertisement "Giving cigarettes is giving harm" were aired on Suzhou and Yizheng, respectively, over one month in 2010. Participants were recruited from 15 locations in Suzhou and 8 locations in Yizheng using a street intercept method. Overall 2306 residents aged 18-45 years completed questionnaires, including 1142 before the campaign and 1164 after, with respective response rates of 79.1% and 79.7%. Chi square tests were used to compare the difference between categorical variables. After the campaign, 36.0% of subjects recalled that they had seen the advertisement. Residents of Suzhou had a higher recall rate than those of Yizheng (47.6% vs. 20.6%, P advertisement were more likely not to give cigarettes in the future than those who reported not seeing the advertisement (38.7% vs. 27.5%, P advertisements helped change societal norms and improve health behavior. Continuous and adequate funding of anti-tobacco media campaigns targeted at different levels of the general population is needed, in conjunction with a comprehensive tobacco control effort.

  1. Mechanics of epithelial closure over non-adherent environments

    Science.gov (United States)

    Vedula, Sri Ram Krishna; Peyret, Grégoire; Cheddadi, Ibrahim; Chen, Tianchi; Brugués, Agustí; Hirata, Hiroaki; Lopez-Menendez, Horacio; Toyama, Yusuke; Neves de Almeida, Luís; Trepat, Xavier; Lim, Chwee Teck; Ladoux, Benoit

    2015-01-01

    The closure of gaps within epithelia is crucial to maintain its integrity during biological processes such as wound healing and gastrulation. Depending on the distribution of extracellular matrix, gap closure occurs through assembly of multicellular actin-based contractile cables or protrusive activity of border cells into the gap. Here we show that the supracellular actomyosin contractility of cells near the gap edge exerts sufficient tension on the surrounding tissue to promote closure of non-adherent gaps. Using traction force microscopy, we observe that cell-generated forces on the substrate at the gap edge first point away from the centre of the gap and then increase in the radial direction pointing into the gap as closure proceeds. Combining with numerical simulations, we show that the increase in force relies less on localized purse-string contractility and more on large-scale remodelling of the suspended tissue around the gap. Our results provide a framework for understanding the assembly and the mechanics of cellular contractility at the tissue level.

  2. Diagnosing medication non-adherence in a patient with myocardial infarction

    Directory of Open Access Journals (Sweden)

    Siqin eYe

    2012-08-01

    Full Text Available BackgroundMedication non-adherence continues to be a major challenge facing the healthcare system. A case is presented of a 48 year-old man with myocardial infarction who was found to be non-adherent to multiple medications. Conceptual models are reviewed along with current approaches for assessment and treatment of medication non-adherence.DesignCase report and literature review.DiscussionA theoretical model for medication non-adherence built on the Theory of Planned Behavior is presented. Empirical evidence is reviewed for determinants of non-adherent behavior such as health beliefs and self-efficacy. Current methods to assess medication non-adherence, including self-report, pill count, biological drug levels, pharmacy refill, and electronic bottles are summarized along with their limitations. Finally, an individualized approach for assessment is described using the case presented and the conceptual framework outlined above. Follow-up for the patient and potential interventions to improve medication adherence are discussed. ConclusionDespite the challenges, a conceptual framework for medication non-adherence can guide assessment and treatment. Further research for innovative and effective methods to detect and treat medication non-adherence is urgently needed to aid clinicians in treating this pervasive behavioral problem.

  3. Non-adherence to treatment of chronic wounds: patient versus professional perspectives.

    Science.gov (United States)

    Moffatt, Christine; Murray, Susie; Keeley, Vaughan; Aubeeluck, Aimee

    2017-08-30

    The reasons for the non-adherence to treatment for wound healing are complex and fall into unintentional and intentional categories. This study explored intentional and unintentional non-adherence to treatment from patient/carer and health care professional perspectives. Patients with wounds receiving ALLEVYN Life dressings (n = 20) and patients not receiving ALLEVYN Life dressings who were deemed to be non-adherent to treatment regimes (n = 6) took part in semi-structured interviews to explore their experiences of living with a wound, treatment and intentional and unintentional non-adherence. Three focus groups of health care professionals explored issues surrounding non-adherence to treatment regimes. Groups included nurses and doctors (n = 25). We found that relationships between participants and health care professionals varied in character across the groups. All participants expressed reasons for both intentional and unintentional adherence. Many reasons for intentional non-adherence are related to comfort and working the regime around patients' lives. Health care professionals considered the most common form of non-adherence to be unintentional. However, patients describe the most common form of non-adherence as being intentional. The relationship between patients and health care professionals varied in character between the groups. Discrepancies between professional and patient perspectives need to be reconciled and addressed to improve adherence to treatment regimes. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  4. Predictors and outcomes of non-adherence in patients receiving maintenance hemodialysis.

    Science.gov (United States)

    Tohme, Fadi; Mor, Maria K; Pena-Polanco, Julio; Green, Jamie A; Fine, Michael J; Palevsky, Paul M; Weisbord, Steven D

    2017-08-01

    Predictors of and outcomes associated with non-adherent behavior among patients on chronic hemodialysis (HD) have been incompletely elucidated. We conducted a post hoc analysis of data from the SMILE trial to identify patient factors associated with non-adherence to dialysis-related treatments and the associations of non-adherence with clinical outcomes. We defined non-adherence as missed HD and abbreviated HD. We used negative binomial regression to model the associations of demographic and clinical factors with measures of non-adherence, and negative binomial and Cox regression to analyze the associations of non-adherence with hospitalizations and mortality, respectively. We followed 286 patients for up to 24 months. Factors independently associated with missing HD included Tuesday/Thursday/Saturday HD schedule [incident rate ratio (IRR) 1.85, p non-smoking (IRR 1.32, p = 0.03), and younger age (IRR 1.22, p non-adherence to HD-related treatments, and independent associations of non-adherence with hospitalization and mortality. These findings should inform the development and implementation of interventions to improve adherence and reduce health resource utilization.

  5. Understanding non-adherence in chronic heart failure: A mixed-method case study

    NARCIS (Netherlands)

    M. Oertle (M.); R.A. Bal (Roland)

    2010-01-01

    textabstractObjectives: Understanding non-adherence to guidelines in patients with co-morbidities by supplementing quantitative data through patient-centred qualitative research. It is hypothesised that clinical constraints and patient-related factors explain the vast proportion of non-adherence.

  6. Non-Adherence to Study Time Management Strategies among NOUN Students and Implications for Academic Stress

    Science.gov (United States)

    Okopi, Fidel O.

    2011-01-01

    The study was designed to investigate the NOUN students' non-adherence to their time management strategies (TMS) during the course of their studies. The researcher also wanted to find out whether their gender, age, marital and employment statuses have influence on their adherence/non-adherence to the plan or not. The researcher also examined the…

  7. Self-reported reasons for treatment non-adherence in Chinese asthma patients: A 24-week prospective telephone follow-up study.

    Science.gov (United States)

    Ma, Qianli; Luo, Guangming; Zhou, Xiangdong; Huang, Ying; Liu, Enmei; Hong, Xin; Mao, Liangping; Wu, Yamei; Chen, Xumei; Liao, Xiuqing; Qin, Guangmei; Wang, Daoxin; Li, Lian; Zhang, Shifu; Wang, Changzheng

    2016-07-12

    Treatment non-adherence is a challenge to achieve asthma control. However, few prospective studies were done for exploring asthma patient adherence in real world. To evaluate treatment adherence and causes of non-adherence in a large asthma Chinese population. To analyze newly-diagnosed patients' adherence first time. About 1582 asthma patients' data were collected from 12 study centers in China from February, 2012 to October, 2012. Disease and treatment information of subjects were collected were at first clinic visit, at 4, 12, and 24 weeks after that, follow-up phone calls were carried out for recording subjects' treatment adherence based on their self-reports. Subjects who reported non-adherence were additionally asked to choose the primary non-adherence cause from a list of nine potential causes. Treatment adherence rate of all subjects markedly decreased from 83.3% at week 4 to 42.0% at week 24 after the first clinic visit. Significantly, at week 24, good treatment adherence rate in newly-diagnosed patients was lower than those patients with asthma history (22.9% vs. 63.9%, P patients were three times more likely to become non-adherence than those patients with asthma history. Female patients had lower treatment adherence rate than male patients (38.3% vs. 45.6%, P = .006). Subjects in 30-39 year age group had the worst treatment adherence (27.3%). The most commonly chosen cause for non-adherence was "relief of symptoms after short-term controller medication use" (43.8%). Asthma patients' treatment adherence could be improved by improving patient education, doctor/patient partnership, and level of medical service in Chinese population. © 2016 John Wiley & Sons Ltd.

  8. Primary medication non-adherence after discharge from a general internal medicine service.

    Directory of Open Access Journals (Sweden)

    Brooks A Fallis

    Full Text Available BACKGROUND: Medication non-adherence frequently leads to suboptimal patient outcomes. Primary non-adherence, which occurs when a patient does not fill an initial prescription, is particularly important at the time of hospital discharge because new medications are often being prescribed to treat an illness rather than for prevention. METHODS: We studied older adults consecutively discharged from a general internal medicine service at a large urban teaching hospital to determine the prevalence of primary non-adherence and identify characteristics associated with primary non-adherence. We reviewed electronic prescriptions, electronic discharge summaries and pharmacy dispensing data from April to August 2010 for drugs listed on the public formulary. Primary non-adherence was defined as failure to fill one or more new prescriptions after hospital discharge. In addition to descriptive analyses, we developed a logistical regression model to identify patient characteristics associated with primary non-adherence. RESULTS: There were 493 patients eligible for inclusion in our study, 232 of whom were prescribed new medications. In total, 66 (28% exhibited primary non-adherence at 7 days after discharge and 55 (24% at 30 days after discharge. Examples of medications to which patients were non-adherent included antibiotics, drugs for the management of coronary artery disease (e.g. beta-blockers, statins, heart failure (e.g. beta-blockers, angiotensin converting enzyme inhibitors, furosemide, stroke (e.g. statins, clopidogrel, diabetes (e.g. insulin, and chronic obstructive pulmonary disease (e.g. long-acting bronchodilators, prednisone. Discharge to a nursing home was associated with an increased risk of primary non-adherence (OR 2.25, 95% CI 1.01-4.95. CONCLUSIONS: Primary non-adherence after medications are newly prescribed during a hospitalization is common, and was more likely to occur in patients discharged to a nursing home.

  9. Interleukin-3 greatly expands non-adherent endothelial forming cells with pro-angiogenic properties

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    Lachlan M. Moldenhauer

    2015-05-01

    Full Text Available Circulating endothelial progenitor cells (EPCs provide revascularisation for cardiovascular disease and the expansion of these cells opens up the possibility of their use as a cell therapy. Herein we show that interleukin-3 (IL3 strongly expands a population of human non-adherent endothelial forming cells (EXnaEFCs with low immunogenicity as well as pro-angiogenic capabilities in vivo, making their therapeutic utilisation a realistic option. Non-adherent CD133+ EFCs isolated from human umbilical cord blood and cultured under different conditions were maximally expanded by day 12 in the presence of IL3 at which time a 350-fold increase in cell number was obtained. Cell surface marker phenotyping confirmed expression of the hematopoietic progenitor cell markers CD133, CD117 and CD34, vascular cell markers VEGFR2 and CD31, dim expression of CD45 and absence of myeloid markers CD14 and CD11b. Functional experiments revealed that EXnaEFCs exhibited classical properties of endothelial cells (ECs, namely binding of Ulex europaeus lectin, up-take of acetylated-low density lipoprotein and contribution to EC tube formation in vitro. These EXnaEFCs demonstrated a pro-angiogenic phenotype within two independent in vivo rodent models. Firstly, a Matrigel plug assay showed increased vascularisation in mice. Secondly, a rat model of acute myocardial infarction demonstrated reduced heart damage as determined by lower levels of serum creatinine and a modest increase in heart functionality. Taken together, these studies show IL3 as a potent growth factor for human CD133+ cell expansion with clear pro-angiogenic properties (in vitro and in vivo and thus may provide clinical utility for humans in the future.

  10. Adherence and non-adherence to treatments: focus on pharmacy practice in Nepal.

    Science.gov (United States)

    Bastakoti, Suresh; Khanal, Saval; Dahal, Bibek; Pun, Nirmala Tilija

    2013-04-01

    Nepal is one of the developing countries having many limitations in providing the quality health services to its population. In many countries, improvement in patients' adherence to the pharmacotherapy had been one of major outcome of quality pharmaceutical services. Till date, very less thing has been done in this area in Nepal; so it seems mandatory to improve the patient adherence to the treatment plans. Adherence to the medical therapy can be explained by the extent of the behavioral coincidence to the medication and non-medication regimen by a patient whereas compliance and concordance are two different models of patient adherence to the therapy. Compliance model suggests that patients have been brought responsible for being unable to follow 'doctor's order and concordance tempts to measure the degree of agreement between patient and his or her clinician about the nature of illness and the best possible therapy for the welfare of the patient. Non-adherence to the therapy may lead to different problems as consequences of non-adherence in four different level- individual, institutional, societal and national levels. Although some programs like, "Direct Observation Treatment, Short-course (DOTS) for tuberculosis, implementation of antiretroviral treatment schedules for HIV patients and pediatric vaccination models," are the examples of attention towards the cases of noncompliance in Nepal. It has long been faced its limitations in the forms of either untrained manpower or lack of good documentation of patients' adherence to therapy or high illiteracy rate or unaffordibility of patients to their treatment or lack of pharmaceutical care services.

  11. Treatment of inflammatory bowel disease: is your patient at risk of non-adherence?

    Science.gov (United States)

    Magalhães, Joana; Dias de Castro, Francisca; Boal Carvalho, Pedro; Leite, Sílvia; Moreira, Maria João; Cotter, José

    2014-01-01

    Adherence to therapy is a key factor when analyzing the efficacy of a treatment in clinical practice. The aim of our study was to assess the frequency of non-adherence to treatment among patients with inflammatory bowel disease and evaluate which factors could be related. One hundred thirty eight consecutive inflammatory bowel disease outpatients (55.8% with Crohn's disease and 44.2% with Ulcerative Colitis) filled in an anonymous questionnaire, which included information about demography, duration of the disease, specific therapy for inflammatory bowel disease, and data possibly related to extent of non-adherence to treatment. Statistics were performed with SPSS v.18.0. Categorical variables were compared with Fisher's exact test. A p value non-adherence was reported by 29.7% of patients. 70.7% of them reported unintentional non-adherence and 51.2% forgot at least one dose per week. Non-adherence was statistically associated with: short disease duration (p non-adherence. Young patients, patients with short disease duration and under topical aminosalicyates presented a higher risk for nonadherence to treatment. Gastroenterologist's attention should be focused on the identification of risk factors potentially involved in non-adherence to therapy and in the promotion of measures to improve it.

  12. Non-adherence in difficult asthma: time to take it seriously.

    Science.gov (United States)

    Heaney, Liam G; Horne, Rob

    2012-03-01

    Recent studies have demonstrated a high prevalence of non-adherence with anti-inflammatory medication in patients referred for specialist assessment with difficult-to-control asthma. As well as poor asthma outcome and increased healthcare cost, failure to detect non-adherence makes identification of true treatment-resistant/refractory asthma challenging. This is because guideline definitions of refractory asthma are all predicated on failure to respond to high-dose anti-inflammatory therapy but do not state how adherence with this therapy should be assessed. With the advent of novel expensive biological therapies, the systematic identification of non-adherence becomes more essential to avoid targeting therapies at an inappropriate patient group. Novel biomarkers of steroid exposure, in combination with more traditional surrogate measures such as prescription filling assessment, may allow more objective assessments of non-adherence to be developed in the future. When identified, non-adherence can potentially be targeted and improved, but the key challenge is to empower patients to make informed choices about medicines rather than decisions influenced by misplaced beliefs about benefit and harm. There is an urgent need for the systematic development of individualised interventions which allow non-adherence to be effectively managed. Thus, non-adherence must become a priority in the clinical assessment of difficult-to-control asthma because addressing non-adherence is likely to deliver greater benefits in this group than any novel treatment. It is essential that future research examines strategies and interventions to address non-adherence in subjects with difficult-to-control asthma.

  13. High prevalence of medication non-adherence in a sample of community-dwelling older adults with adult protective services-validated self-neglect.

    Science.gov (United States)

    Turner, Anisha; Hochschild, Ann; Burnett, Jason; Zulfiqar, Amber; Dyer, Carmel B

    2012-09-01

    Medication non-adherence can exacerbate disease severity, leading to impairments that interfere with self-care activities in older adults, and, ultimately, death. Elder self-neglect is the most common report to Adult Protective Services (APS) across the USA and is a significant risk factor for early mortality. These individuals often suffer from multiple comorbid diseases that require careful management, but for various reasons they are unwilling or unable to provide themselves with the self-care resources necessary for maintaining health and safety. No studies have assessed whether medication adherence is associated with elder self-neglect. The purpose of this study was to assess and describe medication adherence in this population, as well as evaluate associations between medication adherence and cognitive impairment, depression, physical function, and abilities to perform basic and instrumental activities of daily living (BADLs and IADLs). A cross-sectional study of 100 community-dwelling adults 65 years of age and older with APS-substantiated elder self-neglect were assessed. In-home comprehensive geriatric assessments (CGAs) were completed and included medication reviews. Information on each medication, including the amount taken from the date dispensed, was collected and used to determine adherence. The criteria for non-adherence were taking 110 % of at least one medication. The sample was also split into groups of low adherence (≤29 %), moderate adherence (29-86 %) and high adherence (≥86 %). Scores on the CGA measures Mini-Mental State Examination, Geriatric Depression Scale, Physical Performance Test (PPT) and Kohlman Evaluation of Living Skills were assessed to determine whether cognitive impairment, depression, physical function, and/or ability to perform BADLs and IADLs were associated with non-adherence or low, moderate or high levels of adherence. Twenty-five per cent of the sample was taking more than seven medications daily. The average rate of

  14. Anxiety and depression symptoms as risk factors for non-adherence to antiretroviral therapy in Brazil.

    Science.gov (United States)

    Campos, Lorenza Nogueira; Guimarães, Mark Drew Crosland; Remien, Robert H

    2010-04-01

    Depression and anxiety are common among HIV-infected people and rank among the strongest predictors of non-adherence to antiretroviral therapy (ART). This longitudinal study aimed to assess whether symptoms of anxiety and depression are predictors of non-adherence among patients initiating ART at two public referral centers (n = 293) in Belo Horizonte, Brazil. Prevalence of severe anxiety and depression symptoms before starting ART was 12.6% and 5.8%, respectively. Severe anxiety was a predictor of non-adherence to ART during follow-up period (RH = 1.87; 95% CI = 1.14-3.06) adjusted for low education, unemployment, alcohol use in the last month and symptoms of AIDS; while a history of injection drug use had borderline statistical significance with non-adherence. These findings suggest that using a brief screening procedure to assess anxiety and depression symptoms before initiating ART help identify individuals for interventions to improve adherence and quality of life.

  15. Psychosocial predictors of non-adherence to chronic medication: systematic review of longitudinal studies

    NARCIS (Netherlands)

    Zwikker, H.E.; Bemt, B.J.F van den; Vriezekolk, J.E.; Ende, C.H.M. van den; Dulmen, S. van

    2014-01-01

    OBJECTIVES: Several cross-sectional studies suggest that psychosocial factors are associated with non-adherence to chronic preventive maintenance medication (CPMM); however, results from longitudinal associations have not yet been systematically summarized. Therefore, the objective of this study was

  16. Psychosocial predictors of non-adherence to chronic medication: systematic review of longitudinal studies.

    NARCIS (Netherlands)

    Zwikker, H.E.; Bemt, B.J. van den; Vriezekolk, J.E.; Ende, C.H. van den; Dulmen, S. van

    2014-01-01

    Objectives: Several cross-sectional studies suggest that psychosocial factors are associated with non-adherence to chronic preventive maintenance medication (CPMM); however, results from longitudinal associations have not yet been systematically summarized. Therefore, the objective of this study was

  17. Psychosocial predictors of non-adherence to chronic medication: systematic review of longitudinal studies

    NARCIS (Netherlands)

    Zwikker, H.E.; Bemt, B.J.F van den; Vriezekolk, J.E.; Ende, C.H.M. van den; Dulmen, S. van

    2014-01-01

    OBJECTIVES: Several cross-sectional studies suggest that psychosocial factors are associated with non-adherence to chronic preventive maintenance medication (CPMM); however, results from longitudinal associations have not yet been systematically summarized. Therefore, the objective of this study was

  18. Experiences of non-adherence to Internet-delivered cognitive behavior therapy: A qualitative study

    Directory of Open Access Journals (Sweden)

    Olof Johansson

    2015-05-01

    Full Text Available Many trials on Internet-delivered psychological treatments have had problems with nonadherence, but not much is known about the subjective reasons for non-adhering. The aim of this study was to explore participants' experiences of non-adherence to Internet-delivered psychological treatment. Grounded theory was used to analyze data from seven in-depth interviews with persons who had non-adhered to a study on Internet-delivered cognitive behavioral therapy for generalized anxiety disorder. The process of non-adherence is described as an interaction between patient factors and treatment factors. A working model theory was generated to illustrate the experience of nonadherence. The model describes a process where treatment features such as workload, text-content complexity and treatment process don't match personal prerequisites regarding daily routines, perceived language skills and treatment expectations respectively, resulting in the decision to nonadhere. Negative effects were also stated as a reason for non-adherence. Several common strategies used for increasing adherence to Internet-delivered therapy in general are by these non-completers regarded as factors directly related to their reason for non-adherence.

  19. Detecting non-adherence by urine analysis in patients with uncontrolled hypertension: rates, reasons and reactions.

    Science.gov (United States)

    Pucci, M; Martin, U

    2017-04-01

    Poor adherence with pharmacotherapy is well recognised as one of the main barriers to achieving satisfactory blood pressure control, although accurately measuring patient adherence has historically been very challenging. Urine analysis by high-performance liquid chromatography-tandem mass spectrometry has recently become routinely available as a method of screening for non-adherence. In addition to measuring rates of adherence in hypertensive patients, this study aimed to investigate the reasons for non-adherence given by patients and how patients react when they are informed of their results. This was a retrospective observational study looking at results from the routine use of this assay in a specialist hypertension clinic in Birmingham, UK, in patients with uncontrolled hypertension and those under consideration for renal denervation. Out of the 131 patients analysed, only 67 (51%) were taking all their medications as prescribed. Forty-three patients (33%) were taking some of their medications, whilst 21 patients (16%) were completely non-adherent. The most common reasons cited for non-adherence were adverse effects of medication and forgetfulness. Adherence rates for thiazide/thiazide-like diuretics and spironolactone were lower than for other classes of antihypertensive drug. Despite the objective nature and high sensitivity of the test, 36% of non-adherent patients disputed the results. A minority of patients did not attend follow-up. Further research investigating the implications of a 'non-adherence' result on the patient-clinician relationship is required.

  20. Medication non-adherence in adult patients affected by inflammatory bowel disease: a critical review and update of the determining factors, consequences and possible interventions.

    Science.gov (United States)

    Lenti, Marco Vincenzo; Selinger, Christian P

    2017-03-01

    Achieving adherence to medications can be a serious challenge for patients affected by inflammatory bowel disease (IBD). Medical treatment is fundamental for inducing and maintaining remission, preventing flares and reducing the risk of colorectal cancer. Non-adherence may affect patients' quality of life resulting in unfavourable treatment outcomes, more hospitalizations and higher healthcare-related costs. Recognising and improving adherence is therefore a primary aim for the treatment of IBD. Areas covered: We critically discuss the current knowledge on medication non-adherence in adult patients affected by IBD, also mentioning a few issues concerning the paediatric and adolescent populations. In particular, we reviewed the literature focusing on the definition and detection of non-adherence, on its extent and on the possible non-modifiable and modifiable factors involved (patient-centred, therapy-related, disease-related and physician-related). Furthermore, we analysed the interventional studies performed so far. The literature review was conducted through PubMed addressing medication non-adherence in IBD, using the keywords 'adherence' and related terms and 'IBD, ulcerative colitis or Crohn's disease'. Expert commentary: Adherence to therapy for IBD is a complex yet fundamental issue that cannot be solved by addressing a single aspect only. Future studies should focus on patient-tailored and multidimensional interventions.

  1. Patient Education in a 14-month Randomised Trial Fails to Improve Adherence in Ulcerative Colitis: Influence of Demographic and Clinical Parameters on Non-adherence.

    Science.gov (United States)

    Nikolaus, S; Schreiber, S; Siegmund, B; Bokemeyer, B; Bästlein, E; Bachmann, O; Görlich, D; Hofmann, U; Schwab, M; Kruis, W

    2017-09-01

    Recent observational studies document that non-adherence to mesalamine therapy during remission is frequent. We aimed to investigate patient impact of patient education using objective assessments of adherence. A 14-month randomised, prospective clinical trial of adherence to mesalamine was conducted in 248 patients with ulcerative colitis [UC], Colitis Activity Index [CAI] ≤ 9, receiving standard care [n = 122] versus a standardised patient education programme [n = 126]. Primary endpoint was adherence at all visits (5-aminosalicylic acid [5-ASA] urine levels). Secondary endpoints included quality of life (inflammatory bowel disease questionnaise [IBDQ]), disease activity, partial adherence, and self-assessment of adherence. Patient allocation was well balanced. Baseline non-adherence was high in quiescent/mildly active UC [52.4%] without difference between the groups (52.4% of patients in the education group versus 52.5% in the standard care group [p = 0.99]). No difference between the intervention group and standard care was seen in IBDQ, partial adherence, self-assessment of adherence, or therapy satisfaction at all visits. We suggest a model in which individual risks for non-adherence are driven by patients with young age, short disease duration, and low education levels. Non-adherence is frequent in a population with quiescent/mildly active UC. Although more than 25% of the population was not in remission at the various time points, no relationship between disease activity and adherence was seen over the 14-month observation period. Physicians should maximise their efforts to motivate high-risk patients for adherence. Future trials should use objective exposure assessments to examine the impact of continuous education and consultations on the background of individual risks to develop non-adherence.

  2. Targeting Medication Non-Adherence Behavior in Selected Autoimmune Diseases: A Systematic Approach to Digital Health Program Development.

    Directory of Open Access Journals (Sweden)

    Trevor van Mierlo

    Full Text Available 29 autoimmune diseases, including Rheumatoid Arthritis, gout, Crohn's Disease, and Systematic Lupus Erythematosus affect 7.6-9.4% of the population. While effective therapy is available, many patients do not follow treatment or use medications as directed. Digital health and Web 2.0 interventions have demonstrated much promise in increasing medication and treatment adherence, but to date many Internet tools have proven disappointing. In fact, most digital interventions continue to suffer from high attrition in patient populations, are burdensome for healthcare professionals, and have relatively short life spans.Digital health tools have traditionally centered on the transformation of existing interventions (such as diaries, trackers, stage-based or cognitive behavioral therapy programs, coupons, or symptom checklists to electronic format. Advanced digital interventions have also incorporated attributes of Web 2.0 such as social networking, text messaging, and the use of video. Despite these efforts, there has not been little measurable impact in non-adherence for illnesses that require medical interventions, and research must look to other strategies or development methodologies. As a first step in investigating the feasibility of developing such a tool, the objective of the current study is to systematically rate factors of non-adherence that have been reported in past research studies.Grounded Theory, recognized as a rigorous method that facilitates the emergence of new themes through systematic analysis, data collection and coding, was used to analyze quantitative, qualitative and mixed method studies addressing the following autoimmune diseases: Rheumatoid Arthritis, gout, Crohn's Disease, Systematic Lupus Erythematosus, and inflammatory bowel disease. Studies were only included if they contained primary data addressing the relationship with non-adherence.Out of the 27 studies, four non-modifiable and 11 modifiable risk factors were

  3. Childhood adversity as a predictor of non-adherence to statin therapy in adulthood.

    Directory of Open Access Journals (Sweden)

    Maarit Jaana Korhonen

    Full Text Available To investigate whether adverse experiences in childhood predict non-adherence to statin therapy in adulthood.A cohort of 1378 women and 538 men who initiated statin therapy during 2008-2010 after responding to a survey on childhood adversities, was followed for non-adherence during the first treatment year. Log-binomial regression was used to estimate predictors of non-adherence, defined as the proportion of days covered by dispensed statin tablets <80%. In fully adjusted models including age, education, marital status, current smoking, heavy alcohol use, physical inactivity, obesity, presence of depression and cardiovascular comorbidity, the number of women ranged from 1172 to 1299 and that of men from 473 to 516, because of missing data on specific adversities and covariates.Two in three respondents reported at least one of the following six adversities in the family: divorce/separation of the parents, long-term financial difficulties, severe conflicts, frequent fear, severe illness, or alcohol problem of a family member. 51% of women and 44% of men were non-adherent. In men, the number of childhood adversities predicted an increased risk of non-adherence (risk ratio [RR] per adversity 1.11, 95% confidence interval [CI] 1.01-1.21], P for linear trend 0.013. Compared with those reporting no adversities, men reporting 3-6 adversities had a 1.44-fold risk of non-adherence (95% CI 1.12-1.85. Experiencing severe conflicts in the family (RR 1.27, 95% CI 1.03-1.57] and frequent fear of a family member (RR 1.27, 95% CI 1.00-1.62] in particular, predicted an increased risk of non-adherence. In women, neither the number of adversities nor any specific type of adversity predicted non-adherence.Exposure to childhood adversity may predict non-adherence to preventive cardiovascular medication in men. Usefulness of information on childhood adversities in identification of adults at high risk of non-adherence deserves further research.

  4. Perceptions of social capital and cost-related non-adherence to medication among the elderly.

    Science.gov (United States)

    Luz, Tatiana Chama Borges; Loyola Filho, Antônio Ignácio de; Lima-Costa, Maria Fernanda

    2011-02-01

    The aim of this study was to examine the association between social capital and cost-related non-adherence (CRN) in an elderly population, using data from 1,134 respondents to the Greater Metropolitan Belo Horizonte Health Survey. CRN was lower for those elderly with a better perception of attachment to their neighbourhoods (PR = 0.68; 95%CI: 0.50-0.94), with more social contacts (one to five, PR = 0.49; 95%CI: 0.30-0.80 and more than five, PR = 0.42; 95%CI: 0.26-0.67), and with private health insurance coverage (PR = 0.64; 95%CI: 0.45-0.93). Meanwhile, CRN was significantly higher for those with fair to poor self-rated health (PR =1.66; 95%CI: 0.95-2.90 and PR = 2.62; 95%CI: 1.46-4.71 respectively), with multiple comorbidities (two, PR = 3.45; 95%CI: 1.38-8.62 and three or more, PR = 4.42; 95%CI: 1.74-11.25), and with a lower frequency of physician-patient dialogue about health/treatment (rarely/never, PR = 1.91; 95%CI: 1.16-3.13). These findings highlight the need to take into account the social context in future research on CRN.

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

    Science.gov (United States)

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

    2014-07-01

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

  6. Determinants of non adherence to tuberculosis treatment in Argentina: barriers related to access to treatment

    Directory of Open Access Journals (Sweden)

    María Belén Herrero

    2015-06-01

    Full Text Available OBJECTIVE: To identify the association between non-adherence to tuberculosis treatment and access to treatment. METHODS: A cross-sectional study was carried out in the Metropolitan Area of Buenos Aires, Argentina. One hundred twenty three patients notified in 2007 (38 non adherent and 85 adherents were interviewed regarding the health care process and socio-demographic characteristics. Factors associated to non-adherence were assessed through logistic regression analysis. RESULTS: An increased risk of non-adherence with to treatment was found in male patients (OR = 2.8; 95%CI 1.2 - 6.7, patients who had medical check-ups at hospitals (OR = 3.4; 95%CI 1.1 - 10.0 and those who had difficulties with transportation costs (OR = 2.5; 95%CI 1.1 - 5.9. CONCLUSION: Risk of non-adherence increases as a result of economic barriers in accessing health care facilities. Decentralization of treatment to primary health care centers and social protection measures for patients should be considered as priorities for disease control strategies in order to lessen the impact of those barriers on adherence to treatment.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Shirin Jahan Mumu

    2014-01-01

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

  9. Bypassing non-adherence via PEG in a critically ill HIV-1-infected patient.

    Science.gov (United States)

    Leipe, J; Hueber, A J; Rech, J; Harrer, T

    2008-08-01

    This case study describes a 44-year-old, chronically non-adherent, HIV-infected male with relapsing, life threatening toxoplasmic encephalitis (TE) and other recurring opportunistic infections. Non-adherence resulted in critical illness, suppressed CD4 lymphocyte count and elevated viral load. In order to bypass the patient's complete psychological aversion to taking medication, and after exhausting various psychological interventions, a percutaneous endoscopic gastronomy (PEG) tube was inserted for delivery of indispensable medication. During the 15-month follow-up the patient was adherent, exhibiting a consistently undetectable viral load, high CD4 count and a remission of the opportunistic infections. This is an interesting case study demonstrating life-saving and long-term benefit of PEG in an exceptional setting, which has implications for future research and treatment of non-adherent HIV-infected patients.

  10. Particle size evolution in non-adhered ductile powders during mechanical alloying

    Energy Technology Data Exchange (ETDEWEB)

    Guerrero-Paz, J. [Centro de Investigaciones en Materiales y Metalurgica, UAEH (Mexico); Robles-Hernandez, F.C.; Hernandez-Silva, D.; Jaramillo-Vigueras, D. [Dept. de Ingenieria Metalurgica, ESIQIE - Inst. Politecnico Nacional, Mexico D.F. (Mexico); Martinez-Sanchez, R. [Centro de Investigacion en Materiales Avanzados, Chihuahua (Mexico)

    2001-07-01

    The interaction among events as deformation, cold-welding and fracture, occurring during the mechanical milling of powders is unclear and controversial. We believe that the understanding of such interaction can be deduced from particle size evolution studies. It is well known that the elemental ductile powders adhere to the milling media. However when some of these powders are combined to form an alloy by milling, the adherence phenomenon is not observed. Systems which include ductile powders, such as, Cu-15at.%Al, Co-68at.%Al and Ni-25at.%Al were processed with not adherence to the milling media, thus allowing to follow up the particle size evolution during the complete milling process. The particle size was measured by the sedimentation-photometry technique. Those results were supported by scanning and transmission electron microscopy. The results showed a high proportion near 95% in number of particles of submicrometric size at early milling times for the three systems. However its particle size evolution for each system was different. Such findings can be important to understand some mechanisms as the grain size refinement, the alloy formation and the microstructural evolution. In the studied systems, the particle size measurements are presented based on volume or mass, area, line and number of the particles. The particle size results based on volume and line or number of the particles can give an idea of the evolution of the biggest particles and the finest ones respectively during the milling. Also the behavior of the complete particle system can be deduced from the results based in the area of the particles. Results of particle size as well as observations by microscopy helped to suggest the particle size and shape evolution of the studied systems. Such findings were employed to previously propose a grain size refinement mechanism for ductile powder systems non-adherent to the milling media during the mechanical alloying. (orig.)

  11. Non-adherence to antibiotic therapy in patients visiting community pharmacies.

    Science.gov (United States)

    Fernandes, Milene; Leite, Andreia; Basto, Maria; Nobre, Miguel Araújo; Vieira, Nuno; Fernandes, Rui; Nogueira, Paulo; Nicola, Paulo Jorge; Jorge, Paulo

    2014-02-01

    Patient non-adherence to antibiotic therapy may lead to therapeutic failure, re-infection, and bacterial resistance. Assessing the factors associated with this problem is important for promoting rational use of antibiotics. This study aimed to measure prevalence and reasons for non-adherence to antibiotic treatment and to identify associated factors. Patients were recruited for the study in community pharmacies in Lisbon, Portugal, from February to April, 2009. Data from prescriptions for oral antibiotics were collected for adult subjects. Adherence to treatment was assessed with a modified Portuguese version of the Morisky scale. Factors associated with non-adherence were identified through bivariate analysis and logistic regression models. A total of 243 patients were included in the study. They had a mean age 46.5 ± 16.6 years and 74.5 % of the sample was female. The prevalence of non-adherence was 57.7 % and was related to delays and failures in taking the prescribed medicine. Increasing age (OR 0.97), difficulty in buying the antibiotic (OR 2.34), duration of treatment (OR 1.28), difficulty with ingestion (OR 3.08), and satisfaction with the information given by physician (OR 0.33) were identified as independent factors associated with non-adherence. Non-adherence to antibiotics is common in the community setting. Factors related to the antibiotic, the patient, and the patient-physician relationship should be addressed to promote adherence. Pharmacists should provide information to patients about correct use of antibiotics and address barriers to adherence.

  12. Medication non-adherence among adult psychiatric out patients in Jimma University Specialized Hospital, Southwest Ethiopia.

    Science.gov (United States)

    Tesfay, Kenfe; Girma, Eshetu; Negash, Alemayehu; Tesfaye, Markos; Dehning, Sandra

    2013-11-01

    Information on adherence of adult psychiatric patients to biological modes of treatment is scarce in Ethiopia. Knowledge on adherence is essential in terms of future prognosis, quality of life and functionality of such patients. This study was conducted to assess the magnitude and associated factors of non-adherence to medication. A hospital based cross-sectional study was conducted in November 2011 at the psychiatry facility of Jimma University Specialized Hospital, which provides service to more than 10 mill people. A sample of 422 adults with psychiatric illness in the follow-up outpatients was selected consecutively. Data was collected using a pre-tested questionnaire by face-to-face interview and from patient medical records. The four-item Morisky scale was used to assess degree of medication adherence. Data was analyzed using SPSS version 16 and descriptive, chi-square test and logistic regression statistical methods were used. P-Value of less than 0.05 was considered as statistically significant in the final model. Out of the 422 patients, 40.3% were females and 59.7% males. The prevalence rate for non-adherence was 41.2%, non-affective psychoses diagnosis contributing the highest rate (44.5%). From the total non-adherent respondents, 78.2% attributed their non-adherence to forgetting. Irregular follow-up, poor social support and complex drug regimen were independently associated variables with non-adherence. The result of the study showed that non-adherence among psychiatric patients in Southwest Ethiopia is high and revealed possible associated factors. Adherence needs integrated efforts in creating a mechanism in enhancing regular follow-up, informal social support system and ongoing awareness creation among professionals.

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

    OpenAIRE

    Denhaerynck, Kris

    2006-01-01

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

  14. Giving Context to the Physician Competency Reference Set: Adapting to the Needs of Diverse Populations.

    Science.gov (United States)

    Eckstrand, Kristen L; Potter, Jennifer; Bayer, Carey Roth; Englander, Robert

    2016-07-01

    Delineating the requisite competencies of a 21st-century physician is the first step in the paradigm shift to competency-based medical education. Over the past two decades, more than 150 lists of competencies have emerged. In a synthesis of these lists, the Physician Competency Reference Set (PCRS) provided a unifying framework of competencies that define the general physician. The PCRS is not context or population specific; however, competently caring for certain underrepresented populations or specific medical conditions can require more specific context. Previously developed competency lists describing care for these populations have been disconnected from an overarching competency framework, limiting their uptake. To address this gap, the Association of American Medical Colleges Advisory Committee on Sexual Orientation, Gender Identity, and Sex Development adapted the PCRS by adding context- and content-specific qualifying statements to existing PCRS competencies to better meet the needs of diverse patient populations. This Article describes the committee's process in developing these qualifiers of competence. To facilitate widespread adoption of the contextualized competencies in U.S. medical schools, the committee used an established competency framework to develop qualifiers of competence to improve the health of individuals who are lesbian, gay, bisexual, transgender; gender nonconforming; or born with differences in sexual development. This process can be applied to other underrepresented populations or medical conditions, ensuring that relevant topics are included in medical education and, ultimately, health care outcomes are improved for all patients inclusive of diversity, background, and ability.

  15. Giving Context to the Physician Competency Reference Set: Adapting to the Needs of Diverse Populations

    Science.gov (United States)

    Eckstrand, Kristen L.; Potter, Jennifer; Bayer, Carey Roth; Englander, Robert

    2016-01-01

    Delineating the requisite competencies of a 21st-century physician is the first step in the paradigm shift to competency-based medical education. Over the past two decades, more than 150 lists of competencies have emerged. In a synthesis of these lists, the Physician Competency Reference Set (PCRS) provided a unifying framework of competencies that define the general physician. The PCRS is not context or population specific; however, competently caring for certain underrepresented populations or specific medical conditions can require more specific context. Previously developed competency lists describing care for these populations have been disconnected from an overarching competency framework, limiting their uptake. To address this gap, the Association of American Medical Colleges Advisory Committee on Sexual Orientation, Gender Identity, and Sex Development adapted the PCRS by adding context- and content-specific qualifying statements to existing PCRS competencies to better meet the needs of diverse patient populations. This Article describes the committee’s process in developing these qualifiers of competence. To facilitate widespread adoption of the contextualized competencies in U.S. medical schools, the committee used an established competency framework to develop qualifiers of competence to improve the health of individuals who are lesbian, gay, bisexual, transgender; gender nonconforming; or born with differences in sexual development. This process can be applied to other underrepresented populations or medical conditions, ensuring that relevant topics are included in medical education and, ultimately, health care outcomes are improved for all patients inclusive of diversity, background, and ability. PMID:26796092

  16. 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.

  17. Clinical and economic impact of non-adherence in COPD : A systematic review

    NARCIS (Netherlands)

    van Boven, Job F. M.; Chavannes, Niels H.; van der Molen, Thys; Rutten-van Molken, Maureen P. M. H.; Postma, Maarten J.; Vegter, Stefan

    2014-01-01

    BACKGROUND: Medication for Chronic Obstructive Pulmonary Disease (COPD) has shown to substantially reduce symptoms and slow progression of disease. However, non-adherence to medication is common and associated with worsened clinical and economic outcomes. OBJECTIVE: The objective of this study was t

  18. Understanding statin non-adherence: knowing which perceptions and experiences matter to different patients.

    NARCIS (Netherlands)

    Wouters, H.; Dijk, L. van; Geers, H.C.J.; Winters, N.A.; Geffen, E.C.G. van; Stiggelbout, A.M.; Bouvy, M.L.

    2016-01-01

    Background: Non-adherence to statins is substantial and is associated with numerous perceptions and experiences. However, time limits in clinical practice constrain in depth explorations of these perceptions and experiences. Objectives: To propose and examine a strategy aimed at an efficient

  19. Is inconsistent pre-treatment bedtime related to CPAP non-adherence?

    Science.gov (United States)

    Sawyer, Amy M; King, Tonya S; Sawyer, Douglas A; Rizzo, Albert

    2014-12-01

    Lack of adherence to continuous positive airway pressure therapy (CPAP) limits the effectiveness of treatment of obstructive sleep apnea (OSA). We hypothesized that an irregular bedtime would be negatively related to regular use of CPAP treatment. If so, modifying bedtime schedule may address the persistent problem of inconsistent CPAP use in adults with OSA. In a prospective longitudinal study, we examined whether inconsistent self-reported bedtime before initiation of CPAP treatment, operationalized as bedtime variability, was (1) different among those adherent (≥4 hours per night) and non-adherent to CPAP treatment at 1 week and 1 month; and/or (2) was related to 1-week and 1-month CPAP use when other variables were accounted for. Consecutively recruited newly diagnosed OSA adults (n = 79) completed sleep diaries prior to CPAP treatment. One-week and 1-month objective CPAP use data were collected. Pre-treatment bedtime variability was different among CPAP non-adherers and adherers at 1 month and was a significant predictor of non-adherence at 1 month in multi-variable analyses. The odds of 1-month CPAP non-adherence were 3.5 times greater in those whose pre-treatment bedtimes varied by >75 minutes. Addressing sleep schedule prior to CPAP initiation may be an opportunity to improve CPAP adherence.

  20. Assessing Nutritional Parameters of Brown Bear Diets among Ecosystems Gives Insight into Differences among Populations.

    Directory of Open Access Journals (Sweden)

    Claudia López-Alfaro

    Full Text Available Food habit studies are among the first steps used to understand wildlife-habitat relationships. However, these studies are in themselves insufficient to understand differences in population productivity and life histories, because they do not provide a direct measure of the energetic value or nutritional composition of the complete diet. Here, we developed a dynamic model integrating food habits and nutritional information to assess nutritional parameters of brown bear (Ursus arctos diets among three interior ecosystems of North America. Specifically, we estimate the average amount of digestible energy and protein (per kilogram fresh diet content in the diet and across the active season by bears living in western Alberta, the Flathead River (FR drainage of southeast British Columbia, and the Greater Yellowstone Ecosystem (GYE. As well, we estimate the proportion of energy and protein in the diet contributed by different food items, thereby highlighting important food resources in each ecosystem. Bear diets in Alberta had the lowest levels of digestible protein and energy through all seasons, which might help explain the low reproductive rates of this population. The FR diet had protein levels similar to the recent male diet in the GYE during spring, but energy levels were lower during late summer and fall. Historic and recent diets in GYE had the most energy and protein, which is consistent with their larger body sizes and higher population productivity. However, a recent decrease in consumption of trout (Oncorhynchus clarki, whitebark pine nuts (Pinus albicaulis, and ungulates, particularly elk (Cervus elaphus, in GYE bears has decreased the energy and protein content of their diet. The patterns observed suggest that bear body size and population densities are influenced by seasonal availability of protein an energy, likely due in part to nutritional influences on mass gain and reproductive success.

  1. Assessing Nutritional Parameters of Brown Bear Diets among Ecosystems Gives Insight into Differences among Populations.

    Science.gov (United States)

    López-Alfaro, Claudia; Coogan, Sean C P; Robbins, Charles T; Fortin, Jennifer K; Nielsen, Scott E

    2015-01-01

    Food habit studies are among the first steps used to understand wildlife-habitat relationships. However, these studies are in themselves insufficient to understand differences in population productivity and life histories, because they do not provide a direct measure of the energetic value or nutritional composition of the complete diet. Here, we developed a dynamic model integrating food habits and nutritional information to assess nutritional parameters of brown bear (Ursus arctos) diets among three interior ecosystems of North America. Specifically, we estimate the average amount of digestible energy and protein (per kilogram fresh diet) content in the diet and across the active season by bears living in western Alberta, the Flathead River (FR) drainage of southeast British Columbia, and the Greater Yellowstone Ecosystem (GYE). As well, we estimate the proportion of energy and protein in the diet contributed by different food items, thereby highlighting important food resources in each ecosystem. Bear diets in Alberta had the lowest levels of digestible protein and energy through all seasons, which might help explain the low reproductive rates of this population. The FR diet had protein levels similar to the recent male diet in the GYE during spring, but energy levels were lower during late summer and fall. Historic and recent diets in GYE had the most energy and protein, which is consistent with their larger body sizes and higher population productivity. However, a recent decrease in consumption of trout (Oncorhynchus clarki), whitebark pine nuts (Pinus albicaulis), and ungulates, particularly elk (Cervus elaphus), in GYE bears has decreased the energy and protein content of their diet. The patterns observed suggest that bear body size and population densities are influenced by seasonal availability of protein an energy, likely due in part to nutritional influences on mass gain and reproductive success.

  2. Mouse adipose tissue stromal cells give rise to skeletal and cardiomyogenic cell sub-populations.

    Science.gov (United States)

    Dromard, Cécile; Barreau, Corinne; André, Mireille; Berger-Müller, Sandra; Casteilla, Louis; Planat-Benard, Valerie

    2014-01-01

    We previously reported that adipose tissue could generate cardiomyocyte-like cells from crude stromal vascular fraction (SVF) in vitro that improved cardiac function in a myocardial infarction context. However, it is not clear whether these adipose-derived cardiomyogenic cells (AD-CMG) constitute a homogenous population and if AD-CMG progenitors could be isolated as a pure population from the SVF of adipose tissue. This study aims to characterize the different cell types that constitute myogenic clusters and identify the earliest AD-CMG progenitors in vitro for establishing a complete phenotype and use it to sort AD-CMG progenitors from crude SVF. Here, we report cell heterogeneity among adipose-derived clusters during their course of maturation and highlighted sub-populations that exhibit original mixed cardiac/skeletal muscle phenotypes with a progressive loss of cardiac phenotype with time in liquid culture conditions. Moreover, we completed the phenotype of AD-CMG progenitors but we failed to sort them from the SVF. We demonstrated that micro-environment is required for the maturation of myogenic phenotype by co-culture experiments. These findings bring complementary data on AD-CMG and suggest that their emergence results from in vitro events.

  3. Mouse adipose tissue stromal cells give rise to skeletal and cardiomyogenic cell sub-populations

    Directory of Open Access Journals (Sweden)

    Cécile eDromard

    2014-08-01

    Full Text Available We previously reported that adipose tissue could generate cardiomyocyte-like cells from crude stromal vascular fraction (SVF in vitro that improved cardiac function in a myocardial infarction context. However, it is not clear whether these adipose-derived cardiomyogenic cells (AD-CMG constitute a homogenous population and if AD-CMG progenitors could be isolated as a pure population from the SVF of adipose tissue. This study aims to characterize the different cell types that constitute myogenic clusters and identify the earliest AD-CMG progenitors in vitro for establishing a complete phenotype and use it to sort AD-CMG progenitors from crude SVF. Here, we report cell heterogeneity among adipose-derived clusters during their course of maturation and highlighted sub-populations that exhibit original mixed cardiac/skeletal muscle phenotypes with a progressive loss of cardiac phenotype with time in liquid culture conditions. Moreover, we completed the phenotype of AD-CMG progenitors but we failed to sort them from the stromal vascular fraction. We demonstrated that micro-environment is required for the maturation of myogenic phenotype by co-culture experiments. These findings bring complementary data on AD-CMG and suggest that their emergence results from in vitro events.

  4. Self-reported non-adherence to ART and virological outcome in a multiclinic UK study.

    Science.gov (United States)

    Sherr, L; Lampe, F C; Clucas, C; Johnson, M; Fisher, M; Leake Date, H; Anderson, J; Edwards, S; Smith, C J; Hill, T; Harding, R

    2010-08-01

    Adherence is of fundamental importance to ART success. We examined the association of self-reported non-adherence with demographic factors, health and behaviour issues, and virological outcome, in a multi-clinic study. Seven hundred and seventy-eight HIV patients in five clinics in London and Brighton completed a questionnaire on adherence and HIV/health issues at baseline in 2005/6. For 486 subjects taking ART, non-adherence in the past week was defined as: (A)>or=1 dose missed or taken incorrectly (wrong time/circumstances); (B)>or=1 dose missed; (C)>or=2 doses missed. Questionnaire data were matched with routine treatment and virology data for consenting subjects (61.4%). We assessed four virological outcomes in 307 of 486 patients: (i) VL>50c/mL using latest VL at the questionnaire and excluding patients starting HAART50c/mL using the first VL from 6 to 12 months post-questionnaire; (iii) any VL>50c/mL from 6 to 12 months post-questionnaire; (iv) among patients with VL50c/mL over two years follow up. Non-adherence was reported by 278 (57.2%), 102 (21.0%) and 49 (10.1%) of 486 patients, for definitions A, B and C, respectively. Non-adherence declined markedly with older age, and tended to be more commonly reported by Black patients, those born outside the UK, those with greater psychological symptoms and those with suicidal thoughts. There was a weaker association with physical symptoms and no association with gender/sexuality, education, unemployment, or risk behaviour (p>0.1). In logistic regression analyses, younger age, non-UK birth and psychological variables were independent predictors of non-adherence [e.g., for non-adherence B: odds ratios (95% CI) were 0.95 (0.92, 0.98) for every year older age; 1.6 (1.0, 2.5) for non-UK born; 2.3 (1.5, 3.7) for suicidal thoughts]. Non-adherence was associated with poorer virological outcome; the most consistent association was for definition C. Among 255 patients with VLdefinition C was independently associated with

  5. Predictors of Non-Adherence to Breast Cancer Screening among Hospitalized Women.

    Directory of Open Access Journals (Sweden)

    Waseem Khaliq

    Full Text Available Disparities in screening mammography use persists among low income women, even those who are insured, despite the proven mortality benefit. A recent study reported that more than a third of hospitalized women were non-adherent with breast cancer screening. The current study explores prevalence of socio-demographic and clinical variables associated with non-adherence to screening mammography recommendations among hospitalized women.A cross sectional bedside survey was conducted to collect socio-demographic and clinical comorbidity data thought to effect breast cancer screening adherence of hospitalized women aged 50-75 years. Logistic regression models were used to assess the association between these factors and non-adherence to screening mammography.Of 250 enrolled women, 61% were of low income, and 42% reported non-adherence to screening guidelines. After adjustment for socio-demographic and clinical predictors, three variables were found to be independently associated with non-adherence to breast cancer screening: low income (OR = 3.81, 95%CI; 1.84-7.89, current or ex-smoker (OR = 2.29, 95%CI; 1.12-4.67, and history of stroke (OR = 2.83, 95%CI; 1.21-6.60. By contrast, hospitalized women with diabetes were more likely to be compliant with breast cancer screening (OR = 2.70, 95%CI 1.35-5.34.Because hospitalization creates the scenario wherein patients are in close proximity to healthcare resources, at a time when they may be reflecting upon their health status, strategies could be employed to counsel, educate, and motivate these patients towards health maintenance. Capitalizing on this opportunity would involve offering screening during hospitalization for those who are overdue, particularly for those who are at higher risk of disease.

  6. Understanding Statin Non-Adherence: Knowing Which Perceptions and Experiences Matter to Different Patients.

    Directory of Open Access Journals (Sweden)

    Hans Wouters

    Full Text Available Non-adherence to statins is substantial and is associated with numerous perceptions and experiences. However, time limits in clinical practice constrain in depth explorations of these perceptions and experiences.To propose and examine a strategy aimed at an efficient assessment of a wide array of perceptions and experiences regarding the efficacy, side effects, and practical problems of statins. Furthermore, to assess associations between this wide array of experiences and perceptions and non-adherence and to examine whether patients' 'perceived self-efficacy' moderated these associations.Patients were recruited through community pharmacies. A wide array of specific patient perceptions and experiences was efficiently assessed using the electronic Tailored Medicine Inventory that allows people to skip irrelevant questions. Adherence was measured through self-report and pharmacy refill data.Of the two-hundred twenty-nine patients who participated (mean age 63.9, standard deviation 10.2, 40%-70% doubted the necessity of or lacked knowledge about the efficacy of statins, 20%-35% of the patients were worried about joint and muscle side effects or had experienced these, and 23% had encountered practical problems regarding information about statins, intake of tablets, the package, or the blister. Experiencing more practical problems was associated with increased unintentional non-adherence (Odds ratio 1.54, 95%CI:1.13-2.10, P < 0.01, whereas worrying about side effects was associated with increased intentional non-adherence (Odds ratio 1.90, 95%CI:1.17-3.08, P < 0.01. Higher 'perceived self-efficacy' did not moderate these associations.Insight into patients' specific barriers with regard to appropriate statin use may reveal personal reasons for being non-adherent. The Tailored Medicine Inventory is a promising tool to devise individualized intervention strategies aimed at improving adherence by the clinician-patient alliance.

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

    Directory of Open Access Journals (Sweden)

    Wakibi Samwel N

    2011-12-01

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

  8. Predictors of Non-Adherence to Breast Cancer Screening among Hospitalized Women.

    Science.gov (United States)

    Khaliq, Waseem; Aamar, Ali; Wright, Scott M

    2015-01-01

    Disparities in screening mammography use persists among low income women, even those who are insured, despite the proven mortality benefit. A recent study reported that more than a third of hospitalized women were non-adherent with breast cancer screening. The current study explores prevalence of socio-demographic and clinical variables associated with non-adherence to screening mammography recommendations among hospitalized women. A cross sectional bedside survey was conducted to collect socio-demographic and clinical comorbidity data thought to effect breast cancer screening adherence of hospitalized women aged 50-75 years. Logistic regression models were used to assess the association between these factors and non-adherence to screening mammography. Of 250 enrolled women, 61% were of low income, and 42% reported non-adherence to screening guidelines. After adjustment for socio-demographic and clinical predictors, three variables were found to be independently associated with non-adherence to breast cancer screening: low income (OR = 3.81, 95%CI; 1.84-7.89), current or ex-smoker (OR = 2.29, 95%CI; 1.12-4.67), and history of stroke (OR = 2.83, 95%CI; 1.21-6.60). By contrast, hospitalized women with diabetes were more likely to be compliant with breast cancer screening (OR = 2.70, 95%CI 1.35-5.34). Because hospitalization creates the scenario wherein patients are in close proximity to healthcare resources, at a time when they may be reflecting upon their health status, strategies could be employed to counsel, educate, and motivate these patients towards health maintenance. Capitalizing on this opportunity would involve offering screening during hospitalization for those who are overdue, particularly for those who are at higher risk of disease.

  9. Understanding Statin Non-Adherence: Knowing Which Perceptions and Experiences Matter to Different Patients.

    Science.gov (United States)

    Wouters, Hans; Van Dijk, Liset; Geers, Harm C J; Winters, Nina A; Van Geffen, Erica C G; Stiggelbout, Anne M; Bouvy, Marcel L

    2016-01-01

    Non-adherence to statins is substantial and is associated with numerous perceptions and experiences. However, time limits in clinical practice constrain in depth explorations of these perceptions and experiences. To propose and examine a strategy aimed at an efficient assessment of a wide array of perceptions and experiences regarding the efficacy, side effects, and practical problems of statins. Furthermore, to assess associations between this wide array of experiences and perceptions and non-adherence and to examine whether patients' 'perceived self-efficacy' moderated these associations. Patients were recruited through community pharmacies. A wide array of specific patient perceptions and experiences was efficiently assessed using the electronic Tailored Medicine Inventory that allows people to skip irrelevant questions. Adherence was measured through self-report and pharmacy refill data. Of the two-hundred twenty-nine patients who participated (mean age 63.9, standard deviation 10.2), 40%-70% doubted the necessity of or lacked knowledge about the efficacy of statins, 20%-35% of the patients were worried about joint and muscle side effects or had experienced these, and 23% had encountered practical problems regarding information about statins, intake of tablets, the package, or the blister. Experiencing more practical problems was associated with increased unintentional non-adherence (Odds ratio 1.54, 95%CI:1.13-2.10, P non-adherence (Odds ratio 1.90, 95%CI:1.17-3.08, P patients' specific barriers with regard to appropriate statin use may reveal personal reasons for being non-adherent. The Tailored Medicine Inventory is a promising tool to devise individualized intervention strategies aimed at improving adherence by the clinician-patient alliance.

  10. Lipid modification gives rise to two distinct Haloferax volcanii S-layer glycoprotein populations.

    Science.gov (United States)

    Kandiba, Lina; Guan, Ziqiang; Eichler, Jerry

    2013-03-01

    The S-layer glycoprotein is the sole component of the protein shell surrounding Haloferax volcanii cells. The deduced amino acid sequence of the S-layer glycoprotein predicts the presence of a C-terminal membrane-spanning domain. However, several earlier observations, including the ability of EDTA to selectively solubilize the protein, are inconsistent with the presence of a trans-membrane sequence. In the present report, sequential solubilization of the S-layer glycoprotein by EDTA and then with detergent revealed the existence of two distinct populations of the S-layer glycoprotein. Whereas both S-layer glycoprotein populations underwent signal peptide cleavage and N-glycosylation, base hydrolysis followed by mass spectrometry revealed that a lipid, likely archaetidic acid, modified only the EDTA-solubilized version of the protein. These observations are consistent with the S-layer glycoprotein being initially synthesized as an integral membrane protein and subsequently undergoing a processing event in which the extracellular portion of the protein is separated from the membrane-spanning domain and transferred to a waiting lipid moiety.

  11. Patient-reported non-adherence and immunosuppressant trough levels are associated with rejection after renal transplantation.

    Science.gov (United States)

    Scheel, Jennifer; Reber, Sandra; Stoessel, Lisa; Waldmann, Elisabeth; Jank, Sabine; Eckardt, Kai-Uwe; Grundmann, Franziska; Vitinius, Frank; de Zwaan, Martina; Bertram, Anna; Erim, Yesim

    2017-03-29

    Different measures of non-adherence to immunosuppressant (IS) medication have been found to be associated with rejection episodes after successful transplantation. The aim of the current study was to investigate whether graft rejection after renal transplantation is associated with patient-reported IS medication non-adherence and IS trough level variables (IS trough level variability and percentage of sub-therapeutic IS trough levels). Patient-reported non-adherence, IS trough level variability, percentage of sub-therapeutic IS trough levels, and acute biopsy-proven late allograft rejections were assessed in 267 adult renal transplant recipients who were ≥12 months post-transplantation. The rate of rejection was 13.5%. IS trough level variability, percentage of sub-therapeutic IS trough levels as well as patient-reported non-adherence were all significantly and positively associated with rejection, but not with each other. Logistic regression analyses revealed that only the percentage of sub-therapeutic IS trough levels and age at transplantation remained significantly associated with rejection. Particularly, the percentage of sub-therapeutic IS trough levels is associated with acute rejections after kidney transplantation whereas IS trough level variability and patient-reported non-adherence seem to be of subordinate importance. Patient-reported non-adherence and IS trough level variables were not correlated; thus, non-adherence should always be measured in a multi-methodological approach. Further research concerning the best combination of non-adherence measures is needed.

  12. Medication beliefs, treatment complexity, and non-adherence to different drug classes in patients with type 2 diabetes.

    Science.gov (United States)

    de Vries, Sieta T; Keers, Joost C; Visser, Rosalie; de Zeeuw, Dick; Haaijer-Ruskamp, Flora M; Voorham, Jaco; Denig, Petra

    2014-02-01

    To assess the relationship of patients' medication beliefs and treatment complexity with unintentional and intentional non-adherence for three therapeutic groups commonly used by patients with type 2 diabetes. Survey data about adherence (Medication Adherence Report Scale) and beliefs about medicines (Beliefs about Medicines Questionnaire) were combined with prescription data from the Groningen Initiative to ANalyse Type 2 diabetes Treatment (GIANTT) database. Patients were classified as being adherent, mainly unintentional non-adherent, or partly intentional non-adherent per therapeutic group (glucose-, blood pressure-, and lipid-lowering drugs). Treatment complexity was measured using the Medication Regimen Complexity Index, which includes the dosage form, dosing frequency and additional directions of taking the drug. Analyses were performed using Kruskal-Wallis and Mann-Whitney U-tests. Of 257 contacted patients, 133 (52%) returned the questionnaire. The patients had a mean age of 66years and 50% were females. Necessity beliefs were not significantly different between the adherers, mainly unintentional non-adherers, and partly intentional non-adherers (differences smaller than 5 points on a scale from 5 to 25). For blood pressure-lowering drugs, patients reporting intentional non-adherence had higher concern beliefs than adherers (8 point difference, P=0.01). Treatment complexity scores were lower for adherers but similar for mainly unintentional and partly intentional non-adherers to glucose- and blood pressure-lowering drugs. Treatment complexity was related to non-adherence in general. Beliefs about necessity were not strongly associated with non-adherence, while patients' concern beliefs may be associated with intentional non-adherence. However, the role of these determinants differs per therapeutic group. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Detection of Outliers Due to Participants’ Non-Adherence to Protocol in a Longitudinal Study of Cognitive Decline

    Science.gov (United States)

    Shipley, Martin J.; Welch, Catherine; Kivimaki, Mika; Singh-Manoux, Archana

    2015-01-01

    Background Participants’ non adherence to protocol affects data quality. In longitudinal studies, this leads to outliers that can be present at the level of the population or the individual. The purpose of the present study is to elaborate a method for detection of outliers in a study of cognitive ageing. Methods In the Whitehall II study, data on a cognitive test battery have been collected in 1997-99, 2002-04, 2007-09 and 2012-13. Outliers at the 2012-13 wave were identified using a 4-step procedure: (1) identify cognitive tests with potential non-adherence to protocol, (2) choose a prediction model between a simple model with socio-demographic covariates and one that also includes health behaviours and health measures, (3) define an outlier using a studentized residual, and (4) study the impact of exclusion of outliers by estimating the effect of age and diabetes on cognitive decline. Results 5516 participants provided cognitive data in 2012-13. Comparisons of rates of annual decline over the first three and all four waves of data suggested outliers in three of the 5 tests. Mean residuals for the 2012-13 wave were larger for the basic compared to the more complex prediction model (all poutliers. Residuals greater than two standard deviation of residuals identified approximately 7% of observations as being outliers. Removal of these observations from the analyses showed that both age and diabetes had associations with cognitive decline similar to that observed with the first three waves of data; these associations were weaker or absent in non-cleaned data. Conclusions Identification of outliers is important as they obscure the effects of known risk factor and introduce bias in the estimates of cognitive decline. We showed that an informed approach, using the range of data collected in a longitudinal study, may be able to identify outliers. PMID:26161552

  14. Detection of Outliers Due to Participants' Non-Adherence to Protocol in a Longitudinal Study of Cognitive Decline.

    Science.gov (United States)

    Dugravot, Aline; Sabia, Severine; Shipley, Martin J; Welch, Catherine; Kivimaki, Mika; Singh-Manoux, Archana

    2015-01-01

    Participants' non adherence to protocol affects data quality. In longitudinal studies, this leads to outliers that can be present at the level of the population or the individual. The purpose of the present study is to elaborate a method for detection of outliers in a study of cognitive ageing. In the Whitehall II study, data on a cognitive test battery have been collected in 1997-99, 2002-04, 2007-09 and 2012-13. Outliers at the 2012-13 wave were identified using a 4-step procedure: (1) identify cognitive tests with potential non-adherence to protocol, (2) choose a prediction model between a simple model with socio-demographic covariates and one that also includes health behaviours and health measures, (3) define an outlier using a studentized residual, and (4) study the impact of exclusion of outliers by estimating the effect of age and diabetes on cognitive decline. 5516 participants provided cognitive data in 2012-13. Comparisons of rates of annual decline over the first three and all four waves of data suggested outliers in three of the 5 tests. Mean residuals for the 2012-13 wave were larger for the basic compared to the more complex prediction model (all poutliers. Residuals greater than two standard deviation of residuals identified approximately 7% of observations as being outliers. Removal of these observations from the analyses showed that both age and diabetes had associations with cognitive decline similar to that observed with the first three waves of data; these associations were weaker or absent in non-cleaned data. Identification of outliers is important as they obscure the effects of known risk factor and introduce bias in the estimates of cognitive decline. We showed that an informed approach, using the range of data collected in a longitudinal study, may be able to identify outliers.

  15. Non-adherence to antipsychotic medication, relapse and rehospitalisation in recent-onset schizophrenia

    Directory of Open Access Journals (Sweden)

    Widen Jan H

    2008-04-01

    Full Text Available Abstract Background The aims of this study were to describe outcome with respect to persistent psychotic symptoms, relapse of positive symptoms, hospital admissions, and application of treatment by coercion among patients with recent onset schizophrenia being adherent and non-adherent to anti-psychotic medication. Materials and methods The study included 50 patients with recent onset schizophrenia, schizoaffective or schizophreniform disorders. The patients were clinically stable at study entry and had less than 2 years duration of psychotic symptoms. Good adherence to antipsychotic medication was defined as less than one month without medication. Outcomes for poor and good adherence were compared over a 24-month follow-up period. Results The Odds Ratio (OR of having a psychotic relapse was 10.27 and the OR of being admitted to hospital was 4.00 among non-adherent patients. Use of depot-antipsychotics were associated with relapses (OR = 6.44. Conclusion Non-adherence was associated with relapse, hospital admission and having persistent psychotic symptoms. Interventions to increase adherence are needed. Trial registration Current Controlled Trials NCT00184509. Key words: Adherence, schizophrenia, antipsychotic medication, admittances, relapse.

  16. Understanding Non-Adherence From the Inside: Hypertensive Patients' Motivations for Adhering and Not Adhering.

    Science.gov (United States)

    Herrera, Pablo A; Moncada, Laura; Defey, Denise

    2017-06-01

    Patients' low adherence to medical treatment in chronic illnesses is one of the biggest public health problems. Numerous studies attend to the diverse factors associated with patient adherence. However, little research has been done to explore patients' reasons for non-compliance from their own point of view. In this article, we aim to understand patient non-adherence using dialogical self-theory and qualitative research methods. We interviewed 51 hypertensive patients to explore their anti- and pro-adherence motivations. Results show that most patients adhere and non-adhere to different aspects of treatment programs (medication, exercise, diet) according to the way they construct meaning to those activities. Also, our findings support the notion that patients' non-adherent behavior aims to preserve important values such as self-esteem, autonomy, affiliation, well-being, freedom, and health (or that more adherence is not worth the extra effort). We discuss the therapeutic relevance of empathically understanding patients' worldview and implicit beliefs.

  17. Can drugs work in patients who do not take them? The problem of non-adherence in resistant hypertension.

    Science.gov (United States)

    Ruzicka, Marcel; Hiremath, Swapnil

    2015-09-01

    Patients with uncontrolled hypertension on adequate combination and doses of blood pressure-lowering drugs present a diagnostic and therapeutic dilemma. Currently, hypertension guidelines point out uncommon causes of hypertension (either organic such as secondary hypertension or drugs/substances interfering with blood pressure-lowering drugs or causing hypertension) as a cause of hypertension resistance. Non-adherence to drugs, however, is equally, if not more, a cause of hypertension resistance. True resistance to pharmacotherapy is relatively uncommon, as in the majority of patients with non-adherence and/or secondary hypertension, the diagnosis of the problem may potentially lead to better control. Conventionally applied indirect methods to detect non-adherence are inadequate to uncover all cases of non-adherence, especially intentional non-adherence. Rigorous methods to detect non-adherence including direct observed therapy and measuring drug/metabolite levels in body fluids should be considered simultaneously if not before costly and invasive investigations for patients with difficult to control hypertension. However, data on the effectiveness of whether diagnosing non-adherence ultimately controls hypertension is still awaited.

  18. Predictors and impact of non-adherence in adults with attention-deficit/hyperactivity disorder receiving OROS methylphenidate: results from a randomized, placebo-controlled trial

    NARCIS (Netherlands)

    Kooij, J.J.; Rosler, M.; Philipsen, A.; Wachter, S.; Dejonckheere, J.; Kolk, A. van der; Agthoven, M. van; Schauble, B.

    2013-01-01

    BACKGROUND: Medication non-adherence has an important impact on treatment efficacy and healthcare burden across a range of conditions and therapeutic areas. The aim of this analysis was to determine predictors of non-adherence and impact of non-adherence on treatment response in adults with attentio

  19. Cognitive and Behavioural Correlates of Non-Adherence to HIV Anti-Retroviral Therapy: Theoretical and Practical Insight for Clinical Psychology and Health Psychology

    Science.gov (United States)

    Begley, Kim; McLaws, Mary-Louise; Ross, Michael W.; Gold, Julian

    2008-01-01

    This cross-sectional study identified variables associated with protease inhibitor (PI) non-adherence in 179 patients taking anti-retroviral therapy. Univariate analyses identified 11 variables associated with PI non-adherence. Multiple logistic regression modelling identified three predictors of PI non-adherence: low adherence self-efficacy and…

  20. Non-adherence in children with asthma reviewed : The need for improvement of asthma care and medical education

    NARCIS (Netherlands)

    Klok, Ted; Kaptein, Adrian A.; Brand, Paul L. P.

    Adherence to daily inhaled corticosteroid therapy is a key determinant of asthma control. Therefore, improving adherence to inhaled corticosteroids is the most effective method through which healthcare providers can help children with uncontrolled asthma. However, identifying non-adherent patients

  1. Non-adherence in children with asthma reviewed : The need for improvement of asthma care and medical education

    NARCIS (Netherlands)

    Klok, Ted; Kaptein, Adrian A; Brand, Paul L P

    2015-01-01

    Adherence to daily inhaled corticosteroid therapy is a key determinant of asthma control. Therefore, improving adherence to inhaled corticosteroids is the most effective method through which healthcare providers can help children with uncontrolled asthma. However, identifying non-adherent patients

  2. Patient-reported non-adherence and immunosuppressant trough levels are associated with rejection after renal transplantation

    National Research Council Canada - National Science Library

    Jennifer Scheel; Sandra Reber; Lisa Stoessel; Elisabeth Waldmann; Sabine Jank; Kai-Uwe Eckardt; Franziska Grundmann; Frank Vitinius; Martina de Zwaan; Anna Bertram; Yesim Erim

    2017-01-01

    .... The aim of the current study was to investigate whether graft rejection after renal transplantation is associated with patient-reported IS medication non-adherence and IS trough level variables...

  3. Non-adherence to subcutaneous biological medication in patients with rheumatoid arthritis: a multicentre, non-interventional study.

    Science.gov (United States)

    Calvo-Alén, Jaime; Monteagudo, Indalecio; Salvador, Georgina; Vázquez-Rodríguez, Tomás R; Tovar-Beltrán, Juan V; Vela, Paloma; Maceiras, Francisco; Bustabad, Sagrario; Román-Ivorra, José A; Díaz-Miguel, Consuelo; Rosas, José; Raya, Enrique; Carmona, Loreto; Cea-Calvo, Luis; Arteaga, María J; Fernández, Sabela; Marras, Carlos

    2017-01-01

    To evaluate non-adherence to prescribed subcutaneous biologicals in rheumatoid arthritis (RA) patients in Spain. ARCO (Study on Adherence of Rheumatoid Arthritis patients to SubCutaneous and Oral Drugs) was a multicentre, non-interventional retrospective study involving 42 rheumatology clinics from representative hospitals throughout Spain. The primary objective was to assess the percentage of patients (aged ≥18 years with an established RA diagnosis) with non-adherence to prescribed subcutaneous biologicals using clinical records and hospital pharmacy dispensing logs as the primary information sources. Adherence was assessed using the Medication Possession Ratio (MPR). Additionally, patients completed the Morisky-Green Medication Adherence Questionnaire. A total of 364 patients (77.5% females, mean age 54.9 years, median RA duration since diagnosis 7.8 years) were enrolled in ARCO. Non-adherence (MPR ≤80%) was reported in 52/363 evaluable patients (14.3%), and was lower in patients receiving initial monthly drug administration (6.4%) than with weekly (17.4%; p=0.034) or every two weeks (14.4%; p=0.102) administration. By multivariate analysis, non-adherence was positively associated with RA duration above the median and with using induction doses. Monthly administration, compared to weekly administration, was inversely associated with non-adherence. Age, gender, order of administration, and changes in the interval of administration, showed no association with non-adherence. Compared with the MPR, the Morisky-Green questionnaire performed poorly in detecting non-adherence. Non-adherence to the prescribed subcutaneous biological drug occurred in 14.3% of patients with RA. Patients using the most convenient administration period (i.e. monthly) had better adherence than those using more frequent dosing schedules.

  4. Psychometric Properties of the Medication Non-Adherence Questionnaire in Patients With Psychiatric Disorders

    Directory of Open Access Journals (Sweden)

    Bahreini

    2015-07-01

    Full Text Available Background Non-adherence to medication in psychiatric patients and identification of related risk factors has provided serious challenges for care service providers. Objectives The current study aims to determine the psychometrics of a questionnaire used to indicate risk factors related to non-adherence to medication in psychiatric patients. Patients and Methods Four-hundred patients with psychiatric disorders in Bushehr and Shiraz were enrolled in this cross-sectional study using convenient sampling methods. An initial questionnaire was designed with 23 items. Following the confirmation of content and face validity of the questionnaire, the questionnaire was completed by the participants and 11 experts contributing to the administration. The item impact score, content validity index (CVI, and content validity ratio (CVR were examined using exploratory factor analysis. In order to calculate the internal and external reliability, the Kuder-Richardson and re-test methods were used. Results Factor analysis revealed five factors in the questionnaire. Five of 23 items had low content validity and were eliminated. The CVI and CVR of the questionnaire were 0.89 and 0.85, respectively. One statement was eliminated owing to a reduced factor load. Internal reliability was r = 0.86, estimated using the Kuder-Richardson method, and external reliability was r = 0.93, estimated via a Pearson correlation coefficient. Five factors resulting from the questionnaire had optimal reliability according to the Cronbach’s alpha coefficient (0.79. Five factors were extracted, including factors related to disease, patient and environment, attitudes toward treatment and therapist, drug side effects, and previous experience to treatment. Conclusions The questionnaire on risk factors related to medication non-adherence in patients with psychiatric disorders had acceptable psychometric characteristics, and is a useful tool to be implemented in medical centers and

  5. Non-adherence to telemedicine interventions for drug users: systematic review

    Directory of Open Access Journals (Sweden)

    Taís de Campos Moreira

    2014-06-01

    Full Text Available OBJECTIVE To estimate rates of non-adherence to telemedicine strategies aimed at treating drug addiction. METHODS A systematic review was conducted of randomized controlled trials investigating different telemedicine treatment methods for drug addiction. The following databases were consulted between May 18, 2012 and June 21, 2012: PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library, Embase, Clinical trials and Google Scholar. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of the studies. The criteria evaluated were: appropriate sequence of data generation, allocation concealment, blinding, description of losses and exclusions and analysis by intention to treat. There were 274 studies selected, of which 20 were analyzed. RESULTS Non-adherence rates varied between 15.0% and 70.0%. The interventions evaluated were of at least three months duration and, although they all used telemedicine as support, treatment methods differed. Regarding the quality of the studies, the values also varied from very poor to high quality. High quality studies showed better adherence rates, as did those using more than one technique of intervention and a limited treatment time. Mono-user studies showed better adherence rates than poly-user studies. CONCLUSIONS Rates of non-adherence to treatment involving telemedicine on the part of users of psycho-active substances differed considerably, depending on the country, the intervention method, follow-up time and substances used. Using more than one technique of intervention, short duration of treatment and the type of substance used by patients appear to facilitate adherence.

  6. What makes orphans in Kigali, Rwanda, non-adherent to antiretroviral therapy? Perspectives of their caregivers

    Directory of Open Access Journals (Sweden)

    Kimiyo Kikuchi

    2014-12-01

    Full Text Available Introduction: Every year, approximately 260,000 children are infected with HIV in low- and middle-income countries. The timely initiation and high level of maintenance of antiretroviral therapy (ART are crucial to reducing the suffering of HIV-positive children. We need to develop a better understanding of the background of children's ART non-adherence because it is not well understood. The purpose of this study is to explore the background related to ART non-adherence, specifically in relation to the orphan status of children in Kigali, Rwanda. Methods: We conducted 19 focus group discussions with a total of 121 caregivers of HIV-positive children in Kigali. The primary data for analysis were verbatim transcripts and socio-demographic data. A content analysis was performed for qualitative data analysis and interpretation. Results: The study found several contextual factors that influenced non-adherence: among double orphans, there was psychological distance between the caregivers and children, whereas economic burden was the primary issue among paternal orphans. The factors promoting adherence also were unique to each orphan status, such as the positive attitude about disclosing serostatus to the child by double orphans’ caregivers, and feelings of guilt about the child's condition among non-orphaned caregivers. Conclusions: Knowledge of orphan status is essential to elucidate the factors influencing ART adherence among HIV-positive children. In this qualitative study, we identified the orphan-related contextual factors that influenced ART adherence. Understanding the social context is important in dealing with the challenges to ART adherence among HIV-positive children.

  7. Factors associated with non-adherence to the treatment of vivax malaria in a rural community from the Brazilian Amazon Basin.

    Science.gov (United States)

    Almeida, Eduardo Dias; Vieira, José Luiz Fernandes

    2016-04-01

    INTRODUCTION We investigated the association between demographic and behavioral factors and non-adherence to antimalarial therapy. METHODS A demographic questionnaire and 5-item self-reported questionnaire regarding non-adherence were completed by 135 patients after treatment for Plasmodium vivax. RESULTS Treatment interruption, but not demographic factors, was significantly associated with non-adherence to therapy. The likelihood of non-adherence was 5.16 times higher when the patients felt better than when they felt worse. The relative risk of parasitic resurgence was 3.04 times higher in non-adherent patients. CONCLUSIONS Treatment interruption is significantly associated with treatment adherence.

  8. Differences in Adherence and Non-Adherence Behaviour Patterns to Inhaler Devices Between COPD and Asthma Patients.

    Science.gov (United States)

    Plaza, Vicente; López-Viña, Antolín; Entrenas, Luis Manuel; Fernández-Rodríguez, Concepción; Melero, Carlos; Pérez-Llano, Luis; Gutiérrez-Pereyra, Fernando; Tarragona, Eduard; Palomino, Rosa; Cosio, Borja G

    2016-10-01

    Differences between COPD and asthma may also differentially affect adherence to inhaled drugs in each disease. We aimed to determine differences in behaviour patterns of adherence and non-adherence to inhaled therapy between patients with COPD and patients with asthma using the Test of Adherence to Inhalers (TAI) questionnaire. A total of 910 patients (55% with asthma, 45% with COPD) participated in a cross-sectional multicentre study. Data recorded included sociodemographics, education level, asthma or COPD history, TAI score, the Asthma Control Test (ACT), the COPD Assessment Test (CAT) and spirometry. Asthma patients were statistically significant less adherents, 140 (28%) vs. 201 (49%), and the pattern of non-adherence was more frequently erratic (66.8% vs. 47.8%) and deliberate (47.2% vs. 34.1%) than COPD patients; however unwitting non-adherence was more frequently observed in COPD group (31.2% vs. 22.8%). Moreover, taking together all sample studied, only being younger than 50 years of age (OR 1.88 [95% CI: 1.26-2.81]) and active working status (OR 1.45 [95% CI: 1.00-2.09]) were risk factors for non-adherence in the multivariate analysis, while having asthma remained in the limits of the significance (OR 1.44 [95%CI: 0.97-2.14]). Even though non-adherence to inhalers is more frequently observed in asthma than in COPD patients and exhibited a different non-adherence patterns, these differences are more likely to be related to sociodemographic characteristics. However, differences in non-adherence patterns should be considered when designing specific education programmes tailored to each disease.

  9. Neuronal-like cell differentiation of non-adherent bone marrow cell-derived mesenchymal stem cells*

    Institute of Scientific and Technical Information of China (English)

    Yuxin Wu; Jinghan Zhang; Xiaoming Ben

    2013-01-01

    Non-adherent bone marrow cel-derived mesenchymal stem cel s from C57BL/6J mice were sepa-rated and cultured using the “pour-off” method. Non-adherent bone marrow cel-derived mesen-chymal stem cel s developed colony-forming unit-fibroblasts, and could be expanded by supple-mentation with epidermal growth factor. Immunocytochemistry showed that the non-adherent bone marrow cel-derived mesenchymal stem cel s exposed to basic fibroblast growth factor/epidermal growth factor/nerve growth factor expressed the neuron specific markers, neurofilament-200 and NeuN, in vitro. Non-adherent bone marrow cel-derived mesenchymal stem cel s fromβ-galactosidase transgenic mice were also transplanted into focal ischemic brain (right corpus striatum) of C57BL/6J mice. At 8 weeks, cel s positive for LacZ andβ-galactosidase staining were observed in the ischemic tissues, and cel s co-labeled with both β-galactosidase and NeuN were seen by double immunohistochemical staining. These findings suggest that the non-adherent bone marrow cel-derived mesenchymal stem cel s could differentiate into neuronal-like cel s in vitro and in vivo.

  10. Current practice and clinicians' perception of medication non-adherence in patients with inflammatory bowel disease: A survey of 98 clinicians.

    Science.gov (United States)

    Soobraty, Anisah; Boughdady, Sarah; Selinger, Christian P

    2017-02-06

    The survey ascertains perceptions and describes current practice of clinicians regarding medication non-adherence in patients with Inflammatory Bowel Disease. Gastroenterologists, trainees and inflammatory bowel disease (IBD) specialist nurses from the United Kingdom were invited to a web based survey collecting data on clinician demographics, patient volume and level of interest in IBD. Respondents were asked to estimate non-adherence levels and report use of screening tools and interventions to improve adherence. Non-adherence was seen as an infrequent problem by 57% of 98 respondents. Levels of non-adherence were estimated lower than evidence suggests by 29% for mesalazine (5ASA), 26% for immunomodulators (IMM) and 21% for biologics (BIOL). Respondents reporting non-adherence as a frequent problem were more likely to report adherence levels in line with evidence (5ASA P non-adherence. Patient counselling on benefits and risks of medication was a commonly used intervention. Clinicians treating IBD patients frequently underestimate non-adherence and use of validated screening tools is infrequent. Most respondents identified the main factors associated with non-adherence in line with evidence and often counselled patients accordingly. Professional education should focus more on non-adherence practice to avoid adverse treatment outcomes associated with non-adherence.

  11. Pinpointing differences in cisplatin-induced apoptosis in adherent and non-adherent cancer cells

    DEFF Research Database (Denmark)

    Tastesen, Hanne Sørup; Holm, Jacob Bak; Poulsen, Kristian Arild

    2010-01-01

    Platinum compounds are used in the treatment of cancer. We demonstrate that cisplatin-induced (10 µM) apoptosis (caspase-3 activity) is pronounced within 18 hours in non-adherent Ehrlich ascites tumour cells (EATC), whereas there is no increase in caspase-3 activity in the adherent Ehrlich Lettré...... ascites tumour cells (ELA). Loss of KCl and cell shrinkage are hallmarks in apoptosis and has been shown in EATC. However, we find no reduction in cell volume and only a minor loss of K(+) which is accompanied by net uptake of Na(+) following 18 hours cisplatin exposure in ELA. Glutathione and taurine...... have previously been demonstrated to protect cells from apoptosis. We find, however, that increase or decrease in the cellular content of glutathione and taurine has no effect on cisplatin-induced cell death in EATC and ELA. Nevertheless, knock-down of the taurine transporter TauT leads...

  12. Factors related to non-adherence to the realization of the Papanicolaou test

    Directory of Open Access Journals (Sweden)

    Márcia Aparecida dos Santos Silva

    2015-09-01

    Full Text Available Objective: to identify reasons for low adherence to the Papanicolaou test in women seeking care in primary health care. Methods: cross-sectional study. Data collection carried out during home visits, applying questionnaire to characterize sociodemographic aspects as well as the reasons for non-adherence to examination and suggestions for facilitating adherence. Results: among 169 women, 67% were of reproductive age and 73.9% have finished elementary school. The failure to previously scheduled examination was due mainly to the beliefs and attitudes (36.1% and service organization (25.4%. The feelings reported by women during the Papanicolaou test were shame (55.6%, discomfort (32.5% and pain (20.7%. Conclusion: Although the screening of cervical cancer is essential for timely intervention, a significant proportion of women still does not adhere to examination by myths and taboos, beliefs, and health attitudes, as well as service organization.

  13. Risk factors for cost-related medication non-adherence among older patients with diabetes

    Institute of Scientific and Technical Information of China (English)

    James; X; Zhang; Jhee; U; Lee; David; O; Meltzer

    2014-01-01

    AIM: To assess the risk factors for cost-related medication non-adherence(CRN) among older patients with diabetes in the United States. METHODS: We used data from the 2010 Health and Retirement Study to assess risk factors for CRN including age, drug insurance coverage, nursing home residence, functional limitations, and frequency of hospitalization. CRN was self-reported. We conducted multivariate regression analysis to assess the effect of each risk factor. RESULTS: Eight hundred and seventy-five(18%) of 4880 diabetes patients reported CRN. Age less than 65 years, lack of drug insurance coverage, and frequent hospitalization significantly increased risk for CRN. Limitation in both activities of daily living and instrumental activities of daily living were also generally associated with increased risk of CRN. Residence in a nursing home and Medicaid coverage significantly reduced risk.CONCLUSION: These results suggest that expandingprescription coverage to uninsured, sicker, and community-dwelling individuals is likely to produce the largest decreases in CRN.

  14. The Patient's Perspective: Adherence or Non-adherence to Asthma Controller Therapy?

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Backer, V; Soes-Petersen, U

    2006-01-01

    )-guidelines' symptom severity classification, 85% should have been on ICS. Accidental and intentional non-adherence with ICS at least twice a week was reported by 27% and 24%, respectively. In case of deterioration, 60% of the patients preferred to take more reliever medication, instead of increasing the ICS dose......STUDY OBJECTIVE: Adherence with controller therapy poses a major challenge to the effective management of persistent asthma. The aim of this study was to explore the patient-related aspects of adherence among adult asthmatics. DESIGN AND PARTICIPANTS: The participants (n = 509 adult asthmatics......), recruited from all parts of Denmark, answered the questionnaire concerning asthma knowledge, attitudes, adherence, and treatment through the Internet. RESULTS: A total of 67% of the patients were prescribed inhaled corticosteroids (ICS). However, according to Global Initiative for Asthma (GINA...

  15. Giving presentations

    CERN Document Server

    Ellis, Mark

    1997-01-01

    This is part of a series of books, which gives training in key business communication skills. Emphasis is placed on building awareness of language appropriateness and fluency in typical business interactions. This new edition is in full colour.

  16. Women and men report different behaviours in, and reasons for medication non-adherence: a nationwide Swedish survey

    Directory of Open Access Journals (Sweden)

    Thunander Sundbom L

    2012-12-01

    Full Text Available Objectives: The aim of the present study was to analyse gender differences in self-reported non-adherence (NA to prescribed medication in the Swedish general population. We aimed to study unintentional and intentional NA as well as the reasons given for NA. Methods: A questionnaire was mailed to a cross-sectional, random, national sample of people aged 18-84 years in Sweden (n=7985. The response rate was 61.1% (n=4875. The questionnaire covered use of prescription drugs, NA behaviour and reasons for NA. Results: Use of prescription drugs was reported by 59.5% (n=2802 of the participants, and 66.4% (n=1860 of these participants did not adhere to the prescribed regimen. No overall gender differences in reporting NA were found. However, when analysing the various types of NA behaviour and the reasons for NA, different gender patterns emerged. Men were more likely to report forgetting [OR=0.77 (95%CI 0.65:0.92], changing the dosage [OR=0.64 (95%CI 0.52:0.79] and that they had recovered [14.3%, (OR=0.71 (95%CI 0.56:0.90] as a reason. In contrast, more women than men reported filling the prescription but not taking the drug [OR=1.25 (95%CI 1.02:1.54] and reported the development of adverse drug reactions (ADRs [OR=1.89 (95%CI 1.37:2.59] as a reason more commonly. The gender differences remained, in most cases, after controlling for confounders such as age, socioeconomic factors, medical problems and attitudes toward drugs.Conclusions: Women and men have different patterns of NA behaviour and different reasons for NA. Therefore, if adherence is to be improved, a wide knowledge of all the reasons for NA is required, along with an understanding of the impact of gender on the outcomes.

  17. Non-adherence in children with asthma reviewed : The need for improvement of asthma care and medical education

    NARCIS (Netherlands)

    Klok, Ted; Kaptein, Adrian A; Brand, Paul L P

    2015-01-01

    Adherence to daily inhaled corticosteroid therapy is a key determinant of asthma control. Therefore, improving adherence to inhaled corticosteroids is the most effective method through which healthcare providers can help children with uncontrolled asthma. However, identifying non-adherent patients i

  18. Non-adherence in children with asthma reviewed : The need for improvement of asthma care and medical education

    NARCIS (Netherlands)

    Klok, Ted; Kaptein, Adrian A.; Brand, Paul L. P.

    2015-01-01

    Adherence to daily inhaled corticosteroid therapy is a key determinant of asthma control. Therefore, improving adherence to inhaled corticosteroids is the most effective method through which healthcare providers can help children with uncontrolled asthma. However, identifying non-adherent patients i

  19. Disentangling breast cancer patients' perceptions and experiences with regard to endocrine therapy: nature and relevance for non-adherence.

    NARCIS (Netherlands)

    Wouters, H.; Geffen, E.C.G. van; Baas-Thijssen, M.C.; Krol-Warmerdam, E.M.; Stiggelbout, A.M.; Belitser, S.; Bouvy, M.L.; Dijk, L. van

    2013-01-01

    Background & study aims: Adjuvant endocrine therapy effectively prevents recurrence and progression of estrogen-receptor positive breast cancer. However, studies reveal substantial non-adherence. The objective was therefore to identify the nature of the experiences and beliefs of women treated with

  20. Disentangling breast cancer patients' perceptions and experiences with regard to endocrine therapy: nature and relevance for non-adherence.

    NARCIS (Netherlands)

    Wouters, H.; Geffen, E.C.G. van; Baas-Thijssen, M.C.; Krol-Warmerdam, E.M.; Stiggelbout, A.M.; Belitser, S.; Bouvy, M.L.; Dijk, L. van

    2013-01-01

    Background & study aims: Adjuvant endocrine therapy effectively prevents recurrence and progression of estrogen-receptor positive breast cancer. However, studies reveal substantial non-adherence. The objective was therefore to identify the nature of the experiences and beliefs of women treated with

  1. Medication beliefs, treatment complexity, and non-adherence to different drug classes in patients with type 2 diabetes

    NARCIS (Netherlands)

    de Vries, Sieta T.; Keers, Joost C.; Visser, Rosalie; de Zeeuw, Dick; Haaijer-Ruskamp, Flora M.; Voorham, Jaco; Denig, Petra

    2014-01-01

    Objective: To assess the relationship of patients' medication beliefs and treatment complexity with unintentional and intentional non-adherence for three therapeutic groups commonly used by patients with type 2 diabetes. Methods: Survey data about adherence (Medication Adherence Report Scale) and be

  2. Determinants of non-adherence to antiretroviral therapy in adult hospitalized patients, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Tsega B

    2015-03-01

    Full Text Available Bayew Tsega,1 Bhagavathula Akshaya Srikanth,1 Zewdneh Shewamene21Department of Clinical Pharmacy, 2Department of Pharmacology, School of Pharmacy – College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaAim: The aim of this study was to assess the rate of antiretroviral therapy (ART adherence and to identify any determinants among adult patients.Methods: A cross-sectional study was conducted on 351 ART patients in the ART clinic of the University of Gondar referral hospital. Data were collected by a pretested interviewer-administered structured questionnaire from May to June 2014. Multivariate logistic regression was used to determine factors significantly associated with adherence.Results: Of 351 study subjects, women were more predominant than men (64.4% versus 35.6%. Three hundred and forty (96.9% patients agreed and strongly agreed that the use of ART is essential in their life, and approximately 327 (93.2% disclosed their sero-status to family. Seventy-nine (22.5% participants were active substance users. The level of adherence was 284 (80.9%. Three hundred forty-one (97.2% respondents had good or fair adherence. Among the reasons for missing doses were forgetfulness (29 [43.3%], missing appointments (14 [20.9%], running out of medicine (9 [13.4%], depression, anger, or hopelessness (4 [6.0%], side effects of the medicine used (2 [3.0%], and nonbelief in the ART (2 [3.0%]. The variables found significantly associated with non-adherence were age (P-value 0.017, employment (P-value 0.02, HIV disclosure (P-value 0.04, and comfortability to take ART in the presence of others (P-value 0.02.Conclusion: From this study, it was determined that forgetfulness (43.3% was the most common reason for missing doses. Also, employment and acceptance in using ART in the presence of others are significant issues observed for non-adherence. Hence, the ART counselor needs to place more emphasis on the provision and use of memory aids

  3. Generation of Mouse Spermatogonial Stem-Cell-Colonies in A Non-Adherent Culture.

    Science.gov (United States)

    Azizi, Hossein; Skutella, Thomas; Shahverdi, Abdolhossein

    2017-01-01

    The properties of self-renewal and division in spermatogonial stem cells (SSCs) support spermatogenesis. There is a number of reported methods for in vitro SSC culture systems. The development of a culture system that effectively supports isolation and selfrenewal of germline stem cells (GSCs) is of tremendous benefit for clinical trials, experimental research, and as potential treatment for male infertility. The current study aims to consider the cultivation and behavior of GSCs in a non-adherent culture system. In this experimental study, we cultured testicular cells from neonatal mice in agarose coated plates in the presence of Dulbecco's modified Eagle's medium (DMEM) medium (CTRL group), 10% fetal bovine serum (FBS)+DMEM (10% group), and growth factor (G group) that contained 2% FBS, glial cell-derived neurotrophic factor (GDNF), epidermal growth factor (EGF), and fibroblast growth factor (FGF). Mouse spermatogonial stem-like colonies were isolated approximately 3 weeks after digestion of the testis tissue. After passages 2-3, the identity of the mouse spermatogonial stem-like cells was confirmed by immunocytochemistry, reverse transcription-polymerase chain reaction (RT-PCR), and flow cytometry against the germ cell markers α6, β1, c-Kit, Thy-1, c-Ret, Plzf, and Oct4. The statistical significance between mean values in different groups was determined by one-way analysis of variance (ANOVA). We observed spermatogonial stem-like colonies in the G and 10% groups, but not the CTRL group. Immunocytochemistry, flow cytometry, and RT-PCR confirmed expressions of germ cell markers in these cells. In the spermatogonial stem-like cells, we observed a significant expression (Pcell markers in the G and 10% groups versus the testis cells (T). Their proliferative and apoptotic activities were examined by Ki67 and PI/annexin V-FITC. Alkaline phosphatase assay showed that mouse spermato- gonial stem-like colonies were partially positive. A non-adherent culture system could

  4. Perceived need to take medication is associated with medication non-adherence in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Zwikker HE

    2014-11-01

    Full Text Available Hanneke E Zwikker,1,2 Sandra van Dulmen,3–5 Alfons A den Broeder,1,2 Bart J van den Bemt,1,2,6 Cornelia H van den Ende1,2 1Department of Rheumatology, 2Department of Pharmacy, Sint Maartenskliniek, Nijmegen, the Netherlands; 3Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands; 4NIVEL (Netherlands Institute for Health Services Research, Utrecht, the Netherlands; 5Department of Health Science, Buskerud and Vestfold University College, Drammen, Norway; 6Department of Pharmacy, Radboud University Medical Centre, Nijmegen, the Netherlands Background: This is the first cross-sectional study that aims to examine associations between beliefs about medication and non-adherence in patients with rheumatoid arthritis (RA using disease-modifying antirheumatic drugs, taking potential psychological confounders into account.Methods: Eligible patients (diagnosed with RA for ≥1 year or ≥18 years, using greater than or equal to one disease-modifying antirheumatic drug were included by their rheumatologist during regular outpatient visits between September 2009 and September 2010. Included patients received questionnaires. The Beliefs about Medicines Questionnaire was used to measure the perceived need to take medication (necessity beliefs, the concerns about taking medication (concern beliefs, general medication beliefs, and attitudes toward taking medication. Medication non-adherence (no/yes was measured using the Compliance Questionnaire Rheumatology (CQR. Associations between beliefs and non-adherence, and the influence of demographical, clinical, and psychological factors (symptoms of anxiety/depression, illness cognitions, self-efficacy were assessed using logistic regression.Results: A total of 580 of the 820 eligible patients willing to participate were included in the analyses (68% female, mean age 63 years, 30% non-adherent to their medication. Weaker necessity beliefs (OR [odds ratio]: 0.8, 95% CI

  5. Population Density Modulates Drug Inhibition and Gives Rise to Potential Bistability of Treatment Outcomes for Bacterial Infections

    Science.gov (United States)

    Maltas, Jeff; Brumm, Peter; Wood, Kevin B.

    2016-01-01

    The inoculum effect (IE) is an increase in the minimum inhibitory concentration (MIC) of an antibiotic as a function of the initial size of a microbial population. The IE has been observed in a wide range of bacteria, implying that antibiotic efficacy may depend on population density. Such density dependence could have dramatic effects on bacterial population dynamics and potential treatment strategies, but explicit measures of per capita growth as a function of density are generally not available. Instead, the IE measures MIC as a function of initial population size, and population density changes by many orders of magnitude on the timescale of the experiment. Therefore, the functional relationship between population density and antibiotic inhibition is generally not known, leaving many questions about the impact of the IE on different treatment strategies unanswered. To address these questions, here we directly measured real-time per capita growth of Enterococcus faecalis populations exposed to antibiotic at fixed population densities using multiplexed computer-automated culture devices. We show that density-dependent growth inhibition is pervasive for commonly used antibiotics, with some drugs showing increased inhibition and others decreased inhibition at high densities. For several drugs, the density dependence is mediated by changes in extracellular pH, a community-level phenomenon not previously linked with the IE. Using a simple mathematical model, we demonstrate how this density dependence can modulate population dynamics in constant drug environments. Then, we illustrate how time-dependent dosing strategies can mitigate the negative effects of density-dependence. Finally, we show that these density effects lead to bistable treatment outcomes for a wide range of antibiotic concentrations in a pharmacological model of antibiotic treatment. As a result, infections exceeding a critical density often survive otherwise effective treatments. PMID:27764095

  6. Patient survey to identify reasons for non-adherence and elicitation of quality of life concepts associated with immunosuppressant therapy in kidney transplant recipients.

    Science.gov (United States)

    Muduma, Gorden; Shupo, Francis C; Dam, Sophie; Hawken, Natalia A; Aballéa, Samuel; Odeyemi, Isaac; Toumi, Mondher

    2016-01-01

    Renal transplantation (RT) is considered the treatment of choice for end-stage renal disease compared to dialysis, offering better health-related quality of life (HRQoL) and higher survival rates. However, immunosuppressants are essential for the long-term survival of kidney grafts and patients' non-adherence to their medication leads to poor outcomes. Immunosuppressants can also significantly alter patients' HRQoL because of their side effects and the complex chronic medication regimen they represent. To elicit key concepts related to adherence to immunosuppressant therapy (IT) and reasons for non-adherence in terms of patient reported outcomes, side effects, and the impact of the medication on HRQoL in RT population, including patient preference of once daily over twice-daily immunosuppressive regimen. Results were used to develop an IT-specific conceptual framework and provide suggestions for improving patients' adherence to IT. Interviews were conducted with three clinical experts to determine key concepts related to RT and immunosuppressants. Thirty-seven participants in four focus groups were asked to cite important concepts related to adherence and impact of IT on HRQoL and to rate them. Qualitative analysis was conducted to code participants' responses. Non-adherence among participants where admitted was unintentional. The reason for this included forgetfulness, interference with lifestyle, being asleep at the time the medication should be taken, change in routine, and impact of side effects. Overall, participants reported that the evening dose was more problematic to remember and that the exclusion of this dose could make them more adherent. Participants also reported that IT impacted on their HRQoL in a number of ways including: placing restrictions on their lifestyle, causing anxiety, or impairing their ability to work. This study provides qualitative evidence about the barriers to IT adherence and the components of HRQoL that are important from the

  7. The impact of non-adherence to medication in patients with schizophrenia on health, social care and societal costs. Analysis of the QUATRO study

    NARCIS (Netherlands)

    King, D.; Knapp, M.; Patel, A.; Amaddeo, F.; Tansella, M.; Schene, A.H.; Koeter, M.; Angermeyer, M.; Becker, T.

    2014-01-01

    Aims. For people with schizophrenia, non-adherence to antipsychotic medications may result in high use of health and other services. The objective of our research was to examine the economic consequences of non-adherence in patients with schizophrenia taking antipsychotic medication. Methods. Data w

  8. Non-adherence to anti-TNF therapy is associated with illness perceptions and clinical outcomes in outpatients with inflammatory bowel disease : results from a prospective multicentre study

    NARCIS (Netherlands)

    Have, Mike van der; Oldenburg, Bas; Kaptein, Ad A; Jansen, Jeroen M; Scheffer, Robert C H; van Tuyl, Bas A; van der Meulen-de Jong, Andrea E; Pierik, Marieke; Siersema, Peter D; van Oijen, Martijn G H; Fidder, Herma H

    2016-01-01

    BACKGROUND AND AIMS: Non-adherence to anti-tumor necrosis factor (TNF) agents in patients with inflammatory bowel disease (IBD) is a serious problem. In this study, we assessed risk factors for non-adherence and examined the association between adherence to anti-TNF agents and loss of response (LOR)

  9. Current practice and clinicians’ perception of medication non-adherence in patients with inflammatory bowel disease: A survey of 98 clinicians

    Science.gov (United States)

    Soobraty, Anisah; Boughdady, Sarah; Selinger, Christian P

    2017-01-01

    AIM The survey ascertains perceptions and describes current practice of clinicians regarding medication non-adherence in patients with Inflammatory Bowel Disease. METHODS Gastroenterologists, trainees and inflammatory bowel disease (IBD) specialist nurses from the United Kingdom were invited to a web based survey collecting data on clinician demographics, patient volume and level of interest in IBD. Respondents were asked to estimate non-adherence levels and report use of screening tools and interventions to improve adherence. RESULTS Non-adherence was seen as an infrequent problem by 57% of 98 respondents. Levels of non-adherence were estimated lower than evidence suggests by 29% for mesalazine (5ASA), 26% for immunomodulators (IMM) and 21% for biologics (BIOL). Respondents reporting non-adherence as a frequent problem were more likely to report adherence levels in line with evidence (5ASA P < 0.001; IMM P = 0.012; BIOL P = 0.015). While 80% regarded screening as important only 25% screen regularly (40% of these with validated assessment tools). Respondents stated forgetfulness, beliefs about necessity of medication and not immediately apparent benefits as the main reasons for non-adherence. Patient counselling on benefits and risks of medication was a commonly used intervention. CONCLUSION Clinicians treating IBD patients frequently underestimate non-adherence and use of validated screening tools is infrequent. Most respondents identified the main factors associated with non-adherence in line with evidence and often counselled patients accordingly. Professional education should focus more on non-adherence practice to avoid adverse treatment outcomes associated with non-adherence. PMID:28217376

  10. Impact of non-adherent Ibuprofen foam dressing in the lives of patients with venous ulcers.

    Science.gov (United States)

    Salomé, Geraldo Magela; Ferreira, Lydia Masako

    2017-01-01

    to evaluate pain in patients with lower limb venous ulcer who used non-adherent Ibuprofen foam dressing (IFD). we conducted a prospective study of patients with lower limb venous ulcers treated from April 2013 to August 2014. We used the Numerical Scale and McGill Pain Questionnaire, performing the assessments at the moment of inclusion of the patient in the study and every eight days thereafter, totaling five consultations. We divided the patients into two groups: 40 in the Study Group (SG), who were treated with IFD, and 40 in the Control Group (CG), treated with primary dressing, according to tissue type and exudate. at the first consultation, patients from both groups reported intense pain. On the fifth day, SG patients reported no pain and the majority of CG reported moderate pain. Regarding the McGill Pain Questionnaire, most patients of both groups reported sensations related to sensory, affective, evaluative and miscellaneous descriptors at the beginning of data collection; after the second assessment, there was slight improvement among the patients in the SG. After the third consultation, they no longer reported the mentioned descriptors. CG patients displayed all the sensations of these descriptors until the fifth visit. non-adherent Ibuprofen foam dressing is effective in reducing the pain of patients with venous ulcers. avaliar a dor em pacientes portadores de úlcera venosa de membros inferiores que utilizaram curativo de espuma não aderente com Ibuprofeno (CEI). estudo prospectivo de pacientes portadores de úlceras venosas de membros inferiores tratados no período de abril de 2013 a agosto de 2014. Foram utilizados os questionários Escala Numérica e Questionário de Dor de McGille, as avaliações eram feitas no momento da inclusão do paciente no estudo e a cada oito dias, totalizando cinco consultas. Os pacientes foram divididos em dois grupos: 40 no Grupo Estudo (GE), que foram tratados com CEI, e 40 no Grupo Controle (GC), tratados com

  11. Causes of non-adherence to therapeutic guidelines in severe community-acquired pneumonia.

    Science.gov (United States)

    Gattarello, Simone; Ramírez, Sergio; Almarales, José Rafael; Borgatta, Bárbara; Lagunes, Leonel; Encina, Belén; Rello, Jordi

    2015-01-01

    To assess the adherence to Infectious Disease Society of America/American Thoracic Society guidelines and the causes of lack of adherence during empirical antibiotic prescription in severe pneumonia in Latin America. A clinical questionnaire was submitted to 36 physicians from Latin America; they were asked to indicate the empirical treatment in two fictitious cases of severe respiratory infection: community-acquired pneumonia and nosocomial pneumonia. In the case of community acquired pneumonia, 11 prescriptions of 36 (30.6%) were compliant with international guidelines. The causes for non-compliant treatment were monotherapy (16.0%), the unnecessary prescription of broad-spectrum antibiotics (40.0%) and the use of non-recommended antibiotics (44.0%). In the case of nosocomial pneumonia, the rate of adherence to the Infectious Disease Society of America/American Thoracic Society guidelines was 2.8% (1 patient of 36). The reasons for lack of compliance were monotherapy (14.3%) and a lack of dual antibiotic coverage against Pseudomonas aeruginosa (85.7%). If monotherapy with an antipseudomonal antibiotic was considered adequate, the antibiotic treatment would be adequate in 100% of the total prescriptions. The compliance rate with the Infectious Disease Society of America/American Thoracic Society guidelines in the community-acquired pneumonia scenario was 30.6%; the most frequent cause of lack of compliance was the indication of monotherapy. In the case of nosocomial pneumonia, the compliance rate with the guidelines was 2.8%, and the most important cause of non-adherence was lack of combined antipseudomonal therapy. If the use of monotherapy with an antipseudomonal antibiotic was considered the correct option, the treatment would be adequate in 100% of the prescriptions.

  12. Reasons for non-adherence to obesity treatment in children and adolescents

    Directory of Open Access Journals (Sweden)

    Thaïs Florence D. Nogueira

    2013-09-01

    Full Text Available OBJECTIVE To analyze the reasons for non-adherence to follow-up at a specialized outpatient clinic for obese children and adolescents. METHODS Descriptive study of 41 patients, including information from medical records and phone recorded questionnaires which included two open questions and eight closed ones: reason for abandonment, financial and structural difficulties (distance and transport costs, relationship with professionals, obesity evolution, treatment continuity, knowledge of difficulties and obesity complications. RESULTS Among the interviewees, 29.3% reported that adherence to the program spent too much time and it was difficult to adjust consultations to patientsâ€(tm and parentsâ€(tm schedules. Other reasons were: childrenâ€(tms refusal to follow treatment (29.3%, dissatisfaction with the result (17.0%, treatment in another health service (12.2%, difficulty in schedule return (7.3% and delay in attendance (4.9%. All denied any relationship problems with professionals. Among the respondents, 85.4% said they are still overweight. They reported hurdles to appropriate nutrition and physical activity (financial difficulty, lack of parentsâ€(tm time, physical limitation and insecure neighborhood. Among the 33 respondents that reported difficulties with obesity, 78.8% had emotional disorders such as bullying, anxiety and irritability; 24.2% presented fatigue, 15.1% had difficulty in dressing up and 15.1% referred pain. The knowledge of the following complications prevailed: cardicac (97.6%, aesthetic (90.2%, psychological (90.2%, presence of obesity in adulthood (90.2%, diabetes (85.4% and cancer (31.4%. CONCLUSIONS According to the results, it is possible to create weight control public programs that are easier to access, encouraging appropriate nutrition and physical activities in order to achieve obesity prevention.

  13. Reasons for non-adherence to obesity treatment in children and adolescents.

    Science.gov (United States)

    Nogueira, Thaïs Florence D; Zambon, Mariana Porto

    2013-09-01

    OBJECTIVE To analyze the reasons for non-adherence to follow-up at a specialized outpatient clinic for obese children and adolescents. METHODS Descriptive study of 41 patients, including information from medical records and phone recorded questionnaires which included two open questions and eight closed ones: reason for abandonment, financial and structural difficulties (distance and transport costs), relationship with professionals, obesity evolution, treatment continuity, knowledge of difficulties and obesity complications. RESULTS Among the interviewees, 29.3% reported that adherence to the program spent too much time and it was difficult to adjust consultations to patients' and parents' schedules. Other reasons were: children's(tm)s refusal to follow treatment (29.3%), dissatisfaction with the result (17.0%), treatment in another health service (12.2%), difficulty in schedule return (7.3%) and delay in attendance (4.9%). All denied any relationship problems with professionals. Among the respondents, 85.4% said they are still overweight. They reported hurdles to appropriate nutrition and physical activity (financial difficulty, lack of parents' time, physical limitation and insecure neighborhood). Among the 33 respondents that reported difficulties with obesity, 78.8% had emotional disorders such as bullying, anxiety and irritability; 24.2% presented fatigue, 15.1% had difficulty in dressing up and 15.1% referred pain. The knowledge of the following complications prevailed: cardicac (97.6%), aesthetic (90.2%), psychological (90.2%), presence of obesity in adulthood (90.2%), diabetes (85.4%) and cancer (31.4%). CONCLUSIONS According to the results, it is possible to create weight control public programs that are easier to access, encouraging appropriate nutrition and physical activities in order to achieve obesity prevention.

  14. Reasons for non-adherence to obesity treatment in children and adolescents

    Science.gov (United States)

    Nogueira, Thaïs Florence D.; Zambon, Mariana Porto

    2013-01-01

    OBJECTIVE To analyze the reasons for non-adherence to follow-up at a specialized outpatient clinic for obese children and adolescents. METHODS Descriptive study of 41 patients, including information from medical records and phone recorded questionnaires which included two open questions and eight closed ones: reason for abandonment, financial and structural difficulties (distance and transport costs), relationship with professionals, obesity evolution, treatment continuity, knowledge of difficulties and obesity complications. RESULTS Among the interviewees, 29.3% reported that adherence to the program spent too much time and it was difficult to adjust consultations to patientsâ€(tm) and parentsâ€(tm) schedules. Other reasons were: childrenâ€(tm)s refusal to follow treatment (29.3%), dissatisfaction with the result (17.0%), treatment in another health service (12.2%), difficulty in schedule return (7.3%) and delay in attendance (4.9%). All denied any relationship problems with professionals. Among the respondents, 85.4% said they are still overweight. They reported hurdles to appropriate nutrition and physical activity (financial difficulty, lack of parentsâ€(tm) time, physical limitation and insecure neighborhood). Among the 33 respondents that reported difficulties with obesity, 78.8% had emotional disorders such as bullying, anxiety and irritability; 24.2% presented fatigue, 15.1% had difficulty in dressing up and 15.1% referred pain. The knowledge of the following complications prevailed: cardicac (97.6%), aesthetic (90.2%), psychological (90.2%), presence of obesity in adulthood (90.2%), diabetes (85.4%) and cancer (31.4%). CONCLUSIONS According to the results, it is possible to create weight control public programs that are easier to access, encouraging appropriate nutrition and physical activities in order to achieve obesity prevention. PMID:24142316

  15. Eight pairs of descending visual neurons in the dragonfly give wing motor centers accurate population vector of prey direction.

    Science.gov (United States)

    Gonzalez-Bellido, Paloma T; Peng, Hanchuan; Yang, Jinzhu; Georgopoulos, Apostolos P; Olberg, Robert M

    2013-01-08

    Intercepting a moving object requires prediction of its future location. This complex task has been solved by dragonflies, who intercept their prey in midair with a 95% success rate. In this study, we show that a group of 16 neurons, called target-selective descending neurons (TSDNs), code a population vector that reflects the direction of the target with high accuracy and reliability across 360°. The TSDN spatial (receptive field) and temporal (latency) properties matched the area of the retina where the prey is focused and the reaction time, respectively, during predatory flights. The directional tuning curves and morphological traits (3D tracings) for each TSDN type were consistent among animals, but spike rates were not. Our results emphasize that a successful neural circuit for target tracking and interception can be achieved with few neurons and that in dragonflies this information is relayed from the brain to the wing motor centers in population vector form.

  16. The patient-physician interaction as a meeting of experts: one solution to the problem of patient non-adherence.

    Science.gov (United States)

    Yelovich, Mary-Clair

    2016-08-01

    Patient non-adherence is a common and important concern in clinical medicine. Some cases of patient non-adherence are cases in which the patient disagrees with the physician's recommended treatment based on particular reasons. Drawing upon science and technology studies literature, specifically the discussion by Collins and Evans and Wynne of how best to understand scientific controversies, I relate their ideas to the analogous conflict that may occur within a clinical interaction. I draw upon their recognition of the importance of contributory expertise and interactional expertise in providing legitimate knowledge. I also draw upon Wynne's idea of the 'negotiation of meanings' as an important element of the clinical interaction. To resolve potential conflicts between patient and physician before they develop into 'non-adherence', I propose the implementation of a new epistemological framework that recognizes legitimate knowledge offered by the patient as well as the physician. By situating this patient expertise framework within the paradigm of patient-centred medicine, and by assuming the goal of medical treatment to be treatment of suffering, patient expertise becomes centralized as a means of determining the nature of patient suffering. Two aspects of the patient's tacit knowledge - the body aspect and the meaning aspect - both of which are context-dependent and directly accessible only to the patient, are thus recognized as knowledge essential to the success of the interaction. The physician's role becomes that of both medical expert and possessor of 'interactional expertise', by which the physician recognizes and includes patient expertise in the treatment decision. By recognizing and incorporating the negotiation of meanings into the development of a treatment plan, this epistemological model of patient expertise should prevent cases of non-adherence based on disagreement. © 2016 John Wiley & Sons, Ltd.

  17. Predictors of non-adherence to follow-up visits and deferasirox chelation therapy among jordanian adolescents with Thalassemia major.

    Science.gov (United States)

    Al-Kloub, Manal Ibrahim; A Bed, Mona A; Al Khawaldeh, Omar A; Al Tawarah, Yasin M; Froelicher, Erika Sivarajan

    2014-10-01

    Poor adherence to treatment can have negative effects on outcomes and heath care cost. However, little is known about the factors that impact adherence to deferasirox chelation therapy. The aims of this study were to identify rates and predictors of non-adherence to medical regimen among thalassemia major adolescents on deferasirox oral chelation therapy by using subjective (self-reporting) and objective (serum ferritin and follow-up visits) measures. Convenient samples of 164 adolescents, aged 12-19 years were recruited from three National Thalassemia Centers in Jordan. Patients were interviewed using a four-section questionnaire and the medical records were checked. Results indicated that rate of adherence according to self-report was (73%); while to follow-up medical appointments and serum ferritin level rates was 57% and 47%, respectively. One-third of participant adolescents (n = 52) were psychologically impaired. Multivariate analysis showed that factors affecting adolescent non-adherence to deferasirox chelation therapy is different from that affecting adherence to follow-up visits. In general, adolescents more than 16 years old, presence of sibling with thalassemia, lack of parental monitoring, lower family income, decrease frequency of blood transfusion, and psychological impairment were found significant predictors of non-adherence among adolescents. Disease knowledge was not associated with adherence status of the adolescents. Clinician should be aware of high prevalence of low adherence to chelation therapy during adolescent years. Nurses need to regularly assess, monitor, and promote adherence behavior that might impact patients' outcomes.

  18. Phosphate binder pill burden, patient-reported non-adherence, and mineral bone disorder markers: Findings from the DOPPS.

    Science.gov (United States)

    Fissell, Rachel B; Karaboyas, Angelo; Bieber, Brian A; Sen, Ananda; Li, Yun; Lopes, Antonio A; Akiba, Takashi; Bommer, Jürgen; Ethier, Jean; Jadoul, Michel; Pisoni, Ronald L; Robinson, Bruce M; Tentori, Francesca

    2016-01-01

    Because of multiple comorbidities, hemodialysis (HD) patients are prescribed many oral medications, including phosphate binders (PBs), often resulting in a high "pill burden." Using data from the international Dialysis Outcomes and Practice Patterns Study (DOPPS), we assessed associations between PB pill burden, patient-reported PB non-adherence, and levels of serum phosphorus (SPhos) and parathyroid hormone (PTH) using standard regression analyses. The study included data collected from 5262 HD patients from dialysis units participating in the DOPPS in 12 countries. PB prescription ranged from a mean of 7.4 pills per day in the United States to 3.9 pills per day in France. About half of the patients were prescribed at least 6 PB pills per day, and 13% were prescribed at least 12 PB pills per day. Overall, the proportion of patients who reported skipping PBs at least once in the past month was 45% overall, ranging from 33% in Belgium to 57% in the United States. There was a trend toward greater PB non-adherence and a higher number of prescribed PB pills per day. Non-adherence to PB prescription was associated with high SPhos (>5.5 mg/dL) and PTH (>600 pg/mL). Adherence to PB is a challenge for many HD patients and may be related to the number of PB pills prescribed. Prescription of a simplified PB regimen could improve patient adherence and perhaps improve SPhos and PTH levels. © 2015 International Society for Hemodialysis.

  19. Claustrophobic tendencies and continuous positive airway pressure therapy non-adherence in adults with obstructive sleep apnea.

    Science.gov (United States)

    Edmonds, Janalyn Cantey; Yang, Hyunju; King, Tonya S; Sawyer, Douglas A; Rizzo, Albert; Sawyer, Amy M

    2015-01-01

    (1) Determine claustrophobia frequency in adults with obstructive sleep apnea (OSA) after first CPAP night; (2) determine if claustrophobia influences CPAP non-adherence. Claustrophobia is common among CPAP-treated OSA adults yet few studies have examined the problem. Secondary analysis of prospective, longitudinal study of OSA adults (n = 97). CPAP-Adapted Fear and Avoidance Scale (CPAP-FAAS) collected immediately after CPAP titration polysomnogram. objective CPAP use at 1 week and 1 month. Sixty-three percent had claustrophobic tendencies. Females had higher CPAP-FAAS scores than males. FAAS ≥ 25, positive score for claustrophobic tendencies, was influential on CPAP non-adherence at 1 week (aOR = 5.53, 95% CI 1.04, 29.24, p = 0.04) and less CPAP use at 1month (aOR = 5.06, 95% CI 1.48, 17.37, p = 0.01) when adjusted for body mass index and CPAP mask style. Claustrophobia is prevalent among CPAP-treated OSA adults and influences short-term and longer-term CPAP non-adherence. Interventions are needed to address this treatment-related barrier. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Does non-adherence to DMARDs influence hospital-related healthcare costs for early arthritis in the first year of treatment?

    Science.gov (United States)

    Pasma, Annelieke; Schenk, Charlotte; Timman, Reinier; van ‘t Spijker, Adriaan; Appels, Cathelijne; van der Laan, Willemijn H.; van den Bemt, Bart; Goekoop, Robert; Hazes, Johanna M. W.; Busschbach, Jan J. V.

    2017-01-01

    Introduction Non-adherence to disease-modifying antirheumatic drugs (DMARDs) is suspected to relate to health care costs. In this study we investigated this relation in the first year of treatment. Methods In a multi-center cohort study with a one year follow up, non-adherence was continuously measured using electronic monitored medication jars. Non-adherence was defined as the number of days with a negative difference between expected and observed opening of the container. Cost measurement focused on hospital costs in the first year: consultations, emergency room visits, hospitalization, medical procedures, imaging modalities, medication costs, and laboratory tests. Cost volumes were registered from patient medical files. We applied multivariate regression analyses for the association between non-adherence and costs, and other variables (age, sex, center, baseline disease activity, diagnosis, socioeconomic status, anxiety and depression) and costs. Results Of the 275 invited patients, 206 were willing to participate. 74.2% had rheumatoid arthritis, 20.9% had psoriatic arthritis and 4.9% undifferentiated arthritis. 23.7% of the patients were more than 20% non-adherent over the follow-up period. Mean costs are € 2117.25 (SD € 3020.32). Non-adherence was positively related to costs in addition to baseline anxiety. Conclusion Non-adherence is associated with health care costs in the first year of treatment for arthritis. This suggests that improving adherence is not only associated with better outcome, but also with savings. PMID:28152001

  1. Non-adherence to medication regimens among older African-American adults.

    Science.gov (United States)

    Bazargan, Mohsen; Smith, James; Yazdanshenas, Hamed; Movassaghi, Masoud; Martins, David; Orum, Gail

    2017-07-25

    of their medications, compared with participants with high drug regimen complexity index. While other studies have documented that non-adherence remains an important issue among older adults, our study shows that for underserved elderly African Americans, these issues are particularly striking. A periodic comprehensive assessment of all medications that they use remains a critical initial step to identify medication related issues. Assessment of their disease and medication related knowledge (e.g., therapeutic purposes, side-effects, special instructions, etc.) and their ability to follow complicated medication regimens and modification of their drug regimens requires inter-professional collaboration.

  2. Prescription factors associated with medication non-adherence in Japan assessed from leftover drugs in the SETSUYAKU-BAG campaign: Focus on oral antidiabetic drugs

    Directory of Open Access Journals (Sweden)

    Kaori Koyanagi

    2016-07-01

    Full Text Available Background: Medication adherence has an important influence on health outcomes in patients with chronic diseases. However, few studies have been performed in Japan to determine factors related to medication non-adherence. Objective: The aim of this study was to identify prescription factors related to medication non-adherence by investigating patient characteristics, all prescriptions, and prescriptions for oral antidiabetic drugs (OADs.Methods: A retrospective cross-sectional survey of prescription data about implementation of dosing regimen was performed at community pharmacies engaged in appropriate use of leftover drugs. We evaluated the amount of drugs originally prescribed and the reduced amount after use of leftover drugs, and then calculated prescription reduction ratio (PRR. We analyzed prescription factors contributing to non-adherence based on the PRR.Results: Prescription information for 1,207 patients was reviewed, revealing that patients were non-adherent to 58% of prescriptions. Lack of a drug copayment, fewer concurrent drugs, and drugs not in single-dose packaging were associated with non-adherence. Among the 1,207 patients, 234 prescriptions for diabetes and 452 OAD formulations were included. Forty-seven percent of prescriptions and 29% of the formulations were non-adherent. A higher dosing frequency and preprandial administration were associated with non-adherence. Among the OADs, adherence was lower for α-glucosidase inhibitors and biguanides than for sulfonylureas. Conclusions: Several factors related to patient characteristics, general drug prescriptions, and OAD prescriptions were associated with non-adherence. Further consideration will be needed to improve adherence to medication in Japan. Health care providers should perform more careful monitoring of adherence in patients with the factors identified by this study.

  3. Factors Affecting Non-Adherence among Patients Diagnosed with Unipolar Depression in a Psychiatric Department of a Tertiary Hospital in Kolkata, India

    OpenAIRE

    Sohini Banerjee; Ravi Prasad Varma

    2013-01-01

    Non-adherence to depression treatment is a common clinical problem globally. However, limited research is available from India. This cross-sectional study aimed to assess non-adherence to prescribed treatment among patients with unipolar depression at a psychiatric out-patient department (OPD) of a tertiary hospital in Kolkata, India. The Morisky Medication Adherence Scale (MMAS) was used and a questionnaire designed by the Principal Investigator (PI) was administered. A total of 239 patients...

  4. Non-adherence to disease-modifying antirheumatic drugs is associated with higher disease activity in early arthritis patients in the first year of the disease

    OpenAIRE

    2015-01-01

    INTRODUCTION: Non-adherence to disease-modifying antirheumatic drugs (DMARDs) hampers the targets of rheumatoid arthritis (RA) treatment, obtaining low disease activity and decreasing radiological progression. This study investigates if, and to what extent, non-adherence to treatment would lead to a higher 28-joint count disease activity score (DAS28) in the first year after diagnosis. METHODS: Adult patients from an ongoing cohort study on treatment adherence were selected if they fulfilled ...

  5. Tuberculosis Treatment Non-Adherence and Lost to Follow Up among TB Patients with or without HIV in Developing Countries: A Systematic Review.

    Science.gov (United States)

    Tola, Habteyes Hailu; Tol, Azar; Shojaeizadeh, Davoud; Garmaroudi, Gholamreza

    2015-01-01

    This systematic review intended to combine factors associated with tuberculosis treatment non-adherence and lost to follow up among TB patients with/without HIV in developing countries. Comprehensive remote electronic databases (MEDLINE, (PMC, Pub Med Central), Google scholar and Web of science) search was conducted using the following keywords: Tuberculosis, treatment, compliance, adherence, default, behavioural factors and socioeconomic factors. All types of studies intended to assess TB treatment non-adherence and lost to follow up in developing countries among adult TB patient from 2008 to data extraction date were included. Twenty-six original and one-reviewed articles, which meet inclusion criteria, were reviewed. TB treatment non-adherence and lost to follow up were continued across developing countries. The main factors associated with TB treatment non-adherence and lost to follow up were socioeconomic factors: lack of transportation cost, lack of social support, and patients-health care worker poor communication. Behavioural factors were Feeling better after few weeks of treatments, tobacco and alcohol use, knowledge deficit about duration of treatment and consequences of non-adherence and lost to follow up. TB treatment non-adherence and lost to follow up were continued across developing countries throughout the publication years of reviewed articles. Numerous, socioeconomic and behavioural factors were influencing TB treatment adherence and lost to follow up. Therefore, well understanding and minimizing of the effect of these associated factors is very important to enhance treatment adherence and follow up completion in developing countries.

  6. Non-adherence to self-care practices & medication and health related quality of life among patients with type 2 diabetes: a cross-sectional study.

    Science.gov (United States)

    Saleh, Farzana; Mumu, Shirin J; Ara, Ferdous; Hafez, Md Abdul; Ali, Liaquat

    2014-05-07

    Non-adherence to lifestyle modification among diabetic patients develops the short-term risks and the long-term complications as well as declines the quality of life. This study aimed to find out the association between non-adherence to self-care practices, medication and health related quality of life (HR-QoL) among type 2 diabetic patients. At least 1 year diagnosed patients with type 2 diabetes (N = 500), age>25 years were conveniently selected from the Out-Patient Department of Bangladesh Institute of Health Sciences Hospital. Patients' self-care practices were assessed via interviewer-administered questionnaires using an analytical cross-sectional design. HRQoL was assessed by an adapted and validated Bangla version of the EQ-5D (EuroQol Group, 2009) questionnaire which has five domains- mobility, self-care, usual activities, pain/discomfort and anxiety/depression and two levels on each dimension. EQ-5D responses were further translated into single summery EQ-5D index using UK TTO value set. Patients' were considered as non-adhered to self-care practices according to the guidelines of Diabetic Association of Bangladesh. Multivariable linear regression was used to assess the association between non-adherence towards self-care practices and HRQoL. Among the study patients, 50.2% were females and mean ± SD age was 54.2 (±11.2) years. Non-adherence rate were assessed for: blood glucose monitoring (37%), diet (44.8%), foot care (43.2%), exercise (33.2%) and smoking (37.2%). About 50.4% patients had problem in mobility, 28.2% in self-care, 47.6% in usual activities, 72.8% in pain/discomfort and 73.6% in anxiety/depression. On chi-squared test, significant association was found between non adherence to foot care and problem with mobility, self-care and usual activities (p non-adherence to exercise and poor mobility, self- care, usual activities, pain and anxiety (p Non-adherence to diet was associated with poor mobility (p non-adherence to foot care (p

  7. Patient survey to identify reasons for non-adherence and elicitation of quality of life concepts associated with immunosuppressant therapy in kidney transplant recipients

    Directory of Open Access Journals (Sweden)

    Muduma G

    2016-01-01

    Full Text Available Gorden Muduma,1 Francis C Shupo,2 Sophie Dam,3 Natalia A Hawken,3 Samuel Aballéa,3 Isaac Odeyemi,1 Mondher Toumi4 1Astellas Pharma Europe Ltd, Chertsey, 2Creativ-Ceutical Ltd, London, UK; 3Creativ-Ceutical Ltd, Paris, 4Public Health (EA 3279, Faculty of Medicine, Aix-Marseille University, Marseille, France Background: Renal transplantation (RT is considered the treatment of choice for end-stage renal disease compared to dialysis, offering better health-related quality of life (HRQoL and higher survival rates. However, immunosuppressants are essential for the long-term survival of kidney grafts and patients’ non-adherence to their medication leads to poor outcomes. Immunosuppressants can also significantly alter patients’ HRQoL because of their side effects and the complex chronic medication regimen they represent. Purpose: To elicit key concepts related to adherence to immunosuppressant therapy (IT and reasons for non-adherence in terms of patient reported outcomes, side effects, and the impact of the medication on HRQoL in RT population, including patient preference of once daily over twice-daily immunosuppressive regimen. Results were used to develop an IT-specific conceptual framework and provide suggestions for improving patients’ adherence to IT. Materials and methods: Interviews were conducted with three clinical experts to determine key concepts related to RT and immunosuppressants. Thirty-seven participants in four focus groups were asked to cite important concepts related to adherence and impact of IT on HRQoL and to rate them. Qualitative analysis was conducted to code participants’ responses. Results: Non-adherence among participants where admitted was unintentional. The reason for this included forgetfulness, interference with lifestyle, being asleep at the time the medication should be taken, change in routine, and impact of side effects. Overall, participants reported that the evening dose was more problematic to remember

  8. Disentangling breast cancer patients' perceptions and experiences with regard to endocrine therapy: nature and relevance for non-adherence.

    Science.gov (United States)

    Wouters, Hans; van Geffen, Erica C G; Baas-Thijssen, Monique C; Krol-Warmerdam, Elly M; Stiggelbout, Anne M; Belitser, Svetlana; Bouvy, Marcel L; van Dijk, Liset

    2013-10-01

    Adjuvant endocrine therapy effectively prevents recurrence and progression of estrogen-receptor positive breast cancer. However, studies reveal substantial non-adherence. The objective was therefore to identify the nature of the experiences and beliefs of women treated with endocrine therapy in an attempt to find potential determinants of non-adherence. Online Focus Groups (OFGs) and individual interviews were conducted with 37 women who were treated with endocrine therapy. Sixty-three statements derived from the OFGs and 11 belief items from the Beliefs about Medicines Questionnaire (BMQ) were used in a Q-sorting task conducted with 14 of the women. The quantitative Q-sorting data were statistically analyzed with Hierarchical Cluster Analysis. A six cluster solution was revealed that included the clusters 'information', 'efficacy', 'tenacity', 'coping', 'side effects' and 'usage'. Women's own experiences and perceptions were not clearly delineated from the beliefs measured with the BMQ. However, women judged their own experiences and perceptions with regard to endocrine therapy as more relevant for adherence than the BMQ beliefs. In order to understand and to improve women's adherence to endocrine therapy, women's own perceptions and experiences about endocrine therapy should be targeted in addition to common beliefs that apply to a wide range of medicines. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Multilevel Correlates of Non-Adherence in Kidney Transplant Patients Benefitting from Full Cost Coverage for Immunosuppressives: A Cross-Sectional Study.

    Science.gov (United States)

    Marsicano, Elisa Oliveira; Fernandes, Neimar Silva; Colugnati, Fernando Antônio Basile; Fernandes, Natalia Maria Silva; De Geest, Sabina; Sanders-Pinheiro, Helady

    2015-01-01

    Adherence is the result of the interaction of the macro, meso, micro, and patient level factors. The macro level includes full coverage of immunosuppressive medications as is the case in Brazil. We studied the correlates of immunosuppressive non-adherence in post kidney transplant patients in the Brazilian health care system. Using a cross-sectional design, adherence to immunosuppressives was assessed in a sample of 100 kidney transplant patients using a composite non-adherence score consisting of three methods (self-report [i.e., The Basel Adherence Scale for Assessment of Immunossupressives-BAASIS], collateral report, and immunosuppressive blood levels). Multilevel correlations of non-adherence were assessed (macro, meso, micro and patient level). Univariate and multivariate logistic regression was applied to assess the correlates of non-adherence. Our sample consisted primarily of male (65%), Caucasians (72%) with a mean age of 45.0 ± 13.5 years old, who received grafts from a living donor (89%), with a mean time after transplantation of 72.3 ± 44.4 months. Prevalence of non-adherence was 51%. Family income higher than five reference wages (21.6 vs. 4%; OR 6.46 [1.35-30.89], p = 0.009; patient level), and having access to private health insurance (35.3% vs. 18.4%; OR 2.42 [0.96-6.10], p = 0.04; meso level) were associated with non-adherence in univariate analysis. Only the higher family income variable was retained in the multiple logistic regression model (OR 5.0; IC: 1.01-25.14; p = 0.04). Higher family income was the only factor that was associated with immunosuppressive non-adherence. In Brazil, lower income recipients benefit from better access to care and coverage of health care costs after transplantation. This is supposed to result in a better immunosuppressive adherence compared to high-income patients who have experienced these benefits continuously.

  10. Identification of patients at risk of non-adherence to oral antirheumatic drugs in rheumatoid arthritis using the Compliance Questionnaire in Rheumatology: an ARCO sub-study.

    Science.gov (United States)

    Marras, Carlos; Monteagudo, Indalecio; Salvador, Georgina; de Toro, Francisco J; Escudero, Alejandro; Alegre-Sancho, Juan J; Raya, Enrique; Ortiz, Ana; Carmona, Loreto; Mestre, Yvonne; Cea-Calvo, Luis; Calvo-Alén, Jaime

    2017-07-01

    The ARCO study (Study on Adherence of Rheumatoid Arthritis patients to SubCutaneous and Oral Drugs), a multicenter, non-interventional retrospective study, was primarily designed to assess the percentage of patients [aged ≥18 years with an established rheumatoid arthritis (RA) diagnosis] with non-adherence to prescribed subcutaneous biologicals. This paper reports data for the secondary objective from a subset of patients, namely to evaluate non-adherence to prescribed oral antirheumatic drugs in RA patients in Spain using the validated Compliance Questionnaire Rheumatology (CQR). Patients also completed the Morisky-Green Medication Adherence Questionnaire, Beliefs about Medicines Questionnaire, and a questionnaire (developed and validated in Spain) on patient satisfaction with RA treatment and preferences. A total of 271 patients (76.7% females; mean age 55.6 years) were being treated with oral drugs for RA, of which 234 completed the CQR questionnaire. Non-adherence was reported in 49/234 (20.9%) patients. The proportion of non-adherence in younger patients (aged ≤48 years; 37.5%) was double that recorded in patients aged >48 years (p = 0.006). Patients with a perception of lower efficacy also had a higher risk of non-adherence (p = 0.012). Multivariable analysis showed that younger age and male gender were independently associated with risk of non-adherence. There was only slight agreement between the CQR and Morisky-Green assessment tools (kappa coefficient = 0.186), possibly reflecting the fact that both questionnaires measure slightly different aspects of medication adherence. In conclusion, one out of five RA patients was identified as at risk for non-adherence with the CQR, and this was more frequent in younger patients and in males.

  11. Reasons behind non-adherence of healthcare practitioners to pediatric asthma guidelines in an emergency department in Saudi Arabia

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    Wahabi Hayfaa A

    2012-07-01

    Full Text Available Abstract Background The prevalence of childhood bronchial asthma in Saudi Arabia has increased in less than a decade from 8% to 23%. Innovations in the management of asthma led to the development of evidence based clinical practice guidelines and protocols to improve the patients’ outcomes. The objectives of this study are to examine the compliance of the healthcare providers in the Pediatrics Emergency Department, in King Khalid University Hospital, with the recommendations of the Pediatrics Asthma Management Protocol (PAMP, and to explore the reasons behind non-adherence. Methods This study is designed in 2 parts, a patients’ chart review and a focus group interview. The medical records of all the children who presented to the Pediatric Emergency Department (PED and were diagnosed as asthmatic, during the period from the 1st of January 2009 to the 31st of March 2009, were reviewed to investigate the compliance of healthcare providers (physicians and nurses with 8 recommendations of the PAMP which are considered to be frequently encountered evidence-practice gaps, and these are 1 documentation of asthma severity grading by the treating physician and nurse 2 limiting the prescription of Ipratropium for children with severe asthma 3 administration of Salbutamol through an inhaler and a spacer 4 documentation of parental education 5 prescription of systemic corticosteroids to all cases of acute asthma 6 limiting chest x-ray requisition for children with suspected chest infection 7 management of all cases of asthma as outpatients, unless diagnosed as severe or life threatening asthma 8 limiting prescription of antibiotics to children with chest infection. The second part of this study is a focus group interview designed to elicit the reasons behind non- adherence to the recommendations detected by the chart review. Two separate focus group interviews were conducted for 10 physicians and 10 nurses. The focus group interviews were tape

  12. Comparison of adherent and non-adherent staphylococci in the induction of polymorphonuclear leukocyte activation in vitro

    DEFF Research Database (Denmark)

    Riber, U; Espersen, F; Kharazmi, A

    1995-01-01

    The ability to consume complement and activate neutrophils was investigated for staphylococci adherent to silicone surfaces and non-adherent staphylococci. Staphylococcus epidermidis strain ATCC 14990 and Staphylococcus aureus strain E 2371 were used in this study. The bacteria were allowed...... at 37 degrees C. The bacteria consumed complement to approximately the same extent when adherent to the catheter segments, but more slowly in comparison with planktonic bacteria. When planktonic bacteria were compared, complement was consumed more quickly by S. epidermidis than by S. aureus. Measuring...... the induction of chemiluminescence by planktonic bacteria, S. epidermidis induced a lower response than S. aureus, while when adherent to the catheter segments the bacteria induced similar responses. These responses were only 15 to 20% of those induced by planktonic bacteria and only slightly higher than...

  13. Levels and correlates of non-adherence to WHO recommended inter-birth intervals in Rufiji, Tanzania

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    Exavery Amon

    2012-12-01

    Full Text Available Abstract Background Poorly spaced pregnancies have been documented worldwide to result in adverse maternal and child health outcomes. The World Health Organization (WHO recommends a minimum inter-birth interval of 33 months between two consecutive live births in order to reduce the risk of adverse maternal and child health outcomes. However, birth spacing practices in many developing countries, including Tanzania, remain scantly addressed. Methods Longitudinal data collected in the Rufiji Health and Demographic Surveillance System (HDSS from January 1999 to December 2010 were analyzed to investigate birth spacing practices among women of childbearing age. The outcome variable, non-adherence to the minimum inter-birth interval, constituted all inter-birth intervals Results A total of 15,373 inter-birth intervals were recorded from 8,980 women aged 15–49 years in Rufiji district over the follow-up period of 11 years. The median inter-birth interval was 33.4 months. Of the 15,373 inter-birth intervals, 48.4% were below the WHO recommended minimum length of 33 months between two live births. Non-adherence was associated with younger maternal age, low maternal education, multiple births from the preceding pregnancy, non-health facility delivery of the preceding birth, being an in-migrant resident, multi-parity and being married. Conclusion Generally, one in every two inter-birth intervals among 15–49 year-old women in Rufiji district is poorly spaced, with significant variations by socio-demographic and behavioral characteristics of mothers and newborns. Maternal, newborn and child health services should be improved with a special emphasis on community- and health facility-based optimum birth spacing education in order to enhance health outcomes of mothers and their babies, especially in rural settings.

  14. Depression longitudinally mediates the association of appearance concerns to ART non-adherence in HIV-infected individuals with a history of injection drug use.

    Science.gov (United States)

    Blashill, Aaron J; Gordon, Janna R; Safren, Steven A

    2014-02-01

    Appearance concerns are common among HIV-infected individuals, and previous cross-sectional and longitudinal data indicate that these concerns are associated with antiretroviral therapy (ART) non-adherence. However, to date, no known prospective data have explored the mechanism behind this relationship. Thus, the aim of the current study was to test depression severity as a prospective mediator of the relationship between appearance concerns and ART non-adherence in HIV-infected individuals with a history of injection drug use (IDU). Participants were 89 HIV-infected individuals with a history of IDU who participated in a prospective, randomized controlled trial of cognitive behavioral therapy for depression and medication adherence. Clinician-administered measures of depression severity and appearance concerns, along with electronic monitoring of ART non-adherence were included. Data were analyzed using longitudinal linear mixed-level modeling, and mediation was tested via the Monte Carlo Method of Assessing Mediation. Appearance concerns were predictive of depression severity, γ = .31, SE = .076, 95 % CI [.16, .46], t = 4.1, p = .0001, and depression severity was predictive of ART non-adherence, γ = 3.3, SE = 1.3, 95 % CI [.8, 5.8], t = 2.6, p = .01. The effect of appearance concerns on ART non-adherence, however, was significantly mediated by depression severity, γ = 1.02, 95 % CI [.21, 2.1]. Appearance concerns are associated with depression severity, which in turn is associated with ART non-adherence. Integrative interventions addressing appearance concerns, depression and ART adherence are needed, as this is one potential pathway towards worse health outcomes in HIV-infected individuals.

  15. Predictors and impact of non-adherence in adults with attention-deficit/hyperactivity disorder receiving OROS methylphenidate: results from a randomized, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Kooij J J Sandra

    2013-01-01

    Full Text Available Abstract Background Medication non-adherence has an important impact on treatment efficacy and healthcare burden across a range of conditions and therapeutic areas. The aim of this analysis was to determine predictors of non-adherence and impact of non-adherence on treatment response in adults with attention-deficit/hyperactivity disorder (ADHD. Methods Post-hoc analysis of a 13-week randomized, double-blind placebo-controlled study of OROS methylphenidate (MPH 54 and 72 mg/day. Primary efficacy variable was the Conners’ Adult ADHD Rating Scale – Screening Version (CAARS:O-SV. Daily adherence was calculated as average daily adherence (100 × capsules taken/2, with overall adherence calculated as the average daily adherence. Predictors of adherence were assessed using mixed-effects logistic regression. Descriptive statistics were generated for change in CAARS:O-SV score for adherent (> 95% adherence and non-adherent subjects. Predictors of change were analyzed using a mixed model. Results Subjects were allocated to OROS MPH (54 mg, n = 87; 72 mg, n = 92 or placebo (n = 97. Mean adherence was 92.6% and 93.3% (OROS MPH 54 and 72 mg/day, respectively, versus 97.5% (placebo. Adherence was higher and less variable in completers. Factors significantly associated with non-adherence included female sex, shorter time since ADHD diagnosis, higher education level (completion of university and score on the Drug Use Screening Inventory psychiatric disorders subscale. Improvements from baseline in CAARS:O-SV score were numerically greater in subjects defined as adherent than in those who were non-adherent. Significant predictors of CAARS:O-SV change in patients who completed the study included percentage adherence up to the point of assessment (p p p = 0.0003. Conclusion The results of this analysis suggest that newly diagnosed patients, those with a high score on the DUSI-R psychiatric disorder scale, women, and subjects with high educational degrees may

  16. Prescription patterns, adherence and characteristics of non-adherence in children with asthma in primary care.

    Science.gov (United States)

    Engelkes, Marjolein; Janssens, Hettie M; de Jongste, Johan C; Sturkenboom, Miriam C J M; Verhamme, Katia M C

    2016-03-01

    Adherence to treatment remains important for successful asthma management. Knowledge about asthma medication use and adherence in real-life offers opportunities to improve asthma treatment in children. To describe prescription patterns, adherence and factors of adherence to drugs in children with asthma. Population-based cohort study in a Dutch primary care database (IPCI), containing medical records of 176,516 children, aged 5-18 years, between 2000 and 2012. From asthma medication prescriptions, age, gender, seasonal and calendar year rates were calculated. Adherence was calculated using medication possession ratio (MPR) and ratio of controller to total asthma drug (CTT). Characteristics of children with high-vs.-low adherence were compared. The total asthma cohort (n = 14,303; 35,181 person-years (PY) of follow-up) was mainly treated with short-acting β2-agonists (SABA; 40 users/100 PY) and inhaled corticosteroids (ICS; 32/100 PY). Median MPR for ICS was 56%. Children with good adherence (Q4 = MPR > 87%) were younger at start of ICS, more often visited specialists and had more exacerbations during follow-up compared to children with low adherence (Q1 = MPR children with asthma were mainly prescribed SABA, and ICS. Adherence to ICS was relatively low. Characteristics of children with good adherence were compatible with more severe asthma, suggesting that adherence is driven by treatment need or intensity of medical follow-up. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Factors Associated with Non-Participation and Non-Adherence in Directly Observed Mass Drug Administration for Malaria in The Gambia.

    Directory of Open Access Journals (Sweden)

    Susan Dierickx

    Full Text Available The potential benefits of Mass Drug Administration (MDA for malaria elimination are being considered in several malaria endemic countries where a decline in malaria transmission has been reported. For this strategy to work, it is important that a large proportion of the target population participates, requiring an in-depth understanding of factors that may affect participation and adherence to MDA programs.This social science study was ancillary to a one-round directly observed MDA campaign with dihydroartemisinin-piperaquine, carried out in 12 villages in rural Gambia between June and August 2014. The social science study employed a mixed-methods approach combining qualitative methods (participant observation and in-depth interviewing and quantitative methods (structured follow-up interviews among non-participating and non-adhering community members.Of 3942 people registered in the study villages, 67.9% adhered to the three consecutive daily doses. For the remaining villagers, 12.6% did not attend the screening, 3.5% was not eligible and 16% did not adhere to the treatment schedule. The main barriers for non-participation and adherence were long and short-term mobility of individuals and specific subgroups, perceived adverse drug reactions and rumors, inconveniences related to the logistics of MDA (e.g. waiting times and the perceived lack of information about MDA.While, there was no fundamental resistance from the target communities, adherence was 67.9%. This shows the necessity of understanding local perceptions and barriers to increase its effectiveness. Moreover, certain of the constraining factors were socio-spatially clustered which might prove problematic since focal areas of residual malaria transmission may remain allowing malaria to spread to adjacent areas where transmission had been temporarily interrupted.

  18. Reasons for non-adherence to vaccination at mother and child care clinics (MCCs) in Lambaréné, Gabon

    NARCIS (Netherlands)

    N.G. Schwarz; M. Gysels; C. Pell; J. Gabor; M. Schlie; S. Issifou; B. Lell; P.G. Kremsner; M.P. Grobusch; R. Pool

    2009-01-01

    The aim of this paper is to explore attitudes of mothers towards childhood vaccinations and reasons for non-attendance and non-adherence to mother-child clinics (MCCs). Forty in-depth interviews with mothers of children under 5 years of age revealed positive attitudes towards vaccination that seem a

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

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    Deborah A Gust

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

  20. Multilevel Correlates of Non-Adherence in Kidney Transplant Patients Benefitting from Full Cost Coverage for Immunosuppressives: A Cross-Sectional Study

    Science.gov (United States)

    Marsicano, Elisa Oliveira; Fernandes, Neimar Silva; Colugnati, Fernando Antônio Basile; Fernandes, Natalia Maria Silva; De Geest, Sabina; Sanders-Pinheiro, Helady

    2015-01-01

    Background Adherence is the result of the interaction of the macro, meso, micro, and patient level factors. The macro level includes full coverage of immunosuppressive medications as is the case in Brazil. We studied the correlates of immunosuppressive non-adherence in post kidney transplant patients in the Brazilian health care system. Methods Using a cross-sectional design, adherence to immunosuppressives was assessed in a sample of 100 kidney transplant patients using a composite non-adherence score consisting of three methods (self-report [i.e., The Basel Adherence Scale for Assessment of Immunossupressives–BAASIS], collateral report, and immunosuppressive blood levels). Multilevel correlations of non-adherence were assessed (macro, meso, micro and patient level). Univariate and multivariate logistic regression was applied to assess the correlates of non-adherence. Results Our sample consisted primarily of male (65%), Caucasians (72%) with a mean age of 45.0 ± 13.5 years old, who received grafts from a living donor (89%), with a mean time after transplantation of 72.3 ± 44.4 months. Prevalence of non-adherence was 51%. Family income higher than five reference wages (21.6 vs. 4%; OR 6.46 [1.35–30.89], p = 0.009; patient level), and having access to private health insurance (35.3% vs. 18.4%; OR 2.42 [0.96–6.10], p = 0.04; meso level) were associated with non-adherence in univariate analysis. Only the higher family income variable was retained in the multiple logistic regression model (OR 5.0; IC: 1.01–25.14; p = 0.04). Conclusions Higher family income was the only factor that was associated with immunosuppressive non-adherence. In Brazil, lower income recipients benefit from better access to care and coverage of health care costs after transplantation. This is supposed to result in a better immunosuppressive adherence compared to high-income patients who have experienced these benefits continuously. PMID:26619070

  1. Multilevel Correlates of Non-Adherence in Kidney Transplant Patients Benefitting from Full Cost Coverage for Immunosuppressives: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Elisa Oliveira Marsicano

    Full Text Available Adherence is the result of the interaction of the macro, meso, micro, and patient level factors. The macro level includes full coverage of immunosuppressive medications as is the case in Brazil. We studied the correlates of immunosuppressive non-adherence in post kidney transplant patients in the Brazilian health care system.Using a cross-sectional design, adherence to immunosuppressives was assessed in a sample of 100 kidney transplant patients using a composite non-adherence score consisting of three methods (self-report [i.e., The Basel Adherence Scale for Assessment of Immunossupressives-BAASIS], collateral report, and immunosuppressive blood levels. Multilevel correlations of non-adherence were assessed (macro, meso, micro and patient level. Univariate and multivariate logistic regression was applied to assess the correlates of non-adherence.Our sample consisted primarily of male (65%, Caucasians (72% with a mean age of 45.0 ± 13.5 years old, who received grafts from a living donor (89%, with a mean time after transplantation of 72.3 ± 44.4 months. Prevalence of non-adherence was 51%. Family income higher than five reference wages (21.6 vs. 4%; OR 6.46 [1.35-30.89], p = 0.009; patient level, and having access to private health insurance (35.3% vs. 18.4%; OR 2.42 [0.96-6.10], p = 0.04; meso level were associated with non-adherence in univariate analysis. Only the higher family income variable was retained in the multiple logistic regression model (OR 5.0; IC: 1.01-25.14; p = 0.04.Higher family income was the only factor that was associated with immunosuppressive non-adherence. In Brazil, lower income recipients benefit from better access to care and coverage of health care costs after transplantation. This is supposed to result in a better immunosuppressive adherence compared to high-income patients who have experienced these benefits continuously.

  2. Non-adherence to the older antihypertensive therapy: a challenge to be faced by the professional staff

    Directory of Open Access Journals (Sweden)

    Inalva Valadares Freitas

    2011-01-01

    Full Text Available This article aims to identify and discuss the factors related to non-adherence to antihypertensive therapy. It is a literature search that was to switch the chronological period from 1975 to2009. We used primary source of data available in databases Bireme, sites of the Brazilian Society of Hypertension and the Brazilian Society of Cardiology. The results show that many factors may predispose for non-compliance should be analyzed and addressed by patients, health professionals and institutions. Among these may be highlighted factors related to disease and treatment, such as absence of symptoms and side effects, difficulties in access to medicines and services, socio-demographic characteristics, such as illiteracy and low level of knowledge about health-related functional disability as cognitive deficits, visual and auditory, psychological profile of the patient and locus of control, factors related to the belief, lifestyle and culture, relational factors as inadequate social support, family and institutional and professional relationship of health-ill patient. Studies of adherence may contribute significantly to both the planning and organization of health and to reorient care practices from the perspective of rational use of medicines by the elderly.

  3. Non-adherence to prescribed home rehabilitation exercises for musculoskeletal injuries: the role of the patient-practitioner relationship.

    Science.gov (United States)

    Wright, Bradley James; Galtieri, Nicholas Justin; Fell, Michelle

    2014-02-01

    To identify which factors best explain non-adherence to home rehabilitation exercises (HRE) for patients with musculoskeletal injuries. Cross-sectional study. Participants (n = 87) aged 17-91 years completed questionnaires measuring demographic and injury-related information, self-efficacy, personality, health locus of control, patient-practitioner relationship, optimism, health value and adherence to HRE. In addition, each participant's attending physiotherapist assessed the participant's adherence and effort during the appointment. A hierarchical regression with 3 steps (step 1: disposition; step 2: cognitive factors; step 3: patient-practitioner relationship) and adherence to HRE as the dependent variable was conducted. The factors in step 3 were the most significant and explained 16% (p adherence to HRE. In addition, a high score for patient neuroticism was found to correlate with poor adherence to HRE. These preliminary results suggest that the patient-practitioner relationship is the best predictor of adherence to HRE, and that improving patient perception of the clinician's productivity, communication of information and trust during consultations may improve adherence to HRE.

  4. Automated microraft platform to identify and collect non-adherent cells successfully gene-edited with CRISPR-Cas9.

    Science.gov (United States)

    Attayek, Peter J; Waugh, Jennifer P; Hunsucker, Sally A; Grayeski, Philip J; Sims, Christopher E; Armistead, Paul M; Allbritton, Nancy L

    2017-05-15

    Microraft arrays have been used to screen and then isolate adherent and non-adherent cells with very high efficiency and excellent viability; however, manual screening and isolation limits the throughput and utility of the technology. In this work, novel hardware and software were developed to automate the microraft array platform. The developed analysis software identified microrafts on the array with greater than 99% sensitivity and cells on the microrafts with 100% sensitivity. The software enabled time-lapse imaging and the use of temporally varying characteristics as sort criteria. The automated hardware released microrafts with 98% efficiency and collected released microrafts with 100% efficiency. The automated system was used to examine the temporal variation in EGFP expression in cells transfected with CRISPR-Cas9 components for gene editing. Of 11,499 microrafts possessing a single cell, 220 microrafts were identified as possessing temporally varying EGFP-expression. Candidate cells (n=172) were released and collected from the microraft array and screened for the targeted gene mutation. Two cell colonies were successfully gene edited demonstrating the desired mutation.

  5. Treatment non-adherence in teenage and young adult cancer patients: a preliminary study of patient perceptions.

    Science.gov (United States)

    Kondryn, Helena J; Edmondson, Claire L; Hill, Jonathan W; Eden, Tim O B

    2009-12-01

    Non-adherence (NA) by adolescents receiving cancer treatment is believed to be a major problem. However, adequate measures of NA have not been developed. The purpose of this study was to (1) assess the internal reliability of a new scale reflecting low-risk NA behaviours, (2) examine whether the scores on this scale were associated with high-risk NA behaviours and (3) assess the relationship between NA behaviours and patient attitudes towards stopping treatment. Thirty-three patients (16-24 years) with solid tumours reported on their previous adherence with treatment. Low-risk NA behaviours were assessed on a 0-40 scale derived from the sum of 10 items. High-risk NA behaviours and attitudes towards stopping treatment were assessed by questions with yes/no response options. Internal reliability of the low-risk NA scale was alpha=0.73. Patients not seeking help for pyrexia had higher total low-risk NA scores than those who sought help (mean 7.4, SD 5.3 vs mean 3.5, SD 3.6, t=2.1, p=0.03). There was also a trend for individuals who ignored pyrexia to be more likely to have contemplated stopping treatment than those who sought medical assistance (Fisher's Exact=0.09). A scale reflecting low-risk NA behaviour had good internal reliability and was associated with not seeking help when pyrexic. Ignoring a temperature was also associated with contemplating stopping treatment. We are now conducting a prospective study using the measure to assess validity against a range of information regarding NA.

  6. Tumour-cytolytic human monocyte-derived macrophages: a simple and efficient method for the generation and long-term cultivation as non-adherent cells in a serum-free medium.

    Science.gov (United States)

    Streck, R J; Hurley, E L; Epstein, D A; Pauly, J L

    1992-01-01

    We report a simple and efficient culture procedure for the generation of tumour-cytolytic human monocyte-derived macrophages (MAC). In this method, normal human peripheral blood mononuclear cells, isolated using a conventional Ficoll-Hypaque density gradient procedure, are cultured as a heterogenous leukocyte population in Teflon or other hydrophobic cultureware, in a commercially available serum-free culture medium (M-SFM) that has been formulated specifically for the cultivation and ex vivo stimulation of human monocytes and MAC, and in the absence of exogenous mitogens, antigens, cytokines or other stimulants. This procedure features a negative-selection technique that takes advantage of the differential survival of blood leukocytes. Using the prescribed in vitro conditions, lymphocytes survived relatively poorly, whereas monocytes differentiated in the absence of exogenous stimulants into mature tumour-cytolytic MAC. The MAC were present as non-adherent, single cells that expressed good viability (greater than 95%) for a prolonged period (greater than 60 days). When compared to conventional procedures for generating MAC, the prescribed technique is thought to offer several important advantages in that it: (a) eliminates the tedious and cumbersome monocyte isolation procedures, thus providing a significant savings not only in time and money but also in eliminating repetitive cell manipulations that have often been associated with damage to monocyte morphology and/or function; (b) reduces the loss of monocyte subsets that are not recovered during specific isolation procedures; (c) facilitates harvesting a single cell, non-adherent suspension of immunocompetent MAC suitable for various examinations including analyses defining MAC morphology, cytochemistry, phenotype and function; and (d) eliminates variability and artifacts associated with different sera that are utilised frequently as medium supplements. The utility of the prescribed method is illustrated by the

  7. An update on the Barriers to Adherence and a Definition of Self-Report Non-adherence Given Advancements in Antiretroviral Therapy (ART).

    Science.gov (United States)

    Sauceda, John A; Neilands, Torsten B; Johnson, Mallory O; Saberi, Parya

    2017-03-28

    Relying on the most frequently reported barriers to adherence and convenient definitions of non-adherence may lead to less valid results. We used a dominance analysis (a regression-based approach) to identify the most important barriers to adherence based on effect size using data collected through an online survey. The survey included the Adherence Barrier Questionnaire, self-reported non-adherence defined as a 4-day treatment interruption, and HIV clinical outcomes. The sample (N = 1217) was largely male, gay identified, and White. Nearly 1 in 3 participants reported "simply forgot" as a barrier; however, in a dominance analysis, it yielded a small effect size it its association with a 4-day treatment interruption. Further, dominance analyses stratified by race/ethnicity and age suggested that not all barriers impact all groups equally. The most frequently reported barriers to adherence were not the most important, and interventions should focus on barriers more strongly linked to clinical outcomes.

  8. Associations between patients' adherence and GPs' attitudes towards risk, statin therapy and management of non-adherence--a survey and register-based study.

    Science.gov (United States)

    Barfoed, Benedicte L; Paulsen, Maja S; Christensen, Palle M; Halvorsen, Peder A; Jarbøl, Dorte E; Larsen, Mogens L; Munch, Maria R; Søndergaard, Jens; Nielsen, Jesper B

    2016-04-01

    Previous studies suggest that doctors' personal lifestyle, risk taking personality and beliefs about risk reducing therapies may affect their clinical decision-making. Whether such factors are further associated with patients' adherence with medication is largely unknown. To estimate associations between GPs' attitudes towards risk, statin therapy and management of non-adherence and their patients' adherence, and to identify subgroups of GPs with poor patient adherence. All Danish GPs were invited to participate in an online survey. We asked whether they regarded statin treatment as important, how they managed non-adherence and whether non-adherence annoyed them. The Jackson Personality Inventory-revised was used to measure risk attitude. The GPs' responses were linked to register data on their patients' redeemed statin prescriptions. Mixed effect logistic regression was used to estimate associations between patient adherence and GPs' attitudes. Adherence was estimated by the proportion of days covered in a 1-year period using an 80% cut-off. We received responses from 1398 GPs (42.2%) who initiated statin therapy in 12 192 patients during the study period. In total 6590 (54.1%) of these patients were adherent. Patients who had GPs rarely assessing their treatment adherence were less likely to be adherent than those who had GPs assessing their patients' treatment adherence now and then, odds ratio (OR) 0.86 [confidence interval (CI) 0.77-0.96]. No other associations were found between patients' adherence and GPs' attitudes. Our findings suggest that GPs' attitudes to risk, statin therapy or management of non-adherence are not significantly associated with their patients' adherence. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. High self-reported non-adherence to antiretroviral therapy amongst adolescents living with HIV in Malawi: barriers and associated factors

    Directory of Open Access Journals (Sweden)

    Maria H Kim

    2017-01-01

    Conclusions: In our study, nearly half of all ALHIV reported non-adherence to ART in the past month. Violence in the home or alcohol use in the past year as well as poor treatment self-efficacy were associated with worse adherence. Sub-optimal adherence is a major issue for ALHIV and compromise treatment outcomes. Programmes specifically tailored to address those challenges most pertinent to ALHIV may help improve adherence to ART.

  10. Mortes evitáveis em pacientes de trauma associadas a não adesão às diretrizes de atendimento Preventable deaths in trauma patients associated with non adherence to management guidelines

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    Antonio Cesar Marson

    2010-09-01

    patients treated for traumatic injuries and to identify adherence to guidelines recommendations of treatment and association with death. The recommendations adopted were defined by the committee on trauma of the American College of Surgeons in advanced trauma life support. METHODS: Retrospective cohort study conducted at a teaching hospital. The study population was victims of trauma > 12 years of age with injury severity scores > 16 who were treated between January 1997 and December 2001. Data collection was divided into three phases: pre-hospital, in-hospital, and post-mortem. The data collected were analyzed using EPI INFO. RESULTS: We analyzed 207 patients, 147 blunt trauma victims (71% and 60 (29% penetrating trauma victims. Trauma victims had a 40.1% mortality rate. We identified 221 non adherence events that occurred in 137 patients. We found a mean of 1.61 non adherence per patient, and it occurred less frequently in survivors (1.4 than in non-survivors (1.9; p=0.033. According to the trauma score and injury severity score methodology, 54.2% of deaths were considered potentially preventable. Non adherence occurred 1.77 times more frequently in those considered potentially preventable deaths compared to other non-survivors (95% CI: 1.12-2.77; p=0.012, and 92.9% of the multiple non adherence occurred in the first group (p=0.029. CONCLUSIONS: Non adherence occurred more frequently in patients with potentially preventable deaths. Non adherence to guidelines recommendations can be considered a contributing factor to death in trauma victims and can lead to an increase in the number of potentially preventable deaths.

  11. Non-adherence to Anti-TNF Therapy is Associated with Illness Perceptions and Clinical Outcomes in Outpatients with Inflammatory Bowel Disease: Results from a Prospective Multicentre Study.

    Science.gov (United States)

    van der Have, Mike; Oldenburg, Bas; Kaptein, Ad A; Jansen, Jeroen M; Scheffer, Robert C H; van Tuyl, Bas A; van der Meulen-de Jong, Andrea E; Pierik, Marieke; Siersema, Peter D; van Oijen, Martijn G H; Fidder, Herma H

    2016-05-01

    Non-adherence to anti-tumour necrosis factor [TNF] agents in patients with inflammatory bowel disease [IBD] is a serious problem. In this study, we assessed risk factors for non-adherence and examined the association between adherence to anti-TNF agents and loss of response [LOR]. In this multicentre, 12-month observational study, outpatients with IBD were included. Demographic and clinical characteristics were recorded. Adherence was measured with the Modified Morisky Adherence Scale-8 [MMAS-8] and 12-month pharmacy refills [medication possession ratio, MPR]. Risk factors included demographic and clinical characteristics, medication beliefs, and illness perceptions. Cox regression analysis was performed to determine the association between MPR and LOR to anti-TNF, IBD-related surgery or hospitalisation, dose intensification, or discontinuation of anti-TNF. In total, 128 patients were included [67 infliximab, 61 adalimumab], mean age 37 ( ± standard deviation [SD] 14) years, 71 [56%] female. Median disease duration was 8 (interquartile range [IQR] 4-14) years. Clinical disease activity was present in 41/128 [32%] patients, 36/127 [28%] patients had an MMAS-8 illness duration [OR 0.60, 95% CI 0.38-0.96]. Adherence is linearly and negatively [OR 0.14, 95% CI 0.03-0.63] associated with LOR. Non-adherence to anti-TNF agents is strongly associated with LOR to anti-TNF agents, adalimumab use, and illness perceptions. The latter may provide an important target for interventions aimed at improving adherence and health outcomes. Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  12. Non-adherence to diet and exercise recommendations amongst patients with type 2 diabetes mellitus attending Extension II Clinic in Botswana

    Directory of Open Access Journals (Sweden)

    Adewale B. Ganiyu

    2013-01-01

    Full Text Available Background: Patients diagnosed with type 2 diabetes mellitus in Extension II Clinic in Botswana have difficulty in adhering to the lifestyle modifications recommended by healthcare practitioners. Poor adherence to lifestyle recommendations leads to poor control of the condition and consequently to complications.Objectives: The aim of the study was to determine reasons for poor adherence to lifestyle recommendations amongst the patients. The objectives were to determine: reasons for pooradherence to dietary requirements, exercise recommendations, the support they had in adhering to the recommendations, and their understanding of the role of dietary and exercise requirements in the management of their condition.Method: This was a cross-sectional descriptive study. The sample comprised of 105 participants. Data on participants’ baseline characteristics and adherence to dietary and exercise habits were analysed using the SPSS 14.0 version.Results: The sample of 104 participants comprised of 61 (58.7% women. The rates of nonadherence to diet and exercise were 37% and 52% respectively. The main reasons for nonadherence to diet were: poor self-discipline (63.4%; lack of information (33.3% and thetendency to eat out (31.7%. The main reasons for non-adherence to exercise were: lack of information (65.7%; the perception that exercise exacerbated their illness (57.6% and lack of an exercise partner (24.0%.Conclusion: There was a relatively high rate of non-adherence to both diet and exercise recommendations by patients suffering from type 2 diabetes mellitus at Extension II Clinic,Botswana, with non-adherence to exercise recommendations more common.

  13. The currently used commercial DNA-extraction methods give different results of clostridial and actinobacterial populations derived from human fecal samples.

    Science.gov (United States)

    Maukonen, Johanna; Simões, Catarina; Saarela, Maria

    2012-03-01

    Recently several human health-related microbiota studies have had partly contradictory results. As some differences may be explained by methodologies applied, we evaluated how different storage conditions and commonly used DNA-extraction kits affect bacterial composition, diversity, and numbers of human fecal microbiota. According to our results, the DNA-extraction did not affect the diversity, composition, or quantity of Bacteroides spp., whereas after a week's storage at -20 °C, the numbers of Bacteroides spp. were 1.6-2.5 log units lower (P bacteria, Eubacterium rectale (Erec)-group, Clostridium leptum group, bifidobacteria, and Atopobium group were 0.5-4 log units higher (P DNA-extraction as detected with qPCR, regardless of storage. Furthermore, the bacterial composition of Erec-group differed significantly after different DNA-extractions; after enzymatic DNA-extraction, the most prevalent genera detected were Roseburia (39% of clones) and Coprococcus (10%), whereas after mechanical DNA-extraction, the most prevalent genera were Blautia (30%), Coprococcus (13%), and Dorea (10%). According to our results, rigorous mechanical lysis enables detection of higher bacterial numbers and diversity from human fecal samples. As it was shown that the results of clostridial and actinobacterial populations are highly dependent on the DNA-extraction methods applied, the use of different DNA-extraction protocols may explain the contradictory results previously obtained. © 2011 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

  14. Giving Medicine to Children

    Science.gov (United States)

    ... Products For Consumers Home For Consumers Consumer Updates Articulos en Espanol Giving Medicine to Children Share Tweet ... right medicine and the right amount More in Articulos en Espanol Alimentos y Bebidas Cosméticos Dispositivos Médicos ...

  15. Giving Medication to Children

    Science.gov (United States)

    ... For Consumers Home For Consumers Consumer Updates Giving Medication to Children Share Tweet Linkedin Pin it More ... the upper limit. back to top Q: Are medications that are intended for children clinically tested on ...

  16. Patient reported health outcomes and non-adherence in psoriasis patients receiving adalimumab or ustekinumab for moderate to severe plaque psoriasis.

    Science.gov (United States)

    Goren, Amir; Carter, Chureen; Lee, Seina

    2016-01-01

    The objective of this study is to compare health outcomes of patients using biologic therapies ustekinumab (UST) or adalimumab (ADA) for moderate-to-severe plaque psoriasis (PsO) and assess biologics non-adherence. Two phases of web-based survey data were collected, assessing adult patients with PsO from a Diplomat® Specialty Pharmacy US claims database (Diplomat Specialty Pharmacy; Flint, MI). Measures included demographics, treatment and health characteristics/behaviors, treatment satisfaction, health-related quality of life (HRQoL), and productivity. Pooled and stratified (by biologics experience) bivariate and multivariable analyses were conducted. UST (n = 262) versus ADA (n = 83) users more frequently had psoriasis cleared (40.5% versus 15.4%, respectively, with no visible signs), better HRQoL as per Dermatology Life Quality Index (DLQI) score = 0 (45.2% versus 19.2%), and higher current effectiveness satisfaction, all p patients (n = 68) had better (53.4% lower) DLQI scores, lower percent body surface affected (%BSA; 0.85 versus 1.43), more %BSA improvement (-1.60 versus -1.03), and lower activity impairment (90.4% lower), all p Non-adherence to UST (11.8%) versus ADA (32.5%) was lower, p patients reported higher clearing rates, better DLQI, and lower activity impairment.

  17. Give blood at CERN

    CERN Multimedia

    SC Unit

    2008-01-01

    ACCIDENTS and ILLNESSES don’t take a break! DO SOMETHING AMAZING - GIVE BLOOD! IT’S IN ALL OUR INTERESTS. 30 July 2008 from 9.30 a.m. to 4 p.m. CERN RESTAURANT NOVAE First floor - Salle des Pas Perdus After you have given blood, you are invited to partake of refreshments kindly offered by NOVAE.

  18. Giving behavior of millionaires

    NARCIS (Netherlands)

    Smeets, P.; Bauer, R.; Gneezy, U.

    2015-01-01

    This paper studies conditions influencing the generosity of wealthy people. We conduct incentivized experiments with individuals who have at least €1 million in their bank account. The results show that millionaires are more generous toward low-income individuals in a giving situation when the other

  19. Psychosocial predictors of non-adherence and treatment failure in a large scale multi-national trial of antiretroviral therapy for HIV: data from the ACTG A5175/PEARLS trial.

    Directory of Open Access Journals (Sweden)

    Steven A Safren

    Full Text Available PEARLS, a large scale trial of antiretroviral therapy (ART for HIV (n = 1,571, 9 countries, 4 continents, found that a once-daily protease inhibitor (PI based regimen (ATV+DDI+FTC, but not a once-daily non-nucleoside reverse transcriptase inhibitor/nucleoside reverse transcriptase inhibitor (NNRTI/NRTI regimen (EFV+FTC/TDF, had inferior efficacy compared to a standard of care twice-daily NNRTI/NRTI regimen (EFV+3TC/ZDV. The present study examined non-adherence in PEARLS.Outcomes: non-adherence assessed by pill count and by self-report, and time to treatment failure. Longitudinal predictors: regimen, quality of life (general health perceptions  =  QOL-health, mental health  =  QOL-mental health, social support, substance use, binge drinking, and sexual behaviors. "Life-Steps" adherence counseling was provided.In both pill-count and self-report multivariable models, both once-a-day regimens had lower levels of non-adherence than the twice-a-day standard of care regimen; although these associations attenuated with time in the self-report model. In both multivariable models, hard-drug use was associated with non-adherence, living in Africa and better QOL-health were associated with less non-adherence. According to pill-count, unprotected sex was associated with non-adherence. According to self-report, soft-drug use was associated with non-adherence and living in Asia was associated with less non-adherence. Both pill-count (HR = 1.55, 95% CI: 1.15, 2.09, p<.01 and self-report (HR = 1.13, 95% CI: 1.08, 1.13, p<.01 non-adherence were significant predictors of treatment failure over 72 weeks. In multivariable models (including pill-count or self-report nonadherence, worse QOL-health, age group (younger, and region were also significant predictors of treatment failure.In the context of a large, multi-national, multi-continent, clinical trial there were variations in adherence over time, with more simplified regimens generally being

  20. Changes in first-line injectable disease-modifying therapy for multiple sclerosis: predictors of non-adherence, switching, discontinuation, and interruption of drugs.

    Science.gov (United States)

    Degli Esposti, Luca; Piccinni, Carlo; Sangiorgi, Diego; Perrone, Valentina; Aledda, Lucia; Marrosu, Maria Giovanna; Lombardo, Fabio

    2017-01-11

    This study was aimed to describe changes of Disease-Modifying Treatments (DMT) in an Italian cohort of patients with multiple sclerosis (MS) and to identify predictors of therapeutic modifications. Patients with MS and treated with the first-line injectable DMT (interferons-IFNs or glatiramer) between 1/7/2009 and 31/10/2012 were selected from administrative databases of the MS Center of Cagliari (Sardinia, Italy). Socio-demographic, therapeutic, and clinical information was collected in the 6 months preceding the index date. All patients were followed for 36 months to evaluate therapeutic changes in terms of non-adherence, switch, temporary discontinuation, and permanent interruption. Predictors of changes were estimated by multivariable regression models. Data on 1698 patients were collected: glatiramer was prescribed in 27% of cases, IFNβ-1b in 22%, IFNβ-1a-im in 20%, IFNβ-1a-sc-44mcg in 19%, and IFNβ-1a-sc-22mcg in 12%. Non-adherence was observed in 25% of cases, therapeutic switch in 30%, discontinuation in 37%, and permanent interruption in 28%. The risk of non-adherence was higher for IFNβ-1b, compared with IFNβ-1a-im (adjOR = 1.73). Therapeutic switch occurred especially in patients recently diagnosed (each year from diagnosis causes a decrease of this risk adjHR = 0.97); the risk of discontinuation was higher with EDSS = 4-6 and 7-9 (adjHR = 1.52 and 4.42, respectively). The risk of permanent interruption increased with the augmentation of disability (adjHR = 1.67 and 5.43 for EDSS 4-6 and 7-9). This study mirrored a detailed framework of DMT prescription and identified factors related to changes in the MS therapy. These findings could support healthcare providers in the evaluation and maximization of benefits associated with a long-term DMT.

  1. Single-colour flow cytometric assay to determine NK cell-mediated cytotoxicity and viability against non-adherent human tumor cells.

    Science.gov (United States)

    Thakur, Ajit; Zaman, Abeyat; Hummel, Jeff; Jones, Kim; Hortelano, Gonzalo

    2012-03-01

    A flow cytometry-based cytotoxicity (FCC) assay was developed using a single fluorophore, calcein-acetoxymethyl diacetylester (calcein-AM), to measure NK cell-mediated cytotoxicity. Non-adherent human K562 and U937 target cells were individually labelled with calcein-AM and co-incubated with effector NK cells to measure calcein loss, and therefore calculate target cell cytotoxicity. This FCC assay also provided a measure of sample viability. Notably, cell viability measured by traditional calcein/7-amino-actinomycin D (7-AAD) double labelling and Trypan Blue methods were comparable to the viability calculated using calcein-loss FCC. This FCC assay may also be used with various effector and target cell types and as a multi-parameter tool to measure viability and immunophenotype cells for tissue engineering purposes.

  2. Topographical and mechanical characterization of living eukaryotic cells on opaque substrates: development of a general procedure and its application to the study of non-adherent lymphocytes.

    Science.gov (United States)

    Daza, Rafael; Cruces, Julia; Arroyo-Hernández, María; Marí-Buyé, Núria; De la Fuente, Mónica; Plaza, Gustavo R; Elices, Manuel; Pérez-Rigueiro, José; Guinea, Gustavo V

    2015-03-19

    The mechanical behavior of living murine T-lymphocytes was assessed by atomic force microscopy (AFM). A robust experimental procedure was developed to overcome some features of lymphocytes, in particular their spherical shape and non-adherent character. The procedure included the immobilization of the lymphocytes on amine-functionalized substrates, the use of hydrodynamic effects on the deflection of the AFM cantilever to monitor the approaching, and the use of the jumping mode for obtaining the images. Indentation curves were analyzed according to Hertz's model for contact mechanics. The calculated values of the elastic modulus are consistent both when considering the results obtained from a single lymphocyte and when comparing the curves recorded from cells of different specimens.

  3. Occupational variations in obesity, smoking, heavy drinking, and non-adherence to physical activity recommendations: findings from the 2010 National Health Interview Survey.

    Science.gov (United States)

    Shaikh, Raees A; Sikora, Asia; Siahpush, Mohammad; Singh, Gopal K

    2015-01-01

    Understanding occupational variations in health risks is necessary to identify high risk groups. We examined the recent prevalence of obesity, heavy alcohol consumption, smoking, and leisure time physical activity (PA) across occupations. Data from the 2010 National Health Interview Survey were used. Analysis was limited to adults, 18 and older who had a job or business the week before the interview (n = 14,754). Adjusted prevalences of outcomes across occupations were calculated using logistic regression. The highest prevalence of obesity was within community and social services and morbid obesity was in computer and mathematical occupations. That of smoking was highest in healthcare support, heavy drinking in food preparation and serving related, and non-adherence to PA recommendations in the farming, fishing, and forestry occupations. Important health risk factors vary across occupations. Worksite and public health interventions need to be designed and modified to address such occupational health disparities. © 2014 Wiley Periodicals, Inc.

  4. Risk-factors for non-adherence to antiretroviral therapy Fatores preditivos de não-adesão à terapia antiretroviral

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    Márcia Cristina Fraga Silva

    2009-06-01

    Full Text Available Cross-sectional study analyzed as case-control to identify risk factors for non-adherence to antiretroviral therapy. We studied 412 out-clinics HIV infected subjects of three public hospitals of Recife, Pernambuco. The objective was to examine the association between non-adherence to the antiretroviral therapy and biological, social-behavior and demographics and economic factors, factors related to the disease and/or treatment, factors related to life habits and depression symptoms. Variables significantly associated with non-adherence to antiretroviral therapy were: time elapsed since HIV diagnosis (p = 0.002, daily dose (p = 0.046, use of alcohol (p = 0.030 and past drug use (p = 0.048, and borderline p-values were found for educational level (p = 0.093 and family monthly income (p = 0.08. In the multivariable analysis, the factors that remained in the final model were family monthly income, time period with HIV infection and use of alcohol. No association was observed between non-adherence to antiretroviral therapy and gender, age, sexual orientation, marital status, educational level and place of residence. Based on our results and the local situation we suggest: assessment of social needs; training of partners and/or families on supporting adherence, creation of "adherence groups" to motivate and to reassure patients on the benefits of treatment; counseling and/or psychotherapy for alcohol drinkers.Estudo transversal com análise tipo caso-controle, que avaliou 412 pacientes de hospitais públicos do Recife - PE, com o objetivo de identificar fatores preditivos de não adesão à terapia antiretroviral. Verificou-se associação entre não adesão à terapia antiretroviral e aspectos biológicos, sócio-comportamentais e demográficos, econômicos, relacionados à doença e ao tratamento, aos hábitos de vida e aos distúrbios do humor. Variáveis com associação estatisticamente significante com não adesão na análise univariada foram

  5. Tailored Lay Health Worker Intervention Improves Breast Cancer Screening Outcomes in Non-Adherent Korean-American Women

    Science.gov (United States)

    Han, Hae-Ra; Lee, H.; Kim, M. T.; Kim, K. B.

    2009-01-01

    Despite rapidly increasing incidence rates of breast cancer, recent immigrants such as Korean-American (KA) women report disproportionately lower utilization of screening tests compared with other ethnic groups. Early screening of breast cancer for this population may be greatly facilitated by indigenous lay health workers (LHWs). We conducted an…

  6. Financial incentives to improve adherence to anti-psychotic maintenance medication in non-adherent patients - a cluster randomised controlled trial (FIAT

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    Firn Mike

    2009-09-01

    Full Text Available Abstract Background Various interventions have been tested to achieve adherence to anti-psychotic maintenance medication in non-adherent patients with psychotic disorders, and there is no consistent evidence for the effectiveness of any established intervention. The effectiveness of financial incentives in improving adherence to a range of treatments has been demonstrated; no randomised controlled trial however has tested the use of financial incentives to achieve medication adherence for patients with psychotic disorders living in the community. Methods/Design In a cluster randomised controlled trial, 34 mental health teams caring for difficult to engage patients in the community will be randomly allocated to either the intervention group, where patients will be offered a financial incentive for each anti-psychotic depot medication they receive over a 12 month period, or the control group, where all patients will receive treatment as usual. We will recruit 136 patients with psychotic disorders who use these services and who have problems adhering to antipsychotic depot medication, although all conventional methods to achieve adherence have been tried. The primary outcome will be adherence levels, and secondary outcomes are global clinical improvement, number of voluntary and involuntary hospital admissions, number of attempted and completed suicides, incidents of physical violence, number of police arrests, number of days spent in work/training/education, subjective quality of life and satisfaction with medication. We will also establish the cost effectiveness of offering financial incentives. Discussion The study aims to provide new evidence on the effectiveness and cost effectiveness of offering financial incentives to patients with psychotic disorders to adhere to antipsychotic maintenance medication. If financial incentives improve adherence and lead to better health and social outcomes, they may be recommended as one option to improve the

  7. Causes, Timing, and Impact of Dual Antiplatelet Therapy Interruption for Surgery (from the Patterns of Non-adherence to Anti-platelet Regimens In Stented Patients Registry).

    Science.gov (United States)

    Schoos, Mikkel; Chandrasekhar, Jaya; Baber, Usman; Bhasin, Aarti; Sartori, Samantha; Aquino, Melissa; Vogel, Birgit; Farhan, Serdar; Sorrentino, Sabato; Kini, Annapoorna; Kruckoff, Mitchell; Moliterno, David; Henry, Timothy D; Weisz, Giora; Gibson, C Michael; Iakovou, Ioannis; Colombo, Antonio; Steg, P Gabriel; Witzenbichler, Bernhard; Chieffo, Alaide; Cohen, David; Stuckey, Thomas; Ariti, Cono; Dangas, George; Pocock, Stuart; Mehran, Roxana

    2017-09-15

    Temporary interruption of dual antiplatelet therapy (DAPT) is not infrequently required in patients undergoing percutaneous coronary intervention (PCI). We sought to describe the procedures and outcomes associated with DAPT interruption in patients treated with DAPT following successful PCI from the Patterns of non-adherence to anti-platelet regimens in stented patients registry (n = 5018). DAPT interruption was prespecified as physician recommended cessation for antiplatelet agent was interrupted in 57.2% cases and interruption was frequently recommended by noncardiologists (51.3%). Where type of surgery was reported, majority of DAPT interruptions occurred for minor surgery (68.4% vs 31.6%) and a similar cessation pattern of single versus dual antiplatelet cessation was observed regardless of minor or major surgery. Subsequent to DAPT interruption, 12 patients (2.4%) experienced 1 thrombotic event each, of which 5 (1.0%) occurred during the interruption period. All events occurred in patients who either stopped both agents (8 of 12) or clopidogrel-only (4 of 12), with no events occurring due to aspirin cessation alone. In conclusion, in the Patterns of Non-adherence to Anti-platelet Regiments in Stented Patients registry, 1 in 10 patients were recommended DAPT interruption for surgery within 2 years of PCI. Interruption was more common for a single agent rather than both antiplatelet agents regardless of severity of surgery, and was frequently recommended by noncardiologists. Only 1% of patients with DAPT interruption experienced a subsequent thrombotic event during the interruption period, which mainly occurred in patients stopping both antiplatelet agents. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Consulting a traditional healer and negative illness perceptions are associated with non-adherence to treatment in Indonesian women with breast cancer.

    Science.gov (United States)

    Iskandarsyah, Aulia; de Klerk, Cora; Suardi, Dradjat R; Sadarjoen, Sawitri S; Passchier, Jan

    2014-10-01

    The aim of the present study was to test the association between psychosocial factors and delay in uptake of treatment and treatment non-adherence in Indonesian women with breast cancer. Seventy consecutive patients with breast cancer who were treated at the Hasan Sadikin Hospital in Indonesia were recruited. They completed a demographic form, the non-adherence questionnaire, the Breast Cancer Knowledge Test, the Brief Illness Perception Questionnaire, the Multidimensional Health Locus of Control Scales, the Satisfaction with Cancer Information Profile and the Distress Thermometer. Seventeen (24%) out of 70 patients reported that they had delayed initiating treatment at the hospital, and nine (13%) out of 70 patients had missed two or more consecutive treatment sessions. In the bivariate analyses, we found no significant differences on any of the psychological variables between patients who delayed initiating treatment and those patients who did not, whereas patients who had missed two or more consecutive sessions had lower satisfaction with the type and timing of information provided and more negative illness perceptions than patients who had not missed their sessions. In multivariate regression analyses, consulting a traditional healer before diagnosis was associated with treatment delay (β = 1.27, p = 0.04). More negative illness perceptions (β = 0.10, p = 0.02) and whether a traditional healer had been consulted after diagnosis (β = 1.67, p = 0.03) were associated with missing treatment sessions. Indonesian health professionals need to be aware of patients' negative illness perceptions and their unrealistic belief in traditional healers. Copyright © 2014 John Wiley & Sons, Ltd.

  9. NON-ADHERENT BEHAVIOR IN PATIENTS WITH ANXIETY AND HYPERTENSION: FOCUS ON NON-PHARMACOLOGICAL TREATMENT AS A METHOD TO INCREASE COMPLIANCE

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    I. A. Viktorova

    2016-01-01

    Full Text Available Aim. The analysis of non-adherent behavior factors, improvement of the management of patients with arterial hypertension (HT and anxiety due to increase of compliance, by non-drug treatment in addition to antihypertensive drug therapy.Material and methods. 209 patients with HT and anxiety were included into the study. Adherence to the drug therapy was assessed by Moriski Green's questionnaire. Anxiety disorders were diagnosed by the Hospital Anxiety and Depression Scale. Intensity of subjectively endured stress was estimated by the Visual Analogue Scale of stress at work and home, quality of life – by SF-36 questionnaire.Results. 149 factors were studied and the factors influencing adherence to treatment were defined in this cohort of patients. On the basis of selected factors and results of binary logistical regression a forecasting technique for non-adherent behavior of patients with HT and anxiety was created. Changes in adherence to treatment after cycle of trainings atSchool ofHealth by the standard program (n=104 or after the same trainings with the special "Non-Drug Method of Influence" additionally (n=105 were assessed. Training of patients with HT and anxiety at School of Health with the use of "NonDrug Method of Influence" raised a level of adherence to drug antihypertensive therapy by 35.4Ѓ}3.3%, in comparison with initial data (χ.=8.96; р=0.049 with maintaining achieved results during 24 months of follow-up.Conclusion. The basic advantage of "Non-Drug Method of Influence" is that exercises of a progressing muscular relaxation and operated mental visualization normalize blood pressure indices, raise adherence to drug antihypertensive treatment with maintaining achieved results during 24 months of follow-up.

  10. Death: 'nothing' gives insight.

    Science.gov (United States)

    Ettema, Eric J

    2013-08-01

    According to a widely accepted belief, we cannot know our own death--death means 'nothing' to us. At first sight, the meaning of 'nothing' just implies the negation or absence of 'something'. Death then simply refers to the negation or absence of life. As a consequence, however, death has no meaning of itself. This leads to an ontological paradox in which death is both acknowledged and denied: death is … nothing. In this article, I investigate whether insight into the ontological paradox of the nothingness of death can contribute to a good end-of-life. By analysing Aquinas', Heidegger's and Derrida's understanding of death as nothingness, I explore how giving meaning to death on different ontological levels connects to, and at the same time provides resistance against, the harsh reality of death. By doing so, I intend to demonstrate that insight into the nothingness of death can count as a framework for a meaningful dealing with death.

  11. Psychosocial and demographic predictors of adherence and non-adherence to health advice accompanying air quality warning systems: a systematic review.

    Science.gov (United States)

    D'Antoni, Donatella; Smith, Louise; Auyeung, Vivian; Weinman, John

    2017-09-22

    Although evidence shows that poor air quality can harm human health, we have a limited understanding about the behavioural impact of air quality forecasts. Our aim was to understand to what extent air quality warning systems influence protective behaviours in the general public, and to identify the demographic and psychosocial factors associated with adherence and non-adherence to the health advice accompanying these warnings. In August 2016 literature was systematically reviewed to find studies assessing intended or actual adherence to health advice accompanying air quality warning systems, and encouraging people to reduce exposure to air pollution. Predictors of adherence to the health advice and/or self-reported reasons for adherence or non-adherence were also systematically reviewed. Studies were included only if they involved participants who were using or were aware of these warning systems. Studies investigating only protective behaviours due to subjective perception of bad air quality alone were excluded. The results were narratively synthesised and discussed within the COM-B theoretical framework. Twenty-one studies were included in the review: seventeen investigated actual adherence; three investigated intended adherence; one assessed both. Actual adherence to the advice to reduce or reschedule outdoor activities during poor air quality episodes ranged from 9.7% to 57% (Median = 31%), whereas adherence to a wider range of protective behaviours (e.g. avoiding busy roads, taking preventative medication) ranged from 17.7% to 98.1% (Median = 46%). Demographic factors did not consistently predict adherence. However, several psychosocial facilitators of adherence were identified. These include knowledge on where to check air quality indices, beliefs that one's symptoms were due to air pollution, perceived severity of air pollution, and receiving advice from health care professionals. Barriers to adherence included: lack of understanding of the indices

  12. Reasons for non-adherence to cardiometabolic medications, and acceptability of an interactive voice response intervention in patients with hypertension and type 2 diabetes in primary care: a qualitative study.

    Science.gov (United States)

    Kassavou, Aikaterini; Sutton, Stephen

    2017-08-11

    This study explored the reasons for patients' non-adherence to cardiometabolic medications, and tested the acceptability of the interactive voice response (IVR) as a way to address these reasons, and support patients, between primary care consultations. The study included face-to-face interviews with 19 patients with hypertension and/or type 2 diabetes mellitus, selected from primary care databases, and presumed to be non-adherent. Thirteen of these patients pretested elements of the IVR intervention few months later, using a think-aloud protocol. Five practice nurses were interviewed. Data were analysed using multiperspective, and longitudinalthematic analysis. Negative beliefs about taking medications, the complexity of prescribed medication regimens, and the limited ability to cope with the underlying affective state, within challenging contexts, were mentioned as important reasons for non-adherence. Nurses reported time constraints to address each patient's different reasons for non-adherence, and limited efficacy to support patients, between primary care consultations. Patients gave positive experiential feedback about the IVR messages as a way to support them take their medicines, and provided recommendations for intervention content and delivery mode. Specifically, they liked the voice delivering the messages and the voice recognition software. For intervention content, they preferred messages that were tailored, and included messages with 'information about health consequences', 'action plans', or simple reminders for performing the behaviour. Patients with hypertension and/or type 2 diabetes, and practice nurses, suggested messages tailored to each patient's reasons for non-adherence. Participants recommended IVR as an acceptable platform to support adherence to cardiometabolic medications between primary care consultations. Future studies could usefully test the acceptability, and feasibility, of tailored IVR interventions to support medication adherence

  13. Correlates of non-adherence to antiretroviral therapy in a cohort of HIV-positive drug users receiving antiretroviral therapy in Hanoi, Vietnam.

    Science.gov (United States)

    Jordan, M R; Obeng-Aduasare, Y; Sheehan, H; Hong, S Y; Terrin, N; Duong, D V; Trung, N V; Wanke, C; Kinh, N V; Tang, A M

    2014-08-01

    The HIV epidemic in Vietnam is concentrated, with high prevalence estimates among injection drug users and commercial sex workers. Socio-demographics, substance use and clinical correlates of antiretroviral therapy non-adherence were studied in 100 HIV-1 infected drug users receiving antiretroviral therapy for at least 6 months in Hanoi, Vietnam. All study participants were men with a mean age of 29.9 ± 4.9 years. The median duration on antiretroviral therapy was 16.2 ± 12.7 months; 83% reported 'very good' or 'perfect' adherence in the past 30 days on a subjective one-item Likert scale at time of study enrollment; 48% of participants reported drug use within the previous 6 months, with 22% reporting current drug use. Injection drug use with or without non-injection drug use in the past 6 months (95% C.I. 2.19, 1.30-3.69) and years on antiretroviral therapy (95% C.I. 1.43, 1.14-1.78) were correlated with suboptimal adherence. These findings support Vietnam's ongoing scale-up of harm reduction programmes for injection drug users and their integration with antiretroviral therapy delivery. Moreover, results highlight the need to identify and implement new ways to support high levels of antiretroviral therapy adherence as duration on antiretroviral therapy increases.

  14. A pilot evaluation of the efficacy of a couple-tailored print intervention on colorectal cancer screening practices among non-adherent couples.

    Science.gov (United States)

    Manne, Sharon L; Kashy, Deborah A; Weinberg, David S; Boscarino, Joseph A; Bowen, Deborah J; Worhach, Sara

    2013-01-01

    The objective of this study was to evaluate the efficacy of a couple-tailored print (CTP) intervention on colorectal cancer screening (CRCS), CRCS intentions, and on knowledge and attitudes among couples in which neither partner is on schedule with regard to CRCS. A total of 168 married couples with both members non-adherent with CRCS were randomly assigned to receive either a CTP pamphlet accompanied by a generic print (GP) pamphlet or a GP pamphlet only. Couples completed measures of CRCS, intentions, relational perspective on CRCS, discussions about CRCS, spouse support for CRCS, spouse influence strategies, CRC knowledge, perceived CRC risk, and CRCS benefits and barriers. Results indicated there was no significant benefit of CTP vs. GP on CRCS, but there was a significant increase in CRCS intentions in CTP compared with GP. There was also a significant increase in relationship perspective on CRCS, a significant increase in husbands' support of their wives' CRCS, and a significant increase in CRCS benefits in CTP. In summary, CTP did not increase CRCS practices but increased intentions and perceived benefits of CRCS as well as improving couples' ability to view CRCS as having benefit for the marital relationship.

  15. Comparison of gene expression of mitogenic kinin path in adherent and non-adherent CD 34-stem cells using oligonucleotide microarrays.

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    Krzysztof Machaj

    2008-02-01

    Full Text Available One of the more interesting cells present in the umbilical cord blood - as far as their potential clinical use is concerned - are stem cells not presenting the CD34 antigen. These are the pluripotential cells with their biological properties similar to mesenchymal stem cells, with the ability to differentiate into such tissue types as bone, cartilage, nervous (to some extent, glia and muscle. The authors compared the activity of genes coding the proteins in mitogenic signal paths activated by kinin receptors using oligonucleotide microarrays in adherent and non-adherent CD 34- cells derived from umbilical cord blood. In the linear regression model with a 95% prognosis area for differentiating genes outside this area, the following genes were selected: c-jun (present in 3 isoforms and c-fos. The fos and jun genes create the AP-1 transcriptive factor which regulates the expression of genes taking part in numerous cellular processes, including the cell cycle and mitosis. The obtained results shed some light on the molecular processes behind the MSC proliferation and are a starting point for further studies on the mesenchymal stem cell biology.

  16. Vets, denialists and rememberers: social typologies of patient adherence and non-adherence to HAART from the perspective of HIV care providers.

    Science.gov (United States)

    Orchard, Treena; Salters, Kate; Palmer, Alexis; Michelow, Warren; Lepik, Katherine J; Hogg, Robert

    2015-01-01

    For many people living with HIV/AIDS taking highly active antiretroviral therapy (HAART) is difficult due to various individual and social factors, including the side effects of these medications, HIV/AIDS stigma and poor patient-provider relationships. Most studies that examine barriers to and facilitators of adherence to HAART have been conducted with people on these medications, which is critical to improving adherence among various HIV-affected groups. Less attention has been paid to the experiences of HIV care providers, which is an important gap in the literature considering the key role they play in the delivery of HAART and the management of patient treatment plans. This paper presents findings from a qualitative pilot study that explored how HIV care providers assess adherence and non-adherence to HAART among their HIV-positive patients in Vancouver, British Columbia. Drawing upon individual interviews conducted with HIV physicians (n = 3), social service providers (n = 3) and pharmacists (n = 2), this discussion focuses on the social typologies our participants use to assess patient success and failure related to adherence. Eleven unique categories are featured and the diversity within and across these categories illustrate a broad spectrum of adherence-related behaviours among patients and the social meanings providers attribute to these behaviours. As one of the first explorations of the social typologies used by HIV care providers to assess patient performance on HAART, these data contribute valuable insights into the experiences of providers within the context of adherence-related care delivery.

  17. Adherence to oral anticancer chemotherapy: What influences patients' over or non-adherence? Analysis of the OCTO study through quantitative-qualitative methods.

    Science.gov (United States)

    Bourmaud, Aurélie; Henin, Emilie; Tinquaut, Fabien; Regnier, Véronique; Hamant, Chloé; Colomban, Olivier; You, Benoit; Ranchon, Florence; Guitton, Jérôme; Girard, Pascal; Freyer, Gilles; Tod, Michel; Rioufol, Catherine; Trillet-Lenoir, Véronique; Chauvin, Franck

    2015-07-04

    Numerous oral anticancer chemotherapies are available. Non-adherence or over-adherence to these chemotherapies can lead to lowered efficacy and increased risk of adverse events. The objective of this study was to identify patients' adherence profiles using a qualitative-quantitative method. A capecitabine treatment was initiated for 38 patients with advanced breast or colorectal cancer. At inclusion, information on patients' beliefs was reported using a questionnaire. Later, Information on patients' relation to treatment was obtained from a sub-group during an interview with a sociologist. Questionnaires were analyzed using Multiple Classification Analysis to cluster patients. Treatment adherence was evaluated by an electronic medication event monitoring systems (MEMS caps) and then correlated with patient clusters. Interviews were analyzed to complete and explain results. 38 patients were enrolled between 2008 and 2011 and completed the questionnaire. Twenty had adherence measured with MEMS caps all along treatment. Between 4 and 6 months after inclusion, 16 patients were interviewed. Patient profile B (retired, with a regular life, surrounded by a relative's attention to drug adherence, with a low educational level) was statistically associated with adequate adherence (p = 0.049). A tendency for lower adherence was observed among more highly educated patients with an irregular, active life (NS). All patients taking capecitabine demonstrated a risk of over-adherence, potentiating side effects. These encouraging primary results suggest that further studies should be undertaken and that educational programs tailored to patient profiles should be evaluated to enhance adherence for those who need it and to empower all patients to manage treatment side effects.

  18. Patterns of non-adherence to supplementation with calcium and vitamin D in persistent postmenopausal women are similar at start and one year later: a qualitative longitudinal study

    Directory of Open Access Journals (Sweden)

    Tereza Touskova

    2016-09-01

    adherence. The patterns of non-adherence were very similar at follow-up. Signing of the informed consent seems to act as bias more than regular medical check-up.

  19. Patterns of Non-adherence to Supplementation with Calcium and Vitamin D in Persistent Postmenopausal Women Are Similar at Start and 1 Year Later: A Qualitative Longitudinal Study

    Science.gov (United States)

    Touskova, Tereza; Vytrisalova, Magda; Palicka, Vladimir; Hendrychova, Tereza; Chen, Yang-Ti; Fuksa, Leos

    2016-01-01

    Background: Osteoporosis is a chronic disease and adherence can fluctuate over time. Therefore, longer observation is necessary to investigate the stability of patients' adherence. The study aim was to compare the overall adherence (OA) to supplementation with the fixed combination of calcium and vitamin D (Ca/D) in postmenopausal women at baseline and after 1 year, and to evaluate the fluctuation of the OA in individual months. Furthermore, we studied whether adherence is influenced by signing of informed consent and routine medical check-up. Methods: This was a longitudinal, observational study. The data were obtained from the Osteocenter of University Hospital in Hradec Kralove, Czech Republic. Adherence was measured using electronic bottles type Medication Events Monitoring System (MEMS). The study was carried out in two 3-month periods; the baseline in 2013 (signing of informed consent while medical check-up) and the follow-up (medical check-up) in 2014. The adherence and adherence-related outcomes were studied in patients who had initiated osteoporosis treatment and were persistent. Results: 21 (49%) out of 43 patients who avoided drug dispenser and were persistent both at baseline and at follow-up, completed the study and were included. Median age was 76. Evaluating the whole 3-month periods, the OA did not differ significantly at baseline and at follow-up, the OA was 71 and 68%, respectively. However, the adherence in month 1 at baseline was significantly higher than the adherence in month 2 at baseline (p adherence in month 1 at follow-up (p = 0.010). Analysing the study period without month 1, a stable adherence was observed in 48% of patients. About 33% of doses were omitted at baseline and 34% at follow-up. As many as 71% of the patients took drug holidays at baseline, and 76% at follow-up. Conclusion: The OA was insufficient, around 70% both at baseline and at follow-up. One half of the patients showed a stable adherence. The patterns of non-adherence

  20. The prevalence and factors associated for anti-tuberculosis treatment non-adherence among pulmonary tuberculosis patients in public health care facilities in South Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Woimo, Tadele Teshome; Yimer, Wondwossen Kassahun; Bati, Temesgen; Gesesew, Hailay Abrha

    2017-03-20

    Evidence exists pointing out how non-adherence to treatment remains a major hurdle to efficient tuberculosis control in developing countries. Many tuberculosis (Tb) patients do not complete their six-month course of anti-tuberculosis medications and are not aware of the importance of sputum re-examinations, thereby putting themselves at risk of developing multidrug-resistant and extensively drug-resistant forms of tuberculosis and relapse. However, there is a dearth of publications about non-adherence towards anti-Tb medication in these settings. We assessed the prevalence of and associated factors for anti-Tb treatment non-adherence in public health care facilities of South Ethiopia. This was a cross-sectional survey using both quantitative and qualitative methods. The quantitative study was conducted among 261 Tb patients from 17 health centers and one general hospital. The qualitative aspect included an in-depth interview of 14 key informants. For quantitative data, the analysis of descriptive statistics, bivariate and multiple logistic regression was carried out, while thematic framework analysis was applied for the qualitative data. The prevalence of non-adherence towards anti-Tb treatment was 24.5%. Multiple logistic regression analysis demonstrated that poor knowledge towards tuberculosis and its treatment (AOR = 4.6, 95%CI: 1.4-15.6), cost of medication other than Tb (AOR = 4.7, 95%CI: 1.7-13.4), having of health information at every visit (AOR = 3, 95% CI: 1.1-8.4) and distance of DOTS center from individual home (AOR = 5.7, 95%CI: 1.9-16.8) showed statistically significant association with non-adherence towards anti- tuberculosis treatment. Qualitative study also revealed that distance, lack of awareness about importance of treatment completion and cost of transportation were the major barriers for adherence. A quarter of Tb patients interrupted their treatment due to knowledge, availability and accessibility of DOTS service. We recommend

  1. The Limits to Giving Back

    Directory of Open Access Journals (Sweden)

    Jade S. Sasser

    2014-07-01

    Full Text Available In this thematic section, authors consider the limitations on giving back that they faced in field research, or saw others face. For some authors, their attempts at giving back were severely limited by the scope of their projects, or their understandings of local cultures or histories. For others, very specific circumstances and historical interventions of foreigners in certain places can limit how and to what extent a researcher is able to have a reciprocal relationship with the participating community. Some authors, by virtue of their lesser positions of power relative to those that they were studying, simply decided not to give back to those communities. In each article it becomes apparent that how and in what ways people give back is unique (and limited both to their personal values and the contexts in which they do research.

  2. Food insecurity is associated with increased risk of non-adherence to antiretroviral therapy among HIV-infected adults in the Democratic Republic of Congo: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Patou Masika Musumari

    Full Text Available BACKGROUND: Food insecurity is increasingly reported as an important barrier of patient adherence to antiretroviral therapy (ART in both resource-poor and rich settings. However, unlike in resource rich-settings, very few quantitative studies to date have investigated the association of food insecurity with patient adherence to ART in Sub-Saharan Africa. The current study examines the association between food insecurity and adherence to ART among HIV-infected adults in the Democratic Republic of Congo (DRC. METHODS AND FINDINGS: This is a cross-sectional quantitative study of patients receiving ART at three private and one public health facilities in Kinshasa, DRC. Participants were consecutively recruited into the study between April and November 2012. Adherence was measured using a combined method coupling pharmacy refill and self-reported adherence. Food insecurity was the primary predictor, and was assessed using the Household Food Insecurity Access Scale (HFIAS. Of the 898 participants recruited into the study, 512 (57% were food insecure, and 188 (20.9% were not adherent to ART. Food insecurity was significantly associated with non-adherence to ART (AOR, 2.06; CI, 1.38-3.09. We also found that perceived harmfulness of ART and psychological distress were associated respectively with increased (AOR, 1.95; CI, 1.15-3.32 and decreased (AOR, 0.31; CI, 0.11-0.83 odds of non-adherence to ART. CONCLUSION: Food insecurity is prevalent and a significant risk factor for non-adherence to ART among HIV-infected individuals in the DRC. Our findings highlight the urgent need for strategies to improve food access among HIV-infected on ART in order to ensure patient adherence to ART and ultimately the long-term success of HIV treatment in Sub-Saharan Africa.

  3. Giving Psychology Away Is Expensive

    Science.gov (United States)

    Gorsuch, Richard L.; Wallace, William L.

    2005-01-01

    This article presents comments on "Does Psychology make a significant difference in our lives?" by P. Zimbardo. We deeply appreciate the documentation and inspiration provided by Zimbardo on how psychology is reaching out to the public by "giving psychology away" (p. 340). We totally agree that psychology has much, much more to offer that could be…

  4. Present Action Spurs Deferred Giving.

    Science.gov (United States)

    Jarc, Jerry A.

    1985-01-01

    Examines ways parishes or schools can promote deferred gifts, payable on death to the parish or institution. Suggests that financial planning seminars and will clinics, planned-giving promotion committees, and dissemination of free pamphlets on estate planning are good ways to promote these bequests. (DMM)

  5. How to Safely Give Ibuprofen

    Science.gov (United States)

    ... for the correct dosage. To give: Check the expiration date to make sure it's not expired. If it ... 3 tablets Reviewed by: Karla R. Hughes, RPh Date reviewed: March 2015 previous 1 • 2 • 3 For Teens For Kids For Parents MORE ON THIS TOPIC Medications: Using Them Safely Talking to the Pharmacist Headaches ...

  6. (Micro)Financing to Give

    DEFF Research Database (Denmark)

    Bajde, Domen

    2013-01-01

    and workings of microfinance. We illustrate how market-like elements are productively and problematically deployed in philanthropic giving and address the need to consider a broader range of socio-material relations involved in the framing of transactions. A complex network of actors and (trans)actions needs...

  7. Giving them a second chance

    Energy Technology Data Exchange (ETDEWEB)

    Mohn, L.

    Manaties are finding a haven in the warm water discharges from Florida power plants. They and other endangered species are the subject of a short film, A Second Chance, which tells the story of the efforts electric utilities are making to give wildlife another chance. The movie shows 15 programs of participating utilities to identify and promote activities with a positive environmental impact on bald eagles, crocodiles, bighorn sheep, and other threatened species. The film is available in print or broadcast tape form. (DCK)

  8. Vulnerability and non-adherence to antiretroviral therapy among HIV patients, Minas Gerais State, Brazil Vulnerabilidade e não-adesão à terapia antiretroviral, Minas Gerais, Brasil

    Directory of Open Access Journals (Sweden)

    Palmira de Fátima Bonolo

    2008-11-01

    Full Text Available The aim of the present study was to describe vulnerability profiles and to verify their association with non-adherence to antiretroviral therapy (ART among 295 HIV-patients receiving their first prescription in two public-referral centers in Minas Gerais States, Brazil. The cumulative incidence of non-adherence was 36.9%. Three pure vulnerability profiles (lower, medium and higher were identified based on the Grade of Membership method (GoM. Pure type patients of the "higher vulnerability" profile had, when compared to the overall sample, an increased probability of being younger, not understanding the need of ART, having a personal reason to be HIV-tested, not disclosing their HIV status, having more than one (non-regular sexual partner, reporting use of alcohol, tobacco and illicit drugs, and having sex among men. Non-adherence to ART was statistically associated (p Este estudo teve como objetivos descrever os perfis de vulnerabilidade e verificar suas associações com a não-adesão à terapia anti-retroviral (TARV entre os 295 pacientes com HIV que recebiam suas primeiras prescrições em dois serviços públicos de referência de Minas Gerais, Brasil. A incidência cumulativa de não-adesão foi 36,9%. Foram identificados três perfis puros de vulnerabilidade (baixa, média e alta baseados no método Grade of Membership (GoM. Os tipos puros de pacientes do perfil de "alta vulnerabilidade" tinham, comparados aos outros, probabilidade maior de serem jovens, de não perceberem a necessidade da TARV, de terem uma razão pessoal para realização do teste HIV, de não terem revelado seu status HIV, de terem mais de um (não fixo parceiro sexual, de relatarem uso de álcool, tabaco e drogas ilícitas e sexo entre homens. Não-adesão à TARV foi associada significativamente a esse perfil (p < 0,001. A heterogeneidade da amostra foi alta, pois mais de 40% dos pacientes eram tipos mistos. Conclui-se que os profissionais de saúde devem ser

  9. Extracciones e indicaciones de extracciones dentales en población rural chilena de 11 a 30 años Extractions and indications of dental extractions in rural chilean population give 11 to 30 years

    Directory of Open Access Journals (Sweden)

    S Olate

    2006-04-01

    Full Text Available Introducción: A pesar de la creciente tecnología odontológica y el progresivo aumento de la cantidad de odontólogos, el precario estándar de salud oral de la población rural se ha mantenido a lo largo del tiempo. El objetivo de esta investigación es describir y cuantificar las exodoncias de piezas dentarias permanentes en población rural. Metodología: Se realizó un estudio de tipo descriptivo seleccionando el 100% de los sujetos atendidos en el Consultorio Chol-Chol, (IX Región de 11 a 30 años de edad que obtuvieron su alta integral durante los años 2001 y 2003. Los diagnósticos fueron realizados por dos odontólogos experimentados en ausencia de apoyo radiográfico (procedimiento realizado de acuerdo al instrumental y equipos disponibles. Se evaluó el estado de cada una de las piezas dentarias exceptuando los terceros molares. Resultados: Fueron analizadas 181 fichas clínicas de los cuales el 36,42% fueron del sexo masculino, siendo la edad media de la muestra 18,27 años. 143 sujetos presentaron piezas perdidas en el momento del examen, a 117 sujetos se les indico extracción de piezas dentales permanentes. Al finalizar el tratamiento 167 (92,2% sujetos presentaron ausencia de piezas dentarias permanentes, con un promedio de 5,6 piezas al finalizar el alta integral. Conclusión: Los pacientes adolescentes y adultos jóvenes en condiciones de ruralidad presentan alta frecuencia de patologías orales que determinan la exodoncia de las piezas dentales. Estos pacientes necesitaran a corto plazo extensas rehabilitaciones para recuperar su sistema estomatognático.Introduction: In spite of high end dental technology and the progressive increase in the amount of Dentists in our Country, the precarious standard of oral health in the rural population have stayed throughout the time, specially in ethnic groups such as Mapuche population. The objective of the present study is to describe and to quantify dental extractions in permanent

  10. To Give or Not to Give, That Is the Question : How Methodology Is Destiny in Dutch Giving Data

    NARCIS (Netherlands)

    Bekkers, René; Wiepking, Pamala

    2006-01-01

    In research on giving, methodology is destiny. The volume of donations estimated from sample surveys strongly depends on the length of the questionnaire used to measure giving. By comparing two giving surveys from the Netherlands, the authors show that a short questionnaire on giving not only undere

  11. Laminin-adherent versus suspension-non-adherent cell culture conditions for the isolation of cancer stem cells in the DAOY medulloblastoma cell line.

    Science.gov (United States)

    de la Rosa, Javier; Sáenz Antoñanzas, Ander; Shahi, Mehdi H; Meléndez, Bárbara; Rey, Juan A; Castresana, Javier S

    2016-09-01

    Medulloblastoma (MB) is a highly malignant tumor of childhood. MB seems to be initiated and maintained by a small group of cells, known as cancer stem cells (CSCs). The CSC hypothesis suggests that a subset of tumor cells is able to proliferate, sustain the tumor, and develop chemoresistance, all of which make of CSC an interesting target for new anticancer therapies. The MB cell line DAOY was cultured in suspension by a medullosphere traditional culturing method and in adherent conditions by laminin-pre-coated flasks and serum-free medium enriched with specific growth factors. An increase in the stem features was shown when cells were successively cultured in hypoxia conditions. By contrast, a reduction in these properties was appreciated when cells were exposed to differentiation conditions. In addition, the CD133+ and CD133- subpopulations were isolated from cells grown in laminin-pre-coated flasks, and in vitro experiments showed that the CD133+ fraction represented the stem population and it could have CSC with a higher probability than the CD133- fraction. We can conclude that the laminin culture method in adherent conditions and the medullosphere traditional culturing method in suspension are similarly good for obtaining stem-like cells in the DAOY cell line.

  12. Give consideration to financial abuse among the older population.

    Science.gov (United States)

    Swan, Amy

    2007-10-01

    This article, brought to you in association with Help the Aged, considers financial exclusion, low levels of financial capability, and cognitive impairment among older people, which can lead to them becoming reliant on significant others to manage their finances.

  13. Percepciones y prácticas relacionadas con la tuberculosis y la adherencia al tratamiento en Chiapas, México Perceptions and practices of tuberculosis patients and non-adherence to therapy in Chiapas, Mexico

    Directory of Open Access Journals (Sweden)

    Guadalupe del Carmen Alvarez-Gordillo

    2000-11-01

    Full Text Available OBJETIVO: Conocer las percepciones y prácticas que los enfermos de tuberculosis tienen sobre la enfermedad y la adherencia al tratamiento. MATERIAL Y MÉTODOS: Estudio cualitativo de 11 entrevistas grupales a 62 pacientes con tuberculosis diagnosticados durante 1997 y 1998 en las regiones Centro, Los Altos y Fronteriza de Chiapas, México. RESULTADOS: Las causas de la enfermedad referidas por los pacientes fueron el contagio por trastes, el trabajo excesivo, la alimentación, el frío y otras sin relación con la transmisión de persona a persona. La incapacidad para el trabajo se reflejó en crisis económica del paciente y su familia. El estigma social impactó emocionalmente en la vida personal, familiar, laboral y de comunidad. CONCLUSIONES: El desconocimiento sobre la enfermedad propició la elección de diferentes alternativas para su atención. Los servicios de salud y la inadecuada relación médico-paciente influyó en el retardo en el diagnóstico y falta de adherencia al tratamiento. Se sugiere un programa de difusión sobre aspectos básicos de la enfermedad y su tratamiento.OBJECTIVE: To identify health perceptions and practices and non-adherence to therapy among tuberculosis patients. MATERIAL AND METHODS: Qualitative research work consisting of 11 group interviews with 62 tuberculosis patients during 1997-1998 in the Central, Highlands, and Border Regions of Chiapas, Mexico. RESULTS: Perceived causes of tuberculosis included contagion via food utensils, excess work, malnutrition, and cold, as well as other causes unrelated to person-to-person contagion. The resulting incapability to work resulted in an economic crisis for both the patients and their family members. As a result of the social stigma imposed by the disease, patients perceived a negative impact on their personal life, family, work, and community. CONCLUSIONS: Lack of knowledge regarding tuberculosis is an important factor in the selection of and adherence to

  14. Know Concentration Before Giving Acetaminophen to Infants

    Science.gov (United States)

    ... For Consumers Home For Consumers Consumer Updates Know Concentration Before Giving Acetaminophen to Infants Share Tweet Linkedin ... infants has only been available in a stronger concentration that doesn’t require giving the infants as ...

  15. Mapping the imaginary of charitable giving

    DEFF Research Database (Denmark)

    Bajde, Domen

    2012-01-01

    The meaningfulness of charitable giving is largely owed to the imaginary conceptions that underpin this form of giving. Building on Taylor's notion of “social imaginary” and Godelier's work on “gift imaginary,” we theorize the imaginary of charitable giving. Through a combination of qualitative m...... across relatively stable assemblages of conceptions of poverty, donors, end-recipients and charitable giving. These assemblages are suggested to form a multifaceted imaginary that is both cultural (shared) and personal (individually performed)....

  16. Mapping the imaginary of charitable giving

    DEFF Research Database (Denmark)

    Bajde, Domen

    2012-01-01

    The meaningfulness of charitable giving is largely owed to the imaginary conceptions that underpin this form of giving. Building on Taylor's notion of “social imaginary” and Godelier's work on “gift imaginary,” we theorize the imaginary of charitable giving. Through a combination of qualitative m...... across relatively stable assemblages of conceptions of poverty, donors, end-recipients and charitable giving. These assemblages are suggested to form a multifaceted imaginary that is both cultural (shared) and personal (individually performed)....

  17. Income Tax Policy and Charitable Giving

    Science.gov (United States)

    Brooks, Arthur C.

    2007-01-01

    Many studies over the past 20 years have looked at the response of charitable donations to tax incentives--the tax price elasticity of giving. Generally, authors have assumed this elasticity is constant across all types of giving. Using the 2001 Panel Study of Income Dynamics data on charitable giving, this paper estimates the tax price elasticity…

  18. The Practical Realities of Giving Back

    Directory of Open Access Journals (Sweden)

    Ashton Bree Wesner

    2014-07-01

    Full Text Available In this thematic section, authors consider practical ways of giving back to the communities in which they conduct research. Each author discusses their evolving thoughts on how to give back in these practical ways. Some of these authors discuss giving back by giving money, food, rides, parties, and water bottles. In other cases, authors discuss giving back by creating jobs in the short or long term, grant writing, advocacy, and education. Story-telling is also a theme that many of the authors in this section discuss. For some authors, non-material forms of giving back are critical—simply maintaining social ties to the communities in which they worked, or sharing humor. The authors consider the utility of their attempts at giving back, and in some cases present their personal philosophy or guidelines on the subject.

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

    Directory of Open Access Journals (Sweden)

    Masuma Akter Khanam

    2014-10-01

    Full Text Available Background: Poor adherence has been identified as the main cause of failure to control hypertension. Poor adherence to antihypertensive treatment is a significant cardiovascular risk factor, which often remains unrecognized. There are no previous studies that examined adherence with antihypertensive medication or the characteristics of the non-adherent patients in Bangladesh. Objective: This paper aims to describe hypertension and factors affecting adherence to treatment among hypertensive persons in rural Bangladesh. Design: The study population included 29,960 men and women aged 25 years and older from three rural demographic surveillance sites of the International Center for Diarrheal Disease Research, Bangladesh (icddr,b: Matlab, Abhoynagar, and Mirsarai. Data was collected by a cross-sectional design on diagnostic provider, initial, and current treatment. Discontinuation of medication at the time of interview was defined as non-adherence to treatment. Results: The prevalence of hypertension was 13.67%. Qualified providers diagnosed only 53.5% of the hypertension (MBBS doctors 46.1 and specialized doctors 7.4%. Among the unqualified providers, village doctors diagnosed 40.7%, and others (nurse, health worker, paramedic, homeopath, spiritual healer, and pharmacy man each diagnosed less than 5%. Of those who started treatment upon being diagnosed with hypertension, 26% discontinued the use of medication. Age, sex, education, wealth, and type of provider were independently associated with non-adherence to medication. More men discontinued the treatment than women (odds ratio [OR] 1.74, confidence interval [CI] 1.48–2.04. Non-adherence was greater when hypertension was diagnosed by unqualified providers (OR 1.52, CI 1.31–1.77. Hypertensive patients of older age, least poor quintile, and higher education were less likely to be non-adherent. Patients with cardiovascular comorbidity were also less likely to be non-adherent to antihypertensive

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

    Science.gov (United States)

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

    2014-01-01

    Background Poor adherence has been identified as the main cause of failure to control hypertension. Poor adherence to antihypertensive treatment is a significant cardiovascular risk factor, which often remains unrecognized. There are no previous studies that examined adherence with antihypertensive medication or the characteristics of the non-adherent patients in Bangladesh. Objective This paper aims to describe hypertension and factors affecting adherence to treatment among hypertensive persons in rural Bangladesh. Design The study population included 29,960 men and women aged 25 years and older from three rural demographic surveillance sites of the International Center for Diarrheal Disease Research, Bangladesh (icddr,b): Matlab, Abhoynagar, and Mirsarai. Data was collected by a cross-sectional design on diagnostic provider, initial, and current treatment. Discontinuation of medication at the time of interview was defined as non-adherence to treatment. Results The prevalence of hypertension was 13.67%. Qualified providers diagnosed only 53.5% of the hypertension (MBBS doctors 46.1 and specialized doctors 7.4%). Among the unqualified providers, village doctors diagnosed 40.7%, and others (nurse, health worker, paramedic, homeopath, spiritual healer, and pharmacy man) each diagnosed less than 5%. Of those who started treatment upon being diagnosed with hypertension, 26% discontinued the use of medication. Age, sex, education, wealth, and type of provider were independently associated with non-adherence to medication. More men discontinued the treatment than women (odds ratio [OR] 1.74, confidence interval [CI] 1.48–2.04). Non-adherence was greater when hypertension was diagnosed by unqualified providers (OR 1.52, CI 1.31–1.77). Hypertensive patients of older age, least poor quintile, and higher education were less likely to be non-adherent. Patients with cardiovascular comorbidity were also less likely to be non-adherent to antihypertensive medication (OR 0

  1. HPV vaginal self-sampling among women non-adherent to Papanicolaou screening in Chile Autotoma vaginal para detección de virus del papiloma humano en mujeres no adherentes a tamizaje con Papanicolaou en Chile

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    Javiera Léniz

    2013-04-01

    Full Text Available OBJECTIVE: To evaluate acceptance, preference and compliance with referral of vaginal self-sampling for the detection of Human papillomavirus (HPV among women non-adherent to Papanicolaou (Pap screening in Santiago, Chile. MATERIALS AND METHODS: Using multistage sampling we identified women aged 30-64 years who reported not receiving a Pap test in the previous three years and offered them Pap testing at the health center or vaginal self-sampling for HPV testing at home. Self-collected samples were analyzed with hybrid capture. All HPV+ women were referred for colposcopy, biopsy and treatment when needed. RESULTS: 1 254 eligible women were contacted; 86.5% performed self-sampling and 8.1% refused; 124 women were HPV+ (11.4%: 95%CI 9.6-13.5 of whom 85.5% attended colposcopy; 12 had CIN2+ (1.1%: 95 %CI 0.5-1.7. CONCLUSION: HPV vaginal self-sampling can be easily implemented in Chile and could improve coverage, successfully reaching women who drop out of the screening program.OBJETIVO: Evaluar la aceptación, preferencia y adherencia a seguimiento de la autotoma vaginal para detección del virus del papiloma humano (VPH en mujeres inasistentes a Papanicolaou (Pap en Santiago, Chile. MATERIAL Y MÉTODOS: Mediante un muestreo polietápico se identificaron mujeres entre 30 y 64 años inasistentes a Pap por < 3 años, invitándolas a realizarse un Pap en su centro de salud o una autotoma vaginal a domicilio. Las muestras fueron analizadas con captura de híbridos. Las mujeres VPH+ fueron referidas a colposcopía, biopsia y tratamiento en caso necesario. RESULTADOS: 1 254 mujeres elegibles fueron contactadas; 86.5% aceptó la autotoma vaginal y 8.1% la rechazó; 124 mujeres resultaron VPH+ (11.4%: IC95% 9.6-13.5 de las que 85.5% asistió a colposcopía; 12 tenían CIN2+ (1.1%: IC95% 0.5-1.7. CONCLUSIÓN: La autotoma vaginal para detección de VPH es implementable en Chile y su utilización podría mejorar la cobertura del programa rescatando a mujeres

  2. The Effect of Media on Charitable Giving and Volunteering: Evidence from the "Give Five" Campaign

    Science.gov (United States)

    Yoruk, Baris K.

    2012-01-01

    Fundraising campaigns advertised via mass media are common. To what extent such campaigns affect charitable behavior is mostly unknown, however. Using giving and volunteering surveys conducted biennially from 1988 to 1996, I investigate the effect of a national fundraising campaign, "Give Five," on charitable giving and volunteering patterns. The…

  3. The Luxury of Igniting Change by Giving

    DEFF Research Database (Denmark)

    Llamas, Rosa; Uth Thomsen, Thyra

    2016-01-01

    of distant others by giving them valuable philanthropic gifts and thereby ultimately transforming the self of the giver. The paper shows how giving away economic capital (money and time), social capital (networks and influence), and cultural capital (skills and knowledge) to non-related others can provide...... the giver with a sense of luxury in terms of pleasure, purpose, and connection with humankind. Thus, the findings not only extend the traditional conceptualization of luxury from having to giving, but also challenge current conceptualizations of sharing out as a non-reciprocal pro-social behavior......This study investigates the phenomenon of luxury from a consumer perspective, by means of multisited phenomenological inquiry. The findings expand the pervasive view of luxury as accumulation of highly valued goods by offering a transformative perspective of luxury as transforming the life...

  4. Termination of Commercial Contracts by giving Notice

    DEFF Research Database (Denmark)

    Edlund, Hans Henrik

    2008-01-01

    or not the contract can be terminated by giving notice. The international UNIDROIT principles and the Lando Commission have included a rule allowing the parties to a contract which is for an indefinite period to give notice, but it can be very difficult to distinguish between indefinite and definite periods....... Furthermore, it is open to question whether the continuation of an expired contract is to be considered as a contract for an indefinite period, and whether contracts for definite periods are irrevocable. Even though these questions are not regulated, it is not recommended that new and more detailed principles......Some long-term contracts are brought to an end if one of the parties gives notice. Usually, such a step is not considered a breach of contract. It causes the contract to end in accordance with the contract. When no express rules cover the situation, it is often not entirely clear whether...

  5. Give and Take in Dictator Games

    DEFF Research Database (Denmark)

    Cappelen, Alexander W.; Nielsen, Ulrik Haagen; Sørensen, Erik Ø.;

    2014-01-01

    It has been shown that participants in the dictator game are less willing to give money to the other participant when their choice set also includes the option to take money. We examine whether this effect is due to the choice set providing a signal about entitlements in a setting where...... in Denmark. The findings are consistent with dictator giving partly being motivated by a desire to signal that one is not entirely selfish or by a desire to follow a social norm that is choice-set dependent....

  6. Conscientious refusals and reason-giving.

    Science.gov (United States)

    Marsh, Jason

    2014-07-01

    Some philosophers have argued for what I call the reason-giving requirement for conscientious refusal in reproductive healthcare. According to this requirement, healthcare practitioners who conscientiously object to administering standard forms of treatment must have arguments to back up their conscience, arguments that are purely public in character. I argue that such a requirement, though attractive in some ways, faces an overlooked epistemic problem: it is either too easy or too difficult to satisfy in standard cases. I close by briefly considering whether a version of the reason-giving requirement can be salvaged despite this important difficulty.

  7. Give and Take in Dictator Games

    DEFF Research Database (Denmark)

    Cappelen, Alexander W.; Nielsen, Ulrik Haagen; Sørensen, Erik Ø.

    2014-01-01

    It has been shown that participants in the dictator game are less willing to give money to the other participant when their choice set also includes the option to take money. We examine whether this effect is due to the choice set providing a signal about entitlements in a setting where...... in Denmark. The findings are consistent with dictator giving partly being motivated by a desire to signal that one is not entirely selfish or by a desire to follow a social norm that is choice-set dependent....

  8. The Costs and Benefits of Deferred Giving.

    Science.gov (United States)

    Fink, Norman S.; Metzler, Howard C.

    It is argued in this book that while there can be a significant payoff for deferred giving programs, it is important to determine their cost effectiveness. Modern business methods of cost accounting, benefits analysis, and actuarial and econometric forecasting are applied to the Pomona College plan, whose study was supported by Lilly Endowment,…

  9. CAS paleoichthyologist gives Artedi Lecture in Sweden

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ Prof. ZHANG Miman (CHANG Mee-mann), a CAS Member from the CAS Institute of Vertebrate Paleontology and Paleoanthropology, was invited to give a talk at the Artedi Lectures at the Royal Swedish Academy of Sciences in Stockholm, Sweden, on 5 December, 2008.

  10. Bidding to give in the field

    NARCIS (Netherlands)

    Onderstal, Sander; Schram, Arthur J. H. C.; Soetevent, Adriaan R.

    2013-01-01

    In a door-to-door fundraising field experiment, we study the impact of fundraising mechanisms on charitable giving. We approached about 4500 households, each participating in an all-pay auction, a lottery, a non-anonymous voluntary contribution mechanism (VCM), or an anonymous VCM. In contrast to th

  11. The Costs and Benefits of Deferred Giving.

    Science.gov (United States)

    Fink, Norman S.; Metzler, Howard C.

    It is argued in this book that while there can be a significant payoff for deferred giving programs, it is important to determine their cost effectiveness. Modern business methods of cost accounting, benefits analysis, and actuarial and econometric forecasting are applied to the Pomona College plan, whose study was supported by Lilly Endowment,…

  12. Preditores de não aderência ao seguimento preconizado para mulheres com lesão intraepitelial escamosa de alto grau (HSIL Predictors of non-adherence to the prescribed follow-up in women with high-grade squamous intraepithelial lesion (HSIL

    Directory of Open Access Journals (Sweden)

    Maria Isabel do Nascimento

    2009-06-01

    with non-adherence to the prescribed follow-up in women with high-grade squamous intraepithelial lesions (HSIL, attending a public health care service in the "Baixada Fluminense", Rio de Janeiro, Brazil. This was a retrospective cohort study including women screened through cytology, entering the health care service between 01/01/2002 and 12/31/2005 and submitted to a colposcopy. Data collection ended on 12/31/07. Through the revision of 1496 medical records, 641 eligible women with a histopathological diagnosis of HSIL obtained after excision of the transformation zone were identified. After application of the exclusion criteria, the study population comprised 537 (84% women, classified into two groups: "non-adherent" (29.4%, who abandoned the follow-up procedures and "adherent" (70.6% who remained in follow-up along the required period. Statistical analysis was carried out though qui-square and t-tests and logistic regression. The final model contained the variables smoker (OR 1.72, not having a job outside the house (OR 1.56, having the examination carried out with a videocolposcopy (OR 1.80, age (OR 0.97 and history of three or more gestations (OR 0.49. The study disclosed a vulnerability profile pointing to individual and organizational-level determinants. Strategies to attain better follow-up must be aimed to modifiable life style factors as smoking and to structural characteristics of health care services in the studied area.

  13. Intergenerational Transmission of Religious Giving: Instilling Giving Habits across the Life Course

    Directory of Open Access Journals (Sweden)

    Patricia Snell Herzog

    2016-07-01

    Full Text Available This paper investigates the research question: How do religious youth learn to give? While it is likely that youth learn religious financial giving from a variety of different sources, this investigation focuses primarily on how parents teach giving to their children. Supplementary data are also analyzed on the frequency in which youth hear extra-familial calls to give within their religious congregations. In focusing on parental transmission, the analysis identifies a number of approaches that parents report using to teach their children religious financial giving. It also investigates thoughts and feelings about religious financial giving by the children of these parents as a means of assessing the potential impacts of parental methods. Additionally, congregation member reflections on how they learned to give provide insights on giving as a process that develops across the life course, often instilled in childhood, but not appearing behaviorally until adulthood. As such, this paper contributes to a life course understanding of religious giving and has implications for giving across generations.

  14. Fatores associados à não-adesão ao tratamento com anti-hipertensivos em pessoas atendidas em unidades de saúde da família Risk factors associated with non-adherence to anti-hypertensive medication among patients treated in family health care facilities

    Directory of Open Access Journals (Sweden)

    Ernani Tiaraju de Santa-Helena

    2010-12-01

    Full Text Available Para estimar a prevalência e analisar fatores associados à não-adesão ao tratamento de pessoas com hipertensão arterial sistêmica, atendidas em unidades de saúde da família, procedeu-se a estudo transversal com 595 pacientes. A variável dependente não-adesão foi medida com questionário (Questionário de Adesão a Medicamentos - QAM-Q. Foram coletadas variáveis sócio-econômicas, assistenciais, pessoais e do tratamento, analisadas por modelo de regressão logística hierarquizado. A prevalência de não-adesão foi de 53%. As variáveis associadas à não-adesão foram: (1 sócio-econômicas _ pertencer às classes econômicas C/D/E, estar inserido no mercado de trabalho, em ocupações não qualificadas; (2 assistenciais _ precisar comprar os medicamentos e mais que 6 meses desde a última consulta, e; (3 características das pessoas e do tratamento _ interromper previamente o tratamento, estar em tratamento há menos de 3 anos e presença de transtorno mental comum. O estudo dos determinantes da não-adesão articulados em um modelo hierarquizado sugere que as desigualdades sociais se mostram diretamente associadas à não-adesão, ou mediadas por fatores dos serviços e das pessoas.In order to estimate the prevalence of treatment non-adherence and associated factors among individuals with systemic arterial hypertension treated at family health care facilities, a cross-sectional study was performed with 595 patients. The dependent variable non-adherence was measured with a Medication Adherence Questionnaire (MAQ. A hierarchical logistic regression model was used to analyze socioeconomic, health care-related, personal, and treatment-related variables. Prevalence of non-adherence was 53%. Variables associated with non-adherence were: (1 socioeconomic _ belonging to economic classes C, D, or E; work market participation in unskilled labor; (2 health care _ out-of-pocket payment for medication; more than six months since last

  15. Giving Reasons, A Contribution to Argumentation Theory

    Directory of Open Access Journals (Sweden)

    Lilian Bermejo-Luque

    2011-10-01

    Full Text Available In Giving Reasons: A Linguistic-pragmatic-approach to Argumentation Theory (Springer, 2011, I provide a new model for the semantic and pragmatic appraisal of argumentation. This model is based on a characterization of argumentation as a second order speech-act complex. I explain the advantages of this model respecting other proposals within Argumentation Theory, such as Pragma-dialectics, Informal Logic, the New Rhetoric or the Epistemic Approach.

  16. Role-modeling and conversations about giving in the socialization of adolescent charitable giving and volunteering.

    Science.gov (United States)

    Ottoni-Wilhelm, Mark; Estell, David B; Perdue, Neil H

    2014-01-01

    This study investigated the relationship between the monetary giving and volunteering behavior of adolescents and the role-modeling and conversations about giving provided by their parents. The participants are a large nationally-representative sample of 12-18 year-olds from the Panel Study of Income Dynamics' Child Development Supplement (n = 1244). Adolescents reported whether they gave money and whether they volunteered. In a separate interview parents reported whether they talked to their adolescent about giving. In a third interview, parents reported whether they gave money and volunteered. The results show that both role-modeling and conversations about giving are strongly related to adolescents' giving and volunteering. Knowing that both role-modeling and conversation are strongly related to adolescents' giving and volunteering suggests an often over-looked way for practitioners and policy-makers to nurture giving and volunteering among adults: start earlier, during adolescence, by guiding parents in their role-modeling of, and conversations about, charitable giving and volunteering.

  17. Advice on Giving a Scientific Talk

    Science.gov (United States)

    Kurtz, D. W.

    2006-04-01

    What makes one speaker exciting and another boring? You have been to good talks and you have sat through far too many poor ones, so what makes the difference? It doesn't really matter whether it is a scientific talk, a public talk or a classroom lecture: Your prime concern is to think about the audience. You are talking to them. You are performing. Look at them; talk to them; think about what they are hearing and seeing. They very much want you to give a good talk -- that is why they have chosen to be your audience. But at the start of your talk they are worried you might not, so they are nervous. Your first job is to relax them and get their trust that you are going to do a good job. Then you will relax and you will be off to a great start. Of course your content matters; if you have a great discovery, they will forgive you anything. But it is still better to make a good presentation. I give some advice here on what to do, and what not to do, when giving any kind of talk, but with emphasis on short scientific talks presented at conferences. You should be a little nervous at the start of a talk - that is caused by your concern to do a good job. With a good start your talk will flow, you will then present your discoveries, and with a good ending your audience will applaud appreciatively and want to ask you questions. You will have enjoyed performing and want to do it again. Speaking can be fun for you, and rewarding for your audiences.

  18. Nurses' intentions to give lifestyle support.

    Science.gov (United States)

    McKenzie, Karen

    Models of behaviour change can help identify factors that influence health behaviours such as eating a healthy diet and physical activity. The Theory of Planned Behaviour has been shown to be relatively effective at predicting people's intention to engage in health-related behaviours. More recent research has explored whether it can help predict the intentions of one group of people to support another group to engage in healthy behaviour. This has implications for nurses, who are often facilitators of patient health. This article gives an overview of the model and discusses its potential implications for nurses.

  19. Hiring Seniors: Everybody Gives, Everybody Benefits

    Science.gov (United States)

    Ruder, Robert

    2011-01-01

    Living on fixed incomes and faced with increasing taxes, senior citizens frequently feel the squeeze of a tightening economy more than other populations. Their retirement dollars buy less as their property taxes inch upward, despite the fact that they don't have school-age children. The Hempfield and Manheim Township School Districts in…

  20. Giving Devices the Ability to Exercise Reason

    Directory of Open Access Journals (Sweden)

    Thomas Keeley

    2008-10-01

    Full Text Available One of the capabilities that separates humans from computers has been the ability to exercise "reason / judgment". Computers and computerized devices have provided excellent platforms for following rules. Computer programs provide the scripts for processing the rules. The exercise of reason, however, is more of an image processing function than a function composed of a series of rules. The exercise of reason is more right brain than left brain. It involves the interpretation of information and balancing inter-related alternatives. This paper will discuss a new way to define and process information that will give devices the ability to exercise human-like reasoning and judgment. The paper will discuss the characteristics of a "dynamic graphical language" in the context of addressing judgment, since judgment is often required to adjust rules when operating in a dynamic environment. The paper will touch on architecture issues and how judgment is integrated with rule processing.

  1. Ethics – Information or Giving-Form

    Directory of Open Access Journals (Sweden)

    Valentin MURESAN

    2017-06-01

    Full Text Available There are three ways of introducing and actually using ethics in schools: the informative one, the formative one and the institutional one. The first is theoretical teaching ethics. The second refers to character building. The third is related to the creation of “ethical infrastructures”. We shall advocate here for the second form and put it in contrast with the first which is considered today as the only one practicable in Romania. We refuse to admit that the role of the first years of human living is the most important period in the moral constitution of the child. In Romanian schools „character building” is almost inexistent. The profound root of this situation and the illusion that we did our best to change this state, is our incapacity to distinguish between giving a moral form to a human being and inform her on moral questions. The implications of adopting this distinction are vast: to reconsider the importance of kindergarten and of the initial learning as having a similar importance as higher education and therefore similar budgets and much more political support; rethinking the universities’ mission and the kind of relations they have with the secondary schools; the role of family, church, schools and local community in the formation of strong moral characters; and most difficult, to assure the convergence of all these factors.

  2. Bangladesh: giving girls the "key of keys".

    Science.gov (United States)

    Chhabra, R

    1998-01-01

    In Bangladesh, 100 nongovernmental organizations (NGOs) have worked with the government to create approximately 52,000 nonformal schools for children who have never attended school or have dropped out. The Bangladesh Rural Advancement Committee (BRAC) alone has 34,000 nonformal education centers. The BRAC program has been particularly effective at increasing educational opportunities for girls, and BRAC is a major implementing agency of the agreement forged by the International Labor Organization and the UN Children's Fund with the Bangladesh Garment Manufacturers Export Association, which gives about 10,000 former child garment workers a meager stipend allowing them to study instead of work. BRAC, the Grameen Bank, and several other NGOs are also developing alternative income-generating methods to compete with the exploitative working conditions suffered by impoverished girls. BRAC now has more than a million students enrolled each year, 700,000 of whom are girls. Students participate in special condensed courses in classes that average 33 pupils (20 must be girls). Gender sensitivity is incorporated at every level. BRAC also relies on community participation in running the schools, and the flexible hours and imaginative curriculum have resulted in very high attendance rates. Government actions (making primary education compulsory and tripling education expenditure) have also resulted in increased primary enrollment while special programs seek to increase the number of girls in secondary schools.

  3. Giving what one should: explanations for the knowledge-behavior gap for altruistic giving.

    Science.gov (United States)

    Blake, Peter R

    2017-08-07

    Several studies have shown that children struggle to give what they believe that they should: the so-called knowledge-behavior gap. Over a dozen recent Dictator Game studies find that, although young children believe that they should give half of a set of resources to a peer, they typically give less and often keep all of the resources for themselves. This article reviews recent evidence for five potential explanations for the gap and how children close it with age: self-regulation, social distance, theory of mind, moral knowledge and social learning. I conclude that self-regulation, social distance, and social learning show the most promising evidence for understanding the mechanisms that can close the gap. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Paedomorphic facial expressions give dogs a selective advantage.

    Directory of Open Access Journals (Sweden)

    Bridget M Waller

    Full Text Available How wolves were first domesticated is unknown. One hypothesis suggests that wolves underwent a process of self-domestication by tolerating human presence and taking advantage of scavenging possibilities. The puppy-like physical and behavioural traits seen in dogs are thought to have evolved later, as a byproduct of selection against aggression. Using speed of selection from rehoming shelters as a proxy for artificial selection, we tested whether paedomorphic features give dogs a selective advantage in their current environment. Dogs who exhibited facial expressions that enhance their neonatal appearance were preferentially selected by humans. Thus, early domestication of wolves may have occurred not only as wolf populations became tamer, but also as they exploited human preferences for paedomorphic characteristics. These findings, therefore, add to our understanding of early dog domestication as a complex co-evolutionary process.

  5. Rethinking the social and cultural dimensions of charitable giving

    DEFF Research Database (Denmark)

    Bajde, Domen

    2009-01-01

    Gifts to distant others, such as charitable giving, represent an important segment of contemporary gift-giving that has often been overlooked due to the excessive focus on dyadic giving between intimate individuals. In response, this paper adopts a sociological systemic perspective on gift......-giving and focuses on charitable gifts as an emblem of postmodern gift-giving to distant others. Historical evidence and sociological theory on postmodern solidarity are combined to shed light on the fluid duality of contemporary giving and the importance of the imaginary in charitable giving. The outlined socially...

  6. Stellar Populations

    NARCIS (Netherlands)

    Peletier, Reynier F.

    2013-01-01

    This is a summary of my lectures during the 2011 Canary Islands Winter School in Puerto de la Cruz. I give an introduction to the field of stellar populations in galaxies, and highlight some new results. Since the title of the Winter School is Secular Evolution in Galaxies I mostly concentrate on ne

  7. Who gives? Multilevel effects of gender and ethnicity on workplace charitable giving.

    Science.gov (United States)

    Leslie, Lisa M; Snyder, Mark; Glomb, Theresa M

    2013-01-01

    Research on diversity in organizations has largely focused on the implications of gender and ethnic differences for performance, to the exclusion of other outcomes. We propose that gender and ethnic differences also have implications for workplace charitable giving, an important aspect of corporate social responsibility. Drawing from social role theory, we hypothesize and find that gender has consistent effects across levels of analysis; women donate more money to workplace charity than do men, and the percentage of women in a work unit is positively related to workplace charity, at least among men. Alternatively and consistent with social exchange theory, we hypothesize and find that ethnicity has opposing effects across levels of analysis; ethnic minorities donate less money to workplace charity than do Whites, but the percentage of minorities in a work unit is positively related to workplace charity, particularly among minorities. The findings provide a novel perspective on the consequences of gender and ethnic diversity in organizations and highlight synergies between organizational efforts to increase diversity and to build a reputation for corporate social responsibility.

  8. Moving from ‘Giving Back’ to Engagement

    Directory of Open Access Journals (Sweden)

    Gautam Bhan

    2014-07-01

    Full Text Available This research note is part of the thematic section, Giving Back in Solidarity, in the special issue titled “Giving Back in Field Research,” published as Volume 10, Issue 2 in the Journal of Research Practice.

  9. Territorial Entanglements: Ambiguities of Giving Back in Northwestern Laos

    Directory of Open Access Journals (Sweden)

    Michael Benjamin Dwyer

    2014-07-01

    Full Text Available This research note is part of the thematic section, Limits to Giving Back, in the special issue titled “Giving Back in Field Research,” published as Volume 10, Issue 2 in the Journal of Research Practice.

  10. A Pilot Study of Nurses' Experience of Giving Spiritual Care

    Science.gov (United States)

    Deal, Belinda

    2010-01-01

    Using spiritual and religious resources gives patients and families strength to cope during a crisis, but nurses often do not offer spiritual care (Kloosterhouse & Ames, 2002). The purpose of this phenomenological study was to explore nurses" lived experience of giving spiritual care. A descriptive phenomenological approach was used to…

  11. Sources and Uses of Annual Giving at Private Research Universities.

    Science.gov (United States)

    Smith, Christopher L.; Ehrenberg, Ronald G.

    2003-01-01

    Investigated why private research universities differ in the sources and uses of their annual giving using data from 74 private universities and a subset of 29 private universities. Findings identify some factors that determine giving, but models could explain only part of the differences in funding from different sources. (SLD)

  12. OPINION GIVING SERVICES AS A SOURCE OF CONSUMER INFORMATION

    Directory of Open Access Journals (Sweden)

    Joanna Wyrwisz

    2015-09-01

    Full Text Available The goal of the article is to determine the place and role of opinion giving services in consumer behaviours. The discussion is conducted around the thesis saying that in the information society, opinion giving services constitute an important source of information for consumers in the process of selecting and purchasing both products and services. In the article the research approach based on the theoretical and empirical examinations was presented. The discussion starts with presenting a defi nition and types of opinion giving services which constitute the base for the characteristics of activities and usefulness of web portals collecting consumers opinions. The use of opinion giving services provided in the purchase process was evaluated. An essential interest in other consumers opinions, placed in Internet, was observed together with perceiving them as credible. Positive assessment of the functionality of opinion giving services was noticed.

  13. Assessment of indicators for hospital drug formulary non-adherence

    NARCIS (Netherlands)

    Fijn, R; Lenderink, AW; Egberts, ACG; Brouwers, JRBJ; De Jong-Van DenBerg, LTW

    2001-01-01

    Background: Translation of rational drug therapy into practice remains an international problem. Although pharmacotherapeutic treatment guidelines (PTGs) as managerial tools are favoured over hospital drug formularies (HDFs), the latter are still applied in most hospitals. HDF enforcement often

  14. [No response to antihypertensive therapy: consider non-adherence

    NARCIS (Netherlands)

    Braam, R.L.; Uum, S.H.M. van; Lenders, J.W.M.; Thien, Th.

    2007-01-01

    In 3 patients, 2 men aged 62 and 43 years, respectively, and 1 woman aged 53 years, the medication prescribed to reduce blood pressure was insufficiently effective. Drug adherence was questioned. The first patient was afraid of the side effects mentioned in the medication information leaflet. The

  15. Concern between medication non-adherence and diabetes associated depression

    Directory of Open Access Journals (Sweden)

    Krishnan Vengadaragava Chary

    2016-04-01

    Conclusions: Unnoticed depression among diabetic individuals reduces treatment adherence and must be addressed in any patient showing poor response to the treatment. Improving treatment adherence helps to combat diabetes as well as depression. [Int J Basic Clin Pharmacol 2016; 5(2.000: 523-527

  16. Concern between medication non-adherence and diabetes associated depression

    OpenAIRE

    Krishnan Vengadaragava Chary; Porchelvan Swaminathan

    2016-01-01

    Background: Diabetes mellitus is one of the health disorders that acquire mankind immensely. An ominous twin of diabetes mellitus is diabetes associated depression which is often unrecognised in routine diabetic care. The objective of this study was to find the prevalence and correlation between medication adherence and diabetes associated depression. Methods: It is a conducted as cross sectional study using Morisky medication adherence scale to evaluate treatment adherence of type II diab...

  17. Statin non-adherence: clinical consequences and proposed solutions

    OpenAIRE

    Rosenson, Robert S.

    2016-01-01

    Large controlled clinical trials have demonstrated reductions with statin therapy in cardiovascular events in patients presenting with acute coronary syndromes and stable coronary heart disease and individuals at high risk of a cardiovascular event. In trials of acute coronary syndromes and stable coronary heart disease, high-intensity statin therapy is more effective in the prevention of recurrent cardiovascular events than low-intensity statin therapy. Thus, evidence-based guidelines recomm...

  18. medication non-adherence among adult psychiatric out patients in ...

    African Journals Online (AJOL)

    GB

    2013-11-03

    Nov 3, 2013 ... Irregular follow-up, poor social support and complex drug regimen were independently associated variables with non- ..... patient-provider relationship scale, two hundred ..... social desirability bias as the setting of data.

  19. GIVE THE PUBLIC SOMETHING, SOMETHING MORE INTERESTING THAN RADIOACTIVE WASTE

    Energy Technology Data Exchange (ETDEWEB)

    Codee, Hans D.K.

    2003-02-27

    In the Netherlands the policy to manage radioactive waste is somewhat different from that in other countries, although the practical outcome is not much different. Long-term, i.e. at least 100 years, storage in above ground engineered structures of all waste types is the first element in the Dutch policy. Second element, but equally important, is that deep geologic disposal is foreseen after the storage period. This policy was brought out in the early eighties and was communicated to the public as a practical, logical and feasible management system for the Dutch situation. Strong opposition existed at that time to deep disposal in salt domes in the Netherlands. Above ground storage at principle was not rejected because the need to do something was obvious. Volunteers for a long term storage site did not automatically emerge. A site selection procedure was followed and resulted in the present site at Vlissingen-Oost. The waste management organization, COVRA, was not really welcomed here , but was tolerated. In the nineties facilities for low and medium level waste were erected and commissioned. In the design of the facilities much attention was given to emotional factors. The first ten operational years were needed to gain trust from the local population. Impeccable conduct and behavior was necessary as well as honesty and full openness to the public Now, after some ten years, the COVRA facilities are accepted. And a new phase is entered with the commissioning of the storage facility for high level waste, the HABOG facility. A visit to that facility will not be very spectacular, activities take place only during loading and unloading. Furthermore it is a facility for waste, so unwanted material will be brought into the community. In order to give the public something more interesting the building itself is transformed into a piece of art and in the inside a special work of art will be displayed. Together with that the attitude of the company will change. We are

  20. Reciprocity revisited: Give and take in Dutch and immigrant families

    NARCIS (Netherlands)

    A. Komter; J.M.D. Schans

    2008-01-01

    Classical theory suggests that "generalized reciprocity," giving without clear expectations of returns, is characteristic for exchange within the family. Modern theory assumes differences between Western, "individualistic" cultures, and non-Western, more "collectivistic" cultures, presumably leading

  1. Validating that palliative care giving is a stressful occupation: the ...

    African Journals Online (AJOL)

    2010-02-03

    Feb 3, 2010 ... Results: The study found the following aspects inherent in care giving to be immensely stressful and challenging: ... Inadequate food, psychological support and community support networks. ...... An experimental psychology of.

  2. "To All Stroke Survivors - Never, Ever Give Up"

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Stroke Rehabilitation "To All Stroke Survivors – Never, Ever Give Up." Past Issues / Spring ... have for other Americans who are recovering from strokes and other serious health challenges? What about their ...

  3. Astronaut Twins Give Clues to Health Hazards of Spaceflight

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163391.html Astronaut Twins Give Clues to Health Hazards of Spaceflight NASA ... aboard the International Space Station, and his identical twin Mark, a retired astronaut. Mark remained on Earth ...

  4. developing skills of giving and receiving feedbacks between ...

    African Journals Online (AJOL)

    User

    One of the strategies to improve quality of teaching and learning at training institutes could be by developing the skill of giving and receiving feedbacks among the individuals involved in the training .... the two groups; one group of students and.

  5. Who, Who, Who Gives a Hoot about Bones?

    Science.gov (United States)

    Dolan, Arthur

    1988-01-01

    Describes a mouse skeleton reconstruction activity from owl pellets. Gives information about the materials, directions for students, and a five-day unit schedule. Provides some owl pellet sources. (YP)

  6. Giving Voice: Studies in honour of Christine Anthonissen

    African Journals Online (AJOL)

    Kate H

    Giving Voice: Studies in honour of Christine Anthonissen ... essay on discourse in the novel, defines the novel as “a diversity of social ... harmonious relationship. .... the effects are if the researcher does not share the participants' social class.

  7. Reciprocity revisited: Give and take in Dutch and immigrant families

    NARCIS (Netherlands)

    Komter, A.; Schans, J.M.D.

    2008-01-01

    Classical theory suggests that "generalized reciprocity," giving without clear expectations of returns, is characteristic for exchange within the family. Modern theory assumes differences between Western, "individualistic" cultures, and non-Western, more "collectivistic" cultures, presumably leading

  8. Benefits of Giving (A Book Review Using Islamic Perspective

    Directory of Open Access Journals (Sweden)

    M. Hamdar Arraiyyah

    2016-01-01

    Full Text Available This writing is a book review. It discusses a book entitled Give and Take. The book introduces a new approach to success. It makes three categories of people in doing interaction or communication. They are takers, matchers, and givers. The writer of the book, Adam Grant, explains the principles and characteristics of each category. He shows a lot of facts to prove that being a giver brings benefits for people and the doer as well. The objects of giving here comprise different kinds help like wealth, ideas, knowledge, skills and information. Therefore, he motivates people to become givers. In this connection, the reviewer would like to show that Islamic religion also motivates its followers to give helps to others. Though, there are some similarities and differences between the benefits of giving mentioned in the book and the verses of the Holy Qur’an and the sayings of Prophet Muhammad Peace be upon him.

  9. Did El Nino Weather Give Zika a Boost?

    Science.gov (United States)

    ... fullstory_162611.html Did El Nino Weather Give Zika a Boost? Climate phenomenon could have helped infection- ... might have aided the explosive spread of the Zika virus throughout South America, a new study reports. ...

  10. Mouse Gives Birth to Pups Using 3-D Printed Ovary

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_165622.html Mouse Gives Birth to Pups Using 3-D Printed Ovary Breakthrough ... to use hormone replacement therapies in order to trigger puberty," explained co-researcher Monica Laronda. She's a ...

  11. The accompanying adult: authority to give consent in the UK.

    Science.gov (United States)

    Lal, Seema Madhur Lata; Parekh, Susan; Mason, Carol; Roberts, Graham

    2007-05-01

    Children may be accompanied by various people when attending for dental treatment. Before treatment is started, there is a legal requirement that the operator obtain informed consent for the proposed procedure. In the case of minors, the person authorized to give consent (parental responsibility) is usually a parent. To ascertain if accompanying persons of children attending the Department of Paediatric Dentistry at the Eastman Dental Hospital, London were empowered to give consent for the child's dental treatment. A total of 250 accompanying persons of children attending were selected, over a 6-month period. A questionnaire was used to establish whether the accompanying person(s) were authorized to give consent. The study showed that 12% of accompanying persons had no legal authority to give consent for the child's dental treatment. Clinicians need to be aware of the status of persons accompanying children to ensure valid consent is obtained.

  12. Giving the Gift of Life at the End of Life

    Science.gov (United States)

    ... About AOA Contact Us A A A Advancing the distinctive philosophy and practice of osteopathic medicine Inside ... Manipulative Treatment Becoming a DO Video Library Giving the Gift of Life at the End of Life ...

  13. We should give love to whoever needs without hesitation

    Institute of Scientific and Technical Information of China (English)

    杨彩荣

    2010-01-01

    @@ The text Fog tells us a touching story, in which an old blind man helped a girl out of a thick fog by his unique sense of touch. From the text, we know the girl has never helped the old man, or even she doesn't know him. But he helped her! What's more, he thinks the fog gives him a chance to pay back the help that 'people give to him when it's sunny" .

  14. Assessing Nutritional Parameters of Brown Bear Diets among Ecosystems Gives Insight into Differences among Populations

    National Research Council Canada - National Science Library

    López-Alfaro, Claudia; Coogan, Sean C P; Robbins, Charles T; Fortin, Jennifer K; Nielsen, Scott E

    2015-01-01

    ... or nutritional composition of the complete diet. Here, we developed a dynamic model integrating food habits and nutritional information to assess nutritional parameters of brown bear (Ursus arctos...

  15. What drives the gender gap in charitable giving? Lower empathy leads men to give less to poverty relief.

    Science.gov (United States)

    Willer, Robb; Wimer, Christopher; Owens, Lindsay A

    2015-07-01

    We draw upon past research on gender and prosocial emotions in hypothesizing that empathy can help explain the gender gap in charitable giving. In a nationally representative survey, we found that men reported less willingness to give money or volunteer time to a poverty relief organization, gaps that were mediated by men's lower reported feelings of empathy toward others. We also experimentally tested how effective a variety of different ways of framing poverty relief were for promoting giving. Framing poverty as an issue that negatively affects all Americans increased men's willingness to donate to the cause, eliminating the gender gap. Mediation analysis revealed that this "aligned self-interest" framing worked by increasing men's reported poverty concern, not by changing their understanding of the causes of poverty. Thus, while men were generally less motivated by empathy, they responded to a framing that recast charitable giving as consistent with their self-interest. Exposure to the same framing, however, led women to report lower willingness to volunteer time for poverty relief, suggesting that framing giving as consistent with self-interest may discourage those who give because of an empathic response to poverty.

  16. Infants' online perception of give-and-take interactions.

    Science.gov (United States)

    Elsner, Claudia; Bakker, Marta; Rohlfing, Katharina; Gredebäck, Gustaf

    2014-10-01

    This research investigated infants' online perception of give-me gestures during observation of a social interaction. In the first experiment, goal-directed eye movements of 12-month-olds were recorded as they observed a give-and-take interaction in which an object is passed from one individual to another. Infants' gaze shifts from the passing hand to the receiving hand were significantly faster when the receiving hand formed a give-me gesture relative to when it was presented as an inverted hand shape. Experiment 2 revealed that infants' goal-directed gaze shifts were not based on different affordances of the two receiving hands. Two additional control experiments further demonstrated that differences in infants' online gaze behavior were not mediated by an attentional preference for the give-me gesture. Together, our findings provide evidence that properties of social action goals influence infants' online gaze during action observation. The current studies demonstrate that infants have expectations about well-formed object transfer actions between social agents. We suggest that 12-month-olds are sensitive to social goals within the context of give-and-take interactions while observing from a third-party perspective.

  17. Collective Philanthropy: Describing and Modeling the Ecology of Giving

    CERN Document Server

    Gottesman, William L; Dodds, Peter Sheridan

    2013-01-01

    Reflective of income and wealth distributions, philanthropic gifting appears to follow an approximate power-law size distribution as measured by the size of gifts received by individual institutions. We explore the ecology of gifting by analysing data sets of individual gifts for a diverse group of institutions dedicated to education, medicine, art, public support, and religion. We find that the detailed forms of gift-size distributions differ across but are relatively constant within charity categories. We construct a model for how a donor's income affects their giving preferences in different charity categories, offering a mechanistic explanation for variations in institutional gift-size distributions. We discuss how knowledge of gift-sized distributions may be used to assess an institution's gift-giving profile, to help set fundraising goals, and to design an institution-specific giving pyramid.

  18. Gift-giving in the medical student--patient relationship.

    Science.gov (United States)

    Alamri, Yassar Abdullah S

    2012-08-01

    There is paucity in the published literature that provides any ethical guidance guiding gift-giving within the student--patient relationship. This is perhaps because the dynamics of the medical student--patient relationship have not yet been explored as extensively as the doctor--patient relationship. More importantly, however, gift--giving in the doctor-patient relationship has traditionally been from the patient to the doctor and not vice versa. This article examines the literature published in this vicinity reflecting on an encounter with a patient.

  19. Constructing populations in biobanking

    DEFF Research Database (Denmark)

    Tupasela, Aaro; Snell, Karoliina; Cañada, Jose a.

    2015-01-01

    This article poses the question of whether biobanking practices and standards are giving rise to the construction of populations from which various biobanking initiatives increasingly draw on for legitimacy? We argue that although recent biobanking policies encourage various forms of engagement...... to the construction of populations, whereby specific nationalities, communities, societies, patient groups and political systems become imbued or bio-objectified with particular characteristics, such as compliant, distant, positive, commercialized or authoritarian. This bio-objectification process is problematic...... in relation to policy aspirations ascribed to biobanking engagement since it gives rise to reified notions of different populations....

  20. Reciprocity Revisited : Give and Take in Dutch and Immigrant Families

    NARCIS (Netherlands)

    Komter, Aafke; Schans, Djamila

    2008-01-01

    The idea that reciprocity is the basic principle underlying forms of social organization, among which the family, is as old as classical anthropology and sociology. The essence of the principle is that giving prompts receiving, thereby creating forms of ongoing exchange and durable cooperation. Reci

  1. New Trends in Name-Giving in Turkey

    Directory of Open Access Journals (Sweden)

    Erol Sakallı

    2016-07-01

    Full Text Available The author gives a brief review of traditional customs of name-giving in Turkey and analyses some recent trends. The observations are based on 1270 Turkish names collected from the author’s students and reflecting naming practices in Turkey over last several decades. The data has been collected randomly regardless of social, regional, religious or ethnic backgrounds, all names being accompanied by the indication of the age of their bearers. The collected data were categorized into three groups: commemorative names, desiderata names and fortuitous names. This categorization shows the distribution of Turkish names and the changes in the stock of personal names over the years. The traditional name-giving customs are still observed in Turkey, however, new trends are becoming more prominent in the country. The author explains the changes with reference to social evolution which incites young educated parents, most of whom are university graduates living in urban areas and having only one child, to adopt new strategies of name-giving testifying their increasing individualism and weakening ties with traditions.

  2. A Conversation Model Enabling Intelligent Agents to Give Emotional Support

    NARCIS (Netherlands)

    Van der Zwaan, J.M.; Dignum, V.; Jonker, C.M.

    2012-01-01

    In everyday life, people frequently talk to others to help them deal with negative emotions. To some extent, everybody is capable of comforting other people, but so far conversational agents are unable to deal with this type of situation. To provide intelligent agents with the capability to give emo

  3. Formal Speaking——How to Give a Great Speech

    Institute of Scientific and Technical Information of China (English)

    JosephDeVeto

    2004-01-01

    Most successful people in the world are very good at “public speaking”.They know how to get up in front of a crowd and give a “formal speech”. They know how to move people, how to get them to take action. It's not easy to do, but

  4. Undergraduate Financial Aid and Subsequent Giving Behavior. Discussion Paper.

    Science.gov (United States)

    Dugan, Kelly; Mullin, Charles H.; Siegfried, John J.

    Data on 2,822 Vanderbilt University graduates were used to investigate alumni giving behavior during the 8 years after graduation. A two-stage model accounting for individual truncation was used first to estimate the likelihood of making a contribution and second to estimate the average gift size conditional on contributing. The type of financial…

  5. Advice-giving in the English lingua franca classroom

    African Journals Online (AJOL)

    and, if so, in what way? The results of this study show ... advice-giving a student employs in classroom discourse. ... a school subject form part of the Expanding Circle. ..... In Sulee's class, students responded to her queries about the best way to find a job .... The most obvious limitation of this study is the size of the data set.

  6. Alumni Giving to Elite Private Colleges and Universities.

    Science.gov (United States)

    Clotfelter, C. T.

    2003-01-01

    Examines patterns of alumni giving, using data on two cohorts of former students from a sample of private colleges and universities. Higher levels of contributions are associated with high income, whether or not the person graduated from the institution where he or she first attended college, and the degree of satisfaction with his or her…

  7. A Conversation Model Enabling Intelligent Agents to Give Emotional Support

    NARCIS (Netherlands)

    Van der Zwaan, J.M.; Dignum, V.; Jonker, C.M.

    2012-01-01

    In everyday life, people frequently talk to others to help them deal with negative emotions. To some extent, everybody is capable of comforting other people, but so far conversational agents are unable to deal with this type of situation. To provide intelligent agents with the capability to give emo

  8. Reprint of: Bidding to give in the field

    NARCIS (Netherlands)

    Onderstal, S.; Schram, A.J.H.C.; Soetevent, A.R.

    2014-01-01

    In a door-to-door fundraising field experiment, we study the impact of fundraising mechanisms on charitable giving. We approached about 4500 households, each participating in an all-pay auction, a lottery, a non-anonymous voluntary contribution mechanism (VCM), or an anonymous VCM. In contrast to th

  9. Reprint of : Bidding to give in the field

    NARCIS (Netherlands)

    Onderstal, Sander; Schram, Arthur J. H. C.; Soetevent, Adriaan R.

    2014-01-01

    In a door-to-door fundraising field experiment, we study the impact of fundraising mechanisms on charitable giving. We approached about 4500 households, each participating in an all-pay auction, a lottery, a non-anonymous voluntary contribution mechanism (VCM), or an anonymous VCM. In contrast to th

  10. It Is Better To Give Than It Is To Receive

    Institute of Scientific and Technical Information of China (English)

    孙犁

    2015-01-01

    <正>Intro:In the world millions of people are suffering from hunger especially people in the African areas,while some other people are enjoying some luxuries,such as jewelry,concert tickets,i Pods and so on.Should people give up their luxuries to those who are suffering from hunger?The answer is definitely

  11. 2 Authors Say Routledge Recycled Their Work without Giving Credit

    Science.gov (United States)

    Bartlett, Thomas

    2008-01-01

    This article reports on two authors' work that has been recycled by Routledge without giving credit or royalty. When William E. Deal casually flipped through "Theory for Performance Studies: A Student's Guide," published this year by Routledge, he noticed a few familiar sentences. After taking a closer look, Mr. Deal, a professor of religious…

  12. Host-parasite coevolutionary arms races give way to fluctuating selection.

    Science.gov (United States)

    Hall, Alex R; Scanlan, Pauline D; Morgan, Andrew D; Buckling, Angus

    2011-07-01

    Host-parasite coevolution is a key driver of biological diversity and parasite virulence, but its effects depend on the nature of coevolutionary dynamics over time. We used phenotypic data from coevolving populations of the bacterium Pseudomonas fluorescens SBW25 and parasitic phage SBW25Φ2, and genetic data from the phage tail fibre gene (implicated in infectivity evolution) to show that arms race dynamics, typical of short-term studies, decelerate over time. We attribute this effect to increasing costs of generalism for phages and bacteria with increasing infectivity and resistance. By contrast, fluctuating selection on individual host and parasite genotypes was maintained over time, becoming increasingly important for the phenotypic properties of parasite and host populations. Given that costs of generalism are reported for many other systems, arms races may generally give way to fluctuating selection in antagonistically coevolving populations.

  13. Arduino & RepRap - Creating Wealth by Giving it Away

    DEFF Research Database (Denmark)

    2011-01-01

    , growth in wealth is longevity and prosperity. Is it possible to grow wealth independently of money? This talk will be from Adrian Bowyer - creator of RepRap, the open-source replicating 3D printer - and from David Cuartielles - creator of Arduino, the open-source microcontroller. Both projects have...... founded significant and growing industries - and hence significant and growing wealth - by giving away all the data required to build RepRaps and Arduinos completely free. They have also short-circuited most conventional industrial infrastructure by placing the ability to create wealth directly...... in the hands of private individuals. The presenters contend that this is the way of the future: companies, and - more importantly - those private individuals will be giving away their primary products and making a living on the sideline activities that such donations attract. Software has been heading...

  14. Beijing Specialists Give Free Medical Treatment in Yunnan Province

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    <正>To help improve the physical conditions of the people in the Hui ethnic minority areas of Yunnan Province, from December 6 to 11,2005, a 10-member medical team of specialists from the Capital went to the Weishan Yi and Hui Ethnic Minority Autonomous County of Dali Prefecture and Xundian Hui and Yi Ethnic Minority Autonomous County of Kunming City to give free medical treatment for 6 days. This activity was

  15. A Conversation Model Enabling Intelligent Agents to Give Emotional Support

    OpenAIRE

    Van der Zwaan, J.M.; Dignum, V; Jonker, C.M.

    2012-01-01

    In everyday life, people frequently talk to others to help them deal with negative emotions. To some extent, everybody is capable of comforting other people, but so far conversational agents are unable to deal with this type of situation. To provide intelligent agents with the capability to give emotional support, we propose a domain-independent conversational model that is based on topics suggested by cognitive appraisal theories of emotion and the 5-phase model that is used to structure onl...

  16. PC-give and David Hendry's econometric methodology

    OpenAIRE

    Neil R. Ericsson; Julia Campos; Hong-Anh Tran

    1991-01-01

    This paper summarizes David Hendry's empirical econometric methodology, unifying discussions in many of his and his co-authors' papers. Then, we describe how Hendry's suite of computer programs PC-GIVE helps users implement that methodology. Finally, we illustrate that methodology and the programs with three empirical examples: post­war narrow money demand in the United Kingdom, nominal income determination in the United Kingdom from Friedman and Schwartz (1982), and consumers' expenditure in...

  17. MP I joint giving way--a case study.

    Science.gov (United States)

    Lohrer, H

    2001-02-01

    A case history of a 26 year old international class female 400 m hurdle sprinter is presented. While sprinting she felt a sudden and very intensive pain at her left hallux. After this she was unable to run and had episodes of giving way in the MP I joint elicited by minor activity. Operative investigation revealed a broad disruption of the MP I medial collateral ligament. After periosteal flap repair and early functional aftertreatment she returned to full high level sports ability.

  18. Giving an account of one's pain in the anthropological interview.

    Science.gov (United States)

    Buchbinder, Mara

    2010-03-01

    In this paper, I analyze the illness stories narrated by a mother and her 13-year-old son as part of an ethnographic study of child chronic pain sufferers and their families. In examining some of the moral, relational and communicative challenges of giving an account of one's pain, I focus on what is left out of some accounts of illness and suffering and explore some possible reasons for these elisions. Drawing on recent work by Judith Butler (Giving an Account of Oneself, 2005), I investigate how the pragmatic context of interviews can introduce a form of symbolic violence to narrative accounts. Specifically, I use the term "genre of complaint" to highlight how anthropological research interviews in biomedical settings invoke certain typified forms of suffering that call for the rectification of perceived injustices. Interview narratives articulated in the genre of complaint privilege specific types of pain and suffering and cast others into the background. Giving an account of one's pain is thus a strategic and selective process, creating interruptions and silences as much as moments of clarity. Therefore, I argue that medical anthropologists ought to attend more closely to the institutional structures and relations that shape the production of illness narratives in interview encounters.

  19. Self-Giving as Spiritual Dimension in Leadership

    Science.gov (United States)

    Benawa, A.; Tarigan, N.; Makmun, S.

    2017-03-01

    This article aims to show that today it is very important to consider the spiritual dimension in leadership, because the absence of the spiritual dimension makes it impossible for a human to evolve. As the leader, whoever should be accountable is not only on the horizontal level and at the vertical level as well. Phenomenological studies and literature about the practice of leadership are faced with a number of theories about leadership and then synthesized into more whole leadership rather than just to brand a leadership itself. Based on the assumption a leader is merely a sociological problem that needs to be completed with a spiritual dimension, while in its historical development of leadership, it is never excluded from the spiritual dimension. This article concludes that self-giving as a spiritual dimension in leadership will give more benefit to develop the life system as well as the purpose of leadership itself rather than the apparent leadership, which actually hurts or even manipulate the members for the sake of egoistic the leader and their inner circle. Therefore, it is very important for education to teach self-giving as a spiritual dimension to all students of the World, especially in Asia.

  20. Private Giving Crowding Government Funding in Public Higher Education

    Directory of Open Access Journals (Sweden)

    G. Thomas Sav

    2010-01-01

    Full Text Available Problem statement: Private giving and government funding are critical revenue sources for public colleges and universities. If increased private giving reduces government funding, then that type and extent of crowding out carries important managerial and public policy implications. Approach: The study used a government funding reaction function and an instrumental variable approach to empirically estimate the potential for crowding out. Results: The study examined the extent to which private giving reduces or crowds out state government funding of public colleges and universities. Government free riding was at question and investigated to determine how active it is in terms of private donations partially or wholly displacing state government funding. The findings suggested that the rate of crowding out was 43% on the dollar. That compares to the 45% political substitution of the 1960’s but is much diminished from the 1980’s dollar for dollar crowding out. Those are aggregate comparisons for all public institutions. A disaggregated approach in this study additionally revealed that doctoral universities were victims of the same 43% crowd out but that at two other levels, master degree granting and associate degree granting colleges, there was the opposite effect of crowding in. Those colleges received state funding augmentations of 32-92% on their dollar of privately provided donations. Conclusion/Recommendations: The study’s finding of the existence of both crowding out and crowding in can carry important policy implications for college and university funding. Future managerial and public policy decision making should take that into account. However, political sustainability and economy wide and localized effects over time of crowding out and in could prove fruitful avenues of inquiry for future research.

  1. A Childhood Rich in Culture Gives a Socioeconomic Bonus

    DEFF Research Database (Denmark)

    Austring, Bennye Düranc

    2015-01-01

    Artiklen ridser den nyeste forskning op inden for feltet 'art rich learning', altså æstetiske læreprocesser af god kvalitet. In the book ”Art and Culture Give Children a Life that Works” 60 (Danish and non-Danish) experts, practitioners, artists and several Ministers from the Danish Government...... focus on the significance of Art and Culture for children. The book provides lots of inspiration for teachers, pedagogues and cultural mediators and contains many examples of specific cultural activities, links and bibliographic references....

  2. Does friendship give us non-derivative partial reasons ?

    OpenAIRE

    Andrew Reisner

    2008-01-01

    One way to approach the question of whether there are non-derivative partial reasons of any kind is to give an account of what partial reasons are, and then to consider whether there are such reasons. If there are, then it is at least possible that there are partial reasons of friendship. It is this approach that will be taken here, and it produces several interesting results. The first is a point about the structure of partial reasons. It is at least a necessary condition of a reason’s being...

  3. Confounding Issues in the Deadweight Loss of Gift-Giving

    OpenAIRE

    H. Kristl Davison; Bing, Mark N.; E. Bruce Hutchinson; Leila J. Pratt

    2008-01-01

    When a gift is given, someone other than the final consumer makes the consumption choice. Thus there is a possibility that the gift will not match the preferences of the receiver, i.e., the gift will represent a wise use of the money given the gift-giver's tastes but not necessarily a wise use of money given the recipient's tastes. In other words, gift giving can result in a deadweight loss. This paper addresses and clarifies the discrepancy between Waldfogel's (1993) finding of a deadweight ...

  4. Reluctant altruism and peer pressure in charitable giving

    Directory of Open Access Journals (Sweden)

    Diane Reyniers

    2013-01-01

    Full Text Available Subjects donate individually (control group or in pairs (treatment group. Those in pairs reveal their donation decision to each other. Average donations in the treatment group are significantly higher than in the control group. Paired subjects have the opportunity to revise their donation decision after discussion. Pair members shift toward each others' initial decisions. Subjects are happier with their decision when their donations are larger, but those in pairs are less happy, controlling for amount donated. These findings suggest reluctant altruism due to peer pressure in charitable giving.

  5. What are the impacts of giving up the driving licence?

    DEFF Research Database (Denmark)

    Siren, Anu Kristiina; Haustein, Sonja

    2014-01-01

    in their activities after giving up their licence. In travel frequency, neither the differences between renewers and non-renewers nor the changes over time within the groups were pronounced. The groups differed in their use of transport modes already at the baseline: the renewers drove, while nonrenewers travelled...... as passengers, used public transport, walked or cycled. Not renewing the licence was a strong predictor of unmet mobility needs, especially in relation to leisure activities. The present study indicates that younger seniors’ mobility is not likely to be affected by the strict renewal policies. However, given...

  6. Giving Voice to Values: an undergraduate nursing curriculum project.

    Science.gov (United States)

    Lynch, Sandra; Hart, Bethne; Costa, Catherine M

    2014-01-01

    Among the competency standards stipulated by the Australian Nursing and Midwifery Council for graduating students are competencies in moral and ethical decision making and ethics education within professions such as nursing has traditionally focussed on these competencies, on raising ethical awareness and developing skills of analysis and reasoning. However, ethics education in tertiary settings places less emphasis on developing students' capacities to act on their values. This paper explains and explores the adoption of Dr. Mary Gentile's curriculum (the Giving Voice to Values curriculum).which specifically focuses on developing students' capacities to act on their values. The curriculum (Gentile, 2010) assists students and professionals to explore, script and rehearse responses which build upon their capacity to respond in accordance with their own values in complex workplace settings in which they face conflicts of value and belief. The paper firstly examines the theoretical underpinnings of the Giving Voice to Values (GVV) curriculum. It then presents the integration and evaluation phase of a Project inspired by the GVV methodology, using a case study approach within two areas of an undergraduate nursing curriculum. As a pilot project, this initiative has provided signposts to further curriculum development and to research pathways within the UNDA School of Nursing, by highlighting students' uncertainties regarding their own professional values, and their intense struggles to voice their values within health care contexts.

  7. Dictator Game Giving: The Importance of Descriptive versus Injunctive Norms.

    Science.gov (United States)

    Raihani, Nichola J; McAuliffe, Katherine

    2014-01-01

    Human behaviour is influenced by social norms but norms can entail two types of information. Descriptive norms refer to what others do in this context, while injunctive norms refer to what ought to be done to ensure social approval. In many real-world situations these norms are often presented concurrently meaning that their independent effects on behaviour are difficult to establish. Here we used an online Dictator Game to test how descriptive and injunctive norms would influence dictator donations when presented independently of one another. In addition, we varied the cost of complying with the norm: By stating that $0.20 or $0.50 cent donations from a $1 stake were normal or suggested, respectively. Specifying a higher target amount was associated with increased mean donation size. In contrast to previous studies, descriptive norms did not seem to influence giving behaviour in this context, whereas injunctive norms were associated with increased likelihood to give at least the target amount to the partner. This raises the question of whether injunctive norms might be more effective than descriptive norms at promoting prosocial behaviour in other settings.

  8. Fetal and adult hematopoietic stem cells give rise to distinct T cell lineages in humans.

    Science.gov (United States)

    Mold, Jeff E; Venkatasubrahmanyam, Shivkumar; Burt, Trevor D; Michaëlsson, Jakob; Rivera, Jose M; Galkina, Sofiya A; Weinberg, Kenneth; Stoddart, Cheryl A; McCune, Joseph M

    2010-12-17

    Although the mammalian immune system is generally thought to develop in a linear fashion, findings in avian and murine species argue instead for the developmentally ordered appearance (or "layering") of distinct hematopoietic stem cells (HSCs) that give rise to distinct lymphocyte lineages at different stages of development. Here we provide evidence of an analogous layered immune system in humans. Our results suggest that fetal and adult T cells are distinct populations that arise from different populations of HSCs that are present at different stages of development. We also provide evidence that the fetal T cell lineage is biased toward immune tolerance. These observations offer a mechanistic explanation for the tolerogenic properties of the developing fetus and for variable degrees of immune responsiveness at birth.

  9. Estudo de casos sobre abandono do tratamento da tuberculose: avaliação do atendimento, percepção e conhecimentos sobre a doença na perspectiva dos clientes (Fortaleza, Ceará, Brasil Non-adherence to tuberculosis treatment: a study on perceptions and knowledge of the disease and evaluation of health services from the patient perspective (Fortaleza, Ceará, Brazil

    Directory of Open Access Journals (Sweden)

    Mary Braga de Lima

    2001-08-01

    Full Text Available Esta pesquisa foi desenvolvida em 1995 e 1996 no Centro de Saúde Oliveira Pombo, Fortaleza, Ceará. Os objetivos foram os seguintes: geral - identificação de fatores que determinam o abandono do tratamento da tuberculose; específicos - análise da dinâmica do atendimento e da freqüência de casos e de abandono do tratamento; identificação das características sócio-econômicas e culturais dos clientes (atores sociais; causas impeditivas ao tratamento; conhecimentos e percepção da doença pelos clientes. Duas abordagens metodológicas foram utilizadas: de natureza epidemiológica descritiva e sociológica interpretativa, utilizando questionário semi-estruturado com os seguintes conteúdos: sexo; idade; estado civil; escolaridade; ocupação; rendimento; descrição da residência; formas de deslocamento; níveis de conhecimentos e percepção sobre a doença e o tratamento; identificação de sentimentos reativos à doença; avaliação sobre o atendimento; comportamento e estilos de vida prejudiciais; decisões de mudanças para melhoria da saúde. Os resultados obtidos apontaram fatores múltiplos de natureza complexa, que influem direta ou indiretamente para o abandono do tratamento.This research was developed in 1995-1996 in the Oliveira Pombo Health Center (CSOP, Fortaleza, Ceará, Brazil. The aim was to explore factors influencing non-adherence to tuberculosis treatment. Specific objectives were: dynamics of tuberculosis notification and treatment of non-adherence cases at the CSOP; demographic, social, economic, and cultural profiles of clientele (social actors; default reasons that interrupt treatment; and knowledge and perception of the disease. The methodological approach was based on descriptive epidemiology and on sociological interpretivism. A semi-structured interview was used for questions related to the social actors, such as: demographic, social, economic, cultural, and behavioral factors; knowledge and perceptions of

  10. Giving Students the Power to Engage with Learning

    Science.gov (United States)

    Cochran, Kathryn F.; Reinsvold, Lori A.; Hess, Chelsie A.

    2016-11-01

    This critical discourse analysis study identifies and describes power relationships in elementary classrooms that support science engagement by providing students time to think, ask questions, and find their voices to talk about subject matter. The first analyses involved identification and description of classroom episodes showing high levels of student power and engagement associated with learning science. Classroom episodes were grouped into seven power patterns: use of questions, teacher sharing authority, giving students credit for knowledge, legitimate digressions, enhanced feedback, and writing opportunities. The second analyses documented the manner in which these patterns formed more complex classroom engagement processes called power clusters. These examples further our understanding of the dynamics of classroom discourse and the relationships between student power and engagement in subject matter.

  11. Testing the Correlations between Corporate Giving, Performance and Company Value

    Directory of Open Access Journals (Sweden)

    Camelia-Daniela Hategan

    2017-07-01

    Full Text Available The paper seeks to identify the relationship between the charitable contributions, performance, and market value of Romanian listed companies. To achieve the objective, a panel data analysis was conducted on a group of companies listed at Bucharest Stock Exchange in the period 2011 to 2016, which registered profit for the entire period. The empirical analysis points out, using a logistic regression, which financial and non-financial indicators contribute to the decisions of the companies to make the charitable contributions. It also tests the impact of those indicators and corporate giving activities like Corporate Social Responsibility (CSR activities on company value, represented by Tobin’s Q Ratio and on company performance, expressed by Return on Equity (ROE. The results show that there is a positive correlation between the charitable contributions, performance, and market value of the Romanian listed companies.

  12. The Effect of Giving Feedback to Students' Writing

    Directory of Open Access Journals (Sweden)

    Mochamad Zainuddin

    2004-01-01

    Full Text Available Although writing is as important as other skills such as listening, speaking, and reading, it needs more special attention. In order to write well, students need a long process to learn to write and they need continous feedback. The aim of this article is to know whether giving feedback to students' writing has a significant effect or not. Two groups of students, experimental and control, were involved. The compositions of the first group were given feedback, while those of the second group were not given feedback. The study shows that provision of feedback improves student's writing. In light of the result of the study, it is recommended that teachers provide feedback on students' writing.

  13. Nutrition and the brain: what advice should we give?

    Science.gov (United States)

    Cooper, James K

    2014-09-01

    The knowledge base of nutrition and the brain is steadily expanding. Much of the research is aimed at ways to protect the brain from damage. In adults, the major causes of brain damage are aging and dementia. The most prominent dementia, and the condition that grabs the most public attention, is Alzheimer's disease. The assumption in the field is that possibly some change in nutrition could protect the brain and prevent, delay, or minimize Alzheimer's disease damage. Presented here is a framework for understanding the implications of this research. There is a gap between publishing research results and change in public nutrition behavior. Several influencing elements intervene. These include regulatory agencies and all the organizations and people who advise the public, all with their own perspectives. In considering what advice to give, advisors may consider effectiveness, research model, persuasiveness, and risks, among other factors. Advice about nutrition and Alzheimer's disease today requires several caveats.

  14. Association Analysis of Alumni Giving: A Formal Concept Analysis

    Science.gov (United States)

    Hashemi, Ray R.; Le Blanc, Louis A.; Bahar, Mahmood; Traywick, Bryan

    A large sample (initially 33,000 cases representing a ten percent trial) of university alumni giving records for a large public university in the southwestern United States are analyzed by Formal Concept Analysis (FCA). This likely represents the initially attempt to perform analysis of such data by means of a machine learing technique. The variables employed include the gift amount to the university foundation (UF) as well as traditional demographic variables such as year of graduation, gender, ethnicity, marital status, etc. The UF serves as one of the institution's non-profit, fund-raising organizations. It pursues substantial gifts that are designated for the educational or leadership programs of the giver's choice. Although they process gifts of all sizes, the UF focus is on major gifts and endowments.

  15. GIVE VOICES TO SILENT LEARNERS IN SPEAKING CLASS

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    It is commonly experienced by teachers that they meet silent learners in speaking class,especiallyin an EFL setting at the tertiary level in China.This paper attempts to diagnose the problems inthe current curriculum,curriculum materials and teaching methods used to teach the productiveskill of speaking,which are supposed to be the direct cause of students in"losing their voices",Itbegins with a brief description of the teaching and learning situation in a teachers’ college which isalso typical at other tertiary levels as well.Concrete examples of modification to the teaching ofthe skill are provided with the hope to give back"voices"to the silent students in speaking class.

  16. The good engineer: giving virtue its due in engineering ethics.

    Science.gov (United States)

    Harris, Charles E

    2008-06-01

    During the past few decades, engineering ethics has been oriented towards protecting the public from professional misconduct by engineers and from the harmful effects of technology. This "preventive ethics" project has been accomplished primarily by means of the promulgation of negative rules. However, some aspects of engineering professionalism, such as (1) sensitivity to risk (2) awareness of the social context of technology, (3) respect for nature, and (4) commitment to the public good, cannot be adequately accounted for in terms of rules, certainly not negative rules. Virtue ethics is a more appropriate vehicle for expressing these aspects of engineering professionalism. Some of the unique features of virtue ethics are the greater place it gives for discretion and judgment and also for inner motivation and commitment. Four of the many professional virtues that are important for engineers correspond to the four aspects of engineering professionalism listed above. Finally, the importance of the humanities and social sciences in promoting these virtues suggests that these disciplines are crucial in the professional education of engineers.

  17. Osteocyte regulation of bone mineral: a little give and take.

    Science.gov (United States)

    Atkins, G J; Findlay, D M

    2012-08-01

    Osteocytes actively participate in almost every phase of mineral handling by bone. They regulate the mineralisation of osteoid during bone formation, and they are also a major RANKL-producing cell. Osteocytes are thus able to liberate bone mineral by regulating osteoclast differentiation and activity in response to a range of stimuli, including bone matrix damage, bone disuse and mechanical unloading, oestrogen deficiency, high-dose glucocorticoid and chemotherapeutic agents. At least some of these activities may be regulated by the osteocyte-secreted product, sclerostin. There is also mounting evidence that in addition to regulating phosphate homeostasis systemically, osteocytes contribute directly to calcium homeostasis in the mature skeleton. Osteocyte cell death and the local loss of control of bone mineralisation may be the cause of focal hypermineralisation of bone and osteopetrosis, as seen in aging and pathology. The sheer number of osteocytes in bone means that "a little give and take" in terms of regulation of bone mineral content translates into a powerful whole organism effect.

  18. Traveller's thrombosis: airlines still not giving passengers the WRIGHT advice!

    Science.gov (United States)

    Scurr, J R H; Ahmad, N; Thavarajan, D; Fisher, R K

    2010-10-01

    This study has examined the impact of the World Health Organization's Research into Global Hazards of Travel (WRIGHT) Project's phase 1 report on the information given by airlines to their passengers regarding traveller's thrombosis. Official websites of all airlines flying from Heathrow (UK) and John F Kennedy (USA) were located through links on the websites of these two busy international airports. In June 2007, each site was scrutinized by three independent researchers to identify if traveller's thrombosis and its risk factors were discussed and what methods of prevention were advised. This exercise was repeated a year after the publication of the WRIGHT report. One hundred and nineteen international airlines were listed in 2007 (12 were excluded from analysis). A quarter (27/107) of airlines warned of the risk of traveller's thrombosis. A year later, five airlines were no longer operational and there had been no increase in the discussion of traveller's thrombosis (23/102). Additional risk factors discussed in June 2007 versus September 2008: previous venous thromboembolism (16%, 15%); thrombophilia (14%, 15%); family history (11%, 9%); malignancy (12%, 14%); recent surgery (19%, 16%); pregnancy (17%, 16%) and obesity (11%, 12%). Prophylaxis advice given in June 2007 versus September 2008: in-flight exercise (34%, 42%); Hydration (30%, 34%); medical consultation prior to flying (20%, 18%); graduated compression stockings (13%, 12%); aspirin (airlines continue to fail to warn of the risk of traveller's thrombosis or offer appropriate advice. Alerting passengers at risk gives them an opportunity to seek medical advice before flying.

  19. Can Maxwell's fish eye lens really give perfect imaging?

    CERN Document Server

    Sun, Fei

    2010-01-01

    Both explicit analysis and FEM numerical simulation are used to analyze the field distribution of a line current in the so-called Maxwell's fish eye lens [bounded with a perfectly electrical conductor (PEC) boundary]. We show that such a 2D Maxwell's fish eye lens cannot give perfect imaging due to the fact that high order modes of the object field can hardly reach the image point in Maxwell's fish eye lens. If only zeroth order mode is excited, a good image of a sharp object may be achieved in some cases, however, its spot-size is larger than the spot size of the initial object field. The image resolution is determined by the field spot size of the image corresponding to the zeroth order component of the object field. Our explicit analysis consists very well with the FEM results for a fish eye lens. Time-domain simulation is also given to verify our conclusion. Multi-point images for a single object point are also demonstrated.

  20. Does friendship give us non-derivative partial reasons ?

    Directory of Open Access Journals (Sweden)

    Andrew Reisner

    2008-02-01

    Full Text Available One way to approach the question of whether there are non-derivative partial reasons of any kind is to give an account of what partial reasons are, and then to consider whether there are such reasons. If there are, then it is at least possible that there are partial reasons of friendship. It is this approach that will be taken here, and it produces several interesting results. The first is a point about the structure of partial reasons. It is at least a necessary condition of a reason’s being partial that it has an explicit relational component. This component, technically, is a relatum in the reason relation that itself is a relation between the person to whom the reason applies and the person whom the action for which there is a reason concerns. The second conclusion of the paper is that this relational component is also required for a number of types of putatively impartial reasons. In order to avoid trivialising the distinction between partial and impartial reasons, some further sufficient condition must be applied. Finally, there is some prospect for a way of distinguishing between impartial reasons that contain a relational component and partial reasons, but that this approach suggests that the question of whether ethics is partial or impartial will be settled at the level of normative ethical discourse, or at least not at the level of discourse about the nature of reasons for action.

  1. Constructing populations in biobanking

    DEFF Research Database (Denmark)

    Tupasela, Aaro; Snell, Karoliina; Cañada, Jose a.

    2015-01-01

    This article poses the question of whether biobanking practices and standards are giving rise to the construction of populations from which various biobanking initiatives increasingly draw on for legitimacy? We argue that although recent biobanking policies encourage various forms of engagement w...

  2. Charitable giving for HIV and AIDS: results from a Canadian national survey.

    Directory of Open Access Journals (Sweden)

    Dan Allman

    Full Text Available BACKGROUND: For the first time, a national survey of adults in Canada posed questions on charitable giving for HIV and AIDS. The objective of this analysis was to explore the behaviour and attitudes of this population in terms of charitable giving. METHODS: In 2011, individuals in Canada 16 years of age or older were recruited for a survey from an online panel supplemented by random digit dial telephone interviewing. The margin of error was +/-2.1 percentage points (95%. Chi-square tests were used to detect bivariate associations. A multivariate logistic regression model was fit to compare those who had donated to HIV and AIDS in the past 12 months with those who had donated to other disease or illness charities. RESULTS: 2,139 participated. 82.5% had donated to a charitable cause in the past 12 months. 22.2% had ever donated to HIV and AIDS, with 7.8% doing so in the past 12 months. Individuals who had donated to HIV and AIDS versus other disease or illness charities tended to be younger (p<0.05, single (p<0.005, more highly educated (p<0.001 and to self-identify as a member of a sexual minority group (p<0.001. Multivariate analysis revealed individuals who self-identified as a member of a sexual minority group were significantly much more likely to have donated to HIV and AIDS than to other disease or illness charities in the past 12 months (OR, 7.73; p<0.001; CI 4.32-13.88. DISCUSSION: Despite a generally philanthropic orientation, relatively few respondents had ever been involved in charitable giving for HIV and AIDS. Those who had could be understood relationally as individuals at closer social proximity to HIV and AIDS such as members of sexual minority groups.

  3. Wives giving care to husbands with Alzheimer's disease: a process of interpretive caring.

    Science.gov (United States)

    Perry, JoAnn

    2002-08-01

    Wives giving care to spouses with dementia are a particularly vulnerable segment of the caregiving population. In this article a grounded theory study of 20 such wives is described, with their experiences explained as a process of interpretive caring. Wives began the process by either seeing changes in their husbands or recognizing changes in their work. Following this, the wives moved on to a phase of drawing inferences about what they observed and then took over their husbands' roles and responsibilities. These changes prompted the wives to rewrite identities for their husbands that incorporated the dementia and to rewrite identities for themselves to reflect their new roles, abilities, and strengths. Finally, the wives set about constructing a new daily life to sustain both partners. This process is neutral and allows for positive aspects of caring to be considered along with grief and frustration.

  4. Discussion of Population Modernization Theory and Actuality Analysis of Population Modernization in China

    Institute of Scientific and Technical Information of China (English)

    Wang Shu

    2004-01-01

    This paper discusses the basic concept and connotation of population modernization.The author briefly analyzes the actuality of population modernization in China, gives some advice and puts forward some measures.

  5. Cairo: repackaging population control.

    Science.gov (United States)

    Simons, H

    1995-01-01

    Aid agencies, charities, and other nongovernmental organizations once denounced population control programs as racist interference in the third world. Yet, at the United Nations Conference on Population and Development in Cairo last September, these same organizations endorsed very similar ideas. The U.N. can now claim that even its fiercest critics not only have muted their criticism of population control programs but now positively endorse them. Over the last 30 years, population control has been consciously repackaged by the U.S. establishment. The image of population control has changed from being overtly anti-third world to being about giving the people of the third world--especially women--basic rights in family planning. Wrapped up in the language of women's empowerment and environmentalism, the establishment's old arguments about there being too many nonwhite babies in the world, have, unfortunately, won the day.

  6. Unique Stellar System Gives Einstein a Thumbs-Up

    Science.gov (United States)

    2008-07-01

    Taking advantage of a unique cosmic coincidence, astronomers have measured an effect predicted by Albert Einstein's theory of General Relativity in the extremely strong gravity of a pair of superdense neutron stars. The new data indicate that the famed physicist's 93-year-old theory has passed yet another test. Double Pulsar Graphic Artist's Conception of Double Pulsar System PSR J0737-3039A/B CREDIT: Daniel Cantin, DarwinDimensions, McGill University Click on image for more graphics. The scientists used the National Science Foundation's Robert C. Byrd Green Bank Telescope (GBT) to make a four-year study of a double-star system unlike any other known in the Universe. The system is a pair of neutron stars, both of which are seen as pulsars that emit lighthouse-like beams of radio waves. "Of about 1700 known pulsars, this is the only case where two pulsars are in orbit around each other," said Rene Breton, a graduate student at McGill University in Montreal, Canada. In addition, the stars' orbital plane is aligned nearly perfectly with their line of sight to the Earth, so that one passes behind a doughnut-shaped region of ionized gas surrounding the other, eclipsing the signal from the pulsar in back. "Those eclipses are the key to making a measurement that could never be done before," Breton said. Einstein's 1915 theory predicted that, in a close system of two very massive objects, such as neutron stars, one object's gravitational tug, along with an effect of its spinning around its axis, should cause the spin axis of the other to wobble, or precess. Studies of other pulsars in binary systems had indicated that such wobbling occurred, but could not produce precise measurements of the amount of wobbling. "Measuring the amount of wobbling is what tests the details of Einstein's theory and gives a benchmark that any alternative gravitational theories must meet," said Scott Ransom of the National Radio Astronomy Observatory. The eclipses allowed the astronomers to pin

  7. Substitution or Symbiosis? Assessing the Relationship between Religious and Secular Giving

    Science.gov (United States)

    Hill, Jonathan P.; Vaidyanathan, Brandon

    2011-01-01

    Research on philanthropy has not sufficiently examined whether charitable giving to religious causes impinges on giving to secular causes. Examining three waves of national panel data, we find that the relationship between religious and secular giving is generally not of a zero-sum nature; families that increase their religious giving also…

  8. Giving USA 1997: The Annual Report on Philanthropy for the Year 1996.

    Science.gov (United States)

    Kaplan, Ann E., Ed.

    This report presents a comprehensive review of private philanthropy in the United States during 1996. After a preliminary section, the first section presents data on giving, using text, graphs, and charts. Sections cover: overall 1996 contributions; changes in giving by source and use; total giving (1966-1996); inflation-adjusted giving in 5-year…

  9. Rosette nebula globules: Seahorse giving birth to a star

    Science.gov (United States)

    Mäkelä, M. M.; Haikala, L. K.; Gahm, G. F.

    2017-09-01

    Context. The Rosette nebula is an H ii region ionized mainly by the stellar cluster NGC 2244. Elephant trunks, globules, and globulettes are seen at the interface where the H ii region and the surrounding molecular shell meet. Aims: We have observed a field in the northwestern part of the Rosette nebula where we study the small globules protruding from the shell. Our aim is to measure their properties and study their star-formation history in continuation of our earlier study of the features of the region. Methods: We imaged the region in broadband near-infrared (NIR) JsHKs filters and narrowband H2 1-0 S(1), Pβ, and continuum filters using the SOFI camera at the ESO/NTT. The imaging was used to study the stellar population and surface brightness, create visual extinction maps, and locate star formation. Mid-infrared (MIR) Spitzer IRAC and WISE and optical NOT images were used to further study the star formation and the structure of the globules. The NIR and MIR observations indicate an outflow, which is confirmed with CO observations made with APEX. Results: The globules have mean number densities of 4.6 × 104 cm-3. Pβ is seen in absorption in the cores of the globules where we measure visual extinctions of 11-16 mag. The shell and the globules have bright rims in the observed bands. In the Ks band 20 to 40% of the emission is due to fluorescent emission in the 2.12 μmH2 line similar to the tiny dense globulettes we studied earlier in a nearby region. We identify several stellar NIR excess candidates and four of them are also detected in the Spitzer IRAC 8.0 μm image and studied further. We find an outflow with a cavity wall bright in the 2.124 μmH2 line and at 8.0 μm in one of the globules. The outflow originates from a Class I young stellar object (YSO) embedded deep inside the globule. An Hα image suggests the YSO drives a possible parsec-scale outflow. Despite the morphology of the globule, the outflow does not seem to run inside the dusty fingers

  10. Perceptions of the population and health professionals regarding visceral leishmaniasis.

    Science.gov (United States)

    Carmo, Rose Ferraz; da Luz, Zélia Maria Profeta; Bevilacqua, Paula Dias

    2016-02-01

    Based on theoretical qualitative research reference methodology, this study sought to investigate the perception of visceral leishmaniasis (VL) by social actors directly involved in the prevention and control of the disease. Thirty-eight semi-structured interviews were conducted with residents, focus groups were staged with 18 health workers in an endemic VL area and depositions were collected, which after being processed by content analysis revealed shortcomings and challenges. The population associated VL with dogs, acknowledged their co-responsibility in tackling the disease and demanded information. Health workers identified environmental sanitation as an essential factor for VL prevention. Among the shortcomings, the lack of information about the disease and culpability of the individual because of non-adherence to prevention measures were observed, especially environmental management. Probably, approaches emphasizing the role of the environment as a health promotion agent and the timely definition of specific environmental measures against VL, constitute a prospect for overcoming these shortcomings. The consensus is that the main challenge for enhancing the prevention and control might be the participatory and dialogical construction of these approaches between health professionals and the population.

  11. Giving Asthma Support to Patients (GASP): a novel online asthma education, monitoring, assessment and management tool.

    Science.gov (United States)

    Ram, Felix S; McNaughton, Wendy

    2014-09-01

    Giving Asthma Support to Patients (GASP) is a unique online tool developed to provide asthma education at point of care, and to provide health care professionals in primary care with skills and knowledge to undertake a structured asthma assessment. A retrospective cohort study was undertaken to evaluate the effectiveness of GASP. Data for patients aged 5-64 years seen in primary care (Waitemata region of Auckland) with uncontrolled asthma who had completed a minimum of two GASP assessments between 1 November 2008 and 17 April 2011 were extracted from a secure, self-populating database. Outcome measures were compared between each patient's visit 1 and 2 assessments. A total of 761 patients provided data using GASP. There was a significant reduction between GASP assessments in the risk of exacerbations, hospital admissions, emergency department presentations, requirement for corticosteroids, and bronchodilator reliance. Results from this retrospective cohort study are promising. A randomised controlled trial of the use of GASP in primary care is warranted to confirm these findings. The effectiveness of the GASP tool also needs to be further investigated in Maori and Pacific populations. The findings of this study of GASP show its potential and support its use in the primary care setting.

  12. Boundary Caps Give Rise to Neurogenic Stem Cells and Terminal Glia in the Skin

    Directory of Open Access Journals (Sweden)

    Aurélie Gresset

    2015-08-01

    Full Text Available While neurogenic stem cells have been identified in rodent and human skin, their manipulation and further characterization are hampered by a lack of specific markers. Here, we perform genetic tracing of the progeny of boundary cap (BC cells, a neural-crest-derived cell population localized at peripheral nerve entry/exit points. We show that BC derivatives migrate along peripheral nerves to reach the skin, where they give rise to terminal glia associated with dermal nerve endings. Dermal BC derivatives also include cells that self-renew in sphere culture and have broad in vitro differentiation potential. Upon transplantation into adult mouse dorsal root ganglia, skin BC derivatives efficiently differentiate into various types of mature sensory neurons. Together, this work establishes the embryonic origin, pathway of migration, and in vivo neurogenic potential of a major component of skin stem-like cells. It provides genetic tools to study and manipulate this population of high interest for medical applications.

  13. Correlations and Neuronal Population Information.

    Science.gov (United States)

    Kohn, Adam; Coen-Cagli, Ruben; Kanitscheider, Ingmar; Pouget, Alexandre

    2016-07-01

    Brain function involves the activity of neuronal populations. Much recent effort has been devoted to measuring the activity of neuronal populations in different parts of the brain under various experimental conditions. Population activity patterns contain rich structure, yet many studies have focused on measuring pairwise relationships between members of a larger population-termed noise correlations. Here we review recent progress in understanding how these correlations affect population information, how information should be quantified, and what mechanisms may give rise to correlations. As population coding theory has improved, it has made clear that some forms of correlation are more important for information than others. We argue that this is a critical lesson for those interested in neuronal population responses more generally: Descriptions of population responses should be motivated by and linked to well-specified function. Within this context, we offer suggestions of where current theoretical frameworks fall short.

  14. Learning About Ethical Leadership Through the Giving Voice to Values Curriculum.

    Science.gov (United States)

    Gentile, Mary C

    2015-01-01

    This chapter explores the Giving Voice to Values curriculum, one innovative approach to integrating ethics into leadership development. The chapter describes how Giving Voice to Values is being used in educational settings across the globe.

  15. Give & Take

    Science.gov (United States)

    Dutton, Gail

    2012-01-01

    Employees in a negotiation training workshop are chatting happily in a company cafeteria near San Francisco. They're not on break. They're on assignment. Their objective: to discover three things they didn't know--and wouldn't have guessed--about each other. The exercise isn't about the information, though. It's about the methods they used to get…

  16. Transparent Giving

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Public trust in charities generally remains low, but the government is taking steps to improve their accountability Chen Xiaozhu, a civil servant in Beijing, follows the development of China's charities and enthusiastically participates in different charitable activities. But she cannot forget an incident at Shanghai's Fudan

  17. STUDY OF GIVING FEED SUPPLEMENT ON PRODUCTIVITY PO CATTLE IN SUBANG DISTRICT

    Directory of Open Access Journals (Sweden)

    Erni Gustiani

    2014-02-01

    Full Text Available Decreasing of population and productivity of beef cattle due to low of post partus reproduction capability. Feeding at the last of pregnancy and early lactation period has not appropriate with the needs of cattle that caused this condition. Need the right strategy and technology to support that condition. Improvement of feed quality intake at the period is one attempt to increase of productivition capability. Assessment aims to determine the performance of beef cattle productivity capability through the improvement of feed quality. Research was conducted at Family Jaya livestock farmers group in Ponggang Village, Serangpanjang District, Subang Regency, and carried out from June to November 2013. Feed quality improvement by introduction feed supplementation (concentrates and UMB that is given at the last of pregnancy period and the early lactation period during 2 months before partus and 2 months after partus(flushing. While animal control / comparison fed in accordance with the habits of farmers is only given forage and agricultural waste which is not given every day. Provision of drinking water is done ad-libitum. Livestock productivity parameters measured were body weight calf; daily weight gain of cattle calf and post-partum estrus parent. Data collected were tabulated and analyzed by t-test. The study showed that cattle treated with additional feed gives a better effect on birth weight, weight gain of cattle and post-partum estrus.

  18. Counting Populations

    Science.gov (United States)

    Damonte, Kathleen

    2004-01-01

    Scientists use sampling to get an estimate of things they cannot easily count. A population is made up of all the organisms of one species living together in one place at the same time. All of the people living together in one town are considered a population. All of the grasshoppers living in a field are a population. Scientists keep track of the…

  19. Normative population theory.

    Science.gov (United States)

    Cowen, T

    1989-01-01

    This article finds utilitarian and contractarian approaches to solving the problem of optimal population unacceptable. The principles of utility refer to the best population as the one which contains the greatest sum of utility or the one with the highest average utility. Yet Parfits's repugnant conclusion states that these can imply a very large population at a very low standard of living. Cowen's Methuselah's Paradox says that for any possible happy and meaningful life, we can imagine another, much longer life which demonstrates the absurdity of the utility principles. Lewis argues for a conception of well being based upon choices over whole irreducible states of affairs, i.e., an ordinal concept of value. The contractarian approach assumes that we would rationally choose what type of life we were to live if the choice were made without anyone knowing his particular standing in the world--the veil of ignorance. This requires the individuals to choose on the basis of self interest, but gives too much weight to the individuals actually being born. The most promising population theory appears to be the ideal participant method. Simply stated the optimal population is what an individual would prefer if he had to sequentially live out each life in his choice. Further, this method may be able to reduce the difficulties with evaluating alternate populations to the common problem of aggregating disparate preferences.

  20. Twenty years trends and socio-demographic characteristics of HIV prevalence in women giving birth in Catalonia (Spain).

    Science.gov (United States)

    Carnicer-Pont, Dolors; Montoliu, Alexandra; Marín, José Luis; Almeda, Jesús; González, Victoria; Muñoz, Rafael; Martínez, Carmen; Jané, Mireia; Casabona, Jordi

    2015-01-01

    Studies of the prevalence of HIV in sentinel populations are one of the key strategies to monitor the HIV epidemic. We describe HIV prevalence trends and identify differences across time in the sociodemographic characteristics of HIV-infected women giving birth in Catalonia. We used dried blood specimens, residual to newborn screening, which have been collected in Catalonia every 2 months since 1994. The total number of samples obtained until 2009 and in 2013 represented half of yearly newborns. From 2010 to 2012, the total number of samples obtained represented a quarter of yearly newborns. We studied the prevalence by year and place of current residence (Barcelona-city, cities>200,000 inhabitants and cities ≤ 200,000 inhabitants) and by the mother's birth country. A total of 624,912 infants were tested for HIV antibodies from January 1994 to December 2013. HIV prevalence trends among women giving birth in Catalonia decreased until 2007. Thereafter, there was a change to a steady trend until 2013. However, among foreign women giving birth and living in cities ≤ 200,000 inhabitants, the prevalence of HIV increased from 2007 to 2013. To ensure early identification and treatment of HIV-infected mothers, it is essential to maintain HIV surveillance programs and pre- and post-natal screening programs, both in Barcelona and in cities with 200,000 inhabitants or less, especially in immigrant women. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  1. Four motivations for charitable giving: implications for marketing strategy to attract monetary donations for medical research.

    Science.gov (United States)

    Dawson, S

    1988-06-01

    Medical research foundations can compete more effectively for charitable dollars by being aware of motivations for giving when designing marketing strategy. The study tests the extent to which the motives of reciprocity, income, career, and self-esteem predict monetary giving to medical research. The results indicate that reciprocity and income motives are significant predictors of giving, as are household assets and age. Interpretation of these results leads to several suggestions for marketing strategy.

  2. Charity begins at home: How socialization experiences influence giving and volunteering

    OpenAIRE

    Bekkers, René

    2005-01-01

    This paper shows that charity begins at home. Using retrospective reports on youth experiences from the Giving in the Netherlands Panel Survey (n=1,964, 2001) I find that (1) parents who volunteer when their children are young promote giving and volunteering of their children once they have become adults; (2) the intensity of youth participation in nonprofit organizations is positively related to current giving and volunteering; (3) that parental volunteering and youth participation promote c...

  3. Foraging in groups affects giving-up densities: solo foragers quit sooner.

    Science.gov (United States)

    Carthey, Alexandra J R; Banks, Peter B

    2015-07-01

    The giving-up density framework is an elegant and widely adopted mathematical approach to measuring animals' foraging decisions at non-replenishing artificial resource patches. Under this framework, an animal should "give up" when the benefits of foraging are outweighed by the costs (e.g., predation risk, energetic, and/or missed opportunity costs). However, animals of many species may forage in groups, and group size is expected to alter perceived predation risk and hence influence quitting decisions. Yet, most giving-up density studies assume either that individuals forage alone or that giving-up densities are not affected by group foraging. For animals that forage both alone and in groups, differences in giving-up densities due to group foraging rather than experimental variables may substantially alter interpretation. However, no research to date has directly investigated how group foraging affects the giving-up density. We used remote-sensing cameras to identify instances of group foraging in two species of Rattus across three giving-up density experiments to determine whether group foraging influences giving-up densities. Both Rattus species have been observed to vary between foraging alone and in groups. In all three experiments, solo foragers left higher giving-up densities on average than did group foragers. This result has important implications for studies using giving-up densities to investigate perceived risk, the energetic costs of searching, handling time, digestion, and missed opportunity costs, particularly if groups of animals are more likely to experience certain experimental treatments. It is critically important that future giving-up density studies consider the effects of group foraging.

  4. Factores de no adherencia al tratamiento en personas con Diabetes Mellitus tipo 2 en el domicilio. La visión del cuidador familiar Fatores de não aderência ao tratamento em pessoas com diabetes mellitus tipo 2 no domicílio. A visão do cuidador familiar Non adherence factors to treatment of people with type 2 Diabetes Mellitus at home. Family caregiver’s view

    Directory of Open Access Journals (Sweden)

    Teresa Nury Hoyos Duque

    2011-07-01

    ça a longo prazo. Conclusão. Desde a visão dos cuidadores familiares, a aderência ao tratamento das pessoas com DM2 é escassa, sendo múltiplas os fatores que influem nelaObjective. To understand the non adherence factors to treatment of people with type 2 Diabetes Mellitus (DM2 from the family caregiver’s view. Methodology. Ethnographic study performed in 2008. 18 interviews to type 2 DM patient’s caregivers who belonged to diabetes control programs from healthcare institutions of the city of Medellin (Colombia were conducted. Six observations of significant moments of care were also made. Results. Treatment adherence in people with type 2 DM is mediated by multiple factors that difficult it, as: Cultural beliefs of the disease, disagreement between healthcare professionals and popular knowledge, tiredness of taking that many medicines, fear of multiple punctures for insulin application, dissatisfaction with healthcare services and the long term cost of the disease. Conclusion. From the family caregiver’s view, treatment adherence of people with type 2 DM is low as a consequence of multiple factors which influence it.

  5. Giving and Receiving Social Support at Work: The Roles of Personality and Reciprocity

    Science.gov (United States)

    Bowling, Nathan A.; Beehr, Terry A.; Swader, William M.

    2005-01-01

    Social support is an important variable in occupational stress research and theory, yet little is know about the factors that influence the amount of social support one gives, and receives at work. We examined personality (extraversion, neuroticism, and agreeableness) and reciprocity as potential antecedents to giving and receiving support from…

  6. 33 CFR 83.16 - Action by give-way vessel (Rule 16).

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Action by give-way vessel (Rule....16 Action by give-way vessel (Rule 16). Every vessel which is directed to keep out of the way of another vessel shall, so far as possible, take early and substantial action to keep well clear....

  7. 20 CFR 416.1321 - Suspension for not giving us permission to contact financial institutions.

    Science.gov (United States)

    2010-04-01

    ... contact financial institutions. 416.1321 Section 416.1321 Employees' Benefits SOCIAL SECURITY....1321 Suspension for not giving us permission to contact financial institutions. (a) If you don't give us permission to contact any financial institution and request any financial records about you...

  8. 20 CFR 416.207 - You do not give us permission to contact financial institutions.

    Science.gov (United States)

    2010-04-01

    ... financial institutions. 416.207 Section 416.207 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... institutions. (a) To be eligible for SSI payments you must give us permission to contact any financial institution and request any financial records that financial institution may have about you. You must give...

  9. Grids for Kids gives next-generation IT an early start

    CERN Multimedia

    2008-01-01

    "Grids for Kids gives children a crash course in grid computing," explains co-organiser Anna Cook of the Enabling Grids for E-sciencE project. "We introduce them to concepts such as middleware, parallel processing and supercomputing, and give them opportunities for hands-on learning.

  10. Charity begins at home : How socialization experiences influence giving and volunteering

    NARCIS (Netherlands)

    Bekkers, René

    2005-01-01

    This paper shows that charity begins at home. Using retrospective reports on youth experiences from the Giving in the Netherlands Panel Survey (n=1,964, 2001) I find that (1) parents who volunteer when their children are young promote giving and volunteering of their children once they have become a

  11. The meaning of "not giving in". Lived experiences among women with breast cancer

    DEFF Research Database (Denmark)

    Jensen, Kirsten Pryds; Bäck-Pettersson, Siv; Segesten, K

    2000-01-01

    This article explores the meaning to women with breast cancer of "not giving in". Giorgi's phenomenological method was applied, and data were collected through open interviews.......This article explores the meaning to women with breast cancer of "not giving in". Giorgi's phenomenological method was applied, and data were collected through open interviews....

  12. Students Can Give Psychology Away: Oral Presentations on YouTube

    Science.gov (United States)

    Malouff, John M.; Emmerton, Ashley J.

    2014-01-01

    This article describes a novel assignment involving students giving a presentation on YouTube about how to apply behavior-modification principles to change a specific type of behavior, chosen by each student. The presentations covered topics such as how to end nail biting and how to reduce anxiety about public speaking. Giving an oral presentation…

  13. The Straightforwardness of Advice: Advice-Giving in Interactions Between Swedish District Nurses and Patients.

    Science.gov (United States)

    Leppanen, Vesa

    1998-01-01

    A study examined advice-giving interactions between Swedish district nurses and patients, comparing these sequences with parallel interactions between British health visitors and first-time mothers in previous research. Analysis focused on how advice-giving is organized in the settings, including how advice is initiated and designed, its…

  14. Giving support to others reduces sympathetic nervous system-related responses to stress.

    Science.gov (United States)

    Inagaki, Tristen K; Eisenberger, Naomi I

    2016-04-01

    Social support is a major contributor to the link between social ties and beneficial health outcomes. Research to date has focused on how receiving support from others might be good for us; however, we know less about the health effects of giving support to others. Based on prior work in animals showing that stimulating neural circuitry important for caregiving behavior can reduce sympathetic-related responses to stressors, it is possible that, in humans, giving to others can reduce stressor-evoked sympathetic nervous system responding, which has implications for health outcomes. To test the effect of giving support on the physiological stress response, participants either wrote a supportive note to a friend (support-giving condition) or wrote about their route to school/work (control condition) before undergoing a standard laboratory-based stress task. Physiological responses (heart rate, blood pressure, salivary alpha-amylase, salivary cortisol), and self-reported stress were collected throughout the protocol. In line with hypotheses, support giving (vs. control) reduced sympathetic-related responses (systolic blood pressure and alpha-amylase) to the stressor. No effects of support giving were found on self-reported psychological stress or cortisol levels. Results add to existing knowledge of the pathways by which support giving may lead to health benefits and highlight the contribution of giving to others in the broader social support-health link.

  15. The Sources and Uses of Annual Giving at Selective Private Research Universities and Liberal Arts Colleges.

    Science.gov (United States)

    Ehrenberg. R. G.; Smith, C. L.

    2003-01-01

    Econometric analysis uses data from a panel of selected private research universities and liberal-arts colleges that span a 31-year period to provide explanations for differences across institutions in the sources and uses of giving. Finds, for example, that richer institutions devote a larger share of their annual giving to further building their…

  16. Giving form to computational things: developing a practice of interaction design

    DEFF Research Database (Denmark)

    Vallgårda, Anna K. A.

    2014-01-01

    between states. Thus, an interaction design practice needs to encompass this temporal form giving in combination with physical form giving and performances of the interaction gestalt. In this paper, I propose this trinity of forms as a framework to unfold the practice of interaction design. I further...

  17. Promoting Population

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    THE world's population reached 5 billion in 1987,then 6 billion in 1999;now,in 2011,it is 7 billion.For a country with a set birth control policy,the way in which Chinese people and the media view this number has greatly changed.People are increasingly reflecting on the concept of population from a more scientific and rational perspective.This shift is a change from how people perceived population in the past.

  18. Reciprocity is not give and take: asymmetric reciprocity to positive and negative acts.

    Science.gov (United States)

    Keysar, Boaz; Converse, Benjamin A; Wang, Jiunwen; Epley, Nicholas

    2008-12-01

    Unlike economic exchange, social exchange has no well-defined "value." It is based on the norm of reciprocity, in which giving and taking are to be repaid in equivalent measure. Although giving and taking are colloquially assumed to be equivalent actions, we demonstrate that they produce different patterns of reciprocity. In five experiments utilizing a dictator game, people reciprocated in like measure to apparently prosocial acts of giving, but reciprocated more selfishly to apparently antisocial acts of taking, even when the objective outcomes of the acts of giving and taking were identical. Additional results demonstrate that acts of giving in social exchanges are perceived as more generous than objectively identical acts of taking, that taking tends to escalate, and that the asymmetry in reciprocity is not due to gaining versus losing resources. Reciprocity appears to operate on an exchange rate that assigns value to the meaning of events, in a fashion that encourages prosocial exchanges.

  19. Why Feminism? How Feminist Methodologies Can Aid Our Efforts to ‘Give Back’ Through Research

    Directory of Open Access Journals (Sweden)

    Hekia Ellen Golden Bodwitch

    2014-07-01

    Full Text Available In this thematic section, the authors take a critical stance to the notion of giving back. They emphasize that giving back should be a model of solidarity and movement building, not charity. They push us to consider the ways in which the framework of giving back may actually reinforce hierarchical relationships between the researcher and the researched. In doing so, they offer new ways of thinking about the relationship between researchers and their communities of subjects. The strategies employed by these authors resonate with work from feminist activists and scholars whose approaches bring us alternative theories and methods through which to address the potentially dangerous effects of speaking for others through research. Examined alongside the giving back pieces in this section, these feminist contributions illuminate ways that we can give back by advancing the anti-oppression agendas of marginalized subjects through our research.

  20. The population threat.

    Science.gov (United States)

    Teitelbaum, M S

    1992-01-01

    Commentary is provided on the challenges faced by the new Clinton administration in formulating US key foreign policy initiatives. There is an urgent need to provide balanced and effective foreign aid for reducing high fertility rates in the developing world. There is also a need to effectively monitor the large migrations of populations. Over the past 10 years, the US has not been actively practicing world leadership on population issues. 3 changes in 1993 give impetus to redirect foreign policy: 1) the waning influence of fringe groups who controlled population issues; 2) the campaign promises to restore UN population stabilization programs; and 3) the evidence from the Persian Gulf and Yugoslavia that demographic issues require planning and assessment. Global population growth has been concentrated in the past 40 years, in part due to mortality declines and sustained high fertility. Of significance is the rapidness and momentum of growth. A high percentage are and will be children. Urban population is also growing rapidly in high fertility countries. Countries with high fertility and significant rural-to-urban migration also have large international migrations. The evolution of policy since the 1950s, which for the most part ignored population issues, is discussed. The American debates have been charged with emotionalism: about human sexuality, legitimacy of voluntary fertility control, the role and status of women and men, abortion, intergenerational transfer of obligations, ethnic solidarity and the sovereignty of national borders, and the proper roles of the state versus the marketplace. There have been over 200 years of ideological argument over population issues. The Malthusian argument was that large population size did not increase prosperity, and growth should be limited. The Marxist-Leninist position was that contraception was Malthusian, abortion was a woman's right, and population growth was neutral. By late 1970 the Chinese Maoists adopted the moral

  1. Population Blocks.

    Science.gov (United States)

    Smith, Martin H.

    1992-01-01

    Describes an educational game called "Population Blocks" that is designed to illustrate the concept of exponential growth of the human population and some potential effects of overpopulation. The game material consists of wooden blocks; 18 blocks are painted green (representing land), 7 are painted blue (representing water); and the remaining…

  2. Population Blocks.

    Science.gov (United States)

    Smith, Martin H.

    1992-01-01

    Describes an educational game called "Population Blocks" that is designed to illustrate the concept of exponential growth of the human population and some potential effects of overpopulation. The game material consists of wooden blocks; 18 blocks are painted green (representing land), 7 are painted blue (representing water); and the remaining…

  3. Social support and ambulatory blood pressure: an examination of both receiving and giving.

    Science.gov (United States)

    Piferi, Rachel L; Lawler, Kathleen A

    2006-11-01

    The relationship between the social network and physical health has been studied extensively and it has consistently been shown that individuals live longer, have fewer physical symptoms of illness, and have lower blood pressure when they are a member of a social network than when they are isolated. Much of the research has focused on the benefits of receiving social support from the network and the effects of giving to others within the network have been neglected. The goal of the present research was to systematically investigate the relationship between giving and ambulatory blood pressure. Systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate were recorded every 30 min during the day and every 60 min at night during a 24-h period. Linear mixed models analyses revealed that lower systolic and diastolic blood pressure and mean arterial pressure were related to giving social support. Furthermore, correlational analyses revealed that participants with a higher tendency to give social support reported greater received social support, greater self-efficacy, greater self-esteem, less depression, and less stress than participants with a lower tendency to give social support to others. Structural equation modeling was also used to test a proposed model that giving and receiving social support represent separate pathways predicting blood pressure and health. From this study, it appears that giving social support may represent a unique construct from receiving social support and may exert a unique effect on health.

  4. Imaginary populations

    Directory of Open Access Journals (Sweden)

    A. Martínez–Abraín

    2010-01-01

    Full Text Available A few years ago, Camus & Lima (2002 wrote an essay to stimulate ecologists to think about how we define and use a fundamental concept in ecology: the population. They concluded, concurring with Berryman (2002, that a population is "a group of individuals of the same species that live together in an area of sufficient size to permit normal dispersal and/or migration behaviour and in which population changes are largely the results of birth and death processes". They pointed out that ecologists often forget "to acknowledge that many study units are neither natural nor even units in terms of constituting a population system", and hence claimed that we "require much more accuracy than in past decades in order to be more effective to characterize populations and predict their behaviour". They stated that this is especially necessary "in disciplines such as conservation biology or resource pest management, to avoid reaching wrong conclusions or making inappropriate decisions". As a population ecologist and conservation biologist I totally agree with these authors and, like them, I be¬lieve that greater precision and care is needed in the use and definition of ecological terms. The point I wish to stress here is that we ecologists tend to forget that when we use statistical tools to infer results from our sample to a population we work with what statisticians term "imaginary", "hypothetical" or "potential" popula¬tions. As Zar (1999 states, if our sample data consist of 40 measurements of growth rate in guinea pigs "the population about which conclusions might be drawn is the growth rates of all the guinea pigs that conceivably might have been administered the same food supplement under identical conditions". Such a population does not really exist, and hence it is considered a hypothetical or imaginary population. Compare that definition with the population concept that would be in our minds when performing such measurements. We would probably

  5. Population policy.

    Science.gov (United States)

    1987-03-01

    Participants in the Seminar on Population Policies for Top-level Policy Makers and Program Managers, meeting in Thailand during January 1987, examined the challenges now facing them regarding the implementation of fertility regulation programs in their respective countries -- Bangladesh, China, India, Indonesia, Malaysia, Nepal, Pakistan, the Philippines, the Republic of Korea, and Thailand. This Seminar was organized to coincide with the completion of an Economic and Social Commission for Asia and the Pacific (ESCAP) study investigating the impact and efficiency of family planning programs in the region. Country studies were reviewed at the Seminar along with policy issues about the status of women, incentive and disincentive programs, and socioeconomic factors affecting fertility. In Bangladesh the government recognizes population growth as its top priority problem related to the socioeconomic development of the country and is working to promote a reorientation strategy from the previous clinic-oriented to a multidimensional family welfare program. China's family planning program seeks to postpone marraige, space the births of children between 3-5 years, and promote the 1-child family. Its goal is to reduce the rate of natural increase from 12/1000 in 1978 to 5/1000 by 1985 and 0 by 2000. India's 7th Five-Year-Plan (1986-90) calls for establishing a 2-child family norm by 2000. In Indonesia the government's population policy includes reducing the rate of population growth, achieving a redistribution of the population, adjusting economic factors, and creating prosperous families. The government of Indonesia reversed its policy to reduce the population growth rate in 1984 and announced its goal of achieving a population of 70 million by 2100 in order to support mass consumption industries. It has created an income tax deduction system favoring large families and maternity benefits for women who have up to 5 children as incentives. Nepal's official policy is to

  6. Occupational care giving conditions and human rights: A study of elderly caregivers in Botswana

    Directory of Open Access Journals (Sweden)

    Simon Kangethe

    2010-01-01

    Full Text Available The article aims to explore and discuss the occupational care giving conditions pitting them against human rights. The article′s objective is to initiate discussions and generate literature pertaining to occupational care giving load and assessing the human rights challenge it poses. The article uses analysis of the literature review from an array of eclectic data sources. The following factors were found besetting the caregivers′ human rights: (1 Aging; (2 Cultural and community attitudes towards care giving; (3 Risk of contagion; (4 Health hazards and lack of compensation. Recommendations: (1 Adoption of grandparents/grandchildren care symbiosis system; (2 Government remuneration policy for caregivers; (3 Mainstreaming of gender education to encourage men and youth develop an interest in care giving; (4 Institution of laws and policies by countries to provide for the compensation of caregivers′ occupational hazards and risks.

  7. An Excel sheet for inferring children's number-knower levels from give-N data.

    Science.gov (United States)

    Negen, James; Sarnecka, Barbara W; Lee, Michael D

    2012-03-01

    Number-knower levels are a series of stages of number concept development in early childhood. A child's number-knower level is typically assessed using the give-N task. Although the task procedure has been highly refined, the standard ways of analyzing give-N data remain somewhat crude. Lee and Sarnecka (Cogn Sci 34:51-67, 2010, in press) have developed a Bayesian model of children's performance on the give-N task that allows knower level to be inferred in a more principled way. However, this model requires considerable expertise and computational effort to implement and apply to data. Here, we present an approximation to the model's inference that can be computed with Microsoft Excel. We demonstrate the accuracy of the approximation and provide instructions for its use. This makes the powerful inferential capabilities of the Bayesian model accessible to developmental researchers interested in estimating knower levels from give-N data.

  8. Factors influencing trainers' feedback-giving behavior: a cross-sectional survey

    NARCIS (Netherlands)

    Pelgrim, E.A.M.; Kramer, A.W.M.; Mokkink, H.G.A.; Vleuten, C.P.M. van der

    2014-01-01

    BACKGROUND: The literature provides some insight into the role of feedback givers, but little information about within-trainer factors influencing 'feedback-giving behaviours'. We looked for relationships between characteristics of feedback givers (self-efficacy, task perception, neuroticism,

  9. Do Not Give Infants Cough and Cold Products Designed for Older Children

    Science.gov (United States)

    ... for You Special Features Use Caution When Giving Cough and Cold Products to Kids Share Tweet Linkedin ... age should not be given any kind of cough and cold product that contains a decongestant or ...

  10. Patterns of Giving to One's Alma Mater among Young Graduates from Selective Institutions.

    Science.gov (United States)

    Monks, James

    2003-01-01

    Examines individual characteristics correlated with alumni giving by graduates from 28 highly selective institutions of higher education. Finds satisfaction with undergraduate experience the single biggest determinant of the generosity of alumni donations. (Contains 11 references.) (PKP)

  11. When breastfeeding is unsuccessful--mothers' experiences after giving up breastfeeding

    DEFF Research Database (Denmark)

    Larsen, Jette Schilling; Kronborg, Hanne

    2013-01-01

    Some mothers have to give up breastfeeding even though they want to breastfeed. To give up breastfeeding can be a sensitive issue in a time when breastfeeding is promoted as the healthiest for mother and child. The aim of this study was to describe mothers’ experiences after they gave up...... breastfeeding even though they intended to breastfeed. A qualitative social constructive approach was used to describe mothers’ experiences after giving up breastfeeding. Danish first-time mothers who had expected and wanted to breastfeed were interviewed four months after birth. The interviews were analysed...... by meaning condensation. The mothers experienced that giving up breastfeeding was a crucial but necessary decision for the child’s health and well-being. They tried to “be on the side of the angels” by caring for and bonding with the child. The mothers were divided between expressing milk or formula feeding...

  12. Relics: penguin population programs.

    Science.gov (United States)

    Sun, L; Xie, Z

    2001-01-01

    What has been responsible for the increase in Chinstrap penguin populations during the past 40 years in maritime Antarctica? One view ascribes it to an increase in availability of their prey brought on by the decrease in baleen whale stocks. The contrary opinion, attributes it to environmental warming. This causes a gradual decrease in the frequency of cold years with extensive winter sea ice cover. A number of penguin monitoring programs are in progress and are expected to provide some answers to these questions. Unfortunately, it is not easy to distinguish natural variability from anthropogenic change since penguins are easily accessible predators of krill and the feeding range of the penguins has almost overlapped with the krill fishery in time and space in the last four decades. Therefore it is important to reconstruct the change of ancient penguin abundance and distribution in the absence of human activity. Many efforts have focused on surveying the abandoned penguin rookeries, but this method has not been able to give a continuous historical record of penguin populations. In several recent studies, ancient penguin excreta was scooped from the penguin relics in the sediments of the lake on penguin rookery, Ardley Island, maritime Antarctica. In these studies, penguin droppings or guano soil deposited in the lake and changes in sediment geochemistry have been used to calculate penguin population changes based upon the geochemical composition of the sediment core. The results suggest that climate change has a significant impact on penguin populations.

  13. Talking to Honourable Members: advice for academics on giving evidence to Parliamentary committees

    OpenAIRE

    McLean, Iain

    2011-01-01

    How do Parliamentary committees treat academics? What is like to feel ambushed when you hoped your opinion might make an impact in policy making? Iain McLean, Professor of Politics at Oxford University, offers some insight into the experience of giving evidence as an expert witness to Parliamentary committees, and gives some essential advice for academics who might consider offering their opinions in the future.

  14. A Conceptual Framework for Defense Acquisition Decision Makers: Giving the Schedule its Due

    Science.gov (United States)

    2014-01-01

    JAN 2014 2. REPORT TYPE 3. DATES COVERED 00-00-2014 to 00-00-2014 4. TITLE AND SUBTITLE A Conceptual Framework for Defense Acquisition Decision...by ANSI Std Z39-18 A Conceptual Framework for Defense Acquisition Decision Makers: Giving the Schedule its Due « Image designed by Diane Fleischer... Conceptual Framework for Defense Acquisition Decision Makers: Giving the Schedule Its Due Chad Dacus and Col Stephen Hagel, USAF (Ret.) Conceptual

  15. Giving information to family members of patients in the intensive care unit: Iranian nurses' ethical approaches.

    Science.gov (United States)

    Farahani, Mansoureh A; Gaeeni, Mina; Mohammadi, Nooreddin; Seyedfatemi, Naima

    2014-01-01

    Receiving information related to patients hospitalized in the intensive care unit is among the most important needs of the family members of such patients. When health care professionals should decide whether to be honest or to give hope, giving information becomes an ethical challenge We conducted a research to study the ethical approaches of Iranian nurses to giving information to the family members of patients in the intensive care units. This research was conducted in the intensive care units of three teaching hospitals in Iran. It employed a qualitative approach involving semi-structured and in-depth interviews with a purposive sample of 12 nurses to identify the ethical approaches to giving information to family members of the intensive care unit patients. A conventional content analysis of the data produced two categories and five subcategories. The two categories were as follows: a) informational support, and b) emotional support. Informational support had 2 subcategories consisting of being honest in giving information, and providing complete and understandable information. Emotional support in giving information had 3 sub-categories consisting of gradual revelation, empathy and assurance. Findings of the study indicated that ethical approaches to giving information can be in the form of either informational support or emotional support, based on patients' conditions and prognoses, their families' emotional state, the necessity of providing a calm atmosphere in the ICU and the hospital, and other patients and their families' peace. Findings of the present study can be used as a basis for further studies and for offering ethical guidelines in giving information to the families of patients hospitalized in the ICU.

  16. Våde enge kan give iltmangel i vandløb

    DEFF Research Database (Denmark)

    Frier, Jens-Ole; Iversen, Niels; Rasmussen, Michael R.

    2008-01-01

    Våde enge oprettes i disse år mange steder i det danske landskab. I nogle tilfælde vil områderne give den positive tiltænkte ændring til glæde for naturen, andre steder kan det give problemer og føre til betydelig iltmangel i vandløbene. denne artikel beskriver et sådant tilfælde, og vi forsøger...

  17. REASON-GIVING IN COURT PRACTICE: THE EXAMPLE OF FRENCH IMMIGRATION LITIGATION

    Directory of Open Access Journals (Sweden)

    Mathilde Cohen, Columbia Law School-School of Law, Estados Unidos

    2012-10-01

    Full Text Available Abstract: This Article examines the thesis according to which the practice of giving reasons for decisions is a central element of liberal democracies. In this view, public institutions’ practice—and sometimes duty—to give reasons is required so that each individual may view the state as reasonable and therefore, according to deliberative democratic theory, legitimate. Does the giving of reasons in actual court practice achieve these goals?  Drawing on empirical research carried out in a French administrative court, this Article argues that, in practice, reason-giving often falls either short of democracy or beyond democracy. Reasons fall short of democracy in the first case because they are transformed from a device designed to “protect” citizens from arbitrariness into a professional norm intended to “protect” the judges themselves and perhaps further their career goals. In the second case, reasons go beyond democracy because judges’ ambitions are much greater than to merely provide petitioners with a ground for understanding and criticizing the decision: they aim at positively—and paternalistically in some instances—guiding people’s conduct.  The discussion proceeds by drawing attention to social aspects that are often neglected in theoretical discussions on reason-giving. A skeptical conclusion is suggested: one can rarely guarantee that any predetermined value will be achieved by the giving of reasons. The degree to which individuals are empowered by the reasons given to them is dependent on the way in which decision-givers envision their reason-giving activity, and this representation is itself conditioned by the social setting of the court. Keywords: Arbitrariness. Reason-giving. Judges.

  18. Strategies parents use to give children oral medicine: a qualitative study of online discussion forums

    Science.gov (United States)

    2017-01-01

    Aim The aim of this study was to describe strategies parents use to give oral medicine to children. Methods We conducted an Internet-based qualitative study of posts from online forums where parents discussed how to give children oral medicine. The posts were analyzed using systematic text condensation. The investigators coded and developed groups iteratively, ending up with a consensus on final themes. Results We included 4581 posts. Parents utilized three main strategies to give oral medicine to children: (1) Open administration give medicine to the child knowingly by changing the palatability, actively involve the child in play or use persuasion; (2) Hidden administration give medicine to the child unknowingly by camouflaging it in food, while sleeping or distracted by another activity; (3) Forced administration force children to take medicine with the use of restraint. Parents expressed three perspectives towards using force: Finding it unproblematic, using force despite not liking it or refusing to use force. No single strategy was described as the obvious first choice, and the strategies were not used in any particular order. Parents who gave up getting their child to ingest the medicine reported to contact the prescriber for a different medication, or stopped the treatment completely. Conclusions The three strategies are a robust and precise way to categorize techniques used by parents to give children oral medicine. We suggest that health professionals use the strategies to talk to parents and children about administration of oral medicines. PMID:28581890

  19. A comparison between willingness to pay and willingness to give up time.

    Science.gov (United States)

    van Helvoort-Postulart, Debby; Dirksen, Carmen D; Kessels, Alfons G H; van Engelshoven, Jos M A; Myriam Hunink, M G

    2009-02-01

    We compared the willingness-to-pay and willingness to give up time methods to assess preferences for digital subtraction angiography (DSA), computed tomography angiography (CTA) and magnetic resonance angiography (MRA). Respondents were hypertensive patients suspected of having renal artery stenosis. Data were gathered using telephone interviews. Both the willingness-to-pay and willingness to give up time methods revealed that patients preferred CTA to MRA in order to avoid DSA. The agreement between willingness-to-pay and willingness to give up time responses was high (kappa 0.65-0.85). The willingness-to-pay method yielded relatively more protest answers (12%) as compared to willingness to give up time (2%). So, our results provided evidence for the comparability of willingness to pay and willingness to give up time. The high percentage of protest answers on the willingness-to-pay questions raises questions with respect to the application of the willingness-to-pay method in a broad decision-making context. On the other hand, the strength of willingness-to-pay is that the method directly arrives at a monetary measure well founded in economic theory, whereas the willingness to give up time method requires conversion to monetary units.

  20. Strategies parents use to give children oral medicine: a qualitative study of online discussion forums.

    Science.gov (United States)

    Bergene, Elin Høien; Rø, Torstein Baade; Steinsbekk, Aslak

    2017-06-01

    The aim of this study was to describe strategies parents use to give oral medicine to children. We conducted an Internet-based qualitative study of posts from online forums where parents discussed how to give children oral medicine. The posts were analyzed using systematic text condensation. The investigators coded and developed groups iteratively, ending up with a consensus on final themes. We included 4581 posts. Parents utilized three main strategies to give oral medicine to children: (1) Open administration give medicine to the child knowingly by changing the palatability, actively involve the child in play or use persuasion; (2) Hidden administration give medicine to the child unknowingly by camouflaging it in food, while sleeping or distracted by another activity; (3) Forced administration force children to take medicine with the use of restraint. Parents expressed three perspectives towards using force: Finding it unproblematic, using force despite not liking it or refusing to use force. No single strategy was described as the obvious first choice, and the strategies were not used in any particular order. Parents who gave up getting their child to ingest the medicine reported to contact the prescriber for a different medication, or stopped the treatment completely. The three strategies are a robust and precise way to categorize techniques used by parents to give children oral medicine. We suggest that health professionals use the strategies to talk to parents and children about administration of oral medicines.

  1. [Population education].

    Science.gov (United States)

    Niang, M

    1992-12-01

    Africa has the highest population growth rate in the world (3%). It has 650 million people (about 900 million in 2000). Rapid population growth has serious consequences which, if not addressed, will be disastrous. This worrisome situation has led some governments to adopt demographic policies to slow down population growth. The UN Economic, Scientific and Cultural Organization (UNESCO) recommends that schools provide population education. Various population conferences have popularized population education in schools among African countries. UNESCO began its regional program on population education in Africa in 1969. National family life and population education (FL/PE) projects have increased from 4 in 1970 to 32 in 1990 (17 in French- and Portuguese-speaking Africa and 5 in English-speaking Africa). These projects teach students about the links between demographic problems and socioeconomic factors and contemporary culture. They aim for total development of the individual and improvement of the quality of life for the individual, family, and community. Topics covered in FL/PE are birth rate; fertility; health; and maternal, infant, and child mortality; unwanted pregnancy; illegal abortion; sexually transmitted diseases; rural-urban migration; and urbanization. Benin introduced FL/PE at all levels of its education system while Senegal, Guinea, Mauritania, and Zaire introduced it to only the primary and secondary school levels. Some countries teach FL/PE as one discipline while most countries (e.g., Senegal) have integrated it into other disciplines (e.g., geography). FL/PE should begin in primary schools because they have the most students and prepare students for middle schools, which provide FL/PE. Elementary education in Senegal is being overhauled to introduce current major problems bit by bit. Senegal also wants to incorporate FL/PE into literacy and adult education programs. Integration of FL/PE into other disciplines should be encouraged.

  2. Population and development.

    Science.gov (United States)

    Pavlik, Z

    1995-01-01

    During the Paleolithic period, 10,000-100,000 people lived on the earth; their number exceeded 1 million at the beginning of the Neolithic period, reached 10 million during the Bronze Age, 100 million at the beginning of the Iron Age, 1 billion at the beginning of the 19th century, and 5.7 billion in 1995. The estimated global population will be 10 billion by the middle of the 21st century and is expected to stabilize at around 10-12 billion subsequently. Increased agricultural production helped bring about greater numbers of humanity and the advancement of society with a developing social hierarchy, although life expectancy was low at 22-28 years. In Europe, the Renaissance gradually evolved into the Industrial Revolution, and a demographic revolution accompanied this process. In some countries, population size increased more than five times. Eventually, mortality and fertility levels decreased and life expectancy increased. In Western civilization, increased individualism, secularization, compulsory school attendance, decreased agricultural population, emancipation of women, increased costs of raising children, and social and economic progress ensued. All this was preceded by 18th century conditions, when, in England, capital accumulation led to wealth on the one side and destitution on the other, giving rise to Malthus's famous theory. However, during the 19th century these social inequalities gradually evened out. After World War II, the question arose of whether the populations of other civilizations (Confucian, Japanese, Islamic, Hindu, Slavic-Orthodox, Latin American, and African) would also undergo a demographic transition and how soon. At any rate, developed country population size, as a percentage of global population, will drop from 22% to 13%, and that of Africa will increase from 12% to 26%, during the 21st century.

  3. The term nevestnina – A contribution to the terminology of matrimonial gift giving

    Directory of Open Access Journals (Sweden)

    Vojislav Stanimirović

    2016-03-01

    Full Text Available This essay attempts to bring more order to terminology of matrimonial gift giving – the ever more complicated area in the past couple of decades. Furthermore, it reaffirms the idea of the evolution of matrimonial gift giving, and after many decades in which historians of law and ethnologists focused their research on particularities of matrimonial gift giving in certain cultures and epochs, points out the need of their systematization. Connecting history of law with ethnology, the author offers more precise references of the term brideprice, giving it back its usability, linking it with all the matrimonial gift givings the groom’s side presents to the bride’s father who possesses the exclusive authority to handle it as he pleases. On the other hand, the paper emphasizes the unjust disregard and neglect of another type of matrimonial gift giving in science, or perhaps its erroneous definitions by some authors. Namely, all those matrimonial gift giving from the groom’s side directly or indirectly intended for the girl herself. Girl’s father no longer controls the matrimonial gift giving and he bestows most or all of it to the girl on the wedding. It is what girl brings into marriage under the veil of trousseau, and later partially of dowry. Later on, these symbolic matrimonial gift givings were no longer given to girl’s father not even symbolically, but rather went straight into her hands. These new matrimonial gift givings can no longer be assigned to a category of buying the bride, while the term indirect dowry proposed by Goody is inappropriate for it creates a false picture of these matrimonial gift givings. That is why, in the absence of an appropriate name, the author took the liberty of coining the term nevestnina to cover both aspects of these matrimonial gift-giving. The term bridewealth used in the English speaking areas to replace the politically incorrect term brideprice is proper for the term nevestnina. For the later

  4. Negotiators who give too much: unmitigated communion, relational anxieties, and economic costs in distributive and integrative bargaining.

    Science.gov (United States)

    Amanatullah, Emily T; Morris, Michael W; Curhan, Jared R

    2008-09-01

    A series of studies found that the personality dimension of unmitigated communion (H. L. Fritz & V. S. Helgeson, 1998) leads negotiators to make concessions to avoid straining relationships. Results indicate that even within the population of successful business executives, this dimension of relational anxiety can be identified distinctly from more general relational orientations, such as agreeableness, and that it distinctly predicts accommodating tendencies in everyday conflicts. In economic games, unmitigated communion predicts giving in contexts in which the relational norm of reciprocity applies, but not in contexts tapping instrumental or altruistic motives for cooperation. In distributive negotiations, the effect of unmitigated communion in lowering a negotiator's outcome is mediated by prenegotiation anxieties about relational strain and plans to make large concessions if needed to avoid impasse (lower reservation points). In integrative negotiations, high unmitigated communion on both sides of the negotiation dyad results in relational accommodation, evidenced by decreased success in maximizing economic joint gain but increased subjective satisfaction with the relationship.

  5. The Optimum Growth Rate for Population Reconsidered

    OpenAIRE

    Jaeger, Klaus; Kuhle, Wolfgang

    2007-01-01

    This article gives exact general conditions for the existence of an interior optimum growth rate for population in the neoclassical two-generations-overlapping model. In an economy where high (low) growth rates of population lead to a growth path which is efficient (inefficient) there always exists an interior optimum growth rate for population. In all other cases there exists no interior optimum. The Serendipity Theorem, however, does in general not hold in an economy with government debt. M...

  6. A phenomenologic investigation of pediatric residents' experiences being parented and giving parenting advice.

    Science.gov (United States)

    Bax, A C; Shawler, P M; Blackmon, D L; DeGrace, E W; Wolraich, M L

    2016-09-01

    Factors surrounding pediatricians' parenting advice and training on parenting during residency have not been well studied. The primary purpose of this study was to examine pediatric residents' self-reported experiences giving parenting advice and explore the relationship between parenting advice given and types of parenting residents received as children. Thirteen OUHSC pediatric residents were individually interviewed to examine experiences being parented and giving parenting advice. Phenomenological methods were used to explicate themes and secondary analyses explored relationships of findings based upon Baumrind's parenting styles (authoritative, authoritarian, permissive). While childhood experiences were not specifically correlated to the parenting advice style of pediatric residents interviewed, virtually all reported relying upon childhood experiences to generate their advice. Those describing authoritative parents reported giving more authoritative advice while others reported more variable advice. Core interview themes related to residents' parenting advice included anxiety about not being a parent, varying advice based on families' needs, and emphasis of positive interactions and consistency. Themes related to how residents were parented included discipline being a learning process for their parents and recalling that their parents always had expectations, yet always loved them. Pediatric residents interviewed reported giving family centered parenting advice with elements of positive interactions and consistency, but interviews highlighted many areas of apprehension residents have around giving parenting advice. Our study suggests that pediatric residents may benefit from more general educational opportunities to develop the content of their parenting advice, including reflecting on any impact from their own upbringing.

  7. Care-giving as a Canadian-Vietnamese tradition: 'it's like eating, you just do it'.

    Science.gov (United States)

    Donovan, Rhonda; Williams, Allison M

    2015-01-01

    The objective of this study was to examine how Vietnamese family caregivers (FCGs) perceive, manage and experience end-of-life care-giving for seriously ill family members. Using an instrumental case study design, this longitudinal qualitative research employed the use of cultural brokers/language interpreters to help ensure that the research was conducted in a culturally-appropriate manner. Participants (n = 18) discussed their experiences of care-giving within the context of a traditional cultural framework, which was found to influence their motivations and approaches to care-giving, as well as their propensities towards the use of various supports and services. The study was carried out in southern Ontario, Canada, and participants were providing home-based care-giving in the community. Data were collected throughout 2010 and 2011. The ways in which care-giving was perceived and expressed are reflected in three themes: (i) Natural: identity and care work; (ii) Intentional: whole-person care; and (iii) Intensive: standards, struggle and the context of care. This research confirms the need for culturally-appropriate services and supports while illustrating that Vietnamese FCGs not only value, but are also likely to use healthcare and social services if they are language-accessible, built on trust and demonstrate respect for their values as individuals, regardless of culture.

  8. Causes of non-adherence to therapeutic guidelines in severe community-acquired pneumonia

    OpenAIRE

    Gattarello,Simone; Ramírez, Sergio; Almarales,José Rafael; Borgatta, Bárbara; Lagunes, Leonel; Encina, Belén; Rello, Jordi; ,

    2015-01-01

    Objective To assess the adherence to Infectious Disease Society of America/American Thoracic Society guidelines and the causes of lack of adherence during empirical antibiotic prescription in severe pneumonia in Latin America. Methods A clinical questionnaire was submitted to 36 physicians from Latin America; they were asked to indicate the empirical treatment in two fictitious cases of severe respiratory infection: community-acquired pneumonia and nosocomial pneumonia. Results In the case of...

  9. Interactive Effects of Neurocognitive Impairment and Substance Use on Antiretroviral Non-adherence in HIV Disease

    Science.gov (United States)

    Thaler, Nicholas S.; Sayegh, Philip; Kim, Michelle S.; Castellon, Steven A.; Hinkin, Charles H.

    2015-01-01

    While numerous studies have established the adverse independent effects of clinical conditions including neurocognitive dysfunction, psychiatric illness, and substance abuse/dependence on medication adherence among HIV-infected adults, fewer have studied their interactive effects. The current study examined this issue among 204 HIV-infected participants based upon current neurocognitive functioning and DSM-IV-diagnosed psychiatric illness and current substance abuse or dependence. Results confirmed that participants with any of these risk factors demonstrated poorer adherence than individuals with no risk factors. A neurocognitive status × substance abuse/dependence interaction was also identified such that participants with impaired neurocognition and a co-occurring substance abuse/dependence diagnosis demonstrated the poorest adherence. Results confirm the deleterious impact of these risk factors in isolation and also identify a specific interactive effect for individuals with comorbid neurocognitive impairment and a substance abuse/dependence disorder. Findings highlight the need for interventions that simultaneously address these problems. PMID:25589442

  10. Content validation of the dimensions constituting non-adherence to treatment of arterial hypertension

    Directory of Open Access Journals (Sweden)

    Jose Wicto Pereira Borges

    2013-10-01

    Full Text Available The objective of the study was to validate the content of the dimensions that constituted nonadherence to treatment of arterial systemic hypertension. It was a methodological study of content validation. Initially an integrative review was conducted that demonstrated four dimensions of nonadherence: person, disease/treatment, health service, and environment. Definitions of these dimensions were evaluated by 17 professionals, who were specialists in the area, including: nurses, pharmacists and physicians. The Content Validity Index was calculated for each dimension (IVCi and the set of the dimensions (IVCt, and the binomial test was conducted. The results permitted the validation of the dimensions with an IVCt of 0.88, demonstrating reasonable systematic comprehension of the phenomena of nonadherence.

  11. Exploring the Factors and Effects of Non-Adherence to Antiretroviral ...

    African Journals Online (AJOL)

    institutional and physical environments, the analysis of the data identified the following themes conducive to ... the risk of developing drug resistance (AIDSinfo, 2015), and that have ..... body, and diarrhea. ..... exercise empathy and treat their patients with dignity. .... Social Forces, 64(1), 151–167. doi: 10.1093/sf/64.1.151.

  12. Predictors of Non-Adherence to Breast Cancer Screening among Hospitalized Women: e0145492

    National Research Council Canada - National Science Library

    Waseem Khaliq; Ali Aamar; Scott M Wright

    2015-01-01

    .... Patients and Methods A cross sectional bedside survey was conducted to collect socio-demographic and clinical comorbidity data thought to effect breast cancer screening adherence of hospitalized women aged 50-75 years...

  13. Prevention is better than cure – the art of avoiding non-adherence to antiretroviral treatment

    Directory of Open Access Journals (Sweden)

    Leith Kwaan

    2010-11-01

    Full Text Available The much-used phrase ‘prevention is better than cure’ is applicable to many circumstances, including human immunodeficiency virus (HIV infection. In recent years suggestions have been made for a move towards treatment strategies that emphasise prevention of foreseeable adherence problems on a patient-by-patient basis, through focused patient preparation before commencing antiretroviral therapy (ART. This is well elucidated in a statement made in 2004 by Coetzee et al.:1 ‘As it is difficult to ascertain robust predictors of adherence, there has been a move to concentrate on patient preparation before the initiation of ART rather than the use of non-clinical predictors of adherence or selection criteria. A paradigm focused on preparation rather than selection is better suited to the aggressive targets for the scaling up of ART in countries with large epidemics (such as in South Africa, where the view of ART as a very expensive rationed intervention is rapidly changing.’

  14. Non-adherence in adolescent transplant recipients: the role of uncertainty in health care providers.

    Science.gov (United States)

    Aujoulat, Isabelle; Deccache, Alain; Charles, Anne-Sophie; Janssen, Magda; Struyf, Catherine; Pélicand, Julie; Ciccarelli, Olga; Dobbels, Fabienne; Reding, Raymond

    2011-03-01

    To optimize self-management and adherence in adolescent patients, HCPs need to discuss not only medical and treatment-related issues, but also general health and psychosocial concerns. Our study aimed to explore how the members of the paediatric team in our programme understand NA in adolescents, and how they define their own role regarding self-management education. We used a sequential mixed methods design and conducted a qualitative observational and in-depth interview study (n=22) and a quantitative descriptive study through self-administered questionnaires (n=31). Our results show a discrepancy between the HCPs' understanding of the complex psychosocial factors impacting on long-term adherence, and their current limited practice of patient education. A number of uncertainties were found to explain the HCPs' perceived difficulty to engage in comprehensive patient education activities: uncertainty regarding (i) the health status of transplant recipients; (ii) a shared operational definition of adherence and the cause of organ rejection in some cases; (iii) the extent to which adherence is a shared responsibility which involves the HCPs as patient educators; (iv) the long-term impact of a LRD. To avoid the risk of conveying incongruent messages, multidisciplinary health care teams need to explicitly acknowledge and discuss the various areas of uncertainty, some of which are inherent to transplantation.

  15. Challenging factors for enuresis treatment: Psychological problems and non-adherence.

    Science.gov (United States)

    Van Herzeele, Charlotte; De Bruyne, Pauline; De Bruyne, Elke; Walle, Johan Vande

    2015-12-01

    The evidence for organic pathogenetic factors in enuresis and the discovery of effective therapies targeting the bladder and/or nocturnal diuresis have overwhelmed every potential role of psychological factors in pathogenesis and treatment. However, psychopathology is still important in enuresis because according to the document of the International Children's Continence Society (ICCS) 20-30% of the children with enuresis have at least one psychological/psychiatric disorder at rates two times higher than non-wetting children. The most common comorbid disorder with enuresis is attention deficit hyperactivity disorder. The aim of this review is to translate the existing evidence on the importance of a psychological screening into daily clinical practice of the medical practitioner. The use of the minimal psychological screening tool should be considered mandatory in each primary setting. If psychological problems are indicated, referral of the patient to a multidisciplinary setting should be considered, not only to allow psychological assessment to screen for a possible psychopathology, but also since therapy resistance might be expected. This review concentrates on two items from psychopathology/psychotherapy that might predict insufficient treatment response: the psychological comorbidities as described according to the DSM-5 criteria and the underestimated importance of therapy adherence. Adherence is a cornerstone of effective therapy in enuresis. It is a problem involving the doctor, the patient, and the parents. Increasing adherence takes effort and is time-consuming. But it is worthwhile knowing that several studies have demonstrated that high adherence is associated with high therapy success of enuresis. Eventually, this is the ultimate goal of treatment.

  16. Population dynamics

    Directory of Open Access Journals (Sweden)

    Cooch, E. G.

    2004-06-01

    Full Text Available Increases or decreases in the size of populations over space and time are, arguably, the motivation for much of pure and applied ecological research. The fundamental model for the dynamics of any population is straightforward: the net change over time in the abundance of some population is the simple difference between the number of additions (individuals entering the population minus the number of subtractions (individuals leaving the population. Of course, the precise nature of the pattern and process of these additions and subtractions is often complex, and population biology is often replete with fairly dense mathematical representations of both processes. While there is no doubt that analysis of such abstract descriptions of populations has been of considerable value in advancing our, there has often existed a palpable discomfort when the ‘beautiful math’ is faced with the often ‘ugly realities’ of empirical data. In some cases, this attempted merger is abandoned altogether, because of the paucity of ‘good empirical data’ with which the theoretician can modify and evaluate more conceptually–based models. In some cases, the lack of ‘data’ is more accurately represented as a lack of robust estimates of one or more parameters. It is in this arena that methods developed to analyze multiple encounter data from individually marked organisms has seen perhaps the greatest advances. These methods have rapidly evolved to facilitate not only estimation of one or more vital rates, critical to population modeling and analysis, but also to allow for direct estimation of both the dynamics of populations (e.g., Pradel, 1996, and factors influencing those dynamics (e.g., Nichols et al., 2000. The interconnections between the various vital rates, their estimation, and incorporation into models, was the general subject of our plenary presentation by Hal Caswell (Caswell & Fujiwara, 2004. Caswell notes that although interest has traditionally

  17. Relationships between nurse care-giving behaviours and preterm infant responses during bathing: a preliminary study.

    Science.gov (United States)

    Liaw, Jen-Jiuan; Yang, Luke; Chou, Hsiu-Ling; Yang, Meei-Horng; Chao, Shih-Ching

    2010-01-01

    The purpose of this study was to explore the relationships between specific nurse care-giving behaviours and preterm infant behavioural responses during bathing and to identify nurse behaviours associated with infant 'stress'. Although recent advances in medical technology have improved neonatal intensive care, the high mortality and morbidity rates in preterm infants have not decreased proportionally. As caregivers strive to reduce infant mortality and morbidity, a factor for consideration is which caregiver behaviours are associated with preterm infant well-being. A descriptive correlational design. Convenience samples of 24 preterm infants and 12 nurses were recruited. A total of 120 baths were videotaped. Infant and nurse behaviours were measured using the coding schemes developed by the researchers. Pearson coefficient correlation, non-parametric Kruskal-Wallis test, t-test and generalised linear models were methods for data analysis. As nurses provided more support, stress was reduced in the infants, and their self-regulation during the bath was enhanced especially by the use of 'containment' and 'positional support'. Conversely, non-therapeutic caregiver behaviours including 'rapid and rough handling' of the baby, 'chatting with other people' and 'inappropriate handling' increased infant 'stress' during the bath. The findings provide new information about the link between care-giving and infant responses and how caregivers can better interact with preterm infants during a very sensitive period of brain development. How nurses take care of the preterm infants influences their responses to care-giving stimuli. To interact better with the infant during care-giving procedures, nurses need to provide more supportive care-giving behaviours especially 'position support' and 'containment' based on the infant's needs, and avoid care-giving that may be too rough and occur too quickly without attending the baby's stressful signals, positioning the baby in

  18. Gift-Giving in the Podiatric Medical Student-Patient Relationship.

    Science.gov (United States)

    López, Daniel López; Pazo, Paula Torreiro; Iglesias, Marta E Losa; de Bengoa Vallejo, Ricardo Becerro

    2016-09-02

    We sought to explore the relationship between the podiatric medical student and the patient as it relates to the act of gift-giving as a sign of gratefulness for the services provided. This article presents the clinical case of a man who visited a podiatric medical student because of pain in his feet and subsequently presented the student with several gifts. Philanthropy, empathy, a positive attitude, treatment instructions, and the time devoted to the patient are some of the reasons why patients offer gifts to podiatric medical students. The relationship between the podiatric medical student and the patient and the act of gift-giving by patients are of ethical concern.

  19. Impure and Multiple! Taking Full Advantage of Belk’s Extensions of Giving

    DEFF Research Database (Denmark)

    Bajde, Domen

    2014-01-01

    to be a person that extends and shares himself ‘out’ profusely. Following his generous example, I wish to share some thoughts on the ‘extensions’ that Belk’s work on gift giving and sharing achieves and/or helps us envision. I discuss five papers, beginning with the ‘Agapic love’ paper (Belk and Coon, 1993......) and the ‘Perfect gift’ paper (Belk, 1996), which I discuss primarily in relation to ‘pure giving’. Next, I move to the more recent triplet of papers on ‘Sharing’ (Belk, 2007, 2010; Belk and Llamas, 2012) which I discuss in light of the multiplicity of giving....

  20. A literature review of empirical studies of philanthropy : eight mechanisms that drive charitable giving.

    NARCIS (Netherlands)

    Bekkers, René; Wiepking, Pamala

    2010-01-01

    The authors present an overview of the academic literature on charitable giving based on a literature review of more than 500 articles. They structure their review around the central question of why people donate money to charitable organizations. We identify eight mechanisms as the most important f

  1. Iris Marion Young's Imaginations of Gift Giving: Some Implications for the Teacher and the Student

    Science.gov (United States)

    Galea, Simone

    2006-01-01

    The paper discusses Iris Marion Young's idea of asymmetric reciprocity that rethinks typical understandings of gift giving. Iris Marion Young's proposals for asymmetric ethical relationships have important implications for democratic contexts that seek to take differences seriously. Imagining oneself in the place of the other or expecting from the…

  2. Giving Time and/or Money : Trade-off or Spill-over?

    NARCIS (Netherlands)

    Bekkers, René

    2002-01-01

    The relation of giving money to charitable causes and volunteering for an association is examined in a sample of 612 respondents living in The Netherlands. In contrast to the expectation that check writing activism is used as a compensation for a lack of active involvement in civil society, voluntee

  3. Dead bodies matter: Gift giving and the unveiling of body donor monuments in the Netherlands

    NARCIS (Netherlands)

    Bolt, S.H.

    2012-01-01

    Body donors are people who voluntarily donate their entire body, after death, to anatomical science. Based on anthropological fieldwork in the Netherlands this article explores the construction of body donor monuments since 2007. These developments are analyzed by means of gift-giving theories. Body

  4. Does Generosity Beget Generosity? Alumni Giving and Undergraduate Financial Aid. NBER Working Paper No. 17861

    Science.gov (United States)

    Meer, Jonathan; Rosen, Harvey S.

    2012-01-01

    We investigate how undergraduates' financial aid packages affect their subsequent donative behavior as alumni. The empirical work is based upon micro data on alumni giving at an anonymous research university. We focus on three types of financial aid, scholarships, loans, and campus jobs. A novel aspect of our modeling strategy is that, consistent…

  5. I'm Giving You the Chocolate Factory! 2017 President's Message

    Science.gov (United States)

    Reeve, Edward M.

    2017-01-01

    In this article, the newly elected 2017-2018 President of the International Technology and Engineering Educators Association (ITEEA), Edward M. Reeve, presents his welcome message in the format of Willy Wonka giving Charlie the Chocolate Factory. Upon becoming a member of ITEEA, one automatically gets a "golden ticket" as a professional…

  6. Understanding Care Giving and Care Receiving Experiences throughout the Life Course

    DEFF Research Database (Denmark)

    Morita, Makiko

    and expectations for the future. Guided by life course approach, the analysis focuses on older couples in Denmark and Japan, and explores the following questions; how have older Danish and Japanese couples experienced care giving and care taking over the life course? How do they perceive these experiences? How...

  7. Whose Expertise?: An Analysis of Advice Giving in Early Childhood Parent-Teacher Conferences

    Science.gov (United States)

    Cheatham, Gregory A.; Ostrosky, Michaelene M.

    2011-01-01

    Early childhood and early childhood special education programs have a focus on parent-educator partnerships. Parent-teacher conferences are a context for these partnerships, and advice giving is one type of exchange occurring within conferences. Parent-teacher conference advice was investigated through participant interviews and the methodology of…

  8. The impact of culture and recipient perspective on direction giving in the service of wayfinding

    NARCIS (Netherlands)

    Hund, Alycia M.; Schmettow, Martin; Noordzij, Matthijs L.

    2012-01-01

    We examined how culture and recipient perspective affect direction giving during wayfinding. Participants from the United States and the Netherlands provided directions from starting locations to destinations for fictional recipients driving through a town (route perspective) or looking at a map of

  9. A Principal's View: Giving Up My Traditional Ship. Personal Reflections of Shared Decision-Making.

    Science.gov (United States)

    Daniels, Cecil T.

    1990-01-01

    Describes one Florida principal's pursuit of school-based management and shared decision making for the wrong reason--to escape from central office domination. Although chosen as the lesser of two evils, the new committee structure has worked well for Myrtle Grove School. Since giving up veto power to gain staff trust and commitment, teacher…

  10. 76 FR 60455 - The White House Council for Community Solutions Gives Notice of Their Following Meeting

    Science.gov (United States)

    2011-09-29

    ... COMMUNITY SERVICE Sunshine Act Meeting Notice The White House Council for Community Solutions Gives Notice... to the Council's electronic mailbox at WhiteHouseCouncil@cns.gov . The public can also follow the...: Leslie Boissiere, Executive Director, White House Council for Community Solutions, Corporation...

  11. Anonymity in giving in a natural context : an economic field experiment in thirty churches

    NARCIS (Netherlands)

    Soetevent, Adriaan R.

    2003-01-01

    The role of anonymity in giving is examined in a field experiment performed in thirty Dutch churches. For a period of 29 weeks, the means by which offerings are gathered is determined by chance, prescribing for each offering the use of either `closed' collection bags or open collection baskets. When

  12. Identification of matrix conditions that give rise to the linear coupling resonances

    Energy Technology Data Exchange (ETDEWEB)

    Gardner,C.J.

    2009-03-01

    General definitions of horizontal and vertical amplitudes for linear coupled motion are developed from the normal form of the one-turn matrix. This leads to the identification of conditions on the matrix that give rise to the linear coupling sum and difference resonances. The correspondence with the standard hamiltonian treatment of the resonances is discussed.

  13. Factors influencing trainers' feedback-giving behavior: a cross-sectional survey

    NARCIS (Netherlands)

    Pelgrim, E.A.M.; Kramer, A.W.M.; Mokkink, H.G.A.; Vleuten, C.P.M. van der

    2014-01-01

    BACKGROUND: The literature provides some insight into the role of feedback givers, but little information about within-trainer factors influencing 'feedback-giving behaviours'. We looked for relationships between characteristics of feedback givers (self-efficacy, task perception, neuroticism, extrav

  14. IV Iron: To Give or to Hold in the Presence of Infection in Adults Undergoing Hemodialysis.

    Science.gov (United States)

    Hain, Debra; Braun, Mauro

    2015-01-01

    Intravenous (IV) iron is often given to treat iron deficiency anemia in adults undergoing hemodialysis. Evidence supports an association between IV iron and infection exits, which often create a clinical dilemma: whether to give or to hold in the presence of infection. This article presents the best available evidence regarding the risk of IV iron and infection along with nephrology nursing practice implications.

  15. Giving to Excellence: Generating Philanthropic Support for UK Higher Education. Ross-CASE Report 2016

    Science.gov (United States)

    Jain, Yashraj

    2016-01-01

    This report presents findings from the 2016 Ross-CASE Survey of Philanthropic Giving to Universities in UK. The project was conducted by CASE Europe and funded by HEFCE and the Ross-Group. This year's survey comes at a time of great change for the UK charity sector. The historical trend data of previous surveys will be invaluable in helping…

  16. How do models give us knowledge? The case of Carnot’s ideal heat engine

    NARCIS (Netherlands)

    Knuuttila, Tarja; Boon, Mieke

    2011-01-01

    Our concern is to explain how and why models give us useful knowledge. We argue that if we are to understand how models function in the actual scientific practice the representational approach to models proves either misleading or too minimal—depending on how representation is defined. By ‘represent

  17. The role of personal values in children's costly sharing and non-costly giving.

    Science.gov (United States)

    Abramson, Lior; Daniel, Ella; Knafo-Noam, Ariel

    2017-04-22

    This study examined whether children's values, global and abstract motivations serving as guiding principles, are organized similarly to those of adults, whether values can predict individual differences in children's sharing behaviors, and whether the normative nature of the situation influences the expression of these individual differences. Children (N=243, ages 5-12years) participated in a values ranking task as part of a visit to a science museum. The majority of children (n=150) also participated in a task examining costly sharing (i.e., sharing that results in giving up part of one's own resources) and non-costly giving (i.e., giving that does not influence one's own share). Starting from 5years of age, children showed a structure of values similar to that of adolescents and adults, specifically contrasting preferences for opposing values (i.e., self-transcendence with self-enhancement and openness to change with conservation). Importance given to self-transcendence values related positively to costly sharing but not to non-costly giving, indicating that in situations where it is more normative to share, individual differences in values are less expressed in children's actual sharing. In addition, children's sex and age moderated the relation between values and behavior. Children's values are an important aspect of their developing personalities. Taking them into consideration can greatly promote the research of prosocial and normative development as well as our understanding of individual differences in children's behavior. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Teaching Techniques: Give or Take? Test Review in the ESL/EFL Classroom

    Science.gov (United States)

    Mermelstein, Aaron David

    2016-01-01

    This article describes "Give or Take?", a fun game that teachers can use to review vocabulary in the English as a second language or foreign language (ESL/EFL) classroom. This game is easy to prepare, and it is a fun and efficient way to review for quizzes or larger midterm or final exams. It can be adapted to almost any grade level or…

  19. Alumni Satisfaction with Their Undergraduate Academic Experience and the Impact on Alumni Giving and Participation

    Science.gov (United States)

    Gaier, Scott

    2005-01-01

    The hypothesis for this research was that the higher the level of academic satisfaction, the more likely it is for alumni to be involved with the university. Alumni involvement was defined as alumni giving and/or alumni participating with their alma mater within the last three years. There were 1,608 alumni from a large state university who…

  20. What does phenomenology offer to the study of care-giving?

    Science.gov (United States)

    Upton, Norman; Reed, Val

    2006-01-01

    Care giving to a dementia sufferer is complex (Parsons, 1997) and inherently stressful (Baldwin et al 1989). It is suggested that the predominance of the care-giver stressor-burden research paradigm during the last thirty years has frequently been uni-dimensional, objectively oriented, generally equivocal, and unconvincing in its findings. Dillehay and Sandys (1990), suggest that preoccupation w ith such typically narrow approaches has delayed the much-needed development of a more accurate understanding of the lived experience (the phenomenology of care-giving). Researching the experience of care giving to a dementing relative requires a research strategy, which acknowledges the intricacies, complexities, subjectivity and humanness of that experience. That is the premise behind this paper. A multi-dimensional phenomenological PhD study is presented. The focus is on understanding care giving from the individual and collective perspectives of forty-six spouse caregivers. The methodological implications (including influences of Husserl and Heidegger) are outlined before the phenomenological research findings are presented and discussed. Ethical approval was given by the Bassetlaw Hospital and Community NHS Trust Ethics Committee (now part of the Nottinghamshire Healthcare NHS Trust).

  1. Giving Peace a Chance: Gandhi and King in the English Classroom.

    Science.gov (United States)

    Gill, David

    2000-01-01

    Describes how one high school English teacher developed and taught a unit that would give students the opportunity to see how violence and nonviolence affects their lives. Notes the unit involves discussing the lives and careers of Mahatma Gandhi and Martin Luther King, Jr., viewing film clips and film, reading, writing in journals, and writing a…

  2. The identifiable victim effect in charitable giving: evidence from a natural field experiment

    DEFF Research Database (Denmark)

    Lesner, Tine; Rasmussen, O. D.

    2014-01-01

    We design a natural field experiment to enhance our understanding of the role of the identifiable victim effect in charitable giving. Using direct mail solicitations to 25797 prior donors of a nonprofit charity, we tested the responsiveness of donors to make a contribution to either an identifiab...

  3. The Mathematics of Tithing: A Study of Religious Giving and Mathematical Development

    Science.gov (United States)

    Taylor, Edd V.

    2013-01-01

    The purpose of this study was to examine children's mathematical understandings related to participation in tithing (giving 10% of earnings to the church). Observations of church services and events, as well as interviews with parents, children, and church leaders, were analyzed in an effort to capture the ways in which mathematical problem…

  4. On the Verbs of"Giving"Class of English Ditransitive Construction

    Institute of Scientific and Technical Information of China (English)

    桂红梅

    2015-01-01

    As one of the most frequently used sentence patterns in various languages,ditransitive construction has been a hot issue argued by many linguists and scholars.This thesis discusses the verbs of"Giving" class of Ditransitive Construction in English and the relationship between verbs and constructions,in attempt to reveal the features of this structure.

  5. Playful vs. serious instruction giving in a 3D game environment

    NARCIS (Netherlands)

    Boer Rookhuiszen, Roan; Theune, Mariët

    2009-01-01

    In this paper we introduce two NLG systems that we developed for the GIVE challenge, which was aimed at the evaluation of natural language generation (NLG) systems. The Challenge involved automatically generating instructions for users to carry out a task in a 3D game environment. One of our systems

  6. The partial catalytic oxidation of methane to give oxygen-containing compounds

    Science.gov (United States)

    Krylov, Oleg V.

    1992-11-01

    The three principal paths of the partial oxidation of methane, to give methanol, formaldehyde, and synthesis gas, have been reviewed. The kinetics and mechanism of the processes have been described. The possible oxidation of methane using different oxidising agents — oxygen and carbon dioxide — has been examined. The bibliography includes 139 references.

  7. Cowpeas in Northern Ghana and the Factors that Predict Caregivers’ Intention to Give Them to Schoolchildren

    NARCIS (Netherlands)

    Abizari, A.R.; Pilime, N.; Armar-Klemesu, M.; Brouwer, I.D.

    2013-01-01

    Background Cowpeas are important staple legumes among the rural poor in northern Ghana. Our objectives were to assess the iron and zinc content of cowpea landraces and identify factors that predict the intention of mothers/caregivers to give cowpeas to their schoolchildren. Methods and Findings We p

  8. A Survey on Acupuncture for Giving Up Heroin and Treatment of the Withdrawal Syndrome

    Institute of Scientific and Technical Information of China (English)

    Zhang Jie; Wang Lanqiong; Zeng Lin; Liao Qishun; Chen Ping

    2007-01-01

    @@ This paper summarizes the study of acupuncture for giving up heroin and treatment of withdrawal syndrome in China from 1995 to 2003, which includes the selection of acupoints, the evaluation of the therapeutic effects, studies of acupoints and application of relevant instruments, as well as treatment of the withdrawal syndromes of heroin with acupuncture.

  9. Self-sacrifice and self-affirmation within care-giving.

    Science.gov (United States)

    van Nistelrooy, Inge

    2014-11-01

    According to the ethics of care, practices of care are sources of moral knowledge that take human relatedness into account. However, caregivers may also find themselves in situations that demand sacrifices, even to the point where their own self is at stake. This may not only be cause for concern about the risks of caregivers, the result of an unequal distribution of power, but it may as well be a chance for affirmation of one's identity, of self-attestation. As Ricoeur argues, giving of the self or even giving one's life may be the ultimate expression of one's belonging, in friendship, devotion or loyalty. Ricoeur also considers the meaning of giving a gift, which to him does not lie in any return gift, but rather in the gift as offering, as generosity. Giving is first of all a risk, a sacrifice, with only the hope that it will be received. In this article I aim to extend his argument to the realm of caregiving, thereby supporting my claim that some sort of self-sacrifice is implied in the very act of caring for others.

  10. An Investigation of the Influence Acknowledgement Programs Have on Alumni Giving Behavior: Implications for Marketing Strategy

    Science.gov (United States)

    Bingham, Frank G., Jr.; Quigley, Charles J., Jr.; Murray, Keith B.

    2002-01-01

    Understanding the factors that influence alumni giving is a critical task of institutional marketers and development officers. To better understand the factors that influence alumni support, this research reports the results of a field experiment in which the effect that acknowledgement of alumni contributions has on their subsequent donation…

  11. ''Show me, how does it look now'': Remote Help-giving in Collaborative Design

    NARCIS (Netherlands)

    Vyas, Dhaval; van der Veer, Gerrit C.; Heylen, Dirk K.J.; Nijholt, Antinus; Norros, L.

    2009-01-01

    This paper examines the role of visual information in a remote help-giving situation involving the collaborative physical task of designing a prototype remote control. We analyze a set of video recordings captured within an experimental setting. Our analysis shows that using gestures and relevant

  12. Where Are the Facts? "Jason's Gold" Gives Meaning to the Yukon Gold Rush

    Science.gov (United States)

    Wasta, Stephanie; Lott, Carolyn

    2006-01-01

    This article discusses how fictional works can give a purposeful context and an appropriate venue for developing essential social studies concepts in middle-school students. The author uses the example of a National Council for the Social Studies (NCSS) notable book, "Jason's Gold" that blends history with story to become historical…

  13. Dead bodies matter: Gift giving and the unveiling of body donor monuments in the Netherlands

    NARCIS (Netherlands)

    Bolt, S.H.

    2012-01-01

    Body donors are people who voluntarily donate their entire body, after death, to anatomical science. Based on anthropological fieldwork in the Netherlands this article explores the construction of body donor monuments since 2007. These developments are analyzed by means of gift-giving theories. Body

  14. Parental care-giving and home environment predicting offspring's temperament and character traits after 18 years.

    Science.gov (United States)

    Josefsson, Kim; Jokela, Markus; Hintsanen, Mirka; Cloninger, Claude Robert; Pulkki-Råback, Laura; Merjonen, Päivi; Hutri-Kähönen, Nina; Keltikangas-Järvinen, Liisa

    2013-10-30

    Although many personality theories emphasize the role of parental behaviors in shaping personality development, empirical data from longitudinal studies remain scarce. It is also not known, if parental behaviors affect character development more strongly than temperament or vice versa. In a prospective study, 1083 volunteer participants of the Young Finns study completed the Temperament and Character Inventory (TCI). Parents of the participants had answered questions about parenting attitudes, socioeconomic status, health behaviors, and role satisfaction 18 years before. We studied the univariate and the cumulative effects of parental care-giving and family environment on offspring's personality traits. Parental care-giving and home-environment were more strongly associated with offspring character traits reflecting personality maturity (Self-directedness and Cooperativeness) than with offspring temperament traits (Novelty seeking, Harm avoidance, Reward dependence and Persistence) reflecting emotional and behavioral tendencies. The differences were most evident in the cumulative effects model. Maternal variables were stronger predictors than paternal variables. The present findings suggest that not all personality traits are similarly predicted by parental care-giving and home-environment. In particular, character development is more strongly related to such measures than temperament. Parental care-giving and home-environment are more strongly related to psychological maturity (character) than emotional and behavioral tendencies (temperament).

  15. The impact of culture and recipient perspective on direction giving in the service of wayfinding

    NARCIS (Netherlands)

    Hund, Alycia M.; Schmettow, Martin; Noordzij, Matthijs Leendert

    2012-01-01

    We examined how culture and recipient perspective affect direction giving during wayfinding. Participants from the United States and the Netherlands provided directions from starting locations to destinations for fictional recipients driving through a town (route perspective) or looking at a map of

  16. Now or never! The effect of deadlines on charitable giving: Evidence from a natural field experiment

    DEFF Research Database (Denmark)

    Damgaard, Mette Trier; Gravert, Christina Annette

    that a reminder increases both the likelihood of making a donation and the amount donated. We find no effect of the deadlines on the propensity to give. Instead we observe a “now-or-never” effect; either donations are made immediately or not at all. In line with the “avoiding-the-ask” theory, both shorter...

  17. Teacher's Study Guide on the Biology of Human Populations: Africa.

    Science.gov (United States)

    United Nations Educational, Scientific, and Cultural Organization, Paris (France).

    This teacher's guide is designed to give background information on current biological subjects not usually treated in student texts. The book is divided into five parts, each representing one of the following topics: (1) evolution of human populations; (2) environment of human populations; (3) dynamics of human populations; (4) reproduction in…

  18. Automating annotation of information-giving for analysis of clinical conversation.

    Science.gov (United States)

    Mayfield, Elijah; Laws, M Barton; Wilson, Ira B; Penstein Rosé, Carolyn

    2014-02-01

    Coding of clinical communication for fine-grained features such as speech acts has produced a substantial literature. However, annotation by humans is laborious and expensive, limiting application of these methods. We aimed to show that through machine learning, computers could code certain categories of speech acts with sufficient reliability to make useful distinctions among clinical encounters. The data were transcripts of 415 routine outpatient visits of HIV patients which had previously been coded for speech acts using the Generalized Medical Interaction Analysis System (GMIAS); 50 had also been coded for larger scale features using the Comprehensive Analysis of the Structure of Encounters System (CASES). We aggregated selected speech acts into information-giving and requesting, then trained the machine to automatically annotate using logistic regression classification. We evaluated reliability by per-speech act accuracy. We used multiple regression to predict patient reports of communication quality from post-visit surveys using the patient and provider information-giving to information-requesting ratio (briefly, information-giving ratio) and patient gender. Automated coding produces moderate reliability with human coding (accuracy 71.2%, κ=0.57), with high correlation between machine and human prediction of the information-giving ratio (r=0.96). The regression significantly predicted four of five patient-reported measures of communication quality (r=0.263-0.344). The information-giving ratio is a useful and intuitive measure for predicting patient perception of provider-patient communication quality. These predictions can be made with automated annotation, which is a practical option for studying large collections of clinical encounters with objectivity, consistency, and low cost, providing greater opportunity for training and reflection for care providers.

  19. Population aging.

    Science.gov (United States)

    1999-04-01

    This paper focuses on the impact of population aging in China, the most densely populated country in the world. Statistics indicate that by the end of 1998, 83.75 million out of the 1.248 billion Chinese people will be over 65 years old. According to the UN standards, China will soon become an aging society. The aging population poses several challenges to the country with the greatest challenge being the increasing social responsibility to care for the aged. With the undeveloped legislative framework to protect the interests of the aged and the serious drawbacks in the pension system to cater only to the income part and not the service part of the aged, China is not yet ready for the advent of aging. Violation of the rights of senior citizens is still very rampant despite enactment of the law on Protection of the Rights of the Elderly in 1996. Moreover, China is not economically ready to become an aging society. China faces this challenge by adopting a three-pronged approach to solve the problem namely: family support, establishment of nursing homes, and creating a social security framework that addresses the needs of the society suited to the Chinese condition. It is believed that with the growing economy of the country and the rising income of its people, a comprehensive social security net will be created to take care of the aged.

  20. Stickleback Population

    Directory of Open Access Journals (Sweden)

    Ulrika Candolin

    2012-01-01

    Full Text Available Human-induced eutrophication has increased offspring production in a population of threespine stickleback Gasterosteus aculeatus in the Baltic Sea. Here, we experimentally investigated the effects of an increased density of juveniles on behaviours that influence survival and dispersal, and, hence, population growth—habitat choice, risk taking, and foraging rate. Juveniles were allowed to choose between two habitats that differed in structural complexity, in the absence and presence of predators and conspecific juveniles. In the absence of predators or conspecifics, juveniles preferred the more complex habitat. The preference was further enhanced in the presence of a natural predator, a perch Perca fluviatilis (behind a transparent Plexiglas wall. However, an increased density of conspecifics relaxed the predator-enhanced preference for the complex habitat and increased the use of the open, more predator-exposed habitat. Foraging rate was reduced under increased perceived predation risk. These results suggest that density-dependent behaviours can cause individuals to choose suboptimal habitats where predation risk is high and foraging rate low. This could contribute to the regulation of population growth in eutrophicated areas where offspring production is high.

  1. Dynamic expression of the Robo ligand Slit2 in bone marrow cell populations.

    Science.gov (United States)

    Smith-Berdan, Stephanie; Schepers, Koen; Ly, Alan; Passegué, Emmanuelle; Forsberg, E Camilla

    2012-02-15

    The bone marrow (BM) niche is essential for lifelong hematopoietic stem cell (HSC) maintenance, proliferation and differentiation. Several BM cell types, including osteoblast lineage cells (OBC), mesenchymal stem cells (MSC) and endothelial cells (EC) have been implicated in supporting HSC location and function, but the relative importance of these cell types and their secreted ligands remain controversial. We recently found that the cell surface receptors Robo4 and CXCR4 cooperate to localize HSC to BM niches. We hypothesized that Slit2, a putative ligand for Robo4, cooperates with the CXCR4 ligand SDF1 to direct HSC to specific BM niche sites. Here, we have isolated OBC, MSC and EC by flow cytometry and determined their frequency within the bone marrow and the relative mRNA levels of Slit2, SDF1 and Robo4. We found that expression of Slit2 and SDF1 were dynamically regulated in MSC and OBC-like populations following radiation, while Robo4 expression was restricted to EC. Radiation also significantly affected the cellularity and frequency of both the non-adherent and adherent cells within the BM stroma. These data support a physiological role for Slit2 in regulating the dynamic function of Robo-expressing cells within BM niches at steady state and following radiation.

  2. Indian populations

    CERN Document Server

    Spahni,J

    1974-01-01

    Le Prof. J.C. Spahni qui a parcouru les Andes, Vénezuela etc. parle de ses expériences et connaissances qu'il a vécu au cours des 14 ans parmi les populations indiennes de la Cordillière des Andes. Il a ramené des objets artisanals indiens lesquels l'auditoire peut acquérir. L'introduction-conférence est suivi d'un film, commenté par lui-même; après l'entracte il y un débat-dialogue avec le public.

  3. Do simple models give a correct description of the wind condition in a coastal area ?

    Energy Technology Data Exchange (ETDEWEB)

    Kaellstrand, B. [Uppsala Univ. (Sweden). Dept. of Meteorology

    1996-12-01

    When the surface conditions changes at a coastline, an internal boundary layer evolves, with a wind speed and turbulence intensity influenced by these new conditions. Aircraft measurements across the coastline, performed during near neutral conditions, are compared with a model and thirteen more simple expressions for the growth of an internal boundary layer (IBL). The majority of the expressions overestimate the IBL height, while other underestimate it. Some of the expressions give reasonable result close to the coast. The model gives good agreement, even for larger distances. The vertical potential temperature gradient turned out to be an important parameter for the growth of the IBL, even with this near neutral conditions. 21 refs, 5 figs, 1 tab

  4. Dead bodies matter: gift giving and the unveiling of body donor monuments in the Netherlands.

    Science.gov (United States)

    Bolt, Sophie

    2012-12-01

    Body donors are people who voluntarily donate their entire body, after death, to anatomical science. Based on anthropological fieldwork in the Netherlands this article explores the construction of body donor monuments since 2007. These developments are analyzed by means of gift-giving theories. Body donation is a practice in which the medical and scientific value of the donor bodies has always been praised. Increasingly the fact that the bodies represent real human beings who have mourning relatives has also been acknowledged. This change in attitude has resulted in a desire on the part of anatomical professionals to give back a monument, not only for the donors themselves but also, in particular, for the donors' relatives. The great public interest in the monuments has revealed that many of the bereaved, in the absence of having the physical body of the donor, need a symbolic final resting place for their loved ones.

  5. Giving feedback in medical teaching: a case of lung function laboratory/spirometry.

    Science.gov (United States)

    Meo, Sultan Ayoub

    2013-01-01

    Feedback in medical teaching is an important part of medical education, it encourages and enhances the learners' knowledge, skills and professional performance at various stages of their schooling. A constructive feedback enhances the awareness of strength and areas for improvement. An adequate, meaningful and fruitful feedback needs motivation, emphasis, objectivity, expertise, and active participation in the session. Before giving feedback, the instructor should be well prepared and must have practice on the task. The instructor should utilize all means such as good oral presentation, eye contact, visual cues, utilize body language to actively involve the learners in a session, all these activities enhance the knowledge, skill and attitude of the learners. The aim of this commentary is to highlight the basic issues in giving an appropriate feedback in medical teaching with special emphasis on a lung function laboratory / Spirometry.

  6. For the sake of whom: conversation analysis of advice giving in offender counseling.

    Science.gov (United States)

    Jing-ying, Guo

    2013-08-01

    Regarded as beneficial and preferable to the clients, advice delivery has been an integral part of counseling; however, there are controversies over the suitability of giving advice in counseling services, including counseling conducted in the context of prisons. Based on conversation analysis, this article tries to explore when and how police counselors in two Chinese prisons give advice and how inmate clients respond to and seek advice in offender counseling. It is found that advice delivery, supposed to be for the inmate clients' sake, only serves a phatic function in the context of prisons in which security is a priority, and transforming inmates into law-abiding citizen is the overall goal of prison rehabilitation and correction. Hence, offender counselors, intending to alleviate depression and anxiety in inmate clients, are caught in a dilemma.

  7. A survey on acupuncture for giving up heroin and treatment of the withdrawal syndrome.

    Science.gov (United States)

    Zhang, Jie; Wang, Lanqiong; Zeng, Lin; Liao, Qishun; Chen, Ping

    2007-06-01

    This paper summarizes the study of acupuncture for giving up heroin and treatment of withdrawal syndrome in China from 1995 to 2003, which includes the selection of acupoints, the evaluation of the therapeutic effects, studies of acupoints and application of relevant instruments, as well as treatment of the withdrawal syndromes of heroin with acupuncture. The therapeutic effect of acupuncture and moxibustion is definite and indispensable, especially at the time when there is no specific remedy for heroin addition.

  8. Personal and household care giving for adult children to parents and social stratification

    OpenAIRE

    Sarasa Urdiola, Sebastià; Billingsley, Sunnee

    2008-01-01

    Using SHARE database the paper explores the factors conditioning personalcare giving from adult children to their parents. Frequency and intensity ofpersonal care is contrasted with the reciprocal expectations that children haveabout wealth inheritance from their parents and with the opportunity costs of helping, as well as with the capacity of parents of getting help from othersources of personal care. The results may help to understand how inequalitiesin accessing to formal services relate ...

  9. Cooler reflective pavements give benefits beyond energy savings: durability and illumination

    Energy Technology Data Exchange (ETDEWEB)

    Pomerantz, Melvin; Akbari, Hashem; Harvey, John T.

    2000-06-01

    City streets are usually paved with asphalt concrete because this material gives good service and is relatively inexpensive to construct and maintain. We show that making asphalt pavements cooler, by increasing their reflection of sunlight, may lead to longer lifetime of the pavement, lower initial costs of the asphalt binder, and savings on street lighting and signs. Excessive glare due to the whiter surface is not likely to be a problem.

  10. Cowpeas in Northern Ghana and the factors that predict caregivers' intention to give them to schoolchildren.

    Directory of Open Access Journals (Sweden)

    Abdul-Razak Abizari

    Full Text Available BACKGROUND: Cowpeas are important staple legumes among the rural poor in northern Ghana. Our objectives were to assess the iron and zinc content of cowpea landraces and identify factors that predict the intention of mothers/caregivers to give cowpeas to their schoolchildren. METHODS AND FINDINGS: We performed biochemical analysis on 14 landraces of cowpeas and assessed the opinion of 120 caregiver-child pairs on constructs based on the combined model of the Theory of Planned Behaviour and Health Belief Model. We used correlations and multiple regressions to measure simple associations between constructs and identify predictive constructs. Cowpea landraces contained iron and zinc in the range of 4.9-8.2 mg/100 g d.w and 2.7-4.1 mg/100 g d.w respectively. The landraces also contained high amounts of phytate (477-1110 mg/100 g d.w and polyphenol (327-1055 mg/100 g d.w. Intention of mothers was strongly associated (rs = 0.72, P<0.001 with and predicted (β = 0.63, P<0.001 behaviour. The constructs, barriers (β = -0.42, P = 0.001 and attitudes towards behaviour (β = 0.25, P<0.028, significantly predicted intention albeit the predictive ability of the model was weak. CONCLUSIONS: We conclude that some cowpea landraces from northern Ghana have appreciable amounts of iron and zinc but probably with poor bioavailability. Attitudes towards giving cowpeas and perception of barriers are important predictors of caregivers' intention to give cowpeas to their schoolchildren. Finally our results suggest that increasing knowledge on nutritional benefits of cowpeas may increase health values caregivers hold for their children in support of giving cowpeas to schoolchildren.

  11. Giving support to others reduces sympathetic nervous system-related responses to stress

    OpenAIRE

    Inagaki, TK; Eisenberger, NI

    2015-01-01

    © 2015 Society for Psychophysiological Research. Social support is a major contributor to the link between social ties and beneficial health outcomes. Research to date has focused on how receiving support from others might be good for us; however, we know less about the health effects of giving support to others. Based on prior work in animals showing that stimulating neural circuitry important for caregiving behavior can reduce sympathetic-related responses to stressors, it is possible that,...

  12. Gender Differences In Giving Directions: A Case Study Of English Literature Students At Binus University

    Directory of Open Access Journals (Sweden)

    Tjoo Hong Sing

    2011-05-01

    Full Text Available Many researchers have said that there are differences in the ways people give direction between males and females, especially in spatial task (cardinal directions, topography, mileage, building, right/left markers (e.g., Lawton, 2001; Dabbs et al., 1998. Here, the thesis investigates what differences occur between both genders in giving direction. The respondents are 25 females and 25 males of fifth semester Binus University students majoring in English Literature. The respondents answered with a certain route from Binus’s Anggrek Campus to Senayan City. The study was conducted by qualitative and quantitative method. From the data analysis, the writer discovered that gender does affect in selecting the key words in explaining direction it is found that there were differences in choosing key words in giving direction between females and males. The difference is women use more than twice spatial references than men do. In terms of verbal abilities, it was confirmed that female use longer explanation. However, in other aspects such as serial orientation and maintenance words, the result is inconclusive. 

  13. Security giving in surrogacy motherhood process as a caring model for commissioning mothers: A theory synthesis.

    Science.gov (United States)

    Zandi, Mitra; Vanaki, Zohreh; Shiva, Marziyeh; Mohammadi, Eesa; Bagheri-Lankarani, Narges

    2016-07-01

    Despite the increasing use of surrogacy, there are no caring theories/models that serve as the basis for nursing care to surrogacy commissioning mothers. This study has designed a model for caring of surrogacy commissioning mothers in 2013. The theory synthesis of Walker and Avant's strategies of theory construction (2011) was used to design a caring model/theory. The theory synthesis includes three stages: (i) selection of focal concept (the concept of "security giving in motherhood" was selected); (ii) review of studies in order to identify factors related to focal concept relevant studies (42 articles and 13 books) were reviewed, statements and concepts related to focal concept were then extracted and classified, and their relations were specified; and (iii) organization of concepts and statements within a relevant general and effective manifestation of the phenomenon under study which led to developing of a model. In this caring model/theory, entitled "security giving in surrogacy motherhood", nurses roles were conceptualized within the conceptual framework that includes three main roles: (i) coordination; (ii) participation; and (iii) security giving (physical, emotional, and legal support; empowerment; presence; relationship management between both parties and advocacy). Training surrogacy specialist nurses and establishment of surrogacy care centers are important factors for implementation of the model. This model could help to provided better caring for surrogacy clients, especially for commissioning mothers. © 2016 Japan Academy of Nursing Science.

  14. Worthless donations: male deception and female counter play in a nuptial gift-giving spider

    Directory of Open Access Journals (Sweden)

    Albo Maria J

    2011-11-01

    Full Text Available Abstract Background In nuptial gift-giving species, benefits of acquiring a mate may select for male deception by donation of worthless gifts. We investigated the effect of worthless gifts on mating success in the spider Pisaura mirabilis. Males usually offer an insect prey wrapped in silk; however, worthless gifts containing inedible items are reported. We tested male mating success in the following experimental groups: protein enriched fly gift (PG, regular fly gift (FG, worthless gift (WG, or no gift (NG. Results Males that offered worthless gifts acquired similar mating success as males offering nutritional gifts, while males with no gift experienced reduced mating success. The results suggest that strong selection on the nuptial gift-giving trait facilitates male deception by donation of worthless gifts. Females terminated matings faster when males offered worthless donations; this demonstrate a cost of deception for the males as shorter matings lead to reduced sperm transfer and thus give the deceiving males a disadvantage in sperm competition. Conclusion We propose that the gift wrapping trait allows males to exploit female foraging preference by disguising the gift content thus deceiving females into mating without acquiring direct benefits. Female preference for a genuine prey gift combined with control over mating duration, however, counteracts the male deception.

  15. The information-giving skills of resident physicians: relationships with confidence and simulated patient satisfaction.

    Science.gov (United States)

    Ishikawa, Hirono; Son, Daisuke; Eto, Masato; Kitamura, Kiyoshi; Kiuchi, Takahiro

    2017-02-08

    Sharing information is crucial for discussion of problems and treatment decision making by patients and physicians. However, the focus of communication skills training in undergraduate medical education has been on building the relationship and gathering information; thus, resident physicians tend to be less confident about sharing information and planning treatment. This study evaluated the medical interviews conducted by resident physicians with a focus on information giving, and investigated its relationships with their confidence in communication and simulated patient (SP) satisfaction. Among 137 junior resident physicians at a university hospital in Japan who participated in a survey of communication skills, 25 volunteered to conduct simulated medical interviews. The medical interviews were video-recorded and analyzed using the Roter Interaction Analysis System, together with additional coding to explore specific features of information giving. The SPs evaluated their satisfaction with the medical interview. Resident physicians who were more confident in their communication skills provided more information to the patients, while SP satisfaction was associated only with patient-prompted information giving. SPs were more satisfied when the physicians explained the rationales for their opinions and recommendations. Our findings underscore the importance of providing relevant information in response to the patient requests, and explaining the rationales for the opinions and recommendations. Further investigation is needed to clinically confirm our findings and develop an appropriate communication skills training program.

  16. 41 CFR 102-74.60 - Are Federal agencies required to give blind vendors priority in operating cafeterias?

    Science.gov (United States)

    2010-07-01

    ... required to give blind vendors priority in operating cafeterias? 102-74.60 Section 102-74.60 Public....60 Are Federal agencies required to give blind vendors priority in operating cafeterias? Yes. Federal agencies are required to give Randolph-Sheppard vendors priority in the operation of cafeterias when the...

  17. Exploring states of panacea and perfidy of family and community volunteerism in palliative care giving in Kanye CHBC program, Botswana

    Directory of Open Access Journals (Sweden)

    Simon Kangethe

    2010-01-01

    Recommendations: The study recommends: (1 Socializing boys early enough in life into care giving; (2 Offering incentives to the caregivers; (3 Use of public forums to persuade men to accept helping women in carrying out care giving duties; (4 And enlisting support of all leaders to advocate for men′s involvement in care giving.

  18. O Ato de Presentear em Relacionamentos Comerciais [Gift-giving in Business Relationships

    Directory of Open Access Journals (Sweden)

    Aline de Assis Teixeira

    2011-12-01

    Full Text Available Este trabalho teve como objetivo compreender o ato de presentear que ocorre em relacionamentos comerciais entre provedores de serviços e consumidores. Dois métodos qualitativos foram utilizados na pesquisa: (i entrevistas ficcionais e (ii técnica do incidente crítico. A partir deste estudo, observou-se que a motivação para o ato de presentear em relacionamentos comercias decorreu, principalmente, da satisfação dos consumidores em relação aos serviços prestados pelos profissionais. Os tipos de presentes citados variaram bastante, sendo os itens de uso pessoal os mais citados em relacionamentos comerciais, o que permite maior intimidade entre a díade. Os clientes narraram como data escolhida para o ato de presentear, dias comuns que sucederam o recebimento de favores ou de atendimentos satisfatórios. Os provedores de serviços, por outro lado, narraram o recebimento de presentes em datas comemorativas. Em relação ao realinhamento do relacionamento após o ato de presentear, também foram identificadas divergências nas respostas da díade. Enquanto a maior parte dos clientes fez referência ao efeito de fortalecimento do relacionamento, os profissionais mostraram-se relutantes em admitir mudanças comportamentais após o recebimento de presentes. ---- Gift-giving in Business Relationships ---- Abstract ---- This study aimed at understanding the gift giving in business relations between service providers and consumers. Two qualitative methods were conducted: fiction interviews and critical incident technique. From this study, we observed that motivation for the act of giving in commercial relationships was mainly due to consumer satisfaction in relation to services provided. The kind of gifts mentioned varied widely and may be perceived, however, that personal items were most often cited in business relationships that allow greater dyad closeness. Ordinary days were pointed out by clients as being the chosen date for gift giving

  19. Science, names giving and names calling: Change NDM-1 to PCM

    Directory of Open Access Journals (Sweden)

    Singh Ajai

    2011-01-01

    Full Text Available A journal editor recently apologised for publishing a 2010 paper in which authors designated an enzyme as New Delhi metallo-β-lactamase-1 (NDM-1 and its related gene blaNDM-1 after a city, New Delhi. This name had raised an outcry in India, with health authorities, media and medical practitioners demanding New Delhi be dropped from the name. The name was actually first given in another 2009 paper, whose corresponding author remains the same as the 2010 paper. There is a tradition of eponymous names in science. But those found derogatory to races, groups, cities, and countries have been changed. For example, "Mongolism" was changed to Down′s syndrome; "Australia" antigen to HBsAg; "Mexican" Swine flu to H1N1; "GRID" (Gay Related Immune Deficiency and 4H-Disease (Haitians, Homosexuals, Haemophiliacs and Heroin Users Disease to AIDS. It is necessary that NDM-1 also be changed to a name based on scientific characteristics. NDM-1 must be changed to PCM (plasmid-encoding carbapenem-resistant metallo-β-lactamase. It is also necessary to review the tradition of naming organisms, diseases, genes, etc. after cities, countries and races. Often, such names giving amounts to names calling. It needs to be discarded by scientists in all new names giving from now on. "Geographical" and "racial" names giving must be replaced by "scientific" names giving. Journal editors must ensure that such scientific names giving is laid down as standard guideline in paper submissions. All such names still in currency need to be phased out by replacing them with names based on scientific characteristics, or in honour of their pioneering scientist/s or institutions. The lead author of the above 2010 paper has said he was not consulted about the final draft and did not agree with the conclusions of the paper. To ensure that corresponding authors do not ride roughshod over co-authors, and lead and other authors do not backtrack on papers, editors must ensure written

  20. Science, names giving and names calling: Change NDM-1 to PCM

    Directory of Open Access Journals (Sweden)

    Ajai R Singh

    2011-03-01

    Full Text Available A journal editor recently apologised for publishing a 2010 paper in which authors designated an enzyme as New Delhi metallo-β-lactamase-1 (NDM-1 and its related gene blaNDM-1 after a city, New Delhi. This name had raised an outcry in India, with health authorities, media and medical practitioners demanding New Delhi be dropped from the name. The name was actually first given in another 2009 paper, whose corresponding author remains the same as the 2010 paper. There is a tradition of eponymous names in science. But those found derogatory to races, groups, cities, and countries have been changed. For example, "Mongolism" was changed to Down's syndrome; "Australia" antigen to HBsAg; "Mexican" Swine flu to H1N1; "GRID" (Gay Related Immune Deficiency and 4H-Disease (Haitians, Homosexuals, Haemophiliacs and Heroin Users Disease to AIDS. It is necessary that NDM-1 also be changed to a name based on scientific characteristics. NDM-1 must be changed to PCM (plasmid-encoding carbapenemase-resistant metallo-β-lactamase. It is also necessary to review the tradition of naming organisms, diseases, genes, etc. after cities, countries and races. Often, such names giving amounts to names calling. It needs to be discarded by scientists in all new names giving from now on. "Geographical" and "racial" names giving must be replaced by "scientific" names giving. Journal editors must ensure that such scientific names giving is laid down as standard guideline in paper submissions. All such names still in currency need to be phased out by replacing them with names based on scientific characteristics, or in honour of their pioneering scientist/s or institutions. The lead author of the above 2010 paper has said he was not consulted about the final draft and did not agree with the conclusions of the paper. To ensure that corresponding authors do not ride roughshod over co-authors, and lead and other authors do not backtrack on papers, editors must ensure written

  1. Science, Names Giving and Names Calling: Change NDM-1 to PCM.

    Science.gov (United States)

    Singh, Ajai R

    2011-01-01

    A journal editor recently apologised for publishing a 2010 paper in which authors designated an enzyme as New Delhi metallo-β-lactamase-1 (NDM-1) and its related gene bla(NDM-1) after a city, New Delhi. This name had raised an outcry in India, with health authorities, media and medical practitioners demanding New Delhi be dropped from the name. The name was actually first given in another 2009 paper, whose corresponding author remains the same as the 2010 paper. There is a tradition of eponymous names in science. But those found derogatory to races, groups, cities, and countries have been changed. For example, "Mongolism" was changed to Down's syndrome; "Australia" antigen to HBsAg; "Mexican" Swine flu to H1N1; "GRID" (Gay Related Immune Deficiency) and 4H-Disease (Haitians, Homosexuals, Haemophiliacs and Heroin Users Disease) to AIDS. It is necessary that NDM-1 also be changed to a name based on scientific characteristics. NDM-1 must be changed to PCM (plasmid-encoding carbapenem-resistant metallo-β-lactamase). It is also necessary to review the tradition of naming organisms, diseases, genes, etc. after cities, countries and races. Often, such names giving amounts to names calling. It needs to be discarded by scientists in all new names giving from now on. "Geographical" and "racial" names giving must be replaced by "scientific" names giving. Journal editors must ensure that such scientific names giving is laid down as standard guideline in paper submissions. All such names still in currency need to be phased out by replacing them with names based on scientific characteristics, or in honour of their pioneering scientist/s or institutions. The lead author of the above 2010 paper has said he was not consulted about the final draft and did not agree with the conclusions of the paper. To ensure that corresponding authors do not ride roughshod over co-authors, and lead and other authors do not backtrack on papers, editors must ensure written concurrence of all

  2. Germany's Population: Turbulent Past, Uncertain Future

    OpenAIRE

    Heilig, G.K.; Büttner, T; W. Lutz

    1990-01-01

    When the two Germanies were reunited in 1990, 16 million East Germans were added to the West German population, giving it a 20 million person advantage over Italy, France and the United Kingdom. This report traces the history of German population growth from the 1870s through World War II and up to the present. The authors examine the demographic trends of the new Germany and the prospects for future growth. Until 1990, marriage, fertility, and mortality followed different paths in the...

  3. Population growth and its implications

    Directory of Open Access Journals (Sweden)

    Badii, M. H.

    2005-01-01

    Full Text Available Human populations have grown at an unprecedented rate over the past three centuries. By 2001, the world population stood at 6.2 billion people. If the current trend of 1.4 % per year persists, the population will double in 51years. Most of that growth will occur in the less developed countries of Asia, Africa, and Latin America. There is a serious concern that the number of humans in the world and our impact on the environment will overload the life support systems of the earth. The crude birth rate is the number of births in a year divided by the average population. A more accurate measure of growth is the general fertility rate, which takes into account the age structure and fecundity of the population. The crude birth rate minus the crude death rate gives the rate of natural increase. When this rate reaches a level at which people are just replacing themselves, zero population growth is achieved. In the more highly developed countries of the world, growth has slowed are even reversed in recent years so that without immigration from other areas, population would be declining. The change from high birth and death rates that accompanies in industrialization is called a demographic transition. Many developing nations have already begun this transition. Death rates have fallen, but birth rates remain high. Some demographers believe that as infant mortality drops and economic development progresses so that people in these countries can be sure of secure future, they will complete the transition to a stable population or a high standard living. While larger populations bring many problems, they also may be a valuable resource of energy, intelligence, and enterprise that will make it possible to overcome resource limitation problems. A social just view argues that a more equitable distribution of wealth might reduce both excess population growth and environmental degradation. We have many more options now for controlling fertility than were available

  4. The logistic, two-sex, age-structured population model.

    Science.gov (United States)

    Yang, Kai; Milner, Fabio

    2009-03-01

    In this paper, we introduce the logistic effect into the two-sex population model introduced by Hoppensteadt. We address the problem of existence and uniqueness of continuous and classical solutions. We first give sufficient conditions for a unique continuous solution to exist locally and also globally. Next, the existence of classical solutions is established under some mild assumptions on the vital rates. Finally, we study the existence of equilibria and give an upper bound for the total population at steady state.

  5. Population Genetics with Fluctuating Population Sizes

    CERN Document Server

    Chotibut, Thiparat

    2016-01-01

    Standard neutral population genetics theory with a strictly fixed population size has important limitations. An alternative model that allows independently fluctuating population sizes and reproduces the standard neutral evolution is reviewed. We then study a situation such that the competing species are neutral at the equilibrium population size but population size fluctuations nevertheless favor fixation of one species over the other. In this case, a separation of timescales emerges naturally and allows adiabatic elimination of a fast population size variable to deduce the fluctuations-induced selection dynamics near the equilibrium population size. The results highlight the incompleteness of the standard population genetics with a strictly fixed population size.

  6. Population Genetics with Fluctuating Population Sizes

    Science.gov (United States)

    Chotibut, Thiparat; Nelson, David R.

    2017-05-01

    Standard neutral population genetics theory with a strictly fixed population size has important limitations. An alternative model that allows independently fluctuating population sizes and reproduces the standard neutral evolution is reviewed. We then study a situation such that the competing species are neutral at the equilibrium population size but population size fluctuations nevertheless favor fixation of one species over the other. In this case, a separation of timescales emerges naturally and allows adiabatic elimination of a fast population size variable to deduce the fluctuation-induced selection dynamics near the equilibrium population size. The results highlight the incompleteness of the standard population genetics with a strictly fixed population size.

  7. The influence on birthweight of maternal living conditions a decade prior to giving birth

    Directory of Open Access Journals (Sweden)

    John Singhammer

    2009-10-01

    Full Text Available The study’s aim was to correlate measures of mothers’ socio-economic status, a decade prior to giving birth, with their children’s birthweight. As part of a larger study, information on birth characteristics from 706 babies born 1970-73 were linked with census data obtained from their mothers near the time of birth as well as one decade earlier. The 706 individuals were selected at random from two national surveys in 1998 and 2000 and traced back to the time of birth in the period 1970-73. Information on birth characteristics was linked to census data obtained from the mothers in 1960 and 1970. Included was information on parent’s living conditions (e.g. income, type of dwelling, indoor plumbing, telephone, number of people in the household. Information on mother’s health during pregnancy, a decade before childbirth and near childbirth, and data on mothers’ and the infants’ health at birth was obtained from the Medical Birth Registry of Norway. In analysis that included both early and current socio-economic conditions maternal education and rural residency at the time of giving birth were observed as statistical significant predictors of birthweight. Results were adjusted for maternal age, parity, plurality, gender and diagnoses before and during pregnancy, all factors observed to attenuate birthweight. Indicators of women’s socio-economic conditions a decade prior to giving birth were not significantly associated with birthweight. These findings do not clearly support suggestions in the literature that an infant’s vitality may be influenced by the family’s socio-economic conditions years before birth.

  8. Knowledge generation about care-giving in the UK: a critical review of research paradigms.

    Science.gov (United States)

    Milne, Alisoun; Larkin, Mary

    2015-01-01

    While discourse about care and caring is well developed in the UK, the nature of knowledge generation about care and the research paradigms that underpin it have been subjected to limited critical reflection and analysis. An overarching synthesis of evidence - intended to promote debate and facilitate new understandings - identifies two largely separate bodies of carer-related research. The first body of work - referred to as Gathering and Evaluating - provides evidence of the extent of care-giving, who provides care to whom and with what impact; it also focuses on evaluating policy and service efficacy. This type of research tends to dominate public perception about caring, influences the type and extent of policy and support for carers and attracts funding from policy and health-related sources. However, it also tends to be conceptually and theoretically narrow, has limited engagement with carers' perspectives and adopts an atomistic purview on the care-giving landscape. The second body of work - Conceptualising and Theorising - explores the conceptual and experiential nature of care and aims to extend thinking and theory about caring. It is concerned with promoting understanding of care as an integral part of human relationships, embedded in the life course, and a product of interdependence and reciprocity. This work conceptualises care as both an activity and a disposition and foregrounds the development of an 'ethic of care', thereby providing a perspective within which to recognise both the challenges care-giving may present and the significance of care as a normative activity. It tends to be funded from social science sources and, while strong in capturing carers' experiences, has limited policy and service-related purchase. Much could be gained for citizens, carers and families, and the generation of knowledge advanced, if the two bodies of research were integrated to a greater degree. © 2014 John Wiley & Sons Ltd.

  9. Online simulation of classical inorganic analysis - interactive, self instructive simulations give more lab-time

    DEFF Research Database (Denmark)

    Josephsen, Jens

    2005-01-01

    Laboratory exercises, investigations, and experiments are invariably included in university chemistry teaching. The learning of empirical facts, chemical procedures and methods in chemistry depends heavily on the experience, which may be obtained from such teaching activities [1]. Experimental work...... (and in university programmes it often isn’t), but rather to give them experience with chemicals and methods, a computer-based laboratory simulation may function as a cheap and fast extension of student lab time. Virtual investigations seem to be a promising kind of tool [6,7,8] for several reasons...

  10. Charitable giving and reflexive individuals: How personal reflexivity mediates between structure and agency.

    Science.gov (United States)

    Sanghera, Balihar

    2017-03-01

    This article examines how individuals are reflexive beings who interpret the world in relation to things that matter to them, and how charitable acts are evaluated and embedded in their lives with different degrees of meaning and importance. Rather than framing the discussion of charitable practices in terms of an altruism/egoism binary or imputing motivations and values to social structures, the article explains how reflexivity is an important and neglected dimension of social practices, and how it interacts with sympathy, sentiments and discourses to shape giving. The study also shows that there are different modes of reflexivity, which have varied effects on charity and volunteering.

  11. Comments on reactions of oxide derivatives of uranium with hexachloropropene to give UCl4

    OpenAIRE

    Patel, D.; Wooles, A J; Hashem, E; Omorodion, H; Baker, R J; Liddle, S.T.

    2015-01-01

    PUBLISHED DOI: 10.1039/c5nj00476d We report that U3O8, UO2(NO3)2·6H2O, and UO2Cl2 react with hexachloropropene (HCP) to give UCl4 in 60, 100, and 92% yields, respectively, and report a protocol to recycle the HCP. This renders the preparation of UCl4 more accessible and sustainable. 2,5-Dichlorohexachlorofulvene has been identified as a significant by-product from these reactions The authors are grateful to the Royal Society, EPSRC, ERC, University of Nottingham, UK National Nucle...

  12. The First Eight Years ~ Giving Kids a Foundation for a Lifetime Success Resource Review

    Directory of Open Access Journals (Sweden)

    Patricia Dawson

    2013-12-01

    Full Text Available The First Eight Years: Giving Kids a Foundation for a Lifetime Success” is a recent KIDS COUNT policy report from the Annie E. Casey Foundation. The report discusses how a child’s early development from birth through age 8 is critical in one’s transition into elementary school as well as long-term academic success. The report also provides broad policy recommendations to help America’s children succeed and data on early childhood development for every state.

  13. Explaining the HERA Anomaly Without Giving Up R-parity Conservation

    OpenAIRE

    Dutta, B.; Mohapatra, R. N.; Nandi, S

    1997-01-01

    We point out that in extended supersymmetric models such as supersymmetric left-right models, it is possible to have leptoquarks that explain the HERA high $Q^2$ anomaly without giving up R-parity conservation. The leptoquarks belong to vectorlike $(2, 2, \\pm{4/3}, 3 or 3^*) $ representations of $SU(2)_L\\times SU(2)_R\\times U(1)_{B-L}\\times SU(3)_c$ (denoted $G_{2213}$). Unlike the R-parity violating scenario, the leptoquarks are accompanied by new superpartners,the leptoquarkino which leads ...

  14. Giving toys to children reduces their anxiety about receiving premedication for surgery.

    Science.gov (United States)

    Golden, Leonard; Pagala, Murali; Sukhavasi, Sujatha; Nagpal, Dheeraj; Ahmad, Ayeesha; Mahanta, Aruna

    2006-04-01

    Children have increased anxiety during the preoperative period. The administration of oral premedication to children is often met with apprehension, reluctance, or refusal. We sought to determine whether giving a small toy to the children would decrease the anxiety associated with taking oral premedication. This was a prospective study involving 100 children 3-6 yr of age randomized into two equal groups. The anxiety of each child was assessed using the Modified Yale Preoperative Anxiety Scale. The results showed significantly less anxiety in children who received a toy before oral administration of midazolam.

  15. The Meaning of Giving Birth: Voices of Hmong Women Living in Vietnam.

    Science.gov (United States)

    Corbett, Cheryl A; Callister, Lynn Clark; Gettys, Jamie Peterson; Hickman, Jacob R

    2017-02-27

    Increasing knowledge about the sociocultural context of birth is essential to promote culturally sensitive nursing care. This qualitative study provides an ethnographic view of the perspectives on birthing of Hmong mothers living in the highlands of Vietnam. Unique cultural beliefs exist in Hmong culture about the spiritual and physical world as well as ritual practices associated with childbearing. This includes variations of ancestor worship, reincarnation, and healing practices by shamans. Traditionally, Hmong families take an active role in childbirth with birth frequently occurring in the home. Situated within a large collaborative anthropology project, a convenience sample of 8 Hmong women, who had recently given birth, were interviewed regarding the perinatal experience. In addition, ethnic traditional birth attendants (midwives) and other village women contributed perspectives providing richly descriptive data. This ethnographic study was conducted during 6 weeks of immersed participant observation with primary data collection carried out through fieldwork. Data were analyzed to derive cultural themes from interviews and observations. Significant themes included (1) valuing motherhood, (2) laboring and giving birth silently, (3) giving birth within the comfort of home and family, (4) feeling capable of birthing well, (5) feeling anxiety to provide for another child, and (6) embracing cultural traditions. Listening to the voices of Hmong women enhances understanding of the meaning of childbirth. Gaining greater understanding of Hmong cultural beliefs and practices can ensure childbearing women receive respectful, safe, and quality care.

  16. A bit of give and take: the relationship between the extracellular matrix and the developing chondrocyte.

    Science.gov (United States)

    Behonick, Danielle J; Werb, Zena

    2003-11-01

    The extracellular matrix (ECM), once thought to be a static structural component of tissues, is now known to play a complex and dynamic role in a variety of cellular functions in a number of diverse tissues. A significant body of literature attests to the ability of the ECM to communicate both spatial and temporal information to adherent cells, thereby directing cell behavior via interactions between the ECM and cell-surface receptors. Moreover, volumes of experimental data show that a great deal of communication travels in the opposite direction, from the cell to the ECM, allowing for regulation of the cues transmitted by the ECM. As such, the ECM, with respect to its components and their organization, is not a fixed reflection of the state the local microenvironment in which a cell finds itself at a particular time, but rather is able to respond to and effect changes in its local microenvironment. As an example of the developmental consequences of ECM interactions, this review gives an overview of the 'give and take' relationship between the ECM and the cells of the developing skeletal elements, in particular, the chondrocyte.

  17. The teacher benefits from giving autonomy support during physical education instruction.

    Science.gov (United States)

    Cheon, Sung Hyeon; Reeve, Johnmarshall; Yu, Tae Ho; Jang, Hue Ryen

    2014-08-01

    Recognizing that students benefit when they receive autonomy-supportive teaching, the current study tested the parallel hypothesis that teachers themselves would benefit from giving autonomy support. Twenty-seven elementary, middle, and high school physical education teachers (20 males, 7 females) were randomly assigned either to participate in an autonomy-supportive intervention program (experimental group) or to teach their physical education course with their existing style (control group) within a three-wave longitudinal research design. Manipulation checks showed that the intervention was successful, as students perceived and raters scored teachers in the experimental group as displaying a more autonomy-supportive and less controlling motivating style. In the main analyses, ANCOVA-based repeated-measures analyses showed large and consistent benefits for teachers in the experimental group, including greater teaching motivation (psychological need satisfaction, autonomous motivation, and intrinsic goals), teaching skill (teaching efficacy), and teaching well-being (vitality, job satisfaction, and lesser emotional and physical exhaustion). These findings show that giving autonomy support benefits teachers in much the same way that receiving it benefits their students.

  18. The dilemma of giving mathematics homework from the perspective of pre-service elementary teachers

    Directory of Open Access Journals (Sweden)

    Von Anthony Gayas Torio

    2016-01-01

    Full Text Available Homework is defined as an additional task that a student does outside of the school. This added activity is in recognition of the necessity to spend additional time for subjects such as Mathematics. The dilemma comes in the form of the advantages and disadvantages that can be derived from homework. Studies have revealed varying effects of homework to students on academic and non-academic areas. Teachers are at the forefront of the decision towards the giving or not of homework. Pre-service teachers at the elementary level represent the future leaders of the educational system and should be acquainted and involved at the onset of the dilemma. The main objective of this study is to determine the perspective of pre-service elementary teachers towards homework. The anatomy of their belief can be a key towards addressing the issue via teacher training. The descriptive method of research was used through case studies. Constant comparative method was used to analyze results. Salient results revealed that the subjects favor the giving homework on the following grounds: it helps add knowledge, confidence and satisfaction. Those who do not favor homework find it as an additional burden and a source of additional stress. Difficulties in complying with homework are usually associated with limited time, bad influence of peers and teacher factor. Students usually spend late nights to comply with homework and are unable to perform at the best of their potentials.

  19. Strengthen Quality Management of Case to Give Full Play to Its Value

    Institute of Scientific and Technical Information of China (English)

    WUQiuju

    2004-01-01

    This article elaborates the viewpoint that how to strengthen quality management of case to give full play to its value, the points that the author urged are in following aspects, including raising quality consciousness of case writing, upgrading the writing quality of case, paying attention to the value of case and ensuring the quality of case. 1. Training doctor's “basic skill”. 2. Training system of doctor, a.In the first month after check - in, arrange two lectures about writing of case to unify the requirement and inform them how to write it. b. Give them the writing standard of anamnesis, which they can refer to when writing. 3. The system that the directors spot - check the anamnesis. The American qaulity administrative power, world- famous Doctor Milan prophesied that “21 century is century of quality”, having entered 21 century, facts also further proved the facticity of this prophesy. The new era in which the quality is supreme, quality directly influences whether the case can fully play its value.

  20. Strengthen Quality Management of Case to Give Full Play to Its Value

    Institute of Scientific and Technical Information of China (English)

    WU Qiuju

    2004-01-01

    This article elaborates the viewpoint that how to strengthen quality management of case to give full play to its value, the points that the author urged are in following aspects, including raising quality consciousness of case writing, upgrading the writing quality of case, paying attention to the value of case and ensuring the quality of case. 1. Training doctor' s "basic skill". 2. Training systen of doctor. a.In the first month after check-in, arrange two lectures about writing of case to unify the requirement and inform them how to write it. b. Give them the writing standard of anamnesis, which they can refer to when writing. 3. The system that the directors spot- check the anamnesis. The American qaulity administrative power,world-famous Doctor Milan prophesied that "21 century is century of quality" ,having entered 21century, facts also further proved the facticity of this prophesy. The new era in which the quality is supreme, quality directly influences whether the case can fully play its value.

  1. Disparities in pre-eclampsia and eclampsia among immigrant women giving birth in six industrialised countries

    DEFF Research Database (Denmark)

    Urquia, Ml; Glazier, Rh; Gagnon, Aj

    2014-01-01

    Australia, Canada, Spain and the USA and national data from Denmark and Sweden. POPULATION: All immigrant and non-immigrant women delivering in the six industrialised countries within the most recent 10-year period available to each participating centre (1995-2010). METHODS: Data was collected using...

  2. The Experience of Care-Giving for a Person with Parkinson's Disease

    Science.gov (United States)

    Bogard, Connie Lynn

    2010-01-01

    As the population continues to become more aged and at risk for chronic illness, there will be a growing need for caregivers. Caregivers to persons with Parkinson's disease (PD) face the challenge of providing care over many years due to the chronic progressive nature of this neurological disorder. The purpose of this study was to understand and…

  3. Giving Literacy Away. Alternative Strategies for Increasing Adult Literacy Development, Training Capacity and Program Participation.

    Science.gov (United States)

    Reder, Stephen M.

    The phenomenon of adult functional illiteracy in the United States is examined, and strategies are considered for addressing the problem. Reasons for the failure of existing programs (schools, adult education, and volunteer tutoring) to close the literacy gap are explored; among these factors are the relative growth of underserved populations,…

  4. Caregiver criticism, help-giving, and the burden of schizophrenia among Mexican American families.

    Science.gov (United States)

    Villalobos, Bianca T; Ullman, Jodie; Krick, Tracy Wang; Alcántara, Darcy; Kopelowicz, Alex; López, Steven R

    2017-09-01

    This study tested an attribution model of help-giving in family caregivers of persons with schizophrenia as it relates to caregivers' reported burden. We hypothesized (a) that caregivers' attributions of their ill relatives' responsibility for their symptoms would be associated with more negative and less positive affective reactions, (b) that affective reactions would be related to perceptions of administered support, and (c) that support would in turn predict greater burden. We examined 60 family caregivers of Mexican origin living in Southern California. Mexican Americans were chosen because of their high degree of contact with their ill relative, thereby facilitating the examination of help-giving and burden. Contrary to past studies, caregivers' attributions and affective stance were assessed independently, the former based on self-report and the latter based on codes drawn from the Camberwell Family Interview. Caregiver burden was assessed at baseline and one year later. Path analyses showed partial support for the attribution model of help-giving. Specifically, attributions of responsibility negatively predicted caregiver's warmth, which in turn predicted more administered support. Contrary to hypotheses, attributions were not associated with caregiver criticism, and criticism was positively related to administered support. In addition, caregiver support was not related to burden at either baseline or a year later. Criticism was a significant predictor of burden at follow-up through burden at baseline. The emotional stance of caregivers predicts burden independent of the help they provide. Caregiver criticism not only predicts negative patient outcomes but can predict negative caregiver outcomes as well. Positive clinical implications In family treatment, it is important to address caregiver criticism not only because of its relationship to poor clinical outcomes of ill relatives but also because of its relationship to greater caregiver burden. Integrating a

  5. Do women give the same information on binge drinking during pregnancy when asked repeatedly?

    DEFF Research Database (Denmark)

    Strandberg-Larsen, K; Andersen, Anne-Marie Nybo; Olsen, Jørn;

    2006-01-01

    OBJECTIVE: To study if pregnant women give the same answers to questions on frequency and timing of binge drinking when asked more than once during and after pregnancy. DESIGN: Cohort study.Setting:The Danish National Birth Cohort. SUBJECTS: The study is based on 76 307 pregnant women with repeated...... information on binge drinking during the early part of pregnancy and 8933 pregnant women with information on binge drinking during pregnancy weeks 30-36, obtained while pregnant and 6 months after delivery. RESULTS: More women reported binge drinking, if the interview took place close to the period...... in question. As the report of binge drinking was highest in the first of two interviews referring to the same period, as well as women who participated in the first interview in pregnancy week 12 or earlier reported more binge drinking compared to women who participated in the interview later in pregnancy...

  6. Information about a layperson's knowledge supports experts in giving effective and efficient online advice to laypersons.

    Science.gov (United States)

    Nückles, Matthias; Wittwer, Jörg; Renkl, Alexander

    2005-12-01

    To give effective and efficient advice to laypersons, experts should adapt their explanations to the layperson's knowledge. However, experts often fail to consider the limited domain knowledge of laypersons. To support adaptation in asynchronous helpdesk communication, researchers provided computer experts with information about a layperson's knowledge. A dialogue experiment (N = 80 dyads of experts and laypersons) was conducted that varied the displayed information. Rather than sensitizing the experts to generally improve the intelligibility of their explanations, the individuating information about the layperson enabled them to make specific partner adjustments that increased the effectiveness and efficiency of the communication. The results are suggestive of ways in which the provision of instructional explanations could be enhanced in Internet-based communication.

  7. Understanding Care Giving and Care Receiving Experiences throughout the Life Course

    DEFF Research Database (Denmark)

    Morita, Makiko

    the social network of their everyday lives. These interactions are long-term changing processes as both the systems and wide-ranging conditions in everyday life are neither static nor immutable. In particular, the present paper draws attention to how older people understand the ways that the welfare systems...... and expectations for the future. Guided by life course approach, the analysis focuses on older couples in Denmark and Japan, and explores the following questions; how have older Danish and Japanese couples experienced care giving and care taking over the life course? How do they perceive these experiences? How...... have older Danish and Japanese couples experienced mutual support and communication with children, grandchildren, parents, neighbours and friends? How do their understandings exert influence on the forming of expectations and views for the future? The empirical core of the analysis is the qualitative...

  8. Exposure to childhood traumas ups the odds of giving birth to daughters.

    Science.gov (United States)

    Kaitz, Marsha; Rokem, Ann Marie; Mankuta, David; Davidov, Maayan; Faraone, Stephen V

    2014-04-01

    This study examined the likelihood of giving birth to a daughter as a function of women's exposure to four categories of stressors: childhood trauma, adult trauma, chronic stressors, and recent (adverse) life events. Hypothesis 1 stated that exposure to recent life events (near conception) and to childhood traumas would increase women's chances of having a girl baby. Hypothesis 2 stated that the relationship between stress and gender outcome is mediated by persistent posttraumatic stress disorder (PTSD) symptoms. The final sample was comprised of 225 women. The design was prospective observational. At first contact, women were retained if they were 3.0 for women who had been exposed to more than two such events. PTSD symptoms (partially) mediated the relationship between childhood trauma and infant gender. Findings suggest that women's exposure to childhood trauma contributes to the determination of the sex ratio at birth and that PTSD symptoms are part of the cause.

  9. Medical faculty and curriculum design - 'No, no, it's like this: You give your lectures...'

    DEFF Research Database (Denmark)

    Mørcke, Anne Mette; Eika, Berit

    2009-01-01

    Background and aims: The purpose of this study was to understand more completely the (tacit) curriculum design models of medical faculty. We report on two research questions: (1) Can medical faculty give an account of their curriculum design assumptions? and (2) What are their assumptions concern......, to a belief that learning outcomes are incompatible with higher education. Finally, we found that teachers do not necessarily play a clear, central role in curriculum design....... concerning curriculum design? Method: We conducted an explorative, qualitative case study. We interviewed educational decision makers at the three Danish medical schools and associate professors from different courses concerning curriculum design. We carried out four individual, in-depth interviews and four...... focus groups with 20 participants in all. Results and conclusions: Only one decision maker had an explicit curriculum design model. However, all participants had assumptions concerning curriculum design. We displayed their assumptions as five essentially different and increasingly complex models...

  10. Twenty Hirsch index variants and other indicators giving more or less preference to highly cited papers

    CERN Document Server

    Schreiber, Michael

    2010-01-01

    The Hirsch index or h-index is widely used to quantify the impact of an individual's scientific research output, determining the highest number h of a scientist's papers that received at least h citations. Several variants of the index have been proposed in order to give more or less preference to highly cited papers. I analyse the citation records of 26 physicists discussing various suggestions, in particular A, e, f, g, h(2), h_w, h_T, \\hbar, m, {\\pi}, R, s, t, w, and maxprod. The total number of all and of all cited publications as well as the highest and the average number of citations are also compared. Advantages and disadvantages of these indices and indicators are discussed. Correlation coefficients are determined quantifying which indices and indicators yield similar and which yield more deviating rankings of the 26 datasets. For 6 datasets the determination of the indices and indicators is visualized.

  11. Austere kindness or mindless austerity: the efects of gift-giving to beggars in east London

    Directory of Open Access Journals (Sweden)

    Johannes Lenhard

    2014-04-01

    Full Text Available The current austerity policies in the United Kingdom are creating a precarious situation for many people on the margins of society. Employing micro-level ethnographic analysis, this article addresses how government decisions affect people living on the street. Observations of how local policies demonize gift-giving to street people led me to revisit arguments about the positive and negative effects of gifts. Four months of fieldwork amongst people who beg in the City of London confirmed the Maussian ambiguity of gift exchange. The material benefit of monetary gifts is often accompanied by shared time and conversation; gifts to beggars can go beyond materiality and are hence able to create bonds of sociability.

  12. Giving freedom and physical meaning to the effective parameters of metamaterials for all frequencies

    CERN Document Server

    Dirdal, Christopher A; Skaar, Johannes

    2014-01-01

    Metamaterial effective parameters may exhibit freedom from dispersion constraints owing to their loss of physical meaning outside a subset of frequencies and wave numbers $(\\omega, k)$. For instance, effective parameters $\\epsilon_\\text{eff}$ and $\\mu_\\text{eff}$ can have a negative imaginary part for passive metamaterial systems, or may not tend to unity when analytically continued to high frequencies. We characterize this freedom through generalized Kramers-Kronig relations, and allocate alternative meaning to the effective parameters that remains valid for all $(\\omega, k)$. There exists several alternative definitions for $\\mu_\\text{eff}$ or $\\epsilon_\\text{eff}$, thereby giving different frequency variations for high frequencies, while nevertheless converging to the same dispersion for long wavelengths.

  13. Protein and peptide alkoxyl radicals can give rise to C-terminal decarboxylation and backbone cleavage

    DEFF Research Database (Denmark)

    Davies, Michael Jonathan

    1996-01-01

    when the free amino acid does not, and that hydroperoxides can be formed on both the backbone (at alpha-carbon positions) and the side chain. Decomposition of alpha-carbon hydroperoxides by Fe(II)-EDTA gives initially an alkoxyl radical via a pseudo-Fenton reaction; these radicals fragment rapidly...... with k estimated as > or = 10(7) s(-1). With N-acetyl amino acids and dipeptides beta-scission of an alkoxyl radical at the C-terminal alpha-carbon results in C-terminal decarboxylation, with release of CO2.-; the corresponding amides undergo deamidation with release of .C(O)NH2. Cyclic dipeptides...... undergo analogous reactions with cleavage of the alpha-carbon to carbonyl-carbon bond and formation of .C(O)NHR radicals. With substrates with large aliphatic side chains, radicals from side-chain hydroperoxides are also observed. C-terminal decarboxylation and backbone fragmentation are also observed...

  14. Responsibility-Sharing in the Giving and Receiving of Assessment Feedback.

    Science.gov (United States)

    Nash, Robert A; Winstone, Naomi E

    2017-01-01

    Many argue that effective learning requires students to take a substantial share of responsibility for their academic development, complementing the responsibilities taken by their educators. Yet this notion of responsibility-sharing receives minimal discussion in the context of assessment feedback, where responsibility for enhancing learning is often framed as lying principally with educators. Developing discussion on this issue is critical: many barriers can prevent students from engaging meaningfully with feedback, but neither educators nor students are fully empowered to remove these barriers without collaboration. In this discussion paper we argue that a culture of responsibility-sharing in the giving and receiving of feedback is essential, both for ensuring that feedback genuinely benefits students by virtue of their skilled and proactive engagement, and also for ensuring the sustainability of educators' effective feedback practices. We propose some assumptions that should underpin such a culture, and we consider the practicalities of engendering this cultural shift within modern higher education.

  15. Responsibility-Sharing in the Giving and Receiving of Assessment Feedback

    Directory of Open Access Journals (Sweden)

    Robert A. Nash

    2017-09-01

    Full Text Available Many argue that effective learning requires students to take a substantial share of responsibility for their academic development, complementing the responsibilities taken by their educators. Yet this notion of responsibility-sharing receives minimal discussion in the context of assessment feedback, where responsibility for enhancing learning is often framed as lying principally with educators. Developing discussion on this issue is critical: many barriers can prevent students from engaging meaningfully with feedback, but neither educators nor students are fully empowered to remove these barriers without collaboration. In this discussion paper we argue that a culture of responsibility-sharing in the giving and receiving of feedback is essential, both for ensuring that feedback genuinely benefits students by virtue of their skilled and proactive engagement, and also for ensuring the sustainability of educators' effective feedback practices. We propose some assumptions that should underpin such a culture, and we consider the practicalities of engendering this cultural shift within modern higher education.

  16. Metallic Nickel Hydroxide Nanosheets Give Superior Electrocatalytic Oxidation of Urea for Fuel Cells.

    Science.gov (United States)

    Zhu, Xiaojiao; Dou, Xinyu; Dai, Jun; An, Xingda; Guo, Yuqiao; Zhang, Lidong; Tao, Shi; Zhao, Jiyin; Chu, Wangsheng; Zeng, Xiao Cheng; Wu, Changzheng; Xie, Yi

    2016-09-26

    The direct urea fuel cell (DUFC) is an important but challenging renewable energy production technology, it offers great promise for energy-sustainable developments and mitigating water contamination. However, DUFCs still suffer from the sluggish kinetics of the urea oxidation reaction (UOR) owing to a 6 e(-) transfer process, which poses a severe hindrance to their practical use. Herein, taking β-Ni(OH)2 nanosheets as the proof-of-concept study, we demonstrated a surface-chemistry strategy to achieve metallic Ni(OH)2 nanosheets by engineering their electronic structure, representing a first metallic configuration of transition-metal hydroxides. Surface sulfur incorporation successfully brings synergetic effects of more exposed active sites, good wetting behavior, and effective electron transport, giving rise to greatly enhanced performance for UOR. Metallic nanosheets exhibited a much higher current density, smaller onset potential and stronger durability.

  17. Two-Dimensional Phase Transition of Viral Capsid Gives Insights into Subunit Interactions

    Science.gov (United States)

    Tresset, Guillaume; Chen, Jingzhi; Chevreuil, Maelenn; Nhiri, Naïma; Jacquet, Eric; Lansac, Yves

    2017-01-01

    We show that the thermal dissociation of icosahedral viral capsids can be interpreted in terms of a two-dimensional phase transition. The approach provides a useful framework to get direct insights into the interactions at work between viral components. We devise a mean-field lattice model that relates the melting temperature to subunit attractive energy, effective charge, and chemical potential. Through fluorescence thermal shift assay on a plant viral system, we illustrate how the model gives access to the interaction parameters for empty and loaded viral capsids in various ionic conditions. This work should help construct physical models accounting for the assembly and disassembly mechanisms of viruses, with possible fallout in the development of therapeutic inhibitors.

  18. How Research on Charitable Giving Can Inform Strategies to Promote Human Milk Donations to Milk Banks.

    Science.gov (United States)

    Stevens, Jack; Keim, Sarah A

    2015-08-01

    Many hospitalized preterm infants do not exclusively receive mother's own milk, so milk from another mother may be sought. Previous research indicated that just 1% of US women who express breast milk actually donate it for another family. Therefore, strategies to boost donation rates should be identified. We draw upon the experimental literature on charitable giving of monetary donations to offer 6 strategies to promote breast milk donations to milk banks in North America. These strategies include (1) highlighting a potential identifiable recipient of donated breast milk as opposed to highlighting groups of potential recipients; (2) emphasizing similarities between the potential donor and potential beneficiaries; (3) emphasizing similarities between the potential donor and previous donors; (4) using negative arousal to promote donations; (5) emphasizing the self-interest of those asking for breast milk donations; and (6) highlighting the specific effect of breast milk donations. Potential limitations of these strategies are discussed.

  19. Cis-Antisense Transcription Gives Rise to Tunable Genetic Switch Behavior: A Mathematical Modeling Approach.

    Science.gov (United States)

    Bordoy, Antoni E; Chatterjee, Anushree

    2015-01-01

    Antisense transcription has been extensively recognized as a regulatory mechanism for gene expression across all kingdoms of life. Despite the broad importance and extensive experimental determination of cis-antisense transcription, relatively little is known about its role in controlling cellular switching responses. Growing evidence suggests the presence of non-coding cis-antisense RNAs that regulate gene expression via antisense interaction. Recent studies also indicate the role of transcriptional interference in regulating expression of neighboring genes due to traffic of RNA polymerases from adjacent promoter regions. Previous models investigate these mechanisms independently, however, little is understood about how cells utilize coupling of these mechanisms in advantageous ways that could also be used to design novel synthetic genetic devices. Here, we present a mathematical modeling framework for antisense transcription that combines the effects of both transcriptional interference and cis-antisense regulation. We demonstrate the tunability of transcriptional interference through various parameters, and that coupling of transcriptional interference with cis-antisense RNA interaction gives rise to hypersensitive switches in expression of both antisense genes. When implementing additional positive and negative feed-back loops from proteins encoded by these genes, the system response acquires a bistable behavior. Our model shows that combining these multiple-levels of regulation allows fine-tuning of system parameters to give rise to a highly tunable output, ranging from a simple-first order response to biologically complex higher-order response such as tunable bistable switch. We identify important parameters affecting the cellular switch response in order to provide the design principles for tunable gene expression using antisense transcription. This presents an important insight into functional role of antisense transcription and its importance towards

  20. Population and health.

    Science.gov (United States)

    Kwon, E H

    1975-01-01

    Quality of population is as important as quantity when one is discussing public health needs or quality of the labor force. Population quality as measured by physical disease, mental disease, maternal death and morbidity rates, fetal and infant mortality rates, and family size and child health is discussed. Charts give figures for Korea from a variety of sample surveys and census studies for 1973. All developing countries have high child death rates from communicable diseases. Korea, in addition, suffers from several parasitic diseases. The problems of maternal death and morbidity are due to disease, hard physical labor during pregnancy, poorly attended births (26% were attended by a mother or mother-in-law and 11% by friends and relatives), and high parity. Figures show that the danger of childbirth is greatest for the 1st baby, lower for the 2nd and 3rd, then rises, climbing steeply after the 5th birth. Iron deficiency anemia and oxalic acid deficiency together with general malnutrition contribute to high maternal morbidity and mortality and fetal death or improper brain development. It is also well accepted that children from large families have slower physical and mental growth than children in smaller families. Family planning problems can best be solved by integrating birth spacing and birth limitation programs into a total maternal and child health scheme and emphasizing the health aspects of family planning. Maternity-centered family planning is but 1 example of such an integrated approach. This integration will make better use of personnel, result in better program supervision, and will help the mother understand it is in her best interest to practice family planning.